The Treatment of Salicylate Poisoning Using Mannitol and Forced Alkaline Diuresis

1. A comparison has been made between alkaline mannitol diuresis and alkaline glucose diuresis in the treatment of salicylate poisoning during an 8 hr period. 2. Mannitol gave a higher rate of urine flow, but there was no significant difference in the rate of salicylate excretion. 3. Serum levels of sodium, potassium and calcium fell in both groups, mainly during the first 2 hr. The mean fall in serum sodium was greater (21·4 mEq/l compared with 10·0 mEq/l) and that in serum potassium less (0·6 mEq/l compared with 1·5 mEq/l) in patients who received mannitol than in those who did not. 4. All serum electrolyte values had returned to normal within 24 hr of the end of the treatment period. 5. Acid—base changes occurring during treatment are described. 6. No adverse clinical features were seen in either treatment group. 7. Syrup of ipecacuanha was used to induce emesis. The mean recovery of salicylate in the vomitus was 38% of the apparent total ingested. The variability in recovery (0–81%) was not related to the delay between ingestion and vomiting. 8. It is concluded that mannitol does not increase the excretion of salicylate. It maintains good urinary excretion, thereby increasing the safety of the procedure. It is associated with a smaller fall in serum potassium and permits rapid removal of salicylate for a smaller rise in serum pH than does forced alkaline diuresis alone.

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Study of Electrolyte Serum Disturbances and Acid-base Status in Patients with Oral-maxillofacial and Dental Sepsis

Revista de Chimie ◽

10.37358/rc.17.7.5714 ◽

2017 ◽

Vol 68 (7) ◽

pp. 1552-1556

Author(s):

Elena Mihaela Carausu ◽

Violeta Trandafir ◽

Laura Ghibu ◽

Ovidiu Stamatin ◽

Laura Elisabeta Checherita

Keyword(s):

Healthcare Expenditure ◽

Early Recognition ◽

Serum Levels ◽

Public Health Issue ◽

Serum Electrolyte ◽

Acid Base ◽

Sodium Potassium ◽

Electrolyte Disturbances ◽

Clinical Challenge ◽

Acid Base Status

Septicaemia is an important public health issue and a clinical challenge with a major impact on healthcare expenditure and resources. The present retrospective study was conducted over 127 patients registered during 2006-2015 for the area of Moldavia, Romania. In our study we are concerned about the serum electrolyte disturbances and acid-base status in patients with oral-maxillofacial and dental septicaemia. We measured serum levels of sodium, potassium, chloride, alkali reserve and pH. The prevalence of electrolyte disturbances was: 15.85% for sodium, 69.15% for potassium and 55.50% for chloride. Early recognition of acid-base status and serum electrolytes disturbances proves to be of great importance for clinical management since it signalizes the gravity of the disease and the increase of fatality rate, and is imperative to save the lives of patients with dental and oral-maxillofacial septicaemia.

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Use of Renin-Angiotensin System Blockers Increases Serum Potassium in Anuric Hemodialysis Patients

American Journal of Nephrology ◽

10.1159/000491552 ◽

2018 ◽

Vol 48 (2) ◽

pp. 79-86 ◽

Cited By ~ 3

Author(s):

Ezio Movilli ◽

Corrado Camerini ◽

Paola Gaggia ◽

Roberto Zubani ◽

Giovanni Cancarini

Keyword(s):

Blood Pressure ◽

Serum Potassium ◽

Hemodialysis Patients ◽

K Value ◽

Interdialytic Weight Gain ◽

Increased Risk ◽

Dialysis Vintage ◽

Significant Difference ◽

Severe Hyperkalemia ◽

The Mean

Background: Angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are increasingly used in uremic patients (pts). However, their effect on serum potassium (sK) concentrations in anuric pts on chronic hemodialysis treatment (HD) is controversial. The aim of the study was to evaluate sK before and after the start of ACEi/ARB therapy. Methods: In the period 1/1/2015 – 31/12/2015, 112 out of 240 prevalent HD pts on thrice weekly HD treatment followed at our institution started the ACEi/ARB therapy. The mean age was 67 ± 14 years, 67/112 were men, dialysis vintage was 6–212 months. In the 3 months before (PRE; N° 36 HD sessions) and after (POST; N° 36 HD sessions) the start of ACEi/ARB therapy, the following variables were evaluated in pre dialysis after the long interdialysis interval: sK (mean of 12 determinations; mmol/L), maximum sK (maximum K value observed during observations; sKmax; mmol/L), serum sodium (sNa; mmol/L), pre dialysis systolic blood pressure (SBP; mm Hg) and diastolic blood pressure (DBP; mm Hg), body weight (BW; Kg), interdialytic weight gain (IWG; Kg), Kt/V, serum bicarbonate concentrations (sBic; mmol/L), protein catabolic rate (PCRn; g/KgBW/day). SBP, DBP, IWG are the mean of the 24 HD sessions. Out of 112 patients, 102 were on antihypertensive therapy. The duration of HD and blood and dialysate flow rates were kept constant. Data are expressed as mean ± SD. Student t test for paired and unpaired data for normally distributed variables, Mann-Whitney test for medians, χ2 test for categorical data were employed to compare groups. A significant difference was defined as p < 0.05. Results: sK increased from 5.0 ± 0.4 mmol/L PRE to 5.7 ± 0.5 mmol/L POST (p < 0.0001). sKmax increased from 5.3 ± 0.5 mmol/L PRE to 6.2 ± 0.6 mmol/L POST (p < 0.0001). The percentage of pts with normal sK concentrations decreased from 82% PRE to 29% POST (p < 0.0001). Mild hyperkalemia increased from 18 to 52% (p < 0.001); in 31% of the patients, it was necessary to reduce the K dialysate concentration. None of the patients had severe hyperkalemia PRE, but 19% developed severe hyperkalemia POST (p < 0.0001) necessitating treatment withdrawal. Mean sK in these pts varied from 5.2 ± 0.3 mmol/L PRE to 6.5 ± 0.2 mmol/L at the moment of withdrawal (p < 0.0001) and sKmax from 5.5 ± mmol/L PRE to 6.9 ± 0.3 mmol/L (p< 0.0001). After withdrawal of ACEi/ARB, sK and sKmax concentrations decreased to basal levels within 1 month. There were no significant changes of BW, IWG, SBP, DBP, Na, Hb, Kt/V, sBic, and PCRn in both periods. Conclusions: ACEi/ARB therapy is associated with an increased risk of hyperkalemia in anuric hemodialysis patients. The proportion of patients with normal sK concentrations decreased from 82 to 29% and with mild hyperkalemia increased from 18 to 52%. Severe hyperkalemia necessitating the interruption of ACEi/ARB therapy developed in 19% of patients. This suggests great caution in the widest utilization of this class of drugs in HD patients.

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Associations of Trauma Severity with Mean Platelet Volume and Levels of Systemic Inflammatory Markers (IL1β, IL6, TNFα, and CRP)

Mediators of Inflammation ◽

10.1155/2016/9894716 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 10

Author(s):

Baris Alper ◽

Baris Erdogan ◽

Mehmet Özgür Erdogan ◽

Korkut Bozan ◽

Murat Can

Keyword(s):

Mean Platelet Volume ◽

Injury Severity ◽

Serum Levels ◽

Study Group ◽

Platelet Volume ◽

Trauma Severity ◽

Severity Scores ◽

Severity Of Injury ◽

Significant Difference ◽

The Mean

We investigated the associations of injury severity scores (ISSs) with the mean platelet volume, the serum levels of two interleukins (IL1βand IL6), and the serum levels of tumour necrosis factor-α(TNFα) and C-reactive protein (CRP). We sought to identify biochemical parameters that could be used as components of a new biochemical parameter-based ISS system. The levels of CRP, TNFα, IL1β, and IL6 differed significantly (allpvalues < 0.05) between severely injured patients and controls. The mean platelet volume (MPV) did not correlate with the ISSs (p> 0.05). The TNFαand IL6 levels were useful for determining the severity of injury, and the CRP level was elevated in all trauma patients but did not correlate with the ISS. The IL1βlevel was higher in the study group but did not increase as the ISS increased. IL6 and TNFαlevels were higher in the study group and increased as the ISS increased. We found no significant difference between the trauma group and healthy individuals in terms of MPV values. IL6 and TNFαlevels can be used to assess trauma severity. However, neither the MPV nor the CRP or IL1βlevel is useful for this purpose.

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Effects of acute stimulation with luteinizing hormone-releasing hormone (LRH) on biologically active and immunoreactive serum luteinizing hormone (LH) in pubertal boys

Acta Endocrinologica ◽

10.1530/acta.0.1070289 ◽

1984 ◽

Vol 107 (3) ◽

pp. 289-294 ◽

Cited By ~ 7

Author(s):

Vanna Montanini ◽

Marco Francesco Celani ◽

Gian Franco Baraghini ◽

Cesare Carani ◽

Paolo Marrama

Keyword(s):

Luteinizing Hormone ◽

Serum Levels ◽

Biologically Active ◽

Acute Administration ◽

Adult Men ◽

Serum Luteinizing Hormone ◽

Significant Difference ◽

The Mean ◽

Pubertal Boys

Abstract. The responses of biologically active LH (BIO-LH) and immunoreactive LH (RIA-LH) to acute stimulation with LRH (0.1 mg iv) were studied in 8 pubertal boys (9–15 years, 2nd–4th Tanner's stage), and in 10 healthy adult men (20–46 years). Serum levels of BIO-LH were assessed by an in vitro bioassay method based upon testosterone production by mechanically dispersed mouse Leydig cell preparations. In pubertal boys the mean BIO-LH/RIA-LH (B/I) ratio of basally secreted LH was significantly lower than in adult men (1.2 ± 0.2 (sem) and 2.2 ± 0.2 respectively, P < 0.01). After acute administration of LRH the mean B/I ratio of circulating LH showed a significant increase from the basal value in pubertal boys (2.6 ± 0.2, P < 0.01 vs basal values), whereas no significant difference in LH B/I ratios were demonstrated throughout the study period in adult men (2.1 ± 0.1, P = NS vs basal values). In agreement with this finding, the mean relative maximum response for BIO-LH (BIO-LH Δ%) was higher in pubertal boys than in adult men (1702.7 ± 500.3 and 499.6 ± 65.4% respectively, P < 0.05), whereas the mean RIA-LH Δ% was similar in both groups (609.1 ± 85.1 and 534.1 ± 75.5% respectively, P = NS). No significant differences were shown in the BIO-LH Δ area between pubertal boys (4.9 ± 0.9 area units × 103) and adult men (6.7 ± 1.2 area units × 103, P = NS), whereas the mean RIA-LH Δ area was significantly lower in the former group (1.9 ± 0.4 area units × 103 vs 3.2 ± 0.5 area units × 103, P < 0.05). Our study emphasizes that the pubertal pituitary possesses a greater responsiveness for BIO-LH than the adult pituitary, and that in pubertal boys acute stimulation with LRH evokes the release of a more bioactive form of LH.

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Model Pengembangan Pembelajaran PJBL Berbasis Proyek untuk Meningkatkan Kreatifitas Siswa

Indonesian Journal of Learning Education and Counseling ◽

10.31960/ijolec.v3i2.741 ◽

2021 ◽

Vol 3 (2) ◽

pp. 140-147

Author(s):

Nana Misrochah

Keyword(s):

Data Analysis ◽

Mean Value ◽

T Test ◽

Acid Base ◽

Paired Sample ◽

Cooking Oil ◽

Achievement Rate ◽

Significant Difference ◽

Acid Base Titration ◽

The Mean

Through this research, it is hoped that acid-base titration learning will be more meaningful and can contribute to student creativity. PjBL model is an integrated learning that is carried out cooperatively through projects that develop student skills, so that student creativity will increase. The project given in this research is making of soap from the wrinkled oil. In the process can be attributed to the application of acid-base titration material by calculation of acid numbers and saponification numbers on the cooking oil before being processed into soap. The results of data analysis shows data significance> 0.05 which means that the data is normally distributed for pretest and posttest. The data of paired sample t-test shows that the significance obtained is 0,000 <0.05 which means that there is a significant difference between the mean value of the integrated creativity test with the acid-base titration concept before treatment is given after treatment is given. Creativity improvement were calculated using the N-Gain value resulting in an average achievement rate of 0.50 and belonging to the moderate category. Posttest results indicate that the implementation of project-based LKP is effective in improving student creativity with classically average is 81.5%.

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Assessment of Neopterin Serum Level for Monitoring Therapy of Patients with Mycobacterium Tuberculosis

Jundishapur Journal of Health Sciences ◽

10.5812/jjhs.113068 ◽

2021 ◽

Vol 13 (3) ◽

Author(s):

Shokrollah Salmanzadeh ◽

Razieh Mombeini ◽

Seyed Mohammad Alavi ◽

Morteza Abdullatif Khafaie

Keyword(s):

Serum Levels ◽

Response To Treatment ◽

Sputum Smear ◽

Major Health Problem ◽

Tb Treatment ◽

Monitoring Therapy ◽

Significant Difference ◽

The Mean ◽

First Time

Background: Tuberculosis (TB) is a major health problem worldwide. To date, the standard diagnostic method for TB is still the direct observation of Mycobacterium TB in a sputum smear or culture. Objectives: There is an urgent need for a method to detect the disease in a shorter time with acceptable sensitivity and specificity and help monitor the treatment. Methods: A panel of 34 adults newly diagnosed with smear-positive pulmonary TB was followed during their treatment period of five months. Neopterin (NPT) serum levels were measured three times (before treatment and two and five months after treatment) using the Brahms ELItest Neopterin kit, and the results were analyzed using descriptive and graphical methods. Results: The mean NPT for the first time before treatment was 27.47 ± 20.7 nmol/L. NPT was measured two months after the anti-TB treatment, and the associated mean was 16.97 ± 14.14 nmol/L. At the end of the fifth month, the mean NPT concentration reached 11.3 ± 10.5 nmol/L. The mean serum NPT before treatment had a statistically significant difference with the mean NPT at the end of the second and fifth months of the treatment (P = 0.001). Conclusions: According to the national protocol for treating TB, a sputum smear is still necessary for patients’ follow-up. It seems that the serum NPT level should be measured to monitor response to treatment in patients that, for any reason are not able to give sputum in TB treatment follow-up.

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Pseudonormokalemia in Patients with Thrombocytosis.

Blood ◽

10.1182/blood.v108.11.3964.3964 ◽

2006 ◽

Vol 108 (11) ◽

pp. 3964-3964

Author(s):

Amir S. Steinberg ◽

Raimonda Goldman ◽

Randy L. Levine ◽

Georgia Panagopoulos ◽

Marvin C. Cooper

Keyword(s):

Platelet Count ◽

Serum Potassium ◽

Interim Analysis ◽

Plasma Potassium ◽

Normal Serum ◽

Control Group ◽

P Value ◽

Significant Difference ◽

The Mean ◽

The Difference

Abstract Introduction: Pseudohyperkalemia represents an artificial elevation in serum potassium concentration. It is well described that patients with thrombocytosis may have elevated serum but normal plasma potassium. The difference between serum and plasma potassium is felt to be due to potassium release from platelets during clotting. We propose to prove that a similar mechanism will lead to a "pseudonormokalemia," where serum potassium appears to be in the normal range (3.5–5.0 MEq/L) despite below-normal levels in the plasma(<3.5 MEq/L). Method: This is an interim analysis of a prospective, IRB-approved planned comparison of 146 patients. We compared 36 thrombocytosis patients (platelets>500,000/uL) to 36 control patients (platelets<500,000/uL). Patients were identified from a list of lab results generated by a computer search and serum and plasma potassium and CBC were then drawn concomitantly. The two groups were compared using either the t-test or the Mann-Whitney U test depending on the distribution of the variables. A p <.05 was considered a priori to indicate statistical significance. Results: There was no statistically significant difference in sex distribution or age between the two groups. The average platelet count was 643,190/uL in the thrombocytosis group (SD 134,426 uL) and 280,220/uL (SD 106,217 uL) in the control group with a p value <0.001. While the serum potassium was noted to be significantly different between the two groups, the plasma potassium was not (see table). This was reflected in the difference between the serum and plasma potassium in the two groups. The thrombocytosis group was noted to have a difference between serum and plasma potassium of .52 MEq/L (SD .32 MEq/L) while the control group had a difference of .18 MEq/L (SD .23 MEq/L). The thrombocytosis group had 14 cases in which the difference between serum and plasma potassium was over 0.5 MEq/L whereas the control group had none. Conclusion: In this study, patients with thrombocytosis had higher mean serum potassium levels than the control group but similar mean plasma potassium levels. The mean difference between serum and plasma potassium (Delta) exceeded 0.5 MEq/L in the thrombocytosis arm and there was a statistically significant difference in the Delta values between the two groups. The mean platelet volume (MPV) of the thrombocytosis group was smaller than that of the control group. This indicates that the elevation in serum potassium in the thrombocytosis group cannot be attributed to the actual size of the platelets but rather to the number of platelets involved. Patients with thrombocytosis and normal serum potassium may actually be hypokalemic as this study demonstrates. As we continue to evaluate patients, we believe this difference will become more demonstratable. On interim analysis, our study suggests that in patients with thrombocytosis and normal serum potassium, plasma potassium should be considered along with routine labs. Group Comparison Values (N=36) Thrombocytosis Group-Platelets>500,000/uL Control Group-Platelets<500,000/uL p value Age 60.33 yrs 57.53 yrs p =.50 Serum K+ 4.43 MEq/L 4.15 MEq/L <.001 Plasma K+ 3.91 MEq/L 3.97 MEq/L p =.54 Mean Delta between Serum and Plasma K+ .52 MEq/L (SD .32) .18 MEq/L (SD .23) <0.001 Platelet Count 643.19 X103/uL 280.22X103/uL <0.001 MPV 7.27 fl 8.24 fl <0.001 WBC 12.05 mm3 9.98 mm3 p =.16

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Urinary Composition During Hypothermia

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1956.185.3.528 ◽

1956 ◽

Vol 185 (3) ◽

pp. 528-532 ◽

Cited By ~ 45

Author(s):

William E. Segar ◽

Philip A. Riley ◽

Timothy G. Barila

Keyword(s):

Body Temperature ◽

Serum Potassium ◽

Whole Blood ◽

Normal Values ◽

Urine Flow ◽

Sodium Potassium ◽

Blood Ph ◽

Glomerular Filtrate ◽

Renal Tubular ◽

Linear Manner

Five dogs were cooled artificially to 22°C and then warmed to 37°C. Blood and urine chemical changes were periodically studied. An increase in whole blood ph and a decrease in serum potassium were observed; and little change in hematocrit, serum Na, Cl or total CO2 concentrations occurred during cooling. Both blood ph and serum potassium concentrations returned to normal values upon warming the animals. Urine flow increased with cooling and the U/P ratios of sodium, potassium and chloride approached unity as body temperature was progressively lowered. The U/P ratio of creatinine dropped from 150 to 8. The ability of the kidney to produce ammonia or to acidify the urine decreased in a linear manner as cooling progressed and returned promptly upon warming. The changes in volume and composition of the urine which were produced by cooling, indicate that such urine is essentially glomerular filtrate which has undergone isosmotic reabsorption but which has remained unaltered by further renal tubular activity.

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Determination of The Concentration of Calcium Level in Blood of Babies Kept Growing on Breastfeeding, Artificial Feeding and Mixed Feeding in Libya

Khalij-Libya Journal of Dental and Medical Research ◽

10.47705/kjdmr.204201 ◽

2020 ◽

Vol 4 (2) ◽

pp. 1-6

Author(s):

Khaled Benelhaj ◽

Fathia Lazrag

Keyword(s):

Calcium Level ◽

Serum Levels ◽

Artificial Feeding ◽

Mixed Feeding ◽

Blood Calcium ◽

Male And Female ◽

Group I ◽

Significant Difference ◽

The Mean ◽

Mean Concentration

Objectives: This study was designed to investigate the concentration of calcium level in blood of breast, artificial and mixed feeding babies. Methods: The total number of babies covered were 269 babies of different ages, however, the babies were divided into four groups, including group (I) consists of 98 male and female babies aged between (1 day -6 months), group (II) consists of 53 male and female babies aged between (7 m -12 m), group (III) consists of 59 male and female babies aged between (13 m -18 m), and group (IV) consists of 59 male and female babies aged between (19 m -2 m). Results: The mean concentration of serum blood calcium in breast feeding (9.25 mg/dL) was significantly lower (P < 0.05) than artificial feeding (9.79 mg/ dL) and mixed feeding (9.88 mg/dL). Meanwhile, the mean concentration of serum blood calcium level (8.93 mg/ dL) in babies aged between (13 m-18m) was significantly lower (p<0.05) than other aged groups. However, the effect of the babies’ gender o the concentration of calcium indicated that the serum calcium levels did not show any significant difference among males and females’ babies. Conclusion: The relationship between age type of feeding and the gender show a correlation among the factors studied, therefore, it can be concluded that the babies fed on mixed milk got a benefit regarding the levels of these minerals as their serum levels are higher than the serum levels of babies fed on breast and artificial milk.

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Cord Blood Theophylline Levels and Respiratory Morbidities In Preterm Infants

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2018.856 ◽

2019 ◽

pp. 1

Author(s):

Tolga Hasan Celik ◽

Ayse Korkmaz ◽

Sule Yigit ◽

Murat Yurdakok

Keyword(s):

Cord Blood ◽

Premature Infants ◽

Neonatal Period ◽

Serum Levels ◽

University Hospital ◽

Blood Gas ◽

Significant Difference ◽

The Mean ◽

Blood Gas Parameters ◽

Pulmonary Morbidity

Objective: to investigate whether there is any relationship between cord blood theophylline levels and pulmonary morbidities in the early neonatal period in premature infants.Study Design: This prospective cohort study was conducted in Hacettepe University Hospital Neonatology Unit, between November 2010 and January 2012. Cord blood samples were collected at birth from premature infants, and theophylline levels were measured. Theophylline levels of cord blood were compared between infants with and without pulmonary morbidity.Results: A total of 90 infants (42 females, 48 males) were enrolled in the study. The mean gestational age was 31.1±3.1 weeks, and the mean birth weight was 1527±540 g. Early respiratory morbidities developed in 57 infants (63.3%), while no respiratory morbidities were observed in 33 infants (36.7%). There was no significant difference between the groups in blood gas parameters, oxygen saturation values and cord blood theophylline levels.Conclusions: Although the theophylline levels that were measured in the cord blood were much lower than therapeutic serum levels, we concluded that the cord theophylline level is not valuable as a prognostic factor for pulmonary morbidities in premature newborns.

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