Piperacillin/tazobactam‐induced neurotoxicity in a hemodialysis patient: A case report

Antibiotics are potentially a cause of neurotoxicity in dialysis patients, the most common are the beta‐lactams as ceftazidime and cefepime, and few cases have been reported after piperacillin/tazobactam use. This report presents a case of a hypertensive and diabetic 67‐year‐old woman in regular hemodialysis, which previously had a stroke. She was hospitalized presenting pneumonia, which was initially treated with cefepime. Two days after treatment, she presented dysarthria, left hemiparesis, ataxia, and IX and X cranial nerves paresis. Computed tomography showed no acute lesions and cefepime neurotoxicity was hypothesized, and the antibiotic was replaced by piperacillin/tazobactam. The neurologic signs disappeared; however, 4 days after with piperacillin/tazobactam treatment, the neurological manifestations returned. A new computed tomography showed no new lesions, and the second antibiotic regimen withdrawn. After two hemodialysis sessions, the patient completely recovered from neurological manifestations. The patient presented sequentially neurotoxicity caused by two beta‐lactams antibiotics. This report meant to alert clinicians that these antibiotics have dangerous neurological effects in chronic kidney disease patients.     

“Ärztliche Freiheit und Berufsethos“ — Hängen ärztliche Berufsfreiheit und ärztliches Berufsethos zusammen?

Ohne Zusammenfassung     

Configurational and nonconfigurational interactions between odorants in binary mixtures.

Studies on odor mixture perception suggest that although odor components can often be identified in mixtures, mixtures can also give rise to novel perceptual qualities that are not present in the components. Using an olfactory habituation task, the authors evaluated how the perceptual similarity between components in a mixture affects the perceptual quality of the mixture itself. Rats perceived binary mixtures composed of similar components as different from their 2 components, whereas binary mixtures composed of dissimilar components were perceived as very similar to their components. Results show that for both types of mixtures, pretraining to Component A reduces subsequent learning about Component B in rats trained in the presence of A. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Magnetic force microscopy studies on the magnetic ordering in organic materials induced by high-energy proton irradiation

In this study, ferromagnetic microstructures in highly oriented pyrolytic graphite and superparamagnetic spots in polyimide foils were created by 2.25 MeV proton microbeam irradiation and characterized using atomic and magnetic force microscopy. For this purpose, graphite samples were irradiated with cross-like patterns of 15 μm × 15 μm size using ion fluences in the range of (0.003–2.5) × 10¹⁸ cm⁻². The irradiated crosses showed strong magnetic signals and a complex domain structure in the magnetic images depending on the geometrical dimensions of the crosses. Furthermore, polyimide foils were irradiated with microspots and fluences in the range of (0.016–3.1) × 10¹⁹ cm⁻². Magnetic force microscopy shows very strong phase shifts in these irradiated areas.     

Suitable test structures for submicron ion beam analysis

For the precise determination of the sizes of submicron beam spots test structures with an excellent edge definition are required. For this purpose a semiconductor heterostructure consisting of an 1.62 μm GaInP epi-layer grown on (0 0 1) GaAs has been made, which provides atomically sharp edges for beam spot size measurements. Since the sample has been thinned down by standard transmission electron microscope (TEM) preparation techniques, it can be used for both PIXE and STIM. The sample has been investigated with a TEM and the ion nanoprobe LIPSION. A one-dimensional beam profile in the low current mode was determined by a STIM measurement using 2 MeV protons and yielded a FWHM of (41±4) nm, which is the smallest value reported so far for high energy nuclear micro- and nanoprobes. Furthermore we present nickel nanowhiskers produced at the GSI Darmstadt by electrochemical preparation of etched ion track membranes that have been used to obtain two-dimensional images of the shapes of submicron beam spots. For these measurements a scan over a single nickel nanowhisker having a diameter of 220 nm and a height of about 6 μm was performed.     

Structure of metal site in Cd-substituted His117Gly mutant of azurin with and without addition of imidazole derivatives

The present work uses 111mCd-perturbed angular correlations of gamma-rays (PAC) to investigate the structure of the metal site of the His117Gly mutant of Pseudomonas aeruginosa azurin in aqueous solution and the effect on the structure upon addition of the following exogenous ligands: imidazole, 4-methyl imidazole, 1-methyl imidazole, 2-methyl imidazole and histidine. The nuclear quadrupole interaction of cadmium bound to the mutant without addition of exogenous ligands shows a strong pH dependence with three different nuclear quadrupole interactions consistent with two pKa values at about 7.2 and 8.6 at 2 degrees C. Addition of the imidazole derivatives resulted in a significant change in the PAC spectrum showing that they coordinate. This is in accordance with observations by EPR for the same mutant with copper at the metal site [den Blaauwen, T. & Canters, G. W. (1993) J. Am. Chem. Soc. 115, 1121-1129]. However, whereas EPR and ultraviolet/visual absorption show that the characteristics of the wild-type copper protein are regained by addition of the imidazole derivatives with the exception of the possible bidentates (histidine and histamine), the comparison of the PAC results to model calculations shows that the cadmium ion must be fourfold coordinated in most cases, probably binding an additional water or hydroxide ligand. A fourfold coordination is in contrast to cadmium-substituted wild-type azurin where PAC data inferred a threefold coordination by a Cys and two His residues [Danielsen, E. Bauer, R., Hemmingsen, L., Andersen. M., Bjerrum, M. J., Butz, T., Tr?ger, W., Canters, G. W., Hoitink, C. W. G., Karlsson, G., Hansson, O. & Messerschmidt, A. (1995) J. Biol. Chem. 270, 573-580]     

Innovation By Half-Measures in German Manufacturing

The Paper develops a critique of industrial restructuring measures from the perspective of social innovation theory. Three kinds of industrial restructure are discussed: business process re-engineering; computer-integrated manufacturing; and lean production. The paper argues that the dominant approaches to these restructuring initiatives are socially deficient in that they do not draw on the full potential of the workforce.