Urine Specific Gravity Research Articles

Effectiveness of heat stress interventions among outdoor workers: a protocol paper

IntroductionHeavy work in scorching temperatures can cause dehydration and heat stress, which can lead to a number of heat-related diseases. Heavy work in intense heat without rest or hydration is the main cause. The “Water, Rest, Shade” (WRS) intervention program for outdoor workers in hot weather reduces heat stress.MethodsThis study follows a quasi-experimental design involving 250 outdoor workers from both agriculture and brick kilns. To assess the environmental heat exposure levels, Quest Temp 3 M WBGT Monitor will be used. Tympanic temperature, Heart rate (HR), Sweat rate (SwR), and Urine specific gravity (USG) to assess the physiological responses to heat exposure using standard protocols. Blood samples will be collected to measure serum creatinine and calculate Glomerular filtration rate (GFR), and urine samples to measure pH, leucocytes, proteinuria, and hematuria. Then administer a validated and modified HOTHAPS questionnaire to capture the perception data. After the baseline assessments, Categorize the workers into two groups based on the selection criteria and the participants’ willingness. Then provide a week-long WRS intervention to the intervention group (IG). The non-intervention group will collect the same data without any intervention to assess the efficacy of the intervention by comparing both groups and measuring outcome indicators.Expected outcomeThe study will generate much-needed information to raise awareness of the importance of heat stress prevention for outdoor workers.ConclusionThis study will demonstrate the effectiveness of an intervention, provide much-needed strategies for reducing heat stress, assess both health impacts and implementation quality, and design comprehensive workplace and labor laws aim to minimise risks to millions of unorganised outdoor workers health.

Evidence of renal tubular injury in canine patients after elective desexing.

To investigate the frequency of perioperative acute kidney injury (AKI) in American Society of Anesthesiologists (SA) Grade I canine patients undergoing elective desexing using urine microscopy techniques and assess if pre- and intraoperative factors affect risk of developing AKI. Prospective observational clinical study conducted between September 2020 and October 2020. University teaching hospital. Thirty-two female and four male dogs between 5 months and 5 years of age classified as ASA I undergoing elective desexing surgery. Urinalysis was performed preoperatively and 20-24 h postoperatively to identify markers of renal tubular injury (RTI), particularly the presence of granular and renal tubular epithelial cell (RTEC) casts on sediment analysis. Dogs underwent a full physical examination and a preoperative assessment including measurement of urine specific gravity (USG), packed cell volume (PCV), total plasma protein and serum creatinine (sCr) was conducted as a part of the desexing programme. Anaesthetic records were examined for any evidence of intraoperative hypotension, defined as a mean arterial pressure (MAP) of <60 mmHg for any duration of time. MAP was measured using an indirect oscillometric technique. For analysis, animals were subdivided into affected and nonaffected groups, with affected animals those that hadpostoperative increases in granular and RTEC casts. Categorical and comparative analyses were then performed between groups to identify associations of increased casts with pre-, intra- and postoperative variables. A frequency of RTI of 5.6% was identified. This was accompanied by a significant association between increases in casts with total duration (p = 0.027) and number (p = 0.016) of hypotensive episodes. RTI is an anaesthetic consideration in ASA I veterinary patients undergoing elective desexing surgery. The identification of an association between the total duration and number of hypotensive episodes and the frequency of RTI highlights the importance of early detection of hypotension along with prompt and effective intervention in veterinary patients.

Central diabetes insipidus in two related juvenile deerhounds

AbstractTwo related juvenile deerhounds were evaluated 2 years apart because of polydipsia, pollakiuria and periuria. Until shortly before presentation, each dog lived outdoors from 6 weeks of age with its littermates, and each litter shared a single drinking water source. Physical examination findings were unremarkable. The most noteworthy laboratory finding was hyposthenuria, although both dogs also had serum sodium concentrations at the upper end of the laboratory reference range. Both dogs responded to treatment with desmopressin acetate eye drops, which relieved their clinical signs and increased their urine specific gravities, confirming a diagnosis of central diabetes insipidus. To the best of the authors’ knowledge this is the first report of diabetes insipidus in deerhounds and only the third report to suggest that central diabetes insipidus might be heritable in dogs, as it is in humans.

Plasma and serum volume remain unchanged following a 12-h fast from food and drink despite changes in blood and urinary hydration markers.

The effect of mild dehydration on plasma and serum volume has not been well established. Furthermore, the ability of urinary and blood biomarkers to monitor small hydration changes have not been solidified. There were two objectives of this research: 1. Determine if mild dehydration affects plasma and serum volume; 2. Determine if mild dehydration can be detected better by urinary or blood biomarkers. 47 subjects were recruited; 10 subjects were removed from the study and 37 subjects (27% male) completed the study. This was a crossover study design such that each subject underwent all protocols in a counterbalanced order. Protocols consisted of 12-h dehydration, 12-h hydration, and control. Neither plasma volume (p = 0.914), plasma volume status (p = 0.649), nor serum volume (p = 0.273) were different among protocols. Body mass (p < 0.001) was lower following the dehydration protocol. Urine color (p < 0.001), urine osmolality (p < 0.001), urine specific gravity (p < 0.001), serum osmolality (p < 0.001), and plasma osmolality (p < 0.001) were all lower following the hydration protocol. Hematocrit (p = 0.842) and hemoglobin concentration (p = 0.558) were not different among protocols. Dehydration did not affect plasma or serum volume. Therefore, a 12-h fast from food and water as done in this study will not likely affect laboratory test results of biomarker concentration. All 3 urinary measures were able to detect changes in hydration status, whereas only 2 blood measures were able to detect changes in hydration status. This may indicate that urinary measures are best at detecting small changes in hydration status.

Risk factors of renal function deterioration after radical nephroureterectomy for upper tract urothelial carcinoma.

To investigate the risk factors of renal function deterioration after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). A total of 153 patients with UTUC who underwent radical surgery at a high-volume center in China from January 2015 to December 2019 were included in this study. The renal function of all patients was evaluated during follow-up. Besides, these patients were grouped according to postoperative renal function. The risk factors of renal function deterioration included age, sex, body mass index (BMI), T stage, tumor location and size, lymph node invasion, lymph node dissection (LND), surgical margin, tumor histology, lymphovascular invasion (LVI), hypertension, diabetes, hematuria, blood transfusion, hydronephrosis on the affected side, urine specific gravity, creatinine, uric acid, and preoperative glomerular filtration rate (GFR) on the healthy and affected sides. The correlation between risk factors and inclusion indexes was analyzed using univariate and multivariate analyses. A total of 153 patients were enrolled in this study, and the follow-up continued for 14 (11, 24) months. Acute kidney injury (AKI) was diagnosed in 65 patients in the short-term follow-up after RNU, and renal function deterioration was diagnosed in 52 patients in the long-term follow-up after RNU. The univariate analysis of 65 patients with short-term AKI revealed that there were statistically significant differences in preoperative hydronephrosis, hypertension, urinary protein, tumor size, preoperative Hb, preoperative creatinine, blood transfusion, and preoperative GFR of the healthy kidney. The multivariate Logistic regression analysis results showed that preoperative creatinine, GFR of the healthy kidney, and blood transfusion were independent risk factors for AKI. Moreover, The multivariate Logistic regression analysis of 52 patients with long-term renal insufficiency after surgery indicated that there were statistically significant differences in preoperative hydronephrosis, tumor size, preoperative GFR of the healthy kidney, and postoperative AKI. For patients with UTUC, the preoperative creatinine level is high, blood transfusion was given during or after procedure and the GFR of the healthy kidney is low, it is easy to have AKI in the short term after operation. In addition, there was no hydronephrosis before operation, the tumor size was small, the GFR of the healthy kidney was low before operation, AKI occurred after operation, the renal function was easy to deteriorate for a long time after operation. The above risk factors may aggravate renal function deterioration of these patients after surgery, resulting in the loss of the opportunity to continue treatment.

Exposure to Phthalates and Alternative Plasticizers in Patients with Impaired Kidney Function in Korea: Temporal Trend during 2011-2020 and Its Association with Chronic Kidney Disease.

Phthalates are chemical risk factors of chronic kidney disease (CKD); however, little is known about temporal trends of phthalate exposure and associated health risks among CKD patients. Such information is even scarce for alternative plasticizers. CKD patients were recruited from 2011 to 2020 in Korea (n = 200) and assessed for the temporal changes of both traditional and alternative plasticizer exposure. Their associations with kidney dysfunction were also investigated. In CKD patients, urinary levels of DEP, BBzP, and DEHP metabolites declined significantly during this period, while those of the DEHTP metabolite increased. The level of DEHP metabolites showed a negative association with the estimated glomerular filtration rate (eGFR) in multiple association models, but additional eGFR subgroup analysis failed to show consistent results. Associations between phthalate exposure and eGFR were influenced by the severity of kidney dysfunction: DEHP and BBzP exposure showed negative associations with eGFR only among the patients with moderate kidney dysfunction (eGFR 30-59 mL/min/1.73 m2). Changing associations by CKD severity may be explained by negative correlations between eGFR and both urinary creatinine concentration and specific gravity. Our observations show that DEHTP has rapidly replaced DEHP and exposure to several phthalates adversely influences kidney function even among CKD patients.

The effect of consuming a sucrose-containing sports drink on acute kidney injury risk during a four-hour simulated occupational heat stress.

Occupational heat stress increases acute kidney injury risk. Drinking a soft drink sweetened with high fructose corn syrup further elevates this acute kidney injury risk. However, the impact of sucrose, another fructose containing-sweetener, on acute kidney injury risk remains unexplored. We tested the hypothesis that drinking a sucrose-containing sports drink increases acute kidney injury risk when compared to drinking a sugar-free sports drink during four hours of simulated occupational heat stress. Ten healthy adults consumed a sucrose-containing or sugar-free sport drink ad libitum during four-hour exposures to wet bulb globe temperatures of ~28°C. 30 min of work and 30 min of rest were completed each hour. Work involved treadmill walking at a fixed rate of metabolic heat production (sucrose-containing: 6.0±1.2 W/kg, sugar-free: 5.5±0.9 W/kg, p=0.267). The product of urinary insulin-like growth factor-binding protein 7 and tissue inhibitor of metalloproteinase-2, normalized to urine specific gravity ([IGFBP7·TIMP-2]USG), provided an acute kidney injury risk index. Mean core (intestinal: n=13, rectal: n=7) temperature (sucrose-containing: 37.5±0.1°C, sugar-free: 37.5±0.3 °C; p=0.914), peak core temperature (sucrose-containing: 37.8±0.2°C, sugar-free: 37.9±0.3 °C; p=0.398), and percent changes in body mass (sucrose-containing: -0.5±0.4%, sugar-free: -0.3±0.6%; p=0.386) did not differ between groups. [IGFBP7∙TIMP-2]USG increased in both groups (time effect: p=0.0254) with no drink (p=0.675) or interaction (p=0.715) effects. Peak change [IGFBP7∙TIMP-2]USG did not differ between sucrose-containing (median 0.0116 [-0.0012, 0.1760] (ng/mL)²/1000) and sugar-free (median 0.0021 [0.0003, 0.2077] (ng/mL)²/1000; p=0.796). Sucrose-containing sports drink consumption during simulated occupational heat stress does not modify acute kidney injury risk when compared to sugar free-sport drink consumption.

Evaluating the role of urine chemistry in shock wave lithotripsy outcomes.

Extracorporeal Shock Wave Lithotripsy (ESWL) is a commonly used method for the noninvasive treatment of kidney stones. However, achieving optimal treatment outcomes and minimizing potential damage to the kidney necessitates careful consideration for the total amount of energy utilized. This study aims to investigate whether urine pH and urine specific gravity have an impact on the total amount of energy applied during SWL. Between January 2023 and December 2023, 129 patients with renal stones underwent SWL in our department using the Storz Medical Modulith Inline lithotripter. Stone-free rates, complications, and the impact of patient, urine, and stone characteristics on energy use were analyzed. Urine samples were analyzed for pH and specific gravity. Stone characteristics, including size, HU, and skin-to-stone distance, were recorded. The obtained data were evaluated regarding the possible relationship between the total energy amount (determined as a risk factor) and the age, BMI, urine pH, urine specific gravity, stone size, HU, and skin-to-stone distance by using the Pearson correlation coefficient. p-value of < 0.05 was considered statistically significant. Evaluation of our findings revealed a negative linear relationship between total amount of energy used and the urine pH, indicating a decrease in the total energy amount as urine pH shifts towards alkaline values (p = 0.038; p < 0.05). However, no statistically significant relationship was observed between age, BMI, urine specific gravity, stone size, HU, and skin-to-stone distance and the total energy amount. Our findings demonstrated a significant relationship between urine pH and the total amount of energy applied during SWL sessions, suggesting the need for further prospective research to better understand the possible association between these two parameters. Such investigations could contribute to the development of more reasonable and effective strategies for kidney stone treatment in an attempt to minimize the potential kidney damage.

7899 Mixture Of Urinary Concentrations Of Phenols And Phthalate Metabolites In Relation To Serum Levels Of Lipid Biomarkers Among Pregnant Women: Results From The EARTH Study

Abstract Disclosure: X. Shen: None. M. Génard-Walton: None. P.L. Williams: None. T. James-Todd: None. J.B. Ford: None. K.M. Rexrode: None. D. Zhang: None. J.E. Chavarro: None. R.B. Hauser: None. L. Minguez Alarcon: None. Given the limited evidence on endocrine-disrupting chemicals (EDCs), evaluated as mixture, in relation to lipid biomarkers during pregnancy, we examined whether mixtures of urinary concentrations of bisphenol A (BPA), parabens and phthalate metabolites were associated with serum lipid levels among 175 pregnant women who enrolled in Environment and Reproductive Health (EARTH) Study from 2005 to 2017. The outcomes were assessed at one random timepoint pre women during pregnancy, including serum levels of total triglycerides, total cholesterol, high-density lipoprotein (HDL), non-HDL, and low-density lipoprotein (LDL). We grouped the chemical biomarkers [di(2-ethylhexyl) phthalate (DEHP) metabolites and BPA; other phthalate metabolites; parabens] assessed in urine collected at the same time and applied Bayesian Kernel Machine Regression (BKMR) and quantile g-computation to evaluate the associations while adjusting for confounders [urine specific gravity, age, pre-pregnancy body mass index (BMI), race, education level, infertility diagnosis, mode of conception, number of babies in this pregnancy and trimester]. In the adjusted BKMR models, we found no associations between the overall chemical biomarker mixture and lipid levels for example total cholesterol [mean difference (95% CRI, credible interval) = 0.02 (-0.31, 0.34)] and LDL [mean difference (95% CRI) = 0.10 (-0.22, 0.43)] when comparing concentrations at the 75th to the 25th percentile. When stratified by BMI, we found suggestive positive relationships between the paraben group and total cholesterol and LDL among women with high BMI [mean difference (95% CRI) = 0.16 (-0.23, 0.55) and 0.16 (-0.25, 0.57)], but not among women with low BMI [mean difference (95% CRI) = -0.02 (-0.16, 0.12) and -0.02 (-0.15, 0.12)]. Among the paraben group, propylparaben was driving the associations among high BMI group [mean difference (95% CRI) = 0.25 (-0.26, 0.75) and 0.35 (-0.25, 0.95)], but not among low BMI group [mean difference (95% CRI) = 0.00 (-0.06, 0.07) and 0.00 (-0.07, 0.07)]. In addition, we found suggestive positive associations of DEHP metabolites and BPA group with total cholesterol, non-HDL and LDL among women with lower BMI, but none of the chemicals was identified as an important contributor to these associations. This study highlights that the associations between EDCs and cardiovascular biomarkers, such as circulating lipids, differ by BMI among pregnant women. Presentation: 6/1/2024

8301 A Rare Case of IgG4-Related Hypophysitis

Abstract Disclosure: P. Kesavan Chary: None. J.M. Silverstein: None. Background: IgG4-related disease (IgG4-RD) is an immune-mediated condition that presents as systemic inflammation and fibrosis of tissues, often affecting multiple organs. Isolated IgG4-related Hypophysitis is rare and characterized by lymphoplasmacytic infiltration of the pituitary gland by IgG4-positive plasma cells. A combination of clinical, serologic, radiologic, and histopathologic findings is used for diagnosis of IgG4-RD and approximately two-thirds of all patients have elevated serum IgG4 levels. We report a case of isolated IgG4-related Hypophysitis in a middle-aged woman serologically negative for IgG4-related disease. Case Report: A 52 year old female with history of steroid dependent severe persistent asthma, allergic rhinitis, and chronic sinusitis presented with one month of headache, polyuria, and polydipsia. MRI Brain demonstrated an enlarged, rounded pituitary gland 16 x 11 x 9 mm, with homogeneous enhancement, extension into the suprasellar cistern, and mild thickening of the infundibulum suspected to represent a pituitary adenoma. Lab evaluation revealed mild hyperprolactinemia (prolactin 83.2, normal 4.8-23.3 ng/mL) and secondary adrenal insufficiency based on an abnormal high-dose cosyntropin stimulation test in the setting of a low adrenocorticotrophic hormone (ACTH) level (&amp;lt;2.0 pg/mL). Remaining pituitary hormone levels were normal. Inpatient work-up for polyuria and polydipsia showed a low urine specific gravity of 1.003. An overnight water deprivation test was performed. Baseline urine osmolality (UOsm) was 95 mOsm/kg and serum sodium was 144 mmol/L; after 3 hours of water deprivation, serum Osm increased to 301 mOsm/kg (275-300 mOsm/kg) and UOsm only to 215 mOsm/kg, while her sodium increased to 145 mmol/L. Results were felt to be consistent with AVP deficiency (Central Diabetes Insipidus) and the patient was started on desmopressin. Because of the presence of AVP deficiency, further work-up was done to evaluate for an infiltrative process or malignancy. ANA, RPR, ESR, CRP, CBC, ACE level, T-SPOT, and IgG subclasses were unremarkable. Further imaging studies yielded a negative nuclear bone scan and PET/CT scan. For diagnostic purposes, the patient underwent biopsy via an endoscopic endonasal transsphenoidal approach. Pathology showed the presence of &amp;gt;10 IgG4+ plasma cells in a single high-power field, consistent with a diagnosis of IgG4-related Hypophysitis. Conclusion: Isolated IgG4-related Hypophysitis is the least common clinical presentation of IgG4-RD, which is itself a rare and relatively newly recognized condition. IgG4-related Hypophysitis should be suspected in patients presenting with AVP deficiency and pituitary stalk enlargement with an otherwise negative work up. Presentation: 6/2/2024

Hydration Considerations to Improve the Physical Performance and Health of Firefighters.

Background/Objectives: Firefighters are exposed to a high level of stress as they often perform physically challenging work in hazardous environments while responsible for rescuing and keeping those around them safe. To add to this stress, they are also required to work in heavy, unbreathable personal protective equipment which promotes dehydration. These occupational demands paired with dehydration may lead to increased core temperatures, cardiac strain, and overall risk for sudden cardiac events. Thus, it is important to include hydration assessments and determine fluid needs when firefighters are on shift to ensure their personal safety as well as the safety of those around them by optimizing physical performance by maintaining adequate hydration. Therefore, the purpose of this review is to identify markers of hydration, classifications of hydration status, current hydration recommendations, and hydration interventions that may contribute to the overall clarity of hydration protocols that may optimize performance and health of firefighters. In addition, the impact of common medications, exercise training, and health conditions on hydration status related to firefighters will be discussed. Methods: A comprehensive literature search was conducted to discuss the purpose statements. Results: Hydration recommendations for firefighters include (1) assessing hydration status with multiple measurements including body mass, urine specific gravity and thirst sensation, and (2) following general hydration recommendations on rest days and exercise hydration protocols during firefighting activities which may be altered according to hydration status measurements. Conclusion: Randomized controlled trials in firefighters are needed to determine the impact of maintaining adequate hydration on health markers.

Assessment of the renal function of patients with anorexia nervosa

BackgroundA decreased glomerular filtration rate (GFR), estimated using creatinine (Cr– eGFR), is often found at the initial presentation of anorexia nervosa (AN). Its pathophysiology has been explained mainly by dehydration, and chronic hypokalemia is also thought to be a cause. However, because we have often experienced cases of AN with decreased Cr-eGFR without these conditions, we must consider different etiologies. The focus of this paper is on low free triiodothyronine (FT3) syndrome. We also discuss the utility of eGFR, estimated using cystatin-C (CysC-eGFR), for these patients.MethodsThe data of 39 patients diagnosed with AN between January 2005 and December 2023 was available for study. The characteristics of patients at the lowest and highest body mass index standard deviation score (BMI-SDS) were examined. Data on the parameters Cr-eGFR, CysC-eGFR, dehydration markers, potassium (K), and hormonal data and BMI-SDS were assessed during the treatment course to evaluate the correlations in these parameters. Blood hematocrit, uric acid (UA), blood urine nitrogen (BUN) level, and urine specific gravity were adopted as dehydration markers; FT3, free thyroxine, thyroid stimulating hormone, and insulin-like growth factor were adopted as hormonal data. Cr-eGFR and simultaneously evaluated dehydration markers, K, or hormonal data were extracted and correlations associated with the changes in BMI-SDS were examined. Furthermore, Cr-eGFR and simultaneously assessed CysC-eGFR were compared.ResultsWhen the BMI-SDS was at the lowest value, low-FT3 syndrome was shown. Severe hypokalemia was not found in our study. A linear relation was not found between Cr-eGFR and BMI-SDS. A statistically significant correlation was found between Cr-eGFR and FT3 (p = 0.0025). Among the dehydration markers, statistically significant correlations were found between Cr-eGFR and BUN or UA. The difference between Cr-eGFR and CysC-eGFR was prominent, and CysC-eGFR showed much higher values.ConclusionsOur data indicates that low-FT3 syndrome and dehydration were related to the renal function of our patients with AN. Furthermore, our data suggest that caution is needed in the interpretation of kidney function evaluation when using CysC-eGFR in cases of AN.

Based on Sportomics: Comparison of Physiological Status of Collegiate Sprinters in Different Pre-Competition Preparation Periods.

This study aimed to assess the impact of pre-competition training by comparing the differences of collegiate sprinters in physiological state between strengthening and tapering training period by sportomics and combining their sport performance. Fifteen collegiate sprinters were investigated or tested on their body composition, dietary habits, energy expenditure, sleep efficiency, heart rate and respiratory rate during training, blood (blood cells, biochemical and immune markers) and urine (urinalysis), gut microbiome distribution, microbiome and blood metabolites, and their functions during the strengthening (Group A) and tapering training period (Group B) prior to competing in the national competitions. We found that 26.67% of sprinters achieved personal bests (PB) after the competition. The limb skeletal muscle mass and lymphocyte ratio of male sprinters in Group B were lower than those in Group A, and the serum creatine kinase (CK) level was higher than Group A (p < 0.05). The levels of serum CK, interleukin-6 (IL-6), interleukin-1β (IL-1β), and urine-specific gravity (SG) of the two groups were higher than the upper limit of the reference value. The detection rates of urine white blood cell (WBC) and protein in Group B were higher than those in Group A. The gut microbiome health index (GMHI) of Group A was higher than that of Group B, and the microbial dysbiosis index was lower than that of Group B. The ratio of Firmicutes/Bacteroidota (F/B) in Group A was higher than that in Group B. There were 65 differential metabolites in the A/B group, and the enriched pathway was mainly the NF-kappa B signaling pathway (up); B/T cell receptor signaling pathway (up); Th1 and Th2 cell differentiation (up); phenylalanine metabolism (up); and growth hormone synthesis, secretion, and action (up). There were significant differences in blood metabolites between the A and B groups, with a total of 89 differential metabolites, and the enriched pathway was mainly the NF-kappa B signaling pathway (up), T cell receptor signaling pathway (up), Th1 and Th2 cell differentiation (up), and glycerophospholipid metabolism (down). In conclusion, the imbalance of the gut microbiome and inflammation and immune-related metabolites of collegiate sprinters during the pre-competition tapering training period may be the cause of their limited sports performance.

Hematological and performance adaptations to altitude training (2,320m) in elite middle-distance and distance swimmers.

Elite swimmers often schedule altitude training camps ahead of major events in an attempt to maximize performance. However, the relationships between altitude-induced hematological changes, markers of training adaptation, and performance changes in such context are unclear. This study assessed hematological status, markers of daily adaptation, and swimming performance in elite middle-distance and distance swimmers during a 22-day altitude training camp at 2,320m, 2weeks prior to World Championship qualification competition. Venous blood was obtained and total hemoglobin mass (tHbmass) measured (CO rebreathing) in 7 elite swimmers (4 females, 3 males) 8days before and on day 22 of the altitude camp. Resting heart rate, peripheral oxygen saturation, urinary specific gravity, body mass, fatigue and self-reported sleep duration and quality were monitored daily during the altitude camp. Swimming performance was assessed through a standardized set (6 sets of 4 maximal repetitions of 100m front crawl) on days 3, 10 and 17 of the camp, and at sea level competitions (200m-1,500m) immediately after the camp, and 2weeks later. tHbmass (+5.6 ± 3.3%; range: 2.1%-11.0%; p < 0.05), red blood cell count, hemoglobin concentration, hematocrit increased at the end of the training camp (p < 0.05). Performance at altitude improved throughout the camp (+1.4 ± 0.4%; range: 0.7%-2.5%; p < 0.05). No significant relationship was noted between hematological changes, the change in altitude performance and any of the monitored daily markers of adaptation during the camp. Compared to the swimmers' previous personal best, competition performances did not improve immediately (2.5% ± 1.9% slower times) and 2weeks after altitude (1.2% ± 1.4% slower times). The 22-day altitude training camp at 2,320m was beneficial for elite swimmers' tHbmass, hematological status and performance at altitude, but these benefits did not clearly translate into enhanced sea level performance immediately after or 2weeks later. The present study confirms the large inter-individual variability in hematological responses to altitude training, and that the improvement in performance at altitude and sea level may depend on factors other than the increase in tHbmass alone.

Effects of fortified electrolyte drink on cognitive, mood, and nutritional parameters: a randomised, single‐blind, placebo‐controlled study

SummaryElectrolyte drinks contain charged minerals and are easily accessible in the market. It has become popular for the food and beverage industry to add nutrients and/or active ingredients to electrolyte drinks and market them as functional beverages. This study aims to determine the interactive effects of electrolyte drinks added caffeine, glucose, and B‐group vitamins (FED) on cognitive, mood index, and nutritional parameters. A total of 34 university students participated in this randomised, single‐blind, and placebo‐controlled study. Participants in the intervention group consumed 500 mL of FED, while participants in the control group consumed 500 mL of an electrolyte drink (ED). Baseline and post‐intervention data on cognitive performance, mood index, blood glucose, blood pressure, heart rate, and urine specific gravity were measured. Results indicated no significant differences (P &gt; 0.05) in post‐intervention cognitive performance scores for simple reaction time, choice reaction time, verbal paired associates, visual paired associates, and digit symbol matching between the FED and ED groups. Levels of fatigue, confusion, and total mood disturbance (TMD) were significantly reduced (P &lt; 0.05) by 46.50%, 62.75%, and 9.54%, respectively, following FED consumption. Post‐intervention data indicated no differences between the FED and ED groups in blood pressure, heart rate, and urine specific gravity, except for the blood glucose parameter, in which the blood glucose level of the FED group was significantly greater (P &lt; 0.05) than that of the ED group. This study indicates that FED consumed in a realistic dose can reduce fatigue, confusion, and TMD. Further studies with a higher caffeine dosage, but within the safe range, could be conducted to investigate the cognitive enhancement potential of FED.

Bioelectrical Impedance Vector Analysis (BIVA) for Assessment of Hydration Status: A Comparison between Endurance and Strength University Athletes.

Athletic performance is greatly impacted by hydration status. The combination of several techniques is recommended to accurately measure water losses and gains. The aim of this study is to assess the validity of bioelectrical impedance vector analysis (BIVA) as a tool for measuring hydration status in endurance and strength athletes. A total of 148 athletes were evaluated on one experimental day, pre- and post-training. Urine samples were collected and analyzed for color and specific gravity. Body weight changes were measured, sweat rate was calculated, and BIVA was performed. Reference ellipses were plotted using data of 200 healthy non-athletic individuals. A moderate significant agreement was noted between raw bioelectrical values and urine specific gravity (USG) (p > 0.05). The sensitivity of classic BIVA in detecting minor changes in hydration status is confirmed both graphically and statistically. R/h and Z statistically significantly decreased post-training. Male athletes exhibited a specific BIA vector distribution compared to the reference population and were slightly more hydrated than female athletes. BIVA validation may be an essential step to allow its use among university students to assess dehydration in a non-invasive, practical, and inexpensive way.

CYSTOCENTESIS AND URINALYSIS IN ZOOMEDICINE: AN UNDERESTIMATED TOOL FOR LARGE FELID STANDARD HEALTH CHECKS.

Chronic kidney disease (CKD) is a prevalent disease among felids; yet its origin is still poorly understood, and the disease often remains asymptomatic for years, underscoring the need for early diagnosis. This study aimed to investigate the diagnostic value of urinalysis in accurately staging CKD, particularly as routine health checks in large felids often overlook its significance. In this research, ultrasound-guided cystocentesis (UGC) was performed on 50 captive nondomestic felids during routine veterinary health checks under general anesthesia. Urinalysis included microscopic examination of the sediment, measurement of urine specific gravity (USG) and protein to creatinine ratio (UPC). Additional serum kidney markers, such as creatinine and symmetric dimethylarginine, were compared with USG and UPC to assess their diagnostic value as urinary biomarkers. The results demonstrated proteinuria (UPC > 0.4) or borderline proteinuria (UPC 0.2-0.4) in 49% of the animals. Among these cases, 62% were of renal origin, and 38% were postrenal causes. USG was significantly higher in felids with borderline proteinuria compared to those with proteinuria. A moderate, but significant negative correlation between serum parameters and USG was observed, emphasizing the importance of assessing both diagnostic parameters during kidney evaluations. Additionally, felids with CKD have an increased risk of urinary tract infections, necessitating microscopic urinalysis and bacterial culture analysis. Abnormalities, including hematuria, pyuria, crystalluria, and bacteriuria, were found in approximately 38% of cases through microscopical examination of urine. No complications associated with UGC were observed and abnormal findings were detected in 60% of the cases. Based on these results, the authors recommend the inclusion of UGC and urinalysis as standard diagnostic tools in general health checks for nondomestic felids. This approach provides valuable insights into the early detection and staging of CKD, supporting early intervention and supportive medical care to prolong renal health in these animals.

Hydration status of esports players in a live competition

Objectives: esports are an increasingly popular activity that involves professional players. Dehydration hinders cognitive performance, on which these competitors rely heavily. This observational study assessed the hydration state of esports players on a competition day and its possible associations with esports and lifestyle-related features.Methods: The hydration status of esports players was assessed on a tournament day through urine-specific gravity and by comparison with the Armstrong urine color chart. Binary logistic regression and univariate analysis of variance were applied to assess the relationships between urine-specific gravity and age, BMI, hours of sleep per day, hours of video game play per day, esports title, physical activity level, and professionalism level.Results: Ninety-eight esports players participated in this study. The average urine-specific gravity, assessed through refractometry, was 1.020 (SD = 0.007) g/cm³. 10.2% were classified as well hydrated, 25.5% with minimal dehydration, 60.2% with significant dehydration, and 4.1% with serious dehydration. Considering the eight-color urine chart method, 16.3% were classified with minimal dehydration, 65.3% with significant dehydration, and 18.4% as serious dehydration. There were no significant associations between hydration status and lifestyle-related variables (p > 0.05). The results of the two methods of assessing hydration status presented a positive, moderate, and statistically significant correlation (r = 0.711, p < 0.001). The agreement between the two classifications was 56.1%, with Cohen’s kappa showing a weak agreement (k = 0.213, p < 0.001) even if with linear (k = 0.330, p < 0.001) or quadratic (k = 0.471, p < 0.001) weighting.

Impact of Skin Care Products on Phthalates and Phthalate Replacements in Children: the ECHO-FGS.

Phthalates and their replacements have been implicated as developmental toxicants. Young children may be exposed to phthalates/replacements when using skin care products (SCPs). Our objective is to assess the associations between use of SCPs and children's urinary phthalate/replacement metabolite concentrations. Children (4-8 years old) from the Environmental Influences on Child Health Outcomes-Fetal Growth Study (ECHO-FGS) cohort provided spot urine samples from 2017 to 2019, and mothers were queried about children's SCP use in the past 24 h (). Concentrations of 16 urinary phthalate/replacement metabolites were determined by liquid chromatography-tandem mass spectrometry (). We used linear regression to estimate the child's use of different SCPs as individual predictors of urinary phthalate/replacement metabolites, adjusted for urinary specific gravity, age, sex assigned at birth, body mass index, and self-reported race/ethnic identity, as well as maternal education, and season of specimen collection. We created self-organizing maps (SOM) to group children into "exposure profiles" that reflect discovered patterns of use for multiple SCPs. Children had lotions applied (43.0%) frequently, but "2-in-1" hair-care products (7.5%), sunscreens (5.9%), and oils (4.3%) infrequently. Use of lotions was associated with 1.17-fold [95% confidence interval (CI): 1.00, 1.34] greater mono-benzyl phthalate and oils with 2.86-fold (95% CI: 1.89, 4.31) greater monoethyl phthalate (MEP), 1.43-fold (95% CI: 1.09, 1.90) greater monobutyl phthalate (MBP), and 1.40-fold (95% CI: 1.22, 1.61) greater low-molecular-weight phthalates (LMW). Use of 2-in-1 haircare products was associated with 0.84-fold (95% CI: 0.72, 0.97) and 0.78-fold (95% CI: 0.62, 0.98) lesser mono(3-carboxypropyl) phthalate (MCPP) and MBP, respectively. Child's race/ethnic identity modified the associations of lotions with LMW, oils with MEP and LMW, sunscreen with MCPP, ointments with MEP, and hair conditioner with MCPP. SOM identified four distinct SCP-use exposure scenarios (i.e., profiles) within our population that predicted 1.09-fold (95% CI: 1.03, 1.15) greater mono-carboxy isononyl phthalate, 1.31-fold (95% CI: 0.98, 1.77) greater mono-2-ethyl-5-hydroxyhexyl terephthalate, 1.13-fold (95% CI: 0.99, 1.29) greater monoethylhexyl phthalate, and 1.04-fold (95% CI: 1.00, 1.09) greater diethylhexyl phthalate. We found that reported SCP use was associated with urinary phthalate/replacement metabolites in young children. These results may inform policymakers, clinicians, and parents to help limit children's exposure to developmental toxicants. https://doi.org/10.1289/EHP13937.

Hubungan Protein Urine dengan Berat Jenis Urine Pada Pasien Gangguan Ginjal

Kidney impairment is a condition where there is a decrease in kidney function. The kidneys filter the blood and excrete metabolic waste through urine. When the kidneys are damaged, the ability of the kidneys to filter blood and excrete waste may decrease. Supporting examination parameters for examining kidney disorders are urinalysis examinations such as Urine Protein and Urine Specific gravity. This study aims to determine the relationship between urine protein and urine specific gravity in patients with kidney disorders. This study was conducted with an analytical observational design with a cross-sectional approach with a sample of 34 samples. The results were tested using the Spearman test. The results showed the highest urine protein level was +4 and the highest urine specific gravity level was 1.005. Spearman test results showed a value of 0.004 (&lt;0.05). There is a relationship between urine protein and urine specific gravity in patients with kidney disorders. Keywords: urine specific gravity, kidney disorders, urine protein