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severe hypokalaemia

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https://www.readbyqxmd.com/read/27905308/a-case-of-extreme-hypokalaemia
#1
L M Ten Bos, T C Veenstra, B D Westerhof, F H Bosch
Hypokalaemia is a common clinical problem. It can lead to severe disturbances in cardiac, neurological and muscle function. We present the case of a 45-year-old woman who was transported to our hospital with cardiac arrest following ventricular fibrillation. Blood sampling revealed severe acidosis (pH 7.02) and extreme hypokalaemia (0.9 mmol/l). The low serum potassium level was most likely caused by the combination of a very deficient diet and use of a thiazide diuretic. She never reported any symptoms. An acute intracellular shift of potassium due to epinephrine and perhaps also the cathecholamines in Red Bull may have further decreased the serum potassium concentration...
November 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27782749/lower-physical-fitness-in-patients-with-primary-aldosteronism-is-linked-to-the-severity-of-hypertension-and-kalaemia
#2
V Tuka, M Matoulek, T Zelinka, J Rosa, O Petrák, O Mikeš, Z Krátká, B Štrauch, R Holaj, J Widimský
Hypokalaemia as a typical feature of primary aldosteronism (PA) is associated with muscle weakness and could contribute to lower cardiopulmonary fitness. The aim of this study was to describe cardiopulmonary fitness and exercise blood pressure and their determinants during a symptom-limited exercise stress test in patients with PA. We performed a cross-sectional study of patients with confirmed PA who were included before adrenal vein sampling on whom a symptom-limited exercise stress test with expired gas analysis was performed...
October 26, 2016: Physiological Research
https://www.readbyqxmd.com/read/27730793/ondansetron-induced-life-threatening-hypokalemia
#3
S K Mathew, K Krishnan Kutty, I Ramya, C Padmakumar, Prince Pius
Ondansetron is widely used in general practice for nausea and vomiting due to any cause. We report a rare side effect, life-threatening hypokalaemia following intravenous Ondansetron injection. It may be judicious to restrict the use of Odansetron to patients with severe vomiting due to chemotherapy or in post-operative state. Life-threatening hypokalemia can occur without any warning and may be difficult to manage in a primary set up.
February 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27418967/short-term-mortality-risk-of-serum-potassium-levels-in-acute-heart-failure-following-myocardial-infarction
#4
Maria Lukács Krogager, Lotti Eggers-Kaas, Kristian Aasbjerg, Rikke Nørmark Mortensen, Lars Køber, Gunnar Gislason, Christian Torp-Pedersen, Peter Søgaard
AIMS: Diuretic treatment is often needed in acute heart failure following myocardial infarction (MI) and carries a risk of abnormal potassium levels. We examined the relation between different levels of potassium and mortality. METHODS AND RESULTS: From Danish national registries we identified 2596 patients treated with loop diuretics after their first MI episode where potassium measurement was available within 3 months. All-cause mortality was examined according to seven predefined potassium levels: hypokalaemia <3...
October 2015: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/27380495/patiromer-a-review-in-hyperkalaemia
#5
E S Kim, Emma D Deeks
Patiromer (Veltassa(™)) for oral suspension is a sodium-free potassium binder that is approved in the USA for the treatment of hyperkalaemia. In clinical trials, patiromer significantly reduced serum potassium levels from baseline to week 4 in patients with chronic kidney disease (CKD) and mild to severe hyperkalaemia (OPAL-HK), or CKD, mild to moderate hyperkalaemia and type 2 diabetes mellitus (AMETHYST-DN), who were receiving renin-angiotensin-aldosterone system inhibitors (RAASis; drugs that inhibit the renal excretion of potassium)...
August 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27323674/early-treatment-with-intravenous-lipid-emulsion-in-a-potentially-lethal-hydroxychloroquine-intoxication
#6
R Ten Broeke, E Mestrom, L Woo, H Kreeftenberg
This case report describes the possible benefit of intravenous lipid emulsion in two patients surviving a severe intoxication with hydroxychloroquine in a dose that was previously considered to be lethal. The first case involves a 25-year-old female who ingested 17.5 grams of hydroxychloroquine, approximately one hour before presentation. An ECG showed QRS widening and the lab results showed hypokalaemia. She became unconscious, and developed hypotension and eventually apnoea. After intubation, supportive care consisted of norepinephrine and supplementation of potassium...
June 2016: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/27322572/hypokalaemia-in-hospitalised-patients
#7
Angela Greco, Giovanni Rabito, Michela Pironi, Marco Bissig, Saida Parlato, Laura Andreocchi, Giorgia Bianchi, Marilù Poretti Guigli, Michael Llamas, Rita Monotti, Leander Sciolli, Franco Ravetta, Roberto Della Bruna, Anna Zasa, Daniela Stehrenberger, Olivier Giannini, Luca Gabutti
QUESTIONS UNDER STUDY: Hypokalaemia in inpatients is common, and is associated with morbidity and mortality. Its management is risky and not always effective. We launched an educational programme with the aim of increasing the rate of potassium normalisation during hospital stay, and of reducing unmonitored cases. METHODS: The project consisted of three phases: (I) retrospective analysis on 26 471 patients hospitalised in 2012 in five acute care hospitals of southern Switzerland (Ente Ospedaliero Cantonale, EOC) with identification of improvement goals on a sample survey (588 cases of hypokalaemia); (II) revision of internal guidelines, and implementation of educational activities in one of the five hospitals (Ospedale Regionale di Locarno, ODL); (III) follow-up analysis on the 26 726 patients hospitalised in 2014 and second sampling to complete the evaluation of the efficacy of the intervention...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27277374/bartter-syndrome-with-normal-aldosterone-level-an-unusual-presentation
#8
S S Huque, M H Rahman, S Khatun
Bartter syndrome (BS) is a hereditary disease, with an autosomal recessive or autosomal dominant mode of transmission. It is characterized by salt wasting hypochloraemic, hypokalaemic metabolic alkalosis and hyperreninaemia with normal blood pressure. The primary defect is in the thick ascending limb of loop of Henle (TAL). Herein, we report a case that had typical features of BS like severe dehydration, severe hypokalaemia, metabolic alkalosis and failure to thrive but had normal aldosterone level which is very uncommon...
April 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27252863/the-mckittrick-wheelock-syndrome-a-rare-cause-of-curable-diabetes
#9
Benjamin G Challis, Chung Thong Lim, Alison Cluroe, Ewen Cameron, Stephen O'Rahilly
UNLABELLED: McKittrick-Wheelock syndrome (MWS) is a rare consequence of severe dehydration and electrolyte depletion due to mucinous diarrhoea secondary to a rectosigmoid villous adenoma. Reported cases of MWS commonly describe hypersecretion of mucinous diarrhoea in association with dehydration, hypokalaemia, hyponatraemia, hypochloraemia and pre-renal azotemia. Hyperglycaemia and diabetes are rarely reported manifestations of MWS. Herein we describe the case of a 59-year-old woman who presented with new-onset diabetes and severe electrolyte derangement due to a giant rectal villous adenoma...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27248003/serum-potassium-and-sodium-levels-after-subarachnoid-haemorrhage
#10
Inga Chen, Patrick Mitchell
BACKGROUND: Many studies have demonstrated that subarachnoid haemorrhage (SAH) is associated with hyponatraemia but associations with potassium levels are less well studied. There is a clear physiological link between sodium and potassium and abnormal potassium levels that can lead to dangerous outcomes. The purpose of the present study is to define changes in levels of both these cations that occur in standardised salt management of SAH. METHOD: 114 records of patients admitted between 2 January 2011 and 27 December 2011 with SAH at a single institution were obtained retrospectively...
October 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27211205/secondary-hypertension-in-adults
#11
Troy Hai Kiat Puar, Yingjuan Mok, Roy Debajyoti, Joan Khoo, Choon How How, Alvin Kok Heong Ng
Secondary hypertension occurs in a significant proportion of adult patients (~10%). In young patients, renal causes (glomerulonephritis) and coarctation of the aorta should be considered. In older patients, primary aldosteronism, obstructive sleep apnoea and renal artery stenosis are more prevalent than previously thought. Primary aldosteronism can be screened by taking morning aldosterone and renin levels, and should be considered in patients with severe, resistant or hypokalaemia-associated hypertension. Symptoms of obstructive sleep apnoea should be sought...
May 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27068441/spak-and-osr1-play-essential-roles-in-potassium-homeostasis-through-actions-on-the-distal-convoluted-tubule
#12
Mohammed Z Ferdaus, Karl W Barber, Karen I López-Cayuqueo, Andrew S Terker, Eduardo R Argaiz, Brandon M Gassaway, Régine Chambrey, Gerardo Gamba, Jesse Rinehart, James A McCormick
KEY POINTS: STE20 (Sterile 20)/SPS-1 related proline/alanine-rich kinase (SPAK) and oxidative stress-response kinase-1 (OSR1) phosphorylate and activate the renal Na(+) -K(+) -2Cl(-) cotransporter 2 (NKCC2) and Na(+) Cl(-) cotransporter (NCC). Mouse models suggest that OSR1 mainly activates NKCC2-mediated sodium transport along the thick ascending limb, while SPAK mainly activates NCC along the distal convoluted tubule, but the kinases may compensate for each other. We hypothesized that disruption of both kinases would lead to polyuria and severe salt-wasting, and generated SPAK/OSR1 double knockout mice to test this...
September 1, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27052658/a-phase-ii-trial-of-abiraterone-acetate-plus-prednisone-in-patients-with-triple-negative-androgen-receptor-positive-locally-advanced-or-metastatic-breast-cancer-ucbg-12-1
#13
H Bonnefoi, T Grellety, O Tredan, M Saghatchian, F Dalenc, A Mailliez, T L'Haridon, P Cottu, S Abadie-Lacourtoisie, B You, M Mousseau, J Dauba, F Del Piano, I Desmoulins, F Coussy, N Madranges, J Grenier, F C Bidard, C Proudhon, G MacGrogan, C Orsini, M Pulido, A Gonçalves
BACKGROUND: Several expression array studies identified molecular apocrine breast cancer (BC) as a subtype that expresses androgen receptor (AR) but not estrogen receptor α. We carried out a multicentre single-arm phase II trial in women with AR-positive, estrogen, progesterone receptor and HER2-negative (triple-negative) metastatic or inoperable locally advanced BC to assess the efficacy and safety of abiraterone acetate (AA) plus prednisone. PATIENTS AND METHODS: Patients with a metastatic or locally advanced, centrally reviewed, triple-negative and AR-positive (≥10% by immunohistochemistry, IHC) BC were eligible...
May 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/26972906/current-views-on-the-diagnosis-and-management-of-hypokalaemia-in-children
#14
REVIEW
Jakub Zieg, Lucie Gonsorcikova, Daniel Landau
UNLABELLED: Hypokalaemia is a common electrolyte disorder in children, caused by decreased potassium intake, increased gastrointestinal and urinary losses or transcellular shift. Patients with severe hypokalaemia may suffer from symptoms such as life-threatening cardiac arrhythmias. The aim of our study was to review the aetiology of hypokalaemia, suggest a diagnostic algorithm and discuss the management of patients with various aetiologies of hypokalaemia. CONCLUSION: Understanding the pathophysiology of hypokalaemic states, along with a detailed medical history, physical examination and specific laboratory tests are required for proper diagnosis and appropriate treatment...
July 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/26894113/severe-hypokalaemia-hypertension-and-intestinal-perforation-in-ectopic-adrenocorticotropic-hormone-syndrome
#15
Tezcan Kaya, Cengiz Karacaer, Seyyid Bilal Açikgöz, Yusuf Aydemir, Ali Tamer
Ectopic adrenocorticotropic hormone (ACTH) syndrome is a rare cause of the Cushing's syndrome. The occurrence of the ectopic ACTH syndrome presenting with severe hypokalaemia, metabolic alkalosis, and hypertension has been highlighted in case reports. However, presentation with lower gastrointestinal perforation is not known. We report the case of a 70-year-old male patient with severe hypokalaemia, metabolic alkalosis, hypertension, and colonic perforation as manifestations of an ACTH-secreting small cell lung carcinoma...
January 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26878327/hypothermia-for-neuroprotection-in-adults-after-cardiopulmonary-resuscitation
#16
REVIEW
Jasmin Arrich, Michael Holzer, Christof Havel, Marcus Müllner, Harald Herkner
BACKGROUND: Good neurological outcome after cardiac arrest is difficult to achieve. Interventions during the resuscitation phase and treatment within the first hours after the event are critical. Experimental evidence suggests that therapeutic hypothermia is beneficial, and several clinical studies on this topic have been published. This review was originally published in 2009; updated versions were published in 2012 and 2016. OBJECTIVES: We aimed to perform a systematic review and meta-analysis to assess the influence of therapeutic hypothermia after cardiac arrest on neurological outcome, survival and adverse events...
February 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26865828/point-of-admission-serum-electrolyte-profile-of-children-less-than-five-years-old-with-dehydration-due-to-acute-diarrhoea
#17
Matthias Mariere Okposio, Alphonsus Ndidi Onyiriuka, Blessing Imuetiyan Abhulimhen-Iyoha
BACKGROUND/OBJECTIVE: Fluid, electrolytes and acid base disturbances are responsible for most deaths due to acute diarrhoea. The aim of this study is to describe the point-of-admission serum electrolyte profile of children with dehydration due to acute diarrhoea. METHODS: In this cross-sectional study, the serum electrolyte levels of 185 children with dehydration due to acute diarrhoea were assessed at the point of admission at the Diarrhoea Treatment and Training Unit of the University of Benin Teaching Hospital...
December 2015: Tropical Medicine and Health
https://www.readbyqxmd.com/read/26833215/therapeutic-strategies-for-the-treatment-of-severe-cushing-s-syndrome
#18
Krystallenia I Alexandraki, Ashley B Grossman
Severe Cushing's syndrome presents an acute emergency and is defined by massively elevated random serum cortisol [more than 36 μg/dL (1000 nmol/L)] at any time or a 24-h urinary free cortisol more than fourfold the upper limit of normal and/or severe hypokalaemia (<3.0 mmol/L), along with the recent onset of one or more of the following: sepsis, opportunistic infection, intractable hypokalaemia, uncontrolled hypertension, heart failure, gastrointestinal haemorrhage, glucocorticoid-induced acute psychosis, progressive debilitating myopathy, thromboembolism or uncontrolled hyperglycaemia and ketocacidosis...
March 2016: Drugs
https://www.readbyqxmd.com/read/26664399/report-of-severe-menorrhagia-following-the-maximum-amount-of-lamotrigine-overdose
#19
Farid Hajiali, Marjan Nassiri-Asl
Lamotrigine is an antiepileptic drug used as a treatment for partial and generalised seizures as well as for bipolar disorder type I. Till date, very few cases of lamotrigine overdose have been reported. The spectra of clinical effects of lamotrigine in acute overdose are not well established. In severe cases of poisoning, serious effects such as coma, respiratory depression, recurrent seizures and intraventricular conduction disturbances have been noted. Here, we report a case of lamotrigine overdose in a 26-year-old divorcee with paradoxical seizure activity and coma...
2015: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/26581339/infantile-hypertrophic-pyloric-stenosis-at-a-tertiary-care-hospital-in-tanzania-a-surgical-experience-with-102-patients-over-a-5-year-period
#20
Phillipo L Chalya, Mange Manyama, Neema M Kayange, Joseph B Mabula, Alicia Massenga
BACKGROUND: Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infants. There is paucity of published data regarding this condition in our setting. This study describes the clinical presentation, mode of treatment and outcome of treatment of this disease and identifies factors responsible for poor outcome of these patients. METHODS: This was a descriptive retrospective study of infants with HPS admitted to Bugando Medical Centre and subsequently underwent surgery between February 2009 and January 2014...
2015: BMC Research Notes
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