The study objective was to determine if the healthy participants were exposed to diethyl phthalate (DEP) and di (2-ethylhexyl) phthalate (DEHP) and if this exposure could be linked to the development ...of metabolic syndrome. The study included 103 healthy volunteers of similar age with normal BMI values, waist circumference, total cholesterol, HDL, LDL, and triglycerides. DEP and DEHP were measured in the morning urine samples to detect monoethyl phthalate (MEP) and mono-2-ethylhexyl phthalate (MEHP). Two phthalate groups and a control group were formed. Both MEP group and control group had similar results. The correlations between MEP and the measured parameters were insignificant. The correlation between the MEHP group and the age was significantly negative, but between the MHEP group and the waist circumference the correlation was significantly positive. Lipids and lipoproteins were within the reference values and equal in both groups. The significant negative correlation was observed only between MEHP and HDL. Our population is exposed to DEP and DEHP. There was only a significant correlation between DEHP and the observed metabolic syndrome components. Its negative impact was higher as the participants were younger.
Multiple Causes of Hyponatremia: A Case Report Icin, Tijana; Medic-Stojanoska, Milica; Ilic, Tatjana ...
Medical principles and practice,
01/2017, Letnik:
26, Številka:
3
Journal Article
Recenzirano
Odprti dostop
To present a case with 4 different potential causes of hyponatremia.
The patient presented with the following symptoms: nausea, vomiting, diarrhea, and dark urine after drinking large amounts of ...fluids that included alcohol and caffeine. Laboratory, microbiological, and morphological examinations revealed the existence of severe hyponatremia and acute poststreptococcal glomerulonephritis. The patient developed acute symptomatic seizures and coma. Gradual normalization of the sodium level led to a recovery of consciousness.
Treatment with hypertonic sodium, fluid restriction, and antibiotics led to a complete recovery. In the case of multiple causes of hyponatremia, it is necessary to treat all causes.
Introduction. Adrenal insufficiency results from the inadequate adrenocortical conjunction. Adrenal insufficiency can be primary, secondary and tertiary one. The most common cause of adrenal ...suppression is the effect of exogenous therapy with glucocorticoids. Glucocorticoids. Corticosteroids are used in treatment of endocrine and non-endocrine diseases. They are applied as a substitution therapy in the patients with primary and secondary adrenal insufficiency. Due to their immunosuppressive and anti-inflammatory characteristics, they are used to treat a wide range of diseases. They are usually divided according to the length and size of the effect i.e. how they are applied. Adrenal Insufficiency. Glucocorticoid therapy may lead to a number of adverse effects such as a disorder in glucose metabolism, osteoporosis or frequent infections. Adrenal suppression is the most common complication resulting from corticosteroid application. The function of the hypothalamus-pituitaryadrenal axis may be inhibited for months after the treatment cessation. There are several predictors of potential glucocorticoid-induced adrenal suppression. Diagnosing Adrenal Insufficiency. The most frequent symptoms and signs of adrenal insufficiency are fatigue, nausea and vomiting, hyponatremia, hyperpigmentation or hypotension. Algorithm for the diagnosis of adrenal insufficiency must be followed in clinical practice. Reduction in Glucocorticoid Therapy. Reduction or complete cessation of the therapy is indicated when the maximum therapeutic benefit has been achieved or when considerable side effects, such as diabetes mellitus, severe hypertension, osteoporosis i.e. adrenal insufficiency, develop. Conclusion. Numerous synthetic glucocorticoids have been developed to be used in everyday clinical practice and they can be administered systemically or locally. A lot of side effects are associated with chronic administration of glucocorticoids. In order to avoid complications, it is recommended to administer intermediate-acting glucocorticoids every second day. In addition, the patients must be monitored carefully and glucocorticoid therapy should be discontinued gradually to prevent adrenal insufficiency or reactivation of the disease under therapy. Key words: Glucocorticoids; Adrenal Insufficiency; Drug-Related Side Effects and Adverse Reactions; Diagnosis; Signs and Symptoms; Hydrocortisone Sazetak Uvod. Adrenalna insuficijencija posledica je neadekvatne adrenokortikalne sprege. Razlikujemo primarnu, sekundarnu i tercijarnu adrenalnu insuficijenciju. Efekat egzogene terapije glukokortikoidima je najcesci uzrok adrenalne supresije. Glukokortikoidi. Kortikosteroidi se koriste u lecenju endokrinih i neendokrinih oboljenja. Primenjuju se kao supstituciona terapija kod bolesnika sa primarnom ili sekundarnom adrenalnom insuficijencijom. Zbog imunosupresivnih i antiinflamatornih osobina koriste se u sirokom spektru oboljenja. Najcesce ih delimo prema duzini i jacini dejstva, odnosno prema nacinu primene. Adrenalna insuficijencija. Terapija glukokortikoidima moze da dovede do brojnih nezeljenih efekata - poremecaja metabolizma glukoze, osteoporoze ili cestih infekcija. Najcesca komplikacija prilikom upotrebe kortikosteroida je adrenalna supresija. Inhibicija funkcije hipotalamusno-hipofiznonadbubrezne osovine, izazvana upotrebom kortikosteroida, moze trajati mesecima nakon sto je tretman obustavljen. Postoji nekoliko prediktora potencijalne glukokortikoidima indukovane adrenalne supresije. Dijagnostika adrenalne insuficijencije. Nadbubrezna insuficijencija manifestuje se skupom simptoma i znakova, a najcesce su to malaksalost, mucnina i povracanje, hiponatremija, hiperpigmentacija ili hipotenzija. U klinickoj praksi neophodno je pratiti algoritam dijagnostike nadbubrezne insuficijencije. Smanjenje glukokortikoidne terapije. Smanjene ili potpuno ukidanje terapije je indikovano kada je postignuta maksimalna terapeutska korist, ili kada se pojave znacajni sporedni efekti poput dijabetesa melitus, teske hipertenzije, osteoporoze, odnosno nadbubrezne insuficijencije. Zakljucak. Razvijeni su brojni sintetski glukokortikoidi koji se koriste u svakodnevnoj klinickoj praksi koji se mogu ordinirati sistemski ili lokalno. Mnogi sporedni efekti su povezani sa hronicnom administracijom glukokortikoida. Da bi se izbegle komplikacije, preporucuje se terapija na drugi dan primenom glukokortikoida srednje dugog dejstva. Takode, potrebno je pazljivo pracenje pacijenata i postepeno ukidanje glukokortiokoidne terapije kako bi se izbegla nadbubrezna insuficijencija ili reaktivacija bolesti pod terapijom. Kljucne reci: glikokortikoidi; adrenalna insuficijencija; nuspojave i nezeljeni efekti lekova; dijagnoza; znaci i simpotomi; kortizol
Introduction. Adrenal insufficiency results from the inadequate
adrenocortical conjunction. Adrenal insufficiency can be primary, secondary
and tertiary one. The most common cause of adrenal ...suppression is the effect
of exogenous therapy with glucocorticoids. Glucocorticoids. Corticosteroids
are used in treatment of endocrine and non-endocrine diseases. They are
applied as a substitution therapy in the patients with primary and secondary
adrenal insufficiency. Due to their immunosuppressive and anti-inflammatory
characteristics, they are used to treat a wide range of diseases. They are
usually divided according to the length and size of the effect i.e. how they
are applied. Adrenal Insufficiency. Glucocorticoid therapy may lead to a
number of adverse effects such as a disorder in glucose metabolism,
osteoporosis or frequent infections. Adrenal suppression is the most common
complication resulting from corticosteroid application. The function of the
hypothalamus-pituitary-adrenal axis may be inhibited for months after the
treatment cessation. There are several predictors of potential
glucocorticoid-induced adrenal suppression. Diagnosing Adrenal
Insufficiency. The most frequent symptoms and signs of adrenal insufficiency
are fatigue, nausea and vomiting, hyponatremia, hyperpigmentation or
hypotension. Algorithm for the diagnosis of adrenal insufficiency must be
followed in clinical practice. Reduction in Glucocorticoid Therapy.
Reduction or complete cessation of the therapy is indicated when the
maximum therapeutic benefit has been achieved or when considerable side
effects, such as diabetes mellitus, severe hypertension, osteoporosis i.e.
adrenal insufficiency, develop. Conclusion. Numerous synthetic
glucocorticoids have been developed to be used in everyday clinical practice
and they can be administered systemically or locally. A lot of side effects
are associated with chronic administration of glucocorticoids. In order to
avoid complications, it is recommended to administer intermediate-acting
glucocorticoids every second day. In addition, the patients must be
monitored carefully and glucocorticoid therapy should be discontinued
gradually to prevent adrenal insufficiency or reactivation of the disease
under therapy.
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