znaci, koji savet su poslusali, ili nisu, i kakvu je to promenu u njihovom stanju izazvalo, na bolje ili gore.

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bravo u potpunosti se slazem sa tobom..

heavenbesideu
slazem se donekle sa ovim gore sto si rekao da treba da se mijenja način zivota...Tačno je da promjena zivota dovodi do jako dobrih rezultata ali isto tako smatram da način zivota (osim ako ne koristis nešto bas otrovno i ne ubijaš se time)..nije jedini koji dovodi do zdravstvenih probLEMA..Stvar je mnogo kompleksnija...ja lično vjerujem da veliku većinu bolesti uzrokuju razne bakterije , paraziti i gljivice...vise nego bilo kakav način zivota.

Hvala vam doktore sto ste uvek ovde sa nama i u ime svih prisutnih vas puno pozdravljam

Ako se slozimo da je kiselina ta sto nas pravi bolenim...sa tim mogu da se složim jer zato mnogim ljudima odgovara soda bikarbona, tj ona im otklanja mnoge simptome...ali tu je nešto sto mi se ne slaze sa mojom logikom..

Kao prvo kažu da probiotici koji su navodno jako zdravi zahtjevaju kiselu sredinu...
dalje...kažu da proteini stvaraju kiselu sredinu u organizmu dok vecina bolesnih ljudi osjeti da im proteini gode a da ih bolesnim čini secer tj UH, cokolada mlijecni proizvodi isl..

Nisam sigurna da li i secer i cokolada i mlijecni proizvodi trebaju kiselinu da bi se provarili ili je stvaraju kasnije u tijelu ...ali sve i da se zadržimo samo na proteinima o kojima sam citala da stvaraju kiselinu ..kako to da nam proteini gode tj ne osjecamo kiselinu kada njih jedemo ili to nema veze sa kiselinom u zeludcu?

I dalje da li bi onda bilo jednostavno samo jesti šta god hoćeš i zaliti na kraju kad se sve svari sa jednom casom sode bikarbone razmucene u casi?

u stvari organizam postane kasnije osjetljiv na ishranu kada je već posrnuo..kada ga je već nešto prije toga unistilo...
Pitanje moje je šta je to unistilo organizam da ne može vise da funkcionise onako kako je prije funkcionisalo...(ovdje kažem za normalne ljude koji svoj organizam nisu zloupotrbljavali i unistavali ga)

Kako je diskusija krenula u pravcu rasprave o acidozi tijela kao bitnom faktoru za pojav obolenja kod toga je potrebno znati osnovne stvari o tome.
Idemo redom:
Normalan pH organizma covjeta se određuje u krv i kreće se od pH 7.35 do 7.45. Sve ono sto je ispod 7.35 smatra se acidozom i može se podijeliti u blagu, srednju i tesku acidozu. Odredjivanje pH u krvi se radi jer krv prozi kroz sve dijelove ljudskog organizma i kao jedinstven sistem je povezan i sa stanicama i međustanicnim prostorom. Odredjivanje pH u: zelucanoj kislilini, pljuvacki, dvanestercu, stolici mokraci nisu mjerodavni za donosenje zakljucaka o kiselosti organizma.
Porast pH organizma=krvi može nastati unutra samog organizma (endogeno) ili kao posledica unosa kiselih produkata (exogeno).
Endogena acidoza se dijeli u Respiratornu i metabolicku.
Enodgena kiselost nastaje kao posledica bolesti organa koji održavaju acidobazno stanje (pluca, bubrezi jetra) ili kao posledica poremecaja metabolizma u organizmu (secera, masti, bjelancevina itd).
Egzogena kiselost nastaje kao posledica unosa hranjivih tvari u kolicini koja može narusiti pH organizma ili kao posledica trovanja.

Kako nastaje acidoza evo vam sazeto, onima koji razumiju engleski
Koliko je slozeno sami će te zakljuciti i vjerujem ako niste ljekari da necete moći ni razumeti. Ovo dajem jednostavno da vidite nivo vaseg znanja kod rasprave o ovom problemu. A sada tekst:

PATHOPHYSIOLOGY

There are 3 approaches to understanding acid/base balance: A qualitative approach using the Henderson/Hasselbalch equation, a semiqualitative approach with base excess, and the Strong Ion Theory. The 3 theories are reviewed below.

Henderson-Hasselbalch approach to acid/base physiology

The Henderson-Hasselbalch equation describes the relationship between blood pH and the components of the H2 CO3 buffering system. This qualitative description of acid/base physiology allows the metabolic component to be separated from the respiratory components of acid/base balance.

pH = 6.1 + log (HCO3/ H2 CO3)

Bicarbonate (HCO3) is in equilibrium with the metabolic components.

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Bicarbonate production in the kidney
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Acid production from endogenous or exogenous sources

Carbonic acid (H2 CO3) is in equilibrium with the respiratory component, as shown by the below equation:

H2 CO3 = PCO2 (mm Hg) X 0.03

Metabolic acidosis can be caused by the following:

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Increase in the generation of H+ from endogenous (eg, lactate, ketones) or exogenous acids (eg, salicylate, ethylene glycol, methanol)
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Inability of the kidneys to excrete the hydrogen from dietary protein intake (type I, IV renal tubular acidosis)
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The loss of bicarbonate (HCO3) due to wasting through the kidney (type II renal tubular acidosis) or the gastrointestinal tract (diarrhea)
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The kidneys response to a respiratory alkalosis

Base excess approach to acid/base physiology

Unfortunately, the Henderson/Hasselbalch equation is not linear; pCO2 adjusts pH as part of the normal respiratory compensation for acid/base derangements. This nonlinearity of Henderson-Hasselbalch prevents this equation from quantifying the exact amount of bicarbonate deficit in a metabolic acidosis. This observation led to the development of a semiquantitative approach, base excess (BE).

BE = (HCO3 – 24.4 + [2.3 X Hgb + 7.7] X [pH – 7.4]) X (1 – 0.023 X Hgb)

Base excess attempts to give a quantitative amount of bicarbonate (mmol) that is required to be added or subtracted to restore 1 L of whole blood to a pH of 7.4 at a pCO2 of 40 mm Hg. To standardize BE for hemoglobin, the following formula was developed with improved in vivo accuracy, the standardized base excess (SBE):

SBE = 0.9287 X (HCO3 – 24.4 + 14.83 X [pH – 7.4])
Strong Ion approach to acid/base physiology

These classical descriptions of acid/base physiology often failed to account for acid/base findings in critically ill patients. An alkalosis was often noted in critically ill patients as their serum albumin level decreased, which could not be quantified by Henderson Hasselbalch or BE. Also, the „dilutional” acidosis frequently encountered after a large infusion of normal saline could not be explained by either of these 2 approaches to acid/base balance.

Both Henderson Hasselbalch and BE assume that the cations (Ca2+, Mg2+) and anions (Cl-, albumin, PO4-) in plasma remain unchanged in a patient with metabolic acidosis. Yet, in critically ill patients, these ions are known to be in dynamic flux. During the 1980s, Dr. Peter Stewart developed an acid/base theory (Strong Ion) using quantitative chemistry, which accounted for fluctuations of all the ions dissolved in plasma. Based on the requirements for electrical neutrality in any solution as any one of the concentrations of these ions changes, water must dissociate into H+ or OH- to balance the charge. The pH in this scheme is not a consequence of the ratio of acid to base in solution but determined by 3 independent variables:

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Strong ion difference (SID) – Ions almost completely dissociated at physiologic pH.

SID = [Na+ + K+ + Ca2+ + Mg2+] – [Cl- + Lactate-]

(Ca2+ and Mg2+ are the concentrations of their ionized forms, Mg2+ X 0.7 = ionized Mg2+ concentration)

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Total weak acid concentration (Atot) – Ions that can exist dissociated (A-) or associated (AH) at physiologic pH (buffers)

Atot = 0.325275 X [albumin] + 2 X [phosphate]

*
pCO 2 (mm Hg)

The Henderson Hasselbalch equation can be reformulated with variables from the Strong Ion Theory to give a more generalizeable solution to pH.

pH = pK1 ’ + log [SID] – Ka – [ATOT]/[Ka + 10–pH]

SPCO2

(K1’ is the equilibrium constant for the Henderson-Hasselbalch equation, Ka is the weak acid dissociation constant, and S is the solubility of CO2 in plasma.) See the image below.
Approach for evaluating metabolic acidosis. Approach for evaluating metabolic acidosis.

Once a metabolic acidosis is suspected by low bicarbonate concentration, an arterial blood gas analysis should be obtained. The low HCO3 level can be caused either by a primary metabolic acidosis or as the metabolic compensation for a respiratory alkalosis. The direction of the pH will separate metabolic acidosis (pH <7.35) from a respiratory alkalosis (pH> 7.45).

The normal respiratory response (Kussmaul breathing) to a metabolic acidosis is a decrease in pCO2. This is given by the Winter’s equation:

PCO2 = 1.5 X (observed HCO3) + 8±2

(A quick rule of thumb: The PCO2 should approximate the last two digits of pH. For example, pH 7.25, PCO2 should be close to 25 mm Hg.)

Failure to have an appropriate respiratory response to metabolic acidosis represents a failure of airway and/or breathing, which must be addressed before any other workup commences.

Once an appropriate respiratory response for a metabolic acidosis has been established, the workup for the presence of unmeasured anions can progress by using the traditional anion gap, the delta-delta approach, or the strong ion gap. This allows the differential of metabolic acidosis to be narrowed and the appropriate therapy applied.

To differentiate between the causes of metabolic acidosis, one traditionally calculates the anion gap (AG), corresponding the presence of unmeasured anions.

AG = (Na+) - ([Cl-] + [HCO3-])

The anion gap allows for the differentiation of 2 groups of metabolic acidosis. Metabolic acidosis with a high AG is associated with the addition of endogenously or exogenously generated acids. Metabolic acidosis with a normal AG is associated with the loss of HCO3 from the kidney or GI tract, or the failure of the kidney to excrete H+.

The delta/delta concept allows for the partitioning of metabolic acidosis into an anion gap and a non-anion gap component, which can occur contemporaneously. The concept behind delta/delta is based on the assumption that for every increase in anion gap of 1 mmol/L above normal (12 mmol), serum HCO3- will drop by an equal amount.[1]

Δ anion gap = Δ HCO3

If the delta HCO3- is greater than the delta anion gap, then a concomitant non-anion gap acidosis must exist along side the anion gap acidosis. One example would be a patient with a congenital renal tubular acidosis in diabetic ketoacidosis (DKA).

Stewart provides a replacement for the standard anion gap and delta/delta, which allows one to directly measure the amount of unmeasured anions in solution corrected for changes from normal of Ca2+, Mg2+, albumin, and phosphate.[2] This is the Strong Ion Gap (SIG).

SIG = ([Na+ + K+ + Ca2+ + Mg2+] – [Cl- + lactate]) –

([2.46 x 10- X pCO2/10-pH] + [albumin{g/dL} X

{0.123 x pH – 0.631}] + [PO4 - {mmol/L} X {pH – 0.469}]

All the strong ions are expressed in mEq/L, and only the ionized portions of Mg2+ and Ca2+ are considered (to convert total to ionized Mg2+, multiply by 0.7). Because of the complexity of the above equation, several Internet resources are available to calculate the SIG. For example, The Steart approach to acid-base is a good resource. The normal SIG is between 0 and 2. SIG has been shown to be better than blood lactate, pH, or injury severity scores in trauma patients and pediatric surgery patients as a predictor of mortality.

Sve najbolje Galeb

Ovo nije isti text koji sam jucer procitala ali je isto atko jako dobar..
Approximately 50 to 60 percent of a human's body weight is from water. The percentage varies based on several factors. For instance, fat holds very little water while muscle is about 75 to 77 percent water. The obese couch potato may contain 50 percent or less in water weight. On the other hand, a fit muscular person may have 60 to 65 percent of water in body weight.

The water in the body can be compared to swimming pool water. Swimming pools are strictly monitored to keep the water at a certain pH balance. The water should not be too acidic nor too alkalitic. The fluid in the human body must stay within normal ranges also. Th normal pH balance in the human body is 7.35 to 7.45, (which is basically neutral). If the pH gets low (acidosis) or high (alkalosis) there will be specific problems that could be life threatening.

The water in the human body is further broken down into specific categories. Intracellular fluid (ICF) is water actually contained inside cells. Extracellular fluid (ECF) is water outside the cells. Combined, ICF and ECF equal 60 percent on average of the total body weight. Extracellular fluid is further broken down into interstitial fluid, plasma, bone, connective tissue, and transcellular fluid. Interstitial fluid, primarily located in the lymphatic system, equals about 12 percent of body weight. Plasma, basically the liquid portion of the blood, equals about 4.5 percent of body weight. Connective tissue accounts for about 4.5 percent, with the smallest amount of 1.5 percent being composed of transcellular fluid.
The body has several different ways to ensure that the pH balance stays in the normal range of 7.35 to 7.45. These are referred to as buffer systems. Through normal day to day activity in the body, acids are formed as waste products that need to be neutralized or eliminated. Some of the acids are released with CO2 from exhaling; others are excreted via the kidneys. These systems work together in the healthy human body to keep the pH level within normal ranges.

If for some reason the buffering systems fail or are hindered, the pH balance will be upset. Either too much or too little of the acids will be neutralized. The causes of this can be as simple as the flu or as complications from trauma, disease or serious illness. Once the body senses the pH is out of kilter, it will attempt to compensate to correct the problem. The conditions for when this happens are known as acidosis or alkalosis. These are further broken down into either metabolic or respiratory in nature. This includes metabolic acidosis, respiratory acidosis, metabolic alkalosis, and respiratory alkalosis.

One of the chief buffers in the blood is bicarbonate, which helps neutralize acids. This is like taking an antacid for heartburn. Metabolic acidosis is caused by the loss of bicarbonates or an increased production of acids. Some causes for bicarbonate loss can be severe diarrhea, drug intoxication or abuse, or severe illness. Some causes for increased acid production include serious illness or injuries, and decreased blood flow. An example of this is when you leg „falls asleep”. Blood flow is decreased allowing acid to build up. Upon standing, blood flow is restored. The tingly pin and needle sensation is caused from the excess acid in the tissues. The acid is then neutralized resulting in the pin and needle sensation subsiding.
Respiratory acidosis is usually caused by insufficient respirations or air exchange. This can be caused by head or chest trauma and respiratory diseases such as emphysema. In cases of emphysema, the lungs cannot perform normally due to an increase of dead air space. Acidosis develops slowly over a period of time. These are usually treated with bronchodilators and small amounts of oxygen to increase air exchange in the lungs. With a severe decrease in breathing caused by trauma or respiratory arrest, the amount of acid quickly increases. Adequate measures need to be taken to treat the cause.

Metabolic alkalosis occurs when too much acid is excreted from the body. This can be caused by eliminating too much fluid by frequent urination, by excessive vomiting, or various diseases. If the body becomes too alkalitic, the nervous system and the heart can be affected. The heart may speed up and become irritable while breathing slows in order to compensate. By slowing respirations, less acid is „blown off” from the lungs. This is in contrast to hyperventilation often seen in metabolic acidosis. Metabolic alkalosis is treated based on findings from laboratory tests.

Respiratory alkalosis is caused when the body is stressed. Some of the causes include shock, sepsis, trauma and asthma. Too much acid is „blown off” from increased respirations or hyperventilation. In cases of hyperventilation of psychogenic origin, the increase in alkalosis causes the tingly sensation around the mouth and in the fingertips. Because of hyperventilation, blood is slowed to the brain so the respiratory center tells the body to increase respirations. In psychogenic hyperventilation, the symptoms of tingling and feeling of smothering continue to worsen. Treatment of respiratory alkalosis is basically to treat the cause. This can include the simple paper bag method for psychogenic hyperventilation, to using sedation to slow respiration. By slowing the breathing, the blood flow is returned to the brain. This allows the respiratory center to regulate itself and get the levels back to normal. Interesting, in psychogenic hyperventilation, if the person continues to hyperventilate, they often pass out. Respirations slow and return to normal, in turn the body gets back to normal.