Daily Fluid Intake Research Articles

High salt loading increases brain derived neurotrophic factor in supraoptic vasopressin neurones.

High salt loading (SL) is associated with inappropriate arginine vasopressin (AVP) release and increased mean arterial pressure. Previous work has shown that chronic high salt intake impairs baroreceptor inhibition of rat AVP neurones through brain-derived neurotrophic factor (BDNF) dependent activation of tyrosine receptor kinase B (TrkB) and down-regulation of K+/Cl- co-transporter KCC2. This mechanism diminishes the GABAA inhibition of AVP neurones in the supraoptic nucleus (SON) by increasing intracellular chloride. However, the source of BDNF leading to this ionic plasticity is unknown. In the present study, we used adeno-associated viral vectors with short hairpin RNA against BDNF to test whether SON is the source of BDNF contributing to increased AVP release and elevated mean arterial pressure in high salt loaded rats. Virally mediated BDNF knockdown (shBDNF) in the SON of salt loaded rats significantly blocked the increases in BDNF mRNA and AVP heterogeneous RNA expression. The observed increase in the activation of TrkB receptor during salt loading is consistent with previous studies. Western blot analysis of SON punches revealed that tyrosine phosphorylation of TrkB (pTrkBY515) was significantly decreased in salt shBDNF rats compared to the salt scrambled (SCR) rats. Injections of shBDNF in the SON also significantly prevented the increase in plasma AVP concentration associated with salt loading. However, the salt loading induced increase in mean arterial pressure was not decreased with BDNF knockdown in the SON. Average daily fluid intake and urine output were significantly elevated in both salt SCR and salt shBDNF rats compared to the euhydrated controls. Daily average urine sodium concentration was significantly higher in shBDNF injected salt rats than the other groups. These findings indicate that BDNF produced in the SON contributes to the increased AVP secretion during high salt loading but not with respect to the subsequent increase in mean arterial pressure.

Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections

Increased hydration is often recommended as a preventive measure for women with recurrent cystitis, but supportive data are sparse. To assess the efficacy of increased daily water intake on the frequency of recurrent cystitis in premenopausal women. Randomized, open-label, controlled, 12-month trial at a clinical research center (years 2013-2016). Among 163 healthy women with recurrent cystitis (≥3 episodes in past year) drinking less than 1.5 L of fluid daily assessed for eligibility, 23 were excluded and 140 assigned to water or control group. Assessments of daily fluid intake, urinary hydration, and cystitis symptoms were performed at baseline, 6- and 12-month visits, and monthly telephone calls. Participants were randomly assigned to drink, in addition to their usual fluid intake, 1.5 L of water daily (water group) or no additional fluids (control group) for 12 months. Primary outcome measure was frequency of recurrent cystitis over 12 months. Secondary outcomes were number of antimicrobial regimens used, mean time interval between cystitis episodes, and 24-hour urinary hydration measurements. The mean (SD) age of the 140 participants was 35.7 (8.4) years, and the mean (SD) number of cystitis episodes in the previous year was 3.3 (0.6). During the 12-month study period, the mean (SD) number of cystitis episodes was 1.7 (95% CI, 1.5-1.8) in the water group compared with 3.2 (95% CI, 3.0-3.4) in the control group, with a difference in means of 1.5 (95% CI, 1.2-1.8; P < .001). Overall, there were 327 cystitis episodes, 111 in the water group and 216 in the control group. The mean number of antimicrobial regimens used to treat cystitis episodes was 1.9 (95% CI, 1.7-2.2) and 3.6 (95% CI, 3.3-4.0), respectively, with a difference in means of 1.7 (95% CI, 1.3-2.1; P < .001). The mean time interval between cystitis episodes was 142.8 (95% CI, 127.4-160.1) and 84.4 (95% CI, 75.4-94.5) days, respectively, with a difference in means of 58.4 (95% CI, 39.4-77.4; P < .001). Between baseline and 12 months, participants in the water group, compared with those in the control group, had increased mean (SD) urine volume (1.4 [0.04] vs 0.1 [0.04] L; P < .001) and voids (2.4 [0.2] vs -0.1 [0.2]; P < .001) and decreased urine osmolality (-402.8 [19.6] vs -24.0 [19.5] mOsm/kg; P < .001). Increased water intake is an effective antimicrobial-sparing strategy to prevent recurrent cystitis in premenopausal women at high risk for recurrence who drink low volumes of fluid daily. ClinicalTrials.gov identifier: NCT02444975.

FluidMeter

Water is the most vital nutrient in the human body accounting for about 60% of the body weight. To maintain optimal health, it is important for humans to consume a sufficient amount of fluids daily. Therefore, tracking the amount of human daily fluid intake has a myriad of health applications like dehydration prevention. In this paper, we present FluidMeter: a ubiquitous and unobtrusive system to track the amount of fluid intake leveraging the inertial sensors embedded in smartwatches. To achieve this, FluidMeter first separates the drinking activities from other human activities (playing, running, eating, etc.). Thereafter, it analyzes the sampled sensors data during the extracted drinking episodes to recognize the sequence of micro-activities (lift the bottle, sip, release the bottle) that constitute the drinking activity. Finally, it applies some machine learning algorithms on some features extracted from sampled sensor data during the sipping period to gauge the amount of fluid intake in the designated drinking episode. FluidMeter is evaluated by collecting more than 260 hours of different human activities by 70 different participants using different smartwatch models. The results show that FluidMeter can recognize the drinking activity and its micro-activities accurately which is comparable to that achieved by the state-of-the-art techniques. Finally, FluidMeter can estimate the overall amount of fluid intake in grams accurately with a estimation error limited to 15%, highlighting its promise as a ubiquitous health service.

Can we predict the outcome of oral dissolution therapy for radiolucent renal calculi? ; A prospective study

We prospectively assessed the efficacy and the predictors of the success of oral dissolution therapy by alkalization for lucent renal calculi. Patients with radiolucent renal stones were counseled to undergo oral dissolution therapy, which entails oral potassium citrate 20 mEq 3 times daily, 3 L daily fluid intake and a dietary regimen. The study primary end point was the achievement of a 6-month stone-free rate with oral dissolution therapy. The other end point was a change in stone surface area as measured by noncontrast computerized tomography at 3 and 6 months. Between February 2015 and January 2016 only 182 of the 212 eligible patients who agreed to participate were compliant with oral dissolution therapy and included in the final analysis. Mean stone surface area at enrollment was 1.3 cm (range 0.16 to 11.84). At 3 months 97 (53.2%), 65 (35.7%) and 20 (11.1%) patients were oral dissolution therapy responders (stone-free), partial responders and nonresponders, respectively. Oral dissolution therapy achieved a 6-month stone-free rate of 83%, including 97 and 54 patients after 3 and 6 months of oral dissolution therapy, respectively. On regression analysis the initial 3-month response to oral dissolution therapy (p = 0.001), lower stone density (p = 0.03) and higher urine pH 12 weeks after treatment (p = 0.01) independently predicted the oral dissolution therapy response at 6 months. Regardless of stone size, oral dissolution therapy was an effective treatment approach for lucent renal stones. The initial response to oral dissolution therapy after 3 months was the key factor in determining the potential oral dissolution therapy response after 6 months. In addition, treatment compliance in achieving the targeted urine pH and low stone density has an independent role in the oral dissolution therapy response.

Acceptability of Mobile Health Technology for Promoting Fluid Consumption in Patients With Nephrolithiasis

ObjectiveTo evaluate kidney stone patients’ interest in lifestyle behavior modification and a variety of mobile health (mHealth) technologies to improve adherence to fluid consumption recommendations for the prevention of nephrolithiasis. Of particular interest was the acceptability of various intervention components for the design of a stone-specific mHealth technology. Materials and MethodsUsing a cross-sectional design, adult patients with a diagnosis of kidney stones (n = 94) were recruited from outpatient clinics to complete a three-part questionnaire. ResultsPatients reported being willing to make lifestyle changes to prevent kidney stones (97%). The majority of the patients recalled the recommendation to increase fluid intake (93%) but few monitored their daily fluid intake (30%). Most patients had never installed an app (95%) or owned a device (100%) to help with increasing fluid consumption, but believed an app or device could improve their adherence (72%) and would be interested in using an app or device (86%). The mHealth intervention components most widely perceived as useful included automated lapse detection with notifications, educational materials, self-monitoring tools, scheduler with prompts and/or reminders and/or notifications, connected water bottles and text message reminders to drink. ConclusionPatients are interested in lifestyle behavior change to prevent stones but technology has not been widely adopted to improve adherence to fluid intake recommendations for stone prevention. This study identified a number of viable mHealth intervention components that should be considered when designing a stone-specific mHealth technology to support adherence to increased fluid consumption recommendations.

Lifestyle and demographic factors associated with human semen quality and sperm function

ABSTRACTIn this study, we sought to investigate the effect of lifestyle and demographic factors on classic and functional semen parameters. Three hundred and twenty-eight subjects who underwent semen analysis were recruited. Routine SA, sperm vitality, acrosome reaction (AR) assay and sperm DNA fragmentation index (DFI) were analyzed. Demographic and lifestyle information, including (1) BMI, (2) current smoking and alcohol drinking frequency, (3) sleep habits, (4) daily fluid intake, (5) weekly meat intake, (6) sports frequency, (7) trouser cell phone use, (8) age, and (9) abstinence time, were collected. Generalized additive models were used to analyze the possible non-linear association. The results showed that total sperm count (TSC) was significantly associated with age (P = 0.001), abstinence time (P = 0.001) and daily coffee intake (P = 0.044). Semen volume was significantly associated with age (P < 0.001) and daily coffee intake (P < 0.001). Sperm concentration was significantly associated with abstinence time (P = 0.011) and average sleep duration (P = 0.010). Sperm motility was significantly associated with age (P = 0.002) and daily juice intake (P = 0.001). Total motile sperm count was significantly associated with age (P = 0.003) and abstinence time (P = 0.009). DFI was significantly associated with age (P = 0.002), irregular sleeping habit (P = 0.008) and abstinence time (P = 0.032). The percentage of AR sperm was significantly associated with daily juice intake (P = 0.013). In conclusion, DFI and TSC were the most sensitive semen parameters for demographic and lifestyle features, whereas age had more influence on semen parameters than other demographic and lifestyle features.Abbreviations: BMI: body mass index; SA: semen analysis; AR: acrosome reaction; DFI: DNA fragmentation index; GAM: generalized additive model; TSC: total sperm count; TMC: total motile sperm count; IUI: intrauterine insemination; SCSA: sperm chromatin structure assay; SD: standard deviation; IQR: interquartile range; CBAVD: congenital bilateral absence of vas deferens; NEQAS: national external quality assessment service; HTF: human tubal fluid; HSA: human serum albumin.

Utilization of Mobile Nutrition Applications by Patients With Chronic Kidney Disease

Utilization of Mobile Nutrition Applications by Patients With Chronic Kidney Disease

Actual liquid consumption by highly qualified athletes in the mode of the training process

The purpose of the study was to evaluate the actual intake of fluids by athletes of various sports during the day with one and two training sessions before, during and after workout. The dietary intake, including consumption of various types of liquid foods and beverages, was evaluated by the method of 24-hour recall in 280 athletes of high qualification (candidates for masters and masters of sports) of both gender of various sports during the training period. It has been established that the main drink of rehydration was drinking bottled water. Bottled water was consumed on average by 86% of athletes. It was consumed by 95-96% of sportsmen from the group of single combats and power kinds, whereas in other groups the share of water consumers was less - 67-79%. In second place in terms of percentage of consuming was tea. Consumption of sports drinks was observed only during training by athletes from the group of cyclic sports (31%) and single combat (11%). Calculating the per capita fluid intake of athletes who had 2 workouts a day showed that athletes from the martial arts group consumed the largest volumes of fluid in the mode of both training sessions as compared to representatives of other sports. Athletes of other sports consumed on average less liquid in the 2nd training mode compared to the 1st one. The total fluid intake during two training sessions was maximum in the group of martial arts and was minimum in the group of complex coordination sports. It should be specially noted a small proportion of athletes who consumed specialized sports drinks - only 17% of athletes and more than half of them - cyclical sportsmen. Consumption of liquid food outside training has been observed in 76% of athletes. The mean volume of consumed liquid products varied by the user from 382 and 437 ml in complex coordination and game sports up to 504-553 ml in other sports. The daily fluid intake was maximum (2326 ml) in athletes engaged in martial arts, minimum (1009 ml) - in athletes of complex coordination sports.

Long-term outcome in inherited nephrogenic diabetes insipidus.

BackgroundInherited nephrogenic diabetes insipidus (NDI) is a rare disorder characterized by impaired urinary concentrating ability. Little clinical data on long-term outcome exists.MethodThis was a single-centre retrospective medical record review of patients with a diagnosis of NDI followed between 1985 and 2017. We collected available data on growth, weight, school performance, complications and comorbidities.ResultsWe identified 36 patients with available data and a clinical diagnosis of NDI, which was genetically confirmed in 33 of them. Patients presented at a median age of 0.6 years and median length of follow-up was 9.5 years. Chief symptoms at presentation were faltering growth, vomiting/feeding concerns, polyuria/polydipsia, febrile illness and hypernatraemic dehydration. Median weight standard deviation scores (SDS) improved from −2.1 at presentation to 0.2 at last follow-up. In contrast, height SDS remained essentially unchanged at −1.1 at presentation and −0.9 at last follow-up. Most patients were treated with prostaglandin synthesis inhibitors and thiazides, yet weaned off during school age without an obvious change in urine output. Median estimated glomerular filtration rate at last follow-up was 81 mL/min/1.73 m2. Urological complications were noted in 15 patients, constipation in 11 and learning difficulties in 5. Median age at resolution of nocturnal enuresis was 11 years. Estimated median daily fluid intake at median age of 13 years was 3800 mL/m2.ConclusionThe overall prognosis in inherited NDI is favourable with regular treatment. As expected, most complications were related to polyuria. There is an apparent loss of efficacy of medications during school age. Our data inform the prognosis and management of patients with NDI.

Chemolysis of a Uric Acid Stone in a Horseshoe Kidney

Chemolysis of kidney stone is not unheard of. However, to our knowledge, there is no previous report of chemolysis of a kidney stone in a horseshoe kidney. We report the first ever case of chemolysis of a stone in a horseshoe kidney. As part of his visible haematuria workup 4 years ago, a 66-year-old gentleman with a history of gout was found to have a horseshoe kidney. In early 2017, he was seen in the urology clinic with some non-specific abdominal pain without a recent history of visible haematuria, lower urinary tract symptoms, and urinary tract infections. His CT KUB (computed tomography of kidneys, ureters and bladder), revealed a 1.3cm stone in his horseshoe kidney [Figure 1 and 2]. At the same time, his CT KUB has also picked up some retroperitoneal lymphadenopathy in the abdomen and pelvis which were suspicious of lymphoma. His serum uric acid level was noted to be normal. Subsequently, he underwent a laparoscopic right iliac lymph node biopsy which confirmed nodal marginal zone non-Hodgkin's B-cell lymphoma. He was reviewed by the haematology team and they decided to adopt a watch and wait approach to his disease with quarterly CT CAP (computed tomography of chest, abdomen and pelvis) scans. During this period of time, he had several gout attacks and he was started on allopurinol i.e. 100mg once a day. He also considerably increased his daily fluid intake. 6 months after his initial CT KUB, he was found to be completely stone free on his CT scan [Figure 3 and 4].

Inadequate fluid intake can increase the risk of constipation among pregnant women

Objectives: To analyze the association between the fiber and fluid consumption with constipation in pregnancy.Materials and Methods: An analytic cross-sectional study conducted at Jagir Public Health Center Surabaya, with the samples of healthy pregnant women aged between 20-35 years old (n=99). Respondents were asked to record the amount of daily fluid intake, defecation frequency, and type of faeces, everyday for 7 days, also made a food recall during 24 hours. The recom-mendation of adequate fluid intake in first trimester was 2180 ml/day and 2300 ml/day for second and third trimester. The value of adequate fiber consumption was 25-30 g/day. Constipation diagnosed by the frequency of defecation &lt;2x/week, or based on Bristol Stool Form Scale included as type 1, type 2, or type 3.Results: Pregnant women whose adequate fluid intake was 40,4% and those with adequate fiber intake was 4.1%. The percentage of constipation among them was 29.5%. There was significant association between fluid intake and constipation (p: 0,000; RR:1,85). There was no significant association between fiber intake and constipation p:0,317 (p&lt;0.05). There was also no significant association between parity, gestational age, and level of education with constipation (p&lt;0.05).Conclusion: Inadequate maternal fluid intake can increase the risk of constipation by 1.85 folds, and the adequate fluid intake may prevent constipation during pregnancy.

Factors Contributing to Hydration, Fluid Intake and Health Status of Inpatients With and Without Dysphagia PostStroke.

Dysphagia has been strongly associated with poor hydration in acute stroke settings. However, in sub-acute settings, the contribution to dehydration of dysphagia in combination with other common stroke comorbidities has not been explored. The aim of this study was to investigate which demographic and stroke comorbidities, including dysphagia, contribute most significantly to oral fluid intake, hydration status and specific adverse health outcomes for patients in sub-acute rehabilitation following stroke. Data from 100 inpatients from three Australian rehabilitation facilities (14 with confirmed dysphagia and 86 without dysphagia) were analysed. Hierarchical multiple regressions were conducted to determine which demographic or stroke comorbidities were most predictive of each outcome: average daily fluid intake; Blood urea nitrogen/creatinine (BUN/Cr) ratio as an index of hydration and medically diagnosed adverse events of pneumonia, dehydration, urinary tract infection or constipation. Average daily beverage intake (M=1448ml, SD 369ml) was significantly and independently predicted by Functional Independence Measure (FIM) at admission (F change=9.212, p=0.004). BUN/Cr ratio (M=20, SD 5.16) was predicted only by age (F change=4.026, p=0.049). Adverse health events, diagnosed for 20% of participants, were significantly predicted by Admission FIM (OR 1.040, 95% CI 1.001, 1.081, p=0.047). Dysphagia was not a significant predictor of any of the outcomes measured. Rather, overall functional dependency was the most significant predictor of poor oral fluid intake and fluid-related adverse health outcomes in sub-acute stroke. Clinical Trial number: Data for the post hoc analysis presented in this article came from the registered trial ACTRN12610000752066.

Synergetic Effects of Prenatal and Postnatal High Sucrose Intake on Glucose Tolerance and Hepatic Insulin Resistance in Rat Offspring.

High sucrose intake during pregnancy is linked to type 2 diabetes mellitus and altered insulin resistance. This study attempts to ascertain whether prenatal high sucrose intake (20% sucrose) alleviates the detrimental effects of high postnatal sugar consumption in the offspring, and the molecular mechanisms are investigated using a rat model. High prenatal sucrose exposure increases the body weight of the offspring at 1-3 weeks of age. Exposure to both prenatal and postnatal high sucrose increases glucose tolerance in the 4-month-old adult offspring compared with offspring receiving other treatments. Postnatal high sucrose exposure suppresses food intake but increases the total daily caloric and fluid intake. Both fasting blood glucose and plasma triglyceride levels are increased, but the fasting insulin level is unaffected. Prenatal high sucrose intake enlarges pancreatic islet area; however, prenatal-plus-postnatal high sucrose exposure induces smaller pancreatic islets. IRS-1(S612) protein phosphorylation is significantly increased, and the GSK-3β (S9) phosphorylation level is reduced. Both prenatal and prenatal-plus-postnatal high sucrose exposure substantially affect biological functions related to insulin homeostasis. IRS-1(S612) protein phosphorylation appears to be a part of the molecular mechanism underlying these effects. These results add to the understanding of how high sucrose intake contributes to insulin resistance and diabetes pathogenesis and how postnatal nutrition and lifestyle may mitigate detrimental prenatal exposures.

Inadequate fluid intake in long term care residents: prevalence and determinants

Dehydration is estimated to be present in half of long term care residents, as many do not consume the recommended levels of fluid intake. This study aims to describe fluid intake in long term care residents and identify the factors associated with fluid intake. Data were collected from 622 long term care residents, with a mean age of 86.8 ± 7.8. Total fluid intake was estimated over three non-consecutive days. Potential resident and unit-level variables risk factors for low fluid intake were collected, such as dementia status, activities of daily living, and eating challenges. Average daily fluid intake ranged from 311–2390 mL (1104.1 ± 379.3). Hierarchical regression analysis revealed that fluid intake was negatively associated with increased age, cognitive impairment, eating challenges and increased dining room staffing. Being male and requiring more physical assistance were positively associated with intake. Variables identified to predict intake could help inform strategies and targeted interventions to improve fluid intake.

Public Awareness towards Renal Stone Causes, Symptoms and Management amongst Saudis

Introduction: renal stone is an important health problem in the world and is the most common disease in urinary tract system. It is particularly a common problem in areas of hot climate like Saudi Arabia. Knowledge and lifestyle attitude of individuals towards renal stone plays a role in delivering optimum management. Aim: to determine the public awareness of renal stones causes, symptoms and management amongst Saudis. Patients and Methods: the data of this quantitative cross-sectional study was collected from participants from two regions in Saudi Arabia. Participants were given a self-administered questionnaire written in Arabic from October 2017 till November 2017. Individuals under the age of 18, tourists, medical staff and people unable to read Arabic were excluded. Data were analyzed using SPSS. Results: four hundred and seven participants with a mean age of 35 filled the questionnaire. About half of them had experienced renal stones either personally or in a direct family member. 91.4% of them are aware that increased water intake decreases the formation of renal stones. As for symptoms of urinary stones, 65.36% of them thought that pain and other urinary symptoms would occur when having urinary stones. Radiology imaging was the most chosen mode of diagnosing urinary tract stones especially amongst participants above the age of 35 (p-value= 0.002) with surgical intervention as the best treatment according to the participants. 57.2% of the participants believe that drinking parsley water prevents the formation of renal stones. Individuals who experienced renal stones before were more knowledgeable about the commonest type of renal stones (p-value= 0.005) and the quantity of recommended daily fluid intake (p-value= 0.008). Conclusion and Recommendation: this data indicates that the participants are to some degree aware of some aspects of renal stone prevention, symptoms and modes of diagnosis and treatment. Individuals who experienced renal stones were more knowledgeable in some aspects. Further emphasis on public awareness of renal stones is recommended.

Randomised controlled trial to determine the efficacy and safety of prescribed water intake to prevent kidney failure due to autosomal dominant polycystic kidney disease (PREVENT-ADPKD)

IntroductionMaintaining fluid intake sufficient to reduce arginine vasopressin (AVP) secretion has been hypothesised to slow kidney cyst growth in autosomal dominant polycystic kidney disease (ADPKD). However, evidence to support this...

Implementing a Protocol to Improve Self-Care Behaviors in Adult Patients With Heart Failure.

Heart failure (HF) is a condition that affects millions of Americans and costs $30 billion to treat annually. HF is the cause for frequent hospitalizations. Self-care practices have been found to improve quality of life, decrease hospitalizations, and reduce treatment costs. Fifteen adult patients with a HF diagnosis ages 18 to 70 voluntarily participated in the implementation of a protocol aimed at improving self-care behaviors in patients with HF in a private cardiology practice located in a southeastern city. The project was a quality improvement design. A protocol was implemented using resources from the American Heart Association. Monitoring logs were provided to patients to record daily weights, sodium intake, blood pressure, and symptoms. Educational resources included information about medications and a list of valid HF websites. Participants were provided medication organizers and a two-liter container with which to monitor daily fluid intake. The written information and logs were compiled in red folders. Of the 15 participants, there were no hospital admissions or readmissions for HF during the implementation period. Leg and ankle swelling worsened; dyspnea improved; fewer participants felt like a burden to their family; HF knowledge improved. The findings indicate the feasibility of implementing the protocol throughout a private practice organization.

A Nutrition Recovery Station Following Recreational Exercise Improves Fruit Consumption but Does Not Influence Fluid Recovery.

Immediate postexercise access to fruit/fluid via a recovery "station" is a common feature of mass participation sporting events. Yet little evidence exists examining their impact on subsequent dietary intake. The aim of this study was to determine if access to fruit/water/sports drinks within a recovery station significantly alters dietary and fluid intakes in the immediate postexercise period and influences hydration status the next morning. 127 (79 males) healthy participants (M ± SD, age = 22.5 ± 3.5y, body mass (BM) = 73 ± 13kg) completed two self-paced morning 10km runs separated by 1 week. Immediately following the first run, participants were randomly assigned to enter (or not) the recovery station for 30min. All participants completed the alternate recovery option the following week. Participants recorded BM before and after exercise and measured Urine Specific Gravity (USG) before running and again the following morning. For both trial days, participants also completed 24h food and fluid records via a food diary that included photographs. Paired-sample t tests were used to assess differences in hydration and dietary outcome variables (Recovery vs. No Recovery). No difference in preexercise USG or BM change from exercise were observed between treatments (p's > .05). Attending the recovery zone resulted in a greater total daily fluid (Recovery = 3.37 ± 1.46L, No Recovery = 3.16 ± 1.32L, p = .009) and fruit intake (Recovery = 2.37 ± 1.76 servings, No Recovery = 1.55 ± 1.61 servings, p > .001), but had no influence on daily total energy (Recovery = 10.15 ± 4.2MJ, No Recovery = 10.15 ± 3.9MJ), or macronutrient intakes (p > .05). Next morning USG values were not different between treatments (Recovery = 1.018 ± 0.007, No Recovery = 1.019 ± 0.009, p > .05). Recovery stations provide an opportunity to modify dietary intake which promote positive lifestyle behaviors in recreational athletes.

Effectiveness of a fluid chart in outpatient management of suspected dengue fever: A pilot study.

IntroductionDengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever.ObjectiveTo assess the feasibility and effectiveness of using a fluid chart to improve oral fluid intake in patients with suspected dengue fever in a primary care setting.MethodsThis feasibility study used a randomized controlled study design. The data was collected over two months at a primary care clinic in a teaching hospital. The inclusion criteria were: age > 12 years, patients who were suspected to have dengue fever based on the assessment by the primary healthcare clinician, fever for > three days, and thrombocytopenia (platelets < 150 x 109/L). Both groups received a dengue home care card. The intervention group received the fluid chart and a cup (200ml). Baseline clinical and laboratory data, 24-hour fluid recall (control group), and fluid chart were collected. The main outcomes were: hospitalization rates, intravenous fluid requirement and total oral fluid intake.FindingsAmong the 138 participants who were included in the final analysis, there were fewer hospital admissions in the intervention group (n = 7, 10.0%) than the control group (n = 12, 17.6%) (p = 0.192). Similarly, fewer patients (n = 9, 12.9%) in the intervention group required intravenous fluid compared to the control group (n = 15, 22.1%), (p = 0.154). There was an increase in the amount of daily oral fluid intake in the intervention group (about 3,000 ml) compared to the control group (about 2,500 ml, p = 0.521). However, these differences did not reach statistical significance.ConclusionThis is a feasible and acceptable study to perform in a primary care setting. The fluid chart is a simple, inexpensive tool that may reduce hospitalization and intravenous fluid requirement in suspected dengue patients. A randomized controlled trial with larger sample size is needed to determine this conclusively.Trial registrationInternational Standard Randomized Controlled Trial Number (ISRCTN) Registry ISRCTN25394628 http://www.isrctn.com/ISRCTN25394628

Prevention of Recurrent Acute Uncomplicated Cystitis by Increasing Daily Water in Premenopausal Women: A Prospective, Randomized, Controlled Study

BackgroundIncreased hydration is commonly recommended as a preventive measure for women with recurrent acute uncomplicated cystitis (rAUC), but supportive data are sparse. The aim of this study was to assess the efficacy of increased daily water intake on the frequency of rAUC in premenopausal women.Methods140 healthy premenopausal asymptomatic women drinking less than 1.5 L of total fluid daily (24 hours) and suffering from rAUC (33 episodes in the past year) were randomized to receive, in addition to their usual daily fluid intake, either 1.5 L water daily (water group) or no additional fluids (control group), for 12 months. Assessments of daily water and total fluid intake, urine volume and osmolality, number of urine voids, and occurrence of AUC symptoms and a reminder to notify investigators of any such symptoms were performed at baseline, 6- and 12-month clinic visits in addition to monthly telephone calls. The primary outcome was frequency of rAUC episodes (31 AUC symptom and 3103 CFU/mL of a uropathogen in voided urine) over 12 months.ResultsBetween baseline and 12 month’s follow-up, the water group, compared with the control group, had statistically significant increases in mean daily water intake (1.15 vs. −0.01 L), total fluid intake (1.65 vs. 0.03 L), urine volume (1.40 vs. 0.04 L), and number of urine voids (2.2 vs. −0.2), and a decrease in urine osmolality (−408 vs. −35 mOsm/Kg). The mean number of rAUC episodes in the water group was significantly less than in the control group (1.6 vs. 3.1; odds ratio 0.52, 95% CI 0.46–0.60, P < 0.0001) (figure shows cumulative sum of AUC episodes over 12 months in both study groups). The mean number of antimicrobial regimens used to treat AUC events was 1.8 in the water group vs. 3.5 in the control group (P < 0.0001). In addition, the mean number of days to first rAUC and the mean number of days between rAUC episodes was longer in the water group compared with the control group (148 vs. 93, P = 0.0005 and 143 vs. 85, P < 0.0001, respectively).ConclusionsOur results provide strong evidence that increased water intake is an effective antimicrobial-sparing preventive strategy for women with rAUC. Increasing daily water intake by approximately 1.5 L reduced rAUC episodes by 48% and antimicrobial regimens by 47% over 12 months.Disclosures M. Vecchio, Danone Research: Employee, Salary. A. Iroz, Dzanone Research: Employee, Salary. I. Tack, Danone Research: Consultant, Consulting fee and Speaker honorarium. Q. Dornic, Danone research: Employee, Salary. I. Seksek, Danone Research: Employee, Salary.