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    Prognostic factors of atrial fibrillation following coronary artery bypass graft surgery.
    Gen Thorac Cardiovasc Surg 2017 Jun 24. Epub 2017 Jun 24.
    Department of Cardiothoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, 2 Eiveniu St, 50009, Kaunas, Lithuania.
    Objective: Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery. To prevent this complication, routine pharmacological prophylactic drugs could be administered. Our study aimed to analyze the various perioperative factors associated with the development of POAF after coronary artery bypass graft (CABG) surgery. Read More

    Severe menses-associated hypertension successfully treated with gonadotropin-releasing hormone agonist.
    J Clin Hypertens (Greenwich) 2017 Jun 23. Epub 2017 Jun 23.
    Department of Medicine, ASH Comprehensive Hypertension Center, University of Chicago Medicine, Chicago, IL, USA.
    A case of a 32-year-old nulliparous white woman referred for a 5-year history of severe hypertension, hypokalemia, and resultant systolic dysfunction is presented. She additionally had a left ventricular ejection fraction of 30% including left ventricular dilation and normal left ventricular mass index, as measured by cardiac magnetic resonance imaging when she initially presented to us. Her history revealed that her severe hypertension episodes were monthly and would occur around the catamenial (menses-associated) time. Read More

    Periodic Paralysis and Encephalopathy as Initial Manifestations of Graves' Disease: Case Report and Review of the Literature.
    Neurologist 2017 Jul;22(4):134-137
    *Neurology Department, Papageorgiou General Hospital ‡Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece †Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
    Background: Thyrotoxic periodic paralysis (TPP) is an uncommon complication of Graves' disease, characterized by the triad of acute hypokalemia without total body potassium deficit, episodic muscle paralysis, and thyrotoxicosis. Graves' encephalopathy is an extremely rare form of encephalopathy associated with autoimmune thyroid disease (EAATD), characterized by neuropsychiatric symptoms, increased antithyroid antibodies and cerebrospinal fluid protein concentration, nonspecific electroencephalogram abnormalities, and cortico-responsiveness. Coexistence of both these complications in the same patient has not been reported before. Read More

    A Case of Pulmonary Carcinoid Tumor with a Superimposed Aspergilloma Presenting As a Covert Ectopic Adrenocorticotropic Hormone Syndrome.
    Front Endocrinol (Lausanne) 2017 8;8:123. Epub 2017 Jun 8.
    Division of Endocrinology, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
    Ectopic adrenocorticotropic hormone (ACTH) syndrome is a challenging diagnosis only responsible for approximately 10% of Cushing syndrome cases. It has been associated with a variety of benign and malignant tumors including a carcinoid tumor accompanied by aspergilloma in our case that was significantly difficult to be detected. We report a patient over 70 years old with uncontrolled hypertension and hypokalemia presenting with generalized edema. Read More

    Torsade de Pointes Induced by Hypokalemia from Imipenem and Piperacillin.
    Case Rep Cardiol 2017 30;2017:4565182. Epub 2017 May 30.
    Mount Sinai Hospital, Department of Cardiology, Suite L629, 1500 S. California Ave, Chicago, IL 60608, USA.
    Imipenem-cilastatin and piperacillin-tazobactam are two antibiotics with broad antimicrobial coverage. Besides the many well established adverse effects of these drugs, there have been few case reports of hypokalemia. Here we present an interesting case of resistant hypokalemia caused by these drugs leading to Torsades de Pointes which has never been reported in the past. Read More

    Thyrotoxic periodic paralysis: a case study and review of the literature.
    J Community Hosp Intern Med Perspect 2017 Mar 6;7(2):103-106. Epub 2017 Jun 6.
    Department of Family Medicine, Guthrie Medical Group, PC, Sayre, PA, USA.
    Acute hypokalemic paralysis is a rare cause of acute weakness. Morbidity and mortality associated with unrecognized disease can occur and include respiratory failure and possibly death. Common causes of hypokalemic paralysis include thyrotoxic periodic paralysis (TPP) which is a disorder most frequently seen in Asian males. Read More

    Impact of Admission Serum Potassium on Mortality in Patients with Chronic Kidney Disease and Cardiovascular Disease.
    QJM 2017 Jun 16. Epub 2017 Jun 16.
    Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN.
    Background: The aim of this study was to assess the relationship between admission serum potassium (K) and in-hospital mortality in all hospitalized patients stratified by chronic kidney disease (CKD) and/or cardiovascular disease (CVD) status.

    Methods: All adult hospitalized patients who had admission serum K between years 2011 and 2013 were enrolled. Admission serum K was categorized into seven groups (<3. Read More

    Comparison of thiazide-like diuretics versus thiazide-type diuretics: a meta-analysis.
    J Cell Mol Med 2017 Jun 19. Epub 2017 Jun 19.
    The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, and The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China.
    Thiazide diuretics are widely used for the management of hypertension. In recent years, it has been actively debated that there is interchangeability of thiazide-type diuretics hydrochlorothiazide and thiazide-like diuretics including indapamide and chlorthalidone for the treatment of hypertension. With the purpose of seeking out the best thiazide diuretic for clinicians, we summarized the existing evidence on the two types of drugs and conducted a meta-analysis on their efficacy in lowering blood pressure and effects on blood electrolyte, glucose and total cholesterol. Read More

    Thyrotoxic periodic paralysis as an initial presentation of Graves' disease in a Saudi patient.
    BMJ Case Rep 2017 Jun 19;2017. Epub 2017 Jun 19.
    Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
    Thyrotoxic periodic paralysis (TPP) is a well-known complication of hyperthyroidism, characterised by recurrent flaccid paralysis with hypokalaemia. To date, only five cases of this rare disorder have been reported in Saudi Arabia. Here, we report an additional case involving a 25-year-old Saudi man who presented with lower limb paralysis and severe hypokalaemia. Read More

    Genetics of pleiotropic effects of dexamethasone.
    Pharmacogenet Genomics 2017 Jun 16. Epub 2017 Jun 16.
    Departments of aPharmaceutical Sciences bBiostatistics cOncology dComprehensive Cancer Center, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
    Objectives: Glucocorticoids such as dexamethasone have pleiotropic effects, including desired antileukemic, anti-inflammatory, or immunosuppressive effects, and undesired metabolic or toxic effects. The most serious adverse effects of dexamethasone among patients with acute lymphoblastic leukemia are osteonecrosis and thrombosis. To identify inherited genomic variation involved in these severe adverse effects, we carried out genome-wide association studies (GWAS) by analyzing 14 pleiotropic glucocorticoid phenotypes in 391 patients with acute lymphoblastic leukemia. Read More

    McKittrick-Wheelock syndrome: unusual, but potentially lethal.
    Rev Esp Enferm Dig 2017 Jun 19;109. Epub 2017 Jun 19.
    Medicina Interna, Complexo Hospitalario Universitario A Coruña.
    McKittrick-Wheelock syndrome is characterized by extracellular volume depletion and severe fluid and electrolyte imbalance caused by secretory tumors of the rectum, usually villous adenomas. Patients usually present signs of dehydration, hyponatremia, hypokalemia, and prerenal azotemia due to the chronic diarrhea, rich in ions and water. Since this is a potencially lethal entity without treatment, and a very unusual condition, we report a clinical case. Read More

    Low extracellular potassium prolongs repolarization and evokes early afterdepolarization in human induced pluripotent stem cell-derived cardiomyocytes.
    Biol Open 2017 Jun 15;6(6):777-784. Epub 2017 Jun 15.
    Institute of Biomedical Technology, University of Tampere, Tampere, Finland
    Long QT syndrome (LQTS) is characterized by a prolonged QT-interval on electrocardiogram and by increased risk of sudden death. One of the most common and potentially life-threatening electrolyte disturbances is hypokalemia, characterized by low concentrations of K(+) Using a multielectrode array platform and current clamp technique, we investigated the effect of low extracellular K(+) concentration ([K(+)]Ex) on the electrophysiological properties of hiPSC-derived cardiomyocytes (CMs) generated from a healthy control subject (WT) and from two symptomatic patients with type 1 of LQTS carrying G589D (LQT1A) or IVS7-2A>G mutation (LQT1B) in KCNQ1 The baseline prolongations of field potential durations (FPDs) and action potential durations (APDs) were longer in LQT1-CMs than in WT-CMs. Exposure to low [K(+)]Ex prolonged FPDs and APDs in a concentration-dependent fashion. Read More

    Liquorice-induced hypokalaemia in patients treated with Yokukansan preparations: identification of the risk factors in a retrospective cohort study.
    BMJ Open 2017 Jun 15;7(6):e014218. Epub 2017 Jun 15.
    Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
    Objective: To evaluate serum potassium levels and rates of hypokalaemia in patients treated with liquorice-containing Japanese traditional Kampo-medicines Yokukansan (YK) and Yokukansan-ka-chinpihange (YKCH).

    Design: Retrospective cohort study.

    Setting: Patients receiving YK preparations for dementia and other psychiatric disorders in the University of Tsukuba Hospital in Japan. Read More

    Diospyros rhodocalyx (Tako-Na), a Thai folk medicine, associated with hypokalemia and generalized muscle weakness: a case series.
    Clin Toxicol (Phila) 2017 Jun 15:1-5. Epub 2017 Jun 15.
    c Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital , Mahidol University , Bangkok , Thailand.
    Introduction: Diospyros rhodocalyx (Tako-Na) is a Thai folk medicine purported to promote longevity, treat impotence, etc. We present patients with hypokalemia, weakness and hypertension after consuming Tako-Na tea.

    Case Series: Case 1: A 61-year-old man was brought in nine hours after drinking 400-500 mL of Tako-Na tea. Read More

    Hypokalemia with Trifluoperazine at Therapeutic Dose.
    Indian J Psychol Med 2017 May-Jun;39(3):352-353
    Department of Psychiatry, LGB Regional Institute of Mental Health, Tezpur, Assam, India.
    This case report outlines a rare presentation of hypokalemia with therapeutic doses of trifluoperazine in a patient with schizophrenia. Although there was comorbid diabetes mellitus in the patient, its effect was ruled out subsequently. On recovery, rechallenge with trifluoperazine resulted in the same effect at a milder level. Read More

    A Trial of Itraconazole or Amphotericin B for HIV-Associated Talaromycosis.
    N Engl J Med 2017 06;376(24):2329-2340
    From Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit (T.L., N.T.T., T.P.T., N.T.H., H.B.L., H.T.N., H.F.L.W., J.N.D., J.F., G.T., M.W.), and the Hospital for Tropical Diseases (N.T.K.C., N.L.N.T., N.V.V.C.), Ho Chi Minh City, the National Hospital for Tropical Diseases (N.V.K., N.T.L.) and Bach Mai Hospital (P.T.T.T., D.D.C.), Hanoi, Viet Tiep Hospital, Hai Phong (P.T.H.P., V.H.V.), and Vietnam-Sweden Uong Bi Hospital, Quang Ninh (D.T.H.H., V.V.T.) - all in Vietnam; the Centre for Tropical Medicine and Global Health (T.L., J.N.D., G.T., M.W.), and the Worldwide Antimalarial Resistance Network (L.M.), University of Oxford, Oxford, United Kingdom; the Department of Medical Microbiology, Radboudumc, Nijmegen, the Netherlands (H.F.L.W.); and the Hawaii Center for AIDS, University of Hawaii at Manoa, Honolulu (T.L., C.S.).
    Background: Talaromyces marneffei infection is a major cause of human immunodeficiency virus (HIV)-related death in South and Southeast Asia. Guidelines recommend initial treatment with amphotericin B deoxycholate, but this drug has substantial side effects, a high cost, and limited availability. Itraconazole is available in oral form, is associated with fewer unacceptable side effects than amphotericin, and is widely used in place of amphotericin; however, clinical trials comparing these two treatments are lacking. Read More

    The Glu331del mutation in the CYP17A1 gene causes atypical congenital adrenal hyperplasia in a 46,XX female.
    Gynecol Endocrinol 2017 Jun 13:1-5. Epub 2017 Jun 13.
    g Department of Life, Health and Environmental Sciences , University of L'Aquila , L'Aquila , Italy.
    17α-Hydroxylase deficiency is an uncommon type of congenital adrenal hyperplasia (CAH) caused by mutations in the CYP17A1 gene encoding both 17α-hydroxylase and 17,20-lyase, essential for sex steroids production. Main clinical features include lack of pubertal development, hypertension, and hypokalemia. We report the first case of a 46,XX female homozygote for the p. Read More

    Water, electrolyte, acid-base, and trace elements alterations in cirrhotic patients.
    Int Urol Nephrol 2017 Jun 12. Epub 2017 Jun 12.
    Department of Medicine, Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
    Chronic hepatic patients, and particularly those suffering from cirrhosis, are predisposed to different sort of water, electrolyte, acid-base, and trace elements disorders due to their altered liver function, and also to their exposition to infectious, inflammatory, oncologic, and pharmacologic variables whose combination undermines their homeostatic capability. Hyponatremia, hypokalemia, hyperkalemia, hypocalcemia, metabolic acidosis, respiratory, and metabolic alkalosis are the main internal milieu alterations in this group. Read More

    Rhabdomyolysis and coeliac disease: A causal or casual association? A case report and review of literature.
    Clin Res Hepatol Gastroenterol 2017 Jun 9. Epub 2017 Jun 9.
    Department of Pediatrics, AORN Santobono-Pausilipon, via M. Fiore, 80129 Naples, Italy.
    Background: Rhabdomyolysis is a rare, potentially life-threatening condition, caused by multiple disorders. The association with Coeliac Disease (CD) has been rarely reported and in these cases muscular damage was imputed to hypokalemia. Herein we describe a new case of severe rhabdomyolysis in a child subsequently diagnosed as affected by CD, and review previous reports. Read More

    Effect of Hypokalemia on Functional Outcome at 3 Months Post-Stroke Among First-Ever Acute Ischemic Stroke Patients.
    Med Sci Monit 2017 Jun 10;23:2825-2832. Epub 2017 Jun 10.
    Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland).
    BACKGROUND Hypokalemia has been confirmed to be a predictor of adverse cardiovascular and renal outcomes. There is a paucity of studies focusing on the potential connection between the serum K+ level and the outcome after acute ischemic stroke (AIS). This study investigated whether hypokalemia in the acute stroke stage contributes to worse functional outcome in AIS patients. Read More

    Phase I dose-escalation trial of intravaginal curcumin in women for cervical dysplasia.
    Open Access J Clin Trials 2017 22;9:1-10. Epub 2016 Dec 22.
    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta GA, USA.
    Background: This is a Phase I trial demonstrating safety and tolerability of intravaginal curcumin for future use in women with cervical neoplasia.

    Objective: The objective of this study was to assess the safety, tolerability, and pharmacokinetics of intravaginal curcumin in healthy women.

    Study Design: We conducted a 3+3 dose-escalation Phase I trial in a group of women aged 18-45 years. Read More

    A Phase Ib Dose-Escalation Study of the Safety, Tolerability, and Pharmacokinetics of Cobimetinib and Duligotuzumab in Patients with Previously Treated Locally Advanced or Metastatic Cancers with Mutant KRAS.
    Oncologist 2017 Jun 7. Epub 2017 Jun 7.
    Vall d'Hebron University Hospital and Institute of Oncology, CIBERONC, Universitat Autònoma de Barcelona, Barcelona, Spain.
    Lessons Learned: Cobimetinib and duligotuzumab were well tolerated as single agents and in combination with other agents.The cobimetinib and duligotuzumab combination was associated with increased toxicity, most notably gastrointestinal, and limited efficacy in the patient population tested.

    Background: KRAS-mutant tumors possess abnormal mitogen-activated protein kinases (MAPK) pathway signaling, leading to dysregulated cell proliferation. Read More

    Prolonged Ketosis in a Patient With Euglycemic Diabetic Ketoacidosis Secondary to Dapagliflozin.
    J Investig Med High Impact Case Rep 2017 Apr-Jun;5(2):2324709617710040. Epub 2017 May 24.
    Emory University, Atlanta, GA, USA.
    Since the approval of sodium-glucose cotransporter 2 (SGLT2) inhibitors by the US Food and Drug Administration for type 2 diabetes, there have been several reports of euglycemic diabetic ketoacidosis in patients using this class of medication. We present a case of euglycemic diabetic ketoacidosis where ketonemia and glucosuria persisted well beyond the expected effect of dapagliflozin. Our patient is a 50-year-old woman with type 2 diabetes since age 35 who was taking metformin and dapagliflozin. Read More

    [Early hypophosphataemia in at risk newborns. Frequency and magnitude].
    An Pediatr (Barc) 2017 Jun 3. Epub 2017 Jun 3.
    Servicio de Neonatología, Hospital Universitario 12 de Octubre, Facultad de Medicina, Universidad Complutense de Madrid, Red SAMID del Instituto Carlos III, Instituto de Investigación Hospital Universitario 12 de Octubre, Madrid, España.
    Objective: To determine the frequency and magnitude of neonatal hypophosphataemia (<4mg/dL) in a neonatal Intensive Care Unit and to describe risk groups.

    Patients And Methods: Retrospective study of hospitalised newborns over a 44 month period (phase 1). Retrospective study of <1,500g/<32 weeks of gestation newborns over a 6 month period (phase 2). Read More

    Liddle's Syndrome.
    J Ayub Med Coll Abbottabad 2016 Oct-Dec;28(4):809-811
    Department of Paediatrics, Aga Khan University Hospital Karachi, Pakistan.
    Hypertension in paediatric age group is commonly secondary to a known cause. It is crucial to identify the cause of hypertension and treat it before development of any associated complications to prevent morbidity and mortality. Paediatric Hypertension is one of the important clinical finding in a child with certain clinical syndrome. Read More

    Celiac Crisis: A Rare Or Rarely Recognized Disease.
    J Ayub Med Coll Abbottabad 2016 Oct-Dec;28(4):672-675
    Department of Hepatology & Nutrition, Children Hospital & Institute of child health, Lahore, Pakistan.
    Objective: Celiac crisis is a serious life threatening complication of celiac disease characterized by profuse diarrhoea, severe dehydration and metabolic disturbances leading to neuromuscular weakness, cardiac arrhythmias and sudden death. It has been described as rare condition and not well documented in the literature. To improve awareness and facilitate diagnosis of this condition, we studied risk factors, pattern of presentation and management plans of celiac crisis. Read More

    Severe Cushing's syndrome due to small cell prostate carcinoma - a case and review of literature.
    Endocr Connect 2017 Jun 5. Epub 2017 Jun 5.
    J Conaglen, Waikato Clinical Campus, University of Auckland, Auckland, New Zealand
    Cushings syndrome (CS) due to ectopic adrenocorticotrophic hormone (ACTH) is associated with a variety of tumours most of which arise in the thorax or abdomen. Prostate carcinoma is a rare but important cause of rapidly progressive CS. To report a case of severe CS due to ACTH production from prostate neuroendocrine carcinoma and summarise previous published cases. Read More

    Secretory diarrhea and hypokalemia associated with colonic pseudo-obstruction: A case study and systematic analysis of the literature.
    Neurogastroenterol Motil 2017 Jun 5. Epub 2017 Jun 5.
    Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
    Background: Colonic pseudo-obstruction (CPO) is characterized by colonic distention in the absence of mechanical obstruction or toxic megacolon. Concomitant secretory diarrhea (SD) with hypokalemia (SD-CPO) due to gastrointestinal (GI) loss requires further characterization.

    Aim: To perform a systematic review of SD-CPO, report a case study, and compare SD-CPO with classical CPO (C-CPO). Read More

    Abiraterone plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer.
    N Engl J Med 2017 Jun 4. Epub 2017 Jun 4.
    From Gustave Roussy, University of Paris Sud, Villejuif, France (K.F.); Janssen Research and Development, Los Angeles (N.T.), Beerse, Belgium (P.D.P.), San Diego, CA (T.K.), and Raritan, NJ (Y.C.P.); Instituto de Oncologia de Rosário, Rosário, Argentina (L.F.); National Cancer Center Hospital East, Chiba, Japan (N.M.); 12 de Octubre University Hospital, Madrid (A.R.-A.); P.A. Hertsen Moscow Cancer Research Institute, Moscow (B.Y.A.); Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey (M.Ö.); Fudan University Shanghai Cancer Center, Shanghai, China (D.Y.); Studienpraxis Urologie, Nürtingen, Germany (S.F.); Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom (A.P.); Janssen Global Services, Raritan, NJ (M.B.T.); and BC Cancer Agency, Vancouver, Canada (K.N.C.).
    Background Abiraterone acetate, a drug that blocks endogenous androgen synthesis, plus prednisone is indicated for metastatic castration-resistant prostate cancer. We evaluated the clinical benefit of abiraterone acetate plus prednisone with androgen-deprivation therapy in patients with newly diagnosed, metastatic, castration-sensitive prostate cancer. Methods In this double-blind, placebo-controlled, phase 3 trial, we randomly assigned 1199 patients to receive either androgen-deprivation therapy plus abiraterone acetate (1000 mg daily, given once daily as four 250-mg tablets) plus prednisone (5 mg daily) (the abiraterone group) or androgen-deprivation therapy plus dual placebos (the placebo group). Read More

    Loss of transcriptional activation of the potassium channel Kir5.1 by HNF1β drives autosomal dominant tubulointerstitial kidney disease.
    Kidney Int 2017 May 31. Epub 2017 May 31.
    Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Centre, Nijmegen, Netherlands. Electronic address:
    Hepatocyte nuclear factor 1 homeobox B (HNF1β) is an essential transcription factor for the development and functioning of the kidney. Mutations in HNF1β cause autosomal dominant tubulointerstitial kidney disease characterized by renal cysts and maturity-onset diabetes of the young (MODY). Moreover, these patients suffer from a severe electrolyte phenotype consisting of hypomagnesemia and hypokalemia. Read More

    True rate of mineralocorticoid receptor antagonists-related hyperkalemia in placebo-controlled trials: A meta-analysis.
    Am Heart J 2017 Jun 23;188:99-108. Epub 2017 Mar 23.
    Universität des Saarlandes, Klinik für Innere Medizin III, Homburg/Saar, Germany.
    Background: Mineralocorticoid receptor antagonists (MRA) improve survival in heart failure with reduced ejection fraction but are often underused, mostly due to concerns of hyperkalemia. Because hyperkalemia occurs also on placebo, we aimed to determine the truly MRA-related rate of hyperkalemia.

    Methods: We performed a meta-analysis including randomized, placebo-controlled trials reporting hyperkalemia on MRAs in patients after myocardial infarction or with chronic heart failure. Read More

    A Case of Kidney Involvement in Primary Sjögren's Syndrome.
    Am J Case Rep 2017 Jun 3;18:622-626. Epub 2017 Jun 3.
    Department of Medicine, University of California, Los Angeles, CA, USA.
    BACKGROUND Sjögren's syndrome is an autoimmune disorder caused by the infiltration of monocytes in epithelial glandular and extra-glandular tissues. Hallmark presentations include mouth and eye dryness. Although renal involvement is uncommon in primary Sjögren's syndrome (pSS), patients may experience renal tubular acidosis type I (RTA I), tubulointerstitial nephritis, diabetes insipidus (DI), nephrolithiasis, and Fanconi syndrome. Read More

    Randomized comparison of liposomal amphotericin B versus placebo to prevent invasive mycoses in acute lymphoblastic leukaemia.
    J Antimicrob Chemother 2017 May 30. Epub 2017 May 30.
    Department of Medicine II, University Hospital, Goethe University, Frankfurt, Germany.
    Objectives: To prevent invasive fungal disease (IFD) in adult patients undergoing remission-induction chemotherapy for newly diagnosed acute lymphoblastic leukaemia (ALL).

    Patients And Methods: In a double-blind multicentre Phase 3 study, patients received prophylactic liposomal amphotericin B (L-AMB) at 5 mg/kg intravenously or placebo twice weekly in a 2:1 random allocation during remission-induction treatment. The primary endpoint was the development of proven or probable IFD. 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 retrospective analysis of postoperative hypokalemia in pituitary adenomas after transsphenoidal surgery.
    PeerJ 2017 23;5:e3337. Epub 2017 May 23.
    Department of Neurosurgery, First Hospital of Jilin University, Changchun, China.
    Background: Pituitary adenoma is one of the most common intracranial neoplasms, and its primary treatment is endoscopic endonasal transsphenoidal tumorectomy. Postoperative hypokalemia in these patients is a common complication, and is associated with morbidity and mortality. This study aimed to analyze the etiopathology of postoperative hypokalemia in pituitary adenomas after endoscopic transsphenoidal surgery. Read More

    Renal Dysfunction Induced by Kidney-Specific Gene Deletion of Hsd11b2 as a Primary Cause of Salt-Dependent Hypertension.
    Hypertension 2017 Jul 30;70(1):111-118. Epub 2017 May 30.
    From the Division of Clinical Epigenetics, Research Center of Advanced Science and Technology, The University of Tokyo, Japan (K.U., M.N., D.H., N.A., W.K., A.W., T.M., T.F.); Department of Clinical Laboratory, International University of Health and Welfare, School of Medicine, Tokyo, Japan (T.S.); CREST, Japan Agency for Medical Research and Development (AMED), Tokyo (T.S., T.M., T.F.); National Center of Competence in Research 'Kidney Control of Homeostasis', Zurich, Switzerland (J.L.); Institute of Anatomy, University of Zurich, Switzerland (J.L.); Division of Nephrology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (M.-Z.Z.); and Department of Nephrology and Endocrinology, National Defense Medical College, Saitama, Japan (A.W.).
    Genome-wide analysis of renal sodium-transporting system has identified specific variations of Mendelian hypertensive disorders, including HSD11B2 gene variants in apparent mineralocorticoid excess. However, these genetic variations in extrarenal tissue can be involved in developing hypertension, as demonstrated in former studies using global and brain-specific Hsd11b2 knockout rodents. To re-examine the importance of renal dysfunction on developing hypertension, we generated kidney-specific Hsd11b2 knockout mice. Read More

    Irinotecan-temozolomide with temsirolimus or dinutuximab in children with refractory or relapsed neuroblastoma (COG ANBL1221): an open-label, randomised, phase 2 trial.
    Lancet Oncol 2017 May 23. Epub 2017 May 23.
    Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:
    Background: Outcomes for children with relapsed and refractory neuroblastoma are dismal. The combination of irinotecan and temozolomide has activity in these patients, and its acceptable toxicity profile makes it an excellent backbone for study of new agents. We aimed to test the addition of temsirolimus or dinutuximab to irinotecan-temozolomide in patients with relapsed or refractory neuroblastoma. Read More

    Elevated baseline potassium level within reference range is associated with worse clinical outcomes in hospitalised patients.
    Sci Rep 2017 May 25;7(1):2402. Epub 2017 May 25.
    Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea.
    The clinical significance of elevated baseline serum potassium (K(+)) levels in hospitalised patients is rarely described. Hence, we performed a retrospective study assessing the significance of elevated K(+) levels in a one-year admission cohort. Adult patients without hypokalaemia or end-stage renal disease were included. Read More

    Kir2.1 and K2P1 channels reconstitute two levels of resting membrane potential in cardiomyocytes.
    J Physiol 2017 May 24. Epub 2017 May 24.
    Department of Biological Sciences, University at Albany, State University of New York, Albany, NY, 12222, USA.
    Strong inward rectifier K(+) (Kir2) channels primarily maintain normal resting membrane potential of cardiomyocytes. In sub-physiological extracellular K(+) concentrations or pathological hypokalaemia, human cardiomyocytes show both hyperpolarized and depolarized resting membrane potentials; these depolarized potentials cause cardiac arrhythmia; however, the underlying mechanism is unknown. Here we show that Kir2. Read More

    Hypertension and cardiac arrhythmias: executive summary of a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).
    Eur Heart J Cardiovasc Pharmacother 2017 Jun 20. Epub 2017 Jun 20.
    Institute of Cardiovascular Science, University College London, UK.
    Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in HTN patients, especially in those with left ventricular hypertrophy (LVH), CAD, or HF. Read More

    A young man with recurrent paralysis.
    JAAPA 2017 Jun;30(6):22-25
    At the time this article was written, Magdalena Chavez was a student in the PA program at the University of Texas Southwestern Medical Center in Dallas. She now practices internal medicine in Irving, Tex. Jeffrey Williams is an assistant professor in the PA program at the University of Texas Southwestern Medical Center. The authors have disclosed no potential conflicts of interest, financial or otherwise.
    Hypokalemia can cause reactions from mild muscular cramping to life-threatening paralysis and cardiac dysrhythmias. This article describes a patient whose unusual, recurrent muscular symptoms and electrolyte abnormalities were eventually identified as Gitelman syndrome, a rare genetic disorder resulting in severe refractory hypokalemia. 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

    Posaconazole Induced Hypertension and Hypokalemia: In vivo 11β-hydroxysteroid dehydrogenase Inhibition.
    Antimicrob Agents Chemother 2017 May 22. Epub 2017 May 22.
    Department of Internal Medicine, Division of Endocrinology, University of California Davis Medical Center.
    We describe a case of apparent mineralocorticoid excess (AME) secondary to posaconazole and suggest the biochemical mechanism. Clinical and laboratory investigation confirmed 11β-hydroxysteroid dehydrogenase inhibition and withholding therapy led to a resolution of all clinical and laboratory abnormalities. A lower dose of posaconazole was later restarted and avoided recurrence of this syndrome. Read More

    Weekly high-dose liposomal amphotericin B (L-AmB) in critically ill septic patients with multiple Candida colonization: The AmBiDex study.
    PLoS One 2017 22;12(5):e0177093. Epub 2017 May 22.
    Medical and Infectious Diseases ICU, Paris Diderot University/Bichat Hospital, Paris, France.
    Background: To demonstrate the feasibility and safety of weekly high-dose liposomal amphotericin B (L-AmB) (as a pre-emptive antifungal treatment) for 2 weeks in patients with septic shock and Candida colonization.

    Methods: Pilot, multicentre, open-label, prospective study conducted in seven French ICUs. Non-immunocompromised patients, receiving mechanical ventilation were eligible if they presented ICU-acquired severe sepsis requiring newly administered antibacterial agents and Candida colonization in at least two sites. Read More

    Sudden Unexpected Death during Sleep in Familial Dysautonomia: A case-control study.
    Sleep 2017 May 18. Epub 2017 May 18.
    Department of Neurology, Dysautonomia Center, New York University School of Medicine, New York, NY.
    Study Objectives: Sudden unexpected death during sleep (SUDS) is the most common cause of death in patients with familial dysautonomia, an autosomal recessive disease characterized by sensory and autonomic dysfunction. It remains unknown what causes SUDS in these patients and who is at highest risk. We tested the hypothesis that SUDS in FD is linked to sleep-disordered breathing. Read More

    Effect of isotonic versus hypotonic maintenance fluid therapy on urine output, fluid balance, and electrolyte homeostasis: a crossover study in fasting adult volunteers.
    Br J Anaesth 2017 Jun;118(6):892-900
    Department of Intensive Care Medicine, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Edegem (Antwerp), Belgium.
    Background.: Daily and globally, millions of adult hospitalized patients are exposed to maintenance i.v. Read More

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