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At least 1,117 records · Page 62Linked to original sources
PubMed1995

Disordered water homeostasis in schizophrenia and cerebral ventricular size.

BACKGROUND: A possible association between disordered water homeostasis and cerebral ventricular size in patients with schizophrenia was investigated. METHOD: In a cross-sectional study of hospitalised patients, cerebral ventricular size was measured in 16 schizophrenic patients with disordered water homeostasis and 16 matched schizophrenic controls by magnetic resonance imaging. RESULTS: Ventricle to brain ratio, third ventricular index, bicaudate index and bifrontal index tended to be greater in those with schizophrenia with disordered water homeostasis, although differences were significant only for the bifrontal index (P < 0.05). Strong negative correlations were found between ventricular size and performance on neuropsychological testing in the disordered water homeostasis group. CONCLUSION: These results provide evidence for an association between structural brain abnormality and disordered water homeostasis in a subset of schizophrenic patients.

Cerebral Ventricles↗
PubMedDate not supplied

Humidification: Indications and hazards in respiratory therapy.

Scientific data fail to support the widespread use of humidity and mist in respiratory therapy. A clear indication exists to provide humidification of inspired air in patients in whom the proximal airway is bypassed by endotracheal cannulation. Indications for the use of concentrated mist atmospheres in therapy of lung disease is less well documented, and too often the importance of adequate systemic hydration is overlooked. Theory supports the use of a highly humid or mist atmosphere in therapy of upper airway disease, but little benefit is derived from such therapy in diseases of the smaller airways and lung parenchyma. Danger of bacterial contamination and infection and an increase in airway resistance are significant hazards to the patient exposed to highly humid atmospheres.

Airway Resistance↗
PubMed2006

Morbidity and mortality associated with vasopressin analogue treatment.

DDAVP is a drug that should be used with caution for each patient individually. Particular care is needed to avoid fluid overload and rapid fluctuations in sodium concentration. Not only families but physicians as well should be educated and aware of the adverse effects of DDAVP, especially in high risk patients. Extreme caution is needed in children with severe neurological and developmental problems who cannot control their fluid intake themselves. Similarly, caution is needed in patients with hypodipsia and DI who have difficulty in balancing water intake and DDAVP dose. The treatment of DI is water; however, DDAVP is given to avoid a large fluid intake which can result in medullary washout. Frequent home monitoring of body weight and regular determinations of serum sodium may help to disclose the early phase of over-hydration or dehydration. DDAVP therapy should be temporarily interrupted during acute illness, febrile episodes, hot days and other conditions with increased water intake. It should be used with considerable caution in patients with cystic fibrosis, or renal or cardiovascular diseases. In patients with enuresis, it is recommended that DDAVP medication should not be continued for longer than 3 months without stopping for 1 week for full reassessment. Fluid intake should be limited 1 hour before and 8 hours after the dose. Generally, undertreatment with vasopressin analogue is safer than overtreatment. A simple measure to avoid overtreatment is to miss one dose once a week; a rapid onset diuresis ('washout' effect) provides considerable reassurance.

Adolescent↗
PubMedDate not supplied

Dramatic recovery from neurological deficits in a patient with central pontine myelinolysis following severe hyponatremia.

A 28-year-old woman developed central pontine myelinolysis (CPM) following severe hyponatremia. Radiological examinations demonstrated a characteristic pontine lesion of CPM. Her neurological symptoms (drowsiness, emotional lability, dysarthria, dysphagia, and quadriparesis) were improved dramatically by treatment with thyrotropin-releasing hormone (TRH) and rehabilitation. However, results of repeat computed tomographic (CT) scans of the brain remained unchanged. This case therefore suggests that TRH may be beneficial for the treatment of CPM, and that CT findings appear to be a limited prognostic indicator for CPM.

Abortion, Induced↗
PubMed1994

The consulting psychiatrist and the polydipsia-hyponatremia syndrome in schizophrenia.

OBJECTIVE: The authors seek to extend understanding and treatment of hospitalized schizophrenics presenting with complications of polydipsia and dilutional hyponatremia. Attending physicians may ask the consultation/liaison psychiatrist to see schizophrenics with hyponatremically-induced delirium or other psychiatric syndromes. The referring physician may or may not have identified polydipsia and dilutional hyponatremia and their complications. This article will help the consultation/liaison psychiatrist recognize early evidence of water imbalance, describe evaluation, and provide somatic and behavioral treatment approaches to this life-threatening syndrome. METHOD: Over the past ten years, the authors have treated more than 100 patients with the polydipsia-hyponatremia syndrome. The authors discuss their and others' experience with drugs that help and hinder patients suffering from dilutional hyponatremia. They review current key articles from the polydipsia-hyponatremia syndrome literature including articles identified via Medline search 1985-94. RESULTS: Schizophrenics with the polydipsia-hyponatremia syndrome most commonly present with polydipsia, polyuria, urinary incontinence, cognitive, affective, and behavioral changes, seizures, or coma. Quantitating polydipsia, hyponatremia, and diurnal changes in body weight facilitate therapeutic interventions. Treatment include patient and caregiver education, drug therapies to better treat psychosis and better treat osmotic dysregulation, behavioral interventions to interdict polydipsia, and diurnal weight monitoring. CONCLUSIONS: Once recognized, acute, subacute, and chronic complications of the polydipsia-hyponatremia syndrome are readily treatable. Besides treating the patient, consultation/liaison psychiatrists can teach their medical colleagues about this syndrome. In so doing, they will enhance the quality of their patients' lives and help the internist and surgeon feel more comfortable when working with schizophrenics.

Angiotensin II↗
PubMed1998

Is propranolol effective in primary polydipsia?

OBJECTIVE: Psychiatric patients presenting with polydipsia are often difficult to treat with standard psychiatric interventions. Pharmacological intervention was attempted in these patients based on the hypothesis that angiotensin II, a potent dipsinogen, may be involved in the drinking behavior of patients with polydipsia. Beta-blockers inhibit renin release (and thus indirectly angiotensin II) by blocking beta receptors in the kidney. METHODS: Three patients were identified as excessive water drinkers during their hospital admissions. All three patients were eunatremic but polydipsic at the time of study. Two of the three had histories of hyponatremia and required emergency medical treatment on more than one occasion. No patients had been controlled by strict fluid restriction. Trials of propranolol were initiated to control their water drinking. RESULTS: After starting propranolol, two patients responded quickly. In one patient, fluid intake decreased from 2650 +/- 647 to 1577 +/- 361, p < .001. In the other, fluid intake decreased from over 7000 ml before starting propranolol to around 3000 ml. The mean noon body weight of the third patient, in whom it was not possible to document fluid intake or urine volume before and after administering beta-blocker, was 72.6 +/- 2.6 Kg and 66.0 +/- 1.0 Kg, respectively (p < .0001). CONCLUSIONS: These results suggest that propranolol may be useful for the treatment of polydipsia in patients with schizophrenia. Its efficacy could be related to inhibition of the renin-angiotensin system. Additional research using the controlled pharmacotherapeutic trials is required to confirm these findings.

Adrenergic beta-Antagonists↗
PubMed1995

Hyponatremia, convulsions and neuroleptic malignant syndrome in a male with schizoaffective disorder.

OBJECTIVE: The aim of the study was to highlight the diagnostic difficulties occurring when hyponatremia presents concurrently with neuroleptic malignant syndrome (NMS). Diagnostic issues in the differentiation between hyponatremia and NMS are discussed. CLINICAL PICTURE: A case of dilutional hyponatremia (DH) secondary to psychogenic polydipsia (PP) associated with NMS occurring in a male with schizoaffective disorder is described. The clinical picture was complicated by convulsions, perhaps due to clonazepam withdrawal and possible lithium toxicity. TREATMENT: The patient was treated with supportive medical measures. OUTCOME: The patient made a full recovery. CONCLUSIONS: Hyponatremia and NMS have been found to be associated. This association may be due to an undefined common pathogenesis, or may be coincidental. Hyponatremia may also hinder the diagnosis of NMS.

Adult↗
PubMed1992

Seizure with hyponatremia in a child prescribed desmopressin for nocturnal enuresis.

We report a case of hyponatremia associated with a grand mal seizure in a 28 month-old child after intra-nasal desmopressin administration for high fluid intake with nocturnal enuresis. In view of the temporary symptomatic action and the seriousness of certain side-effects of desmopressin we recommend that desmopressin be used with caution in childhood enuresis.

Administration, Intranasal↗
PubMed1976

Mechanical properties and density of bone in a case of severe endemic fluorosis.

Mechanical properties of 25 standardized specimens of compact bone from a 45-year-old man with extreme endemic fluorosis were compared with similar specimens of nonfluorotic bone. Data from dry and wet tested specimens were compared. Tensile strength, strain, energy absorbed to failure, and modulus of elasticity were reduced in fluorotic specimens while compressive strength, strain and energy were increased in both wet and dry specimens. Compressive properties exceeded tensile properties. Drying increased tensile and compressive strength and modulus but decreased tensile and compressive strength and energy absorbed. Dry specimens tended to follow Hooke's Law but wet specimens exhibited visco-elastic behavior. Wet fluorotic specimens had lower tensile properties but higher compressive properties and were more dense than fresh human compact bone.

Bone and Bones↗