High Levels Of Potassium Research Articles

Comprehensive Evaluation of Microbiological and Physicochemical Properties of Commercial Drinking Yogurts in Korea

Most consumers consider yogurt to be a healthy food because it contains probiotic microorganisms. Although a plethora of commercially produced yogurts exists, nutritional and functional aspects of the commercial yogurts have not been well characterized. In this study, the microbiological and physicochemical properties of popular drinking yogurts in Korea were extensively characterized. The viability of lactic acid bacteria, including lactobacilli and bifidobacteria, varied between yogurt samples. These lactobacilli and bifidobacteria showed effective antimicrobial activities against foodborne pathogenic bacteria. Unlike the titratable acidity and pH, the soluble solids content varied between yogurt samples. All the yogurt samples contained high levels of potassium (average 143.53 mg/100 g) and calcium (average 133.92 mg/100 g), as well as phosphorus and sodium. Lactose, fructose, and glucose were the major sugar components in most yogurt samples, whereas the levels of sucrose and maltose were relatively low. Among several organic acids analyzed in the yogurt samples, lactic acid (average 767.67 mg/100 g) and citric acid (average 170.91 mg/100 g) were the most predominant. Taken together, this study provides preliminary information about the nutritional and functional characteristics of commercially available drinking yogurts.

Multi-analytical study of 14th to 19th century illuminated Moroccan manuscripts

Moroccan manuscripts heritage preserves valuable information regarding different fields of Arabian history and culture. Despite this fact, analytical studies carried out in Moroccan manuscripts are scarce. In this work, we made use of a multi-analytical methodology to study, for the first time, four illuminated manuscripts from the Royal library of Rabat covering the span 14th to 19th centuries. The chemical structure of inks and paper support was identified. Elemental distribution obtained by micro-energy dispersive X-ray fluorescence (μ-EDXRF) showed the use of iron, copper and vermillion in black, blue and red inks, respectively. Arsenic and lead were identified as orange inks in the 17th and 19th century manuscripts, respectively. Quantitative characterization of the paper supports obtained by triaxial geometry EDXRF spectrometry showed high levels of sulphur, chlorine and potassium. Regarding the study of the manuscripts support, cellulose $I_{\beta}$ was determined by X-ray diffraction (XRD) in all the analyzed samples. Cellulose fibers observations by scanning electron microscopy showed that the manuscripts are in general, in a good condition. Calcite is the main filler determined by XRD.

Post harvest behavior of tomato as influenced by nitrogen and potassium levels

Tomato (Lycopersicon esculentum) is highly perishable and has potential for processing industries in bumper producing seasons in Nepal. The study on judicious use of nitrogen and potassium levels was aimed to explore the quality attributes along with the shelf life of tomato fruits. Three levels of nitrogen comprising 0 kg/ha (N0), 100 kg/ha (N100), 200 kg/ha (N200) and four levels of potassium 0 K2O kg/ha (K0), 80 K2O kg/ha (K80), 160 K2O kg/ha (K160), 240 K2O kg /ha (K240) were used as treatments in randomized complete block design with three replications at Chitwan (Inner Terai) Nepal. Tomatoes at breaker stage were harvested from the field and 10 fruits from each treatment per replication were kept for physiological weight loss, color rating and shelf life in ambient condition (17.5±3 0C and 80.5±6.5 % RH). Fruit quality with respect to physicochemical properties like firmness, TSS, TA, pH and Vitamin C was assessed at the end of shelf life. Higher potassium levels hasten color development and increased TSS, firmness and vitamin C content. Physiological weight loss was greatly reduced and extended shelf life was achieved with 100 kg N/ha and 240 kg K2O/ha.

Prevalence of Electrolyte Imbalance in Hypoxic-ischemic Encephalopathy: A Hospital-based Prospective Observational Study

Background: The present study aimed to investigate the prevalence of electrolyte imbalance in hypoxic-ischemic encephalopathy (HIE). Moreover, the correlation of this condition with Apgar score is evaluated. Methods: This prospective observational hospital-based study was conducted on 75 neonates affected by asphyxiation. Immediately (within ≤ 30 min of stabilization) after resuscitation, basic routine tests along with sodium (Na+), potassium (K+), and calcium (Ca++) were requested from laboratory to be quantitatively estimated. These neonates were clinically examined and classified into various stages of HIE according to recommended staging classification. The values of electrolytes were calculated and compared between various stages of HIE. Furthermore, the correlation between these electrolytes and Apgar score was assessed. Results: It was observed in our study that HIE is associated with low levels of sodium and calcium. On the other hand, it is correlated with high levels of potassium. As severity of HIE increases, sodium and calcium levels decrease, while potassium level augments. Apgar score was significantly correlated with sodium and potassium. However, the correlation of potassium and sodium with Apgar score was shown to be negative and positive, respectively. Calcium levels did not have a significant correlation with Apgar score. Conclusion: Electrolyte imbalances, such as hyponatremia, hyperkalemia, and hypocalcemia are common in HIE. Hyponatremia and hyperkalaemia are significantly correlated with Apgar score. Therefore, Apgar score can be used as a determinant to start electrolyte therapy in HIE.

Multivariate calibration for the improvement of the quantification of cadmium in the presence of potassium as interferent by total reflection X‐ray fluorescence

A multivariate calibration method was applied to improve the accuracy of the determination of cadmium in the presence of potassium by total reflection X‐ray fluorescence (TXRF). Due to TXRF's relatively low resolution, a particular interference caused by potassium at line Kα 3.31 keV as interference can compromise the cadmium determination at line Lα 3.13 keV, respectively. The method is based on the hypothesis that the application of a multivariate calibration method, for example, partial least squares, could reduce variations due to interference and, consequently, improve the selectivity and accuracy in Cd determination. In this work, this strategy was evaluated on the X‐ray fluorescence emission signals between 2.50 and 3.90 keV for a set of 26 different synthetic calibration mixtures and eight different mixtures for external calibration. Based on a certified reference material (Clay 2—CRM051) with high potassium levels, a significant improvement of accuracy for cadmium determination was observed, overcoming the problems associated with spectral interferences by potassium.

Air and Steam Gasification of Almond Biomass

Experiments were performed to characterize the gasification products of almond shells removed in nut processing operations and to determine the effect of gasifying media on bed agglomeration. Agglomeration in the reactor bed due to reactions between the flue gas and the bed medium was significantly worse under air gasification than under steam gasification. The higher heating value during air gasification of almond biomass ranged from 4–6 MJ kg-3, whereas gas concentrations ranged from 14%–18% H2, 3–4% CH4, 43– 50% N2, 16 – 19% CO, and 16 –17% CO2. For steam gasification, higher heating value was 10–12 MJ kg-3 and gas concentrations were 35–40% H2, 5 – 7% CH4, 17 – 21% N2, 18 – 21% CO, and 16 – 18% CO2. The high level of potassium in the almond shells led to strong corrosion of the bed material due to flue gas transport of potassium compounds. As a result of long duration and elevated temperature approaching 1000 oC, potassium together with silica are mainly transported as aerosol melt particles that form an adhesive resulting in enhanced agglomeration.

Serial measurement of electrolyte and citrate concentrations in blood-primed continuous hemodialysis circuits during closed-circuit dialysis.

For continuous renal replacement therapy in small infants, due to the large extracorporeal volume involved, blood priming can be necessary to prevent hypotension and hemodilution. Because packed red blood cells (RBCs) have high levels of potassium and citrate, closed-circuit dialysis is often performed. We assessed the metrics of closed-circuit dialysis and serial citrate concentration changes. We performed dialysis of closed circuits primed with expired human packed RBC solution and 5% albumin. Blood and dialysate flow rates were 70 and 33.3mL/min, respectively. The extracorporeal volume was 70mL. We measured pH, electrolytes, and citrate in the closed circuit every 3min for 15min. We also assessed the adequacy of closed-circuit dialysis using the formula: [dialysate flow rate (mL/min) × time of dialysis (min)]/extracorporeal volume (mL) and we assessed the correlation between citrate and ionized calcium concentrations. To reach normal concentrations of sodium, potassium, and chloride, 2.4 times as much dialysate fluid as extracorporeal volume was needed. In contrast, for ionized calcium, bicarbonate, and citrate, 3.8 times as much dialysate fluid as extracorporeal volume was required. By simple linear regression analysis, the concentration of citrate was significantly correlated with that of ionized calcium. For closed-circuit dialysis using an RBC solution, the formula [dialysate flow rate (mL/min) × time of dialysis (min)]/extracorporeal volume (mL) would be a better parameter to estimate efficacy, compared with other metrics. Additionally, the citrate concentration can be readily estimated from the ionized calcium concentration during closed-circuit dialysis.

Hazardous impact of vinasse from distilled winemaking by-products in terrestrial plants and aquatic organisms

Vinasses obtained from the distillation of winemaking by-products (WDV) are complex effluents with variable physicochemical properties. Frequently, WDVs are used to irrigate agricultural soil, and/or discharged into aquatic bodies, which may result in serious environmental pollution, due to the presence of organic acids and recalcitrant compounds (polyphenols, tannins and metals). The present study aimed to evaluate the toxicity impact of an untreated WDV on terrestrial and aquatic organisms, at different levels of biological organization. The effluent was collected at the distillation column exit and characterized according to several physicochemical properties. The WDV potential phytotoxicity was assessed by germination inhibition assays on six agricultural crops, and its acute toxicity was assessed on Aliivibrio fisheri (microtox assay), Daphnia magna neonates (freshwater crustacean), and zebrafish Danio rerio (fish embryo toxicity test, FET).The WDV presented a low pH (3.88), high levels of electrical conductivity, ECond (6.36 dS m−1) and salinity (3.3 ppt), besides high level of potassium (2.1 g L−1) and organic compounds (TOC = 17.7 g L−1), namely polyphenols (1.7 g L−1). The diluted WDV displayed variable inhibitory effects on the plant endpoints (percentage of inhibition of germination and radicle elongation and germination index). Overall, plants' susceptibility to increasing concentrations of WDV were differential (onion ≈ garden cress ≥ tomato > lettuce > maize > green beans) and the germination index EC50 varied from 10.9 to 64.4% v/v. Also, the acute negative effects toward aquatic organisms were determined, decreasing from the more complex organism to the simpler one: zebrafish embryos (96 h-LC50 = 0.34% v/v)>D. magna (48 h-LC50 = 4.8% v/v)>A. fisheri (30min-EC50 = 7.0% v/v). In conclusion, the findings suggest that WDVs might have a high toxicological impact on both terrestrial plants and aquatic organisms, even at high dilution levels, reinforcing the need for appropriate treatments before considering its discharge or reuse.

Association between serum potassium levels and short-term mortality in patients with atrial fibrillation or flutter co-treated with diuretics and rate- or rhythm-controlling drugs.

We investigated the association between potassium levels and 90-day all-cause mortality in atrial fibrillation or flutter (AF) patients co-treated with diuretics and rate- or rhythm-controlling drugs. During 2000-12, first-time AF patients treated with beta-blockers, amiodarone, sotalol, verapamil, or digoxin combined with any diuretic within 90 days post-AF discharge were included. Following co-treatment, a potassium measurement within 90 days after initiating diuretic treatment was required. Mortality risk associated with potassium <3.5, 3.5-3.7, 3.8-4.0, 4.5-4.7, 4.8-5.0, and >5.0 mmol/L (reference: 4.1-4.4 mmol/L) was assessed using multivariable Cox regression. In total, 14425 AF patients were included (median age: 78 years; women: 52%). Patients most often received beta-blocker monotherapy (29%), beta-blockers and digoxin combined (25%), digoxin monotherapy (24%), amiodarone monotherapy (3%), and verapamil monotherapy (3%). Increased 90-day mortality risk was associated with <3.5 mmol/L [hazard ratio (HR) 2.05, 95% confidence interval (CI) 1.68-2.50], 3.5-3.7 mmol/L (HR 1.28, 95% CI 1.05-1.57), 4.5-4.7 mmol/L (HR 1.20, 95% CI 1.02-1.41), 4.8-5.0 mmol/L (HR 1.37, 95% CI 1.14-1.66), and >5.0 mmol/L: (HR 1.84, 95% CI 1.53-2.21). Compared with beta-blocker monotherapy, rate- or rhythm-controlling drugs did not modify the association between potassium groups and mortality risk. In addition to hypo- and hyperkalaemia, low and high normal range potassium levels were associated with increased 90-day mortality risk in AF patients co-treated with diuretics and rate- or rhythm-controlling drugs. These associations were independent of rate- or rhythm-controlling drugs.

Abstract 2670: Spatial potassium buffering among clustered glioblastoma cells is proposed to enable survival scavenging of nutrients released by interior necrotic cells

Abstract Glioblastoma cells are known for surviving harsh environments and for forming secondary structures of Scherer (cell clusters around neurons/axons, blood vessels, regions of coagulative necrosis, &amp; in the subpia). The astrocytic lineage of glioblastomas suggests recapitulation of astrocytic-type syncytia that buffer potassium released from neurons/axons. Here, multiple glioblastoma cell lines were stressed by nutrient withdrawal to observe cell behavior in view of their astrocytic lineage &amp; known genome sequence of 1 cell line. Methods: Single cell suspensions of 4 glioblastoma cell lines (U87, LN229, T98G &amp; A172) were added to a settling chamber (Neuro Probe, Gaithersburg, MD). After 0.5 hr of gradual nutrient withdrawal, slides (Diff Quik stain) were analyzed, 2 replicate wells per cell line. U87 cells with cytoplasmic vacuoles were quantified to indicate the degeneration in cell clusters. When vacuoles collectively had a diameter at least 1/3 of an ave. nuclear diameter in the same 100X microscopic field, the vacuolated cell was deemed +. Potassium ion channel genes potentially used by glioblastoma cells per the Online Mendelian Inheritance in Man (OMIM) database were checked in genome sequence results for U87 cells (Clark MJ, et al. PLoS Genet 2010 6(1): e10000832). Results: All glioblastoma cell lines displayed cell adherence &amp; wrapping around single swollen, often heavily vacuolated degenerating cells of the same lineage after nutrient withdrawal. As clustered U87 cells (putative syncytia) increased in cell number, the number of constituent cells with vacuoles decreased (Pearson regressions, p=.04, p=.006) in 2 replicate wells. Whereas single cells were +, 72% and 51%, vacuolated cells fell to 18% and 11% in putative syncytia of over 20 cells in 100X microscopic fields across the width (7 mm) of each well. Thus, within increasing-sized putative syncytia, which offer increasing potassium buffering capacity, significantly fewer constituent cells displayed vacuoles. Presumably this was due to available nutrients from one to few necrotic cells in their midst during nutrient withdrawal. Potassium ion channeling within astrocytic-type syncytia, termed "spatial buffering" explains how viable glioblastoma cells adhere to degenerating cells despite high potassium levels. Genome sequencing of U87 cells revealed that only KCNMB2 &amp; KCNJ16 of 47 potassium channeling genes pertinent to brain, were negatively affected by genetic defects. Functional losses of KCNMB2 as an enhancer for KCNMA1 (intact), and KCNJ16 as a co-assembler with other family members (intact), are unlikely to prevent potassium buffering. Preservation of nearly all potassium channeling genes in U87 suggests that maintenance of spatial buffering in astrocytic-type syncytia permits viable cells to surround necrotic cells and salvage released nutrients as a survival strategy. Citation Format: Marie Beckner. Spatial potassium buffering among clustered glioblastoma cells is proposed to enable survival scavenging of nutrients released by interior necrotic cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2670.

Maprang “Bouea macrophylla Griffith” seeds: proximate composition, HPLC fingerprint, and antioxidation, anticancer and antimicrobial properties of ethanolic seed extracts

In this study, the Maprang (Bouea macrophylla Griffith) seeds of 3 Thai varieties of this plant were studied in terms of nutrition, phytochemicals, chemical antioxidants and the bioactivity of their extracts. Maprang seeds revealed high levels of carbohydrates, dietary fiber, energy, potassium, phosphorus, magnesium, and calcium. The Maprang seed extracts possessed a high polyphenolic content and exhibited antioxidant properties against DPPH˙, ABTS˙+, and ferric reduction. Additionally, 18-compounds were charaterized by RP-HPLC-DAD with two being recognized as gallic acid and ellagic acid and 16-unknown gallotannins. The HPLC fingerprint was composed of 4 major compounds. The extract showed active growth inhibition against leukemia, lung cancer cell lines and for 15 strains of bacteria. It is known to be particularly effective in drug resistant cells. Our results indicated that maprang seeds are a new natural source of nutrition, minerals and phytochemicals that may be applicable for use as a food supplement and as an effective drug in the treatment of certain diseases.

THE EFFECT OF SPIRONOLACTONE VERSUS TORSEMIDE ON BLOOD PRESSURE TARGETS IN RESISTANT HYPERTENSION PATIENTS

Objective: to evaluate effects on blood pressure (BP) control in two treatment options spironolactone (SPIR) versus torsemide (TOR) as an add-on therapy in resistant hypertensive (RAH) patients. Design and method: We studied 78 patients with true RAH confirmed by the office and ambulatory BP monitoring (ABPM). Patients were randomized into 2 groups through 12 weeks of once daily treatment with of SPIR (25–50 mg) or TOR (5–10 mg) in addition to their baseline triple-combination and then rotated with drugs. BP was measured in the office and by ABPM. Changes in laboratory tests were also studied. The predictive values of plasma aldosterone, active renin concentration (ARC) and aldosterone-renin ratio (ARR), serum potassium, 24-h urinary excretion sodium of determining the antihypertensive response were analyzed. Results: There were no significant differences on the reduction of average office BP and average nighttime BP by SPIR and TOR. SPIR reduced average systolic 24-h BP by 11.7 mmHg and average systolic daytime BP by 12.2 mmHg compared with a reduction of 8.9 mmHg (P < 0.05) and 9.1 mmHg (P < 0.05) with TOR, respectively. Overall, 36.8 % RAH patients achieved targets of clinical BP and 24-h ABPM levels on SPIR and 30.9 % on TOR. After 12 weeks of treatment mean plasma potassium concentrations increased from 4.3 to 4.7 mmol/L (P < 0.0001) on SPIR but did not significant change on TOR. Serum potassium (β = −0.441, P < 0.05), 24-h urinary excretion sodium (β = 0.432, P < 0.05) and ARR (β = 0.543, P < 0.03) were predictors of BP-lowering effect of SPIR and plasma aldosterone (β = −0.680, P < 0.001), ARC (β = 0.463, P < 0.03) were predictors of reduction BP for TOR in multivariate modeling. Conclusions: Greater antihypertensive effect of SPIR is related to aldosterone status, urinary sodium excretion and serum potassium level in resistant hypertension. TOR may be suited for RAH patients that have high ARC and in people with lower sodium intake or high serum potassium level.

Proximate composition and anti-nutritional factors of fava-bean (Vicia faba), green-pea and yellow-pea (Pisum sativum) flour

Pulse grains were identified as a key resource for food innovation during the International Year of the Pulse (IYP), 2016. Pulse flour offers a sustainable source of plant protein for innovation in protein enriched cereal based foods. Fava-bean (Vicia faba), green- and yellow-pea (Pisum sativum) flour were analysed for proximate composition, minerals, amino acids, phenolic content, phytic acid and trypsin inhibitory activity. Fava-bean flour had the highest protein content (28 g/100 g), while green-pea flour had the highest total dietary fibre content (15 g/100 g). All three flours contained essential amino acids in adequate quantity, highlighting them as a source of good quality protein for in the formulation of protein-enriched foods. Fava-bean flour had significantly higher phenolic content and antioxidant activity than pea flours (387 mg GAE/100 g and 250 mg AAE/100 g respectively). Pulse flour contained high levels of potassium and zinc, while fava-bean flour was also high in iron. Phytic acid ranged from 543 to 889 mg/100 g; the lowest of which was observed in green-pea flour. Green-pea flour also exhibited the lowest trypsin inhibition (3.7 TIU/mg). Results demonstrate the significant potential of pulse flour to enhance the nutritional value of cereal based foods which is not possible with wheat flour alone.

Biochemical analysis on selected fruits ofAnnonaspecies

The family Annonaceae comprises about 80 genera and 850 species occurring in the tropics, but with relics of earlier distributions remaining in some temperate regions. The large, edible, pulpy fruits typically called “annona” include species of Annona, custard apple (A. squamosa), soursop/graviola (A. muricata) and bullock's heart (A. reticulata) which are known to have excellent health and medicinal benefits which deserve to be further explored. They contain antioxidants, possess anti cardio-vascular, anti-obese, anti-diabetic, anti-cancer, anti-microbial activity and have a positive effect on blood haemoglobin. It is also efficacious to control blood pressure, normalize digestive function, cure constipation, treat diarrhoea and dysentery. High potassium and magnesium levels in these fruits help to protect against heart disease. These fruits also contain vitamin A, which is beneficial for a healthy skin, hair and eyes. High magnesium content helps balance the water in the body, remove acid from the joints and reduce the symptoms of rheumatism and arthritis. The potassium contained in it, helps fight muscle weakness and fatigue. In the light of the above facts, a biochemical study was made to assess their proximate principle and mineral content to pave the way for better utilization, to meet nutritional security and to aid in disease prevention.

PENGARUH WAKTU PELEPASAN TOURNIQUET TERHADAP KADAR KALIUM PADA PENGAMBILAN DARAH VENA

ABSTRACTTourniquet can be a problem if it is tied too long and too tightly when taking venous blood can affect potassium levels and result in high false potassium levels (pseudohiperkalemia). This study aims to determine the effect of Tourniquet release time on potassium levels in venous blood collection. This study uses the Quasy Experiment method using a Non-Equivalent Control group design involving two groups with two different treatments. The variables of this study were the time of tourniquet release and potassium levels. Data processing in this study was conducted in univariate and bivariate. Analysis of the data in this study also used the Independent T Test to determine the effect between variables.The results of the study through statistical analysis showed that the average blood potassium level in the first group was 3.784 mEq / L and the second group was 4.896 mEq / L. From the results of statistical tests obtained a value of P value (0,000) &lt;α (0.05) which means Ha is accepted so that the results of this study are there are differences in the average potassium levels at the moment of release of tourniquet blood entering and releasing the tourniquet after blood. The conclusion of this study is that the release time of the tourniquet can affect potassium levels and it is recommended for medical personnel to release the tourniquet while the blood enters the syringe needle when taking venous blood to avoid high levels of potassium in the serum.Keywords: Tourniquet Release, Potassium Levels, and Pseudohiperkalemia

Early potato production is positively affected by potassium fertilization

Two field experiments were conducted during 2017-2018 and 2018-2019, at the Experimental Farm, Faculty of Agriculture, Suez Canal University, Ismailia, Egypt with aim of investigation of potassium application on earliness of potato. To achieve this goal, five different net potassium levels: 0, 60, 90, 120, and 150 kg/Feddan were applied and potato tubers were harvested at two harvesting times: 90 and 105 days after planation. The results reported that both potassium application and harvesting time as well as their interaction significantly affected most of the studied traits. The highest values of plant height, plant fresh weight, plant dry matter, tuber dry matter, marketable yield/feddan, total yield/feddan, soluble solid content (SSC), nitrogen (N) content and potassium (K) content were obtained from the plants received 120 kg K and harvested at 105 days after planation. While, the potassium fertilized plant at 120 kg/feddan and harvested at 90 days achieved the maximum values of total yield per plant, total sugar and non-reducing sugars. However, the difference between these two treatments was not necessarily significant for some traits. In addition, the results of the current study interestingly clarified that potassium level (150 kg) negatively affected some yield attributes in both harvesting times compared to the other potassium levels. Consequently, the result of the current study indicates that high level of potassium (120 kg) can hasten the earliness of potato, which may achieve notable financial profits for potato growers.

The effects of cerebral curvature on cortical spreading depression

Neuronal activity evokes a localised increase in cerebral blood flow through neurovascular coupling (NVC), a communication system between a group of cells known as a neurovascular unit (NVU). Dysfunctional NVC can lead to pathologies such as cortical spreading depression (CSD), characterised by a slowly propagating wave of neuronal depolarisation and high extracellular potassium (K+) levels. CSD is associated with several neurological disorders such as migraine, stroke, and traumatic brain injury. Insight into the spatial dynamics of CSD in humans is mainly deduced from animal experiments on the smooth lissencephalic brain (in particular murine experiments), however the human cortex is gyrencephalic (highly folded) and is considered likely to exhibit different and more complex patterns of CSD.In this study a large scale numerical NVC model of multiple NVUs is coupled to a vascular tree simulating a two-dimensional cerebral tissue slice. This model is extended with a spatial Gaussian curvature mapping that can simulate the highly folded nature of the human cortex. For a flat surface comparable to a lissencephalic cortex the model can simulate propagating waves of high extracellular K+ travelling radially outwards from a stimulated area at approximately 6.7 mm/min, corresponding well with multiple experimental results. The high K+ concentration induces a corresponding wave of vasoconstriction (with decreased blood flow) then slight vasodilation, achieved through cellular communication within the NVU. The BOLD response decreases below baseline by approximately 10% followed by an increase of 1%.For a surface with spatially varied curvature comparable to a section of gyrencephalic cortex, areas of positive Gaussian curvature inhibit wave propagation due to decreased extracellular diffusion rate. Whereas areas of negative curvature promote propagation. Consequently extracellular K+ is observed travelling as wave segments (as opposed to radial waves) through flat or negatively curved “valleys” corresponding to folds (sulci) in the cortex. If the wave size (defined as the activated area of high K+ concentration) is too small or diffusion rate too low then wave segments can cease propagation. If the diffusion rate is high enough the wave segments can grow from open ends forming loose spiral waves. These results may provide some insight into the differences seen between human and animal experiments.

Acute Physical and Occupational Therapy and Serum Potassium: When Is It Safe?

Purpose: High or low serum potassium (K+) levels are associated with increased risk of cardiac arrhythmias. No research-based guidelines or suggested values for K+ in regard to safe provision of physical therapist (PT) and occupational therapist (OT) services for patients in an acute care setting are currently available. This study was designed to determine whether patients with serum K+ levels of 3.1 to 5.9 mmol/L can participate safely in acute PT and OT interventions without serious adverse events. Methods: A total of 380 subjects admitted to an acute care hospital were stratified into groups with hypokalemia (K+ levels of 3.1-3.4 mmol/L), hyperkalemia (K+ levels of 5.1-5.9 mmol/L), or normal K+ levels (K+ levels of 3.5-5.0 mmol/L) and provided with standard PT or OT intervention. Baseline clinical characteristics and adverse outcomes were compared between groups. Results: No serious adverse events occurred. Termination of treatment due to minor adverse events occurred in 8 (2%) subject cases and all occurred in the normal K+ group (n = 8, 3%) (P = .029). Rates of adverse outcomes did not differ significantly between normal (n = 37, 15.5%) and abnormal K+ (n = 26, 16.4%) groups. Conclusions: Results of this study suggest that provision of PT and OT interventions for patients with serum K+ levels of 3.1 to 5.9 mmol/L is safe.

Abstract P086: Significant Association of House Collapse With High Urine Na/K Ratios Among 24,580 Coastal Residents Who Survived the Great East Japan Earthquake

Introduction: There is an association between dietary sodium/potassium intake and the pathogenesis of hypertension and cardiovascular disease. Some reports have indicated a correlation between psychological distress and high sodium intake. Victims who are affected by natural disasters tend to consume an unbalanced diet, with high sodium and low potassium levels, which may stem partly from high psychological distress due to natural disasters. Hypothesis: We tested the hypothesis that house collapse was associated with high urine Na/K (UNa/K) ratios in victims of the Great East Japan Earthquake. We also hypothesized that psychological distress could modify the relationship between house collapse and UNa/K ratio. Methods: We analyzed complete data collected from 24,580 coastal residents who did not take anti-hypertensive medications, were 20 to 74 years of age, and were enrolled in the Tohoku Medical Megabank Project Community-based Cohort (TMM CommCohort) Study. Participants were recruited between 2013 and 2015 at municipality-specific health checkup sites in the Iwate and Miyagi Prefectures. UNa/K ratios were assessed using spot urine samples. Participants were classified into four groups according to the extent of house collapse: total collapse (TC, n=4206); half collapse (HC, n=2825); partial collapse (PC, n=5964); and no damage (ND, n=11585). Using a covariance analysis, the multivariate-adjusted geometric means of the UNa/K ratios according to the group of house collapse were calculated, with adjustments for sex, age, systolic blood pressure, estimated glomerular filtration rate, HbA1c level, low-density lipoprotein cholesterol level, Kessler Psychological Distress Scale (K6) score, current alcohol consumption, current smoking habits, and daily exercise. In addition, after stratification according to K6 score (9/10), the multivariate-adjusted geometric means of the Una/K ratios were calculated according to house collapse group. Results: The multivariate-adjusted geometric means (95% confidence intervals) of UNa/K ratios of those whose houses underwent TC, HC, and PC were 3.33 (3.28-3.39), 3.37 (3.30-3.44), and 3.34 (3.30-3.40), respectively, all of which were significantly greater than the value of 3.23 (3.20-3.27) that was observed for the ND group. In analysis stratified by K6 score, the same tendencies were observed in both groups of K6&lt;10 and K6≥10. Conclusions: House collapse was significantly associated with high UNa/K ratios, and psychological distress did not modify this association.

Repeat Laboratory Testing in the Pediatric Emergency Department: How Often and How Important?

Little is known about repeat testing for patients admitted to children's hospitals from the emergency department (ED). The objective of this study was to describe the trend of repeat laboratory testing from a children's hospital ED. Laboratory studies were analyzed for July 2002 to June 2010 for complete blood counts (CBCs; 7 years), basic metabolic panels (BMPs; 2.5 years), and coagulation studies (7 years) ordered and reordered in the ED within 8 hours for patients admitted to the hospital. Results for tests were generated and classified into high, low, and normal based on reference ranges. To reflect actual practice, we expanded the normal range from 95% of lower bound to 105% of upper bound. A total of 37,035 CBCs, 11,414 BMPs, and 3903 coagulation studies were ordered. Proportions of these tests repeated were 0.9%, 1.9%, and 1.9%, respectively. Mean time to repeat was 2 hours. For CBCs, 25% of repeats were for a missing component; 35% were for low platelet counts. Sixty-eight percent of initial BMPs were repeated for high potassium. Half of coagulation studies were repeated for high prothrombin time; 36% were repeated for a missing component. On repeat, 75% of BMPs with high potassium levels and 65% of CBCs with low platelet count returned normal values, but 16% of coagulation studies repeated for high prothrombin time returned normal values. Repeat ED laboratory testing occurs infrequently at a children's hospital, and a large proportion of repeats is attributed to missing results. When repeated, abnormal results on initial studies are often returned as normal.