The American journal of the medical sciences
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Comparative Study
Calculation of sodium bicarbonate requirement in metabolic acidosis.
Despite the host of complications which may be associated with intravenous sodium bicarbonate infusion, the use of this agent is a frequent necessity in patients with metabolic acidosis. No satisfactory formula for calculating bicarbonate dose had previously been described, although such an approach might be expected to reduce the incidence of these complications. ⋯ In all but one, the post-infusion pH was between 7.25 and 7.37, with a mean of 7.30 +/- 0.04 and no instances of serious overtitration. It is concluded that the formula is useful as a pragmatic aid in the management of patients with metabolic acidosis.
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Polymorphonuclear leukocyte chemotaxis was investigated in 35 patients with recurrent polyserositis during attacks and during spontaneous or colchicine-induced remissions. Chemotaxis was found to be unchanged in the attack-free period in untreated patients, increased by about 50% during attacks, and decreased by about 50% during colchicine treatment.
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Thirty patients with drug associated acute nontraumatic rhabdomyolysis were evaluated. Acute renal failure, oliguric (ORF) in ten and nonoliguric (NORF) in another ten patients, was observed. The remaining ten patients did not develop renal failure (NRF). ⋯ It was not seen in patients without renal failure. There were no differences in age, incidence of coma, muscle swelling, and muscle enzyme between those who did and those who did not develop hypercalcemia. Sixteen patients with nerve entrapment had higher incidence of coma and muscle swelling than the rest of the patients.