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Berhanu Y, Yusuf T, Mohammed A, Meseret F, Demeke Habteyohans B, Alemu A, Tolosa G, Keneni M, Weldegebreal F, Desalew A. Hyponatremia and its associated factors in children admitted to the pediatric intensive care unit in eastern Ethiopia: a cross-sectional study. BMC Pediatr 2023; 23:310. [PMID: 37340344 DOI: 10.1186/s12887-023-04118-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/08/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Hyponatremia is a serious problem that leads to substantial increases morbidity and mortality in critically ill children. The identification of risk factors, implementation of preventive measures, and timely diagnosis and management are crucial to reduce adverse events related to hyponatremia. Despite the higher burden of the problem in Ethiopia, evidence related to the risk factors for hyponatremia among children in Ethiopia is limited; in particular, no study has been identified in eastern Ethiopia. Therefore, we aimed to determine the magnitude of hyponatremia and its associated factors in children admitted to the pediatric intensive care unit at the Hiwot Fana Comprehensive Specialized University Hospital. METHODS A facility-based cross-sectional study was conducted using 422 medical records of pediatric patients admitted to the pediatric intensive care unit at Hiwot Fana Comprehensive Specialized University Hospital from January 2019 to December 2022. Medical records were reviewed to collect data. Data were analyzed using a statistical package for social sciences (SPSS) version 26. A binary logistic regression model with an adjusted odds ratio (aOR) and a 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was set at p < 0.05. RESULTS The magnitude of hyponatremia was 39.1% (95% CL: 34.4-43.8%). The age of the child (aOR = 2.37;95% CL:1.31-4.31), diagnosis of sepsis (aOR = 2.33; 95% CL:1.41-3.84), surgical procedures (aOR = 2.39; 95% CL:1.26-4.56), nutritional status (aOR = 2.60; 95% CL:1.51-4.49), and length of hospital stay (aOR = 3.04; 95% CL: 1.73-5.33) were factors significantly associated with hyponatremia. CONCLUSIONS Four out of ten children admitted to pediatric intensive care units had hyponatremia. Hyponatremia was significantly associated with the age of the child, malnutrition, sepsis, surgical procedures, and length of hospital stay. To reduce the burden of hyponatremia and associated mortality, attention should be focused on improving the care of malnourished children, and those with sepsis, and the quality of postoperative monitoring services. Moreover, intervention strategies aimed at reducing the burden of hyponatremia should target the identified factors.
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Affiliation(s)
- Yeshi Berhanu
- Department of Pediatrics and Child Health, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Turina Yusuf
- Department of Pediatrics and Child Health, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ahmed Mohammed
- Department of Pediatrics and Child Health, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fentahun Meseret
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Betelhem Demeke Habteyohans
- Department of Pediatrics and Child Health, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ayichew Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Gadissa Tolosa
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mulualem Keneni
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fitsum Weldegebreal
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Assefa Desalew
- Department of Pediatrics and Child Health Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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SSRI/SNRI -induced Hyponatremia: A Case Series of 26 Patients in a Single Institution from 2018 to 2020. Psychiatr Q 2023:10.1007/s11126-023-10018-x. [PMID: 36913163 DOI: 10.1007/s11126-023-10018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2023] [Indexed: 03/14/2023]
Abstract
Antidepressant medications are widely used by patients with depression or a depressive disorder. In spite of a generally favorable safety profile of selective serotonin reuptake inhibitors or serotonin - norepinephrine reuptake inhibitors (SSRI/SNRI), several cases of a possible connection between SSRI/SNRI and hyponatremia have been reported. To describe the clinical characteristics of patients with hyponatremia after SSRI/SNRI exposure, and to examine the association between SSRI/SNRI exposure and the presence of hyponatremia in a Chinese population. A retrospective single-center case series study. We performed a retrospective evaluation of inpatients with SSRI/SNRI-induced hyponatremia from a single institution in China between 2018 and 2020. Clinical data were obtained through review of medical records. Patients who met the initial inclusion criteria but did not develop hyponatremia acted as controls. The study was approved by the Clinical Research Ethics Board of Beijing Hospital (Beijing, P.R. China). We identified 26 patients with SSRI/SNRI-induced hyponatremia. The incidence rate of hyponatremia was 1.34% (26/1937) in the study population. The mean age at diagnosis was 72.58 (±12.84) years, with a male: female ratio of 1:1.42. The duration between SSRI/SNRI exposure and the onset of hyponatremia was 7.65 (±4.88) days. The minimum serum sodium level was 2328.23 (±107.25) mg/dL in the study group. Seventeen patients (65.38%) received sodium supplements. Four patients (15.38%) switched to another antidepressant. Fifteen patients (57.69%) recovered by the time of discharge. There were significant differences in serum potassium, serum magnesium and serum creatinine level between the two groups (p < 0.05). The rate of use of sertraline was significantly higher in the study group compared with the control group (p < 0.05). This pattern was not found in other SSRI/SNRI (p > 0.05). The results of our study show that SSRI/SNRI exposure, in addition to hyponatremia, may also affect the level of serum potassium, serum magnesium and serum creatinine. A history of hyponatremia and exposure to SSRI/SNRI may be potential risk factors for the development of hyponatremia. Future prospective studies are needed to validate these findings.
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Quesnel DA, Cooper M, Fernandez-Del-Valle M, Reilly A, Calogero RM. Medical and physiological complications of exercise for individuals with an eating disorder: A narrative review. J Eat Disord 2023; 11:3. [PMID: 36627654 PMCID: PMC9832767 DOI: 10.1186/s40337-022-00685-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/01/2022] [Indexed: 01/12/2023] Open
Abstract
Individuals with eating disorders (ED) experience prolonged malnutrition, binge episodes, and compensatory behaviours that affect every organ system. Psychological and physiological symptoms are worsened with comorbid dysfunctional exercise, seen in up to 80% of those with an ED. Although return to exercise is an important component of treatment and recovery, little is known about the contraindications and risks of exercise engagement specific to those with an ED. This paper provides a comprehensive narrative review of the medical and physiological complications of engaging in exercise during ED treatment and outlines when exercise may be contraindicated or used in modified or cautionary ways. We conducted a literature search on MEDLINE, PubMed, and PsychArticles to identify relevant articles, which yielded six categories of medical and physiological complications of ED that may be exacerbated by exercise: energy availability, cardiovascular health, electrolyte abnormalities, biomedical function markers, sex hormones, and body composition. We summarize the evidence for these complications for readers and offer an initial set of recommendations for incorporating exercise during ED treatment based on our findings. This review may serve as a resource for members of ED treatment teams to help evaluate more readily and confidently whether exercise is safe for individual patients and when modifications and caution may be warranted.
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Affiliation(s)
- Danika A Quesnel
- Department of Psychological Clinical Science, University of Toronto, 320 Huron Street, Toronto, ON, M5S 3J7, Canada.
| | - Marita Cooper
- Department of Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Maria Fernandez-Del-Valle
- Department of Functional Biology, University of Oviedo, Oviedo, Spain.,Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - Alanah Reilly
- Alanah Reilly Exercise Physiologist, Brisbane, Australia
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Clinical-Pathological Conference Series from the Medical University of Graz. Wien Klin Wochenschr 2022; 135:203-209. [PMID: 36346432 PMCID: PMC10119202 DOI: 10.1007/s00508-022-02097-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/10/2022]
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5
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Li X, Xu Y, Li X, Liu W, Yao D, Chen W, Yu H, He L, Lu S, Jiang C, Zhu W, Meng L. Real-world effectiveness and protection of SARS-CoV-2 vaccine among patients hospitalized for COVID-19 in Xi’an, China, December 8, 2021, to January 20, 2022: A retrospective study. Front Immunol 2022; 13:978977. [PMID: 36211421 PMCID: PMC9538118 DOI: 10.3389/fimmu.2022.978977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/09/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction In December 2021, a large-scale epidemic broke out in Xi’an, China, due to SARS-CoV-2 infection. This study reports the effect of vaccination on COVID-19 and evaluates the impact of different vaccine doses on routine laboratory markers. Methods The laboratory data upon admission, of 231 cases with COVID-19 hospitalized from December 8, 2021 to January 20, 2022 in Xi’an, including blood routine, lymphocyte subtypes, coagulative function tests, virus specific antibodies and blood biochemical tests were collected and analyzed. Results Of the 231 patients, 21 were not vaccinated, 158 were vaccinated with two doses and 52 with three doses. Unvaccinated patients had a higher proportion of moderate and severe symptoms than vaccinated patients, while two-dose vaccinated patients had a higher proportion than three-dose vaccinated patients. SARS-CoV-2 specific IgG levels were significantly elevated in vaccinated patients compared with unvaccinated patients. Particularly, unvaccinated patients had lower counts and percentages of lymphocytes, eosinophils and CD8+ T-lymphocytes, and elevated coagulation-related markers. In addition, vaccination had no effect on liver and kidney function. Conclusions Vaccination against SARS-CoV-2, inducing high IgG level and increased CD8+ T cells and eosinophils, and regulating coagulation function, can significantly attenuate symptoms of COVID-19, suggesting that the vaccine remains protective against SARS-CoV-2.
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Affiliation(s)
- Xiaowei Li
- National Joint Engineering Research Center of Biodiagnostics and Biotherapy, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an Jiaotong University, Xi’an, China
| | - Yinjuan Xu
- Department of Biochemistry and Molecular Biology, Institute of Molecular and Translational Medicine (IMTM), Xi’an Jiaotong University Health Science Center, Xi’an, China
- Department of Laboratory Medicine, Xi’an Chest Hospital, Xi'an, China
| | - Xiaomeng Li
- Department of Biochemistry and Molecular Biology, Institute of Molecular and Translational Medicine (IMTM), Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Wenbin Liu
- Department of Biochemistry and Molecular Biology, Institute of Molecular and Translational Medicine (IMTM), Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Dan Yao
- Nursing Department, Xi’an Children’s Hospital, Affiliated Children’s Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Weichao Chen
- Department of Respiratory Medicine, Xi’an Children’s Hospital, Affiliated Children’s Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Hongchuan Yu
- Department of Respiratory Medicine, Xi’an Children’s Hospital, Affiliated Children’s Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Langchong He
- School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
| | - Shemin Lu
- National Joint Engineering Research Center of Biodiagnostics and Biotherapy, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an Jiaotong University, Xi’an, China
- Department of Biochemistry and Molecular Biology, Institute of Molecular and Translational Medicine (IMTM), Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Congshan Jiang
- National Regional Children’s Medical Center (Northwest), Key Laboratory of Precision Medicine to Pediatric Diseases of Shaanxi Province, Xi’an Key Laboratory of Children’s Health and Diseases, Shaanxi Institute for Pediatric Diseases, Xi’an Children’s Hospital, Affiliated Children’s Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wenhua Zhu
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an Jiaotong University, Xi’an, China
- Department of Biochemistry and Molecular Biology, Institute of Molecular and Translational Medicine (IMTM), Xi’an Jiaotong University Health Science Center, Xi’an, China
- *Correspondence: Liesu Meng, ; Wenhua Zhu,
| | - Liesu Meng
- National Joint Engineering Research Center of Biodiagnostics and Biotherapy, Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi’an Jiaotong University, Xi’an, China
- Department of Biochemistry and Molecular Biology, Institute of Molecular and Translational Medicine (IMTM), Xi’an Jiaotong University Health Science Center, Xi’an, China
- *Correspondence: Liesu Meng, ; Wenhua Zhu,
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Bhasin-Chhabra B, Veitla V, Weinberg S, Koratala A. Demystifying hyponatremia: A clinical guide to evaluation and management. Nutr Clin Pract 2022; 37:1023-1032. [PMID: 36036229 DOI: 10.1002/ncp.10907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/18/2022] [Accepted: 08/05/2022] [Indexed: 12/20/2022] Open
Abstract
Hyponatremia (serum sodium <135 mEq/L) is a frequent electrolyte abnormality complicating the clinical care of hospitalized patients. Hyponatremia has been associated with an increased risk of mortality. Hyponatremia can be seen in patients with euvolemia, hypovolemia, or hypervolemia. Evaluation of hyponatremia relies on clinical assessment and estimation of serum sodium, urine electrolytes, and serum and urine osmolality in addition to other case-specific laboratory parameters. In addition, point-of-care ultrasonography is an important adjunct to physical assessment in estimation of volume status. Understanding the pathophysiology of the underlying process can lead to a timely diagnosis and appropriate management of hyponatremia.
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Affiliation(s)
- Bhavna Bhasin-Chhabra
- Division of Nephrology, Department of Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - Vineet Veitla
- Division of Nephrology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Samuel Weinberg
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Abhilash Koratala
- Division of Nephrology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Mickelsen R, French V, Amaya S. Hydatidiform Mole with Coexisting Fetus and Syndrome of Inappropriate Antidiuretic Hormone Secretion: A Case Report. J Endocr Soc 2021; 5:bvab129. [PMID: 34458655 PMCID: PMC8389177 DOI: 10.1210/jendso/bvab129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Indexed: 11/19/2022] Open
Abstract
Context Molar pregnancies have been associated with hyperthyroidism and hypertensive disorders. Coexisting molar and fetal pregnancies, which are very rare, have an even higher risk of complications. Case Description We describe a case of hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion (SIADH) associated with a molar pregnancy. A 36-year-old patient at 13 weeks gestation with a coexisting molar pregnancy presented with headache, nausea, and vomiting. She was found to have hypertension, hyperthyroidism, and hyponatremia. The hyponatremia was further assessed with an isotonic saline challenge which resulted in a diagnosis of SIADH. The patient underwent dilation and curettage and her hyponatremia resolved. She later developed gestational trophoblastic neoplasia. Conclusions A molar pregnancy can present with unusual associated conditions, such as SIADH. Hyponatremia in a patient with molar pregnancy may be mistakenly attributed to other side effects of trophoblastic tissue (hyperthyroidism, pre-eclampsia, or hyperemesis gravidarum). Hyponatremia in a patient with a molar pregnancy warrants evaluation for SIADH.
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Affiliation(s)
- Riley Mickelsen
- University of Kansas, School of Medicine, Kansas City, KS 66160, USA
| | - Valerie French
- University of Kansas, Department of Obstetrics and Gynecology, Kansas City, KS 66160, USA
| | - Stephanie Amaya
- University of Kansas, Department of Obstetrics and Gynecology, Kansas City, KS 66160, USA
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Two-Dimensional Disposable Graphene Sensor to Detect Na + Ions. NANOMATERIALS 2021; 11:nano11030787. [PMID: 33808672 PMCID: PMC8003527 DOI: 10.3390/nano11030787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022]
Abstract
The monitoring of Na+ ions distributed in the body has been indirectly calculated by the detection of Na+ ions in urine. We fabricated a two–dimensional (2D) Na+ ion sensor using a graphene ion–sensitive field–effect transistor (G–ISFET) and used fluorinated graphene as a reference electrode (FG–RE). We integrated G–ISFET and FG on a printed circuit board (PCB) designed in the form of a secure digital (SD) card to fabricate a disposable Na+ ion sensor. The sensitivity of the PCB tip to Na+ ions was determined to be −55.4 mV/dec. The sensor exhibited good linearity despite the presence of interfering ions in the buffer solution. We expanded the evaluation of the PCB tip to real human patient urine samples. The PCB tip exhibited a sensitivity of −0.36 mV/mM and linearly detected Na+ ions in human patient urine without any dilution process. We expect that G–ISFET with FG–RE can be used to realize a disposable Na+ ion sensor by serving as an alternative to Ag/AgCl reference electrodes.
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Zaprudnova RA. Level of natremia as an index of the condition of the organism of animals under stress. REGULATORY MECHANISMS IN BIOSYSTEMS 2021. [DOI: 10.15421/022116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In the diagnosis of stressful conditions in humans and other animals, ionic indicators remain practically unused. In this work, we studied the changes in the concentrations of sodium ions in the blood plasma of freshwater fish under stress caused by stressors of different quality and quantity. Most of the experiments were carried out on adult bream (Abramis brama L) from the Rybinsk Reservoir. Separate experiments were duplicated on adult individuals of roach (Rutilus rutilus L.), pike (Esox lucius L.), and blue bream (Abramis ballerus L.). The concentration of cations in the blood plasma was determined using a Flapho-4 flame photometer. Under the action of mild and short-term stressors of different qualities, the sodium concentration in the internal environment altered toward an increase in concentration gradients on the cell membrane (eustress or physiological stress). Hypernatremia was approximately 10%. Under the action of strong and/or prolonged stressors of different strength, the sodium concentration in the internal environment changed toward a decrease in concentration gradients on the cell membrane (distress or pathological stress). Hyponatremia was 50% in the conditions of acute lethal stress, 20% in subacute lethal stress, 10% or more in chronic lethal stress. During strong acute reversible stress, hyponatremia could reach 30%. Analysis of the material on mammals allowed us to conclude that the adaptation mechanisms in fish and higher vertebrates are similar. In this work, for the first time, the state of the system of electrolyte balance of animals under stress was analyzed from the standpoint of the leading role of ionic concentration gradients on the cell membrane (mainly sodium) in the energetics (level of disequilibrium) of the organism. We propose a concept that in normal and extreme conditions fish use two different defense reactions (or adaptation strategies): active and passive, consisting, respectively, in increasing or decreasing the level of disequilibrium (energy) in the organism. The hyponatremia recorded by numerous authors, which accompanies diseases in humans, is evidently a nonspecific reaction of the organism and serves as an indicator of reduced energy of the organism. It is suggested that the sodium level in the internal environment of the organism be used for diagnosing the stress state of animals.
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Overwyk KJ, Pfeiffer CM, Storandt RJ, Zhao L, Zhang Z, Campbell NRC, Wiltz JL, Merritt RK, Cogswell ME. Serum Sodium and Potassium Distribution and Characteristics in the US Population, National Health and Nutrition Examination Survey 2009-2016. J Appl Lab Med 2021; 6:63-78. [PMID: 33236098 DOI: 10.1093/jalm/jfaa127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/24/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Concern has been expressed by some that sodium reduction could lead to increased prevalence of hyponatremia and hyperkalemia for specific population subgroups. Current concentrations of serum sodium and potassium in the US population can help address this concern. METHODS We used data from the National Health and Nutrition Examination Survey 2009-2016 to examine mean and selected percentiles of serum sodium and potassium by sex and age group among 25 520 US participants aged 12 years or older. Logistic regression models with predicted residuals were used to examine the age-adjusted prevalence of low serum sodium and high serum potassium among adults aged 20 or older by selected sociodemographic characteristics and by health conditions or medication use. RESULTS The distributions of serum sodium and potassium concentrations were within normal reference intervals overall and across Dietary Reference Intake life-stage groups, with a few exceptions. Overall, 2% of US adults had low serum sodium (<135 mmol/L) and 0.6% had high serum potassium (>5 mmol/L). Prevalence of low serum sodium and high serum potassium was higher among adults aged 71 or older (4.7 and 2.0%, respectively) and among adults with chronic kidney disease (3.4 and 1.9%), diabetes (5.0 and 1.1%), or using certain medications (which varied by condition), adjusted for age; whereas, prevalence was <1% among adults without these conditions or medications. CONCLUSIONS Most of the US population has normal serum sodium and potassium concentrations; these data describe population subgroups at higher risk of low serum sodium and high serum potassium and can inform clinical care.
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Affiliation(s)
- Katherine J Overwyk
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.,IHRC, Inc., Atlanta, GA
| | - Christine M Pfeiffer
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Renee J Storandt
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lixia Zhao
- Division of Health Informatics and Surveillance, Center for Surveillance Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA
| | - Zefeng Zhang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Norm R C Campbell
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Jennifer L Wiltz
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.,United States Public Health Service, Atlanta, GA
| | - Robert K Merritt
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mary E Cogswell
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Lippold C, Patel A. Correction of hyponatremia by infusing D5W (5% dextrose in water solution) prefilter in patients receiving continuous renal replacement therapy: A case series. Hemodial Int 2020; 24:E27-E32. [DOI: 10.1111/hdi.12819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/01/2019] [Accepted: 01/12/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Cassiopia Lippold
- Department of Nephrology, Baltimore VA Medical Center Baltimore Maryland USA
- Department of Nephrology, University of Maryland School of Medicine Baltimore Maryland USA
| | - Ami Patel
- Department of Nephrology, Baltimore VA Medical Center Baltimore Maryland USA
- Department of Nephrology, University of Maryland School of Medicine Baltimore Maryland USA
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12
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Zoroddu MA, Aaseth J, Crisponi G, Medici S, Peana M, Nurchi VM. The essential metals for humans: a brief overview. J Inorg Biochem 2019; 195:120-129. [PMID: 30939379 DOI: 10.1016/j.jinorgbio.2019.03.013] [Citation(s) in RCA: 433] [Impact Index Per Article: 86.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/25/2019] [Accepted: 03/18/2019] [Indexed: 12/11/2022]
Abstract
The human body needs about 20 essential elements in order to function properly and among them, for certain, 10 are metal elements, though for every metal we do need, there is another one in our body we could do without it. Until about 1950 poor attention was given to the so-called "inorganic elements" and while researches on "organic elements" (C, N, O and H) and organic compounds were given high priority, studies on essential inorganic elements were left aside. Base on current knowledge it is ascertained today that metals such as Na, K, Mg, Ca, Fe, Mn, Co, Cu, Zn and Mo are essential elements for life and our body must have appropriate amounts of them. Here a brief overview to highlight their importance and current knowledge about their essentiality.
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Affiliation(s)
| | - Jan Aaseth
- Research Department, Innlandet Hospital, Brumunddal, Norway; Inland Norway University of Applied Sciences, Elverum, Norway
| | - Guido Crisponi
- Department of Life and Environmental Sciences, University of Cagliari, Italy
| | - Serenella Medici
- Department of Chemistry and Pharmacy, University of Sassari, Italy
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Abstract
Primary psychogenic polydipsia (PPD) is a chronic, relapsing condition in which there is a disturbance in thirst control primarily due to an underlying disorder such as a psychogenic condition. It is characterized by an increase of fluid intake along with excretion of excessive amounts of dilute urine exceeding 40 to 50 mL/kg of body weight. PPD is typically seen in patients with schizophrenic symptoms due to elevated levels of dopamine that stimulate the thirst center or in patients with a psychiatric history receiving anticholinergic drugs. There are many reported cases of PPD related to an underlying schizophrenia disorder, but rarely is PPD seen in bipolar patients. We herein report a case of recurrent mania in a patient from a community hospital, who presented with chronic hyponatremia due to PPD. The patient had a history of bipolar disorder type 1 and was admitted to the hospital four times within three weeks with hyponatremia and presenting symptoms of mood lability, psychomotor agitation, pressured speech, racing thoughts, sleeping disturbances, distractibility, and inflated self-esteem. These were the same circumstances and manic presentation in her subsequent medical admissions. Due to her repeat manic presentation and consistently low sodium levels, we believe that her manic symptoms were a result of hyponatremia due to PPD. This patient serves as a unique case wherein switching medications and treating with oral sodium chloride did not prevent the manic episodes as she continues to become hyponatremic secondary to PPD. Due to the difficulty in managing and diagnosing a patient like this, case studies are helpful in studying treatment and maintenance for future cases.
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Affiliation(s)
- Sahil Parag
- Medical Education and Simulation, West Virginia School of Osteopathic Medicine, Lewisburg, USA
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Application of copper(II)-mediated radical cross-dehydrogenative coupling to prepare spirocyclic oxindoles and to a formal total synthesis of Satavaptan. Tetrahedron 2018. [DOI: 10.1016/j.tet.2018.09.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Prognostic value of preoperative hyponatremia and thrombocytosis in patients with epithelial ovarian cancer. Wien Klin Wochenschr 2018; 130:575-580. [PMID: 30178070 DOI: 10.1007/s00508-018-1388-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/14/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Preoperative hyponatremia and thrombocytosis are associated with perioperative morbidity in patients with epithelial ovarian cancer (EOC). The aim of the present study was to evaluate preoperative hyponatremia and thrombocytosis as prognostic parameters in patients with EOC. METHODS In a retrospective cohort study, serum levels of sodium and thrombocyte counts were evaluated in 498 patients with EOC. Data were extracted from the prospectively maintained database. Results were correlated with clinicopathological parameters and patient survival. RESULTS Mean (standard deviation) overall pretherapeutic serum sodium levels and thrombocyte counts in patients with EOC were 138.8 (2.9) mmol/l and 340.1 (122.6) × 103/µl, respectively. Hyponatremia (serum sodium levels ≤ 134 mmol/l) was found in 33 (6.7%) patients and thrombocytosis (thrombocytes ≥ 450/µl) in 88 (17.7%) patients. Serum sodium levels were associated with the presence or absence of residual tumor tissue after primary surgery. Thrombocyte counts were associated with Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) tumor stage, presence/absence of residual tumor, histological grade and histological type. Patients with thrombocytosis presented with advanced tumor stage, a higher rate of postoperative residual tumor mass, higher tumor grade, and a higher rate of serous ovarian cancer. In a multivariate logistic regression analysis, only the established clinicopathological parameters but not serum sodium and thrombocyte count were independent predictors of patient overall survival. CONCLUSION Preoperative hyponatremia and thrombocytosis are not useful as additional independent prognostic parameters in patients with EOC.
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16
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Gibson D, Drabkin A, Krantz MJ, Mascolo M, Rosen E, Sachs K, Welles C, Mehler PS. Critical gaps in the medical knowledge base of eating disorders. Eat Weight Disord 2018; 23:419-430. [PMID: 29681012 DOI: 10.1007/s40519-018-0503-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/22/2018] [Indexed: 12/14/2022] Open
Abstract
Eating disorders are unique in that they inherently have much medical comorbidity both as a part of restricting-type eating disorders and those characterized by purging behaviors. Over the last three decades, remarkable progress has been made in the understanding and treatment of the medical complications of eating disorders. Yet, unfortunately, there is much research that is sorely needed to bridge the gap between current medical knowledge and more effective and evidence-based medical treatment knowledge. These gaps exist in many different clinical areas including cardiology, electrolytes, gastrointestinal and bone disease. In this paper, we discuss some of the knowledge gap areas, which if bridged would help develop more effective medical intervention for this population of patients.
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Affiliation(s)
- Dennis Gibson
- ACUTE, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA
| | - Anne Drabkin
- ACUTE, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA
| | - Mori J Krantz
- Division of Cardiology, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA
| | | | - Elissa Rosen
- ACUTE, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA
| | - Katherine Sachs
- ACUTE, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA
| | - Christine Welles
- ACUTE, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA
| | - Philip S Mehler
- ACUTE, at Denver Health, 777 Bannock Street, Denver, CO, 80204, USA.
- Eating Recovery Center, Denver, 7351E Lowry Blvd, Denver, CO, 80230, USA.
- , Denver, USA.
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Selective Serotonin Reuptake Inhibitor-Induced Hyponatremia and the Plastic Surgery Patient. Plast Reconstr Surg 2018; 141:614e. [PMID: 29596202 DOI: 10.1097/prs.0000000000004243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Gaglani B, Gupta S, Chavez O, Libardo R. Influenza as a Cause of SIADH Related Hyponatremia: A Case Report. J Clin Diagn Res 2017; 11:OD10-OD11. [PMID: 28658832 DOI: 10.7860/jcdr/2017/25785.9797] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 02/14/2017] [Indexed: 01/10/2023]
Abstract
Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH) is one of the most common causes of hyponatremia in hospitalized patients. The distinct aetiologies and co-morbidities associated with hyponatremia pose substantial challenges in identifying and managing this disorder. Several infectious causes of SIADH are reported but hyponatremia associated with SIADH and influenza virus infection is less commonly seen. We present a case of hyponatremia associated with influenza, which was subsequently diagnosed as SIADH.
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Affiliation(s)
- Bhavita Gaglani
- PGY3 (R3) Resident, Department of Internal Medicine, St. Barnabas Hospital, Bronx, New York, USA
| | - Sorab Gupta
- PGY3 (R3) Resident, Department of Internal Medicine, St. Barnabas Hospital, Bronx, New york, USA
| | - Octavio Chavez
- PGY2 (R2) Resident, Department of Internal Medicine, St. Barnabas Hospital, Bronx, New york, USA
| | - Rueda Libardo
- PGY2 (R2) Resident, Department of Internal medicine, St. Barnabas Hospital, Bronx, New york, USA
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Weismann D, Schneider A, Höybye C. Clinical aspects of symptomatic hyponatremia. Endocr Connect 2016; 5:R35-R43. [PMID: 27609587 PMCID: PMC5314806 DOI: 10.1530/ec-16-0046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 09/08/2016] [Indexed: 01/29/2023]
Abstract
Hyponatremia (HN) is a common condition, with a large number of etiologies and a complicated treatment. Although chronic HN has been shown to be a predictor of poor outcome, sodium-increasing treatments in chronic stable and asymptomatic HN have not proven to increase life expectancy. For symptomatic HN, in contrast, the necessity for urgent treatment has broadly been accepted to avoid the development of fatal cerebral edema. On the other hand, a too rapid increase of serum sodium in chronic HN may result in cerebral damage due to osmotic demyelinisation. Recently, administration of hypertonic saline bolus has been recommended as first-line treatment in patients with moderate-to-severe symptomatic HN. This approach is easy to memorize and holds the potential to greatly facilitate the initial treatment of symptomatic HN. First-line treatment of chronic HN is fluid restriction and if ineffective treatment with tolvaptan or in some patients other agents should be considered. A number of recommendations and guidelines have been published on HN. In the present review, the management of patients with HN in relation to everyday clinical practice is summarized with focus on the acute management.
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Affiliation(s)
- Dirk Weismann
- Department of Internal Medicine IIntensivcare Unit, University Hospital of Würzburg, Würzburg, Germany
| | - Andreas Schneider
- Department of Internal Medicine IIntensivcare Unit, University Hospital of Würzburg, Würzburg, Germany
| | - Charlotte Höybye
- Department of EndocrinologyMetabolism and Diabetology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Surgery and MedicineKarolinska Institute, Stockholm, Sweden
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20
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Filippatos TD, Liamis G, Christopoulou F, Elisaf MS. Ten common pitfalls in the evaluation of patients with hyponatremia. Eur J Intern Med 2016; 29:22-5. [PMID: 26706473 DOI: 10.1016/j.ejim.2015.11.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 11/13/2015] [Accepted: 11/24/2015] [Indexed: 10/22/2022]
Abstract
Hyponatremia is the most common electrolyte disorder in hospitalized patients associated with increased morbidity and mortality. On the other hand, inappropriate treatment of hyponatremia (under- or mainly overtreatment) may also lead to devastating consequences. The appropriate diagnosis of the causative factor is of paramount importance for the proper management and avoidance of treatment pitfalls. Herein, we describe the most common pitfalls in the evaluation of the hyponatremic patient, such as failure to exclude pseudohyponatremia or hypertonic hyponatremia (related to glucose, mannitol or glycine), to properly assess urine sodium concentration and other laboratory findings, to diagnose other causes of hyponatremia (cerebral salt wasting, reset osmostat, nephrogenic syndrome of inappropriate antidiuresis, prolonged strenuous exercise, drugs) as well as inability to measure urine osmolality or delineate the diagnosis and cause of the syndrome of inappropriate antidiuretic hormone secretion. Clinicians should be aware of these common clinical practice pitfalls, which could endanger patients with hyponatremia.
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Affiliation(s)
- T D Filippatos
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.
| | - G Liamis
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - F Christopoulou
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - M S Elisaf
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
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21
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Mehler PS, Walsh K. Electrolyte and acid-base abnormalities associated with purging behaviors. Int J Eat Disord 2016; 49:311-8. [PMID: 26876281 DOI: 10.1002/eat.22503] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Eating disorders that are associated with purging behaviors are complicated by frequent blood electrolyte and acid-base abnormalities. Herein, we review the major electrolyte and acid-base abnormalities and their treatment methods. The body of rigorous, eating disorder-specific literature on this topical area is not robust enough to perform a systematic review as defined by PRISMA guidelines. Therefore, a qualitative review of mostly medical literature was conducted. RESULTS Hypokalemia, hyponatremia, and sodium chloride-responsive metabolic alkalosis are the most common serum changes that occur as a result of purging behaviors. They vary depending on the mode and frequency of purging behaviors. They can all potentially cause dangerous medical complications and are in need of definitive medical treatment. DISCUSSION Eating disorders that are associated with purging behaviors are associated with a number of electrolyte and acid-base changes which are complex in their origin, documented to be medically dangerous and this definitive treatment is necessary to help achieve a successful treatment outcome, and in need of definitive treatment as described herein.
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Affiliation(s)
- Philip S Mehler
- Eating Recovery Center of Denver, Denver, Colorado.,ACUTE, Denver Health, Denver, Colorado.,University of Colorado School of Medicine, Denver, Colorado
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