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Fluid an electrolytes

Marco Baldrighi, Pier Paolo Sainaghi, Mattia Bellan, Ettore Bartoli, Luigi Mario Castello
INTRODUCTION: Although hypovolemia remains the most relevant problem during acute decompensated diabetes in its clinical manifestations (diabetic ketoacidosis, DKA, and hyperglycemic hyperosmolar state, HHS), the electrolyte derangements caused by the global hydroelectrolytic imbalance usually complicate the clinical picture at presentation and may be worsened by treatment itself. AIM: This review article is focused on the management of dysnatremias during hyperglycemic hyperosmolar state with the aim of providing clinicians a useful tool to early indentify the sodium derangement in order to address properly its treatment...
March 19, 2018: Current Diabetes Reviews
Ana Margarida Monteiro, Olinda Marques, Sofia Martins, Ana Antunes
The authors report a case of a 15-year-old girl with hypopituitarism due to pituitary stalk interruption syndrome diagnosed in the neonatal period. The patient was admitted to the emergency room with impaired consciousness and hypoglycaemia. The day before, she increased her water intake to about 1.5 L to perform a pelvic ultrasound. In the following hours, she developed vomiting and food refusal. Blood analysis revealed hypoglycaemia, hyponatraemia, decreased serum osmolality and normal urinary density. Hyponatraemia and adrenal crisis were managed with a gradual but slow resolution of consciousness and electrolytic balance...
March 9, 2018: BMJ Case Reports
Tsukasa Ikemura, Katsuhiko Suzuki, Nobuhiro Nakamura, Koichi Yada, Naoyuki Hayashi
PURPOSE: It remains unclear whether rehydration restores retinal blood flow reduced by exhaustive exercise. We investigated the effect of fluid intake on retinal blood flow after exhaustive exercise. METHODS: Blood flow in the inferior (ITRA) and superior temporal retinal arterioles (STRA) was measured before and after incremental cycling exercise until exhaustion in 13 healthy males. After the exercise, the subjects rested without drinking (control condition: CON) or with drinking an electrolyte containing water (rehydrate condition: REH) and were followed up for a period of 120 min...
March 8, 2018: European Journal of Applied Physiology
Denis E Bragin, Gloria L Statom, Edwin M Nemoto
OBJECTIVE: In previous work we showed that high intracranial pressure (ICP) in the rat brain induces a transition from capillary (CAP) to pathological microvascular shunt (MVS) flow, resulting in brain hypoxia, edema, and blood-brain barrier (BBB) damage. This transition was correlated with a loss of cerebral blood flow (CBF) autoregulation undetected by static autoregulatory curves but identified by induced dynamic ICP (iPRx) and cerebrovascular (iCVRx) reactivity. We hypothesized that loss of CBF autoregulation as correlated with MVS flow would be identified by iPRx and iCVRx in traumatic brain injury (TBI) with elevated ICP...
2018: Acta Neurochirurgica. Supplement
Daniela Chlíbková, Pantelis T Nikolaidis, Thomas Rosemann, Beat Knechtle, Josef Bednář
Purpose: Hypohydration and hyperhydration are significant disorders of fluid metabolism in endurance performance; however, little relevant data exist regarding multi-stage endurance activities. The aim of the present study was to examine the effect of running seven marathons in 7 consecutive days on selected anthropometric, hematological and biochemical characteristics with an emphasis on hydration status. Methods: Participants included 6 women and 20 men (age 42.6 ± 6.2 years). Data was collected before day 1 (B1 ) and after day 1 (A1 ), 4 (A4 ), and 7 (A7 )...
2018: Frontiers in Physiology
Henrik Dimke, Jürgen Schnermann
The thick ascending limb (TAL) extends from the border of the inner medulla to the renal cortex, thus ascending through regions with wide differences in tissue solute and electrolyte concentrations. Structural and functional differences between TAL cells in the medulla (mTAL) and the cortex (cTAL) would therefore be useful to adapt TAL transport function to a changing external fluid composition. While mechanisms common to all TAL cells play a central role in the reclamation of about 25% of the NaCl filtered by the kidney, morphological features, Na+ / K+ -ATPase activity, NKCC2 splicing and phosphorylation does vary between segments and cells...
February 24, 2018: Acta Physiologica
Jose Yeste, Laura Martínez-Gimeno, Xavi Illa, Pablo Laborda, Anton Guimerà, Juan P Sánchez-Marín, Rosa Villa, Ignacio Giménez
Transepithelial electrical measurements in the renal tubule have provided a better understanding of how kidney regulates electrolyte and water homeostasis through the reabsorption of molecules and ions (e.g., H2 O and NaCl). While experiments and measurement techniques using native tissue are difficult to prepare and to reproduce, cell cultures conducted largely with the Ussing chamber lack the effect of fluid shear stress which is a key physiological stimulus in the renal tubule. To overcome these limitations, we present a modular perfusion chamber for long-term culture of renal epithelial cells under flow that allows the continuous and simultaneous monitoring of both transepithelial electrical parameters and transepithelial NaCl transport...
February 20, 2018: Biotechnology and Bioengineering
Jie Wang, Chunli Gong, Sheng Wen, Hai Liu, Caiqin Qin, Chuanxi Xiong, Lijie Dong
Poor dispersion and inert ionic conduction are two major obstacles towards using carbon nanotubes (CNTs) to modify polymer electrolyte membranes (PEMs) in energy conversion devices. In this work, solvent-free carbon nanotube fluids (CNT fluids) with liquid-like behavior are prepared through an ion exchange method and incorporated into a chitosan (CS) matrix to fabricate composite membranes. The electrostatic interactions between SO3 - groups in the CNT fluids and NH2 groups in the CS matrix, in addition to the unique flow properties of the CNT fluids, promote the uniform dispersion of CNT fluids in the CS matrix...
April 15, 2018: Carbohydrate Polymers
Jae-Myung Jang, Tae-Eon Park, Seung-Dai Kim, Han-Cheol Choe
The modified surface during implantation is considered to be an effective strategy to improve high adhesion of bone cell and osseointegration activity. In this paper, the TiO2 barrier oxide Layer has been fabricated by using the ion characteristic of an electrolytic solution, the surface characteristics have been investigated by EDS, XPS, and FE-SEM. From the analysis of the chemical states, phosphorus and calcium were observed in the TiO2 barrier layer, which were penetrated from the electrolyte into the oxide layer during deposit process...
March 1, 2018: Journal of Nanoscience and Nanotechnology
Natalie Friedli, Zeno Stanga, Alison Culkin, Martin Crook, Alessandro Laviano, Lubos Sobotka, Reto W Kressig, Jens Kondrup, Beat Mueller, Philipp Schuetz
OBJECTIVES: Refeeding syndrome (RFS) can be a life-threatening metabolic condition after nutritional replenishment if not recognized early and treated adequately. There is a lack of evidence-based treatment and monitoring algorithm for daily clinical practice. The aim of the study was to propose an expert consensus guideline for RFS for the medical inpatient (not including anorexic patients) regarding risk factors, diagnostic criteria, and preventive and therapeutic measures based on a previous systematic literature search...
March 2018: Nutrition
Lindsay B Baker, Corey T Ungaro, Bridget C Sopeña, Ryan P Nuccio, Adam J Reimel, James M Carter, John R Stofan, Kelly A Barnes
This study determined the relations between regional (REG) and whole body (WB) sweating rate (RSR and WBSR, respectively) and REG and WB sweat [Na+] during exercise. Twenty-six recreational athletes (17 men, 9 women) cycled for 90 min while WB sweat [Na+] was measured using the washdown technique. RSR and REG sweat [Na+] were measured from 9 regions using absorbent patches. RSR and REG sweat [Na+] from all regions were significantly (p<0.05) correlated with WBSR (r=0.58-0.83) and WB sweat [Na+] [r=0.74-0...
February 8, 2018: Journal of Applied Physiology
Chenang Lyu, Jianping Wang, Matthew Powell-Palm, Boris Rubinsky
It was recently shown that electrolysis may play a substantial detrimental role in microfluidic electroporation. To overcome this problem, we have developed a non-electrolytic micro/nano electroporation (NEME) electrode surface, in which the metal electrodes are coated with a dielectric. A COMSOL based numerical scheme was used to simultaneously calculate the excitation frequency and dielectric material properties dependent electric field delivered across the dielectric, fluid flow, electroporation field and Clausius-Mossotti factor for yeast and E...
February 6, 2018: Scientific Reports
G Ramsay, A Baggaley, P G Vaughan Shaw, E Soltanmohammadi, N Ventham, Ng Guat Shi, R Pearson, S R Knight, C T Forde, N Moore, J Kilkenny, K D Clement, M Kumar
AIMS: Intravenous (IV) fluid administration continues to be a mainstay of care in General Surgery. Yet if they are prescribed incorrectly significant morbidity including electrolyte abnormalities, renal impairment and cardiac failure can develop. Despite this, it is frequently the responsibility of the most junior staff to prescribe IV fluids. We aim to analyse the understanding of IV fluid prescribing amongst junior doctors and to describe variability in clinical practice. METHODS: We undertook a multicentre questionnaire study...
January 31, 2018: International Journal of Surgery
Mohamad Hasyizan Hassan, Wan Mohd Nazaruddin Wan Hassan, Rhendra Hardy Mohd Zaini, Wan Fadzlina Wan Muhd Shukeri, Huda Zainal Abidin, Chong Soon Eu
Background: Normal saline (NS) is a common fluid of choice in neurosurgery and neuro-intensive care unit (ICU), but it does not contain other electrolytes and has the potential to cause hyperchloremic metabolic acidosis with prolonged infusion. These problems may be reduced with the availability of balanced fluid (BF), which becomes a more physiological isotonic solution with the presence of complete electrolyte content. This study aimed to compare the changes in electrolytes and acid-base between NS and BF (Sterofundin® ISO) therapy for post-operative severe traumatic brain injury (TBI) patients in neuro-ICU...
October 2017: Malaysian Journal of Medical Sciences: MJMS
Yuchen Guo, Liang He, Yiming Liu, Xueyuan Cao
RATIONALE: Paralytic ileus is characterized by the signs and symptoms of intestinal obstruction but without any mechanical lesions in the intestinal lumen. Several medical and surgical conditions can lead to this ailment, such as electrolyte disturbances that impair intestinal motility. However, hypercalcemia secondary to multiple myeloma as a major cause of paralytic ileus has rarely been reported. PATIENT CONCERNS: The patient got severe constipation with difficulty in the passage of both gas and feces for 7 days...
December 2017: Medicine (Baltimore)
Weiwei Jiang, Jie Zhang, Xiaofeng Lv, Xiaoqun Xu, Qiming Geng, Weibing Tang
BACKGROUND AND OBJECTIVES: The stoma of intermediate position enterostomy (IPE) often leads to high output, which is related to electrolyte abnormalities, and prolongs patient recovery post-operatively. The continuous nasogastric tube feeding method has the advantage of reducing the risk of feeding intolerance, and improves nutrient absorption. In the current study, we review our experience with continuous tube feeding and compare the clinical outcomes with intermittent oral feeding in patients with an IPE post-operatively...
2018: Asia Pacific Journal of Clinical Nutrition
R Ariel Gomez, Maria Luisa S Sequeira-Lopez
An accumulating body of evidence suggests that renin-expressing cells have developed throughout evolution as a mechanism to preserve blood pressure and fluid volume homeostasis as well as to counteract a number of homeostatic and immunological threats. In the developing embryo, renin precursor cells emerge in multiple tissues, where they differentiate into a variety of cell types. The function of those precursors and their progeny is beginning to be unravelled. In the developing kidney, renin-expressing cells control the morphogenesis and branching of the renal arterial tree...
January 30, 2018: Nature Reviews. Nephrology
Philip B Miner
Uroguanylin interacting with intestinal Guanylate Cyclase C (GC-C) receptors plays an important role in gastrointestinal fluid and electrolyte homeostasis. Plecanatide is the first uroguanylin analog that stimulates GC-C receptors on gastrointestinal mucosa with pH-sensitive receptor binding. Binding to the GC-C receptor activates intracellular conversion of GTP to cGMP resulting in the stimulation of intestinal fluid secretion. Areas covered: Herein, all published research regarding the development of and clinical experience with plecanatide is reviewed...
January 29, 2018: Expert Opinion on Pharmacotherapy
Vaka K Sigurjonsdottir, Swasti Chaturvedi, Cherry Mammen, Scott M Sutherland
Acute kidney injury (AKI) is characterized clinically as an abrupt decline in renal function marked by reduced excretion of waste products, disordered electrolytes, and disrupted fluid homeostasis. The recent development of a standardized AKI definition has transformed our understanding of AKI epidemiology and outcomes. We now know that in the short term, children with AKI experience greater morbidity and mortality; additionally, observational studies have established that chronic renal sequelae are far more common after AKI events than previously realized...
January 26, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Florian Simon, Alexander Oberhuber, Nikolaos Floros, Albert Busch, Markus Udo Wagenhäuser, Hubert Schelzig, Mansur Duran
Acute ischemia of an extremity occurs in several stages, a lack of oxygen being the primary contributor of the event. Although underlying patho-mechanisms are similar, it is important to determine whether it is an acute or chronic event. Healthy tissue does not contain enlarged collaterals, which are formed in chronically malperfused tissue and can maintain a minimum supply despite occlusion. The underlying processes for enhanced collateral blood flow are sprouting vessels from pre-existing vessels (via angiogenesis) and a lumen extension of arterioles (via arteriogenesis)...
January 26, 2018: International Journal of Molecular Sciences
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