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    A Systematic Review of Fatalities Related to Acute Ingestion of Salt. A Need for Warning Labels?
    Nutrients 2017 Jun 23;9(7). Epub 2017 Jun 23.
    The School of Public Policy, University of Calgary, Calgary, AB T2N 4Z6, Canada.
    There are sporadic cases of fatalities from acutely eating salt. Yet, on social media, there are "challenges to" and examples of children and some adults acutely eating salt, and recently a charity advocated eating small amounts of salt to empathize with Syrian refugees. We performed a systematic review of fatalities from ingesting salt to assess if relatively moderate doses of salt could be fatal. Read More

    Toxicity and biodistribution of orally administered casein nanoparticles.
    Food Chem Toxicol 2017 Jun 10;106(Pt A):477-486. Epub 2017 Jun 10.
    Department of Pharmacology and Toxicology, Drug Development Unit, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain. Electronic address:
    In the last years, casein nanoparticles have been proposed as carriers for the oral delivery of biologically active compounds. However, till now, no information about their possible specific hazards in vivo was available. The aim of this work was to assess the safety of casein nanoparticles when administered orally to animals through a 90 days dose-repeated toxicity study (OECD guideline 408), that was performed in Wistar rats under GLP conditions. Read More

    Intraoperative Dexmedetomidine-Induced Polyuric Syndrome.
    Cureus 2017 May 3;9(5):e1218. Epub 2017 May 3.
    Anesthesiology, Riverside University Health System Medical Center, Moreno Valley, California, United States.
    A 23-year-old male trauma patient with a cervical spine fracture underwent an anterior and posterior discectomy and spinal fusion surgery. The patient presented to the operating room with a stabilizing halo fixation device in place, and a fiberoptic intubation was performed with dexmedetomidine for sedation. During the surgical procedure, general anesthesia was maintained with a propofol and remifentanil infusion as the patient was monitored using somatosensory and motor evoked potentials. Read More

    Can Hypo/Hypernatremic Conditions be a Factor for Na Ion Channel Kinetics: Model Study.
    Turk Neurosurg 2017 Apr 21. Epub 2017 Apr 21.
    Selcuk University, School of Medicine, Department of Biophysics, Konya, Turkey.
    Aim: Dysnatremic cases are frequently faced in clinical practice and the macroscopic effects of it and its consequences are well known, but microscopic effects of it are not well defined, this research tries to reveal the effects of dysnatremia at the cellular level.

    Material And Methods: By using an action potential simulation, the effects of the extracellular sodium concentration on the sodium ion channel kinetics are studied. The experimental sets are chosen to mimic hypo/hypernatremic conditions and in both cases degree of the severity is varied. Read More

    Biochemical derangements prior to emergency laparotomy at Queen Elizabeth Central Hospital, Blantyre, Malawi: A cross-sectional pilot study.
    Malawi Med J 2017 Mar;29(1):55-56
    Department of Surgery, North Devon District Hospital, Barnstaple, United Kingdom.
    Background: The aim of this study was to examine biochemical investigations not routinely performed prior to emergency laparotomy in patients at Queen Elizabeth Central Hospital, a low-resource public hospital in Blantyre, Malawi.

    Methods: A prospective cross-sectional study of adults (N = 15) needing emergency laparotomy over a 4-week period were studied at Queen Elizabeth Central Hospital. Biochemical investigations, not routinely performed for economic reasons, were performed preoperatively; these included sodium, potassium, chloride, carbon dioxide, urea, and calcium levels. Read More

    A 9-Day-Old With Weight Loss and Diarrhea.
    Pediatrics 2017 May 11;139(5). Epub 2017 Apr 11.
    Cleveland Clinic Children's, Cleveland, Ohio.
    A 9-day-old infant girl presented with diarrhea and weight loss of 19% since birth. She was born via spontaneous vaginal delivery at 39 weeks' gestation to a mother positive for group B Streptococcus who received adequate intrapartum prophylaxis. The infant was formula-fed every 2 to 3 hours with no reported issues with feeding or swallowing. Read More

    Tris-base buffer: a promising new inhibitor for cancer progression and metastasis.
    Cancer Med 2017 May 29. Epub 2017 May 29.
    Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center, Tampa, Florida.
    Neutralizing tumor external acidity with oral buffers has proven effective for the prevention and inhibition of metastasis in several cancer mouse models. Solid tumors are highly acidic as a result of high glycolysis combined with an inadequate blood supply. Our prior work has shown that sodium bicarbonate, imidazole, and free-base (but not protonated) lysine are effective in reducing tumor progression and metastasis. Read More

    Pulmonary hypertension and right heart failure due to severe hypernatremic dehydration.
    Perfusion 2017 Jul 1;32(5):413-415. Epub 2017 Feb 1.
    Department of Pediatrics, Division of Critical Care, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA.
    Introduction: Neonates are at risk of developing hypernatremic dehydration and its associated complications, such as stroke, dural sinus thrombosis and renal vein thrombosis. Pulmonary hypertension has not been described as a complication of hypernatremia.

    Case Report: We report a case of a seven-day-old neonate with severe hypernatremic dehydration who went on to develop pulmonary hypertension and right heart failure needing extracorporeal membrane oxygenation (ECMO). Read More

    Use of Chlorothiazide in the Management of Central Diabetes Insipidus in Early Infancy.
    Case Rep Pediatr 2017 3;2017:2407028. Epub 2017 May 3.
    Department of Pediatrics, Division of Pediatric Endocrinology, New York University School of Medicine, New York, NY, USA.
    Management of central diabetes insipidus in infancy is challenging. The various forms of desmopressin, oral, subcutaneous, and intranasal, have variability in the duration of action. Infants consume most of their calories as liquids which with desmopressin puts them at risk for hyponatremia and seizures. Read More

    Do Patients With a Baseline Clinical Condition Warranting the Cautious Use of Parenteral Nutrition Develop Subsequent Metabolic Complications?
    Nutr Clin Pract 2017 Jun 1;32(3):400-406. Epub 2016 Dec 1.
    1 Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, Pennsylvania, USA.
    Background: The American Society for Parenteral and Enteral Nutrition Adult Nutrition Support Core Curriculum describes clinical conditions that warrant cautious use of parenteral nutrition (CCWCPN). The Core Curriculum authors acknowledge there is no evidence for specific criteria suggested for the clinical conditions. Consequently, the purpose of this study was to determine the impact of a baseline CCWCPN on the development of subsequent metabolic complications in patients receiving parenteral nutrition (PN). Read More

    Electrolyte Disturbances in Critically Ill Cancer Patients: An Endocrine Perspective.
    J Intensive Care Med 2017 Jan 1:885066617706650. Epub 2017 Jan 1.
    3 Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
    Electrolyte disturbances are frequently encountered in critically ill oncology patients. Hyponatremia and hypernatremia as well as hypocalcemia and hypercalcemia are among the most commonly encountered electrolyte abnormalities. In the intensive care unit, management of critical electrolyte disturbances is focused on initial evaluation and immediate treatment plan to prevent severe complications. Read More

    Dysnatremia is an Independent Indicator of Mortality in Hospitalized Patients.
    Med Sci Monit 2017 May 21;23:2408-2425. Epub 2017 May 21.
    Division of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China (mainland).
    BACKGROUND Dysnatremia is a risk factor for poor outcomes. We aimed to describe the prevalence and outcomes of various dysnatremia in hospitalized patients. High-risk patients must be identified to improve the prognosis of dysnatremia. Read More

    A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome.
    Case Rep Oncol 2017 Jan-Apr;10(1):321-324. Epub 2017 Apr 6.
    aWalter Reed National Military Medical Center, Bethesda, MD, USA.
    Carcinoid tumors are neuroendocrine tumors that mainly arise in the gastrointestinal tract, lungs, and bronchi. Bronchopulmonary carcinoids have been associated with Cushing syndrome, which results from ectopic adrenocorticotrophic hormone (ACTH) secretion. We report the case of a 65-year-old man, a colonel in the US Air Force, with metastatic bronchopulmonary carcinoid tumors treated on a clinical trial who was hospitalized for complaints of increasing thirst, polydipsia, polyuria, weakness, and visual changes. Read More

    Target Serum Sodium Levels During Intensive Care Unit Management of Aneurysmal Subarachnoid Hemorrhage.
    Shock 2017 May 11. Epub 2017 May 11.
    *Emergency Medical Center, Kagawa University Hospital, Miki, Kita, Kagawa, Japan †Department of Neurosurgery, Kagawa University Hospital, Miki, Kita, Kagawa, Japan.
    Introduction: Dysnatremia commonly occur in the intensive care unit (ICU)- management of patients with aneurysmal subarachnoid hemorrhage (SAH). However, detailed management strategies have not been provided even by current guidelines. The purposes of this study were to examine the association of abnormal serum sodium levels with unfavorable neurologic outcomes and to identify the target range of serum sodium in patients with SAH. Read More

    Evaluation of water and electrolytes disorders in severe acute diarrhea patients treated by WHO protocol in eight large hospitals in Tehran; a nephrology viewpoint.
    J Renal Inj Prev 2017 24;6(2):109-112. Epub 2016 Nov 24.
    Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran.
    Introduction: The most common cause of death from diarrhea is the shock caused by dehydration, electrolytes and acid-base disorders. Objectives: The aim of this study was to evaluate water and electrolytes disorders in diarrhea patients after treating severe acute diarrhea. Patients and Methods: In this study we used a historical cohort and studied patients who were hospitalized due to acute diarrhea and were similarly treated for dehydration and water and electrolyte disorders as recommended by the World Health Organization (WHO) guideline. Read More

    Adipsic diabetes insipidus revealing a bifocal intracranial germinoma.
    Ann Endocrinol (Paris) 2017 May 5. Epub 2017 May 5.
    Department of Endocrinology, CHU de Liège, University of Liège, 4000 Liège, Belgium. Electronic address:
    Adipsic diabetes insipidus is a rare complication of intracranial tumors in which impaired antidiuretic hormone secretion is associated with the loss of thirst sensation. Here, we present the case of a patient with bifocal intracranial germinoma, diagnosed due to symptoms mainly caused by adipsic diabetes insipidus. This is, to our knowledge, the first case of adipsic diabetes insipidus revealing an intracranial germinoma reported in the literature. Read More

    [Application of improved regional citrate anticoagulation in continuous hemofiltration in children].
    Zhonghua Er Ke Za Zhi 2017 May;55(5):334-337
    Intensive Care Unit, the Children's Hospital, Chongqing Medical University; Ministry of Education Key Laboratory of Child Development and Disorders; Key Laboratory of Pediatrics in Chongqing; Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing 400014, China.
    Objective: To investigate the application of regional citrate anticoagulation with calcium hemofiltration basic solution in continuous hemofiltration in children. Method: The clinical data of 18 patients with citrate anticoagulation in continuous hemofiltration in children, excluding the hepatic failure and septic shock cases, were analyzed retrospectively, from September 2015 to August 2016 in Intensive Care Unit of the Children's Hospital of Chongqing Medical University.The commercial calcium hemofiltration basic solution was used as displacement liquid . Read More

    Severe Hypernatremic Dehydration and Lower Limb Gangrene in an Infant Exposed to Lamotrigine, Aripiprazole, and Sertraline in Breast Milk.
    Breastfeed Med 2017 May 8. Epub 2017 May 8.
    2 Department of Pediatrics, CHU Sainte-Justine, University of Montreal , Montreal, Canada .
    Background: Hypernatremic dehydration is well described in exclusively breastfed neonates, although life-threatening complications are rarely reported.

    Materials And Methods: The present article describes a case of severe hypernatremic dehydration in a previously healthy term neonate. Other published cases of severe complications of hypernatremic dehydration are discussed. Read More

    Neurologic Intensive Care Unit Electrolyte Management.
    Nurs Clin North Am 2017 Jun 7;52(2):321-329. Epub 2017 Apr 7.
    Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, OR 97239, USA. Electronic address:
    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. Read More

    Severity of community acquired hypernatremia is an independent predictor of mortality.
    Intern Emerg Med 2017 May 4. Epub 2017 May 4.
    Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, South Korea.
    Hypernatremia develops commonly in critically ill patients during hospitalization, and is associated with adverse outcomes. However, community acquired hypernatremia (CAH) has been rarely studied. We conducted a study in patients who presented to an urban referral hospital, and were admitted with CAH. Read More

    [Prehospital arterial blood gas analysis after collapse connected to triathlon participation].
    Ugeskr Laeger 2017 May;179(18)
    Long-distance athletes are at risk of serious fluid and electrolyte disturbances, such as hypernatraemia (dehydration). Recently, cases of serious morbidity have been reported, due to acute exercise-associated hyponatraemia, which can advance to encephalopathy. An arterial blood gas analysis (ABG) was drawn from collapsed athletes at the championship of full-distance triathlon 2015, and different electrolyte imbalances were found. Read More

    Potentially modifiable factors contributing to sepsis-associated encephalopathy.
    Intensive Care Med 2017 May 2. Epub 2017 May 2.
    Department of Intensive Care Medicine and Infectious Diseases, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75877, Paris Cedex, France.
    Purpose: Identifying modifiable factors for sepsis-associated encephalopathy may help improve patient care and outcomes.

    Methods: We conducted a retrospective analysis of a prospective multicenter database. Sepsis-associated encephalopathy (SAE) was defined by a score on the Glasgow coma scale (GCS) <15 or when features of delirium were noted. Read More

    Safety and Efficacy of Citrate Anticoagulation for Continuous Renal Replacement Therapy for Acute Kidney Injury After Liver Transplantation: A Single-Center Experience.
    Transplant Proc 2017 May;49(4):674-676
    Renal and Dialysis Unit, University Hospital of Verona, Verona, Italy.
    Background: Acute kidney injury (AKI) after liver transplantation (LT) is a frequent and serious complication. The incidence of AKI requiring continuous renal replacement therapy (CRRT) ranges from 10% to 30%. Kidney Disease: Improving Global Outcomes guidelines indicate the use of citrate as a locoregional anticoagulant drug for CRRT regardless of the patient's hemorrhagic risk. Read More

    Comparison of the incidences of hyponatremia in adult postoperative critically ill patients receiving intravenous maintenance fluids with 140 mmol/L or 35 mmol/L of sodium: retrospective before/after observational study.
    J Anesth 2017 Apr 28. Epub 2017 Apr 28.
    Department of Anesthesiology, Kobe University Hospital, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
    Purpose: The purpose of this study was to compare the incidences of hyponatremia in adult postoperative critically ill patients receiving isotonic and hypotonic maintenance fluids.

    Methods: In this single-center retrospective before/after observational study, we included patients who had undergone an elective operation for esophageal cancer or for head and neck cancer and who received postoperative intensive care for >48 h from August 2014 to July 2016. In those patients, sodium-poor solution (35 mmol/L of sodium; Na35) had been administered as maintenance fluid until July 2015. Read More

    Salt, sweat, and unclear? Diaphoresis and hypernatremia in end-stage kidney disease: Questions.
    Pediatr Nephrol 2017 Apr 27. Epub 2017 Apr 27.
    Division of Nephrology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104-4399, USA.
    This quiz will discuss two patients with end-stage kidney disease (ESKD) on dialysis presenting with diaphoresis and hypernatremia. Read More

    Usefulness of anti-rabphilin-3A antibodies for diagnosing central diabetes insipidus in the third trimester of pregnancy.
    Endocr J 2017 Apr 14. Epub 2017 Apr 14.
    Department of Endocrinology and Applied Medical Science, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.
    We report a 27-year-old pregnant woman with polyuria, polydipsia and headache in the third trimester of pregnancy. Hypernatremia (153 mEq/L), high plasma osmolality (300 mOsm/kgH2O) and low urinary osmolality (92 mOsm/kgH2O) were observed at the admission to our hospital. Plasma arginine vasopressin (AVP) level was inappropriately low (2. Read More

    Renal tubular NHE3 is required in the maintenance of water and sodium chloride homeostasis.
    Kidney Int 2017 Apr 3. Epub 2017 Apr 3.
    Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida, USA. Electronic address:
    The sodium/proton exchanger isoform 3 (NHE3) is expressed in the intestine and the kidney, where it facilitates sodium (re)absorption and proton secretion. The importance of NHE3 in the kidney for sodium chloride homeostasis, relative to the intestine, is unknown. Constitutive tubule-specific NHE3 knockout mice (NHE3(loxloxCre)) did not show significant differences compared to control mice in body weight, blood pH or bicarbonate and plasma sodium, potassium, or aldosterone levels. Read More

    Renal compensatory adaptation for water handling in a patient with adipsic diabetes insipidus after clipping of a ruptured aneurysm of the anterior communicating artery
    Clin Nephrol 2017 Apr 4. Epub 2017 Apr 4.
    A 38-year-old Japanese man who had undergone clipping surgery for a ruptured aneurysm of the anterior communicating artery 2 days prior, suddenly developed refractory hypernatremia (serum sodium (Na) 156 - 162 mmol/L). Symptoms included low plasma vasopressin, fluctuating urine osmolality (120 - 710 mOsm/kg) and lack of thirst, all suggesting adipsic diabetes insipidus (ADI). Hypernatremia was corrected by scheduled water intake with desmopressin administration. Read More

    NFAT5 and SLC4A10 Loci Associate with Plasma Osmolality.
    J Am Soc Nephrol 2017 Mar 30. Epub 2017 Mar 30.
    Due to the number of contributing authors, the affiliations are listed in the supplemental material.
    Disorders of water balance, an excess or deficit of total body water relative to body electrolyte content, are common and ascertained by plasma hypo- or hypernatremia, respectively. We performed a two-stage genome-wide association study meta-analysis on plasma sodium concentration in 45,889 individuals of European descent (stage 1 discovery) and 17,637 additional individuals of European descent (stage 2 replication), and a transethnic meta-analysis of replicated single-nucleotide polymorphisms in 79,506 individuals (63,526 individuals of European descent, 8765 individuals of Asian Indian descent, and 7215 individuals of African descent). In stage 1, we identified eight loci associated with plasma sodium concentration at P<5. Read More

    Clinical characteristics of zinc phosphide poisoning in Thailand.
    Ther Clin Risk Manag 2017 14;13:335-340. Epub 2017 Mar 14.
    Ramathibodi Poison Center.
    Objective: The objectives of this study were to describe the clinical characteristics and outcomes of poisoning by zinc phosphide, a common rodenticide in Thailand, and to evaluate whether these outcomes can be prognosticated by the clinical presentation.

    Materials And Methods: A 3-year retrospective cohort study was performed using data from the Ramathibodi Poison Center Toxic Exposure Surveillance System.

    Results: In total, 455 poisonings were identified. Read More

    A Novel Practical Equation for Treatment of Emergent Hypernatremia and Dehydration Phase in Infants.
    J Res Pharm Pract 2017 Jan-Mar;6(1):56-59
    Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
    Serum sodium (Na) concentration more than 145 mmol/L is defined as hypernatremia. Hypernatremia carries an acute morbidity and mortality, especially in neonates and infants. Rapid correction of hypernatremia leads to severe cerebral damages, and seizure is the most common neurological complication of hypernatremia. Read More

    Long-Term Neurodevelopmental Outcome of Neonates with Hypernatremic Dehydration.
    Breastfeed Med 2017 Apr 22;12:163-168. Epub 2017 Mar 22.
    4 Division of Medical Education, Mayfield House, University of Brighton , Brighton, United Kingdom .
    Background: Neonatal hypernatremic dehydration (NHD) is a dangerous condition that can lead to severe weight loss, renal impairment, and central nervous system complications. We aimed to evaluate the consequences of NHD in infants in their second year of life.

    Materials And Methods: This was a prospective case-control study in Ghaem hospital, Mashhad, Iran. Read More

    Clinical aspects of changes in water and sodium homeostasis in the elderly.
    Rev Endocr Metab Disord 2017 Mar;18(1):49-66
    FMC Extracorporeal Life Support Center, Fresenius Medical Care; Medical and Health Science Center, University of Debrecen, Debrecen, Hungary.
    The population of elderly individuals is increasing worldwide. With aging, various hormonal and kidney changes occur, both affecting water homeostasis. Aging is a risk factor for chronic kidney disease (CKD) and many features of CKD are reproduced in the aging kidney. Read More

    Analyzing the efficacy of frequent sodium checks during hypertonic saline infusion after elective brain tumor surgery.
    Clin Neurol Neurosurg 2017 May 22;156:24-28. Epub 2017 Feb 22.
    Departments of Neurosurgery, Los Angeles, United States; Radiation Oncology, Los Angeles, United States; Head and Neck Surgery, Los Angeles, United States; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, United States. Electronic address:
    Objective: To assess the utility of frequent sodium checks (every 6h) in patients receiving hypertonic saline (HS) after elective brain tumor surgeries.

    Patients And Methods: A single-institution retrospective review of patients having undergone elective craniotomies for brain tumors and treated with postoperative continuous intravenous infusions of 3% HS was performed. Changes in serum sodium values were analyzed at different time points. Read More

    Severe Hypernatremia Caused by Acute Exogenous Salt Intake Combined with Primary Hypothyroidism.
    Electrolyte Blood Press 2016 Dec 31;14(2):27-30. Epub 2016 Dec 31.
    Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
    This report describes a case of severe hypernatremia with a serum sodium concentration of 188.1mmol/L caused by exogenous salt intake. A 26-year-old man diagnosed with Crohn's disease 5 years previously visited our clinic due to generalized edema and personality changes, with aggressive behavior. Read More

    Iatrogenic hypernatremia in hemodialysis patients: A result erroneous online conductivity monitor and conductivity meter reading.
    Hemodial Int 2017 Mar 8. Epub 2017 Mar 8.
    Renal Division, Morehouse School of Medicine, Atlanta, Georgia, USA.
    Hyponatremia is common in chronic kidney disease and in end stage kidney disease (ESKD) but hypernatremia is infrequent in ESKD. The incidence of hypernatremia is higher in ambulatory peritoneal dialysis (PD) than in hemodialysis (HD) patients. In PD patients it is often a result of excessive ultrafiltration but in HD it is often a result of dialysate composition errors. Read More

    Could dysnatremias play a role as independent factors to predict mortality in surgical critically ill patients?
    Medicine (Baltimore) 2017 Mar;96(9):e6182
    aDivision of Intensive Care Medicine, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo bIntensive Care Unit, São Francisco Hospital, Ribeirão Preto cSocial Medicine Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
    Several studies have demonstrated the impact of dysnatremias on mortality of intensive care unit (ICU) patients. The objective of this study was to assess whether dysnatremia is an independent factor to predict mortality in surgical critically ill patients admitted to ICU in postoperative phase.One thousand five hundred and ninety-nine surgical patients (58. Read More

    Effects of pneumoperitoneum on severe hypernatremia in an adult patient who underwent laparoscopic surgery of hydatid cysts.
    J Clin Anesth 2017 Feb 28;37:52-54. Epub 2016 Dec 28.
    Ramon y Cajal University Hospital, Ctra. Colmenar km 9, 100, Madrid.
    We describe the first case of severe hypernatremia associated to laparoscopic surgery for hydatid cyst in an adult patient after the use of hypertonic saline solution with complete resolution. Severe hypernatremia is an unusual fact at the immediate postoperative period but may have fatal consequences for the patient and need immediate action. The patient reached a serum sodium concentration of 179 mmol/L without adverse effects after 6 days of treatment. Read More

    Endocr Pract 2017 May 22;23(5):600-604. Epub 2017 Feb 22.
    Objective: Central diabetes insipidus (CDI) is a rare heterogeneous condition with various underlying causes. This study sought to increase the still-limited data on the clinical characteristics and long-term course in adults diagnosed with CDI.

    Methods: Data on demographics, presentation, imaging findings, affected pituitary axes, treatment, and complications were collected retrospectively from the files of 70 adult patients with CDI followed at a referral endocrine clinic. Read More

    Zinc Toxicosis in a Boxer Dog Secondary to Ingestion of Holiday Garland.
    J Med Toxicol 2017 Feb 21. Epub 2017 Feb 21.
    New York State Animal Health Diagnostic Center, Ithaca, NY, 14853, USA.
    Introduction: Increased admissions occur in small animal veterinary emergency clinics during some holidays, and some of the increased caseload is due to ingestion of toxic substances. This report documents zinc toxicosis contributing to the death of a dog after ingestion of holiday tinsel garland.

    Case Study: A mature boxer dog presented with a 4-day history of vomiting and diarrhea. Read More

    Method of Hypertonic Saline Administration: Effects on Osmolality in Traumatic Brain Injury Patients.
    J Clin Neurosci 2017 May 15;39:147-150. Epub 2017 Feb 15.
    Department of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN 1211 21st Avenue South, 404 Medical Arts Building, Nashville, TN 37232, United States.; Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN 1161 21st Ave. So., T4224 Medical Center North, Nashville, TN 37232, United States.
    Hypertonic saline (HTS) is an effective therapy for reducing intracranial pressure (ICP). The ideal method of administration is unknown. The purpose of this study was to evaluate the method of HTS infusion and time to goal osmolality. Read More

    A systematic review of known interventions for the treatment of chronic nonhypovolaemic hypotonic hyponatraemia and a meta-analysis of the vaptans.
    Clin Endocrinol (Oxf) 2017 Jun 27;86(6):761-771. Epub 2017 Mar 27.
    Otsuka Pharmaceutical Europe Ltd, Wexham, UK.
    International and national guidelines on the treatment of chronic nonhypovolaemic hypotonic hyponatraemia differ; therefore, we have undertaken this systematic review and meta-analysis to investigate the efficacy and safety of interventions for the treatment of chronic nonhypovolaemic hypotonic hyponatraemia. Following registration of the review protocol with PROSPERO, systematic literature searches were conducted to identify randomized and quasi-randomized controlled trials assessing any degree of fluid restriction or any drug treatment with the aim of increasing serum sodium concentration in patients with chronic nonhypovolaemic hypotonic hyponatraemia. Where appropriate, outcome data were synthesized in a meta-analysis. Read More

    The effect of nonpharmacological training on delirium identification and intervention strategies of intensive care nurses.
    Intensive Crit Care Nurs 2017 Feb 14. Epub 2017 Feb 14.
    Cumhuriyet University, Faculty of Health Sciences, Nursing Department, Sivas, Turkey. Electronic address:
    Objective: This study aims to investigate the effect of nonpharmacological intervention training on delirium recognition and the intervention strategies of intensive care (ICU) nurses.

    Method: This is a quasi-experimental study conducted using a pretest-posttest design. The study sample included a total of 95 patients staying in the medical ICU of a university hospital and 19 nurses working in these units. Read More

    [Hyponatremia and its etiology in pediatric patients admitted to the emergency room].
    Rev Med Inst Mex Seguro Soc 2017 ;55 Suppl 1:S64-S70
    Servicio de Cardiología Pediátrica, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
    Background: The importance of hyponatremia is underestimated despite it is a frequent alteration in a hospital environment. Usually no cause is investigated and it is treated as an isolated data. The aim was to determine the prevalence and etiology of hyponatremia in pediatric patients. Read More

    Hypernatremia in the Neonate: Neonatal Hypernatremia and Hypernatremic Dehydration in Neonates Receiving Exclusive Breastfeeding.
    Indian J Crit Care Med 2017 Jan;21(1):30-33
    Department of Paediatrics, Lata Mangeshkar Hospital, Hingna, Nagpur, Maharashtra, India.
    Aims And Objectives: Evaluation of neonatal hypernatremia and hypernatremic dehydration in neonates receiving exclusive breastfeeding.

    Introduction: Neonatal hypernatremia is a serious condition in the newborn period. We present infants with hypernatremic dehydration due to breast milk (BM) hypernatremia. Read More

    Neurologic manifestations of major electrolyte abnormalities.
    Handb Clin Neurol 2017 ;141:705-713
    Department of Neurology, Washington University, St. Louis, MO, USA. Electronic address:
    The brain operates in an extraordinarily intricate environment which demands precise regulation of electrolytes. Tight control over their concentrations and gradients across cellular compartments is essential and when these relationships are disturbed neurologic manifestations may develop. Perturbations of sodium are the electrolyte disturbances that most often lead to neurologic manifestations. Read More

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