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Lactic Acidosis Liver Failure

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Please *LIKE || COMMENT | | SHARE | | SUBSCRIBE* to support this channel. For more info visit http://www.DiseasesAndTreatment.com/ ============================================================= Lactic Acidosis ,MELAS Syndrome, what, is, causes, symptoms, diagnosis, treatment, complications, prevention , cure, risk factors, outlook, prognosis, remedies, surgery, causes of Lactic Acidosis, symptoms of Lactic Acidosis, treatment of Lactic Acidosis, diagnosis of Lactic Acidosis, Lactic Acidosis symptoms, Lactic Acidosis treatment, Lactic Acidosis causes,

Lactic Acidosis In Fulminant Hepatic Failure: Some Aspects Of Pathogenesis And Prognosis*

Lactic acidosis in fulminant hepatic failure: Some aspects of pathogenesis and prognosis * Author links open overlay panel DavidBihari*** Get rights and content To obtain further evidence of tissue hypoxia in fulminant hepatic failure, we have measured the mixed venous lactate concentration and the acid-base status of 32 patients at the time of their admission, in grade III or IV encephalopathy. The mixed venous lactate was elevated in 26 of the 32 patients (median 5.0 mmol/l, range 0.821.1 mmol/l), and, in 17 patients, this was associated with evidence of a metabolic acidosis. Mixed venous lactate levels correlated inversely with the mean arterial pressure (r = 0.56, P < 0.005), systemic vascular resistance (r = 0.62, P < 0.001) and the oxygen extraction ratio (r = 0.44, P < 0.02). The 17 patients with a raised mixed venous lactate and metabolic acidosis had a significantly reduced systemic vascular resistance and oxygen extraction ratio compared with the other 15 (median systemic vascular resistances 944 and 1710 dynes/cm5/m2, respectively, P < 0.05, median oxygen extraction ratios 19 and 23%, respectively, P < 0.05). Survival was markedly reduced in the patients with hyperlacta Continue reading >>

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Popular Questions

  1. blanketpigs

    This has been hard for me to accept. I loved to stock up on Atkins bars and have this back-up pile for variety/treats/grab'n'go meal.
    I loved the reassuring "total carbs - polyols = net carbs" line on the wrapper. It's Atkins after all, surely they know what they are talking about. Now I knew that not all sugar alcohols are equal, but I couldn't be bothered to remember which one is which, so I grouped them in my mind as "basically sweeteners with 2 kcal/g that should be treated like fiber".
    Sugar alcohol GI kcal/g

    Sugar
    100
    4
    Maltitol syrup
    52
    3
    Polyglycitol
    39
    2.8
    Maltitol
    36
    2.7
    Xylitol
    13
    3
    Isomalt
    9
    2.1
    Sorbitol
    9
    2.5
    Lactitol
    6
    2
    Erythritol
    1
    0.2
    Mannitol
    1
    1.5
    Atkins is mainly maltitol syrup with a bit of sorbitol. It does have a slower release compared to sugar, but so does pasta and anything that is not pure sugar.
    Actual net carb count for Atkins bar
    EDIT: For an estimate I counted polyols as 1/2 because of half GI, but thinking again maltitol has 3 kcal/g, which means it is 3/4 absorbed (max is 4 kcal for a carb). So instead of subtracting full 12.6g we only have to subtract 25% of 12.6, since the rest is absorbed, GI of other foods is not taken into account when calculating their net carbs after all.
    Recalculated Atkins carbs
    A general rule of thumb is - if it gives you diarrhea (like sorbitol in sugar free gummy bears), it is not impacting your blood sugar, if it doesn't (like maltitol in Atkins products) - it is impacting your blood sugar.
    I feel betrayed. Sure, it is best to avoid low carb "junk food" and graze on a celery stick dipped in peanut butter, but IMO the more options there are, the more sustainable it is.
    Seeing every single keto entry on MFP getting it wrong, including /r/keto Script, prompted me to make this post.

  2. james_bell

    You skipped glycerin which is a sugar alcohol but not digested as far as i know, and it's heavily used by Atkins. My rule of thumb is to treat maltitol and the syrup like 3/4 sugar. That puts many of Atkins bars on the bad list. Much of the rest is still okay for me tho.
    Maltitol is the cheap and easy way to claim "sugar free" on the label but because it's not as sweet as sugar they often have to use more of it than sugar.
    Edit: Also, the gassy effect that some of these have indicate they are being digested by bacteria in the large intestine, which as I understand it means some amount of it didn't make it into your bloodstream.

  3. blanketpigs

    Yep, it means that a significant amount didn't make it into your bloodstream. 1/4 can be enough if the total amount eaten was large. I've read that maltitol has a roughly 100g threshold before causing ill effects. It varies depending on how much maltitol-digesting bacteria you have.
    And yes, glycerin/glycerol is also one of the good ones. Thing is, can't tell how much of each they use. If it was all glycerin with a bit of maltitol and sorbitol, would be ok.

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BGS Global Hospital performs successful Liver Transplant to treat Acute Liver Failure Karnatakas largest liver transplant program clocks in 140 liver transplants till date Bangalore, December 7, 2016: BGS Global Hospital, a part of Parkway Pantai,successfully performed a liver transplant saving the life of a 51-year-old patient from Bangalore suffering from acute liver failure caused by anti-tuberculosis medication. His condition was fast deteriorating when he arrived at the hospital. Acute liver failure is loss of liver function that occurs rapidly in days or weeks in a person who has no pre-existing liver disease. It is much less common compared to other liver diseases requiring liver transplantation, such as decompensated cirrhosis of the liver, which develops more slowly. Acute liver failurecauses serious complications, including excessive bleeding and increasing pressure on the brain. Other organs like the heart, lungs and kidneys may also require support in such patients. It is a medical emergency that requires intensive care, ideally in transplant centres. Depending on the cause, acute liver failure can sometimes be reversed with medical treatment. In many situations, though, a liver transplant may be the only cure. A liver transplant was the only option for Manjunath. It took place in late October 2016, andlasted nearly 12 hours including the time to taken to harvest the organ from the donor. A multi-disciplinary team including Dr. Sanjay Govil, Dr. Suresh Raghavaiah Dr. Raghavendra CV (Transplant Surgery team), Dr. Vinit Shah (Hepatologist), a team of intensivists and anesthetists worked on this surgery. Commenting on the case, Dr. Sanjay Govil, Sr. Consultant, HPB & Liver Transplant Surgery said, For patients with acute liver failure, time is of the essence. Transplantation must be performed within days of hospital admission and requires an experienced and dedicated team of doctors including intensivists, hepatologists, transplant surgeons and anesthetists to maintain the patient while awaiting an organ for transplantation. Dr. Suresh Raghavaiah, Consultant, HPB & Multi Organ Transplant Surgery, added that Liver support measures such as plasma exchange to purify blood and remove toxins are particularly useful and in specific instances might permit the liver to recover spontaneously without transplantation. An elective liver transplant patient usually requires about 3 weeks of hospitalization and about 3 months of recovery outside of the hospital. In Manjunath's case, given that he was very sick, he stayed in the hospital for 5 weeks and continues to be on follow up with the doctors. Commenting on the importance of raising awareness for organ donation, Dr. Suresh Raghavaiah, Consultant, HPB &Multi Organ Transplant Surgery, said Mr. Manjunath is alive today only because of the gift of life he received through the generosity of his organ donor. There are more than 400 patients waiting for an organ right now in Karnataka. We need more people to enlist to donate their organs after death to save more lives. Each donor can save up to eight lives through organ donation. There are several factors that have led to the establishment of a robust liver transplant program in BGS Global Hospital. The foremost was the formation of a team comprising of highly skilled liver transplant surgeons, hepatologists, specialized anesthetists and intensive care experts. Dedicated and specially trained nurses form an important part of the team. Equally important are the provision of the best medical equipment available to treat critically ill patients. Notably, BGS Global Hospital is the only hospital in Karnataka with a special dedicated liver ICU where all forms of advanced liver diseases can be managed in a state of the art manner. said Mr. Thomas Mathew, Chief Operating Officer, BGS Global Hospital Bangalore BGS Global Hospital is currently host to the busiest transplant program in Karnataka with over 140 successful Liver transplants. They currently average 3-4 liver transplants a month. They have also successfully managed the most multi-organ transplants in Karnataka including 7 Liver-Kidney and 3 Kidney-Pancreas transplants. BGS Global Hospital has an experienced team performing a high number of living donor Liver Transplants. This year alone, they have performed more than 40 transplants, including 11 living donor liver transplants, with a success rate of over 90%. About BGS Global Hospital BGS Global Hospital at Bangalore is a unit of Global Hospitals India. Global Hospitals is part of Parkway Pantai, a fully owned subsidiary of IHH Healthcare. In India Global Hospitals operates a chain of multi-super specialty hospitals offering tertiary and quaternary healthcare services with over 2,000 beds and state-of the-art, world-class hospitals in Hyderabad, Chennai, Bangalore and Mumbai. A pioneer in kidney, liver, heart and lung transplants, Global Hospitals provides comprehensiv

Significant Lactic Acidosis With Acute Liver Failure At Presentation In Haemophagocytic-lymphohistiocytosis

The causes of acute liver failure in early infancy require prompt recognition and treatment to improve the prognosis. High serum lactate levels typically lead the clinician to consider mitochondrial or other metabolic disorders. We describe a series of young infants with Haemophagocytic Lymphohistiocytosis (HLH) who initially presented with unusually high lactate levels. Retrospective case note analysis of children with a final diagnosis of HLH who had high lactate levels at presentation. We identified 5 infants (M: F 3:2) with a median age of 34 (3-270) days, all presenting with pyrexia, poor feeding, deranged liver function tests and worsening coagulopathy. All had hepatosplenomegaly and ascites detected clinically or by ultrasound examination. Significant lactic acidosis was present early in the illness (median 14.2 (10.5-29.8) mmol/l) despite adequate perfusion and renal function in 4 out of the 5 infants. Extensive investigations for possible metabolic causes did not yield an alternative diagnosis. All were thrombocytopenic (median19,000 (7,000-23,000)/mm3) and had low fibrinogen levels (0.5 (0.5-0.7) g/l). Hyperferritinaemia (32,055 (20,000-180,370) nanogram/ml) and elevated Continue reading >>

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Popular Questions

  1. bookyeti

    Hello, Keto veterans out there! How do I know if I'm in ketosis? I know it's not overly necessary to know, but I'm curious.
    I've been sticking to Keto faithfully for 5 days now, keeping my macros at 5%C-25%P-70%F. I've never been over 20g of net carbs since I started, and I have been hitting my 70-75% fat macro almost perfectly.
    I have read about the "ketosis" signs to look for ('fruity' breath, different smell to urine, metalic taste in the mouth, more energy), but I haven't noticed any of these. The only thing is that I lost 2 lbs. overnight. I also haven't been experiencing the dreaded "carb flu" that everyone talks about, but that may be because I've been keeping my fat intake quite high (70-75%) and drinking plenty of water (10-12 glasses at least). Also in the past month I have been reducing my carbs gradually down to about 100-125g/day, until I started keto five days ago.
    Is there anyway to know for sure?
    (Unfortunately, I don't have any Keto strips, at the moment - they don't sell them near here, so I had to order them online. They're in the mail.)

  2. RiesigJay

    My personal glucose-to-ketones transition may be unique, but I remember sitting at the dining room table, doing homework on my laptop, when I got the sudden urge to go for a run or exercise or something.
    I ended up cleaning up the whole apartment (at the time I was attending college and had 4 housemates - I'm sure you can imagine how messy it was). I literally could not continue sitting and clacking away at the keyboard. I had to move.
    That was my transition and I knew, without a doubt, I had entered ketosis. Perhaps your experience will be similar.

  3. albertabeefy

    Hello, Keto veterans out there! How do I know if I'm in ketosis? I know it's not overly necessary to know, but I'm curious.
    I've been sticking to Keto faithfully for 5 days now, keeping my macros at 5%C-25%P-70%F. I've never been over 20g of net carbs since I started, and I have been hitting my 70-75% fat macro almost perfectly. It would be virtually impossible to NOT be in ketosis at this point. You're well on your way to being fully keto-adapted.
    I have read about the "ketosis" signs to look for ('fruity' breath, different smell to urine, metalic taste in the mouth, more energy), but I haven't noticed any of these. Many people do NOT experience those. Those are signs during the initial entry into ketosis usually experienced by someone who's done a much-more drastic dietary change than you've done.
    If you're used to eating 50-60% carbs, then go into ketosis, you'll likely experience some or all of those symptoms for a day or two, sometimes more. For someone that's reduced carbohydrate more gradually, and is already relatively low-carb, the shift is often asymptomatic.
    The only thing is that I lost 2 lbs. overnight. I also haven't been experiencing the dreaded "carb flu" that everyone talks about, but that may be because I've been keeping my fat intake quite high (70-75%) and drinking plenty of water (10-12 glasses at least). Also in the past month I have been reducing my carbs gradually down to about 100-125g/day, until I started keto five days ago. The weight-loss is likely a result of lost water/glycogen as you push further into keto-adaptation. Because you were already quite low-carb, you'll likely not experience the 'keto-flu' or other symptoms.
    Is there anyway to know for sure?
    (Unfortunately, I don't have any Keto strips, at the moment - they don't sell them near here, so I had to order them online. They're in the mail.) Ketostix sometimes don't even register, especially for those of us that stay well-hydrated. If you test on a day when your water intake is lower, you'll most definitely get a pink result. Purple would mean you're very dehydrated ...
    If you've already been under 100g and at a reasonable caloric intake, it's also quite possible you already WERE in ketosis and didn't know it. Many people mistakenly think you need to eat 20-30g to be in ketosis, and that's not necessarily the case.
    It's easier to GET ketogenic starting at 20-30g a day, and some find best glycemic control, etc., at very low levels, but most people eating 2000+ calories a day can easily maintain ketosis/keto-adaptation at 100g a day of carbohydrate if they're not sedentary.
    As an anecdotal example, for me to get OUT of ketosis takes 2-3 full SEDENTARY days of 150g + carbohydrate intake. There are some people that think I'm not ketogenic at 50 or 70g of carbohydrate a day . . . they're simply misinformed.
    Lyle McDonald - a leading expert on ketogenic diets - states:
    "Since many books give the 30 g/day value for a ketogenic diet, folks get a little anxious about carb intakes that are higher than that.
    However, strictly speaking, any diet with less than 100 g/day of carbohydrate will cause ketosis to develop to some degree (more ketones will be generated as carbs are lowered)." Those who engage in exercise, especially strength-training, can often eat a little more than others without issue. Lyle did some calculations (rough, by his own admission) and states:
    "The carbohydrate requirements for weight training actually aren’t that great. I did some rough calculations in The Ketogenic Diet and concluded that, for every 2 work sets (assuming a set length of 30-45 seconds) or so, you’ll need 5 grams of carbohydrates to replenish the glycogen used.
    So if you did a workout containing 24 work sets, you’d only need about 60 extra grams (24 sets * 5 grams/2 sets = 60 grams) of carbohydrate to replace the glycogen used." 24 sets is 4 sets of six exercises ... which is a fairly heavy day for many of us. I typically do 5 sets of 4 exercises every-other-day. This would be 20*5/2 = 50g ... however I'm a little larger than most so I'll typically have 50, 70 even 90g of carbohydrate on my strength-training days, depending on the effort.
    So, what I'm saying is if you were exercising, especially doing strength-training or any anaerobic interval training, etc., while eating 100-125g of carbohydrate a day, you were quite-possibly already IN ketosis . . .

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To get mycotoxins out of your body, the best supplement is "Bind" from Systemic Formulas. It is an activated charcoal product. Here's a good anti-candida diet: http://www.myradiary.com/1214/candida.... Please like, share and subscribe to my YouTube page to get notifications whenever I post a new video! You have already taken the first step to better your health by watching my video! Next, I recommend that you join our Long Distance Patient Program so that you can get diet modification and supplement recommendations designed specifically for you by me or one of my fellow practitioners in our Ann Arbor, Michigan office. You have to be a patient of our office in order to receive supplements, per our distribution agreement with the producer of the Standard Process brand supplements. Becoming a Long Distance Patient as outlined below allows you that access. In order to be part of our online patient program, you would purchase an annual membership for $200. This membership includes an initial 30 minute phone appointment with me or one of our practitioners. At that time, the practitioner will make a recommendation to you for diet modifications, supplements and the quantities that you should take. After the phone call, you are able to order supplements for a year, as needed, directly from our website and our app. We will then promptly ship the supplements out to you. Follow up phone calls with your practitioner are $125 for a 20 minute phone/SKYPE appointment. If you would like to move forward and take advantage of this opportunity, please call: (734) 302-7575 or email [email protected] to schedule your phone appointment, and make the $200 payment. You can reach us by phone Monday through Saturday 9am-5pm EST. To learn more about our office and clinical practice, go to: http://thenutritionalhealingcenter.com Since not everyone is fortunate enough to live within driving distance of Ann Arbor, Michigan, and many feel that an telephone/online consultation is not enough to meet their clinical needs, I am happy to offer you our Long Distance Patient Travel Package. The package is comprised of a series of appointments with myself or another practitioner that are time sensitive, and a time allowance of 48-72 hours in our beautiful city is required. Not only are your health issues of concern thoroughly evaluated, but you receive a comprehensive full body evaluation, two different computerized cardiac health tests, a great deal of teaching and health education, and leave with a program of diet modification and supplement support that the practitioner is confident will improve your health and quality of life. This program can initiate your relationship with our clinic, and be followed up with telephone/online consultations, or it can be incorporated into your already existing program with our clinic to further enhance the program you already have in place. The cost for the Long Distance Travel Package is $560 and includes everything mentioned above. We also have a relationship with a lovely landmark hotel conveniently located less than 2 miles from our office, that offers a reduced nightly rate to our patients. In the meantime, if you are truly interested in what we have to offer, please watch these 5 important videos of mine: https://www.youtube.com/playlist?list... If you find my info helpful, please visit my Patreon page. https://www.patreon.com/drdarrenschmi... We look forward to helping you feel your best! This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. UCC 1-308 without prejudice.

Causes Of Lactic Acidosis

INTRODUCTION AND DEFINITION Lactate levels greater than 2 mmol/L represent hyperlactatemia, whereas lactic acidosis is generally defined as a serum lactate concentration above 4 mmol/L. Lactic acidosis is the most common cause of metabolic acidosis in hospitalized patients. Although the acidosis is usually associated with an elevated anion gap, moderately increased lactate levels can be observed with a normal anion gap (especially if hypoalbuminemia exists and the anion gap is not appropriately corrected). When lactic acidosis exists as an isolated acid-base disturbance, the arterial pH is reduced. However, other coexisting disorders can raise the pH into the normal range or even generate an elevated pH. (See "Approach to the adult with metabolic acidosis", section on 'Assessment of the serum anion gap' and "Simple and mixed acid-base disorders".) Lactic acidosis occurs when lactic acid production exceeds lactic acid clearance. The increase in lactate production is usually caused by impaired tissue oxygenation, either from decreased oxygen delivery or a defect in mitochondrial oxygen utilization. (See "Approach to the adult with metabolic acidosis".) The pathophysiology and causes Continue reading >>

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Popular Questions

  1. Bekky1975

    Just out of hospital following DKA

    Hi
    I'm off work following recovery from recent keto-acidosis. Been T1 diagnosed for nearly 5 years but really struggle to accept my illness. Try and pretend I don't have Diabetes. Did anyone else out there have this problem? What will it take to get out of this denial? I'm 31 and thought I would be more sensible!!!

  2. vrocco1

    I'm very sorry you had that experience. How did you end up DKA? I'm guessing you skipped a dose of insulin?
    It has only happened to me once, and that was during a month long bout with the flu. I really learned my lesson on that one. Keeping your A1C low is a lot of effort, but keeping yourself out of the hospital does not take much effort at all.
    You may be suffering from a bit of depression, and that is why you are in denial. You might want to talk to your Doctor about that possibility. Denial is definitely our enemy. Depression is very common in diabetics.
    I hope you decide to spend some time with us. It really can help! I sure hope you feel better soon.

  3. Jodes800

    Hi Bekky,
    I totally understand what you're going through! I was daignosed at 10 but had a couple of years when I was a teenager that I went into denial. I would still have my injections but would eat whatever I liked!
    I soon realised that this way of thinking was doing me no good and that I had to deal with it or go on feeling ill for the rest of my life so I started taking better care of myself. I also thought about the complications that could arise in the future and what that could mean for me...for example would I be able to have the family that I have always dreamed of?
    I have been in and out of hospital on many occassions with Ketoacidosis, due to viruses and stomach bugs etc, but the doctors never told me what it was! I didn't know anything about Ketoacidosis and because of this i had a really severe Ketoacidosis incident when I was 18. I was at university and was feeling progressively more unwell...I went to A & E where doctors failed to do any blood or urine samples and diagnosed me with anxiety! I also called another doctor out that night who gave me a sleeping tablet and left me in my room alone and with no medical assistance...I was found the next morning minutes from death..and was in Intensive care for a week.
    I totally understand how you must be feeling at the moment as it takes away all your energy and takes a while for you to start feeling stronger. The Ketoacidosis won't cause any long term damage to your health but you should be aware that not taking care of your diabetes or having an illness of any kind can cause Ketoacidosis. More often than not it is treated quickly and efficiently by the medical proffessionals but sometimes it isn't-like in my case-so always check for ketones if you start to feel unwell or your blood sugars run high.
    You won't be in denial forever..diabetes takes a long time to understand and come to terms with....at 10 years old I think it may have been easier for me to accept than for someone diagnosed in their 20's...but I still found it incredibly hard!
    You've done the right thing joining this site as there are so many great people out there to talk to and for the first time since my diagnosis 15 years ago I feel like I can offload my fears and anxieties and also share good news with people who can empathise with what I'm going through...We're all here to help and anytime you feel down tell us about it and we'll try to help! We all understand how you're feeling!
    Big hugs!

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