Elevated PTH with normal serum calcium level: a structured approach

Normocalcaemic hyperparathyroidism is a common biochemical finding, usually identified during an assessment of bone or renal health. Hypercalcaemia must be considered by calculation of adjusted calcium, and a careful history taken to assess dietary calcium intake and for the possibility of a malabsorption syndrome. 25‐hydroxyvitamin D (25OHD) should be measured and replaced if indicated. The management plan for the patient is influenced by the context in which calcium and PTH were measured. In this brief review we describe the assessment of a patient with normocalcaemic hyperparathyroidism.     

Antifungal Properties of Some Components of Senna Alata Flower

Antifungal activity of some components of Senna alata flower was examined against five fungi. The methanolic crude extract and the partially purified fractions were both active against standard strains of Aspergillus niger, Geotricum candidum, and Candida utilis, and local isolates of Aspergillus brevipes and Penicillium species, but at different concentrations. The minimum inhibitory concentration of the methanolic crude extract was low for all the fungal strains except Aspergillus niger with 5.0 mg/mL concentration, while the minimum inhibitory concentration of partially purified components (C and F) ranged between 0.312 mg/mL for extract F against Penicillium species and 2.5 mg/mL for extract C against Aspergillus niger, Penicillium species and Candida utilis. The minimum fungicidal concentration of the crude methanolic extract was generally higher than 5 mg/mL for most of the fungi but the partially purified extract exhibited fungicidal concentrations ranging from 2.5 mg/mL to 5.0 mg/mL. Antifungal properties against mycelial growth was also demonstrated by all the extracts against the tested strains, with the crude methanolic extract losing its activity after 48 hours. The partially purified Senna alata extracts exhibited a relatively high antifungal activity against mycelial growth with total suppression of sporulation for four days at a concentration of 2 mg/mL, while preventing fungal growth after the seventh day.     

Human prion diseases and the risk of their transmission during anatomical dissection

Prion diseases (or transmissible spongiform encephalopathies) are a unique group of fatal progressive neurodegenerative diseases of the central nervous system. The infectious agent is hypothesized to consist solely of a highly protease‐resistant misfolded isoform of the host prion protein. Prions display a remarkable degree of resistance to chemical and physical decontamination. Many common forms of decontamination or neutralization used in infection control are ineffective against prions, except chaotropic agents that specifically disrupt proteins. Human cadaveric prosection or dissection for the purposes of teaching and demonstration of human anatomy has a distinguished history and remains one of the fundamentals of medical education. Iatrogenic transmission of human prion diseases has been demonstrated from the inoculation or implantation of human tissues. Therefore, although the incidence of human prion diseases is rare, restrictions exist upon the use of tissues from patients reported with dementia, specifically the brain and other central nervous system material. A current concern is the potential for asymptomatic variant Creutzfeldt–Jakob disease transmission within the UK population. Therefore, despite the preventative measures, the transmission of prion disease through human tissues remains a potential risk to those working with these materials. In this review, we aim to summarize the current knowledge on human prion disease relevant to those working with human tissues in the context of anatomical dissection. Clin. Anat. 27:821–832, 2014. © 2014 Wiley Periodicals, Inc.     

Atrial Flutter Demonstrated by M-Mode Echocardiography

This report and images describe a case of atrial flutter with 2:1 conduction pattern in a 3 year-old male with d-TGA, ASD, and VSD status-post repair, which was demonstrated by M-mode echocardiography.     

When you see it,let it be: Urgency,mindfulness and adolescent substance use

The emotion-based domains of impulsivity, positive and negative urgency, are facets that have garnered attention due to their associations with substance use, and mindfulness based strategies have shown promise in reducing substance use in adults. The aim of the current study was to examine relations among urgency, mindfulness, and substance use in adolescence. Cross-sectional data were collected from students (N = 1,051) at a large, private high school in the Pacific Northwest. Both positive and negative urgency were uniquely associated with greater likelihood of lifetime and current alcohol use; only positive urgency predicted lifetime marijuana use. Mindfulness was associated with a lower likelihood of lifetime alcohol or marijuana use. Interactions between urgency and mindfulness were not supported. Our findings highlight the need to explore relations among baseline mindfulness, skills based mindfulness, and personality in adolescent alcohol and other drug use.