Acute Symptomatic Hyponatraemia – A Practical Approach

MA Fox;  ; JA Fox;

doi:10.52964/amja.0159

Acute Symptomatic Hyponatraemia – A Practical Approach

Acute Medicine Journal ◽

10.52964/amja.0159 ◽

2007 ◽

Vol 6 (2) ◽

pp. 55-59

Author(s):

MA Fox ◽

◽

JA Fox ◽

Keyword(s):

Neurological Dysfunction ◽

Practical Approach ◽

Medical Emergency ◽

Electrolyte Abnormality ◽

Aggressive Management ◽

Future Edition ◽

Specific Symptoms

Hyponatraemia is the commonest electrolyte abnormality yet is poorly understood. Symptoms are dependent on the rate of onset and severity. The presence of features suggestive of neurological dysfunction should be regarded as a medical emergency and treated actively. The risk of not treating outweighs that of over aggressive management. This article concentrates on the immediate management of the patient presenting acutely with severe symptomatic hyponatraemia, and is illustrated by a case recently presenting to our department. The patient who is incidentally found to be hyponatraemic in the context of another presenting illness, or presenting with more minor, non-specific symptoms presents different challenges to the admitting clinician, which will be dealt with in a future edition of the journal.

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Successful intervention for overwhelming postsplenectomy infection caused by non-vaccine pneumococcal serotype 23A

Oxford Medical Case Reports ◽

10.1093/omcr/omaa018 ◽

2020 ◽

Vol 2020 (3) ◽

Author(s):

Yuichi Kojima ◽

Kazuna Ikeda ◽

Akihiro Matsumura ◽

Shun Shimohama ◽

Bin Chang ◽

...

Keyword(s):

Immune Defense ◽

Medical Emergency ◽

Empiric Antibiotic Therapy ◽

Good Recovery ◽

Aggressive Management ◽

Overwhelming Postsplenectomy Infection ◽

Invasive Infections ◽

Empiric Antibiotic ◽

Pneumococcal Serotype ◽

Encapsulated Bacteria

Abstract The spleen plays an important role in the body’s immune defense against invasive infections, particularly those caused by encapsulated bacteria. Encapsulated bacterial infection in asplenic patients is a medical emergency called overwhelming postsplenectomy infection (OPSI) and has a mortality rate of 50–70%. Here, we report the case of a 51-year-old Asian man who complained of emesis and diarrhea as primary symptoms. He rapidly progressed to coma and was eventually diagnosed with OPSI (pyogenic ventriculitis/spondylitis) caused by non-vaccine pneumococcal serotype 23A. Aggressive management, including empiric antibiotic therapy, a staircase approach for intracranial pressure-targeted therapy and laminectomy/laminoplasty, resulted in a good recovery. Our report highlights that non-vaccine pneumococcal serotypes can cause disease in vaccinated patients.

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A Conductive Education Approach to Individuals with Motor Disorders

British Journal of Occupational Therapy ◽

10.1177/030802268905200708 ◽

1989 ◽

Vol 52 (7) ◽

pp. 271-272 ◽

Cited By ~ 2

Author(s):

Jo Clark-Wilson ◽

Ann Gent

Keyword(s):

Skill Acquisition ◽

Education System ◽

Therapeutic Approach ◽

Neurological Dysfunction ◽

Practical Approach ◽

Background Information ◽

Motor Disorders ◽

Neurological Rehabilitation ◽

The Uk

This article aims to describe the concepts of conductive education to inform therapists of this practical approach to neurological rehabilitation. Background information of its development in Hungary and the UK is given. The work of the conductors is described and methods which facilitate learning are discussed in relation to skill acquisition. The value of the conductive education system as a therapeutic approach for individuals with neurological dysfunction is stated.

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Seizures in Newborn: An Update

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v4i1.12000 ◽

2012 ◽

Vol 4 (1) ◽

pp. 26-31

Author(s):

N Begum ◽

T Begum ◽

S Khatoon

Keyword(s):

Good Practice ◽

Neurodevelopmental Outcome ◽

Later Life ◽

Neurological Dysfunction ◽

Medical Emergency ◽

Neonatal Seizure ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Symptomatic Seizures ◽

Ischemic Encephalopathy

Neonatal seizure is the most prominent neurological dysfunction in the neonatal period which constitutes a medical emergency. Seizures result from excessive depolarization of neurons within the nervous system. Tonic, clonic, subtle and myoclonic are the different forms of neonatal seizure. Among the causes hypoxic ischemic encephalopathy is the commonest. Jitteriness and benign neonatal sleep myoclonus should be differentiated from the neonatal seizure. Proper history taking and meticulous examination should aimed to identify the seizure and find out the aetiology. Important investigations include blood sugar, serum electrolytes (Na, Ca, Mg), arterial blood gas, anion gap, cerebrospinal fluid examination, ultrasound examination of the head and electroencephalography. Upon identification of common metabolic derangements like hypoglycaemia, hypocalcaemia, hypomagnesemia, they are treated as per recommended protocol. The rest of the symptomatic seizures (nonmetabolic) are treated with phenobarbitone. If seizures failed to respond or recur after Phenobarbitone therapy, Phenytoin, Midozolam are the subsequent options. As the recurrence rate is relatively small and the potential toxicities are high on developing brain, the good practice is to stop anticonvulsant as early as possible. Neonatal seizures have an adverse effect on neurodevelopmental outcome and predispose to cognitive, behavioral, or epileptic complications in later life. DOI: http://dx.doi.org/10.3329/jssmc.v4i1.12000 J Shaheed Suhrawardy Med Coll, 2012;4(1):26-31

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The Need for Aggressive Pursuit of Healthy Childhood Voices

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.2001.102 ◽

1989 ◽

Vol 20 (1) ◽

pp. 102-107 ◽

Cited By ~ 18

Author(s):

Joel C. Kahane ◽

Robert Mayo

Keyword(s):

Early Identification ◽

Voice Disorders ◽

Prevention Programs ◽

Incidence Trends ◽

Aggressive Management ◽

Prevention And Treatment ◽

Current Incidence

In this paper we argue for the aggressive management of voice disorders. Aggressive management includes early identification, prevention, and treatment of voice disorders. The argument for aggressive management is supported by current incidence trends, laryngologists' expectations, and the benefits of prevention programs.

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