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https://www.readbyqxmd.com/read/29472424/pentobarbital-induced-lactic-acidosis-following-status-epilepticus-barbiturate-coma
#1
Todd Rabkin Golden, Veronika Solnicky, Rita Wadeea, Sehem Ghazala
We present a rare case of pentobarbital infusion causing propylene glycol-induced lactic acidosis, during refractory status epilepticus treatment in a 66-year-old man without seizure history.
February 22, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29471047/a-urinary-biosignature-for-mitochondrial-myopathy-encephalopathy-lactic-acidosis-and-stroke-like-episodes-melas
#2
Karien Esterhuizen, J Zander Lindeque, Shayne Mason, Francois H van der Westhuizen, Anu Suomalainen, Anna H Hakonen, Christopher J Carroll, Richard J Rodenburg, Paul B de Laat, Mirian C H Janssen, Jan A M Smeitink, Roan Louw
We used a comprehensive metabolomics approach to study the altered urinary metabolome of two mitochondrial myopathy, encephalopathy lactic acidosis and stroke like episodes (MELAS) cohorts carrying the m.3243A>G mutation. The first cohort were used in an exploratory phase, identifying 36 metabolites that were significantly perturbed by the disease. During the second phase, the 36 selected metabolites were able to separate a validation cohort of MELAS patients completely from their respective control group, suggesting usefulness of these 36 markers as a diagnostic set...
February 19, 2018: Mitochondrion
https://www.readbyqxmd.com/read/29465046/clinical-and-laboratory-features-of-metformin-intoxication-in-suicidal-patients-attending-an-intensive-care-unit
#3
A Cetinkaya, D Avci, A Erden, O Akca, O Ozer, U Kalan, A I Gunal
Introduction: This study has been performed for the purpose of researching the complications occurred at patients who took metformin overdose in an attempt to suicide. None of the patients has the diagnosis of diabetes mellitus and never used metformin. Materials and Methods: This retrospective cross-sectional study was carried out with 21 patients who has neither diagnosed diabetes mellitus nor taken metformin for suicide before. Results: It was observed that there is a moderate, negative (r = -0...
February 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29464268/reversible-dilation-of-cerebral-macrovascular-changes-in-melas-episodes
#4
Yuxin Li, Weixingzi Xu, Chong Sun, Jie Lin, Jianxun Qu, Jiawen Cao, Haiqing Li, Liqin Yang
PURPOSE: To investigate the cerebral macrovascular changes as well as the relationship of large vessels and cerebral blood flow (CBF) in mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) using magnetic resonance angiography (MRA) and arterial spin labeling (ASL) perfusion MR imaging (MRI). METHODS: A total of 20 patients diagnosed with MELAS (12 males, 8 females; mean age, 23.3 years) underwent conventional MRI, time-of-flight (TOF) MRA and three dimensional ASL...
February 20, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29456175/metformin-induced-lactic-acidosis-mila-a-case-report-and-review-of-current-diagnostic-paradigm
#5
Lauren Krowl, Hassan Al-Khalisy, Pratibha Kaul
A new diagnostic paradigm has been proposed to better categorize causes of Metformin-Associated Lactic Acidosis (MALA). The diagnostic criteria defines a link between Metformin and lactic acidosis if lactate is >5mmol/L, Ph<7.35 and Metformin assay >5mg/L. Metformin assays are not readily available in emergency departments including nationwide Veteran's Affairs Hospitals; thereby making this proposed classification tool difficult to use in today's clinical practice. We describe a case report of a 45-year-old male, who took twice the amount of Metformin prescribed and presented with Metformin-induced lactic acidosis...
February 15, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29455774/metformin-in-heart-failure-patients
#6
REVIEW
Abdulhalim Jamal Kinsara, Yasser Mansour Ismail
The use of metformin was considered a contraindication in heart failure patients because of the potential risk of lactic acidosis; however, more recent evidence has shown that this should no longer be the case. We reviewed the current literature and the recent guideline to correct the misconception.
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29440645/mammalian-cells-undergo-endoreduplication-in-response-to-lactic-acidosis
#7
Zhihao Tan, De Zhi Valerie Chu, Yong Jie Andrew Chan, Yi Ena Lu, Giulia Rancati
Polyploidization, a common event during the evolution of different tumours, has been proposed to confer selective advantages to tumour cells by increasing the occurrence of mutations promoting cancer progression and by conferring chemotherapy resistance. While conditions leading to polyploidy in cancer cells have been described, a general mechanism explaining the incidence of this karyotypic change in tumours is still missing. In this study, we tested whether a widespread tumour microenvironmental condition, low pH, could induce polyploidization in mammalian cells...
February 13, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29437806/rhabdomyolysis-in-stuve-wiedemann-syndrome
#8
Pemantah Sandheeah Ramdeny, Colin Powell, Mallinath Chakraborty, Louise Hartley
A 6-month-old male infant with Stuve-Wiedemann syndrome (SWS) presented with an acute respiratory arrest secondary to a rhinovirus respiratory infection from which he was rapidly resuscitated. He developed an acute kidney injury requiring supportive treatment and on day 3 of his illness was noted to have developed severe rhabdomyolysis (creatine kinase level 132 040 U/L (normal <320 U/L)). He was born from consanguineous parents with homozygous mutations in the leukaemia inhibitory factor receptor. He had skeletal dysplasia with metabolic bone disease and episodes of hyperthermia with lactic acidosis...
February 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29435189/effect-of-metformin-on-kidney-function-in-patients-with-type-2-diabetes-mellitus-and-moderate-chronic-kidney-disease
#9
Wei-Hao Hsu, Pi-Jung Hsiao, Pi-Chen Lin, Szu-Chia Chen, Mei-Yueh Lee, Shyi-Jang Shin
Background: Impaired renal function can lead to the accumulation of metformin, and elevated concentrations of metformin have been associated with lactic acidosis. The aim of this study was to evaluate the effect of continuous metformin treatment in patients with type 2 diabetes mellitus (DM) and moderate chronic kidney disease (CKD) (estimated glomerular filtration rate (eGFR) 30-0 ml/min/1.73 m 2 ) on renal function. Methods: A total of the 616 patients were enrolled from the research database of Kaohsiung Medical University Hospital from January 1 to 2009 and December 31, 2013...
January 12, 2018: Oncotarget
https://www.readbyqxmd.com/read/29431385/glucose-management-in-hospitalized-patients
#10
Charles Kodner, Laurie Anderson, Katherine Pohlgeers
Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens. Uncontrolled blood glucose levels can lead to deleterious effects on wound healing, increased risk of infection, and delays in surgical procedures or discharge from the hospital. Previously recommended strict blood glucose targets for hospitalized patients result in more cases of hypoglycemia without improvement in patient outcomes...
November 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/29429571/ndufb8-mutations-cause-mitochondrial-complex-i-deficiency-in-individuals-with-leigh-like-encephalomyopathy
#11
Dorota Piekutowska-Abramczuk, Zahra Assouline, Lavinija Mataković, René G Feichtinger, Eliška Koňařiková, Elżbieta Jurkiewicz, Piotr Stawiński, Mirjana Gusic, Andreas Koller, Agnieszka Pollak, Piotr Gasperowicz, Joanna Trubicka, Elżbieta Ciara, Katarzyna Iwanicka-Pronicka, Dariusz Rokicki, Sylvain Hanein, Saskia B Wortmann, Wolfgang Sperl, Agnès Rötig, Holger Prokisch, Ewa Pronicka, Rafał Płoski, Giulia Barcia, Johannes A Mayr
Respiratory chain complex I deficiency is the most frequently identified biochemical defect in childhood mitochondrial diseases. Clinical symptoms range from fatal infantile lactic acidosis to Leigh syndrome and other encephalomyopathies or cardiomyopathies. To date, disease-causing variants in genes coding for 27 complex I subunits, including 7 mitochondrial DNA genes, and in 11 genes encoding complex I assembly factors have been reported. Here, we describe rare biallelic variants in NDUFB8 encoding a complex I accessory subunit revealed by whole-exome sequencing in two individuals from two families...
February 1, 2018: American Journal of Human Genetics
https://www.readbyqxmd.com/read/29428506/8-year-retrospective-analysis-of-intravenous-arginine-therapy-for-acute-metabolic-strokes-in-pediatric-mitochondrial-disease
#12
Rebecca D Ganetzky, Marni J Falk
BACKGROUND: Intravenous (IV) arginine has been reported to ameliorate acute metabolic stroke symptoms in adult patients with Mitochondrial Encephalopathy with Lactic Acidosis and Stroke-like Episodes (MELAS) syndrome, where its therapeutic benefit is postulated to result from arginine acting as a nitric oxide donor to reverse vasospasm. Further, reduced plasma arginine may occur in mitochondrial disease since the biosynthesis of arginine's precursor, citrulline, requires ATP. Metabolic strokes occur across a wide array of primary mitochondrial diseases having diverse molecular etiologies that are likely to share similar pathophysiologic mechanisms...
February 2, 2018: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/29427160/metformin-associated-lactic-acidosis-a-case-report
#13
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
https://www.readbyqxmd.com/read/29417853/challenges-in-the-diagnosis-of-acute-cyanide-poisoning
#14
J L Parker-Cote, J Rizer, J P Vakkalanka, S V Rege, C P Holstege
OBJECTIVE: The aim of this systematic review was to identify isolated acute cyanide poison cases and to identify reported signs, symptoms, and laboratory findings. METHODS: We searched MEDLINE, Cochrane Reviews, and Web of Science case reports and series using a number of MeSH descriptors pertaining to cyanide, toxicity, and poisonings. We excluded studies on plants, laboratory analyses, smoke inhalation poisonings, animals as well as non-English language articles and those in which data were not available...
February 8, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29416246/effect-of-lactate-versus-acetate-based-intravenous-fluids-on-acid-base-balance-in-patients-undergoing-free-flap-reconstructive-surgeries
#15
Sunil Rajan, Soumya Srikumar, Pulak Tosh, Lakshmi Kumar
Background and Aims: Use of lactated intravenous fluids during long surgeries could cause lactate accumulation and lactic acidosis. Acetate-based solutions could be advantageous as they are devoid of lactate. The primary aim of the study was to assess the effect of use of an acetated solution or Ringer's lactate (RL) as intraoperative fluid on lactate levels in patients without hepatic dysfunction undergoing prolonged surgeries. Material and Methods: This was a prospective, randomized, controlled trial involving sixty patients belonging to American Society of Anesthesiologists Physical Status I to II undergoing major head and neck surgeries with free flap reconstruction...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29410974/bacteremia-and-septic-arthritis-due-to-a-nontoxigenic-strain-of-clostridium-difficile-in-a-patient-with-sickle-cell-disease
#16
Emilie Hill, Adrienne D Workman, Francesca Lee, Rita Hollaway, Dominick Cavuoti, Bonnie C Prokesch
A 22-year-old female with sickle cell disease presented with fevers, bilateral knee pain, and lethargy. Laboratory data revealed a leukocytosis and lactic acidosis. Blood and synovial fluid cultures grew a non-toxin-producing strain of Clostridium difficile. This case highlights the fact that nontoxigenic Clostridium difficile can cause significant disease.
February 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29409505/open-label-pilot-for-treatment-targeting-gut-dysbiosis-in-myalgic-encephalomyelitis-chronic-fatigue-syndrome-neuropsychological-symptoms-and-sex-comparisons
#17
Amy Wallis, Michelle Ball, Henry Butt, Donald P Lewis, Sandra McKechnie, Phillip Paull, Amber Jaa-Kwee, Dorothy Bruck
BACKGROUND: Preliminary evidence suggests that the enteric microbiota may play a role in the expression of neurological symptoms in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Overlapping symptoms with the acute presentation of D-lactic acidosis has prompted the use of antibiotic treatment to target the overgrowth of species within the Streptococcus genus found in commensal enteric microbiota as a possible treatment for neurological symptoms in ME/CFS. METHODS: An open-label, repeated measures design was used to examine treatment efficacy and enable sex comparisons...
February 6, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29406897/survival-analysis-of-a-cohort-of-chinese-patients-with-mitochondrial-encephalomyopathy-with-lactic-acidosis-and-stroke-like-episodes-melas-based-on-clinical-features
#18
Zhe Zhang, Danhua Zhao, Xiao Zhang, Hui Xiong, Xinhua Bao, Yun Yuan, Zhaoxia Wang
BACKGROUND: Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) is a common mitochondrial syndrome. The aim of this study was to conduct a survival analysis based on the clinical features of a Chinese MELAS patient cohort. METHODS: This is a retrospective single-center study. The MELAS patients were followed up for 1-8years (median 4years). The disease severity was evaluated by the modified Rankin Scale (mRS). The survival analysis was performed using Kaplan-Meier analysis and Cox proportional hazards model...
February 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29399540/drug-interactions-of-metformin-involving-drug-transporter-proteins
#19
REVIEW
Naina Mohamed Pakkir Maideen, Abdurazak Jumale, Rajkapoor Balasubramaniam
Metformin is a most widely used medication all around the world to treat Type 2 diabetes mellitus. It is also found to be effective against various conditions including, Prediabetes, Gestational diabetes mellitus (GDM), Polycystic Ovarian Syndrome (PCOS), Obesity, Cancer, etc. It is a cationic drug and it depends Organic Cation Transporters (OCTs) and Multidrug and Toxin Extruders (MATEs) mostly for its pharmacokinetics movement. The probability of drug interaction increases with the number of concomitant medications...
December 2017: Advanced Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/29391354/metformin-associated-lactic-acidosis-mimicking-ischaemic-bowel
#20
Sajjad Ali, Heloise Labuschagne, Nickolay Azarov, Zakaria Hindi, Lavi Oud
Metformin-associated lactic acidosis (MALA) is a rare complication among patients who are diabetic, commonly presenting with non-specific findings, and developing mostly among those with other risk factors for lactic acidosis. We report the development of MALA in a 67-year-old man with diabetes who presented with progressive abdominal pain and bloody diarrhoea. On presentation the patient was in shock, with signs suggestive of peritonitis, and with severe lactic acidosis, renal failure and non-specific findings on abdominal CT...
February 1, 2018: BMJ Case Reports
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