44 research outputs found
Ludwig von Mises and the 'Ordo-Interventionists' More than Just Aggression and Contempt?
Esophageal dysfunction in diabetes mellitus: is there a relation to clinical manifestation of neuropathy?
Low-sea-level emplacement of a very large Late Pleistocene 'megaturbidite' in the western Mediterranean Sea
Large-volume turbidites, termed 'megaturbidites' or 'megabeds', result from catastrophic slope failures and the associated downslope transport of enormous quantities of sediment from continental margins to the deep sea. Such large sediment failures can generate tsunamis and, in terrains underlain by gas hydrates (clathrates), may be associated with the release of substantial amounts of the greenhouse gas methane. It has been proposed that the megaturbidite events may be triggered by seismic activity, or may result from gas hydrate release itself, caused by a lowering of hydrostatic pressure on clathrates as a result of low sea level. Previous conclusions on the significance of sea-level change, however, have been conditional because of the lack of absolute times of turbidite emplacement. Here we use accelerator-mass-spectrometry radiocarbon dating in five widely spaced cores to constrain the date of emplacement of a large-volume (500 km3) bed in the Balearic Basin of the western Mediterranean. This turbidite is exceptional in its magnitude and represents the main sedimentation event in the Balearic Basin over the past 100 kyr. Our data provide an estimate of 22,000 calendar years before present for emplacement of the megabed, a time when sea level stood at its lowest level during the Last Glacial Maximum. The coincidence of these dates is consistent with emplacement due to clathrate destabilization caused by low sea level, although other triggering mechanisms, such as seismic shock, cannot be ruled out
Routine ultrasound screening in diabetic pregnancies
Objectives To assess the detection rate of congenital fetal malformations and specific problems related to routine ultrasound screening in women with pre-existing diabetes. Methods A retrospective study was carried out to assess the performance of routine ultrasound screening in women with pre-existing diabetes (Types 1 and 2) within a tertiary institution. The incidence, type and risk factors for congenital fetal malformations were determined. The detection rate of fetal anomalies for diabetic women was compared with that for the low-risk population. Factors affecting these detection rates were evaluated. Results During the study period, 12 169 low-risk pregnant women and 130 women with pre-existing diabetes had routine ultrasound screening performed within the institution. A total of 10 major anomalies (7.7%) and three minor anomalies (2.3%) were present in the fetuses of the diabetic women. Central nervous system and cardiovascular system anomalies accounted for 60% of the major anomalies. Peri-conceptional hemoglobin A 1 c of more than 9% was associated with a high prevalence of major anomalies (14311000). Women who had fetuses with major anomalies bad a significantly higher incidence of obesity (78% vs. 37%; P < 0.05). Ultrasound examination of these diabetic pregnancies showed high incidences of suboptimal image quality (37%), incomplete examinations, and repeat examinations (17%). Compared to the 'low-risk' non-diabetic population from the same institution, the relative risk for a major congenital anomaly among the diabetic women was 5.9-fold higher (95% confidence interval, 2.9-11.9). The detection rate for major fetal anomalies was significantly lower for diabetic women (30% vs. 73%; P < 0.01), and the mean body mass index for the diabetic group was significantly higher (29 vs. 23 kg/m(2); P < 0.001). Conclusion The incidence of congenital anomalies is higher in diabetic pregnancies. Unfortunately, the detection rate for fetal anomalies by antenatal ultrasound scan was significantly, worse than that for the low-risk population. This is likely to be related to the maternal body habitus and unsatisfactory examinations. Methods to overcome these difficulties are discussed