Hydroelectrolytic Balance Research Articles

Participatory Development of a Tool for Recording the Hydroelectrolytic Balance of Critical Patients

Participatory Development of a Tool for Recording the Hydroelectrolytic Balance of Critical Patients

Effect of Temperature and Ionic Substitutions on the Tegumental Potentials of Protoscoleces of Echinococcus granulosus.

The protoscolex (PSC) is generated by asexual reproduction at the larval stage of taeniid Echinococcus granulosus that causes cystic echinococcosis or hydatidosis, a worldwide zoonosis. The PSC is enveloped by a complex cellular syncytial tegument responsible for ionic movements and the hydroelectrolytic balance of the parasite. We recently reported on two electrical potentials in bovine lung protoscoleces (PSCs) that reflect differences in ionic movements between the parasite's invaginated and evaginated developmental stages. Here, we explored the effect of temperature and ionic substitutions on the tegumental potentials of bovine lung PSCs of Echinococcus granulosus by microelectrode impalements. We observed that the transient peak potential was temperature-dependent, consistent with an active transport component in the invaginated state only. Further changes in the electrical potentials by high K+ depolarization, low external Ca2+, and addition of the diuretic amiloride are in agreement with the presence of a Ca2+-sensitive cation-selective electrodiffusional pathway in the outer surface of the parasite. Variations in electrical potential differences through the tegument provide an accessible and valuable parameter for studying ionic transport mechanisms and, therefore, potential targets for developing novel antiparasitic drugs.

Participation of the angiotensinergic and vasopressinergic mechanisms in the maintenance of cardiorespiratory parameters in sodium depleted rats

Changes in blood volume can be caused by different conditions, such as vomiting, diarrhea, alteration of sodium intake, trauma, or the use of diuretics, which can lead to severe health deterioration. Understanding the mechanisms involved in the maintenance of physiological parameters and the hydroelectrolytic balance of the human body during hypovolemia, can help with preventing and handling these high-risk situations. Hence, this study investigated cardiorespiratory [mean arterial pressure (MAP), heart rate (HR), pulmonary ventilation (VE)] and blood parameters, of sodium depleted rats with furosemide and the roles of the central and peripheral renin-angiotensin and the peripheral vasopressinergic systems in controlling blood pressure in these animals. Different groups under the same conditions received subcutaneous (s.c.) injections of furosemide (diuretic/saliuretic) or vehicle, intracerebroventricular (i.c.v.) or intravenous (i.v.) injections of losartan [angiotensin II (ANG II) AT1 receptor antagonist] or saline, and i.v. injections of Manning compound (AVPX, vasopressin V1 receptor antagonist). Sodium depletion increased the VE (708 ± 71, vs. normovolemic: 478 ± 40 mL/min/kg body wt) and did not modify baseline mean arterial pressure (104 ± 4, vs. normovolemic: 105 ± 4 mmHg) and heart rate (334 ± 20, vs. normovolemic: 379 ± 13 bpm). The i.v. losartan (10 mg/kg of body wt) treatment significantly reduced MAP in all groups and elevated HR, with a greater impact in sodium depleted rats before repletion. On the other hand, the i.c.v. losartan (3.3 μg/kg of body wt) and i.v. AVPX (10 μg/kg of body wt) treatments did not alter the MAP and HR in control, sodium depleted, and sodium repleted rats. These results indicate that sodium depletion affects cardiorespiratory control increasing baseline ventilation and peripheral angiotensinergic mechanisms are relevant for maintaining cardiovascular parameters in sodium depleted rats. Besides, this study suggests vasopressin V1 receptors do not participate in the maintenance of MAP and HR in sodium depleted animals with furosemide.

Opposite Effect of Thyroid Hormones on Oxidative Stress and on Mitochondrial Respiration in COVID-19 Patients.

Background: Thyroid hormones (TH)s are master regulators of mitochondrial activity and biogenesis. Nonthyroidal illness syndrome (NTIS) is generally considered an adaptative response to reduced energy that is secondary to critical illness, including COVID-19. COVID-19 has been associated with profound changes in the cell energy metabolism, especially in the cells of the immune system, with a central role played by the mitochondria, considered the power units of every cell. Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects and alters mitochondrial functions, both to influence its intracellular survival and to evade host immunity. Aim of the study: This study was undertaken to analyze the oxidative balance and mitochondrial respiration in COVID-19 patients with and without NTIS to elucidate the role that thyroid hormones (TH)s play in this context. Methods: In our cohort of 54 COVID-19 patients, admitted to our University Hospital during the COVID-19 pandemic, we evaluated the generation of reactive oxygen species (ROS) by measuring the serum levels of derivatives of reactive oxygen metabolites (dROMs), and we analyzed the antioxidant capacity by measuring the serum biological antioxidant potential (BAP). We then analyzed the mitochondrial respiration in peripheral blood mononuclear cells (PBMC)s of 28 of our COVID-19 patients, using the seahorse instrument (Agilent). Results were correlated with the serum levels of THs and, in particular, of FT3. In addition, the role of T3 on bioelectrical impedance analysis (BIA) and mitochondrial respiration parameters was directly evaluated in two COVID-19 patients with NTIS, in which treatment with synthetic liothyronine (LT3) was given both in vivo and in vitro. Results: In our COVID-19 patients with NTIS, the dROMs values were significantly lower and the BAP values were significantly higher. Consequently, the oxidative stress index (OSi), measured as BAP/dROMs ratio was reduced compared to that observed in COVID-19 patients without NTIS, indicating a protective role exerted by NTIS on oxidative stress. In our COVID-19 patients, the mitochondrial respiration, measured in PBMCs, was reduced compared to healthy controls. Those with NTIS showed a reduced maximal respiratory capacity and a reduced proton leak, compared to those with normal FT3 serum values. Such lowered mitochondrial respiratory capacity makes the cells more vulnerable to bioenergetic exhaustion. In a pilot study involving two COVID-19 patients with NTIS, we could reinforce our previous observation regarding the role of T3 in the maintenance of adequate peripheral hydroelectrolytic balance. In addition, in these two patients, we demonstrated that by treating their PBMCs with LT3, both in vitro and in vivo, all mitochondrial respiration parameters significantly increased. Conclusions: Our results regarding the reduction in the serum levels of the reactive oxygen species (ROS) of COVID-19 patients with NTIS support the hypothesis that NTIS could represent an adaptative response to severe COVID-19. However, beside this beneficial effect, we demonstrate that, in the presence of an acute reduction of FT3 serum levels, the mitochondrial respiration is greatly impaired, with a consequent establishment of a hypoenergetic state of the immune cells that may hamper their capacity to react to massive viral infection.

Challenging Preservation of the Renal Function in a Case of an Acute Erythroid Leukemia (Fab M6) Known with Moderate-to-Severe Chronic Kidney Disease

Abstract Acute erythroid leukemia (AEL) is a subtype of Acute Myeloid Leukemia (AML), comprising less than 5% of AML cases, characterized by erythroblastic proliferation. It’s a rare and aggressive form of acute leukemia whose biology remains poorly described, and there are many controversies around diagnosis influencing prognostic and therapeutic challenges. The average survival time for this type of Leukemia is 3 months. We present a unique case of a patient already known to have Chronic Kidney Disease stage G4, diagnosed with Acute Erythroid Leukemia (Fab M6), confirmed by Flow-Cytometry (infiltration of 93% erythroblasts in the Bone Marrow), who underwent specific chemotherapy (Azacitidine and Venetoclax) for 4 months. Due to severe pancytopenia and the presence of leukemic hiatus, it was challenging to avoid hemodialysis/hemofiltration, overcome metabolic acidosis and hyperuricemia, preserve serum creatinine levels at acceptable levels, and maintain hydroelectrolytic balance. All drug dosages (chemotherapy and supportive treatment) were adapted to the patient’s renal function.

Details Regarding the Medical Treatment of Children with Clostridium Difficile Infection - Clinical Case

Abstract The diarrheal disease produced by Clostridium difficile has a clinical picture that can vary from mild forms to life-threatening forms with a high risk of recurrence. The classic clinical picture described at that time was post-antibiotic, nosocomial diarrhea, which especially affects the elderly. It is the case of a male child of 5 years and 10 months, who presented himself in the morning with vomiting, diarrheal stools and flatulence. He underwent antibiotic treatment for 5 days for acute erythematous angina. From a biological point of view, the blood count is within normal limits, minimal inflammatory tests, examination of coproculture is normal. Clostridium Difficile infection or viral infection with Rotavirus, Norovirus or Adenovirus is suspected. A digestive multiplex panel is performed with a positive Clostridium difficile test and positive rotavirus, norovirus and adenovirus antigens. The treatment instituted was antibiotic, hydroelectrolytic balance, simpatomatic, accompanied by a hygienic-dietary regimen, with a favorable evolution. Acute gastroenteritis with Clostridium difficile is a disease with severe complications in children. Its typical nosocomial character begins to be less and less specific, with the increase in the rate of community infections, which should make clinicians aware and make them more responsible in terms of recommending antibiotic therapy in outpatient settings.

Lithium treatment in children and adolescents with anorexia nervosa: clinical use, side effects and tolerability.

Current guidelines, due to potential toxicity and lack of clinical evidence, do not recommend the use of lithium in the treatment of Anorexia Nervosa (AN). Scarce evidence is available on the use, side effects, and tolerability of this drug in children and adolescents with AN, a population characterized by specific clinical, metabolic, and hydro-electrolytic balance features. Here we report a case series of children and adolescents hospitalized for AN and treated with lithium. Case series reporting the use of lithium in 7 female young patients with AN. Reasons for introduction, dosages, formulation, plas-ma levels, adverse drug reactions (ADR) and modifi-cations of electrocardiogram (EKG) and plasma levels of glucose, cholesterol, creatinine, urea, sodium, and thyroid-stimulating hormone (TSH) were assessed. Re-sults. Reasons for the introduction of lithium included unstable mood, insufficient compliance with nutri-tional programs, and psychomotor agitation. In all of the patients an improvement on target symptoms was observed. Lithium was started at 171.4 (+/-56.7) mg/day, up to 600.0 (+/-173.2) mg/day. The most frequent scheme was three times daily. The mean plasmatic concentration was 0.6 (+/-0.3) mmol/L at one month. One pa-tient experienced polyuria, polydipsia and dry mouth, and another showed increased creatinine kinase. No major modifications of EKG, glucose, cholesterol, cre-atinine, urea, sodium emerged. In this sample of children and adolescents hospitalized for AN, lithium was administered to improve psychiatric symptoms impairing compliance. All the patients experienced an improvement on these symptoms after being admin-istered lithium. ADR were reported in 2 cases. These data should be investigated in wider populations and controlled studies.

Qualidade de vida de pacientes renais crônicos em tratamento dialítico hemodialítico em Guaraí- TO

Chronic Renal Insufficiency (CRF) is a slow-graded pathology, characterized by structural and / or functional changes in renal function, a vital organ in maintaining hydroelectrolytic balance. To evaluate the quality of life of chronic renal patients undergoing substitution therapy undergoing Hemodialysis and Peritoneal Dialysis. Field research with a qualitative exploratorydescriptive approach, carried out at the Health Education Clinic (CEPS) of the Instituto Educacional Santa Catarina - IESC / FAG in the city of Guaraí - TO. The study population consists of 07 patients with CRF undergoing Renal Replacement Therapy (RRT). The WHOQOL questionnaire was applied to assess Quality of Life (QOL), the information collected was organized and presented in the form of graphs. In the QOL domain, 71.4% of the survey participants declared their QOL to be poor or very bad and only 28.6% reported good QOL, these results show how much the disease interferes with the individual's biopsychosocial aspects. The prevalence of patients on Hemodialysis is significantly higher when compared to Peritoneal Dialysis. The QoL of patients on RRT is substantially lower due to the burden caused by the disease, which reinforces the need for preventive measures.

Гипервитаминоз D у ребенка первого года жизни

Objective of the Paper: To describe a case history of the diagnosis and management of hypervitaminosis D in a 3-month baby. Key Points. Hypervitaminosis D can be caused either by intake of high doses of this product, or hypersensitivity to its toxic effects. This paper describes a clinical history of diagnosis and management of hypervitaminosis D in a 3-month baby boy. Medical history (daily intake of vitamin D in doses manifold exceeding the age-specific preventive dose for 2 months), laboratory tests (increased blood concentrations of 25-hydroxycholecalciferol and calcium, reduced parathormone levels) made it possible to diagnose hypervitaminosis D. The condition of the baby improved after withdrawal of vitamin D and therapy aiming at normalisation of the hydro-electrolytic balance and body functions. It was recommended not to take vitamin D until the 25-hydroxycholecalciferol level normalises. Conclusion. In order to prevent hypervitaminosis D, it is essential to strictly adhere to the preventive and therapeutic doses of vitamin D, preferably with blood calcidiol monitoring. Keywords: hypervitaminosis D, 25-hydroxycholecalciferol, intoxication, preventive dose, therapeutic dose.

Swimming training improves cardiovascular autonomic dysfunctions and prevents renal damage in rats fed a high-sodium diet from weaning.

What is the central question of this study? How does swimming exercise training impact hydro-electrolytic balance, renal function, sympathetic contribution to resting blood pressure and cerebrospinal fluid (CSF) [Na+ ] in rats fed a high-sodium diet from weaning? What is the main finding and its importance? An exercise-dependent reduction in blood pressure was associated with decreased CSF [Na+ ], sympathetically driven vasomotor tonus and renal fibrosis indicating that the anti-hypertensive effects of swimming training in rats fed a high-sodium diet might involve neurogenic mechanisms regulated by sodium levels in the CSF rather than changes in blood volume. High sodium intake is an important factor associated with hypertension. High-sodium intake with exercise training can modify homeostatic hydro-electrolytic balance, but the effects of this association are mostly unknown. In this study, we sought to investigate the effects of swimming training (ST) on cerebrospinal fluid (CSF) Na+ concentration, sympathetic drive, blood pressure (BP) and renal function of rats fed a 0.9% Na+ (equivalent to 2% NaCl) diet with free access to water for 22weeks after weaning. Male Wistar rats were assigned to two cohorts: (1) fed standard diet (SD) and (2) fed high-sodium (HS) diet. Each cohort was further divided into trained and sedentary groups. ST normalised BP levels of HS rats as well as the higher sympathetically related pressor activity assessed by pharmacological blockade of ganglionic transmission (hexamethonium). ST preserved the renal function and attenuated the glomerular shrinkage elicited by HS. No change in blood volume was found among the groups. CSF [Na+ ] levels were higher in sedentary HS rats but were reduced by ST. Our findings showed that ST effectively normalised BP of HS rats, independent of its effects on hydro-electrolytic balance, which might involve neurogenic mechanisms regulated by Na+ levels in the CSF as well as renal protection.

The Effect of Dehydration on the Development of Endothelial Dysfunction in Young Athletes: a Comparative Analysis of the Effectiveness of a New Honey Isotonic Drink and Standard Means of Restoring Hydro-Electrolytic Balance

Aim of the research. To prove the effectiveness of using isotonic honey drink “Gold F25 IsoDrink Light” (IsoDrink-L) based on the study of the hydration process and endothelial function in young athletes. Materials and methods. A randomized controlled study was performed in young athletes under the age of 18 years. Athletes of the main group (n = 40) consumed IsoDrink-L for a month; athletes of the control group (n = 34) consumed water and isotonic drink “X”. A bioimpedance-based device was used to determine the total amount of water, the absolute and relative proportions of intra- and extracellular water, as well as the ratio of extracellular water to the total amount of water. Hematocrit, specific gravity and color of morning urine, samples with reactive hyperemia and hyperventilation in the brachial artery, including the determination of the endothelial sensitivity index were assessed. Results. All athletes had dehydration in the form of extracellular dehydration, cellular hyperhydration, “blood thickening”, hyponatremia, increased specific gravity and urine color, as well as endothelial dysfunction. All symptoms disappeared after using IsoDrink-L for 1 month. No dynamics was observed in the control group, where 95 % of the athletes took water and 5 % – isotonic drink “X”. ROC analysis showed that the endothelial sensitivity index with a sensitivity of 95.8 % and a specificity of 99.4 % detects endothelial dysfunction. The canonical correlation coefficient between the set of hydration-dependent and endothelium-dependent signs was R = 0.71 (p < 0.0001). We established the danger of uncontrolled water consumption for rehydration in young athletes, as well as the high efficiency of isotonic honey drink and the evidence for its use for the correction of dehydration and endothelial dysfunction. A low awareness of athletes, doctors and coaches about the importance of using effective methods of rehydration in children’s sports was revealed. Conclusion. It was found that water imbalance in young athletes directly or indirectly contributes to the development of endothelial dysfunction, thereby increasing cardiovascular risk. Original approaches to the development of honey isotonic drink for young athletes with proven hydrating and endothelium-protective properties are proposed.

Acute coronary syndrome with ST segment elevation in a patient with Addison disease: Case report and brief review of physiopathological mechanisms: A case study.

The adrenal gland serve important roles in the modulation of the immune response, the adjustment of blood pressure, the stress reaction via glucocorticoids and the hydroelectrolytic balance via mineralocorticoids. Primary adrenal insufficiency, known as Addison disease, is characterized by a decrease in glucocorticoid secretion (cortisol) and, more rarely, by a hyposecretion of mineralocorticoids (aldosterone). The production of cortisol, which is a hormone that helps the body respond to stress, is regulated in the brain, the hypothalamus and the pituitary gland. The hypothalamus stimulates the pituitary gland to produce adrenocorticotropic hormone, which stimulates cortisol production from the adrenal gland. If left untreated, Addison disease has a high mortality rate. Corticotherapy used in the treatment of Addison disease is associated with a certain cardiovascular risk. The proatherogenic effect of corticoids is based on the chronic inflammatory response of the vascular wall to a series of events. The aim of the current case report was to review the pathophysiological mechanisms and interactions that may lead to the onset of acute coronary syndrome with ST elevation in a patient with Addison disease.

Effects of Hypotonic and Isotonic Enteral Electrolyte Solutions Administered in Continuous Flow in Weaned Foals.

The effects of fluid therapy with maintenance enteral electrolytic solutions administered by nasogastric route in continuous flow have not previously been studied in weaned foals. This study primary goal was to compare the effects of two maintenance enteral electrolytic solutions administered by nasogastric route in continuous flow on the hydro electrolytic balance in weaned foals. This paper was a controlled trial in a cross-over design (6 × 2) performed in six foals with a mean age of 7.3 ± 1.4 months; each animal received two treatments, IsoES and HypoES, with an interval of 7 days between treatments. After 12 h of fasting, the animals were treated with enteral electrolyte solutions administered via nasogastric route in continuous flow in a volume of 15 mL/kg/h for 12 h. The evaluations were performed at T-12h (the beginning of the fasting), T0h (end of fasting and beginning of fluid therapy), T4h (4 h of fluid therapy), T8h (8 h of fluid therapy), T12h (end of fluid therapy), and T24h (12 h after the end of fluid therapy). Twelve hours of fasting resulted in a reduction (P < 0.05) in body weight, abdominal circumference, whereas serum sodium, SID and enophthalmos increased. Twelve hours of fluid therapy normalized these parameters and promoted increased urinary volume and decreased urinary density without causing electrolyte imbalances. Both enteral electrolytic solutions were effective in reestablishing clinical and laboratorial variables without causing electrolyte imbalances.

The role of the renin-angiotensin system in the appearance and progression of renal cell carcinoma: a literature review

Renal cell carcinoma (RCC) is one of the most common forms of malignant epithelial tumors of this localization. The development of new approaches to the diagnosis, prognosis and treatment of RCC is an topical issue of molecular medicine. The renin-angiotensin system (RAS) is not only an important component of the central and humoral mechanisms of controlling blood pressure and hydroelectrolytic balance, but also refers to the body systems involved in complex carcinogenesis pathways. Researches on the role of RAS in tumor progression are currently the priority. The data on the role of RAS in the development and progression of malignant tumors in the kidneys are being discussed. In this article, we present an overview of data on the role of RAS in the emergence and development of RCC, an analysis of the molecular mechanisms of development and progression of RCC, the prospects for using indicators of the RAS: angiotensin-converting enzymes (ACE), ACE2 and angiotensin II receptors as markers of diagnosis and monitoring of neoplastic transformation processes in the kidney. The prospects for the use of new, effective anticancer drugs with a targeted effect on definite indicators of the RAS of RCC were analyzed.

MULTIDISCIPLINARY MANAGEMENT OF A CASE OF INTESTINAL FAILURE DUE TO SHORT BOWEL SYNDROME IN GARDNER SYNDROME

Objective There still is little attention about both nutritional/metabolic consequences and multi-organ involvement after intestinal surgery. Our multidisciplinary team aimed to an integrated approach to short bowel syndrome (SBS). Research Methods & Procedures A 37-years-old man affected by Gardner Syndrome, who previously underwent colectomy and several small bowel resections elsewhere without receiving appropriate nutritional prescriptions, was admitted into our hospital to be evaluated for intestinal transplant: biochemistry showed acute renal failure and multiple critical dysionias and the patient referred habitual copious liquid output, also containing undigested food, from ileostomy; he had lost 30 kg (-40% usual body weight, BW) in the last month. He promptly underwent nutritional assessment and, consequently, nutritional treatment: firstly we corrected dysionias and immediately started thiamin supplementation, thereafter we prescribed a personalized semielemental low-fiber diet per os, parceled out on 5-6 meals, and we started a personalized admixture parenteral nutrition support (PN). Regardless of appropriate evidences, the patient finally refused to give his consent to intestinal transplant, he was then discharged in PN and personalized diet per os. Results Despite severe dehydration and malnutrition, we early achieved and maintained hydro-electrolytic balance, thus recovering renal enhancement; besides, Refeeding Syndrome was adequately prevented and, beyond rehydration, the patient also started regaining BW. Conclusions SBS can result in both intestinal and renal failure. It needs a multidisciplinary approach, including early and appropriate nutritional assessment and treatment. When intestinal transplant is not possible, even if recommended, PN remains the main therapeutic strategy.

Cardiovascular and hidroelectrolytic changes in rats fed with high-fat diet

Obesity activates the renin-angiotensin and sympathetic systems facilitating hypertension and changes in the hydroelectrolytic balance. In the present study, in rats fed with high-fat diet (HFD), we investigated daily water intake and urinary excretion, prandial consumption of water and the changes in blood pressure and water intake to intracerebroventricular (icv) angiotensin II (ANG II). Male Holtzman rats (290–320 g) were fed with standard diet (SD, 11% calories from fat) or HFD (45% calories from fat) for 6 weeks. Part of the animals received a stainless steel cannula in the lateral ventricle (LV) at the 6th week after the beginning of the diets and the experiments were performed at the 7th week. The pressor effect, but not the dipsogenic response to acute icv injection of ANG II, was potentiated in the HFD rats. Daily water intake and urinary volume were reduced in rats fed with HFD with no significant changes in sodium excretion. Prandial water consumption was also reduced in rats ingesting HFD, an effect almost totally reverted blocking salivation with atropine. These results show a potentiation of the pressor response to icv ANG II in HFD-fed rats, without changing icv ANG II-induced water intake. In addition, prandial and daily water intake and urinary volume were reduced in HFD-fed rats, without changing sodium excretion. Salivation in rats ingesting HFD may play a role in the reduced prandial and daily water intake.

SUN-117 Neuroendocrine Mechanisms Responsible for the Hydromineral Control in Rats with Obesity Induced by High Fat Diet (HFD)

Besides being studied regarding cardiovascular diseases and metabolic disturbances, little is known about how obesity might modulate the hydroeletroctrolytic balance. Some studies suggest that such modulation might exist. This current study has the objective of clarify the neuroendocrine mechanisms of salt and water homeostasis in obese rats under normal and osmotic challenge conditions. Wistar male rats weighting 100 grams were used; they were divided into two groups, one submitted to high fat diet (HFD) and the other submitted to normal diet, both for 9 weeks. After that they were kept in a metabolic cage for three days in order to measure food, water and sodium intake and urinary volume. After 24 or 48 hour fluid deprivation, they were given back water, in the first hour, and water and saline (1,8% NaCl), in the second hour, determining the ingestion of both fluids. One week later, the rats were submitted again to 24 or 48 hour fluid deprivation and then euthanized to obtain blood samples and tissues. During the basal period, the obese rats drank less water and ate less food than the non-obese rats. After the 24 or 48 hour dehydration, the obese rats drank less water than the non-obese. Besides that, the dehydrated obese rats also had a reduced hematocrit, reduced plasma osmolality, and reduced levels of K⁺ in plasma, a tendency to bigger levels of Na⁺ in plasma when compared to dehydrated non-obese rats. It was possible to observe an adipose tissue mass reduction in obese dehydrated rats when compared to obese hydrated rats. Accordingly, we were able to see that obesity indeed changes the hydroelectrolytic balance and there is the hypothesis that obese rats might use fat as a water reserve through of beta oxidation of lipids, which is an issue still under investigation. Sources of Research Support: Sao Paulo Research Foudation (FAPESP) Grant #2013/09799-1; Fapesp Grant #2018/10920-3.

Modulation of NHE3 Activity in Rat Renal Proximal Tubules during the Estrous Cycle Phases and Direct Impact of Estradiol and Progesterone

Estradiol (E2) and progesterone (P4) are two of the major steroid hormones involved in the control of reproductive functions in females. Among other effects, E2 and P4 can modulate sodium reabsorption along the nephron, altering the hydroelectrolytic balance, leading to hydrosaline retention. Na/H exchanger, isoform 3, is the main route for sodium bicarbonate reabsorption in renal proximal tubules (PT). The aims of the present study are to evaluate the activity of NHE3 in the different estrous cycle phases and to investigate the direct effects of E2 and P4 on NHE3 activity in kidneys of control (sham) or ovariectomized rats (OVX). All the protocols were approved by the Committee on Animal Research and Ethics from the Ceara State University (protocol #2722214/2016). The estrous cycle of female Wistar rats were evaluated during 15 days and animals randomly assigned to OVX or sham group. Thereafter, two weeks after surgery, the activity of NHE3 was evaluated in vivo by using the stationary microperfusion (SM) technique and after this procedure, the kidneys were stored for evaluation of NHE3 protein abundance by Western Blot (WB). In a first set of experiments, PT were punctured to perfuse control solution (PCS) in order to compare the different phases of the estrous cycle against OVX‐group. In a second set, PTs were perfused with E2 or P4 to compare with OVX animals. SM allows the measurement of H+ secretion in proximal tubules, representing an indirect measure of NHE3 function. It was observed that OVX presented lower H+ secretory activity than all cyclic groups and the estrous group presented higher secretion rates: [JHCO3‐ nmol.cm‐2.s‐1 OVX 1.74 ± 0.07 (10); Proestrus 1.90 ± 0.12 (12)a; Estrus 2.35 ± 0.08 (13)ab; Metaestrus 1.97 ± 0.12 (15)ac and Diestrus 1.89 ± 0.08 (14)ac, where a p &lt;0.05 vs OVX, b p &lt;0.05 vs Proestrus and c p &lt;0.05 vs Estrus]. In addition, an increase in proximal H+ secretion/bicarbonate reabsorption was observed in all E2 and P4 concentrations when administered intratubularly and compared to the OVX group: [JHCO3‐, nmol.cm‐2s‐ OVX+Vehicle 1.84 ± 0.06 (11); E2 (0.1 nM) 2.18 ± 0.07 (15)a; E2 (1 nM) 2.24 ± 0.08 (11)a; E2 (10 nM) 2.20 ± 0.09 (12)a; P4 (0.1 nM), 2.18 ± 0.11 (13)a, P4 (10 nM), 2.10 ± 0.07 (10)a, where a p &lt;0.05 vs OVX + Vehicle]. NHE3 total/villin expression in brush border membranes of PT is lower in the Diestrus group when compared to all other groups: OVX 0.79 ± 0.26 (n=5); Proestrus 0.64 ± 0.08 (n=6); Estrus 0.76 ± 0.30 (n=6); Metaestrus 0.69 ± 0.12 (n=6); Diestrus 0.22 ± 0.12 (n=6)*, p &lt;0.05 vs OVX, Proestrus, Estrus and Metaestrus. Significative changes in NHE3 activity occurs in the different phases of estrous cycles with higher activity in the estrus and lower in diestrus. In addition, it was observed a positive regulation of NHE3 by E2 and P4 in PT which may contribute to sodium retention if this stimulus is maintained for a long‐term.Support or Funding InformationCNPq/FUNCAPThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Diabetes Keto-acidosis in Children: A Report of Two Cases and Literature Review

Aims: To present features of two cases of diabetes keto-acidosis observed in the Nouveau Village de Pédiatrie, Democratic Republic of Congo (DRC), between 2014 and 2018.&#x0D; Cases Presentation: The first case was a male patient, 13 years-old, who arrived with fever, vomiting, polyuria, unconsciousness, respiratory distress and coma. His fasting plasma glucose was 570 mg/dl. Urea nitrogen 56,4 mg/dl; Creatinine 2,1 mg/dl. C reactive protein was 27 mg/l. The treatment of diabetes ketoacidosis (DKA) was based on insulin, fluids and antibiotics. Despite glycemic normalization, he died with cerebral edema and sepsis. The second case was a female child of 6 years, received with fever, polydipsia, asthenia, polyuria, a familial history of diabetes. Random plasma glucose was 500 mg/dl and C reactive protein 10 mg/l. Despite insulin and antibiotics, her clinical state worsened by a pyelonephritis and pulmonary edema and, probably tuberculosis. She also died.&#x0D; Conclusion: Diabetes mellitus type 1 in children, complicated with DKA and sepsis, have worse prognosis. More children death would be avoidable by correct global treatment including insulin and hydro-electrolytic balance to prevent cerebral or pulmonary edema. Children with tuberculosis should realize routine screening for diabetes mellitus and inversely.

Median preoptic nucleus excitatory neurotransmitters in the maintenance of hypertensive state

The crucial role of the median preoptic nucleus (MnPO) in the maintenance of hydroelectrolytic balance and autonomic regulation have been highlighted. Recently, the participation of the MnPO in the control of sympathetic nerve activity was demonstrated in essential hypertension model. However, peculiarities on the neurochemical changes underlying the differential role of MnPO during hypertension remain to be clarified. Therefore, this study aimed to investigate the main excitatory pathways that modulate MnPO neurons in hypertensive rats. Spontaneously hypertensive rats (SHR) and rats submitted previously to the Goldblatt protocol (two kidneys; one clip; 2K1C) were used. Rats of both groups (250 to 350 g, n = 6) were anesthetized with urethane (1.2 g/kg,i.v.) and instrumented to record mean arterial pressure (MAP), heart rate (HR) and renal sympathetic nerve activity (RSNA). Nanoinjection (100 nl) of saline (NaCl, 150 mM), losartan (AT1 receptor antagonist; 10 mM) and kynurenic acid (glutamate receptor antagonist; 50 mM) into the MnPO were performed. In 2K1C rats, glutamatergic blockade promoted decreases in MAP and RSNA (-19.1 ± 0.9 mmHg, -21.6 ± 2.8%, p < 0.05) when compared to saline (-0.4 ± 0.6 mmHg, 0.2 ± 0.7%, p < 0.05). Angiotensinergic inhibition also reduced these parameters (-11.5 ± 1.2 mmHg, -10.5 ± 1.0%, p < 0.05) in 2K1C. In SHR, Kynurenic acid nanoinjections produced hypotension and sympathoinhibition (-21.0 ± 2.5 mmHg, -24.7 ± 2.4%, p < 0.05), as well losartan nanoinjections (-9.7 ± 1.2 mmHg; p < 0.05) and RSNA (-12.0 ± 2.4%, p < 0.05). These findings support the conclusion that a tonic excitatory neurotransmission exerted by angiotensin II, and mostly by glutamate in the MnPO could participate in the modulation of blood pressure and RSNA independent on whether hypertension is primarily neurogenic or is secondary to stenosis in renal artery.