Chloremia and Fluid Therapy – A Systematic Review

2020 ◽  
Author(s):  
David Astapenko ◽  
Pavel Navratil ◽  
Jiri Pouska ◽  
Vladimir Cerny
Keyword(s):  
Metabolic Acidosis ◽  
Mortality Rates ◽  
The Body ◽  
Infusion Therapy ◽  
Organ Function ◽  
Compound Words ◽  
Negative Effect ◽  
Crystalloid Solutions ◽  
Hyperchloremic Metabolic Acidosis ◽  
Medical Concepts

Abstract Background: Crystalloid solutions are one of the most widely used remedies in the field. While generally used in medicine for almost 190 years, studies focused largely on their safety have only been published since the new millennium. The most widely used solution, normal saline, is most often referred to in this context. Its excessive administration results in hyperchloremic metabolic acidosis with other consequences, including higher mortality rates. Current balanced solutions are safer in this respect and are designed to have a composition close to that of blood plasma.Methods: Original papers and review articles eligible for developing the present paper were identified by searching online in the electronic MEDLINE database. The key words searched for included hyperchloremia, hypochloremia and compound words containing the word “chloride”, infusion therapy, metabolic acidosis, renal failure, and review.Results: A total of 21,758 papers published before 31 May 2020 were identified; of this number, 630 duplicates were removed from the list. Upon excluding articles based on their title or abstract, 1850 papers were screened, of which 63 full-text articles were assessed.Conclusions: According to the latest medical concepts, dyschloremia (both hyperchloremia and hypochloremia) is a factor indisputably having a negative effect on selected variables of clinical outcome. As infusion therapy can significantly impact chlorine homeostasis of the body, the choice of infusion solutions should always take into account the potentially adverse impact of chlorine content on chloremia and organ function.

scholarly journals Clinical physiology aspects of chloremia in fluid therapy: a systematic review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
David Astapenko ◽  
Pavel Navratil ◽  
Jiri Pouska ◽  
Vladimir Cerny
Keyword(s):  
Systematic Review ◽  
Metabolic Acidosis ◽  
Fluid Therapy ◽  
Chloride Content ◽  
The Body ◽  
Infusion Therapy ◽  
Clinical Physiology ◽  
Chloride Homeostasis ◽  
Negative Effect ◽  
Medical Concepts

Abstract Background This systematic review discusses a clinical physiology aspect of chloride in fluid therapy. Crystalloid solutions are one of the most widely used remedies. While generally used in medicine for almost 190 years, studies focused largely on their safety have only been published since the new millennium. The most widely used solution, normal saline, is most often referred to in this context. Its excessive administration results in hyperchloremic metabolic acidosis with other consequences, including higher mortality rates. Methods Original papers and review articles eligible for developing the present paper were identified by searching online in the electronic MEDLINE database. The keywords searched for included hyperchloremia, hypochloremia, and compound words containing the word “chloride,” infusion therapy, metabolic acidosis, renal failure, and review. Results A total of 21,758 papers published before 31 May 2020 were identified; of this number, 630 duplicates were removed from the list. Upon excluding articles based on their title or abstract, 1850 papers were screened, of which 63 full-text articles were assessed. Conclusions According to the latest medical concepts, dyschloremia (both hyperchloremia and hypochloremia) represents a factor indisputably having a negative effect on selected variables of clinical outcome. As infusion therapy can significantly impact chloride homeostasis of the body, the choice of infusion solutions should always take into account the potentially adverse impact of chloride content on chloremia and organ function.

scholarly journals Hyperchloremic metabolic acidosis during bipolar transurethral resection of the prostate: a report of two cases

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110244
Author(s):  
Ann Hee You ◽  
Ji Yoo Lee ◽  
Jeong-Hyun Choi ◽  
Mi Kyeong Kim
Keyword(s):  
Metabolic Acidosis ◽  
Transurethral Resection ◽  
Normal Saline ◽  
Isotonic Saline ◽  
Hemodynamic Instability ◽  
Acid Base ◽  
Electrolyte Disturbance ◽  
Irrigation Fluid ◽  
Laboratory Test Results ◽  
Hyperchloremic Metabolic Acidosis

Compared with monopolar transurethral resection of the prostate (TURP), which requires electrolyte-free irrigation fluid, normal saline can be used as the irrigation solution in bipolar and laser TURP. The risk of TURP syndrome and severe electrolyte disturbance is minimized when normal saline is used as the irrigation fluid. However, the use of isotonic saline also causes acid-base imbalance and electrolyte disturbance. We experienced two patients who developed hyperchloremic metabolic acidosis during bipolar TURP. After proper intervention, hemodynamic instability resolved, and laboratory test results normalized. Anesthesiologists must pay attention to acid-base and electrolyte status when rapid absorption of excessive isotonic solution is suspected, even during bipolar and laser TURP, which use normal saline as the irrigation fluid.

scholarly journals Psychological Consequences of the Delay in the Silent Mentor Programme During the COVID-19 Pandemic: Perspectives From Family Members of Silent Mentors

2021 ◽  
pp. 003022282110009
Author(s):  
Li Ping Wong ◽  
Sik Loo Tan ◽  
Haridah Alias ◽  
Thiam Eng Sia ◽  
Aik Saw
Keyword(s):  
Mental Health ◽  
Qualitative Interviews ◽  
Psychological Impact ◽  
Family Members ◽  
Well Being ◽  
The Body ◽  
Functional Health ◽  
Psychological Consequences ◽  
Negative Effect ◽  
Health And Well Being

The COVID-19 pandemic has put a hold on the Silent Mentor Programme (SMP); this pause has not only caused unprecedented challenges for the delivery of medical education but has forced changes in the programme ceremony sessions. We aimed to describe the psychological impact and experiences of family members of silent mentors during the COVID-19 pandemic using qualitative interviews. Many expressed feelings of remorse and unrest about the unprecedented delay of the SMP. The delay increased negative emotions particularly among some elderly family members; however, there was no prominent negative effect on their functional health and well-being. Several participants relayed the belief that the soul cannot rest until the body receives a proper burial while some worried about the deterioration of the physical condition of the mentors. In conclusion, findings provide insights into the importance of not overlooking the mental health implications of delaying the SMP in future outbreaks or crises.

scholarly journals Metabolic Acidosis in Patients with CKD: Epidemiology, Pathogenesis, and Treatment

2021 ◽  
pp. 1-16
Author(s):  
Marcin Adamczak ◽  
Stanisław Surma
Keyword(s):  
Metabolic Acidosis ◽  
Sodium Bicarbonate ◽  
Current Knowledge ◽  
Venous Blood ◽  
The Body ◽  
Hydrogen Ions ◽  
Ckd Progression ◽  
New Drug ◽  
Treatment And Prevention

<b><i>Background:</i></b> Metabolic acidosis in CKD is diagnosed in patients with plasma or venous blood bicarbonate concentration lower than 22 mmol/L. Metabolic acidosis occurs in about 20% of patients with CKD. Metabolic acidosis may lead to dysfunction of many systems and organs as well as CKD progression. Currently, sodium bicarbonate is mainly used for pharmacological treatment of metabolic acidosis in patients with CKD. Veverimer is a new drug dedicated to treatment of metabolic acidosis in patients with CKD. Orally given veverimer binds hydrogen ions in the intestines and subsequently is excreted from the body with feces. Clinical studies have shown that veverimer is effective in increasing serum bicarbonate concentrations in CKD patients with metabolic acidosis. Here, we present review of the epidemiology, pathogenesis, diagnosis, treatment, and prevention of metabolic acidosis in CKD patients. <b><i>Summary:</i></b> Metabolic acidosis is common in patients with CKD and contributes to CKD progression and many complications, which worsen the prognosis in these patients. Currently, sodium bicarbonate is mainly used in metabolic acidosis treatment. The role of the new drug veverimer in the metabolic acidosis therapy needs further studies. <b><i>Key Message:</i></b> The aim of this review article is to summarize the current knowledge concerning the epidemiology, pathogenesis, diagnosis, treatment, and prevention of metabolic acidosis in CKD patients.

Political connection, family ownership and corporate risk disclosure: empirical evidence from Jordan

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Malek Hamed Alshirah ◽  
Ahmad Farhan Alshira’h ◽  
Abdalwali Lutfi
Keyword(s):  
The Body ◽  
The Political ◽  
Family Ownership ◽  
Political Connection ◽  
Risk Disclosure ◽  
Moderator Effect ◽  
Content Type ◽  
Negative Effect ◽  
Corporate Risk ◽  
Level Of Risk

Purpose This study aims to empirically examine whether the political connection is related to risk disclosure practices. The study also seeks to contribute to the existent risk disclosure literature by investigating the moderator effect of family ownership on this relationship. Design/methodology/approach The content analysis approach was used to collect data and determine the level of risk disclosure over the non-financial Jordanian firms listed on 1Amman Stock Exchange. The sample of this study contains 376 annual reports over four years from 2014 to 2017. It used the random effect regressions to examine the hypothesis of the study. Findings The results show that politically connected companies disclose less risk information than the unconnected ones in Jordan. The results also refer that family ownership contributes in mitigating the negative effect of the political connection on the level of corporate risk. Practical implications The results have implications for regulatory institutions such as the Jordan Securities Commission to take the negative effect of political connection in their consideration and impose further regulations to monitor this board’s attribute and control politicians’ domination on the board decisions. Originality/value The current study also contributes to the body of literature by investigating the effects of the political connections on the level of risk disclosure in the financial reports. To the best of the authors’ knowledge, the current study is the first to examine the effect of the political connection on the risk disclosure practices. Moreover, the study is among the first studies that examine the moderating role of family ownership on such relationship.

Organization of Therapeutic Nutrition in a Complex of Therapeutic Measures for Acute Glomerulonephritis

2020 ◽  
pp. 14-20
Author(s):  
Elena Vitalievna Perminova
Keyword(s):  
Salt Content ◽  
The Body ◽  
Acute Glomerulonephritis ◽  
Dietary Recommendations ◽  
Excretory Function ◽  
Special Diet ◽  
Organization Of Care ◽  
Negative Effect ◽  
Therapeutic Measures ◽  
High Incidence Rate

Organization of care for patients with glomerulonephritis is a rather urgent problem today, due to the high incidence rate and the tendency to progression of renal dysfunction. When discussing treatment issues, it is necessary to pay attention to the fulfillment of three basic requirements for patients, which include normalization of the life regime (in particular, the exclusion of night work, avoiding stressful situations and heavy physical activity when having high blood pressure), the implementation of certain dietary recommendations and prolonged drug treatment [3]. Diseases of the kidneys as the main organ, the affection of which leads to a deterioration of excretory function, require a special diet with a restriction of a number of products. Against the background of glomerulonephritis disruption of the process of glomerular filtration, which in some cases leads to the development of renal failure, it is necessary to reduce the intake of food substances that can have a negative effect on the body — alcohol, smoked meats, spicy, salty foods, preserves, sausages, foods with high protein and salt content. Moreover, one should also take control of the amount of fluid consumed and ensure compliance with the frequency and regularity of food intake.

EVALUATION OF TOXIOLOGICAL INDICATORS OF MONTHMORRILLONITE CLAY FOR THE PURPOSE OF USING THEM AS ALUMOSILICATE SOBENT AGAINST THE NEGATIVE EFFECT OF MYCOTOXINS ON THE BODY OF ANIMALS AND BIRDS

2021 ◽  
Vol 1 (1) ◽  
pp. 72-78
Keyword(s):  
Experimental Studies ◽  
The Body ◽  
Montmorillonite Clay ◽  
Test Substance ◽  
Negative Effects ◽  
Experimental Animals ◽  
Eyelid Edema ◽  
White Rats ◽  
Mucous Membranes ◽  
Negative Effect

The article presents the results of laboratory studies to assess the toxicological parameters of montmorillonite clay from the Pogadaevskoye deposit in the West Kazakhstan region in order to use them as an aluminosilicate sorbent in the composition of feeds that reduce the negative effects of mycotoxins on the body of animals and birds. The relevance of research is associated with the cultivation of healthy and highly productive animals and poultry in order to ensure the food security of the Republic of Kazakhstan.The studies carried out to assess the toxicological parameters of montmorillonite clay in order to use them as an aluminosilicate sorbent in experimental animals (rabbits and white rats) allowed the following results to be obtained: Visual study of the intensity of erythema when exposed to the test substance on the skin of rabbits showed their absence (0 points). The study of the intensity of edema (an increase in the thickness of the skin clutch of rabbits) when exposed to the test substance on the skin of rabbits showed no reaction (0 points). Studies evaluating the irritating effect of the test substances on the mucous membranes of the eyes of rabbits by symptoms of damage showed the absence of hyperemia (0 points). Weak eyelid edema (1 point), the minimum amount of discharge in the corner of the eye (1 point). The results of studies on the classification assessment of the test substance for the severity of the irritant effect on the eyes of rabbits showed that the average total score of the severity of the irritative effect corresponds to 1 point. A comprehensive analysis of the results obtained on the basis of scientific and experimental studies to assess the toxicological indicators of montmorillonite clay from the Pogadaevskoye deposit in relation to irritating effects on the skin and mucous membranes of experimental animals (rabbits) showed their harmlessness.

Lung Cancer Detection using Image Processing Techniques and its Classification

2021 ◽  
Vol 9 (9) ◽  
pp. 1578-1583
Author(s):  
Aishwarya .R
Keyword(s):  
Lung Cancer ◽  
Image Processing ◽  
Support Vector Machine ◽  
Cell Carcinoma ◽  
Mortality Rates ◽  
The Body ◽  
Support Vector ◽  
Lung Tumour ◽  
Image Processing Techniques ◽  
Processing Techniques

Abstract: Lung cancer has been a major contribution to mortality rates world-wide for many years now. There is a need for early diagnosis of lung cancer which if implemented, will help in reducing mortality rates. Recently, image processing techniques have been widely applied in various medical facilities for accurate detection and diagnosis of abnormality in the body images like in various cancers such as brain tumour, breast tumour and lung tumour. This paper is a development of an algorithm based on medical image processing to segment the lung tumour in CT images due to the lack of such algorithms and approaches used to detect tumours. The work involves the application of different image processing tools in order to arrive at the desired result when combined and successively applied. The segmentation system comprises different steps along the process. First, Image preprocessing is done where some enhancement is done to enhance and reduce noise in images. In the next step, the different parts in the images are separated to be able to segment the tumour. In this phase threshold value was selected automatically. Then morphological operation (Area opening) is implemented on the thresholded image. Finally, the lung tumour is accurately segmented by subtracting the opened image from the thresholded image. Support Vector Machine (SVM) classifier is used to classify the lung tumour into 4 different types: Adenocarcinoma(AC), Large Cell Carcinoma(LCC) Squamous Cell Carcinoma(SCC), and No tumour (NT). Keywords: Lung tumour; image processing techniques; segmentation; thresholding; image enhancement; Support Vector Machine; Machine learning;

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