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Desmopression is an effective adjunct treatment for reversing excessive hyponatremia overcorrection

World journal of Clinical Cases 2013年第5期1卷 155-158页

作者： Kamel A Gharaibeh matthew j craig Christian A Koch Anna A Lerant Tibor Fülp va Csongrádi Department of Internal Medicine University of Mississippi Medical CenterJacksonMS 39216-4505United States Department of Anesthesiology University of Mississippi Medical CenterJacksonMS 39216-4505United States Department of Medicine University of Debrecen Medical and Health Science CentreUniversity of Debrecen4032 DebrecenHungary

We report a case of a 50-year-old malnourished African American male with hiccups, nausea and vomiting who was brought to the Emergency Department after repeated seizures at home. Laboratory evaluations revealed sodium(Na+) 107 mmol/L, unmeasurably low potassium, chloride < 60 mmol/L, bicarbonate of 38 mmol/L and serum osmolality 217 m Osm/kg. Seizures were controlled with 3% saline Ⅳ. Once nausea was controlled with iv antiemetics, he developed large volume free water diuresis with 6 L of dilute urine in 8 h(urine osmolality 40-60 m Osm/kg) and serum sodium rapidly rose to 126 mmol/L in 12 h. Both intravenous desmopressin and 5% dextrose in water was given to achieve a concentrated urine and to temporarily reverse theacute rise of sodium, respectively. Serum Na+ was gradually re-corrected in 2-3 mmol/L daily increments from 118 mmol/L until 130 mmol/L. Hypokalemia was slowly corrected with resultant auto-correction of metabolic alkalosis. The patient discharged home with no neurologic sequaele on the 11 th hospital day. In euvolemic hyponatremic patient, controlling nausea may contribute to unpredictable free water diuresis. The addition of an antidiuretic hormone analog, such as desmopressin can limit urine output and prevent an unpredictable rise of the serum sodium.

关键词： Hyponatremia Hypokalemia Overcorrection Polyuria Antidiuretic hormone Vasopressin Desmopressin Osmotic demyelination syndrome Central pontine myelinolysis

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A randomized controlled trial of Promoting Physical Activity in Regional and Remote Cancer Survivors(PPARCS)

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journal of Sport and Health Science 2024年第1期13卷 81-89页

作者： Sarah j.Hardcastle Chloe Maxwell-Smith Vinicius Cavalheri Terry Boyle Marta Leyton Román Cameron Platell Michael Levitt Christobel Saunders Frank Sardelic Sophie Nightingale jacob McCormick craig Lynch Paul A.Cohen Max Bulsara Dana Hince Sport and Physical Activity Research Centre Sheffield Hallam UniversitySheffieldS102BPUK Institute for Health Research The University of Notre DameFremantleWA 6959Australia Curtin School of Population Health Curtin UniversityPerthWA 6845Australia Curtin School of Allied Health Curtin UniversityPerthWA 6845Australia Allied Health South Metropolitan Health ServiceMurdochWA 6150Australia Australian Centre for Precision Health University of South AustraliaAdelaideSA 5001Australia Department of Didactics of Musical Plastic and Body ExpressionUniversity of ExtremaduraCaceres 10071Spain St.john of God Subiaco Hospital PerthWA 6008Australia Department of Surgery University of MelbourneMelbourneVIC 3010Australia Tamara Private Hospital TamworthNSW 2340Australia Peter MacCallum Cancer Centre MelbourneVIC 3000Australia College of Health and Medicine Australian National UniversityCanberraACT 2600Australia Division of Obstetrics and Gynaecology Medical SchoolUniversity of Western AustraliaPerthWA 6009Australia

Background:Physical activity(PA)is important for cancer survivors.Trials of remotely delivered interventions are needed to assist in reaching under-served non-metropolitan cancer survivors.The objective of this study was to ascertain whether wearable technology,coupled with health coaching was effective in increasing PA in breast and colorectal cancer survivors living in regional and remote areas in Australia.Methods:Cancer survivors from 5 states were randomized to intervention and control arms.Intervention participants were given a Fitbit Charge 2TMand received up to 6 telephone health coaching sessions.Control participants received PA print materials.Accelerometer assessments at baseline and 12 weeks measured moderate-to-vigorous PA(MVPA),light PA,and sedentary behavior.Results:Eighty-seven participants were recruited(age=63±11 years;74(85%)female).There was a significant net improvement in MVPA of 49.8 min/week,favoring the intervention group(95%confidence interval(95%CI):13.6-86.1,p=0.007).There was also a net increase in MVPA bouts of 39.5 min/week(95%CI:11.9-67.1,p=0.005),favoring the intervention group.Both groups improved light PA and sedentary behavior,but there were no between-group differences.Conclusion:This’s the first study to demonstrate that,when compared to standard practice(i.e.,PA education),a wearable technology intervention coupled with distance-based health coaching,improves MVPA in non-metropolitan cancer survivors.The results display promise for the use of scalable interventions using smart wearable technology in conjunction with phone-based health coaching to foster increased PA in geographically disadvantaged cancer survivors.

关键词： Behavior change Exercise Health disparities Oncology Wearable technology

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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： jason Philip Appleton Lisa j Woodhouse craig S Anderson Sandeep Ankolekar Lesley Cala Mark Dixon Timothy j England Kailash Krishnan Grant Mair Keith W Muir john Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C Sandset jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is unclear.Here,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of onset.The primary outcome was a shift in scores on the modified Rankin scale(mRS)at day 90.Secondary outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’markers.Data were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%CI.Results 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]min.Neuroimaging‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe stroke.Conclusions In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital trials.WHAT IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those with acute stroke treated within 6hours of stroke

关键词： Glasgow nitrate random

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Psychiatric comorbidities in epilepsy:population co-occurrence,genetic correlations and causal effects

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General Psychiatry 2024年第1期37卷 103-111页

作者： Viktor H Ahlqvist Christina Dardani Paul Madley-Dowd Harriet Forbes jessica Rast Caichen Zhong Renee M Gardner Christina Dalman Kristen Lyal craig Newschaffer Torbjorn Tomson Michael Lundberg Daniel Berglind Neil M Davies Brian K Lee Cecilia Magnusson Dheeraj Rai Department of Global Public Health Karolinska InstitutetStockholmSweden Medical Research Council Integrative Epidemiology Unit Bristol Medical SchoolUniversity of BristolBristolUK Centre for Academic Mental Health Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK Faculty of Epidemiology and Population Health London School of Hygiene and Tropical MedicineLondonUK A.j.Drexel Autism Institute Drexel UniversityPhiladelphiaPAUSA Department of Epidemiology and Biostatistics School of Public HealthDrexel UniversityPhiladelphiaPAUSA College of Health and Human Development Pennsylvania State UniversityState CollegePAUSA Department of Clinical Neuroscience Karolinska InstitutetStockholmSweden Centre for Epidemiology and Community Medicine Region StockholmStockholmSweden K.G jebsen Center for Genetic Epidemiology Department of Public Health and NursingNorwegian University of Science and TechnologyTrondheimNorway Division of Psychiatry University Collge LondonLondonUK Department of Statistical Sciences University Cllge LondonLondonK NIHR Biomedical Research Centre University of BristoBristolUK Avon and Wiltshire Partnership NHS Mental Health TrustBristolUK

Background Psychiatric comorbidities are common in patients with epilepsy.Reasons for the co-occurrence of psychiatric conditions and epilepsy remain poorly understood.Aim We aimed to triangulate the relationship between epilepsy and psychiatric conditions to determine the extent and possible origins of these conditions.Methods Using nationwide Swedish health registries,we quantified the lifetime prevalence of psychiatric disorders in patients with epilepsy.We then used summarydata from genome-wide association studies to investigate whether the identified observational associations could be attributed to a shared underlying genetic aetiology using cross-trait linkage disequilibrium score regression.Finally,we assessed the potential bidirectional relationships using two-sample Mendelian randomisation.Results In a cohort of 7628495 individuals,we found that almost half of the 94435 individuals diagnosed with epilepsy were also diagnosed with a psychiatric condition in their lifetime(adjusted lifetime prevalence,44.09%;95%confidence interval(Cl)43.78%to 44.39%).We found evidence for a genetic correlation between epilepsy and some neurodevelopmental and psychiatric conditions.For example,we observed a genetic correlation between epilepsy and attention-deficit/hyperactivity disorder(r,=0.18,95%Cl 0.09 to 0.27,p<0.001)—a correlation that was more pronounced in focal epilepsy(r=0.23,95%CI 0.09 to 0.36,p<0.001).Findings from Mendelian randomisation using common genetic variants did not support bidirectional effects between epilepsy and neurodevelopmental or psychiatric conditions.Conclusions Psychiatric comorbidities are common in patients with epilepsy.Genetic correlations may partially explain some comorbidities;however,there is little evidence of a bidirectional relationship between the genetic liability of epilepsy and psychiatric conditions.These findings highlight the need to understand the role of environmental factors or rare genetic variations in the origins of psychiatric comorbidities in epilepsy.

关键词： epilepsy Psychiat lifetime

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Core needle biopsy and embolization of fat-poor renal tumors in children with tuberous sclerosis complex

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World journal of Pediatrics 2023年第6期19卷 614-618页

作者： Derek j.Roebuck Samantha Chippington Bligh D.Berry craig Gibson Department of Medical Imaging Perth Children's Hospital15 Hospital AvenueNedlands 6009Australia Division of Paediatrics Medical SchoolUniversity ofWestern AustraliaCrawley 6009Australia Department of Radiology Great Ormond Street Hospital for ChildrenLondon WCIN 3JHUK PathWest Laboratory Medicine WA Murdoch 6150Australia

Tuberous sclerosis complex(TSC)is an autosomal dominant disease caused by inactivating germline mutations in TSC1 or TSC2.These genes code for hamartin and tuberin,proteins that normally form a complex that down-regulates the mechanistic(or mammalian)target of rapamycin(mTOR)pathway,which is crucial to cell growth,proliferation and survival.

关键词： needle sclerosis biopsy

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Dominant species of mid-elevation grasslands of the uKhahlamba-Drakensberg Park are predicted to be largely immune to climate change

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山地科学学报(英文) 2023年第9期20卷 2468-2486页

作者： Debbie jEWITT craig D.MORRIS Tim G.O’CONNOR Michelle j.TEDDER Ezemvelo KZN Wildlife Scientific ServicesPO Box 13053Cascades 3202South Africa School of Animal Plant and Environmental SciencesUniversity of the WitwatersrandJohannesburgPrivate Bag X3WITS 2050South Africa Agricultural Research Council-Animal Production(ARC-AP) ℅School of Life Sciences University of KwaZulu-NatalPrivate Bag X01Scottsville 3209PietermaritzburgSouth Africa School of Life Sciences University of KwaZulu-NatalPrivate Bag X01Scottsville 3209PietermaritzburgSouth Africa

Anticipating global change impact on natural vegetation,especially in poorly researched systems,requires an understanding of the environmental factors that most strongly influence the organisation of plant communities at different scales.The environmental relations of plant communities in the Drakensberg mountains of South Africa remain poorly researched.This study investigated the influence of selected environmental determinants on the dominant species of plant community organisation in this area.In order to provide an overview of the influence of the environment on botanical composition and plant diversity,this study,conducted as four discrete exercises,investigated the interplay of altitude,aspect and slope on the abundance of selected species,and to examine the influence of latitude,geological substrate and local topography on species composition.Plant diversity showed no pattern of response to investigated environmental variables.Species composition was related to temperature and solarradiation variables.High altitude sites facing east were distinct for non-graminoid species.Altitude and latitude exerted a pronounced effect on species composition,confounded by longitude and precipitation gradients.Geological substrate,in concert with slope steepness and orientation,influenced composition,restricting the abundance but not distribution of some grasses.Highly individualistic responses were found for C_3,C_4,and non-graminoid species in relation to altitude,slope and aspect.Slope and aspect mediate the effects of altitude and hence temperature for some species.This study has demonstrated the complexity of drivers influencing species and compositional distribution in the Drakensberg and permits a preliminary consideration of potential changes in the composition and dominance structure of mid-elevation grasslands in response to climate change.The dominant grass species were widespread across environmental gradients,occupying currently warm,cool,moist and dry habitats.Hence,we predict that these midelevation C_4 gr

关键词： Drakensberg Environmental gradients Grasslands Mountain biodiversity Vegetation

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SimMarket research student playbook / Nancy j. Nentl, craig Miller.

SimMarket research student playbook / Nancy J. Nentl, Craig ...

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2003年

作者： Nancy j. Nentl craig Miller.

来源：畅想之星图书光盘版（南... 评论

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Forensic isoscapes based on intra-individual temporal variation of δ^(18)O and ^(206)Pb/^(207)Pb in human teeth

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Forensic Sciences Research 2021年第1期6卷 42-52页

作者： Laura A.Regan Nathan W.Bower Samuel j.Brown craig C.Lundstrom Gideon Bartov matthew D.Cooney Office of Net Assessment Department of DefenseWashingtonDCUSA Chemistry and Biochemistry Department Colorado CollegeColorado SpringsCOUSA Geology Department University of IllinoisUrbanaILUSA Information Technology Services Colorado CollegeColorado SpringsCOUSA

Isotopic signatures used in the georeferencing of human remains are largely fixed by spatially distinct geologic and environmental processes.However,location-dependent temporal changes in these isotope ratios should also be considered when determining an individual’s provenance and/or trajectory.Distributions of the relevant isotopes can be impacted by predictable external factors such as climate change,delocalisation of food and water sources and changes in sources and uses of metals.Using Multi-Collector Inductively-Coupled Plasma Mass Spectrometer(MC-ICP-MS)analyses of ^(206)Pb/^(207)Pb in tooth enamel and dentin from a population of 21±1-year-old individuals born circa 1984 and isotope ratio mass spectrometry(IRMS)of δ^(18)O in their enamel,we examined the expected influence of some of these factors.The resulting adjustments to the geographic distribution of isotope ratios(isoscapes)found in tooth enamel and dentin may contain additional useful information for forensic identification,but the shifts in values can also impact the uncertainty and usefulness of identifications if they are not taken into account.

关键词： Forensic sciences dentin enamel environmental geolocation isoscape radiogenic and stable isotopes

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Correlation of MRI-determined small bowel Crohn’s disease categories with medical response and surgical pathology

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World journal of Gastroenterology 2009年第27期15卷 3367-3375页

作者： Ian craig Lawrance Christopher j Welman Peter Shipman Kevin Murray School of Medicine and Pharmacology University of Western AustraliaFremantle Hospital WA 6160 Australia Department of Gastroenterology Fremantle Hospital WA 6160 Australia Department of Radiology Fremantle Hospital WA 6160 Australia Statistical Consulting Group School of Mathematics and Statistics University of Western AustraliaWA 6160 Australia

AIM: To determine whether magnetic resonance imaging (MRI) can be used to categorize small bowel Crohn's disease (SB CD) into groups that correlate with response to medical therapy and surgical pathology.METHODS: Data was collected from all patients with MRI evidence of SB CD without significant colonic disease over a 32-mo period. Two radiologists, blinded to clinical findings, evaluated each MRI and grouped them based on bowel wall thickness and wall enhancement. These categories were: (1) "fibrosis", (2) "mild segmental hyper-enhancement and mild wall thickening", (3) "mild segmental hyper-enhancement and marked wall thickening", (4) "marked segmental transmural hyper-enhancement". Patient response to additional medical therapy post-MRI was prospectively determined at 8-wk. Non-responders underwent endoscopy and were offered therapeutic endoscopy or surgery. Surgical pathology was assessed against the MRI category. RESULTS: Fifty-five patients were included. Females and category "2" patients were more likely, and patients with luminal narrowing and hold-up less likely, to respond to medical therapy (P < 0.05). Seventeen patients underwent surgery. The surgical pathologicalfindings of fibrosis and the severity of inflammation correlated with the MRI category in all cases.CONCLUSION: Our fi ndings suggest that SB CD can be grouped by the MRI f indings and that these groups are associated with patients more likely to respond to continued medical therapy. The MRI categories also correlated with the presence and level of intestinal inflammation and fibrosis on surgical pathology, and may be of prognostic use in the management of CD patients.

关键词：病理反应 MRI 小肠外科医疗

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Additive manufacturing(3D printing)of electrically conductive polymers and polymer nanocomposites and their applications

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eScience 2022年第4期2卷 365-381页

作者： Kirstie R.Ryan Michael P.Down Nicholas j.Hurst Edmund M.Keefe craig E.Banks Faculty of Science and Engineering Manchester Metropolitan UniversityChester StreetManchesterM15GDUK

Additive manufacturing,or three-dimensional(3D)printing,offers a unique solution for fabricating complex geometries with high tolerances.Currently,many commercial additive manufacturing machines focus on the printing of polymers with limited functionalities.However,conductive polymers(CPs)can be processed to enable the additive manufacturing of conductive,low-density,and low-cost parts for a myriad of applications.This review summarizes the relevant achievements in the additive manufacturing of conductive polymers(CPs)and conductive polymer nanocomposites,with a discussion of the advantages and limitations of processing and printing these materials compared with alternative traditional manufacturing methods and their properties.Finally,the prospective applications of these additive manufacturing printed conductive materials are explored.

关键词： Conducting polymers Additive manufacturing Electrochemcial applications Supercapacitors Batteries

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