Admission Dysnatremia in Citically ill Children

Introduction: Many causes of admission to the pediatric intensive care unit (PICU) may potentially induce hyponatremia. This study was aimed at evaluating the incidence of admission dysnatremia in the PICU and its relationship with the underlying disease and demographic factors.Materials and Methods: This observational prospective study was conducted in a 12-bed medical PICU in a tertiary governmental teaching hospital for six months. The study group comprised patients aged 1 month to 18 years. Patients who received intravenous fluid within 24 hours before admission were excluded. Serum sodium was checked on admission and concentrations below 135 and above 145 mEq/L were considered hyponatremia and hypernatremia, respectively.Results: One hundred and ninety-five patients (117 males, 60%) were included in the study. The mean serum sodium level was 137.8 mEq/L ± 5.2. Forty-two patients (20.5%) were hyponatremic and 10 (5.1%) werehypernatremic. The most prevalent diagnosis in hyponatremic patientswas pulmonary diseases followed by renal diseases, central nervoussystem (CNS) diseases, diabetic ketoacidosis (DKA), gastrointestinal (GI)diseases, and cardiovascular and hematologic-oncologic diseases. Fiftypercent of nephrologic patients were hyponatremic. Hyponatremia wasfound in 26.5%, 23.5%, 20%, 16.6%, and 14.2%of the children with lungdiseases, DKA, hematologic-oncologic diseases, cardiovascular diseases,and CNS and GI diseases, respectively. Moreover, 20%, 16.6%, 11.7%,7.1%, and 2.9%of the patients with infectious diseases, cardiovasculardiseases, DKA, CNS diseases, and pulmonary diseases hadhypernatremia, respectively.Conclusions: Hyponatremia is frequent in our PICU. Patients suffering from renal diseases, pulmonary problems, DKA, and hematologic-oncologic diseases have a higher chance of hyponatremia (≥20%).Keywords: Sodium; Hyponatremia; Fluid Therapy; Children; Intensive Care

Impaired Rho GTPase activation abrogates cell polarization and migration in macrophages with defective lipolysis

Infiltration of monocytes and macrophages into the site of inflammation is critical in the progression of inflammatory diseases such as atherosclerosis. Cell migration is dependent on the continuous organization of the actin cytoskeleton, which is regulated by members of the small Rho GTPase family (RhoA, Cdc42, Rac) that are also important for the regulation of signal transduction pathways. We have recently reported on reduced plaque formation in an atherosclerotic mouse model transplanted with bone marrow from adipose triglyceride lipase-deficient (Atgl−/−) mice. Here we provide evidence that defective lipolysis in macrophages lacking ATGL, the major enzyme responsible for triacylglycerol hydrolysis, favors an anti-inflammatory M2-like macrophage phenotype. Our data implicate an as yet unrecognized principle that insufficient lipolysis influences macrophage polarization and actin polymerization, resulting in impaired macrophage migration. Sustained phosphorylation of focal adhesion kinase [due to inactivation of its phosphatase by elevated levels of reactive oxygen species (ROS)] results in defective Cdc42, Rac1 and RhoA activation and in increased and sustained activation of Rac2. Inhibition of ROS production restores the migratory capacity of Atgl−/− macrophages. Since monocyte and macrophage migration are a prerequisite for infiltrating the arterial wall, our results provide a molecular link between lipolysis and the development of atherosclerosis

Evaluation of incentives for body area network-based healthcare systems

With ever-increasing advancements of body area networks and participatory sensing, various healthcare applications have emerged. These applications are used to collect physiological and activity data from people and to evaluate their health situation in an online manner. The ultimate goal here is to ensure health and well-being of participants. Although various researches have been performed on underlying system of these applications from the technical point of view, very few have focused on ways to encourage people to use them and to increase their acceptability. In this paper, we present a taxonomy for motivations and incentives used in body area network based healthcare systems. Furthermore, we identify incentives' features and output expectancies and use them in a model to determine important factors that persuade people to accept and use a health monitoring system. Finally, we evaluate each incentive using Analytical Hierarchy Process (AHP) technique to identify the most effective elements of each incentive having a specific goal in mind