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Long QT syndrome (LQTS) can present with syncope and seizure-like activity in the setting of torsades de pointes (TdP) with hemodynamic instability. Electrolyte abnormalities and medications can predispose to TdP in the setting of latent LQTS. An implantable cardioverter defibrillator (ICD) is needed if patients with TdP continue to be symptomatic despite medical treatment. We report a case of a patient who presented with seizures and was found to have prolonged corrected QT interval (QTc). During her admission, she was treated with ondansetron. She went into torsades de pointes and continued to have prolonged QTc. She underwent implantable cardioverter defibrillator (ICD) placement and remains asymptomatic to date.

No description available.

No description available.

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No description available.

Den svenska narkotikamarknaden är mer omfattande än vad som tidigare bedömts. Majoriteten av cannabisen som konsumeras i Sverige är insmugglad och är den substans som brukas mest globalt. Trots Covid-19 pandemin med tillhörande restriktioner, har både användningen och smugglingen varit fortsatt hög. Tidigare forskning har indikerat att sambandet mellan cannabisanvändningen och cannabissmugglingen inte är enkelriktad. Såväl som en ökad cannabisanvändning kan leda till en ökad smuggling, kan även en ökad smuggling leda till en ökad användning. Den kriminologiska forskningen på ämnet är dock fortfarande begränsad, där inga studier är genomförda i en svensk kontext. Det är därför av vikt att inrikta mer kriminologisk relevant forskning på de två narkotikamarknaderna i Sverige. Föreliggande studie syftar därför till att undersöka och bidra med djupare förståelse för förhållandet mellan cannabissmugglingen och cannabisanvändningen med förhoppningen att förbättra det brottsförebyggande arbetet. Studiens syfte och frågeställningar har besvarats genom semistrukturerade intervjuer, Tullverkets beslagsstatistik samt självrapporterad cannabisanvändning från Folkhälsomyndigheten. Resultatet indikerade på att både användningen och smugglingen av cannabis har ökat från år 2008-2020. Den ökade användningen berodde på en minskad riskuppfattning och positiva attityder bland allmänheten, där legaliseringen av cannabisbruket runt om i världen har ansetts vara bidragande. Genom intervjuerna kunde ett ömsesidigt förhållande mellan narkotikamarknaderna fastställas. Allmänhetens cannabisanvändning motiverar kriminella grupper att bedriva smugglingen av cannabis. Samtidigt som cannabissmugglingen leder till att cannabis görs tillgängligt i landet, vilket ökar användningen av drogen. Vidare anses en kombination av både social och situationell prevention vara betydelsefull för ett framgångsrikt preventivt arbete mot smugglingen och användningen av cannabis. Resultat från denna studie kan därmed användas för att utforma åtgärder som kan implementeras och riktas mot både cannabissmugglingen och cannabisanvändningen. / The Swedish drug market is more extensive than previously assessed. The majority of the drugs consumed in Sweden are trafficked from other countries and cannabis is the most used substance globally. Despite the Covid-19 pandemic with associated restrictions, both use of cannabis and smuggling of cannabis have remained high. Previous research has indicated that the link between cannabis use and cannabis smuggling is not one-sided. As well as an increase in cannabis use can lead to an increase in smuggling, an increase in smuggling can also lead to an increase in use. However, criminological research on the subject is still limited, where no studies have been conducted in a Swedish context. It is therefore of importance to focus more criminologically relevant research on the two drug markets in Sweden. The present study therefore aims to research and contribute to a deeper understanding of the relationship between cannabis smuggling and cannabis use with the hope of improving crime prevention work. The methods used in this study consist of semi-structured interviews, the Swedish Customs’ seizure statistics and self-reported cannabis use from the Swedish Public Health Agency. The results indicated that both the use as well as the smuggling of cannabis has increased from 2008-2020. The increased use is due to a reduced risk perception and positive attitudes, where legalization around the world has been considered a contributing factor. Through the interviews, a reciprocal relationship between cannabis smuggling and cannabis use could be established. Increased cannabis use encourages criminal groups to smuggle cannabis. Simultaneously, cannabis smuggling increases availability in the country, which in turn leads to higher usage. Furthermore, a combination of social and situational prevention is considered important for successful preventative work against smuggling and use of cannabis.  Results from this study can thus be used to design measures that can be implemented and directed at both markets.

<p dir="ltr">Seizure involves a sudden, uncontrolled electrical disturbance of the brain due to many different causes apart from epilepsy, for example, high fever, low level of blood sugar, alcohol withdrawal, and many more, including the infections in the brain. In fact, epilepsy is a group of chronic neurological disorders characterized by recurrent unprovoked sudden-onset seizures. It stands as one of the prevalent brain disorders globally, impacting over 70 million individuals. The origins of epilepsy are multifaceted, coming from a mix of genetic and environmental factors including genetic predispositions, brain-related conditions (like tumors or strokes), infectious diseases, and traumatic brain injuries. Seizures can be partly referred to the dysregulation of ion channels, including voltage-gated sodium channels which will impact the action potential (electrical impulses that are responsible for the communication that takes place between neurons in the brain). These voltage-gated sodium channels mediate the depolarization responsible for the generation and conduction of action potentials. They are crucial in the generation and continuous electrical signals of the tissues that respond rapidly, like the neurons, and thus forming part of their function. In epilepsy, therefore, it is relevant to that domain in which abnormal functions of these sodium channels come up. Any change or dysfunction of these channels affect the excitability of the neurons themselves, with the consequence that an increased probability occurs in which abnormal electrical activity can be generated, hence the convulsions. Voltage-gated sodium channels are made up of large transmembrane proteins, having a single alpha subunit and related beta subunits. The beta subunit is an auxiliary protein that modulates channel gating, kinetics, surface expression, and the unique resurgent current, thereby influencing neuronal excitability and signaling. Resurgent currents represent a kind of current that can develop during action potential repolarization. They are characterized by a resurgent sodium current, the current which follows the initial sodium inflow in depolarization. Resurgent sodium currents are characterized by a rebound increase in sodium current during the repolarization phase of the action potential. Unlike the classic transient sodium current that inactivates rapidly upon membrane depolarization, the resurgent current is facilitated by the partial block and unblock of the sodium 17 channel pore by the β subunit or other intracellular molecules during the repolarization phase. This allows sodium ions to flow into the cell when this blockage removed before it goes to closed state. It is believed widely to be of keen importance in neuronal excitability. The role of resurgent currents in epilepsy is likely genetically influenced with some environmental influence. Genetic mutations and dysregulation of the gene code for voltage-gated sodium channels, especially those related to beta subunits, can be linked to some atypical resurgent current. This increases the chance of having a seizure, which could develop into epilepsy. Four beta subunits have been identified up to now. As such, my investigation will focus on the beta 4 subunit and its possible involvement in increased susceptibility to seizures. My study will involve a genetically modified mouse β4 knockout (K.O) of the voltage-gated sodium channel, which will be compared with a wild type (WT) mouse model. To facilitate this comparison, I will prepare cortical brain slices from both the genetically modified and WT mice using a (Leica VT1200s vibratome). These slices will then be analyzed with multi-electrode arrays to detect electrical activity and measure the neurons' electrical responses. Additionally, I use 4- Aminopyridine, a potassium channel blocker, to stimulate electrical activity in the neurons and brain slices. Using the methodology outlined above, I aimed to investigate the ability to induce and measure neuronal activity in the β4 K.O mouse model. This involved comparing the neuronal activity between the β4 K.O and WT mice in terms of frequency and amplitude. The analysis of the recorded data was performed using Spike2 software, in conjunction with the multi-electrode array recordings. Furthermore, I explored whether variations in temperature (body temp vs 40℃) affect neuronal activity differently in β4 K.O compared to WT mice. In conclusion, my observations revealed that neuronal activity could indeed be induced in the β4 K.O mice, with a noted decrease in the frequency of this activity compared to WT mice, but an increase in amplitude. These outcomes were consistent at both normal body temperature and at an elevated temperature of 40°C, as analyzed using Spike2 software. However, when conducting a statistical analysis using a two-way ANOVA to compare between the β4 K.O and WT mice, and between body temperature and 40°C conditions, no significant differences were observed. Despite this, it is a general observation and conclusion that β4 K.O mice exhibit altered neuronal activity 18 compared to WT mice. To gain a deeper understanding of the role of the β4 subunit on the alpha subunit of the voltage-gated sodium channel, adopting alternative methods such as patch clamp techniques or in vivo studies with intracranial electrodes may be beneficial. This suggestion comes considering various challenges and limitations encountered during my study, such as maintaining the viability of the slices for extended periods and minimizing noise in multi-electrode array (MEA) recordings. Mutations of β-subunit-encoding genes have been associated with such a wide array of debilitating diseases that include epilepsy, cancer, neuropathic pain, and febrile seizures, to some of the most prevalent conditions in neurodegeneration. Further study will be needed to better understand the biology of these important proteins and their potential for use as new targets for several disease states. Even so, the role of β4 remains somewhat controversial.</p>

In October 2001 , President George W. Bush issued an executive order authorizing the National Security Agency (NSA) to conduct secret wiretapping of telephone communications between U.S. citizens and terrorist suspects overseas in the wake of the September 11th terrorist attacks. The program, later called the Terrorist Surveillance Program (TSP), remained secret until December 2005, when the New York Times revealed the existence of the TSP. In January 2006, the American Civil Liberties Union (ACLU) filed suit in the United States District Court for the Eastern District of Michigan, claiming that the NSA's surveillance program violated the First and Fourth Amendments of the U.S. Constitution, as well as the separation of powers doctrine. The government argued that the program met constitutional scrutiny under the "special needs" doctrine warrant exception. Additionally, the Bush administration asserted that Congress specifically gave the President permission to authorize the program by its passing the Authorization for Use of Military Force (AUMF). This thesis analyzes the constitutionality of the domestic surveillance program by discussing the constitutional questions that the NSA's program elicits under the Fourth Amendment. Also, this thesis reviews the legality of the TSP under the Foreign Intelligence Surveillance Act (FISA). After an analysis of the Supreme Court's jurisprudence in Fourth Amendment, privacy, and eavesdropping cases, this thesis concludes that the NSA' s warrantless eavesdropping program most likely violates the Fourth Amendment and the separation of powers doctrine. Further, this thesis asserts that the TSP is illegal under the FISA and that the Executive lacks statutory authorization.

This dissertation explores the role of brainstem structures in the development and expression of generalized tonic-clonic seizures. The functional consequences of brainstem seizures are investigated using the kindling paradigm in order to understand the behavioral and cognitive effects of generalized seizures. <BR><BR> I begin by investigating the general characteristics of brainstem kindling. The first experiment demonstrates that certain brainstem sites are indeed susceptible to kindling and begins to delineate the features that distinguish brainstem seizures from those evoked at other brain regions. Further investigation of the EEG signal features using wavelet analysis reveals that changes in the spectral properties of the electrographic activity during kindling include significant changes to high-frequency activity and organized low-frequency activity. I also identify transitions that include frequency sweeps and abrupt seizure terminations. The changing spectral features are shown to be critically associated with the evolution of the kindled seizures and may have important functional consequences. The surprising responsiveness of some brainstem structures to kindling forces us to reconsider the overall role of these structures in epileptogenesis as well as in the healthy dynamical functioning of the brain. <BR><BR> In order to study the functional consequences, a series of experiments examines the changes in behavior, cognition and affect that follow these brainstem seizures. Although the results show no effects on spatial learning or memory, there are significant and complex effects on anxiety- and depression-like behavior that appear to be related to motivation. In order to further study the cognitive effects, a second set of behavioral experiments considers how context (i.e., the environment) interacts with the behavioral changes. The results indicate that changes in affect may only be apparent when choice between seizure-related and seizure-free contexts is given, suggesting that the environment and choice can play key roles in the behavioral consequences of seizures. This thesis also includes an appendix that applies synchrotron imaging to investigate the anatomical consequences of electrode implantation in kindling and shows that significantly increased iron depositions occur even with purportedly biocompatible electrodes widely used in research and clinical settings. <BR><BR> Examination of the role of brainstem structures in generalized seizures in this dissertation offers new perspectives and insights to epileptogenesis and the behavioral effects of epilepsy. The changes in EEG features, behavior, affect and motivation observed after brainstem seizures and kindling may have important clinical implications. For example, the results suggest a need to reexamine the concept of psychogenic seizures, a potential connection to Sudden Unexplained Death in Epilepsy (SUDEP), and the contribution of environmental factors. It is hoped that these findings will help elucidate the complex issues involved in understanding and improving the quality of life for people with epilepsy.