Prolonged Neuromuscular Blockade Following Succinylcholine Administration to a Patient with a Reduced Butyrylcholinesterase Activity

This case is about a 48-year-old woman known with a reduced butyrylcholinesterase activity, who developed prolonged neuromuscular blockade following the unintentional administration of succinylcholine. We took the opportunity to monitor the development of neuromuscular function during this period and blood samples were taken for molecular genetic analysis and for quantitative and qualitative analysis since not all causative mutations are functionally characterized. Reduced butyrylcholinesterase activity is discussed in many aspects. Clinical considerations are suggested concerning genetic counselling

Laparoscopic Splenectomy for Hairy Cell Leukemia in Pregnancy

Objective. We present a successful case of laparoscopic splenectomy for a massively enlarged spleen at 25 weeks of gestation for hairy cell leukemia in pregnancy in a woman with initial hemoglobin of 4.3 gm/dl and platelet count of 18,000/mm3. Study Design. Case report. Results. This report provides an approach to management that may be applicable in those cases where thrombocytopenia or other clinical imperatives preclude delaying treatment till after pregnancy. Conclusion. Hairy cell leukemia is a clonal B-Cell malignancy, for which there is very limited experience worldwide for its management when it occurs during pregnancy. Laparoscopic splenectomy should be considered as a therapeutic option, even with a significantly enlarged spleen, in order to avoid the risks of fetal exposure to chemotherapeutic agents. Unique considerations relating to pregnancy are highlighted

A perspective from extinct radionuclides on a Young Stellar Object: The Sun and its accretion disk

Meteorites, which are remnants of solar system formation, provide a direct glimpse into the dynamics and evolution of a young stellar object (YSO), namely our Sun. Much of our knowledge about the astrophysical context of the birth of the Sun, the chronology of planetary growth from micrometer-sized dust to terrestrial planets, and the activity of the young Sun comes from the study of extinct radionuclides such as 26Al (t1/2 = 0.717 Myr). Here we review how the signatures of extinct radionuclides (short-lived isotopes that were present when the solar system formed and that have now decayed below detection level) in planetary materials influence the current paradigm of solar system formation. Particular attention is given to tying meteorite measurements to remote astronomical observations of YSOs and modeling efforts. Some extinct radionuclides were inherited from the long-term chemical evolution of the Galaxy, others were injected into the solar system by a nearby supernova, and some were produced by particle irradiation from the T-Tauri Sun. The chronology inferred from extinct radionuclides reveals that dust agglomeration to form centimeter-sized particles in the inner part of the disk was very rapid (<50 kyr), planetesimal formation started early and spanned several million years, planetary embryos (possibly like Mars) were formed in a few million years, and terrestrial planets (like Earth) completed their growths several tens of million years after the birth of the Sun.Comment: 49 pages, 9 figures, 1 table. Uncorrected preprin

Understanding extreme sea levels for broad-scale coastal impact and adaptation analysis

One of the main consequences of mean sea level rise (SLR) on human settlements is an increase in flood risk due to an increase in the intensity and frequency of extreme sea levels (ESL). While substantial research efforts are directed towards quantifying projections and uncertainties of future global and regional SLR, corresponding uncertainties in contemporary ESL have not been assessed and projections are limited. Here we quantify, for the first time at global scale, the uncertainties in present-day ESL estimates, which have by default been ignored in broad-scale sea-level rise impact assessments to date. ESL uncertainties exceed those from global SLR projections and, assuming that we meet the Paris agreement goals, the projected SLR itself by the end of the century in many regions. Both uncertainties in SLR projections and ESL estimates need to be understood and combined to fully assess potential impacts and adaptation needs