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 A new computed tomography showed no new lesions, and the second antibiotic regimen withdrawn.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

Whole-body kinetics and dosimetry of L-3--123I-iodo-alpha-methyltyrosine

BACKGROUND: Desflurane anesthesia can produce cerebral metabolic depression and increase cerebral blood flow. We evaluated the effect of desflurane on brain tissue oxygen pressure (PO2), carbon dioxide pressure (PCO2) and pH during neurosurgery. METHODS: Following a craniotomy, the dura was opened and a Paratrend 7 sensor, which measures PO2, PCO2, pH and temperature, was inserted into brain tissue. In 6 control patients in group 1, anesthesia was maintained constant with 3% end-tidal desflurane over 60 min, including a 30-min stabilization period. In group 2, 9 patients were ventilated with 3% desflurane under baseline conditions. After a 30-min stabilization period, baseline tissue gases and pH were measured and end-tidal desflurane was increased to 6% and then 9% for 15-min intervals. Mean arterial pressure (MAP) was maintained with intravenous phenylephrine. RESULTS: Under baseline conditions, cardiovascular and brain tissue measures were similar between the 2 groups. Increasing end-tidal desflurane from 3% to 9% produced burst-suppression EEG in all patients and significantly increased tissue PO2 and pH and decreased PCO2. No parameters changed significantly in the control group during steady-state anesthesia. CONCLUSION: These results show that 9% desflurane can improve brain tissue metabolic status before temporary brain artery occlusion if cerebral perfusion pressure is maintained. This may be particularly important in patients with symptoms of ischemia before surgery.     

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.     

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.     

Tree-based partitioning of date for association rule mining

The most computationally demanding aspect of Association Rule Mining is the identification and counting of support of the frequent sets of items that occur together sufficiently often to be the basis of potentially interesting rules. The task increases in difficulty with the scale of the data and also with its density. The greatest challenge is posed by data that is too large to be contained in primary memory, especially when high data density and/or low support thresholds give rise to very large numbers of candidates that must be counted. In this paper, we consider strategies for partitioning the data to deal effectively with such cases. We describe a partitioning approach which organises the data into tree structures that can be processed independently. We present experimental results that show the method scales well for increasing dimensions of data and performs significantly better than alternatives, especially when dealing with dense data and low support thresholds. Shakil Ahmed received a first class BSc (Hons) degree from Dhaka University, Bangladesh, in 1990; and an MSc (first class), also Dhaka University, in 1992. He received his PhD from The University of Liverpool, UK, in 2005. From 2000 onwards he is a member of the Data Mining Group at the Department of Computer Science of the University of Liverpool, UK. His research interests include data mining, Association Rule Mining and pattern recognition. Frans Coenen has been working in the field of Data Mining for many years and has written widely on the subject. He received his PhD from Liverpool Polytechnic in 1989, after which he took up a post as a RA within the Department of Computer Science at the University of Liverpool. In 1997, he took up a lecturing post within the same department. His current Data Mining research interests include Association rule Mining, Classification algorithms and text mining. He is on the programme committee for ICDM'05 and was the chair for the UK KDD symposium (UKKDD'05). Paul Leng is professor of e-Learning at the University of Liverpool and director of the e-Learning Unit, which is responsible for overseeing the University's online degree programmes, leading to degrees of MSc in IT and MBA. Along with e-Learning, his main research interests are in Data Mining, especially in methods of discovering Association Rules. In collaboration with Frans Coenen, he has developed efficient new algorithms for finding frequent sets and is exploring applications in text mining and classification.