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PloS One 2018The cultivation of bananas and other plants is limited by environmental stresses caused by climate change. In order to recognize physiological, biochemical and molecular...
BACKGROUND
The cultivation of bananas and other plants is limited by environmental stresses caused by climate change. In order to recognize physiological, biochemical and molecular components indicated to confer tolerance to water stress in Musa spp. we present the first systematic review on the topic.
METHODS
A systematic literature review was conducted using four databases for academic research (Google Academic, Springer, CAPES Journal Portal and PubMed Central). In order to avoid publication bias, a previously established protocol and inclusion and exclusion criteria were used.
RESULTS
The drought tolerance response is genotype-dependent, therefore the most studied varieties are constituted by the "B" genome. Tolerant plants are capable of super-expressing genes related to reisistance and defense response, maintaining the osmotic equilibrium and elimination of free radicals. Furthermore, they have higher amounts of water content, chlorophyll levels, stomatic conductance and dry root matter, when compared to susceptible plants.
CONCLUSIONS
In recent years, few integrated studies on the effects of water stress on bananas have been carried out and none related to flood stress. Therefore, we highlight the need for new studies on the mechanisms of differentially expressed proteins in response to stress regulation, post-translational mechanisms and epigenetic inheritance in bananas.
Topics: Acclimatization; Chlorophyll; Droughts; Epigenesis, Genetic; Free Radicals; Gene Expression Regulation, Plant; Musa; Organism Hydration Status; Osmoregulation; Plant Proteins; Plant Stomata; Protein Processing, Post-Translational
PubMed: 30507957
DOI: 10.1371/journal.pone.0208052 -
Clinical Nutrition ESPEN Dec 2018Fluid retention is a risk factor for mortality in several medical conditions. However, the accurate and fast assessment of hydration status remains a challenge in the... (Meta-Analysis)
Meta-Analysis
Association of hyperhydration evaluated by bioelectrical impedance analysis and mortality in patients with different medical conditions: Systematic review and meta-analyses.
BACKGROUND AND AIMS
Fluid retention is a risk factor for mortality in several medical conditions. However, the accurate and fast assessment of hydration status remains a challenge in the clinical practice. Bioelectrical impedance analysis (BIA) could be an alternative to assess volume status. This systematic review aimed to evaluate the use of BIA to identify hydration status in patients with different medical conditions and to verify the association of hyperhydration, assessed by BIA, with mortality.
METHODS
This systematic review and meta-analyses included 29 studies conducted from 2002 to 2017 among different medical conditions in adults. Eligible studies were randomized and non-randomized clinical trials, prospective and retrospective observational studies. For quality assessment of studies, Effective Public Health Practice Project (EPHPP) was used.
RESULTS
Twelve studies provided data eligible for meta-analyses. A direct association between hyperhydration and mortality was observed (Odds Ratio [OR] 4.38; Confidence interval 95% [95% CI] 2.76-6.94), even when stratified for medical condition (OR 4.37; 95% CI 1.15-6.92) and BIA device (OR 4.37; 95% CI 2.75-6.92).
CONCLUSION
Hyperhydration, evaluated by BIA, was positive associated with mortality. Therefore, the prognostic impact of hyperhydration may be properly assessed by a bedside tool such as BIA.
Topics: Critical Illness; Electric Impedance; Fluid Therapy; Humans; Water-Electrolyte Balance
PubMed: 30390867
DOI: 10.1016/j.clnesp.2018.08.022 -
Journal of Critical Care Dec 2018This systematic review and meta-analysis was conducted to evaluate the mortality risk in severe sepsis and septic shock with a low and high fluid volume/balance.
PURPOSE
This systematic review and meta-analysis was conducted to evaluate the mortality risk in severe sepsis and septic shock with a low and high fluid volume/balance.
METHODS
Cohort studies that compared the mortality of patients with low or high fluid volume/balance were included. Electronic databases: PubMed/Medline PLUS, Embase, Scopus, and Web of Science were searched. Patient mortality at the longest follow-up was the primary outcome measure. The data were analyzed using STATA 14 statistical software.
RESULTS
The current study included fifteen studies with 31,443 severe sepsis and/or septic shock patients. Patients with a high fluid balance have a 70% increased risk of mortality (pooled RR: 1.70; CI: 1.20, 2.41; P = .003). Survivors of severe sepsis and/or septic shock received higher fluid volume in the first three hours. However, fluid volume administered in the first 24 h was higher for non-survivors. Low volume resuscitation in the first 24 h had a significant mortality reduction (P = .02).
CONCLUSION
High fluid balance from the first 24 h to ICU discharge increases the risk of mortality in severe sepsis and/or septic shock. However, randomized clinical trials should be conducted to resolve the dilemma of fluid resuscitation.
Topics: Fluid Therapy; Humans; Iran; Sepsis; Shock, Septic; Water-Electrolyte Balance
PubMed: 30199843
DOI: 10.1016/j.jcrc.2018.08.018 -
Blood Purification 2018Overhydration is common among peritoneal dialysis (PD) patients and can affect PD-related outcomes. This paper aims to systematically investigate whether... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Overhydration is common among peritoneal dialysis (PD) patients and can affect PD-related outcomes. This paper aims to systematically investigate whether bioimpedance-assessed overhydration is a predictor for mortality and technique failure in PD patients.
METHODS
We conducted a systematic review and meta-analysis of cohort studies on overhydration and prognosis in PD patients, strictly complying with the Preferred Reporting Items for Systematical Reviews and Meta-analyses.
RESULTS
Eight articles met the selection criteria and 5 studies were included in the meta-analysis. Meta-analyses-revealed overhydration, defined as a high ratio of extracellular water/total body water (ECW/TBW), was significantly associated with higher risk for all-cause mortality and technique failure. Other higher dichotomized overhydration indicators and continuous hydration variables all indicated overhydration as a significant risk factor for all-cause mortality.
CONCLUSION
Overhydration, defined by a higher ratio of ECW/TBW, might be an independent predictor for all-cause mortality and technique failure among PD patients. However, more studies are needed to confirm this conclusion. Video Journal Club 'Cappuccino with Claudio Ronco' at https://www.karger.com/Journal/ArticleNews/223997?sponsor=52.
Topics: Female; Humans; Male; Mortality; Peritoneal Dialysis; Water-Electrolyte Balance
PubMed: 30189422
DOI: 10.1159/000492148 -
The British Journal of Dermatology Nov 2018Transepidermal water loss (TEWL) is one of the most important skin barrier characteristics. Higher TEWL is usually associated with skin barrier impairments, and lower... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Transepidermal water loss (TEWL) is one of the most important skin barrier characteristics. Higher TEWL is usually associated with skin barrier impairments, and lower TEWL with healthy skin.
OBJECTIVES
To update an existing systematic review and meta-analysis to provide TEWL reference values for healthy skin in adults.
METHODS
The databases MEDLINE and Embase and other sources were searched. This update includes studies identified by two combined searches that cover the period from 1947 to 13 April 2017. Primary empirical observational and interventional studies in healthy adults providing quantitative estimates of TEWL measurements including measures of spread, such as SDs, with clear reporting of skin areas and age were included. Data were extracted per skin area and statistically pooled.
RESULTS
After full-text assessment, the results of 45 studies were included additionally to the existing meta-analysis. TEWL estimates were identified for 86 skin areas in 212 studies. The lowest TEWL of 2·3 g m h (95% confidence interval 1·9-2·7) was reported for breast skin and the highest TEWL of 44·0 g m h (95% confidence interval 39·8-48·2) for the axilla. Sample sizes ranged from four (forehead middle left middle) to 4013 (mid volar right forearm). The clinical relevance of the difference between TEWL estimates for different measurement devices seems to be minimal. TEWL in elderly patients was either similar to or lower than values in the younger group.
CONCLUSIONS
Reference estimates are useful for clinical study planning and interpretation of results. TEWL is highly dependent on skin area, and our results further support the symmetry between right and left measuring sites. TEWL in elderly people seems to be generally similar or decreased compared with younger individuals, but available evidence is limited. Reporting of TEWL should be improved: mean and spread parameters should always be reported in future studies.
Topics: Adult; Age Factors; Clinical Trials as Topic; Data Interpretation, Statistical; Humans; Reference Values; Skin; Water Loss, Insensible
PubMed: 30022486
DOI: 10.1111/bjd.17025 -
Journal of Nephrology Apr 2019Achievement of sodium and fluid balance is considered a major determinant of dialysis adequacy in peritoneal dialysis (PD). However, the contribution of different PD... (Meta-Analysis)
Meta-Analysis
Achievement of sodium and fluid balance is considered a major determinant of dialysis adequacy in peritoneal dialysis (PD). However, the contribution of different PD modalities to dialytic sodium removal (DSR) remains ill-defined. We performed a systematic review and meta-analysis to compare DSR by manual (continuous ambulatory PD, CAPD) versus automated PD (APD). Alternative PD strategies to remove sodium were also analyzed. Seven cohort studies, including 683 patients, 406 in CAPD and 277 in APD, were meta-analyzed out of the 30 studies selected based on DSR data availability. Overall, the unstandardized mean difference between CAPD and APD was significant [- 56 mmol/day (95% CI - 106, - 6), p = 0.027]. Heterogeneity was high (I 87.2%; p < 0.001). Meta-regression showed a strict correlation of DSR difference with creatinine dialysate/plasma ratio (D/P) (p = 0.04). DSR was significantly lower in APD than CAPD [86.2 (57.3-115.1) vs. 141.3 (107.6-174.9) mmol/day, p = 0.015]. Conversely, ultrafiltration (UF) did not differ [1122.6 (891.2-1354.0) in CAPD and 893.6 (823.0-964.2) ml/day in APD, p = 0.064]. A very strong correlation between DSR and achieved UF was found in CAPD (R = 0.94; p < 0001) while no relationship was detected in APD (R = - 0.07; p = 0.85). CAPD allows a higher DSR than APD, even though UF is not different. APD removes more water than sodium; therefore, DSR should be measured rather than estimated from the achieved UF. The difference in DSR between the two modalities decreases in high transporters. Novel strategies proposed to increase DSR, e.g. lower sodium dialysate or adapted-APD, are promising, but ad hoc studies are necessary.
Topics: Aged; Female; Humans; Kidney Diseases; Male; Middle Aged; Natriuresis; Peritoneal Dialysis; Peritoneal Dialysis, Continuous Ambulatory; Renal Elimination; Treatment Outcome; Water-Electrolyte Balance
PubMed: 29978446
DOI: 10.1007/s40620-018-0507-1 -
Journal of Advanced Nursing Jul 2018To identify effective treatments and risk factors associated with death rattle in adults at the end of life. (Review)
Review
AIM
To identify effective treatments and risk factors associated with death rattle in adults at the end of life.
BACKGROUND
The presence of noisy, pooled respiratory tract secretions is among the most common symptoms in dying patients around the world. It is unknown if "death rattle" distresses patients, but it can distress relatives and clinicians. Treatments appear unsatisfactory, so prophylaxis would be ideal if possible.
DESIGN
Quantitative systematic review and narrative summary following Cochrane Collaboration guidelines.
DATA SOURCES
CINAHL, MEDLINE, Health Source Nursing and Web of Science were searched for international literature in any language published from 1993 - 2016 using MeSH headings and iterative interchangeable terms for "death rattle".
REVIEW METHODS
Randomized controlled trials were appraised using the Cochrane Collaboration's tool for assessing risk of bias. Non-randomized studies were assessed using ROBINS-I tool for assessing risk of bias in non-randomized studies of interventions. Instances of treatment and risk were extracted and relevant key findings extracted in line with Cochrane methods.
RESULTS
Five randomized trials and 23 non-randomized studies were analysed. No pharmacological or non-pharmacological treatment was found superior to placebo. There was a weak association between lung or brain metastases and presence of death rattle, but otherwise inconsistent empirical support for a range of potential risk factors.
CONCLUSIONS
Clinicians have no clear evidence to follow in either treating death rattle or preventing it occurring. However, several risk factors look promising candidates for prospective analysis, so this review concludes with clear recommendations for further research.
Topics: Adult; Age Factors; Cholinergic Antagonists; Consciousness; Cough; Deglutition Disorders; Female; Humans; Length of Stay; Male; Patient Positioning; Prospective Studies; Randomized Controlled Trials as Topic; Respiratory Sounds; Respiratory System; Respiratory System Agents; Respiratory Tract Infections; Risk Factors; Sex Factors; Terminal Care; Terminally Ill; Water-Electrolyte Balance
PubMed: 29495089
DOI: 10.1111/jan.13557 -
Skin Research and Technology : Official... Aug 2018Associations between daily amounts of drinking water and skin hydration and skin physiology receive increasingly attention in the daily life and in clinical practice....
BACKGROUND
Associations between daily amounts of drinking water and skin hydration and skin physiology receive increasingly attention in the daily life and in clinical practice. However, there is a lack of evidence of dermatological benefits from drinking increased amounts of water.
MATERIALS AND METHODS
Pubmed and Web of Science were searched without any restrictions of publication dates. References of included papers and related reviews were checked. Eligibility criteria were primary intervention and observational studies investigating the effects of fluid intake on skin properties in English, German, Spanish or Portuguese language, including subjects being healthy and 18+ years.
RESULTS
Searches resulted in 216 records, 23 articles were read in full text, and six were included. The mean age of the samples ranged from 24 to 56 years. Overall the evidence is weak in terms of quantity and methodological quality. Disregarding the methodological limitations a slight increase in stratum corneum and "deep" skin hydration was observed after additional water intake, particularly in individuals with lower prior water consumption. Reductions of clinical signs of dryness and roughness were observed. The extensibility and elasticity of the skin increased slightly. Unclear associations were shown between water intake and transepidermal water loss, sebum content, and skin surface pH.
CONCLUSIONS
Additional dietary water intake may increase stratum corneum hydration. The underlying biological mechanism for this possible relationship is unknown. Whether this association also exists in aged subjects is unclear. Research is needed to answer the question whether increased fluid intake decreases signs of dry skin.
Topics: Body Water; Drinking; Epidermis; Humans; Hydrogen-Ion Concentration; Sebum; Skin; Skin Physiological Phenomena; Water; Water Loss, Insensible
PubMed: 29392767
DOI: 10.1111/srt.12454 -
Perioperative Medicine (London, England) 2018Dehydration is highly prevalent and is associated with adverse cardiovascular and renal events. Clinical assessment of dehydration lacks sensitivity. Perhaps a patient's... (Review)
Review
BACKGROUND
Dehydration is highly prevalent and is associated with adverse cardiovascular and renal events. Clinical assessment of dehydration lacks sensitivity. Perhaps a patient's thirst can provide an accurate guide to fluid therapy. This systematic review examines the sensitivity of thirst in responding to changes in plasma osmolality in participants of any age with no condition directly effecting their sense of thirst.
METHODS
Medline and EMBASE were searched up to June 2017. Inclusion criteria were all studies reporting the plasma osmolality threshold for the sensation of thirst.
RESULTS
A total of 12 trials were included that assessed thirst intensity on a visual analogue scale, as a function of plasma osmolality (pOsm), and employed linear regression to define the thirst threshold. This included 167 participants, both healthy controls and those with a range of pathologies, with a mean age of 41 (20-78) years.The value ±95% CI for the pOsm threshold for thirst sensation was found to be 285.23 ± 1.29 mOsm/kg. Above this threshold, thirst intensity as a function of pOsm had a mean ± SEM slope of 0.54 ± 0.07 cm/mOsm/kg. The mean ± 95% CI vasopressin release threshold was very similar to that of thirst, being 284.3 ± 0.71 mOsm/kg.Heterogeneity across studies can be accounted for by subtle variation in experimental protocol and data handling.
CONCLUSION
The thresholds for thirst activation and vasopressin release lie in the middle of the normal range of plasma osmolality. Thirst increases linearly as pOsm rises. Thus, osmotically balanced fluid administered as per a patient's sensation of thirst should result in a plasma osmolality within the normal range. This work received no funding.
PubMed: 29344350
DOI: 10.1186/s13741-017-0081-4 -
JACC. Cardiovascular Interventions Feb 2017The objective of this meta-analysis of randomized trials was to evaluate if the administration of furosemide with matched hydration using the RenalGuard System reduces... (Meta-Analysis)
Meta-Analysis Review
Prevention of Contrast-Induced Acute Kidney Injury by Furosemide With Matched Hydration in Patients Undergoing Interventional Procedures: A Systematic Review and Meta-Analysis of Randomized Trials.
OBJECTIVES
The objective of this meta-analysis of randomized trials was to evaluate if the administration of furosemide with matched hydration using the RenalGuard System reduces contrast-induced acute kidney injury (CI-AKI) in patients undergoing interventional procedures.
BACKGROUND
CI-AKI is a serious complication following angiographic procedures and a powerful predictor of unfavorable early and long-term outcomes.
METHODS
Online databases were searched up to October 1, 2016, for randomized controlled trials. The primary outcome was the incidence of CI-AKI, and the secondary outcomes were need for renal replacement therapy, mortality, stroke, and adverse events.
RESULTS
A total of four trials (n = 698) published between 2011 and 2016 were included in the analysis and included patients undergoing percutaneous coronary procedures and transcatheter aortic valve replacement. RenalGuard therapy was associated with a lower incidence of CI-AKI compared with control treatment (27 of 348 [7.76%] patients vs. 75 of 350 [21.43%] patients; odds ratio [OR]: 0.31; 95% confidence interval [CI]: 0.19 to 0.50; I = 4%; p < 0.00001) and with a lower need for renal replacement therapy (2 of 346 [0.58%] patients vs. 12 of 348 [3.45%] patients; OR: 0.19; 95% CI: 0.05 to 0.76; I = 0%; p = 0.02). No major adverse events occurred in patients undergoing RenalGuard therapy.
CONCLUSIONS
The main finding of this meta-analysis is that furosemide with matched hydration by the RenalGuard System may reduce the incidence of CI-AKI in high-risk patients undergoing percutaneous coronary intervention or transcatheter aortic valve replacement. However, further independent high-quality randomized trials should elucidate the effectiveness and safety of this prophylactic intervention in interventional cardiology.
Topics: Acute Kidney Injury; Chi-Square Distribution; Contrast Media; Diuretics; Evidence-Based Medicine; Furosemide; Humans; Incidence; Kidney; Odds Ratio; Percutaneous Coronary Intervention; Protective Factors; Radiography, Interventional; Randomized Controlled Trials as Topic; Renal Replacement Therapy; Risk Assessment; Risk Factors; Stroke; Transcatheter Aortic Valve Replacement; Treatment Outcome; Water-Electrolyte Balance
PubMed: 28231903
DOI: 10.1016/j.jcin.2016.11.006