Serum sodium changes in marathon participants who use NSAIDs

IntroductionThe primary mechanism through which the development of exercise-associated hyponatraemia (EAH) occurs is excessive fluid intake. However, many internal and external factors have a role in the maintenance of total body water and non-steroidal anti-inflammatory medications (NSAIDs) have been implicated as a risk factor for the development of EAH. This study aimed to compare serum sodium concentrations ([Na]) in participants taking an NSAID before or during a marathon (NSAID group) and those not taking an NSAID (control group).MethodsParticipants in a large city marathon were recruited during race registration to participate in this study. Blood samples and body mass measurements took place on the morning of the marathon and immediately post marathon. Blood was analysed for [Na]. Data collected via questionnaires included athlete demographics, NSAID use and estimated fluid intake.ResultsWe obtained a full data set for 28 participants. Of these 28 participants, 16 took an NSAID on the day of the marathon. The average serum [Na] decreased by 2.1 mmol/L in the NSAID group, while it increased by 2.3 mmol/L in the control group NSAID group (p=0.0039). Estimated fluid intake was inversely correlated with both post-marathon serum [Na] and ∆ serum [Na] (r=−0.532, p=0.004 and r=−0.405 p=0.032, respectively).ConclusionSerum [Na] levels in participants who used an NSAID decreased over the course of the marathon while it increased in those who did not use an NSAID. Excessive fluid intake during a marathon was associated with a lower post-marathon serum [Na].

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Effects of a 14-Day Hydration Intervention on Individuals with Habitually Low Fluid Intake

Annals of Nutrition and Metabolism ◽

10.1159/000515375 ◽

2021 ◽

Author(s):

Aaron R. Caldwell ◽

Megan E. Rosa-Caldwell ◽

Carson Keeter ◽

Evan C. Johnson ◽

François Péronnet ◽

...

Keyword(s):

Body Weight ◽

Total Body Water ◽

Fluid Intake ◽

Urine Volume ◽

Urine Osmolality ◽

Body Water ◽

Control Group ◽

Intervention Phase ◽

Total Body ◽

Experimental Group

Background: Debate continues over whether or not individuals with low total water intake (TWI) are in a chronic fluid deficit (i.e., low total body water) [<xref ref-type="bibr" rid="ref1">1</xref>]. When women with habitually low TWI (1.6 ± 0.5 L/day) increased their fluid intake (3.5 ± 0.1 L/day) for 4 days 24-h urine osmolality decreased, but there was no change in body weight, a proxy for total body water (TBW) [<xref ref-type="bibr" rid="ref2">2</xref>]. In a small (n = 5) study of adult men, there were no observable changes in TBW, as measured by bioelectrical impedance, after increasing TWI for 4 weeks [<xref ref-type="bibr" rid="ref3">3</xref>]. However, body weight increased and salivary osmolality decreased indicating that the study may have been underpowered to detect changes in TBW. Further, no studies to date have measured changes in blood volume (BV) when TWI is increased. Objectives: Therefore, the purpose of this study was to identify individuals with habitually low fluid intake and determine if increasing TWI, for 14 days, resulted in changes in TBW or BV. Methods: In order to identify individuals with low TWI, 889 healthy adults were screened. Participants with a self-reported TWI less than 1.8 L/day (men) or 1.2 L/day (women), and a 24-h urine osmolality greater than 800 mOsm were included in the intervention phase of the study. For the intervention phase, 15 participants were assigned to the experimental group and 8 participants were assigned to the control group. The intervention period lasted for 14 days and consisted of 2 visits to our laboratory: one before the intervention (baseline) and 14 days into the intervention (14-day follow-up). At these visits, BV was measured using a CO-rebreathe procedure and deuterium oxide (D2O) was administered to measure TBW. Urine samples were collected immediately prior, and 3–8 h after the D2O dose to allow for equilibration. Prior to each visit, participants collected 24-h urine to measure 24-h hydration status. After the baseline visit, the experimental group increased their TWI to 3.7 L for males and 2.7 L for females in order to meet the current Institute of Medicine recommendations for TWI. Results: Twenty-four-hour urine osmolality decreased (−438.7 ± 362.1 mOsm; p < 0.001) and urine volume increased (1,526 ± 869 mL; p < 0.001) in the experimental group from baseline, while there were no differences in osmolality (−74.7 ± 572 mOsm; p = 0.45), or urine volume (−32 ± 1,376 mL; p = 0.89) in the control group. However, there were no changes in BV (Fig. <xref ref-type="fig" rid="f01">1</xref>a) or changes in TBW (Fig. <xref ref-type="fig" rid="f01">1</xref>b) in either group. Conclusions: Increasing fluid intake in individuals with habitually low TWI increases 24-h urine volume and decreases urine osmolality but does not result in changes in TBW or BV. These findings are in agreement with previous work indicating that TWI interventions lasting 3 days [<xref ref-type="bibr" rid="ref2">2</xref>] to 4 weeks [<xref ref-type="bibr" rid="ref3">3</xref>] do not result in changes in TBW. Current evidence would suggest that the benefits of increasing TWI are not related changes in TBW.

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Increasing Water Intake in Chronic Kidney Disease: Why? Safe? Possible?

Annals of Nutrition and Metabolism ◽

10.1159/000381241 ◽

2015 ◽

Vol 66 (Suppl. 3) ◽

pp. 18-21 ◽

Cited By ~ 4

Author(s):

William F. Clark ◽

Jessica M. Sontrop ◽

Louise Moist ◽

S.-H. Huang

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Adverse Effects ◽

Water Intake ◽

Serum Sodium ◽

Fluid Intake ◽

Controlled Trial ◽

Urine Volume ◽

Control Group

Increased water intake may slow the progression of chronic kidney disease by lowering vasopressin levels. Prior to initiating a large randomized controlled trial on the effect of increased water intake on renal decline, we conducted a six-week pilot study to examine the safety and feasibility of asking adults with chronic kidney disease to increase their water intake. We randomly assigned 29 patients to either a hydration or a control group. The hydration group was asked to increase water intake by 1 to 1.5 l/day relative to their weight, gender, and 24 h urine osmolality, in addition to usual consumed beverages; the control group was asked to continue with usual fluid intake. After six weeks, the change in urine volume was significantly different between groups (0.9 l/day; p = 0.002) with no change in serum sodium and no serious adverse effects. Similarly, preliminary results of our large clinical trial of the same intervention (489 patients enrolled to date) demonstrated a significant separation between groups on 24 h urine volume (at 12 months the mean difference between groups was 1.2 l/day; p < 0.001) with no serious adverse effects. Serum sodium has remained stable in both groups over follow-up. To our knowledge, this trial is currently the largest of its kind to date; the significant separation between groups with respect to urine volume indicates that we will have scientifically reliable data on the effect of increased fluid intake on renal decline. The analysis of primary and secondary outcomes will be conducted at the conclusion of follow-up in July 2016.

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Single Instillation of Hypertonic Saline Immediately Following Transurethral Resection of Bladder Tumor for Recurrence Prevention –A Phase I Study

Bladder Cancer ◽

10.3233/blc-200328 ◽

2021 ◽

pp. 1-6

Author(s):

Jonathan Modai ◽

Alexey Kovalyonok ◽

Avigdor Scherz ◽

Dina Preise ◽

Yuval Avda ◽

...

Keyword(s):

Adverse Events ◽

Hypertonic Saline ◽

Serum Sodium ◽

Transurethral Resection ◽

Bladder Tumor ◽

Osmotic Dehydration ◽

Control Group ◽

Plasma Sodium ◽

Pelvic Cavity ◽

Blue Discoloration

BACKGROUND: Urologic guidelines recommend perioperative instillation of chemotherapy after transurethral resection of bladder tumor (TURBT) to decrease tumor recurrence, yet implementation of this recommendation is partial due to associated morbidity. Hypertonic saline destroys cells by osmotic dehydration and might present a safer alternative. OBJECTIVE: To evaluate the safety of 3% hypertonic saline (Hypersal) intravesical instillation following TURBT in rats and in humans. METHODS: In 8 rats whose bladders were electrically injured, intravesical blue-dyed Hypersal was administered. We measured serum sodium levels before and after instillation and pathologically evaluated their pelvic cavity for signs of inflammation or blue discoloration. Twenty-four patients were recruited to the human trial (NIH-NCT04147182), 15 comprised the interventional and 10 the control group (one patient crossed over). Hypersal was given postoperatively. Serum sodium was measured before, 1 hour and 12–24 hours after instillation. Adverse effects were documented and compared between the groups. RESULTS: In rats, average sodium levels were 140.0 mEq/L and 140.3 mEq/L before and following instillation, respectively. Necropsy revealed no signs of inflammation or blue discoloration. In humans the average plasma sodium levels were 138.6 mEq∖L, 138.8 mEq∖L and 137.7 mEq∖L before, 1 hour and 12–24 hours after instillation, respectively. During the postoperative follow-up there was one case of fever. A month after the surgery, dysuria was reported by 5 patients while urgency and hematuria were reported by one patient each. The most severe adverse events were grade 2 on the Clavien-Dindo scale. Adverse events were similar in the control group. CONCLUSIONS: Hypersal instillation is safe and tolerable immediately after TURBT.

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Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽

10.1038/s41393-021-00693-7 ◽

2021 ◽

Author(s):

Helge Kasch ◽

Uffe Schou Løve ◽

Anette Bach Jønsson ◽

Kaare Eg Severinsen ◽

Marc Possover ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Outcome Measures ◽

Outcome Measure ◽

Secondary Outcome ◽

Controlled Study ◽

Control Group ◽

Walking Ability ◽

Data Set ◽

Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

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Back in Time for Breakfast: An Analysis of the Changing Breakfast Cereal Aisle

Nutrients ◽

10.3390/nu13020489 ◽

2021 ◽

Vol 13 (2) ◽

pp. 489

Author(s):

Emilie Croisier ◽

Jaimee Hughes ◽

Stephanie Duncombe ◽

Sara Grafenauer

Keyword(s):

Dietary Fibre ◽

Saturated Fat ◽

Health Claims ◽

Whole Grain ◽

Breakfast Cereal ◽

Full Data ◽

Data Set ◽

Time Points ◽

Total Fat ◽

Over Time

Breakfast cereal improves overall diet quality yet is under constant scrutiny with assertions that the category has not improved over time. This study aimed to comprehensively analyse the category of breakfast cereals, the nutritional values, and health claims across eight distinct sub-categories at four time points (2013, 2015, 2018, and 2020). An audit of products from four major supermarkets in metropolitan Sydney (Aldi, Coles, IGA, and Woolworths) collected ingredient lists, nutrition information, claims and Health Star Rating (HSR) for biscuits and bites; brans; bubbles, puffs, and flakes; granola and clusters; hot cereal flavoured; hot cereal plain; muesli; breakfast biscuits. The median (IQR) were calculated for energy, protein, fat, saturated fat, carbohydrate, sugars, dietary fibre, and sodium for comparisons over time points by nutrient. Data from 2013 was compared with 2020 (by sub-category and then for a sub-section of common products available at each time point). Product numbers between 2013 (n = 283) and 2020 (n = 543) almost doubled, led by granola and clusters. Whole grain cereals ≥ 8 g/serve made up 67% of products (↑114%). While there were positive changes in nutrient composition over time within the full data set, the most notable changes were in the nutrition composition of cereals marketed as the same product in both years (n = 134); with decreases in mean carbohydrate (2%), sugar (10%) and sodium (16%) (p < 0.000), while protein and total fat increased significantly (p = 0.036; p = 0.021). Claims regarding Dietary Fibre and Whole Grain doubled since 2013. Analysis of sub-categories of breakfast cereal assisted in identifying some changes over time, but products common to both timeframes provided a clearer analysis of change within the breakfast category, following introduction of HSR. Whole grain products were lower in the two target nutrients, sodium and sugars, and well-chosen products represent a better choice within this category.

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Osmotically inactive sodium and potassium storage: lessons learned from the Edelman and Boling data

AJP Renal Physiology ◽

10.1152/ajprenal.00215.2016 ◽

2016 ◽

Vol 311 (3) ◽

pp. F539-F547 ◽

Cited By ~ 10

Author(s):

Minhtri K. Nguyen ◽

Dai-Scott Nguyen ◽

Minh-Kevin Nguyen

Keyword(s):

Linear Regression ◽

Measurement Errors ◽

Linear Regression Analysis ◽

Sodium Concentration ◽

Lessons Learned ◽

Dynamic Changes ◽

Data Set ◽

Storage Pool ◽

Total Body ◽

Sodium And Potassium

Because changes in the plasma water sodium concentration ([Na+]pw) are clinically due to changes in the mass balance of Na+, K+, and H2O, the analysis and treatment of the dysnatremias are dependent on the validity of the Edelman equation in defining the quantitative interrelationship between the [Na+]pw and the total exchangeable sodium (Nae), total exchangeable potassium (Ke), and total body water (TBW) (Edelman IS, Leibman J, O'Meara MP, Birkenfeld LW. J Clin Invest 37: 1236–1256, 1958): [Na+]pw = 1.11(Nae + Ke)/TBW − 25.6. The interrelationship between [Na+]pw and Nae, Ke, and TBW in the Edelman equation is empirically determined by accounting for measurement errors in all of these variables. In contrast, linear regression analysis of the same data set using [Na+]pw as the dependent variable yields the following equation: [Na+]pw = 0.93(Nae + Ke)/TBW + 1.37. Moreover, based on the study by Boling et al. (Boling EA, Lipkind JB. 18: 943–949, 1963), the [Na+]pw is related to the Nae, Ke, and TBW by the following linear regression equation: [Na+]pw = 0.487(Nae + Ke)/TBW + 71.54. The disparities between the slope and y-intercept of these three equations are unknown. In this mathematical analysis, we demonstrate that the disparities between the slope and y-intercept in these three equations can be explained by how the osmotically inactive Na+ and K+ storage pool is quantitatively accounted for. Our analysis also indicates that the osmotically inactive Na+ and K+ storage pool is dynamically regulated and that changes in the [Na+]pw can be predicted based on changes in the Nae, Ke, and TBW despite dynamic changes in the osmotically inactive Na+ and K+ storage pool.

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BODY WATER COMPARTMENTS IN THE PREMATURE INFANT, WITH SPECIAL REFERENCE TO THE EFFECTS OF THE RESPIRATORY DISTRESS SYNDROME AND OF MATERNAL DIABETES AND TOXEMIA

PEDIATRICS ◽

10.1542/peds.29.6.883 ◽

1962 ◽

Vol 29 (6) ◽

pp. 883-889

Author(s):

Wesley M. Clapp ◽

L. Joseph Butterfield ◽

Donough O'Brien

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Total Body Water ◽

Distress Syndrome ◽

Body Water ◽

Control Group ◽

Extracellular Water ◽

Water Compartments ◽

Significant Difference ◽

Total Body

Normal values for both total body water and extracellular water have been determined in 86 premature infants aged 1 to 90 days and weighing 940 to 2,435 gm, with use of the techniques of deuterium oxide and bromide dilution. Nine full-term infants aged 1 to 6 days and weighing 2,590 to 4,985 gm were similarly studied. Nine infants with the respiratory distress syndrome and eight infants of toxemic mothers studied in the first 24 hours of life showed no significant difference in their body water compartments in comparison to a control group of normal infants matched for age and weight. Seven infants of diabetic mothers studied in the first 24 hours of life showed a significant decrease in total body water, expressed as percentage of body weight, with a normal intracellular to extracellular water ratio. These data indirectly support other evidence that there is an increase in body fat in these infants at birth. See Table in the PDF file

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Buyer’s Bankruptcy Risk, Sourcing Strategy, and Firm Value: Evidence from the Supplier Protection Act

Management Science ◽

10.1287/mnsc.2021.4270 ◽

2021 ◽

Author(s):

Karca D. Aral ◽

Erasmo Giambona ◽

Ye Wang

Keyword(s):

Operations Management ◽

Financial Distress ◽

Firm Value ◽

Trade Credit ◽

Treated Group ◽

Control Group ◽

Regulatory Change ◽

Data Set ◽

Bankruptcy Risk ◽

Sourcing Strategy

What should a distressed buyer’s sourcing strategy be? We find that this depends on the dynamics in a potential in-court bankruptcy. To establish causality, we use a novel sourcing data set in combination with a unique quasi-natural experimental setting provided by a regulatory shock that significantly strengthened the protection granted to suppliers when a distressed buyer files for bankruptcy: the Supplier Protection Act. We find that, following this regulatory change, the number of suppliers for buyers near financial distress (those most affected by the act, the treated group) increased by nearly 35% relative to financially sound firms (the control group). We also find that this shift allowed distressed buyers to obtain more trade credit, expand inventory holdings, and increase performance, leading to an overall increase in firm value of 7.2%. In turn, these effects led to a sizable reduction in the probability of the affected buyers defaulting and filing for bankruptcy. Our results have important implications for corporate executives: right-sizing the supply base can be critical for buyers near financial distress, and implementing policies to engage and protect suppliers can be the way out of distress. This paper was accepted by Vishal Gaur, operations management.

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Hemostasis in rats with different levels of motor activity after vital stress

Тромбоз, гемостаз и реология ◽

10.25555/thr.2019.3.0893 ◽

2019 ◽

Author(s):

Ю.А. Бондарчук ◽

О.В. Алексеева ◽

И.И. Шахматов ◽

Ю.Б. Лебедева ◽

Е.Ю. Медведева

Keyword(s):

Motor Activity ◽

Male Rats ◽

Control Group ◽

Psychoemotional Stress ◽

Partner Death ◽

Mental Trauma ◽

Total Body ◽

Antithrombin Iii Activity ◽

Different Levels ◽

Body Response

Введение. Психоэмоциональный стресс, связанный с риском для жизни и здоровья (витальный стресс), вызывает комплексную ответную реакцию всего организма. Система гемостаза, обеспечивающая жидкостные характеристики циркулирующей крови, играет существенную роль в формировании процессов адаптации или дезадаптации. Нарушения равновесия в процессах свертывания и противосвертывания вместе с изменениями микроциркуляции являются основой патогенеза острых и хронических заболеваний с развитием тромботических либо геморрагических осложнений. Цель исследования: оценить состояние системы гемостаза у крыс с разным уровнем двигательной активности после острой психогенной травмы в виде витального стресса. Материалы и методы. Исследования выполнены на 44 лабораторных половозрелых крысахсамцах линии Wistar, которые составили 2 экспериментальные группы с низкой (n 15) и высокой (n 15) двигательной активностью и контрольную группу интактных животных (n 14). Спонтанную двигательную активность оценивали с помощью теста открытое поле . В качестве острого психотравмирующего воздействия использовали модель психической травмы у крыс в виде витального стресса, вызванного переживанием гибели партнера от действий хищника. Результаты. Острое психотравмирующее воздействие у животных с низкой двигательной активностью вызывало угнетение агрегации тромбоцитов. В группе животных с высокой двигательной активностью была выявлена гиперкоагуляция по внешнему пути активации плазменного гемостаза, а также на конечных этапах коагуляции. В обеих экспериментальных группах наблюдали укорочение времени полимеризации фибринмономера, снижение уровня фибриногена, а также активности антитромбина III на фоне активации фибринолиза. Заключение. Изменения состояния системы гемостаза у крыс с разным уровнем двигательной активности после острого психоэмоционального стресса имели одинаковую направленность, но различную степень выраженности ответной реакции. Полученные результаты позволяют охарактеризовать однократное психоэмоциональное воздействие как не выходящее за рамки эустресса (по данным коагулограммы). Introduction. Psychoemotional stress associated with the risk to life and health (vital stress) causes a complex total body response. Hemostasis supports fluid characteristics of circulating blood and plays a significant role in the formation of adaptation or disadaptation processes. Imbalance in the processes of coagulation and anticoagulation with microcirculation changes are the basis of pathogenesis of acute and chronic diseases with the development of thrombotic or hemorrhagic complications. Aim: to assess hemostasis state in rats with different levels of motor activity after acute psychogenic trauma (vital stress). Materials and methods. The studies were performed on 44 laboratory matured Wistar male rats that were divided into 2 experimental groups with low (n 15) and high (n 15) motor activity and a control group of intact animals (n 14). Spontaneous motor activity was assessed using the open field test. A model of mental trauma was used for the formation of acute psychotraumatic effect in rats in the form of vital stress caused by the experience of partner death from a predator. Results. Acute psychotraumatic effect in animals with low motor activity caused inhibition of platelet aggregation. In animals with high motor activity, hypercoagulation was revealed in the external pathway of plasma hemostasis activation, as well as at the final stages of coagulation. Shortening of fibrin monomer polymerization time, decreasing of fibrinogen level and antithrombin III activity with fibrinolysis activation were observed in both experimental groups. Conclusion. After acute psychoemotional stress hemostasis changes in rats with different levels of motor activity had the same direction, but different intensity of response. The obtained results allow to characterize a single psychoemotional effect as not exceeding the limits of eustress (according to the coagulogram data).

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EFFECTS OF EXERCISE ON PHYSICAL FITNESS AND ANTHROPOMETRIC VARIABLES IN EX-CRACK COCAINE USERS

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220172304173106 ◽

2017 ◽

Vol 23 (4) ◽

pp. 284-289

Author(s):

Jéssica Abatti Martins ◽

Ana Maria Volpato ◽

Vanise dos Santos Ferreira Viero ◽

Antonio Jose Grande ◽

Leonardo Roever ◽

...

Keyword(s):

Body Composition ◽

Physical Fitness ◽

Crack Cocaine ◽

Controlled Trial ◽

Exercise Group ◽

Control Group ◽

Beneficial Effects ◽

Before And After ◽

Cocaine Users ◽

Total Body

ABSTRACT Introduction: Worldwide cocaine use in all its various forms is increasing; cocaine users exceeded 17 million in the world. In Brazil, this data is also alarming. A survey conducted in 2010 found that the country has more than 900,000 crack-cocaine users. Objective: To evaluate the effects of exercise on anthropometric variables and components of physical fitness in ex-crack cocaine users. Methods: Randomized controlled trial with 20 men, divided into exercise group (n=10) and control group (n=10), admitted to a detoxification center. We assessed the physical fitness components related to health (cardiorespiratory endurance, flexibility, muscular strength/endurance, and body composition) before and after the physical training program. Results: The exercise contributed to the maintenance of anthropometric variables, while the control group had an increased in total body fat and visceral fat. Regarding physical fitness, resistance training led to the increase of most variables studied, particularly strength and cardiorespiratory capacity. On the other hand, the VO2max and the strength of the sedentary subjects were reduced (P<0.05). Conclusion: The exercise showed beneficial effects on the components of physical fitness and maintenance of body composition.

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