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https://www.readbyqxmd.com/read/28915321/regulation-and-functions-of-the-renin-angiotensin-system-in-white-and-brown-adipose-tissue
#1
Mandana Pahlavani, Nishan S Kalupahana, Latha Ramalingam, Naima Moustaid-Moussa
The renin angiotensin system (RAS) is a major regulator of blood pressure, fluid, and electrolyte homeostasis. RAS precursor angiotensinogen (Agt) is cleaved into angiotensin I (Ang I) and II (Ang II) by renin and angiotensin converting enzyme (ACE), respectively. Major effects of Ang II, the main bioactive peptide of this system, is mediated by G protein coupled receptors, Angiotensin Type 1 (AGTR1, AT1R) and Type 2 (AGTR2, AT2R) receptors. Further, the discovery of additional RAS peptides such as Ang 1-7 generated by the action of another enzyme ACE2 identified novel functions of this complex system...
September 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28913489/cerebral-salt-wasting-syndrome-in-patients-with-minor-head-trauma-two-case-reports
#2
Gabriela Csipak, Natalia Hagau
We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28895701/management-of-cirrhotic-ascites-in-children-review-and-recommendations-part-2-electrolyte-disturbances-nonelectrolyte-disturbances-therapeutic-options
#3
David F Bes, M Cristina Fernández, Ivone Malla, Horacio A Repetto, Daniel Buamscha, Susana López, Roxana Martinitto, Miriam Cuarterolo, Fernando Alvarez
Ascites is a major complication of cirrhosis. There are several evidence-based articles and guidelines for the management of adults, but few data have been published in relation to children. In the case of a pediatric patient with cirrhotic ascites (PPCA), the following questions are raised: How are the clinical assessment and ancillary tests performed? When is ascites considered refractory? How is it treated? Should fresh plasma and platelets be infused before abdominal paracentesis to prevent bleeding? What are the hospitalization criteria? What are the indicated treatments? What complications can patients develop? When and how should hyponatremia be treated? What are the diagnostic criteria for spontaneous bacterial peritonitis? How is it treated? What is hepatorenal syndrome? How is it treated? When should albumin be infused? When should fluid intake be restricted? The recommendations made here are based on pathophysiology and suggest the preferred approach to diagnostic and therapeutic aspects, and preventive care...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28892994/life-threatening-severe-hypernatraemic-dehydration-in-neonates-a-report-of-two-cases
#4
Priyaja Paramasivam, Sujay Kumar Earan, Arulkumaran Arunagirinadhan, Shilpa Kantamneni
Hypernatraemic dehydration in neonates may lead to potentially lethal consequences like cerebral oedema, intracranial haemorrhage, hydrocephalus and gangrene. In the light of increase in the infants presenting with hypernatraemic dehydration, there is a definitive need to heighten the awareness and have a high degree of suspicion in diagnosis for this potentially lethal condition. We report two neonates of severe hypernatraemia with dehydration highlighting its diagnosis and management. Treatment of hypernatraemic dehydration involves correction of electrolyte imbalance by careful restoration of fluids and ensuring appropriate intake of calories...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28892600/the-suspect-siadh
#5
Kristen Tee, Jerry Dang
BACKGROUND: Hyponatraemia is one of the most commonly encountered electrolyte abnormalities in general practice. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is an important but under-recognised cause. OBJECTIVE: This article explores the presentation, investigation, diagnosis and management of SIADH. DISCUSSION: SIADH can occur secondary to medications, malignancy, pulmonary disease, or any disorder involving the central nervous system...
September 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28890943/trial-of-amiloride-in-type-2-diabetes-with-proteinuria
#6
Mark L Unruh, V Shane Pankratz, John E Demko, Evan C Ray, Rebecca P Hughey, Thomas R Kleyman
INTRODUCTION: Renal Na(+) retention and extracellular fluid volume expansion are hallmarks of nephrotic syndrome, which occurs even in the absence of activation of hormones that stimulate renal Na(+) transporters. Plasmin-dependent activation of the epithelial Na(+) channel (ENaC) has been proposed to have a role in renal Na(+) retention in the setting of nephrotic syndrome. We hypothesized that the ENaC inhibitor amiloride would be an effective therapeutic agent in inducing a natriuresis and lowering blood pressure in individuals with macroscopic proteinuria...
September 2017: KI Reports
https://www.readbyqxmd.com/read/28880351/-refeeding-syndrome-during-alcohol-detoxification
#7
J J S Rutten, H Post, G H de Weert-van Oene, V J A Buwalda
Refeeding syndrome (RS) can occur when malnourished patients are reintroduced to carbohydrates. The symptoms are caused by a combination of electrolyte shifts and fluid retention. Symptoms are wide-ranging; some patients may suffer from harmless muscle cramps, others from more severe neurological and cardiological symptoms that can even lead to death. Although alcohol dependence is a risk factor for the development of RS, little attention is being given to this problem in addiction treatment. In this article we report a case of RS that occurred during alcohol detoxification...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28879182/vasopressin-receptor-antagonists-in-hyponatremia-uses-and-misuses
#8
REVIEW
Helbert Rondon-Berrios, Tomas Berl
Decreases in the concentration of sodium in plasma constitute hyponatremia, the commonest electrolyte disorder in clinical medicine. It is now well established that its presence conveys an increased mortality risk even when the decrement is mild. In addition, recent evidence suggests that chronic and apparently asymptomatic hyponatremia is associated with increased morbidity including neurocognitive deficits and bone fractures. Furthermore, hyponatremia is associated with higher health care-related expenses...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28878933/comparison-of-a-two-bag-system-versus-conventional-treatment-protocol-one-bag-system-in-the-management-of-diabetic-ketoacidosis
#9
Iqbal Munir, Ramiz Fargo, Roger Garrison, Almira Yang, Andy Cheng, Ilho Kang, Ali Motabar, Karen Xu, Lawrence K Loo, Daniel I Kim
OBJECTIVE: We compared the conventional 'one-bag protocol' of management of diabetic ketoacidosis (DKA) with the 'two-bag protocol' which utilizes two bags of fluids, one containing saline and supplemental electrolytes and the other containing the same solution with the addition of 10% dextrose. RESEARCH DESIGN AND METHODS: A retrospective chart review and analysis was done on adult patients admitted for DKA to the Riverside University Health System Medical Center from 2008 to 2015...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/28871060/hydroxysteroid-dehydrogenase-hsd1l-is-localised-to-the-pituitary-gonadal-axis-of-primates
#10
A Daniel Bird, Spencer Greatorex, David Reser, Gareth G Lavery, Timothy J Cole
Steroid hormones play clinically important and specific regulatory roles in the development, growth, metabolism, reproduction and brain function in human. The type 1 and 2 11-beta hydroxysteroid dehydrogenase enzymes (11β-HSD1 and 2) have key roles in the pre-receptor modification of glucocorticoids allowing aldosterone regulation of blood pressure, control of systemic fluid and electrolyte homeostasis and modulation of integrated metabolism and brain function. Although the activity and function of 11β-HSDs is thought to be understood, there exists an open reading frame for a distinct 11βHSD-like gene; HSD11B1L, which is present in human, non-human primate, sheep, pig and many other higher organisms, whereas an orthologue is absent in the genomes of mouse, rat and rabbit...
October 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28869249/glp-1-and-the-kidney-from-physiology-to-pharmacology-and-outcomes-in-diabetes
#11
REVIEW
Marcel H A Muskiet, Lennart Tonneijck, Mark M Smits, Michaël J B van Baar, Mark H H Kramer, Ewout J Hoorn, Jaap A Joles, Daniël H van Raalte
The gastrointestinal tract - the largest endocrine network in human physiology - orchestrates signals from the external environment to maintain neural and hormonal control of homeostasis. Advances in understanding entero-endocrine cell biology in health and disease have important translational relevance. The gut-derived incretin hormone glucagon-like peptide 1 (GLP-1) is secreted upon meal ingestion and controls glucose metabolism by modulating pancreatic islet cell function, food intake and gastrointestinal motility, amongst other effects...
September 4, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28868290/coffee-with-high-but-not-low-caffeine-content-augments-fluid-and-electrolyte-excretion-at-rest
#12
Adam D Seal, Costas N Bardis, Anna Gavrieli, Petros Grigorakis, J D Adams, Giannis Arnaoutis, Mary Yannakoulia, Stavros A Kavouras
BACKGROUND: Low levels of caffeine ingestion do not induce dehydration at rest, while it is not clear if larger doses do have an acute diuretic effect. The aim of the present investigation was to examine the acute effect of low and high levels of caffeine, via coffee, on fluid balance in habitual coffee drinkers (at least one per day) at rest. METHODS: Ten healthy adults (eight males and two females; age: 27 ± 5 years, weight: 89.5 ± 14.8 kg, height: 1...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/28866139/impact-of-caloric-intake-in-critically-ill-patients-with-and-without-refeeding-syndrome-a-retrospective-study
#13
Laura E Olthof, W A C Kristine Koekkoek, Coralien van Setten, Johannes C N Kars, Dick van Blokland, Arthur R H van Zanten
BACKGROUND & AIMS: Refeeding syndrome comprises metabolic disturbances that occur after the reintroduction of feeding after prolonged fasting. Standard care consists of correcting fluid and electrolytes imbalances. Energy intake during refeeding syndrome is heavily debated. This study addresses the effect of caloric intake on outcome during the management of refeeding syndrome. METHODS: A retrospective study among critically ill invasive mechanically ventilated patients admitted for >7 days to a medical-surgical ICU...
August 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28864374/trends-in-the-incidence-and-in-hospital-outcomes-of-cardiogenic-shock-complicating-thyroid-storm
#14
Divyanshu Mohananey, Nathaniel Smilowitz, Pedro A Villablanca, Nirmanmoh Bhatia, Sahil Agrawal, Anushka Baruah, Muhammad S Ali, Sripal Bangalore, Harish Ramakrishna
BACKGROUND: Thyroid storm (TS) constitutes an endocrine emergency with an incidence of up to 10% of all admissions for thyrotoxicosis. Cardiogenic shock (CS) is a rare complication of TS and very limited data exists on its incidence and outcomes. We aimed to estimate the national trends in incidence and outcomes of CS among patients admitted to US hospitals with TS. MATERIALS AND METHODS: We queried the nationwide inpatient sample for patients with the discharge diagnosis of TS between the years of 2003 and 2011...
August 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28861607/glomerular-and-tubular-effects-of-nitric-oxide-no-are-regulated-by-angiotensin-ii-ang-ii-in-an-age-dependent-manner-through-activation-of-both-angiotensin-receptors-at1rs-and-at2rs-in-conscious-lambs
#15
Angela E Vinturache, Francine G Smith
Renin-angiotensin (RAS) and nitric oxide (NO) systems and the balance and interaction between them are considered of primary importance in maintaining fluid and electrolyte homeostasis. It has been suggested that the effects of NO may be modulated at least in part by the angiotensin (Ang) II, yet the roles of angiotensin receptor type 1 (AT1R) and type 2 (AT2R) are not well understood. Even though both Ang II and NO are elevated at birth and during the newborn period, their contribution to the adaptation of the newborn to life after birth as well as their physiological roles during development are poorly understood...
August 31, 2017: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/28859453/comparison-of-complications-trends-and-costs-in-endoscopic-vs-microscopic-pituitary-surgery-analysis-from-a-us-health-claims-database
#16
Anthony O Asemota, Masaru Ishii, Henry Brem, Gary L Gallia
BACKGROUND: Microsurgical and endoscopic techniques are commonly utilized surgical approaches to pituitary pathologies. There are limited data comparing these 2 procedures. OBJECTIVE: To evaluate postoperative complications, associated costs, and national and regional trends of microscopic and endoscopic techniques in the United States employing a nationwide database. METHODS: The Truven MarketScan database 2010 to 2014 was queried and Current Procedural Terminology codes identified patients that underwent microscopic and/or endoscopic transsphenoidal pituitary surgery...
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28852495/reasons-for-admission-and-predictors-of-national-30-day-readmission-rates-in-patients-with-end-stage-renal-disease-on-peritoneal-dialysis
#17
Lili Chan, Priti Poojary, Aparna Saha, Kinsuk Chauhan, Rocco Ferrandino, Bart Ferket, Steven Coca, Girish Nadkarni, Jaime Uribarri
BACKGROUND: The number of patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) has increased by over 30% between 2007 and 2014. The Centers for Medicare and Medicaid has identified readmissions in ESRD patients to be a quality measure; however, there is a paucity of studies examining readmissions in PD patients. METHODS: Utilizing the National Readmission Database for the year 2013, we aimed to determine reasons for admission, the associated rates of unplanned readmission and independent predictors of readmissions in PD patients...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28844536/us-pediatric-trauma-patient-unplanned-30-day-readmissions
#18
Krista K Wheeler, Junxin Shi, Henry Xiang, Rajan K Thakkar, Jonathan I Groner
PURPOSE: We sought to determine readmission rates and risk factors for acutely injured pediatric trauma patients. METHODS: We produced 30-day unplanned readmission rates for pediatric trauma patients using the 2013 National Readmission Database (NRD). RESULTS: In US pediatric trauma patients, 1.7% had unplanned readmissions within 30days. The readmission rate for patients with index operating room procedures was no higher at 1.8%. Higher readmission rates were seen in patients with injury severity scores (ISS)=16-24 (3...
August 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28834108/influence-of-hang-time-and-location-on-bacterial-contamination-of-intravenous-bags-in-a-veterinary-emergency-and-critical-care-setting
#19
Julien Guillaumin, Nichole M Olp, Karissa D Magnusson, Amy L Butler, Joshua B Daniels
OBJECTIVE: To assess the rate of bacterial contamination of fluid and ports in intravenous bags in a veterinary emergency room (ER) and intensive care unit (ICU). DESIGN: Experimental model. SETTING: Ninety intravenous fluid bags of lactated balanced-electrolytes solution (1 L) hung in a university hospital. INTERVENTIONS: Bags were hung in 2 different locations in the ER (sink and bins) and one location in the ICU (sink) for 11 days...
September 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28833697/effect-of-intravenously-administered-crystalloid-solutions-on-acid-base-balance-in-domestic-animals
#20
REVIEW
W Muir
Intravenous fluid therapy can alter plasma acid-base balance. The Stewart approach to acid-base balance is uniquely suited to identify and quantify the effects of the cationic and anionic constituents of crystalloid solutions on plasma pH. The plasma strong ion difference (SID) and weak acid concentrations are similar to those of the administered fluid, more so at higher administration rates and with larger volumes. A crystalloid's in vivo effects on plasma pH are described by 3 general rules: SID > [HCO3-] increases plasma pH (alkalosis); SID < [HCO3-] decreases plasma pH (alkalosis); and SID = [HCO3-] yields no change in plasma pH...
September 2017: Journal of Veterinary Internal Medicine
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