Thirst and drugs: A study in the World Health Organization's pharmacovigilance database.

Thirst is a complex physiological compensatory mechanism but could also be associated with drugs. This association was poorly investigated previously. Using the WHO global pharmacovigilance database, Vigibase®, disproportionality analyses potential associations between exposure to drugs and thirst reports were performed. All reports of thirst in adults between 01/01/2000 and 31/12/2023 were included. Results are expressed as reporting odds ratio (ROR). Analysis of the 3186 reports of thirst (978 'serious') allowed, first, to confirm the association between thirst and exposure to vasopressin antagonists (tolvaptan), lithium, gliflozins (dapagliflozin, empagliflozin), pregabalin and antimuscarinic drugs (glycopyronium, oxybutynin, tiotropium). Second, new safety signals were described with monoamine reuptake inhibitors (antidepressants: duloxetine, venlafaxine; anti-obesity agent: sibutramine), antipsychotic (olanzapine), glucocorticoid (prednisolone), diuretic (furosemide) drugs as well with ribavirin or sodium oxybate. This study is the first to offer a list of drugs associated with thirst in humans.

The Effect of Isolated and Combined Application of Menthol and Carbohydrate Mouth Rinses on 40 km Time Trial Performance, Physiological and Perceptual Measures in the Heat.

The current study compared mouth swills containing carbohydrate (CHO), menthol (MEN) or a combination (BOTH) on 40 km cycling time trial (TT) performance in the heat (32 °C, 40% humidity, 1000 W radiant load) and investigates associated physiological (rectal temperature (Trec), heart rate (HR)) and subjective measures (thermal comfort (TC), thermal sensation (TS), thirst, oral cooling (OC) and RPE (legs and lungs)). Eight recreationally trained male cyclists (32 ± 9 y; height: 180.9 ± 7.0 cm; weight: 76.3 ± 10.4 kg) completed familiarisation and three experimental trials, swilling either MEN, CHO or BOTH at 10 km intervals (5, 15, 25, 35 km). The 40 km TT performance did not differ significantly between conditions (F2,14 = 0.343; p = 0.715; η2 = 0.047), yet post-hoc testing indicated small differences between MEN and CHO (d = 0.225) and MEN and BOTH (d = 0.275). Subjective measures (TC, TS, RPE) were significantly affected by distance but showed no significant differences between solutions. Within-subject analysis found significant interactions between solution and location upon OC intensity (F28,196 = 2.577; p < 0.001; η2 = 0.269). While solutions containing MEN resulted in a greater sensation of OC, solutions containing CHO experienced small improvements in TT performance. Stimulation of central CHO pathways during self-paced cycling TT in the heat may be of more importance to performance than perceptual cooling interventions. However, no detrimental effects are seen when interventions are combined.

Sensory Perception of an Oral Rehydration Solution during Exercise in the Heat.

Prolonged exercise in the heat elicits a number of physiological changes as glycogen stores are low and water and electrolytes are lost through sweat. However, it is unclear whether these changes provoke an increase in liking of saltiness and, therefore, palatability of an oral rehydration solution (ORS). Twenty-seven recreationally active participants (n = 13 males; n = 14 females) completed sensory analysis of an ORS, a traditional sports drink (TS), and a flavored water placebo (PL) at rest and during 60 min (3 × 20-min bouts) of cycling exercise at 70% age-predicted maximum heart rate (HRmax) at 35.3 ± 1.4 °C and 41 ± 6% relative humidity. Before and after every 20 min of exercise, drinks were rated (using 20-mL beverage samples) based on liking of sweetness, liking of saltiness, thirst-quenching ability, and overall liking on a nine-point hedonic scale. Hydration status was assessed by changes in semi-nude body mass, saliva osmolality (SOsm), and saliva total protein concentration (SPC). After 60 min of exercise, participants lost 1.36 ± 0.39% (mean ± SD) of body mass and there were increases in SOsm and SPC. At all time points, liking of sweetness, saltiness, thirst-quenching ability, and overall liking was higher for the TS and PL compared to the ORS (p < 0.05). However, the saltiness liking and thirst-quenching ability of the ORS increased after 60 min of exercise compared to before exercise (p < 0.05). There was also a change in predictors of overall liking with pre-exercise ratings mostly determined by liking of sweetness, saltiness, and thirst-quenching ability (p < 0.001), whereas only liking of saltiness predicted overall liking post-exercise (R2 = 0.751; p < 0.001). There appears to be a hedonic shift during exercise in which the perception of saltiness becomes the most important predictor of overall liking. This finding supports the potential use of an ORS as a valuable means of hydration during the latter stages of prolonged and/or intense exercise in the heat.

Safety and efficacy of Tolvaptan in real-world patients with autosomal dominant polycystic kidney disease- interim results of SLOW-PKD surveillance.

BACKGROUND: Tolvaptan is a vasopressin type 2 receptor antagonist and has been used to treat autosomal dominant polycystic kidney disease (ADPKD) since 2014. There has been limited real-world data on the safety and efficacy of tolvaptan. METHODS: This post-marketing surveillance was conducted to evaluate the long-term safety and the efficacy of tolvaptan in Japanese patients with ADPKD in real-world clinical settings. The baseline characteristics of 1630 patients treated with tolvaptan are reported. Safety analysis comprises evaluation of adverse drug reactions (ADRs). The efficacy evaluation includes percent change in total kidney volume (TKV) and change in estimated glomerular filtration rate (eGFR) before and after tolvaptan treatment. RESULTS: Mean age was 49.7 ± 11.2 years and 843 (51.7%) patients were male. Baseline TKV was 2158 ± 1346 mL and eGFR was 44.4 ± 21.7 mL/min/1.73 m2. The majority of CKD patients were stage G3b (27.0%) and G4 (30.1%). Frequently reported ADRs were hepatic function abnormal (8.3%), thirst (8.2%), and hyperuricaemia (6.9%). The frequency of ALT elevation (> 30 and > 90 IU/L) was slightly high (32.9 and 8.3%) to previous studies. After tolvaptan treatment, the annual rate of percentage change in TKV reduced from 11.68%/year to 2.73%/year (P < 0.0001). Similar results were also obtained for the effect on change in eGFR from - 3.31 to - 2.28 mL/min/1.73 m2/year after initiation of tolvaptan treatment (P = 0.0403). CONCLUSION: There were no major problems with safety of tolvaptan treatment and comparable efficacy for TKV and eGFR was observed in relation to the previous pivotal two randomized control trials in this post-marketing surveillance.

Advances in the Management of Perioperative Patients' Thirst.

In response to an increase in osmolarity or a decrease in plasma volume, surgical patients often experience thirst during the perioperative period. Thirst causes intense discomfort for patients, but perioperative nurses and health care providers have received minimal direction on how to address this concern. This article presents evidence related to the advances in the management of patients' thirst and discusses clinical strategies that perioperative personnel can safely implement for their patients during the preoperative and postoperative periods. The Thirst Study and Research Group at Londrina State University, Brazil, developed the Thirst Management Model to provide a standardized method for perioperative personnel. Four pillars comprise this model: identification of thirst, measurement of thirst, safety assessment for the management of thirst, and application of relief strategies. This evidence-based model should assist perioperative nurses with translating knowledge and scientific evidence into clinical practice to provide safe patient care.

Effects of Sodium Reduction on Energy, Metabolism, Weight, Thirst, and Urine Volume: Results From the DASH (Dietary Approaches to Stop Hypertension)-Sodium Trial.

Two recent studies challenged traditional paradigms of mammalian sodium physiology, suggesting that sodium reduction might cause weight gain by altering metabolism. This new theory has important implications for population-wide dietary recommendations. However, these observations have not been confirmed. In the DASH (Dietary Approaches to Stop Hypertension)-Sodium trial, 412 adults with systolic blood pressure of 120 to 159 mm Hg and diastolic blood pressure of 80 to 95 mm Hg not taking antihypertensive medications were randomly assigned to the DASH diet or a control diet (parallel design). On their assigned diet, participants randomly consumed each of the 3 sodium levels for 4 weeks (crossover design). Participants were provided all meals but could drink noncaloric beverages (eg, water) freely. Throughout the trial, energy intake was adjusted to maintain weight constant. The 3 sodium levels (at 2100 kcal/day) were: low (1150 mg of Na/day), medium (2300 mg of Na/day), and high (3450 mg of Na/day). Energy intake, weight, self-reported thirst, and 24-hour urine volume were assessed after each period. Participants were 57% women and 57% black; mean age was 48 years [SD, 10]). Among those assigned the control, mean weight increased slightly with higher sodium but not among those assigned DASH. Energy intake did not vary across sodium levels in either diet (P-trends ≥0.36). Higher sodium resulted in more thirst (P-trends <0.001 on both diets) and higher urine volume (suggesting higher fluid intake) during the control diet (P-trend=0.007). Reducing sodium did not increase energy requirements to maintain stable weights but did decrease thirst and urine volume (control diet only), findings consistent with the traditional understanding of mammalian sodium physiology. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000608.

The use of mentholated popsicle to reduce thirst during preoperative fasting: A randomised controlled trial.

AIMS AND OBJECTIVES: To compare mentholated popsicle with usual care (absolute fasting) in the change of thirst intensity and discomfort of patients in the preoperative fasting. BACKGROUND: Thirst is defined as the desire to drink water, and it is considered to be a multifactorial symptom. In the preoperative fasting, the patient may experience intense thirst, often for a long time, that can lead to feelings of suffocation, desperation, fear and anxiety. DESIGN: A randomised controlled trial. METHODS: Forty patients, aged between 18-60 years, were randomised to mentholated popsicle group or absolute fasting group (twenty in each). The primary outcomes were thirst intensity, evaluated by a numeric scale ranging from 0 (no thirst)-10 (the worst possible thirst), and discomfort from thirst (evaluated by the Perioperative Thirst Discomfort Scale), both measured twice (baseline and after 20 min of intervention). The CONSORT checklist was used to report this study. RESULTS: Mean age was similar in both groups (38 years in the mentholated popsicle group and 39 in the absolute fasting group). At baseline, the mentholated popsicle group had higher median for the scales of intensity (6.5) and discomfort (7.5) from thirst than the absolute fasting group (5.0 and 5.0, respectively). At the end of 20 min, the popsicle group had a statistically significant decrease in intensity and discomfort from thirst (median decreases of 5.0 and 7.0 points, respectively) when compared to the absolute fasting group (median increases of 0.5 and 1.0 points, respectively). CONCLUSIONS: The use of mentholated popsicle decreased the intensity and discomfort from thirst, and it is a viable strategy for the management of thirst in the preoperative fasting. RELEVANCE TO CLINICAL PRACTICE: In the preoperative fasting, making mentholated popsicles available to patients is an easy strategy to manage thirst, which might lead to better care.

Brain osmo-sodium sensitive channels and the onset of sodium appetite.

The aim of the present study was to determine whether the TRPV1 channel is involved in the onset of sodium appetite. For this purpose, we used TRPV1-knockout mice to investigate sodium depletion-induced drinking at different times (2/24 h) after furosemide administration combined with a low sodium diet (FURO-LSD). In sodium depleted wild type and TRPV1 KO (SD-WT/SD-TPRV1-KO) mice, we also evaluated the participation of other sodium sensors, such as TPRV4, NaX and angiotensin AT1-receptors (by RT-PCR), as well as investigating the pattern of neural activation shown by Fos immunoreactivity, in different nuclei involved in hydromineral regulation. TPRV1 SD-KO mice revealed an increased sodium preference, ingesting a higher hypertonic cocktail in comparison with SD-WT mice. Our results also showed in SD-WT animals that SFO-Trpv4 expression increased 2 h after FURO-LSD, compared to other groups, thus supporting a role of SFO-Trpv4 channels during the hyponatremic state. However, the SD-TPRV1-KO animals did not show this early increase, and maybe as a consequence drank more hypertonic cocktail. Regarding the SFO-NaX channel expression, in both genotypes our findings revealed a reduction 24 h after FURO-LSD. In addition, there was an increase in the OVLT-NaX expression of SD-WT 24 h after FURO-LSD, suggesting the participation of OVLT-NaX channels in the appearance of sodium appetite, possibly as an anticipatory response in order to limit sodium intake and to induce thirst. Our work demonstrates changes in the expression of different osmo­sodium-sensitive channels at specific nuclei, related to the body sodium status in order to stimulate an adequate drinking.

Hormonal regulation of thirst in the amphibious ray-finned fish suggests the requirement for terrestrialization during evolution.

Thirst has evolved for vertebrate terrestrial adaptation. We previously showed that buccal drying induced a series of drinking behaviours (migration to water-taking water into the mouth-swallowing) in the amphibious mudskipper goby, thereby discovering thirst in ray-finned fish. However, roles of dipsogenic/antidipsogenic hormones, which act on the thirst center in terrestrial tetrapods, have remained unclear in the mudskipper thirst. Here we examined the hormonal effects on the mudskipper drinking behaviours, particularly the antagonistic interaction between angiotensin II (AngII) and atrial natriuretic peptide (ANP) which is important for thirst regulation in mammalian 'forebrain'. Expectedly, intracerebroventricular injection of ANP in mudskippers reduced AngII-increased drinking rate. ANP also suppressed the neural activity at the 'hindbrain' region for the swallowing reflex, and the maintenance of buccopharyngeal water due to the swallowing inhibition may attenuate the motivation to move to water. Thus, the hormonal molecules involved in drinking regulation, as well as the influence of buccopharyngeal water, appear to be conserved in distantly related species to solve osmoregulatory problems, whereas hormonal control of thirst at the forebrain might have been acquired only in tetrapod lineage during evolution.

Menthol chewing gum on preoperative thirst management: randomized clinical trial. / Goma de mascar mentolada no manejo da sede pré-operatória: ensaio clínico randomizado.

OBJECTIVE: to evaluate the effectiveness of menthol chewing gum, in the relief of the intensity and discomfort of the surgical patient's thirst in the preoperative period. METHOD: a randomized controlled trial, with 102 patients in the preoperative period, randomized in a control group, with usual care, and an experimental group, which received menthol gum, which was the study treatment variable. The primary clinical outcome was the variation in thirst intensity, evaluated by the Numeral Verbal Scale, and the secondary, the variation of the discomfort of thirst, evaluated by the Perioperative Thirst Discomfort Scale. Mann-Whitney test was used to compare measures between groups. The significance level adopted was of 0.05. RESULTS: menthol chewing gum significantly reduced the intensity (p <0.001), with Cohen's medium-effect d, and thirst discomfort (p <0.001), with a large-effect Cohen's d. CONCLUSION: menthol chewing gum was effective in reducing the intensity and discomfort of preoperative thirst. The strategy proved to be an innovative, feasible and safe option in the use for the surgical patient, in the management of the preoperative thirst, in elective surgeries. NCT: 03200197.

Package of menthol measures for thirst relief: a randomized clinical study.

OBJECTIVE: To evaluate the effectiveness of the menthol package (lip hydration and ice popsicles) compared to a package of non-menthol measures (lip hydration and ice popsicles) as a way to relieve thirst in patients in the Anesthetic Recovery Room. METHOD: Randomized and parallel trial study, with 120 patients randomized patients in an experimental group - menthol measurements (n=59) and control group - measures without menthol (n = 61). RESULTS: There was a significant (p<0.05) decrease in intensity, hydration, dryness and taste in the oral cavity between the three moments of assessment/intervention in the two groups. The difference was significant in the experimental group for thirst intensity at the second assessment/intervention point (p<0.05) after a single administration of the menthol package. CONCLUSION: There was a reduction in thirst intensity in both groups. Patients who received menthol packages showed a significant decrease in intensity after a single evaluation/intervention time. NCT: 02869139.

Package of menthol measures for thirst relief: a randomized clinical study / Paquete de medidas mentoladas para el alivio de lased: estudio clínico aleatorizado / Pacote de medidas mentoladas para o alívio da sede: estudo clínico randomizado

ABSTRACT Objective: To evaluate the effectiveness of the menthol package (lip hydration and ice popsicles) compared to a package of non-menthol measures (lip hydration and ice popsicles) as a way to relieve thirst in patients in the Anesthetic Recovery Room. Method: Randomized and parallel trial study, with 120 patients randomized patients in an experimental group - menthol measurements (n=59) and control group - measures without menthol (n = 61). Results: There was a significant (p<0.05) decrease in intensity, hydration, dryness and taste in the oral cavity between the three moments of assessment/intervention in the two groups. The difference was significant in the experimental group for thirst intensity at the second assessment/intervention point (p<0.05) after a single administration of the menthol package. Conclusion: There was a reduction in thirst intensity in both groups. Patients who received menthol packages showed a significant decrease in intensity after a single evaluation/intervention time. NCT: 02869139.

RESUMEN Objetivo: Evaluar la efectividad del paquete de medidas mentoladas (hidratación labial y picolé de hielo) comparado a un paquete de medidas no mentoladas (hidratación labial y picolé de hielo) como un método de alivio de la sed en pacientes en la Sala de Recuperación Post-Anestésica. Método: En un ensayo clínico aleatorizado, paralelo, 120 pacientes aleatorizados en un grupo experimental - medidas mentoladas (n=59) y un grupo control - medidas sin el mentol (n=61). Resultados: Hubo una disminución significativa (p<0,05) sobre la intensidad, hidratación, sequedad y gusto en la cavidad oral entre los tres momentos de evaluación/intervención en los dos grupos, indistintamente. La diferencia fue significativa en el grupo experimental para la intensidad de la sed en el segundo momento de la evaluación/intervención (p<0,05) después de una única administración del paquete de medidas mentoladas. Conclusión: Se encontró una reducción de la intensidad de la sed en los dos grupos. Los pacientes que recibieron las medidas mentoladas presentaron una disminución significativa de la intensidad después de un único momento de evaluación/intervención. NCT: 02869139.

RESUMO Objetivo: Avaliar a efetividade do pacote de medidas mentoladas (hidratação labial e picolé de gelo) comparado a um pacote de medidas não mentoladas (hidratação labial e picolé de gelo) como método de alívio da sede em pacientes na Sala de Recuperação Anestésica. Método: Ensaio clínico randomizado, paralelo, 120 pacientes aleatorizados em grupo experimental - medidas mentoladas (n=59) e grupo controle - medidas sem o mentol (n=61). Resultados: Houve diminuição significativa (p<0,05) sobre a intensidade, hidratação, secura e gosto na cavidade oral entre os três momentos de avaliação/intervenção nos dois grupos indistintamente. A diferença foi significativa no grupo experimental para intensidade da sede no segundo momento de avaliação/intervenção (p<0,05) após uma única administração do pacote de medidas mentoladas. Conclusão: Houve redução da intensidade da sede nos dois grupos. Os pacientes que receberam as medidas mentoladas apresentaram diminuição significativa da intensidade após um único momento de avaliação/intervenção. A NCT: 02869139.

Acute intravenous acyl ghrelin infusion induces thirst but does not affect sodium excretion: two randomized, double-blind, placebo-controlled crossover studies in hypopituitary patients.

OBJECTIVE: Acyl ghrelin, which is the endogenous ligand for the growth hormone secretagogue receptor, potently stimulates pituitary growth hormone release, and to some degree adrenocorticotropic hormone and prolactin. Ghrelin is also orexigenic and has recently been shown to stimulate renal sodium absorption in rodent models. Increased thirst sensation has been observed as a side effect of acyl ghrelin administration in some human studies. The objective of this clinical trial was to investigate the direct effects of acyl ghrelin on thirst sensation and sodium excretion in hypopituitary patients. DESIGN: Hypopituitary patients on stable replacement with hydrocortisone and growth hormone were investigated in two double-blind and placebo-controlled crossover studies. The patients received a 5-h intravenous infusion of acyl ghrelin (5 pmol/kg/min in the first study and 1 pmol/kg/min in the second study). Thirst sensation was measured on a Visual Analog Scale (VAS). In the second study plasma osmolality, vasopressin, copeptin, water intake, diuresis and urinary excretion of sodium and creatinine were measured. RESULTS: In the initial study, acyl ghrelin (5 pmol/kg/min) increased thirst sensation (time × treatment analysis of variance for the effect of acyl ghrelin infusion P = 0.003). In the second study acyl ghrelin (1 pmol/kg/min) also increased thirst (P = 0.04) but did not affect urinary excretion of either sodium or water. CONCLUSIONS: We demonstrate that acyl ghrelin infusion increases thirst sensation, without affecting sodium excretion or diuresis in human subjects.

Effect of chewing gum on thirst: an integrative review.

OBJECTIVE: To identify and analyze the evidence on the effect of chewing gum on thirst in adults. METHOD: Integrative review, guided by the question: "What is the scientific evidence about the effects of chewing gum on adult's thirst?" LILACS, PubMed, Scopus and Web of Science were the databases consulted. RESULTS: Of a total of 2,414 articles found, 12 papers were selected whose publications varied between 1991 and 2016. The use of chewing gum resulted in increased salivary volume (five studies), xerostomia relief (seven studies), and thirst reduction (four studies). It was not possible to establish the number of chewing gums per day, being frequent the recommendation to use as desired. There was a predominance of studies with patients under dialysis and with cancer. CONCLUSION: Chewing gum is an effective strategy to reduce thirst discomfort in adults.

Effect of chewing gum on thirst: an integrative review / Efecto de la goma de mascar sobre la sed: revisión integrativa / Efeito da goma de mascar sobre a sede: revisão integrativa

ABSTRACT Objective: To identify and analyze the evidence on the effect of chewing gum on thirst in adults. Method: Integrative review, guided by the question: "What is the scientific evidence about the effects of chewing gum on adult's thirst?" LILACS, PubMed, Scopus and Web of Science were the databases consulted. Results: Of a total of 2,414 articles found, 12 papers were selected whose publications varied between 1991 and 2016. The use of chewing gum resulted in increased salivary volume (five studies), xerostomia relief (seven studies), and thirst reduction (four studies). It was not possible to establish the number of chewing gums per day, being frequent the recommendation to use as desired. There was a predominance of studies with patients under dialysis and with cancer. Conclusion: Chewing gum is an effective strategy to reduce thirst discomfort in adults.

RESUMEN Objetivo: Identificar y analizar las evidencias en cuanto al efecto de la goma de mascar sobre la sed en adultos. Método: Revisión integrativa, orientada por la cuestión: "¿Cuáles son las evidencias científicas acerca de los efectos de la goma de mascar sobre la sed en adultos?" Las bases de datos consultadas fueron: LILACS, PubMed, Scopus y Web of Science. Resultados: De un total de 2.414 artículos encontrados, se seleccionaron 12 trabajos cuyas publicaciones variaron entre los años 1991 y 2016. El uso de la goma de mascar resultó en el aumento del volumen salivar (cinco estudios), en el alivio de la xerostomía (siete estudios) y en la reducción de la sed (cuatro estudios). No fue posible establecer el número de gomas al día, siendo frecuente la recomendación de utilizarse según lo deseado. Hubo predominio de estudios con pacientes dialíticos y con pacientes con cáncer. Conclusión: La goma de mascar es una estrategia efectiva para reducir la molestia de la sed en adultos.

RESUMO Objetivo: Identificar e analisar as evidências quanto ao efeito da goma de mascar sobre a sede em adultos. Método: Revisão integrativa, norteada pela questão: "Quais são as evidências científicas acerca dos efeitos da goma de mascar sobre a sede em adultos?" As bases de dados consultadas foram: LILACS, PubMed, Scopus e Web of Science. Resultados: De um total de 2.414 artigos encontrados, selecionaram-se 12 trabalhos cujas publicações variaram entre os anos de 1991 e 2016. O uso da goma de mascar resultou no aumento do volume salivar (cinco estudos), no alívio da xerostomia (sete estudos) e na redução da sede (quatro estudos). Não foi possível estabelecer o número de gomas por dia, sendo frequente a recomendação de utilizar-se conforme desejado. Houve predomínio de estudos com pacientes dialíticos e com pacientes oncológicos. Conclusão: A goma de mascar é uma estratégia efetiva para reduzir o desconforto da sede em adultos.

Goma de mascar mentolada no manejo da sede pré-operatória: ensaio clínico randomizado / Menthol chewing gum on preoperative thirst management: randomized clinical trial / Goma de mascar mentolada en el manejo de la sed preoperatoria: ensayo clínico aleatorizado

Objetivo avaliar a efetividade da goma de mascar mentolada em aliviar a intensidade e o desconforto da sede do paciente cirúrgico no período pré-operatório. Método ensaio clínico controlado randomizado, com 102 pacientes em período pré-operatório, aleatorizados em grupo-controle, com cuidado usual, e grupo experimental, que recebeu goma de mascar mentolada, a variável de tratamento do estudo. O desfecho clínico primário foi a variação da intensidade da sede, avaliada pela Escala Verbal Numérica, e o secundário, a variação do desconforto da sede, avaliada pela Escala de Desconforto da Sede Perioperatória. Teste de Mann-Whitney foi usado para comparar as medidas entre os grupos. Nível de significância adotado de 0,05. Resultados a goma de mascar mentolada reduziu significativamente a intensidade (p<0,001), com d de Cohen de efeito médio, e o desconforto da sede (p<0,001), com d de Cohen de efeito grande. Conclusão a goma de mascar mentolada mostrou-se efetiva na redução da intensidade e do desconforto da sede pré-operatória. A estratégia mostrou-se uma opção inovadora, viável e segura no uso para o paciente cirúrgico, no manejo da sede pré-operatória, em cirurgias eletivas. NCT: 03200197.

Objective to evaluate the effectiveness of menthol chewing gum, in the relief of the intensity and discomfort of the surgical patient's thirst in the preoperative period. Method a randomized controlled trial, with 102 patients in the preoperative period, randomized in a control group, with usual care, and an experimental group, which received menthol gum, which was the study treatment variable. The primary clinical outcome was the variation in thirst intensity, evaluated by the Numeral Verbal Scale, and the secondary, the variation of the discomfort of thirst, evaluated by the Perioperative Thirst Discomfort Scale. Mann-Whitney test was used to compare measures between groups. The significance level adopted was of 0.05. Results menthol chewing gum significantly reduced the intensity (p <0.001), with Cohen's medium-effect d, and thirst discomfort (p <0.001), with a large-effect Cohen's d. Conclusion menthol chewing gum was effective in reducing the intensity and discomfort of preoperative thirst. The strategy proved to be an innovative, feasible and safe option in the use for the surgical patient, in the management of the preoperative thirst, in elective surgeries. NCT: 03200197.

Objetivo evaluar la efectividad de la goma de mascar mentolada en aliviar la intensidad y la incomodidad de la sed del paciente quirúrgico en el período preoperatorio. Método ensayo clínico controlado aleatorizado, con 102 pacientes en período preoperatorio, aleatorizados en grupo control, con cuidado usual, y grupo experimental, que recibió goma de mascar mentolada, la variable de tratamiento del estudio. El resultado clínico primario fue la variación de la intensidad de la sed, evaluada por la Escala Verbal Numérica, y el secundario, la variación de la incomodidad de la sed, evaluada por la Escala de Desconocimiento de la Sede Perioperatoria. La prueba de Mann-Whitney fue utilizada para comparar las medidas entre los grupos. Nivel de significancia adoptado de 0,05. Resultados la goma de mascar mentolada redujo significativamente la intensidad (p <0,001), con d de Cohen de efecto promedio, y el malestar de la sed (p <0,001), con d de Cohen de efecto grande. Conclusión la goma de mascar mentolada se mostró efectiva en la reducción de la intensidad y de la incomodidad de la sed preoperatoria. La estrategia se mostró una opción innovadora, viable y segura en el uso para el paciente quirúrgico, en el manejo de la sed preoperatoria, en cirugías electivas. NCT: 03200197.

Short-term exposure to bisphenol A affects water and salt intakes differently in male and ovariectomised female rats.

Thirst and sodium appetite are motivational states that lead to the search for and ingestion of water and sodium, thus contributing to maintenance of hydromineral balance. Oestrogens affect fluid intake and sodium preference. Bisphenol A (BPA) is an environmental endocrine-disrupting substance with oestrogenic activity. Whether there are sex differences in the ingestive effects of BPA is unknown. Therefore, the aim of the present work was to determine the effect of short-term treatment of low doses of BPA on thirst and sodium appetite in adult male and ovariectomised Wistar rats. Rats were subcutaneously injected with either vehicle or 10, 50, 100, or 500 µg/kg/day BPA for a week. Two-bottle tests (water and 2.7% NaCl solution) were conducted in the animals' home cages with and without 24 h water deprivation. BPA reduced water and 2.7% NaCl intakes in a sex-dependent-manner. Fluid intakes displayed inverted U-shaped dose-response curves, with different dose dependencies in spontaneously drinker rats than after 24 h water deprivation dehydration. Future studies on the role of BPA in sex-dependent body fluid homeostasis should elucidate the effects of BPA on the neuroendocrine controls of thirst and salt appetite.

Behavioral responses and fluid regulation in male rats after combined dietary sodium deficiency and water deprivation.

Most investigators use a single treatment such as water deprivation or dietary sodium deficiency to evaluate thirst or sodium appetite, which underlie behavioral responses to body fluid challenges. The goal of the present experiments was to assess the effects of combined treatments in driving behaviors. Therefore, we evaluated the effect of combined overnight water deprivation and dietary sodium deficiency on water intake and salt intake by adult male rats in 2-bottle (0.5M NaCl and water) tests. Overnight water deprivation alone increased water intake, and 10days of dietary sodium deficiency increased 0.5M NaCl intake, with a secondary increase in water intake. During combined water deprivation and dietary sodium deficiency, water intake was enhanced and 0.5M NaCl was reduced, but not eliminated, suggesting that physiologically relevant behavioral responses persist. Nonetheless, the pattern of fluid intake was altered by the combined treatments. We also assessed the effect of these behaviors on induced deficits in body sodium and fluid volume during combined treatments and found that, regardless of treatment, fluid ingestion partially repleted the induced deficits. Finally, we examined urine volume and sodium excretion during dietary sodium deficiency with or without overnight water deprivation and found that, whether or not rats were water deprived, and regardless of water consumption, sodium excretion was minimal. Thus, the combination of water deprivation and dietary sodium deficiency appears to arouse drives that stimulate compensatory behavioral responses. These behaviors, in conjunction with physiological adaptations to the treatments, underlie body sodium and volume repletion in the face of combined water deprivation and dietary sodium deficiency.

How to quench your thirst. The effect of water-based products varying in temperature and texture, flavour, and sugar content on thirst.

The sensation of thirst plays an important role in the consumption of water or other fluids to rehydrate the body in order to keep bodily functions working properly. An increase in saliva secretion, wetting the mouth by ingestion of liquids, and cooling and sour components in products can alleviate this sensation already before absorption of fluids by the body. This study aimed to investigate the thirst-quenching ability of water-based products differing in temperature and texture (cold solids and cool liquids), flavour (flavoured and non-flavoured) and sugar content in two consecutive experiments. The first experiment tested four products of 10ml each (flavoured popsicles, flavoured beverages, ice cubes, and water). 45 healthy, thirsty participants (8 men and 37 women, mean age 25.7years SD±6.6) were randomly assigned to a flavour group representing the flavour of the popsicles and beverages: mint, lemon, raspberry. Each flavour group tasted all four products (popsicles, beverages, water, ice cubes) in four sessions on consecutive days. Participants rated their thirst and four attributes (flavour intensity, thirst-quenching, refreshing, saliva stimulating) during 3min of consumption on a 100mm VAS scale and ranked all four products on thirst-quenching ability at the end of the last session. The second experiment was performed similarly (n=61, 6 men and 55 women, mean age 23.5years SD±2.87), but used sugar-reduced popsicles to compare to the regular popsicles from the first experiment. In addition, saliva was collected before and after consumption. In the first experiment, cold solid (55.8±0.99) and flavoured (55.9±0.95) products were found to be more thirst-quenching than cool liquid (52.8±0.96) and non-flavoured products (52.8±0.96). The second experiment confirmed that saliva production increased upon consumption of these popsicles, with an increase of saliva weight from 1.7g SD ±0.15 before consumption to 2.0 SD ±0.22 after consumption. Sugar-reduced popsicles were similar in thirst-quenching ability compared to regular popsicles. Overall, cold, solid, flavoured products (such as popsicles) performed best in quenching thirst, and it appeared that sugar-reduction in these products to create healthier alternatives can be achieved without compromising on thirst-quenching abilities. These results can be useful for optimisation of products to alleviate thirst in daily life, as well as in clinical settings for patients where fluid restriction is needed.