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    High dose insulin for beta-blocker and calcium channel-blocker poisoning: 17years of experience from a single poison center.
    Am J Emerg Med 2018 Feb 6. Epub 2018 Feb 6.
    Minnesota Poison Control System, Department of Emergency Medicine, Hennepin County Medical Center, University of Minnesota Medical School, Minneapolis, MN, United States.
    Background/objectives: High dose insulin (HDI) is a standard therapy for beta-blocker (BB) and calcium channel-blocker (CCB) poisoning, however human case experience is rare. Our poison center routinely recommends HDI for shock from BBs or CCBs started at 1U/kg/h and titrated to 10U/kg/h. The study objective was to describe clinical characteristics and adverse events associated with HDI. Read More

    Hypokalemia associated with pseudo-Cushing's syndrome and magnesium deficiency induced by chronic alcohol abuse.
    CEN Case Rep 2018 Feb 15. Epub 2018 Feb 15.
    Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
    Hypokalemia and hypomagnesemia are frequently observed in patients with chronic alcoholism. However, the involvement of deranged cortisol regulation in patients with those conditions has not been reported. A 63-year-old Japanese male with chronic alcoholism was referred to the Department of Diabetes, Endocrinology and Metabolism for examination and treatment of hypokalemic periodic paralysis. Read More

    The refeeding syndrome. Importance of phosphorus.
    Med Clin (Barc) 2018 Feb 12. Epub 2018 Feb 12.
    Servicio de Endocrinología y Nutrición, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
    Refeeding syndrome (RS) is a complex disease that occurs when nutritional support is initiated after a period of starvation. The hallmark feature is the hypophosphataemia, however other biochemical abnormalities like hypokalaemia, hypomagnesaemia, thiamine deficiency and disorder of sodium and fluid balance are common. The incidence of RS is unknown as no universally accepted definition exists, but it is frequently underdiagnosed. Read More

    Flucloxacillin-induced hypokalaemia: a case report.
    Acta Clin Belg 2018 Feb 15:1-4. Epub 2018 Feb 15.
    b Department of nephrology , AZ Maria Middelares , Ghent , Belgium.
    Objective and importance Flucloxacillin is a narrow-spectrum beta-lactam antibiotic with activity against penicillinase producing staphylococci and streptococci. Severe hypokalaemia is an uncommon, but serious adverse effect in patients treated with penicillin derivates. Clinical presentation We report a case of severe hypokalaemia in a patient treated with high dose intravenous flucloxacillin. Read More

    Analysis of the necessity of serum electrolyte monitoring for up to eight weeks after the completion of anti-epidermal growth factor receptor antibody administration.
    • Authors:
    Pharmazie 2016 Jul;71(7):402-407
    Electrolyte disturbances are a known side effect of cetuximab (cmab) and panitumumab (pmab) administration and monitoring is recommended during and for at least 8 weeks after pmab administration. However, the recommended duration of electrolyte monitoring is not stated on the cmab package insert in the EU or Japan and no previous studies have investigated the appropriate monitoring period for cmab and pmab. We retrospectively investigated electrolyte levels in 16 cmab-treated patients and 7 pmab-treated patients between 1 June 2009 and 31 December 2014. Read More

    Novel Compound Heterozygous CLCNKB Gene Mutations (c.1755A>G/ c.848_850delTCT) Cause Classic Bartter Syndrome.
    Am J Physiol Renal Physiol 2018 Feb 14. Epub 2018 Feb 14.
    Nephrology, Children's Hospital of Nanjing Medical University, China.
    Inactivated variants in CLCNKB gene encoding the basolateral chloride channel ClC-Kb cause classic Bartter syndrome characterized by hypokalemic metabolic alkalosis and hyperreninemic hyperaldosteronism. Here we identified two cBS siblings presenting hypokalemia in a Chinese family due to novel compound heterozygous CLCNKB mutations (c.848_850delTCT/c. Read More

    Can aldosterone break your heart? Takotsubo cardiomyopathy in a patient with newly diagnosed primary aldosteronism.
    BMJ Case Rep 2018 Feb 5;2018. Epub 2018 Feb 5.
    Department of Cardiology, Borgess Medical Center, Michigan State University, Kalamazoo, Michigan, USA.
    We report a case of a 47-year-old Caucasian woman with medical history of hypertension and hypokalemia, who presented to Emergency Room with symptoms resembling acute coronary syndrome ST-segment elevation myocardial infarction. Coronary angiogram revealed clear coronary arteries and left ventriculogram confirmed the diagnosis of Takotsubo cardiomyopathy. She was treated conservatively with good clinical outcome. Read More

    Phase I trial of dasatinib, lenalidomide, and temozolomide in children with relapsed or refractory central nervous system tumors.
    J Neurooncol 2018 Feb 9. Epub 2018 Feb 9.
    Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, 4650 Sunset Boulevard, MS #54, Los Angeles, CA, 90027, USA.
    Single agent studies targeting the tumor microenvironment in central nervous system (CNS) tumors have largely been disappointing. Combination therapies targeting various pathways and cell types may be a more effective strategy. In this phase I study, we evaluated the combination of dasatinib, lenalidomide, and temozolomide in children with relapsed or refractory primary CNS tumors. Read More

    Medical findings in 1,026 consecutive adult inpatient-residential eating disordered patients.
    Int J Eat Disord 2018 Feb 8. Epub 2018 Feb 8.
    Eating Recovery Center, Denver, Denver, Colorado.
    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. Read More

    Two mutations in the thiazide-sensitive NaCl co-transporter gene in a Romanian Gitelman syndrome patient: case report.
    Ther Clin Risk Manag 2018 22;14:149-155. Epub 2018 Jan 22.
    Department of Functional Sciences.
    Background: Gitelman syndrome (GS) is considered as the most common renal tubular disorder, and we report the first Romanian patient with GS confirmed at molecular level and diagnosed according to genetic testing.

    Patient And Methods: This paper describes the case of a 27-year-old woman admitted with severe hypokalemia, slight hypomagnesemia, hypocalcemia, hypocalciuria, metabolic alkalosis, hyperreninemia, low blood pressure, limb muscle weakness, marked fatigue and palpitations. Family history revealed a consanguineous family with autosomal-recessive transmission of GS with two cases over five generations. Read More

    [Analysis of clinical characteristics of paraganglioma in 42 patients].
    Zhonghua Yi Xue Za Zhi 2018 Jan;98(4):280-283
    Department of Endocrinology, Peking University First Hospital, Beijing 100034, China.
    To summarize the clinical characteristics of paraganglioma.A total of 215 pheochromocytoma/ paraganglioma cases in Peking University First Hospital between January 1996 and December 2014 were retrospectively analyzed. The patients were divided into two groups according to the tumor position: pheochromacytoma group (173 patients) and paraganglioma group (42 patients). Read More

    Renal replacement therapy in the neonatal intensive care unit.
    Pediatr Neonatol 2017 Dec 21. Epub 2017 Dec 21.
    Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch and School of Medicine, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan, ROC. Electronic address:
    Background: Renal replacement therapy (RRT) is becoming increasingly necessary for supporting critically ill neonates. Few studies have reported the use of RRT in the neonatal intensive care unit (NICU). Therefore, we performed a retrospective study to describe the use of RRT in our NICU and its associated efficacy, complications, and outcomes. Read More

    Balanced Fluid Versus Saline-Based Fluid in Post-operative Severe Traumatic Brain Injury Patients: Acid-Base and Electrolytes Assessment.
    Malays J Med Sci 2017 Oct 26;24(5):83-93. Epub 2017 Oct 26.
    Department of Anaesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
    Background: Normal saline (NS) is a common fluid of choice in neurosurgery and neuro-intensive care unit (ICU), but it does not contain other electrolytes and has the potential to cause hyperchloremic metabolic acidosis with prolonged infusion. These problems may be reduced with the availability of balanced fluid (BF), which becomes a more physiological isotonic solution with the presence of complete electrolyte content. This study aimed to compare the changes in electrolytes and acid-base between NS and BF (Sterofundin® ISO) therapy for post-operative severe traumatic brain injury (TBI) patients in neuro-ICU. Read More

    Ephedrine Alkaloids-Free Ephedra Herb Extract, EFE, Has No Adverse Effects Such as Excitation, Insomnia, and Arrhythmias.
    Biol Pharm Bull 2018 ;41(2):247-253
    Department of Pharmacognosy, School of Pharmacy, Kitasato University.
    Ephedrine alkaloids-free Ephedra Herb extract (EFE) has been developed to eliminate the adverse effects caused by ephedrine alkaloid-induced sympathetic hyperactivation. Previously, we reported that EFE possesses analgesic, anti-influenza, and cancer metastatic inhibitory effects at comparable levels to that of Ephedra Herb extract (EHE). However, it has not yet been demonstrated that EFE is free from the known side effects of EHE, such as excitation, insomnia, and arrhythmias. Read More

    Itraconazole induced hypertension and hypokalemia: Mechanistic evaluation.
    Mycoses 2018 Jan 31. Epub 2018 Jan 31.
    Department of Medical Microbiology and Immunology, University of California-Davis, Davis, CA, USA.
    We describe a case of apparent mineralocorticoid excess (hypertension, hypokalemia, metabolic alkalosis and low plasma renin activity) secondary to itraconazole therapy. Inhibition of 11β-hydroxysteroid dehydrogenase 2 was demonstrated, and withholding itraconazole led to resolution of adverse effects that did not recur with voriconazole. This report adds to a growing body of evidence linking apparent mineralocorticoid excess with certain triazoles. Read More

    Differential roles of WNK4 in regulation of NCC in vivo.
    Am J Physiol Renal Physiol 2018 Jan 31. Epub 2018 Jan 31.
    Internal Medicine, University of Iowa Carver College of Medicine, United States.
    The Na+-Cl- cotransporter (NCC) in distal convoluted tubule (DCT) plays important roles in renal NaCl reabsorption. Current hypothesis for the mechanism of regulation of NCC focuses on WNK4 and intracellular Cl- concentration ([Cl-]i). WNK kinases bind Cl- and Cl- binding decreases the catalytic activity. Read More

    [VIPoma : a rare etiology of diarrhea with hypokalemia].
    Rev Med Suisse 2018 Jan;14(592):289-293
    Service de médecine interne, Hôpital de la Tour, avenue J.-D. Maillard 3, 1217 Genève.
    VIPoma or Verner Morrison syndrome is a very rare disease with an incidence rate of 1 case per 10 000 000 person-years. It is a neuroendocrine tumor issue from β-pancreatic islets leading to profuse diarrhea, hypokalemia and gastric achlorydria due to secretion of vasoactive intestinal polypeptide (VIP) hormone. Diagnosis is based on histology of tumor and the dosage of VIP in a blood sample. Read More

    Abiraterone acetate and prednisone in the pre- and post-docetaxel setting for metastatic castration-resistant prostate cancer: a mono-institutional experience focused on cardiovascular events and their impact on clinical outcomes.
    Ther Adv Med Oncol 2018 9;10:1758834017745819. Epub 2018 Jan 9.
    Academic Unit of Medical Oncology, San Martino Polyclinic Hospital, Institute for Cancer Research and Treatment, L.go R. Benzi 10, 16132, Genoa, Italy.
    Background: The aim of this work was to to evaluate the incidence and risk factors of adverse events (AEs), focusing on cardiovascular events (CVEs) and hypokalemia, in patients treated with abiraterone acetate (AA) and prednisone (PDN) outside clinical trials, and their association with survival outcomes.

    Methods: This was a retrospective cohort study of 105 patients treated from 2011 to 2016. Incidence of AEs was descriptively summarized in the whole cohort and by subgroup (pre-post-docetaxel). Read More

    A novel compound heterozygous variant of the SLC12A3 gene in Gitelman syndrome pedigree.
    BMC Med Genet 2018 Jan 29;19(1):17. Epub 2018 Jan 29.
    Department of Endocrinology, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, 3 East Qing Chun Road, Zhejiang, Hangzhou, 310016, China.
    Background: Gitelman syndrome (GS) is an autosomal recessive disorder caused by genic mutations of SLC12A3 (Solute carrier family 12 member 3), which encodes the Na-Cl cotransporter (NCC), and presents with characteristic metabolic abnormalities, including hypokalemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria. In this study, we report a case of a GS pedigree, including analysis of GS-associated gene mutations.

    Methods: We performed next-generation sequencing analysis and Sanger sequencing to explore the SLC12A3 mutations in a GS pedigree that included a 35-year-old female patient with GS and five family members within three generations. Read More

    First-in-human phase I dose escalation study of MK-8033 in patients with advanced solid tumors.
    Invest New Drugs 2018 Jan 29. Epub 2018 Jan 29.
    Center for Oncology and Blood Disorders, Houston, TX, USA.
    Background C-Met, which is frequently activated in multiple cancers, has been implicated in tumor formation, progression, metastasis, angiogenesis, and resistance to multiple therapies. MK-8033 is a small-molecule inhibitor of c-Met that binds preferentially to the activated conformation, and has demonstrated anti-tumor activity in preclinical models. This first-in-human trial was performed to establish the safety and maximum tolerated dose (MTD), as well as preliminary pharmacokinetics (PK) and clinical activity. Read More

    Evaluation of an individualized dose titration regimen of patiromer to prevent hyperkalaemia in patients with heart failure and chronic kidney disease.
    ESC Heart Fail 2018 Jan 25. Epub 2018 Jan 25.
    Department of Internal Medicine, General Hospital Murska Sobota and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
    Aims: Hyperkalaemia risk precludes optimal renin-angiotensin-aldosterone system inhibitor use in patients with heart failure (HF), particularly those with chronic kidney disease (CKD). Patiromer is a sodium-free, non-absorbed potassium (K)-binding polymer approved for the treatment of hyperkalaemia. In PEARL-HF, patiromer 25. Read More

    E7777 in Japanese patients with relapsed/refractory peripheral and cutaneous T-cell lymphoma: A phase 1 study.
    Cancer Sci 2018 Jan 24. Epub 2018 Jan 24.
    Department of Clinical Development, Eisai Co Ltd, Tokyo.
    E7777, a recombinant cytotoxic fusion protein comprising diphtheria toxin fragments A and B and human interleukin-2, shares an amino acid sequence with denileukin diftitox but has improved purity and an increased percentage of active protein monomer species. A phase 1 study was conducted to evaluate the tolerability, safety, pharmacokinetics and anti-tumour activity of E7777 in Japanese patients with relapsed/refractory peripheral and cutaneous T-cell lymphoma. E7777 (6, 12 and expanded 9 μg/kg/day) was administered to 13 patients via intravenous infusion on 5 consecutive days per 21-day cycle. Read More

    Prevalence of Cardiovascular Disease and Its Risk Factors in Primary Aldosteronism: A Multicenter Study in Japan.
    Hypertension 2018 Mar 22;71(3):530-537. Epub 2018 Jan 22.
    From the Department of Diabetes, Endocrinology, and Nutrition (Y. Ohno, M.S., N.I.) and Department of Urology (T. Yamasaki, O.O.), Kyoto University, Japan; Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Japan (Y. Takeda); Department of Endocrinology, Metabolism, and Nephrology, Keio University School of Medicine, Tokyo, Japan (I.K., H.I.); Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan (H.U., M.T., M.N.); Department of Endocrinology and Metabolism, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan (T.I.); Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Japan (T. Katabami, Y. Tanaka); Department of Diabetes and Endocrinology, Sapporo City General Hospital, Japan (N.W., Y.S.); Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University, Japan (T. Yoshimoto, Y. Ogawa); Department of Metabolic Medicine, Kumamoto University, Japan (J.K.); Department of Nephrology and Endocrinology, Faculty of Medicine, The University of Tokyo, Japan (K.T., M.F.); Department of Endocrinology and Diabetes, Okazaki City Hospital, Japan (M.W.); Department of Cardiology, Sanda City Hospital, Japan (Y.M.); Division of Nephrology, Hypertension, and Endocrinology, Nihon University School of Medicine, Tokyo, Japan (H.K.); Department of Endocrinology, Metabolism, Rheumatology, and Nephrology, Oita University, Yufu, Japan (H.S.); Department of Cardiology, Akashi Medical Center, Japan (K.K.); Department of Metabolic Medicine (M.O.) and Department of Geriatric and General Medicine (K.Y.), Osaka University Graduate School of Medicine, Japan; Department of Cardiology, JR Hiroshima Hospital, Japan (Y.F.); Clinical Research Institute, National Hospital Organization Kyusyu Medical Center, Fukuoka, Japan (A.O.); Department of Endocrinology, Tenriyorozu Hospital, Tenri, Japan (S.O.); Department of Internal Medicine, Uwajima City Hospital, Japan (S.M.); Department of Internal Medicine, Matsuyama Red Cross Hospital, Japan (T.F.); Department of Endocrinology and Metabolism, Tottori University Hospital, Japan (S.I.); Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan (T. Yoneda); Division of Nephrology, Hypertension, Endocrinology, and Diabetology/Metabolism, Fukushima Medical University Hospital, Japan (S.H.); Department of Endocrinology and Diabetes Mellitus, Fukuoka University Hospital, Japan (T. Yanase); Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan (T.S.); Kyoto University Health Services, Japan (T. Kawamura); and Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Japan (F.M., Y. Tabara).
    There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) in patients with primary aldosteronism (PA); however, their results have left it unclear whether CVD is affected by the plasma aldosterone concentration or hypokalemia. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalence of CVD among patients with PA with that among age-, sex-, and blood pressure-matched essential hypertension patients and participants with hypertension in a general population cohort. We also performed binary logistic regression analysis to determine which parameters significantly increased the odds ratio for CVD. Read More

    Safety, Efficacy, and Timeliness of Intravenous Potassium Chloride Replacement Protocols in a Pediatric Cardiothoracic Intensive Care Unit.
    J Intensive Care Med 2018 Jan 1:885066617752659. Epub 2018 Jan 1.
    5 Department of Pediatrics, Cardon Children's Medical Center, Mesa, AZ, USA.
    Objective: Hypokalemia in children following cardiac surgery occurs frequently, placing them at risk of life-threatening arrhythmias. However, renal insufficiency after cardiopulmonary bypass warrants careful administration of potassium (K). Two different nurse-driven protocols (high dose and tiered dosing) were implemented to identify an optimal Kreplacement regimen, compared to an historical low-dose protocol. Read More

    Zero-Order Release of Gossypol Improves Its Antifertility Effect and Reduces Its Side Effects Simultaneously.
    Biomacromolecules 2018 Jan 22. Epub 2018 Jan 22.
    State Key Laboratory of Medicinal Chemical Biology and Key Laboratory of Functional Polymer Materials, Institute of Polymer Chemistry, College of Chemistry, Nankai University and Collaborative Innovation Center of Chemical Science and Engineering (Tianjin) , Tianjin 300071, China.
    Gossypol was considered a promising male contraceptive but finally failed due to two side effects: hypokalemia and the irreversibility of its contraceptive effect. Here we demonstrate that sustained zero-order release could be a solution for these problems. The in vitro release of gossypol from gossypol/PEG layer-by-layer films follows a perfect zero-order kinetics. Read More

    Inotuzumab ozogamicin in combination with low-intensity chemotherapy for older patients with Philadelphia chromosome-negative acute lymphoblastic leukaemia: a single-arm, phase 2 study.
    Lancet Oncol 2018 Feb 16;19(2):240-248. Epub 2018 Jan 16.
    Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
    Background: Inotuzumab ozogamicin, an anti-CD22 monoclonal antibody bound to a toxin, calicheamicin, has shown single-agent activity in relapsed or refractory acute lymphoblastic leukaemia. We aimed to assess the activity and safety of inotuzumab ozogamicin in combination with low-intensity chemotherapy in older patients with acute lymphoblastic leukaemia.

    Methods: We did a single-arm, phase 2 study at the MD Anderson Cancer Center (Houston, TX, USA). Read More

    Genetic defect of a combined 17 α-hydroxylase/17,20-lyase deficiency patient with adrenal crisis.
    Gynecol Endocrinol 2018 Jan 18:1-5. Epub 2018 Jan 18.
    a Department of Gynecology , The Obstetrics and Gynecology Hospital , Shanghai , PR China.
    Combined 17 α-hydroxylase/17,20-lyase deficiency (17OHD) is a rare autosomal recessive disease that is a type of congenital adrenal hyperplasia, which results in hypertension, hypokalemia, sexual infantilism, primary amenorrhea in females (46,XX), or pseudohermaphroditism in males (46,XY). It is mainly caused by mutation in the CYP17A1 gene, which encodes a key enzyme in the steroidogenic pathway. However, these patients rarely experience adrenal crisis, due to abnormally high corticosterone levels. Read More

    Acid-Base and Electrolyte Disorders in Patients with and without Chronic Kidney Disease: An Update.
    Kidney Dis (Basel) 2017 Dec 5;3(4):136-148. Epub 2017 Oct 5.
    Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
    Kidneys play a pivotal role in the maintenance and regulation of acid-base and electrolyte homeostasis, which is the prerequisite for numerous metabolic processes and organ functions in the human body. Chronic kidney diseases compromise the regulatory functions, resulting in alterations in electrolyte and acid-base balance that can be life-threatening. In this review, we discuss the renal regulations of electrolyte and acid-base balance and several common disorders including metabolic acidosis, alkalosis, dysnatremia, dyskalemia, and dysmagnesemia. Read More

    New Findings on the Pathogenesis of Distal Renal Tubular Acidosis.
    Kidney Dis (Basel) 2017 Dec 24;3(3):98-105. Epub 2017 Aug 24.
    Department of Cardiothoracic and Respiratory Science, University of Campania "Luigi Vanvitelli," Naples, Italy.
    Background: Distal renal tubular acidosis (dRTA) is characterized by an impairment of the urinary acidification process in the distal nephron. Complete or incomplete metabolic acidosis coupled with inappropriately alkaline urine are the hallmarks of this condition. Genetic forms of dRTA are caused by loss of function mutations of either, encoding the AE1 anion exchanger, orand, encoding for the B1 and a4 subunits of the vHATPase, respectively. Read More

    Effect of Short Hydration on Cisplatin-Induced Nephrotoxicity in Cancer Patients: A Retrospective Study.
    Int J Hematol Oncol Stem Cell Res 2017 Oct;11(4):262-267
    Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
    The aim of this study was to evaluate the protective role of short hydration against nephrotoxicity induced by cisplatin (CDDP).Twenty-two patients (13 men and 9 women) under CDDP therapy were enrolled in this retrospective study between 2009 and 2014. The CDDP was given in 500 ml of isotonic solution, and before and after CDDP administration, the patients received 10mEq potassium chloride15% and 1gr magnesium sulfate in 1000 ml isotonic saline. Read More

    Infantile hypertrophic pyloric stenosis: a 4-year experience from two tertiary care centres in Cameroon.
    BMC Res Notes 2018 Jan 16;11(1):33. Epub 2018 Jan 16.
    Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
    Objective: This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon.

    Results: A total of 21 patients were included from the two centres. The mean age at presentation was 5. Read More

    Efficacy and tolerability of trastuzumab emtansine in advanced human epidermal growth factor receptor 2-positive breast cancer.
    Hong Kong Med J 2018 Feb 12;24(1):56-62. Epub 2018 Jan 12.
    Department of Clinical Oncology, Queen Elizabeth Hospital, Jordan, Hong Kong.
    Introduction: The management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer has changed dramatically with the introduction and widespread use of HER2-targeted therapies. There is, however, relatively limited real-world information about the effectiveness and safety of trastuzumab emtansine (T-DM1) in Hong Kong Chinese patients. We assessed the efficacy and toxicity profiles among local patients with HER2-positive advanced breast cancer who had received T-DM1 therapy in the second-line setting and beyond. Read More

    Phase II study of tailored S-1 monotherapy with a 1-week interval after a 2-week dosing period in elderly patients with advanced non-small cell lung cancer.
    Respir Investig 2018 Jan 21;56(1):80-86. Epub 2017 Oct 21.
    Department of Respiratory Medicine and Rheumatology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, Tokushima 770-8503, Japan. Electronic address:
    Background: S-1 is an oral fluoropyrimidine that is active in the treatment of non-small cell lung cancer (NSCLC); however, an optimal treatment schedule and appropriate dose adjustments of S-1 in elderly patients have not yet been established.

    Methods: We conducted a phase II trial to evaluate the efficacy and safety of a 2-week S-1 monotherapy treatment followed by a 1-week interval as a first-line treatment of elderly NSCLC patients, by adjusting the dose based on the individual creatinine clearance (Ccr) and body surface area (BSA). The primary endpoint was the disease control rate. Read More

    Thyrotoxic Channelopathies.
    J Assoc Physicians India 2017 Nov;65(11):98-99
    Resident Internal Medicine, Manipal Hospitals, Bangalore, Karnataka.
    Thyrotoxic periodic paralysis (TPP), a disorder most commonly seen in Asian men, is characterized by abrupt onset of hypokalemia and paralysis. The condition primarily affects the lower extremities and is secondary to thyrotoxicosis. Early recognition of TPP is vital to initiating appropriate treatment and to avoiding the risk of rebound hyperkalemia that may occur if high-dose potassium replacement is given. Read More

    Gitelman Syndrome: Presenting During Pregnancy with Adverse Foetal Outcome.
    J Assoc Physicians India 2017 Oct;65(10):104-105
    Resident, Dept. of Medicine, Pt. B. D. Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana.
    Gitelman syndrome (GS) is a rare autosomal recessive salt-losing tubulopathy. The incidence of Gitelman syndrome is 25 cases in 1 million among western population. This patient presented with loose stool, vomiting and sudden onset quadriparesis. Read More

    Potassium intake modulates the thiazide-sensitive sodium-chloride cotransporter (NCC) activity via the Kir4.1 potassium channel.
    Kidney Int 2018 Jan 6. Epub 2018 Jan 6.
    Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA. Electronic address:
    Kir4.1 in the distal convoluted tubule plays a key role in sensing plasma potassium and in modulating the thiazide-sensitive sodium-chloride cotransporter (NCC). Here we tested whether dietary potassium intake modulates Kir4. Read More

    Clinical analysis of hyperkalemia after esophagectomy: A case report.
    Medicine (Baltimore) 2017 Dec;96(48):e8966
    Department of Surgical Oncology, Henan Key Laboratory of Cancer Epigenetics, Cancer Institute, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan Province, China.
    Rationale: The occurrence of hyperkalemia after esophagectomy is clinically rare. Patients who underwent esophagectomy often have a serum potassium level due to perioperative reduced intake, fluids loss, consumption and other reasons. These patients often require the artificial administration of potassium. Read More

    Reducing Overutilization of Preoperative Medical Referrals Among Patients Undergoing Radical Cystectomy Using an Evidence-based Algorithm.
    Urology 2018 Jan 2. Epub 2018 Jan 2.
    Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH. Electronic address:
    Objective: To evaluate the frequency with which preoperative medical evaluations lead to changes in perioperative management of patients undergoing radical cystectomy and to examine the impact of an evidence-based algorithm on referral utilization.

    Materials And Methods: A retrospective review of 176 patients undergoing radical cystectomy in 2013-2014 was conducted. Patients referred for additional preoperative medical or cardiology evaluation were identified and the incidence of diagnostic testing or management changes resulting from such evaluations were determined. Read More

    Extending knowledge of the clinical picture of Balkan adder (Vipera berus bosniensis) envenoming: The first photographically-documented neurotoxic case from South-Western Hungary.
    Toxicon 2018 Mar 2;143:29-35. Epub 2018 Jan 2.
    "Moritz Kaposi" General Hospital, Department of Surgery, Tallián Gyula u. 20-32, H-7400 Kaposvár, Hungary.
    We report a severe envenoming associated with minimal local symptoms following a Balkan adder (Vipera berus bosniensis) bite in South-Western Hungary. A 63-year-old male with a history of hypertension and sinus bradycardia (45/min) was bitten by a sub-adult specimen of V. b. Read More

    Potential Usefulness of Early Potassium Supplementation for Preventing Severe Hypokalemia Induced by Liposomal Amphotericin B in Hematologic Patients: A Retrospective Study.
    Clin Ther 2018 Feb 2;40(2):252-260. Epub 2018 Jan 2.
    Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan; Department of Clinical Pharmacology and Therapeutics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
    Purpose: Liposomal amphotericin B (L-AMB) is an essential antifungal agent for patients with hematologic diseases; however, the drug causes severe hypokalemia at a high frequency. Meanwhile, there is little evidence regarding the risk factors for L-AMB-induced severe hypokalemia, and the prevention protocol has not been established. The goal of this study was to identify the risk factors related to severe hypokalemia induced by L-AMB in hematologic patients. Read More

    Management of QT prolongation induced by anti-cancer drugs: Target therapy and old agents. Different algorithms for different drugs.
    Cancer Treat Rev 2018 Feb 6;63:135-143. Epub 2017 Dec 6.
    Division of Cardiology, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy. Electronic address:
    The side effects of anticancer drugs still play a critical role in survival and quality of life. Although the recent progresses of cancer therapies have significantly improved the prognosis of oncologic patients, side effects of antineoplastic treatments are still responsible for the increased mortality of cancer survivors. Cardiovascular toxicity is the most dangerous adverse effect induced by anticancer therapies. Read More

    Evaluation of the Saline Infusion Test and the Captopril Challenge Test in Chinese Patients with Primary Aldosteronism.
    J Clin Endocrinol Metab 2017 Dec 28. Epub 2017 Dec 28.
    Sichuan University West China Hospital, Chengdu, Sichuan, P.R. China.
    Context: The aim of this study was to determine whether the diagnosis cutoff values associated with the saline infusion test (SIT) and captopril challenge test (CCT) in The Endocrine Society guidelines are applicable to Chinese subjects.

    Objective And Design: We performed a head-to-head comparison of the SIT and CCT among Chinese subjects with primary aldosteronism (PA) and essential hypertension (EH).

    Participants And Setting: 164 hypertensive patients were enrolled. Read More

    Phase I Trial of M7824 (MSB0011359C), a Bifunctional Fusion Protein Targeting PD-L1 and TGFβ, in Advanced Solid Tumors.
    Clin Cancer Res 2018 Jan 3. Epub 2018 Jan 3.
    Genitourinary Malignancies Branch, National Cancer Institute, NIH, Bethesda, Maryland.
    M7824 (MSB0011359C) is an innovative first-in-class bifunctional fusion protein composed of a mAb against programmed death ligand 1 (PD-L1) fused to a TGFβ "trap."In the 3+3 dose-escalation component of this phase I study (NCT02517398), eligible patients with advanced solid tumors received M7824 at 1, 3, 10, or 20 mg/kg once every 2 weeks until confirmed progression, unacceptable toxicity, or trial withdrawal; in addition, a cohort received an initial 0.3 mg/kg dose to evaluate pharmacokinetics/pharmacodynamics, followed by 10 mg/kg dosing. Read More

    Treatment of Severe Hyponatremia.
    Clin J Am Soc Nephrol 2018 Jan 2. Epub 2018 Jan 2.
    University of Rochester School of Medicine and Dentistry, Rochester General Hospital, Rochester, New York
    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. Read More

    Clinical Presentation, Prognostic Factors, and Outcome in Neutropenic Enteropathy of Childhood Leukemia.
    J Pediatr Hematol Oncol 2017 Dec 29. Epub 2017 Dec 29.
    Departments of Pediatric Surgery.
    Leukemia patients are at risk for neutropenic enteropathy (NEP) because of the effects of intensified chemotherapy. Medical records of 18 patients having 20 episodes of NEP were reviewed retrospectively. Primary diagnosis was acute lymphoblastic leukemia in 12 and myeloblastic leukemia in 6 cases. Read More

    Comparison of hydrocortisone and prednisone in the glucocorticoid replacement therapy post-adrenalectomy of Cushing's Syndrome.
    Oncotarget 2017 Dec 31;8(62):106113-106120. Epub 2017 Aug 31.
    University of the District of Columbia, Washington, DC, USA.
    Cushing's syndrome requires glucocorticoid replacement following adrenalectomy. Based on a simplified glucocorticoid therapy scheme and the peri-operative observation, we investigated its efficacy and safety up to 6 months post-adrenalectomy in this cohort study. We found the adrenocorticotropic hormone (ACTH) levels were normal post-adrenalectomy, and sufficient to stimulate the recovery of the dystrophic adrenal cortex, thus exogenous supplemental ACTH might not be necessary. Read More

    Kir2.1 channels set two levels of resting membrane potential with inward rectification.
    Pflugers Arch 2017 Dec 27. Epub 2017 Dec 27.
    Department of Biological Sciences, University at Albany, State University of New York, Albany, NY, 12222, USA.
    Strong inward rectifier Kchannels (Kir2.1) mediate background Kcurrents primarily responsible for maintenance of resting membrane potential. Multiple types of cells exhibit two levels of resting membrane potential. Read More

    A novel compound heterozygous mutation in the CYP17A1 gene in a patient with 17α-hydroxylase/17,20-lyase deficiency.
    Discov Med 2017 Nov;24(133):175-182
    Department of Endocrinology, Third Affiliated Hospital of Wenzhou Medical University, Ruian, Zhejiang 325200, China.
    Purpose: 17α-hydroxylase/17,20-lyase deficiency is a rare disease caused by mutation of the CYP17A1 gene, resulting in hypertension, hypokalemia, alkalosis, female hypogonadism, and male pseudohermaphroditism. Here we report a case of a 15-year-old girl with 17α-hydroxylase/17,20-lyase deficiency, and analyze her clinical and molecular genetic characteristics.

    Patient And Methods: A 15-year-old Chinese girl had fever, fatigue, high blood pressure, and blood potassium level being significantly lower than normal. Read More

    Recognizing thyrotoxic hypokalemic periodic paralysis.
    JAAPA 2018 Jan;31(1):31-34
    Kamini Patel is on the faculty at the Department of Emergency Medicine at Rutgers-Robert Wood Johnson Medical School in New Brunswick, N.J., and the Department of Emergency Medicine at the Icahn School of Medicine at Mount Sinai, New York, N.Y. Jonathan V. McCoy is an associate professor and research director in the Department of Emergency Medicine at Rutgers-Robert Wood Johnson Medical School. Patrick M. Davis is a clinical instructor in the Department of Emergency Medicine at Rutgers-Robert Wood Johnson Medical School, the Department of Emergency Medicine at New York Institute of Technology's College of Osteopathic Medicine; and the University of New England's College of Osteopathic Medicine in Biddeford, Maine. The authors have disclosed no potential conflicts of interest, financial or otherwise.
    Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare but potentially serious complication of thyrotoxicosis. The resulting muscle weakness is profound, associated with more severe hypokalemia, yet reversible. However, clinicians must be cautious because patients can develop life-threatening hyperkalemia during treatment. Read More

    A Challenging Case of Pseudohyperkalemia in Chronic Lymphocytic Leukemia.
    J Investig Med High Impact Case Rep 2017 Oct-Dec;5(4):2324709617746194. Epub 2017 Dec 13.
    MedStar Washington Hospital Center, Washington, DC, USA.
    Pseudohyperkalemia is an uncommon finding in chronic lymphocytic leukemia. It is a misleading condition that could lead to iatrogenic hypokalemia when unwarranted treatment is administered. We describe an interesting case of pseudohyperkalemia in severe leukocytosis and how we identified it. Read More

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