Autophagy,mitochondria and 3-nitropropionic acid joined in the same model

Huntington''s disease (HD) is a neurodegenerative disorder caused by a mutation in the gene encoding the huntingtin protein. Although the precise mechanism by which neuronal degeneration occurs is still unclear, several elements are important to its development: (1) altered gene expression and protein synthesis, (2) mitochondrial damage and (3) improper regulation of the autophagy programme. In this issue of British Journal of Pharmacology, Galindo and co-workers provide the first evidence for a role of the mitochondrial permeability transition pore (mPTP) in mitochondrial fragmentation and autophagy activation. In a model of cell death induced by 3-nitropropionic acid (3-NP) in human neural cells, the authors describe clear functions for mPTP and Bax, but not the mitochondrial fusion/fission machinery, mitochondrial fragmentation and autophagy (mitophagy). This commentary summarises the significance of this relationship and suggests several points for future development.     

Pregnant intravenous drug user tricuspid valve infective endocarditis treated with a successful simultaneous valve replacement and Cesarean section

A 30‐year‐old female patient known to be an intravenous drug user (IVDU) was admitted to Bajcsy‐Zsilinszky Hospital Cardiology Intensive Care Unit at 29‐week gestation with severe sepsis and right heart failure. She had methicillin‐sensitive Staphylococcus aureus on blood culture. Echocardiography confirmed the diagnosis of tricuspid valve infective endocarditis (IE). She had acute deterioration and hemodynamic instability for which an emergency tricuspid valve replacement (TVR) with a simultaneous Cesarean section (CS) was performed simultaneously. Medical management is the standard treatment in IE of IVDU pregnant patients, but in case of life‐threatening complications, emergency TVR and CS are to be considered. This is the first reported case of IVDU IE treated with simultaneous TVR and CS.     

Within a Hospital Setting

A psychoanalyst may function as an enlivening object, to awaken the growth of relatedness in patients whose curtailed object relations confine them to primitive forms of engagement. The model is informed by the insights of the child psychoanalytic psychotherapist Anne Alvarez in her treatment of disturbed youth. The idea of the analyst in an enlivening role is viewed within a contemporary context of expanded perspectives on the analyst's role and evolving notions of therapeutic action.     

Protracted neurocardiogenic reaction

Vasovagal reactions following catheterization procedures are relatively common complications, mostly in their milder forms. We present a case report of a young male undergoing selective coronarography with a dramatic postprocedural course including haemodynamic instability, and especially very late normalization of the neurological status.