e. the ratio of autosomes to gonosomes (a process well understood in flies, but still hypothesized

in mammals), b) the implication of non-translated, sex-specific, regulatory RNAs (roX and Xist, respectively) as key elements in this process and the location of similar mediators in the Z chromosome of chicken c) the inclusion of a chromatin modification epigenetic final step, which ensures that gene expression remains stably regulated throughout the affected area of the gonosome. This review summarizes these points and proposes a possible role for comparative genetics, as they seem to constitute proof of 4 maintained cell economy (by using the same basic regulatory elements in various different scenarios)

throughout numerous centuries of evolutionary buy Fosbretabulin history.”
“What is known and objective: We report a case of severe liver dysfunction exacerbated Compound C after interferon beta (IFNB)-1b injection in a patient with multiple sclerosis (MS) who had been taking a melilot (sweet clover) supplement. Although IFNB-1b therapy for MS can cause mild liver dysfunction, severe hepatotoxicity attributable to supplement use has been reported.\n\nCase summary: A 23-year-old Japanese woman taking a melilot supplement containing coumarin at 10 mg/day for 3 years was admitted to our hospital to receive IFNB-1b therapy for MS. Fourteen days after subcutaneous injection of IFNB-1b every other day, her aspartate transaminase (AST) and alanine aminotransferase (ALT) levels were elevated at 235 and 681 IU/L, respectively. selleck inhibitor After the discontinuation of IFNB-1b therapy and supplement intake, AST and ALT returned to normal levels. Later, she started receiving an intramuscular injection of IFNB-1a weekly without supplement intake. She was able to continue IFNB-1a

therapy this time, showing a slight elevation of AST level at 61 IU/L.\n\nWhat is new and conclusion: The combination of IFNB-1b therapy and melilot supplement intake may cause severe liver dysfunction in patients with MS. Given the doubtful value of the supplement, we suggest that it should be avoided by patients receiving interferon therapy.”
“Anxiety disorders constitute a significant public health problem. Current gold standard treatments are limited in their effectiveness, prompting the consideration of alternative approaches. In this review, we examine the evidence for exercise as an intervention for anxiety disorders. This evidence comes from population studies, studies of nonclinical anxiety reduction, as well as a limited number of studies of clinically anxious individuals. All of these studies provide converging evidence for consistent beneficial effects of exercise on anxiety, and are consistent with a variety of accounts of the mechanism of anxiety reduction with exercise.

In this prospective study, we evaluated the efficacy of USG-FNACs this website performed at a breast cancer screening center by 123 comparing the FNAC results with the corresponding definitive histological examination outcome. We also investigated the role that CNB can play as a complementary diagnostic tool for FNAC in selected cases. A total of 229 consecutive nonpalpable breast masses were included in this study. Each FNAC was placed into one of four categories:

3.5% nondiagnostic, 13.5% benign, 12.3% atypical/suspicious (indeterminate), and 70.7% malignant. The overall diagnostic accuracy was 98.9%, with a specificity and sensitivity of 99.3

and 96.7%, respectively. The overall positive predictive values and negative predictive values were 99.3 and 96.7%, respectively. Only 37 masses (16%) were converted ZD1839 to CNB, with the indeterminate cytology being the most common cause (54%) for this conversion. Two cases demonstrating the superior benefit of FNAC over CNB are illustrated. Although we started the study by reserving CNB as a first choice to assess microcalcifications without architectural distortion, we ended the study by deciding to perform combined FNAC and CNB for this type of lesions. In conclusion, aiming to maximize the pre-operative diagnosis of cancer, it would be cost efficient and time saving to use FNAC as a first-line investigation to benefit from the wealth of cytological information yielded, followed by CNB in selected cases. Diagn. Cytopathol. 2010;38:880-889. (C)

2010 Wiley-Liss, Inc.”
“Glucokinase plays a central role in glucose homeostasis and small molecule activators of the glucokinase enzyme have been the subject of significant pharmaceutical research in the quest for agents capable of delivering improved glycaemic selleck chemical control. Here we describe our medicinal chemistry campaign to improve on our previously described development candidate in this area, AZD1092, focussed on removal of Ames liability and improved permeability characteristics. This work culminated in the superior compound AZD1656 which has progressed to phase 2 clinical trials.”
“Quantum-mechanical methods that are both computationally fast and accurate are not yet available for electronic excitations having charge transfer character. In this work, we present a significant step forward towards this goal for those charge transfer excitations that take place between non-covalently bound molecules.

The average choroidal thickness of the APAC eyes at each location or segment was compared to that of the fellow eyes.\n\nRESULTS. At all macular locations, the choroidal thickness was greatest at the subfovea for both groups. Comparison of the choroidal thickness between the groups showed that the thickness in the APAC eyes was significantly greater than in the PACS eyes at all locations except at 1 mm, 3 mm superior, 3 mm inferior, and 3 mm temporal from the fovea (P < 0.005). The mean subfoveal choroidal thickness was 349.0 +/- 78.1 mu m in the APAC eyes and 308.1 +/- 70.5

mu m in the PACS eyes, with a statistically significant difference (P < 0.005). Multivariable linear regression analysis showed Selleckchem GSK2879552 that the subfoveal choroidal thickness was significantly greater in association with the APAC diagnosis and diastolic blood pressure and thinner in association with older subjects.\n\nCONCLUSIONS. APAC eyes have a higher level of macular choroidal thickness than PACS eyes when the IOP

is reduced. However, the source of this difference is unclear and mTOR inhibitor must be investigated further.”
“AIM: To study the expression of beta-catenin in esophageal squamous cell carcinoma (ESCC) at stage T2-3N0M0 and its relation with the prognosis of ESCC patients.\n\nMETHODS: Expression of beta-catenin in 227 ESCC specimens was detected by immunohistochemistry (IHC). A reproducible semi-quantitative method which takes both staining percentage and intensity into account was applied in IHC scoring, and receiver operating characteristic curve URMC-099 price analysis was used to select the cut-off score for high or low IHC reactivity. Then, correlation of beta-catenin expression with clinicopathological features and prognosis of ESCC patients was determined.\n\nRESULTS: No significant correlation was observed between beta-catenin expression and clinicopathological parameters in terms of gender, age, tumor size, tumor grade, tumor location, depth of 123 invasion

and pathological stage. The Kaplan-Meier survival curve showed that the up-regulated expression of beta-catenin indicated a poorer post-operative survival rate of ESCC patients at stage T2-3N0M0 (P = 0.004), especially of those with T3 lesions (P = 0.014) or with stage IIB diseases (P = 0.007). Multivariate analysis also confirmed that beta-catenin was an independent prognostic factor for the overall survival rate of ESCC patients at stage T2-3N0M0 (relative risk = 1.642, 95% CI: 1.159-2.327, P = 0.005).\n\nCONCLUSION: Elevated beta-catenin expression level may be an adverse indicator for the prognosis of ESCC patients at stage T2-3N0M0, especially for those with T3 lesions or stage IIB diseases. (C) 2010 Baishideng. All rights reserved.

“
“A 63-year-old man presented with an asymptomatic papillary, sessile lesion of the juxtalimbal bulbar conjunctiva that was surgically Bucladesine in vitro excised with cryotherapy. Histopathologically, the lesion created some diagnostic confusion as it displayed an endophytic, or inverted, growth pattern-with squamous cells pushing into the substantia propria around fibrovascular cores, but without significant cytologic atypia, consistent with a conjunctival inverted papilloma (IP). Unlike previously reported cases of conjunctival IP, there were no goblet cells or cysts within the tumor. Immunostaining was diffusely positive for cytokeratin (CK) 7, and CK14 stained the basilar and

suprabasilar cells, as in normal conjunctiva. CK17 weakly and non-uniformly stained the tumor, ruling out a dysplasia, which is usually strongly

positive. The lesion’s cytokeratin profile therefore paralleled that of normal conjunctiva. The proliferation index with Ki67 nuclear staining was extremely low ( smaller than 1%), as was p53 nuclear staining (10-20%), both in contrast to squamous cell dysplasias or carcinomas that have a much higher percentage of positive cells. The lesion was negative for human papillomavirus subtypes associated with squamous neoplasias including carcinomas. We review the’previous literature devoted to this comparatively rare condition Selleckchem SIS 3 and contrast its benign clinical course with that of inverted papillomas of the sinonasal, 3 lacrimal drainage, and genitourinary systems and provide a set of criteria for establishing the diagnosis. (C) 2015 Elsevier Inc. All rights reserved.”
“Inflammatory kidney disease is a major clinical problem that can result in end-stage renal failure. In this article, we show that Ab-mediated inflammatory kidney injury and renal disease in a mouse nephrotoxic serum nephritis model was inhibited by amino acid metabolism and a protective autophagic response.

The metabolic signal was driven by IFN-gamma-mediated induction of indoleamine 2,3-dioxygenase 1 (IDO1) enzyme activity with subsequent activation of a stress response dependent on the eIF2 alpha kinase 3-Methyladenine cost general control nonderepressible 2 (GCN2). Activation of GCN2 suppressed proinflammatory cytokine production in glomeruli and reduced macrophage recruitment to the kidney during the incipient stage of Ab-induced glomerular inflammation. Further, inhibition of autophagy or genetic ablation of Ido1 or Gcn2 converted Ab-induced, self-limiting nephritis to fatal end-stage renal disease. Conversely, increasing kidney IDO1 activity or treating mice with a GCN2 agonist induced autophagy and protected mice from nephritic kidney damage. Finally, kidney tissue from patients with Ab-driven nephropathy showed increased IDO1 abundance and stress gene expression.

Histological examination was performed for all patients.\n\nResults: Bladder cancer patients excreted urinary TSA, 8-OHdG, and MDA significantly higher than healthy controls. Based on receiver operating characteristic curve analysis, urinary TSA had adequate diagnostic potential to distinguish patients from healthy populations, and its cutoff value Selleckchem AZD2014 was chosen at 95.26 mu g/g creatinine. Sensitivity,

specificity, and accuracy of urinary TSA determination were 75.6%, 75.6%, and 75.6%, respectively. Both in patient and healthy groups, urinary TSA was linearly correlated with urinary 8-OHdG Patients with high-severity grade (n=27) excreted urinary TSA significantly greater than those with low-severity grade (n=18).\n\nConclusion: Urinary TSA, 8-OHdG, and MDA increased in patients with bladder cancer. The elevated urinary TSA was associated with enhanced oxidative stress. In addition, urinary TSA increased with progressiveness of the tumor.”
“Objective: This

study investigated whether doctors’ attire influences the perception of empathy in the patient-doctor relationship during a therapeutic encounter.\n\nMethods: A total number of 143 patients were divided into four groups when they were consulting a Traditional Korean Medicine doctor. Depending on the group, the same doctor was wearing four different attires – Casual, Suit, Traditional dress, White coat – when having a clinical consultation with the patients.\n\nResults: MCC950 mw selleck chemicals The patients preferred white coat and traditional dress more than other attires, giving highest scores to white coat in competency, trustworthiness and preference of attire and to traditional dress in comfortableness and contentment with the consultation. The “Consultation and Relational Empathy (CARE)” score was significantly higher in the “White coat” and “Traditional”

groups, compared to the “Casual” and “Suit” groups.\n\nConclusion: The strong association between the patients’ preference of doctors’ attire and the CARE score indicates that the doctor’s attire plays not only an important role for establishing confidence and trustworthiness but also for the perception of empathy in the patient-doctor relationship.\n\nPractice implications: The doctor’s attire can function as an effective tool of non-verbal communication in order to signal confidence, trust and empathy and establish a good patient-doctor relationship. (C) 2012 Elsevier Ireland Ltd. All rights reserved.”
“Background: Nowadays, although its clinical value remains controversial institutions utilize hair mineral analysis. Arguments about the reliability of hair mineral analysis persist, and there have been evaluations of commercial laboratories performing hair mineral analysis.

Published by Elsevier Inc.”
“Background: ASP2215 Few articles have documented regimens and timing of perioperative chemotherapy for bladder cancer in routine practice. Here, we describe practice patterns in the general population of Ontario, Canada. Methods: In this retrospective

cohort study, treatment and physician billing records were linked to the Ontario Cancer Registry to describe use of neoadjuvant (NACT) and adjuvant (ACT) chemotherapy among all patients with muscle-invasive bladder cancer treated with cystectomy in Ontario 1994-2008. Time to initiation of ACT (TTAC) was measured from cystectomy. Multivariate Cox regression was used to identify factors associated with overall (OS) and cancer-specific survival (CSS). Results: Of 2944 patients undergoing cystectomy, 4% (129/2944) and 19% (571/2944) were treated with NACT and ACT, respectively. Five-year OS was 25% [95% confidence interval (CI) 17% to 34%] for NACT, 29% (95% CI 25% to 33%) for ACT cases. Among patients with identifiable drug regimens, cisplatin was used in 82% (253/308) and carboplatin in 14% (43/308). The most common regimens were gemcitabine-cisplatin

(54%, 166/308) and methotrexate, vinblastine, doxorubicin, cisplatin (MVAC) www.selleckchem.com/products/BIRB-796-(Doramapimod).html (21%, 66/308). Mean TTAC was 10 weeks; 23% of patients had TTAC bigger than 12 weeks. TTAC bigger than 12 weeks was associated with inferior OS [hazard ratio (HR) 1.28, 95% CI 1.00-1.62] and CSS (HR 1.30, 95% CI 1.00-1.69). In adjusted analyses, OS and CSS were lower among patients treated with carboplatin compared with those treated with cisplatin; OS HR 2.14 (95% CI 1.40-3.29) and CSS HR 2.06 (95% CI 1.26-3.37). Conclusions: Most patients in the general population receive cisplatin, and this may be associated with superior outcomes to carboplatin. Initiation of ACT beyond 12 weeks is associated with inferior survival. Patients selleck inhibitor should start ACT as soon as

they are medically fit to do so.”
“Background: Following adhesion to fibronectin neutrophils can develop membrane tubulovesicular extensions (IVEs) that can be 200 nm wide and several cell diameters long. TVEs attach neutrophils to the other cells, substrata or bacteria over distance. To understand the physiological significance of TVEs we performed proteome analysis of TVE content in neutrophils plated to fibronectin in the presence of compounds known to induce TVE formation (nitric oxide donor diethylamine NONOate, 4-bromophenacyl bromide, cytochalasin D).\n\nMethods: Development of TVEs was confirmed by scanning electron microscopy. TVEs were disrupted following removal of inductors and biochemical, high-performance liquid chromatography and mass spectrometry investigations were employed to characterize the proteins within the incubation media.\n\nResults: WE disruption released (a) the granular bactericides lactoferrin, lipocalin, myeloperoxidase, cathepsin G and defensins; (b) energy metabolism enzymes; (c) actin cytoskeleton proteins; (d) S100 proteins; and (e) annexin 1.

For the continuous grazing system, sheep grazed the same plots each year, and for the alternating system, grazing and hay making were

alternated annually between two adjacent plots. In July, August, and September 2009 and 2010, feed intake and live weight of sheep were selleck screening library determined. The GS did not affect dOM (P=0.101), OMI (P=0.381), and LWG of sheep (P=0.701). Across both GS LWG decreased from 98 g . d(-1) for GI1 to 62 g . d(-1) for GI6 (P smaller than 0.001; R-2=0.42). There were no interactions between GS and GI for all measured parameters (P bigger than = 0.061), indicating that alternating grazing did not compensate for negative effects of heavy grazing even after 4 yr of grassland use. In summary, our study showed that irrespective of GI, alternating grassland use does not improve dOM, OMI, and hence, LWG of sheep. However, it click here might enhance revenues and ecological sustainability in the long term when compared to the common practice of continuous grazing at very high stocking rates.”
“Assortative mating, an ubiquitous form of nonrandom mating, strongly impacts Darwinian fitness and can drive biological diversification. Despite its ecological and evolutionary importance, the behavioural processes underlying assortative mating are often unknown, and in particular, mechanisms not involving mate choice

have been largely ignored so far. Here, we propose that assortative mating can arise from prudent habitat choice’, a general mechanism that acts under natural selection, and that it can occur despite a complete mixing of phenotypes. We show that in the

cichlid Eretmodus cyanostictus size-assortative mating ensues, because individuals of weaker 4 competitive ability QNZ nmr ignore high-quality but strongly competed habitat patches. Previous studies showed that in E.cyanostictus, size-based mate preferences are absent. By field and laboratory experiments, here we showed that (i) habitat quality and body size are correlated in this species; (ii) territories with more stone cover are preferred by both sexes in the absence of competition; and (iii) smaller fish prudently occupy vacant territories of worse quality than do larger fish. Prudent habitat choice is likely to be a widespread mechanism of assortative mating, as both preferences for and dominance-based access to high-quality habitats are generic phenomena in animals.”
“INTRODUCTION: Activation of renal sympathetic nerves is associated with the development of hypertension. Catheter-based renal sympathetic denervation with radiofrequency energy ablation is a new promising treatment option for resistant hypertension. We here report the first Danish experiences and results with this technique.\n\nMATERIAL AND METHODS: Nine patients with resistant hypertension and a day-time 24-hour ambulatory blood pressure (BP) of 152/89 mmHg +/- 10/10 (standard deviation) mmHg despite treatment with 5.4 +/- 1.

Follow-up examinations including clinical assessment and Doppler ultrasound imaging were performed at 3 months and every 6 months thereafter. Findings demonstrated bypass patency and healing of the covered defect in all cases. Outcome in this initial series demonstrates the clinical feasibility of the new BF reconstruction technique, which allows revascularization and coverage of tissue defects using a one-piece anatomic unit.”
“The aim of this paper was to analyze

energy-related properties of forestry and agricultural wastes for energy production purposes, and to compare them with fossil fuels. The forestry wastes used were red cedar, Eucalyptus, and Pinus wood 123 shavings. The agricultural wastes analyzed were rice husk, coffee wastes, sugar cane bagasse, maize harvesting wastes, and bamboo cellulose pulp. The forestry wastes presented more suitable properties for bioenergy production

Galardin cost than the agricultural wastes. Selleckchem Stattic Desirable energetic properties were found for coffee wastes. The opposite was verified for rice husks. Among the biomass studied, coffee wastes presented the highest equivalent in fossil fuel volume and hence may lead to the highest decrease in CO2 emissions by fossil fuels used in Brazil for steam and heat production. The results suggests that CO2 benefits can be obtained if bioenergy is generated in the same locale where biomass is produced, avoiding CO2 cost of logistics and leading to greater end-use efficiency. The present work promotes the widespread use of different lignocellulosic wastes for bioenergy production and gives useful information for the planning and the control of power plants using biomass.”
“Erythrocytes have an environment of continuous pro-oxidant generation due to the presence of hemoglobin (Hb), which represents an additional and quantitatively significant source of superoxide (O-2(center dot-)) generation in biological systems. To counteract oxidative stress, erythrocytes have a self-sustaining antioxidant defense system. Thus, red blood cells uniquely function to protect Hb via a selective barrier

allowing gaseous and other ligand transport as well as providing antioxidant protection not only to themselves but also to other tissues and organs in the body. Sickle BMS-777607 concentration hemoglobin molecules suffer repeated polymerization/depolymerization generating greater amounts of reactive oxygen species, which can lead to a cyclic cascade characterized by blood cell adhesion, hemolysis, vaso-occlusion, and ischemia-reperfusion injury. In other words, sickle cell disease is intimately linked to a pathophysiologic condition of multiple sources of pro-oxidant processes with consequent chronic and systemic oxidative stress. For this reason, newer therapeutic agents that can target oxidative stress may constitute a valuable means for preventing or delaying the development of organ complications. (C) 2013 Elsevier Inc. All rights reserved.

05, compared to control animals). Zn(II)-curcumin exerted a greater anti-ulcerogenic effect than curcumin at the same dose (24 mg/kg), leading to a reduced severity of gastric ulcers, lower MDA content, and increased SOD activity and GSH levels (P < 0.05). In conclusion, these results confirm that the Zn(II)-curcumin complex possesses an enhanced mucosal 432 barrier defense activity compared to curcumin alone, due to its synergistic ability to decrease oxidative stress and attenuate MMP-9-mediated inflammation.

Crown Copyright (C) 2013 Published by Elsevier Ltd. All rights reserved.”
“Despite the increasing industrial use of different nanomaterials, data on their genotoxicity are scant. In the present study, we examined the potential genotoxic effects of carbon nanotubes (CNTs; >50% single-walled, click here similar to 40% other CNTs; 1.1 nm x 0.5-100 mu m; Sigma-Aldrich)

and graphite www.selleckchem.com/products/sbc-115076.html nanofibres (GNFs; 95%; outer diameter 80-200 nm, inner diameter 30-50 nm, length 5-20 mu m; Sigma-Aldrich) in vitro. Genotoxicity was assessed by the single cell gel electrophoresis (comet) assay and the micronucleus assay (cytokinesis-block method) in human bronchial epithelial BEAS 2B cells cultured for 24 h, 48 h, or 72 h with various doses (1-100 mu g/cm(2), corresponding to 3.8-380 mu g/ml) of the carbon nanomaterials. In the comet assay, CNTs induced a dose-dependent increase in DNA damage at all treatment times, with a statistically significant effect starting at the lowest dose tested. GNFs increased DNA damage at all doses in the 24-h treatment, at two doses (40 and 100 mu g/cm(2)) in the 48-h treatment (dose-dependent effect) and at four doses (lowest 10 mu g/cm(2)) in the 72-h treatment. In the micronucleus assay, no increase in micronucleated cells was observed with either

selleck screening library of the nanomaterials after the 24-h treatment or with CNTs after the 72-h treatment. The 48-h treatment caused a significant increase in micronucleated cells at three doses (lowest 10 mu g/cm(2)) of CNTs and at two doses (5 and 10 mu g/cm(2)) of GNFs. The 72-h treatment with GNFs increased micronucleated cells at four doses (lowest 10 mu g/cm(2)). No dose-dependent effects were seen in the micronucleus assay. The presence of carbon nanomaterial on the microscopic slides disturbed the micronucleus analysis and made it impossible at levels higher than 20 mu g/cm(2) of GNFs in the 24-h and 48-h treatments. In conclusion, our results suggest that both CNTs and GNFs ace genotoxic in human bronchial epithelial BEAS 2B cells in vitro. This activity may be due to the fibrous nature of these carbon nanomaterials with a possible contribution by catalyst metals present in the materials-Co and Mo in CNTs (<5 wt.%) and Fe (<3 wt.%) in GNFs. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

Ten out of

the twelve sponge species studied showed activity in one or more of the bioassays. Aqueous extracts of Cinachyrella sp. and Petromica citrina showed a large action spectrum over resistant-bacteria such as Staphylococcus aureus, coagulase-negative staphylococci and Enterococcus faecalis. Aqueous extract of P. citrina was fractioned and aqueous fraction showed a greatest inhibitory activity on Staphylococcus strains. In addition, this fraction demonstrated a bactericidal effect on exponentially growing S. aureus cells at the MIC (16 mu g/mL). The mechanism of action of bioactive fraction is still unclear, but we showed that it 3 affect protein biosynthesis of Staphylococcus. Our results demonstrated for the first time click here that P. citrina is a potential source of new https://www.selleckchem.com/products/wh-4-023.html drugs for the treatment of infections by antibiotic-resistant bacteria.”
“Glutamate receptors are important target molecules of the acute effect of ethanol. We studied ethanol sensitivity of homomeric GluR-D receptors expressed in human embryonic kidney 293 cells and examined whether recently discovered transmembrane alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor regulatory proteins (TARPs) affect ethanol sensitivity. Coexpression of the TARPs, stargazin, and gamma 4 increased

the time constant (tau-value) of current decay in the presence of agonist, thus slowing the onset of desensitization and increasing the steady-state current. Ethanol produced less inhibition of the peak current than the steady-state current for all types of the GluR-D receptors. In addition, ethanol concentration-dependently accelerated the rate of desensitization, measured as the tau-value of fast decay of peak current. This effect was enhanced with coexpression of TARPs. The recovery from desensitization was

slowed down CHIR98014 datasheet by coexpression of gamma 4 but ethanol did not affect this process in any GluR-D combination. The results support the idea that increased desensitization is an important mechanism in the ethanol inhibition of AMPA receptors and indicate that coexpression of TARPs can alter this effect of ethanol. (C) 2009 Elsevier Inc. All rights reserved.”
“Introduction: Large villous adenomas or adenocarcinomas of the rectum can determine secretory diarrhea, associated with a depleting syndrome of prerenal acute renal failure, hyponatremia, hypokalemia, and hypoproteinemia, with favorable prognosis if early detected and properly treated. The syndrome is rare, with approximately 50 cases reported in the literature. Aim: Acute renal failure, caused by fluids and electrolytes hypersecretion, secondary to a malignant rectal villous adenoma is revealed in a 55-year-old patient, admitted with major hydro-electrolytic and acid-base disturbances to our Nephrology Department.