Association between potassium supplementation and the occurrence of acute kidney injury in patients with hypokalemia administered liposomal amphotericin B: a nationwide observational study

Background: Hypokalemia and acute kidney injury (AKI) occur in patients administered liposomal amphotericin B (L-AMB), a wide-spectrum anti-fungicidal drug. However, the association between potassium supplementation and the occurrence of AKI in patients with hypokalemia who were administered L-AMB is not well understood.Methods: Using nationwide claims data and laboratory data, the occurrence of AKI during L-AMB treatment was retrospectively compared between patients with hypokalemia who were or were not supplemented with potassium and between those adequately or inadequately supplemented with potassium (serum potassium levels corrected to ≥3.5 mEq/L or remained < 3.5 mEq/L, respectively) before or after L-AMB treatment initiation.Results: We identified 118 patients who developed hypokalemia before L-AMB treatment initiation (43 received potassium supplementation [25 adequate and 18 inadequate supplementation] and 75 did not receive potassium supplementation), and 117 patients who developed hypokalemia after L-AMB initiation (79 received potassium supplementation [including 23 adequate and 15 inadequate supplementation] and 38 did not receive potassium supplementation). The occurrence of any stage of AKI was similar between patients with hypokalemia, regardless of potassium supplementation (i.e., before L-AMB treatment initiation [supplementation, 51%; non-supplementation, 45%; P = 0.570] or after L-AMB initiation [supplementation, 28%; non-supplementation, 32%; P = 0.671]). After adjusting for confounding factors, we found that the occurrence of any stage of AKI was not associated with potassium supplementation before L-AMB initiation (odds ratio [OR]: 1.291, 95% confidence interval [CI]: 0.584–2.852, P = 0.528) or after L-AMB initiation (OR: 0.954, 95% CI: 0.400–2.275, P = 0.915). The occurrence of any stage of AKI tended to decline in patients with hypokalemia who were adequately supplemented with potassium (44%) before, but not after, L-AMB initiation relative to that in patients inadequately supplemented with potassium (61%), however this result was not significant (P = 0.358).Conclusion: Potassium supplementation was not associated with any stage of AKI in patients with hypokalemia who were administered L-AMB

Fractal dimension computation from equal mass partitions.

International audienceNumerical methods which utilize partitions of equal-size, including the box-counting method, remain the most popular choice for computing the generalized dimension of multifractal sets. However, it is known that mass-oriented methods generate relatively good results for computing generalized dimensions for important cases where the box-counting method is known to fail. Here, we revisit two mass-oriented methods and discuss their strengths and limitations. V C 2014 AIP Publishing LLC. [http://dx.doi.org/10.1063/1.4885778] Fractal sets are characterized by self-similarity, and power laws can be associated with them. Examples of fractals in nature are ubiquitous. Their discovery led to the extension of the notion of dimension. For monofrac-tals, the scaling pattern is homogeneous and the set can be characterized by a single dimension. In contrast, mul-tifractals are inhomogeneous and require a spectrum of dimensions D q to capture their geometry. In finding the generalized dimensions, the box-counting method has been by far the most popular choice among researchers across various fields. However, it is known that the class of methods which deal with partitions into cells of equal size, including the box-counting method, is ill-suited for computing the generalized dimensions on some domain of q. In this paper, two alternative methods which utilize mass-oriented partitions, rather than partitions of equal-size, are investigated

Cosmology in one dimension: Vlasov dynamics

International audienceNumerical simulations of self-gravitating systems are generally based on N-body codes, which solve the equations of motion of a large number of interacting particles. This approach suffers from poor statistical sampling in regions of low density. In contrast, Vlasov codes, by meshing the entire phase space, can reach higher accuracy irrespective of the density. Here, we perform one-dimensional Vlasov simulations of a long-standing cosmological problem, namely, the fractal properties of an expanding Einstein–de Sitter universe in Newtonian gravity. The N-body results are confirmed for high-density regions and extended to regions of low matter density, where the N-body approach usually fails

Heterotopic Pancreas of the Jejunum Incidentally Detected by Preoperative Abdominal CT: Report of Two Cases and Review of the Literature

Heterotopic pancreas (HP) is typically an asymptomatic malformation that can present anywhere along the gastrointestinal tract. It is often detected incidentally on surgery for other diseases or autopsy. We encountered 2 patients with jejunal HP incidentally detected by computed tomography (CT) performed for close evaluation of other diseases. In a 57-year-old woman diagnosed with reactive lymphoid hyperplasia on the dorsal portion of the pancreas head, CT detected a 15 mm oval-shaped submucosal lesion at the jejunum. In an 87-year-old woman diagnosed with type 2 adenocarcinoma occupying the sigmoid colon, CT detected a round-shaped submucosal tumor 15 mm in diameter in the jejunum. Both cases were histologically diagnosed as type 1 HP according to the classification by Heinrich. Contrast-enhanced CT revealed that the CT analyses of HP and pancreatic parenchyma were nearly identical in the arterial phase, but in the equilibrium phase, contrast enhancement persisted longer in HP than in the pancreatic parenchyma. There has been no report of asymptomatic jejunal HP preoperatively diagnosed by CT. These cases are presented with a review of the literature, particularly focusing on CT findings