Plasma ionized magnesium in tubular disorders with and without total hypomagnesemia

 Selective electrodes have been designed for determining plasma ionized magnesium. In kidney disease the relationship between ionized and total circulating magnesium is often altered. Hence plasma ionized magnesium (ETH 7025 membrane) was determined in 25 patients with primary renal tubular disorders; 6 patients had total hypomagnesemia. Total plasma magnesium was never reduced in the remaining 19 patients. Plasma ionized magnesium values were low in the 6 patients with total hypomagnesemia. In 18 of the 19 patients without total hypomagnesemia plasma ionized magnesium values were not reduced. Ionized hypomagnesemia was noted in a patient with normal total plasma magnesium in the context of hypercalciuric nephrocalcinosis of unknown origin. The study demonstrates an excellent concordance between plasma total and ionized magnesium in tubular disorders associated with total hypomagnesemia and a good concordance in tubular disorders that are not linked with total hypomagnesemia. The determination of circulating ionized magnesium is of little value in the diagnostic work-up of the vast majority of renal tubular disorders. The determination might perhaps disclose latent hypomagnesemia in nephrocalcinosis of unknown cause. Received: 20 March 1998 / Revised: 28 May 1998 / Accepted: 29 May 1998     

A new case of malonyl coenzyme A decarboxylase deficiency presenting with cardiomyopathy

A new case of mitochondrial malonyl coenzyme A decarboxylase deficiency is described. The patient presented with an initial episode of metabolic acidosis, seizures, hypoglycemia, and cardiac failure at 2 months of age which slowly resolved. Subsequent evaluations at 4 years of age for developmental delay revealed a prominent elevation of malonic acid in urine. Malonyl carnitine was also elevated. The activity of malonyl CoA decarboxylase in cultured fibroblasts was 7% of normal. Conclusion Malonyl CoA decarboxylase deficiency may result in inhibition of fatty acid oxidation, which may account for the cardiomyopathy. Received: 12 April 1996 / Accepted: 24 September 1996     

抗菌药使用中药物治疗错误的研究

目的：研究抗茵药使用中药物治疗错误（ME）的发生情况，探讨其防范重点。方法：药师深入中心ICU病房，通过调查病历、直接观察的方式发现抗茵药ME。结果：10个月研究期间共发现ME301次，其中可预防药物不良事件（ADE）19次（3．3％），潜在ADE94次（16．2％）。有潜在危害ME（可预防的ADE＋潜在ADE）中有生命威胁6次（5．3％），严重88次（77．9％），明显19次（16．8％）。结论：抗茵药使用中ME经常发生，其中约1／3有潜在危害且往往带来严重后果，应该采取措施防范ME、特别是有潜在危害ME的发生。     

准分子激光原位角膜磨镶术对血-房水屏障功能的影响

目的 :评价准分子激光原位角膜磨镶术 (LASIK)对血 房水屏障功能的影响。方法 :对河南省眼科研究所行LASIK手术的 2 0例 (38眼 )屈光不正患者在手术前 1d及手术后 1d、1w分别行激光闪辉 /细胞光度仪 (KowaFC 2 0 0 0 )检查 ,测定房水闪辉光度值和细胞数 ,观察其数值变化 ,以判断LASIK手术对血 房水屏障功能的影响。结果 :手术前及手术后 1d、1w的房水闪辉光度值分别为 (3.5 3± 1.33)ph/ms、(4 .17± 1.2 4 )ph/ms和 (3.6 2± 1.34)ph/ms,细胞数分别为 (0 .31± 0 .6 1)个 /mm3 、(0 .2 4± 0 .34)个 /mm3 和 (0 .2 2± 0 .5 4 )个 /mm3 ,手术前后差异均无显著性 ,P >0 .0 5。结论 :LASIK手术安全可靠 ,对血 房水屏障无明显影响。     

3种配准方式下肺癌图像引导放射治疗摆位误差的比较

目的研究滑轨CT不同配准方式对肺癌大分割调强放疗摆位误差的影响。方法选取2016年10月至2017年10月在安徽医科大学第一附属医院放疗科就诊的肺癌患者24例,每周行滑轨CT扫描所得图像与原计划图像行灰度、骨性、手动3种模式在线配准,得出X、Y、Z轴3个方向平移误差,并进行统计分析。结果灰度配准、骨性配准和手动配准方式测量的X、Y、Z轴摆位误差分别为(0. 21±0. 16)、(0. 29±0. 15)、(0. 37±0. 22) cm,(0. 27±0. 16)、(0. 35±0. 25)、(0. 29±0. 19) cm,(0. 18±0. 12)、(0. 28±0. 16)、(0. 23±0. 14) cm,结果显示Y轴平移误差最大,其次为X轴,Z轴最小,且3组数据的差异有统计学意义(P <0. 05)。其中灰度模式在X、Y、Z轴上平移误差较骨性模式均缩小,灰度模式在X、Z轴上平移误差较手动模式有所缩小,差异有统计学意义(P <0. 05)。结论肺癌患者行图像引导大分割调强放疗时,应用滑轨CT中的灰度模式可缩小摆位误差。     

Application of 3D Scanning as an Indirect Method to Analyze and Eliminate Errors on the Manufactured Yoke-Type Forgings Forged in SMED Device on Modernized Crank Press

This article proposes an indirect measurement method based on a dimensional and shape analysis of forgings for the evaluation of the manufacture and the proper operation of the key elements of the crank press, in which after modernization, a quick tool assembly based on SMED (Single Minute Exchange of Die) was implemented. As a result of the introduced changes aiming at improving the forging aggregate and increasing the production efficiency, errors were observed on the manufactured products-forgings in the form of twists and joggles. In order to solve the problem, a lot of advanced methods was used, including: dynamic system of deformation analysis, numerical modeling and as well as dimensional and shape analysis by 3d scanning. Despite the above, this approach (classic way) did not solve the problem. A proprietary method with the use of 3D reverse scanning was proposed, which allows to solve the problem of forgings errors. Based on the measurement results and analyses for a few variants of production cycles, the necessary changes were obtained, making it possible to minimize the errors and obtain proper products in respect of geometry and quality.     

Opportunities for Improving Post-Hospital Home Medication Management Among Older Adults

SUMMARY

Effective post-hospital home medication management among older adults is a convoluted, error-prone process. Older adults, whose complex medication regimens are often changed at hospital discharge, are susceptible to medication-related problems (e.g., Adverse Drug Events or ADEs) as they resume responsibility for managing their medications at home. Human error theory frames the discussion of multi-faceted, interacting factors including care system functions, like discharge medication teaching that contribute to post-hospital ADEs. The taxonomy and causes of post-hospital ADEs and related risk factors are reviewed, as we describe in high-risk older adults a population that may benefit from targeted interventions. Potential solutions and future research possibilities highlight the importance of interdisciplinary teams, involvement of clinical pharmacists, use of transitional care models, and improved use of informational technologies.