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PubMed1979

[Alcoholic ketoacidosis. One case (author's transl)].

Severe ketoacidosis sometimes develops in chronic alcoholics after increased alcohol intake associated with dietary restriction. This particular case was unusual from two standpoints: a considerable, prolonged and unexplained increase in serum free fatty acid, and discordance between the degree of ketonaemia and an abundant liver glycogen load.

Acidosis↗
PubMed2001

Unexpected electrolyte changes in a vomiting man.

A 27 year old man presented with 24 hours of unexplained vomiting. His past health was unremarkable except for a deep vein thrombosis one year earlier. At that time his serum electrolytes were normal. The results of repeat electrolyte measurement are shown in Table 1.

Acidosis↗
PubMed2002

Oral hypoglycaemics. When not to use what.

BACKGROUND: In the 1940s and '50s the first oral hypoglycaemic agents (the sulphonylureas and metformin) became available. These remained the only agents for the next 50 years. Over the last five years three new classes have been released. General practitioners now have a wider range of effective hypoglycaemic agents from which to choose. OBJECTIVES: This article focuses on those patients where particular agents should not be used: i.e. 'when not to use what'. DISCUSSION: In general however, it must be remembered that problems with oral hypoglycaemics are rare. The great majority of patients have no problems with their prescribed hypoglycaemic medication.

Acarbose↗
PubMed2003

Cerebrolysin inhibits lipid peroxidation induced by insulin hypoglycemia in the brain and heart of mice.

As a consequence of enhanced production of oxygen free radicals, lipid peroxidation leads to the degradation of membrane lipids and disturbances of membrane permeability. Lipid peroxidation increases under stress conditions such as hypoxia, ischemia or acidosis as well as in metabolic diseases, e.g. diabetes mellitus. We have shown that subcomatous doses of insulin (6.0 IU/kg) significantly increase thiobarbituric acid reactive substances (TBARs), especially malondialdehyde (MDA) - the endproduct of lipid peroxidation, in the brain and heart of mice. In our model of insulin-induced hypoglycemia, mice were treated with the neuroprotective, peptide-containing drug Cerebrolysin (100 mg/kg b.w.). Animals were sacrificed by decapitation two or three hours after the injection of tested substance and samples were taken to determine several serum parameters (glucose, total protein, triglycerides and lactic acid) and TBARs in the brain and heart. Although Cerebrolysin was not able to affect serum parameters after subcomatous insulin injection, the drug significantly influenced lipid peroxidation. A single injection of Cerebrolysin already decreased TBARs levels in the brain and heart tissue. Presuming that an increase of TBARs reflects disturbances of the cell membrane, we have documented a promising effect of Cerebrolysin on cell integrity.

Amino Acids↗
PubMed2003

Unexpected survival from severe metformin-associated lactic acidosis.

Lactic acidosis is a recognised complication of the antihyperglycaemic biguanide agent metformin, especially in patients with renal failure. We report a case of severe lactic acidosis and hypothermia due to metformin treatment and renal impairment. The favourable outcome despite extremely unfavourable clinical signs and symptoms for survival after admission and initial treatment was unexpected. Specific aspects of the clinical course are addressed.

Acidosis, Lactic↗
PubMed1971

Lactic acidosis.

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Acid-Base Equilibrium↗