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    Tumor antigen glycosaminoglycan modification regulates antibody-drug conjugate delivery and cytotoxicity.
    Oncotarget 2017 Apr 7. Epub 2017 Apr 7.
    Department of Clinical Sciences, Section of Oncology and Pathology, Lund University, Lund, Sweden.
    Aggressive cancers are characterized by hypoxia, which is a key driver of tumor development and treatment resistance. Proteins specifically expressed in the hypoxic tumor microenvironment thus represent interesting candidates for targeted drug delivery strategies. Carbonic anhydrase (CAIX) has been identified as an attractive treatment target as it is highly hypoxia specific and expressed at the cell-surface to promote cancer cell aggressiveness. Read More

    Regulation of organelle function by metformin.
    IUBMB Life 2017 Apr 26. Epub 2017 Apr 26.
    Nagoya Research Center for Brain and Neural Circuits, Graduate School of Science, Nagoya University, Nagoya, Japan.
    Metformin ameliorates hyperglycemia without the side effects of lactic acidosis or hypoglycemia. Metformin lowers the blood glucose level by decreasing hepatic glucose production in the liver and by increasing glucose uptake in the muscle. Recent studies show that metformin induces cell death in certain cancer cell lines by interfering with the metabolism of the cancer cells. Read More

    Flexible bronchoscopy and mechanical ventilation in managing Mounier-Kuhn syndrome: a case report.
    Sao Paulo Med J 2017 Apr 20. Epub 2017 Apr 20.
    MD. Professor, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey.
    Context:: Mounier-Kuhn syndrome is a rare congenital condition with distinct dilatation and diverticulation of the tracheal wall. The symptoms may vary and the treatment usually consists of support.

    Case Report:: The patient was a 60-year-old male with recurrent hospital admission. Read More

    Spreading depolarization remarkably exacerbates ischemia-induced tissue acidosis in the young and aged rat brain.
    Sci Rep 2017 Apr 25;7(1):1154. Epub 2017 Apr 25.
    Department of Medical Physics and Informatics, Faculty of Medicine & Faculty of Science and Informatics, University of Szeged, H-6720 Szeged, Korányi fasor 9, Hungary.
    Spreading depolarizations (SDs) occur spontaneously in the cerebral cortex of subarachnoid hemorrhage, stroke or traumatic brain injury patients. Accumulating evidence prove that SDs exacerbate focal ischemic injury by converting zones of the viable but non-functional ischemic penumbra to the core region beyond rescue. Yet the SD-related mechanisms to mediate neurodegeneration remain poorly understood. Read More

    Hemodynamics and gas exchange during chest compressions in neonatal resuscitation.
    PLoS One 2017 25;12(4):e0176478. Epub 2017 Apr 25.
    Pediatrics, SUNY University at Buffalo, Buffalo, New York, United States of America.
    Purpose: Current knowledge about pulmonary/systemic hemodynamics and gas exchange during neonatal resuscitation in a model of transitioning fetal circulation with fetal shunts and fluid-filled alveoli is limited. Using a fetal lamb asphyxia model, we sought to determine whether hemodynamic or gas-exchange parameters predicted successful return of spontaneous circulation (ROSC).

    Methods: The umbilical cord was occluded in 22 lambs to induce asphyxial cardiac arrest. Read More

    A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction.
    Curr Gastroenterol Rep 2017 Jun;19(6):28
    Division of Gastroenterology and Hepatology, Department of Medicine, William Beaumont Hospital, 3535 West Thirteen Mile Road, Royal Oak, MI, 48073, USA.
    Purpose Of Review: This study aimed to systematically review small bowel obstruction (SBO), focusing on recent changes in diagnosis/therapy.

    Recent Findings: SBO incidence is about 350,000/annum in the USA. Etiologies include adhesions (65%), hernias (10%), neoplasms (5%), Crohn's disease (5%), and other (15%). Read More

    Applications of pHLIP Technology for Cancer Imaging and Therapy.
    Trends Biotechnol 2017 Apr 21. Epub 2017 Apr 21.
    Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT 06520, USA. Electronic address:
    Acidity is a biomarker of cancer that is not subject to the blunting clonal selection effects that reduce the efficacy of other biomarker technologies, such as antibody targeting. The pH (low) insertion peptides (pHLIP(®)s) provide new opportunities for targeting acidic tissues. Through the physical mechanism of membrane-associated folding, pHLIPs are triggered by the acidic microenvironment to insert and span the membranes of tumor cells. Read More

    Ten-year follow-up of a case of necrotizing fasciitis successfully treated with negative-pressure wound therapy, dermal regeneration template application, and split- thickness skin autograft.
    Acta Chir Belg 2017 Apr 25:1-5. Epub 2017 Apr 25.
    a Department of Plastic and Reconstructive Surgery , Brugmann University Hospital, Free University of Brussels , Brussels , Belgium.
    Introduction: Necrotizing fasciitis is a rapidly progressive and often fatal infection of the fasciae and subcutaneous tissues.

    Patient And Methods: In this case report, we present the treatment of a 63-year-old patient suffering from diabetes mellitus, who was admitted to the emergency unit for severe right gluteal pain, which had begun 24 hours before admission. Cutaneous symptoms, oliguria, metabolic acidosis, acute renal failure, severe hypotension, and tachycardia occurred, and the patient was admitted to Intensive Care a few hours after initial admission. Read More

    DIABETIC KETOACIDOSIS IN PATIENTS WITH TYPE 2 DIABETES RECENTLY COMMENCED ON SGLT-2 INHIBITORS: AN ONGOING CONCERN.
    Endocr Pract 2017 Apr;23(4):506-508
    Objective: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are increasingly used as an adjunctive treatment for type 2 diabetes. We report the occurrence of diabetic ketoacidosis (DKA) in 3 patients with type 2 diabetes recently commenced on SGLT-2 inhibitors.

    Methods: Clinical presentation, laboratory data, and treatment outcomes of all 3 cases are described. Read More

    Distinct ON/OFF fluorescence signals from dual-responsive activatable nanoprobes allows detection of inflammation with improved contrast.
    Biomaterials 2017 Mar 28;133:119-131. Epub 2017 Mar 28.
    Skaggs School of Pharmacy and Pharmaceutical Sciences, KACST - UCSD Center for Excellence in Nanomedicine and Engineering, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0600, USA. Electronic address:
    Visualization of biochemical changes associated with disease is of great clinical significance, as it should allow earlier, more accurate diagnosis than structural imaging, facilitating timely clinical intervention. Herein, we report combining stimuli-responsive polymers and near-infrared fluorescent dyes (emission max: 790 nm) to create robust activatable fluorescent nanoprobes capable of simultaneously detecting acidosis and oxidative stress associated with inflammatory microenvironments. The spectrally-resolved mechanism of fluorescence activation allows removal of unwanted background signal (up to 20-fold reduction) and isolation of a pure activated signal, which enables sensitive and unambiguous localization of inflamed areas; target-to-background ratios reach 22 as early as 3 h post-injection. Read More

    Patient with multiple acyl-CoA dehydrogenation deficiency disease and FLAD1 mutations benefits from riboflavin therapy.
    Neuromuscul Disord 2017 Mar 9. Epub 2017 Mar 9.
    Research Programs Unit, Molecular Neurology, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland; Department of Pediatric Neurology, Hospital for Children and Adolescence, Helsinki University Central Hospital, Helsinki, Finland.
    Multiple acyl-CoA dehydrogenation deficiency is genetically heterogenous metabolic disease with mutations in genes involved in electron transfer to the mitochondrial respiratory chain. Disease symptoms vary from severe neonatal form to late-onset presentation with metabolic acidosis, lethargy, vomiting, muscle pain and weakness. Riboflavin therapy has been shown to ameliorate diseases symptoms in some of these patients. Read More

    Other organ involvement and clinical aspects of Wilson disease.
    Handb Clin Neurol 2017 ;142:157-169
    Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland; Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland. Electronic address:
    Wilson disease (WD) is a rare disorder of copper metabolism that presents mainly with hepatic and neuropsychiatric features. Copper accumulates not only in the liver and brain, but also in other organs. Liver injury can also be the cause of secondary impairment of other tissues. Read More

    Vitamin B1 in critically ill patients: needs and challenges.
    Clin Chem Lab Med 2017 Apr 22. Epub 2017 Apr 22.
    Department of Intensive Care, Austin Health, Heidelberg.
    Background: Thiamine has a crucial role in energy production, and consequently thiamine deficiency (TD) has been associated with cardiac failure, neurological disorders, oxidative stress (lactic acidosis and sepsis) and refeeding syndrome (RFS). This review aims to explore analytical methodologies of thiamine compound quantification and highlight similarities, variances and limitations of current techniques and how they may be relevant to patients.

    Content: An electronic search of Medline, PubMed and Embase databases for original articles published in peer-reviewed journals was conducted. Read More

    Acute kidney injury, plasma lactate concentrations and lactic acidosis in metformin users: A GoDarts study.
    Diabetes Obes Metab 2017 Apr 21. Epub 2017 Apr 21.
    Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee.
    Aims: Metformin is renally excreted and has been associated with the development of lactic acidosis. Although current advice is to omit metformin during illnesses that may increase risk of acute kidney injury (AKI), the evidence supporting this is lacking. We investigated the relationship between AKI, lactate concentrations and the risk of lactic acidosis in those exposed to metformin. Read More

    The role of renal proximal tubule transport in the regulation of blood pressure.
    Kidney Res Clin Pract 2017 Mar 31;36(1):12-21. Epub 2017 Mar 31.
    Department of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, Japan.
    The electrogenic sodium/bicarbonate cotransporter 1 (NBCe1) on the basolateral side of the renal proximal tubule plays a pivotal role in systemic acid-base homeostasis. Mutations in the gene encoding NBCe1 cause severe proximal renal tubular acidosis accompanied by other extrarenal symptoms. The proximal tubule reabsorbs most of the sodium filtered in the glomerulus, contributing to the regulation of plasma volume and blood pressure. Read More

    Cancer Chemotherapy Specific to Acidic Nests.
    Cancers (Basel) 2017 Apr 20;9(4). Epub 2017 Apr 20.
    Graduate School of Pharmaceutical Sciences, Chiba University, Chiba 260-8675, Japan.
    The realization of cancer therapeutics specific to cancer cells with less of an effect on normal tissues is our goal. Many trials have been carried out for this purpose, but this goal is still far from being realized. It was found more than 80 years ago that solid cancer nests are acidified, but in vitro studies under acidic conditions have not been extensively studied. Read More

    Pomegranate as a possible treatment in reducing risk of developing wound healing, obesity, neurodegenerative disorders, and diabetes mellitus.
    Mini Rev Med Chem 2017 Apr 19. Epub 2017 Apr 19.
    Faculty of Medicine, Çukurova University - Department of Medical Microbiology Adana, Others. Turkey.
    Four distinguished although overlying stages make up the methodical procedure of wound healing, which are hemostasis, inflammation, proliferation and remodelling. Multiple sclerosis (MS) comprises a persistent inflammatory infection of the central nervous system, and is related to demyelination, neurodegeneration, as well as susceptibility to oxidative pressure. Obesity signifies a swiftly developing danger to the wellbeing of populations in a rising number of nations. Read More

    Mechanisms Underlying the Emergence of Post-acidosis Arrhythmia at the Tissue Level: A Theoretical Study.
    Front Physiol 2017 30;8:195. Epub 2017 Mar 30.
    School of Computer Science and Technology, Harbin Institute of TechnologyHarbin, China.
    Acidosis has complex electrophysiological effects, which are associated with a high recurrence of ventricular arrhythmias. Through multi-scale cardiac computer modeling, this study investigated the mechanisms underlying the emergence of post-acidosis arrhythmia at the tissue level. In simulations, ten Tusscher-Panfilov ventricular model was modified to incorporate various data on acidosis-induced alterations of cellular electrophysiology and intercellular electrical coupling. Read More

    Clinical and Molecular Characterization of Patients with Fructose 1,6-Bisphosphatase Deficiency.
    Int J Mol Sci 2017 Apr 18;18(4). Epub 2017 Apr 18.
    Department of Endocrinology and Metabolism, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
    Fructose-1,6-bisphosphatase (FBPase) deficiency is a rare, autosomal recessive inherited disease caused by the mutation of the FBP1 gene, the incidence is estimated to be between 1/350,000 and 1/900,000. The symptoms of affected individuals are non-specific and are easily confused with other metabolic disorders. The present study describes the clinical features of four Chinese pediatric patients who presented with hypoglycemia, hyperlactacidemia, metabolic acidosis, and hyperuricemia. Read More

    Experience of carrier couples identified through a population-based carrier screening pilot program for four founder autosomal recessive diseases in Saguenay-Lac-Saint-Jean.
    Prenat Diagn 2017 Apr 18. Epub 2017 Apr 18.
    Medical Genetics, Department of Pediatrics, CHU Sainte-Justine and Department of Pediatrics, Université de Montréal.
    A pilot population-based carrier screening program started in 2010 in the Saguenay-Lac-Saint-Jean region of Quebec, Canada for four recessive diseases with local founder effects (tyrosinemia type I, ARSACS, congenital lactic acidosis, and Andermann syndrome).

    Objectives: Describe the experience of carrier couples identified through this program.

    Methods: Semi-structured interviews were performed with carrier couples. Read More

    Metformin-associated lactic acidosis (MALA): moving towards a new paradigm.
    Diabetes Obes Metab 2017 Apr 17. Epub 2017 Apr 17.
    Association REMEDES, Ville-sur-Jarnioux, France.
    Although metformin has been used for over 60 years, the balance between the drug's beneficial and adverse effects is still subject to debate. Following an analysis of how cases of so-called "metformin-associated lactic acidosis" (MALA) are reported in the literature, the present article reviews the pitfalls to be avoided when assessing the purported association between metformin and lactic acidosis. By starting from pathophysiological considerations, we propose a new paradigm for lactic acidosis in metformin-treated patients. Read More

    Role of Coma Acidosis Malaria Score in Patients with Severe Malaria among Indian Population: a Tertiary Care Center Experience.
    Eurasian J Med 2017 Feb;49(1):30-35
    Department of Pathology, Pt B.D. Sharma University of Health Sciences, Haryana, India.
    Objective: Malaria is a prime public health threat in developing countries like India. There is an unmet need of a simplified methodology for the purpose of triage and provision of intensive care to the severely infected patients in these areas.

    Materials And Methods: We did a prospective study in patients (n=60) admitted with severe malaria in a single tertiary care center in the state of Haryana, India. Read More

    Comparing slow and rapid bolus of ephedrine in pregnant patients undergoing planned cesarean section under spinal anesthesia.
    J Anaesthesiol Clin Pharmacol 2017 Jan-Mar;33(1):92-96
    Department of Anaesthesiology and Critical Care, JIPMER, Puducherry, India.
    Background And Aims: While ephedrine was the preferred drug for treating spinal-induced hypotension in pregnancy, its use has declined because of resultant fetal acidosis. The objective of this randomized control trial was to compare the effects of a slow and rapid bolus of ephedrine on fetal acidosis, maternal blood pressure, and heart rate (HR) during cesarean section performed under spinal anesthesia.

    Material And Methods: Eighty full-term parturients scheduled for cesarean section under spinal anesthesia were randomly allocated into two groups. Read More

    Is trial of labor harmful in breech delivery? A cohort comparison for breech and vertex presentations.
    J Gynecol Obstet Hum Reprod 2017 Apr 13. Epub 2017 Apr 13.
    Pôle femme-mère-nouveau-né, université Lille, hôpital Jeanne-de-Flandre, CHU de Lille, 59000 Lille, France; EA 2694 santé publique, épidémiologie et qualité des soins, university Lille, 59000 Lille, France.
    Introduction: Planned vaginal delivery in breech presentation is accompanied by an excess neonatal risk that has, however, rarely been compared to that of delivery in vertex presentation. Because of the severity of complications that can occur in long-term follow-up, the risk of asphyxia is of particular concern.

    Material And Methods: To assess immediate neonatal status after a planned vaginal delivery of fetuses in breech compared with vertex presentation, we planned a retrospective hospital cohort study of singleton term deliveries from 2000 to 2011. Read More

    The effect of the apneic period on the respiratory physiology of patients undergoing intubation in the emergency department.
    Am J Emerg Med 2017 Apr 2. Epub 2017 Apr 2.
    Department of Emergency Medicine, Lincoln Medical and Mental Health Center, Bronx, NY, USA.
    Objectives: We sought to examine the physiological impact the apneic period has on the respiratory physiology of patients undergoing intubation in the emergency department and whether DAO, the delivery of 15L oxygen by nasal cannula during apnea, can affect the development of respiratory acidosis.

    Methods: This was a prospective observational cohort study conducted at an urban academic level 1 trauma center. A convenience sample of 100 patients was taken. Read More

    Emergency Medicine Myths: Cerebral Edema in Pediatric Diabetic Ketoacidosis and Intravenous Fluids.
    J Emerg Med 2017 Apr 12. Epub 2017 Apr 12.
    Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.
    Background: Pediatric diabetic ketoacidosis (DKA) is a disease associated with several complications that can be severe. One complication includes cerebral edema (CE), and patients may experience significant morbidity with this disease.

    Objective: This review evaluates the myths concerning CE in pediatric DKA including mechanism, presentation of edema, clinical assessment of dehydration, and association with intravenous (i. Read More

    Prediction and validation of the duration of hemodialysis sessions for the treatment of acute ethylene glycol poisoning.
    Kidney Int 2017 Apr 12. Epub 2017 Apr 12.
    CHU de Québec Research Center, L'Hôtel-Dieu de Québec Hospital, Québec, QC, Canada; Division of Nephrology, Faculty of Medicine, Université Laval, Québec, QC, Canada. Electronic address:
    The duration of hemodialysis (HD) sessions for the treatment of acute ethylene glycol poisoning is dependent on concentration, the operational parameters used during HD, and the presence and severity of metabolic acidosis. Ethylene glycol assays are not readily available, potentially leading to undue extension or premature termination of HD. We report a prediction model for the duration of high-efficiency HD sessions based retrospectively on a cohort study of 26 cases of acute ethylene glycol poisoning in 24 individuals treated by alcohol dehydrogenase competitive inhibitors, cofactors and HD. Read More

    The electrical heart axis and ST events in fetal monitoring: A post-hoc analysis following a multicentre randomised controlled trial.
    PLoS One 2017 14;12(4):e0175823. Epub 2017 Apr 14.
    Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
    Objective: Reducing perinatal morbidity and mortality is one of the major challenges in modern health care. Analysing the ST segment of the fetal electrocardiogram was thought to be the breakthrough in fetal monitoring during labour. However, its implementation in clinical practice yields many false alarms and ST monitoring is highly dependent on cardiotocogram assessment, limiting its value for the prediction of fetal distress during labour. Read More

    Development and Diseases of the Collecting Duct System.
    Results Probl Cell Differ 2017 ;60:165-203
    Department of Regenerative and Cancer Cell Biology, Albany Medical College, MC-165, 47 New Scotland Avenue, Albany, NY, 12208, USA.
    The collecting duct of the mammalian kidney is important for the regulation of extracellular volume, osmolarity, and pH. There are two major structurally and functionally distinct cell types: principal cells and intercalated cells. The former regulates Na(+) and water homeostasis, while the latter participates in acid-base homeostasis. Read More

    [Clinical features of hereditary distal renal tubular acidosis and SLC4A1 gene mutation].
    Zhongguo Dang Dai Er Ke Za Zhi 2017 Apr;19(4):381-384
    Department of Endocrinology/Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
    Objective: To study the clinical features of two families with distal renal tubular acidosis (dRTA) and mutations in the pathogenic gene SLC4A1.

    Methods: Family investigation, medical history collection, and measurement of biochemical parameters were performed to analyze the clinical phenotype and genetic characteristics of dRTA. Direct sequencing was used to detect SLC4A1 gene mutations. Read More

    [Extracorporeal CO2 Elimination (ECCO2R) for Hypercapnic Respiratory Failure: From Pathophysiology to Clinical Application].
    Pneumologie 2017 Apr 13;71(4):215-220. Epub 2017 Apr 13.
    ARDS und ECMO Zentrum Köln-Merheim, Lungenklinik, Abteilung Pneumologie, Intensiv- und Beatmungsmedizin, Köln.
    Extracorporeal CO2 removal (ECCO2R) is becoming an increasingly established treatment option for patients with acute severe hypercapnic respiratory failure. Technically, pumpless arterio-venous systems using the natural arterio-venous pressure gradient and also pump-driven veno-venous systems are available. Here, veno-venous ECCO2R has become the preferred technique, as settings for arterio-venous ECCO2R are restricted and side effects are more common with arterio-venous ECCO2R. Read More

    Lethal Bentazone Intoxication - A Report of Two Cases.
    J Forensic Sci 2017 Apr 13. Epub 2017 Apr 13.
    Toxicology Laboratory, Department of Forensic Medicine and Criminology, University of Zagreb, School of Medicine, Zagreb, Croatia.
    This study presents two cases of lethal bentazone poisonings, their clinical presentation, the course of the disease and the autopsy findings. The first is a 50-year-old male who had sprayed corn with a solution of bentazone and was admitted to the hospital with sweating, fever, nausea, vomiting of aqueous and hemorrhagic content, and bloody, watery stools. He was treated according to the symptoms including extracorporeal hemodialysis, but eventually suffered from multiorgan failure (acute respiratory failure, acute liver failure, coagulopathy, acute renal failure, metabolic acidosis, and gastrointestinal bleeding) and died 11. Read More

    Effect of Intravenous Small-Volume Hypertonic Sodium Bicarbonate, Sodium Chloride, and Glucose Solutions in Decreasing Plasma Potassium Concentration in Hyperkalemic Neonatal Calves with Diarrhea.
    J Vet Intern Med 2017 Apr 13. Epub 2017 Apr 13.
    Bavarian Animal Health Service (Tiergesundheitsdienst Bayern e.V.), Poing, Germany.
    Background: Hyperkalemia is a frequently observed electrolyte imbalance in dehydrated neonatal diarrheic calves that can result in skeletal muscle weakness and life-threatening cardiac conduction abnormalities and arrhythmias.

    Hypothesis: Intravenous administration of a small-volume hypertonic NaHCO3 solution is clinically more effective in decreasing the plasma potassium concentration (cK) in hyperkalemic diarrheic calves than hypertonic NaCl or glucose solutions.

    Animals: Twenty-two neonatal diarrheic calves with cK >5. Read More

    Effects of Hypercapnia and Hypercapnic Acidosis on Hospital Mortality in Mechanically Ventilated Patients.
    Crit Care Med 2017 Apr 12. Epub 2017 Apr 12.
    1Department of Intensive Care medicine, Frankston Hospital, Frankston, Victoria, Australia. 2Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia. 3ANZIC-RC, Department of Epidemiology & Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, Victoria, Australia. 4Department of Intensive Care Medicine, St Vincent's Hospital, Sydney, NSW, Australia. 5University of New South Wales, Kensington, NSW, Australia.
    Objectives: Lung-protective ventilation is used to prevent further lung injury in patients on invasive mechanical ventilation. However, lung-protective ventilation can cause hypercapnia and hypercapnic acidosis. There are no large clinical studies evaluating the effects of hypercapnia and hypercapnic acidosis in patients requiring mechanical ventilation. Read More

    Prompt rise in urinary ammonium excretion suffices to mitigate metabolic acidosis in an experimental animal model of severe normovolemic hemodilution.
    Physiol Res 2017 Apr 12. Epub 2017 Apr 12.
    Institute of Physiological Chemistry, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.
    Recently, we have established a model of severe stepwise normovolemic hemodilution to a hematocrit of 10% in rats employing three different colloidal volume replacement solutions (Voluven, Volulyte and Gelafundin) that are routinely used in clinical practice at present. We did not see severe dilutional acidosis as to be expected, but a decline in urinary pH. We here looked on further mechanisms of renal acid excretion during normovolemic hemodilution. Read More

    Acquired 5-oxoproline acidemia successfully treated with N-acetylcysteine.
    Proc (Bayl Univ Med Cent) 2017 Apr;30(2):169-170
    Division of Nephrology, Massachusetts General Hospital (Hundemer, Fenves) and the Division of Renal Medicine, Brigham and Women's Hospital (Hundemer), Boston, Massachusetts.
    Acquired 5-oxoprolinemia is increasingly recognized as a cause of anion gap metabolic acidosis. It predominantly occurs in chronically ill, malnourished women with impaired renal function and chronic acetaminophen ingestion. Depletion of glutathione and cysteine stores leads to elevated 5-oxoproline levels. Read More

    [Fetal scalp pH during labor: Which threshold for intervention?]
    J Gynecol Obstet Hum Reprod 2017 Feb 30;46(2):183-187. Epub 2017 Jan 30.
    Maternité Port-Royal, hôpital Cochin, DHU risques et grossesse, Assistance publique-Hôpitaux de Paris, 53, avenue de l'Observatoire, 75014 Paris, France. Electronic address:
    Objective: In case of abnormal fetal heart rate, there is no consensus on the decision threshold pH scalp leading to a rapid birth. The objective of this study was to compare neonatal issues and cesarean rate in two maternity using different decision thresholds of scalp pH.

    Material And Methods: A comparative retrospective study conducted in two level III maternity units between January 2013 and May 2014, one maternity unit used a decision threshold of 7. Read More

    Effectiveness and safety of induction of labor for term breech presentations.
    J Gynecol Obstet Hum Reprod 2017 Jan 10;46(1):29-34. Epub 2016 Feb 10.
    Pôle Femme-Mère-Nouveau-né, hôpital Jeanne-de-Flandre, université Lille-Nord-de-France, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 2694, université Lille-Nord-de-France, 59000 Lille, France.
    In term breech deliveries, vaginal delivery can be safely envisioned in some conditions (related to patient selection and obstetrician experience). Very few data are currently available, however, about the possibility of inducing labor in these situations.

    Objective: To assess the effectiveness and safety of induction of labor for breech presentations. Read More

    Altered mental status predicts mortality in cardiogenic shock - results from the CardShock study.
    Eur Heart J Acute Cardiovasc Care 2017 Apr 1:2048872617702505. Epub 2017 Apr 1.
    1 Division of Emergency Medicine, University of Helsinki, Helsinki University Hospital, Finland.
    Background: Altered mental status is among the signs of hypoperfusion in cardiogenic shock, the most severe form of acute heart failure. The aim of this study was to investigate the prevalence of altered mental status, to identify factors associating with it, and to assess the prognostic significance of altered mental status in cardiogenic shock.

    Methods: Mental status was assessed at presentation of shock in 215 adult cardiogenic shock patients in a multinational, prospective, observational study. Read More

    Non-Hemodynamic Effects of Catecholamines.
    Shock 2017 Apr 11. Epub 2017 Apr 11.
    *Institute of Anesthesiological Pathophysiology and Process Engineering, University Hospital, Ulm, Germany †Department of Anesthesiology, University Hospital, Ulm, Germany.
    Circulatory shock is defined as an imbalance between tissue oxygen supply and demand, and mostly results from a loss of blood volume, cardiac pump failure and/or reduction of vasomotor tone. The clinical hallmarks of circulatory shock are arterial hypotension and lactate acidosis. Since the degree and duration of hypotension are major determinants of outcome, vasopressor administration represents a cornerstone therapy to treat these patients. Read More

    Emerging roles of lipid metabolism in cancer progression.
    Curr Opin Clin Nutr Metab Care 2017 Apr 11. Epub 2017 Apr 11.
    aPole of Pharmacology and Therapeutics (FATH), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium *Olivier Feron and Cyril Corbet equally contributed to this article.
    Purpose Of Review: Lipid metabolism in cancer cells and tumor-associated stromal cells was recently identified to contribute to disease progression particularly in response to changes in tumor microenvironment such as acidosis and hypoxia.

    Recent Findings: New molecular mechanisms driving lipid metabolism in various cancers were elicited through genetic silencing, pharmacological inhibition of key metabolic enzymes, including those involved in fatty acid oxidation and synthesis, and modulation of diet composition.

    Summary: To proliferate, metastasize, or resist stress conditions imposed by the microenvironment, many cancer cells rely on fatty acid β-oxidation to generate acetyl-CoA and fuel the TCA cycle, and on fatty acid synthesis to produce building blocks. Read More

    A Rare Cause of Recurrent Acute Pancreatitis in a Child: Isovaleric Acidemia with Novel Mutation.
    Pediatr Gastroenterol Hepatol Nutr 2017 Mar 27;20(1):61-64. Epub 2017 Mar 27.
    Department of Pediatric Gastroenterology Hepatology and Nutrition, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey.
    Recurrent acute pancreatic attacks is a rare clinical condition (2-5% of all acute pancreatis) in children and is mainly idiopathic in most cases. Sometimes it may be associated with congenital anomalies, metabolic diseases or hereditary conditions. Isovaleric acidemia (IVA) is a rare autosomal recessive amino acid metabolism disorder associated with isovaleryl coenzyme A dehydrogenase deficiency presenting the clinical findings such metabolic acidosis with increased anion gap, hyperammonemia, ketonemia, hypoglycemia, "the odor of sweaty feet," abdominal pain, vomiting, feeding intolerance, shock and coma. Read More

    Effects of dystocia on blood gas parameters, acid-base balance and serum lactate concentration in heavy draft newborn foals.
    J Equine Sci 2017 28;28(1):27-30. Epub 2017 Mar 28.
    Department of Applied Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan; United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan; Research Center for Global Agromedicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan.
    Dystocia is often lethal for neonatal foals; however, its clinicopathological features remain largely unknown. We investigated the effect of dystocia on the foal blood profile. Venous blood samples were collected from 35 foals (5 Percheron and 30 crossbreds between Percheron, Belgian, and Breton heavy draft horses) at 0 hr, 1 hr, 12 hr and 1 day after birth. Read More

    Transient Distal Renal Tubular Acidosis in Organophosphate Poisoning.
    Indian J Crit Care Med 2017 Mar;21(3):170-171
    Department of General Medicine, MES Medical College, Perinthalmanna, Kerala, India.
    Renal complications due to organophosphate poisoning are very rare. We are presenting a unique case of transient distal renal tubular acidosis due to organophosphate poisoning, which to the best of our knowledge is the first of its kind. An elderly female after deliberate self-harm with ingestion of chlorpyrifos had multiple ventricular arrhythmias due to hypokalemia secondary to distal renal tubular acidosis which improved completely after treatment. Read More

    [The topical problems of the application of the TASER electroshock devices].
    Sud Med Ekspert 2017 ;60(2):57-64
    Federal state budgetary institution 'Russian Centre of Forensic Medical Expertise', Russian Ministry of Health, Moscow, Russia, 125284.
    The objective of the present study was the analysis of publications in the foreign medical literature concerning the problems of safety, clinical diagnostics, pathological morphology, and treatment of the patients subjected to the impact by various models of the TASER electroshock devices. The materials for this article were borrowed from the available Internet resources and libraries. The methods of scientific analysis were employed to follow up the dynamics of publication and to determine the number of publications on the issues of interest. Read More

    Acidosis, but Not Alkalosis, Affects Anaerobic Metabolism and Performance in a 4-km Time Trial.
    Med Sci Sports Exerc 2017 Apr 11. Epub 2017 Apr 11.
    1Sports Science Research Group, Department of Physical Education and Sports Science, CAV, Federal University of Pernambuco, Brazil; 2Endurance Performance Research Group (GEDAE-USP), School of Physical Education and Sport, University of São Paulo, Brazil; 3Institute of Sport, Exercise and Active Living, College of Sport and Exercise Science, Victoria University, Australia; 4School of Medical and Health Sciences, Edith Cowan University, Australia; 5Human Performance Research Group, Academic Department of Physical Education, Technological Federal University of Parana, Curitiba, Parana, Brazil.
    Purpose: To determine the effect of pre-exercise metabolic acidosis and alkalosis on power output (PO) and aerobic and anaerobic energy expenditure during a 4-km cycling time trial (TT).

    Methods: Eleven recreationally trained cyclists (VO2peak 54.1 ± 9. Read More

    Anesthetic Management of Mitochondrial Encephalopathy With Lactic Acidosis and Stroke-Like Episodes (MELAS Syndrome) in a High-Risk Pregnancy: A Case Report.
    A A Case Rep 2017 Apr 10. Epub 2017 Apr 10.
    From the *Department of Anesthesiology, University of Toronto; and †Department of Anesthesia and Pain Management, Mount Sinai Hospital, Toronto, Ontario, Canada.
    MELAS syndrome (mitochondrial encephalopathy, lactic acidosis, and stroke-like symptoms) is a rare and complex mitochondrial disorder. We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Read More

    Nab-paclitaxel plus either gemcitabine or simplified leucovorin and fluorouracil as first-line therapy for metastatic pancreatic adenocarcinoma (AFUGEM GERCOR): a non-comparative, multicentre, open-label, randomised phase 2 trial.
    Lancet Gastroenterol Hepatol 2017 May 28;2(5):337-346. Epub 2017 Feb 28.
    Department of Oncology, Institut Mutualiste Montsouris, Paris, France.
    Background: Nab-paclitaxel plus gemcitabine has become a standard treatment regimen in patients with metastatic pancreatic adenocarcinoma; however, retrospective data suggest that gemcitabine might be inefficient in 50-60% of patients and thus not an optimum regimen in combination with nab-paclitaxel. We did a phase 2 trial to assess the activity and safety of a new regimen of nab-paclitaxel plus simplified leucovorin and fluorouracil.

    Methods: We did a non-comparative, multicentre, open-label, randomised phase 2 trial in 15 hospitals and institutions in France. Read More

    Pharmacological, but not genetic, alteration of neural Epo modifies the CO2/H(+) central chemosensitivity in postnatal mice.
    Respir Physiol Neurobiol 2017 Apr 8;242:73-79. Epub 2017 Apr 8.
    Université Laval, Faculté de Médecine, Centre de Recherche Institut universitaire de cardiologie et de pneumologie de Québec, Département de Pédiatrie, Québec, QC, Canada; Molecular biology and Biotechnology Institute, Universidad Mayor de San Andres, La Paz, Bolivia. Electronic address:
    Cerebral erythropoietin (Epo) plays a crucial role for respiratory control in newborn rodents. We showed previously that soluble Epo receptor (sEpoR: an Epo antagonist) reduces basal ventilation and hypoxic hyperventilation at postnatal day 10 (P10) and in adult mice. However, at these ages (P10 and adulthood), Epo had no effect on central chemosensitivity. Read More

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