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fluid and electrolyte

Christina Schumann, Michael Faust
BACKGROUND:  Diabetic ketoacidosis and the hyperosmolar hyperglycemic state are the most serious diabetic emergencies. Before the discovery of insulin in 1921 by Banting and Best the diagnosis of type 1 diabetes was fatal ending in diabetic ketoacidosis equivalent to a torturous death. Today, mortality from diabetic ketoacidosis is low at approximately 2 %. But each death from these two acute metabolic complications of diabetes is potentially avoidable by improved patient and healthcare professional education...
March 2018: Deutsche Medizinische Wochenschrift
Emmanuel Ademola Anigilaje
The survival of a child with severe volume depletion at the emergency department depends on the competency of the first responder to recognize and promptly treat hypovolemic shock. Although the basic principles on fluid and electrolytes therapy have been investigated for decades, the topic remains a challenge, as consensus on clinical management protocol is difficult to reach, and more adverse events are reported from fluid administration than for any other drug. While the old principles proposed by Holliday and Segar, and Finberg have stood the test of time, recent systematic reviews and meta-analyses have highlighted the risk of hyponatraemia, and hyponatraemic encephalopathy in some children treated with hypotonic fluids...
2018: Frontiers in Pediatrics
Yang Ji-Hu, Huang Guo-Dong, Ji Tao, Wang Hai-Dong, Liu Yu-Fei, Guo Jian, Li Zhen, Li Wei-Ping
OBJECTIVE: To explore the surgical methods and clinical effect of endoscopic endonasal approaches for the treatment of invasive pituitary adenomas(IPA). METHODS: A retrospective analysis of the clinical data of 74 patients(75 procedures) with invasive pituitary adenomas treated by different endoscopic endonasal approaches at the Department of Neurosurgery, the First Affiliated Hospital of Shenzhen University from May 2014 to August 2017. The data include clinical manifestation, imaging features, surgical methods and complications, resection rate, cure rate, prognosis and complications in different Knosp classifications and Hardy stages...
March 7, 2018: World Neurosurgery
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
Maria-Eleni Roumelioti, Todd S Ing, Helbert Rondon-Berrios, Robert H Glew, Zeid J Khitan, Yijuan Sun, Deepak Malhotra, Dominic S Raj, Emmanuel I Agaba, Glen H Murata, Joseph I Shapiro, Antonios H Tzamaloukas
Osmotic diuresis results from urine loss of large amounts of solutes distributed either in total body water or in the extracellular compartment. Replacement solutions should reflect the volume and monovalent cation (sodium and potassium) content of the fluid lost. Whereas the volume of the solutions used to replace losses that occurred prior to the diagnosis of osmotic diuresis is guided by the clinical picture, the composition of these solutions is predicated on serum sodium concentration and urinary sodium and potassium concentrations at presentation...
March 6, 2018: International Urology and Nephrology
Katja N Adamik, Rafael Obrador, Judith Howard
OBJECTIVE: To evaluate the effects of a 6% hydroxyethyl starch (130/0.42) in either a buffered, electrolyte-balanced (HES-BAL) or saline (HES-SAL) carrier solution on electrolyte concentrations and acid-base parameters in healthy anaesthetized dogs. STUDY DESIGN: Prospective randomised clinical study. ANIMALS: A group of 40 client-owned dogs undergoing general anaesthesia for elective surgical procedures or diagnostic imaging. METHODS: During anaesthesia, dogs were intravenously administered 15 mL kg-1 of either HES-SAL (n = 20) or HES-BAL (n = 20) over 30-40 minutes...
January 11, 2018: Veterinary Anaesthesia and Analgesia
Kwai Lam, Lauren Schwartz, Jennifer Batisti, Kishore R Iyer
BACKGROUND: Teduglutide is a glucagon-like peptide 2 (GLP-2) analog that has been approved for the treatment of adult short bowel syndrome (SBS)-associated intestinal failure (IF; SBS-IF). Teduglutide increases villus height and crypt depth in the small bowel mucosa, promoting nutrition absorption and enteral independence from parenteral nutrition (PN). We aim to report our single-center experience with teduglutide in adult patients with SBS to provide real-world context to its use. METHOD: We conducted a retrospective analysis on patients managed within our tertiary-level intestinal rehabilitation program to identify patients with SBS-IF treated with teduglutide from 2009-2015...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Armin Fashi, Amir Ahmad Salarian, Abbasali Zamani
A novel and efficient device of solvent stir-bar microextraction (SSBME) system coupled with GC-FID detection was introduced for the pre-concentration and determination of malondialdehyde (MDA) in different biological matrices. In the proposed device, a piece of porous hollow fiber was located on a magnetic rotor by using a stainless steel-wire (as a mechanical support) and the whole device could stir with the magnetic rotor in sample solution cell. The device provided higher pre-concentration factor and better precision in comparison with conventional SBME due to the reproducible, stable and high contact area between the stirred sample and the hollow fiber...
May 15, 2018: Talanta
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
Liang Li, Feng-Hua Sun, Wendy Ya-Jun Huang, Stephen Heung-Sang Wong
The purpose of this study was to examine the effects of different amounts of whey protein in carbohydrate-electrolyte (CE) drinks on post-exercise rehydration. Ten males completed 5 trials in a randomised cross-over design. A 4-h recovery was applied after a 60-min run at 65% VO2peak in each trial. During recovery, the participants ingested a high-carbohydrate CE drink (CE-H), a low-carbohydrate CE drink (CE-L), a high-whey-protein (33 g·L-1 ) CE drink (CW-H), a medium-whey-protein (22 g·L-1 ) CE drink (CW-M) or a low-whey-protein (15 g·L-1 ) CE drink (CW-L) in a volume equivalent to 150% of their body mass (BM) loss...
March 1, 2018: European Journal of Sport Science
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
Sabrina Arshed, Michael R Pinsky
Fluids during resuscitation from shock increase mean systemic pressure and venous return. The pressure gradient for venous return must increase. Mean systemic pressure is the amount of vascular space in unstressed and stressed volume, mostly unstressed. Shock states can decrease mean systemic pressure by increasing unstressed volume, decreasing total blood volume, or decreasing the pressure gradient for venous return. Crystalloids across bodily spaces restore normal volume, whereas colloids remain in the intravascular space...
April 2018: Critical Care Clinics
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
Melaine A Kuenemann, Denis Fourches
The With-No-Lysine (WNK) serine/threonine kinase family constitutes a unique and distinctive branch of the kinome. The four proteins of this family (WNK1/2/3/4) are involved in blood pressure regulation, body fluid, and electrolyte homeostasis. Herein, we modeled and analyzed the binding modes of all publicly-available small orthosteric and allosteric binders (including WNK463 and WNK467) experimentally tested towards any of the WNK family member. To do so, we relied on state-of-the-art cheminformatics approaches including structure-based molecular docking and molecular dynamics simulations...
February 23, 2018: Molecular Informatics
Deepak P Dubal, Daniel Rueda-Garcia, Carlos Marchante, Raul Benages, Pedro Gomez-Romero
Solid Hybrid materials abound. But flowing versions of them are new actors in the materials science landscape and in particular for energy applications. This paper presents a new way to deliver nanostructured hybrid materials for energy storage, namely, in the form of nanofluids. We present here the first example of a hybrid electroactive nanofluid (HENFs) combining capacitive and faradaic energy storage mechanisms in a single fluid material. This liquid electrode is composed of reduced graphene oxide and polyoxometalates (rGO-POMs) forming a stable nanocomposite for electrochemical energy storage in novel Nanofluid Flow Cells...
February 22, 2018: Chemical Record: An Official Publication of the Chemical Society of Japan ... [et Al.]
Zhi Yang, Runxiang Yang, Min Ji Kwak, Aiham Qdaisat, Junzhong Lin, Charles E Begley, Cielito C Reyes-Gibby, Sai-Ching Jim Yeung
BACKGROUND: Although cancer patients (CPs) are increasingly likely to visit emergency department (ED), no population-based study has compared the characteristics of CPs and non-cancer patients (NCPs) who visit the ED and examined factors associated with hospitalization via the ED. In this study, we (1) compared characteristics and diagnoses between CPs and NCPs who visited the ED in a cancer center or general hospital; (2) compared characteristics and diagnoses between CPs and NCPs who were hospitalized via the ED in a cancer center or general hospital; and (3) investigated important factors associated with such hospitalization...
2018: PloS One
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
Yuan Zhang, Jianxing Li, Jingyuan Li
Magnesium and its alloys have unique advantages to act as resorbable bone fixation materials, due to their moderate mechanical properties and biocompatibility, which are similar to those of human tissue. However, early resorption and insufficient mechanical strength are the main problems that hinder their application. Herein, the effects of microstructure transformation on the mechanical properties and corrosion performance of Mg-Zn-Mn-Ca were investigated with electrochemical and immersion measurements at 37 °C in a simulated body fluid (SBF)...
February 2, 2018: Journal of the Mechanical Behavior of Biomedical Materials
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