A Case of Abulia From Left Middle Cerebral Artery Stroke in an Adolescent Treated Successfully With Short Duration Olanzapine.

INTRODUCTION: Abulia is defined as a pathological state of amotivation, apathy, and global absence of willpower. It presents with a challenging array of overlapping symptoms, making effective identification and treatment difficult. CASE PRESENTATION: We describe the first known report of an adolescent with a ventricular assist device who developed abulia following a left middle cerebral artery (MCA) stroke who responded successfully to treatment with olanzapine. DISCUSSION: The neurobiological etiology of abulia is still unclear but is postulated to be related to deficits in the dopaminergic reward circuitry in the frontal-subcortical-mesolimbic regions. There have been reports of poststroke patients with abulia being treated by modulating this dopamine circuitry and in some cases with short-term low-dose olanzapine. CONCLUSION: Further research is needed to develop a better understanding of the pathophysiology of abulia leading to more effective treatment algorithms including more specific diagnostic tools and effective pharmacological interventions.

'The Plastic Nile': First Evidence of Microplastic Contamination in Fish from the Nile River (Cairo, Egypt).

The presence of microplastics (MPs) in the world's longest river, the Nile River, has yet to be reported. This small-scale study aimed to provide the first information about MPs in the Nile River by sampling the digestive tracts of two fish species, the Nile tilapia (Oreochromis niloticus, n = 29) and catfish (Bagrus bayad, n = 14). Fish were purchased from local sellers in Cairo, and then their gastrointestinal tracts were dissected and examined for MPs. Over 75% of the fish sampled contained MPs in their digestive tract (MP prevalence of 75.9% and 78.6% for Nile tilapia and catfish, respectively). The most abundant MP type was fibers (65%), the next most abundant type was films (26.5%), and the remaining MPs were fragments. Polyethylene (PE), polyethylene terephthalate (PET) and polypropylene (PP) were all non-destructively identified by attenuated total reflectance Fourier transform infrared spectroscopy. A comparison with similar studies from marine and freshwater environments shows that this high level of MP ingestion is rarely found and that fish sampled from the Nile River in Cairo are potentially among the most in danger of consuming MPs worldwide. Further research needs to be conducted, but, in order to mitigate microplastic pollution in the Nile River, we must act now.