RESUMO
Coat color is a factor affecting heat tolerance in tropical ruminant and a particular coat color can determine which is more resilient to environmental changes. The aim of this study was to measure the level of adaptation of Morada Nova sheep with different coat color by using an Adaptability Index (AI). Adult ewes were used, including two different coat colors of Morada Nova sheep (red and white) with mean of body weight of 28.02 ± 5.70 kg and 31.47 ± 3.41 kg, respectively. Physiology parameters, hematology, electrolytes, acid-base status, mineral, renal functions, metabolites, enzymes, and proteins were measured. AI was designed using a multivariate approach (principal component analysis) to "weigh" the influence of each variable in the animal responses. The variables more important for adaptive aspects of Red Morada Nova were: haematology, electrolytes and acid-base status. The hemoglobin (HG), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), sodium (Na+), oxygen pressure (PO2), glucose (GLU) and albumin (ALB) were significantly higher in Red Morada Nova sheep and hydrogen carbonate (HCO3), base excess (BE), total carbon dioxide concentration (TCO2) and URE were significantly higher in the white phenotype. The variables more important for adaptive aspects of White Morada Nova sheep were: (K+), total protein (TP), PO2, HG, cholesterol (CHO), rectal temperature (RT) and glucose (GLU). Both phenotypes showed a high adaptation level, however, a higher value was generated for the Red Morada Nova sheep (81.97). This study concludes that both phenotypes of the Morada Nova sheep breed are well adapted to the climatic condition of the Brazilian tropical region using different adaptive mechanisms.
Assuntos
Adaptação Fisiológica , Animais , Ovinos/fisiologia , Feminino , Pelo Animal , Eletrólitos/sangue , Hemoglobinas/análiseRESUMO
Laser-induced breakdown spectroscopy (LIBS) was recently introduced as a rapid bone analysis technique in bone-infiltrating head and neck cancers. Research efforts on laser surgery systems with controlled tissue feedback are currently limited to animal specimens and the use of nontumorous tissues. Accordingly, this study aimed to characterize the electrolyte composition of tissues in human mandibular bone-infiltrating head and neck cancer. Mandible cross-sections from 12 patients with bone-invasive head and neck cancers were natively investigated with LIBS. Representative LIBS spectra (n = 3049) of the inferior alveolar nerve, fibrosis, tumor stroma, and cell-rich tumor areas were acquired and histologically validated. Tissue-specific differences in the LIBS spectra were determined by receiver operating characteristics analysis and visualized by principal component analysis. The electrolyte emission values of calcium (Ca) and potassium (K) significantly (p < 0.0001) differed in fibrosis, nerve tissue, tumor stroma, and cell-rich tumor areas. Based on the intracellular detection of Ca and K, LIBS ensures the discrimination between the inferior alveolar nerve and cell-rich tumor tissue with a sensitivity of ≥95.2% and a specificity of ≥87.2%. The heterogeneity of electrolyte emission values within tumorous and nontumorous tissue areas enables LIBS-based tissue recognition in mandibular bone-infiltrating head and neck cancer.
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Neoplasias de Cabeça e Pescoço , Lasers , Animais , Humanos , Análise Espectral/métodos , Eletrólitos , Mandíbula , FibroseRESUMO
Eumelanin is a natural pigment that can be particularly valuable for sustainable bioelectronic devices due to its inherent biocompatibility and hydration-dependent conductivity. However, the low conductivity of eumelanin limits its technological development. In this research, electrochemical doping was proposed as an alternative route to increase the electronic conductivity of synthetic eumelanin derivatives. Thin films of sulfonated eumelanin were deposited on platinum interdigitated electrodes and electrochemically treated by using cyclic voltammetry and chronoamperometry treatments. X-ray photoelectron spectroscopy analysis confirmed ion doping in sulfonated melanin. Current-voltage, current-time, and electrochemical impedance measurements were used to investigate the effect of different aqueous electrolytes (including KCl and LiClO4) treatments on the charge transport of sulfonated eumelanin. We show that the conductivity depends on the type and size of the anion used and can reach 10-3 S·cm-1. Additionally, depending on the electrolyte, there is a change in charge transport from mixed ionic/electronic to a predominantly electronic-only conduction. Our results show that the chemical nature of the ion plays an important role in the electrochemical doping and, consequently, in the charge transport of eumelanin. These insights serve as inspiration to explore the use of alternative electrolytes with different compositions further and develop eumelanin-based devices with tunable conductivities.
Assuntos
Alcanossulfonatos , Melaninas , Condutividade Elétrica , Eletrônica , EletrólitosRESUMO
Drought and heat are two stresses that often occur together and may pose significant risks to crops in future climates. However, the combined effects of these two stressors have received less attention than single-stressor investigations. This study used a rapid and straightforward phenotyping method to quantify the variation in 128 African eggplant genotype responses to drought, heat, and the combined effects of heat and drought at the seedling stage. The study found that the morphophysiological traits varied significantly among the 128 eggplants, highlighting variation in response to abiotic stresses. Broad-sense heritability was high (> 0.60) for chlorophyll content, plant biomass and performance index, electrolyte leakage, and total leaf area. Positive and significant relationships existed between biomass and photosynthetic parameters, but a negative association existed between electrolyte leakage and morpho-physiological traits. The plants underwent more significant stress when drought and heat stress were imposed concurrently than under single stresses, with the impact of drought on the plants being more detrimental than heat. There were antagonistic effects on the morphophysiology of the eggplants when heat and drought stress were applied together. Resilient genotypes such as RV100503, RV100501, JAMBA, LOC3, RV100164, RV100169, LOC 3, RV100483, GH5155, RV100430, GH1087, GH1087*, RV100388, RV100387, RV100391 maintained high relative water content, low electrolyte leakage, high Fv/Fm ratio and performance index, and increased biomass production under abiotic stress conditions. The antagonistic interactions between heat and drought observed here may be retained or enhanced during several stress combinations typical of plants' environments and must be factored into efforts to develop climate change-resilient crops. This paper demonstrates improvised climate chambers for high throughput, reliable, rapid, and cost-effective screening for heat and drought and combined stress tolerance in plants.
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Solanum melongena , Solanum , Solanum melongena/genética , Solanum/genética , Secas , Resposta ao Choque Térmico , EletrólitosRESUMO
Ultratrace elemental detections from a limited volume of samples can offer significant benefits in biomedical fields. However, it can be challenging to concentrate the particles being analyzed in a small area to improve the accuracy of detection. Ring-like deposits on the edges of colloidal droplets are a vexing problem in many applications. Herein, we report ultratrace elemental detection using a superhydrophobic surface-enhanced laser-induced breakdown spectroscopy (SELIBS) substrate fabricated by laser ablation followed by a soft lithography technique. In this work, the SELIBS spectra on a superhydrophobic polydimethylsiloxane (PDMS) substrate replicated from a laser-patterned master Teflon substrate are investigated. This work highlights the application of this newly created superhydrophobic substrate for detecting trace elements in body fluids using SELIBS. The developed PDMS substrate was successfully adopted to investigate the electrolyte variation in serum samples of oral cancer patients and normal volunteers. Principal component analysis (PCA) and match-no-match analysis were used to distinguish the elemental variation in cancer and control groups.
Assuntos
Dimetilpolisiloxanos , Neoplasias Bucais , Humanos , Neoplasias Bucais/diagnóstico , Eletrólitos , Análise Espectral , Interações Hidrofóbicas e HidrofílicasRESUMO
Mammalian kidneys are specialized to maintain fluid and electrolyte homeostasis. The epithelial transport processes along the renal tubule that match output to input have long been the subject of experimental and theoretical study. However, emerging data have identified a new dimension of investigation: sex. Like most tissues, the structure and function of the kidney is regulated by sex hormones and chromosomes. Available data demonstrate sex differences in the abundance of kidney solute and electrolyte transporters, establishing that renal tubular organization and operation are distinctly different in females and males. Newer studies have provided insights into the physiological consequences of these sex differences. Computational simulations predict that sex differences in transporter abundance are likely driven to optimize reproduction, enabling adaptive responses to the nutritional requirements of serial pregnancies and lactation - normal life-cycle changes that challenge the ability of renal transporters to maintain fluid and electrolyte homeostasis. Later in life, females may also undergo menopause, which is associated with changes in disease risk. Although numerous knowledge gaps remain, ongoing studies will provide further insights into the sex-specific mechanisms of sodium, potassium, acid-base and volume physiology throughout the life cycle, which may lead to therapeutic opportunities.
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Rim , Caracteres Sexuais , Animais , Feminino , Humanos , Masculino , Rim/fisiologia , Túbulos Renais , Eletrólitos , Sódio , MamíferosRESUMO
The most well-known criterion for POC devices is ASSURED, and affordability, i.e., using low-cost instrumentation, is the most challenging one. This manuscript provides a pathway for transitioning ESSENCE, an impedance-based biosensor platform, from using an expensive benchtop analyzer-KeySight 4294A (~$50k)-to using a significantly portable and cheaper USB oscilloscope-Analog Discovery 2 (~$200) -with similar sensitivity (around 100 times price difference). To achieve this, we carried out a fundamental study of the interplay between an electrolyte like potassium chloride (KCl), and an electrolyte buffer like phosphate buffered saline (PBS) in the presence and absence of a redox buffer like ferro/ferricyanide system and ([Ru(bpy)3]2+). Redox molecules in the electrolyte caused a significant change in the Nyquist curve of the impedance depending on the redox molecule type. The redox species and the background electrolyte have their own RC semicircles in the Nyquist curve, whose overlap depends on the redox concentration and electrolyte ionic strength. We found that by increasing the electrolyte ionic strength or the redox concentration, the RC semicircle moves to higher frequencies and vice versa. Importantly, the use of the buffer electrolyte, instead of KCl, led to a lower standard deviation and overall signal (lesser sensitivity). However, to achieve the best results from the biorecognition signal, we chose a buffered electrolyte like PBS with high ionic strength and lowered the redox probe concentrations to minimize the standard deviation and reduce any noise from migrating to the low-cost analyzer. Comparing the two analyzers shows similar results, with a lowered detection limit from the low-cost analyzer.
Assuntos
Técnicas Biossensoriais , Eletrólitos , Impedância Elétrica , OxirreduçãoRESUMO
BACKGROUND: Patients in the intensive care unit (ICU) are at high risk for refeeding syndrome (RFS), yet there is uncertainty regarding how RFS should be operationalized in the ICU. We evaluated different definitions for RFS and tested how they associated with patient-centered outcomes in the ICU. METHODS: This was a retrospective comparison study. Patients age ≥18 years were eligible if they were newly initiated on enteral feeding while hospitalized in the ICU. Eight definitions for RFS were operationalized, including that from the American Society for Parenteral and Enteral Nutrition (ASPEN), all based on electrolyte levels from immediately before until up to 5 days after the initiation of enteral nutrition. Patients were followed for death or for ICU-free days, a measure of healthcare utilization. RESULTS: In all, 2123 patients were identified, including 406 (19.1%) who died within 30 days of ICU admission and 1717 (80.9%) who did not. Prevalence of RFS varied from 1.5% to 88% (ASPEN definition) depending on the RFS definition used. The excess risk for death associated with RFS varied from 33% to 92% across definitions. The development of RFS based on the ASPEN definition was associated with a greater decrease in ICU-free days compared with other definitions, but the relationship was not statistically significant. CONCLUSION: Eight definitions for RFS were evaluated, none of which showed strong associations with death or ICU-free days. It may be challenging to achieve a standardized definition for RFS that is based on electrolyte values and predicts mortality or ICU-free days.
Assuntos
Síndrome da Realimentação , Humanos , Adulto , Adolescente , Síndrome da Realimentação/diagnóstico , Síndrome da Realimentação/etiologia , Estado Terminal/terapia , Estudos Retrospectivos , Nutrição Enteral/efeitos adversos , EletrólitosRESUMO
Excess manganese (Mn) concentrations can pose environmental and health risks. Currently, research on Mn removal by electrocoagulation (EC) using transition metal electrodes and the determination of its potential environmental impacts is limited. This study aims to assess the electrocoagulation process's performance with a titanium electrode as a sacrificial anode while also performing a life cycle assessment (LCA) of the process. The initial pH, current density (CD), electrode spacings, electrolyte types, concentrations, and electrode arrangement were all examined. For synthetic wastewater, most of the experiments used a concentration of Mn of 2 mg/L and sodium chloride as a supporting electrolyte at a concentration of 1 g/L. LCA software (OpenLCA 1.11) was used to assess the potential environmental impacts. Optimal operating conditions within the experimental range were as follows: initial pH = 7, CD = 10 mA/cm2, gap distance = 2 cm, and 1 g/L NaCl. Under these conditions, the maximum Mn removal efficiency was 96.5% after 60 min. There was an improvement of 2% rise after 60 min when the temperature increased from 20 °C to 40 °C. For real wastewater, the highest removal efficiencies for Mn and chemical oxygen demand after 60 min were 91.3% and 92%, respectively. The pseudo second order model provides the highest coefficient of determination for expressing the experimental data. Global warming, human non-carcinogenic toxicity, and terrestrial ecotoxicity were the most important categories of impact examined in this work according to the LCA (0.00064 kg CO2 eq, 0.00018 kg 1,4-DCB, and 0.00028 kg 1,4-DCB, respectively). To effectively remove Mn using EC with Ti electrodes, it appears that a period of electrolysis of 10 min would be sufficient under most of the conditions investigated in this study. The reduction in the electrolysis time will lead to a reduction in the operating costs of the system.
Assuntos
Águas Residuárias , Poluentes Químicos da Água , Humanos , Animais , Manganês , Titânio , Eletrocoagulação , Eletrólitos , Eletrodos , Cloreto de Sódio , Estágios do Ciclo de Vida , Eliminação de Resíduos LíquidosRESUMO
OBJECTIVE: The aim of the study is to evaluate opioid analgesic utilization and predictors for adverse events during hospitalization and discharge disposition among patients admitted with osteoarthritis or spine disorders. DESIGN: This is a retrospective study of 12,747 adult patients admitted to six private community hospitals from 2017 to 2020. Opioid use during hospitalization and risk factors for hospital-acquired adverse events and nonhome discharge were investigated. RESULTS: The total number of patients using opioids decreased; however, the daily morphine milligram equivalent use for patients on opioids increased from 2017 to 2020. Increased odds of nonhome discharge were associated with older age, Medicaid, Medicare insurance, and increased lengths of stay, increased body mass index, daily morphine milligram equivalent, and electrolyte replacement in the osteoarthritis group. In the spine group, older age, Black race, Medicaid, Medicare, no insurance, increased Charlson Comorbidity Index, lengths of stay, polypharmacy, and heparin use were associated with nonhome discharge. Adverse events were associated with increased age, lengths of stay, Medicare, polypharmacy, antiemetic, and benzodiazepine use in the osteoarthritis group and increased Charlson Comorbidity Index, lengths of stay, and electrolyte replacement in the spine group. CONCLUSIONS: Despite the decreasing number of patients using opioids over the years, patients on opioids had an increased daily morphine milligram equivalent over the same period.
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Analgésicos Opioides , Osteoartrite , Adulto , Humanos , Idoso , Estados Unidos , Analgésicos Opioides/uso terapêutico , Estudos Retrospectivos , Pacientes Internados , Medicare , Hospitalização , Hospitais , Osteoartrite/tratamento farmacológico , Eletrólitos , Derivados da MorfinaRESUMO
Herein electrochemical oxidation (EO) is proposed as a novel path to treat the process water obtained from hydrothermal carbonization of olive tree pruning. The aim of this work is to analyze the organic matter removal achieved by the treatment along with the identification of the chemical species formed after the electro-oxidation process at different experimental conditions. Three different tests were performed in a boron doped diamond cell, using Na2SO4 and NaCl as supporting electrolytes to compare the results obtained with the raw process water. The organic matter removal was evaluated by means of total organic carbon and chemical oxygen demand, while Gas Chromatography Mass Spectrometry was used to determine the chemical species present before and after the treatment. The addition of a promoter considerably increased the organic matter removal. In fact, the experiments performed using supporting electrolytes showed the best results in terms of organic matter removal compared to the control experiment (30-40% vs. 17%); This reduction agrees with the volatile fatty acids' measurements. Almost all the chemical species identified in the different feedstocks were partially or totally removed after the EO treatment depending on the experimental conditions. The specific energy consumption and the cost calculated for the treatment is highly dependent on the time of electro-oxidation and the supporting electrolyte used, obtaining values from 1 to 45 /kg CODremoved. All in all, this work suggests an interesting path towards a further utilization of process water from hydrothermal carbonization processes.
Assuntos
Poluentes Químicos da Água , Água , Poluentes Químicos da Água/análise , Eletrodos , Diamante , Oxirredução , Eletrólitos/químicaRESUMO
Abstract Malaria, a disease of public health concern is a known cause of kidney failure, and dependence on herbal medicines for its treatment is increasing due to the high cost of drugs. So this study is designed to evaluate the ameliorating effect of ethanol extract from Salacia nitida root bark on electrolyte and renal perturbations in Plasmodium berghei-infected mice. Thirty malariainfected mice divided into five groups of six mice each and another group of six uninfected mice were used for the study. 280, 430, and 580 mg/kg of extract were given to infected mice in groups B, C, and D, 4 mg/kg of artesunate given to group E mice, and 4 ml/kg of physiological saline given to group A and uninfected group F mice for five days. Serum Na+, K+, HCO3, Cl-, TB, urea, creatinine, BUN concentrations, and BUN/creatinine ratio were determined using standard methods. Results showed significant increases (p < 0.05) in Na+, K+, and HCO3 and decreases in Cl-, TB, urea, creatinine, BUN, and BUN/creatinine ratio in the infected treated mice in groups B - E. This study showed that ethanol extract of S. nitida root bark is efficient in the treatment of renal disorders and blood electrolyte perturbations
Assuntos
Animais , Masculino , Feminino , Camundongos , Raízes de Plantas/efeitos adversos , Salacia/efeitos adversos , Insuficiência Renal/induzido quimicamente , Malária/patologia , Preparações Farmacêuticas/análise , Custos e Análise de Custo/classificação , Eletrólitos/agonistas , Artesunato/antagonistas & inibidoresRESUMO
The resource disposal of electrolytic manganese residue can effectively solve the problem of environmental pollution caused by it, among which the problem of heavy metal pollution is the most prominent. In this study, a new type of eco-friendly brick mixed with electrolytic manganese residue was designed. The influence of the content of electrolytic manganese residue on its macroscopic properties, microscopic properties, and leaching characteristics was analyzed by test methods such as compressive strength test, radioactivity test, XRF, XRD, FTIR, and ICP test of bricks. The results showed that the manganese content in the EMR leachate was 8120 mg/L, which exceeded the Chinese standard. The leaching experiment of ordinary aqueous solution of sintered bricks mixed with 20% EMR showed that the content of heavy metals was far lower than the Chinese national standard. There was no non-carcinogenic risk of heavy metals in the strong acid leaching solution of sintered bricks mixed with 20% EMR. Only the carcinogenic risk values of Cr for adults and children were 4.21 × 10-4 and 9.82 × 10-4 respectively, both exceeding the USEPA limit, but the application scene of sintered bricks was difficult to achieve strong acidity, so it was judged that it had no carcinogenic risk to the human body. Characteristic heavy metals such as Mn, Cr, and As existed stably in sintered bricks through substitution and encapsulation. In addition, the compressive strength and radioactivity of EMR sintered bricks met the requirements of the Chinese national standard "Fired Ordinary Bricks." This product can be used as national standard MU20 grade brick. This study provided an efficient method for the safe and environmentally friendly disposal of EMR in a sustainable control system.
Assuntos
Poluentes Ambientais , Metais Pesados , Criança , Humanos , Manganês/química , Poluentes Ambientais/análise , Íons , Eletrólitos/química , Medição de RiscoRESUMO
OBJECTIVES: Economic hardship has a serious impact on adolescents' mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents' suicidal behaviors. METHODS: This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions. RESULTS: The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively. CONCLUSIONS: ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.
Assuntos
Comportamento do Adolescente , COVID-19 , Adolescente , Humanos , Estudos Transversais , Eletrólitos , Internet , Pandemias , República da Coreia/epidemiologia , Fatores de Risco , Assunção de Riscos , Classe Social , Ideação SuicidaRESUMO
BACKGROUND: Nontraumatic subdural hematoma (SDH) is a common neurological disease that causes extensive morbidity and mortality. Craniotomy or burr hole craniostomy (BHC) is indicated for symptomatic lesions, but both are associated with high recurrence rates. Although extensive research exists on postoperative complications after BHCs, few studies have examined the underlying causes and predictors of unplanned 30-day hospital readmissions at the national level. OBJECTIVE: To compare causes for hospital readmission within 30 days after surgical SDH evacuation with BHC and evaluate readmission rates and independent predictors of readmission. METHODS: This retrospective cohort observational study was designed using the Nationwide Readmissions Database. We identified patients who had undergone BHC for SDH evacuation (2010-2015). National estimates and variances within the cohort were calculated after stratifying, hospital clustering, and weighting variables. RESULTS: We analyzed 2753 patients who had BHC for SDH evacuation: 675 (24.5%) had at least one 30-day readmission. Annual readmission rates did not vary across the study period ( P = .60). The most common cause of readmission was recurrent SDH (n = 630, 93.3%), and the next most common was postoperative infection (n = 12, 1.8%). Comorbidities significantly associated with readmission included fluid and electrolyte disorders, chronic blood loss anemia, chronic obstructive pulmonary disease, depression, liver disease, and psychosis ( P ≤ .04), but statistically significant independent predictors for readmission included only chronic obstructive pulmonary disease and fluid and electrolyte disorders ( P ≤ .007). CONCLUSION: These national trends in 30-day readmission rates after nontraumatic SDH evacuation by BHC not otherwise published provide quality benchmarks that can aid national quality improvement efforts.
Assuntos
Hematoma Subdural Crônico , Doença Pulmonar Obstrutiva Crônica , Humanos , Hematoma Subdural Crônico/cirurgia , Readmissão do Paciente , Estudos Retrospectivos , Preços Hospitalares , Craniotomia , Drenagem , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/cirurgia , Hospitais , Doença Pulmonar Obstrutiva Crônica/cirurgia , Eletrólitos , Resultado do TratamentoRESUMO
This study aimed to investigate the relationship between cost-sharing and drug prescribing and its appropriateness in Korean elderly veterans with chronic conditions. This is a cross-sectional study using real-world claims data. Veterans with primary hypertension or dyslipidemia were compared with two controls with higher levels of cost-sharing. Study subjects (ageâ ≥65 years) were selected through stratified random sampling and matching the individual attributes. The primary outcome was the annual amount of drugs prescribed per patient, and the secondary outcomes included several other measures investigating multifaceted aspects of drug prescribing, medical institution utilization behavior, and prescribing appropriateness. Gamma regression models or logistic regression models were employed. Veterans were prescribed 59%~74% more drugs (exp (ß) = 1.59 [95% confidence interval [CI]â =â 1.55-1.64] ~ 1.74 [1.70-1.79]) compared to the National Health Insurance (NHI) patients. This was attributed mainly to longer prescribing days (44%) and slightly more prescriptions (6%~7%) than NHI patients. Veterans spent 14%~15% higher medication costs. Veterans were less likely to visit multiple medical institutions by estimates of 0.77 (0.76-0.79) ~ 0.80 (0.79-0.82). Similar but smaller differences were observed between veterans and medical aid (MedAid) patients. The veteran patients showed a more than 50% increased risk of therapeutic duplication than the other two controls (adjusted odds ratio [ORs]â =â 1.47 [1.37-1.57] ~ 1.61 [1.50-1.72]). Inappropriate drug prescribing was also more common in veterans than the two controls (adjusted ORsâ =â 1.20 [1.11-1.31] ~ 1.32 [1.22-1.43]). In Korean elderly veterans with chronic illnesses, a level of cost-sharing was associated with having more prescribed medicines, and increased inappropriate prescribing.
Assuntos
Veteranos , Idoso , Humanos , Doença Crônica , Estudos Transversais , Prescrições de Medicamentos , Eletrólitos , República da CoreiaRESUMO
From August 15, 2015 to March 5, 2016, Tanzania reported 16,521 cholera cases and 251 deaths, with 4,596 cases and 44 deaths in its largest city, Dar es Salaam. To evaluate outbreak response efforts, we conducted a household survey with drinking water testing in the five most affected wards in Dar es Salaam. We interviewed 641 households 6 months after the beginning of the outbreak. Although most respondents knew that cholera causes diarrhea (90%) and would seek care if suspecting cholera (95%), only 45% were aware of the current outbreak in the area and only 5% would use oral rehydration salts (ORS) if ill. Of 200 (31%) respondents reporting no regular water treatment, 46% believed treatment was unnecessary and 18% believed treatment was too expensive. Fecal contamination was found in 45% of water samples and was associated with water availability (P = 0.047). Only 11% of samples had detectable free chlorine residual, which was associated with water availability (P = 0.025), reported current water treatment (P = 0.006), and observed free chlorine product in the household (P = 0.015). The provision of accessible, adequately chlorinated water supply, and implementation of social mobilization campaigns advocating household water treatment and use of ORS should be prioritized to address gaps in cholera prevention and treatment activities.
Assuntos
Cólera , Água Potável , Humanos , Cloro , Cólera/epidemiologia , Cólera/prevenção & controle , Eletrólitos , Sais , Tanzânia/epidemiologiaRESUMO
Fluid and electrolyte homeostasis exhibited by the kidneys is a complex process that is challenging to regulate with artificial renal replacement therapy (RRT). RRT has been used as a treatment modality for electrolyte and acid-base disturbances in patients with acute kidney injury and chronic kidney disease. This review highlights the management of electrolyte shifts, acid-base disturbances, and medication considerations in RRT, with a focus on intermittent hemodialysis and continuous RTT in the inpatient setting.