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Infections and Their Mimics in Returning Travelers in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Elise Kochoumian, Jonathon Moore, Bushra Mina, Kevin Cahill
Severe hyponatremia can cause neuromuscular disorder and seizures in those affected. Hyponatremia can be corrected with 0.9% saline or hypertonic saline solution, especially in the presence of seizure or neurological abnormalities. Sodium should be corrected at a level of 0.5 mEq/L/h and should not exceed 10 mEq/L in 24 hours or 18 mEq/L in 48 hours. Exceeding those limits can cause osmotic demyelination syndrome.
Rabies and other lyssaviruses
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Thiravat Hemachudha, Jiraporn Laothamatas, Henry Wilde
Routine laboratory studies are nondiagnostic. Complete blood counts are usually normal or show mild leukocytosis with neutrophilia. Hyponatremia is present in approximately one-third of the patients regardless of the clinical type or stage of the disease [1]. This can be explained by inadequate intake from dysphagia and hydrophobia or SIADH. Hypernatremia with polyuria is rare. CSF examination is normal in most cases. However, mild CSF pleocytosis (less than 30 cells/dL) with lymphocytic predominance can be found. Slightly elevated protein level (less than 100 mg/dL) in GBS-like rabies patients who are HIV-seronegative, should alert the clinician, particularly when fever, hyponatremia, and bladder dysfunction occur early in the course of illness. A pleocytosis of over 100 cell/dL (110–950) is rare and suggests another diagnosis.
Bioelectric and Biomagnetic Signal Analysis
Published in Arvind Kumar Bansal, Javed Iqbal Khan, S. Kaisar Alam, Introduction to Computational Health Informatics, 2019
Arvind Kumar Bansal, Javed Iqbal Khan, S. Kaisar Alam
Low concentration of sodium in blood is called hyponatremia. A low concentration of Na+ ion causes the lack of cell-depolarization resulting into lack of contraction of atria and ventricles reducing the blood-flow in the body. The body-cells get deoxygenated and lack necessary nutrients. Deoxygenation of body-cells leads to confusion, nausea and headaches. The PQ-interval and QRS-complex get elongated showing slow depolarization caused by lack of sodium concentration outside cells during depolarization. Severe case of hyponatremia can result into first-degree of AV-block and later turn into second-degree and third-degree AV-block.
Predictive value of post-procedural hyponatremia on contrast-induced nephropathy in patients who underwent coronary angiography or percutaneous coronary intervention
Published in Acta Cardiologica, 2022
Murat Gucun, Muzaffer Kahyaoglu, Mehmet Celik, Ahmet Guner, Okan Akyuz, Yusuf Yilmaz
Blood samples for a whole blood count and the biochemistry parameters were obtained from the patients at the time of presentation. Also, serum creatinine (SCr) and serum sodium levels were examined at the time of admission and daily within three consecutive days after the procedure. Serum sodium concentrations were corrected for the presence of hyperglycaemia with the following equations: corrected sodium = measured sodium + [2.4 (glucose − 100)/100] [11]. We assigned patients into hyponatremia and non-hyponatremia groups based on serum sodium concentrations. Following the procedure, patients with a sodium concentration <135 meq/L at least once in the follow-up period were included in the hyponatremia group; whereas the other patients included in the non-hyponatremia group. Non-ionic, iso-osmolar contrast medium (iohexol) was used during the procedures. CI-AKI was defined as a 25% relative increase, or 0.5 mg/dL absolute increase in serum creatinine levels above baseline within 72 h of contrast exposure, in the absence of an alternative explanation [12]. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation [13].
Elevated neutrophil-lymphocyte ratio combined with hyponatremia indicate poor prognosis in renal cell carcinoma
Published in Acta Oncologica, 2020
Maria Møller Pedersen, Frede Donskov, Lars Pedersen, Zuo-Feng Zhang, Mette Nørgaard
Hyponatremia is a strong, prognostic feature. Our data showed hyponatremia not only linked to underlying chronic inflammation, as previously suggested [23]. In patients with poor prognostic features, i.e., anemia, thrombocytopenia, elevated NLR, the addition of hyponatremia provided even further poor prognostic information. Previous research have demonstrated the development of hyponatremia as an overall negative prognostic signal for various conditions [21], e.g., liver cirrhosis patients on waiting list for liver transplantation [32] or childhood meningitis [33]; hyponatremia was associated with increased mortality. Our data are in line with this and in line with previous findings in localized and metastatic RCC patients [18,20]. Our findings of a higher mortality among RCC patients with hyponatremia should prompt further research in this area. Hyponatremia may be linked to illness in general, since patients with RCC often have comorbidity. However, after adjusting for comorbidity, the association still remained elevated. Furthermore, hyponatremia may occur due to reduced kidney function caused by RCC. Since we did not have data on kidney function, we could not examine this further. However, the patients who had a nephrectomy, all had their date of surgery after the diagnosis of renal cell cancer, accordingly, serum sodium, which was measured up to 30 days before diagnosis, was measured before date of surgery and therefore, sodium levels is not suspected to be influenced by kidney surgery.
Pharmacologic therapies for the management of non-neurogenic urinary incontinence in children
Published in Expert Opinion on Pharmacotherapy, 2019
Tiernan Middleton, Pamela Ellsworth
DDAVP nasal spray is not indicated for use in primary nocturnal enuresis due to increased risk of hyponatremia and hyponatremia-related convulsions compared to tablets. The effects of hyponatremia include seizures, confusion, headache, worsening of edema, and cardiac arrhythmias. DDAVP overdose can lead to an increased risk of water retention and hyponatremia due to prolonged duration of action. In children, the most commonly reported adverse effects during treatment was headache (1%). Less commonly reported side effects were psychiatric disorders including changes in mood, aggression, anxiety, and nightmares which tended to abate after treatment was discontinued and gastrointestinal disorders such as pain (.65%), nausea and vomiting (.35%, .2%), and diarrhea (.15%). Anaphylactic reactions have occurred in spontaneous reports but were not reported in clinical trials[14].