Hypoglycemia in Non-Diabetic In-Patients: Clinical or Criminal?

BACKGROUND AND AIM: We wished to establish the frequency of unexpected hypoglycemia observed in non diabetic patients outside the intensive care unit and to determine if they have a plausible clinical explanation. METHODS: We analysed data for 2010 from three distinct sources to identify non diabetic hypoglycaemic patients: bedside and laboratory blood glucose measurements; medication records for those treatments (high-strength glucose solution and glucagon) commonly given to reverse hypoglycemia; and diagnostic codes for hypoglycemia. We excluded from the denominator admissions of patients with a diagnosis of diabetes or prescribed diabetic medication. Case notes of patients identified were reviewed. We used capture-recapture methods to establish the likely frequency of hypoglycemia in non-diabetic in-patients outside intensive care unit at different cut-off points for hypoglycemia. We also recorded co-morbidities that might have given rise to hypoglycemia. RESULTS: Among the 37,898 admissions, the triggers identified 71 hypoglycaemic episodes at a cut-off of 3.3 mmol/l. Estimated frequency at 3.3 mmol/l was 50(CI 33-93), at 3.0 mmol/l, 36(CI 24-64), at 2.7 mmol/l, 13(CI 11-19), at 2.5 mmol/l, 11(CI 9-15) and at 2.2 mmol/l, 8(CI 7-11) per 10,000 admissions. Admissions of patients aged above 65 years were approximately 50% more likely to have an episode of hypoglycemia. Most were associated with important co-morbidities. CONCLUSION: Significant non-diabetic hypoglycemia in hospital in-patients (at or below 2.7 mmol/l) outside critical care is rare. It is sufficiently rare for occurrences to merit case-note review and diagnostic blood tests, unless an obvious explanation is found

Age determination of sediment core CAPATANA, Capatana, Romania

Contains fulltext : 203516.pdf (publisher's version ) (Open Access)Radboud University, 06 juni 2019Promotores : Olde Rikkert, M.G.M., Kessels, R.P.C. Co-promotores : Aaronson, J.A., Bossers, W.J.R

Tritium in water electrolytic enrichment and liquid scintillation counting RID C-4186-2011

A batch of electrolysis cells was developed for tritium in water samples enrichment by at least a factor 10. The cell batch is controlled by a pre-programmable electronic system that interrupts the current through any cell when the planned electrolyte volume is attained. A starting and a final distillation of water samples are carried out before and after the electrolytic enrichment. Both distillations are made to dryness in order to avoid isotopic fractionation. A second electrolysis step allowed the tritium enrichment factor (EFT) to be doubled. The EFT was calculated by means of the deuterium enrichment factor (EFD) that was measured by mass spectrometry. The EFT was also measured by liquid scintillation counting. The calculated and measured EFT values were found in good agreement, especially for samples with significant tritium content. (c) 2006 Elsevier Ltd. All rights reserved