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https://www.readbyqxmd.com/read/30041918/rhabdomyolysis-is-it-an-overlooked-dka-complication
#1
Omar Farooq Nafea Al-Azzawi, Manal Khudder Abdul Razak, Surra Jabory Hammody
BACKGROUND: Rhabdomyolysis is considered by some studies as a rare complication of a common disorder of diabetic ketoacidosis, while others consider it as not so uncommon. The mechanism is still not clear but can be attributed to a number of factors like acidosis, hyperglycemia and electrolyte disturbances especially hypophosphatemia and hypokalaemia. Missing it may lead to more serious complications and may prolong and/or complicate full recovery of diabetic ketoacidosis. AIM: The aim of this study was to measure the incidence of rhabdomyolysis among patients presented with diabetic ketoacidosis in the emergency department of Baghdad Teaching hospital, its relation to the severity of diabetic ketoacidosis and the associated electrolytes disturbances...
July 19, 2018: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/30026775/a-novel-mutation-of-beta-ketothiolase-deficiency-the-first-report-from-iran-and-review-of-literature
#2
Rahim Vakili, Somayyeh Hashemian
Beta-ketothiolase deficiency is a rare autosomal recessive disorder characterized by an inborn error of isoleucine catabolism and affecting ketone body metabolism. Clinical features characterized by intermittent keto acidotic episodes are associated with clinical signs and symptoms of toxic encephalopathy such as lethargy, hypotonia, vomiting, tachypnea, and coma in some patients, with an onset during infancy or toddler-hood. A two months old girl presented to pediatric ward of Imam Reza Hospital in Mashhad City, Northwestern Iran in October 2016, with acute episode of fever and toxic encephalopathy with attack of vomiting, hypotonia, lethargy, tonic-clonic seizures and then a day in coma, few days after vaccination...
2018: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/30014008/recurrent-encephalopathy-during-febrile-illnesses-in-a-6-year-old-boy
#3
Eliza Szuch, Jeanna Auriemma
Acute onset of encephalopathy is often due to infections or intoxications, but a high index of suspicion should exist for metabolic or autoimmune causes particularly in recurrent cases. A 6-year-old previously healthy Caucasian male presented with confusion and somnolence. He had several days of fever, myalgia, headaches, and rhinorrhea and was influenza-A positive. He was noted to have new urinary incontinence, inability to follow commands, and was responsive only to noxious stimuli. His neurological examination revealed bilateral ankle clonus...
2018: Global Pediatric Health
https://www.readbyqxmd.com/read/29997690/prevalence-of-maternal-urinary-ketones-in-pregnancy-in-overweight-and-obese-women
#4
Helen L Robinson, Helen L Barrett, Katie Foxcroft, Leonie K Callaway, Marloes Dekker Nitert
Background: Ketonuria may be associated with adverse fetal outcomes. This study aimed to determine the prevalence of ketonuria at three time points in pregnancy and to assess whether ketonuria correlates with a clinical indication for performing a urine test. Methods: Women had fasting urinary ketone levels measured at 16 and 28 weeks gestation and random ketone levels measured close to 36 weeks gestation. All ketone levels in the third trimester were recorded along with the clinical indication for the test...
June 2018: Obstetric Medicine
https://www.readbyqxmd.com/read/29986720/efficacy-of-ketogenic-diet-on-body-composition-during-resistance-training-in-trained-men-a-randomized-controlled-trial
#5
RANDOMIZED CONTROLLED TRIAL
Salvador Vargas, Ramón Romance, Jorge L Petro, Diego A Bonilla, Ismael Galancho, Sergio Espinar, Richard B Kreider, Javier Benítez-Porres
BACKGROUND: Ketogenic diets (KD) have become a popular method of promoting weight loss. More recently, some have recommended that athletes adhere to ketogenic diets in order to optimize changes in body composition during training. This study evaluated the efficacy of an 8-week ketogenic diet (KD) during energy surplus and resistance training (RT) protocol on body composition in trained men. METHODS: Twenty-four healthy men (age 30 ± 4.7 years; weight 76.7 ± 8...
July 9, 2018: Journal of the International Society of Sports Nutrition
https://www.readbyqxmd.com/read/29766633/empagliflozin-as-adjunct-to-insulin-in-japanese-participants-with-type-1-diabetes-results-of-a-4-week-double-blind-randomized-placebo-controlled-phase-2-trial
#6
Akira Shimada, Toshiaki Hanafusa, Atsutaka Yasui, Ganghyuck Lee, Yusuke Taneda, Akiko Sarashina, Kosuke Shiki, Jyothis George, Nima Soleymanlou, Jan Marquard
AIMS: This phase 2, double-blind, randomized, placebo-controlled trial (ClinicalTrials.gov NCT02702011) with 4 sites in Japan investigated the pharmacodynamics (PD), pharmacokinetics (PK) and safety profile of empagliflozin in Japanese participants with type 1 diabetes mellitus (T1DM) as adjunctive therapy to insulin. MATERIALS AND METHODS: Participants using multiple daily injections of insulin for ≥12 months, with HbA1c of 7.5%-10.0%, entered a 2-week, open-label, placebo run-in period, followed by a 4-week, double-blind period during which participants were randomized 1:1:1:1 to receive empagliflozin 2...
May 15, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29719393/biological-responses-to-core-shell-structured-fe-3-o-4-sio-2-nh-2-nanoparticles-in-rats-by-a-nuclear-magnetic-resonance-based-metabonomic-strategy
#7
Zhongxue Yuan, Rui Xu, Jinquan Li, Yueli Chen, Binghui Wu, Jianghua Feng, Zhong Chen
Background: Core-shell-structured nanoparticles (NPs) have attracted much scientific attention due to their promising potential in biomedical fields in recent years. However, their underlying mechanisms of action and potential adverse effects following administration remain unknown. Methods: In the present study, a 1 H nuclear magnetic resonance-based metabonomic strategy was applied to investigate the metabolic consequences in rats following the intravenous administration of parent NPs of core-shell-structured nanoparticles, Fe3 O4 @SiO2 -NH2 (Fe@Si) NPs...
2018: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/29715177/updated-review-of-postmortem-biochemical-exploration-of-hypothermia-with-a-presentation-of-standard-strategy-of-sampling-and-analyses
#8
Guillaume Rousseau, Pascal Reynier, Nathalie Jousset, Clotilde Rougé-Maillart, Cristian Palmiere
Hypothermia is defined as a core body temperature below 35°C and can be caused by environmental exposure, drug intoxication, metabolic or nervous system dysfunction. This lethal pathology with medico-legal implications is complex to diagnose because macroscopic and microscopic lesions observed at the autopsy and the histological analysis are suggestive but not pathognomonic. Postmortem biochemical explorations have been progressively developed through the study of several biomarkers to improve the diagnosis decision cluster...
May 1, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29651419/management-of-glioblastoma-multiforme-in-a-patient-treated-with-ketogenic-metabolic-therapy-and-modified-standard-of-care-a-24-month-follow-up
#9
Ahmed M A Elsakka, Mohamed Abdel Bary, Eman Abdelzaher, Mostafa Elnaggar, Miriam Kalamian, Purna Mukherjee, Thomas N Seyfried
Few advances have been made in overall survival for glioblastoma multiforme (GBM) in more than 40 years. Here, we report the case of a 38-year-old man who presented with chronic headache, nausea, and vomiting accompanied by left partial motor seizures and upper left limb weakness. Enhanced brain magnetic resonance imaging revealed a solid cystic lesion in the right partial space suggesting GBM. Serum testing revealed vitamin D deficiency and elevated levels of insulin and triglycerides. Prior to subtotal tumor resection and standard of care (SOC), the patient conducted a 72-h water-only fast...
2018: Frontiers in Nutrition
https://www.readbyqxmd.com/read/29621522/metabolic-changes-in-urine-and-serum-during-progression-of-diabetic-kidney-disease-in-a-mouse-model
#10
Nan Hee Kim, Jin Seong Hyeon, Nam Hoon Kim, Ahreum Cho, Gayoung Lee, Seo Young Jang, Mi-Kyung Kim, Eun Young Lee, Choon Hee Chung, Hunjoo Ha, Geum Sook Hwang
Diabetic kidney disease (DKD) involves various pathogenic processes during progression to end stage renal disease, and activated metabolic pathways might be changing based on major pathophysiologic mechanisms as DKD progresses. In this study, nuclear magnetic resonance spectroscopy (NMR)-based metabolic profiling was performed in db/db mice to suggest potential biomarkers for early detection and its progression. We compared concentrations of serum and urinary metabolites between db/m and db/db mice at 8 or 20 weeks of age and investigated whether changes between 8 and 20 weeks in each group were significant...
May 15, 2018: Archives of Biochemistry and Biophysics
https://www.readbyqxmd.com/read/29470628/bladder-debris-on-ultrasound-in-the-emergency-department-correlation-with-urinalysis
#11
Ghaneh Fananapazir, Behrad Golshani, Ling-Xin Chen, John P McGahan, Angelo M de Mattos, Michael T Corwin
PURPOSE: To evaluate the correlation between the presence of bladder debris on ultrasound and urinalysis results in the emergency department setting. METHODS: Adult patients presenting to the emergency department with an ultrasound of the bladder and a urinalysis performed within 24 h of the ultrasound were included in this retrospective study. Two radiologists in consensus evaluated for the presence or absence of debris within the bladder. Urinalysis results were recorded including continuous variables (specific gravity and pH) and categorical variables (presence of occult blood, bilirubin, ketones, glucose, protein, urobilinogen, nitrite, leukocyte esterase, white blood cells, and red blood cells)...
February 22, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29163194/on-the-metabolism-of-exogenous-ketones-in-humans
#12
Brianna J Stubbs, Pete J Cox, Rhys D Evans, Peter Santer, Jack J Miller, Olivia K Faull, Snapper Magor-Elliott, Satoshi Hiyama, Matthew Stirling, Kieran Clarke
Background and aims: Currently there is considerable interest in ketone metabolism owing to recently reported benefits of ketosis for human health. Traditionally, ketosis has been achieved by following a high-fat, low-carbohydrate "ketogenic" diet, but adherence to such diets can be difficult. An alternative way to increase blood D-β-hydroxybutyrate (D-βHB) concentrations is ketone drinks, but the metabolic effects of exogenous ketones are relatively unknown. Here, healthy human volunteers took part in three randomized metabolic studies of drinks containing a ketone ester (KE); (R)-3-hydroxybutyl (R)-3-hydroxybutyrate, or ketone salts (KS); sodium plus potassium βHB...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29025285/safety-and-efficacy-of-canagliflozin-in-elderly-patients-with-type-2-diabetes-mellitus-a-1-year-post-marketing-surveillance-in-japan
#13
Maki Goda, Tomoko Yamakura, Kazuyo Sasaki, Takumi Tajima, Makoto Ueno
OBJECTIVE: To evaluate the safety and efficacy of canagliflozin in elderly patients with type 2 diabetes mellitus (T2DM) in clinical settings. METHODS: The authors conducted a 1-year post-marketing surveillance (PMS) of canagliflozin in almost all the elderly patients (≥65 years old) with T2DM who began taking canagliflozin during the first 3 months after its launch in Japan. The main outcomes included the incidences of adverse drug reactions (ADRs), serious ADRs, and the changes of laboratory tests as well as efficacy variables...
February 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28878168/metabolomics-analysis-of-urine-samples-from-children-after-acetaminophen-overdose
#14
Laura K Schnackenberg, Jinchun Sun, Sudeepa Bhattacharyya, Pritmohinder Gill, Laura P James, Richard D Beger
Acetaminophen (APAP), a commonly used over-the-counter analgesic, accounts for approximately fifty percent of the cases of acute liver failure (ALF) in the United States due to overdose, with over half of those unintentional. Current clinical approaches for assessing APAP overdose rely on identifying the precise time of overdose and quantitating acetaminophen alanine aminotransferase (ALT) levels in peripheral blood. Novel specific and sensitive biomarkers may provide additional information regarding patient status post overdose...
September 6, 2017: Metabolites
https://www.readbyqxmd.com/read/28761628/modified-atkins-diet-in-adult-with-refractory-epilepsy-a-controlled-randomized-clinical-trial
#15
Mohammad Zare, Ali Asghar Okhovat, Ahmad Esmaillzadeh, Jafar Mehvari, Mohammad Reza Najafi, Mohammad Saadatnia
Background: The usefulness of the modified Atkins diet (mAD) in refractory epilepsy in adults has been rarely investigated. We aimed to evaluate the efficacy of mAD in adult with refractory epilepsy. Methods: In a controlled randomized clinical trial, we enrolled 66 refractory adult epileptic cases from February 2010 to December 2012. The patients were randomly divided into two groups, case groups (22 patients) used antiepileptic drugs and mAD and control group (32 patients) only use antiepileptic drugs. The primary outcome was at least 50% decrement in seizure frequency after 2 months of therapy...
April 4, 2017: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/28347463/level-of-minerals-and-trace-elements-in-the-urine-of-the-participants-of-mountain-ultra-marathon-race
#16
Jasna Jablan, Suzana Inić, Hagen Stosnach, Maja Ortner Hadžiabdić, Lovorka Vujić, Ana-Marija Domijan
The aim of the present study was to explore impact of endurance exercise on urinary level of minerals and trace elements as well as on some oxidative stress and biochemical parameters. Urine samples were collected from participants (n=21) of mountain ultra-marathon race (53km; Medvednica, Zagreb, Croatia), before (baseline value), immediately after, 12h and 24h after the race. In urine samples level of minerals (Ca, P, K and Na) and trace elements (Se, Zn, Mn, Cu, Fe and Co) were assessed using the bench top Total reflection X-ray Fluorescence (TXRF) spectrometer...
May 2017: Journal of Trace Elements in Medicine and Biology
https://www.readbyqxmd.com/read/28325783/renal-handling-of-ketones-in-response-to-sodium-glucose-cotransporter-2-inhibition-in-patients-with-type-2-diabetes
#17
Ele Ferrannini, Simona Baldi, Silvia Frascerra, Brenno Astiarraga, Elisabetta Barsotti, Aldo Clerico, Elza Muscelli
OBJECTIVE: Pharmacologically induced glycosuria elicits adaptive responses in glucose homeostasis and hormone release, including decrements in plasma glucose and insulin levels, increments in glucagon release, enhanced lipolysis, and stimulation of ketogenesis, resulting in an increase in ketonemia. We aimed at assessing the renal response to these changes. RESEARCH DESIGN AND METHODS: We measured fasting and postmeal urinary excretion of glucose, β-hydroxybutyrate (β-HB), lactate, and sodium in 66 previously reported patients with type 2 diabetes and preserved renal function (estimated glomerular filtration rate ≥60 mL · min-1 · 1...
June 2017: Diabetes Care
https://www.readbyqxmd.com/read/28287425/the-relationship-between-mitochondrial-respiratory-chain-activities-in-muscle-and-metabolites-in-plasma-and-urine-a-retrospective-study
#18
Corinne Alban, Elena Fatale, Abed Joulani, Polina Ilin, Ann Saada
The relationship between 114 cases with decreased enzymatic activities of mitochondrial respiratory chain (MRC) complexes I-V (C I-V) in muscle and metabolites in urine and plasma was retrospectively examined. Less than 35% disclosed abnormal plasma amino acids and acylcarnitines, with elevated alanine and low free carnitine or elevated C4-OH-carnitine as the most common findings, respectively. Abnormal urine organic acids (OA) were detected in 82% of all cases. In CI and CII defects, lactic acid (LA) in combination with other metabolites was the most common finding...
March 10, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28239404/impact-of-a-6-week-non-energy-restricted-ketogenic-diet-on-physical-fitness-body-composition-and-biochemical-parameters-in-healthy-adults
#19
Paul Urbain, Lena Strom, Lena Morawski, Anja Wehrle, Peter Deibert, Hartmut Bertz
BACKGROUND: The ketogenic diet (KD) is a very low-carbohydrate, high-fat and adequate-protein diet that without limiting calories induces different metabolic adaptations, eg, increased levels of circulating ketone bodies and a shift to lipid metabolism. Our objective was to assess the impact of a 6-week non-energy-restricted KD in healthy adults beyond cohorts of athletes on physical performance, body composition, and blood parameters. METHODS: Our single arm, before-and-after comparison study consisted of a 6-week KD with a previous preparation period including detailed instructions during classes and individual counselling by a dietitian...
2017: Nutrition & Metabolism
https://www.readbyqxmd.com/read/28178390/metabolic-and-hemodynamic-effects-of-sodium-dependent-glucose-cotransporter-2-inhibitors-on-cardio-renal-protection-in-the-treatment-of-patients-with-type-2-diabetes-mellitus
#20
REVIEW
Atsunori Kashiwagi, Hiroshi Maegawa
The specific sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) inhibit glucose reabsorption in proximal renal tubular cells, and both fasting and postprandial glucose significantly decrease because of urinary glucose loss. As a result, pancreatic β-cell function and peripheral insulin action significantly improve with relief from glucose toxicity. Furthermore, whole-body energy metabolism changes to relative glucose deficiency and triggers increased lipolysis in fat cells, and fatty acid oxidation and then ketone body production in the liver during treatment with SGLT2 inhibitors...
July 2017: Journal of Diabetes Investigation
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