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[PMID]:29384972
[Au] Autor:Liu YH; Han XB; Fei YH; Xu HT
[Ti] Título:Long-term low-dose tolvaptan treatment in hospitalized male patients aged >90 years with hyponatremia: Report on safety and effectiveness.
[So] Source:Medicine (Baltimore);96(52):e9539, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The retrospective study aimed at investigating the safety and clinical efficacy of long-term application of tolvaptan in patients >90 years old with hyponatremia. Although tolvaptan has been used to treat hyponatremia, the effect of its long-term use in elderly patients was unknown.Seven patients over 90 with isovolumic or hypervolemic hyponatremia admitted to the PLA Navy General Hospital between October 2011 and October 2013 were enrolled. The patients' serum sodium levels <135 mmol/L persisted for more than 3 months, and oral treatment with tolvaptan lasted for more than 12 months. Tolvaptan dose started from 7.5 mg once daily, with maximum dose no more than 30 mg daily. Clinical and laboratory data of the patients before and after treatment were compared.Serum sodium and chlorine levels increased significantly in the 1st 3 days after treatment (P < .05). All patients' serum sodium levels were above 135 mmol/L 1 month after treatment, and sustained through 1 year after treatment, without extra sodium supplementation. No serious complications were observed.The result indicated a significant improvement in the serum sodium levels and no serious adverse effects after long-term use in very elderly patients.
[Mh] Termos MeSH primário: Antagonistas de Receptores de Hormônios Antidiuréticos/uso terapêutico
Benzazepinas/uso terapêutico
Hiponatremia/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Antagonistas de Receptores de Hormônios Antidiuréticos/administração & dosagem
Antagonistas de Receptores de Hormônios Antidiuréticos/efeitos adversos
Benzazepinas/administração & dosagem
Benzazepinas/efeitos adversos
Peso Corporal
Cloro/sangue
Relação Dose-Resposta a Droga
Hospitalização
Seres Humanos
Masculino
Estudos Retrospectivos
Sódio/sangue
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidiuretic Hormone Receptor Antagonists); 0 (Benzazepines); 21G72T1950 (tolvaptan); 4R7X1O2820 (Chlorine); 9NEZ333N27 (Sodium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009539


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[PMID]:29263154
[Au] Autor:Krogh J; Kistorp CN; Jafar-Mohammadi B; Pal A; Cudlip S; Grossman A
[Ad] Endereço:Department of EndocrinologyHerlev University Hospital, Copenhagen, Denmark jesper.krogh@dadlnet.dk.
[Ti] Título:Transsphenoidal surgery for pituitary tumours: frequency and predictors of delayed hyponatraemia and their relationship to early readmission.
[So] Source:Eur J Endocrinol;178(3):247-253, 2018 Mar.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: A major cause of readmission after transsphenoidal surgery (TSS) is delayed hyponatraemia. The purpose of this study was to identify predictors of hyponatraemia one week post surgery and predictors of 30-day readmissions for hyponatraemia. DESIGN: A retrospective cohort study including patients who had TSS performed for pituitary lesions. METHOD: The risk of readmission for hyponatraemia was assessed in consecutive patients between January 2008 and March 2016. The risk of hyponatraemia one week post surgery was assessed in patients admitted for TSS between July 2011 and March 2016. RESULTS: Of all included patients, 56/522 (10.7%) were readmitted within 30 days. Hyponatraemia was found in 14/56 (25%) of 30-day readmissions. We did not identify any predictive variable for hyponatraemia on readmission. The number of patients with hyponatraemia on the seventh post-operative day was 26/314 (8.3%). The risk of hyponatraemia one week post surgery was increased by an odds ratio of 2.40 (95% CI: 1.06-5.40) in patients with a tumour abutting the optic chiasm and by an odds ratio of 1.16 (1.04-1.31) per mmol/L decrease in sodium levels on the first post-operative day. CONCLUSIONS: Hyponatraemia occurred in 25% of readmissions; however, we did not identify any predictive variable for readmission with hyponatraemia. One week post surgery, 8.9% had hyponatraemia. Tumours pressing on the optic chiasm as well as a fall in sodium levels on the first post-operative day were associated with an increased risk of hyponatraemia one week post surgery. We suggest that a day 7 serum sodium <130 nmol/L should lead to concern and the provision of patient advice.
[Mh] Termos MeSH primário: Adenoma/cirurgia
Hiponatremia/epidemiologia
Procedimentos Neurocirúrgicos
Readmissão do Paciente/estatística & dados numéricos
Neoplasias Hipofisárias/cirurgia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Coortes
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Estudos Retrospectivos
Osso Esfenoide
Seio Esfenoidal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0879


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[PMID]:29375117
[Au] Autor:Nakamura M; Sunagawa O; Kinugawa K
[Ad] Endereço:Second Department of Internal Medicine, University of Toyama.
[Ti] Título:Tolvaptan Improves Prognosis in Responders with Acute Decompensated Heart Failure by Reducing the Dose of Loop Diuretics.
[So] Source:Int Heart J;59(1):87-93, 2018.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:It is unknown whether a response to tolvaptan (TLV) is related to prognosis in patients with acute decompensated heart failure (ADHF). We selected 25 patients as responders by their urinary response to TLV and by reduction of loop diuretics from 37 consecutive ADHF patients treated with TLV. As a control group, we selected 25 patients from 100 consecutive ADHF patients who were not treated with TLV by propensity score matching for age, serum sodium level, serum creatinine level, plasma B-type natriuretic peptide (BNP) level, systolic blood pressure, heart rate, and dose of loop diuretics. The primary outcome was defined as a composite endpoint of mortality and/or hemodialysis. The amount of loop diuretics administered to responders was reduced by TLV from 68.8 ± 26.2 mg to 30.4 ± 18.6 mg of furosemide equivalents per day, whereas the loop diuretic dose administered to non-responders was increased. The event-free survival of the TLV responders during 20 months was significantly better than that of the control group (95.8% versus 68.4%, P = 0.0406). The TLV responders, plasma BNP level, and estimated glomerular filtration rate were significantly related to the events in the Cox proportional hazard analysis. Patients with ADHF who respond to TLV may have a better prognosis than propensity-matched patients not receiving TLV treatment. In TLV responders, it may be possible to improve the patient's prognosis if the dose of loop diuretics can be reduced with TLV therapy.
[Mh] Termos MeSH primário: Benzazepinas/administração & dosagem
Insuficiência Cardíaca/tratamento farmacológico
Inibidores de Simportadores de Cloreto de Sódio e Potássio/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Antagonistas de Receptores de Hormônios Antidiuréticos/administração & dosagem
Intervalo Livre de Doença
Relação Dose-Resposta a Droga
Feminino
Seguimentos
Taxa de Filtração Glomerular/efeitos dos fármacos
Taxa de Filtração Glomerular/fisiologia
Insuficiência Cardíaca/mortalidade
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Hiponatremia
Japão/epidemiologia
Masculino
Prognóstico
Pontuação de Propensão
Estudos Retrospectivos
Taxa de Sobrevida/tendências
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidiuretic Hormone Receptor Antagonists); 0 (Benzazepines); 0 (Sodium Potassium Chloride Symporter Inhibitors); 21G72T1950 (tolvaptan)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.17-099


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[PMID]:28468797
[Au] Autor:Kuruvilla J; Savona M; Baz R; Mau-Sorensen PM; Gabrail N; Garzon R; Stone R; Wang M; Savoie L; Martin P; Flinn I; Jacoby M; Unger TJ; Saint-Martin JR; Rashal T; Friedlander S; Carlson R; Kauffman M; Shacham S; Gutierrez M
[Ad] Endereço:Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
[Ti] Título:Selective inhibition of nuclear export with selinexor in patients with non-Hodgkin lymphoma.
[So] Source:Blood;129(24):3175-3183, 2017 06 15.
[Is] ISSN:1528-0020
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patients with relapsed or refractory (R/R) non-Hodgkin lymphoma (NHL) have a poor prognosis and limited treatment options. We evaluated selinexor, an orally bioavailable, first-in-class inhibitor of the nuclear export protein XPO1, in this phase 1 trial to assess safety and determine a recommended phase 2 dose (RP2D). Seventy-nine patients with various NHL histologies, including diffuse large B-cell lymphoma, Richter's transformation, mantle cell lymphoma, follicular lymphoma, and chronic lymphocytic leukemia, were enrolled. In the dose-escalation phase, patients received 3 to 80 mg/m of selinexor in 3- or 4-week cycles and were assessed for toxicities, pharmacokinetics, and antitumor activity. In the dose-expansion phase, patients were treated with selinexor at 35 or 60 mg/m The most common grade 3 to 4 drug-related adverse events were thrombocytopenia (47%), neutropenia (32%), anemia (27%), leukopenia (16%), fatigue (11%), and hyponatremia (10%). Tumor biopsies showed decreases in cell-signaling pathways (Bcl-2, Bcl-6, c-Myc), reduced proliferation (Ki67), nuclear localization of XPO1 cargos (p53, PTEN), and increased apoptosis after treatment. Twenty-two (31%) of the 70 evaluable patients had an objective responses, including 4 complete responses and 18 partial responses, which were observed across a spectrum of NHL subtypes. A dose of 35 mg/m (60 mg) was identified as the RP2D. These findings suggest that inhibition of XPO1 with oral selinexor at 35 mg/m is a safe therapy with encouraging and durable anticancer activity in patients with R/R NHL. The trial was registered at www.clinicaltrials.gov as #NCT01607892.
[Mh] Termos MeSH primário: Núcleo Celular/metabolismo
Hidrazinas/administração & dosagem
Hidrazinas/farmacocinética
Linfoma não Hodgkin/tratamento farmacológico
Linfoma não Hodgkin/metabolismo
Triazóis/administração & dosagem
Triazóis/farmacocinética
[Mh] Termos MeSH secundário: Transporte Ativo do Núcleo Celular/efeitos dos fármacos
Adulto
Idoso
Idoso de 80 Anos ou mais
Anemia/induzido quimicamente
Anemia/metabolismo
Anemia/patologia
Apoptose/efeitos dos fármacos
Núcleo Celular/patologia
Relação Dose-Resposta a Droga
Feminino
Seres Humanos
Hidrazinas/efeitos adversos
Hiponatremia/induzido quimicamente
Hiponatremia/metabolismo
Hiponatremia/patologia
Linfoma não Hodgkin/patologia
Masculino
Meia-Idade
Proteínas de Neoplasias/metabolismo
Neutropenia/induzido quimicamente
Neutropenia/metabolismo
Neutropenia/patologia
Trombocitopenia/induzido quimicamente
Trombocitopenia/metabolismo
Trombocitopenia/patologia
Triazóis/efeitos adversos
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE I; JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Hydrazines); 0 (KPT-330); 0 (Neoplasm Proteins); 0 (Triazoles)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180121
[Lr] Data última revisão:
180121
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170505
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1182/blood-2016-11-750174


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[PMID]:29078838
[Au] Autor:Arieff AI; Gabbai R; Goldfine ID
[Ad] Endereço:Department of Medicine, University of California San Francisco, San Francisco, California. Electronic address: a.arieff@comcast.net.
[Ti] Título:Cerebral Salt-Wasting Syndrome: Diagnosis by Urine Sodium Excretion.
[So] Source:Am J Med Sci;354(4):350-354, 2017 Oct.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cerebral salt-wasting syndrome (CSWS) was initially described over 60 years ago in hyponatremic patients with a cerebral lesion. However, the diagnostic criteria for CSWS have not been fully established. Thus, when hyponatremia is observed in patients with CSWS, they may be misdiagnosed as having the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Thus, it is critical to differentiate between these 2 conditions because their treatments are diametrically opposed. MATERIALS AND METHODS: We carried out a retrospective study of 45 patients with CSWS and compared them to 60 normonatremic control patients, and 28 patients with SIADH. All patients had their 24-hour urine volumes and sodium (Na) excretion measured. RESULTS: In patients with CSWS, urinary Na excretion was 394 ± 369mmol/24 hours and urinary volume was 2,603 ± 996mL/24 hours; both values significantly greater than in controls (P < 0.01). By contrast, in patients with SIADH, the urine Na excretion was only 51 ± 25mmol/24 hours and urine volume was 745 ± 298mL/24 hours; values significantly lower than in patients with CSWS (P < 0.01). CONCLUSIONS: CSWS was diagnosed in patients with cerebral lesion who had (1) symptomatic hyponatremia, (2) urine Na excretion 2 standard deviations above controls and (3) increased urine volume. Patients with SIADH also had symptomatic hyponatremia but, in contrast to patients with CSWS, they had decreased Na excretion and urine volume. Thus urine Na excretion and volume are very important for diagnosing the cause of hyponatremia in patients with cerebral lesions.
[Mh] Termos MeSH primário: Encefalopatias
Hiponatremia
Sódio/urina
[Mh] Termos MeSH secundário: Encefalopatias/diagnóstico
Encefalopatias/urina
Feminino
Seres Humanos
Hiponatremia/diagnóstico
Hiponatremia/urina
Masculino
Meia-Idade
Estudos Retrospectivos
Síndrome
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
9NEZ333N27 (Sodium)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171029
[St] Status:MEDLINE


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[PMID]:28976856
[Au] Autor:Palmer BF; Clegg DJ
[Ad] Endereço:From the Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (B.F.P.); and the Department of Biomedical Sciences, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles (D.J.C.).
[Ti] Título:Electrolyte Disturbances in Patients with Chronic Alcohol-Use Disorder.
[So] Source:N Engl J Med;377(14):1368-1377, 2017 Oct 05.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Desequilíbrio Ácido-Base/etiologia
Alcoolismo/complicações
Desequilíbrio Hidroeletrolítico/etiologia
[Mh] Termos MeSH secundário: Desequilíbrio Ácido-Base/tratamento farmacológico
Alcoolismo/fisiopatologia
Seres Humanos
Hiponatremia/etiologia
Cetose/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMra1704724


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[PMID]:28871578
[Au] Autor:Seki T; Yasuda A; Oki M; Kitajima N; Takagi A; Nakajima N; Miyajima A; Fukagawa M
[Ad] Endereço:Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Iseharashi, Kanagawa 259-1193, Japan. tsekimdpdd@tokai-u.jp.
[Ti] Título:Secondary Adrenal Insufficiency Following Nivolumab Therapy in a Patient with Metastatic Renal Cell Carcinoma.
[So] Source:Tokai J Exp Clin Med;42(3):115-120, 2017 Sep 20.
[Is] ISSN:2185-2243
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Currently, nivolumab (an anti-programmed cell death-1 receptor monoclonal antibody) is available for many types of advanced cancers in Japan. However, there have been few detailed case reports about endocrine-related adverse events of this therapy. Here, we report a patient with metastatic renal cell carcinoma who presented with secondary adrenal insufficiency following nivolumab therapy. Endocrinological assessment by rapid adrenocorticotropic hormone (ACTH) and corticotropin-releasing hormone (CRH) tests revealed that the patient's disorder was a secondary adrenal insufficiency due to pituitary dysfunction. Moreover, the results of the thyrotropin-releasing hormone (TRH), luteinizing hormone-releasing hormone (LH-RH) and growth hormone-releasing peptide-2 (GHRP-2) tests showed that only the ACTH function was destroyed (isolated ACTH deficiency). The magnetic resonance imaging (MRI) findings of hypophysitis, which is the major cause of isolated ACTH deficiency, usually demonstrate enlargement of the pituitary gland. However, the MRI findings of our case showed no abnormalities of the pituitary gland and stalk. Therefore, not only oncologists, but also other specialists, including doctors in emergency units, should have knowledge of this specific feature. Our clinical observation could be useful to avoid a delay in diagnosis and to treat life-threatening adverse effects of nivolumab therapy, such as secondary adrenal insufficiency.
[Mh] Termos MeSH primário: Insuficiência Adrenal/induzido quimicamente
Anticorpos Monoclonais/efeitos adversos
Antineoplásicos/efeitos adversos
Carcinoma de Células Renais/tratamento farmacológico
Neoplasias Renais/tratamento farmacológico
[Mh] Termos MeSH secundário: Insuficiência Adrenal/diagnóstico
Hormônio Adrenocorticotrópico/sangue
Idoso
Anticorpos Monoclonais/administração & dosagem
Antineoplásicos/administração & dosagem
Biomarcadores/sangue
Carcinoma de Células Renais/secundário
Hormônio Liberador da Corticotropina/sangue
Feminino
Seres Humanos
Hiponatremia/induzido quimicamente
Hipofisite/complicações
Hipofisite/diagnóstico por imagem
Infusões Intravenosas
Neoplasias Renais/secundário
Imagem por Ressonância Magnética
Doenças da Hipófise/complicações
Doenças da Hipófise/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antineoplastic Agents); 0 (Biomarkers); 31YO63LBSN (nivolumab); 9002-60-2 (Adrenocorticotropic Hormone); 9015-71-8 (Corticotropin-Releasing Hormone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE


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[PMID]:28810281
[Au] Autor:Mönig H; Arlt A
[Ti] Título:[Hyponatremia: Differential Diagnosis and Treatment].
[Ti] Título:Hyponatriämie: Differenzialdiagnose und Therapie..
[So] Source:Dtsch Med Wochenschr;142(16):1231-1247, 2017 Aug.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Hyponatremia is the most common electrolyte abnormality seen in hospitalized patients, with up to 30 % having a plasma sodium concentration below 135 mmol/l. It is now clear that the clinical problem extends beyond the neurological symptoms, which can be explained by intracerebral osmotic fluid shifts and brain edema. Instead, chronic hyponatremia is associated with impaired gait stability and an increased risk of bone fragility fractures. Moreover, hyponatremia has been demonstrated to be an indicator of poor prognosis in a variety of conditions.Hyponatremia can be a life-threatening disorder due to increased intracranial pressure, thus requiring prompt and efficacious treatment. However, overly rapid correction may be complicated by osmotic demyelination syndrome with catastrophic clinical sequelae, i. e., spastic quadriparesis, or even coma or death.To avoid inappropriate treatment, the underlying pathophysiology in each case as well as the time course (acute vs. chronic) and the clinical and biochemical severity must be considered.The purpose of this review is to provide the reader with a systematic approach to the correct diagnosis and management of hyponatremia based on available European and international guidelines.
[Mh] Termos MeSH primário: Hiponatremia
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Europa (Continente)
Seres Humanos
Hiponatremia/diagnóstico
Hiponatremia/fisiopatologia
Hiponatremia/terapia
Guias de Prática Clínica como Assunto
Sódio/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
9NEZ333N27 (Sodium)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170816
[St] Status:MEDLINE
[do] DOI:10.1055/s-0043-108953


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[PMID]:28806046
[Au] Autor:Braun MM; Mahowald M
[Ad] Endereço:Madigan Army Medical Center Family Medicine Residency, 9040 Jackson Ave, Tacoma, WA 98431.
[Ti] Título:Electrolytes: Sodium Disorders.
[So] Source:FP Essent;459:11-20, 2017 Aug.
[Is] ISSN:2159-3000
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sodium disorders (ie, hyponatremia, hypernatremia) are common electrolyte disturbances in clinical medicine and are associated with increased rates of morbidity and mortality. Etiologies of hyponatremia are classified into four categories. The first is pseudohyponatremia, in which the sodium level is low due to hyperproteinemia, hyperlipidemia, or hyperglycemia. The other three categories are based on overall patient fluid status and include hypovolemic (commonly due to fluid loss), hypervolemic (commonly due to fluid retention from heart failure, cirrhosis, or renal failure), and euvolemic (most often because of syndrome of inappropriate secretion of antidiuretic hormone). Hypovolemic hyponatremia is managed by rehydration with isotonic saline. Hypervolemic hyponatremia is managed by addressing the underlying cause. Euvolemic hyponatremia is managed by restricting free water intake, addressing the underlying cause, and occasionally with drugs (eg, vasopressin receptor antagonists). Patients with severe or acutely symptomatic hyponatremia (eg, altered mental status, seizures), including those with acute symptomatic exercise-induced hyponatremia, require urgent treatment. This should consist of hypertonic saline administration along with monitoring of sodium levels to avoid overly rapid correction. Hypernatremia most often occurs because of water loss or inadequate water intake. Depending on severity, management involves oral or intravenous hypotonic fluids and addressing the underlying cause.
[Mh] Termos MeSH primário: Antagonistas de Receptores de Hormônios Antidiuréticos/uso terapêutico
Hidratação
Hipernatremia/terapia
Hiponatremia/terapia
Solução Salina Hipertônica/uso terapêutico
Cloreto de Sódio/uso terapêutico
[Mh] Termos MeSH secundário: Exercício
Insuficiência Cardíaca/complicações
Seres Humanos
Hipernatremia/etiologia
Hiponatremia/etiologia
Hipovolemia/complicações
Síndrome de Secreção Inadequada de HAD/complicações
Soluções Isotônicas/uso terapêutico
Cirrose Hepática/complicações
Insuficiência Renal/complicações
Desequilíbrio Hidroeletrolítico/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antidiuretic Hormone Receptor Antagonists); 0 (Isotonic Solutions); 0 (Saline Solution, Hypertonic); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE


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[PMID]:28805553
[Au] Autor:Katch RK; Scarneo SE; Adams WM; Armstrong LE; Belval LN; Stamm JM; Casa DJ
[Ad] Endereço:a University of Connecticut.
[Ti] Título:Top 10 Research Questions Related to Preventing Sudden Death in Sport and Physical Activity.
[So] Source:Res Q Exerc Sport;88(3):251-268, 2017 Sep.
[Is] ISSN:2168-3824
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Participation in organized sport and recreational activities presents an innate risk for serious morbidity and mortality. Although death during sport or physical activity has many causes, advancements in sports medicine and evidence-based standards of care have allowed clinicians to prevent, recognize, and treat potentially fatal injuries more effectively. With the continual progress of research and technology, current standards of care are evolving to enhance patient outcomes. In this article, we provided 10 key questions related to the leading causes and treatment of sudden death in sport and physical activity, where future research will support safer participation for athletes and recreational enthusiasts. The current evidence indicates that most deaths can be avoided when proper strategies are in place to prevent occurrence or provide optimal care.
[Mh] Termos MeSH primário: Traumatismos em Atletas/prevenção & controle
Morte Súbita/prevenção & controle
[Mh] Termos MeSH secundário: Arritmias Cardíacas/terapia
Regulação da Temperatura Corporal
Lesões Encefálicas Traumáticas/complicações
Lesões Encefálicas Traumáticas/terapia
Desfibriladores Implantáveis
Serviços Médicos de Emergência/organização & administração
Exercício/fisiologia
Futebol Americano/lesões
Golpe de Calor/prevenção & controle
Golpe de Calor/terapia
Seres Humanos
Hiponatremia/etiologia
Hiponatremia/prevenção & controle
Hiponatremia/terapia
Programas de Rastreamento
Educação Física e Treinamento/recursos humanos
Volta ao Esporte
Fatores de Risco
Traço Falciforme/complicações
Traço Falciforme/terapia
Esportes/classificação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE
[do] DOI:10.1080/02701367.2017.1342201



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