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management of lactic acidosis

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https://www.readbyqxmd.com/read/28711257/seasonal-and-maternal-effects-on-acid-base-l-lactate-electrolyte-and-hematological-status-of-205-dairy-calves-born-to-eutocic-dams
#1
L Kovács, F L Kézér, E Albert, F Ruff, O Szenci
In this study, we used linear mixed models to determine the effects of season, time of sampling relative to birth (factors), duration of the delivery process, duration of maternal grooming, calf body weight (BW) at birth, and time of day (covariates) on values of venous blood gas, acid-base and electrolyte parameters, and l-lactate concentrations in dairy calves born to eutocic dams in summer (SUM, n = 101) and winter (WIN, n = 104). Neonatal vitality was assessed at 0, 1, and 24 h after delivery in a linear scoring system using muscle tone, erection of the head, muscle reflexes, heart rate, and sucking drive as criteria...
July 12, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28620551/mitochondrial-cardiomyopathy-presenting-as-dilated-phase-of-hypertrophic-cardiomyopathy-diagnosed-with-histological-and-genetic-analyses
#2
Toshiki Kuno, Syohei Imaeda, Yohei Asakawa, Hiroshi Nakamura, Genzou Takemura, Daisuke Asahara, Akira Kanamori, Tomoyuki Kabutoya, Yohei Numasawa
We report a case with 46-year-old man diagnosed with mitochondrial cardiomyopathy in the dilated phase of hypertrophic cardiomyopathy. Since cardiac magnetic resonance imaging, beta-methyl-p-(123)I-iodophenyl-pentadecanoic myocardial scintigraphy, and positron emission tomography/computed tomography revealed no remarkable findings, we performed electron microscopic examination, which aided in diagnosing mitochondrial cardiomyopathy. Muscle biopsy was also compatible with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes and DNA analysis also concluded it...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28620491/pseudo-thrombotic-thrombocytopenic-purpura-presenting-as-multi-organ-dysfunction-syndrome-a-rare-complication-of-pernicious-anemia
#3
Saroj Kandel, Nibash Budhathoki, Shanta Pandey, Bikash Bhattarai, Aam Baqui, Ramesh Pandey, Divya Salhan, Danilo Enriquez, Joseph Quist, Frances M Schmidt
OBJECTIVE: We present a rare case of pernicious anemia presented as multi-organ dysfunction syndrome, later found to have pseudo-thrombotic thrombocytopenic purpura. METHODS: An 86-year-old female presented with respiratory distress, altered mental status, acute renal failure and was intubated in emergency room. She was found to have severe anemia, thrombocytopenia, high lactate, high lactate dehydrogenase and low haptoglobin. Peripheral smear revealed multilobulated neutrophils with schistocytes, poikilocytes and anisocytes...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28616207/changes-in-metformin-use-in-chronic-kidney-disease
#4
Talha H Imam
Metformin is one of the oldest and most widely prescribed antidiabetic medicines worldwide. It is the only such medicine that has shown a reduction of cardiovascular mortality in diabetes mellitus type 2. Since many diabetic patients have chronic kidney disease, its use is often curtailed by practitioners due to fear of lactic acidosis and the US Food and Drug Administration (FDA) warnings that, until recently, had been in place for decades. Current guidelines, though somewhat vague regarding dosages, clearly pave the way for spreading the use of metformin in patients with lower glomerular filtration rates...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28600630/arterial-versus-venous-lactate-a-measure-of-sepsis-in-children
#5
Sahan Asela Samaraweera, Berwyck Gibbons, Anami Gour, Philip Sedgwick
This study assessed the agreement between arterial and venous blood lactate and pH levels in children with sepsis. This retrospective, three-year study involved 60 PICU patients, with data collected from electronic or paper patient records. The inclusion criteria comprised of children (≤17 years old) with sepsis and those who had a venous blood gas taken first with an arterial blood gas taken after within one hour. The lactate and pH values measured through each method were analysed. There is close agreement between venous and arterial lactate up to 2 mmol/L...
June 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28568353/prevention-of-complications-in-glycogen-storage-disease-type-ia-with-optimization-of-metabolic-control
#6
REVIEW
M Dambska, E B Labrador, C L Kuo, D A Weinstein
Prior to 1971, type Ia glycogen storage disease was marked by life-threatening hypoglycemia, lactic acidosis, severe failure to thrive, and developmental delay. With the introduction of continuous feeds in the 1970s and cornstarch in the 1980s, the prognosis improved, but complications almost universally developed. Changes in the management of type Ia glycogen storage disease have resulted in improved metabolic control, and this manuscript reviews the increasing evidence that complications can be delayed or prevented with optimal metabolic control as previously was seen in diabetes...
June 1, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28530382/diabetes-update-new-pharmacotherapy-for-type-2-diabetes
#7
REVIEW
Beth Choby
Multiple new drugs for managing type 2 diabetes have entered the market in the past 5 years. Guidelines from the American Diabetes Association recommend metformin for initial therapy, followed by a second drug if A1c goals are not met or initially for patients with A1c levels greater than 9%. Conversely, the American Association of Clinical Endocrinologists recommends initial management with two drugs if the A1c level is greater than 7.5%. The risk of lactic acidosis associated with metformin has been shown to be less than previously thought, with newer guidelines permitting use with an estimated glomerular filtration rate of 45 to 60 mL/min/1...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28515908/renal-manifestations-of-primary-mitochondrial-disorders
#8
Josef Finsterer, Fulvio Alexandre Scorza
The aim of the present review was to summarize and discuss previous findings concerning renal manifestations of primary mitochondrial disorders (MIDs). A literature review was performed using frequently used databases. The study identified that primary MIDs frequently present as mitochondrial multiorgan disorder syndrome (MIMODS) at onset or in the later course of the MID. Occasionally, the kidneys are affected in MIDs. Renal manifestations of MIDs include renal insufficiency, nephrolithiasis, nephrotic syndrome, renal cysts, renal tubular acidosis, Bartter-like syndrome, Fanconi syndrome, focal segmental glomerulosclerosis, tubulointerstitial nephritis, nephrocalcinosis, and benign or malign neoplasms...
May 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28398928/anesthetic-management-of-mitochondrial-encephalopathy-with-lactic-acidosis-and-stroke-like-episodes-melas-syndrome-in-a-high-risk-pregnancy-a-case-report
#9
Josh D Bell, Kushlin Higgie, Mital Joshi, Joshua Rucker, Sahar Farzi, Naveed Siddiqui
MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered...
July 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28196511/antiretroviral-therapy-related-adverse-effects-can-sub-saharan-africa-cope-with-the-new-test-and-treat-policy-of-the-world-health-organization
#10
Jobert Richie N Nansseu, Jean Joel R Bigna
BACKGROUND: Recent studies have shown that early antiretroviral therapy (ART) initiation results in significant HIV transmission reduction. This is the rationale behind the "test and treat" policy of the World Health Organization (WHO). Implementation of this policy will lead to an increased incidence of ART-related adverse effects, especially in sub-Saharan Africa (SSA). Is the region yet ready to cope with such a challenging issue? MAIN BODY: The introduction and widespread use of ART have drastically changed the natural history of HIV/AIDS, but exposure to ART leads to serious medication-related adverse effects mainly explained by mitochondrial toxicities, and the situation will get worse in the near future...
February 15, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28128878/heat-stroke-leading-to-acute-liver-injury-failure-a-case-series-from-the-acute-liver-failure-study-group
#11
Brian C Davis, Holly Tillman, Raymond T Chung, Richard T Stravitz, Rajender Reddy, Robert J Fontana, Brendan McGuire, Timothy Davern, William M Lee
BACKGROUND & AIMS: In the United States, nearly 1000 annual cases of heat stroke are reported but the frequency and outcome of severe liver injury in such patients is not well described. The aim of this study was to describe cases of acute liver injury (ALI) or failure (ALF) caused by heat stroke in a large ALF registry. METHODS: Amongst 2675 consecutive subjects enrolled in a prospective observational cohort of patients with ALI or ALF between January 1998 and April 2015, there were eight subjects with heat stroke...
April 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27913098/succinyl-coa-synthetase-sucla2-deficiency-in-two-siblings-with-impaired-activity-of-other-mitochondrial-oxidative-enzymes-in-skeletal-muscle-without-mitochondrial-dna-depletion
#12
Xiaoping Huang, Jirair K Bedoyan, Didem Demirbas, David J Harris, Alexander Miron, Simone Edelheit, George Grahame, Suzanne D DeBrosse, Lee-Jun Wong, Charles L Hoppel, Douglas S Kerr, Irina Anselm, Gerard T Berry
Mutations in SUCLA2 result in succinyl-CoA ligase (ATP-forming) or succinyl-CoA synthetase (ADP-forming) (A-SCS) deficiency, a mitochondrial tricarboxylic acid cycle disorder. The phenotype associated with this gene defect is largely encephalomyopathy. We describe two siblings compound heterozygous for SUCLA2 mutations, c.985A>G (p.M329V) and c.920C>T (p.A307V), with parents confirmed as carriers of each mutation. We developed a new LC-MS/MS based enzyme assay to demonstrate the decreased SCS activity in the siblings with this unique genotype...
March 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/27843092/rmnd1-related-leukoencephalopathy-with-temporal-lobe-cysts-and-hearing-loss-another-mendelian-mimicker-of-congenital-cytomegalovirus-infection
#13
Nicole Ulrick, Amy Goldstein, Cas Simons, Ryan J Taft, Guy Helman, Amy Pizzino, Miriam Bloom, Julie Vogt, Karen Pysden, Daria Diodato, Diego Martinelli, Ahmad Monavari, Daniela Buhas, Clara D M van Karnebeek, Imen Dorboz, Odile Boespflug-Tanguy, Diana Rodriguez, Martine Tétreault, Jacek Majewski, Genevieve Bernard, Yi Shiau Ng, Robert McFarland, Adeline Vanderver
BACKGROUND: Leukoencephalopathy with temporal lobe cysts may be associated with monogenetic conditions such as Aicardi-Goutières syndrome or RNASET2 mutations and with congenital infections such as cytomegalovirus. In view of the fact that congenital cytomegalovirus is difficult to confirm outside the neonatal period, excluding a Mendelian disorder is extremely relevant, changing family planning and medical management in affected families. We performed diagnostic testing in individuals with leukoencephalopathy with temporal lobe cysts without a definitive diagnosis of congenital cytomegalovirus infection...
January 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/27805342/management-of-sitagliptin-and-metformin-combination-toxic-overdose
#14
Sudhish Sehra, Shalini Jaggi, Devindra Sehra, Rajesh Aggarwal, Vikas Saraswat, Deven Juneja
Metformin and Sitagliptin are often used in combination in the management of non-insulin dependent diabetes mellitus. Though toxicity is rare, but occurs more frequently in cases of intentional or unintentional overdose of these drugs. Here, we present a case of an intentional overdose of a metformin- sitagliptin combination (70g metformin and 3500mg sitagliptin) in a suicide attempt by a young non-diabetic female who presented with severe lactic acidosis and was successfully treated with prompt hemodialysis and bicarbonate therapy...
November 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27752032/starvation-ketoacidosis-as-a-cause-of-unexplained-metabolic-acidosis-in-the-perioperative-period
#15
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/27723911/d-lactic-acidosis-case-report-and-review-of-the%C3%A2-literature
#16
Elisabeth Fabian, Ludwig Kramer, Franz Siebert, Christoph Högenauer, Reinhard Bernd Raggam, Heimo Wenzl, Guenter J Krejs
D-lactic acidosis is a rare complication that occurs mainly in patients with malabsorption due to a surgically altered gastrointestinal tract anatomy, namely in short bowel syndrome or after bariatric surgery. It is characterized by rapid development of neurological symptoms and severe metabolic acidosis, often with a high serum anion gap. Malabsorbed carbohydrates can be fermented by colonic microbiota capable of producing D-lactic acid. Routine clinical assessment of serum lactate covers only L-lactic acid; when clinical suspicion for D-lactic acidosis is high, special assays for D-lactic acid are called for...
January 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27703432/linezolid-toxicity-and-mitochondrial-susceptibility-a-novel-neurological-complication-in-a-lebanese-patient
#17
Ossama K Abou Hassan, Mohamad Karnib, Riyad El-Khoury, Georges Nemer, Mamdouha Ahdab-Barmada, Pierre BouKhalil
The recent rise in the use of linezolid to treat a variety of resistant pathogens has uncovered many side effects. Some patients develop lactic acidosis, myelosuppression, optic or peripheral neuropathies, and myopathies. We evaluated an elderly patient who presented to the Emergency Room with linezolid toxicity and a novel neurologic complication characterized by bilateral globi pallidi necrosis. Mitochondrial ribosome inhibition was described to be the predisposing factor. The patient belongs to the mitochondrial J1 haplotype known to be associated with side effects of the drug...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27687406/anesthetic-considerations-for-renal-transplant-surgery-in-patients-with-mitochondrial-myopathy-encephalopathy-lactic-acidosis-and-stroke-like-episodes-syndrome-a-case-report
#18
Michelle L Humeidan, Julia Dalia, Wanye D Traetow
Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes syndrome is a progressive syndrome with variable involvement of multiple-organ systems. These patients require special consideration for preoperative optimization, intraoperative management, and postoperative care. The medical literature regarding perioperative management of these patients relies heavily on case reports. Here we present a novel experience providing care for a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes syndrome who underwent renal transplantation for focal segmental glomerulosclerosis and end-stage renal disease...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27583122/prescribing-attitudes-behaviors-and-opinions-regarding-metformin-for-patients-with-diabetes-a-focus-group-study
#19
Katy E Trinkley, Daniel C Malone, Jennifer A Nelson, Joseph J Saseen
BACKGROUND: The purpose of this study was to identify the reasons why metformin prescribing is suboptimal. METHODS: Two semi-structured focus groups with attitudinal questionnaires and a brief educational presentation were held in two US cities. Participants included providers (physicians, pharmacists, midlevel practitioners) caring for patients with type 2 diabetes mellitus (T2DM) in an ambulatory setting. Outcome measures included provider attitudes, behaviors and opinions regarding the use of metformin...
September 2016: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/27492679/celiac-disease-presenting-as-profound-diarrhea-and-weight-loss-a-celiac-crisis
#20
Vadim Bul, Brett Sleesman, Brian Boulay
BACKGROUND Celiac disease is a hypersensitivity enteropathy that can have various presentations in adults. Rarely, patients can present with severe lab abnormalities, dehydration and weight loss caused by celiac disease - a celiac crisis. CASE REPORT A 46-year-old male with a past medical history significant for diabetes mellitus, type 2 (DM2) and recently treated Bell's Palsy presented to the emergency room complaining of weakness, diarrhea and lightheadedness. On presentation, the patient had a systolic blood pressure (SBP) of 60 mm Hg and a lactic acidosis with pH of 7...
August 5, 2016: American Journal of Case Reports
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