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Nathan Goodyear

Intravenous Fluid Use in Athletes - 0 views

  • Treatment of exercise-associated hyponatremia with hypertonic IV infusion to correct plasma sodium levels is also a standard and accepted use of IV fluid infusions
  • athletes who present for medical care with hypernatremia who cannot tolerate oral fluids can benefit from IV fluids
  • Vaporization of sweat accounts for 80% of heat loss in hot, dry atmospheric conditions. This mechanism of water loss is the major contributor for exercise-associated dehydration
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  • The rate of water loss can be quantified through measurement of sweat rate
  • Pre- and postexercise body weight measurements are the most common means to estimate overall water loss but are condition specific
  • It appears that 1% to 2% body weight loss is well tolerated by the exercising athlete
  • Dehydration, defined as greater than 2% loss of body weight, can negatively affect performance
  • In highly trained endurance athletes, plasma volume and sodium serum concentration were preserved despite a 5% body weight loss
  • In Ironman triathletes, dehydration to 5% body weight loss did not correlate with occurrence of medical complications
  • hydration should begin hours prior to exercise, especially if known deficits are present, and fluids should be consumed at a slow, steady rate, with 5 to 7 mL/kg taken 4 hours prior to exercise
  • Sodium concentration did not produce significant changes in the rate of absorption but was primarily dependent on carbohydrate concentration
  • Replacing 150% of body weight loss over 60 minutes has been tolerated without complications
  • IV treatment of severe dehydration (>7% body weight loss), exertional heat illness, nausea, emesis, or diarrhea, and in those who cannot ingest oral fluids for other reasons, is clinically indicated
  • A recent survey of the National Football League teams revealed that 75% (24 of 32) of the teams utilized IV infusion of fluids for prehydration in at least some otherwise healthy individuals
  • In the National Football League, an average of 1.5 L of normal saline was administered approximately 2.5 hours prior to competition
  • after 2 hours of exercise, the rectal temperature was 0.6° higher in the group not receiving IV infusion. Also, stroke volume and cardiac output were 11% to 16% lower in the control group versus the IV infusion group.
  • Recent evidence suggests the etiology of EAMC is related to muscle fatigue and neuronal excitability
  • no correlation between hydration status or electrolyte concentrations with EAMC
  • there may be a subset of muscle cramping that is associated with a loss of both body fluid and sodium
  • Glycerol is the primary agent for oral hyperhydration
  • elevation of plasma volume by 200 to 300 mL via dextran infusion resulted in 15% increase in stroke volume, 4% increase in VO2 max, and an increase in the exercise time to fatigue
  • Neither the tonicity nor mode of hydration resulted in improved speed of rehydration, greater fluid retention, or improved performance
  • There are beneficial anecdotal reports of EAMC treatment in elite and professional-level athletes with IV hydration during the course of an event
  • Plasma volume was better restored during rehydration with IV fluids at preexercise and 5 minutes of exercise. At 15 minutes, there was no difference between IV and oral rehydration
  • More rapid restoration of plasma volume was accomplished in the IV treatment group with no advantages over oral rehydration in physiological strain, heat tolerance, ratings of perceived effort, or thermal sensations
  • No difference was found in exercise time to exhaustion. IV and oral rehydration methods were equally effective. Heart rates were statistically higher in the oral rehydration group through 75 minutes of exercise, and there were higher increases in norepinephrine plasma concentrations
  • No significant differences between the groups were found for time to recovery, number of days with pain, number of days with stiffness, sleep disturbance, fatigue, rectal temperature, and loss of appetite
  • The current data suggest that IV rehydration is faster than oral
  • There may be physiological benefits of decreased heart rate and norepinephrine in athletes rehydrated via IV route
  • Postexercise blood 1 hour and 24 hours showed no differences in circulating myoglobin or creatine kinase
  • The use of IV fluid may be beneficial for a subset of fluid sensitive athletes
  • this should be reserved for high-level athletes with strong histories of symptoms in well-monitored settings.
  • Volume expanders may also be beneficial for some athletes
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    to be read
Nathan Goodyear

Exercise-Associated Muscle Cramps - 0 views

  • athletes who develop EAMC often ingest similar amounts of fluid during exercise as do their noncramping counterparts
  • Oral fluid ingestion may be ineffective, and intravenous fluid may provide a faster delivery for athletes suffering from acute EAMC
  • It is interesting that stretching the affected muscle almost immediately relieves EAMC
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  • Stretching, the primary treatment for acute EAMC
  • National Athletic Trainers’ Association recommends that athletes prone to muscle cramping add 0.3 to 0.7 g/L of salt to their drinks to stave off muscle cramps
  • Others have recommended adding higher amounts of sodium (about 3.0 to 6.0 g/L) to sports drinks based on the frequency of EAMC
  • intravenous infusion of fluids removes this delay, and it has been used to aid athletes who develop acute EAMC
  • maintaining hydration and adequate electrolyte levels is a good prevention strategy for individuals susceptible to EAMC
  • Fluid volumes of 1.8 L per hour have been well tolerated by tennis athletes who are susceptible to EAMC
  • Monitoring an athlete’s body weight is an easy method of ensuring adequate fluid replacement and individualizes each athlete’s fluid needs
  • the National Athletic Trainers’ Association and the American College of Sports Medicine recommend a volume of fluid that allows for less than a 2% body weight reduction
  • Endurance training may also serve as an effective means of preventing EAMC by expanding plasma volume and the extracellular fluid compartment15 and delaying neuromuscular fatigue
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    Exercise associated muscle cramps or EAMC is not worked out.  The theories include dehydration, mineral/electrolyte deficiencies, and neuromuscular activity.
Willow O'Donnell

Refurbished B. Braun Horizon NXT Infusion IV Pump | willowmed | Buzznet - 0 views

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    Refurbished B. Braun Horizon NXT Infusion IV Pump The Refurbished B. Braun Horizon NXT Infusion IV Pump is intended for use with B. Braun Horizon I.V. sets to regulate the flow of primary and secondary fluids when positive pressure is required. The infusion system features the capability of delivering fluid from a negative head height, and provides volumetric accuracy for all standard I.V. fluids, including blood, lipids and TPN.
Nathan Goodyear

Intravenous Fluid Use in Athletes - 0 views

  • The current data suggest that IV rehydration is faster than oral
  • There may be physiological benefits of decreased heart rate and norepinephrine in athletes rehydrated via IV route
  • Muscle damage during exercise in the heat was assessed by myoglobin and creatine kinase
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  • Postexercise blood 1 hour and 24 hours showed no differences in circulating myoglobin or creatine kinase
  • IV administration of fluids can rapidly replace plasma volume
  • The rapid increase in plasma volume is transient, and no measureable difference between IV and oral prehydration exists after 15 minutes of exercise
  • The use of IV fluid may be beneficial for a subset of fluid sensitive athletes
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    IV nutrition pre-event, intra-event, and post-event for recovery.
Willow O'Donnell

Refurbished B. Braun Horizon NXT Infusion IV Pump - 0 views

  •  
    Refurbished B. Braun Horizon NXT Infusion IV Pump The Refurbished B. Braun Horizon NXT Infusion IV Pump is intended for use with B. Braun Horizon I.V. sets to regulate the flow of primary and secondary fluids when positive pressure is required. The infusion system features the capability of delivering fluid from a negative head height, and provides volumetric accuracy for all standard I.V. fluids, including blood, lipids and TPN.
Willow O'Donnell

Refurbished B. Braun Horizon Nxt Infusion Iv Pump - 0 views

  •  
    Refurbished B. Braun Horizon NXT Infusion IV Pump The Refurbished B. Braun Horizon NXT Infusion IV Pump is intended for use with B. Braun Horizon I.V. sets to regulate the flow of primary and secondary fluids when positive pressure is required. The infusion system features the capability of delivering fluid from a negative head height, and provides volumetric accuracy for all standard I.V. fluids, including blood, lipids and TPN.
Nathan Goodyear

Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and h... - 0 views

  • Proposed mechanism
  • The data show that pharmacologic ascorbate concentrations produced Asc•− selectively in extracellular fluid compared with blood and that H2O2 formation occurred when Asc•− concentrations were >100 nM in extracellular fluid.
  • These data validate the hypothesis that ascorbate is a prodrug for selective delivery of reactive species to the extravascular space
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  • pharmacologic ascorbate as a prooxidant drug for therapeutic use.
  • Recently we reported that pharmacologic ascorbic acid concentrations produced H2O2 concentrations of ≥25 μM, causing cancer cell death in vitro
  • We found that H2O2 concentrations generated in vivo were those that caused cancer cell death in vitro
  • When ascorbate was given parenterally, Asc•−, the product of a loss of one electron from ascorbate, was detected preferentially in extracellular fluid compared with blood
  • Asc•− generation in extracellular fluid depended on the ascorbate dose and the resulting concentrations
  • With i.v. administration of ascorbate, Asc•− concentrations were as much as 12-fold greater in extracellular fluid compared to blood and approached 250 nM
  • In blood, such Asc•− concentrations were never produced and were always <50 nM
  • These data are all consistent with the hypothesis that pharmacologic ascorbate concentrations in vivo serve as a prodrug for selective delivery of H2O2 to the extracellular space
  • After oral ingestion, control of intracellular and extracellular ascorbate concentrations is mediated by three mechanisms: intestinal absorption, tissue transport, and renal reabsorption
  • intestinal absorption, or bioavailability, declines at doses >200 mg
    • Nathan Goodyear
       
      significant limitation of gut absorption of vitamin C--at 200 mg po.
  • corresponding to plasma concentrations of ≈60 μM
    • Nathan Goodyear
       
      equates to 0.06 mM.  Max blood levels found with po AA dosing has been 0.22 mM
  • at approximately this concentration, the ascorbate tissue transporter SVCT2 approaches Vmax, and tissues appear to be saturated
    • Nathan Goodyear
       
      SVCT2 Rc in gut reach max binding.
  • also at ≈60 μM, renal reabsorption approaches saturation, and excess ascorbate is excreted in urine
  • Parenteral administration bypasses tight control
  • When tight control is bypassed, H2O2 forms in the extracellular space
  • in vivo validation of ascorbate as a prodrug for selective H2O2 formation
  • Temporarily bypassing tight control with parenteral administration of ascorbate allows H2O2 to form in discrete time periods only, decreasing likelihood of harm, and provides a pharmacologic basis for therapeutic use of i.v. ascorbate
  • H2O2 formation results in selective cytotoxicity
  • Tumor cells are killed with exposure to H2O2 for ≤30 min
  • In vitro, killing is mediated by H2O2 rather than Asc•−
  • In addition to cancer treatment, another potential therapeutic use is for treatment of infections. H2O2 concentrations of 25–50 μM are bacteriostatic
  • virally infected cells may also be candidates
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    follow up invivo study to previous study from 2005.  Here, the authors prove their hypothesis that ascorbate is a prodrug for delivery of H2O2.
Nathan Goodyear

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1332190/pdf/brjsmed00019-0063.pdf - 0 views

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    study finds IV hydration with glucose and larger volume did not recover as well as those with 100 ml  of IV fluids.  This conclusion is incomplete as the time differences between the 2 groups was significant--group 2 (2.5 L fluid group) finished much faster and studies have shown that these endurance athletes are more prone to dehydration, more significant weight loss, adverse effects from the event.  This likely explains the difference between the 2 groups.
Nathan Goodyear

Thyroid hormones in fibrocystic breast dise... [Eur J Endocrinol. 1995] - PubMed - NCBI - 0 views

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    free T3 levels found to be higher in breast cyst fluid than in serum. This correlated with elevated K+/Na+ ratio which is associated with malignant transformation.  This elevated free breast cyst fluid correlated with estradiol concentration
Nathan Goodyear

Exercise and Fluid Replacement : Medicine & Science in Sports & Exercise - 0 views

  • During exercise, consuming beverages containing electrolytes and carbohydrates can provide benefits over water alone under certain circumstances
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    exercise and fluid replacement
Nathan Goodyear

Fluid Balance During and After an Ironman Triathlon - ResearchGate - 0 views

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    ultra distance triathlon athletes lost 2.5 kg weight during event.  Athletes that developed hyponatremia appeared to be fluid overloaded during event.
indiacardiacsurg

Dr. T S Kler Predict Contrast-Associated Kidney Injury After Percutaneous Coronary Inte... - 0 views

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    Dr. T S Kler Best cardiologist Delhi uses x-ray imaging, known as angiography, to determine which arteries have the most intense blockages, and inject a fluid referred to the as iodinated evaluation into the bloodstream to make the blockages seen on x-ray. That fluid is toxic, and high-risk agencies could have kidney issues as an end result. For Consultation Dr.TS Kler Email - drtskler@indiacardiacsurgerysite.com Call for Appointment- +91-9370586696
Nathan Goodyear

Increased estrogen formation and estrogen to androgen ratio in the synovial fluid of pa... - 0 views

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    high estrogen to Testosterone levels in synovial fluid in those with RA.  The authors here propose that DHEA can stimulate inflammation through aromatase activity.
Nathan Goodyear

Serum Aldosterone Concentration and Cardiovascular Risk in Women with Polycystic Ovaria... - 0 views

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    PCOS associated with elevated aldosterone and thus fluid retention
Nathan Goodyear

Dysnatremia predicts a delayed recovery in collapsed ultramarathon ... - PubMed - NCBI - 0 views

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    The majority of ultra marathon runners deal with hypernatremia versus hyponatremia.  The majority were normonatremic.  Intravenous fluids can more rapidly resolve hypernatremia versus oral liquids and serves as useful means to reduce hypernatremia when oral liquids proves intolerable.
Nathan Goodyear

Serum biochemistry and morbidity among runners presenting for medic... - PubMed - NCBI - 0 views

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    Study looked at 9 athletes that were treated with IV fluids and found no significant morbidity with exercise associated hyponatremia.
Nathan Goodyear

Toxicity of the spike protein of COVID-19 is a redox shift phenomenon: A novel therapeu... - 0 views

  • Redox shift is due to Warburg effect and mitochondrial impairment.
  • Redox shift is due to Warburg effect and mitochondrial impairment.
  • Redox shift is due to Warburg effect and mitochondrial impairment.
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  • The cytokine storm is a consequence of mitochondrial dysfunction
  • The cytokine storm is a consequence of mitochondrial dysfunction
  • The cytokine storm is a consequence of mitochondrial dysfunction
  • The cytokine storm is a consequence of mitochondrial dysfunction
  • Lipoic acid, Methylene Blue and Chlorine dioxide relieve COVID-19 spike protein toxicity
  • Lipoic acid, Methylene Blue and Chlorine dioxide relieve COVID-19 spike protein toxicity
  • Lipoic acid, Methylene Blue and Chlorine dioxide relieve COVID-19 spike protein toxicity
  • Lipoic acid, Methylene Blue and Chlorine dioxide relieve COVID-19 spike protein toxicity
  • most diseases display a form of anabolism due to mitochondrial impairment
  • most diseases display a form of anabolism due to mitochondrial impairment
  • most diseases display a form of anabolism due to mitochondrial impairment
  • infection by Covid-19 follows a similar pattern
  • chronic inflammation
  • Long-term effects include redox shift and cellular anabolism as a result of the Warburg effect and mitochondrial dysfunction
  • Long-term effects include redox shift and cellular anabolism as a result of the Warburg effect and mitochondrial dysfunction
  • Long-term effects include redox shift and cellular anabolism as a result of the Warburg effect and mitochondrial dysfunction
  • Long-term effects include redox shift and cellular anabolism as a result of the Warburg effect and mitochondrial dysfunction
  • infection by Covid-19 follows a similar pattern
  • unrelenting anabolism leads to the cytokine storm,
  • unrelenting anabolism leads to the cytokine storm,
  • unrelenting anabolism leads to the cytokine storm,
  • chronic inflammation
  • chronic inflammation
  • infection by Covid-19 follows a similar pattern
  • Lipoic acid and Methylene Blue have been shown to enhance the mitochondrial activity, relieve the Warburg effect and increase catabolism
  • Lipoic acid and Methylene Blue have been shown to enhance the mitochondrial activity, relieve the Warburg effect and increase catabolism
  • Lipoic acid and Methylene Blue have been shown to enhance the mitochondrial activity, relieve the Warburg effect and increase catabolism
  • Methylene Blue, Chlorine dioxide and Lipoic acid may help reduce long-term Covid-19 effects by stimulating the catabolism
  • Methylene Blue, Chlorine dioxide and Lipoic acid may help reduce long-term Covid-19 effects by stimulating the catabolism
  • Methylene Blue, Chlorine dioxide and Lipoic acid may help reduce long-term Covid-19 effects by stimulating the catabolism
  • direct consequence of redox iMeBalance, itself a consequence of decreased energy yield by the mitochondria
  • direct consequence of redox iMeBalance, itself a consequence of decreased energy yield by the mitochondria
  • mitochondrial dysfunction and increased levels of lactate, which are important characteristics of metabolic shift and Warburg effect in many diseases
  • mitochondrial dysfunction and increased levels of lactate, which are important characteristics of metabolic shift and Warburg effect in many diseases
  • increased lactate dehydrogenase activity (LDH) was observed in COVID-19 patients
  • increased lactate dehydrogenase activity (LDH) was observed in COVID-19 patients
  • almost every disease presents an increased anabolism
  • almost every disease presents an increased anabolism
  • cell division is the most sophisticated way to release entropy
  • cell division is the most sophisticated way to release entropy
    • Nathan Goodyear
       
      Wow
    • Nathan Goodyear
       
      Wow
  • transition from catabolism to anabolism is driven by a redox shift
  • transition from catabolism to anabolism is driven by a redox shift
  • viral spike protein binds to ACE2 receptor of the host cell [22,23].
  • redox signaling plays an important role in regulating immune function and inflammation, and disruptions in this signaling can lead to excessive cytokine production and immune system activation
  • Aging is associated with a poor control of the redox balance
  • thiol/disulfide homeostasis
  • reduced extracellular environment in the elderly and the increased susceptibility to Covid-19 infection
  • reduced extracellular environment in the elderly and the increased susceptibility to Covid-19 infection
  • Redox signaling tightly modulates the inflammatory response and oxidative stress has been reported in acute Covid-19
  • People at high risk are the elderly, patients suffering from metabolic syndrome such as obesity, or those suffering from chronic diseases such as cancer or inflammation
  • COVID-19 patients with severe disease have higher levels of oxidative stress markers and lower antioxidant levels
  • oxidative stress can activate the NLRP3 inflammasome, which is a protein complex that plays a key role in the cytokine storm
  • inflammation leads to the formation of ROS and RNS, while redox iMeBalance results in cellular damage, which in turn triggers an inflammatory response
  • persistently elevated mtROS triggers endothelial dysfunction and inflammation, which results in a vicious loop involving ROS, inflammation, and mitochondrial dysfunction
  • Damaged mitochondria releasing ROS induce inflammation via the NLRP3 inflammasome
  • Damaged mitochondria releasing ROS induce inflammation via the NLRP3 inflammasome
  • reduced environment during the cytokine storm
  • IL-2 is highly up-regulated in Covid-19 patients [37], and IL-2 is known to significantly stimulate the generation of NO in patients
  • Nitric acid is also the key mediator of IL-2-induced hypotension and vascular leak syndrome
  • mitochondrial dysfunction has been linked to the pathogenesis of Covid-19
  • mitochondrial dysfunction triggered by SARS-CoV-2 leads to damage to the mitochondria
  • mitochondrial dysfunction triggered by SARS-CoV-2 leads to damage to the mitochondria
  • As catabolism is decreased, entropy is released through anabolism
  • Elevated levels of lactate, a characteristic of the Warburg effect, were also reported in the high-risk Covid-19
  • elevated levels of ventricular lactic acid consistent with oxidative stress
  • A decrease of ΔΨm is implicated in several inflammation-related diseases
  • decrease in ΔΨm in leucocytes from Covid-19 patients
  • vaccinated with RNA or DNA vaccines triggering the synthesis of the viral spike protein in human cells
  • viral reactivation in varicella-zoster virus [55] or hepatitis [56], coagulopathy and resulting stroke and myocarditis following both DNA-based vaccines [57] and RNA-based vaccines
  • Covid-19, mitochondrial impairment
  • characteristic of the Warburg effect is present in almost every disease and appears to be a central feature in most of the hallmarks of cancer
  • inflammation, mitochondrial dysfunction and increased lactate concentrations in the extracellular fluid
  • In Covid-19, like any inflammation, there is a metabolic rewiring where cells rely on glycolysis
  • As the mitochondria are impaired, the infected cell cannot catabolize efficiently. It will release lactic acid in the blood stream
    • Nathan Goodyear
       
      Mitochondrial impairment
  • Striking similarities are seen between cancer, Alzheimer's disease and Covid-19, all related to the Warburg effect
  • Cancer, inflammation, Alzheimer's, and Parkinson's diseases share a common peculiarity, the inability of the cell to export entropy outside the body in the harmless form of heat
    • Nathan Goodyear
       
      Entropy: lack of order or predictability; gradual decline into disorder.
  • MEB relieves the Warburg effect [87], improves memory [77], is active in the treatment of depressive episodes [79,80] and reduces the importance of ischemic strokes
  • MEB relieves the Warburg effect [87], improves memory [77], is active in the treatment of depressive episodes [79,80] and reduces the importance of ischemic strokes
  • MEB has been shown to inhibit SARS-Cov-2 replication in vitro
  • MEB has been shown to inhibit SARS-Cov-2 replication in vitro
  • It has been shown that Covid-19-patients treated with MEB, have a significant reduction in hospital stay duration and mortality
  • MeB is an acceptor-donor molecule
  • MeB + can take a pair of electrons (of H atoms) and MeBH can release this pair easily, so that MeB is partially recycled like a catalyst
  • MeB acts as an electron bridge between a donor (FADH2, FMNH, NADH) and an acceptor (complex IV of ETC or oxygen itself)
  • As a coenzyme of pyruvate dehydrogenase (PDH), alpha-lipoic acid (ALA) initiates the formation of acetyl-CoA to feed the TCA cycle
  • ALA enhances the catabolism of carbon. cycle and therefore may reduce the Warburg effect and consequently, lactate production
  • Methylene Blue plays a similar role after the TCA cycle, by carrying electrons to complex IV of the electron transport chain
  • Drugs such as lipoic acid and MeB, which target the metabolism, decrease the redox shift by increasing catabolism
Nathan Goodyear

New roles for estrogens in rheumatoid arthritis. - PubMed - NCBI - 0 views

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    Estradiol appears to be pro-inflammatory in the synovial fluids of men/women with RA.  This appears to be mediated through NF-KappaB.
Nathan Goodyear

Current Status of Salivary Hormone Analysis - 0 views

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    salivary testing of hormones has proven to be reliable from initial reviews, 1982, to  current studies.  As this study points out, salivary testing has even been shown to be superior to other body fluids.  So, why the lack of use by the clinician?  not due to the research!
Nathan Goodyear

Current Status of Salivary Hormone Analysis -- Gröschl 54 (11): 1759 -- Clini... - 0 views

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    saliva testing of hormones said to be "reliable and, in some cases, even superior to other body fluids".  Of course, no test is perfect, but saliva test provides that best assessment available
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