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severe hypokalaemia

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https://www.readbyqxmd.com/read/29155816/liposomal-amphotericin-b-in-travelers-with-cutaneous-and-muco-cutaneous-leishmaniasis-not-a-panacea
#1
Romain Guery, Benoit Henry, Guillaume Martin-Blondel, Claire Rouzaud, Florence Cordoliani, Gundel Harms, Jean-Pierre Gangneux, Françoise Foulet, Emmanuelle Bourrat, Michel Baccard, Gloria Morizot, Paul-Henri Consigny, Antoine Berry, Johannes Blum, Olivier Lortholary, Pierre Buffet
BACKGROUND: Complex cutaneous and muco-cutaneous leishmaniasis (CL and MCL) often requires systemic therapy. Liposomal amphotericin B (L-AmB) has a strong potential for a solid clinical benefit in this indication. METHODS: We conducted a retrospective analysis of data from a French centralized referral treatment program and from the "LeishMan" European consortium database. All patients with parasitologically proven CL or MCL who received at least one dose of L-AmB were included...
November 20, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29127128/all-sorts-of-tests-only-one-question-an-unexpected-cause-of-hypertension
#2
Sarah Foster, Rachel Foster, Peter Jackson, Soon Song
A 48-year-old woman presented to the Accident and Emergency department with a 4 month history of headaches, nausea and dizziness. She was found to have severe hypertension and hypokalaemia. Extensive investigations did not find any secondary cause for hypertension. The patient was discharged with oral doxazosin therapy which controlled the blood pressure. Before the follow-up appointment at the hypertension clinic, the patient and her husband identified that her headaches coincided with liquorice tea consumption of up to three cups per day...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29090271/oral-rehydration-of-malnourished-children-with-diarrhoea-and-dehydration-a-systematic-review
#3
Kirsty A Houston, Jack G Gibb, Kathryn Maitland
Background: Diarrhoea complicates over half of admissions to hospital with severe acute malnutrition (SAM). World Health Organization (WHO) guidelines for the management of dehydration recommend the use of oral rehydration with ReSoMal (an oral rehydration solution (ORS) for SAM), which has lower sodium (45mmols/l) and higher potassium (40mmols/l) content than old WHO ORS. The composition of ReSoMal was designed specifically to address theoretical risks of sodium overload and potential under-treatment of severe hypokalaemia with rehydration using standard ORS...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/29069937/the-safety-of-high-dose-insulin-euglycaemia-therapy-in-toxin-induced-cardiac-toxicity
#4
Colin B Page, Nicole M Ryan, Geoffrey K Isbister
CONTEXT: High-dose insulin euglycaemia (HIE) is recommended in the management of toxin-induced cardiac toxicity, with increasing insulin doses now being used. We aimed to investigate the safety of HIE in toxin-induced cardiac toxicity. METHODS: This was a retrospective review of cases from two clinical toxicology units. Demographics, toxin(s) ingested, clinical effects, investigations (serum glucose, electrolytes), treatments (insulin, glucose, electrolyte replacement), length of stay (LOS) and outcomes were extracted from the patients' medical records...
October 26, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28940440/continuous-infusion-vs-intermittent-bolus-injection-of-furosemide-in-acute-decompensated-heart-failure-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#5
REVIEW
K T Ng, J L L Yap
Loop diuretics remain a fundamental pharmacological therapy to remove excess fluid and improve symptom control in acute decompensated heart failure. Several recent randomised controlled trials have examined the clinical benefit of continuous vs. bolus furosemide in acute decompensated heart failure, but have reported conflicting findings. The aim of this review was to compare the effects of continuous and bolus furosemide with regard to mortality, length of hospital stay and its efficacy profile in acute decompensated heart failure...
September 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28919599/clinico-biochemical-profile-of-women-with-hyperemesis-gravidarum-admitted-in-a-tertiary-hospital
#6
S Kabir, M S Basher, H Akhter, T Latif, S N Akhter, R K Karmoker, S A Shaon, K Ahmed
Hyperemesis gravidarum is the most severe form of nausea and vomiting in pregnancy with poor pregnancy outcome. Hormonal changes, psychological and immunological factors are attributed to the condition. Recently, prevalence of Helicobacter pylori among women with Hyperemesis gravidarum has been revealed. A descriptive, cross-sectional study was carried out at antenatal ward, Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital, Mymensingh among thirty-six purposively selected patients with Hyperemesis gravidarum to assess the clinic-biochemical profile...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28894410/life-threatening-dyskalaemia-after-barbiturate-coma-therapy-the-strategy-of-management
#7
Yeap Boon Tat, Wan Mohd Nazaruddin Wan Hassan, Ting Yung Chuen, Abdul Rahman Izaini Ghani
Barbiturate coma therapy (BCT) is a treatment option that is used for refractory intracranial hypertension after all other options have been exhausted. Although BCT is a brain protection treatment, it also has several side effects such as hypotension, hepatic dysfunction, renal dysfunction, respiratory complications and electrolyte imbalances. One less concerning but potentially life-threatening complication of BCT is dyskalaemia. This complication could present as severe refractory hypokalaemia during the therapy with subsequent rebound hyperkalaemia after cessation of the therapy...
March 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28866977/intensity-of-early-correction-of-hyperglycaemia-and-outcome-of-critically-ill-patients-with-diabetic-ketoacidosis
#8
Johan Mårtensson, Michael Bailey, Balasubramanian Venkatesh, David Pilcher, Adam Deane, Yasmine Ali Abdelhamid, Marco Crisman, Brij Verma, Christopher MacIsaac, Geoffrey Wigmore, Yahya Shehabi, Takafumi Suzuki, Craig French, Neil Orford, Nima Kakho, Johannes Prins, Elif I Ekinci, Rinaldo Bellomo
OBJECTIVES: To determine the impact of the intensity of early correction of hyperglycaemia on outcomes in patients with diabetic ketoacidosis (DKA) admitted to the intensive care unit. METHODS: We studied adult patients with DKA admitted to 171 ICUs in Australia and New Zealand from 2000 to 2013. We used their blood glucose levels (BGLs) in the first 24 hours after ICU admission to determine whether intensive early correction of hyperglycemia to ≤ 180 mg/dL was independently associated with hypoglycaemia, hypokalaemia, hypo-osmolarity or mortality, compared with partial early correction to > 180 mg/dL as recommended by DKA-specific guidelines...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28804909/evaluation-of-clinical-laboratory-imaging-findings-and-outcome-in-99-dogs-with-leptospirosis
#9
S Knöpfler, A Mayer-Scholl, E Luge, R Klopfleisch, A D Gruber, K Nöckler, B Kohn
OBJECTIVE: To report clinical, laboratory and diagnostic imaging features and prognostic factors in dogs with leptospirosis from North-East Germany. MATERIALS AND METHODS: Medical records of dogs diagnosed with leptospirosis from 2006 to 2013 were evaluated retrospectively. RESULTS: The study included 99 dogs. At initial presentation, the most common clinical signs were lethargy (96%), anorexia (88%), vomiting (85%), painful abdomen (39%), diarrhoea (38%), oliguria (27%) and tachypnoea (26%)...
August 14, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28751432/severe-hypokalaemia-as-a-cause-of-acute-transient-quadriparesis
#10
Martin Bell Lybecker, Henrik Bjørnsgaard Madsen, Jens Meldgaard Bruun
Hypokalaemic paralysis covers a heterogeneous group of disorders caused either by an enhanced shift of potassium into the cells or following a significant renal or gastrointestinal loss of potassium. We present the case of a 48-year-old Caucasian man with paralysis of both upper and lower extremities. ECG showed sinus rhythm and characteristic changes of hypokalaemia with depression of the ST segment, prolonged QTc interval of 581ms and U waves seen as a small positive deflection at the T wave in the middle precordial leads...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28715077/age-and-gender-related-peculiarities-of-patients-with-delirium-in-the-cardiac-intensive-care-unit
#11
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...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28689048/the-impact-of-hypothermia-on-serum-potassium-concentration-a-systematic-review
#12
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...
September 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
#13
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
#14
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...
November 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
October 2017: Journal of Critical Care
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