COVID-19 is presenting a colossal challenge to frontline NHS staff. This paper highlights how plastic surgery teams can use their diverse skills and resources in times of crisis. Through effective strategy and leadership we present how we are adapting as a department to serve our plastic surgery patients, other hospital teams and the Trust.
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Abstract Background Stroke volume (SV) and cardiac output (CO) are basic hemodynamic parameters which aid in targeting organ perfusion and oxygen delivery in critically ill patients with hemodynamic instability. While there are several methods for obtaining this data, the use of transthoracic echocardiography (TTE) is gaining acceptance among intensivists and emergency physicians. With TTE, there are several points that practitioners...
9h
Abstract Intra-aortic balloon counterpulsation (IAoBC) is a mechanical circulatory support device that has been used for more than 50 years, mainly for cardiogenic shock. Although its effect on mortality is controversial, IAoBC is still used in a wide variety of pre- and postoperative clinical settings in cardiac surgery centers. IAoBC has a complication rate of approximately 30%, mostly associated with problems during insertion and malpositioning. Thus, an insertion technique...
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Abstract The pandemic of COVID-19 is seriously challenging the medical organization in many parts of the world. This novel corona virus SARS-CoV-2 has a specific tropism for the low respiratory airways, but causes severe pneumonia in a low percentage of patients. However, the rapid spread of the infection during this pandemic is causing the need to hospitalize a high number of patients. Pneumonia in COVID-19 has peculiar features and can be studied by lung ultrasound in the early...
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Abstract Background The Hospital Pediatrico Universitario (HOPU) is the principal institution in Puerto Rico offering medical services to the children of the island and the Caribbean. There is limited use of point-of-care ultrasound (PoCUS) in their emergency department (ED) and obtaining an ultrasound through radiology is prohibitively time consuming. The objective of this study is to increase PoCUS knowledge and comfort by the...
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by Yoan Arribat, Dogan Grepper, Sylviane Lagarrigue, Timothy Qi, Sarah Cohen, Francesca Amati Lipid droplets (LD) are affected in multiple human disorders. These highly dynamic organelles are involved in many cellular roles. While their intracellular dispersion is crucial to ensure their function and other organelles-contact, underlying mechanisms are still unclear. Here we show that Spastin, one of the major proteins involved in Hereditary Spastic Paraplegia (HSP), controls LD dispersion. Spastin...
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The latest coronavirus news updated every day including coronavirus cases, the latest news, features and interviews from New Scientist and essential information about the covid-19 pandemic
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People from an ethnic minority are disproportionately affected by covid-19. Researchers say the reasons are rooted in existing social and healthcare inequalities
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Thousands of babies were born with severe brain damage after the 2015 Zika outbreak. New findings could tell us which therapies could help them most
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Strange orbits of distant space rocks have been used to infer that the solar system has an unseen ninth planet, but those orbits may be less strange than we thought, meaning there is no need for a new planet
12h
Mars could have had an ancient ocean in its northern hemisphere, and a large raft of volcanic rock may have floated across it to settle into mounds we can see today
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An aerial view of crabeater seals in Antarctica, mating damselflies and a twilight rocket launch were among the most lauded entries to the inaugural Nature TTL Photographer of the Year award
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Wednesday marks the 50th anniversary of Earth Day, often spoken of as the birth of the green movement. Denis Hayes helped coordinate the first event, and speaks to New Scientist about its impact
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The incredible benefits of strength training are only just becoming apparent. That's good timing, when working out indoors is beneficial to everyone's health
18h
An aerial view of crabeater seals in Antarctica, mating damselflies and a twilight rocket launch were among the most lauded entries to the inaugural Nature TTL Photographer of the Year award
20h
A phenotype is emerging for the proximal pair of G-dark bands in 11q (11q14.1 and q14.3) but not yet for the distal pair (11q22.1 and q22.3). A mother and daughter with the same directly transmitted 12.3-Mb interstitial deletion of 11q21q22.3 (GRCh37: 93,551,765-105,817,723) both had initial feeding difficulties and failure to thrive, speech delay, learning difficulties, and mild dysmorphism. Among 17 patients with overlapping deletions, developmental or speech delay, dysmorphism, hypotonia, intellectual...
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This scientific commentary refers to ‘Prognosis for patients with cognitive motor dissociation identified by brain-computer interface’, by Pan etal. (doi: 10.1093/brain/awaa026).
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This scientific commentary refers to ‘Electrographic predictors of successful weaning from anaesthetics in refractory status epilepticus’, by Rubin etal. (doi:10.1093/brain/awaa069).
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This scientific commentary refers to ‘Network localization of clinical, cognitive, and neuropsychiatric symptoms in Alzheimer’s disease’, by Tetreault etal. (doi:10.1093/brain/awaa058).
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Brain receives far more manuscript submissions than can reasonably be sent for formal peer review. Although the reasons for editorial rejection are diverse and include such factors as under-powered study design, limited conceptual novelty or remoteness from clinical translation, the motivation behind the authors’ work is rarely in doubt. Nevertheless, there remains a small number of submissions where the route to clinical application or to improved understanding of disease mechanisms is very difficult...
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This scientific commentary refers to ‘A catalogue of new incidence estimates of monogenic neurodevelopmental disorders caused by de novo variants’ by López-Rivera etal. (doi:10.1093/brain/awaa051).
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AbstractChronic disability in multiple sclerosis is linked to neuroaxonal degeneration. 4-aminopyridine (4-AP) is used and licensed as a symptomatic treatment to ameliorate ambulatory disability in multiple sclerosis. The presumed mode of action is via blockade of axonal voltage gated potassium channels, thereby enhancing conduction in demyelinated axons. In this study, we provide evidence that in addition to those symptomatic effects, 4-AP can prevent neuroaxonal loss in the CNS. Using in vivo optical...
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AbstractCongenital disorders of glycosylation are a growing group of rare genetic disorders caused by deficient protein and lipid glycosylation. Here, we report the clinical, biochemical, and molecular features of seven patients from four families with GALNT2-congenital disorder of glycosylation (GALNT2-CDG), an O-linked glycosylation disorder. GALNT2 encodes the Golgi-localized polypeptide N-acetyl-d-galactosamine-transferase 2 isoenzyme. GALNT2 is widely expressed in most cell types and directs...
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AbstractIntravenous third-line anaesthetic agents are typically titrated in refractory status epilepticus to achieve either seizure suppression or burst suppression on continuous EEG. However, the optimum treatment paradigm is unknown and little data exist to guide the withdrawal of anaesthetics in refractory status epilepticus. Premature withdrawal of anaesthetics risks the recurrence of seizures, whereas the prolonged use of anaesthetics increases the risk of treatment-associated adverse effects....
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AbstractHuman episodic memory critically depends on subregions of the medial temporal lobe, which are part of functional brain systems such as the anterior-temporal and the posterior-medial system. Here we analysed how Alzheimer’s pathology affects functional connectivity within these systems. Data from 256 amyloid-β-negative cognitively unimpaired, 103 amyloid-β-positive cognitively unimpaired, and 83 amyloid-β-positive individuals with mild cognitive impairment were analysed. Amyloid-β and tau...
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The Arc de Siècle: functional neurological disorder during the ‘forgotten’ years of the 20th century
Using archived records, plus oral histories from retired neurologists, Fend et al. examine attitudes to functional neurological disorders in the mid-20th century. While frequently scathing in their correspondence, most neurologists of the time adopted a pragmatic approach with many referring patients to psychiatrists.
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AbstractIt is well established that chronic cognitive problems after traumatic brain injury relate to diffuse axonal injury and the consequent widespread disruption of brain connectivity. However, the pattern of diffuse axonal injury varies between patients and they have a correspondingly heterogeneous profile of cognitive deficits. This heterogeneity is poorly understood, presenting a non-trivial challenge for prognostication and treatment. Prominent amongst cognitive problems are deficits in working...
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AbstractFrontotemporal dysconnectivity is a key pathology in schizophrenia. The specific nature of this dysconnectivity is unknown, but animal models imply dysfunctional theta phase coupling between hippocampus and medial prefrontal cortex (mPFC). We tested this hypothesis by examining neural dynamics in 18 participants with a schizophrenia diagnosis, both medicated and unmedicated; and 26 age, sex and IQ matched control subjects. All participants completed two tasks known to elicit hippocampal-prefrontal...
11h
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In the summer of 2018, Charlotte Caldwell was stopped at Heathrow airport for attempting to bring a full-extract cannabis oil into the UK. The oil was intended for her son, Billy, who has a rare form of epilepsy called Dravet syndrome. But because all use of full-extract cannabis oils was illegal in the UK at the time, Caldwell’s oil was confiscated when she tried to declare it. Billy’s seizures worsened and he was eventually hospitalized, triggering widespread calls for him to be allowed access...
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AbstractCSF biomarkers, including total-tau, neurofilament light chain (NfL) and amyloid-β, are increasingly being used to define and stage Alzheimer’s disease. These biomarkers can be measured more quickly and less invasively in plasma and may provide important information for early diagnosis of Alzheimer’s disease. We used stored plasma samples and clinical data obtained from 4444 non-demented participants in the Rotterdam study at baseline (between 2002 and 2005) and during follow-up until January...
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AbstractPatients with visual snow syndrome suffer from a continuous pan-field visual disturbance, additional visual symptoms, tinnitus, and non-perceptional symptoms. The pathophysiology of visual symptoms might involve dysfunctional visual cortex. So far, the extra-visual system has not been investigated. We aimed at identifying structural and functional correlates for visual and non-visual symptoms in visual snow syndrome. Patients were compared to age- and sex-matched controls using 18F-2-fluoro-2-deoxy-d-glucose...
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AbstractRecently, the genetic variability in lysosomal storage disorders has been implicated in the pathogenesis of Parkinson’s disease. Here, we found that variants in prosaposin (PSAP), a rare causative gene of various types of lysosomal storage disorders, are linked to Parkinson’s disease. Genetic mutation screening revealed three pathogenic mutations in the saposin D domain of PSAP from three families with autosomal dominant Parkinson’s disease. Whole-exome sequencing revealed no other variants...
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