In-vitro performance of a single-chambered total artificial heart in a Fontan circulation

Journal of Artificial Organs - An in-vitro study was conducted to investigate the general feasibility of using only one pumping chamber of the SynCardia total artificial heart (TAH) as a...     

Accuracy of portable quantitative capnometers and capnographs under prehospital conditions

This study was designed to assess the pCO(2) accuracy of portable mainstream (Tidal Wave, Novametrix; Propaq 106, Protocol) and sidestream capnometers (Capnocheck 8200, BCI; Capnocount mini, Weinmann; NPB-75, Nellcor Puritan Bennett; SC-210, Pryon) with respect to international standards and preclinical emergency conditions. Measurements were performed under temperature conditions of +22 degrees C and -20 degrees C using dry gas mixtures with different CO(2) concentrations (STPD) and in patients ventilated with pure oxygen (BTPS). Accuracy presented to be between +1% (Capnocheck) and +12% (Propaq) (STPD) and between -0.4% (Capnocheck) and +11% (Tidal Wave) (BTPS). The measurements were affected by low ambient temperature only in the NPB-75 (+15%). Our results indicate that portable quantitative capnometers are able to fulfill accuracy requirements as requested by international standards but can be affected by changing ambient temperatures.     

The link between childhood trauma and dissociation in frequent users of classic psychedelics and dissociatives

Background: Childhood trauma severity is associated with the level of subsequent substance use as well as with the self-reported severity of dissociation. Classic psychedelics and dissociatives target neurotransmitter systems thought to be involved in the onset of dissociative symptoms and may evoke severe and long-lasting symptoms of depersonalization in some users. However, it is currently unclear whether drug use puts people with a history of childhood trauma at higher risk of developing dissociative symptoms.

Objectives: The current study investigates whether the one-year prevalence of substance use significantly moderates the link between childhood trauma and the severity of depersonalization.

Methods: Participants (n = 297, of which 80.2% were active users) filled out an online self-report questionnaire including the Childhood Trauma Questionnaire (CTQ), the Cambridge Depersonalisation Scale (CDS), and information about their substance use.

Results: Results indicate that childhood trauma and substance use are significant individual predictors of dissociation scores in this sample, but no moderation of substance use on the link between childhood trauma and depersonalization was established.

Conclusions: It is hypothesized that the quality (particularly the context) of the experience of substance use rather than the sheer quantity may be responsible for the manifestation of depersonalization.     

Substitution Urethroplasty with Closure Versus Nonclosure of the Buccal Mucosa Graft Harvest Site: A Randomized Controlled Trial with a Detailed Analysis of Oral Pain and Morbidity

Background

Optimal surgical management of the buccal mucosa harvest site in patients with urethral stricture disease during buccal mucosa graft urethroplasty (BMGU) remains controversial.

Immunophenotypic characterization of peripheral B cells. During short-term immunotherapy with tree pollen allergoid and the immunoadjuvant monophosphoryl lipid A.

The effects of immunotherapy (IT) on the activation and functions of B cells are not well described yet. We therefore measured the expression of several surface markers on peripheral B cells during short-term IT. Twelve patients with seasonal allergic rhinoconjunctivitis, sensitized to hazel, alder, and birch pollen proven by positive history, skin test, sIgE, and nasal provocation test, were included in the study. Eight patients received short-term IT with TA tree pollen and the immunoadjuvant monophosphoryl Lipid A; 4 patients received a placebo suspension containing 2% tyrosine. After separation of PBMCs, the expression of surface molecules on peripheral B cells were analyzed by flow cytometry before the start of IT, before the 3rd injection, at the end of IT, and after the pollen season. The expression of CD23, CD54, and HLA-DR-II on CD19+ B cells decreased during IT and then increased again after the pollen season. In the placebo group, the expression of CD23, CD54, and HLA-DR-II remained unchanged during the first three measurements. After the season, the expression of CD23, CD54 and HLA-DR-II increased in both groups. CD86 expression was decreased during treatment in both groups. Although CD86 expression increased in both groups after the season, the increase was more pronounced in the placebo group. No changes in the expression of CD32, CD40, and HLA-ABC-I were registered during the study. The results show that expression of CD23, CD54, and HLA-DR-II on peripheral B cells decreases during IT, which indicates reduced B-cell activation. Whether these effects are a result of direct allergen action on the B cells or whether they are mediated by T cells and their clinical relevance remains to be elucidated.     

A novel missense mutation in a neonate with nonketotic hyperglycinemia

Nonketotic hyperglycinemia (OMIM #605899), also known as glycine encephalopathy, is an autosomal recessive disorder of glycine metabolism caused by a defect in the glycine cleavage system. A term neonate developed progressive lethargy, muscular hypotonia, and respiratory insufficiency on day 2 after birth, but no overt clinical seizures. Amplitude-integrated electroencephalography indicated a continuous burst-suppression pattern. The diagnosis of nonketotic hyperglycinemia was made biochemically and was confirmed by genetic studies, which revealed two missense mutations (one not previously described) within the glycine decarboxylase gene, GLDC. Nonketotic hyperglycinemia should be incorporated into the differential diagnosis of neonatal hypotonia, to avoid an erroneous diagnosis of sepsis or hypoxic ischemic injury. Amplitude-integrated electroencephalography may be helpful in the initial assessment of severely sick and hypotonic neonates without overt clinical seizures, and may direct further diagnostic evaluation.