Expert-analytical approach to assessing activity of vitamin D based on determination of vitamin D associated links by indicators of water-electrolyte metabolism

The authors used the proposed method of mathematical and statistical processing of laboratory data (indicators of electrolyte metabolism and osteomarkers) of archived data of 82 patients with various bone diseases aged 9.90 ± 0.55 years compared the structural changes in the panel of ratios of individual electrolytes and the influence of individual indicators on them in personalized data, on the basis of which a conclusion was made about a single mechanism of coinciding influences in the exchange of bone tissue. At the same time, it was found that the complex of associated links detected by the vitamin influence on the panel of electrolyte ratios may differ signifcantly in some cases from each other. These differences consisted in highly pronounced differences in the activity of vitamin D in relation to various components of osteosynthesis and osteolysis, which are described in the modern literature. On this basis, the authors conclude that the used method (analytical system) allows to identify the functional connections of the dynamics of the indicator of vitamin D in individual cases with the dynamics of other indicators of bone, which signifcantly expands the informativeness of the results of laboratory examination of the patient in determining the leading systems the implementation of functional activity of the vitamin. The presented results justify the possibility of creating and describing different images of vitamin D-related changes in the plasma electrolyte composition, followed by their use in the identifcation of certain disorders of calcium metabolism and/or evaluating the effectiveness of the therapy used in each individual case.

Gut Microbiota, Glucose, Lipid, and Water-Electrolyte Metabolism in Children With Nonalcoholic Fatty Liver Disease

There is evidence that nonalcoholic fatty liver disease (NAFLD) is affected by gut microbiota, glucose, and lipid. However, the function of water-electrolyte metabolism remains undefined in children with NAFLD. Therefore, the aim of this case-control study was to better understand these interactions. The sample consisted of 75 children, aged between 7 and 16, of whom 25 had nonalcoholic fatty liver (NAFL), 25 had nonalcoholic steatohepatitis (NASH), and 25 were obese and without NAFLD. These groups were matched by age, sex, and body mass index. Data were collected between June, 2019 and December, 2019 at the Hunan Children’s Hospital, in China. Microbiome composition in fecal samples was assessed using 16S ribosomal RNA amplicon sequencing. In the clinical indices, 12 glucose and lipid metabolism indices were included, and six water-electrolyte metabolism indices were included. The results indicated that microbiomes of NAFLD children had lower alpha diversity but higher beta diversity index than the other two groups. Specifically, anti-inflammatory and probiotics abundance (e.g., Faecalibacterium, Akkermansia, and Bifidobacterium_adolescentis) was significantly decreased in NAFLD, whereas the abundance of harmful bacteria (e.g., Staphylococcaceae) was increased. Moreover, the abundance of butyrate-producing bacteria (e.g., Faecalibacterium, Roseburia_inulinivorans, Roseburia_intestinalis, and Coprococcus_comes) was significantly decreased in NASH. The abundance of these bacteria were associated with glucose, lipid, and water-electrolyte metabolism (e.g., glucose, triglyceride, cholesterol, inorganic salt, total body water, etc.), implying that the NAFLD and its severity were associated with glucose, lipid, and water-electrolyte metabolism dysbiosis. Therefore, these findings suggest that the gut microbiome, especially butyrate-producing bacteria, play an important role in the development of NAFLD in children.

Study of renal function indices to determine hypoxic hypoxia resistance in divers

Aim: using oral stress kidney tests to reveal changes in renal function and water-electrolyte metabolism in divers with different initial resistance to hypoxic hypoxia.Materials and methods. 44 men were studied. All subjects were evaluated for their initial resistance to hypoxic hypoxia. Oral renal stress tests were performed to determine the status of kidney function.Results and their discussion. For the selection of divers, it is necessary to carry out oral stress tests with water, 10% potassium chloride solution and 7.5% calcium lactate solution. In divers with low and medium resistance to hypoxic hypoxia, there is a deterioration in the calcium and potassium uretic function of the kidneys after oral stress renal tests. The method for determining the resistance of divers to hypoxic hypoxia should be supplemented by the regularity developed by us.

Atrial fibrillation in diabetic patients.

The article summarizes the main clinical and theoretical data on features of atrial fibrillation (AF) course in combination with diabetes mellitus (DM). The potential relationship between these comorbid conditions is analyzed on the basis of the results of epidemiological and randomized studies, the gender features of the course of AF in this category of patients are assessed. Particular attention is paid to pathogenetic bases of AF development in DM (fibrosis, neurohumoral regulation, impaired energy metabolism of cardiomyocytes, oxidative stress, genetic factors, electrolyte metabolism disorders).

Osmotic Demyelinating Syndrome

ABSTRACT. This article discusses the clinical cases of rare and difficult to diagnose brain damage — osmotic demyelinating syndrome (ODS). ODS is a lifethreatening condition, manifested by acute demyelination of the headbrain on the background of water-electrolyte disturbances,usually associated with fast management of hyponatremia. Within the framework of ODS, central pontine myelinolysis (CPM) and extra-pontine myelinolysis (EPM) are observed, which are accompanied by acute demyelination in the pons and white matter of the cerebral hemispheres, respectively. In 60%, CPM combine with EPM. The main reason for the development of ODS is a violation of water-electrolyte metabolism associated with alcohol abuse, chronic hepatic and/or renal failure, diabetes mellitus, Sheehan syndrome, polydipsia, condition after the removal of pituitary adenoma, bulimia, immunodeficiency syndrome. Today, the diagnosis of ODS is based on magnetic resonance imaging of the brain. The article indicates the main causes of the disease, clinical features, methods of diagnosis and treatment, as well as the outcomes of the disease.

Application of sorbitol based infusion preparation for normalization of water-electrolyte exchange in surgery patients with direct rectal cancer

Objective. To study the effect of intravenous infusions of the complex drug Rheosorbilact polyfunctional action on the indicators of water-electrolyte metabolism in operated patients with rectal cancer after anterior resection of the rectum in the early postoperative period. Materials and methods. Clinical application of the complex drug Rheosorbilact of multifunctional action was carried out in 30 patients with rectal cancer after the operation of anterior resection of the rectum in the early postoperative period. Studies of plasma electrolytes in operated patients were performed before surgery, on the 1st day after surgery, and on the 2nd, 3rd, 5th day after administration of the drug Rheosorbilact. Results. As a result of studies in patients with colorectal cancer after anterior resection of the rectum in the first days after surgery revealed a decrease in potassium, sodium, calcium in blood plasma. To correct the indicators of water-electrolyte metabolism in operated patients after anterior resection of the rectum immediately after surgery intravenously injected infusion drug Rheosorbilact multifunctional action. After repeated, within 5 days, intravenous infusions of the drug Rheosorbilact, revealed normalization of the concentrations of potassium, sodium, calcium in blood plasma in operated patients with colorectal cancer. Conclusions. Repeated intravenous infusions of the complex drug Rheosorbilact multifunctional action lead to normalization of water-electrolyte metabolism in patients with colorectal cancer after anterior resection of the rectum in the early postoperative period. Normalization of water-electrolyte metabolism in operated patients is confirmed by the content of potassium, sodium and calcium ions in the infusion drug Rheosorbilact. Rheosorbilact is recommended for widespread medical use in such patients, especially in the early postoperative period.

PHYSIOLOGICAL SUBSTANTIATION OF DETERMINING THE RESISTANCE OF DIVERS TO THE TOXIC EFFECT OF OXYGEN USING ORAL STRESS RENAL TESTS

Aim of the work: to identify changes in renal function under the action of dosed hyperoxia using oral stress renal tests and to determine the relationship between the state of the functions of the excretory system and the body’s resistance to toxic effects of oxygen.Materials and methods. A survey of 44 men was carried out. Changes in water-electrolyte metabolism and renal function were determined using developed oral renal stress tests. Results and discussion. It has been shown that the normal functioning of the excretory system plays an important role in the high human resistance to the toxic effects of oxygen.

Positive water balance and consequences for water-electrolyte metabolism in patients with polytrauma

Objective. To assess the effect of a three-day positive water balance (PWB) during infusion therapy on the level of blood plasma electrolytes (sodium, chlorine), hematocrit, the concentration of total hemoglobin and the influence of the studied factors on patient survival in the intensive care unit.Materials and methods. In 47 patients with polytrauma who had multiple organ dysfunction and signs of systemic inflammation, using non-parametric analysis, the ROC-curve method, logistic regression, and relative risk analysis, we studied the effect of PWB on sodium and chlorine metabolism, hematocrit, total hemoglobin concentration and evaluated their relationship with treatment outcome. The subjects were divided into two groups: I — surviving patients whose PWB level for three days was less than 3,000 ml (n = 28) and II — the died (n = 19) whose PWB level for three days was more than 3,000 ml.Results. The average value of sodium for three days was significantly higher in patients of group II: 140.267 ± 3.713 mmol/l against the patients (138.067 ± 2.515 mmol/l; p = 0.020906) of group I. By the end of three days, the level of total hemoglobin was statistically significantly lower in group II (101.89 ± 18.27 g/l) than in group I (120.30 ± 21.70 g/l); p < 0.000025. The hematocrit index was also significantly lower in patients of group II (29.40 ± 4.85 %) than in group I (34.30 ± 6.03 %); p < 0.000034.Conclusion. At a PWB level of three days over 3,000 ml, there is an increase in blood sodium with a tendency to hypernatremia, a hemodilution effect with a decrease in hemoglobin and hematocrit. A negative effect of PWB on water-electrolyte metabolism, an acid-base state, the disorders of which cause an increased risk of death, is observed several times more often in patients with excess PWB (more than 3,000 ml in three days) than among patients with lower PWB (less than 3,000 ml for the same period).

Study of Serum Electrolyte Levels in Type 2 Diabetes Mellitus

Introduction: The incidence of diabetes mellitus is increasing rapidly with interference in electrolytes sodium (Na+), potassium (K+) and chloride (Cl-). The prevalence of diabetes mellitus is rapidly rising all over the globe at an alarming rate. Objective: Study of serum electrolyte levels in type 2 Diabetes Mellitus. Material and methods: Total of 100 subjects were included in the study, out of which two groups were formed; 50 type 2 diabetes mellitus patients and 50 controls. Centrifuged serum was analyzed for estimation of Na+, K+ and Cl- level by the Accustar auto analyzer. Results: In type 2 diabetes mellitus serum Na+ level was observed significantly decreased while Cl- and K+ levels were increased. Both the electrolytes (Na+ Cl-) differ significantly in diabetes and control group. Conclusion: Electrolyte metabolism is disturbed in type 2 diabetes mellitus and proper glycemic control and evaluation of electrolyte levels can reduce the fatalities associated with electrolyte derangement in type 2 diabetes mellitus.