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 A new computed tomography showed no new lesions, and the second antibiotic regimen withdrawn.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)     

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.     

IV. Referate

Ohne Zusammenfassung     

Artificial added mass instabilities in sequential staggered coupling of nonlinear structures and incompressible viscous flows

Within this paper the so-called artificial added mass effect is investigated which is responsible for devastating instabilities within sequentially staggered Fluid-structure Interaction (FSI) simulations where incompressible fluids are considered.A discrete representation of the added mass operator M_A is given and ‘instability conditions’ are evaluated for different temporal discretisation schemes. It is proven that for every sequentially staggered scheme and given spatial discretisation of a problem, a mass ratio between fluid and structural mass density can be found at which the coupled system becomes unstable. The analysis is quite general and does not depend upon the particular spatial discretisation schemes used. However here special attention is given to stabilised finite elements employed on the fluid partition. Numerical investigations further highlight the results.     

Improved Accuracy of High-Order WENO Finite Volume Methods on Cartesian Grids

We propose a simple modification of standard weighted essentially non-oscillatory (WENO) finite volume methods for Cartesian grids, which retains the full spatial order of accuracy of the one-dimensional discretization when applied to nonlinear multidimensional systems of conservation laws. We derive formulas, which allow us to compute high-order accurate point values of the conserved quantities at grid cell interfaces. Using those point values, we can compute a high-order flux at the center of a grid cell interface. Finally, we use those point values to compute high-order accurate averaged fluxes at cell interfaces as needed by a finite volume method. The method is described in detail for the two-dimensional Euler equations of gas dynamics. An extension to the three-dimensional case as well as to other nonlinear systems of conservation laws in divergence form is straightforward. Furthermore, similar ideas can be used to improve the accuracy of WENO type methods for hyperbolic systems which are not in divergence form. Several test computations confirm the high-order accuracy for smooth nonlinear problems.