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Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Infection of the bladder can cause discomfort or burning on micturition, increased urinary frequency and offensive-smelling urine. Upper tract infection can cause loin pain, fever and rigors. Prostatic disease can result in a poor urinary stream, hesitancy, terminal dribbling and urinary frequency. Incontinence can arise for mechanical reasons or as a result of neuromuscular instability. Polyuria is an increase in total daily urine volume and is usually associated with a defect in the mechanism for controlling water excretion or with excess water intake.
Endocrine Disorders
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Lisa Spence, Nana Adwoa Gletsu Miller, Tamara S. Hannon
Diabetes insipidus is rare in children but can occur due to a genetic abnormality or secondary to hypothalamic or pituitary tumors or following neurosurgery. Unlike diabetes mellitus, blood glucose concentrations are normal in diabetes insipidus. Rather, common symptoms for both conditions are frequent urination (polyuria) and constant thirst (polydipsia). In the case of diabetes insipidus, the urine is dilute and odorless while for diabetes mellitus, the urine is concentrated with glucose. The etiology of diabetes insipidus involves disruption of hormonal regulation of water balance, most often due to abnormal production or function of vasopressin. Vasopressin (also called anti-diuretic hormone) is made in the hypothalamus and its function is to increase fluid balance by reducing the excretion of water from the kidney. Thus, a main complication of diabetes insipidus is dehydration that results from water loss through excessive urination. Treatment of diabetes insipidus aims to address the primary cause, whether a tumor or hormonal. Treatment also focuses on drinking sufficient water to avoid dehydration.
Endocrine diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Pregnant women with severe CDI may be treated with maintenance dosing of DDAVP, which is not degraded by placental vasopressinase. The usual dose is 0.1 to 0.2mL (10–20mg) intranasally once daily at bedtime or else twice daily. The major clinical risk of DDAVP treatment is excessive dosing, with the potential for seizures due to water intoxication (severe plasma hypoosmolar hyponatremia). In the authors’ experience, this risk is minimized by limiting therapy to once-daily dosing, administered at bedtime, deliberately allowing a late-day period of breakthrough polyuria. Some patients with preexisting CDI may require an increase in the dose of DDAVP during pregnancy; therapy can be titrated by clinical response of symptoms and further guided by matched urine and serum sodium and osmolality.
The efficacy and safety of a homoharringtonine-based protocol for children with acute myeloid leukemia: A retrospective study in China
Published in Pediatric Hematology and Oncology, 2020
Yanjing Tang, Chengjuan Luo, Shuhong Shen, Huiliang Xue, Ci Pan, Wenting Hu, Xiaoxiao Chen, Jiaoyang Cai, Jing Chen, Jingyan Tang
Toxicity responses were evaluated according to the modified National Cancer Institute Common Toxicity Criteria. We evaluated myelosuppression by the duration of neutropenia (ANC <200/μl and <500/μl) or thrombocytopenia (PLT <50,000/μl) in the HD cytarabine courses. Infectious diseases and episodes were defined as clinical signs or symptoms, fever of unknown origin, and microbiologically-documented or clinically-documented infection. Febrile neutropenia was defined as neutropenia with the temperature >38.5 °C once or 38 °C–38.5 °C twice within 4-h interval. Microbiologically-documented bloodstream infection was defined as fever with microorganism species identified from peripheral blood culture and/or from the central venous catheter culture. Invasive fungal infection was defined as proven, probable, or possible according with the European Organization for Research and Treatment of Cancer (EORTC)/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group criteria.16 The indications for pediatric intensive care unit (PICU) admission were severe infectious disease such as shock, acute respiratory distress syndrome, and drug-induced severe organ dysfunction. In addition, a blood glucose test was added for patients with clinical symptoms such as polydipsia and polyuria.
Extracellular vesicles in type 2 diabetes mellitus: key roles in pathogenesis, complications, and therapy
Published in Journal of Extracellular Vesicles, 2019
Yongwei Xiao, Lei Zheng, Xiaofeng Zou, Jigang Wang, Jianing Zhong, Tianyu Zhong
Diabetes mellitus is a group of metabolic disorders characterized by high blood sugar levels over a prolonged period [1]. It occurs either when the pancreas does not produce sufficient insulin or when the body cannot effectively use the insulin produced. Generally, the symptoms of patients with diabetes mellitus include polyuria, polydipsia, constant hunger, and weight loss. Diabetes mellitus, if not well controlled, will cause serious complications including heart attack, kidney failure, unhealed wounds, vision loss, and nerve damage [2–6]. In addition, diabetes is also a risk factor for the prevalence of cancer [7]. Currently, the number of patients with diabetes mellitus has reached more than 422 million worldwide and has been increasing rapidly [8]. This disease has become an important public health problem. Notably, this figure was predicted to increase to 693 million by 2045 [9].
Nocturia in female patients: Current clinical features, treatment patterns and outcomes at a tertiary referral centre
Published in Arab Journal of Urology, 2019
Siri Drangsholt, Benoit Peyronnet, Maria Arcila-Ruiz, Rachael D. Sussman, Ricardo Palmerola, Dominique R. Pape, Nirit Rosenblum, Victor W. Nitti, Benjamin M. Brucker
After exclusion of 164 male patients, 239 female patients were included for analysis. The patients’ characteristics are summarised in Table 1. The mean age was 73.3 years, with a mean duration from nocturia onset of 2.4 years and a mean of 3.9 episodes of nocturia per night. In all, 91 patients had received at least one treatment for nocturia prior to their first visit to our site (38.1%), mostly anticholinergics. Most women had at least one concomitant pelvic floor dysfunction (64.4%), with 129 (54%) reporting daytime OAB symptoms. A majority of women (51.5%) had at least one comorbidity possibly contributing to their nocturia, with prior cardiac history and obesity being the most common (28.8% and 11.4%, respectively). A BD was suggested within the two first visits to 110 patients (46%), but was completed by only 72 patients (30.1%, completion rate = 65.5%). According to the BDs, the mean (SD) number of voids per 24 h was 11.1 (4), the NPI was 41.2 (16.8)%, and the maximum voided volume was 364 (222.1) mL. The prevalence of nocturnal polyuria, reduced bladder capacity, and global polyuria were 75%, 40.2%, and 18.1%, respectively. Excessive fluid intake was identified as the causative factor of the vast majority of global polyuria cases (76.9%).