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Respir Care 2019 Mar 19. Epub 2019 Mar 19.

Department of Respiratory and Critical Care Medicine, Schaffner Hospital, Lens, France.

Background: The use of noninvasive ventilation (NIV) in the emergency setting to reverse hypercapnic coma in frail patients with end-stage chronic respiratory failure and do-not-intubate orders remains a questionable issue given the poor outcome of this vulnerable population. We aimed to answer this issue by assessing not only subjects' outcome with NIV but also subjects' point of view regarding NIV for this indication.

Methods: A prospective observational case-control study was conducted in 3 French tertiary care hospitals during a 2-y period. Read More

Nutrition 2018 Dec 11;62:108-114. Epub 2018 Dec 11.

Department of Translational and Precision Medicine, Sapienza University of Rome, Italy.

Objective: Chronic kidney disease (CKD) is a condition with high cardiovascular mortality associated with emerging risk factors, including sarcopenia. Several mechanisms can affect muscle mass, such as vitamin D deficiency, low protein intake, physical inactivity, metabolic acidosis, and inflammation leading to a worsening of cardiovascular outcomes and cognitive function. We aimed to evaluate the prevalence of sarcopenia in CKD patients on conservative and replacement therapy and the associations between sarcopenia and markers of atherosclerosis, endothelial dysfunction, psychological and cognitive function. Read More

BMC Pulm Med 2019 Mar 12;19(1):61. Epub 2019 Mar 12.

Department of Medicine, Tripler Army Medical Center, 1 Jarrett White Rd, Tripler AMC, Hawaii, 96859, USA.

Background: Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by accumulation of phospholipoproteinaceous material in the alveoli. The presentation is nonspecific but typically includes dyspnea; the spectrum of disease includes rapidly progressive hypoxic respiratory failure. Whole lung lavage (WLL) is the treatment of choice in symptomatic PAP, but transient worsening of oxygenation sometimes requires salvage modalities of support such as extracorporeal membrane oxygenation (ECMO). Read More

J Physiol 2019 Mar 13. Epub 2019 Mar 13.

Department of Neurology, University of Iowa, Iowa City, IA, 52242, USA.

Key Points: Neurons of the retrotrapezoid nucleus (RTN) and medullary serotonin (5-HT) neurons are both candidates for central CO /pH chemoreceptors, but it is not known how interactions between them influence their responses to pH. We found that RTN neurons in brain slices were stimulated by exogenous 5-HT and by heteroexchange release of endogenous 5-HT, and these responses were blocked by antagonists of 5-HT receptors. The pH response of RTN neurons in brain slices was markedly reduced by the same antagonists of 5-HT receptors. Read More

Vet Clin Pathol 2019 Mar 12. Epub 2019 Mar 12.

Centro Veterinario Los Sauces, Madrid, Spain.

Two pet rabbits were presented with an acute decrease in appetite and activity. Rabbit 1 showed severe hypothermia, bradycardia, arrhythmias, a heart murmur, dyspnea, occlusion of the nares with secretions, icterus, dehydration, and gaseous gastrointestinal dilation. The urine was dark yellow. Read More

Pediatr Emerg Care 2019 Mar 7. Epub 2019 Mar 7.

Background: Congenital adrenal hyperplasia is an autossomic recessive condition. The most common mutation is in the CYP21A2 gene situated in chromosome 6, leading to a 21-hydroxylase deficiency. Clinical presentation ranges from light hyperandrogenism to potentially fatal adrenal salt-losing crisis. Read More

Crit Care Med 2019 Apr;47(4):e332-e339

Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.

Objectives: Venovenous extracorporeal membrane oxygenation is indicated in patients with severe refractory acute respiratory failure. Venous thrombosis due to indwelling catheters is a frequent complication. The aim of this study was to analyze the incidence of cannula-related thrombosis and its risk factors after venovenous extracorporeal membrane oxygenation. Read More

J Pediatr 2019 Mar 7. Epub 2019 Mar 7.

Department of Pediatrics, Division of Neonatology, Stanford University, Stanford, CA.

We assessed the utility of near-infrared spectroscopy to evaluate neonates with mitochondrial disorders. We observed abnormally high cerebral oxygen saturation levels indicating insufficient tissue oxygen utilization. We propose that near-infrared spectroscopy may be an additional tool in the diagnostic evaluation of a suspected mitochondrial disorder. Read More

Rev Endocr Metab Disord 2019 Mar 8. Epub 2019 Mar 8.

Medicover GmbH, Berlin, Germany.

Cerebral edema and elevated intracranial pressure (ICP) are common complications of acute brain injury. Hypertonic solutions are routinely used in acute brain injury as effective osmotic agents to lower ICP by increasing the extracellular fluid tonicity. Acute kidney injury in a patient with traumatic brain injury and elevated ICP requiring renal replacement therapy represents a significant therapeutic challenge due to an increased risk of cerebral edema associated with intermittent conventional hemodialysis. Read More

Respir Physiol Neurobiol 2019 Mar 4;263:20-25. Epub 2019 Mar 4.

Department of Physiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan. Electronic address:

The role of TRP channels in the ventilatory response to CO was investigated in vivo. To this end, the respiration of unrestrained adult TRPM8-, TRPV1- and TRPV4-channel knockout mice was measured using whole-body plethysmography. Under control conditions and hyperoxic hypercapnia, no difference in respiratory parameters was observed between adult wild-type mice and TRPV1- and TRPV4-channel knockout mice. Read More

ACS Chem Neurosci 2019 Mar 13. Epub 2019 Mar 13.

State Key Laboratory of Membrane Biology, School of Life Sciences , Peking University , Beijing 100871 , China.

Brain ischemia is often accompanied by brain acidosis and this acidosis can affect ischemic neuronal injury. Ischemic neuronal injury is initiated by a decrease in ATP production which mainly relies on mitochondrial oxidative phosphorylation. Ischemia often causes mitochondrial dysfunction, and acidosis has been found to affect mitochondrial function, suggesting that acidosis accompanying ischemia may influence neurons by targeting mitochondrial metabolism. Read More

Echocardiography 2019 Mar 4. Epub 2019 Mar 4.

Division of Critical Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background: Echocardiography was reported to be a good predictor of weaning failure when using T-piece method, but information about its efficacy in a pressure support setting is scarce. This study aimed to investigate the efficacy of echocardiography during spontaneous breathing trial with low-level pressure support for predicting weaning failure among medical critically ill patients.

Methods: This prospective cohort study was conducted in adult respiratory failure patients that tolerated low pressure support weaning for 30 minutes. Read More

Nat Commun 2019 Mar 4;10(1):1034. Epub 2019 Mar 4.

State Key Laboratory of Medicinal Chemical Biology, Tianjin Key Laboratory of Protein Sciences, College of Life Sciences, Nankai University, Tianjin, 300071, China.

The interactions between tumor cells with their microenvironments, including hypoxia, acidosis and immune cells, lead to the tumor heterogeneity which promotes tumor progression. Here, we show that SIAH2-NRF1 axis remodels tumor microenvironment through regulating tumor mitochondrial function, tumor-associated macrophages (TAMs) polarization and cell death for tumor maintenance and progression. Mechanistically, low mitochondrial gene expression in breast cancers is associated with a poor clinical outcome. Read More

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2019 Feb;31(2):155-159

Department of Critical Care Medicine, Fu Xing Hospital, Capital Medical University, Beijing 100038, China.

Objective: To analyze the risk factors of death in intensive care unit (ICU) patients with sepsis and acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT).

Methods: The data of patients with sepsis complicated with AKI who received CRRT treatment from March 1st to August 31st in 2012 in BAKIT study (a prospective observational study of AKI epidemiology in 30 ICUs of 28 hospitals in Beijing) were re-analyzed. The demographic data, clinical and laboratory data of patients were collected, including gender, age, case source, body mass index (BMI), blood pressure, the length of ICU stay, complications, other organs' function, drug use, CRRT, mechanical ventilation and vasoactive drugs. Read More

Int J Radiat Biol 2019 Mar 1:1-25. Epub 2019 Mar 1.

a Department of Radiation Oncology , University Medical Center , Mainz , Germany.

Purpose: In the early 1920s, Warburg published experimental data on the enhanced conversion of glucose to pyruvate (followed by lactate formation) even in the presence of abundant oxygen (aerobic glycolysis, Warburg effect). He attributed this metabolic trait to a respiratory injury and considered this a universal metabolic alteration in carcinogenesis. This interpretation of the data was questioned since the early 1950s. Read More

Cold Spring Harb Mol Case Stud 2019 Feb 28. Epub 2019 Feb 28.

Yale University School of Medicine;

Variants in the mitochondrial alanyl-tRNA synthetase 2 gene (OMIM 612035) are associated with infantile mitochondrial cardiomyopathy or later-onset leukoencephalopathy with premature ovarian insufficiency. Here, we report two newborn siblings who died soon after birth with primary pulmonary hypoplasia without evidence of cardiomyopathy. Whole exome sequencing detected the same compound heterozygous variants in both siblings (c. Read More

Can J Anaesth 2019 Feb 19. Epub 2019 Feb 19.

Malignant Hyperthermia Investigation Unit, Toronto General Hospital, 323-200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada.

Purpose: The present report of two fatal awake malignant hyperthermia (MH) episodes in an MH susceptible (MHS) family is intended to raise awareness among medical personnel and MHS individuals to the possibility of life-threatening non-anesthesia-triggered MH episodes and to provide a strong incentive for development of effective preventive measures.

Clinical Features: Two young athletic males (28 and 16 yr old), members of the same extended family with a history of anesthesia-related MH episodes and deaths, succumbed ten years apart on two different continents, with symptoms unrelated to anesthesia but strikingly similar to typical anesthetic-induced MH. Both suffered an abrupt surge in body temperature, tachycardia, tachypnea, muscle rigidity, hyperkalemia, and respiratory and metabolic acidosis. Read More

MedEdPORTAL 2018 Aug 17;14:10741. Epub 2018 Aug 17.

Assistant Professor, Department of Emergency Medicine, Wake Forest Baptist Medical Center.

Introduction: Chronic salicylate toxicity is an uncommon, potentially life-threatening poisoning that requires high clinical suspicion in order to make the diagnosis. We created a simulation case that challenges learners to analyze case information, construct a differential diagnosis of an elevated anion gap metabolic acidosis with respiratory alkalosis, and initiate treatment for this toxicity.

Methods: The simulation case was designed for emergency medicine residents and pediatric emergency medicine fellows. Read More

Rev Med Suisse 2019 Feb;15(639):422-426

Service de néphrologie, HUG, 1211 Genève 14.

Metformin is the first line therapy for patients with diabete type 2. However, the molecule is known to be responsible for lactic acidosis through its inhibition of the mitochondrial respiratory chain complex, a pathology called MALA (metformin associated lactic acidosis). This complication has been widely discussed in the literature because its development is usually the result of a multifactorial and complex process. Read More

Korean J Anesthesiol 2019 Feb 19. Epub 2019 Feb 19.

Department of Anaesthesiology, Singapore General Hospital, Outram Road, Singapore 169608.

The trans-tracheal rapid insufflation of oxygen [TRIO] device is a less commonly used device that is an alternative to trans-tracheal jet ventilation for maintaining oxygenation in a 'cannot intubate, cannot oxygenate' [CICO] scenario. However, it may result in inadequate ventilation which can result in hypercarbia and respiratory acidosis and hence should only be used as a temporizing measure before a definitive airway can be secured. We describe its successful use in maintaining oxygenation after jet ventilator failure in a parturient presenting for an excision of laryngeal papilloma who developed a CICO scenario. Read More

Nephrol Dial Transplant 2019 Feb 14. Epub 2019 Feb 14.

Department of Medicine D, Rambam Health Care Campus and Ruth & Bruce Rappaport Faculty of Medicine, Technion-IIT, Haifa, Israel.

Concepts regarding hypoxic acute kidney injury (AKI) are derived from widely used warm ischemia-reflow (WIR) models, characterized by extensive proximal tubular injury and associated with profound inflammation. However, there is ample clinical and experimental data indicating that hypoxic AKI may develop without total cessation of renal blood flow, with a different injury pattern that principally affects medullary thick limbs in the outer medulla. This injury pattern likely reflects an imbalance between blood and oxygen supply and oxygen expenditure, principally for tubular transport. Read More

World Neurosurg 2019 Feb 11. Epub 2019 Feb 11.

Department of Biochemistry, Erzurum Research-Training Hospital, Erzurum, Turkey.

Objective: We created a neck trauma model by injecting blood into the sheath of rabbits' carotid bodies (CBs). Then we determined the relationship between neuronal degeneration of the CB due to hemorrhage of this organ and its clinical effects such as blood pH and heart rhythm.

Methods: The present study included 24 adult male New Zealand rabbits. Read More

Cureus 2018 Nov 26;10(11):e3635. Epub 2018 Nov 26.

Department of Nephrology, Maimonides Medical Center, New York, USA.

Topiramate (TMP) is a broad-spectrum anticonvulsant drug used to treat a wide variety of seizure disorders, for migraine prophylaxis, and for many other indications. An important side effect of TMP is metabolic acidosis, which is mediated by renal tubular defects. TMP inhibits carbonic anhydrase, an enzyme that is necessary for acid handling in the proximal renal tubule. Read More

Diabetes 2019 Feb 12. Epub 2019 Feb 12.

Division of Biochemistry, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, SE-171 77 Stockholm, Sweden

Thioredoxin Interacting Protein (TXNIP) is an alpha arrestin that can bind to and inhibit the antioxidant protein thioredoxin (TXN). TXNIP expression is induced by glucose, promotes ß-cell apoptosis in the pancreas and deletion of its gene in mouse models protects against diabetes. TXNIP is currently studied as a potential new target for antidiabetic drug therapy. Read More

BMJ Case Rep 2019 Feb 9;12(2). Epub 2019 Feb 9.

Neurology, Vinayaka Neuro Multispecialty Clinic, Warangal, India.

We report a case of 50-year-old male patient from tribal area in South Indian state of Telangana, who ingested the liquid extract from crushed leaves of the plant, cleistanthus collinius with the intention of self-harm. Immediate gastric lavage and activated charcoal administration was done and the patient was subsequently admitted into an acute medical care unit. During first 24 hours of monitoring, the patient was clinically stable. Read More

Am J Trop Med Hyg 2019 Feb;100(2):275-279

Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Dakshina Kannada district in the Southwestern region of Karnataka state, India, including Mangaluru city is endemic to malaria. About 80% of malaria infections in Mangaluru and its surrounding areas are caused by and the remainder is due to . Malaria-associated clinical complications significantly occur in this region. Read More

Arch Dis Child Fetal Neonatal Ed 2019 Feb 6. Epub 2019 Feb 6.

The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.

Objective: Infants with a congenital diaphragmatic hernia (CDH) are at high risk of developing pulmonary hypertension after birth, but little is known of their physiological transition at birth. We aimed to characterise the changes in cardiopulmonary physiology during the neonatal transition in an ovine model of CDH.

Methods: A diaphragmatic hernia (DH) was surgically created at 80 days of gestational age (dGA) in 10 fetuses, whereas controls underwent sham surgery (n=6). Read More

J Sports Sci 2019 Feb 6:1-7. Epub 2019 Feb 6.

b Faculty of Sport , University of Ljubljana , Ljubljana , Slovenia.

The aim of this study was to investigate the effect of pre-induced inspiratory muscle fatigue (IMF) on race-paced swimming and acid-base status. Twenty-one collegiate swimmers performed two discontinuous 400-m race-paced swims on separate days, with (IMF trial) and without (control trial) pre-induced IMF. Swimming characteristics, inspiratory and expiratory mouth pressures, and blood parameters were recorded. Read More

World J Diabetes 2019 Jan;10(1):16-22

Division of Pulmonary, Critical Care and Sleep Medicine, Texas A and M University, Corpus Christy, TX 78412, United States.

Diabetes affects approximately 30 million persons in the United States. Diabetes ketoacidosis is one of the most serious and acute complications of diabetes. At the time of presentation and during treatment of diabetic ketoacidosis (DKA), several metabolic and electrolyte derangements can ultimately result in respiratory compromise. Read More

Eur J Med Genet 2019 Jan 25. Epub 2019 Jan 25.

Pediatric Department, Latifa Hospital, Dubai Health Authority, P.O.Box 4115, Dubai, United Arab Emirates.

Pontocerebellar Hypoplasia type 1 is a rare heterogeneous neurodegenerative disorder with multiple subtypes linked to dysfunction of the exosome complex. Patients with mutations in exosome subunits exhibit a generally lethal phenotype characterized by cerebellar and pontine hypoplasia in association with spinal motor neuropathy and multiple systemic and neurologic features. Recently, two variants in the novel PCH1 associated protein EXOSC9 p. Read More

J Inflamm (Lond) 2019 15;16. Epub 2019 Jan 15.

1Department of Morphology, Surgery and Experimental Medicine, Intensive Care Section, University of Ferrara, 44121 Ferrara, Italy.

Acute lung injury (ALI) affects over 10% of patients hospitalised in critical care, with acute respiratory distress syndrome (ARDS) being the most severe form of ALI and having a mortality rate in the region of 40%. There has been slow but incremental progress in identification of biomarkers that contribute to the pathophysiology of ARDS, have utility in diagnosis and monitoring, and that are potential therapeutic targets (Calfee CS, Delucchi K, Parsons PE, Thompson BT, Ware LB, Matthay MA, Thompson T, Ware LB, Matthay MA, Lancet Respir Med 2014, 2:611--620). However, a major issue is that ARDS is such a heterogeneous, multi-factorial, end-stage condition that the strategies for "lumping and splitting" are critical (Prescott HC, Calfee CS, Thompson BT, Angus DC, Liu VX, Am J Respir Crit Care Med 2016, 194:147--155). Read More

Clin Respir J 2019 Mar 10;13(3):184-188. Epub 2019 Feb 10.

Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

Introduction: Non-invasive ventilation (NIV) is recommended for treatment of acute hypercapnic respiratory failure (AHRF) in acute exacerbations of COPD. National UK audit data suggests that mortality rates are rising in COPD patients treated with NIV.

Objective: To investigate temporal trends in in-hospital mortality in COPD patients undergoing a first episode of ward-based NIV for AHRF. Read More

J Hum Genet 2019 Apr 18;64(4):297-304. Epub 2019 Jan 18.

United Diagnostic and Research Center for Clinical Genetics, School of Public Health of Xiamen University & Xiamen Maternal and Child Health Hospital, Xiamen, Fujian, 361003, China.

COQ4 mutations have recently been shown to cause a broad spectrum of mitochondrial disorders in association with CoQ10 deficiency. Herein, we report the clinical phenotype, in silico and biochemical analyses, and intervention for a novel c.370 G > A (p. Read More

Cells 2019 Jan 17;8(1). Epub 2019 Jan 17.

Department of Neurosurgery, Mackay Memorial Hospital, Taipei 10449, Taiwan.

Dysfunction of mitochondria causes defects in oxidative phosphorylation system (OXPHOS) and increased production of reactive oxygen species (ROS) triggering the activation of the cell death pathway that underlies the pathogenesis of aging and various diseases. The process of autophagy to degrade damaged cytoplasmic components as well as dysfunctional mitochondria is essential for ensuring cell survival. We analyzed the role of autophagy inpatient-specific induced pluripotent stem (iPS) cells generated from fibroblasts of patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) with well-characterized mitochondrial DNA mutations and distinct OXPHOS defects. Read More

Respir Res 2019 Jan 17;20(1):11. Epub 2019 Jan 17.

Department of Life Science and Technology, Tokyo Institute of Technology, 4259-B13 Nagatsuta-cho, Midori-ku, Yokohama, 226-8501, Japan.

Background: Adhesion G-protein coupled receptor F5 (ADGRF5) was recently identified as an essential regulator of pulmonary surfactant homeostasis in alveolar type II cells. We previously showed that in addition to abnormal surfactant accumulation, Adgrf5-deficient (Adgrf5) mice exhibit emphysema-like signs, suggesting a possible role for ADGRF5 in immune regulation. Here, we extended the phenotypic analysis of Adgrf5 mice to help understand its biological role in the lung, and especially in immune regulation. Read More

FASEB J 2019 Jan 16:fj201802056R. Epub 2019 Jan 16.

Centre for Experimental Medicine, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University of Belfast, Belfast, United Kingdom.

Acute respiratory distress syndrome (ARDS) is a devastating disorder characterized by diffuse inflammation and edema formation. The main management strategy, low tidal volume ventilation, can be associated with the development of hypercapnic acidosis (HCA). Mesenchymal stem cells (MSCs) are a promising therapeutic candidate currently in early-phase clinical trials. Read More

Nervenarzt 2019 Feb;90(2):121-130

Friedrich-Baur-Institut an der Neurologischen Klinik und Poliklinik, Klinikum der Universität München, Ziemssenstr. 1, 80336, München, Deutschland.

Mitochondrial diseases (MD) are caused by mutations in the mitochondrial DNA or nuclear DNA. The clinical manifestation is often most severe in tissues with high energy demands. The most common MDs are Leber's hereditary optic neuropathy (LHON), chronic progressive external ophthalmoplegia (CPEO) and mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS). Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018 Nov;43(11):1177-1181

Department of Anesthesia, First Affiliated Hospital of Nanchang University, Nanchang 330006, China.

Objective: To establish rat model of lung ischemia/reperfusion (IR) in vivo, and to explore the effects of acidification pretreatment for respiratory acidosis on the expression of matrix metalloproteinase-9 (MMP-9) and the possible mechanisms.
 Methods: A total of 36 male Sprague-Dawley rats were divided into a sham group (S group), a IR group, and an experiment group (RA group) (n=12 in each group). The rat left lung hilum in the S group was dissociated, followed by perfusion without ischemia. Read More

Free Radic Biol Med 2019 Jan 10;134:200-214. Epub 2019 Jan 10.

Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuou, Ami-machi, Ibaraki 300-0395, Japan. Electronic address:

The tumor microenvironment has previously been reported to be hypercapnic (as high as ~84 mmHg), although its effect on tumor cell behaviors is unknown. In this study, high CO levels, ranging from 5% to 15%, protected lung cancer cells from anticancer agents, such as cisplatin, carboplatin and etoposide, by suppressing apoptosis. The cytoprotective effect of a high CO level was independent of acidosis and was due to mitochondrial metabolic reprogramming that reduced mitochondrial respiration, as assessed by oxygen consumption, oxidative phosphorylation, mitochondrial membrane and oxidative potentials, eventually leading to reduced reactive oxidant species production. Read More

Respirology 2019 Apr 12;24(4):308-317. Epub 2019 Jan 12.

Respiratory and Critical Care Unit, University Hospital St Orsola-Malpighi, Bologna, Italy.

Non-invasive ventilation (NIV) with bilevel positive airway pressure is a non-invasive technique, which refers to the provision of ventilatory support through the patient's upper airway using a mask or similar device. This technique is successful in correcting hypoventilation. It has become widely accepted as the standard treatment for patients with hypercapnic respiratory failure (HRF). Read More

J Physiol 2019 Mar 30;597(6):1421-1423. Epub 2019 Jan 30.

Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, Alberta, Canada.

Ann Intensive Care 2019 Jan 7;9(1). Epub 2019 Jan 7.

Medical Intensive Care, Department of Cardiology, Klinikum Nuremberg, Paracelsus Medical University, Nuremberg, Germany.

Background: Lung-protective strategies are the cornerstone of mechanical ventilation in critically ill patients with both ARDS and other disorders. Extracorporeal CO removal (ECCOR) may enhance lung protection by allowing even further reductions in tidal volumes and is effective in low-flow settings commonly used for renal replacement therapy. In this study, we describe for the first time the effects of a labeled and certified system combining ECCOR and renal replacement therapy on pulmonary stress and strain in hypercapnic patients with renal failure. Read More

Rev Med Interne 2019 Jan 4. Epub 2019 Jan 4.

Service de médecine interne, faculté de médecine SMBH, UMR1125, LI2P, université Paris 13, hôpital universitaire Seine-Saint-Denis, AP-HP Sorbonne Paris Cité, 93000 Bobigny, France. Electronic address:

Introduction: Acute muscle involvement is an infrequent complication of corticosteroids, characterized by muscle weakness and a rhabdomyolysis, rapidly regressive after withdrawal of corticosteroids.

Case Report: We report the case of a woman admitted in intensive care unit for acute severe asthma, treated with high doses of methylprednisolone. Serum CPK level raised with a peak at 28,160 UI/L (n<250 UI/L) at day 15, suggesting acute rhabdomyolysis with renal failure. Read More

FASEB J 2018 Dec 31:fj201801870R. Epub 2018 Dec 31.

Applied Surgery and Metabolism Laboratory, School of Biological Sciences, The University of Auckland, Auckland, New Zealand.

Decreases in pH (acidosis) in vitro can alter skeletal muscle mitochondrial function [respiration and reactive oxygen species (ROS) emission]. However, because skeletal muscles readily adapt to exercise, the effects of acidosis may be different on sedentary vs. trained muscle. Read More

J Zoo Wildl Med 2018 Dec;49(4):1025-1028

Pangolins are one of the most-trafficked endangered species and are rare in zoologic collections. Blood gas and select biochemical analysis was performed on nine African white-bellied tree pangolins ( Phataginus tricuspis). Paired blood samples were collected from the ventral tail vasculature prior to (T1) and after 10 min (T2) of sevoflurane anesthesia, and selected blood gas and biochemical parameters were measured using a portable blood gas analyzer. Read More

Respir Res 2018 Dec 27;19(1):261. Epub 2018 Dec 27.

Pneumology Department, Clinic Institute of Thorax (ICT), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Ciber de Enfermedades Respiratorias (CIBERES), Villarroel 170, 08036, Barcelona, Spain.

Background: Chronic obstructive pulmonary disease (COPD) patients may experience an acute exacerbation (AECOPD) that requires hospitalisation. The length of hospital stay (LHS) has a great economic impact on the health-care system. Knowing the predictors of prolonged LHS could help to identify possible interventions. Read More

Clin Biochem 2019 Mar 19;65:53-54. Epub 2018 Dec 19.

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States.

A 35-month-old female with nonketotic hyperglycinemia (NKH) presented to the Emergency department with severe hypoglycemia, fever, and several episodes of seizures. Due to worsening respiratory status, additional seizures and anion gap worsening metabolic acidosis the patient was transferred to the pediatric intensive care unit. The useful mnemonics for causes of high anion gap metabolic acidosis are the classic MUDPILES (representing Methanol, Uraemia, Diabetes, Paraldehyde, Iron (and Isoniazid), Lactate, Ethylene glycol, and Salicylate) and the more recently proposed GOLD MARK (Glycols [ethylene and propylene], Oxoproline, l-lactate, d-lactate, Methanol, Aspirin, Renal failure, and Ketoacidosis) as causes of the anion gap metabolic acidosis were all ruled out. Read More

P R Health Sci J 2018 Dec;37(Special Issue):S99-S101

VA Caribbean Healthcare System, San Juan, PR.

An 80-year-old man experienced general weakness, myalgias, arthralgias, fever, chills, and diarrhea for one week. He had hypotension and tachycardia. He also had leukocytosis, thrombocytopenia, increased creatinine levels, elevated liver enzymes, elevated creatine phosphokinase (CPK) levels, and metabolic acidosis with hypoxemia, for which he was admitted to the Intensive Care Unit (ICU). Read More