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hyponatremia guidelines

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https://www.readbyqxmd.com/read/27857513/difficulties-in-the-diagnosis-and-management-of-hyponatremia
#1
REVIEW
Mihaela Mocan, Lia Manuela Terheş, Sorin Nicu Blaga
Hyponatremia is the most common electrolyte imbalance encountered in clinical practice. Beside the difficulty of the etiological diagnosis, the general lack of awareness regarding the negative impact of hyponatremia on the quality of life and the lack of targeted treatments until recent years may be responsible for the poor management of the disorder. Therefore we consider of utmost importance to improve the knowledge regarding the diagnosis and management of hyponatremia, by underlining the difficulties of the etiological diagnosis and its management...
2016: Clujul Medical (1957)
https://www.readbyqxmd.com/read/27754188/sp-05-1-should-the-target-for-blood-pressure-reduction-be-lower-in-adults-with-hypertension-and-a-history-of-cardiovascular-disease
#2
Paul Whelton
BACKGROUND: Choice of the optimal target for blood pressure (BP) reduction during treatment of patients with hypertension, including those with underlying co-morbid conditions, is an important challenge in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to provide guidance in selection of a Systolic BP target during treatment of hypertension. METHODS: Adults ≥50 years old with hypertension and at least one additional risk factor for cardiovascular disease (CVD), but excluding persons with diabetes mellitus, prior stroke, or advanced chronic kidney disease (CKD) were randomly assigned to intensive therapy (intensive), targeting a systolic BP (SBP) <120 mmHg, or standard therapy (standard), targeting a SBP <140 mmHg...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27747968/perioperative-intravenous-fluid-therapy-in-children-guidelines-from-the-association-of-the-scientific-medical-societies-in-germany
#3
Robert Sümpelmann, Karin Becke, Sebastian Brenner, Christian Breschan, Christoph Eich, Claudia Höhne, Martin Jöhr, Franz-Josef Kretz, Gernot Marx, Lars Pape, Markus Schreiber, Jochen Strauss, Markus Weiss
This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1-2...
October 17, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27693178/cyclophosphamide-administration-routine-in-autoimmune-rheumatic-diseases-a-review
#4
Kaian Amorim Teles, Patrícia Medeiros-Souza, Francisco Aires Correa Lima, Bruno Gedeon de Araújo, Rodrigo Aires Correa Lima
Cyclophosphamide (CPM) is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy (pre-ChT), administration of cyclophosphamide, and post-chemotherapy (post-ChT), taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis...
September 17, 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/27609587/clinical-aspects-of-symptomatic-hyponatremia
#5
Dirk Weismann, Andreas Schneider, Charlotte Höybye
Hyponatremia (HN) is a common condition, with a large number of aetiologies and a complicated treatment. While chronic HN has been shown to be a predictor of poor outcome, sodium-increasing treatments in chronic stable and asymptomatic HN has not proven to increase life expectancy. For symptomatic HN, in contrast, the necessity for urgent treatment has broadly been accepted to avoid the development of fatal cerebral oedema. On the other hand, a too rapid increase of serum sodium in chronic HN may result in cerebral damage due to osmotic demyelination...
September 8, 2016: Endocrine Connections
https://www.readbyqxmd.com/read/27581783/adverse-effects-of-voriconazole-over-a-decade-of-use
#6
Miriam T Levine, Pranatharthi H Chandrasekar
Voriconazole use has increased since the drug's introduction in 2002, and new and unique adverse effects are emerging as patients undergo prolonged therapy. Most concerning is the increased risk of cutaneous malignancies, primarily squamous cell carcinoma (SCC); this risk is duration dependent and the associated malignancies tend to be more aggressive and multifocal. Voriconazole is also associated with phototoxicity (which may be a precursor to malignancy), periostitis, hallucinations and encephalopathy, peripheral neuropathy, alopecia, nail changes, hyponatremia, and other adverse effects...
September 1, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27529844/prevalence-and-prognostic-significance-of-hyponatremia-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-data-from-the-akershus-cardiac-examination-ace-2-study
#7
Jacob A Winther, Jon Brynildsen, Arne Didrik Høiseth, Ivar Følling, Pål H Brekke, Geir Christensen, Tor-Arne Hagve, Joseph G Verbalis, Torbjørn Omland, Helge Røsjø
BACKGROUND: Hyponatremia is prevalent and associated with mortality in patients with heart failure (HF). The prevalence and prognostic implications of hyponatremia in acute exacerbation of chronic obstructive pulmonary (AECOPD) have not been established. METHOD: We included 313 unselected patients with acute dyspnea who were categorized by etiology of dyspnea according to established guidelines (derivation cohort). Serum Na+ was determined on hospital admission and corrected for hyperglycemia, and hyponatremia was defined as [Na+]<137 mmol/L...
2016: PloS One
https://www.readbyqxmd.com/read/27442355/hyponatremia-associated-with-preeclampsia
#8
Armin S Razavi, Stephen T Chasen, Ritu Gyawali, Robin B Kalish
OBJECTIVE: The objective of our study was to evaluate the prevalence and clinical factors associated with hyponatremia in patients with preeclampsia. STUDY DESIGN: This is a descriptive study of all patients who delivered at our institution from 2013 to 2014. Patients with preeclampsia were identified from electronic medical records. Preeclampsia with and without severe features was defined using the criteria outlined in the American Congress of Obstetricians and Gynecologists Hypertension in Pregnancy guidelines...
July 21, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27149296/insufficient-evidence-of-benefit-regarding-mortality-due-to-albumin-substitution-in-hcc-free-cirrhotic-patients-undergoing-large-volume-paracentesis
#9
F Kütting, J Schubert, J Franklin, A Bowe, V Hoffmann, M Demir, A Pelc, D Nierhoff, U Töex, H M Steffen
BACKGROUND: Current guidelines for clinical practice recommend the infusion of human albumin after large volume paracentesis. After inspecting the current evidence behind this recommendation, we decided to conduct a systematic review and meta-analysis in order to address the effect of albumin on mortality and morbidity in the context of large volume paracentesis. METHODS: We performed a comprehensive search of large databases and abstract books of conference proceedings up to March 15th 2016 for randomized controlled trials, testing the infusion of human albumin against alternatives (vs...
May 3, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27094044/siad-practical-recommendations-for-diagnosis-and-management
#10
REVIEW
M Cuesta, A Garrahy, C J Thompson
Hyponatremia is the commonest electrolyte disturbance encountered in hospitalized patients, and the syndrome of inappropriate antidiuresis (SIAD) is the most frequent underlying disorder. There is a well-recognized relationship between hyponatremia and increased morbidity and mortality. Therefore, to provide appropriate treatment is critical to improve the clinical outcome related to SIAD-hyponatremia. There have been important advances in the treatment of SIAD over the last decade, leading to the publication of several clinical guidelines...
September 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/26958746/prognostic-significance-of-hyponatremia-in-acute-intracerebral-hemorrhage-pooled-analysis-of-the-intensive-blood-pressure-reduction-in-acute-cerebral-hemorrhage-trial-studies
#11
Cheryl Carcel, Shoichiro Sato, Danni Zheng, Emma Heeley, Hisatomi Arima, Jie Yang, Guojun Wu, Guofang Chen, Shihong Zhang, Candice Delcourt, Pablo Lavados, Thompson Robinson, Richard I Lindley, Xia Wang, John Chalmers, Craig S Anderson
OBJECTIVES: To determine the association of hyponatremia at presentation with clinical and imaging outcomes in patients with acute intracerebral hemorrhage. DESIGN: Retrospective pooled analysis of prospectively collected data from 3,243 participants of the pilot and main phases of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials 1 and 2 (international, multicenter, open, blinded endpoint, randomized controlled trials designed to assess the effects of early intensive blood pressure lowering in patients with acute intracerebral hemorrhage)...
July 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26956638/drug-related-hyponatremic-encephalopathy-rapid-clinical-response-averts-life-threatening-acute-cerebral-edema
#12
Arthur J Siegel, Sophie S Forte, Nasir A Bhatti, Steven E Gelda
BACKGROUND: Drug-induced hyponatremia characteristically presents with subtle psychomotor symptoms due to its slow onset, which permits compensatory volume adjustment to hypo-osmolality in the central nervous system. Due mainly to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), this condition readily resolves following discontinuation of the responsible pharmacological agent. Here, we present an unusual case of life-threatening encephalopathy due to adverse drug-related effects, in which a rapid clinical response facilitated emergent treatment to avert life-threatening acute cerebral edema...
2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/26951464/-news-on-hyponatremia
#13
Wiebke Fenske, Mirjam Christ-Crain
Hyponatremia is the most common electrolyte disorder in clinical practice with often severe and devastating complications. Hyponatremia itself as well as its inappropriate management is associated with pronounced morbidity and increased mortality risk. This manuscript presents some relevant novel findings in this field and discusses them in the context of the recently elaborated first European Guideline of hyponatremia.
April 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/26951244/loop-diuretics-in-the-treatment-of-hypertension
#14
REVIEW
Line Malha, Samuel J Mann
Loop diuretics are not recommended in current hypertension guidelines largely due to the lack of outcome data. Nevertheless, they have been shown to lower blood pressure and to offer potential advantages over thiazide-type diuretics. Torsemide offers advantages of longer duration of action and once daily dosing (vs. furosemide and bumetanide) and more reliable bioavailability (vs. furosemide). Studies show that the previously employed high doses of thiazide-type diuretics lower BP more than furosemide. Loop diuretics appear to have a preferable side effect profile (less hyponatremia, hypokalemia, and possibly less glucose intolerance)...
April 2016: Current Hypertension Reports
https://www.readbyqxmd.com/read/26926685/first-in-class-first-in-human-phase-i-study-of-selinexor-a-selective-inhibitor-of-nuclear-export-in-patients-with-advanced-solid-tumors
#15
Albiruni R Abdul Razak, Morten Mau-Soerensen, Nashat Y Gabrail, John F Gerecitano, Anthony F Shields, Thaddeus J Unger, Jean R Saint-Martin, Robert Carlson, Yosef Landesman, Dilara McCauley, Tami Rashal, Ulrik Lassen, Richard Kim, Lee-Anne Stayner, Mansoor R Mirza, Michael Kauffman, Sharon Shacham, Amit Mahipal
Purpose This trial evaluated the safety, pharmacokinetics, pharmacodynamics, and efficacy of selinexor (KPT-330), a novel, oral small-molecule inhibitor of exportin 1 (XPO1/CRM1), and determined the recommended phase II dose. Patients and Methods In total, 189 patients with advanced solid tumors received selinexor (3 to 85 mg/m(2)) in 21- or 28-day cycles. Pre- and post-treatment levels of XPO1 mRNA in patient-derived leukocytes were determined by reverse transcriptase quantitative polymerase chain reaction, and tumor biopsies were examined by immunohistochemistry for changes in markers consistent with XPO1 inhibition...
December 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/26914931/midazolam-and-thiopental-for-the-treatment-of-refractory-status-epilepticus-a-retrospective-comparison-of-efficacy-and-safety
#16
Flavio Bellante, Benjamin Legros, Chantal Depondt, Jacques Créteur, Fabio Silvio Taccone, Nicolas Gaspard
Current management guidelines for refractory status epilepticus (RSE) recommend the use of intravenous continuous anesthetic therapy, but there is little evidence to guide the selection of the most efficacious and safest drug. We conducted a retrospective study to evaluate the efficacy and safety of midazolam versus thiopental for treatment of RSE. Retrospective case-control series of prospectively identified patients treated with midazolam or thiopental for RSE between January 2007 and December 2014. The primary outcome was control of RSE...
April 2016: Journal of Neurology
https://www.readbyqxmd.com/read/26879322/chordoid-glioma-of-the-third-ventricle-a-patient-presenting-with-siadh-and-a-review-of-this-rare-tumor
#17
Matilde Calanchini, Simon Cudlip, Monika Hofer, James Byrne, Andrea Fabbri, Ashley Grossman
INTRODUCTION: Chordoid glioma of the third ventricle is a rare and recently described tumor characterized by a unique histomorphology and exclusive association with the suprasellar/third ventricular compartment. Its clinical, radiological and histological features may vary. Despite the fact that chordoid glioma is a low-grade tumor, its prognosis has been relatively poor because of its insidious presentation and the difficulty in obtaining complete surgical resection. MATERIALS AND METHODS: Here, we report on a new case of chordoid glioma occurring in a 48-year-old woman, presented with hyponatremia, and on the initial work-up with a diagnosis of hyponatremia due at least in part to SIADH...
August 2016: Pituitary
https://www.readbyqxmd.com/read/26876281/electrolyte-and-acid-base-abnormalities-associated-with-purging-behaviors
#18
REVIEW
Philip S Mehler, Kristine Walsh
OBJECTIVE: Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted. RESULTS: Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors...
March 2016: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/26793317/approach-to-hyponatremia-in-congestive-heart-failure-a-survey-of-canadian-specialist-physicians-and-trainees
#19
Amanda Miller, Bonnie Kuehl, Karthik Tennankore, Steven Soroka
BACKGROUND: Hyponatremia is a recognized complication of congestive heart failure (CHF) and is associated with reduced survival. Therefore, early identification and appropriate management of hyponatremia is important. The aim of this study was to determine the general approach amongst Canadian healthcare practitioners and trainees to the identification and management of hyponatremia complicating CHF. METHODS: Respondents completed 15 multiple-choice style questions in 3 case scenarios regarding the approach to management of hyponatremia complicating CHF using an online survey on UKidney...
2016: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/26702084/magnitude-of-and-prognostic-factors-associated-with-1-year-mortality-after-hospital-discharge-for-acute-decompensated-heart-failure-based-on-ejection-fraction-findings
#20
Andrew H Coles, Mayra Tisminetzky, Jorge Yarzebski, Darleen Lessard, Joel M Gore, Chad E Darling, Robert J Goldberg
BACKGROUND: Limited data exist about the magnitude of and the factors associated with prognosis within 1 year for patients discharged from the hospital after acute decompensated heart failure. Data are particularly limited from the more generalizable perspective of a population-based investigation and should be further stratified according to currently recommended ejection fraction (EF) findings. METHODS AND RESULTS: The hospital medical records of residents of the Worcester, Massachusetts, metropolitan area who were discharged after acute decompensated heart failure from all 11 medical centers in central Massachusetts during 1995, 2000, 2002, 2004, and 2006 were reviewed...
December 2015: Journal of the American Heart Association
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