Changes in electrolyte concentrations and hydration status in endurance horses following transport and an overnight stay prior to competition

OBJECTIVE To evaluate changes in electrolyte concentrations and hydration status that take place in endurance horses prior to the start of a competition and determine whether these changes would be associated with elimination. ANIMALS 19 horses entered in the 2016 Tevis Cup 100-Miles (160 km) One-Day Western States Trail Ride. PROCEDURES Heparinized blood samples were collected at 5 time points: prior to transport to the ride (T0), during check-in the day before the ride (T1), 1 to 2 hours before the start of the ride (T2), at the 15-km mark (T3), and at the 55-km mark (T4). Packed cell volume and plasma sodium, potassium, chloride, urea nitrogen, glucose, bicarbonate, and total protein concentrations were determined and compared across time points and between finishers and nonfinishers. RESULTS Signif icant differences were detected among plasma sodium, potassium, and urea nitrogen concentrations measured prior to the start of the ride (ie, T0, T1, and T2). For all variables except chloride and bicarbonate concentrations, significant differences were detected between values obtained prior to the start of the ride and values obtained during the ride (ie, T3 and T4). Only bicarbonate concentration at the 15-km mark of the ride was significantly associated with finishing status. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that significant changes in plasma sodium, potassium, and urea nitrogen concentrations can occur in endurance horses during transport to a competition and when horses are stabled overnight before an event. Additionally, a lower bicarbonate concentration following a steep climb early during the ride was associated with subsequent elimination.

Factors Related to Muscle Cramps during Hemodialysis in End Stage Renal Disease Patients

Background: Muscle cramps are a common complication during hemodialysis that can cause patients extremely painful.Objective: To determine factors related to muscle cramps during hemodialysis in patients with end-stage renal disease.Methods: A descriptive correlational study was conducted in end-stage renal disease patients undergoing hemodialysis at Hemodialysis center, Faculty of Medicine Ramathibodi Hospital between February and March 2020. The data collection instruments included muscle cramps report form, demographic questionnaire, and factors related to muscle cramps questionnaire. The data were analyzed using descriptive statistics and multiple logistic regression.Results: A total of 44 patients were recruited in the study. The mean age was 63.3 years. A total of 458 muscle cramps during hemodialysis assessments were recorded in the one month. The result showed that 45 muscle cramps (9.8%) occurred during hemodialysis. Factors significantly related to muscle cramps during hemodialysis included interdialytic weight gain ≥ 3.5 kilograms (OR = 4.5, P < .05), experiencing cramps before hemodialysis (OR = 25.5, P < .05), and high serum bicarbonate concentration (OR = 5.6, P < .05).Conclusions: This study found that 9.8% of patients reported muscle cramps during hemodialysis. Interdialytic weight gain, having cramps before hemodialysis, and serum bicarbonate concentration were significantly related to muscle cramps during hemodialysis in patients with end-stage renal disease.

Chemical and isotopic composition of CO2-rich magnesium–sodium–bicarbonate–sulphate-type mineral waters from volcanoclastic aquifer in Rogaška Slatina, Slovenia

Bottled natural mineral waters from an andesitic aquifer in Slovenia are enriched in magnesium (1.1 g/l), sulphate (2.2 g/l) and dissolved inorganic carbon (204 g/l). We analysed major ions, trace elements, tritium activity, 14C, δ18OH2O, δ2HH2O,δ13CDIC, gas composition and noble gases in six wells. In addition, 87Sr//86Sr, δ34SSO4 and δ11B were analysed here for the first time. Stable isotopes with δ18O = −11.97 to −10.30‰ and δ2H = −77.3 to −63.8 confirm meteoric origin. CO2 degassing is evident at three wells, causing the oxygen shift of about −1.3‰. Tritium activity was detectable only in the shallowest well, where the freshwater component was dated to the 1960s. δ13CDIC in five waters is −1.78 to + 1.33‰, typical of carbonate dissolution. Radiocarbon is low, 1.03–5.16 pMC. Chemical correction with bicarbonate concentration and δ13C correction methods gave best mean residence times, slightly longer than previously published. Sulphate has δ34S 26.6–28.9‰ and δ18O 8.9–11.1‰ due to dissolution of evaporites in carbonate rocks. Boron at concentrations of 1.2–6.1 mg/l has two origins: δ11B = 11.3–16.4‰ from hydrothermal alteration and δ11B = 26.6–31.7‰ from carbonate dissolution. Strontium at concentrations of 0.5–22.0 mg/l has 87Sr//86Sr, indicating three sources: 0.7106 for Miocene clastic rocks, 0.7082 for Triassic carbonates and 0.7070 for Lower Oligocene andesitic rocks. CO2 represents the majority of the dissolved (> 98.84 vol%) and separated gas (> 95.23 vol%). Methane is only found in two wells with a max. of 0.30 vol%. All waters show excess helium and 16–97% of mantle-derived helium. Since all show subsurface degassing, the paleo-infiltration temperature could not be calculated.

Formulasi Sediaan Tablet Effervescent dari Ekstrak Etanol Tanaman Bundung (Actionoscirpus grossus) sebagai Antioksidan

Bundung (Actinoscirpus grossus) is a plant that contains an antioxidant compound proven in previous studies, which has a moderate antioxidant or IC50 by 128 ppm. Antioxidant compounds can reduce the negative impact of oxidants, including metal binding enzymes and proteins. Antioxidant compounds act by donating one electron to the oxidant compound to inhibit oxidants activity. The purpose of this study was to formulate the Bundung plant extract into effervescent tablets, obtain effervescent samples that are physically stable, and can be used as antioxidants to inhibit free radicals in the body. The research method was experimental by using scoring parameters to determine the most optimal formulation. Physical evaluation includes organoleptic, weight uniformity, friability, hardness, and dissolving time. The results showed that the optimum formula was the formula I with a concentration of 68 mg of citric acid and sodium bicarbonate. Tablet effervescent is a brown color and characteristic odor of Bundung plant extract. Effervescent tablets have an weight uniformity (0.314 grams), friability (0.05%), hardness (7.75 ± 0.43 kg). Variations in citric acid and sodium bicarbonate concentration can affect uniformity, friability, hardness, and dissolving time. Room conditions cause this during the production process of effervescent tablets.

Diagnosis and Management of Obesity Hypoventilation Syndrome during Labor

Obesity hypoventilation syndrome (OHS) is a disorder in which patients with a body mass index ≥30 kg/m2 develop awake hypercapnia with a partial pressure of carbon dioxide ≥45 mm Hg, in the absence of other diseases that may produce alveolar hypoventilation. Additional clinical features include sleep disordered breathing, restrictive lung disease, polycythemia, hypoxemia, and an increased serum bicarbonate concentration (≥27 mEq/L). Anesthesia providers should be familiar with OHS because it is often undiagnosed, it is associated with a higher mortality rate than obstructive sleep apnea, and it is projected to increase in prevalence along with the obesity epidemic. In this case, a 33-year-old obese woman with presumed OHS developed respiratory acidosis during induction of labor. Continuous positive airway pressure treatment was initiated, but the patient continued to have hypercapnia. A cesarean delivery was recommended. The patient had baseline orthopnea due to her body habitus; thus, despite adequate labor analgesia, a cesarean delivery was completed with general endotracheal anesthesia. We believe this patient had OHS despite a serum bicarbonate <27 mEq/L, a partial pressure of oxygen >70 mm Hg, and a hemoglobin <16 g/dL, which would typically rule out OHS. Pregnant women experience a decrease in serum bicarbonate concentration due to progesterone-mediated hyperventilation, an increase in arterial oxygenation from increased minute ventilation and higher cardiac output, and a decrease in hemoglobin due to the physiologic anemia of pregnancy. Thus, OHS may be defined differently in pregnant than in non-pregnant patients.

Acid-base and Electrolyte Disturbances in Children Presenting with Acute Watery Diarrhoea in Emergency Observation and Referral Unit of Dhaka Shishu (Children) Hospital

Background: Acute watery diarrhoea (AWD) is a leading cause of illness and death amongst children in developing countries. Electrolyte and acid-base disturbances play an important role in the associated morbidity and mortality. Objectives: To observe the acid-base and electrolyte changes in moderate and severe dehydration in AWD in children. Methods: This cross sectional study was carried out in the Observation and Referral Unit of Dhaka Shishu (Children) Hospital from July 2018 to December 2018. Children below five years of age who came with acute diarrhoea with moderate to severe dehydration were included in the study. After admission 2ml of whole blood was collected with all aseptic measures at the time of insertion of intravenous cannula before giving intravenous fluids to measure serum levels of Na and K while arterial blood was also taken for analysis. The data was analyzed by using SPSS version 20. Results: Total 125 AWD cases were admitted among them 98(78.4%) had moderate dehydration whereas 27(21.6%) had severe dehydration. Hyponatremic dehydration was present in 41(32.8%) cases. Among them 30(30.6%) had moderate dedydration and 11(40.4%) had severe dehydration, hypernatremic dehydration was present in 11.11% cases, hypokalemia was present in 54(43.2%) cases. Among them 42(42.86%) had moderate dedydration and 12(44.44%) had severe dehydration. Metabolic acidosis was present in 38(30.4%) cases [28(28.57%) in moderate dedydration and 10(37.04%) in severe dehydration]. The comparison of mean serum sodium and potassium value of the children with moderate and severe degrees of dehydration did not attain statistical significance, but there was a significant difference in bicarbonate concentration among moderate and severe dehydration cases (p=0.02). Conclusion: Hyponatremia and hypokalamia was the commonest electrolyte abnormality among moderate to severe dehydration with AWD. Mean serum sodium and potassium of the children with moderate and severe degrees of dehydration did not attain statistical significance, but bicarbonate concentration was significantly low among severe dehydration cases. DS (Child) H J 2020; 36(2): 120-124

Measurements of Bicarbonate in Water Containing Ocean-Level Sulfate Using a Simple Multi-Pass Optical Raman System

The concentration of dissolved inorganic carbon in the oceans at depths of a few meters to thousands of meters is a critical parameter for understanding global warming. The concentration is both pH dependent and depth dependent. Current analysis that employs pH meters must account for several other parameters, such as salinity, temperature, pressure, and the dissolved carbon’s form, carbon dioxide, bicarbonate, or carbonate. Recently, Raman spectroscopy has been used to measure these forms directly in water at ~1000 ppm, which is unfortunately insufficient for typical ocean concentrations, such as ~115 ppm bicarbonate near the surface. Here, we employed a simple multi-pass optical system, a flat mirror to reflect the laser back through the sample, and a concave mirror opposite the entrance slit that effectively doubled the laser power and the collected Raman photons, respectively. This multi-pass optical Raman system with a 1.5 W, 532 nm laser was used to measure 30 ppm bicarbonate in water that contained 2650 ppm sulfate to simulate ocean water, a bicarbonate concentration well below that near the ocean surface. Furthermore, spectral analysis employed the bicarbonate C=O symmetric stretch at 1360 cm−1 instead of the C–OH stretch at 1015 cm−1 to avoid the intense, overlapping sulfate SO4 symmetric stretch at 985 cm−1. The calculated standard deviation of ~5 ppm for the described approach suggests that accurate measurement of bicarbonate in situ is possible, which has been, heretofore, either calculated based on pH or measured in a lab.

The Continuum of Acid Stress

Acid-related injury from chronic metabolic acidosis is recognized through growing evidence of its deleterious effects, including kidney and other organ injury. Progressive acid accumulation precedes the signature manifestation of chronic metabolic acidosis, decreased plasma bicarbonate concentration. Acid accumulation that is not enough to manifest as metabolic acidosis, known as eubicarbonatemic acidosis, also appears to cause kidney injury, with exacerbated progression of CKD. Chronic engagement of mechanisms to mitigate the acid challenge from Western-type diets also appears to cause kidney injury. Rather than considering chronic metabolic acidosis as the only acid-related condition requiring intervention to reduce kidney injury, this review supports consideration of acid-related injury as a continuum. This “acid stress” continuum has chronic metabolic acidosis at its most extreme end, and high-acid-producing diets at its less extreme, yet detrimental, end.