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Hyponatraemia

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https://www.readbyqxmd.com/read/28315624/extrapontine-myelinolysis-manifested-selectively-by-acute-severe-parkinsonian-syndrome-case-report
#1
IIvana Stetkarova, Zuzana Svobodova, Jozef Soltez, Jinda Svatova
OBJECTIVES: Osmotic demyelination syndrome (ODMS) is a rare and serious neurologic disorder with acute myelin disintegration, usually in the pontine area (central pontine myelinolysis) and to a lesser extent, even in other areas of the central nervous system (extrapontine myelinolysis). The main underlying mechanism is the change of serum osmolality with quick correction of low mineral levels, mainly hyponatraemia. Clinical manifestation is various and depends on the localization. DESIGN: We describe an acute isolated extrapontine myelinolysis causing acute onset of parkinsonism in a 61-year-old man who developed quickly progressing parkinsonian syndrome after the rapid correction of hyponatraemia...
November 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28314688/nivolumab-treatment-for-oesophageal-squamous-cell-carcinoma-an-open-label-multicentre-phase-2-trial
#2
Toshihiro Kudo, Yasuo Hamamoto, Ken Kato, Takashi Ura, Takashi Kojima, Takahiro Tsushima, Shuichi Hironaka, Hiroki Hara, Taroh Satoh, Satoru Iwasa, Kei Muro, Hirofumi Yasui, Keiko Minashi, Kensei Yamaguchi, Atsushi Ohtsu, Yuichiro Doki, Yuko Kitagawa
BACKGROUND: Nivolumab is a human monoclonal IgG4 antibody that inhibits programmed cell death protein 1 (PD-1) expressed on activated T cells. We investigated the safety and activity of nivolumab in patients with treatment-refractory oesophageal cancer. METHODS: We did an open-label, single-arm, multicentre phase 2 study. Eligible patients had advanced squamous-cell carcinoma, adenosquamous-cell carcinoma, or adenocarcinoma of the oesophagus refractory or intolerant to fluoropyrimidine-based, platinum-based, and taxane-based chemotherapy...
March 14, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28287295/-differential-diagnostic-dilemmas-after-use-of-an-out-of-date-antihypertensive-medication-case-report
#3
Péter Arányi, János Tomcsányi
Hydrochlorothiazide became one of the most commonly prescribed first-line antihypertensive medication, though its use is often complicated with serious side-effects. A 66-year-old female patient with a history of hypertension had suffered a transient loss of consciousness, and referred to our cardiology unit with an ST-segment elevation and giant negative T-waves in V1-2 ECG leads, long QT-segment and elevated serum creatine-kinase (5392 U/L) and troponin I (4,357 ng/ml) levels. Acute myocardial infarction was not proven (later coronarography revealed preserved coronary circulation), but severe hyponatraemia and hypokalaemia was detected, explaining a possible symptomatic seizure, and which could be accounted for a 25 mg daily hydrochlorothiazide antihypertensive treatment and - as a precipitating insult - a one-week history of gastroenteritis...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28272569/a-woman-in-her-50s-with-chronic-fatigue-syndrome-sepsis-and-hyponatraemia
#4
Kiarash Tazmini, Torstein R Meling, Thor Håkon Skattør, Øystein Kalsnes Jørstad, Anders Palmstrøm Jørgensen
No abstract text is available yet for this article.
March 2017: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/28260255/lack-of-appropriate-investigations-in-making-a-diagnosis-of-syndrome-of-inappropriate-antidiuretic-hormone
#5
Alex Barnes, Jordan Y Z Li, Jonathan M Gleadle
The syndrome of inappropriate antidiuretic hormone (SIADH) is reported as the most common cause of hyponatraemia. This retrospective cross-sectional study evaluated the diagnosis of SIADH in 110 hospitalised patients in an Australian tertiary hospital with reference to recently published clinical guidelines. Investigation of SIADH was incomplete in all but 20% of cases. Adrenal insufficiency and hypothyroidism were not excluded in a significant number of cases.
March 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28251745/in-children-requiring-intravenous-fluid-for-hydration-maintenance-which-out-of-hypotonic-saline-and-isotonic-saline-is-less-likely-to-result-in-the-development-of-hyponatraemia
#6
Michael Ma Tran, Esther M Tantsis, Joanne M Ging
The administration of intravenous fluids remains a common intervention for hospitalised children. Commonly used hypotonic fluids administered at maintenance rates provide 2-4 mmol/kg/day of sodium. Being hypotonic, the development of hyponatraemia remains a risk. The consequences of hyponatraemia are not insignificant, with possibilities of irreversible neurological morbidity and mortality. There is currently no clear consensus on the optimal composition of fluids to be used for intravenous rehydration. A review of the available literature suggests that children who receive isotonic fluid have a lower risk of developing hyponatraemia, regardless of the rate of administration...
March 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28214374/a-systematic-review-of-known-interventions-for-the-treatment-of-chronic-non-hypovolaemic-hypotonic-hyponatraemia-and-a-meta-analysis-of-the-vaptans
#7
REVIEW
Sunil Bhandari, Alessandro Peri, Iain Cranston, Rachael McCool, Alison Shaw, Julie Glanville, Larisa Petrakova, Karl O'Reilly
International and national guidelines on the treatment of chronic non-hypovolaemic hypotonic hyponatraemia differ; therefore we have undertaken this systematic review and meta-analysis to investigate the efficacy and safety of interventions for the treatment of chronic non-hypovolaemic hypotonic hyponatraemia. Following registration of the review protocol with PROSPERO, systematic literature searches were conducted to identify randomised and quasi-randomised controlled trials assessing any degree of fluid restriction or any drug treatment with the aim of increasing serum sodium concentration in patients with chronic non-hypovolaemic hypotonic hyponatraemia...
February 18, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28194574/tolvaptan-treatment-for-severe-neonatal-autosomal-dominant-polycystic-kidney-disease
#8
Rodney D Gilbert, Hazel Evans, Kazeem Olalekan, Arvind Nagra, Mushfequr R Haq, Mark Griffiths
BACKGROUND: Severe neonatal autosomal-dominant polycystic kidney disease (ADPKD) is rare and easily confused with recessive PKD. Managing such infants is difficult and often unsuccessful. CASE DIAGNOSIS/TREATMENT: A female infant with massive renal enlargement, respiratory compromise and hyponatraemia was treated with the arginine vasopressin receptor 2 antagonist tolvaptan. This resolved hyponatraemia, and there was no further increase in renal size. CONCLUSION: Tolvaptan may be a useful treatment for severe neonatal PKD...
February 13, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28190877/hyponatraemia-unfolding-osmotic-demyelination
#9
Andrea Aguilar
No abstract text is available yet for this article.
February 13, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28153848/cjd-mimics-and-chameleons
#10
REVIEW
Simon Mead, Peter Rudge
Rapidly progressive dementia mimicking Creutzfeldt-Jakob disease (CJD) is a relatively rare presentation but a rewarding one to become familiar with, as the potential diagnoses range from the universally fatal to the completely reversible. Patients require urgent decisions about assessment and investigation and have quickly evolving needs for treatments and support, through symptom management and end-of-life care in most cases. We have based this pragmatic review on the experiences of a specialist prion referral centre in the UK, which, unsurprisingly, is strongly biased towards seeing patients with CJD...
April 2017: Practical Neurology
https://www.readbyqxmd.com/read/28102885/profound-hyponatraemia-in-the-emergency-department-seasonality-and-risk-factors
#11
Tibor Huwyler, Jerome Stirnemann, Nicolas Vuilleumier, Christophe Marti, Sarah Dugas, Pierre-Alexandre Poletti, Francois P Sarasin, Olivier T Rutschmann
AIMS OF THE STUDY: Profound hyponatremia (<125 mmol/l) is frequent in the emergency department. Its incidence appears to increase during hot weather. Our objectives were to investigate seasonal variations in the incidence of profound hyponatraemia and identify its risk factors. METHODS: The incidence of profound hyponatremia among patients admitted to the emergency department of a university hospital was compared between summer and winter periods over two successive years...
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28102880/profound-hyponatraemia-in-the-emergency-department-a-hot-topic
#12
Mirjam Christ-Crain
No abstract text is available yet for this article.
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27982422/update-review-of-the-acute-porphyrias
#13
REVIEW
Penelope E Stein, Michael N Badminton, David C Rees
Acute porphyrias are rare inherited disorders due to deficiencies of haem synthesis enzymes. To date, all UK cases have been one of the three autosomal dominant forms, although penetrance is low and most gene carriers remain asymptomatic. Clinical presentation is typically with acute neurovisceral attacks characterised by severe abdominal pain, vomiting, tachycardia and hypertension. Severe attacks may be complicated by hyponatraemia, peripheral neuropathy sometimes causing paralysis, seizures and psychiatric features...
December 16, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27969545/ps01-78-evaluation-of-hyponatraemia-in-lung-cancer-patients-a-uk-teaching-hospital%C3%A2-experience-topic-medical-oncology
#14
Joyce Thompson, Ankit Jain, Mariam Jafri, Sophie Mascall
No abstract text is available yet for this article.
November 2016: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/27965312/hyponatraemia-induced-rhabdomyolysis-complicated-by-anuric-acute-kidney-injury-a-renal-replacement-conundrum
#15
Paul Secombe, Chris Milne
Hyponatraemia-induced rhabdomyolysis is a rare, but reported phenomenon, particularly in patients with chronic schizophrenia on depot antipsychotics prone to psychogenic polydipsia. To the best of our knowledge, there are no reported cases of hyponatraemia-induced rhabdomyolysis complicated by oligo-anuric acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). The initiation of CRRT is complicated in severe hyponatraemia, predominantly due to the need to avoid rapid changes in tonicity associated with rapid changes in sodium...
December 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27959472/polymer-based-oral-rehydration-solution-for-treating-acute-watery-diarrhoea
#16
REVIEW
Germana V Gregorio, Maria Liza M Gonzales, Leonila F Dans, Elizabeth G Martinez
BACKGROUND: Acute diarrhoea is one of the main causes of morbidity and mortality among children in low-income countries. Glucose-based oral rehydration solution (ORS) helps replace fluid and prevent further dehydration from acute diarrhoea. Since 2004, the World Health Organization (WHO) has recommended the osmolarity of less than 270 mOsm/L (ORS ≤ 270) versus greater than 310 mOsm/L formulation (ORS ≥ 310). Polymer-based ORS (for example, prepared using rice or wheat) slowly releases glucose and may be superior to glucose-based ORS...
December 13, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27935814/society-for-endocrinology-endocrine-emergency-guidance-emergency-management-of-severe-symptomatic-hyponatraemia-in-adult-patients
#17
Stephen Ball, Julian Barth, Miles Levy
No abstract text is available yet for this article.
September 2016: Endocrine Connections
https://www.readbyqxmd.com/read/27935121/urea-is-successful-in-treating-inappropriate-antidiuretic-hormone-secretion-in-an-infant
#18
Stephanie Dufek, Christine Booth, Adrian Carroll, William Van't Hoff, Robert Kleta, Detlef Bockenhauer
No abstract text is available yet for this article.
March 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/27935017/early-esli-study-long-term-experience-with-eslicarbazepine-acetate-after-first-monotherapy-failure
#19
V Villanueva, P Bermejo, J Montoya, M Toledo, A Gómez-Ibáñez, M Garcés, L Vilella, F J López-González, X Rodriguez-Osorio, D Campos, P Martínez, P Giner, J Zurita, J Rodríguez-Uranga, J Ojeda, J A Mauri, J L Camacho, J Ruiz-Giménez, J J Poza, A Massot-Tarrús, M L Galiano, M Bonet
PURPOSE: Evaluate real-life experience with eslicarbazepine acetate (ESL) after first monotherapy failure in a large series of patients with focal epilepsy. METHOD: Multicentre, retrospective, 1-year, observational study in patients older than 18 years, with focal epilepsy, who had failed first antiepileptic drug monotherapy and who received ESL. Data from clinical records were analysed at baseline, 3, 6 and 12 months to assess effectiveness and tolerability. RESULTS: Eslicarbazepine acetate was initiated in 253 patients...
December 9, 2016: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/27922286/central-pontine-myelinolysis-during-pregnancy-pathogenesis-diagnosis-and-management
#20
María Luisa Sánchez-Ferrer, María Teresa Prieto-Sánchez, Rodrigo Orozco-Fernández, Francisco Machado-Linde, Anibal Nieto-Diaz
Central pontine myelinolysis (CPM) is a rare condition usually caused by rapid sodium correction in hyponatraemia after a severe neurological syndrome. Only few cases have been reported during pregnancy, most of which were reported in patients with hyperemesis. We describe the successful management of the first case of twin pregnancy in a patient who presented with CPM after treatment for premature labour and then review the literature on CPM in pregnancy (aetiology, diagnosis and management). Our patient required emergency delivery to achieve electrolyte and fluid balance...
December 6, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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