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https://www.readbyqxmd.com/read/28224871/-a-patient-with-severe-digoxin-toxicity
#1
K P van Rhee, R van Bentum, K van Keulen, M I Kuypers, M B Haak
BACKGROUND: Digoxin is a cardiac glycoside that is frequently prescribed in atrial fibrillation and heart failure. Symptoms such as nausea, hyperkalaemia, cardiac arrhythmias and cardiac arrest are seen in digoxin toxicity. The treatment focuses on reduction of digoxin absorption, prevention of hypokalaemia and hyperkalaemia, treatment of symptoms and, in severe toxicity, administration of digoxin antibodies. CASE DESCRIPTION: A 73-year-old man with a history of extensive cardiac disease was seen 45 minutes after ingesting 20 mg of digoxin...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28212787/application-of-a-pattern-of-incremental-haemodialysis-based-on-residual-renal-function-when-starting-renal-replacement-therapy
#2
José L Merino, Patricia Domínguez, Blanca Bueno, Yésika Amézquita, Beatriz Espejo, Vicente Paraíso
INTRODUCTION: The interest in the preservation of residual kidney function on starting renal replacement therapy (RRT) is very common in techniques such as peritoneal dialysis but less so in haemodialysis (HD). In our centre the pattern of incremental dialysis (2 HD/week) has been an option for a group of patients. Here we share our experience with this regimen from March 2008. MATERIAL AND METHODS: We included incident patients with residual diuresis >1,000ml/24h, clinical stability, absence of oedema, absence of hyperkalaemia >6...
January 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28210905/hypermagnesemia-disturbances-in-rats-no-related-pentadecapeptide-bpc-157-abrogates-l-name-and-l-arginine-worsen
#3
Maria Medvidovic-Grubisic, Vasilije Stambolija, Danijela Kolenc, Jadranka Katancic, Tamara Murselovic, Ivna Plestina-Borjan, Sanja Strbe, Domagoj Drmic, Ivan Barisic, Aleksandra Sindic, Sven Seiwerth, Predrag Sikiric
AIM: Stable gastric pentadecapeptide BPC 157, administered before a high-dose magnesium injection in rats, might be a useful peptide therapy against magnesium toxicity and the magnesium-induced effect on cell depolarization. Moreover, this might be an NO-system-related effect. Previously, BPC 157 counteracts paralysis, arrhythmias and hyperkalaemia, extreme muscle weakness; parasympathetic and neuromuscular blockade; injured muscle healing and interacts with the NOS-blocker and NOS-substrate effects...
February 16, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/28192629/the-effect-of-co-trimoxazole-on-serum-potassium-concentration-safety-evaluation-of-a-randomised-controlled-trial
#4
Wei Yee Chan, Allan B Clark, Andrew M Wilson, Yoon K Loke
AIMS: Co-trimoxazole maintains a well-established role in the treatment of Pneumocystis jirovecii and Toxoplasma gondii, as well as urinary tract infections. Observational studies report hyperkalemia associated with co-trimoxazole which may stem from an amiloride-like potassium sparing effect. Our study reports on changes in serum potassium on patients without acute infections, and the influence of concomitant anti-kaliuretic drugs on this effect. METHODS: Post-hoc analysis of a randomised controlled trial in patients with interstitial lung disease who were assigned to placebo or 960 mg twice daily co-trimoxazole...
February 13, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28155610/mineralocorticoid-antagonists-in-esrd-an-overview-of-their-efficacy-and-safety
#5
Panagiotis I Georgianos, Vasilios Vaios, Theodoros Eleftheriadis, Pantelis Zebekakis, Vassilios Liakopoulos
Add-on mineralocorticoid-receptor-antagonists (MRAs) spironolactone and eplerenone can enhance the cardioprotective action of angiotensin-converting-enzyme-inhibitors (ACEIs), angiotensin-receptor-blockers (ARBs) and/or β-blockers in non-dialysis patients with congestive heart failure (CHF) and reduced left ventricular (LV) ejection fraction. The efficacy and safety of MRAs among patients on chronic dialysis is less well studied. A growing body of evidence derived from small randomized studies suggests that MRA therapy may improve a number of surrogate cardiovascular (CV) risk factors (i...
February 1, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28108367/a-propensity-score-matched-analysis-of-the-impact-of-minimum-inhibitory-concentration-on-mortality-in-patients-with-pseudomonas-aeruginosa-bacteraemia-treated-with-piperacillin-tazobactam
#6
Chris A Gentry, Riley J Williams
The Clinical and Laboratory Standards Institute (CLSI) recently re-examined Pseudomonas aeruginosa minimum inhibitory concentration (MIC) susceptibility breakpoints for piperacillin/tazobactam (TZP). The objectives of this study were to analyse the impact of elevated TZP MICs (32-64 mg/L) versus lower respective MICs on P. aeruginosa bacteraemia patient outcomes. Data were gathered from a Veterans Health Administration national clinical database on P. aeruginosa bacteraemia episodes from 2007 to 2013. Patients treated with TZP were identified, comprising 53 elevated MIC episodes and 301 low MIC episodes...
January 17, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28076917/multi-organ-dysfunction-due-to-bath-salts-are-we-aware-of-this-entity
#7
Rohith Valsalan, Benoj Varghese, Diya Soman, Jonathan Buckmaster, Steven Yew, David Cooper
Methylenedioxypyrovalerone (MDPV) is a synthetic, cathinone-derivative, central nervous system stimulant taken to produce a cocaine- or methamphetamine-like high. Physical manifestations include tachycardia, hypertension, arrhythmias, hyperthermia, sweating, rhabdomyolysis, hyperkalaemia, disseminated intravascular coagulation, oliguria and seizures. We report a patient who presented with severe metabolic acidosis, multi-organ dysfunction, rhabdomyolysis, hyperkalaemia and seizures. This case highlights that even though a urine drug screen for routine psychostimulant drugs is negative, clinicians need to be vigilant about the adverse effects of MDPV as a possible cause of multi-organ dysfunction...
January 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28004486/pharmacological-interventions-for-the-management-of-acute-hyperkalaemia-in-adults
#8
Emmanuel Effa, Angela Webster
No abstract text is available yet for this article.
January 2017: Nephrology
https://www.readbyqxmd.com/read/27905476/heart-failure-neprilysin-inhibition-attenuates-risk-of-hyperkalaemia-in-hfref
#9
Karina Huynh
No abstract text is available yet for this article.
January 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27903702/cold-acclimation-improves-chill-tolerance-in-the-migratory-locust-through-preservation-of-ion-balance-and-membrane-potential
#10
Mads Kuhlmann Andersen, Rasmus Folkersen, Heath A MacMillan, Johannes Overgaard
Most insects have the ability to alter their cold tolerance in response to temporal temperature fluctuations, and recent studies have shown that insect cold tolerance is closely tied to the ability to maintain transmembrane ion-gradients that are important for the maintenance of cell membrane potential (Vm). Accordingly, several studies have suggested a link between preservation of Vm and cellular survival after cold stress, but none have measured Vm in this context. We tested this hypothesis by acclimating locusts (Locusta migratoria) to high (31°C) and low temperature (11°C) for four days before exposing them to cold stress (0°C) for up to 48 hours and subsequently measuring ion balance, cell survival, muscle Vm, and whole animal performance...
November 30, 2016: Journal of Experimental Biology
https://www.readbyqxmd.com/read/27856806/comparative-effectiveness-of-fourth-line-anti-hypertensive-agents-in-resistant-hypertension-a-systematic-review-and-meta-analysis
#11
REVIEW
Sarah-Jo Sinnott, Laurie A Tomlinson, Adrian A Root, Rohini Mathur, Kathryn E Mansfield, Liam Smeeth, Ian J Douglas
AIM: We assessed the effectiveness of fourth-line mineralocorticoid receptor antagonists in comparison with other fourth-line anti-hypertensive agents in resistant hypertension. METHODS AND RESULTS: We systematically searched Medline, EMBASE and the Cochrane library from database inception until January 2016. We included randomised and non-randomised studies that compared mineralocorticoid receptor antagonists with other fourth-line anti-hypertensive agents in patients with resistant hypertension...
November 17, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27825591/optimized-management-of-heart-failure-patients-aged-80-years-or-more-improves-outcomes-versus-usual-care-the-hf80-randomized-trial
#12
RANDOMIZED CONTROLLED TRIAL
Charles Vorilhon, Frédéric Jean, Aurélien Mulliez, Guillaume Clerfond, Bruno Pereira, Vincent Sapin, Géraud Souteyrand, Bernard Citron, Pascal Motreff, Jean-René Lusson, Romain Eschalier
BACKGROUND: The prevalence and incidence of heart failure (HF) in elderly patients are increasing worldwide. Management of HF with reduced ejection fraction (HF-REF) in patients aged 80 years or more follows international guidelines, despite the lack of a dedicated study in this frail population. AIMS: To determine whether optimized management of HF-REF in patients aged 80 years or more can improve quality of life at 6 months. METHODS: Patients aged 80 years or more hospitalized for acute HF-REF were randomized prospectively into an optimized group or a control group (usual care)...
December 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27807020/miliary-tuberculosis-in-an-immunocompetent-male-with-a-fatal-outcome
#13
Louise Dunphy, Elizabeth Keating, T Parke
A man aged 33 years, born in Nepal, but resident in the UK for 7 years presented to the emergency department with a 4-day history of general malaise, fever (temperature 38.6°C) and a non-productive cough. His medical history was unremarkable and no high-risk behaviour was identified. Clinical examination confirmed decreased air entry bilaterally with bibasal crackles. He was tachycardic, with a heart rate of 120 bpm. Further investigation with a 12-lead ECG confirmed supraventricular tachycardia (SVT) which was terminated with vagal manoeuvres...
November 2, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27756978/medicinal-mishap-trimethoprim-induced-critical-hyperkalaemia
#14
REVIEW
Alice Kennard, Darren M Roberts
No abstract text is available yet for this article.
August 2016: Australian Prescriber
https://www.readbyqxmd.com/read/27754166/sy-12-2-ace-inhibitors-and-arbs-similarities-and-differences-in-cv-risk-reduction
#15
Alexander Danser
Blockade of the renin-angiotensin-aldosterone system (RAAS) can be accomplished at the level of the angiotensin-generating enzymes renin and angiotensin-converting enzyme (ACE; using renin inhibitors or ACE inhibitors), the type 1 angiotensin II (AT1) receptor or mineralocorticoid receptor (MR; using angiotensin receptor blockers [ARBs] or MR blockers) and/or renin release (using beta-blockers). Several of these drugs are often combined-for example in heart failure-but such approaches may ultimately lead to RAAS annihilation with adverse consequences such as hypotension, renal dysfunction and hyperkalaemia...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754015/br-04-1management-of-treatment-resistant-hypertension
#16
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27750339/-the-silent-killer-hyper-and-hypokalaemia
#17
Mark Dominik Alscher
The estimation of potassium in the serum is basis for the diagnosis of potassium disturbances. The value is a result of intake, excretion and internal distribution of potassium between intra- and extracellular compartments of the body. Clinically, we often see disturbances of potassium. The causes are explained by an aging population with morbidities that warrant diuretic treatment on the one side, and chronic kidney diseases on the other. In the first cases, we see hypokalaemia, in the latter hyperkalaemia...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27729353/development-of-guidance-on-the-timeliness-in-response-to-acute-kidney-injury-warning-stage-test-results-for-adults-in-primary-care-an-appropriateness-ratings-evaluation
#18
Tom Blakeman, Kathryn Griffith, Dan Lasserson, Berenice Lopez, Jung Y Tsang, Stephen Campbell, Charles Tomson
OBJECTIVES: Tackling the harm associated with acute kidney injury (AKI) is a global priority. In England, a national computerised AKI algorithm is being introduced across the National Health Service (NHS) to drive this change. The study sought to maximise its clinical utility and minimise the potential for burden on clinicians and patients in primary care. DESIGN: An appropriateness ratings evaluation using the RAND/UCLA Appropriateness Method. SETTING: Clinical scenarios were developed to test the timeliness in (1) communication of AKI warning stage test results from clinical pathology services to primary care, and (2) primary care clinician response to an AKI warning stage test result...
October 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27659366/pseudohyperkalaemia-a-rare-complication-of-splenectomy
#19
R Wilson, R T Skelly
Pseudohyperkalaemia is an uncommon and frequently unrecognised biochemical abnormality. It occurs as a consequence of aggregation and lysis of platelets in vitro. As a result, potassium is released, which causes an elevated serum concentration. We present the case of a 21-year-old man with a traumatic splenic injury necessitating laparotomy and splenectomy. Following surgery he developed hyperkalaemia. Further investigations diagnosed pseudohyperkalaemia, one of the causes of which is thrombocytosis secondary to splenectomy...
February 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27643121/sy-12-2-ace-inhibitors-and-arbs-similarities-and-differences-in-cv-risk-reduction
#20
Alexander Danser
Blockade of the renin-angiotensin-aldosterone system (RAAS) can be accomplished at the level of the angiotensin-generating enzymes renin and angiotensin-converting enzyme (ACE; using renin inhibitors or ACE inhibitors), the type 1 angiotensin II (AT1) receptor or mineralocorticoid receptor (MR; using angiotensin receptor blockers [ARBs] or MR blockers) and/or renin release (using beta-blockers). Several of these drugs are often combined-for example in heart failure-but such approaches may ultimately lead to RAAS annihilation with adverse consequences such as hypotension, renal dysfunction and hyperkalaemia...
September 2016: Journal of Hypertension
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