Persistent Thirst Research Articles

Phenylethanoid glycosides from traditional Mongolian medicine Cymbaria daurica alleviate alloxan-induced INS-1 cells oxidative stress and apoptosis

Cymbaria daurica L. is a well-known traditional Mongolian medicine, which has been used to treat diabetes-related conditions characterized by persistent thirst and hunger, copious urination, and weight loss. We aimed to investigate the protective effects of C. daurica extracts and phenylethanoid glycosides including verbascoside and isoacteoside on INS-1 cells. We discovered phenylethanoid glycosides from n-butanol extract with large content through extraction and separation. We continue to study the protective effects of phenylethanoid glycosides including verbascoside and isoacteoside on INS-1 cells. INS-1 cells were treated with C. daurica, cell viability assay, RNA-seq technology, superoxide dismutase activity and malonaldehyde content, quantitative real time-PCR and Western blot analysis were used to study the protective effects of C. daurica. Cell viability assay resulted that n-butanol extract and verbascoside, isoacteoside showed protective effects of C. daurica. According to the RNA-seq technology to identify the differentially expressed genes in INS-1 cells, the pathway of gene enrich the protective effect of C. daurica on oxidative stress. SOD activity and the content of MDA indicated that C. daurica could enhance the antioxidant capacity of INS-1 cells. Further investigation indicated C. daurica alleviate oxidative stress by inhibiting INS-1 cell apoptosis. C. daurica may play an anti-diabetic role by inhibiting islet cell apoptosis.

This Time Is Different, but It Will End the Same Way: Unrecognized Secular Changes in the Bond Market since the 2008 Crisis That May Precipitate the Next Crisis

The US bond market had over $42.39 trillion of outstanding debt at the end of the third quarter of 2018, eclipsing the US stock market’s approximately $30 trillion in market capitalization. The sheer size of the bond market provides ample opportunities, as well as risks, for institutional investors. Some of these risks escape investors’ radar because of the nature of fixed income securities: low transparency, illiquidity, and over-the-counter (OTC) trading. In this article, the authors present our concerns regarding five secular changes wrought by the over-regulation of the marketplace after the financial crisis of 2008 and investors’ persistent thirst for yield. Further, although painful lessons were gleaned after the punishing 2008 financial crisis, the authors present empirical evidence that suggests that many sectors, such as auto loans and collateralized loan obligations, that were largely unscathed by this crisis may be at risk in the next downturn. This article is based on original data sources and academic research. The authors are in continuing dialogue with other experts that may further the research, and welcome interested parties to get in contact. <b>TOPICS:</b>Financial crises and financial market history, statistical methods <b>Key Findings</b> • Lack of market-making and other regulatory changes that will impede price discovery in the next downturn. • Masking of the deterioration of underlying collateral and rearview mirror analysis. • New versions of the old games played by the rating agencies. • Explosion in number of Asset-Liability mismatched structures. • Regulatory changes in compliance of financial institutions.

This Time Is Different, but It Will End the Same Way: Unrecognized Secular Changes in the Bond Market since the 2008 Crisis That May Precipitate the Next Crisis

The US bond market had over $42.39 trillion of outstanding debt at the end of the third quarter of 2018, eclipsing the US stock market’s approximately $30 trillion in market capitalization. The sheer size of the bond market provides ample opportunities, as well as risks, for institutional investors. Some of these risks escape investors’ radar because of the nature of fixed-income securities: low transparency, illiquidity, and over-the-counter (OTC) trading. In this paper, we present our concerns regarding five secular changes brought up by the over-regulation of the marketplace after the financial crisis of 2008 and investors’ persistent thirst for yield. Further, while painful lessons were gleaned after the punishing 2008 financial crisis, we present empirical evidence that suggests that many sectors, such as the auto loans and collateralized loan obligations, that were largely unscathed by this crisis may be at risk in the next downturn. This paper is based on original data sources and academic research. The authors are in continuing dialogue with other experts that may further the research, and welcome interested parties to get in contact.

Treatment with various forms of desmopressin in a patient with apparently non-idiopathic diabetes insipidus

Diabetes insipidus (DI) is a rare syndrome characterized by an excretion of abnormally large volumes of diluted urine and a corresponding increase in fluid intake. In the absence of treatment, patients with this disease experience significant difficulties due to the constant need to visit the toilet for urination and persistent thirst. Desmopressin, a synthetic analogue of the antidiuretic hormone, has been the treatment of choice for the central form of DI for many decades. Just like with any other hormone replacement therapies, the more accurately the dose is chosen for a particular patient, the better and safer the expected clinical response. In this article, we present a clinical case that demonstrates the clinical difficulties encountered in the treatment of a patient with central DI.

Mice deficient for ERAD machinery component Sel1L develop central diabetes insipidus.

Deficiency of the antidiuretic hormone arginine vasopressin (AVP) underlies diabetes insipidus, which is characterized by the excretion of abnormally large volumes of dilute urine and persistent thirst. In this issue of the JCI, Shi et al. report that Sel1L-Hrd1 ER-associated degradation (ERAD) is responsible for the clearance of misfolded pro-arginine vasopressin (proAVP) in the ER. Additionally, mice with Sel1L deficiency, either globally or specifically within AVP-expressing neurons, developed central diabetes insipidus. The results of this study demonstrate a role for ERAD in neuroendocrine cells and serve as a clinical example of the effect of misfolded ER proteins retrotranslocated through the membrane into the cytosol, where they are polyubiquitinated, extracted from the ER membrane, and degraded by the proteasome. Moreover, proAVP misfolding in hereditary central diabetes insipidus likely shares common physiopathological mechanisms with proinsulin misfolding in hereditary diabetes mellitus of youth.

Analysis of Speech-Language Pathology Graduate Students' Experience with Thickened Liquids

Purpose: Thickened liquids are frequently recommended for patients with dysphagia to minimize aspiration. When discussing the use of thickened liquids with graduate students in Communication Sciences &amp; Disorders (CSD), it is beneficial to discuss the potential effect(s) of this dietary recommendation. Graduate level preparation involving first-hand experience with thickened liquids may help future speech-language pathologists (SLPs) develop a more complete understanding of the effects of diet modification. The purpose of the current study was to examine the reactions of graduate students in CSD to a brief period of thickened liquid use as an experiential learning activity. Methods: Sixty-eight graduate students enrolled in an accredited CSD program completed the study. As part of a class assignment, students were instructed to consume only thickened liquids for 24 hours. No further restrictions on food intake were made. Each student wrote a brief summary detailing his/her experience at the conclusion of the thickened liquid intake session. The narratives were examined for key terms that seemed to define the participants’ experiences. Results: Experiential terms were divided into physical symptoms, emotional responses, and behavioral changes. Common symptoms included persistent thirst, dryness, fatigue, perception of the experience as being unpleasant, irritability, and difficulty concentrating. Conclusion: Many of the symptoms were associated with dehydration secondary to reduced fluid intake, per the students’ reports. Specific symptoms included craving water, fatigue, and headache. All participants reported a greater understanding of thickened liquid use upon completion.

Thirst Trajectory and Factors Associated With Persistent Thirst in Patients With Heart Failure

BackgroundThirst is often increased in patients with heart failure (HF) and can cause distress during the course of the condition. The aim of the present study was to describe the trajectory of thirst during an 18-month period and to identify variables associated with persistent thirst in patients with HF. Methods and ResultsData were collected from 649 patients with HF with the use of the Revised Heart Failure Compliance Scale at 1, 6, 12, and 18 months after a period of hospital treatment for worsening HF. Thirst trajectory was described for the 4 follow-up visits and logistic regression analysis was used to identify factors independently associated with persistent thirst. In total, 33% (n = 212) of the patients reported thirst on ≥1 occasions and 34% (n = 46) continued to have thirst at every follow-up visit. Nineteen percent (n = 121) of the patients had persistent thirst. Patients with persistent thirst were more often younger and male and had more HF symptoms. Higher body mass index and serum urea also increased the risk of persistent thirst. ConclusionsPatients with HF who were thirsty at the 1-month follow-up were more often also thirsty at subsequent visits. Assessment of thirst is warranted in clinical practice because one-fifth of patients suffer from persistent thirst.

Metastatic Prostate Adenocarcinoma Presenting Central Diabetes Insipidus

The pituitary gland and infundibulum can be involved in a variety of medical conditions, including infiltrative diseases, fungal infections, tuberculosis, and primary and metastatic tumors. Metastases to the pituitary gland are absolutely rare, and they are generally secondary to pulmonary carcinoma in men and breast carcinoma in women. Pituitary metastases more commonly affect the posterior lobe and the infundibulum than the anterior lobe. The posterior lobe involvement may explain why patients with pituitary metastases frequently present with diabetes insipidus. We are presenting a case report of a 78-year-old male patient who had metastatic prostate with sudden onset of polyuria and persistent thirst. He had no electrolyte imbalance except mild hypernatremia. The MRI scan of the brain yielded a suspicious area in pituitary gland. A pituitary stalk metastasis was found on magnetic resonance imaging (MRI) of pituitary. Water deprivation test was compatible with DI. A clinical response to nasal vasopressin was achieved and laboratory results revealed central diabetes insipidus. As a result, the intrasellar and suprasellar masses decreased in size, and urinary output accordingly decreased.

Smoking, polyuria and impaired vision

The pituitary gland can be involved in a variety of medical conditions, including metastatic tumors. Metastases to the pituitary gland, although absolutely rare, more commonly affect the posterior pituitary lobe and so frequently present with diabetes insipidus. We report on a 48-year-old male heavy smoker patient suffering from sudden onset of polyuria and persistent thirst. Laboratory results revealed central diabetes insipidus. Computed tomography (CT) scan of the brain showed a mass located in the sella turcica and in the suprasellar region. CT scan of the chest showed a mass in the right superior lobe with mediastinal lymphadenopathy, with bronchoscopy and biopsy features of pulmonary adenocarcinoma. The patient received radiotherapy on the pituitary gland and adjuvant chemotherapy, and as intrasellar and suprasellar mass decreased in size, urinary output was accordingly reduced. Therefore, is that in patients with risk factors for cancer and sudden onset of diabetes insipidus pituitary metastasis should be taken into account in differential diagnosis.

Assessment of Chemical Factors in Relation to Child Hyperactivity

A questionnaire evaluation of 486 hyperactive children (HA) (82% boys, aged 7-13 years and 18% girls, aged 8-13 years) showed that more than 60% of cases reported a positive behavioural response (i.e. increased problems) in relation to consuming or being exposed to synthetic colourings and flavourings, food and beverage preservatives, cow's milk and associated products, chemical detergents and perfume. In contrast, 172 sex- and age-matched control children (C) reported only 12% of cases responding to synthetic colourings and flavourings and chemical solvents. The main health problems reported by the 96% of hyperactive children affected by synthetic colourings and flavourings were persistent thirst problems, the development of eczema, ear and/or chest infections, and the production of excessive amounts of catarrh. Trace element measurements undertaken by inductively coupled plasma mass spectrometry showed that a low zinc and iron status is associated with hyperactive children when compared with control children for blood serum, urine and washed scalp hair (HA C). In many cases, hyperactive children also had very highly significant raised levels of aluminium, cadmium and/or lead (HA C), particularly in urine and washed scalp hair samples. Hyperactive children with a known behavioural response following the consumption of a beverage containing tartrazine, E ( n= 23), sunset yellow, E ( n= 12) 102 110 and amaranth, E ( n= 12) were given a dose of chemical food colour (50 mg) and their zinc 123 levels (blood serum and urine) and behavioural activity were monitored for 120 min. A sexand age-matched control group was also studied. Only hyperactive children showed a significant reduction in blood serum zinc levels and an increase in urinary zinc output following the consumption of E and E . Amaranth had no effect on their zinc status over 102 110 the study time period. There were no significant changes in the zinc levels for control children for all three chemical food colours. The main behavioural changes were observed in the hyperactive children given E and E . For the 23 children who consumed a tartrazine 102 110 beverage there were increased levels of overactivity ( n= 18 children), aggressive ( n= 16) and/or violent ( n= 4) activity, poor speech ( n= 2), poor coordination ( n= 12), and the development of asthma and/or eczema ( n= 8). Most of these were severe or moderate changes. Only one control child showed minor behavioural responses to tartrazine.

Transient vasopressin release and thirst in response to prolonged intracerebroventricular infusions of hypertonic mannitol in saline.

In the conscious goat infusions of 0.4 M mannitol in 0.15 M NaCl into the lateral cerebral ventricle (40 or 100 min, 0.02 ml/min) caused slight, transient vasopressin release and temporary thirst, whereas infusions or pure, hypertonic (0.7 M) mannitol did not elicit thirst and inhibited the basic vasopressin release in the nonhydrated animal. In contrast, infusions of equiosmolal (0.35 M) NaCl induced persistent thirst and pronounced elevation of the plasma vasopressin concentration throughout the infusion period. The cerebrospinal fluid (CSF) osmolality was raised by the same order of magnitude (= 13%) after the mannitol/NaCl and the hypertonic NaCl infusions. The CSF Na+ concentration was elevated by greater than 10% at 5 min after hypertonic NaCl infusions, but it was reduced by approximately 10% at 5 min after the mannitol/NaCl infusions. There was no appreciable difference in the CSF K+ concentration after the infusions. The results are discussed with regard to the possible importance of CSF Na+-concentration as opposed to strict osmotic factors for the excitation of receptors involved in the control of water balance.

Blood levels and management of lithium treatment.

The limited value of plasma measurements in the management of treatment with lithium is discussed in the light of the mechanisms of its therapeutic actions and toxic effects.The plasma level of lithium usually rises twofold or threefold in the three to five hours after ingestion of each dose of delayed-release tablets and then gradually falls. The precise shape and height of the lithium curve depend on gastric emptying, which can be slowed with propantheline or speeded with metoclopramide. Depressed or demented patients may be irregular in taking their tablets and variable in food intake. Both the time of the blood test and this behaviour must be considered before changing the prescribed dose of lithium salt because of a laboratory result. A lithium tolerance curve may be a safer guide to treatment than single measures.Mild intermittent thirst is a common early side effect, and severe persistent thirst with polyuria is an uncommon later effect of daily intakes of at least 1,500 mg lithium carbonate. This diabetes insipidus is reversible, non-progressive, unrelated to plasma level, and distinct in attack from lithium-induced hypothyroidism, which may occur at low dosage but is also usually of late onset and reversible or treatable with thyroxine while lithium is continued. Obesity is another occasional effect of large doses. These side effects and the antimanic and prophylactic effects may have different mechanisms.