Lazy lips: hyperkalemia and acute tetraparesis-a case report from an urban emergency department.

A 58-year-old male patient was admitted to our emergency department at a large university hospital due to acute onset of general weakness. It was reported that the patient was bradycardic at 30/min and felt an increasing weakness of the limbs. At admission to the emergency department, the patient was not feeling any discomfort and denied dyspnoea or pain. The primary examination of the nervous system showed the cerebral nerves II-XII intact, muscle strength of the lower extremities was 4/5, and a minimal sensory loss of the left hemisphere was found. In addition, the patient complained about lazy lips. During ongoing examinations, the patient developed again symptomatic bradycardia, accompanied by complete tetraplegia. The following blood test showed severe hyperkalemia probably induced by use of aldosterone antagonists as the cause of the patient's neurologic symptoms. Hyperkalemia is a rare but treatable cause of acute paralysis that requires immediate treatment. Late diagnosis can delay appropriate treatment leading to cardiac arrhythmias and arrest.

Sēfer Yōsîppôn : bi-lšôn aškenaz ... waś fr alṭi tzaiṭin iz gšehn ; un wi eś miṭ (ḥurban Bayit šēnî) ggangn ...

Yôsēf Ben-Gōryôn hak-kōhēn

Eine bešraibung fun di hašmenoim biz nach ḥurban bes-ha-mikdaš oder di letzte tzaiṭen fun di judiše meluche un jehre beluṭige milchomes miṭ den griechen un roimer

fun Mendl Pomerantz

Benchmark problems for reactive transport modeling of the generation and attenuation of acid rock drainage

Acid rock drainage (ARD) is a problem of international relevance with substantial environmental and economic implications. Reactive transport modeling has proven a powerful tool for the process-based assessment of metal release and attenuation at ARD sites. Although a variety of models has been used to investigate ARD, a systematic model intercomparison has not been conducted to date. This contribution presents such a model intercomparison involving three synthetic benchmark problems designed to evaluate model results for the most relevant processes at ARD sites. The first benchmark (ARD-B1) focuses on the oxidation of sulfide minerals in an unsaturated tailing impoundment, affected by the ingress of atmospheric oxygen. ARD-B2 extends the first problem to include pH buffering by primary mineral dissolution and secondary mineral precipitation. The third problem (ARD-B3) in addition considers the kinetic and pH-dependent dissolution of silicate minerals under low pH conditions. The set of benchmarks was solved by four reactive transport codes, namely CrunchFlow, Flotran, HP1, and MIN3P. The results comparison focused on spatial profiles of dissolved concentrations, pH and pE, pore gas composition, and mineral assemblages. In addition, results of transient profiles for selected elements and cumulative mass loadings were considered in the intercomparison. Despite substantial differences in model formulations, very good agreement was obtained between the various codes. Residual deviations between the results are analyzed and discussed in terms of their implications for capturing system evolution and long-term mass loading predictions.

[Der judišer ḥurban fun Poilen Galitzie un Bukowina fun ṭag-buch 674 - 677 (1914 - 1917)] : [1., 2. ṭeil]

Digitalisat der Ausg. Wilno {[u.a.], 1923

[Der judišer ḥurban fun Poilen Galitzie un Bukowina fun ṭag-buch 674 - 677 (1914 - 1917)] : [4. ṭeil]

Digitalisat der Ausg. Wilno {[u.a.], 1922

[Der judišer ḥurban fun Poilen Galitzie un Bukowina fun ṭag-buch 674 - 677 (1914 - 1917)] : [3. ṭeil]

Digitalisat der Ausg. Wilno {[u.a.], 1924

Land system science and sustainable development of the earth system: A global land project perspective

Land systems are the result of human interactions with the natural environment. Understanding the drivers, state, trends and impacts of different land systems on social and natural processes helps to reveal how changes in the land system affect the functioning of the socio-ecological system as a whole and the tradeoff these changes may represent. The Global Land Project has led advances by synthesizing land systems research across different scales and providing concepts to further understand the feedbacks between social-and environmental systems, between urban and rural environments and between distant world regions. Land system science has moved from a focus on observation of change and understanding the drivers of these changes to a focus on using this understanding to design sustainable transformations through stakeholder engagement and through the concept of land governance. As land use can be seen as the largest geo-engineering project in which mankind has engaged, land system science can act as a platform for integration of insights from different disciplines and for translation of knowledge into action.

THEODORE, a two-step heating system for the EC/OC determination of radiocarbon (14C) in the environment

Measurements of 14C in the organic carbon (OC) and elemental carbon (EC) fractions, respectively, of fine aerosol particles bear the potential to apportion anthropogenic and biogenic emission sources. For this purpose, the system THEODORE (two-step heating system for the EC/OC determination of radiocarbon in the environment) was developed. In this device, OC and EC are transformed into carbon dioxide in a stream of oxygen at 340 and 650 �C, respectively, and reduced to filamentous carbon. This is the target material for subsequent accelerator mass spectrometry (AMS) 14C measurements, which were performed on sub-milligram carbon samples at the PSI/ETH compact 500 kV AMS system. Quality assurance measurements of SRM 1649a, Urban Dust, yielded a fraction of modern fM in total carbon (TC) of 0.522 ±0.018 (n ¼ 5, 95% confidence level) in agreement with reported values. The results for OC and EC are 0.70± 0.05 (n ¼ 3) and 0.066 ± 0.020 (n ¼ 4), respectively.

20. Armee-Bulletin: Nachdem die unter Bem in Siebenbürgen eingedrungenen Rebellen, welche vom Oberst Urban ...

Welsch (Projektbearbeiter): Erfolgreicher Angriff der Österreicher auf das von der ungarischen Revolutionsarmee besetzte Hermannstadt. Österreichische Einnahme von Versecz, Sammlung der Rebellen um Debreczin

23. Armee-Bulletin: Gleichzeitig mit den bereits bekannten Vortheilen, welche unsere tapfere Armee unter Oberst Urban ...

Welsch (Projektbearbeiter): Österreichische Einnahme von Arad nach heftigem Widerstand, kampflose Kapitulation der Festung Essek. Eine starke, von der Zips kommende ungarische Kolonne befindet sich auf dem Wege zu befreundeten Kräften im oberen Theißraum (über Eperies in Richtung Kaschau)

INFLUENCE OF A CLINIC BASED IMMUNIZATION INFORMATION SYSTEM ON INFANT IMMUNIZATIONS

This study focuses on the impact of a clinic-based intervention program on the immunization status of limited-income urban children. The intervention program consisted of an information session for clinic health care providers and the placement of individualized immunization information labels on clinic notes at the time of each visit. The degree of impact of the intervention on immunization administration was ascertained through a comparison of two similar groups of infants born in the same months of the year immediately before (N = 201) and after (N = 203) the information session and initiation of the labeling system. The timeliness of administration of each diphtheria, pertussis, tetanus and trivalent oral polio vaccine (DPT/TOPV) in the first year series of three was compared pre- to postintervention. Significantly more third immunizations were given the postintervention subjects within ten days of the recommended time of application ( p = .0361). Life table analysis indicated that the probability of an infant's passing one year of age without the administration of the third immunization decreased for postintervention infants (p = .0515). The intervention was most successful in assuring administration of the series of immunizations in those infants who were seen by the health care provider for at least 50% of their first year visits. Results indicate that minor changes in the format of information given a relatively continuous provider can increase completion of immunization series in infants. ^

Evaluating the impact of vertical integration on health system peformance

Vertical integration is grounded in economic theory as a corporate strategy for reducing cost and enhancing efficiency. There were three purposes for this dissertation. The first was to describe and understand vertical integration theory. The review of the economic theory established vertical integration as a corporate cost reduction strategy in response to environmental, structural and performance dimensions of the market. The second purpose was to examine vertical integration in the context of the health care industry, which has greater complexity, higher instability, and more unstable demand than other industries, although many of the same dimensions of the market supported a vertical integration strategy. Evidence on the performance of health systems after integration revealed mixed results. Because the market continues to be turbulent, hybrid non-owned integration in the form of alliances have increased to over 40% of urban hospitals. The third purpose of the study was to examine the application of vertical integration in health care and evaluate the effects. The case studied was an alliance formed between a community hospital and a tertiary medical center to facilitate vertical integration of oncology services while maintaining effectiveness and preserving access. The economic benefits for 1934 patients were evaluated in the delivery system before and after integration with a more detailed economic analysis of breast, lung, colon/rectal, and non-malignant cases. A regression analysis confirmed the relationship between the independent variables of age, sex, location of services, race, stage of disease, and diagnosis, and the dependent variable, cost. The results of the basic regression model, as well as the regression with first-order interaction terms, were statistically significant. The study shows that vertical integration at an intermediate health care system level has economic benefits. If the pre-integration oncology group had been treated in the post-integration model, the expected cost savings from integration would be 31.5%. Quality indicators used were access to health care services and research treatment protocols, and access was preserved in the integrated model. Using survival as a direct quality outcome measure, the survival of lung cancer patients was statistically the same before and after integration. ^

Kundmachung: Johann Urban, von Wien gebürtig, 37 Jahre alt, katholisch ...

Welsch (Projektbearbeiter): Verurteilung des ehemaligen Geschäftsführers einer Textilfabrik und Mitgliedes der Wiener Sicherheitswache Urban (in Umwandlung der zuvor ausgesprochenen Todesstrafe) zu zwölfjähriger Zwangsarbeit wegen Aufruhrs und bewaffneten Widerstands gegen das Militär

Ueber Drainage

D. H.