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hyponatremia guidelines

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https://www.readbyqxmd.com/read/29295830/treatment-of-severe-hyponatremia
#1
Richard H Sterns
Patients with severe (serum sodium ≤120 mEq/L), symptomatic hyponatremia can develop life-threatening or fatal complications from cerebral edema if treatment is inadequate and permanent neurologic disability from osmotic demyelination if treatment is excessive. Unfortunately, as is true of all electrolyte disturbances, there are no randomized trials to guide the treatment of this challenging disorder. Rather, therapeutic decisions rest on physiologic principles, animal models, observational studies, and single-patient reports...
January 2, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29260376/desmopressin-use-in-pediatric-nocturnal-enuresis-patients-is-there-a-sex-difference-in-prescription-patterns
#2
Marie Krarup Schroeder, K V Juul, B Mahler, J P Nørgaard, S Rittig
Desmopressin is a long-established treatment for nocturnal enuresis with clear guidelines regarding its usage. A sex difference in renal sensitivity has recently been reported in adults. The objective of this study was to investigate real-life desmopressin prescription in the Danish pediatric population, and prescription patterns which may reflect a sex difference in pediatric usage. Formulation, dose, treatment duration, and safety (hyponatremia) were investigated. 40,596 children received 214,220 desmopressin prescriptions between 2004 and 2011 in the Danish National Prescription Registry...
December 19, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29174200/group-2-adrenal-insufficiency-screening-methods-and-confirmation-of-diagnosis
#3
Philippe Chanson, Laurence Guignat, Bernard Goichot, Olivier Chabre, Dinane Samara Boustani, Rachel Reynaud, Dominique Simon, Antoine Tabarin, Damien Gruson, Yves Reznik, Marie-Laure Raffin Sanson
A diagnosis of adrenal insufficiency should be suspected in the presence of a number of non-specific symptoms (fatigue, anorexia, weight loss, hypotension, hyponatremia and hyperkalemia amongst adrenal causes of insufficiency). The diagnosis should be considered in case of pituitary disease or a state of shock. Treatment should be commenced immediately without waiting for confirmation from biochemical tests, which rely on cortisol level at 8am (expected to be low) and on ACTH level (expected to be high in the case of primary adrenal insufficiency)...
December 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29173694/cyclophosphamide-administration-routine-in-autoimmune-rheumatic-diseases-a-review
#4
Kaian Amorim Teles, Patricia Medeiros-Souza, Francisco Aires Correa Lima, Bruno Gedeon de Araújo, Rodrigo Aires Correa Lima
Cyclophosphamide 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, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis...
November 2017: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/29156484/-perioperative-intravenous-fluid-therapy-in-children
#5
Robert Sümpelmann
The objective of this consensus-based S1 Guideline for perioperative fluid therapy in children is to maintain or re-establish the child's homeostasis. Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. For the intraoperative background infusion a physiologically composed balanced isotonic electrolyte solution (BS) with 1 - 2.5% glucose is recommended to maintain normal glucose concentrations and to avoid hyponatremia, hyperchloremia, and lipolysis...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29141492/a-case-report-of-hyponatremia-after-surgery-for-conn-s-adenoma
#6
Giulia Furlanis, Stella Bernardi, Monica Cavressi, Lorenzo Zandonà, Renzo Carretta, Bruno Fabris, Moreno Bardelli
Primary aldosteronism (PA), also known as Conn's syndrome, is a frequent cause of secondary hypertension. If PA is due to a documented unilateral adrenal adenoma, adrenalectomy is the treatment of choice. Endocrine Society guidelines suggest monitoring potassium after adrenalectomy, while there is no mention of sodium disorders after surgery. Here we report the case of a patient with Conn's syndrome who developed hyponatremia after surgery. This was an unexpected event in the course of the treatment, which sheds light on the fact that low levels of aldosterone strongly influence sodium concentration, and advises clinicians to monitor sodium after adrenalectomy...
October 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/29120656/-syndrome-of-inappropriate-antidiuresis-and-the-current-management-of-hyponatremia
#7
Ivica Lazúrová
Hyponatremia defined as serum sodium lower than 135 mmol/L is the most common electrolyte abnormality in outpatients and also in hospitalized patients. It has been documented that hyponatremia is associated with significantly higher morbidity, mortality and longer hospitalization stay. Hyponatremia is manifested by variety of symptoms, from mild up to life threatening conditions. Syndrome of inappropriate antidiuresis (SIAD) is the most common type of hyponatremia. This article presents new aspects in the etiology, diagnosis, differential diagnosis ant treatment of the SIAD according to European guidelines...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28991694/dilemmas-in-the-diagnosis-and-treatment-of-intracranial-tuberculomas
#8
REVIEW
Rajeswari Ramachandran, M Muniyandi, Vijay Iyer, T Sripriya, B Priya, T G Govindarajan
Tuberculosis (TB) remains a major public health problem across the globe. A common form of extrapulmonary TB (EPTB) with high mortality and morbidity is neuro TB or tuberculosis of the nervous system. The management of brain TB remains a big challenge due to the lack of specific diagnostic tools and appropriate treatment guidelines. In this context, this manuscript discusses clinical, diagnostic and treatment dilemmas in the management of intracranial tuberculomas. Brain tuberculoma may occur at any site within the cranium, no part of the brain substance or ventricular surface being exempt...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28987848/prevention-and-treatment-for-hyponatremia-in-patients-with-subarachnoid-hemorrhage-a-systematic-review
#9
REVIEW
Kieran Shah, Ricky Turgeon, Peter A Gooderham, Mary H H Ensom
BACKGROUND: Current guidelines have not systematically assessed the literature for the management of hyponatremia in patients with subarachnoid hemorrhage. OBJECTIVE: To evaluate the efficacy and safety of current preventative and treatment strategies of hyponatremia in patients with subarachnoid hemorrhage. METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, MEDLINE, and PubMed for relevant studies. Primary outcomes of interest included neurological functional outcomes, symptomatic vasospasm, and others...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28959072/challenges-in-the-management-of-a-patient-with-myxoedema-coma-in-ghana-a-case-report
#10
Josephine Akpalu, Yacoba Atiase, Ernest Yorke, Henrietta Fiscian, Cecilia Kootin-Sanwu, Albert Akpalu
Myxoedema coma is a rare life-threatening disease, and it is essential that it is managed appropriately to reduce the associated high mortality. However, in the setting where efficient healthcare delivery is hampered by inadequacies, the management of such cases may pose a significant challenge. We present the case of a middle-aged woman diagnosed with myxoedema coma and severe hyponatremia. The case report highlights some of the challenges that may be encountered during the management of myxoedema coma in similar settings and outlines the management strategies undertaken to overcome them in the absence of national guidelines...
March 2017: Ghana Medical Journal
https://www.readbyqxmd.com/read/28953058/albumin-use-in-patients-with-cirrhosis-in-france-results-of-the-albu-live-survey-a-case-for-better-easl-guidelines-diffusion-and-or-revision
#11
Armand Garioud, Jean-François Cadranel, Arnaud Pauwels, Jean-Baptiste Nousbaum, Thierry Thévenot, Thong Dao, Alexandre Louvet, Philippe Sogni, Nathalie Talbodec, Teresa M Antonini, Christophe Bureau, Dominique Thabut, Laure Elkrief, Vincent Jouannaud, Gilles Macaigne, Brigitte Bernard-Chabert, Hortensia Lison, Laurent Alric, Nicolas Carbonell, Héléne Labadie, Xavier Amiot, Armand Abergel, Bertrand Hanslik, Vincent Leroy, Victor De Lédinghen, Jacques Denis
INTRODUCTION: The use of human albumin for the management of cirrhosis has increased. Recommendations have been published for therapeutic paracentesis (TP), spontaneous bacterial peritonitis (SBP), and type 1 hepatorenal syndrome (HRS). The goal of this survey was to assess the prescription practices of French hepatogastroenterologists. METHODS: All hepatogastroenterologists were contacted. The questionnaire evaluated (1) the use of albumin in validated indications and (2) the prescription of albumin for nonvalidated clinical situations...
August 4, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28895701/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-2-electrolyte-disturbances-nonelectrolyte-disturbances-therapeutic-options
#12
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamscha, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Alvarez
Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of a pediatric patient with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to diagnostic and therapeutic aspects, and preventive care...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28814256/current-issues-in-intravenous-fluid-use-in-hospitalized-children
#13
Jennifer Fuchs, Sarah T Adams, Julie Byerley
BACKGROUND: Fluid and electrolyte therapy is an important component in the care of the hospitalized child. Previous pediatric guidelines have followed the Holliday-Segar method of calculating and delivering maintenance IV fluids, using hypotonic fluids in maintenance therapy. However, research demonstrates that hypotonic fluids can lead to iatrogenic hyponatremia and that isotonic fluid is a safer alternative. OBJECTIVE: To provide the ideal approach to intravenous (IV) fluid use in the hospitalized child and determine the safety and effectiveness of isotonic maintenance fluid therapy...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28810281/-hyponatremia-differential-diagnosis-and-treatment
#14
REVIEW
Heiner Mönig, Alexander Arlt
Hyponatremia is the most common electrolyte abnormality seen in hospitalized patients, with up to 30 % having a plasma sodium concentration below 135 mmol/l. It is now clear that the clinical problem extends beyond the neurological symptoms, which can be explained by intracerebral osmotic fluid shifts and brain edema. Instead, chronic hyponatremia is associated with impaired gait stability and an increased risk of bone fragility fractures. Moreover, hyponatremia has been demonstrated to be an indicator of poor prognosis in a variety of conditions...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28758978/dietary-approaches-in-the-management-of-diabetic-patients-with-kidney-disease
#15
REVIEW
Gang Jee Ko, Kamyar Kalantar-Zadeh, Jordi Goldstein-Fuchs, Connie M Rhee
Chronic kidney disease (CKD) is one of the most prevalent complications of diabetes, and patients with diabetic kidney disease (DKD) have a substantially higher risk of cardiovascular disease and death compared to their non-diabetic CKD counterparts. In addition to pharmacologic management strategies, nutritional and dietary interventions in DKD are an essential aspect of management with the potential for ameliorating kidney function decline and preventing the development of other end-organ complications. Among DKD patients with non-dialysis dependent CKD, expert panels recommend lower dietary protein intake of 0...
July 31, 2017: Nutrients
https://www.readbyqxmd.com/read/28750874/guidelines-on-hyponatremia-that-not-always-guide
#16
Roberto Alcázar, Alberto Tejedor
No abstract text is available yet for this article.
July 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28737869/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-1-pathophysiology-diagnostic-evaluation-hospitalization-criteria-treatment-nutritional-management
#17
REVIEW
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamsch, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Álvarez
Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of pediatric patients with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to its diagnostic and therapeutic aspects, and preventive care...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28720136/bilateral-multiple-pulmonary-artery-aneurysms-associated-with-cavitary-pulmonary-tuberculosis-a-case-report
#18
Pedro Pallangyo, Frederick Lyimo, Smita Bhalia, Hilda Makungu, Bashir Nyangasa, Flora Lwakatare, Pal Suranyi, Mohamed Janabi
BACKGROUND: Pulmonary artery aneurysms constitute <1% of aneurysms occurring in the thoracic cavity. Congenital cardiac defects are responsible for the majority (>50%) of cases, however, pulmonary artery aneurysm is a rare sequelae of pulmonary tuberculosis reported in about 5% of patients with chronic cavitary tuberculosis on autopsy. The natural history of this potentially fatal condition remains poorly understood and guidelines for optimal management are controversial. CASE PRESENTATION: A 24-year-old man, a nursing student of African descent, was referred to us from an up-country regional hospital with a 4-week history of recurrent episodes of breathlessness, awareness of heartbeats and coughing blood 3 weeks after completing a 6-month course of anti-tuberculosis drugs...
July 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28666669/medical-treatment-of-nocturia-in-men-with-lower-urinary-tract-symptoms-systematic-review-by-the-european-association-of-urology-guidelines-panel-for-male-lower-urinary-tract-symptoms
#19
REVIEW
Vasileios I Sakalis, Markos Karavitakis, Dina Bedretdinova, Thorsten Bach, J L H Ruud Bosch, Mauro Gacci, Christian Gratzke, Thomas R Herrmann, Stephan Madersbacher, Charalampos Mamoulakis, Kari A O Tikkinen, Stavros Gravas, Marcus J Drake
CONTEXT: The treatment of nocturia is a key challenge due to the multi-factorial pathophysiology of the symptom and the disparate outcome measures used in research. OBJECTIVE: To assess and compare available therapy options for nocturia, in terms of symptom severity and quality of life. EVIDENCE ACQUISITION: Medical databases (Embase, Medline, Cochrane Systematic Reviews, Cochrane Central) were searched with no date restriction. Comparative studies were included which studied adult men with nocturia as the primary presentation and lower urinary tract symptoms including nocturia or nocturnal polyuria...
November 2017: European Urology
https://www.readbyqxmd.com/read/28619670/hyponatraemia-diagnosis-and-treatment-clinical-practice-guidelines
#20
Goce Spasovski, Raymond Vanholder, Bruno Allolio, Djillali Annane, Steve Ball, Daniel Bichet, Guy Decaux, Wiebke Fenske, Ewout J Hoorn, Carole Ichai, Michael Joannidis, Alain Soupart, Robert Zietse, Maria Haller, Sabine van der Veer, Wim van Biesen, Evi Nagler, Liliana Gonzalez-Espinoza, Alberto Ortiz
Hyponatremia, defined as a serum sodium concentration <135mmol/l, is the most common water-electrolyte imbalance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from mild to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay. Despite this, the management of hyponatremia patients remains problematic. The prevalence of hyponatremia in a wide variety of conditions and the fact that hyponatremia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and specialty-based approaches to diagnosis and treatment...
July 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
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