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Etomidate-induced hypokalemia in electronic cigarette users: two case reports and literature review.Frontiers in Endocrinology 2024Hypokalemia is a common clinical condition that can lead to muscle weakness, difficulty breathing, malignant arrhythmias, and even death. This report describes two cases... (Review)
Review
Hypokalemia is a common clinical condition that can lead to muscle weakness, difficulty breathing, malignant arrhythmias, and even death. This report describes two cases of severe hypokalemia resulting from the use of electronic cigarettes containing etomidate, both accompanied by varying degrees of adrenal hyperplasia. In both cases, the patients were admitted to the hospital with lower limb weakness and difficulty walking. Relevant examinations revealed low blood potassium, low cortisol, high adrenocorticotropic hormone, low renin, and low aldosterone levels in the patients, with Case 2 also having significant hypertension. In both cases, adrenal CT scans showed thickening of the adrenal glands. After the delivery of potassium supplementation in both cases, blood potassium levels gradually returned to normal and muscle strength gradually improved. The case reports are followed by a review of the literature on etomidate and its related mechanisms of action with discussion of its association with hypokalemia.
Topics: Adult; Humans; Male; Electronic Nicotine Delivery Systems; Etomidate; Hypokalemia
PubMed: 38872965
DOI: 10.3389/fendo.2024.1321610 -
Advanced Science (Weinheim,... Jun 2024White light-emitting diodes (WLEDs) with high color-rendering index (CRI, >90) are important for backlight displays and solid-state lighting applications. Although the...
White light-emitting diodes (WLEDs) with high color-rendering index (CRI, >90) are important for backlight displays and solid-state lighting applications. Although the well-developed colloidal quantum dots (QDs) based on heavy metals such as cadmium and lead are promising candidates for WLEDs, the low CRI still remains a significant limitation. In addition, the severe toxicity of heavy metals greatly limits their widespread use. Herein, the study demonstrates low-cost and environmentally friendly carbon quantum dots (CQDs)-based WLEDs that exhibit a high CRI of 94.33, surpassing that of conventional cadmium/lead-containing QD-based WLEDs. This achievement is attained through the employment of a binary host-induced exciplex strategy. The high hole/electron mobility and suitable energy levels of the donor and acceptor give rise to a broadband orange-yellow emission stemming from the exciplex. As the host, the binary exciplex is capable of contributing blue and orange-yellow emission components while efficiently mitigating the aggregation-induced quenching of CQDs. Meanwhile, CQDs effectively address the deep-red emission gap, enabling the realization of CQDs-based WLEDs with high CRI. These WLEDs also exhibit a remarkably low turn-on voltage of 2.8 V, a maximum luminance exceeding 2000 cd m , a correlated color temperature of 4976 K, and Commission Internationale de l'Eclairage coordinates of (0.34, 0.32).
PubMed: 38872266
DOI: 10.1002/advs.202404485 -
Surgical Endoscopy Jun 2024Sarcopenia has been reported to be associated with short-term outcomes after gastric endoscopic submucosal dissection (ESD). The "strength, assistance with walking,...
BACKGROUND
Sarcopenia has been reported to be associated with short-term outcomes after gastric endoscopic submucosal dissection (ESD). The "strength, assistance with walking, rising from a chair, climbing stairs, and falls" (SARC-F) questionnaire has been widely used as a screening tool for sarcopenia; however, SARC-F combined with body mass index and age (SARC-F+EBM) has recently been reported to be more useful than SARC-F alone. This study aimed to investigate the association between sarcopenia, measured using SARC-F+EBM, and short-term outcomes after gastric ESD.
METHODS
Patients who underwent gastric ESD at our institution between May 2020 and June 2023 were included, and their medical records were reviewed retrospectively. A SARC-F+EBM score ≥ 12 indicated sarcopenia. We evaluated the incidence of adverse events and the length of hospital stay in the sarcopenia and non-sarcopenia groups.
RESULTS
Overall, 263 patients (64 and 199 in the sarcopenia and non-sarcopenia groups, respectively) were investigated. The incidence of adverse events with a Common Terminology Criteria for Adverse Events grade ≥ 3 was not significantly different between the sarcopenia and non-sarcopenia groups (6.2% vs. 8.5%, p = 0.791). The proportion of patients with an extended hospital stay (≥ 10 days) was significantly higher in the sarcopenia group than that in the non-sarcopenia group (12.5% [8/64] vs. 3.5% [7/199], p = 0.012). Multivariate analysis showed that sarcopenia and lesions that present technical difficulty in ESD were independent risk factors for extended hospital stays (≥ 10 days). Of the eight cases having extended hospital stays in the sarcopenia group, four were due to the management after gastric ESD, three were due to family circumstances, and one was due to decreased activities of daily living.
CONCLUSIONS
Sarcopenia is not a predictor of adverse events associated with gastric ESD. However, patients with sarcopenia may be hospitalized for longer owing to non-ESD-related factors.
PubMed: 38864884
DOI: 10.1007/s00464-024-10903-x -
Scientific Reports Jun 2024As age increases, a decline in lower extremity strength leads to reduced mobility and increased fall risks. This decline outpaces the age-related reduction in muscle...
As age increases, a decline in lower extremity strength leads to reduced mobility and increased fall risks. This decline outpaces the age-related reduction in muscle mass, resulting in mobility limitations. Older adults with varying degrees of mobility-disability use different stepping strategies. However, the link between functional lower extremity strength and stepping strategy is unknown. Therefore, understanding how age-related reductions in functional lower extremity strength influence stepping strategy is vital to unraveling mobility limitations. Twenty participants (17F, 72 ± 6 years) were recruited and tested at a local community event. Participants were outfitted with inertial measurement units (IMU) and walked across a pressurized walkway under single and dual motor task conditions (walking with and without carrying a tray with water) at their usual and fast speeds. Participants were dichotomized into normal (11) or low functional strength groups (9) based on age-specific normative cutoffs using the instrumented 5-repetition Sit-to-Stand test duration. Our study reveals that older adults with normal strength prefer adjusting their step time during walking tasks, while those with reduced strength do not exhibit a preferred stepping strategy. This study provides valuable insights into the influence of functional lower extremity strength on stepping strategy in community-dwelling older adults during simple and complex walking tasks. These findings could aid in diagnosing gait deviations and developing appropriate treatment or management plans for mobility disability in older adults.
Topics: Humans; Aged; Male; Female; Walking; Lower Extremity; Muscle Strength; Independent Living; Gait; Aged, 80 and over; Mobility Limitation
PubMed: 38862689
DOI: 10.1038/s41598-024-64293-0 -
Optics Express May 2024Tin diselenide (SnSe), a layered transition metal dichalcogenide (TMDC), stands out among other TMDCs for its extraordinary photoactive ability and low thermal...
Tin diselenide (SnSe), a layered transition metal dichalcogenide (TMDC), stands out among other TMDCs for its extraordinary photoactive ability and low thermal conductivity. Consequently, it has stimulated many influential researches on photodetectors, ultrafast pulse shaping, thermoelectric devices, etc. However, the carrier mobility in SnSe, as determined experimentally, remains limited to tens of cmVs. This limitation poses a challenge for achieving high-performance SnSe-based devices. Theoretical calculations, on the other hand, predict that the carrier mobility in SnSe can reach hundreds of cmVs, approximately one order of magnitude higher than experimental value. Interestingly, the carrier mobility could be underestimated significantly in long-range transportation measurements due to the presence of defects and boundary scattering effects. To address this discrepancy, we employ optic pump terahertz probe spectroscopy to access the photoinduced dynamical THz photoconductivity of SnSe. Our findings reveal that the intrinsic carrier mobility in conventional SnSe single crystal is remarkably high, reaching 353.2 ± 37.7 cmVs, consistent with the theoretical prediction. Additionally, dynamical THz photoconductivity measurements reveal that the SnSe crystal containing rich defects efficiently capture photoinduced conduction-band electrons and valence-band holes with time constants of ∼20 and ∼200 ps, respectively. Meanwhile, we observe an impulsively stimulated Raman scattering at 0.60 THz. Our study not only demonstrates ultrafast THz spectroscopy as a reliable method for determining intrinsic carrier mobility and detection of low frequency coherent Raman mode in materials but also provides valuable reference for the future application of high-performance SnSe-based devices.
PubMed: 38858943
DOI: 10.1364/OE.523383 -
Child's Nervous System : ChNS :... Jun 2024Giant extradural thoracic schwannomas are very rare tumors in the pediatric age group and often occur together with neurofibromatosis. Giant schwannomas span across more...
INTRODUCTION
Giant extradural thoracic schwannomas are very rare tumors in the pediatric age group and often occur together with neurofibromatosis. Giant schwannomas span across more than two vertebral segments and have an extraspinal extension of over 2.5 cm. In this case, we report on a 5-year-old boy with a purely extradural giant schwannoma without accompanying neurofibromatosis.
CLINICAL PRESENTATION
A 5-year-old male patient was admitted to the orthopedics and traumatology outpatient clinic with complaints of difficulty in walking following waist and left leg pain after falling from a chair. Contrast-enhanced spinal MRI and cranial MRI showed an extradural spinal lesion measuring 22 × 18 × 35 mm that pushed the spinal cord to the right at the T10-12 level and extended into the left foramen at the T11-12 level. The patient was operated. The tumor was removed completely by performing bilateral laminoplasty at the T10-11-12 levels. Histopathology result reported schwannoma.
CONCLUSION
Giant schwannomas are slow-growing tumors that rarely occur in childhood. In these patients, spinal traumas can lead to serious neurological deficits. Early diagnosis and successful surgery can prevent permanent neurological damage.
PubMed: 38858275
DOI: 10.1007/s00381-024-06494-6 -
Journal of Transport & Health Jan 2024Older drivers now expect to drive longer than previous cohorts and will make up about 25% of licensed U.S. drivers by 2050. Identifying early predictors of nighttime...
INTRODUCTION
Older drivers now expect to drive longer than previous cohorts and will make up about 25% of licensed U.S. drivers by 2050. Identifying early predictors of nighttime driving difficulty, a precursor to driving retirement, can inform screening procedures and timely linkage to interventions supporting driving or transitioning to driving cessation.
METHODS
We examined self-reported physical and mental health baseline predictors of greater nighttime driving difficulty in five and ten years using weighted multivariate logistic analyses of 2261 drivers, aged 57 to 85, from the National Social Life, Health, and Aging Project (NSHAP). Transition matrix models describe probabilities of having greater, lesser, or the same nighttime driving difficulty after five years based on baseline driving conditions and the significant logistic model factors. We built a transition matrix tool that offers users the ability to calculate expected probabilities of change in nighttime driving difficulty based on the identified salient factors.
RESULTS
Five-year predictors of greater nighttime driving difficulty included perceived poor physical health (OR = 3.75), limitations to activities of daily living (ADLs; OR = 1.97), and clinical levels of depressive and anxiety symptoms (OR = 1.63; OR = 1.71). Excellent physical health (OR = 0.52), mental health (OR = 0.60), and any frequency of physical activity compared to 'never' were protective (OR = 0.37-0.51). Physical health, walking pain, and limitations to ADLs were predictive at ten-years. Transition models showed physical health and anxiety were most indicative of greater nighttime driving difficulty at 5-years for those reporting no difficulty at baseline, but limitations to ADLs were more predictive otherwise.
CONCLUSIONS
Lay practitioners could capitalize on the use of self-report screening measures to identify older adults who may experience near-term nighttime driving difficulty. Earlier identification may better guide long-term driving retirement planning or engagement in appropriate health interventions. The transition matrix modeling tool is freely available to facilitate development and validation of related measures.
PubMed: 38855420
DOI: 10.1016/j.jth.2023.101724 -
Neurobiology of Aging May 2024We determined beta-band intermuscular (IMC) and corticomuscular coherence (CMC) as a function of age and walking balance difficulty. Younger (n=14, 23y) and older...
We determined beta-band intermuscular (IMC) and corticomuscular coherence (CMC) as a function of age and walking balance difficulty. Younger (n=14, 23y) and older individuals (n=19, 71y) walked 13 m overground, on a 6-cm-wide ribbon overground, and on a 6-cm-wide (5-cm-high) beam. Walking distance as a proxy for walking balance and speed were computed. CMC was estimated between electroencephalographic signal at Cz electrode and surface electromyographic signals of seven leg muscles, while IMC was calculated in four pairs of leg muscles, during stance and swing gait phases. With increasing difficulty, walking balance decreased in old individuals and speed decreased gradually independent of age. Beam walking increased IMC, while age increased IMC in proximal muscle pairs, and decreased IMC in distal muscle pairs. Age and difficulty increased CMC independent of gait phases. Concluding, CMC and IMC increased with walking balance difficulty and age, except for distal muscle pairs, which had lower IMC with age. These findings suggest an age-related increase in corticospinal involvement in the neural control of walking balance. DATA AVAILABILITY: The datasets used in this study are available from the corresponding author upon reasonable request.
PubMed: 38850592
DOI: 10.1016/j.neurobiolaging.2024.05.004 -
Medicine Jun 2024This study aimed to investigate the different impacts of sensorial and mobility frailty on overall and domain-specific cognitive function. Further, the independent... (Observational Study)
Observational Study
This study aimed to investigate the different impacts of sensorial and mobility frailty on overall and domain-specific cognitive function. Further, the independent associations between other intricate capacity (IC) dimensions, including vitality and psychological dimensions, and overall and domain-specific cognitive function were investigated. A total of 429 participants (mean age, 72.91 ± 7.014 years; 57.30% female) underwent IC capacity assessment. Other covariates, such as demographics, health-related variables were also assessed. Overall or domain-specific cognitive impairment was used as a dependent variable in logistic regression analyses adjusted for demographic, health-related, and psychosocial confounders. After adjustment for demographic, health-related, and psychosocial confounders, individuals with sensorial frailty (odds ratio [OR] = 0.435; 95% confidence interval [CI] = 0.236-0.801; P = .008) had a significantly lower risk of mild cognitive impairment (MCI), marginally low delayed memory impairment (OR = 0.601, 95% CI = 0.347-1.040; P = .069), and language impairment (OR = 0.534, 95% CI = 0.305-0.936; OR = 0.318, P = .029; OR = 0.318,95% CI = 0.173-0.586; P < .001) by Boston naming and animal fluency tests than did those with both sensorial and mobility frailty or mobility frailty only. Depressive symptoms had a significant negative influence on executive function. Cardiovascular disease and non-skin malignancy were independent determinants of MCI, and diabetes mellitus was independently associated with processing speed, attention, and executive function. Sensorial and mobility frailty were independent risk factors for cognitive impairment. Mobility frailty had a greater negative influence on the overall cognitive function and memory and language function than did sensorial frailty. The reserve decline in the psychological dimension of IC and chronic diseases also had a significant adverse influence on overall and domain-specific cognition function.
Topics: Humans; Female; Male; Aged; Cognitive Dysfunction; Independent Living; China; Cognition; Frailty; Frail Elderly; Aged, 80 and over; Geriatric Assessment; Cross-Sectional Studies; Mobility Limitation; East Asian People
PubMed: 38847667
DOI: 10.1097/MD.0000000000038500 -
Annals of Medicine and Surgery (2012) Jun 2024Intramedullary nondysraphic spinal lipomas are extremely rare among primary spinal cord tumors. These patients present with nonspecific sensory symptoms followed by...
INTRODUCTION
Intramedullary nondysraphic spinal lipomas are extremely rare among primary spinal cord tumors. These patients present with nonspecific sensory symptoms followed by deterioration of motor symptoms. As the safety margins for neurological preservation are thin, meticulously locating the extent of the tumor and choosing the resection modalities is essential.
CASE REPORT
The authors report a rare case of a 35-year-old male who presented with progressive difficulty in walking for 6 months associated with numbness and tingling sensation in the bilateral upper and lower limbs. He was diagnosed with nondysraphic intramedullary cervicothoracic lipoma and underwent subtotal resection of the tumor.
CONCLUSION
Nondysraphic intramedullary spinal cord lipomas are rare and may present as nonspecific neurological symptoms. Hence, they should be considered differentials of intramedullary spinal cord tumors. Surgery appears to be the mainstay of treatment.
PubMed: 38846861
DOI: 10.1097/MS9.0000000000002060