Water intoxication presenting as maternal and neonatal seizures: a case report.

Introduction We present an unusual case of fitting in the mother and newborn child, and the challenges faced in the management of their hyponatraemia due to water intoxication. Case presentation A previously well 37-year-old, primigravid Caucasian woman presented with features mimicking eclampsia during labour. These included confusion, reduced consciousness and seizures but without a significant history of hypertension, proteinuria or other features of pre-eclampsia. Her serum sodium was noted to be low at 111 mmol/litre as was that of her newborn baby. She needed anti-convulsants with subsequent intubation to stop the fitting and was commenced on a hypertonic saline infusion with frequent monitoring of serum sodium. There is a risk of long-term neurological damage from central pontine myelinolysis if the hyponatraemia is corrected too rapidly. Mother and baby went on to make a full recovery without any long-term neurological complications. Conclusion There is little consensus on the treatment of life-threatening hyponatraemia. Previous articles have outlined several possible management strategies as well as their risks. After literature review, an increase in serum sodium concentration of no more than 8–10 mmol/litre in 24 hours is felt to be safe but can be exceeded with extreme caution if life-threatening symptoms do not resolve. Formulae exist to calculate the amount of sodium needed and how much hypertonic intravenous fluid will be required to allow safer correction. We hypothesise the possible causes of hyponatraemia in this patient and underline its similarity in symptom presentation to eclampsia

The String Deviation Equation

The relative motion of many particles can be described by the geodesic deviation equation. This can be derived from the second covariant variation of the point particle's action. It is shown that the second covariant variation of the string action leads to a string deviation equation.Comment: 18 pages, some small changes, no tables or diagrams, LaTex2

Chemical and Toxicological Characterization of the Upper York River, Virginia The Mattaponi and Pamunkey Rivers

This study describes the most extensive effort to characterize the chemistry, toxicology and community of the sediments of the Mattaponi and Pamunkey Rivers. This was accomplished using a study design modified to expand the number of stations occupied by reducing the cost of analyses by compositing replicate samples collected from each study site rather than performing toxicity tests on these samples individually. In previous studies, the variability in field replicate samples was equivalent to the variability in laboratory replicates. This design has long been used to analyze samples for various chemical contaminants as a cost savings endeavor. More ...

Preliminary evaluation of water quality in tidal creeks of Virginia\u27s Eastern Shore in relation to vegetable cultivation

In response to concerns raised about the impacts of vegetable cultivation using plastic ground covers on water quality, we have initiated a broad-scale, systematic study of water quality in seaside tidal creeks of Virginia\u27 s Eastern Shore. Our objective was to determine if acute toxicity associated with heavy metals or pesticides was more prevalent in tidal creeks with drainage areas which include this agricultural practice than in those which do not. Though such correlations do not confirm cause and effect, they may serve as the basis for future, more targeted investigations and for some immediate changes in land management practices which, regardless of the specific cause, are likely to produce some remediation. Eleven study sites, located in six different watersheds, were selected to evaluate acute toxicity (from heavy metals and organic pesticides. Land use patterns and acreage within each watershed was determined from aerial photographs. The amount of vegetable plasti-culture in the watersheds of the study sites ranged from 0-13% of total acreage. An assay for heavy metals, based upon enzyme inhibition in a bacterial strain, was used to determine if up to seven metals (including copper) were present at acutely toxic levels. Both water samples and aqueous extracts of sediment samples were tested. A continuous series of 96 hr in situ bioassays using the grass shrimp, Palaemonetes pugio, were conducted from Aug. I, 1996 - Sept. 22, 1996 at each station to assay for toxicity from organic pesticides. Grass shrimp are known to be quite sensitive to insecticides and the in situ bioassay approach provides a continuous means of monitoring for toxic events

Depolarization Redistributes Synaptic Membrane and Creates a Gradient of Vesicles on the Synaptic Body at a Ribbon Synapse

AbstractWe used electron tomography of frog saccular hair cells to reconstruct presynaptic ultrastructure at synapses specialized for sustained transmitter release. Synaptic vesicles at inhibited synapses were abundant in the cytoplasm and covered the synaptic body at high density. Continuous maximal stimulation depleted 73% of the vesicles within 800 nm of the synapse, with a concomitant increase in surface area of intracellular cisterns and plasmalemmal infoldings. Docked vesicles were depleted 60%–80% regardless of their distance from the active zone. Vesicles on the synaptic body were depleted primarily in the hemisphere facing the plasmalemma, creating a gradient of vesicles on its surface. We conclude that formation of new synaptic vesicles from cisterns is rate limiting in the vesicle cycle

Chemical and toxicological characterization of the lower Mobjack Bay, York River, Virginia segment of the Chesapeake Bay

The Chesapeake Bay segment called Lower Mobjack Bay Lower York River Virginia was found to have insufficient data to characterize in 1999. Therefore this area was selected for a chemical, toxicological, benthic community characterization study of the sediments in 2002. The segment was divided into 3 strata: the lower York River, the Poquoson River, and Back River, each with 4 randomly selected stations. Samples were collected in October 2002 for evaluation of conditions. There were few significant chemical exceedances of the ER-L or ER-M in the three strata and no toxicologically effects from exposure to sediment samples from any stratum. In contrast, the Poquoson and Back River strata showed consistent community degradation ranging from degraded to seriously degraded. The lack of chemical and toxicological impacts and the intensive residential land use makes it reasonable to conclude that the likely explanation for the degraded benthic community is eutrophication. There is not, however, confirmatory data for this interpretation

Determination of Load Equivalency for Unpaved Roads

The load equivalency method is widely used to consider the effect of traffic loading on pavement design, and the equivalent axle load factor (EALF) for paved roads has been studied often. For unpaved roads, however, EALF is not well understood because it is not necessarily the same as it is for paved roads. In this study, cyclic plate load tests were conducted on unpaved road sections (six base-over-subgrade sections and four subgrade-only sections) constructed in a geotechnical box (2 m × 2.2 m × 2 m) to investigate the load equivalency for unpaved roads. The base-over-subgrade sections were constructed as unstabilized, T1 geogrid–stabilized, and T2 geogrid–stabilized base courses of 15% California bearing ratio (CBR) with thicknesses of 0.23 m and 0.30 m over weak subgrade of 2% CBR. The subgrade-only sections were constructed with CBR values of 6.2%, 7.4%, 9.5%, and 11.0%. The intensities of the cyclic loads were increased from 5 kN to 65 kN, at increments of 5 kN. For each load intensity, 100 cycles were applied on one test section. The EALFs were analyzed in terms of permanent deformation. The results showed that the regression powers of the ratios of axle loads for unpaved roads with aggregate bases over weak subgrade ranged from 1.9 to 2.9, which were lower than a power of 4, the typical value used for paved roads. The powers for subgrade-only sections had an even wider range, from 1.1 to 3.4. The increase of base thickness, the presence of geogrid, and the use of a higher-grade geogrid increased the power

Field Validation of Multi-Species Laboratory Test Systems for Estuarine Benthic Communities

The aim of this project was to evaluate the validity of using multi-species laboratory systems to assess the response of eatuarine benthic communities to an introduced stress. Over a 5- year period experiments in Apalachicola Bay, Florida, and the York River, Virginia, sought to (1) develop criteria for microcosm tests for evaluating the capacity of microcosms to model natural communities in the presence and absence of a pollution-induced stress, and (2) assess the validity of extrapolating test results from one location to another. Procedures for constructing, maintaining and sampling microcosms were tested and refined over the study period. A large number of laboratory and field tests were conducted synoptically over this period, including experiments in which microcosms and field sites were dosed with toxicants (mixed hydrocarbons in some and pentachlorophenol in others). We have investigated various methodologies for analysing and interpreting data derived from microcosm tests

Book Reviews

The Accidental Guerilla: Fighting Small Wars in the Midst of a Big One. By David Kilcullen. Aviation and Airport Security: Terrorism and Safety Concerns. By Kathleen M. Sweet. Executive Measures, Terrorism and National Security: Have the Rules of the Game Changed? By David Bonner. Spycraft: The Secret History of the CIA\u27s Spy techs from Communism to Al-Qaeda. By Robert Wallace and H. Keith Melton, with Henry Robert Schlesinger. Troublesome Young Men: The Rebels who brought Churchill to Power and Saved England. By Lynne Olson