scholarly journals Surgical Outcomes of Aldosterone-Producing Adenoma on the Basis of the Histopathological Findings

2021 ◽  
Vol 12 ◽  
Author(s):  
Huiping Wang ◽  
Fen Wang ◽  
Yushi Zhang ◽  
Jin Wen ◽  
Dexin Dong ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Logistic Regression Model ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Clinical Success ◽  
Histopathological Diagnosis ◽  
Multiple Logistic Regression ◽  
Venous Sampling ◽  
Normal Morphology ◽  
Aldosterone Producing Adenoma

IntroductionPrevious studies on the surgical outcomes of aldosterone-producing adenoma (APA) patients were mainly based on the histopathological diagnosis of HE staining or adrenal venous sampling (AVS) instead of the functional pathology. The aim of the present study was to evaluate the surgical outcomes of APA patients based on the functional pathological diagnosis of APA according to HISTALDO (histopathology of primary aldosteronism) consensus.MethodsClinical data of 137 patients with suspected APA were analyzed retrospectively. All patients had hypertension and spontaneous hypokalemia. In all patients, CT showed a unilateral solitary hypodense adrenal lesion, and a contralateral adrenal gland of normal morphology. Tumors were removed and immunostained for CYP11B2, and their pathology were identified based on HISTALDO consensus. Patients were followed up 6 to 24 months after operation.ResultsAmong 137 cases of presumptive APA diagnosed by CT, 130 (95%) cases were pathologically diagnosed with classical pathology, including 123 APA(90%) and 7 aldosterone-producing nodule (APN) (5%). 7 cases (5%) had non-functioning adenoma (NFA) with aldosterone-producing micronodule (APM) or multiple aldosterone-producing micronodule (MAPM) in the surrounding adrenal tissue. In all 137 patients, hypertension was complete or partial clinical success postoperatively. Complete clinical success was achieved in 73 (53%), and partial clinical success was achieved in 64 (47%) cases. Serum potassium level recovered to normal in all. In 123 patients with APA, complete clinical success was reached in 67 (54%), and partial clinical success was reached in 56 (46%) cases. Gender, duration of hypertension and the highest SBP were significant independent predictors for cure of APA after surgery. A multiple logistic regression model integrating the three predictors was constructed to predict the outcome, which achieved a sensitivity of 72.4% and a specificity of 73.1%.ConclusionThe specificity of CT in the diagnosis of APA and APN patients with hypokalemia was 95%. All patients achieved complete or partial clinical success after surgery. Gender, duration of hypertension and the highest SBP were independent predictors for the postoperative cure of APA.

A rare case of hypokalaemia and hypophosphataemia secondary to geophagia

2021 ◽  
Vol 14 (5) ◽  
pp. e239322
Author(s):  
Charmaine Schmidt ◽  
Jonathan Oxley Oxland ◽  
Robert Freercks
Keyword(s):  
Creatine Kinase ◽  
Iron Deficiency ◽  
Phosphate Binder ◽  
Rare Case ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Electrolyte Abnormality ◽  
Distal Muscle

We report a case of severe hypokalaemia and moderate hypophosphataemia from clay ingestion. A 60-year-old woman presented with flaccid paralysis. Investigations revealed a serum potassium level of 1.8 mmol/L, phosphate level of 0.56 mmol/L and creatine kinase level of 30 747 IU/L. She had marked proximal and distal muscle weakness due to severe hypokalaemia and concurrent hypophosphataemia, which likely contributed to the onset of rhabdomyolysis. The patient subsequently admitted to significant pica, most likely secondary to an associated iron deficiency. We conclude that the ingested clay acted as a potassium and phosphate binder. Although we did not investigate the content of the clay in this case, it has been reported that clay can bind potassium in vitro and is rich in minerals such as aluminium that could play a role in the binding of phosphate, although the exact mechanism remains unclear. The patient recovered fully and outpatient follow-up at 6 months and again at 40 months confirmed no electrolyte abnormality, myopathy nor any further geophagia.

scholarly journals Serum potassium level as a biomarker for acute caffeine poisoning

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Tomoatsu Tsuji ◽  
Seiji Morita ◽  
Takeshi Saito ◽  
Yoshihide Nakagawa ◽  
Sadaki Inokuchi
Keyword(s):  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level

Favorable surgical outcomes of aldosterone-producing adenoma based on lateralization by CT imaging and hypokalemia: a non-AVS-based strategy

2017 ◽  
Vol 49 (12) ◽  
pp. 2151-2156 ◽  
Author(s):  
Hai Li ◽  
Jianbin Liu ◽  
Xiujuan Feng ◽  
Liehua Liu ◽  
Guohong Wei ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Ct Imaging ◽  
Aldosterone Producing Adenoma

Ventricular fibrillation during uniform myocardial anoxia due to asphyxia

1960 ◽  
Vol 198 (5) ◽  
pp. 955-958 ◽  
Author(s):  
Jay D. Coffman ◽  
D. E. Gregg
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Current Theory ◽  
The Other ◽  
Right Atrial ◽  
Serum Electrolytes ◽  
Anesthetized Dogs ◽  
A Current

Thirty-three anesthetized dogs of varying weights were subjected to complete asphyxia by tracheal occlusion to produce uniform anoxia of the heart. Eleven showed electrocardiographic evidence of ventricular fibrillation while the other twenty-two demonstrated cardiac arrest. The development of ventricular fibrillation correlated with the heavier body and heart weights and with a lower average right atrial serum potassium level as compared to the dogs not fibrillating. Other serum electrolytes, pH, body temperature and sex showed no correlation with the arrhythmia. The importance of the fact that large dogs have a greater susceptibility to develop ventricular fibrillation during uniform anoxia of the heart is discussed in relation to experimental research on dogs and to a current theory of the cause of ventricular fibrillation.

scholarly journals The Case of Bradycardia Occured in the Setting of Hyperkalemia in a Patient in Ambulatory Hemodialysis Department

2021 ◽  
Vol 11 (1) ◽  
pp. 60-66
Author(s):  
G. A. Ignatenko ◽  
G. G. Taradin ◽  
A. E. Bagry ◽  
I. V. Rakitskaya ◽  
K. E. Mogilevskaya ◽  
...  
Keyword(s):  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Kidney Diseases ◽  
Clinical Manifestations ◽  
Junctional Rhythm ◽  
Chronic Kidney Diseases ◽  
Electrolyte Disorder ◽  
Ambulatory Treatment ◽  
Dangerous Condition

The presented article contains the clinical observation of bradycardia development in 64-year-old patient with chronic kidney disease who was in ambulatory treatment at the hemodialysis department. During electrocardiogram recording an arrhythmia was detected as a junctional rhythm. The specific changes on electrocardiogram, presence of risk factors, and data of additional collection of history disease allowed purposing the development of dangerous condition — hyperkalemia. The diagnosis was confirmed after detection of the serum potassium level. This case illustrates the necessity to consider the possibility of hyperkalemia in patients with chronic kidney diseases including those who undergoing hemodialysis treatment. Relevant clinical manifestations and changes on the electrocardiogram require the urgent assessment of the serum potassium level for timely and adequate correction of the electrolyte disorder.

scholarly journals Serum Potassium Levels and Adverse Outcomes in Patients with Acute Myocardial Infarction

Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
pp. 5-8
Author(s):  
Rizwan Abbas ◽  
Tazeen Nazar ◽  
Bilal Aziz ◽  
Furqan Saeed ◽  
Kashif Nawaz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Serum Potassium ◽  
Potassium Level ◽  
Adverse Outcome ◽  
Serum Potassium Level ◽  
Computer Software ◽  
Case Series ◽  
Adverse Outcomes ◽  
Low Serum

Objective: To determine the effect of serum potassium levels on short term mortality outcomes in patients with acute myocardial infarction. Methods: This Descriptive Case Series was conducted in the CCU of Mayo Hospital Lahore from 15th November, 2017 to 15th May, 2018. A total of 156 patients of either sex between the age group of 30-60 years and diagnosed as cases of myocardial infarction with symptoms of less than 24 hours duration and serum potassium level of <3.5 mEq/L were included in the study. Patients were then followed up for 7 days and adverse outcome was recorded. Data was analyzed using computer software SPSS Version 22.0. Results: Out of the 156 patients, 119 (76.3%) were males and 37 (23.7%) were females. Mean age of the patients was 47.88±6.24 years, mean weight 85.31±13.14 Kg, mean duration of presenting complaints was 10.269±4.51 hours and mean Serum Potassium levels were 3.05±0.25 mEq/L. Adverse outcome in the form of mortality due to arrhythmias was seen in 15 (9.6%) patients. Conclusion: Low serum potassium level (<3.5mEq/L/L) was significantly associated with increased adverse outcome in acute myocardial infarction patients. Keywords: Acute myocardial infarction, Low serum potassium levels, Adverse outcome How to cite: Abbas R., Nazar T, Aziz B., Saeed F., Nawaz K., Nabeel M. serum potassium levels and adverse outcomes in patients with acute myocardial infarction. Esculapio 2021;17(01):5-8

The effect of serum potassium level on in-hospital and long-term mortality in ST elevation myocardial infarction

2016 ◽  
Vol 221 ◽  
pp. 505-510 ◽  
Author(s):  
Muhammed Keskin ◽  
Adnan Kaya ◽  
Mustafa Adem Tatlısu ◽  
Mert İlker Hayıroğlu ◽  
Osman Uzman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Serum Potassium ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Long Term Mortality
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