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severe hypokalaemia

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https://www.readbyqxmd.com/read/28715077/age-and-gender-related-peculiarities-of-patients-with-delirium-in-the-cardiac-intensive-care-unit
#1
Pranas Serpytis, Petras Navickas, Alvydas Navickas, Rokas Serpytis, Giedrius Navickas, Sigita Glaveckaite
BACKGROUND: The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28689048/the-impact-of-hypothermia-on-serum-potassium-concentration-a-systematic-review
#2
REVIEW
Sarah Buse, Marc Blancher, Damien Viglino, Mathieu Pasquier, Maxime Maignan, Pierre Bouzat, Thorsten Annecke, Guillaume Debaty
BACKGROUND: Blood potassium is the main prognostic biomarker used for triage in hypothermic cardiac arrest. The aim of this review was to assess the impact of hypothermia on blood potassium levels and compare the underlying pathophysiological theories. METHODS: The Medline electronic database was searched via PubMed for articles published from January 1970 to December 2016. The search strategy included studies related to hypothermia and potassium levels. The relevant literature on clinical studies and experimental studies was reviewed by the authors...
July 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28685938/acquired-gitelman-syndrome-in-a-primary-sj%C3%A3-gren-syndrome-patient-with-a-slc12a3-heterozygous-mutation-a-case-report-and-literature-review
#3
Xiangchen Gu, Zheling Su, Min Chen, Yanqiu Xu, Yi Wang
Acquired Gitelman's syndrome (GS) associated with Sjögren syndrome (SS) is rare. A 50-year-old woman was admitted to our department because of nausea, acratia and sicca complex. Laboratory tests after admission showed renal failure, hypokalaemia, metabolic alkalosis, hypomagnesaemia and hypocalciuria, all of which met the diagnostic criteria for GS. Diagnostic evaluation identified primary SS as the cause of the acquired GS. Light microscopy of the renal tissue from the patient showed severe membranoproliferative glomerunephritis and tubulointerstitial nephritis...
August 2017: Nephrology
https://www.readbyqxmd.com/read/28660884/the-association-between-consistent-licorice-ingestion-hypertension-and-hypokalaemia-a-systematic-review-and-meta-analysis
#4
R Penninkilampi, E M Eslick, G D Eslick
There have been numerous case reports of severe adverse events including deaths following chronic licorice ingestion. The aim of the present study was to evaluate the effect of chronic ingestion of licorice on blood pressure, plasma potassium, plasma renin activity and plasma aldosterone. A search of MEDLINE, PubMed, EMBASE, CENTRAL, DARE, CINAHL and Current Contents Connect was performed from inception through to 26 April 2017. Trials that included a treatment group ingesting a product containing at least 100 mg of glycyrrhizic acid daily were selected...
June 29, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28630226/thyrotoxic-periodic-paralysis-as-an-initial-presentation-of-graves-disease-in-a-saudi-patient
#5
S F Alqahtani, M M Aleithan
Thyrotoxic periodic paralysis (TPP) is a well-known complication of hyperthyroidism, characterised by recurrent flaccid paralysis with hypokalaemia. To date, only five cases of this rare disorder have been reported in Saudi Arabia. Here, we report an additional case involving a 25-year-old Saudi man who presented with lower limb paralysis and severe hypokalaemia. Clinically, he showed symptoms and signs suggestive of Graves' disease, which was confirmed by laboratory investigations. Carbimazole, a beta-blocker and potassium replacement were administered, resulting in dramatic improvement of the TTP...
June 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28587906/-early-hypophosphataemia-in-at-risk-newborns-frequency-and-magnitude
#6
Gerardo Bustos Lozano, Álvaro Hidalgo Romero, Ana Melgar Bonis, Noelia Ureta Velasco, Carlos Orbea Gallardo, Carmen Pallás Alonso
OBJECTIVE: To determine the frequency and magnitude of neonatal hypophosphataemia (<4mg/dL) in a neonatal Intensive Care Unit and to describe risk groups. PATIENTS AND METHODS: Retrospective study of hospitalised newborns over a 44 month period (phase 1). Retrospective study of <1,500g/<32 weeks of gestation newborns over a 6 month period (phase 2). Prospective study of <1,500g or 1,550-2,000g, and intrauterine growth restriction (IUGR) newborns. Measurements were made on the 1st, 3rd, 7th, and 14th days of life (phase 3)...
June 3, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28586591/celiac-crisis-a-rare-or-rarely-recognized-disease
#7
Nadia Waheed, Huma Arshad Cheema, Hassan Suleman, Zafar Fayyaz, Iqra Mushtaq, Muhammad, Almas Hashmi
BACKGROUND: Celiac crisis is a serious life threatening complication of celiac disease characterized by profuse diarrhoea, severe dehydration and metabolic disturbances leading to neuromuscular weakness, cardiac arrhythmias and sudden death. It has been described as rare condition and not well documented in the literature. To improve awareness and facilitate diagnosis of this condition, we studied risk factors, pattern of presentation and management plans of celiac crisis. METHODS: It was a descriptive cross sectional study...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28584167/severe-cushing-s-syndrome-due-to-small-cell-prostate-carcinoma-a-case-and-review-of-literature
#8
REVIEW
M S Elston, V B Crawford, M Swarbrick, M S Dray, M Head, J V Conaglen
Cushing's syndrome (CS) due to ectopic adrenocorticotrophic hormone (ACTH) is associated with a variety of tumours most of which arise in the thorax or abdomen. Prostate carcinoma is a rare but important cause of rapidly progressive CS. To report a case of severe CS due to ACTH production from prostate neuroendocrine carcinoma and summarise previous published cases. A 71-year-old male presented with profound hypokalaemia, oedema and new onset hypertension. The patient reported two weeks of weight gain, muscle weakness, labile mood and insomnia...
July 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28567198/biochemical-derangements-prior-to-emergency-laparotomy-at-queen-elizabeth-central-hospital-blantyre-malawi-a-cross-sectional-pilot-study
#9
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/28500918/experience-using-high-dose-glucose-insulin-potassium-gik-in-critically-ill-patients
#10
Elise M A Slob, Rob Shulman, Mervyn Singer
PURPOSE: To audit the use of GIK in terms of safety, haemodynamic effects, and impact on catecholamine dosage. MATERIALS AND METHODS: A retrospective, descriptive, evaluative audit of GIK use within the adult ICU of a London teaching hospital was conducted. Rescue therapy of GIK (up to 1.0Unitsinsulin/kg/h) was administered to improve cardiac function. Outcomes were ICU survival, change in cardiac index (CI) and blood lactate levels, events of hypoglycaemia, hyperglycaemia, hypokalaemia and hyperkalaemia, and discontinuation time of catecholamine inotropes...
April 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28487303/female-phenotype-with-male-karyotype-a-clinical-enigma
#11
Suja Sukumar, Pavan Uppula, Santosh Kumar, Anil Bhansali
Development of gonadal and phenotypic sex during embryogenesis invariably corresponds to the genotypic sex. However, some disorders of sex development are associated with discordance between the chromosomal, gonadal or phenotypic sex which include complete androgen insensitivity syndrome, 46XY complete gonadal dysgenesis (Swyer syndrome) and, rarely, congenital adrenal hyperplasia due to CYP 17A1 (17α-hydroxylase) deficiency. The enzyme CYP17A1 includes 17α-hydroxylase and 17,20-lyase which are required for the synthesis of cortisol and sex steroids, respectively...
May 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28469890/hypokalaemia-addressing-human-factors-and-improving-education-around-prescription-and-administration-of-intravenous-iv-potassium-infusion-in-trauma-and-orthopaedics
#12
Vanushia Thirumal, Gavin Love
A high incidence of hypokalaemia was noted in Trauma and Orthopaedics of Ninewells Hospital. We sought to establish the reason behind this and implemented three PDSA cycles via questionnaires to 30 ward staff, both doctors and nurses over a 1 week period in December, February and July 2016. Key baseline measures include availability of IV fluids with 40mmol potassium on the wards, confidence prescribing or administering IV fluids with 40mmol potassium, necessity for cardiac monitoring during slow IV potassium replacement and recognition of confusion and learning need in this area...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28456753/severe-hypercalcaemia-and-hypophosphataemia-with-an-optimised-preterm-parenteral-nutrition-formulation-in-two-epochs-of-differing-phosphate-supplementation
#13
Shaveta Mulla, Susan Stirling, Sarah Cowey, Rosie Close, Sara Pullan, Rosalind Howe, Lynne Radbone, Paul Clarke
OBJECTIVE: To compare in two epochs of differing phosphate provision serum calcium, phosphate, potassium, and sodium concentrations and the frequency of abnormality of these electrolytes and of sepsis in preterm infants who received an optimised higher amino acid-content formulation. DESIGN AND SETTING: Retrospective cohort study at a single tertiary-level neonatal unit. PATIENTS: Preterm infants given parenteral nutrition (PN) in the first postnatal week during two discrete 6-month epochs in 2013-2014...
April 29, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28386507/an-unusual-case-of-resistant-hypokalaemia-in-a-patient-with-large-bowel-obstruction-secondary-to-neuroendocrine-carcinoma-of-the-prostate
#14
Umasankar Mathuram Thiyagarajan, A Ponnuswamy, A Bagul, A Gupta
Neuroendocrine Carcinoma of the Prostate (NECP) is rare and only few cases have been reported, constituting less than 0.5% of prostatic malignancies. We report a rare case of large bowel obstruction from NECP posing a further challenge in management due to resistant hypokalaemia. A 70-year-old man presented with clinical signs of large bowel obstruction who was known to have prostatic carcinoma three years ago, treated initially with hormone therapy then chemoradiation. The blood profile showed a severe hypokalaemia and CT scan revealed liver and lung metastases apart from confirming large bowel obstruction from local invasion of NECP...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28348804/cytolethal-distending-toxin-producing-escherichia-coli-strains-causing-severe-diarrhoea-in-young-mexican-children
#15
Mario Meza-Segura, Mussaret Bano Zaidi, Samantha Maldonado-Puga, Jazmin Huerta-Cantillo, Lucia Chavez-Dueñas, Fernando Navarro-Garcia, Teresa Estrada-Garcia
Introduction. Cytolethal distending toxins (CDTs), encoded by cdt genes, have DNase activity leading to cellular and nuclear distension, resulting in irreversible cell cycle arrest and apoptosis of target cells. cdt-positive Escherichia coli strains have been isolated from children with diarrhoea. There is, however, scant information on the prevalence and clinical presentation of diarrhoeal disease caused by these strains. Furthermore, toxin production of cdt-positive strains is rarely confirmed. We report five young children with diarrhoea caused by CDT-producing E...
February 2017: JMM Case Reports
https://www.readbyqxmd.com/read/28348753/delayed-recognition-of-fatal-invasive-meningococcal-disease-in-adults
#16
Frederick W Nagel, Ifeoma Ezeoke, Mike Antwi, Paula E Del Rosso, Marie Dorsinville, Beth M Isaac, Althea Hayden, Robert S Hoffman, Scott D Weingart, Don Weiss
INTRODUCTION: Invasive meningococcal disease can be difficult to detect early in its course when patients may appear well and the severity of their illness is obscured by non-specific complaints. CASE PRESENTATION: We report five cases of meningococcal sepsis in adult patients who presented to an emergency department early in the course of their disease, but whose severity of illness was not recognized. CONCLUSION: Suspicion of meningococcal sepsis should be heightened in the setting of hypotension, tachycardia, elevated shock index, leukopaenia with left shift, thrombocytopaenia and hypokalaemia, prompting early sepsis care...
June 2016: JMM Case Reports
https://www.readbyqxmd.com/read/28287295/-differential-diagnostic-dilemmas-after-use-of-an-out-of-date-antihypertensive-medication-case-report
#17
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/28263150/-rhabdomyolysis-caused-by-hyperemesis-gravidarum
#18
Lana Rashid Flachs Madsen, Marie Søgaard
Hyperemesis gravidarum (HG) is a condition of severe nausea and vomiting during pregnancy, accompanied by dehydration, electrolyte derangement and lack of nutrition. We describe a 26-year-old woman pregnant at 29 weeks of gestation, complaining about muscle pain and difficulties standing up after suffering from long-term HG followed by a weight loss of 35 kg. She had severe hypokalaemia and abnormally elevated muscle enzyme concentrations as a result of a massive catabolic process. We discuss severe HG as a rare cause of rhabdomyolysis and the importance of early aggressive resuscitation to avoid renal failure...
February 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28250297/multimodal-treatment-of-vasoactive-intestinal-polypeptide-producing-pancreatic-neuroendocrine-tumors-with-liver-metastases
#19
REVIEW
Mari Iwasaki, Kouhei Tsuchida, Hidehito Jinnai, Toshinori Komatsubara, Takahiro Arisaka, Misako Tsunemi, Masakazu Nakano, Makoto Iijima, Hideyuki Hiraishi
A 53-year-old man presented with diarrhoea and hypokalaemia and was diagnosed with a neuroendocrine tumour of unknown origin with multiple liver metastases. Somatostatin analogues led to a reduction in the size of the tumours and improvement of his symptoms. However, after several years, the tumours grew in size, and the patient's clinical symptoms recurred. The patient underwent transcatheter arterial embolization (TAE) of the hepatic artery to treat the liver metastases. Immediately after embolization, the symptoms disappeared...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28224871/-a-patient-with-severe-digoxin-toxicity
#20
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
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