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PLoS One 2021 13;16(4):e0250062. Epub 2021 Apr 13.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.

Background: Acute decompensation (AD) of liver cirrhosis (LC) and subsequent acute-on-chronic liver failure (ACLF) are fatal and impair quality of life. Insufficient knowledge of the highly heterogeneous natural history of LC, including decompensation, re-compensation, and possible recurrent decompensation, hinders the development and application of novel therapeutics. Approximately 10%-50% of AD/ACLF is reported to be precipitated by any indeterminate (unidentifiable, cryptogenic, or unknown) acute insults; however, its clinical characteristics are unclear. Read More

Neurol Neuroimmunol Neuroinflamm 2021 May 5;8(3). Epub 2021 Mar 5.

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (S.M.-C., L.T., A.V., A.-L.P., G.P., C.B., L.-D.D., B.J., V.R., J. Honnorat), Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; SynatAc Team (S.M.-C., L.T., A.V., A.-L.P., G.P., C.B., L.-D.D., B.J., V.R., J. Honnorat), Institut NeuroMyoGène, INSERM U1217/CNRS UMR 5310, Université de Lyon, Université Claude Bernard Lyon 1, France; Clinic Research and Epidemiology Department (J. Haesebaert), Hospices Civils de Lyon, Lyon, France, HESPER Team, EA 7425, Medicine School, Université Claude Bernard Lyon 1, France; Neurology Department 2-Mazarin (G.B., D.P., A. Alentorn), Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, APHP; Brain and Spinal Cord Institute (G.B., D.P., A. Alentorn), INSERM U1127/CNRS UMR 7255, Université Pierre-et-Marie-Curie, Universités Sorbonnes, Paris, France; HLA Laboratory (V.D.), French Blood Service, EFS Auvergne-Rhône-Alpes, Lyon, France; Stanford University Center for Sleep Sciences and Medicine (A. Ambati, E.M.), Palo Alto, CA; and Department of Psychiatry (R.T.), Hôpitaux Universitaires Henri Mondor, Créteil, France, Mondor Institute for Biomedical Research, INSERM U955, Université de Paris-Est-Créteil, France.

Objective: Antibodies against leucine-rich glioma-inactivated 1 (LGI1-Abs) characterize a limbic encephalitis (LE) strongly associated with HLA-DRB1*07:01, although some patients lack LGI1-Abs in CSF or do not carry this allele. Whether they represent a different subtype of disease or have different prognoses is unclear.

Methods: Retrospective analysis of clinical features, IgG isotypes, and outcome according to LGI1-Ab CSF positivity and DRB1*07:01 in a cohort of anti-LGI1 LE patients. Read More

Eur J Pediatr 2021 Apr 12. Epub 2021 Apr 12.

Hospices Civils de Lyon, réanimation pédiatrique, Hôpital Femme Mère Enfant, F-69500, Bron, France.

Neurological morbidity is a growing concern in children with severe bronchiolitis. The aim of the study was to evaluate the frequency of occurrence and the factors associated with seizures in very young infants < 3 months of age, admitted to a pediatric intensive care unit (PICU) for severe bronchiolitis. We performed a single center retrospective cohort study evaluating occurrence of seizures in infants admitted to the PICU between 2010 and 2018 for severe bronchiolitis. Read More

Am J Physiol Renal Physiol 2021 Apr 12. Epub 2021 Apr 12.

Internal Medicine, Hanyang University College of Medicine, Korea (South), Republic of.

Psychotropic drugs may be associated with hyponatremia, but an understanding of how they induce water retention in the kidney remains elusive. Previous studies have postulated that they may increase vasopressin production in the hypothalamus without supporting evidences. In this study, we investigated the possibility of drug-induced nephrogenic syndrome of inappropriate antidiuresis (NSIAD) using haloperidol, sertraline, and carbamazepine. Read More

Clin Lung Cancer 2021 Mar 16. Epub 2021 Mar 16.

Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address:

Lancet Respir Med 2021 Apr 6. Epub 2021 Apr 6.

University of Chicago, Chicago, IL, USA.

Background: Malignant pleural mesothelioma (MPM) has few treatment options. Pembrolizumab showed preliminary clinical benefit in programmed death ligand 1 (PD-L1)-positive MPM. We evaluated the efficacy and safety of pembrolizumab monotherapy in patients with previously treated MPM irrespective of PD-L1 status in the KEYNOTE-158 study. Read More

Am J Gastroenterol 2021 Feb 1. Epub 2021 Feb 1.

1Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore; 2Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore; 3Division of Gastroenterology and Hepatology, Department of Medicine, Ng Teng Fong General Hospital, Singapore; 4Programme in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore.

Introduction: Decompensation with ascites portends a poor prognosis in cirrhosis. The aim of this study was to compare the outcomes of patients with nonalcoholic steatohepatitis (NASH) with hepatitis B virus (HBV) cirrhosis after decompensation with ascites.

Methods: We conducted a retrospective study to evaluate the outcomes of patients with NASH and HBV cirrhosis who were admitted to hospital for first-onset ascites from January 1, 2004, to June 30, 2015. Read More

Mymensingh Med J 2021 Apr;30(2):267-273

Dr Mohammed Amdad Ullah Khan, Assistant Professor, Department of Medicine, Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:

Pneumonia is an acute on chronic infection involving the pulmonary parenchyma. Most cases are caused by microbial pathogens usually bacteria or viruses and less often fungi or parasites. Hyponatraemia on admission is associated with greater risk of death and increased length of hospital stays. Read More

J Clin Res Pediatr Endocrinol 2021 Apr 8. Epub 2021 Apr 8.

Pediatric Endocrinologist at Pediatric endocrine department,. Obesity, Endocrine, and Metabolism Center, , King Fahad Medical City, Riyadh, Saudi Arabia.

Pseudohypoaldosteronism type 1 (PHA1) is an autosomal-recessive disorder characterized by defective regulation of body sodium levels. The abnormality results from mutations in the gene-encoding subunits of the epithelial sodium channel (ENaC). Patients with PHA1 present in infancy as being in adrenal crisis. Read More

Front Vet Sci 2021 22;8:651672. Epub 2021 Mar 22.

Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Knoxville, TN, United States.

Old World Camelids (OWC) represent two species ( and ) with increasing numbers in North America. Gastrointestinal (GI) parasitism is a major cause of clinical disease in camelids and leads to significant economic impacts. Literature reporting on clinical parasitism of camels is localized to India, Africa, and the Middle East, with limited information available on OWCs in North America. Read More

BMJ Case Rep 2021 Apr 7;14(4). Epub 2021 Apr 7.

Department of Pediatrics, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.

Bartter syndrome (BS) is a well-recognised inherited tubular dysfunction that causes polyuria, metabolic alkalosis and hypokalaemia. Among BS cases, antenatal/neonatal BS (ABS) usually shows distinct polyhydramnios prenatally and presents features of BS in the early neonatal period. We encountered a premature infant with type 3 ABS presenting with mild polyuria and discuss the pathogenesis of mild polyuria in type 3 ABS. Read More

Wellcome Open Res 2019 29;4:189. Epub 2021 Mar 29.

Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Hyponatremia is the commonest electrolyte abnormality in hospitalized patients and is associated with poor outcome. Hyponatremia is categorized on the basis of serum sodium into severe (< 120 mEq/L), moderate (120-129 mEq/L) and mild (130-134mEq/L) groups. Serum sodium has an important role in maintaining serum osmolality, which is maintained by the action of antidiuretic hormone (ADH) secreted from the posterior pituitary, and natriuretic peptides such as atrial natriuretic peptide and brain natriuretic peptide. Read More

J Nephrol 2021 Apr 7. Epub 2021 Apr 7.

Nephrology Department, Nantes University Hospital, Nantes, France.

Aim: Our objective was to describe the impact of hyponatremia on the outcomes of COVID-19 patients [outcomes selected: intensive care unit (ICU) admission, mechanical ventilation or death].

Methods: Two groups of COVID-19 patients were retrospectively screened on the basis of plasma sodium level at admission: hyponatremic (sodium < 135 mM, n = 92) or normonatremic (sodium ≥ 135 mM, n = 198) patients. Pearson's chi- (qualitative variables) and Student's T tests (quantitative variables) were used to compare the two groups. Read More

Minerva Pediatr (Torino) 2021 Apr 2. Epub 2021 Apr 2.

Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.

Hyponatriemia is the most common electrolyte disorder in the paediatric population. Symptoms are related to the time in which hyponatriemia has developed. The acute presentation could be dramatic, with neurological symptoms like headache, seizure, impaired mental status and even coma. Read More

J Clin Anesth 2021 Apr 2;72:110281. Epub 2021 Apr 2.

Department of Anesthesiology, Osaka Medical College, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan. Electronic address:

Front Pediatr 2021 18;9:625377. Epub 2021 Mar 18.

Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.

Recent studies have shown that several children diagnosed with COVID-19 have developed Kawasaki Disease (KD)-like symptoms. This systematic review aims to assess the demographic, laboratory, and clinical characteristics of children with KD-like syndrome during the COVID-19 pandemic and evaluate efficacy of treatments and patients' outcome. A comprehensive search was carried out systematically through PubMed, Scopus, and Web of Science (WoS), medRxiv, and bioRxiv by two reviewers independently for all studies or preprints data on the demographic, laboratory, and clinical characteristics of children with K. Read More

Cureus 2021 Feb 26;13(2):e13569. Epub 2021 Feb 26.

Internal Medicine, The Chicago Medical School Internal Medicine Residency Program at Northwestern McHenry Hospital, McHenry, USA.

There is an increasing prevalence of type 2 diabetes mellitus (DM) among adolescents due to obesity. Diabetes can cause hypertriglyceridemia, defined as triglyceride (TG) levels above 150 mg/dl, leading to severe complications, including cardiovascular events, fatty liver disease, and acute pancreatitis. We present a case of acute pancreatitis manifested by both hypertriglyceridemia and new-onset DM. Read More

J Neurol Sci 2021 Mar 27;424:117428. Epub 2021 Mar 27.

Departments of Neurosurgery, Los Angeles (UCLA), Los Angeles, CA, United States; Departments of Radiation Oncology, Los Angeles (UCLA), Los Angeles, CA, United States; Departments of Head and Neck Surgery, Los Angeles (UCLA), Los Angeles, CA, United States; Jonsson Comprehensive Cancer Center, Los Angeles (UCLA), Los Angeles, CA, United States; Los Angeles Biomedical Research Institute, Los Angeles (UCLA), Los Angeles, CA, United States; Harbor-UCLA Medical Center, Los Angeles (UCLA), Los Angeles, CA, United States; David Geffen School of Medicine, Los Angeles (UCLA), Los Angeles, CA, United States. Electronic address:

Background: The seizure activity associated with hypothalamic hamartomas (HHs) is refractory to medical management and surgical intervention is often required. Stereotactic Radiofrequency Ablation (SRFA) is a minimally invasive technique offering targeted lesion ablation with a reduced risk of complications.

Objective: Here, we review the current literature on the use of SRFA for HHs. Read More

Am J Med Sci 2021 Apr 1. Epub 2021 Apr 1.

Department of Pharmacy Services, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address:

Background: Desmopressin (DDAVP) is often used for hyponatremia management but has been associated with increases in hospital length of stay and duration of hypertonic saline use. The purpose of this study was to evaluate hyponatremia management strategies and their effect on sodium correction in critically ill patients requiring 3% hypertonic saline (3HS).

Methods: This retrospective, single-center study included patients with hyponatremia (serum sodium ≤ 125 mEq/L) receiving 3HS from May 31 2015 to May 31 2019. Read More

Nutrients 2021 Mar 16;13(3). Epub 2021 Mar 16.

Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, 1-1 Mukogawa-Cho, Nishinomiya, Hyogo 663-8501, Japan.

Sodium intake theoretically has dual effects on both non-dialysis chronic kidney disease (CKD) patients and dialysis patients. One negatively affects mortality by increasing proteinuria and blood pressure. The other positively affects mortality by ameliorating nutritional status through appetite induced by salt intake and the amount of food itself, which is proportional to the amount of salt under the same salty taste. Read More

Trop Med Infect Dis 2021 Mar 12;6(1). Epub 2021 Mar 12.

Albany Medical College, Albany, NY 12208-3478, USA.

The original studies demonstrating the efficacy of oral glucose-electrolytes solutions in reducing or eliminating the need for intravenous therapy to correct dehydration caused by acute watery diarrheas (AWD) were focused chiefly on cholera patients. Later research adapted the oral therapy (ORT) methodology for treatment of non-cholera AWDs including for pediatric patients. These adaptations included the 2:1 regimen using 2 parts of the original WHO oral rehydration solution (ORS) formulation followed by 1 part additional plain water, and a "low sodium" packet formulation with similar average electrolyte and glucose concentrations when dissolved in the recommended volume of water. Read More

Nutrients 2021 Mar 9;13(3). Epub 2021 Mar 9.

Human Performance Laboratory and Korey Stringer Institute, University of Connecticut, Storrs, CT 06269-1110, USA.

During endurance exercise, two problems arise from disturbed fluid-electrolyte balance: dehydration and overhydration. The former involves water and sodium losses in sweat and urine that are incompletely replaced, whereas the latter involves excessive consumption and retention of dilute fluids. When experienced at low levels, both dehydration and overhydration have minor or no performance effects and symptoms of illness, but when experienced at moderate-to-severe levels they degrade exercise performance and/or may lead to hydration-related illnesses including hyponatremia (low serum sodium concentration). Read More

Vet Sci 2021 Mar 7;8(3). Epub 2021 Mar 7.

Earth Animal Hospital, 4-3-43 Hokushin-cho, Kitami, Hokkaido 090-0052, Japan.

This report describes the first clinical case, to our knowledge, of a dog with polyglandular deficiency syndrome with diabetes mellitus and hypoadrenocorticism. A six-year-old female Cavalier King Charles Spaniel presented with a history of lethargy and appetite loss. The dog was diagnosed with diabetic ketoacidosis based on hyperglycemia and renal glucose and ketone body loss. Read More

Pediatrics 2021 Apr 1. Epub 2021 Apr 1.

Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, Minnesota

Arginine vasopressin (AVP)-mediated osmoregulatory disorders, such as diabetes insipidus (DI) and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) are common in the differential diagnosis for children with hypo- and hypernatremia and require timely recognition and treatment. DI is caused by a failure to concentrate urine secondary to impaired production of or response to AVP, resulting in hypernatremia. Newer methods of diagnosing DI include measuring copeptin levels; copeptin is AVP's chaperone protein and serves as a surrogate biomarker of AVP secretion. Read More

Horm Res Paediatr 2021 Apr 1;93(9-10):497-509. Epub 2021 Apr 1.

Division of Pediatric Endocrinology, Department of Pediatrics, School of Medicine, Marmara University, Istanbul, Turkey.

Background: Craniopharyngioma (CP), despite being a malformational tumor of low histological grade, causes considerable morbidity and mortality mostly due to hypothalamo-pituitary dysfunction that is created by tumor itself or its treatment.

Summary: Fluid-electrolyte disturbances which range from dehydration to fluid overload and from hypernatremia to hyponatremia are frequently encountered during the acute postoperative period and should be carefully managed to avoid permanent neurological sequelae. Hypopituitarism, increased cardiovascular risk, hypothalamic damage, hypothalamic obesity, visual and neurological deficits, and impaired bone health and cognitive function are the morbidities affecting the well-being of these patients in the long term. Read More

J Crit Care 2021 Mar 22;64:53-61. Epub 2021 Mar 22.

Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan. Electronic address:

Purpose: Severe hyponatremia, defined as serum sodium concentration ([sNa]) ≤ 120 mEq/L, requires aggressive treatment to prevent potentially fatal cerebral edema, seizures, and other sequelae, but overcorrection can also result in life-threatening cerebral hemorrhage and demyelination. We compared the safety and efficacy of nasal desmopressin to conventional management for the prevention of [sNa] overcorrection.

Material And Methods: This retrospective analysis compared 47 patients treated with desmopressin to 17 patients treated conventionally at a university hospital ICU in Japan between 2013 and 2018 using propensity score-based approaches. Read More