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https://www.readbyqxmd.com/read/28099643/balanced-crystalloids-for-septic-shock-resuscitation
#1
Thiago Domingos Corrêa, Alexandre Biasi Cavalcanti, Murillo Santucci Cesar de Assunção
Timely fluid administration is crucial to maintain tissue perfusion in septic shock patients. However, the question concerning which fluid should be used for septic shock resuscitation remains a matter of debate. A growing body of evidence suggests that the type, amount and timing of fluid administration during the course of sepsis may affect patient outcomes. Crystalloids have been recommended as the first-line fluids for septic shock resuscitation. Nevertheless, given the inconclusive nature of the available literature, no definitive recommendations about the most appropriate crystalloid solution can be made...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28094030/glucocorticoid-induced-leucine-zipper-protein-regulates-sodium-and-potassium-balance-in-the-distal-nephron
#2
Priyanka Rashmi, GianLuca Colussi, Michael Ng, Xinhao Wu, Atif Kidwai, David Pearce
Glucocorticoid induced leucine zipper protein (GILZ) is an aldosterone-regulated protein that controls sodium transport in cultured kidney epithelial cells. Mice lacking GILZ have been reported previously to have electrolyte abnormalities. However, the mechanistic basis has not been explored. Here we provide evidence supporting a role for GILZ in modulating the balance of renal sodium and potassium excretion by regulating the sodium-chloride cotransporter (NCC) activity in the distal nephron. Gilz(-/-) mice have a higher plasma potassium concentration and lower fractional excretion of potassium than wild type mice...
January 13, 2017: Kidney International
https://www.readbyqxmd.com/read/28091865/improving-the-diagnostic-workup-of-hyponatremia-in-the-setting-of-kidney-disease-a-continuing-medical-education-cme-initiative
#3
Ladan Golestaneh, Joel Neugarten, William Southern, Faraj Kargoli, Amanda Raff
PURPOSE: Hyponatremia is a common electrolyte disorder and is associated with mortality. We examined the frequency of appropriate testing in response to an episode of inpatient hyponatremia in a large urban hospital to better inform our educational intervention. We then evaluated the impact of a live CME activity with a focus on CKD- and ESRD-associated hyponatremia physiology, on diagnostic practices of audience hospitalist attendings. METHODS: We performed a retrospective database analysis of all patients admitted to Montefiore Medical Center in 2014 to examine the performance of hospital staff in response to hyponatremia across all CKD stages...
January 13, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28090568/pathophysiology-of-intestinal-na-h-exchange
#4
Michael A Gurney, Daniel Laubitz, Fayez K Ghishan, Pawel R Kiela
Several members of the SLC9A family of Na(+)/H(+) exchangers are expressed in the gut, with varying expression patterns and cellular localization. Not only do they participate in the regulation of basic epithelial cell functions, including control of transepithelial Na(+) absorption, intracellular pH (pH i ), cell volume, and nutrient absorption, but also in cellular proliferation, migration, and apoptosis. Additionally, they modulate the extracellular milieu in order to facilitate other nutrient absorption and to regulate the intestinal microbial microenvironment...
January 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28090048/hyponatremia-in-an-elderly-patient-due-to-isolated-hypoaldosteronism-occurring-after-licorice-withdrawal
#5
Yuji Hataya, Akifumi Oba, Takafumi Yamashita, Yasato Komatsu
Hyponatremia is one of the most common electrolyte disorders encountered in the elderly. We present the case of an 81-year-old man who developed hyponatremia due to isolated hypoaldosteronism occurring after licorice withdrawal. He had severe hypokalemia with hypertension and was diagnosed with pseudoaldosteronism. He had been taking a very small dose of licorice as a mouth refresher since his early adulthood. Five months after licorice withdrawal, he developed hypovolemic hyponatremia, which was resolved with administration of fludrocortisone acetate...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28073139/-influence-of-comorbidities-on-revision-rate-within-the-first-year-after-primary-total-hip-arthroplasty
#6
Roman Nesslage, Kerstin Radtke, Lisa Hohloch, Thilo Flörkemeier, Henning Windhagen, Gabriela von Lewinski
: Background Total hip arthroplasty (THA) is very frequently performed. Despite low complication rates, revisions play an important clinical and economical role. The aim of this study was to identify comorbid diseases of patients undergoing primary THA and their potential influence on the survival of hip replacements. Patients/Material and Methods A total of 867 patients were included in this retrospective study. All revisions were reviewed that took place at our hospital within one year of primary implantation of THA...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28069320/mild-induced-hypothermia-for-patients-with-severe-traumatic-brain-injury-after-decompressive-craniectomy
#7
Chunhai Tang, Yun Bao, Min Qi, Lizhi Zhou, Fan Liu, Jian Mao, Qingmei Lei, Songtao Qi, Binghui Qiu
PURPOSE: To evaluate the efficacy and safety of mild induced hypothermia for intracranial hypertension in patients with traumatic brain injury after decompressive craniectomy. METHODS: A total of 60 adults with intracranial pressure (ICP) of more than 20 mm Hg after decompressive craniectomy were randomly assigned to standard care (control group) or hypothermia (32°C-35°C) plus standard care. Then, ICP, cerebral perfusion pressure, Glasgow Outcome Scale score, and complications were assessed...
December 29, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28043617/bedaquiline-in-the-multidrug-resistant-tuberculosis-treatment-belarus-experience
#8
Alena Skrahina, Hennadz Hurevich, Dennis Falzon, Liudmila Zhilevich, Valiantsin Rusovich, Masoud Dara, Svetlana Setkina
BACKGROUND/OBJECTIVE: Outcomes of treatment for multidrug-resistant tuberculosis (MDR-TB) remain poor worldwide. Among patients with MDR-TB in Belarus who started treatment in 2012, only 54% completed it successfully, with treatment failure reported in 22% of the patients; additionally, 11% died and 13% were lost to follow-up or remained unevaluated. In Belarus, to improve outcomes, bedaquiline was introduced in MDR-TB treatment in June 2015. The national TB program developed measures to monitor safety and effectiveness of bedaquiline-containing regimens in line with the World Health Organization recommendations...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28029538/an-unusual-etiology-of-hypokalemia-in-a-patient-with-an-eating-disorder
#9
Kelly A Curran, Amy B Middleman
Patients with eating disorders are at risk for electrolyte imbalances that can lead to life-threatening complications. Timely recognition and evaluation of electrolyte abnormalities, including hypokalemia, are essential. In this case report, we describe an uncommon etiology of hypokalemia in a patient with disordered eating.
October 28, 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28029394/non-anion-gap-metabolic-acidosis-a-clinical-approach%C3%A2-to%C3%A2-evaluation
#10
Mandana Rastegar, Glenn T Nagami
Acid-base disturbances can result from kidney or nonkidney disorders. We present a case of high-volume ileostomy output causing large bicarbonate losses and resulting in a non-anion gap metabolic acidosis. Non-anion gap metabolic acidosis can present as a form of either acute or chronic metabolic acidosis. A complete clinical history and physical examination are critical initial steps to begin the evaluation process, followed by measuring serum electrolytes with a focus on potassium level, blood gas, urine pH, and either direct or indirect urine ammonium concentration...
October 28, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28025645/clinical-and-laboratory-features-of-acute-porphyria-a-study-of-36-subjects-in-a-chinese-tertiary-referral-center
#11
Jing Yang, Qianlong Chen, Hang Yang, Baolai Hua, Tienan Zhu, Yongqiang Zhao, Huadong Zhu, Xuezhong Yu, Li Zhang, Zhou Zhou
Porphyria is a group of eight metabolic disorders characterized by defects in heme biosynthesis. The presentation of porphyria is highly variable, and the symptoms are nonspecific, which accounts in part for delays in establishing a diagnosis. In this study, we report the characteristics of 36 Chinese acute porphyria patients. Most of them were female (33/36), and the median age was 25.3 years (range 18-45 years). The most frequent presenting symptom was abdominal pain (32/36). Hyponatremia was the most common electrolyte abnormality (29/36), and the serum sodium concentration was significantly negatively correlated with convulsion (p = 0...
2016: BioMed Research International
https://www.readbyqxmd.com/read/28012118/risk-factors-for-qtc-prolongation-systematic-review-of-the-evidence
#12
Eline Vandael, Bert Vandenberk, Joris Vandenberghe, Rik Willems, Veerle Foulon
Background QTc-interval prolongation has been associated with serious adverse events, such as Torsade de Pointes and sudden cardiac death. In the prevention of QTc-prolongation, special attention should go to high-risk patients. Aim of the review The aim of this review is to summarize and assess the evidence for different risk factors for QTc-prolongation (demographic factors, comorbidities, electrolytes, QTc-prolonging medication). Methods Potential studies were retrieved based on a systematic search of articles published until June 2015 in the databases Medline and Embase...
December 23, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28003191/calcineurin-inhibitor-cyclosporine-a-activates-renal-na-k-cl-cotransporters-via-local-and-systemic-mechanisms
#13
Katharina Ilse Blankenstein, Aljona Borschewski, Robert Labes, Alexander Paliege, Christin Boldt, James A McCormick, David H Ellison, Michael Bader, Sebastian Bachmann, Kerim Mutig
Calcineurin dephosphorylates NFAT transcription factors, thereby facilitating T-cell mediated immune responses. Calcineurin inhibitors are instrumental for immunosuppression after organ transplantation, but may cause side effects including hypertension and electrolyte disorders. Kidneys were recently shown to display activation of the furosemide-sensitive Na-K-2Cl cotransporter (NKCC2) of the thick ascending limb and the thiazide-sensitive Na-Cl cotransporter (NCC) of the distal convoluted tubule upon calcineurin inhibition using cyclosporin A (CsA)...
December 21, 2016: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/27998859/-effect-of-magnesium-sulphate-infusion-on-emergence-agitation-in-patients-undergoing-esophageal-carcinoma-with-general-anesthesia-a-randomized-double-blind-controlled-trial
#14
Min Xie, Xiang-Kui Li, Jie Chen
OBJECTIVE: To evaluate the safety and effectiveness of magnesium sulphate for reducing the incidence of the emergence agitation in patients undergoing surgery for esophageal carcinoma with general anesthesia. METHODS: This randomized, double-blind, controlled clinical trial was conducted in patients undergoing elective radical resection of esophageal carcinoma in Sichuan Provincial People's Hospital between October, 2015 and March, 2016. The patients underwent surgeries under general intravenous anesthesia, and after anesthesia induction, the patients were infused with magnesium sulphate at the rate of 0...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27995392/abnormal-barrier-function-in-gastrointestinal-disorders
#15
Ricard Farré, María Vicario
There is increasing concern in identifying the mechanisms underlying the intimate control of the intestinal barrier, as deregulation of its function is strongly associated with digestive (organic and functional) and a number of non-digestive (schizophrenia, diabetes, sepsis, among others) disorders. The intestinal barrier is a complex and effective defensive functional system that operates to limit luminal antigen access to the internal milieu while maintaining nutrient and electrolyte absorption. Intestinal permeability to substances is mainly determined by the physicochemical properties of the barrier, with the epithelium, mucosal immunity, and neural activity playing a major role...
December 20, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27987266/neuroimaging-of-chronic-alcohol-misuse
#16
REVIEW
Caitriona Logan, Hamed Asadi, Hong Kuan Kok, Seamus T Looby, Paul Brennan, Alan O'Hare, John Thornton
Alcohol is one of the most commonly abused substances worldwide. It results in a wide range of diseases and disorders affecting many organ systems. Alcohol-related nutritional deficiencies and electrolyte disturbance leave chronic abusers at risk of a range of demyelinating conditions to which the radiologist and clinician should always be alert. These include Wernicke's encephalopathy, Korsakoff's syndrome, Marchiafava-Bignami disease and osmotic demyelination. Cerebral volume loss is also a commonly encountered neuroimaging phenomenon in chronic alcohol abusers...
December 16, 2016: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/27976879/oxide-ion-conductivity-in-the-hexagonal-perovskite-derivative-ba3monbo8-5
#17
Sacha Fop, Janet M S Skakle, Abbie C McLaughlin, Paul A Connor, John T S Irvine, Ronald I Smith, Eve J Wildman
Oxide ion conductors are important materials with a range of technological applications and are currently used as electrolytes for solid oxide fuel cells and solid oxide electrolyzer cells. Here we report the crystal structure and electrical properties of the hexagonal perovskite derivative Ba3MoNbO8.5. Ba3MoNbO8.5 crystallizes in a hybrid of the 9R hexagonal perovskite and palmierite structures. This is a new and so far unique crystal structure that contains a disordered distribution of (Mo/Nb)O6 octahedra and (Mo/Nb)O4 tetrahedra...
December 28, 2016: Journal of the American Chemical Society
https://www.readbyqxmd.com/read/27975067/hyperlactatemia-and-the-outcome-of-type-2-diabetic-patients-suffering-acute-myocardial-infarction
#18
Jovanovic Aleksandar, Peric Vladan, Snezana Markovic-Jovanovic, Radojica Stolic, Jadranka Mitic, Tanja Smilic
Background. Increased lactate production is frequent in unregulated/complicated diabetes mellitus. Methods. Three groups, each consisting of 40 patients (type 2 diabetics with myocardial infarction, DM+AMI, nondiabetics suffering myocardial infarction, MI, and diabetics with no apparent cardiovascular pathology, DM group), were tested for pH, serum bicarbonate and electrolytes, blood lactate, and CK-MB. Results. Blood lactate levels were markedly higher in AMI+DM compared to MI group (4.54 ± 1.44 versus 3...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27966545/the-novel-homozygous-kcnj10-c-986t-c-p-leu329pro-variant-is-pathogenic-for-the-sesame-east-homologue-in-malinois-dogs
#19
Mario Van Poucke, Kimberley Stee, Sofie F M Bhatti, An Vanhaesebrouck, Leslie Bosseler, Luc J Peelman, Luc Van Ham
SeSAME/EAST syndrome is a multisystemic disorder in humans, characterised by seizures, sensorineural deafness, ataxia, developmental delay and electrolyte imbalance. It is exclusively caused by homozygous or compound heterozygous variations in the KCNJ10 gene. Here we describe a similar syndrome in two families belonging to the Malinois dog breed, based on clinical, neurological, electrodiagnostic and histopathological examination. Genetic analysis detected a novel pathogenic KCNJ10 c.986T>C (p.(Leu329Pro)) variant that is inherited in an autosomal recessive way...
December 14, 2016: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/27964714/diuretic-and-antioxidant-activities-of-the-aqueous-extract-of-leaves-of-vepris-heterophylla-engl-r-let-rutaceae-in-rats
#20
Fidèle Ntchapda, Christian Bonabe, David Romain Kemeta Azambou, Emmanuel Talla, Théophile Dimo
BACKGROUND: Vepris heterophylla (Rutaceae) is a medicinal plant used empirically in African traditional medicine for many clinical conditions including edematous disorders and hypertension. V. heterophylla aqueous extract has been used in northern part of Cameroon by traditional healers for the treatment of arterial hypertension. The study aim was to assess the putative diuretic and antioxidant properties of V. heterophylla leaves aqueous extract. METHODS: Adult rats were administered with V...
December 13, 2016: BMC Complementary and Alternative Medicine
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