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European Journal of Nutrition Mar 2019Athletes in Olympic combat sports experience body water fluctuations resulting from training and intentional dehydration when making weight. Despite the popularity of... (Meta-Analysis)
Meta-Analysis
PURPOSE
Athletes in Olympic combat sports experience body water fluctuations resulting from training and intentional dehydration when making weight. Despite the popularity of urine specific gravity (U) and urine osmolality (U) measurement in characterizing fluid fluctuations, their utility remains questioned. This systematic review/meta-analysis examined the utility of urinary hydration indices in laboratory and field settings in Olympic combat sport athletes.
METHODS
27 articles met the inclusion criteria for systematic review, 15 studies were included in the meta-analysis; with U and U the main outcome variables. Meta-regression analyses evaluated the interrelationship among body mass (B), fluid intake, and urine measures.
RESULTS
Significant U alterations were observed following different sampling time frames: dehydration (ES 0.59; 95% CI 0.46-0.72; p = 0.001), follow-up period (ES 0.31; 95% CI 0.11-0.50; p = 0.002) and rehydration (ES - 0.34; 95% CI - 0.56 to - 0.12; p = 0.003). Direct comparison of laboratory (ES 0.20; 95% CI - 0.19 to 0.59; p = 0.324) and field (ES 0.35; 95% CI 0.14-0.56; p = 0.001) sampling showed marginally trivial and small effects. Small effects on U were observed following dehydration (ES 0.31; 95% CI 0.12-0.74, p = 0.15), follow-up period (ES 0.39; 95% CI 0.08-0.70, p = 0.015) and rehydration (ES - 0.45; 95% CI - 0.60 to 0.30, p = 0.001). Meta-regression analysis suggests only fluid intake predicts U alterations (p = 0.044) during rehydration protocols.
CONCLUSIONS
There were likely small changes in both U and U readings across all experimental conditions, with moderate-to-large heterogeneity in all studies, except for U readings during dehydration protocols. The meta-regression failed to provide conclusive evidence concerning the interrelationship among urine measures, B fluctuations, and fluid intake.
Topics: Adult; Athletes; Dehydration; Drinking; Female; Humans; Male; Osmolar Concentration; Sports; Urinalysis; Water-Electrolyte Balance; Young Adult
PubMed: 30820653
DOI: 10.1007/s00394-019-01937-2 -
Radiology Nov 2022Background Changing iodinated contrast media (ICM) may reduce the risk of recurrent ICM-induced hypersensitivity reactions in patients with a prior reaction. Purpose To... (Meta-Analysis)
Meta-Analysis
Background Changing iodinated contrast media (ICM) may reduce the risk of recurrent ICM-induced hypersensitivity reactions in patients with a prior reaction. Purpose To perform a systematic review on the effectiveness of ICM change in comparison with no change to prevent recurrent ICM immediate hypersensitivity reactions. Materials and methods Multiple data bases were searched without language restriction between January 1990 and August 2021 to identify comparative studies of any design that included patients with a prior ICM hypersensitivity reaction to low-osmolality ICM and re-exposure to intravascular ICM. The methods used included a duplicate assessment of eligibility, double extraction of quantitative data, validity assessment, and random-effects meta-analysis. The primary outcome was the incidence of all-grade immediate recurrent hypersensitivity reactions. Secondary outcomes were the incidence of severe immediate recurrent hypersensitivity reactions and other adverse events associated with ICM change. Results Six retrospective observational studies at moderate to severe risk of bias assessed 7155 adult patients (4329 in the ICM change group and 2826 in the no-change group). Studies adopted nonstandardized switching methods, and the proportions of the ICM change group ranged between 19% (five of 27 examinations) and 80% (3104 of 3880 examinations). A Bayesian meta-analysis revealed that changing ICM was associated with a reduced risk of recurrent hypersensitivity reaction by 61% (risk ratio = 0.39; 95% credible interval [CrI]: 0.24, 0.58). The wide-ranging estimates of risk reduction were not explained by the risk of bias ratings, the event rates in the no-change group, the index-reaction severity, or the co-administered nonstandard premedication. Rare severe recurrent reactions (five studies with five events) precluded a conclusion (risk ratio = 0.34, favoring ICM change; CrI: 0.01, 3.74). Adverse events associated with ICM change were not reported. Conclusion In observational evidence of limited quality, iodinated contrast media (ICM)-change was associated with a reduced risk of recurrent immediate hypersensitivity reaction in patients with a prior ICM-induced hypersensitivity reaction. © RSNA, 2022 See also the editorial by McDonald in this issue.
Topics: Adult; Humans; Contrast Media; Retrospective Studies; Bayes Theorem; Iodine Compounds; Hypersensitivity, Immediate; Hypersensitivity
PubMed: 35852428
DOI: 10.1148/radiol.220370 -
Journal of the American College of... Feb 2021Frequent monitoring of hydration status may help to avoid the adverse effects of dehydration. Other than urine color assessment, hydration assessment methods are largely...
Frequent monitoring of hydration status may help to avoid the adverse effects of dehydration. Other than urine color assessment, hydration assessment methods are largely impractical for the general population and athletes to implement on a routine basis. Despite its widespread use, the validity of urine color as an indicator of hydration status has not been systematically evaluated. The objective of this systematic review is to determine the validity of urine color evaluation as a hydration status assessment method in the general adult population, older adults, and athletes. Using the PRISMA guidelines, electronic databases were searched to identify original research articles of all study design types for inclusion. Of the 424 articles screened, 10 met inclusion criteria. Most studies compared urine color to either urinary specific gravity or urine osmolality, and reported significant associations (r) ranging from 0.40 to 0.93. Lower correlations were noted in studies of adults aged >60 years. Studies generally reported a high sensitivity of urine color as a diagnostic tool for detecting dehydration and supported the ability of this method to distinguish across categories of hydration status. Research is needed to determine if clinicians, patients, and clients can accurately utilize this method in clinical and real-world settings. Future research is also needed to extend these findings to other populations, such as children.Key teaching pointsInadequate hydration can lead to impairments in physical performance and cognitive function.Methods used to assess hydration status include plasma/serum osmolality, urinary specific gravity (USG), urine osmolality (Uosm), change in body weight, urine volume, and urine color.Urine color assessment is a practical method that is routinely used in clinical, athletic, and other settings. The validity of this method has not been systemically evaluated.Available research was limited to 10 articles.Validity of this method was generally supported; however, research has not investigated the validity of this method by clinicians, patients and clients.
Topics: Aged; Athletes; Biomarkers; Child; Dehydration; Humans; Osmolar Concentration; Urinalysis; Urine
PubMed: 32330109
DOI: 10.1080/07315724.2020.1750073 -
European Journal of Sport Science Jul 2020Pre-exercise hypohydration can impair soccer performance and has been extensively studied in different soccer populations. Therefore, the aim of this systematic review...
Pre-exercise hypohydration can impair soccer performance and has been extensively studied in different soccer populations. Therefore, the aim of this systematic review was to report hypohydration prevalence, measured by blood or urine samples, in different soccer populations based on sex (males and females), performance level (professional and recreational players) and context (training sessions and games). The Pubmed, Web of Science and SPORTDiscus databases were systematically searched until November 2018. Data were pooled to compare hypohydration prevalence between the different subgroups. Following the systematic search selection process, 24 studies were included. The results indicated that overall pre-exercise hypohydration prevalence was 63.3%, 37.4% and 58.8% for urine specific gravity (USG), urine osmolality (U Osm) and urine colour, respectively. Furthermore, no study implemented blood samples to examine hypohydration prevalence in soccer players. The subgroup analyses using USG data indicated that pre-exercise hypohydration prevalence was significantly higher amongst males (66.0%; = 0.001), professional soccer players (66.2%; = 0.020) and before a training session (79.6%; < 0.001). Pre-exercise hypohydration prevalence was 46.8% among female soccer players, 55.6% in recreational soccer players and 41,3% before a game. The subgroup analyses using U Osm data indicated that hypohydration prevalence was significantly higher before a training session (52.6%; = 0.023). Based on these results, it can be concluded that hypohydration prevalence in soccer players is of major concern. Future research should explore how pre-exercise hydration status can be improved in a sustainable way.
Topics: Athletic Performance; Bias; Cohort Studies; Cross-Sectional Studies; Dehydration; Female; Humans; Male; Osmolar Concentration; Prevalence; Sex Factors; Soccer; Specific Gravity; Urinalysis; Urine
PubMed: 31526234
DOI: 10.1080/17461391.2019.1669716 -
Diagnostics (Basel, Switzerland) Apr 2024: To evaluate the clinical usefulness of demographic data, fetal imaging findings and urinary analytes were used for predicting poor postnatal renal function in children... (Review)
Review
: To evaluate the clinical usefulness of demographic data, fetal imaging findings and urinary analytes were used for predicting poor postnatal renal function in children with congenital megacystis. : A systematic review was conducted in MEDLINE's electronic database from inception to December 2023 using various combinations of keywords such as "luto" [All Fields] OR "lower urinary tract obstruction" [All Fields] OR "urethral valves" [All Fields] OR "megacystis" [All Fields] OR "urethral atresia" [All Fields] OR "megalourethra" [All Fields] AND "prenatal ultrasound" [All Fields] OR "maternal ultrasound" [All Fields] OR "ob-stetric ultrasound" [All Fields] OR "anhydramnios" [All Fields] OR "oligohydramnios" [All Fields] OR "renal echogenicity" [All Fields] OR "biomarkers" [All Fields] OR "fetal urine" [All Fields] OR "amniotic fluid" [All Fields] OR "beta2 microglobulin" [All Fields] OR "osmolarity" [All Fields] OR "proteome" [All Fields] AND "outcomes" [All Fields] OR "prognosis" [All Fields] OR "staging" [All Fields] OR "prognostic factors" [All Fields] OR "predictors" [All Fields] OR "renal function" [All Fields] OR "kidney function" [All Fields] OR "renal failure" [All Fields]. Two reviewers independently selected the articles in which the accuracy of prenatal imaging findings and fetal urinary analytes were evaluated to predict postnatal renal function. : Out of the 727 articles analyzed, 20 met the selection criteria, including 1049 fetuses. Regarding fetal imaging findings, the predictive value of the amniotic fluid was investigated by 15 articles, the renal appearance by 11, bladder findings by 4, and ureteral dilatation by 2. The postnatal renal function showed a statistically significant relationship with the occurrence of oligo- or anhydramnion in four studies, with an abnormal echogenic/cystic renal cortical appearance in three studies. Single articles proved the statistical prognostic value of the amniotic fluid index, the renal parenchymal area, the apparent diffusion coefficient (ADC) measured on fetal diffusion-weighted MRI, and the lower urinary tract obstruction (LUTO) stage (based on bladder volume at referral and gestational age at the appearance of oligo- or anhydramnios). Regarding the predictive value of fetal urinary analytes, sodium and β2-microglobulin were the two most common urinary analytes investigated (n = 10 articles), followed by calcium (n = 6), chloride (n = 5), urinary osmolarity (n = 4), and total protein (n = 3). Phosphorus, glucose, creatinine, and urea were analyzed by two articles, and ammonium, potassium, N-Acetyl-l3-D-glucosaminidase, and microalbumin were investigated by one article. The majority of the studies (n = 8) failed to prove the prognostic value of fetal urinary analytes. However, two studies showed that a favorable urinary biochemistry profile (made up of sodium < 100 mg/dL; calcium < 8 mg/dL; osmolality < 200 mOsm/L; β2-microglobulin < 4 mg/L; total protein < 20 mg/dL) could predict good postnatal renal outcomes with statistical significance and urinary levels of β2-microglobulin were significantly higher in fetuses that developed an impaired renal function in childhood (10.9 ± 5.0 mg/L vs. 1.3 ± 0.2 mg/L, -value < 0.05). : Several demographic data, fetal imaging parameters, and urinary analytes have been shown to play a role in reliably triaging fetuses with megacystis for the risk of adverse postnatal renal outcomes. We believe that this systematic review can help clinicians for counseling parents on the prognoses of their infants and identifying the selected cases eligible for antenatal intervention.
PubMed: 38611669
DOI: 10.3390/diagnostics14070756 -
Archives of Gynecology and Obstetrics Sep 2022Acute Sheehan's syndrome is a rare, but potentially life-threatening, obstetric event that can be complicated by diabetes insipidus. Little information on the diagnosis...
PURPOSE
Acute Sheehan's syndrome is a rare, but potentially life-threatening, obstetric event that can be complicated by diabetes insipidus. Little information on the diagnosis and treatment of Sheehan's syndrome with diabetes insipidus is available. We report on a 28-year-old patient who developed acute Sheehan's syndrome with diabetes insipidus after giving birth, and on a systematic review of similar cases.
METHODS
We performed a systematic review of the literature cataloged in PubMed and Google Scholar using the keywords "Sheehan syndrome" OR "Sheehan's syndrome" AND "diabetes insipidus" to identify relevant case reports published between 1990 and 2021. Eight Reports met the inclusion criteria (English-language abstracts available, onset in the puerperium, information about the day of the onset).
RESULTS
In the present case, postpartum curettage was necessary to remove the residual placenta. The total amount of blood loss was severe (2500 ml). On the second day postpartal, the patient developed polyuria. Laboratory analysis revealed hypernatremia with increased serum osmolality and decreased urinary osmolality. Hormone analysis showed partial hypopituitarism involving the thyroid, corticotropic, and gonadotropic axes. The prolactin level was elevated. Brain magnetic resonance imaging showed pituitary gland infarction. Desmopressin therapy was initiated and resolved the polyuria. Hormone replacement therapy was administered. Four months later, the patient was well, with partial diabetes insipidus. The literature review indicated that this case was typical in terms of symptoms and disease onset. Most reported cases involve hypotension and peripartum hemorrhage, but some patients without hemorrhage also develop Sheehan's syndrome. Elevated prolactin levels are uncommon and associated with poor prognosis in patients with Sheehan's syndrome.
CONCLUSION
Acute Sheehan's syndrome with diabetes insipidus involves nearly all pituitary hormone axes, indicating severe disease. Prolactin elevation could suggest that a case of Sheehan's syndrome is severe.
Topics: Adult; Diabetes Mellitus; Female; Humans; Hypopituitarism; Polyuria; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Prolactin
PubMed: 34779875
DOI: 10.1007/s00404-021-06294-2 -
Progress in Lipid Research Nov 2020Fish are the main source of long-chain polyunsaturated fatty acids (LC-PUFA, >C) for human consumption. In general, it has been widely observed that the fatty acid (FA)...
Fish are the main source of long-chain polyunsaturated fatty acids (LC-PUFA, >C) for human consumption. In general, it has been widely observed that the fatty acid (FA) profiles of farmed fish are reflective of the diet. However, the degree of tissue FA "distortion" based on incorporation of different dietary FA into fish tissues varies greatly depending on FA type, fish species and environmental factors. In terms of fish FA composition, this variation has not been comprehensively reviewed, raising the question: "Are fish what they eat?". To date, this remains unanswered in detail. To this end, the present review quantitatively summarized the 'diet-fish' FA relationship via an analysis of FA composition in diets and fish tissues from 290 articles published between 1998 and 2018. Comparison of this relationship among different fish species, tissue types or individual FA was summarized. Furthermore, the influence of environmental factors such as temperature and salinity, as well as of experimental conditions such as fish size and trophic level, feeding duration, and dietary lipid level on this relationship are discussed herein. Moreover, as a means of restoring LC-PUFA in fish, an emphasis was paid to the fish oil finishing strategy after long-term feeding with alternative lipid sources. It is envisaged that the present review will be beneficial in providing a more comprehensive understanding of the fundamental relationship between the FA composition in diets, and subsequently, in the farmed fish. Such information is integral to maintaining the quality of farmed fish fillets from the perspective of FA composition.
Topics: Animal Nutritional Physiological Phenomena; Animals; Aquaculture; Body Size; Circadian Rhythm; Fatty Acids; Fishes; Salinity; Species Specificity; Temperature; Tissue Distribution
PubMed: 33010278
DOI: 10.1016/j.plipres.2020.101064 -
Environmental Research Jun 2024Oysters are enriched with high-quality protein and are widely known for their exquisite taste. The production of oysters plays an important role in the local economies... (Review)
Review
Oysters are enriched with high-quality protein and are widely known for their exquisite taste. The production of oysters plays an important role in the local economies of coastal communities in many countries, including Atlantic Canada, because of their high economic value. However, because of the changing climatic conditions in recent years, oyster aquaculture faces potentially negative impacts, such as increasing water acidification, rising water temperatures, high salinity, invasive species, algal blooms, and other environmental factors. Although a few isolated effects of climate change on oyster aquaculture have been reported in recent years, it is not well understood how climate change will affect oyster aquaculture from a systematic perspective. In the first part of this study, we present a systematic review of the impacts of climate change and some key environmental factors affecting oyster production on a global scale. The study also identifies knowledge gaps and challenges. In addition, we present key research directions that will facilitate future investigations.
Topics: Climate Change; Animals; Aquaculture; Ostreidae; Salinity
PubMed: 38437901
DOI: 10.1016/j.envres.2024.118561 -
Medicina Oral, Patologia Oral Y Cirugia... Mar 2021Drooling is a major morbidity in several neurological diseases. Intraglandular botulinum neurotoxin (BoNT) injections have been used to manage this condition. However,...
BACKGROUND
Drooling is a major morbidity in several neurological diseases. Intraglandular botulinum neurotoxin (BoNT) injections have been used to manage this condition. However, by decreasing salivary flow, BoNT injections may result in an increased risk of caries and other oral adverse effects. In this study, we aimed to assess whether, in patients with drooling, intraglandular BoNT injections are associated with increased dental caries development, modifications on salivary composition (oral pH, buffering capacity and osmolality) and cariogenic bacterial load.
MATERIAL AND METHODS
We performed a systematic review, searching PubMed, CENTRAL, Web of Science, and Scopus for all experimental and observational studies reporting on adverse effects of intraglandular BoNT injections in patients with drooling. Primary study selection, quality assessment, and data extraction were independently performed by two researchers. No studies were excluded based on their language, publication status or date of publication. Studies' quality was based on revised Cochrane Risk of Bias tools. Meta-analysis was not performed.
RESULTS
We retrieved 1025 studies, of which 5 were included. Two studies were two randomized controlled trials and three quasi-experimental studies. None of the included studies found BoNT injections to be associated with dental caries development or with significant reductions in oral pH. One of the included primary studies even observed an increase in salivary buffer capacity. One study found an increase in Lactobacilli counts. As for the risk of bias, two studies were classified as having a critical risk, two as high risk and one as having some concerns.
CONCLUSIONS
Currently, there is no evidence that, in patients with drooling, BoNT injections associate with increased risk of dental caries or disturbances in oral pH or salivary buffering capacity. However, the included primary studies had important limitations and differences in their methodologies.
Topics: Botulinum Toxins, Type A; Cerebral Palsy; Dental Caries; Humans; Neuromuscular Agents; Oral Health; Sialorrhea
PubMed: 33340083
DOI: 10.4317/medoral.24101 -
Environmental Research Feb 2023The incorporation of a spacer among membranes has a major influence on fluid dynamics and performance metrics. Spacers create feed channels and operate as turbulence...
The incorporation of a spacer among membranes has a major influence on fluid dynamics and performance metrics. Spacers create feed channels and operate as turbulence promoters to increase mixing and reduce concentration/temperature polarization effects. However, spacer geometry remains unoptimized, and studies continue to investigate a wide range of commercial and custom-made spacer designs. The in-depth discussion of the present systematic review seeks to discover the influence of Reynolds number or solution flowrate on flow hydrodynamics throughout a spacer-filled channel. A fast-flowing solution sweeping one membrane's surface first, then the neighboring membrane's surface produces good mixing action, which does not happen commonly at laminar solution flowrates. A sufficient flowrate can suppress the polarization layer, which may normally require the utilization of a simple feed channel rather than complex spacer configurations. When a recirculation eddy occurs, it disrupts the continuous flow and effectively curves the linear fluid courses. The higher the flowrate, the better the membrane performance, the higher the critical flux (or recovery rate), and the lower the inherent limitations of spacer design, spacer shadow effect, poor channel hydrodynamics, and high concentration polarization. In fact, critical flow achieves an acceptable balance between improving flow dynamics and reducing the related trade-offs, such as pressure losses and the occurrence of concentration polarization throughout the cell. If the necessary technical flowrate is not used, the real concentration potential for transport is relatively limited at low velocities than would be predicted based on bulk concentrations. Electrodialysis stack therefore may suffer from the dissociation of water molecules. Next studies should consider that applying a higher flowrate results in greater process efficiency, increased mass transfer potential at the membrane interface, and reduced stack thermal and electrical resistance, where pressure drop should always be indicated as a consequence of the spacer and circumstances used, rather than a problem.
Topics: Hydrodynamics; Membranes, Artificial; Water Purification; Salinity; Dialysis; Electrochemistry
PubMed: 36574794
DOI: 10.1016/j.envres.2022.115115