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Hyponatraemia

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https://www.readbyqxmd.com/read/28631393/comparison-of-thiazide-like-diuretics-versus-thiazide-type-diuretics-a-meta-analysis
#1
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/28619670/hyponatraemia-diagnosis-and-treatment-clinical-practice-guidelines
#2
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/28574597/mortality-rates-are-lower-in-siad-than-in-hypervolaemic-or-hypovolaemic-hyponatraemia-results-of-a-prospective-observational-study
#3
Martín Cuesta, Aoife Garrahy, David Slattery, Saket Gupta, Anne Marie Hannon, Karen McGurren, Mark Sherlock, William Tormey, Christopher J Thompson
OBJECTIVE: Hyponatremia is associated with increased mortality, but the mortality associated specifically with SIAD is not known. We hypothesised that mortality in SIAD was elevated, but that it was less than in hypervolemic(HEN) or hypovolemic(HON) hyponatremia. DESIGN: Mortality rates are presented as risk ratios(RR),with 95% confidence intervals (CI), and compared to normonatremic controls(NN). METHODS: Prospective, single center, non-interventional study of all patients with hyponatremia(≤ 130 mmol/l) admitted to hospital...
June 2, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28572613/mesenchymal-stem-cells-correct-haemodynamic-dysfunction-associated-with-liver-injury-after-extended-resection-in-a-pig-model
#4
Hans-Michael Tautenhahn, Sandra Brückner, Christiane Uder, Silvio Erler, Madlen Hempel, Martin von Bergen, Janine Brach, Sandra Winkler, Franziska Pankow, Claudia Gittel, Manja Baunack, Undine Lange, Johannes Broschewitz, Matthias Dollinger, Michael Bartels, Uta Pietsch, Kerstin Amann, Bruno Christ
In patients, acute kidney injury (AKI) is often due to haemodynamic impairment associated with hepatic decompensation following extended liver surgery. Mesenchymal stem cells (MSCs) supported tissue protection in a variety of acute and chronic diseases, and might hence ameliorate AKI induced by extended liver resection. Here, 70% liver resection was performed in male pigs. MSCs were infused through a central venous catheter and haemodynamic parameters as well as markers of acute kidney damage were monitored under intensive care conditions for 24 h post-surgery...
June 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28572229/hyponatraemia-presentations-and-management
#5
Rosemary Dineen, Christopher J Thompson, Mark Sherlock
Hyponatraemia is the most common electrolyte disturbance encountered in clinical practice. It is associated with -significant morbidity and mortality, thus appropriate investigation and treatment is essential. Hyponatraemia presents with a spectrum of clinical presentations ranging from no symptoms to life-threatening neurological sequelae. Hyponatraemia has multiple aetiologies and distinguishing the underlying aetiology facilitates appropriate treatment. This review provides an overview of the presentations and approaches to management of this common clinical condition...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28567198/biochemical-derangements-prior-to-emergency-laparotomy-at-queen-elizabeth-central-hospital-blantyre-malawi-a-cross-sectional-pilot-study
#6
Mark G Williams
BACKGROUND: The aim of this study was to examine biochemical investigations not routinely performed prior to emergency laparotomy in patients at Queen Elizabeth Central Hospital, a low-resource public hospital in Blantyre, Malawi. METHODS: A prospective cross-sectional study of adults (N = 15) needing emergency laparotomy over a 4-week period were studied at Queen Elizabeth Central Hospital. Biochemical investigations, not routinely performed for economic reasons, were performed preoperatively; these included sodium, potassium, chloride, carbon dioxide, urea, and calcium levels...
March 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28558697/does-an-electronic-cognitive-aid-have-an-effect-on-the-management-of-severe-gynaecological-turp-syndrome-a-prospective-randomised-simulation-study
#7
Michael St Pierre, Georg Breuer, Dieter Strembski, Christopher Schmitt, Bjoern Luetcke
BACKGROUND: Lack of familiarity with the content of current guidelines is a major factor associated with non-compliance by clinicians. It is conceivable that cognitive aids with regularly updated medical content can guide clinicians' task performance by evidence-based practices, even if they are unfamiliar with the actual guideline. Acute hyponatraemia as a consequence of TURP syndrome is a rare intraoperative event, and current practice guidelines have changed from slow correction to rapid correction of serum sodium levels...
May 30, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28540093/myxedema-crisis-presenting-with-seizures-a-rare-life-threatening-presentation-a-case-report-and-review-of-the-literature
#8
Sonali Sihindi Chapa Gunatilake, Uditha Bulugahapitiya
Myxedema crisis is a life-threatening extreme form of hypothyroidism with a high mortality rate if left untreated. Myxedema crisis is commonly seen in older patients, especially in women, and is associated with signs of hypothyroidism, hypothermia, hyponatraemia, hypercarbia, and hypoxemia. Patients might present with different organ specific symptoms. Seizures are a recognized but rare manifestation of myxedema with a very high mortality rate. Prompt diagnosis and appropriate management may improve the prognosis...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28532189/non-selective-beta-blocker-treatment-does-not-impact-on-kidney-function-in-cirrhotic-patients-with-varices
#9
Bernhard Scheiner, Diego Parada-Rodriguez, Theresa Bucsics, Philipp Schwabl, Mattias Mandorfer, Nikolaus Pfisterer, Florian Riedl, Wolfgang Sieghart, Arnulf Ferlitsch, Michael Trauner, Markus Peck-Radosavljevic, Thomas Reiberger
GOALS AND BACKGROUND: Non-selective beta-blockers (NSBBs) are used for bleeding prophylaxis in cirrhotic patients with gastroesophageal varices (GEVs). Recent data suggested that NSBB treatment might increase the risk of renal dysfunction in patients with refractory ascites due to an impaired response to acute haemodynamic stress. STUDY: Retrospective longitudinal assessment of kidney function in a cohort of cirrhotic patients with GEVs with vs. without NSBB therapy...
May 22, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28520883/effect-of-isotonic-versus-hypotonic-maintenance-fluid-therapy-on-urine-output-fluid-balance-and-electrolyte-homeostasis-a-crossover-study-in-fasting-adult-volunteers
#10
N Van Regenmortel, T De Weerdt, A H Van Craenenbroeck, E Roelant, W Verbrugghe, K Dams, M L N G Malbrain, T Van den Wyngaert, P G Jorens
Background.: Daily and globally, millions of adult hospitalized patients are exposed to maintenance i.v. fluid solutions supported by limited scientific evidence. In particular, it remains unclear whether fluid tonicity contributes to the recently established detrimental effects of fluid, sodium, and chloride overload. Methods.: This crossover study consisted of two 48 h study periods, during which 12 fasting healthy adults were treated with a frequently prescribed solution (NaCl 0...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28500261/osmotic-demyelination-syndrome-in-type-1-diabetes-in-the-absence-of-dyselectrolytaemia-an-overlooked-complication
#11
Chandramohan Sharma, Banshi Lal Kumawat, Maulik Panchal, Mohit Shah
Central pontine myelinolysis (CPM) is a demyelinating disorder of central nervous system which involves central portion of the pons and sometimes extrapontine areas also. It is commonly reported in settings of hyponatraemia or its rapid correction, but in the last few years it has also been reported in patients with diabetes in the absence of electrolyte disturbances or correction of serum osmolality. Here we report a case of a 20-year-old female patient, with a known history of type 1 diabetes mellitus, who presented with acute onset spastic quadriparesis with dysarthria and mild ataxia which evolved over 2 weeks...
May 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28482780/voriconazole-induced-hyponatraemia-associated-with-homozygous-cyp2c19-2-genotype
#12
Sharon Ho, Matthew Rawlins, Paul Ingram, Peter Boan
No abstract text is available yet for this article.
May 8, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28473024/-prehospital-arterial-blood-gas-analysis-after-collapse-connected-to-triathlon-participation
#13
Asbjørn Ettrup-Christensen, Louise Amstrup-Hansen, Stine T Zwisler
Long-distance athletes are at risk of serious fluid and electrolyte disturbances, such as hypernatraemia (dehydration). Recently, cases of serious morbidity have been reported, due to acute exercise-associated hyponatraemia, which can advance to encephalopathy. An arterial blood gas analysis (ABG) was drawn from collapsed athletes at the championship of full-distance triathlon 2015, and different electrolyte imbalances were found. Our findings show that prehospital ABG can assist in differentiating the cause of collapse, and presumably, targeted treatment can be initiated already on scene...
May 1, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28470800/oral-versus-intravenous-hypertonic-saline-for-exercise-associated-hyponatraemia
#14
Israel Berger
Exercise-associated hyponatraemia is a potentially serious acute condition that may present early as asymptomatic or mildly symptomatic. Standard treatment is intravenous hypertonic saline, which can be challenging and carries some risk. An alternative may be oral therapy. We undertook a review of existing literature to assess whether paediatric populations should receive oral or intravenous hypertonic saline solutions. One study addressed our question but was aimed at a presumably adult population of runners...
May 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28468538/-a-rare-cause-of-hyponatraemia-mckittrick-wheelock-syndrome-case-report
#15
Rita Nagy, Csaba Márkus, László Jáger, Csaba Tóth, Zoltán Lőcsei
Authors present a case of acute renal failure and hyponatraemia caused by a secretory tubulovillous adenoma of the colon, the rare so called McKittrick-Wheelock syndrome. A 75 year old woman was in need of treatment many times on medical wards because of watery diarrhoea, severe dehydration, hydroelectrolyte disturbance. The authors keep their case to be worthy to present, owing to the syndrome's rarity and difficulties of differential diagnosis. Orv Hetil. 2017; 158(18): 711-714.
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28458906/delayed-dyskinesia-and-prolonged-psychosis-in-a-patient-presenting-with-profound-hyponatraemia
#16
Victoria John, Philip Evans, Atul Kalhan
SUMMARY: A 65-year-old woman was admitted to the emergency unit with a 48 h history of generalised weakness and confusion. On examination, she had mild slurring of speech although there was no other focal neurological deficit. She had profound hyponatraemia (serum sodium level of 100 mmol/L) on admission with the rest of her metabolic parameters being within normal range. Subsequent investigations confirmed the diagnosis of small-cell lung cancer with paraneoplastic syndrome of inappropriate antidiuresis (SIAD)...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28458890/cerebral-salt-wasting-following-traumatic-brain-injury
#17
Peter Taylor, Sasan Dehbozorgi, Arshiya Tabasum, Anna Scholz, Harsh Bhatt, Philippa Stewart, Pranav Kumar, Mohd S Draman, Alastair Watt, Aled Rees, Caroline Hayhurst, Stephen Davies
SUMMARY: Hyponatraemia is the most commonly encountered electrolyte disturbance in neurological high dependency and intensive care units. Cerebral salt wasting (CSW) is the most elusive and challenging of the causes of hyponatraemia, and it is vital to distinguish it from the more familiar syndrome of inappropriate antidiuretic hormone (SIADH). Managing CSW requires correction of the intravascular volume depletion and hyponatraemia, as well as mitigation of on-going substantial sodium losses...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28451449/benefit-of-tolvaptan-in-the-management-of-hyponatraemia-in-patients-with-diuretic-refractory-congestive-heart-failure-the-semi-sec-project
#18
Antonio Pose, Luis Almenar, Juan José Gavira, Amador López-Granados, Teresa Blasco, Juan Delgado, Oscar Aramburu, Avelino Rodríguez, Luis Manzano, Nicolás Manito
AIMS: Hyponatraemia is an electrolyte disorder that occurs in advanced congestive heart failure (HF) and worsens prognosis. We explored the usefulness of tolvaptan, which has shown promising results in the treatment of this condition. METHODS AND RESULTS: This study is based on a retrospective national registry (2011-15) of patients hospitalized with refractory HF and hyponatraemia who agreed to receive tolvaptan when standard treatment was ineffective. The benefit of tolvaptan was analysed according to the following criteria: normalization ([Na(+)] ≥ 135 mmol/L) or increased sodium levels [Na(+)] ≥ 4 mEq/L on completion of treatment, and increase in urine output by 300 or 500 mL at 48 h...
May 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28446482/secondary-parkinsonism-in-a-patient-of-psychogenic-polydipsia
#19
Rimesh Pal, Liza Das, Pinaki Dutta, Anil Bhansali
A 44-year-old man presented with history of slurring of speech, slowness in activities, abnormal posturing of the upper limbs and drooling of saliva from the mouth. He had a 5-yearlong history of compulsive water drinking, consuming 12-15 L of water every day. He was earlier evaluated for the same and found to have low serum sodium (126 mEq/L). Presently, he was admitted at a primary care facility with fever and altered sensorium. He was found to have serum sodium of 94 mEq/L. His sensorium improved with hypertonic saline infusion; however, after a lucid interval of 48 hours, he developed florid extrapyramidal symptoms...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28427368/complications-of-miliary-tuberculosis-low-mortality-and-predictive-biomarkers-from-a-uk-cohort
#20
Jonathan Underwood, Fiona Cresswell, Alex P Salam, Alex J Keeley, Charles Cleland, Laurence John, Robert N Davidson
BACKGROUND: Untreated, miliary tuberculosis (TB) has a mortality approaching 100%. As it is uncommon there is little specific data to guide its management. We report detailed data from a UK cohort of patients with miliary tuberculosis and the associations and predictive ability of admission blood tests with clinical outcomes. METHODS: Routinely collected demographic, clinical, blood, imaging, histopathological and microbiological data were assessed for all patients with miliary TB identified from the London TB register from 2008 to 2012 from Northwest London Hospitals NHS Trust...
April 20, 2017: BMC Infectious Diseases
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