Calcium foliar fertilization and its effect on quality and shelf life in andean blackberry fruits (Rubus glaucus Benth.)

Calcium is the third most crucial nutrient for andean blackberry; however, its absorption is limited in acid soils, and its low mobility in the plant decreases its effects on fruits. Therefore, the effect of foliar fertilizers with calcium on andean blackberry fruits was estimated. In three locations, experiments were established with five calcium sources (Ca chelate, CaB nitrate, Ca oxide, CaB and CaBZn gluconate) and a control without calcium, applied in three phenological stages and recording: weight, diameters, firmness, color, juice, pulp, pH, soluble solids, acidity, dehydration, and damage. Soil and tissue analysis was performed to identify the relationship between the plant's nutritional conditions and its fertilization response. For the statistical analysis were used mixed models, tests of means, and principal components. Foliar fertilization with chelate, nitrate, and calcium oxide in andean blackberry crops with thorns, in production, with pruning management, and in the phenological stages of flower bud, fruit set, and red fruit, is a viable alternative to improve firmness, weight, and diameter of the fruits. In contrast, the chemical and color parameters in andean blackberry fruits depend on the edaphoclimatic conditions of each zone. This fertilization should be considered as a complement in soils without acidity problems and with balanced cationic saturations.

El calcio es el tercer nutriente más importante para la mora; sin embargo, su absorción se ve limitada en suelos ácidos y su baja movilidad en planta disminuye su efecto en frutos. Por tanto, se estimó el efecto de fertilizantes foliares con calcio en frutos de mora. En tres localidades, se establecieron experimentos con cinco recursos de Ca (quelato de Ca, nitrato de CaB, óxido de Ca, KCaB y gluconato de CaBZn) y un control sin calcio, aplicados en tres etapas fenológicas y registrándose: peso, diámetros, firmeza, color, jugo, pulpa, pH, sólidos solubles, acidez, deshidratación y daños. Se realizó análisis de suelo y tejido, para identificar la relación entre las condiciones nutricionales de la planta y su respuesta a la fertilización. Para el análisis estadístico, se utilizaron modelos mixtos, pruebas de medias y componentes principales. La fertilización foliar con quelato, nitrato y óxido de calcio en cultivos de mora andina con espinas, en producción, con manejo de podas y en las etapas fenológicas de botón floral, cuajado y fruto rojo, es una alternativa viable para mejorar la firmeza, peso y diámetro de los frutos. En contraste, los parámetros químicos y de color en frutos de mora andina dependen de las condiciones edafoclimáticas propias de cada zona. Esta fertilización, se debe considerar como complemento en suelos sin problemas de acidez y con saturaciones catiónicas equilibradas.

Factores de riesgo asociados a deshidratación hipernatrémica neonatal

Introducción: La deshidratación hipernatrémica neonatal es un problema creciente, en la que la alimentación y los conocimientos sobre cuidados del recién nacido juegan un papel primordial. Objetivo: Determinar los factores de riesgo asociados a la deshidratación hipernatrémica en neonatos. Métodos: Estudio observacional descriptivo retrospectivo en una población de 20 neonatos con deshidratación hipernatrémica ingresados en el servicio de cuidados intermedios de un hospital de Lima, Perú entre junio 2017- septiembre 2018. Todos tenían concentraciones de sodio sérico≥150 mmol/L. La recolección de la información se extrajo de las historias clínicas. Resultados: De los 20 neonatos con deshidratación hipernatrémica; los nacidos por cesárea equivalen a 30 %, mientras que por parto vaginal, a 70% de los casos. Se demostró que hay una relación inversa entre número de gestación y concentraciones de sodio al ingreso, sin embargo, no hubo significación estadística. Se logró una disminución entre sodio de entrada y su primer control, con una media de disminución de 0,57 meq/L/h. Clínicamente los neonatos afectados desarrollaron en mayor porcentaje ictericia y fiebre. No se encontró relación significativa entre el resto de los factores asociados. Conclusiones: Entre los factores de riesgo asociados a la deshidratación hipernatrémica, destaca que el grupo nacidos por cesárea fue menor que los nacidos por parto vaginal, lo que influye en el número de altas precoces al nacimiento. Ictericia y fiebre continúan siendo las características clínicas que debe identificarse tempranamente. Se trata de un cuadro prevenible si se brinda adecuada información a la madre sobre cuidado neonatal.

Introduction: Neonatal hypernatremic dehydration is a growing problem, in which feeding and knowledge about newborn care play a key role. Objective: To determine the risk factors associated with hypernatremic dehydration in neonates. Methods: Retrospective descriptive observational study in a population of 20 neonates with hypernatremic dehydration admitted to the intermediate care service of a hospital in Lima, Peru between June 2017 and September 2018. All of them had serum sodium concentrations≥150 mmol/L. The collection of information was extracted from medical records. Results: Of the 20 neonates with hypernatremic dehydration, those born by cesarean section are equivalent to 30%, while by vaginal delivery, 70% of cases. It was shown that there is an inverse relationship between gestation number and sodium concentrations at admission, however, there was no statistical significance. A decrease was achieved between input sodium and its first control, with a mean decrease of 0.57 meq/L/h. Clinically, the affected neonates developed a higher percentage of jaundice and fever. No significant relationship was found between the rest of the associated factors. Conclusions: Among the risk factors associated with hypernatremic dehydration, it stands out that the group born by cesarean section was lower than those born by vaginal delivery, which influences the number of early discharges at birth. Jaundice and fever continue to be the clinical features that should be identified early. This is a preventable condition if adequate information is provided to the mother about neonatal care.

Assessment of mothers' knowledge and use of oral rehydration therapy for diarrhoea in children under 5 years in Ife, Nigeria

Diarrhoeadisease is the second leading cause of death in children under 5 years old, and is responsible for killing about 300, 000 children annually in Nigeria. Oral rehydration therapy (ORT) is the preferred treatment for fluid and electrolyte losses due to diarrhoea in children with mild to moderate dehydration. This study aimed to assess the knowledge and use of ORT in the management of diarrhoea in children under 5 years at Seventh Day Adventist Hospital (SDAH, Ife).Method: A structured questionnaire was adopted for this study design and data was collected using a self-structured questionnaire both self-administered and interviewer administered.Results: Of 80 participants, 44 (55%) of the respondents had heard of ORT before this study, while 36 (45%) had not. 48 (60%) responded that they use oral rehydration solution while 32 (40%) of mothers said they had not used ORT. There was significant difference in both outcomes. The result revealed that there was significant difference in morbidity and mortality between mothers who use ORT and those who do not. But there was no significant difference between the knowledge of ORT compared with its use.Conclusion:Appropriate knowledge of the therapy will positively influence its use which will drastically prevent morbidity associated with diarrhoea as well as contain the incidence of mortality

Diagnosis and treatment of hypertonic dehydration in the elderly / 中华老年医学杂志

Hypertonic dehydration is prevalent in the elderly, increases the risk of adverse events, reduces quality of life, and increases hospitalization and mortality.Current methods of diagnosing dehydration, such as physical signs, urine tests, urea nitrogen/creatinine, bioelectrical impedance and saliva, are not suitable for the diagnosis of dehydration in the elderly.There is no gold standard for the diagnosis of hypertonic dehydration in the elderly.The European Society for Clinical Nutrition and Metabolism(ESPEN)recommends the direct measurement of plasma/serum osmotic pressure or using an osmotic pressure formula[osmolarity(mmol/L)=1.86 ×(Na + + K + )+ 1.15×glucose+ urea+ 14](all measured in mmol/L)for the diagnosis of hypertonic dehydration.

Receptor Activator of NF-kB Ligand Induced Osteoclastogenesis in Cervical Spondylosis - Role of Balamula Ghritam (A Powerful Antioxidant Drug) as Uttarabhaktika Sneha

The discs which are located in between the vertebras to act as shock absorbers during jolts to prevent spine injuries get either dislocated, bulged out or get thinned on continuous pressure being exerted upon them either by travel or a posture that is unsuitable to their alignment. In cases of discs getting thinned out and the height of these discs get reduced due to various causes produce undue pressure over the cervical spine resulting in oxidative stress and production of free radicals in the body causing deterioration of bone tissue and bone mass leading to regulation of RANKL/OPG ratio levels causing degeneration of bone. It is possible to resurrect the dehydrated discs with rehydration using Balamula (Sida cordifolia root) with the help of its properties and actions that it can positively act upon the area by refilling the gaps of erosions and assure a recovery with the proper administration of it in the form of ghee which has been processed with it and its intake being after food. Material & Methods: Various Ayurvedic classical textbooks and published journal articles were reviewed and analysed. Results: Evidences from various studies show that the phytochemicals obtain from Balamula (Sida cordifolia root) and Go- Ghritam (cow’s ghee) acts as antioxidant, reduces the activity of osteoclast and bone resorption by inhibiting RANKL receptor pathway. It also has anti-inflammatory, anti-arthritic, anti-analgesic effect that found to be effective in reducing the symptoms of cervical spondylosis.

Effects of Solar Drying on the Structural and Thermodynamic Characteristics of Bee Pollen / Efectos del secado solar sobre las características estructurales y termodinámicas del polen apícola

Background: Bee pollen is a natural product collected and transformed by bees, intended for human consumption, given its nutritional and bioactive richness. The fundamental operation of adequacy is drying, which allows its preservation, avoiding chemical or microbiological degradation, typically using tray dryers with hot air that use electricity or fuel for heat generation. Solar drying is an alternative that uses radiation as an energy source. However, it should be ensured that this type of process guarantees the quality of the product while not degrading its properties and, therefore, maintaining its morphological integrity. Objective: to establish the effect of solar drying on bee pollen structure compared to the conventional cabin dehydration process. Methods: Bee pollen was dehydrated using two types of dryers: a solar dryer and a forced convection oven. The solar dryer operating conditions were an average temperature of 19-35 °C with a maximum of 38 °C and average relative humidity (RH) of 55 %. Cabin dryer operating conditions were a set point temperature of 55 ± 2 °C and 10 % RH average humidity. The morphologic and thermodynamic properties of dried bee pollen, such as phase transition enthalpy through Differential Scanning Calorimetry (DSC), porosity and surface area through surface area analysis, and microscopic surface appearance by Scanning Electron Microscopy (SEM), were measured. Results: The results showed dry bee pollen, both in the cabin dryer and solar dryer, did not suffer morphological changes seen through SEM compared to fresh bee pollen. Moreover, surface area analysis indicated the absence of porosity in the microscopic or macroscopic structure, demonstrating that solar or cabin drying processes did not affect the specific surface area concerning fresh bee pollen. Additionally, Differential Scanning Calorimetry (DSC) and Thermo Gravimetric Analysis (TGA) showed that endothermic phase transitions for dried bee pollen by cabin or solar dryer were at 145 °C and 160 °C, respectively. This can be mostly associated with free water loss due to the morphological structure preservation of the material compared to fresh bee pollen. Conclusion: These results demonstrate that solar drying is a reliable alternative to bee pollen dehydration as there were no effects that compromised its structural integrity

Antecedentes: El polen apícola es un producto natural recolectado y transformado por las abejas. La operación fundamental de adecuación del polen es el secado, lo que permite su conservación, evitando su degradación química o microbiológica, típicamente se utilizan secadores de bandejas con aire caliente que emplean electricidad o combustibles para la generación de calor. El secado solar es una alternativa que utiliza la radiación solar como fuente de energía. Sin embargo, se debe garantizar que este tipo de proceso asegure la calidad del producto a la vez que no degrade sus propiedades, manteniendo su integridad morfológica. Objetivo: Establecer el efecto del secado solar sobre la estructura del polen apícola en comparación al proceso convencional de deshidratación en cabina. Métodos: El polen de abeja se deshidrató utilizando dos tipos de secadores: secador solar y horno de convención forzada. Las condiciones de operación del secador solar fueron una temperatura promedio de 19-45 °C con un máximo de 38 °C y una humedad relativa (HR) promedio de 55 %. Las condiciones de operación del secador de cabina fueron una temperatura de referencia de 55 ± 2 °C y una humedad promedio de 10 % HR. Se midieron las propiedades morfológicas y termodinámicas del polen de abeja desecado, como la entalpía de transición de fase mediante calorimetría diferencial de barrido (DSC), la porosidad y el área superficial mediante análisis de área superficial y el aspecto microscópico de la superficie mediante microscopía electrónica de barrido (SEM). Resultados: Los resultados mostraron que el polen seco tanto en el secador de cabina como en el secador solar muestra que no sufrió cambios morfológicos vistos a través de Microscopía Electrónica de Barrido y en comparación con el polen fresco de abeja, además un análisis de sortometría indicó la ausencia de porosidad en la estructura microscópica y macroscópica, lo que indica que los procesos de secado solar o en cabina no tuvieron efectos sobre el área superficial específica con respecto al polen fresco de las abejas. En adición, los resultados de calorimetría diferencial de barrido (DSC) y análisis termogravimétrico (TGA) muestran que las transiciones de fase endotérmicas para el polen seco tanto en secado de cabina como solar fueron a 145 °C y 160 °C, que puede asociarse mayormente a la pérdida de agua libre, debido a la conservación de la estructura morfológica del material y en comparación al polen fresco. Conclusión: Estos resultados demuestran que el secado solar es una alternativa viable para la deshidratación del polen al no existir efectos que comprometan su integridad estructural

Risk Factors for Dyselectrolytemia in Children with Acute Diarrhoea in the Inpatient Setting in North India

Background: Dyselectrolytemia is a common accompaniment of acute diarrheal illnesses and contributes to increased morbidity and mortality. Aim: To study the incidence and identify the risk factors for developing dyselectrolytemia in children getting admitted with acute diarrhoea. Study design: Prospective observational study. Methods: Detailed history, examination, and investigations were recorded in specially designed proforma. Serum electrolyte levels were measured at admission in all the study subjects and correlated with clinical presentation and demographic profile. Results: Out of 107 children, 64.5% had no dehydration, 31.8% had some dehydration, and only 3.4% were severely dehydrated at the time of admission. Most common electrolyte abnormality were hyponatremia(25.2%) and hypochloraemia (25.2%), followed by hypokalaemia (11.2%), hyperchloremia (9.3%) and hypernatremia (6.5%). The degree of dehydration was found to significantly affect serum electrolyte profile (p value<0.05). Hyponatremia (41%), hypokalaemia(26.5%), and hypochloraemia(35%) were seen more commonly in patients with some dehydration, while a higher proportion of patients with severe dehydration had hypernatremia (50%) and hyperkalaemia (25%). Consumption of diluted ORS was significantly associated with the development of hyponatremia (73.9%), hypokalaemia(34.8%), and hypochloraemia(56.5%) p value<0.05. Conclusion: Dyselectrolytemia is a common accompaniment of diarrheal dehydration, the most common being hyponatremia. The severity of dehydration and dilute ORS administration are important risk factors for dyselectrolytemia.

Síndrome de enterocolite induzida por proteína alimentar como diagnóstico diferencial das alergias alimentares: relato de caso / Food protein-induced enterocolitis syndrome as a differential diagnosis for food allergies: a case report

A síndrome da enteropatia induzida por proteína alimentar, aguda ou crônica, é um tipo de alergia alimentar não mediada por IgE, que surge entre os 5 e 9 meses de idade, e é caracterizada por episódios de vômitos que começam aproximadamente 1 a 4 horas após a ingestão do alérgeno, algumas vezes acompanhados de letargia, palidez cutânea e diarreia com sangue, resultando em instabilidade hemodinâmica e choque em 15% dos casos. Sua epidemiologia em larga escala é desconhecida, assim como o mecanismo imunopatológico, no entanto, sugere-se um papel importante das células T no processo inflamatório. As manifestações e a gravidade dependem da frequência e da dose do alimento desencadeante, bem como do fenótipo e da idade de cada paciente. A suspeita se dá com base principalmente na história clínica e nos sintomas característicos da doença, que tendem a melhorar após a retirada do alimento suspeito. O teste de provocação oral é o padrão ouro para o diagnóstico, mas deve ser reservado para os casos em que a história é confusa e a hipótese incerta. A abordagem de primeira linha no tratamento visa corrigir a desidratação ou estabilizar o choque quando presente, e interromper imediatamente a oferta de alimentos com potencial indutor de reação alérgica. Relatamos o caso de uma lactente de 2 meses de idade com diagnóstico da síndrome, cujo objetivo é atentar o leitor quanto as suas particularidades, auxiliando-o no diagnóstico precoce e adequado a fim de evitar a depleção progressiva e a evolução para sua forma potencialmente grave.

Acute or chronic food protein-induced enteropathy syndrome is a type of non-IgE-mediated food allergy occurring between 5 and 9 months of age. It is characterized by episodes of vomiting that begin approximately 1 to 4 hours after allergen intake, sometimes accompanied by lethargy, skin pallor, and bloody diarrhea, leading to hemodynamic instability and shock in 15% of cases. Its epidemiology is largely unknown, as well as its immunopathological mechanism; however, an important role of T cells in the inflammatory process is observed. Manifestations and severity depend on the frequency and dose of the triggering food, as well as the phenotype and age of each patient. Suspicion is based mainly on clinical history and characteristic symptoms of the disease, which tend to improve after the removal of the suspect food. Oral provocation testing is the gold standard for diagnosis, but it should be reserved for cases whose history is confusing and hypothesis is uncertain. The first-line treatment approach seeks to correct dehydration or to stabilize shock, if present, and to immediately stop the supply of food that potentially induce an allergic reaction. We report the case of a 2-month-old infant diagnosed with the syndrome, with the aim of drawing the readers' attention to its particularities, thus assisting in early and adequate diagnosis in order to avoid progressive depletion and deterioration to its potentially severe form.

Consumption of osmo-dehydrated Andean Berry (Vaccinium meridionale Swartz) decreases levels of pro-inflammatory biomarkers of overweight and obese adults / Consumo de agraz osmodeshidratado (Vaccinium meridionale Swartz) disminuye los niveles de biomarcadores proinflamatorios de adultos con sobrepeso y obesidad

Background: A Body Mass Index (BMI) greater than 24.9 Kg/m2 promotes chronic inflammation due to increased secretion of pro-inflammatory adipokines. Consuming fruits rich in bioactive compounds such as berries is a promising strategy to counteract this effect. Objectives: Determine the effect of osmo-dehydrated Andean Berry consumption on inflammatory biomarkers (TNF-α, IL- 6, IL-1ß, and adiponectin) and plasma antioxidant capacity in overweight and obese adults after 21 days. Methods: Andean Berry was osmo-dehydrated in 70% sucrose syrup. Antioxidant activity, proximal composition, phenolic content, microbiological analysis, and sensory analysis of the product were determined. Twenty-five obese and overweight subjects consumed 35g of osmo-dehydrated berry for 21 days. Inflammatory biomarkers and antioxidant capacity in plasma were evaluated at the beginning and end of the study. Results: Osmo-dehydrated Andean Berry presented a total phenolic content of 692.7 ± 47.4 mg Gallic Acid Equivalents/100 g. All biomarkers evaluated in the subjects showed statistically significant differences (p> 0.05), except for CRP, before and after the study. IL-6 presented the more significant reduction among all pro-inflammatory adipokines with an effect size of 18.4 Conclusions: Regular consumption of osmo-dehydrated Andean Berry contributes to decreasing pro-inflammatory biomarkers and improves the plasma antioxidant capacity of overweight and obese adults

Antecedentes: un índice de masa corporal (IMC) superior a 24.9 kg/m2 promueve la inflamación crónica debido al aumento en la secreción de adipocinas proinflamatorias. El consumo de frutas ricas en compuestos bioactivos como las bayas es una estrategia prometedora para contrarrestar este efecto. Objetivo: Determinar el efecto del consumo de agraz osmodeshidratado en biomarcadores inflamatorios (TNF-α, IL- 6, IL-1ß y adiponectina) y capacidad antioxidante plasmática de adultos con sobrepeso y obesidad después de 21 días. Métodos: El agraz fue osmo-deshidratado en jarabe de sacarosa al 70%. Se determinó la actividad antioxidante, composición proximal, contenido fenólico, análisis microbiológico y análisis sensorial del producto. Veinticinco sujetos obesos y con sobrepeso consumieron 35 g de agraz osmodeshidratado durante 21 días. Se evaluaron biomarcadores inflamatorios y capacidad antioxidante en plasma al inicio y al final del estudio. Resultados: El agraz osmodeshidratado presentó un contenido fenólico total de 692.7 ± 47.4 mg GAE / 100 g. Todos los biomarcadores evaluados en los sujetos mostraron diferencias estadísticamente significativas (p> 0.05), a excepción de la PCR, antes y después del estudio. La IL-6 presentó la mayor reducción entre todas las adipocinas proinflamatorias con un tamaño del efecto de 18.4 Conclusiones: El consumo regular de agraz osmodeshidratado contribuye a disminuir los biomarcadores proinflamatorios y mejora la capacidad antioxidante plasmática de adultos con sobrepeso y obesidad

VIPoma: a rare cause of diarrhea. A case report / VIPoma: una causa poco frecuente de diarrea. Case report

Abstract Introduction: Vasoactive intestinal peptide-secreting tumor (VIPoma) is a rare functional pancreatic neuroendocrine tumor (F-PNET) characterized by secretory diarrhea, hypokalemia, and hypochlorhydria. Its low incidence and high risk of malignancy pose a clinical challenge that requires a high degree of clinical suspicion. Case presentation: A 61-year-old woman visited the emergency department of a tertiary care hospital in Medellín, Colombia, due to chronic diarrhea (7 months) that led to dehydration, renal failure, metabolic acidosis, and hypokalemia. As a result, a treatment based on loperamide, intravenous fluids and broad-spectrum antibiotics was started. In addition, chromogranin A levels of 477 ug/L (<100) were reported, while an abdominal MRI showed a 33x30mm mass in the head and uncinate process of the pancreas, so outpatient surgical management was decided. However, three days after discharge, and due to the persistence of clinical signs, the patient was admitted to another hospital (also a tertiary care hospital), where, given the high suspicion of VIPoma, and once the diarrhea was solved, the mass was removed (Whipple procedure) without any complication. Finally, the diagnosis was confirmed based on serum vasoactive intestinal peptide levels (930 pg/mL (RV<75)) and the pathology report (PNET tumor grade 2). Two years after the surgery, the patient was asymptomatic, and no residual lesions or metastases were evident in a control MRI. Conclusion: Late diagnosis of VIPoma is associated with worsened quality of life, severe complications, and high prevalence of metastasis. Therefore, it should be suspected in patients with chronic secretory diarrhea that is not caused by an infection, since early diagnosis and timely treatment can contribute to achieving better survival rates in these patients.

Resumen Introducción. El tumor secretor de péptido intestinal vasoactivo o VIPoma es un tumor funcional neuroendocrino pancreático (F-PNET) raro caracterizado por diarrea secretora, hipokalemia e hipoclorhidria. Su baja incidencia y alto riesgo de malignidad representan un reto clínico que requiere un alto grado de sospecha clínica. Presentación del caso. Mujer de 61 años quien consultó al servicio de urgencias de un hospital de tercer nivel en Medellín, Colombia, por diarrea crónica (7 meses) que llevó a des-hidratación, falla renal, acidosis metabólica e hipokalemia, por lo que se inició manejo con loperamida, líquidos endovenosos y antibióticos de amplio espectro. Además, se reportaron niveles de cromogranina A de 477 ug/L (<100) y, mediante resonancia magnética (RM) abdominal, se identificó masa de 33x30mm en cabeza y proceso uncinado de páncreas, por lo que se decidió manejo quirúrgico ambulatorio. Sin embargo, tres días después del alta, la paciente ingresó, por persistencia de los signos, a un segundo hospital (también de tercer nivel), donde ante la alta sospecha de VIPoma, y una vez superada la diarrea, se extirpó la masa (procedimiento de Whipple). Finalmente, con base en los niveles séricos de péptido intestinal vasoactivo (930 pg/ml (VR<75)) y el informe de patología (tumor PNET grado 2), se confirmó el diagnóstico. Dos años después del procedimiento, la paciente se encontraba asintomática y sin evidencia de lesiones residuales ni metástasis en RM de control. Conclusión. El diagnóstico tardío de VIPoma se asocia con detrimento de la calidad de vida, complicaciones graves y alta prevalencia de metástasis, por lo que debe sospecharse en pacientes con diarrea crónica secretora no causada por infecciones, pues de diagnosticarse a tiempo e iniciarse el tratamiento oportuno se pueden lograr mejores tasas de supervivencia en estos pacientes.

Hidratación en el síndrome urémico hemolítico / Hydration in hemolytic uremic syndrome

El síndrome urémico hemolítico asociado a diarrea es precedido por una gastroenteritis por Escherichia coli productora de toxina Shiga. Se recomiendan medidas de sostén, especialmente, la restricción hídrica para evitar la sobrecarga cardiopulmonar. Sin embargo, la expansión de volumen con líquidos isotónicos, en el período prodrómico o síndrome urémico hemolítico establecido, es segura y eficaz, reduce los requerimientos de diálisis, los días de internación y de terapia intensiva, los eventos neurológicos y la hiponatremia.Por ello, se propone, bajo supervisión nefrológica y/o garantizando el acceso a un centro de alta complejidad a corto plazo, hidratar a todo paciente sin signos de sobrecarga cardiopulmonar, independientemente de su función renal, con expansión inicial de volumen. Luego, si se logra una diuresis adecuada, no dializarlo (excepto que presente un trastorno metabólico/electrolítico intratable médicamente) y continuar la hidratación con una solución isotónica de dextrosa al 5 % para una adecuada hidratación y diuresis.

Diarrhea-associated hemolytic uremic syndrome is preceded by gastroenteritis due to Shiga toxin-producing Escherichia coli. Support measures are recommended, specifically, fluid restriction to avoid cardiopulmonary overload. However, in the prodromal period or with established hemolytic uremic syndrome, volume expansion with isotonic fluids is safe and effective, and reduces the need for dialysis, the length of hospital and intensive care stay, neurological events, and hyponatremia.Therefore, when nephrological monitoring is available and/or short-term access to a tertiary care hospital is guaranteed, it is suggested to hydrate patients with no signs of cardiopulmonary overload, regardless of their renal function, with initial volume expansion. Afterwards, if an adequate urine output is achieved, the patient should not be dialyzed (except if they have a medically intractable metabolic/electrolyte disorder) and hydration should be continued with an isotonic solution containing 5 % dextrose for adequate hydration and urine output.

Deshidratación en el paciente adulto / Dehydration in Adult Patients

Resumen: La deshidratación es un estado clínico como consecuencia de la pérdida de agua y solutos, las causas en adultos son diversas, entre ellas están las pérdidas gastrointestinales, renales, alteraciones en la piel (quemaduras) o secuestro del tercer espacio (fracturas). El diagnóstico es clínico, los signos y síntomas determinan el grado de deshidratación y el tratamiento a implementar. En este trabajo se hace una revisión sobre la fisiología, fisiopatología, cuadro clínico, y manejo terapéutico del paciente adulto, ya que existe escasa literatura dirigida a este grupo etario.

Abstract: Dehydration is a clinical state due to the loss of water and solutes; in adults the causes of this clinical state are diverse: gastrointestinal and renal losses, skin alterations (burns) or sequestration of the third space (fractures). The diagnosis is clinical, the signs and symptoms determine the degree of dehydration and the treatment to be implemented. In this work a review is made on the physiology, pathophysiology, clinical picture and therapeutic treatment of the adult patient, since there is little literature directed to this age group.

Fluid balance during taekwondo training / Equilíbrio hídrico durante treinamento de taekwondo / Equilibrio hídrico durante entrenamiento de taekwondo

ABSTRACT Introduction Dehydration has been described as one of the main factors of reduced performance in combat sports activities, leading to death in extreme cases. Objective To investigate the pre-training hydration status and changes in fluid homeostasis during two taekwondo training sessions. Methods Eighteen male college athletes (age 22.6 ± 3.37 years) were assessed. The study design aimed to reproduce the conditions of a 90-minute taekwondo training session, divided into three stages: a) warm-up exercises (20 min); b) poomsae (30 min) and c) technical training (40 min). The athletes had ad libitum water intake during training. To assess the hydration status we considered body mass (BM), the amount of liquid consumed and urine output, which enabled us to establish absolute and relative fluid loss in kg and percentage as well as the sweating rate. We also considered urine specific gravity (USG), urine color (U-COL), and subjective sensation of thirst (Sthirst) before and after the training session. Pre- and post-training results were compared separately in each session and between sessions. Results There was a significant difference (P<0.05) in pre-training BM between the two days of training. There was a significant difference (P<0.05) in the final BM on both days of the experiment. Most subjects had relative dehydration below 2%. A significant difference (P<0.05) was recorded pre and post training for U-COL and Sthirst, with the highest rates obtained at the end of each session. Participants always started training at a low dehydration status (USG >1,020g.ml-1). Conclusions The athletes tended to start the training sessions in dehydration status, which increases over the course of the training. Ad libitum water intake was not sufficient to balance fluid loss. Changes in fluid levels between sessions were similar. Level of Evidence II; Therapeutic Studies Investigating the Results Level of Treatment.

RESUMO Introdução A desidratação tem sido descrita como um dos principais fatores de redução de desempenho em atividades de luta, levando, em casos extremos, à morte. Objetivos Investigar o estado da hidratação antes do treino e as alterações no balanço hídrico corporal durante dois treinamentos de taekwondo. Métodos Foram avaliados 18 atletas universitários do sexo masculino (22,6 ± 3,37 anos). O desenho do estudo procurou reproduzir uma condição de treinamento de taekwondo com duração de 90 minutos, dividido em três etapas: a) aquecimento (20 min.), b) poomsae (30 min.) e c) treino técnico (40 min.). Durante o treino, adotou-se o consumo de água ad libitum. Para avaliar o estado de hidratação, considerou-se a massa corporal (MC), a quantidade de líquido consumido e o volume de urina produzido, o que permitiu estabelecer a perda hídrica absoluta e relativa em kg e porcentagem, além da taxa de sudorese. Foi considerada ainda a gravidade específica da urina (GEU), bem como sua coloração (COL-U), além da sensação subjetiva de sede (SSede) antes e depois do treino. Os resultados antes e depois do treino foram comparados de forma isolada em cada sessão, assim como entre as sessões. Resultados Houve diferença significativa (P < 0,05) da MC pré-treinamento entre os dois dias de treino. Houve redução significativa (P < 0,05) da MC final em ambos os dias de experimento. A maior parte dos avaliados apresentou desidratação relativa inferior a 2%. Registrou-se diferença significativa (P < 0,05) antes e depois do treino para COL-U e para SSede, com os maiores índices obtidos ao final de cada sessão. Os participantes sempre iniciaram o comparados de forma isolada em cada sessão, assim como entre as sessões. Resultados Houve diferença significativa (P < 0,05) da MC pré-treinamento entre os dois dias de treino. Houve redução significativa (P < 0,05) da MC final em ambos os dias de experimento. A maior parte dos avaliados apresentou desidratação relativa inferior a 2%. Registrou-se diferença significativa (P < 0,05) antes e depois do treino para COL-U e para SSede, com os maiores índices obtidos ao final de cada sessão. Os participantes sempre iniciaram o treinamento em leve estado de desidratação (GEU > 1.020 g.ml-1). Conclusões Os atletas tendem a iniciar os treinamentos em estado de desidratação, que se amplia durante o treino. O consumo de líquidos ad libitum não foi suficiente para equilibrar a perda hídrica. As alterações hídricas entre as sessões foram semelhantes. Nível de Evidência II; Estudos terapêuticos- Investigação dos resultados do tratamento.

RESUMEN Introducción La deshidratación ha sido descrita como uno de los principales factores de reducción del desempeño en actividades de lucha, llevando, en casos extremos, a la muerte. Objetivos Investigar el estado de la hidratación antes del entrenamiento y las alteraciones en el balance hídrico corporal durante dos entrenamientos de taekwondo. Métodos Se evaluaron 18 atletas universitarios del sexo masculino (22,6 ± 3,37 años). El diseño del estudio intentó reproducir una condición de entrenamiento de taekwondo con duración de 90 minutos, dividido en tres etapas: a) calentamiento (20 min); b) poomsae (30 min); y c) entrenamiento técnico (40 min). Durante el entrenamiento, se adoptó el consumo de agua ad libitum. Para evaluar el estado de hidratación, se consideró la masa corporal (MC), la cantidad de líquido consumido y el volumen de orina producido, lo que permitió establecer la pérdida hídrica absoluta y relativa en kg y porcentaje, además de la tasa de sudoración. Fue considerada además la gravedad específica de la orina (GEO), así como su coloración (COL-O), además de la sensación subjetiva de sed (SSed), antes y después del entrenamiento. Los resultados antes y después del entrenamiento fueron comparados de forma aislada en cada sesión, así como entre las sesiones. Resultados Hubo diferencia significativa (P<0,05) de la MC preentrenamiento entre los dos días de entrenamiento. Hubo reducción significativa (P<0,05) de la MC final en ambos días de experimento. La mayor parte de los evaluados presentó deshidratación relativa inferior a 2%. Se registró diferencia significativa (P<0,05) antes y después del entrenamiento para COL-O y para SSed, con los mayores índices obtenidos al final de cada sesión. Los participantes siempre iniciaron el entrenamiento en leve estado de deshidratación (GEO > 1.020 g.ml-1). Conclusiones Los atletas tienden a iniciar los entrenamientos en estado de deshidratación, que se amplía durante el entrenamiento. El consumo de líquidos ad libitum no fue suficiente para equilibrar la pérdida hídrica. Las alteraciones hídricas entre las sesiones fueron semejantes. Nivel de Evidencia II; Estudios terapéuticos - Investigación de los resultados del tratamiento.

Nivel de conocimiento de las madres sobre el estado de deshidratación en niños con diarrea. Hospital Pediátrico Dr. Agustín Zubillaga

Se realizó una investigación cuantitativa con diseño descriptivo transversal con el objetivo de evaluar el nivel de conocimiento de las madres sobre el estado de deshidratación en niños menores de cinco años con diarrea que acudieron al Hospital Pediátrico Dr. Agustín Zubillaga durante el período abril-junio del año 2018. La muestra estuvo formada por 60 madres. Se empleó una fuente primaria y un cuestionario para la recolección de los datos. La mayoría de las madres tienen un conocimiento regular sobre el estado de deshidratación de niños con relación a la definición, causas y complicaciones de la diarrea (70%). En cuanto a los signos de deshidratación, 83,3% tienen un nivel de conocimiento deficiente, 11,7% un nivel regular y 5% un nivel bueno. En relación al nivel de conocimiento sobre las medidas para prevenir la deshidratación, 46,7% de las madres tuvieron un nivel deficiente, 38,3% un nivel regular mientras que 15% tuvo un buen nivel. En general, el nivel de conocimiento que tienen las madres de pacientes con diarrea es deficiente en más de la mitad de ellas (55%), mientras que 38,3% tuvieron un nivel regular y 6,7% un nivel de conocimiento bueno. Estos resultados indican la necesidad de hacer campañas de información para las madres y familiares sobre la diarrea y la deshidratación por diarrea por parte de las autoridades y personal médico en general.

A quantitative research with cross-sectional descriptive design was conducted with the aim of evaluating the level of knowledge of mothers about the state of dehydration in children under five years of age with diarrhea who attended the Dr. Agustín Zubillaga Pediatric Hospital during the period April-June 2018. The sample consisted of 60 mothers. A primary source and a questionnaire were used for data collection. Most of the mothers have a regular knowledge about the state of dehydration of children in relation to the definition, causes and complications of diarrhea (70%). Regarding the signs of dehydration, 83.3% have a poor level of knowledge, 11.7% a fair level and 5% a good level. Regarding the level of knowledge about measures to prevent dehydration, 46.7% of the mothers had a poor level, 38.3% a fair level while 15% had a good level. In general, the level of knowledge that mothers of patients with diarrhea have is deficient in more than half of them (55%), while 38.3% had a regular level and 6.7% had a good level of knowledge. These results indicate the need for information campaigns for mothers and family members on diarrhea and diarrheal dehydration by the authorities and medical personnel in general.

Reporte de caso: Manejo anestésico en un paciente pediátrico con ictiosis más deshidratación grave / Case report: Anesthetic management of an infant patient with ichthyosis plus severe dehydration

INTRODUCTION: Ichthyosis are hereditary disorders of keratinization which are characterized for the presence of hyperkeratosis and/or peeling. This disorder group can put in danger the life of the patient because of the severe alteration of the skin barrier, associated with a severe transdermic loss of water, different grades of hypothermia and a hypernatremic dehydration. OBJECTIVE: Introducing the clinic case of an infant patient with the diagnosis of ichthyosis plus severe dehydration who is scheduled for placement of CVC. CLINICAL CASE: Male infant, 3 months old, with the diagnosis of ichthyosis and severe dehydration, scheduled for placement of CVC. CONCLUSIONS: Due to the urgency of our patient, who presented severe dehydration, an inhaled general anesthesia with sevoflurane and oxygen was decided, without instrumenting the airway which in these patients has the risk of being potentially difficult, from the placement of the face mask itself, until finding lesions within the oral cavity, ventilatory assis- tance should be maintained by the pediatric anesthesiologist, once venous access is achieved, the fluids restitution is performed with loads of 10 to 20 ml/kg of the patient's weight, hyperthermia was controlled with physical means.

INTRODUCCIÓN: Las ictiosis son trastornos hereditarios de la queratinización caracterizadas por la presencia de hiperqueratosis y/o descamación. Este grupo de patologías pueden poner en peligro la vida del paciente debido a la severa alteración de la barrera cutánea, asociada a intensa pérdida transepidérmica de agua, diferentes grados de hipotermia y la deshidratación hipernatrémica. OBJETIVO: Presentar un caso clínico de paciente lactante menor con diagnóstico de ictiosis, cursando un cuadro grave por deshidratación, al que se le instala un CVC. CASO CLÍNICO: Lactante masculino, 3 meses de edad, con diagnóstico de ictiosis y deshidratación grave programado para colocación de CVC. CONCLUSIONES: Debido a la urgencia del paciente quien presentaba un caso de deshidratación severa se decide anestesia general inhalada con sevoflurano y oxígeno, sin instrumentación de la vía área, la cual en estos pacientes tiene el riesgo de ser potencialmente difícil, desde la propia colocación de la mascarilla facial hasta encontrar lesiones dentro de la cavidad oral; se debe mantener la asistencia ventilatoria por el anestesiólogo pediatra, una vez logrado el acceso venoso se procede a la restitución hídrica con cargas de 10 a 20 ml/kg de peso del paciente, el control de la hipertermia fue con medios físicos.

Research Progress on Application of Sports Beverage to Post-exercise Fluid Restoration / 中国医学科学院学报

A good hydration status is important to the exercise performance and cognitive function of exercisers.The effective restoration of fluid balance after exercise is helpful to prevent dehydration,maintain body fluid balance,accelerate fatigue recovery,and enhance exercise performance.As the most effective sports nutrition supplement,sports beverage has different ingredients and formulas,and also has various effects.To provide clues for the development of sports beverage,this article reviews the types,components,effects,and mechanisms of sports beverage currently used in post-exercise fluid restoration.

Effect of the Seasonal Adaptability on Carbohydrate-electrolyte Beverage Efforts on Post-exercise Rehydration in Healthy Young Men / 中国医学科学院学报

Objective To compare the effects of carbohydrate-electrolyte beverage on post-exercise rehydration of healthy young men in different seasons,and to explore the influence of seasonal adaptability on fluid and electrolyte balance.Methods Fifteen healthy men,aged(24.4±0.5)years,completed 2 trails in a random crossover design both in summer and winter.During recovery,they consumed a drink volume equivalent to 100% of their sweat loss with plain boiled water(the water group)or carbohydrate-electrolyte beverage(the beverage group).Recovery was monitored for further 180 minutes by the collection of blood and urine samples.Results The dehydration time in summer was significantly shorter by about 20 minutes than that in winter(

Ectopic expression of the AmDREB1F gene from Ammopiptanthus mongolicus enhances stress tolerance of transgenic Arabidopsis / 生物工程学报

Dehydration-responsive element binding proteins (DREBs) are an important class of transcription factors related to plant stress tolerance. Ammopiptanthus mongolicus is an evergreen broadleaf shrub endemic to desert areas of northwest China, and it has a very high tolerance to harsh environments. In order to reveal the functions and mechanisms of the AmDREB1F gene from this species in enduring abiotic stresses, we performed subcellular localization test, expression pattern analysis, and stress tolerance evaluation of transgenic Arabidopsis harboring this gene. The protein encoded by AmDREB1F was localized in the nucleus. In laboratory-cultured A. mongolicus seedlings, the expression of AmDREB1F was induced significantly by cold and drought but very slightly by salt and heat stresses, and undetectable upon ABA treatment. In leaves of naturally growing shrubs in the wild, the expression levels of the AmDREB1F gene were much higher during the late autumn, winter and early spring than in other seasons. Moreover, the expression was abundant in roots and immature pods rather than other organs of the shrubs. Constitutive expression of AmDREB1F in Arabidopsis induced the expression of several DREB-regulated stress-responsive genes and improved the tolerance of transgenic lines to drought, high salinity and low temperature as well as oxidative stress. The constitutive expression also caused growth retardation of the transgenics, which could be eliminated by the application of gibberellin 3. Stress-inducible expression of AmDREB1F also enhanced the tolerance of transgenic Arabidopsis to all of the four stresses mentioned above, without affecting its growth and development. These results suggest that AmDREB1F gene may play positive regulatory roles in response to abiotic stresses through the ABA-independent signaling pathways.

Relationship between postoperative acute kidney injury and preoperative dehydration in patients undergoing surgery for gastrointestinal tumor / 中华麻醉学杂志

Objective:To evaluate the relationship between postoperative acute kidney injury (AKI) and preoperative dehydration in the patients undergoing surgery for gastrointestinal tumor.Methods:A total of 231 patients, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, aged≥18 yr, undergoing elective surgery for gastrointestinal tumor with general anesthesia, were enrolled.Preoperative dehydration index was calculated according to preoperative urine color, specific gravity, osmotic pressure and creatinine.Preoperative dehydration was defined as dehydration index≥3.5.AKI was defined according to the Kidney Disease Improving Global Outcomes criteria.Logistic regression analysis was conducted to assess the association between preoperative dehydration and postoperative AKI.Results:Of the 231 patients who met our inclusion criteria, 27 (11.7%) developed postoperative AKI, and 13 patients (48.1%) had preoperative dehydration among the patients developed postoperative AKI.The results of logistic analysis showed that preoperative dehydration was an independent risk factor for postoperative AKI in the patients undergoing surgery for gastrointestinal tumor ( OR=4.03, 95% confidence interval 1.72-9.39). Conclusion:Preoperative dehydration is an independent risk factor for postoperative AKI in the patients undergoing surgery for gastrointestinal tumor.

Clinical analysis of hormone combined with cerebral glycoside carnosine and dehydrating drugs in the treatment of traumatic optic nerve injury / 中华急诊医学杂志

Objective:To retrospectively analyze the effect of hormone combined with cerebral glycoside carnosine and dehydration drugs in traumatic optic neuropathy (TON) patients.Methods:The enrolled 215 TON patients in our hospital from February 2014 to September 2021 were randomly divided into the combination group ( n=143) and routine group ( n=142). The baseline data, visual acuity recovery before and after treatment and adverse reactions of each group were compared. Univariate analysis was conducted to analyze the differences in indicators of good prognosis and visual acuity improvement between the two groups. Results:The effective rate of vision recovery in the combination group was significantly increased than that in the routine group ( P<0.05). After treatment, the intraocular pressure and visual field defect in the combination group were significantly decreased than those in the routine group ( P<0.05). Univariate subgroup analysis showed that there were statistically significant differences between TON patients with age ≤40 years, residual light sensation after injury, visit time ≤24 h, and VEP not extinguished with combined treatment of hormone, brain glycoside carnotin and dehydrating drugs and the routine group ( P<0.05). Univariate subgroup analysis showed that TON patients with optic canal fracture without optic nerve swelling and tortuosity had a good prognosis after treatment with combined hormone, cerebral glucoside carnosine and dehydration, which was statistically different from that in the routine group ( P<0.05). Conclusions:Brain glycosides carnosine and dehydration therapy on the basis of combined hormone a prednisolone sodium succinate treatment can improve vision in TON patients, lighten the optic nerve injury, will not increase the occurrence risk of adverse reactions, and have higher security. It is necessary to focus on high-risk patient over 40 years old, more than 24 h of treatment time, VEP extinction, optic nerve swelling poor efficacy. It is worthy of clinical promotion.