Increase In Sodium Concentration Research Articles

STUDY OF IRRITANT AND SKIN-RESORPTIVE ACTION OF SODIUM-CONTAINING DRUG

Sodium-containing preparations have antimicrobial, anti-inflammatory and wound-healing activity, which determines their use in veterinary medicine. This effect is due to a wide range of physiological effects of sodium ions on animals metabolism. The article presents the results of experimental studies of the irritant effect of sodium-containing drugs: known – 2 % glycetinate, its analogues – 2 % ovocid, 3 % ovocid, 1.5 % potassium-sodium drug (Na / K, 1.5%). Studies of irritant and skin-resorptive action of drugs were performed by immersing the tail of animals in a test tube with the substance on white rats weighing 250–270 g. Four groups of rats were formed with 3 animals each: rats of I group (control) tails were immersed in test tubes with 2 % glycetinate, animals of II group – in test tubes with 2% oocide, III group – in test tubes with 3 % oocide, and in IV group rats – with Na / K, 1.5% drug. The exposure time was 4 hours. The animals were subjected to clinical observations, assessing their general condition and the reaction of the tail’s skin. The effect of drugs on the morphological and biochemical parameters of the rats blood was studied. The study of the local irritant effect of the studied drugs in rats from I, II and III groups showed a moderate local irritant reaction, as evidenced by the appearance of redness and thickening of the skin, and in group IV animals appeared only slight redness on the skin of the tails. This indicates a weaker local irritant effect of potassium-sodium-containing drug (1.5% K, Na), compared with other studied drugs.
 According to hematological studies, in the rats’s blood of groups III and IV, a reliable increase, within normal limits, the number of leukocytes and a decrease in hemoglobin content, compared with those of animals of group I. It was found that at 4 hours of the experiment under the action of the studied potassium-sodium drugs increases the permeability of Sodium and Potassium through the rats’s skin into the blood. In particular, in serum of animals from groups II and IV there was a reliable increase of Potassium content by 2.1 times, respectively, and a significant increase in Sodium content in the blood of animals from groups III and IV, compared with control group. In animals of groups II and IV there was a reliable increase of serum aspartate aminotransferase activity, and in rats of group III – increase of serum alanine aminotransferase, alkaline phosphatase activity and in triacylglycerol’s content, compared with rats of group I, which indicates the effect of 2 % glycecin analogues on metabolic processes in animals.

Viscoelasticity and Volume of Cortical Neurons under Glutamate Excitotoxicity and Osmotic Challenges

Neural activity depends on the maintenance of ionic and osmotic homeostasis. Under these conditions, the cell volume must be regulated to maintain optimal neural function. A disturbance in the neuronal volume regulation often occurs in pathological conditions such as glutamate excitotoxicity. The cell volume, mechanical properties, and actin cytoskeleton structure are tightly connected to achieve the cell homeostasis. Here, we studied the effects of glutamate-induced excitotoxicity, external osmotic pressure, and inhibition of actin polymerization on the viscoelastic properties and volume of neurons. Atomic force microscopy was used to map the viscoelastic properties of neurons in time-series experiments to observe the dynamical changes and a possible recovery. The data obtained on cultured rat cortical neurons were compared with the data obtained on rat fibroblasts. The neurons were found to be more responsive to the osmotic challenges but less sensitive to the inhibition of actin polymerization than fibroblasts. The alterations of the viscoelastic properties caused by glutamate excitotoxicity were similar to those induced by the hypoosmotic stress, but, in contrast to the latter, they did not recover after the glutamate removal. These data were consistent with the dynamic volume changes estimated using ratiometric fluorescent dyes. The recovery after the glutamate-induced excitotoxicity was slow or absent because of a steady increase in intracellular calcium and sodium concentrations. The viscoelastic parameters and their changes were related to such parameters as the actin cortex stiffness, tension, and cytoplasmic viscosity.

ICP-Mass-Spectrometry Ionic Profile of Whole Saliva in Patients with Untreated and Treated Periodontitis.

Over the past decade, there has been growing interest in the association between macro and trace minerals in body fluids and systemic diseases related to chronic inflammation and oxidative stress. Due to the paucity of data in the literature on periodontitis, the aim of this cross-sectional study was to assess the relationship between mineral elements in saliva and periodontal status in patients with untreated and treated periodontitis compared to periodontally healthy controls. Salivary samples from 66 nonsmoker healthy patients (20 periodontally healthy, 24 untreated severe periodontitis and 22 treated severe periodontitis) were analyzed by using inductively coupled plasma mass-spectrometry (ICP-MS). Significant increases in copper (Cu), sodium (Na), iron (Fe) and manganese (Mn) concentrations occurred in saliva of severe periodontitis subjects compared to periodontally healthy controls. No differences were detected between healthy controls and treated periodontitis patients apart from levels of zinc (Zn) and lithium (Li) that were found to be increased and reduced, respectively, in periodontitis group. Most subjects were correctly separated by cluster analysis into active periodontitis and periodontally healthy individuals. Treated periodontitis individuals were classified as healthy subjects. Based on these preliminary results, the assessment of salivary concentration of mineral elements might be useful in discriminating periodontal health and disease.

Review of Implications of Road Salt Use on Groundwater Quality—Corrosivity and Mobilization of Heavy Metals and Radionuclides

The negative impacts of road salt (primarily NaCl) on freshwater ecosystems and ground and surface waters used for drinking purposes have been extensively documented. Besides direct increases in chloride (Cl−) and sodium (Na+) concentrations in receiving waters, these ions are responsible for a myriad of soil chemical changes and processes resulting in increased corrosivity of water and subsequent leaching of lead (Pb) and copper (Cu); mobilization of heavy metals in soils to ground and surface water including cadmium (Cd), chromium (Cr), Cu, Pb, nickel (Ni), manganese (Mn), and zinc (Zn); and radionuclide mobilization presenting increased risks to drinking water quality. This article summarizes literature describing the mechanisms and the implications of road salt on water corrosivity and mobilization of both metals and radionuclides on groundwater resources and public health.

Structural and functional responses of Carex aquatilis to increasing sodium concentrations

Carex aquatilis is a widespread boreal species that is abundant in open fens and marshes. The species has broad natural tolerances to differing water levels and ion concentrations including occurrences in brackish marshes but not sodic wetlands. Sandhill Wetland, constructed on Syncrude Canada Ltd. mineral surface lease in the Athabasca Oil Sands Region, is a research site that was engineered to support a self-sustaining wetland. The site is currently in its eighth year post wet-up and is partially dominated by C. aquatilis. Increasing Na+ concentrations in the porewaters at Sandhill Wetland are an on-going concern for the performance of the existing plant communities. Here we examine the responses of C. aquatilis to an increasing regime of sodium carried out in a greenhouse experiment. We posed three questions for this experiment: (1) is there a threshold response for performance of C. aquatilis to increasing sodium, (2) if so, does it occur in the range of sodium that is present at current reclamation programs, and (3) is C. aquatilis resistant to high concentrations of sodium? Carex aquatilis survived all treatment concentrations of sodium including the highest treatment of 2354 mg L− 1. In general, both structural and functional attributes of C. aquatilis did not differ between the 17 and 1079 mg L− 1 treatments; however, performances of all attributes were reduced in the 2354 mg L− 1 treatment. Belowground biomass had greater decreases compared to aboveground components, including both biomass and photosynthesis. The aboveground decreases in performance were associated with exclusion of sodium from the aboveground components by the belowground components. Reduction in photosynthesis was strongly correlated with reduced stomatal conductance and lower transpiration. Although C. aquatilis demonstrated a wide tolerance to sodium concentrations, a clear threshold was present between 1079 and 2354 mg L− 1. These decreases in performance in our greenhouse trials were at levels currently present at Sandhill Wetland, and careful assessment of sodium concentrations in the near future needs to be continued.

Functional modulation of atrio-ventricular conduction by enhanced late sodium current and calcium-dependent mechanisms in Scn5a1798insD/+ mice.

Aims SCN5A mutations are associated with arrhythmia syndromes, including Brugada syndrome, long QT syndrome type 3 (LQT3), and cardiac conduction disease. Long QT syndrome type 3 patients display atrio-ventricular (AV) conduction slowing which may contribute to arrhythmogenesis. We here investigated the as yet unknown underlying mechanisms.Methods and resultsWe assessed electrophysiological and molecular alterations underlying AV-conduction abnormalities in mice carrying the Scn5a1798insD/+ mutation. Langendorff-perfused Scn5a1798insD/+ hearts showed prolonged AV-conduction compared to wild type (WT) without changes in atrial and His-ventricular (HV) conduction. The late sodium current (INa,L) inhibitor ranolazine (RAN) normalized AV-conduction in Scn5a1798insD/+ mice, likely by preventing the mutation-induced increase in intracellular sodium ([Na+]i) and calcium ([Ca2+]i) concentrations. Indeed, further enhancement of [Na+]i and [Ca2+]i by the Na+/K+-ATPase inhibitor ouabain caused excessive increase in AV-conduction time in Scn5a1798insD/+ hearts. Scn5a1798insD/+ mice from the 129P2 strain displayed more severe AV-conduction abnormalities than FVB/N-Scn5a1798insD/+ mice, in line with their larger mutation-induced INa,L. Transverse aortic constriction (TAC) caused excessive prolongation of AV-conduction in FVB/N-Scn5a1798insD/+ mice (while HV-intervals remained unchanged), which was prevented by chronic RAN treatment. Scn5a1798insD/+-TAC hearts showed decreased mRNA levels of conduction genes in the AV-nodal region, but no structural changes in the AV-node or His bundle. In Scn5a1798insD/+-TAC mice deficient for the transcription factor Nfatc2 (effector of the calcium-calcineurin pathway), AV-conduction and conduction gene expression were restored to WT levels.ConclusionsOur findings indicate a detrimental role for enhanced INa,L and consequent calcium dysregulation on AV-conduction in Scn5a1798insD/+ mice, providing evidence for a functional mechanism underlying AV-conduction disturbances secondary to gain-of-function SCN5A mutations.

Structure, Reactivity, and Mechanical Properties of Sustainable Geopolymer Material: A Reactive Molecular Dynamics Study

Sodium aluminosilicate hydrate (NASH) gel, the primary binding phase in geopolymer, determines the mechanical properties and durability of environment-friendly construction materials. In this work, the models of NASH gel were obtained by two-step procedure: the temperature quenching method and Grand Canonical Monte Carlo water adsorption. The reactive force field molecular dynamics was utilized to investigate the structure, reactivity and mechanical performance of the NASH gel with Na/Al ratio ranging from 1 to 3. Q species, the connectivity factor, shows that the increase of sodium content in NASH gel leads to depolymerization of aluminosilicate network and more non-bridging oxygen atoms. The adsorbed water molecules dissociate near the non-bridging oxygen with high reactivity in defective aluminosilicate structure. The newly produced hydroxyls associate with the aluminate species, contributing to formation of pentahedron local structure. The sodium ions distributed in the cavity of the aluminosilicate skeleton have around 4 ~ 7 nearest neighbors. Furthermore, with increasing the amount of sodium, the molecular structure of the aluminosilicate skeleton is transformed from an integrity network to partial destroyed branch structures, which gradually decreases the stiffness and cohesive force of NASH gel characterized by the uniaxial tensile testing. During the large tensile deformation process, the reactive force field MD correlates the mechanical response with the chemical reaction pathway. The aluminosilicate skeleton is stretched broken to resist the tensile loading and the hydrolytic reaction of water molecules near the stretched Si-O and Al-O bond further accelerates the degradation of NASH gel. Hopefully, this work can shed light on material design for the high performance of sustainable geopolymer at nanoscale.

Severe Hyponatremia and Continuous Renal Replacement Therapy: Safety and Effectiveness of Low-Sodium Dialysate

Rationale & ObjectiveIn patients with severe hyponatremia in the setting of acute kidney injury or end-stage kidney disease, continuous renal replacement therapy (CRRT) using standard-sodium (140 mEq/L) fluids may lead to excessively rapid correction of plasma sodium concentration. Use of dialysate and replacement fluids with reduced sodium concentrations can provide a controlled rate of correction of plasma sodium concentration.Study DesignWe performed a single-center retrospective analysis of the safety and effectiveness of this approach in patients with plasma sodium concentrations ≤ 126 mEq/L who underwent CRRT for 24 or more hours using low-sodium (119 or 126 mEq/L) dialysate and replacement fluids. Change in plasma sodium level was assessed at 24 and 48 hours after initiation of low-sodium CRRT and at the end of treatment.Setting & ParticipantsBetween January 2016 and June 2018, a total of 23 hyponatremic patients underwent continuous venovenous hemodiafiltration using low-sodium dialysate and replacement fluids; 4 patients were excluded from analysis because of CRRT duration less than <24 hours.ResultsThe 19 patients included in the study had a mean age of 56 years, 11 (58%) were men, and 15 (79%) were white. The initial mean plasma sodium level was 121 mEq/L and the initial CRRT effluent dose was 27 mL/kg/h. Only 2 (11%) patients had an increase in plasma sodium concentration > 6 mEq/L at 24 hours. Mean changes in plasma sodium levels at 24 and 48 hours and at the time of CRRT discontinuation were 3, 3, and 6 mEq/L, respectively. None of the patients developed osmotic demyelination syndrome.LimitationsKey limitations were small sample size and lack of a control group.ConclusionsUse of low-sodium dialysate and replacement fluids is a safe strategy for the prevention of overly rapid correction of plasma sodium levels in hyponatremic patients undergoing CRRT.

Sodium in the Relapsing–Remitting Multiple Sclerosis Spinal Cord: Increased Concentrations and Associations With Microstructural Tissue Anisotropy

Associations between brain total sodium concentration, disability, and disease progression have recently been reported in multiple sclerosis. However, such measures in spinal cord have not been reported. To measure total sodium concentration (TSC) alterations in the cervical spinal cord of people with relapsing-remitting multiple sclerosis (RRMS) and a control cohort using sodium MR spectroscopy (MRS). Retrospective cohort. Nineteen people with RRMS and 21 healthy controls. 3 T sodium MRS, diffusion tensor imaging, and 3D gradient echo. Quantification of total sodium concentration in the cervical cord using a reference phantom. Measures of spinal cord cross-sectional area, fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity from 1 H MRI. Clinical assessments of 9-Hole Peg Test, 25-Foot Timed walk test, Paced Auditory Serial Addition Test with 3-second intervals, grip strength, vibration sensitivity, and posturography were performed on the RRMS cohort as well as reporting lesions in the C2/3 area. Multiple linear regression models were run between sodium and clinical scores, cross-sectional area, and diffusion metrics to establish any correlations. A significant increase in spinal cord total sodium concentration was found in people with RRMS relative to healthy controls (57.6 ± 18 mmol and 38.0 ± 8.6 mmol, respectively, P < 0.001). Increased TSC correlated with reduced fractional anisotropy (P = 0.034) and clinically with decreased mediolateral stability assessed with posturography (P = 0.045). Total sodium concentration in the cervical spinal cord is elevated in RRMS. This alteration is associated with reduced fractional anisotropy, which may be due to changes in tissue microstructure and, hence, in the integrity of spinal cord tissue. 1 TECHNICAL EFFICACY STAGE: 2.

A wearable sensor for the detection of sodium and potassium in human sweat during exercise

The SwEatch platform, a wearable sensor for sampling and measuring the concentration of electrolytes in human sweat in real time, has been improved in order to allow the sensing of two analytes. The solid contact ion-sensitive electrodes (ISEs) for the detection of Na+ and K+ have been developed in two alternative formulations, containing either poly(3,4-ethylenedioxythiophene) (PEDOT) or poly(3-octylthiophene-2,5-diyl) (POT) as a conductive polymer transducing component. The solution-processable POT formulation simplifies the fabrication process, and sensor to sensor reproducibility has been improved via partial automation using an Opentron® automated pipetting robot. The resulting electrodes showed good sensitivity (52.4 ± 6.3 mV/decade (PEDOT) and 56.4 ± 2.2 mV/decade (POT) for Na+ ISEs, and 45.7 ± 7.4 mV/decade (PEDOT) and 54.3 ± 1.5 mV/decade (POT) for K+) and excellent selectivity towards potential interferents present in human sweat (H+, Na+, K+, Mg2+, Ca2+). The 3D printed SwEatch platform has been redesigned to incorporate a double, mirrored fluidic unit which is capable of drawing sweat from the skin through passive capillary action and bring it in contact with two independent electrodes. The potentiometric signal generated by the electrodes is measured by an integrated electronics board, digitised and transmitted via Bluetooth to a laptop. The results obtained from on-body trials on athletes during cycling show a relatively small increase in sodium (1.89 mM–2.97 mM) and potassium (3.31 mM–7.25 mM) concentrations during the exercise period of up to 90 min.

Effect of Na promoter on the catalytic performance of Pd-Cu/hydroxyapatite catalyst for room-temperature CO oxidation

The effect of Na promoter on the catalytic performance of Pd-Cu/hydroxyapatite (Pd-Cu/HAP) for room-temperature CO oxidation has been investigated. The HAP supports were prepared via the precipitation method. The Na promoter was used to modify the HAP support, and the corresponding Pd-Cu/HAP catalysts were synthesized by an impregnation approach. Compared with non-Na promoted Pd-Cu/HAP catalyst, the catalytic activities of Na promoted Pd-Cu/HAP catalysts were enhanced gradually with the increase of sodium content. The excellent catalytic performance of Na promoted Pd-Cu/HAP catalyst could be attributed to the presence of more active Cu(OH)Cl species and less weak basic sites, especially, higher active surface Pd+ species and more surface Cu+ species.

Magnetic resonance electrical property mapping at 21.1 T: a study of conductivity and permittivity in phantoms, ex vivo tissue and in vivo ischemia

Electrical properties (EP), namely conductivity and permittivity, can provide endogenous contrast for tissue characterization. Using electrical property tomography (EPT), maps of EP can be generated from conventional MRI data. This report investigates the feasibility and accuracy of EPT at 21.1 T for multiple RF coils and modes of operation using phantoms. Additionally, it demonstrates the EP of the in vivo rat brain with and without ischemia.Helmholtz-based EPT was implemented in its Full-form, which demands the complex field, and a simplified form requiring either just the field phase for conductivity or the field magnitude for permittivity. Experiments were conducted at 21.1 T using birdcage and saddle coils operated in linear or quadrature transceive mode, respectively. EPT approaches were evaluated using a phantom, ex and in vivo Sprague-Dawley rats under naïve conditions and ischemic stroke via transient middle cerebral artery occlusion.Different conductivity reconstruction approaches applied to the phantom displayed average errors of 12%–73% to the target acquired from dielectric probe measurements. Permittivity reconstructions showed higher agreement and an average 3%–8% error to the target depending on reconstruction approach. Conductivity and permittivity of ex and in vivo rodent brain were measured. Elevated EP in the ischemia region correlated with the increased sodium content and the influx of water intracellularly following ischemia in the lesion were detected.The Full-form technique generated from the linear birdcage provided the best accuracy for EP of the phantom. Phase-based conductivity and magnitude-based permittivity mapping provided reasonable estimates but also demonstrated the limitations of Helmholtz-based EPT at 21.1 T. Permittivity reconstruction was improved significantly over lower fields, suggesting a novel metric for in vivo brain studies. EPT applied to ischemic rat brain proved sensitivity to physiological changes, motivating the future application of more advanced reconstruction approaches.

Growth-promoting bacteria and natural regulators mitigate salt toxicity and improve rapeseed plant performance.

Salinity is a major environmental stress that limits plant production and portraits a critical challenge to food security in the world. In this research, the impacts of plant growth-promoting bacteria (Pseudomonas RS-198 and Azospirillum brasilense RS-SP7) and foliar application of plant hormones (salicylic acid 1mM and jasmonic acid 0.5mM) on alleviating the harmful effects of salt stress in rapeseed plants (Brassica napus cv. okapi) were examined under greenhouse condition. Salt stress diminished rapeseed biomass, leaf area, water content, nitrogen, phosphorus, potassium, calcium, magnesium, and chlorophyll content, while it increased sodium content, endogenous salicylic and jasmonic acids, osmolyte production, H2O2 and O2•- generations, TBARS content, and antioxidant enzyme activities. Plant growth, nutrient content, leaf expansion, osmolyte production, and antioxidant enzyme activities were increased, but oxidative and osmotic stress indicators were decreased by bacteria inoculation + salicylic acid under salt stress. Antioxidant enzyme activities were amplified by jasmonic acid treatments under salt stress, although rapeseed growth was not generally affected by jasmonic acid. Bacterial + hormonal treatments were superior to individual treatments in reducing detrimental effects of salt stress. The best treatment in rectifying rapeseed growth under salt stress was combination of Pseudomonas and salicylic acid. This combination attenuated destructive salinity properties and subsequently amended rapeseed growth via enhancing endogenous salicylic acid content and some essential nutrients such as potassium, phosphorus, and magnesium.

Where air quality has been impacted by weather changes in the United States over the last 30 years?

Previous studies have contributed to the understanding on the impacts of weather on air pollution. Most of these investigations focused primarily on future climate scenarios, laboratory experiments, or weather trends-related air pollution at regional scale. In particular, an important limitation of the trends studies is that the estimated weather impact on air pollution may be underestimated or overestimated given that the regional scale does not capture the site-to-site variation of air pollution and weather. The primary objective of this research is to addresses this gap by quantifying weather-associated changes in air pollution at site location (air pollution sites) in the U.S between 1988 and 2018. We quantified the past weather-related increases CO, NO2, O3, nitrate, organic carbon, silicon, sodium, sulfate, and SO2 concentration using Generalized Additive Models (GAMs). We used a framework that derives “penalties” (weather penalty, in μg/m3, ppm or ppb per year) for each season (warm and cold). Three pollutants presented significant results (weather penalties), including CO, NO2, and O3. Our findings show significant spatio-temporal variation of climate impact on CO, NO2, and O3. For example, in the warm season we estimated a total penalty over the study period for the sites with the highest penalty on CO (site in Boise, Idaho), NO2 (site in New York City), and O3 (site in Tucson, Arizona) of 6.18 (95%CI: 0.30; 12.0) ppm, 182.04 (95%CI: 39.33; 324.72) ppb, and 0.09 (95%CI: 0.030; 0.150) ppm, respectively. In the cold season, the estimated total penalty for the sites with the highest penalty on CO (site in Los Angeles, California), NO2 (site in Washington, Pennsylvania), and O3 (site in Decatur, Illinois) was 12.01 (95%CI: 1.50; 22.50) ppm, 285.03 (95%CI: 14.37; 555.69) ppb, and −0.066 (95%CI: -0.120; −0.030) ppm, respectively. Our results should be of interest to policy makers to create future strategies related to environmental health and climate change. Climate models typically show large variation in projections of the key variables influencing pollution, and our model based on local scale allowed us to identify statistically robust results.

Quantifying Large Lattice Relaxations in Photovoltaic Devices

Temporal variations of Cu(In,Ga)Se$_2$ photovoltaic device properties during light exposure at various temperatures and voltage biases for times up to 100 h were analyzed using the kinetic theory of large lattice relaxations. Open-circuit voltage and p-type doping increased with charge injection and decreased with temperature at low injection conditions. Lattice relaxation can account for both trends and activation energies extracted from the data were approximately 0.9 and 1.2 eV for devices with lower and higher sodium content, respectively. In these devices, increased sodium content resulted in higher initial p-type doping with greater stability. First principles calculations providing revised activation energies for the ($V_{Se}-V_{Cu}$) complex suggest that this defect does not account for the metastability observed here.

Effect of Leaf Extract of Senna alata on Biochemical Indices of Wistar Rats Infected with Trypanosoma brucei brucei

This study was aimed at determining the effect of leaves of Senna alata extract on biochemical indices of Wistar rats infected with Trypanosoma brucei brucei. Phytochemical screening revealed the absence of steroids in all extracts, absence of saponins in chloroform extracts and the presence of free anthraquinones only in chloroform extract. Post-infection treatment of animals stirred the emergence of parasitaemia by Day 3. Only animals receiving 200 mg/kg b.wt. of chloroform extract survived by day 16. A significant (P&lt;0.05) decrease in ALT for groups receiving methanol (400 mg/kg b.wt.), chloroform and aqueous extracts and significant (P&lt;0.05) increase in unconjugated bilirubin in the group receiving methanol extract (200 mg/kg b.wt.) compared to infected not treated rats. Significant (P&lt;0.05) decrease in potassium concentration in groups receiving methanol and chloroform, and a significant (P&lt;0.05) increase in sodium concentration in the group receiving 400 mg/kg b.wt. of aqueous extract compared to the infected not treated rats. These results thereby demonstrate the ameliorative potential of Senna alata leaves against T. brucei brucei.

A Randomized Trial of Empagliflozin to Increase Plasma Sodium Levels in Patients with the Syndrome of Inappropriate Antidiuresis.

Treatment options to address the hyponatremia induced by the syndrome of inappropriate antidiuresis (SIAD) are inadequate. The sodium glucose cotransporter 2 (SGLT2) inhibitor empagliflozin promotes osmotic diuresis via urinary glucose excretion and therefore, might offer a novel treatment option for SIAD. In this double-blind, randomized trial, we recruited 88 hospitalized patients with SIAD-induced hyponatremia <130 mmol/L at the University Hospital Basel from September 2016 until January 2019 and assigned patients to receive, in addition to standard fluid restriction of <1000 ml/24 h, a once-daily dose of oral empagliflozin or placebo for 4 days. The primary end point was the absolute change in plasma sodium concentration after 4 days of treatment. Secondary end points included predisposing factors for treatment response and safety of the intervention. Of the 87 patients who completed the trial, 43 (49%) received treatment with empagliflozin, and 44 (51%) received placebo. Baseline plasma sodium concentrations were similar for the two groups (median 125.5 mmol/L for the empaflozin group and median 126 mmol/L for the placebo group). Patients treated with empagliflozin had a significantly higher increase of median plasma sodium concentration compared with those receiving placebo (10 versus 7 mmol/L, respectively; P=0.04). Profound hyponatremia (<125 mmol/L) and lower baseline osmolality levels increased the likelihood of response to treatment with empagliflozin. Treatment was well tolerated, and no events of hypoglycemia or hypotension occurred among those receiving empagliflozin. Among hospitalized patients with SIAD treated with fluid restriction, those who received empagliflozin had a larger increase in plasma sodium levels compared with those who received placebo. This finding indicates that empagliflozin warrants further study as a treatment for the disorder.

Metabolic dynamics of native lambs fed with Tifton 85 hay or Maniçoba hay associated with the spineless cactus

ABSTRACT The objective of this study was to evaluate the metabolic response of native lambs fed Tifton 85 hay (Cynodon dactylon) or Maniçoba hay (Manihot pseudoglaziovii) associated with spineless cactus (Nopalea cochenillifera Salm Dyck). Sixteen Morada Nova lambs were used, with a mean initial weight of 19.36±1.48kg, distributed in a randomized block design, with two treatments and eight replications. Dry matter intake was higher for lambs fed Maniçoba hay compared to Tifton hay, while the body weight at slaughter was not influenced by diets. Regarding the blood metabolites, only the serum concentration of urea was influenced, with higher value observed in the lambs that fed the diet containing Tifton hay. When analyzing blood biomarkers, in the different biweekly collections, a linear increase in the blood concentration of urea, glucose, fructosamine, alkaline phosphatase and sodium was observed, as well as a quadratic effect for serum potassium. The other blood metabolites were not influenced in function of the collection days. The replacement of Tifton 85 hay for Maniçoba hay does not cause negative changes in the dynamics of different biomarkers and presents itself as a promising forage resource.

Food Products That May Cause an Increase in Blood Pressure.

To review latest reports of the food products which might increase blood pressure and therefore might participate in the pathogenesis of hypertension. Results of clinical study suggest that consumption of high-sodium food leads to transient increase in plasma sodium concentration. This is accompanied by blood pressure increase. Results of both clinical and experimental studies suggest direct vasculotoxic effects of sodium. Increased plasma sodium concentration could mediate its effects on blood pressure by changes in endothelial cell stiffness and glycocalyx integrity. Energy drinks are non-alcoholic beverages with increasing popularity. Clinical, interventional, randomized, placebo controlled, and cross-sectional studies showed that energy drinks may increase arterial blood pressure. Blood pressure increase after exposure for the energy drinks is mainly related to the caffeine content in these drinks. Many case reports were published concerning the clinically significant increase in blood pressure caused by the consumption of liquorice root or food products containing liquorice, such as candies, tea, Pontefract cookies, and chewing gum. Liquorice contains a precursor of glycyrrhetic acid. Glycyrrhetic acid reduces the activity of the 11β-hydroxysteroid dehydrogenase type 2 (11ß-HSD2) isoenzyme, which leads to activation of the mineralocorticoid receptor by cortisol in the distal convoluted tubule resulting in hypertension, hypokalemia, and metabolic alkalosis. The relationship between chronic alcohol intake and blood pressure is well established on the basis of a diverse body of evidence including animal experiments, epidemiological studies, mendelian randomization studies, and interventional studies. Results of recent studies suggested that binge drinking (i.e., episodic consumption of a very high amount of alcohol beverages) has pronounced hypertensinogenic effects. Recently, it was documented that also low doses of alcohol may increase the risk of cardiovascular complications. Therefore, the amount of alcohol consumption that is safe is zero. High-salt food products, energy drinks, food products containing liquorice, and alcoholic beverages have hypertensinogenic properties. Patients with hypertension and other cardiovascular diseases should avoid even accidental consumption of these food products.

A Comparison of Hypertonic Saline and Mannitol on Intraoperative Brain Relaxation in Patients with Raised Intracranial Pressure during Supratentorial Tumors Resection: A Randomized Control Trial

Hyperosmotic agents are used to decrease intracranial pressure (ICP). We aim to compare the effect of euvolemic solutions of 3% hypertonic saline (HTS) and 20% mannitol on intraoperative brain relaxation in patients with clinical or radiological evidence of raised ICP undergoing surgery for supratentorial tumors. A. Intraoperative brain relaxation was comparable between the two groups. There was a statistically significant difference in the mean arterial pressures (MAPs) between the two groups after one minutes (min) with a greater degree of decrease in blood pressure recorded in the mannitol group (P = 0.041). MAP with mannitol was significantly lower than the preinduction value after 75 min of administration of drug (P = 0.003). Urine output was significantly higher in the mannitol group (P = 0.00). Administration of HTS was associated with a transient increase in serum sodium concentrations, which was statistically significant but returned to normal within 48 h (P < 0.001). Both mannitol and HTS provided adequate intraoperative brain relaxation. On the contrary, there was no statistically significant fall in blood pressure with HTS. Thus, we advocate the use of HTS over mannitol as it maintains better hemodynamic stability.