Fluid Nutrition Research Articles

New Insights into the Assessment of Peri-Operative Risk in Women Undergoing Surgery for Gynecological Neoplasms: A Call for a New Tool

Existing tools for predicting postoperative complications in women undergoing surgery for gynecological neoplasms are evaluated in this narrative review. Although surgery is a very efficient therapy for gynecological tumors, it is not devoid of the possibility of negative postoperative outcomes. Widely used tools at present, such as the Surgical Apgar Score and the Modified Frailty Index, fail to consider the complex characteristics of gynecological malignancies and their related risk factors. A thorough search of the PubMed database was conducted for our review, specifically targeting studies that investigate several aspects impacting postoperative outcomes, including nutritional status, obesity, albumin levels, sodium levels, fluid management, and psychological well-being. Research has shown that both malnutrition and obesity have a substantial impact on postoperative mortality and morbidity. Diminished sodium and albumin levels together with compromised psychological well-being can serve as reliable indicators of negative consequences. The role of appropriate fluid management in enhancing patient recovery was also investigated. The evidence indicates that although current mechanisms are useful, they have limitations in terms of their range and do not thoroughly address these recently identified risk factors. Therefore, there is a need for a new, more comprehensive tool that combines these developing elements to more accurately forecast postoperative problems and enhance patient results in gynecological oncology. This paper highlights the need to create such a tool to improve clinical practice and the treatment of patients.

Characteristics of patients with intestinal failure with parenteral nutrition and/or outpatient parenteral fluids without social security.

Characteristics of patients with intestinal failure with parenteral nutrition and/or outpatient parenteral fluids without social security.

The Ratio of Remaining to Expected Small Bowel Length Predicts Enteral Autonomy in Pediatric Patients with Short Bowel Syndrome

BackgroundPediatric patients with short bowel syndrome (SBS) often require long-term parenteral nutrition and intravenous fluid support (PN) until enteral autonomy (EA). However, long-term PN accounts for many complications. We aimed to investigate the outcome and predictors of EA in these patients. Material and MethodsThis retrospective observational study was conducted in Children’s Medical Center, Chang Gung Memorial Hospital, a tertiary hospital in Northern Taiwan. Twenty-four patients afflicted with short bowel syndrome between 2002 and 2021 were included. Demographics, operation results, follow-up status, complications, and outcomes were reviewed. ResultsAmong the 24 patients, 14 were males (58%). The median age at bowel resection was 3 days (IQR, 1.3 to 28.8 days). The most common etiologies were total/subtotal intestinal aganglionosis (TIA) (N=6) and malrotation with midgut volvulus (N=6). The median length of the residual small intestine was 25cm (IQR, 7.8 to 71.3cm). Ten (41.7%) had preserved ileocecal valve, and 14 (58.3%) had colon-in-continuity. Intestinal failure-associated liver disease (IFALD) occurred in 14 patients (58.3%), but none had advanced disease. Seven (29.2%) patients achieved enteral autonomy after 10.1±7.3 months. Five patients (21%) expired due to sepsis. Logistic regression and Kaplan-Meier analysis showed the predictors of enteral autonomy were remaining-to-expected small bowel length ratio > 25% and the absence of IFALD. ConclusionsIn this pediatric short bowel syndrome study, enteral autonomy was achieved in 29% after a mean PN duration of 10 months. The remaining-to-expected small bowel length ratio at bowel resection was the most critical predictor of enteral autonomy.

Baseline Characteristics of Adult Patients Treated and Never Treated with Teduglutide in a Multinational Short Bowel Syndrome and Intestinal Failure Registry.

The Short Bowel Syndrome (SBS) Registry (NCT01990040) is a multinational real-world study evaluating the long-term safety of teduglutide in patients with SBS and intestinal failure (SBS-IF) in routine clinical practice. This paper describes the study methodology and baseline characteristics of adult patients who have (ever-treated) or have never (never-treated) received teduglutide. A total of 1411 adult patients (679 ever-treated; 732 never-treated) were enrolled at 124 sites across 17 countries. The mean (standard deviation [SD]) age at enrollment was 55.4 (15.46) years, and 60.2% of patients were women. Crohn's disease was the most common cause of major intestinal resection in both ever-treated (34.1%) and never-treated patients (20.4%). A similar proportion of ever-treated and never-treated patients had a prior history of colorectal polyps (2.7% vs. 3.6%), whereas proportionally fewer ever-treated patients reported a history of colorectal cancer (1.8% vs. 6.2%) or any malignancy (17.7% vs. 30.0%) than never-treated patients. Never-treated patients received a numerically greater mean (SD) volume of parenteral nutrition and/or intravenous fluids than ever-treated patients (12.4 [8.02] vs. 10.1 [6.64] L/week). Ever-treated patients received a mean teduglutide dosage of 0.05 mg/kg/day. This is the first report of patient baseline characteristics from the SBS Registry, and the largest cohort of patients with SBS-IF to date. Overall, ever-treated and never-treated patients had similar baseline characteristics. Differences between treatment groups may reflect variations in patient selection and degree of monitoring.

Hydroelectrolytic and nutritional needs of infants with epidermolysis bullosa during the first month of life.

Dehydration and malnutrition are common in infants with severe epidermolysis bullosa (EB), but their nutritional needs have been poorly studied. The principal aim was to assess the nutritional status, fluid and electrolyte balance, and nutritional intake of newborns with EB during the first month of life and estimate their needs during this period. This was a retrospective study over an eight-year period. Inclusion criteria were neonates with confirmed EB admitted to our neonatal referral unit during the first month of life. Exclusion criteria were hospitalisations <7 days. Twenty-seven patients with EB (mean [min-max] gestational age = 39 weeks [33;41]; birth weight = 2986g [1982; 4150]), were included. Four patients (15%) had hyponatraemia <135mmol/L at admission (age at admission = 4.8 days +/- 2.6 [2; 7]). Sixteen patients (59%) had a sodium deficit -requiring fluid and sodium intake well above recommendations from the World Health Organisation (WHO). The risk of hyponatraemia was significantly higher in infants with the greatest body surface area affected but did not appear to be related to EB subtype. Caloric and protein intake were well above the WHO's recommendations, preventing acquired growth restriction. The rate of sodium deficit in neonates with EB is high and related to the significance of skin exudate. The administration of nutrient intake greater than that recommended helps to prevent acquired growth restriction. We propose recommendations for nutritional intake and monitoring in neonates with EB in the first month of life.

Ayurvedic Management of Multifactorial Female Infertility – A case report

Introduction: Infertility is a medical condition that can cause psychological, physical, mental, spiritual, and medical detriments to the patient. “Infertility is defined as failure to conceive within one or more years having regular unprotected coitus. All types of female Infertility in Ayurveda are described under the heading of Vandhya. According to Acharya Sushruta, there are four factors responsible for creation of Garbha i.e. Ritu (Ovulatory period/ period for copulation), Kshetra (reproductive tract including Uterus, Fallopian tube, Ovary), Ambu (Nutritive fluid for fertilized ovum), Beeja (Shukra &amp; Shonita i.e. Sperm &amp; Ovum). Among these four factors tubal blockage can be considered as the deformity of Kshetra i.e. Kshetradushti and Low level of Anti mullerian hormone can be compared to Dhatukshayajanya Vandhyatav. Aim and Obejctive: This case study was done to treat multifactorial female infertility with Ayurvedic treatment protocol and provide better quality of life. Methodology: A female Patient of 28 years of age, came to OPD of Prasuti Tantra Evum Stree roga with complaint of inability to conceive since 2 years of unprotected intercourse. Patient was diagnosed with female infertility due to bilateral tubal blockage, and low AMH level treated by Ayurvedic intervention i.e. - Virechana Karma, Yuktaratha Basti (3 days) along with Uttarabasti with Apamargkshara Taila (6 days) and Nagakesara Choorna orally (after stopping of menstrual bleeding). Result: Female infertility cured after treatment and conception achieved. Discussion: Ayurvedic approach would be beneficial in conservative management of tubal blockage and has an effective result in female infertility.

The vitamin and trace element status of intestinal failure patients receiving long-term home parenteral nutrition and home parenteral fluids

The vitamin and trace element status of intestinal failure patients receiving long-term home parenteral nutrition and home parenteral fluids

Gut Microbiota and Gastrointestinal Symptoms in the Global Assessment of Obsessive-Compulsive Disorder: A Narrative Review of Current Evidence and Practical Implications.

A growing body of literature suggests a link between bowel syndromes (e.g., irritable bowel syndrome and inflammatory bowel disease), gut microbiome alterations, and psychiatric disorders. This narrative review aims to explore the potential role of the gut microbiome in the pathogenesis and clinical presentation of obsessive-compulsive disorder (OCD) and to explore whether there is sufficient evidence to warrant considering gastrointestinal symptoms and their implication for the gut microbiome during the assessment and treatment of OCD. For this purpose, a PubMed search of studies focusing on OCD, gut microbiota, irritable bowel syndrome, and inflammatory bowel disease was conducted by two independent reviewers. While the current literature on gut microbiome and gastrointestinal issues in OCD remains limited, emerging evidence suggests gut microbiome alterations and high rates of bowel syndromes in this population. These findings emphasize the importance of incorporating comprehensive gastrointestinal assessments into the "global assessment of OCD". Such assessment should encompass various factors, including gastrointestinal physical comorbidities and symptoms, nutritional habits, bowel habits, fluid intake, exercise patterns, and potential microbiome dysfunctions and inflammation. Considering the treatment implications, interventions targeting gut health, such as probiotics and dietary modifications, may hold promise in improving symptoms in OCD patients with comorbid gastrointestinal problems. Further research in this area is warranted to better understand the interplay between gut health and OCD and to explore the effectiveness of targeted interventions in improving clinical outcomes.

Flow Rates of Bottle Nipples/Teats With Different Thicknesses of Barium and Infant Formula

Purpose: The aim of this study was to evaluate the bottle nipple flow rate of liquid barium sulfate of three different International Dysphagia Diet Standardisation Initiative (IDDSI) thicknesses (i.e., thin, slightly thick, and mildly thick) and compare flow rates of infant formula thickened with Gelmix or oatmeal cereal to comparable thicknesses. Method: Liquid preparations were IDDSI flow tested to determine thickness. Nipple flow rate testing was conducted using 50 ml of liquid in a 4-oz Dr. Brown's bottle with the venting system in place. Liquid was extracted using a breast pump. The weight of liquid extracted was converted to flow in milliliters per minute using the density of the liquid in grams per milliliter. Results: Across nipple types and liquid thicknesses, the flow rate through the bottle nipple with formula was faster than with barium of the same thickness. Thickening with oatmeal cereal resulted in clogging of the nipple. Pulverizing the oatmeal did not improve clogging but did impact caloric density of the formula. Conclusions: Bottle nipple flow rates of liquid barium sulfate are not consistent with flow rates of thin infant formula or formula thickened with Gelmix to the same IDDSI thickness. These findings may impact the safety of oral feeding for some infants. Parents and clinicians need to be aware of clogging with oatmeal cereal as a factor that could contribute to variability in flow as well as difficulty extracting fluid for nutrition.

Gut instinct: Navigating the landscape of parenteral support in short bowel syndrome.

Depending on the remaining bowel anatomy and the degree of bowel adaptation, patients with short bowel syndrome (SBS) may require parenteral nutrition (PN) and/or intravenous fluid support, sometimes temporarily and sometimes permanently. Although the use of parenteral support in SBS is often lifesaving, it is not without its limitations. Herein, we undertake a focused review of several issues related to use of parenteral support in patients with SBS, including initiation of parenteral support, considerations when formulating PN, select complications, short-term and long-term nutrition monitoring, and weaning strategies.

How a positive fluid balance develops in acute kidney injury: A binational, observational study

PurposeA positive fluid balance (FB) is associated with harm in intensive care unit (ICU) patients with acute kidney injury (AKI). We aimed to understand how a positive balance develops in such patients. MethodsMultinational, retrospective cohort study of critically ill patients with AKI not requiring renal replacement therapy. ResultsAKI occurred at a median of two days after admission in 7894 (17.3%) patients. Cumulative FB became progressively positive, peaking on day three despite only 848 (10.7%) patients receiving fluid resuscitation in the ICU. In those three days, persistent crystalloid use (median:60.0 mL/h; IQR 28.9–89.2), nutritional intake (median:18.2 mL/h; IQR 0.0–45.9) and limited urine output (UO) (median:70.8 mL/h; IQR 49.0–96.7) contributed to a positive FB. Although UO increased each day, it failed to match input, with only 797 (10.1%) patients receiving diuretics in ICU. After adjustment, a positive FB four days after AKI diagnosis was associated with an increased risk of hospital mortality (OR 1.12;95% confidence intervals 1.05–1.19;p-value <0.001). ConclusionAmong ICU patients with AKI, cumulative FB increased after diagnosis and was associated with an increased risk of mortality. Continued crystalloid administration, increased nutritional intake, limited UO, and minimal use of diuretics all contributed to positive FB. Key pointsQuestionHow does a positive fluid balance develop in critically ill patients with acute kidney injury?FindingsCumulative FB increased after AKI diagnosis and was secondary to persistent crystalloid fluid administration, increasing nutritional fluid intake, and insufficient urine output. Despite the absence of resuscitation fluid and an increasing cumulative FB, there was persistently low diuretics use, ongoing crystalloid use, and a progressive escalation of nutritional fluid therapy.MeaningCurrent management results in fluid accumulation after diagnosis of AKI, as a result of ongoing crystalloid administration, increasing nutritional fluid, limited urine output and minimal diuretic use.

The significance of single-cell transcriptome analysis in epididymis research.

As a crucial component of the male reproductive system, the epididymis plays multiple roles, including sperm storage and secretion of nutritive fluids for sperm development and maturation. The acquisition of fertilization capacity by sperm occurs during their transport through the epididymis. Compared with the testis, little has been realized about the importance of the epididymis. However, with the development of molecular biology and single-cell sequencing technology, the importance of the epididymis for male fertility should be reconsidered. Recent studies have revealed that different regions of the epididymis exhibit distinct functions and cell type compositions, which are likely determined by variations in gene expression patterns. In this research, we primarily focused on elucidating the cellular composition and region-specific gene expression patterns within different segments of the epididymis and provided detailed insights into epididymal function in male fertility.

Teduglutide improves liver chemistries in short bowel syndrome-associated intestinal failure: Post hoc analysis.

Chronic hepatic complications are common in patients with short bowel syndrome-associated intestinal failure (SBS-IF). Teduglutide, a glucagon-like peptide-2 analogue, demonstrated efficacy in reducing parenteral nutrition and/or intravenous fluid dependence among patients with SBS-IF in phase 3 clinical studies. This was a post hoc analysis of pooled data from two separate randomized, double-blind, placebo-controlled, multinational phase 3 clinical studies. Adult patients with SBS-IF with parenteral nutrition and/or intravenous fluid dependence without liver disease at baseline were randomized to treatment with the glucagon-like peptide-2 analogue teduglutide (0.05 or 0.10 mg/kg/day) or placebo subcutaneously once daily for 24 weeks. Mixed-effects models assessed the baseline predictors of change in liver chemistries. Between baseline and week 24, teduglutide treatment (n = 109) was associated with least squares mean reductions in aspartate aminotransferase (-7.51 IU/L; P = 0.014), alanine aminotransferase (-12.15 IU/L; P = 0.002), and bilirubin (-5.03 µmol/L [-0.057 mg/dl]; P < 0.001) compared with that of the placebo (n = 59). These values were independent of reductions in parenteral nutrition and/or intravenous fluid dependence. Teduglutide treatment was associated with reductions in liver chemistries by week 24, which is beneficial for patients with SBS-IF beyond improvements in parenteral nutrition and/or intravenous fluid dependence. Future studies should examine how long-term teduglutide might mitigate the risk of liver disease in patients with SBS-IF.

Ayurvedic Management of Vandhyatva (Primary Infertility) w.s.r. to Tubal Blockage – A Case Report

Introduction: Motherhood is a dream of all women’s and is complete after conception and child birth.Infertility is defined as a failure to conceive within one or more years of regular unprotected coitus1.Infertility affects approximately 5-15% of reproductive-aged couples in any community.Tubal blockage is one of the most common causative factors in female infertility.The prevalence is 19.1% in the fertility age group2.All types of female infertility in Ayurveda are described under the heading of Vandhya.It is among 80 types of Vata vikaras.During the period of Acharya Charaka, Infertile couples were considered as shade less, branchless, fruitless waste tree or like a lamp in picture or portrait which will not emit any light or brightness3.In Ayurveda, Infertility is termed as “Vandhyatva” and Vitiation of Vata is the prime factor for creation of disease. According to Acharya Sushruta, there are four factors responsible for creation of GARBHA i.e. Ritu (Ovulatory period/period of copulation), Kshetra (Reproductive tract including Uterus, Fallopian tubes, Ovary), Ambu( Nutritive fluid for fertilized ovum &amp; fetus), Beej i.e. Shukra and Shonita (Sperm &amp; Ovum)4. Among these four factors tubal blockage canbe considered as the deformity of Kshetra means Kshetradushti.Correlating fallopian tubes with the Artavavaha (Artava-beeja-vaha) Strotasa, its block can be compared as Sanga type of Strotodushti. Abnormality of tubes is generally of two types :- 1. Structural :- Anatomical blockage :- Due to Vitiation of VATA-KAPHA/ PITTA-KAPHA 2. Functional :- Defect in ciliary function of tube – Due to Vitiation of VATA. This condition is not described in Ayurvedic Classics as itself tubal blocks but blockages of fallopian tubes can be better correlated with Vandhyatva due to Artava bijavaha strotavrodha (Blockages in fallopian tubes) All three Doshas may be responsible for causing blockages but mainly Vata-Kapha pradhanata is more. Normalizing the Vitiated Vata-Kaphapradhana doshas leads to restoration of tubal function and easy conception. Several Ayurvedic interventions are advised such as Panchakarma (purification therapy) for vitiated Doshas in female reproductive organs, Snehapana (oral intake of medicated oil) followed by Virechana (medicated purgation) to produce quality ovum. Correlating fallopian tubes with the Artavavaha Srotas, its block is compared with the Sanga Srotodushti (obstructive pathology occurring in channels) of this Srotas. By virtue of the purification therapy and internal medication working synergistically might remove the Srotodusthti. Aim and Objective: To evaluate the efficacy of Ayurvedic treatment in the management of infertility. Case description: A Female patient of 27 years old, having complaint of scanty menses 1 year and failure to conceive since last 2 years came to OPD PTSR, ITRA, on May 2022 diagnosed as Anapatya (primary infertility) associated with bilateral tubal blockage. Diagnosis: Hysterosalpingography findings showed bilateral distal partial fallopian tubal block. Intervention: Virechana karma in first cycle followed by two cycles of Erandamuladi Niruha Basti for 8 days and uttarbasti for 6 days Saman Chikitsha with satpuspa choorana for two month. A six month protocol. Outcome: Within 6 months of treatment, patient got tubal spillage, conceive and then delivered a full term female baby weight 3.5 kg by LSCS . Conclusion: Ayurveda has a better treatment option for infertility special reference with tubal blockage in the form of Sodhana and Samana therapy. Keyword – Infertility, Shodhana therapy, Tubal blockage, Uttarabasti, Vandhyatva.

Cardiac tamponade with chylopericardium in a 6-year-old boy with central venous catheter: a case report

Cardiac tamponade (CT) is a rare but potentially lethal complication associated with central venous catheters (CVCs). We present a 6-year-old boy who developed CT after CVC insertion in the right internal jugular vein, with its tip in the inferior vena cava. Initially, he was hospitalized to a tertiary hospital with presumptive diagnoses of pneumonia and left ankle cellulitis. Three days after CVC placement, he developed CT, manifesting as recurrent episodes of hypotension and bradycardia. Once a bedside echocardiography showed CT, pericardiocentesis was performed, resulting in successful resuscitation. Pericardiocentesis revealed a milk-appearing pericardial fluid, indicating chylopericardium. The boy also underwent debridement and joint irrigation of the left ankle, which turned out to be osteomyelitis. Although CVC tips in most reported CVC-related CTs have been commonly located in the right atrium, our case featured a tip located in the inferior vena cava. Additionally, chylopericardium was likely due to the extravasation of total parenteral nutrition fluid, rather than the usual causes, such as recent thoracic surgery. Understanding the mechanisms behind chylopericardium associated with CVCs and timely pericardiocentesis is crucial for improving the outcomes.

Preterm Delivery in Obese Mothers Predicts Tumor Necrosis Factor-α Levels in Breast Milk.

Background: Breast milk (BM) is a nutritive fluid that is rich in bioactive components such as hormones and cytokines that can shape the newborn's feeding habits and program the newborn's immature immune system. BM components can change under different scenarios that include maternal body mass index (BMI) and premature birth. This study aimed to study the interaction of premature status or maternal obesity on the hormonal and cytokine profile in BM according to the sex of the offspring. Materials and Methods: We recruited 31 women with preterm births from the Centro de Alta Especialidad Dr. Rafael Lucio in Mexico. Luminex multiplexing assay was used for quantifying cytokine profile of monocyte chemoattractant protein-1, tumor necrosis factor (TNF)-α, interferon-γ, interleukin (IL)1-β, IL-2, IL-4, IL-6, IL-7, and hormones insulin, ghrelin, leptin, and glucagon in mature BM samples. Biological modeling was performed to predict the interaction between cytokines and hormones, maternal BMI status, infant birth sex, parity, and gestational age. Results: BM multiplex analysis showed positive correlations for TNF-α and increasing prematurity and for higher maternal BMI and IL-2, IL-4, and IL-6 cytokines. Multiple regression models identified an interaction between maternal BMI and gestational weeks in male infants that is associated to TNF-α accumulation in BM. Biological modeling predicts that preterm delivery in mothers with obesity modulates TNF- α levels in mature BM of women with male offspring. Conclusion: Prematurity and obesity modify BM's immune profile. TNF- α expression increases as prematurity increases, and maternal BMI correlates positively with increases in IL-2, IL-6, and IL-4. Our multiple regression model also shows that maternal BMI and gestational weeks in male infants predict TNF-α.

경정맥영양주사치료(intravenous nutrition therapy)의 근거 및 임상적 활용 범위

Intravenous nutrition therapy (IVNT) of functional medicine is often used as a confused concept with amino acid fluids or total parenteral nutrition (TPN) fluids due to its name of nutrition therapy. However, IVNT is a fluid treatment method whose composition and purpose are different from amino acid fluids and TPN fluids. IVNT may be applied to alleviating chronic fatigue, liver detoxification, anticancer effects in cancer patients, or relieving side effects from chemotherapy, depending on its components. IVNT can be applied to restore mitochondrial and adrenal dysfunction for alleviating chronic fatigue, and in the liver detoxification process, IVNT provides therapeutic effects through the supply of essential coenzymes and cofactors required for the liver detoxification phase and also reduces hepatic inflammation through antioxidant effects. Anti-cancer effects can be expected in cancer patients through high-dose antioxidant treatment. It is important for clinicians to select appropriate tests before applying IVNT to patients, and to apply appropriate IVNT through accurate differentiation diagnosis. In addition, Clinicians should familiarize with the precautions for each minerals and vitamins and be able to administer IVNT safely and effectively.

Transient Hypoglycemia and Biochemical Differences in Infants Less Than 1,250 G at Birth Fed Human Milk with Human Milk-Derived Fortifier versus Cow Milk-Derived Fortifier.

Fortification of human milk (HM) with either human milk-derived fortifier (HMDF) or cow milk-derived fortifier (CMDF) is important in preterm infants. The objective is to compare the incidence of hypoglycemia, and biochemical values in infants less than 1,250 g at birth fed HMDF versus CMDF. It is a retrospective cohort study on infants less than 1,250 g at birth who were fed with HMDF or CMDF. Hypoglycemia was defined as blood glucose (BG) level equal to or less than 60 mg/dL within 72 hours of full enteral feeds when off total parenteral nutrition and intravenous fluids. Ninety infants were enrolled (HMDF = 61, CMDF = 29). HMDF group had a higher rate of hypoglycemia (46 vs. 24%; p = 0.048) after achievement of full enteral feeding. The median minimum BG was lower (61 vs. 71; p ≤ 0.01), while blood urea nitrogen (12 vs. 6; p ≤ 0.01) and albumin (3.1 vs. 2.7; p ≤ 0.01) were higher in HMDF group compared with CMDF. At full enteral feedings in infants less than 1,250 g at birth, an HMDF diet may predispose to hypoglycemia needing intervention. Close monitoring of BG levels once off parenteral nutrition is recommended. · Exclusive human milk (EHM) feeding results in better nutritional indices.. · EHM feeding at higher calorie/ounce improves growth.. · Blood glucose needs to be monitored when off TPN during EHM feeding..

Artificially raised creatinine concentrations due to analytical interference for samples contaminated with total parenteral nutrition fluid.

A sample received in the laboratory from a patient receiving total parenteral nutrition (TPN) indicated that the patient may have renal dysfunction, but the results were not considered to be reliable enough to report. Investigations using a reference method for measurement of creatinine confirmed positive interference in the creatinine assay and distribution of samples via an External Quality Assessment (EQA) Scheme showed that this positive interference was method dependent. Residual TPN fluid (Nutriflex Lipid Special) left in the bag after the patient had completed the infusion was collected and added to a patient serum pool in increasing amounts and distributed to different laboratories for analysis of creatinine and glucose through an EQA Scheme. Positive interference in a number of different creatinine assays was identified as a result of a component in the TPN fluid. Positive interference from high concentrations of glucose has been demonstrated to be a cause for falsely high results in Jaffe creatinine assays. The concern would be that a sample contaminated with TPN fluid would have both abnormal electrolytes and creatinine concentrations and give the impression that the patient was in renal failure due to analytical interference in the creatinine assay and laboratory staff need to be aware of this problem.

The Effect of Isotonic Drinks and Yellow Watermelon Juice on the Hydration Status of T-Rex Jawa’s Football and Futsal Players

Hydration status is a condition that describes the balance of fluids in the body and is an important condition for ensuring the metabolic function of body cells. The purpose of this study was to determine the effect of giving iosotonic drinks and yellow watermelon juice on the hydration status of T-Rex Jawa’s football and futsal players. This research is a quasi-experimental study using crossover design. The sample was 26 people, all of whom were used as control groups and treatment groups. The control group was given 350 ml of isotonic drink and the treatment group was given 350 ml of yellow watermelon juice. Measurements in this study included weight, height, physical activity, energy intake, nutrients and fluids and hydration status values. The results showed that there were differences in hydration status values before and after treatment in both the control group and the treatment group. The Mann Whitney test showed p=0.006, namely that there was a significant difference between the decrease in the hydration status value of the control group and the treatment group, where a greater decrease was shown by the control group. Nutritional status, physical activity, energy intake, macronutrients, minerals and fluids are not correlated with hydration status.