BACKGROUND: Non-thyroidal illness syndrome (NTIS) can be defined as the presence of abnormal thyroid function in the absence of primary thyroid dysfunction and is associated with acute illness. Thyroid function testing is generally not advised in the critically ill patient. Thyroid-stimulating hormone (TSH) measurement is the preferred screening test for thyroid disease, but results may be misleading and variable in the setting of critical illnessOBJECTIVE: To describe the pattern of requests for TSH testing in patients admitted to the emergency department and intensive care units at Tygerberg Hospital, Cape Town, South AfricaMETHODS: A retrospective, descriptive (observational) study was conducted over a 6-month period to determine the number of requests for TSH testing received for patients admitted to the emergency department and intensive care unitsRESULTS: A total of 1 139 requests for TSH testing were received from the emergency department and intensive care units, of which 166 were excluded. Of the 973 requests evaluated, 14% yielded abnormal results. The majority (79.4%) of the abnormal TSH results were most likely attributed to NTIS. Follow-up TSH results after 6 - 8 weeks were available in only 18% of cases with abnormal TSH levels at initial presentationCONCLUSION: We found that TSH testing was often requested in critically ill patients, but that most results were either normal or indicative of NTIS. Follow-up testing of abnormal TSH results was rarely performed. We recommend continued education of junior clinicians regarding thyroid function testing in critically ill patients

BACKGROUND: Urine dipstick testing for ketones is widely used when diabetic ketoacidosis (DKA) is suspected in patients with hyperglycaemia. If urinary ketones are positive, patients are referred for further management - often inappropriately, as the test is a poor surrogate for plasma ketones. Plasma beta-hydroxybutyrate (β-OHB) levels >3 mmol/L are diagnostic of DKA, while levels <1 mmol/L are insignificant OBJECTIVES: To evaluate a hand-held electrochemical (point-of-care testing; POCT) ketone monitor and compare it with the gold-standard manual enzymatic method (MEM) for detection of plasma ketones METHODS: In a prospective and comparative study, we evaluated the measurement of β-OHB by means of POCT and the MEM in 61 consecutive samples from patients with suspected DKA at Tygerberg and Karl Bremer hospitals, Cape Town, South Africa. Capillary (for POCT) and plasma samples (for the MEM) were obtained simultaneously and compared for accuracy. Precision was assessed with control samples RESULTS: The POCT method was precise (coefficient of variation <4.5%), and there was a good correlation between the two methods (r=0.95). Regression analysis showed a proportional bias, with POCT reading higher than the MEM. However, when assessed at the relevant medical decision limits (β-OHB >3 mmol/L and <1 mmol/L), the total allowable error (bias + imprecision) was not exceeded. Patients will therefore still be classified correctly. The POCT method had a sensitivity of 100% and specificity of 89% for DKA (β-OHB >3 mmol/L), while at levels <1 mmol/L sensitivity was 100% and specificity 87.5% CONCLUSION: The POCT device provides an accurate and precise result and can be used as an alternative to the MEM in the diagnosis of DKA

O comportamento à corrosão de cerâmicas à base de Si3N4 contendo misturas de Y2O3/SiO2 e RE2O3/SiO2 como aditivos nas proporções de 14 e 21% em volume ambos na estequiometria dos dissilicatos Y2Si2O7 e RE2Si2O7, respectivamente, foi estudado em soluções aquosas de HCl 0,1N a 100 °C. A resistência à corrosão foi avaliada pela perda de massa das amostras e análise química das soluções após os testes. As análises por microscopia eletrônica das amostras atacadas revelou que basicamemte a fase vítrea intergranular foi dissolvida pela solução ácida, deixando um esqueleto de grãos de b-Si3N4 entrelaçados.

The corrosion resistance of Si3N4 ceramics with 14 and 21 vol.% of Y2O3/SiO2 and RE2O3/SiO2 mixtures as additive, both in the stoichiometry of disilicates Y2 Si2O7 and RE2Si2O7, respectively, has been investigated in 0.1N HCl solutions. Samples were prepared by a two step gas pressure sintering process, under a final N2 pressure of 10 MPa and a maximum temperature of 1850 °C for 30 min. The corrosion resistance was evaluated by the mass change of polished samples and chemical analysis of the solutions after the tests. Analysis by electron microscopy showed that the glassy intergranular phase is dissolved by the acid solution, leaving a skeleton of interlinked b -Si3N4 grains.