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Correction for hyponatremia

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https://www.readbyqxmd.com/read/29297709/utilization-and-budget-impact-of-tolvaptan-in-the-inpatient-setting-among-patients-with-heart-failure-and-hyponatremia
#1
Alpesh N Amin, Jesse D Ortendahl, Amanda L Harmon, Siddhesh A Kamat, Robert A Stellhorn, Sandra L Chase, Shirin V Sundar
OBJECTIVE: Assess characteristics of patients with heart failure (HF) and hyponatremia (HN) using tolvaptan, a selective vasopressin V2-receptor antagonist, for sodium correction, and estimate the budget impact of tolvaptan use in a hospital. METHODS: The Premier Hospital Database was analyzed to assess the utilization of tolvaptan, characteristics of users and non-users, and hospitalization costs among patients with HF and HN. Using these findings, a model was developed to estimate tolvaptan costs in proportion to total medical costs of managing patients with HF and HN, and the budget impact of tolvaptan use...
January 3, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29279076/symptomatic-hyponatremia-after-bowel-preparation-report-of-two-cases-and-literature-review
#2
Juliana Moura Costa, João Bruno Soares
INTRODUCTION: Bowel preparation for colonoscopy and/or colorectal surgery can cause electrolyte imbalances. The risk of electrolyte imbalances seems to be related to the type of bowel cleansing solution, age of patients and comorbidities. CASE REPORT: We report two cases of symptomatic hyponatremia (focal neurological signs and coma) after bowel preparation with sodium picosulfate/magnesium citrate for colonoscopy. In both cases, symptoms related to hyponatremia rapidly disappeared after sodium level correction with intravenous administration of hypertonic saline (3% NaCl)...
November 29, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29198689/utility-of-tolvaptan-in-the-perioperative-management-of-severe-hyponatremia-during-liver-transplantation-a-case-report
#3
A Parekh, P Rajaram, G Patel, R M Subramanian
Severe hyponatremia can complicate the pretransplantation management of patients with decompensated cirrhosis while they await liver transplantation. Before the liver transplant, it is critical to correct severe hyponatremia to an appropriate level to reduce the risks of perioperative complications such as central pontine myelinolysis, cerebral edema, and seizures. Vasopressin receptor antagonists, and in particular tolvaptan, offer a therapeutic modality that can correct severe refractory hyponatremia in a timely and predictable manner before liver transplantation...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29187749/hyponatremia-in-patients-receiving-parenteral-nutrition-the-importance-of-correcting-serum-sodium-for-total-proteins-the-role-of-the-composition-of-parenteral-nutrition-in-the-development-of-hyponatremia
#4
Emilia Gómez-Hoyos, Silvia Fernández-Peña, Martín Cuesta, Ana Ortolá, Pilar Matía, Natalia Pérez-Ferre, Daniel De Luis, Alfonso Calle-Pascual, Miguel Ángel Rubio, Isabelle Runkle-De la Vega
BACKGROUND/OBJECTIVES: Hyponatremia is the most common electrolyte disorder, and is associated with high-morbimortality rates. The true prevalence of hyponatremia in patients on parenteral nutrition (PN) is unknown, and the relationship between PN composition and development of hyponatremia has yet to be studied. Hypoproteinemia, a common finding in patients receiving PN, induces an overestimation of serum sodium (SNa) levels, when using indirect electrolyte methodology. Thus, SNa should be corrected for serum total protein levels (TP)...
November 30, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29182206/-mckrittick-wheelock-syndrome-report-of-one-case
#5
Alejandro Kral, Jorge Vega
McKittrick-Wheelock syndrome is caused by chronic water and electrolyte hypersecretion from an intestinal tumor, usually a villous adenoma, located in the rectum or sigmoid. Patients often have dehydration, hypovolemic shock and kidney failure associated with hypokalemia, hyponatremia, hypochloremia and metabolic acidosis. We report a 62-year-old male, suffering chronic diarrhea for eight years who was admitted after a syncope. He had severe hypokalemia, hyponatremia, metabolic acidosis, hypovolemia and acute renal failure...
July 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29177819/a-case-of-chronic-asymptomatic-central-pontine-myelinolysis-with-histological-evidence-of-remyelination
#6
Harry R Haynes, Patrick J Gallagher, Andrea Cordaro, Marcus Likeman, Seth Love
Central pontine myelinolysis (CPM) is a neurological demyelinating disease of the pons. Although usually associated with rapid correction of hyponatremia, CPM may occur despite normonatremia, is often associated with chronic alcoholism and may be asymptomatic. Histological confirmation of asymptomatic CPM is rare. We describe an unusual post-mortem case of extensive but asymptomatic CPM in a chronic alcoholic patient with normonatremia. The affected part of the pons contained thinly myelinated axons with appearances supporting remyelination...
November 25, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29142352/localized-pontine-uptake-in-fluorine-18-fuorodeoxyglucose-positron-emission-tomography-computed-tomography-in-a-case-of-hyponatremia-a-case-report-and-review-of-literature
#7
Thangalakshmi Sivathapandi, Shelley Simon, Indirani Elangovan
A rare acquired demyelinating lesion of the pons central pontine myelinolysis (CPM) typically occurs after rapid correction of hyponatremia. There is disruption of blood-brain barrier due to osmotic stress allowing access for inflammatory mediators in extravascular brain tissue, which most likely attracts glial cells of the brain, attracts macrophages, and activates astrocytes. We present a case of female with a known history of inflammatory bowel disease who presented with altered sensorium and hyponatremia...
October 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29135397/electrolytes-imbalance-caused-by-amikacin-in-patients-receiving-multi-drug-resistance-tuberculosis-treatment-at-hazara-region-kpk-pakistan
#8
Faheem Jan, Mukhtiar Hassan, Naveed Muhammad, Shahid Wali, Hafiz Sajid Akbar, Qazi Mashhood Atta, Farzana Gul
Introduction: Multi drug resistance-tuberculosis (MDR-TB) is considered amongst one of the fatal medical and public health issue. Greater frequency of adverse reactions has been observed using 2nd line antituberculosis drugs, which rises the rate of morbidity. Hypokalemia and hyponatremia are common in patients receiving MDR-TB treatment. Materials and Methods: This study was aimed to assess the effect of amikacin as multidrug resistance tuberculosis treatment on serum sodium and potassium level...
September 2017: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/29095576/is-central-pontine-myelinolysis-reversible
#9
David Lee Rebedew
Central pontine myelinolysis (CPM) is a rare phenomenon that causes significant morbidity and mortality. Active therapeutic interventions for CPM can have a positive impact on recovery and overall prognosis. This case represents a 34-year-old white man with a chronic history of alcohol abuse who had Parkinsonian symptoms 13 days after rapid correction of his serum sodium in the hospital. Similarly to prior CPM case reports, this patient significantly improved following reinduction of hyponatremia, methylprednisolone, and/or plasmapharesis...
December 2016: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29075541/unusual-complication-of-multidrug-resistant-tuberculosis
#10
Prerna Sharma, Ravindra Nath Sahay
INTRODUCTION: Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany. CASE REPORT: 23-year-old female patient presented with carpopedal spasms and tingling sensations in hands. Patient was being treated with capreomycin for two months for tuberculosis. On further investigation, hypocalcemia, hyponatremia, hypomagnesemia, hypokalemia, and hypochloremic metabolic alkalosis were noted...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/29061503/outcomes-in-severe-hyponatremia-treated-with-and-without-desmopressin-ddavp
#11
Thomas E MacMillan, Rodrigo B Cavalcanti
BACKGROUND: Overcorrection of plasma sodium in severe hyponatremia is associated with osmotic demyelination syndrome. Desmopressin (DDAVP) can prevent overcorrection of plasma sodium in hyponatremia. The objective of this study is to compare outcomes in hyponatremia based on DDAVP usage. METHODS: Retrospective, observational study including all admissions to internal medicine with hyponatremia (plasma sodium concentration < 123 mEq/L), from 2004-2014 at two academic hospitals in Toronto, Canada...
October 20, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29057220/iatrogenic-dysnatremias-in-children-with-acute-gastroenteritis-in-high-income-countries-a-systematic-review
#12
Silviu Grisaru, Jianling Xie, Susan Samuel, Stephen B Freedman
BACKGROUND: Acute gastroenteritis (AGE) causing dehydration with or without dysnatremias is a common childhood health challenge. While it is accepted that oral rehydration therapy is preferred, clinical factors or parent and healthcare provider preferences may lead to intravenous rehydration (IVR). Isotonic solutions are increasingly recommended in most scenarios requiring IVR. Nevertheless, children with AGE, having ongoing losses of water and electrolytes, represent a unique population...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28957470/treatment-of-severe-cholera-a-review-of-strategies-to-reduce-stool-output-and-volumes-of-rehydration-fluid
#13
Thomas Butler
Background: Severe cholera is a life-threatening illness of hypovolemic shock and metabolic acidosis due to rapid and profuse diarrheal fluid loss. Emergency life-saving therapy is i.v. saline, optionally supplemented with potassium and alkali to correct the fluid deficit, potassium losses and acidosis. After this initial rehydration, for the next 2 days ongoing stool losses are replaced with oral rehydration solution (ORS), which contains sodium chloride, potassium and alkali together with glucose or rice powder as a source of glucose to serve as a carrier for sodium...
May 1, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28943585/the-outcome-of-cirrhotic-patients-with-ascites-is-improved-by-the-normalization-of-the-serum-sodium-level-by-tolvaptan
#14
Tomomi Kogiso, Mutsuki Kobayashi, Kuniko Yamamoto, Yuichi Ikarashi, Kazuhisa Kodama, Makiko Taniai, Nobuyuki Torii, Etsuko Hashimoto, Katsutoshi Tokushige
Objective Hyponatremia is frequently observed in patients with decompensated liver cirrhosis and it is also related to a poor prognosis. The vasopressin V2-receptor antagonist tolvaptan is used to treat cirrhotic patients with ascites and increases the serum sodium (Na) level. In this study, we investigated (i) whether or not correction of the Na level improves the prognosis of cirrhotic patients with ascites and (ii) predictors of normalization of the serum Na level after tolvaptan therapy. Methods This was a single-center retrospective study...
November 15, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28924482/atypical-presentation-of-central-pontine-myelinolysis-in-hyperglycemia
#15
Swapna Talluri, Raghu Charumathi, Muhammad Khan, Kerri Kissell
Central pontine myelinolysis (CPM) usually occurs with rapid correction of severe chronic hyponatremia. Despite the pronounced fluctuations in serum osmolality, CPM is rarely seen in diabetics. This is a case report of CPM associated with hyperglycemia. A 45-year-old non-smoking and non-alcoholic African American male with past medical history of type 2 diabetes, hypertension, stage V chronic kidney disease and hypothyroidism presented with a two-week history of intermittent episodes of gait imbalance, slurred speech and inappropriate laughter...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28816830/fatal-cerebral-edema-seizures-and-hyponatremia-after-trazodone-overdose
#16
Jose David Avila
Trazodone is a serotonin antagonist and reuptake inhibitor that is widely used for the treatment of depression and insomnia. Fatal overdose is rare and usually occurs when combined with other drugs or alcohol. Only a few lethal cases of pure trazodone overdose have been reported, all attributed to cardiotoxicity. We reported a 37-year-old woman who presented after ingesting 6.45 g of trazodone in a suicidal attempt. She was hyponatremic because of the syndrome of inappropriate antidiuretic hormone secretion and, shortly after, had a seizure and developed fatal cerebral edema...
September 2017: Clinical Neuropharmacology
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
#17
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...
November 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28798240/tetraparesia-an-unusual-presentation-of-disseminated-tuberculosis
#18
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
#19
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
#20
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
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