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In the general population, hypomagnesemia has been associated with cardiovascular events and hypermagnesemia with overall mortality. In chronic kidney disease (CKD) the evidence is not so strong. The objective of our study was to investigate the relationship between serum magnesium (SMg) concentration and cardiovascular morbidity and mortality, all-cause mortality, and the progression to kidney failure in a population with CKD.
Observational study of a cohort of 746 patients with CKD. Baseline characteristics and analytical profile were collected at the first visit, and patients were followed for a mean of 42.6months.
A cohort of 746 patients were analyzed, age 70±13years, 62.9% were male, 45.2% had CKD grade 3, and 35.9% grade 4. The mean SMg concentration was 2.09±0.33mg/dL, with a close correlation between SMg concentration and serum creatinine, phosphorus, and intact parathyroid hormone (iPTH) values. Use of calcitriol was associated with higher SMg (SMgH) concentration, while calcium supplements an Thus, magnesium supplementation should be used with caution in these patients.
Magnesium concentration increases with decreasing kidney function. Hypermagnesemia predicts cardiovascular events and all-cause mortality in this same population. Thus, magnesium supplementation should be used with caution in these patients.Elevated toxins in soybeans extensively threaten Asian residents and over one billion vegetarians worldwide. An integrated dataset of toxic trace metal(loid)s especially cadmium (Cd) analysis in soybean grain samples (n = 5217) from 12 countries/regions of origin was compiled for risk analysis. Worldwide grain Cd averaged 0.093 mg kg-1, but mean values varied 16-fold between regions, with South China (0.32 mg kg-1) > Argentina (0.15 mg kg-1) = German (0.13 mg kg-1) > Japan (0.11 mg kg-1) > the United States (0.064 mg kg-1) > Central-North China (0.020-0.60 mg kg-1) ≥ Iran (0.042 mg kg-1) = Brazil (0.023 mg kg-1) = South Korea (0.020 mg kg-1). Regression analysis suggested widespread contamination and acidic soil features significantly contributed the elevated food Cd contamination worldwide. Arsenic (As) and lead (Pb) are also of concern because excessive levels were often observed in grains. Given that soil Cd bioavailability is generally low in alkaline pH ranges, the feasibility of producing safe food from contaminated land was investigated by greenhouse experiments with one low-Cd soybean cultivar grown on 20 contaminated calcareous soils. Equilibrium-based approaches i.e., 0.01 M CaCl2 and in-situ porewater extractions, and diffusion-based diffusive gradients in thin-films technique were used to determine the plant-available fractions of soil metal(loid)s to explain the bioaccumulation variation. The results suggested that soybean grains bioaccumulated mean 0.76 mg Cd kg-1, ranging from 0.16 to 2.1 mg kg-1, whereas As and Pb bioaccumulation was low. Cadmium accumulation was closely correlated with plant-available Cd fractions especially the 0.01 M CaCl2-extractable Cd, but negatively correlated with soil pH. Even in the alkaline pH range, a slight decrease of soil pH would increase grain Cd significantly. Study region and those arable lands that have similar soil conditions are not recommended for growing soybean unless novel remediation strategies are developed.
Posttraumatic maltorsion and implant failure after closed reduction of proximal femoral fractures remain a cause of concern. Although the reproducibility of torsion measuring techniques on CT for femoral shaft fractures has been thoroughly analyzed, little is known about the trochanteric fractures. Apart from the well-known CT limitations, posttraumatic alteration of bony landmarks makes torsional assessment even more challenging. Main goal of this study was to examine the reliability of different CT techniques on trochanteric femoral fractures after closed nail fixation. Secondary goal was to see whether the measurements within the examined population were influenced by the fracture type and patient age or BMI.
20 cases (AO.31-A1 or -A2) were retrospectively examined. Six established CT techniques for torsional assessment were performed from three different investigators twice at different time points. The intraclass correlation coefficient (ICC for 95% CI) was used to analyze the interobserver and intraeasuring method used in each case constitutes an essential element of the radiological reports.
Parallel plate fixation for distal humeral fractures provides good clinical outcomes. However, few studies have investigated the insertion sequence of the distal screws, although long screw insertion into the distal fragment is technically demanding. The purpose of this study was to investigate a correlation between the insertion sequence of the distal screws and the screw insertion difficulty.
Medial and lateral anatomical locking plates were closely fitted to the medial and lateral sides of the 10 intact humerus bone models on the computer. Most distal screws have 2 patterns the screw was inserted from the lateral side first followed by insertion from the medial side (group 1) or from the medial side first followed by insertion from the lateral side (group 2). We calculated the target area wherein the second screw can be inserted.
The length of the first most distal screw in group 2 was significantly longer than that in group 1 (58.4 vs. 49.8mm, p<0.05). The target areas in both groups were divided into the distal and proximal areas. The distal and proximal areas in group 1 were 91.6 and 61.6mm
, respectively, and those in group 2 were 191.1 and 11.3mm
, respectively. The distal area in group 2 was significantly greater than in the other areas (p<0.05).
In parallel plate fixation for distal humeral fracture, most distal screws could be more easily inserted from the medial side first followed by insertion from the lateral side than from the lateral side first followed by insertion from the medial side.
In parallel plate fixation for distal humeral fracture, most distal screws could be more easily inserted from the medial side first followed by insertion from the lateral side than from the lateral side first followed by insertion from the medial side.
In France, consumption of antidepressant drugs by children and teenagers has been on the rise, even though recommendations for use are limited due to their association with serious adverse reactions. The objective of this study was to describe the patterns of antidepressant drug dispensing among children and adolescents in the French region of Midi-Pyrenees.
The data regarding the Midi-Pyrenees region were extracted from the French Health Insurance Database (SNDS) using their ATC codes. The reimbursements for antidepressants, benzodiazepines and neuroleptics dispensed to patients from 6 to 17 years old between January 2015 and June 2017 were analyzed, after which data on the antidepressants themselves were selected. The population was divided into sub-groups according to age (children 6 to 11 years old, teenagers 12 to 17 years old).
During the 30 months analyzed, 12,783 antidepressants were dispensed to 3506 patients. The antidepressants were primarily issued (90%) to teenagers. In terms of prevalence,.fr addressed to general practitioners might improve the implementation of recommendations and guidelines.COVID-19 is a disease with many clinical, biochemical, and radiological signs that has a predilection for the lungs, probably because of the high number of ACE-2 receptors in this organ. The infection of cells activates proinflammatory substances, causing diffuse alveolar damage, which is the histopathological basis of ARDS. The exudative phase would manifest as ground-glass opacities and consolidation, and the proliferative phase would manifest as a tendency toward a more linear morphology. Both CT and PET/CT findings support the inflammatory character of the lung lesions in the initial phase of the disease and in patients with mild-moderate disease. Severe cases have pulmonary hypoperfusion that is likely due to abnormal alveolar ventilation and perfusion. On the other hand, a prothrombotic state increases the risk of thromboembolic disease through the activation of coagulation and platelet pathways with the production of fibrin degradation products (D-dimer) and consumption of platelets.
Thyroid nodules frequently require ultrasound and Fine Needle Aspiration Cytology (FNAC) evaluation. However, FNA cytology does not allow differentiation between follicular adenoma and carcinoma on Bethesda type IV lesions. This situation leads to many unnecessary surgical procedures because it is not possible to assure the benignity of the lesions, even when most of the specimens correspond to adenomas or even other benign lesions. The objective in this study is to establish if there are any US characteristics that would help us to predict the risk of malignancy of nodules with a pathological diagnosis of follicular neoplasm in order to achieve a more conservative management for non-suspicious nodules.
We studied 61 nodules in 61 patients (51 women and 10 men) that underwent thyroid surgery and had histopathological results of either follicular adenoma or carcinoma. Different US characteristics of the nodules were analysed (composition, echogenicity, margin, calcification status, the presence of halo andIV thyroid nodules but their absence does not allow to predict benignity in these nodules. Inversely, when a halo sign lesion is observed, benign follicular neoplasm should be considered.
The presence of calcifications, ill-defined borders and the overall impression or suspicion of malignancy are associated with a higher risk for follicular carcinoma in Bethesda type IV thyroid nodules but their absence does not allow to predict benignity in these nodules. Inversely, when a halo sign lesion is observed, benign follicular neoplasm should be considered.A 26-y-old experienced scotoma scintillans after 59 min of scuba diving at a maximum depth of 26 m. After the patient smoked a cigarette, the scotoma scintillans ceased. However, he then developed a headache, general fatigue, and shoulder and elbow pain. He therefore called an ambulance. Based on the rules of the medical cooperative system for decompression sickness in Izu Peninsula, the fire department called a physician-staffed helicopter. After a physician checked the patient, his complaints remained aside from a low-grade fever. A portable ultrasound revealed bubbles in his inferior vena cava. Because of the risk of his being infected with COVID-19, he was transported to our hospital not by air evacuation but via ground ambulance staff while receiving a drip infusion of fluid and oxygen. After arriving at the hospital, his symptoms had almost subsided. Whole-body computed tomography revealed gas around the bladder, left hip, right knee, bilateral shoulder, joints, and right intramedullary humerus. The patient received high-concentration oxygen, infusion therapy, and observational admission. On the second day of admission, his symptoms had completely disappeared, and he was discharged. GC376 manufacturer To our knowledge, this is the first report that computed tomography might be useful for detecting gas in multiple joints, suggesting the onset of decompression sickness after diving. This might be the first report of gas in an intramedullary space after diving as a potential cause of dysbaric osteonecrosis.
