Hypoglycaemia in spinal muscular atrophy

Repeated episodes of hypoglycaemia were observed in two girls with spinal muscular atrophy. During a 12 h fast blood glucose fell to 3.4 and 2.7 mmol/L, respectively. One girl developed hypoglycaemia and ketonuria. Reduced gluconeogenesis was probably the cause of hypoglycaemia in these patients who had a muscle mass of about 10% of bodyweight (normal 30-40%). Hypoglycaemia must be suspected and treated when patients with severe muscle wasting due to chronic neuromuscular disorders are admitted comatose. In our experience this condition is often regarded as respiratory insufficiency.     

Self-consistent model of nuclear power development and fuel cycle

The use of a high-boiling heat-transfer metal (lead) deterministically ensures sufficient nuclear, engineering, and ecological safety in design and hypothetical accidents. The transmutation nuclear fuel cycle makes global environmental safety closer, when the equivalent activity of the long-lived components of hot waste is lower than, or close to, that of the raw material used. When such equality is reached, nuclear power can be considered to be waste-free, in a sense. A conceptual model envisaging a large-scale, long-term nuclear energy industry is proposed as a solution to the aforementioned problems. Ministry of Atomic Energy of the Russian Federation. NIKIéT (Scientific Research and Design Institute for Power Engineering). Translated from Atomnaya énergiya, Vol. 86, No. 5, pp. 361–370, May, 1999.     

Nasal ventilation

Nasal intermittent positive pressure ventilation is likely to have an increasing role in the management of acute ventilatory failure, weaning, and chronic ventilatory problems. Further improvements in ventilator and mask design will be seen. Appropriate application is likely to reduce both mortality and admissions to intensive care, while domiciliary use can improve life expectancy and/or quality of life in chronic ventilatory disorders. As with any new technique, enthusiasm should not outweigh clear outcome information, and possible new indications should always be subject to careful assessment.