Hypomagnesemic hypocalcemia secondary to renal magnesium wasting.

Two patients developed severe hypomagnesemia, hypocalcemia, and hypokalemia as a result of renal wasting of magnesium and potassium shortly after being treated with large doses of gentamicin. When therapy with gentamicin was discontinued renal loss of magnesium and potassium ceased, and serum calcium, magnesium, and potassium returned toward normal. Serum immunoreactive parathyroid hormone levels were inappropriately low during the episodes of hypocalcemia. Both patients represent examples of hypomagnesemic hypocalcemia induced by inappropriate magnesuria, possibly caused by gentamicin. These observations suggest that serum calcium, magnesium, and potassium should be monitored during gentamicin therapy.     

Malignant syphilis in patient with human immunodeficiency virus (HIV): case report and literature review

Malignant syphilis is an infrequent manifestation of syphilis in HIV infected patients. Only 21 cases have been published in medical literature. Most frequent in men, 62%, the mean age of presentation is 34 years. The most frequent symptoms are: 100% ulcerative cutaneous lesions, 47% fever and 33% ocular affectation. About 80% of the patients have a CD4 count >200. Lues serological test was 100% positive and 81% responded to penicillin. We report a 18 year old woman diagnosed of HIV infection, admitted to our service because of fever, painful oral sores, over-elevated eritematous lesions and cratered ulcers all over the body, with the initial suspicion of chickenpox. Lues serology turned out to be positive, as well as the Warthin Starry stain. After penicillin treatment was initiated, skin lesions improved, although residual lesions currently persist. Malignant syphilis should be considered in infected HIV patients with fever and ulcerated skin injuries as a possible diagnosis. Eventhough serological tests allow diagnosis confirmation, Warthin Starry stain can be useful when serology is negative. The first choice of treatment is penicillin and in case of penicillin allergy, a third generation cefalosporine should be used.     

Bicycle-related injuries requiring hospitalization in the United Arab Emirates

ObjectivesTo study the anatomical distribution, severity, and outcome of bicycle-related injuries requiring hospitalization in Al-Ain city, United Arab Emirates in order to improve preventive measures.MethodsAll patients with bicycle-related injuries who were admitted to Al-Ain Hospital or who died after arrival were studied. Data were prospectively collected over a period of six years (October 2001–October 2007). Demography of patients, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), hospital stay, and mortality were analysed.ResultsThere were 130 patients (126 males). Mean (SD) age was 27.1 (14.5) years. 17.7% were United Arab Emirates (UAE) nationals. None of the patients was wearing a helmet. The percentage of UAE nationals of less than 15 years old was significantly higher (65.2%) than non-UAE nationals (14.3%) (p < 0.0001, Fisher's Exact Test). The most common mechanism of injury for UAE nationals was falling from a bicycle (73.7%) whilst for non-UAE nationals was hitting a moving vehicle (66.7%). 96 (73.9%) patients had head and face injuries whilst 91 patients (70%) had extremity injuries. On arrival to the hospital, the median (range) ISS was 4 (1–41) and the median (range) GCS was 15 (3–15). The median (range) of total hospital stay was 4 (1–95) days. 17 patients (13.1%) were admitted to the Intensive Care Unit. Two patients died because of head injury (overall mortality was 1.5%).ConclusionsThe majority of hospitalized injured cyclists in our study were low income adults using cycling as a cheap transportation method. Compulsory helmet use by bicycle riders and subsidising helmet cost should be adopted so as to reduce morbidity and mortality of bicycle-related injuries.     

Fast and Precise Non-Contact Measurement of Cylindrical Surfaces with Air Gauges

In this paper, the results of an investigation on the application of air gauges in the measurement of out-of-roundness parameters are presented. The principle of the measuring system is explained, in particular the novel design of the floating gauge head. An algorithm for fully automated measurement and data processing is described. The results from a series of initial measurements provided the data for further simulations, which revealed possible sources of errors. The simulations helped to evaluate the influence of some of the parameters on the final measurement results. After various accuracy tests, the method accuracy (MA) parameter was calculated in relation to the dedicated reference form tester. The result MA = 9.29% was judged to be highly satisfactory considering the short measurement time and non-contact method.     

Joint symbolic analyses of heart rate,blood pressure,and respiratory dynamics

Introduction

The dynamics of cardiovascular variables are modulated by respiration. The aim of this study was to assess baroreflex function in normal subjects based on the joint symbolic dynamics of heart rate, blood pressure and respiration.

Methods

ECG, continuous blood pressure and respiration were recorded in ten healthy subjects during rest in the supine position and upon standing. Beat-to-beat time series of heart rate, systolic blood pressure and respiratory phase were extracted and transformed into binary symbol sequences. Words of length two that were reflective of baroreflex activity were statistically analysed with respect to the respiratory phase.

Results

Symbolic analysis showed a significant influence of the respiratory phase on the occurrence of baroreflex patterns. Upon standing, the frequency of baroreflex words increased and the effect of respiration appeared to be reduced.

Conclusions

Symbolic dynamics provide a simple representation of cardiovascular dynamics and may be useful for assessing baroreflex function.