osmolality

渗透压
  • 文章类型: Journal Article
    心肌水肿是心脏病理过程的常见症状,导致心血管疾病加重,导致不可逆的心肌重塑。基于患者的研究表明,心肌水肿与心律失常有关。目前,目前还没有研究证实水肿如何影响功能性合胞体中钙动力学的变化.我们用Fluo-4对新生大鼠心肌细胞单层进行了钙动力学的光学映射。使用NaCl含量调节溶液的渗透压。初始Tyrode溶液含有140mMNaCl(1T),低渗溶液含有105(0.75T)和70mMNaCl(0.5T)。这项研究表明,随着溶液渗透压的降低,钙波传播速度急剧下降。渗透压的连续降低还显示出从正常波前到螺旋波的过渡以及具有波中断的多个激发小波。我们的研究表明,在细胞模型中,低渗透压和,因此,心肌水肿,可能导致致命的室性心律失常,据我们所知,这一点以前从未被研究过。在0.75T时出现螺旋波,而多个激励小波发生在0.5T,在细胞水肿的情况下,在起搏方案没有变化的情况下,这些数据以前没有记录在二维单层中。
    Myocardial edema is a common symptom of pathological processes in the heart, causing aggravation of cardiovascular diseases and leading to irreversible myocardial remodeling. Patient-based studies show that myocardial edema is associated with arrhythmias. Currently, there are no studies that have examined how edema may influence changes in calcium dynamics in the functional syncytium. We performed optical mapping of calcium dynamics on a monolayer of neonatal rat cardiomyocytes with Fluo-4. The osmolality of the solutions was adjusted using the NaCl content. The initial Tyrode solution contained 140 mM NaCl (1T) and the hypoosmotic solutions contained 105 (0.75T) and 70 mM NaCl (0.5T). This study demonstrated a sharp decrease in the calcium wave propagation speed with a decrease in the solution osmolality. The successive decrease in osmolality also showed a transition from a normal wavefront to spiral wave and multiple wavelets of excitation with wave break. Our study demonstrated that, in a cellular model, hypoosmolality and, as a consequence, myocardial edema, could potentially lead to fatal ventricular arrhythmias, which to our knowledge has not been studied before. At 0.75T spiral waves appeared, whereas multiple wavelets of excitation occurred in 0.5T, which had not been recorded previously in a two-dimensional monolayer under conditions of cell edema without changes in the pacing protocol.
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  • 文章类型: Journal Article
    研究加纳市售多用途软性隐形眼镜溶液的物理性质。
    pH(KelilongICL-099pH计,中国),渗透压(OSMOMAT3000,GONOTEC,德国),表面张力(Sigma700张力计,瑞典),和粘度(CFOC-200粘度计,Cannon公司,USA)的各种软性隐形眼镜多用途溶液(MPS)在室温下一式三份进行了测量。还在34°C眼表温度下进行粘度测量。检查的解决方案是无Opti-FreeReplenish(OFR),Trufresh(TF),Avizor(AV),Freshlook(FL),和刷新(RF)。
    几种溶液在108-231mOsm/kg的范围内基本上是低渗的,例外是阿维佐尔,其具有更接近人类眼泪的渗透压值(301±0.58mOsm/kg)。溶液的pH值范围(6.33-8.24,平均值(SD)=7.53±0.18)落在报告的眼表容许范围内(6.20-9.00)。表面张力值范围为35.86至42.27mNm,平均值为38.49±2.32mNm。大多数溶液在室温(25°C)下的平均粘度为1.44±0.49cP,范围为1.04-2.15cP。在眼表温度(34°C)下获得了0.79至1.58cP的显着较低值,p=0.0001)。
    在加纳用作MPS的许多溶液的物理性质是明显可变的。然而,pH值,表面张力,和粘度落在眼睛生理耐受的可接受范围内;除了渗透压,其中大部分超出了眼表报告的容许范围。这些信息可能部分解释了一些患者对某些护理系统表现出强烈偏好的原因,并且在向患者开具眼部护理系统时应该帮助临床决策。
    UNASSIGNED: To investigate the physical properties of commercially available multipurpose soft contact lens solutions in Ghana.
    UNASSIGNED: pH (Kelilong ICL-099 pH meter, China), osmolality (OSMOMAT 3000, GONOTEC, Germany), surface tension (Sigma 700 Tensiometer, Sweden), and viscosity (CFOC-200 Viscometer, Cannon Company, USA) of various soft contact lens multipurpose solutions (MPS) were measured in triplicates at room temperature. Viscosity measurements were also taken at 34 °C ocular surface temperature. The solutions examined were Opti-Free Replenish (OFR), Trufresh (TF), Avizor (AV), Freshlook (FL), and Refresh (RF).
    UNASSIGNED: Several solutions were largely hypo-osmotic in the range of 108-231 mOsm/kg, the exception being Avizor, which had osmolality values that were closer to human tears (301 ± 0.58 mOsm/kg). The range of pH values of the solutions (6.33-8.24, mean (SD) = 7.53 ± 0.18) fell within the reported tolerable range for the ocular surface (6.20-9.00). Surface tension values ranged from 35.86 to 42.27 mNm with a mean of 38.49 ± 2.32 mNm. The average viscosity of most solutions at room temperature (25 °C) was 1.44 ± 0.49 cP with a range of 1.04-2.15 cP. Significantly lower values ranging from 0.79 to 1.58 cP were obtained at ocular surface temperature (34 °C), p = 0.0001).
    UNASSIGNED: The physical properties of many of the solutions used as MPS in Ghana are markedly variable. Nevertheless, pH, surface tension, and viscosity fall within the acceptable limits of ocular physiological tolerance; except for osmolality, which majority were outside the reported tolerable range for the ocular surface. This information may partly explain the reason some patients exhibit strong preferences for certain care systems and should aid clinical decision-making when prescribing eye care systems to patients.
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  • 文章类型: Journal Article
    这项研究旨在测量和比较可在斯洛文尼亚市场上购买的等渗饮料的渗透压和张力。主要目标是检查测得的饮料渗透压与EFSA设定的等渗饮料要求之间的一致性。使用凝固点降低方法用渗透压计测量渗透压。之后,开发了两种观察张力的互补方法。将红细胞暴露于不同渗透压的标准NaCl溶液中,以观察溶液浊度和红细胞形态对细胞体积和形状的影响。这两种方法使我们能够确定标准溶液是否低于,iso-,或者高渗.这样,我们发现,在18种被调查的等渗饮料中,有12种的渗透压在270-330mOsm/kg的范围内,根据EFSA的要求。然而,6个样本不符合该标准,因此不应有"等渗"标签,也不应如此描述.溶液浊度的测量表明,大多数等渗饮料的张力比相同渗透压的标准NaCl溶液低。然而,对等渗饮料中的红细胞的检查表明,这些饮料的低pH值使测量更加复杂。最后,通过证明等渗饮料的不同成分如何通过红细胞膜,我们发现即使是等渗饮料也往往不是等渗的,因为这些饮料中主动运输的糖的浓度相对较高。
    This study aimed to measure and compare the osmolality and tonicity of isotonic beverages that can be bought on the Slovenian market. The main goal was to examine how good is the agreement between the measured osmolalities of the beverages and the requirements for isotonic beverages set up by EFSA. Osmolalities were measured with an osmometer using the freezing point depression method. Afterwards, two complementary methods for the observation of tonicity were developed. Erythrocytes were exposed to standard NaCl solutions of different osmolalities to observe their influence on the volume and shape of cells following the turbidity of the solution and the morphology of erythrocytes. These two methods enabled us to determine whether standard solutions were hypo-, iso-, or hypertonic. In this way, we found that the osmolality of 12 out of the 18 investigated isotonic beverages was in the range of 270-330 mOsm/kg, as required by EFSA. However, six samples did not meet this criterion and should therefore not have the label \"isotonic\" or be described as such. The measurements of turbidity of solutions indicated that most isotonic beverages exhibit a lower tonicity than standard NaCl solutions of identical osmolality. However, examination of the erythrocytes in isotonic beverages showed that the measurements were additionally complicated by the low pH values of these beverages. Finally, by demonstrating how different components of isotonic beverages pass through the erythrocyte membranes, we found that even isoosmolal beverages are often not isotonic, as the concentration of actively transported sugars in these beverages is relatively high.
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  • 文章类型: Journal Article
    最近血清渗透压增加与急性应激反应有关,随着时间的推移会导致肥胖风险增加,高血压,和其他慢性疾病。盐和果糖是可引起血清渗透压急性变化的两种主要刺激。在这里,我们研究了钠和果糖消耗的早期代谢作用,并确定钠或果糖负荷的影响是否可以通过阻断水合作用的渗透压变化来减轻。将44名没有疾病和药物的健康受试者分为四组。禁食过夜后,第1组的受试者喝了500毫升的咸汤,而第2组的人饮用500毫升无盐汤15分钟。第3组受试者在5分钟内饮用500毫升100%苹果汁,而第4组受试者在5分钟内饮用500毫升100%苹果汁和500毫升水。血压(BP),血浆钠,和葡萄糖水平测量每15分钟在前2小时。血清和尿液渗透压,血清尿酸,皮质醇,成纤维细胞生长因子21(FGF21),醛固酮,促肾上腺皮质激素(ACTH)水平,和血浆肾素活性(PRA)在基线和2小时测量。盐或果糖的急性摄入增加血清渗透压(最大〜4mOsm/L峰值在75分钟)与收缩压和舒张压血压升高相关,PRA,醛固酮,ACTH,皮质醇,血浆葡萄糖,尿酸,FGF21盐倾向于引起肾素-血管紧张素系统(RAS)的更大激活,而果糖引起葡萄糖和FGF21的更大升高。在这两种情况下,水合可以阻止渗透压并在很大程度上阻止急性应激反应。血清渗透压的急性变化可以诱导ACTH-皮质醇的显著激活,RAS,葡萄糖代谢,和对水合反应的尿酸轴。除了经典的脱水,盐,含果糖的糖可以激活这些反应。尽管暴露于糖和盐,但保持良好的水分可能会带来好处。需要更多的研究来调查水合作用是否可以阻止糖和盐对疾病的慢性影响。
    Increasing serum osmolality has recently been linked with acute stress responses, which over time can lead to increased risk for obesity, hypertension, and other chronic diseases. Salt and fructose are two major stimuli that can induce acute changes in serum osmolality. Here we investigate the early metabolic effects of sodium and fructose consumption and determine whether the effects of sodium or fructose loading can be mitigated by blocking the change in osmolality with hydration. Forty-four healthy subjects without disease and medication were recruited into four groups. After overnight fasting, subjects in Group 1 drank 500 mL of salty soup, while those in Group 2 drank 500 mL of soup without salt for 15 min. Subjects in Group 3 drank 500 mL of 100% apple juice in 5 min, while subjects in Group 4 drank 500 mL of 100% apple juice and 500 mL of water in 5 min. Blood pressure (BP), plasma sodium, and glucose levels were measured every 15 min in the first 2 h. Serum and urine osmolarity, serum uric acid, cortisol, fibroblast growth factor 21 (FGF21), aldosterone, adrenocorticotropic hormone (ACTH) level, and plasma renin activity (PRA) were measured at the baseline and 2 h. Both acute intake of salt or fructose increased serum osmolality (maximum ∼4 mOsm/L peaking at 75 min) associated with a rise in systolic and diastolic BP, PRA, aldosterone, ACTH, cortisol, plasma glucose, uric acid, and FGF21. Salt tended to cause greater activation of the renin-angiotensin-system (RAS), while fructose caused a greater rise in glucose and FGF21. In both cases, hydration could prevent the osmolality and largely block the acute stress response. Acute changes in serum osmolality can induce remarkable activation of the ACTH-cortisol, RAS, glucose metabolism, and uric acid axis that is responsive to hydration. In addition to classic dehydration, salt, and fructose-containing sugars can activate these responses. Staying well hydrated may provide benefits despite exposure to sugar and salt. More studies are needed to investigate whether hydration can block the chronic effects of sugar and salt on disease.
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  • 文章类型: Journal Article
    赤藓糖醇对多种昆虫显示出优异的杀虫性能,但是它导致昆虫死亡和不育的分子机制尚不完全清楚。用1M赤藓糖醇喂养72h和96h后评估果蝇的死亡率和不育性,和基因表达谱通过RNA测序进一步比较。GO和KEGG的富集分析表明,脂肪动力学激素基因(Akh)的表达,淀粉酶基因(Amyrel),α-葡萄糖苷酶基因(Mal-B1/2,Mal-A1-4,Mal-A7/8),甘油三酯脂肪酶基因(Bmm)显著上调,而胰岛素样肽基因(Dilp2、Dilp3和Dilp5)显著下调。与蛋壳组装相关的17个基因,包括12月1日(向下315倍),Vm26Ab(下跌2014倍)和Vm34Ca(下跌6034倍),显着下调,甚至没有表达。然而,3个利尿激素基因(DH44、DH31、CAPA)和8个水通道蛋白基因(Drip、大大脑,AQP,Eglp1,Eglp2,Eglp3,Eglp4和Prip)参与渗透压调节(所有p值>0.05)。我们的结论是赤藓糖醇,α-葡萄糖苷酶的竞争性抑制剂,底物和酶结合严重减少,抑制中肠中有效的碳水化合物水解并最终由于能量剥夺而导致死亡。很明显,果蝇并没有因血淋巴的渗透压而死亡。我们的发现阐明了赤藓糖醇喂养引起的果蝇死亡率和不育的分子机制。也为赤藓糖醇作为环境友好型农药的应用提供了重要的理论依据。
    Erythritol has shown excellent insecticidal performance against a wide range of insect species, but the molecular mechanism by which it causes insect mortality and sterility is not fully understood. The mortality and sterility of Drosophila melanogaster were assessed after feeding with 1M erythritol for 72 h and 96 h, and gene expression profiles were further compared through RNA sequencing. Enrichment analysis of GO and KEGG revealed that expressions of the adipokinetic hormone gene (Akh), amylase gene (Amyrel), α-glucosidase gene (Mal-B1/2, Mal-A1-4, Mal-A7/8), and triglyceride lipase gene (Bmm) were significantly up-regulated, while insulin-like peptide genes (Dilp2, Dilp3 and Dilp5) were dramatically down-regulated. Seventeen genes associated with eggshell assembly, including Dec-1 (down 315-fold), Vm26Ab (down 2014-fold) and Vm34Ca (down 6034-fold), were significantly down-regulated or even showed no expression. However, there were no significant differences in the expression of three diuretic hormone genes (DH44, DH31, CAPA) and eight aquaporin genes (Drip, Big brain, AQP, Eglp1, Eglp2, Eglp3, Eglp4 and Prip) involved in osmolality regulation (all p value > 0.05). We concluded that erythritol, a competitive inhibitor of α-glucosidase, severely reduced substrates and enzyme binding, inhibiting effective carbohydrate hydrolysis in the midgut and eventually causing death due to energy deprivation. It was clear that Drosophila melanogaster did not die from the osmolality of the hemolymph. Our findings elucidate the molecular mechanism underlying the mortality and sterility in Drosophila melanogaster induced by erythritol feeding. It also provides an important theoretical basis for the application of erythritol as an environmentally friendly pesticide.
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  • 文章类型: Journal Article
    有一个有限的研究集中在评估长期玉米赤霉烯酮(ZEN)摄入量对奶牛健康的有害影响在控制条件下。进行此实验是为了评估每天9.45mg水平的ZEN污染的总混合日粮(TMR)暴露时间是否会对动物健康参数产生负面影响。如牛奶成分,瘤胃和粪便发酵,和泌乳奶牛的咀嚼活动。对于这个实验,我们使用了18头泌乳西门塔尔牛,连续26天饲喂60%的饲料和40%的浓缩物(以干物质为基础)。前4天是在第一个取样日(第0天)之前适应的。采样事件发生在没有ZEN的第0天(基线),然后是第1天,第7天,第14天和第21天(含毒素)。在加入ZEN的第三周,每分钟的干物质摄入量(drymatteradvance,decision)和反刍性咀嚼增加;同时,沉思,吃,饮酒时间没有受到影响。大多数乳成分变量也不受影响。瘤胃液渗透压在第21天增加,瘤胃液总短链脂肪酸(SCFA)在第7天减少。粪便SCFA在第21天增加,乙酸盐与丙酸盐的比例从第1天开始增加,显示毒素摄入的影响。动物健康参数,比如心率,呼吸频率,和体温,受到ZEN摄入量的负面影响,分别在第4天和第6天、第9天和第12天以及第16天和第18天持续增加。响应于第7天的ZEN摄入,肝酶谷氨酸脱氢酶降低。每天的总ZEN摄入量为9.45mg,对MDI没有不利影响。然而,某些健康参数受到负面影响,包括体温,呼吸频率,和心率,从第7天开始摄入ZEN,在最后一个采样日可能失去水平衡的额外迹象。
    There is a limited research focus on evaluating the detrimental effects of prolonged zearalenone (ZEN) intake on dairy cows\' health under controlled conditions. This experiment was conducted to evaluate whether the length of exposure to a ZEN-contaminated total mixed ration (TMR) at a level of 9.45 mg per day can negatively influence animal health parameters, such as milk composition, rumen and fecal fermentation, and the chewing activity of lactating dairy cows. For this experiment, we used 18 lactating Simmental cows that were fed a diet of 60% forage and 40% concentrate (on dry matter basis) for 26 consecutive days. The first 4 days were for adaptation prior to the first sampling day (day 0). The sampling events took place on day 0 (baseline) without ZEN, followed by day 1, day 7, day 14, and day 21 (with toxin). Dry matter intake (DMI) and ruminating chews per minute increased on the third week of ZEN inclusion; meanwhile, ruminating, eating, and drinking times were not affected. Most milk composition variables were also unaffected. Rumen fluid osmolality increased on day 21 and total short-chain fatty acids (SCFA) of ruminal fluid decreased on day 7. Fecal SCFA increased on day 21 and the acetate-to-propionate ratio increased from day 1 onwards, showing the influence of toxin intake. Animal health parameters, like heart rate, respiratory rate, and body temperature, were negatively influenced by ZEN intake, all increasing consistently on days 4 and 6, 9 and 12, and 16 and 18, respectively. The liver enzyme glutamate dehydrogenase decreased in response to ZEN intake on day 7. A total daily ZEN intake at the level of 9.45 mg did not show detrimental effects on DMI. Nevertheless, certain health parameters were negatively affected, including body temperature, respiratory rate, and heart rate, starting from the 7th day of ZEN intake, with additional signs of possible loss of water balance on the last sampling day.
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  • 文章类型: English Abstract
    Hyponatremia is a disorder of water homeostasis. Water balance is maintained by the collaboration of renal function and cerebral structures, which regulate thirst mechanisms and secretion of the antidiuretic hormone. Measurement of serum-osmolality, urine osmolality and urine-sodium concentration help to diagnose the different reasons for hyponatremia. Hyponatremia induces cerebral edema and might lead to severe neurological symptoms, which need acute therapy. Also, mild forms of hyponatremia should be treated causally, or at least symptomatically. An inadequate fast increase of the serum sodium level should be avoided, because it raises the risk of cerebral osmotic demyelination. Basic pathophysiological knowledge is necessary to identify the different reasons for hyponatremia which need different therapeutic procedures.
    UNASSIGNED: Die Hyponatriämie ist eine Störung des Wasserhaushaltes. Die Wasserhomöostase wird durch das Zusammenspiel von Nierenfunktion und den zerebralen Strukturen des Durstempfindens und der Produktion des antidiuretischen Hormons aufrechterhalten. Durch die Messung der Serum-Osmolalität, Harn-Osmolalität und Harn- Natriumkonzentration können die meisten Ursachen der Hyponatriämie identifiziert werden. Hyponatriämien führen zu einem Hirnödem und können damit schwere neurologische Symptome verursachen, welche eine akute Therapie benötigen. Aber auch milde Formen der Hyponatriämie bedürfen einer, wenn möglich kausalen, oder zumindest symptomatischen Behandlung. Eine inadäquat rasche Korrektur der Hyponatriämie sollte vermieden werden, da diese das Risiko für ein zerebrale osmotische Demyelinisierung erhöht. Da die Art der Therapie eng mit der Ursache der Hyponatriämie zusammenhängt, ist eine Grundkenntnis der pathophysiologischen Prozesse für eine optimale Behandlung notwendig.
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  • 文章类型: Journal Article
    基于近距离工作和缺乏户外暴露的近视病因学理论得到了不一致的支持,并没有阻止全球近视患病率的上升。需要引起和预防近视的新科学理论。在食用缺乏氯化钠的传统饮食的本地人中,近视患病率较低,营养流行病学证据支持近视患病率上升与膳食钠摄入量之间的关系.东亚人群与高膳食钠相关的近视率最高。在20世纪末的美国观察到钠和近视患病率上升的类似关联。本观点综合了营养流行病学证据和病理生理学概念,并提出轴性近视是由于眼睛玻璃体中液体潴留增加而引起的。由膳食氯化钠摄入量诱导。盐干扰视网膜膜的离子通透性,增加流体进入玻璃体的渗透梯度流动,并在轴向伸长期间拉伸眼组织。根据目前的营养流行病学证据,实验研究应该调查氯化钠作为近视原因的影响,临床研究应该测试在近视矫正和预防中的极低盐饮食。
    Theories of myopia etiology based on near work and lack of outdoor exposure have had inconsistent support and have not prevented the rising prevalence of global myopia. New scientific theories in the cause and prevention of myopia are needed. Myopia prevalence is low in native people consuming traditional diets lacking in sodium chloride, and nutritional epidemiological evidence supports the association of rising myopia prevalence with dietary sodium intake. East Asian populations have among the highest rates of myopia associated with high dietary sodium. Similar associations of sodium and rising myopia prevalence were observed in the United States in the late 20th century. The present perspective synthesizes nutritional epidemiology evidence with pathophysiological concepts and proposes that axial myopia occurs from increased fluid retention in the vitreous of the eye, induced by dietary sodium chloride intake. Salt disturbs ionic permeability of retinal membranes, increases the osmotic gradient flow of fluid into the vitreous, and stretches ocular tissue during axial elongation. Based on the present nutritional epidemiology evidence, experimental research should investigate the effect of sodium chloride as the cause of myopia, and clinical research should test a very low-salt diet in myopia correction and prevention.
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  • 文章类型: Journal Article
    背景:下尿路症状(LUTS)在进行性多发性硬化症(pwPMS)患者中很常见,因此,他们可能会限制他们的液体摄入量。我们旨在调查LUTS与pwPMS水合状态不足的客观证据相关的假设。
    方法:在这项前瞻性研究中,在2年内研究了55个pwPMS。分析了6个月的第一天早上的尿液样本的尿渗透压和钠作为水合标志物。LUTS症状严重程度分为三类(紧迫性,排尿和不适)使用问卷进行评估和量化。在受试者内部和受试者之间评估了LUTS严重程度和水合作用之间的相关性,控制年龄。
    结果:分析了来自55名参与者的274份尿液样本以及所附LUTS数据。生化数据显示,随着年龄的增长,尿液浓缩能力的预期损失。在47%的参与者中观察到水合不足。LUTS非常常见(87%报告尿急和89%的排尿症状)。萎缩和不适,但不是紧急严重性,与水合标记相关,参与者内部和参与者之间。
    结论:LUTS在pwPMS中非常常见,并与水合不足有关。MS中水化不足的原因和后果需要进一步研究,因为(i)这将更多关注pwPMS中的LUTS管理,以及(ii)脱水与可逆性认知功能障碍和身体机能不佳相关.
    BACKGROUND: Lower urinary tract symptoms (LUTS) are common in persons with progressive multiple sclerosis (pwPMS), who may consequently limit their fluid intake. We aimed to investigate the hypothesis that LUTS associate with objective evidence of inadequate hydration status in pwPMS.
    METHODS: In this prospective study, 55 pwPMS were studied over 2 years. A 6-monthly first-morning urine specimen was analysed for urinary osmolality and sodium as hydration markers. LUTS symptom severity in three categories (urgency, voiding and discomfort) was assessed and quantified using a questionnaire. Correlation between LUTS severity and hydration was assessed within subjects and between subjects, controlling for age.
    RESULTS: Some 274 urine samples with accompanying LUTS data from 55 participants were analysed. Biochemical data showed the expected loss of urine-concentrating capacity with increasing age. Inadequate hydration was observed in 47% of participants. LUTS were very common (87% reported urgency and 89% voiding symptoms). Voiding and discomfort, but not urgency severity, were correlated with hydration markers, both within and between participants.
    CONCLUSIONS: LUTS are very common in pwPMS, and associate with inadequate hydration. The causes and consequences of inadequate hydration in MS need further study, since (i) this will focus greater attention on LUTS management in pwPMS and (ii) dehydration has been associated with reversible cognitive dysfunction and physical underperformance.
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  • 文章类型: Journal Article
    目的:评估心脏骤停后早期失钠与6个月功能转归之间的潜在关联。
    方法:我们汇集了4项随机临床试验的数据,这些试验涉及心脏骤停后入院ICU的患者在自主循环稳定恢复(ROSC)后昏迷。入院性贫血被归类为正常(135-145mmol/L),低,或高。我们分析了6个月时贫血类别与脑功能类别(CPC)1或2之间的关联,调整和不调整改良的心脏骤停医院预后评分(mCAHP)。
    结果:我们包括1163例患者(581例来自Hyperion,来自TTH48的352,来自COMACARE的120,和110来自Xe-HYPOTHECA),平均年龄为63±13岁,男性占主导地位(72.5%)。在63.6%的病例中确定了心脏原因。从塌陷到ROSC的中位时间为20[15-29]分钟。总的来说,入住ICU时平均血钠为137.5±4.7mmol/L;211例(18.6%)和31例(2.7%)患者有低钠血症和高钠血症,分别。通过单变量分析,6个月时的CPC1或2在低钠血症组中明显不常见(50/211[24%]vs.363/893[41%];P=0.001);mCAHP调整后的比值比为0.45(95CI0.26-0.79,p=0.005)。高钠血症患者数量太少,无法进行有意义的多变量分析。
    结论:早期低钠血症常见于心脏骤停后的ROSC患者,并与较差的6个月功能预后相关。这种关联的潜在机制仍有待阐明,以确定针对低钠血症的干预措施是否值得研究。注册ClinicalTrial.gov,NCT01994772,2013年11月,21。
    To evaluate the potential association between early dysnatremia and 6-month functional outcome after cardiac arrest.
    We pooled data from four randomised clinical trials in post-cardiac-arrest patients admitted to the ICU with coma after stable return of spontaneous circulation (ROSC). Admission natremia was categorised as normal (135-145 mmol/L), low, or high. We analysed associations between natremia category and Cerebral Performance Category (CPC) 1 or 2 at 6 months, with and without adjustment on the modified Cardiac Arrest Hospital Prognosis Score (mCAHP).
    We included 1163 patients (581 from HYPERION, 352 from TTH48, 120 from COMACARE, and 110 from Xe-HYPOTHECA) with a mean age of 63 ± 13 years and a predominance of males (72.5%). A cardiac cause was identified in 63.6% of cases. Median time from collapse to ROSC was 20 [15-29] minutes. Overall, mean natremia on ICU admission was 137.5 ± 4.7 mmol/L; 211 (18.6%) and 31 (2.7%) patients had hyponatremia and hypernatremia, respectively. By univariate analysis, CPC 1 or 2 at 6 months was significantly less common in the group with hyponatremia (50/211 [24%] vs. 363/893 [41%]; P = 0.001); the mCAHP-adjusted odds ratio was 0.45 (95%CI 0.26-0.79, p = 0.005). The number of patients with hypernatremia was too small for a meaningful multivariable analysis.
    Early hyponatremia was common in patients with ROSC after cardiac arrest and was associated with a poorer 6-month functional outcome. The mechanisms underlying this association remain to be elucidated in order to determine whether interventions targeting hyponatremia are worth investigating. Registration ClinicalTrial.gov, NCT01994772, November 2013, 21.
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