60 research outputs found

    Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome after renal transplantation in the United States

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    BACKGROUND: The incidence and risk factors for diabetic ketoacidosis (diabetic ketoacidosis) and hyperglycemic hyperosmolar syndrome (hyperglycemic hyperosmolar syndrome, previously called non-ketotic hyperosmolar coma) have not been reported in a national population of renal transplant (renal transplantation) recipients. METHODS: We performed a historical cohort study of 39,628 renal transplantation recipients in the United States Renal Data System between 1 July 1994 and 30 June 1998, followed until 31 Dec 1999. Outcomes were hospitalizations for a primary diagnosis of diabetic ketoacidosis (ICD-9 code 250.1x) and hyperglycemic hyperosmolar syndrome (code 250.2x). Cox Regression analysis was used to calculate adjusted hazard ratios for time to hospitalization for diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome. RESULTS: The incidence of diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome were 33.2/1000 person years (PY) and 2.7/1000 PY respectively for recipients with a prior diagnosis of diabetes mellitus (DM), and 2.0/1000 PY and 1.1/1000 PY in patients without DM. In Cox Regression analysis, African Americans (AHR, 2.71, 95 %CI, 1.96–3.75), females, recipients of cadaver kidneys, patients age 33–44 (vs. >55), more recent year of transplant, and patients with maintenance TAC (tacrolimus, vs. cyclosporine) had significantly higher risk of diabetic ketoacidosis. However, the rate of diabetic ketoacidosis decreased more over time in TAC users than overall. Risk factors for hyperglycemic hyperosmolar syndrome were similar except for the significance of positive recipient hepatitis C serology and non-significance of female gender. Both diabetic ketoacidosis (AHR, 2.44, 95% CI, 2.10–2.85, p < 0.0001) and hyperglycemic hyperosmolar syndrome (AHR 1.87, 95% CI, 1.22–2.88, p = 0.004) were independently associated with increased mortality. CONCLUSIONS: We conclude that diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome were associated with increased risk of mortality and were not uncommon after renal transplantation. High-risk groups were identified

    The p.M292T NDUFS2 mutation causes complex I-deficient Leigh syndrome in multiple families

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    Isolated complex I deficiency is the most frequently observed oxidative phosphorylation defect in children with mitochondrial disease, leading to a diverse range of clinical presentations, including Leigh syndrome. For most patients the genetic cause of the biochemical defect remains unknown due to incomplete understanding of the complex I assembly process. Nonetheless, a plethora of pathogenic mutations have been described to date in the seven mitochondrial-encoded subunits of complex I as well as in 12 of the nuclear-encoded subunits and in six assembly factors. Whilst several mitochondrial DNA mutations are recurrent, the majority of these mutations are reported in single families. We have sequenced core structural and functional nuclear-encoded subunits of complex I in a cohort of 34 paediatric patients with isolated complex I deficiency, identifying pathogenic mutations in 6 patients. These included a novel homozygous NDUFS1 mutation in an Asian child with Leigh syndrome, a previously identified NDUFS8 mutation (c.236C>T, p.P79L) in a second Asian child with Leigh-like syndrome and six novel, compound heterozygous NDUFS2 mutations in four white Caucasian patients with Leigh or Leigh-like syndrome. Three of these children harboured an identical NDUFS2 mutation (c.875T>C, p.M292T), which was also identified in conjunction with a novel NDUFS2 splice site mutation (c.866+4A>G) in a fourth Caucasian child who presented to a different diagnostic centre, with microsatellite and single nucleotide polymorphism analyses indicating that this was due to an ancient common founder event. Our results confirm that NDUFS2 is a mutational hotspot in Caucasian children with isolated complex I deficiency and recommend the routine diagnostic investigation of this gene in patients with Leigh or Leigh-like phenotypes

    AGRICULTURE AND BIOLOGY JOURNAL OF NORTH AMERICA Pharmacological action of integument extracts of red palm weevil, Rhynchophorus ferrugineus on albino mice

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    ABSTRACT Extracts were prepared from the tergum and sternum of male and female red palm weevil, Rhynchophorus ferrugineus, using acetone, chloroform and diethyl ether. Pharmacological actions were examined in mice. All of the extracts showed certain behavioral actions that included central nervous system inhibition and stimulation with no effects on pain perception or temperature regulation.Two of the extracts labeled numbers 1 and 2 (acetone and chloroform extracts of the female insect tergum) were found to exhibit cardiac depressant effects. Extract No.1 induced time-dependent bradycardia ( up to 40% inhibition of heart rate) that was significantly antagonized by atropine. It also enhanced calcium chloride-induced bradycardia in mice. Insect extract No.2 also exhibited cardiac depressant effect (up to 37.5%bradycardia) that was not affected by atropine.The extract significantly blocked calcium chloride-induced bradycardia. Extracts No.1 and 2 seemed to contain muscarinic and calcium channel bloking components, respectively. Isolation of these components may pave the way for discovery of potential cardiac depressants that may be useful in treatment of certain cardiac dysrrhythmias

    Modelling the unsaturated hydraulic conductivity of a sandy loam soil using Gaussian process regression

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    Unsaturated soil hydraulic conductivity is a main parameter in agricultural and environmental studies, necessary for predicting and managing water and solute transport in soils. This parameter is difficult to measure in agricultural fields; thus, a simple and practical estimation method would be preferable, and quantitative methods (analytical and numerical) to predict the field parameters should be developed. Field experiments were conducted to collect water quality data to model the unsaturated hydraulic conductivity of a sandy loam soil. A mini disk infiltrometer (MDI) was used to measure soil infiltration rate. Input variables included electrical conductivity and the sodium adsorption ratio of irrigation water. Suction rate (pressure head), soil bulk density, and soil moisture content acted as inputs, with unsaturated soil hydraulic conductivity as output. The performance of Gaussian process regression (GPR) was analysed, with multiple linear regression (LR) and multi-layer perceptron (MLP) models used for comparison. Three performance criteria were compared: correlation coefficient (r), root mean square error (RMSE), and mean absolute error (MAE). The simulations employed the Waikato environment for knowledge analysis (WEKA) open source tool. The results indicate that the GPR with Pearson VII function-based universal kernel (PUK kernel), cache size 250007, Omega 1.0 and Sigma 1.0 performs better than other kernels when evaluating test split data, with a correlation coefficient of 0.9646. The RMSEs for GPR (PUK kernel), MLP, and LR were 1.16 × 10−04, 1.87 × 10−04, and 2.22 × 10−04 cm·s−1, respectively. Predictive data mining algorithms (DMA) enable an estimate of unknown values based on patterns in a database. Therefore, the present methodology can be put to use in predictive tools to manage water and solute transport in soils, as the GPR model provides much greater accuracy than the LR and MLP models in predicting the unsaturated hydraulic conductivity of a sandy loam soil

    Effect of Ammonium Sulphate Incorporated with Calcium Nitrate Fertilizers on Nutritional Status, Fruit Set and Yield of Pomegranate Trees cv. Wonderful

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    The effect of (NH4)2SO4:Ca(NO3)2 ratios applied by fertigation on nutritional status, fruit set, yield, and marketable yield of pomegranate trees cv. Wonderful was evaluated. The trees were provided with five nutrient solutions with the same total nitrogen level (200 units/ha) but with different (NH4)2SO4:Ca(NO3)2 ratios (100:0, 90:10, 80:20, 70:30, and 60:40). Increasing the (NH4)2SO4 ratio from 60 to 100% significantly reduced the nitrogen (N), magnesium (Mg), calcium (Ca), and potassium (K) concentrations while significantly increasing P and Fe concentrations in pomegranate leaves. The highest (NH4)2SO4 proportion (100%) induced a reduction in both chlorophyll content and dry matter values in pomegranate leaves. The maximum fruit set (33.65% and 31.40%) and the minimum fruit drop (6.74% and 6.25%) were recorded at the applied ratio of 60% of (NH4)2SO4:40% of Ca(NO3)2. The applied proportion of 70% of (NH4)2SO4:30% of Ca(NO3)2 provided the minimum fruit sunburn (9.54% and 9.74%) and fruit cracking (6.45% and 5.64%), maximum yield (33.62 and 33.00 kg/tree), and marketable yield (27.41 and 27.93 kg/tree) in the 2019 and 2020 seasons, respectively. Our results provide valuable information about the effects of partial replacement of nitrogen fertilizer from (NH4)2SO4 with nitrogen fertilizer from Ca(NO3)2 on the growth characteristics of pomegranate trees cv. Wonderful

    A hybrid security system for drones based on ICMetric technology.

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    Recently, the number of drones has increased, and drones' illegal and malicious use has become prevalent. The dangerous and wasteful effects are substantial, and the probability of attacks is very high. Therefore, an anomaly detection and protection system are needed. This paper aims to design and implement an intelligent anomaly detection system for the security of unmanned aerial vehicles (UAVs)/drones. The proposed system is heavily based on utilizing ICMetric technology to exploit low-level device features for detection. This technology extracts the accelerometer and gyroscope sensors' bias to create a unique number known as the ICMetric number. Hence, ICMetric numbers represent additional features integrated into the dataset used to detect drones. This study performs the classification using a deep neural network (DNN). The experimental results prove that the proposed system achieves high levels of detection and performance metrics

    Regional anesthesia for geriatric population

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    Advancements in modern health care over 20 years have substantially increased the average lifespan in developed countries, and the fastest growing population is the elderly population. The proportion of people in Saudi Arabia aged 60 or more is predicted to be 25 percent of the total population of 40 million by the end of 2050. Moreover, the number of people aged 80 or more is expected to reach 1.6 million or 4 percent of the total population in the same period. Improvements in surgical techniques, anesthesia, and intensive care units make surgical interventions in older and sicker patients possible. It is estimated that over half of the population older than 65 years will require surgical intervention at least once during the remainder of their lives. Therefore, elderly patients are becoming an even larger part of anesthetic practice. Regional anesthesia (RA) is frequently used in elderly patients, especially during orthopedic surgery, genitourologic and gynecologic procedures, and hernia repair. Although age can no longer be considered a contraindication to anesthesia and surgery, anesthesia-related morbidity and mortality remain higher among elderly than among young adult surgical patients. Undoubtedly, peripheral nerve (PN) blocks improve analgesia and reduce opioid consumption and their associated side effects. This is beneficial in the perioperative care of elderly patients who may have less physiologic reserve to withstand the side effects of general anesthesia (GA)
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