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1.
Medicine (Baltimore) ; 99(27): e21092, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629741

RESUMO

RATIONALE: Univentricular dextrocardia is a rare congenital heart disease that usually presents cyanotic manifestations from childhood. Due to the sustained dysfunction of blood oxygenation, it is very difficult to keep an asymptomatic survival. Herein, we described an interesting case of univentricular dextrocardia who suffered from initial symptoms in his middle age. PATIENT CONCERNS: A 54-year-old male patient with numbness and tingling of limbs was admitted to hospital due to the secondary manifestations of congenital heart disease. DIAGNOSIS: The patient was diagnosed as univentricular dextrocardia with pulmonary hypertension and secondary erythrocytosis based on computed tomography (CT) scan, echocardiography, and laboratory examinations. INTERVENTIONS: Intravenous hydration therapy with normal saline successfully eliminated his hyperviscosity associated symptoms. In view of socio-economic reasons, this patient refused surgical evaluation and further medical interventions. OUTCOMES: During 18-month follow up, he received no drug except for regular water intake. Fortunately, his life quality was satisfactory, and no other symptoms emerged except for mild numbness of limbs. LESSONS: In univentricular dextrocardia, it is possible to keep a long-term asymptomatic period due to the slow progress of pathophysiology. In this population, regular cardiac function evaluation and avoiding dehydration may help improve the quality of life.


Assuntos
Desidratação/prevenção & controle , Dextrocardia/diagnóstico por imagem , Cardiopatias Congênitas/complicações , Assistência ao Convalescente , Grupo com Ancestrais do Continente Asiático/etnologia , Dextrocardia/fisiopatologia , Dextrocardia/terapia , Ecocardiografia/métodos , Hospitalização , Humanos , Hipertensão Pulmonar/etiologia , Masculino , Pessoa de Meia-Idade , Policitemia/etiologia , Policitemia/terapia , Qualidade de Vida , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
2.
Eur J Endocrinol ; 183(2): R29-R40, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32580146

RESUMO

For an endocrinologist, nephrogenic diabetes insipidus (NDI) is an end-organ disease, that is the antidiuretic hormone, arginine-vasopressin (AVP) is normally produced but not recognized by the kidney with an inability to concentrate urine despite elevated plasma concentrations of AVP. Polyuria with hyposthenuria and polydipsia are the cardinal clinical manifestations of the disease. For a geneticist, hereditary NDI is a rare disease with a prevalence of five per million males secondary to loss of function of the vasopressin V2 receptor, an X-linked gene, or loss of function of the water channel AQP2. These are small genes, easily sequenced, with a number of both recurrent and private mutations described as disease causing. Other inherited disorders with mild, moderate or severe inability to concentrate urine include Bartter's syndrome and cystinosis. MAGED2 mutations are responsible for a transient form of Bartter's syndrome with severe polyhydramnios. The purpose of this review is to describe classical phenotype findings that will help physicians to identify early, before dehydration episodes with hypernatremia, patients with familial NDI. A number of patients are still diagnosed late with repeated dehydration episodes and large dilations of the urinary tract leading to a flow obstructive nephropathy with progressive deterioration of glomerular function. Families with ancestral X-linked AVPR2 mutations could be reconstructed and all female heterozygote patients identified with subsequent perinatal genetic testing to recognize affected males within 2 weeks of birth. Prevention of dehydration episodes is of critical importance in early life and beyond and decreasing solute intake will diminish total urine output.


Assuntos
Diabetes Insípido Nefrogênico/genética , Diabetes Insípido Nefrogênico/fisiopatologia , Desidratação/prevenção & controle , Diabetes Insípido Nefrogênico/terapia , Feminino , Triagem de Portadores Genéticos , Doenças Genéticas Ligadas ao Cromossomo X/genética , Testes Genéticos , Humanos , Hipernatremia , Recém-Nascido , Glomérulos Renais/fisiopatologia , Masculino , Mutação , Neurofisinas/sangue , Neurofisinas/fisiologia , Concentração Osmolar , Gravidez , Diagnóstico Pré-Natal , Precursores de Proteínas/sangue , Precursores de Proteínas/fisiologia , Receptores de Vasopressinas/genética , Receptores de Vasopressinas/fisiologia , Vasopressinas/sangue , Vasopressinas/fisiologia
3.
Diabet Med ; 37(7): 1094-1102, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32333691

RESUMO

The month of Ramadan forms one of the five pillars of the Muslim faith. Adult Muslims are obligated to keep daily fasts from dawn to sunset, with exceptions. This year Ramadan is due to begin on 23 April 2020 and the longest fast in the UK will be approximately 18 hours in length. In addition, due to the often high-calorie meals eaten to break the fast, Ramadan should be seen as a cycle of fasting and feasting. Ramadan fasting can impact those with diabetes, increasing the risk of hypoglycaemia, hyperglycaemia and dehydration. This year, Ramadan will occur during the global COVID-19 pandemic. Reports show that diabetes appears to be a risk factor for more severe disease with COVID-19. In addition, the UK experience has shown diabetes and COVID-19 is associated with dehydration, starvation ketosis, diabetic ketoacidosis and hyperosmolar hyperglycaemic state. This makes fasting in Ramadan particularly challenging for those Muslims with diabetes. Here, we discuss the implications of fasting in Ramadan during the COVID-19 pandemic and make recommendations for those with diabetes who wish to fast.


Assuntos
Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/terapia , Jejum/metabolismo , Férias e Feriados , Islamismo , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/metabolismo , Desidratação/epidemiologia , Desidratação/metabolismo , Desidratação/prevenção & controle , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/metabolismo , Cetoacidose Diabética/epidemiologia , Dietoterapia , Gerenciamento Clínico , Jejum/efeitos adversos , Hidratação , Humanos , Hiperglicemia/epidemiologia , Hiperglicemia/metabolismo , Hiperglicemia/prevenção & controle , Coma Hiperglicêmico Hiperosmolar não Cetótico/epidemiologia , Coma Hiperglicêmico Hiperosmolar não Cetótico/metabolismo , Hipoglicemia/epidemiologia , Hipoglicemia/metabolismo , Hipoglicemia/prevenção & controle , Hipoglicemiantes/uso terapêutico , Cetose/epidemiologia , Cetose/metabolismo , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/metabolismo , Medição de Risco , Reino Unido
4.
Diabetes Metab Syndr ; 14(4): 405-406, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32335366

RESUMO

It has been reported that frequent occurrence of COVID-19 infection in these patients is associated with low cytosolic pH. During virus infection, serum lactate dehydrogenase (LDH) level excessively rises. LDH is a cytosolic enzyme and the serum level increases as the cell break down. When anaerobic conditions develop, lactate formation increases from pyruvate. Cell pH is regulated by very complex mechanisms. When lactate increases in the extracellular area, this symporter carries lactate and H+ ion into the cell, and the intracellular pH quickly becomes acidic. Paradoxically, Na+/H+ exchanger activation takes place. While H+ ion is thrown out of the cell, Na+ and Ca+2 enter the cell. When Na+ and Ca+2 increase in the cell, the cells swell and die. Dapagliflozin is a sodium-glucose cotransporter-2 inhibitor. Dapagliflozin has been reported to reduce lactate levels by various mechanisms. Also, it reduces oxygen consumption in tissues and causes the use of glucose in the aerobic pathway, thereby reducing lactate production. A lactate decrease in the environment reduces the activation of lactate/H+ symporter. Thus, the H ion pumping into the cell by this symporter is reduced and the cytosolic pH is maintained. Dapagliflozin also directly inhibits NHE. Thus, Na+ and Ca+2 flow to the cell are inhibited. Dapagliflozin provides the continuation of the structure and functions of the cells. Dapagliflozin can prevent the severe course of COVID-19 infection by preventing the lowering of cytosolic pH and reducing the viral load.


Assuntos
Compostos Benzidrílicos/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Diabetes Mellitus/tratamento farmacológico , Glucosídeos/uso terapêutico , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Comorbidade , Infecções por Coronavirus/epidemiologia , Desidratação/prevenção & controle , Diabetes Mellitus/epidemiologia , Humanos , Insulina/uso terapêutico , Ácido Láctico/metabolismo , Consumo de Oxigênio/efeitos dos fármacos , Pneumonia Viral/epidemiologia
5.
Br J Nurs ; 29(1): 50-54, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917945

RESUMO

INTRODUCTION: access to water at the bedside is a cornerstone of patient care. Among bedbound inpatients, water within reach at the bedside is a basic human dignity and one that ought not to be neglected. AIM: the authors sought to identify the extent to which accessible hydration facilities were provided to a bedbound inpatient population. METHODS: a cross-sectional, point-prevalent audit of hospitalised medical inpatients across five centres was conducted. Data were collected between meal times and noted baseline demographics and admission details, adequacy of oral hydration provision at the bedside and, where provision was inadequate, factors associated with this. RESULTS: across a total surveyed patient population of 559 we identified 138 patients who were bedbound. Among these bedbound patients, 6% (n=8) had no water provided at the bedside. However, 7 of these were deemed to be unable to swallow safely. In total, 44 (32%) of the 138 bedbound patients were unable to reach the water at their bedside; 18 of these patients would have been able to drink for themselves had the water been in reach. CONCLUSION: there is significant room for improvement in ensuring patients who are immobile are able to reach drinking apparatus at the bedside. In the five centres surveyed, approximately one in five bedbound patients with no contraindication are unable to reach an essential means of hydration.


Assuntos
Auditoria Clínica , Desidratação/prevenção & controle , Água Potável , Hospitalização , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Inglaterra , Feminino , Hospitais Gerais , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Medicina Estatal , Adulto Jovem
6.
J. pediatr. (Rio J.) ; 95(6): 689-695, Nov.-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1056654

RESUMO

ABSTRACT Objective: The literature indicates a single universal cut-off point for weight loss after birth for the risk of hypernatremia, without considering other factors. The aim of this study was to construct and internally validate cut-off points for the percentage weight loss associated with the risk of hypernatremia, taking into account risk factors. Methods: A prospective study with a three-day follow-up was conducted in 165 neonates with a gestational age ≥35 weeks. The main outcome variable was mild or moderate hypernatremia (serum sodium ≥ 145 mmol/L). Secondary variables (risk factors) were maternal and infant variables. A multivariate logistic regression model was constructed to predict hypernatremia, obtaining its probability and the optimal discriminant cut-off point for hypernatremia (receiver operating characteristic analysis). Based on this point, threshold weight loss values were obtained according to the other variables. These values were internally validated by bootstrapping. Results: There were 51 cases (30.9%) of hypernatremia. The mean percentage weight loss for hypernatremic infants was 8.6% and 6.0% for the rest. Associated variables in the multivariate model included greater weight loss, male gender, higher education level, multiparity, and cesarean delivery. The model had an area under the receiver operating characteristic curve of 0.84 (sensitivity = 77.6%; specificity = 73.2%). Similar values were obtained in the bootstrapping validation. The lowest percentage weight loss was 4.77%, for cesarean delivery in male infants of mothers with a higher education level. Conclusions: The weight loss percentage values depended on the type of delivery, parity, newborn gender, and level of maternal education. External studies are required to validate these values.


RESUMO Objetivo: A literatura indica um único ponto de corte universal na perda de peso após o nascimento para risco de hipernatremia, sem considerar outros fatores. Nosso objetivo foi criar e validar internamente pontos de corte para o percentual de perda de peso associado ao risco de hipernatremia considerando fatores de risco. Métodos: Foi feito um estudo prospectivo que incluiu 165 neonatos com idade gestacional ≥ 35 semanas, acompanhados por três dias. A principal variável de resultado foi hipernatremia leve ou moderada (sódio sérico ≥ 145 mmol/L). As variáveis secundárias (fatores de risco) foram variáveis maternas e dos neonatos. Um modelo multivariado de regressão logística foi criado para diagnosticar hipernatremia, obteve sua probabilidade e o ponto de corte discriminativo ideal para hipernatremia (análise da Característica de Operação do Receptor). Com base nesse ponto, obtivemos então os valores limites de perda de peso de acordo com as outras variáveis. Esses valores foram internamente validados por. Resultados: Há 51 casos (30,9%) de hipernatremia. O percentual de perda de peso para neonatos hipernatrêmicos foi 8,6% e 6,0% para o restante. As variáveis associadas no modelo multivariado incluíram maior perda de peso, sexo masculino, maior nível de escolaridade, multiparidade e cesárea. O modelo apresentou uma área sob a curva da Característica de Operação do Receptor de 0,84 (sensibilidade = 77,6%; especificidade = 73,2%). Valores semelhantes foram obtidos na validação da bootstrapping. O menor percentual de perda de peso foi 4,77% para cesárea em neonatos do sexo masculino de mães com maior nível de escolaridade. Conclusões: Os valores percentuais de perda de peso dependem do tipo de parto, paridade, sexo do recém-nascido e nível de escolaridade materna. São necessários estudos externos para validar esses valores.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Perda de Peso , Desidratação/diagnóstico , Hipernatremia/diagnóstico , Aleitamento Materno , Análise Multivariada , Estudos Prospectivos , Fatores de Risco , Idade Gestacional , Desidratação/etiologia , Desidratação/prevenção & controle , Hipernatremia/etiologia , Hipernatremia/prevenção & controle
8.
Nutrients ; 11(7)2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31324008

RESUMO

Personalized hydration strategies play a key role in optimizing the performance and safety of athletes during sporting activities. Clinicians should be aware of the many physiological, behavioral, logistical and psychological issues that determine both the athlete's fluid needs during sport and his/her opportunity to address them; these are often specific to the environment, the event and the individual athlete. In this paper we address the major considerations for assessing hydration status in athletes and practical solutions to overcome obstacles of a given sport. Based on these solutions, practitioners can better advise athletes to develop practices that optimize hydration for their sports.


Assuntos
Ingestão de Líquidos , Esportes , Água , Atletas , Desidratação/prevenção & controle , Humanos
9.
Br J Community Nurs ; 24(7): 323-327, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31265346

RESUMO

There is an increase in the demand for community services to provide care closer to home, and care teams are placing a growing emphasis on admission avoidance and early discharge. Community and district nurses are key professionals in this care delivery and are required to be alert to the risk factors for clinical deterioration, such as dysphagia (swallowing problems). Especially in older adults and those with frailty, dysphagia can cause a wide range of problems, from dehydration and malnutrition to respiratory tract infections that warrant antibiotic use and even hospitalisation. This article describes how dysphagia can be identified and managed in the community setting and explains the benefits and impact of speech and language therapy and wider multidisciplinary team intervention.


Assuntos
Enfermagem em Saúde Comunitária , Serviços de Saúde Comunitária , Transtornos de Deglutição/enfermagem , Transtornos de Deglutição/complicações , Transtornos de Deglutição/diagnóstico , Desidratação/etiologia , Desidratação/prevenção & controle , Dietoterapia , Fragilidade , Humanos , Desnutrição/etiologia , Desnutrição/prevenção & controle , Equipe de Assistência ao Paciente , Encaminhamento e Consulta , Infecções Respiratórias/etiologia , Infecções Respiratórias/prevenção & controle , Medição de Risco , Patologia da Fala e Linguagem , Medicina Estatal , Reino Unido
10.
Indian Pediatr ; 56(6): 468-471, 2019 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-31278225

RESUMO

OBJECTIVE: To evaluate the efficacy of ondansetron for the treatment of vomiting and thus reducing the need for intravenous (IV) rehydration in children with gastroenteritis. DESIGN: Double-blind, placebo-controlled, randomized trial. SETTING: Pediatric ward of An Giang General Hospital, South Vietnam, between December 2013 and June 2014. PARTICIPANTS: 61 inpatient children (age 11-60 mo) suffering from gastroenteritis with vomiting. Exclusion criteria were: underlying chronic conditions, immunodeficiency, malnutrition or history of allergy to ondansetron. INTERVENTION: Single bolus of IV ondansetron at a dose of 0.2 mg/kg or placebo. OUTCOME MEASURES: Proportion of patients who needed IV rehydration, proportion of patients with cessation of vomiting, amount of oral rehydration solution intake, duration of diarrhea and the length of hospital stay. RESULTS: After drug administration, 22 (73%) of the 30 patients in the ondansetron group had complete cessation of vomiting compared with 7 (23%) of the 31 patients in the placebo group (RR 0.32; 95% CI 0.16 to 0.63, P<0.001). 3 (10%) patients in the ondansetron group required IV rehydration as compared with 12 (39%) in the placebo group (RR 0.51; 95% CI 0.33 to 0.79, P=0.009). The median amount of oral rehydration solution intake in 24 hours was significantly greater in the ondansetron group (450 mL vs 350 mL, P=0.019).The duration of diarrhea and the length of hospital stay were not different between the two groups. CONCLUSIONS: In hospitalized children having gastro-enteritis associated with emesis, ondansetron is effective in the cessation of episodes of vomiting and in lowering the rates of IV rehydration, without reducing the duration of diarrhea and hospital stay.


Assuntos
Antieméticos/uso terapêutico , Desidratação/prevenção & controle , Gastroenterite/complicações , Ondansetron/uso terapêutico , Vômito/tratamento farmacológico , Pré-Escolar , Desidratação/etiologia , Desidratação/terapia , Diarreia/etiologia , Método Duplo-Cego , Esquema de Medicação , Feminino , Hidratação/estatística & dados numéricos , Gastroenterite/terapia , Humanos , Lactente , Injeções Intravenosas , Tempo de Internação/estatística & dados numéricos , Masculino , Resultado do Tratamento , Vômito/etiologia
11.
Eur J Pediatr ; 178(9): 1317-1324, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31267223

RESUMO

Preterm infants are at risk of increased trans-epidermal water loss and infections due to epidermal immaturity. The emollient and anti-infective properties of coconut oil make it a potentially beneficial topical agent for this population. We aimed to systematically review randomised trials assessing the effects of topical coconut oil in preterm infants. Medline, EMBASE, Cochrane Central Register of Controlled Trials and CINAHL were searched. Seven trials (n = 727 infants) were included. The majority of trials included relatively mature infants (gestation > 32 weeks, birth weight > 1200 g). The duration of intervention (5-31 days) and outcomes of interest varied among included studies. Meta-analysis using random effects model found significantly lower incidence of hospital-acquired blood stream infections (HABSI) in the coconut oil group (11/164 vs 32/166; relative risk 0.35, 95% confidence interval 0.18, 0.67, p = 0.001; I2 = 0%, two RCTs). Overall, infants in the coconut oil group had decreased water loss, decreased infection rates, better growth and skin condition. There were no significant adverse effects associated with coconut oil application. The overall quality of evidence was considered moderate for the outcome of HABSI and low for the outcome of physical growth based on GRADE guidelines.Conclusion: Topical coconut oil application to the skin may be beneficial in preterm infants, but the quality of evidence is low to moderate. Adequately powered randomised controlled trials, especially in very preterm (< 32 weeks) and extremely preterm (< 28 weeks) infants, are needed. What is Known: • Coconut oil has been used traditionally for topical application in terms of infants in Asian countries What is New: • This systematic review found that topical application of coconut oil may reduce the risk of infection and improve weight gain and skin condition in preterm infants. However, the quality of evidence was considered to be moderate to low based on GRADE guidelines.


Assuntos
Anti-Infecciosos/uso terapêutico , Óleo de Coco/uso terapêutico , Desidratação/prevenção & controle , Emolientes/uso terapêutico , Doenças do Prematuro/prevenção & controle , Sepse Neonatal/prevenção & controle , Higiene da Pele/métodos , Administração Cutânea , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Ganho de Peso
13.
J Athl Train ; 54(5): 541-549, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31058540

RESUMO

CONTEXT: Little is known about how educating runners may correct common misconceptions surrounding heat safety and hydration strategies. OBJECTIVE: To investigate (1) beliefs and knowledge about heat safety and hydration strategies among recreational runners and (2) the effectiveness of an educational video in optimizing performance in the heat. DESIGN: Cross-sectional study. SETTING: Survey. PATIENTS OR OTHER PARTICIPANTS: A total of 2091 (25.1%) of 8319 runners registered for the 2017 Falmouth Road Race completed at least 1 of the 3 administered surveys. INTERVENTION(S): A 5.3-minute video and an 11-question survey regarding heat safety and hydration strategies were developed, validated, and implemented. The survey was e-mailed to registrants 9 weeks before the race (PRERACE), after they viewed the video (POSTEDU), and the afternoon of the race (POSTRACE). MAIN OUTCOME MEASURE(S): The total score for responses to 2 multiple choice questions and nine 5-point (response range = strongly agree to strongly disagree) Likert-scale questions. RESULTS: The PRERACE results showed that more than 90% of respondents recognized the importance of staying hydrated beginning the day before the planned activity, correctly identified that dark color urine is not a sign of euhydration, and believed that dehydration may increase the risk for heat syncope. Conversely, fewer than 50% of respondents knew the number of days required to achieve heat acclimatization, the role of sweat-rate calculation in optimizing one's hydration strategy, or the risk of water intoxication from drinking too much water. An improvement in survey score from PRERACE to POSTEDU was observed (mean difference = 2.00; 95% confidence interval = 1.68, 2.33; P < .001) among runners who watched the video, and 73% of the improvement in their scores was retained from POSTEDU to POSTRACE (mean difference = -0.54; 95% confidence interval = -0.86, -0.21; P < .001). CONCLUSIONS: The video successfully shifted runners' beliefs and knowledge to enable them to better optimize their performance in the heat.


Assuntos
Desidratação , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde/métodos , Temperatura Alta/efeitos adversos , Corrida , Adulto , Estudos Transversais , Cultura , Desidratação/etiologia , Desidratação/prevenção & controle , Desidratação/psicologia , Ingestão de Líquidos , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Corrida/educação , Corrida/fisiologia , Corrida/psicologia , Inquéritos e Questionários , Água
14.
Eur J Appl Physiol ; 119(8): 1711-1723, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31098832

RESUMO

PURPOSE: To examine the effect of carbohydrate (CHO) mouth rinsing on endurance running responses and performance in dehydrated individuals. METHODS: In a double blind, randomised crossover design, 12 well-trained male runners completed 4 running time to exhaustion (TTE) trials at a speed equivalent to 70% of VO2peak in a thermoneutral condition. Throughout each run, participants mouth rinsed and expectorated every 15 min either 25 mL of 6% CHO or a placebo (PLA) solution for 10 s. The four TTEs consisted of two trials in the euhydrated (EU-CHO and EU-PLA) and two trials in the dehydrated (DY-CHO and DY-PLA) state. Prior to each TTE run, participants were dehydrated via exercise and allowed a passive rest period during which they were fed and either rehydrated equivalent to their body mass deficit (i.e., EU trials) or ingested only 50 mL of water (DY trials). RESULTS: CHO mouth rinsing significantly improved TTE performance in the DY compared to the EU trials (78.2 ± 4.3 vs. 76.9 ± 3.8 min, P = 0.02). The arousal level of the runners was significantly higher in the DY compared to the EU trials (P = 0.02). There was no significant difference among trials in heart rate, plasma glucose and lactate, and psychological measures. CONCLUSIONS: CHO mouth rinsing enhanced running performance significantly more when participants were dehydrated vs. euhydrated due to the greater sensitivity of oral receptors related to thirst and central mediated activation. These results show that level of dehydration alters the effect of brain perception with presence of CHO.


Assuntos
Carboidratos/uso terapêutico , Desidratação/tratamento farmacológico , Tolerância ao Exercício , Antissépticos Bucais/uso terapêutico , Corrida , Adulto , Limiar Anaeróbio , Carboidratos/administração & dosagem , Desidratação/prevenção & controle , Humanos , Masculino , Antissépticos Bucais/administração & dosagem , Estado de Hidratação do Organismo
15.
Nature ; 569(7758): 649-654, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31142854

RESUMO

About 800 million people depend in part on meltwater from the thousands of glaciers in the high mountains of Asia. Water stress makes this region vulnerable to drought, but glaciers are a uniquely drought-resilient source of water. Here I show that seasonal glacier meltwater is equivalent to the basic needs of 221 ± 59 million people, or most of the annual municipal and industrial needs of Pakistan, Afghanistan, Tajikistan, Turkmenistan, Uzbekistan and Kyrgyzstan. During drought summers, meltwater dominates water inputs to the upper Indus, Aral and Chu/Issyk-Kul river basins. This reduces the risk of social instability, conflict and sudden migrations triggered by water scarcity, which is already associated with the large, rapidly growing populations and hydro-economies of these basins. Regional meltwater production is, however, unsustainably high-at 1.6 times the balance rate-and is expected to increase in future decades before ultimately declining. These results update and reinforce a previous publication in Nature on this topic, which was retracted after an inadvertent error was discovered.


Assuntos
Secas , Congelamento , Camada de Gelo/química , Abastecimento de Água/estatística & dados numéricos , Aclimatação , Ásia , Desidratação/prevenção & controle , Ecossistema , Humanos , Política , Chuva , Rios , Estações do Ano , Temperatura
17.
Int Arch Occup Environ Health ; 92(7): 977-990, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30997573

RESUMO

OBJECTIVE: Agricultural workers worldwide exposed to heat stress could be at the risk of kidney injury, which could lead to chronic kidney disease of an unknown origin (CKDu). Hydration has been promoted as a key measure to reduce kidney injury. In the presence of a hydration intervention, the incidence of acute kidney injury (AKI) was calculated in a sugarcane worker population in Guatemala and several risk factors were evaluated. METHODS: We measured kidney function at the beginning and end of the work shift at three time points in 517 sugarcane workers. We defined AKI as an increase in serum creatinine of 26.5 µmol/L or 50% or more from the pre-shift value. Associations between AKI and risk factors were examined, including interactions with hydration status. RESULTS: The prevalence of dehydration post-shift (> 1.020 specific gravity) was 11% in February, 9% in March, and 6% in April. Cumulative incidence of AKI was 53% in February, 54% in March, and 51% in April. AKI was associated with increasing post-shift specific gravity, a dehydration marker, (OR 1.24, 95% CI 1.02-1.52) and with lower electrolyte solution intake (OR 0.94, 95% CI 0.89-0.99). CONCLUSIONS: Dehydration and insufficient electrolyte consumption are risk factors for AKI. However even well-hydrated sugarcane workers routinely experience AKI. While hydration is important and protective, there is a need to understand other contributors to risk of AKI and identify prevention strategies with these workers.


Assuntos
Lesão Renal Aguda/prevenção & controle , Fazendeiros , Transtornos de Estresse por Calor/epidemiologia , Exposição Ocupacional/efeitos adversos , Lesão Renal Aguda/etiologia , Adulto , Estudos de Coortes , Creatinina/sangue , Desidratação/epidemiologia , Desidratação/prevenção & controle , Eletrólitos , Guatemala , Humanos , Estudos Longitudinais , Masculino , Prevalência , Estudos Prospectivos , Saccharum , Gravidade Específica
18.
Int J Sport Nutr Exerc Metab ; 29(2): 175-180, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30943836

RESUMO

The 2019 International Amateur Athletics Federation Track-and-Field World Championships will take place in Qatar in the Middle East. The 2020 Summer Olympics will take place in Tokyo, Japan. It is quite likely that these events may set the record for hottest competitions in the recorded history of both the Track-and-Field World Championships and Olympic Games. Given the extreme heat in which track-and-field athletes will need to train and compete for these games, the importance of hydration is amplified more than in previous years. The diverse nature of track-and-field events, training programs, and individuality of athletes taking part inevitably means that fluid needs will be highly variable. Track-and-field events can be classified as low, moderate, or high risk for dehydration based on typical training and competition scenarios, fluid availability, and anticipated sweat losses. This paper reviews the risks of dehydration and potential consequences to performance in track-and-field events. The authors also discuss strategies for mitigating the risk of dehydration.


Assuntos
Desempenho Atlético/fisiologia , Desidratação/prevenção & controle , Fenômenos Fisiológicos da Nutrição Esportiva , Atletismo/fisiologia , Atletas , Água Corporal , Ingestão de Líquidos , Humanos , Estado de Hidratação do Organismo , Fatores de Risco , Sudorese
19.
J Gerontol Nurs ; 45(4): 21-29, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30917202

RESUMO

Water intake and hydration status of assisted living memory care (ALMC) residents were evaluated. Thirty-two residents (eight men; mean age 86.5 years; Global Deterioration Scale [GDS] 3 to 7) from four ALMC units participated. Ingested food and fluid amount, type, and time, and ingestion behaviors were observed from 7:00 a.m. to 7:00 p.m. Related factors were obtained from chart review/participant survey. Mean fluid intake was 1,160.16 mL; mean water intake from food and fluid was 56.55% (SD = 23.4%) of recommended water intake (RWI). Only one participant met 100% RWI. Using osmolality laboratory results (available for 21 participants), five participants were hydrated, whereas eight (38.1%) participants were in impending dehydration and dehydration categories, respectively. Fluid intake, GDS, and level of assistance during meals predicted RWI. Water intake of ALMC residents is inadequate, placing them at risk for dehydration, and justifies development and implementation of care standards for increasing water intake. [Journal of Gerontological Nursing, 45(4), 21-29.].


Assuntos
Desidratação/prevenção & controle , Ingestão de Líquidos , Avaliação Geriátrica/métodos , Enfermagem Geriátrica/métodos , Transtornos da Memória/diagnóstico , Transtornos da Memória/fisiopatologia , Casas de Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino
20.
Medicina (Kaunas) ; 55(3)2019 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-30871128

RESUMO

Background and objectives: Hyperthermia with dehydration alters several brain structure volumes, mainly by changing plasma osmolality, thus strongly affecting neural functions (cognitive and motor). Here, we aimed to examine whether the prevention of significant dehydration caused by passively induced whole-body hyperthermia attenuates peripheral and/or central fatigability during a sustained 2-min isometric maximal voluntary contraction (MVC). Materials and Methods: Ten healthy and physically active adult men (21 ± 1 years of age) performed an isometric MVC of the knee extensors for 2 min (2-min MVC) under control (CON) conditions, after passive lower-body heating that induced severe whole-body hyperthermia (HT, Tre > 39 °C) with dehydration (HT-D) and after HT with rehydration (HT-RH). Results: In the HT-D trial, the subjects lost 0.94 ± 0.15 kg (1.33% ± 0.13%) of their body weight; in the HT-RH trial, their body weight increased by 0.1 ± 0.42 kg (0.1% ± 0.58%). After lower-body heating, the HT-RH trial (vs. HT-D trial) was accompanied by a significantly lower physiological stress index (6.77 ± 0.98 vs. 7.40 ± 1.46, respectively), heart rate (47.8 ± 9.8 vs. 60.8 ± 13.2 b min-1, respectively), and systolic blood pressure (-12.52 ± 5.1 vs. +2.3 ± 6.4, respectively). During 2-min MVC, hyperthermia (HT-D; HT-RH) resulted in greater central fatigability compared with the CON trial. The voluntary activation of exercising muscles was less depressed in the HT-RH trial compared with the HT-D trial. Over the exercise period, electrically (involuntary) induced torque decreased less in the HT-D trial than in the CON and HT-RH trials. Conclusions: Our results suggest that pre-exercise rehydration might have the immediate positive effect of reducing physiological thermal strain, thus attenuating central fatigability even when exercise is performed during severe (Tre > 39 °C) HT, induced by passive warming of the lower body.


Assuntos
Desidratação/prevenção & controle , Exercício Físico/fisiologia , Febre/tratamento farmacológico , Hidratação , Contração Isométrica/fisiologia , Solução Salina/uso terapêutico , Estresse Fisiológico , Adulto , Análise de Variância , Atletas , Pressão Sanguínea/fisiologia , Temperatura Corporal/fisiologia , Voluntários Saudáveis , Frequência Cardíaca/fisiologia , Humanos , Joelho/fisiologia , Masculino , Músculo Esquelético/fisiologia , Estado de Hidratação do Organismo/fisiologia , Estatísticas não Paramétricas , Adulto Jovem
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