Extreme hyperglycemia with ketoacidosis and hyperkalemia in a patient on chronic hemodialysis

A patient on hemodialysis for end-stage renal disease secondary to diabetic nephropathy was admitted in a coma with Kussmaul breathing and hypertension (232/124 mmHg). She had extreme hyperglycemia (1884 mg/dL), acidosis (total CO(2) 4 mmol/L), hyperkalemia (7.2 mmol/L) with electrocardiographic abnormalities, and hypertonicity (330.7 mOsm/kg). Initial treatment with insulin drip resulted in a decrease in serum potassium to 5.3 mmol/L, but no significant change in mental status or other laboratory parameters. Hemodialysis of 1.75 hours resulted in rapid decline in serum glucose and tonicity and rapid improvement of the acidosis, but no change in mental status, which began to improve slowly after the hemodialysis was stopped, but with ongoing treatment with continuous insulin infusion. The rate of decline in tonicity during hemodialysis (14.5 mOsm/kg/h) was high, raising concerns about neurological complications. In this case, extreme hyperglycemia with ketoacidosis, hyperkalemia, and coma developing in a hemodialysis patient responded to insulin infusion. Monitoring of the clinical status and the pertinent laboratory values is required to assess the need for other therapeutic measures including volume and potassium replacement and emergency dialysis. The indications for and risks of emergency dialysis in this setting are not clearly defined.     

BRCA Mutations in Prostate Cancer: Assessment,Implications and Treatment Considerations

Prostate cancer ranks fifth in cancer-related mortality in men worldwide. DNA damage is implicated in cancer and DNA damage response (DDR) pathways are in place against this to maintain genomic stability. Impaired DDR pathways play a role in prostate carcinogenesis and germline or somatic mutations in DDR genes have been found in both primary and metastatic prostate cancer. Among these, BRCA mutations have been found to be especially clinically relevant with a role for germline or somatic testing. Prostate cancer with DDR defects may be sensitive to poly(ADP-ribose) polymerase (PARP) inhibitors which target proteins in a process called PARylation. Initially they were used to target BRCA-mutated tumor cells in a process of synthetic lethality. However, recent studies have found potential for PARP inhibitors in a variety of other genetic settings. In this review, we explore the mechanisms of DNA repair, potential for genomic analysis of prostate cancer and therapeutics of PARP inhibitors along with their safety profile.     

Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review

Esketamine (ESK) has been approved as a rapid-acting intranasal treatment for treatment-resistant depression (TRD). Although existing studies have investigated the efficacy of ESK in the 4-week induction phase, our knowledge about long-term ESK efficacy remains poor. The aim of this systematic review was to summarize the available data on long-term ESK efficacy for TRD. A systematic search was performed including articles in English, up to 31 March 2021. The search found 7 relevant studies, involving 1024 adult TRD patients. Continuing treatment with ESK after the 4-week induction phase may be associated with stable efficacy in relapse prevention among TRD patients. Conversely, the long-term antidepressant effectiveness upon discontinuation of ESK might be limited, although data from three studies had a moderate to high risk of bias. Overall, the results on the effectiveness of this compound in the long term are mixed. According to our findings, ESK treatment should be continued following the induction phase to reach a stable efficacy in relapse prevention, while the long-term antidepressant and anti-suicidal effects of ESK after discontinuation are inconsistent. Currently, the level of proof of ESK efficacy in long-term TRD treatment remains low and more RCTs with larger sample sizes and active comparators are needed.     

Characterization of a water-dispersible metal protective coating with Fourier transform infrared spectroscopy, modulated differential scanning calorimetry, and ellipsometry

An ethylene-methacrylic acid copolymer, formulated by BASF as a waterborne suspension of its alkylammonium salt and used, among other applications, in art conservation as a temporary protective coating was characterized using Fourier transform infrared (FT-IR) spectroscopy aided by modulated differential scanning calorimetry (MDSC) and ellipsometry. The thermal conversion of thin copolymer films from the freshly applied state, where carboxylic acid and carboxylate ion functional groups co-exist, to a purely acidic working state was spectroscopically followed. Transmission mid-infrared data of the working state showed a 1 : 12 ratio of methacrylic acid towards ethylene units. The glass transition temperature (T(g)) in the same state was found at 45 °C. Copolymer films spin-coated on mechanically polished bronze and iron coupons were characterized with transflection infrared spectroscopy and compared to corresponding transmission mid-infrared spectra of copolymer films spin-coated on silicon wafers. In the case of bronze coupons, evidence for interaction of the carboxylate ion with the copper substrate was obtained. The chemical structure and the thermal behavior of the coating, as well as some implications on its protective capability towards iron and copper alloys, is discussed as this material has received considerable attention in the field of metal conservation and coatings.     

Mint and pomegranate extracts/oils as antibacterial agents against Escherichia coli O157:H7 and Listeria monocytogenes on shredded carrots

Among minimally processed vegetables, shredded carrots are particularly popular. The aim of this study was to evaluate the antimicrobial activity of different washing treatments with aqueous solutions of mint essential oil (EO) (1:1000), mint hydrosol (1:10), and pomegranate juice (1:10) against two major foodborne pathogens on shredded carrots as well as their effect on carrot's quality. The results of this study indicate that the tested washing treatments resulted in a small but significant decrease of the microbial load of Escherichia coli and Listeria monocytogenes on the sixth day of storage. Pomegranate juice and mint hydrosol were more effective against L.   monocytogenes, whereas mint EO was more effective against E.   coli. Furthermore, an increase in carrot's total phenolics and antioxidants was observed with the application of mint hydrosol and pomegranate juice, whereas mint EO resulted in a decrease on the sixth day of storage. Additionally, a decreased chroma of the shredded carrots were observed during the application of mint hydrosol on the sixth day. Total carotenoids, ascorbic acid, total soluble solids, and tritratable acidity were not differing after six days of storage of shredded carrots. These washing products can be used for the partial disinfection of shredded carrots.

Practical applications

Pomegranate and mint natural products solution can be used for the partial disinfection of minimally processed fresh produce as an alternative to chlorine, and these products can be a part of the sanitation process.     

Fault tolerant and prioritized scheduling in OGSA‐based mobile Grids

Grids and mobile Grids can form the basis and the enabling technology for pervasive and utility computing due to their ability to being open, highly heterogeneous and scalable. In this paper we present a scheme for advancing quality of service (QoS) attributes, such as fault tolerance and prioritized scheduling, in OGSA‐based mobile Grids. The fault tolerance is achieved by producing and managing sufficient replicas of tasks submitted for execution on the mobile Grid resources. We design a simple and efficient prioritization scheme, which allows the scheduling of the tasks submitted by the Grid users as distinguished priorities that can be managed and exploited as a QoS parameter by the Grid infrastructure operator. The results that are presented show the efficiency of the proposed scheme in being simple and additionally enriching with reliability and QoS features the applications that are built on the concept of mobile Grids. Copyright © 2008 John Wiley & Sons, Ltd.     

Non-toxic poly(ethylene terephthalate)/clay nanocomposites with enhanced barrier properties

Motivated by the technological need for poly(ethylene terephthalate) materials with improved barrier properties together with the requirement for sustainability this study focuses on an eco-friendly sulfonated polyester as clay compatibilizer to facilitate polymer mixing during melt compounding. We demonstrate that the nanocomposites based on sulfonated polyester are a reliable alternative to their imidazolium counterparts, exhibiting enhanced properties (water vapor and UV transmission), without sacrificing the excellent transparency, clarity and mechanical strength of the matrix.