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1.
Rev. chil. obstet. ginecol. (En línea) ; Rev. chil. obstet. ginecol;88(6): 389-393, dic. 2023. tab
Article de Espagnol | LILACS | ID: biblio-1530038

RÉSUMÉ

El síndrome de absorción intravascular en histeroscopia se origina por la rápida absorción vascular de soluciones isotónicas e hipotónicas utilizadas en irrigación intrauterina, ocasionando hipervolemia y dilución de electrolitos, especialmente hiponatremia. Cuando este síndrome es debido a intoxicación por glicina al 1,5% causa acidosis severa y neurotoxicidad. La incidencia de este síndrome es baja pero puede aumentar por factores como: falta de control de altura de bolsas de irrigación, ausencia de equilibrio de fluidos de soluciones de irrigación, tejidos altamente vascularizados como miomas uterinos y uso de sistema de electrocirugía monopolar. Se reporta el caso de una paciente con miomas uterinos, programada para resección mediante histeroscopia que cursa con síndrome de absorción intravascular por glicina, el temprano diagnóstico y rápido tratamiento intraoperatorio y postoperatorio permitió una evolución favorable. El manejo se basó en el uso de diuréticos, restricción de fluidos y soluciones hipertónicas de sodio.


Intravascular absorption syndrome in hysteroscopy is caused by rapid vascular absorption of isotonic and hypotonic solutions used in intrauterine irrigation, causing hypervolemia and electrolyte dilution, especially hyponatremia. When this syndrome is due to 1.5% glycine toxicity, it causes severe acidosis and neurotoxicity. The incidence of this syndrome is low but may increase due to factors such as: lack of control of the height of irrigation bags, lack of fluid balance in irrigation solutions, highly vascularized tissues such as uterine myomas and use of a monopolar electrosurgery system. The case of a patient with uterine myomas, scheduled for resection by hysteroscopy, who presents with intravascular glycine absorption syndrome, is reported. Early diagnosis and rapid intraoperative and postoperative treatment allowed a favorable evolution. Management was based on the use of diuretics, fluid restriction, and hypertonic sodium solutions.


Sujet(s)
Humains , Femelle , Adulte , Hystéroscopie/effets indésirables , Glycine/effets indésirables , Hyponatrémie/étiologie , Hyponatrémie/thérapie , Syndrome , Troubles de l'équilibre hydroélectrolytique/étiologie , Troubles de l'équilibre hydroélectrolytique/thérapie , Diurétiques/usage thérapeutique , Myomectomie de l'utérus , Solution hypertonique/usage thérapeutique , Irrigation thérapeutique/effets indésirables
2.
J. coloproctol. (Rio J., Impr.) ; 42(2): 187-189, Apr.-June 2022. ilus
Article de Anglais | LILACS | ID: biblio-1394417

RÉSUMÉ

Introduction: McKittrick-Wheelock syndrome is a rare condition that arises from a hypersecretory state secondary to large colorectal tumors, mainly villous adenomas, leading to an electrolytic disorder associated with chronic diarrhea that usually persists for years. It is a relatively unknown disease that can lead to severe complications such as acute kidney injury, severe hyponatremia, and hypokalemia. In fact, it causes death in most untreated cases. Surgical removal of the tumor is the most successful treatment, and symptoms tend to disappear after proper management. Case Report: A 62-year-old man with a 2-year history of mucoid diarrhea preceded by abdominal pain presented with acute kidney injury, hyponatremia, and hypokalemia. A digital rectal examination and sigmoidoscopy were performed, and revealed a large laterally-spreading tumor in the rectum. Further investigation showed a rectal tubulovillous adenoma with secondary McKittrick-Wheelock syndrome. An anterior resection of the rectum with a colonic J-pouch and a diverting ileostomy were performed, and the patient improved with the resolution of the renal failure and electrolyte disturbances. The histopathological analysis revealed an invasive rectal adenocarcinoma. Discussion: McKittrick-Wheelock syndrome is a condition with a low incidence that needs early intervention and proper diagnosis. It is of extreme importance that this disease is included in the differential diagnoses for chronic diarrhea associated with an electrolytic disorder. (AU)


Sujet(s)
Humains , Mâle , Adulte d'âge moyen , Tumeurs du rectum/complications , Troubles de l'équilibre hydroélectrolytique/étiologie , Adénocarcinome/complications , Diarrhée/étiologie , Atteinte rénale aigüe/étiologie , Syndrome
3.
Rev. Soc. Bras. Clín. Méd ; 19(1): 67-72, março 2021. ilus., tab.
Article de Portugais | LILACS | ID: biblio-1361755

RÉSUMÉ

O objetivo deste estudo foi evidenciar e discutir as principais alterações hidroeletrolíticas em pessoas com cirrose. Trata-se de uma revisão integrativa, de natureza qualitativa. Os artigos foram selecionados por meio da plataforma Medical Literature Analysis and Retrievel System Online. Os principais achados identificados a partir dos artigos selecionados foram a ocorrência de hiponatremia, o mau prognóstico diante da presença de distúrbios hidroeletrolíticos em relação à sobrevida em pessoas com cirrose e a importância da albumina. Indivíduos com cirrose são suscetíveis ao desenvolvimento de distúrbios hidroeletrolíticos devido às mudanças fisiopatológicas da doença e às condições clínicas apresentadas. A hiponatremia e a hipocalemia são os mais recorrentes, destacando, porém, a necessidade de atenção aos demais distúrbios. (AU)


The objective of this study was to show and discuss the main hydroelectrolytic alterations in cirrhotic patients. This is an integrative review, a qualitative study, in which articles were selected at the Medical literature Analysis and Retrieval System Online. The main findings identified in the articles selected were the occurrence of hyponatremia, the poor prognostic, due to the presence of hydroelectrolytic disorders, regarding cirrhotic individuals survival and the importance of albumin. Individuals with cirrhosis are susceptible to the development of hydroelectrolytic disorders due to the pathophysiological alterations of the disease and because of the clinical status presented. Hyponatremia and hypokalemia are the most recurrent, but attention shall be given to the other disorders too. (AU)


Sujet(s)
Humains , Troubles de l'équilibre hydroélectrolytique/métabolisme , Cirrhose du foie/métabolisme , Pronostic , Troubles de l'équilibre acidobasique/étiologie , Troubles de l'équilibre hydroélectrolytique/complications , Troubles de l'équilibre hydroélectrolytique/étiologie , Analyse de survie , Hypophosphatémie/étiologie , Hypoalbuminémie/étiologie , Recherche qualitative , Albumines/usage thérapeutique , Cirrhose du foie/complications , Cirrhose du foie/physiopathologie , Cirrhose du foie/thérapie , Magnésium, carence/étiologie
4.
Rev. bras. ter. intensiva ; 32(1): 99-107, jan.-mar. 2020. tab, graf
Article de Anglais, Portugais | LILACS | ID: biblio-1138474

RÉSUMÉ

RESUMO Objetivo: Avaliar se a sobrecarga de fluidos na terapia hídrica é fator prognóstico para pacientes com choque séptico quando ajustada para os alvos de depuração de lactato. Métodos: Este estudo envolveu uma coorte retrospectiva e foi conduzido em um hospital de cuidados nível IV localizado em Bogotá, na Colômbia. Foi organizada uma coorte de pacientes com choque séptico, e suas características e balanço hídrico foram documentados. Os pacientes foram estratificados por níveis de exposição segundo a magnitude da sobrecarga de fluidos por peso corporal após 24 horas de terapia. A mortalidade foi determinada aos 30 dias, e foi desenvolvido um modelo de regressão logística incondicional com ajuste para fatores de confusão. A significância estatística foi estabelecida com nível de p ≤ 0,05. Resultados: Foram 213 pacientes com choque séptico e, após o tratamento, 60,8% deles tiveram depuração de lactato acima de 50%. Dentre os pacientes 97 (46%) desenvolveram sobrecarga de fluidos ≥ 5%, e apenas 30 (13%) desenvolveram sobrecarga ≥ 10%. Pacientes com sobrecarga de fluidos ≥ 5% receberam, em média, 6.227mL de soluções cristaloides (DP ± 5.838mL) em 24 horas, enquanto os não expostos receberam 3.978mL (DP ± 3.728mL), com p = 0.000. Os pacientes que desenvolveram sobrecarga de fluidos foram mais frequentemente tratados com ventilação mecânica (70,7% versus 50,8%; p = 0,003), albumina (74,7% versus 55,2%; p = 0,003) e corticosteroides (53,5% versus 35,0%; p = 0,006) do que os que não desenvolveram sobrecarga de fluidos. Em análise multivariada, o balanço acumulado de fluidos não se associou com mortalidade (RC 1,03; IC95% 0,89 - 1,20). Conclusão: Após ajuste para severidade da condição e depuração adequada de lactato, a ocorrência de balanço hídrico positivo não se associou com aumento da mortalidade nessa coorte latino-americana de pacientes sépticos.


ABSTRACT Objective: To assess whether fluid overload in fluid therapy is a prognostic factor for patients with septic shock when adjusted for lactate clearance goals. Methods: This was a retrospective cohort study conducted at a level IV care hospital in Bogotá, Colombia. A cohort of patients with septic shock was assembled. Their characteristics and fluid balance were documented. The patients were stratified by exposure levels according to the magnitude of fluid overload by body weight after 24 hours of therapy. Mortality was determined at 30 days, and an unconditional logistic regression model was created, adjusting for confounders. The statistical significance was established at p ≤ 0.05. Results: There were 213 patients with septic shock, and 60.8% had a lactate clearance ≥ 50% after treatment. Ninety-seven (46%) patients developed fluid overload ≥ 5%, and only 30 (13%) developed overload ≥ 10%. Patients exhibiting fluid overload ≥ 5% received an average of 6227mL of crystalloids (SD ± 5838mL) in 24 hours, compared to 3978mL (SD ± 3728mL) among unexposed patients (p = 0.000). The patients who developed fluid overload were treated with mechanical ventilation (70.7% versus 50.8%) (p = 0.003), albumin (74.7% versus 55.2%) (p = 0.003) and corticosteroids (53.5% versus 35.0%) (p = 0.006) more frequently than those who did not develop fluid overload. In the multivariable analysis, cumulative fluid balance was not associated with mortality (OR 1.03; 95%CI 0.89 - 1.20). Conclusions: Adjusting for the severity of the condition and adequate lactate clearance, cumulative fluid balance was not associated with increased mortality in this Latin American cohort of septic patients.


Sujet(s)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Sujet âgé , Choc septique/métabolisme , Choc septique/thérapie , Acide lactique/métabolisme , Traitement par apport liquidien , Pronostic , Choc septique/complications , Troubles de l'équilibre hydroélectrolytique/étiologie , Études rétrospectives , Études de cohortes
5.
Rev. gaúch. enferm ; Rev. gaúch. enferm;38(3): e66789, 2017. tab
Article de Portugais | LILACS, BDENF | ID: biblio-901653

RÉSUMÉ

RESUMO Objetivo Validar intervenções e atividades de enfermagem propostas pela Nursing Interventions Classification, para pacientes com insuficiência renal aguda ou doença renal crônica agudizada, em terapia hemodialítica com os diagnósticos de enfermagem Volume de Líquidos Excessivo e Risco de Volume de Líquidos Desequilibrado. Métodos Validação de conteúdo com 19 enfermeiros peritos de um hospital universitário. A coleta de dados ocorreu de setembro a novembro de 2011, por meio de instrumentos que continham as intervenções e atividades de enfermagem em estudo. A análise considerou a média dos escores obtidos na validação. Resultados O Controle Hídrico foi validado como intervenção prioritária (média ≥ 0.8), com oito atividades principais para o diagnóstico Volume de Líquidos Excessivo e oito para o diagnóstico Risco de Volume de Líquidos Desequilibrado. Conclusão A intervenção validada de Controle Hídrico possibilita o monitoramento do equilíbrio hídrico e facilita a prevenção de complicações, consideradas importantes atividades do cuidado ao paciente em terapia hemodialítica.


RESUMEN Objectivo Validar intervenciones y actividades de enfermería propuestas por la Nursing Interventions Classification, para pacientes con insuficiencia renal aguda o enfermedad renal crónica agudizada, en terapia hemodialítica con los diagnósticos de enfermería Volumen de Líquidos Excesivo y Riesgo de Desequilibrio de Volumen de Líquidos. Métodos Validación de contenido con 19 enfermeros expertos de un hospital universitario. La recolección de datos fue realizada de septiembre a noviembre de 2011 con instrumentos que contenían las intervenciones y actividades de enfermería en estudio. El análisis consideró el promedio de los puntajes obtenidos en la validación. Resultados El Manejo de Líquidos fue validado como intervención prioritaria (media >0.8), con ocho actividades principales para el diagnóstico Volumen de Líquidos Excesivo y ocho para el diagnóstico Riesgo de Desequilibrio de Volumen de Líquidos. Conclusión La intervención validada de Manejo de Líquidos posibilita el monitoreo del balance hídrico y facilita la prevención de complicaciones, consideradas importantes actividades del cuidado al paciente en terapia hemodialítica.


ABSTRACT Objective To validate interventions and nursing activities proposed by the Nursing Interventions Classification for patients with acute renal failure or acute chronic renal disease in hemodialysis therapy with the Excess Fluid Volume and Risk for Imbalanced Fluid Volume nursing diagnoses. Methods Validation of content with 19 expert nurses from a university hospital. The data collection was made from September to November 2011 through instruments that contained the interventions and nursing activities in study. The data analysis considered the average of scores obtained in the validation process. Results The Fluid Management was validated as a priority intervention (mean ≥ 0.8), with eight main activities for the Excess Fluid Volume nursing diagnosis and eight for the Risk for Imbalanced Fluid Volume nursing diagnosis. Conclusion The validated intervation of the Fluid Management enables the monitoring of the hydric balance and facilitates the prevention of complications, which are important activities in the nursing care of the patients in hemodialysis therapy.


Sujet(s)
Humains , Mâle , Femelle , Dialyse rénale/soins infirmiers , Spécialités en soins infirmiers , Équilibre hydroélectrolytique , Troubles de l'équilibre hydroélectrolytique/soins infirmiers , Troubles de l'équilibre hydroélectrolytique/étiologie , Troubles de l'équilibre hydroélectrolytique/prévention et contrôle , Diagnostic infirmier , Dialyse rénale/effets indésirables , Atteinte rénale aigüe/soins infirmiers , Atteinte rénale aigüe/thérapie , Unités hospitalières d'hémodialyse , Hôpitaux universitaires , Unités de soins intensifs , Défaillance rénale chronique/soins infirmiers , Défaillance rénale chronique/thérapie
6.
Rev. gaúch. enferm ; Rev. gaúch. enferm;37(2): e61554, 2016. tab, graf
Article de Portugais | LILACS, BDENF | ID: biblio-960729

RÉSUMÉ

RESUMO Objetivo Testar a aplicabilidade clínica da Nursing Outcomes Classification em pacientes com insuficiência cardíaca descompensada e Diagnóstico de Enfermagem Volume de Líquidos Excessivo. Métodos Estudo longitudinal conduzido em duas etapas em um hospital universitário no ano de 2013. Na primeira etapa, utilizou-se a validação por consenso de especialistas para selecionar os resultados de enfermagem e os indicadores relacionados ao diagnóstico de enfermagem; na segunda, foi realizado um estudo longitudinal para avaliação clínica dos pacientes, utilizando-se o instrumento contendo os resultados e indicadores produzidos no consenso. Resultados Foram realizadas avaliações em 17 pacientes. Na avaliação clínica, mensuraram-se os resultados de enfermagem através da avaliação de seus indicadores. Seis resultados apresentaram aumento nos escores, quando comparados às médias da primeira e da última avaliação. A utilização da Nursing Outcomes Classification na prática clínica demonstrou melhora dos pacientes internados por insuficiência cardíaca descompensada. Conclusão A Nursing Outcomes Classification foi sensível às alterações no quadro clínico dos pacientes.


RESUMEN Objetivo Testar la aplicabilidad clínica de la Nursing Outcomes Classification en pacientes con insuficiencia cardíaca descompensada y Diagnóstico de Enfermería Volumen de Líquidos Excesivo. Método Estudio longitudinal, realizado en dos etapas, en un hospital universitario, en 2013. En la primera etapa se utilizó la validación por consenso de especialistas para seleccionar los resultados de enfermería y los indicadores relaciones al diagnóstico de enfermería; en la segunda fue realizado un estudio longitudinal para evaluación clínica de los pacientes, utilizándose el instrumento que contiene los resultados y los indicadores producto del consenso. Resultados Fueron realizadas evaluaciones en 17 pacientes. Durante la evaluación clínica se midieron los resultados de enfermería a través de la evaluación de sus indicadores. Seis resultados mostraron un aumento en las puntuaciones, cuando se comparó las medias de los resultados de la primera y última evaluación. La utilización de la Nursing Outcomes Classification en la práctica clínica fue capaz de demostrar mejoría clínica de los pacientes internados por insuficiencia cardíaca descompensada. Conclusión La Clasificación de Resultados de Enfermería fue sensible a las alteraciones en el cuadro clínicos de los pacientes.


ABSTRACT Objective The purpose of this study was to test the clinical applicability of the Nursing Outcomes Classification in patients with decompensated heart failure and the nursing diagnosis of fluid volume excess. Methods This is a longitudinal study conducted in two stages at a university hospital, in 2013. During the first stage the consensus of experts was used to select the nursing outcomes and the indicators related to diagnosing fluid volume excess. The longitudinal study was conducted in the second stage to clinically evaluate the patients using the instrument containing the results and indicators produced in the consensus. Results A total of 17 patients were assessed. The nursing outcomes were measured during the clinical evaluation by analysing their indicators. The scores increased in six of the results, in comparison with the average results of the first and last assessment. The Nursing Outcomes Classification during medical practice revealed a clinical improvement among the patient who were admitted following decompensated heart failure. Conclusion The Nursing Outcomes Classification managed to detect changes in the clinical status of patients.


Sujet(s)
Humains , Mâle , Femelle , Sujet âgé , Troubles de l'équilibre hydroélectrolytique/soins infirmiers , Terminologie normalisée des soins infirmiers , Défaillance cardiaque/soins infirmiers , Évaluation des besoins en soins infirmiers/méthodes , Troubles de l'équilibre hydroélectrolytique/classification , Troubles de l'équilibre hydroélectrolytique/diétothérapie , Troubles de l'équilibre hydroélectrolytique/étiologie , Diagnostic infirmier , Brésil , Résultat thérapeutique , Consensus , Coeur/physiopathologie , Défaillance cardiaque/classification , Défaillance cardiaque/complications , Défaillance cardiaque/physiopathologie , Hôpitaux universitaires , Rein/physiopathologie , Adulte d'âge moyen
7.
Article de Anglais | IMSEAR | ID: sea-157643

RÉSUMÉ

Malaria is re-emerging as the major infectious killer and it is the top priority tropical disease of the World Health Organization. Indian sub-continent harbours a global threat in the form of epicenter of multidrug resistant plasmodium falciparum. High prevalence of Complicated Falciparum Malaria in Costal Andhra Pradesh requiring ICU admission with high morbidity and mortality prompted this study. 60 cases of falciparum malaria in 3 sub groups, i.e, uncomplicated falciparum, severe falciparum with ARF, severe falciparum without ARF are taken. In Group-II, i.e, severe falciparum with ARF pts., mean serum potassium is 5.06 -hyperkalemia, mean PaO2 and PaCO2 are 80.33 and 32.75 respectively and mean bicarbonate value is 19.83, mean PH is 7.10, which reflects underlying metabolic acidosis and compensatory respiratory alkalosis, also mortality is 6 in Group-II out of total 9 deaths. Hence electrolytes and acid-base disturbance, especially hyperkalemia and acidosis are important cause of mortality in severe falciparum malaria. In acute renal failure setting, which is associated with both hyperkalemia and acidosis, prognosis is worsened. “Humanity has but three great enemies : fever, famine and war; of these by far the greatest, by far the most terrible, is fever(William Osler).


Sujet(s)
Troubles de l'équilibre acidobasique/étiologie , Humains , Paludisme à Plasmodium falciparum/épidémiologie , Paludisme à Plasmodium falciparum/mortalité , Paludisme à Plasmodium falciparum/physiologie , Morbidité , Mortalité , Troubles de l'équilibre hydroélectrolytique/étiologie
8.
Rev. Esc. Enferm. USP ; Rev. Esc. Enferm. USP;48(3): 446-453, 06/2014. tab
Article de Anglais | LILACS, BDENF | ID: lil-715708

RÉSUMÉ

Objective: To identify the prevalence of nursing diagnosis of fluid volume excess and their defining characteristics in hemodialysis patients and the association between them. Method: Cross-sectional study conducted in two steps. We interviewed 100 patients between the months of December 2012 and April 2013 in a teaching hospital and one hemodialysis clinic. The inference was performed by diagnostician nurses between July and September 2013. Results: The diagnostic studied was identified in 82% of patients. The characteristics that were statistically associated: bounding pulses, pulmonary congestion, jugular vein distention, edema, change in electrolytes, weight gain, intake greater than output and abnormal breath sounds. Among these, edema and weight gain had the highest chances for the development of this diagnostic. Conclusion: The analyzed diagnostic is prevalent in this population and eight characteristics presented significant association.
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Objetivo: Identificar la prevalencia del diagnóstico de enfermería Exceso de volumen de líquidos y sus características definitorias en pacientes sometidos a hemodiálisis y verificar la asociación entre ambos. Método: Estudio transversal, realizado en dos etapas. Se entrevistaron 100 pacientes, entre los meses de diciembre de 2012 y abril de 2013, de un hospital universitario y de una clínica de hemodiálisis. La inferencia diagnóstica fue realizada por enfermeros diagnosticadores, entre julio y septiembre de 2013. Resultados: El diagnóstico estudiado fue identificado en 82% de los pacientes. Las características que presentaron asociación estadística fueron: agitación, congestión pulmonar, distensión de la yugular, edema, electrolitos alterados, aumento de peso, ingesta mayor a las pérdidas y sonidos adventicios. Entre estos, el edema y el aumento de peso presentan mayor relación para la formulación del diagnóstico. Conclusión: Se concluye que el diagnóstico analizado es prevalente en esta población y que presentó asociación significativa con ocho características.
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Objetivo: Identificar a prevalência do diagnóstico de enfermagem Volume de líquidos excessivo e de suas características definidoras em pacientes submetidos à hemodiálise e verificar a associação entre ambos. Método: Pesquisa transversal realizada em duas etapas. Foram entrevistados 100 pacientes, entre os meses de dezembro de 2012 e abril de 2013, em um hospital universitário e em uma clínica de hemodiálise. A inferência foi realizada por enfermeiros diagnosticadores, entre julho e setembro de 2013. Resultados: O diagnóstico estudado foi identificado em 82% dos pacientes. As características que apresentaram associação estatística foram: agitação, congestão pulmonar, distensão de jugular, edema, eletrólitos alterados, ganho de peso, ingestão maior que o débito e ruídos adventícios. Dentre estas, edema e ganho de peso apresentaram as maiores chances para o desenvolvimento desse diagnóstico. Conclusão: O diagnóstico analisado é prevalente nesta clientela e oito características apresentaram associação significante.
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Sujet(s)
Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Diagnostic infirmier , Dialyse rénale/effets indésirables , Troubles de l'équilibre hydroélectrolytique/diagnostic , Troubles de l'équilibre hydroélectrolytique/étiologie , Études transversales , Défaillance cardiaque
9.
J. bras. nefrol ; 35(1): 1-5, jan.-mar. 2013. ilus, tab
Article de Portugais | LILACS | ID: lil-670909

RÉSUMÉ

A Injúria Renal Aguda (IRA) é cada vez mais prevalente nos países desenvolvidos e nos em desenvolvimento, e está associada com morbidade e mortalidade severas. A maioria das causas da IRA pode ser evitada por meio de intervenções em nível individual, comunitário, regional e intra-hospitalar. Medidas efetivas devem incluir, em toda a comunidade, os esforços para aumentar a consciência dos efeitos devastadores do IRA e fornecer orientações sobre as estratégias de prevenção, bem como o reconhecimento e tratamento precoces. Os esforços devem ser focados em minimizar as causas de IRA, aumentando a consciência da importância de medidas seriadas de creatinina sérica em pacientes de alto risco para IRA, e documentar o volume de urina em pessoas gravemente doentes para obtenção de diagnóstico precoce; até o momento, não há ainda um papel definitivo para outros biomarcadores. Há a necessidade de protocolos para sistematizar a conduta em condições de IRA pré-renal e em infecções específicas. Dados mais precisos sobre a verdadeira incidência e o impacto clínico da IRA ajudarão a melhor conhecer a importância desta doença, a aumentar o conhecimento de IRA por parte dos governantes, dos médicos em geral e de outros profissionais de saúde para ajudar na prevenção da doença. A prevenção é a chave para evitar a pesado ônus de mortalidade e morbidade associada com IRA.


Sujet(s)
Enfant , Humains , Atteinte rénale aigüe , Commémorations et événements particuliers , Atteinte rénale aigüe/économie , Atteinte rénale aigüe/épidémiologie , Atteinte rénale aigüe/étiologie , Atteinte rénale aigüe/prévention et contrôle , Atteinte rénale aigüe/thérapie , Pays développés , Pays en voie de développement , Santé mondiale , Accessibilité des services de santé , Hospitalisation , Ressources en santé , Maladie iatrogène , Traitement substitutif de l'insuffisance rénale , Sociétés médicales , Sepsie/complications , Troubles de l'équilibre hydroélectrolytique/étiologie
10.
Arch. argent. pediatr ; 109(5): 91-96, sept.-oct. 2011. ilus, tab
Article de Espagnol | LILACS | ID: lil-633202

RÉSUMÉ

El seudohipoaldosteronismo de tipo 1 es un síndrome infrecuente de resistencia a la aldosterona que se manifiesta con pérdida salina, hiponatremia, hiperpotasemia, acidosis metabólica hiperclorémica e hiperaldosteronismo hiperreninémico. El síndrome puede ser genético; secundario a uropatías e infección urinaria entre otras causas o presentarse esporádicamente. La pérdida salina puede ser sistémica y grave o localizada a nivel renal, por lo general, con mejor pronóstico. El cuadro clínico se manifiesta predominantemente en los primeros siete meses de vida; un marcado retraso pondoestatural y vómitos recurrentes suelen ser los signos clínicos habituales, rara vez se presenta como una emergencia hidroelectrolítica en forma de shock hipovolémico, arritmias cardíacas hiperpotasémicas y crisis convulsiva por hiponatremia. Se presentan cuatro pacientes que debutaron como una emergencia hidroelectrolítica.


Pseudohypoaldosteronism type 1 is a rare syndrome of resistance to aldosterone manifested by salt wasting, hyponatremia, hyperkalemia, hyperchloremic metabolic acidosis, and hiperreninemic hyperaldosteronism. The syndrome may be genetic, secondary to uropathies and urinary tract infection among other causes or it may occur sporadically. The salt wasting may be systemic and severe or localized to the kidney usually with better prognosis. The clinical picture is prevalent in the first seven months of life, failure to thrive and recurrent vomiting are usually the common clinical signs, an electrolyte emergency in the form of hypovolemic shock, hyperkalemic cardiac arrhythmias and hyponatremic seizures is rare. Four patients presenting with an electrolyte emergency are reported.


Sujet(s)
Femelle , Humains , Nourrisson , Mâle , Pseudohypoaldostéronisme/diagnostic , Urgences , Pseudohypoaldostéronisme/complications , Troubles de l'équilibre hydroélectrolytique/étiologie
11.
Rev. bras. pesqui. méd. biol ; Braz. j. med. biol. res;43(3): 316-323, Mar. 2010. tab
Article de Anglais | LILACS, SES-SP | ID: lil-539723

RÉSUMÉ

The objective of the present study was to determine the prevalence of electrolyte disturbances in AIDS patients developing acute kidney injury in the hospital setting, as well as to determine whether such disturbances constitute a risk factor for nephrotoxic and ischemic injury. A prospective, observational cohort study was carried out. Hospitalized AIDS patients were evaluated for age; gender; coinfection with hepatitis; diabetes mellitus; hypertension; time since HIV seroconversion; CD4 count; HIV viral load; proteinuria; serum levels of creatinine, urea, sodium, potassium and magnesium; antiretroviral use; nephrotoxic drug use; sepsis; intensive care unit (ICU) admission, and the need for dialysis. Each of these characteristics was correlated with the development of acute kidney injury, with recovery of renal function and with survival. Fifty-four patients developed acute kidney injury: 72 percent were males, 59 percent had been HIV-infected for >5 years, 72 percent had CD4 counts <200 cells/mm³, 87 percent developed electrolyte disturbances, 33 percent recovered renal function, and 56 percent survived. ICU admission, dialysis, sepsis and hypomagnesemia were all significantly associated with nonrecovery of renal function and with mortality. Nonrecovery of renal function was significantly associated with hypomagnesemia, as was mortality in the multivariate analysis. The risks for nonrecovery of renal function and for death were 6.94 and 6.92 times greater, respectively, for patients with hypomagnesemia. In hospitalized AIDS patients, hypomagnesemia is a risk factor for nonrecovery of renal function and for in-hospital mortality. To determine whether hypomagnesemia is a determinant or simply a marker of critical illness, further studies involving magnesium supplementation in AIDS patients are warranted.


Sujet(s)
Adolescent , Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Syndrome d'immunodéficience acquise/mortalité , Atteinte rénale aigüe/mortalité , Magnésium, carence/mortalité , Troubles de l'équilibre hydroélectrolytique/mortalité , Syndrome d'immunodéficience acquise/complications , Atteinte rénale aigüe/étiologie , Maladie grave , Méthodes épidémiologiques , Magnésium, carence/étiologie , Pronostic , Récupération fonctionnelle , Troubles de l'équilibre hydroélectrolytique/étiologie , Jeune adulte
12.
Rev. méd. Chile ; 136(7): 900-904, jul. 2008. ilus, tab
Article de Espagnol | LILACS | ID: lil-496013

RÉSUMÉ

Villous colorectal adenomas are common tumors that normally provoke scarce symptomatology. We report a 59 year-old female that was admitted with severe dehydration due to severe diarrhea lasting 10 days and vomiting in the last 48 hours. On rectal palpation a large tumor located 5 cm above the anus was palpated. Colonoscopy confirmed the presence of a villous adenoma that was excised surgically. In this patient, the fluid and electrolyte hypersecretion of the rectal villous adenoma provoked a depletion syndrome with serious hydroelectrolytic alterations, acute renal failure and hypovolemic shock. This syndrome was first described by McKittrick and Wheelock in 1954.


Sujet(s)
Femelle , Humains , Adulte d'âge moyen , Adénome villeux/complications , Tumeurs du côlon/complications , Troubles de l'équilibre hydroélectrolytique/étiologie , Adénome villeux/anatomopathologie , Adénome villeux/chirurgie , Tumeurs du côlon/anatomopathologie , Tumeurs du côlon/chirurgie , Diarrhée/étiologie , Rectum/chirurgie , Syndrome
13.
Acta cir. bras ; Acta cir. bras;22(5): 372-378, Sept.-Oct. 2007. tab
Article de Anglais | LILACS | ID: lil-463462

RÉSUMÉ

PURPOSE: To study the effects on the water, electrolyte, and acid-base balances in rabbits submitted to antegrade enema with different solutions through appendicostomy. METHODS: Forty male New Zealand rabbits were submitted to appendicostomy, and distributed in 4 groups, according to the antegrade enema solution: PEG group, polyethylene glycol electrolyte solution (n=10); ISS group, isotonic saline solution (n=10); GS group, glycerin solution (n=10); SPS group, sodium phosphate solution (n=10). After being weighed, arterial blood gas analysis, red blood count, creatinine and electrolytes were measured at 4 times: preoperatively (T1); day 6 postop, before enema (T2); 4h after enema (T3); and 24h after T3 (T4). RESULTS: In PEG group occurred Na retention after 4h, causing alkalemia, sustained for 24h with HCO3 retention. In ISS group occurred isotonic water retention and hyperchloremic acidosis after 4h, which was partially compensated in 24h. GS group showed metabolic acidosis after 4h, compensated in 24h. In SPS group occurred hypernatremic dehydration, metabolic acidosis in 4h, and hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis with partially compensated dehydration in 24h. CONCLUSIONS: All solutions used in this study caused minor alterations on water, electrolyte or acid-base balances. The most intense ones were caused by hypertonic sodium phosphate solution (SPS) and isotonic saline solution (ISS) and the least by polyethyleneglycol electrolyte solution (PEG) and glycerin solution 12 percent (GS).


OBJETIVO: Estudar os efeitos no equilíbrio hídrico, eletrolítico e ácido-base, do enema anterógrado com diferentes soluções em coelhos através de apendicostomia. MÉTODOS: 40 coelhos Nova Zelândia, machos, submetidos a apendicostomia, distribuídos em quatro grupos segundo a solução de enema: grupo PEG (n = 10) solução de polietilenoglicol com eletrólitos; grupo SF (n = 10) solução fisiológica; grupo SG (n = 10) solução glicerinada; grupo FS (n = 10) solução de fosfato de sódio. Realizou-se pesagem, gasometria arterial, série vermelha, creatinina e ionograma, em quatro tempos: TI (pré-operatório); T2 (6o PO antes do enema); T3 (4h após enema); T4 (24h após T3). RESULTADOS: No PEG ocorreu retenção de Na em 4h, com alcalemia por retenção de HCO3, mantida por 24h. No SF ocorreu retenção hídrica isotônica e acidose hiperclorêmica em 4h, resolvidos parcialmente com 24h. No SG ocorreu acidose metabólica hiperclorêmica em 4h, compensada com 24h. No FS ocorreu desidratação hipenatrêmica, acidose metabólica com ânion gap elevado em 4h, hipopotassemia, hipocalcemia, hipomagnesemia e alcalose metabólica com recuperação parcial da desidratação em 24h. CONCLUSÕES: Todas as soluções empregadas neste estudo causam alterações de pouca intensidade no equilíbrio hídrico, eletrolítico ou ácido-base. As mais intensas foram causadas pela solução de fosfato de sódio e solução fisiológica, e as menos intensas pela solução de polietilenoglicol com eletrólitos e solução glicerinada.


Sujet(s)
Animaux , Mâle , Lapins , Équilibre acido-basique/effets des médicaments et des substances chimiques , Lavement (produit)/méthodes , Glycérol/effets indésirables , Phosphates/effets indésirables , Polyéthylène glycols/effets indésirables , Équilibre hydroélectrolytique/effets des médicaments et des substances chimiques , Troubles de l'équilibre acidobasique/sang , Troubles de l'équilibre acidobasique/étiologie , Appendice vermiforme/chirurgie , Cathartiques/administration et posologie , Cathartiques/effets indésirables , Lavement (produit)/effets indésirables , Glycérol/administration et posologie , Solution isotonique/administration et posologie , Solution isotonique/effets indésirables , Modèles animaux , Magnésium, carence/sang , Magnésium, carence/étiologie , Phosphates/administration et posologie , Polyéthylène glycols/administration et posologie , Facteurs temps , Troubles de l'équilibre hydroélectrolytique/sang , Troubles de l'équilibre hydroélectrolytique/étiologie
15.
J. bras. pneumol ; J. bras. pneumol;32(4): 294-300, jul.-ago. 2006. tab
Article de Portugais | LILACS | ID: lil-452324

RÉSUMÉ

OBJETIVO: Determinar a freqüência relativa de hipomagnesemia em pacientes com limitação crônica do fluxo aéreo atendidos num ambulatório de referência do norte do Paraná, nos anos de 2000 a 2001, e verificar se há relação entre esse distúrbio e hipoxemia, outros distúrbios eletrolíticos e com a gravidade da doença. MÉTODOS: Estudo descritivo sobre a freqüência relativa de hipomagnesemia em 72 pacientes com limitação crônica do fluxo aéreo. Os pacientes realizaram dosagens séricas de magnésio e outros eletrólitos, além de realizarem o estadiamento de sua doença de base. RESULTADOS: A prevalência encontrada de hipomagnesemia foi de 27,8 por cento. A idade média foi de 65 ± 9,9 anos, com predominância de homens. O volume expiratório forçado no primeiro segundo médio foi de 1,13 ± 0,52 L. A maioria dos pacientes encontrava-se em estádios avançados da doença (68,1 por cento). Não houve associação do magnésio sérico baixo com outros distúrbios eletrolíticos, hipoxemia ou estádios de gravidade. CONCLUSÃO: A alta freqüência de pacientes em estádios avançados deve-se, provavelmente, ao fato de o ambulatório ser um centro de referência da região. Novos estudos devem ser realizados para determinar prováveis causas dessa alta prevalência de hipomagnesemia.


OBJECTIVE: To determine the relative frequency of hypomagnesemia among patients with chronic airflow limitation treated as outpatients at a referral center in the northern part of the state of Paraná between 2000 and 2001, as well as to determine whether hypomagnesemia correlates with hypoxia, with other electrolyte disturbances and with the severity of airflow limitation. METHODS: This was a descriptive study of the relative frequency of hypomagnesemia in 72 patients with chronic airflow limitation. All of the patients were submitted to blood tests to determine serum levels of magnesium and other electrolytes, as well as to staging of the underlying disease. RESULTS: The prevalence of hypomagnesemia was 27.8 percent. The mean age was 65 ± 9.9 years, and there was a predominance of males. The mean forced expiratory volume in one second was 1.31 ± 0.52 L. Most of the patients (68.1 percent) were found to be in the advanced stages of the disease. Hypomagnesemia was not found to correlate with other electrolyte disturbances, hypoxemia or disease stage. CONCLUSION: The high frequency of patients in the advanced stages is likely attributable to the fact that the outpatient facility is a referral center for the region. Further studies should be conducted in order to determine the probable causes of this high prevalence of hypomagnesemia.


Sujet(s)
Sujet âgé , Femelle , Humains , Mâle , Hypoxie/complications , Bronchopneumopathies obstructives/complications , Magnésium/sang , Troubles de l'équilibre hydroélectrolytique/étiologie , Maladie chronique , Études transversales , Bronchopneumopathies obstructives/sang , Prévalence , Indice de gravité de la maladie , Troubles de l'équilibre hydroélectrolytique/épidémiologie
16.
Article de Anglais | IMSEAR | ID: sea-39700

RÉSUMÉ

BACKGROUND: Many children with brain tumors have abnormalities in water and sodium homeostasis, such as diabetes insipidus (DI), the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cerebral salt wasting syndrome (CSW), either pre-operatively or post-operatively. But little data have been published on the incidence, time of onset and clinical course of water and sodium disorders in children with brain tumors. OBJECTIVES: To characterize the water and sodium disorders in children undergoing surgical treatment for brain tumors. PATIENTS AND METHOD: The medical records of children with brain tumors admitted for surgery at King Chulalongkorn Memorial Hospital from January 1997 to December 2002 were retrospectively reviewed. RESULTS: There were 79 patients, 46 males and 33 females included in this study. Water and sodium disorders occurred in 36 patients (45.57%), 23 patients had DI, 12 patients had SIADH and 1 patient had cerebral salt wasting syndrome (CSW). Nine of the 36 patients had pre-operative onset of water and sodium disorders (8 DI and 1 SIADH). The development of DI and SIADH was associated with the location of the brain tumors. Patients with sellar and suprasellar tumors had the highest incidence of DI (75.86%). Patients with tumors of the cerebral hemispheres had the highest incidence of SIADH (44.44%). Onset of post-operative DI ranged from 2 to 19 hours (mean 9.68 hours) and most patients developed SIADH within 24 hours post-operatively. CONCLUSIONS: DI and SIADH are common problems in children with brain tumors, especially after surgical treatment and the onset usually occurs within 24 hours after surgery. Patients with sellar and suprasellar tumors are more likely to have DI, patients with tumors of cerebral hemispheres and posterior fossa tumors are more likely to have SIADH.


Sujet(s)
Adolescent , Tumeurs du cerveau/complications , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Mâle , Complications postopératoires , Études rétrospectives , Troubles de l'équilibre hydroélectrolytique/étiologie
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