Risk factors for the development of hypokalemia in neonatal diarrheic calves.

BACKGROUND: Neonatal diarrheic calves have a clear negative potassium balance because of intestinal losses and decreased milk intake but in the presence of acidemia, they usually show normokalemic or hyperkalemic plasma concentrations. OBJECTIVES: To assess whether marked hypokalemia occurs in response to the correction of acidemia and dehydration and to identify factors that are associated with this condition. ANIMALS: Eighty-three calves with a clinical diagnosis of neonatal diarrhea. METHODS: Prospective cohort study. Calves were treated according to a clinical protocol using an oral electrolyte solution and commercially available packages of 8.4% sodium bicarbonate, 0.9% saline and 40% dextrose infusion solutions. RESULTS: The proportion of hypokalemic calves after 24 hours of treatment (19.3%) was twice as great as it was on admission to the hospital. Plasma K(+) after 24 hours of treatment was not significantly correlated to venous blood pH values at the same time but positively correlated to venous blood pH values on admission (r = 0.51, P < .001). Base excess on admission (Odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.70-0.94), duration of diarrhea (OR = 1.37, 95% CI = 1.05-1.80), milk intake during hospitalization (OR = 0.54, 95% CI = 0.37-0.79) and plasma sodium concentrations after 24 hours (OR = 1.12, 95% CI = 1.01-1.25) were identified to be independently associated (P < .05) with a hypokalemic state after 24 hours of treatment. CONCLUSIONS AND CLINICAL IMPORTANCE: Findings of this study suggest that marked depletion of body potassium stores is evident in diarrheic calves that suffered from marked metabolic acidosis, have a low milk intake and a long history of diarrhea.

Effects of alkalinization and rehydration on plasma potassium concentrations in neonatal calves with diarrhea.

BACKGROUND: Increased plasma potassium concentrations (K(+)) in neonatal calves with diarrhea are associated with acidemia and severe clinical dehydration and are therefore usually corrected by intravenous administration of fluids containing sodium bicarbonate. OBJECTIVES: To identify clinical and laboratory variables that are associated with changes of plasma K(+) during the course of treatment and to document the plasma potassium-lowering effect of hypertonic (8.4%) sodium bicarbonate solutions. ANIMALS: Seventy-one neonatal diarrheic calves. METHODS: Prospective cohort study. Calves were treated according to a clinical protocol using an oral electrolyte solution and commercially available packages of 8.4% sodium bicarbonate (250-750 mmol), 0.9% saline (5-10 L), and 40% dextrose (0.5 L) infusion solutions. RESULTS: Infusions with 8.4% sodium bicarbonate solutions in an amount of 250-750 mmol had an immediate and sustained plasma potassium-lowering effect. One hour after the end of such infusions or the start of a sodium bicarbonate containing constant drip infusion, changes of plasma K(+) were most closely correlated to changes of venous blood pH, plasma sodium concentrations and plasma volume (r = -0.73, -0.57, -0.53; P < .001). Changes of plasma K(+) during the subsequent 23 hours were associated with changes of venous blood pH, clinical hydration status (enophthalmos) and serum creatinine concentrations (r = -0.71, 0.63, 0.62; P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: This study emphasizes the importance of alkalinization and the correction of dehydration in the treatment of hyperkalemia in neonatal calves with diarrhea.

Pyrazolopyrimidinediones are selective agents for Helicobacter pylori that suppress growth through inhibition of glutamate racemase (MurI).

Pyrazolopyrimidinediones are a novel series of compounds that inhibit growth of Helicobacter pylori specifically. Using a variety of methods, advanced analogues were shown to suppress the growth of H. pylori through the inhibition of glutamate racemase, an essential enzyme in peptidoglycan biosynthesis. The high degree of selectivity of the series for H. pylori makes these compounds attractive candidates for novel H. pylori-selective therapy.