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Correction for hyponatremia

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https://www.readbyqxmd.com/read/28528344/dysnatremia-is-an-independent-indicator-of-mortality-in-hospitalized-patients
#1
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
#2
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
#3
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
#4
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
#5
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
#6
C Dupont, M Carayol, C Le Ray, C Deneux-Tharaux, D Riethmuller
No abstract text is available yet for this article.
May 2, 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28458891/severe-symptomatic-hyponatremia-associated-with-the-use-of-polyethylene-glycol-based-bowel-preparation
#7
Navira Samad, Ian Fraser
SUMMARY: Colonoscopy is a useful tool in modern medicine and is increasingly employed for both diagnostic and treatment reasons. However, its effectiveness is highly reliant on the quality of bowel cleansing. Among different bowel-cleansing agents available, PEG (polyethylene glycol) is considered to be the safest cleansing agent, especially in relation to fluid and electrolyte problems. We present here a case of severe symptomatic hyponatremia that developed after the use of PEG for an elective colonoscopy...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28435905/transurethral-resection-of-the-prostate-bladder-explosion-and-hyponatremic-encephalopathy-a-rare-case-report-of-malpractice
#8
Giuseppe Vacchiano, Aldo Rocca, Rita Compagna, Anna Ginevra Immacolata Zamboli, Vera Cirillo, Lorenza Di Domenico, Veronica Di Nardo, Giuseppe Servillo, Bruno Amato
We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability...
January 2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28422408/prevention-of-the-osmotic-demyelination-syndrome-after-liver-transplantation-a-multidisciplinary-perspective
#9
J F Crismale, K A Meliambro, S DeMaria, D B Bronster, S Florman, T D Schiano
The osmotic demyelination syndrome (ODS) is a serious neurologic condition that occurs in the setting of rapid correction of hyponatremia. It presents with protean manifestations, from encephalopathy to the "locked-in" syndrome. ODS can complicate liver transplantation (LT), and its incidence may increase with the inclusion of serum sodium as a factor in the Model for End-Stage Liver Disease score. A comprehensive understanding of risk factors for the development of ODS in the setting of LT, along with recommendations to mitigate the risk of ODS, are necessary...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28419981/thiazide-associated-hyponatremia-report-of-the-hyponatremia-registry-an-observational-multicenter-international-study
#10
Volker Burst, Franziska Grundmann, Torsten Kubacki, Arthur Greenberg, Ingrid Becker, Despina Rudolf, Joseph Verbalis
BACKGROUND: Hyponatremia is a frequent and potentially life-threatening adverse side effect of thiazide diuretics. This sub-analysis of the Hyponatremia Registry database focuses on current management practices of thiazide-associated hyponatremia (TAH) and compares differences between TAH and syndrome of inappropriate antidiuretic hormone secretion (SIADH). METHODS: We analyzed 477 patients from 225 US and EU sites with euvolemic hyponatremia ([Na+] ≤130 mEq/L) who were receiving a thiazide diuretic...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28393593/a-study-of-hyponatremia-in-acute-encephalitis-syndrome-a-prospective-study-from-a-tertiary-care-center-in-india
#11
Usha Kant Misra, Jayantee Kalita, Rajesh Kumar Singh, Sanjeev Kumar Bhoi
PURPOSE: To evaluate the frequency and causes of hyponatremia in acute encephalitis syndrome (AES) and its effect on outcome. PATIENTS AND METHODS: Consecutive patients with AES were subjected to neurological evaluation including Glasgow Coma Scale, focal weakness, movement disorder, and reflex changes. The etiology of AES was based on blood and cerebrospinal fluid enzyme-linked immunosorbent assay and polymerase chain reaction. We have categorized patients into neurological or systemic AES...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28356136/efficacy-and-safety-of-rapid-intermittent-correction-compared-with-slow-continuous-correction-with-hypertonic-saline-in-patients-with-moderately-severe-or-severe-symptomatic-hyponatremia-study-protocol-for-a-randomized-controlled-trial-salsa-trial
#12
Anna Lee, You Hwan Jo, Kyuseok Kim, Soyeon Ahn, Yun Kyu Oh, Huijai Lee, Jonghwan Shin, Ho Jun Chin, Ki Young Na, Jung Bok Lee, Seon Ha Baek, Sejoong Kim
BACKGROUND: Hyponatremia is the most common electrolyte imbalance encountered in clinical practice, associated with increased mortality and length of hospital stay. However, no high-quality evidence regarding whether hypertonic saline is best administered as a continuous infusion or a bolus injection has been found to date. Therefore, in the current study, we will evaluate the efficacy and safety of rapid intermittent correction compared with slow continuous correction with hypertonic saline in patients with moderately severe or severe symptomatic hyponatremia...
March 29, 2017: Trials
https://www.readbyqxmd.com/read/28303369/clinical-aspects-of-changes-in-water-and-sodium-homeostasis-in-the-elderly
#13
REVIEW
Christian A Koch, Tibor Fulop
The population of elderly individuals is increasing worldwide. With aging, various hormonal and kidney changes occur, both affecting water homeostasis. Aging is a risk factor for chronic kidney disease (CKD) and many features of CKD are reproduced in the aging kidney. Dehydration and hyperosmolarity can be triggered by diminished thirst perception in this population. Elderly with dementia are especially susceptible to abnormalities of their electrolyte and body water homeostasis and should be (re-)assessed for polypharmacy...
March 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/28295447/effectiveness-and-tolerability-of-conivaptan-and-tolvaptan-for-the-treatment-of-hyponatremia-in-neurocritically-ill-patients
#14
Caroline Der-Nigoghossian, Christine Lesch, Karen Berger
STUDY OBJECTIVE: To describe the effectiveness and tolerability of conivaptan and tolvaptan for the correction of hyponatremia in neurocritically ill patients. DESIGN: Retrospective cohort study. SETTING: Neurointensive care units at two academic medical centers. PATIENTS: Thirty-six adults admitted to the neurocritical care unit who received at least one dose of conivaptan (5 patients) or tolvaptan (31 patients) between June 2012 and May 2013...
March 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28289647/central-pontine-myelinolysis-induced-by-alcohol-withdrawal-a-case-report
#15
Jae Ho Kim, Sae Hyun Kim, Ho Joong Jeong, Young Joo Sim, Dong Kyu Kim, Ghi Chan Kim
Central pontine myelinolysis (CPM) is a demyelinating disorder characterized by the loss of myelin in the center of the basis pons, and is mainly caused by the rapid correction of hyponatremia. We report the case of a young woman who presented with gait disturbance and alcohol withdrawal, and who was eventually diagnosed with CPM. Generally, the cause and pathogenesis of CPM in chronic alcoholics remain unclear. In this cases, the CPM may be unrelated to hyponatremia or its correction. However, it is possible that the osmotic pressure changes due to refeeding syndrome after alcohol withdrawal was the likely cause in this case...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28270885/does-accidental-overcorrection-of-symptomatic-hyponatremia-in-chronic-heart-failure-require-specific-therapeutic-adjustments-for-preventing-central-pontine-myelinolysis
#16
REVIEW
Renato De Vecchis, Michel Noutsias, Carmelina Ariano, Arturo Cesaro, Carmela Cioppa, Anna Giasi, Nicola Maurea
This review aims at summarizing essential aspects of epidemiology and pathophysiology of hyponatremia in chronic heart failure (CHF), to set the ground for a practical as well as evidence-based approach to treatment. As a guide through the discussion of the available evidence, a clinical case of hyponatremia associated with CHF is presented. For this case, the severe neurological signs at presentation justified an emergency treatment with hypertonic saline plus furosemide, as indicated. Subsequently, as the neurological emergency began to subside, the reversion of the trend toward hyponatremia overcorrection was realized by continuous infusion of hypotonic solutions, and administration of desmopressin, so as to prevent the very feared risk of an osmotic demyelination syndrome...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28255808/euvolemic-hyponatremia-in-cancer-patients-report-of-the-hyponatremia-registry-an-observational-multicenter-international-study
#17
Volker Burst, Franziska Grundmann, Torsten Kubacki, Arthur Greenberg, Despina Rudolf, Abdulla Salahudeen, Joseph Verbalis, Christian Grohé
PURPOSE: Hyponatremia secondary to SIADH is frequent in cancer patients and potentially deleterious. The aim of this sub-analysis of the Hyponatremia Registry database is to analyze current diagnostic and therapeutic management practices in cancer patients with SIADH. METHODS: We analyzed 358 cancer patients who had serum sodium concentration ([Na(+)]) ≤ 130 mEq/L and a clinical diagnosis of SIADH from 225 sites in the USA and EU. RESULTS: Precise diagnostic testing was performed in only 46%...
March 2, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28217021/central-pontine-myelinolysis-and-localized-fluorodeoxyglucose-uptake-seen-on-18-f-fdg-pet-ct
#18
Frederik Rønne, Peer Carsten Tfelt-Hansen, Lene Rørdam
Case report describing the finding of central pontine myelinolysis (CPM) using combined fluorine-18 ( (18)F)-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). The patient was a known alcoholic who, during admission was under treatment for hyponatremia, showed a significant decline in both motor and cognitive function. Combined (18)F-FDG PET/CT showed localized FDG uptake in the pons, consistent with the finding of CPM observed on magnetic resonance imaging (MRI). CPM is a demyelinating lesion of the pons, resulting in several neurological symptoms...
January 2017: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28193165/cardiorenal-anemia-syndrome-and-survival-among-heart-failure-patients-in-tanzania-a-prospective-cohort-study
#19
Pedro Pallangyo, Francis Fredrick, Smita Bhalia, Paulina Nicholaus, Peter Kisenge, Benjamin Mtinangi, Mohamed Janabi, Stephen Humphrey
BACKGROUND: Cardiorenal anemia syndrome (CRAS) is an evolving global epidemic associated with increased morbimortality and cost of care. The management of patients with CRAS remains a challenging undertaking worldwide and the lack of evidence-based clinical guidelines adds to the challenge. We aimed to explore the prevalence and survival rates of heart failure patients with CRAS in Tanzania. METHODS: We screened 789 patients and consecutively recruited 463 who met the inclusion criteria...
February 14, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28160775/craniopharyngioma-presenting-with-severe-hyponatremia-hyponatremia-induced-myopathy-and-panhypopituitarism-a-case-report
#20
M D S A Dilrukshi, G V N Sandakumari, P K Abeysundara, T Chang
BACKGROUND: Craniopharyngiomas are rare intracranial tumors commonly presenting with neurological symptoms. Reports of severe hyponatremia as a presenting manifestation of a craniopharyngioma and hyponatremia-induced myopathy are rare. We report the case of a patient with craniopharyngioma presenting with severe hyponatremia, panhypopituitarism, and hyponatremia-induced myopathy. CASE PRESENTATION: A 52-year-old Sri Lankan man presented with anorexia, nausea, fatigue, generalized muscle weakness, and cramps for 1 week...
February 5, 2017: Journal of Medical Case Reports
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