Advancing Lithium Battery Performance through Porous Conductive Polyaniline-Modified Graphene Composites Additive.

This study aimed to enhance lithium battery performance through the utilization of porous conductive polyaniline-modified graphene composites (PMGCs). Given the growing importance of green energy, coupled with the development of lithium-ion battery systems and electric vehicles, achieving high-speed charge and discharge performance is imperative. Traditional approaches involve incorporating additives like carbon nanotubes and graphene into electrodes to improve conductivity, but they encounter challenges related to cost and aggregation issues. In this study, polyaniline (PANI), a cost-effective, stable, and conductive polymer, was explored. PMGCs was formed by employing ammonium persulfate (APS) as an oxidant during PANI polymerization, simultaneously serving as a surface modifier for graphene. This study systematically investigated the impacts of varying amounts of PMGCs on lithium-ion battery electrodes by assessing the reductions in internal resistance, aging effects, different charge and discharge rates, and cycle performance. The PMGC exhibited a porous structure formed by nanoscale PANI intertwining on graphene. Various measurements, including FT-IR, TGA, Raman spectroscopy, and battery performance assessments, confirmed the successful synthesis and positive effects of PMGCs. The results indicated that a 0.5% addition of PMGC led to a reduced internal resistance and enhanced fast-charge and discharge capacity. However, an excessive amount of PMGCs adversely affected aging and self-discharge. This study provides valuable insights into optimizing the PMGC content for improved lithium battery performance, presenting potential advancements in energy storage systems and electric vehicles.

Calcium Stimulation Test for Insulinoma Localization in an End-stage Renal Disease Patient on Diazoxide.

Insulinomas are rare, and even rarer in patients with end-stage renal disease (ESRD). Clear criteria for the biochemical diagnosis of insulinomas in patients with renal failure have not been established, and hypoglycemia is often attributed to the renal disease itself, frequently leading to a delay in diagnosis. We describe a case of a patient who presented with asymptomatic recurrent hypoglycemia during hemodialysis. Disease progression and biochemical testing strongly suggested an insulinoma. Computed tomography (CT) of the abdomen and pelvis, 111In-pentetreotide scintigraphy and endoscopic ultrasound did not localize a pancreatic tumor. A calcium stimulation test was performed while the patient was taking diazoxide due to severe hypoglycemia with fasting for a couple of hours without treatment. The test showed a marked increase in insulin after calcium infusion in the dorsal pancreatic artery, localizing the tumor to the body and tail of the gland. Exploratory surgery easily identified a tumor at the body of the pancreas and pathology confirmed an insulin-secreting pancreatic neuroendocrine tumor. On follow-up, there was resolution of the hypoglycemia. We review the challenges of diagnosing an insulinoma in ESRD and describe a successful intra-arterial calcium stimulation test done in an ESRD patient while continuing diazoxide.

Failure of iodine uptake in microscopic pulmonary metastases after recombinant human thyroid-stimulating hormone stimulation.

Elevated thyroid stimulating hormone (TSH) is required when preparing for radioactive iodine therapy in patients with differentiated thyroid cancer. Recombinant human TSH (rhTSH: Thyrogen; Genzyme Corporation, Cambridge, MA) avoids hypothyroidism and has been commonly used in place of thyroid hormone withdrawal (THW) in this process. We describe a 31-year-old woman with sclerosing variant of papillary thyroid cancer with multiple lymph node metastases and elevated postoperative thyroglobulin suggesting the presence of distant metastases, who was found to have miliary pulmonary metastases on the posttherapy I-131 scan after THW, but not visible on the post therapy scan after rhTSH preparation.

Inpatient diabetes management by specialized diabetes team versus primary service team in non-critical care units: impact on 30-day readmission rate and hospital cost.

OBJECTIVE: We compared the cost-effectiveness of two inpatient diabetes care models: one offered by a specialized diabetes team (SDT) versus a primary service team (PST). RESEARCH DESIGN AND METHODS: We retrospectively evaluated 756 hospital admissions of patients with diabetes to non-critical care units over 6 months. Out of 392 patients who met the eligibility criteria, 262 were matched 1:1 based on the mean of the initial four blood glucose (BG) values after admission. Primary outcomes were 30-day readmission rate and frequency, hospital length of stay (LOS) and estimated hospital cost. Secondary outcomes included glycemic control and BG variability. RESULTS: Diabetes complexity and in-hospital complications were significantly higher among patients treated by SDT versus PST. Thirty-day readmission rate to medical services was lower by 30.5% in the SDT group versus the PST group (P<0.001), while 30-day readmission rate to surgical services was 5% higher in the SDT group versus the PST group (P<0.05), but frequency of 30-day readmissions was lower (1.1 vs 1.6 times, P<0.05). LOS in medical services was not different between the two groups, but it was significantly longer in surgical services in SDT (P<0.05). However, LOS was significantly lower in patients who were seen by SDT during the first 24 hours of admission compared with those who were seen after that (4.7 vs 6.1 days, P<0.001). Compliance to follow-up was higher in the SDT group. These changes were translated into considerable cost saving. CONCLUSIONS: Inpatient diabetes management by an SDT significantly reduces 30-day readmission rate to medical services, reduces inpatient diabetes cost, and improves transition of care and adherence to follow-up. SDT consultation during the first 24 hours of admission was associated with a significantly shorter hospital LOS.

First, do no harm: the risks of overtreating children with epilepsy.

BACKGROUND: Although overtreatment with antiepileptic drugs contributes to the morbidity associated with epilepsy, many children still are overtreated. OBJECTIVE: To evaluate if the withdrawal of at least one antiepileptic drug (AED) in children with refractory epilepsy using polytherapy enable a better seizure control. METHOD: This was a prospective study. Children with refractory epilepsy using at least two AEDs were included. Once the patient, or guardian, agreed to participate in the study, one or more AED were slowly tapered off. The remaining AEDs dosages could be adjusted as needed, but a new AED could not be introduced. RESULTS: Fifteen patients were evaluated, three girls; ages ranging from 3 to 18 (mean=8.7 years). After at least one AED withdrawal, two (13.5%) patients became seizure free, seizures improved >50% in 5 (33.5%) patients, did not change in 5 (33.5%), and seizure frequency became worse in 3 (20%). Adverse events improved in 12 patients (80%). CONCLUSION: The withdrawal of at least one AED is a valuable option in the treatment of selected children with refractory epilepsy.

What about us? Siblings of children with epilepsy.

RATIONALE: It is known that epilepsy has a severe impact in the quality of life of the patients; however, it affects the lives of all family members. The psychosocial repercussions of epilepsy are often of greater significance than the seizures themselves. METHODS: This was a prospective study, conducted from January 2005 to December 2005 at the pediatric epilepsy clinic of our University Hospital. Parents were interviewed by one of the authors according to a structured questionnaire about the impact of epilepsy in the life of the siblings of children with epilepsy. RESULTS: One hundred and twenty-seven children, siblings of 78 patients with epilepsy were evaluated. From the 127 siblings of children with epilepsy, 60 were girls and 67 were boys. Ages ranged from 5 to 18 years old (mean=11.7 years). After the diagnosis of epilepsy, the siblings had only negative feelings toward the disease, mostly sadness and fear. CONCLUSION: Our data showed that the impact of epilepsy in the lives of siblings of children with epilepsy is much more severe than previously suspected.

First, do no harm: the risks of overtreating children with epilepsy

BACKGROUND: Although overtreatment with antiepileptic drugs contributes to the morbidity associated with epilepsy, many children still are overtreated. OBJECTIVE: To evaluate if the withdrawal of at least one antiepileptic drug (AED) in children with refractory epilepsy using polytherapy enable a better seizure control. METHOD: This was a prospective study. Children with refractory epilepsy using at least two AEDs were included. Once the patient, or guardian, agreed to participate in the study, one or more AED were slowly tapered off. The remaining AEDs dosages could be adjusted as needed, but a new AED could not be introduced. RESULTS: Fifteen patients were evaluated, three girls; ages ranging from 3 to 18 (mean=8.7 years). After at least one AED withdrawal, two (13.5 percent) patients became seizure free, seizures improved >50 percent in 5 (33.5 percent) patients, did not change in 5 (33.5 percent), and seizure frequency became worse in 3 (20 percent). Adverse events improved in 12 patients (80 percent). CONCLUSION: The withdrawal of at least one AED is a valuable option in the treatment of selected children with refractory epilepsy.

INTRODUÇÃO: Apesar do tratamento excessivo com drogas antiepilépticas (DAE) contribuir para a morbidade associada à epilepsia, muitas crianças ainda são submetidas a politerapia desnecessária. OBJETIVO: Avaliar se a retirada de pelo menos uma DAE em crianças com epilepsia refratária utilizando politerapia pode proporcionar melhor controle das crises epilépticas. MÉTODOS: Este foi um estudo prospectivo. Crianças com epilepsia refratária em uso de pelo menos duas DAE foram incluídas. Após assinatura do consentimento informado, uma ou mais DAE foram lentamente retiradas. As doses das outras DAE que não foram retiradas poderiam ser ajustadas se necessário, mas uma nova DAE não pode ser introduzida. RESULTADOS: Quinze pacientes foram avaliados, três eram meninas, com idades entre 3 e 18 anos (média=8,7). Após a retirada de pelo menos uma DAE, 2 (13,5 por cento) pacientes ficaram livre de crises, as crises melhoraram em 5 (33,5 por cento), não mudaram em 5 (33,5 por cento) e a frequencia das crises pioraram em 3 (20 por cento) pacientes. Os eventos adversos melhoraram em 12 patientes (80 por cento). CONCLUSÃO: A retirada de pelo menos uma DAE é uma opção válida no tratamento de crianças com epilepsia refratária.