Lactic Acidosis Nejm

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Hear first-hand from seven residents how this program delivers on its promises. Features, observations and personal accounts. http://www.hopkinsbayview.org/medicin... See us on facebook at "Johns Hopkins Bayview Internal Medicine Residency"

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61 yo F with HTN, DM brought in by daughter for acute onset of a single acuteepisode of visual hallucinations. She saw a girl (non existent) run across her living room and then saw lasagna (non existent) all over herself. Daughter was with her at this time and called 911. Medical and neurologicalproblems were ruled out with MRI/MRA, labs, complete neurological exam. On further asking she says that her visual acuity has declined over past few months. She had possibly Charles Bonnet syndrome. Charles Bonnet syndrome is a benign condition where patients with decreased visual acuity have vivid visual hallucinations as a release phenomenon. Reassurance and treatment of the underlying visual disorder is the treatment of this disorder. 32 yo M brought in by sister and mother for sitting in a water-filled bathtub for three whole days. He sat in the tub all dressed and did not eat/drink for the whole time but ketp reading the bible stating that he had to save mankind by reading the bible. When brought in to the ED, other than being agitated, hyper-religiousand needing restraints, he also displayed autonomic instability. DDx included Neuroleptic Malignant Syndrome,acute psychosis, malignant Continue reading >>

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  1. Scrunchii

    Ok, ok I know...don't fast while breastfeeding!
    Problem is, I breastfeed my kids a long time and I've been either preggo or breastfeeding for 6.5 years (I have two kids, 5 and 2). I spontaneously IF and eat in a 6-10 window depending on when I get hungry. I need to lose some weight because of some back pain and was wanting to do some short (1-2 days) fasts.
    So, has anyone here fasted while breastfeeding? What happened to your milk? What are the arguments against breastfeeding and fasting? Thank you for any info.

  2. Chellb

    I have no personal experience with fasting and breastfeeding, but I understand what you mean about the "Just wait until you're done breastfeeding" advice, since I too measured my breastfeeding time in years, not months. So, no real advice, just commiseration. For solid breastfeeding advice, Kellymom is always a good place to start: http://kellymom.com/nutrition/mothers-diet/fasting/

    It looks like it's mostly about religious fasting. Oh, and I should mention that my kids are now Loonnngg past the bfing stage.

  3. Scrunchii

    Thanks for the link. I'll check it out.
    Since my baby is two years old now I was thinking about some fasting experiments.

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WATCH FULL VIDEO: https://goo.gl/APNPrA?73961

Metformin Induced Lactic Acidosis Nejm

by : incidence, management and prevention. Drug Saf 2010;33(9):727-40. 3. Kalantar-Zadeh K, Uppot RN, Lewandrowski KB. Case records of the Massachusetts General Hospital (Case 23-2013). A 54-year-old woman with abdominal pain, vomiting, and confusion. N Engl J Med 2013;Jan 22, 1998 Correspondence from The New England Journal of Medicine in Patients with Diabetes Treated with . Prepare to become a physician, build your knowledge, lead a health care organization, and advance your career with Group information and services. Dec 11, 2014 Using dialysis to provide bicarbonate can prevent a decrease in ionized calcium, prevent volume overload and hyperosmolality (potential complications of bicarbonate infusion), and remove substances associated with , such as . Through an alkalinizing effect, base administration,Aug 31, 1995 Such a mechanism of action might diminish the removal of lactate from plasma and present a risk of . .. On the other hand, if the - increase in the sensitivity of muscle to insulin included an anticatabolic effect of insulin on protein metabolism, one would expect no change inJan 2, 2003 is a toxic effect of linezolid whose mechanism is unknown. Other drugs, includi Continue reading >>

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    I've seen quite a few people struggling with intermittent fasting this week. You did not have to go nuts with it on your first day. Go as long as you can without eating in the morning. If that's only 30 more minutes than what you normally would do, then that's fine.
    Work your way up to it. You'll be able to go longer and longer stretches the more times you try it. Stop trying to be a superhero on your first day of intermittent fasting.
    You'll start to get in the groove of it, and you have a bad day, then eat! And try again another day. Intermittent fasting shouldn't be a huge struggle.
    Also, you don't have to do it everyday. Do it once a month if that's all you can mentally handle. It's totally fine.

  2. JustFluffy

    It's also 100% okay if IF just isn't right for you! Some people like having smaller, more frequent meals, some people can handle only eating once or twice a day. Everyone is different.
    As long as you're losing, do what works best for you. IF is just an added tool/benefit.

  3. trojanguy

    Yeah, I was going to ask what the point is. I eat 3 meals a day and am feeling great, losing weight, etc. Wasn't sure why I'd throw fasting into the equation.

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Learn how to deal with Infant Choking & Perform Infant CPR today. Watch our video and share with your friends.

Lactic Acidosis In An Infant Receiving Hiv Prophylaxis

Lactic Acidosis in an Infant Receiving HIV Prophylaxis The rate of vertical transmission of human immunodeficiency virus (HIV) has dramatically decreased with the administration of antiretroviral treatments (ART) to HIV-infected mothers and their infants. The Pediatric AIDS Clinical Trials Group 076 (PACTG 076) originally showed zidovudine, a nucleoside analogue reverse transcriptase inhibitor (NRTI), to be a safe and effective therapy in preventing vertical transmission when administered to both mother and child.1 Guidelines currently recommend zidovudine for HIV prophylaxis for 4-6 weeks for neonates exposed to HIV in utero.2 Despite the overall safety findings of zidovudine from PACTG 076, rare, but serious, side effects have been observed. Although data are conflicting, NRTIs have been linked to mitochondrial toxicity that leads to lactic acidosis, cardiac abnormalities, neurologic delays, and death.3-5 We present a case of presumed mitochondrial toxicity and lactic acidosis in an infant exposed to zidovudine for HIV prophylaxis. A 5-week-old female born to an HIV-positive mother presented to a referring hospital for excessive vomiting of 2 days duration. Emesis was reported t Continue reading >>

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  1. JEarle99

    Someone told me while doing ketosos, you should drink lemon water to reduce the chance of kidney stones. If I'm having half of a lemon in water, is it likely to get kicked out of ketosis?
    The only other carbs in eating is spinach, kale and avocados.

  2. larry

    Lemon juice is 8 % carbohydrate. So figure out how much you're taking in and add it to your daily carbohydrate count.

  3. Fiorella

    I doubt it. Juice from one lemon is about 6 g net carbs. If you use quarter lemon in a mug of hot water, it will likely not be a problem. I drink black tea everyday, and a add fresh slices of lemon. It does not kick me out of ketosis. But, the best thing to do is test and see how your body takes it.

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