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electrolyte management

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https://www.readbyqxmd.com/read/28433336/the-association-of-postoperative-glycemic-control-and-lower-extremity-procedure-outcomes
#1
Todd R Vogel, Jamie B Smith, Robin L Kruse
OBJECTIVE: The effect of postoperative hyperglycemia in patients undergoing open and endovascular procedures on the lower extremities has not been fully characterized with regard to associated admission diagnoses, hospital complications, mortality, and 30-day readmission. This study evaluated the relationship of postoperative hyperglycemia on outcomes after lower extremity vascular procedures for peripheral artery disease. METHODS: Patients with peripheral artery disease admitted for elective lower extremity procedures between September 2008 and March 2014 were selected from the Cerner Health Facts (Cerner Corporation, Kansas City, Mo) database using International Classification of Diseases, Ninth Edition, Clinical Modification diagnosis and procedure codes...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28429460/automated-t-wave-analysis-can-differentiate-acquired-qt-prolongation-from-congenital-long-qt-syndrome
#2
Alan Sugrue, Peter A Noseworthy, Vaclav Kremen, J Martijn Bos, Bo Qiang, Ram K Rohatgi, Yehu Sapir, Zachi I Attia, Peter Brady, Pedro J Caraballo, Samuel J Asirvatham, Paul A Friedman, Michael J Ackerman
BACKGROUND: Prolongation of the QT on the surface electrocardiogram can be due to either genetic or acquired causes. Distinguishing congenital long QT syndrome (LQTS) from acquired QT prolongation has important prognostic and management implications. We aimed to investigate if quantitative T-wave analysis could provide a tool for the physician to differentiate between congenital and acquired QT prolongation. METHODS: Patients were identified through an institution-wide computer-based QT screening system which alerts the physician if the QTc ≥ 500 ms...
April 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28422812/randomized-double-blind-trial-of-ringer-s-lactate-versus-normal-saline-in-pediatric-acute-severe-diarrheal-dehydration
#3
Gayathri Bhuvaneswaran Kartha, Ramachandran Rameshkumar, Subramanian Mahadevan
OBJECTIVE: To compare the effectiveness of Ringer Lactate (RL) versus normal saline (NS) in the correction of pediatric acute severe diarrheal dehydration, as measured by improvement in clinical status and pH (≥7.35). METHODS: 68 children aged 1-month to 12-year with acute severe diarrheal dehydration (World Health Organization (WHO classification) were randomized into RL (n = 34) and NS-group (n = 34) and received 100 ml/kg of the assigned intravenous fluid according to WHO PLAN-C for the management of diarrheal dehydration...
April 18, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28422408/prevention-of-the-osmotic-demyelination-syndrome-after-liver-transplantation-a-multidisciplinary-perspective
#4
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/28416250/therapeutic-hypothermia-for-neonates-with-hypoxic-ischemic-encephalopathy
#5
REVIEW
Ming-Chou Chiang, Yuh-Jyh Jong, Chyi-Her Lin
Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe hypoxic ischemic encephalopathy (HIE). The Task Force of the Taiwan Child Neurology Society and the Taiwan Society of Neonatology held a joint meeting in 2015 to establish recommendations for using TH on newborn patients with HIE. Based on current evidence and experts' experiences, this review article summarizes the key points and recommendations regarding TH for newborns with HIE, including: (1) selection criteria for TH; (2) choices of method and equipment for TH; (3) TH prior to and during transport; (4) methods for temperature maintenance, monitoring, and rewarming; (5) systemic care of patients during TH, including the care of respiratory and cardiovascular systems, management of fluids, electrolytes, and nutrition, as well as sedation and drug metabolism; (6) monitoring and management of seizures; (7) neuroimaging, prognostic factors, and outcomes; and (8) adjuvant therapy for TH...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28413524/perioperative-complications-in-endovascular-neurosurgery-anesthesiologist-s-perspective
#6
Megha U Sharma, Pragati Ganjoo, Daljit Singh, Monica S Tandon, Jyotsna Agarwal, Durga P Sharma, Anita Jagetia
BACKGROUND: Endovascular neurosurgery is known to be associated with potentially serious perioperative complications that can impact the course and outcome of anesthesia. We present here our institutional experience in the anesthetic management of various endovascular neurosurgical procedures and their related complications over a 10-year period. METHODS: Data was obtained in 240 patients pertaining to their preoperative status, details of anesthesia and surgery, perioperative course and surgery-related complications...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28386507/an-unusual-case-of-resistant-hypokalaemia-in-a-patient-with-large-bowel-obstruction-secondary-to-neuroendocrine-carcinoma-of-the-prostate
#7
Umasankar Mathuram Thiyagarajan, A Ponnuswamy, A Bagul, A Gupta
Neuroendocrine Carcinoma of the Prostate (NECP) is rare and only few cases have been reported, constituting less than 0.5% of prostatic malignancies. We report a rare case of large bowel obstruction from NECP posing a further challenge in management due to resistant hypokalaemia. A 70-year-old man presented with clinical signs of large bowel obstruction who was known to have prostatic carcinoma three years ago, treated initially with hormone therapy then chemoradiation. The blood profile showed a severe hypokalaemia and CT scan revealed liver and lung metastases apart from confirming large bowel obstruction from local invasion of NECP...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28372715/management-of-hyperglycemic-crises-diabetic-ketoacidosis-and-hyperglycemic-hyperosmolar-state
#8
REVIEW
Maya Fayfman, Francisco J Pasquel, Guillermo E Umpierrez
Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are the most serious and life-threatening hyperglycemic emergencies in diabetes. DKA is more common in young people with type 1 diabetes and HHS in adult and elderly patients with type 2 diabetes. Features of the 2 disorders with ketoacidosis and hyperosmolality may coexist. Both are characterized by insulinopenia and severe hyperglycemia. Early diagnosis and management are paramount. Treatment is aggressive rehydration, insulin therapy, electrolyte replacement, and treatment of underlying precipitating events...
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28371408/two-cases-of-humoral-hypercalcemia-of-malignancy-complicating-infantile-fibrosarcoma
#9
Ryan Hirschfeld, Jennifer J G Welch, Douglas J Harrison, Robin Kremsdorf, Anjulika Chawla
We report two infants with infantile fibrosarcoma (IFS) complicated by severe hypercalcemia. Assessment demonstrated suppressed parathyroid hormone and 1,25-dihydroxyvitamin D levels with elevated circulating levels of parathyroid hormone related protein, indicating the diagnosis of humoral hypercalcemia of malignancy (HHM). HHM is a paraneoplastic syndrome rarely associated with pediatric malignancies. Hypercalcemia manifested clinically with neurologic symptoms and soft tissue calcium deposition and required aggressive management with intravenous fluids, diuretics, and supplemental electrolytes...
March 29, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28359870/adsorption-of-emerging-contaminant-metformin-using-graphene-oxide
#10
Shuai Zhu, Yun-Guo Liu, Shao-Bo Liu, Guang-Ming Zeng, Lu-Hua Jiang, Xiao-Fei Tan, Lu Zhou, Wei Zeng, Ting-Ting Li, Chun-Ping Yang
The occurrence of emerging contaminants in our water resources poses potential threats to the livings. Due to the poor treatment in wastewater management, treatment technologies are needed to effectively remove these products for living organism safety. In this study, Graphene oxide (GO) was tested for the first time for its capacity to remove a kind of emerging wastewater contaminants, metformin. The research was conducted by using a series of systematic adsorption and kinetic experiments. The results indicated that GO could rapidly and efficiently reduce the concentration of metformin, which could provide a solution in handling this problem...
July 2017: Chemosphere
https://www.readbyqxmd.com/read/28356904/clinical-utility-of-patiromer-sodium-zirconium-cyclosilicate-and-sodium-polystyrene-sulfonate-for-the-treatment-of-hyperkalemia-an-evidence-based-review
#11
REVIEW
Mario V Beccari, Calvin J Meaney
INTRODUCTION: Hyperkalemia is a serious medical condition that often manifests in patients with chronic kidney disease and heart failure. Renin-angiotensin-aldosterone system inhibitors are known to improve outcomes in these disease states but can also cause drug-induced hyperkalemia. New therapeutic options exist for managing hyperkalemia in these patients which warrant evidence-based evaluation. AIM: The objective of this article was to review the efficacy and safety evidence for patiromer, sodium zirconium cyclosilicate (ZS9), and sodium polystyrene sulfonate (SPS) for the treatment of hyperkalemia...
2017: Core Evidence
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/28320069/usefulness-of-laboratory-and-radiological-investigations-in-the-management-of-supraventricular-tachycardia
#13
Aadith Ashok, Miguel Cabalag, David McD Taylor
OBJECTIVE: Although ED patients presenting with supraventricular tachycardia (SVT) are commonly investigated, the value of these investigations has been questioned. We aimed to determine the frequency and utility of investigations in patients with SVT. METHODS: We undertook an explicit retrospective medical record audit of patients with SVT who presented to a single ED (January 2004 to June 2014). Data on demographics, presenting complaints, investigations and outcomes were extracted...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28306420/ventriculo-ureteral-shunt-insertion-using-percutaneous-nephrostomy-a-novel-minimally-invasive-option-in-a-patient-with-chronic-hydrocephalus-complicated-by-multiple-distal-ventriculoperitoneal-shunt-failures
#14
Ashok Pillai, Georgie Mathew, Sivasankaran Nachimuthu, Sanjeevan Vasudevan Kalavampara
The management of ventriculoperitoneal (VP) shunt failure is a common problem in neurosurgical practice. On occasion, extraperitoneal sites for CSF diversion are required when shunting to the peritoneal cavity has failed after multiple attempts. The authors report a novel minimally invasive procedure allowing cannulation of the ureter for the purpose of ventriculo-ureteral (VU) shunting. Sixteen years prior to presentation, this 46-year-old woman had contracted tuberculous meningitis and had chronic hydrocephalus, with multiple distal shunt failures in recent months...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28302660/rhabdomyolysis-induced-compartment-syndrome-secondary-to-atorvastatin-and-strenuous-exercise
#15
Louise Dunphy, Rossel Morhij, Sarah Tucker
A 50-year-old male UK resident with a history of hypertension and hypercholesterolaemia presented to the emergency department with a 48-hour history of sudden onset bilateral thigh swelling and pain unrelieved by regular analgesia. 3 days prior to presentation, he performed a vigorous workout in the gym. His medications included ramipril 5 mg once daily and atorvastatin 20 mg at night time. He was a non-smoker and did not consume alcohol. He reported no known drug allergies. Physical examination confirmed bilateral swollen thighs, with no overlying skin changes, clinically suggestive of compartment syndrome...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28283364/absolute-ethanol-embolisation-of-mandibular-arteriovenous-malformations-following-direct-percutaneous-puncture-and-release-of-coils-via-a-microcatheter
#16
D Wang, L Su, Y Han, Z Wang, L Zheng, X Fan
OBJECTIVE/BACKGROUND: To evaluate the safety, efficacy, and medium-term outcome of a modified technique of ethanol embolisation of mandibular arteriovenous malformations (AVMs) following a direct percutaneous transvenous approach to the release of coils via a microcatheter. METHODS: From January 2012 to July 2014, 18 consecutive patients (mean age 20.9 years [range 10-35 years]) with symptomatic AVMs of the mandible were enrolled. A microcatheter was inserted into the lesion via a direct percutaneous puncture needle...
March 7, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28258576/diabetes-insipidus
#17
H A Jenny Lu
Disruption of water and electrolyte balance is frequently encountered in clinical medicine. Regulating water metabolism is critically important. Diabetes insipidus (DI) presented with excessive water loss from the kidney is a major disorder of water metabolism. To understand the molecular and cellular mechanisms and pathophysiology of DI and rationales of clinical management of DI is important for both research and clinical practice. This chapter will first review various forms of DI focusing on central diabetes insipidus (CDI) and nephrogenic diabetes insipidus (NDI ) ...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28255480/multiple-electrolyte-and-metabolic-emergencies-in-a-single-patient
#18
Caprice Cadacio, Phuong-Thu Pham, Ruchika Bhasin, Anita Kamarzarian, Phuong-Chi Pham
While some electrolyte disturbances are immediately life-threatening and must be emergently treated, others may be delayed without immediate adverse consequences. We discuss a patient with alcoholism and diabetes mellitus type 2 who presented with volume depletion and multiple life-threatening electrolyte and metabolic derangements including severe hyponatremia (serum sodium concentration [SNa] 107 mEq/L), hypophosphatemia ("undetectable," <1.0 mg/dL), and hypokalemia (2.2 mEq/L), moderate diabetic ketoacidosis ([DKA], pH 7...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28250586/physiological-performance-of-two-contrasting-rice-varieties-under-water-stress
#19
Furqan Khan, Priyanka Upreti, Ruchi Singh, Pradeep Kumar Shukla, Pramod Arvind Shirke
Two rice varieties PR-115 and Super-7 were imposed to water stress and different physiological traits were monitored to evaluate the performance of these varieties under drought. Under water stress condition although the relative water content, osmotic potential, chlorophyll content, photosynthesis rate, carbon discrimination and biomass decreased in both the varieties however, the reduction was more pronounced in Super-7 variety. Oryzanol a trans-ester of ferulic acid functions as antioxidant and it increased along with total phenolic and anthocyanin content in both the varieties under drought stress...
January 2017: Physiology and Molecular Biology of Plants: An International Journal of Functional Plant Biology
https://www.readbyqxmd.com/read/28244719/thiamin-and-folic-acid-deficiency-accompanied-by-resistant-electrolyte-imbalance-in-the-re-feeding-syndrome-in-an-elderly-patient
#20
Sibel Ocak Serin, Gulsah Karaoren, Yildiz Okuturlar, Ethem Unal, Seda Ahci, Eda Karakoc, Sema Ucak Basat
INTRODUCTION: Re-feeding Syndrome (RS) is a deadly complication, which can be encountered during "refeeding" of malnourished patients. In these patients, thiamin deficiency may develop and "risk awareness" is the most significant factor in the management of these patients. In this case report, the treatment is presented of an elderly patient who was diagnosed with RS and followed-up in the intensive care unit (ICU) due to resistant fluidelectrolyte imbalance. CASE: An 87-year-old elderly woman was admitted to the hospital due to aspiration pneumonia...
March 2017: Asia Pacific Journal of Clinical Nutrition
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