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acidosis metabolic [keywords]
- The selective ASIC3 inhibitor APETx2 alleviates gastric mucosal lesion in the rat. [Journal Article, Research Support, Non-U.S. Gov't]
- Pharmazie 2014 Jul; 69(7):542-6.
This study aimed to assess the in vivo efficacy of acid sensing ion channel 3 (ASIC3) inhibitor APETx2 to alleviate acute gastric mucosal lesion (AGML) in a rat model. Thirty-six male Wistar rats were divided randomly into three groups: control group, water immersion restraint stress (WIRS) group, and APETx2 treatment group (n = 12). AGML was induced by WIRS for 6 h, and 25 microg/kg APETx2 was injected intraperitoneally before the onset of stress. Intragastric pH, ulcer index (UI) and gastric histopathological changes were measured, ASIC3 expression in thoracic dorsal root ganglia (DRG) neurons was examined by immunohistochemistry, PCR and Western blot analysis. Compared with control group, WIRS group showed obvious gastric injury with increased UI score, decreased intragastric pH and increased ASIC3 expression in DRG neurons (p < 0.05). APETx2 treatment before WIRS significantly alleviated gastric mucosal injury, decreased UI score, decreased gastric acidity and reduced ASIC3 expression in thoracic DRG neurons (p < 0.05). In conclusion, ASIC3 expression in DRG neurons projecting to the stomach is positively correlated with gastric mucosal lesion and acidosis in WIRS model. ASIC3 inhibitor APETx2 could improve gastric acidosis and alleviate AGML.
- Adaptive brain shut-down counteracts neuroinflammation in the near-term ovine fetus. [Journal Article]
- Front Neurol 2014.:110.
Repetitive umbilical cord occlusions (UCOs) in ovine fetus leading to severe acidemia result in adaptive shut-down of electrocortical activity [electrocorticogram (ECoG)] as well as systemic and brain inflammation. We hypothesized that the fetuses with earlier ECoG shut-down as a neuroprotective mechanism in response to repetitive UCOs will show less brain inflammation and, moreover, that chronic hypoxia will impact this relationship.Near-term fetal sheep were chronically instrumented with ECoG leads, vascular catheters, and a cord occluder and then underwent repetitive UCOs for up to 4 h or until fetal arterial pH was <7.00. Eight animals, hypoxic prior to the UCOs (SaO2 <55%), were allowed to recover 24 h post insult, while 14 animals, 5 of whom also were chronically hypoxic, were allowed to recover 48 h post insult, after which brains were perfusion-fixed. Time of ECoG shut-down and corresponding pH were noted, as well as time to then reach pH <7.00 (ΔT). Microglia (MG) were counted as a measure of inflammation in gray matter layers 4-6 (GM4-6) where most ECoG activity is generated. RESULTS are reported as mean ± SEM for p < 0.05.Repetitive UCOs resulted in worsening acidosis over 3-4 h with arterial pH decreasing to 6.97 ± 0.02 all UCO groups' animals, recovering to baseline by 24 h. ECoG shut-down occurred 52 ± 7 min before reaching pH <7.00 at pH 7.23 ± 0.02 across the animal groups. MG counts were inversely correlated to ΔT in 24 h recovery animals (R = -0.84), as expected. This was not the case in normoxic 48 h recovery animals, and, surprisingly, in hypoxic 48 h recovery animals, this relationship was reversed (R = 0.90).Adaptive brain shut-down during labor-like worsening acidemia counteracts neuroinflammation in a hypoxia- and time-dependent manner.
- Limited Diagnostic Value of Routine Screening of Neonates with the Urinary Group B Streptococcal Antigen Tests. [JOURNAL ARTICLE]
- Pediatr Neonatol 2014 Jul 21.
A urinary latex test for detection of antigens from group B Streptococcus (GBS) has been used for the diagnosis of invasive GBS disease. However, the value of routine screening of infants with this test has not been determined.All infants admitted to Linkou Chang-Gung Memorial Hospital (Taoyuan, Taiwan) from January 2005 to May 2013 were screened with a urinary GBS antigen test (Wellcogen Strep B). Medical records were retrospectively reviewed to determine the diagnostic value of this test.A total of 14,277 infants were tested and 38 cases had confirmed diagnoses of invasive GBS disease (34 bacteremia, 18 meningitis, 14 both), corresponding to a prevalence of 0.27% among our admitted infants. A total of 106 infants had positive results, but only 26 had confirmed disease. Among infants with confirmed disease, 12 had negative antigen results. These data allowed calculation of the sensitivity (68.4%), specificity (99.4%), positive predictive value (24.5%), and negative predictive value (99.9%). Adjusting for prevalence, the disease probability of a positive test result was 23.6%, and the probability of a negative post-test result was 0.09%. The absolute risk reduction of a negative result was very small (0.18%). Analysis of demographic, clinical, and laboratory parameters indicated that late age of onset (≥7 days-old), presence of seizure, fever, respiratory distress, leukopenia, bandemia, thrombocytopenia, coagulopathy, metabolic acidosis, and elevated levels of C-reactive protein (CRP) were significantly related to the presence of a true positive test result.In our study population, the positive predictive value of the GBS antigen test was poor and the risk reduction of a negative result was weak. These results indicate that routine screening with this test has a limited diagnostic value. However, GBS antigen testing appears to be useful for early detection of disease in infants with certain demographic, clinical, and laboratory risk factors.
- Prevalence of and risk factors for reduced serum bicarbonate in chronic kidney disease. [JOURNAL ARTICLE]
- Nephrology (Carlton) 2014 Jul 27.
The prevalence of metabolic acidosis increases as glomerular filtration rate falls. However, most patients with stage 4 chronic kidney disease have normal serum bicarbonate concentration while some with stage 3 chronic kidney disease have low serum bicarbonate, suggesting that other factors contribute to generation of acidosis. The purpose of this study is to identify risk factors, other than reduced glomerular filtration rate, for reduced serum bicarbonate in chronic kidney disease.This is a cross-sectional analysis of baseline data from the Chronic Renal Insufficiency Cohort Study. Multivariable logistic and linear regression models were used to relate predictor variables to the odds of low serum bicarbonate (< 22 mM) compared to normal serum bicarbonate (22 - 30 mM) and the coefficients of Δ serum bicarbonate concentration.The prevalence of low serum bicarbonate at baseline was 17.3%. Lower estimated glomerular filtration rate had the strongest relationship with low serum bicarbonate. Factors associated with higher odds of low serum bicarbonate, independent of estimated glomerular filtration rate, were urinary albumin/creatinine ≥ 10 mg/gm, smoking, anemia, hyperkalemia, non-diuretic use, and higher serum albumin. These and younger age, higher waist circumference, and use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers associated with negative Δ serum bicarbonate in linear regression models.Several factors not typically considered to associate with reduced serum bicarbonate in chronic kidney disease were identified including albuminuria ≥ 10 mg/gm, anemia, smoking, higher serum albumin, higher waist circumference, and use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers. Future studies should explore the longitudinal effect of these factors on serum bicarbonate concentration.
- A hierarchy of factors influence discontinuous gas exchange in the grasshopper Paracinema tricolor (Orthoptera: Acrididae). [JOURNAL ARTICLE]
- J Exp Biol 2014 Jul 25.
The evolutionary origin and maintenance of discontinuous gas exchange (DGE) in tracheate arthropods are poorly understood and highly controversial. We investigated prioritisation of abiotic factors in the gas exchange control cascade by examining oxygen, water and haemolymph pH regulation in the grasshopper Paracinema tricolor. Using a full-factorial design, grasshoppers were acclimated to hypoxic or hyperoxic (5%O2, 40%O2) gas conditions, or dehydrated or hydrated, whereafter their CO2 release was measured under a range of O2 and relative humidity (RH) conditions (5%, 21%, 40%O2 and 5%, 60%, 90%RH). DGE was significantly less common in grasshoppers acclimated to dehydrating conditions compared to the other acclimations (hypoxia=98%; hyperoxia=100%; hydrated=100%; dehydrated=67%). The dehydrated acclimation resulted in a significant decrease in haemolymph pH from 7.0 ± 0.3 to 6.6 ± 0.1 (mean ± standard deviation, p=0.018) and also significantly increased the O-phase duration under 5%O2 treatment conditions (5%O2=44.1 ± 29.3 min; 40%O2=15.8 ± 8.0 min; 5%RH=17.8 ± 1.3 min; 60%RH=24.0 ± 9.7 min; 90%RH=20.6 ± 8.9 min (mean ± standard deviation)). The observed acidosis could potentially explain the extension of the O-phase under low RH conditions, when it would perhaps seem more useful to reduce the O-phase to lower respiratory water loss. The results confirm that DGE occurrence and modulation is affected by multiple abiotic factors. A hierarchical framework for abiotic factors influencing DGE is proposed in which the following stressors are prioritised in decreasing order of importance: oxygen supply; CO2 excretion and pH modulation; oxidative damage protection and water savings.
- Diet and diet-related disorders in captive ruminants at the national zoological gardens of South Africa. [JOURNAL ARTICLE]
- Zoo Biol 2014 Jul 24.
Although diet-related disorders have received much attention in the zoo literature, evidence-based results on relationships between diet and disease are still rare, often due to a lack of quantitative dietary information that can be linked to clinical or necropsy reports. We investigated 24 species of captive ruminants from one facility for which quantitative feeding instructions and necropsy reports between 1991 and 2012 were available. Species were classified as grazer (GR), intermediate feeder (IM), or browser (BR). Feeding type and body mass were significantly correlated to the diet fed, with smaller and BR species receiving higher proportions of non-roughage diet items. There were no significant differences between feeding types in the occurrence of parakeratosis/ruminitis/acidosis (PRA) at necropsy, but in body condition score, with BR more often in poor and less often in excellent body condition at necropsy. While there was no direct correlation between the proportion of non-roughage diet items and PRA across species, there was a significant effect of the proportion of non-roughage diet items on PRA when body mass was also taken into account: larger species, and those that received more non-roughage diet items, had higher prevalence of PRA. The results underline that diet and lack of structured feed items can be associated with the disease complex of acidosis in ruminants, but also suggest that this is modified by factors related to animal size. These latter may include susceptibility to acidosis, or husbandry-related opportunities to monopolize non-roughage feeds and ingest higher proportions than intended by feeding instructions. Zoo Biol. XX:XX-XX, 2014. © 2014 Wiley Periodicals, Inc.
- Extracorporeal membrane oxygenation saved a mother and her son from fulminant peripartum cardiomyopathy. [Journal Article]
- J Obstet Gynaecol Res 2014 Jul; 40(7):1940-3.
A 34-year-old full-term pregnant woman presented with abruptly aggravating dyspnea. A chest X-ray showed pulmonary edema, and an echocardiogram revealed a left ventricular ejection fraction of 39%. Despite conventional medical treatment for acute heart failure and mechanical ventilation, hypoxia and metabolic acidosis were aggravated, and the fetal heart rate decreased to 90 b.p.m., suggestive of fetal distress. We decided to initiate extracorporeal membrane oxygenation (ECMO) and perform a cesarean section. The infant was successfully delivered without hypoxic brain damage. The patient was weaned from ECMO 6 days after delivery and was extubated 1 day after discontinuation of ECMO. Left ventricular systolic function had completely recovered at this time. This is the first report of a patient with peripartum cardiomyopathy who had a successful delivery with the support of ECMO, demonstrating that ECMO can serve as a rescue therapy, not only treating peripartum cardiomyopathy but also permitting a safe delivery.
- Whey Versus Soy Protein Diets and Renal Status in Rats. [JOURNAL ARTICLE]
- J Med Food 2014 Jul 23.
Abstract Different dietary protein sources can promote different renal statuses. We examined the effects of whey protein (WP) and soy protein (SP) intake on plasma, urinary, and morphological renal parameters in rats. One hundred and twenty Wistar rats were randomly distributed into 2 experimental groups fed with either WP or SP diets over 12 weeks. These diets were based on commercial WP or SP isolates. The urinary calcium content was higher in the WP diet compared to the SP diet group (P<.001) whereas the urinary citrate level was lower (P<.001). The urinary pH was more acidic in the WP diet group compared to the SP diet group (P<.001); however, no differences were observed between the groups for any of the renal morphological parameters analyzed (all, P>.05) or other plasma renal markers such as albumin or urea concentrations. The increase of acid and urinary calcium and the lower urinary citrate level observed in the WP diet group could increase the incidence of nephrolithiasis compared to the SP diet group. Despite the WP showed poorer acid-base profile, no significant morphological renal changes were observed. These results suggest that the use of SP instead of WP appears to promote a more alkaline plasma and urinary profile, with their consequent renal advantages.
- Changes in Blood Constituents of Rabbits Subjected to Transportation under Hot, Humid Tropical Conditions. [Journal Article]
- Asian-Australas J Anim Sci 2013 Jun; 26(6):874-8.
Unlike Europe (particularly, Italy and Spain), where a number of studies have been conducted on the stressful effects of transport on rabbit welfare, few studies have been conducted on transportation of rabbits under hot, humid tropical conditions experienced in countries like Malaysia. We studied the effects of transportation in hot humid tropical conditions of Malaysia on physiometabolic changes in New Zealand white rabbits. Eighty experimental animals were divided into two groups of 40 bucks each and transported for either 3 or 1 h. Transportation caused a significant upsurge of aspartate aminotransferase, alanine aminotransferase and creatine kinase activities (p<0.001) though did not significantly affect lactate dehydrogenase (LDH) activity (p = 0.0706). Both transportation periods caused elevation in plasma glucose levels, lactic acidosis and dehydration as evidenced through elevated packed cell volume and plasma protein concentration. It was concluded that regardless of the duration, transport of rabbits under hot humid tropical conditions, resulted in heat distress since the rabbits showed hyperglycemia, hypercalcemia, lactacidemia, lymphocytopenia, dehydration and increase in blood enzyme activities.
- Laundry Detergent Pod Ingestions: Is There a Need for Endoscopy? [JOURNAL ARTICLE]
- J Med Toxicol 2014 Jul 22.
Laundry detergent pod (LDP) exposures in children have resulted in several referrals to the emergency department. Signs and symptoms can include gastrointestinal symptoms (vomiting, drooling), neurological symptoms (depressed sensorium), or metabolic changes (lactic acidosis). There is limited literature on esophageal injury following LDP ingestions.We reviewed three cases of pediatric LDP ingestions that underwent an upper endoscopy in a tertiary care pediatric hospital. All of our patients were younger than 3 years old. The upper endoscopies revealed superficial esophageal erosions in two patients and erythema in the other. None of the patients had oral burns. Two of them developed swallowing dysfunction. Follow-up upper GI studies were normal.Our three patients ingested laundry detergent pods and all of them developed some degree of esophageal injury despite the absence of oral erythema, ulcers, or swelling. A review of literature suggests LDP exposures are more severe than non-pod detergents. Reasons as to why this may be remain unclear, although investigation into the ingredients and mode of delivery may help us to better understand. In a literature review, no esophageal strictures have been reported after LDP ingestion. We reviewed esophageal injury classification systems in an attempt to predict who may be at greatest risk for stricture based on initial findings.Our case series demonstrates it is hard to predict esophageal injury based on signs and symptoms. Based on a literature review, long-term esophageal stricture is unlikely, but if gastrointestinal symptoms persist, it is reasonable to evaluate with an upper endoscopy. Larger studies are needed.