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    Evaluation of Serum for Pathophysiological Effects of Prolonged Low Salinity Water Exposure in Displaced Bottlenose Dolphins (Tursiops truncatus).
    Front Vet Sci 2017 8;4:80. Epub 2017 Jun 8.
    Harbor Branch Oceanographic Institute, Florida Atlantic University, Fort Pierce, FL, United States.
    We conducted a retrospective study of serum biochemistry and hematologic findings from displaced, out-of-habitat bottlenose dolphins (Tursiops truncatus) exposed to various low salinity environments in waters along the southern United States including southeastern Atlantic and northern Gulf of Mexico. Serum sodium, chloride, and calculated osmolality were significantly lower and below reference ranges in displaced animals compared to free-ranging case control animals. This suggests clinical hyponatremia, hypochloremia, and hypo-osmolality due to an uptake of low saline water from the environment. Read More

    Efficacy and safety of eslicarbazepine acetate monotherapy for partial-onset seizures: Experience from a multicenter, observational study.
    Epilepsy Behav 2017 Jun 19;73:173-179. Epub 2017 Jun 19.
    Hospital Universitario Ramón y Cajal, Servicio de Neurología, Madrid, Spain. Electronic address:
    Eslicarbazepine acetate (ESL, Aptiom™) is a once-daily anticonvulsant, approved as adjunctive treatment of partial-onset seizures (POS). Historical-controlled trials investigating the use of ESL as monotherapy have demonstrated a favorable efficacy and tolerability profile in patients with POS. This prospective, non-interventional study recruited POS patients in 17 hospitals in Spain. Read More

    Acute intermittent porphyria: a test of clinical acumen.
    J Community Hosp Intern Med Perspect 2017 Mar 6;7(2):100-102. Epub 2017 Jun 6.
    Department of Internal Medicine, Manmohan Memorial Medical College, Kathmandu, Nepal.
    Acute intermittent porphyria (AIP) is a rare autosomal dominant hepatic porphyria due to deficiency of hydroxymethylbilane synthase (HMBS), also known as porphobilinogen deaminase leading to accumulation of porphyrin precursors. However, gene defect alone is usually not sufficient to cause an acute attack, and many extrinsic factors play a role. Diagnostic tests are defined, but clinical suspicion is often delayed as symptoms mimic other common conditions. 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

    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

    Pure small cell recurrent prostate cancer developing syndrome of inappropriate antidiuretic hormone secretion.
    Tumori 2017 Jun 14. Epub 2017 Jun 14.
    Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan - Italy.
    Purpose: Pure small cell neuroendocrine carcinoma of the prostate is a rare entity characterized by a poor prognosis due to early metastatic spread as well as resistance to treatment. Considering its increasing occurrence, clinicians should be aware of its aggressive behavior, the relevance of an early diagnosis, and proper management.

    Methods: A 71-year-old man treated with brachytherapy for localized low-risk prostate cancer developed widespread disease 7 years later with a prostate-specific antigen-negative neuroendocrine small cell phenotype. Read More

    Elevated High Density Lipoprotein Cholesterol is associated with hyponatremia in hypertensive patients.
    Am J Med 2017 Jun 13. Epub 2017 Jun 13.
    Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address:
    Background: Recently, the Systolic Blood Pressure Intervention Trial (SPRINT) showed that intensive lowering of systolic blood pressure is beneficial, but is associated with more adverse events. Hyponatremia was notably more frequent in the intensive treatment group. Investigating its risk factors is crucial for preventing this complication. Read More

    Selective Serotonin Reuptake Inhibitor-Induced Hyponatremia: Clinical Implications and Therapeutic Alternatives.
    Clin Neuropharmacol 2017 Jun 16. Epub 2017 Jun 16.
    Department of Psychiatry, Hospital Universitario de La Princesa, Madrid, Spain.
    Background: Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed among the general population. Despite their benign side effect profile, these drugs can cause significant adverse effects in elderly patients, including severe hyponatremia. We report 1 case of SSRI-induced hyponatremia and review therapeutic alternatives. Read More

    Role of the Vasopressin/Apelin Balance and Potential Use of Metabolically Stable Apelin Analogs in Water Metabolism Disorders.
    Front Endocrinol (Lausanne) 2017 31;8:120. Epub 2017 May 31.
    Laboratory of Central Neuropeptides in the Regulation of Body Fluid Homeostasis and Cardiovascular Functions, Center for Interdisciplinary Research in Biology (CIRB), INSERM, U1050/CNRS, UMR 7241, College de France, Paris, France.
    Apelin, a (neuro)vasoactive peptide, plays a prominent role in controlling body fluid homeostasis and cardiovascular functions. In animal models, experimental data demonstrate that intracerebroventricular injection of apelin into lactating rats inhibits the phasic electrical activity of arginine vasopressin (AVP) neurons, reduces plasma AVP levels, and increases aqueous diuresis. In the kidney, apelin increases diuresis by increasing the renal microcirculation and by counteracting the antidiuretic effect of AVP at the tubular level. Read More

    Hyponatraemia diagnosis and treatment clinical practice guidelines.
    Nefrologia 2017 Jun 12. Epub 2017 Jun 12.
    IIS-Fundación Jiménez Díaz, Facultad de Medicina, Universidad Autónoma de Madrid; Fundación Renal Íñigo Álvarez de Toledo-IRSIN y REDINREN, Madrid, España. Electronic address:
    Hyponatremia, defined as a serum sodium concentration <135mmol/l, is the most common water-electrolyte imbalance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from mild to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay. Despite this, the management of hyponatremia patients remains problematic. Read More

    Prevalence of Hyponatremia and Its Associated Morbimortality in Hospitalized Patients Receiving Parenteral Nutrition.
    Ann Nutr Metab 2017 Jun 16;71(1-2):1-7. Epub 2017 Jun 16.
    Endocrinology and Nutrition Department, Hospital Clínico Universitario de Valladolid-IEN, Facultad de Medicina Universidad de Valladolid, Valladolid, Spain.
    Background: The objective of the study was to determine the prevalence of hyponatremia (HN) and its associated morbimortality in hospitalized patients receiving parenteral nutrition (PN).

    Methods: A retrospective study including 222 patients receiving total PN (parenteral nutrition group [PNG]) over a 7-month period in a tertiary hospital and 176 matched to 179 control subjects without PN (control subjects group [CSG]). Demographic data, Charlson Comorbidity Index (CCI), date of HN detection-(serum sodium or SNa <135 mmol/L)-intrahospital mortality, and hospital length-of-stay (LOS) were registered. Read More

    A case of acute Sheehan's syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage.
    BMC Pregnancy Childbirth 2017 Jun 14;17(1):188. Epub 2017 Jun 14.
    Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
    Background: Sheehan's syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan's syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan's syndrome is rare, and clinicians have little exposure to it. Read More

    Prognostic role of hypochloremia in acute ischemic stroke patients.
    Acta Neurol Scand 2017 Jun 14. Epub 2017 Jun 14.
    Department of Neurology, Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
    Objectives: The impact of electrolyte imbalance on clinical outcomes after acute ischemic stroke (AIS) is still not understood. We investigated the association between hypochloremia and hyponatremia upon hospital admission and in-hospital mortality in AIS patients.

    Materials And Methods: A total of 3314 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included in this study. Read More

    U.S. Food and Drug Administration Approval Summary: Atezolizumab for Metastatic Non-Small Cell Lung Cancer.
    Clin Cancer Res 2017 Jun 13. Epub 2017 Jun 13.
    Office of Oncology Drug Products, U.S. Food and Drug Administration.
    On October 18 2016, the U.S. Food and Drug Administration approved atezolizumab (TECENTRIQ®, Genentech Inc. 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

    Practice Patterns for Neurosurgical Utilization and Outcome in Acute Intracerebral Hemorrhage: Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials 1 and 2 Studies.
    Neurosurgery 2017 Jun 10. Epub 2017 Jun 10.
    Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Diseases, University of Leicester, Leicester, United Kingdom.
    Background: The prognosis in acute spontaneous intracerebral hemorrhage (ICH) is related to hematoma volume, where >30 mL is commonly used to define large ICH as a threshold for neurosurgical decompression but without clear supporting evidence.

    Objectives: To determine the factors associated with large ICH and neurosurgical intervention among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT).

    Methods: We performed pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2839) studies of ICH patients (<6 h of onset) with elevated systolic blood pressure (SBP, 150-220 mm Hg) who were randomized to intensive (target SBP < 140 mm Hg) or contemporaneous guideline-recommended (target SBP < 180 mm Hg) management. Read More

    Serum sodium correction rate and the outcome in severe hyponatremia.
    Am J Emerg Med 2017 May 31. Epub 2017 May 31.
    Department of Medical, Surgical, Neurological, Metabolic and Geriatrics Sciences, University of Campania "L. Vanvitelli", Italy.
    Study Objective: We investigated the serum sodium correction rate on length of hospitalization and survival rate, in severe chronic hyponatremic patients at the Emergency Department (ED).

    Design: An observational study using clinical chart review.

    Setting: The ED of the University Hospital of Marcianise, Caserta, Italy with approximately 30,000 patients visits a year. Read More

    Efficacy and safety of postoperative bio-chemoradiotherapy using cetuximab and docetaxel for high-risk head and neck cancer patients in Japan.
    Cancer Chemother Pharmacol 2017 Jul 8;80(1):203-207. Epub 2017 Jun 8.
    Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University, School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
    Purpose: To confirm the efficacy and safety of cetuximab and docetaxel in postoperative radiotherapy for high-risk head and neck cancer patients who cannot to be administered high-dose cisplatin.

    Patients And Methods: The eligibility criteria required stage III-IVB head and neck cancer patients who had undergone total resection, and for whom pathological evaluation revealed positive or close margins in the primary site and/or extracapsular nodal extension and/or two or more nodal metastases. In each case, the patients general condition prevented the use of high-dose cisplatin. Read More

    Opioid-induced hyponatremia in a patient with central diabetes insipidus: independence from ADH.
    J Pediatr Endocrinol Metab 2017 May;30(6):693-696
    Hyponatremia can be a complication of opioid therapy, which has been postulated to occur secondary to inappropriate antidiuretic hormone secretion (syndrome of inappropriate antidiuretic hormone secretion [SIADH]). We report severe hyponatremia following wisdom teeth extraction with opioid analgesia in a 19-year-old female with diabetes insipidus (DI) and acquired panhypopituitarism that challenges this theory. As this patient has DI, we believe opioid treatment caused severe hyponatremia by the following mechanisms: (1) Opioids have a direct antidiuretic effect independent of changes in ADH, as demonstrated in Brattleboro rats with central DI. Read More

    Pseudohypoaldosteronism types I and II: little more than a name in common.
    J Pediatr Endocrinol Metab 2017 May;30(5):597-601
    Nephrology Department, Hospital Sant Joan de Déu (University of Barcelona), Barcelona.
    Pseudohypoaldosteronism (PHA) comprises a diverse group of rare diseases characterized by sodium and potassium imbalances incorrectly attributed to a defect in aldosterone production. Two different forms of PHA have been described, type I (PHAI) and type II (PHAII). PHAI has been subclassified into renal and systemic. Read More

    Hyponatremia and increased risk of dementia: A population-based retrospective cohort study.
    PLoS One 2017 7;12(6):e0178977. Epub 2017 Jun 7.
    Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan.
    Hyponatremia is the most common electrolyte disorder and also a predictor of mild cognition impairment. However, the association between hyponatremia and dementia in long follow up periods is rarely investigated. A retrospective cohort study was performed using the claims data of all insured residents who were covered by Taiwan's universal health insurance from 2000 to 2011. Read More

    Prognostic impact of hyponatremia occurring at various time points during hospitalization on mortality in patients with acute myocardial infarction.
    Medicine (Baltimore) 2017 Jun;96(23):e7023
    Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
    We investigated the incidence and prognostic impact of hyponatremia occurring at various time points during hospitalization on long-term mortality in acute myocardial infarction (AMI) survivors. We retrospectively studied 1863 patients diagnosed with AMI. Baseline, nadir, and discharge sodium levels during hospitalization were recorded and analyzed. Read More

    Blood Oxygenation Level-Dependent Functional MRI of Early Evidences of Brain Plasticity after Hemodialysis Session by Helixone Membrane of Patients with Indices of Adrenal Deficiency.
    Ann Neurosci 2017 May 12;24(2):82-89. Epub 2017 May 12.
    The Clinical Neuroscience Laboratory, Faculty of Medicine of Fez, University Hospital of Fez, Fez, Morocco.
    Background: Various alterations of hypothalamic-pituitary-adrenal axis function have been described in patients with chronic renal failure. Nevertheless, controversial evidences were stated about the association between adrenal function deficiency (AD) and hemodialysis (HD).

    Purpose: The goal of this paper was to estimate indirect indices of the adrenal gland dysfunction which is potentially influenced by oxidative stress (OS) that still generates brain plasticity and reorganization of the functional control. 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

    Mild encephalopathy/encephalitis with a reversible splenial lesion (MERS): A report of five neonatal cases.
    J Huazhong Univ Sci Technolog Med Sci 2017 Jun 6;37(3):433-438. Epub 2017 Jun 6.
    Pharmacy Department, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430016, China.
    Mild encephalopathy/encephalitis with a reversible splenial (MERS) lesion is a clinic-radiological entity. The clinical features of MERS in neonates are still not systemically reported. This paper presents five cases of MERS, and the up-to-date reviews of previously reported cases were collected and analyzed in the literature. Read More

    [Nephrogenic syndrome of inappropriate antidiuresis: Early diagnosis avoids severe hyponatremia complications].
    Arch Pediatr 2017 Jul 2;24(7):630-633. Epub 2017 Jun 2.
    Pediatric Endocrinology unit, hôpital universitaire des Enfants-Reine-Fabiola, n(o) 15, avenue J.J.-Crocq, 1020 Bruxelles, Belgique.
    Aim: Nephrogenic syndrome of inappropriate antidiuresis (NSIAD) is a rare disease characterized by a kidney disability to dilute urine and, as a result, severe recurrent hyponatremia. Due to wide variability in clinical expression, the diagnosis still remains a challenge for clinicians. We report our experience of a case in which NSIAD was diagnosed early. Read More

    Differences Between Alcoholic and Nonalcoholic Patients With Wernicke Encephalopathy: A Multicenter Observational Study.
    Mayo Clin Proc 2017 Jun;92(6):899-907
    Department of Internal Medicine, Hospital Universitario de Salamanca, Salamanca, Spain. Electronic address:
    Objective: To analyze the differences in characteristics and prognosis between alcoholic and nonalcoholic patients with Wernicke encephalopathy (WE).

    Patients And Methods: A retrospective observational cohort of 468 patients diagnosed with WE with at least 2 Caine criteria was selected from all patients discharged with a diagnosis of WE from 21 medical centers in Spain from January 1, 2000, through December 31, 2012. Demographic, clinical, and outcome variables were described. Read More

    Mortality rates are lower in siad, than in hypervolaemic or hypovolaemic hyponatraemia; results of a prospective observational study.
    Clin Endocrinol (Oxf) 2017 Jun 2. Epub 2017 Jun 2.
    Academic Department of Endocrinology, Beaumont Hospital/RCSI Medical School, Dublin, Ireland.
    Objective: Hyponatremia is associated with increased mortality, but the mortality associated specifically with SIAD is not known. We hypothesised that mortality in SIAD was elevated, but that it was less than in hypervolemic(HEN) or hypovolemic(HON) hyponatremia.

    Design: Mortality rates are presented as risk ratios(RR),with 95% confidence intervals (CI), and compared to normonatremic controls(NN). Read More

    Mesenchymal stem cells correct haemodynamic dysfunction associated with liver injury after extended resection in a pig model.
    Sci Rep 2017 Jun 1;7(1):2617. Epub 2017 Jun 1.
    Clinics of Visceral, Transplantation, Thoracic and Vascular Surgery, University of Leipzig, Liebigstraße 21, 04103, Leipzig, Germany.
    In patients, acute kidney injury (AKI) is often due to haemodynamic impairment associated with hepatic decompensation following extended liver surgery. Mesenchymal stem cells (MSCs) supported tissue protection in a variety of acute and chronic diseases, and might hence ameliorate AKI induced by extended liver resection. Here, 70% liver resection was performed in male pigs. Read More

    Hyponatraemia - presentations and management.
    Clin Med (Lond) 2017 Jun;17(3):263-269
    Adelaide and Meath Hospitals Incorporating the National Children's Hospital, Tallaght Dublin and Trinity College Dublin, Ireland
    Hyponatraemia is the most common electrolyte disturbance encountered in clinical practice. It is associated with -significant morbidity and mortality, thus appropriate investigation and treatment is essential. Hyponatraemia presents with a spectrum of clinical presentations ranging from no symptoms to life-threatening neurological sequelae. Read More

    A hypothesis for mechanism for brain oedema due to glycine.
    Med Hypotheses 2017 Jun 9;103:58-61. Epub 2017 Apr 9.
    SUNY Downstate Medical Center, 450, Clarkson Ave, Brooklyn, NY 11203, United States.
    Death following the use the glycine distension solution in transurethral prostatectomy (TURP) or hysteroscopic surgery has been attributed to the toxic effect of glycine on the brain through the glycine receptors and hyperammonemia, contending that glycine-associated hyponatremia is isosmotic and therefore would not cause brain oedema. Here we propose a hypothesis that the mechanism of brain oedema and death is actually osmotic brain oedema caused by selective diffusion of glycine into the brain while sodium cannot diffuse out of the brain despite favourable concentration gradient because of the absence of sodium transporter on the cerebral capillaries needed for the exit of sodium from the brain. The mechanism for unidirectional diffusion of solutes into the brain in glycine-associated hyponatremia is explained. Read More

    Successful Radiotherapy for Advanced Small Cell Carcinoma of the Prostate with Syndrome of Inappropriate Secretion of Antidiuretic Hormone.
    Urol Case Rep 2017 Jul 22;13:147-148. Epub 2017 May 22.
    Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan.
    Small cell carcinoma of the prostate (SCCP) is rare in clinical practice. It is often accompanied with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). We present a case of SCCP with SIADH that was successfully treated with radiotherapy in the metastatic lymphnodes and prostate. Read More

    Neuropsychiatric Manifestations in a Patient with Panhypopituitarism.
    Case Rep Psychiatry 2017 8;2017:5082687. Epub 2017 May 8.
    Interfaith Medical Center, Brooklyn, NY, USA.
    We present a case of an incidental diagnosis of panhypopituitarism in a 68-year-old African American man admitted to our psychiatric inpatient unit with symptoms suggestive of schizophrenia. The case was unusual as a first-episode psychosis given the patient's age. In the course of his admission, the patient's clinical condition deteriorated culminating in a sudden altered mental status which prompted a transfer to the medical floors and further investigations. Read More

    Thyrotoxicosis leading to adrenal crises reveals primary bilateral adrenal lymphoma.
    Endocrinol Diabetes Metab Case Rep 2017 16;2017. Epub 2017 May 16.
    Anatomopathology Department, Hospital de Egas Moniz C.H.L.O.-E.P.E, LisbonPortugal.
    Primary adrenal lymphoma is a rare malignancy. It frequently presents bilaterally and with symptoms of adrenal insufficiency. Amiodarone may induce secondary organ dysfunction, and thyrotoxicosis develops in 15% of cases. 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

    Low-dose Desmopressin and Tolterodine Combination Therapy for Treating Nocturia in Women with Overactive Bladder: A Double-blind, Randomized, Controlled Study.
    Low Urin Tract Symptoms 2017 May 31. Epub 2017 May 31.
    Ferring Pharmaceuticals, Copenhagen S, Denmark.
    Objective: Evaluation of safety and efficacy of desmopressin/tolterodine combination therapy in women.

    Methods: This double-blind, randomized, proof-of-concept study enrolled 106 patients (≥18 years), with overactive bladder (OAB) and nocturia, with ≥2 nocturnal voids, receiving a 3-month once-daily combination (desmopressin 25 µg, orally-disintegrating tablets [ODT]/tolterodine 4 mg [Detrol® LA]; n = 49) or monotherapy (tolterodine 4 mg/placebo ODT; n = 57). Primary endpoint was change from baseline in mean number of nocturnal voids. Read More

    Does an electronic cognitive aid have an effect on the management of severe gynaecological TURP syndrome? A prospective, randomised simulation study.
    BMC Anesthesiol 2017 May 30;17(1):72. Epub 2017 May 30.
    Anästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhaustrasse 12, 91054, Erlangen, Germany.
    Background: Lack of familiarity with the content of current guidelines is a major factor associated with non-compliance by clinicians. It is conceivable that cognitive aids with regularly updated medical content can guide clinicians' task performance by evidence-based practices, even if they are unfamiliar with the actual guideline. Acute hyponatraemia as a consequence of TURP syndrome is a rare intraoperative event, and current practice guidelines have changed from slow correction to rapid correction of serum sodium levels. Read More

    An infant presenting with failure to thrive and hyperkalaemia owing to transient pseudohypoaldosteronism: case report.
    Paediatr Int Child Health 2017 May 30:1-4. Epub 2017 May 30.
    a Departments of Paediatrics , Ghent University Hospital , Ghent , Belgium.
    A 3-month-old boy presented with failure to thrive and a history of a prenatally detected unilateral hydroureteronephrosis which was confirmed after birth. His growth and developmental milestones had been normal during the first 2 months but in the third month his appetite was poor with reduced intake but no vomiting. At presentation, his temperature was normal, there was mild dehydration and there was weight loss (his weight had decreased by 270 g in the past month). Read More

    Characteristics and Outcomes of Patients with Profound Hyponatremia due to Primary Polydipsia.
    Clin Endocrinol (Oxf) 2017 May 27. Epub 2017 May 27.
    Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland.
    Objective: Hyponatremia due to excessive fluid intake (i.e. primary polydipsia (PP)) is common. 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

    Development of a computer-interpretable clinical guideline model for decision support in the differential diagnosis of hyponatremia.
    Int J Med Inform 2017 Jul 19;103:55-64. Epub 2017 Apr 19.
    Servicio de Endocrinología, Metabolismo y Nutrición, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
    Introduction: Hyponatremia is the most common type of electrolyte imbalance, occurring when serum sodium is below threshold levels, typically 135mmol/L. Electrolyte balance has been identified as one of the most challenging subjects for medical students, but also as one of the most relevant areas to learn about according to physicians and researchers. We present a computer-interpretable guideline (CIG) model that will be used for medical training to learn how to improve the diagnosis of hyponatremia applying an expert consensus document (ECDs). Read More

    Visit to visit systolic blood pressure variability predicts treatment related adverse event of hyponatremia in sprint.
    Cardiovasc Ther 2017 May 25. Epub 2017 May 25.
    Department of Medicine, Einstein Medical Center, Philadelphia, PA 19141.
    Hypertension is a common condition and an important cardiovascular risk factor. SPRINT trial showed that the beneficial effects of targeting systolic blood pressure <120 mmHg were accompanied by more adverse events. De-identified SPRINT database was used for this analysis. Read More

    Carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy.
    Epilepsia 2017 May 24. Epub 2017 May 24.
    Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, The Netherlands.
    Objective: To ascertain possible determinants of carbamazepine (CBZ)- and oxcarbazepine (OXC)-induced hyponatremia in a large cohort of people with epilepsy.

    Methods: We collected data on serum sodium levels in people with epilepsy who were attending a tertiary epilepsy center while on treatment with CBZ or OXC. We defined hyponatremia as Na+ ≤134 mEq/L and severe hyponatremia as Na+ ≤128 mEq/L. Read More

    Recurrent syndrome of inappropriate antidiuretic hormone secretion due to tolterodine in an elderly male patient.
    Saudi J Kidney Dis Transpl 2017 May-Jun;28(3):625-628
    Department of Internal Medicine, Division of Nephrology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia.
    Hyponatremia is defined as serum sodium of <135 mmol/L and equates with a low serum osmolality once translocational hyponatremia and pseudohyponatremia are ruled out. True hyponatremia develops when normal urine-diluting mechanisms are disturbed. In elderly patients, this complication is not uncommon, especially in nursing homes and assisted living facilities. Read More

    [Rapid progress of a cerebral edema due to fulminant hyponatremia].
    Med Klin Intensivmed Notfmed 2017 May 24. Epub 2017 May 24.
    Klinik II für Innere Medizin, Universitätsklinikum zu Köln, Köln, Deutschland.
    Severe acute hyponatremia is a life-threatening illness. We report the case of a 38-year-old woman with lethal cerebral edema due to acute isovolemic hyponatremia. Read More

    A case of a cerebral cavernous malformation of the third ventricle that caused the syndrome of inappropriate secretion of antidiuretic hormone.
    Surg Neurol Int 2017 26;8:53. Epub 2017 Apr 26.
    Department of Neurosurgery, Wakayama Rosai Hospital, Wakayama, Japan.
    Background: Cerebral cavernous malformations (CCMs, also known as cavernous hemanigiomas) of the third ventricle are uncommon. Here, we present a rare case of a CCM that caused the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).

    Case Description: A 68-year-old man presented with acute-onset cognitive and memory disturbance. Read More

    Myxedema Crisis Presenting with Seizures: A Rare Life-Threatening Presentation-A Case Report and Review of the Literature.
    Case Rep Endocrinol 2017 2;2017:4285457. Epub 2017 May 2.
    Endocrinology, Colombo South Teaching Hospital, Kalubowila, Sri Lanka.
    Myxedema crisis is a life-threatening extreme form of hypothyroidism with a high mortality rate if left untreated. Myxedema crisis is commonly seen in older patients, especially in women, and is associated with signs of hypothyroidism, hypothermia, hyponatraemia, hypercarbia, and hypoxemia. Patients might present with different organ specific symptoms. Read More

    A case report of pedigree of a homozygous mutation of the steroidogenic acute regulatory protein causing lipoid congenital adrenal hyperplasia.
    Medicine (Baltimore) 2017 May;96(21):e6994
    aDepartment of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Key Laboratory of Health and Family Planning Commission, Beijing, China bThe Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, China.
    Rationale: Lipoid congenital adrenal hyperplasia (LCAH) is extremely rare, but is the most fatal form of congenital adrenal hyperplasia resulting from mutations in the steroidogenic acute regulatory protein (STAR) gene. LCAH arises from severe defects in the conversion of cholesterol to pregnenolone, the precursor of all steroids.

    Patient Concerns: A case was reported that an 11-month-old Chinese girl who presented with a sex development disorder and hyponatremia. Read More

    Hyponatremia in Guillain-Barré Syndrome.
    J Clin Neuromuscul Dis 2017 Jun;18(4):207-217
    *School of Medicine, University of Missouri, Kansas City, MO; and †Department of Neurology, University of Kansas Medical Center, Kansas City, KS.
    Objectives: To evaluate incidence, risk factors, and in-hospital outcomes associated with hyponatremia in patients hospitalized for Guillain-Barré Syndrome (GBS).

    Methods: We identified adult patients with GBS in the Nationwide Inpatient Sample (2002-2011). Univariate and multivariable analyses were used. 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

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