The purpose of this chronoepidemiologic study was to investigate the time-relationships between the yearly variations in occurrence of violent suicide in Belgium and the yearly variations in various biochemical, metabolic and immune variables in the Belgian population. The weekly mean number of deaths due to violent suicide for all of Belgium for the period 1979–1987 was computed. Twenty-six normal volunteers had monthly blood samplings during one calendar year for assays of plasma L-tryptophan (L-TRP), competing amino acids (CAA), and melatonin levels, maximal [3H]paroxetine binding to platelets, serum total cholesterol, calcium, magnesium, and soluble interleukin-2 receptor concentrations, and number of CD4+ T, CD8+ T and CD20+ B lymphocytes. The annual rhythm in violent suicide rate is highly significantly synchronized with the annual rhythms in L-TRP, [3H]paroxetine binding, cholesterol, calcium, magnesium, CD20+ B cells, and CD4+/CD8+ ratio; the mean peak (violent suicide, [3H]paroxetine binding) or nadir (all other variables) occurs around 3 May. There were significant inverse time-relationships between the time series of violent suicide rate and L-TRP, L-TRP/CAA ratio, total cholesterol, calcium and magnesium, CD4+/CD8+ T cell ratio and number of CD20+ B cells. Maximal [3H]paroxetine binding to platelets was significantly and positively related to the time series of violent suicide. An important part (56.4%) of the variance in mean weekly number of violent suicide rate was explained by the time series of L-TRP, cholesterol and melatonin.

Introduction: With rising health care costs impairing access to care, the judicious use of diagnostic tests has become a critical issue for most jurisdictions. Among tests regularly performed in the emergency department (ED), calcium (Ca), magnesium (Mg) and phosphorus (P) laboratory testing represents an annual expenditure of more than $4 million for the Québec health care system. We then sought to determine the best indications for ordering these serum levels by identifying patient risk factors predicting abnormal results. Methods: We are conducting a retrospective cohort study in two academic hospitals of Québec City, one providing acute general care and the other providing specialized care to oncologic and nephrologic patients. We included 1000 patients who had serum Ca and/or Mg and/or P levels prescribed by an emergency physician between January 1st 2016 and May 1st 2016. We are collecting demographic (e.g. age) and clinical (e.g. comorbidities) characteristics identified from literature review as potential explanatory variables of an abnormal serum level. Predictive models of a positive test result will be derived from logistic regressions. Results: We have evaluated 143 patients. ED prevalence rates of hypo- and hyper-calcemia (10.1% and 4,3%), hypo- and hyper-magnesemia (13.0% and 7,2%), hypo- and hyper-phosphatemia (9.5% and 13,9%) were similar to those reported in literature. Preliminary bivariate analysis (p<0.05) have shown that, for patients who had serum Ca/Mg/P levels prescribed, one in four complained of weakness, one in five complained of abdominal pain and one in five presented on physical examination an abnormal mental status. Acute and chronic renal failure appears to be a strong predictor of anomalies of any of those electrolytes. Neoplasia, metastasis, hallucinations, bone pain and confusion are more specifically associated with hypercalcemia. Use of corticosteroids is associated with hypocalcemia. Conclusion: Our bivariate analyses have identified potential risk factors of abnormal Ca/Mg/P results. Multivariate logistic regressions will be conducted on the complete planned cohort to further test these preliminary results.

Introduction: In the Emergency Department (ED), increasing time pressures and acuity require physicians to have access to quick and reliable data to guide patient care decisions. Blood gases (BGs) allow quick access to key information, and are used frequently in the ED. Our objective was to review the literature on reliability and accuracy of electrolyte measurements obtained from BGs in high acuity settings. Methods: A comprehensive literature review was conducted in September of 2015. The search strategy, done in conjunction with a medical librarian, identified studies that assessed the accuracy of BGs when compared to traditional laboratory serum measurements. Prior to the review we determined sodium and potassium would be the area of focus. Eligibility parameters for the studies included samples from acute care areas - the ED and ICU - and a comparison of BG and serum values taken simultaneously from the patient. Results: Our review included 12 studies, 9 in adult and 3 in pediatrics. There were approximately 1,135 patients included, consisting of 851 adult and 284 pediatric cases. The results were mixed; 9 studies agreed that sodium and potassium readings from BGs were accurate enough to guide acute care decisions, 5 did not. Furthermore, important questions were raised regarding the varying accuracy of BGs depending on what physiological level the electrolytes were at during the time of collection, i.e. at critical vs non-critical levels. Conclusion: This is the first literature review to examine the existing evidence on the accuracy of BGs in acute care environments. Given the variability in the results, a larger study needs to be done to determine the validity and reliability of blood gases for electrolytes in acute care settings. Only by ensuring the accuracy of data collected via point-of-care BGs can the most informed decisions be made surrounding patient care in acute care settings.

This study investigated four electrolytes (tap water, mineral water, seawater, and Al2O3 nanoparticles emulsified in deionized water) to prepare nanofluids for enhancing their microgeneration and heattransfer capabilities by conducting thermoelectric performance experiments on power generation facilities. This study first performed a two-step synthesis process by using emulsion-ultrasonic technology for fabricating an Al2O3 nanofluid to determine the optimal suspended stability for the alumina nanofluid used as an electrolyte according to the Zeta potential, pH value, thermal conductivity, and viscosity. The alumina nanofluid was then compared with the other aqueous solutions to determine the characteristics of the effects of the output currents, voltages, resistances, and temperature distributions at different operating temperatures, distances, and electrode areas. Finally, the emulsifying effect of the alumina nanofluid between 0 wt % and 2 wt % demonstrated the most favorable stability, particle fraction, thermal conductivity, and stable current output.

We present a case of a previously healthy adolescent male for outpatient evaluation of prolonged QT interval. He was ultimately found to have acquired QT interval prolongation secondary to hypocalcaemia related to undiagnosed hypoparathyroidism. This case report highlights the importance of routine electrolyte analysis, even in the outpatient setting, during initial diagnostic workup for QT interval prolongation.

The requirements of different electrolytes (sodium, potassium and chloride), dietary electrolyte balance (DEB) and salt source in broilers have considerably changed in recent times. The increasing level of sodium (Na), potassium (K) and DEB are associated with higher pH (i.e. alkalosis) while lower levels of chloride (Cl) and DEB are linked with a lower pH (i.e. acidosis). A narrow range of DEB (150-250 mEq/kg) is recommended to overcome the variations in acid base homeostasis and normal blood chemistry especially in summer conditions. The supplementation of suitable salts like NaHCO3 and KCl are proven to be beneficial to sustain viability of various biochemical processes. The cations usually alleviate whereas anions exacerbate the lysine:arginine antagonism. In most cases, the electrolytes and their balance (DEB) are considered ineffective in order to influence carcass and related traits; however, the supplementation of their respective salts, particularly NaHCO3 and KCl under heat stress, showed contrary but potentially useful results. The role of electrolytes in combination with coccidiostats is still ambiguous; however, the level of both entities (electrolytes and coccidiostats) should be kept low and studied in detail for mutual compatibility. The inclusion level of electrolytes from various salt sources changes whenever there is change in coccidiostat and environmental condition. Keeping in mind environmental constraints, it is recommended to use the lowest dosage of NaHCO3/ NaCl alongside ionophores. Consequently, it is recommended to supplement electrolytes through a combination of NaHCO3 and KCl, and maintaining dietary electrolyte balance (150-250 mEq/kg) is mandatory to exploit improved physiological responses of broilers for maximum growth response.

Electrolytes (sodium, potassium and chloride) are compounds that dissolve into positive and negative particles in solution. The relationship between these compounds, known as the ‘dietary electrolyte balance’ (DEB), is affected by either electrolyte or its supplemental salt source. The National Research Council recommended 0.20% sodium, chloride, and 0.30% potassium for starter phase and lower doses of sodium and chloride for the finisher phase of broilers. However, these requirements are increased under heat stress conditions, and birds perform better when increasing levels of these electrolytes are offered, maintaining a DEB of preferably 250 mEq/kg. Increased levels of these electrolytes, especially sodium, were found effective for growth but caused increased water consumption and ultimately higher litter moisture in summer. Potassium and chloride were found effective in the diets of heat-stressed broilers. Sodium bicarbonate and potassium chloride have been recognised as the best choice in salt selection for broiler diets, particularly under hot summer conditions. In conclusion, a combination of the electrolytes with higher levels of cations and lower level of anions is recommended. Furthermore, the requirements of these electrolytes should be explored, with reference to current poultry housing systems and modern genetics.

This paper reviews the handling of water and electrolytes by the ageing kidney and the clinical consequences in everyday clinical practice. Normal physiology in the adult kidney is discussed, followed by description of the main physiological changes (adaption) that occur as the kidney ages. Clearly, successful management of the elderly patient requires a knowledge of these changes, which result in: (i) increased tendency for volume depletion and dehydration; (ii) decreased ability to tolerate a volume load; (iii) increased propensity for potassium disturbances (hypo- and hyperkalaemia); (iv) diminished production of renin and blunted physiological response to the effects of aldosterone and antidiuretic hormone; (v) increased tendency to lower levels of phosphate; and (vi) tendency for the development of hypocalcaemia and hypomagnesaemia. A brief review of the role of extracellular fluid volume depletion and other factors contributing to acute renal failure in elderly patients is also presented.

Some of the clinical signs seen in horses during endurance races may result from increases in neuromuscular excitability and are related to plasma [K+] and [Ca++]. The present study aimed to test the following hypotheses: (1) Potassium supplementation will affect plasma [K+] and may result in clinical signs related to neuromuscular hyperexcitability during an 80 km endurance ride. (2) Plasma [Ca++] will reflect dietary cation–anion balance (DCAB) and calcium intake. Feeding with a high DCAB and high dietary calcium content (1.5% total calcium of daily ration) diets would lead to higher plasma [Ca++] during an endurance race than on feeding high DCAB diets with a moderate dietary calcium content (1% of total calcium of daily ration). The current study was undertaken during the 80 km endurance research ride in 2002 in Virginia, USA. Forty volunteer rider–horse pairs participated in the race. During the race, electrolyte mixtures with (EM+K) and without (EM − K) potassium were supplied to 18 and 22 horses, respectively. After the race, the horses receiving EM − K during the race were supplied with a recovery formula containing potassium (EM-REC). The horses were fed in addition to their own forage (hay and pasture) either their own commercial concentrate (CC; 1% calcium, n = 11) or one of two research-supplied concentrates during 3 months preceding the research ride, one concentrate rich in sugar and starch (SS; 2% calcium, n = 15) and the other rich in fat and fibre (FF; 2% calcium, n = 14). Peripheral blood samples were taken the day before, within 3 min of the arrival at the vet checks at 27, 48 and 80 km, and after 3 h of recovery. Plasma samples were analysed for pH, haematocrit (Hct), [Na+], [K+], [Cl− ], [Ca++], [Mg++], total protein (TP) and albumin [alb]. Effects of sampling times, treatments and interactions were evaluated by ANOVA in a mixed model with repeated measures and applied to the 25 horses that completed 80 km. Eliminated horses had their blood sampled before entering the elimination vet check and 3 h after elimination, and were compared with finishing horses by t-test. As the ride progressed, significant increases were found in plasma pH, [Na+], , [TP], [alb], Hct and osmolality; and decreases in [K+], [Mg++], PCO2, [Ca++] and [Cl− ]. Horses supplied with potassium-free, sodium-rich electrolyte formulae (EM − K) had 12.5% lower (P = 0.001) mean plasma [K+], 7.8% lower (P = 0.024) TP and 8.4% lower (P = 0.004) albumin at 80 km, and at 3 h after the race they had 6.8% lower (P = 0.045) TP, when compared with EM+K supplemented horses. Horses fed with SS and FF had higher [Ca++] at 27 (P = 0.027), 56 (P = 0.006) and 80 km (P = 0.022) when compared with horses fed with CC. The lower [K+] in the EM − K group, and the higher [Ca++] in the SS- and FF-supplemented horses may help prevent increases in neuromuscular excitability and related clinical signs. The lower TP and albumin indicate less dehydration in the EM − K group and could help prevent related disorders.

Fluid and electrolyte balance is often poorly understood and inappropriate prescribing can cause increased post-operative morbidity and mortality. The efficiency of the physiological response to a salt or water deficit, developed through evolution, contrasts with the relatively inefficient mechanism for dealing with salt excess. Saline has a Na+:Cl-of 1:1 and can produce hyperchloraemic acidosis, renal vasoconstriction and reduced glomerular filtration rate. In contrast, the more physiological Hartmann's solution with a Na+:Cl-of 1·18:1 does not cause hyperchloraemia and Na excretion following infusion is more rapid. Salt and water overload causes not only peripheral and pulmonary oedema, but may also produce splanchnic oedema, resulting in ileus or acute intestinal failure. This overload may sometimes be an inevitable consequence of resuscitation, yet it may take 3 weeks to excrete this excess. It is important to avoid unnecessary additional overload by not prescribing excessive maintenance fluids after the need for resuscitation has passed. Most patients require 2–2·5 litres water and 60–100?mmol?Na\d for maintenance in order to prevent a positive fluid balance. This requirement must not be confused with those for resuscitation of the hypovolaemic patient in whom the main aim of fluid therapy is repletion of the intravascular volume. Fluid and electrolyte balance is a vital component of the metabolic care of surgical and critically-ill patients, with important consequences for gastrointestinal function and hence nutrition. It is also of importance when prescribing artificial nutrition and should be given the same careful consideration as other nutritional and pharmacological needs.

Three solid-oxide fuel cell (SOFC) electrolytes, yttria-stabilized zirconia (YSZ), rare-earth–doped ceria (REDC), and lanthanum strontium gallium magnesium oxide (LSGM), are reviewed on their electrical properties, materials compatibility, and mass transport properties in relation to their use in SOFCs. For the fluorite-type oxides (zirconia and ceria), electrical properties and thermodynamic stability are discussed in relation to their valence stability and the size of the host and dopant ions. Materials compatibility with electrodes is examined in terms of physicochemical features and their relationship to the electrochemical reactions. The application of secondary ion mass spectrometry (SIMS) to detect interface reactivity is demonstrated. The usefulness of doped ceria is discussed as an interlayer to prevent chemical reactions at the electrode–electrolyte interfaces and also as an oxide component in Ni–cermet anodes to avoid carbon deposition on nickel surfaces. Finally, the importance of cation diffusivity in LSGM is discussed, with an emphasis on the grain-boundary effects.

The present study characterized the fluid and electrolyte shifts that occur in Standardbred racehorses during recovery from high-intensity exercise. Jugular venous blood was sampled from 13 Standardbreds in racing condition, at rest and for 2 h following a high-intensity training workout. Total body water (TBW), extracellular fluid volume (ECFV) and plasma volume (PV) were measured at rest using indicator dilution techniques (D2O, thiocyanate and Evans Blue, respectively). Changes in TBW were assessed from measures of body mass, and changes in PV and ECFV were calculated from changes in plasma protein concentration. Exercise resulted in a 26.9% decrease in PV. At 10 min of recovery TBW and ECFV were decreased by 2.2% and 16.5% respectively, while intracellular fluid volume was increased by 7.1%. There was a continued loss of fluid due to sweating throughout the recovery period such that TBW was decreased by 3.9% at 90 min of recovery. This decrease in TBW was nearly equally partitioned between the extracellular and intracellular fluid compartments. Plasma Na+ and Cl− contents were decreased at 1 min of recovery, but not different from rest by 40 min of recovery. Plasma K+ content at 1 min post exercise was not different from the pre-exercise value; however, by 5 min of recovery K+ content was significantly decreased and it remained decreased throughout the recovery period. It is concluded that there are very rapid and large fluid and electrolyte shifts between body compartments during and after high-intensity exercise, and that full recovery of these shifts requires 90–120 min.