Poulsenmcqueen0258

OBJECTIVES To evaluate the incidence of severe potassium disturbances during barbiturate coma therapy in patients with severe traumatic brain injury (TBI), and the characteristics of these patients. METHODS The study comprised 37 patients with severe TBI who were treated for barbiturate coma between 2015 and 2017 in level 3 intensive care units of two hospitals. RESULTS No potassium disturbance occurred in 14 patients. Seventeen patients developed mild-moderate hypokalemia (2.6-3.5mEq/L), and 6 patients developed severe hypokalemia ( less then 2.5mEq/L) following the induction of barbiturate therapy. The incidence of mild-to-severe barbiturate-induced hypokalemia was 62.2% and the rate of severe hypokalemia was 16.2%. The mean potassium supply per day during thiopentone therapy was statistically significantly different between patients with mild-to-moderate hypokalemic and those with severe hypokalemic (p less then 0.001). Four of 6 patients with severe hypokalemia developed rebound hyperkalemia exceeding 6mEq/L following the cessation of barbiturate infusion. The nadir potassium concentration was 1.5mEq/L and the highest value was 6.8mEq/L. The mean time to reach nadir potassium concentrations was 2.8 days. The mortality rate of the 6 patients was 66.7%. Of the 2 survivors of severe hypokalemia, the Glasgow Outcome Scale (GOS) on discharge and the extended GOS one year after the trauma were 5 and 8 respectively. CONCLUSIONS Severe hypokalemia refractory to medical treatment and rebound hyperkalemia is a serious adverse effect of thiopentone coma therapy in patients with severe TBI. Excessive and aggressive potassium replacement during the barbiturate-induced hypokalemia period must be avoided. Weaning barbiturate treatment over time may be advantageous in the management of severe serum potassium disturbances. BACKGROUND Few studies have addressed the effect of bariatric surgery on factors related to energy balance, including resting energy expenditure (REE) and thermic effect of food (TEF). To our knowledge, very few studies have examined changes in REE and none have investigated modifications in TEF after sleeve gastrectomy (SG) performed in adolescents. OBJECTIVE To assess energy expenditure in females who underwent SG as adolescents and matched-control participants as preliminary data about the potential of SG to confer differences in postprandial energy expenditure. SETTING Children's Hospital Medical Center, Cincinnati, Ohio, United States. METHODS In this observational study, REE and respiratory quotient (RQ) were measured via indirect calorimetry, followed by a standardized meal and assessment of TEF and postprandial RQ. Plasma drawn before and every 15 minutes after the meal was assayed for insulin, glucose, and C-peptide. Usual dietary intake was estimated using 24-hour recall interviews. RESULTS Fasting REE and RQ were similar between surgical and control groups. Postmeal TEF also did not differ between groups. The surgical group had higher RQ early in the postprandial period, whereas the control group RQ was higher after 125 minutes post meal. Compared with the control group, the surgical group had lower postprandial glucose, higher insulin and C-peptide, and consumed less daily energy during usual intake. CONCLUSIONS Postprandial RQ was consistent with the rapid gastric emptying typical of SG, yet we observed no group differences in REE or TEF. These findings may have been due to limited statistical power. More comprehensive studies of EE after SG are warranted. OBJECTIVES The Test of Gross Motor Development-3 (TGMD-3) evaluates fundamental gross motor skills across two domains locomotor and ball skills. This study aimed to perform a full psychometric assessment of this test in a large sample of Italian pre- and primary school children. DESIGN Cross-sectional and test-retest study design. METHOD Children N = 5210; mean age years = 8.38, SD = 1.97; % females = 48 completed three trials, including one practice. Only the scores of the two latter 'formal' trials were recorded for the evaluation. Factorial validity and measurement invariance of TGMD-3 across age and gender groups and test-retest reliability for the overtime measure consistency were tested. Item response theory analysis further tested single items' performances. CNO agonist RESULTS Explorative and confirmatory factor analyses confirmed the two-factor structure of the TGMD-3. Multi-group confirmatory factor analyses indicated that there were no significant reductions in model adjustments between the configural, metric and structural invariance solutions for gender and age groups. Test-retest results ranged between 0.967 and 0.990 for both skill sets across age groups. Item response theory analysis using a graded response model showed low standard error and high-test information levels covering a wide spectrum range of both locomotor and ball skills. CONCLUSIONS These results highlight the strong construct validity and reliability of the TGMD-3 to measure gross motor skills in children across gender and age groups. Item response theory analysis evidenced how the performance criteria included in this test cover a wide range of gross the motor skills spectrum. The use of TGMD-3 may inform motor development programs and support curricular decisions in schools. Crown All rights reserved.OBJECTIVES Biathlon is a discipline that combines cross country skiing with rifle shooting. It demands high shooting accuracy and fast shooting times under increasing levels of physiological fatigue. Building on Vickers and Williams (2007), the current study aimed at scrutinizing the impact of physiological fatigue and gaze behavior on shooting performance in elite and sub-elite biathletes. DESIGN Ten members of the German national senior team (elite) and 13 members of the German national junior team (sub-elite) participated in a performance test. They conducted a roller skiing test on a treadmill including four increasing intensity levels followed by shooting blocks of five shots in both prone and standing position. METHODS Physiological measurements consisted of heart rate and blood lactate, shooting performance data included shooting accuracy and time. Eye movements were assessed, i.e. the duration of the final fixation, using a gun-mounted eye tracking system. RESULTS Physiological fatigue systematically increased across intensity levels.