Body Fluid Loss Research Articles

Effects of 6-h exposure to low relative humidity and low air pressure on body fluid loss and blood viscosity

The purpose of this study was to investigate the effects of 6-h exposure to low relative humidity (RH) and low air pressure in a simulated air cabin environment on body fluid loss (BFL) and blood viscosity. Fourteen young healthy male subjects were exposed to four conditions, which combined RH (10% RH or 60% RH) and air pressure (NP: sea level or LP: equivalent to an altitude of 2000m). Subjects remained seated on a chair in the chamber for 6h. Their diet and water intake were restricted before and during the experiment. Insensible water loss (IWL) in LP10% condition was significantly greater than in NP60% condition; thus, combined 10%RH and LP conditions promoted a greater amount of IWL. The BFL under the LP condition was significantly greater than that under the NP condition. Blood viscosity significantly increased under LP conditions. Increases in red blood cell counts (RBCs) and BFL likely contributed to the increased blood viscosity. These findings suggest that hypobaric-induced hypoxia, similar to the conditions in the air cabin environment, may cause increased blood viscosity and that the combined low humidity and hypobaric hypoxia conditions increase IWL.

Laparoscopic Resection of Choledochal Cyst: Report of a Case

We report a choledochal cyst that was successfully treated with laparoscopic surgery. A 32-year-old Japanese woman was referred to our hospital with a suspected choledochal cyst. Magnetic resonance cholangiopancreatography and computed tomography showed the common bile duct to be grossly dilated to the hepatic confluence. A diagnosis of type-Ia choledochal cyst in the Todani classification was made, and laparoscopic resection was performed. The patient was placed in the lithotomy position under general anesthesia, and 4 ports were inserted. After the cystic duct was dissected, the hepatoduodenal ligament was incised and a choledochal cyst was identified. Next, the common bile duct was mobilized and dissected away from the surrounding vessels and tissues. Taping of the common bile duct allowed better exposure and dissection of the surrounding tissues. Mobilization of the bile duct and dissection of the surrounding tissue was performed to the bifurcation of the common hepatic duct. Then the common hepatic duct was transected just distal to the choledochal cyst. The inferior common bile duct was dissected from the pancreas to identify the distal end of the choledochal cyst and the pancreaticobiliary junction behind the duodenum. The narrow segment of the choledochal cyst was identified and divided after distal closure with clips. After the gall bladder was dissected from the liver bed, the choledochal cyst and gallbladder were removed. A Roux limb was created extracorporeally via the umbilical incision. The jejunum 30 cm distal to the ligament of Treitz was removed through the transumbilical incision and transected. To create the Roux limb, the mesentery of the jejunum was also extracorporeally separated. A 50-cm Roux limb was made by means of side-to-side anastomosis with an endostapler. After a jejunostomy for hepaticojejunostomy anastomosis was created, the Roux limb was returned to the abdominal cavity. Then, pneumoperitoneum was started again, and the Roux limb was brought up laparoscopically in a retrocolic fashion. An end-to-side hepaticojejunostomy was intracorporeally established with a continuous, single-layer full-thickness 4-0 vicryl suture. Total operation time was 715 minutes. Intraoperative body fluid loss was 250 mL, and the postoperative course was uneventful with no major complications. The patient was discharged from hospital on the 12th postoperative day. She remains asymptomatic with normal liver function after 24 months of follow-up.

A case of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with lupus erythematosus in the central nervous system.

We report on a case of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with lupus erythematosus in the central nervous system (CNS). A 73-year-old woman with essential hypertension suddenly demonstrated consciousness disturbance. Upon her admission, laboratory data showed significant hyponatremia (114mEq/L) and a lack of body fluid loss. Diminished free water excretion (urine osmolality 684mOsm/kg) and normal urine Na excretion (FENa 1.70%) were consistent with the diagnosis of SIADH, which was confirmed by an inappropriately high concentration of plasma antidiuretic hormone (ADH) (15.3pg/mL at 256mOsm/kg of plasma osmolality). The hyponatremia was corrected by a combination of oral water intake restriction and saline infusion with furosemide administration until the 20th hospital day. Simultaneously, the presence of exudative pleural effusion in both chest cavities, suggesting the existence of pleuritis, and high titer of anti-nuclear antibody (ANA, 5120×) and anti-double-strand DNA antibody (6500IU/mL), indicated the subclinical development of systemic lupus erythematosus (SLE), although the diagnostic criteria were not satisfied at that time. On the 34th hospital day, the sudden onset of unknown consciousness disturbance confirmed the diagnosis of SLE as CNS lupus. In previous case reports on SLE and/or SIADH, a few cases in which SLE and SIADH developed concomitantly regularly showed high immunological activities, as in our case. Some common pathophysiological bases might be involved in the concomitant appearance of those disorders.

Efficacy and safety of a modified dosage regimen of nesiritide in patients older than 75 years with acute heart failure.

To explore efficacy and safety of a modified dosage regimen of nesiritide in patients (≥75 years) with acute heart failure (AHF). Total 140 patients (≥75 years) with AHF were enrolled in this study. They were randomly and evenly divided into two group--control and nesiritide group. The control group received only conventional treatment for AHF, while the nesiritide group received conventional treatment plus a continual intravenous infusion of nesiritide at a rate of 0.0075-0.015 μg·kg(-1)·min(-1) for 10-15 hours (total 0.5- 1.0 mg) once daily for 13 days. Medical research council scales in nesiritide group were significantly lower than those in control group on day 4, 8 and 14. Scores of edema had no significant difference, but were lower in nesiritide group on day 8 and 14. The nesiritide group had markedly more net body fluid losses. NT-proBNP, serum creatinine, blood pressure, cTnI, 30-day and 60-day mortality had no significant difference between two groups. Nesiritide resulted in improvements in dyspnea and edema, and similar adverse effects compared with conventional treatment. In spite of no reduction on short-term mortality and a reversible influence on renal function, nesiritide was still an important choice for the elderly (≥75 years) with AHF.

Donor site/epithelialising wound management: The ideal burn dressing: fact or fiction?

Burns are considered to be one of the most severe injuries to manage because they affect the protective functions of the largest organ of the body: the skin. Disruption of the skin’s protective barrier leads to loss of body fluids and increased risk of serious infection. Each year it is estimated that 250 000 individuals in the UK suffer a burn injury, with 300 deaths as a result (National Network for Burn Care, 2001). A burn is a tissue injury resulting from the effect of heat from sources such as fire, hot fluids and gases or friction. Exposure to other damage-inducing sources such as ultraviolet and ionising irradiation, electricity or chemicals can also result in burns (Coull, 1989). Any exposure of the skin to temperatures higher than 45°C will result in cellular damage. The extent of this damage is determined by the temperature of the heat source and the duration of exposure. The size of the burn injury (represented as a percentage of the patients’ body surface area) and the depth of the injury will dictate the likelihood of healing and so, will determine the management approach required. Pain, inflammation, oedema and loss of body fluid occur in all burn injuries. In extensive burns, this can lead to shock, acute failure of internal organs and death. Burns are classified according to the depth of damage and the structures involved. Superficial dermal burns have damage to the capillary network and the upper layers of the epidermis. Burns oedema occurs and there may be some blister formation. These wounds are very painful. In this type of injury the lower regenerative layers of the epidermal tissues survive. Therefore, if the patient is given appropriate supportive therapy (fluid resuscitation if needed,

An Unusual Presentation of Dhat Syndrome

An Unusual Presentation of Dhat Syndrome

Composite Gels Based on Poly (Vinyl alcohol) for Biomedical Uses

Nowadays, poly (vinyl alcohol) (PVA) hydrogels are being studied for several biomedical applications such as joint replacement, wound dressings and controlled drug-releasing devices, among others. Reinforced PVA hydrogels show good mechanical properties and are a suitable option to replace cartilages. Furthermore, these materials can prevent loss of body fluids, be a barrier against bacteria and also permeable to oxygen, for these all interesting properties, they are used like wound dressings. For drug delivery systems a material that can control the dose and release at the site of action is desirable, this can be accomplished using hydrogels, which are loaded with a drug, and then they can release it when an external stimulus (light, temperature, magnetic field, etc.) takes place. The aim of this work was to obtain composite hydrogels for the previously mentioned biomedical applications. Hydroxyapatite (HA) reinforced PVA gels were prepared for potential uses as cartilage replacement, HA improves the mechanical, tribological and fixing properties of the polymer, reaching values similar to that of the cartilages. For wound dressings, the hydrogel was reinforced with bentonite (clay) in order to increase the dimensional stability and antimicrobial properties. Gels with controlled drug release capability under magnetic stimulation (ferrogels) were also synthesized and characterized here.

A Case of Generalized Hyperhidrosis Complicated with Acute Renal Failure

임상에서 흔히 ì ‘í•˜ëŠ” 국소다한증에 비하여 ì „ì‹ ë‹¤í•œì¦ì€ 발생빈도가 ìƒëŒ€ì ìœ¼ë¡œ 낮지만 환자의 일상생활에 미치는 영향은 더 크다. ì €ìžë“¤ì€ ìˆ˜ë „ê°„ 지속된 ì „ì‹ ë‹¤í•œì¦ê³¼ 이에 합병된 급성 ì‹ ë¶€ì „ì— 대하여 수액공급과 항콜린성 ì œì œë¥¼ 통하여 ìž„ìƒì  í˜¸ì „ì„ 보인 사례를 경험하였기에 ì „ì‹ ë‹¤í•œì¦ì˜ 원인 및 치료에 대한 ë¬¸í—Œê³ ì°°ê³¼ 함께 ë³´ê³ í•˜ëŠ” 바이다. 중심 단어: ì „ì‹ ë‹¤í•œì¦; 급성 ì‹ ë¶€ì „; ì „ë¶„-요오드 검사; 항콜린성 ì œì œ

Author response to dehydration during sleep affects cognitive performance

To the Editor: We read the recent article by Robert Bourke and colleagues [1] with great interest. The fact that sleep, or, more importantly, disturbed sleep, can have an influence on cognitive and academic functions is very important. We feel, however, that an alternative, more physiological, point of view could be appropriate here. During sleep people breath through their noses in some part to limit water loss but, depending on the length of time spent asleep and on the particular conditions of the place where one sleeps, such as a heated and/or a dry bedroom, mild dehydration occurs [2]. Oral breathing causes a net water loss in normal healthy subjects [3]. Thus, if this occurs at any time during sleep, then there would be an increased loss of body fluid. With insomnia, snoring, and sleep apnoea, which would further increase mouth opening and thus oral breathing, the overall dehydration could be even more dramatic. Morning water drinking may not fully correct this overnight dehydration, suggesting long term effects on both extra and intracellular fluid compartments which would influence regulatory hormone release and brain function. In fact there is a relation between cognition and hydration level, with dehydration decreasing cognitive performance [4]. Thus it is not surprising that sleep, and especially disturbed sleep, would cause perturbations in body fluid hydration levels and, over the long term, the consequent effects on cognition could become quite aggravated. In contrast, increased hydration has been shown to improve cognitive performance, at least in children [5]. This suggests that a possible treatment would be to recommend increased water intake, perhaps during the daytime rather than in the evening in order to avoid the necessity of getting up to go to the toilet during sleep.

Monitoring Change of Body Fluid during Physical Exercise using Bioimpedance Spectroscopy and Finite Element Simulations

Abstract Athletes need a balanced body composition in order to achieve maximum performance. Especially dehydration reduces power and endurance during physical exercise. Monitoring the body composition, with a focus on body fluid, may help to avoid reduction in performance and other health problems. For this, a potential measurement method is bioimpedance spectroscopy (BIS). BIS is a simple, non-invasive measurement method that allows to determine different body compartments (body fluid, fat, fat-free mass). However, because many physiological changes occur during physical exercise that can influence impedance measurements and distort results, it cannot be assumed that the BIS data are related to body fluid loss alone. To confirm that BIS can detect body fluid loss due to physical exercise, finite element (FE) simulations were done. Besides impedance, also the current density contribution during a BIS measurement was modeled to evaluate the influence of certain tissues on BIS measurements. Simulations were done using CST EM Studio (Computer Simulation Technology, Germany) and the Visible Human Data Set (National Library of Medicine, USA). In addition to the simulations, BIS measurements were also made on athletes. Comparison between the measured bioimpedance data and simulation data, as well as body weight loss during sport, indicates that BIS measurements are sensitive enough to monitor body fluid loss during physical exercise.

AQP-1 Association with Body Fluid Loss in 10-km Runners

Intrinsic body fluid regulation is critical for optimizing endurance performance. Aquaporins (AQPs) are a family of transmembrane proteins that transport water and glycerol across cellular membranes. A recent report revealed an association between a single nucleotide polymorphism (SNP) in the 3' untranslated region of the aquaporin-1 (AQP1) gene and endurance performance. The purpose of the study was to explore the association between the AQP1 SNP and acute body fluid loss in long distance runners. The subjects (N=91, Age=26±3 yrs; Ht=170±11 cm; Wt=61±5 kg; mean±SD) were biologically unrelated male long distance runners. Data were collected before and after an international 10 km road race. Body fluid loss was determined by the difference between nude body weight before and after the 10 km run. The AQP1 (G→C) gene variation was detected by the ARMS-PCR procedure. Genotypes were determined by PCR product size. Carriers of the AQP1 SNP had a significantly greater adjusted body fluid loss (3.7±0.9 kg) than non-carriers (1.5±1.1 kg) (P<0.05). In conclusion, our study found an association between the AQP1 SNP and acute body fluid loss in long distance runners.

Hydration status of rugby league players during home match play throughout the 2008 Super League season

The hydration status of rugby league players during competitive home match play was assessed throughout the 2008 Super League season. Fourteen players from 2 Super League clubs were monitored (72 observations). On arrival, 2 h prior to kick off, following normal prematch routines, players' body mass were measured following a urine void. Prematch fluid intake, urine output, and osmolality were assessed until kick off, with additional measurements at half time. Fluid intake was also monitored during match play for club B only, and final measurements of variables were made at the end of the match. Mean body mass loss per match was 1.28± 0.7kg (club A, 1.15kg; club B, 1.40kg), which would equate to an average level of dehydration of 1.31% (mass loss, assumed to be water loss, expressed as a percentage of body mass), with considerable intra-individual coefficient of variation (CV, 47%). Mean fluid intake for club B was 0.64± 0.5 L during match play, while fluid loss was 2.0± 0.7 L, with considerable intra-individual CV (51% and 34%, respectively). Mean urine osmolality was 396± 252 mosm·kg-1 on arrival, 237± 177 mosm·kg-1 prematch, 315± 133 mosm·kg-1 at half time, and 489± 150 mosm·kg-1 postmatch. Body mass losses were primarily a consequence of body fluid losses not being completely balanced by fluid intake. Furthermore, these data show that there is large inter- and intra-individual variability of hydration across matches, highlighting the need for future assessment of individual relevance.

Fluid loss among swimmers during different duration water workouts

To compare the amount of fluid lost among swimmers during different duration water workouts, 15 swimmers (10 males and 5 females) with age ranging from 17 to 23 with a...

Efeitos cardiovascular e metabólico da reposição volêmica com solução salina hipertônica 7,5% associada ou não ao hidroxietilamido 130/0,4 em gatas com hipovolemia induzida

A hipovolemia é caracterizada por uma perda de fluido corpóreo, cursando com inadequado fluxo circulatório e consequentemente lesão tecidual. Neste trabalho, objetivou-se comparar a expansão volêmica resultante da administração de solução salina hipertônica (NaCl 7,5%), isolada ou em associação com hidroxietilamido 130/0,4 (HES 130/0,4), em gatas com hipovolemia induzida, sob anestesia geral inalatória com isofluorano. Foram utilizadas 12 gatas, sem raça definida, adultas, com massa corporal média de 3,07±0,56kg. Os animais foram anestesiados com isofluorano e, após a preparação cirúrgica, foram mantidos em 1CAM sob ventilação controlada. Após a estabilização do plano anestésico, foram avaliados os parâmetros basais. Em ato contínuo, iniciou-se a fase de hipovolemia, por meio da retirada de 30ml kg-1 de sangue da artéria femoral. Após 60 minutos da estabilização do quadro de hipovolemia, foi realizada nova mensuração dos dados, alocando-se os animais aleatoriamente em dois grupos: GSH (grupo solução hipertônica, n=6), que receberam, na fase de expansão volêmica, NaCl 7,5% isolada, na dose de 4ml kg-1, e GSHC (grupo salina hipertônica associado ao coloide, n=6), que receberam NaCl 7,5%, na mesma dose citada, em associação com HES 130/0,4, na dose de 30ml kg-1. Após realização do tratamento, foram avaliados novamente os efeitos cardiovasculares e hemogasométricos por 120 minutos. As pressões arteriais média (PAM), sistólica (PAS) e diastólica (PAD) foram maiores logo após a expansão volêmica (T0) para o GSH. De T45 até T120, as PAM, PAS e PAD foram maiores para o GSHC, em comparação com o GSH. A pressão venosa central foi maior no GSHC até T60. Não foram observadas diferenças entre grupos para frequência cardíaca e respiratória, íons sódio e potássio, déficit de base, bicarbonato, saturação de oxigênio na hemoglobina, glicose, PaCO2, PaO2 e pH. Conclui-se que a administração de NaCl 7,5% isoladamente aumenta rapidamente a PAM, PAS e PAD em gatos com hipovolemia induzida, mantendo esse efeito por apenas 30 minutos, enquanto que a administração de hidroxietilamido 130/0,4 associado à NaCl 7,5% promove reestabelecimento mais tardio (após 30 minutos), porém mais duradouro (até 120 minutos) da PAM, PAS e PAD em gatas com hipovolemia induzida. A administração de HES 130/0,4 associada à NaCl 7,5% promove aumento acentuado da PVC por até 60 minutos após a administração.

Urinary aquaporin-2 is elevated in infant atopic dermatitis

Conflicts of interest: none declared. Madam, One of the key features of atopic dermatitis (AD) is increased transepidermal water loss (TEWL),1, 2 a phenomenon attributable partly to impaired barrier function of the skin due to some genetic defects such as filaggrin gene (FLG) mutations, or to inflammatory status in AD.1 Remarkable loss of body fluid would induce a series of systemic regulatory reactions. The functional antidiuretic hormone (ADH)–aquaporin (AQP)‐2 axis is a major regulatory system to keep water balance. AQP‐2 mediates water transport across the apical plasma membrane of the renal collecting ducts. Kidney AQP‐2 expression can be estimated quantitatively by urinary excretion of AQP‐2. Moreover, the amount of urinary AQP‐2 (u‐AQP‐2) is positively correlated with the plasma levels of ADH in normal subjects.3 Increased serum ADH was detected in severe AD, a result possibly due to a dehydrated state caused by increased TEWL in these patients.2 Therefore, it is possible that u‐AQP‐2 is altered in AD. We conducted a case–control study to measure the u‐AQP‐2 level in paediatric patients with AD, and assessed its correlation with several clinical and laboratory parameters.

Nursing Considerations for Children Undergoing Delayed Sternal Closure After Surgery for Congenital Heart Disease

Nursing Considerations for Children Undergoing Delayed Sternal Closure After Surgery for Congenital Heart Disease

Pathogen Entrapment by Transglutaminase—A Conserved Early Innate Immune Mechanism

Clotting systems are required in almost all animals to prevent loss of body fluids after injury. Here, we show that despite the risks associated with its systemic activation, clotting is a hitherto little appreciated branch of the immune system. We compared clotting of human blood and insect hemolymph to study the best-conserved component of clotting systems, namely the Drosophila enzyme transglutaminase and its vertebrate homologue Factor XIIIa. Using labelled artificial substrates we observe that transglutaminase activity from both Drosophila hemolymph and human blood accumulates on microbial surfaces, leading to their sequestration into the clot. Using both a human and a natural insect pathogen we provide functional proof for an immune function for transglutaminase (TG). Drosophila larvae with reduced TG levels show increased mortality after septic injury. The same larvae are also more susceptible to a natural infection involving entomopathogenic nematodes and their symbiotic bacteria while neither phagocytosis, phenoloxidase or—as previously shown—the Toll or imd pathway contribute to immunity. These results firmly establish the hemolymph/blood clot as an important effector of early innate immunity, which helps to prevent septic infections. These findings will help to guide further strategies to reduce the damaging effects of clotting and enhance its beneficial contribution to immune reactions.

Recent Advances of Oral Rehydration Therapy (ORT)

Diarrheal disease is one of the leading causes of worldwide morbidity and mortality, especially in children. It causes loss of body fluid, which may lead to severe dehydration, electrolyte imbalance, shock and even to death. The mortality rate from acute diarrhea has decreased over the last few decades. This decline, especially in developing countries is largely due to the implantation of the standard World Health Organization-oral rehydration solution (WHO-ORS). However, the use of standard ORS has been limited by its inability to reduce fecal volume or diarrhea duration. Subsequently, this has led to various attempts to modify its compositions. And these modifications include the use of reduced osmolarity ORS, polymer-based ORS and zinc supplementation. Some of these variations have been successful and others are still under investigation. Therefore, further trials are needed to progress toward the ideal ORS. In this article, we briefly reviewed the pathophysiologic basis of the ORS, followed by the standard WHO-ORS and several modifications to improve the ORS.

The Effect Of Sodium And Carbohydrate In A Rehydration Food On Subsequent Exercise Performance

The purpose of this study was to determine the effectiveness of two rehydration beverages on fluid restoration and metabolism on subsequent exercise following exerciseand heat-induced dehydration. Twelve male subjects were dehydrated by ~3 % of body mass with exercise and heat exposure. In a randomly assigned, counterbalanced design, subjects were rehydrated at room temperature with either 175 ml of chicken noodle soup (SOUP: Campbell Soup Company, Camden, NJ) or an artificially sweetened placebo (CON) at the beginning of the 120 min rehydration period and 20 min later. Water was ingested every 20 min during the remaining 100 min of rehydration. Soup contained 161.0 mmol/l Na, 5.3 mmol/l K, and 32.6 g total carbohydrate. CON contained 14.4 mmol/l Na, 16.0 mmol/l K, and no carbohydrate. Total fluid ingestion was matched with body fluid loss during dehydration. After rehydration, subjects performed 30 min of steady state exercise at 68% VO2peak. Subjects then performed a time trial in which they accumulated as rapidly as possible the amount of work equal to 30 min of exercise at 70% VO2peak in a thermo-neutral environment (25 C and 40% relative humidity). There was no significant difference in percent recovery of body mass during rehydration (CON: 79.4 ± 3.3%; SOUP: 80.9 ± 3.4%). Time trial performance was significantly improved in SOUP (30.6 ± 0.8 min) compared with CON (33.2 ± 1.4 min; p=0.031). The rate of carbohydrate oxidation tended to be higher in SOUP (2.33 ± 0.09 g/min) compared with CON (2.18 ± 0.11 g/min; p=0.076). No differences in heart rate or ratings of perceived exercise were found during post-rehydration exercise. These results

Aquaporin-1 Gene Polymorphism Association With Acute Body Fluid Loss In Long Distance Runners

Aquaporin-1 Gene Polymorphism Association With Acute Body Fluid Loss In Long Distance Runners