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Metabolic Acidosis In Shock

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What is INSULIN SHOCK THERAPY? What does INSULIN SHOCK THERAPY mean? INSULIN SHOCK THERAPY meaning - INSULIN SHOCK THERAPY definition - INSULIN SHOCK THERAPY explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Insulin shock therapy or insulin coma therapy (ICT) was a form of psychiatric treatment in which patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks. It was introduced in 1927 by Austrian-American psychiatrist Manfred Sakel and used extensively in the 1940s and 1950s, mainly for schizophrenia, before falling out of favour and being replaced by neuroleptic drugs in the 1960s. It was one of a number of physical treatments introduced into psychiatry in the first four decades of the twentieth century. These included the convulsive therapies (cardiazol/metrazol therapy and electroconvulsive therapy), deep sleep therapy and psychosurgery. Insulin coma therapy and the convulsive therapies are collectively known as the shock therapies. Insulin coma therapy was a labour-intensive treatment that required trained staff and a special unit. Patients, who were almost invariably diagnosed with schizophrenia, were selected on the basis of having a good prognosis and the physical strength to withstand an arduous treatment. There were no standard guidelines for treatment; different hospitals and psychiatrists developed their own protocols. Typically, injections were administered six days a week for about two months. The daily insulin dose was gradually increased to 100150 units until comas were produced, at which point the dose would be levelled out. Occasionally doses of up to 450 units were used. After about 50 or 60 comas, or earlier if the psychiatrist thought that maximum benefit had been achieved, the dose of insulin was rapidly reduced before treatment was stopped. Courses of up to 2 years have been documented. After the insulin injection patients would experience various symptoms of decreased blood glucose: flushing, pallor, perspiration, salivation, drowsiness or restlessness. Sopor and comaif the dose was high enoughwould follow. Each coma would last for up to an hour and be terminated by intravenous glucose. Seizures sometimes occurred before or during the coma. Many would be tossing, rolling, moaning, twitching, spasming or thrashing around. Some psychiatrists regarded seizures as therapeutic and patients were sometimes also given electroconvulsive therapy or cardiazol/metrazol convulsive therapy during the coma, or on the day of the week when they didnt have insulin treatment. When they were not in a coma, insulin coma patients were kept together in a group and given special treatment and attention; one handbook for psychiatric nurses, written by British psychiatrist Eric Cunningham Dax, instructs nurses to take their insulin patients out walking and occupy them with games and competitions, flower-picking and map-reading, etc. Patients required continuous supervision as there was a danger of hypoglycemic aftershocks after the coma. In "modified insulin therapy", used in the treatment of neurosis, patients were given lower (sub-coma) doses of insulin. A few psychiatrists (including Sakel) claimed success rates for insulin coma therapy of over 80 percent in the treatment of schizophrenia; a few others argued that it merely sped up remission in those patients who would undergo remission anyway. The consensus at the time was somewhere in between - claiming a success rate of about 50 percent in patients who had been ill for less than a year (about double the spontaneous remission rate) with no influence on relapse. Sakel suggested the therapy worked by "causing an intensification of the tonus of the parasympathetic end of the autonomic nervous system, by blockading the nerve cell, and by strengthening the anabolic force which induces the restoration of the normal function of the nerve cell and the recovery of the patient." The shock therapies in general had developed on the erroneous premise that epilepsy and schizophrenia rarely occurred in the same patient. Another theory was that patients were somehow "jolted" out of their mental illness.

Causes Of Metabolic Acidosis In Canine Hemorrhagic Shock: Role Of Unmeasured Ions

Causes of metabolic acidosis in canine hemorrhagic shock: role of unmeasured ions 6Clinic of Anesthesiology, Intensive Care Medicine and Pain Management, Krankenhaus Nordwest, Steinbacher Hohl 2-26, 60488 Frankfurt, Germany 1Clinic of Anesthesiology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 Munich, Germany 2Department of Thoracic and Vascular Surgery, University of Ulm, Steinhvelstrasse 9, 89075 Ulm, Germany 3Department of General, Visceral and Thoracic Surgery, Clinic of Nuremberg, Prof.-Ernst-Nathan-Strasse 1, 90419 Nuremberg, Germany 4Sangart Inc., 6175 Lusk Blvd., San Diego, CA 92121, USA 5Alliance Pharmaceutical Corp., 4660 La Jolla Village Drive, San Diego, CA 92122, USA 6Clinic of Anesthesiology, Intensive Care Medicine and Pain Management, Krankenhaus Nordwest, Steinbacher Hohl 2-26, 60488 Frankfurt, Germany 7Department of Physiology, Ludwig-Maximilians-University, Pettenkoferstrasse 12, 80336 Munich, Germany Dirk Bruegger: [email protected] ; Gregor I Kemming: [email protected] ; Matthias Jacob: [email protected] ; Franz G Meisner: [email protected] ; Christoph J Wojtczyk: ed.grebnreun-mukin Continue reading >>

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  1. Nicole

    Just wondered if anyone actually uses ketostix to monitor their progress and if so where can I buy them and how much are they roughly?

  2. Jo

    Any pharmacy. They are about 3 or 4 pounds I think.

  3. Kathryn

    I get mine from Amazon http://www.amazon.co.uk/Ketostix-Reagent-Strips-Urinalysis-Ketone/dp/B0000532GJ/ref=sr_1_2?ie=UTF8&qid=1390600939&sr=8-2&keywords=ketostix

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Understand shock (cardiogenic, hypovolemic, and septic) with clear illustrations from Dr. Seheult of http://www.medcram.com. This is video 1 of 2 on shock (the types of shock and treatment). Speaker: Roger Seheult, MD Clinical and Exam Preparation Instructor Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine. MedCram: Medical topics explained clearly including: Asthma, COPD, Acute Renal Failure, Mechanical Ventilation, Oxygen Hemoglobin Dissociation Curve, Hypertension, Shock, Diabetic Ketoacidosis (DKA), Medical Acid Base, VQ Mismatch, Hyponatremia, Liver Function Tests, Pulmonary Function Tests (PFTs), Adrenal Gland, Pneumonia Treatment, any many others. New topics are often added weekly- please subscribe to help support MedCram and become notified when new videos have been uploaded. Subscribe: https://www.youtube.com/subscription_... Recommended Audience: Health care professionals and medical students: including physicians, nurse practitioners, physician assistants, nurses, respiratory therapists, EMT and paramedics, and many others. Review for USMLE, MCAT, PANCE, NCLEX, NAPLEX, NDBE, RN, RT, MD, DO, PA, NP school and board examinations. More from MedCram: Complete Video library: https://www.youtube.com/c/medcram Facebook: https://www.facebook.com/MedCram Google+: https://plus.google.com/u/1/+Medcram Twitter: https://twitter.com/MedCramVideos Produced by Kyle Allred PA-C Please note: MedCram medical videos, medical lectures, medical illustrations, and medical animations are for medical educational and exam preparation purposes, and not intended to replace recommendations by your health care provider.

Cardiogenic Shock - Heartupdate.com

Cardiogenic shock is a syndrome caused by a severe insufficiency of the heart pump manifested by the inability to provide the necessary oxygen and tissue nutrients and to remove metabolic activity product of metabolism. The main condition that leads to cardiogenic shock is the acute myocardial infarction in which necrosis is over 40% of the muscle mass of the left ventricle. In AMI, shock usually appears at 6-8 hours after the onset, but it is possible to install and after 1-2 days by extending the myocardial necrosis or by the AMI complications such as ventricular aneurysm, ventricular septal rupture (rupture of the wall that separates the two ventricles) and ventricular wall rupture. Other causes of cardiogenic shock are: diseases of the heart valves, especially aortic and mitral, intra-atrial thrombosis (formation of the clots with fairly large volume inside the atria), myocarditis, and dilated hypertrophic cardiomyopathy, arrhythmias with large increases in ventricular rate. Myocardial area affected of necrosis becomes akinetic (no more participating in heart contractions, becomes inert) and part of the myocardium that surrounds the necrosis is dyskinetic (contractions are wea Continue reading >>

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  1. yogipete

    I've wanted a ketonix for a while but am not going to fork over hundreds of dollars. So I followed some advice and got myself a cheap breathalyzer on ebay. Apparently they don't distinguish between alcohol and acetone.
    IT WORKS!
    Now I can measure easily whether or not I am in ketosis anytime I suspect I may have dropped out. The ketostix stopped working for me a long time ago as my body is very well adapted and I don't excrete a lot of measurable ketones.The breathalyzer is not much good for finding your millimoler value of ketones, but then again, by all accounts neither is a ketonix itself. The breathalyzer cost me $12 and you can get them cheaper. In fact, it's only the cheaper ones that work. You can get these breathalyzers as cheap as a few dollars.
    Here's the one I used below

    That reading above is while fully sober... * I swear * Only trouble is it beeps like crazy when it detects 0.05% or over (the legal alcohol driving limit in australia). I'm sure other models wouldn't beep.


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    Engineering Myself: Using a Cheap Breathalizer to Measure Ketosis engineeringmyself.com

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    https://jenslabs.com/2013/06/06/ketosense-an-arduino-based-ketosis-detector/





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  2. BillJay

    Thanks @yogipete ! This is both interesting and worrisome at the same time!

    I may get a cheap one myself, but in the meantime I'd love to see if others can replicate your results.

  3. yogipete

    My pleasure.

    I might also add that the reading is consistent regardless of my method of blowing etc... which is a problem that haunts the ketonix. I've done a few baseline tests on my partnerr who always blows 0 (she's currently non-keto) while I generally blow between .04 and .05 (but in any one moment of the day the reading is always identical regardless of my personal clumsiness in using the meter). I'm looking forward to testing some more non-keto friends.

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https://www.facebook.com/drinkhealthy... - Do you want to learn how to get rid of lactic acid as an athlete, and start recovering quicker with more energy? Learn how to reduce lactic acid symptoms and increase your performance. Getting rid of lactic acid may be easier than you have imagined. Many professional athletes know the importance of eliminating lactic acid so they can recover quicker and perform at an optimal level. Start flushing out that lactic acid today! Many people suffer from lactic acidosis symptoms and are rigorously searching for a lactic acid treatment. More and more athletes are searching for solutions on how to get rid of lactic acid. In this video you will learn what a professional football player from the Seattle Seahawks is using to eliminate lactic acid after his workouts, practices, and NFL games. Learn how to make lactic acid a symptom of the past. Begin your journey to faster recovery today. See what the pro's are using to reduce lactic acid, recover quicker, and have more energy. Uncertain of what lactic is? Here is the definition https://en.wikipedia.org/wiki/Lactic_... Contact me for more information on getting rid of lactic acid FB: http://www.facebook.com/duncan.fraser... IG: http://www.instagram.com/kangendunc [email protected] See a full demonstration of this solution that helps get rid of lactic acid https://www.youtube.com/watch?v=MTxR9... Duncan Fraser 0:00 - 0:13 - Introduction 0:14 - 2:11 - Shan Stratton and Michael Robinson Discuss how to get rid of lactic acid 2:11 - 2:21 - 4 benefits of this incredible technology 2:21 - 2:39 - Conclusion Get in contact with me if you have problems with lactic acid and learn more on my FB page. Visit my Facebook page below. https://www.facebook.com/drinkhealthy...

Lactic Acidosis: Background, Etiology, Epidemiology

Author: Kyle J Gunnerson, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, MCCM more... In basic terms, lactic acid is the normal endpoint of the anaerobic breakdown of glucose in the tissues. The lactate exits the cells and is transported to the liver, where it is oxidized back to pyruvate and ultimately converted to glucose via the Cori cycle. In the setting of decreased tissue oxygenation, lactic acid is produced as the anaerobic cycle is utilized for energy production. With a persistent oxygen debt and overwhelming of the body's buffering abilities (whether from chronic dysfunction or excessive production), lactic acidosis ensues. [ 1 , 2 ] (See Etiology.) Lactic acid exists in 2 optical isomeric forms, L-lactate and D-lactate. L-lactate is the most commonly measured level, as it is the only form produced in human metabolism. Its excess represents increased anaerobic metabolism due to tissue hypoperfusion. (See Workup.) D-lactate is a byproduct of bacterial metabolism and may accumulate in patients with short-gut syndrome or in those with a history of gastric bypass or small-bowel resection. [ 3 ] By the turn of the 20th century, many physicians recognized that patien Continue reading >>

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Popular Questions

  1. itguy08

    What do I need to know about high blood sugar and diabetic ketoacidosis (DKA)

    Yes, me again..sorry. I basically need to be retrained in everything.
    So at what point should I be worried about DKA, when my blood sugar is over 300? 250? How long do I need to be in that high range until I worry? 1 hour? 3 hours? 10 hours? At what point should 911 be called or that I get a ride to the hospital from someone?
    When drinking water, how much should I drink? How often? What is my pee color is clear or very light yellow? Do I need electrolytes also (sodium and potassium) or is water fine?
    I read in Dr. Bernstein's book Diabetes Solution about intramuscular insulin shots to treat high blood sugar faster but he doesnt say if I should change doses. I assume potency is the same, just the speed at which it works. 10 units will be 10 units regardless if it takes 3 hours to work in fat, or 1 hour to work in muscle.
    Do I really have to wait 3-5 hours before giving more insulin to treat highs? Seems like a long time to stay in high blood sugar 250-300+ just to make sure all your previous insulin has done its thing.

  2. CalgaryDiabetic

    I have guidelines for pumpers from Alberta health services that : if BG > 15 mmol/L i.e. 270 then
    - Check for ketones (urine or blood), if none do correction
    - if ketones are present then correct with
    1.5 X (actual BG -target BG)/insulin sensitivity factor
    Recheck BG in one hour.
    If BG not going down then check ketones again
    Again if ketones are present the correct again with:
    1.5 X (actual BG -target BG)/insulin sensitivity factor
    I have a freestyle meter that measures betahydroxybutarate in the blood. this probably is the gold standard for now. Test strips are expensive. I am not sure what pee strips measure.
    Drink 250 to 500 ml of wter every 30 minutes to prevent dehydration.
    Continue checking BG and ketones every 1 to 2 hours.
    My ketones in the blood are typically 0.2 mmol/L i.e 2.1 mg/dL and I would like them to the more like 2 mmol/L. i.e. 21 mg/dL I don't know when DKA occurs but probably above 5 i.e 52 would be time to worry.
    BTW my Endo said that people on a low carb diet have a lesser chance of going into DKA which in his opinion is caused by a mismatch between insulin needs and insulin supply.

  3. itguy08

    Originally Posted by CalgaryDiabetic
    My ketones in the blood are typically 0.2 mmol/L i.e 2.1 mg/dL and I would like them to the more like 2 mmol/L. i.e. 21 mg/dL I don't know when DKA occurs but probably above 5 i.e 52 would be time to worry.
    I dont know what any of that is. 0.2 mmol/L? 2.1mg/dL? 52? Lol im so lost sorry.
    Giving correction every hour is safe?
    I have keto strips that get darker the more ketoens you have and I am in the middle of the 40-80 range which is moderate-high but just now it seemed to be between light and moderate or between 15 and 40 and my blood sugar is going down. Its at 221 right now 12:10pm and was 212 at 11:50am. Not going up just hovering around those numbers.
    Its been like 7 hours and I blame dawn phenomena. What a ***** to deal with.

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