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Effects Of Metabolic Acidosis On Cardiovascular System

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Metabolic Acidosis And Cardiovascular Disease

Metabolic acidosis can be acute (lasting minutes to a few days) or chronic (lasting weeks to years) in nature. Depression of cardiac function is a common complication of acute metabolic acidosis developing when blood pH is <7.17.2. The response to catecholamines is also muted. The mechanisms underlying these effects are complex involving activation of several channels or transporters. Both a reduction in interstitial and intracellular pH appear to play a role. Administration of base in the form of bicarbonate does not improve cardiac function despite improvement in extracellular pH. This might be related to excess generation of carbon dioxide during the buffering process and a reduction in ionized calcium. The link between chronic metabolic acidosis and cardiovascular disease is less clear. No acute effects have been noted. Some studies suggest acidosis contributes to development of hypertension. A role in genesis of ischemic cardiovascular disease is also postulated. The chapter reviews available information on the impact of acute and chronic metabolic acidosis on cardiovascular function, the possible underlying mechanisms, and the impact of base therapy. Do you want to read the Continue reading >>

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Popular Questions

  1. Tresmemphis

    I have a question. Im having a difficult time consuming my 1080 calories a day. Im getting between 600-800. But they are in the percentage of 70-80 percent fat, 15 percent protein and 5 percent carb. My question is due to low calories can I get knocked out of ketosis?

  2. mummydee

    It is What you eat , not how much that puts you into ketosis. Your body will burn sugars first for energy and by removing all sugars in every form your body then moves into using fat for energy.
    If you are on Atkins induction you still must eat 20 net grams of carbs but only from veggies creams and cheeses.
    You will get knocked out of ketosis the moment you eat any sugars.
    If it is a plant, eat it, if it comes from a plant, don't!

  3. k9gold

    If your on induction and on Atkins 20 you should be eating 20 NC with 12-15 of them coming from foundation veggies. You should be having 4 to 6 oz of protein with each of the three meals. The cheese limit is 4oz a day and some people find to lose they need to consume less than 4oz. Calories for women are 1500-1800. The Atkins site has the list of foods for all phases. If you eat to little calories your body goes into starvation mode and holds on to everything. Hope this helps

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Find out how the sympathetic nerves increase the heart's force of contraction and speed of relaxation! Rishi is a pediatric infectious disease physician and works at Khan Academy. Created by Rishi Desai. Watch the next lesson: https://www.khanacademy.org/test-prep... Missed the previous lesson? https://www.khanacademy.org/test-prep... NCLEX-RN on Khan Academy: A collection of questions from content covered on the NCLEX-RN. These questions are available under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 United States License (available at http://creativecommons.org/licenses/b...). About Khan Academy: Khan Academy offers practice exercises, instructional videos, and a personalized learning dashboard that empower learners to study at their own pace in and outside of the classroom. We tackle math, science, computer programming, history, art history, economics, and more. Our math missions guide learners from kindergarten to calculus using state-of-the-art, adaptive technology that identifies strengths and learning gaps. We've also partnered with institutions like NASA, The Museum of Modern Art, The California Academy of Sciences, and MIT to offer specialized content. For free. For everyone. Forever. #YouCanLearnAnything Subscribe to Khan Academys NCLEX-RN channel: https://www.youtube.com/channel/UCDx5... Subscribe to Khan Academy: https://www.youtube.com/subscription_...

Acidosis And Contractility Of Heart Muscle.

Acidosis and contractility of heart muscle. The contractility of heart muscle is sensitive to small and physiological changes of extracellular pH. The reduction of contractility associated with an acidosis is determined by the fall of pH in the intracellular fluid. The function of many organelles within the cardiac cell is affected by hydrogen ions. The tension generated by isolated myofibrils at a fixed calcium concentration is reduced at low pH. The dominant mechanism for the reduction of contractility in whole tissue is competitive inhibition of the slow calcium current by hydrogen ions. The reduction of the slow calcium current is similar when the same fall of developed tension is induced by acidosis or by a reduction of extracellular calcium concentration. Measurement of tissue pH with fast-responding extracellular electrodes show that, in myocardial ischaemia, tissue acidosis develops at the same time or only seconds before the onset of contractile failure. Much of the reduced contractility can be accounted for by the severity of the acidosis. Although a mild acidosis can delay or prevent damage to the myocardium from ischaemia or hypoxia, a severe acidosis is not beneficial Continue reading >>

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Popular Questions

  1. legking

    Ketostix = negative! Wft!?

    I was browsing the forums and found several references to Ketostix, so I picked some up. However, ALL of my tests (tried yesterday about 5 times, and once this morning as soon as I woke up) came out negative!
    I'm on CKD right now, a day before my carb-up, and I'm flummoxed. I'm very diligent about what I take in; I mean, the vast majority of my diet consists of tuna & mayo, pepperettes, cheese, salmon and nuts.
    The only explanation I can think of is either I'm not using them correctly, or I drink so much water and pee so often that any ketones would be so diluted as to come up negative. Can anyone with experience with this gimme some feedback? Thanks in advance!

  2. Man2kx

    How long have you been dieting the CKD phase for?
    What do your workouts look like? Are you getting enough intensity?
    How much liquid do you drink a day?
    As far as using them correctly, you're supposed to urinate and wait for the color for 15 seconds. It usually shows up instantly though but for very slight changes in hue (i.e. to maybe see some pink) then you may have to wait your 15 secs.

  3. Jason762

    2.17: How can I tell if I'm in ketosis?
    A: The primary method: Ketostix (urine analysis strips) . Ketostix can be obtained at a pharmacy. If your pharmacy has a diabetics supply area, it will be there, otherwise simply ask the pharmicist. Ketostix measure the prescence of ketones in the urine. If the strips get dark, you're in ketosis. Ketosis is also evidenced by particuarly bad or "fruity" breath and foul smelling urine. A metallic taste in the mouth is also commonly noted. Many people notice a different mental state when they're in ketosis. For some, they get "foggy" about things while others are exactly the opposite: they feel more alert. This appears to vary considerably from individual to individual. Ketostix are not a completely reliable indication of ketosis, but it's the best we have. [HC]
    2.18: What if my ketostix aren't getting dark?
    A: There are varying degrees of ketosis. If the strips aren't changing color at all, you may still be in, just not excreting sufficient ketones to react the sticks. But as long as you are showing at least "trace", you are in ketosis. The correlation of the degree of darkness of the strips to fat loss is unclear, the strips represent the amount of ketones present in the urine (i.e. excreted). If you burned up all your ketones as energy , the strips won't show anything. Darker strips don't necessary indicate greater fat loss. Some individuals find that lesser degrees of ketosis are better for fat loss although this is not universal. [HC]
    Hope this helps. Got it from http://low-carb.org/faq/#Q1
    Jason

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Block 2, Week 8, Faculty Objective 6

Physiological Effects Of Hyperchloraemia And Acidosis

Physiological effects of hyperchloraemia and acidosis Chelsea and Westminster NHS Foundation Trust Chelsea and Westminster NHS Foundation Trust BJA: British Journal of Anaesthesia, Volume 101, Issue 2, 1 August 2008, Pages 141150, J. M. Handy, N. Soni; Physiological effects of hyperchloraemia and acidosis, BJA: British Journal of Anaesthesia, Volume 101, Issue 2, 1 August 2008, Pages 141150, The advent of balanced solutions for i.v. fluid resuscitation and replacement is imminent and will affect any specialty involved in fluid management. Part of the background to their introduction has focused on the non-physiological nature of normal saline solution and the developing science about the potential problems of hyperchloraemic acidosis. This review assesses the physiological significance of hyperchloraemic acidosis and of acidosis in general. It aims to differentiate the effects of the causes of acidosis from the physiological consequences of acidosis. It is intended to provide an assessment of the importance of hyperchloraemic acidosis and thereby the likely benefits of balanced solutions. Hyperchloraemic acidosis is increasingly recognized as a clinical entity, a new enemy within, Continue reading >>

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Popular Questions

  1. nilanjana

    Ketones are relatively much harder to oxidise, but they do undergo oxidation reactions at extreme temperatures. Our teacher also told us about Popoff's rule which says that during oxidation of unsymmetrical ketones, the


    >
    C
    =

    O group remains with the smaller of the two alky groups.. Could you please give me a hint as to how this happens, and the probable reaction mechanism for this?
    Also, please give the complete balanced equation when Butan-2-one is oxidized to a carboxylic acid.

  2. Ben Norris

    I am uncertain about the "Popoff's" rule you mention. There are two reactions that can oxidize ketones, and one seems to follow the behavior you are suggesting, but does not form a carboxylic acid. The other reaction does form carboxylic acids, but is more complex.
    The Baeyer-Villager oxidation is an oxidation of ketones to esters using a peracid in the presence of a mild base:


    C
    H




    3COC
    H




    3 + RC
    O




    3
    H




    N
    a




    2HP
    O





    4


    → C
    H




    3C
    O
    − OC
    H




    3 +
    RCOO
    H
    The mechanism involves the fragmentation of on of the C-CO bonds. Unsymmetrical ketones fragment in a predictable pattern, but not always that the carbonyl remains with the smaller group. The fragment that would be a more stable carbocation (even though carbocations are not formed in this reaction) is the one to move. The migratory aptitude is tertiary alkyl > cyclohexyl > secondary alkyl, aryl > H > primary alkyl > methyl . For exampl, with 2-methyl-3-octanone, the isopropyl group moves because it is attached via a

    2
    ∘ carbon:


    (C
    H




    3)




    2CHCOC
    H




    2C
    H




    2C
    H




    2C
    H




    2C
    H




    3 + RC
    O

    O
    − O
    H




    N
    a




    2HP
    O





    4


    → (C
    H




    3)




    2C
    H
    OCOC
    H




    2C
    H




    2C
    H




    2C
    H




    2C
    H




    3 +
    RCOO
    H
    Nitric acid chews ketones apart into two carboxylic acids. Concentrated

    KMn
    O





    4 in acid also does this. These reactions are a little bit harder to find information on, since they tend to be considered uncontrollable.
    The reaction goes through a series of oxidations from ketone to

    α-hydroxyketone to cleaved acids through several enol intermediates.


    RC
    H




    2COC
    H




    2
    R


    HN
    O





    3


















    − RC
    H
    =
    C(O
    H)C
    H




    2
    R




    HN
    O





    3


    → RC
    H(O
    H)COC
    H




    2

    R

    RC
    H(O
    H)COC
    H




    2
    R


    HN
    O





    3


















    − R
    C(O
    H)
    =
    C(O
    H)C
    H




    2
    R




    HN
    O





    3



    RC
    O
    If the ketone is unsymmetrical, there is no guarantee that is will cleave predictably. For example, 2-butanone could cleave into propoanic acid and carbon dioxide or two equivalents of acetic acid.


    C
    H




    3C
    H




    2COC
    H




    3




    HN
    O





    3



    n(C
    H




    3C
    H




    2COO
    H + C
    O




    2) + (1-
    n)(2C
    H




    3COO
    H
    )
    A balanced equation for the formation of acetic acid would look like:

    C
    H




    3C
    H




    2COC
    H




    3 + 3N
    O




    3

    − +
    ⟶ 2C
    H




    3C
    O




    2
    H + 3N
    O




    2



    A balanced equation for the formation of propanoic acid and carbon dioxide would look like:

    C
    H




    3C
    H




    2COC
    H




    3 + 4N
    O




    3

    − +
    ⟶ C
    H




    3C
    H




    2COO
    H + C
    O




    2 + 4N
    O




    2

    − +
    H




    2

    O
    The permanganate reactions are tougher to balance, since permanganate is a three electron oxidant.
    Update
    When I wrote this answer, I had never heard of Popoff's rule. No textbook I own mentions this rule, and a Google search about it brings up this question as the top hit (and similar questions at other sites like ask.yahoo.com as the other hits). I now know that Aleksandr Popov published a paper in Liebigs Annalen in 1872 describing a variation of the reaction that would become the Baeyer-Village oxidation. This article is behind a paywall for me, and the first page preview confirms I would not be able to make much of it. I only know a small amount German and the PDF sadly looks like a low quality copy of a copy of a copy.
    However, from the title Die Oxydation der Ketone als Mittel zur Bestimmung der Constitution der fetten Säuren und der Alkohole I can parse what the paper was about. Roughly this paper was about The oxidization of ketones - a means for determining the constitution of the fatty acids and alcohols . Thus his method involved the oxidation to the ester and hydrolysis of said ester in one step. I don't know what reagents Popov used, but I'm preety sure it was not a peroxyacid (since this reagent will not hydrolyze the ester). I have previously answered a question about migratory aptitude in Baeyer-Villager reactions. Since I cannot read Popov's paper, nor can I find any authoritative resource on his rule (on- or offline), I have to assume that the known migratory aptitude for the Baeyer-Village reaction is the same as Popov's rule.
    Migratory aptitude in Baeyer-Villiger reaction

  3. Muhammad Tariq Waqas

    Popoff's rule states that during the oxidation of an unsymmetrical ketone, the cleavage of the C-CO bond is such that the keto group always stays with the smaller alkyl group. so but-2-one on oxidation give ethanoic acid

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