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alcoholic ketoacidosis

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https://www.readbyqxmd.com/read/28150506/beta-hydroxybutyrate-and-pyroglutamate-can-be-included-in-a-rapid-gc-ms-screening-method-for-differential-diagnosis-of-metabolic-acidosis
#1
Siri Føreid, Gaut Gadeholt
A rapid gas chromatographic mass spectrometric method for measuring anions associated with acute anion gap metabolic acidosis is described. The method is an extension of a previous method. The method quantifies glycolic acid, beta-hydroxybutyric acid with good linearity and pyroglutamic acid with a reproducible curvature relation between 1 and 20 mmol/L and can help the clinician distinguish effectively between ethylene glycol poisoning, alcoholic and diabetic ketoacidosis and cysteine deficiency so early that it will have clinical consequences...
April 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28145026/self-reported-regular-alcohol-consumption-in-adolescents-and-emerging-adults-with-type-1-diabetes-a-neglected-risk-factor-for-diabetic-ketoacidosis-multicenter-analysis-of-29-630-patients-from-the-dpv-registry
#2
Julia M Hermann, Michael Meusers, Rainer Bachran, Ursula Kuhnle-Krahl, Norbert Jorch, Sabine E Hofer, Reinhard W Holl
BACKGROUND: The risk of hypoglycemia increases after alcohol consumption in patients with type 1 diabetes. This study aimed to investigate the association between metabolic control and self-reported alcohol consumption in young patients with type 1 diabetes. MATERIALS AND METHODS: N = 29 630 patients with type 1 diabetes aged 12 to <30 years (median age 17.0 [14.9, 18.3] years, duration of diabetes 6.8 [3.3, 10.9] years, 53% male) from the German/Austrian DPV registry were analyzed...
February 1, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28003053/sglt2-inhibitor-associated-diabetic-ketoacidosis-clinical-review-and-recommendations-for-prevention-and-diagnosis
#3
REVIEW
Ronald M Goldenberg, Lori D Berard, Alice Y Y Cheng, Jeremy D Gilbert, Subodh Verma, Vincent C Woo, Jean-François Yale
PURPOSE: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the newest class of antihyperglycemic agents available on the market. Regulator warnings and concerns regarding the risk of developing diabetic ketoacidosis (DKA), however, have dampened enthusiasm for the class despite the combined glycemic, blood pressure, and occasional weight benefits of SGLT2 inhibitors. With the goal of improving patient safety, a cross-Canada expert panel and writing group were convened to review the evidence to-date on reported SGLT2 inhibitor-related DKA incidents and to offer recommendations for preventing and recognizing patients with SGLT2 inhibitor-associated DKA...
December 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27930814/septic-ketoacidosis-a-potentially-lethal-entity-with-renal-tubular-epithelial-vacuolization
#4
Chong Zhou, Roger W Byard
Fatal ketoacidosis due to diabetes mellitus, alcoholism, and starvation may produce characteristic basal vacuolization of renal tubular epithelial cells (RTEC). Septic ketoacidosis has recently been recognized clinically as a distinct condition in which septicemia can lead to elevation of ketones and various anions unrelated to diabetes mellitus, alcoholism, or caloric deprivation. We report four lethal cases with significantly elevated vitreous ketones secondary to sepsis and/or severe localized infection in individuals with no history of diabetes mellitus, alcoholism, or starvation...
January 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27924173/predictors-of-recurrent-hospital-admission-for-patients-presenting-with-diabetic-ketoacidosis-and-hyperglycemic-hyperosmolar-state
#5
Annabel L Bradford, Courtney Champagne Crider, Xizheng Xu, Syed Hasan Naqvi
BACKGROUND: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are two serious, preventable complications of diabetes mellitus. Analysis of variables associated with recurrent DKA and HHS admission has the potential to improve patient outcomes by identifying possible areas for intervention. The aim of this study was to evaluate potential predictors of recurrent DKA or HHS admission. METHODS: This was a retrospective case-control study of 367 patients presenting during a 5-year period with DKA or HHS at a US tertiary academic medical center...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27913012/hyperglycemic-high-anion-gap-metabolic-acidosis-in-patients-receiving-sglt-2-inhibitors-for-diabetes-management
#6
Juliette Sandifer Kum-Nji, Aidar R Gosmanov, Helmut Steinberg, Samuel Dagogo-Jack
Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are a class of antidiabetic medications that improve glycemic control via inhibiting the reabsorption of filtered glucose and are approved for use in type 2 diabetes (T2DM). These drugs have recently been associated with euglycemic diabetic ketoacidosis (DKA). An increasing number of cases of SGLT-2i-associated DKA have occurred in patients with T2DM. Herein, we describe five episodes of hyperglycemic DKA in four type 2 diabetes patients receiving SGLT-2i therapy...
November 9, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27829960/ketoacidosis-in-a-non-diabetic-adult-with-chronic-etoh-consumption
#7
Catherine-Audrey Boutin, Mikhael Laskine
Although much more rare than its diabetic counterpart, ketoacidosis secondary to alcohol withdrawal in the context of fasting has its own complex pathophysiology and can easily mimic the acute insulin deficiency presentation. We present here a rare case of a non-diabetic alcoholic patient who presented in ketoacidosis after a period of reduced intake.
December 2016: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27752032/starvation-ketoacidosis-as-a-cause-of-unexplained-metabolic-acidosis-in-the-perioperative-period
#8
Monique Mostert, Anthony Bonavia
BACKGROUND Besides providing anesthesia for surgery, the anesthesiologist's role is to optimize the patient for surgery and for post-surgical recovery. This involves timely identification and treatment of medical comorbidities and abnormal laboratory values that could complicate the patient's perioperative course. There are several potential causes of anion and non-anion gap metabolic acidosis in surgical patients, most of which could profoundly affect a patient's surgical outcome. Thus, the presence of an acute acid-base disturbance requires a thorough workup, the results of which will influence the patient's anesthetic management...
October 18, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27697197/a-patient-with-alcoholic-ketoacidosis-and-profound-lactemia
#9
Ryan S Gerrity, Anthony F Pizon, Andrew M King, Kenneth D Katz, Nathan B Menke
BACKGROUND: Alcoholic ketoacidosis (AKA) is a complex syndrome that results from disrupted metabolism in the setting of excessive alcohol use and poor oral intake. Dehydration, glycogen depletion, high redox state, and release of stress hormones are the primary factors producing the characteristic anion gap metabolic acidosis with an elevated β-hydroxybutyrate (β-OH) and lactate. CASE REPORT: We present the case of a 47-year-old man who presented to the emergency department with metabolic acidosis and profoundly elevated lactate levels who had AKA...
October 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27474326/optical-isopropanol-biosensor-using-nadh-dependent-secondary-alcohol-dehydrogenase-s-adh
#10
Po-Jen Chien, Ming Ye, Takuma Suzuki, Koji Toma, Takahiro Arakawa, Yasuhiko Iwasaki, Kohji Mitsubayashi
Isopropanol (IPA) is an important solvent used in industrial activity often found in hospitals as antiseptic alcohol rub. Also, IPA may have the potential to be a biomarker of diabetic ketoacidosis. In this study, an optical biosensor using NADH-dependent secondary alcohol dehydrogenase (S-ADH) for IPA measurement was constructed and evaluated. An ultraviolet light emitting diode (UV-LED, λ=340nm) was employed as the excitation light to excite nicotinamide adenine dinucleotide (NADH). A photomultiplier tube (PMT) was connected to a two-way branch optical fiber for measuring the fluorescence emitted from the NADH...
October 1, 2016: Talanta
https://www.readbyqxmd.com/read/27375734/euglycemic-diabetic-ketoacidosis-in-a-27-year-old-female-patient-with-type-1-diabetes-treated-with-sodium-glucose-cotransporter-2-sglt2-inhibitor-canagliflozin
#11
Nimrah Bader, Lubna Mirza
We are reporting a timely case of atypical euglycemic diabetic ketoacidosis in a type 1 diabetic patient treated with sodium-glucose cotransporter-2 (SGLT-2) inhibitor canagliflozin. The clinical history, physical examination findings and laboratory values are described. Other causes of acidosis such as salicylate toxicity or alcohol intoxication were excluded. Ketoacidosis resolved after increasing dextrose and insulin doses supporting the hypothesis that SGLT-2 inhibitors may lead to hypoinsulinemia. Euglycemic ketoacidosis did not recur in our patient after discontinuing canagliflozin...
May 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27239954/postmortem-biochemistry-in-suspected-starvation-induced-ketoacidosis
#12
Cristian Palmiere, Camilla Tettamanti, Marc Augsburger, Sandra Burkhardt, Sara Sabatasso, Christelle Lardi, Dominique Werner
Significantly increased blood ketone body levels can be occasionally observed in the forensic setting in situations other than exposure to cold, diabetic or alcoholic ketoacidosis. Though infrequent, these cases do occur and deserve thorough evaluation in order to establish appropriate differential diagnoses and quantify the role that hyperketonemia may play in the death process. Starvation ketoacidosis is a rare cause of metabolic acidosis and is a phenomenon that occurs normally during fasting, as the body switches from carbohydrate to lipid energy sources...
August 2016: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/27131037/postmortem-biochemistry-current-applications
#13
REVIEW
S L Belsey, R J Flanagan
The results of biochemical analyses in specimens obtained postmortem may aid death investigation when diabetic and alcoholic ketoacidosis is suspected, when death may have been the result of drowning, anaphylaxis, or involved a prolonged stress response such as hypothermia, and in the diagnosis of disease processes such as inflammation, early myocardial infarction, or sepsis. There is often cross-over with different disciplines, in particular with clinical and forensic toxicology, since some endogenous substances such as sodium chloride, potassium chloride, and insulin can be used as poisons...
July 2016: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/27097605/euglycemic-diabetic-ketoacidosis
#14
Anar Modi, Abhinav Agrawal, Farah Morgan
INTRODUCTION: Diabetic ketoacidosis (DKA) is one of the most serious complications of diabetes. It is characterised by the triad of hyperglycemia (blood sugar >250 mg/dl), metabolic acidosis (arterial pH <7.3 and serum bicarbonate <18 mEq/L) and ketosis. Rarely these patients can present with blood glucose (BG) levels of less than 200 mg/dl, which is defined as euglycemic DKA. The possible etiology of euglycemic DKA includes the recent use of insulin, decreased caloric intake, heavy alcohol consumption, chronic liver disease and glycogen storage disorders...
April 21, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27082665/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-position-statement-on-the-association-of-sglt-2-inhibitors-and-diabetic-ketoacidosis
#15
Yehuda Handelsman, Robert R Henry, Zachary T Bloomgarden, Sam Dagogo-Jack, Ralph A DeFronzo, Daniel Einhorn, Ele Ferrannini, Vivian A Fonseca, Alan J Garber, George Grunberger, Derek LeRoith, Guillermo E Umpierrez, Matthew R Weir
AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology DKA = diabetic ketoacidosis EMA = European Medicines Agency FDA = U.S. Food and Drug Administration SGLT-2 = sodium glucosecotransporter 2 T1D = type 1 diabetes T2D = type 2 diabetes.
June 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27002274/unpeeling-the-evidence-for-the-banana-bag-evidence-based-recommendations-for-the-management-of-alcohol-associated-vitamin-and-electrolyte-deficiencies-in-the-icu
#16
Alexander H Flannery, David A Adkins, Aaron M Cook
OBJECTIVE: Patients with a chronic alcohol use disorder presenting to the ICU may be deficient in important vitamins and electrolytes and are often prescribed a "banana bag" as a reflexive standard of therapy. The difficulty of diagnosing Wernicke's encephalopathy in the critical care setting is reviewed. Furthermore, whether the contents and doses of micronutrients and electrolytes in standard banana bags meet the needs of critically ill patients with an alcohol use disorder is assessed based on available evidence...
August 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26949539/alcoholic-ketoacidosis-a-case-report-and-review-of-the-literature
#17
Nurulamin M Noor, Krishna Basavaraju, Dan Sharpstone
Alcoholic ketoacidosis (AKA) is a cause of severe metabolic acidosis usually occurring in malnourished patients with a history of recent alcoholic binge, often on a background of alcohol dependency. AKA can be fatal due to associated electrolyte abnormalities and subsequent development of cardiac arrhythmias. This is a diagnosis that is often delayed or missed, in patients who present with a severe lactic and ketoacidosis. Here we report the case of a 64-year-old female who presented with generalized abdominal pain, nausea and shortness of breath...
March 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/26949146/acute-oesophageal-necrosis-black-oesophagus
#18
Ignasi Galtés, María Ángeles Gallego, Raquel Esgueva, Carles Martin-Fumadó
A 54-year-old man was admitted to hospital after being found unconscious in his home. He had a history of alcoholism, multiple drug addictions, and type I diabetes mellitus. At admission, he had hyperglycaemia (550 mg/dL) with glucosuria and ketone bodies in the urine, along with septic shock refractory to bilateral alveolar infiltrates and severe respiratory failure. The patient died 24 hours post admission due to multiple organ failure, with diabetic ketoacidosis decompensated by possible respiratory infection in a patient with polytoxicomania...
March 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/26909776/lactation-ketoacidosis-an-unusual-entity-and-a-review-of-the-literature
#19
REVIEW
Sarah Gleeson, Eoin Mulroy, David E Clarke
A 31-year-old woman presented to the hospital with symptoms of nausea, malaise, and emesis. She was breastfeeding her 10-month-old infant. She was found to have severe ketoacidosis. The patient was not in diabetic ketoacidosis or alcoholic ketoacidosis; nor had she ingested any toxins. After she was admitted to the hospital, received intravenous fluids, and stopped breastfeeding, her symptoms resolved. She was found to have lactation ketoacidosis, an uncommon condition in humans. A review of all causes of ketoacidosis is presented with special emphasis on lactation ketocacidosis...
December 0: Permanente Journal
https://www.readbyqxmd.com/read/26489986/risk-factors-for-recurrent-admissions-with-diabetic-ketoacidosis-a-case-control-observational-study
#20
H Cooper, A Tekiteki, M Khanolkar, G Braatvedt
AIM: To perform a detailed analysis of patients with recurrent diabetic ketoacidosis admissions in order to establish risk factors for readmission. METHODS: The medical records of all adults and young people (> 15 years) with Type 1 diabetes admitted to Auckland City Hospital over a 15-year period from 1997 to 2011 with a primary diagnosis of ketoacidosis were analysed. Patients readmitted with ketoacidosis within 5 years of their index admission were identified and compared with patients without ketoacidosis readmission who were matched for age, gender, ethnicity and duration of diabetes...
April 2016: Diabetic Medicine: a Journal of the British Diabetic Association
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