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We aimed to investigate clinical and laboratory characteristics of acute alcohol intoxication (AAI) in adolescents who presented to the pediatric emergency department (ED) at a tertiary referral center from 2006 to 2019. All consecutive adolescents with AAI (n = 335) and their sex- and age-matched control subjects (n = 335) with undetectable ethanol levels were included in this case-matched study. Mean serum ethanol level was 156.4 ± 58.4 (range: 50.8-341.2) mg/dL in the acute alcohol intoxication (AAI) group. Glasgow coma scores were lower in AAI group (14 [14-15] vs 15 [15-15], P <.001). Acidosis (16.3%), hyperlactatemia (60.9%), hypoglycemia (1.7%), hypernatremia (2.2%), hypokalemia (12.3%), hyperchloremia (20.4%), hypocalcemia (13.9%), hypermagnesemia (9.7%), and hyperalbuminemia (10.4%) were significantly more common in the AAI group than the control group. Blood pH, lactate, Na+, K+, Ca++, Mg++, albumin, blood urea nitrogen (BUN), and uric acid levels were correlated with serum ethanol levels. This study shows that AAI frequently leads to mild to moderate metabolic/biochemical derangements in adolescents. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 02-month-old male with poor weight gain. Topics include appearing malnourished, jaundiced, and having bilateral eye discharge without conjunctival injection; and Genitourinary examination revealing normal external male genitalia and bilateral descended testes.

A case study of a 2760 g female infant was born at a community hospital at 39 weeks and 2 days to a 19-year-old G1P0 mother via spontaneous vaginal delivery, with pregnancy was complicated by intrauterine growth restriction. Topics include transferred to a level 4 neonatal intensive care unit for endocrinology evaluation and a brain magnetic resonance imaging; and Intraventricular hemorrhage was ruled out etiology of infant's central diabetes insipidus was attributed to presumed meningitis.

We sought to investigate the magnitude, clinical features, treatment, and outcome of children suffering from hypernatremic diarrhea and to identify risk factors for fatal outcome among them. We reviewed 2 data sets of children <15 years admitted to the in-patient ward of the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b) with diarrhea and hypernatremia (serum sodium ≥150 mmol/L): (a) March 2001 to March 2002 (n = 371) and (b) March 2009 to August 2011 (n = 360). We reviewed their records and collected relevant information for analyses. The prevalence of hypernatremia was 5.1% (371/7212) and 2.4% (360/15 219), case fatality rate was 15% and 19%, respectively. In logistic regression analysis, the risk for death significantly increased in association with serum sodium ≥170 mmol/L, nutritional edema, hypoglycemia, respiratory distress, and absent peripheral pulses and reduced with the sole use of oral rehydration salts (ORS) or ORS following intravenous fluid, if indicated (for all, P < .05). Thus, managing children with hypernatremia using only ORS or ORS following intravenous fluid may help reduce the number of deaths. [ABSTRACT FROM AUTHOR]

The article presents three case of hypernatremia patients. Patient 1 hospitalized for evaluation for persistent emesis and significant weight loss, ceftriaxone and oral antibiotics were give and she showed improvement. Patient 2 presented with multiple episodes of nonbloody diarrhea and emesis, management of dehydration and showed improvement. Patient 3 presented with dusky spells and the patient was managed with home breast-feeding support.

The article presents a case study of a 4-month-old full-term male, who was admitted to the hospital for hypernatremia and failure to thrive. It mentions that the patient started developing feeding difficulty around 2.5 months old because of influenza. The patient was diagnosed for nephrogenic diabetes insipidus (NDI) upon further examination. The article mentions that in NDI, patient's ability to concentrate urine is impaired while his antidiuretic hormone (ADH) secretion is normal.

This article reports a case of severe reversible hypernatremia exacerbated by an herbal agent ‘goldenseal’ (Hydrastis canadensis) in an 11-year-old girl with new onset type I diabetes mellitus presented with diabetic ketoacidosis. A literature review is presented and possible mechanism of hypernatremia caused by this herbal preparation is discussed [ABSTRACT FROM AUTHOR]

There is a concern that lactation failure and neonatal morbidity might be more common than previously thought. Maybe the early discharge, the lack of timely follow-up, or poor information during pregnancy or after delivery play important roles. A case of severe hypernatremic dehydration secondary to lactation failure is reported and we analyze recent recommendations. [ABSTRACT FROM AUTHOR]

Presents the case of a breastfed infant with hypernatremic dehydration who developed symptomatic dural sinus thrombosis that required treatment with urokinase. Analysis on the patient report; Discussion on hypernatremic dehydration in breastfed infants.

Presents two cases illustrating the management of hypernatremic dehydration in breastfed infants, with emphasis on the prevention of iatrogenic central nervous system (CNS) dysfunction during rehydration therapy. Human milk as ideal source of nutrition for the healthy term infant; Importance of successful postpartum maternal endocrine adaptation in concert with effective mother-infant interaction.

Reports on the incidence and morbidity of hypernatremic dehydration (HD) in infants with gastroenteritis in Kuwait. Retrospective analysis of medical records; Lower incidence of malnutrition in patients with HD compared to other forms of dehydration; Climatic conditions unrelated to the incidence of HD; Association of HD with high solute feeding.

The sodium and water intakes of a group of infants treated for diarrhea and dehydration in 1972–73, when hypernatremia was common, and a group of infants treated for diarrhea and dehydration in 1978–79, when hypernatremia was rare, were compared. Infants from both study periods whose intake was poor and who received feedings containing sodium in concentrations greater than 17 mEq/liter were more likely to develop elevated serum sodium concentrations. In a group of infants recovering from diarrhea, the effect upon the serum concentration of sodium of varying water and sodium intake was studied. Those treated with small amounts of a solution containing 30 mEq sodium per liter regularly demonstrated an elevation of serum sodium, whereas those treated with large amounts of the same solution regularly demonstrated a depression. It is concluded that infants with diarrhea should receive feedings containing sodium in concentrations less than 17 mEq/liter unless a high fluid intake can he assured. [ABSTRACT FROM AUTHOR]

This article focuses on the clinical management of hypernatremic dehydration. The unique fluid and osmolar changes make this entity more difficult to recognize and treat clinically than the more common isoionic dehydration. In hypernatremic dehydration, the loss of hypotonic fluids from the extracellular space results in a relative rise in extracellular ions. Sodium is the main extracellular cation, and serum sodium concentrations may exceed normal limits of 150 mEq/L. Under these circumstances, extracellular osmolality will also exceed normal and an osmotic gradient across cell membranes will occur. Homeostasis requires that the osmolalities on both sides of the cell membrane be equal.

Can one tell whether dehydration is hyper, hypo, or isotonic in a hospitalized child by history and physical alone? Should one always get a serum-sodium concentration on a child hospitalized with the diagnosis of dehydration? Is hypovolemia a major feature on admission to the hospital? How common are central nervous system manifestations in the experimental animal versus the clinical condition of hyperelectrolytemia? Would it be appropriate to give dextrose and water only, in rehydrating a patient with hypernatremia? Does rapid dehydration have an adverse effect on these children? If convulsions occur, does this necessarily mean permanent brain damage? [ABSTRACT FROM AUTHOR]

Critical malnutrition and hypernatremic dehydration resulting from inadequate breast-feeding have previously been reported; the finding of elevated sodium concentration in expressed samples of mother's milk from these infants is found concurrently. This is the first case report describing successful relactation following management of hypernatremic dehydration in a breast-fed infant. Mother's milk was of inadequate volume and had a high sodium content. Treatment of the primary cause of this disorder, insufficient lactation, was effective in allowing successful relactation; a nursing supplementer is described. [ABSTRACT FROM AUTHOR]

Three cases of hypernatremic dehydration in children with severe psychomotor retardation are described. All the children were receiving processed foods that contained extremely high amounts of sodium and were unintentionally deprived of free water. Salt and water intake must be monitored closely in children who can neither communicate thirst nor regulate their diet. [ABSTRACT FROM AUTHOR]

The nutritional, psychological, and immunological advantages of breast feeding to human newborns are well established. Human milk has served as the primary source of nutrition to the newborn for millions of years. Despite these advantages, breast feeding failure was documented in approximately 20 percent of primiparous women. Up to 50 percent of lactating women may exhibit significant nursing difficulties. Early recognition and management of breast-feeding-related difficulties is essential to avoid critical complications, such as severe malnutrition, hypothermia, hypoglycemia, hypernatremia and shock. This article describes two cases of critical malnutrition with hypernatremia secondary to failure of breast-feeding.

Excessively concentrated milk formula was administered accidentally to five newborn infants. Diarrhea, dehydration, hypernatremia, and hyperosmolality were present in all of them. Abnormal neurologic manifestations during the acute disease were observed in one infant. On follow-up, psychomotor development and electroencephalographic recordings were normal in four infants. One infant, in whom accelerated growth of head circumference had been noted before the episode of diarrhea, was found to have obstruction of the foramen of Monro at the age of 6 weeks. Possible errors in preparing milk formulas by medical staff resulting in hypertonic dehydration are stressed in this report. [ABSTRACT FROM AUTHOR]