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Sodium osmolality

T Ravindran, Paneerselvam, Radha, T Allwyn Yabesh
Osmotic demyelination syndrome is an acute shift in serum osmolality causing demyelination, which may be due to rapid correction of hyponatremia, hyperglycaemia, hypokalemia and ketoacidosis. We present a case of 55yr old female and a known diabetic presented with the choreic movements involving left upper and lower limb for 2 days without any weakness.Her blood sugar was 428mg/dl at the time of admission with wide fluctuations.Her CT Brain showed hyperdensity in the right basal ganglia and the MRI brain showed hyperintense lesion in T2 weighted images showing features suggestive of osmotic demyelination...
April 2016: Journal of the Association of Physicians of India
Tory J Andrews, Robert D Cox, Christina Parker, James Kolb
BACKGROUND: Sodium-glucose cotransporter-2 (SGLT2) inhibitor medications are a class of antihyperglycemic agents that increase urinary glucose excretion by interfering with the reabsorption of glucose in the proximal renal tubules. In May of 2015, the U.S. Food and Drug Administration released a warning concerning a potential increased risk of ketoacidosis and ketosis in patients taking these medications. CASE REPORT: We present a case of a 57-year-old woman with type 2 diabetes mellitus taking a combination of canagliflozin and metformin who presented with progressive altered mental status over the previous 2 days...
October 4, 2016: Journal of Emergency Medicine
Maulee Hiromi Arambewela, Noel P Somasundaram, Chaminda Garusinghe
BACKGROUND: Hypernatremia is a frequent occurrence among hospitalized patients. Severe hypernatremia is associated with mortality rates of over 60 %. Extreme hypernatremia, defined as sodium levels >190 mmol/l, is a rare occurrence. The literature on electrocardiographic changes occurring with this degree of hypernatremia is extremely scarce. We report the case of an 11-year-old Sri Lankan girl who presented with sodium levels of 226 mmol/l following infusion with 3 % hypertonic saline who developed diffuse QT prolongation leading to fatal ventricular tachycardia...
October 1, 2016: Journal of Medical Case Reports
Tim Heise, Jens Jordan, Christoph Wanner, Martina Heer, Sreeraj Macha, Michaela Mattheus, Søren S Lund, Hans J Woerle, Uli C Broedl
PURPOSE: Our aim was to investigate the effects of the sodium glucose cotransporter 2 inhibitor empagliflozin on urinary and serum glucose and electrolytes, urinary volume, osmolality, and the renin-angiotensin system in patients with type 2 diabetes. METHODS: In an open-label study, 22 patients receiving metformin (median age 56 years; range 40-65 years) received empagliflozin 25 mg once daily for 5 days. Food, fluid, and sodium intake were standardized for 3 days before and during treatment...
September 28, 2016: Clinical Therapeutics
Marta Kuczeriszka, Leszek Dobrowolski, Agnieszka Walkowska, Janusz Sadowski
BACKGROUND: Purine P2X and P2Y receptors (P2-R) are involved in control of renal circulation, especially in the medulla, wherein they appear to interact with angiotensin II (Ang II). Our experimental approach enabled examination of interaction with Ang II per se, in the absence of blood pressure elevation. In this whole-kidney functional study we focused on the influence of P2X1-R on perfusion of the renal medulla. METHODS: Acute experiments were conducted with normal rats, untreated or subjected to two weeks' infusion of Ang II (osmotic minipumps)...
August 1, 2016: Pharmacological Reports: PR
Xuming Sun, Ellen Tommasi, Doris Molina, Renu Sah, K Bridget Brosnihan, Debra I Diz, Snezana Petrovic
Diets rich in grains and meat and low in fruits and vegetables (acid-producing diets) associate with incident hypertension, whereas vegetarian diets associate with lower blood pressure (BP). However, the pathways that sense and mediate the effects of acid-producing diets on BP are unknown. Here, we examined the impact of the deletion of an acid sensor GPR4 on BP. GPR4 is a proton-sensing, G protein-coupled receptor and an acid sensor in brain, kidney and blood vessels. We found that GPR4 mRNA was higher in subfornical organ (SFO) than other brain regions...
September 28, 2016: American Journal of Physiology. Renal Physiology
Osama W Amro, Jessica K Paulus, Farzad Noubary, Ronald D Perrone
BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) affects millions of people worldwide. Vasopressin promotes disease progression. STUDY DESIGN: A randomized controlled trial with equal (1:1) allocation. SETTING & PARTICIPANTS: This trial examined the effect of combining a low-osmolar (low-sodium [1,500mg/d], low-protein [0.8g per kilogram of body weight]) diet and adjusted water intake on vasopressin secretion in 34 patients with ADPKD...
September 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Hafiz Muhammad Sharjeel Arshad, Aleida Rodriguez, Faten Suhail
Background. The Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is considered to be the most common cause of euvolemic hyponatremia. The most common malignancy associated with SIADH is small cell lung cancer. We present a rare case of a patient with SIADH secondary to well differentiated squamous cell carcinoma of the naso-oropharynx. Case. A 46-year-old Caucasian woman presented to emergency department with four-week history of progressive dysphagia. On examination, she was found to have a pharyngeal mass...
2016: Case Reports in Nephrology
Mahavir Singh, Poonam Yadav, Anshu Sharma, V K Garg, Dinesh Mittal
The milk samples from buffaloes of Murrah breed at mid lactation stage, reared at an organised dairy farm, were screened for subclinical mastitis based on bacteriological examination and somatic cell count following International Dairy Federation criteria. Milk samples from subclinical mastitis infected and healthy buffaloes were analysed to evaluate physicochemical alterations in terms of protein, fat, pH, electrical conductivity, chloride, minerals (sodium, potassium and calcium) and trace elements (iron, zinc, copper and selenium)...
September 9, 2016: Biological Trace Element Research
Seunghun Ock, Sion Jo, Jae Baek Lee, Youngho Jin, Taeoh Jeong, Jaechol Yoon, Boyoung Park
BACKGROUND: Hyperglycemia and hyperosmolality are associated with poor outcomes among acute ischemic stroke (AIS) patients. OBJECTIVES: We evaluated the association between hyperglycemia and hyperosmolality, as a combination measure, with poor outcome among AIS patients. METHODS: We conducted a retrospective study of AIS patients admitted to the study hospital emergency department between January and December 2014. Hyperglycemia was defined as serum glucose >144 mg/dL, and hyperosmolality was defined as a serum osmolality >295 mOsm/kg...
August 27, 2016: American Journal of Emergency Medicine
Mustafa A Tatlisu, Adnan Kaya, Muhammed Keskin, Osman Uzman, Edibe B Borklu, Goksel Cinier, Mert I Hayiroglu, Kiymet Tatlisu, Mehmet Eren
BACKGROUND: The aim of this study was to investigate the association of plasma osmolality with all-cause mortality in ST-segment elevation myocardial infarction (STEMI) patients treated with a primary percutaneous coronary intervention. METHODS: This study included 3748 patients (mean age 58.3±11.8 years, men 81%) with STEMI treated with primary percutaneous coronary intervention. The following formula was used to measure the plasma osmolality at admission: osmolality=1...
September 7, 2016: Coronary Artery Disease
Min Jeong Han, Soon Chul Kim, Chan Uhng Joo, Sun Jun Kim
RATIONALE FOR THIS CASE REPORT: Cerebral Salt-Wasting Syndrome (CSWS) is characterized by hyponatremia and sodium wasting in the urine. These conditions are triggered by various neurosurgical disorders such as subarachnoid hemorrhage, brain tumor, head injury, and brain surgery. To our knowledge, CSWS caused by Wernicke encephalopathy (WE) has been rarely reported. PRESENTING CONCERNS OF THE PATIENT: A 2-year-old male patient presented to our hospital due to a seizure attack...
September 2016: Medicine (Baltimore)
Kamel S Kamel, Martin Schreiber, Ana P C P Carlotti, Mitchell L Halperin
Diabetic ketoacidosis (DKA), a common cause of severe metabolic acidosis, remains a life-threatening condition due to complications of both the disease and its treatment. This Acid-Base and Electrolyte Teaching Case discusses DKA management, emphasizing complications of treatment. Because cerebral edema is the most common cause of mortality and morbidity, especially in children with DKA, we emphasize its pathophysiology and implications for therapy. The risk for cerebral edema may be minimized by avoiding a bolus of insulin, excessive saline resuscitation, and a decrease in effective plasma osmolality early in treatment...
September 3, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Mari Ohtaka, Yusuke Hattori, Yohei Kumano, Yoko Maeda, Takuya Kondo, Taku Mochizuki, Takashi Kawahara, Jun-Ichi Teranishi, Yasuhide Miyoshi, Yasushi Yumura, Hiroji Uemura
Hyponatremia is one of the common electrolyte disorders associated with cisplatin (CDDP) administration. We report here two cases of hyponatremia associated with CDDP. Case 1 : A 75-year-old man with urothelial carcinoma of bladder (cT3N1M0) underwent neoadjuvant chemotherapy with CDDP and gemcitabine. He lost consciousness on the eighth day after the chemotherapy. Blood tests showed severe hyponatremia (Na 113 mEq/l), low plasma osmolality and high level of plasma vasopressin. Urine tests showed low osmolality...
July 2016: Hinyokika Kiyo. Acta Urologica Japonica
E M Crane, J C Munro, S L Bourgon, M Diel de Amorim, R Ventura, A H Fredeen, Y R Montanholi
Haematological metabolic profiles in heifers could contribute to the development of proxies for oestrous detection and provide clues to further characterize biological changes during oestrus. One hundred and seven beef heifers were observed for oestrous behaviour twice daily for 124 days. Feed intake and productive performance (body weight and composition) traits were measured, and feed efficiency was determined using residual feed intake (kg DM/day). Blood plasma samples were collected when signs of oestrus were observed and every 30 ± 2 days...
October 2016: Reproduction in Domestic Animals, Zuchthygiene
Nadine G Haddad, Zeina M Nabhan, Erica A Eugster
OBJECTIVE: Polydipsia and polyuria are a common reason for referral to the Pediatric Endocrine clinic. In the absence of hyperglycemia, diabetes insipidus (DI) should be considered. The objectives of the study were to determine the prevalence of central DI in a group of children presenting for evaluation of polydipsia and polyuria, and to determine if predictive features were present in patients in whom the diagnosis of DI was made. METHODS: The study was a retrospective chart review of children presenting to the Endocrine clinic with complaints of polydipsia and polyuria over a 5 year period...
August 19, 2016: Endocrine Practice
Jacob M Taylor, Lauren Ptomey, Jill M Hamilton-Reeves, Debra K Sullivan, Catherine Creed, Susan E Carlson, Donald E Wesson, Jared J Grantham, Cheryl A Gibson
BACKGROUND: Salt, protein, acid precursors, and fluid intake have been identified as factors that influence cyst growth in ADPKD. Unfortunately, the feasibility of following these dietary restrictions/enhancements from a patient's point-of-view has yet to be studied. The purpose of this study is to understand better the experiences of patients following a relatively complex dietary prescription targeting these factors. METHODS: Twelve adults with ADPKD and kidney function >30ml/min/1...
2016: PloS One
Jennifer S Hanberg, Veena Rao, Jozine M Ter Maaten, Olga Laur, Meredith A Brisco, F Perry Wilson, Justin L Grodin, Mahlet Assefa, J Samuel Broughton, Noah J Planavsky, Tariq Ahmad, Lavanya Bellumkonda, W H Wilson Tang, Chirag R Parikh, Jeffrey M Testani
BACKGROUND: Recent epidemiological studies have implicated chloride, rather than sodium, as the driver of poor survival previously attributed to hyponatremia in heart failure. Accumulating basic science evidence has identified chloride as a critical factor in renal salt sensing. Our goal was to probe the physiology bridging this basic and epidemiological literature. METHODS AND RESULTS: Two heart failure cohorts were included: (1) observational: patients receiving loop diuretics at the Yale Transitional Care Center (N=162) and (2) interventional pilot: stable outpatients receiving ≥80 mg furosemide equivalents were studied before and after 3 days of 115 mmol/d supplemental lysine chloride (N=10)...
August 2016: Circulation. Heart Failure
M Schrader, B Treff, T Sandholtet, N Maassen, V Shushakov, J Kaesebieter, M Maassen
BACKGROUND: Investigations of the effect of beverages containing carbohydrates, only, on the sodium and fluid balance during intermittent exercise of high intensity are rare. Therefore, we compared the effects of water and carbohydrate supplementation on plasma, blood volume, and electrolyte shifts during intermittent exercise. METHODS: Ten male subjects performed an intermittent exercise test twice. In one trial, tap water (4 ml/kg/15 min) was consumed (Plac trial)...
September 2016: European Journal of Applied Physiology
Vid Leban, Gordana Kozelj, Miran Brvar
INTRODUCTION: In Europe body purification and natural balance restoring rituals are becoming increasingly popular, but an introduction of Amazonian shamanic rituals in urban Europe can result in unexpected adverse events. CASE REPORT: A 44-year-old woman attended a Kambô or Sapo ritual in Slovenia where dried skin secretion from a giant leaf frog (Phyllomedusa bicolor) was applied to five freshly burned wounds at her shoulder. Afterwards, she drank 6 litres of water and gradually developed nausea and vomiting, confusion, lethargy, muscle weakness, spasms and cramps, seizure, decreased consciousness level and short-term memory loss...
September 15, 2016: Toxicon: Official Journal of the International Society on Toxinology
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