English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Salt-sensitivity is present in approximately half of the population with essential hypertension.1 Among several methods used to diagnose salt-sensitivity, Weinberger’s saline infusion test is widely accepted; this test compares the blood pressure (BP) measured after infusing 2 l of isotonic saline over 4 h with the BP measured during a salt-restricted diet and administration of three 40-mg doses of oral furosemide. A 10 mmHg or greater difference in mean BP between the salt-loaded and salt-depleted phases of the test is defined salt-sensitivity.2 In three patients to be described, infusion of isotonic saline induced a surge of BP far in excess to the mild hypertensive effect required to diagnose salt-sensitive hypertension. Such episodes are not well described in the literature.### Patient 1A 96-year-old woman was referred with the diagnosis of left lower lobe pneumonia. Amoxicillin/clavulanate intravenous (i.v.) 1 g × 3/day was started. Notable in the patient’s medical history were multi-infarct dementia, dysphagia, grade I arterial hypertension, vitamin B12 and iron deficiency. Her regular medications were simvastatin 20 mg, furosemide 40 mg, vitamin B12 and ferum sulfate 160 mg/day. The patient’s BP readings on the day of admission were 185/90, 139/77, 145/65 mmHg, the heart rate 72 bpm, temperature 38.6°C. The serum creatinine was 0.7 mg/dl, WBC 12 300/mm3, polymorphonuclear leukocytes 79%. Two days later, the temperature returned to normal but the abdomen became distended with no passage of stool or gas and high-pitched bowel sounds suggesting intestinal obstruction or pseudoobstruction. On plain abdominal X-ray, the colon was distended, air visible in all colonic segments including the rectosigmoid and the maximum cecal diameter 7 cm. The BP was 138/70 mmHg. Serum levels of sodium, potassium, calcium and thyrotropin were within the normal range. On surgical consultation, a diagnosis of colonic pseudoobstruction was posited and conservative management recommended. The patient was kept fasted and i.v. saline was started. Four hours later, she became …

Flush hypertension during infusion of saline