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https://www.readbyqxmd.com/read/28024277/qt-prolongation-caused-by-insulin-induced-hypoglycaemia-an-interventional-study-in-119-individuals
#1
Stella Kacheva, Beate Karges, Katrin Göller, Nikolaus Marx, Karl Mischke, Wolfram Karges
AIMS: Hypoglycaemia is associated with increased risk of cardiovascular events and mortality in patients with diabetes, but the extent and mechanisms of this link are ill defined. We here prospectively studied cardiac repolarization abnormalities during insulin-induced hypoglycaemia in humans. METHODS: 119 individuals (69 males, age 47.5±13.4years, range 18-82years) were assessed during hypoglycaemia after the injection of 0.1-0.25units/kg human insulin. Corrected QT intervals (QTc) and QT dispersion (QTd) were calculated from serially recorded twelve lead electrocardiograms, and plasma glucose and other endocrine markers were studied...
December 3, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28011953/hyperventilation-assists-proarrhythmia-development-during-delayed-repolarization-in-clofilium-treated-anaesthetized-mechanically-ventilated-rabbits
#2
H Papp, A Sarusi, A S Farkas, H Takacs, P Kui, D Vincze, E Ivany, A Varro, J G Papp, T Forster, A Farkas
Hyperventilation reduces partial pressure of CO2 (PCO2) in the blood, which results in hypokalaemia. Hypokalaemia helps the development of the life-threatening torsades de pointes type ventricular arrhythmia (TdP) evoked by repolarization delaying drugs. This implies that hyperventilation may assist the development of proarrhythmic events. Therefore, this study experimentally investigated the effect of hyperventilation on proarrhythmia development during delayed repolarization. Phenylephrine (an α1-adrenoceptor agonist) and clofilium (as a representative repolarization delaying agent inhibiting the rapid component of the delayed rectifier potassium current, IKr) were administered intravenously to pentobarbital-anaesthetized, mechanically ventilated, open chest rabbits...
October 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/27994859/primary-sclerosing-cholangitis-a-new-cause-of-distal-renal-tubular-acidosis
#3
Valentin Goutaudier, Ilan Szwarc, Jean-Emmanuel Serre, Georges-Philippe Pageaux, Àngel Argilés, Jean Ribstein
We describe the first case of distal renal tubular acidosis (dRTA) associated with primary sclerosing cholangitis. A 26-year-old Lao-Thai male patient presented with severe jaundice, metabolic acidosis and hypokalaemia. He was diagnosed of dRTA. Liver transplantation resulted in correction of electrolyte disturbances and hyperbilirubinaemia. A fludrocortisone-furosemide test revealed normal urinary acidification, demonstrating no residual dRTA. This observation suggests that dRTA may be an early manifestation of bilirubin-associated nephropathy or the consequence of an immune mechanism...
December 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27959472/polymer-based-oral-rehydration-solution-for-treating-acute-watery-diarrhoea
#4
REVIEW
Germana V Gregorio, Maria Liza M Gonzales, Leonila F Dans, Elizabeth G Martinez
BACKGROUND: Acute diarrhoea is one of the main causes of morbidity and mortality among children in low-income countries. Glucose-based oral rehydration solution (ORS) helps replace fluid and prevent further dehydration from acute diarrhoea. Since 2004, the World Health Organization (WHO) has recommended the osmolarity of less than 270 mOsm/L (ORS ≤ 270) versus greater than 310 mOsm/L formulation (ORS ≥ 310). Polymer-based ORS (for example, prepared using rice or wheat) slowly releases glucose and may be superior to glucose-based ORS...
December 13, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27957745/exploring-new-zealand-prescription-data-using-sequence-symmetry-analyses-for-predicting-adverse-drug-reactions
#5
P S Nishtala, T-Y Chyou
WHAT IS KNOWN AND OBJECTIVE: Prescription sequence symmetry analyses (PSSA) is a ubiquitous tool employed in pharmacoepidemiological research to predict adverse drug reactions (ADRs). Several studies have reported the advantage of PSSA as a method that can be applied to a large prescription database with computational ease. The objective of this study was to validate New Zealand (NZ) prescription database as a potential source for identifying ADRs using the PSSA method. METHODS: We analysed de-identified individual-level prescription data for people aged 65 years and above for the period 2005 to 2014 from the pharmaceutical collections supplied by the NZ Ministry of Health...
December 13, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27927710/adrenocortical-carcinoma-an-unusual-cause-of-secondary-hypertension
#6
Daniel Veron Esquivel, Fernando Batiz, Alfonso Farias Vega, Perla A Carrillo Gonzalez
We present the case of a female patient aged 39 years who was admitted to our hospital due to hypertension, severe hypokalaemia and metabolic alkalosis; physical examination was remarkable for plethoric moon face, centripetal obesity and bilateral lower extremity oedema. She was admitted for intravenous potassium replacement and further assessment of hypertension and associated clinical findings. Laboratory testing showed increased levels of aldosterone, renin, cortisol, testosterone and androstenedione. An abdominal CT revealed a large mass in the right adrenal gland with hepatic involvement...
December 7, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27914822/effects-of-sodium-thiosulfate-versus-observation-on-development-of-cisplatin-induced-hearing-loss-in-children-with-cancer-accl0431-a-multicentre-randomised-controlled-open-label-phase-3-trial
#7
David R Freyer, Lu Chen, Mark D Krailo, Kristin Knight, Doojduen Villaluna, Bonnie Bliss, Brad H Pollock, Jagadeesh Ramdas, Beverly Lange, David Van Hoff, Michele L VanSoelen, John Wiernikowski, Edward A Neuwelt, Lillian Sung
BACKGROUND: Sodium thiosulfate is an antioxidant shown in preclinical studies in animals to prevent cisplatin-induced hearing loss with timed administration after cisplatin without compromising the antitumour efficacy of cisplatin. The primary aim of this study was to assess sodium thiosulfate for prevention of cisplatin-induced hearing loss in children and adolescents. METHODS: ACCL0431 was a multicentre, randomised, open-label, phase 3 trial that enrolled participants at 38 participating Children's Oncology Group hospitals in the USA and Canada...
November 30, 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27905308/a-case-of-extreme-hypokalaemia
#8
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/27868385/impact-of-eplerenone-on-cardiovascular-outcomes-in-heart-failure-patients-with-hypokalaemia
#9
Patrick Rossignol, Nicolas Girerd, George Bakris, Orly Vardeny, Brian Claggett, John J V McMurray, Karl Swedberg, Henry Krum, Dirk J van Veldhuisen, Harry Shi, Sean Spanyers, John Vincent, Renaud Fay, Zohra Lamiral, Scott D Solomon, Faiez Zannad, Bertram Pitt
AIMS: Although hypokalaemia is common among patients with heart failure (HF), the prognostic significance of baseline hypokalaemia and hypokalaemia during follow-up in HF patients receiving a mineralocorticoid receptor antagonist (MRA) remains uncertain. METHODS AND RESULTS: Results of the EMPHASIS-HF trial in patients (n = 2737) with HF and reduced EF with mild symptoms, randomized to eplerenone or placebo, were analysed with regard to the presence or occurrence of hypokalaemia (serum K(+) <4...
November 20, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27857247/life-threatening-torsades-de-pointes-due-to-abiraterone-induced-hypokaelemia-in-a-patient-with-metastatic-prostate-cancer
#10
Afrasyab Khan, Barry Kneale
We present a case of a 77 year-old gentleman with previous coronary artery bypass grafting, admitted to hospital with recurrent torsades de pointes (TdP) due to abiraterone-induced hypokalaemia and prolonged QTc. The patient was on abiraterone and prednisone for metastatic prostate cancer. He required multiple defibrillations for recurrent TdP. Abiraterone is a relatively novel drug used in metastatic prostate cancer and we discuss this potential adverse effect and its management in this unusual presentation...
November 18, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27795825/usefulness-of-clinical-observations-and-blood-chemistry-values-for-predicting-clinical-outcomes-in-dairy-goats-with-pregnancy-toxaemia
#11
Miguel S Lima, Júlia M Silveira, Nuno Carolino, Luis P Lamas, Rita A Pascoal, Charles A Hjerpe
BACKGROUND: Pregnancy toxaemia (PT) is a disease that affects pregnant goats during their last month of gestation and is characterized by a high case fatality rate. This study involved 32 does maintained on a commercial dairy goat farm that were diagnosed with PT. A physical examination was performed on and haematology parameters obtained from each doe, at the time of diagnosis. The data from the 24 PT goats that died was compared with the corresponding data from the 8 PT goats that survived...
2016: Irish Veterinary Journal
https://www.readbyqxmd.com/read/27782749/lower-physical-fitness-in-patients-with-primary-aldosteronism-is-linked-to-the-severity-of-hypertension-and-kalaemia
#12
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/27766821/gitelman-syndrome-presenting-during-pregnancy-with-adverse-foetal-outcome
#13
N Nand, A R Deshmukh, R Mathur, V Chauhan, Brijlal
Gitelman syndrome (GS) is a rare autosomal recessive salt-losing tubulopathy. The incidence of Gitelman syndrome is 25 cases in 1 million among western population. This patient presented with loose stool, vomiting and sudden onset quadriparesis. Investigations revealed hypokalaemia, metabolic acidosis, hypomagnesaemia, hypocalciuria, hypermagnesuria. Symptoms and hypokalemia improved after starting oral magnesium and potassium supplements. But the patient again presented with symptomatic hypokalemia and delivered a still born foetus with hydrocephalus...
October 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27750339/-the-silent-killer-hyper-and-hypokalaemia
#14
Mark Dominik Alscher
The estimation of potassium in the serum is basis for the diagnosis of potassium disturbances. The value is a result of intake, excretion and internal distribution of potassium between intra- and extracellular compartments of the body. Clinically, we often see disturbances of potassium. The causes are explained by an aging population with morbidities that warrant diuretic treatment on the one side, and chronic kidney diseases on the other. In the first cases, we see hypokalaemia, in the latter hyperkalaemia...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27748541/a-novel-variant-in-the-slc12a1-gene-in-two-families-with-antenatal-bartter-syndrome
#15
Anders Breinbjerg, Charlotte Siggaard Rittig, Niels Gregersen, Søren Rittig, Jane Hvarregaard Christensen
AIM: Bartter syndrome is an autosomal-recessive inherited disease in which patients present with hypokalaemia and metabolic alkalosis. We present two apparently nonrelated cases with antenatal Bartter syndrome type I, due to a novel variant in the SLC12A1 gene encoding the bumetanide-sensitive sodium-(potassium)-chloride cotransporter 2 in the thick ascending limb of the loop of Henle. METHODS: Blood samples were received from the two cases and 19 of their relatives, and deoxyribonucleic acid was extracted...
January 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/27730793/ondansetron-induced-life-threatening-hypokalemia
#16
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/27635095/relationship-between-serum-total-magnesium-and-serum-potassium-in-emergency-surgical-patients-in-a-tertiary-hospital-in-ghana
#17
Robert Djagbletey, Brenda Phillips, Frank Boni, Christian Owoo, Ebenezer Owusu-Darkwa, Papa Kobina Gyakye deGraft-Johnson, Alfred E Yawson
INTRODUCTION: Potassium and magnesium are the two most abundant intra-cellular cations. They play pivotal roles in many essential biological processes. Deficiencies of these electrolytes are of clinical importance in hospitalised patients. AIM: To determine the relationship between serum total magnesium and potassium levels in adult patients requiring an emergency intra-abdominal surgery and the clinical utility of this relationship in the care of patients. METHODS: A cross sectional study was conducted over a five month period at the Korle-Bu Teaching Hospital...
June 2016: Ghana Medical Journal
https://www.readbyqxmd.com/read/27511444/radiofrequency-ablation-compared-with-laparoscopic-adrenalectomy-for-aldosterone-producing-adenoma
#18
S Y Liu, C M Chu, A P Kong, S K Wong, P W Chiu, F C Chow, E K Ng
BACKGROUND: Radiofrequency ablation (RFA) is an emerging treatment for primary aldosteronism owing to aldosterone-producing adenoma. Whether RFA could be an alternative treatment to laparoscopic adrenalectomy is unknown. METHODS: This was a retrospective comparative study in patients with aldosterone-producing adenoma undergoing either laparoscopic adrenalectomy or CT-guided percutaneous RFA between 2004 and 2012. Short-term outcomes and long-term resolution rates of primary aldosteronism (normalized aldosterone to renin ratio), hypokalaemia and hypertension (BP lower than 140/90 mmHg without antihypertensive medical therapy) were evaluated...
October 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27478593/kaliopenic-nephropathy-revisited
#19
Saban Elitok, Markus Bieringer, Wolfgang Schneider, Friedrich C Luft
In the 'older' literature, a definitive renal pathology was described in patients with long-standing hypokalaemia and depletion of the body's potassium reserves. The topic is relevant because possibly a quite cheaply reversible element in the course of chronic kidney disease progression could be addressed. Earlier, pathologists drew attention to vacuolar changes in renal tubular epithelium accompanied by inflammatory interstitial changes in patients with potassium losses. The diagnostic term 'kaliopenic nephropathy' was coined to describe such patients...
August 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27418967/short-term-mortality-risk-of-serum-potassium-levels-in-acute-heart-failure-following-myocardial-infarction
#20
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
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