Sudden bilateral loss of vision in a 19-year-old man

Introduction: Posterior Reversible Leukoencephalopathy Syndrome (PRES) is caused by ischaemia commonly affecting the posterior cerebral vasculature. It presents with sudden decreased vision, headaches, nausea, vomiting, seizures, and altered mental status. Case presentation: A 19-year-old male presented to the ophthalmic emergency complaining of sudden bilateral loss of vision, which was down to light perception He reported headaches, nausea, and drowsiness since the previous day. He was a known case of hypertension secondary to IgA nephropathy. Magnetic resonance imaging (MRI) with STIR and FLAIR sequences showed foci of hyperintensity within the occipital lobes bilaterally. This confirmed the suspected diagnosis of PRES. Discussion: Aetiological factors of PRES include sudden increase in blood pressure, eclampsia, porphyria, renal disease, and Cushing syndrome. These lead to blood-brain barrier injury either by hyper- or hypoperfusion, endothelial dysfunction, changes in blood vessel morphology, hypocapnea, or immune system activation. Histopathological changes in PRES include activated astrocytes, scattered macrophages and lymphocytes, often in the absence of inflammation or neuronal damage. Conclusion: PRES is usually a reversible neuroophthalmological condition, however prompt recognition and appropriate management is important to prevent permanent brain injury or even death.peer-reviewe

Genetic basis of between-individual and within-individual variance of docility

Funded by Alces Software UCLA Academic Senate Division of Life Sciences National Geographic Society National Science Foundation. Grant Numbers: IDBR-0754247, DEB-1119660, DBI-0242960, DBI-0731346 University of Aberdeen Data deposited at Dryad: doi:10.5061/dryad.11vf0.Peer reviewedPostprin

An upper limb Functional Electrical Stimulation controller based on Reinforcement Learning: A feasibility case study.

Controllers for Functional Electrical Stimulation (FES) are still not able to restore natural movements in the paretic arm. In this work, Reinforcement Learning (RL) is used for the first time to control a hybrid upper limb robotic system for stroke rehabilitation in a real environment. The feasibility of the FES controller is tested on one healthy subject during elbow flex-extension in the horizontal plane. Results showed an absolute position error <1.2° for a maximum range of motion of 50°

Suggestion, hypnosis and hypnotherapy: a survey of use, knowledge and attitudes of anaesthetists

Publisher's copy made available with the permission of the publisher © Australian Society of AnaesthetistsClinical hypnosis is a skill of using words and gestures (frequently called suggestions) in particular ways to achieve specific outcomes. It is being increasingly recognised as a useful intervention for managing a range of symptoms, especially pain and anxiety. We surveyed all 317 South Australian Fellows and trainees registered with ANZCA to determine their use, knowledge of, and attitudes towards positive suggestion, hypnosis and hypnotherapy in their anaesthesia practice. The response rate was 218 anaesthetists (69%). The majority of respondents (63%) rated their level of knowledge on this topic as below average. Forty-eight per cent of respondents indicated that there was a role for hypnotherapy in clinical anaesthesia, particularly in areas seen as traditional targets for the modality, i.e. pain and anxiety states. Nearly half of the anaesthetists supported the use of hypnotherapy and positive suggestions within clinical anaesthesia. Those respondents who had experience of clinical hypnotherapy were more likely to support hypnosis teaching at undergraduate or postgraduate level when compared with those with no experience.http://www.aaic.net.au/Article.asp?D=200408

Skin reactions triggered by the use of cosmetic products in nonspecific lipid transfer protein-sensitive patients.

Nonspecific lipid transfer proteins (nsLTPs) are members of the prolamine superfamily and they are found in pollen and food, as well as in latex. Due to the strong stability both against pepsin digestion and thermal denaturation, sensitisation towards these proteins is often associated with severe systemic reactions (angioedema, urticaria, asthma, anaphylaxis, etc.) following the ingestion of both raw or fresh food and cooked or preserved food. Many studies have shown reactivity towards nsLTPs both via inhalation and orally and in this study we present two cases of nsLTPs-sensitive patients who manifested the immediate onset of skin reactions following the use of cosmetic products containing these proteins. Thus, in order to prevent immediate reactions linked to their use, it is necessary to recommend nsLTPs-sensitive patients to avoid the topical use of products containing these proteins (and obviously the ingestion of foods containing these proteins)

Carências e desejos: estudo sobre a opção pela esterilização entre mulheres residentes na Região Sul do Município de São Paulo, em 1992

The present study aims at discussing the women's option for sterilization. 215 sterilized women residing in the southern area of the city of São Paulo in 1992 where interviewed. The use of contraceptive methods before sterilization, the reasons of this choice and the satisfaction with sterilization were analysed. From among women that have used reversible methods before sterilization, 67% referred the pill. 67% of women referred problems with the precedent method as the reason for leaving its use. 91% affirmed they were satisfied with the irreversible method. 74% answered the sterilization brought no changes in their lives and 60% answered there was no modification in affective and sexual relationship. The analysis of the questions about the situation of woman after sterilization, yielded that the health problems attributed to reversible methods and the security in view of unwanted pregnancy are the main elements determining the satisfaction with the sterilization. The analysis undertaken in this study suggests the option for sterilization is related to the problems derived from the indiscriminate use of pill and lack of effective assistance to reproductive health, pointing to importance of implementing health programs in this field.O presente estudo teve por objetivo discutir a opção das mulheres pela esterilização cirúrgica. A amostra constituiu-se em 215 mulheres esterilizadas, residentes na Região Sul do Município de São Paulo, em 1992. Foram analisadas variáveis referentes ao uso de métodos anticoncepcionais anteriormente à esterilização, aos motivos desta opção e à satisfação com a esterilização. Das mulheres que eram usuárias de métodos reversíveis antes da esterilização, 67% referiu a pílula. 67% das mulheres referiram problemas com o método anterior, como motivo por ter deixado de usá-lo. 91% afirmaram estar satisfeitas com o método irreversível. 74% das mulheres responderam que a esterilização não trouxe mudanças em sua vida e 60% das mulheres responderam que não houve mudança no relacionamento afetivo e sexual. Ao percorrer as questões relativas à situação da mulher após a esterilização, verificou-se que os problemas de saúde atribuídos aos métodos reversíveis e a segurança frente à gravidez indesejada são os principais elementos que determinaram a satisfação com a esterilização. A análise empreendida neste estudo sugere que a opção pela esterilização está relacionada com as dificuldades oriundas do uso indiscriminado da pílula e da falta de assistência efetiva à saúde reprodutiva, apontando para a importância da implementação dos programas de saúde voltados para este âmbito