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 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hypernatremia is a potentially life-threatening electrolyte abnormality. This problem develops most often because of loss of water from the animal, but in rare cases hypernatremia results from gain of sodium chloride. Important conditions predisposing to hypernatremia include diarrhea, vomiting, heat stroke, fever, limited access to water, excessive diuretic use, renal diseases, and pituitary diabetes insipidus. This condition rarely develops if animals have adequate access to water. Clinical signs relate to central nervous system derangements and can progress to seizures and coma. Diagnosis is based on the serum sodium concentration; treatment should be instituted if it is greater than 170 mEq per L. Treatment is based on knowledge of the volume status of the patient and the probable cause for the hypernatremia. In general, 5 per cent dextrose in water or other hypotonic fluids are given slowly intravenously. The rate of administration should be adjusted so the water deficit is replaced over 48 to 72 h. Too rapid correction of hypernatremia can lead to cerebral edema and worsening of the animal. In cases of salt intoxication, diuretics must be given in addition to slow water replacement to avoid the development of pulmonary edema.
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PMID:Hypernatremia. 264 64

The authors describe a case of hypodipsia and severe hypernatremia most probably secondary to hydrocephalus in a 22-year-old man in the absence of abnormalities of ADH secretion or metabolism. The patient became hypernatremic only in situations when the decreased spontaneous fluid intake was insufficient to replace that lost caused by sweating or vomiting. Adequate hydration returned the sodium value to normal.
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PMID:Hypodipsia and hypernatremia in congenital hydrocephalus. 273 44

The institutionalized elderly are at risk for developing fluid volume depletion with progression to hypernatremia. This is particularly common in patients transferred to an acute care setting from a nursing home. A marked reduction in intracellular fluid and the increase in body fat associated with normal aging predispose the elderly to water loss with very little environmental prompting. Conditions contributing to the development of fluid volume deficit include febrile illness, utilization of enteral supplements, gastrointestinal bleeding, use of loop diuretics, renal failure, prolonged vomiting, diarrhea, diabetes, and disability induced fluid restriction. This can lead to apathy and confusion, which are often incorrectly attributed to dementia. The utilization of Roy's Adaptation Model to this problem focuses on the regulator subsystem and the physiologic mode.
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PMID:Managing hypernatremia in fluid deficient elderly. 274 41

In a prospective one year study, comprising children with acute gastroenteritis admitted to hospital or treated as outpatients, the clinical and laboratory features of rotavirus diarrhoea (168 cases) were compared with those of enteric adenovirus (32 cases), bacterial (42), mixed (16), and non-specific (135) infections. The rotavirus disease was remarkably consistent, with a sudden onset of vomiting, a high frequency of fever and dehydration, and a mean duration of diarrhoea of 5.9 days. Outpatients excreting rotavirus had a similar but milder illness, mainly on account of less pronounced vomiting. The predominant symptom of enteric adenoviruses was long lasting diarrhoea (mean 10.8 days). Abdominal pain, bloody stools, prolonged diarrhoea (mean 14.1 days), leucocytosis, and a raised erythrocyte sedimentation rate strongly suggested a bacterial aetiology. Mixed infections caused longer lasting diarrhoea (mean 8.0 days) than rotavirus alone, but the severity of the illness was not increased. The clinical features of infection with unidentified pathogens most resembled those of bacterial infections. Respiratory symptoms were not significantly associated with any particular pathogen. Hypernatraemia and complications were uncommon. This study showed that the clinical features of gastroenteritis with rotavirus, enteric adenoviruses, and bacteria each exhibited patterns that could guide the experienced clinician to a presumptive diagnosis.
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PMID:Clinical features of acute gastroenteritis associated with rotavirus, enteric adenoviruses, and bacteria. 301 37

Literature data on current methods of induced abortion during the 2nd trimester are reviewed with special emphasis on the use of intraamniotic administration of hypertonic saline solution. A 20% saline is injected during amniocentesis either intra-abdominally or through the vagina; the optimum time period for pregnancy termination is 21-23 weeks of gestation. In the majority of patients, miscarriage occurs within 24-36 hours. The incidence of complications after administration of 20% saline ranges from 1.7-2.18%. Complications include hypernatremia, hemolysis, anuria, coma, seizures, incomplete abortion, hemorrhage, and inflammatory pelvic disease. Contraindications for pregnancy termination using hypertonic saline include cardiovascular diseases, central nervous system diseases, kidney diseases, late pregnancy toxemias, presence of postoperative cicatrix on the uterus, and placenta previa. The mechanism of abortifacient action of hypertonic saline may be associated with stimulation of the synthesis of endogenous prostaglandins (PG). The findings that PG can stimulate uterine contractions prompted clinical trials of PG as abortifacient agents. Longterm iv administration of PGF2 alpha and PGE during 2nd trimester was found to be associated with serious complications (nausea, vomiting, diarrhea, phlebitis at the site of vein puncture). For this reason, the method of iv administration of PG was abandoned. Intra-amniotic administration of PGF2 alpha (40-50 mg) was shown to induce abortion in 82-91% of the patients within 48 hours after injection. The incidence of hemorrhage and rupture of the cervix uteri after PG administration was significantly greater than that after saline injection. The intramuscular and vaginal administration of synthetic PG alone or in combination with Laminaria was shown to provide the most effective and safe method of induced abortion during the 2nd trimester.
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PMID:[Artificial termination of pregnancy in late periods]. 332 84

We studied a patient with the rare syndrome of chronic hypernatremia associated with a frontal expansive process. The pituitary function was evaluated during dynamic tests bearing on radioimmunoassay of serum neurophysins levels. A test of water restrictionloading was performed during which urine appeared diluted (190-200 mOsm/kg) while the degree of serum osmolality was high (310-317 mOsm/kg). An hemodynamic stimulation resulted in a significant increase in serum neurophysins (from 3.5 +/- 0.3 to 5.5 +/- 0.2 ng/ml). After one intravenous injection of 2 mg nicotine, vomiting was observed, followed by a sharp rising of serum neurophysins levels (from 3.2 +/- 0.5 to 10.6 +/- 0.2 ng/ml). During hypertonic saline infusion, serum osmolality increased from 270 to 310 mOsm/kg, while neurophysins showed no significant change. Such results evidence a selective impairment of the hypothalamic-neurohypophyseal response to osmotic stimuli, with intact mechanisms of non-osmotic stimulation. In this patient, natremia was brought back to normal values by adequate water supply.
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PMID:[Hypodypsia and selective dysfunction of osmoreceptors in the hypernatremia syndrome]. 645 32

Strychnine toxicosis is characterized by inducible tetanic seizures and metaldehyde poisoning by fine fasciculations progressing to generalized tremors and seizures. Intoxication with 1080 causes seizures, random running movements, vomiting, defecation, urination, acidosis and hyperglycemia. Intoxication with rodenticides causing coagulopathy is characterized by hemorrhage into body cavities but not necessarily external hemorrhage. Anticholinesterase insecticides cause salivation, urination and defecation, while chlorinated hydrocarbon insecticides cause CNS disturbances. Ethylene glycol intoxication results in ataxia, depression, coma, vomiting and tachypnea, followed by acute renal failure. Urea poisoning causes bloat and CNS signs in cattle. Monensin intoxication in horses lasts several days and causes stiffness, colic, uneasiness and recumbency. Salt poisoning results in depression, seizures and hypernatremia. Lead poisoning is associated with central and peripheral nervous system signs, as well as increased numbers of nucleated RBC and basophilic stippling of RBC. Arsenic poisoning results in GI pain, diarrhea, weakness and death. Copper toxicosis in sheep is manifested by hemolytic anemia, hemoglobinemia and hemoglobinuria. Plants that may intoxicate domestic animals include sorghum, greasewood, halogeton, water hemlock, Japanese yew, larkspur, lupine, milk-weed, philodendron, oleander, castor bean and precatory bean.
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PMID:Practical toxicologic diagnosis. 649 3

Two hundred thirty-four of 242 neonates (96.7%) with a mean dehydration of 5.1% body weight were rehydrated with a glucose-electrolyte solution given orally in an average time of 7 44 hours. Eight (3.3%) neonates required intravenous fluid therapy. Emesis was not an obstacle for complete oral rehydration. Hypernatremia, hyponatremia, and acidosis present on admission were corrected within a few hours. Oral rehydration is an entirely satisfactory choice for treatment of uncomplicated dehydration in neonates.
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PMID:Treatment of 242 neonates with dehydrating diarrhea with an oral glucose-electrolyte solution. 684 14

In outlining the pathology of various electrolyte metabolism abnormalities in cancer patients we considered the main clinical points between pathologies and emergency treatment. In regard to sodium (Na+) metabolism, one pathologic state that requires our attention is hypernatremia. Hypernatremia is accompanied with dehydration and is due to water loss, vomiting, diarrhea and renal insufficiency. One of the major causes of this condition is lack of the antidiuretic hormone due to intracranial metastasis of the tumor. When hypernatremia becomes severe, it is accompanied with circulatory failure, muscular asthenia, disorientation, convulsions, coma and other cerebral symptoms. Treatment consists of replenishing the water content by infusion of electrolyte solutions which should be carefully conducted after complete diagnose of the severity of the patient's pathological condition. Hyponatremia, like sick cell syndrome, is observed relatively frequently in cancer patients. When the serum Na level falls markedly, it induces cerebral edema and causes disorders of consciousness. The major treatment consists of providing both water and sodium supplements. Hyperkalemia is observed at the time of renal insufficiency, tissue lesions, vomiting, and diarrhea. When serum potassium level rises, it causes bradycardia, ventricular fibrillation, or cardiac arrest. It is important to diagnostically apprehend the severity of this condition using EKG and determining the serum K1+ level. For emergency treatment injection of calcium gluconate is very effective. Hypokalemia is often manifested by the loss of intestinal fluids due to diarrhea or during administration of diuretic agents. Clinical symptoms include neural paralysis but emergencies occur relatively infrequently. K C1 injections are used in treating this condition. Hypercalcemia is manifested in cancer patients during hyperparathyroidism. Its clinical symptoms include lassitude, tachycardia, nausea, vomiting, and renal dys-function, leading to neural symptoms in severe cases. The main treatment consists of injection of physiological saline solution and administration of calcitonin, mithramycin. Hypocalemia is manifested during renal insufficiency, lack of vitamin D, and hypothyroidism. In classic cases it causes tetanic spasms. Injection of calcium is an effective treatment but since during tetanic spasms alcalosis may easily occur, treatment should only be provided after obtaining a complete understanding of the patient's condition. The pathological conditions described above can not be said to specific to cancer but it should be kept in mind that one of their main causative factors is the involvement of mechanism which produces ectopic hormones from cancerous tissues.
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PMID:[Electrolyte metabolism and emergency]. 688 72

Previous studies demonstrated the efficacy of oral glucose/electrolytes solution (GES) in rehydration of moderately dehydrated infants; the importance of providing one volume (200 ml) of solute-free water for every two volumes (400 ml) of GES ingested was also stressed. In this study we investigated a variation of our previous method intended to make it simpler and more practical. The entire calculated volume of GES was administered as rapidly as possible followed by a volume of free water equal to one-half the volume of GES ingested. In total 50 children (25 girls), aged 10 days to 24 months, with diarrhoeal dehydration were studied; the mean degree of dehydration was 7.2% of body weight. Hypernatraemia present on admission was corrected within a few hours, as was severe metabolic acidosis. Vomiting rapidly diminished or disappeared following onset of therapy and the mean rate of ingestion of fluids was high, 28 ml/kg/h, allowing for rapid rehydration; the mean time required for rehydration was 7.9 h (range 2.3-17). The described method offers simplicity and practicality, while still providing free water to correct or prevent hypernatraemia.
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PMID:Oral rehydration of infants with acute diarrhoeal dehydration: a practical method. 744


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