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https://www.readbyqxmd.com/read/28718098/massive-hemorrhage-and-transfusion-in-the-operating-room
#1
Brian Muirhead, Andrew D H Weiss
PURPOSE: In this Continuing Professional Development module, we review the pathophysiology and clinical manifestations associated with massive hemorrhage as well as laboratory investigations and appropriate therapeutic measures. In addition to reviewing the available blood/plasma products and adjunct therapy, we also explore the role of the anesthesiologist in a massive transfusion protocol scenario. PRINCIPAL FINDINGS: Massive hemorrhage can be either anticipated or unexpected...
July 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28715463/potassium-citrate-prevents-increased-osteoclastogenesis-resulting-from-acidic-conditions-implication-for-the-treatment-of-postmenopausal-bone-loss
#2
Donatella Granchi, Elena Torreggiani, Annamaria Massa, Renata Caudarella, Gemma Di Pompo, Nicola Baldini
The extracellular acidic milieu in bones results in activation of osteoclasts (OC) and inhibition of osteoblasts (OB) causing a net loss of calcium from the skeleton and the deterioration of bone microarchitecture. Alkalinization through supplementation with potassium citrate (K citrate) has been proposed to limit the osteopenia progression, even though its pharmacological activity in bone microenvironment is not well defined. We evaluated if K citrate was able to prevent the adverse effects that acidic milieu induces on bone cells...
2017: PloS One
https://www.readbyqxmd.com/read/28714513/in-vivo-evaluation-of-tumour-acidosis-for-assessing-the-early-metabolic-response-and-onset-of-resistance-to-dichloroacetate-by-using-magnetic-resonance-ph-imaging
#3
Annasofia Anemone, Lorena Consolino, Laura Conti, Francesca Reineri, Federica Cavallo, Silvio Aime, Dario Livio Longo
Dichloroacetate (DCA) can reverse the glycolytic phenotype that is responsible of increased lactate production and extracellular pH acidification in cancer cells. Magnetic resonance imaging-chemical exchange saturation transfer (MRI-CEST) pH mapping is a novel non-invasive imaging approach that can measure in vivo extracellular tumour pH. We examined whether MRI-CEST pH mapping can monitor in vivo changes in tumour acidosis for assessing treatment response to DCA. Cell viability and extracellular pH were assessed in TS/A breast cancer cells treated with 1-10 mM DCA for 24 h in normoxia or hypoxia (1% O2) conditions...
August 2017: International Journal of Oncology
https://www.readbyqxmd.com/read/28712726/sengers-syndrome-associated-mitochondrial-acylglycerol-kinase-is-a-subunit-of-the-human-tim22-protein-import-complex
#4
Yilin Kang, David A Stroud, Michael J Baker, David P De Souza, Ann E Frazier, Michael Liem, Dedreia Tull, Suresh Mathivanan, Malcolm J McConville, David R Thorburn, Michael T Ryan, Diana Stojanovski
Acylglycerol kinase (AGK) is a mitochondrial lipid kinase that catalyzes the phosphorylation of monoacylglycerol and diacylglycerol to lysophosphatidic acid and phosphatidic acid, respectively. Mutations in AGK cause Sengers syndrome, which is characterized by congenital cataracts, hypertrophic cardiomyopathy, skeletal myopathy, exercise intolerance, and lactic acidosis. Here we identified AGK as a subunit of the mitochondrial TIM22 protein import complex. We show that AGK functions in a kinase-independent manner to maintain the integrity of the TIM22 complex, where it facilitates the import and assembly of mitochondrial carrier proteins...
July 11, 2017: Molecular Cell
https://www.readbyqxmd.com/read/28711257/seasonal-and-maternal-effects-on-acid-base-l-lactate-electrolyte-and-hematological-status-of-205-dairy-calves-born-to-eutocic-dams
#5
L Kovács, F L Kézér, E Albert, F Ruff, O Szenci
In this study, we used linear mixed models to determine the effects of season, time of sampling relative to birth (factors), duration of the delivery process, duration of maternal grooming, calf body weight (BW) at birth, and time of day (covariates) on values of venous blood gas, acid-base and electrolyte parameters, and l-lactate concentrations in dairy calves born to eutocic dams in summer (SUM, n = 101) and winter (WIN, n = 104). Neonatal vitality was assessed at 0, 1, and 24 h after delivery in a linear scoring system using muscle tone, erection of the head, muscle reflexes, heart rate, and sucking drive as criteria...
July 12, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28710307/is-it-safe-to-acutely-discontinue-insulin-therapy-in-patients-with-chronic-hyperglycaemia-starting-glp-1r-agonists
#6
Julie Omolola Okiro, Catherine Mc Hugh, Abuelmagd Abdalla
We report two patients with chronic hyperglycaemia secondary to type 2 diabetes who developed severe vomiting on d. The first patient was diagnosed with a mixed picture of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) and the second, with DKA. They were on insulin therapy which was discontinued on commencing d because of inefficacy and weight gain. The HHS patient developed dehydration secondary to vomiting and had lactic acidosis but no other precipitant could be found in either case...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28710236/complement-factor-b-mutation-associated-ahus-and-myocardial-infarction
#7
Natália Noronha, Filipa Dias Costa, Andrea Dias, Alexandra Dinis
A 6-month-old female infant was referred with a 3-day history of low-grade fever, slight nasal congestion and rhinorrhoea. On admission, the clinical findings were unremarkable and she was discharged home. However, she became progressively more listless with a decreased urine output and was once again seen in the emergency department. Analytically she was found to have metabolic acidosis, hyperkalaemia, thrombocytopaenia, anaemia and schistocytes in the peripheral blood smear. Based on these findings, the diagnosis of haemolyticâ-uremic syndrome was made...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28708460/tolerance-to-hypercarbia-is-repeatable-and-related-to-a-component-of-the-metabolic-phenotype-in-a-freshwater-fish
#8
Caleb T Hasler, Ian A Bouyoucos, Cory D Suski
Freshwater fish may be exposed to high levels of carbon dioxide (CO2) because of several actions, including anesthesia and high levels of aquatic respiration and potentially as the result of using high-CO2 plumes as a barrier to the movements of invasive fishes. Metabolic phenotype can potentially drive how freshwater fish respond to high CO2. We therefore quantified how tolerance (measured using time to equilibrium loss [ELT]) was driven by metabolic phenotype in a cosmopolitan freshwater fish species, Micropterus salmoides...
September 2017: Physiological and Biochemical Zoology: PBZ
https://www.readbyqxmd.com/read/28707991/a-case-study-of-intractable-diarrhea-due-to-neonatal-microvillous-inclusion-disease
#9
Ozgul Bulut, Bulent Ahishali, Mine Gulluoglu, Sertac Arslanoglu
BACKGROUND: Microvillous inclusion disease (MVID) is one of the most severe congenital diarrhea disorders, caused by a genetic defect in enterocyte differentiation and polarization. CASE REPORT: We describe a neonate who presented with severe weight loss, hypernatremic dehydration and metabolic acidosis due to intractable diarrhea due to MVID, confirmed by electron microscopy Conclusion: MVID can present with severe weight loss, hypernatremic dehydration and metabolic acidosis that is life threatening...
July 14, 2017: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/28707030/-update-acute-hypercapnic-respiratory-failure
#10
REVIEW
F Seiler, F C Trudzinski, M Kredel, C Lotz, P M Lepper, R M Muellenbach
BACKGROUND: Hypercapnic respiratory failure is a frequent problem in critical care and mainly affects patients with acute exacerbation of COPD (AECOPD) and acute respiratory distress syndrome (ARDS). In recent years, the usage of extracorporeal CO2 removal (ECCO2R) has been increasing. OBJECTIVE: Summarizing the state of the art in the management of hypercapnic respiratory failure with special regard to the role of ECCO2R. METHODS: Review based on a selective literature search and the clinical and scientific experience of the authors...
July 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28702957/non-invasive-ventilation-for-the-management-of-acute-hypercapnic-respiratory-failure-due-to-exacerbation-of-chronic-obstructive-pulmonary-disease
#11
REVIEW
Christian R Osadnik, Vanessa S Tee, Kristin V Carson-Chahhoud, Joanna Picot, Jadwiga A Wedzicha, Brian J Smith
BACKGROUND: Non-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: To compare the efficacy of NIV applied in conjunction with usual care versus usual care involving no mechanical ventilation alone in adults with AHRF due to AECOPD. The aim of this review is to update the evidence base with the goals of supporting clinical practice and providing recommendations for future evaluation and research...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28702099/strategies-for-early-metabolic-disturbances-in-patients-with-an-end-jejunostomy-or-end-ileostomy-experience-from-a-specialized-home-parenteral-nutrition-hpn-center
#12
Michał Ławiński, Dominika Haraszczuk, Aleksandra Gradowska, Justyna Z Kostro, Agnieszka Bzikowska, Jacek Sobocki
INTRODUCTION: An end stoma syndrome is usually the result of an intentional surgical intervention in the course of staged treatment or a complication of surgery. These patients most frequently suffer from water and electrolyte disturbances, malnutrition syndromes caused by malabsorption of trace elements and/or vitamins, and undernutrition. AIM: To present early metabolic disturbances observed in patients with an end jejunostomy or end ileostomy syndrome on the first day of their hospitalization in a specialist Home Parenteral Nutrition (HPN) center...
2017: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/28701845/fatal-postoperative-hemolysis-due-to-severe-falciparum-malaria
#13
Amol T Kothekar, Vijaya Patil, Nambiraj Konar, Jigeeshu Divatia
A 60-year-old apparently healthy female patient underwent mastectomy for breast cancer. She had sinus tachycardia and no other abnormal finding in the preoperative period. However, the immediate postoperative course was stormy with the development of anemia, thrombocytopenia, hemolysis, and renal failure with severe metabolic acidosis. Peripheral blood smear revealed the presence of ring forms of Plasmodium falciparum. Multiorgan failure and death occurred within 36 h of surgery in spite of initiation of antimalarial agents...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28700408/three-versus-four-factor-prothrombin-complex-concentrates-for-factor-based-resuscitation-in-a-porcine-hemorrhagic-shock-model
#14
Donald Michael Moe, Michael Scott Lallemand, John Mason McClellan, Joshua Porter Smith, Shannon T Marko, Matthew J Eckert, Matthew J Martin
BACKGROUND: Bleeding is a leading cause of preventable death following severe injury. Prothrombin complex concentrates (PCC) treat inborn coagulation disorders and reverse oral anticoagulants, but are proposed for use in "factor-based" resuscitation strategies. Few studies exist for this indication in acidosis, or that compare 3-factor (3PCC) versus 4-factor (4PCC) products. We aimed to assess and compare their safety and efficacy in a porcine model of severe hemorrhagic shock and coagulopathy...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28700186/-the-treatment-of-aki-in-nephrology-hospitalization-the-sle-hdf-15-litres-in-10-hours
#15
REVIEW
Marcello Napoli, Maria Luisa Lefons, Giovanni Sandri, Efisio Sozzo, Carmela Ambrosino
The AKI in intensive care has been widely treated by international and national guidelines. The treatment of AKI in patients not requiring admission in Intensive Care Unit, but often hospitalized in Nephrology Unit, it is showed of less relevance. For over 5 years we have used for the treatment of AKI of patients admitted in Nephrology Unit an intermittent slow technique, implemented in approximately 600 patients with AKI for a total of about 3000 treatments. In this study we report the clinical results obtained in 100 consecutive patients referred to our Nephrology Unit from 1st January 2014...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28697025/reboa-for-the-ivc-resuscitative-balloon-occlusion-of-the-inferior-vena-cava-rebovc-to-abate-massive-hemorrhage-in-retro-hepatic-vena-cava-injuries
#16
Cassandra L Reynolds, Adam C Celio, Lindsay C Bridges, Catalina Mosquera, Brian O'Connell, Michael R Bard, Connie M DeLa'o, Eric A Toschlog
BACKGROUND: The use of resuscitative endovascular balloon occlusion as a maneuver for occlusion of the aorta is well described. This technique has life-saving potential in other cases of traumatic hemorrhage. Retro-hepatic inferior vena cava (IVC) injuries have a high rate of mortality, in part, due to the difficulty in achieving total vascular isolation. This studies purpose was to investigate the ability of resuscitative balloon occlusion of the IVC (REBOVC) to control supra-hepatic IVC hemorrhage in a swine model of trauma...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28695670/mitochondrial-dysfunction-and-cerebral-metabolic-abnormalities-in-patients-with-mitochondrial-encephalomyopathy-subtypes-evidence-from-proton-mr-spectroscopy-and-muscle-biopsy
#17
Feng-Nan Niu, Hai-Lan Meng, Lei-Lei Chang, Hong-Yan Wu, Wei-Ping Li, Ren-Yuan Liu, Hui-Ting Wang, Bing Zhang, Yun Xu
AIMS: Accumulated evidence indicates that cerebral metabolic features, evaluated by proton magnetic resonance spectroscopy ((1) H-MRS), are sensitive to early mitochondrion dysfunction associated with mitochondrial encephalomyopathy (ME). The metabolite ratios of lactate (lac)/Cr, N-acetyl aspartate (NAA)/creatine (Cr), total choline (tCho)/Cr, and myoinositol (mI)/Cr are measured in the infarct-like lesions by (1) H-MRS and may reveal metabolic changes associated with ME. However, the application of this molecular imaging technique in the investigation of the pathology of ME subtypes is unknown...
July 11, 2017: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/28694730/topiramate-induced-metabolic-acidosis-and-kidney-stones-a-case-study
#18
Tomas Salek, Ivan Andel, Irena Kurfurstova
INTRODUCTION: The aim of this study is to present a case of 44 years old woman with topiramate induced metabolic acidosis and kidney stones. MATERIALS AND METHODS: The laboratory features of topiramate caused renal tubular acidosis in blood and urine during topiramate treatment, with correction of metabolic acidosis by potassium citrate, and after topiramate withdrawal are presented. Differential diagnosis of all possible causes of metabolic acidosis is discussed...
June 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/28693440/serum-lactate-level-and-mortality-in-metformin-associated-lactic-acidosis-requiring-renal-replacement-therapy-a-systematic-review-of-case-reports-and-case-series
#19
Hung-Chieh Yeh, I-Wen Ting, Ching-Wei Tsai, Jenn-Yu Wu, Chin-Chi Kuo
BACKGROUND: The current practice concerning timing, mode, and dose of renal replacement therapy (RRT) in patients with metformin-associated lactic acidosis (MALA) with renal failure remains unknown. To investigate whether serum lactate level and prescription pattern of RRT are associated with mortality in patients with MALA requiring RRT. METHODS: We searched PubMed/Medline and EMBASE from inception to Sep 2014 and applied predetermined exclusion criteria. Case-level data including case's demographics and clinical information related to MALA were abstracted...
July 10, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28689977/design-and-synthesis-of-potent-and-orally-active-gpr4-antagonists-with-modulatory-effects-on-nociception-inflammation-and-angiogenesis
#20
Wolfgang Miltz, Juraj Velcicky, Janet Dawson, Amanda Littlewood-Evans, Marie-Gabrielle Ludwig, Klaus Seuwen, Roland Feifel, Berndt Oberhauser, Arndt Meyer, Daniela Gabriel, Mark Nash, Pius Loetscher
GPR4, a G-protein coupled receptor, functions as a proton sensor being activated by extracellular acidic pH and has been implicated in playing a key role in acidosis associated with a variety of inflammatory conditions. An orally active GPR4 antagonist 39c was developed, starting from a high throughput screening hit 1. The compound shows potent cellular activity and is efficacious in animal models of angiogenesis, inflammation and pain.
June 29, 2017: Bioorganic & Medicinal Chemistry
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