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Current Pain and Headache Reports Jul 2021We define dehydration and its relationship to pain physiology including both primary and secondary headache disorders. (Review)
Review
PURPOSE OF REVIEW
We define dehydration and its relationship to pain physiology including both primary and secondary headache disorders.
RECENT FINDINGS
Intravenous fluids administered for acute migraine attacks in an emergency department setting have not been shown to improve pain outcomes. However, increased intravascular volume before diagnostic lumbar puncture may reduce the frequency of post-lumbar puncture headache from iatrogenic spinal fluid leak. Maintenance of euhydration can help treat orthostatic and "coat-hanger" headache due to autonomic disorders. Similarly, prevention of fluid losses can mitigate secondary headaches provoked by dehydration such as cerebral venous thrombosis or pituitary apoplexy. Dehydration alone may cause headache, but oftentimes exacerbates underlying medical conditions such as primary headache disorders or other conditions dependent on fluid balance.
Topics: Dehydration; Fluid Therapy; Headache; Humans
PubMed: 34268642
DOI: 10.1007/s11916-021-00966-z -
Deutsches Arzteblatt International Sep 2020Despite the introduction of vaccination against rotavirus, and even though it can often be treated on an outpatient basis, acute infectious gastroenteritis is... (Review)
Review
BACKGROUND
Despite the introduction of vaccination against rotavirus, and even though it can often be treated on an outpatient basis, acute infectious gastroenteritis is nevertheless the second most common non-traumatic cause of emergency hospitaliza - tion in children aged 1 to 5 years, accounting for approximately 9% of cases (39 410 cases in 2017). The most common path - ogens are viruses (47% rotavirus, 29% norovirus, and 14% adenovirus).
METHODS
This review is based on publications retrieved by a selective search in PubMed employing the terms "acute gastro - enteritis children" AND "dehydration" OR "rehydration" OR "prevention," and by manual searching (based, for example, on reference lists and expert knowledge), with subsequent evaluation including consideration of the relevant guidelines.
RESULTS
The degree of dehydration can be judged from weight loss and other clinical findings. In 17 randomized controlled trials conducted on a total of 1811 children with mild or moderate dehydration, oral rehydration with oral rehydration solution was just as effective as intravenous rehydration with respect to weight gain, duration of diarrhea, and fluid administration, and was associated with shorter hospital stays (weighted mean difference, -1.2 days; 95% confidence interval [-2.38; -0.02]). Oral rehydration therapy failed in 4% of patients [1; 7]. In children who are vomiting or who refuse oral rehydration solution, continuous nasogastric application is just as effective as intravenous rehydration and is the treatment of first choice.
CONCLUSION
In Germany, children with mild or moderate dehydration are often hospitalized for intravenous rehydration therapy, despite the good evidence supporting ambulatory oral rehydration. Obstacles to intersectoral care, the nursing shortage, and inadequate reimbursement must all be overcome in order to reduce unnecessary hospitalizations and thereby lessen the risk of nosocomial infection.
Topics: Acute Disease; Child; Child, Preschool; Dehydration; Fluid Therapy; Gastroenteritis; Germany; Humans; Infant; Infusions, Intravenous
PubMed: 33263539
DOI: 10.3238/arztebl.2020.0615 -
Nutrients Jul 2019Personalized hydration strategies play a key role in optimizing the performance and safety of athletes during sporting activities. Clinicians should be aware of the many... (Review)
Review
Personalized hydration strategies play a key role in optimizing the performance and safety of athletes during sporting activities. Clinicians should be aware of the many physiological, behavioral, logistical and psychological issues that determine both the athlete's fluid needs during sport and his/her opportunity to address them; these are often specific to the environment, the event and the individual athlete. In this paper we address the major considerations for assessing hydration status in athletes and practical solutions to overcome obstacles of a given sport. Based on these solutions, practitioners can better advise athletes to develop practices that optimize hydration for their sports.
Topics: Athletes; Dehydration; Drinking; Humans; Sports; Water
PubMed: 31324008
DOI: 10.3390/nu11071550 -
Nutrients Mar 2021During endurance exercise, two problems arise from disturbed fluid-electrolyte balance: dehydration and overhydration. The former involves water and sodium losses in... (Review)
Review
During endurance exercise, two problems arise from disturbed fluid-electrolyte balance: dehydration and overhydration. The former involves water and sodium losses in sweat and urine that are incompletely replaced, whereas the latter involves excessive consumption and retention of dilute fluids. When experienced at low levels, both dehydration and overhydration have minor or no performance effects and symptoms of illness, but when experienced at moderate-to-severe levels they degrade exercise performance and/or may lead to hydration-related illnesses including hyponatremia (low serum sodium concentration). Therefore, the present review article presents (a) relevant research observations and consensus statements of professional organizations, (b) 5 rehydration methods in which pre-race planning ranges from no advanced action to determination of sweat rate during a field simulation, and (c) 9 rehydration recommendations that are relevant to endurance activities. With this information, each athlete can select the rehydration method that best allows her/him to achieve a hydration middle ground between dehydration and overhydration, to optimize physical performance, and reduce the risk of illness.
Topics: Athletes; Dehydration; Endurance Training; Female; Fluid Therapy; Humans; Hyponatremia; Male; Physical Endurance; Sodium; Sweating; Water; Water-Electrolyte Imbalance
PubMed: 33803421
DOI: 10.3390/nu13030887 -
Nephrology, Dialysis, Transplantation :... Jan 2023Climate change should be of special concern for the nephrologist, as the kidney has a critical role in protecting the host from dehydration, but it is also a favorite...
Climate change should be of special concern for the nephrologist, as the kidney has a critical role in protecting the host from dehydration, but it is also a favorite target of heat stress and dehydration. Here we discuss how rising temperatures and extreme heat events may affect the kidney. The most severe presentation of heat stress is heat stroke, which can result in severe electrolyte disturbance and both acute and chronic kidney disease (CKD). However, lesser levels of heat stress also have multiple effects, including exacerbating kidney disease and precipitating cardiovascular events in subjects with established kidney disease. Heat stress can also increase the risk for kidney stones, cause multiple electrolyte abnormalities and induce both acute and chronic kidney disease. Recently there have been multiple epidemics of CKD of uncertain etiology in various regions of the world, including Mesoamerica, Sri Lanka, India and Thailand. There is increasing evidence that climate change and heat stress may play a contributory role in these conditions, although other causes, including toxins, could also be involved. As climate change worsens, the nephrologist should prepare for an increase in diseases associated with heat stress and dehydration.
Topics: Humans; Climate Change; Nephrology; Dehydration; Renal Insufficiency, Chronic; Kidney; Heat Stress Disorders
PubMed: 34473287
DOI: 10.1093/ndt/gfab258 -
Nutrients Sep 2021Low-intake dehydration is a common and often chronic condition in older adults. Adverse health outcomes associated with low-intake dehydration in older adults include... (Review)
Review
Low-intake dehydration is a common and often chronic condition in older adults. Adverse health outcomes associated with low-intake dehydration in older adults include poorer cognitive performance, reduced quality of life, worsened course of illness and recovery, and a high number of unplanned hospital admissions and increased mortality. The subjective methods to assess (risk of) dehydration are not reliable, and the evidence about preventive measures are also limited. So is the knowledge about the optimal intake of beverages per day. This narrative review presents the state of the science on the role of low intake hydration in older adults. Despite its simple cause-the inadequate intake of beverages-low-intake dehydration appears to be a very complex problem to address and much more research is needed in the area. Based on the existing evidence, it seems necessary to take setting specific differences and individual problems and needs into account to tackle dehydration in older adults. Further, it is necessary to increase awareness of the prevalence and severity of low-intake dehydration among older adults and in nursing staff in care homes and hospitals as well as among caregivers of older adults living at home.
Topics: Age Factors; Aged; Dehydration; Drinking; Humans
PubMed: 34579019
DOI: 10.3390/nu13093142 -
Nutrients Jun 2023Adequate hydration is essential for the maintenance of health and physiological functions in humans. However, many older adults do not maintain adequate hydration, which... (Review)
Review
Adequate hydration is essential for the maintenance of health and physiological functions in humans. However, many older adults do not maintain adequate hydration, which is under-recognized and poorly managed. Older adults are more vulnerable to dehydration, especially those living with multiple chronic diseases. Dehydration is associated with adverse health outcomes in older adults, and acts as an independent factor of the hospital length of stay, readmission, intensive care, in-hospital mortality, and poor prognosis. Dehydration is a prevalent health problem in older adults, accounting for substantial economic and social burden. This review attempts to provide current knowledge of hydration including patterns of body water turnover, the complex mechanisms behind water homeostasis, the effects of dehydration on the health of the body, and practical guidance for low-intake dehydration in older adults.
Topics: Humans; Aged; Dehydration; Body Water; Drinking
PubMed: 37299572
DOI: 10.3390/nu15112609 -
International Journal of Biological... Sep 2022Type I collagen is a ubiquitous structural protein in animal tissues. It is normally present in a hydrated form. However, collagen is very dependent on associated water...
Type I collagen is a ubiquitous structural protein in animal tissues. It is normally present in a hydrated form. However, collagen is very dependent on associated water for its mechanical properties. In skin, where type I collagen is dominant, there is a longstanding concern that the skin and therefore collagen may partially dry out and result in structural degradation. Here we show that dehydration of type I collagen fibrils, using 2-propanol, results in a two-stage dehydration process. Initially, the fibrils do not change length, i.e. the D-period remains constant, but shrinkage occurs within the fibrils by an increase in the gap region and a decrease in the overlap region within a D-band and a shortening of the helical turn distance and fibril diameter. Only with further dehydration does the length of the collagen fibril decrease (a decrease in D-period). This mechanism explains why collagen materials are resistant to gross structural change in the early stages of dehydration and shows why they may then suffer from sudden external shrinkage with further dehydration.
Topics: Animals; Collagen; Collagen Type I; Dehydration; Extracellular Matrix; Skin
PubMed: 35793742
DOI: 10.1016/j.ijbiomac.2022.06.180 -
Cell Metabolism Apr 2020High-sugar diets cause thirst, obesity, and metabolic dysregulation, leading to diseases including type 2 diabetes and shortened lifespan. However, the impact of obesity...
High-sugar diets cause thirst, obesity, and metabolic dysregulation, leading to diseases including type 2 diabetes and shortened lifespan. However, the impact of obesity and water imbalance on health and survival is complex and difficult to disentangle. Here, we show that high sugar induces dehydration in adult Drosophila, and water supplementation fully rescues their lifespan. Conversely, the metabolic defects are water-independent, showing uncoupling between sugar-induced obesity and insulin resistance with reduced survival in vivo. High-sugar diets promote accumulation of uric acid, an end-product of purine catabolism, and the formation of renal stones, a process aggravated by dehydration and physiological acidification. Importantly, regulating uric acid production impacts on lifespan in a water-dependent manner. Furthermore, metabolomics analysis in a human cohort reveals that dietary sugar intake strongly predicts circulating purine levels. Our model explains the pathophysiology of high-sugar diets independently of obesity and insulin resistance and highlights purine metabolism as a pro-longevity target.
Topics: Animals; Dehydration; Drosophila; Humans; Insulin Resistance; Longevity; Obesity; Sugars; Water
PubMed: 32197072
DOI: 10.1016/j.cmet.2020.02.016 -
Sports Medicine (Auckland, N.Z.) Feb 2022Body-fluid loss during prolonged continuous exercise can impair cardiovascular function, harming performance. Delta percent plasma volume (dPV) represents the change in... (Meta-Analysis)
Meta-Analysis
The Hydrating Effects of Hypertonic, Isotonic and Hypotonic Sports Drinks and Waters on Central Hydration During Continuous Exercise: A Systematic Meta-Analysis and Perspective.
BACKGROUND
Body-fluid loss during prolonged continuous exercise can impair cardiovascular function, harming performance. Delta percent plasma volume (dPV) represents the change in central and circulatory body-water volume and therefore hydration during exercise; however, the effect of carbohydrate-electrolyte drinks and water on the dPV response is unclear.
OBJECTIVE
To determine by meta-analysis the effects of ingested hypertonic (> 300 mOsmol kg), isotonic (275-300 mOsmol kg) and hypotonic (< 275 mOsmol kg) drinks containing carbohydrate and electrolyte ([Na] < 50 mmol L), and non-carbohydrate drinks/water (< 40 mOsmol kg) on dPV during continuous exercise.
METHODS
A systematic review produced 28 qualifying studies and 68 drink treatment effects. Random-effects meta-analyses with repeated measures provided estimates of effects and probability of superiority (p) during 0-180 min of exercise, adjusted for drink osmolality, ingestion rate, metabolic rate and a weakly informative Bayesian prior.
RESULTS
Mean drink effects on dPV were: hypertonic - 7.4% [90% compatibility limits (CL) - 8.5, - 6.3], isotonic - 8.7% (90% CL - 10.1, - 7.4), hypotonic - 6.3% (90% CL - 7.4, - 5.3) and water - 7.5% (90% CL - 8.5, - 6.4). Posterior contrast estimates relative to the smallest important effect (dPV = 0.75%) were: hypertonic-isotonic 1.2% (90% CL - 0.1, 2.6; p = 0.74), hypotonic-isotonic 2.3% (90% CL 1.1, 3.5; p = 0.984), water-isotonic 1.3% (90% CL 0.0, 2.5; p = 0.76), hypotonic-hypertonic 1.1% (90% CL 0.1, 2.1; p = 0.71), hypertonic-water 0.1% (90% CL - 0.8, 1.0; p = 0.12) and hypotonic-water 1.1% (90% CL 0.1, 2.0; p = 0.72). Thus, hypotonic drinks were very likely superior to isotonic and likely superior to hypertonic and water. Metabolic rate, ingestion rate, carbohydrate characteristics and electrolyte concentration were generally substantial modifiers of dPV.
CONCLUSION
Hypotonic carbohydrate-electrolyte drinks ingested continuously during exercise provide the greatest benefit to hydration.
Topics: Bayes Theorem; Dehydration; Exercise; Humans; Osmolar Concentration; Sodium; Water-Electrolyte Balance
PubMed: 34716905
DOI: 10.1007/s40279-021-01558-y