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Wellcome Open Res 2020 26;5:51. Epub 2020 Mar 26.

Krankenanstalt Rudolfstiftung, Messerli Institute, Vienna, 1180, Austria.

Stroke-like episodes (SLEs) are a hallmark of mitochondrial encephalopathy, lactic acidosis, and stroke-like episode (MELAS) syndrome but occur in other mitochondrial disorders (MIDs) as well. The morphological equivalent of the SLE is the stroke-like lesion (SLL) on magnetic resonance imaging (MRI). The pathophysiology of SLLs is under debate, but several hypotheses have been raised to explain the phenomenon. Read More

Rev Recent Clin Trials 2020 Jul 9. Epub 2020 Jul 9.

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8 - 00168 Roma. Italy.

Background: Diabetic Ketoacidosis (DKA) is one of the most commonly encountered diabetic complication emergencies. It typically affects people with type 1 diabetes at the onset of the disease. It can also affect people with type 2 diabetes, although this is uncommon. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Jul 2;252:286-293. Epub 2020 Jul 2.

Global Academy of Medical Education & Training, London, United Kingdom.

Objective: To determine the cardiotocograph (CTG) changes in women with symptomatic COVID-19 infection.

Study Design: 12 anonymised CTG traces from 2 hospitals in Spain were retrospectively analysed by 2 independent assessors. CTG parameters were studied based on fetal pathophysiological responses to inflammation and hypoxia that would be expected based on the pathogenesis of COVID-19 patients. Read More

Pediatr Radiol 2020 Jul 8. Epub 2020 Jul 8.

Division of Neuroradiology, Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.

This article is the second of a two-part series on intracranial calcification in childhood. In Part 1, the authors discussed the main differences between physiological and pathological intracranial calcification. They also outlined histological intracranial calcification characteristics and how these can be detected across different neuroimaging modalities. Read More

Cureus 2020 Jun 4;12(6):e8435. Epub 2020 Jun 4.

Pediatric Endocrinology, Nemours Children's Hospital, Orlando, USA.

Severe hypercalcemia in diabetic ketoacidosis (DKA) among children is rare and can be life-threatening. Its exact etiology is not clear and several mechanisms related to dehydration and metabolic acidosis have been proposed. Rigorous hydration with the correct fluid choice usually corrects the hypercalcemia in those without other underlying causes of hypercalcemia such as hyperparathyroidism. Read More

Kyobu Geka 2020 Jul;73(7):498-502

Department of Cardiovascular Surgery, Kitazato University, Sagamihara, Japan.

Right minithoracotomy has become the standard approach along with sternotomy in mitral and tricuspid valve surgery. Transareolar incision, compared with submammary incision, is advantageous in that it often allows better angle for antegrade cardioplegia cannulation through the main wound. It also provides a better cosmesis. Read More

Intern Med 2020 Jul 7. Epub 2020 Jul 7.

Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan.

We herein present a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), who developed serious acute renal failure with lactic acidosis, followed by rhabdomyolysis. Despite receiving intensive care, he suffered multiple cardiopulmonary arrests and died 10 days after presentation due to a sudden deterioration of his symptoms. Renal pathology revealed diffuse tubular necrosis with interstitial edema and tubular dilatation on light microscopy, and a severe degeneration of intracellular organelles on electron microscopy. Read More

BMJ Open 2020 Jul 8;10(7):e038532. Epub 2020 Jul 8.

Faculty of Medicine - LMU, Walter-Brendel Center of Experimental Medicine, München, Germany.

Introduction: Sepsis is defined as detrimental immune response to an infection. This overwhelming reaction often abolishes a normal reconstitution of the immune cell homeostasis that in turn increases the risk for further complications. Recent studies revealed a favourable impact of ketone bodies on resolution of inflammation. Read More

BMJ Case Rep 2020 Jul 8;13(7). Epub 2020 Jul 8.

Department of Internal Medicine, Ako City Hospital, Ako, Hyogo, Japan.

A 72-year-old Japanese man treated with omeprazole for 11 years was admitted due to loss of consciousness and muscle weakness. Wolff-Parkinson-White syndrome-induced tachycardia was considered as the cause of syncope. His blood examination revealed rhabdomyolysis, hypokalaemia, hypomagnesaemia, hypocalcaemia, hyperlactacidaemia, hyperammonaemia and high-anion-gap metabolic acidosis. Read More

Anesthesiology 2020 Jul 2. Epub 2020 Jul 2.

From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Institute for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Department of Surgery Icahn School of Medicine at Mount Sinai, New York, New York. From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Institute for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. Department of Surgery Icahn School of Medicine at Mount Sinai, New York, New York.

Background: During the COVID-19 pandemic, ventilator sharing was suggested to increase availability of mechanical ventilation. The safety and feasibility of ventilator sharing is unknown.

Methods: A single ventilator in pressure control mode was used with flow control valves to simultaneously ventilate two patients with different lung compliances. Read More

Animal 2020 Jun 23:1-12. Epub 2020 Jun 23.

CRSAD, Deschambault, QCG0A 1S0, Canada.

Sub-acute ruminal acidosis (SARA) is sometimes observed along with reduced milk fat synthesis. Inconsistent responses may be explained by dietary fat levels. Twelve ruminally cannulated cows were used in a Latin square design investigating the timing of metabolic and milk fat changes during Induction and Recovery from SARA by altering starch levels in low-fat diets. Read More

Ann Med Surg (Lond) 2020 Aug 13;56:165-168. Epub 2020 Jun 13.

Professor, Department of Anaesthesiology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.

Introduction: The risk of developing ketoacidosis in patients with type 1 diabetes at high altitude is high. Anorexia associated with acute mountain sickness, dehydration and additional exercise associated with climbing exacerbates the generation of ketones and the development of ketoacidosis.

Case Presentation: A 33-year-old gentleman with known history of uncontrolled type 1 diabetes mellitus trekked to Everest Base Camp at an altitude of 3440 m and became unwell. Read More

Exp Clin Transplant 2020 Jul 6. Epub 2020 Jul 6.

From the Department of Anesthesia, Nemazee Hospital, Shiraz, Fars, Iran.

Objectives: One of the most prevalent complications of orthotopic liver transplant is primary graft dysfunction. Recent studies have shown the preconditioning effect of remifentanil on animal livers but not human livers. Here, we compared the preconditioning effects of remifentanil and fentanyl in orthotopic liver transplant in human patients. Read More

Med Hypotheses 2020 Jun 22;143:110022. Epub 2020 Jun 22.

910 S Gretna Green Way, Los Angeles, CA 90049, United States. Electronic address:

The current SARS-Cov-2 virus pandemic challenges critical care physicians and other caregivers to find effective treatment for desperately ill patients - especially those with sudden and extreme hypoxemia. Unlike patients with other forms of Acute Respiratory Distress Syndrome, these patients do not exhibit increased lung stiffness or dramatic dyspnea., even in the presence of arterial blood oxygen levels lower than that seen normally in mixed venous blood. Read More

Radiology 2020 Jul 7:200373. Epub 2020 Jul 7.

From the Department of Radiology and Biomedical Imaging (L.J.S., L.A.D., I.T.S., J.J.W., J.S., M.D.L., L.A., A.B., J.D., F.H., D.C., J.C.), Department of Internal Medicine, Section of Rheumatology (R.R.M., L.L., R.J.B.), Department of Immunobiology (N.J.), and Department of Pathology (V.P., X.Z.), Yale University School of Medicine, 300 Cedar St, New Haven, CT 06520; Institute of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität, and Berlin Institute of Health, Berlin, Germany (L.J.S., L.A.D., I.T.S., L.A.); Visage Imaging, San Diego, Calif (M.D.L.); Department of Biomedical Engineering, Yale School of Engineering and Applied Science, New Haven, Conn (J.D.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.).

Background The immuno-metabolic interplay has gained interest for determining and targeting immunosuppressive tumor micro-environments that remain a barrier to current immuno-oncologic therapies in hepatocellular carcinoma. Purpose To develop molecular MRI tools to reveal resistance mechanisms to immuno-oncologic therapies caused by the immuno-metabolic interplay in a translational liver cancer model. Materials and Methods A total of 21 VX2 liver tumor-bearing New Zealand white rabbits were used between October 2018 and February 2020. Read More

Hosp Pract (1995) 2020 Jul 7. Epub 2020 Jul 7.

Department of Military and Community Medicine, Phramongkutklao College of Medicine , Bangkok, Thailand.

Background: The objective of this study was to evaluate the predictors and associated outcomes of rhabdomyolysis in admitted patients for heat stroke in the United States.

Methods: The National Inpatient Sample was utilized to identify hospitalized patients with a primary diagnosis of heat stroke from the years 2003-2014. Rhabdomyolysis was identified using hospital diagnosis code. Read More

CEN Case Rep 2020 Jul 6. Epub 2020 Jul 6.

Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.

Mutations in SLC4A1, encoding the chloride-bicarbonate exchanger known as anion exchanger 1, have been reported as the sole genetic cause of autosomal dominant distal renal tubular acidosis (dRTA). This disorder is extremely rare and most patients show no clinical symptoms during childhood. Here, we report a case of an infant with early-onset autosomal dominant dRTA caused by SLC4A1 mutation p. Read More

Am J Respir Cell Mol Biol 2020 Jul 6. Epub 2020 Jul 6.

University of South Alabama, Physiology and Cell Biology, Mobile, Alabama, United States.

KD025 is a ROCK2 inhibitor currently being tested in clinical trials for treatment of fibrotic lung diseases. The therapeutic effects of KD025 are partly due to its inhibition of profibrotic pathways and fat metabolism. However, whether KD025 affects pulmonary microvascular endothelial cell (PMVEC) function is unknown, despite evidence that alveolar capillary membrane disruption constitutes major causes of death in fibrotic lung diseases. Read More

J Matern Fetal Neonatal Med 2020 Jul 6:1-7. Epub 2020 Jul 6.

Department of Pediatrics, Section of Critical Care and Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.

Sodium bicarbonate is a frequently used electrolyte for the acute treatment of metabolic acidosis in critically ill patients. We performed a systematic review and meta-analysis to determine the effect of sodium bicarbonate on hemodynamics, gas exchange and oximetry in critically children. A systematic review of published manuscripts was conducted to identify studies of children who received sodium bicarbonate as part of the treatment for metabolic acidosis. Read More

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 Dairy Sci 2020 Jul 1. Epub 2020 Jul 1.

Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria. Electronic address:

During early lactation, both primiparous (PP) and multiparous (MP) cows are commonly fed diets rich in starch and low in forages to support their high energy requirements. Yet, the PP cows experience this dietary challenge for the first time, which might result in higher odds for them to develop rumen and systemic health disorders. The primary objective of this study was to evaluate the effect of decreasing the amount of forages in the diet on chewing and sorting behaviors and rumen and systemic health variables in PP and MP dairy cows. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Jun 17;252:181-186. Epub 2020 Jun 17.

CHU Lille, Department of Obstetrics, FHU "1000 Days for Health", F-59000 Lille, France.

Objective: To determine which parameter of umbilical arterial cord gas analysis, pH, base deficit, lactate concentration, ionogram values, or glucose level index is the best predictor of neonatal morbidity at term.

Design: We conducted a 15-month retrospective cohort study that included all nonanomalous, singleton, term births at a single center. The predictive ability of lactate concentration, base deficit, pH, ionogram values, and glucose level were compared using receiver-operating characteristic curves for global and neurological composite morbidity. Read More

J Surg Res 2020 Jun 30;255:405-410. Epub 2020 Jun 30.

Division of Trauma, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio. Electronic address:

Background: There is a paucity of data to predict early death or futility after trauma. The objective of this study was to characterize the laboratory values, blood product administration, and hospital disposition for patients with trauma who died within 72 h of admission.

Methods: All deaths within 72 h of admission over a 5-y period at a level I trauma center were reviewed. Read More

Nephrology (Carlton) 2020 Jul 3. Epub 2020 Jul 3.

Department of Pediatrics, Fujieda Municipal General Hospital, Fujieda, Japan.

Pseudohypoaldosteronism type II (PHA II) is inherited in an autosomal dominant manner and is characterized by hypertension, hyperkalemia, and hyperchloremic metabolic acidosis. The enhancement of WNK functions is correlated to the pathogenesis of the condition. Cullin 3 (CUL3) forms an E3 ubiquitin ligase complex, and it can ubiquitinate WNK. Read More

Cochrane Database Syst Rev 2020 Jul 1;7:CD002251. Epub 2020 Jul 1.

Department of Women's Anaesthesia, Women's and Children's Hospital, Adelaide, Australia.

Background: Maternal hypotension is the most frequent complication of spinal anaesthesia for caesarean section. It can be associated with nausea or vomiting and may pose serious risks to the mother (unconsciousness, pulmonary aspiration) and baby (hypoxia, acidosis, neurological injury).

Objectives: To assess the effects of prophylactic interventions for hypotension following spinal anaesthesia for caesarean section. Read More

Anesth Analg 2020 Jun 30. Epub 2020 Jun 30.

From the Department of Anaesthesia, Princess Alexandra Hospital-Southern Clinical School, Faculty of Medicine, The University of Queensland, Brisbane, Australia.

Background: High-flow nasal oxygen (HFNO) is an emerging technology that has generated interest in tubeless anesthesia for airway surgery. HFNO has been shown to maintain oxygenation and CO2 clearance in spontaneously breathing patients and is an effective approach to apneic oxygenation. Although it has been suggested that HFNO can enhance CO2 clearance during apnea, this has not been established. Read More

Clin Obstet Gynecol 2020 Jun 30. Epub 2020 Jun 30.

University of Utah and Intermountain Healthcare, Murray, Utah.

Fetal heart tracings (FHTs) are useful as a window into the oxygenation status of the fetal brain. Patterns in the FHT reflect the oxygen status of the fetal brain. Fetal adaptive response to progressive hypoxemia and acidosis are detectable and produce recognizable patterns in the fetal heart rate. Read More

Am J Trop Med Hyg 2020 Jul 6. Epub 2020 Jul 6.

Department of Critical Care, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India.

Dengue-related mortality has significantly reduced with early and appropriate fluid resuscitation. However, we continue to see dengue-related fatalities in patients despite early intervention and advanced critical care support. This was a retrospective study conducted at a tertiary care private hospital in Mumbai, India. Read More

Sci Rep 2020 Jul 2;10(1):10867. Epub 2020 Jul 2.

Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, CB2 3EG, UK.

A cohort study of 6,500,000 human pregnancies showed an increased risk of adverse fetal outcomes following abdominal but not non-abdominal surgery under general anesthesia. This may be the consequence of uterine handling during abdominal surgery. However, there are no data on any effects on the cardiometabolic physiology of the fetus or mother in response to uterine manipulation in otherwise healthy pregnancy. Read More

Pediatr Nephrol 2020 Jul 1. Epub 2020 Jul 1.

Department of Pediatric Nephrology, Cukurova University Faculty of Medicine, Adana, Turkey.

Background: The present study aimed to assess genotype-phenotype correlations with long-term prognosis in children with distal kidney tubular acidosis (dKTA). The kidney function of children with dKTA could be impaired in the long-term.

Methods: Thirty-one children with dKTA from 23 families were included in the present study. Read More

J Assoc Physicians India 2020 Apr;68(4):29-31

Senior Advisor Medicine and Oncology, Command Hospital, Bengaluru, Karnataka.

Background: Heat-related illnesses includes a range of manifestation starting from minor illness like heat rashes/ heat cramps to more complicated illness like heat exhaustion and the most severe heat stroke. Often derangements in biochemical parameters including metabolic acidosis, respiratory alkalosis, electrolytes, transminitis and renal dysfunction are noticed in patients with heat stroke. Objective: The present study was an attempt to compare the clinical and changes in biochemical parameters in exertional heat exhaustion and heat stroke patients among cadets from a military training centre admitted to an Armed forces hospital in South India. Read More

Semin Thorac Cardiovasc Surg 2020 Jun 28. Epub 2020 Jun 28.

Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado School of Medicine, Aurora CO. Electronic address:

World J Clin Cases 2020 Jun;8(12):2585-2589

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si 13620, Gyeonggi-do, South Korea.

Background: Acute phosphate nephropathy (APN) is a disease that can occur when exposed to high doses of phosphate. The most common cause of APN is the use of oral sodium phosphate for bowel cleansing preparations. However, there are other less commonly known sources of phosphate that are equally important. Read More

BMJ Case Rep 2020 Jun 30;13(6). Epub 2020 Jun 30.

Division of Pulmonary and Critical Care Medicine, South Shore Hospital, Weymouth, Massachusetts, USA.

A 37-year-old woman who had 8 weeks post partum, breast feeding and on a low carbohydrate and high protein (ketogenic) diet, was admitted to the hospital with acute onset of nausea, vomiting and abdominal pain of 1-day duration. On admission, she was found to have high anion gap metabolic acidosis, elevated beta-hydroxybutyric acid level, normal glucose level and evidence of ketoacidosis. She was treated with lactated Ringer solution, along with dextrose 5% solution with the resolution of symptoms and metabolic derangement. Read More

Microcirculation 2020 Jun 30. Epub 2020 Jun 30.

Laboratory of Experimental and Clinical Neurosurgery, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland.

Objective: In this study, we examined the effect of acute hyponatremia associated with vasopressin (AVP) on the responses of the isolated rat's middle cerebral arteries (MCAs) and parenchymal arterioles (PAs) to acidosis, nitric oxide donor (SNAP) and to endothelium-dependent vasodilator adenosine triphosphate (ATP).

Methods: The studies were performed on isolated, perfused and pressurized MCAs and PAs in control conditions and during AVP-associated hyponatremia. Hyponatremia was induced in vitro by lowering Na concentration from 144 to 121 mM in intra- and extravascular fluid in the presence of AVP. Read More

Mol Genet Genomic Med 2020 Jun 30:e1379. Epub 2020 Jun 30.

Department of Laboratory Medicine, Kyung Hee University School of Medicine, Seoul, Korea.

Background: Malonic aciduria (MA, OMIM#248360) is an extremely rare inherited metabolic disorder caused by the deficiency of malonyl-CoA decarboxylase. The phenotype exhibited by patients with MA is variable, but may include symptoms, such as developmental delay in early childhood, seizures, vomiting, metabolic acidosis, hypoglycemia, ketosis, and cardiomyopathy. We describe the first case of a Korean child with MA who presented with dilated cardiomyopathy (DCMP) at the age of 3 months. 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

Nutrition 2020 May 19;79-80:110858. Epub 2020 May 19.

Unit of Dietetic and Clinical Nutrition, University Hospital Maggiore della Carità, Novara, Italy.

In adults, a very uncommon presentation of celiac disease (CD) is a celiac crisis, a life-threatening and severe form of the disease having a dramatic onset with diarrhea and metabolic acidosis with electrolyte and fluid imbalance. Treatment of celiac crisis requires a gluten-free diet; however, the risk for refeeding syndrome (RFS) should be considered in patients showing marked malabsorption symptoms and important unintentional weight loss. Therefore, to avoid metabolic and potentially fatal complications of re-nutrition, nutritional management is crucial for a safe recovery after a celiac crisis. Read More

J Anim Physiol Anim Nutr (Berl) 2020 Jun 28. Epub 2020 Jun 28.

Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, Hannover, Germany.

Subacute rumen acidosis (SARA) is a common problem in dairy cattle. High-concentrate rations lead to an accumulation of short-chain fatty acids (SCFA) in the rumen and a subsequent decrease in ruminal pH. As SARA impairs animal welfare and productivity, numerous in vivo studies are focusing on evaluation of prevention strategies. 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

Liver Transpl 2020 Jun 27. Epub 2020 Jun 27.

Seattle, Washington, United States.

Acute kidney injury at the time of liver transplantation( LT) is associated with increased mortality, particularly for those patients who require hemodialysis (Zand). There are several theoretical benefits of intraoperative RRT (IORRT). Dialysis can correct metabolic acidosis and electrolyte abnormalities including hyperkalemia common during liver transplantation, particularly during the anhepatic phase can reduce fluid overload, especially when large amounts of blood product transfusions are administered. Read More

Diabetes Res Clin Pract 2020 Jun 25;166:108279. Epub 2020 Jun 25.

Department of Medical Education, Saint Michael's Medical Centre, New York Medical College, NJ, United States; Department of Infectious Disease, Saint Michael's Medical Centre, New York Medical College, NJ, United States.

Aim: One of the risk factors for poor outcome with SARS-CoV-2 infection is diabetes mellitus; diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the most serious complications of diabetes mellitus. We aimed to explore the clinical characteristics and outcomes of COVID-19 patients presenting with combined DKA/HHS to our institution.

Methods: A retrospective, hospital based observation case series was performed on patients with SARS-CoV-2 admitted to Intensive Care Unit between 3/20/2020 and 4/20/2020. Read More

Indian J Pediatr 2020 Jun 26. Epub 2020 Jun 26.

Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.

Renal tubular acidosis (RTA) comprises a group of disorders characterized by low capacity for net acid excretion and persistent hyperchloremic metabolic acidosis, despite preserved glomerular filtration rate. RTA are classified into chiefly three types (1, 2 and 4) based on pathophysiology and clinical and laboratory characteristics. Most patients have primary RTA that presents in infancy with polyuria, growth retardation, rickets and/or hypotonia. Read More

Nat Commun 2020 Jun 26;11(1):3257. Epub 2020 Jun 26.

Departments of Surgery, Nuclear Medicine and Molecular Imaging, Medical Imaging Center Groningen, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Cancer cell metabolism leads to a uniquely acidic microenvironment in solid tumors, but exploiting the labile extracellular pH differences between cancer and normal tissues for clinical use has been challenging. Here we describe the clinical translation of ONM-100, a nanoparticle-based fluorescent imaging agent. This is comprised of an ultra-pH sensitive amphiphilic polymer, conjugated with indocyanine green, which rapidly and irreversibly dissociates to fluoresce in the acidic extracellular tumor microenvironment due to the mechanism of nanoscale macromolecular cooperativity. Read More