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https://www.readbyqxmd.com/read/29142896/sodium-variability-is-associated-with-increased-mortality-in-severe-burn-injury
#1
Soman Sen, Nam Tran, Brian Chan, Tina L Palmieri, David G Greenhalgh, Kiho Cho
Background: Dysnatremias are associated with increased mortality in critically ill patients. Hypernatremia in burn patients is also associated with poor survival. Based on these findings, we hypothesized that high plasma sodium variability is a marker for increased mortality in severely burn-injured patients. Methods: We performed a retrospective review of adult burn patients with a burn injury of 15% total body surface area (TBSA) or greater from 2010 to 2014. All patients included in the study had at least three serum sodium levels checked during admission...
2017: Burns and trauma
https://www.readbyqxmd.com/read/29137091/the-effects-of-hypervolemic-infusion-on-microcirculation-perfusion-of-patients-during-laparoscopic-colorectal-surgery
#2
Yunxin Deng, Qianlin Zhu, Buwei Yu, Minhua Zheng, Jue Jin
The aim of this study is to assess the effects of hypervolemic infusion with different solutions on microcirculation perfusion during laparoscopic colorectal surgery.Thirty-six patients were randomly divided into Ringer lactate solution [RL] group, succinylated gelatin injection [Gel] group, and hypertonic saline hydroxyethyl starch 40 injection [HS] group. Hypervolemic infusion was performed during the induction period of general anesthesia. Arterial blood-gas parameters, noninvasive hemodynamics, gastric tonometry values, and central venous pressure (CVP) were compared at baseline (T1); the end of hypervolemic infusion (T2); 5 min (T3), 15 min (T4), 30 min (T5), and 60 min (T6) during pneumoperitoneum; 5 min (T7), 15 min (T8), and 25 min (T9) after pneumoperitoneum...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29106785/n-terminal-pro-b-type-natriuretic-peptide-in-three-different-mechanisms-of-dysnatremia-onset-after-a-child-s-craniopharyngioma-surgery
#3
(no author information available yet)
Craniopharyngioma, due to its sellar location, can be perioperatively complicated by different types of dysnatremia. We present a rare postoperative onset of a combination of three different mechanisms of dysnatremia with N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) and renal function parameters in a boy with a good outcome after craniopharyngioma surgery: 1/ Central diabetes insipidus (CDI) onset immediately after the operation, hypernatremia with peak serum sodium (SNa) 158 mmol/l) caused by free water polyuria (electrolyte-free water clearance, EWC 0...
October 6, 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/29097159/the-epidemiology-and-clinical-associations-of-stroke-in-patients-with-acute-myeloid-leukemia-a-review-of-10-972-admissions-from-the-2012-national-inpatient-sample
#4
Christopher Del Prete, Taeha Kim, Frederick Lansigan, Joseph Shatzel, Harley Friedman
BACKGROUND: Acute leukemia is known to confer an elevated risk of both hemorrhagic and thrombotic complications, but the development of stroke in this population is poorly characterized. This study assesses clinical and epidemiologic factors in a population of inpatients with acute myeloid leukemia (AML) and stroke. METHODS: Using the 2012 National Inpatient Sample, demographic and clinical data including age, gender, race, length of stay, in-hospital procedures, discharge diagnosis, disposition, and mortality incidence were extracted...
September 20, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/29095382/recognition-and-management-of-pediatric-salt-toxicity
#5
Eike Blohm, Amy Goldberg, Ann Salerno, Carole Jenny, Edward Boyer, Kavita Babu
OBJECTIVES: Immediate recognition of salt toxicity and aggressive resuscitative measures are critical in the treatment of this lethal poisoning. Despite heroic measures, pediatric deaths due to salt toxicity still occur from irreversible neurological damage. The objective of this article is to review the relevant literature and offer a therapeutic algorithm for the management of pediatric patients presenting with salt toxicity. METHODS: A literature search for cases of salt toxicity was conducted...
October 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29088954/morbidity-and-mortality-associated-with-hypernatremia-in-patients-with-severe-traumatic-brain-injury
#6
Aditya Vedantam, Claudia S Robertson, Shankar P Gopinath
OBJECTIVE Hypernatremia is independently associated with increased mortality in critically ill patients. Few studies have evaluated the impact of hypernatremia on early mortality in patients with severe traumatic brain injury (TBI) treated in a neurocritical care unit. METHODS A retrospective review of patients with severe TBI (admission Glasgow Coma Scale score ≤ 8) treated in a single neurocritical care unit between 1986 and 2012 was performed. Patients with at least 3 serum sodium values were selected for the study...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29067526/hypernatremia-and-acute-pancreatitis-in-chronic-kidney-disease-back-to-the-salt-mines-answers
#7
Marie de Tersant, Thérésa Kwon, Marie-Alice Macher, Anne Maisin, Georges Deschênes, Olivier Niel
No abstract text is available yet for this article.
October 24, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29067525/hypernatremia-and-acute-pancreatitis-in-chronic-kidney-disease-back-to-the-salt-mines-questions
#8
Marie de Tersant, Thérésa Kwon, Marie-Alice Macher, Anne Maisin, Georges Deschênes, Olivier Niel
BACKGROUND: Acute pancreatitis can be a life-threatening complication in patients with chronic kidney disease (CKD), especially in kidney transplant recipients. CASE DIAGNOSIS/TREATMENT: The patient was 7 years old when he received renal transplantation for CKD secondary to posterior urethral valves. Two years later, he presented with severe necrotizing pancreatitis (Ranson's score 5, Balthazar's score 8). Viral and genetic testing came back negative; pancreatitis was attributed to the patient's treatments (prednisone, trimethoprim-sulfamethoxazole, and everolimus)...
October 24, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29057220/iatrogenic-dysnatremias-in-children-with-acute-gastroenteritis-in-high-income-countries-a-systematic-review
#9
Silviu Grisaru, Jianling Xie, Susan Samuel, Stephen B Freedman
BACKGROUND: Acute gastroenteritis (AGE) causing dehydration with or without dysnatremias is a common childhood health challenge. While it is accepted that oral rehydration therapy is preferred, clinical factors or parent and healthcare provider preferences may lead to intravenous rehydration (IVR). Isotonic solutions are increasingly recommended in most scenarios requiring IVR. Nevertheless, children with AGE, having ongoing losses of water and electrolytes, represent a unique population...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29026268/characteristic-clinical-features-of-adipsic-hypernatremia-patients-with-subfornical-organ-targeting-antibody
#10
Akari Nakamura-Utsunomiya, Takeshi Y Hiyama, Satoshi Okada, Masaharu Noda, Masao Kobayashi
Adipsic hypernatremia is a rare disease presenting as persistent hypernatremia with disturbance of thirst regulation and hypothalamic dysfunction. As a result of congenital disease, tumors, or inflammation, most cases are accompanied by structural abnormalities in the hypothalamic-pituitary area. While cases with no hypothalamic-pituitary structural lesion have been reported, their etiology has not been elucidated. Recently, we reported three patients with adipsic hypernatremia whose serum-derived immunoglobulin (Ig) specifically reacted with mouse subfornical organ (SFO) tissue...
2017: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
https://www.readbyqxmd.com/read/28970664/diabetic-ketoacidosis-with-extreme-hypernatremia-in-a-4-year-old-girl
#11
Manish Kumar Arya, Sheikh Minhaj Ahmed, Krishnakumar N Shah, Uma S Ali
A 4-year-old girl admitted with altered mental status, new-onset diabetes mellitus, and diabetic ketoacidosis (DKA) had a rapid rise in serum sodium from 158 mEq/L (corrected sodium 165 mEq/L) at the admission to 204 mEq/L within 18 hours of admission despite standard fluid and insulin therapy recommended for the treatment of DKA. During her illness, she developed arterial and deep vein thrombosis (DVT), bloodstream infection with Candida species, and extensive skin blistering and denudation. The child needed mechanical ventilation, insulin infusion, careful fluid titration to bring down the sodium gradually, and low-molecular weight heparin for her DVT...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28906370/the-association-of-hypernatremia-and-hypertonic-saline-irrigation-in-hepatic-hydatid-cysts-a-case-report-and-retrospective-study
#12
Rujun Zeng, Renhua Wu, Qingguo Lv, Nanwei Tong, Yuwei Zhang
RATIONALE: Hypernatremia is a rare but fatal complication of hypertonic saline (HS) irrigation in hepatic hydatid disease. It needs careful monitoring and treatment. PATIENT CONCERNS: A 28-year-old woman with hepatic hydatid cysts who received operation treatment developed electrolyte disturbances. We also conducted a retrospective study about influence of HS application on electrolytes in patients with hepatic hydatid disease receiving surgery. DIAGNOSES: Hypernatremia, developed after HS irrigation...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28895166/diabetes-insipidus-after-discontinuation-of-vasopressin-infusion-for-septic-shock
#13
H Rana, N Ferguson, P V Dicpinigaitis
WHAT IS KNOWN AND OBJECTIVE: Despite widespread use of vasopressin for the treatment of septic shock, few cases of diabetes insipidus (DI) following its discontinuation have been reported. CASE SUMMARY: A 54-year-old man presented with pneumonia progressing to septic shock, requiring norepinephrine and vasopressin for refractory hypotension. After clinical improvement, the patient on 3 separate occasions developed polyuria and severe hypernatremia upon discontinuation of vasopressin, with prompt recovery upon its resumption...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28883217/safety-and-efficacy-of-long-term-use-of-tolvaptan-in-patients-with-heart-failure-and-chronic-kidney-disease
#14
Yusuke Uemura, Rei Shibata, Kenji Takemoto, Tomohiro Uchikawa, Masayoshi Koyasu, Shinji Ishikawa, Ryo Imai, Yuta Ozaki, Takashi Watanabe, Tsubasa Teraoka, Masato Watarai, Toyoaki Murohara
BACKGROUND: We assessed the long-term safety and efficacy of tolvaptan in 102 patients with heart failure (HF) and chronic kidney disease (CKD). Median follow-up duration was 1.6 years (1.0-4.4 years).Methods and Results:One patient discontinued tolvaptan because of hypernatremia. There were no changes in renal function or electrolytes during the 1-year follow-up. The cardiac-related death-free or HF-related hospitalization-free survival rate was significantly higher in patients receiving tolvaptan than in propensity score-matched patients who did not receive tolvaptan...
September 5, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28883166/standards-based-procedural-phenotyping-the-arden-syntax-on-i2b2
#15
Sebastian Mate, Ixchel Castellanos, Thomas Ganslandt, Hans-Ulrich Prokosch, Stefan Kraus
Phenotyping, or the identification of patient cohorts, is a recurring challenge in medical informatics. While there are open source tools such as i2b2 that address this problem by providing user-friendly querying interfaces, these platforms lack semantic expressiveness to model complex phenotyping algorithms. The Arden Syntax provides procedural programming language construct, designed specifically for medical decision support and knowledge transfer. In this work, we investigate how language constructs of the Arden Syntax can be used for generic phenotyping...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28860033/hospital-associated-hypernatremia-spectrum-and-clinical-outcomes-in-an-unselected-cohort
#16
Evangelos Tsipotis, Lori Lyn Price, Bertrand L Jaber, Nicolaos E Madias
BACKGROUND: Although hypernatremia is associated with adverse outcomes, most studies examined selected populations. METHODS: Discharge data of 19,072 unselected hospitalized adults were analyzed. The crude relationship between serum sodium [Na(+)] and mortality defined hypernatremia as serum [Na(+)] >142 mEq/L. Patients with community-acquired hypernatremia or hospital-acquired hypernatremia were compared with normonatremic patients (admission [Na(+)] 138-142 mEq/L) regarding in-hospital mortality, length of stay, and discharge disposition...
August 30, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28836327/serum-sodium-level-within-the-normal-range-is-associated-with-maximum-voluntary-tongue-pressure-against-the-palate-among-community-dwelling-older-japanese-men
#17
Yuji Shimizu, Shimpei Sato, Jun Koyamatsu, Hirotomo Yamanashi, Miho Higashi, Mako Nagayoshi, Koichiro Kadota, Shin-Ya Kawashiri, Noboru Takamura, Takahiro Maeda
AIM: Recent geriatric studies have focused on maximum voluntary tongue pressure against the palate (MTP) as a diagnostic value for dysphagia, as dysphagia causes aspiration pneumonia. Dysphagia can also cause water intake difficulties, resulting in hypernatremia by indicating the presence of hyperosmotic dehydration. However, no studies have reported on a possible association between reduced MTP and serum sodium levels. METHODS: To evaluate hyperosmotic dehydration within the normal range as an indicator of reduced MTP, we carried out a cross-sectional study of 655 older Japanese community-dwelling men (age ≥60 years) who undertook a general health check-up from 2015 to 2016...
August 23, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28817693/clinical-signs-profound-acidemia-hypoglycemia-and-hypernatremia-are-predictive-of-mortality-in-1-400-critically-ill-neonatal-calves-with-diarrhea
#18
Florian M Trefz, Ingrid Lorenz, Annette Lorch, Peter D Constable
Profound acidemia impairs cellular and organ function and consequently should be associated with an increased risk of mortality in critically ill humans and animals. Neonatal diarrhea in calves can result in potentially serious metabolic derangements including profound acidemia due to strong ion (metabolic) acidosis, hyper-D-lactatemia, hyper-L-lactatemia, azotemia, hypoglycemia, hyperkalemia and hyponatremia. The aim of this retrospective study was to assess the prognostic relevance of clinical and laboratory findings in 1,400 critically ill neonatal calves with diarrhea admitted to a veterinary teaching hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28815407/efficacy-and-safety-of-the-early-use-of-v2-receptor-antagonists-in-elderly-patients-with-decompensated-heart-failure
#19
Ryuichi Matsukawa, Toru Kubota, Masanori Okabe, Yusuke Yamamoto, Hiroshi Meno
We recently reported that the early initiation of tolvaptan in congestive heart failure shortened the hospital stay and reduced the rate of in-hospital death. However, whether or not these results apply to elderly patients with congestive heart failure is unclear. We performed a sub-analysis of our previous study. Among the 102 patients in that study, we retrospectively analyzed the elderly patients >75 years of age treated with tolvaptan. First, we analyzed the efficacy of early tolvaptan use in these patients...
August 16, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28814256/current-issues-in-intravenous-fluid-use-in-hospitalized-children
#20
Jennifer Fuchs, Sarah T Adams, Julie Byerley
BACKGROUND: Fluid and electrolyte therapy is an important component in the care of the hospitalized child. Previous pediatric guidelines have followed the Holliday-Segar method of calculating and delivering maintenance IV fluids, using hypotonic fluids in maintenance therapy. However, research demonstrates that hypotonic fluids can lead to iatrogenic hyponatremia and that isotonic fluid is a safer alternative. OBJECTIVE: To provide the ideal approach to intravenous (IV) fluid use in the hospitalized child and determine the safety and effectiveness of isotonic maintenance fluid therapy...
August 16, 2017: Reviews on Recent Clinical Trials
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