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Mark G Williams
BACKGROUND: The aim of this study was to examine biochemical investigations not routinely performed prior to emergency laparotomy in patients at Queen Elizabeth Central Hospital, a low-resource public hospital in Blantyre, Malawi. METHODS: A prospective cross-sectional study of adults (N = 15) needing emergency laparotomy over a 4-week period were studied at Queen Elizabeth Central Hospital. Biochemical investigations, not routinely performed for economic reasons, were performed preoperatively; these included sodium, potassium, chloride, carbon dioxide, urea, and calcium levels...
March 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
Asbjørn Ettrup-Christensen, Louise Amstrup-Hansen, Stine T Zwisler
Long-distance athletes are at risk of serious fluid and electrolyte disturbances, such as hypernatraemia (dehydration). Recently, cases of serious morbidity have been reported, due to acute exercise-associated hyponatraemia, which can advance to encephalopathy. An arterial blood gas analysis (ABG) was drawn from collapsed athletes at the championship of full-distance triathlon 2015, and different electrolyte imbalances were found. Our findings show that prehospital ABG can assist in differentiating the cause of collapse, and presumably, targeted treatment can be initiated already on scene...
May 1, 2017: Ugeskrift for Laeger
Sunil Bhandari, Alessandro Peri, Iain Cranston, Rachael McCool, Alison Shaw, Julie Glanville, Larisa Petrakova, Karl O'Reilly
International and national guidelines on the treatment of chronic nonhypovolaemic hypotonic hyponatraemia differ; therefore, we have undertaken this systematic review and meta-analysis to investigate the efficacy and safety of interventions for the treatment of chronic nonhypovolaemic hypotonic hyponatraemia. Following registration of the review protocol with PROSPERO, systematic literature searches were conducted to identify randomized and quasi-randomized controlled trials assessing any degree of fluid restriction or any drug treatment with the aim of increasing serum sodium concentration in patients with chronic nonhypovolaemic hypotonic hyponatraemia...
June 2017: Clinical Endocrinology
Martín Cuesta, Mark J Hannon, Christopher J Thompson
INTRODUCTION: Adipsic diabetes insipidus (ADI) is a very rare disorder, characterized by hypotonic polyuria due to arginine vasopressin (AVP) deficiency and failure to generate the sensation of thirst in response to hypernatraemia. As the sensation of thirst is the key homeostatic mechanism that prevents hypernatraemic dehydration in patients with untreated diabetes insipidus (DI), adipsia leads to failure to respond to aquaresis with appropriate fluid intake. This predisposes to the development of significant hypernatraemia, which is the typical biochemical manifestation of adipsic DI...
June 2017: Pituitary
Jeffrey Tan, Samuel Ndoro, Uchenna Okafo, Aoife Garrahy, Amar Agha, Danny Rawluk
Adipsic diabetes insipidus (ADI) is an extremely rare complication following microsurgical clipping of anterior communicating artery aneurysm (ACoA) and left middle cerebral artery (MCA) aneurysm. It poses a significant challenge to manage due to an absent thirst response and the co-existence of cognitive impairment in our patient. Recovery from adipsic DI has hitherto been reported only once. A 52-year-old man with previous history of clipping of left posterior communicating artery aneurysm 20 years prior underwent microsurgical clipping of ACoA and left MCA aneurysms without any intraoperative complications...
December 16, 2016: New Zealand Medical Journal
Chanabasappa V Chavadi, K Suprasanna, Anees Dudekula, Madhav Hegde, Swetha Kory
Rapid correction of hyponatremia is a well-known cause of central pontine and extrapontine myelinolysis. But uncommonly seen and rarely reported in Hypernatraemia. We report a rare case presenting as postpartum psychosis, wherein imaging revealed myelinolysis of corticospinal tracts in wine glass distribution and empty delta sign due to cortical venous thrombosis. At follow-up 3 months later, revealed significant neurological improvement. Concurrance occurrence of this dual pathology is not been described, which in our case was due to high serum sodium levels at presentation and dehydration...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
I R Adekunle-Olarinde, S J McCall, R S Barlas, A D Wood, A B Clark, J H Bettencourt-Silva, A K Metcalf, K M Bowles, R L Soiza, J F Potter, P K Myint
OBJECTIVES: To examine the usefulness of including sodium (Na) levels as a criterion to the SOAR stroke score in predicting inpatient and 7-day mortality in stroke. MATERIALS AND METHODS: Data from the Norfolk and Norwich University Hospital Stroke & TIA register (2003-2015) were analysed. Univariate and then multivariate models controlling for SOAR variables were used to assess the association between admission sodium levels and inpatient and 7-day mortality. The prognostic ability of the SOAR and SOAR Na scores for mortality outcomes at both time points were then compared using the Area Under the Curve (AUC) values from the Receiver Operating Characteristic curves...
May 2017: Acta Neurologica Scandinavica
Daynia E Ballot, Victor A Davies, Peter A Cooper, Tobias Chirwa, Andrew Argent, Mervyn Mer
OBJECTIVE: Report on survival to discharge of children in a combined paediatric/neonatal intensive care unit (PNICU). DESIGN AND SETTING: Retrospective cross-sectional record review. PARTICIPANTS: All children (medical and surgical patients) admitted to PNICU between 1 January 2013 and 30 June 2015. OUTCOME MEASURES: Primary outcome-survival to discharge. Secondary outcomes-disease profiles and predictors of mortality in different age categories...
2016: BMJ Open
Osama Adnan Kensara, Firas Sultan Azzeh
OBJECTIVE: To assess the nutritional status of low birth weight infants from Makkah area immediately after birth. METHODS: The prospective study was conducted between October and December 2012 at Al-Noor Speciality Hospital, Makkah, Saudi Arabia, and comprised low birth weight infants who were divided into three equal groups according to their birth weight: group A (low birthweight1501-2500gm), group B (very low birthweight1001-1500gm), and group C (extremely low birth weight < 1000gm)...
April 2016: JPMA. the Journal of the Pakistan Medical Association
Daniela Marx-Berger, David V Milford, Meenakshi Bandhakavi, William Van't Hoff, Robert Kleta, Mehul Dattani, Detlef Bockenhauer
AIM: Using fluid restriction to treat the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in infants is potentially hazardous, as fluid intake and caloric intake are connected. Antagonists for the type 2 vasopressin receptor have demonstrated efficacy in adult patients with SIADH, but evidence in children is lacking. We reviewed our experience from two cases in the UK. METHODS: This was a retrospective review of the clinical data on two patients diagnosed with SIADH in infancy and treated with tolvaptan, an oral vasopressin receptor antagonist...
July 2016: Acta Paediatrica
Shailesh Bihari, Dani-Louise Dixon, Mark D Lawrence, Andrew D Bersten
BACKGROUND: Sucrose induced hyperosmolarity is lung protective but the safety of administering hyperosmolar sucrose in patients is unknown. Hypertonic saline is commonly used to produce hyperosmolarity aimed at reducing intra cranial pressure in patients with intracranial pathology. Therefore we studied the protective effects of 20% saline in a lipopolysaccharide lung injury rat model. 20% saline was also compared with other commonly used fluids. METHODS: Following lipopolysaccharide-induced acute lung injury, male Sprague Dawley rats received either 20% hypertonic saline, 0...
June 15, 2016: Respiratory Physiology & Neurobiology
K Y Choe, E Trudel, C W Bourque
Synaptic and extrasynaptic transmission mediated by ionotropic GABA and glycine receptors plays a critical role in shaping the action potential firing (spiking) activity of hypothalamic magnocellular neurosecretory cells and therefore determines the rate at which vasopressin and oxytocin are released from the neurohypophysis. The inhibitory effect of these transmitters relies on the maintenance of a low concentration of intracellular chloride ions such that, when activated by GABA or glycine, a hyperpolarisation of the neuronal membrane potential results...
April 2016: Journal of Neuroendocrinology
Maria Kuźmińska
The article concerns case of 21-year old patient after intracranial tumour surgery, who was admitted to the internal diseases department due to hypernatraemia. On the basis of the whole clinical status the patient was diagnosed with diabetes insipidus and disturbance of sensation of thirst which may in turn cause hypernatraemia. There were conducted physical examinations as well as some additional tests which allowed the diagnosis of combined pituitary hormone deficiency. In this situation the disorders of sodium level was rebalanced and hormonal substitution in terms of antidiuretic hormone, adrenocortical hormone, thyroid hormone and testosterone was started...
2015: Przegla̧d Lekarski
K Y Choe, M Prager-Khoutorsky, W T Farmer, K K Murai, C W Bourque
In the ventral glial limitans (VGL) of the supraoptic nucleus (SON) of the rat, a unique astrocyte type is found with an ability to undergo striking morphological plasticity in response to a wide range of physiological stimulations such as chronic hypernatraemia. This includes a thinning of the VGL, which contains the somata and proximal processes of these astrocytes, as well as an almost complete withdrawal of their vertically-oriented distal processes. Currently, there is little information available on the types of astrocytes that reside in the SON-VGL and which of these exhibit state-dependent structural plasticity...
April 2016: Journal of Neuroendocrinology
I Felizardo Lopes, S Dezelée, D Brault, O Steichen
INTRODUCTION: Hypernatraemia in hospitalised patients is less common and less studied than hyponatraemia, although it also seems to be associated with a poor prognosis. The present study evaluates its prevalence, risk factors and prognosis in an internal medicine department. METHODS: Full hospital stays over 28 months in a 36-bed internal medicine department were analysed retrospectively. Patients with at least one plasma sodium ≥ 150 mmol/l were compared first with all other patients and then individually with sex- and age-matched normonatraemic controls...
December 2015: Netherlands Journal of Medicine
M Eijgelsheim, E J Hoorn
No abstract text is available yet for this article.
December 2015: Netherlands Journal of Medicine
Juan Diego Toledo, Carlos Morell, Maximo Vento
AIM: Using hypotonic intravenous solutions for baseline fluid needs in paediatric patients on a nil by mouth diet may cause serious complications, including hyponatraemia, cerebral oedema and even death. We analysed the evolution of natraemia and explored any adverse effects on children treated with intravenous isotonic fluids. METHODS: This was a prospective study of 50 patients consecutively admitted to a general paediatric ward who were treated with isotonic intravenous fluids and on a nil by mouth diet...
June 2016: Acta Paediatrica
M Cecconi, H Hochrieser, M Chew, M Grocott, A Hoeft, A Hoste, I Jammer, M Posch, P Metnitz, P Pelosi, R Moreno, R M Pearse, J L Vincent, A Rhodes
BACKGROUND: Abnormal serum sodium concentrations are common in patients presenting for surgery. It remains unclear whether these abnormalities are independent risk factors for postoperative mortality. METHODS: This is a secondary analysis of the European Surgical Outcome Study (EuSOS) that provided data describing 46 539 patients undergoing inpatient non-cardiac surgery. Patients were included in this study if they had a recorded value of preoperative serum sodium within the 28 days immediately before surgery...
January 2016: British Journal of Anaesthesia
Djillali Annane, Eric Bellissant, Pierre Edouard Bollaert, Josef Briegel, Didier Keh, Yizhak Kupfer
BACKGROUND: Sepsis occurs when an infection is complicated by organ failures as defined by a sequential organ failure assessment (SOFA) score of two or higher. Sepsis may be complicated by impaired corticosteroid metabolism. Giving corticosteroids may benefit patients. The original review was published in 2004 and was updated in 2010 and again in 2015. OBJECTIVES: To examine the effects of corticosteroids on death at one month in patients with sepsis, and to examine whether dose and duration of corticosteroids influence patient response to this treatment...
December 3, 2015: Cochrane Database of Systematic Reviews
V Spatenkova, O Bradac, P de Lacy, P Skrabalek, P Suchomel
BACKGROUND: Dysnatraemias are common and carry a risk of poor prognosis in acute subarachnoid hemorrhage (SAH) patients. The aim of this study was to determine the frequency and outcome of dysnatraemias in 344 SAH patients treated by a targeted sodium management regimen. METHODS: We performed a 10-year observational dysnatraemia study. Hyponatraemia was defined as serum sodium (SNa) below 135 mmol/l, hypernatraemia SNa above 150 mmol/l. RESULTS: Dysnatraemia occurred in 35...
October 23, 2015: Journal of Neurosurgical Sciences
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