Hypertonic saline versus fluid restriction: The pitfalls in managing acute hyponatremia in a patient with long-standing spinal cord injury.

Spinal cord injury-induced hyponatremia is an under-recognized entity, without a mention in the European hyponatremia guidelines. We present a case of a 56-year-old female quadraplegic patient with cervical cord injury, presenting with severe hyponatremia and tonic-clonic seizures. This case highlights the challenges in medical management; action mechanisms are further discussed.

Subclinical hypothyroidism: Should we treat?

Subclinical hypothyroidism (also known as compensated hypothyroidism or mild hypothyroidism) is a condition associated with a raised serum concentration of thyroid stimulating hormone (TSH) but a normal serum free thyroxine (FT4). It is common, affecting about 10% of women above the age of 55 years. Autoimmunity is the commonest cause of subclinical hypothyroidism.

trans-Chloridobis(4-methyl-pyridine-κN)(4,4',4''-tri-tert-butyl-2,2':6',2''-terpyridine-κN,N',N'')ruthenium(II) hexa-fluoridophosphate acetone monosolvate.

The title compound, [RuCl(C(6)H(7)N)(2)(C(27)H(35)N(3))]PF(6)·C(3)H(6)O, was obtained unintentionally as the product of the reaction of 1,1'-methyl-enebis(4-methyl-pyridinium) hexa-fluoriso-phos-phate and RuCl(3)(tpy*) (tpy* is 4,4',4''-tri-tert-butyl-2,2':6',2''-terpyridine) in the presence of triethyl-amine and LiCl. The mol-ecular structure of the complex displays an octa-hedral geometry around the Ru(II) ion and the unit cell contains an acetone solvent mol-ecule and one orientationally disordered PF(6) (-) anion (occupancy ratio 0.75:0.