Clinical vampirism A presentation of 3 cases and a re-evaluation of Haigh, the 'acid-bath murderer'

Clinical vampirism is named after the mythical vampire, and is a recognizable, although rare, clinical entity characterized by periodic compulsive blooddrinking, affinity with the dead and uncertain identity. It is hypothetically the expression of an inherited archaic myth, the act of taking blood being a ritual that gives temporary relief. From ancient times vampirists have given substance to belief in the existence of supernatural vampires. Four vampirists, including Haigh, the 'acid-bath murderer', are described. From childhood they cut themselves, drank their own, exogenous human or animal blood to relieve a craving, dreamed of bloodshed, asspciated with the dead, and had a changing identity. They were intelligent, with no family mental or social pathology. Some self-cutters are auto-vampirists; females are not likely to assault others for blood, but males are potentially dangerous. Vampirism may be a cause of unpredictable repeated assault and murder, and should be looked for in violent criminals who are self-mutilators. No specific treatment is known

Shape-changing nanomagnets: A new approach to in vivo biosensing

The idea that optical color can be determined by size and shape is well known at the nanoscale. Colors of quantum dots and plasmonic nanostructures, for example, can be tuned through particle size and shape. Among others, this has directly enabled many different multi-colored nanoparticle labels that underpin a host of optically-based in vitro bioimaging applications, including multiplexed high-throughput bioassays and colorimetric sensing and visualization of biomolecular processes and function. Imaging and sensing in more realistic in vivo environments is more challenging, however. Optical probes can be sized or shaped to yield resonances closer to the more optically favorable near-infrared window, but optical penetration, signal intensity, and spatial resolution, still deteriorate rapidly with increasing depth beneath the surface. But what about in the radio-frequency (RF) portion of the spectrum? Are there any analogous nanoparticle structures that can shift the frequency, or equivalently color, of RF signals for which penetration and/or distortion through biological tissue would no longer be a limitation and where imaging and sensing would be naturally immune to any photostability, phototoxicity, and autofluoresence background issues? Please click Additional Files below to see the full abstract

Medium-term follow-up of Crohn's disease in Cape Town

The 82 cases of Crohn's disease diagnosed in Greater Cape Town between 1970 and 1979 were followed up after a median time. of 9,6 years from diagnosis. Sixty patients were contacted; 6 had died and 16 were not available for followup. Only 1 death was disease-related. Mortality in Crohn's disease was not increased. There were no cases of carcinoma of the colon. At diagnosis most patients had had moderately severe disease, and 10 years later, 80% had mild-to-moderate symptoms. The 5-year resection rate was 46% and the 10-year rate 68%; 23% of patients required a second resection within 5 years of the first, and 42% within 10 years. Surgery occurred earlier in those with ileitis. Ten patients were over the age of 60 years at diagnosis; there was no apparent difference between the extent of their disease and that in the group as a whole. However, the elderly patients appeared to have a better prognosis - 59% having been symptom-free for more than 1 year, and none having required a second resection.S Afr Med J 1989; 76: 139-14

Mental health leadership and patient access to care: a public–private initiative in South Africa

BACKGROUND: Mental health leadership is a critical component of patient access to care. More specifically, the ability of mental health professionals to articulate the needs of patients, formulate strategies and engage meaningfully at the appropriate level in pursuit of resources. This is not a skill set routinely taught to mental health professionals. METHODS: A public-private mental health leadership initiative, emanating from a patient access to care programme, was developed with the aim of building leadership capacity within the South African public mental health sector. The express aim was to equip health care professionals with the requisite skills to more effectively advocate for their patients. The initiative involved participants from various sites within South Africa. Inclusion was based on the proposal of an ongoing "project", i.e. a clinician-initiated service development with a multidisciplinary focus. The projects were varied in nature but all involved identification of and a plan for addressing an aspect of the participants' daily professional work which negatively impacted on patient care due to unmet needs. Six such projects were included and involved 15 participants, comprising personnel from psychiatry, psychology, occupational therapy and nursing. Each project group was formally mentored as part of the initiative, with mentors being senior professionals with expertise in psychiatry, public health and nursing. The programme design thus provided a unique practical dimension in which skills and learnings were applied to the projects with numerous and diverse outcomes. RESULTS: Benefits were noted by participants but extended beyond the individuals to the health institutions in which they worked and the patients that they served. Participants acquired both the skills and the confidence which enabled them to sustain the changes that they themselves had initiated in their institutions. The initiative gave impetus to the inclusion of public mental health as part of the curriculum for specialist training. CONCLUSIONS: Despite the significant adverse social and economic costs of mental illness, psychiatric and related services receive a low level of priority within the health care system. Ensuring that mental health receives the recognition and the resources it deserves requires that mental health care professionals become effective advocates through mental health leadership

No health without mental health: Establishing psychiatry as a major discipline in an African Faculty of Health Sciences

Psychiatry has not always been a major clinical discipline in medical schools. Although the Faculty of Health Sciences of the University of Cape Town (UCT) celebrates its Centenary in 2012, a closely aligned major psychiatric hospital is older than the Medical School, while the Department of Psychiatry is only 50 years old. These differing dates reflect the history of and challenge for psychiatry; mental disorders contribute a major portion of the burden of disease, while appropriate recognition and resourcing of services and training has been delayed. There are ongoing challenges in aligning the visions of an old state-run system that focused on those with severe psychotic illness, a newer governmental vision of the importance of treating mental disorders in the community, the realities of current under-resourcing, and the international aspiration that psychiatry is one of the clinical neurosciences. Nevertheless, considerable strides have been made towards moving psychiatry from the periphery of society and medicine to a central discipline within the Faculty of Health Sciences at UCT

More doctors and dentists are needed in South Africa

Background. An aim of the Colleges of Medicine of South Africa (CMSA) project ‘Strengthening Academic Medicine and Specialist Training’ was to research the number and needs of specialists and subspecialists within South Africa. Methods. Data were collected from several sources: Deans of the 8 Faculties of Health Sciences and the Presidents of the 27 constituent Colleges of the CMSA completed a survey; and the HPCSA’s Register of Approved Registrar Posts for Faculties of Health Sciences was examined and the results tabulated. Results. South Africa compares unfavourably with middle-income countries on the ratios of medical and dental professionals; many districts have limited access to specialists and subspecialists. The unacceptable ratio of doctors, dentists and other health professionals per capita needs to be remedied, given South Africa’s impressive reputation for its output of health professionals, including the areas of medical training, clinical practice and clinical research. The existing output from South Africa’s 8 medical schools of MB ChB and specialist graduates is not being absorbed into the public health system, and neither are other health professionals. Conclusion. Dynamic leadership and policy interventions are required to advocate and finance the planned increase of medical, dental and other health professionals in South Africa

Time domain deBroglie wave interferometry along a magnetic guide

Time domain deBroglie wave interferometry [Cahn et al, Phys. Rev. Lett. 79, 784] is applied to Rb87 atoms in a magnetic guide. A standing wave light field is carefully aligned along the guiding direction of the magnetic trapping potential from a soft-ferromagnetic 4-foil structure. A sequence of two standing wave pulses is applied to the magnetically trapped atoms. The backscattered light at the atomic density grating revival time is collected and detected via a heterodyning technique. In addition to the observed recoil oscillations that fit the interferometer theory for atoms in free space, we observe a decay of the interferometer contrast on a millisecond time scale with unexpected millisecond-scale oscillations. We find that the oscillating decay is explained by a residual variation of the linear trapping potential along the standing wave direction.Comment: 22 pages, 7 figure

Quantifying MRI frequency shifts due to structures with anisotropic magnetic susceptibility using pyrolytic graphite sheet

Magnetic susceptibility is an important source of contrast in magnetic resonance imaging (MRI), with spatial variations in the susceptibility of tissue affecting both the magnitude and phase of the measured signals. This contrast has generally been interpreted by assuming that tissues have isotropic magnetic susceptibility, but recent work has shown that the anisotropic magnetic susceptibility of ordered biological tissues, such as myelinated nerves and cardiac muscle fibers, gives rise to unexpected image contrast. This behavior occurs because the pattern of field variation generated by microstructural elements formed from material of anisotropic susceptibility can be very different from that predicted by modelling the effects in terms of isotropic susceptibility. In MR images of tissue, such elements are manifested at a sub-voxel length-scale, so the patterns of field variation that they generate cannot be directly visualized. Here, we used pyrolytic graphite sheet which has a large magnetic susceptibility anisotropy to form structures of known geometry with sizes large enough that the pattern of field variation could be mapped directly using MRI. This allowed direct validation of theoretical expressions describing the pattern of field variation from anisotropic structures with biologically relevant shapes (slabs, spherical shells and cylindrical shells)

Large T1 contrast enhancement using superparamagnetic nanoparticles in ultra-low field MRI

Superparamagnetic iron oxide nanoparticles (SPIONs) are widely investigated and utilized as magnetic resonance imaging (MRI) contrast and therapy agents due to their large magnetic moments. Local field inhomogeneities caused by these high magnetic moments are used to generate T2 contrast in clinical high-field MRI, resulting in signal loss (darker contrast). Here we present strong T1 contrast enhancement (brighter contrast) from SPIONs (diameters from 11 nm to 22 nm) as observed in the ultra-low field (ULF) MRI at 0.13 mT. We have achieved a high longitudinal relaxivity for 18 nm SPION solutions, r1 = 615 s−1 mM−1, which is two orders of magnitude larger than typical commercial Gd-based T1 contrast agents operating at high fields (1.5 T and 3 T). The significantly enhanced r1 value at ultralow fields is attributed to the coupling of proton spins with SPION magnetic fluctuations (Brownian and Néel) associated with a low frequency peak in the imaginary part of AC susceptibility (χ”). SPION-based T1-weighted ULF MRI has the advantages of enhanced signal, shorter imaging times, and iron-oxidebased nontoxic biocompatible agents. This approach shows promise to become a functional imaging technique, similar to PET, where low spatial resolution is compensated for by important functional information