Sandershagen6071

The normal range for potassium is within narrow limits. Hyperkalemia is an electrolyte disorder that frequently affects patients in the emergency department (ED), and can result in significant morbidity and mortality if not identified and treated rapidly.

This article provides an evidence-based narrative review of the management of hyperkalemia, with focused updates for the emergency clinician.

We searched in MEDLINE, EMBASE, Web of Science, and Scopus databases for articles in English published in peer-reviewed journals and indexed up until May 2020. We used multiple search terms, including hyperkalemia, potassium, acute hyperkalemia, emergency department, dyskalemia, potassium disorders, kidney disease, epidemiology, electrolyte disturbance, severe hyperkalemia, and emergency management.

In the ED, interventions aimed to protect patients from the immediate dangers of elevated serum potassium are divided into the following stabilizing cardiac membrane potentials, reducing serum potassium levels throuidence on the optimal management of hyperkalemia and more research is needed to establish optimal strategies to manage acute hyperkalemia in the emergency department.Microplastics (plastic less then 5 mm in size) are now known to contaminate riverine systems but understanding about how their concentrations vary spatially and temporally is limited. This information is critical to help identify key sources and pathways of microplastic and develop management interventions. This study provides the first investigation of microplastic abundance, characteristics and temporal variation along the Ganges river; one of the most important catchments of South Asia. From 10 sites along a 2575 km stretch of the river, 20 water samples (3600 L in total) were filtered (60 samples each from pre- and post-monsoon season). Overall, 140 microplastic particles were identified, with higher concentrations found in the pre-monsoon (71.6%) than in post-monsoon (61.6%) samples. The majority of microplastics were fibres (91%) and the remaining were fragments (9%). We estimate that the Ganges, with the combined flows of the Brahmaputra and Meghna rivers (GBM), could release up to 1-3 billion (109) microplastics into the Bay of Bengal (north-eastern portion of the Indian Ocean) every day. This research provides the first step in understanding microplastic contamination in the Ganges and its contribution to the oceanic microplastic load.An on-line Dual Energy X-ray Absorptiometry (DXA) scanner was used in an Australian abattoir to predict computed tomography (CT) determined composition % of fat, lean muscle and bone in lamb carcasses at chain speed. This study assessed the effect of spray-chilling on these estimates, as well as their repeatability over a 10-min period, and over a 72 h period. There was no prediction bias between the 15 spray-chilled and 15 non-spray-chilled carcasses. When repeat DEXA scans were undertaken across a 10-min period, there was a high level of repeatability for the prediction of CT Fat %. When repeat scans were conducted at 6 time points across a 72 h period the precision of the DXA prediction of CT Fat % of 30 carcasses remained high (R2 = 0.94, RMSEP = 1.20%), although small biases existed between time points (P less then 0.01). These biases were minimised when the DXA scanner had been operational prior to experimentation, suggesting a 'warm-up' effect.This study investigates the performance of a partial least squares regression model to predict intramuscular fat (IMF) in lamb M. longissimus lumborum developed using near infrared (NIR) data collected under a range of different conditions. A total of 26 independent NIR datasets were collected across 7 years, including 14 flocks, four devices and several measurement conditions. A model is developed and its performance is tested using a total of n = 3201 NIR spectra and intramuscular fat percentage measurements by wet chemistry. The model had a coefficient of determination by cross-validation of 0.52, which agrees with previous results using smaller numbers of animals. Overall the results show that near infrared models can be robust across many varying conditions. These models could potentially be implemented in an automated meat quality monitoring system.

We aimed to assess the compound muscle action potential (CMAP) scan in the follow-up of chronic inflammatory demyelinating polyneuropathy (CIDP) patients and investigate the correlation of CMAP scan parameters with functional and standard electrodiagnostic tests.

We evaluated four parameters of abductor pollicis brevis (APB) CMAP scan (i.e., step numbers, step percentage, S10, S90), functional measures (e.g., Medical Research Council Sum Scores), and electrodiagnostic tests, including nerve conduction study (NCS) and motor NCS of the median nerve in the baseline and after six months of treatment.

Twenty patients completed baseline clinical and electrodiagnostic studies. However, sixteen patients completed the follow-up study. The median of step numbers at baseline was 3.5 (2-4.2), which decreased to 2.5 (0-3) (p = 0.005). After the treatment, step percentage reduced from 28.6 (23.9-38.7) to 13.4 (0-23.6) (p = 0.001). The scores obtained from the clinical scales showed significant recovery of most of the functions, while the alterations of NCSS and NCS of the median nerve were not significant.

We found a significant reduction in step number and step percentage after follow-up. This alteration was not reflected in standard electrodiagnostic values. The improvement of functional scales alongside the CMAP scan parameters suggests that the CMAP scan could be considered an appropriate outcome measurement in research and clinical fields.

We found a significant reduction in step number and step percentage after follow-up. This alteration was not reflected in standard electrodiagnostic values. The improvement of functional scales alongside the CMAP scan parameters suggests that the CMAP scan could be considered an appropriate outcome measurement in research and clinical fields.Parkinson's disease (PD) is a complex neurodegenerative disease with a strong genetic component. To date, several genes have been associated with monogenic forms of the disease, but these only explain a small fraction of the observed familial aggregation in PD. Recently, a heterozygous loss-of-function variant in LIN28A was associated with PD pathogenesis in the Asian population. Here, we comprehensively investigate the role of LIN28A variants in PD patients of European ancestry and assess susceptibility using individual-level genotyping data from 14,671 PD cases and 17,667 controls, as well as whole-genome sequencing data from 1647 patients with PD and 1050 controls. In addition, we further assess the summary statistics from the most recent genome-wide association studies meta-analyses to date for PD risk and age at onset. After evaluating these data, we did not find evidence to support a role for LIN28A as a major causal gene for PD. However, additional large-scale familial and case-control studies in non-European ancestry populations are necessary to further evaluate the role of LIN28A in PD etiology.Increased burdens of rare coding variants in genes related to lysosomal storage disease or mitochondrial pathways were reported to be associated with idiopathic Parkinson's disease. Under a hypothesis that the burden of damaging rare coding variants is increased in causative genes for hereditary parkinsonism, we analyzed the burdens of rare coding variants with a case-control design. Two cohorts of whole-exome sequencing data and a cohort of genome-wide genotyping data of clinically validated idiopathic Parkinson's disease cases and controls, which were open to the public, were used. Selleck Binimetinib The sequence kernel association test-optimal was used to analyze the burden of rare variants in the hereditary parkinsonism gene set, which was constructed from the Online Mendelian Inheritance in Man database through manual curation. The hereditary parkinsonism gene set consisted of 17 genes with a locus symbol prefix for familial Parkinson's disease and 75 hereditary atypical parkinsonism genes. We detected a significant association of enriched burdens of predicted damaging rare coding variants in hereditary parkinsonism genes in all three datasets. Meta-analyses of the rare variant burden test in a subgroup of gene sets revealed an association between burdens of rare damaging variants with PD in a hereditary atypical parkinsonism gene set, but not in a subgroup gene set with a locus symbol prefix for familial Parkinson's disease. Our results highlight the roles of rare damaging variants in causative genes for hereditary atypical parkinsonian disorders. We propose that Mendelian genes associated with hereditary disorders accompanying parkinsonism are involved in Parkinson's disease-related genetic networks.

Colorectal cancer (CRC) follow-up has a major impact on outpatient services. The aim was to examine patient acceptability and costs of a new remote follow-up regimen for patients with CRC.

All patients with stage I-III CRC and having completed at least one-year of follow-up at Radboud University Medical Center located in Nijmegen, The Netherlands, were considered for remote follow-up. Enrolled patients received the EORTC-C30 (Quality of Life, QoL), Cancer Worry Scale (Fear of Cancer Recurrence, FCR), (e)Health literacy and patient satisfaction questionnaires. Follow-up use and costs were evaluated.

A total of 118 patients with stage I-III CRC have been followed according to the new remote follow-up regimen. Median length of follow-up at start of remote follow-up was 34 months (interquartile range of 24-41) and all patients were sufficiently health literate. Overall satisfaction towards remote follow-up at 6-and 12-months was rated 7.8 and 7.5 out of 10. Satisfaction with the online self-management information was rated 8 out of 10. Over a one-year period, QoL remained high and patients experienced low FCR. More than 70% of the patients self-organized their care, while the others sought contact by telephone, MyChart or hospital visits. Remote follow-up for the total cohort led to €22,408 cost-savings over one-year compared to standard hospital follow-up.

Implementation of remote follow-up for patients with stage I-III CRC is feasible, comes with high patient satisfaction and considerable cost-savings. Short-term results did not show differences in QoL or FCR during the course of remote follow-up.

Implementation of remote follow-up for patients with stage I-III CRC is feasible, comes with high patient satisfaction and considerable cost-savings. Short-term results did not show differences in QoL or FCR during the course of remote follow-up.The central nervous system was thought to be devoid of lymphatics. Recently, the existence of an authentic brain lymphatic system, known as the glymphatic system, composed of paravascular channels penetrating arterial and venous brain vessels and dural lymphatics cleaning the interstitial space, has been demonstrated. Aquaporin-4, located in astrocyte feet attached to the paravascular spaces, plays a key role in the clearance of waste molecules, such as beta-amyloid or tau proteins. The activity of this system is increased during sleep, mainly in the slow wave phase and while sleeping on one side, and with exercise, and is reduced with aging. Even though data are still preliminary, the glymphatic system could be decisively involved in the pathophysiology of neurological disorders such as neurodegenerative and demyelinating diseases, normal pressure hydrocephalus, stroke or certain headaches. The discovery of this system should provide new opportunities for the treatment of these neurological disorders.