MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'fluids'. Sat, 03 Sep 2011 02:37:13 +0100 http://www.medworm.com/index.php?rid=5158998&cid=t_110344_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcdc-outlines-injury-prevention-strategies-in-extreme-weather-conditions%2F2011.08.24 It may seem rather unusual to talk about injuries and weather in the same context, but extreme weather can pose significant risks for many kinds of injury.  Currently, many parts of the United States are experiencing a major heat wave, with record-setting heat and heat indices over the next few weeks.  As we have seen in the recent past, deaths are occurring from heat-related and possibly from participation in outside activities that increase the risk of heat-related illness. During the month of August, many athletes train for the fall sports season, sometimes participating in two practices a day over the course of a few weeks.  While training is necessary and important for athletes to build up their stamina and to improve their performance, health consequences can be deadly if (more&#8... Better Health blogs http://www.medworm.com/rss/comments.php?id=5158998 Wed, 24 Aug 2011 16:00:44 +0100 5158998 http://www.medworm.com/index.php?rid=5125743&cid=t_110344_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fer-nurse-explains-what-its-really-like-to-be-an-rn%2F2011.08.12 You want to be a registered nurse? Let’s cut through the B.S. and get real about it. Put a hold on all this soft-focus “I live to care!” or “It gives my life meaning…” Here’s the reality. *** You will study your butt off. Nursing science is based on biology, chemistry, microbiology, anatomy, physiology, psychology, sociology and philosophy. Yeah, every single one of them. You will incorporate those into every decision you make in your practice. It’s called critical thinking. You master it and become a professional, or you don’t and you become a robotic technician. Bottom line. Your choice. Oh, and the studying doesn’t stop after you graduate. Nursing school is just the warm-up. *** The work is physically exhausting and emotionally demanding. (more…) *... Better Health blogs http://www.medworm.com/rss/comments.php?id=5125743 Fri, 12 Aug 2011 12:00:35 +0100 5125743 http://www.medworm.com/index.php?rid=4968490&cid=t_110344_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffood-allergies-treating-severe-allergic-reactions%2F2011.06.25 An allergic reaction in an outdoor setting can rapidly become a life-threatening emergency. While most of us think of food allergies as annoyances, they can be quite serious or even life threatening. Itchy skin rashes can progress to breathing difficulty, swollen soft tissues (e.g., lips, tongue, throat) that compromise the airway, and low blood pressure or even shock. Therefore, it’s important to be familiar with the signs and symptoms of severe allergy and to be prepared to respond rapidly in the event of an emergency. An EpiPen (an epinephrine auto-injector) The National Institute of Allergy and Infectious Diseases has released Food Allergy Guidelines for healthcare professionals to help guide the care of patients with life-threatening food allergies. The full guidelines can be found ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4968490 Sat, 25 Jun 2011 18:00:00 +0100 4968490 http://www.medworm.com/index.php?rid=3139258&cid=t_110344_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Fhuffing-inhalants-by-kids%2F Inhalants: The new, convenient high for kids and teens Today children and teens are finding new, inexpensive and more convenient ways to get high by using products – found under the kitchen sink or in the bathroom of their homes – that are just as harmful and potentially deadly as drugs like marijuana, cocaine and heroine. [...] (Source: Recovery Is Sexy.com) Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=3139258 Sat, 02 Jan 2010 15:50:51 +0100 3139258 http://www.medworm.com/index.php?rid=2172740&cid=t_110344_87_f&fid=34825&url=http%3A%2F%2Fwww.wesleyjsmith.com%2Fblog%2F2009%2F02%2Feluana-englaro-dies.html Eluana Englaro has died. From the story: Eluana Englaro, the 38-year-old comatose woman at the center of an Italian right-to-die case, died Monday night despite efforts by Prime Minister Silvio Berlusconi to order doctors to feed her, the clinic said.She had been in a coma since a 1992 car crash. A moment of silence was observed in the Senate, which was debating a law that would have forced the clinic in northern Italy where she was hospitalized to resume feeding her through a tube after nutrition was stopped at the request of the family.This was too fast to have been caused by dehydration. Perhaps her body just gave out.I hope the Italian government looks into this issue in depth and with sobriety. Removing sustenance based on a patient's quality of life is too important to be left to rus... Secondhand Smoke blogs http://www.medworm.com/rss/comments.php?id=2172740 Mon, 09 Feb 2009 21:37:00 +0100 2172740 http://www.medworm.com/index.php?rid=2172742&cid=t_110344_87_f&fid=34825&url=http%3A%2F%2Fwww.wesleyjsmith.com%2Fblog%2F2009%2F02%2Fitalian-parliament-debates-eluana.html As Eluana Englar is being dehydrated to death, the Italian Parliament is debating a proposed law that would prohibit causing cognitively disabled people to die in this manner. From the story: Italian senators raced Monday to discuss a bill designed to keep a woman in vegetative state from having her feeding tube disconnected, the latest twist in a right-to-die case that has consumed Italy. The bill aimed at keeping Eluana Englaro alive is expected to win quick approval. It is supported by Premier Silvio Berlusconi, whose conservative forces have solid majority in Parliament...In line with the high court ruling, medical workers on Friday began gradually suspending food and water for Englaro. Citing privacy rules, they have not given updates on the procedure. But Italy's center-right governm... Secondhand Smoke blogs http://www.medworm.com/rss/comments.php?id=2172742 Mon, 09 Feb 2009 17:15:00 +0100 2172742 http://www.medworm.com/index.php?rid=2060836&cid=t_110344_87_f&fid=34825&url=http%3A%2F%2Fwww.wesleyjsmith.com%2Fblog%2F2008%2F12%2Fdoctors-refuse-to-dehydrate-italian.html I believe that the issue of "conscience," that is the right of physicians, nurses, and other health care professionals not to engage in intentional life-terminating actions will be huge in the coming decade in bioethics. It has already begun in Italy after a father won the right in court to have his daughter's feeding tube withdrawn. But even though the EU Court has refused to save Eluana Englaro's life, no doctor in Italy will agree to participate in her intentional dehydration. From the story: Italian officials say they are taking a hands-off approach after a European court rejected efforts to block a father's efforts to let his comatose daughter die.Italy's ANSA news agency Tuesday said Beppino Englaro has been unable to find a clinic that will facilitate the death of his daughter, Elua... Secondhand Smoke blogs http://www.medworm.com/rss/comments.php?id=2060836 Tue, 23 Dec 2008 20:06:00 +0100 2060836 http://www.medworm.com/index.php?rid=2005525&cid=t_110344_87_f&fid=34825&url=http%3A%2F%2Fwww.wesleyjsmith.com%2Fblog%2F2008%2F12%2Fwhat-we-are-becoming-time-to-dehydrate.html A disturbing column in today's LA Times has a woman wanting to "let" her Dad go by removing his feeding tube--which would really be to make him go, since there could only be one outcome from such a decision.Dad isn't unconscious. He is debilitated and disabled by a stroke. He apparently had an advance directive eschewing "extraordinary" care, which the family--rightly in my view--did not see as applying to a feeding tube. And yet, we are told that even so, he should be "let go," e.g., be dehydrated to death, because his life isn't worth living. From the column, byline Diana Wagman:But what kind of life? Since that morning, he has been in a deep sleep, rousing rarely and unpredictably and only enough to say a word or two. He's paralyzed on his right side. His eyes are closed, and the nurses... Secondhand Smoke blogs http://www.medworm.com/rss/comments.php?id=2005525 Tue, 02 Dec 2008 17:33:00 +0100 2005525 http://www.medworm.com/index.php?rid=1980505&cid=t_110344_87_f&fid=34825&url=http%3A%2F%2Fwww.wesleyjsmith.com%2Fblog%2F2008%2F11%2Flauren-richardson-life-saved.html Readers of SHS may recall the Lauren Richardson situation: Lauren experience a catastrophic brain injury and was diagnosed as in a persistent vegetative state. Her mother wanted to remove her tube sustenance and her father resisted. Litigation ensued. At the 11th hour, Lauren's parents have come together in agreement to her live. From the story: After gaining nationwide attention nearly a year ago as the focus of a court battle between her estranged parents--with her father arguing for her right to life and her mother countering that her final wishes were being violated--the 24-year-old severely brain-damaged woman will be going home with her father.Her parents, Randy Richardson and Edith Towers, resolved their differences and ended their nearly two-year legal battle amicably with a joint ... Secondhand Smoke blogs http://www.medworm.com/rss/comments.php?id=1980505 Sat, 22 Nov 2008 17:40:00 +0100 1980505 http://www.medworm.com/index.php?rid=1652242&cid=t_110344_87_f&fid=34825&url=http%3A%2F%2Fwww.wesleyjsmith.com%2Fblog%2F2008%2F07%2Fjanet-rivera-case-medicalized-tyranny.html I told you all this was coming, and here it is. A California woman named Janet Rivera, age 46, who we are told is unconscious, has a family who want her to continue to receive food and water. Her husband was even her guardian. But he was removed as guardian and a total stranger--the county coroner no less--was put in his place. And the doctors convinced him that the time had come for Rivera to die.Why remove Janet's husband as decider? No abuse was alleged. Apparently he had difficulties with the technicalities. From the story:Sanger woman Janet Rivera, 46, has been in a coma since she had a heart attack in February 2006. For more than two years, Rivera's husband, Jesus Rivera, made all of his wife's medical decisions while Rivera was under the care of the DeWitt Community Subacute Center ... Secondhand Smoke blogs http://www.medworm.com/rss/comments.php?id=1652242 Thu, 24 Jul 2008 23:12:00 +0100 1652242 http://www.medworm.com/index.php?rid=1605759&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3630     ABG pH 7.35 pCO2 48 pO2 74 calc HCO3 25 50 year old man presents with chest pain and a recent abnormal stress test.  He has a 30-40 pack year history.  This ABG was taken on room air. Can you describe a set of circumstances that would give you these results? (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1605759 Thu, 10 Jul 2008 15:27:36 +0100 1605759 http://www.medworm.com/index.php?rid=1449200&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3581   I am current at the ACP annual meeting, and this morning heard a brilliant grand rounds on hyponatremia - given by Juan Carlos Ayus.  I have found an excellent article in the Southern Medical Journal that he co-authored on treatment of dysnatremias and also provide this Medscape link - Hospital-Acquired Hyponatremia — Why Are Hypotonic Parenteral Fluids Still Being Used? Hospital-acquired hyponatremia can be lethal. There have been multiple reports of death or permanent neurological impairment in both children and adults. The main factor contributing to the development of hospital-acquired hyponatremia is routine use of hypotonic fluids in patients in whom the excretion of free water, which is retained in response to excess arginine vasopressin (AVP), might be impaired. ... DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1449200 Sat, 17 May 2008 14:29:44 +0100 1449200 http://www.medworm.com/index.php?rid=1442618&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3576   Was It the Drinking Binge?   Solution to "Was It the Drinking Binge?"     (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1442618 Wed, 14 May 2008 15:24:43 +0100 1442618 http://www.medworm.com/index.php?rid=1409491&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3555   Yesterday’s numbers: Electrolyte panel Na 141 Cl 112 BUN 18 K 4.3 HCO3 15 creat 0.7 Blood Sugar 105 ABG pH 7.33 pCO2 25 pO2 103 calc HCO3 13   Additional information: 1. She had increased ileal output. 2. Serum albumin was 5.7 3. Urine Na 10, urine K 47 and urine Cl 72 Her anion gap is 14, which is normal given her elevated albumin Her urine anion gap is negative, consistent with sufficient ammonium (NH4+) in her urine The urine anion gap results supports increased ileal output and bicarbonate loss as the cause of the normal gap acidosis The respiratory response is appropriate.  Remember to use the calculated HCO3- when using the Winter’s formula.  The expected pCO2 thus is 27.5 and close enough to the observed pCO2 to exclude a... DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1409491 Wed, 30 Apr 2008 19:34:45 +0100 1409491 http://www.medworm.com/index.php?rid=1406673&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3553   Started rounds today and had several interesting laboratory findings.  I plan to post some patient quizzes for the next 3 days. Electrolyte panel Na 141 Cl 112 BUN 18 K 4.3 HCO3 15 creat 0.7 Blood Sugar 105 ABG pH 7.33 pCO2 25 pO2 103 calc HCO3 13   Today’s patient is well known to our service.  She is 32 and has a long history of Crohn’s disease, with an ileostomy.  Consider the differential diagnosis, and recommend tests to prove your hypothesis.  (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1406673 Tue, 29 Apr 2008 18:45:37 +0100 1406673 http://www.medworm.com/index.php?rid=1323071&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3516 To remind you: Exam reveals a markedly volume contracted 61 year old woman. Electrolyte panel Na 135 Cl 88 BUN 127 K 4.3 HCO3 14 creat 7.4 Blood Sugar 109 ABG pH 7.3 pCO2 26 pO2 70 calc HCO3 13 Her serum albumin was 4.8. Her urine creatinine was 330 with a urine sodium of 14. Her PTH level was 138. Resolution This patient had remarkable volume contraction. She had both an increased anion gap acidosis as well as a metabolic alkalosis. 1. Anion gap = 33, defining an increased anion gap acidosis. 2. Using the delta gap process, we subtract her expected gap (14 in this patient with an albumin of 4.8) from her measured gap. The difference is 19. If we add 19 to her observed bicarbonate of 14, we obtain her adjusted bicarbonate of 33. This suggests that she first developed ... DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1323071 Mon, 24 Mar 2008 19:25:38 +0100 1323071 http://www.medworm.com/index.php?rid=1316543&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3511 Here is another puzzle for acid base aficionados. The patient is a 61 year old woman admitted for severe nausea and vomiting. She states that she has had 6 days of severe nausea, vomiting and diarrhea. The diarrhea was watery. Her past medical history included “CHF with normal EF”, gout, hypertension and a previous episode [...] (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1316543 Thu, 20 Mar 2008 13:44:50 +0100 1316543 http://www.medworm.com/index.php?rid=1277533&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3495 We made rounds on an 82 year old man today. Because his electrolyte panel revealed a bicarbonate level of 40, we order an ABG. The patient has known COPD and CHF. He was intubated until 2 days ago. He received aggressive diuresis for volume overload. Now his ABG reveals: ABG pH 7.46 pCO2 66 pO2 61 calc HCO3 46 Questions [...] (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1277533 Tue, 04 Mar 2008 17:37:30 +0100 1277533 http://www.medworm.com/index.php?rid=1234457&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3480 Readers know that I love teaching acid base and electrolytes. For years I (and many other educators) have difficulty explaining why edematous states can lead to hyponatremia. We always have talked about ineffective intravascular volume, although when you measure the intravascular volume it measures as increased. Thus, we had a difficult concept [...] (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1234457 Fri, 15 Feb 2008 19:58:03 +0100 1234457 http://www.medworm.com/index.php?rid=1223611&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3472 I have used this presentation for the past 30 years. It provides students a wonderful opportunity to consider the entire differential diagnosis of hypercalcemia. The answer is a surprise to many. In the presentation I fail to mention that the tachycardia persisted after volume expansion. (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1223611 Mon, 11 Feb 2008 21:24:12 +0100 1223611 http://www.medworm.com/index.php?rid=1221221&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3470 Today my team is admitting, so I made rounds in the afternoon. Our service is relatively quiet, so I took time to discuss a classic case from my residency. I previously did a podcast on this patient, but I suspended the podcast service and will have to write out the case now. This case [...] (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1221221 Mon, 11 Feb 2008 00:51:15 +0100 1221221 http://www.medworm.com/index.php?rid=1220795&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3469 I forgot to include the calculated HCO3 in the acid base problem.  I have editted the entry to now include that number. My apologies to readers - I hope this number make the explanation more clear. (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1220795 Sun, 10 Feb 2008 19:31:46 +0100 1220795 http://www.medworm.com/index.php?rid=1219799&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3467 One of my main teaching philosophies includes understanding how to teach basics and when to move to more advanced concepts. Solving yesterday’s problem requires some more advanced concepts. The normal anion gap depends on the albumin level (albumin is the major component of the normal anion gap.) Therefore, when the albumin is decreased below [...] (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1219799 Sat, 09 Feb 2008 12:59:08 +0100 1219799 http://www.medworm.com/index.php?rid=1217802&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3466 60 yo male with strong alcohol history is admitted for cellulitis.  On his second day in the hospital he develops delirium tremens and aspirates.  In the ICU he requires sedation for his DTs. He had the following laboratory values on the 3rd day of ICU care: Electrolyte panel Na 142 Cl 110 BUN 27 K 4.5 HCO3 17 creat 2.0 Blood Sugar 468 ABG pH 7.24 pCO2 25 pO2 126 His albumin is 3.  His serum osms are [...] (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1217802 Fri, 08 Feb 2008 19:47:25 +0100 1217802 http://www.medworm.com/index.php?rid=1149552&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fwww.medrants.com%2Findex.php%2Farchives%2F3437 A 52-year-old Man With a Low Bicarbonate Level Enjoy - the answer will be posted next week (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=1149552 Mon, 14 Jan 2008 20:13:03 +0100 1149552 http://www.medworm.com/index.php?rid=911711&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fmedrants.com%2Findex.php%2Farchives%2F3350 The housestaff obtained this ABG on a patient presented yesterday at morning report. Your task is to explain the acid-base disorder and the oxygen level. On room air - serum bicarbonate is 44 ABG pH 7.52 pCO2 54 pO2 62 (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=911711 Fri, 28 Sep 2007 15:27:46 +0100 911711 http://www.medworm.com/index.php?rid=861303&cid=t_110344_87_f&fid=34469&url=http%3A%2F%2Fmedrants.com%2Findex.php%2Farchives%2F3328 I saw a similar patient 3 years ago. This case report is important - A case of valproate-induced hyperammonemic encephalopathy: look beyond the liver The patient was admitted to hospital for further investigations and for monitoring with video electroencephalography. In the first 48 hours after admission, her level of consciousness fluctuated. Subsequent tests revealed an [...] (Source: DB's Medical Rants) DB's Medical Rants blogs http://www.medworm.com/rss/comments.php?id=861303 Tue, 11 Sep 2007 13:29:37 +0100 861303 http://www.medworm.com/index.php?rid=525456&cid=t_110344_87_f&fid=34865&url=http%3A%2F%2Fwww.thecancerblog.com%2F2007%2F04%2F06%2Ffour-health-tips-busted-or-are-they%2F Filed under: Prevention, All Cancers, Opinion, Daily newsHere's my problem with health-related advice and wisdom -- it's always changing. And I'm never sure if I'm buying into the right practice. Should I eat low-fat foods, for example, or should I stick with moderate amounts of regular food? Is red meat a good source of protein and other goodies or a direct path to breast cancer recurrence? Will sunscreen save my life or cause malignant lesions to develop on my fair skin? I honestly don't know what to think about these questions -- or the handful of new ones that just came to my attention.There's the one about eggs. Some say they cause a rise in cholesterol. But now I learn that when eaten in moderation -- about two per day -- eggs do not contain enough cholesterol to do any damage.Then t... The Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=525456 Fri, 06 Apr 2007 04:00:00 +0100 525456