scholarly journals Sekundarni psevdohipoaldosteronizem pri novorojenčku z akutnim vnetjem sečil – Prikaz primera

2017 ◽  
Vol 86 ◽  
Author(s):  
Alenka Stepišnik ◽  
Irena Cetin-Lovšin ◽  
Sonja Posega-Devetak
Keyword(s):  
Urinary Tract ◽  
Adrenal Hyperplasia ◽  
Severe Hyponatremia ◽  
Electrolyte Disorder ◽  
Tubular Cells ◽  
Electrolyte Disturbances ◽  
Life Threatening ◽  
Secondary Pseudohypoaldosteronism ◽  
Urinary Tract Malformations ◽  
Transepithelial Sodium Transport

Hiponatremia and hyperkalemia in a newborn can be a life threatening disorder caused by different diseases, including congenital adrenal hyperplasia, or less frequently by a genetical or acquired tubular cell resistance to aldosteron, called pseudohypoaldosteronism. Secondary pseudohypoaldosteronism is a rare, reversible electrolyte disorder caused by aldosterone resistance in infants with congenital urinary tract malformations and/or urinary tract infection.We present a 4-week-old boy with severe hyponatremia, hyperkalemia and elevated aldosterone levels during an episode of pyelonephritis. The disorder improved completely with antibiotic treatment, rehydration and electrolyte correction. Further investigations showed no structural urinary tract anomalies. According to the literature, we concluded that electrolyte disturbances were caused by aldosterone resistance of the inflamed tubular cells and subsequent defective transepithelial sodium transport.

scholarly journals Multiple Electrolyte and Metabolic Emergencies in a Single Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Caprice Cadacio ◽  
Phuong-Thu Pham ◽  
Ruchika Bhasin ◽  
Anita Kamarzarian ◽  
Phuong-Chi Pham
Keyword(s):  
Sodium Concentration ◽  
Management Plan ◽  
Serum Osmolality ◽  
Volume Depletion ◽  
Severe Hyponatremia ◽  
Current Case ◽  
Electrolyte Disturbances ◽  
Life Threatening ◽  
Osmotic Demyelinating Syndrome

While some electrolyte disturbances are immediately life-threatening and must be emergently treated, others may be delayed without immediate adverse consequences. We discuss a patient with alcoholism and diabetes mellitus type 2 who presented with volume depletion and multiple life-threatening electrolyte and metabolic derangements including severe hyponatremia (serum sodium concentration [SNa] 107 mEq/L), hypophosphatemia (“undetectable,” <1.0 mg/dL), and hypokalemia (2.2 mEq/L), moderate diabetic ketoacidosis ([DKA], pH 7.21, serum anion gap [SAG] 37) and hypocalcemia (ionized calcium 4.0 mg/dL), mild hypomagnesemia (1.6 mg/dL), and electrocardiogram with prolonged QTc. Following two liters of normal saline and associated increase in SNa by 4 mEq/L and serum osmolality by 2.4 mosm/Kg, renal service was consulted. We were challenged with minimizing the correction of SNa (or effective serum osmolality) to avoid the osmotic demyelinating syndrome while replacing volume, potassium, phosphorus, calcium, and magnesium and concurrently treating DKA. Our management plan was further complicated by an episode of significant aquaresis. A stepwise approach was strategized to prioritize and correct all disturbances with considerations that the treatment of one condition could affect or directly worsen another. The current case demonstrates that a thorough understanding of electrolyte physiology is required in managing complex electrolyte disturbances to avoid disastrous outcomes.

scholarly journals Lower Urinary Tract Neoplasia

2018 ◽  
Vol 5 (4) ◽  
pp. 96 ◽  
Author(s):  
Maureen Griffin ◽  
William Culp ◽  
Robert Rebhun
Keyword(s):  
Urinary Tract ◽  
Urinary Bladder ◽  
Lower Urinary Tract ◽  
Treatment Options ◽  
Transitional Cell ◽  
Companion Animals ◽  
Disease Process ◽  
Life Threatening ◽  
Comparative Model ◽  
Lower Urinary

Lower urinary tract neoplasia in companion animals is a debilitating and often life-threatening disease. Tumors of the bladder, urethra, and prostate often occur independently, although extension of these tumors into adjacent regions of the lower urinary tract is documented frequently. The most common lower urinary tract tumor in dogs and cats is transitional cell carcinoma (TCC). In both dogs and cats, TCC affecting the urinary bladder is generally considered to be highly aggressive with both local and metastatic disease potential, and this disease poses unique treatment challenges. Whereas much literature exists regarding the TCC disease process, treatment options, and prognosis in dogs, relatively few studies on feline TCC have been published due to the lower incidence of TCC in this species. Prostate tumors, most commonly adenocarcinomas, occur less commonly in dogs and cats but serve an important role as a comparative model for prostate neoplasia in humans. This article serves as a review of the current information regarding canine and feline lower urinary tract neoplasia as well as the relevance of these diseases with respect to their human counterparts.

scholarly journals Applicability of Magnetic Resonance Imaging in the Assessment of Fetal Urinary Tract Malformations

2019 ◽  
Vol 70 (1) ◽  
pp. 83-95 ◽  
Author(s):  
Tatiana Mendonça Fazecas ◽  
Edward Araujo Júnior ◽  
Heron Werner ◽  
Pedro Daltro ◽  
Alberto Borges Peixoto ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Urinary Tract ◽  
Magnetic Resonance ◽  
Three Dimensional ◽  
Surface Coil ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Urinary Tract Malformations ◽  
Weighted Sequences ◽  
Urinary Tract Anomalies

Objective To assess the applicability of magnetic resonance imaging (MRI) to complement ultrasound in the diagnosis of fetal urinary tract anomalies. Methods This was a retrospective cohort study that included 41 women between 19 weeks and 37 weeks and 6 days of gestation carrying fetuses with malformations of the urinary tract which were initially diagnosed by ultrasound and then referred for MRI. In all cases, the diagnosis was confirmed after birth either through imaging or autopsy. A surface coil was positioned over the abdomen and T2-weighted sequences were obtained in the axial, coronal, and sagittal planes; T1 in at least one plane; and three-dimensional (3-D) TRUFI in fetuses with dilatation of the urinary tract. Results Mean gestational age at the time of MRI examination was 28.21 weeks. The rapid T2 sequences allowed all the anomalies of the fetal urinary tract to be assessed, whereas 3-D TRUFI sequencing proved very useful in evaluating anomalies involving dilatation of the urinary tract. The signs of pulmonary hypoplasia characterized by hypointense signal in the T2-weighted sequences were identified in 13 of the 41 fetuses. Conclusion MRI confirmed and added information to the ultrasound regarding fetal urinary tract anomalies, as well as information related to the other associated malformations, their progress in the prenatal period, and possible postnatal prognosis.

Is Aberrant Mammary Tissue a Marker for Chronic Alcoholism or Kidney-Urinary Tract Malformations?

Dermatology ◽  
1998 ◽  
Vol 197 (2) ◽  
pp. 132-136 ◽  
Author(s):  
F.M. Camacho ◽  
J.C. Moreno-Giménez ◽  
M.J. García-Hernández
Keyword(s):  
Urinary Tract ◽  
Chronic Alcoholism ◽  
Mammary Tissue ◽  
Urinary Tract Malformations

scholarly journals Human urine alters methicillin-resistant Staphylococcus aureus virulence and transcriptome

2021 ◽  
Author(s):  
Santosh Paudel ◽  
Kamal Bagale ◽  
Swapnil Patel ◽  
Nicholas J. Kooyers ◽  
Ritwij Kulkarni
Keyword(s):  
Gene Expression ◽  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Human Urine ◽  
Molecular Mechanisms ◽  
Methicillin Resistant ◽  
Life Threatening ◽  
Tract Infections

Gram-positive methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of hospital-associated urinary tract infections (UTI), especially in catheterized individuals. Despite being rare, MRSA UTI are prone to potentially life-threatening exacerbations such as bacteremia that can be refractory to routine antibiotic therapy. To delineate the molecular mechanisms governing MRSA urinary pathogenesis, we exposed three S. aureus clinical isolates, including two MRSA strains to human urine for 2h and analyzed virulence characteristics and changes in gene expression. The in vitro virulence assays showed that human urine rapidly alters adherence to human bladder epithelial cells and fibronectin, hemolysis of sheep RBCs, and surface hydrophobicity in a staphylococcal strain-specific manner. In addition, RNA-Seq analysis of uropathogenic strain MRSA-1369 revealed that 2h-long exposure to human urine alters MRSA transcriptome, by modifying expression of genes encoding enzymes catalyzing metabolic pathways, virulence factors, and transcriptional regulators. In summary, our results provide important insights into how human urine specifically and rapidly alters MRSA physiology and facilitates MRSA survival in the nutrient-limiting and hostile urinary microenvironment. Importance: Methicillin-resistant Staphylococcus aureus (MRSA) is an uncommon cause of urinary tract infections (UTI) in the general population. However, it is important to understand MRSA pathophysiology in the urinary tract because isolation of MRSA in urine samples often precedes potentially life-threatening MRSA bacteremia. In this report, we describe how exposure to human urine alters MRSA global gene expression and virulence. We hypothesize that these alterations may aid MRSA in acclimating to the nutrient-limiting, immunologically hostile conditions within the urinary tract leading to MRSA-UTI.

scholarly journals Managing drug-induced QT prolongation in clinical practice

2020 ◽  
pp. postgradmedj-2020-138661
Author(s):  
Rani Khatib ◽  
Fatima R N Sabir ◽  
Caroline Omari ◽  
Chris Pepper ◽  
Muzahir Hassan Tayebjee
Keyword(s):  
Qt Interval ◽  
Simple Algorithm ◽  
Torsades De Pointes ◽  
Daily Practice ◽  
Qt Prolongation ◽  
Key Factors ◽  
Drug Induced ◽  
Electrolyte Disturbances ◽  
Related Risk ◽  
Life Threatening

Many drug therapies are associated with prolongation of the QT interval. This may increase the risk of Torsades de Pointes (TdP), a potentially life-threatening cardiac arrhythmia. As the QT interval varies with a change in heart rate, various formulae can adjust for this, producing a ‘corrected QT’ (QTc) value. Normal QTc intervals are typically <450 ms for men and <460 ms for women. For every 10 ms increase, there is a ~5% increase in the risk of arrhythmic events. When prescribing drugs associated with QT prolongation, three key factors should be considered: patient-related risk factors (eg, female sex, age >65 years, uncorrected electrolyte disturbances); the potential risk and degree of QT prolongation associated with the proposed drug; and co-prescribed medicines that could increase the risk of QT prolongation. To support clinicians, who are likely to prescribe such medicines in their daily practice, we developed a simple algorithm to help guide clinical management in patients who are at risk of QT prolongation/TdP, those exposed to QT-prolonging medication or have QT prolongation.

Sign in / Sign up

Export Citation Format

Share Document