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Hypovolemia in syncope and orthostatic intolerance role of the renin-angiotensin system.

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OBJECTIVE Orthostatic intolerance is the cause of significant disability in otherwise normal patients. Orthostatic tachycardia is usually the dominant hemodynamic abnormality, but symptoms may include dizziness, visual changes, discomfort in the head or neck, poor concentration, fatigue,

"Fixing a heart": the game of electrolytes in anorexia nervosa.

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METHODS A 25-year-old woman with chronic anorexia nervosa and depression presented with sudden weakness and fatigue. Psychosocial history was notable for binge-starve cycles over the past year and a decline in overall well-being. Vitals on presentation were notable for hypothermia, hypotension, and

The effect of nitrate supplementation on muscle contraction in healthy adults.

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This study examined the effect of dietary supplementation with inorganic nitrate ([Formula: see text] ) on markers of contractile function in human knee extensors. In a double-blinded, randomized cross-over design, 18 (12 M) healthy participants undertook four days of supplementation with either

Clinical and pathological findings of a fatal systemic capillary leak syndrome (Clarkson disease): a case report.

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Systemic capillary leak syndrome (SCLS) is a rare disorder with episodes of hypotension, hypoalbuminemia, and hemoconcentration. During attacks endothelial hyperpermeability results in leakage of plasma proteins into the interstitial space. Attacks vary in severity and may be lethal.A 49-year-old

[Two patients with Eisenmenger syndrome treated with novel agents that target vasodilation of the pulmonary capillary bed].

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Two women with Eisenmenger syndrome, aged 63 and 45 years, presented with different symptoms: the first patient had peripheral oedema, proteinuria, progressive fatigue and cyanosis and the other had increasing dyspnoea and blue lips. The first patient was successfully treated with diuretics but

Hyperglycemic Hyperosmolar State During Induction Chemotherapy for Acute Lymphoblastic Leukemia.

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We present the case of a 16-year-old boy who presented with fatigue, polyuria, and polydipsia while on chemotherapy for his relapsed acute lymphoblastic leukemia (ALL). Blood gas examination confirmed the diagnosis of hyperosmolar hyperglycemic state. The etiology for his hyperglycemia was most

Activity and Exercise Intolerance After Concussion: Identification and Management of Postural Orthostatic Tachycardia Syndrome.

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OBJECTIVE Postural orthostatic tachycardia syndrome (POTS) is increasingly recognized as a complication affecting recovery from concussion. Individuals with POTS demonstrate refractory dizziness, lightheadedness, cognitive dysfunction, fatigue, headache, chronic pain, nausea and gastrointestinal

Phase I trial of PT-100 (PT-100), a cytokine-inducing small molecule, following chemotherapy for solid tumor malignancy.

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PT-100 upregulates cytokine expression competitively inhibiting the dipeptidyl peptidase activity of fibroblast activation protein (FAP) and dipeptidyl peptidase IV (DPP-IV). This dose-escalation study was conducted to evaluate the safety of PT-100 in patients receiving myelosuppressive chemotherapy

Emergent management of the airway. New pharmacology and the control of comorbidities in cardiac disease, ischemia, and valvular heart disease.

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Once it is decided that the patient in distress requires tracheal intubation, the primary goal is to secure the airway as quickly and safely as possible to assure adequate oxygenation and ventilation. The clinician should quickly review the patient's history, physical examination findings, and

Ebola virus disease and critical illness.

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As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa.EVD presentation is nonspecific and characterized

Assessment of dry weight by monitoring changes in blood volume during hemodialysis using Crit-Line.

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BACKGROUND Routine assessment of dry weight in chronic hemodialysis patients relies primarily on clinical evaluation of patient fluid status. We evaluated whether measurement of postdialytic vascular refill could assist in the assessment of dry weight. METHODS Twenty-eight chronic, stable

Ombitasvir-Paritaprevir-Ritonavir-Dasabuvir (Viekira Pak)-Induced Lactic Acidosis.

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OBJECTIVE To report a case series of three patients with hepatitis C virus infection who all presented with severe type B lactic acidosis shortly after starting treatment with ombitasvir-paritaprevir-ritonavir-dasabuvir. METHODS Case series. METHODS ICU. METHODS Three patients, all who had HCV

Management of Orthostatic Hypotension in Parkinson's Disease

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Orthostatic hypotension (OH) is a common non-motor feature of Parkinson's disease that may cause unexplained falls, syncope, lightheadedness, cognitive impairment, dyspnea, fatigue, blurred vision, shoulder, neck, or low-back pain upon standing. Blood pressure (BP) measurements supine and after 3

Superior Mesenteric Arteriovenous Fistula Presenting with Massive Lethal Upper Gastrointestinal Bleeding 14 Years after Small Bowel Resection.

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BACKGROUND Arteriovenous fistulas (AVFs) of the superior mesenteric vasculature are rarely encountered. We present a case of an iatrogenic superior mesenteric AVF in a patient who had undergone a small bowel resection 14 years previously. METHODS The 45-year-old male was admitted with bloody

The Postural Tachycardia Syndrome (POTS): pathophysiology, diagnosis & management.

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Postural tachycardia syndrome (POTS), characterized by orthostatic tachycardia in the absence of orthostatic hypotension, has been the focus of increasing clinical interest over the last 15 years 1. Patients with POTS complain of symptoms of tachycardia, exercise intolerance, lightheadedness,

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