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Patterns of decerebration in infants and children: defects in homeostasis and sequelae.

Sixty-four infants and children showing signs of decerebrate rigidity admitted to a paediatric unit have been studied. Cases of head injury, myelomeningocoele, and tumours were excluded from the series. The aetiological factors causing decerebration in the remainder fell into four main groups: infections, hypoxia, metabolic disease, and intracranial haemorrhage. Increased intracranial pressure was diagnosed in 87%. Defects in homeostasis occurred in 75%, respiratory abnormalities were present in 66%, cardiovascular in 33%, hypothermia in 30%, and hyponatraemia in 17%. Early recognition and tre

Frailty as a Predictor of COVID-19 Mortality in the South Indian Population: An Observational Study.

Background Frailty is a clinical syndrome characterized by diminished strength, endurance, and physiological function that significantly inc … te aminotransferase (AST) (65.2%), alkaline phosphatase (ALP) (67.5%), elevated creatinine (68.9%), hypernatremia (100%), hyperkalemia (80%), and elevated D-dimer (44.7%) were all significantly linked to mortality. Additionally, patients requiring oxygen (65%), ventilation (96.8%), or bilevel positive airway pressure (BiPAP) (77.8%) had higher mortality rates. …

What is the role of lidocaine or phenytoin in tricyclic antidepressant-induced cardiotoxicity?

INTRODUCTION: Tricyclic antidepressant (TCA) poisoning is a relatively common occurrence and remains a significant cause of mortality and mo … bicarbonate or hypertonic saline, or in which physiological derangement (e.g., severe alkalosis or hypernatremia) limits effective use of these primary strategies.

Copeptin as a surrogate marker for arginine vasopressin: analytical insights, current utility, and emerging applications.

Copeptin is a 39-amino-acid long glycosylated peptide with a leucine-rich core segment in the C-terminal part of pre-pro-vasopressin. It exh … Furthermore, copeptin could reliably identify those with AVP deficiency among patients with severe hypernatremia, though its diagnostic utility is reportedly limited in the differential diagnosis of profound hyponatremia. Copeptin measurement may be a useful tool for early goal-directed management of post-operative AVP deficiency. Additionally, the potential p …

Safety of Withholding Perioperative Hydrocortisone for Patients With Pituitary Adenomas With an Intact Hypothalamus-Pituitary-Adrenal Axis: A Randomized Clinical Trial.

IMPORTANCE: Pituitary adenoma is the second most common primary brain tumor. Perioperative hydrocortisone has been used for decades to avoid … CI, -3.0% to 3.9%). Incidences of new-onset diabetes mellitus (1 of 218 [0.5%] vs 9 of 218 [4.1%]), hypernatremia (9 of 218 [4.1%] vs 21 of 218 [9.6%]), hypokalemia (23 of 218 [10.6%] vs 34 of 218 [15.6%]), and hypocalcemia (6 of 218 [2.8%] vs 19 of 218 [8.7%]) were lower in the no-hydrocortisone group than in the hydrocortisone group. Lower preoperative mornin …

A novel association of osmotic demyelination in Sjögren's syndrome prompts revisiting role of aquaporins in CNS demyelinating diseases: A literature review.

BACKGROUND: Primary Sjögren's syndrome (SS) is a chronic systemic autoimmune disease with varied neurological manifestations. SS is associat … ered without significant sequelae. None had hyponatremia, while all patients had hypokalemia and/or hypernatremia. Hypokalemia causing nephrogenic diabetes insipidus (NDI) followed by rapid rise in sodium and the resultant osmotic stress could potentially explain the occurrence of ODS in SS-RTA. Aquaporin (AQP) in astrocytes is implicated in ODS, and renal AQP …

Electrolyte Imbalance Among Bangladeshi Patients With COVID-19.

Introduction Infection with SARS-CoV-2 begins in the lower respiratory tract, but COVID-19 often involves the renal system, resulting in ser … ctively, compared with females. In severe COVID-19 cases compared with moderate cases, the risks of hypernatremia, elevated chloride levels, and elevated serum creatinine levels were increased by 2.83-fold (95% CI = 1.26, 6.36, P = 0.012), 5.37-fold (95% CI = 1.90, 15.3, P = 0.002), and 2.00-fold (95% CI = 1.08, 4.31, P = 0.039), respectively. Conclusion Serum …

[Sepsis associated encephalopathy is an independently risk factor for nosocomial coma in patients with supratentorial intracerebral hemorrhage: a retrospective cohort study of 261 patients].

OBJECTIVE: To investigate whether the presence of sepsis associated encephalopathy (SAE) would predict nosocomial coma (NC) and poor outcome … . 10.0%), pneumonia (37.8% vs. 24.0%), septic shock (8.1% vs. 0), acute liver failure (5.4% vs. 0), hypernatremia (8.1% vs. 0), CT indicating that more frequent vasogenic edema (64.9% vs. 16.0%) and white matter lesion (13.5% vs. 2.0%), and less mannitol usage (94.6% vs. 100.0%), and less brain midline shift (32.4% vs. 68.0%) and hematoma enlargement (8.1% vs. …

Application of group LASSO regression based Bayesian networks in risk factors exploration and disease prediction for acute kidney injury in hospitalized patients with hematologic malignancies.

BackgroundPatients who were diagnosed with hematologic malignancies (HM) had a higher risk of acute kidney injury (AKI). This study applies the Bayesian networks (BNs) to investigate the interrelationships between AKI and its risk factors among HM patients, and to evaluate the predictive and inferential ability of BNs model in different clinical settings.MethodsDuring 2014 and 2015, a total of 2501 inpatients with HM were recruited in this retrospective study conducted in a tertiary hospital, Shanghai of China. Patients' demographics, medical history, clinical and laboratory records on admissi

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… In a similar situation but hypernatremia, the probability of AKI was estimated to be 68.3%. In contrast, patients with normal eGFR, hemoglobin and sodium level had the lowest rate (5.2%). … Olgar et al. reported that among leukemia patients, hyponatremia and hypernatremia accounted for 11.7 and 9.5%, hypokalemia and hyperkalemia accounted for 7.6 and 6.0% [ 31 ]. …

COVID-19 and Headache Medicine: A Narrative Review of Non-Steroidal Anti-Inflammatory Drug (NSAID) and Corticosteroid Use.

OBJECTIVE: To summarize the current literature on non-steroidal anti-inflammatory drug and corticosteroid use during the coronavirus disease 2019 (COVID-19) pandemic, recognizing that these are commonly used treatments in the field of headache medicine. BACKGROUND: The use of non-steroidal anti-inflammatory drugs and corticosteroids in patients during the COVID-19 pandemic has been a controversial topic within the medical community and international and national health organizations. Lay press and social media outlets have circulated opinions on this topic despite the fact that the evidence f

What is the safe approach for neonatal hypernatremic dehydration? A retrospective study from a neonatal intensive care unit.

OBJECTIVES: The aims of this study were to evaluate the prevalence, complications, and mortality of hypernatremic dehydration in neonates and to compare the effect of correction rate at 48 hours on mortality and on neurological outcome in the short term. METHODS: This retrospective study was conducted between January 2007 and 2011 in the neonatal intensive care unit. Term neonates were included. The patients were grouped as follows: group 1 = 150 to 160 mmol/L, group 2 = 161 to 170 mmol/L and group 3 = 171 to 189 mmol/L. RESULTS: Among 4280 neonates, 81 cases (1.8%) had hypernatremic dehydra

Initial Six Month's Study of Neonatal Covid-19 in a Tertiary Care Hospital of Bangladesh.

The pandemic Covid-19 affects mainly adult causing fatal illness specially who have co-morbidities. But as days pass by with increasing surv … in 2/43(4.7%) and thrombocytopenia in 5/43(11.6%). Elevated CRP was present in 14/29 (32.6%) cases, hypernatremia in 10/33 (30.3%), hyponatremia in 1/33(3%), increased serum creatinine in 10/18(55.6%), and prolonged PT, aPTT in 2/2(100%). Hyperglycaemia was found in 1/15(6.7%) cases and hypoglycaemia in 2/15(13.3%). No organism was found in blood C/S. In chest …

Acute kidney injury manifesting as renal tubular acidosis with proximal and distal renal tubular dysfunction in a dog with acute pancreatitis.

OBJECTIVE: To describe the clinical presentation and management of a critically ill dog with profound renal tubular acidosis (RTA) with proximal and distal renal tubular dysfunction. CASE SUMMARY: A 3-year-old neutered female Border Terrier was presented with frequent regurgitation resulting from acute pancreatitis with severe ileus. Venous acid-base analysis and complete urinalysis confirmed the presence of normal anion gap metabolic acidosis with inappropriately alkaline urine (pH 8), consistent with distal RTA. Urinalysis, urine amino acids, and urinary fractional excretion of electrolytes

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… The previously documented hypernatremia had also increased (164 mmol/L; RI, 139–150 mmol/L). Corrected chloride was 122 mmol/L (RI, 106–127 mmol/L), which was suggestive of a free water deficit. … The hypernatremia therefore initially appears contradictory in the face of sodium diuresis. …

Common pitfalls in the use of hypertonic sodium bicarbonate for cardiac toxic drug poisonings.

BACKGROUND: Hypertonic sodium bicarbonate is advocated for the treatment of sodium channel blocker poisoning, but its efficacy varies amongs … with hypertonic sodium bicarbonate is to set maximum doses. Exceeding 6 mmol/kg is likely to cause hypernatremia, fluid overload, metabolic alkalosis, and cerebral oedema in many patients and potentially be lethal. RECOMMENDATION FOR THE USE OF HYPERTONIC SODIUM BICARBONATE IN SODIUM CHANNEL BLOCKER POISONING: We propose that hypertonic sodium bicarbonate the …

ВРЕМЯ АНДОКРИСНОЛОГИИ COVID-19-2021 Борьба с диабетом инсипидом и гипонатрамией.

AbstractCOVID-19 , изменила характер медицинских консультаций, сделав упор на виртуальное консультирование пациентов, что имеет отношение к пациентам с диабетом инсипиду (ДИ) или гипонатрамией. Основным осложнением лечения демопрессией в ДИ является разбавляющая гипонатраемия. Поскольку плазменный мониторинг натрия не всегда возможен во время COVID-19, мы рекомендуем откладывать дозу десмопрессина раз в неделю до тех пор, пока не произойдет акварез, позволяющий экстрактировать избыточную оставляемую воду. Пациенты должны ежедневно измерять вес своего тела. Пациенты с детективом-детективом, пом

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… Prevalence and outcomes of hyponatremia and hypernatremia in patients hospitalized with COVID-19 . … Hyponatremia, hypernatremia, and mortality in patients with chronic kidney disease with and without congestive heart failure . …

Quantifying the effects of wound healing risk and potential on clinical measurements and outcomes of severely burned patients: A data-driven approach.

INTRODUCTION: Given recent advances in computational power, the goal of this study was to quantify the effects of wound healing risk and potential on clinical measurements and outcomes of severely burned patients, with the hope of providing more insight on factors that affect wound healing. METHODS: This retrospective study involved patients who had at least 10% TBSA% "burned" and three burn mappings each. To model risk to wounds, we defined the variable θ, a hypothetical threshold for TBSA% "open wound" used to demarcate "low-risk" from "high-risk" patients. Low-risk patients denoted those p

Неврологические последствия гипергликемии: сообщение о редком представлении о синдроме осмотической демиелинации.

Синдром осмотического обезвоживания (ОРД) представляет собой редкое, но потенциально опасное для жизни неврологическое расстройство. Она характеризуется невоспалительным обезвоживанием, которое, как правило, вызвано внезапными сменами сыворотки. Однако появляющиеся данные свидетельствуют о том, что резкие осмотические изменения, вызванные сильной гипергликемией, даже при отсутствии натриевого дисбаланса, могут также приводить к образованию ОРВ. ПРЕДОСТАВЛЕНИЕ СЛУЧАИ: А 57-year-old мужского пола с плохо управляемым типом 2 Больной диабет и хроническое употребление алкоголя сопровождаются период

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… In these cases, rapid reduction of blood glucose, repeated swings between hyperglycemia and hypoglycemia, or persistent hypernatremia have been implicated–each contributing to abrupt serum osmolality shifts that trigger demyelination. 5 , 14 Notably, ODS has also occurred in diabetic individuals without … In cases of hyperglycemia-induced ODS, it is imperative to correct serum glucose levels gradually, mirroring the cautious approach used for correcting hypernatremia. Continuous monitoring of neurological status, serum glucose concentrations, and serum osmolality is essential. …

A Recipe for Disaster - Sodium Bicarbonate Overdose.

AUDIENCE: Emergency medicine residents post-graduate years 1-4. INTRODUCTION: Sodium bicarbonate is a compound found commonplace in many ho … ble to their future patient care. TOPICS: Sodium bicarbonate, baking soda, alkalosis, hypokalemia, hypernatremia, toxicology, prolonged QTc, oral board case.