Hyponatremia Research Articles

Transient Receptor Potential channels (TRP) in GtoPdb v.2023.3

Transient Receptor Potential channels (TRP) in GtoPdb v.2023.3

Association of hypertension in pregnancy with serum electrolyte disorders in late pregnancy among Cameroonian women

Multiple electrolyte disorders, including sodium, potassium and calcium disorders, have been associated with hypertension in pregnancy. Most of these studies failed to evaluate the combined effect of low and high sodium, potassium, calcium and chloride ion concentrations on hypertension in pregnancy. This study evaluates the combined effect of these ion categories (low, normal, high) on hypertension in pregnancy. Biochemical ion assays and blood pressure measurements were carried out on 1074 apparently healthy pregnant women in late third trimester. Serum potassium, sodium, chloride, and ionised calcium were measured by ion-selective electrode potentiometry, while total plasma calcium was measured by absorption spectrophotometry. Hypertension in pregnancy was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. The prevalence of hyponatraemia, hypokalaemia, hypochloraemia, ionised hypocalcaemia and total hypocalcaemia in late pregnancy was 1.30 [0.78–2.18]%, 3.55 [2.60–4.84]%, 1.96 [1.28–2.97]%, 1.49 [0.92–2.21]% and 43.58 [40.64–46.56]%, respectively. Hypernatraemia, hyperkalaemia, hyperchloraemia, ionised hypercalcaemia and total hypercalcaemia were found in 1.49 [0.92–2.41]%, 2.34 [1.59–3.43]%, 4.38 [3.31–5.77]%, 39.94 [37.06–42.90]%, 2.79 [1.96–3.96]% of the participants, respectively. The prevalence of hypertension in pregnancy was 7.17 [5.77–8.87]%. When ion categories were considered in multiple logistic regression, only ionised and total calcium had significant associations with hypertension in pregnancy. Women with ionised hypercalcaemia had lower odds of hypertension in pregnancy (AOR = 0.50 [0.29–0.87], p-value = 0.015), and women with total hypocalcaemia had higher odds of hypertension in pregnancy (AOR = 1.99 [1.21–3.29], p-value = 0.007), compared to women with ionised and total normocalcaemia, respectively. Increasing kalaemia was associated significantly with higher odds of hypertension in pregnancy; however, kalaemia below and above the normal concentrations had no significant association with hypertension. Nonetheless, participants with kalaemia ≤ 3.98 mmol/L, had lower odds of hypertension in pregnancy compared with those with higher kalaemia (OR = 0.40 [0.24–0.66], p-value = 0.0003). Calcium disorders remain the most frequent electrolyte disorders in pregnancy. When normal cut-offs are considered for calcium and other ions, only ionised and total calcium influence the occurrence of hypertension in pregnancy. Kalaemia seems to affect hypertension in pregnancy but primarily within its normal concentrations. Serum electrolyte follow-up is indispensable for a proper pregnancy follow-up.

Low sodium availability in hydroponically manipulated host plants promotes cannibalism in a lepidopteran herbivore

As an abundant element in the Earth’s crust, sodium plays an unusual role in food webs. Its availability in terrestrial environments is highly variable, but it is nonessential for most plants, yet essential for animals and most decomposers. Accordingly, sodium requirements are important drivers of various animal behavioural patterns and performance levels. To specifically test whether sodium limitation increases cannibalism in a gregarious lepidopteran herbivore, we hydroponically manipulated Helianthus annuus host plants' tissue-sodium concentrations. Gregarious larvae of the bordered patch butterfly, Chlosyne lacinia, cannibalized siblings when plant-tissue sodium concentrations were low in two separate experiments. Although cannibalism was almost non-existent when sodium concentrations were high, individual mortality rates were also high. Sodium concentration in host plants can have pronounced effects on herbivore behaviour, individual-level performance, and population demographics, all of which are important for understanding the ecology and evolution of plant-animal interactions across a heterogeneous phytochemical landscape.

Sodium Levels and Outcomes in Patients With Metastatic Renal Cell Carcinoma Receiving Nivolumab

Low sodium levels have been associated with negative outcomes among patients with metastatic renal cell carcinoma (mRCC) receiving therapies other than immune checkpoint inhibitors (ICIs). To investigate the role of natremia in patients with mRCC receiving nivolumab as a second-line or subsequent therapy. In this retrospective cohort study, the clinical and biochemical data of patients with mRCC receiving nivolumab were collected from October 2015 to November 2019 as part of a multicenter Italian study. Data analysis was performed from February to March 2023. Nivolumab was administered intravenously at a dose of 3 mg/kg every 2 weeks and, since May 2018, at a fixed dose of 240 mg every 2 weeks or 480 mg every 4 weeks. Patients were divided into 2 groups according to their median serum sodium value (<140 or ≥140 mEq/L). The primary outcomes were the associations of pre-ICI and post-ICI sodium levels with overall survival (OS), progression-free survival (PFS), objective response rate, and disease control rate (DCR). The Kaplan-Meier method was used to estimate PFS and OS, and differences between groups were compared using the log-rank test. A total of 401 patients with mRCC receiving nivolumab as second-line therapy were evaluated, and 355 eligible patients (median [range] age, 76 [44-84] years; 258 male patients [72.7%]) were included in the final cohort. Among patients with pre-ICI sodium greater than or equal to 140 mEq/L compared with those with sodium less than 140 mEq/L, the median PFS was 9.3 months (95% CI, 6.5-11.5 months) vs 7.4 months (95% CI, 4.6-10.1 months; P = .90), and the median OS was 29.2 months (95% CI, 21.8-35.9 months) vs 20.0 months (95% CI, 14.1-26.8 months; P = .03). Patients with post-ICI sodium values greater than or equal to 140 mEq/L had longer PFS (11.1 months [95% CI, 8.5-1.5 months] vs 5.1 months [95% CI, 4.1-7.5 months]; P = .01) and OS (32.9 months [95% CI, 25.1-42.6 months] vs 17.1 months [95% CI, 12.6-24.5 months]; P = .006) compared with patients with sodium values less than 140 mEq/L. Patients with both pre-ICI and post-ICI sodium values greater than or equal to 140 mEq/L exhibited a significant improvement in clinical outcomes compared with those with a value less than 140 mEq/L (PFS, 11.5 months [95% CI, 8.8-16.4 months] vs 5.8 months [95% CI, 4.4-8.3 months]; P = .008); OS, 37.6 months [95% CI, 29.0-49.9 months] vs 19.4 months [95% CI, 14.1-24.5 months]; P = .01). Moreover, sodium levels greater than or equal to 140 mEq/L were associated with significantly better DCR than lower sodium levels. In this retrospective cohort study of patients with mRCC receiving nivolumab, sodium values greater than or equal to 140 mEq/L, both before and/or after ICI, were associated with better OS and PFS, as well as a higher DCR, compared with levels less than 140 mEq/L. These findings suggest that sodium levels may be associated with survival outcomes in patients with mRCC and may have potential use as variables to consider in patients' risk scores.

Dosing and transition characteristics in people with narcolepsy transitioning from sodium oxybate to low-sodium oxybate: Data from the real-world TENOR study

ObjectiveThe Transition Experience of persons with Narcolepsy taking Oxybate in the Real-world (TENOR) study assessed the real-world experience of people with narcolepsy switching from sodium oxybate (SXB) to low-sodium oxybate (LXB; 92 % less sodium than SXB). MethodsTENOR is a patient-centric, prospective, observational, virtual-format study. Eligible participants included US adults with narcolepsy transitioning from SXB to LXB (±7 days from LXB initiation). Longitudinal data were collected from baseline (taking SXB) through 21 weeks post-transition. ResultsTENOR included 85 participants with narcolepsy (type 1, n = 45; type 2, n = 40). Mean (SD) age was 40.3 (13.0) years; the majority (73 %) were female and White (87 %). At study completion, wake-promoting agents were the most common concomitant medications (47 %). Mean (SD) SXB treatment duration was 57.8 (52.1) months; 96 % took SXB twice nightly. After transitioning, 97 % continued on twice-nightly regimens. Mean (SD) dose of both total nightly SXB (n = 85) and baseline LXB (n = 84) was 7.7 (1.5) g; SXB-LXB dose conversions at baseline were gram-for-gram in 87 % of participants. The mean final total nightly dose of LXB was 7.9 g. The most common participant-reported reasons for transitioning included lower sodium content for improved long-term health (93 %), physician recommendation (47 %), to avoid cardiovascular issues (39 %), to avoid side effects (31 %), and to improve control of narcolepsy symptoms (18 %). ConclusionMost participants transitioned from SXB to LXB using a gram-for-gram strategy. The most commonly cited reason for transition was long-term health benefits due to lower sodium.

Co-delivery of drugs by adhesive transdermal patches equipped with dissolving microneedles for the treatment of rheumatoid arthritis

In this study, a dosage form consisting of dissolving (D) microneedles (M) and an adhesive (A) transdermal patch (P; DMAP) was designed and pre-clinically evaluated for the treatment of rheumatoid arthritis (RA). The tip of the dissolving microneedles (DMNs) was loaded with the macromolecular drug melittin (Mel@DMNs), this to treat joint inflammation and bone damage, while the adhesive transdermal patches contained the low molecular weight drug diclofenac sodium (DS; DS@AP) for pain relief. Mel@DMNs and DS@AP were ingeniously connected through an isolation layer for compounding Mel-DS@DMAP for the simultaneous delivery of the drugs. In vitro and in vivo experiments showed that DS@AP did not affect the mechanical properties and dissolution process of Mel@DMNs while the pores formed by the microneedles promoted the skin penetration of DS. Treatment of rats suffering from RA with Mel-DS@DMAP reduced paw swelling and damage of the synovium, joint and cartilage, suggesting that the ‘patch-microneedle’ dosage form might be promising for the treatment and management of RA.

Effect of Activator and Mineral Admixtures on the Autogenous Shrinkage of Alkali-Activated Slag/Fly Ash

The high autogenous shrinkage of alkali-activated fly ash/slag (AASF) poses a significant concern for the widespread application of AASF in structural engineering. The present study compares the efficacy of activator and mineral admixtures in mitigating the autogenous shrinkage of AASF, and discusses the underlying mechanism. The results show that the use of activators with a lower silicate modulus and a lower sodium content, as well as incorporating metakaolin (MK) or silica fume, can reduce the autogenous shrinkage of AAMs. These approaches delay the appearance of the second exothermic peak, which corresponds to the later formation of C-A-S-H gels and slower development of capillary pressure. The inclusion of MK not only retards the reaction but also facilitates the formation of N-A-S-H gels, resulting in a coarse pore structure and reduced water consumption. The use of the activator with a lower silicate modulus (reduced from 1.5 to 1.0) leads to a higher internal relative humidity and the reduced pore volume of silt-shaped and ink-bottle pores (2–50 nm) in AASF, thereby reducing the autogenous shrinkage without significant strength reduction.

Predictive modeling of postoperative gastrointestinal dysfunction: the role of serum bilirubin, sodium levels, and surgical duration in gynecological cancer care.

To elucidate the role of preoperative serum bilirubin and sodium levels, along with the duration of surgery, in predicting postoperative gastrointestinal dysfunction (POGD) following gynecological cancer surgery, informing tailored perioperative strategies. We conducted a retrospective analysis of 281 patients undergoing gynecological cancer surgery between 2018 and 2023. This analysis focused on preoperative serum bilirubin and sodium levels and intraoperative factors (surgical duration) as potential predictors of POGD. Logistic regression models were utilized for analysis, controlling for relevant confounders. Elevated preoperative serum bilirubin was associated with a reduced risk of POGD (mean level in non-POGD cases: 14.172 ± 4.0701, vs. POGD cases: 9.6429 ± 3.5351; p< 0.001), suggesting a protective role. Lower preoperative sodium levels were identified in the POGD group (136.26 mEq/L [IQR: 135.2-137.63]) compared to the non-POGD group (139.32 mEq/L [IQR: 137.7-140.75]; p< 0.001), highlighting its predictive value. Additionally, longer surgical duration was associated with increased POGD incidence, with POGD cases experiencing surgeries lasting 6.1547 ± 1.9426 hours compared to 4.5959 ± 1.5475 hours in non-POGD cases (p< 0.001). Our findings underscore the importance of serum bilirubin, sodium levels, and surgical duration as significant predictors of POGD in patients undergoing gynecological cancer surgery. These indicators should be integrated into a predictive model, aiding clinicians in identifying high-risk patients, allowing for personalized perioperative care adjustments, potentially mitigating POGD risks.

Examination about clinical efficacy and safety of active use of tolvaptan for decompensated congestive heart failure cases

Abstract Background In Japan, Tolvaptan is approved for use as a potent oral diuretic, mainly for severe congestive heart failure. However, over time since the launch of Tolvaptan, there have been many reports of its usefulness when used earlier in milder cases. Based on this background, in August 2015, our facility introduced a clinical pathway (PATH) for acute care for cases with decompensated congestive heart failure (DCHF), in which immediate use of tolvaptan with conventional diuretics ware stipulated to keep patient’s activity by early diuresis. Purpose In this study, we verified the clinical usefulness and safety of PATH for DCHF that prescribes the active use of tolvaptan. Methods From April 2014 to July 2022, 846 DCHF cases admitted to our hospital for the first time were included. They were divided into two groups, N-group(154 cases before introduction of PATH) and P-group(692 cases introduced PATH and prescribed Tolvaptan as stipulated). We investigated their implementation status of each medical treatment in acute phase and hospitalization period(HP), and compared the difference between the two groups. And in P-group, we investigated the occurrence of adverse event(AE), deterioration of renal function (R-event) and hypernatremia (N-event) that required unplanned discontinuation of tolvaptan use, and we investigated the clinical features about the cases with each adverse event. Results There was almost no difference in the patient background before admission or the patient's condition at admission. In P-group, the performance rate of each acute medical care for DCHF was lower and their performance period was shorter compared in N-group. The performance rate of cardiac rehabilitation was higher and its starting time was earlier in P-group. (Figure 1) As a result, HP was significantly shorter in P-group. AE incidence in P-group were 2.2%(R-event) and 4.8%(N-event). Mean age tended to be higher and cognitive function was lower in both AE cases. Cases with R-event were more likely to have pre-existing renal insufficiency. In N-event cases, their activity level before admission was lower and blood sodium level at admission was higher. Most of the N-event(85%) occurred within 7 days.(Figure 2) Conclusions With the introduction of unique clinical pathway that stipulates the active use of tolvaptan, the acute care of cases with decompensated congestive heart failure had been greatly simplified and streamlined, and the hospitalization period had been shortened. Although it is unlikely that all the results were due to the medicinal effects of Tolvaptan, it was thought that the realization of early mobilization due to its strong diuretic effect was linked to these results. A certain rate of feared adverse events, especially hypernatremia, was found to occur, but the rate appeared to be acceptable. However, in elderly and cognitively impaired cases, special caution seemed to be required for several days after the start of tolvaptan use.Figure 1Figure 2

Association of electrolyte imbalance, coagulopathy, procalcitonin and mortality in patients with SARS-CoV-2

Introduction and Aim: “SARS-CoV-2” (Severe Acute Respiratory Syndrome Coronavirus -2), a member of the coronavirus family, is the culprit behind COVID-19 (coronavirus disease 2019). We intended to examine the risk factors for infection in patients presenting with corona virus in the emergency department and to report electrolyte disturbance, coagulopathy, procalcitonin, and mortality in COVID-19 patients. The aim was to examine how electrolytes, coagulation parameters, and procalcitonin are associated with mortality in patients with COVID-19. Materials and Methods: Retrospective observational analysis, information on 106 individuals with SARS-CoV-2 infection was gathered, and survivors and non-survivors were further identified. Continuous parametric variables were statistically reported as Mean ±SD. Analysis was done on the relationship between biochemical markers and mortality. Results: Substantially low Sodium (P = 0.09), Potassium (P = 0.01), and Chloride (P = 0.000) levels were identified in ‘severe COVID-19 patients’ with survivors than in non-survivors, although the p-value for chloride was significantly connected with non-survivors. No statistically significant data were reported for Prothrombin Time (PT). In patients in the survival group, there was an elevated International Normalized Ratio (INR) with a 0.05 p-value and a significant correlation (p = 0.04). With a p-value of 0.01 in both survivors and non-survivors, activated partial thromboplastin time (APTT) was marginally elevated dimer values were discovered to be noticeably higher in both survivors and non-survivors, and they were substantially connected with a p-value of 0.05. With a p-value of 0.01 the surviving group was shown to have higher procalcitonin levels. Conclusion: This analysis demonstrates that the extremity of COVID-19 is linked to acid-base imbalance, coagulopathy, and death.

LDL electronegativity and male predominance in early ventricular tachyarrhythmias following ST-elevation myocardial infarction: evidence of sexual dimorphism associated reduction of sodium currents

Abstract Background Early ventricular tachycardia/fibrillation (VT/VF) in patients with ST-elevation myocardial infarction (STEMI) was associated with a higher morbidity and mortality rate. We sought to investigate the gender-specific risk and explore the underlying mechanisms of early VT/VF in STEMI patients. Methods We analyzed the clinical and laboratory data among 2965 consecutive STEMI patients between Jan 1, 2008 and Dec 31, 2021. Early VT/VF was defined as occurrence of spontaneous VT/VF of ≥30 seconds or requirement of immediate cardioversion/defibrillation due to hemodynamic compromise within the first 48 hours after onset of symptoms. To explore the mechanisms underlying early VT/VF, ex vivo ischemic-reperfusion experiments were conducted in 8-week-old ApoE-/- mice fed a high-fat diet for 8 weeks to promote atherogenesis. Results Of the 2965 STEMI patients studied, 256 (8.6%) experienced early VT/VF. Patients who developed early VT/VF were younger (58±13 vs. 61±13 years old, P=0.012) and had a higher proportion of males (87% vs. 83%, P=0.043). Notably, some patients with early VT/VF had significantly higher plasma levels of L5, the most electronegative subclass of low-density lipoprotein (LDL), compared to those without early VT/VF (n=19, L5: 10.14±3.09% vs. n=43, L5: 2.11±0.23%, P=0.006). In animal study, we have previously showed that male mice have higher plasma L5 concentrations than female mice. In this study, all male mice (n=4) developed VT/VF following the sham operation, whereas none of the female mice (n=3) did. Moreover, male mice had significantly slower heart conduction velocity than female mice in whole heart preparations (13.37±3.81 cm/s vs. 40.70±4.97 cm/s, P&amp;lt;0.001), despite having similar action potential duration (61.00±7.07 vs. 50.33±4.16 ms, P=0.999). In addition, isolated ventricular myocytes from male mice exhibited markedly lower sodium current density (-29.20±3.04 pA/pF, n=6) compared to those from female mice (-114.05±6.41 pA/pF, n=6, P&amp;lt;0.001). The reduced sodium current density was accompanied by lower membranous Nav1.5 protein expression (0.38±0.06 vs. 0.89±0.09 A.U., P&amp;lt;0.001) and higher cytosolic Nav1.5 levels (0.59±0.06 vs. 0.29±0.04 A.U., P&amp;lt;0.01) in male mice. Conclusions Our study demonstrates that male STEMI patients with early VT/VF have higher levels of L5, the most electronegative LDL subclass. This gender disparity in the susceptibility of early VT/VF may be caused by compromised sodium channel trafficking, likely linked to increased LDL electronegativity.

Abstract 17418: Daily Intake of Fruits and Vegetables Moderates the Effect of a Nutrition Intervention on Symptom Burden in Patients With Heart Failure

Introduction: Patients with heart failure (HF) often remain symptomatic after optimization of medical treatment. Complementary interventions may reduce symptom burden. We conducted a 6-month randomized controlled trial of a nutrition intervention (NIHFT) to reduce fluid overload, oxidative stress, and inflammation, which are major pathologic pathways underlying HF symptoms.Aims: 1) To examine the effects of NIHFT on HF symptom burden (i.e., shortness of breath, edema, and fatigue); and 2) to determine if intake of fruits and vegetables, primary sources of antioxidants and anti-inflammatories, moderated the effect of the NIHFT on HF symptom burden. Methods: Patients with HF (n=116) with complete baseline data were included (61% male, 63±12 years old, 64% NYHA III/IV). Intervention group received 1) individualized educational intervention for sodium reduction that included promoting fruit and vegetable intake, 2) daily low sodium tomato or vegetable juice, and 3) omega-3 supplementation (1050 mg EPA, 150 mg DHA/capsule/day) for 6 months. Symptom burden was measured by the Memorial Symptom Assessment Scale-HF at baseline and 3 and 6-month. Daily intake of fruits and vegetables at baseline was dichotomized (≤1 vs ≥2 servings/day). A linear mixed-effect model was used. Results: There was no direct effect of the NIHFT on symptom burden. However, baseline intake of fruits and vegetables moderated the effect of the intervention on overall symptom burden scores (beta estimate= -4.67, SE=1.89, P=0.015). Reduction in symptom burden was greater among patients with lower baseline fruit and vegetable intake compared to those with higher intake. Among the subscales (i.e., frequency, severity, and distress) of overall symptom burden, frequency (beta estimate= -1.63, SE=0.66, P=0.014) and severity (beta estimate= -1.81, SE=0.61, P=0.004) were significantly moderated by the intake of fruits and vegetables. Conclusions: The findings indicate that the nutrition intervention was more effective in reducing symptom burden for patients with lower baseline intake of fruits and vegetables. This suggests that increased fruit and vegetable intake may further reduce HF symptom burden in patients on optimal medication therapy.

Abstract 15707: Dietary Potassium and Sodium Intake and Cardiovascular Fitness in United States Community Dwelling Young Adults

Introduction: Low cardiovascular fitness strongly predicts cardiovascular disease and all-cause mortality in adults. Higher sodium (Na) and lower potassium (K) intakes have shown to be associated with adverse cardiovascular events. However, the association of K and Na intake with cardiovascular fitness is unknown in young adults. Methods: We included data on participants aged 20 to 49 years from three cycles (1999-2004) of the National Health and Nutrition Examination Survey. Estimated VO2max was measured using submaximal exercise test. 24-hour dietary interview format was used to estimate Na and K intake. The main exposure of interest was Na and K intake per 1000mg/day, and a nine-category variable for joint Na and K intake was generated by dividing Na and K intake into tertiles (low, moderate, high). The main outcome measure was eVO2max scaled to standard deviation (1-SD). The cross-sectional association between Na and K intake and eVO2max was assessed using survey design-based multivariable linear regression adjusted for clinically and biologically plausible confounders. Results: There were 3222 participants, with mean age 33.9 years; 48% were female and 70.6% identified as White. Only 27 (0.8%) participants met the dietary recommendation goal for Na (&lt;2g) and K (&gt;3.5g) intake per the World Health Organization. K intake per 1000mg was positively associated with a (1-SD) increase in eVO2max (β estimate = 0.04, P value = 0.01) in a fully adjusted model. Na intake per 1000mg was positively associated with (1-SD) increase in eVO2max (β estimate = 0.004, P value = 0.80) without reaching statistical significance in a fully adjusted model. The association of K intake and eVO2max was modified by Na intake ( P value = 0.01). The joint category with moderate Na intake and high K intake was positively associated with eVO2max (β estimate = 0.21, P value = 0.009) compared to the joint category with low Na and K intake in a fully adjusted model. Conclusion: These findings suggest that higher potassium intake is associated with higher cardiovascular fitness independent of blood pressure, especially in conjunction with lower sodium intake. Higher potassium intake may have a role in improving cardiovascular fitness in young adults and could prevent future cardiovascular events.

Differential diagnosis for multiple systemic inflammatory syndrome in children: clinical and laboratory clues

Objectives: We aimed to identify biochemical markers and clinical findings with high sensitivity and specificity that can be used in the differential diagnosis of patients suspected of having Multisystem Inflammatory Syndrome in Children (MISC) in the pediatric emergency department (PED). Moreover, we also examined early warning signs for predicting severe MIS-C patients requiring admission to intensive care unit (ICU). Methods: We conducted a retrospective analysis of patients presenting to the PED with suspected MIS-C. Patient records were assessed for initial complaints, physical examination findings, laboratory and ımaging test results, diagnoses, and follow-up plans. Patients diagnosed with MIS-C were categorized as the MIS-C group, while others were categorized as the non-MIS-C group. Comparisons were made between these two groups. Results: A total of 266 patients were included, with 68 diagnosed with COVID-19-associated MIS-C, including 20 monitored in the pediatric ICU. MIS-C patients had higher mean age, hospitalization, and ICU admission rates compared to non-MIS-C. MIS-C group showed higher prevalence of respiratory symptoms, hematological involvement, and shock. We observed lymphopenia, thrombocytopenia, hyponatremia, and elevated levels of blood C-reactive protein (CRP), procalcitonin, triglycerides, troponin, Brain Natriuretic Peptide (BNP), D-dimer, and fibrinogen in the MIS-C group. ICU patients had higher procalcitonin, aspartate aminotransferase, alanine aminotransferase, triglycerides, troponin, BNP, and ferritin levels, and lower sodium levels. Conclusions: COVID-19-associated MIS-C group had higher rates of respiratory symptoms, hematological involvement, and shock. Lymphopenia, thrombocytopenia, elevated CRP, and D-dimer can guide MIS-C differential diagnosis. Additional tests (procalcitonin, troponin, BNP, triglycerides, ferritin) are recommended for high-suspicion cases. Patients with elevated BNP levels may require ICU admission.

A low dietary sodium dose is associated with a more pronounced aldosterone response in normotensive than in hypertensive individuals

In this comprehensive meta-regression analysis encompassing 79 randomized controlled trials, we observed that in populations assigned to a high sodium intake level exceeding 94 mmol, there was no discernible link between plasma aldosterone levels and sodium intake. However, among populations with normal blood pressure subjected to a lower sodium intake, falling below 111 mmol (N = 1544), the association between sodium intake and plasma aldosterone levels manifested as a decrease of 192 pg/ml per 100 mmol of sodium (95% CI − 303 to − 81). In hypertensive populations (N = 1145), this association was less pronounced, with a reduction of 46 pg/ml per 100 mmol sodium, (95% CI − 112 to 20). Furthermore, in normotensive populations the plasma aldosterone increase associated with a decrease in sodium intake was 70 pg/ml per 100 mmol sodium (95% CI 27 to 113). In hypertensive populations, the observed increase was more modest, at 30 pg/ml per 100 mmol sodium, (95% CI 6.8 to 54). A limitation of this study lies in the absence of individual participant data. Our analysis included adjustments for potential effect-modifiers, encompassing bias estimation, which did not substantially alter these associations. One perspective of the present results may be to prompt a reconsideration of current sodium reduction recommendations.

What is the aetiology of dysnatraemia in COVID-19 and how is this related to outcomes in patients admitted during earlier and later COVID-19 waves? A multicentre, retrospective observational study in 11 Dutch hospitals

ObjectivesTo evaluate the relationship among dysnatraemia at hospital presentation and duration of admission, risk of intensive care unit (ICU) admission and all-cause mortality and to assess the underlying pathophysiological mechanism...

Incidence, aetiology and outcome of infants presenting with low sodium and high potassium - population surveillance study in Wales

Incidence, aetiology and outcome of infants presenting with low sodium and high potassium - population surveillance study in Wales

Enhanced viability of probiotics in composite hydrogel beads

Composite hydrogel is common way to protect probiotics from harsh environment. The study designed and optimized double-saccharide composite hydrogel beads for the encapsulation of Companilactobacillus crustorum MN047 (C. crustorum MN047) by adjusting the combination ratios of low methoxyl pectin (LMP) and sodium alginate (SAG) and the concentrations of calcium chloride (CaCl2). Encapsulation efficiency of hydrogel beads ranged from 87.69% to 99.98%. Hydrogel beads significantly increased the viability of C. crustorum MN047 in the simulated gastrointestinal (the number of viable probiotics was more than 7 log CFU/g at simulated SIF for 4 h) and storage environments (the number of viable probiotics was more than 7 log CFU/g at 25 °C at day30). Rheological tests proved pectin-based hydrogel possessed stronger crosslinking degree than alginate-based hydrogel. FT-IR and SEM indicated C. crustorum MN047 was encapsulated successfully, and polyelectrolyte polymers along with Ca-crosslinking play an important role in the formation mechanism. These results are attributed to the design of probiotic encapsulation systems and the promotion of the exploitation of probiotic functional products.

Dietary Sodium Alginate Effect on Growth, Digestion, Body Composition, Antioxidant Capacity, and Mucous Immune Response in Yellowfin Sea Bream, Acanthopagrus latus

Abstract In the present study, the effects of dietary supplementation of low molecular weight sodium alginate on growth, body composition, anti-oxidant enzymes, digestive enzymes, and immune response in yellowfin sea bream juvenile (Acanthopagrus latus) were investigated. Fish (n=180) were divided into 3 groups with 3 replicates and received dietary treatments including basal diet without sodium alginate (control treatment), basal diet containing 5 g sodium alginate per kg diet (0.5% treatment), and 10 g sodium alginate per kg diet (1% treatment) for 8 weeks. The results showed that the final weight, weight gain, specific growth rate, condition factor, feed conversion, and protein efficiency ratios did not reveal a significant improvement compared to the control treatment (P&gt;0.05). The obtained results indicated that dietary sodium alginate did not affect body composition (P&gt;0.05). The activity of antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) in the groups fed on 0.5 and 1% sodium alginate showed a significant increase (P&lt;0.05) compared to the control group. But, the activity of lipid peroxidation (MDA) in the groups fed on 0.5 and 1% sodium alginate showed a significant decrease (P&lt;0.05) compared to the control group. The digestive enzymes increased significantly (P&lt;0.05) by supplementation of sodium alginate, compared to the control group. Mucus lysozyme and complement activity were not significantly different (P&gt;0.05). Overall, it can be concluded that feeding of yellowfin sea bream on the diet supplemented with 0.5 and 1 percent sodium alginate for a period of 8 weeks does not enhance the non-specific immune response and growth. Nonetheless, sodium alginate improved the activity of the antioxidant and digestive enzymes, indicating the positive effects of sodium alginate on enzymatic responses.

Kawasaki Disease Associated Acute Abdomen: Most Require No Surgery.

To summarize the clinical features and treatment experiences of patients with Kawasaki disease (KD)-associated acute abdomen (KD-AA). We conducted a retrospective case-control study of patients with KD-AA treated at our hospital between January 2006 and November 2022. Of the 917 children with KD, 43 (4.7%) presented with AA. Of these, 33 with complete information were included in the KD-AA group. Patients with KD-AA were significantly older, with higher neutrophil rate, C-reactive protein, procalcitonin, and alanine transaminase levels and lower hemoglobin, albumin, and serum sodium levels. Additionally, more patients with KD-AA presented with aseptic meningitis and KD shock syndrome than those with KD alone (all p<0.05). The two groups did not differ in the incidence of intravenous immunoglobulin (IVIG) resistance, incomplete KD, or coronary artery abnormalities. All patients received aspirin and IVIG therapy, with nine receiving a second dose of IVIG and 11 receiving corticosteroids. Only two patients with KD-AA underwent surgery, and the prognosis of all patients with KD-AA was good. KD-AA should be suspected in febrile children with abdominal symptoms. Prompt diagnosis of KD-AA is important for early effective treatment to avoid unnecessary surgical harm. KD, complicated by acute abdomen, has a good prognosis.