Background: Delayed symptomatic hyponatremia (DSH) is an unpredictable postoperative complication after transsphenoidal pituitary surgery. Universal postoperative sodium screening and water restriction are two strategies to detect or prevent the development of DSH. We performed a meta-analysis of studies characterizing the rate of DSH using sodium screening and water restriction protocols.
Methods: Literature search was done using MEDLINE/PUBMED, EMBASE, and Cochrane databases. Inclusion criteria are (1) development of DSH after endoscopic or microscopic transsphenoidal, sellar surgery, and (2) reporting of a standardized postoperative sodium screening protocol for monitoring or prevention of DSH.
Results: A total of 23 publications fulfilled the inclusion criteria resulted in a total of 5870 patients. Two meta-analyses were conducted. Of the 19 studies (N = 4488 patients) examining rate of DSH after sodium screening, DSH rates ranged from 0% to 19.7%. In the first meta-analysis, using a random-effect estimate of the combined proportions, the overall rate of DSH was 5.60% (4.0%-7.1%, I = 96.54%, T = 0.0007). In the second meta-analysis, a fixed-effect model of four studies consisted of 1382 patients. Eight hundred fifty-two patients were included prior to and 530 were included after water restriction protocol. Meta-analysis showed an odds ratio (OR) of 5.02 (95% CI: 2.16-11.65) favoring water restriction.
Conclusion: This meta-analysis summarized rates of DSH with sodium screening protocol to be 5.60% (4.0%-7.1%) and showed a decreased risk of DSH after implementation of a water restriction protocol. The results are limited due to few studies examining fluid restriction (N = 4) and heterogeneity in water restriction protocols. No adverse events were seen with fluid restriction protocol. Prospective and multicenter studies should be conducted to further investigate the utility of water restriction following transsphenoidal pituitary surgery.
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http://dx.doi.org/10.1016/j.clineuro.2022.107166 | DOI Listing |
Arch Argent Pediatr
January 2025
Hospital Italiano de Buenos Aires, City of Buenos Aires, Argentina.
Introduction. Middle-ear ventilation tubes are commonly placed in pediatric patients because of the high frequency of otitis media. Although avoidance of water activity has been recommended to prevent otorrhea, studies indicate that exposure to water does not increase these episodes.
View Article and Find Full Text PDFJ Phys Chem B
January 2025
Department of Computational Sciences, School of Basic Sciences, Central University of Punjab, Bathinda 151401, India.
The effect of confinement on the tetrahedral ordering of liquid water plays a vital role in controlling their microscopic structure and dynamics as well as their spectroscopic properties. In this article, we have performed the classical molecular dynamics simulations of four different CTAB/water/chloroform reverse micelles with varied water content to study how the tetrahedral ordering of nanoscale water inside reverse micellar confinement influences the microscopic dynamics and the structural relaxation of water···water hydrogen bonds and its impact on the low-frequency intermolecular vibrational bands. We have noticed from the results obtained from simulated trajectories the lowering trends of tetrahedral ordering of water pools in reverse micellar confinements as we move from bulk to confined and strictly confined environments.
View Article and Find Full Text PDFSci Total Environ
January 2025
Centre for Agroecology Water and Resilience (CAWR), Coventry University, Wolston Lane, Ryton on Dunsmore, CV8 3LG, UK. Electronic address:
The widespread occurrence of new and emerging and persistent organic pollutants (NEPs and POPs) in surface water poses a risk to drinking water supply and consequently human health. The aim of this work was to investigate the occurrence and potential transport of 42 target NEPs and POPs (including per-and polyfluoroalkyl substances (PFAS), pharmaceuticals, pesticides and bisphenols) along the rural and urban environments of three rivers in England. The type and concentrations of pollutants varied between the sampling days and points.
View Article and Find Full Text PDFJ Phycol
January 2025
Departamento de Botânica, Instituto de Biociências, Universidade de São Paulo, Sao Paulo, Brazil.
The filamentous red algal genus Bryocladia was recently deeply revised based on molecular and morphological data. However, data from the Southwestern Atlantic Ocean are scarce. Here, we provide a phylogenetic study of Bryocladia representatives from the Brazilian coast with new additions to the genus.
View Article and Find Full Text PDFAngew Chem Int Ed Engl
January 2025
Nanjing University of Aeronautics and Astronautics, College of Materials Science and Technology, No. 169 Sheng Tai West Road, Jiangning District, Nanjing, Jiangsu, China, 211106, Nanjing, CHINA.
The neutral oxygen catalysis is an electrochemical reaction of the utmost importance in energy generation, storage application, and chemical synthesis. However, the restricted availability of protons poses a challenge to achieving kinetically favorable oxygen catalytic reactions. Here, we alter the interfacial water orientation by adjusting the Brønsted acidity at the catalyst surface, to break the proton transfer limitation of neutral oxygen electrocatalysis.
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