Hyponatremia secondary to SIADH is frequent in cancer patients and potentially deleterious. The aim of this sub-analysis of the Hyponatremia Registry database is to analyze current diagnostic and therapeutic management practices in cancer patients with SIADH. We analyzed 358 cancer patients who had serum sodium concentration ([Na+]) ≤ 130 mEq/L and a clinical diagnosis of SIADH from 225 sites in the USA and EU. Precise diagnostic testing was performed in only 46%. Almost 12% of all patients did not receive any hyponatremia treatment. The most frequent therapies were fluid restriction (20%), isotonic saline (14%), fluid restriction/isotonic saline (7%), tolvaptan (8%), and salt tablets (7%). Hypertonic saline was used in less than 3%. Tolvaptan produced the greatest median rate of [Na+] change (IQR) (3.0 (4.7) mEq/L/day), followed by hypertonic saline (2.0(7.0) mEq/L/day), and fluid restriction/isotonic saline (1.9(3.2) mEq/L/day). Both fluid restriction and isotonic saline monotherapies were significantly less effective (0.8(2.0) mEq/L/day and 1.3(3.0) mEq/L/day, respectively) and were associated with clinically relevant rates of treatment failure. Only 46% of patients were discharged with [Na+] ≥ 130 mEq/L. Overly rapid correction of hyponatremia occurred in 11.7%. Although essential for successful hyponatremia management, appropriate diagnostic testing is not routinely performed in current practice. The most frequently employed monotherapies were often ineffective and sometimes even aggravated hyponatremia. Tolvaptan was used less often but showed significantly greater effectiveness. Despite clear evidence that hyponatremia is associated with poor outcome in oncology patients, most patients were discharged still hyponatremic. Further studies are needed to assess the beneficial impact of hyponatremia correction with effective therapies.
The Electron Density Distribution of Amides and Related Compounds (C. Breneman & M. Martinov). Origin of the Amide Rotational Barrier (K. Wiberg). The Amide Linkage as a Ligand--Its Properties and the Role of Distortion (A. Greenberg). Studies in Amide Hydrolysis: The Acid, Base, and Water Reactions (R. Brown). The Thermochemistry of Amides (J. Liebman, et al.). Stereospecificity in the alpha-Lactam (Aziridinone) Synthon (R. Hoffman). beta-Lactams: Cyclic Amides of Distinction (A. Bose, et al.). Sterically Hindered Twisted Amides (S. Yamada). Photoelectron Spectroscopy of Amides and Lactams (P. Rademacher). The Role of Amides in the Noncovalent Synthesis of Supramolecular Structures in Solution, at Interfaces, and in Solids (G. Palmore & J. MacDonald). beta-Lactam Antibacterial Agents: Computational Chemistry Investigations (D. Boyd). Three-Dimensional Design of Enzyme Inhibitors with Heterocyclic Amide Bond Mimics (R. Bohacek & W. Shakespeare). Ab Initio Conformational Analysis of Protein Subunits: A Case Study of the Serine Diamide Model (A. Perczel & I. Csizmadia). Gas-Phase Ion Chemistry of Amides, Peptides, and Proteins (C. Cassady). beta-Sheet Interactions Between Proteins (S. Maitra & J. Nowick). Head-to-Tail Cyclic Peptides and Cyclic Peptide Libraries (A. Spatola & P. Romanovskis). From Crystal Structures of Oligopeptides to Protein Folding. The Importance of Peptide Bond-Side Chain Hyperconjugation (A. Cieplak). Role of the Peptide Bond in Protein Structure and Folding (N. Kallenbach, et al.). Index.
The RAM model provided by the U.S. EPA has been applied to the metropolitan Detroit area for SO2 concentrations and is compared to concentrations predicted by a numerical model and to field data obtained by the 14 station air sampling network maintained by the Wayne County Air Pollution Control Division. Great care was taken to develop the emission inventory. Based upon examination of the temporal and spatial correspondence of the respective model predictions and observed concentrations, the correlation coefficients for the 24-hour averaged data, the correlation coefficients for over 700 3-hour averaged observations, and the cumulative frequency distributions of the model output and observations, it is concluded that the numerical model provides a superior predictive tool to evaluate cause and effect relations, but that the RAM model, at far lower cost, predicts the correct magnitude of the worst events. Hence RAM might well be used in the Detroit Area for statistically based regulatory decisions.
ADVERTISEMENT RETURN TO ISSUEPREVArticleNEXTStructure and dynamics of Troeger's base and simple derivatives in acidic mediaArthur Greenberg, Nicholas Molinaro, and Michael LangCite this: J. Org. Chem. 1984, 49, 6, 1127–1130Publication Date (Print):March 1, 1984Publication History Published online1 May 2002Published inissue 1 March 1984https://pubs.acs.org/doi/10.1021/jo00180a035https://doi.org/10.1021/jo00180a035research-articleACS PublicationsRequest reuse permissionsArticle Views566Altmetric-Citations56LEARN ABOUT THESE METRICSArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated. Share Add toView InAdd Full Text with ReferenceAdd Description ExportRISCitationCitation and abstractCitation and referencesMore Options Share onFacebookTwitterWechatLinked InRedditEmail Other access optionsGet e-Alertsclose Get e-Alerts
Familial hypocalciuric hypercalcemia (FHH) is caused by heterozygous inactivation of the calcium-sensing receptor, which is notably expressed in parathyroid and kidney. FHH is characterized by asymptomatic hypercalcemia and hypophosphatemia and confers minimal, if any, morbidity. Renal transplantation in patients with FHH has not been described previously. This report describes a patient with FHH who developed end-stage renal disease from another cause and subsequently received a living related donor kidney transplant from her FHH-affected daughter. The excellent posttransplant clinical course of both recipient and donor is emphasized.
This chapter contains sections titled: If You Do Find The Philosopher's Stone, "Take Care To Lose It Again"—Benjamin Franklin Saltpetre, Abigail. Pins, John "It Is a Pity So Few Chemists Are Dyers, and So Few Dyers Chemists" Two Early Visions: Oxidation Without Oxygen and Women as Strong Scientists 'Tis A Bonnie Chymistrie We Brrring Ye "For It's Hot as Hell … In Phila-del'-phi-a" Adams Opposes Atoms Twelve Cents for A Chemistry Lecture
