Lege Artis Medicinae

[The First Mindfulness Conference in Hungary ]

BRYS Zoltán, KIS János Tibor, SIMONCSICS Eszter

SEPTEMBER 20, 2018

Lege Artis Medicinae - 2018;28(08-09)

[Those familiar with psychology are no strangers to the here-and-now attention exercises Wilhelm Reich asked his clients to allow the present moment to be observed. The here-and-now focus later become the focus of neo- and postreichian movements and a number of other psychotherapeutic movements too. Among the analysts Jung, Horney and Fromm showed a interest in the present-focused Zen Buddhist practices...]

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[Hyponatraemia (serum sodium concentration < 136 mmol/l) is the most frequent electrolyte abnormality that inceases the risk of both in-hospital, and outpatient mortality. Antidiuretic hormone action or low glomerular fitration rate or low excretable osmoles or their combination are involved in its pathogenesis. Differential diagnosis is based on medical and medication histories, serum- and urine osmolality and urine sodium concentration. Measurement of fractional excretions of urea and uric acid help identifying low effective circulting volume, renal hypoperfusion. Symptomatic hyponatraemia or an acute decrease of serum sodium concentration exceeding 10 mmol/l should be treated with 3% NaCl to avoid impending threat to life. The principles of the treatment of chronic hyponatraemia are restriction of water intake and elimination of etiologic factor(s) (eg. medications - most often thiazides). In case of contracted axtracellular volume, isotonic saline should be given. In case of euvolaemia, restriciton of water intake is fundamental. In case of expanded extracellular volume, (heart failure, liver cirrhosis, nephrosis), water and NaCl intake should be restricted along with aldosteron antagonist and loop diuretic therapy. In chronic hyponatraemia, the rise of serum sodium concentration should not exceed 10 mmol/l during the first 24 hours and 8 mmol/l/day thereafter. ]

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