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Life Sci 2019 Apr 17. Epub 2019 Apr 17.

Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China. Electronic address:

Aims: Improvements in cancer treatment have significantly extended the lifespan of patients. However, due to the adverse effects of cancer treatment, cancer survivors are at increased risk of cardiovascular complications. Doxorubicin is a widely used spectrum antitumor drug, but the life-threatening side-effect of cardiotoxicity limits its clinical application. Read More

Glob Pediatr Health 2019 8;6:2333794X19840364. Epub 2019 Apr 8.

Beaumont Health System, Royal Oak, MI, USA.

Profound hypokalemia in the presence of diabetic ketoacidosis (DKA) is life-threatening condition predisposing patients to cardiac arrhythmias and potentially death. Rarely do patients present with profound hypokalemia (serum K level <2.5 mEq/L). Read More

Indian J Urol 2019 Apr-Jun;35(2):121-128

Department of Urology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Introduction: We present the short-term voiding patterns and functional and urodynamic outcomes of W-shaped ileal orthotopic neobladder (ONB) following radical cystectomy (RC).

Materials And Methods: Forty-one patients who underwent RC and W-shaped ONB creation between July 2015 and January 2018 were enrolled. Data were analyzed in terms of voiding patterns, urodynamic findings, and functional outcomes at 6 months after surgery. Read More

Geburtshilfe Frauenheilkd 2019 Apr 1;79(4):389-395. Epub 2019 Feb 1.

Sektion für Geburtshilfe und Perinatalmedizin, Klinikum rechts der Isar, Technische Universität München, München, Germany.

Various methods of intrapartum analgesia are available these days. Pethidine, meptazinol and epidural analgesia are among the most commonly used techniques. A relatively new one is patient-controlled intravenous analgesia with remifentanil, although the experiences published so far in Germany are limited. Read More

Can J Respir Ther 2017 1;53(3):33-36. Epub 2017 Aug 1.

Duke University Medical Center, Durham, NC.

Background: The use of noninvasive ventilation (NIV) in severe acute asthma is controversial. A pH < 7.25, PaCO > 60 mmHg, and altered mental status have been described as contraindications to NIV in acute asthma. Read More

Pol J Vet Sci 2019 Mar;22(1):37-42

Department of Clinical Science, College of Veterinary Medicine and Animal Science, University of Sao Paulo (FMVZ/USP). Av. Prof. Orlando Marques de Paiva, 87, Cidade Universitária, CEP 05508-270, São Paulo, SP, Brazil.

The present study aimed to evaluate the efficiency of hypertonic saline solution (HSS) as a novel treatment of acute ruminal lactic acidosis (ARLA) in cattle, focusing on urinary excretion of acids. Twelve cannulated steers were submitted to experimentally induced ARLA by adminis- tering sucrose into the rumen. Twenty hours later, the cattle were randomly divided into two equal groups. Read More

JPEN J Parenter Enteral Nutr 2019 Apr 17. Epub 2019 Apr 17.

University of Missouri-Kansas City School of Medicine, Department of Internal Medicine, Kansas City, Missouri, USA.

Diabetic ketoacidosis is defined as hyperglycemia >250 mg/dL with metabolic acidosis of arterial pH <7.3, serum bicarbonate <18 mEq/L with positive urine and serum ketones and an anion gap >10. Euglycemic ketoacidosis has been reported in patients with type 2 diabetes and in patients with type 1 diabetes. Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2019 Apr;51(2):293-297

Department of Urology, Peking University People's Hospital, Beijing 100044, China.

Objective: To compare the effectiveness and complications between enterocystoplasty and small intestinal submucosa (SIS) cystoplasty through follow-ups of patients with augmentation cystoplasty in Peking University People's Hospital, offering alternative approach for future treatment.

Methods: In this study, retrospective analyses were carried out in 10 patients who underwent enterocystoplasty or SIS cystoplasty in Peking University People's Hospital from November 2011 to December 2016. Clinical data were collected including medical history, surgical procedures, laboratory examinations and complications. Read More

Exp Clin Transplant 2019 Apr 17. Epub 2019 Apr 17.

From the Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: Normal saline is the most common crystalloid solution that is used in renal transplant surgery. In this study, our aim was to determine the effects of a combination of half saline and bicarbonate versus normal saline as a routine solution.

Materials And Methods: For this double-blind random-ized clinical trial, we enrolled 100 adult patients undergoing kidney transplant. Read More

Am J Nephrol 2019 Apr 17;49(6):438-448. Epub 2019 Apr 17.

Department of Internal Medicine, Texas A&M Health Sciences Center College of Medicine, Dallas, Texas, USA,

Background: Current guidelines recommend treatment of metabolic acidosis in chronic kidney disease (CKD) with sodium-based alkali. We tested the hypothesis that treatment with base-producing fruits and vegetables (F + V) better improves cardiovascular disease (CVD) risk indicators than oral sodium bicarbonate (NaHCO3).

Methods: We randomized 108 macroalbuminuric, matched, nondiabetic CKD patients with metabolic acidosis to F + V (n = 36) in amounts to reduce dietary acid by half, oral NaHCO3 (HCO3, n = 36) 0. Read More

Can Vet J 2019 Apr;60(4):377-380

Department of Clinical Studies New Bolton Center (Luethy, Nolen-Watson), Department of Pathobiology (Bender, Murphy), University of Pennsylvania School of Veterinary Medicine, 382 West Street Road Kennett Square, Kennett Square, Pennsylvania 19348, USA; Marion DuPont Scott Equine Medical Center, Virginia-Maryland College of Veterinary Medicine, Leesburg, Virginia, USA (Marchitello).

A 7-month-old spayed female Vietnamese pot-bellied pig (VPBP) was presented for diffuse muscle fasciculations and seizure-like activity that had started 4 hours before presentation. The pig was stuporous and displayed diffuse involuntary gross motor movement and muscle fasciculations, as well as hypertonicity of all 4 limbs. Hematologic analysis revealed hemoconcentration, severe hyperlactatemia, moderate metabolic acidosis, increased creatine kinase and gamma-glutamyltransferase. Read More

Nephron 2019 Apr 16:1-8. Epub 2019 Apr 16.

Department of Anesthesiology, Hamamatsu Rosai Hospital, Japan Organization of Occupational Health and Safety, Hamamatsu, Japan.

Background: Renal function tends to deteriorate in a hyperchloremic acidifying environment, which is reflected by a decrease in the difference between sodium and chloride.

Objectives: To examine the effect of furosemide administered under hyperchloremic acidosis on intraoperative oliguria and acute kidney injury in patients with preoperatively normal renal function.

Methods: In patients undergoing abdominal or orthopedic surgeries (April 2010-November 2018), we retrospectively identified patients who preoperatively had a normal renal function but experienced intraoperative oliguria under hyperchloremic acidosis (a sodium-chloride difference < 30 mEq/L) without dehydration. Read More

Intern Med J 2019 Apr 15. Epub 2019 Apr 15.

Tours University Hospital, Emergency Medicine Department, 37044, Tours, France and François-Rabelais University, School of Medicine, 37044, Tours, France.

Objectives: Exacerbations of chronic obstructive pulmonary disease (COPD) are common in emergency departments (ED). Guidelines recommend administration of inhaled bronchodilators, systemic corticosteroids and antibiotics along with non-invasive ventilation (NIV) for patients with respiratory acidosis. We aimed to determine compliance with guideline recommendations for patients with treated for COPD in ED in Europe (EUR) and South East Asia/Australasia (SEA) and to compare management and outcomes. Read More

Adv Sci (Weinh) 2019 Apr 28;6(7):1800935. Epub 2019 Jan 28.

Department of Electrical Engineering University of California Santa Cruz Santa Cruz CA 95064 USA.

Bioelectronic devices that modulate pH can affect critical biological processes including enzymatic activity, oxidative phosphorylation, and neuronal excitability. A major challenge in controlling pH is the high buffering capacity of many biological media. To overcome this challenge, devices need to be able to store and deliver a large number of protons on demand. Read More

Hypertens Res 2019 Apr 15. Epub 2019 Apr 15.

Department of Nuclear Medicine, General Hospital "LAΪKO", Athens, Greece.

Peripheral arterial disease (PAD) is substantially prevalent among patients in the end stage of renal disease (ESRD). We considered factors related to peripheral arterial disease in patients undergoing hemodialysis including the important role of monocyte chemoattractant protein-1 (MCP-1) serum concentrations. We studied 150 patients in on-line-predilution hemodiafiltration. Read More

MedEdPORTAL 2016 Nov 18;12:10504. Epub 2016 Nov 18.

Emergency Medicine Resident, Perelman School of Medicine at the University of Pennsylvania.

Introduction: Oncologic emergencies are life-threatening and often require advanced team-management skills as well as a mastery of disease processes and therapeutic interventions. Simulation of an oncologic emergency case is a useful way to experience, reflect on, and practice these skills. This case involving a simulated patient in blast crisis was created as part of our Emergency Medicine (EM) Resident Simulation Curriculum at the Perelman School of Medicine at the University of Pennsylvania. Read More

Crit Care Med 2019 May;47(5):e434-e435

Division of Pulmonary & Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.

Am J Respir Crit Care Med 2019 Apr 15. Epub 2019 Apr 15.

Regions Hospital, St. Paul, Minnesota, United States.

Rationale: Hyperlactatemia in sepsis may derive from a prevalent impairment of oxygen supply/demand and/or oxygen utilization. Discriminating between these two mechanisms may be relevant for the early fluid resuscitation strategy.

Objectives: Understanding the relationship between central venous oxygen saturation (ScvO2), lactate and base excess to better determine the origin of lactate. Read More

Front Pediatr 2019 29;7:69. Epub 2019 Mar 29.

Department of Pediatric, Makassed General Hospital, Beirut, Lebanon.

Tyrosinemia type III is the rarest type of tyrosinemia, because of a mutation in 4-OH-phenylpyruvate dioxygenase (HPD). This causes two different types of diseases with different modes of inheritance: tyrosinemia type III and hawkinsinuria. Hawkinsinuria is an autosomal dominant disease, which presents a failure to thrive and metabolic acidosis; however, the liver is not affected. Read More

SAGE Open Med Case Rep 2019 3;7:2050313X19839529. Epub 2019 Apr 3.

Department of Intensive Care, "Pugliese-Ciaccio" General Hospital, Catanzaro, Italy.

Traumatic rhabdomyolysis is a clinical and biological syndrome secondary to lysis of striated muscle fibers resulting in extended musculoskeletal damage. An acute muscle damage causes the release of constituent elements of the sarcoplasmic reticulum, such as muscle enzymes, potassium, and myoglobin in plasma circulation; these conditions are at great risk of dangerous systemic complications for life such as hypovolemic shock, hyperkalemia, and acute kidney injury. We describe the case of a patient who suffered a severe musculoskeletal and vascular trauma with elevated creatine kinase values and myoglobinemia treated early with coupled plasma filtration adsorption in order to prevent kidney damage, associated with volume replacement, loop diuretics, and correction of metabolic acidosis. Read More

Indian J Nephrol 2019 Mar-Apr;29(2):116-121

Department of Nephrology, Government Stanley Hospital, The Tamilnadu DR MGR Medical University, Chennai, Tamil Nadu, India.

Metabolic acidosis is a prevalent yet overlooked entity among renal transplant recipients (RTRs) and incurs adverse effects on graft function. Although graft dysfunction and calcineurin inhibitor usage have been linked with renal tubular acidosis (RTA), there is no Indian data on prevalence or risk factors of post-transplant acidosis. A cross-sectional study was conducted on 106 adult RTRs, with a transplant duration of >6 months and an estimated glomerular filtration rate (GFR) >40 ml/min/1. Read More

Indian J Nephrol 2019 Mar-Apr;29(2):84-89

Department of Nephrology, JIPMER, Puducherry, India.

Metabolic acidosis is known to have adverse consequences in patients with chronic kidney disease (CKD) including protein-energy wasting, inflammation, bone disease, and disturbance in endocrine function. Unlike in the management of patients with predialysis CKD, bicarbonate levels were not being routinely monitored in dialysis patients at our center. The KDOQI guidelines recommend serum bicarbonate levels ≥22 mEq/L in patients on dialysis. Read More

Rev Prat 2019 Feb;69(2):162-165

Service des maladies infectieuses et tropicales, groupe hospitalier La Pitié-Salpêtrière, Paris-Sorbonne Université, Paris, France.

Severe and complicated malaria. About 15% of the 4500 to 5000 cases of malaria occurring each year in France will prove to be severe malaria. Severe forms of malaria mainly involve P. Read More

Brain Dev 2019 Apr 11. Epub 2019 Apr 11.

Department of Pediatrics, Shimane University, Faculty of Medicine, Izumo, Shimane, Japan.

Multiple acyl-CoA dehydrogenase deficiency (MADD), also known as glutaric acidemia type II, is classically caused by a congenital defect in electron transfer flavoprotein (ETF) or ETF dehydrogenase (ETFDH). Flavin adenine dinucleotide synthase (FADS) deficiency caused by mutations in FLAD1 was recently reported as a novel riboflavin metabolism disorder resembling MADD. Here, we describe a Japanese boy with FADS deficiency due to a novel mutation (p. Read More

Am J Obstet Gynecol 2019 Apr 10. Epub 2019 Apr 10.

In the past century, some areas of obstetric including intrapartum care have been slow to benefit from the dramatic advances in technology and medical care. Although fetal heart rate monitoring (cardiotocography, CTG) became available a half century ago, its interpretation often differs between institutions and countries, its diagnostic accuracy needs improvement, and a technology to help reduce the unnecessary obstetric interventions that have accompanied the CTG is urgently needed. During the second half of the 20 century, key findings in animal experiments captured the close relationship between myocardial glycogenolysis, myocardial workload, and ST changes, thus demonstrating that ST waveform analysis of the fetal ECG can provide information on oxygenation of the fetal myocardium and establishing the physiological basis for the use of ECG in intrapartum fetal surveillance. Read More

J Cardiovasc Transl Res 2019 Apr 12. Epub 2019 Apr 12.

Department of Anesthesiology, The Heilongjiang Province Key Lab of Research on Anesthesiology and Critical Care Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin, China.

Previous studies proposed that acidic reperfusion may be a protective strategy for myocardial ischemia-reperfusion therapy with potential of clinical transformation. In this study, we investigated whether therapeutic hypercapnia could mimic acidosis postconditioning in isolated hearts with a 30-min left coronary artery ligation-reperfusion model in rats. Therapeutic hypercapnia (inhalation 20% CO for 10 min) is cardioprotective with a strict therapeutic time window and acidity: it reduced the infarct ratio and serum myocardial enzyme and increased the myocardial ATP content. Read More

Wien Klin Wochenschr 2019 Apr 12. Epub 2019 Apr 12.

Klinische Abteilung für Endokrinologie und Stoffwechsel, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.

Diabetic ketoacidosis (DKA) and the hyperglycemic hyperosmolar state (HHS) represent potentially life-threatening situations in adults. Therefore, rapid comprehensive diagnostic and therapeutic measures with close monitoring of vital and laboratory parameters are required. The treatment of DKA and HHS is essentially the same and replacement of the mostly substantial fluid deficit with several liters of a physiological crystalloid solution is the first and most important step. Read More

Cell Calcium 2019 Apr 4;80:63-70. Epub 2019 Apr 4.

Dipartimento di Fisiologia e Farmacologia "V. Erspamer", Sapienza Università di Roma, Rome, Italy; IRCCS Neuromed, Pozzilli, Italy. Electronic address:

NMDA receptors (NMDARs) are glutamate-gated ion channels involved in excitatory synaptic transmission and in others physiological processes such as synaptic plasticity and development. The overload of Ca ions through NMDARs, caused by an excessive activation of receptors, leads to excitotoxic neuronal cell death. For this reason, the reduction of Ca flux through NMDARs has been a central focus in finding therapeutic strategies to prevent neuronal cell damage. Read More

Open Access Maced J Med Sci 2019 Mar 26;7(6):962-966. Epub 2019 Mar 26.

Department of Emergency Medicine, Orthopedic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Background: Death in multiple trauma (MT) patients is one of the serious concerns of the medical service provider. Any prediction of the likelihood of death on the assessment of the patient's condition is performed using different variables, one of the tools in the triage of patients to determine their condition.

Aim: We aimed to investigate the frequency and the predictive value of death in 24 hours triad of death in patients qualified with multiple traumas admitted to Imam Khomeini hospital. Read More

J Exp Biol 2019 Apr 11. Epub 2019 Apr 11.

Zoophysiology, Department of Bioscience, Aarhus University, Aarhus, Denmark

The swamp eel () uses its buccal cavity to air-breathe while the gills are strongly reduced. They burrow into mud during the dry season, are highly tolerant of air-exposure, and experience severe hypoxia in both their natural habitat and in aquaculture. To study their ability to compensate for respiratory acidosis, we implanted catheters to sample both arterial blood and urine during hypercapnia (4% CO) in either water and air, or during whole animal air-exposure. Read More

FASEB J 2019 Apr 11:fj201802456R. Epub 2019 Apr 11.

Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China.

Over the years, rumen fluid transplantation (RT) has been successfully applied to treat acute rumen acidosis in ruminants, but how it functions in the ruminal microbial homeostasis and host function remains largely unknown. Here, we investigated the dynamic changes of rumen fermentation and bacterial communities following RT and its beneficial effects on rumen epithelial morphology and function in a sheep model of rumen acidosis. The results showed that RT resulted in dynamic changes in rumen fermentation and increased the concentrations of total volatile fatty acid, acetate, propionate, and butyrate, but it decreased the levels of lactate and LPS in the rumen. Read More

Pediatr Transplant 2019 Apr 11:e13411. Epub 2019 Apr 11.

Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.

Background: In current practice, pediatric kidney transplant recipients receive large volumes of intravenous fluid intraoperatively to establish allograft perfusion, and further fluid to replace urinary and insensible losses postoperatively. Acute electrolyte imbalance can result, with potential for neurological sequelae. We aimed to determine the incidence and severity of postoperative plasma electrolyte imbalance in pediatric kidney transplant recipients managed with the current standard intravenous crystalloid regimen. Read More

Neuropathology 2019 Apr 10. Epub 2019 Apr 10.

Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Japan.

We present an autopsied case with A8344G-mutated myoclonus epilepsy with ragged red fibers (MERRF)/mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) overlap syndrome accompanied by stroke-like episodes localized to the precentral gyrus. A 16-year-old Japanese woman suddenly experienced repetitive consciousness disturbances with increased serum lactate and creatine kinase levels. Magnetic resonance imaging showed abnormal intensity of bilateral precentral gyrus. Read More

Interact Cardiovasc Thorac Surg 2019 Apr 9. Epub 2019 Apr 9.

Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan.

Sodium glucose cotransporter 2 inhibitors are currently widely used antihyperglycaemic medications that are considered to be associated with euglycaemic diabetic ketoacidosis. We report 2 cases of patients who received sodium glucose cotransporter 2 inhibitors until emergency coronary artery bypass grafting (CABG) and developed euglycaemic ketoacidosis after surgery; they were treated with sugar replenishment and insulin infusion. In one case, coronary angiography revealed a spastic change of the bypass graft possibly due to severe acidosis. Read More

Front Pediatr 2019 22;7:75. Epub 2019 Mar 22.

Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.

Asphyxiated neonates often have myocardial dysfunction and renal insufficiency. Previously we demonstrated that doxycycline improved cardio-renal function through matrix metalloproteinase (MMP)-2 inhibition in an acute swine model of neonatal hypoxia-reoxygenation. The prolonged cardio-renal protective effects of doxycycline in neonates still remained unknown. Read More

BMJ 2019 Apr 9;365:l1328. Epub 2019 Apr 9.

Humanitas University Gradenigo Hospital, 8 Corso Regina Margherita, 10132 Turin, Italy.

Objective: To assess the efficacy and safety of dual sodium glucose cotransporter (SGLT) 1/2 inhibitor sotagliflozin in type 1 diabetes mellitus.

Design: Meta-analysis of randomised controlled trials.

Data Sources: Medline; Cochrane Library; Embase; international meeting abstracts; international and national clinical trial registries; and websites of US, European, and Japanese regulatory authorities, up to 10 January 2019. Read More

Am J Emerg Med 2019 Mar 23. Epub 2019 Mar 23.

Division of Medical Toxicology, Department of Emergency Medicine, The Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, NY, New York, USA. Electronic address:

Introduction: The goals of this study are to describe clinical characteristics and risk factors for metabolic acidosis with hyperlactatemia in emergency department (ED) patients with acute metformin overdose.

Methods: This was a secondary analysis of data from a retrospective observational cohort of adult ED patients presenting with acute drug overdose at two tertiary care hospitals over 5 years. The primary outcomes were: (1) hyperlactatemia, defined as a lactate concentration ≥ 2 mmol/L at any point during hospital admission and, (2) metformin associated lactic acidosis (MALA), defined as a lactate concentration ≥ 5 mmol/L and pH <7. Read More

Curr Hypertens Rev 2019 Apr 9. Epub 2019 Apr 9.

Department of Physiology, Wayne State University School of Medicine and the John D. Dingell VA Medical Center, Detroit, Michigan, MI. United States.

Advances in molecular research techniques have enabled a new frontier in discerning the mechanisms responsible for monogenic diseases. In this review, we discuss the current research on the molecular pathways governing blood pressure disorders with a Mendelian inheritance pattern, each presenting with a unique pathophysiology. Glucocorticoid remediable aldosteronism (GRA) and apparent mineralocorticoid excess (AME) are caused by mutations in regulatory enzymes that induce increased production of mineralocorticoids or inhibit degradation of glucocorticoids, respectively. Read More

Proc Biol Sci 2019 Feb;286(1897):20182863

1 Biosciences, University of Exeter , Geoffrey Pope Building, Stocker Road, Exeter EX4 4QD , UK.

Ocean acidification (OA) studies to date have typically used stable open-ocean pH and CO values to predict the physiological responses of intertidal species to future climate scenarios, with few studies accounting for natural fluctuations of abiotic conditions or the alternating periods of emersion and immersion routinely experienced during tidal cycles. Here, we determine seawater carbonate chemistry and the corresponding in situ haemolymph acid-base responses over real time for two populations of mussel ( Mytilus edulis) during tidal cycles, demonstrating that intertidal mussels experience daily acidosis during emersion. Using these field data to parameterize experimental work we demonstrate that air temperature and mussel size strongly influence this acidosis, with larger mussels at higher temperatures experiencing greater acidosis. Read More

Int Urol Nephrol 2019 Apr 8. Epub 2019 Apr 8.

Department of Statistics, Prasanna School of Public Health, MAHE, Udupi, India.

Purpose: To study the incidence of lactic acidosis due to metformin in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) stage 3-5.

Methods: We estimated plasma lactate in patients of CKD stage 3 and worse who were continuing metformin on their own prior to stopping the drug.

Result: Of 40 patients included, median duration of T2DM was 60 months (interquartile range IQR 24-120). Read More

Clin Transl Allergy 2019 25;9:19. Epub 2019 Mar 25.

5Department of Dermatology and Allergy Biederstein, Technical University of Munich, Biedersteiner Strasse 29, 80802 Munich, Germany.

Background: In wheat-dependent exercise-induced anaphylaxis (WDEIA), cofactors such as exercise, acetylsalicylic acid (ASA), alcohol or unfavorable climatic conditions are required to elicit a reaction to wheat products. The mechanism of action of these cofactors is unknown, but an increase of gliadin absorption has been speculated. Our objectives were to study gliadin absorption with and without cofactors and to correlate plasma gliadin levels with factors influencing protein absorption in healthy volunteers. Read More

Sci Rep 2019 Apr 8;9(1):5752. Epub 2019 Apr 8.

Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA.

Mitochondrial DNA (mtDNA) 3243A > G tRNALeu heteroplasmic mutation (m.3243A > G) exhibits clinically heterogeneous phenotypes. While the high mtDNA heteroplasmy exceeding a critical threshold causes mitochondrial encephalomyopathy, lactic acidosis with stroke-like episodes (MELAS) syndrome, the low mtDNA heteroplasmy causes maternally inherited diabetes with or without deafness (MIDD) syndrome. Read More

Seizure 2019 Mar 26;69:41-43. Epub 2019 Mar 26.

Children's Mercy Hospital, Division of Neurology, Kansas City, United States.

Purpose: The ketogenic diet has been found to be safe and effective in the treatment of drug resistant epilepsy in childhood. The age range of children undergoing this treatment has steadily been going down. There is strong evidence that it is a safe alternative in infants with drug resistant seizures. Read More

J Law Med 2019 Apr;26(3):549-556

Professor, Head of Discipline of Obstetrics and Gynaecology, Western Sydney University; Conjoint Senior Lecturer Women's and Children's Health, University of New South Wales.

For most prospective mothers, pain in childbirth is their greatest fear. However, intolerable labour pain should no longer be accepted by the health professions. Without adequate pain control in labour fetal damage can be significant. Read More

BMJ Paediatr Open 2019 15;3(1):e000424. Epub 2019 Mar 15.

Mater Research, Mater Research Institute/University of Queensland, Brisbane, Queensland, Australia.

Objective: The aim of this study was to develop a predictive model using maternal, intrapartum and ultrasound variables for a composite of severe adverse neonatal outcomes (SANO) in term infants.

Design: Prospectively collected observational study. Mixed effects generalised linear models were used for modelling. Read More

Case Rep Emerg Med 2019 5;2019:9301432. Epub 2019 Mar 5.

Department of Emergency and Hospital Medicine, Lehigh Valley Health Network and University of South Florida Morsani College of Medicine, Lehigh Valley Campus, Cedar Crest Boulevard & I-78, Allentown, PA 18103, USA.

Massive acetaminophen (N-acetyl-p-aminophenol; APAP) ingestion is characterized by a rapid onset of mitochondrial dysfunction, including metabolic acidosis, lactemia, and altered mental status without hepatotoxicity which may not respond to the standard doses of N-acetylcysteine (NAC). A 64-year-old woman without medical history presented comatose after an ingestion of 208 tablets of Tylenol PM™ (APAP 500 mg and diphenhydramine 25 mg). The initial APAP concentration measured 1,017 g/mL (therapeutic range 10-30 g/mL), and elevated anion gap metabolic acidosis, lactemia, and 5-oxoprolinemia were detected. Read More

Zhonghua Bing Li Xue Za Zhi 2019 Apr;48(4):298-302

Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.

To investigate the ultrastructural features of muscle in patients with mitochondrial encephalomyopathy for its diagnosis and differential diagnosis. The clinical data of 27 mitochondrial encephalomyopathy patients who underwent left or right biceps brachii muscle biopsy at Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University from July 2006 to August 2017 were analyzed retrospectively. The muscle biopsy specimens were examined underlight microscope and transmission electron microscope. Read More

Neoplasia 2019 Apr 3;21(5):450-458. Epub 2019 Apr 3.

Julius Bernstein Institute of Physiology, University of Halle-Wittenberg, Germany.

Epithelial-to-mesenchymal transition (EMT) is an important process of tumor progression associated with increased metastatic potential. EMT can be activated by external triggers such as cytokines or metabolic parameters (e.g. Read More