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https://www.readbyqxmd.com/read/28642733/a-case-of-pulmonary-carcinoid-tumor-with-a-superimposed-aspergilloma-presenting-as-a-covert-ectopic-adrenocorticotropic-hormone-syndrome
#1
Kyoung Jin Kim, Ji Hee Yu, Nan Hee Kim, Young Hye Kim, Young Sik Kim, Ji A Seo
Ectopic adrenocorticotropic hormone (ACTH) syndrome is a challenging diagnosis only responsible for approximately 10% of Cushing syndrome cases. It has been associated with a variety of benign and malignant tumors including a carcinoid tumor accompanied by aspergilloma in our case that was significantly difficult to be detected. We report a patient over 70 years old with uncontrolled hypertension and hypokalemia presenting with generalized edema. Laboratory results revealed ACTH-dependent Cushing syndrome, but imaging studies did not show any discrete lesions secreting ACTH...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28622013/acetazolamide-usage-in-severe-chronic-obstructive-pulmonary-disease-pros-and-cons
#2
Rosemary Adamson, Erik R Swenson
Acetazolamide is a carbonic anhydrase (CA) inhibitor sometimes used as a respiratory stimulant for patients with COPD with the goal of improving oxygenation, reducing carbon dioxide retention and aiding liberation from mechanical ventilation and/or attempting to correct a metabolic alkalosis. However, the net effect of CA inhibition is multifactorial and complex since CA is inhibited in many tissues that may negatively affect the patient with lung disease. The full impact of acetazolamide and other CA inhibitors depends critically on dosing, age, and pulmonary, renal, hepatic, hematological, and respiratory muscle function and reserves...
June 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28616421/cystic-fibrosis-prevalence-among-a-group-of-high-risk-children-in-the-main-referral-children-hospital-in-iran
#3
Mohammad Reza Modaresi, Jamal Faghinia, Mohsen Reisi, Majid Keivanfar, Shiva Navaie, Javad Seyyedi, Faride Baharzade
BACKGROUND: Knowledge about cystic fibrosis (CF) in Iran is very limited. The objective of this study was to determine the prevalence of CF among a group of high-risk children with suggestive clinical features in the main referral hospital in Iran. MATERIALS AND METHODS: This study children consisted of 505 patients who had presented with one or more of the following symptoms: chronic or recurrent respiratory symptoms, gastrointestinal symptoms as rectal prolapse, steatorrhea, hepatobiliary disease as prolonged jaundice, failure to thrive, hyperglycemia and glycosuria, hypochloremic metabolic alkalosis, hypoprothrombinemia, anemia or edema, and positive family history of CF...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28608260/water-electrolyte-acid-base-and-trace-elements-alterations-in-cirrhotic-patients
#4
REVIEW
Carlos G Musso, Rossina Juarez, Richard J Glassock
Chronic hepatic patients, and particularly those suffering from cirrhosis, are predisposed to different sort of water, electrolyte, acid-base, and trace elements disorders due to their altered liver function, and also to their exposition to infectious, inflammatory, oncologic, and pharmacologic variables whose combination undermines their homeostatic capability. Hyponatremia, hypokalemia, hyperkalemia, hypocalcemia, metabolic acidosis, respiratory, and metabolic alkalosis are the main internal milieu alterations in this group...
June 12, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28599903/metabolic-acidosis-or-respiratory-alkalosis-evaluation-of-a-low-plasma-bicarbonate-using-the-urine-anion-gap
#5
Daniel Batlle, Jamie Chin-Theodorou, Bryan M Tucker
Hypobicarbonatemia, or a reduced bicarbonate concentration in plasma, is a finding seen in 3 acid-base disorders: metabolic acidosis, chronic respiratory alkalosis and mixed metabolic acidosis and chronic respiratory alkalosis. Hypobicarbonatemia due to chronic respiratory alkalosis is often misdiagnosed as a metabolic acidosis and mistreated with the administration of alkali therapy. Proper diagnosis of the cause of hypobicarbonatemia requires integration of the laboratory values, arterial blood gas, and clinical history...
June 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28595508/sedative-and-cardiorespiratory-effects-of-detomidine-constant-rate-infusion-in-sheep
#6
Rauane Sousa de Moura, Isabela Plazza Bittar, Luiz Henrique da Silva, Ana Carolina Vasquez Villela, Marcelo Borges Dos Santos Júnior, Naida Cristina Borges, Leandro Guimarães Franco
The use of sheep in experiments is widespread and is increasing worldwide, and so is the need to develop species-specific anaesthetic techniques to ensure animal safety. Previous studies have mentioned several protocols involving the administration of alpha-2 adrenergic agonists in sheep; however, assessment of the efficacy and safety of these infusion techniques is still relatively new. Thus, the aim of the present study is to assess the effectiveness of detomidine constant rate infusion (CRI) in sheep by measuring the cardiovascular and respiratory parameters, blood gas variables and sedation scores...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28550912/does-metabolic-alkalosis-influence-cerebral-oxygenation-in-infantile-hypertrophic-pyloric-stenosis
#7
Matthias Nissen, Grigore Cernaianu, Rene Thränhardt, Mohammad R Vahdad, Karin Barenberg, Ralf-Bodo Tröbs
BACKGROUND: This pilot study focuses on regional tissue oxygenation (rSO2) in patients with infantile hypertrophic pyloric stenosis in a perioperative setting. To investigate the influence of enhanced metabolic alkalosis (MA) on cerebral (c-rSO2) and renal (r-rSO2) tissue oxygenation, two-site near-infrared spectroscopy (NIRS) technology was applied. MATERIALS AND METHODS: Perioperative c-rSO2, r-rSO2, capillary blood gases, and electrolytes from 12 infants were retrospectively compared before and after correction of MA at admission (T1), before surgery (T2), and after surgery (T3)...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28524033/-procedural-analysis-of-acid-base-balance-disorder-case-serials-in-4-patents
#8
Chunyuan Ma, Guijie Wang
OBJECTIVE: To establish the standardization process of acid-base balance analysis, analyze cases of acid-base balance disorder with the aid of acid-base balance coordinate graph. METHODS: The acid-base balance theory were reviewed systematically on recent research progress, and the important concepts, definitions, formulas, parameters, regularity and inference in the analysis of acid-base balance were studied. The analysis of acid-base balance disordered processes and steps were figured...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28512417/a-case-of-paraneoplastic-cushing-syndrome-presenting-as-hyperglycemic-hyperosmolar-nonketotic-syndrome
#9
Christina E Brzezniak, Nicole Vietor, Patricia E Hogan, Bryan Oronsky, Bennett Thilagar, Carolyn M Ray, Scott Caroen, Michelle Lybeck, Neil Oronsky, Corey A Carter
Carcinoid tumors are neuroendocrine tumors that mainly arise in the gastrointestinal tract, lungs, and bronchi. Bronchopulmonary carcinoids have been associated with Cushing syndrome, which results from ectopic adrenocorticotrophic hormone (ACTH) secretion. We report the case of a 65-year-old man, a colonel in the US Air Force, with metastatic bronchopulmonary carcinoid tumors treated on a clinical trial who was hospitalized for complaints of increasing thirst, polydipsia, polyuria, weakness, and visual changes...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28501971/electrolyte-and-acid-base-disturbances-in-end-stage-liver-disease-a-physiopathological-approach
#10
REVIEW
José Víctor Jiménez, Diego Luis Carrillo-Pérez, Rodrigo Rosado-Canto, Ignacio García-Juárez, Aldo Torre, David Kershenobich, Eduardo Carrillo-Maravilla
Electrolyte and acid-base disturbances are frequent in patients with end-stage liver disease; the underlying physiopathological mechanisms are often complex and represent a diagnostic and therapeutic challenge to the physician. Usually, these disorders do not develop in compensated cirrhotic patients, but with the onset of the classic complications of cirrhosis such as ascites, renal failure, spontaneous bacterial peritonitis and variceal bleeding, multiple electrolyte, and acid-base disturbances emerge. Hyponatremia parallels ascites formation and is a well-known trigger of hepatic encephalopathy; its management in this particular population poses a risky challenge due to the high susceptibility of cirrhotic patients to osmotic demyelination...
May 13, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28491446/severe-muscle-fasciculations-and-tremor-in-a-cat-with-hypochloraemic-metabolic-alkalosis-secondary-to-duodenal-obstruction
#11
Alison Jukes, Marcus Gunew, Rhett Marshall
CASE SUMMARY: An 18-month-old, female spayed, Australian Mist cat presented with a 24 h history of muscle tremors and inappetence progressing to collapse with generalised muscle fasciculations. The cat was diagnosed with a hypochloraemic metabolic alkalosis due to a duodenal foreign body found to be a trichobezoar at coeliotomy. The cat made a complete recovery after enterotomy to remove the trichobezoar, with cessation of neuromuscular clinical signs and normalisation of its electrolyte and acid-base imbalances...
January 2017: JFMS open reports
https://www.readbyqxmd.com/read/28482382/-application-of-improved-regional-citrate-anticoagulation-in-continuous-hemofiltration-in-children
#12
K Bai, C J Liu, Y Q Fu, F Xu
Objective: To investigate the application of regional citrate anticoagulation with calcium hemofiltration basic solution in continuous hemofiltration in children. Method: The clinical data of 18 patients with citrate anticoagulation in continuous hemofiltration in children, excluding the hepatic failure and septic shock cases, were analyzed retrospectively, from September 2015 to August 2016 in Intensive Care Unit of the Children's Hospital of Chongqing Medical University.The commercial calcium hemofiltration basic solution was used as displacement liquid ...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28465843/hypercapnea-and-acidemia-despite-hyperventilation-following-endotracheal-intubation-in-a-case-of-unknown-severe-salicylate-poisoning
#13
Shannon M Fernando, Valérie Charbonneau, Hans Rosenberg
Salicylates are common substances for deliberate self-harm. Acute salicylate toxicity is classically associated with an initial respiratory alkalosis, followed by an anion gap metabolic acidosis. The respiratory alkalosis is achieved through hyperventilation, driven by direct stimulation on the respiratory centers in the medulla and considered as a compensatory mechanism to avoid acidemia. However, in later stages of severe salicylate toxicity, patients become increasingly obtunded, with subsequent loss of airway reflexes, and therefore intubation may be necessary...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28398947/acidosis-but-not-alkalosis-affects-anaerobic-metabolism-and-performance-in-a-4-km-time-trial
#14
Carlos Rafaell Correia-Oliveira, João Paulo Lopes-Silva, Romulo Bertuzzi, Glenn K McConell, David John Bishop, Adriano Eduardo Lima-Silva, Maria Augusta Peduti Dal'Molin Kiss
PURPOSE: To determine the effect of pre-exercise metabolic acidosis and alkalosis on power output (PO) and aerobic and anaerobic energy expenditure during a 4-km cycling time trial (TT). METHODS: Eleven recreationally trained cyclists (VO2peak 54.1 ± 9.3 mL·kg·min) performed a 4-km TT 100 min after ingesting in a double-blind matter 0.15 g·kg of body mass of ammonium chloride (NH4Cl, acidosis), 0.3 g·kg of sodium bicarbonate (NaHCO3, alkalosis) or 0.15 g·kg of CaCO3 (placebo)...
April 11, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28393002/hellp-syndrome-in-a-pregnant-patient-with-gitelman-syndrome
#15
Minhyeok Lee, Dong-Il Kim, Kyung-Ho Lee, Jun-Hyun Byun, Jiyong Hwang, Won-Min Hwang, Sung-Ro Yun, Se-Hee Yoon
Gitelman syndrome is characterized by hypokalemia, metabolic alkalosis, hypocalciuria, and hypomagnesemia. The clinical course of Gitelman syndrome in pregnant women remains unclear, but it is thought to be benign. We report here the first Korean case of atypical eclampsia in a 31-year-old who was diagnosed with Gitelman syndrome incidentally during an antenatal screening test. The patient did well during pregnancy despite significant hypokalemia. At 33 weeks' gestation, the patient exhibited eclampsia, hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, and renal insufficiency without significant hypertension or proteinuria...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28342684/persistent-pulmonary-hypertension-of-the-newborn
#16
REVIEW
Mamta Fuloria, Judy L Aschner
Failure of the normal circulatory adaptation to extrauterine life results in persistent pulmonary hypertension of the newborn (PPHN). Although this condition is most often secondary to parenchymal lung disease or lung hypoplasia, it may also be idiopathic. PPHN is characterized by elevated pulmonary vascular resistance with resultant right-to-left shunting of blood and hypoxemia. Although the preliminary diagnosis of PPHN is often based on differential cyanosis and labile hypoxemia, the diagnosis is confirmed by echocardiography...
March 23, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28327689/unusual-case-of-failure-to-thrive-type-iii-bartter-syndrome
#17
S Agrawal, K Subedi, P Ray, A Rayamajhi
Bartter syndrome Type III is a rare autosomal recessive disorder resulting from an inherited defect in the thick ascending limb of the loop of henle of the nephrons in kidney. The typical clinical manifestations in childhood are failure to thrive and recurrent episodes of vomiting. Typical laboratory findings which help in the diagnosis are hypokalemic metabolic alkalosis, hypomagnesemia and hypercalciuria. We report a case of Type III Bartter syndrome not responding to repeated conventional treatment of failure to thrive...
September 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28325561/a-new-slc12a3-founder-mutation-p-val647met-in-gitelman-s-syndrome-patients-of-roma-ancestry
#18
Helena Gil-Peña, Eliecer Coto, Fernando Santos, Mar Espino, Jose Mª Cea Crespo, Giannis Chantzopoulos, Filadelfia Komianou, Juan Gómez, Belén Alonso, Sara Iglesias, Cyrielle Treard, Rosa Vargas-Poussou
BACKGROUND: Gitelman's syndrome (GS) is an autosomal recessive disorder caused by mutations in the SLC12A3 gene. GS is characterized by hypokalaemic metabolic alkalosis, hypomagnesemia and hypocalciuria. Most of the reported patients of Roma ancestry are homozygous for an SLC12A3 intron 9 frameshifting mutation (c.1180+1G>T). Some forms of Bartter's syndrome result from mutations in the CLNCKB gene and clinically overlap with GS. OBJECTIVES: To characterize a second SLC12A3 mutation in Roma patients negative for the intron 9 variant...
March 18, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28302238/gitelman-syndrome
#19
Qurat Ul Ain Mustafa, Zujaja Hina Haroon, Aamir Ijaz, Muhammad Tanveer Sajid, Muhammad Ayyub
Gitelman syndrome (GS) is the most frequently inherited renal salt-wasting tubulointerstitial disease. It follows variable but usually asymptomatic benign course. We present a rare case of GS that remained clinical enigma. A 22-year male presented with severe episodic fatigue involving all limbs associated with episodes of sinking, palpitations, salt craving, increased thirst and frequent micturition hampering his routine daily activities. Laboratory workup revealed serum potassium, 2.7 mmol/L, serum magnesium, 0...
March 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28296160/changes-in-serum-bicarbonate-levels-caused-by-acetate-containing-bicarbonate-buffered-hemodialysis-solution-an-observational-prospective-cohort-study
#20
Mandip Panesar, Neal Shah, Sarosh Vaqar, Kaushik Ivaturi, Gregory Gudleski, Mary Muscarella, Judy Lambert, Winnie Su, Brian Murray
Fresenius Medical Care's NaturaLyte dialysate has been associated with increased risk of sudden cardiac death by causing metabolic alkalosis from its acetate content based on retrospective data using pre-dialysis bicarbonate levels only. The study objective was to measure inter/intra-dialytic changes in serum bicarbonate and degree of alkalosis conferred by varying concentrations of NaturaLyte bicarbonate dialysate. Thirty-nine hemodialysis patients were divided into four groups based on prescribed bicarbonate dialysate concentrations; Group 1 (N = 9): 30-32 mEq/L, Group 2 (N = 5): 33-34 mEq/L, Group 3 (N = 10): 35-36 mEq/L, Group 4 (N = 15): 37-40 mEq/L...
April 2017: Therapeutic Apheresis and Dialysis
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