The abdomen
Peter Kopelman, Dame Jane Dacre in Handbook of Clinical Skills, 2019
Although no glandular secretion occurs in the small and large intestines, there is a rapid exchange of water and electrolytes across parts of the mucosa. Water moves in response to osmotic gradients, a hypertonic solution being rapidly diluted by the movement of water from blood to lumen, and a hypotonic solution being rapidly concentrated by the absorption of water. Sodium is actively absorbed in both the small and large intestine, while potassium is absorbed by the small intestine but secreted by the large intestine. In normal circumstances, albumin leaks into the gut lumen in various secretions such as saliva, gastric juice, succus entericus and bile. The exuded albumin is digested and the nitrogen subsequently absorbed as amino acids. This intestinal loss accounts for approximately 10% of the total albumin catabolism in the normal subject.
Management of hyponatremia in patients with heart failure: A retrospective study
Elida Zairina, Junaidi Khotib, Chrismawan Ardianto, Syed Azhar Syed Sulaiman, Charles D. Sands, Timothy E. Welty in Unity in Diversity and the Standardisation of Clinical Pharmacy Services, 2017
The remaining hyponatremic patients received sodium chloride both as capsules and intravenous solution. However, sodium chloride capsules were administered mostly in combination with sodium chloride solution to patients with severe hyponatremia. Isotonic solution of sodium chloride is very good for patients with hypovolemic hyponatremia, whereas the hypertonic solution has an efficacious effect for hyponatremic patients with hypervolemic or euvolemic conditions (Bhaskar 2010, Spasovski 2014). The most important aspect of administering the sodium chloride solution is the rate of correction, particularly for patients with acute hyponatremia. Overly rapid administration of hypertonic solution of sodium chloride can induce neuron obstruction leading to severe neurologic disorder (Verbalis 2007, Spasovski 2014).
Ageing
Henry J. Woodford in Essential Geriatrics, 2022
Non-oral enteral feeding is sometimes appropriate. Small-bore and soft nasogastric tubes are usually better tolerated. Reducing the flow rate or changing feed formulation can diminish the incidence of diarrhoea. There is a risk of re-feeding syndrome (see page 225). Percutaneous endoscopic gastrostomy (PEG) tubes are discussed on pages 129 and 224. Total parenteral nutrition is a possible alternative, but there is little evidence of a benefit when used in older people; it has potential harms and high costs. The hypertonic solution used needs to be given via a large calibre vein (usually via central venous access). In general terms, enteral nutrition is preferable to the parenteral route whenever possible.37
Nasal saline irrigation: prescribing habits and attitudes of physicians and pharmacists
Published in Scandinavian Journal of Primary Health Care, 2021
Jesse Tapiala, Antti Hyvärinen, Sanna Toppila-Salmi, Eero Suihko, Elina Penttilä
In summary, the most popular method for NSI was a Neti pot (n = 477; 80.7%) filled with an isotonic solution (n = 440; 73.9%) that was 30–40 degrees Celsius (n = 417; 70.1%). Hypertonic (n = 18; 3.0%) or hypotonic (n = 11; 1.8%) solutions were rarely administered and the rest did not instruct the tonicity (n = 126; 21.2%). Volumes of 51–100 ml (n = 72; 12.2%) and 101–200 ml (n = 83; 14.0%) were recommended the most, while the majority gave no recommendation at all (n = 316; 53.4%). Many of the respondents recommended homemade solutions (n = 483; 81.2%) as opposed to purchasing ready-to-use nasal solutions from pharmacies (n = 325; 54.6%). Irrigations were most instructed as a daily (n = 222; 37.8%) or twice-a-day (n = 277; 47.2%) therapy. Regular irrigations were recommended by 77 (12.9%) of the respondents, while the rest (n = 518; 87.1%) opted for a short-term usage (mean: 6.52 days, SD = 3.9, min = 1 day and max = 30 days). There was no significant difference in the length of the recommended use between pharmacists and physicians.
Approach to and management of abnormalities in plasma sodium
Published in Acta Clinica Belgica, 2019
G. Decaux
Generally, the tonicity is more important for the organism than is the osmolality. Tonicity is the concentration of solutes, which have the capacity to exert an osmotic force across membranes and thereby initiate a movement of water into or out of cells depending on the gradient. Thus, since urea and some other low molecular weight substances, such as ethanol, methanol or ethylene glycol rapidly penetrate cells, they exert no effective osmotic force across most body membranes. Hence, hyponatremia associated for example with severe azotemia represents a true hypotonic state in regards to the cells and this despite a normal or high osmolality (depending on the level of uremia). Water movement across semipermeable membranes rapidly dissipates any pathologic attempt to create a transcellular concentration gradient. Consequently, determination of extracellular osmolality also gives the intracellular osmolality. Measurement of serum osmolality is indicated when pseudohyponatremia is suspected because of lactescent serum, multiple myeloma or in ‘translocational hyponatremia’. Translocational hyponatremia is observed when the patient has accumulation in the extracellular fluid (ECF) of a solute which does not penetrate the cell (glucose, mannitol, sorbitol, glycerol, maltose, glycine, radiocontrast agents), and which draws water from the intracellular compartment. It has been shown that a correction factor of a 2.4 mEq/l decrease in sodium concentration per 100 mg/dl increase in glucose concentration is a better overall estimate of this association than the usual correction factor of 1.6 [3].
Vitamin K2 protects PC12 cells against Aβ (1-42) and H2O2-induced apoptosis via p38 MAP kinase pathway*
Published in Nutritional Neuroscience, 2020
Elham Hadipour, Zahra Tayarani-Najaran, Masoud Fereidoni
Apoptosis was measured by staining propidium iodide (PI) and Sub-G1 peak in a flow cytometric device. DNA fragmentation is one of the events that occur during apoptosis while mono and oligo parts of the nucleosomal DNA form. When the cell permeability increases with a hypertonic solution, then the DNA fragment with a low molecular weight can be removed from the cell. As a result, apoptotic cells have lower DNA content. Before the cell cycles G1 Peak, there is another peak that belongs to them and represents the percentage of apoptosis.22 For this assessment, 105 PC12 seeded in each well of a 12-well plate, and after a day, PC12 cells were treated with NGF (50 ng/ml) and allowed to differentiate for 48 h. Vitamin K2 (20 and 50 μM) was added into the cultures 24 h in prior to Aβ (1-42) (25 µM for 48 h) and H2O2 (150 µM for 24 h) exposure. After treatment with Aβ (1-42) and H2O2, cells were harvested and 400 μl hypotonic buffer which contains 50 μg/ml PI in 0.1% sodium citrate plus 0.1% Triton X-100 was added to each sample before flow cytometric analysis using a FAC Scan flow cytometer (BD Biosciences, CA, USA).
Related Knowledge Centers
- Cell Wall
- Imbibition
- Osmotic Pressure
- Semipermeable Membrane
- Cell Membrane
- Cytosol
- Chemical Biology
- Solution
- Cell
- Plasmodesma