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John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
Penelope Trimpou, Daniel S Olsson, Olof Ehn, Oskar Ragnarsson
OBJECTIVE: Diabetes insipidus (DI) and primary polydipsia (PP) are characterised by polyuria and polydipsia. It is crucial to differentiate between these two disorders since the treatment is different. The aim of this study was to evaluate the diagnostic value of the short and an extended variant of the water deprivation test (WDT) and of measuring urinary vasopressin (AVP) in patients with polyuria and polydipsia. DESIGN: A retrospective, single-centre study based on WDTs performed between 2004 and 2014 including 104 consecutive patients with the polyuria-polydipsia syndrome...
October 2017: Hormones: International Journal of Endocrinology and Metabolism
Tatsunori Yoshida, Hiroshi Tsujimoto, Takayuki Ichikawa, Shinji Kounami, Hiroyuki Suzuki
Acute lymphoblastic leukemia (ALL) presenting as Fanconi syndrome (FS) is extremely rare. Here, we report a case of ALL presenting as bilateral nephromegaly following FS. A 2-year-old girl was unexpectedly diagnosed with bilateral nephromegaly. After 2 weeks, she developed general fatigue, thirst, and polyuria. Laboratory examinations revealed renal tubular acidosis, hypokalemia, hypophosphatemia, and aminoaciduria, and FS was diagnosed. Replacement of bicarbonate and potassium did not improve her condition...
January 2018: Case Reports in Oncology
J D Adams, Yasuki Sekiguchi, Hyun-Gyu Suh, Adam D Seal, Cameron A Sprong, Tracie W Kirkland, Stavros A Kavouras
PURPOSE: The aim of the present study was to examine the effect of dehydration on exercise performance independently of thirst with subjects blinded of their hydration status. METHODS: Seven male cyclists (weight: 72±9 kg, body fat: 14±6%, VO2peak: 59.4±6 ml[BULLET OPERATOR]kg·min) exercised for 2 hours on a cycle ergometer at 55% VO2peak, in a hot-dry environment (35°C, 30% rh), with a nasogastric (NG) tube under euhydrated - non-thirst (EUH-NT) and dehydrated - non-thirst (DEH-NT) conditions...
March 5, 2018: Medicine and Science in Sports and Exercise
M A Sunil, V S Sunitha, E K Radhakrishnan, M Jyothis
BACKGROUND: Acacia catechu has been widely used in Ayurveda for treating many diseases. Its heartwood extract is used in asthma, cough, bronchitis, colic, diarrhea, dysentery, boils, skin afflictions, sores and for stomatitis. The decoction of heartwood is used for drinking purpose in southern part of India especially in Kerala. OBJECTIVE: The current study was carried out to scientifically evaluate immunomodulatory effects of heartwood extracts of A. catechu in Swiss albino mice...
March 1, 2018: Journal of Ayurveda and Integrative Medicine
Mona N Bahouth, R F Gottesman, S L Szanton
BACKGROUND AND PURPOSE: Hydration status at the time of stroke has been acknowledged as an important determinant in early stroke recovery. However, the diagnosis of dehydration, or more accurately, a volume-contracted state, at the time of stroke is challenging since there are currently no consensus diagnostic criteria. In this systematic review, we gather the available evidence about diagnosis and treatment of dehydration after stroke. METHODS: Studies of hospitalized ischemic stroke patients that reported rates of dehydration from January 1997 to March 2017 were screened for inclusion via a systematic search of PubMed, CINAHL, Cochrane, and Scopus using keywords hydration, dehydration, hemodilution, viscosity, volume status, and thirst...
March 1, 2018: Journal of Neurology
Masahiro Oishi, Yasuhiko Hayashi, Yasuo Sasagawa, Daisuke Kita, Osamu Tachibana, Mitsutoshi Nakada
OBJECTIVES: It is well-known that Rathke's cleft cysts (RCCs) infrequently cause headache, endocrinological dysfunction, and visual disturbance, and in rare cases, cause diabetes insipidus (DI). Although surgical evacuation of the cyst content can result in high rates of symptomatic improvement, not only the treatment efficacy but also the pathophysiology of DI with RCC are undetermined. The aim of this study is to elucidate the underlying mechanisms and outcomes of DI associated with RCCs...
February 21, 2018: Clinical Neurology and Neurosurgery
Korrie Pol, Cees de Graaf, Diederick Meyer, Monica Mars
Oligofructose is a prebiotic dietary fibre obtained from chicory root inulin. Oligofructose supplementation may affect satiety, food intake, body weight and/or body composition. The aim was to examine the efficacy of oligofructose-supplemented granola bars on the following weight management outcomes: satiety, energy intake, body weight and body composition in overweight or obese adults. In all, fifty-five adults with overweight or obesity (thirty-six females/nineteen males; age: 41 (sd 12) years; 90·6 (sd 11·8) kg; BMI: 29·4 (sd 2·6) kg/m2) participated in a parallel, triple-blind, placebo-controlled intervention...
March 1, 2018: British Journal of Nutrition
Vineet Augustine, Sertan Kutal Gokce, Sangjun Lee, Bo Wang, Thomas J Davidson, Frank Reimann, Fiona Gribble, Karl Deisseroth, Carlos Lois, Yuki Oka
Neural circuits for appetites are regulated by both homeostatic perturbations and ingestive behaviour. However, the circuit organization that integrates these internal and external stimuli is unclear. Here we show in mice that excitatory neural populations in the lamina terminalis form a hierarchical circuit architecture to regulate thirst. Among them, nitric oxide synthase-expressing neurons in the median preoptic nucleus (MnPO) are essential for the integration of signals from the thirst-driving neurons of the subfornical organ (SFO)...
February 28, 2018: Nature
Stefano Guarino, Mario Diplomatico, Rosaria Marotta, Anna Pecoraro, Daniela Furlan, Lorenzo Cerrone, Emanuele Miraglia Del Giudice, Cesare Polito, Angela La Manna, Pierluigi Marzuillo
Patients affected by nephrogenic diabetes insipidus (NDI) can present with hypernatremic dehydration, and first-line rehydration schemes are completely different from those largely applied in usual conditions determining a mild to severe hypovolemic dehydration/shock. In reporting the case of a patient affected by NDI and presenting with severe dehydration triggered by acute pharyngotonsillitis and vomiting, we want to underline the difficulties in managing this condition. Restoring the free-water plasma amount in patients affected by NDI may not be easy, but some key points can help in the first line management of these patients: (1) hypernatremic dehydration should always be suspected; (2) even in presence of severe dehydration, skin turgor may be normal and therefore the skinfold recoll should not be considered in the dehydration assessment; (3) decreased thirst is an important red flag for dehydration; (4) if an incontinent patient with NDI appears to be dehydrated, it is important to place the urethral catheter to accurately measure urine output and to be guided in parenteral fluid administration; (5) if the intravenous route is necessary, the more appropriate fluid replenishment is 5% dextrose in water with an infusion rate that should slightly exceed the urine output; (6) the 0...
February 28, 2018: Pediatric Emergency Care
Emmanuel Amabebe, F O Robert, L F O Obika
Pregnancy and lactation are accompanied by an increase in circulating blood volume secondary to a 10 mOsmol/kgH20 decrease in plasma osmolality, decrease in the osmotic threshold for thirst and arginine vasopressin (AVP) release, prolactin-induced AVP, oxytocin and aldosterone release, as well as increased water intake and retention. The increased blood volume as a result of increased thirst; drinking and fluid retention could be beneficial for milk production and secretion during lactation. Furthermore, AVP can directly initiate milk ejection similar to oxytocin by interacting with both vasopressin and oxytocin receptors located in myoepithelial cells of the mammary gland...
December 30, 2017: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
B A Yates, L A Ellis, C L Butts, B P McDermott, K H Williamson, L E Armstrong
OBJECTIVES: Water is an essential nutrient for thermoregulation, metabolism, cognition, and overall physiological homeostatic function. However, aging adults display a blunted thirst mechanism and subsequently have an increased risk for dehydration or hyponatremia. Fluid consumption behaviors are modifiable and the importance of practicing adequate drinking behaviors for aging adults is amplified during exercise. Identification of aging adult's hydration beliefs and how they attain hydration advice could provide valuable information into ways to promote better drinking habits to reduce fluid imbalances...
2018: Journal of Nutrition, Health & Aging
T Kunkhyen, E Perez, M Bass, A Coyne, M J Baum, J A Cherry
In mice, olfaction is crucial for identifying social odors (pheromones) that signal the presence of suitable mates. We used a custom-built olfactometer and a thirst-motivated olfactory discrimination Go/No-Go (GNG) task to ask whether discrimination of volatile odors is sexually dimorphic and modulated in mice by adult sex hormones. Males and females gonadectomized prior to training failed to learn even the initial phase of the task, which involved nose poking at a port in one location obtaining water at an adjacent port...
February 23, 2018: Hormones and Behavior
Ekrem Dere, Anja Ronnenberg, Björn Tampe, Sahab Arinrad, Manuela Schmidt, Elisabeth Zeisberg, Hannelore Ehrenreich
Based on the intellicage paradigm, we have developed a novel cognitive, emotional and social phenotyping battery that permits comprehensive standardized behavioral characterization of mice in an experimenter-independent social setting. Evaluation of this battery in a large number of male and female C57BL/6 wildtype mice, tested in >20 independent cohorts, revealed high reproducibility of the behavioral readouts and may serve as future reference tool. We noticed robust sex-specific differences in general activity, cognitive and emotional behavior, but not regarding preference for social pheromones...
February 20, 2018: Neurobiology of Learning and Memory
Benjamin S Hsiao, Samuel Chigome, Nelson Torto
No abstract text is available yet for this article.
March 2018: Nature Materials
Tamara D Hew-Butler, Christopher Eskin, Jordan Bickham, Mario Rusnak, Melissa VanderMeulen
Clinical medicine defines dehydration using blood markers that confirm hypertonicity (serum sodium concentration ([Na+ ])>145 mmol/L) and intracellular dehydration. Sports medicine equates dehydration with a concentrated urine as defined by any urine osmolality (UOsm) ≥700 mOsmol/kgH2 O or urine specific gravity (USG) ≥1.020. Objective: To compare blood versus urine indices of dehydration in a cohort of athletes undergoing routine screenings. Methods: 318 collegiate athletes (193 female) provided blood and urine samples and asked to rate how thirsty they were on a 10-point visual analogue scale...
2018: BMJ Open Sport & Exercise Medicine
Zhaohai Bai, Michael R F Lee, Lin Ma, Stewart Ledgard, Oene Oenema, Gerard L Velthof, Wenqi Ma, Mengchu Guo, Zhanqing Zhao, Sha Wei, Shengli Li, Xia Liu, Petr Havlík, Jiafa Luo, Chunsheng Hu, Fusuo Zhang
China has an ever-increasing thirst for milk, with a predicted 3.2-fold increase in demand by 2050 compared to the production level in 2010. What are the environmental implications of meeting this demand, and what is the preferred pathway? We addressed these questions by using a nexus approach, to examine the interdependencies of increasing milk consumption in China by 2050 and its global impacts, under different scenarios of domestic milk production and importation. Meeting China's milk demand in a business as usual scenario will increase global dairy-related (China and the leading milk exporting regions) greenhouse gas (GHG) emissions by 35% (from 565 to 764 Tg CO2eq ) and land use for dairy feed production by 32% (from 84 to 111 million ha) compared to 2010, while reactive nitrogen losses from the dairy sector will increase by 48% (from 3...
February 7, 2018: Global Change Biology
F Hughes, S C Ng, M Mythen, H Montgomery
BACKGROUND: Fluid management is a major factor determining perioperative outcome, yet in reality, fluid administration practice is variable. Thirst however, is a highly sensitive and reliable indicator of fluid deficits. We explored the use of thirst sensation to trigger i.v. fluid boluses to guide individualized fluid management. METHODS: We performed a randomised double crossover trial on 16 healthy male volunteers, of mean age 31 yr and BMI 24.4 kg m-2 . Twice, after administrations of oral furosemide (40 mg) and 12 h of oral fluid restriction, participants received a 4-h i...
February 2018: British Journal of Anaesthesia
Claire Gizowski, Cristian Zaelzer, Charles W Bourque
Previous studies have shown that mice housed under 12:12 h light-dark conditions display a pronounced increase in water intake during a 2-hour anticipatory period (AP) near the end of their active period (Zeitgeber Time ZT; ZT21.5-ZT23.5) compared to the preceding basal period (BP, ZT19.5-ZT21.5). This increased water intake during the AP is not associated with physiological stimuli for thirst, such as food intake, hyperosmolality, hyperthermia, or hypovolemia. Denying mice the water intake supplement during the AP causes them to be dehydrated at wake time...
February 5, 2018: Journal of Neuroendocrinology
Yongfeng Wang, Jieting Tang, Tao Han, Huiguo Ding, Weijiang Ye, Maorong Wang, Jun Cheng, Yongping Yang, Chengwei Chen, Qing Xie, Qing Mao, Junqi Niu, Zhenghua Wang, Zhong Wei, Yingxuan Chen, Minde Zeng, Yimin Mao
AIM: To evaluate tolvaptan as a novel therapeutic option for Chinese patients with liver cirrhosis-associated ascites in a phase 2 clinical trial. METHODS: This randomized, double-blind, placebo-controlled, multicenter trial was conducted in patients with insufficient responses to combination therapies of an oral loop diuretic and an aldosterone antagonist. Reduction in body weight and abdominal circumference, increase in 24-h cumulative urine volume, and improvement in serum sodium from baseline to end of treatment in the 15 mg and the 30 mg tolvaptan groups were compared to those in the placebo group...
February 1, 2018: Journal of Digestive Diseases
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