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Interpreting Arterial Blood Gases in Trauma Patients
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
To differentiate high AG or non-AG or metabolic acidosis or metabolic acidosis mixed with metabolic alkalosis, the delta-delta ratio should be calculated.Delta-delta ratio < 1 = Non-AG metabolic acidosisDelta-delta ratio 1–2 = High AG metabolic acidosisDelta-delta ratio > 2 = High AG metabolic acidosis with concurrent metabolic alkalosis
EEG in the Diagnosis of Early Alzheimer Disease
Published in Robert E. Becker, Ezio Giacobini, Alzheimer Disease, 2020
H. Soininen, P. Riekkinen, V.J. Partanen, A. Pääkkönen, E-L. Helkala, V. Laulumaa
Our results of a study (Penttilä et al., 1985) on changes in quantitative EEG in 42 patients with presumptive diagnosis of AD at different stages of cognitive deterioration agree with findings of Coben and coworkers (1983). When the percentage powers of the alpha, theta and delta bands were compared, it was discovered that the theta power increased in mild AD. The most marked increase in the delta power did not occur until severe AD. The decrease in the alpha power was significant in moderate but not mild AD. The alpha/theta ratio decreased abruptly in mild AD, whereas the alpha/delta ratio declined more linearly, and the difference was significant in marked and severe AD compared to control values. The occipital peak frequency was in the alpha band in mild and moderate AD, and it was not significantly decreased in mild disease, whereas the mean frequency was significantly decreased already in mild AD. There was a significant correlation between the peak frequency and the neuropsychological test score (r=0.60, p<0.001). Thus according to our observations, the best variables diffentiating mild AD from controls are the percentage power of the theta band, alpha/theta ratio and the mean frequency in the range 1.5-20.0 Hz. It is evident that the slowing of the dominant occipital rhythm and accentuation of diffuse irregular slow waves describe rather advanced but not mild AD.
Brain, interrupted: alpha/delta EEG ratio in survivors of pre- and post-natal adversity
Published in International Journal of Neuroscience, 2021
Raha Hassan, Harriet L. MacMillan, Saroj Saigal, Louis A. Schmidt
The idea that changes in the EEG power spectrum track brain maturation has a long and rich history (e.g. [13–15]. Collectively, these studies showed that, with development, there is an increase in EEG power in the faster frequencies (e.g. alpha) and a decrease in EEG power in slower frequencies (e.g. delta). As a result, increases in an alpha/delta ratio may ostensibly reflect increases in brain maturation [16–18]. Indeed, some researchers have used EEG ratio scores between faster relative to slower EEG frequencies as a proxy of brain maturation and development. For example, one group recently reported increases in a beta/theta band in relation to the development of executive functioning in children [19]. As well, increases in EEG power in faster frequencies in the frontal region have been linked to the development of executive and regulatory processes [20]. Whether the alpha/delta ratio is sensitive to samples characterized by exposure to adverse experiences remains unknown.
High anion gap metabolic acidosis induced by cumulation of ketones, L- and D-lactate, 5-oxoproline and acute renal failure
Published in Acta Clinica Belgica, 2018
Laura Heireman, Boris Mahieu, Mark Helbert, Wim Uyttenbroeck, Jan Stroobants, Marian Piqueur
In the case presented here, the patient was chronically treated with fosfomycin antibiotic therapy. It is not known whether this antibiotic is associated with 5-oxoproline intoxication. Moreover, in addition to the HAGMA, decreased ammonia production due to renal failure and diarrhoea may have contributed to the acidosis. In contrast, vomiting may cause a metabolic alkalosis. However, the so-called delta ratio, defined as [(anion gap-12)/(24-bicarbonate serum concentration)], was 1.3, revealing the presence of a pure HAGMA (range 1.0–2.0). Uncontrolled glycaemia resulting in diminished glutathione levels in combination with chronic paracetamol (and fosfomycin) intake, urosepsis and impaired renal function may have played an important role in the induction of 5-oxoproline acidosis in this case.