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severe hypokalaemia

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https://www.readbyqxmd.com/read/29703920/prevalent-metabolic-derangement-and-severe-thrombocytopenia-in-abo-incompatible-liver-recipients-with-pre-transplant-plasma-exchange
#1
Hye-Mee Kwon, In-Gu Jun, JungBok Lee, Young-Jin Moon, Kyeo-Woon Jung, Hye-Won Jeong, Yong-Seok Park, Jun-Gol Song, Gyu-Sam Hwang
Desensitisation with therapeutic plasma exchange (TPE) is essential for ABO-incompatible (ABO-I) liver transplants (LTs). However, excessive citrate load and coagulation disturbances after TPE have been poorly studied, in particular in cirrhotic patients with hypocapnic alkalosis, metabolic compensation and electrolyte imbalances. We retrospectively evaluated 1123 consecutive LT recipients (923 ABO-compatible [ABO-C], 200 ABO-I) from November 2008 to May 2015. TPE was generally performed a day before LT and blood sampling was performed before anaesthesia induction...
April 27, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29477991/severe-hypophosphataemia-a-rare-cause-of-postoperative-muscle-weakness
#2
Aarti Narayan, Arun Subramanian
We report a case of severe generalised muscle weakness in a 66-year-old man who underwent revision of left knee arthroplasty. On postoperative day 1, he developed non-focal muscle weakness and shortness of breath which progressed over a 6-hour period. Serum phosphorus level was severely low at 0.5 mg/dL, along with mild degree of hypokalaemia, hypocalcaemia and hypomagnesaemia. His symptoms completely resolved after emergent phosphorus replacement. The authors believe this case is of educational interest to physicians as generalised muscle weakness is an uncommon presentation of severe hypophosphataemia...
February 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29472988/mineralocorticoid-hypertension-and-hypokalaemia-induced-by-posaconazole
#3
Charlotte Boughton, David Taylor, Lea Ghataore, Norman Taylor, Benjamin C Whitelaw
We describe severe hypokalaemia and hypertension due to a mineralocorticoid effect in a patient with myelodysplastic syndrome taking posaconazole as antifungal prophylaxis. Two distinct mechanisms due to posaconazole are identified: inhibition of 11β hydroxylase leading to the accumulation of the mineralocorticoid hormone 11-deoxycorticosterone (DOC) and secondly, inhibition of 11β hydroxysteroid dehydrogenase type 2 (11βHSD2), as demonstrated by an elevated serum cortisol-to-cortisone ratio. The effects were ameliorated by spironolactone...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29447079/flucloxacillin-induced-hypokalaemia-a-case-report
#4
Eva De Backer, Heidi Hannon
Objective and importance Flucloxacillin is a narrow-spectrum beta-lactam antibiotic with activity against penicillinase producing staphylococci and streptococci. Severe hypokalaemia is an uncommon, but serious adverse effect in patients treated with penicillin derivates. Clinical presentation We report a case of severe hypokalaemia in a patient treated with high dose intravenous flucloxacillin. Conclusion This case report highlights the importance of monitoring electrolytes during treatment with high dose flucloxacillin...
February 15, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29338765/infantile-hypertrophic-pyloric-stenosis-a-4-year-experience-from-two-tertiary-care-centres-in-cameroon
#5
Rene Ndongo, Paul Nkemtendong Tolefac, Faustin Félicien Mouafo Tambo, Matin Hongieh Abanda, Marcelin Ngowe Ngowe, Olivier Fola, Bonaventure Dzekem, Patrick Eroyl Weledji, Maurice Aurelien Sosso, Jacqueline Ze Minkande
OBJECTIVE: This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon. RESULTS: A total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants...
January 16, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29305081/extending-knowledge-of-the-clinical-picture-of-balkan-adder-vipera-berus-bosniensis-envenoming-the-first-photographically-documented-neurotoxic-case-from-south-western-hungary
#6
Csaba Varga, Tamás Malina, Viktória Alföldi, Gergely Bilics, Ferenc Nagy, Tibor Oláh
We report a severe envenoming associated with minimal local symptoms following a Balkan adder (Vipera berus bosniensis) bite in South-Western Hungary. A 63-year-old male with a history of hypertension and sinus bradycardia (45/min) was bitten by a sub-adult specimen of V. b. bosniensis in Somogy County on 04 May 2017. The patient was transported to and treated at the Emergency Department of "Moritz Kaposi" General Hospital, Kaposvár. Locally only pain and minimal swelling with a small haematoma developed on the bitten finger...
March 1, 2018: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/29304463/management-of-qt-prolongation-induced-by-anti-cancer-drugs-target-therapy-and-old-agents-different-algorithms-for-different-drugs
#7
REVIEW
Carmela Coppola, Anna Rienzo, Giovanna Piscopo, Antonio Barbieri, Claudio Arra, Nicola Maurea
The side effects of anticancer drugs still play a critical role in survival and quality of life. Although the recent progresses of cancer therapies have significantly improved the prognosis of oncologic patients, side effects of antineoplastic treatments are still responsible for the increased mortality of cancer survivors. Cardiovascular toxicity is the most dangerous adverse effect induced by anticancer therapies. A survey conducted by the National Health and Nutrition Examination, showed that 1807 cancer survivors followed up for seven years: 51% died of cancer and 33% of heart disease (Vejpongsa and Yeh, 2014)...
February 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29241762/eltrombopag-for-advanced-myelodysplastic-syndromes-or-acute-myeloid-leukaemia-and-severe-thrombocytopenia-aspire-a-randomised-placebo-controlled-phase-2-trial
#8
Moshe Mittelman, Uwe Platzbecker, Boris Afanasyev, Sebastian Grosicki, Raymond S M Wong, Achilles Anagnostopoulos, Benjamin Brenner, Claudio Denzlinger, Giuseppe Rossi, Arnon Nagler, Regina Garcia-Delgado, Maria Socorro O Portella, Zewen Zhu, Dominik Selleslag
BACKGROUND: Thrombocytopenia is a life-threatening complication in patients with advanced myelodysplastic syndromes (MDS) and acute myeloid leukaemia (AML). In this study (ASPIRE), we aimed to assess eltrombopag, an oral thrombopoietin receptor agonist, for thrombocytopenia (grade 4) treatment in adult patients with advanced MDS or AML. METHODS: ASPIRE consisted of an open-label, double-blind phase for 8 weeks and a randomised, double-blind phase (parts 1 and 2, reported here) for 12 weeks, and an open-label extension (part 3)...
January 2018: Lancet Haematology
https://www.readbyqxmd.com/read/29219824/thyrotoxic-periodic-paralysis-an-unusual-presentation-of-hyperthyroidism
#9
M Salih, C M J van Kinschot, R P Peeters, W W de Herder, E J J Duschek, J van der Linden, C van Noord
Thyrotoxic periodic paralysis (TPP) is a complication of hyperthyroidism among Asians, characterised by sudden onset of hypokalaemia and muscle paralysis. Several factors may contribute to a delay in diagnosis, including the subtlety of hyperthyroidism, the transient nature of the events and the rarity of this disease in the West. As life-threatening arrhythmias may occur during an attack, awareness among physicians is necessary for early recognition and treatment. Advances have been made in understanding the pathophysiological mechanism leading to hypokalaemia, which include recently identified mutations of the inwardly rectifying potassium channel Kir2...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29155816/liposomal-amphotericin-b-in-travelers-with-cutaneous-and-muco-cutaneous-leishmaniasis-not-a-panacea
#10
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 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29127128/all-sorts-of-tests-only-one-question-an-unexpected-cause-of-hypertension
#11
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
#12
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
#13
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
#14
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...
February 2018: Anaesthesia
https://www.readbyqxmd.com/read/28919599/clinico-biochemical-profile-of-women-with-hyperemesis-gravidarum-admitted-in-a-tertiary-hospital
#15
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
#16
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
#17
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
#18
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%)...
October 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28751432/severe-hypokalaemia-as-a-cause-of-acute-transient-quadriparesis
#19
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
#20
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
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