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Acidosis metabolic

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https://www.readbyqxmd.com/read/29052836/topical-hemostatics-for-bleeding-control-in-pre-hospital-setting-then-and-now
#1
H Erhan Güven
Massive hemorrhage causes instant and early deaths because of hypovolemia. However, even if the victim makes it to the hospital, hypothermia, metabolic acidosis, and coagulation impairments caused by bleeding pose a great risk for survival. Many topical hemostatic agents are developed for neck, armpit, or groin injuries that are not amenable to tourniquet application and for extremity wounds to be used in conjunction with tourniquets. This paper focuses on those hemostatics that differ based on the action mechanism and are suitable for pre-hospital setting and summarizes the latest recommendations regarding their usage...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29050011/urine-ammonium-metabolic-acidosis-and-progression-of-chronic-kidney-disease
#2
Negiin Pourafshar, Shirin Pourafshar, Manoocher Soleimani
The metabolism of a typical Western diet generates 50-100 mEq of acid (H+) per day, which must be excreted in the urine for the systemic acid-base to remain in balance. The 2 major mechanisms that are responsible for the renal elimination of daily acid under normal conditions are ammonium (NH4+) excretion and titratable acidity. In the presence of systemic acidosis, ammonium excretion is intensified and becomes the crucial mechanism for the elimination of acid. The impairment in NH4+ excretion is therefore associated with reduced acid excretion, which causes excess accumulation of acid in the body and consequently results in metabolic acidosis...
October 19, 2017: Nephron
https://www.readbyqxmd.com/read/29046378/fluctuating-seawater-ph-pco2-regimes-are-more-energetically-expensive-than-static-ph-pco2-levels-in-the-mussel-mytilus-edulis
#3
Stephanie Mangan, Mauricio A Urbina, Helen S Findlay, Rod W Wilson, Ceri Lewis
Ocean acidification (OA) studies typically use stable open-ocean pH or CO2 values. However, species living within dynamic coastal environments can naturally experience wide fluctuations in abiotic factors, suggesting their responses to stable pH conditions may not be reflective of either present or near-future conditions. Here we investigate the physiological responses of the mussel Mytilus edulis to variable seawater pH conditions over short- (6 h) and medium-term (2 weeks) exposures under both current and near-future OA scenarios...
October 25, 2017: Proceedings. Biological Sciences
https://www.readbyqxmd.com/read/29046209/-paroxysmal-muscle-weakness-liver-enlargement-and-hypoglycemia-in-a-boy
#4
Ya-Jie Cui, Chun-Lan Song, Yi-Bing Cheng
A boy aged 11 years was admitted due to intermittent weakness and difficulty in walking for 6 years, and hepatomegaly, glycopenia and unconsciousness for 4 years. The laboratory examinations showed severe metabolic acidosis, hypoglycemia, and abnormal liver function. CT scan showed marked liver enlargement with fat density shadow. The boy was given fluid infusion, correction of acidosis, intravenous injection of glucose, L-carnitine, compound vitamin B, and coenzyme Q10, but he was in a persistent coma and it was difficult to correct refractory metabolic acidosis and hypoglycemia...
October 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29044345/first-report-of-granulicatella-sp-endocarditis-in-a-kidney-transplant-patient
#5
Flávio Jota de Paula, Precil Diego Miranda de Menezes Neves, Ramaiane Aparecida Bridi, Alice Tung Wan Song, Elias David-Neto
Granulicatella and Abiotrophia are genera of fastidious Gram-positive cocci commensal of the oral, genitourinary, and intestinal flora. We report the first case of infective endocarditis caused by Granulicatella sp. in a kidney transplant recipient. A 67-year-old male kidney transplant recipient was admitted to the hospital for investigation of fever, abdominal pain, and diarrhea. On physical examination, he was dehydrated. Laboratory tests identified impaired renal function (creatinine level of 15.5 mg/dl; reference, 3...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29044339/metabolic-acidosis-in-hemodialysis-patients-a-review
#6
Luiza Raksa Rezende, Pablo Brandão de Souza, Giselly Rosa Modesto Pereira, Jocemir Ronaldo Lugon
Metabolic acidosis is highly prevalent in hemodialysis patients. The disorder is associated with increased mortality and its deleterious effects are already present in the predialysis phase of chronic kidney disease. Metabolic acidosis has been linked to progression of chronic kidney disease, changes in protein and glucose metabolism, bone and muscle disorders and cardiovascular disease. At present, the control of metabolic acidosis in hemodialysis is mainly focused on the supply of bicarbonate during dialysis session, but further studies are needed to set the optimum target serum bicarbonate and the best concentration of the bicarbonate dialysate...
July 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29043143/focal-segmental-glomerulosclerosis-associated-with-mitochondrial-disease
#7
Kenneth Lim, David Steele, Andrew Fenves, Ravi Thadhani, Eliot Heher, Amel Karaa
Primary mitochondrial diseases (MD) are complex, heterogeneous inherited diseases caused by mutations in either the mitochondrial or nuclear DNA. Glomerular diseases in MD have been reported with tRNA mutation m.3243A>G causing a syndrome of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS). We describe here a case of focal segmental glomerulosclerosis (FSGS) associated with a new tRNA mutation site. A 34-year-old man with a history of living related kidney transplantation, diabetes, hearing loss, and developmental delay presented to the outpatient clinic with complaints of new behavioral difficulties, worsening symptoms, and brain involvement on imaging...
2017: Clin Nephrol Case Stud
https://www.readbyqxmd.com/read/29042903/renal-tubular-acidosis-in-patients-with-primary-sj%C3%A3-gren-s-syndrome
#8
Su Woong Jung, Eun Ji Park, Jin Sug Kim, Tae Won Lee, Chun Gyoo Ihm, Sang Ho Lee, Ju-Young Moon, Yang Gyun Kim, Kyung Hwan Jeong
Primary Sjögren's syndrome (pSS) is characterized by lymphocytic infiltration of the exocrine glands resulting in decreased saliva and tear production. It uncommonly involves the kidneys in various forms, including tubulointerstitial nephritis, renal tubular acidosis, Fanconi syndrome, and rarely glomerulonephritis. Its clinical symptoms include muscle weakness, periodic paralysis, and bone pain due to metabolic acidosis and electrolyte imbalance. Herein, we describe the cases of two women with pSS whose presenting symptoms involve the kidneys...
September 2017: Electrolyte & Blood Pressure: E & BP
https://www.readbyqxmd.com/read/29041862/impact-of-chronic-maternal-stress-during-early-gestation-on-maternal-fetal-stress-transfer-and-fetal-stress-sensitivity-in-sheep
#9
Michelle Dreiling, Rene Schiffner, Sabine Bischoff, Sven Rupprecht, Nasim Kroegel, Harald Schubert, Otto W Witte, Matthias Schwab, Florian Rakers
Acute stress-induced reduction of uterine blood flow (UBF) is an indirect mechanism of maternal-fetal stress transfer during late gestation. Effects of chronic psychosocial maternal stress (CMS) during early gestation, as may be experienced by many working women, on this stress signaling mechanism are unclear. We hypothesized that CMS in sheep during early gestation augments later acute stress-induced decreases of UBF, and aggravates the fetal hormonal, cardiovascular, and metabolic stress responses during later development...
October 18, 2017: Stress: the International Journal on the Biology of Stress
https://www.readbyqxmd.com/read/29038192/two-gaps-too-many-three-clues-too-few-do-elevated-osmolal-and-anion-gaps-with-crystalluria-always-mean-ethylene-glycol-poisoning
#10
Maneesh Gaddam, Ravi Kanth Velagapudi, Emad Abu Sitta, Abed Kanzy
A 60-year-old African-American man with a medical history significant for heavy alcohol abuse, hypertension, delirium tremens, nephrolithiasis and seizure disorder was brought to the hospital with altered mental status. He was found to have high anion gap metabolic acidosis with significantly elevated lactate along with an elevated osmolal gap and calcium oxalate crystals in his urine. With this combination of findings, ethylene glycol poisoning was high in the differential. This case report describes why ethylene glycol poisoning was not the diagnosis in this patient despite the presence of these three classic laboratory findings, therefore emphasising the fact that these findings should not be taken at face value because they can be seen collectively in a patient yet each have a different cause...
October 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29036793/clinical-relevance-of-early-sublingual-microcirculation-monitoring-in-septic-shock-patients
#11
Nivin Sharawy, Reham Mahrous, Sara Whynot, Ronald George, Christian Lehmann
INTRODUCTION: Although microcirculation dysfunction plays unique role in septic shock, translation of microcirculation to clinical practices is limited by current semi-quantities analysis and unclear clinical relevance of microcirculation monitoring. Our aim was to critically evaluate the characteristic nature and relevant clinical important of microcirculation. EVIDENCE ACQUISITION: Pubmed (2000 to August 2015) were searched to identify observation, case-control, intervention and randomized clinical studies evaluating the relationship between microcirculation alterations and mortality, morbidity and drug responses...
October 7, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29033250/propionyl-coa-carboxylase-a-review
#12
REVIEW
Parith Wongkittichote, Nicholas Ah Mew, Kimberly A Chapman
Propionyl-CoA carboxylase (PCC) is the enzyme which catalyzes the carboxylation of propionyl-CoA to methylmalonyl-CoA and is encoded by the genes PCCA and PCCB to form a hetero-dodecamer. Dysfunction of PCC leads to the inherited metabolic disorder propionic acidemia, which can result in an affected individual presenting with metabolic acidosis, hyperammonemia, lethargy, vomiting and sometimes coma and death if not treated. Individuals with propionic acidemia also have a number of long term complications resulting from the dysfunction of the PCC enzyme...
October 7, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/29032379/oral-bicarbonate-slows-decline-of-residual-renal-function-in-peritoneal-dialysis-patients
#13
Xiang-Yang Liu, Xiu-Mei Gao, Ning Zhang, Rui Chen, Feng Wu, Xin-Chao Tao, Chun-Jun Li, Ping Zhang, Pei Yu
BACKGROUND/AIMS: Metabolic acidosis is a common consequence of end-stage renal disease (ESRD) which may result in a substantial adverse outcome. The effect of oral bicarbonate on the preservation of residual renal function (RRF) in peritoneal dialysis (PD) patients has been rarely reported. METHODS: We randomly assigned 40 continuous ambulatory peritoneal dialysis (CAPD) patients to the oral bicarbonate group or placebo group at a 1: 1 ratio. All enrollments were followed for a duration of 104 weeks...
2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29031359/treatment-of-abnormalities-of-potassium-homeostasis-in-ckd
#14
REVIEW
Biff F Palmer, Deborah J Clegg
Hyperkalemia, defined as serum potassium concentrations greater than 5.0 to 5.5 mEq/L, is a frequent occurrence in clinical practice because of the increasing incidence and prevalence of CKD. Patients at risk for this disorder are commonly treated with drugs that interfere in the renin-angiotensin-aldosterone system, thereby enhancing the occurrence and prevalence of this disorder. Discontinuation of these drugs because of the development of hyperkalemia deprives these patients the renal-protective and cardiovascular benefits this class of pharmacology has been shown to provide...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29031356/management-of-the-metabolic-acidosis-of-chronic-kidney-disease
#15
REVIEW
Nimrit Goraya, Donald E Wesson
Subjects with CKD and reduced glomerular filtration rate are at risk for chronic metabolic acidosis, and CKD is its most common cause. Untreated metabolic acidosis, even in its mildest forms, is associated with increased mortality and morbidity and should therefore be treated. If reduced glomerular filtration rate or the tubule abnormality causing chronic metabolic acidosis cannot be corrected, it is typically treated with dietary acid (H(+)) reduction using Na(+)-based alkali, usually NaHCO3. Dietary H(+) reduction can also be accomplished with the addition of base-producing foods such as fruits and vegetables and limiting intake of H(+)-producing foods like animal-sourced protein...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29031355/adverse-effects-of-the-metabolic-acidosis-of-chronic-kidney-disease
#16
REVIEW
Jeffrey A Kraut, Nicolaos E Madias
The kidney has the principal role in the maintenance of acid-base balance, and therefore, a fall in renal net acid excretion and positive H(+) balance often leading to reduced serum [HCO3(-)] are observed in the course of CKD. This metabolic acidosis can be associated with muscle wasting, development or exacerbation of bone disease, hypoalbuminemia, increased inflammation, progression of CKD, protein malnutrition, alterations in insulin, leptin, and growth hormone, and increased mortality. Importantly, some of the adverse effects can be observed even in the absence of overt hypobicarbonatemia...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29031354/epidemiology-of-acid-base-derangements-in-ckd
#17
REVIEW
Wei Chen, Matthew K Abramowitz
Acid-base disorders are in patients with chronic kidney disease, with chronic metabolic acidosis receiving the most attention clinically in terms of diagnosis and treatment. A number of observational studies have reported on the prevalence of acid-base disorders in this patient population and their relationship with outcomes, mostly focusing on chronic metabolic acidosis. The majority have used serum bicarbonate alone to define acid-base status due to the lack of widely available data on other acid-base disorders...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29031353/regulation-of-acid-base-balance-in-chronic-kidney-disease
#18
REVIEW
Glenn T Nagami, L Lee Hamm
The kidneys play a major role in the regulation of acid-base balance by reabsorbing bicarbonate filtered by the glomeruli and excreting titratable acids and ammonia into the urine. In CKD, with declining kidney function, acid retention and metabolic acidosis occur, but the extent of acid retention depends not only on the degree of kidney impairment but also on the dietary acid load. Acid retention can occur even when the serum bicarbonate level is apparently normal. With reduced kidney function, acid transport processes in the surviving nephrons are augmented but as disease progresses ammonia excretion and, in some individuals, the ability to reabsorb bicarbonate falls, whereas titratable acid excretion is preserved until kidney function is severely impaired...
September 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29030467/metabolic-acidosis-and-subclinical-metabolic-acidosis-in-ckd
#19
Kalani L Raphael
Metabolic acidosis is not uncommon in CKD and is linked with bone demineralization, muscle catabolism, and higher risks of CKD progression and mortality. Clinical practice guidelines recommend maintaining serum total CO2 at ≥22 mEq/L to help prevent these complications. Although a definitive trial testing whether correcting metabolic acidosis improves clinical outcomes has not been conducted, results from small, single-center studies support this notion. Furthermore, biologic plausibility supports the notion that a subset of patients with CKD have acid-mediated organ injury despite having a normal serum total CO2 and might benefit from oral alkali before overt acidosis develops...
October 13, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29026846/intracranial-hemorrhage-in-methanol-toxicity-challenging-the-probable-heparin-effect-during-hemodialysis
#20
Hossein Hassanian-Moghaddam, Hooman Bahrami-Motlagh, Nasim Zamani, Seyed Amirhossein Fazeli, Behdad Behnam
Brain hemorrhages are rare complications of acute methanol poisoning. There is a debate on association of brain hemorrhage in methanol toxicity and application of systemic anticoagulation during hemodialysis (HD). A 70-year-old male presented to us with severe metabolic acidosis and a methanol level of 7.6 mg/dL. Ethanol and folinic acid were administered, and HD was performed. Brain computed tomography (CT) scan which was normal on presentation showed extensive bilateral subcortical supratentorial hypodensities on the 3(rd) day after commencing the treatment...
July 2017: Journal of Research in Pharmacy Practice
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