scholarly journals Life‐threatening heat‐related illness with severe hyponatremia in an aluminum smelter worker

2019 ◽  
Vol 62 (12) ◽  
pp. 1068-1075 ◽  
Author(s):  
James C. Wesdock ◽  
A. Michael Donoghue
Keyword(s):  
Aluminum Smelter ◽  
Severe Hyponatremia ◽  
Life Threatening ◽  
Smelter Worker

scholarly journals A Case Report on Hyponatremia: Leading Sign of Hypopituitarism [Secondary to Adrenal Insufficiency]

2020 ◽  
Vol 5 (8) ◽  
pp. 57-60
Author(s):  
Dr. Poornima . ◽  
Dr. Arul Amutha Elizabeth
Keyword(s):  
Case Report ◽  
Adrenal Insufficiency ◽  
Severe Hyponatremia ◽  
Altered Sensorium ◽  
Life Threatening ◽  
Underlying Disorder ◽  
Made In

Severe hyponatremia due to hypopituitarism and adrenal insufficiency can be life threatening and treatment with glucocorticoids is very effective once the diagnosis of the underlying disorder has been made. In our experience, the diagnosis of hypopituitarism in hyponatremic patients is often overlooked. We report the case of a 54 year old female admitted to our hospital in an obtunded state with altered sensorium. We found that a severe hyponatremia was the cause of patient condition . Previously she was diagnosed with recurrent episodes of hyponatremia leading to encephalopathy. The diagnosis of hypopituitarism is often overlooked in hyponatremic patients. Hyponatremia should always be ruled out for endocrinological cause Our study concludes that hyponatremia is due to hypopituitarism that is secondary to adrenal insufficiency leading to encephalopathy.

scholarly journals Multiple Electrolyte and Metabolic Emergencies in a Single Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Caprice Cadacio ◽  
Phuong-Thu Pham ◽  
Ruchika Bhasin ◽  
Anita Kamarzarian ◽  
Phuong-Chi Pham
Keyword(s):  
Sodium Concentration ◽  
Management Plan ◽  
Serum Osmolality ◽  
Volume Depletion ◽  
Severe Hyponatremia ◽  
Current Case ◽  
Electrolyte Disturbances ◽  
Life Threatening ◽  
Osmotic Demyelinating Syndrome

While some electrolyte disturbances are immediately life-threatening and must be emergently treated, others may be delayed without immediate adverse consequences. We discuss a patient with alcoholism and diabetes mellitus type 2 who presented with volume depletion and multiple life-threatening electrolyte and metabolic derangements including severe hyponatremia (serum sodium concentration [SNa] 107 mEq/L), hypophosphatemia (“undetectable,” <1.0 mg/dL), and hypokalemia (2.2 mEq/L), moderate diabetic ketoacidosis ([DKA], pH 7.21, serum anion gap [SAG] 37) and hypocalcemia (ionized calcium 4.0 mg/dL), mild hypomagnesemia (1.6 mg/dL), and electrocardiogram with prolonged QTc. Following two liters of normal saline and associated increase in SNa by 4 mEq/L and serum osmolality by 2.4 mosm/Kg, renal service was consulted. We were challenged with minimizing the correction of SNa (or effective serum osmolality) to avoid the osmotic demyelinating syndrome while replacing volume, potassium, phosphorus, calcium, and magnesium and concurrently treating DKA. Our management plan was further complicated by an episode of significant aquaresis. A stepwise approach was strategized to prioritize and correct all disturbances with considerations that the treatment of one condition could affect or directly worsen another. The current case demonstrates that a thorough understanding of electrolyte physiology is required in managing complex electrolyte disturbances to avoid disastrous outcomes.

scholarly journals Sekundarni psevdohipoaldosteronizem pri novorojenčku z akutnim vnetjem sečil – Prikaz primera

2017 ◽  
Vol 86 ◽  
Author(s):  
Alenka Stepišnik ◽  
Irena Cetin-Lovšin ◽  
Sonja Posega-Devetak
Keyword(s):  
Urinary Tract ◽  
Adrenal Hyperplasia ◽  
Severe Hyponatremia ◽  
Electrolyte Disorder ◽  
Tubular Cells ◽  
Electrolyte Disturbances ◽  
Life Threatening ◽  
Secondary Pseudohypoaldosteronism ◽  
Urinary Tract Malformations ◽  
Transepithelial Sodium Transport

Hiponatremia and hyperkalemia in a newborn can be a life threatening disorder caused by different diseases, including congenital adrenal hyperplasia, or less frequently by a genetical or acquired tubular cell resistance to aldosteron, called pseudohypoaldosteronism. Secondary pseudohypoaldosteronism is a rare, reversible electrolyte disorder caused by aldosterone resistance in infants with congenital urinary tract malformations and/or urinary tract infection.We present a 4-week-old boy with severe hyponatremia, hyperkalemia and elevated aldosterone levels during an episode of pyelonephritis. The disorder improved completely with antibiotic treatment, rehydration and electrolyte correction. Further investigations showed no structural urinary tract anomalies. According to the literature, we concluded that electrolyte disturbances were caused by aldosterone resistance of the inflamed tubular cells and subsequent defective transepithelial sodium transport.

scholarly journals SUN-699 Canagliflozin Induced Severe Hyponatremia- a Rare Life Threatening and Poorly Understood Complication- a Case Report

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Maheswaran Dhanasekaran ◽  
Suchita Mehta
Keyword(s):  
Antidiuretic Hormone ◽  
Sglt2 Inhibitor ◽  
Acute Onset ◽  
Sglt2 Inhibitors ◽  
Qualitative Assessment ◽  
Renal Tubules ◽  
Volume Depletion ◽  
Osmotic Diuresis ◽  
Severe Hyponatremia ◽  
Life Threatening

Abstract Background: Sodium-glucose cotransporter-2 (SGLT2) inhibitors induce osmotic diuresis by inhibiting the proximal renal tubular reabsorption of the filtered glucose load. This can occasionally lead to severe dehydration, hypotension and in some cases, severe hyponatremia. The effects of SGLT2 inhibitors on sodium and water handling by the renal tubules is not well studied. Clinical Case: A 49-year-old male with history of type 2 diabetes mellitus on canagliflozin, an SGLT2 inhibitor, who was brought to the Emergency Room following a motor vehicle accident from acute onset of confusion and altered mental status. Initial trauma workup was negative. He was found to have severe hyponatremia to 118 mEq/ L (n 135–145 mEq/ L) and was also noted to be in euglycemic ketoacidosis with positive serum ketones (qualitative assessment) along with acute onset urinary retention. Urine toxicology was negative including negative blood alcohol level. Thyroid function was normal 1.080 mIU/ L (n 0.47- 6.90mIU/L). His total urine osmolar excretion was ~ 2400 mOsm in 12h (n 500–800 mOsm/kg of water/ 24 hours), confirming the diagnosis of his ongoing massive osmotic diuresis. On admission, his antidiuretic hormone (ADH) level was noted to be elevated to 9.1 pg/mL (n &lt;4.3pg/ mL). This severe degree of hyponatremia was postulated to be secondary to canagliflozin causing massive osmotic diuresis resulting in severe intravascular volume depletion with reflex increase in antidiuretic hormone (ADH) compounded by increased free water intake by the patient. Conclusion: With more widespread use of this relatively new hypoglycemic medication with protective metabolic and cardiovascular benefits that include weight loss and reduction of BP in T2DM patients, it is equally important to understand the physiology of potentially life-threatening adverse effects associated with severe volume depletion by massive osmotic diuresis and electrolyte abnormalities that include hypernatremia (even hyponatremia), and the timely recognition of euglycemic ketoacidosis.

scholarly journals Hyponatremia: A clinical approach

2017 ◽  
Vol 89 (8) ◽  
pp. 134-140 ◽  
Author(s):  
D Yu Shchekochikhin ◽  
N L Kozlovskaya ◽  
F Yu Kopylov ◽  
A L Syrkin ◽  
E M Shilov
Keyword(s):  
Clinical Practice ◽  
Elderly Patients ◽  
Individual Case ◽  
Clinical Analysis ◽  
Clinical Approach ◽  
Severe Hyponatremia ◽  
Chronic Hyponatremia ◽  
Life Threatening ◽  
Appropriate Therapy ◽  
Balance Problems

Hyponatremia is the most common electrolyte metabolic abnormality in clinical practice. The unfavorable course of many diseases is associated with hyponatremia. Acute severe hyponatremia is life-threatening because cerebral edema may develop. Less obvious chronic hyponatremia increases the risk of balance problems, falls and fractures, especially in elderly patients. In any occasion, hyponatremia should not be now regarded only as a laboratory phenomenon in critically ill patients, but it necessitates a thorough clinical analysis of each individual case and appropriate therapy. The paper presents approaches to diagnosing and treating hyponatremia in various clinical situations.

scholarly journals Assessment of Hyponatremia in Pneumonia in Children

2019 ◽  
Vol 3 (3) ◽  
pp. 542-547
Author(s):  
Chandra Bhushan Jha ◽  
Akhil Tamrakar
Keyword(s):  
Serum Sodium ◽  
Sodium Level ◽  
Severe Pneumonia ◽  
Cross Sectional Study ◽  
Radiological Diagnosis ◽  
Severe Hyponatremia ◽  
Acute Phase Reactants ◽  
Cross Sectional ◽  
Medical College ◽  
Life Threatening

Introduction: Pneumonia has been the leading cause of mortality in children. Among the various complications of pneumonia, hyponatremia has often been overlooked which incidentally happens to be the commonest and life threatening as well. There are several reports on high prevalence of hyponatremia in the western countries as an indicator of severity of pneumonia. These researches have been lacking in Nepal. Objectives: The objectives of this study was to determine the prevalence of hyponatremia in children between 2 months to 5 years of children with radiologically or clinically proven pneumonia admitted at Birat Medical College & Teaching Hospital (BMCTH) and also to investigate the relationship between serum sodium level and other laboratory parameters. Methodology: A descriptive cross-sectional study was carried out at BMCTH on children aged 2 months to 5 years admitted with pneumonia. Those who met the inclusion criteria were included. History and physical examination was done to confirm diagnosis and classify the severity of pneumonia on the basis of WHO classification. A 2ml blood sample was then withdrawn from the patient and taken to the laboratory for serum sodium as well as other relevant parameters. Results: A total of 50 children of age ranging from 2 months to 5 years who were admitted with clinical or radiological diagnosis of pneumonia were enrolled in the study. Cough was present in 76% of studied children while fever was present in 92%. Clinical diagnosis revealed majority of children with severe pneumonia (40%).Leukocytosis was seen in 70% of children while acute phase reactants CRP was positive in 86% of the children. Hyponatremia was revealed in 80% of the children with pneumonia. Among children between 2 months to 12 months 20% had severe hyponatremia while children in age group between 1 to 3 years 6% had severe hyponatremia and between 3 to 5 yrs of children 8% had severe hyponatremia. The relation was statistically not significant. Leukocytosis was demonstrated in 58% of children with hyponatremia . The relation however was not statistically significant. CRP was found positive in 76% of children with hyponatremia. This was statistically significant. There were 18% of the children who had very severe pneumonia along with severe hyponatremia. While 14% with severe hyponatremia had severe pneumonia and only 2% of the children with severe hyponatremia had pneumonia. In children with moderate hyponatremia 16% of them suffered from moderate pneumonia and 10% had very severe pneumonia and 4% had pneumonia. Among children with pneumonia 12% had pneumonia only while 2% had severe pneumonia and 6% had very severe pneumonia. Conclusion: Children admitted with clinical or radiological diagnosis of pneumonia and were assessed for sodium level. Hyponatremia was detected in children with pneumonia which was statistically significant. Hence along with management of pneumonia, hyponatremia should also be cautiously addressed in these patients. 

Assembly of VP26 in herpes simplex virus-1 capsid implicated by 3-D structure of recombinant capsid

1995 ◽  
Vol 53 ◽  
pp. 840-841
Author(s):  
Z. Hong Zhou ◽  
Jing He ◽  
Joanita Jakana ◽  
J. D. Tatman ◽  
Frazer J. Rixon ◽  
...  
Keyword(s):  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
3D Structure ◽  
Structure Study ◽  
Herpes Simplex Virus 1 ◽  
Shell Proteins ◽  
Life Threatening ◽  
Infected Cells ◽  
Simplex Virus ◽  
Hsv 1

Herpes simplex virus-1 (HSV-1) is a ubiquitous virus which is implicated in diseases ranging from self-curing cold sores to life-threatening infections. The 2500 Å diameter herpes virion is composed of a glycoprotein spike containing, lipid envelope, enclosing a protein layer (the tegument) in which is embedded the capsid (which contains the dsDNA genome). The B-, and A- and C-capsids, representing different morphogenetic stages in HSV-1 infected cells, are composed of 7, and 5 structural proteins respectively. The three capsid types are organized in similar T=16 icosahedral shells with 12 pentons, 150 hexons, and 320 connecting triplexes. Our previous 3D structure study at 26 Å revealed domain features of all these structural components and suggested probable locations for the outer shell proteins, VP5, VP26, VP19c and VP23. VP5 makes up most of both pentons and hexons. VP26 appeared to bind to the VP5 subunit in hexon but not to that in penton.

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

1743: Risk Count Assessment: A New Concept for Detection of Life Threatening Prostate Cancer During a Window of Curability

2007 ◽  
Vol 177 (4S) ◽  
pp. 579-580 ◽  
Author(s):  
H. Ballentine Carter ◽  
Anna E. Kettermann ◽  
Luigi Ferrucci ◽  
Patricia Landis ◽  
E. Jeffrey Metter
Keyword(s):  
Prostate Cancer ◽  
Life Threatening
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