Presentation
Hyponatremia was not present in any burn patient with CPM. We conclude that severely burned patients, like alcoholics, are especially susceptible to CPM, and that in burn patients with CPM there is a striking association with serum hyperosmolality. [ncbi.nlm.nih.gov]
Children with long-term steroid use and gastroenteritis are at increased risk. [ 2 ] Presentation [ 2 ] HHS usually presents in older patients with type 2 diabetes mellitus. [patient.info]
In the present study, we evaluated the role of the NOS/NO and HO (haem oxygenase)/CO (carbon monoxide) systems in the osmotic regulation of OT release from rat hypothalamus in vitro. [bioscirep.org]
The membrane is permeable to water only and not to the solutes (Na + and Cl - ) present. [anaesthesiamcq.com]
Entire Body System
- Inflammation
Abstract Although ammonia modifies the third component of complement (C3) and activates the alternative pathway, inflammation is not seen in the renal medulla where ammonia concentrations are normally elevated. [ncbi.nlm.nih.gov]
Likewise, they don’t all have the same signs—some have ocular inflammation or increased tear film breakup time, and some don’t. But one thing they do have in common is tear film hyperosmolarity. (See “What is Hyperosmolarity?” below.) [reviewofoptometry.com]
Look in the mouth for dryness, check the pharynx for inflammation and perform auroscopy, looking for middle-ear infection. A quick screening cranial nerve examination may reveal visual field deficits, nystagmus or other cranial nerve palsies. [patient.info]
- Congestive Heart Failure
Good clinical judgment should be employed, especially when the patient has comorbid conditions such as acute myocardial infarction, a history of congestive heart failure, or renal failure. In such cases, close hemodynamic monitoring is indicated. [aafp.org]
Cardiovascular
- Heart Failure
Abstract Patients in the coronary care unit with acute pulmonary edema, heart failure, and other organic heart disease were studied. Blood and urine samples were taken on admission prior to any treatment and later at prescribed intervals. [ncbi.nlm.nih.gov]
Risk factors include: A stressful event such as infection, heart attack, stroke, or recent surgery Heart failure Impaired thirst Limited access to water (especially in people with dementia or who are bedbound) Older age Poor kidney function Poor management [medlineplus.gov]
Cardiac examination : This may reveal evidence of heart failure as the precipitant illness, or give reason to suspect myocardial infarction or infective endocarditis. Abdominal examination : This should look for signs of an acute abdomen. [patient.info]
Good clinical judgment should be employed, especially when the patient has comorbid conditions such as acute myocardial infarction, a history of congestive heart failure, or renal failure. In such cases, close hemodynamic monitoring is indicated. [aafp.org]
- Tachycardia
Vital signs : Tachycardia is common due to dehydration. Hypotension may be present due to severe fluid depletion or underlying sepsis/cardiac impairment. [patient.info]
Neurologic
- Seizure
Patients with hyperosmolality showed disturbance of consciousness, convulsive seizures, hyperexcitability, and tachypnea. The latency of photo-evoked eyelid microvibration tended to be prolonged with an elevation of the plasma osmolality. [ncbi.nlm.nih.gov]
If not treated right away, seizures, coma, or death may result. [medlineplus.gov]
Seizures are present in up to 25% of cases. Seizures may be generalised, focal, movement-induced or myoclonic-jerk type. [patient.info]
- Convulsions
Patients with hyperosmolality showed disturbance of consciousness, convulsive seizures, hyperexcitability, and tachypnea. The latency of photo-evoked eyelid microvibration tended to be prolonged with an elevation of the plasma osmolality. [ncbi.nlm.nih.gov]
Because phosphate replacement can cause severe hypocalcemia in this setting, serum calcium levels should be monitored closely. 25 Hypomagnesemia may manifest as arrhythmias, muscle weakness, convulsions, stupor, and agitation. [aafp.org]
- Headache
Symptoms of high blood sugar including increased thirst (polydipsia), increased volume of urination (polyuria), and increased hunger ( polyphagia ). [5] Symptoms of HHS include: Altered level of consciousness Neurologic signs including: blurred vision, headaches [en.wikipedia.org]
Workup
Serum
- Urea Increased
Although osmotic tolerance limits of renal IM cells are lower than physiologically necessary when exposed to either NaCl or urea increases, a mixture of NaCl and urea significantly increases osmotic tolerance limits ( 8 ). [pnas.org]
Treatment
Blood and urine samples were taken on admission prior to any treatment and later at prescribed intervals. All the patients with APE were found to have elevated plasma osmolalities and hyperglycemia on admission which decreased with treatment. [ncbi.nlm.nih.gov]
545 Dialysis ultrafiltration and hemofiltration 555 Use of drugs in uremia and dialysis 567 Donor and recipient selection in renal transplantation 587 Immunosuppression and treatment of rejection in renal transplantation 595 XIII 606 Renal tubular and [books.google.com]
Prognosis
J Gen Intern Med 6:495–502 Article PubMed CAS Google Scholar Pinies JA, Cairo G, Gaztambide S, et al (1994) Course and prognosis of 132 patients with diabetic non ketotic hyperosmolar state. [link.springer.com]
[…] isotonic saline if hypernatraemia is > 155 -> then also use hypertonic saline to reduce the rate of reduction ADH supplementation if patient is euvolaemic -> DDAVP (V2 receptor agonist) 1-4mcg/day IV/IM/SC/IN can infuse and titrate against urine output PROGNOSIS [lifeinthefastlane.com]
] Risk factors Infections, stroke, trauma, certain medications, heart attacks [4] Diagnostic method Blood tests [2] Differential diagnosis Diabetic ketoacidosis [2] Treatment Intravenous fluids, insulin, low molecular weight heparin, antibiotics [3] Prognosis [en.wikipedia.org]
Prognosis Mortality rates have improved in recent years but remain high at 15-20%. [ 4 ] Prevention [ 2 ] People with diabetes should be well educated about how to manage their condition, particularly when ill. [patient.info]
Course and prognosis of 132 patients with diabetic non ketotic hyperosmolar state. Diabete Metab. 1994;20:43–8. 10. Matz R. Management of the hyperosmolar hyperglycemic syndrome. Am Fam Physician. 1999;60:1468–76. 11. [aafp.org]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Hyperosmolality complicating the management of burned patients has multiple etiologies. Sepsis, hyperglycemia, renal failure, electrolyte disturbances, shock, and substances absorbed from the burn wound may be contributing factors. [ncbi.nlm.nih.gov]
Epidemiology
Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]
Annales françaises de médecine d'urgence volume 3, pages 324–326 (2013)Cite this article Access options Buy single article Instant access to the full article PDF. 39,95 € Price includes VAT (Finland) Références Klouche K, Avenas S, Amigues L, et al (2004) Epidemiology [link.springer.com]
Substance misuse: Alcohol Cocaine Amfetamines MDMA (ecstasy) Diabetes-related First presentation of diabetes mellitus: Unsuspected Undiagnosed Poor diabetic control/non-compliance: Intentional Accidental Self-neglect Neglect or abuse by carers/family Epidemiology [patient.info]
Pathophysiology
Nieman Springer Science & Business Media, ٢٢/٠١/٢٠٠٣ - 345 من الصفحات Experienced physicians concisely explain the pathophysiology and clinical manifestations of endocrine disorders and survey all the latest laboratory diagnostics. [books.google.com]
Also remaining to be answered are questions regarding other physiological, pathophysiological, and pharmacological factors that either impair or enhance volume regulatory processes, and thereby modify the neurological manifestations accompanying disorders [ncbi.nlm.nih.gov]
This pathophysiologic concept may be of particular relevance to diabetics with severe derangements of metabolic control. [diabetes.diabetesjournals.org]
Nocturnal Polyuria in Older People: Pathophysiology and Clinical Implications. Journal of the American Geriatrics Society, Vol. 48, Issue. 10, p. 1321. CrossRef Google Scholar Swaab, D.F. 1999. Advances in Brain Vasopressin. [cambridge.org]
OVERVIEW Diabetes insipidus (DI) is a condition caused by loss of the effect of antidiuretic hormone on the collecting ducts of the kidneys, resulting in loss of free water. diabetes insipidus can be central or nephrogenic This article will focus on CDI PATHOPHYSIOLOGY [lifeinthefastlane.com]
Prevention
Hyperosmotic mannitol significantly induced hyperpolarization of the endothelial cells, which was prevented by 1 microM glibenclamide (n = 6). [ncbi.nlm.nih.gov]
This 50th Anniversary edition offers coverage of nutrition's role in disease prevention, international nutrition issues, public health concerns, the role of obesity in a variety of chronic illnesses, genetics as it applies to nutrition, and areas of major [books.google.com]