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umar111

Computer Science: Computer hardware - 0 views

computersciencetopper.blogspot.com/...computer-hardware.html

Best computer computer computer Science it blog

shared by umar111 on 26 Apr 23 - No Cached
  • umar111 on 26 Apr 23
     
    Computer Science Tuesday, April 25, 2023 Computer hardware Computer hardware is the physical components that make up a computer system. It includes everything from the central processing unit (CPU) to the monitor, keyboard, and mouse. Understanding the different types of hardware and how they work together is essential for anyone who works with computers. In this article, we will explore the various components of computer hardware, including internal and external components, and the peripherals that connect to them. We will also discuss the importance of hardware maintenance, the latest advancements in computer technology, and factors to consider when choosing the right hardware for your needs. Whether you are a computer technician, a gamer, or simply someone who uses a computer for everyday tasks, this article will help you better understand the world of computer hardware. Introduction to Computer Hardware Computer hardware refers to the physical components that make up a computer system. It includes everything from the processor and memory to input/output devices such as the keyboard and monitor. In this article, we will explore the different types of computer hardware and their functions. What is Computer Hardware Computer hardware refers to the physical components of a computer system. It includes all the components that can be touched, seen, and used to interact with a computer, such as the monitor, keyboard, and mouse. Hardware is different from computer software, which refers to the programs and applications that run on a computer system. History of Computer Hardware The history of computer hardware dates back to the 1820s when Charles Babbage, an English mathematician, and inventor, designed the first analytical engine, which was considered to be the first mechanical computer. With time, more complex electronic computers were developed, including the first Intel microprocessor in 1971. Since then, computer hardware has continued to evolve, becoming
Nathan Goodyear

Hormonal alterations in rheumatoid arthritis, including the effects of pregnancy. - Pub... - 0 views

www.ncbi.nlm.nih.gov/...11084945

RA rheumatoid arthritis pregnancy hormones

shared by Nathan Goodyear on 09 May 16 - No Cached
  • Nathan Goodyear on 09 May 16
     
    low adrenal hormone output and sex hormone output associated with RA; low adrenal output may pose a more direct effect.  This is likely why pregnancy is associated with a decrease with RA and the postpartum is associated with an increase.
Nathan Goodyear

Thyroid hormone abnormalities in heart failure: po... [Thyroid. 1996] - PubMed result - 0 views

www.ncbi.nlm.nih.gov/...8936683

T3 thyroid hypothyroid hypothyroidism heart failure cardiac output

shared by Nathan Goodyear on 01 Feb 11 - No Cached
  • Nathan Goodyear on 01 Feb 11
     
    T3 improves cardiac output in those with heart failure
Nathan Goodyear

Adrenal and gonadal steroid hormone deficiency in the pathogenesis of rheumatoid arthri... - 0 views

www.ncbi.nlm.nih.gov/...8833045

rheumatoid arthritis RA hormones autoimmune disease

shared by Nathan Goodyear on 09 May 16 - No Cached
  • Nathan Goodyear on 09 May 16
     
    Only abstract available here.  Low adrenal hormone output and low sex hormone production associated with increase RA.  Causation not proved here.
Nathan Goodyear

Early life events predict adult testicular function; data derived from the Western Aust... - 0 views

www.ncbi.nlm.nih.gov/...27340882

Testosterone weight obesity smoking hormones estrogen low t low Testosterone men men's health

shared by Nathan Goodyear on 30 Jun 16 - No Cached
  • Nathan Goodyear on 30 Jun 16
     
    optimal weight associated with higher testicular volume and Testosterone levels in men.  Maternal smoking and higher cord bleed estrogens associated with lower sperm output.  This would with the other literature on EDCs.
Nathan Goodyear

Hypothalamo-Pituitary-Adrenal Axis Dysfunction in Chronic Fatigue Syndrome, and the Eff... - 0 views

jcem.endojournals.org/...3545.full.pdf

CFS chronic fatigue syndrome adrenal fatigue cortisol therapy

shared by Nathan Goodyear on 12 May 12 - No Cached
  • Nathan Goodyear on 12 May 12
     
    This study reveals CFS to be low adrenal cortisol output problem. In this study, low dose cortisol (hydrocortisone) therapy improved symptoms of fatigue and improved the CRH adrenal stimulation of adrenal cortisol production.
Nathan Goodyear

DHEA effects on brain and behavio... [J Steroid Biochem Mol Biol. 2014] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...24928552

brain steroids hormone hormones DHEA

shared by Nathan Goodyear on 16 Jun 14 - No Cached
  • Nathan Goodyear on 16 Jun 14
     
    Interesting animal study finds that the brain can make sex hormones, DHEA and Testosterone in this article, de novo from cholesterol.  This is one mechanism by which the body can adapt to low T.  This also brings to light the effects that low adrenal output can have on T as well.
Nathan Goodyear

Exercise-associated hyponatremia: role of cytokines. - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...16843089

EAH exercise induced hyponatremia SIADH rhabdomyolysis hyponatremia endurance exercise endurance athletes endurance sports endurance athletes

shared by Nathan Goodyear on 27 Jan 15 - No Cached
  • Nathan Goodyear on 27 Jan 15
     
    study links rhabdomyolysis to exercise induced hyponatremia.  This article links the depletion of glycogen to muscle release of IL-6 leading to increase in ECW and thus hyponatremia. The abstract discusses fluid restriction vs hypertonic 3% NaCL to reverse the more severe cases.  The first signs are of weight gain and thus weight should be monitored.  Decreased renal output is also associated with EAH.  Altered mental status is an early sign.
wheelchairindia9

Pristine Flex Ostrich Mobility Wheelchair - 0 views

www.wheelchairindia.com/...ex-Ostrich-Mobility-Wheelchair

Pristine Flex Ostrich Mobility Wheelchair Ostrich Mobility Wheelchair pristine flex electric wheelchair Ostrich Wheel Chair Pristine FLEX Ostrich Pristine FLEX

shared by wheelchairindia9 on 04 Mar 16 - No Cached
  • wheelchairindia9 on 04 Mar 16
     
    Pristine Flex Ostrich Mobility Wheelchair Pristine is the most stylish powered wheelchair with revolutionary Split Frame Chassis (SFC). This indoor outdoor mobility equipment gives great comfort, stability and safety even in the toughest outdoor conditions. The body panels and the shopping basket make this equipment best suited for your kind of lifestyle. Pristine Flex Ostrich Mobility Wheelchair Features Split Frame Chassis (SFC). Call alarm, fault alarm, reverse alarm (on request). Low voltage alarm. Key pad locking. Mobility cut-off while charging. Auto shut-off after 3 minutes. Five speed selector. Length adjustable joystick control unit (can be changed from left to right and vice versa). Foldable, height adjustable and angle adjustable foot rest. Wide arm rest with height and width adjustment. Bucket seat with headrest and lap belt. Seat can be folded for transportation. Seat reclines 25 degrees in 6 steps. Removable and width adjustable calf support. Reflectors as per standards. Head lamp. Tail lamp. Pristine Flex Ostrich Mobility Wheelchair Specifications Load capacity: 110 Kg Speed: 9.5 Kmph max Speed selection: 5 speeds, Speed 1- 1.5Kmph, Speed 2-2.5 Kmph, speed 3- 4.8 Kmph, Speed 4- 7.2 Kmph, Speed 5- 9.5 Kmph Power: 320W Motor speed: 5300 rpm Gear ratio: 32:1 Brake: Electromagnetic Permissible Gradeability: 12 Degrees Drive range: 32-35 Km Ground clearance:2.5 inches Turn circle radius: 620mm Tire: Puncture free foam filled rubber tires Front- Tire diameter: 220X55 mm, Rear- Tire diameter: 320X72mm, Anti tippers-1 inch solid Battery: 24 Volt 48 Ah Sealed Maintenance Free VRLA Charger Input-230/240 Volts AC Single phase, Output-24 Volts-4 Amps DC Overall length with footrest (at 90 degree):1180mm, Overall width:640mm, Overall height: 1250mm, Overall height after folding the seat: 690mm, Overall weight: 102 Kg Seat depth: 500mm, Seat width:480mm, Backrest height: 540mm (without head rest), Backrest width: 440mm, Se
Nathan Goodyear

Common genetic variation in the IGF1 associates with maximal force output. - Abstract -... - 0 views

europepmc.org/...21552154

genetic genetics muscle protein IGF-1

shared by Nathan Goodyear on 29 Jan 13 - No Cached
  • Nathan Goodyear on 29 Jan 13
     
    genetic variations effect the bodies ability to build muscle through protein metabolism. 
Nathan Goodyear

Natural Killer Cells in Pregnancy and Recurrent Pregnancy Loss: Endocrine and Immunolog... - 0 views

edrv.endojournals.org/...44.full

natural killer cells pregnancy loss recurrent immune system miscarriage NK

shared by Nathan Goodyear on 15 Apr 12 - No Cached
  • NK cells have been the cells most extensively studied, primarily because they constitute the predominant leukocyte population present in the endometrium at the time of implantation and in early pregnancy
  • parental chromosomal abnormalities, uterine anatomic anomalies, endometrial infections, endocrine etiologies (luteal phase defect, thyroid dysfunction, uncontrolled diabetes mellitus), antiphospholipid syndrome, inherited thrombophilias, and alloimmune causes
  • estrogen
  • ...28 more annotations...
  • progesterone
  • prolactin
  • In summary, in vivo animal experiments have shown an inhibitory role of estrogen on peripheral NK cell lytic activity, which is partly due to suppression of NK cell output by the bone marrow and partly due to suppression of individual NK cell cytotoxicity. However, in vitro studies so far have failed to show conclusively a direct effect of estrogen on NK cells.
  • At the progesterone concentrations believed to be present in the uterus [up to 10−5 m at the maternal-fetal interface (35)], studies consistently show inhibition of lymphocyte proliferation (33) and inhibition of NK cytolytic activity in vitro
  • The exact role of prolactin in NK cell regulation is unknown.
  • The overall effects of estrogen on NK cells are likely multifactorial, therefore, and depend on the type of cell affected as well as the kind of ER expressed by that cell.
  • It is known that progesterone can directly affect T cell differentiation in vitro, suppressing development of the Th1 pathway and enhancing differentiation along the Th2 pathway (44)
  • Th1 cells predominantly produce interferon-γ (IFN-γ), IL-2, and TNF-β and are involved in cell-mediated immunity. Th2 cells produce IL-4, IL-5, IL-6, IL-10, and IL-13 and stimulate humoral immunity
  • Furthermore, in response to progesterone, γδ T cells produce progesterone-induced blocking factor (PIBF) (54
  • A defining characteristic of NK cells is their ability to lyse target cells without prior sensitization and without restriction by HLA antigens.
  • NK cell function is mainly regulated by IL-2 and IFN-γ
  • IL-2 causes both NK cell proliferation and enhanced cytotoxicity. IFN-γ augments NK cytolytic activity, but does not cause NK proliferation. The two cytokines act synergistically to augment NK cytotoxicity (6).
  • The largest leukocyte population in the endometrium consists of NK cells named large granulated lymphocytes
  • there is a significant increase in the number of uNK cells throughout the secretory phase, which peaks in early pregnancy when uNK cells comprise about 75% of uterine leukocytes (62)
  • Second, uNK cell phenotype changes during the normal menstrual cycle and early pregnancy (68)
  • general proinflammatory effect of estrogen, causing an influx of macrophages and neutrophils, which is antagonized by progesterone through its receptor (70, 71).
  • The mechanism of such a progesterone-induced local immunosuppression is unclear.
  • progesterone plays an important role in proliferation and differentiation of uNK cells (32).
  • Through promotion of a uterine Th2 environment, progesterone could indirectly affect uNK cell function
  • The mechanism of this increase in uNK cell numbers has been addressed in both human and mouse models, and is likely the result of: 1) recruitment of peripheral NK cells to the uterus, and 2) proliferation of existing uNK cells
  • prolactin system plays an important role in implantation and the maintenance of pregnancy
  • the exact pathways of hormonal regulation of NK cells remain to be delineated.
  • The exact function of uNK cells has not yet been unequivocally determined
  • uNK cells express a different cytokine profile, compared with resting peripheral NK cells. mRNAs for granulocyte CSF, M-CSF, GM-CSF, TNF-α, IFN-γ, TGF-β, and leukemia inhibitory factor (LIF) have been found in decidual CD56+ cells
  • Their increased numbers in early pregnancy, their hormonal dependence, and their close proximity to the infiltrating trophoblast all suggest that they play an important role in the regulation of the maternal immune response to the fetal allograft and the control of trophoblast growth and invasion during human pregnancy
  • role of uNK cell-derived cytokines on trophoblast growth and differentiation (114, 115, 116, 117).
  • Th1 immunity to trophoblast is associated with RPL, whereas Th2 immunity is associated with a successful pregnancy
  • RPL is associated with Th1 immunity, for which NK cells are partly responsible.
  • Nathan Goodyear on 15 Apr 12
     
    dysregulated immune system plays role in recurrent miscarriage.  Specifically, this article discusses natural killer cells (NK).
Nathan Goodyear

Hypothalamo-Pituitary-Adrenal Axis Dysfunction in Chronic Fatigue Syndrome, and the Eff... - 0 views

jcem.endojournals.org/...3545.long

CFS chronic fatigue syndrome hydrocortisone cortisol fatigue adrenal fatigue hypoadrenia HPA adrenal insufficiency adrenal adrenals

shared by Nathan Goodyear on 01 May 12 - No Cached
  • We conclude that the improvement in fatigue seen in some patients with chronic fatigue syndrome during hydrocortisone treatment is accompanied by a reversal of the blunted cortisol responses to human CRH
  • These data further suggest that the hypocortisolism found in chronic fatigue syndrome may be secondary to reduced adrenal gland output.
  • 5-mg replacement dose of hydrocortisone, and the remainder 10 mg
  • Nathan Goodyear on 01 May 12
     
    low dose hydrocortisone therapy (defined as 5-10 mg), in this study, was used to treat CFS.  This study found an improvement in symptoms in these patients.  Additionally, low cortisol was found in these patients with CFS.  Their conclusion, was that low adrenal function is a component of CFS and low dose hydrocortisone therapy is an effective treatment.   Now, is the low cortisol as the result of increased metabolism as well?
Nathan Goodyear

Nutrition & Metabolism | Full text | Fructose, insulin resistance, and metabolic dyslip... - 0 views

www.nutritionandmetabolism.com/...5

fructose metabolic syndrome metabolic syndrome insulin resistance obesity nutrition metabolism

shared by Nathan Goodyear on 16 Sep 13 - Cached
  • For thousands of years humans consumed fructose amounting to 16–20 grams per day
  • daily consumptions amounting to 85–100 grams of fructose per day
  • Of key importance is the ability of fructose to by-pass the main regulatory step of glycolysis, the conversion of glucose-6-phosphate to fructose 1,6-bisphosphate, controlled by phosphofructokinase
  • ...29 more annotations...
  • Thus, while glucose metabolism is negatively regulated by phosphofructokinase, fructose can continuously enter the glycolytic pathway. Therefore, fructose can uncontrollably produce glucose, glycogen, lactate, and pyruvate, providing both the glycerol and acyl portions of acyl-glycerol molecules. These particular substrates, and the resultant excess energy flux due to unregulated fructose metabolism, will promote the over-production of TG (reviewed in [53]).
  • Glycemic excursions and insulin responses were reduced by 66% and 65%, respectively, in the fructose-consuming subjects
  • reduction in circulating leptin both in the short and long-term as well as a 30% reduction in ghrelin (an orexigenic gastroenteric hormone) in the fructose group compared to the glucose group.
  • A prolonged elevation of TG was also seen in the high fructose subjects
  • Both fat and fructose consumption usually results in low leptin concentrations which, in turn, leads to overeating in populations consuming energy from these particular macronutrients
  • Chronic fructose consumption reduces adiponectin responses, contributing to insulin resistance
  • A definite relationship has also been found between metabolic syndrome and hyperhomocysteinemia
  • the liver takes up dietary fructose rapidly where it can be converted to glycerol-3-phosphate. This substrate favours esterification of unbound FFA to form the TG
  • Fructose stimulates TG production, but impairs removal, creating the known dyslipidemic profile
  • the effects of fructose in promoting TG synthesis are independent of insulinemia
  • Although fructose does not appear to acutely increase insulin levels, chronic exposure seems to indirectly cause hyperinsulinemia and obesity through other mechanisms. One proposed mechanism involves GLUT5
  • If FFA are not removed from tissues, as occurs in fructose fed insulin resistant models, there is an increased energy and FFA flux that leads to the increased secretion of TG
  • In these scenarios, where there is excess hepatic fatty acid uptake, synthesis and secretion, 'input' of fats in the liver exceed 'outputs', and hepatic steatosis occurs
  • Carbohydrate induced hypertriglycerolemia results from a combination of both TG overproduction, and inadequate TG clearance
  • fructose-induced metabolic dyslipidemia is usually accompanied by whole body insulin resistance [100] and reduced hepatic insulin sensitivity
  • Excess VLDL secretion has been shown to deliver increased fatty acids and TG to muscle and other tissues, further inducing insulin resistance
  • the metabolic effects of fructose occur through rapid utilization in the liver due to the bypassing of the regulatory phosphofructokinase step in glycolysis. This in turn causes activation of pyruvate dehydrogenase, and subsequent modifications favoring esterification of fatty acids, again leading to increased VLDL secretion
  • High fructose diets can have a hypertriglyceridemic and pro-oxidant effect
  • Oxidative stress has often been implicated in the pathology of insulin resistance induced by fructose feeding
  • Administration of alpha-lipoic acid (LA) has been shown to prevent these changes, and improve insulin sensitivity
  • LA treatment also prevents several deleterious effects of fructose feeding: the increases in cholesterol, TG, activity of lipogenic enzymes, and VLDL secretion
  • Fructose has also been implicated in reducing PPARα levels
  • PPARα is a ligand activated nuclear hormone receptor that is responsible for inducing mitochondrial and peroxisomal β-oxidation
  • decreased PPARα expression can result in reduced oxidation, leading to cellular lipid accumulation
  • fructose diets altered the structure and function of VLDL particles causing and increase in the TG: protein ratio
  • LDL particle size has been found to be inversely related to TG concentration
  • therefore the higher TG results in a smaller, denser, more atherogenic LDL particle, which contributes to the morbidity of the metabolic disorders associated with insulin resistance
  • High fructose, which stimulates VLDL secretion, may initiate the cycle that results in metabolic syndrome long before type 2 diabetes and obesity develop
  • A high flux of fructose to the liver, the main organ capable of metabolizing this simple carbohydrate, disturbs normal hepatic carbohydrate metabolism leading to two major consequences (Figure 2): perturbations in glucose metabolism and glucose uptake pathways, and a significantly enhanced rate of de novo lipogenesis and TG synthesis, driven by the high flux of glycerol and acyl portions of TG molecules coming from fructose catabolism
  • Nathan Goodyear on 16 Sep 13
     
    Fructose and metabolic syndrome.  Good discussion of the impact of high fructose intake and metabolic dysfunction.  This study also does a great job of highlighting the historical change of fructose intake.
Nathan Goodyear

Therapy in the Early Stage: Incretins - 0 views

care.diabetesjournals.org/...S264.full

incretins glucose diabetes

shared by Nathan Goodyear on 11 Dec 13 - No Cached
  • Increased resistance to insulin action in the skeletal muscle and liver associated with enhanced hepatic glucose output and impaired insulin secretion due to a progressive decline of β-cell function are long-recognized core defects
  • in addition, other mechanisms/organs are involved, augmenting the pathological pathways: adipocytes (altered fat metabolism due to insulin resistance), gastrointestinal tract (incretin deficiency and/or resistance), pancreatic α-cells (hyperglucagonemia and increased hepatic sensitivity to glucagon), kidneys (enhanced glucose reabsorption), and central nervous system (insulin resistance)
  • β-cell failure
    • Nathan Goodyear
      Nathan Goodyear on 11 Dec 13
       
      and studies have shown that a reduction in insulin function will decrease LH production and thus lead to a decrease in Testosterone production in men.
  • ...2 more annotations...
  • Incretins are gut-derived hormones, members of the glucagon superfamily, released in response to nutrient ingestion (mainly glucose and fat)
  • They exert a wide range of effects, including stimulation of pancreatic insulin secretion in a glucose-dependent manner and play an important role in the local gastrointestinal and whole-body physiology
  • Nathan Goodyear on 11 Dec 13
     
    good discussion on incretins and their role in glucose homeostasis. 
Nathan Goodyear

Metabolic Effects of Dietary Fiber Consumption and Prevention of Diabetes - 0 views

jn.nutrition.org/...439.long

soluble insoluble fiber dietary diet nutrition diabetes

shared by Nathan Goodyear on 22 Oct 13 - No Cached
  • DF are highly complex substances that can be described as any nondigestible carbohydrates and lignins not degraded in the upper gut
  • Commonly, DF are classified according to their solubility in water, even though grading according to viscosity, gel-forming capabilities, or fermentation rate by the gut microbiota might be physiologically more relevant
  • Main sources of soluble DF are fruits and vegetables
  • ...8 more annotations...
  • n increased intake of total DF was inversely associated with markers of insulin resistance in several studies
  • consumption of insoluble DF increased whole body glucose disposal independent of changes in body weight in both short-term and more prolonged studies
  • Short-chain fatty acids (SCFA) such as acetate, propionate, and butyrate are produced by bacterial fermentation of indigestible DF polysaccharides in the colon
  • increased production of SCFA is assumed to be beneficial by reducing hepatic glucose output and improving lipid homeostasis
  • a high DF diet (oligofructose) reduced gram-negative bacterial content and body weight, whereas a high fat diet increased the proportion of a gram-negative bacterial lipopolysaccharides (LPS) containing microbiota in humans
  • Prospective cohort studies indicate that diets high in insoluble cereal DF and whole grains might reduce diabetes risk
  • soluble DF (i.e., pectin, inulin, and β-glucans)
  • cereal DF (i.e., cellulose and hemicelluloses)
  • Nathan Goodyear on 22 Oct 13
     
    Good discussion of dietary fiber intake and Diabetes.  
wheelchairindia9

Golden Motor Wheelchair - 0 views

disabilityproduct.in/...GM-LITE-POWER-WHEELCHAIR

Power Chair Motors Enable Independent Mobility limited upper body strength Golden Motor Wheelchair With large motors and frames easy and healthy movement Bronco Power Wheelchair

shared by wheelchairindia9 on 15 Sep 15 - No Cached
  • wheelchairindia9 on 15 Sep 15
     
    GM LITE POWER WHEELCHAIR GM Lite Brushless Power Wheelchair with Batteries is a revolutionary light weight power wheelchair using brushless motor. It is the most economic power wheelchair without sacrificing safety & durability. The wheelchair promotes pressure redistribution, reduces downward sliding and helps maintain good posture. Specifications: 10 times longer life Lightest - 23 kg 5 year long life, safe LiFePO4 battery (10ah) High efficiency brushless hub motor 5 seconds folding and unfolding Easy to carry Load : 120 kg Speed : 8km/hr Range: 15 km Slope : 12% 24V180W brushless 8-inch gear hub motor
Nathan Goodyear

http://www.biomed.cas.cz/physiolres/pdf/prepress/932627.pdf - 0 views

www.biomed.cas.cz/...932627.pdf

resistance training exercise resistance Testosterone cortisol men obese obesity hormone hormones

shared by Nathan Goodyear on 02 Sep 14 - No Cached
  • Nathan Goodyear on 02 Sep 14
     
    good discussion of the effects of resistance training on Testosterone and cortisol in obese men.  The literature is more more clear on the effects of resistance training on healthy men, but the evidence in obese men is less clear--likely due to the disrupted metabolism.
Nathan Goodyear

Intravenous Fluid Use in Athletes - 0 views

www.ncbi.nlm.nih.gov/...PMC3435915

IV intravenous fluid nutrition athletes athlete sports medicine sports exercise

shared by Nathan Goodyear on 13 Jan 15 - No Cached
  • 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
  • ...30 more annotations...
  • 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
  • Nathan Goodyear on 13 Jan 15
     
    to be read
Nathan Goodyear

Comparisons of normal saline and lactated Ringer's resuscitation on hemodynamics, metab... - 0 views

www.ncbi.nlm.nih.gov/...PMC4029282

IV fluids lactated ringers normal saline LR NS

shared by Nathan Goodyear on 03 Jul 18 - No Cached
  • NS contains 154 mM Na+ and Cl-, with an average pH of 5.0 and osmolarity of 308 mOsm/L.
  • LR solution has an average pH of 6.5, is hypo-osmolar (272 mOsm/L), and has similar electrolytes (130 mM Na+, 109 mM Cl-, 28 mM lactate, etc.) to plasma
  • hyperchloremic acidosis
  • ...26 more annotations...
  • LR’s acid base balance is superior to that of NS’s
  • There were no significant differences between LR and NS groups in fibrinogen concentrations or platelet count
  • Total protein dropped
  • no significant differences in Hct (Table  1) or total protein between LR and NS groups
  • Bicarbonate HCO3- levels were decreased by hemorrhage but returned to pre-hemorrhage values by 3 h after LR resuscitation, whereas no return was observed with NS resuscitation
  • Na+ was increased after NS resuscitation
  • No changes in Na+ or K+ were observed
  • K+ did not change initially after NS resuscitation but was elevated at 6 h afterwards
  • Ca++ was similarly decreased
  • Cl- was elevated for 6 h after NS resuscitation, with no changes shown after LR resuscitation
  • PT was similarly prolonged by resuscitation with LR (from 11.2 ± 0.2 sec at baseline to 12.1 ± 0.2 sec at 6 h) and NS
  • Plasma aPTT was also similarly prolonged by resuscitation with LR (from 17.1 ± 0.5 sec baseline to 20.1 ± 1.2 sec at 6 h) or NS
  • NS resuscitation resulted in better oxygen delivery and oxygen delivery-to-oxygen demand ratio as an index of oxygen debt
  • NS had better tissue perfusion and oxygen metabolism than LR
  • LR resuscitation returned BE and bicarbonate to pre-hemorrhage levels within 3 h, but no return of BE or bicarbonate was observed for 6 hr with NS resuscitation
  • current blood bank guidelines state that LR should not be mixed with blood to prevent the risk of clot formation from calcium included in LR
  • LR resuscitation should not be given with blood through the same iv-line and crystalloids should be avoided in patients with blood transfusion
  • PT and aPTT were prolonged for 6 h after hemorrhage and resuscitation, suggesting a hypocoagulable states
  • potential thrombotic risk from LR resuscitation is unlikely.
  • we suspected that the blood pressure after NS resuscitation would be lower than that of LR due to its vasodilator effects
  • NS required a larger resuscitation volume and was associated with poor acid base status and elevated serum potassium in this model
  • NS required 50% more volume and was associated with a higher cardiac output and lower peripheral resistance, as compared to LR resuscitation
  • These differences are possibly due to the vasodilator effects from NS
  • an elevation of K+ was observed at 6 h post NS resuscitation, while no change of K+ was observed after LR resuscitation
  • The mechanism for the increase of K+ from NS is not fully known
  • NS is associated with vasodilator effects and the risks of metabolic acidosis and hyperkalemia
  • Nathan Goodyear on 03 Jul 18
     
    LR vs NS crystalloid.
Nathan Goodyear

Clinical review: Specific aspects of acute renal failure in cancer patients - 0 views

www.ncbi.nlm.nih.gov/...PMC1550893

cancer renal failure

shared by Nathan Goodyear on 13 Aug 18 - No Cached
  • uric acid crystal formation in the renal tubules secondary to hyperuricaemia
  • calcium phosphate deposition related to hyperphosphataemia
  • usually develops shortly after the initiation of cytotoxic chemotherapy
  • ...18 more annotations...
  • Non-recombinant urate oxidase (Uricozyme®)
  • recombinant urate oxidase (Rasburicase®)
  • urine alkalisation may induce calcium phosphate deposition
  • renal replacement therapy should be started on an emergency basis when hydration fails to produce a prompt metabolic improvement or when ARF develops
  • Up to 50% of patients with newly diagnosed multiple myeloma have renal failure and up to 10% require dialysis
  • renal ultrasonography remains the method of choice for investigating extra-renal obstruction
  • The relief of the obstruction, either by percutaneous nephrostomy or through a ureteral stent, is the cornerstone of treatment
  • TMA may be associated with the cancer itself, with cancer chemotherapy, or with allogeneic BMT
  • thrombotic microangiopathy (TMA)
  • it may be as high as 5%
  • Most of the cases occur in patients with solid tumours, the most common type being adenocarcinoma (stomach, breast and lung)
  • The pathophysiology of the TMA-malignancy association remains controversial, although many studies suggest an insult to the vascular endothelium
  • mitomycin C. Subsequently, TMA has been reported with many anti-cancer agents, including gemcita-bine, bleomycin, cisplatin, CCNU, cytosine arabinoside, daunorubicin, deoxycoformycin, 5-FU, azathioprine and interferon α
  • Plasma exchanges have been shown to improve prognosis in the general population of patients with TMA
  • Causative factors should be looked for and antihypertensive treatment given. Lastly, in the absence of guidelines, we believe that plasma exchange should be proposed in patients with severe cancer treatment-associated TMA
  • The most widely used protective measure is saline infusion to induce solute diuresis
  • During methotrexate infusion and elimination, fluids should be given to maintain a high urinary output and urinary alkalisation should be performed to keep the urinary pH above 7.5. Rescue with folinic acid (50 mg four times a day) should be started 24 hours after each high-dose metho-trexate infusion and serum methotrexate concentrations should be measured every day
  • cyclophosphamide and ifosfamide
  • Nathan Goodyear on 13 Aug 18
     
    cancer and renal failure
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