1/6. Hyperhomocysteinaemia and upper extremity deep venous thrombosis: a case report.A case is presented of a 24 yr old military aircrew applicant who developed a right axillary subclavian deep venous thrombosis following physical exertion. Investigations revealed damage to the right axillary subclavian venous system and limitation to flow. Coagulation studies also showed an elevated plasma homocysteine level. hyperhomocysteinemia has recently been recognized as a risk factor for venous thromboembolic disease. Damage caused by the thrombosis, the hyperhomocysteinemia and environmental factors encountered in flight, may predispose him to recurrent episodes of thrombosis. This complex case involves aspects of hematology and the nature of coagulation which are only just being elucidated and as yet are poorly understood, and highlights some serious aeromedical implications for pilots afflicted with these conditions.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/6. breast feeding--when nature fails to satisfy.Human milk is the ideal source of nutrition for the healthy neonate. milk from the mother whose diet is sufficient will supply the necessary nutrients. It is a considerable problem to discern if the milk supply is the adequate quantity for the infant. If the infant's water and caloric needs are not met for several days, signs and symptoms of hypernatremic dehydration >10% may develop. This report presents a case of a 15-day-old, breast-fed infant who developed significant hypernatremic dehydration.- - - - - - - - - - ranking = 4keywords = nature (Clic here for more details about this article) |
3/6. Fluid resuscitation of acute hypovolemic hypoperfusion states in pediatrics.Multiorgan hypoperfusion due to a loss of effective circulating blood volume, whether a consequence of hemorrhage or dehydration, constitutes a medical emergency. Fluid must be added rapidly to the circulatory system, in the form of blood, colloid, or crystalloid solution. The type of fluid used for volume expansion depends on the nature of the losses. The aim of treatment is to expand effective circulating blood volume and to restore nutrient delivery and gas exchange at the cellular level.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/6. hypoglycemia in a child with congenital muscular dystrophy.Since skeletal muscle is an important source of precursor for gluconeogenesis, it would not be surprising if carbohydrate metabolism was altered in some muscle disorders. We report a 7-10/12-year-old white male with congenital muscular dystrophy whose recurrent episodes of vomiting and dehydration were due to fasting hypoglycemia. He was found to have a blood glucose of 21 mg/dl with an episode of vomiting and dehydration. Diagnostic fasting replicated the symptoms and hypoglycemia. Associated laboratory findings included hypoalaninemia, ketonemia, and acidosis. With use of frequent feedings, there were no further episodes over 1-9/12 years of observation. To our knowledge this is the first report of hypoglycemia complicating muscular dystrophy. However, hypoglycemia may not be diagnosed because of the nonspecific nature of the symptoms. hypoglycemia should be considered when children with reduced muscle mass develop otherwise unexplained vomiting.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/6. Severe hypernatremia complicating urinary tract obstruction.Severe hypernatremia and hyperosmolar dehydration developed in a patient with partial urinary tract obstruction. The urine was initially hypotonic, and there was no response to exogenous vasopressin. These abnormalities resolved with relief of the urinary tract obstruction and replacement of the water deficit. This case documents lower urinary tract obstruction as a cause of nephrogenic diabetes insipidus and severe hypernatremia and illustrates its reversible nature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/6. Iatrogenic acute hyponatraemia in a college athlete.Hyponatraemia is one of the most common electrolyte abnormalities, leading to significant morbidity and mortality. In the most basic sense, hyponatraemia can be due to sodium loss or fluid excess. The extracellular fluid status is used to clinically divide hyponatraemia into three categories to help to determine both the cause and treatment required. Hyponatraemic patients can be categorised on the basis of their fluid status as hypovolaemic, euvolaemic, or hypervolaemic. Another distinction to make in evaluating hyponatraemia is whether the onset was acute or chronic in nature. The case presented here is iatrogenic acute hypervolaemic hyponatraemia in a college athlete. The patient presented in respiratory distress with an altered mental status after the administration of hypotonic fluids for treatment of muscle cramps. Treatment included intubation, water restriction, and furosemide, to which he responded favourably. Hyponatraemia should be in the differential diagnosis for patients presenting after intravenous fluid administration.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |