Although a predictor of mortality in patients with cirrhosis, hyponatremia can be present even without cirrhosis in those addicted to alcohol, occurring on a dilutional basis because they consume excessive alcoholic beverages that are low in osmolarity (potomania). 10, 11 However, the role of MELDNa in predicting survival in patients with AH has not been studied. 9 Furthermore, studies have shown that a reduced serum Na concentration may have a greater effect on mortality in patients with a low MELD score. MELDNa has been proposed as an alternative to MELD in other clinical scenarios as well, including transjugular intrahepatic portosystemic shunt placement. 8 MELDNa, a modified MELD score that includes serum sodium (Na), has been shown to improve prediction of death in patients with cirrhosis when compared with MELD alone. Hyponatremia is a sign of excessive vasopressin secretion and is predictive of poor survival in patients with cirrhosis. In this regard, mortality risk in patients with AH can be predicted by various models, including the Model for End-Stage Liver Disease (MELD) score. Determining mortality risk in patients with ALD is important to guide treatment decisions. Fatty liver is reversible with alcohol cessation, but patients with AH and cirrhosis have a potentially more severe prognosis. 1 Alcoholic liver disease (ALD) encompasses a broad spectrum of conditions, including fatty liver, alcoholic hepatitis (AH), and cirrhosis. Hyponatremia in patients with AH without ascites is not a predictor of mortality because it may have a dilutional basis secondary to excessive intake of low-osmolar alcohol.ĪH = alcoholic hepatitis ALD = alcoholic liver disease CI = confidence interval MELD = Model for End-Stage Liver Disease Na = sodium OR = odds ratioĮxcessive alcohol consumption is a major source of chronic liver disease in the Western world. A MELD score of 29.0 and a MELDNa score of 34.0 had sensitivity of 85.7% and 83.3% and specificity of 31.0% and 16.7%, respectively.ĬONCLUSION: MELD and MELDNa were similar predictors of 180-day mortality however, MELDNa was a better predictor of mortality than MELD in patients with ascites. A MELD score of 27.0 and a MELDNa score of 28.0 had sensitivity of 76.5% and 87.5% and specificity of 64.9% and 52.5%, respectively. RESULTS: MELD (odds ratio, 1.22 95% confidence interval, 1.05-1.47 P=.007 C statistic, 0.81) and MELDNa (OR, 1.24 95% CI, 1.05-1.56 P=.008 C statistic, 0.78) were significant predictors of 180-day mortality in patients with AH. The C statistic was derived to compare MELD with MELDNa in patients with and without ascites. Logistic regression analysis was done to assess the effect of MELD and MELDNa scores on 180-day mortality. PATIENTS AND METHODS: We examined 26 patients with AH enrolled in a prospective trial between June 1, 2004, and June 30, 2007, at Mayo Clinic. OBJECTIVE: To compare the Model for End-Stage Liver Disease (MELD) with the modified model including sodium (MELDNa) for predicting 180-day mortality in patients with alcoholic hepatitis (AH) and determine the subset in whom serum sodium may enhance 180-day mortality prediction.
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How to make a Mexican inspired watermelon salad Easy to scale from a small dish to a picnic platter.A bit savory with the cotija + olive oil + salt and pepper.What makes this watermelon salad recipe so good Now we see a lot of watermelon centric recipes in Mexican cuisine center on it being paired with a slightly savory spice like Tajin, or watermelon being distilled into an agua fresca. Moreover, because the colors of the watermelon (green, white, and red) are the same as the Mexican flag (green, white, red), el tricolor represents a sense of Mexican pride and nationalism.įrida Kahlo also incorporated watermelons into one of her more famous still life paintings, titled " Sandias". Watermelons have a unique place in Mexican culinary history. Now, Mexico is the #2 exporter of watermelons in the world. In addition, it's worth noting that here in the US, watermelons were grown by free Black people in the 19th century, and were a symbol of slavery abolition. It's reported that watermelons were cultivated in Florida and warmer/southern regions as early as the 16th century. it's technically a berry) to the New World. European colonists and African slaves brought the berry (yeah. The watermelon reached Southern Europe via the Moors, where the warm weather in the south of Spain allows the crop to flourish. Also, if stored in a cool/dry place, could stay edible for weeks to months. Because the watermelon has such a high water content percentage, it served as a hydration source for peoples in the desert. The Roman naturalist, Pliny the Elder, described the watermelon as a refrigerant maxime-an "extremely cooling food"-in his first-century encyclopedia, Historia Naturalis. The watermelon originated in West Africa, and we see references to the watermelon in ancient texts. When the shot switches to the inside of their vehicle, the police cars behind them are suddenly blue.The watermelon's gastronomic history and use in Mexican cuisine When Kramer and Gendason are being chased by the police, the shot from outside their vehicle shows the police cars behind them to be black and white. Simpson chase, including Kramer's quote, "You know who I am, dammit!" Kramer and Gendason's car chase is a spoof of the O.J. In the taxi cab scene where George is telling Elaine that he paid for the big salad, the entrance to Ed Sullivan Theater with Dave Letterman's "Late Show" sign is visible on the left side of the screen in the background. Is this a reference to Jurassic Park, which Wayne Knight was in a year before? Incidentally, this seems to be the same pillowcase that we once saw in George's bedroom. In Newman's apartment, when Jerry comes to visit and Newman opens the door, you can see a he was sitting on a pillow featuring a pterodactyl. Lauren Bowles, who plays a waitress at Monk's Cafe, is actually the younger half-sister of Julia Louis-Dreyfus. The whole bit about George being upset because he got a salad for a character and she didn't thank him was based on a real incident between Larry David and the show's editor Janet Ashikaga. George: I think I would like to play with dolls. Jerry: Big lettuce, big carrots, tomatoes like volleyballs. Jerry: He's a mystery wrapped in a Twinkie. Newman will see whoever is willing to see him.Įlaine: ( on Newman) He's an enigma a mystery wrapped in a riddle. Jerry: Newman never stops seeing anybody. Kramer: Hey, a rule is a rule, and let's face it, without rules there's chaos. Newman: (about Margaret) She wasn't my type. Jerry: I wonder if any woman every said that about Einstein?Įlaine: Perhaps there's more to Newman than meets the eye. Jerry: Generally speaking, you don't need any extra incentive to murder a dry cleaner. No payment, no installer, no spam ads. Mage Hunter Builds - Grim Dawn Builds Base Game Remove Ads Grim Dawn Builds Base Game 1.1.9.7 Game version Hardcore Beginner Leveling Mage Hunter Builds (57) Mage Hunter Build Planner 1.1.9.6 - 1.1.9.7 Arcana Discernible - Elemental PRM Mage Hunter sr+ vid Created by Willnoword at Octo1.1.9.
Each time you take a photo, Smart Shooter will download it and display it on the screen. You can continue to use you camera manually whilst is is connected to the computer. The photo display software uses GPU hardware acceleration, so you can immediately check the photo by zooming and panning in realtime on you PC using the mouse. Smart Shooter can automatically download and display the last taken photo. You can also change the transparency of the Live View image so it is displayed as an overlay over the last taken photo.Įach frame of the Live View output can be saved to a JPG file on the PC. If you camera supports Live View, then Smart Shooter can display the Live View image in realtime on the PC. Smart Shooter 4 is aimed at both the professional and amateur photographer. Scripting language lets you control your camera, allowing you to take multiple photos with varying settings just by clicking a single button. The software tech info says the Sony A7R iv works with the software including Live View. Smart Shooter 4 can't detect or find the camera. Camera is cabled with USB-C out of camera to USB-A into the computer. Automatic download and display means you can fully evaluate your photos in seconds, and real time live view output will help you focus and compose the scene. Can't get TEtherTools Smart Shooter 4 to recognize the camera A7R iv. Smart Shooter 4 allows you to fully control your camera from your Mac or PC, giving you freedom to explore and experiment to help make the perfect picture. Backed by Tether Tools support, we believe Smart Shooter 4 is the best in class tether utility. Smart Shooter 4 provides tethered capture for most Canon, Sony and Nikon cameras utilizing a reworked user interface, to provide speed and performance for your tethering needs.
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