-
International Journal of Clinical... Sep 2020The impact of food and drinks on body fluid metabolism is of direct clinical relevance but current evidence remains fragmented.
CONTEXT
The impact of food and drinks on body fluid metabolism is of direct clinical relevance but current evidence remains fragmented.
AIM
Synthesise current evidence on the role of food and drinks in urine production.
METHODS
Systematic review as per PRISMA guidelines using MEDLINE and EMBASE databases (completed October 2019). Studies reporting on the effect of food, food constituents, and drinks on urine production were included. Two authors performed an independent extraction of relevant articles using predetermined data sets and completed quality-of-study indicators.
RESULTS
A total of 49 studies were included, of which 21 enroled human subjects, and 28 were clinically relevant animal studies (all of which utilised rodent models). The included studies were determined to be of variable quality. High dietary sodium, as well as wine, spirits, high-caffeine coffee, and caffeinated energy drinks, increased urine production in human studies. Decreased urine production was associated with low dietary sodium and consumption of milk, orange juice, and high-salt/high-sugar drinks. In animal models, a variety of fruits, vegetables, herbs, spices, and honey were associated with increased urine production.
CONCLUSION
Current evidence suggests that although several types of food and drinks may impact body fluid metabolism, the quality of the data is variable. Urine production appears to be influenced by multiple factors including composition (ie, moisture, macronutrients, and electrolytes), metabolite load, and the presence of specific diuresis-promoting substances (eg, caffeine, alcohol) and other bioactive phytochemicals. Future research is needed to support current evidence and the physiologic mechanisms underlying these findings.
Topics: Animals; Beverages; Coffee; Diuresis; Drinking; Food; Humans; Osmolar Concentration; Urination
PubMed: 32441853
DOI: 10.1111/ijcp.13539 -
BMC Urology Jul 2020Physical therapy, including percussion, inversion, vibration and combinations, was clinically performed to improve the stone free rate (SFR) following lithotripsy... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Physical therapy, including percussion, inversion, vibration and combinations, was clinically performed to improve the stone free rate (SFR) following lithotripsy procedures. However, physical therapy is not widely accepted in clinical practice owing to lack of high level evidence support and a standard protocol. The present meta-analysis aimed to evaluate the efficacy and safety of physical therapy in improving SFR following extracorporeal shockwave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS).
METHODS
Systematic review of literature from PubMed, Scopus, Cochrane library and Embase was performed in March 2019. The efficacy and safety of physical therapy after ESWL and RIRS were assessed by meta-analysis of SFR and complication rate.
RESULTS
A total of 8 prospective studies with 1065 patients were enrolled. When compared to non-intervention, physical therapy provided a higher SFR (OR:3.38, 95% CI: 2.45-4.66, p < 0.0001) at all time points (week 1, week 2 and month 1), while there was no significant difference in complications such as hematuria, lumbago, dizziness and urinary tract infection (OR: 0.84; 95%CI: 0.62-1.13; p = 0.237). In subgroup analysis of different stone locations, lower calyx stone (OR: 3.51; 95%CI: 2.21-5.55; p < 0.0001), upper ureter and renal pelvic stones (OR:2.79; 95%CI:1.62-4.81; p = 0.0002) had a higher SFR after physical therapy, while there was no significant improvement in SFR in upper and middle calyx stones. In subgroup analysis of different techniques, EPVL (external physical vibration lithecbole, OR:3.47; 95%CI:2.24-5.37; p < 0.0001) and PDI (percussion, diuresis and inversion, OR:3.24; 95%CI:2.01-5.21; p < 0.0001) were both effective in improving SFR when compared to non-intervention.
CONCLUSIONS
Physical therapy is effective in improving the SFR after ESWL and RIRS, especially for lower calyx stones, upper ureter and renal pelvic stones, while without significant side effects. External physical vibration lithecbole (EPVL) might provide a relative uniformed and repeatable protocol for clinical practice of physical therapy.
TRIAL REGISTRATION
PROSPERO 2019 CRD42019130228 .
Topics: Combined Modality Therapy; Fiber Optic Technology; Humans; Kidney Calculi; Kidney Pelvis; Lithotripsy; Physical Therapy Modalities; Treatment Outcome; Ureteroscopy
PubMed: 32646402
DOI: 10.1186/s12894-020-00664-9 -
Journal of Ethnopharmacology Apr 2023Eleutherococcus nodiflorus (Dunn) S.Y.Hu (Araliaceae), also called Eleutherococcus gracilistylus, Acanthopanax gracilistylus, and Xi-zhu-wu-jia (Wujiapi or Nan Wujiapi)... (Review)
Review
ETHNOPHARMACOLOGICAL RELEVANCE
Eleutherococcus nodiflorus (Dunn) S.Y.Hu (Araliaceae), also called Eleutherococcus gracilistylus, Acanthopanax gracilistylus, and Xi-zhu-wu-jia (Wujiapi or Nan Wujiapi) in Chinese, is a widely used traditional Chinese herb with the effects of dispelling pathogenic wind and eliminating dampness, nourishing liver and kidney, diuresis and detumescence, promoting blood circulation for removing blood stasis, and strengthening the bones and tendons according to the theory of Traditional Chinese Medicine (TCM). It has been used as medicine for the treatment of paralysis, arthritis, rheumatism, lameness, body asthenia, fatigue, edema, beriberi, and liver diseases. Meanwhile, E. nodiflorus (EN, thereafter) has ginseng-like activities known as "ginseng-like herb".
AIMS OF THE REVIEW
This review aims to present comprehensive information for the research progress of EN, including taxonomic position, botany, traditional usages, phytochemistry, pharmaceutical analysis, pharmacology and toxicology. Among them, phytochemical and pharmacological studies are mainly focused.
MATERIALS AND METHODS
Relevant literature was acquired from scientific databases including Web of Science, PubMed, Google Scholar, Baidu Scholar, SciFinder and Chinese national knowledge infrastructure (CNKI). Monographs and Chinese pharmacopeia were also utilized as references.
RESULTS
In the past decade, a great number of phytochemical and pharmaceutical analyses, as well as pharmacological studies on EN have been carried out. Several kinds of chemical compositions have been reported, including essential oil, sesquiterpenes, diterpenes, triterpenes, phenylpropanoids, lignans, caffeoyl quinic acids, flavonoids, steroids, fatty acids, ceramides as well as other compounds, among which, diterpenes and triterpenes were considered to be the most active components. The fingerprint chromatography, qualitative and quantitative analysis were used for the methods of quality control of EN. Considerable pharmacological experiments in vitro and in vivo have demonstrated that EN possessed hypoglycemic, anti-inflammatory, anticancer, anti-ageing, anti-fatigue, immunomodulatory, hepatoprotective, antioxidant, anti-AChE, anti-BuChE, anti-hyaluronidase, and antiobesity activities.
CONCLUSIONS
As an important TCM, a large number of investigations have proved that EN and terpenoids isolated from EN have markedly therapeutic efficacy on diabetes, inflammation, and cancer disorders. These research findings provide modern scientific evidence for the traditional uses of EN. Moreover, more novel and active secondary metabolites from EN, as well as the in vivo and clinical in-depth tests are required in the future.
Topics: Eleutherococcus; Medicine, Chinese Traditional; Drugs, Chinese Herbal; Botany; Phytochemicals; Triterpenes; Ethnopharmacology
PubMed: 36641105
DOI: 10.1016/j.jep.2023.116152 -
Journal of Voice : Official Journal of... Jul 2023Caffeine is considered a dehydrating agent due to its diuretic effects and influences the body's fluid balance. The relationship between voice and hydration has been...
BACKGROUND
Caffeine is considered a dehydrating agent due to its diuretic effects and influences the body's fluid balance. The relationship between voice and hydration has been widely investigated and it is accepted that inadequate hydration has detrimental effects on phonation. Since dehydration negatively affects the vocal folds and caffeine is considered a dehydrating agent, it can be hypothesized that voice might be negatively affected by caffeine intake. This systematic review aims to summarize and appraise the available evidence regarding the effects of caffeine on voice.
METHODS
Randomized and non-randomized experimental studies of healthy participants were retrieved following an electronic searching of six databases in June 2020. No publication, language or date restrictions were applied. Data extraction of relevant data and risk of bias assessment was conducted independently by two reviewers.
RESULTS
Five non-randomized experimental studies were deemed eligible for inclusion. The format of the administered interventions in the included studies was either liquid (coffee) or solid (caffeine tablets). Reported outcome measures used to examine the effects of caffeine on phonation consisted of acoustic, aerodynamic and (auditory & self-) perceptual. No measures were adversely affected by caffeine consumption.
CONCLUSION
Clinicians commonly advise patients to refrain from caffeine, as caffeine intake increases diuresis with subsequent effects on fluid balance. Such imbalances can potentially induce dehydration which can be detrimental to phonation. This notion cannot be supported empirically, as the evidence is deemed unreliable and no firm conclusions can be elicited to guide clinical practice. The results of this review demonstrate the lack of research in the field and the necessity for future investigations in order to inform evidence-based practice through reliable and valid outcomes.
Topics: Humans; Caffeine; Voice Quality; Dehydration; Voice; Phonation; Randomized Controlled Trials as Topic
PubMed: 33752928
DOI: 10.1016/j.jvoice.2021.02.025 -
Transplantation Proceedings Sep 2021The effect of mannitol usage during kidney donation and kidney transplantation is still unclear. Therefore, we performed a systematic review and meta-analysis to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The effect of mannitol usage during kidney donation and kidney transplantation is still unclear. Therefore, we performed a systematic review and meta-analysis to research the difference in graft function between kidney grafts treated with and without mannitol.
METHODS
A literature search was performed in 5 databases and included 8 eligible studies out of 3570 references, which were included up to July 12, 2021. Relevant outcomes for analysis were graft survival, rejection, acute renal failure, delayed graft function, renal failure, creatinine clearance, diuresis, and serum creatinine.
RESULTS
Eight studies were identified, 1 study examining the effect of mannitol during kidney donation and 7 studies during kidney transplantation, of which 6 eligible for meta-analysis. A total of 1143 patients were included in these studies. The following outcome measures demonstrated significant differences in favor of mannitol usage compared with a control group: acute renal failure (risk ratio [RR], 0.45; 95% confidence interval [CI], 0.26-0.79; P < .01]) and delayed graft function (RR, 0.25; 95% CI, 0.08-0.77; P = 0.02 and RR, 0.69; 95% CI, 0.51-0.94; P = 0.94). Differences in other outcome parameters were not significant.
CONCLUSIONS
This systematic review and meta-analysis suggested that the use of mannitol during kidney transplantation leads to lower incidence of acute renal failure and delayed graft function. For all other outcomes, no significant difference was found. Further research should be conducted on the use of mannitol during donor nephrectomy because of the limited availability of studies. Finally, for interpretation of the outcomes, the quality of the evidence should be taken into consideration and we emphasize the need for more up-to-date research.
Topics: Graft Rejection; Graft Survival; Humans; Kidney; Kidney Transplantation; Mannitol
PubMed: 34412911
DOI: 10.1016/j.transproceed.2021.07.001 -
Critical Care Medicine Nov 2021To evaluate the efficacy of the simultaneous hypertonic saline solution and IV furosemide (HSS+Fx) for patients with fluid overload compared with IV furosemide alone... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the efficacy of the simultaneous hypertonic saline solution and IV furosemide (HSS+Fx) for patients with fluid overload compared with IV furosemide alone (Fx).
DATA SOURCES
Electronic databases (MEDLINE, EMBASE, CENTRAL, Cochrane Database of Systematic Reviews, PsycINFO, Scopus, and WOS) were searched from inception to March 2020.
STUDY SELECTION
Randomized controlled trials on the use of HSS+Fx in adult patients with fluid overload versus Fx were included.
DATA EXTRACTION
Data were collected on all-cause mortality, hospital length of stay, heart failure-related readmission, along with inpatient weight loss, change of daily diuresis, serum creatinine, and 24-hour urine sodium excretion from prior to post intervention. Pooled analysis with random effects models yielded relative risk or mean difference with 95% CIs.
DATA SYNTHESIS
Eleven randomized controlled trials comprising 2,987 acute decompensated heart failure patients were included. Meta-analysis demonstrated that HSS+Fx was associated with lower all-cause mortality (relative risk, 0.55; 95% CI, 0.46-0.67; p < 0.05; I2 = 12%) and heart failure-related readmissions (relative risk, 0.50; 95% CI, 0.33-0.76; p < 0.05; I2 = 61%), shorter hospital length of stay (mean difference, -3.28 d; 95% CI, -4.14 to -2.43; p < 0.05; I2 = 93%), increased daily diuresis (mean difference, 583.87 mL; 95% CI, 504.92-662.81; p < 0.05; I2 = 76%), weight loss (mean difference, -1.76 kg; 95% CI, -2.52 to -1.00; p < 0.05; I2 = 57%), serum sodium change (mean difference, 6.89 mEq/L; 95% CI, 4.98-8.79; p < 0.05; I2 = 95%), and higher 24-hour urine sodium excretion (mean difference, 61.10 mEq; 95% CI, 51.47-70.73; p < 0.05; I2 = 95%), along with decreased serum creatinine (mean difference, -0.46 mg/dL; 95% CI, -0.51 to -0.41; p < 0.05; I2 = 89%) when compared with Fx. The Grading of Recommendation, Assessment, Development, and Evaluation certainty of evidence ranged from low to moderate.
CONCLUSIONS
Benefits of the HSS+Fx over Fx were observed across all examined outcomes in acute decompensated heart failure patients with fluid overload. There is at least moderate certainty that HSS+Fx is associated with a reduction in mortality in patients with acute decompensated heart failure. Factors associated with a successful HSS+Fx utilization are still unknown. Current evidence cannot be extrapolated to other than fluid overload states in acute decompensated heart failure.
Topics: Diuretics; Dose-Response Relationship, Drug; Drug Administration Schedule; Furosemide; Heart Failure; Humans; Length of Stay; Randomized Controlled Trials as Topic; Saline Solution, Hypertonic; Water-Electrolyte Imbalance
PubMed: 34166286
DOI: 10.1097/CCM.0000000000005174 -
Seizure Oct 2023Bumetanide, an inhibitor of the sodium-potassium-chloride cotransporter-1, has been suggested as an adjunct to phenobarbital for treating neonatal seizures.
BACKGROUND
Bumetanide, an inhibitor of the sodium-potassium-chloride cotransporter-1, has been suggested as an adjunct to phenobarbital for treating neonatal seizures.
METHODS
A systematic review of animal and human studies was conducted to evaluate the efficacy and safety of bumetanide for neonatal seizures. PubMed, Embase, CINAHL and Cochrane databases were searched in March 2023.
RESULTS
26 animal (rat or mice) studies describing 38 experiments (28 in-vivo and ten in-vitro) and two human studies (one RCT and one open-label dose-finding) were included. The study designs, methods to induce seizures, bumetanide dose, and outcome measures were heterogeneous, with only 4/38 experiments being in animal hypoxia/ischaemia models. Among 38 animal experiments, bumetanide was reported to have antiseizure effects in 21, pro-seizure in six and ineffective in 11. The two human studies (n = 57) did not show the benefits of bumetanide as an add-on agent to phenobarbital in their primary analyses, but one study reported benefit on post-hoc analysis. Overall, hearing impairment was detected in 5/37 surviving infants in the bumetanide group vs. 0/13 in controls. Four of the five infants with hearing impairment had received aminoglycosides concurrently. Other adverse effects reported were diuresis, mild-to-moderate dehydration, hypotension, and electrolyte disturbances. The studies did not report on long-term neurodevelopment. The certainty of the evidence was very low.
CONCLUSION
Animal data suggest that bumetanide has inconsistent effects as an antiseizure medication in neonates. Data from human studies are scarce and raise some concerns regarding ototoxicity when given with aminoglycosides. Well conducted studies in animal models of hypoxic-ischaemic encephalopathy are urgently needed. Future RCTs, if conducted in human neonates, should have an adequate sample size, assess neurodevelopment, minimize using aminoglycosides, be transparent about the potential ototoxicity in the parent information sheet, conduct early hearing tests and have trial-stopping rules that include hearing impairment as an outcome.
Topics: Infant, Newborn; Infant; Humans; Rats; Mice; Animals; Bumetanide; Ototoxicity; Sodium Potassium Chloride Symporter Inhibitors; Solute Carrier Family 12, Member 2; Seizures; Epilepsy; Phenobarbital; Infant, Newborn, Diseases; Aminoglycosides; Hearing Loss; Anticonvulsants
PubMed: 37690372
DOI: 10.1016/j.seizure.2023.09.007 -
Frontiers in Microbiology 2024Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease comprising five stages: fever, hypotension, oliguria, diuresis (polyuria), and convalescence....
INTRODUCTION
Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease comprising five stages: fever, hypotension, oliguria, diuresis (polyuria), and convalescence. Increased vascular permeability, coagulopathy, and renal injury are typical clinical features of HFRS, which has a case fatality rate of 1-15%. Despite this, a comprehensive meta-analyses of the clinical characteristics of patients who died from HFRS is lacking.
METHODS
Eleven Chinese- and English-language research databases were searched, including the China National Knowledge Infrastructure Database, Wanfang Database, SinoMed, VIP Database, PubMed, Embase, Scopus, Cochrane Library, Web of Science, Proquest, and Ovid, up to October 5, 2023. The search focused on clinical features of patients who died from HFRS. The extracted data were analyzed using STATA 14.0.
RESULTS
A total of 37 articles on 140,295 patients with laboratory-confirmed HFRS were included. Categorizing patients into those who died and those who survived, it was found that patients who died were older and more likely to smoke, have hypertension, and have diabetes. Significant differences were also observed in the clinical manifestations of multiple organ dysfunction syndrome, shock, occurrence of overlapping disease courses, cerebral edema, cerebral hemorrhage, toxic encephalopathy, convulsions, arrhythmias, heart failure, dyspnea, acute respiratory distress syndrome, pulmonary infection, liver damage, gastrointestinal bleeding, acute kidney injury, and urine protein levels. Compared to patients who survived, those who died were more likely to demonstrate elevated leukocyte count; decreased platelet count; increased lactate dehydrogenase, alanine aminotransferase, and aspartate aminotransferase levels; prolonged activated partial thromboplastin time and prothrombin time; and low albumin and chloride levels and were more likely to use continuous renal therapy. Interestingly, patients who died received less dialysis and had shorter average length of hospital stay than those who survived.
CONCLUSION
Older patients and those with histories of smoking, hypertension, diabetes, central nervous system damage, heart damage, liver damage, kidney damage, or multiorgan dysfunction were at a high risk of death. The results can be used to assess patients' clinical presentations and assist with prognostication.https://www.crd.york.ac.uk/prospero/, (CRD42023454553).
PubMed: 38638893
DOI: 10.3389/fmicb.2024.1329683 -
International Journal of Psychiatry in... May 2022Lithium is a first-line pharmacotherapy for the treatment of bipolar disorder, but long-term use is associated with nephrotoxicity. However, as dialysis effectively...
BACKGROUND
Lithium is a first-line pharmacotherapy for the treatment of bipolar disorder, but long-term use is associated with nephrotoxicity. However, as dialysis effectively eliminates lithium, it remains a pharmacotherapeutic option for patients on dialysis. This systematic review seeks to evaluate the dosing, safety, efficacy, and monitoring of lithium in patients receiving dialysis.
METHOD
A PubMed database search performed May 5th, 2020, identified 535 article titles. After exclusion criteria were applied, a total of 15 articles were included in this systematic review.
RESULTS
In 18 patients receiving dialysis, lithium was primarily used for the treatment of mood disorders. The majority of patients received 300-900 mg lithium carbonate thrice-weekly following dialysis, but several alternative lithium salts and dosing strategies were utilized. The pharmacokinetic properties of lithium in dialysis are not well understood and can be complicated by a serum lithium "rebound effect" following dialysis, due to a two-compartment volume of distribution. Additionally, presence of residual diuresis in some patients may be reason to administer lithium more frequently than thrice-weekly following dialysis. Lithium was shown to be an effective pharmacotherapy in all patients, with many demonstrating rapid improvement after drug initiation. Five patients experienced an adverse event on lithium, but only one patient required lithium discontinuation.
CONCLUSION
Lithium may be used in patients on dialysis, with close monitoring of pre-dialysis serum lithium concentrations for at least two weeks after treatment initiation, followed by a lower frequency after stabilization to ensure therapeutic concentrations and reduce toxicity risk.
Topics: Antimanic Agents; Dialysis; Humans; Lithium; Lithium Carbonate; Renal Dialysis
PubMed: 34176305
DOI: 10.1177/00912174211028544 -
World Journal of Critical Care Medicine May 2022In patients with respiratory failure, loop diuretics remain the cornerstone of the treatment to maintain fluid balance, but resistance is common.
BACKGROUND
In patients with respiratory failure, loop diuretics remain the cornerstone of the treatment to maintain fluid balance, but resistance is common.
AIM
To determine the efficacy and safety of common diuretic combinations in critically ill patients with respiratory failure.
METHODS
We searched MEDLINE, Embase, Cochrane Library and PROSPERO for studies reporting the effects of a combination of a loop diuretic with another class of diuretic. A meta-analysis using mean differences (MD) with 95% confidence interval (CI) was performed for the 24-h fluid balance (primary outcome) and the 24-h urine output, while descriptive statistics were used for safety events.
RESULTS
Nine studies totalling 440 patients from a total of 6510 citations were included. When compared to loop diuretics alone, the addition of a second diuretic is associated with an improved negative fluid balance at 24 h [MD: -1.06 L (95%CI: -1.46; -0.65)], driven by the combination of a thiazide plus furosemide [MD: -1.25 L (95%CI: -1.68; -0.82)], while no difference was observed with the combination of a loop-diuretic plus acetazolamide [MD: -0.40 L (95%CI: -0.96; 0.16)] or spironolactone [MD: -0.65 L (95%CI: -1.66; 0.36)]. Heterogeneity was high and the report of clinical and safety endpoints varied across studies.
CONCLUSION
Based on limited evidence, the addition of a second diuretic to a loop diuretic may promote diuresis and negative fluid balance in patients with respiratory failure, but only when using a thiazide. Further larger trials to evaluate the safety and efficacy of such interventions in patients with respiratory failure are required.
PubMed: 36331969
DOI: 10.5492/wjccm.v11.i3.178