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

Expectations of rehabilitation following lower limb amputation: a qualitative study.

To explore the expectations of patients about to undergo prosthetic rehabilitation following a lower limb amputation

Superluminal neutrinos in long baseline experiments and SN1987a

Precise tests of Lorentz invariance in neutrinos can be performed using long baseline experiments such as MINOS and OPERA or neutrinos from astrophysical sources. The MINOS collaboration reported a measurement of the muonic neutrino velocities that hints to super-luminal propagation, very recently confirmed at 6 sigma by OPERA. We consider a general parametrisation which goes beyond the usual linear or quadratic violation considered in quantum-gravitational models. We also propose a toy model showing why Lorentz violation can be specific to the neutrino sector and give rise to a generic energy behaviour E^alpha, where alpha is not necessarily an integer number. Supernova bounds and the preferred MINOS and OPERA regions show a tension, due to the absence of shape distortion in the neutrino bunch in the far detector of MINOS. The energy independence of the effect has also been pointed out by the OPERA results.Comment: 22 pages, 7 figures; comment on Cherenkov emission added, version matching JHEP published pape

Gravitational leptogenesis, C, CP and strong equivalence

The origin of matter-antimatter asymmetry is one of the most important outstanding problems at the interface of particle physics and cosmology. Gravitational leptogenesis (baryogenesis) provides a possible mechanism through explicit couplings of spacetime curvature to appropriate lepton (or baryon) currents. In this paper, the idea that these strong equivalence principle violating interactions could be generated automatically through quantum loop effects in curved spacetime is explored, focusing on the realisation of the discrete symmetries C, CP and CPT which must be broken to induce matter-antimatter asymmetry. The related issue of quantum corrections to the dispersion relation for neutrino propagation in curved spacetime is considered within a fully covariant framework.Comment: 32 pages, 5 figure

Pumice attrition in an air-jet

We present the results from a series of jet-attrition experiments performed using a standard ASTM device (ASTM D5757-00) on naturally occurring ash-sized (b 2 mm) pumice, a product of explosive volcanic eruption compris- ing highly porous silicate glass. We investigate the effect of both feed grain size and attrition duration on the pro- duction of fines. We utilize a wet methodology for fines collection to ensure recovery of the total grain size distribution for each experimental run. The experiments convert a restricted size range of pumice particles to a bimodal population of parent and daughter particles. The bimodal distribution develops even after short (~ 15 min) attrition times. With increased attrition time, the volume of daughter particles increases and the mode migrates to finer grain sizes. Jet attrition efficiency depends heavily on the particle size of the feed; our data show little attrition for a feed of 500 μm vs. highly efficient attrition for a 250 μm feed. Our rates of attrition for pumice are extremely high compared to rates recovered from experiments on limestone pellets. Fines pro- duction data are well modeled by: mfines m0 bed ¼ 0:291 1−e−0:312t where m0bed is the initial mass of particles in the bed, t is in hours, and the two adjustable coefficients dictate the long time limiting behaviour (0.291) and the rate at which the limit is reached (−0.312). This functional form provides more realistic limits in time while preserving a zero intercept and defining a plateau for long residence time

Arginase attenuates inhibitory nonadrenergic noncholinergic nerve-induced nitric oxide generation and airway smooth muscle relaxation

BACKGROUND: Recent evidence suggests that endogenous arginase activity potentiates airway responsiveness to methacholine by attenuation of agonist-induced nitric oxide (NO) production, presumably by competition with epithelial constitutive NO synthase for the common substrate, L-arginine. Using guinea pig tracheal open-ring preparations, we now investigated the involvement of arginase in the modulation of neuronal nitric oxide synthase (nNOS)-mediated relaxation induced by inhibitory nonadrenergic noncholinergic (iNANC) nerve stimulation. METHODS: Electrical field stimulation (EFS; 150 mA, 4 ms, 4 s, 0.5 – 16 Hz)-induced relaxation was measured in tracheal preparations precontracted to 30% with histamine, in the presence of 1 μM atropine and 3 μM indomethacin. The contribution of NO to the EFS-induced relaxation was assessed by the nonselective NOS inhibitor L-NNA (0.1 mM), while the involvement of arginase activity in the regulation of EFS-induced NO production and relaxation was investigated by the effect of the specific arginase inhibitor nor-NOHA (10 μM). Furthermore, the role of substrate availability to nNOS in EFS-induced relaxation was measured in the presence of various concentrations of exogenous L-arginine. RESULTS: EFS induced a frequency-dependent relaxation, ranging from 6.6 ± 0.8% at 0.5 Hz to 74.6 ± 1.2% at 16 Hz, which was inhibited with the NOS inhibitor L-NNA by 78.0 ± 10.5% at 0.5 Hz to 26.7 ± 7.7% at 8 Hz (P < 0.01 all). In contrast, the arginase inhibitor nor-NOHA increased EFS-induced relaxation by 3.3 ± 1.2-fold at 0.5 Hz to 1.2 ± 0.1-fold at 4 Hz (P < 0.05 all), which was reversed by L-NNA to the level of control airways in the presence of L-NNA (P < 0.01 all). Similar to nor-NOHA, exogenous L-arginine increased EFS-induced airway relaxation (P < 0.05 all). CONCLUSION: The results indicate that endogenous arginase activity attenuates iNANC nerve-mediated airway relaxation by inhibition of NO generation, presumably by limiting L-arginine availability to nNOS