Primary adipsia and severe hypernatremia in a Pit Bull dog

ABSTRACT: Primary adipsia is a rare condition in which there is failure in the activation threshold of the hypothalamic osmoreceptors, leading to osmolality imbalance. Here, we reported the case of a Pit Bull dog with an altered level of consciousness (started after weaning) and adipsia. There was an increase in plasma osmolality (444 mOsm/kg), sodium (223.7 mg/dL), and chlorine (173 mg/dL) levels. Based on the suspicion of primary adipsia, water was administered via a nasogastric tube, with clinical improvement. The owner was instructed to supply water with food. Eight months after discharge, the dog returned with parvovirus and died. In the anatomopathological examination, no structural changes were observed in the central nervous system. To our knowledge, this is the first report of hypernatremia due to adipsia in a Pit Bull dog, showing that this is a differential diagnosis that should be considered in this breed.

Endocrine Risk Factors for COVID-19 in Context of Aging

Aged people are the most susceptible group to COVID-19 infection. Immunosenescence characterized by impairment of immune function with inflamm-aging contributes to pathophysiological alterations, among which endocrine and metabolic diseases are not exception. Diabetes, obesity along with impairment of disorders of thyroid functions are the most frequent ones, the common feature of which is failure of immune system including autoimmune processes. In the minireview we discussed how COVID-19 and aging impact innate and adaptive immunity, diabetes and selected neuroendocrine processes. Mentioned is also beneficial effect of vitamin D for attenuation of these diseases and related epigenetic issues. Particular attention is devoted to the role of ACE2 protein in the light of its intimate link with renin-angiotensin regulating system.

Rete Middle Cerebral Artery Anomaly Presenting with a Large Intracerebral Hemorrhage: A Case Report

Rete MCA anomaly is extremely rare and has been seldomly discussed in literature. Embryologically MCA develops by fusion of multiple twigs which form a single channel. If there is failure to fuse a plexiform network of vessels persists known as rete MCA. This web like network of vessels is at high risk of haemorrhagic stroke and therefore for patients presenting incidentally correct diagnosis is paramount. Here we report a case of rete MCA anomaly in a 35-year-old gentle man who presented with a large haemorrhagic stroke in emergency. DSA showed unilateral involvement of proximal MCA, and otherwise normal intra-cranial vasculature. With this report we aim to correctly diagnose this rare condition and avoid misdiagnosis leading to unnecessary treatments.

Cerebrospinal Fluid

The total volume of cerebrospinal fluid (CSF) within the ventricles and subarachnoid space is about 150 mL. The absorption of CSF is directly linked to intracranial pressure. In steady states, the rate of CSF absorption equals CSF formation, and the normal resting pressure of CSF is typically between 150 and 180 mm H2O (reference range, 65-200 mm H2O [5-15 mm Hg]). The most common cause of error in measurement of CSF pressure is failure to position the patient properly (the correct position is lateral decubitus; the right atrial pressure serves as the reference [0 mm H2O]).

Is “Failure to treat” a Treatment failure?

Over-servicing in dentistry has been widely reported on and censured due to the potential physical, social and financial harms it can cause a patient. In contrast, under-treatment is less often noticed or raised as a concern as it seldom presents with overt signs of carelessness or disregard. In addition, it is usually not accompanied by any time or financial burdens, thus patients rarely complain about it. While some practitioners may argue that failure to treat is a form of negligence, this paper will explore if, and when it could be justified. While practitioners may never reach a consensus agreement, the ultimate message is that all treatment should be patient centred and should only commence following their educated, considered, autonomous, and voluntary consent.

Accidentally swallowed toothbrush in mentally healthy patient: A case report and review of literature

Most ingested foreign bodies are usually passed through the gastrointestinal tract. Ingested toothbrush however is almost never passed due to their long length, which doesn’t negotiate the C-loop of the duodenum. Early endoscopic removal is however recommended to reduce chances of morbidity and mortality. Surgical option is considered when there is failure of endoscopic retrieval or when complication such as duodenal perforation has set in. In this case we present a 40-years-old man who accidentally ingested toothbrush that was removed surgically through mini laparotomy and gastrostomy.

FAILURE OF ELECTRIC MOTOR-DRIVEN PUMP BOEING SYSTEM 737-800

This study aims to determine the results of the analysis of the causes a failure that occurred in the Electric Motor-Driven Pump system on an aircraft. Boeing 737-800. The data used is in the form of a Pilot Report from the Batik airline.Water in the period 2013 to 2020.The method used in this research is Failure Mode and Effect Criticality Analysis (FMECA). FMECA is a method used to analyze the causes of damage to a system / component,along with the effects if there is damage to the system / component. The first step in this research is to find case data happened to the hydraulic system (ATA 29) on the airline Batik Air, then perform data processing. From the results of the analysis, the results of the RPN value on Electric Motor-Driven.The highest pump is because EMDP cannot supply pressure to the system. Based on the RPN calculation, the RPN value was obtained at 12. This value obtained from the matrix in the safety standard manual from Batik Air.

Treatment of Vasculitis: Beyond the Basics

Vasculitis is the inflammation of blood vessels in the human body. It causes changes and remodeling in the walls of the vessels that include thickening, narrowing and scarring. As a result, the blood flow to the organs and tissues gets restricted leading to organ damage. The cause of primary vasculitis is not known; however, most cases are thought to be autoimmune. In the present era, it is getting difficult to treat vasculitis with conventional therapies, which includes cyclophosphamide, methotrexate, azathioprine and mycophenolate mofetil, with increasing rates of relapses. Since ever, corticosteroids and cytotoxic agents or immunosuppressants have been the mainstay for treating systemic vasculitis. However, the introduction of newer biological agents have bring about a revolution in the treatment of relapses and in cases where there is failure to induce and sustain remission.