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Hyponatremia physiology

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https://www.readbyqxmd.com/read/29851190/choosing-wisely-in-pediatric-anesthesia-an-interpretation-from-the-german-scientific-working-group-of-paediatric-anaesthesia-wakka
#1
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
May 30, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29846113/mechanistic-target-of-rapamycin-mtor-integrating-growth-factor-and-nutrient-signaling-in-the-collecting-duct
#2
Aaron Brown, Maurice B Fluitt, Carolyn M Ecelbarger
The renal collecting duct and other post-macula densa sites are the primary tubular regions for fine-tuning of electrolyte homeostasis in the body. A role for the mechanistic target of rapamycin (mTOR), a serine-threonine kinase, has recently been appreciated as playing a central role in this regulation. mTOR exists in two distinct multi-protein functional complexes, i.e., mTORC1 and mTORC2. Upregulation of mTORC1, by growth factors and amino acids, is associated with cell cycle regulation and hypertrophic changes in the cell...
May 30, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29770745/2706-km-cycling-in-two-weeks-effects-on-cardiac-function-in-six-elderly-male-athletes
#3
Thomas Morville, Mads Rosenkilde, Nick Mattsson, Flemming Dela, Jørn W Helge, Hanne K Rasmusen
INTRODUCTION: Physiological effects of exercise on trained and untrained individuals have been studied extensively. Typically, young or middle-aged individuals are examined before and after short periods of vigorous exertion. METHODS: We studied six elderly male athletes (61±8 years (mean ± SD); baseline VO2 max 48±5 ml·kg-1 · min-1 ) with focus on cardiac function and biomarkers following 14 consecutive days of moderate intensity exercise. Cardiac dimensions, function, biomarkers, and other measures of cardiovascular health were examined at baseline and 2 and 28 h after the last day of cycling a total of 2706 km...
May 17, 2018: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/29484346/factors-associated-with-pre-event-hydration-status-and-drinking-behavior-of-middle-aged-cyclists
#4
B A Yates, L A Ellis, C L Butts, B P McDermott, K H Williamson, L E Armstrong
OBJECTIVES: Water is an essential nutrient for thermoregulation, metabolism, cognition, and overall physiological homeostatic function. However, aging adults display a blunted thirst mechanism and subsequently have an increased risk for dehydration or hyponatremia. Fluid consumption behaviors are modifiable and the importance of practicing adequate drinking behaviors for aging adults is amplified during exercise. Identification of aging adult's hydration beliefs and how they attain hydration advice could provide valuable information into ways to promote better drinking habits to reduce fluid imbalances...
2018: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29417593/medical-findings-in-1-026-consecutive-adult-inpatient-residential-eating-disordered-patients
#5
Philip S Mehler, Dan V Blalock, Keegan Walden, Simrat Kaur, Jennifer McBride, Kristine Walsh, Jennifer Watts
OBJECTIVE: Eating disorders are associated with multiple medical complications. We report contemporary medical data, for newly admitted adult inpatient and residential level of care patients. METHOD: Medical records of a transdiagnostic sample of 1,026 patients, with eating disorders, were retrospectively reviewed for the presence of a broad array of medical complications at time of admission. The prevalence of physiologically relevant medical complications was assessed across major eating disorder categories...
April 2018: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/29295830/treatment-of-severe-hyponatremia
#6
REVIEW
Richard H Sterns
Patients with severe (serum sodium ≤120 mEq/L), symptomatic hyponatremia can develop life-threatening or fatal complications from cerebral edema if treatment is inadequate and permanent neurologic disability from osmotic demyelination if treatment is excessive. Unfortunately, as is true of all electrolyte disturbances, there are no randomized trials to guide the treatment of this challenging disorder. Rather, therapeutic decisions rest on physiologic principles, animal models, observational studies, and single-patient reports...
April 6, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29156484/-perioperative-intravenous-fluid-therapy-in-children
#7
Robert Sümpelmann
The objective of this consensus-based S1 Guideline for perioperative fluid therapy in children is to maintain or re-establish the child's homeostasis. Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. For the intraoperative background infusion a physiologically composed balanced isotonic electrolyte solution (BS) with 1 - 2.5% glucose is recommended to maintain normal glucose concentrations and to avoid hyponatremia, hyperchloremia, and lipolysis...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28834962/artificial-syndrome-of-inappropriate-antidiuresis-model-as-potential-use-for-diagnostic-and-therapeutic-strategies
#8
Julie Refardt, Bettina Winzeler, Fabian Meienberg, Mirjam Christ-Crain
Hyponatremia is the most frequent electrolyte disorder with the syndrome of inappropriate antidiuresis (SIADH) being its predominant cause. Physiological studies in patients with SIADH are difficult to interpret due to usually several comorbidities and polymedication. Therefore, a SIADH model in healthy volunteers would be very helpful to allow insight in this complex disease and to test new therapeutic approaches. The aim of the study was to create a SIADH model with evaluation of subsequent physiological changes...
September 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28828605/taurine-homeostasis-and-volume-control
#9
Herminia Pasantes-Morales
Taurine content is high (mM) in mammalian brain. By its major role as an osmolyte, taurine contributes to the cell volume control, which is particularly critical in the brain. Taurine participates in osmotic adjustments required to maintain the organization and size of intracellular compartments. It counteracts volume fluctuations in unbalanced transmembrane fluxes of ions and neurotransmitters, preserving the functional synaptic contacts. Taurine has a key role in the long-term adaptation to chronic hyponatremia as well as in other pathologies leading to brain edema...
2017: Advances in Neurobiology
https://www.readbyqxmd.com/read/28819575/therapeutic-approach-to-the-management-of-severe-asymptomatic-hyponatremia
#10
Thaofiq Ijaiya, Sandhya Manohar, Kameswari Lakshmi
Hyponatremia is an electrolyte imbalance encountered commonly in the hospital and ambulatory settings. It can be seen in isolation or present as a complication of other medical conditions. It is therefore a challenge to determine the appropriate therapeutic intervention. An understanding of the etiology is key in instituting the right treatment. Clinicians must not be too hasty to correct a random laboratory value without first understanding the physiologic principle. We present such a case of a patient who presented with sodium of 98 mmol/L, the lowest recorded in the current literature, and yet was asymptomatic...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28797976/physiologic-mechanisms-of-water-and-electrolyte-disturbances-after-transsphenoidal-pituitary-surgery
#11
Evan T Blair, John S Clemmer, H Louis Harkey, Robert L Hester, W Andrew Pruett
BACKGROUND: Disturbances in water and electrolyte homeostasis are common after transsphenoidal surgery. These disorders are variable and unpredictable, increasing patient risk and complicating postsurgical treatment. Clinically, it is generally accepted that damage to the pituitary is the cause, but the mechanisms behind the response variability and underlying pathophysiology remain unknown. OBJECTIVE: To test the hypothesis that changing the degree of damage to the pituitary stalk produces a spectrum of water and electrolyte disturbance along which all presentations of postsurgical water and electrolyte disturbances can be identified...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28674911/the-basic-metabolic-profile-in-heart-failure-marker-and-modifier
#12
REVIEW
Ahmed Elfar, Kamalanathan K Sambandam
PURPOSE OF REVIEW: The physiologic determinants of each of the components of the basic metabolic profile in patients with heart failure will be explored. Additionally, the review will discuss the prognostic value of alterations in the basic metabolic profile as well as their effects on management. RECENT FINDINGS: Abnormalities in the basic metabolic profile have significant correlation with clinical outcomes and can modify treatment in heart failure. Hypochloremia has recently received increased attention for these reasons...
August 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28478880/neurologic-intensive-care-unit-electrolyte-management
#13
REVIEW
Craig Hutto, Mindy French
Dysnatremia is a common finding in the intensive care unit (ICU) and may be a predictor for mortality and poor clinical outcomes. Depending on the time of onset (ie, on admission vs later in the ICU stay), the incidence of dysnatremias in critically ill patients ranges from 6.9% to 15%, respectively. The symptoms of sodium derangement and their effect on brain physiology make early recognition and correction paramount in the neurologic ICU. Hyponatremia in brain injured patients can lead to life-threatening conditions such as seizures and may worsen cerebral edema and contribute to alterations in intracranial pressure...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28367176/therapeutic-efficacy-of-nutritional-support-by-percutaneous-endoscopic-gastrostomy-in-critically-ill-patients-a-self-control-clinical-trial
#14
Fei Zhou, Ya-Ling Gao, Zheng-Jin Liu, Yi-Qun Hu
BACKGROUND & OBJECTIVE: Percutaneous endoscopic gastrostomy (PEG) is a procedure to provide enteral nutrition for critically ill patients. It is commonly used in clinical practice; however, the widespread use of PEG is controversial. Our objective was to evaluate the therapeutic effect of nutritional support by PEG in these critically ill patients. METHODS: A total of 64 critically ill patients including 41 males and 23 females (aged 23-84) were identified by the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system during September 2004 to June 2012...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28255480/multiple-electrolyte-and-metabolic-emergencies-in-a-single-patient
#15
Caprice Cadacio, Phuong-Thu Pham, Ruchika Bhasin, Anita Kamarzarian, Phuong-Chi Pham
While some electrolyte disturbances are immediately life-threatening and must be emergently treated, others may be delayed without immediate adverse consequences. We discuss a patient with alcoholism and diabetes mellitus type 2 who presented with volume depletion and multiple life-threatening electrolyte and metabolic derangements including severe hyponatremia (serum sodium concentration [SNa ] 107 mEq/L), hypophosphatemia ("undetectable," <1.0 mg/dL), and hypokalemia (2.2 mEq/L), moderate diabetic ketoacidosis ([DKA], pH 7...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28223002/reset-osmostat-the-result-of-chronic-desmopressin-abuse
#16
Daniel C Andreoli, William L Whittier
A reset osmostat as a cause of hyponatremia can be found in a variety of clinical settings, including pulmonary and neurologic diseases, as well as in physiologic circumstances such as pregnancy. This teaching case describes a 72-year-old white man with a long-standing history of self-medicating with desmopressin acetate (DDAVP) who presented with profound hyponatremia. On discontinuation of DDAVP treatment, he was found to have a reset osmostat. The mild hyponatremia persisted on follow-up. We theorize that the reset osmostat may have developed secondary to long-standing DDAVP use...
June 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28131863/early-oxytocin-inhibition-of-salt-intake-after-furosemide-treatment-in-rats
#17
Sheri L Core, Kathleen S Curtis
Body fluid homeostasis requires a complex suite of physiological and behavioral processes. Understanding of the role of the central nervous system (CNS) in integrating these processes has been advanced by research employing immunohistochemical techniques to assess responses to a variety of body fluid challenges. Such techniques have revealed sex/estrogen differences in CNS activation in response to hypotension and hypernatremia. In contrast, it has been difficult to conclusively identify specific CNS areas and neurotransmitter systems that are activated by hyponatremia using these techniques...
January 25, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28091865/improving-the-diagnostic-workup-of-hyponatremia-in-the-setting-of-kidney-disease-a-continuing-medical-education-cme-initiative
#18
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...
March 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28017410/disorders-of-sodium-and-water-homeostasis
#19
REVIEW
Julien Guillaumin, Stephen P DiBartola
This review article discusses normal and abnormal sodium balance in small animals. The terms and concepts central to understanding normal sodium and water balance are presented as well as of the physiology of body fluid compartments and the movement of fluid between those compartments. As dysnatremia is a very common disorder across the spectrum of critically ill patients, the main focus of the article is to present several clinical examples of both acute and chronic hypernatremia and hyponatremia and their practical, clinical management...
March 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27780935/incidence-and-physiological-mechanism-of-carboplatin-induced-electrolyte-abnormality-among-patients-with-non-small-cell-lung-cancer
#20
Yushui Ma, Likun Hou, Fei Yu, Gaixia Lu, Shanshan Qin, Ruting Xie, Huiqiong Yang, Tingmiao Wu, Pei Luo, Li Chai, Zhongwei Lv, Xiaodong Peng, Chunyan Wu, Da Fu
To clarify the association between carboplatin and electrolyte abnormality, a pooled-analysis was performed with the adverse event reports of non-small cell lung cancer patients. A total of 19901 adverse events were retrieved from the FDA Adverse Event Reporting System (FAERS). Pooled reporting odds ratios (RORs) and 95% CIs suggested that carboplatin was significantly associated with hyponatremia (pooled ROR = 1.57, 95% CI 1.18-2.09, P = 1.99×10-3) and hypokalemia (pooled ROR = 2.37, 95% CI 1.80-3.10, P = 5...
March 14, 2017: Oncotarget
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