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Interpreting Arterial Blood Gases in Trauma Patients
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
In metabolic alkalosis, pH is increased due to the increased level of HCO3–, either due to loss of hydrogen ions (H+) or gain of HCO3–. The following clinical conditions may result in metabolic alkalosis:Hypovolaemia with Cl– depletionGI loss of H+ (vomiting, gastric suction, diarrhoea with chloride-rich fluid, villous adenoma)Renal loss of H+ (use of diuretics, hypercapnia following mechanical ventilation)Hypervolaemia with Cl- expansionRenal loss of H+: volume overload (heart failure, cirrhosis, nephrotic syndrome), bicarbonate administration, hyperaldosteronism, hypercortisolism, excess ACTH, exogenous steroids, severe hypokalaemia, renal artery stenosis
The patient with acute respiratory problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
The bond between haemoglobin and oxygen can be influenced by a number of factors: Temperature.2,3 diphosphoglycerate (2,3-DPG).Hydrogen ions or pH status.PaCO2.
Tubular Function
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Various factors alter the intracellular/extracellular distribution of potassium ions. Insulin and epinephrine stimulate the cell membrane Na+/K+-ATPase so that potassium is shifted into the cell after a meal and during exercise, respectively. During acidosis, when the plasma hydrogen ion concentration is high, potassium ions move out of the cells and hydrogen ions move in. During alkalosis, potassium moves into the cells and hydrogen ions move out.
Cryoablation as a first-line therapy for atrial fibrillation: current status and future prospects
Published in Expert Review of Medical Devices, 2022
Jason G. Andrade, Marc W. Deyell, Marc Dubuc, Laurent Macle
In contrast to radiofrequency energy, lesion formation with cryothermal ablation occurs through convective cooling. This tissue injury occurs through a combination of freezing-induced cellular injury and ischemic cell death due to microcirculatory failure [32]. Freezing induction results in progressive retardation of cellular metabolism, resulting in the loss of ion pump transport and induction of a more acidic intracellular environment [33]. Continued cooling leads to the formation of extracellular ice, generating hypertonia and a compensatory egress of water from the intracellular space [34]. This osmotic gradient precipitates a diffusion gradient resulting in the movement of hydrogen ions out of the cell and migration of solute ions into the cell, further reducing intracellular pH. This leads to enzyme impairment, protein damage, mitochondrial injury, and plasma membrane injury [34]. Subsequent to the freezing phase is coalescence of the intracellular and extracellular ice crystals. This coalescence augments the osmotic damage, and generates shear forces that further disrupt cellular architecture [35]. Rewarming-induced restoration of the microcirculation leads to vascular obliteration and microthrombi formation, extending the tissue destruction through ischemic cellular necrosis [36]. Reactive inflammation followed by replacement fibrosis constitutes the final phase, resulting in a mature lesion with a dense well-circumscribed central region of cold-induced fibrosis surrounded by a narrow border of cellular death due to microvascular injury and apoptosis [37].
Genotoxic, biochemical and histopathological studies to assessment the topiramate hepatorenal toxicity in mice
Published in Drug and Chemical Toxicology, 2022
Aida I. El Makawy, Dalia M. Mabrouk, Faten M. Ibrahim, Kawkab A. Ahmed
Hepatotoxicity related to TPM has been suggested before in many case-reports (Bjoro et al. 1998, Doan and Clendenning 2000, Bumb et al. 2003). The AEDs mechanism of hepatotoxicity is unclear, but it may be related to interference with the mitochondrial beta oxidation of fatty acids. Acquired impairment in beta-oxidation of AEDs may contribute to the liver toxicity (Siemes et al.1993). However, in these publications patients used multiple antiepileptic drugs including Topiramate TMP. Topiramate leads to mixed renal tubular acidosis by the inhibition of carbonic anhydrate in renal tubules, which leads to systemic metabolic acidosis with low concentration of plasma bicarbonate and alkaline urine pH with urine citrate low concentration. These metabolic change results in calcium phosphate stone formation (Dell’Orto et al. 2014). Topiramate growing use can cause metabolic acidosis by the proximal renal tubule and the excretion of hydrogen ions by the distal renal tubule (Tan et al. 2014).
The influence of hydrogen ions on coagulation in traumatic brain injury, explored by molecular dynamics
Published in Brain Injury, 2021
Carlos Romero Díaz, Laura Pérez Campos Mayoral, María Teresa Hernández Huerta, Abraham Salvador Majluf-Cruz, Stephanie Elizabeth Plascencia Mora, Eduardo Pérez-Campos Mayoral, Gabriel Mayoral Andrade, Margarito Martínez Cruz, Edgar Zenteno, Carlos Alberto Matias Cervantes, Gabriela Vásquez Martínez, Ruth Martínez Cruz, Miguel Ángel Reyes Franco, Eli Cruz Parada, Socorro Pina Canseco, Eduardo Pérez-Campos
We used AMBER 14 version pmemd.cuda (26). All the structures were selected from the protein data bank (www.rcsb.org): glycoprotein GP IIb-IIIa (2VDK.pdb) (17), tissue factor and FVII (4YLQ.pdb) (27), alpha and gamma chains of fibrinogen (3GHG.pdb), a dimeric form of thrombin (3LU9.pdb) (28), an activated form of FXa (4ZHA.pdb), FXI (5EOK.pdb) (29), and D-Dimer (1N86.pdb) (30). Six hydrogen ions (H3O+.pdb) were added to the molecules with <300 residues, and 10 to 20 hydrogen ions were added to molecules with > 300 residues. All the molecules were solvated in 6.0 Angstroms using the TIP3PBOX water model (31). Minimization of 5000 steps, heating (100 ps), 7 repetitions of density balance (700 ps in total) and system equilibrium (1 ns) were performed. After the application of molecular dynamics, using VMD (32), we observed hydrogen ion trajectories and the union and distances of hydrogen ions to some residues, which was calculated by CPPTRAJ (33).