scholarly journals Characterization of Calcium Homeostasis in Lithium-Treated Patients Reveals Both Hypercalcaemia and Hypocalcaemia

2019 ◽  
Vol 44 (2) ◽  
pp. 517-525 ◽  
Author(s):  
Adrian D. Meehan ◽  
Göran Wallin ◽  
Johannes Järhult
Keyword(s):  
Calcium Homeostasis ◽  
Medical Records ◽  
Treatment Duration ◽  
Lithium Treatment ◽  
Significant Proportion ◽  
Prevalence Studies ◽  
Parathyroid Dysfunction ◽  
Very High

Abstract Introduction Prevalence studies demonstrate that a significant proportion of lithium-treated patients develop hypercalcaemia (3–30%). Lithium-associated hyperparathyroidism (LHPT) is poorly defined, and calcium homeostasis may be affected in a more complicated fashion than purely by elevated PTH secretion. The current study aims to examine in detail calcium homeostasis principally with regard to lithium duration. Methods Medical records of 297 lithium-treated patients (193 women, 104 men; median age 58 years) were examined, and information on gender, age, lithium treatment duration and calcium homeostasis was obtained. The median treatment duration with lithium was 16 (1.5–45) years. Results A total of 8504 calcium values were retrieved. Before initiation of lithium treatment, serum calcium was on average 2.33 mmol/l (2.02–2.60). During the treatment period, 178 patients (60%) remained normocalcaemic, 102 (34%) developed hypercalcaemia or were strongly suspected of LHPT, 17 (6%) had 3 or more intermittent episodes of hypocalcaemia. Forty-one per cent of patients with suspected or confirmed LHPT had low (<4 mmol) 24-h urine calcium levels. The success rate after 33 parathyroidectomies was 35%, hyperplasia being diagnosed in 75% of extirpated glands. Conclusions The prevalence of hypercalcaemia during lithium treatment is very high. In addition, hypocalcaemic episodes appear to occur frequently, possibly reflecting a more complicated parathyroid dysfunction than previously known. Long-term surgical results are unsatisfactory. LHPT biochemical profile is different from that of primary hyperparathyroidism and is in some ways similar to familial hypocalciuric hypercalcaemia.

Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion

2021 ◽  
pp. 000348942110155
Author(s):  
Leonard Haller ◽  
Khush Mehul Kharidia ◽  
Caitlin Bertelsen ◽  
Jeffrey Wang ◽  
Karla O’Dell
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Assessment Tool ◽  
Demographic Data ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Long Term Follow Up

Objective: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF). Methods: About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks—3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records. Results: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 ( P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively. Conclusion: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.

VERITAS OBSERVATIONS OF RELATIVISTIC OUTFLOWS IN LOW- AND INTERMEDIATE-FREQUENCY-PEAKED BL LAC OBJECTS

2014 ◽  
Vol 28 ◽  
pp. 1460178
Author(s):  
◽  
HEIKE PROKOPH
Keyword(s):  
Gamma Ray ◽  
Intermediate Frequency ◽  
Bl Lac Objects ◽  
Bl Lacertae ◽  
Bl Lac ◽  
Bl Lacs ◽  
Gamma Ray Telescopes ◽  
Very High

The majority of blazars detected at very high energies (VHE; E > 100 GeV) are high-frequency-peaked BL Lac objects (HBLs). Low- and intermediate-frequency-peaked BL Lacs (LBLs/IBLs with synchrotron-peak frequencies in the infrared and optical regime) are generally more powerful, more luminous, and have a richer jet environment than HBLs. However, only a handful of these IBL and LBLs have been detected by ground-based gamma-ray telescopes, typically during high-flux states. The VERITAS array has been monitoring five known VHE LBLs/IBLs since 2009: 3C 66A, W Comae, PKS 1424+240, S5 0716+714 and BL Lacertae, with typical exposures of 5-10 hours per year. The results of these long-term observations are presented, including a bright, subhour-scale VHE flare of BL Lacertae in June 2011, the first low-state detections of 3C 66A and W Comae, and the detection and characterization of the IBL B2 1215+30.

A historical cohort study of kidney damage in long-term lithium patients: continued surveillance needed

2001 ◽  
Vol 16 (4) ◽  
pp. 199-206 ◽  
Author(s):  
H. Bendz ◽  
M. Aurell ◽  
J. Lanke
Keyword(s):  
Renal Function ◽  
Treatment Duration ◽  
Filtration Rate ◽  
Lithium Treatment ◽  
Initial Study ◽  
Historical Cohort ◽  
Record Review ◽  
Insufficient Knowledge

SummaryBackgroundInsufficient knowledge on the longitudinal fate of renal function in lithium patients incited this retrospective study of 149 patients.MethodMedical record review of a lithium cohort (N = 149), 8–12 years after an initial renal function study.ResultsTwenty-one patients had died, one from uremia probably not caused by lithium, and 42 had discontinued lithium. Reduced urinary concentrating capacity (Umax) or glomerular filtration rate (GFR) was not more frequent among deceased or off-lithium patients than among the 86 patients who were on lithium at follow-up. In 63 of the latter patients, Umax had been re-examined after the initial study, and GFR in 29 patients. Reduced Umax and GFR had become twice as common, and average Umax and GFR had decreased significantly. The reduction of GFR was associated with lithium treatment duration and age, and reduced Umax with treatment duration only.ConclusionsReduced renal function is not a major cause of treatment discontinuation but becomes increasingly common with treatment duration.

scholarly journals Validation of Swedevox registry of continuous positive airway pressure (CPAP), long-term mechanical ventilator (LTMV) and long-term oxygen therapy (LTOT)

2020 ◽  
pp. 00340-2020 ◽  
Author(s):  
Magnus Ekström ◽  
Dirk Albrecht ◽  
Susanne Andersson ◽  
Ludger Grote ◽  
Birgitta Kärrsten Rundström ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Medical Records ◽  
Airway Pressure ◽  
Oxygen Therapy ◽  
Positive Airway Pressure ◽  
Mechanical Ventilator ◽  
Diagnosis Group ◽  
Long Term Oxygen Therapy ◽  
Very High

BackgroundThe Swedish Registry of Respiratory Failure (Swedevox) collects nationwide data on patients starting continuous positive airway pressure (CPAP) treatment, long-term mechanical ventilator (LTMV) and long-term oxygen therapy (LTOT). We validated key information in Swedevox against source data from medical records.MethodsThis was a retrospective validation study of patients starting CPAP (n=175), LTMV (n=177) or LTOT (n=175) across seven centres 2013–2017. Agreement with medical record data was analysed using differences in means (standard deviation) and proportion (%) of a selection of clinically relevant variables. Variables of interest included for CPAP: Apnea Hypopnea Index (AHI), height, weight, body mass index (BMI) and Epworth Sleepiness Scale (ESS) score; for LTMV: date of blood gas, PaCO2 (breathing air), weight and diagnosis group; and for LTOT: blood gases breathing air and oxygen, spirometry and main diagnosis.ResultsData on CPAP and LTOT had very high validity across all evaluated variables (all <5% discrepancy). For LTMV, variability was higher against source information for PaCO2 (>0.5 kPa in 25.9%), weight (>5 kg in 47.5%) and diagnosis group. Inconsistency was higher for patients starting LTMV acutely versus electively (PaCO2 –difference >0.5 kPa in 36% versus 21%, p<0.05, respectively). However, there were no signs of systematic bias (mean differences close to zero) across the evaluated variables.ConclusionValidity of Swedevox data, compared with medical records, was very high for CPAP, LTMV and LTOT. The large sample size and lack of systematic differences support that Swedevox data are valid for health care quality assessment and research.

scholarly journals Encapsulating Peritoneal Sclerosis in Long-Termed Peritoneal Dialysis Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Heng-Jung Hsu ◽  
Shih-Ying Yang ◽  
I-Wen Wu ◽  
Kuang-Hung Hsu ◽  
Chiao-Yin Sun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Medical Records ◽  
Treatment Duration ◽  
Logistic Model ◽  
Clinical Characteristics ◽  
Univariate Analysis ◽  
Control Group ◽  
Dialysis Patients ◽  
Multivariate Logistic Model

Background.Encapsulating peritoneal sclerosis (EPS) is a rare but serious clinical complication of long-term peritoneal dialysis (PD) patients with high mortality. The purpose of this study was to assess the clinical characteristics of patients with EPS and to search for possible factors useful for EPS prevention and early diagnosis.Method.This retrospective study was performed in a single dialysis center in Taiwan between August 1990 and April 2014. Overall, a total of 565 patients were included and the medical records of those patients who had developed EPS (EPS group) and those who had not developed EPS (control group) were collected. We compared several factors between these two groups.Result.In the univariate analysis, EPS was significantly associated with a change of transport state (Delta 2) (p= 0.007), duration of PD (p< 0.001), duration of peritonitis treatment (p= 0.001), number of peritonitis episodes (p= 0.002), and fungus related peritonitis (p= 0.031). After multivariate logistic model analysis, we found that only the duration of PD was independently significantly associated with EPS (p= 0.034). In addition, we used the ROC curve and found that a duration of peritoneal dialysis of about 8.4 years is the best cut-off point to predict EPS occurrence.Conclusion.In this study, long-termed PD duration is the only strong independent risk factor for EPS development. Total peritonitis times, total peritonitis treatment duration, and marked increased peritoneal D/Pcrratio were also significantly associated with the duration of PD.

Structural characterization of polycrystalline (Nd,Al)-substituted zirconolite

2002 ◽  
Vol 757 ◽  
Author(s):  
Pascal Loiseau ◽  
Daniel Caurant ◽  
Noël Baffier ◽  
Catherine Fillet
Keyword(s):  
Structural Characterization ◽  
Single Phase ◽  
Rietveld Method ◽  
Structure Refinement ◽  
Significant Proportion ◽  
Optical Absorption Spectroscopy ◽  
Minor Actinides ◽  
X Ray

ABSTRACTZirconolite (formally CaZrTi2O7) is a crystalline phase particularly well adapted to actinide immobilization because of its excellent long-term behavior and its good containment capacity. Most of the French studies on zirconolite deal with minor actinides that are mainly responsible for the long-term radiotoxicity of high-level radioactive wastes. For these kind of studies, trivalent minor actinides (Am3+, Cm3+) can be simulated by a lanthanide ion with an ionic radius similar to that of Nd3+. Thus, several materials having the composition Ca1-xNdxZrTi2-xAlxO7 (0 ≤ x ≤ 0.8) were prepared by solid state reaction. These polycristalline materials were first characterized by X-ray diffraction and scanning electron microscopy associated with energy dispersive X-ray analysis in order to determine the nature of the crystalline phases formed. For low neodymium content (x ≤ 0.1), electron spin resonance of Nd3+ ions revealed that a significant proportion of these ions entered into trace amounts of perovskite. Nevertheless, all Ca1-xNdxZrTi2-xAlxO7 samples with x ≤ 0.6 can be considered as almost single phase zirconolite-2M. Structure refinement by the Rietveld method of Ca0.7Nd0.3ZrTi1.7Al0.3O7 showed that Nd3+ and Al3+ ions mainly entered respectively into the calcium site and into the split five-fold coordinated titanium site. Structural characterization of Ca0.3Nd0.7ZrTi1.3Al0.7O7 and Ca0.2Nd0.8ZrTi1.2Al0.8O7 samples confirmed that these compositions led to the crystallization of almost single phase zirconolite-3O, an orthorhombic polytype of zirconolite, whose structure was also refined by the Rietveld method. Results concerning neodymium location in Ca0.7Nd0.3ZrTi1.7Al0.3O7 and Ca0.3Nd0.7ZrTi1.3Al0.7O7 were qualitatively confirmed by optical absorption spectroscopy at low temperature.

scholarly journals Characterization of a progenitor cell population in childhood T-cell acute lymphoblastic leukemia

Blood ◽  
2006 ◽  
Vol 109 (2) ◽  
pp. 674-682 ◽  
Author(s):  
Charlotte V. Cox ◽  
Hannah M. Martin ◽  
Pamela R. Kearns ◽  
Paul Virgo ◽  
Roger S. Evely ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
T Cell ◽  
Lymphoblastic Leukemia ◽  
Significant Proportion ◽  
Serial Passage ◽  
Cell Acute Lymphoblastic Leukemia

Abstract A significant proportion of children with T-cell acute lymphoblastic leukemia (T-ALL) continue to fail therapy. Consequently, characterization of the cells that proliferate to maintain the disease should provide valuable information on the most relevant therapeutic targets. We have used in vitro suspension culture (SC) and nonobese diabetic–severe combined immune deficient (NOD/SCID) mouse assays to phenotypically characterize and purify T-ALL progenitor cells. Cells from 13 pediatric cases were maintained in vitro for at least 4 weeks and expanded in 8 cases. To characterize the progenitors, cells were sorted for expression of CD34 and CD4 or CD7 and the subfractions were evaluated in vitro and in vivo. The majority of cells capable of long-term proliferation in vitro were derived from the CD34+/CD4− and CD34+/CD7− subfractions. Moreover, the CD34+/CD4− or CD7− cells were the only subfractions capable of NOD/SCID engraftment. These T-ALL cells successfully repopulated secondary and tertiary recipients with equivalent levels of engraftment, demonstrating self-renewal ability. The immunophenotype and genotype of the original leukemia cells were preserved with serial passage in the NOD/SCID mice. These data demonstrate the long-term repopulating ability of the CD34+/CD4− and CD34+/CD7− subfractions in T-ALL and suggest that a cell with a more primitive phenotype was the target for leukemic transformation in these cases.

Long-Term Characterization of 6H-SiC Transistor Integrated Circuit Technology Operating at 500 °C

2008 ◽  
Vol 1069 ◽  
Author(s):  
Philip Neudeck ◽  
David J. Spry ◽  
Liang-Yu Chen ◽  
Carl W. Chang ◽  
Glenn M. Beheim ◽  
...  
Keyword(s):  
Integrated Circuits ◽  
Integrated Circuit ◽  
Field Effect Transistors ◽  
Aircraft Engines ◽  
Electrical Parameters ◽  
Air Atmosphere ◽  
Circuit Technology ◽  
Very High

ABSTRACTNASA has been developing very high temperature semiconductor integrated circuits for use in the hot sections of aircraft engines and for Venus exploration. This paper reports on long-term 500 °C electrical operation of prototype 6H-SiC integrated circuits based on epitaxial 6H-SiC junction field effect transistors (JFETs). As of this writing, some devices have surpassed 4000 hours of continuous 500 °C electrical operation in oxidizing air atmosphere with minimal change in relevant electrical parameters.

Alkali Activated Cementitious Materials: An Overview

1991 ◽  
Vol 245 ◽  
Author(s):  
D. M. Roy ◽  
M. R. Silsbee
Keyword(s):  
Amorphous Materials ◽  
Cementitious Materials ◽  
Solution Chemistry ◽  
Reaction Products ◽  
Alumino Silicate ◽  
Alkali Activated ◽  
Very High

ABSTRACTAlkali-activated cementitious materials have considerable potential, with properties ranging from very high early strength to very high long term strength and low porosity. The role of alkalis in activating industrial by-products such as ground granulated (glassy) blast-furnace slag, ultra-fine silica fume or other by-product silicas, glassy fly ashes, and other amorphous materials is discussed. These by-product materials are activated by alkali additions which break the strong silicon oxygen bonds in the silicate or alumino-silicate network, accompanied by the formation of new reaction products. The role of the different components in multi-component activated cements on the reactivity and the nature of the resultant products is discussed. Characterization of starting materials and reaction products by XRD, SEM (including environmental SEM), chemical, and particle characterization techniques has been made. Additional results include investigation of pore solution chemistry as a function of time. Some inferences for long term durability are discussed.

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