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American Journal of Physiology.... Jul 2014Two types of aquaporin 5 (AQP5) genes (aqp-xt5a and aqp-xt5b) were identified in the genome of Xenopus tropicalis by synteny comparison and molecular phylogenetic...
Two types of aquaporin 5 (AQP5) genes (aqp-xt5a and aqp-xt5b) were identified in the genome of Xenopus tropicalis by synteny comparison and molecular phylogenetic analysis. When the frogs were in water, AQP-xt5a mRNA was expressed in the skin and urinary bladder. The expression of AQP-xt5a mRNA was significantly increased in dehydrated frogs. AQP-xt5b mRNA was also detected in the skin and increased in response to dehydration. Additionally, AQP-xt5b mRNA began to be slightly expressed in the lung and stomach after dehydration. For the pelvic skin of hydrated frogs, immunofluorescence staining localized AQP-xt5a and AQP-xt5b to the cytoplasm of secretory cells of the granular glands and the apical plasma membrane of secretory cells of the small granular glands, respectively. After dehydration, the locations of both AQPs in their respective glands did not change, but AQP-xt5a was visualized in the cytoplasm of secretory cells of the small granular glands. For the urinary bladder, AQP-xt5a was observed in the apical plasma membrane and cytoplasm of a number of granular cells under normal hydration. After dehydration, AQP-xt5a was found in the apical membrane and cytoplasm of most granular cells. Injection of vasotocin into hydrated frogs did not induce these changes in the localization of AQP-xt5a in the small granular glands and urinary bladder, however. The results suggest that AQP-xt5a might be involved in water reabsorption from the urinary bladder during dehydration, whereas AQP-xt5b might play a role in water secretion from the small granular gland.
Topics: Amino Acid Sequence; Animals; Aquaporin 5; Cloning, Molecular; Dehydration; Gene Expression Regulation; Immunohistochemistry; Molecular Sequence Data; Osmoregulation; Phylogeny; Protein Isoforms; RNA, Messenger; Skin; Synteny; Urinary Bladder; Water; Water-Electrolyte Balance; Xenopus; Xenopus Proteins
PubMed: 24717674
DOI: 10.1152/ajpregu.00186.2013 -
The Journals of Gerontology. Series A,... Oct 2016Water-loss dehydration in older people is associated with increased mortality and disability. We aimed to assess the prevalence of dehydration in older people living in...
BACKGROUND
Water-loss dehydration in older people is associated with increased mortality and disability. We aimed to assess the prevalence of dehydration in older people living in UK long-term care and associated cognitive, functional, and health characteristics.
METHODS
The Dehydration Recognition In our Elders (DRIE) cohort study included people aged 65 or older living in long-term care without heart or renal failure. In a cross-sectional baseline analysis, we assessed serum osmolality, previously suggested dehydration risk factors, general health, markers of continence, cognitive and functional health, nutrition status, and medications. Univariate linear regression was used to assess relationships between participant characteristics and serum osmolality, then associated characteristics entered into stepwise backwards multivariate linear regression.
RESULTS
DRIE included 188 residents (mean age 86 years, 66% women) of whom 20% were dehydrated (serum osmolality >300 mOsm/kg). Linear and logistic regression suggested that renal, cognitive, and diabetic status were consistently associated with serum osmolality and odds of dehydration, while potassium-sparing diuretics, sex, number of recent health contacts, and bladder incontinence were sometimes associated. Thirst was not associated with hydration status.
CONCLUSIONS
DRIE found high prevalence of dehydration in older people living in UK long-term care, reinforcing the proposed association between cognitive and renal function and hydration. Dehydration is associated with increased mortality and disability in older people, but trials to assess effects of interventions to support healthy fluid intakes in older people living in residential care are needed to enable us to formally assess causal direction and any health benefits of increasing fluid intakes.
Topics: Aged; Aged, 80 and over; Biomarkers; Cross-Sectional Studies; Dehydration; Female; Frail Elderly; Geriatric Assessment; Humans; Long-Term Care; Male; Prevalence; Risk Factors; United Kingdom
PubMed: 26553658
DOI: 10.1093/gerona/glv205 -
Archives of Disease in Childhood Aug 2001To develop an evidence and consensus based guideline for the management of the child who presents to hospital with diarrhoea (with or without vomiting), a common problem... (Review)
Review
OBJECTIVE
To develop an evidence and consensus based guideline for the management of the child who presents to hospital with diarrhoea (with or without vomiting), a common problem representing 16% of all paediatric medical attenders at an accident and emergency department. Clinical assessment, investigations (biochemistry and stool culture in particular), admission, and treatment are addressed. The guideline aims to aid junior doctors in recognising children who need admission for observation and treatment and those who may safely go home.
EVIDENCE
A systematic review of the literature was performed. Selected articles were appraised, graded, and synthesised qualitatively. Statements on recommendation were generated.
CONSENSUS
An anonymous, postal Delphi consensus process was used. A panel of 39 selected medical and nursing staff were asked to grade their agreement with the generated statements. They were sent the papers, appraisals, and literature review. On the second and third rounds they were asked to re-grade their agreement in the light of other panelists' responses. Consensus was predefined as 83% of panelists agreeing with the statement.
RECOMMENDATIONS
Clinical signs useful in assessment of level of dehydration were agreed. Admission to a paediatric facility is advised for children who show signs of dehydration. For those with mild to moderate dehydration, estimated deficit is replaced over four hours with oral rehydration solution (glucose based, 200-250 mOsm/l) given "little and often". A nasogastric tube should be used if fluid is refused and normal feeds started following rehydration. Children at high risk of dehydration should be observed to ensure at least maintenance fluid is tolerated. Management of more severe dehydration is detailed. Antidiarrhoeal medication is not indicated.
VALIDATION
The guideline has been successfully implemented and evaluated in a paediatric accident and emergency department.
Topics: Acute Disease; Adolescent; Antidiarrheals; Child; Child, Preschool; Dehydration; Delphi Technique; Diagnosis, Differential; Diarrhea; Evidence-Based Medicine; Fluid Therapy; Gastroenteritis; Humans; Infant; Infant, Newborn; Patient Admission
PubMed: 11466188
DOI: 10.1136/adc.85.2.132 -
Diseases of the Colon and Rectum Nov 2018Twenty-nine percent of postileostomy discharges are readmitted, most commonly because of dehydration. However, there is a lack of detailed data specifically evaluating...
BACKGROUND
Twenty-nine percent of postileostomy discharges are readmitted, most commonly because of dehydration. However, there is a lack of detailed data specifically evaluating factors associated with readmission with dehydration. In addition, patients with a history of an ileostomy have often been excluded from previous studies and therefore represent a group of understudied ileostomates.
OBJECTIVE
This study aimed to evaluate factors available at discharge associated with 30-day readmission for dehydration, rather than all-cause readmissions.
DESIGN
This was a retrospective cohort study.
SETTING
Study patients received ileostomies at a tertiary academic medical center from 2014 to 2016.
PATIENTS
Patients with a preexisting ileostomy that was not recreated per the operative note were excluded, whereas those who received a new ileostomy were included.
MAIN OUTCOME MEASURE
The primary outcome measured was 30-day readmission for dehydration as defined by objective clinical criteria.
RESULTS
A total of 262 patients underwent ileostomy creation and were discharged alive. Twenty-five percent were ≥65 years of age, 53% were men, 14% had a history of ileostomy, 18% had a creatinine >1.0 on discharge, and 26% had high ileostomy output at any time during the index admission. Among all ileostomates, the all-cause readmission rate was 30%. Mean days to readmission for any cause was 8.5, whereas for dehydration it was 11.6 days. Of the readmissions, 37% were readmitted with a diagnosis of dehydration, and dehydration was the sole reason in 26%. Among those with dehydration, the most common length of stay was 2 days. In multivariable logistic regression, 30-day readmission with dehydration was associated with older age, male sex, history of an ileostomy, high ileostomy output during index admission, and a discharge creatinine >1.0.
LIMITATIONS
This study was limited by its retrospective design.
CONCLUSIONS
Ileostomy dehydration efforts have focused on new ileostomy patients; however, our data suggest that patients with a history of an ileostomy are actually at risk for readmission with dehydration. Further studies aimed at the reduction of readmission with dehydration after ileostomy are warranted and should include patients with a history of an ileostomy. See Video Abstract at http://links.lww.com/DCR/A643.
Topics: Age Factors; Aged; Creatinine; Dehydration; Female; Humans; Ileostomy; Length of Stay; Male; Middle Aged; Patient Readmission; Postoperative Complications; Retrospective Studies; Risk Factors; Sex Factors; United States
PubMed: 30239391
DOI: 10.1097/DCR.0000000000001137 -
The American Journal of Clinical... Sep 2010Well-recognized markers for static (one time) or dynamic (monitoring over time) dehydration assessment have not been rigorously tested for their usefulness in clinical,... (Clinical Trial)
Clinical Trial
BACKGROUND
Well-recognized markers for static (one time) or dynamic (monitoring over time) dehydration assessment have not been rigorously tested for their usefulness in clinical, military, and sports medicine communities.
OBJECTIVE
This study evaluated the components of biological variation and the accuracy of potential markers in plasma, urine, saliva, and body mass (B(m)) for static and dynamic dehydration assessment.
DESIGN
We studied 18 healthy volunteers (13 men and 5 women) while carefully controlling hydration and numerous preanalytic factors. Biological variation was determined over 3 consecutive days by using published methods. Atypical values based on statistical deviations from a homeostatic set point were examined. Measured deviations in body fluid were produced by using a separate, prospective dehydration experiment and evaluated by receiver operating characteristic (ROC) analysis to quantify diagnostic accuracy.
RESULTS
All dehydration markers displayed substantial individuality and one-half of the dehydration markers displayed marked heterogeneity of intraindividual variation. Decision levels for all dehydration markers were within one SD of the ROC criterion values, and most levels were nearly identical to the prospective group means after volunteers were dehydrated by 1.8-7.0% of B(m). However, only plasma osmolality (P(osm)) showed statistical promise for use in the static dehydration assessment. A diagnostic decision level of 301 plusmn 5 mmol/kg was proposed. Reference change values of 9 mmol/kg (P(osm)), 0.010 [urine specific gravity (U(sg))], and 2.5% change in B(m) were also statistically valid for dynamic dehydration assessment at the 95% probability level.
CONCLUSIONS
P(osm) is the only useful marker for static dehydration assessment. P(osm), U(sg), and B(m) are valid markers in the setting of dynamic dehydration assessment.
Topics: Adult; Biomarkers; Body Weight; Dehydration; Female; Humans; Male; Osmolar Concentration; Prospective Studies; ROC Curve; Reference Values; Saliva; Specific Gravity; Young Adult
PubMed: 20631205
DOI: 10.3945/ajcn.2010.29490 -
Nutrients Sep 2020Athletes use different combinations of weight loss methods during competition preparation. The aim of this study was to identify and characterize pre-competition weight...
Athletes use different combinations of weight loss methods during competition preparation. The aim of this study was to identify and characterize pre-competition weight loss models, which describe these combinations. The second aim was to determine if any existing model pose a higher risk of severe dehydration and whether any of the models could be continued as a lower-risk option. The third aim was to explore whether athletes who used different weight management strategies could be differentiated based on age, sex, training experience or anthropometric parameters. Study participants were randomly selected from Olympic taekwondo competitors and 192 athletes were enrolled. Active (47% weight-reducing athletes), passive (31%) and extreme (22%) models have been described. In the extreme model, athletes combined the highest number of different weight loss methods (3.9 ± 0.9 methods vs. 2.4 ± 0.9 in active and 1.5 ± 0.6 in passive), reduced significantly more body mass than others (6.7 ± 3.5% body mass vs. 4.3 ± 1.9% and 4.5 ± 2.4%; < 0.01) and all of them used methods with the highest risk of severe dehydration. The active and passive models could be continued as a lower-risk option, if athletes do not combine dehydrating methods and do not prolong the low energy availability phase. The extreme model carried the highest risk of severe dehydration. Every fifth weight-reducing taekwondo athlete may have been exposed to the adverse effects of acute weight loss. Taekwondo athletes, regardless of age, sex, training experience and anthropometric parameters, lose weight before the competition and those characteristics do not differentiate them between models.
Topics: Adolescent; Anthropometry; Athletes; Child; Cluster Analysis; Competitive Behavior; Dehydration; Female; Humans; Male; Martial Arts; Poland; Risk Factors; Weight Loss; Young Adult
PubMed: 32932611
DOI: 10.3390/nu12092793 -
Italian Journal of Pediatrics Dec 2010There is a high frequency of diarrhea and vomiting in childhood. As a consequence the focus of the present review is to recognize the different body fluid compartments,... (Review)
Review
There is a high frequency of diarrhea and vomiting in childhood. As a consequence the focus of the present review is to recognize the different body fluid compartments, to clinically assess the degree of dehydration, to know how the equilibrium between extracellular fluid and intracellular fluid is maintained, to calculate the effective blood osmolality and discuss both parenteral fluid maintenance and replacement.
Topics: Body Fluids; Body Water; Dehydration; Diarrhea; Extracellular Fluid; Fluid Therapy; Humans; Hypernatremia; Hyponatremia; Intracellular Fluid; Osmolar Concentration; Severity of Illness Index; Sodium Chloride; Treatment Outcome; Vomiting; Water-Electrolyte Balance
PubMed: 21144005
DOI: 10.1186/1824-7288-36-78 -
American Journal of Public Health Aug 1994Dehydration has been underappreciated as a cause of hospitalization and increased hospital-associated mortality in older people. This study used national data to analyze...
OBJECTIVES
Dehydration has been underappreciated as a cause of hospitalization and increased hospital-associated mortality in older people. This study used national data to analyze the burden and outcomes following hospitalizations with dehydration in the elderly.
METHODS
Data from 1991 Medicare files were used to calculate rates of hospitalization with dehydration, to examine demographic characteristics and concomitant diagnoses associated with dehydration, and to analyze the contribution of dehydration to mortality.
RESULTS
In 1991, 6.7% (731,695) of Medicare hospitalizations had dehydration listed as one of the five reported diagnoses, a rate of 236.2/10,000 elderly Medicare beneficiaries. In 1991, Medicare reimbursed over $446 million for hospitalizations with dehydration as the principal diagnosis. Older people, men, and Blacks had elevated risks for hospitalization with dehydration. Acute infections, such as pneumonia and urinary tract infections, were frequent concomitant diagnoses. About 50% of elderly Medicare beneficiaries hospitalized with dehydration died within a year of admission.
CONCLUSIONS
Hospitalization of elderly people with dehydration is a serious and costly medical problem. Attention should be focused on understanding predisposing factors and devising strategies for prevention.
Topics: Age Factors; Aged; Aged, 80 and over; Comorbidity; Cost of Illness; Dehydration; Female; Health Care Costs; Health Services Research; Hospital Mortality; Humans; Insurance, Health, Reimbursement; Male; Medicare; Outcome Assessment, Health Care; Patient Admission; Population Surveillance; Prognosis; Risk Factors; United States
PubMed: 8059883
DOI: 10.2105/ajph.84.8.1265 -
Journal of Speech, Language, and... Jan 2020Objective Consuming less water (systemic dehydration) has long been thought to dehydrate the vocal folds. An , repeated measures study tested the assumption that...
Objective Consuming less water (systemic dehydration) has long been thought to dehydrate the vocal folds. An , repeated measures study tested the assumption that systemic dehydration causes vocal fold dehydration. Proton density (PD)-weighted magnetic resonance imaging (MRI) of rat vocal folds was employed to investigate (a) whether varying magnitudes of systemic dehydration would dehydrate the vocal folds and (b) whether systemic rehydration would rehydrate the vocal folds. Method Male ( 25) and female ( 14) Sprague Dawley rats were imaged with 7T MRI, and normalized PD-weighted signal intensities were obtained at predehydration, following dehydration, and following rehydration. Animals were dehydrated to 1 of 3 levels by water withholding to induce body weight loss: mild (< 6% body weight loss), moderate (6%-10% body weight loss), and marked (> 10% body weight loss). Results There was a significant decrease in vocal fold signal intensities after moderate and marked dehydration ( < .0167). Rehydration increased the normalized signal intensity to predehydration levels for only the moderate group ( < .0167). Normalized signal intensity did not significantly change after mild dehydration or when the mildly dehydrated animals were rehydrated. Additionally, there were no significant differences in PD-weighted MRI normalized signal intensity between male and female rats ( > .05). Conclusion This study provides evidence supporting clinical voice recommendations for rehydration by increasing water intake after an acute, moderate systemic dehydration event. However, acute systemic dehydration of mild levels did not dehydrate the vocal folds as observed by PD-weighted MRI. Future programmatic research will focus on chronic, recurring systemic dehydration.
Topics: Animals; Dehydration; Disease Models, Animal; Female; Fluid Therapy; Magnetic Resonance Imaging; Male; Rats; Rats, Sprague-Dawley; Vocal Cords
PubMed: 31922926
DOI: 10.1044/2019_JSLHR-19-00062 -
Scientific Reports Oct 2019Chronic kidney disease (CKD) has become a major issue in long-term healthcare. It is caused by recurrent kidney injury, which is possible induced by dehydration and heat...
Chronic kidney disease (CKD) has become a major issue in long-term healthcare. It is caused by recurrent kidney injury, which is possible induced by dehydration and heat stress. Therefore, it is important to access the dehydration diagnosis on fields. Conventional instruments for assessing dehydration from blood and urine samples are expensive and time-consuming. These disadvantages limit their applications in high-risk groups susceptible to kidney disease. To address this unmet need, this study presents a portable miniaturized device for dehydration diagnosis with clinical saliva samples. With co-plane coating-free gold electrodes, the dehydration diagnosis was achieved with a saliva specimen at low volumes (50-500 μL). To examine the characteristics, the developed device was assessed by using standard conductivity solutions and the examined variation was <5%. To validate the use for field applications, saliva samples were measured by the developed device and the measured results were compared with standard markers of serum osmolality (N = 30). These data indicate that the measured saliva conductivity is consistent with serum osmolality. And it shows significant difference between healthy adults and healthy farmers (p < 0.05), who typically suffer high risks of CKD. Based on this work, the proposed device and measurement offer a useful method to diagnosis dehydrations and indicate possible potential for CKD.
Topics: Dehydration; Electric Conductivity; Electrochemical Techniques; Electrodes; Equipment Design; Humans; Kidney; Renal Insufficiency, Chronic; Saliva
PubMed: 31611585
DOI: 10.1038/s41598-019-51463-8