1.Osmol gap method for the detection of diethylene glycol in human serum
Holland G MICHAEL ; Nelsen JAMIE ; Rosano G THOMAS
World Journal of Emergency Medicine 2010;1(2):104-107
BACKGROUND:Measurement of the osmol gap (OG) is a technique that is used frequently in toxic alcohol poisonings (ethylene glycol (EG) and methanol) as a rapid means to estimate exposure, and can be performed in virtually all hospital laboratories. The value of the OG has not been previously evaluated for diethylene glycol (DEG) exposures. The primary objective of this study was to evaluate the utility of the OG in estimating DEG serum concentrations using the most common formula that is currently used for estimating methanol, ethanol, and ethylene glycol concentrations.METHODS:This was a controlled laboratory investigation using serum samples individually spiked with a known quantity of toxic alcohol compared to no toxic alcohol. Test samples were spiked with ethanol, DEG, EG, and methanol. Serum chemistries and osmolality and osmolarity were determined, and the OG was determined for each specimen.RESULTS:The percent error of estimating DEG concentrations of 26.3% was similar to the mean percent error for estimating other alcohol concentrations, 30.5%±5.6% (P>0.05, 95% confidence interval 16.7%-44.3%).CONCLUSIONS:The severity of metabolic effects associated with DEG and the need to appropriately determine rescue treatments mandate early detection of significant exposures for effective triage and patient management. Our results indicate that the percent error of the osmol gap method for estimating DEG concentration is similar to that of other toxic alcohols; this simple technique could be a valuable clinical tool, since quantitative DEG analysis is rarely available.
2.Concurrent validity of power output derived from the non-motorised treadmill test in sedentary adults.
Annals of the Academy of Medicine, Singapore 2008;37(4):279-285
INTRODUCTIONMany consider the Wingate Anaerobic Test (WAnT) as a reference standard assessment mode in the measurement of lower limb short-term power output. However the WAnT is criticised for having low ecological validity, in non-cycling tasks and is reliant on a predetermined applied force, which might not elicit the highest power output. A viable alternative to the WAnT is the Non-Motorised Treadmill (NMT) Test, which allows for power measurement in all-out intensity effort sprint-running. With the reliability of the NMT to elicit power in sedentary adults already established, the aim was to compare peak power (PP) and mean power (MP) derived from a 10-s sprint on the NMT to that derived from a 10-s WAnT, to establish concurrent validity.
MATERIALS AND METHODSTwelve male [age 26.6 +/- 2.4 years, body mass (BM) 63.0 +/- 7.2 kg] and 11 female (age 25.3 +/- 3.6 years, BM 51.0 +/- 4.0 kg) sedentary adults participated in the study. PP and MP in absolute, ratio-scaled and allometrically-scaled to BM were analysed. Ratio limits of agreement (LOA) was used to establish the agreement between PP and MP from the NMT and the WAnT.
RESULTSPP in absolute and ratio-scaled to BM from the NMT was between 1.04 and 1.12 times that of PP from the WAnT in 95% of the attempts (PP: NMT, 647.1 +/- 176.4W vs WAnT, 597.0 +/- 146.0W). MP in absolute and ratio-scaled to BM from the NMT test was between 0.88 and 0.97 times of that from the WAnT (MP: NMT, 508.9 +/- 130.7W vs WAnT, 548.7 +/- 131.3W). Power produced on the NMT and the WAnT by sedentary adults shared moderate and acceptable levels of agreement.
CONCLUSIONSThese results affirmed that the NMT could be considered as a viable alternative to the WAnT for the assessment of PP and MP in allout intensity sprint-running lasting 10 s in sedentary adults.
Adult ; Exercise ; physiology ; Exercise Test ; instrumentation ; standards ; Female ; Humans ; Life Style ; Male ; Motor Activity ; physiology ; Muscle Strength ; physiology ; Physical Fitness ; physiology
3.Association of sarcopenia with osteoporosis in patients with chronic obstructive pulmonary disease
Jamie R. CHUA ; Michael L. TEE
Osteoporosis and Sarcopenia 2020;6(3):129-132
Objectives:
Systemic consequence of Chronic Obstructive Pulmonary Disease (COPD) is associated with progressive loss of muscle mass and function. Preliminary studies showed presence of sarcopenia in COPD leads to reduced pulmonary function and quality of life; studies on whether this condition results in consequent loss of bone mineral density (BMD) is still inconsistent. This study aims to examine the association of sarcopenia in COPD with osteoporosis.
Methods:
This is a post-hoc analysis of a study on forty-one (n ¼ 41) participants with COPD seen in a tertiary public hospital in Manila, Philippines who underwent pulmonary function test and dual-energy x-ray absorptiometry. Sarcopenia was defined using a Philippine-based criteria of low fat free mass index (FFMI) and low muscle strength - hand grip strength, and osteoporosis using World Health Organization T-score diagnostic criteria.
Results:
The prevalence of osteoporosis among COPD is 44%, and 63% in COPD with sarcopenia. There was no statistical difference seen in pulmonary function variables between COPD with and without osteoporosis. Significant positive correlations were observed between Forced Expiratory Volume in 1 s, FFMI, and appendicular lean muscle with total body BMD. Sarcopenia in COPD was associated with significantly increased risk for osteoporosis.
Conclusions
High prevalence rate of osteoporosis, and even higher among sarcopenic Filipino COPD patients should be further studied. The findings also suggest that sarcopenia in COPD is associated with increased risk of osteoporosis, and osteoporosis alone does not seem to affect lung function.
4.The modern testicular prosthesis: patient selection and counseling, surgical technique, and outcomes.
Solomon HAYON ; Jamie MICHAEL ; R Matthew COWARD
Asian Journal of Andrology 2020;22(1):64-69
The testicular prosthesis can be an afterthought for providers when performing an orchiectomy for testicular cancer, torsion, atrophic testis, or trauma. However, data suggest that patients find the offer of a testicular prosthesis and counseling regarding placement to be extremely important from both a pragmatic and a psychosocial perspective. Only two-thirds of men undergoing orchiectomy are offered an implant at the time of orchiectomy and of those offered about one-third move forward with prosthesis placement. The relatively low acceptance rate is in stark contrast with high patient satisfaction and low complication rates for those who undergo the procedure. The most common postoperative patient concerns are minor and involve implant positioning, size, and weight. Herein, we provide an up-to-date review of modern preoperative evaluation, patient selection, expectation management, surgical technique, and expected outcomes for testicular prostheses.
Counseling
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Gonadal Dysgenesis, 46,XY/surgery*
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Humans
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Male
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Orchiectomy
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Patient Satisfaction
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Patient Selection
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Postoperative Complications/epidemiology*
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Prosthesis Implantation/methods*
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Spermatic Cord Torsion/surgery*
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Testicular Diseases/surgery*
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Testicular Neoplasms/surgery*
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Testis/surgery*
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Urologic Surgical Procedures, Male/methods*