Excessive oral amphetamine use as a possible cause of renal and splanchnic arterial aneurysms: A report of two cases

AbstractIntroduction: Multiple visceral aneurysms are uncommon and usually result from connective tissue diseases, systemic arteritis, or mycotic lesions. An association between multiple visceral aneurysms and excessive oral amphetamine use has not been reported. Methods: The clinical features of 2 patients at the University of Michigan Medical Center for treatment of multiple visceral aneurysms and amphetamine use were reviewed. Results: The patients had histories of excessive oral amphetamine use that ranged from 50 mg daily for 22 years to 200 mg daily for 2 years. No evidence was seen of systemic arteritis, connective tissue disorder, or an infectious process that may have caused the aneurysms. The arteriograms documented multiple splanchnic and renal artery aneurysms that involved both the large and the small arteries. The aneurysms of 1 patient were managed conservatively, and the patient has not had any clinical sequelae of the aneurysms during 14 years of follow-up. The second patient had hematobilia from a ruptured hepatic artery aneurysm that was treated with transcatheter embolic occlusion of the bleeding vessel. The patient had no recurrent gastrointestinal problems and continued to use amphetamines until his death from a cerebrovascular accident 6 years later. Conclusion: A possible association between excessive oral amphetamine use and multiple visceral aneurysms is reported for 2 patients in whom other risk factors were absent. The potential for chronic oral amphetamine use to cause multiple visceral aneurysms is an ill-defined but not unexpected complication of this substance that is known to contribute to arterial hypertension and to produce a form of necrotizing arteritis. (J Vasc Surg 1998;28:727-31.

Nutrient Loading of Streams Entering Sodus Bay and Port Bay, NY 1 April, 1990 To 30 June, 1991

Freshwater resources have historically played a key role in community development and sustainability. Maintaining a high quality freshwater resource is of equal importance. Within the Finger Lakes Region of New York State, degradation of water quality and aesthetics due to excessive plant growth is a growing concern. Involved agencies have recently focused their attention on non-point source pollution as a primary candidate linked to accelerated macrophyte growth and surface water degradation. Wayne County recognizes the importance of maintaining a quality water resource and has responded by developing a Water Quality Program. Established in 1 987 and administered jointly between the Wayne County Soil and Water Conservation District and the Wayne County Planning Department, the program has received financial support made possible through the Finger Lakes Aquatic Vegetation Control Program (AVCP). The AVC program was created through a mutual effort between the New York State Legislature, the Department of Environmental Conservation and the Finger Lakes Water Resources Board. The overall goal of Wayne County\u27s water quality program is to develop a long-term water quality /lake management plan designed to control non-point source pollution on Sodus and Port Bays. Once implemented, this plan will serve to protect the integrity of these resources. A major improvement in our assessment capability occurred with the construction of a continuous stage height recorder on Sodus Creek. The addition of the continuous stream height recorder fine tunes our ability to evaluate nutrient and sediment loading into Sodus Bay during hydrologic events. In addition ,initiation of weekly sampling of Wolcott Creek on Port Bay has expanded this program to another body of water in Wayne County. The objectives of Wayne County\u27s program include: 1 ) To determine the status of Wayne County\u27s primary surface waters and observe changes over time; 2) To document what types and amounts of nutrients may be adversely impacting water quality and the conditions which generate them; 3) To develop a technical database for informed water quality management decisions; and 4) To assess the feasibility and effectiveness of potential control measures likely to be used to reduce non-point sources

Monoamine Oxidase is a Major Determinant of Redox Balance in Human Atrial Myocardium and is Associated With Postoperative Atrial Fibrillation

BACKGROUND: Onset of postoperative atrial fibrillation (POAF) is a common and costly complication of heart surgery despite major improvements in surgical technique and quality of patient care. The etiology of POAF, and the ability of clinicians to identify and therapeutically target high-risk patients, remains elusive. METHODS AND RESULTS: Myocardial tissue dissected from right atrial appendage (RAA) was obtained from 244 patients undergoing cardiac surgery. Reactive oxygen species (ROS) generation from multiple sources was assessed in this tissue, along with total glutathione (GSHt) and its related enzymes GSH-peroxidase (GPx) and GSH-reductase (GR). Monoamine oxidase (MAO) and NADPH oxidase were observed to generate ROS at rates 10-fold greater than intact, coupled mitochondria. POAF risk was significantly associated with MAO activity (Quartile 1 [Q1]: adjusted relative risk [ARR]=1.0; Q2: ARR=1.8, 95% confidence interval [CI]=0.84 to 4.0; Q3: ARR=2.1, 95% CI=0.99 to 4.3; Q4: ARR=3.8, 95% CI=1.9 to 7.5; adjusted Ptrend=0.009). In contrast, myocardial GSHt was inversely associated with POAF (Quartile 1 [Q1]: adjusted relative risk [ARR]=1.0; Q2: ARR=0.93, 95% confidence interval [CI]=0.60 to 1.4; Q3: ARR=0.62, 95% CI=0.36 to 1.1; Q4: ARR=0.56, 95% CI=0.34 to 0.93; adjusted Ptrend=0.014). GPx also was significantly associated with POAF; however, a linear trend for risk was not observed across increasing levels of the enzyme. GR was not associated with POAF risk. CONCLUSIONS: Our results show that MAO is an important determinant of redox balance in human atrial myocardium, and that this enzyme, in addition to GSHt and GPx, is associated with an increased risk for POAF. Further investigation is needed to validate MAO as a predictive biomarker for POAF, and to explore this enzyme's potential role in arrhythmogenesis

The International Cancer Expert Corps: A Unique Approach for Sustainable Cancer Care in Low and Lower-Middle Income Countries

The growing burden of non-communicable diseases including cancer in low- and lower-middle income countries (LMICs) and in geographic-access limited settings within resource-rich countries requires effective and sustainable solutions. The International Cancer Expert Corps (ICEC) is pioneering a novel global mentorship–partnership model to address workforce capability and capacity within cancer disparities regions built on the requirement for local investment in personnel and infrastructure. Radiation oncology will be a key component given its efficacy for cure even for the advanced stages of disease often encountered and for palliation. The goal for an ICEC Center within these health disparities settings is to develop and retain a high-quality sustainable workforce who can provide the best possible cancer care, conduct research, and become a regional center of excellence. The ICEC Center can also serve as a focal point for economic, social, and healthcare system improvement. ICEC is establishing teams of Experts with expertise to mentor in the broad range of subjects required to establish and sustain cancer care programs. The Hubs are cancer centers or other groups and professional societies in resource-rich settings that will comprise the global infrastructure coordinated by ICEC Central. A transformational tenet of ICEC is that altruistic, human-service activity should be an integral part of a healthcare career. To achieve a critical mass of mentors ICEC is working with three groups: academia, private practice, and senior mentors/retirees. While in-kind support will be important, ICEC seeks support for the career time dedicated to this activity through grants, government support, industry, and philanthropy. Providing care for people with cancer in LMICs has been a recalcitrant problem. The alarming increase in the global burden of cancer in LMICs underscores the urgency and makes this an opportune time fornovel and sustainable solutions to transform cancer care globally

Robust evidence for bisexual orientation among men

The question whether some men have a bisexual orientation—that is, whether they are substantially sexually aroused and attracted to both sexes—has remained controversial among both scientists and laypersons. Skeptics believe that male sexual orientation can only be homosexual or heterosexual, and that bisexual identification reflects nonsexual concerns, such as a desire to deemphasize homosexuality. Although most bisexual-identified men report that they are attracted to both men and women, self-report data cannot refute these claims. Patterns of physiological (genital) arousal to male and female erotic stimuli can provide compelling evidence for male sexual orientation. (In contrast, most women provide similar physiological responses to male and female stimuli.) We investigated whether men who self-report bisexual feelings tend to produce bisexual arousal patterns. Prior studies of this issue have been small, used potentially invalid statistical tests, and produced inconsistent findings. We combined nearly all previously published data (from eight previous studies in the United States, United Kingdom, and Canada), yielding a sample of 474 to 588 men (depending on analysis). All participants were cisgender males. Highly robust results showed that bisexual-identified men’s genital and subjective arousal patterns were more bisexual than were those who identified as exclusively heterosexual or homosexual. These findings support the view that male sexual orientation contains a range, from heterosexuality, to bisexuality, to homosexuality

On quark confinement dynamics

Starting from Buchm\"uller's observation that a chromoelectric flux tube meson will exhibit only the Thomas type spin-orbit interaction, we show that a model built upon the related assumption that a quark feels only a constant radial chromoelectric field in its rest frame implies a complete relativistic effective Hamiltonian that can be written explicitly in terms of quark canonical variables. The model yields linear Regge trajectories and exhibits some similarities to scalar confinement, but with the advantage of being more closely linked to QCD.Comment: 12 pages, LaTeX 2.09, uses RevTeX and AMSfonts. To be published in Phys Rev

Time Out of Joint: Hamlet and the Pure Form of Time

The aim of this paper is to explore why Deleuze takes up Hamlet’s claim that ‘time is out of joint’. In the first part of this paper, I explore this claim by looking at how Deleuze relates it to Plato’s Timaeus and its conception of the relationship between movement and time. Once we have seen how time functions when it is ‘in joint’, I explore what it would mean for time to no longer be understood in terms of an underlying rational structure. The claim can be understood as about a relationship between time and action. In the second part of this paper, I want to relate this new understanding of time to Hamlet itself, in order to see how temporality operates within the play. I will conclude by relating these two different conceptions of time out of joint to one another through Nietzsche’s Eternal Return