Lamotrigine Overdose Presenting as Shock and Pulmonary Edema

Abstract: Lamotrigine is a broad-spectrum anti-epileptic drug with a good safety profile used to treat general and focal epilepsy. Toxicity is uncommon and usually mild, and symptoms usually include rash, headache, nausea, abdominal pain, somnolence, dizziness, and aggravated seizure activity. More severe adverse reactions are rare, but have been reported and include encephalopathy, hypotension, wide complex tachycardia, cardiac arrest, and death. Lamotrigine drug levels do not consistently correlate with either therapeutic effect or toxicity, though higher levels are thought to have a higher risk of toxicity. Also, the level is typically a send out test with a 1 to 3 day turnaround time. This case report details a case of Lamotrigine toxicity in a thirteen-year-old Hispanic female with moderately well-controlled focal epilepsy presenting with acute florid pulmonary edema and fluid refractory vasodilatory shock. These symptoms have not been reported together elsewhere in the pediatric literature. By expanding upon the known presentation of Lamotrigine toxicity in children, the time to diagnosis for future cases may be shortened, providers may avoid anchoring bias, and morbidity may decrease

Poly(alkyl methacrylate) tooth coatings for dental care: evaluation of the demineralisation-protection benefit using a time-resolved in vitro method

An in vitro method for the time-resolved quantification of acid-mediated tooth demineralisation has been developed and evaluated against putative non-permanent protective formulations based on a series of poly(alkyl methacrylate)s. Using a thermostatted carousel, dentally relevant substrates consisting of hydroxyapatite discs or sections of bovine teeth have been exposed to aqueous citric acid under controlled conditions, before and after being treated with the polymeric coatings. The dissolution of phosphate was monitored by the determination of 31P by Inductively Coupled Plasma—Mass Spectrometry and by the spectrophotometric phosphovanadomolybdate method. Dose-response plots constructed for both groups of treated substrates have revealed that the coatings significantly reduce erosion rates but are less effective at inhibiting tooth demineralisation than the standard fluoride treatment. The approach has enabled an evaluation of the erosion-protection efficiency of each coating

CMB polarimetry with BICEP: instrument characterization, calibration, and performance

BICEP is a ground-based millimeter-wave bolometric array designed to target the primordial gravity wave signature on the polarization of the cosmic microwave background (CMB) at degree angular scales. Currently in its third year of operation at the South Pole, BICEP is measuring the CMB polarization with unprecedented sensitivity at 100 and 150 GHz in the cleanest available 2% of the sky, as well as deriving independent constraints on the diffuse polarized foregrounds with select observations on and off the Galactic plane. Instrument calibrations are discussed in the context of rigorous control of systematic errors, and the performance during the first two years of the experiment is reviewed.Comment: 12 pages, 15 figures, updated version of a paper accepted for Millimeter and Submillimeter Detectors and Instrumentation for Astronomy IV, Proceedings of SPIE, 7020, 200

Absolute polarization angle calibration using polarized diffuse Galactic emission observed by BICEP

We present a method of cross-calibrating the polarization angle of a polarimeter using BICEP Galactic observations. \bicep\ was a ground based experiment using an array of 49 pairs of polarization sensitive bolometers observing from the geographic South Pole at 100 and 150 GHz. The BICEP polarimeter is calibrated to +/-0.01 in cross-polarization and less than +/-0.7 degrees in absolute polarization orientation. BICEP observed the temperature and polarization of the Galactic plane (R.A= 100 degrees ~ 270 degrees and Dec. = -67 degrees ~ -48 degrees). We show that the statistical error in the 100 GHz BICEP Galaxy map can constrain the polarization angle offset of WMAP Wband to 0.6 degrees +\- 1.4 degrees. The expected 1 sigma errors on the polarization angle cross-calibration for Planck or EPIC are 1.3 degrees and 0.3 degrees at 100 and 150 GHz, respectively. We also discuss the expected improvement of the BICEP Galactic field observations with forthcoming BICEP2 and Keck observations.Comment: 13 pages, 10 figures and 2 tables. To appear in Proceedings of SPIE Astronomical Telescopes and Instrumentation 201

Tuning π-Acceptor/σ-Donor Ratio of the 2-Isocyanoazulene Ligand: Non-Fluorinated Rival of Pentafluorophenyl Isocyanide and Trifluorovinyl Isocyanide Discovered

Isocyanoazulenes (CNAz) constitute a relatively new class of isocyanoarenes that offers rich structural and electronic diversification of the organic isocyanide ligand platform. This article considers a series of 2-isocyano-1,3-X2-azulene ligands (X = H, Me, CO2Et, Br, and CN) and the corresponding zero-valent complexes thereof, [(OC)5Cr(2-isocyano-1,3-X2-azulene)]. Air- and thermally stable, X-ray structurally characterized 2-isocyano-1,3-dimethylazulene may be viewed as a non-benzenoid aromatic congener of 2,6-dimethyphenyl isocyanide (2,6-xylyl isocyanide), a longtime “workhorse” aryl isocyanide ligand in coordination chemistry. Single crystal X-ray crystallographic {Cr–CNAz bond distances}, cyclic voltametric {E1/2(Cr0/1+)}, 13C NMR {δ(13CN), δ(13CO)}, UV-vis {dπ(Cr) → pπ*(CNAz) Metal-to-Ligand Charge Transfer}, and FTIR {νN≡C, νC≡O, kC≡O} analyses of the [(OC)5Cr(2-isocyano-1,3-X2-azulene)] complexes provided a multifaceted, quantitative assessment of the π-acceptor/σ-donor characteristics of the above five 2-isocyanoazulenes. In particular, the following inverse linear relationships were documented: δ(13COtrans) vs. δ(13CN), δ(13COcis) vs. δ(13CN), and δ(13COtrans) vs. kC≡O,trans force constant. Remarkably, the net electron withdrawing capability of the 2-isocyano-1,3-dicyanoazulene ligand rivals those of perfluorinated isocyanides CNC6F5 and CNC2F3

Collinear and Soft Limits of Multi-Loop Integrands in N=4 Yang-Mills

It has been argued in arXiv:1112.6432 that the planar four-point integrand in N=4 super Yang-Mills theory is uniquely determined by dual conformal invariance together with the absence of a double pole in the integrand of the logarithm in the limit as a loop integration variable becomes collinear with an external momentum. In this paper we reformulate this condition in a simple way in terms of the amplitude itself, rather than its logarithm, and verify that it holds for two- and three-loop MHV integrands for n>4. We investigate the extent to which this collinear constraint and a constraint on the soft behavior of integrands can be used to determine integrands. We find an interesting complementarity whereby the soft constraint becomes stronger while the collinear constraint becomes weaker at larger n. For certain reasonable choices of basis at two and three loops the two constraints in unison appear strong enough to determine MHV integrands uniquely for all n.Comment: 27 pages, 14 figures; v2: very minor change

An Absolute Flux Density Measurement of the Supernova Remnant Casseopia A at 32 GHz

We report 32 GHz absolute flux density measurements of the supernova remnant Cas A, with an accuracy of 2.5%. The measurements were made with the 1.5-meter telescope at the Owens Valley Radio Observatory. The antenna gain had been measured by NIST in May 1990 to be $0.505 \pm 0.007 \frac{{\rm mK}}{{\rm Jy}}$. Our observations of Cas A in May 1998 yield $S_{cas,1998} = 194 \pm 5 {\rm Jy}$. We also report absolute flux density measurements of 3C48, 3C147, 3C286, Jupiter, Saturn and Mars.Comment: 30 pages, 4 figures; accepted for publication by AJ. Revised systematic error budget, corrected typos, and added reference