Purpose: To examine hydration practices and risk factors, including the over-consumption of fluids as measured by weight gain, associated with hyponatremia in non-elite runners participating in a cold weather half-marathon and marathon, and to observe gender-related differences in pre- to post-race weight change. Methods: Using an IRB-approved protocol, pre-race weight was measured and participants completed a pre-race questionnaire that included questions on age, gender, non-steroidal anti-inflammatory drug (NSAID) use, hydration beverage preferences, and race experience. Weight was also measured on participating racers shortly after they crossed the finish line, where a post-race questionnaire was also completed. Post-race questions related to during-race behaviors, including during-race fluid consumption frequency, fluid types consumed, number of urination stops, NSAID use just prior to race, and time to complete the race. Results: Pre- and post-race weights were measured for 17 marathon and 75 half-marathon participants. Marathon: The mean weight change for marathon participants was non-significant (-0.56 kg + 1.25; p=0.08). There was a statistically significant difference (p=0.012) in weight change between those who took NSAIDs prior to the race (+0.9 kg ± 1.4) and those who did not (-0.86 kg ± 1.0). Half-marathon: The mean weight change for half-marathon participants was non-significant (+0.14 kg + 1.2; p=0.33). There was a significantly different (p < .01) weight change between males (-0.57 kg ± 0.94) and females (+0.73 kg ± 1.1). There was no statistically significant difference in weight change between those who took NSAIDs and those who did not. Fluid consumption frequency was positively correlated with weight change (R=0.335; p=0.006) in half-marathon participants and (R=0.407; p=0.015) in female half-marathon participants, and finishing time was positively correlated with weight change (R=0.356, p=0.003). Conclusions: On average, the race-related weight change in the marathon runners was negative and not statistically significant, and the race-related weight change in the half-marathoners was positive and not statistically significant. Marathoners who used NSAIDs before the race gained significantly more weight than those who did not. Fluid consumption frequency in the half-marathoners was positively correlated with weight change, and finishing time in half-marathoners was positively correlated with weight change. On average, there was a significant difference (p<.01) in weight gain/loss pattern in males and females, with male half-marathoners losing weight and female half-marathoners gaining weight. These data suggest that females, slower runners, and those using NSAIDs prior to a cold weather endurance event may be at higher risk for over-hydration (as measured by weight gain), which is a major risk factor in hyponatremia.

Class of 2013 Abstract / Specific Aims: To describe the incidence of hyponatremia in patients using SSRIs and to assess how often health care professionals obtain electrolyte panels after SSRI initiation. Also, to identify the most recent sodium level in patients and to compare sodium levels in a patient group using an SSRI and a control group not using an SSRI. Subjects: Patients who received care at a large multi-center ambulatory care clinic between January 1st, 2008 and December 31st, 2011. Methods: An electronic medical record database was used to identify potential patients through medication records reflecting SSRI use or diagnosis of low back pain, obesity, pruritis, rash, or fibromyalgia. The following data was collected: patient gender, age, weight, height, use/non-use of SSRI, plasma sodium level, and documented past hyponatremia diagnosis. Plasma sodium levels and hyponatremia incidence were compared from the SSRI group to the non-SSRI group. In addition, the SSRI group was analyzed for incidence of documented hyponatremia. Monitoring of sodium levels after SSRI initiation was also investigated. Main Results: Overall, 500 charts were reviewed. After inclusion and exclusion criteria were applied, 118 patients were included in the study (38 in the SSRI group, 80 in the control group). The incidence of hyponatremia in the SSRI group and control group was 2.63% and 1.25% respectively. There was no significant difference between groups (p=0.542). Sodium levels were monitored 19.2% of the time after SSRI initiation. Conclusion: The incidence of hyponatremia was similar between groups. Physicians are not adequately monitoring for hyponatremia after SSRI initiation.

Ke Changshu. / "March 2001." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (p. 142-174). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

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As the number of people participating in marathons across the United States rises to include a population of amateur and first time runners, the prevention of hypernatremia and hyponatremia during these races becomes increasingly important to prevent serious outcomes of coma and death. Both of these conditions have been responsible for collapse, hospitalizations and even deaths of runners in past marathons. Prevention of these sodium imbalances in the body begins with adequate knowledge of proper hydration methods to adhere to while running a marathon. This specific area has been neglected by researchers in the past and no proper method of fluid intake has been appropriately supported with scientific trials. However, there is evidence to support the general lack of knowledge in the running community regarding hyponatremia and hypernatremia, as well as the dangerous side effects of over or under hydration during marathon races. This thesis proposes a randomized control trial to specifically study hydration during a marathon with investigation into which fluid is superior, water or sports drink, and whether drinking to thirst is the best strategy for optimal hydration.

Hyponatremia is common in preterm infants. The causes are usually related to the inability of the premature kidneys to excrete a given water load, excessive sodium losses, or inadequate sodium intake. Here, we present a case of severe hyponatremia in an extreme preterm infant, associated with the use of aminophylline. Aminophylline was administered intravenously on day 1 for the treatment of apnea of prematurity. On day 3, the patient developed hyponatremia which was not responsive to sodium replacement and fluid restriction. Due to concerns of aminophylline‑induced hyponatremia, aminophylline was discontinued on day 6, and within 48 h of discontinuation, serum sodium normalized without the need for sodium supplementation. The purpose of the case report is to present a rare complication associated with aminophylline use and to shed light on potential deleterious effects associated with drug shortages.

Intraperitoneal administration of cyclophosphamide 100 mg/kg and 200 mg/kg significantly lowered plasma sodium and significantly increased plasma potassium but did not result in saline preference in a strain of wild-derived house mice given a choice between water and saline (0.15M) to drink. Deoxycorticosterone acetate treatment in dosages up to 1.5 mg for four days also failed to increase salt intake. The data suggest a possible absence of a sodium appetite mechanism in this species.

Orientador: Norma Sueli Pinheio Módolo / Banca: José Reinaldo Cerqueira Braz / Banca: Jedson dos Santos Nascimento / Banca: Antônio Argolo Sampaio Filho / Banca: Guilherme Antônio Moreira de Barros / Resumo: Nas cirurgias cardíacas em crianças, a ocorrência de complicações neurológicas pósoperatórias representa um risco adicional de morbimortalidade. Ainda que uma parcela significativa dessas complicações seja atribuída a lesões de isquemia e reperfusão cerebral, outros fatores inerentes ao próprio procedimento podem contribuir para o seu desenvolvimento. O sistema nervoso central é particularmente sensível a mudanças abruptas da osmolaridade plasmática e variações significativas do teor de solutos no plasma pelo emprego de soluções parenterais com tonicidades diversas são esperadas no intraoperatório. O sódio sérico é o principal responsável pela osmolaridade plasmática e medidas seriadas desse eletrólito durante o procedimento podem indicar tais variações. Avaliar a variação do sódio sérico e as taxas de hiper ou hiponatremia no intraoperatório e de óbito, de infecção e de necessidade de suporte hemodinâmico medicamento conforme a ocorrência de complicações neurológicas no pós‐operatório de cirurgias cardíacas pediátricas, assim como comparar os tempos de internamento e ventilação mecânica entre os pacientes que apresentaram, ou não, tais complicações neurológicas. Dados de prontuário foram coletados em uma ficha padronizada com informações referentes ao procedimento anestésico‐cirúrgico e condições perioperatórias dos pacientes. Foram estabelecidas com testes não paramétricos a comparação dos tempos de ventilação mecânica e internamento na UTI e no hospital entre os pacientes que apresentaram, ou não, complicações neurológicas, assim como a análise da associação dessas complicações com a ocorrência de hiponatremia, hipernatremia, morte, infecção e suporte hemodinâmico medicamentoso no pósoperatório. O efeito da variação intraoperatória do sódio sérico na razão de chances para ocorrência de complicações neurológicas no ... / Abstract: In pediatric heart surgery, the occurrence of postoperative neurological complications introduces additional morbidity and mortality risk. Although a significant fraction of these complications can be attributed to cerebral ischemia and reperfusion injury, other factors inherent to the surgery itself might contribute to their occurrence. The central nervous system is particularly susceptible to abrupt changes of the plasma osmolarity, while significant intraoperative variations of the plasma solute concentration is expected due to the use of parental solutions with variable tonicities. The serum sodium concentration is the main determinant of the plasma osmolarity; thus, a serial measurement might reveal its intraoperative variation. The aims were to assess the intraoperative variation of the serum sodium concentration, the rates of hyponatremia, hypernatremia, death, and infection, and the need for pharmacological hemodynamic support as a function of the occurrence of postoperative neurological complications after pediatric heart surgery. Additionally, one aim was to compare the length of hospitalization and mechanical ventilation between the patients with and without such complications. Data on the anesthetic‐surgical procedure and perioperative state of the patients, which were collected from clinical records, were entered in a standard form. A comparison of the length of mechanical ventilation and stay in the intensive care unit (ICU) and the hospital between the patients with and without neurological complications and an analysis of the correlation of these complications with the postoperative occurrence of hypernatremia, hyponatremia, death, infections, and the need for pharmacological hemodynamic support were performed by means of non‐parametric tests. The effect of the intraoperative variation in the serum sodium concentration on the odds ratio for postoperative f neurological complications was ... / Mestre

Made available in DSpace on 2014-06-11T19:29:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-06-28Bitstream added on 2014-06-13T20:59:38Z : No. of bitstreams: 1 000749188.pdf: 705199 bytes, checksum: 52046300003dc98e846ffc1072cb7f3f (MD5) / Nas cirurgias cardíacas em crianças, a ocorrência de complicações neurológicas pósoperatórias representa um risco adicional de morbimortalidade. Ainda que uma parcela significativa dessas complicações seja atribuída a lesões de isquemia e reperfusão cerebral, outros fatores inerentes ao próprio procedimento podem contribuir para o seu desenvolvimento. O sistema nervoso central é particularmente sensível a mudanças abruptas da osmolaridade plasmática e variações significativas do teor de solutos no plasma pelo emprego de soluções parenterais com tonicidades diversas são esperadas no intraoperatório. O sódio sérico é o principal responsável pela osmolaridade plasmática e medidas seriadas desse eletrólito durante o procedimento podem indicar tais variações. Avaliar a variação do sódio sérico e as taxas de hiper ou hiponatremia no intraoperatório e de óbito, de infecção e de necessidade de suporte hemodinâmico medicamento conforme a ocorrência de complicações neurológicas no pós‐operatório de cirurgias cardíacas pediátricas, assim como comparar os tempos de internamento e ventilação mecânica entre os pacientes que apresentaram, ou não, tais complicações neurológicas. Dados de prontuário foram coletados em uma ficha padronizada com informações referentes ao procedimento anestésico‐cirúrgico e condições perioperatórias dos pacientes. Foram estabelecidas com testes não paramétricos a comparação dos tempos de ventilação mecânica e internamento na UTI e no hospital entre os pacientes que apresentaram, ou não, complicações neurológicas, assim como a análise da associação dessas complicações com a ocorrência de hiponatremia, hipernatremia, morte, infecção e suporte hemodinâmico medicamentoso no pósoperatório. O efeito da variação intraoperatória do sódio sérico na razão de chances para ocorrência de complicações neurológicas no... / In pediatric heart surgery, the occurrence of postoperative neurological complications introduces additional morbidity and mortality risk. Although a significant fraction of these complications can be attributed to cerebral ischemia and reperfusion injury, other factors inherent to the surgery itself might contribute to their occurrence. The central nervous system is particularly susceptible to abrupt changes of the plasma osmolarity, while significant intraoperative variations of the plasma solute concentration is expected due to the use of parental solutions with variable tonicities. The serum sodium concentration is the main determinant of the plasma osmolarity; thus, a serial measurement might reveal its intraoperative variation. The aims were to assess the intraoperative variation of the serum sodium concentration, the rates of hyponatremia, hypernatremia, death, and infection, and the need for pharmacological hemodynamic support as a function of the occurrence of postoperative neurological complications after pediatric heart surgery. Additionally, one aim was to compare the length of hospitalization and mechanical ventilation between the patients with and without such complications. Data on the anesthetic‐surgical procedure and perioperative state of the patients, which were collected from clinical records, were entered in a standard form. A comparison of the length of mechanical ventilation and stay in the intensive care unit (ICU) and the hospital between the patients with and without neurological complications and an analysis of the correlation of these complications with the postoperative occurrence of hypernatremia, hyponatremia, death, infections, and the need for pharmacological hemodynamic support were performed by means of non‐parametric tests. The effect of the intraoperative variation in the serum sodium concentration on the odds ratio for postoperative f neurological complications was ...

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A alocaÃÃo de pacientes em lista de espera para transplante hepÃtico no Brasil segue um critÃrio de urgÃncia, definido pelo escore MELD. Este escore, porÃm, tem falhado como preditor de mortalidade em alguns grupos de pacientes, especialmente os que apresentam hiponatremia. Estudos tÃm sugerido a incorporaÃÃo do sÃdio sÃrico no critÃrio MELD, tendo proposto um novo escore, o MELD-Na. O objetivo deste estudo foi avaliar o sÃdio sÃrico, o MELD, o MELD-Na e a hiponatremia grave como preditores de mortalidade em pacientes da lista de espera para transplante hepÃtico no Estado do Cearà nos anos de 2007 e 2008. Foram avaliados, retrospectivamente, os prontuÃrios de 145 pacientes que estavam na lista de espera neste perÃodo, sendo 85 pacientes que foram transplantados e 60 que evoluÃram à Ãbito aguardando um ÃrgÃo. Foram coletados os dados do sÃdio sÃrico e calculados os escores MELD e MELD-Na da Ãltima avaliaÃÃo dos mesmos antes do desfecho (transplante ou Ãbito), e realizada a anÃlise estatÃstica destas variÃveis comparando os grupos de transplantados com os que foram à Ãbito, no geral e por grupo sanguÃneo. Foi considerado hiponatremia o valor de sÃdio sÃrico inferior a 135 mmol/L, e hiponatremia grave o valor de sÃdio sÃrico inferior a 125 mmol/L. No grupo que foi transplantado, os valores mÃdios do MELD, do MELD-Na, do sÃdio sÃrico e da porcentagem do nÃmero de pacientes com hiponatremia grave foram, respectivamente, 20,88; 22,75; 136,33 mmol/L e 0%; e no grupo dos pacientes que foram à Ãbito, estes valores, foram, respectivamente, 19,65; 23,23; 132,2 mmol/L e 100%, com significÃncia estatÃstica entre os grupos nas variÃveis sÃdio sÃrico e presenÃa de hiponatremia grave. Hiponatremia associou-se claramente, e de forma independente, com Ãbito na lista de espera, principalmente nos grupos sanguÃneos âOâ e âAâ. Conclui-se que o escore MELD-Na foi superior ao escore MELD como preditor de mortalidade em alguns grupos de pacientes cirrÃticos; e que hiponatremia e, principalmente, hiponatremia grave sÃo importantes preditores de mortalidade em pacientes cirrÃticos em lista de espera para transplante hepÃtico. / The allocation of patients in waiting list for liver transplantation in Brazil follows an urgency criteria, definied by MELD score. This score, however, is failing as mortality predictor in some groups of patients, especially those with hyponatremia. Studies suggested that the incorporation of serum sodium into MELD score, proposing a new score, the MELD-Na. The objective of this study is to evaluate the serum sodium, the MELD, the MELD-Na and the severe hyponatremia as mortality predictors in patients in waiting list for liver transplantation in the State of Ceara in the years of 2007 and 2008. The promptuaries of 145 patients that were in the waiting list were, retrospectively, evaluated, with 85 patients that were transplanted, and 60 who have died. Serum sodium data were collected and MELD and MELD-Na scores were calculated on basis on the last evaluation of these patients before the outcome (transplantation or death), and the statistical analysis of these variables comparing the group that was transplanted with the group that have died, in the general and by blood group. Hyponatremia was definied when serum sodium value was under 135 mmol/L, and severe hyponatremia when serum sodium value was under 125 mmol/L. In the transplanted group, the mean values of MELD, of MELD-Na, of serum sodium and the percentage of the number of patients with severe hyponatremia were, respectively, 20,88; 22,75; 136,33 mmol/L and 0%; and in the group that have died, these values were, respectively, 19,65; 23,23; 132,2 mmol/L and 100%, with statistical significance between the groups in the variables serum sodium and presence of severe hyponatremia. Hyponatremia was clearly, and independently, associated with death in the waiting list, especially in the âOâ and âAâ blood groups. The conclusion is that MELD-Na score was superior to MELD score as mortality predictor in some groups of cirrhotic patients; and that hyponatremia and, mainly, severe hyponatremia are important as mortality predictors in cirrhotic patients in waiting list for liver transplantation.