-
[show abstract]
[hide abstract]
ABSTRACT: Hypophosphatemia when combined with phosphate depletion (that is, not due to phosphate shift into the cells) can cause a variety of signs and symptoms. The manifestations depend in large part upon the severity and chronicity of the phosphate depletion, with the plasma phosphate concentration usually being below 0.32 mmol/L in symptomatic patients. The major conditions associated with symptomatic hypophosphatemia are chronic alcoholism, intravenous hyperalimentation without phosphate, and chronic ingestion of antacids. Severe hypophosphatemia can also be seen during treatment for diabetic ketoacidosis and with prolonged hyperventilation.
Acta Clinica Croatica; Vol.43 No.1.
-
[show abstract]
[hide abstract]
ABSTRACT: Hypomagnesemia is a relatively common entity occurring in up to 12% of hospitalized patients; however, the incidence may rise to as high as 60% to 65% in patients in intensive care setting in whom nutrition, diuretics, hypoalbuminemia and aminoglycosides may play important roles. Symptomatic magnesium depletion is often associated with multiple biochemical abnormalities such as hypokalemia, hypocalcemia, and alkalosis acidosis. As a result, it is often difficult to ascribe specific clinical manifestations solely to hypomagnesemia. The symptoms considered typical for magnesium depletion include generalized fatigue, tetany, positive Chvostek's and Trousseau's signs, and generalized convulsions. The route of magnesium repletion varies with the severity of clinical manifestations.
Acta Clinica Croatica; Vol.42 No.1.
-
[show abstract]
[hide abstract]
ABSTRACT: Hyponatremia is the most common electrolyte disorder. Sometimes it is not easy to consider the differential diagnosis and to establish a final diagnosis. Hyponatremia is acute severe (less than 115 mmol/L) when lasting for 36 to 48 hours. This condition is a medical emergency because these patients have pronounced symptoms as the result of brain edema. It should be rapidly corrected to approximately 130 mmol/L to prevent permanent brain damage. In chronic severe hyponatremia, the symptoms are mild and there is no brain edema. Many authors recommend correction to approximately 130 mmol/L at a rate of less than 0.5 mmol/h, to minimize the risk of cerebral myelinolysis. In the near future, vasopressin antagonists will become available. Preliminary experience has already demonstrated their efficacy in inducing sustained water diuresis and correction of hyponatremia.
Acta Clinica Croatica; Vol.41 No.2.
-
[show abstract]
[hide abstract]
ABSTRACT: Myasthenia gravis is an antibody-mediated autoimmune disease in which circulating acetylcholine receptor (AChR) antibodies have been identified that bind to the receptor sites in voluntary muscles, thereby damaging and blocking the receptors. Selective removal of the blocking antibody by plasmapheresis or specific immunoadsorption provides important methods in the treatment of patients with myasthenia gravis. Novel immunoadsorbent columns have been developed especially for the treatment of patients with myasthenia gravis, using a specific affinity ligand (Torpedo 183-200, a synthetic peptide) to remove the blocking antibody. This immunoadsorbent produced specific removal of the blocking antibody without reducing other plasma proteins. Clinical improvement was observed in 78% of myasthenia gravis patients. There were no adverse effects.
Acta Clinica Croatica; Vol.40 No.1.
-
[show abstract]
[hide abstract]
ABSTRACT: We report on a patient with acute neurologic disorder, i.e. Guillain-Barré syndrome, successfully treated by plasmapheresis. The patient suffered a myocardial infarction, which has neither been defined nor described in the available literature as a causative event for acute polyradiculoneuropathy, but merely a random observation. The course of the disease in the patient was complicated by pulmonary infection which we presumed to be a precipitating factor for the occurrence of Guillain-Barré syndrome.
Acta Clinica Croatica; Vol.41 No.3.
-
[show abstract]
[hide abstract]
ABSTRACT: Vitamins are chemically unrelated organic compounds or families of organic compounds that are essential for normal metabolism in humans. As vitamins cannot be synthesized by a human body, they have to be taken in small amounts in the diet to prevent metabolic disorders. Vitamins should be distinguished from other .food supplements, minerals and herbs, which are also taken in small amounts as alternatives or supplements to drugs. Mild deficiencies in several vitamins, at levels below those causing classic vitamin deficiency syndromes (e.g., scurvy or pellagra) are risk factors for chronic degenerative diseases such as atherosclerosis, cancer, and osteoporosis. Data on vitamin supplementation to prevent chronic diseases are reviewed.
Acta Clinica Croatica; Vol.41 No.3.
-
[show abstract]
[hide abstract]
ABSTRACT: Lithium is a therapeutic agent currently in widespread use for the treatment of bipolar disorder. Chronic lithium ingestion in patients with bipolar (manic-depressive) illness has been associated with several different forms of renal injury. Nephrogenic diabetes insipidus is most common, but renal tubular acidosis, nephrotic syndrome, and chronic interstitial nephritis have also been described. Therapy for lithium poisoning depends on the adequacy of renal function and the degree of intoxication.
Acta Clinica Croatica; Vol.41 No.4.
