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Hyponatraemia

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https://www.readbyqxmd.com/read/27862898/low-dose-desmopressin-combined-with-serum-sodium-monitoring-can-prevent-clinically-significant-hyponatraemia-in-patients-treated-for-nocturia
#1
Kristian Vinter Juul, Anders Malmberg, Egbert van der Meulen, Johan Vande Walle, Jens Peter Nørgaard
OBJECTIVE: To explore risk factors for desmopressin-induced hyponatraemia and evaluate the impact of a serum sodium monitoring plan. SUBJECTS AND METHODS: This was a meta-analysis of data from three clinical trials of desmopressin in nocturia. Participants received placebo or desmopressin orally disintegrating tablet ([ODT], 10-100 μg). Incidence of serum sodium <130 mmol/L was recorded by age, sex and dose. Potential predictors of clinically significant hyponatraemia were identified using multivariate analysis in a Cox proportional hazards model...
November 15, 2016: BJU International
https://www.readbyqxmd.com/read/27862139/differential-diagnosis-of-hyponatraemia-moving-forward
#2
Ewout J Hoorn
Hyponatraemia is a resident's nightmare. A water balance disorder disguised as decreased serum sodium concentration. A plethora of diagnostic algorithms that seem to have been developed with the sole purpose of getting you lost as quickly as possible. Nothing but untrustworthy parameters to guide you through this dark wood. And when you finally see light at the end of the tunnel, there is always some staff member, alias electrolyte aficionado, who enjoys public interrogation and makes you feel you're back to square one...
November 8, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27857840/tolvaptan-use-during-hyperhydration-in-paediatric-intracranial-lymphoma-with-siadh
#3
Ruben H Willemsen, Violeta Delgado-Carballar, Daniela Elleri, Ajay Thankamony, G A Amos Burke, James C Nicholson, David B Dunger
: An 11-year-old boy developed severe syndrome of inappropriate antidiuretic hormone secretion (SIADH) after diagnosis of an intracranial B-cell lymphoma. His sodium levels dropped to 118-120 mmol/L despite 70% fluid restriction. For chemotherapy, he required hyperhydration, which posed a challenge because of severe hyponatraemia. Tolvaptan is an oral, highly selective arginine vasopressin V2-receptor antagonist, which has been licensed in adults for the management of SIADH and has been used in treating paediatric heart failure...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27857838/hyponatraemia-secondary-to-nivolumab-induced-primary-adrenal-failure
#4
Harris Trainer, Paul Hulse, Claire E Higham, Peter Trainer, Paul Lorigan
: Checkpoint inhibitors, such as ipilimumab and pembrolizumab, have transformed the prognosis for patients with advanced malignant melanoma and squamous non-small-cell lung cancer, and their use will only expand as experience is gained in a variety of other malignancies, for instance, renal and lymphoma. As the use of checkpoint inhibitors increases, so too will the incidence of their unique side effects, termed immune-related adverse events (irAEs), which can affect dermatological, gastrointestinal, hepatic, endocrine and other systems...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27837439/improving-care-and-outcomes-of-inpatients-with-syndrome-of-inappropriate-antidiuresis-siad-a-prospective-intervention-study-of-intensive-endocrine-input-vs-routine-care
#5
Ploutarchos Tzoulis, Helen Carr, Emmanouil Bagkeris, Pierre Marc Bouloux
PURPOSE: The syndrome of inappropriate antidiuresis is often undertreated with most patients discharged with persistent hyponatraemia. This study tested the hypothesis that an endocrine input is superior to routine care in correcting hyponatraemia and can improve patient outcomes. METHODS: This single-centre prospective-controlled intervention study included inpatients admitted at a UK teaching hospital, with serum sodium ≤ 127 mmol/l, due to syndrome of inappropriate antidiuresis over a 6-month period...
November 12, 2016: Endocrine
https://www.readbyqxmd.com/read/27834126/in-hospital-falls-in-older-patients-the-risk-factors-and-the-role-of-hyponatraemia
#6
Harry Harianto, Mahesan Anpalahan
BACKGROUND: Hyponatraemia has been associated with increased falls risk. However, this has not been adequately investigated in the context of in-hospital falls (IHFs). OBJECTIVES: To determine the potential risk factors for IHFs, particularly the role of hyponatraemia. METHODS: Patients aged >65 years with an incident IHF during admissions under a General Internal Medicine (GIM) Unit over six months were studied. For each case, two age and sex matched controls were randomly selected from patients who were admitted under the GIM unit during the same time as the cases...
November 8, 2016: Current Aging Science
https://www.readbyqxmd.com/read/27819111/cardiac-dysfunction-congestion-and-loop-diuretics-their-relationship-to-prognosis-in-heart-failure
#7
Pierpaolo Pellicori, John G F Cleland, Jufen Zhang, Anna Kallvikbacka-Bennett, Alessia Urbinati, Parin Shah, Syed Kazmi, Andrew L Clark
BACKGROUND: Diuretics are the mainstay of treatment for congestion but concerns exist that they adversely affect prognosis. We explored whether the relationship between loop diuretic use and outcome is explained by the underlying severity of congestion amongst patients referred with suspected heart failure. METHOD AND RESULTS: Of 1190 patients, 712 had a left ventricular ejection fraction (LVEF) ≤50 %, 267 had LVEF >50 % with raised plasma NTproBNP (>400 ng/L) and 211 had LVEF >50 % with NTproBNP ≤400 ng/L; respectively, 72 %, 68 % and 37 % of these groups were treated with loop diuretics including 28 %, 29 % and 10 % in doses ≥80 mg furosemide equivalent/day...
November 7, 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27812063/hyponatraemia-epidemiology-and-aetiology-in-a-tertiary-care-centre-in-pakistan
#8
Nauman Tarif, Omer Sabir, Azra Niaz, Rizwan Akhtar, Kashif Rafique, Nabiha Rizvi
OBJECTIVE: To determine the incidence, aetiology and epidemiology of hospitalized patients with hyponatraemia. METHODS: Subjects were identified through hospital information system for two consecutive low sodium values (< 130 mEq/L) and charts were reviewed retrospectively. Possible etiologic factors were identified and co-morbidities documented. Management plans were also noted. RESULTS: Among the hospitalized patients the incidence of hyponatraemia was 6...
November 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27811940/the-endocrine-manifestations-of-anorexia-nervosa-mechanisms-and-management
#9
REVIEW
Melanie Schorr, Karen K Miller
Anorexia nervosa is a psychiatric disorder characterized by altered body image, persistent food restriction and low body weight, and is associated with global endocrine dysregulation in both adolescent girls and women. Dysfunction of the hypothalamic-pituitary axis includes hypogonadotropic hypogonadism with relative oestrogen and androgen deficiency, growth hormone resistance, hypercortisolaemia, non-thyroidal illness syndrome, hyponatraemia and hypooxytocinaemia. Serum levels of leptin, an anorexigenic adipokine, are suppressed and levels of ghrelin, an orexigenic gut peptide, are elevated in women with anorexia nervosa; however, levels of peptide YY, an anorexigenic gut peptide, are paradoxically elevated...
November 4, 2016: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/27803013/when-plenty-is-too-much-water-intoxication-in-a-patient-with-a-simple-urinary-tract-infection
#10
Laura Christine Lee, Maryann Noronha
Healthcare professionals frequently advise patients with simple infective illness to drink more fluids. Here, a 59-year-old woman with a urinary tract infection followed such advice resulting in hospital admission with symptomatic acute hyponatraemia. Water intoxication is well recognised as a cause of symptomatic hyponatraemia in endurance sports, MDMA use and psychogenic polydipsia. It has rarely been described outside of these circumstances. With normal renal function, it is difficult to overwhelm the excretory capacity for water...
November 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27798497/recent-advances-in-the-diagnosis-and-management-of-tuberculous-meningitis
#11
Nguyen T H Mai, Guy E Thwaites
PURPOSE OF REVIEW: Tuberculous meningitis is a devastating infection that is hard to diagnose and treat. We have reviewed tuberculous meningitis original research published within the past 18 months, selecting studies which we consider have most advanced knowledge. RECENT FINDINGS: We review advances in diagnostic methods, anti-tuberculosis chemotherapy, and the common complications of tuberculous meningitis. New commercial molecular diagnostic tests, such as GeneXpert MTB/RIF, have an important role in tuberculous meningitis diagnosis, but as with all other available tests, they lack sensitivity and cannot rule out the disease...
October 27, 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27772862/a-case-of-extreme-hyponatraemia-secondary-to-a-low-solute-diet-and-primary-polydipsia
#12
J D Smith, L Roberts, H G Schneider
No abstract text is available yet for this article.
February 2016: Pathology
https://www.readbyqxmd.com/read/27770791/prognosis-of-patients-with-severe-hyponatraemia-is-related-not-only-to-hyponatraemia-but-also-to-comorbidities-and-to-medical-management-results-of-an-observational-retrospective-study
#13
Thierry Krummel, Eric Prinz, Marie-Astrid Metten, Claire Borni-Duval, Dorothée Bazin-Kara, Emmanuelle Charlin, Jean-Marc Lessinger, Thierry Hannedouche
BACKGROUND: The true cause of death in severe hyponatraemic patients remains controversial. The present study aimed to analyse the relationship between comorbidity, medical management and prognosis in severe hyponatraemic patients. METHODS: Medical records of all patients hospitalised in our institution in 2012 with a plasma sodium ≤120 mmol/l were retrospectively analysed. RESULTS: One hundred forty-seven of 64 723 adult patients (0.2 %) were identified with severe hyponatraemia...
October 22, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27758813/tuberculous-meningitis-in-an-immunocompetent-male-complicated-by-hydrocephalus
#14
Louise Dunphy, Prashanth Shetty, Rabinder Randhawa, Kharil Amir Rani, Yaw Duodu
A 39-year-old man, born in India but resident in the UK for 10 years, was travelling in America when he became feverish with an altered mentation. He reported a 10-day history of fever, photophobia, headache and fatigue. His medical history included hypothyroidism and migraine. He was a non-smoker, did not consume alcohol and denied a history of drug use. He was transferred to the emergency department. Laboratory investigations confirmed hyponatraemia (sodium 128 mmol/L). A chest radiograph confirmed no focal consolidation...
October 7, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27758794/severe-human-monocytic-ehrlichiosis-presenting-with-altered-mental-status-and-seizures
#15
Christian Geier, Jessica Davis, Marc Siegel
A previously healthy 66-year-old woman living in the Mid-Atlantic USA presented to the hospital with lethargy, ataxia and slurred speech. 2 weeks prior she had removed a tick from her right groin. She reported malaise, fevers, diarrhoea, cough and a rash. Physical examination revealed a maculopapular rash on her chest, and lung auscultation revealed bi-basilar rales. Laboratory tests were remarkable for hyponatraemia, leucopenia and thrombocytopenia. Chest X-ray demonstrated bilateral pleural effusions with pulmonary oedema...
October 6, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27753808/ssa-03-3-dietary-salt-intake-and-hypertension-in-singapore
#16
Vernon Min Sen Oh
According to the Singapore National Health Survey (NHS) of 2010, the population of the Republic of Singapore was 5.076,700, comprising four ethnic groups: Chinese (74.1%), Malays (13.4%), Indians (9.2%), and others (3.3%). The National Health Survey for 2016 is under way and due to be published in 2017. From the six-yearly national health surveys, the crude prevalence of clinical hypertension (HTn), defined as a sustained blood pressure ≥ 140/90 mmHg, in Singaporean residents aged 30 to 69 years rose from 22...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27751847/osimertinib-for-pretreated-egfr-thr790met-positive-advanced-non-small-cell-lung-cancer-aura2-a-multicentre-open-label-single-arm-phase-2-study
#17
Glenwood Goss, Chun-Ming Tsai, Frances A Shepherd, Lyudmila Bazhenova, Jong Seok Lee, Gee-Chen Chang, Lucio Crino, Miyako Satouchi, Quincy Chu, Toyoaki Hida, Ji-Youn Han, Oscar Juan, Frank Dunphy, Makoto Nishio, Jin-Hyoung Kang, Margarita Majem, Helen Mann, Mireille Cantarini, Serban Ghiorghiu, Tetsuya Mitsudomi
BACKGROUND: Osimertinib (AZD9291) is an oral, potent, irreversible EGFR tyrosine-kinase inhibitor selective for EGFR tyrosine-kinase inhibitor sensitising mutations, and the EGFR Thr790Met resistance mutation. We assessed the efficacy and safety of osimertinib in patients with EGFR Thr790Met-positive non-small-cell lung cancer (NSCLC), who had progressed after previous therapy with an approved EGFR tyrosine-kinase inhibitor. METHODS: In this phase 2, open-label, single-arm study (AURA2), patients aged at least 18 years with centrally confirmed EGFR Thr790Met-positive mutations, locally advanced or metastatic (stage IIIB/IV) NSCLC who progressed on previous EGFR tyrosine-kinase inhibitor therapy received osimertinib 80 mg orally once daily; treatment could continue beyond progression if the investigator observed a clinical benefit...
October 14, 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27701711/filling-the-gap-improving-awareness-and-practice-in-hyponatraemia-and-the-syndrome-of-inappropriate-antidiuretic-hormone-secretion-siadh-in-the-older-patient-a-european-consensus-view
#18
M Wehling, C Ashton, E Ekpo, S Gwynn, M Laville, K Olsson, M Spring
Introduction: Causes of hyponatraemia in older patients are multivariate and in the case of SIADH may often be drug induced. Diagnostic and treatment algorithms are unclear for this important age group. Methods: The author group identified 6 broad themes for consensus and formulated 42 separate consensus statements within these 6 themes. Statements were then circulated to geriatricians, general practitioners and other doctors to test agreement at the European level. Results: 64 responses were evaluated from around Europe...
October 4, 2016: Drug Research
https://www.readbyqxmd.com/read/27701482/presentation-and-mortality-of-patients-hospitalised-with-acute-heart-failure-in-botswana
#19
Julius Chacha Mwita, Matthew J Dewhurst, Mgaywa G Magafu, Monkgogi Goepamang, Bernard Omech, Koketso Lister Majuta, Marea Gaenamong, Tommy Baboloki Palai, Mosepele Mosepele, Yohana Mashalla
INTRODUCTION: Heart failure is a common cause of hospitalisation and therefore contributes to in-hospital outcomes such as mortality. In this study we describe patient characteristics and outcomes of acute heart failure (AHF) in Botswana. METHODS: Socio-demographic, clinical and laboratory data were collected from 193 consecutive patients admitted with AHF at Princess Marina Hospital in Gaborone between February 2014 and February 2015. The length of hospital stay and 30-, 90- and 180-day in-hospital mortality rates were assessed...
August 24, 2016: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/27681079/acute-severe-hyponatraemia-secondary-to-polydipsia-and-associated-herbal-remedy-use
#20
Oliver T R Toovey, Ian R Edmond, Nikolaos Makris
A 47-year-old woman presented with seizures secondary to euvolaemic hyponatraemia. A collateral history revealed recent increased oral fluid intake and increased use of herbal remedies including valerian root over the New Year period. There was no history of psychiatric disease to support psychogenic polydipsia. She responded to careful sodium replacement in the intensive care unit and was discharged with no neurological sequelae.
2016: BMJ Case Reports
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