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https://www.readbyqxmd.com/read/28630226/thyrotoxic-periodic-paralysis-as-an-initial-presentation-of-graves-disease-in-a-saudi-patient
#1
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/28619768/liquorice-induced-hypokalaemia-in-patients-treated-with-yokukansan-preparations-identification-of-the-risk-factors-in-a-retrospective-cohort-study
#2
Saori Shimada, Tetsuaki Arai, Akira Tamaoka, Masato Homma
OBJECTIVE: To evaluate serum potassium levels and rates of hypokalaemia in patients treated with liquorice-containing Japanese traditional Kampo-medicines Yokukansan (YK) and Yokukansan-ka-chinpihange (YKCH). DESIGN: Retrospective cohort study. SETTING: Patients receiving YK preparations for dementia and other psychiatric disorders in the University of Tsukuba Hospital in Japan. PARTICIPANTS: 389 patients (male/female: 174/215, 68...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28587906/-early-hypophosphataemia-in-at-risk-newborns-frequency-and-magnitude
#3
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/28586600/liddle-s-syndrome
#4
Danish Abdul Aziz, Fozia Memon, Arshalooz Rahman, Madiha Ali
Hypertension in paediatric age group is commonly secondary to a known cause. It is crucial to identify the cause of hypertension and treat it before development of any associated complications to prevent morbidity and mortality. Paediatric Hypertension is one of the important clinical finding in a child with certain clinical syndrome. We are presenting a case of a 10 month old child presenting with hypertension and hypokalaemia, after excluding all identifiable causes and her positive response to therapy, that is amiloride, along with supportive biochemical data she was diagnosed as a case of monogenic type of hypertension known as Liddle's syndrome...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28586591/celiac-crisis-a-rare-or-rarely-recognized-disease
#5
Nadia Waheed, Huma Arshad Cheema, Hassan Suleman, Zafar Fayyaz, Iqra Mushtaq, Muhammad, Almas Hashmi
OBJECTIVE: 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
#6
Marianne Elston, Veronica Crawford, Michael Swarbrick, Michael Dray, Michelle Head, John V Conaglen
Cushings 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 man presented with profound hypokalaemia, oedema and new onset hypertension. He reported two weeks of weight gain, muscle weakness, labile mood and insomnia...
June 5, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28575414/randomized-comparison-of-liposomal-amphotericin-b-versus-placebo-to-prevent-invasive-mycoses-in-acute-lymphoblastic-leukaemia
#7
Oliver A Cornely, Thibaut Leguay, Johan Maertens, Maria J G T Vehreschild, Achilles Anagnostopoulos, Carlo Castagnola, Luisa Verga, Christina Rieger, Mustafa Kondakci, Georg Härter, Rafael F Duarte, Bernardino Allione, Catherine Cordonnier, Claus Peter Heussel, C Orla Morrissey, Samir G Agrawal, J Peter Donnelly, Mark Bresnik, Michael J Hawkins, Will Garner, Nicola Gökbuget
Objectives: To prevent invasive fungal disease (IFD) in adult patients undergoing remission-induction chemotherapy for newly diagnosed acute lymphoblastic leukaemia (ALL). Patients and methods: In a double-blind multicentre Phase 3 study, patients received prophylactic liposomal amphotericin B (L-AMB) at 5 mg/kg intravenously or placebo twice weekly in a 2:1 random allocation during remission-induction treatment. The primary endpoint was the development of proven or probable IFD...
May 30, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28567198/biochemical-derangements-prior-to-emergency-laparotomy-at-queen-elizabeth-central-hospital-blantyre-malawi-a-cross-sectional-pilot-study
#8
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/28549783/irinotecan-temozolomide-with-temsirolimus-or-dinutuximab-in-children-with-refractory-or-relapsed-neuroblastoma-cog-anbl1221-an-open-label-randomised-phase-2-trial
#9
Rajen Mody, Arlene Naranjo, Collin Van Ryn, Alice L Yu, Wendy B London, Barry L Shulkin, Marguerite T Parisi, Sabah-E-Noor Servaes, Mitchell B Diccianni, Paul M Sondel, Julia G Bender, John M Maris, Julie R Park, Rochelle Bagatell
BACKGROUND: Outcomes for children with relapsed and refractory neuroblastoma are dismal. The combination of irinotecan and temozolomide has activity in these patients, and its acceptable toxicity profile makes it an excellent backbone for study of new agents. We aimed to test the addition of temsirolimus or dinutuximab to irinotecan-temozolomide in patients with relapsed or refractory neuroblastoma. METHODS: For this open-label, randomised, phase 2 selection design trial of the Children's Oncology Group (COG; ANBL1221), patients had to have histological verification of neuroblastoma or ganglioneuroblastoma at diagnosis or have tumour cells in bone marrow with increased urinary catecholamine concentrations at diagnosis...
May 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28546546/elevated-baseline-potassium-level-within-reference-range-is-associated-with-worse-clinical-outcomes-in-hospitalised-patients
#10
Sehoon Park, Seon Ha Baek, Sung Woo Lee, Anna Lee, Ho Jun Chin, Ki Young Na, Yon Su Kim, Dong-Wan Chae, Jin Suk Han, Sejoong Kim
The clinical significance of elevated baseline serum potassium (K(+)) levels in hospitalised patients is rarely described. Hence, we performed a retrospective study assessing the significance of elevated K(+) levels in a one-year admission cohort. Adult patients without hypokalaemia or end-stage renal disease were included. Adverse outcomes were all-cause mortality, hospital-acquired acute kidney injury, and events of arrhythmia. In total, 17,777 patients were included in the study cohort, and a significant difference (P < 0...
May 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28543529/kir2-1-and-k2p1-channels-reconstitute-two-levels-of-resting-membrane-potential-in-cardiomyocytes
#11
Dongchuan Zuo, Kuihao Chen, Min Zhou, Zheng Liu, Haijun Chen
Strong inward rectifier K(+) (Kir2) channels primarily maintain normal resting membrane potential of cardiomyocytes. In sub-physiological extracellular K(+) concentrations or pathological hypokalaemia, human cardiomyocytes show both hyperpolarized and depolarized resting membrane potentials; these depolarized potentials cause cardiac arrhythmia; however, the underlying mechanism is unknown. Here we show that Kir2.1 currents non-linearly counterbalance hypokalaemia-induced K2P1 leak cation currents, reconstituting two levels of resting membrane potential in cardiomyocytes...
May 24, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28541499/hypertension-and-cardiac-arrhythmias-executive-summary-of-a-consensus-document-from-the-european-heart-rhythm-association-ehra-and-esc-council-on-hypertension-endorsed-by-the-heart-rhythm-society-hrs-asia-pacific-heart-rhythm-society-aphrs-and-sociedad-latinoamericana
#12
Gregory Y H Lip, Antonio Coca, Thomas Kahan, Giuseppe Boriani, Antonis S Manolis, Michael Hecht Olsen, Ali Oto, Tatjana S Potpara, Jan Steffel, Francisco Marín, Márcio Jansen de Oliveira Figueiredo, Giovanni de Simone, Wendy S Tzou, Chern En Chiang, Bryan Williams
Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in HTN patients, especially in those with left ventricular hypertrophy (LVH), CAD, or HF. In addition, high doses of thiazide diuretics commonly used to treat HTN, may result in electrolyte abnormalities (e...
June 20, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28520883/effect-of-isotonic-versus-hypotonic-maintenance-fluid-therapy-on-urine-output-fluid-balance-and-electrolyte-homeostasis-a-crossover-study-in-fasting-adult-volunteers
#13
N Van Regenmortel, T De Weerdt, A H Van Craenenbroeck, E Roelant, W Verbrugghe, K Dams, M L N G Malbrain, T Van den Wyngaert, P G Jorens
Background.: Daily and globally, millions of adult hospitalized patients are exposed to maintenance i.v. fluid solutions supported by limited scientific evidence. In particular, it remains unclear whether fluid tonicity contributes to the recently established detrimental effects of fluid, sodium, and chloride overload. Methods.: This crossover study consisted of two 48 h study periods, during which 12 fasting healthy adults were treated with a frequently prescribed solution (NaCl 0...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28500918/experience-using-high-dose-glucose-insulin-potassium-gik-in-critically-ill-patients
#14
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/28495809/comparison-of-enteral-versus-intravenous-potassium-supplementation-in-hypokalaemia-in-paediatric-patients-in-intensive-care-post-cardiac-surgery-open-label-randomised-equivalence-trial-eips
#15
Naveed Ur Rehman Siddiqu, Quratulain Merchant, Babar S Hasan, Arjumand Rizvi, Muneer Amanullah, Amina Rehmat, Anwarul Ul Haq
OBJECTIVES: The primary objective was to compare the efficacy of enteral potassium replacement (EPR) and intravenous potassium replacement (IVPR) as first-line therapy. Secondary objectives included comparison of adverse effects and number of doses required to resolve the episode of hypokalaemia. TRIAL DESIGN: The EIPS trial is designed as a randomised, equivalence trial between two treatment arms. STUDY SETTING: The study was conducted at the paediatric cardiac intensive care unit (PCICU) at Aga Khan University Hospital, Karachi...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28495639/safety-and-tolerability-of-the-first-in-class-agent-cpi-613-in-combination-with-modified-folfirinox-in-patients-with-metastatic-pancreatic-cancer-a-single-centre-open-label-dose-escalation-phase-1-trial
#16
Angela Alistar, Bonny B Morris, Rodwige Desnoyer, Heidi D Klepin, Keyanoosh Hosseinzadeh, Clancy Clark, Amy Cameron, John Leyendecker, Ralph D'Agostino, Umit Topaloglu, Lakmal W Boteju, Asela R Boteju, Rob Shorr, Zuzana Zachar, Paul M Bingham, Tamjeed Ahmed, Sandrine Crane, Riddhishkumar Shah, John J Migliano, Timothy S Pardee, Lance Miller, Gregory Hawkins, Guangxu Jin, Wei Zhang, Boris Pasche
BACKGROUND: Pancreatic cancer statistics are dismal, with a 5-year survival of less than 10%, and more than 50% of patients presenting with metastatic disease. Metabolic reprogramming is an emerging hallmark of pancreatic adenocarcinoma. CPI-613 is a novel anticancer agent that selectively targets the altered form of mitochondrial energy metabolism in tumour cells, causing changes in mitochondrial enzyme activities and redox status that lead to apoptosis, necrosis, and autophagy of tumour cells...
May 8, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28487303/female-phenotype-with-male-karyotype-a-clinical-enigma
#17
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
#18
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
#19
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/28446151/novel-mutation-in-the-slc12a3-gene-in-a-sri-lankan-family-with-gitelman-syndrome-coexistent-diabetes-a-case-report
#20
Chandrika Jayakanthi Subasinghe, Nirmala Dushyanthi Sirisena, Chula Herath, Knut Erik Berge, Trond Paul Leren, Uditha Bulugahapitiya, Vajira Harshadeva Weerabaddana Dissanayake
BACKGROUND: Gitelman syndrome (GS) is a rare autosomal recessively inherited salt-wasting tubulopathy associated with mutations in the SLC12A3 gene, which encodes for NaCl cotransporter (NCC) in the kidney. CASE PRESENTATION: In this report, we describe two siblings from a Sri Lankan non-consanguineous family presenting with hypokalaemia associated with renal potassium wasting, hypomagnesemia, hypocalciuria and hypereninemic hyperaldosteronism with normal blood pressure...
April 26, 2017: BMC Nephrology
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