Lowongan Kerja Terbaru di Indonesia

1. Causes

Diabetes can be caused by too little insulin (a hormone produced by the pancreas to control blood sugar), resistance to insulin, or both.

To understand diabetes, it is important to first understand the normal process of food metabolism. Several things happen when food is digested:

* A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
* An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood sugar. This is because their pancreas does not make enough insulin or their muscle, fat, and liver cells do not respond to insulin normally, or both.

There are three major types of diabetes:

* Type 1 diabetes is usually diagnosed in childhood. The body makes little or no insulin, and daily injections of insulin are needed to sustain life.
* Type 2 diabetes is far more common than type 1 and makes up most of all cases of diabetes. It usually occurs in adulthood. The pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to the insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to the growing number of older Americans, increasing obesity, and failure to exercise.
* Gestational diabetes is high blood glucose that develops at any time during pregnancy in a woman who does not have diabetes.

Diabetes affects more than 20 million Americans. About 54 million Americans have prediabetes. There are many risk factors for diabetes, including:

* A parent, brother, or sister with diabetes
* Obesity
* Age greater than 45 years
* Some ethnic groups (particularly African Americans, Native Americans, Asians, Pacific Islanders, and Hispanic Americans)
* Gestational diabetes or delivering a baby weighing more than 9 pounds
* High blood pressure
* High blood levels of triglycerides (a type of fat molecule)
* High blood cholesterol level
* Not getting enough exercise

2. Symptoms

High blood levels of glucose can cause several problems, including frequent urination, excessive thirst, hunger, fatigue, weight loss, and blurry vision. However, because type 2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all.

Symptoms of type 1 diabetes:

* Increased thirst
* Increased urination
* Weight loss in spite of increased appetite
* Fatigue
* Nausea
* Vomiting

Patients with type 1 diabetes usually develop symptoms over a short period of time, and the condition is often diagnosed in an emergency setting.

Symptoms of type 2 diabetes:

* Increased thirst
* Increased urination
* Increased appetite
* Fatigue
* Blurred vision
* Slow-healing infections
* Impotence in men

3. Signs and Tests

A urine analysis may be used to look for glucose and ketones from the breakdown of fat. However, a urine test alone does not diagnose diabetes. The following blood glucose tests are used to diagnose diabetes:

* Fasting blood glucose level — diabetes is diagnosed if higher than 126 mg/dL on two occasions. Levels between 100 and 126 mg/dl are referred to as impaired fasting glucose or pre-diabetes. These levels are considered to be risk factors for type 2 diabetes and its complications.
* Random (non-fasting) blood glucose level — diabetes is suspected if higher than 200 mg/dL and accompanied by the classic symptoms of increased thirst, urination, and fatigue. (This test must be confirmed with a fasting blood glucose test.)
* Oral glucose tolerance test — diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours (This test is used more for type 2 diabetes.)

You should also ask your doctor how often to you need your hemoglobin A1c (HbA1c) level checked. The HbA1c is a measure of average blood glucose during the previous 2 to 3 months. It is a very helpful way to determine how well treatment is working.

Ketone testing is another test that is used in type 1 diabetes. Ketones are produced by the breakdown of fat and muscle, and they are harmful at high levels. The ketone test is done using a urine sample. High levels of blood ketones may result in a serious condition called ketoacidosis. Ketone testing is usually done at the following times:

* When the blood sugar is higher than 240 mg/dL
* During acute illness (for example, pneumonia, heart attack, or stroke)
* When nausea or vomiting occur
* During pregnancy

4. Treatment

There is no cure for diabetes. Treatment involves medicines, diet, and exercise to control blood sugar and prevent symptoms and complications.

LEARN THESE SKILLS

Basic diabetes management skills will help prevent the need for emergency care. These skills include:

* How to recognize and treat low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia)
* What to eat and when
* How to take insulin or oral medication
* How to test and record blood glucose
* How to test urine for ketones (type 1 diabetes only)
* How to adjust insulin or food intake when changing exercise and eating habits
* How to handle sick days
* Where to buy diabetes supplies and how to store them

After you learn the basics of diabetes care, learn how the disease can cause long-term health problems and the best ways to prevent these problems. People with diabetes need to review and update their knowledge, because new research and improved ways to treat diabetes are constantly being developed.

SELF-TESTING

If you have diabetes, your doctor may tell you to regularly check your blood sugar levels at home. There are a number of devices available, and they use only a drop of blood. Self-monitoring tells you how well diet, medication, and exercise are working together to control your diabetes and can help your doctor prevent complications.

The American Diabetes Association recommends that premeal blood sugar levels fall in the range of 80 to 120 mg/dL and bedtime blood levels fall in the range of 100 to 140 mg/dL. Your doctor may adjust this depending on your circumstances.

WHAT TO EAT

You should work closely with your health care provider to learn how much fat, protein, and carbohydrates you need in your diet. A registered dietician can be very helpful in planning dietary needs.

People with type 1 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugars from becoming extremely high or low.

Persons with type 2 diabetes should follow a well-balanced and low-fat diet.

HOW TO TAKE MEDICATION

Medications to treat diabetes include insulin and glucose-lowering pills called oral hypoglycemic drugs.

Persons with type 1 diabetes cannot make their own insulin, so daily insulin injections are needed. Insulin does not come in pill form. Injections that are generally needed one to four times per day. Some people use an insulin pump, which is worn at all times and delivers a steady flow of insulin throughout the day. Other people may use a new type of inhaled insulin.

Insulin preparations differ in how quickly they start to work and how long they remain active. Sometimes different types of insulin are mixed together in a single injection. The types of insulin to use, the doses needed, and the number of daily injections are chosen by a health care professional trained to provide diabetes care.

People who need insulin are taught to give themselves injections by their health care providers or diabetes educators.

Unlike type 1 diabetes, type 2 diabetes may respond to treatment with exercise, diet, and medicines taken by mouth. There are several types of medicines used to lower blood glucose in type 2 diabetes. They fall into one of three groups:

* Medications called oral sulfonylureas that increase insulin production by the pancreas.
* Medications called thiazolidinediones that help increase the cell’s sensitivity (responsiveness) to insulin.
* Medications that delay absorption of glucose from the gut. These include acarbose and miglitol.

There are some injectable medicines used to lower blood sugar. They include exenatide and pramlintide.

Most persons with type 2 diabetes will need more than one medication for good blood sugar control within 3 years of starting their first medication. Different groups of medications may be combined or used with insulin.

Some people with type 2 diabetes find they no longer need medication if they lose weight and increase activity, because when their ideal weight is reached, their own insulin and a careful diet can control their blood glucose levels.

It is unknown if hypoglycemic medicines taken by mouth are safe for use in pregnancy. Women who have type 2 diabetes and take these medications may be switched to insulin during pregnancy and while breastfeeding.

Gestational diabetes is treated with insulin and changes in diet.

EXERCISE

Regular exercise is especially important for people with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than diabetics who do not exercise regularly. You should be evaluated by your physician before starting an exercise program.

Here are some exercise considerations:

* Choose an enjoyable physical activity that is appropriate for your current fitness level.
* Exercise every day, and at the same time of day, if possible.
* Monitor blood glucose levels before and after exercise.
* Carry food that contains a fast-acting carbohydrate in case you become hypoglycemic during or after exercise.
* Carry a diabetes identification card and a mobile phone or change for a payphone in case of emergency.
* Drink extra fluids that do not contain sugar before, during, and after exercise.

Changes in exercise intensity or duration may need changes in diet or medication dose to keep blood sugar levels from going too high or low.

FOOT CARE

People with diabetes are prone to foot problems because of the likelihood of damage to blood vessels and nerves and a decreased ability to fight infection. Problems with blood flow and damage to nerves may cause an injury to the foot to go unnoticed until infection develops. Death of skin and other tissue can occur.

If left untreated, the affected foot may need to be amputated. Diabetes is the most common condition leading to amputations.

To prevent injury to the feet, people with diabetes should adopt a daily routine of checking and caring for the feet as follows:

* Check your feet every day, and report sores or changes and signs of infection.
* Wash your feet every day with lukewarm water and mild soap, and dry them thoroughly.
* Soften dry skin with lotion or petroleum jelly.
* Protect feet with comfortable, well-fitting shoes.
* Exercise daily to promote good circulation.
* See a podiatrist for foot problems or to have corns or calluses removed.
* Remove shoes and socks during a visit to your health care provider and remind him or her to examine your feet.
* Stop smoking, which hinders blood flow to the feet.

5. Expectations (prognosis)

With good blood glucose and blood pressure control, many of the complications of diabetes can be prevented.

Studies have shown that strict control of blood sugar and blood pressure levels in persons with diabetes helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke.

Complications

Emergency complications include diabetic hyperglycemic hyperosmolar coma.

Long-term complications include:

* Diabetic retinopathy
* Diabetic nephropathy
* Diabetic neuropathy
* Peripheral vascular disease
* Hyperlipidemia, hypertension, atherosclerosis, and coronary artery disease

6. Calling Your Health Care Provider

Go to the emergency room or call the local emergency number (such as 911) if symptoms of ketoacidosis occur:

* Increased thirst and urination
* Nausea
* Deep and rapid breathing
* Abdominal pain
* Sweet-smelling breath
* Loss of consciousness

Go to the emergency room or call the local emergency number if symptoms of extremely low blood sugar (hypoglycemic coma or severe insulin reaction) occur:

* Weakness
* Drowsiness
* Headache
* Confusion
* Dizziness
* Double vision
* Lack of coordination
* Convulsions or unconsciousness

7. Prevention

Maintaining an ideal body weight and an active lifestyle may prevent the onset of type 2 diabetes. Currently there is no way to prevent type 1 diabetes.

Ethylene glycol is produced from ethylene, via the intermediate ethylene oxide. Ethylene oxide reacts with water to produce ethylene glycol according to the chemical equation

C2H4O + H2O → HOCH2CH2OH

This reaction can be catalyzed by either acids or bases, or can occur at neutral pH under elevated temperatures. The highest yields of ethylene glycol occur at acidic or neutral pH with a large excess of water. Under these conditions, ethylene glycol yields of 90% can be achieved. The major byproducts are the ethylene glycol oligomers diethylene glycol, triethylene glycol, and tetraethylene glycol.

This molecule has been observed in space by Hollis, et al.[2]

[edit] Uses

[edit] Coolant

The major use of ethylene glycol is as a coolant or antifreeze in, for example, automobiles and personal computers. Due to its low freezing point, it is also used as a deicing fluid for windshields and aircraft. Ethylene glycol is also commonly used in chilled water air conditioning systems that place either the chiller or air handlers outside, or systems that must cool below the freezing temperature of water.

[edit] Manufacturing

Ethylene glycol has become increasingly important in the plastics industry for the manufacture of polyester fibers and resins, including polyethylene terephthalate, which is used to make plastic bottles for soft drinks. The antifreeze capabilities of ethylene glycol have made it an important component of vitrification mixtures for low-temperature preservation of biological tissues and organs.

Minor uses of ethylene glycol include the manufacture of capacitors, as a chemical intermediate in the manufacture of 1,4-dioxane and as an additive to prevent corrosion in liquid cooling systems for personal computers.

[edit] Chemistry

Ethylene glycol may also be used as a protecting group for carbonyl groups in organic synthesis. Reacting a ketone or aldehyde with ethylene glycol will with acid catalyst (e.g. p-toluenesulfonic acid; BF3·Et2O) will give a cyclic acetal — a 1,3-dioxolane, which is resistant to bases and other nucleophiles. The 1,3-dioxolane protecting group can thereafter be removed, e.g. by further acid hydrolysis.[3] In this example, isophorone was protected using ethylene glycol with p-toluenesulfonic acid in moderate yield. Water was removed by azeotropic distillation to shift the equilibrium to the right.[4]

[edit] Laboratory use

Ethylene glycol is commonly used in laboratories to precipitate out proteins in solution. This is often an intermediary step in fractionation, purification and/or crystallization. It can be used to protect functional groups from reacting during organic synthesis. To get the functional group back to its original composition, simply add water and acid.

Ethylene glycol is commonly used as a preservative for specimens in schools, frequently during dissection. It is said to be safer than formaldehyde, but the safety is questionable.

[edit] Other applications

Ethylene glycol’s high boiling point and affinity for water makes it an ideal desiccant for natural gas production. In the field, excess water vapor is usually removed by glycol dehydration. Ethylene glycol flows down from the top of a tower and meets a rising mixture of water vapor and hydrocarbon gases from the bottom. The glycol chemically removes the water vapor, allowing dry gas to exit from the top of the tower. The glycol and water are separated, and the glycol cycles back through the tower.

Ethylene glycol is also used in the manufacture of some vaccines, but it is not itself present in these injections. It is used as a minor (1–2%) ingredient in shoe polish and also in some inks and dyes. Ethylene glycol has seen some use as a rot and fungal treatment for wood, both as a preventative and a treatment after the fact. It has been used in a few cases to treat partially rotted wooden objects to be displayed in museums. It is one of only a few treatments that are successful in dealing with rot in wooden boats, and is relatively cheap.

[edit] Toxicity

The major danger from ethylene glycol is following ingestion. Due to its sweet taste, children and animals will sometimes consume large quantities of it if given access to antifreeze. Ethylene glycol may also be found as a contaminant in moonshine distilled using an improperly washed car radiator. In developed countries, a bittering agent called denatonium/denatonium benzoate, is generally added to ethylene glycol preparations as an adversant (to prevent accidental ingestion). If one has ingested ethylene glycol, give the person an alcoholic beverage while the paramedics arrive. Alcohol acts as a competitive inhibitor to the active site of the enzyme that converts ethylene glycol to its toxic metabolites. Once alcohol binds, the ethylene glycol is harmlessly excreted out of the body.

Ethylene glycol poisoning is a medical emergency and in all cases a poison control center should be contacted or medical attention should be sought. It is highly toxic with an estimated LD100 in humans of approximately 1.4 ml/kg.[5] However, as little as 30 milliliters (2 tablespoons) can be lethal to adults.[6]

[edit] Symptoms

Symptoms of ethylene glycol poisoning usually follow a three-step progression, although poisoned individuals will not always develop each stage or follow a specific time frame.[5] Stage 1 consists of neurological symptoms including victims appearing to be intoxicated, exhibiting symptoms such as dizziness, headaches, slurred speech, and confusion. Over time, the body metabolizes ethylene glycol into other toxins, first to glycolaldehyde, which is then oxidized to glycolic acid, glyoxylic acid, and finally oxalic acid. Stage 2 is a result of accumulation of these metabolites and consists of tachycardia, hypertension, hyperventilation, and metabolic acidosis. Stage 3 of ethylene glycol poisoning is the result of kidney injury, leading to acute kidney failure.[7] Oxalic acid reacts with calcium and forms calcium oxalate crystals in the kidney.

[edit] Treatment

Initial treatment consists of stabilizing the patient and gastric decontamination. As ethylene glycol is rapidly absorbed, gastric decontamination needs to be performed soon after ingestion to be of benefit. Gastric lavage or nasogastric aspiration of gastric contents are the most common methods employed in ethylene glycol poisoning. Ipecac-induced vomiting or activated charcoal (charcoal does not adsorb glycols) are not recommended. [5]

The antidotes for ethylene glycol poisoning are ethanol or fomepizole; antidotal treatment forms the mainstay of management following ingestion. Ethanol (usually given IV as a 5 or 10% solution in 5% dextrose and water, but, also sometimes given in the form of a strong spirit such as whisky, vodka or gin) acts by competing with ethylene glycol for the enzyme alcohol dehydrogenase thus limiting the formation of toxic metabolites. Fomepizole acts by inhibiting alcohol dehydrogenase, thus blocking the formation of the toxic metabolites.[8]

In addition to antidotes, hemodialysis can also be used to enhance the removal of unmetabolized ethylene glycol, as well as its metabolites from the body. Hemodialysis also has the added benefit of correcting other metabolic derangements or supporting deteriorating kidney function caused by ethylene glycol ingestion. Often both antidotal treatment and hemodialysis are used together in the treatment of poisoning.

[edit] Industrial hazards

Ethylene glycol can begin to breakdown at 230° – 250°F (110° – 121°C). Note that breakdown can occur when the system bulk (average) temperature is below these limits because surface temperatures in heat exchangers and boilers can be locally well above these temperatures.

The electrolysis of ethylene glycol solutions with a silver anode results in an exothermic reaction. The Apollo 1 fire catastrophe was caused by this reaction. The ethylene glycol–water mixture was ignited and was able to burn in the atmosphere of pure low pressure oxygen.[citation needed]

[edit] History

Ethylene glycol was first prepared in 1859 by the French chemist Charles-Adolphe Wurtz. It was produced on a small scale during World War I as a coolant and as an ingredient in explosives. Widespread industrial production began in 1937 when ethylene oxide, a component in its synthesis, became cheaply available.

When first introduced it created a minor revolution in aircraft design because when used in place of water as an engine coolant, its higher boiling point allowed for smaller radiators operating at higher temperatures. Prior to the widespread availability of ethylene glycol, many aircraft manufacturers tried to use evaporative cooling systems which used water at high pressure. Invariably, these proved to be rather unreliable and were easily damaged in combat because they took up large amounts of room on the plane, where they were easily hit by gunfire.

[edit] See also

* Propylene glycol
* Diethylene glycol
* Ethylene glycol (data page)

[edit] References

1. ^ Glenn Elert. Viscosity. Retrieved on 2007-10-02.
2. ^ J. M. Hollis, F. J. Lovas, P. R. Jewell, L. H. Coudert (2002 May 20). “Interstellar Antifreeze: Ethylene Glycol”. The AstroPhysical Journal 571: L59-L62. DOI:10.1086/341148.
3. ^ Theodora W. Greene, Peter G. M. Wuts. Protective Groups in Organic Synthesis, Third Edition, John Wiley & Sons, 312-322. ISBN 0-471-16019-9.
4. ^ J. H. Babler, N. C. Malek and M. J. Coghlan (1978). “Selective hydrolysis of α,β- and β,γ-unsaturated ketals: method for deconjugation of β,β-disubstituted α,β-unsaturated ketones”. J. Org. Chem. 43 (9): 1821-1823. DOI:10.1021/jo00403a047.
5. ^ a b c Brent J (2001). “Current management of ethylene glycol poisoning”. Drugs 61 (7): 979-88. PMID 11434452.
6. ^ Field D (1985). “Acute ethylene glycol poisoning”. Crit Care Med 13 (10): 872-3. PMID 4028762.
7. ^ Barceloux DG, Krenzelok EP, Olson K, Watson W. (1999). “American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Ethylene Glycol Poisoning. Ad Hoc Committee”. J Toxicol Clin Toxicol 37 (5): 537-60. PMID 10497633.
8. ^ Brent J, McMartin K, Phillips S, Burkhart K, Donovan J, Wells M, Kulig K (1999). “Fomepizole for the treatment of ethylene glycol poisoning. Methylpyrazole for Toxic Alcohols Study Group”. N Engl J Med 340 (11): 832-8. PMID 10080845.

ita yg diberikan situs anda bermanfaat bagi banyak orang. Kalaupun demikian butuh waktu lama utk bisa di posisi atas kecuali anda iklankan situs anda
9. Anda sebaiknya harus punya hobi menulis artikel karena kalau tidak situs anda hanya berisi informasi yg diambil dari situs orang lain dan rating anda akan lamban naiknya kalaupun anda ambil dari situs org lain dan terus anda edit dan perbagus, harap cantumin sumber dari berita anda karena ini adalah kode etik jurnalis. Artikel saya saja di internet juga sering dibajak orang tanpa mencamtumkan sumbernya dr mana. Belajarlah berbagi dan saling menghargai sesama netter, kalau anda termasuk orang yang suka membajak, yah mohon dikurangi dan lama-lama dihilangkan…
10. Hal terakhir yg paling penting adalah “jangan pernah menyerah” karena semua orang dan saya juga memulai dari nol. Segala sesuatu selalu ada permulaannya. Belajar, belajar dan belajar adalah kunci utama kalau mau sukses di bidang ini dan saya juga masih melakukannya hingga hari ini

Production

Ethylene glycol is produced from ethylene, via the intermediate ethylene oxide. Ethylene oxide reacts with water to produce ethylene glycol according to the chemical equation

C2H4O + H2O → HOCH2CH2OH

This reaction can be catalyzed by either acids or bases, or can occur at neutral pH under elevated temperatures. The highest yields of ethylene glycol occur at acidic or neutral pH with a large excess of water. Under these conditions, ethylene glycol yields of 90% can be achieved. The major byproducts are the ethylene glycol oligomers diethylene glycol, triethylene glycol, and tetraethylene glycol.

This molecule has been observed in space by Hollis, et al.[2]

[edit] Uses

[edit] Coolant

The major use of ethylene glycol is as a coolant or antifreeze in, for example, automobiles and personal computers. Due to its low freezing point, it is also used as a deicing fluid for windshields and aircraft. Ethylene glycol is also commonly used in chilled water air conditioning systems that place either the chiller or air handlers outside, or systems that must cool below the freezing temperature of water.

[edit] Manufacturing

Ethylene glycol has become increasingly important in the plastics industry for the manufacture of polyester fibers and resins, including polyethylene terephthalate, which is used to make plastic bottles for soft drinks. The antifreeze capabilities of ethylene glycol have made it an important component of vitrification mixtures for low-temperature preservation of biological tissues and organs.

Minor uses of ethylene glycol include the manufacture of capacitors, as a chemical intermediate in the manufacture of 1,4-dioxane and as an additive to prevent corrosion in liquid cooling systems for personal computers.

[edit] Chemistry

Ethylene glycol may also be used as a protecting group for carbonyl groups in organic synthesis. Reacting a ketone or aldehyde with ethylene glycol will with acid catalyst (e.g. p-toluenesulfonic acid; BF3·Et2O) will give a cyclic acetal — a 1,3-dioxolane, which is resistant to bases and other nucleophiles. The 1,3-dioxolane protecting group can thereafter be removed, e.g. by further acid hydrolysis.[3] In this example, isophorone was protected using ethylene glycol with p-toluenesulfonic acid in moderate yield. Water was removed by azeotropic distillation to shift the equilibrium to the right.[4]

[edit] Laboratory use

Ethylene glycol is commonly used in laboratories to precipitate out proteins in solution. This is often an intermediary step in fractionation, purification and/or crystallization. It can be used to protect functional groups from reacting during organic synthesis. To get the functional group back to its original composition, simply add water and acid.

Ethylene glycol is commonly used as a preservative for specimens in schools, frequently during dissection. It is said to be safer than formaldehyde, but the safety is questionable.

[edit] Other applications

Ethylene glycol’s high boiling point and affinity for water makes it an ideal desiccant for natural gas production. In the field, excess water vapor is usually removed by glycol dehydration. Ethylene glycol flows down from the top of a tower and meets a rising mixture of water vapor and hydrocarbon gases from the bottom. The glycol chemically removes the water vapor, allowing dry gas to exit from the top of the tower. The glycol and water are separated, and the glycol cycles back through the tower.

Ethylene glycol is also used in the manufacture of some vaccines, but it is not itself present in these injections. It is used as a minor (1–2%) ingredient in shoe polish and also in some inks and dyes. Ethylene glycol has seen some use as a rot and fungal treatment for wood, both as a preventative and a treatment after the fact. It has been used in a few cases to treat partially rotted wooden objects to be displayed in museums. It is one of only a few treatments that are successful in dealing with rot in wooden boats, and is relatively cheap.

[edit] Toxicity

The major danger from ethylene glycol is following ingestion. Due to its sweet taste, children and animals will sometimes consume large quantities of it if given access to antifreeze. Ethylene glycol may also be found as a contaminant in moonshine distilled using an improperly washed car radiator. In developed countries, a bittering agent called denatonium/denatonium benzoate, is generally added to ethylene glycol preparations as an adversant (to prevent accidental ingestion). If one has ingested ethylene glycol, give the person an alcoholic beverage while the paramedics arrive. Alcohol acts as a competitive inhibitor to the active site of the enzyme that converts ethylene glycol to its toxic metabolites. Once alcohol binds, the ethylene glycol is harmlessly excreted out of the body.

Ethylene glycol poisoning is a medical emergency and in all cases a poison control center should be contacted or medical attention should be sought. It is highly toxic with an estimated LD100 in humans of approximately 1.4 ml/kg.[5] However, as little as 30 milliliters (2 tablespoons) can be lethal to adults.[6]

[edit] Symptoms

Symptoms of ethylene glycol poisoning usually follow a three-step progression, although poisoned individuals will not always develop each stage or follow a specific time frame.[5] Stage 1 consists of neurological symptoms including victims appearing to be intoxicated, exhibiting symptoms such as dizziness, headaches, slurred speech, and confusion. Over time, the body metabolizes ethylene glycol into other toxins, first to glycolaldehyde, which is then oxidized to glycolic acid, glyoxylic acid, and finally oxalic acid. Stage 2 is a result of accumulation of these metabolites and consists of tachycardia, hypertension, hyperventilation, and metabolic acidosis. Stage 3 of ethylene glycol poisoning is the result of kidney injury, leading to acute kidney failure.[7] Oxalic acid reacts with calcium and forms calcium oxalate crystals in the kidney.

[edit] Treatment

Initial treatment consists of stabilizing the patient and gastric decontamination. As ethylene glycol is rapidly absorbed, gastric decontamination needs to be performed soon after ingestion to be of benefit. Gastric lavage or nasogastric aspiration of gastric contents are the most common methods employed in ethylene glycol poisoning. Ipecac-induced vomiting or activated charcoal (charcoal does not adsorb glycols) are not recommended. [5]

The antidotes for ethylene glycol poisoning are ethanol or fomepizole; antidotal treatment forms the mainstay of management following ingestion. Ethanol (usually given IV as a 5 or 10% solution in 5% dextrose and water, but, also sometimes given in the form of a strong spirit such as whisky, vodka or gin) acts by competing with ethylene glycol for the enzyme alcohol dehydrogenase thus limiting the formation of toxic metabolites. Fomepizole acts by inhibiting alcohol dehydrogenase, thus blocking the formation of the toxic metabolites.[8]

In addition to antidotes, hemodialysis can also be used to enhance the removal of unmetabolized ethylene glycol, as well as its metabolites from the body. Hemodialysis also has the added benefit of correcting other metabolic derangements or supporting deteriorating kidney function caused by ethylene glycol ingestion. Often both antidotal treatment and hemodialysis are used together in the treatment of poisoning.

[edit] Industrial hazards

Ethylene glycol can begin to breakdown at 230° – 250°F (110° – 121°C). Note that breakdown can occur when the system bulk (average) temperature is below these limits because surface temperatures in heat exchangers and boilers can be locally well above these temperatures.

The electrolysis of ethylene glycol solutions with a silver anode results in an exothermic reaction. The Apollo 1 fire catastrophe was caused by this reaction. The ethylene glycol–water mixture was ignited and was able to burn in the atmosphere of pure low pressure oxygen.[citation needed]

[edit] History

Ethylene glycol was first prepared in 1859 by the French chemist Charles-Adolphe Wurtz. It was produced on a small scale during World War I as a coolant and as an ingredient in explosives. Widespread industrial production began in 1937 when ethylene oxide, a component in its synthesis, became cheaply available.

When first introduced it created a minor revolution in aircraft design because when used in place of water as an engine coolant, its higher boiling point allowed for smaller radiators operating at higher temperatures. Prior to the widespread availability of ethylene glycol, many aircraft manufacturers tried to use evaporative cooling systems which used water at high pressure. Invariably, these proved to be rather unreliable and were easily damaged in combat because they took up large amounts of room on the plane, where they were easily hit by gunfire.

[edit] See also

* Propylene glycol
* Diethylene glycol
* Ethylene glycol (data page)

[edit] References

1. ^ Glenn Elert. Viscosity. Retrieved on 2007-10-02.
2. ^ J. M. Hollis, F. J. Lovas, P. R. Jewell, L. H. Coudert (2002 May 20). “Interstellar Antifreeze: Ethylene Glycol”. The AstroPhysical Journal 571: L59-L62. DOI:10.1086/341148.
3. ^ Theodora W. Greene, Peter G. M. Wuts. Protective Groups in Organic Synthesis, Third Edition, John Wiley & Sons, 312-322. ISBN 0-471-16019-9.
4. ^ J. H. Babler, N. C. Malek and M. J. Coghlan (1978). “Selective hydrolysis of α,β- and β,γ-unsaturated ketals: method for deconjugation of β,β-disubstituted α,β-unsaturated ketones”. J. Org. Chem. 43 (9): 1821-1823. DOI:10.1021/jo00403a047.
5. ^ a b c Brent J (2001). “Current management of ethylene glycol poisoning”. Drugs 61 (7): 979-88. PMID 11434452.
6. ^ Field D (1985). “Acute ethylene glycol poisoning”. Crit Care Med 13 (10): 872-3. PMID 4028762.
7. ^ Barceloux DG, Krenzelok EP, Olson K, Watson W. (1999). “American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Ethylene Glycol Poisoning. Ad Hoc Committee”. J Toxicol Clin Toxicol 37 (5): 537-60. PMID 10497633.
8. ^ Brent J, McMartin K, Phillips S, Burkhart K, Donovan J, Wells M, Kulig K (1999). “Fomepizole for the treatment of ethylene glycol poisoning. Methylpyrazole for Toxic Alcohols Study Group”. N Engl J Med 340 (11): 832-8. PMID 10080845.

YANGON, 26 Sept�The Board of Trustees of Thiri Mingala Kaba Aye Pagoda organized Dhamma Puja Mingala ceremony to mark Full Moon Day of Tawthalin (Garu Dhamma Akhadaw Day) at the Thiri Mingala Kaba Aye Pagoda on Kaba Aye Hill here this afternoon.

Members of the pagoda board of trustees, and members of 21 Wut associations attended the ceremony.

The congregation recited Namo Tassa three times to launch the ceremony. Members of the Wut associations invited celestial beings, higher celestial beings, the Lord Buddha, and the two Chief Monk Disciples to the religious rites, and paid respects to the Pagoda, and observed Garu Dhamma (Five Precepts). Alternate chairman of the pagoda board of trustees U Saw Kyaing gave talks on Mingala (auscipiousness). The congregation recited religious verses on introduction of Garu Dhamma Jataka, Garu Dhamma, and Maha Dhamma Pala Jataka. They also recited the religious verse on the Five Precepts and shared the merits gained. Next, they recited verses on prayers.

The ceremony ended with three-time recitation of Buddha Sasanam Ciram Titthatu.