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1.
Nutrients ; 13(8)2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34444861

RESUMO

So far, there is no consistent and convincing theory explaining the pathogenesis of migraines. Vascular disorders, the effect of oxidative stress on neurons, and the contribution of magnesium-calcium deficiencies in triggering cortical depression and abnormal glutaminergic neurotransmission are taken into account. However, there are no reliable publications confirming the role of dietary deficits of magnesium and latent tetany as factors triggering migraine attacks. The aim of the study was to evaluate the influence of latent magnesium deficiency assessed with the electrophysiological tetany test on the course of migraine. The study included: a group of 35 patients (29 women and six men; in mean age 41 years) with migraine and a control group of 24 (17 women and seven men; in mean age 39 years) healthy volunteers. Migraine diagnosis was based on the International Headache Society criteria, 3rd edition. All patients and controls after full general and neurological examination were subjected to a standard electrophysiological ischemic tetany test. Moreover, the level of magnesium in blood serum was tested and was in the normal range in all patients. Then, the incidence of a positive tetany EMG test results in the migraine group and the results in the subgroups with and without aura were compared to the results in the control group. Moreover, the relationship between clinical markers of spasmophilia and the results of the tetany test was investigated in the migraine group. As well as the relationship between migraine frequency and tetany test results. There was no statistically significant difference in the occurrence of the electrophysiological exponent of spasmophilia between the migraine and control group. Neither correlation between the occurrence of clinical symptoms nor the frequency of migraine attacks and the results of the tetany test was stated (p > 0.05). However, there was an apparent statistical difference between the subgroup of migraine patients with aura in relation to the control group (p < 0.05). The result raises hope to find a trigger for migraine attacks of this clinical form, the more that this factor may turn out to be easy to supplement with dietary supplementation.


Assuntos
Eletromiografia/métodos , Deficiência de Magnésio/fisiopatologia , Transtornos de Enxaqueca/etiologia , Período Refratário Eletrofisiológico , Tetania/fisiopatologia , Adulto , Estudos de Casos e Controles , Causalidade , Membrana Celular/fisiologia , Feminino , Humanos , Magnésio/sangue , Deficiência de Magnésio/complicações , Deficiência de Magnésio/diagnóstico , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/sangue , Estado Nutricional , Potássio/sangue , Tetania/complicações , Tetania/diagnóstico , Adulto Jovem
2.
Nutrients ; 13(7)2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34203167

RESUMO

Polycystic ovary syndrome (PCOS) is a common disease in women of childbearing age. It is characterized by excessive androgen production, ovulation disorders, and developing metabolic syndrome. The aim of the study was to check whether selected minerals were related to the pathophysiological mechanisms of PCOS. The concentrations of minerals were determined using an inductively coupled atomic plasma-emission spectrometer (ICP-AES Jobin Yvon JY-24). Blood samples from PCOS and control women were collected, processed, and digested with a microwave system in women with PCOS with and without insulin resistance and in the control group. It was found: zinc (Zn)-10.14 ± 2.11, 9.89 ± 1.44 and 10.30 ± 1.67; nickel (Ni) 0.001 ± 0.0009, 0.001 ± 0.0006 and 0.002 ± 0.00001; iron (Fe) 868.0 ± 155.8, 835.3 ± 156.4 and 833.0 ± 94.6; manganese (Mn) 0.017 ± 0.006, 0.017 ± 0.008 and 0.020 ± 0.009; copper (Cu) 0.714 ± 0.129, 0.713 ± 0.114 and 0.761 ± 0.146; magnesium (Mg) 48.4 ± 8.3, 50.0 ± 8.4 and 45.3 ± 10.7; sodium (Na) 374.3 ± 84.3, 396.3 ± 66.6 and 367.9 ± 88.9; potassium (K) 2541.8 ± 330.9, 2409.6 ± 347.1 and 2336.9 ± 211.4 (µg/g). Some micronutrient deficiencies may have a negative effect on the lipid profile in PCOS patients (Ni, Na). Further studies are needed to better understand dependencies.


Assuntos
Minerais/sangue , Minerais/metabolismo , Síndrome do Ovário Policístico/sangue , Adolescente , Adulto , Composição Corporal , Cobre/sangue , Eritrócitos , Feminino , Humanos , Resistência à Insulina , Ferro/sangue , Metabolismo dos Lipídeos , Magnésio/sangue , Manganês/sangue , Níquel/sangue , Potássio/sangue , Sódio/sangue , Oligoelementos/sangue , Adulto Jovem , Zinco/sangue
3.
J Stroke Cerebrovasc Dis ; 30(8): 105875, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34062311

RESUMO

Serum potassium levels are considered as a marker of cerebrovascular emergencies but there is less clarity on the association between initial serum potassium levels recorded on patient's arrival at the emergency department with the type of stroke. This is a case-control study using data of a tertiary care hospital in Japan from April 2018 to September 2019. We identified adult patients with hemorrhagic stroke including subarachnoid hemorrhage (cases) and those with ischemic stroke (controls). Data on age, sex, chief complaints, vital signs, and initial blood tests were collected. We analyzed the association between serum potassium levels and the type of stroke by drawing a LOWESS curve. Additionally, we fitted a logistic regression model to examine the association of interest. There were 416 stroke patients (158 hemorrhagic and 258 ischemic). The median age was 77 years (IQR: 68, 84), and 54% were male. The mean potassium level was 3.69 ± 0.55 mEq/L for hemorrhagic stroke and 4.08 ± 0.65 mEq/L for ischemic stroke. The LOWESS curve showed that the lower initial potassium level was linearly associated with a greater likelihood of hemorrhagic stroke. In the logistic regression model, the odds ratio for the risk of hemorrhagic stroke per 1 mEq/L lower potassium level was 3.31 (95% confidence interval [CI]: 2.24-5.04). This association remained significant in a multivariable model adjusting for other covariates (OR: 2.62 [95% CI: 1.70-4.16]). Initial potassium level was lower in patients with hemorrhagic stroke compared to those with ischemic stroke.


Assuntos
Serviço Hospitalar de Emergência , AVC Hemorrágico/sangue , AVC Isquêmico/sangue , Potássio/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Técnicas de Apoio para a Decisão , Feminino , AVC Hemorrágico/diagnóstico , AVC Hemorrágico/terapia , Humanos , AVC Isquêmico/diagnóstico , AVC Isquêmico/terapia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco
4.
Eur J Endocrinol ; 185(2): 343-353, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34085953

RESUMO

Objective: Hypoglycemia is associated with an increased risk of cardiovascular disease including cardiac arrhythmias. We investigated the effect of hypoglycemia in the setting of acute glycemic fluctuations on cardiac rhythm and cardiac repolarization in insulin-treated patients with type 2 diabetes compared with matched controls without diabetes. Design: A non-randomized, mechanistic intervention study. Methods: Insulin-treated patients with type 2 diabetes (n = 21, age (mean ± s.d.): 62.8 ± 6.5 years, BMI: 29.0 ± 4.2 kg/m2, HbA1c: 6.8 ± 0.5% (51.0 ± 5.4 mmol/mol)) and matched controls (n = 21, age: 62.2 ± 8.3 years, BMI 29.2 ± 3.5 kg/m2, HbA1c: 5.3 ± 0.3% (34.3 ± 3.3 mmol/mol)) underwent a sequential hyperglycemic and hypoglycemic clamp with three steady-states of plasma glucose: (i) fasting plasma glucose, (ii) hyperglycemia (fasting plasma glucose +10 mmol/L) and (iii) hyperinsulinemic hypoglycemia (plasma glucose < 3.0 mmol/L). Participants underwent continuous ECG monitoring and blood samples for counterregulatory hormones and plasma potassium were obtained. Results: Both groups experienced progressively increasing heart rate corrected QT (Fridericia's formula) interval prolongations during hypoglycemia ((∆mean (95% CI): 31 ms (16, 45) and 39 ms (24, 53) in the group of patients with type 2 diabetes and controls, respectively) with similar increases from baseline at the end of the hypoglycemic phase (P = 0.43). The incidence of ventricular premature beats increased significantly in both groups during hypoglycemia (P = 0.033 and P < 0.0001, respectively). One patient with type 2 diabetes developed atrial fibrillation during recovery from hypoglycemia. Conclusions: In insulin-treated patients with type 2 diabetes and controls without diabetes, hypoglycemia causes clinically significant and similar increases in cardiac repolarization that might increase vulnerability for serious cardiac arrhythmias and sudden cardiac death.


Assuntos
Arritmias Cardíacas/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Hipoglicemia/fisiopatologia , Idoso , Arritmias Cardíacas/sangue , Pressão Sanguínea/fisiologia , Diabetes Mellitus Tipo 2/sangue , Eletrocardiografia , Feminino , Glucagon/sangue , Hormônio do Crescimento/sangue , Frequência Cardíaca/fisiologia , Humanos , Hidrocortisona/sangue , Hipoglicemia/sangue , Masculino , Pessoa de Meia-Idade , Norepinefrina/sangue , Potássio/sangue
5.
Nutrients ; 13(5)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064968

RESUMO

Increased potassium intake has been linked to improvements in cardiovascular and other health outcomes. We assessed increasing potassium intake through food or supplements as part of a controlled diet on blood pressure (BP), microcirculation (endothelial function), and potassium and sodium retention in thirty pre-hypertensive-to-hypertensive men and women. Participants were randomly assigned to a sequence of four 17 day dietary potassium treatments: a basal diet (control) of 60 mmol/d and three phases of 85 mmol/d added as potatoes, French fries, or a potassium gluconate supplement. Blood pressure was measured by manual auscultation, cutaneous microvascular and endothelial function by thermal hyperemia, utilizing laser Doppler flowmetry, and mineral retention by metabolic balance. There were no significant differences among treatments for end-of-treatment BP, change in BP over time, or endothelial function using a mixed-model ANOVA. However, there was a greater change in systolic blood pressure (SBP) over time by feeding baked/boiled potatoes compared with control (-6.0 mmHg vs. -2.6 mmHg; p = 0.011) using contrast analysis. Potassium retention was highest with supplements. Individuals with a higher cardiometabolic risk may benefit by increasing potassium intake. This trial was registered at ClinicalTrials.gov as NCT02697708.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Gluconatos , Hipertensão/tratamento farmacológico , Microcirculação , Potássio na Dieta/administração & dosagem , Potássio , Solanum tuberosum/química , Adulto , Fatores de Risco Cardiometabólico , Estudos Cross-Over , Dieta , Suplementos Nutricionais , Fezes/química , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Potássio/sangue , Sódio , Cloreto de Sódio na Dieta , Sódio na Dieta/administração & dosagem , Desequilíbrio Hidroeletrolítico , Adulto Jovem
6.
Nutrients ; 13(5)2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33946894

RESUMO

Increased marinobufagenin (MBG) synthesis has been suggested in response to high dietary salt intake. The aim of this study was to determine the effects of short-term changes in sodium intake on plasma MBG levels in patients with primary salt-sensitive and salt-insensitive hypertension. In total, 51 patients with primary hypertension were evaluated during acute sodium restriction and sodium loading. Plasma or serum concentrations of MBG, natriuretic pro-peptides, aldosterone, sodium, potassium, as well as hematocrit (Hct) value, plasma renin activity (PRA) and urinary sodium and potassium excretion were measured. Ambulatory blood pressure monitoring (ABPM) and echocardiography were performed at baseline. In salt-sensitive patients with primary hypertension plasma MBG correlated positively with diastolic blood pressure (ABPM) and serum NT-proANP concentration at baseline and with serum NT-proANP concentration after dietary sodium restriction. In this subgroup plasma MBG concentration decreased during sodium restriction, and a parallel increase of PRA was observed. Acute salt loading further decreased plasma MBG concentration in salt-sensitive subjects in contrast to salt insensitive patients. No correlation was found between plasma MBG concentration and left ventricular mass index. In conclusion, in salt-sensitive hypertensive patients plasma MBG concentration correlates with 24-h diastolic blood pressure and dietary sodium restriction reduces plasma MBG levels. Decreased MBG secretion in response to acute salt loading may play an important role in the pathogenesis of salt sensitivity.


Assuntos
Bufanolídeos/sangue , Hipertensão/induzido quimicamente , Sódio na Dieta/administração & dosagem , Adulto , Aldosterona/sangue , Fator Natriurético Atrial/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Potássio/sangue , Renina/sangue , Sódio/sangue
7.
Clin Biochem ; 94: 74-79, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33915140

RESUMO

OBJECTIVES: To assess the impact of hemolysis on laboratory results under local conditions and to verify the hemolysis index cut-off for potassium using real-world data. METHODS: The statistical bootstrapping method was performed on 54,125 samples collected at the University Hospital of Örebro (USÖ). The results were compared to a method based on stratification of samples according to hemolysis level, and on paired difference testing. RESULTS: Setting the acceptable allowable limit of error to 10%, the three assessed strategies yielded comparable results with respect to the impact of haemolytic interference on test results for potassium. The suggested cut-offs were 111 mg Hb/dL for the bootstrapping method, between 125-150 mg Hb/dL for the method based on stratification, and around 150 mg/dL for the paired difference testing strategy. The impact of hemolysis on potassium measurement is likely different between primary care patients and inpatients. CONCLUSIONS: Using the effect of hemolysis on potassium measurement as a model, a novel approach towards finding clinically acceptable limits for analytical interference is presented, that relies on the bootstrapping method and on actual patient data from routine laboratory operation, hence incorporating local population characteristics, equipment and instrumental settings.


Assuntos
Hemólise , Humanos , Potássio/sangue
8.
Biochem Med (Zagreb) ; 31(2): 020704, 2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-33927554

RESUMO

Introduction: A specific sequence is recommended for filling blood tubes during blood collection to prevent erroneous test results due to carryover of additives. However, requirement of this procedure is still debatable. This study was aimed to investigate the potassium ethylenediaminetetraacetic acid (K-EDTA) contamination in blood samples taken after a tube containing the additive during routine workflow. The study was also carried out to examine the effect of order of draw on potassium results, regardless of K-EDTA contamination. Materials and methods: In 388 outpatients, to determine the probability of K-EDTA cross-contamination, blood was drawn sequentially into a serum tube, followed by a tube containing K-EDTA, and by another serum tube. In another 405 outpatients, to evaluate the effect of order of draw blood unrelated to K-EDTA contamination, two serum tube were successively collected. Potassium was measured on Cobas 6000 c501 analyser (Roche Diagnostic GmbH, Mannheim, Germany) by indirect ion selective electrode method. Results: Of paired samples collected before and after a K-EDTA tube, 24% had a potassium difference of above 0.3 mmol/L. However, no EDTA contamination was detected in these samples as well as 95% confidence intervals (CI) of limits of agreement for calcium were within the allowable error limits based on reference change values. Interestingly, of blood samples drawn successively, 24% had also a difference greater than 0.3 mmol/L for potassium. Conclusion: Incorrect order of draw using closed blood collection system does not cause K-EDTA contamination, even in routine workflow. However, regardless of K-EDTA contamination, order of draw has significant influence on the potassium results.


Assuntos
Coleta de Amostras Sanguíneas , Ácido Edético/farmacologia , Potássio/sangue , Fluxo de Trabalho , Adolescente , Adulto , Idoso , Cálcio/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
Pan Afr Med J ; 38: 66, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33889232

RESUMO

Introduction: tuberculosis (TB) remains a global health issue with high morbidity and mortality rates especially in the developing countries. It is a multi-organ disease and can influence biochemical changes. This study sought to determine the influence of tuberculosis and its drug treatment on serum biochemical parameters in patients in Nigeria. Methods: it was a descriptive observational cohort study on 150 subjects whose blood samples were analyzed for serum albumin, serum sodium, and serum potassium. The subjects were grouped into 3: TB group= 50 new TB subjects not on treatment, F group= 50 TB subjects on treatment for 2/12 or more and C group= 50 non-TB control subjects. These biochemical variables were compared between the 3 groups. Results: male/female ratio was 1: 1.5, mean age 37.1±0.92 years, and range 18-65 years. The differences in mean values of serum albumin, calcium and sodium between the three groups were significant (p<0.001), whereas that of serum potassium was not significant (p=0.056). Those patients with new case TB had a significantly lower serum sodium, serum albumin and serum calcium than the control group and those on treatment, p<0.001. There was significant positive correlation between serum albumin and serum calcium (r=0.0.420, p<0.001) as well as serum sodium (r=0.310, p<0.001) in the study population. Similarly, the correlation between serum calcium and serum sodium was positive and significant (r=0.200, p=0.014). In contrast, the correlation between serum potassium and serum albumin and that between serum potassium and serum calcium was not significant. Conclusion: tuberculosis with or without anti-tuberculous medications was associated with significant reduction in serum albumin, serum sodium and serum calcium in this study.


Assuntos
Cálcio/sangue , Albumina Sérica/análise , Sódio/sangue , Tuberculose/sangue , Adolescente , Adulto , Idoso , Antituberculosos/administração & dosagem , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Potássio/sangue , Tuberculose/tratamento farmacológico , Adulto Jovem
10.
Nutrients ; 13(5)2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33925724

RESUMO

Arachidonic acid (ARA; 20:4n6) and docosahexaenoic acid (DHA; 22:6n3) are polyunsaturated fatty acids (FA) naturally present in breast milk and added to most North American infant formulas (IF). We investigated the safety and efficacy of novel sodium and potassium salts of arachidonic acid as bioequivalent to support tissue levels of ARA comparable to the parent oil; M. alpina oil (Na-ARA and K-ARA) and including a Na-DHA group. Pigs of both sexes were randomized to one of five dietary treatments (n = 16 per treatment; 8 male and 8 female) from postnatal day 2 to 23. ARA and DHA were included as either triglyceride (TG) or salt. Target dietary ARA/DHA concentrations as percent of total FA by weight were as follows: TT (0.47 TG/0.32 TG), NaT (0.47 Na-salt/0.32 TG), KT (0.47 K-salt/0.32 TG), and Na0 (0.47 Na-salt/0.00), NaNa (0.47 Na-salt/0.32 Na-salt). The primary outcome in this study was bioequivalence of ARA brain accretion. Growth performance; blood and tissue fatty acid levels; liver histology; complete blood cell counts; and serum chemistries were all evaluated. Overall, diets containing test sources of ARA and DHA did not affect growth performance; liver histology; or substantially influence hematological outcomes as compared with TT. The results confirm that the use of Na and K salt forms of ARA yield bioequivalent ARA accretion in the cerebral cortex and retinal tissue compared to TG-ARA. These findings confirm that use of Na-ARA and K-ARA salts in the young pig was safe and nutritionally bioequivalent to TG-ARA for critical neural tissues.


Assuntos
Ácido Araquidônico/administração & dosagem , Ácido Araquidônico/sangue , Dieta/métodos , Potássio/administração & dosagem , Sódio/administração & dosagem , Animais , Feminino , Masculino , Modelos Animais , Potássio/sangue , Sais/administração & dosagem , Sais/sangue , Sódio/sangue , Suínos
11.
Nutrients ; 13(3)2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33804015

RESUMO

BACKGROUND: No study has explored the limitations of current long-term management of hyperkalemia (HK) in outpatient CKD clinics. METHODS: We evaluated the association between current therapeutic options and control of serum K (sK) during 12-month follow up in ND-CKD patients stratified in four groups by HK (sK ≥ 5.0 mEq/L) at baseline and month 12: Absent (no-no), Resolving (yes-no), New Onset (no-yes), Persistent (yes-yes). RESULTS: We studied 562 patients (age 66.2 ± 14.5 y; 61% males; eGFR 39.8 ± 21.8 mL/min/1.73 m2, RAASI 76.2%). HK was "absent" in 50.7%, "resolving" in 15.6%, "new onset" in 16.6%, and "persistent" in 17.1%. Twenty-four hour urinary measurements testified adherence to nutritional recommendations in the four groups at either visit. We detected increased prescription from baseline to month 12 of bicarbonate supplements (from 5.0 to 14.1%, p < 0.0001), K-binders (from 2.0 to 7.7%, p < 0.0001), and non-K sparing diuretics (from 34.3 to 41.5%, p < 0.001); these changes were consistent across groups. Similar results were obtained when using higher sK level (≥5.5 mEq/L) to stratify patients. Mixed-effects regression analysis showed that higher sK over time was associated with eGFR < 60, diabetes, lower serum bicarbonate, lower use of non-K sparing diuretics, bicarbonate supplementation, and K-binder use. Treatment-by-time interaction showed that sK decreased in HK patients given bicarbonate (p = 0.003) and K-binders (p = 0.005). CONCLUSIONS: This observational study discloses that one-third of ND-CKD patients under nephrology care remain with or develop HK during a 12-month period despite low K intake and increased use of sK-lowering drugs.


Assuntos
Bicarbonatos/uso terapêutico , Diuréticos/uso terapêutico , Hiperpotassemia/complicações , Hiperpotassemia/tratamento farmacológico , Insuficiência Renal Crônica/complicações , Idoso , Tampões (Química) , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Nefrologia , Potássio/sangue
12.
J Int Soc Sports Nutr ; 18(1): 22, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33722257

RESUMO

BACKGROUND: Muscle cramp is a painful, involuntary muscle contraction, and that occurs during or following exercise is referred to as exercise-associated muscle cramp (EAMC). The causes of EAMC are likely to be multifactorial, but dehydration and electrolytes deficits are considered to be factors. This study tested the hypothesis that post-exercise muscle cramp susceptibility would be increased with spring water ingestion, but reduced with oral rehydration solution (ORS) ingestion during exercise. METHODS: Ten men performed downhill running (DHR) in the heat (35-36 °C) for 40-60 min to reduce 1.5-2% of their body mass in two conditions (spring water vs ORS) in a cross-over design. The body mass was measured at 20 min and every 10 min thereafter during DHR, and 30 min post-DHR. The participants ingested either spring water or ORS for the body mass loss in each period. The two conditions were counter-balanced among the participants and separated by a week. Calf muscle cramp susceptibility was assessed by a threshold frequency (TF) of an electrical train stimulation to induce cramp before, immediately after, 30 and 65 min post-DHR. Blood samples were taken before, immediately after and 65 min after DHR to measure serum sodium, potassium, magnesium and chroride concentrations, hematocrit (Hct), hemoglobin (Hb), and serum osmolarity. Changes in these varaibles over time were compared between conditions by two-way repeated measures of analysis of variance. RESULTS: The average (±SD) baseline TF (25.6 ± 0.7 Hz) was the same between conditions. TF decreased 3.8 ± 2.7 to 4.5 ± 1.7 Hz from the baseline value immediately to 65 min post-DHR for the spring water condition, but increased 6.5 ± 4.9 to 13.6 ± 6.0 Hz in the same time period for the ORS condition (P < 0.05). Hct and Hb did not change significantly (P > 0.05) for both conditions, but osmolarity decreased (P < 0.05) only for the spring water condition. Serum sodium and chloride concentrations decreased (< 2%) at immediately post-DHR for the spring water condition only (P < 0.05). CONCLUSIONS: These results suggest that ORS intake during exercise decreased muscle cramp susceptibility. It was concluded that ingesting ORS appeared to be effective for preventing EAMC.


Assuntos
Água Potável , Exercício Físico/fisiologia , Temperatura Alta , Águas Minerais/efeitos adversos , Cãibra Muscular/etiologia , Soluções para Reidratação/administração & dosagem , Adulto , Índice de Massa Corporal , Cloretos/sangue , Estudos Cross-Over , Suscetibilidade a Doenças , Ingestão de Líquidos , Hematócrito , Hemoglobina A/análise , Humanos , Magnésio/sangue , Masculino , Águas Minerais/administração & dosagem , Cãibra Muscular/sangue , Cãibra Muscular/prevenção & controle , Concentração Osmolar , Potássio/sangue , Corrida/fisiologia , Sódio/sangue , Fatores de Tempo , Adulto Jovem
14.
J Vet Emerg Crit Care (San Antonio) ; 31(2): 269-273, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33709630

RESUMO

OBJECTIVE: The objective of this study was to evaluate the biochemical and blood gas alterations of whole blood of buffaloes that was stored in citrate-phosphate-dextrose with adenine (CPDA-1) and CPD/SAG-M blood bags for 42 days. DESIGN: Prospective study. INTERVENTIONS: Ten male buffaloes were used in this study. A total volume of 900 mL of blood was collected from each buffalo so that 450 mL was stored in CPDA-1 and 450 mL was stored in CPD/SAG-M bags at 2-6°C for 42 days. The stored blood was evaluated at 7 time points (D): D0 (immediately after blood collection) and 7 (D7), 14 (D14), 21 (D21), 28 (D28), 35 (D35), and 42 (D42) days after collection. Blood gas, biochemical, and microbiological parameters were monitored. MEASUREMENTS AND MAIN RESULTS: The overall blood pH decreased from 6.997 ± 0.05 at D0 to 6.784 ± 0.09 at D42, differing from baseline from D14 onward (P < 0.05). There were increases in partial pressure of oxygen (pO2 ), partial pressure of carbon dioxide (pCO2 ), lactate, and potassium (K) and decreases in the concentrations of sodium, bicarbonate, glucose, and pH (P < 0.05) during storage in both bags but no alterations in total protein concentration. Most of the variables were consistently similar between the 2 types of blood bags (P > 0.05) evaluated, with the exception of pCO2 , HCO3, cholesterol, and total protein, which had higher values in the CPDA-1 bag (P < 0.05). The K, pO2 , and lactate had the highest alterations during storage, with increases from baseline to D42 of 563%, 317%, and 169%, respectively. CONCLUSION: In general, no significant changes of clinical importance were observed after storage of whole blood samples from buffaloes for 42 days in the 2 types of blood bags that are indicated for use with this species.


Assuntos
Anticoagulantes/farmacologia , Preservação de Sangue/veterinária , Búfalos/sangue , Citratos/farmacologia , Glucose/farmacologia , Adenina , Animais , Anticoagulantes/química , Citratos/química , Eritrócitos , Glucose/química , Masculino , Fosfatos , Potássio/sangue , Estudos Prospectivos
15.
Int J Hematol ; 114(1): 102-108, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33782816

RESUMO

Pseudohyperkalemia, a false elevation of potassium level in vitro, can be observed in chronic lymphocytic leukemia (CLL) patients due to fragility of leukocytes along with a high leukocyte count. This retrospective, observational study included all patients diagnosed with CLL at our hospital who had at least one leukocyte count ≥ 50.0 × 109/L during the years 2008-2018. All hyperkalemic episodes (including when leukocyte count was below 50.0 × 109/L) during this period were assessed. Pseudohyperkalemia was defined as when a normal potassium level was measured in a repeated blood test or when known risk factors and ECG changes typical of hyperkalemia were absent. Of the 119 episodes of hyperkalemia observed, 41.2% were considered as pseudohyperkalemia. Pseudohyperkalemia episodes were characterized by significantly higher leukocyte counts as well as higher potassium and LDH levels compared to true hyperkalemia. Pseudohyperkalemia was documented in medical charts only in a minority of cases (n = 4, 8.1%). Treatment was administered in 17 of 49 (34.7%) cases and caused significant hypokalemia in 6 of those cases. The incidence of pseudohyperkalemia in this study was rather high, suggesting that physicians should be more aware of this phenomenon in patients with CLL.


Assuntos
Hiperpotassemia/diagnóstico , Hiperpotassemia/etiologia , Leucemia Linfocítica Crônica de Células B/complicações , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hiperpotassemia/sangue , Incidência , Leucemia Linfocítica Crônica de Células B/sangue , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Potássio/sangue , Estudos Retrospectivos , Fatores de Risco
17.
J Wildl Dis ; 57(1): 178-183, 2021 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-33635992

RESUMO

Hematology and serum biochemistry reference intervals were estimated for the Iberian hare (Lepus granatensis). Most parameters differed significantly between hunted and livetrapped Iberian hares. Significant differences were found for sex (red blood cell count, mean corpuscular volume, total protein, albumin, uric acid, triglycerides, cholesterol, chloride) and age classes (red blood cell count, hematocrit, mean corpuscular hemoglobin, glucose, calcium, and sodium). Sex- and age-specific reference intervals were estimated for these parameters. Red blood cell count, hemoglobin concentration, mean corpuscular hemoglobin, urea, and potassium show seasonal variations, with the lowest values in summer and the highest in winter. Creatinine, calcium, sodium, and phosphorus achieve their highest values in summer and stable baseline values throughout the rest of the year. These reference intervals can be used as baseline to monitor health, physiology, ecology, and nutrition of Iberian hare populations.


Assuntos
Envelhecimento/sangue , Lebres/fisiologia , Animais , Glicemia , Proteínas Sanguíneas , Cálcio/sangue , Cloretos/sangue , Colesterol/sangue , Contagem de Eritrócitos , Índices de Eritrócitos , Feminino , Lebres/sangue , Hematócrito/veterinária , Masculino , Potássio/sangue , Valores de Referência , Estações do Ano , Albumina Sérica , Sódio/sangue , Triglicerídeos/sangue , Ureia/sangue , Ácido Úrico/sangue
18.
Transfusion ; 61(4): 1093-1101, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33565635

RESUMO

BACKGROUND: Hyperkalemia is a rare life-threatening complication of red blood cell (RBC) transfusion. Stored RBCs leak intracellular potassium (K+) into the supernatant; irradiation potentiates the K+ leak. As the characteristics of patients and implicated RBCs have not been studied systematically, a multicenter study of transfusion-associated hyperkalemia (TAH) in the pediatric population was conducted through the AABB Pediatric Transfusion Medicine Subsection. STUDY DESIGN: The medical records of patients <18 years old were retrospectively queried for hyperkalemia occurrence during or ≤12 h after the completion of RBC transfusion in a 1-year period. Collected data included patient demographics, diagnosis, medical history, timing of hyperkalemia and transfusion, mortality, and RBC unit characteristics. RESULTS/FINDINGS: A total of 3777 patients received 19,649 RBC units during the study period in four facilities. TAH was found in 35 patients (0.93%) in 37 occurrences. The patient median age and weight were 1.28 years and 9.80 kg, respectively. All patients had multiple serious comorbidities. There were 79 RBC units transfused in the TAH events; 62% were irradiated, and the median age of the units was 10 days. The median total RBC volume transfused ≤12 h before TAH was 24% of patient estimated total blood volume, and the median infusion rate (IR) was19.6 ml/kg/h. Mortality rate within 1 day after the TAH event was 20%. CONCLUSIONS: The prevalence of TAH in children was low; however, the 1-day mortality rate was 20%. Patients with multiple comorbidities may be at higher risk for TAH. The IR was higher for patients who had TAH than the IR threshold for safe transfusion.


Assuntos
Transfusão de Eritrócitos/efeitos adversos , Hiperpotassemia/etiologia , Infusões Intravenosas/efeitos adversos , Potássio/efeitos da radiação , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Hiperpotassemia/diagnóstico , Hiperpotassemia/epidemiologia , Hiperpotassemia/mortalidade , Lactente , Infusões Intravenosas/estatística & dados numéricos , Masculino , Mortalidade/tendências , Potássio/sangue , Prevalência , Estudos Retrospectivos , Fatores de Risco , Medicina Transfusional/estatística & dados numéricos
19.
Medicine (Baltimore) ; 100(5): e23188, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592818

RESUMO

ABSTRACT: To explore the short-term effect of high-dose spironolactone (80 mg/d) on chronic congestive heart failure (CHF).The general clinical data of 211 patients with CHF from February 2016 to August 2019 were collected and analyzed. Patients were divided into Low-dose group (taking 40 mg/d spironolactone) and High-dose group (taking 80 mg/d spironolactone) according to the patient's previous dose of spironolactone. The changes of B-type brain natriuretic peptide (BNP), NT-pro BNP (N terminal pro B type natriuretic peptide), echocardiography, 6-minute walking test (6MWT), and comprehensive cardiac function assessment data were collected for analysis.Compared with before treatment, the blood potassium of the two groups increased significantly (P < .05), but the blood potassium did not exceed the normal range. Compared with before treatment, BNP, NT-pro BNP, LVEDD, LVEDV and NYHA grading were significantly decreased (P < .05), LVEF and 6-MWT were significantly increased (P < .05). Compared with the Low-dose group, the high-dose group BNP (117.49 ±â€Š50.32 vs 195.76 ±â€Š64.62, P < .05), NT-pro BNP (312.47 ±â€Š86.28 vs 578.47 ±â€Š76.73, P < .05), LVEDD (45.57 ±â€Š5.69 vs 51.96 ±â€Š5.41, P <.05), LVEDV (141.63 ±â€Š51.14 vs 189.85 ±â€Š62.49, P < .05) and NYHA grading (1.29 ±â€Š0.41 vs 1.57 ±â€Š0.49, P < .05) were significantly reduced, but, 6-MWT (386.57 ±â€Š69.72 vs 341.73 ±â€Š78.62, P < .05), LVEF (41.62 ±â€Š2.76 vs 36.02 ±â€Š2.18, P < .05) and total effective rate (92.68% vs 81.39%, P < .05) increased significantly.Compared with 40 mg spironolactone, 80 mg spironolactone can rapidly reduce BNP and NT-pro BNP concentration, enhance exercise tolerance, improve clinical signs and cardiac function classification, and has better efficacy.


Assuntos
Insuficiência Cardíaca/tratamento farmacológico , Espironolactona/uso terapêutico , Idoso , Relação Dose-Resposta a Droga , Ecocardiografia , Feminino , Testes de Função Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Potássio/sangue , Estudos Retrospectivos , Espironolactona/administração & dosagem , Teste de Caminhada
20.
JAMA Dermatol ; 157(3): 296-300, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33502462

RESUMO

Importance: Although recent studies and guideline recommendations indicate that potassium level monitoring is of low usefulness for healthy young women being treated for acne with spironolactone, little is known about whether these recommendations have been implemented in clinical practice. Objective: To evaluate trends in rates of potassium level monitoring among young women treated for acne with spironolactone and clinician variability in monitoring practices. Design, Setting, and Participants: This retrospective cohort study was conducted between January 1, 2008, and June 30, 2019, using data from the Optum deidentified Clinformatics Data Mart database. Participants comprised 108 547 healthy female patients aged 12 to 45 years who were treated for acne with spironolactone. Main Outcome and Measures: The primary outcome was the proportion of women who received a test for baseline potassium level and the proportion of women whose potassium levels were monitored in the first 180 days of being treated for acne with spironolactone. For clinicians who had prescribed at least 5 courses of spironolactone, the percentage of clinicians who ordered baseline potassium testing or monitoring and the percentage of clinicians who always monitored potassium were compared between 2008 and 2015 vs between 2016 and 2018. Results: For 108 547 women included in this cohort study, the mean (SD) age at the start of treatment was 30.7 (8.6) years, and the mean (SD) course duration was 159 (218) days. Between 2008 and 2018, the percentage of women whose potassium levels were monitored within 180 days of starting spironolactone by all clinicians decreased from 41.4% to 38.5%, with a decrease from 48.9% to 41.0% among dermatologists and from 39.7% to 37.7% among internists but with an increase from 71.4% to 75.4% among advanced practice clinicians (ie, nurse practitioners and physician assistants). The proportion of dermatologists who always monitored potassium decreased from 10.6% between 2008 and 2015 to 4.2% between 2016 and 2018. There was no significant difference in the proportion of internists who always monitored potassium from 2008 to 2015 (15.8%) vs from 2016 to 2018 (17.7%). Conclusions and Relevance: Despite increasing evidence and guidelines supporting the elimination of potassium monitoring among healthy young women treated for acne with spironolactone, the present study findings suggest that potassium monitoring remains common, with substantial variability in clinician practices. There is a need for future implementation and dissemination research to understand underlying factors for this variation and to develop strategies to address this practice gap.


Assuntos
Acne Vulgar/tratamento farmacológico , Antagonistas de Receptores de Mineralocorticoides/administração & dosagem , Potássio/sangue , Espironolactona/administração & dosagem , Adolescente , Adulto , Criança , Estudos de Coortes , Bases de Dados Factuais , Monitoramento de Medicamentos/métodos , Monitoramento de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Antagonistas de Receptores de Mineralocorticoides/efeitos adversos , Estudos Retrospectivos , Espironolactona/efeitos adversos , Fatores de Tempo , Adulto Jovem
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