Hyponatremia Research Articles

Sodium intake and the risk of heart failure and hypertension: epidemiological and Mendelian randomization analysis.

This study aimed to analysis the relationship between sodium intake and the risk of heart failure and hypertension through epidemiological studies and Mendelian randomization analysis. We initially conducted an analysis using data from the National Health and Nutrition Examination Survey (NHANES) database to examine the relationship between sodium intake and heart failure, hypertension, systolic blood pressure, and diastolic blood pressure. After adjusting for confounding factors, we found a non-linear association between sodium intake and heart failure (p nonlinear = 0.0448). Subsequently, we utilized Mendelian randomization (MR) analysis by utilizing urinary sodium as a proxy for sodium intake to investigate the relationships between sodium and heart failure, hypertension, systolic blood pressure, and diastolic blood pressure. The results indicated that with increasing urinary sodium, there is an increase in systolic and diastolic blood pressure, as well as an elevated risk of heart failure and hypertension. The evidence provided by this study suggests that higher sodium intake is associated with an increased risk of heart failure and hypertension. However, excessively low sodium intake may not necessarily be beneficial, as there may be maximum benefits at a sodium intake level of around 3,000 mg/d.

Why should we use a low sodium dialysis solution for peritoneal dialysis?

Overhydration is highly prevalent in patients on peritoneal dialysis (PD), with inappropriately high sodium load supposedly playing a central role in the pathophysiology of the conditions. Recent studies have revealed the novel role of the interstitium as a buffer system for sodium ions, and it has been reported that patients on dialysis, including PD, present increased levels of sodium in the interstitium, such as in subcutaneous tissue and muscle. Hence, therapy for correction of overhydration should target the excess extracellular volume and the excess sodium storage in the interstitium. The ultrafiltrate obtained using the currently available PD solutions is hypo- to isonatric as compared to serum, which is disadvantageous for prompt and efficient sodium removal from the body in patients with overhydration. In contrast, use of low sodium PD solutions is characterised by iso- to hypernatric ultrafiltrate, which may beneficial for reducing sodium storage in the interstitium. Trials of low sodium PD solutions have reported possible clinical merits, for example, decreased blood pressure, reduced dryness of mouth and decreased body water content as assessed using bioimpedance methods. Given these observations and the high prevalence of overhydration in current PD populations, it makes medical sense that low sodium solutions be positioned as the new standard solution in the future. However, for medical safety, that is, to avoid hyponatremia and excessive decreases in blood pressure, further studies are needed to establish the appropriate compositions and applications of low sodium solutions.

Insect-based fish feed in decoupled aquaponic systems: Effect on lettuce production and resource use.

The utilisation of insect meal-based fish feed as a substitute for conventional fish meal-based fish feed is considered as a promising innovative alternative to boost circularity in aquaculture and aquaponics. Basic research on its use in aquaponics is limited. So far, no reports on the effects of fish waste water, derived from a recirculating aquaculture system using Black Soldier Fly (BSF) meal-based diets, were available on the growth performance of lettuce. Therefore, this study aimed to compare the effect of reusing fish waste water from tilapia culture (as a base for the nutrient solution) fed with a fish meal-based diet (FM) and a BSF meal-based diet on resource use and lettuce growth in decoupled aquaponic systems. A conventional hydroponics nutrient solution (HP) served as control, and inorganic fertilisers were added to all nutrient solutions to reach comparable target concentrations. The experiment was conducted in a controlled climate chamber in nine separate hydroponics units, three per treatment. Lettuce fresh and dry weight, number of leaves, relative leaf chlorophyll concentration, water consumption, and the usage of inorganic fertilisers were measured. Micro- and macronutrients in the nutrient solutions were monitored in time series. Similar lettuce yield was seen in all treatments, with no significant effects on fresh and dry weight, the number of leaves, and relative chlorophyll values. Water use per plant was also similar between treatments, while the amount of total inorganic fertiliser required was 32% lower in FM and BSF compared to HP. Higher sodium concentrations were found in the FM nutrient solutions compared to BSF and HP. The results confirm that BSF-based diet is a promising alternative to FM-based diet in aquaponics with no negative effects on lettuce growth. Additionally, BSF-based diet might be beneficial in intensive, professional aquaponics applications due to the lower sodium concentration in the nutrient solution.

Gastroenteritis Rehydration Of children with Severe Acute Malnutrition (GASTROSAM): A Phase II Randomised Controlled trial: Trial Protocol.

Children hospitalised with severe acute malnutrition (SAM) are frequently complicated (>50%) by diarrhoea ( ≥3 watery stools/day) which is accompanied by poor outcomes. Rehydration guidelines for SAM are exceptionally conservative and controversial, based upon expert opinion. The guidelines only permit use of intravenous fluids for cases with advanced shock and exclusive use of low sodium intravenous and oral rehydration solutions (ORS) for fear of fluid and/or sodium overload. Children managed in accordance to these guidelines have a very high mortality. The proposed GASTROSAM trial will reappraise current recommendations with mortality as the primary outcome. We hypothesize that liberal rehydration strategies for both intravenous and oral rehydration in SAM children with diarrhoea may reduce adverse outcomes. An open Phase II trial, with a partial factorial design, enrolling children in Uganda, Kenya, Nigeria and Niger aged 6 months to 12 years with SAM hospitalised with gastroenteritis (>3 loose stools/day) and signs of moderate and severe dehydration. In Stratum A (severe dehydration) children will be randomised (1:1:2) to WHO plan C (100mls/kg Ringers Lactate (RL) with intravenous rehydration (IV) given over 3-6 hours according to age including boluses for shock), slow rehydration (100 mls/kg RL over 8 hours (no boluses)) or WHO SAM rehydration regime (ORS only (boluses for shock (standard of care)). Stratum B incorporates all children with moderate dehydration and severe dehydration post-intravenous rehydration and compares (1:1 ratio) standard WHO ORS given for non-SAM (experimental) versus WHO SAM-recommended low-sodium ReSoMal. The primary outcome for intravenous rehydration is mortality to 96 hours and for oral rehydration a change in sodium levels at 24 hours post-randomisation. Secondary outcomes include measures assessing safety (evidence of pulmonary oedema or heart failure); change in sodium from post-iv levels for those in Stratum A; perturbations of electrolyte abnormalities (severe hyponatraemia <125 mmols/L or hypokalaemia. If the trial shows that rehydration strategies for non-malnourished children are safe and improve mortality in SAM this could prompt revisions to the current treatment recommendations or may prompt future Phase III trials.

Dietary Salt Restriction and Adherence to the Mediterranean Diet: A Single Way to Reduce Cardiovascular Risk?

The dietary restriction of salt intake and the adhesion to Mediterranean dietary patterns are among the most recommended lifestyle modifications for the prevention of cardiovascular diseases. A large amount of evidence supports these recommendations; indeed, several studies show that a higher adherence to Mediterranean dietary patterns is associated with a reduced risk of cardiovascular disease. Likewise, findings from observational and clinical studies suggest a causal role of excess salt intake in blood pressure increase, cardiovascular organ damage, and the incidence of cardiovascular diseases. In this context, it is also conceivable that the beneficial effects of these two dietary patterns overlap because Mediterranean dietary patterns are typically characterized by a large consumption of plant-based foods with low sodium content. However, there is little data on this issue, and heterogeneous results are available on the relationship between adherence to salt restriction and to Mediterranean dietary patterns. Thus, this short review focuses on the epidemiological and clinical evidence of the relationship between the adherence to Mediterranean dietary patterns and dietary salt restriction in the context of cardiovascular risk.

Etiological and risk factors in recurrent febrile seizures: Insights through EEG analysis.

Febrile seizures, convulsive episodes in young children during febrile illnesses, are a significant concern due to their potential for recurrence and associated uncertainties. This study investigated the causes and risks associated with recurrent febrile seizures and the critical role of electroencephalogram (EEG) in their accurate diagnosis. Following Institutional Review Board approval and going through the consenting process with parents, this study gathered the clinical features and EEG recordings of children admitted with febrile seizures in the Department of Pediatrics, Mahatma Gandhi Memorial Hospital, Kakatiya Medical College, Warangal, Telangana, India. Descriptive statistics, including mean, standard deviation (SD), frequencies, and percentages, were computed to understand the data comprehensively. The Chi-Square test was employed to analyze the association between variables, with a significance level of 0.05, ensuring reliable and trustworthy findings. Out of 42 children studied, 28 (66.67%) presented with simple febrile seizures, with the mean time of occurrence of seizures from the onset of fever being 7.85 hours. Abnormal EEG was seen in 50% of children with complex febrile seizures and 16% with simple febrile seizures. Generalized epileptiform discharges were the most common epileptic activity observed. Low sodium levels had a significant relationship with febrile seizures in the analysis. This study emphasizes the importance of EEG in diagnosing febrile seizures, particularly in complex cases. Our findings suggest that low sodium levels may be a significant risk factor for febrile seizures. Further research is necessary to identify other preventable risk factors to reduce the burden of the medical condition.

Association of ACE*(Insertion/Deletion) Variant with the Elevated Risk of Preeclampsia Among Gestational Women.

The renin-angiotensin-aldosterone system has an indispensable function in the uteroplacental circulation, placental growth, and blood pressure optimization. The angiotensin I converting enzyme (ACE) gene is a critical integrator for electrolyte balance, and water retention, along with inhibiting preeclampsia. The main goal of this pertaining study is to assess the contribution of ACE*(Ins/Del) variant with the susceptibility for preeclampsia with focus on the severity of the disease among gestational hypertensive women. This retrospective study included 225 participants [125 PE gestational women, and 100 normotensive healthy controls] matching with age, and geographical region. PE women classified into 82 early-onset PE women, accompanied with 43 late-onset PE women. Additionally, PE women categorized into 59 mild PE women, together with 66 severe PE women. The genotyping and characterization of ACE*(Ins/Del) variant were applied using the PCR technique. Our findings indicated higher frequency of the ACE*(Del/Del) genotype and ACE*(D allele) with elevated risk of preeclampsia compared to normotensive controls under recessive (OR = 2.09, and p-value = 0.007), and allelic (OR = 1.75, and p-value = 0.012) models. In addition, testing logistic regression revealed that the levels of endothelin-1 and malondialdehyde exposed significant difference for the ACE*(Del/Del) genotype among early-onset and late-onset PE women (p-value = 0.024, and 0.23, respectively). Furthermore, carriers of the ACE*(Del/Del) genotype observed statistically significant with lower sodium concentrations among severe PE women (p-value = 0.034). The ACE*(Del/Del) genotype and ACE*(D allele) were associated with increased risk preeclampsia among gestational women. Furthermore, early-onset PE and late-onset PE were correlated with endothelin-1 and malondialdehyde concentrations among Egyptian women.

Directly prepared Al-doped FeMoO4 materials from spent hydrogenation catalysts via a low-temperature green process

Environmental-friendly recovery of critical metals from solid wastes directly for new energy materials received lots of concerns. In this paper, the FeMoO4(FMO) materials for new energy storage materials are directly prepared from spent hydrogenation catalysts by “low temperature sodium roasting-water leaching” process. The leaching rates after roasting of main metal element Mo, Al and Ni from wastes are: 91.8 %, 1.7 % and 0.1 %, respectively, then the leachate was directly generated Al-doped FMO materials (Mo/Al = 50:1). As for the application of lithium ion battery anode, the specific capacity is 363.5 mAh/g after 200 cycles, 55 % improvement compared with bare FMO. The tunable phase transformation by roasting temperature regulation is the core to achieve the selective water leaching of Mo, and the intrinsic mechanism have been investigated by calculation and experiments. Finally, the economic evaluation of the whole process shows that for every 1 kg of spent catalyst processed and made into FMO, a profit of $20.8 can be obtained, indicating promising economic benefits. This process provides an environmental technology route for the development of new energy industries under carbon neutrality goals.

Evaluation of low sodium Kačkavalj cheese properties using 3D scanning, scanning electron microscopy and computer vision system

Salt reduction in food is one of the main concerns for public health agencies. Performing two‐way analysis of variance, the effects of salt reduction and replacement on the pasta filata Kačkavalj cheese properties were studied during 6 months. Computer vision system is a novel method for colour evaluation. There were no differences in colour parameters L*, a* and b* (90.40–92.87, 0.07–0.60 and 11.40–18.53 respectively) and microstructure analysed by scanning electron microscopy between variants during ripening. Three‐dimensional scanning revealed that low sodium variants showed lower volume reduction. Salt reduction in Kačkavalj cheese results in high quality product and contributes to consumer health.

Application of the (fr)AGILE scale in the evaluation of multidimensional frailty in elderly inpatients from internal medicine wards: a cross-sectional observational study.

With the rapid growth of an aging global population and proportion, the prevalence of frailty is constantly increasing. Therefore, finding a frailty assessment tool suitable for clinical application by physicians has become the primary link in the comprehensive management of frailty in elderly patients. This study used the (fr)AGILE scale to investigate the frailty status of elderly patients from internal medicine wards and identified relevant factors that affect the severity of frailty. In this study, 408 elderly inpatients in internal medicine departments of Qilu Hospital of Shandong University from May 2021 to August 2022 were enrolled as research subjects, and a cross-sectional observational study was conducted. Researchers evaluated the frailty based on the (fr)AGILE scale score. The general condition, past medical history, physical examination, laboratory examination, nutrition control score, intervention and treatment measures and other elderly patient information was collected. Logistic regression analysis was used to analyze the relevant factors that affect the severity of frailty and hospitalization costs. According to the (fr)AGILE scale score, the elderly patients were divided into groups to determine whether they were frail and the severity of the frailty. Among them, 164 patients were in the prefrailty stage, which accounted for 40.2%. There were 188 cases of mild frailty that accounted for 46.1%, and 56 cases of moderate to severe frailty that accounted for 13.7%. Decreased grip strength, elevated white blood cell levels, and low sodium and potassium are independent risk factors affecting the severity of frailty. As the severity of frailty increases, the proportion of sodium, potassium, albumin supplementation as well as anti-infection gradually increases. Frailty is a common elderly syndrome with a high incidence among elderly patients in internal medicine departments. The main manifestations of frailty vary with different severity levels. Inflammation, anemia, and poor nutritional status can lead to an increase in the severity of frailty as well as blood hypercoagulability, myocardial damage, and additional supportive interventions. This ultimately leads to prolonged hospitalization and increased hospitalization costs.

The Role of Dopamine D2 receptors and Oxidative Stress in the Pathogenesis of Hypertension

Globally, hypertension is the number one risk factor for death, affecting more than 1 billion people. Hypertension is the result of the interactions among genetics, epigenetics, environment, and lifestyle. The long-term regulation of blood pressure rests on renal and non-renal mechanisms. The impaired renal sodium handling in hypertension is caused by aberrant counter-regulatory natriuretic/anti-natriuretic pathways. The sympathetic nervous and renin-angiotensin systems are anti-natriuretic pathways. A counter-regulatory natriuretic pathway is the renal dopaminergic system. Aberrant dopaminergic regulation of renal sodium transport in hypertension is caused by a decrease in renal dopamine synthesis and/or dysfunction of any of the 5 dopamine receptors (D1R, D2R, D3R, D4R, &amp; D5R). Normally, an increase in sodium intake increases while a decrease in sodium intake decreases blood pressure, albeit transiently until sodium balance is achieved. However, ~50 % of hypertensive and ~26% of normotensive subjects have increased blood pressure on high sodium intake, a case of salt sensitivity, while ~20 % have increased blood pressure on a low sodium intake, a case of inverse salt sensitivity. Low and high sodium intakes are associated with increased incidence of cardiovascular events/mortality. In humans with inverse salt sensitivity, there is a linear relationship between the number of single nucleotide polymorphisms in DRD2 (rs6276 and 6277) and decreased renal D2R expression. The increase in blood pressure on a low sodium diet may be due to increased activities of the renin-angiotensin and sympathetic nervous systems that cannot be counteracted by D2R. Hypertension may be a cause or consequence of inflammation or oxidative stress. Deficient D2R function causes renal inflammation independently of the increase in blood pressure. Subjects carrying DRD2 single nucleotide polymorphisms have increased inflammation, mediated by decreased regulation of the miR-217-Wnt5a-Ror2 pathway. The D2R, via paraoxonase2 and sestrin2, maintains normal redox balance and blood pressure. In summary, the D2R is important in the maintenance of normal blood pressure by regulating renal sodium transport, vascular reactivity, inflammation, and redox balance.

High Incidence of Refeeding Syndrome during the Transition from F75 to Ready-to-Use Therapeutic Feeds among Children 6 to 59 Months with Severe Acute Malnutrition at the Pediatric Nutritional Unit of Mulago Hospital.

Refeeding syndrome is a complication developed by children being managed for severe acute malnutrition (SAM). It is caused by changes in electrolyte balance once high-caloric feeding is reinitiated. Phosphorus, potassium, and magnesium are the main electrolytes affected when it occurs. However, hypophosphatemia is the hallmark of the diagnosis of refeeding syndrome. WHO recommends inpatient management of patients with complicated SAM with initially F75 which is low in calories and later transitioned to RUTF which is high in calories but also has a higher phosphorus content. This study aims to determine the incidence and factors associated with refeeding syndrome in the transition phase when treating children aged 6 to 59 months with severe acute malnutrition at the Mwanamugimu Nutritional Unit, Mulago. We conducted a prospective cohort study at the Mwanamugimu Nutritional Unit of Mulago National Referral Hospital. A total of 150 children between 6 and 59 months with SAM were enrolled into the study. We measured serum electrolytes (phosphorus, sodium, and potassium) at admission, initiation of RUTF, and 48 hours after transition. The refeeding syndrome was diagnosed by a drop in serum phosphorus of more than 0.3 mmol from baseline. The data were analyzed using STATA 17.0. Incidence of refeeding syndrome was determined as the proportion of participants whose serum phosphorus declined by more than 0.3 mmol from baseline. For factors associated, a multivariate-modified Poisson regression analysis reporting relative risk was performed with a 0.2 level of significance at bivariate and 0.05 at multivariate analyses. Of the 150 children recruited, 35 were lost to follow-up and 115 children had their data analyzed. Of the 115 participants in the study, 40 developed refeeding syndrome indicating a cumulative incidence of 34.8% with a 95% CI of 26.5-44%. A low baseline serum sodium (RR: 0.89, 95% CI: 0.80-0.99, and P value: 0.038) and having edematous malnutrition (RR: 0.90, 95% CI: 0.81-0.99, and P value; 0.042) at admission were found to be significant (P < 0.05) risk factors of refeeding syndrome. The cumulative incidence of RFS of 34.8% is very high. RFS is found to be associated with low baseline sodium and pedal edema. Children with a low baseline sodium and edema should undergo a cautious transition of feeds.

AN ANALYSIS OF SUITABILITY OF GROUNDWATER FOR AGRICULTURAL PRACTICES IN AMBALA CITY AND AMBALA CANTONMENT AREA, HARYANA, INDIA

The world has witnessed great development in past decades but deterioration of natural resources is a side product of all this progress and achievement. India hosts 16% of the world’s population but water available here is only 4%. Being a major agriculture country, the dependence on groundwater resources is high particularly in non-Himalayan states. The present study explores the quality of groundwater in the study area to cater the needs on agricultural front. In the present study, the groundwater quality for suitability in agriculture from Ambala City and Ambala Cantonment, has been evaluated. A total of 61 groundwater samples have been collected and analysed for pH, EC, TH, HCO3 − , CO3 2−, Cl− , SO4 2−, NO3 – , Ca2+, Mg2+, Na+ and K+ . To assess the groundwater quality for irrigation purpose, parameters like sodium adsorption ratio (SAR), residual sodium carbonate (RSC), permeability index (PI), values have been calculated. The values of SAR indicate that all of the samples were found in good water category. In USSL diagram, the groundwater in Ambala City and Ambala Cantonment for irrigation purposes is of C3S1, C4S1 and C1S1 type indicating that water in Ambala City and Ambala Cantonment exhibits high salinity and low sodium and very high salinity and low sodium hazard. On the basis of RSC, all groundwater samples were observed to be suitable for irrigation purpose.

Groundwater quality evaluation using water quality index and geospatial techniques in parts of Anantapur District, Andhra Pradesh, South India

The main aim of this research is to evaluate the quality of groundwater in parts of Anantapur district, Andhra Pradesh, for drinking and irrigation purposes. Groundwater samples were collected from various locations in the study area during the post-monsoon season and were analyzed for different parameters including pH, EC, TDS, Ca2+, Mg2+, Na+, K+, HCO3−, Cl−, SO42−, and NO3−. The results were then compared with the water quality standards of the World Health Organization (WHO). The major ions were found in the following order: Na+ > Ca2+ > Mg2+ > K+ = HCO3− > SO42− > Cl− > NO3−. The obtained data was then mapped using the Arc-GIS technique to show the spatial distribution pattern of physicochemical properties and major ion concentrations in groundwater. The water quality index showed that 69% of the samples are very poor, and 31% are unfit for drinking purposes due to effective leaching of ions, over-exploitation of groundwater, direct discharge of effluents, and agricultural impact. Based on the Gibbs diagram, the groundwater samples fall within the rock dominance region. The majority of the samples fell into the C3S1 category, which denotes water with high salinity and low sodium which is moderately suitable for irrigation purposes, according to the USSL diagram. According to the Wilcox classification, 27% and 2% of groundwater samples are deemed doubtful and unsuitable, respectively, while 69% of samples are deemed suitable for farming. In addition, most groundwater samples show moderate suitability for irrigation when evaluated for SAR, %Na, PI, RSC, MAR, and KR. Most of the samples, with the exception of a few spots, turned out to be suitable for irrigation. However, due to human activity, some samples had levels of contamination that were higher than allowed and needed to be treated before consumption.

Clinical Profile and Prevalence of Hyponatremia in Critically-ill Patients of All Age Groups

Hyponatremia is defined as a serum sodium level of &lt;135 mEq/L. It is the most prevalent electrolyte imbalance encountered in hospital admissions around the world. Hyponatremia has been reported to be present in between 3.4% to 39.4% of hospital admissions, and it is substantially more prevalent in an Intensive Care Unit (ICU). It has been connected to an increase in mortality, hospital stays, and morbidity. An imbalance of specific ionised salts (sodium, potassium, calcium, bicarbonate, and chloride) in the blood is known as an electrolyte problem. Volume abnormalities are the main cause of disturbances in salt homeostasis, which largely produce neurologic symptoms. Serious consequences arise when these electrolyte imbalances worsen, which are frequent clinical issues in the ICU. Hyponatremia has a multifaceted aetiology and it can be of three types: euvolemic, hypovolemic, or hypervolemic hyponatremia. Regardless of being a frequently encountered electrolyte disturbance, hyponatremia is poorly acknowledged. Its relationship with a myriad of fundamental illnesses and its many aetiologies with varying pathological and physiological pathways make diagnosis problematic. Clinicians should be skilled at recognising the symptoms, causes, and aetiologies of hyponatremia when treating sick patients. The signs, symptoms, and causes of hyponatremia should be readily apparent to clinicians treating unwell patients. The present review focuses on the symptoms and clinical findings of hyponatremia in the critically-ill patient and discusses the types, pathophysiology, and clinical profile of these patients.

Effect of fluoxetine on serum sodium levels in patients with depression

Background: One common selective serotonin reuptake inhibitor (SSRI) used to treat depression and other mood disorders is fluoxetine. Hyponatremia, or low serum sodium levels, is one of the side effects of fluoxetine and other selective serotonin reuptake inhibitors (SSRIs), despite their effectiveness in reducing depressed symptoms. Regular monitoring of serum sodium levels is essential to prevent and manage these side effects. Aim and Objectives: The objective of this study was to evaluate and compare the changes in serum sodium levels in patients with depression taking fluoxetine in different age groups (18–45, 46–70 years) and to evaluate the adverse effects between the two age groups. Materials and Methods: This prospective observational study involved 110 depressed patients who were divided into two age groups, 18–45 and 46–70 years old, and who attended a psychiatric outpatient department at a tertiary care hospital. Before starting fluoxetine therapy as well as in the first and third weeks afterward, serum sodium levels were tested, and adverse effects were noted. Between the two age groups, serum sodium level changes and other side effects were compared. Results: The serum sodium levels in the 46–70-year-old age group significantly dropped at the first and third weeks following therapy, whereas in the 18–45 year-old age group, the decrease in serum sodium levels occurred only after the 3rd week of therapy (P = 0.0005). At the 3rd week of therapy, 46–70-year-old serum sodium levels were substantially lower than those of 18–45-year-old patients (136.6 vs. 140.5, P = 0.0005), and only older patients had hyponatremia after the 1st and 3rd weeks of therapy. The P value is highly statistically significant (&lt; 0.01). Conclusions: Fluoxetine can lower serum sodium levels, which are more common and clinically evident in the 46–70-year age group than in the 18–45-year age group. In the first few weeks of fluoxetine medication, monitoring serum sodium levels is advised, especially for patients in the 46–70 age group.

Therapeutic Effect of Nitroglycerin in Conjunction with Low Molecular Weight Heparin Sodium in Managing Angina Pectoris in Coronary Heart Disease

Therapeutic Effect of Nitroglycerin in Conjunction with Low Molecular Weight Heparin Sodium in Managing Angina Pectoris in Coronary Heart Disease

An Unusual Case of a Central Pontine Myelinolysis Associated with Primary Splenic Diffuse Large B-cell Lymphoma.

A 54-year-old woman with persistent fatigue and a high fever presented with central pontine myelinolysis (CPM) on brain imaging, despite the absence of neurological symptoms. The patient had a slightly low serum sodium concentration. Further investigation led to a diagnosis of primary splenic diffuse large B-cell lymphoma (PS-DLBCL). Brainstem auditory-evoked potentials (BAEP) indicated minor abnormalities. CPM was successfully resolved after splenectomy and immunochemotherapy. This is the first reported case of CPM in a patient with PS-DLBCL confirmed by a pathological diagnosis following splenectomy and BAEP-detected abnormalities that improved with immunochemotherapy.

Prediction for Risk of Hypouricemia in Hospitalized Patients: A Single-center, Retrospective Cohort Study.

Background Hypouricemia, defined as a serum uric acid (SUA) level ≤2 mg/dL, could be a risk factor for death in hospitalized patients. However, how explanatory variables can explain hypouricemia as an objective variable in a logistic regression analysis remains unknown. Purpose To predict the risk factors for hypouricemia in hospitalized patients using a robust Bayesian logistic (RBL) model. Methods This study retrospectively enrolled patients who visited Yonago Medical Center between April 2020 and March 2021. The association between potential risk factors and hypouricemia was analyzed using the RBL model in Python-modulated PyMC3. The final model was selected based on the lowest Watanabe-Akaike information criterion (WAIC). Results Of the 618 patients, 64 (10.4%) had hypouricemia. Based on the model according to the lowest WAIC, independent risk factors for hypouricemia were febuxostat [odds ratio (OR) 5.46, 95% confidence interval (CI) 2.32-13.4], amino acids in parenteral nutrition (OR 5.19, 95% CI 1.62-15.1), TMP-SMX (OR 4.20, 95% CI 1.66-10.9), emaciation (OR 3.48, 95% CI 1.75-7.21), and serum sodium level (OR 0.90, 95% CI 0.84-0.96). Conclusion The RBL model predicted amino acids in parenteral nutrition, TMP-SMX, emaciation, and low serum sodium levels for hypouricemia, in addition to the authentic risk factor febuxostat.

Cation migration in layered oxide cathodes for sodium-ion batteries: fundamental failure mechanisms and practical modulation strategies.

Sodium-ion batteries (SIBs) are regarded as competitive candidates for the next generation of electrochemical energy storage (EES) systems due to their low cost and abundant sodium resources. Layered oxide cathodes have attracted much interest owing to their simple preparation process, high specific capacity and environmental friendliness. However, undesired cation migration during electrochemical reactions can lead to irreversible phase transitions and structural degradation of layered oxide cathode materials, resulting in a sharp decrease in specific capacity and energy density. Therefore, in order to find effective strategies to suppress cation migration, the fundamental failure mechanism of layered oxides and the practical approaches to solve this key scientific issue are thoroughly investigated, and herein the history and current status of developments in this field are also reviewed. Elemental doping and structural design can directionally modify the electronic structure, energy band structure and electronic density of states in layered oxides and enhance cation migration barriers, which benefits the improvement of electrochemical performance and structural stability during the whole sodiation/desodiation process. The summary and prospects of inhibiting cation migration in layered oxides provide insights into the development of advanced cathode materials with high energy density and excellent structural stability for the commercialization of SIBs.