Cardiovascular consequences of cortisol excess

Cushing's syndrome is a consequence of primary or, more commonly, secondary oversecretion of cortisol. Cardiovascular disease is the major cause of morbidity and mortality in Cushing's syndrome, and excess risk remains even in effectively treated patients. The cardiovascular consequences of cortisol excess are protean and include, inter alia, elevation of blood pressure, truncal obesity, hyperinsulinemia, hyperglycemia, insulin resistance, and dyslipidemia. This review analyses the relationship of cortisol excess, both locally and at tissue level, to these cardiovascular risk factors, and to putative mechanisms for hypertension. Previous studies have examined correlations between cortisol, blood pressure, and other parameters in the general population and in Cushing's syndrome. This review also details changes induced by short-term cortisol administration in normotensive healthy men

Emergence of the vowel space in very young children with Down syndrome: An exploratory case study

The current study presents the preliminary results of an investigation into the development of the vowel space in one female child with Down syndrome (DS). Vowel productions at five points in time, ranging from 1;0 to 3;8 years of age, have been analysed to produce age-specific F1-F2 vowel plots and to calculate metrics quantifying changes in their size and dimensions. The results show that changes in DS vowel space area and shape are non-systematic, lacking the definite developmental trajectories present in the productions of typically developing children. An explanation of outcomes using the DIVA model of speech acquisition is proposed

Massive star formation via high accretion rates and early disk-driven outflows

We present an investigation of massive star formation that results from the gravitational collapse of massive, magnetized molecular cloud cores. We investigate this by means of highly resolved, numerical simulations of initial magnetized Bonnor-Ebert-Spheres that undergo collapse and cooling. By comparing three different cases - an isothermal collapse, a collapse with radiative cooling, and a magnetized collapse - we show that massive stars assemble quickly with mass accretion rates exceeding 10^-3 Msol/yr. We confirm that the mass accretion during the collapsing phase is much more efficient than predicted by selfsimilar collapse solutions, i.e. dM/dt ~ c^3/G. We find that during protostellar assembly the mass accretion reaches 20 - 100 c^3/G. Furthermore, we determined the self-consistent structure of bipolar outflows that are produced in our three dimensional magnetized collapse simulations. These outflows produce cavities out of which radiation pressure can be released, thereby reducing the limitations on the final mass of massive stars formed by gravitational collapse. Moreover, we argue that the extraction of angular momentum by disk-threaded magnetic fields and/or by the appearance of bars with spiral arms significantly enhance the mass accretion rate, thereby helping the massive protostar to assemble more quickly.Comment: 22 pages, 12 figures, aastex style, accepted for publication in ApJ, see http://www.ita.uni-heidelberg.de/~banerjee/publications/MassiveStars.pdf for high resolution figure

Reflections on a coaching pilot project in healthcare settings

This paper draws on personal reflection of coaching experiences and learning as a coach to consider the relevance of these approaches in a management context with a group of four healthcare staff who participated in a pilot coaching project. It explores their understanding of coaching techniques applied in management settings via their reflections on using coaching approaches and coaching applications as healthcare managers. Coaching approaches can enhance a manager’s skill portfolio and offer the potential benefits in terms of successful goal achievement, growth, mutual learning and development for both themselves and staff they work with in task focused scenarios

SREBF1 links lipogenesis to mitophagy and sporadic Parkinson disease

Mitochondrial quality control has an impact on many diseases, but intense research has focused on the action of 2 genes linked to heritable forms of Parkinson disease (PD), PINK1 and PARK2/parkin, which act in a common pathway to promote mitophagy. However, criticism has been raised that little evidence links this mechanism to sporadic PD. To gain a greater insight into the mechanisms of PINK1-PARK2 mediated mitophagy, we undertook a genome-wide RNAi screen in Drosophila and human cell models. Strikingly, we discovered several components of the lipogenesis pathway, including SREBF1, playing a conserved role in mitophagy. Our results suggest that lipids influence the stabilization of PINK1 during the initiation of mitophagy. Importantly, SREBF1 has previously been identified as a risk locus for sporadic PD, and thus implicates aberrant mitophagy as contributing to sporadic PD. Our findings suggest a role for lipid synthesis in PINK1-PARK2 mediated mitophagy, and propose a mechanistic link between familial and sporadic PD, supporting a common etiology

What are the most practical primary care screens for post-traumatic stress disorder?

The 4-item Primary Care Post-Traumatic Stress Disorder screen (PC-PTSD) is a simple and effective tool to identify symptoms of post-traumatic stress disorder (PTSD) in primary care patients (strength of recommendation [SOR ]: B, 1 good-quality prospective cohort study and 1 good-quality retrospective cohort study). The 7-item Breslau screen also predictably identifies patients with PTSD symptoms (SOR : B, 1 good-quality prospective cohort study)

The HII region G35.673-00.847: another case of triggered star formation?

As part of a systematic study that we are performing with the aim to increase the observational evidence of triggered star formation in the surroundings of HII regions, we analyze the ISM around the HII region G35.673-00.847, a poorly studied source. Using data from large-scale surveys: Two Micron All Sky Survey, Galactic Legacy Infrared Mid-Plane Survey Extraordinaire (GLIMPSE), MIPSGAL, Galactic Ring Survey (GRS), VLA Galactic Plane Survey (VGPS), and NRAO VLA Sky Survey (NVSS) we performed a multiwavelength study of G35.673-00.847 and its surroundings. The mid IR emission, shows that G35.673-00.847 has an almost semi-ring like shape with a cut towards the galactic west. The radius of this semi-ring is about 1.5' (~1.6 pc, at the distance of ~3.7 kpc). The distance was estimated from an HI absorption study and from the analysis of the molecular gas. Indeed, we find a molecular shell composed by several clumps distributed around the HII region, suggesting that its expansion is collecting the surrounding material. We find several YSO candidates over the molecular shell. Finally, comparing the HII region dynamical age and the fragmentation time of the molecular shell, we discard the collect and collapse as the mechanism responsible for the YSOs formation, suggesting other processes such as radiative driven implosion and/or small-scale Jeans gravitational instabilities.Comment: Accepted for publication in A&A, 18 October 2010. Some figures were degraded to reduce file siz

Preventing Acute Mountain Sickness

Gradual ascent is the most effective method for preventing acute mountain sickness. (Strength of Recommendation [SOR]: B, based on good-quality prospective and retrospective cohort studies.) Acetazolamide should be used to prevent acute mountain sickness in persons with a history of acute mountain sickness or when gradual ascent is not practical. (SOR: A, based on two randomized controlled trials [RCTs] and a meta-analysis of 15 RCTs.) Dexamethasone is effective in preventing acute mountain sickness, but adverse effects must be considered. (SOR: A, based on a meta-analysis of seven RCTs.) Ginkgo extract is not recommended for acute mountain sickness prophylaxis. (SOR: A, based on seven controlled trials.