The association between dietary sodium intake and the risk of cataract: data from Korean National Health and Nutrition Examination Survey 2012 / 한국영양학회지

PURPOSE: Sodium intake is known to be a critical dietary factor in several diseases including cataract. Earlier studies have reported that excess intake of sodium may elevate the risk of cataract. However, little is known about this in Koreans. Thus, the purpose of this study was to examine whether dietary intake of sodium and potassium might modify the risk of cataract. METHODS: A total of 1,319 males (219 cases) and 1,966 females (369 cases) from Korean National Health and Nutrition Examination Survey 2012 were analyzed. Energy adjusted dietary intakes of sodium and potassium and their ratios were evaluated to ascertain their associations with the risk of cataract. Dietary intake levels were stratified into quartiles and their risk modifying effects were estimated with logistic regression models with or without subjects' socio-economic characteristics and life styles for each sex. RESULTS: Findings suggested that various descriptive factors were associated with the risk of cataract either in males or females. Males' intake levels of sodium and potassium and their ratios did not differ between phenotypes. Higher intakes or higher ratio was not associated with the risk of cataract. In contrast, female controls had higher intakes of sodium and potassium. Higher intake of potassium reduced the risk of cataract in females. However, such association was not retained when subjects' socioeconomic status and life styles were factored into the analysis. CONCLUSION: Dietary sodium and potassium intakes minimally affected the risk of cataract in Korean males and females. More studies are needed to ascertain the true pathological effect of sodium intake on cataract aetiology.

Primary hypoadrenocorticism in a dog / Hipoadrenocorticismo primário em um cão / Hipoadrenocorticismo primario en un perro

This report describes the clinical and laboratorial findings as well as the therapeutic protocol performed in a three-year-old mongrel female intact dog, referred to the Veterinary Hospital of FAMEZ/UFMS. The animal had a previous history of recurrent gastrointestinal signs (such as lethargy, vomiting, loss of appetite, melena and abdominal pain), acute crisis episodes, bradycardia, hypotension, hypothermia and increase of capillary refill time, recognized as addisonian crisis due to primary hypoadrenocorticism. Laboratorial findings included anemia, eosinophilia, neutrophilia, lymphocytosis, sodium-potassium ratio of 14,02 mEq/L and prerenal azotemia. Based on that, it was confirmed the diagnosis of primary hypoadrenocorcitism. Thus, it was recommended supplementation therapy with mineralocorticoid (aldosterone) and glucocorticoid (cortisol) corresponding respectively, fludrocortisone acetate of 0.2 mg per kg of BW, by mouth, once daily and prednisone 0.2 mg per kg of BW, by mouth, twice daily until further recommendations. The prognostic was excellent, since the animal significantly improved body condition, andclinical signs disappeared after therapy which lead the sodium-potassium ratio to 35.11 mEq/L. Thus, the clinician must always suspect of primary hypoadrenocorticism in dogs with intermittent nonspecific signs that get better with support therapy. Presumably, hypoarenocorticism must be under diagnosed in veterinary medicine, reinforcing the need to require specific exams in patients that show this wax and wane feature of clinical signs.

O presente relato descreve os achados clínicos, laboratoriais e conduta terapêutica de um animal da espécie canina, fêmea, com três anos de idade, inteiro, sem raça definida, diagnosticado com hipoadrenocorticismo primário atendido no Hospital Veterinário da FAMEZ/UFMS. O animal apresentou histórico de recidivas de sinais gastrintestinais (letargia, vômitos, perda de apetite, melena e dor abdominal), crise adrenal aguda, bradicardia, hipotensão, hipotermia e aumento do tempo de preenchimento capilar. As alterações laboratoriais compreenderam linfocitose, anemia, eosinofilia, neutrofilia, densidade urinária < 1.030, relação sódio: potássio 14,02 mEq/L e azotemia pré-renal. Baseado nos achados clínicos-laboratoriais confirmou-se o hipoadrenocorticismo primário. Em seguida, foi instituído terapia de suplementação de mineralocorticoide (aldosterona) e glicocorticoide (cortisol), correspondendo respectivamente ao acetato de fludrocortisona na dose de 0,2 mg/kg por via oral uma vez ao dia e prednisona 0,2 mg/kg por via oral duas vezes por dia até novas recomendações. O prognóstico foi excelente para este caso, já que houve melhora significativa do animal, com o desaparecimento dos sinais clínicos e com nova relação sódio: potássio de 35,11 mEq/L. Assim, deve-se sempre suspeitar de hipoadrenocorticismo primário canino em pacientes com o curso de aparecimento e desaparecimento com sinais inespecíficos que melhorem com terapia de suporte. Presume-se que o hipoadrenocorticismo primário em cães seja subdiagnosticado na medicina veterinária, por isso a importância dos clínicos em suspeitar e solicitar exames específicos em pacientes que apresentam esse curso da doença.

El informe describe los hallazgos clínicos, de laboratorio y manejo terapéutico de un perro, hembra, con tres años de edad, entera, mestizo, con diagnóstico de hipoadrenocorticismo primario atendido en el Hospital Veterinario de la FAMEZ/UFMS. El animal tuvo un historial de signos gastrointestinales recurrentes (letargia, vómitos, pérdida de apetito, melena y dolor abdominal), crisis renal aguda, bradicardia, hipotensión, hipotermia y un aumento del tiempo de llenado capilar. Las alteraciones de laboratorio presentaron linfocitosis, anemia, eosinofilia, neutrofilia, densidad de la orina < 1,030, relación sodio: potasio 14,02 mEq/L y azotemia prerrenal. Con base en los hallazgos clínicos y de laboratorio, se confirmó el hipoadrenocorticismo primario. A continuación, se introdujo terapia con administración de mineralocorticoide (aldosterona) y glucocorticoide (cortisol), que correspondieron respectivamente al acetato de fludrocortisona a una dosis de 0,2mg/kg por vía oral una vez al día y prednisona 0,2 mg/kg por vía oral dos veces al día hasta nuevas recomendaciones. El pronóstico fue excelente para este caso, ya que hubo mejora significativa del animal, desapareciendo los signos clínicos y con una nueva relación sodio: potasio de 35,11 mEq/L. Por lo tanto, siempre se debe sospechar del hipoadrenocorticismo primario canino en pacientes con el curso de aparecimiento y desaparecimiento con signos inespecíficos que mejoran con terapia de soporte. Es posible que el hipoadrenocorticismo primario en perros sea diagnosticado en la medicina veterinaria, así la importancia de los clínicos en sospechar y solicitar exámenes específicos en pacientes que presentan ese curso de la enfermedad.

Prediction of Cortical Defect Using C-Reactive Protein and Urine Sodium to Potassium Ratio in Infants with Febrile Urinary Tract Infection

PURPOSE: We investigated whether C-reactive protein (CRP) levels, urine protein-creatinine ratio (uProt/Cr), and urine electrolytes can be useful for discriminating acute pyelonephritis (APN) from other febrile illnesses or the presence of a cortical defect on 99mTc dimercaptosuccinic acid (DMSA) scanning (true APN) from its absence in infants with febrile urinary tract infection (UTI). MATERIALS AND METHODS: We examined 150 infants experiencing their first febrile UTI and 100 controls with other febrile illnesses consecutively admitted to our hospital from January 2010 to December 2012. Blood (CRP, electrolytes, Cr) and urine tests [uProt/Cr, electrolytes, and sodium-potassium ratio (uNa/K)] were performed upon admission. All infants with UTI underwent DMSA scans during admission. All data were compared between infants with UTI and controls and between infants with or without a cortical defect on DMSA scans. Using multiple logistic regression analysis, the ability of the parameters to predict true APN was analyzed. RESULTS: CRP levels and uProt/Cr were significantly higher in infants with true APN than in controls. uNa levels and uNa/K were significantly lower in infants with true APN than in controls. CRP levels and uNa/K were relevant factors for predicting true APN. The method using CRP levels, u-Prot/Cr, u-Na levels, and uNa/K had a sensitivity of 94%, specificity of 65%, positive predictive value of 60%, and negative predictive value of 95% for predicting true APN. CONCLUSION: We conclude that these parameters are useful for discriminating APN from other febrile illnesses or discriminating true APN in infants with febrile UTI.

Double logarithmic, linear relationship between postmortem vitreous sodium/potassium electrolytes concentration ratio and time since death in subjects of Chandigarh zone of Northwest India.

Present authors had recently demonstrated a highly significant double logarithmic linear relationship between time since death and serum sodium/potassium concentration ratio and also with the serum chloride concentration in humans. Consecutively the present study was carried out to substantiate this disposition in vitreous humour. The data on postmortem vitreous sodium/potassium electrolytes concentration ratio in 1026 subjects, revealed a highly significant relationship between logarithm of vitreous sodium/potassium electrolytes concentration ratio and logarithm of time since death upto 66 hrs. of death. Postmortem interval can be predicted from vitreous sodium/potassium electrolytes concentration ratio with standard error of estimate 0.1800 hrs. However, factors like environmental temperature, age & gender also influences it significantly.

The clinical implication of sodium-potassium ratios in dogs

Although there have been substantial evidences on the usefulness of electrolytes for the diagnosis of disease, the evidences for a direct link between serum sodium and serum potassium in relation to a specific disease are very limited. This study was performed to investigate an association between diseases and Na:K ratios in dogs. From January 1997 to December 1999, a total of 39 cases with an Na:K ratio less than 27 were retrieved from the medical records of Veterinary Medical Teaching Hospital, Seoul National University. Ten dogs (25.6%) had a renal or urinary disease, and six (15.4%) had a parasitism. Other miscellaneous diseases included deep pyoderma, grade III patellar luxation, bacterial pneumonia, diabetes, pancreatitis, and pyometra. The Na:K ratio was significantly lower in dogs with renal failures than those with parasitic diseases (p=0.0735). With the criterion of the Na:K ratio < 27, twenty seven dogs (69.2%) had hyperkalemia, whereas thirteen dogs (33.3%) had hyponatremia. Of 13 dogs with Na:K ratios between 20 and 24, six were diagnosed as a renal or urinary tract disease, two as diabetes, and two as a parasitism. The Na:K ratios of 9 dogs were < 20, being with the most prevalent with the disease of renal failures (55.6%). The serum Na:K ratios were more closely related to serum potassium concentrations (gamma= -0.8710) than serum sodium concentrations (gamma=0.4703). Two dogs with diabetes had an electrolyte pattern of hyperkalemia with normonatremia. Further studies are needed to determine the usefulness of Na:K ratio for diagnosis of hypoadrenocorticism, and to establish a relationship between patellar luxation and electrolyte unbalance.

A simple and rapid method for collecting saliva to assess sodium status in sheepum / Um método simples e rápido de colheita de saliva para avaliar estados normais ou deficientes de sódio, em ovinos

Fifteen lambs were fed diet with normal (0.11 percent) or deficient levels of sodium ( 0.035 percent), respectively, for five weeks on each diet. At the end of each period saliva was collected by three different methods: swabbing with a 5 x 5 x 1.25cm synthetic sponge, aspiration with a 15cm long plastic tube connected to a 20ml syringe and sucking with a 4mm x 45cm long plastic tube through a water-jet aspirator pump or an eletric motor pump. The volume of saliva collected/min and the salivary sodium: potassium ratio were analysed. Larger volume of saliva was obtained with the developed sucking apparatus than with the sponge or the syringe. There was no influence of the method of saliva collection on the values of salivary Na:K ratio in both periods. Nevertheless, the lower the sodium dietary level was, the smaller the salivary Na:K ratio. Five weeks of low sodium diet intake resulted in a decrease in the salivary Na:K ratio values by half. However, the lambs did not exhibit any clinical sign of sodium deficiency. The advantages of the developed method to collect saliva are discussed.

Neste experimento foram utilizados 15 cordeiros os quais receberam dietas com níveis adequados de sódio (0,11 por cento) ou deficientes deste elemento (0,035 por cento), respectivamente, por dois períodos de cinco semanas cada. Ao término de cada período, foram colhidas amostras de saliva, de todos animais, por três diferentes métodos: absorção com o uso de uma esponja sintética com as seguintes medidas 5 x 5 x 1,25cm; aspiração com um tubo plástico de 15cm de comprimento conectado a uma seringa de 20ml; e através de sucção por tubo plástico, com 4mm x 45cm de comprimento, ligado a uma trompa de vácuo conectada a uma torneira ou a uma bomba motora elétrica geradora de vácuo. Foram avaliados o volume de saliva colhida por minuto e a razão das concentrações de sódio:potásio salivar. Quantidades muito maiores de saliva (p < 0,001) foram colhidas através do método utilizando trompa ou bomba motora de vácuo que com o auxílio de esponja ou de seringa. Não existiu diferença entre a razão das concentrações Na:K salivar nas amostras colhidas pelos três diferentes métodos, nos períodos experimentais. A ingestão de uma dieta pobre em sódio, pelos ovinos, provocou uma queda, de cerca de 50 por cento, nos valores da razão Na:K salivar, comparado com os valores encontrados na dieta normosódica. Porém, os animais submetidos a dieta carente em sódio não apresentaram quaisquer sinais clínicos sugestivos de deficiência deste elemento. As vantagens do método desenvolvido para colheita de saliva são apresentadas e discutidas.