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At least 937 records · Page 52Linked to original sources
PubMed1983

Cytogenetic toxicity of D2O in human lymphocyte cultures. Increased sensitivity in Fanconi's anemia.

Chromosomal aberrations were scored in lymphocyte cultures from healthy individuals, patients with Bloom syndrome, and patients with Fanconi's anemia, after 4-5 h exposure to culture medium containing 90% heavy water (D2O). D2O treatment resulted in occasional pulverization of metaphases, and increased frequencies of chromosomal breakage. Patients with Fanconi's anemia were particularly sensitive to the chromosome breaking effect of D2O.

Anemia, Aplastic↗
PubMed1995

Phosphate-loading test influences on endurance-trained volunteers during restriction of muscular activity and chronic hyperhydration.

The purpose of this investigation was to determine whether negative phosphate balance, which is developed during hypokinesia (a decreased number of walking steps/d) could be reversed with daily supplementation with phosphate, fluid, and salt (FSS). The studies on hypokinesia (HK) were performed for 364 d on 30 endurance-trained male volunteers in the age range of 23-26 yr, with an average maximum oxygen uptake, MOU, of 65 mL/kg min. All subjects were divided into three equal groups: Ten volunteers were placed on a continuous regime of exercise of 14.4 km/d at 10,000 steps/d and served as controls. Ten volunteers were subject to continuous HK without FSS and were considered as the hypokinetic subjects (HS). The remaining subjects were under continuous HK and FSS and were considered as the hypokinetic, hyperhydrated subjects (HHS). The three groups were on a diet that averaged 2620 cal/d and contained 1.7 g calcium, 1.6 g phosphate, and 5.6 g sodium chloride. For simulation of the hypokinetic effect, the HS and HHS groups were kept continuously under 2.9 km/d (3000 walking steps/d) for the duration of the study. Prior to exposure to HK, all volunteers were on the same exercise regime as the controls. During a 60-d pre-HK period and during the remainder of the study, phosphate-loading tests, urinary and plasma phosphate concentrations were performed in all subjects. In the HHS group, plasma phosphate concentration and urinary excretion of phosphate were decreased, while in the HS group these values increased after phosphate loading. Based on our results, we concluded that chronic hyperhydration and phosphate supplementation may be used to minimize phosphate losses in endurance-trained volunteers during prolonged restriction of muscular activity.

Adult↗
PubMed1995

Zinc metabolism in endurance-trained volunteers during prolonged restriction of muscular activity and chronic hyperhydration.

The objective of this study was to evaluate the effects of hypokinesia (HK) and fluid- and salt supplementation (FSS) on zinc metabolism in endurance-trained volunteers (ETV) for a period of 364 d. Thirty long-distance runners aged 22-25 yr with a peak VO2 of 67 mL/min/kg with an average 13.8 km/d running distance were chosen as subjects. They were equally divided into three groups: 1. Controls; 2. HK subjects; and 3. HK + FSS subjects. Throughout the duration of the study, groups 2. and 3. were maintained under an average running distance of 2.7 km/d, whereas group 1. did not experience any modifications to their normal training routines and diets. Prior to and during the experimental period, plasma volume, hemoglobin, sodium, potassium, hematocrit, osmolality, and protein concentrations were determined along with the concentrations and urinary excretions of zinc, magnesium, calcium, and phosphorous. During the HK period, plasma concentrations of these minerals increased significantly when compared to the HK + FSS and control groups. The same was observed for the remaining parameters, which led us to conclude that during prolonged restriction of muscular activity, (PRMA) the body of the HK + FSS volunteers acquire an apparent tendency to retain zinc, whereas in the HK group the opposite is observed.

Adult↗
PubMed1989

Immediate detection of irrigant absorption during transurethral prostatectomy: case report.

A transurethral prostatic resection is described in which immediate detection of a rapid massive irrigant absorption could be made by the use of ethanol-tagged irrigating fluid and repeated measurements of the ethanol concentration in the patient's expired breath. This monitoring enabled the surgeon to prevent further absorption by concluding the operation before symptoms resulted. Furosemide was given immediately to promote renal excretion of the absorbed irrigant, and the intravenous infusions were temporarily restricted to limit the intravascular fluid load. In retrospect, volumetric measurement showed that a total of 2410 ml of irrigant had been absorbed.

Absorption↗
PubMed2005

[Generalized compartment syndrome after excessive drinking. A rare complication of psychological disorders?].

Psychogenic polydipsia can lead to compartment syndromes, which is too infrequently considered in psychiatric patients who binge-drink on hypotonic fluids. If masked by the leading clinical presentation of cerebral edema, compartment syndromes of the extremities may be diagnosed too late or remain undetected. Based on a literature review and case report, we discuss additional factors and the specific features of diagnosis and treatment.

Adult↗
PubMed1997

Involvement of the alpha2-adrenergic system in polydipsia in schizophrenic patients: a pilot study.

Animal studies have suggested the involvement of the adrenergic system in drinking behavior. The present study investigated the involvement of the alpha2-adrenergic system in the polydipsia of patients with chronic schizophrenia by use of an alpha2 agonist and an antagonist. Four patients with schizophrenic disorders accompanied by intermittent hyponatremia and polydipsia were the subjects of, and completed, this study. Drinking behavior was assessed by calculating the percent of maximum weight gain [PMWG: (maximum diurnal weight - standard weight) x 100/standard weight]. Standard weight was defined as body weight after 8 h of water restriction. Clonidine (75, 150, and 225 mg/day) increased the PMWG in a dose-dependent manner in the four subjects. In contrast, in three of the subjects, mianserin (30, 60, and 90 mg/day) decreased PMWG, and the severe polydipsia disappeared almost completely. These findings indicate clearly that the alpha2-adrenergic system is involved in the drinking behavior of schizophrenic patients. Mianserin appears to be clinically useful in treating such patients with polydipsia.

Adrenergic alpha-Agonists↗
PubMed2003

Polydipsia--a study in a long-term psychiatric unit.

This is a retrospective review of the author's experience with polydipsia in a long-term unit for treatment refractory patients at a US psychiatric state hospital during a 5-year period [1996-2000]. Sixty-one patients were admitted to this long-term unit, comprising approximately 1 % of the hospital admissions. Polydipsic patients were followed with diurnal weight changes and other biological measures. This longitudinal study of 61 chronic inpatients suggests that polydipsia is no doubt present in at least 20 % of chronic psychiatric inpatients and hyponatremia in more than 10 %. Two polydipsic patients worsened when switched from clozapine to other atypical antipsychotics. Polydipsia in severe mentally ill patients continues to be a neglected subject and a challenge for psychiatrists. Polydipsic patients should not be switched to other atypical antipsychotics, unless new prospective studies prove that they are as effective as clozapine for polydipsia.

Adult↗
PubMed2001

Cerebral oedema in enuretic children during low-dose desmopressin treatment: a preventable complication.

Seven cases of cerebral oedema have been observed in enuretic children during low-dose desmopressin (DDAVP) treatment given in a dose of 7-21 microg daily in the Czech Republic between 1995 and 1999, after the drug started to be marketed for this indication and delivered in simple bottles with a dropper. All seven children (age 5-11 years, four boys) experienced a period of unconsciousness but all recovered without sequelae. In most cases, safety measures were underestimated and natraemia was not regularly controlled. Two children developed cerebral oedema after excessive water intake in preparation for uroflowmetry, another one drank much during a hot summer day, in one diabetes insipidus was not recognised and two children were clearly non-compliant with reduced fluid intake on a long-term basis. Only in one child, no risk factor was found. Conclusion. Proper selection and instruction of patients is needed to avert cerebral oedema during treatment with desmopressin for nocturnal enuresis.

Brain Edema↗
PubMed2003

Fluid overload and acute renal failure in pediatric stem cell transplant patients.

Acute renal failure (ARF) with fluid overload (FO) occurs often in stem cell transplant (SCT) recipients. We have previously demonstrated that an increased percentage of FO prior to the initiation of continuous renal replacement therapy (CRRT) is associated with mortality in children with ARF. Based on these data, we devised a protocol for the prevention of FO in SCT patients with ARF. SCT patients with ARF and 5% FO were started on furosemide and low-dose dopamine. To allow for nutrition, medication, and blood product administration, RRT was initiated for patients with > or =10% FO. There were 272 patients who received allogeneic SCT from 1999 to 2002. Of these, medical records of 26 SCT patients with a first episode of oliguric ARF were reviewed. The mean patient age was 13+/-5 years (range 2-23.5 years). Mean days to ARF after SCT were 28+/-29 days (range 2-90 days). Of the 26 patients, 11 (42%) survived an initial ARF episode. All 11 survivors either maintained <10% FO during their course or re-attained <10% FO with RRT treatment. Of the 15 non-survivors, 6 had <10% FO at the time of death. Of 14 patients who received RRT, 4 (29%) survived. Mechanical ventilation and pediatric risk of mortality score > or =10 at the time of admission to the intensive care unit were associated with lower survival ( P<0.05). The use of one or more pressors, the presence of graft-versus-host disease, and septic shock were not correlated with survival. Our data demonstrate that maintenance of euvolemia ( <10% FO) is critical but not sufficient for survival in SCT patients with ARF, as all non-euvolemic patients died. We suggest that aggressive use of diuretics and early initiation of RRT to prevent worsening of FO may improve the survival of SCT patients.

Acute Kidney Injury↗
PubMed1990

Long-term neurologic outcome in psychogenic water drinkers with severe symptomatic hyponatremia: the effect of rapid correction.

PURPOSE: The purpose of our study was to ascertain the safety of rapidly correcting acute symptomatic hyponatremia in psychogenic water drinkers, particularly in regard to any delayed adverse neurologic sequelae. PATIENTS AND METHODS: We reviewed the medical records of all known psychogenic water drinkers (34) in our hospital from 1977 to 1989. Using seizure as a marker of severity, we identified 13 patients having a total of 27 episodes associated with severe hyponatremia. We evaluated the charts of those patients in detail to assess the mode of treatment, rate of correction, and long-term neurologic outcome. None of the patients experienced respiratory arrest before treatment, which was initiated within 2 hours of seizure. RESULTS: For all 27 episodes, the initial serum sodium level (mean +/- SE) was 110.9 +/- 1.2 mmol/L, and the rate of correction (mean +/- SE) was 1.65 +/- 0.2 mmol/L/hour. All but one episode were corrected "rapidly" (initial correction rate of 0.7 or more mmol/L/hour) to 120 to 130 mmol/L within 12 hours. The absolute change in the serum sodium level was 15.1 +/- 1.2 mmol/L in 12 hours, 21.6 +/- 1.4 mmol/L in 24 hours, and 25.9 +/- 1.4 mmol/L in 48 hours. In no instance did therapy induce hypernatremia. All patients recovered immediately after treatment. There was no clinical or radiologic evidence of adverse neurologic sequelae immediately after treatment or after 6 years of follow-up. CONCLUSION: In this series of male psychogenic water drinkers, early "rapid" correction of acute symptomatic hyponatremia by raising the serum sodium level 15 mmol/L in 12 hours while maintaining an absolute change in the serum sodium level of 26 mmol/L within 48 hours produced no long-term neurologic sequelae.

Adult↗