High Levels Of Potassium Research Articles

Impact of Hyperkalemia in Heart Failure and Reduced Ejection Fraction: A Retrospective Study.

(1) Background: Hyperkalemia is a common finding in patients with heart failure and reduced ejection fraction (HFrEF), though its prognostic significance is controversial. There is no consensus on optimal potassium levels in these patients. The primary endpoint of this study was to determine the 5-year incidence of hyperkalemia in a cohort of patients with HFrEF. Secondary endpoints were to determine predictors of hyperkalemia and its impact on overall 5-year mortality; (2) Methods: retrospective, longitudinal, single-center observational study of patients with HFrEF followed-up in a specialized unit between 2011 and 2019. Hyperkalemia was considered as potassium concentration > 5.5 mEq/L; (3) Results: Hyperkalemia was observed in 170 (16.8%) of the 1013 patients. The 5-year hyperkalemia-free survival rate was 82.1%. Hyperkalemia was more frequent at the beginning of follow-up. Factors associated with hyperkalemia in the multivariate analysis were baseline potassium (HR 3.13, 95%CI 2.15-4.60; p < 0.001), creatinine clearance (HR 0.99, 95%CI 0.98-0.99; p = 0.013), right ventricular function (HR 0.95, 95%CI 0.91-0.99; p = 0.016) and diabetes mellitus (HR 1.40, 95%CI 1.01-1.96; p = 0.047). The overall survival rate at 5 years was 76.4%. Normal-high potassium levels (5-5.5 mEq/L) were inversely associated with mortality (HR 0.60, 95%CI 0.38-0.94; p = 0.025); (4) Conclusions: Hyperkalemia is a common finding in patients with HFrEF with an impact on the optimization of neurohormonal treatment. In our retrospective study, potassium levels in the normal-high range seem to be safe and are not associated with increased mortality.

P180 EXTREMELY WIDE QRS TACHYCARDIA IN SEVERE HYPERKALEMIA: THE IMPORTANCE OF MONITORING MRA THERAPY

Abstract Although uncommon in the general population, hyperkalemia can affect up to 50% of patients with heart failure who are receiving MRA and/or are affected by CKD . Since potassium is the most abundant intracellular cation, hyperkaliemia causes a profound change in action potential, which manifests as expected electrocardiographic changes (lower voltage P wave, AV block, wide QRS, high voltage T wave) and arrhythmias. Clinic case. A 77–year–old woman was admitted to ED for dyspnea. She had a medical history of stage 3 CKD and a HFrEF with a recent admission in medical department for worsening congestion, from which was dimitted with a supratherapeutic dose of MRA (canrenone 300 mg/die). Physical examination at the admission excluded signs of central or peripheral congestion . An EKG was performed and revealed an heart rate of 95 beats per minute and extremely wide QRS (280 ms). Contextually, a blood gas analysis showed high potassium level (K 9 mmol/l) and metabolic acidosis. Due to the inability to demonstrate the presence of P wave and a regular A–V conduction, a differential diagnosis between a VT and a SVT with a wide QRS was required. The presence of a fusion beat, a negative concordance of QRS in the precordials derivation, and an extreme right axis deviation led to a diagnosis of slow VT. Cuncurrently with the onset of hyperkalemia therapy, an ECV with sinus rhythm restoration was done. The following EKGs showed expected electrical changes based on the measured potassium level. After ECV with K 8 mmol/l: QRS remained wide (180ms) with an heart rate of 65 beats per minute in the presence of possible junctional rhythm or sino–ventricular rhythm, which is sometimes described in hyperkalemia as an expression of atrial inectability with the exception of the conduction fibers. After 1 hour with K 6.3 mmol/l: QRS of normal duration with an HR of 60 bpm and a sinus rhythm but with low voltage P wave and concomitant AV block of I grade that was gradually restored with the normalization of potassium levels after canrenone suspension. Because the numerous side effects of hyperkaliemia careful monitoring of MRA therapy and potassium level plays a critical role in the prevention and diagnosis of arrhythmias and EKG changes in patients with HFrEF.

Enrichment of Baked Goods From Wheat Flour of the Highest Grade With Coffee Husks

This article presents a variant of the manufacture of dietary and preventive baked goods enriched with dietary fiber by adding coffee husks, a by-product of coffee production, to the recipe. In the course of the work, the influence of various volumes of introduced raw materials, in the amount of 3 and 6% of the total mass of flour, on the physicochemical and organoleptic quality indicators of the finished product was studied, a comparative analysis of the obtained bread samples was carried out, and the optimal dosage of coffee shells that did not reduce quality properties of baked goods. Thanks to this method of preparation, it becomes possible to create a product not only rich in fiber, but also with a valuable chemical composition, with a high level of potassium and vitamins. Such bread will be an excellent addition not only to the daily diet, but also to the menu of dietary nutrition necessary for a group of various diseases, ranging from metabolic disorders and obesity to cardiovascular pathologies, as it will close the body’s daily need for dietary fiber. In addition, it should be noted that the problem of environmental pollution with coffee production waste is acute for society. As a rule, secondary raw materials obtained during the processing of coffee are subjected to recycling or incineration. The method of recycling coffee shells proposed in the article allows not only to obtain a new healthy food product and expand the existing range of baked goods, but also significantly reduce the amount of waste remaining from the coffee bean processing process, which also entails financial benefits.

Serum Potassium and Risk of Death or Kidney Replacement Therapy in Older People With CKD Stages 4-5: Eight-Year Follow-up

Hypokalemia may accelerate kidney function decline. Both hypo- and hyperkalemia can cause sudden cardiac death. However, little is known about the relationship between serum potassium and death or the occurrence of kidney failure requiring replacement therapy (KRT). We investigated this relationship in older people with chronic kidney disease (CKD) stage 4-5. Prospective observational cohort study. We followed 1,714 patients (≥65 years old) from the European Quality (EQUAL) study for 8 years from their first estimated glomerular filtration rate (eGFR)<20mL/min/1.73m2 measurement. Serum potassium was measured every 3 to 6 months and categorized as≤3.5,>3.5-≤4.0,>4.0-≤4.5,>4.5-≤5.0 (reference),>5.0-≤5.5, >5.5-≤6.0, and>6.0mmol/L. The combined outcome death before KRT or start of KRT. The association between categorical and continuous time-varying potassium and death or KRT start was examined using Cox proportional hazards and restricted cubic spline analyses, adjusted for age, sex, diabetes, cardiovascular disease, renin-angiotensin-aldosterone system (RAAS) inhibition, eGFR, and subjective global assessment (SGA). At baseline, 66% of participants were men, 42% had diabetes, 47% cardiovascular disease, and 54% used RAAS inhibitors. Their mean age was 76±7 (SD) years, mean eGFR was 17±5 (SD) mL/min/1.73m2, and mean SGA was 6.0±1.0 (SD). Over 8 years, 414 (24%) died before starting KRT, and 595 (35%) started KRT. Adjusted hazard ratios for death or KRT according to the potassium categories were 1.6 (95% CI, 1.1-2.3), 1.4 (95% CI, 1.1-1.7), 1.1 (95% CI, 1.0-1.4), 1 (reference), 1.1 (95% CI, 0.9-1.4), 1.8 (95% CI, 1.4-2.3), and 2.2 (95% CI, 1.5-3.3). Hazard ratios were lowest at a potassium of about 4.9mmol/L. Shorter intervals between potassium measurements would have allowed for more precise estimations. We observed a U-shaped relationship between serum potassium and death or KRT start among patients with incident CKD4-5, with a nadir risk at a potassium level of4.9mmol/L. These findings underscore thepotential importance of preventing both high and low potassium in patients with CKD 4-5. Abnormal potassium blood levels may increase the risk of death or kidney function decline, especially in older people with chronic kidney disease (CKD). We studied 1,714 patients aged≥65 years with advanced CKD from the European Quality (EQUAL) study and followed them for 8 years. We found that both low and high levels of potassium were associated with an increased risk of death or start of kidney replacement therapy, with the lowest risk observed at a potassium level of 4.9 mmol/L. In patients with CKD, the focus is often on preventing high blood potassium. However, this relatively high optimum potassium level stresses the potential importance of also preventing low potassium levels in older patients with advanced CKD.

Hyperpigmentation on the dorsal tongue

•A 73-year-old man had hyperpigmentation on the dorsum of the tongue.•His-symptoms were consistent with addison's disease from metastatic adrenal tumors.•Hyperpigmentation in addison's disease can occur anywhere due to various stimuli.•Hyperpigmentation could indicate susceptibility to acute adrenal insufficiency. A 73-year-old man diagnosed with brain metastasis from non-small cell lung carcinoma, not otherwise specified (NSCLC-NOS), was hospitalized for 1 week due to anorexia. A computed tomography revealed a 16.5 mm irregular-shaped nodule in the right lung apex, lymphadenopathy of the mediastinum, mesentery, and peri-aorta, and bilateral adrenal enlargement (46.3 and 48.7 mm in diameter). About 1 week before admission, his systolic blood pressure, which was approximately 110 mmHg suddenly dropped to approximately 80 mmHg. Simultaneously, his fasting blood glucose, also decreased to approximately 100 mg/dL from 200 mg/dL with a fever of 38 °C; he had poorly controlled type 2 diabetes. Since he had an electrolyte disorder with hyponatremia of 131 mEq/L and a slightly high serum potassium level of 5.7 mEq/L, he was referred to our department. A physical examination revealed hyperpigmentation on the dorsum of his tongue, which he reported had been present for 3 months prior to admission (Fig. 1A). What is the diagnosis? The symptoms are consistent with Addison's disease due to metastatic bilateral adrenal tumors. His-early-morning fasting blood cortisol (9.98 µg/dL) was inappropriately low against a markedly high adrenocorticotropic hormone (ACTH) level (145 pg/mL). His-dehydroepiandrosterone-sulfate level (11 µg/dL) was disproportionately low. Additionally, his plasma aldosterone concentration was <4.0 pg/mL, which is inappropriately low against the active renin concentration of 14.26 pg/mL, suggesting that his bilateral adrenal metastases impaired adrenal steroidogenesis in all layers of the adrenal cortex. The comparatively lower blood glucose, hypotension, and hyperkalemia are compatible with fever-induced acute adrenal insufficiency, which requires hydrocortisone and fludrocortisone replacement. One month following treatment initiation, the tongue discoloration disappeared (Fig. 1B). The coupling of pro-opiomelanocortin (POMC) peptides, α–melanocyte-stimulating hormone, and ACTH with the melanocortin-1 receptor stimulates melanogenesis [[1]Buscà R. Ballotti R. Cyclic AMP a key messenger in the regulation of skin pigmentation.Pigment Cell Res. 2000; 13: 60-69https://doi.org/10.1034/j.1600-0749.2000.130203.xCrossref PubMed Scopus (664) Google Scholar,[2]Wolf Horrell E.M. Boulanger M.C. D'Orazio J.A Melanocortin 1 receptor: structure, function, and regulation.Front Genet. 2016; 7: 95https://doi.org/10.3389/fgene.2016.00095Crossref PubMed Scopus (136) Google Scholar]. In Addison's disease, decreased negative feedback to the hypothalamus and pituitary due to reduced adrenal cortisol secretion increases POMC peptides, causing hyperpigmentation, which tends to occur in areas exposed to ultraviolet, chronic friction, and pressure [[3]Dunlop D. Eighty-six cases of Addison's disease.Br Med J. 1963; 2: 887-891https://doi.org/10.1136/bmj.2.5362.887Crossref PubMed Scopus (153) Google Scholar]. Furthermore, the pigmentation generally occurs on the side of the tongue touching the teeth. The patient had consistently brushed his tongue with a toothbrush and believed the friction might have caused hyperpigmentation; thus, when hyperpigmentation is observed in high-risk patients, they should be informed that they are susceptible to acute adrenal insufficiency when under intense stress, such as fever or trauma.

Phytochemical, Antidiabetic, Antioxidant, Antibacterial, Acute and Sub-Chronic Toxicity of Moroccan Arbutus unedo Leaves.

Moroccan Arbutus unedo is an essential medicinal plant; however, little is known about the biological properties of its leaves mentioned in Moroccan traditional medicine. Various standard experiments were performed to evaluate the phytochemical, antidiabetic, antioxidant, antibacterial, and acute and sub-chronic toxicity characteristics of A. unedo leaves. Phytochemical screening led to the identification of several phytochemical classes, including tannins, flavonoids, terpenoids, and anthraquinones, with high concentrations of polyphenols (31.83 ± 0.29 mg GAEs/g extract) and flavonoids (16.66 ± 1.47 mg REs/g extract). Further, the mineral analysis revealed high levels of calcium and potassium. A. unedo extract demonstrated significant antioxidant and anti-diabetic activities by inhibiting α-amylase (1.350 ± 0.32 g/mL) and α-glucosidase (0.099 ± 1.21 g/mL) compared to the reference drug Acarbose. Also, the methanolic extract of the plant exhibited significantly higher antibacterial activity than the aqueous extract. Precisely, three of the four examined bacterial strains exhibited substantial susceptibility to the methanolic extract . Minimum bactericidal concentration (MBC)/minimum inhibitory concentration (MIC) values indicated that A. unedo harbor abundant bactericidal compounds. For toxicological studies, mice were administered with A. unedo aqueous extract at single doses of 2,000 and 5,000 mg/kg. They did not exhibit significant abnormal behavior, toxic symptoms, or death during the 14-day acute toxicity test and the 90-day sub-chronic toxicity test periods. The general behavior, body weight, and hematological and biochemical status of the rats were assessed, revealing no toxicological symptoms or clinically significant changes in biological markers observed in the mice models, except hypoglycemia, after 90 days of daily dose administration. The study highlighted several biological advantages of A. unedo leaves without toxic effects in short-term application. Our findings suggest that conducting more comprehensive and extensive in vivo investigations is of utmost importance to identify molecules that can be formulated into pharmaceuticals in the future.

Evaluate the Complete Blood Picture and Some Biochemical Parameters in Patients referred to the dialysis unit in Diyala General Hospital

Research done on 40 patients; 24 males, 20-79 years, and 16 females, 42-67 years; referred to dialysis unit, Baqubah hospital, in November and December, 2021; January and February 2022. Creatinine, Urea and Iron, record high levels. Glucose, calcium, sodium, potassium, and phosphate, were within normal, and low levels of albumin. Means of Total Erythrocyte Counts (TECs), hemoglobin (Hb), Hematocrit% (HCT), and Mean Corpuscular Hemoglobin Concentration (MCHC), showed lowered level. While, Mean Cell Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Red Blood Cell Distribution Width- Standard Deviation (RDW-SD), Mean Red Blood Cell Distribution Width- Coefficient of Variation (RDW-CV), were within normal. Total Leucocyte Counts (TLCs), Neutrophils, Lymphocytes, Eosinophil, Basophils, were within normal, Platelet Counts and related parameter were within normal. Within ranges some values were higher than normal as, potassium, phosphate, (RDW-SD), (RDW-CV), Neutrophils%, Eosinophil%, Lymphocytes, Mean Platelets Volume (MPV). While some other values were lower as sodium, (TRCs), (Hb), (HCT %), (MCV), (MCH), (MCHC), (RDW-SD), (TLCs), Lymphocytes%, platelets, Platelet Distribution Width (PDW), Platelet- Large Cell Ratio (P-LCR). But some values of glucose, and calcium, were high, and some other low. At the same time Monocytes%, Basophils% was within normal range. In conclusion creatinine and urea levels have an important role in diagnosis and follow- up of kidney failure. All patients have high levels of urea, iron and creatinine. But not all have higher level of potassium and glucose. Sodium and albumin, showed decreased level. Blood picture revealed microcytic, hypochromic anemia; as (TECs), (Hb), (HCT %), (MCHC) and (RDW-SD) were of lower values.

Development of a Nutraceutical Product Derived from By-Products of the Lipid Extraction of the Brazil Nut (Bertolletia excelsa H.B.K)

The objective of this investigation was to develop a nutraceutical product, in bars, using defatted Brazil nut by-products. The methodological bases of analyses followed the guidelines of the Association of Official Analytical Chemists international and experimental tests of formulations. The bars presented with high protein content with high nutraceutical potential expressed as high levels of magnesium, sodium, calcium and potassium, with emphasis on selenium, supplying around 50% of the daily recommendations. The sulfur amino acids reach approximately the recommended chemical score (97%), the aromatic amino acids with a proportion close to 50% and those of the branched chain supplying the established recommendations for adults. In the sensory tests, the formulation that presented the best attributes and the greatest acceptance (91.78% for the flavor and 97.89% for the general impression) by the tasters was the bar formulation made with a 75:25 ratio of defatted Brazil nuts flour and isolated soy protein.

The Influence of Follicular Fluid Metals on Assisted Reproduction Outcome.

Infertility has become more common, with an increased exposure to toxic compounds including heavy metals (HM). Follicular fluid (FF) surrounds the developing oocyte in the ovary and can be analysed to assess metal content. The levels of twenty-two metals were measured in the FF of ninety-three females in a reproduction unit, and their influence on assisted reproduction technique (ART), were examined. The metals were determined by optical emission spectrophotometry. Low values of copper, zinc, aluminium, and calcium favour polycystic ovary syndrome. The relationships between the number of oocytes and metals: iron (rs=0.303; p=0.003) and calcium (rs=-0.276; p=0.007) are significant, as well as between the number of mature oocytes with iron (rs=0.319; p=0.002), calcium (rs=-0.307; p=0.003) and sodium (rs=-0.215; p=0.039) and are near to significance in the case of aluminium (rs=-0.198; p=0.057). In the group with a fertilisation rate ≤ 75%, 36% of the women presented calcium >176.62 mg/kg compared to the group with a fertilisation rate ≥ 75% where this percentage was only 10% (p=0.011). An excess of iron and calcium reduces the good quality embryo rate, and an excess of potassium impairs the blastocyst rate. If potassium is above 237.18 mg/kg and calcium is below 147.32 mg/kg, these conditions favour embryo implantation. Pregnancy is influenced by high potassium and low copper levels. Controlling exposure to toxic elements is recommended for all couples with reduced fertility or receiving an ART.

Prognostic Implications of Urinary Potassium to Creatinine Ratio in Patients With Predialysis Chronic Kidney Disease: A Cohort Study

Although a low or high serum potassium level in chronic kidney disease (CKD) is associated with worsening renal function and increased cardiovascular disease (CVD) events, urinary potassium excretion has been found to predict adverse health outcomes with conflicting results. We conducted a cohort study to determine whether urinary potassium to creatinine (K/Cr) ratio is an independent risk for further deterioration in renal function or increased CVD events. We identified 650 predialysis patients with CKD hospitalized for an educational program regarding CKD between January 2010 and December 2018. The study outcomes were CKD progression and incident CVD events, with baseline urinary K/Cr ratio categorized into quartiles-Q1, <19.8; Q2, 19.9-27.7; Q3, 27.8-37.9; and Q4, >38.0. During follow-up (median, 35 months), 509 CKD progressions and 129 incident CVD events were identified. Sixty-two patients died during follow-up. Multivariate Cox proportional hazard model showed that after adjustment for demographic factors and laboratory data, patients in Q1 had a 2.02-fold higher risk of worsening renal function than those in Q4 (95% confidence interval, 1.50-2.71; P < 0.001), whereas urinary K/Cr ratio had no association with the incidence of CVD events. Similarly, inverse probability weighting analysis showed an increased risk of CKD progression in the lowest quartile. Furthermore, the association between low fractional excretion of potassium and worsening renal function was confirmed. A low urinary K/Cr ratio is independently associated with worsening renal function but not with a risk of incident CVD event in predialysis patients with CKD.

Assessing Physiochemical Characteristics of Agricultural Waste and Ready Compost at Wadi Al-Far'a Watershed of Palestine.

The Wadi Al-Far'a Watershed (WFW) is one of the most important agricultural lands in Palestine where considerable amounts of organic wastes are generated. Yet, mismanagement of agricultural waste, including random disposal and/or burning, is a prevalent practice in the WFW. Such a practice might result in greenhouse gas emissions and leachate penetration into underlying soil and groundwater. To encourage compost production in the WFW as an efficient way for organic agricultural waste treatment and emission reduction, this study aims at evaluating the quality of both raw organic agricultural waste and ready compost, locally produced or imported. The evaluation considers the physiochemical characteristics as well as the heavy metal contents. The analysis of 17 samples of raw organic agricultural waste showed a good potential for compost production due to the high content of organic matter and other nutrients such as nitrogen and phosphorus. The analysis of 15 ready compost samples, however, showed that compost quality is relatively low due to the high electrical conductivity and low moisture content measurements as well as the high levels of sodium, chloride, and potassium. Furthermore, heavy metal contents of both raw organic agricultural waste and ready compost samples are less than the limits specified by the Palestinian and international standards. Therefore, local farmers can safely use raw organic agricultural waste generated in the WFW for compost production. Composting will not only enhance soil reclamation and crop production but also protect human health and the environment and promote sustainable economic development.

The Increased Clinical and Economic Burden of Hyperkalemia in Medicare Patients Admitted to Long-Term Care Settings.

Older patients are at increased risk for hyperkalemia (HK). This study describes the prevalence, recurrence, and clinical and economic burden of HK in Medicare patients admitted to a long-term care (LTC) setting. Retrospective cohort study using 100% Medicare Fee-for-Service (FFS) claims identified patients aged≥65years with index admission between 2017 and 2019 to a LTC setting (skilled nursing, home health, inpatient rehabilitation, or long-term acute care). Beneficiaries were required to have 12months continuous medical and pharmacy coverage prior to index LTC admission and≥30days after LTC discharge (follow-up). Patient characteristics, healthcare resource utilization, and costs were assessed. HK was defined as ICD-10 diagnosis code E87.5 in any claim position or Medicare Part D fill for oral potassium binder. Of 4,562,231 patients with a LTC stay, the prevalence of HK was 14.7% over the full study period (pre-index, index stay, and follow-up). Excluding those with HK only during the follow-up period resulted in 4,081,103 patients. Of these, 290,567 (7.1%) had HK and 3,790,536 (92.9%) did not have HK during or within 14days prior to index LTC stay. The HK recurrence rate during index stay and follow-up was 48.3%. Unmatched HK versus non-HK patients were more often male (43.0% vs. 35.4%), Black (13.5% vs. 8.0%), dual eligible for Medicaid (34.2% vs. 25.0%), with higher mean Charlson Comorbidity Index scores (6.2 vs. 3.9) (all p<0.0001). After propensity matching, HK patients were 2.2times more likely to be hospitalized, with higher mortality (30.8% vs. 21.5%) and higher total healthcare costs during both index stay (US$26,520 vs. $18,021; p<0.0011) and follow-up ($57,948 vs. $41,744 (p<0.0011) versus matched non-HK patients. Prevalence and recurrence of HK was high among LTC patients, and HK was associated with significantly greater clinical and economic burden during and post-LTC.

Effect of different drying methods on some mineral elements, amino acids and fatty acids of the fruits of some Iraqi palm cultivars

Abstract. Hamza RS, Al-Hashimi AG. 2023. Effect of different drying methods on some mineral elements, amino acids and fatty acids of the fruits of some Iraqi palm cultivars. Biodiversitas 24: 359-369. The current study aimed to produce date palm powder from low-quality local varieties, namely (Dayeri and Zahdi). The dates were dried by three methods (solar, electric and microwave) and the mineral elements of the date powder were investigated. The mineral components in the powder produced by heat treatments increased significantly, although the microwave was the best drying method. The microwave-dried Dayeri date powder had the highest levels of potassium and phosphorus, whereas the microwave-dried Zahdi showed the highest levels of calcium. A discrepancy was observed in the saturated and unsaturated fatty acids of date powder, diagnosed by gas chromatography connected to a mass spectrometer. Fatty acid levels were affected by heat treatments, a decrease in saturated and unsaturated fatty acids was recorded, especially by the electric oven drying method. Amino acids ratio varied between varieties and drying methods; the dates of the Zahdi variety contain the highest percentage of amino acids. The proline amino acid was superior to the other amino acids; the solar-dried Zahdi powder had the highest concentration of proline, while the microwave-dried powder had higher concentrations of leucine and serine. Similar amounts of phenylalanine and threonine were found in Zahdi powder that had been microwave dried. However, the amount of cysteine in that which had been solar-dried was higher. The objective of the current study is to determine some biochemical constituents of the locally considered low-quality dates in southern Iraq. These date varieties have not been investigated before for their nutritional quality.

High Levels of Extracellular Potassium Can Delay Myxoma Virus Replication by Preventing Release of Virions from the Endosomes.

Potassium (K+) is one of the most abundant cations in the human body. Under normal conditions, the vast majority of K+ is found within cells, and the extracellular [K+] is tightly regulated to within 3.0 to 5.0 mM. However, it has recently been shown that high levels of localized necrosis can increase the extracellular concentration of K+ to above 50 mM. This raises the possibility that elevated extracellular K+ might influence a variety of biological processes that occur within regions of necrotic tissue. For example, K+ has been shown to play a central role in the replication cycles of numerous viral families, and in cases of lytic infection, localized regions containing large numbers of necrotic cells can be formed. Here, we show that the replication of the model poxvirus myxoma virus (MYXV) is delayed by elevated levels of extracellular K+. These increased K+ concentrations alter the cellular endocytic pathway, leading to increased phagocytosis but a loss of endosomal/lysosomal segregation. This slows the release of myxoma virus particles from the endosomes, resulting in delays in genome synthesis and infectious particle formation as well as reduced viral spread. Additionally, mathematical modeling predicts that the extracellular K+ concentrations required to impact myxoma virus replication can be reached in viral lesions under a variety of conditions. Taken together, these data suggest that the extracellular [K+] plays a role in determining the outcomes of myxoma infection and that this effect could be physiologically relevant during pathogenic infection. IMPORTANCE Intracellular K+ homeostasis has been shown to play a major role in the replication of numerous viral families. However, the potential impact of altered extracellular K+ concentrations is less well understood. Our work demonstrates that increased concentrations of extracellular K+ can delay the replication cycle of the model poxvirus MYXV by inhibiting virion release from the endosomes. Additionally, mathematical modeling predicts that the levels of extracellular K+ required to impact MYXV replication can likely be reached during pathogenic infection. These results suggest that localized viral infection can alter K+ homeostasis and that these alterations might directly affect viral pathogenesis.

Ispitivanje nutritivnog potencijala različitih genotipova lanika - mineralni sastav i bioaktivna jedinjenja

Camelina sativa is a member of the Brassicaceae family and is characterized as an annual oilseed plant with a short growth cycle. Its seeds offer rich nutritional value comparable with other feed and food sources due to the presence of high-quality oils, protein, essential fatty acids, and bioactive compounds. Our study investigated mineral profile and bioactive compound contents among two different camelina genotypes. The evaluated camelina genotypes NS Zlatka and NS Slatka were developed in Serbia. The bioactive compound investigation included total phenolic and flavonoid contents, chlorophyll a and b, and total carotenoid contents. Furthermore, antioxidant activity was assessed by measuring the DPPH-scavenging capacity of camelina seed extracts. The results demonstrate differences in mineral content between the two genotypes, with variations in sodium, potassium, calcium, magnesium, zinc, iron, manganese, copper, and phosphorus levels. Both genotypes exhibit notable mineral profiles, with particularly high levels of potassium (1007.76-1047.74 mg/100 g) and magnesium (224.09-227.45 mg/100 g), which makes them potentially valuable for both animal feed and human nutrition. Furthermore, analysis reveals substantial levels of total phenolic (8.13-8.16 mg GAE/g DM) and flavonoid (5.91-6.41 mg QE/g DM) compounds in both genotypes, indicating their suitability for applications in the food and pharmaceutical industries. Chlorophyll content analysis demonstrates significant differences between the two genotypes, particularly in chlorophyll a and chlorophyll b levels. These variations suggest differences in photosynthetic capacity and seed maturity. Total carotenoid content remains consistent between the genotypes at levels from 16.43 to 17.91 µg b-CE/g DM, implying similar antioxidant protection mechanisms. Overall, this study provides valuable insights into the biochemical properties of two camelina genotypes, indicating their potential applications in agriculture and human nutrition.

PERK/ATF3-Reduced ER Stress on high potassium environment in the suppression of tumor ferroptosis.

Potassium (K+) is a vital intracellular cation. In the human body, it regulates membrane potential, electrical excitation, protein synthesis, and cell death. Recent studies revealed that dying cancer cells release potassium into the tumor microenvironment (TME), thereby influencing cell survival-related events. Several investigations reported that potassium channels and high potassium levels influence apoptosis. Increasing extracellular potassium and inhibiting K+ efflux channels significantly block the apoptotic machinery. However, it is unknown whether a high-potassium environment also affects other types of cell death such as ferroptosis. In the present study, cell counting kit (CCK-8), colony formation ability, and 5-ethynyl-2'-deoxyuridine (EdU) assays demonstrated that a high-potassium environment reverses erastin-induced ferroptosis. RNA sequencing (RNA-Seq) and Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene ontology (GO) analyses indicated that high potassium levels attenuated the unfolded protein response that is characteristic of endoplasmic reticulum (ER) stress. The ER transmembrane proteins PRKR-like ER kinase (PERK), inositol-requiring enzyme 1α (IRE1α), and activating transcription factor 6 (ATF6) are recognized as ER stress sensors. Here, the PERK blocker GSK2606414 significantly rescued ferroptosis. The present work also disclosed that the ER-related gene activating transcription factor 3 (ATF3) played a vital role in regulating ferroptosis in a high-potassium environment. The foregoing results revealed the roles of potassium and the TME in cancer cell ferroptosis and provided a potential clinical therapeutic strategy for cancer.

Efficacy of orally administered montmorillonite in myoglobinuric acute renal failure model in male rats.

Acute kidney injury can be associated with serious consequences and therefore early treatment is critical to decreasing mortality and morbidity rate. We evaluated the effect of montmorillonite, the clay with strong cation exchange capacity, on the AKI model in rats. Glycerol (50% solution, 10 ml/kg) was injected in the rat hind limbs to induce AKI. 24 hr after induction of acute kidney injury, the rats received oral doses of montmorillonite (0.5 g/kg or 1 g/kg), or sodium polystyrene sulfonate (1 g/kg) for three consecutive days. Glycine induced acute kidney injury in rats with high levels of urea (336.60± 28.19 mg/dl), creatinine (4.10± 0.21 mg/dl), potassium (6.15 ± 0.28 mEq/L), and calcium (11.52 ± 0.19 mg/dl). Both doses of montmorillonite (0.5 and 1 g/kg) improved the serum urea (222.66± 10.02 and 170.20±8.06, P<0.05), creatinine (1.86±0.1, 2.05± 0.11, P<0.05), potassium (4.68 ± 0.4, 4.73 ± 0.34, P<0.001) and calcium (11.15 ± 0.17, 10.75 ± 0.25, P<0.01) levels. Treatment with montmorillonite especially at a high dose reduced the kidney pathological findings including, tubular necrosis, amorphous protein aggregation, and cell shedding into the distal and proximal tubule lumen. However, administration of SPS could not significantly decrease the severity of damages. According to the results of this study, as well as the physicochemical properties of montmorillonite, such as high ion exchange capacity and low side effects, montmorillonite can be a low-cost and effective treatment option to reduce and improve the complications of acute kidney injury. However, the efficacy of this compound in human and clinical studies needs to be investigated.

CLINICAL AND BLOOD PARAMETERS IN RELATION TO THE OUTCOMES OF COMMUNITY ACQUIRED PNEUMONIA

Background: Risk stratification of Community acquired pneumonia (CAP) is challenging for physicians. Though various biomarkers are available, they are costly or not readily available in all health care settings. This study aimed to analyze the prognostic value of routinely available clinical and blood parameters in relation to the outcome of patients admitted with community acquired pneumonia. Methods: This was a hospital-based observational study of the patients admitted to Chitwan Medical College (CMC), Nepal between August 2021 and December 2021. We enrolled patients 18 years old and above with the diagnosis of CAP in the study and excluded patients with COVID and active pulmonary tuberculosis. The outcomes of the patients were recorded as improved, not-improved, or dead. Fischer exact, Kruskal-Wallis or Mann-Whitney tests were used for analysis wherever appropriate. Results: Total 92 patients with mean age 58.2 years were enrolled in the study. Patients who were not improved or were dead had higher age (p=0.029), respiratory rate (p&lt;0.001), shock index (p=0.013), total leukocyte count (TLC) (p=0.019), urea (p=0.046), creatinine (p&lt;0.01), potassium (p&lt;0.001), bilirubin (p=0.029), and lactate (P&lt;0.05) and lower SpO2 (p&lt;0.01), SpO2/FiO2 (p=0.018), pH (p=0.0497), and PaCO2 (p&lt;0.001). Patients with nervous (p&lt;0.001), cardiovascular (p=0.032) and renal system (p=0.019) involvement were also found to be associated with poor outcome. Conclusions: CAP patients with higher TLC, urea, creatinine, bilirubin and lactate, with lower SpO2, SpO2/FiO2, pH and PaCO2 and with involvement of more than one organ systems were found to have unfavorable prognosis. Higher potassium level was also found to be a potential marker of CAP severity.

Nutrient contents in different sources of organic manures used in different farms of Bhaktapur district, Nepal

Organic manure contributes carbonaceous matter to soil, which when decomposed, offers mineral nutrients to plants, also acts as a base exchange material, and helps to improve the physical, chemical, and biological aspects of soil. This study was conducted to assess the amount of total nitrogen, available phosphorous, available potassium, pH, under various organic manure sources. Collected organic matter samples were tested for total nitrogen, available phosphorus, available potassium, soil organic matter, and pH at the soil laboratory of Nepal Polytechnic College, Bharatpur-11, Chitwan, using the NARC, Soil Science Research Centre, Khumaltar, Lalitpur standard rating. The overall nitrogen concentration of goat dung was 1.667%, whereas buffalo manure had the lowest at 0.665%. The available phosphorus content of organic manure in the research area ranged from 0.732% in vermi-compost to 0.432% in compost, with substantial differences amongst manure samples. The goat manure had the highest potassium level (0.853%), whereas buffalo manure had the lowest (0.513%). The pH value of goat manure was 8.4 while the pH content of compost manure was 7.567. The maximum amount of organic matter (54.8) was found in buffalo manure, while the lowest (46.3) was found in vermi compost. The maximum amount of organic matter (54.8%) was found in buffalo manure, while the lowest (46.3%) was found in vermi compost. Modern technology must be adapted for successful and improved manure production. To increase the availability and maintenance of nutrients in organic manure, methods such as covering the manure to protect it from rain and sun, avoiding waterlogged conditions, and correct manure decomposition can be implemented.&#x0D;

Analisis Kadar Nitrogen, Fosfor dan Kalium Pada Lahan Tambang Aspal Buton

Asphalt resources in Buton Island, Southeast Sulawesi Province are the only natural asphalt deposits in Indonesia. In addition to Indonesia, natural asphalt deposits are found in the Trinidad Islands, Albania and Iraq which are used for road coatings, building roofs, mastic flooring, paving mixes and paint mixtures. This study analyzes the levels of Nitrogen, Phosphorus and Kaliam at three asphalt mining locations, namely: heaps from asphalt processing, unprocessed asphalt land and locations from mining processing. The sample was taken from Nambo Village, Lasalimu District, Buton Regency, where the entire area is an asphalt mine. This study aims to provide solutions to the community regarding the handling of nutrient levels in asphalt mining land so that it can be used as agricultural land. The research was conducted through several stages including: Preparation of Tools and Materials; Sample Preparation; Analysis of Soil Nutrient Levels (includes: elemental N analysis, elemental analysis of P and analysis of elemental K). The results obtained that the highest soil nitrogen content was found in asphalt mining waste, namely 0.39% at a depth of 25 cm and 0.27% at a depth of 50 cm, while the lowest nitrogen content was found in soil without mining activities, namely 0.1 at a depth of 50 cm. at a depth of 25 cm and 0.07 at a depth of 50 cm. The highest phosphorus levels were found in soil without mining activities, namely 1302 mg/100g at a depth of 25 cm and 1518 mg/100g at a depth of 50 cm, while the lowest phosphorus levels were found in ex-mining soil, namely 329 mg/100g at a depth of 25 cm and 405 g. mg/100g at a depth of 50 cm. The highest potassium levels were found in soil without mining activities, namely 569 mg/100g at a depth of 25 cm and 521 mg/100g at a depth of 50 cm, while the lowest potassium levels were found in ex-mining soil, which was 127 mg/100g at a depth of 25 cm. and 128 mg/100g at a depth of 50 cm.