BrainStem encephalitis associated with chandipura in Andhra Pradesh outbreak

Clinical data of 104 hospitalized children during the 2003 epidemic of encephalitis in Andhra Pradesh state was retrospectively analysed to know the clinical profile and risk factors associated with mortality. Fever was the first symptom associated with altered sensorium, seizures, diarrhoea and vomiting. Evolution of illness was very rapid with high fatality (47%). Majority of deaths occurred within the first 24 h of illness due to brainstem involvement. On multiple logistic regression analysis, high-grade fever, absent oculocephalic reflex and Glasgow coma score <7 were found to be significantly contributing to the mortality. Evidence of Chandipura virus was detected in these cases as the etiological agent.     

Acanthosis nigricans associated with transitional cell carcinoma of the urinary bladder

An elderly man from the region of Ladakh presented with recurrent episodes of lower respiratory tract infection, rapidly progressive Acanthosis nigricans, Acanthosis palmaris and plantar keratoderma. Detailed investigations revealed underlying metastatic transitional cell carcinoma of the bladder. This case is being reported for its rarity in the literature.     

Complications After Preterm Birth: An Overview for Emergency Physicians

Neonatal intensive care unit graduates may have one or more unresolved morbidity at the time of their discharge from the NICU and may require care from multiple subspecialists. They remain at high risk for visits to the ED and subsequent rehospitalization. These infants, with their unique set of morbidities, may offer an unusual challenge and may overwhelm an ED physician unfamiliar with the various complications after preterm birth. We hope that this article will provide ED physicians with a basic understanding of some of these common complications after preterm birth.     

Test–retest reliability of the multifocal photopic negative response

Purpose

To assess the test–retest reliability of the multifocal photopic negative response (mfPhNR) of normal human subjects.

Methods

Multifocal electroretinograms were recorded from one eye of 61 healthy adult subjects on two separate days using a Visual Evoked Response Imaging System software version 4.3 (EDI, San Mateo, California). The visual stimulus delivered on a 75-Hz monitor consisted of seven equal-sized hexagons each subtending 12° of visual angle. The m-step exponent was 9, and the m-sequence was slowed to include at least 30 blank frames after each flash. Only the first slice of the first-order kernel was analyzed. The mfPhNR amplitude was measured at a fixed time in the trough from baseline (BT) as well as at the same fixed time in the trough from the preceding b-wave peak (PT). Additionally, we also analyzed BT normalized either to PT (BT/PT) or to the b-wave amplitude (BT/b-wave). The relative reliability of test–retest differences for each test location was estimated by the Wilcoxon matched-pair signed-rank test and intraclass correlation coefficients (ICC). Absolute test–retest reliability was estimated by Bland–Altman analysis.

Results

The test–retest amplitude differences for neither of the two measurement techniques were statistically significant as determined by Wilcoxon matched-pair signed-rank test. PT measurements showed greater ICC values than BT amplitude measurements for all test locations. For each measurement technique, the ICC value of the macular response was greater than that of the surrounding locations. The mean test–retest difference was close to zero for both techniques at each of the test locations, and while the coefficient of reliability (COR—1.96 times the standard deviation of the test–retest difference) was comparable for the two techniques at each test location when expressed in nanovolts, the %COR (COR normalized to the mean test and retest amplitudes) was superior for PT than BT measurements. The ICC and COR were comparable for the BT/PT and BT/b-wave ratios and were better than the ICC and COR for BT but worse than PT.

Conclusion

mfPhNR amplitude measured at a fixed time in the trough from the preceding b-wave peak (PT) shows greater test–retest reliability when compared to amplitude measurement from baseline (BT) or BT amplitude normalized to either the PT or b-wave amplitudes.

     

Access to Cancer Specialist Care and Treatment in Patients With Advanced Stage Lung Cancer

Background

Access to specialty care is critical for patients with advanced stage lung cancer. This study assessed access to cancer specialists and cancer treatment in a broad population of patients with advanced stage lung cancer.

Somatostatin neurons control an alcohol binge drinking prelimbic microcircuit in mice

Somatostatin (SST) neurons have been implicated in a variety of neuropsychiatric disorders such as depression and anxiety, but their role in substance use disorders, including alcohol use disorder (AUD), is not fully characterized. Here, we found that repeated cycles of alcohol binge drinking via the Drinking-in-the-Dark (DID) model led to hypoactivity of SST neurons in the prelimbic (PL) cortex by diminishing their action potential firing capacity and excitatory/inhibitory transmission dynamic. We examined their role in regulating alcohol consumption via bidirectional chemogenetic manipulation. Both hM3Dq-induced excitation and KORD-induced silencing of PL SST neurons reduced alcohol binge drinking in males and females, with no effect on sucrose consumption. Alcohol binge drinking disinhibited pyramidal neurons by augmenting SST neurons-mediated GABA release and synaptic strength onto other GABAergic populations and reducing spontaneous inhibitory transmission onto pyramidal neurons. Pyramidal neurons additionally displayed increased intrinsic excitability. Direct inhibition of PL pyramidal neurons via hM4Di was sufficient to reduce alcohol binge drinking. Together these data revealed an SST-mediated microcircuit in the PL that modulates the inhibitory dynamics of pyramidal neurons, a major source of output to subcortical targets to drive reward-seeking behaviors and emotional response.Subject terms: Cellular neuroscience, Addiction     

Homocysteine,Alcoholism, and Its Potential Epigenetic Mechanism

Alcohol is the most socially accepted addictive drug. Alcohol consumption is associated with some health problems such as neurological, cognitive, behavioral deficits, cancer, heart, and liver disease. Mechanisms of alcohol‐induced toxicity are presently not yet clear. One of the mechanisms underlying alcohol toxicity has to do with its interaction with amino acid homocysteine (Hcy), which has been linked with brain neurotoxicity. Elevated Hcy impairs with various physiological mechanisms in the body, especially metabolic pathways. Hcy metabolism is predominantly controlled by epigenetic regulation such as DNA methylation, histone modifications, and acetylation. An alteration in these processes leads to epigenetic modification. Therefore, in this review, we summarize the role of Hcy metabolism abnormalities in alcohol‐induced toxicity with epigenetic adaptation and their influences on cerebrovascular pathology.