Physiological and molecular changes of onion (Allium cepa L.) seeds under different aging conditions.

BACKGROUND: Onion seeds have limited storage capacity compared to other vegetable seeds. It is crucial to identify the mechanisms that induce tolerance to storage conditions and reduce seed deterioration. To address this goal, an experiment was conducted to evaluate changes in germination, biochemical, physiological, and molecular characteristics of onion seed landraces (Horand, Kazerun landraces and Zargan cultivar) at different aging levels (control, three-days and six-days accelerated aging, and natural aging for one year). RESULTS: The findings suggest that there was an increase in glucose, fructose, total sugar, and electrolyte leakage in the Horand (HOR), Kazerun (KAZ) landraces, and Zarghan (ZAR) cultivar, with Kazerun exhibiting the greatest increase. The percentage and rate of germination of Kazerun decreased by 54% and 33%, respectively, in six-day accelerated aging compared to the control, while it decreased by 12% and 14%, respectively, in Horand. Protein content decreased with increasing levels of aging, with a decrease of 26% in Kazerun landrace at six days of aging, while it was 16% in Horand landrace. The antioxidant activities of catalase, superoxide dismutase, and glutathione peroxidase decreased more intensively in Kazerun. The expression of AMY1, BMY1, CTR1, and NPR1 genes were lower in Kazerun landraces than in Horand and Zargan at different aging levels. CONCLUSIONS: The AMY1, BMY1, CTR1, and NPR1 genes play a pivotal role in onion seed germination, and their downregulation under stressful conditions has been shown to decrease germination rates. In addition, the activity of CAT, SOD, and GPx enzymes decreased by seed aging, and the amount of glucose, fructose, total sugar and electrolyte leakage increased, which ultimately led to seed deterioration. Based on the results of this experiment, it is recommended to conduct further studies into the molecular aspects involved in onion seed deterioration. More research on the genes related to this process is suggested, as well as investigating the impact of different priming treatments on the genes expression involved in the onion seed aging process.

[Improved quality of stored packed red blood cells by mechanical rinsing]. / Verbesserte Qualität gelagerter Erythrozytenkonzentrate durch maschinelle Autotransfusion.

BACKGROUND: The transfusion of packed red blood cells (PRBC) is associated with various side effects, including storage damage to PRBCs. The cells change their structure, releasing potassium as well as lactate. Mechanical rinsing, available in many hospitals, is able to remove toxic substances and possibly minimizes the negative side effects of transfusion. OBJECTIVE: The primary aim of our study was to improve the quality of PRBCs before transfusion. The effects of different washing solutions on PRBC quality were analyzed. MATERIAL AND METHODS: This in vitro study compares 30 mechanically washed PRBCs. They were either processed with standard normal saline 0.9% (n = 15, N group) or a hemofiltration solution containing 4 mmol/l potassium (n = 15, HF group) by a mechanical rinsing device (Xtra, LivaNova, Munich, Germany). A subgroup analysis was performed based on the storage duration of the processed PRBCs (7, 14, 37 days). Samples were taken before washing (EKprä), immediately after washing (EKpost) and 10 h later (EKpost10h), after storage in the "wash medium" at room temperature. Concentrations of ATP (probability of survival in transfused erythrocytes), lactate, citrate and electrolytes (potassium, sodium, chloride, calcium) were tested. RESULTS AND CONCLUSION: Mechanical rinsing improves pretransfusion quality of PRBC. Washing with a hemofiltration solution results in a more physiological electrolyte composition. Even 10 h after mechanical rinsing with a hemofiltration solution, the quality of 37-day-old PRBC is comparable to young PRBC that have been stored for 7 days and have not been washed. Washing stored PRBC increases the ATP content, which subsequently leads to an increased probability of survival of red cells after transfusion.

Molecular Basis, Diagnostic Challenges and Therapeutic Approaches of Bartter and Gitelman Syndromes: A Primer for Clinicians.

Gitelman and Bartter syndromes are rare inherited diseases that belong to the category of renal tubulopathies. The genes associated with these pathologies encode electrolyte transport proteins located in the nephron, particularly in the Distal Convoluted Tubule and Ascending Loop of Henle. Therefore, both syndromes are characterized by alterations in the secretion and reabsorption processes that occur in these regions. Patients suffer from deficiencies in the concentration of electrolytes in the blood and urine, which leads to different systemic consequences related to these salt-wasting processes. The main clinical features of both syndromes are hypokalemia, hypochloremia, metabolic alkalosis, hyperreninemia and hyperaldosteronism. Despite having a different molecular etiology, Gitelman and Bartter syndromes share a relevant number of clinical symptoms, and they have similar therapeutic approaches. The main basis of their treatment consists of electrolytes supplements accompanied by dietary changes. Specifically for Bartter syndrome, the use of non-steroidal anti-inflammatory drugs is also strongly supported. This review aims to address the latest diagnostic challenges and therapeutic approaches, as well as relevant recent research on the biology of the proteins involved in disease. Finally, we highlight several objectives to continue advancing in the characterization of both etiologies.

Ionic homeostasis, acid-base balance and the risk of citrate accumulation in patients after cardiovascular surgery treated with continuous veno-venous haemofiltration with post-dilution regional citrate anticoagulation - An observational case-control study.

BACKGROUND: Patients after cardiovascular surgery, requiring renal replacement therapy, can benefit from adequate non-heparin circuit anticoagulation. Simplified regional citrate anticoagulation (RCA) protocol proposes the use of citric acid dextrose formula A (ACD-A) during post-dilutional continuous veno-venous hemofiltration (CVVH) with standard bicarbonate buffered calcium containing replacement solution. Citrate accumulation diagnosed upon total to ionized calcium ratio (tCa/iCa) and low ionized calcium (iCa) are considered as the biggest risks related to regional citrate accumulation. METHODS: This prospective observational case-control study evaluated electrolyte and acid-base homeostasis in cardiovascular surgery patients treated with post-dilution CVVH with a simplified RCA protocol with ACD-A. In total, 50 consecutive cardiovascular surgery patients were evaluated. Base excess, pH, bicarbonate, lactate, Na+, Cl-, Mg++, and inorganic phosphate concentrations, the total to ionized calcium ratio (tCa/iCa), and high anion gap metabolic acidosis were assessed during haemofiltration treatment in survivors and non-survivors. RESULTS: Thirty-three (66%) patients died. The therapies were very well balanced in sodium and chloride homeostasis. The lactate concentration and anion gap decreased during CVVH sessions lasting longer than 72 hours, but no inter-group difference was observed. The tCa/iCa ratio exceeded 4.5% and was significantly higher in non-survivors (p=0.037). Initial lactate concentration did not correlate with tCa/iCa ratio during haemofiltration. Magnesium and phosphate concentrations decreased and additional supplementation with magnesium was necessary. The magnesium concentration was lower in the non-survivors. CONCLUSIONS: The incidence of citrate accumulation exceeded 4% and was significantly higher in non-survivors. Supplementation with magnesium and phosphate ions is needed in CVVH with RCA.

Effects of two-dose intravenous administration of furosemide on clinical variables, electrocardiographic indices and serum electrolytes in dromedary calves.

The intravenous (IV) usage of diuretic agents such as furosemide may cause changes in clinical signs, electrocardiographic (ECG) indices and serum electrolytes (sodium, potassium, chloride, calcium, phosphorus and magnesium) concentrations in dromedary calves. The purpose of this study was to evaluate the clinical, ECG and biochemical effects of two-dose IV administration of furosemide in dromedary calves. A total of 21 clinically healthy male dromedary calves with the age of 5 (± 1) months and weight of 95 (± 5) kg were studied. The animals were randomly divided into three groups of control (normal saline), low-dose furosemide (2.5 mg/kg) and high-dose furosemide (5 mg/kg). Two IV injections with 12-hr intervals were administered in all animals. The clinical and ECG parameters were measured at 0 (baseline), 2 (T2), 24 (T24) and 48 (T48) hours after drug administration. Serum concentrations of electrolytes were measured at T0, T24 and T48 hr. The results of this study showed no changes in clinical parameters (heart rate, rectal temperature, respiratory rate and Unruminal motility), ECG indices and also no significant changes in serum electrolytes levels. Under conditions with free access to fresh water, two-dose IV injection of furosemide (2.5 and 5 mg/kg) could be administered in healthy dromedary calves.

The effect of nutritional education program on quality of life and serum electrolytes levels in hemodialysis patients: A single-blind randomized controlled trial.

OBJECTIVE: To determine the effect of nutrition education program on hemodialysis patients' quality of life (QoL) and serum electrolytes levels. METHODS: This study was a randomized controlled trial in which 94 eligible hemodialysis patients were randomly assigned to intervention (n = 48) and control (n = 46) groups. In the intervention group, the patients were trained in healthy nutrition for four weeks. After two months, samples of both groups completed the Kidney Disease Quality of Life Instrument (KDQOL) and Na, K, P, Ca and Mg levels were also measured and compared. RESULTS: There were no significant differences in QoL scores and electrolytes between the two groups before intervention (p > 0.05). After intervention the QoL scores in the intervention group were significantly higher than in the control group (p < 0.05). However, after intervention the levels of Na, K, P and Mg in the intervention group were significantly lower than in the control group (p < 0.05). Calcium level was not significantly different between the two groups after intervention (p = 0.16). CONCLUSION: The results showed that e-learning is effective in improving the QoL and serum electrolytes of hemodialysis patients. PRACTICE IMPLICATIONS: This paper could serve as support for clinical healthcare professionals to improve patient knowledge and QoL through virtual education methods.

In silico Design, Virtual Screening and Synthesis of Novel Electrolytic Solvents.

We report the building, validation and release of QSPR (Quantitative Structure Property Relationship) models aiming to guide the design of new solvents for the next generation of Li-ion batteries. The dataset compiled from the literature included oxidation potentials (Eox ), specific ionic conductivities (κ), melting points (Tm ) and boiling points (Tb ) for 103 electrolytes. Each of the resulting consensus models assembled 9-19 individual Support Vector Machine models built on different sets of ISIDA fragment descriptors.(1) They were implemented in the ISIDA/Predictor software. Developed models were used to screen a virtual library of 9965 esters and sulfones. The most promising compounds prioritized according to theoretically estimated properties were synthesized and experimentally tested.

Characterization of the Human Skeletal Muscle Metabolome for Elucidating the Mechanisms of Bicarbonate Ingestion on Strenuous Interval Exercise.

Bicarbonate has long been touted as a putative ergogenic aid that improves exercise performance and blood buffering capacity during strenuous exercise. However, the underlying mechanisms of action of bicarbonate intake on skeletal muscle metabolism have yet to be fully elucidated. Herein, we apply two orthogonal analytical platforms for nontargeted profiling of metabolites and targeted analysis of electrolytes from mass-limited muscle tissue biopsies (∼2 mg dried mass) when multisegment injection-capillary electrophoresis-mass spectrometry (MSI-CE-MS) and CE with indirect UV detection are used, respectively. Seven untrained men performed a standardized bout of high-intensity interval exercise trial following either bicarbonate (0.40 g/kg) or placebo ingestion in a double-blinded, placebo-controlled, crossover study design, where paired skeletal muscle tissue and plasma specimens were collected at three time intervals at rest, postexercise, and recovery. Optimization of a quantitative microextraction procedure was first developed for lyophilized tissue prior to characterization of the human muscle metabolome, which resulted in the identification and quantification of more than 80 polar/ionic metabolites reliably (CV < 30%) detected in a majority (>75%) of samples with quality control. Complementary univariate and multivariate statistical methods were used to identify biomarkers associated with strenuous exercise and/or bicarbonate treatment responses, whereas structural elucidation of biologically significant intramuscular metabolites was performed using high-resolution MS/MS. Importantly, bicarbonate ingestion prior to strenuous interval exercise was found to elicit a modest treatment effect ( p < 0.05) in comparison to placebo on metabolic pathways associated with ionic homeostasis (potassium), purine degradation (uric acid), and oxidative stress as regulated by glutathione metabolism (oxidized mixed glutathione disulfide) and histidine-containing dipeptides (anserine) within muscle tissue that was distinctive from dynamic metabolic changes measured in circulation. This work provides deeper biochemical insights into the effect of acute alkalosis in preserving contracting muscle function during high-intensity exercise, which is also applicable to the study of muscle-related pathologies relevant to human health and aging.

Single measurement detection of individual cell ionic oscillations using an n-type semiconductor - electrolyte interface.

Pollen tubes are used as models in studies on the type of tip-growth in plants. They are an example of polarised and rapid growth because pollen tubes are able to quickly invade the flower pistil in order to accomplish fertilisation. How different ionic fluxes are perceived, processed or generated in the pollen tube is still not satisfactorily understood. In order to measure the H+, K+, Ca2+ and Cl- fluxes of a single pollen tube, we developed an Electrical Lab on a Photovoltaic-Chip (ELoPvC) on which the evolving cell was immersed in an electrolyte of a germination medium. Pollen from Hyacinthus orientalis L. was investigated ex vivo. We observed that the growing cell changed the (redox) potential in the medium in a periodic manner. This subtle measurement was feasible due to the effects that were taking place at the semiconductor-liquid interface. The experiment confirmed the existence of the ionic oscillations that accompany the periodic extension of pollen tubes, thereby providing - in a single run - the complete discrete frequency spectrum and phase relationships of the ion gradients and fluxes, while all of the metabolic and enzymatic functions of the cell life cycle were preserved. Furthermore, the global 1/fα characteristic of the power spectral density, which corresponds to the membrane channel noise, was found.

Evaluation of Aristolochia indica L. and Piper nigrum L. methanol extract against centipede Scolopendra moristans L. using Wistar albino rats and screening of bioactive compounds by high pressure liquid chromatography: a polyherbal formulation.

The present study was aimed to explore the anti-venom activity of Aristolochia indica and Piper nigrum plants against the centipede (Scolopendra moristans) envenomation in animal model. In vtiro phytochemical, antioxidant and blocking of proteolysis were carried out by using standard spectrophotometric methods. In vivo anti-venom activity of methanol extracts was determined using Wistar albino rats after fixing lethal and effective doses. The electrolytes, lipid, liver, kidney, hematological parameters were analyzed and histopathology of skin and liver were also examined. Anti-skin cancer by MTT method and HPLC analysis were also carried out. The CAIPN extract showed higher total phenolics (150.65 ± 0.08 mg GAE/g extract) and flavonoids (158.97 ± 0.93 mg RE/g extract) content. Further, the same extract revealed the higher molybdenum reducing, inhibition of lipid peroxidation (80.08 ± 0.22%), DPPH radical scavenging (3.05 µg/mL), and blocking of proteolysis activities (96.45 ± 0.04%). The parameters like hypersensitivity, electrolytes, lipids, blood components, liver and kidney marker of the CAIPN methanol extract (200 mg/kg) treated envenomated rats was remarkable and same as in the normal animals. Such status was also achieved by RBAI and SPN at 600 mg/kg. The histopathological scoring of skin and liver confirmed the venom neutralizing activity of CAIPN. Also, the CAIPN methanol extract was notable in anti-skin cancer activity (208 µg/mL). The presence of the ferulic acid (04 ± 0.09 µg/mg) and quercetin (35.30 ± 0.30 µg/mg) like compounds was confirmed by HPLC analysis. Hence, the present investigation results conclude that the CAIPN was significant in their action and this polyherbal formulation could be considered as a new source for the pharmaceutical industries to develop a new effective, ecofriendly anti-venom drug.

Hair Trace Element and Electrolyte Content in Women with Natural and In Vitro Fertilization-Induced Pregnancy.

The objective of the present study was to perform comparative analysis of hair trace element content in women with natural and in vitro fertilization (IVF)-induced pregnancy. Hair trace element content in 33 women with IVF-induced pregnancy and 99 age- and body mass index-matched control pregnant women (natural pregnancy) was assessed using inductively coupled plasma mass spectrometry. The results demonstrated that IVF-pregnant women are characterized by significantly lower hair levels of Cu, Fe, Si, Zn, Ca, Mg, and Ba at p < 0.05 or lower. Comparison of the individual levels with the national reference values demonstrated higher incidence of Fe and Cu deficiency in IVF-pregnant women in comparison to that of the controls. IVF pregnancy was also associated with higher hair As levels (p < 0.05). Multiple regression analysis revealed a significant interrelation between IVF pregnancy and hair Cu, Fe, Si, and As content. Hair Cu levels were also influenced by vitamin/mineral supplementation and the number of pregnancies, whereas hair Zn content was dependent on prepregnancy anthropometric parameters. In turn, planning of pregnancy had a significant impact on Mg levels in scalp hair. Generally, the obtained data demonstrate an elevated risk of copper, iron, zinc, calcium, and magnesium deficiency and arsenic overload in women with IVF-induced pregnancy. The obtained data indicate the necessity of regular monitoring of micronutrient status in IVF-pregnant women in order to prevent potential deleterious effects of altered mineral homeostasis.

Novel therapeutic approaches of natural oil from black seeds and its underlying mechanisms against kidney dysfunctions in haloperidol-induced male rats.

BACKGROUND: Antipsychotic drugs could be nephrotoxic in schizophrenia patients. METHODS: The present study investigated the protective effect of oil from black seed on kidney dysfunctions using several biological approaches in adult rats. The animals were divided into six groups (n=10): normal control rats; haloperidol (HAL)-induced rats: induced rats were pre-, co- and post-treated with black seed oil (BSO), respectively, and the last group was treated with the oil only. The treatment was done through oral administration, and the experiment lasted 14 days. RESULTS: Therapeutic administration of HAL to rats caused reduction in both enzymatic and non-enzymatic proteins mediated by stable OH˙ and DPPH free radicals. K+, Na+ and MDA contents as well as 51 nucleotidase, aldose-reductase activities were increased with corresponding decrease in the activity of lactate dehydrogenase (LDH) in HAL-induced toxicity rats. Contrariwise, differential treatments with BSO prevented and reversed the nephrotoxicity by depleting K+, Na+, MDA contents and aldose-reductase activity, and AMP hydrolysis with increased adenosine triphosphate (ATP) in the PMFs of rat kidney. The cytotoxicity of HAL elicited on both inner renal cortex and outer medulla was equally alleviated by combined active molecules of oil from black seed (OBS). However, pre-, co- and post-treatment demonstrate significant approaches in averting nephrotoxicity of neuroleptic drug (HAL) via several biological mechanisms. CONCLUSIONS: This study therefore validates the use of black seed oil as therapy particularly for individuals with renal dysfunctions.

Evaluation of the diuretic activity of the aqueous and 80% methanol extracts of the root of Euclea divinorum Hiern (Ebenaceae) in Sprague Dawley rats.

BACKGROUND: Diuretics are drugs that increase the formation of urine and are important for the treatment of various diseases including hypertension and edema. The root decoction of Euclea divinorum has been used as a diuretic agent in the traditional medicine. Therefore, this study was aimed to evaluate the diuretic activity of the crude extracts of the roots of Euclea divinorum in Sprague Dawley rats. METHODS: The aqueous extract (AE) and 80% methanol extract (80ME) of the plant were prepared using decoction and maceration, respectively. Vehicle (distilled water, 10ml/kg), standard drug (hydrochlorothiazide, 10mg/kg) and three doses (100mg/kg, 200mg/kg and 400mg/kg) of the AE and 80ME were given to male rats by oral gavage. Parameters like urine volume (for 5h), electrolyte concentration and pH were measured (at 5th h) and analyzed. Data were analyzed using one way analysis of variance (ANOVA) followed by Tukey post hoc test. Linear regression was also applied to show the dose dependency nature of the diuretic effect. RESULTS: The result indicated that the 80ME of the plant significantly (p<0.05) produced diuresis at 200mg/kg and 400mg/kg. Furthermore, the AE produced significant diuresis (p<0.05) at all doses. With regard to the electrolyte excretion, the AE produced significant natriuresis and kaliuresis at all tested doses (p<0.001), while the 80ME showed significant natriuresis and kaliuresis at 200mg/kg (p<0.01) and 400mg/kg (p<0.001). Preliminary phytochemical screening revealed the presence of secondary metabolites, including saponins, flavonoids, glycosides, steroids, tannins and terpinoids in both extracts. These constituents might be responsible for the diuretic activity of Euclea divinorum. Both extracts were also found to be safe at 2000mg/kg on the acute toxicity study. CONCLUSION: This finding provides a scientific support for the acclaimed traditional use of the roots of Euclea divinorum as a diuretic agent.

Innovative approach for recycling phosphorous from agro-wastewaters using water treatment residuals (WTR).

Phosphorus capture from polluting streams and its re-use using industrial byproducts has the potential to also reduce environmental threats. An innovative approach was developed for P removal from soil leachate and dairy wastewater using Al-based water treatment residuals (Al-WTR) to create an organic-Al-WTR composite (Al/O-WTR), potentially capable of serving as a P fertilizer source. Al-WTR was mixed with either soil leachate, or with dairy wastewater, both of which contained elevated P concentrations (e.g., 7.6-43.5 mg SRP L-1). The Al-WTR removed ∼95% inorganic P, above 80% organic P, and over 60% dissolved organic carbon (DOC) from the waste streams. P removal was correlated with P concentration in the waste streams and was consistent with an increase in Al/O-WTR P content as determined by X-ray fluorescence (XRF) and surface analysis using scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS). Organic C was a major constituent in the original Al-WTR (31.4%) and increased by 1% in the Al/O-WTRs. Organic C accumulation on particles surfaces possibly enhanced weak P bonding. Desorption experiments indicated an initial and substantial P release (30 mg SRP kg-1 Al/O-WTR), followed by relatively constant low P solubility (ca. 10 mg kg-1). Organic C was continuously released to the solution (over 8000 mg kg-1), concomitantly with Ca and other electrolytes, possibly indicating dissolution from inner pores, accounting for the highly porous nature of the Al-WTR, evident by SEM images. The potential of P-loading on Al/O-WTR to promote P recycling should be further studied.

Determinação de valores de referência séricos para os eletrólitos magnésio, cloretos, cálcio e fósforo em ovinos das raças Dorper e Santa Inês / Determination of magnesium, chloride, calcium and phosphorus serum reference values for Dorper and Santa Inês sheep breeds

A ovinocultura no Brasil é uma atividade em grande expansão e, com o aumento da demanda mundial por carne ovina, aumentou-se o interesse no monitoramento da sanidade do rebanho, utilizando diversas ferramentas como auxiliares no diagnóstico clínico, tais como os intervalos de referência séricos. Os elementos minerais constituem 2 a 5,5% do corpo dos vertebrados, exercendo diversas funções no organismo. O objetivo deste trabalho foi obter intervalos de referência para os eletrólitos magnésio, fósforo, cloreto e cálcio para ovinos das raças Dorper e Santa Inês. Foram coletados soros de 487 animais clinicamente sadios, sendo 146 da raça Dorper e 341 da raça Santa Inês. Os eletrólitos foram mensurados utilizando-se kits comerciais. Os dados foram analisados quanto à raça, sexo e idade, e os intervalos de referência determinados. Os resultados revelaram diferenças significativas nos intervalos de referência obtidos para os eletrólitos cálcio e magnésio na variável raça, e para o eletrólito fósforo na variável faixa etária e, quando confrontados com valores de referência já publicados, comprovou-se a existência de diferença estatística significativa entre os mesmos em todos os analitos estudados.

The sheep industry in Brazil is an important economic activity, and with the increasing global demand for sheep meat there is a great interest in the monitoring of the herd health, and serum reference ranges are basic tools for veterinary clinical pathology assays. Mineral elements correspond to 2-5.5% of the body of vertebrates, holding different functions in their physiology. The objective of this study was to obtain reference intervals of the electrolytes magnesium, phosphorus, chloride and calcium for the Dorper and Saint Ines sheep breeds. Sera samples were collected from 487 clinically healthy sheep, 146 from Dorper and 341 from Santa Ines breed. Electrolytes were measured using commercial kits. Data were analyzed taking the race, sex and age variables in account, and reference ranges were established. The results revealed significant statistical differences in reference ranges obtained for the electrolytes calcium and magnesium concerning the variable race, and for the electrolyte phosphorus in the variable age and, when compared with reference values already published, proved the existence of significant differences.

The Effect of Ad Libitum Consumption of a Milk-Based Liquid Meal Supplement vs. a Traditional Sports Drink on Fluid Balance After Exercise.

The aim of this study was to compare the effect of ad libitum intake of a milk-based liquid meal supplement against a carbohydrate-electrolyte sports drink following exercise induced fluid loss. Seven male participants (age 22.3 ± 3.4 years, height 179.3 ± 7.9 cm, body mass 74.3 ± 7.3 kg; mean ± SD) completed 4 separate trials and lost 1.89 ± 0.44% body mass through moderate intensity exercise in the laboratory. After exercise, participants consumed ad libitum over 2 h a milk-based liquid meal supplement (Sustagen Sport) on two of the trials (S1, S2) or a carbohydrate-electrolyte sports drink (Powerade) on two of the trials (P1, P2), with an additional 1 hr observational period. Measures of body mass, urine output, gastrointestinal tolerance and palatability were collected throughout the recovery period. Participants consumed significantly more Powerade than Sustagen Sport over the 2 h rehydration period (P1 = 2225 ± 888 ml, P2 = 2602 ± 1119 mL, S1 = 1375 ± 711 mL, S2 = 1447 ± 857 ml). Total urine output on both Sustagen trails was significantly lower than the second Powerade trial (P2 = 1447 ± 656 ml, S1 = 153 ± 62 ml, S2 = 182 ± 118 mL; p < .05) and trended toward being lower compared with the first Powerade trial (P1 = 1057 ± 699 ml vs. S1, p = .067 and vs. S2, p = .061). No significant differences in net fluid balance were observed between any of the drinks at the conclusion of each trial (P1 = -0.50 ±0. 46 kg, P2 = -0.40 ± 0.35 kg, S1 = -0.61 ± 0.74 kg, S2 = -0.45 ± 0.58 kg). Gastrointestinal tolerance and beverage palatability measures indicated Powerade to be preferred as a rehydration beverage. Ad libitum milk-based liquid meal supplement results in similar net fluid balance as a carbohydrate-electrolyte sports drink after exercise induced fluid loss.

Evaluation of physical stability of all in one parenteral admixtures for pediatric home care with high electrolytes concentrations / Evaluación de la estabilidad física de preparados parenterales «todo en uno» para atención pediátrica domiciliaria con altas concentraciones de electrolitos

Introduction: The aim of the study was to evaluate stability of 48 total parenteral admixtures for pediatric patients who require home parenteral nutrition. Admixtures contain high amounts of electrolytes. In a clinical practice electrolytes-enrichment of the parenteral nutrition admixtures is a usual demand, especially on the neonatal/pediatric wards. The supplementation of parenteral nutrition with high concentration of electrolytes is a living problem due to decreased stability of lipid emulsions in nutrition admixtures caused by bivalent cations. Methods: Preliminary admixtures were prepared in two-chamber ethylene vinyl acetate bags: amino acids, glucose and electrolytes were combined in one chamber and 20% (w/w) lipid emulsions (SMOFlipid®, Intralipid ® or ClinOleic®) were placed separately in the second chamber. Organic salts of calcium and phosphates were used. Pre-admixtures were stored at +4ºC for up to 21 days after preparation. Each composition of admixtures was prepared twice, because contents of the two chambers were combined at t=0 or after 21 days of storage at +4ºC. Visual observations, globule size distribution (using optical microscopy, laser diffraction and photon correlation spectroscopy methods), pH analyses, zeta potential and surface tension were performed after combining all components together with vitamins. Results: Among 48 of investigated admixtures only two were problematic and other may be stored for at least 21 days at 4°C and completed admixtures demonstrated stability for at least 24 h at room temperature. Conclusion: It was possible to obtain stable admixtures despite of the high concentration of electrolytes (AU)

Introducción: El objetivo del estudio fue evaluar la estabilidad de un total de 48 preparados o mezclas parenterales para pacientes pediátricos con necesidad de nutrición parenteral domiciliaria. Los preparados contienen cantidades elevadas de electrolitos. En la práctica clínica, el enriquecimiento con electrolitos de los preparados de nutrición parenteral es una demanda habitual, especialmente en las unidades neonatales/pediátricas. El complemento de la nutrición parenteral con altas concentraciones de electrolitos es un problema corrriente debido a la menor estabilidad de las emulsiones lipídicas en preparados de nutrición provocada por cationes bivalentes. Métodos: Se prepararon mezclas preliminares en bolsas de etilenvinilacetato de dos cámaras: se combinó amino ácidos, glucosa y electrolitos en una cámara y en la segunda cámara se puso por separado emulsiones lipídicas 20% (w/w) (SMOFlipid®, Intralipid® o ClinOleic®). Se utilizaron sales orgánicas de calcio y fosfatos. Se almacenaron pre-mezclas a +4ºC durante 21 días después de la preparación. Cada composición de mezcla fue preparada dos veces, dado que el contentido de las dos cámaras se combinó en t=0 o después de 21 días después del almacenamiento a +4ºC. Se realizaron observaciones visuales, distribución del tamaño globular (empleando métodos de microscopía óptica, difracción por láser y espectroscopía de correlación fotónica), análisis de pH, potencial zeta y tensión superficial después de combinar todos los componentes a la vez con vitaminas. Resultados: De los 48 preparados investigados solo dos resultaron problemáticos y el resto se pudo almacenar durante al menos 21 días a 4°C y las mezclas completadas presentaron estabilidad durante al menos 24 h a temperatura ambiente. Conclusión: Fue posible obtener preparados estables a pesar de la alta concentración de electrolitos (AU)

Use of a symbiotic supplement in a child with short bowel Syndrome; a case report / Uso de suplemento simbiótico en un niño con síndrome del intestino corto; caso clínico

The short bowel syndrome (SBS) is due to loss of bowel after surgery. Characterized by generalized nutrients malabsorption, its signs and symptoms include electrolyte imbalance, deficiency of vitamins, minerals and nutrients that can lead to death. Parenteral and enteral nutrition have a key role in its treatment. Objective: To describe the clinical course of a patient with SBS during continuous use of enteral nutrition supplemented with symbiotic. Case report: A seven-year-old male underwent an emergency laparotomy at 18 months old with a massive bowel resection, remaining about 20 cm of the small intestine and the entire colon. He was dependent of exclusive parenteral nutrition for over a year, leading to the occurrence of numerous infectious complications. Due to complications caused by prolonged use of central venous access, was unable to continue to receive the parenteral nutrition. Enteral nutrition by a nasogastric tube and supplemental symbiotic was the nutritional therapy option for him. The assessment of the volume of losses by the colostomy was measured daily. Results: There was a significant reduction of losses bycolostomy, especially in the first days after introduction of the enteral nutrition plus symbiotic supplementation, as well as significant decrease in gas production. Conclusion: Despite the lack of evidence for a formal recommendation on the use of symbiotic for SBS patients, its use in the nutritional therapy of this patient resulted in reduced electrolyte loss electrolyte and consequent improvement of his clinical and nutritional condition (AU)

El síndrome del intestino corto (SIC) se debe a una pérdida intestinal tras cirugía. Caracterizado por una mal absorción generalizada de nutrientes, sus signos y síntomas incluyen el desequilibrio electrolítico y la deficiencia de vitaminas, minerales y nutrientes que pueden acarrearla muerte. La nutrición parenteral y enteral tiene un papel clave en su tratamiento. Objetivo: Describir el curso clínico de un paciente con SIC durante el uso continuo de nutrición enteral suplementada con un simbiótico. Caso clínico: Un chico de siete años fue sometido a una laparotomía urgente a los 18 meses de edad con una resección intestinal masiva, quedando sólo 20 cm de intestino delgado y el colon al completo. Dependió de nutrición parenteral exclusiva durante más de un año, lo que le produjo numerosas complicaciones infecciosas. Debido a las complicaciones causadas por el uso prolongado de un acceso venoso central, no pudo continuar recibiendo la nutrición parenteral. La opción terapéutica para él fue la nutrición enteral a través de una sonda nasogástrica y un suplemento simbiótico. Se evaluaron a diario las pérdidas de volumen a través de la colostomía. Resultados: Hubo una reducción significativa de las pérdidas por la colostomía, especialmente en los primeros días de la introducción de la nutrición enteral y la suplementación simbiótica, así como un descenso significativo de la producción de gas. Conclusión: A pesar de la falta de evidencia de una recomendación formal para el uso de simbiótico en pacientes con SIC, su empleo en la terapia nutricional de este paciente produjo una reducción de la pérdida de electrolitos y la consiguiente mejoría de su situación clínica y nutricional (AU)

Evaluation of physical stability of all in one parenteral admixtures for pediatric home care with high electrolytes concentrations.

INTRODUCTION: The aim of the study was to evaluate stability of 48 total parenteral admixtures for pediatric patients who require home parenteral nutrition. Admixtures contain high amounts of electrolytes. In a clinical practice electrolytes-enrichment of the parenteral nutrition admixtures is a usual demand, especially on the neonatal/pediatric wards. The supplementation of parenteral nutrition with high concentration of electrolytes is a living problem due to decreased stability of lipid emulsions in nutrition admixtures caused by bivalent cations. METHODS: Preliminary admixtures were prepared in two-chamber ethylene vinyl acetate bags: amino acids, glucose and electrolytes were combined in one chamber and 20% (w/w) lipid emulsions (SMOFlipid®, Intralipid ® or ClinOleic®) were placed separately in the second chamber. Organic salts of calcium and phosphates were used. Pre-admixtures were stored at +4ºC for up to 21 days after preparation. Each composition of admixtures was prepared twice, because contents of the two chambers were combined at t=0 or after 21 days of storage at +4ºC. Visual observations, globule size distribution (using optical microscopy, laser diffraction and photon correlation spectroscopy methods), pH analyses, zeta potential and surface tension were performed after combining all components together with vitamins. RESULTS: Among 48 of investigated admixtures only two were problematic and other may be stored for at least 21 days at 4°C and completed admixtures demonstrated stability for at least 24 h at room temperature. CONCLUSION: It was possible to obtain stable admixtures despite of the high concentration of electrolytes.

Introducción: El objetivo del estudio fue evaluar la estabilidad de un total de 48 preparados o mezclas parenterales para pacientes pediátricos con necesidad de nutrición parenteral domiciliaria. Los preparados contienen cantidades elevadas de electrolitos. En la práctica clínica, el enriquecimiento con electrolitos de los preparados de nutrición parenteral es una demanda habitual, especialmente en las unidades neonatales/pediátricas. El complemento de la nutrición parenteral con altas concentraciones de electrolitos es un problema corrriente debido a la menor estabilidad de las emulsiones lipídicas en preparados de nutrición provocada por cationes bivalentes. Métodos: Se prepararon mezclas preliminares en bolsas de etilenvinilacetato de dos cámaras: se combinó amino ácidos, glucosa y electrolitos en una cámara y en la segunda cámara se puso por separado emulsiones lipídicas 20% (w/w) (SMOFlipid®, Intralipid® o ClinOleic®). Se utilizaron sales orgánicas de calcio y fosfatos. Se almacenaron pre-mezclas a +4ºC durante 21 días después de la preparación. Cada composición de mezcla fue preparada dos veces, dado que el contentido de las dos cámaras se combinó en t=0 o después de 21 días después del almacenamiento a +4ºC. Se realizaron observaciones visuales, distribución del tamaño globular (empleando métodos de microscopía óptica, difracción por láser y espectroscopía de correlación fotónica), análisis de pH, potencial zeta y tensión superficial después de combinar todos los componentes a la vez con vitaminas. Resultados: De los 48 preparados investigados solo dos resultaron problemáticos y el resto se pudo almacenar durante al menos 21 días a 4°C y las mezclas completadas presentaron estabilidad durante al menos 24 h a temperatura ambiente. Conclusión: Fue posible obtener preparados estables a pesar de la alta concentración de electrolitos.

Bases para la terapia con líquidos y electrólitos. Modelos fisiológicos del equilibrio ácido-base (I): el modelo tradicional / Basis for fluid and electrolyte therapy. Physiological models of acid-base balance (I): The traditional model

En las últimas dos décadas hemos asistido a una revolución en el conocimiento científico de la fisiología y las alteraciones del equilibrio ácido-base. En la primera parte de esta serie de artícu­los revisamos el modelo «tradicional», la aproximación centrada en el bicarbonato y basada en el trabajo pionero de Henderson y Hasselbalch, que es aún la más utilizada en la práctica clínica diaria. En la segunda parte, revisamos la teoría de otros modelos más modernos, particularmente el de Stewart, derivado al final de los años setenta desde las leyes de la química física. Con este modelo, tal como fue desarrollado por Peter Stewart y Peter Constable, utilizando la presión parcial de dióxido de carbono, la diferencia de iones fuertes y la concentración total de ácidos débiles, somos capaces de predecir con exactitud la acidez del plasma y deducir el saldo neto de iones no medidos. La interpretación del equilibrio ácido-base no será nunca más un arte intuitivo y arcano. Se ha convertido en un cálculo exacto que puede realizarse automáticamente con ayuda del software moderno. En las últimas dos partes, utilizando a pie de cama el strong ion calculator y la historia clínica, mostraremos que el modelo fisicoquímico cuantitativo tiene ventajas sobre los tradicionales, principalmente en las situaciones fisiológicas extremas que se viven con los pacientes de la unidad de cuidados intensivos pediátrica o en la alteraciones congénitas del metabolismo (AU)

A revolution has recently undergone in the last two decades in the scientific understanding of acid-base physiology and dysfunction. In the first part of this series we review the "traditional" model, the current bicarbonate-centered approach based on the pioneering work of Henderson and Hasselbalch, still the most widely used in clinical practice. In the second part we review theoretically other modern approaches, particularly Stewart's one, derived in the late 1970s from the laws of physical chemistry. Whit this approach, as developed by Peter Stewart and Peter Constable, using the partial pressure of carbon dioxide, the strong ion difference and the concentration of weak acids we can now predict accurately the acidity of plasma and deduce the net concentration of unmeasured ions. Acid-base interpretation has ceased to be an intuitive an arcane art and became an exact computation that can be automated with modern software. In the last two parts, using at the bedside the quantitative "strong ion calculator" together with the medical history, we show how quantitative acid-base analysis has advantages over traditional approaches, mainly in the extreme physiological situations of clinical scenarios like the paediatric intensive care unit or the congenital metabolic diseases (AU)