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Correction for hyponatremia

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https://www.readbyqxmd.com/read/28803333/low-dose-tolvaptan-pk-pd-comparison-of-patients-with-hyponatremia-due-to-syndrome-of-inappropriate-antidiuretic-hormone-secretion-to-healthy-adults
#1
Susan E Shoaf, Patricia Bricmont, Ann Dandurand
PURPOSE: Tolvaptan (TLV) is indicated to treat hyponatremia due to syndrome of inappropriate diuretic hormone (SIADH) in Europe. Treatment is to be initiated at 15 mg QD but post-approval reporting indicates increasing use of 7.5 mg as the starting dose. Physicians believe 7.5 mg is effective and has a lower incidence of overly rapid correction of serum sodium. METHODS: Single TLV doses of 3.75, 7.5, and 15 mg were administered to 14 healthy adults in a crossover design and to 29 subjects ≥18 years with SIADH and serum sodium between 120 and 133 mmol/L in a parallel-group design...
August 12, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28798240/tetraparesia-an-unusual-presentation-of-disseminated-tuberculosis
#2
Filipa Quaresma, Margarida Bentes Jesus
A 48-year-old man with a 4 months history of asthenia, anorexia, 10 kg weight loss and 1 month of hematuria and dysuria was admitted to another hospital for sudden muscular weakness. He was found to have areflexic tetraparesis and was referred to our hospital.On admission, he was bradycardic, tachypneic, with flaccid tetraplegia. Laboratory results showed metabolic acidemia, severe hyperkalemia and hyponatremia, acute renal dysfunction and sterile pyuria. After hyperkalemia correction, the neurological symptoms resolved...
August 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28775063/current-management-of-hyponatremia-in-acute-heart-failure-a-report-from-the-hyponatremia-registry-for-patients-with-euvolemic-and-hypervolemic-hyponatremia-hn-registry
#3
Mark E Dunlap, Paul J Hauptman, Alpesh N Amin, Sandra L Chase, Joseph A Chiodo, Jun R Chiong, Joseph F Dasta
BACKGROUND: Hyponatremia (HN) occurs commonly in patients with acute heart failure and confers a worse prognosis. Current HN treatment varies widely, with no consensus. This study recorded treatment practices currently used for patients hospitalized with acute heart failure and HN. METHODS AND RESULTS: Data were collected prospectively from 146 US sites on patients hospitalized with acute heart failure and HN (serum sodium concentration [Na(+)] ≤130 mEq/L) present at admission or developing in the hospital...
August 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28739771/clinical-characteristics-and-prognosis-of-elderly-small-cell-lung-cancer-patients-complicated-with-hyponatremia-a-retrospective-analysis
#4
Yongping Yang, Naihong Sun, Ping Sun, Liangming Zhang
AIM: This study was designed to evaluate the clinical characteristics and prognosis of elderly small cell lung cancer (SCLC) patients complicated with hyponatremia, thus providing increased attention for appropriate intervention and improving outcomes in symptomatic subjects. PATIENTS AND METHODS: The clinical data of 320 patients with SCLC in the Yuhuangding Hospital from March 1st, 2006, to March 1st, 2012, were studied retrospectively. The prognosis and possible association with hyponatremia was investigated...
August 2017: Anticancer Research
https://www.readbyqxmd.com/read/28730291/electrolyte-disorders-with-platinum-based-chemotherapy-mechanisms-manifestations-and-management
#5
REVIEW
Bryan Oronsky, Scott Caroen, Arnold Oronsky, Vaughn E Dobalian, Neil Oronsky, Michelle Lybeck, Tony R Reid, Corey A Carter
Platinum chemotherapy, particularly cisplatin, is commonly associated with electrolyte imbalances, including hypomagnesemia, hypokalemia, hypophosphatemia, hypocalcemia and hyponatremia. The corpus of literature on these dyselectrolytemias is large; the objective of this review is to synthesize the literature and summarize the mechanisms responsible for these particular electrolyte disturbances in the context of platinum-based treatment as well as to present the clinical manifestations and current management strategies for oncologists and primary care physicians, since the latter are increasingly called on to provide care for cancer patients with medical comorbidities...
July 20, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28704229/treatment-of-hyponatremic-encephalopathy-in-the-critically-ill
#6
Steven G Achinger, Juan Carlos Ayus
OBJECTIVES: Hyponatremic encephalopathy, symptomatic cerebral edema due to a low osmolar state, is a medical emergency and often encountered in the ICU setting. This article provides a critical appraisal and review of the literature on identification of high-risk patients and the treatment of this life-threatening disorder. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: Online search of the PubMed database and manual review of articles involving risk factors for hyponatremic encephalopathy and treatment of hyponatremic encephalopathy in critical illness...
July 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28697837/-poor-weight-gain-recurrent-metabolic-alkalosis-and-hypokalemia-in-a-neonate
#7
Miao Qian, Shu-Ping Han, Zhang-Bing Yu, Xiao-Hui Chen
The study reports a female neonate with a gestational age of 29(+2) weeks and a birth weight of 1 210 g. Ten minutes after birth, the neonate was admitted to the hospital due to shortness of breath. Several days after birth, the neonate presented with hyperglycemia, polyuria, and poor weight gain, accompanied by azotemia, hypochloremic metabolic alkalosis, hypokalemia, and hyponatremia. Laboratory examinations showed elevated levels of aldosterone, renin, and angiotensin II. Gene detection revealed SLC12A1 gene mutation...
July 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28694395/use-of-tolvaptan-in-patients-hospitalized-for-worsening-chronic-heart-failure-with-severe-hyponatremia-the-initial-experience-at-a-single-center-in-turkey
#8
Saim Sağ, Aysel Aydın Kaderli, Abdülmecit Yıldız, Bülent Cuma Gül, Bülent Özdemir, İbrahim Baran, Sümeyye Güllülü, Ali Aydınlar, Yüksel Çavuşoğlu
OBJECTIVE: The aim of the present study was to assess the efficacy and safety of tolvaptan for severe hyponatremia (SH) in hypervolemic heart failure (HF) patients within daily clinical practice. METHODS: We restrospectively reviewed our database on tolvaptan as an add-on treatment in hypervolemic patients admitted to our clinic due to deterioration of HF and having hyponatremia resistant to standard therapy. Severe hyponatremia was defined as serum sodium concentration ≤125 mEq/L...
July 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28675827/hyperglycemia-induced-hyponatremia-reevaluation-of-the-na-correction-factor
#9
Matthew B Wolf
This study addresses the clinically important relationship between the decreases in plasma Na(+) and the increases in plasma glucose concentrations seen in diabetes and other hyperglycemic syndromes. This plasma 'Na(+) correction factor', is generally accepted as 1.6mM Na(+) per 100mg% glucose (0.29mM/mM in SI units) assuming osmotic equilibrium, although much larger numbers have been measured in experiments on normal humans. To resolve this controversy, a mathematical model of whole-body fluid-electrolyte balance was used to perform the experiment wherein plasma glucose concentration was increased to diabetic levels and the plasma Na(+) concentration changes assessed, without the complications seen in human experiments...
June 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28665367/-algorithms-of-the-correction-of-fluid-and-electrolyte-disorders-in-patients-with-severe-ischemic-stroke
#10
V I Ershov, A N Chirkov
AIM: To develop a practical algorithm for the correction of sodium levels and osmolality of blood plasma during the acute period of severe ischemic stroke (IS). MATERIAL AND METHODS: One hundred and fifty patients with cardioembolic or atherothrombotic stroke, aged from 30 to 80 years, hospitalized in the first 12 h after symptom emergence, were examined. Neurological deficit was assessed with the NIHSS. The monitoring of blood plasma sodium level and osmolality of blood plasma in the 1st and 5th day after stroke as well as of blood circulation volume was performed...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28653967/exercise-associated-hyponatremia-in-a-lactating-female
#11
Zach Bailowitz, Raymond Grams, David Teeple, Tamara Hew-Butler
A 37-year-old woman presented to the emergency department with severe headache, which quickly progressed to altered mental status and seizure activity in hospital. Her initial serum sodium concentration ([Na]) was 126 mmol/L. In the 24 hours before admission, she exercised vigorously for 120 minutes (interval training plus yoga) and also consumed more than 4 liters of fluid during that time to both stay hydrated and facilitate milk production because she was actively nursing 2 children. Her serum [Na] and altered mental status corrected slowly over the next 48 hours with furosemide, hypertonic saline, and fluid restriction...
July 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28623637/pure-small-cell-recurrent-prostate-cancer-developing-syndrome-of-inappropriate-antidiuretic-hormone-secretion
#12
Giorgia Peverelli, Paolo Grassi
PURPOSE: Pure small cell neuroendocrine carcinoma of the prostate is a rare entity characterized by a poor prognosis due to early metastatic spread as well as resistance to treatment. Considering its increasing occurrence, clinicians should be aware of its aggressive behavior, the relevance of an early diagnosis, and proper management. METHODS: A 71-year-old man treated with brachytherapy for localized low-risk prostate cancer developed widespread disease 7 years later with a prostate-specific antigen-negative neuroendocrine small cell phenotype...
June 14, 2017: Tumori
https://www.readbyqxmd.com/read/28600073/serum-sodium-correction-rate-and-the-outcome-in-severe-hyponatremia
#13
Mauro Giordano, Tiziana Ciarambino, Emanuela Lo Priore, Pietro Castellino, Lorenzo Malatino, Alessandro Cataliotti, Giuseppe Paolisso, Luigi Elio Adinolfi
STUDY OBJECTIVE: We investigated the serum sodium correction rate on length of hospitalization and survival rate, in severe chronic hyponatremic patients at the Emergency Department (ED). DESIGN: An observational study using clinical chart review. SETTING: The ED of the University Hospital of Marcianise, Caserta, Italy with approximately 30,000 patients visits a year. TYPE OF PARTICIPANTS: We reviewed sixty-seven patients with severe hyponatremia subdivided in 2 subgroups: group A consisting of 35 patients with serum sodium correction rate<0...
May 31, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28585150/mild-encephalopathy-encephalitis-with-a-reversible-splenial-lesion-mers-a-report-of-five-neonatal-cases
#14
Dan Sun, Wen-Hong Chen, Suraj Baralc, Juan Wang, Zhi-Sheng Liu, Yuan-Peng Xia, Lei Chen
Mild encephalopathy/encephalitis with a reversible splenial (MERS) lesion is a clinic-radiological entity. The clinical features of MERS in neonates are still not systemically reported. This paper presents five cases of MERS, and the up-to-date reviews of previously reported cases were collected and analyzed in the literature. Here we describe five cases clinically diagnosed with MERS. All of them were neonates and the average age was about 4 days. They were admitted for the common neurological symptoms such as hyperspasmia, poor reactivity and delirium...
June 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28528344/dysnatremia-is-an-independent-indicator-of-mortality-in-hospitalized-patients
#15
Jiachang Hu, Yimei Wang, Xuemei Geng, Rongyi Chen, Pan Zhang, Jing Lin, Jie Teng, Xiaoyan Zhang, Xiaoqiang Ding
BACKGROUND Dysnatremia is a risk factor for poor outcomes. We aimed to describe the prevalence and outcomes of various dysnatremia in hospitalized patients. High-risk patients must be identified to improve the prognosis of dysnatremia. MATERIAL AND METHODS This prospective study included all adult patients admitted consecutively to a university hospital between October 1, 2014 and September 30, 2015. RESULTS All 90 889 patients were included in this study. According to the serum sodium levels during hospitalization, the incidence of hyponatremia and hypernatremia was 16...
May 21, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28515029/tolvaptan-utilization-in-children-with-chronic-hyponatremia-due-to-inappropriate-antidiuretic-hormone-secretion-siadh-three-case-reports-and-review-of-the-literature
#16
Gerdi Tuli, Daniele Tessaris, Luisa De Sanctis, Patrizia Matarazzo
Hyponatremia is the most common electrolyte disorder among hospitalized patients and it is sometimes considered as a poor outcome predictor. Its correction is thus indicated, even in asymptomatic patients. The conventional treatment is represented by fluid restriction in presence of euvolemia or hypervolemia; whereas loop diuretics are used in some hypervolemic conditions (cardiac heart failure, liver cirrhosis and nephrotic syndrome) and intravenous isotonic or hypertonic solution are administered in hypovolemic conditions...
May 17, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28512320/hyponatremia-upon-presentation-to-the-emergency-department-the-need-for-urgent-neuroimaging-studies
#17
Arne Bokemeyer, Rainer Dziewas, Heinz Wiendl, Wolfram Schwindt, Paul Bicsán, Philipp Kümpers, Hermann Pavenstädt
This study aims to evaluate the necessity of urgent neuroimaging for emergency admissions exhibiting symptomatology of profound hyponatremia. We retrospectively analyzed the medical records of all patients admitted to the emergency room of the University Hospital Münster from 2010 to 2014 with a serum sodium value < 125 mmol/L. From 52918 emergency admissions, 261 patients with profound hyponatremia were identified, of whom 140 (54%) had neurological symptoms. Unspecific weakness and confusion were the most prevalent of these symptoms (59%)...
May 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28487868/severe-symptomatic-acute-hyponatremia-in-traumatic-brain-injury-responded-very-rapidly-to-a-single-15-mg-dose-of-oral-tolvaptan-a-mayo-clinic-health-system-hospital-experience-need-for-caution-with-tolvaptan-in-younger-patients-with-preserved-renal-function
#18
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi
Tolvaptan is now well established as a potent pharmaceutical agent for symptomatic hyponatremia from syndrome of inappropriate antidiuretic hormone secretion (SIADH), congestive heart failure and liver cirrhosis. Previous studies had recruited older (63-65 years) patients with mild renal impairment (serum creatinine, 1.3-1.4 mg/dl). A 2012 report in the Journal of Neurology, Neurosurgery & Psychiatry described tolvaptan as a "lifesaving drug". A major outcome concern in the treatment of chronic hyponatremia is potentially fatal pontine demyelination from over-rapid correction of serum sodium >0...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28478880/neurologic-intensive-care-unit-electrolyte-management
#19
REVIEW
Craig Hutto, Mindy French
Dysnatremia is a common finding in the intensive care unit (ICU) and may be a predictor for mortality and poor clinical outcomes. Depending on the time of onset (ie, on admission vs later in the ICU stay), the incidence of dysnatremias in critically ill patients ranges from 6.9% to 15%, respectively. The symptoms of sodium derangement and their effect on brain physiology make early recognition and correction paramount in the neurologic ICU. Hyponatremia in brain injured patients can lead to life-threatening conditions such as seizures and may worsen cerebral edema and contribute to alterations in intracranial pressure...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28476691/oxytocin-administration-during-spontaneous-labor-guidelines-for-clinical-practice-guidelines-short-text
#20
C Dupont, M Carayol, C Le Ray, C Deneux-Tharaux, D Riethmuller
No abstract text is available yet for this article.
May 2, 2017: Journal of gynecology obstetrics and human reproduction
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