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Lower Extremity Amputation for Ischemia

    • Amputations on the foot require normal or near-normal arterial supply to heal.
    • Pulsatile flow into the deep femoral artery is typically adequate to heal a below-the-knee amputation.
    • Prosthetic limb rehabilitation is more likely in case of below-the-knee amputation than above-the-knee amputation.
    • Above-the-knee amputation is preferred in nonfunctional extremities.

Antipsychotics

    • The currently FDA-approved antipsychotics can be divided into two classes: typical antipsychotics and atypical antipsychotics.
    • Antipsychotics are used to treat a variety of psychiatric disorders.
    • Typical antipsychotics are effective for the treatment of positive symptoms, whereas atypical antipsychotics also have an effect on the negative symptoms of schizophrenia.
    • The typical antipsychotics are generally associated more with the side effects of the extrapyramidal movement, whereas the atypical antipsychotics have a higher risk for metabolic adverse effects.
    • Decreasing adverse effects and improving adherence are the goals of treatment with antipsychotic medications.

Disorders of Water and Sodium Balance: Hypernatremia

    • Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
    • Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
    • Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
    • Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement

Disorders of Water and Sodium Balance: Hypernatremia

    • Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
    • Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
    • Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
    • Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement

Disorders of Water and Sodium Balance: Hypernatremia

    • Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
    • Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
    • Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
    • Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement

Sleep Disorders

    • The MSLT is essential in documenting pathologic sleepiness (e.g., sleep-onset latency of less than 8 minutes) and in diagnosing narcolepsy. The presence of two sleep-onset REMs on four or five nap studies and sleep-onset latency of less than 8 minutes strongly suggests a diagnosis of narcolepsy in the context of an appropriate history.
    • RLS is a lifelong sensorimotor neurologic disorder with a severe impact on sleep and quality of life that may begin at any age. RLS is most severe in middle-aged or elderly persons, in whom it has a chronic, progressive course. The overall prevalence of RLS for the adult population has been estimated to be about 7.2%, particularly in those of European descent, but the prevalence of the most severe cases (severe symptoms occurring at least two nights a week) is approximately 2.7%
    • For transient insomnia or insomnia of short duration, treatment with sedative-hypnotics (e.g., zolpidem, zolpidem extended release, zolpidem tartrate sublingual tablets, zaleplon, eszopiclone, or low-dose doxepin) or short- or intermediate-acting benzodiazepines (e.g., temazepam), as well as ramelteon, a melatonin receptor (MT1 and MT3) agonist, for a few nights to a few weeks is appropriate.

Disorders of Water and Sodium Balance: Hypernatremia

    • Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
    • Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
    • Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
    • Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement

Disorders of Water and Sodium Balance: Hypernatremia

    • Hydrochlorothiazide is not beneficial in treating ICU-acquired hypernatremia
    • Hypernatremia after hypertonic saline irrigation is rare, but might cause severe complications
    • Hypercalcemia induces targeted autophagic degradation of aquaporin-2 at the onset of nephrogenic diabetes insipidus
    • Hypernatremia identified as new predictor of worse clinical outcomes after percutaneous endoscopic gastrostomy placement
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