Levamisole tainted cocaine causing severe neutropenia in Alberta and British Columbia

<p>Abstract</p> <p>Background</p> <p>Five cases of severe neutropenia (neutrophil counts < 0.5 per 10⁹cells/L) associated with exposure to cocaine and levamisole, an antihelimithic agent no longer available in Canada, were identified in Alberta in 2008. Alberta and British Columbia (BC) public health officials issued an advisory and urged health care professionals to report cases to public health. This paper presents the findings of the public health investigations.</p> <p>Methods</p> <p>Cases were identified prospectively through reporting by clinicians and a retrospective review of laboratory and medical examiners data from January 1, 2006 to March 31, 2009. Cases were categorized as confirmed, probable or suspect. Only the confirmed and probable cases are included in this paper.</p> <p>Results</p> <p>We compare cases of severe neutropenia associated with tainted cocaine (NATC) identified in Alberta and BC between January 1, 2008 to March 31, 2009. Of the 42 NATC cases: 23(55%) were from Alberta; 19(45%) were from British Columbia; 57% of these cases reported crack cocaine use (93% of those who identified type of cocaine used); 7% reported using cocaine powder; and the main route of cocaine administration was from smoking (72%). Fifty percent of the NATC cases had multiple episodes of neutropenia associated with cocaine use. Cases typically presented with bacterial/fungal infections and fever. One Alberta NATC case produced anti-neutrophil antibodies, and four were positive for anti-neutrophil cytoplasmic antibody (ANCA). Analysis of two crack pipes and one drug sample obtained from NATC cases confirmed the presence of both cocaine and levamisole. A further 18 cases were identified through the retrospective review of laboratory and medical examiner data in Alberta</p> <p>Interpretation</p> <p>Our findings support a link between neutropenia and levamisole tainted cocaine; particularly from smoking the crack form of cocaine. Some patients may be genetically predisposed to develop levamisole-related neutropenia. Awareness of the differential diagnosis will assist clinicians with case timely detection and appropriate management.</p

Metabolic and cardiovascular features of the course of type 2 diabetes mellitus in men with hypogonadism

Introduction. Androgenic deficiency is an important pathogenetic element in the development of metabolic syndrome and cardiovascular diseases in men. It has been proven that in male patients with type 2 diabetes, hypogonadism develops much more often. Objective – to study the metabolic and cardiovascular features of the course of type 2 diabetes mellitus (T2DM) in men with androgen deficiency.Materials and methods. The study included 124 men with type 2 diabetes. To diagnose hypogonadism, the levels of total testosterone (T), sex hormone binding globulin (SHBG), albumin and luteinizing hormone (LH) were measured. Free testosterone (free T) levels were calculated using a calculator from Ghent University Hospital, Belgium. A retrospective analysis of case histories was carried out (spectrum of late complications, the presence of heart attacks and strokes, laboratory data – total cholesterol (CS), triglycerides (TG), fasting blood plasma glucose, basal insulin level, glycated hemoglobin (HbA1c)). The HOMA-IR index was used to determine the degree of insulin resistance.Results. The average age of men was 57.39 ± 9.41 years. The incidence of laboratory-confirmed hypogonadism is 50.81%. An average positive correlation was found between androgen deficiency and the incidence of non-fatal cardiovascular events (r = 0.45, p &lt; 0.05). There was no statistically significant relationship between the presence of hypogonadism and the incidence and degree of late complications of T2DM. Patients with low T levels tended to have higher HOMA-IR values compared to patients with normal T levels (p &lt; 0.05). At the same time, the indicators of carbohydrate and lipid metabolism did not differ significantly in these groups (p &gt; 0.05).Conclusions. The revealed incidence of hypogonadism in men with T2DM corresponds to the data of international studies. The presence of a significant correlation between low testosterone levels and cardiovascular events in patients with T2DM suggests that hypogonadism can be used as an additional criterion for cardiovascular risk. Testosterone deficiency exacerbates insulin resistance, which can lead to weight gain and impair carbohydrate metabolism

Surface properties of AlInGaN/GaN heterostructure

Surface structural, electronic and electrical properties of the quaternary alloy AlInGaN/GaN heterostructures are investigated. Surface termination, atomic arrangement, electronic and electrical properties of the (0001) surface and (10-11) V-defect facets have been experimentally analyzed using various surface sensitive techniques including spectroscopy and microscopy. Moreover, the effect of sub-band gap (of the barrier layer) illumination on contact potential difference (VCPD) and the role of oxygen chemisorption have been studied

Multicharacterization approach for studying InAl(Ga)N/Al(Ga)N/GaN heterostructures for high electron mobility transistors

We report on our multi–pronged approach to understand the structural and electrical properties of an InAl(Ga)N(33nm barrier)/Al(Ga)N(1nm interlayer)/GaN(3μm)/AlN(100nm)/Al2O3 high electron mobility transistor (HEMT) heterostructure grown by metal organic vapor phase epitaxy (MOVPE). In particular we reveal and discuss the role of unintentional Ga incorporation in the barrier and also in the interlayer. The observation of unintentional Ga incorporation by using energy dispersive X–ray spectroscopy analysis in a scanning transmission electron microscope is supported with results obtained for samples with a range of AlN interlayer thicknesses grown under both the showerhead as well as the horizontal type MOVPE reactors. Poisson–Schrödinger simulations show that for high Ga incorporation in the Al(Ga)N interlayer, an additional triangular well with very small depth may be exhibited in parallel to the main 2–DEG channel. The presence of this additional channel may cause parasitic conduction and severe issues in device characteristics and processing. Producing a HEMT structure with InAlGaN as the barrier and AlGaN as the interlayer with appropriate alloy composition may be a possible route to optimization, as it might be difficult to avoid Ga incorporation while continuously depositing the layers using the MOVPE growth method. Our present work shows the necessity of a multicharacterization approach to correlate structural and electrical properties to understand device structures and their performance

Struktur und Präparation von Polaren und Semipolaren InN-Oberflächen

In dieser Arbeit wurden die atomaren Oberflächenstrukturen von polaren (0001) und (000-1) sowie semipolaren (11-22) InN-Schichten untersucht. Das Ziel der Arbeit ist die fundamentalen Eigenschaften von sauberen InN-Oberflächen deren Präparation und den Einfluss native Oxide auf InN-Eigenschaften zu verstehen. In diesem Zusammenhang wurden an InN-Oberflächen Messungen mit Rastertunnelmikroskopie (STM) und –spektroskopie (STS) sowie Untersuchungen mit Photoelektronenspektroskopie (PES), Beugung niederenergetischer Elektronen (LEED) und Rasterkraftmikroskopie (AFM) durchgeführt. Das Grundverständnis von atomaren, chemischen und elektronischen Eigenschaften von InN ist eine notwendige Voraussetzung für eine mögliche Anwendung in optoelektronischen Bauelementen. Vor der Charakterisierung der InN-Oberflächen wurden die optimalen Parameter für das Wachstum mittels metallorganischer Gasphasenepitaxie (MOVPE) für hoch qualitative InN-Schichten bestimmt. Es zeigte sich, dass die Bildung einer dünnen kristallinen AlN-Schicht auf den Saphirsubstraten notwendig ist um glatte N-polare InN-Schichten zu präparieren. Die Polaritäten können, wie in dieser Arbeit gezeigt wird, sowohl für c-plane InN und GaN-Schichten als auch für semipolare Orientierungen mit XPS bestimmen werden. Für die Untersuchung der atomaren Oberflächenstruktur wurden InN-Schichten im Hochvakuum untersucht, die vorher mit verschiedenen Wachstumsverfahren wie der Molekularstrahlepitaxie, der MOVPE und der Migration-Enhanced-Afterglow-Epitaxie gewachsen wurden. Je nach Wachstumsmethode haben die InN-Schichten unterschiedliche topographische und morphologische Eigenschaften. Atomare Modelle für die N-polare (1x1) und (√3x√3)R30° und die In-polare (1x1) InN-Oberfläche werden diskutiert und mit in der Literatur beschriebenen theoretischen Modellen verglichen und bestätigt. Die oben genannten Rekonstruktionen sind mit unterschiedlich Indium-reichen Schichten terminiert, was zu einer Anreicherung von Elektronen an der InN-Oberfläche führt. Ein besonderer Erfolg dieser Arbeit ist, dass bisher nur mit LEED beobachtete InN-Oberflächenrekonstruktionen mit atomar aufgelösten STM-Bildern bestätigt werden konnten. Zusätzlich wurden die In-polaren InN-Schichten thermisch oxidiert. Dabei zeigte sich, dass sich unter bestimmten Präparationsbedingungen auf InN-Oberflächen eine dünnere (111) In2O3-Schicht bildet. Der Grund für das Wachstum einer solchen gut geordneten atomaren Struktur von (111) In2O3 konnte in der kubischen Bixbyite-Kristallstruktur von In2O3 begründet werden. Die semipolaren (11-22) InN-Schichten haben eine ausgeprägte wellenförmige Struktur auf Oberflächen gezeigt. Je nach Wachstumbedingungen variierte die Periodizität der wellenförmigen Strukturen auf den InN-Oberflächen. STM- und XPS-Ergebnisse zeigen, dass die semipolaren InN-Proben Indium-terminiert sind. Messungen an semipolaren (20-21) InGaN-Schichten zeigten zudem, dass sich wellenförmige Strukturen in Nanometergroße durch die vorgestellten atomaren Oberflächen erklären lassen.In this work the atomic surface structures of polar (0001) and (000-1) as well as semipolar (11-22) InN layers were investigated. This work aims to increase knowledge about fundamental properties of the clean InN surfaces, understand the effects of surface preparation and native oxidation on InN properties. The InN layers were investigated by using scanning tunneling microscopy (STM) and spectroscopy (STS), X-ray photoelectron spectroscopy (XPS), low energy electron diffraction (LEED) and atomic force microscopy (AFM). A fundamental understanding of the atomic, chemical and electronic properties of InN layer is essential for a possible application of the layers in optoelectronic devices. Prior to the characterization of the InN surfaces the optimal parameters for the growth of high quality InN layers by metalorganic vapour phase epitaxy (MOVPE) were determined. It was shown that formation of a thin crystalline AlN layer on sapphire substrate is required in order to obtain smooth N-polar InN layers. This work demonstrates that polarity of the polar InN and GaN layers as well as semipolar orientated layers can be determined by XPS. The studied InN layers were grown by different growth techniques, i.e. molecular beam epitaxy, MOVPE and migration-enhanced-afterglow-epitaxie. The characterization of the layers was performed under ultra-high vacuum conditions. It was found that depending on the used growth method InN layers exhibit different topographical and morphological properties. The atomic models of the N-polar (1x1) and (√3x√3)R30° as well as In-polar (1x1) InN surfaces are discussed and compared to the theoretically proposed models from the literature. The reconstructions mentioned above are terminated by indium-rich layers with different amount of indium, which leads to an accumulation of electrons on the InN surfaces. An outstanding achievement of this work is that previously determined by LEED InN surface reconstructions were confirmed by atomically resolved STM images. In addition, the polar InN layers were thermally oxidized. It was found that the certain preparation conditions lead to the formation of a thin (111) In2O3 layer on the InN surface. The reason for the growth of such a well-ordered atomic structure of (111) In2O3 layer can be explained by the cubic bixbyite crystal structure of In2O3. The semipolar (11-22) InN layers have shown a pronounced undulation surface structure. The periodicity of that undulation structure was found to vary depending on the growth conditions of InN layers. The results based on STM and XPS showed that the semipolar InN layers are indium-terminated. The studies performed on semipolar (20-21) InGaN layers have shown that the nanoscale undulations can be explained by the atomic surface reconstruction discussed in this work

The course of pregnancy and delivery in patients with prolactinoma during treatment with cabergoline

Objectives: To assess the risk of pregnancy and fetal pathology in patients with prolactin-secreting tumors treated with cabergoline in the early stages of gestation.Materials and methods: The study included 24 patients in the age from 24 to 38 years old with prolactin-secreting tumors, become pregnant during therapy with cabergoline (Dostinex). A retrospective analysis of the course and outcomes of 33 pregnancies based on available medical records and questioning of the patients data.Results: Of the 33 pregnancies resulted in births 26 (78.8%), registered a spontaneous miscarriage at 7 weeks period (3%), six women required medical abortions due to the undeveloping pregnancy for a period of 4 to 7 weeks (18.2%). In 6% of cases (two pregnant) gestational diabetes mellitus (GDM) has been diagnosed. The average gestational age was 39.8 weeks (36–41 weeks). Preterm delivery occurred in 4 women, accounting for 15.3%. In 6% of cases (two pregnant) gestational diabetes mellitus (GDM) has been diagnosed. In total 27 children were born (in 1 case - twins), 26 (96.3%) of which at the time of birth – are healthy. The vast majority of pregnancies ended with the birth of a healthy child growth and development that did not differ from those of their peers in the general population, which corresponds to the data released by the majority of foreign researchers.Conclusions: The study confirms the absence of direct adverse effects of cabergoline (Dostinex) on the course and outcome of pregnancies in women receiving the drug at therapeutic doses before pregnancy and during the first 8 weeks of gestation

The course of pregnancy and delivery in patients with prolactinoma during treatment with cabergoline

Objectives: To assess the risk of pregnancy and fetal pathology in patients with prolactin-secreting tumors treated with cabergoline in the early stages of gestation.Materials and methods: The study included 24 patients in the age from 24 to 38 years old with prolactin-secreting tumors, become pregnant during therapy with cabergoline (Dostinex). A retrospective analysis of the course and outcomes of 33 pregnancies based on available medical records and questioning of the patients data.Results: Of the 33 pregnancies resulted in births 26 (78.8%), registered a spontaneous miscarriage at 7 weeks period (3%), six women required medical abortions due to the undeveloping pregnancy for a period of 4 to 7 weeks (18.2%). In 6% of cases (two pregnant) gestational diabetes mellitus (GDM) has been diagnosed. The average gestational age was 39.8 weeks (36–41 weeks). Preterm delivery occurred in 4 women, accounting for 15.3%. In 6% of cases (two pregnant) gestational diabetes mellitus (GDM) has been diagnosed. In total 27 children were born (in 1 case - twins), 26 (96.3%) of which at the time of birth – are healthy. The vast majority of pregnancies ended with the birth of a healthy child growth and development that did not differ from those of their peers in the general population, which corresponds to the data released by the majority of foreign researchers.Conclusions: The study confirms the absence of direct adverse effects of cabergoline (Dostinex) on the course and outcome of pregnancies in women receiving the drug at therapeutic doses before pregnancy and during the first 8 weeks of gestation

Populus nigra Italica Leaves as a Valuable Tool for Mineralogical and Geochemical Interpretation of Inorganic Atmospheric Aerosols’ Genesis

The Olmaliq industrial area in Uzbekistan is believed to represent a risk to the environment and to human health due to the dispersal of contaminants into the air and soil. This study was undertaken to delineate the track of airborne contaminants&rsquo; migration and to assess the distribution of such particles deposited on Populus nigra L. cv Italica leaves and soils. Particles were identified using scanning electron microscopy&ndash;energy-dispersive X-ray spectroscopy (SEM-EDX), while bulk soil composition was quantified by applying inductively coupled plasma mass spectrometry (ICP-MS). The results of this study confirmed the research hypothesis, indicating the industrial center as a source of pollution and human exposure to metallic contaminants. The Olmaliq area in particular is strongly influenced by atmospheric pollutants from local industries. The spread of ultra-fine particles is mainly governed by the industrial output and the direction of prevailing winds

Оцінка ефективності вимірювальної системи з мікротуннелем МКТ-2 для екологічного діагностування тепловозних дизелів

The article is devoted to the solution of the urgent task of reducing the duration and cost of the procedure for measuring the average operating mass emission of particulate matter with exhaust gases of a diesel engine – the standardized environmental indicator PM. The paper describes the technical characteristics and operation principle of a universal measuring system with a microtunnel MKT-2 for controlling the mass emissions of particles with exhaust gases from various types of diesel engines. The method of complex evaluation of the effectiveness of this system was developed by the criteria: accuracy of measurements, duration of sampling of particles in standardized test modes, cost-effectiveness of using MKT-2. With the help of this technique and the results of ecological tests of diesel engine 3A-6D49 of diesel locomotive TGM6 on the cycle ISO 8178-F, the efficiency of MKT-2 was conducted, as a result of which it was established that the resulting measurement error of PM is 3.1%, which corresponds to the requirements of normative documents; the duration of sampling of particles is from 1.8-2.5 minutes – in the modes of the average and nominal power of the diesel engine to 7.5 minutes – at idle; MKT-2 is characterized by a high economic efficiency of use: additional fuel costs during the ISO 8178-F cycle associated with increased sampling time of particles are negligible and amount to 0.5%. Recommendations have been developed for the improvement of MKT-2, the imple-mentation of which will reduce the duration of sampling by 3.8 times.Стаття присвячена вирішенню актуального завдання скорочення тривалості та вартості процедури вимірювання середньоексплуатаційного масового викиду твердих частинок з відпрацьованими газами тепловозного дизеля – нормованого екологічного показника PM. В роботі наведено опис технічних характеристик і принципу дії універсальної вимірювальної системи з мікротунелем МКТ-2 для контролю масових викидів твердих частинок з відпрацьованими газами дизелів різних типів. Розроблено методику комплексної оцінки ефективності даної системи за критеріями: точність вимірювань, тривалість відбору проб твердих частинок на нормованих режимах випробувань, економічна ефективність використання МКТ-2. За допомогою даної методики і результатів екологічних випробувань дизеля 3А-6Д49 тепловоза ТГМ6 за циклом ISO 8178-F проведені дослідження ефективності МКТ-2, в результаті яких встановлено: результуюча похибка вимірювань показника PM становить 3,1%, що відповідає вимогам нормативних документів; тривалості відбору проб твердих частинок на режимах випробувань складають 1,8-7,5 хв; відносне збільшення тривалості і вартості процедури екологічних випробувань дизеля є незначним і становить 0,5%. Розроблено рекомендації щодо вдосконалення МКТ-2, виконання яких дозволить скоротити тривалість відбору проб твердих частинок в 3,8 рази