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Anion gap

Purva Sharma, Yash Jobanputra, Karen Lewin, Stuart Bagatell, Daniel Lichtstein
BACKGROUND: Diabetic ketoacidosis (DKA) is a serious complication of diabetes seen commonly in autoimmune Type 1 diabetes mellitus (DM), however patients with Type 2 diabetes are also at risk. Diabetic ketoacidosis may be precipitated by the catabolic stress of acute illness such as trauma, surgery, or infections. Recent studies have suggested that sodium glucose cotransporter-2 (SGLT-2) inhibitors precipitate DKA in Type 2 diabetes. We present a case series of four patients on SGLT-2 inhibitors who presented with DKA...
March 13, 2018: Reviews on Recent Clinical Trials
Inga Markeviciute, Wolfgang Frenzel
Sample preparation is a key issue in the analysis of many real samples using ion chromatography (IC). One of the many means of sample preparation that has received considerable attention in recent years is the stopped-flow in-line dialysis approach hyphenated to IC. Using appropriate dialysis membranes undesirable high-molecular weight compounds, colloids and dispersed particulate matter are retained whereas the analyte ions pass through the membrane and are separated and quantified by IC. However, in the many papers about analytical use of in-line dialysis (not only in connection with IC) the retention of undesirable compounds has never been quantified...
August 3, 2018: Analytica Chimica Acta
Shalendra Singh, Ankur Khandelwal, Rashmi Datta, Ashutosh Kaushal, Gyaninder Pal Singh
High-dose continuous midazolam therapy has been used successfully for control of refractory status epilepticus. However, normal anion gap (AG) metabolic acidosis, a deleterious complication of this therapy is underrecognized. Even though previously reported in an isolated case report in a pediatric patient, we observed similar complication in an adult patient. Stereotyped normal AG metabolic acidosis along with hypotension developed on two occasions during high-dose continuous midazolam hydrochloride infusion that reverted rapidly following cessation of the infusion...
February 2018: Indian Journal of Critical Care Medicine
A S Sagar, Carlos A Jimenez, Brandy J Mckelvy
Ethylene glycol toxicity is a known cause of anion gap metabolic acidosis, with the presence of an osmolar gap and the right clinical context suggesting to the diagnosis. Rapid recognition and early treatment is crucial. Unfortunately, ethylene glycol levels are not readily available and must be performed at a reference laboratory. We present a case where recognising the significance of the 'lactate gap' assisted in identifying ethylene glycol poisoning.
March 9, 2018: BMJ Case Reports
Cora L Singleton, Michelle L Sauther, Frank P Cuozzo, Ibrahim Antho Youssouf Jacky
The health of 44 wild ring-tailed lemurs ( Lemur catta) at the Bezà Mahafaly Special Reserve was assessed across three age classes: <5 yr (young), 5-9 yr (adult), and ≥10 yr (old). Hematology and biochemistry tests were performed manually (leukocyte count and differential, packed cell volume, total protein) and using a point-of-care analyzer (hematocrit, hemoglobin, glucose, blood urea nitrogen, creatinine, sodium, potassium, chloride, ionized calcium, total carbon dioxide, anion gap), respectively. Urine specific gravity was measured via refractometry...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Johannes C van der Mijn, Mathijs J Kuiper, Carl E H Siegert, Annabeth E Wassenaar, Carel J M van Noesel, Aernout C Ogilvie
Lactic acidosis is a commonly observed clinical condition that is associated with a poor prognosis, especially in malignancies. We describe a case of an 81-year-old patient who presented with symptoms of tachypnea and general discomfort. Arterial blood gas analysis showed a high anion gap acidosis with a lactate level of 9.5 mmol/L with respiratory compensation. CT scanning showed no signs of pulmonary embolism or other causes of impaired tissue oxygenation. Despite treatment with sodium bicarbonate, the patient developed an adrenalin-resistant cardiac arrest, most likely caused by the acidosis...
September 2017: Case Reports in Oncology
Kyle M Conner, Amanda L Perugini, Miko Malabute, Seth N Brown
Bis(iminosemiquinone) complexes of divalent group 10 metals have been described as having open-shell singlet ground states characteristic of very strong coupling between the two ligand radicals. By using the nonlinear temperature dependence of the chemical shifts of the1 H NMR spectra, the singlet-triplet gaps in seven of these compounds have been measured, with the nickel compounds having gaps of about 2400 cm-1 and the palladium compounds about 1800 cm-1 . Bis(iminosemiquinone)platinum complexes have singlet-triplet gaps too large to measure by this technique (over 2800 cm-1 , estimated to be about 3000 cm-1 ), though bis(3,5-di- tert-butylbenzosemiquinonato)platinum(II) has a measurable singlet-triplet gap of 1850 cm-1 ...
March 6, 2018: Inorganic Chemistry
K Bachmann, A Kutter, R S Jud Schefer, N Sigrist
The aim of this study was to determine reference intervals (RI) for venous blood parameters determined with the RAPIDPoint 500 (RP500) blood gas analyzer using blood gas syringes (BGS) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGS. The null hypothesis was that canine venous blood samples collected in BGS and in LH tubes are comparable. Jugular blood was collected from 51 healthy dogs into a BGS and a LH tube...
March 2018: Schweizer Archiv Für Tierheilkunde
Katja N Adamik, Rafael Obrador, Judith Howard
OBJECTIVE: To evaluate the effects of a 6% hydroxyethyl starch (130/0.42) in either a buffered, electrolyte-balanced (HES-BAL) or saline (HES-SAL) carrier solution on electrolyte concentrations and acid-base parameters in healthy anaesthetized dogs. STUDY DESIGN: Prospective randomised clinical study. ANIMALS: A group of 40 client-owned dogs undergoing general anaesthesia for elective surgical procedures or diagnostic imaging. METHODS: During anaesthesia, dogs were intravenously administered 15 mL kg-1 of either HES-SAL (n = 20) or HES-BAL (n = 20) over 30-40 minutes...
January 11, 2018: Veterinary Anaesthesia and Analgesia
Lori-Anne P Schillaci, Suzanne D DeBrosse, Shawn E McCandless
When a child presents with high-anion gap metabolic acidosis, the pediatrician can proceed with confidence by recalling some basic principles. Defects of organic acid, pyruvate, and ketone body metabolism that present with acute acidosis are reviewed. Flowcharts for identifying the underlying cause and initiating life-saving therapy are provided. By evaluating electrolytes, blood sugar, lactate, ammonia, and urine ketones, the provider can determine the likelihood of an inborn error of metabolism. Freezing serum, plasma, and urine samples during the acute presentation for definitive diagnostic testing at the provider's convenience aids in the differential diagnosis...
April 2018: Pediatric Clinics of North America
G Skalley, S Rodríguez-Villar
Threatening refractory metabolic acidosis due to short-term starvation nondiabetic ketoacidosis is rarely reported. Severe ketoacidosis due to starvation itself is a rare occurrence, and more so in pregnancy with a concomitant stressful clinical situation. This case report presents a nondiabetic woman admitted in intensive care for respiratory failure type 1 during the third trimester of pregnancy with a severe metabolic acidosis refractory to medical treatment. We diagnosed the patient with acute starvation ketoacidosis based on her history and the absence of other causes of high anion gap metabolic acidosis after doing a rigorous analysis of her acid-base disorder...
February 27, 2018: Revista Española de Anestesiología y Reanimación
Jieqing Liu, Meng Dong, Shuo Zhang, Yongdong Liu, Rugang Zhong
The SN2 reactions at nitrogen center (SN2@N) play a significant role in organic synthesis, carcinogenesis, and the formation of some environmentally toxic compounds. However, the SN2@N reactions especially for the neutral compounds as nucleophiles are less known. In this work, reactions of dimethylamine (DMA) and F- with NH2Cl were investigated as model reactions to validate an accurate functional from 24 DFT functionals by comparing with the CCSD(T) reference data. M06-2X functional was found to perform best and applied to systematically explore the trends in reactivity for halides (F- and Cl-) and simple amines towards the substrates NH2Cl and NHCl2 (SN2@N) as well as CH3Cl and CH2Cl2 (SN2@C)...
March 2, 2018: Journal of Physical Chemistry. A
Deniz Aygün, Fatih Aygün, Kemal Nişli, Firdevs Baş, Agop Çıtak
Aim: We aimed to study electrocardiographic changes in children with diabetic ketoacidosis and ketosis and to evaluate the relation of the changes with serum electrolyte levels and ketosis. Material and Methods: This study was performed in Istanbul Medical Faculty, Pediatric Emergency and Intensive Care Department between May 2008 and May 2009. The electrocardiographic parameters and QT length of children with diabetic ketoacidosis and ketosis were evaluated at diagnosis and after the treatment...
December 2017: Türk Pediatri Arşivi
Gul Hassan Sethar, Aisha Almoghawi, Nargis Khan, Wehad Altourah, Najat Mohammed Ashour
Pseudohypoaldosteronism (PHA) type II is an extremely rare disorder which presents with hypertension, hyperkalemia, and normal anion gap metabolic acidosis. PHA II is also known as familial hyperkalemic hypertension, Gordon syndrome, and chloride shunt syndrome. PHA II is an autosomal dominant disorder and is caused by mutation in WNK1, WNK4, CULLIN3, KLHL3, OSR, SPAK gene. The expression of these proteins is limited to the distal convoluted tube and collecting duct of the kidney. PHA II usually responds to salt restriction and thiazide diuretics...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Thomas Giner, Violeta Ojinaga, Nikolaus Neu, Miriam Koessler, Gerard Cortina
No abstract text is available yet for this article.
February 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Li-Ping Cheng, Zhi Wang, Qiao-Yu Wu, Hai-Feng Su, Tao Peng, Geng-Geng Luo, Yan-An Li, Di Sun, Lan-Sun Zheng
A discrete 78-nucleus silver-sulfur nanocluster with a sulfate-centered multishell structure was isolated and characterized. Its crystal structure revealed 18 and 60 Ag atoms in the inner and outer shell, respectively. The inner shell of 18-nuclearity Ag atoms is a very rare convex polyhedron featuring an elongated triangular orthobicupola. The incorporation of a sulfate anion and multishell arrangement in the nanocluster led to a dramatic decrease in the band gap (E g = 1.40 eV). Our study showed that simple anions can also induce the formation of high-nuclearity silver clusters with excellent optical properties...
February 16, 2018: Chemical Communications: Chem Comm
M Myilsamy, M Mahalakshmi, N Subha, V Murugesan
Gallium doped mesoporous TiO2 with different weight percentages were synthesized by sol-gel method using Pluronic P123 as the structure directing template. The physico-chemical properties of all the synthesized catalysts were determined by XRD, TEM, SEM-EDAX, N2 adsorption-desorption studies, XPS, UV-vis DRS, FT-IR and photoluminescence spectroscopy. 1.0 wt% Ga-TiO2 exhibited the highest photocatalytic efficiency among all the synthesized materials under visible light due to the high surface area, reduced band gap and suppressed electron-hole recombination...
February 1, 2018: Journal of Nanoscience and Nanotechnology
Shinya Kato, Tetsuro Yoshimura, Nobuhiko Miwa
The polyhydroxy small-gap fullerenes [C120O30(OH)30 · 30H2O · 25Na+: SGFs] were encapsulated in multilamellar liposomes (Lpsm) composed of 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) and 1,2-dioleoyl-sn-glycero-3-phospho-l-serine (DOPS), which are designated as LpsmSGFs (DOPC/DOPS/SGFs = 35 mM:15 mM:246-445 μM, diameter = 141.2 nm, ζ-potential = -35.65 mV). Radiosensitization by LpsmSGFs under X-ray irradiation was evaluated on human melanoma HMV-II cells. On 7th day after X-ray irradiation, cell proliferation degree assessed by WST-8 decreased more markedly on cells pretreated with LpsmSGFs than Lpsm or free-SGFs...
June 1, 2018: Journal of Nanoscience and Nanotechnology
Adam J Dennington, Mark T Weller
The syntheses and structures of five iodobismuthate and nine iodoantimonate hybrid materials are presented. The 1,3-dimethyl-2-oxo-2,3-dihydropyrimidinium cation has been used to template the isostructural, one-dimensional [C6H9N2O][SbI4] (I) and [C6H9N2O][BiI4] (II), while 4-methylmorpholinium templates the compounds, [C5H12NO]4[Sb6I22] (III) and [C5H12NO]4[Bi4I16] (IV), both containing isolated iodopnictogenide cluster anions. Five iodoantimonate compounds, templated by piperazinium cation derivatives, have been synthesised; [C4H12N2][SbI4]2·4H2O (V), [C5H14N2][SbI4]2·3H2O (VI), two polymorphs of [C6H16N2][SbI4]2·2H2O (VII and VIII) and [C6H16N2][Sb4I16]0...
February 12, 2018: Dalton Transactions: An International Journal of Inorganic Chemistry
Takehide Umeda, Taro Minami, Keith Bartolomei, Eleanor Summerhill
A 54-year-old woman with type 2 diabetes mellitus, hypertension, and peripheral vascular disease developed life-threatening lactic acidosis during treatment with metformin for type 2 diabetes. The woman received metformin at 1000 mg orally twice a day for type 2 diabetes. She presented to our emergency department with a 3-day history of severe watery diarrhea, nausea, and vomiting. Her grandson whom she cared for had gastroenteritis several days prior to the onset of her symptoms. She was confused and hypotensive with a blood pressure of 70/39 mmHg...
February 9, 2018: Drug Safety—Case Reports
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