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Frédéric Vandergheynst, Yannick Gombeir, Flavio Bellante, Gaetano Perrotta, Gauthier Remiche, Christian Mélot, Nicolas Mavroudakis, Guy Decaux
BACKGROUND: Hyponatremia is associated with unstable gait and propensity to falls. The potential contribution of peripheral nervous system dysfunction induced by hyponatremia has not yet been addressed by prospective studies. DESIGN: In the first part of this prospective study, we performed two tests evaluating muscle strength (grip test and quadriceps isometric contraction test) together with a timed up and go (TUG) test in 11 patients with chronic mild-to-moderate hyponatremia before and after the normalization of natremia...
April 2016: European Journal of Clinical Investigation
Ross S Cairns, Tamara Hew-Butler
PURPOSE: It is not known if exercise-associated hyponatremia (EAH) is a cause or consequence of exertional rhabdomyolysis (ER).We hypothesized that osmotic stress (EAH) coupled with mechanical stress (running) potentiated muscle cell breakdown (ER). This concept would be supported if a nadir in serum sodium concentration ([Na(+)]) temporally preceded peak creatine kinase levels (CK) during an ultramarathon run. METHODS: Fifteen participants ran ≥104 km and had blood drawn: prior to start; 53; 104 km; and 24-h post run...
March 2016: European Journal of Applied Physiology
A V Smirnov, R V Golubev, A N Vasil'ev, A Iu Zemchenkov, K G Staroselskiĭ
AIM: To assess the results of using an acetate-free succinate-containing dialyzing solution (SDS) against natremia and blood pressure (BP) in patients on chronic hemodialysis (HD). SUBJECTS AND METHODS: Ninety-two patients were transferred from 3 Saint Petersburg HD centers to 3-month HD treatment using SDS. The investigators measured blood biochemical indicators immediately before and 1 and 3 months after the investigation, BP before and after a successive HD session, and the patients' weight and its gain in the period between HD sessions...
2015: Terapevticheskiĭ Arkhiv
Mikhael Giabicani, Pierre-Gildas Guitard, Dominique Guerrot, Steven Grangé, Lauranne Teule, Bertrand Dureuil, Benoît Veber
Extreme hypernatremia in intensive care unit are frequently associated with a poor prognosis and their treatment, when associated with acute renal failure, is not consensual. We report the case of a 39-year-old man admitted in our intensive care unit for coma who presented extreme hyperosmolar hypernatremia (sodium 180 mmol/L, osmolarity 507 mOsm/L) associated with acute renal failure (urea 139.3 mmol/L, creatinine 748 μmol/L) and many other metabolic abnormalities. He was treated with hypotonic fluid administration and continuous renal replacement therapy (veno-venous hemodiafiltration) using an industrial dialysate fluid...
November 2015: Néphrologie & Thérapeutique
Luis Nogueira-Silva, Anne Blanchard, Emmanuel Curis, Aurélien Lorthioir, Valentina Zhygalina, Damien Bergerot, Stéphanie Baron, Laurence Amar, Guillaume Bobrie, Pierre-François Plouin, Joël Ménard, Michel Azizi
CONTEXT: The role of vasopressin (AVP) in the pathophysiology of primary aldosteronism (PA) remains unclear. OBJECTIVES: The primary aim of this study was to investigate AVP secretion in PA by measuring the plasma concentration of copeptin (PCop), the C-terminal portion of provasopressin. The secondary aim was to assess renal sensitivity to AVP. DESIGN AND SETTING: This was a cross-sectional study in a tertiary-care hospital. PROTOCOL: We recruited 115 patients with PA, 48 patients with essential hypertension (EH), and 108 normotensive healthy subjects (HS)...
September 2015: Journal of Clinical Endocrinology and Metabolism
François Gaillard, Sophie Laplanche, Thierry Petitclerc
PURPOSE: Natremia is usually considered to reflect tonicity in non-hemodialyzed patients. Some hemodialysis monitors provide an online value (NaCond) of natremia calculated from conductivity measurements. This study compared the relation between tonicity and natremia (NaLab) measured at laboratory with the relation between tonicity and NaCond in hemodialysis patients. METHODS: Fifty-five hemodialysis sessions performed with a Fresenius 5008 dialysis monitor (Fresenius Medical Care, Bad Homburg, Germany) providing a value of NaCond were analyzed...
May 2015: International Journal of Artificial Organs
Olivier Hanon, Clemence Boully, Laure Caillard, Florian Labourée, Sophie Cochiello, Edouard Chaussade
BACKGROUND: Combination treatments for hypertension most often include a renin-angiotensin-aldosterone system (RAAS) inhibitor. However, systolic blood pressure (SBP) remains difficult to control. Non-RAAS-inhibiting strategies such as calcium channel blocker/thiazide-like diuretic combinations may offer effective alternatives. METHODS: Hypertensive diabetic patients with microalbuminuria were included in this retrospective, post-hoc analysis of the Natrilix SR Versus Enalapril Study in Hypertensive Type 2 Diabetics With MicrOalbuminuRia (NESTOR) trial if they were uncontrolled on monotherapy (indapamide slow release (SR) 1...
August 2015: American Journal of Hypertension
Martin Svaton, Ondrej Fiala, Milos Pesek, Frantisek Bruha, Petr Mukensnabl, Jaroslav Racek, Marek Minarik, Zdenek Bortlicek
BACKGROUND: Hyponatremia is a well-known phenomenon in cancer patients. The aim of our retrospective study was to assess the relationship of natremia levels to predict treatment with erlotinib and also to assess the prognosis of patients with hyponatremia. PATIENTS AND METODS: We analyzed data of 544 patients with advanced-stage non-small cell lung cancer (NSCLC) treated with erlotinib. RESULTS: Hyponatremia was measured in 21.5 % of patients before treatment with erlotinib...
December 2014: Anticancer Research
George Liamis, Evangelos Liberopoulos, Fotios Barkas, Moses Elisaf
Diabetic patients frequently develop a constellation of electrolyte disorders. These disturbances are particularly common in decompensated diabetics, especially in the context of diabetic ketoacidosis or nonketotic hyperglycemic hyperosmolar syndrome. These patients are markedly potassium-, magnesium- and phosphate-depleted. Diabetes mellitus (DM) is linked to both hypo- and hyper-natremia reflecting the coexistence of hyperglycemia-related mechanisms, which tend to change serum sodium to opposite directions...
October 16, 2014: World Journal of Clinical Cases
Mirza Faisal Ahmed Rafiq, Noor Ahmed, Adil Aziz Khan
BACKGROUND: Electrolyte derangements are common sequel of traumatic brain injury. Use of intravenous fluids, diuretics, syndrome of inappropriate ADH secretion and cerebral salt washing are some of the factors responsible for this. Proper in time detection followed by appropriate treatment not only improves neurological status but also decrease morbidity and mortality. This study was conducted to know serum derangements of different electrolytes in patients with traumatic brain injury...
January 2013: Journal of Ayub Medical College, Abbottabad: JAMC
Dana Maresova, Petr Kozler, Jaroslav Pokorny
OBJECTIVES: Our previous experiments with animal models revealed that water intoxication induces brain oedema and opens plasma membranes. Present study is aimed to determine whether the standard method of hyperhydration can influence cerebral microenvironment also in young rats. Neuronal functions were tested by standard electrical cortical stimulation. METHODS: Hyperhydration was induced by administration of distilled water (DW) intraperitoneally. Three groups of young rats were used: 12, 25, and 35-day-old...
2014: Neuro Endocrinology Letters
Pavel Dostal, Vlasta Dostalova, Jitka Schreiberova, Tomas Tyll, Jirina Habalova, Vladimir Cerny, Svatopluk Rehak, Tomas Cesak
BACKGROUND: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The purpose of the study was to compare the effects of equivolume, equiosmolar solutions of mannitol and hypertonic saline (HTS) on brain relaxation and postoperative complications in patients undergoing elective intracranial tumor surgery. METHODS: In this prospective, randomized study, patients with American Society of Anesthesiologists physical status I to III scheduled to undergo a craniotomy for intracranial tumors were enrolled...
January 2015: Journal of Neurosurgical Anesthesiology
Géraldine Allain, Thomas Kerforne, Rodolphe Thuret, Pierre-Olivier Delpech, Thibaut Saint-Yves, Michel Pinsard, Thierry Hauet, Sébastien Giraud, Christophe Jayle, Benoît Barrou
BACKGROUND: Extracorporeal membranous oxygenation is proposed for abdominal organ procurement from donation after circulatory determination of death (DCD). In France, the national Agency of Biomedicine supervises the procurement of kidneys from DCD, specifying the durations of tolerated warm and cold ischemia. However, no study has determined the optimal conditions of this technique. The aim of this work was to develop a preclinical model of DCD using abdominal normothermic oxygenated recirculation (ANOR)...
2014: Transplantation Research
J-F Payen, P Bouzat, G Francony, C Ichai
Hypernatremia is defined by a serum sodium concentration of more than 145 mmol/L and reflects a disturbance of the regulation between water and sodium. The high incidence of hypernatremia in patients with severe brain injury is due various causes including poor thirst, diabetes insipidus, iatrogenic sodium administration, and primary hyperaldosteronism. Hypernatremia in the intensive care unit is independently associated with increased mortality and complications rates. Because of the rapid brain adaptation to extracellular hypertonicity, sustained hypernatremia exposes the patient to an exacerbation of brain edema during attempt to normalize natremia...
June 2014: Annales Françaises D'anesthèsie et de Rèanimation
Junya Furukawa, Hideaki Miyake, Yuji Kusuda, Masato Fujisawa
BACKGROUND: We aimed to evaluate the prognostic significance of hyponatremia in patients with metastatic clear cell renal cell carcinoma (RCC) treated with a tyrosine kinase inhibitor (TKI). METHODS: This study included a total of 209 consecutive Japanese patients undergoing radical nephrectomy who were subsequently treated with either sunitinib or sorafenib as a first-line therapy for metastatic clear cell RCC. In this series, normal natremia and hyponatremia prior to the introduction of TKI was defined as a serum sodium level >136 and ≤136 mEq/L, respectively...
April 2015: International Journal of Clinical Oncology
Michael Darmon, Matthias Pichon, Carole Schwebel, Stéphane Ruckly, Christophe Adrie, Hakim Haouache, Elie Azoulay, Lila Bouadma, Christophe Clec'h, Maïté Garrouste-Orgeas, Bertrand Souweine, Dany Goldgran-Toledano, Hatem Khallel, Laurent Argaud, Anne-Sylvie Dumenil, Samir Jamali, Bernard Allaouchiche, Fabrice Zeni, Jean-François Timsit
Increasing evidence suggests that dysnatremia at intensive care unit (ICU) admission may predict mortality. Little information is available, however, on the potential effect of dysnatremia correction. This is an observational multicenter cohort study in patients admitted between 2005 and 2012 to 18 French ICUs. Hyponatremia and hypernatremia were defined as serum sodium concentration less than 135 and more than 145 mmol/L, respectively. We assessed the influence on day 28 mortality of dysnatremia correction by day 3 and of the dysnatremia correction rate...
May 2014: Shock
François Brischoux, Yurii V Kornilev
The widespread relationship between salt excreting structures (e.g., salt glands) and marine life strongly suggests that the ability to regulate salt balance has been crucial during the transition to marine life in tetrapods. Elevated natremia (plasma sodium) recorded in several marine snakes species suggests that the development of a tolerance toward hypernatremia, in addition to salt gland development, has been a critical feature in the evolution of marine snakes. However, data from intermediate stage (species lacking salt glands but occasionally using salty environments) are lacking to draw a comprehensive picture of the evolution of an euryhaline physiology in these organisms...
2014: PloS One
Stanislas Bataille, Camille Baralla, Dominique Torro, Christophe Buffat, Yvon Berland, Marc Alazia, Anderson Loundou, Pierre Michelet, Henri Vacher-Coponat
BACKGROUND: About 1% of patients admitted to the Emergency Department (ED) have hypernatremia, a condition associated with a mortality rate of 20 to 60%. Management recommendations originate from intensive care unit studies, in which patients and medical diseases differ from those in ED. METHODS: We retrospectively studied clinical characteristics, treatments, and outcomes of severely hypernatremic patients in the ED and risk factors associated with death occurrence during hospitalization...
2014: BMC Nephrology
Miroslaw Jedras, Grzegorz Ostrowski
Hyponatremia is defined as plasma concentration of sodium lower than 135 mmol/L. It usually does not reflect a true sodium deficiency, but rather free water retention caused by vasopressin hypersecretion, with hypoosmolality of body fluids. Hyponatremia may be caused by different diseases and pathological conditions, such as: hypovolemia, hypothyroidism, adrenal insufficiency, syndrome of inappropriate antidiuretic hormone secretion (SIADH), congestive heart failure, hepatic cirrhosis, and adverse drug reactions...
2013: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Mathilde Severac, Jean-Christophe Orban, Thibaut Leplatois, Carole Ichai
A 42-year-old woman presented to our emergency department with headache, nausea, and confusion after completing an Ironman triathlon. She performed the race at a slow pace, in hot and dry weather. The first medical examination reported confusion with a Glasgow Coma Scale score of 13. A few minutes later, she presented with seizures. A cerebral computed tomographic (CT) scan showed major cerebral edema. Blood analysis showed severe acute hyponatremia (123 mEq/L) with hypotonicity (255 mEq/L). Her clinical condition quickly worsened, leading to a Glasgow Coma Scale score of 3 with fixed dilated pupils...
July 2014: American Journal of Emergency Medicine
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