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    1 OF 64

    Antenatal Bartter syndrome presenting with vomiting and constipation mimicking subacute intestinal obstruction in a 20-day-old neonate.
    BMJ Case Rep 2017 Nov 14;2017. Epub 2017 Nov 14.
    Hamad Medical Corporation, Doha, Qatar.
    Antenatal Bartter syndrome is a rare condition that can present with different clinical features. These features include early onset maternal polyhydramnios, failure to thrive, prematurity and nephrocalcinosis.We are presenting this 20-day-old girl who had an antenatal history of polyhydramnios. Read More

    The nutritional limitations of plant-based beverages in infancy and childhood.
    Nutr Hosp 2017 Oct 24;34(5):1205-1214. Epub 2017 Oct 24.
    Hospital La Fe.Valencia.
    Breastfeeding, infant formula and cow's milk are basic foods in infant nutrition. However, they are being increasingly replaced either totally or partially by plant-based beverages.The composition of 164 plant-based beverages available in Spain was reviewed based on the nutritional labeling of the package and the manufacturers' webpages. Read More

    Leigh syndrome in individuals bearing m.9185T>C MTATP6 variant. Is hyperventilation a factor which starts its development?
    Metab Brain Dis 2017 Nov 7. Epub 2017 Nov 7.
    Department of Medical Genetics, The Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730, Warsaw, Poland.
    Leigh syndrome (LS), subacute necrotizing encephalomyelopathy is caused by various genetic defects, including m.9185T>C MTATP6 variant. Mechanism of LS development remains unknown. Read More

    [A case of Gitelman syndrome with physical retardation].
    Zhong Nan Da Xue Xue Bao Yi Xue Ban 2017 Oct;42(10):1236-1238
    Department of Pediatrics, Xiangya Hospital, Central South University, Changsha 410008, China.
    Gitelman syndrome is a rare disease. It is easy to be misdiagnosed and missed diagnosis due to the diverse clinical symptoms. A girl with long-term hypokalemia, who presented with intermittent pain of lower limb muscle and physical retardation, was treated in Xiangya Hospital, Central South University. Read More

    Primary Hyperaldosteronism Due to Adrenocortical Adenoma: a Case Report.
    Acta Med Indones 2017 Jul;49(3):249-254
    Department of Internal Medicine Faculty of Medicine, Diponegoro University - Dr. Kariadi Hospital Semarang, Indonesia.
    Primary hyperaldosteronism is an adrenal abnormality in which there is some degree of autonomy of aldosterone secretion. We report a case of thirty three years old Javanese female presented with uncontrolled hypertension, muscular weakness, cramps  and progressing shortness of breath during working for 6 years. She had history of hypertension since age 20. Read More

    A Basic Therapy Gone Awry.
    Am J Crit Care 2017 Nov;26(6):491-494
    Laura B. Galinko is an anesthesiology resident at New York Presbyterian Hospital/Weill Cornell Medical College, New York, New York. At the time of this case report, Steven H. Hsu was a critical care medicine fellow and Michael L. Fingerhood was a pulmonary medicine fellow at Memorial Sloan Kettering Cancer Center, New York, New York. Cosmin Gauran is an assistant attending, Stephen M. Pastores is the critical care fellowship director, and Neil A. Halpern is the director of the Critical Care Center, and Sanjay Chawla is an associate attending in the Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center.
    Baking soda (sodium bicarbonate) is a common household item that has gained popularity as an alternative cancer treatment. Some have speculated that alkali therapy neutralizes the extracellular acidity of tumor cells that promotes metastases. Internet blogs have touted alkali as a safe and natural alternative to chemotherapy that targets cancer cells without systemic effects. Read More

    Unusual Complication of Multidrug Resistant Tuberculosis.
    Case Rep Nephrol 2017 18;2017:6835813. Epub 2017 Sep 18.
    Division of Medicine, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai 400 012, India.
    Introduction: Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany.

    Case Report: 23-year-old female patient presented with carpopedal spasms and tingling sensations in hands. Read More

    Persistent severe hypokalemia: Gitelman syndrome and differential diagnosis.
    J Bras Nefrol 2017 Jul-Sep;39(3):337-340
    Universidade do Sul de Santa Catarina.
    The main causes of hypokalemia are usually evident in the clinical history of patients, with previous episodes of vomiting, diarrhea or diuretic use. However, in some patients the cause of hypokalemia can become a challenge. In such cases, two major components of the investigation must be performed: assessment of urinary excretion potassium and the acid-base status. Read More

    Epidemiology of Acid-Base Derangements in CKD.
    Adv Chronic Kidney Dis 2017 09;24(5):280-288
    University of Rochester School of Medicine and Dentistry, Rochester, NY; and Albert Einstein College of Medicine, Bronx, NY. Electronic address:
    Acid-base disorders are in patients with chronic kidney disease, with chronic metabolic acidosis receiving the most attention clinically in terms of diagnosis and treatment. A number of observational studies have reported on the prevalence of acid-base disorders in this patient population and their relationship with outcomes, mostly focusing on chronic metabolic acidosis. The majority have used serum bicarbonate alone to define acid-base status due to the lack of widely available data on other acid-base disorders. Read More

    Maternal Pseudo-Bartter Syndrome Associated with Severe Perinatal Brain Injury.
    Indian Pediatr 2017 Sep;54(9):771-773
    Department of Neonatology, KK Women's and Children's Hospital, 100, Bukit Timah Road, Singapore. Correspondence to: Dr Shrenik Vora, Senior Staff Registrar, Department of Neonatology, KK Women's and Children's Hospital, 100, Bukit Timah Road, Singapore 229899,
    Background: Maternal electrolyte imbalance is rarely reported as causative factor of severe perinatal brain injury.

    Case Characteristics: This case outlines a unique maternal and neonatal pseudo-Bartter syndrome presented with metabolic alkalosis and hypochloremia due to maternal severe vomiting.

    Observation: Neonatal MRI brain revealed extensive brain hemorrhages with porencephalic cysts. Read More

    Late-onset Bartter syndrome type II.
    Clin Kidney J 2017 Oct 8;10(5):594-599. Epub 2017 May 8.
    Experimental and Clinical Research Center (ECRC), a joint cooperation between the Charité Medical Faculty and the Max Delbrück Center for Molecular Medicine (MDC) in the Helmholtz Association of National Research Centers, Berlin, Germany.
    Mutations in the ROMK1 potassium channel gene (KCNJ1) cause antenatal/neonatal Bartter syndrome type II (aBS II), a renal disorder that begins in utero, accounting for the polyhydramnios and premature delivery that is typical in affected infants, who develop massive renal salt wasting, hypokalaemic metabolic alkalosis, secondary hyperreninaemic hyperaldosteronism, hypercalciuria and nephrocalcinosis. This BS type is believed to represent a disorder of the infancy, but not in adulthood. We herein describe a female patient with a remarkably late-onset and mild clinical manifestation of BS II with compound heterozygous KCNJ1 missense mutations, consisting of a novel c. Read More

    Acute Hypocalcemia and Metabolic Alkalosis in Children on Cation-Exchange Resin Therapy.
    Case Rep Nephrol 2017 1;2017:6582613. Epub 2017 Aug 1.
    Divisions of Nephrology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
    Background: Sodium polystyrene sulfonate (SPS) is a chelating agent used for the treatment of hyperkalemia. SPS has a wide range of exchange capacity requiring close monitoring of serum electrolytes. We observed two patients who developed acute hypocalcemia and increased metabolic alkalosis after initiating SPS therapy. Read More

    The Role of Sodium Bicarbonate in the Management of Some Toxic Ingestions.
    Int J Nephrol 2017 8;2017:7831358. Epub 2017 Aug 8.
    Department of Medicine, University of Kentucky College of Medicine, Lexington, KY, USA.
    Adverse reactions to commonly prescribed medications and to substances of abuse may result in severe toxicity associated with increased morbidity and mortality. According to the Center for Disease Control, in 2013, at least 2113 human fatalities attributed to poisonings occurred in the United States of America. In this article, we review the data regarding the impact of systemic sodium bicarbonate administration in the management of certain poisonings including sodium channel blocker toxicities, salicylate overdose, and ingestion of some toxic alcohols and in various pharmacological toxicities. Read More

    Changes in acid-base and ion balance during exercise in normoxia and normobaric hypoxia.
    Eur J Appl Physiol 2017 Nov 15;117(11):2251-2261. Epub 2017 Sep 15.
    Department of Anesthesiology, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
    Purpose: Both exercise and hypoxia cause complex changes in acid-base homeostasis. The aim of the present study was to investigate whether during intense physical exercise in normoxia and hypoxia, the modified physicochemical approach offers a better understanding of the changes in acid-base homeostasis than the traditional Henderson-Hasselbalch approach.

    Methods: In this prospective, randomized, crossover trial, 19 healthy males completed an exercise test until voluntary fatigue on a bicycle ergometer on two different study days, once during normoxia and once during normobaric hypoxia (12% oxygen, equivalent to an altitude of 4500 m). Read More

    Association of Amelogenesis Imperfecta and Bartter's Syndrome.
    Indian J Nephrol 2017 Sep-Oct;27(5):399-401
    Department of Nephrology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India.
    Bartter's syndrome is an autosomal recessive renal tubular disorder characterized by hypokalemia, hypochloremia, metabolic alkalosis, and hyperreninemia with normal blood pressure. Bartter's syndrome is associated with hypercalciuria and nephrocalcinosis. Amelogenesis imperfecta (AI) is a group of hereditary disorders that affect dental enamel. Read More

    [Expert consensus for the diagnosis and treatment of patients with Gitelman syndrome].
    • Authors:
    Zhonghua Nei Ke Za Zhi 2017 Sep;56(9):712-716
    Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy caused by inactivating mutations in the SLC12A3 gene that encodes the thiazide-sensitive sodium-chloride cotransporter (NCC). GS is characterized by hypokalemic metabolic alkalosis, hypomagnesemia and hypocalciuria. GS is one of the most common inherited renal tubulopathy with a prevalence estimated at about one to ten per 40 000 people. Read More

    Swimming Three Ice Miles within Fifteen Hours.
    Chin J Physiol 2017 08;60(4):197-206
    Gesundheitszentrum St. Gallen, St. Gallen, Switzerland.
    Ice Mile swimming (1608 m in water of below 5 °Celsius) is becoming increasingly popular. This case study aimed to identify body core temperature and selected haematological and biochemical parameters before and after repeated Ice Miles. An experienced ice swimmer completed three consecutive Ice Miles within 15 h. Read More

    Update in diagnosis and management of primary aldosteronism.
    Clin Chem Lab Med 2017 Aug 28. Epub 2017 Aug 28.
    .
    Primary aldosteronism (PA) is a group of disorders in which aldosterone is excessively produced. These disorders can lead to hypertension, hypokalemia, hypervolemia and metabolic alkalosis. The prevalence of PA ranges from 5% to 12% around the globe, and the most common causes are adrenal adenoma and adrenal hyperplasia. Read More

    Effect of Intravenously Administered Crystalloid Solutions on Acid-Base Balance in Domestic Animals.
    J Vet Intern Med 2017 Sep 20;31(5):1371-1381. Epub 2017 Aug 20.
    College of Veterinary Medicine, Lincoln Memorial University, Harrogate, TN.
    Intravenous fluid therapy can alter plasma acid-base balance. The Stewart approach to acid-base balance is uniquely suited to identify and quantify the effects of the cationic and anionic constituents of crystalloid solutions on plasma pH. The plasma strong ion difference (SID) and weak acid concentrations are similar to those of the administered fluid, more so at higher administration rates and with larger volumes. Read More

    Prevalence and predictors associated with severe pulmonary hypertension in COPD.
    Am J Emerg Med 2017 Aug 5. Epub 2017 Aug 5.
    Department of Biostatistics and Epidemiology, School of Public Health, University of Medical Sciences, Kerman, Iran.
    Background: Pulmonary hypertension (PH) is one of the most common complications of COPD (chronic obstructive pulmonary disease), but its severe form is uncommon. Various factors play an important role in the occurrence and severity of pulmonary hypertension in patients.

    Methods: This cross-sectional study was performed on patients with COPD referred to an emergency department over a one-year period. Read More

    α-Ketoglutarate drives electroneutral NaCl reabsorption in intercalated cells by activating a G-protein coupled receptor, Oxgr1.
    Curr Opin Nephrol Hypertens 2017 Sep;26(5):426-433
    Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
    Purpose Of Review: This review describes the recent discoveries about a powerful electroneutral NaCl reabsorption mechanism in intercalated cells, and its regulation by an intrarenal metabolite paracrine, α-ketoglutartate, and the G-protein coupled receptor, Oxgr1.

    Recent Findings: The distal nephron fine-tunes sodium, chloride, potassium, hydrogen, bicarbonate and water transport to maintain electrolyte homeostasis and blood pressure. Intercalated cells have been traditionally viewed as the professional regulators of acid-base balance, but recent studies reveal that a specific population of intercalated cells, identified by the pendrin-transporter, have a surprising role in the regulation of salt balance. Read More

    Pseudo-Bartter syndrome as the sole manifestation of cystic fibrosis in a child with 711+G>T/IVS8-5T mutation: a new face of an old disease.
    Ann Biol Clin (Paris) 2017 Aug;75(4):466-473
    Biochemistry laboratory, Children's hospital, Research laboratory 'Haemoglobinopathies and Cystic fibrosis, LR00SP03', Tunis, Tunisia.
    Pseudo-Bartter syndrome (PBS) describes an uncommon complication of cystic fibrosis leading to hypochloraemic, hypokalaemic metabolic alkalosis. PBS as the sole manifestation of cystic fibrosis in children is extremely rare and has never been described in patients carrying 5T variant. We report a clinical, biochemical and genetic study of a four year-old boy presenting a pseudo-Bartter syndrome as the sole manifestation of cystic fibrosis. Read More

    Milk-Alkali syndrome induced by H1N1 influenza vaccine.
    Saudi J Kidney Dis Transpl 2017 Jul-Aug;28(4):912-915
    Department of Internal Medicine, Division of Nephrology, King Fahd Hospital of the University, Al-Khobar, Saudi Arabia.
    Milk-Alkali syndrome (MAS) consists of a triad of hypercalcemia, metabolic alkalosis, and acute renal failure. We hereby report a 75-year-old Indian gentleman who presented to our emergency department with a history of generalized weakness and easy fatigability. Investigations were consistent with MAS secondary to calcium carbonate and calcitriol treatment to prevent osteoporosis, aggravated by H1N1 influenza vaccine. Read More

    Gitelman syndrome: an analysis of the underlying pathophysiologic mechanisms of acid-base and electrolyte abnormalities.
    Int Urol Nephrol 2017 Jul 25. Epub 2017 Jul 25.
    Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece.
    Gitelman syndrome is the most common inherited tubular disease resulting from mutations of the SLC12A3 gene that encodes the thiazide-sensitive sodium-chloride cotransporter in the early distal convoluted tubules. The review presents the underlying pathophysiologic mechanisms of acid-base and electrolyte abnormalities observed in patients with Gitelman syndrome. The syndrome is usually characterized by hypokalemic metabolic alkalosis in combination with hypomagnesemia and hypocalciuria. Read More

    [Disorders of water and electrolyte metabolism and changes in acid-base balance in patients with ascitic liver cirrhosis].
    Cas Lek Cesk 2017 ;156(3):150-152
    In patients with advanced cirrhosis with ascites disorders of water and electrolyte metabolism are often present and they are associated with changes in acid-base balance. These changes can be very complicated, their diagnosis and treatment difficult. Dilutional hyponatremia is the most common disorder. Read More

    Post-prandial physiology and intestinal morphology of the Pacific hagfish (Eptatretus stoutii).
    J Comp Physiol B 2017 Jul 18. Epub 2017 Jul 18.
    Department of Biological Sciences, University of Alberta, 116 St. and 85 Ave., Edmonton, AB, T6G 2R3, Canada.
    Hagfishes are unique to the vertebrate lineage in that they acquire dissolved nutrients across multiple epithelia including the intestine, gill, and skin. This feat has been attributed to their immersive feeding behavior that likely simultaneously provides benefits (nutrient rich) and potentially adverse (hypercapnia, hypoxia, high environmental ammonia) physiological effects. Examinations have been conducted of the ex vivo transport capabilities of specific nutrients as well as in vivo effects of the hypothesized feeding environments, yet the physiological effects of feeding itself have never been elucidated. Read More

    Increased urinary prostaglandin E2 metabolite: A potential therapeutic target of Gitelman syndrome.
    PLoS One 2017 10;12(7):e0180811. Epub 2017 Jul 10.
    Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
    Background: Gitelman syndrome (GS), an inherited autosomal recessive salt-losing renal tubulopathy caused by mutations in SLC12A3 gene, has been associated with normal prostaglandin E2 (PGE2) levels since 1995 by a study involving 11 clinically diagnosed patients. However, it is difficult to explain why cyclooxygenase-2 (COX2) inhibitors, which pharmacologically reduce PGE2 synthesis, are helpful to patients with GS, and few studies performed in the last 20 years have measured PGE2 levels. The relationships between the clinical manifestations and PGE2 levels were never thoroughly analyzed. Read More

    Reversible Hypokalemia and Bartter-Like Syndrome during Prolonged Systemic Therapy with Colistimethate Sodium in an Adult Patient.
    Drug Saf Case Rep 2017 Dec;4(1):10
    Section of Viral Diseases, Department of Clinical Medicine, University Hospital 'Federico II' of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy.
    We present the case of a 58-year-old woman who developed hypokalaemia and metabolic alkalosis 2 weeks after therapy with colistimethate sodium for the treatment of chronic lower limb ulcer infection by extensively drug-resistant (XDR) Pseudomonas aeruginosa. The metabolic changes observed resembled Bartter syndrome, a group of congenital disorders affecting the distal segments of the renal tubules. The metabolic abnormalities reversed spontaneously 6 days after drug discontinuation. Read More

    [Poor weight gain, recurrent metabolic alkalosis and hypokalemia in a neonate].
    Zhongguo Dang Dai Er Ke Za Zhi 2017 Jul;19(7):812-815
    Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing 210004, China.
    The study reports a female neonate with a gestational age of 29(+2) weeks and a birth weight of 1 210 g. Ten minutes after birth, the neonate was admitted to the hospital due to shortness of breath. Several days after birth, the neonate presented with hyperglycemia, polyuria, and poor weight gain, accompanied by azotemia, hypochloremic metabolic alkalosis, hypokalemia, and hyponatremia. Read More

    Acquired Gitelman syndrome in a primary Sjögren syndrome patient with a SLC12A3 heterozygous mutation: A case report and literature review.
    Nephrology (Carlton) 2017 Aug;22(8):652-655
    Department of Nephrology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
    Acquired Gitelman's syndrome (GS) associated with Sjögren syndrome (SS) is rare. A 50-year-old woman was admitted to our department because of nausea, acratia and sicca complex. Laboratory tests after admission showed renal failure, hypokalaemia, metabolic alkalosis, hypomagnesaemia and hypocalciuria, all of which met the diagnostic criteria for GS. Read More

    Acid-base disorders in liver disease.
    J Hepatol 2017 Nov 3;67(5):1062-1073. Epub 2017 Jul 3.
    Department of Respiratory and Critical Care Medicine, Otto Wagner Spital, Vienna, Austria. Electronic address:
    Alongside the kidneys and lungs, the liver has been recognised as an important regulator of acid-base homeostasis. While respiratory alkalosis is the most common acid-base disorder in chronic liver disease, various complex metabolic acid-base disorders may occur with liver dysfunction. While the standard variables of acid-base equilibrium, such as pH and overall base excess, often fail to unmask the underlying cause of acid-base disorders, the physical-chemical acid-base model provides a more in-depth pathophysiological assessment for clinical judgement of acid-base disorders, in patients with liver diseases. Read More

    The Basic Metabolic Profile in Heart Failure-Marker and Modifier.
    Curr Heart Fail Rep 2017 Aug;14(4):311-320
    Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd, MC 8516, Dallas, TX, 75390, USA.
    Purpose Of Review: The physiologic determinants of each of the components of the basic metabolic profile in patients with heart failure will be explored. Additionally, the review will discuss the prognostic value of alterations in the basic metabolic profile as well as their effects on management.

    Recent Findings: Abnormalities in the basic metabolic profile have significant correlation with clinical outcomes and can modify treatment in heart failure. Read More

    A Dairy Herd Case Investigation with Very Low Dietary Cation-Anion Difference in Prepartum Dairy Cows.
    Front Nutr 2017 13;4:26. Epub 2017 Jun 13.
    Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States.
    During the periparturient period, subclinical hypocalcemia (total plasma Ca concentration <2.0 mmol/l) is a potential problem for the dairy cow; consequently, its prevention is essential for success of fertility and productive performance. Dietary cation-anion difference (DCAD) has been defined as the difference in milliequivalents of cations (Na, K) and anions (Cl, S) per kilogram of dry matter (DM) and has a direct impact on blood acid-base metabolism. Read More

    Pharmacodynamics of intravenous frusemide bolus in critically ill patients.
    Crit Care Resusc 2017 Jun;19(2):142-149
    Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.
    Objective: To assess the physiological, biochemical and haemodynamic response to a single intravenous (IV) dose of frusemide in critically patients.

    Design, Setting And Patients: A prospective observational study of 21 critically ill patients in a tertiary intensive care unit in Australia.

    Interventions: We collected information on urine output (UO), fluid balance, serum and urinary electrolyte levels, serum biochemical levels and haemodynamics. Read More

    Pendred syndrome.
    Best Pract Res Clin Endocrinol Metab 2017 Mar 10;31(2):213-224. Epub 2017 May 10.
    Northwestern University, Division of Endocrinology, Metabolism and Molecular Medicine, Feinberg School of Medicine, Tarry 15, 303 East Chicago Avenue, Chicago, IL 60611, USA. Electronic address:
    Pendred syndrome is an autosomal recessive disorder that is classically defined by the combination of sensorineural deafness/hearing impairment, goiter, and an abnormal organification of iodide with or without hypothyroidism. The hallmark of the syndrome is the impaired hearing, which is associated with inner ear malformations such as an enlarged vestibular aqueduct (EVA). The thyroid phenotype is variable and may be modified by the nutritional iodine intake. Read More

    A Case of Pulmonary Carcinoid Tumor with a Superimposed Aspergilloma Presenting As a Covert Ectopic Adrenocorticotropic Hormone Syndrome.
    Front Endocrinol (Lausanne) 2017 8;8:123. Epub 2017 Jun 8.
    Division of Endocrinology, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
    Ectopic adrenocorticotropic hormone (ACTH) syndrome is a challenging diagnosis only responsible for approximately 10% of Cushing syndrome cases. It has been associated with a variety of benign and malignant tumors including a carcinoid tumor accompanied by aspergilloma in our case that was significantly difficult to be detected. We report a patient over 70 years old with uncontrolled hypertension and hypokalemia presenting with generalized edema. Read More

    Acetazolamide Use in Severe Chronic Obstructive Pulmonary Disease. Pros and Cons.
    Ann Am Thorac Soc 2017 Jul;14(7):1086-1093
    University of Washington and Department of Veterans Affairs, Seattle, Washington.
    Acetazolamide is a carbonic anhydrase (CA) inhibitor sometimes used as a respiratory stimulant for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving oxygenation, reducing carbon dioxide retention, and aiding liberation from mechanical ventilation and/or attempting to correct a metabolic alkalosis. However, the net effect of CA inhibition is multifactorial and complex, because CA is inhibited in many tissues that may negatively affect the patient with lung disease. The full impact of acetazolamide and other CA inhibitors depends critically on dosing, age, and pulmonary, renal, hepatic, hematological, and respiratory muscle function and reserves. Read More

    Cystic fibrosis prevalence among a group of high-risk children in the main referral children hospital in Iran.
    J Educ Health Promot 2017 5;6:54. Epub 2017 Jun 5.
    Department of Pediatric Pulmonology, Child Growth and Development Research Center, Faculty of Medicine, Research Institute for Primordial Prevention of Noncommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
    Background: Knowledge about cystic fibrosis (CF) in Iran is very limited. The objective of this study was to determine the prevalence of CF among a group of high-risk children with suggestive clinical features in the main referral hospital in Iran.

    Materials And Methods: This study children consisted of 505 patients who had presented with one or more of the following symptoms: chronic or recurrent respiratory symptoms, gastrointestinal symptoms as rectal prolapse, steatorrhea, hepatobiliary disease as prolonged jaundice, failure to thrive, hyperglycemia and glycosuria, hypochloremic metabolic alkalosis, hypoprothrombinemia, anemia or edema, and positive family history of CF. Read More

    Water, electrolyte, acid-base, and trace elements alterations in cirrhotic patients.
    Int Urol Nephrol 2017 Jun 12. Epub 2017 Jun 12.
    Department of Medicine, Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
    Chronic hepatic patients, and particularly those suffering from cirrhosis, are predisposed to different sort of water, electrolyte, acid-base, and trace elements disorders due to their altered liver function, and also to their exposition to infectious, inflammatory, oncologic, and pharmacologic variables whose combination undermines their homeostatic capability. Hyponatremia, hypokalemia, hyperkalemia, hypocalcemia, metabolic acidosis, respiratory, and metabolic alkalosis are the main internal milieu alterations in this group. Read More

    Metabolic Acidosis or Respiratory Alkalosis? Evaluation of a Low Plasma Bicarbonate Using the Urine Anion Gap.
    Am J Kidney Dis 2017 Sep 7;70(3):440-444. Epub 2017 Jun 7.
    Section of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, CT.
    Hypobicarbonatemia, or a reduced bicarbonate concentration in plasma, is a finding seen in 3 acid-base disorders: metabolic acidosis, chronic respiratory alkalosis and mixed metabolic acidosis and chronic respiratory alkalosis. Hypobicarbonatemia due to chronic respiratory alkalosis is often misdiagnosed as a metabolic acidosis and mistreated with the administration of alkali therapy. Proper diagnosis of the cause of hypobicarbonatemia requires integration of the laboratory values, arterial blood gas, and clinical history. Read More

    Sedative and cardiorespiratory effects of detomidine constant rate infusion in sheep.
    Lab Anim 2017 Jan 1:23677217714013. Epub 2017 Jan 1.
    Department of Veterinary Medicine, Federal University of Goiás, Brazil.
    The use of sheep in experiments is widespread and is increasing worldwide, and so is the need to develop species-specific anaesthetic techniques to ensure animal safety. Previous studies have mentioned several protocols involving the administration of alpha-2 adrenergic agonists in sheep; however, assessment of the efficacy and safety of these infusion techniques is still relatively new. Thus, the aim of the present study is to assess the effectiveness of detomidine constant rate infusion (CRI) in sheep by measuring the cardiovascular and respiratory parameters, blood gas variables and sedation scores. Read More

    Does metabolic alkalosis influence cerebral oxygenation in infantile hypertrophic pyloric stenosis?
    J Surg Res 2017 May 30;212:229-237. Epub 2017 Jan 30.
    Department of Pediatric Surgery, St. Mary's Hospital, St. Elisabeth Group, Ruhr-University of Bochum, Herne, Germany.
    Background: This pilot study focuses on regional tissue oxygenation (rSO2) in patients with infantile hypertrophic pyloric stenosis in a perioperative setting. To investigate the influence of enhanced metabolic alkalosis (MA) on cerebral (c-rSO2) and renal (r-rSO2) tissue oxygenation, two-site near-infrared spectroscopy (NIRS) technology was applied.

    Materials And Methods: Perioperative c-rSO2, r-rSO2, capillary blood gases, and electrolytes from 12 infants were retrospectively compared before and after correction of MA at admission (T1), before surgery (T2), and after surgery (T3). Read More

    Ingestion of Sodium Bicarbonate (NaHCO3) Following a Fatiguing Bout of Exercise Accelerates Postexercise Acid-Base Balance Recovery and Improves Subsequent High-Intensity Cycling Time to Exhaustion.
    Int J Sport Nutr Exerc Metab 2017 Oct 22;27(5):429-438. Epub 2017 May 22.
    2 University of Derby.
    This study evaluated the ingestion of sodium bicarbonate (NaHCO3) on postexercise acid-base balance recovery kinetics and subsequent high-intensity cycling time to exhaustion. In a counterbalanced, crossover design, nine healthy and active males (age: 23 ± 2 years, height: 179 ± 5 cm, body mass: 74 ± 9 kg, peak mean minute power (Wpeak) 256 ± 45 W, peak oxygen uptake (V̇O2peak) 46 ± 8 ml.kg(-1). Read More

    Effect of voluntary hypocapnic hyperventilation or moderate hypoxia on metabolic and heart rate responses during high-intensity intermittent exercise.
    Eur J Appl Physiol 2017 Aug 19;117(8):1573-1583. Epub 2017 May 19.
    Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Ibaraki, 305-8574, Japan.
    Purpose: To investigate the effect of voluntary hypocapnic hyperventilation or moderate hypoxia on metabolic and heart rate responses during high-intensity intermittent exercise.

    Methods: Ten males performed three 30-s bouts of high-intensity cycling [Ex1 and Ex2: constant-workload at 80% of the power output in the Wingate anaerobic test (WAnT), Ex3: WAnT] interspaced with 4-min recovery periods under normoxic (Control), hypocapnic or hypoxic (2500 m) conditions. Hypocapnia was developed through voluntary hyperventilation for 20 min prior to Ex1 and during each recovery period. Read More

    [Procedural analysis of acid-base balance disorder: case serials in 4 patents].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 May;29(5):436-441
    Department of Nephrology, Shuyang People's Hospital, Suqian 223600, Jiangsu, China (Ma CY); Teaching Section of Mathematics, China Medical University, Shenyang 110000, Liaoning, China (Wang GJ). Corresponding author: Wang Guijie, Email:
    Objective: To establish the standardization process of acid-base balance analysis, analyze cases of acid-base balance disorder with the aid of acid-base balance coordinate graph.

    Methods: The acid-base balance theory were reviewed systematically on recent research progress, and the important concepts, definitions, formulas, parameters, regularity and inference in the analysis of acid-base balance were studied. The analysis of acid-base balance disordered processes and steps were figured. Read More

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