Great CPC: Metformin toxicity
3.5 out of 5 stars Case 23-2013: a 54-Year-old Woman with Abdominal Pain, Vomiting, and Confusion. Kalantar-Zadeh K et al. N Engl J Med 2013 Jul 25;369:374-382. Full Text This is a very instructive case discussion from the Massachusetts General Hospital. A plane was diverted to Boston because one passenger, a 54-year-old woman, developed increasing abdominal pain and vomiting, along with decreasing mental status. After the plane landed, EMS found that here vital signs were fairly unremarkable (HR = 52 bpm). She was not hypoglycemic. Her medical history included type-2 diabetes, hypertension, and chronic renal disease. Medications included enalapril, metformin, glimepiride, nimesulide, imipramine, aspirin, and ibuprofen. Hospital work-up revealed severe anion-gap metabolic acidosis (venous pH = 6.62, serum bicarbonate 15 mmol/L anion gap> 20 mmol/L severe acidemia (pH
Contributors : Mahliyah Adkins-Threats ; Zhi-Feng Miao ; Jason C MillsSeries Type : Expression profiling by arrayOrganism : Mus musculusGenes related to AMPK activation, cellular respiration, and metabolism are enriched in the gastric parietal cell population. Metformin is known activator of AMPK.We used microarray analysis to identify metformin targets in mature parietal cells and in parietal cell progenitors.
The field of abdominal organ transplantation is multifaceted, with the clinician balancing recipient comorbidities, risks of the surgical procedure, and the pathophysiology of immunosuppression to ensure optimal outcomes. An underappreciated element throughout this process is acute pain management related to the surgical procedure. As the opioid epidemic continues to grow with increasing numbers of transplant candidates on opioids as well the increase in the development of enhanced recovery after surgery protocols, there is a need for greater focus on optimal postoperative pain control to minimize opioid use and improve ou...
The 2020 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation is intended to assist health care professionals worldwide who evaluate and manage potential candidates for deceased or living donor kidney transplantation. This guideline addresses general candidacy issues such as access to transplantation, patient demographic and health status factors, immunological and psychosocial assessment. The roles of various risk factors and comorbid conditions governing an individual’s suitability for transplantation such as adherenc...
Conclusions. Seven years following PFT, the patient gained limb strength with a functional elbow and wrist, although with diminished digital dexterity and sensation. Based on data presented by other programs and our own experience, PFT is indicated for select patients.
Conclusions. From a utilitarian perspective, it is important that kidneys are allocated to recipients that are able to maximize their benefit from the full life of the organ. In KTA recipients, graft quality correlates directly to graft survival. However, in KALT patients receiving the matched-pair kidneys of the KTA recipients, patient mortality, rather than kidney quality, dictates graft survival significantly. As allocation practices continue developing, utilization of expanded criteria kidneys that better match anticipated patient and graft survival should be strongly considered to maximize the benefits of limited re...
Discussion: A tertiary referral center referred 125 individuals to physiotherapy who were eligible for the study; we finally included 93 individuals for statistical analysis. Multiple backward regression analysis showed that gender (95% confidence interval [CI], 2.05-33.82), weight (95% CI, 0.39-1.02), age (95% CI, −0.91 to −0.04), left handgrip strength (95% CI, 0.14-1.44), and inspiratory muscle strength (95% CI, 0.08-0.38) were all independently associated with muscle surface area at L3. All these variables together explained 66% of the variability (R2) in muscle surface area at L3 (P
Conclusion: The current review identified strong, high-quality evidence to recommend hip muscle strengthening in the conservative management of persons with knee OA. Further research is needed to establish the underlying mechanisms for the clinical benefits.
Publication date: Available online 31 March 2020Source: Life SciencesAuthor(s): Mohamed A. Fouda, Korin E. Leffler, Abdel A. Abdel-Rahman
Publication date: Available online 30 March 2020Source: Sensors and Actuators B: ChemicalAuthor(s): Judit Randek, Carl-Fredrik Mandenius
Publication date: Available online 30 March 2020Source: Journal of Organometallic ChemistryAuthor(s): Olga N. Gorunova, Ivan M. Novitskiy, Yuri K. Grishin, Igor P. Gloriozov, V.A. Roznyatovsky, Victor N. Khrustalev, Konstantin A. Kochetkov, Valery V. Dunina
More News: Aspirin | Chronic Kidney Disease | Chronic Pain | CT Scan | Diabetes | Diabetes Type 2 | Dialysis | Enalapril | Endocrinology | Fortamet | Glimepiride | Hemofiltration | Hospitals | Hypertension | Ibuprofen | Imipramine | Men | Metformin | Overdose | Pain | Pancreatitis | PET Scan | Poisoning | Renal Failure | Toxicology | Urology & Nephrology