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Fluid balance physiology

Robert Sümpelmann, Karin Becke, Sebastian Brenner, Christian Breschan, Christoph Eich, Claudia Höhne, Martin Jöhr, Franz-Josef Kretz, Gernot Marx, Lars Pape, Markus Schreiber, Jochen Strauss, Markus Weiss
This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1-2...
October 17, 2016: Paediatric Anaesthesia
Ashima Sharma, Monu Yadav, B Rajesh Kumar, P Sai Lakshman, Raju Iyenger, Gopinath Ramchandran
BACKGROUND: A major change in anesthesia practice as regards to intraoperative infusion therapy is the present requirement. Switching over to balanced fluids can substantially decrease the incidence of lactic acidosis and hyperchloremic acidosis. The deleterious effects of unbalanced fluids are more recognizable during major surgeries. We prospectively studied the influence of Sterofundin (SF) and Ringer lactate (RL) on acid-base changes, hemodynamics, and readiness for extubation during scoliosis surgery...
September 2016: Anesthesia, Essays and Researches
Farron L McIntee, Patrizia Giannoni, Steven Blais, George Sommer, Thomas A Neubert, Agueda Rostagno, Jorge Ghiso
Amyloid β (Aβ) is the major constituent of the brain deposits found in parenchymal plaques and cerebral blood vessels of patients with Alzheimer's disease (AD). Several lines of investigation support the notion that synaptic pathology, one of the strongest correlates to cognitive impairment, is related to the progressive accumulation of neurotoxic Aβ oligomers. Since the process of oligomerization/fibrillization is concentration-dependent, it is highly reliant on the homeostatic mechanisms that regulate the steady state levels of Aβ influencing the delicate balance between rate of synthesis, dynamics of aggregation, and clearance kinetics...
2016: Frontiers in Aging Neuroscience
Morag K Mansley, Jessica R Ivy, Matthew A Bailey
Hypertension is known as the "silent killer," driving the global public health burden of cardiovascular and renal disease. Blood pressure homeostasis is intimately associated with sodium balance and the distribution of sodium between fluid compartments and within tissues. On a population level, most societies consume 10 times more salt that the 0.5 g required by physiological need. This high salt intake is strongly linked to hypertension and to the World Health Organization targeting a ∼30% relative reduction in mean population salt intake to arrest the global mortality due to cardiovascular disease...
September 2016: KI Rep
Hiroko Nishimura
Renin substrate, biological renin activity, and/or renin-secreting cells in kidneys evolved at an early stage of vertebrate phylogeny. Angiotensin (Ang) I and II molecules have been identified biochemically in representative species of all vertebrate classes, although variation occurs in amino acids at positions 1, 5, and 9 of Ang I. Variations have also evolved in amino acid positions 3 and 4 in some cartilaginous fish. Angiotensin receptors, AT1 and AT2 homologues, have been identified molecularly or characterized pharmacologically in nonmammalian vertebrates...
October 7, 2016: Anatomical Science International
Timo Sturm, Julia Leiblein, Verena Schneider-Lindner, Thomas Kirschning, Manfred Thiel
PURPOSE: Clinically unapparent microcirculatory impairment is common and has a negative impact on septic shock, but specific therapy is not established so far. This prospective observational study aimed at identifying candidate parameters for microcirculatory-guided hemodynamic therapy. CLINICALTRIALSGOV: NCT01530932. MATERIALS AND METHODS: Microcirculatory flow and postcapillary venous oxygen saturation were detected during vaso-occlusive testing (VOT) on days 1 (T0), 2 (T24), and 4 (T72) in 20 patients with septic shock at a surgical intensive care unit using a laser Doppler spectrophotometry system (O2C)...
September 29, 2016: Journal of Intensive Care Medicine
Débora Alvares Leite Figueiredo, Paola Cristina Branco, Douglas Amaral Dos Santos, Andrews Krupinski Emerenciano, Renata Stecca Iunes, João Carlos Shimada Borges, José Roberto Machado Cunha da Silva
The rising concentration of atmospheric CO2 by anthropogenic activities is changing the chemistry of the oceans, resulting in a decreased pH. Several studies have shown that the decrease in pH can affect calcification rates and reproduction of marine invertebrates, but little attention has been drawn to their immune response. Thus this study evaluated in two adult tropical sea urchin species, Lytechinus variegatus and Echinometra lucunter, the effects of ocean acidification over a period of 24h and 5days, on parameters of the immune response, the extracellular acid base balance, and the ability to recover these parameters...
September 17, 2016: Aquatic Toxicology
Bart Leemans, Bart M Gadella, Tom Arjun Edgar Stout, Catharina De Schauwer, Hilde Maria Nelis, Maarten Hoogewijs, Ann Van Soom
In contrast to man and many other mammalian species, conventional in vitro fertilization (IVF) with horse gametes is not reliably successful. The apparent inability of stallion spermatozoa to penetrate the zona pellucida in vitro is most likely due to incomplete activation of spermatozoa (capacitation) as a result of inadequate capacitating or fertilizing media. In vivo, the oviduct and its secretions provide a micro-environment that does reliably support and regulate interaction between the gametes. This review focuses on equine sperm-oviduct interaction...
September 20, 2016: Reproduction: the Official Journal of the Society for the Study of Fertility
Rachael M Heuer, Kathleen M Munley, Nafis Narsinghani, Jessica A Wingar, Theresa Mackey, Martin Grosell
Most marine teleosts defend blood pH during high CO2 exposure by sustaining elevated levels of HCO3(-) in body fluids. In contrast to the gill, where measures are taken to achieve net base retention, elevated CO2 leads to base loss in the intestine of marine teleosts studied to date. This loss is thought to occur through transport pathways previously demonstrated to be involved with routine osmoregulation in marine teleosts. The main objective of this study was to characterize the intestinal transport physiology of the gulf toadfish (Opsanus beta) when exposed to varied levels of CO2: control, 5,000, 10,000, and 20,000 μatm CO2 (0...
September 2016: Physiological and Biochemical Zoology: PBZ
Romina Russi, María Inés García, Paulina Vignatti, María Florencia Veiga, Mónica Hebe Vazquez-Levin, Carolina Veaute
The immune response has relevant physiological functions both in the male and female reproductive system, and must be tightly controlled to achieve a successful pregnancy. Several immune factors have been related to infertility, among them humoral and cellular immune responses triggered by sperm antigens. The present study was aimed at evaluating the immune profile induced by DNA immunization against the sperm protease proacrosin in CF1 male mice and its effect upon fertility. Immunized animals exhibited higher anti-proacrosin antibodies levels than controls (indirect ELISA), both in serum (p<0...
August 16, 2016: Journal of Reproductive Immunology
Brij Verma, Nora Luethi, Luca Cioccari, Patryck Lloyd-Donald, Marco Crisman, Glenn Eastwood, Neil Orford, Craig French, Rinaldo Bellomo, Johan Martensson
BACKGROUND: Normal saline (NS) is the most commonly used crystalloid solution worldwide but contains an excess of chloride and may cause metabolic acidosis and hyperchloraemia. Such abnormalities may be attenuated by the use of a balanced solution such as Plasma-Lyte 148 (PL-148). OBJECTIVE: To assess the feasibility, safety and biochemical and physiological effects of resuscitation with NS versus PL-148 in critically ill patients. DESIGN, SETTING AND PARTICIPANTS: An exploratory, multicentre, doubleblind, randomised controlled trial involving patients aged ≥ 18 years who were prescribed crystalloid fluid resuscitation by the treating clinician between 16 July and 22 October 2015, in three multidisciplinary intensive care units in Melbourne, Victoria, Australia...
September 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Roberto De Simone, Angelo Ranieri, Vincenzo Bonavita
Two critical functions for the control of intracranial fluids dynamics are carried on the venous side of the perfusion circuit: the first is the avoidance of cortical veins collapse during the physiological increases of cerebrospinal fluid (CSF) pressure in which they are immersed. The second, is the generation of an abrupt venous pressure drop at the confluence of the cortical veins with the dural sinuses that is required to allow a CSF outflow rate balanced with its production. There is evidence that both of these effects are ensured by a Starling resistor mechanism (a fluid dynamic construct that governs the flow in collapsible tubes exposed to variable external pressure) acting at the confluence of cortical veins in the dural sinus...
September 6, 2016: Panminerva Medica
Carla Bizzarri, Stefania Pedicelli, Marco Cappa, Stefano Cianfarani
In newborns and infants, dehydration and salt wasting represent a relatively common cause of admission to hospital and may result in life-threatening complications. Kidneys are responsible for electrolyte homoeostasis, but neonatal kidneys show low glomerular filtration rate and immaturity of the distal nephron, leading to reduced ability to concentrate urine. High extrarenal fluid losses often contribute to the increased occurrence of electrolyte disorders. Aldosterone is essential for sodium retention in the kidney, salivary glands, sweat glands and colon...
September 7, 2016: Hormone Research in Pædiatrics
Veronika Baresova, Matyas Krijt, Vaclava Skopova, Olga Souckova, Stanislav Kmoch, Marie Zikanova
Purines are essential molecules for nucleic acid synthesis and are the most common carriers of chemical energy in all living organisms. The cellular pool of purines is maintained by the balance between their de novo synthesis (DNPS), recycling and degradation. DNPS includes ten reactions catalysed by six enzymes. To date, two genetically determined disorders of DNPS enzymes have been described, and the existence of other defects manifested by neurological symptoms and the accumulation of DNPS intermediates in bodily fluids is highly presumable...
August 24, 2016: Molecular Genetics and Metabolism
Horacio J Adrogué, Nicolaos E Madias
The physiologic approach has long been used in assessing acid-base status. This approach considers acids as hydrogen ion donors and bases as hydrogen ion acceptors and the acid-base status of the organism as reflecting the interaction of net hydrogen ion balance with body buffers. In the physiologic approach, the carbonic acid/bicarbonate buffer pair is used for assessing acid-base status and blood pH is determined by carbonic acid (ie, Paco2) and serum bicarbonate levels. More recently, the physicochemical approach was introduced, which has gained popularity, particularly among intensivists and anesthesiologists...
August 30, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Aghogho Odudu, Christopher W McIntyre
Cardiac dysfunction is a key factor in the high morbidity and mortality rates seen in hemodialysis (HD) patients. Much of the dysfunction is manifest as adverse changes in cardiac and vascular structure prior to commencing dialysis. This adverse vascular remodeling arises as a dysregulation between pro- and antiproliferative signaling pathways in response to hemodynamic and nonhemodynamic factors. The HD procedure itself further promotes cardiomyopathy by inducing hypotension and episodic regional cardiac ischemia that precedes global dysfunction, fibrosis, worsening symptoms, and increased mortality...
August 24, 2016: Seminars in Dialysis
Aruna Sharma, Preeti Menon, Dafin F Muresanu, Asya Ozkizilcik, Z Ryan Tian, José V Lafuente, Hari Sharma
The BBB is a physiological regulator of transport of essential items from blood to brain for the maintenance of homeostasis of the central nervous system (CNS) within the narrow limit. The BBB is also responsible for export of harmful or metabolic products from brain to blood to keep the fluid microenvironment of the CNS healthy. However, following any noxious insult to the brain caused by trauma, ischemia or environmental/chemical toxins the function of the BBB is altered to small as well as to large molecules e...
August 19, 2016: CNS & Neurological Disorders Drug Targets
Yiyun Lou, Fan Zhang, Yuqin Luo, Liya Wang, Shisi Huang, Fan Jin
The ubiquitously expressed serum and glucocorticoid regulated kinase 1 (SGK1) is tightly regulated by osmotic and hormonal signals, including glucocorticoids and mineralocorticoids. Recently, SGK1 has been implicated as a signal hub for the regulation of sodium transport. SGK1 modulates the activities of multiple ion channels and carriers, such as epithelial sodium channel (ENaC), voltage-gated sodium channel (Nav1.5), sodium hydrogen exchangers 1 and 3 (NHE1 and NHE3), sodium-chloride symporter (NCC), and sodium-potassium-chloride cotransporter 2 (NKCC2); as well as the sodium-potassium adenosine triphosphatase (Na⁺/K⁺-ATPase) and type A natriuretic peptide receptor (NPR-A)...
2016: International Journal of Molecular Sciences
Masoud Mokhtari, Hamide Vahid
BACKGROUND: Salt in Iranian medical sources is mentioned as Malh and has a special place in people's nutrition. The purpose of this study was to investigate the effect of correct use of salt on health and disease prevention in the context of Iranian medicine and its comparison with modern medicine. METHODS: This article reviews Iranian medicine references on the usage of salt and its benefits. Additionally, modern medicine references were searched to identify the dos and don'ts of salt consumption...
May 2016: Iranian Journal of Medical Sciences
Helen Williams
It is proposed that negative central nervous system (CNS) pressure is one of the filling mechanisms of the fluid spaces of the CNS. Negative CNS pressure is caused by the combination of gravitational force and body movement. The venous system imposes pressure fluctuations on the CNS due to changes in posture and body cavity pressure. It is proposed here that filling of veins, arteries and cerebrospinal (CSF) spaces are all assisted by negative CNS pressure. Hyperemia in the CNS in response to pressure changes with movement was described in the first part of this hypothesis...
September 2016: Medical Hypotheses
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