Diet-induced Ketoacidosis in a Non-diabetic: A Case Report

Introduction: Anion gap metabolic acidosis is a common disorder seen in the emergency department. The differential can include toxicological, renal, endocrine, infectious, and cardiogenic disorders. Ketosis, however, is one of the rarer causes of metabolic acidosis seen by the emergency physician in developed nations.Case Report: A 53-year-old female presented after starting a low-carbohydrate ketogenic diet for weight loss. She reported xerostomia, nausea with abdominal pain and a 17-pound weight loss over the previous 22 days. Labs revealed an anion-gap metabolic acidosis with ketosis. She was treated with 5% dextrose in normal saline and a sliding scale insulin coverage. Her anion gap corrected during her hospital course and was discharged on hospital day three.Discussion: The ketogenic diet typically consists of a high-fat, adequate protein and low carbohydrate diet that has previously been thought to be relatively safe for weight loss. However, when carbohydrates are completely removed from the diet an overproduction of ketones bodies results in ketoacidosis. Treatment should be aimed at halting the ketogenic process and patient education.Conclusion: Although rarely included in the differential for metabolic acidosis, diet-induced ketosis should be included by the emergency physician when faced with a patient who recently changed their eating patterns

Metalliferous Biosignatures for Deep Subsurface Microbial Activity

Acknowledgments We thank the British Geological Survey (BGS) for the provision of samples and the Science & Technology Facilities Council (STFC) grant (ST/L001233/1) for PhD funding which aided this project. Research on selenium in reduction spheroids was also supported by NERC grants (NE/L001764/1 and NE/ M010953/1). The University of Aberdeen Raman facility was funded by the BBSRC. We also thank John Still for invaluable technical assistance.Peer reviewedPublisher PD

Numerical calculation of three-point branched covers of the projective line

We exhibit a numerical method to compute three-point branched covers of the complex projective line. We develop algorithms for working explicitly with Fuchsian triangle groups and their finite index subgroups, and we use these algorithms to compute power series expansions of modular forms on these groups.Comment: 58 pages, 24 figures; referee's comments incorporate

Methods for Measuring Cancer Disparities: Using Data Relevant to Healthy People 2010 Cancer-Related Objectives

Healthy People 2010 has two overarching goals: to increase the span of healthy life and to eliminate health disparities across the categories of gender, race or ethnicity, education or income, disability, geographic location, and sexual orientation (1). This report raises some conceptual issues and reviews different methodological approaches germane to measuring progress toward the goal of eliminating cancer-related health disparities (2). Despite the increased attention to social disparities in health, no clear framework exists to define and measure health disparities. This may create confusion in communicating the extent of cancer-related health disparities and hinder the ability of public health organizations to monitor progress toward the Healthy People 2010 cancer objectives

Virtual Population Units: A New Institutional Approach to Fisheries Management

This paper describes an alternative, rights-based approach to the economic problems of fisheries management and governance. The approach is based on the concept of a Virtual Population (VP), which provides an alternative way to define use rights in a fishery management system. Included is a comparison of harvest rates under the VP regime, “sole-owner,†and open-access regimes. In comparison, a VP solution is more efficient than open access and can approach that of a sole owner. More importantly, in our opinion, the approach contains a higher degree of local control over issues such as concentration of ownership and, unlike some community-based systems, provides an explicit, decentralized incentive for conservation. It also contains a built-in incentive mechanism for end-of-year conservation that is absent from individual transferable quotas (ITQs).Virtual populations, virtual population units, ITQs, marginal valuation, Resource /Energy Economics and Policy, Q220, Q590, C720, D830,