275 results match your criteria Alcoholic Ketoacidosis


A Case of Hypoglycemia Associated With the Ketogenic Diet and Alcohol Use.

J Endocr Soc 2020 Jun 18;4(6):bvaa045. Epub 2020 Apr 18.

Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.

The ketogenic diet, which has become an increasingly popular diet, severely restricts carbohydrate intake to shunt metabolism towards fatty acid oxidation and production of ketones as a fuel source. There have been many studies illustrating the positive effects of a ketogenic diet in weight loss and other benefits; however, the long-term effects and potential adverse events of a ketogenic diet have not been well studied or documented in literature. There are a few case reports of ketogenic diet resulting in hypoglycemia. Read More

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http://dx.doi.org/10.1210/jendso/bvaa045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278276PMC

Massive lactic acidosis and ketoacidosis with glucagon deficiency in a chronic alcoholic patient.

Diabetes Metab 2020 Jun 9. Epub 2020 Jun 9.

INSERM UMR_S 938, Saint-Antoine Research Centre, Sorbonne Université, Paris, France; Assistance Publique-Hôpitaux de Paris, Service de Biochimie et Hormonologie, Hôpital Tenon, Paris, France.

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http://dx.doi.org/10.1016/j.diabet.2020.05.011DOI Listing

Starvation ketoacidosis on the acute medical take.

Clin Med (Lond) 2020 May;20(3):298-300

Weston General Hospital, Weston-super-Mare, UK.

Starvation ketoacidosis (SKA) represents one of three metabolic acidoses caused by the accumulation of ketone bodies within the bloodstream. While easily treated, it is a diagnosis that can be easily missed in patients with an unexplained metabolic acidosis.In this case report, we discuss two patients presenting with a starvation ketoacidosis and psychiatric illness. Read More

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http://dx.doi.org/10.7861/clinmed.2020-0012DOI Listing

Utility of Postmortem Vitreous Beta-Hydroxybutyrate Testing for Distinguishing Sudden from Prolonged Deaths and for Diagnosing Ketoacidosis.

J Forensic Sci 2020 Apr 29. Epub 2020 Apr 29.

Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5, Canada.

A retrospective, cross-sectional analysis of vitreous beta-hydroxybutyrate (BHB) on 967 forensic cases over a two-year period was conducted. Cases were sorted into six categories of death: (i) sudden traumatic/non-natural (ST), (ii) sudden natural (SN), (iii) prolonged traumatic/non-natural (PT), (iv) prolonged natural (PN), (v) diabetic ketoacidosis (DKA), and (vi) alcoholic ketoacidosis (AKA). The mean BHB for all cases was 1. Read More

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http://dx.doi.org/10.1111/1556-4029.14443DOI Listing

Hepatic metabolomics and transcriptomics to study susceptibility to ketosis in response to prepartal nutritional management.

J Anim Sci Biotechnol 2019 18;10:96. Epub 2019 Dec 18.

2Department of Animal Sciences and Division of Nutritional Sciences, University of Illinois, Urbana, IL 61801 USA.

Background: Ketosis in dairy cows is associated with body fat mobilization during the peripartal period. Sub-clinical and clinical ketosis arise more frequently in cows that are overfed energy during the entire dry (last 50 to 45 days prior to parturition) or close-up period (last ~ 28 days prepartum).

Methods: A retrospective analysis was performed on 12 cows from a larger cohort that were fed a higher-energy diet [1. Read More

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http://dx.doi.org/10.1186/s40104-019-0404-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6918647PMC
December 2019

Diagnosis and management of acute esophageal necrosis.

Ann Gastroenterol 2019 Nov-Dec;32(6):529-540. Epub 2019 Sep 26.

Gastroenterology Department, Faculty of Medicine, Centro Hospitalar de São João, Porto, Portugal.

Acute esophageal necrosis is a rare syndrome classically characterized by a striking endoscopic image of diffuse and circumferential black mucosal discoloration of distal esophagus, with an abrupt transition at the gastroesophageal junction and variable proximal extension. The typical patient is an older male with general debilitation and multiple comorbidities presenting with hematemesis or melena. The pathophysiology usually involves a combination of esophageal ischemia, backflow injury from gastric chemical contents and impaired mucosal reparative mechanisms associated with debilitated physical states. Read More

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http://dx.doi.org/10.20524/aog.2019.0418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826069PMC
September 2019
3 Reads

Invasive, gangrenous mucormycosis of arm: A fatal opportunistic infection in a highly immunocompromised host.

Indian J Pathol Microbiol 2019 Oct-Dec;62(4):618-620

Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.

Opportunistic fungal infections occur predominantly in immunocompromised (IC) patients. Mucormycosis has the highest mortality among fungal infections. The organism is ubiquitous in its presence. Read More

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http://dx.doi.org/10.4103/IJPM.IJPM_854_15DOI Listing
February 2020
1 Read

Delta Neutrophil Index is Useful to Predict Poor Outcomes in Male Patients with Alcoholic Ketoacidosis.

Electrolyte Blood Press 2019 Jun 30;17(1):7-15. Epub 2019 Jun 30.

Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Korea.

Background: Alcoholic ketoacidosis (AKA) is known as a benign disease, but the related mortality reported in Korea is high. Acidosis and alcohol change the immunity profile, and these changes can be identified early using the delta neutrophil index (DNI). We aimed to evaluate the use of DNI and other standard laboratory parameters as predictors of prognosis in AKA patients. Read More

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https://synapse.koreamed.org/DOIx.php?id=10.5049/EBP.2019.17
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http://dx.doi.org/10.5049/EBP.2019.17.1.7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6629600PMC
June 2019
2 Reads

[Alcoholic ketoacidosis].

Ugeskr Laeger 2019 Jun;181(23)

Alcoholic ketoacidosis is a relatively rare condition, which may have a lethal outcome if left untreated. This review covers definition, pathophysiology, clinical manifestations, diagnostic approach and treatment. Usually, patients respond well and quickly to treatment, if it is started early in the course. Read More

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June 2019
14 Reads

Cyp2b-null male mice are susceptible to diet-induced obesity and perturbations in lipid homeostasis.

J Nutr Biochem 2019 08 21;70:125-137. Epub 2019 May 21.

Environmental Toxicology Program, Clemson University, Clemson, SC 29634; Biological Sciences, Clemson University, Clemson, SC 29634. Electronic address:

Obesity is an endemic problem in the United States and elsewhere, and data indicate that in addition to overconsumption, exposure to specific chemicals enhances obesity. CYP2B metabolizes multiple endo- and xenobiotics, and recent data suggests that repression of Cyp2b activity increases dyslipidemia and age-onset obesity, especially in males. To investigate the role played by Cyp2b in lipid homeostasis and obesity, we treated wildtype and Cyp2b-null mice with a normal (ND) or 60% high-fat diet (HFD) for 10 weeks and determined metabolic and molecular changes. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09552863183123
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http://dx.doi.org/10.1016/j.jnutbio.2019.05.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642837PMC
August 2019
7 Reads

Dynamic repression by BCL6 controls the genome-wide liver response to fasting and steatosis.

Elife 2019 04 15;8. Epub 2019 Apr 15.

Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, United States.

Transcription is tightly regulated to maintain energy homeostasis during periods of feeding or fasting, but the molecular factors that control these alternating gene programs are incompletely understood. Here, we find that the B cell lymphoma 6 (BCL6) repressor is enriched in the fed state and converges genome-wide with PPARα to potently suppress the induction of fasting transcription. Deletion of hepatocyte enhances lipid catabolism and ameliorates high-fat-diet-induced steatosis. Read More

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https://elifesciences.org/articles/43922
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http://dx.doi.org/10.7554/eLife.43922DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464608PMC
April 2019
23 Reads

Post hoc analyses of surrogate markers of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis in patients with type 2 diabetes in a digitally supported continuous care intervention: an open-label, non-randomised controlled study.

BMJ Open 2019 02 25;9(2):e023597. Epub 2019 Feb 25.

Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Objective: One year of comprehensive continuous care intervention (CCI) through nutritional ketosis improves glycosylated haemoglobin(HbA1c), body weight and liver enzymes among patients with type 2 diabetes (T2D). Here, we report the effect of the CCI on surrogate scores of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis.

Methods: This was a non-randomised longitudinal study, including adults with T2D who were self-enrolled to the CCI (n=262) or to receive usual care (UC, n=87) during 1 year. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02359
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http://dx.doi.org/10.1136/bmjopen-2018-023597DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398805PMC
February 2019
34 Reads

Mauriac Syndrome: A Rare Complication of Type 1 Diabetes Mellitus.

Eur J Case Rep Intern Med 2018 27;5(12):000969. Epub 2018 Dec 27.

Department of Internal Medicine, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal.

Mauriac syndrome, first described in 1930, is typically diagnosed in young patients with poorly controlled type 1 diabetes mellitus and growth retardation, delayed puberty, Cushingoid features, hypercholesterolaemia and hepatomegaly. However, the sole presenting feature of Mauriac syndrome can be hepatic glycogenosis in both adults and children. The mainstay of treatment for hepatic glycogenosis is strict control of glucose levels, with an excellent prognosis with improved glycaemic control. Read More

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http://dx.doi.org/10.12890/2018_000969DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346977PMC
December 2018
9 Reads

The logistic organ dysfunction system score predicts the prognosis of patients with alcoholic ketoacidosis.

Ren Fail 2018 Nov;40(1):693-699

b Department of Internal Medicine , Changwon Gyeongsang National University Hospital , Changwon , South Korea.

Alcoholic ketoacidosis (AKA) is occasionally associated with multiple complications leading to death. However, no study has yet evaluated prognostic factors in patients with AKA. It is known that the logistic organ dysfunction system (LODS) score is an objective and useful index to predict the prognosis. Read More

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http://dx.doi.org/10.1080/0886022X.2018.1491405DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011874PMC
November 2018
28 Reads

Acquired partial lipoatrophy as graft-versus-host disease and treatment with metreleptin: two case reports.

J Med Case Rep 2018 Dec 14;12(1):368. Epub 2018 Dec 14.

Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.

Introduction: Acquired partial lipoatrophy has been reported after bone marrow transplantation during childhood; however, no adult cases have previously been reported. We herein report two adult cases of acquired partial lipoatrophy after transplantation.

Case Presentation: A 28-year-old Japanese woman developed diabetic ketoacidosis and received insulin therapy after bone marrow transplantation. Read More

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https://jmedicalcasereports.biomedcentral.com/articles/10.11
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http://dx.doi.org/10.1186/s13256-018-1901-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293520PMC
December 2018
41 Reads

Alcohol-induced ketonemia is associated with lowering of blood glucose, downregulation of gluconeogenic genes, and depletion of hepatic glycogen in type 2 diabetic db/db mice.

Biochem Pharmacol 2019 02 7;160:46-61. Epub 2018 Dec 7.

Center for Pharmacy and Experimental Therapeutics, University of Georgia College of Pharmacy, Augusta, GA, USA; Charlie Norwood VA Medical Center, Augusta, GA, USA; Vascular Biology Center, Department of Pharmacology and Toxicology, Augusta University, Augusta, GA, USA; Department of Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA. Electronic address:

Alcoholic ketoacidosis and diabetic ketoacidosis are life-threatening complications that share the characteristic features of high anion gap metabolic acidosis. Ketoacidosis is attributed in part to the massive release of ketone bodies (e.g. Read More

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http://dx.doi.org/10.1016/j.bcp.2018.12.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6348028PMC
February 2019
17 Reads

Nutritional Ketosis for Weight Management and Reversal of Metabolic Syndrome.

Curr Nutr Rep 2018 09;7(3):97-106

Division of Gastroenterology, University of California Davis, Davis, CA, USA.

Purpose Of Review: The goal of this paper is to review current literature on nutritional ketosis within the context of weight management and metabolic syndrome, namely, insulin resistance, lipid profile, cardiovascular disease risk, and development of non-alcoholic fatty liver disease. We provide background on the mechanism of ketogenesis and describe nutritional ketosis.

Recent Findings: Nutritional ketosis has been found to improve metabolic and inflammatory markers, including lipids, HbA1c, high-sensitivity CRP, fasting insulin and glucose levels, and aid in weight management. Read More

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http://dx.doi.org/10.1007/s13668-018-0235-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6472268PMC
September 2018
14 Reads

Detection of elevated ketone bodies by postmortem 1H-MRS in a case of fetal ketoacidosis.

J Forensic Leg Med 2018 Oct 25;59:16-19. Epub 2018 Jul 25.

Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Zurich, Switzerland; Hospital of Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.

We report a fetal loss following maternal ketoacidosis in a case of cryptic pregnancy. Biochemical analysis of peripheral blood revealed highly elevated levels of beta-hydroxybutyrate (BHB) in the mother (9.2 mmol/l) and the fetus (4. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S1752928X183020
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http://dx.doi.org/10.1016/j.jflm.2018.07.009DOI Listing
October 2018
44 Reads

Soluble CD163 correlates with lipid metabolic adaptations in type 1 diabetes patients during ketoacidosis.

J Diabetes Investig 2019 Jan 30;10(1):67-72. Epub 2018 Jun 30.

Department of Hepatology and Gastroenterology, Aarhus University, Aarhus C, Denmark.

Introduction: Diabetic ketoacidosis (DKA) is associated with inflammation and increased lipolysis. The macrophage activation marker, soluble CD163 (sCD163), is associated with obesity, non-alcoholic fatty liver disease and type 2 diabetes. We aimed to investigate whether sCD163 correlates with key elements of lipolysis in type 1 diabetes patients during mild DKA. Read More

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http://dx.doi.org/10.1111/jdi.12869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319477PMC
January 2019
16 Reads

High fat diet induced obesity is mitigated in Cyp3a-null female mice.

Chem Biol Interact 2018 Jun 5;289:129-140. Epub 2018 May 5.

Biological Sciences, Clemson University, Clemson, SC 29634, United States; Environmental Toxicology Program, Clemson University, Clemson, SC 29634, United States. Electronic address:

Recent studies indicate a role for the constitutive androstane receptor (CAR), pregnane X-receptor (PXR), and hepatic xenobiotic detoxifying CYPs in fatty liver disease or obesity. Therefore, we examined whether Cyp3a-null mice show increased obesity and fatty liver disease following 8-weeks of exposure to a 60% high-fat diet (HFD). Surprisingly, HFD-fed Cyp3a-null females fed a HFD gained 50% less weight than wild-type (WT; B6) females fed a HFD. Read More

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http://dx.doi.org/10.1016/j.cbi.2018.05.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717702PMC
June 2018
12 Reads

Rich table but short life: Diffuse idiopathic skeletal hyperostosis in Danish astronomer Tycho Brahe (1546-1601) and its possible consequences.

PLoS One 2018 19;13(4):e0195920. Epub 2018 Apr 19.

PACEA-UMR 5199, University of Bordeaux, Pessac, France.

The exhumation of Danish astronomer Tycho Brahe (1546-1601) was performed in 2010 to verify speculative views on the cause of his death. Previous analyses of skeletal and hair remains recovered from his grave refuted the presumption that he died from poisoning. These studies also outlined the possibility that he actually died from an acute illness, echoing the rather vague and inaccurate testimony of some historical records. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195920PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909615PMC
July 2018
37 Reads

Prevalence and clinical characteristics of non-alcoholic fatty liver disease in newly diagnosed patients with ketosis-onset diabetes.

Diabetes Metab 2018 11 21;44(5):437-443. Epub 2018 Mar 21.

Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai key Laboratory of Diabetes Mellitus, 600, Yishan Road, 200233 Shanghai, China. Electronic address:

Aim: As the prevalence and clinical characteristics of non-alcoholic fatty liver disease (NAFLD) are still unknown in ketosis-onset diabetes, the present study compared the characteristics of NAFLD in type 1 diabetes (T1D), ketosis-onset and non-ketotic type 2 diabetes (T2D) patients.

Methods: This cross-sectional study was performed with newly diagnosed Chinese patients with diabetes, including 39 T1D, 165 ketosis-onset and 173 non-ketotic T2D, with 30 non-diabetics included as controls. NAFLD was determined by hepatic ultrasonography, then its clinical features were analyzed and its associated risk factors evaluated. Read More

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http://dx.doi.org/10.1016/j.diabet.2018.03.002DOI Listing
November 2018
8 Reads

Glycogenic hepatopathy: A narrative review.

World J Hepatol 2018 Feb;10(2):172-185

Department of Gastroenterology and Hepatology, NYP-Brooklyn Methodist Hospital, Brooklyn, NY 11215, United States.

Glycogenic hepatopathy (GH) is a rare complication of the poorly controlled diabetes mellitus characterized by the transient liver dysfunction with elevated liver enzymes and associated hepatomegaly caused by the reversible accumulation of excess glycogen in the hepatocytes. It is predominantly seen in patients with longstanding type 1 diabetes mellitus and rarely reported in association with type 2 diabetes mellitus. Although it was first observed in the pediatric population, since then, it has been reported in adolescents and adults with or without ketoacidosis. Read More

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http://dx.doi.org/10.4254/wjh.v10.i2.172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838438PMC
February 2018
10 Reads

[Alcoholic ketoacidosis – a review].

Authors:
Jonas Höjer

Lakartidningen 2017 10 3;114. Epub 2017 Oct 3.

- , Sweden - , Sweden.

Alcoholic ketoacidosis - a review A chronic alcoholic with severe metabolic acidosis presents a difficult diagnostic problem in the emergency room. Over and above methanol- and ethylene glycol intoxication, alcoholic ketoacidosis is a common but less recognized etiology. The disorder occurs in alcoholics who have had a recent binge drinking followed by the abrupt cessation of alcohol consumption because of abdominal pain and vomiting, with resulting dehydration, starvation, and then a β-hydroxybutyrate dominated ketoacidosis. Read More

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October 2017
15 Reads

Sudden unexplained death in alcohol misuse (SUDAM) patients have different characteristics to those who died from sudden arrhythmic death syndrome (SADS).

Forensic Sci Med Pathol 2017 Sep 1;13(3):278-283. Epub 2017 Jul 1.

CRY Department of Cardiovascular Pathology, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.

There is growing awareness of sudden unexplained death in alcohol misuse (SUDAM) in which there is no obvious cause of death, no evidence of acute alcohol toxicity or alcoholic ketoacidosis, and the heart is morphologically normal. This study describes the characteristics of a cohort with SUDAM from a tertiary cardiovascular referral center and compares the findings with those of individuals who died from sudden arrhythmic death syndrome (SADS). Cases in this retrospective cross-sectional study were identified from a database of referrals to our center spanning approximately 40 years. Read More

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http://dx.doi.org/10.1007/s12024-017-9877-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5554285PMC
September 2017
23 Reads

Hepatic lipid accumulation: cause and consequence of dysregulated glucoregulatory hormones.

J Endocrinol 2017 Jul 20;234(1):R1-R21. Epub 2017 Apr 20.

School of Animal and Comparative Biomedical SciencesUniversity of Arizona, Tucson, Arizona, USA

Fatty liver can be diet, endocrine, drug, virus or genetically induced. Independent of cause, hepatic lipid accumulation promotes systemic metabolic dysfunction. By acting as peroxisome proliferator-activated receptor (PPAR) ligands, hepatic non-esterified fatty acids upregulate expression of gluconeogenic, beta-oxidative, lipogenic and ketogenic genes, promoting hyperglycemia, hyperlipidemia and ketosis. Read More

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http://dx.doi.org/10.1530/JOE-16-0513DOI Listing
July 2017
15 Reads

Drug-Induced Liver Injury in the Setting of Glycogenic Hepatopathy.

J Gen Intern Med 2017 Jun 21;32(6):714-717. Epub 2017 Feb 21.

Department of Pathology, Loyola University Stritch School of Medicine, Room 7612, 2160 S 1st Avenue, Maywood, IL, 60153, USA.

Glycogenic hepatopathy (GH) is an underdiagnosed complication of uncontrolled type 1 diabetes mellitus (T1DM). It appears as an acute relapsing hepatitis with reversible transaminase elevations secondary to excessive hepatic glycogen accumulation. Patients are often asymptomatic but can present with abdominal pain, nausea and vomiting. Read More

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http://dx.doi.org/10.1007/s11606-017-3996-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442014PMC
June 2017
17 Reads

Beta-hydroxybutyrate and pyroglutamate can be included in a rapid GC-MS screening method for differential diagnosis of metabolic acidosis.

Scand J Clin Lab Invest 2017 Apr 2;77(2):149-152. Epub 2017 Feb 2.

a Department of Pharmacology , Oslo University Hospital , Oslo , Norway.

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. Read More

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https://www.tandfonline.com/doi/full/10.1080/00365513.2016.1
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http://dx.doi.org/10.1080/00365513.2016.1278261DOI Listing
April 2017
13 Reads

Basal Vacuolization in Renal Tubular Epithelial Cells at Autopsy and Their Relation to Ketoacidosis.

J Forensic Sci 2017 May 30;62(3):681-685. Epub 2017 Jan 30.

School of Medicine, The University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia.

Basal vacuolization of renal tubular epithelial cells is a useful postmortem marker for ketoacidosis. To investigate its incidence and relationship to the severity of ketoacidosis, 158 autopsy cases with elevated β-hydroxybutyrate (>1 mmol/L) over a 7-year-period were retrospectively reviewed. Sixty-eight cases (43%) exhibited basal vacuolizations (vitreous β-hydroxybutyrate: 1. Read More

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http://dx.doi.org/10.1111/1556-4029.13311DOI Listing
May 2017
53 Reads

The Interplay Between Diabetes and Pancreatitis: Two Case Reports of Sudden, Natural Deaths and a Review of the Literature.

J Forensic Sci 2017 Mar 16;62(2):519-524. Epub 2016 Nov 16.

Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 165 Ashley Avenue, Charleston, SC, 29425.

Diabetes mellitus (DM) is a common disease involving insulin resistance or deficit that, when left unchecked, may cause severe hyperglycemia and subsequent end-organ damage. Acute pancreatitis (AP) is inflammation of the pancreas that can lead to significant morbidity and mortality. AP and DM both account for a significant amount of sudden deaths, and rarely both disease processes may be present in the same decedent, causing some difficulty in wording the cause of death statement. Read More

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http://dx.doi.org/10.1111/1556-4029.13268DOI Listing
March 2017
9 Reads

Ketoacidosis in a Non-Diabetic Adult With Chronic EtOH Consumption.

J Clin Med Res 2016 Dec 26;8(12):919-920. Epub 2016 Oct 26.

Department of Medicine, Centre Hospitalier de l'Universite de Montreal (CRCHUM), Montreal, QC, H2W 1T8, Canada.

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. Read More

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http://dx.doi.org/10.14740/jocmr2751wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5087634PMC
December 2016
26 Reads

A Patient With Alcoholic Ketoacidosis and Profound Lactemia.

J Emerg Med 2016 Oct;51(4):447-449

Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

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. Read More

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http://dx.doi.org/10.1016/j.jemermed.2015.05.048DOI Listing
October 2016
81 Reads

Postmortem Computed Tomography Findings Associated with Sudden Death in Alcoholics.

Nihon Arukoru Yakubutsu Igakkai Zasshi 2016 Oct;51(5):283-292

Forensic pathologists.frequently encounter sudden natural.death of alcoholic in which fatty liver is the only pathological finding detected at autopsy, however, characteristics of postmortem CT (PMCT) of sudden death of alcoholic have not been reported so far. Read More

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October 2016
31 Reads

Subnuclear lipid-containing vacuolization in cases of ketoacidosis - correlation of morphological findings and ketone body concentrations.

Arch Kriminol 2016 Aug;238(1-2):57-63

In a study on alcoholics, diabetics, cases of hypothermia, combinations of alcoholism, diabetes and hypothermia as well as 55 controls, ketone body measurements were performed in femoral vein blood, heart blood, vitreous humor, cerebrospinal fluid and urine. Histological investigations were carried out on the kidneys of the deceased. In addition to HE-staining, the cuts were stained with Sudan and PAS to allow differentiation between lipids and glycogens. Read More

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August 2016
10 Reads

Liver Pathology in First Presentation Diabetic Ketoacidosis at Autopsy.

Acad Forensic Pathol 2016 Jun 1;6(2):271-280. Epub 2016 Jun 1.

Eastern Ontario Forensic Pathology Unit - Anatomical Pathology.

Diabetes mellitus is an enormous health burden on developed and developing nations. Eight percent of people in the United States are stated to have diabetes mellitus and 79 million people have impaired glucose tolerance. Sudden death from diabetic ketoacidosis (DKA) is common and nonalcoholic fatty liver disease (NAFLD) is a frequent finding in patients with diabetes mellitus and impaired glucose tolerance. Read More

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http://dx.doi.org/10.23907/2016.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6507014PMC
June 2016
4 Reads

Autopsy of a patient with alcoholic suffering from cardiopulmonary arrest at the hospital.

Nihon Arukoru Yakubutsu Igakkai Zasshi 2016 Jun;51(3):234-240

A 48-year-old Japanese woman with >10 years history of alcoholic had been falling repeatedly during 1 week before her death. She complained of nausea and did not eat or drink for 2 days. Thereafter, she became drowsy and she was transferred to the hospital. Read More

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June 2016
8 Reads

Postmortem biochemistry in suspected starvation-induced ketoacidosis.

J Forensic Leg Med 2016 Aug 4;42:51-5. Epub 2016 May 4.

Laboratory of Clinical Chemistry, Lausanne University Hospital, Lausanne, Switzerland.

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. Read More

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http://dx.doi.org/10.1016/j.jflm.2016.04.013DOI Listing
August 2016
39 Reads

Postmortem biochemistry: Current applications.

J Forensic Leg Med 2016 Jul 19;41:49-57. Epub 2016 Apr 19.

Toxicology Unit, Department of Clinical Biochemistry, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK; Toxicology Unit, Dept of Pathology, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.

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. The interpretation of results is often complicated because of the likelihood of postmortem change in analyte concentration or activity, and proper interpretation must take into account all the available evidence. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S1752928X163001
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http://dx.doi.org/10.1016/j.jflm.2016.04.011DOI Listing
July 2016
20 Reads

Unpeeling the Evidence for the Banana Bag: Evidence-Based Recommendations for the Management of Alcohol-Associated Vitamin and Electrolyte Deficiencies in the ICU.

Crit Care Med 2016 Aug;44(8):1545-52

1Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY. 2Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY. 3Division of Pulmonary, Critical Care, and Sleep Medicine, University of Kentucky College of Medicine, Lexington, KY.

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. Read More

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http://dx.doi.org/10.1097/CCM.0000000000001659DOI Listing
August 2016
533 Reads

Alcoholic ketoacidosis: a case report and review of the literature.

Oxf Med Case Reports 2016 Mar 3;2016(3):31-3. Epub 2016 Mar 3.

Department of Gastroenterology , West Suffolk Hospital , Bury St Edmunds , UK.

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. Read More

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http://dx.doi.org/10.1093/omcr/omw006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776050PMC
March 2016
49 Reads

Lactation Ketoacidosis: An Unusual Entity and a Review of the Literature.

Perm J Spring 2016;20(2):71-3. Epub 2016 Feb 22.

Consultant in Medicine at the Dunedin Hospital; and an Honorary Clinical Senior Lecturer at the University of Otago School of Medicine in Dunedin, New Zealand; Clinical Assistant Professor of Medicine at Stanford University School of Medicine; and a Hospitalist at the Santa Clara Medical Center in CA.

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. Read More

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http://dx.doi.org/10.7812/TPP/15-097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867828PMC
March 2017
25 Reads

[Research Advances in Postmortem Chemistry].

Fa Yi Xue Za Zhi 2015 Aug;31(4):287-92, 297

Postmortem chemistry is becoming more and more essential in routine forensic pathology and has made considerable progress over the past years. Biochemical analyses of vitreous humor, blood, urine and cerebrospinal fluid may provide important information in determining the cause of death or in elucidating forensic issues. Postmortem chemistry may be essential for the determination of cause of death when morphological methods (diabetes mellitus, alcoholic ketoacidosis and electrolytic disorders) cannot detect the pathophysiological changes involved in the death process. Read More

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August 2015
35 Reads

[Death by alcoholic ketoacidosis--analytical procedure and case report].

Arch Kriminol 2015 Sep-Oct;236(3-4):103-14

Alcoholic ketoacidosis is a medical emergency, which is characterized at first by an elevated level of ketone bodies. The production of these ketone bodies is accompanied by an equimolar quantity of hydrogen ions and thus causes acidosis, which cannot be detected post-mortem due to anaerobic glycolysis, whereas the three ketone bodies beta-hydroxybutyrate, acetoacetate and acetone can be easily identified. However, the limits of ketone body concentrations mentioned in the literature for diagnosing ketoacidosis vary significantly, partly due to inhomogeneous study groups. Read More

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December 2015
12 Reads

Alcohol Dehydrogenase-1B (rs1229984) and Aldehyde Dehydrogenase-2 (rs671) Genotypes and Alcoholic Ketosis Are Associated with the Serum Uric Acid Level in Japanese Alcoholic Men.

Alcohol Alcohol 2016 May 4;51(3):268-74. Epub 2015 Nov 4.

National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan.

Aims: To identify determinants of hyperuricemia in alcoholics.

Methods: The serum uric acid (UA) levels of 1759 Japanese alcoholic men (≥40 years) were measured on their first visit or within 3 days after admission; ADH1B and ALDH2 genotyping on blood DNA samples were performed. Dipstick urinalyses for ketonuria and serum UA measurements were simultaneously performed for 621 men on their first visit. Read More

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http://dx.doi.org/10.1093/alcalc/agv123DOI Listing
May 2016
24 Reads

A patient with clear consciousness even with a glucose level of 5 mg/dL (0.2 mmol/L).

Am J Emerg Med 2016 May 23;34(5):941.e3-4. Epub 2015 Oct 23.

Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni city, Shizuoka, Japan; Department of Emergency and Critical Care Medicine, Nerima Hospital, Juntendo University, Izunokuni city, Shizuoka, Japan. Electronic address:

A 74-year-old man noted dysarthria and right hemiparesis. His history included a gastric ulcer 2 years previously, and he had gradually lost 10 kg over a 2-year period due to appetite loss. He daily consumed 120 mg of alcohol. Read More

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http://dx.doi.org/10.1016/j.ajem.2015.10.012DOI Listing
May 2016
7 Reads

Fibrocalculous pancreatic diabetes.

Minerva Endocrinol 2016 Mar 16;41(1):70-7. Epub 2015 Oct 16.

Section of Endocrinology, Diabetes and Nutrition, Department of Medicine Boston University School of Medicine and Boston Medical Center, Boston, MA, USA -

The aim of this paper is to review the relevant literature related to the epidemiology, pathophysiology, natural history, clinical features and treatment of fibrocalculous pancreatic diabetes (FCPD). We review the English-language literature on this topic published between 1956 and 2014. FCPD is a form of diabetes usually associated with chronic calcific pancreatitis. Read More

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March 2016
10 Reads

Effects of Inhibiting Dipeptidyl Peptidase-4 (DPP4) in Cows with Subclinical Ketosis.

PLoS One 2015 20;10(8):e0136078. Epub 2015 Aug 20.

Institute of Animal Nutrition, Federal Research Institute for Animal Health, Friedrich-Loeffler-Institute, Braunschweig, Germany.

The inhibition of dipeptidyl peptidase-4 (DPP4) via specific inhibitors is known to result in improved glucose tolerance and insulin sensitivity and decreased accumulation of hepatic fat in type II diabetic human patients. The metabolic situation of dairy cows can easily be compared to the status of human diabetes and non-alcoholic fatty liver. For both, insulin sensitivity is reduced, while hepatic fat accumulation increases, characterized by high levels of non-esterified fatty acids (NEFA) and ketone bodies. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0136078PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4546328PMC
May 2016
21 Reads

Case of alcoholic ketoacidosis accompanied with severe hypoglycemia.

J UOEH 2015 Mar;37(1):43-7

Department of neurology, JCHO (Japan Community Health care Organization) Kyushu Hospital.

We report a 55 year old Japanese man with a history of alcohol abuse, who was in a near fasting state for the previous few days.He was admitted to our hospital with abrupt disturbance of consciousness. He presented disturbance of consciousness with extreme hypoglycemia and ketoacidosis with high β-hydroxybutyric acid concentration. Read More

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https://www.jstage.jst.go.jp/article/juoeh/37/1/37_43/_artic
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http://dx.doi.org/10.7888/juoeh.37.43DOI Listing
March 2015
35 Reads