scholarly journals Problem-based review: The Patient with Acute Adrenal Failure

2013 ◽  
Vol 12 (1) ◽  
pp. 38-43
Author(s):  
Angela Rogers ◽  
◽  
Toby Pillinger ◽  
John A H Wass ◽  
◽  
...  
Keyword(s):  
Steroid Treatment ◽  
Adrenal Crisis ◽  
Adrenal Failure ◽  
Important Condition ◽  
Initial Management ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Acute Adrenal Failure ◽  
Key Aspects

Acute adrenal crisis is an important condition to consider in any shocked patient presenting to the acute medical unit. This article aims to highlight the key aspects of initial management, focussing on the importance of rapid recognition and prompt initiation of steroid treatment.

scholarly journals Diagnosis of Hypoaldosteronism in Infancy

2021 ◽  
Author(s):  
Elpis-Athina Vlachopapadopoulou ◽  
Myrto Bonataki
Keyword(s):  
Clinical Manifestations ◽  
Failure To Thrive ◽  
Steroid Treatment ◽  
Adrenal Failure ◽  
Initial Management ◽  
Salt Wasting ◽  
Aldosterone Production ◽  
Adrenal Hypoplasia ◽  
Aldosterone Synthase Deficiency ◽  
Secondary Causes

Hypoaldosteronism is associated with either insufficient aldosterone production or lack of responsiveness to aldosterone and can be isolated or in the context of primary adrenal failure. Τhe severity of clinical manifestations is inversely correlated to age, with the neonatal period being the most vulnerable time for a patient to present with mineralocorticoid insufficiency. Salt-wasting forms of congenital adrenal hyperplasia (CAH), adrenal hypoplasia congenita (AHC), aldosterone synthase deficiency (ASD) and pseudohypoaldosteronism (PHA) are all causes of hypoaldosteronism in infancy. Affected infants present with salt wasting, failure to thrive and potentially fatal hyperkalemia and shock. Α blood sample for the essential hormonal investigations should be collected before any steroid treatment is given, in order to confirm aldosterone insufficiency and to determine the underlying cause. Renal ultrasonography and urine culture are also useful for exclusion of secondary causes of aldosterone resistance. Initial management requires treatment of electrolyte imbalances and restoration of intravascular fluid volume. In case of a salt-wasting crisis, affected infants are usually treated initially with both hydrocortisone and fludrocortisone, pending the results of investigations. Interpretation of the hormonal profile will guide further therapy and molecular analysis of candidate genes.

scholarly journals Acute adrenal failure: a potentially fatal consequence of an adulterated herbal remedy

2019 ◽  
Vol 12 (2) ◽  
pp. bcr-2018-228443 ◽  
Author(s):  
Harminder Sensi ◽  
Harit Buch ◽  
Loretta Ford ◽  
Rousseau Gama
Keyword(s):  
Herbal Remedy ◽  
Acute Illness ◽  
Herbal Remedies ◽  
Adrenal Crisis ◽  
Adrenal Failure ◽  
Tablet Analysis ◽  
Potential Risks ◽  
Acute Adrenal Failure ◽  
Fatal Consequence

Herbal remedies adulterated with glucocorticoids can cause Cushing’s syndrome. We report a severe presentation of a ‘herbal remedy’ adulterated with glucocorticoids; causing a potentially fatal adrenal crisis precipitated by acute illness. Investigations were consistent with adrenal suppression and confirmed, after tablet analysis, to be due to a ‘herbal remedy’ containing synthetic betamethasone/dexamethasone. This case highlights the need for clinical vigilance and patient education about the potential risks associated with the use of unlicensed treatments and the role of tablet analysis in routine biochemistry.

Overview of acute renal manifestations in cancer patients

2020 ◽  
Vol 19 (1) ◽  
pp. 34-41
Author(s):  
Zay Htet ◽  
◽  
Hannah Stacey ◽  
Mahzuz Karim ◽  
◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Acute Care ◽  
Kidney Injury ◽  
Significant Morbidity ◽  
Contributing Factors ◽  
Initial Management ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Prolonged Hospitalization

Acute kidney injury is frequently encountered in patients with malignancy and is associated with prolonged hospitalization, significant morbidity, and increased mortality. Thorough evaluation is required to identify possible contributing factors, which may range from relatively easily reversible pre-renal causes to complex cancer-specific aetiologies. This review will serve as a practical guide for acute care physicians on the acute medical unit to the assessment and initial management of cancer patients presenting with acute kidney injury.

scholarly journals Acute medical unit clinical skills lab

2019 ◽  
Vol 6 (Suppl 1) ◽  
pp. 140-140
Author(s):  
Sarb Clare ◽  
Joe Wheeler
Keyword(s):  
Clinical Skills ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Skills Lab

scholarly journals Causes of discharge delays from the acute medical unit (AMU) in a tertiary level teaching hospital, Brunei Darussalam

2021 ◽  
pp. 201010582110061
Author(s):  
Dayang Nur Hilmiyah binti Awang Husaini ◽  
Justin Fook Siong Keasberry ◽  
Khadizah Haji Abdul Mumin ◽  
Hanif Abdul Rahman
Keyword(s):  
Observational Study ◽  
Discharge Planning ◽  
Patient Factors ◽  
Medical Unit ◽  
Prolonged Length ◽  
Acute Medical Unit ◽  
Brunei Darussalam ◽  
Medical Issues ◽  
Hospital Factors ◽  
Prolonged Hospital

Background: Many patients admitted to the acute medical unit experience a prolonged length of stay in hospital due to discharge delays. Consequently, this may impact the patients, healthcare institution and national economy in terms of patient safety, decreased hospital capacity, lost patient workdays and financial performance. Objectives: The main aim of this observational study was to identify the causes of discharge delays among acute medical unit patients admitted in the Raja Isteri Pengiran Anak Saleha Hospital, Brunei. Methods: A retrospective observational study, with data of patients admitted to the acute medical unit collected from Brunei Health Information Systems between September and December 2018. Statistical analyses were performed to obtain relevant results and any statistically significant associations. Results: A total of 357 patients were admitted to the acute medical unit over the 4-month period; 218 patients (61.1%) experienced discharge delays. Of these 218 patients, 158 patients (72.5%) encountered discharge delays mainly due to intrinsic patient factors, while the discharge delays in 88 patients (40.4%) were attributed to hospital factors. The main reason for discharge delays for patient factors was slow recovery among 67 patients (30.7%), whereas for hospital factors it was the weekend limitation of services available in 23 patients (10.6%). Conclusions: There were various causes of discharge delays identified among the 218 acute medical unit patients who experienced discharge delays. Older patients with frailty, polypharmacy and complex medical issues were more likely to have a prolonged hospital stay in the acute medical unit. Stringent inclusion criteria, increasing discharge planning as well as an effective multidisciplinary approach will aid in reducing discharge delays from the acute medical unit.

Prevalence of signs of dysphagia and associated risk factors in geriatric patients admitted to an acute medical unit

2021 ◽  
Vol 41 ◽  
pp. 208-216 ◽  
Author(s):  
Maria Dissing Olesen ◽  
Robert Mariusz Modlinski ◽  
Simon Hosbond Poulsen ◽  
Pernille Mølgaard Rosenvinge ◽  
Henrik Højgaard Rasmussen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Geriatric Patients ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Associated Risk Factors

scholarly journals Acute medical unit staffing mismatch

2019 ◽  
Vol 6 (Suppl 1) ◽  
pp. 44-44
Author(s):  
Dominic Reynish
Keyword(s):  
Medical Unit ◽  
Acute Medical Unit

Socialising Disease: Medical Categories and Inclusion of the Aged

2000 ◽  
Vol 48 (3) ◽  
pp. 383-407 ◽  
Author(s):  
Joanna Latimer
Keyword(s):  
Older People ◽  
Hospital Care ◽  
Social Inclusion ◽  
Social Problems ◽  
Older Person ◽  
Medical Unit ◽  
Life Chances ◽  
Acute Medical Unit ◽  
Medical Domain

When older peoples' troubles are categorised as social rather than medical, hospital care can be denied them. Drawing on an ethnography of older people admitted as emergencies to an acute medical unit, the article demonstrates how medical categories can provide shelter for older people. By holding their clinical identity on medical rather than social grounds, physicians who specialise in gerontology in the acute medical domain can help prevent the over-socialising of an older person's health troubles. As well as helping the older person to draw certain resources to themselves, such as treatment and care, this inclusion in positive medical categories can provide shelter for the older person, to keep at bay their effacement as ‘social problems'. These findings suggest that contemporary sociological critique of biomedicine may underestimate how medical categorising, as the obligatory passage through which to access important resources and life chances, can constitute a process of social inclusion.

scholarly journals 31 * DEMENTIA CQUIN COMPLIANCE IN THE ACUTE MEDICAL UNIT: COMPLETED AUDIT CYCLE IN A LONDON TEACHING HOSPITAL

2015 ◽  
Vol 44 (suppl 1) ◽  
pp. i7-i7
Author(s):  
R. Keynejad ◽  
A. Hawksley ◽  
J. Harrison ◽  
A. Skinner ◽  
E. Asgari
Keyword(s):  
Teaching Hospital ◽  
Medical Unit ◽  
Acute Medical Unit ◽  
Audit Cycle
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