Ephedrine requirements are reduced during spinal anaesthesia for caesarean section in preeclampsia

Part of the Portfolio Thesis by Geoffrey H. Sharwood-Smith: The inferior vena caval compression theory of hypotension in obstetric spinal anaesthesia: studies in normal and preeclamptic pregnancy, a literature review and revision of fundamental concepts, available at http://hdl.handle.net/10023/1815Background: Despite controversy over the haemodynamically safest blockade for caesarean section in women with severe preeclampsia, an increasing number of anaesthetists now opt for spinal anaesthesia. In a previous study we found that spinal compared to epidural anaesthesia offered an equally safe but more effective option for these patients. The current study was designed to compare the hypotension induced by spinal anaesthesia, as measured by ephedrine requirement, between 20 normotensive and 20 severely preeclamptic but haemodynamically stabilised women. Method: Standardised spinal anaesthesia was instituted and ephedrine was given in boluses of 6 mg if the systolic pressure fell >20% from the baseline, or if the patient exhibited symptoms of hypotension. Results: The mean ephedrine requirement of the normotensive group (27.9 ± 11.6 mg) was significantly greater (P < 0.01) than that of the preeclamptic group (16.4 ± 15.0 mg). Conclusion: This suggests that the hypotension induced by spinal anaesthesia in women with severe but haemodynamically stabilised preeclampsia, is less than that of normotensive patients.Publisher PD

Tackling concussion, beyond Hollywood

No abstract available

Genetic interplay with soccer ball heading

Mortality from neurodegenerative disease is high among professional soccer players, potentially associated with repeated head impacts during routine gameplay. New data suggest that the apolipoprotein E ε4 allele might exacerbate the effects of soccer ball heading on cognition. However, genotyping of athletes to determine their dementia risk remains a distant prospect

Adjustable high emittance gap filler

A flexible, adjustable refractory filler is disclosed for filling gaps between ceramic tiles forming the heat shield of a space shuttle vehicle, to protect its aluminum skin during atmospheric reentry. The easily installed and replaced filler consists essentially of a strip of ceramic cloth coated, at least along both its longitudinal edges with a room temperature vulcanizable silicone rubber compound with a high emittance colored pigment. The filler may have one or more layers as the gap width requires. Preferred materials are basket weave aluminoborosilicate cloth, and a rubber compounded with silicon tetraboride as the emittance agent and finely divided borosilicate glass containing about 7.5% B2O3 as high temperature binder. The filler cloth strip or tape is cut to proper width and length, inserted into the gap, and fastened with previously applied drops of silicone rubber adhesive

SNTF immunostaining reveals previously undetected axonal pathology in traumatic brain injury

Diffuse axonal injury (DAI) is a common feature of severe traumatic brain injury (TBI) and may also be a predominant pathology in mild TBI or “concussion”. The rapid deformation of white matter at the instant of trauma can lead to mechanical failure and calcium-dependent proteolysis of the axonal cytoskeleton in association with axonal transport interruption. Recently, a proteolytic fragment of alpha-II spectrin, “SNTF”, was detected in serum acutely following mild TBI in patients and was prognostic for poor clinical outcome. However, direct evidence that this fragment is a marker of DAI has yet to be demonstrated in either humans following TBI or in models of mild TBI. Here, we used immunohistochemistry (IHC) to examine for SNTF in brain tissue following both severe and mild TBI. Human severe TBI cases (survival &lt;7d; n = 18) were compared to age-matched controls (n = 16) from the Glasgow TBI archive. We also examined brains from an established model of mild TBI at 6, 48 and 72 h post-injury versus shams. IHC specific for SNTF was compared to that of amyloid precursor protein (APP), the current standard for DAI diagnosis, and other known markers of axonal pathology including non-phosphorylated neurofilament-H (SMI-32), neurofilament-68 (NF-68) and compacted neurofilament-medium (RMO-14) using double and triple immunofluorescent labeling. Supporting its use as a biomarker of DAI, SNTF immunoreactive axons were observed at all time points following both human severe TBI and in the model of mild TBI. Interestingly, SNTF revealed a subpopulation of degenerating axons, undetected by the gold-standard marker of transport interruption, APP. While there was greater axonal co-localization between SNTF and APP after severe TBI in humans, a subset of SNTF positive axons displayed no APP accumulation. Notably, some co-localization was observed between SNTF and the less abundant neurofilament subtype markers. Other SNTF positive axons, however, did not co-localize with any other markers. Similarly, RMO-14 and NF-68 positive axonal pathology existed independent of SNTF and APP. These data demonstrate that multiple pathological axonal phenotypes exist post-TBI and provide insight into a more comprehensive approach to the neuropathological assessment of DAI

Large scale motions of Neptune's bow shock: Evidence for control of the shock position by the rotation phase of Neptune's magnetic field

The Voyager 2 spacecraft observed high levels of Langmuir waves before the inbound crossing of Neptune's bow shock, thereby signifying magnetic connection of the bow shock. The Langmuir waves occurred in multiple bursts throughout two distinct periods separated by an 85 minute absence of wave activity. The times of onsets, peaks, and disappearances of the waves were used together with the magnetic field directions and spacecraft position, to perform a 'remote-sensing' analysis of the shape and location of Neptune's bow shock prior to the inbound bow shock crossing. The bow shock is assumed to have a parabolidal shape with a nose location and flaring parameter determined independently for each wave event. The remote-sensing analysis give a shock position consistent with the time of the inbound shock crossing. The flaring parameter of the shock remains approximately constant throughout each period of wave activity but differs by a factor of 10 between the two periods. The absence of waves between two periods of wave activity coincides with a large rotation of the magnetic field and a large increase in the solar wind ram pressure' both these effects lead to magnetic disconnection of the spacecraft from shock. The planetwards motion of the shock's nose from 38.5 R(sub N) to 34.5 R(sub N) during the second time period occurred while the solar wind ram pressure remained constant to within 15 percent. This second period of planetwards motion of the shock is therefore strong evidence for Neptune's bow shock moving in response to the rotation of Neptune's oblique, tilted magnetic dipole. Normalizing the ram pressure, the remotely-sensed shock moves sunwards during the first wave period and planetwards in the second wave period. The maximum standoff distance occurs while the dipole axis is close to being perpendicular to the Sun-Neptune direction. The remote-sensing analysis provides strong evidence that the location of Neptune's bow shock is controlled by Neptune's rotation phase

Earthquake swarm in the Santa Barbara Channel, California, 1968

Sixty-three minor earthquakes (maximum magnitude = 5.2) occurred in the Santa Barbara Channel during the period June 26 to August 3 1968. The epicenters form a shot-scatter pattern upon a broad, high-standing fault block in the channel midway between Santa Cruz Island and the City of Santa Barbara. Focal mechanism studies indicate that oblique-slip movement occurred along a northwest-striking fault even though the major folds and faults strike nearly east-west. Preliminary studies of the areal hydrocarbon production data show no compelling evidence for a causal relationship with the swarm

Exact diagonalization of the S=1/2 Heisenberg antiferromagnet on finite bcc lattices to estimate properties on the infinite lattice

Here we generate finite bipartite body-centred cubic lattices up to 32 vertices. We have studied the spin one half Heisenberg antiferromagnet by diagonalizing its Hamiltonian on each of the finite lattices and hence computing its ground state properties. By extrapolation of these data we obtain estimates of the T = 0 properties on the infinite bcc lattice. Our estimate of the T = 0 energy agrees to five parts in ten thousand with third order spin wave and series expansion method estimates, while our estimate of the staggered magnetization agrees with the spin wave estimate to within a quarter of one percent.Comment: 16 pages, LaTeX, 1 ps figure, to appear in J.Phys.

Chronic traumatic encephalopathy — confusion and controversies

The term chronic traumatic encephalopathy (CTE) has recently entered public consciousness via media reports and even a Hollywood movie. However, in contrast to general impressions, the incidence of CTE is unknown, the clinical diagnostic criteria have not been agreed upon and the current neuropathological characterization of CTE is acknowledged as preliminary. Additionally, few studies have compared the pathologies of CTE with those of other neurodegenerative disorders or of age-matched controls. Consequently, disagreement continues about the neuropathological aspects that make CTE unique. Furthermore, CTE is widely considered to be a consequence of exposure to repeated head blows, but evidence suggests that a single moderate or severe traumatic brain injury can also induce progressive neuropathological changes. These unresolved aspects of CTE underlie disparate claims about its clinical and pathological features, leading to confusion among the public and health-care professionals alike