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Turkish Journal of Medical Sciences 2024Nocturnal enuresis can be frustrating for children and their families as the child ages. Our aim is to evaluate urine aquaporin 2 (AQP-2) as a noninvasive biomarker of...
BACKGROUND/AIM
Nocturnal enuresis can be frustrating for children and their families as the child ages. Our aim is to evaluate urine aquaporin 2 (AQP-2) as a noninvasive biomarker of water balance in children with primary monosymptomatic nocturnal enuresis (PMNE).
MATERIAL AND METHODS
The study included 90 children; sixty-eight children suffering from PMNE aged (9.57 ± 2.16) years and 22 healthy children with good toilet control, matched sex and age. All enuretic children were subjected to complete history taking, clinical evaluation, and bed wetting diary. Serum arginine vasopressin (AVP) and urine AQP-2 were tested in the morning (at 9-11 am) and evening (at 9-11 pm). Blood urea, creatinine, Na, glucose, urine osmolality, Ca/Cr, Alb/Cr and specific gravity were tested simultaneously.
RESULTS
Serum AVP, urine AQP-2, and urine osmolality were statistically lower in patients than controls. Patients had a significantly lower level of night serum AVP concentrations, urine AQP-2, and urine osmolality than the corresponding morning level. Urine AQP-2 was significantly correlated with urine osmolality (p < 0.05). AQP-2 had a sensitivity of 90% and a specificity of 70%. However, no statistically significant correlation was found between serum AVP and urine AQP-2.
CONCLUSION
Primary monosymptomatic nocturnal enuresis in children could be associated with reduction of urine excretion of AQP-2 at night. Urine AQP-2 is significantly correlated with urine osmolality. Therefore, it may be a noninvasive biomarker of hydration status in children with PMNE, with good sensitivity and specificity.
Topics: Humans; Child; Nocturnal Enuresis; Male; Female; Aquaporin 2; Circadian Rhythm; Biomarkers; Osmolar Concentration; Case-Control Studies; Arginine Vasopressin; Adolescent
PubMed: 38812639
DOI: 10.55730/1300-0144.5780 -
ACS Pharmacology & Translational Science Jul 2023This Viewpoint identifies some of the pitfalls in the bioavailability of water-soluble drugs and introduces a novel bias we term the "hypohydration bias". We suggest...
This Viewpoint identifies some of the pitfalls in the bioavailability of water-soluble drugs and introduces a novel bias we term the "hypohydration bias". We suggest that future bioavailability studies take some important neglected confounding factors into account, and we propose that, to avoid such a bias, some relevant variables such as serum and urine osmolality, dry weight adjustment, fluid balance, semi-nude body mass, saliva osmolality, saliva total protein concentration, and urine specific gravity should be controlled to increase the precision of the bioavailability measurements. We suggest that a new definition of hydration status is needed, and that systematic protocols of bioavailability studies should be revisited.
PubMed: 37470021
DOI: 10.1021/acsptsci.3c00089 -
Cryobiology Dec 2023The cornea is the transparent tissue in front of the eye that bends light to help the eye focus. More than five million people's vision can be restored by a corneal...
The cornea is the transparent tissue in front of the eye that bends light to help the eye focus. More than five million people's vision can be restored by a corneal transplant (keratoplasty), but there is a scarcity of suitable donor tissue. Cryopreservation could potentially increase the on-demand availability of corneas by reducing expiration and contamination during hypothermic storage, and allow equitable distribution. Understanding the transport of water and cryoprotectants across the tissue is important in developing effective cryopreservation protocols. Here, we first measured the shrinking and swelling kinetics at 22 °C and 0 °C of porcine corneoscleral discs when exposed to phosphate-buffered saline and to a cryoprotectant vehicle solution containing 2.5% chondroitin sulfate and 1% dextran. Other valuable measurements were made including the density and osmolality of the vehicle solution at 0 °C, and the water fraction of porcine cornea and sclera. Using the knowledge gained from this first part to minimize background swelling, we then examined permeation kinetics of dimethyl sulfoxide (MeSO) in porcine corneoscleral discs at 0 °C, the temperature at which cryoprotectant loading typically occurs. The concentration data obtained as a function of time were fitted to a Fick's law model of one-dimensional diffusion to measure an effective diffusion coefficient of MeSO, which was found to be 5.306×10 m/s. We further quantified permeation kinetics of MeSO in sclera alone at 0 °C to support our hypothesis that our measurements for corneoscleral discs will not be affected by the presence of the sclera. The obtained effective diffusion coefficient can be used in modelling aimed at developing cryopreservation protocols that minimize the exposure time of the corneas during the cryoprotectant loading step.
Topics: Humans; Animals; Swine; Dimethyl Sulfoxide; Cryopreservation; Cornea; Cryoprotective Agents; Water
PubMed: 37572874
DOI: 10.1016/j.cryobiol.2023.104566 -
Frontiers in Pediatrics 2023Perturbation of osmolality is associated with increased mortality in adults and children in critically ill conditions. However, it is still unclear whether osmolality...
BACKGROUND
Perturbation of osmolality is associated with increased mortality in adults and children in critically ill conditions. However, it is still unclear whether osmolality imbalance impacts the prognosis of critically ill infants. This study aimed to investigate the relationship between plasma osmolality and prognosis in critically ill infants within 24 h of admission.
METHODS
This retrospective study enrolled 1,042 infants who had plasma osmolality data from 2010 to 2018. The initial plasma osmolality (within 24 h after admission) was extracted from the pediatric intensive care database (PIC V1.1). The locally weighted scatter-plot smoothing (LOWESS) and restricted cubic splines (RCS) methods were used to explore the approximate relationship between plasma osmolality and in-hospital mortality. Univariate and multivariate logistic regression analyses were used to further analyse this relationship. Kaplan-Meier analysis was applied to estimate the probability of hospital mortality within 90 days of admission. Subgroup analysis was employed to assess the impact of potential confounders (including postnatal days, gender, and gestational age).
RESULTS
An approximately"U"-shaped relationship between plasma osmolality and mortality was detected. In the logistic regression model, plasma osmolality <270 mmol/L (low osmolality group) was significantly associated with in-hospital mortality (0.05; OR 2.52; 95% CI, 1.15-5.06). Plasma osmolality >300 mmol/L (high osmolality group) was also significantly associated with mortality (0.05; OR 3.52; 95% CI, 1.16-8.83). This association remained even after multivariable adjustments. The 90-day survival rate was lower in the abnormal plasma osmolality group (including high or low osmolality groups) than in the intermediate group (log-rank test, 0.05). The abnormal plasma osmolality group had a significantly higher incidence of all-cause mortality in the 0-7 postnatal days subgroup (high osmolality group, 0.05; OR 5.25; low osmolality group, 0.05; OR 3.01). Infants with abnormal osmolality had a significantly higher mortality rate in the female group (0.05). High osmolality was associated with a higher mortality rate in the preterm group (0.05).
CONCLUSIONS
Both hypoosmolality and hyperosmolality were shown to be independently associated with increased risk of in-hospital infant mortality in NICUs.
PubMed: 37772037
DOI: 10.3389/fped.2023.1173133 -
The Oncologist Aug 2023A protocol was developed to evaluate the value of an NK-1 receptor antagonist for preventing nausea and vomiting resulting from highly emetogenic chemotherapy when an... (Randomized Controlled Trial)
Randomized Controlled Trial
Olanzapine With or Without Fosaprepitant for Preventing Chemotherapy Induced Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy: A Phase III Randomized, Double-Blind, Placebo-Controlled Trial (ALLIANCE A221602).
PURPOSE
A protocol was developed to evaluate the value of an NK-1 receptor antagonist for preventing nausea and vomiting resulting from highly emetogenic chemotherapy when an olanzapine-based antiemetogenic regimen was used.
MATERIALS AND METHODS
A221602, a prospective double-blind, placebo-controlled clinical trial, was developed to compare 2 -olanzapine-containing antiemetic regimens, one with an NK-1 receptor antagonist (aprepitant or fosaprepitant) and one without. Trial patients had a malignant disease for which they received intravenous highly emetogenic chemotherapy (single day cisplatin ≥ 70 mg/m2 or doxorubicin plus cyclophosphamide on 1 day). Patients on both arms received commonly administered doses of a 5-HT3 receptor antagonist, dexamethasone, and olanzapine. Additionally, patients were randomized to receive an NK-1 receptor antagonist (fosaprepitant 150 mg IV or aprepitant 130 mg IV) or a corresponding placebo. The primary objective was to compare the proportion of patients with no nausea for 5 days following chemotherapy between the 2 study arms. This trial was designed to test for the noninferiority of deleting the NK-1 receptor antagonist, with noninferiority defined as a decrease in freedom from nausea by less than 10%.
RESULTS
A total of 690 patients were entered on this trial, 50% on each arm. The proportion of patients without nausea for the complete 5-day study period was 7.4% lower (upper limit of the one-sided 95% confidence interval was 13.5%) in the arm without an NK-1 receptor antagonist compared with the arm with an NK-1 receptor antagonist.
CONCLUSION
This trial did not provide sufficient evidence to support that deletion of the NK-1 receptor antagonist was as good as keeping it, as a part of a 4-drug antiemetic regimen for highly emetogenic chemotherapy (ClinicalTrials.gov Identifier: NCT03578081).
Topics: Humans; Antiemetics; Olanzapine; Aprepitant; Prospective Studies; Receptors, Neurokinin-1; Vomiting; Nausea; Antineoplastic Agents; Double-Blind Method; Dexamethasone
PubMed: 37284847
DOI: 10.1093/oncolo/oyad140 -
Journal of Veterinary Internal Medicine 2023Heart failure-associated hypochloremia can be depletional from diuretics or dilutional from water retention. Serum osmolality reflects water balance but has not been...
BACKGROUND
Heart failure-associated hypochloremia can be depletional from diuretics or dilutional from water retention. Serum osmolality reflects water balance but has not been evaluated in dogs with heart disease.
HYPOTHESIS
To determine if serum osmolality is related to heart disease stage and amount of mathematical correction of serum chloride (Cl ) concentrations in healthy dogs and dogs with myxomatous mitral valve degeneration (MMVD).
ANIMALS
Seventy-seven dogs (20 healthy, 25 Stage B MMVD, 32 Stage C/D MMVD).
METHODS
Serum Cl concentrations were mathematically corrected. Osmolality was calculated (calOsm) and directly measured by freezing point depression (dmOsm) and compared by Bland-Altman analysis. Biochemical variables and osmolality were compared among healthy, Stage B, and Stage C/D dogs. Correlations were explored between osmolality and biochemical variables. Median and range are presented. P < .05 was considered significant.
RESULTS
The calOsm was different among groups (P = .003), with Stage B (310 mOsm/kg; 306, 316) and C/D dogs (312 mOsm/kg; 308, 319) having higher calOsm than healthy dogs (305 mOsm/kg; 302, 308). Osmolality methods were moderately correlated (P < .0001, r = .46) but with proportional bias and poor agreement. The amount of Cl correction was negatively correlated with calOsm (P < .0001, r = -.78) and dmOsm (P = .004, r = -.33). Serum bicarbonate concentration was negatively correlated with Cl (P < .0001, r = -.67).
CONCLUSIONS AND CLINICAL IMPORTANCE
Dogs with Stage B and Stage C/D heart disease had higher calOsm than healthy dogs. Osmolality was inversely related to the amount of Cl correction, which supports its use in assessing relative body water content. Poor agreement between calOsm and dmOsm prevents methodological interchange.
Topics: Dogs; Animals; Chlorides; Heart Diseases; Mitral Valve Prolapse; Heart Failure; Osmolar Concentration; Water; Dog Diseases
PubMed: 37702389
DOI: 10.1111/jvim.16863 -
MBio Aug 2023Changes to gut environmental factors such as pH and osmolality due to disease or drugs correlate with major shifts in microbiome composition; however, we currently...
Changes to gut environmental factors such as pH and osmolality due to disease or drugs correlate with major shifts in microbiome composition; however, we currently cannot predict which species can tolerate such changes or how the community will be affected. Here, we assessed the growth of 92 representative human gut bacterial strains spanning 28 families across multiple pH values and osmolalities . The ability to grow in extreme pH or osmolality conditions correlated with the availability of known stress response genes in many cases, but not all, indicating that novel pathways may participate in protecting against acid or osmotic stresses. Machine learning analysis uncovered genes or subsystems that are predictive of differential tolerance in either acid or osmotic stress. For osmotic stress, we corroborated the increased abundance of these genes during osmotic perturbation. The growth of specific taxa in limiting conditions in isolation correlated with survival in complex communities and in an mouse model of diet-induced intestinal acidification. Our data show that stress tolerance results are generalizable and that physical parameters may supersede interspecies interactions in determining the relative abundance of community members. This study provides insight into the ability of the microbiota to respond to common perturbations that may be encountered in the gut and provides a list of genes that correlate with increased ability to survive in these conditions. IMPORTANCE To achieve greater predictability in microbiota studies, it is crucial to consider physical environmental factors such as pH and particle concentration, as they play a pivotal role in influencing bacterial function and survival. For example, pH is significantly altered in various diseases, including cancers, inflammatory bowel disease, as well in the case of over-the-counter drug use. Additionally, conditions like malabsorption can affect particle concentration. In our study, we investigate how changes in environmental pH and osmolality can serve as predictive indicators of bacterial growth and abundance. Our research provides a comprehensive resource for anticipating shifts in microbial composition and gene abundance during complex perturbations. Moreover, our findings underscore the significance of the physical environment as a major driver of bacterial composition. Finally, this work emphasizes the necessity of incorporating physical measurements into animal and clinical studies to better understand the factors influencing shifts in microbiota abundance.
Topics: Humans; Animals; Mice; Gastrointestinal Microbiome; Microbiota; Bacteria; Osmolar Concentration; Hydrogen-Ion Concentration
PubMed: 37432034
DOI: 10.1128/mbio.00753-23 -
Cells Jul 2023Modern irrigation practices and industrial pollution can contribute to the simultaneous occurrence of salinity and heavy metal contamination in large areas of the world,...
Enhanced Physiological and Biochemical Performance of Mung Bean and Maize under Saline and Heavy Metal Stress through Application of Endophytic Fungal Strain SL3 and Exogenous IAA.
Modern irrigation practices and industrial pollution can contribute to the simultaneous occurrence of salinity and heavy metal contamination in large areas of the world, resulting in significant negative effects on crop productivity and sustainability. This study aimed to investigate the growth-promoting potentials of an important endophytic fungal strain SL3 and to compare its potential with exogenous IAA (indole-3-acetic acid) in the context of salt and heavy metal stress. The strain was assessed for plant growth-promoting traits such as the production of indole-3-acetic acid, gibberellins (GA), and siderophore. We selected two important crops, mung bean and maize, and examined various physiological and biochemical characteristics under 300 mM NaCl and 2.5 mM Pb stress conditions, with and without the application of IAA and SL3. This study's results demonstrated that both IAA and SL3 positively impacted the growth and development of plants under normal and stressed conditions. In NaCl and Pb-induced stress conditions, the growth of mung bean and maize plants was significantly reduced. However, the application of IAA and SL3 helped to alleviate stress, leading to a significant increase in shoot/root length and weight compared to IAA and SL3 non-treated plants. The results revealed that photosynthetic pigments, accumulation of catalase (CAT), phenolic contents, polyphenol oxidase, and flavanols are higher in the IAA and SL3-treated plants than in the non-inoculated plants. This study's findings revealed that applying the SL3 fungal strain positively influenced various physiological and biochemical processes in tested plant species under normal and stress conditions of NaCl and Pb. These findings also suggested that SL3 could be a potential replacement for widely used IAA to promote plant growth by improving photosynthetic efficiency, reducing oxidative stress, and enhancing metabolic activities in plants, including mung and maize. Moreover, this study highlights that SL3 has synergistic effects with IAA in enhancing resilience to salt and heavy stress and offers a promising avenue for future agricultural applications in salt and heavy metal-affected regions.
Topics: Vigna; Zea mays; Agricultural Irrigation; Metals, Heavy; Fungi; Salinity; Soil Pollutants; Soil Microbiology; Plant Growth Regulators
PubMed: 37566039
DOI: 10.3390/cells12151960 -
Nephrology, Dialysis, Transplantation :... Mar 2024The only treatment proven to be renoprotective in autosomal dominant polycystic kidney disease (ADPKD) is a vasopressin V2-receptor antagonist (V2RA). However,... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The only treatment proven to be renoprotective in autosomal dominant polycystic kidney disease (ADPKD) is a vasopressin V2-receptor antagonist (V2RA). However, aquaresis-associated side effects limit tolerability. We investigated whether salt and/or protein intake influences urine volume and related endpoints in V2RA-treated ADPKD patients.
METHODS
In this randomized, controlled, double-blind, crossover trial, ADPKD patients treated with maximally tolerated dose of a V2RA were included. While on a low salt and low protein diet, patients were given additional salt and protein to mimic regular intake, which was subsequently replaced by placebo in random order during four 2-week periods. Primary endpoint was change in 24-h urine volume. Secondary endpoints were change in quality of life, measured glomerular filtration rate (mGFR), blood pressure and copeptin level.
RESULTS
Twelve patients (49 ± 8 years, 25.0% male) were included. Baseline salt and protein intake were 10.8 ± 1.3 g/24-h and 1.2 ± 0.2 g/kg/24-h, respectively. During the low salt and low protein treatment periods, intake decreased to 5.8 ± 1.6 g/24-h and 0.8 ± 0.1 g/kg/24-h, respectively. Baseline 24-h urine volume (5.9 ± 1.2 L) decreased to 5.2 ± 1.1 L (-11%, P = .004) on low salt and low protein, and to 5.4 ± 0.9 L (-8%, P = .04) on low salt. Reduction in 24-h urine volume was two times greater in patients with lower urine osmolality (-16% vs -7%). Polyuria quality of life scores improved in concordance with changes in urine volume. mGFR decreased during the low salt and low protein, while mean arterial pressure did not change during study periods. Plasma copeptin decreased significantly during low salt and low protein periods.
CONCLUSION
Lowering dietary salt and protein intake has a minor effect on urine volume in V2RA-treated ADPKD patients. Reduced intake of osmoles decreased copeptin concentrations and might thus increase the renoprotective effect of a V2RA in ADPKD patients.
Topics: Female; Humans; Male; Antidiuretic Hormone Receptor Antagonists; Glomerular Filtration Rate; Kidney; Polycystic Kidney, Autosomal Dominant; Polyuria; Quality of Life; Sodium Chloride, Dietary; Tolvaptan; Double-Blind Method; Cross-Over Studies
PubMed: 37804179
DOI: 10.1093/ndt/gfad218 -
Brazilian Oral Research 2023The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and...
The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and salivary parameters and 2) compare salivary parameters according to ETW severity in the subgroup of children with ETW. This cross-sectional study included 52 preschool children aged 5 years paired by sex. A calibrated examiner assessed ETW using BEWE criteria, and stimulated saliva was collected to determine salivary flow, osmolality, pH, and buffering capacity. The children were divided into two groups: without ETW (n=26; BEWE score 0) and with ETW (n=26; BEWE scores 1 and 2). Logistic regression analysis was used to determine the magnitude of the association between ETW and salivary parameters and estimates of odds ratios (OR). In the unadjusted analysis, the ETW group was more likely to have lower salivary flow (OR = 0.079; 95%CI = 0.013-0.469; p = 0.005) and lower osmolality (OR = 0.993; 95%CI = 0.985-1.000; p = 0.049). In the adjusted analysis, salivary flow remained significantly associated with ETW (OR = 0.087; 95%CI = 0.014-0.533; p = 0.008). Lower salivary osmolality values were observed in ETW, especially in preschool children with more severe ETW (BEWE score 2). Receiver operating characteristic (ROC) determined a salivary osmolality cutoff point of < 201 for the presence of ETW. In conclusion, salivary flow rate was significantly associated with ETW prevalence. Lower values of salivary osmolality were observed in preschool children with distinct erosive lesions with significant loss of tooth structure (BEWE 2).
Topics: Humans; Child, Preschool; Tooth Erosion; Cross-Sectional Studies; Tooth Wear; Saliva; Prevalence
PubMed: 37820251
DOI: 10.1590/1807-3107bor-2023.vol37.0093