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Gynecol Oncol 2020 Jul 2. Epub 2020 Jul 2.

Division of Gynecologic Oncology, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Desk A81, 9500 Euclid Avenue, Cleveland, OH 44195, United States of America.

Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) may be used to treat peritoneal based malignancies, such as epithelial ovarian cancer (EOC). Despite results of clinical trials supporting an increasing indication for HIPEC in EOC, concerns have existed regarding morbidity and challenges with initiating HIPEC at an institutional level. The objective of this review is to describe evidence-based recommendations to guide implementation of a HIPEC program, following our experience at a high-volume tertiary care center. Read More

J Pediatr Endocrinol Metab 2020 Jul 5. Epub 2020 Jul 5.

Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030,China.

Objectives To investigate the clinical and genetic characteristics of children with glycogen storage disease type IIIa (GSD IIIa) and to explore the muscle involvement and manifestations of GSD IIIa patients. Methods The clinical data of 11 patients with GSD IIIa diagnosed by genetic testing from 2003 to 2019 were retrospectively analyzed. Results Twenty variants of AGL gene were detected in 11 patients, eight of which were novel variants. Read More

J Formos Med Assoc 2020 Jun 26. Epub 2020 Jun 26.

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address:

Background: Previous studies have shown that the development of thrombocytopenia was associated with the elevated plasma concentration of linezolid, but little is known about the relationship between other uncommon adverse drug reactions (ADRs) and plasma concentration. The appropriate dosing adjustment has remained controversial. This prospective observational study was conducted to investigate the association between the plasma concentration of linezolid, ADRs, and clinical outcomes. Read More

Front Oncol 2020 12;10:807. Epub 2020 Jun 12.

Department of Chronic-Degenerative Diseases, National Institute of Respiratory Diseases "Ismael Cosío Villegas", Mexico City, Mexico.

Lactic acidosis (3 to 40 mM, pH < 6.9) is a condition found in solid tumors because tumor cells have a high rate of glucose consumption and lactate production even in the presence of oxygen; nevertheless, the microenvironment might still provide a sufficient glucose supply. Lactic acidosis has been proposed to shift metabolism from aerobic glycolysis toward oxidative phosphorylation (OXPHOS). Read More

Medicine (Baltimore) 2020 Jun;99(26):e20990

Department of Critical Care Medicine, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China.

Rationale: Metformin-associated lactic acidosis (MALA) is rarely encountered, but has a high mortality rate, Conventional treatments include hemodialysis or continuous renal replacement therapy (CRRT); however, when the disease progresses to end-stage, cardiac function is significantly inhibited, circulation cannot be maintained, CRRT cannot be tolerated, V-A extracorporeal membrane oxygenation (ECMO) may be the last treatment.

Patient Concerns: The study report a rare case of MALA in an elderly female patient at the age of 72 who was admitted to hospital because of nausea for 2 days, complicated with systemic fatigue.

Diagnosis: MALA was cofirmed because of patient have increased lactic acid levels, blood pH <7. Read More

Clin Nephrol 2020 Jun 26. Epub 2020 Jun 26.

Malignancy-induced lactic acidosis (MILA), a rare paraneoplastic phenomenon, is mostly described with hematologic malignancies (lymphomas and leukemias) but has also been reported with solid tumors. It is a subset of type B lactic acidosis being mediated without evidence of tissue hypoperfusion. Lymphoma-induced lactic acidosis is often considered an oncologic emergency and is associated with an increased risk of mortality and poor prognosis. Read More

Cureus 2020 May 20;12(5):e8215. Epub 2020 May 20.

Internal Medicine, Creighton University School of Medicine, Omaha, USA.

Historically, elevations in procalcitonin (PCT) have been implicated in medullary thyroid cancer and neuroendocrine tumors. More recently, the trending of PCT has been suggested as a monitor of infection to assess the presence, clearance and eradication of infection, especially in cancer patients. Its increase serves as a marker of bacterial infections. Read More

Mol Genet Metab Rep 2020 Sep 15;24:100616. Epub 2020 Jun 15.

Department of Medical Genetics and Pediatrics, Alberta Children's Hospital, Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Mitochondrial methionyl-tRNA formyltransferase () is a nuclear-encoded gene that produces a protein involved in mitochondrial translation. MTFMT formylates a portion of Met-tRNA, which allows for translation initiation of mitochondrial mRNA. Mutations in this gene have been shown to result in decreased mitochondrial translation with reduction function of the electron transport chain complexes I, III, IV, and V, thus affecting cellular energy production. Read More

Aging (Albany NY) 2020 Jun 23;12(12):11185-11199. Epub 2020 Jun 23.

Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA.

Humanin is a member of a new family of peptides that are encoded by short open reading frames within the mitochondrial genome. It is conserved in animals and is both neuroprotective and cytoprotective. Here we report that in the overexpression of humanin is sufficient to increase lifespan, dependent on . Read More

Nanoscale 2020 Jul;12(25):13801-13810

National Laboratory of Solid State Microstructures, Chemistry and Biomedicine Innovation Center, College of Engineering and Applied Sciences, Jiangsu Key Laboratory of Artificial Functional Materials, Nanjing University, 210093, Nanjing, China.

Lactic acidosis is one of the key characteristics of the tumor microenvironment (TME), and plays a critical role in therapy resistance, making it an attractive target for enhancing anticancer treatment. However, no effective systems exhibit the ability to selectively neutralize tumor lactic acidosis in a controlled manner. Here, we have developed novel ultrasound-responsive alkaline nanorobots (AN-DSP), composed of PLGA nanoparticles containing doxorubicin (DOX), sodium carbonate (Na2CO3) and perfluorocarbon (PFC), for recovering from lactic acidosis-mediated drug resistance. Read More

Acta Anaesthesiol Scand 2020 Jun 21. Epub 2020 Jun 21.

Department of Anaesthesiology and Intensive Care, University of Turku, Turku, Finland.

Introduction: Use of metformin increases plasma lactate concentration and may lead to metformin-associated lactic acidosis (MALA). Previous studies have suggested severe MALA to have a mortality of 17-21%, but have included patients with other coincident conditions such as sepsis. The treatment of choice is continuous renal replacement therapy (CRRT), which has been performed using heparin analogues or no anticoagulation in former studies. Read More

Front Pediatr 2020 28;8:255. Epub 2020 May 28.

The Children's Hospital of San Antonio, San Antonio, TX, United States.

The current literature on propofol infusion as a bridge to extubation in critically ill children is limited to children with burns and congenital cardiac disease. We hypothesize that propofol infusion is a feasible bridge to extubation in mechanically ventilated, critically ill children. Retrospective chart review. Read More

Int J Mol Sci 2020 Jun 14;21(12). Epub 2020 Jun 14.

Department of Endocrinology and Diabetes Mellitus, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.

Metformin is a glucose-lowering agent that is used as a first-line therapy for type 2 diabetes (T2D). Based on its various pharmacologic actions, the renoprotective effects of metformin have been extensively studied. A series of experimental studies demonstrated that metformin attenuates diabetic kidney disease (DKD) by suppressing renal inflammation, oxidative stress and fibrosis. Read More

Medicine (Baltimore) 2020 Jun;99(24):e20310

Department of neurological rehabilitation, The Third People's Hospital of Qingdao.

Rationale: Mitochondrial encephalomyopathy with lactic acidosis and stroke- like episodes (MELAS) syndrome is caused by mitochondrial respiratory chain dysfunction and oxidative phosphorylation disorder. It is a rare clinical metabolic disease involved with multiple systems.

Patient Concerns: A 22-year-old patient presented with limb convulsion accompanied by loss of consciousness, headache, partial blindness, blurred vision, and so on. Read More

J Investig Med High Impact Case Rep 2020 Jan-Dec;8:2324709620934963

Creighton University, Omaha, NE, USA.

Critically ill patients are known to have a variety of electrolyte abnormalities. Lactic acidosis can frequently be seen secondary to shock states and is usually treated with aggressive volume resuscitation. Interestingly, hypophosphatemia is a potential cause of resistant lactic acidosis, which may not be as commonly identified or considered. Read More

Ann R Coll Surg Engl 2020 Jun 15:e1-e3. Epub 2020 Jun 15.

Royal Surrey NHS Foundation Trust, UK.

Acute Budd-Chiari syndrome is a rare condition characterised by obstruction of hepatic venous outflow. We describe the case of a 52-year-old man, with a congenital Morgagni diaphragmatic hernia, who presented with acute onset abdominal pain, shortness of breath, lactic acidosis, hyperbilirubinaemia and transaminasaemia. Computed tomography revealed strangulation of the diaphragmatic hernia and extrinsic compression of the inferior vena cava from the herniated viscera. Read More

Indian J Pediatr 2020 Jun 15. Epub 2020 Jun 15.

Department of Pediatrics, Rainbow Children's Hospital, 157, Anna Salai, Guindy, Chennai, Tamil Nadu, 600015, India.

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.

Diseases 2020 Jun 9;8(2). Epub 2020 Jun 9.

Department of Neurology, Ulm University, 89081 Ulm, Germany.

Pathogenic variants in the are a well-known cause for maternally inherited mitochondrial disorders associated with a wide range of clinical phenotypes. Here, we present a 31- year old female with insulin-dependent diabetes mellitus, recurrent lactic acidosis and ketoacidosis recurrent infections with suspected immunodeficiency with T cell lymphopenia and hypogammaglobulinemia as well as proximal tetraparesis with severe muscle and limb pain and rapid physical exhaustion. Muscle biopsy and respiratory chain activities were normal. Read More

Eur J Med Chem 2020 Aug 30;200:112466. Epub 2020 May 30.

Jiangsu Key Laboratory of Drug Discovery for Metabolic Disease, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China. Electronic address:

Activation of AMPK emerges as a potential therapeutic approach to metabolic diseases. AdipoRon is claimed to be an adiponectin receptor agonist that activates AMPK through adiponectin receptor 1 (AdipoR1). However, AdipoRon also exhibits moderate inhibition of mitochondrial complex I, leading to increased risk of lactic acidosis. Read More

Mitochondrion 2020 Jun 2;53:194-202. Epub 2020 Jun 2.

Biomedical Physiology & Kinesiology, Simon Fraser University, Burnaby, Canada; Centre for Cell Biology, Development, and Disease, Simon Fraser University, Burnaby, BC, Canada. Electronic address:

Animal studies suggest that decreased vascular mitochondrial DNA copy number can promote hypertension. We conducted a chart review of blood pressure and hemodynamics in patients with either mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS, n = 36) or individuals with variants in the mitochondrial DNA polymerase gamma (POLG, n = 26). The latter included both pathogenic variants and variants of unknown significance (VUS). Read More

Photodiagnosis Photodyn Ther 2020 Jun 1:101850. Epub 2020 Jun 1.

Department of Environmental Health, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo, 192-0392, Japan. Electronic address:

Background: Talaporfin sodium (TS) is an authorized photosensitizer for photodynamic therapy (PDT) against some tumors in Japan; however, the drawbacks of the drug include its high cost and side effects. Thus, reducing the dose of TS in each round of TS-PDT against tumors is important for reducing treatment costs and improving patients' quality of life. Dichloroacetate (DCA) is approved for treating lactic acidosis and hereditary mitochondrial diseases, and it is known to enhance reactive oxygen species production and induce apoptosis in cancer cells. Read More

Cureus 2020 May 25;12(5):e8269. Epub 2020 May 25.

Internal Medicine, Texas Health Arlington Memorial Hospital, Arlington, USA.

Lactic acidosis (LA) is usually a medical emergency diagnosed by laboratory evaluation in emergency rooms (ERs) and hospital settings in critically ill patients. LA is classified into two major types based on pathophysiology; type A results from tissue hypoxia and/or hypoperfusion and type B results from deranged metabolic activity in the cells in the absence of hypoxia/hypoperfusion. Prompt evaluation and treatment are essential to prevent morbidity and mortality, especially in patients with type A LA. Read More

Nervenarzt 2020 Jun 2. Epub 2020 Jun 2.

Neurologische Abteilung, Hegau-Bodensee-Klinikum Singen, Virchowstraße 10, 78224, Singen, Deutschland.

Cureus 2020 Apr 27;12(4):e7862. Epub 2020 Apr 27.

Medicine, Nishtar Hospital, Nishtar Medical University, Multan, PAK.

Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) usually manifests in early life. Clinical hallmarks of the disease are mitochondrial myopathies, encephalopathy with stroke-like episodes, seizures, and lactic acidosis. It rarely manifests in late adulthood. Read More

J Cardiothorac Vasc Anesth 2020 Apr 29. Epub 2020 Apr 29.

Department of Anesthesiology & Pain Medicine, University of Washington Medical Center, Seattle, WA.

J Neurol Sci 2020 Jul 19;414:116925. Epub 2020 May 19.

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.

Heliyon 2020 May 21;6(5):e03989. Epub 2020 May 21.

Nanotechnology and Water Sustainability Research Unit, College of Science Engineering and Technology, University of South Africa (UNISA), Florida Park, Johannesburg, South Africa.

Background: Biochemical, hematological and histological changes are major observable clinical and pathological factors associated with . Derangement in the levels of these parameters increases the risk of the development of complications. In another hand, gastrointestinal intolerance due to the development of lactic acidosis on the gastrointestinal tract and the intestinal microbiome is the toxic side effect of various synthetic antidiabetic agents. Read More

BMC Gastroenterol 2020 May 27;20(1):163. Epub 2020 May 27.

The Mater Hospital, Townsville, Australia.

Background: Colonoscopy is a routine procedure in diagnosis and treatment of colonic disease. While generally regarded as a safe procedure, potentially fatal complications can occur. Gas gangrene is one such complication, with very high mortality. Read More

Front Bioeng Biotechnol 2020 8;8:412. Epub 2020 May 8.

Department of Biological Sciences, National University of Singapore, Singapore, Singapore.

Even under normoxia, cancer cells exhibit increased glucose uptake and glycolysis, an occurrence known as the Warburg effect. This altered metabolism results in increased lactic acid production, leading to extracellular acidosis and contributing to metastasis and chemoresistance. Current pH imaging methods are invasive, costly, or require long acquisition times, and may not be suitable for high-throughput pre-clinical small animal studies. Read More

Pediatr Crit Care Med 2020 May 26. Epub 2020 May 26.

University of Washington, Seattle, WA.

Objectives: The objective of this study is to determine outcomes of recurrent cardiac arrest events in the general pediatric inpatient population.

Design: Retrospective cohort study of inpatients in a single institution.

Setting: A tertiary care free-standing children's hospital. Read More

Integr Cancer Ther 2020 Jan-Dec;19:1534735420922579

The Second Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang, China.

Sodium bicarbonate, commonly known as baking soda, is widely used in the clinic as an antacid for treating gastric hyperacidity, among other conditions. Chao et al have reported a clinical trial about targeting intratumor lactic acidosis-transarterial chemoembolization. Based on conventional transarterial chemoembolization, the authors added a 5% sodium bicarbonate solution to cytotoxic drugs, resulting in a high local control rate. Read More

Clin J Am Soc Nephrol 2020 May 22. Epub 2020 May 22.

Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts

Hum Mutat 2020 May 22. Epub 2020 May 22.

Discipline of Child & Adolescent Health, Sydney Medical School, Sydney, Australia.

LARS2 variants are associated with Perrault syndrome, characterised by premature ovarian failure and hearing loss, and with an infantile lethal multi-system disorder: hydrops, lactic acidosis, sideroblastic anemia (HLASA) in one individual. Recently we reported LARS2 deafness with (ovario) leukodystrophy. Here we describe five patients with a range of phenotypes, in whom we identified biallelic LARS2 variants: three patients with a HLASA-like phenotype, an individual with Perrault syndrome whose affected siblings also had leukodystrophy, and an individual with a reversible mitochondrial myopathy, lactic acidosis and developmental delay. Read More

J Med Genet 2020 May 21. Epub 2020 May 21.

Department of Internal Medicine, Radboudumc, Nijmegen, The Netherlands

Background: The mitochondrial DNA (mDNA) 3243A>G variant is the most common pathogenic variant of the mDNA. To interpret results of clinical trials in mitochondrial disease, it is important to have a clear understanding of the natural course of disease. To obtain more insight into the disease burden and the progression of disease in carriers of the mDNA 3243 A>G variant, we followed a cohort of 151 carriers from 61 families prospectively for up to 6 years. Read More

J Med Genet 2020 05 21. Epub 2020 May 21.

Medical Research Council, Mitochondrial Biology Unit, Cambridge, Cambridgeshire, UK

Background: Mitochondria provide ATP through the process of oxidative phosphorylation, physically located in the inner mitochondrial membrane (IMM). The mitochondrial contact site and organising system (MICOS) complex is known as the 'mitoskeleton' due to its role in maintaining IMM architecture. encodes MIC26, a component of MICOS, whose exact function in its maintenance or assembly has still not been completely elucidated. Read More

Indian J Crit Care Med 2020 Mar;24(3):200-202

Department of Pediatrics, ESI-Postgraduate Institute of Medical Science and Research, Model Hospital, Mumbai, Maharashtra, India.

Metabolic acidosis is observed in the pediatric intensive care unit (PICU) in several conditions including sepsis, intoxications, and severe catabolic states. It is occasionally seen due to acute decompensation in an inborn error of metabolism (IEM). Persistent acidosis results in a decrease in myocardial contractility, cardiac output, and catecholamine responsiveness. Read More

Cureus 2020 Apr 16;12(4):e7688. Epub 2020 Apr 16.

Internal Medicine, NCH Healthcare System, Naples, USA.

A 56-year-old male with no known history of substance abuse and no known prior medical conditions presented via ambulance to the emergency department after being found by coworkers with bizarre behavior, vomiting, and slurred speech. He had legally purchased cannabidiol (CBD) gummies marketed for pain and anxiety relief at a gas station several hours prior. Vitals upon arrival were temperature 36. Read More

Anaesthesist 2020 May 18. Epub 2020 May 18.

Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.

Background: Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome is a rare progressive disease with acute neurological episodes caused by a mitochondriopathy. Due to a defect of oxidative phosphorylation in the respiratory chain, there is impaired mitochondrial energy production with subsequent lactic acidosis, especially in situations with increased stress. Due to the high risk of metabolic derailment MELAS syndrome is a great challenge with respect to the perioperative management of anesthesia. Read More

Ann Endocrinol (Paris) 2020 Jun 12;81(2-3):101-109. Epub 2020 May 12.

Department of internal medicine, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Brussels, Belgium.

Diabetes is among the most frequently reported comorbidities in patients infected with COVID-19. According to current data, diabetic patients do not appear to be at increased risk of contracting SARS-CoV-2 compared to the general population. On the other hand, diabetes is a risk factor for developing severe and critical forms of COVID-19, the latter requiring admission to an intensive care unit and/or use of invasive mechanical ventilation, with high mortality rates. Read More

Kidney Int Rep 2020 May 5;5(5):742-745. Epub 2020 Feb 5.

Department of Internal Medicine, Division of Nephrology and Hypertension, Rochester, Minnesota, USA.

Exp Clin Endocrinol Diabetes 2020 May 13. Epub 2020 May 13.

Centre of Internal Medicine I, Marienhospital Stuttgart, Vinzenz von Paul Kliniken, Stuttgart, Germany.

Aims: The aim of this case report is to specify the frequency and mortality of Metformin-Associated Lactic Acidosis (MALA) in emergency medicine, as the diagnosis seems to occur more often than estimated.

Methods: To identify the subjects, we developed screening criteria for MALA. We measured the serum metformin concentration to confirm the diagnosis in all patients fulfilling these criteria. Read More

Diabetes Metab Res Rev 2020 May 10:e3334. Epub 2020 May 10.

Shenzhen Hospital, Southern Medical University, Shenzhen, China.

Background: The incidence of type 1 diabetes mellitus (T1DM) is increasing among youth worldwide, translating to an increased risk ofearly-onset cardiovascular disease (CVD). Mounting studies have shown that metformin may reduce maximal carotidintima-media thickness (cIMT), improve insulin resistance and metabolic control in subjects with T1DM, and thus, may extend cardioprotective benefits. This systematic review and meta-analysis was performed to assess the efficacy and safety of metformin added to insulin therapy on reducing CVD risks and improving metabolism in T1DM. Read More

Transplant Proc 2020 Jun 8;52(5):1566-1569. Epub 2020 May 8.

Renal Transplant Unit, Azienda Ospedaliera Brotzu, Cagliari, Italy.

Background: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome characterized by an excessive immune activation. HLH can be triggered by a variety of events that disrupt immune homeostasis, such as infections and immunosuppression. HLH presents with heterogeneous clinical symptoms and laboratory findings such as pancytopenia, elevated liver enzymes, impaired renal function, and hyperferritinemia. Read More

Cureus 2020 Apr 6;12(4):e7564. Epub 2020 Apr 6.

Nephrology, Raymond G. Murphy Veterans Affairs Medical Center, Albuquerque, USA.

Metabolic acidosis is a common disorder defined by an imbalance in the body's acid-base balance. Identifying the cause of acidosis is critical for its management. We describe a case of acute renal failure with lactic acidosis in a 69-year-old man who was taking metformin for type 2 diabetes. Read More

Disaster Med Public Health Prep 2020 May 8:1-6. Epub 2020 May 8.

Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.

In 2019, a 42-year-old African man who works as an Ebola virus disease (EVD) researcher traveled from the Democratic Republic of Congo (DRC), near an ongoing EVD epidemic, to Philadelphia and presented to the Hospital of the University of Pennsylvania Emergency Department with altered mental status, vomiting, diarrhea, and fever. He was classified as a "wet" person under investigation for EVD, and his arrival activated our hospital emergency management command center and bioresponse teams. He was found to be in septic shock with multisystem organ dysfunction, including circulatory dysfunction, encephalopathy, metabolic lactic acidosis, acute kidney injury, acute liver injury, and diffuse intravascular coagulation. Read More

A A Pract 2020 May;14(7):e01212

From the Department of Anesthesiology and Pain Medicine, Seattle Children's, Seattle, Washington.

A 20-year-old man with a rare neurodegenerative disease developed hypermetabolic symptoms with dyskinesia after a third ventriculostomy for hydrocephalus. The initial presentation was concerning for an acute dystonic reaction after metoclopramide was administered for nausea. He concurrently developed hypermetabolic symptoms, including hyperthermia, tachycardia, and a lactic acidosis. Read More