Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 182
Filtrar
1.
Am J Physiol Regul Integr Comp Physiol ; 318(5): R950-R960, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32233779

RESUMO

Military and civilian emergency situations often involve prolonged exposures to warm and very humid environments. We tested the hypothesis that increases in core temperature and body fluid losses during prolonged exposure to warm and very humid environments are dependent on dry bulb temperature. On three occasions, 15 healthy males (23 ± 3 yr) sat in 32.1 ± 0.1°C, 33.1 ± 0.2°C, or 35.0 ± 0.1°C and 95 ± 2% relative humidity normobaric environments for 8 h. Core temperature (telemetry pill) and percent change in body weight, an index of changes in total body water occurring secondary to sweat loss, were measured every hour. Linear regression models were fit to core temperature (over the final 4 h) and percent changes in body weight (over the entire 8 h) for each subject. These equations were used to predict core temperature and percent changes in body weight for up to 24 h. At the end of the 8-h exposure, core temperature was higher in 35°C (38.2 ± 0.4°C, P < 0.01) compared with 32°C (37.2 ± 0.2°C) and 33°C (37.5 ± 0.2°C). At this time, percent changes in body weight were greater in 35°C (-1.9 ± 0.5%) compared with 32°C (-1.4 ± 0.3%, P < 0.01) but not 33°C (-1.6 ± 0.6%, P = 0.17). At 24 h, predicted core temperature was higher in 35°C (39.2 ± 1.4°C, P < 0.01) compared with 32°C (37.6 ± 0.9°C) and 33°C (37.5 ± 0.9°C), and predicted percent changes in body weight were greater in 35°C (-6.1 ± 2.4%) compared with 32°C (-4.6 ± 1.5%, P = 0.04) but not 33°C (-5.3 ± 2.0%, P = 0.43). Prolonged exposure to 35°C, but not 32°C or 33°C, dry bulb temperatures and high humidity is uncompensable heat stress, which exacerbates body fluid losses.


Assuntos
Regulação da Temperatura Corporal , Exposição Ambiental , Transtornos de Estresse por Calor/fisiopatologia , Temperatura Alta , Umidade , Militares , Medicina Submarina , Adulto , Deslocamentos de Líquidos Corporais , Transtornos de Estresse por Calor/etiologia , Humanos , Masculino , Modelos Biológicos , Estado de Hidratação do Organismo , Sudorese , Fatores de Tempo , Equilíbrio Hidroeletrolítico , Perda de Peso , Adulto Jovem
2.
J Fish Biol ; 96(6): 1388-1398, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32133642

RESUMO

Length-weight relationships (LWRs) were estimated for 36 mesopelagic fish species collected from the equatorial and tropical Atlantic encompassing several oceanographic regions: oligotrophic, equatorial, Cape Blanc, Cape Verde and the Canary Islands. The sample was composed of myctophids (25 species), gonostomatids (5), sternoptychids (3), stomiids (2) and phosichthyids (1). The species were clustered according to body shape: "short-deep" (sternoptychids), "elongate" (gonostomatids, stomiids and some phosichthyids) and "fusiform" (myctophids and some phosichthyids). Three types of weight and LWRs were considered: wet weight (WW), eviscerated wet weight (eWW) and eviscerated dry weight (eDW). The study demonstrated that most species present a positive allometric growth, independent of the weight used. However, the allometric value varied in 40-50% of species depending on the type of weight considered. Significant variations linked to fish morphology were found in the relationship between the slope and intercept of the LWR equation. Significant differences were also noted in the water content linked to fish body shape. Based on the distributions of several species we compare their fitness between oceanographic regions using the relative condition factor (Krel ). Except for Diaphus brachycephalus (oligotrophic vs. equatorial waters) and Lampanyctus alatus (equatorial, Cape Blanc, Cape Verde and the Canary Islands), no regional significant differences were observed in the species analysed.


Assuntos
Tamanho Corporal , Peso Corporal , Meio Ambiente , Peixes/anatomia & histologia , Animais , Oceano Atlântico , Estado de Hidratação do Organismo , Clima Tropical
3.
J Sports Sci ; 38(5): 552-558, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31941416

RESUMO

The objective of this study was to analyse the effect of the use of social networks in smartphones or playing video games on the passing decision-making performance in professional soccer athletes. Participants were 25 male professional soccer athletes (mean ± SD: age 23.4 ± 2.8 years). The participants performed three randomised conditions divided into three groups: control (CON), smartphone (SMA), and video game (VID). Before and after each experimental condition, the Stroop Task assessed the level of induced mental fatigue. Then, the athletes performed a simulated soccer match. A CANON® camera recorded the matches for further analysis on passing decision-making performance. A group effect was identified (p < .01) with impairment on passing decision-making performance for the SMA (p = .01, ES = 0.5) and VID (p = .01, ES = 0.5) conditions. We concluded that the use of social networks on smartphones and/or playing video games right before official soccer matches might impair the passing decision-making performance in professional soccer athletes.


Assuntos
Tomada de Decisões , Smartphone , Futebol/psicologia , Jogos de Vídeo , Adulto , Desempenho Atlético , Estudos Cross-Over , Humanos , Masculino , Redes Sociais Online , Estado de Hidratação do Organismo/fisiologia , Distribuição Aleatória , Futebol/fisiologia , Teste de Stroop , Adulto Jovem
4.
Res Nurs Health ; 43(1): 8-16, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31793019

RESUMO

There is a lack of consensus in the international scientific community with respect to the most suitable hydration strategies when attending nulliparous women during low-risk births. This paper describes the protocol for a randomized controlled trial to compare two hydration strategies and their influence on maternal and neonatal morbidity. The study population consists of nulliparous women admitted to the obstetrics department of a University Hospital. The women are being randomized into two groups: the "optimal hydration" group, which will be guaranteed 300 ml/hr liquids (crystalloids and bottled mineral water) with a minimum diuresis of 35 ml/hr; and the "variability in hydration" group, which will receive intravenous (alternating normal saline, Ringer's lactate solution, glucose, or Voluven®) and clear (bottled mineral water or isotonic drinks [Aquarius®]) liquids, without any established perfusion rate, and without established minimum diuresis. Outcomes for mothers include duration of labor, cesarean section, fever, and dehydration. Outcomes for newborns are respiratory distress, hypoglycemia, hyponatremia, jaundice, weight loss over 48 hr, and breastfeeding difficulties. Analysis will be per-protocol. Administering optimal hydration may improve health and safety for mothers and their newborn and reduce maternal and neonatal morbidity. The study is registered at www.clinicaltrials.gov. The project received funding by the Ministry of Health of Spain and is approved by the Research Ethics Committee.


Assuntos
Hidratação/normas , Trabalho de Parto/fisiologia , Estado de Hidratação do Organismo/fisiologia , Guias de Prática Clínica como Assunto , Cuidado Pré-Natal/normas , Adulto , Feminino , Humanos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Espanha
5.
Nephrology (Carlton) ; 25(1): 82-89, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30887608

RESUMO

AIM: Clinical interpretation of B-type natriuretic peptide (BNP) levels in haemodialysis (HD) patients for fluid management remains elusive. METHODS: We conducted a retrospective observational monocentric study. We built a mathematical model to predict BNP levels, using multiple linear regressions. Fifteen clinical/biological characteristics associated with BNP variation were selected. A first cohort of 150 prevalent HD (from September 2015 to March 2016) was used to build several models. The best model proposed was internally validated in an independent cohort of 75 incidents HD (from March 2016 to December 2017). RESULTS: In cohort 1, mean BNP level was 630 ± 717 ng/mL. Cardiac disease (CD - stable coronary artery disease and/or atrial fibrillation) was present in 45% of patients. The final model includes age, systolic blood pressure, albumin, CD, normo-hydrated weight (NHW) and the fluid overload (FO) assessed by bio-impedancemetry. The correlation between the measured and the predicted log-BNP was 0.567 and 0.543 in cohorts 1 and 2, respectively. Age (ß = 3.175e-2 , P < 0.001), CD (ß = 5.243e-1 , P < 0.001) and FO (ß = 1.227e-1 , P < 0.001) contribute most significantly to the BNP level, respectively, but within a certain range. We observed a logistic relationship between BNP and age between 30 and 60 years, after which this relationship was lost. BNP level was inversely correlated with NHW independently of CD. Finally, our model allows us to predict the BNP level according to the FO. CONCLUSION: We developed a mathematical model capable of predicting the BNP level in HD. Our results show the complex contribution of age, CD and FO on BNP level.


Assuntos
Falência Renal Crônica/terapia , Modelos Biológicos , Peptídeo Natriurético Encefálico/sangue , Diálise Renal/efeitos adversos , Equilíbrio Hidroeletrolítico , Desequilíbrio Hidroeletrolítico/diagnóstico , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/fisiopatologia , Feminino , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estado de Hidratação do Organismo , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Desequilíbrio Hidroeletrolítico/sangue , Desequilíbrio Hidroeletrolítico/etiologia , Adulto Jovem
6.
Nat Commun ; 10(1): 5513, 2019 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-31797921

RESUMO

Recently introduced classes of thin, soft, skin-mounted microfluidic systems offer powerful capabilities for continuous, real-time monitoring of total sweat loss, sweat rate and sweat biomarkers. Although these technologies operate without the cost, complexity, size, and weight associated with active components or power sources, rehydration events can render previous measurements irrelevant and detection of anomalous physiological events, such as high sweat loss, requires user engagement to observe colorimetric responses. Here we address these limitations through monolithic systems of pinch valves and suction pumps for purging of sweat as a reset mechanism to coincide with hydration events, microstructural optics for reversible readout of sweat loss, and effervescent pumps and chemesthetic agents for automated delivery of sensory warnings of excessive sweat loss. Human subject trials demonstrate the ability of these systems to alert users to the potential for dehydration via skin sensations initiated by sweat-triggered ejection of menthol and capsaicin.


Assuntos
Técnicas Biossensoriais/instrumentação , Técnicas Eletroquímicas/instrumentação , Técnicas Analíticas Microfluídicas/instrumentação , Técnicas Analíticas Microfluídicas/métodos , Pele/metabolismo , Suor/metabolismo , Biomarcadores/metabolismo , Técnicas Biossensoriais/métodos , Técnicas Eletroquímicas/métodos , Retroalimentação Fisiológica , Humanos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Estado de Hidratação do Organismo , Reprodutibilidade dos Testes , Pele/química , Suor/química
7.
Med Sci Monit ; 25: 8438-8446, 2019 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-31705647

RESUMO

BACKGROUND Hypernatremia is associated with poor outcomes in critically ill patients, and an accurate assessment of water volume is important to determine appropriate fluid hydration. Bioelectrical impedance analysis (BIA) is a new, noninvasive, and relatively easy method for measuring hydration status. This study aimed to investigate whether bioelectrical impedance measurements of body water could reduce the frequency of blood sampling for fluid replacement in patients with hypernatremia. MATERIAL AND METHODS Fifty-one hospitalized patients were studied with hypernatremia, defined as a serum sodium ≥150 mmol/L determined by laboratory testing. Laboratory and BIA measurements were compared, and water deficiency was calculated with a conventional formula (sodium-corrected Watson formula) and measured by BIA. RESULTS The value of the absolute fluid overload (AFO) equivalent to the overhydration (OH) value, determined using BIA, did not accurately represent water deficit in patients with hypernatremia (r=0.137, P=0.347). Although the total body water (TBW) measured by BIA showed a significant correlation with that determined by the conventional formula (r=0.861, P<0.001), there was a proportional bias (r=0.617, P<0.001). The intracellular water (ICW) measured by BIA underestimated the TBW level calculated by the conventional formula by about 14.06±4.0 L in the Bland-Altman analysis. CONCLUSIONS It is not currently possible to replace blood testing with BIA for assessing volume status in hypernatremic patients. However, ICW value measured by BIA might represent plasma sodium level more accurately than extracellular water (ECW) or TBW value in patients with hypernatremia.


Assuntos
Hipernatremia/diagnóstico , Hipernatremia/metabolismo , Estado de Hidratação do Organismo/fisiologia , Adulto , Composição Corporal , Água Corporal/fisiologia , Desidratação/diagnóstico , Impedância Elétrica , Espaço Extracelular , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Água
8.
Nutrients ; 11(11)2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31717290

RESUMO

Dietary Guidelines for Americans 2015-20 recommend replacing sugar sweetened beverages (SSBs) with plain water in order to promote adequate hydration while reducing added sugar intake. This study explored how water intakes from water, beverages, and foods are distributed across the day. The dietary intake data for 7453 children (4-18 y) and 15,263 adults (>19 y) came from the National Health and Nutrition Examination Survey (NHANES 2011-2016). Water was categorized as tap or bottled. Beverages were assigned to 15 categories. Water intakes (in mL/d) from water, beverages, and food moisture showed significant differences by age group, meal occasion, and time of day. Plain water was consumed in the morning, mostly in the course of a morning snack and between 06:00 and 12:00. Milk and juices were consumed at breakfast whereas SSBs were mostly consumed at lunch, dinner, and in the afternoon. Children consumed milk and juices, mostly in the morning. Adults consumed coffee and tea in the morning, SSBs in the afternoon, and alcohol in the evening. Relatively little drinking water was consumed with lunch or after 21:00. Dietary strategies to replace caloric beverages with plain water need to build on existing drinking habits by age group and meal type.


Assuntos
Ingestão de Líquidos , Hábitos , Bebidas Adoçadas com Açúcar , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Ingestão de Energia , Feminino , Humanos , Masculino , Refeições , Inquéritos Nutricionais , Estado de Hidratação do Organismo , Recomendações Nutricionais , Bebidas Adoçadas com Açúcar/efeitos adversos , Fatores de Tempo , Estados Unidos , Equilíbrio Hidroeletrolítico , Adulto Jovem
9.
J Stroke Cerebrovasc Dis ; 28(12): 104397, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31582273

RESUMO

AIM OF THE STUDY: Diffusion-weighted image (DWI) of magnetic resonance imaging (MRI) can reveal high signal lesion in up to 50% of transient ischemic attack (TIA) patients. However, it is not well-known which factors determine developing DWI positivity. In order to answer this question, we analyzed factors relevant to DWI positivity in TIA patients. METHODS: We had 257 stroke patients at a university emergency/neurology wards. They were 140 men, 117 women, mean age 72 (45-88) years. Among them, 24 (9.3%) had TIA (14 men, 10 women, mean age 71 [58-82] years). All patients underwent a 1.5T MRI. In 24 TIA patients, we investigated the following parameters in relation with stroke maturation: ABCD2 score, smoking habits, blood profile, HbA1C, dyslipidemia, coagulation factors, carotid echography, electrocardiography, cardiac echography, chest X-ray, neurological symptom/signs, imaging, and recurrence of neurological symptom on follow-up. RESULTS: In 24 TIA patients, 13 (54%) were DWI positive and 11 (46%) were DWI negative. After an extensive analysis, all parameters were not relevant to DWI positivity except for plasma osmolarity, i.e., plasma osmolarity in DWI positive cases (305.3 mOsm/l) is significantly higher than that in DWI negative cases (301.3 mOsm/l) (P = .0064). As for recurrence, 4 of 24 TIA patients recurred. They were 1 (9.0%) of 11 DWI negative cases and 3 (23.1%) of 13 DWI positive cases. Therefore, DWI positive cases recurred more frequently than DWI negative cases did, although it did not reach statistical significance. CONCLUSIONS: TIA with DWI positivity in our institute was 54%, closely associated with initial dehydration and might predict stroke recurrence.


Assuntos
Desidratação/complicações , Imagem de Difusão por Ressonância Magnética , Ataque Isquêmico Transitório/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Desidratação/sangue , Desidratação/diagnóstico , Desidratação/fisiopatologia , Feminino , Humanos , Ataque Isquêmico Transitório/sangue , Ataque Isquêmico Transitório/etiologia , Masculino , Pessoa de Meia-Idade , Estado de Hidratação do Organismo , Concentração Osmolar , Valor Preditivo dos Testes , Recidiva , Medição de Risco , Fatores de Risco
10.
Prensa méd. argent ; 105(9 especial): 571-575, oct 2019. fig, tab
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1046618

RESUMO

The mobility of teeth in terms of periotestometry and hydration of periodontal tissues in terms of bioimpedance spectrometry were studied in healthy volunteers without dental and concomitant somatic diseases. It was found that teeth of these subjects have both low and pathological mobility. It was also revealed as increased hydration (edema), indicating the presence of inflammation, and reduced hydration, indicating atrophic processes in periodontal tissues. A comparison of the data of periotestometry and bioimpedance spectrometry showed that the indicators of mobility of the teeth and hydration of the periodontal tissues reflect different characteristics of the functional state of dentoalveolar system, and can be used as complementary in the diagnostic studies.


Assuntos
Doenças Periodontais/diagnóstico , Análise Espectral , Mobilidade Dentária/diagnóstico , Periodonto/anatomia & histologia , Estado de Hidratação do Organismo
12.
Nutrients ; 11(8)2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31405072

RESUMO

Water, the main component of the body, is distributed in the extracellular and intracellular compartments. Water exchange between these compartments is mainly governed by osmotic pressure. Extracellular water osmolarity must remain within very narrow limits to be compatible with life. Older adults lose the thirst sensation and the ability to concentrate urine, and this favours increased extracellular osmolarity (hyperosmotic stress). This situation, in turn, leads to cell dehydration, which has severe consequences for the intracellular protein structure and function and, ultimately, results in cell damage. Moreover, the fact that water determines cell volume may act as a metabolic signal, with cell swelling acting as an anabolic signal and cell shrinkage acting as a catabolic signal. Ageing also leads to a progressive loss in muscle mass and strength. Muscle strength is the main determinant of functional capacity, and, in elderly people, depends more on muscle quality than on muscle quantity (or muscle mass). Intracellular water content in lean mass has been related to muscle strength, functional capacity, and frailty risk, and has been proposed as an indicator of muscle quality and cell hydration. This review aims to assess the role of hyperosmotic stress and cell dehydration on muscle function and frailty.


Assuntos
Metabolismo Energético , Fragilidade/metabolismo , Contração Muscular , Força Muscular , Músculo Esquelético/metabolismo , Equilíbrio Hidroeletrolítico , Desequilíbrio Hidroeletrolítico/metabolismo , Animais , Composição Corporal , Fragilidade/fisiopatologia , Humanos , Músculo Esquelético/fisiopatologia , Estado de Hidratação do Organismo , Pressão Osmótica , Desequilíbrio Hidroeletrolítico/fisiopatologia
13.
Nutrients ; 11(9)2019 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-31450591

RESUMO

Traditionally, it has been thought necessary to lose 2% of body mass due to dehydration to disrupt functioning, although recently, adverse effects have been reported, with a loss of 0.5%-0.7%. It is, however, unclear whether the response to small reductions in mass reflects dehydration as homeostatic mechanisms are thought to be effective. As psychological responses are most commonly reported, it is strange that the possibility of a placebo response has not been considered. Individuals were therefore subject to a temperature of 30 °C for three hours, and mood and cognition were monitored. To consider changes in hydration status, drinks were compared, differing in their ability to rehydrate due to the presence or absence of electrolytes. The possibility of a placebo response was considered by comparing the response to plain or coloured water. Not drinking was disruptive, although a combination of plain water and electrolyte tended to be the most effective means of preventing a decline in mood, indicating a role for rehydration after a loss of 0.66% body mass. There was, however, also evidence of a placebo response: a combination of plain water and electrolyte tended to be better able to prevent a decline in mood than coloured water and electrolyte.


Assuntos
Afeto/efeitos dos fármacos , Bebidas , Cognição/efeitos dos fármacos , Eletrólitos/administração & dosagem , Estado de Hidratação do Organismo/efeitos dos fármacos , Equilíbrio Hidroeletrolítico/efeitos dos fármacos , Adolescente , Adulto , Cor , Feminino , Humanos , Masculino , Memória/efeitos dos fármacos , Efeito Placebo , Tempo de Reação/efeitos dos fármacos , País de Gales , Adulto Jovem
14.
Nutrients ; 11(8)2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31443311

RESUMO

The increasing prevalence of overweight and obesity has become an epidemic public health problem worldwide. In the last years, several investigations have suggested that water intake and retention could have important implications for both weight management and body composition. However, there is a lack of information about this issue globally, and mainly specifically in Spain. Thus, the aim of this study was to analyze the association between hydration status and body composition in a sample of healthy Spanish adults. The study involved 358 subjects, aged 18-39 years. The recently validated "hydration status questionnaire" was used to assess their water intake, elimination, and balance. Anthropometric measurements were performed according to the recommendations of the International Standards for Anthropometric Assessment (ISAK). Body composition variables were acquired by bioelectrical impedance analysis. Differences in anthropometric and body composition variables were assessed through the ANOVA test and considered significant at p < 0.05. Fluid intake was correlated with body water content. Inverse associations between water consumption, normalized by weight, with body weight, body fat mass, and waist circumference were found. Moreover, according to water balance, significant differences in body water content in females were observed. In conclusion, higher fluid intake seems to be related with a healthier body composition. Therefore, the improvement of water intake and water balance could be useful for overweight and obesity prevention, although further studies are needed to confirm the present findings.


Assuntos
Composição Corporal , Ingestão de Líquidos , Estado de Hidratação do Organismo , Sobrepeso/prevenção & controle , Equilíbrio Hidroeletrolítico , Adiposidade , Adolescente , Adulto , Fatores Etários , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Masculino , Sobrepeso/epidemiologia , Sobrepeso/fisiopatologia , Fatores de Proteção , Fatores de Risco , Fatores Sexuais , Espanha/epidemiologia , Adulto Jovem
15.
Nutrients ; 11(8)2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31394869

RESUMO

With the collection of water-intake data, the National Health and Nutrition Examination Survey (NHANES) is becoming an increasingly popular resource for large-scale inquiry into human hydration. However, are we leveraging this resource properly? We sought to identify the opportunities and limitations inherent in hydration-related inquiry within a commonly studied database of hydration and nutrition. We also sought to critically review models published from this dataset. We reproduced two models published from the NHANES dataset, assessing the goodness of fit through conventional means (proportion of variance, R2). We also assessed model sensitivity to parameter configuration. Models published from the NHANES dataset typically yielded a very low goodness of fit R2 < 0.15. A reconfiguration of variables did not substantially improve model fit, and the goodness of fit of models published from the NHANES dataset may be low. Database-driven inquiry into human hydration requires the complete reporting of model diagnostics in order to fully contextualize findings. There are several emergent opportunities to potentially increase the proportion of explained variance in the NHANES dataset, including novel biomarkers, capturing situational variables (meteorology, for example), and consensus practices for adjustment of co-variates.


Assuntos
Água Corporal/fisiologia , Ingestão de Líquidos , Inquéritos Nutricionais , Índice de Massa Corporal , Bases de Dados Factuais , Humanos , Modelos Teóricos , Estado Nutricional , Estado de Hidratação do Organismo , Concentração Osmolar , Reprodutibilidade dos Testes , Urina
16.
J Thorac Cardiovasc Surg ; 158(5): 1446-1455, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31395365

RESUMO

OBJECTIVE: There is an increased risk of mortality in patients in whom acute kidney injury and fluid accumulation develop after cardiothoracic surgery, and the risk is especially high when renal replacement therapy is needed. However, renal replacement therapy remains an essential intervention in managing these patients. The objective of this study was to identify risk factors for mortality in surgical patients requiring renal replacement therapy in a pediatric cardiac intensive care unit. METHODS: We performed a retrospective review of patients requiring renal replacement therapy for acute kidney injury or fluid accumulation after cardiothoracic surgery between January 2009 and December 2017. Survivors and nonsurvivors were compared with respect to multiple variables, and a multivariable logistic regression analysis was performed to identify independent risk factors associated with mortality. RESULTS: The mortality rate for the cohort was 75%. Nonsurvivors were younger (nonsurvivors: 0.8 years; interquartile range, 0.1-8.2; survivors: 14.6 years; interquartile range, 4.2-19.7; P = .002) and had a lower weight-for-age z-score (nonsurvivors: -1.5; interquartile range, -3.1 to -0.4; survivors: -0.5; interquartile range, -0.9 to 0.3; P = .02) compared with survivors. There was no difference with respect to fluid accumulation. In multivariable analysis, a longer duration of stage 3 acute kidney injury before initiation of renal replacement therapy was independently associated with mortality (adjusted odds ratio, 1.39; 95% confidence interval, 1.05-1.83; P = .021). CONCLUSIONS: Mortality in patients requiring renal replacement therapy after congenital heart disease surgery is high. A longer duration of acute kidney injury before renal replacement therapy initiation is associated with increased mortality.


Assuntos
Lesão Renal Aguda , Procedimentos Cirúrgicos Cardiovasculares , Cardiopatias Congênitas/cirurgia , Complicações Pós-Operatórias/terapia , Terapia de Substituição Renal , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/fisiopatologia , Lesão Renal Aguda/terapia , Adolescente , Procedimentos Cirúrgicos Cardiovasculares/efeitos adversos , Procedimentos Cirúrgicos Cardiovasculares/classificação , Procedimentos Cirúrgicos Cardiovasculares/mortalidade , Criança , Feminino , Mortalidade Hospitalar , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Masculino , Estado de Hidratação do Organismo , Complicações Pós-Operatórias/fisiopatologia , Terapia de Substituição Renal/efeitos adversos , Terapia de Substituição Renal/métodos , Terapia de Substituição Renal/mortalidade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Estados Unidos/epidemiologia
17.
Nutrients ; 11(8)2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31412681

RESUMO

Oncology treatment-related diarrhea and malnutrition appear together in oncological patients because of the disease itself, or the treatments that are administered for it. Therefore it is essential to carry out a nutritional treatment. Enteral nutrition formulas, containing peptides and medium chain triglycerides, can facilitate absorption in cases of malabsorption. There are few references to the use of enteral nutrition in the clinical society guidelines of patient management with oncology treatment-related diarrhea (OTRD). A bibliographic review of the studies with oligomeric enteral nutrition in OTRD found only nine studies with chemotherapy (all with the same oligomeric formula in which oral mucositis improves, while the rest of the outcomes show different results), and eight studies with radiotherapy (with different products and very heterogeneous results). We hereby present our action algorithm to supplement the diet of OTRD patients with an oligomeric enteral nutrition formula. The first step is the nutritional assessment, followed by the assessment of the functional capacity of the patient's intestine. With these two aspects evaluated, the therapeutic possibilities available vary in degrees of complexity: These will range from the usual dietary recommendations, to supplementation with oral oligomeric enteral nutrition, along with complete enteral nutrition with oligomeric formula, and up to potentially total parenteral nutrition.


Assuntos
Algoritmos , Antineoplásicos/efeitos adversos , Protocolos Clínicos , Diarreia/terapia , Nutrição Enteral/métodos , Alimentos Formulados , Desnutrição/terapia , Estado Nutricional , Lesões por Radiação/terapia , Diarreia/induzido quimicamente , Diarreia/fisiopatologia , Nutrição Enteral/efeitos adversos , Alimentos Formulados/efeitos adversos , Humanos , Absorção Intestinal , Desnutrição/induzido quimicamente , Desnutrição/fisiopatologia , Valor Nutritivo , Estado de Hidratação do Organismo , Lesões por Radiação/etiologia , Lesões por Radiação/fisiopatologia , Radioterapia/efeitos adversos , Fatores de Risco , Resultado do Tratamento
18.
J Vet Emerg Crit Care (San Antonio) ; 29(6): 616-621, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31468696

RESUMO

OBJECTIVE: To assess the administration of a commercially available activated charcoal suspension with sorbitol (ACS) on serum sodium concentrations and hydration status in healthy dogs. DESIGN: Prospective study. SETTING: Private referral hospital. ANIMALS: Nine healthy adult dogs. INTERVENTIONS: Dogs were administered 1 mg/kg maropitant (Cerenia; Pfizer Animal Health, New York, NY) intravenously 1 hour prior to charcoal administration. Dogs were administered a single dose of 2 g/kg ACS. MEASUREMENTS AND MAIN RESULTS: Blood samples and body weights were obtained prior to charcoal administration and 2, 4, 6, 8, 10, and 12 hours post ACS administration. Venous sodium, potassium, chloride, blood urea nitrogen, creatinine, lactate, packed cell volume, and total plasma protein were measured at each time interval. All dogs returned 2-4 weeks after ACS administration for a 12 hour period of water restriction and to serve as their own control group. The same measurements were repeated during water restriction period as following ACS administration. The increase in serum sodium concentration was significantly higher following ACS administration when compared to control period (P = 0.0002). All dogs administered ACS experienced a significant degree of weight loss (P = 0.0371) when compared to the control period. Following administration of ACS, the hematocrit of the dogs administered ACS was found to be significantly increased (P = 0.0001), when compared to the control period. CONCLUSION: Patients that are administered a single dose of ACS are at risk of developing dehydration and secondary hypernatremia as observed in the dogs during the study period. Patients receiving ACS should have electrolytes monitored and would benefit from fluid therapy as previously recommended.


Assuntos
Carvão Vegetal/farmacologia , Cães/fisiologia , Estado de Hidratação do Organismo/efeitos dos fármacos , Sódio/sangue , Sorbitol/farmacologia , Animais , Nitrogênio da Ureia Sanguínea , Carvão Vegetal/administração & dosagem , Cloretos , Creatinina/sangue , Cães/sangue , Eletrólitos/sangue , Lactatos , Masculino , Potássio , Estudos Prospectivos , Sorbitol/administração & dosagem
19.
Nutr. hosp ; 36(4): 875-883, jul.-ago. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184713

RESUMO

Introduction: adequate hydration status is crucial in most physiological functions; conversely, its assessment is hindered by the limited availability of research tools. Objective: to develop and validate a novel questionnaire that evaluates the hydration status of a healthy adult Spanish population. Method: a novel questionnaire was designed and validated relying on biochemical parameters related to blood, urine, and body water content. The study involved 39 healthy subjects aged between 18 and 39 years. Food and beverage consumption were assessed by the novel questionnaire and through a three-day dietary record. Physical activity was assessed using both: accelerometers and the Short International Physical Activity Questionnaire (IPAQ). Validity was determined by correlation of the aforementioned parameters with the water balance and water intake obtained by the novel questionnaire. The questionnaire was administered twice over the course of 28 days to evaluate its reliability. Results: water balance and total water intake were correlated with specific gravity, and urine color. Water intake obtained by the novel questionnaire was correlated with water intake results from the three-day dietary record. Intraclass correlation coefficient indicated moderate concordance between both recordings, and the Cronbach's alpha revealed high consistency. Finally, the Bland and Altman method indicated that the limits of agreement were acceptable to reveal the reliability of the estimated measures. Conclusions: the questionnaire designed is a new valid and reliable screening tool to estimate hydration status of adult populations in dietary and nutritional assessment


Introducción: un estado hídrico adecuado es crucial para la mayoría de funciones fisiológicas; sin embargo, su evaluación se encuentra obstaculizada por la escasez de herramientas de diagnóstico e investigación. Objetivos: desarrollar y validar un cuestionario que permita evaluar el estado hídrico de población española adulta sana. Métodos: un nuevo cuestionario ha sido diseñado y validado a través de parámetros bioquímicos en orina y sangre y contenido en agua corporal. El estudio incluyó finalmente a 39 sujetos sanos con edades comprendidas entre 18 y 39 años. El consumo de alimentos y bebidas se evaluó empleando el nuevo cuestionario y un diario dietéticos de tres días. La actividad física fue estimada a través de acelerometría y con el Cuestionario Internacional de Actividad Física (IPAQ). La validez se determinó analizando la correlación de los parámetros citados, con el balance y con la ingesta hídrica. El cuestionario fue administrado por duplicado, con un transcurso de 28 días entre ambas cumplimentaciones para evaluar su reproducibilidad. Resultados: el balance y la ingesta hídrica se correlacionaron con la gravedad específica y con el color de la orina. La ingesta hídrica se correlacionó con los resultados procedentes del diario dietético. Según el coeficiente de correlación intraclase, la concordancia entre ambas cumplimentaciones fue moderada y el alfa de Cronbach indicó consistencia elevada. El método Bland-Altman mostró que los límites de confianza eran aceptables para revelar la reproducibilidad de las medidas estimadas. Conclusiones: el cuestionario diseñado constituye una herramienta de cribado válida y fiable para estimar el estado hídrico de población adulta sana


Assuntos
Humanos , Masculino , Feminino , Adulto , Estado de Hidratação do Organismo/fisiologia , Desidratação/diagnóstico , Desidratação/epidemiologia , Antropometria , Estudos Transversais , Voluntários Saudáveis , Inquéritos e Questionários
20.
Nutrients ; 11(7)2019 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-31284689

RESUMO

The detrimental effects of dehydration, to both mental and physical health, are well-described. The potential adverse consequences of overhydration, however, are less understood. The difficulty for most humans to routinely ingest ≥2 liters (L)-or "eight glasses"-of water per day highlights the likely presence of an inhibitory neural circuit which limits the deleterious consequences of overdrinking in mammals but can be consciously overridden in humans. This review summarizes the existing data obtained from both animal (mostly rodent) and human studies regarding the physiology, psychology, and pathology of overhydration. The physiology section will highlight the molecular strength and significance of aquaporin-2 (AQP2) water channel downregulation, in response to chronic anti-diuretic hormone suppression. Absence of the anti-diuretic hormone, arginine vasopressin (AVP), facilitates copious free water urinary excretion (polyuria) in equal volumes to polydipsia to maintain plasma tonicity within normal physiological limits. The psychology section will highlight reasons why humans and rodents may volitionally overdrink, likely in response to anxiety or social isolation whereas polydipsia triggers mesolimbic reward pathways. Lastly, the potential acute (water intoxication) and chronic (urinary bladder distension, ureter dilation and hydronephrosis) pathologies associated with overhydration will be examined largely from the perspective of human case reports and early animal trials.


Assuntos
Encéfalo/fisiopatologia , Ingestão de Líquidos , Estado de Hidratação do Organismo , Polidipsia/fisiopatologia , Polidipsia/psicologia , Intoxicação por Água/fisiopatologia , Intoxicação por Água/psicologia , Equilíbrio Hidroeletrolítico , Animais , Aquaporina 2/metabolismo , Arginina Vasopressina/metabolismo , Encéfalo/metabolismo , Cognição , Modelos Animais de Doenças , Feminino , Humanos , Masculino , Camundongos , Polidipsia/metabolismo , Transdução de Sinais , Micção , Volição , Intoxicação por Água/metabolismo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA