Galactosemia
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop in Atlas of Inherited Metabolic Diseases, 2020
Renal abnormalities are usually first detected in the laboratory by the analysis of the blood and urine. Some patients have had frequency of urination. The picture is that of the renal Fanconi syndrome, in which there is renal tubular glycosuria, generalized aminoaciduria, and proteinuria, and systemically there is hyperchloremic acidosis. The glycosuria of the Fanconi syndrome may cause the galactosuria to be missed. In the past, the initial clinical suspicion of galactose has come from the presence of reducing substance in a sample of urine that tests negative for glucose with glucose oxidase, but once renal dysfunction develops, both tests would be positive. In any case, most clinical laboratories now test for urinary sugar with glucose oxidase. Tests for reducing substance have become the province of the biochemical genetics laboratory. At times of acute illness, there may be hypoglycemia. In young infants, hematologic examination may reveal an erythroblastotic picture.
Involvement of Dopamine with Various Cancers
Nira Ben-Jonathan in Dopamine, 2020
Bladder cancer affects about 3.5 million people globally, with 430,000 new cases diagnosed every year, resulting in close to 200,000 deaths. Age of onset is most often between 65 and 85 years of age. Blood in the urine is the most common symptom in bladder cancer. Other symptoms include pain during urination (dysuria), frequent urination, and lower back pain. However, these signs and symptoms are not specific to bladder cancer and may also be caused by noncancerous conditions, including prostate infections, overactive bladder or cystitis. Risk factors include smoking, family history, prior radiation therapy, frequent bladder infections, and exposure to certain chemicals. The most common type is transitional cell carcinoma, while other types include squamous cell carcinoma and adenocarcinoma. Diagnosis is typically made by cystoscopy and tissue biopsy, while staging is determined by computed tomography (CT) scan and bone scan.
Common diseases of the vulva
Miranda A. Farage, Howard I. Maibach in The Vulva, 2017
Atrophic vaginitis is a condition that occurs when the vulvar vaginal tissue lacks estrogen. It occurs most commonly in postmenopausal females, but can also occur in situations that induce a hypoestrogenic state, such as when women are breastfeeding or taking medications such as Depo medroxyprogesterone or tamoxifen. Atrophic vaginitis does not affect all women. Typically, women with atrophic vulvovaginitis experience burning that can range from intermittent to constant, vaginal dryness, and pain with sexual activity. Some women experience urinary urgency, frequency, nocturia, and/or frequent urinary tract infections. Symptoms can be exacerbated during and after urination. In advanced cases, the skin becomes so thin and fragile that it will bleed with minimal trauma such as wiping or patting with toilet tissue after urination. Examination of the vulvar tissue demonstrates a pale to erythematous mucosa. A urethral caruncle can be present (Figure 11.5). The maturation index from microscopic evaluation of the vaginal discharge demonstrates a decrease in the number of mature squamous epithelial cells and an increase in the number of basal and parabasal epithelial cells. Frequently, there is an increase in white blood cells seen microscopically (14).
Association between dietary inflammatory index and urinary flow rate: a nationwide study, NHANES 2009–2016
Published in The Aging Male, 2023
Yifan Li, Shi Qiu, Xianghong Zhou, Boyu Cai, Sheng Wang, Xingyu Xiong, Kun Jin, Lu Yang, Qiang Wei
The mechanism of the urination reflex is complex, which is affected by nerve conduction, detrusor function, and the bladder outlet. In neuromodulation, related studies have found that when the expression of inflammatory factors in cell micro-environment is up-regulated, it can activate nuclear factorκB (NF-κB) pathway and induce cell apoptosis; on the other hand, inflammatory factors can stimulate nerve cells to start self-protection and repair mechanism, among which TNF -αand IL-6 can cause degeneration and demyelination of peripheral nerve axis, causing nerve conduction dysfunction [27,28]. In terms of muscle control, detrusor and pelvic floor muscles, which are the main muscles affecting urination. It has been reported that IL-1 can inhibit glucose transport and lactic acid production in muscle tissue, resulting in muscle metabolic disorders and inhibition of myoblast proliferation, fusion, and regeneration, finally leading to myasthenia [29]. Meanwhile, a recent study found that the weak urination strongly associated with the presence of lower muscle strength, which including both smooth muscle and skeletal muscle [24].
Safety and effectiveness of empagliflozin in Japanese patients with type 2 diabetes: final results of a 3-year post-marketing surveillance study
Published in Expert Opinion on Drug Safety, 2022
Kohei Kaku, Kazuhiro Yamamoto, Yumiko Fukushima, Hristo Lliev, Atsutaka Yasui
The potential for adverse events relating to volume depletion with SGLT2 inhibitors is also based on their mechanism of action, as glucosuria is accompanied by increased natriuresis and diuresis – at least transiently after drug initiation, as shown in studies in Japanese [28] and European patients [3]. In this study, however, only 1.29% of patients reported excessive urination generally and only 0.19% reported nocturia specifically, with low rates even in older individuals (0.24% and 0.12% of patients aged ≥65 to <75 and ≥75 years, respectively) – the latter is an important finding as nocturia is common in the elderly and negatively affects their general health and quality of life [29,30]. Furthermore, the rates of volume depletion and dehydration were low (0.50% and 0.43%, respectively). In Japan, increased fluid intake and monitoring for hydration in elderly patients is recommended during initial treatment with SGLT2 inhibitors, especially when administered in combination with diuretics [27].
‘Drink clean, safe water and/or other fluids through-out the day even if you do not feel thirsty’: a food-based dietary guideline for the elderly in South Africa
Published in South African Journal of Clinical Nutrition, 2021
Upasana Mukherjee, Carin Napier, Wilna Oldewage-Theron
The literature provided sufficient evidence that water is very important to the elderly and that dehydration is a real problem for them for many reasons. Not regulating fluid intake in the elderly can lead to detrimental effects with physical, mental and economic consequences. Unlike younger people, the elderly are unable to maintain the water balance in the body through the body’s own mechanisms and this has to be monitored. As many of the elderly also face problems of mobility, both drinking water and urination can be a problem. The literature thus supports the food-based dietary guideline for the elderly not only to focus on water consumption, but also that clean, safe water/fluids should be consumed throughout the day even if the elderly do not feel thirsty. We recognise, however, that there are limited water consumption data available specifically related to the elderly and more research is needed to address this.
Related Knowledge Centers
- Autonomic Nervous System
- Bladder
- Central Nervous System
- Excretion
- Reflex
- Somatic Nervous System
- Urine
- Urethra
- Urinary System
- Pontine Micturition Center