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https://www.readbyqxmd.com/read/28721220/severe-diabetic-ketoacidosis-complicated-by-hypocapnic-seizure
#1
A Majid, B J Wheeler
In clinical practice, seizures independent of hypoglycemia are observed in patients with type 1 diabetes mellitus (T1DM) more frequently than expected by chance, suggesting a link. However, seizures during management of diabetic ketoacidosis (DKA) have generally been considered a bad prognostic factor, and usually associated with well-known biochemical or neurological complications. We present the case of a 17-year-old girl with known T1DM managed for severe DKA complicated by hypocapnic seizure. We review the literature on this rare occurrence as well as outline other possible differentials to consider when faced with the alarming combination of DKA and seizure...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28719887/anesthetic-management-of-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-crs-hipec-the-importance-of-hydro-electrolytic-and-acid-basic-control
#2
Fabrício Tavares Mendonça, Marília Moreira Guimarães, Sérgio Honorato de Matos, Rúbia Garcia Dusi
JUSTIFICATION AND OBJECTIVES: Patients affected by gynecological or gastrointestinal tract neoplasms that evolve to peritoneal carcinomatosis experience a significant drop in their quality of life, high morbidity and short survival times with currently available chemotherapeutic schemes. The surgical treatment based on cytoreduction and the employment of hyperthermic intraperitoneal chemotherapy in the intra-operative period is a true challenge to anesthesiologist. CASE REPORT: A 67 years old patient diagnosed with mucinous adenocarcinoma of the Appendix associated with mucinous carcinomatosis, was submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), under general anesthesia and epidural block...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28717547/emphysematous-pyelonephritis-changing-trend-of-clinical-spectrum-pathogenesis-management-and-outcome
#3
Ashok Kumar Sokhal, Manoj Kumar, Bimalesh Purkait, Ankur Jhanwar, Kawaljit Singh, Ankur Bansal, Satyanarayan Sankhwar
OBJECTIVE: To highlight changing trend of clinical spectrum, comparing management options and predictors of outcome of emphysematous pyelonephritis. MATERIAL AND METHODS: This study included patients who were diagnosed as emphysematous pyelonephritis between August, 2001 to July, 2015. We excluded other possible causes of gas in renal system. Baseline patient characteristics, clinical spectrum, serum and urinary biochemical parameters, radiological findings, management and outcomes were recorded...
June 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28711257/seasonal-and-maternal-effects-on-acid-base-l-lactate-electrolyte-and-hematological-status-of-205-dairy-calves-born-to-eutocic-dams
#4
L Kovács, F L Kézér, E Albert, F Ruff, O Szenci
In this study, we used linear mixed models to determine the effects of season, time of sampling relative to birth (factors), duration of the delivery process, duration of maternal grooming, calf body weight (BW) at birth, and time of day (covariates) on values of venous blood gas, acid-base and electrolyte parameters, and l-lactate concentrations in dairy calves born to eutocic dams in summer (SUM, n = 101) and winter (WIN, n = 104). Neonatal vitality was assessed at 0, 1, and 24 h after delivery in a linear scoring system using muscle tone, erection of the head, muscle reflexes, heart rate, and sucking drive as criteria...
July 12, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28705736/a-worldwide-experience-of-the-management-of-battery-failures-and-chronic-device-retrieval-of-the-nanostim-leadless-pacemaker
#5
Dhanunjaya Lakkireddy, Reinoud Knops, Brett Atwater, Petr Neuzil, John Ip, Elkin Gonzalez, Paul Friedman, Pascal Defaye, Derek Exner, Kazutaka Aonuma, Rahul Doshi, Johannes Sperzel, Vivek Reddy
BACKGROUND: The Nanostim leadless pacemaker (LP) met the primary endpoints in an IDE trial, and was shown to be fully retrievable percutaneously. In October 2016, St Jude Medical, issued a worldwide alert of a battery malfunction that caused lost pacing output and LP communication. OBJECTIVE: The objective here is to report the battery failure mechanism and incidence and the worldwide patient management including device retrieval experiences. METHODS: The affected LP battery is a custom Lithium-Carbon Monofluoride (Li-CFx) cell...
July 10, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28701841/continuous-renal-replacement-therapy-applications-on-extracorporeal-membrane-oxygenation-circuit
#6
Ayse Filiz Yetimakman, Murat Tanyildiz, Selman Kesici, Esra Kockuzu, Benan Bayrakci
BACKGROUND AND AIMS: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for applying CRRT on ECMO patients, we aim to share our experience on inclusion of a CRRT device in the ECMO circuit which we believe is easier and safer to apply. MATERIALS AND METHODS: The data were collected on demographics, outcomes, and details of the treatment of ECMO patients who had CRRT...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28699323/intra-procedural-continuous-dialysis-to-facilitate-interventional-catheterization-in-pediatric-patients-with-severe-renal-failure
#7
Angeline D Opina, Athar M Qureshi, Eileen Brewer, Ewa Elenberg, Sarah Swartz, Mini Michael, Henri Justino
BACKGROUND: Interventional catheterization procedures may be needed for patients with severe renal failure who are dependent on dialysis. To avoid the risk of fluid overload and electrolyte derangement during complex procedures in this oliguric/anuric patient population, we performed intra-procedural dialysis, either continuous renal replacement therapy (CRRT) or continous cycling peritoneal dialysis (CCPD). METHODS: We performed a retrospective review of a cohort of pediatric patients, ages 0-18 years, with dialysis-dependent renal failure who received CRRT or CCPD during catheterization procedures from January 2013 to March 2016...
July 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28697860/multimodal-nutritional-management-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#8
Guorui Cao, Qiang Huang, Bin Xu, Zeyu Huang, Jinwei Xie, Fuxing Pei
BACKGROUND: This study aims at evaluating the effectiveness of a new multimodal nutritional management (MNM) on albumin (ALB) transfusion, the incidence of electrolyte disorders, blood loss, perioperative levels of ALB and electrolyte, length of hospital stay (LOH), and complications in patients following total knee arthroplasty without tourniquet. METHODS: A total of 162 patients were randomized to receive either the MNM protocol (n = 81, experimental group) or traditional protocol (n = 81, control group)...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28697495/electrolyte-and-acid-base-abnormalities-in-infants-with-community-acquired-acute-pyelonephritis-prospective-cross-sectional-study
#9
Gregorio P Milani, Angela Grava, Mario G Bianchetti, Sebastiano A G Lava, Laura Dell'Era, Thomas Teatini, Emilio F Fossali
BACKGROUND: Retrospective case series suggest that abnormalities in fluid, electrolyte, and acid-base homeostasis may occur among infants with a febrile urinary tract infection. Potentially inaccurate laboratory methods of sodium testing have often been used. METHODS: Between January 2009 and June 2016, we managed 80 previously healthy infants (52 males and 28 females) ≥4 weeks to ≤24 months of age with their first episode of acute pyelonephritis. Ionized sodium, ionized potassium and ionized chloride were determined by direct potentiometry, as recommended by the International Federation of Clinical Chemistry...
July 12, 2017: Nephron
https://www.readbyqxmd.com/read/28695199/a-selective-electrocatalyst-based-direct-methanol-fuel-cell-operated-at-high-concentrations-of-methanol
#10
Yan Feng, Hui Liu, Jun Yang
Owing to the serious crossover of methanol from the anode to the cathode through the polymer electrolyte membrane, direct methanol fuel cells (DMFCs) usually use dilute methanol solutions as fuel. However, the use of high-concentration methanol is highly demanded to improve the energy density of a DMFC system. Instead of the conventional strategies (for example, improving the fuel-feed system, membrane development, modification of electrode, and water management), we demonstrate the use of selective electrocatalysts to run a DMFC at high concentrations of methanol...
June 2017: Science Advances
https://www.readbyqxmd.com/read/28682903/acute-abrin-poisoning-treated-with-continuous-renal-replacement-therapy-and-hemoperfusion-successfully-a-case-report
#11
Jiliang Huang, Wenbin Zhang, Xin Li, Shufen Feng, Gang Ye, Hongcheng Wei, Xiaobing Gong
RATIONALE: Abrin is a highly toxic protein obtained from the seeds of Abrus precatorius, but poisoning due to ingestion of A precatorius is extremely rare in China. PATIENT CONCERNS: A 16-year-old girl, perfectly healthy before, was admitted to the department of gastroenterology owing to intentional ingestion of 10 crushed A precatorius seeds, with multiple episodes of somnolent and anxious mental status, vomiting, abdominal pain, diarrhea, hematochezia, and hematuria...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28677878/hypocalcaemia-induced-tetany-secondary-to-total-thyroidectomy-a-nursing-case-review
#12
Shannon Bakon, Judy Craft, Martin Christensen
Presentations to the emergency department with a diagnosis of hypocalcaemia-induced tetany secondary to total thyroidectomy are rare. A patient presented to the emergency department of a regional Australian hospital with hypocalcaemia-induced tetany. A case study was employed to reflect on the care provided and identify knowledge practice deficits within this unusual patient presentation. Calcium plays a central role within the nervous system and is vital for both cardiac and muscular contraction. The clinical manifestations of electrolyte disturbances such as hypocalcaemia can be life threatening, and therefore, appropriate assessment, monitoring and management are essential to ensure positive patient outcomes...
July 5, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28671407/perioperative-cardiovascular-medication-management-in-noncardiac-surgery-common-questions
#13
Michael A Mikhail, Arya B Mohabbat, Amit K Ghosh
Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the risk of bleeding, unless the risk of a major adverse cardiac event exceeds the risk of bleeding. Antiplatelet therapy for secondary prevention should be continued perioperatively, except before procedures with very high bleeding risk, such as intracranial procedures...
May 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28657704/assembly-and-stacking-of-flow-through-enzymatic-bioelectrodes-for-high-power-glucose-fuel-cells
#14
Caroline Abreu, Yannig Nedellec, Andrew J Gross, Olivier Ondel, Francois Buret, Alan Le Goff, Michael Holzinger, Serge Cosnier
Bioelectrocatalytic carbon nanotube based pellets comprising redox enzymes were directly integrated in a newly conceived flow-through fuel cell. Porous electrodes and a separating cellulose membrane were housed in a glucose/oxygen biofuel cell design with inlets and outlets allowing the flow of electrolyte through the entire fuel cell. Different flow setups were tested and the optimized single cell setup, exploiting only 5 mmol L(-1) glucose, showed an open circuit voltage (OCV) of 0.663 V and provided 1.03 ± 0...
July 19, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28647800/safety-and-effectiveness-of-tolvaptan-for-fluid-management-after-pediatric-cardiovascular-surgery
#15
Yuzo Katayama, Tsukasa Ozawa, Noritsugu Shiono, Hiroshi Masuhara, Takeshiro Fujii, Yoshinori Watanabe
BACKGROUND: Postoperative fluid management is important after open heart surgery, because cardiopulmonary bypass evokes an abnormal inflammatory response and increases vascular permeability, especially in pediatric patients. We assessed the safety and effectiveness of tolvaptan for management of postoperative fluid retention after congenital heart surgery. METHODS AND RESULTS: This retrospective study analyzed data from 43 children with uncomplicated congenital heart disease who underwent open heart surgery between September 2013 and August 2016...
June 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28631393/comparison-of-thiazide-like-diuretics-versus-thiazide-type-diuretics-a-meta-analysis
#16
REVIEW
Wenjing Liang, Hui Ma, Luxi Cao, Wenjiang Yan, Jingjing Yang
Thiazide diuretics are widely used for the management of hypertension. In recent years, it has been actively debated that there is interchangeability of thiazide-type diuretics hydrochlorothiazide and thiazide-like diuretics including indapamide and chlorthalidone for the treatment of hypertension. With the purpose of seeking out the best thiazide diuretic for clinicians, we summarized the existing evidence on the two types of drugs and conducted a meta-analysis on their efficacy in lowering blood pressure and effects on blood electrolyte, glucose and total cholesterol...
June 19, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28623282/a-nationwide-study-of-severe-and-protracted-diarrhoea-in-patients-with-primary-immunodeficiency-diseases
#17
Wen-I Lee, Chien-Chang Chen, Tang-Her Jaing, Liang-Shiou Ou, Chuen Hsueh, Jing-Long Huang
Diarrhoea lasting longer than 14 days and failing to respond to conventional management is defined as severe and protracted diarrhoea (SD). In this study, we investigated the prevalence, pathogens and prognosis of SD in primary immunodeficiency diseases (PIDs). Among 246 patients with predominantly paediatric-onset PIDs from 2003-2015, 21 [Btk (six), IL2RG (four), WASP, CD40L, gp91 (three each), gp47, RAG2 (one each)] and five [CVID (four), SCID (one)] without identified mutations had SD before prophylactic treatment...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28619670/hyponatraemia-diagnosis-and-treatment-clinical-practice-guidelines
#18
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...
June 12, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#19
Daniel Hertzberg, Linda Rydén, John W Pickering, Ulrik Sartipy, Martin J Holzmann
Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28614115/trafficking-and-regulation-of-the-nkcc2-cotransporter-in-the-thick-ascending-limb
#20
Kerim Mutig
PURPOSE OF REVIEW: The kidney Na-K-2Cl cotransporter (NKCC2) is essential for urinary concentration and renal electrolyte handling. Loss of function mutations in the NKCC2 gene cause urinary salt and potassium wasting, whereas excessive NKCC2 function has been linked to high blood pressure. Loop diuretics, targeting the transporter, are instrumental for relieving edema or hypertension. This review focuses on intrinsic mechanisms regulating NKCC2 activity at the posttranslational level, namely its trafficking and phosphorylation...
June 12, 2017: Current Opinion in Nephrology and Hypertension
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