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From Russia with polyuria

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Open Journal of Endocrine and Metabolic Diseases 2015年第5期5卷 51-53页

作者： DaLim Ki Udaya M. Kabadi Des Moines University Des Moines Iowa USA Veterans Affairs Medical Center Des Moines Iowa USA University of Iowa Iowa City Iowa USA

Introduction: polyuria is a sign for many disease processes, including diabetes mellitus and diabetes insipidus. Urine osmolarity helps distinguish osmotic diuresis caused by diabetes mellitus from water dieresis induced by diabetes insipidus. Case Presentation: We report a case of a 48-year-old woman who presented with polyuria, polydipsia, nocturia, and weight loss after a return from a visit to Russia, during which she received a five-day course of antibiotic Demeclocycline, a tetracycline derivative for dental treatment. She recovered from all clinical manifestations by 8 weeks. Conclusion: Manifestation of transient nephrogenic diabetes insipidus is induced by Demeclocycline.

关键词： polyuria Urine Osmolarity Nephrogenic Diabetes Insipidus Demeclocycline

Mechanisms and Associated Factors of Nocturia in Women Attending Two Urogynecology Clinics: A Cross-Sectional Study

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Open Journal of Obstetrics and Gynecology 2023年第9期13卷 1547-1568页

作者： Ingrid Antunes da Silva José Rodrigo de Moraes Renato Augusto Moreira de Sá Carlos Augusto Faria School of Medicine Federal Fluminense University Niterói Brazil

Introduction: Nocturia has a multifactorial etiology, and its diagnostic approach involves, in addition to medical history and physical examination, the use of a bladder diary to define the pathophysiological mechanisms present in each case. Methods: This study investigated the prevalence of nocturia, its mechanisms, and associated factors in women with lower urinary tract symptoms attending two urogynecology clinics in the state of Rio de Janeiro, Brazil. Anamnesis, physical examination, and a 24-hour bladder diary were conducted. Two definitions of nocturia were considered: one or more nighttime voids and two or more nighttime voids. Mann-Whitney and Chi-square tests were used, with p-value ≤ 0.05 considered significant. Results: A total of 133 participants were included. The majority were aged 60 years or older (61.4%) and had three or more comorbidities (66.7%), with systemic arterial hypertension being the most prevalent (59.1%). Of the total participants, 54 (41.4%) completed the bladder diary. Among those with one or more nighttime voids (70.7%), the prevalence of nocturnal polyuria was 69.1%, reduced nocturnal bladder capacity was 17.3%, and global polyuria was 12.9%. Among participants with two or more nighttime voids (56.4%), the prevalences were respectively 68.2%, 19.1%, and 13.6%. Among the mechanisms, associations were found only with global polyuria, namely: use of insulin, body mass index and tobacco consumption. An association was also found between recurrent urinary tract infection and global polyuria in participants with two or more nighttime voids. Conclusions: The prevalence of nocturia was higher than that reported in general population studies and specialized services for lower urinary tract symptoms. Nocturnal polyuria was the most prevalent mechanism. Associations were observed between the use of insulin, body mass index, tobacco consumption, and recurrent urinary tract infection with global polyuria. No associations were found between any clinical or demographic variables and nocturnal p

关键词： Nocturia polyuria Lower Urinary Tract Symptoms Women’s Health

Desmopression is an effective adjunct treatment for reversing excessive hyponatremia overcorrection

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World Journal of Clinical Cases 2013年第5期1卷 155-158页

作者： Kamel A Gharaibeh Matthew J Craig Christian A Koch Anna A Lerant Tibor Fülp va Csongrádi Department of Internal Medicine University of Mississippi Medical CenterJacksonMS 39216-4505United States Department of Anesthesiology University of Mississippi Medical CenterJacksonMS 39216-4505United States Department of Medicine University of Debrecen Medical and Health Science CentreUniversity of Debrecen4032 DebrecenHungary

We report a case of a 50-year-old malnourished African American male with hiccups, nausea and vomiting who was brought to the Emergency Department after repeated seizures at home. Laboratory evaluations revealed sodium(Na+) 107 mmol/L, unmeasurably low potassium, chloride < 60 mmol/L, bicarbonate of 38 mmol/L and serum osmolality 217 m Osm/kg. Seizures were controlled with 3% saline Ⅳ. Once nausea was controlled with iv antiemetics, he developed large volume free water diuresis with 6 L of dilute urine in 8 h(urine osmolality 40-60 m Osm/kg) and serum sodium rapidly rose to 126 mmol/L in 12 h. Both intravenous desmopressin and 5% dextrose in water was given to achieve a concentrated urine and to temporarily reverse theacute rise of sodium, respectively. Serum Na+ was gradually re-corrected in 2-3 mmol/L daily increments from 118 mmol/L until 130 mmol/L. Hypokalemia was slowly corrected with resultant auto-correction of metabolic alkalosis. The patient discharged home with no neurologic sequaele on the 11 th hospital day. In euvolemic hyponatremic patient, controlling nausea may contribute to unpredictable free water diuresis. The addition of an antidiuretic hormone analog, such as desmopressin can limit urine output and prevent an unpredictable rise of the serum sodium.

关键词： Hyponatremia Hypokalemia Overcorrection polyuria Antidiuretic hormone Vasopressin Desmopressin Osmotic demyelination syndrome Central pontine myelinolysis

Case report: Desmopressin and somnambulism

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Open Journal of Pediatrics 2013年第3期3卷 208-210页

作者： Charlotte Van Herzeele Karlien Dhondt Johan Vande Walle University Hospital Ghent Ghent Belgium

Background: Nocturnal enuresis is caused by a mismatch between nocturnal urine production and bladder capacity. Together with a presumed decreased arousability, this results in an inability to awaken in response to a full bladder. According to recent findings, a disrupted sleep might play a role in the pathophysiology of enuresis. Case: A 7-year-old boy was diagnosed with primary nocturnal enuresis caused by nocturnal polyuria and a concomitant parasomnia, somnambulism. A polysomnographic study was performed before treating the nocturnal enuresis with the oral lyophylisate formulation of desmopressin (melt). After 1 day of treatment, both nocturnal enuresis and somnambulism disappeared. Treatment was ceased after six months. One week later, the child started to produce more urine and redeveloped nocturnal polyuria. Somnambulism reappeared followed by nocturnal enuresis two weeks later. The same treatment protocol was started up, resulting in disappearance of both nocturnal enuresis and somnambulism. Conclusion: This case report documents the beneficial effect of desmopressin melt on both nocturnal enuresis, caused by nocturnal polyuria, and a concomitant parasomnia in particularly somnambulism.

关键词： Children Enuresis Bedwetting Somnambulism Sleep Sleepwalking Desmopressin Nocturnal polyuria Parasomnia