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Gungor S, Tosun B, Candir G, Ozen N. Effects of cold spray on thirst, frequency of oral care, and pain of general surgery intensive care unit patients. Sci Rep 2024; 14:9997. [PMID: 38693271 PMCID: PMC11063212 DOI: 10.1038/s41598-024-58199-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/26/2024] [Indexed: 05/03/2024] Open
Abstract
This study aims to investigate the effects of intraoral cold water spray on thirst, frequency of oral care and postoperative period pain at surgical incision site in patients having abdominal surgery. The study was carried out as a randomized controlled trial, registered under Clinical Trial Number: NCT05940818. The study involved 110 participants, divided equally into two groups (n = 55): the experimental group and the control group. Data were collected using patient information form, NRS, Intensive Care Oral Care Frequency Assessment Scale (ICOCFAS) and Visual Analog Scale (VAS). The severity of thirst at 1st, 8th, 16th h of post-operative period (p < 0.01) and the frequency of oral care application at 16th h were statistically significantly decreased in the experimental group when compared to the control group (p < 0.01).There wasn't statistically significant difference between the patients in the experimental and control groups in terms of pain at surgical incision site (p > 0.05). The patient's thirst and need for frequent oral care in the postoperative period were reduced by the application of a cold water spray. In patients undergoing abdominal surgery, the use of cold water spray application may be recommended to reduce thirst and the need for frequency of oral care application.
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Affiliation(s)
- Serap Gungor
- Kahramanmaras Sutcu Imam University, Vocational School of Health Services, Kahramanmaras, Turkey.
| | - Betul Tosun
- Hacettepe University, Faculty of Nursing, Ankara, Turkey
| | - Gozde Candir
- Adana City Education and Research Hospital, General Surgery İntensive Care, Adana, Turkey
| | - Nurten Ozen
- Demiroglu Bilim University, Florence Nightingale Hospital School of Nursing, Department of English Nursing, İstanbul, Turkey
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2
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Stevenson RJ, Martin-Rivera D, Dixon G, Francis HM. Parent-offspring similarity in hunger and thirst sensations. Appetite 2024; 195:107208. [PMID: 38218415 DOI: 10.1016/j.appet.2024.107208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/21/2023] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
The internal (i.e., interoceptive) sensations that characterise hunger vary between people, and this may also be the case for thirst, although it has not been so well explored. There are probably both heritable and learning-based causes for this interoceptive variability. Consequently, it would seem plausible that parents and their offspring would have more similar patterns of hunger and thirst than pairs of strangers. We tested this idea, in addition to exploring its potential moderating variables, by studying the similarity of self-reported hunger and thirst sensations in 170 students and their primary caregivers from childhood. Both students and caregivers completed the same online-survey, covering hunger and thirst sensations, beliefs about the causes of hunger and thirst, the Three Factor Eating Questionnaire (revised) and demographic data. We find evidence of robust student-caregiver similarity in interoceptive hunger and thirst sensations (medium effect sizes), with these being moderated by caregiver beliefs about the homeostatic nature of each state (medium effect sizes). This suggests a potential role for caregivers in the development of their offspring's interoceptive cues for hunger and for thirst. In addition, thirst, like hunger, appears to be multidimensional, and varies between people. The implications of these findings are discussed.
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Affiliation(s)
| | | | - Gabriela Dixon
- School of Psychology, Macquarie University, Sydney, Australia
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3
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Kurt B, Kapucu S, Çakmak Öksüzoğlu BÖ. Effects of Oral Cryotherapy on Anticipatory, and Acute Nausea and Vomiting in Patients With Breast Cancer Undergoing Adjuvant Chemotherapy: A Randomized Controlled Clinical Trial. Clin Breast Cancer 2024; 24:112-121. [PMID: 38102011 DOI: 10.1016/j.clbc.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 10/05/2023] [Accepted: 10/31/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE To determine the effects of oral cryotherapy (OC) on the anticipatory, and acute nausea and vomiting of patients with breast cancer who are receiving adjuvant chemotherapy. PATIENTS AND METHODS Seventy eligible patients with breast cancer were assigned to 2 groups by stratified randomization. This parallel grouped, randomized, clinical trial used the ice application protocol. OC application for an intervention group (IG, n = 35) was performed in 3 stages: i) instructions on by the investigator at the hospital; ii) the implementation accompanied by the investigator at the hospital; iii) the individual application of at home by patients. The IG had been doing the application for 12 weeks. The patients in the control group (CG, n = 35) received standard care. Additionally, Rhodes Index of Nausea Vomiting, and Retching, and EORTC QLQ-C30 Life Quality Index were conducted on the first (T1 = cycle 1 day 0), second (T2 = cycle 2 day 21), third (T3 = cycle 3 day 42), and fourth (T4 = cycle 4 day 63) cycles of adjuvant chemotherapy. RESULTS The anticipatory nausea scores in the T2 and T4, IG were significantly lower than the CG (P < .05). In the T3, all symptom sub-dimensions except symptom occurrence (t = -0,48; P = .63) of the IG were significantly lower than those of the CG (P < .05). In the T1, T2, T3, and T4, acute nausea, acute vomiting, acute retching, and anticipatory retching scores, were significantly lower than the CG (P < .05). CONCLUSION OC alone was effective and safe for the treatment of nausea and vomiting. The results of this study showed the clinical applicability of OC in the management of nausea and vomiting.
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Affiliation(s)
- Berna Kurt
- Department of Internal Medical Nursing, Nursing Faculty, Hacettepe University, Ankara, Turkey.
| | - Sevgisun Kapucu
- Department of Internal Medical Nursing, Nursing Faculty, Hacettepe University, Ankara, Turkey
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4
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Picó-Munyoz R, Tárrega A, Laguna L. Origins of thirstiness sensation and current food solutions. Compr Rev Food Sci Food Saf 2023; 22:4433-4450. [PMID: 37583300 DOI: 10.1111/1541-4337.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/15/2023] [Accepted: 08/01/2023] [Indexed: 08/17/2023]
Abstract
The sensation of thirstiness is the desire to drink water. In certain situations, the ingestion of liquid water can be restricted. As a result, thirstiness is not relieved, resulting in an uncomfortable and distressing situation. The present review describes thirstiness and hydration, the food products and beverages that cause thirstiness, and the beverages and food products currently available to quench thirstiness in individuals with restricted access to liquid ingestion. It also discusses how to measure the effectiveness of calming thirstiness. To diminish thirstiness distress, different alternatives to liquids are proposed. Individuals with swallowing disorders are given thickened water, individuals with restricted water ingestion are given ice cubes or ice popsicles of different flavors, and sportspeople are given energy gels. However, current beverage solutions seem not to relieve thirst fully, although some stimuli like iced water, flavors (especially lemon and mint), or acids seem to work better than plain stimuli and could be added to existing products. Therefore, there is still a need to incorporate these strategies into beverage and food formulations and to test their effectiveness.
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Affiliation(s)
- Ruth Picó-Munyoz
- Consumer Perception and Behavior and Adapted Nutrition Laboratory, Institute of Agrochemistry and Food Technology (IATA, CSIC), Paterna, Spain
| | - Amparo Tárrega
- Consumer Perception and Behavior and Adapted Nutrition Laboratory, Institute of Agrochemistry and Food Technology (IATA, CSIC), Paterna, Spain
| | - Laura Laguna
- Consumer Perception and Behavior and Adapted Nutrition Laboratory, Institute of Agrochemistry and Food Technology (IATA, CSIC), Paterna, Spain
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Stevenson RJ, Bartlett J, Wright M, Hughes A, Hill BJ, Saluja S, Francis HM. The development of interoceptive hunger signals. Dev Psychobiol 2023; 65:e22374. [PMID: 36811369 PMCID: PMC10107831 DOI: 10.1002/dev.22374] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 02/09/2023]
Abstract
Hunger is often reported when people experience certain internal sensations (e.g., fatigue) or when they anticipate that a food will be good to eat. The latter results from associative learning, while the former was thought to signal an energy deficit. However, energy-deficit models of hunger are not well supported, so if interoceptive hungers are not "fuel gauges," what are they? We examined an alternate perspective, where internal states signaling hunger, which are quite diverse, are learned during childhood. A basic prediction from this idea is offspring-caregiver similarity, which should be evident if caregivers teach their child the meaning of internal hunger cues. We tested 111 university student offspring-primary caregiver pairs, by having them complete a survey about their internal hunger states, alongside other information that may moderate this relationship (i.e., gender, body mass index, eating attitudes, and beliefs about hunger). We observed substantial similarity between offspring-caregiver pairs (Cohen's ds from 0.33 to 1.55), with the main moderator being beliefs about an energy-needs model of hunger, which tended to increase similarity. We discuss whether these findings may also reflect heritable influences, the form that any learning might take, and the implications for child feeding practices.
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Affiliation(s)
- Richard J Stevenson
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Johanna Bartlett
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Madeline Wright
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Alannah Hughes
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Brayson J Hill
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Supreet Saluja
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Heather M Francis
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
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TEREZA DENISEM, BALDASSO GABRIELAM, PAES RODRIGOS, PACHECO MARIAE, ROSA PATRÍCIAP, VENDRAMINE BEATRIZ, HULSE SERGIOC, CAPASSO RAFFAELE, DUTRA RAFAELC. Evaluation of the protocol for thirst management using ice popsicles in the immediate postoperative period: A pilot study in southern Brazilian hospital. AN ACAD BRAS CIENC 2021. [DOI: 10.1590/0001-3765202120201260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- DENISE M. TEREZA
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil
| | | | | | | | | | | | | | | | - RAFAEL C. DUTRA
- Universidade Federal de Santa Catarina, Brazil; Universidade Federal de Santa Catarina, Brazil
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Ligtenberg A, Meuffels M, Veerman E. Effects of environmental temperature on saliva flow rate and secretion of protein, amylase and mucin 5B. Arch Oral Biol 2020; 109:104593. [DOI: 10.1016/j.archoralbio.2019.104593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
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Aroni P, Fonseca LF, Ciol MA, Margatho AS, Galvão CM. The use of mentholated popsicle to reduce thirst during preoperative fasting: A randomised controlled trial. J Clin Nurs 2019; 29:840-851. [DOI: 10.1111/jocn.15138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/17/2019] [Accepted: 11/19/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Patricia Aroni
- Department of Nursing State University of Londrina Londrina Brazil
| | - Ligia F. Fonseca
- Department of Nursing State University of Londrina Londrina Brazil
| | - Marcia A. Ciol
- Department of Rehabilitation Medicine School of Medicine University of Washington Seattle WA USA
| | - Amanda S. Margatho
- General and Specialized Nursing Department Ribeirão Preto College of Nursing University of São Paulo Ribeirão Preto Brazil
| | - Cristina M. Galvão
- General and Specialized Nursing Department Ribeirão Preto College of Nursing University of São Paulo Ribeirão Preto Brazil
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Edmonds CJ, Skeete J, Klamerus E, Gardner M. At what stage in the drinking process does drinking water affect attention and memory? Effects of mouth rinsing and mouth drying in adults. PSYCHOLOGICAL RESEARCH 2019; 85:214-222. [PMID: 31300874 DOI: 10.1007/s00426-019-01229-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 07/06/2019] [Indexed: 11/28/2022]
Abstract
Drinking water is important for health and there is an agreement that drinking water facilitates certain cognitive processes. However, the mechanism underlying the effect of drinking water on cognition is unknown. While attention performance is improved by even a very small drink, memory performance seems to require larger drinks for performance enhancement. This suggests that attention could be affected earlier in the drinking process than memory. We aimed to elucidate further the mechanism involved by investigating the stage during the drinking process influencing performance on cognitive tasks. To this end, we compared mouth rinsing and mouth drying. Mouth rinsing was expected to result in improved attention performance and would suggest that the mechanism responsible is located in the mouth and occurs early in the drinking process, before swallowing. Eighty-seven adults participated in either a treatment (mouth rinsing or mouth drying) or control (no intervention) condition. They were assessed at baseline and 20 min later after intervention on measures of visual attention, short-term memory, subjective thirst and mood. Our results showed that mouth rinsing improved visual attention, but not short-term memory, mood or subjective thirst. Mouth drying did not affect performance. Our results support the hypothesis that different mechanisms underlie the effect of drinking water on different cognitive processes. They suggest that merely sipping water, as opposed to having a large drink, can improve attention.
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Affiliation(s)
- Caroline J Edmonds
- School of Psychology, University of East London, Water Lane, Stratford, E15 4LZ, UK.
| | - Jamila Skeete
- Department of Psychology, University of Westminster, 309 Regent Street, London, W1B 2UW, UK
| | - Eva Klamerus
- School of Psychology, University of East London, Water Lane, Stratford, E15 4LZ, UK
| | - Mark Gardner
- Department of Psychology, University of Westminster, 309 Regent Street, London, W1B 2UW, UK
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10
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Nolte HW, Nolte K, Hew-Butler T. Ad libitum water consumption prevents exercise-associated hyponatremia and protects against dehydration in soldiers performing a 40-km route-march. Mil Med Res 2019; 6:1. [PMID: 30678725 PMCID: PMC6346586 DOI: 10.1186/s40779-019-0192-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/08/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND It remains unclear if ad libitum water drinking, as a hydration strategy, prevents exercise-associated hyponatremia (EAH) during prolonged exercise. The aim of this study was to determine the incidence of EAH within the broader context of fluid regulation among soldiers performing a 40-km route-march ingesting water ad libitum. METHODS Twenty-eight healthy male soldiers participated in this observational trial. Pre- and post-exercise body mass, blood and urine samples were collected. Blood samples were assessed for serum sodium ([Na+]), glucose, creatinine, urea nitrogen (BUN), plasma osmolality, creatine kinase (CK), and plasma arginine vasopressin (AVP) concentrations. Plasma volume (PV) was calculated using hematocrit and hemoglobin. Urine samples were analyzed for osmolality and [Na+]. Water intake was assessed by weighing bottles before, during and after the march. The mean relative humidity was 55.7% (21.9-94.3%) and the mean dry bulb temperature was 27.1 °C (19.5 °C - 37.0 °C) during the exercise. RESULTS Twenty-five soldiers (72 ± 10 kg) (Mean ± SD) completed the march in 09:11 ± 00:43 (hr:min). Participants consumed 736 ± 259 ml/h of water and lost 2.8 ± 0.9 kg (4.0% ± 1.4%, P < 0.05) of body mass. Significant (pre-march vs. post-march; P < 0.05) decreases in serum [Na+] (141 mmol/L vs. 136 mmol/L), plasma osmolality (303 mOsmol/kg H2O vs. 298 mOsmol/kg H2O), and serum creatinine (111 μmol/L vs. 101 μmol/L) and urine [Na+] (168 mmol/L vs. 142 mmol/L), as well as significant increases in plasma AVP (2 pg/ml vs. 11 pg/ml), plasma CK (1423 U/L vs. 3894 U/L) and urine osmolality (1035 mOsmol/kg H2O vs. 1097 mOsmol/kg H2O) were found. The soldier (72 kg) with the lowest post-exercise sodium level completed the march in 08:38. He drank 800 ml/h, lost 2% body mass, and demonstrated (pre-post) increases in plasma osmolality (294-314 mOsmol/kg H2O), BUN (20-30 mg/dl), AVP (2-16 pg/ml) and PV (41%). His urine osmolality decreased from 1114 mOsmol/kg H2O to 1110 mOsmol/kg H2O. No participants finished the route-march with a serum [Na+] indicating hypernatremia (range, 134-143 mmol/L). CONCLUSIONS Ad libitum drinking resulted in 4% body mass loss with a 2 mmol/L serum [Na+] reduction in conjunction with high urine osmolality (> 1000 mOsmol/kg H2O) and plasma AVP. No single hydration strategy likely prevents EAH, but hypernatremia (cellular dehydration) was not seen despite > 2% body mass losses and high urine osmolality.
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Affiliation(s)
- Heinrich W Nolte
- Movement Physiology Research Laboratory, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Kim Nolte
- Division Biokinetics and Sport Science, Department of Physiology, University of Pretoria, Pretoria, South Africa
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11
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VonStein M, Buchko BL, Millen C, Lampo D, Bell T, Woods AB. Effect of a Scheduled Nurse Intervention on Thirst and Dry Mouth in Intensive Care Patients. Am J Crit Care 2019; 28:41-46. [PMID: 30600225 DOI: 10.4037/ajcc2019400] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Thirst is a common, intense symptom reported by hospitalized patients. No studies indicate frequency of use of ice water and lip moisturizer with menthol to ameliorate thirst and dry mouth. In an audit of 30 intensive care unit patients at a 580-bed community teaching hospital, 66% reported dry mouth with higher thirst distress and intensity scores than in published studies. OBJECTIVES To evaluate the effectiveness of scheduled use of ice water oral swabs and lip moisturizer with menthol compared with unscheduled use in relieving thirst and dry mouth for intensive care unit patients. METHODS In a quasi-experimental design, adult patients admitted to 2 intensive care units at a community hospital were provided with ice water oral swabs and lip moisturizer with menthol upon request. The intervention was unscheduled in 1 unit and scheduled in the other unit. The scheduled intervention was provided hourly during a 7-hour period (n = 62 participants). The unscheduled intervention consisted of usual care (n = 41 participants). A numeric rating scale (0-10) was used to measure thirst intensity, thirst distress, and dry mouth before and after 7 hours in both groups. RESULTS The scheduled-use group had significant lessening of thirst intensity (P = .02) and dry mouth (P = .008). Thirst distress in the scheduled-use group did not differ from that in the unscheduled-use group (P = .07). CONCLUSION Scheduled use of ice water oral swabs and lip moisturizer with menthol may lessen thirst intensity and dry mouth in critical care patients.
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Affiliation(s)
- Michelle VonStein
- Michelle VonStein and Cristina Millen are clinical nurses, and Deborah Lampo is a nurse manager, WellSpan York Hospital, York, Pennsylvania. Barbara L. Buchko is director, Evidence-Based Practice and Nursing Research, and Theodore Bell is a research program manager, WellSpan Health, York, Pennsylvania. Anne B. Woods is adjunct faculty, Messiah College, Mechanicsburg, Pennsylvania
| | - Barbara L. Buchko
- Michelle VonStein and Cristina Millen are clinical nurses, and Deborah Lampo is a nurse manager, WellSpan York Hospital, York, Pennsylvania. Barbara L. Buchko is director, Evidence-Based Practice and Nursing Research, and Theodore Bell is a research program manager, WellSpan Health, York, Pennsylvania. Anne B. Woods is adjunct faculty, Messiah College, Mechanicsburg, Pennsylvania
| | - Cristina Millen
- Michelle VonStein and Cristina Millen are clinical nurses, and Deborah Lampo is a nurse manager, WellSpan York Hospital, York, Pennsylvania. Barbara L. Buchko is director, Evidence-Based Practice and Nursing Research, and Theodore Bell is a research program manager, WellSpan Health, York, Pennsylvania. Anne B. Woods is adjunct faculty, Messiah College, Mechanicsburg, Pennsylvania
| | - Deborah Lampo
- Michelle VonStein and Cristina Millen are clinical nurses, and Deborah Lampo is a nurse manager, WellSpan York Hospital, York, Pennsylvania. Barbara L. Buchko is director, Evidence-Based Practice and Nursing Research, and Theodore Bell is a research program manager, WellSpan Health, York, Pennsylvania. Anne B. Woods is adjunct faculty, Messiah College, Mechanicsburg, Pennsylvania
| | - Theodore Bell
- Michelle VonStein and Cristina Millen are clinical nurses, and Deborah Lampo is a nurse manager, WellSpan York Hospital, York, Pennsylvania. Barbara L. Buchko is director, Evidence-Based Practice and Nursing Research, and Theodore Bell is a research program manager, WellSpan Health, York, Pennsylvania. Anne B. Woods is adjunct faculty, Messiah College, Mechanicsburg, Pennsylvania
| | - Anne B. Woods
- Michelle VonStein and Cristina Millen are clinical nurses, and Deborah Lampo is a nurse manager, WellSpan York Hospital, York, Pennsylvania. Barbara L. Buchko is director, Evidence-Based Practice and Nursing Research, and Theodore Bell is a research program manager, WellSpan Health, York, Pennsylvania. Anne B. Woods is adjunct faculty, Messiah College, Mechanicsburg, Pennsylvania
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12
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The role of natural salivary defences in maintaining a healthy oral microbiota. J Dent 2019; 80 Suppl 1:S3-S12. [DOI: 10.1016/j.jdent.2018.08.010] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 08/22/2018] [Indexed: 01/19/2023] Open
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13
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Edmonds CJ, Harte N, Gardner M. How does drinking water affect attention and memory? The effect of mouth rinsing and mouth drying on children's performance. Physiol Behav 2018; 194:233-238. [DOI: 10.1016/j.physbeh.2018.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 05/16/2018] [Accepted: 06/05/2018] [Indexed: 11/30/2022]
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14
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van Belzen L, Postma E, Boesveldt S. How to quench your thirst. The effect of water-based products varying in temperature and texture, flavour, and sugar content on thirst. Physiol Behav 2017; 180:45-52. [DOI: 10.1016/j.physbeh.2017.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 06/16/2017] [Accepted: 08/11/2017] [Indexed: 10/19/2022]
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Bargh MJ, King RFGJ, Gray MP, Jones B. Why do team-sport athletes drink fluid in excess when exercising in cool conditions? Appl Physiol Nutr Metab 2016; 42:271-277. [PMID: 28145733 DOI: 10.1139/apnm-2016-0445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study assessed the potential physiological and perceptual drivers of fluid intake and thirst sensation during intermittent exercise. Ten male rugby players (17 ± 1 years, stature: 179.1 ± 4.2 cm, body mass (BM): 81.9 ± 8.1 kg) participated in six 6-min small-sided games, interspersed with 2 min rest, where fluid intake was ad libitum during rest periods. Pre- and postmeasurements of BM, subjective ratings (thirst, thermal comfort, thermal sensation, mouth dryness), plasma osmolality (POsm), serum sodium concentration (S[Na+]), haematocrit and haemoglobin (to calculate plasma volume change; PV) were taken. Fluid intake was measured during rest periods. BM change was -0.17 ± 0.59% and fluid intake was 0.88 ± 0.38 L. Pre- to post-POsm decreased (-3.1 ± 2.3 mOsm·kg-1; p = 0.002) and S[Na+] remained similar (-0.3 ± 0.7 mmol·L-1, p = 0.193). ΔPV was 5.84 ± 3.65%. Fluid intake displayed a relationship with pre-POsm (r = -0.640, p = 0.046), prethermal comfort (r = 0.651; p = -0.041), ΔS[Na+] (r = 0.816, p = 0.004), and ΔPV (r = 0.740; p = 0.014). ΔThirst sensation displayed a relationship with premouth dryness (r = 0.861, p = 0.006) and Δmouth dryness (r = 0.878, p = 0.004). Yet a weak positive relationship between Δthirst sensation and fluid intake was observed (r = 0.085, p = 0.841). These data observed in an ambient temperature of 13.6 ± 0.9 °C, suggest team-sport athletes drink in excess of fluid homeostasis requirements and thirst sensation in cool conditions; however, this was not influenced by thermal discomfort.
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Affiliation(s)
- Melissa J Bargh
- Institute of Sport, Physical Activity and Leisure, G05 Carnegie Hall, Headingley Campus, Leeds Beckett University, Leeds, W. Yorkshire, United Kingdom LS6 3QS.,Institute of Sport, Physical Activity and Leisure, G05 Carnegie Hall, Headingley Campus, Leeds Beckett University, Leeds, W. Yorkshire, United Kingdom LS6 3QS
| | - Roderick F G J King
- Institute of Sport, Physical Activity and Leisure, G05 Carnegie Hall, Headingley Campus, Leeds Beckett University, Leeds, W. Yorkshire, United Kingdom LS6 3QS.,Institute of Sport, Physical Activity and Leisure, G05 Carnegie Hall, Headingley Campus, Leeds Beckett University, Leeds, W. Yorkshire, United Kingdom LS6 3QS
| | - Michael P Gray
- Institute of Sport, Physical Activity and Leisure, G05 Carnegie Hall, Headingley Campus, Leeds Beckett University, Leeds, W. Yorkshire, United Kingdom LS6 3QS.,Institute of Sport, Physical Activity and Leisure, G05 Carnegie Hall, Headingley Campus, Leeds Beckett University, Leeds, W. Yorkshire, United Kingdom LS6 3QS
| | - Ben Jones
- Institute of Sport, Physical Activity and Leisure, G05 Carnegie Hall, Headingley Campus, Leeds Beckett University, Leeds, W. Yorkshire, United Kingdom LS6 3QS.,Institute of Sport, Physical Activity and Leisure, G05 Carnegie Hall, Headingley Campus, Leeds Beckett University, Leeds, W. Yorkshire, United Kingdom LS6 3QS
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16
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Edmonds CJ, Crosbie L, Fatima F, Hussain M, Jacob N, Gardner M. Dose-response effects of water supplementation on cognitive performance and mood in children and adults. Appetite 2016; 108:464-470. [PMID: 27825957 DOI: 10.1016/j.appet.2016.11.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/01/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
Water supplementation has been found to facilitate visual attention and short-term memory, but the dose required to improve performance is not yet known. We assessed the dose response effect of water on thirst, mood and cognitive performance in both adults and children. Participants were offered either no water, 25 ml or 300 ml water to drink. Study 1 assessed 96 adults and in Study 2, data are presented from 60 children aged 7-9 years. In both studies, performance was assessed at baseline and 20 min after drinking (or no drink); on thirst and mood scales, letter cancellation and a digit span test. For both children and adults, a large drink (300 ml) was necessary to reduce thirst, while a small drink (25 ml) was sufficient to improve visual attention (letter cancellation). In adults, a large drink improved digit span, but there was no such effect in children. In children, but not adults, a small drink resulted in increased thirst ratings. Both children and adults show dose-response effects of drinking on visual attention. Visual attention is enhanced by small amounts of fluid and appears not to be contingent on thirst reduction. Memory performance may be related to thirst, but differently for children and adults. These contrasting dose-response characteristics could imply cognitive enhancement by different mechanisms for these two domains.
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Affiliation(s)
- Caroline J Edmonds
- School of Psychology, University of East London, Stratford Campus, Water Lane, London, E15 4LZ, UK.
| | - Laura Crosbie
- School of Psychology, University of East London, Stratford Campus, Water Lane, London, E15 4LZ, UK
| | - Fareeha Fatima
- Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK
| | - Maryam Hussain
- Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK
| | - Nicole Jacob
- School of Psychology, University of East London, Stratford Campus, Water Lane, London, E15 4LZ, UK
| | - Mark Gardner
- Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK
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Effects of mouthwash interventions on xerostomia and unstimulated whole saliva flow rate among hemodialysis patients: A randomized controlled study. Int J Nurs Stud 2016; 63:9-17. [DOI: 10.1016/j.ijnurstu.2016.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 08/15/2016] [Accepted: 08/16/2016] [Indexed: 11/23/2022]
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18
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Tan PMS, Lee JKW. The role of fluid temperature and form on endurance performance in the heat. Scand J Med Sci Sports 2016; 25 Suppl 1:39-51. [PMID: 25943655 DOI: 10.1111/sms.12366] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2014] [Indexed: 11/30/2022]
Abstract
Exercising in the heat often results in an excessive increase in body core temperature, which can be detrimental to health and endurance performance. Research in recent years has shifted toward the optimum temperature at which drinks should be ingested. The ingestion of cold drinks can reduce body core temperature before exercise but less so during exercise. Temperature of drinks does not seem to have an effect on the rate of gastric emptying and intestinal absorption. Manipulating the specific heat capacity of a solution can further induce a greater heat sink. Ingestion of ice slurry exploits the additional energy required to convert the solution from ice to water (enthalpy of fusion). Body core temperature is occasionally observed to be higher at the point of exhaustion with the ingestion of ice slurry. There is growing evidence to suggest that ingesting ice slurry is an effective and practical strategy to prevent excessive rise of body core temperature and improve endurance performance. This information is especially important when only a fixed amount of fluid is allowed to be carried, often seen in some ultra-endurance events and military operations. Future studies should evaluate the efficacy of ice slurry in various exercise and environmental conditions.
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Affiliation(s)
- P M S Tan
- Combat Protection and Performance, Defence Medical and Environmental Research Institute, DSO National Laboratories, Singapore
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19
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Hew-Butler T, Rosner MH, Fowkes-Godek S, Dugas JP, Hoffman MD, Lewis DP, Maughan RJ, Miller KC, Montain SJ, Rehrer NJ, Roberts WO, Rogers IR, Siegel AJ, Stuempfle KJ, Winger JM, Verbalis JG. Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015. Clin J Sport Med 2015; 25:303-20. [PMID: 26102445 DOI: 10.1097/jsm.0000000000000221] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Tamara Hew-Butler
- *Exercise Science Program, Oakland University, Rochester, Michigan; †Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia; ‡Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; §The Vitality Group, Chicago, Illinois; ¶Department of Physical Medicine and Rehabilitation, VA Northern California Health Care System and University of California Davis, Sacramento, California; ‖Family Medicine Residency Program, Via Christi Hospitals Wichita, Inc, Wichita, Kansas; **Department of Sport and Exercise Nutrition, Loughborough University, Leicestershire, United Kingdom; ††Athletic Training Program, Central Michigan University, Mount Pleasant, Michigan; ‡‡Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts; §§School of Physical Education, Sport and Exercise Science, University of Otago, Dunedin, New Zealand; ¶¶Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota; ‖‖Department of Emergency Medicine, St John of God Murdoch Hospital and University of Notre Dame, Perth, Western Australia; ***Department of Internal Medicine, Harvard Medical School, Boston, Massachusetts; †††Health Sciences Department, Gettysburg College, Gettysburg, Pennsylvania; ‡‡‡Department of Family Medicine, Loyola University Chicago Stritch School of Medicine, Chicago, Illinois; and §§§Department of Endocrinology and Metabolism, Georgetown University Medical Center, Washington, District of Columbia
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20
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Puntillo K, Arai SR, Cooper BA, Stotts NA, Nelson JE. A randomized clinical trial of an intervention to relieve thirst and dry mouth in intensive care unit patients. Intensive Care Med 2014; 40:1295-302. [PMID: 24894026 PMCID: PMC4149585 DOI: 10.1007/s00134-014-3339-z] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 05/12/2014] [Indexed: 12/20/2022]
Abstract
PURPOSE To test an intervention bundle for thirst intensity, thirst distress, and dry mouth, which are among the most pervasive, intense, distressful, unrecognized, and undertreated symptoms in ICU patients, but for which data-based interventions are lacking. METHODS This was a single-blinded randomized clinical trial in three ICUs in a tertiary medical center in urban California. A total of 252 cognitively intact patients reporting thirst intensity (TI) and/or thirst distress (TD) scores ≥3 on 0-10 numeric rating scales (NRS) were randomized to intervention or usual care groups. A research team nurse (RTN#1) obtained patients' pre-procedure TI and TD scores and reports of dry mouth. She then administered a thirst bundle to the intervention group: oral swab wipes, sterile ice-cold water sprays, and a lip moisturizer, or observed patients in the usual care group. RTN#2, blinded to group assignment, obtained post-procedure TI and TD scores. Up to six sessions per patient were conducted across 2 days. RESULTS Multilevel linear regression determined that the average decreases in TI and TD scores from pre-procedure to post-procedure were significantly greater in the intervention group (2.3 and 1.8 NRS points, respectively) versus the usual care group (0.6 and 0.4 points, respectively) (p < 0.05). The usual care group was 1.9 times more likely than the intervention group to report dry mouth for each additional session on day 1. CONCLUSION This simple, inexpensive thirst bundle significantly decreased ICU patients' thirst and dry mouth and can be considered a practice intervention for patients experiencing thirst.
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Affiliation(s)
- Kathleen Puntillo
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA,
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21
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Burdon CA, Easthope CS, Johnson NA, Chapman PG, O'Connor H. The influence of ice slushy on voluntary contraction force following exercise-induced hyperthermia. Appl Physiol Nutr Metab 2014; 39:781-6. [PMID: 24971678 DOI: 10.1139/apnm-2013-0394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study aimed to investigate the effect of exercise-induced hyperthermia on central fatigue and force decline in exercised and nonexercised muscles and whether ingestion of ice slushy (ICE) ameliorates fatigue. Eight participants (5 males, 3 females) completed 45 s maximal voluntary isometric contractions (MVIC) with elbow flexors and knee extensors at baseline and following an exercise-induced rectal temperature (Trec) of 39.3 ± 0.2 °C. Percutaneous electrical muscle stimulation was superimposed at 15, 30 and 44 s during MVICs to assess muscle activation. To increase Trec to 39.3 °C, participants cycled at 60% maximum power output for 42 ± 11 min in 40 °C and 50% relative humidity. Immediately prior to each MVIC, participants consumed 50 g of ICE (-1 °C) or thermoneutral drink (38 °C, CON) made from 7.4% carbohydrate beverage. Participants consumed water (19 °C) during exercise to prevent hypohydration. Voluntary muscle force production and activation in both muscle groups were unchanged at Trec 39.3 °C with ICE (knee extensors: 209 ± 152 N) versus CON (knee extensors: 255 ± 157 N, p = 0.19). At Trec 39.3 °C, quadriceps mean force (232 ± 151 N) decreased versus baseline (302 ± 180 N, p < 0.001) and mean voluntary activation was also decreased (by 15% ± 11%, p < 0.001). Elbow flexor mean force decreased from 179 ± 67 N to 148 ± 65 N when Trec was increased to 39.3 °C (p < 0.001) but mean voluntary activation was not reduced at 39.3 °C (5% ± 25%, p = 0.79). After exercise-induced hyperthermia, ICE had no effect on voluntary activation or force production; however, both were reduced from baseline in the exercised muscle group. Peripheral fatigue was greater than the central component and limited the ability of an intervention designed to alter central fatigue.
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Affiliation(s)
- Catriona A Burdon
- a Exercise and Sport Science, University of Sydney, 75 East St., Lidcombe 2141, NSW, Australia
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Abstract
Inhalation therapy has been employed as the mainstay of the treatment in chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD). Beta-2 agonists, anticholinergic bronchodilators, inhaled corticosteroids, and sodium cromoglycate are often used alone or in combination in an inhaled form. Studies have shown that inhaled drugs used in the treatment have some adverse effects on the oral health based on their dosage, frequency, and duration of use. Several oral conditions such as xerostomia, dental caries, candidiasis, ulceration, gingivitis, periodontitis, and taste changes have been associated with inhalation therapy. Since the prevalence of chronic respiratory diseases is rising, it is important to provide optimal oral care to the individuals receiving inhalation therapy. This article will review the influence of inhaled drugs on the oral health of individuals and adequate management and prevention of the same.
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Affiliation(s)
- Navneet Godara
- Department of Conservative Dentistry and Endodontics, Jaipur Dental College, Dhand, Jaipur, Rajasthan, India
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23
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Labbe D, Martin N, Le Coutre J, Hudry J. Impact of refreshing perception on mood, cognitive performance and brain oscillations: An exploratory study. Food Qual Prefer 2011. [DOI: 10.1016/j.foodqual.2010.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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24
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Nieuwenhuizen WF, Weenen H, Rigby P, Hetherington MM. Older adults and patients in need of nutritional support: Review of current treatment options and factors influencing nutritional intake. Clin Nutr 2010; 29:160-9. [DOI: 10.1016/j.clnu.2009.09.003] [Citation(s) in RCA: 269] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Revised: 08/17/2009] [Accepted: 09/11/2009] [Indexed: 11/28/2022]
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25
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Mattes RD. Hunger and thirst: issues in measurement and prediction of eating and drinking. Physiol Behav 2010; 100:22-32. [PMID: 20060847 DOI: 10.1016/j.physbeh.2009.12.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 12/21/2009] [Accepted: 12/22/2009] [Indexed: 01/03/2023]
Abstract
Associations between hunger and eating and between thirst and drinking are generally weak. This stems, in part, from limitations in the measurement of these sensations which generally rely on temporal, motivational, metabolic and/or self-reported descriptive indices. Each is critically reviewed. Also problematic is the fact that the deterministic depletion-repletion concept of ingestive behavior fails to account for influences of a multitude of contravening cognitive, social, sensory and logistical factors. Although hunger and thirst serve some parallel purposes, sharp distinctions are also present with health implications. Of particular note are the observations that thirst ratings are higher and more stable over the day compared to hunger and thirst may be more motivating to drink than hunger is to eat. Coupling these observations with evidence that beverages have limited satiety value, they pose particular challenges and opportunities. Beverages can facilitate the delivery of nutrients to those desiring or requiring them, but also to those where they are not desired or required. The benefits and risks are a function of their use rather than their inherent properties.
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Affiliation(s)
- Richard D Mattes
- Department of Foods and Nutrition, Purdue University, 212 Stone Hall, 700 W State Street, West Lafayette, IN 47907-2059, USA.
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26
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Davies GA, Wantling E, Stokes JR. The influence of beverages on the stimulation and viscoelasticity of saliva: Relationship to mouthfeel? Food Hydrocoll 2009. [DOI: 10.1016/j.foodhyd.2009.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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27
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Labbe D, Almiron-Roig E, Hudry J, Leathwood P, Schifferstein H, Martin N. Sensory basis of refreshing perception: Role of psychophysiological factors and food experience. Physiol Behav 2009; 98:1-9. [PMID: 19375436 DOI: 10.1016/j.physbeh.2009.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 04/07/2009] [Accepted: 04/08/2009] [Indexed: 10/20/2022]
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28
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Hew-Butler T, Verbalis JG, Noakes TD. Updated fluid recommendation: position statement from the International Marathon Medical Directors Association (IMMDA). Clin J Sport Med 2006; 16:283-92. [PMID: 16858210 DOI: 10.1097/00042752-200607000-00001] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Tamara Hew-Butler
- Department of Human Biology, University of Cape Town, Cape Town, South Africa.
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29
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Mündel T, King J, Collacott E, Jones DA. Drink temperature influences fluid intake and endurance capacity in men during exercise in a hot, dry environment. Exp Physiol 2006; 91:925-33. [PMID: 16777932 DOI: 10.1113/expphysiol.2006.034223] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The effect of different drink temperatures on the perception of exertion and exercise endurance has not been extensively investigated. Consequently, the purpose of the present study was to examine the effect of drink temperature on fluid intake and endurance during cycling in the heat. Eight healthy, non-acclimated males (26 +/- 7 years; maximum oxygen uptake, 54 +/- 5 ml kg(-1) min(-1); mean +/- S.D.) cycled to exhaustion at 34 degrees C and at 65% of their peak aerobic power, consuming a drink at either 19 degrees C (CON) or 4 degrees C (COLD). Six of the eight subjects cycled for longer during COLD, with exhaustion occurring at 62 +/- 4 min, compared to 55 +/- 4 min for CON (P < 0.05; mean +/- S.E.M.). Subjects consumed significantly more fluid during COLD compared to CON (1.3 +/- 0.3 l h(-1) compared to 1.0 +/- 0.2 l h(-1); P < 0.05). Heart rate tended to be lower by approximately 5 beats min(-1) during COLD, and rectal temperature during the second half of the exercise period was approximately 0.25 degrees C lower during the COLD trial; however, these trends were not significant (P = 0.08 and P = 0.07, respectively). No differences were observed between trials for ventilation, concentrations of prolactin, glucose and lactate or perceived exertion. It is concluded that a drink at 4 degrees C during exercise in the heat enhances fluid consumption and improves endurance by acting as a heat sink, attenuating the rise in body temperature and therefore reducing the effects of heat stress.
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Affiliation(s)
- Toby Mündel
- School of Sport and Exercise Sciences, The University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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30
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Sung JM, Kuo SC, Guo HR, Chuang SF, Lee SY, Huang JJ. Decreased Salivary Flow Rate as a Dipsogenic Factor in Hemodialysis Patients: Evidence from an Observational Study and a Pilocarpine Clinical Trial. J Am Soc Nephrol 2005; 16:3418-29. [PMID: 16177001 DOI: 10.1681/asn.2005040346] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Decreased salivary flow rate causes xerostomia (symptoms of oral dryness) in patients who undergo hemodialysis (HD); however, whether it thus contributes to thirst and excess interdialytic weight gain (IDWG) remains undetermined. In the observational study, 3 mo of data of 90 stable HD patients were collected, and sensations of thirst and xerostomia were assessed by 100-mm visual analog scales (VAS). Multivariate analyses revealed that the VAS oral dryness score was an independent determinant for thirst, daily IDWG, and IDWG%. Unstimulated whole salivary flow rate (UWS) was measured in 45 participants and was negatively correlated with VAS oral dryness score (r = -0.690, P <or= 0.001), daily IDWG (r = -0.361, P = 0.016), and daily IDWG% (r = -0.302, P = 0.045). In the interventional trial, the test drug was 5 mg of oral pilocarpine solution or placebo. Sixty hyperdipsic HD patients (IDWG% > 2%/d) were randomly assigned to either the sequence pilocarpine (2 wk)-washout (3 wk)-placebo (2 wk)-washout (2 mo)-placebo (3 mo) or placebo (2 wk)-washout (3 wk)-pilocarpine (2 wk)-washout (2 mo)-pilocarpine (3 mo) with 35 participants completing the trial. During the 2-wk crossover period (the first to seventh weeks), pilocarpine increased UWS and decreased xerostomia and thirst. The IDWG(2d) decreased (by approximately 0.2 kg; P = 0.013) but not IDWG(3d). During the 3-mo interventional period, pilocarpine increased UWS but decreased both IDWG(2d) (by 0.76 kg; P = 0.021) and IDWG(3d) (by 1.07 kg; P = 0.007). It also modestly increased serum albumin and decreased mean BP. Pilocarpine-related adverse effects were generally mild. In conclusion, decreased salivary flow is a dipsogenic factor in HD patients, and pilocarpine can alleviate it.
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Affiliation(s)
- Junne-Ming Sung
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
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31
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Bots CP, Brand HS, Veerman ECI, Korevaar JC, Valentijn-Benz M, Bezemer PD, Valentijn RM, Vos PF, Bijlsma JA, ter Wee PM, Van Amerongen BM, Nieuw Amerongen AV. Chewing gum and a saliva substitute alleviate thirst and xerostomia in patients on haemodialysis. Nephrol Dial Transplant 2005; 20:578-84. [PMID: 15665029 DOI: 10.1093/ndt/gfh675] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most patients on haemodialysis (HD) have to maintain a fluid-restricted diet to prevent a high interdialytic weight gain (IWG). The prevalence of xerostomia (the feeling of a dry mouth) is higher in HD patients than in controls. Recently, we demonstrated that xerostomia and thirst were positively correlated with IWG in HD patients. Thus, this may play a role as a stimulus for fluid intake between dialysis sessions. The aim of the present study was to investigate the effect of chewing gum or a saliva substitute on xerostomia, thirst and IWG. METHODS This study was a randomized two-treatment crossover design with repeated measures. After the use of chewing gum or saliva substitute for 2 weeks, a wash-out period of 2 weeks was introduced and hereafter the other regimen was carried out. Xerostomia and thirst were assessed by validated questionnaires as xerostomia inventory (XI) and dialysis thirst inventory (DTI), at baseline and after each treatment period, as were IWG and salivary flow rates. RESULTS Sixty-five HD patients (42 men, 54.6+/-14.1 years; 23 women, 54.7+/-16.3 years) participated in this study. Chewing gum decreased XI from 29.9+/-9.5 to 28.1+/-9.1 (P<0.05). Chewing gum as well as a saliva substitute reduced DTI significantly (P<0.05), but no differences occurred for the average IWG or salivary flow rates. CONCLUSIONS The use of chewing gum and, to a lesser extent, a saliva substitute may alleviate thirst and xerostomia in some HD patients.
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Affiliation(s)
- Casper P Bots
- Department of Oral Biochemistry, Academic Center for Dentistry, Amsterdam, The Netherlands.
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32
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Bots CP, Brand HS, Veerman ECI, Valentijn-Benz M, Van Amerongen BM, Valentijn RM, Vos PF, Bijlsma JA, Bezemer PD, Ter Wee PM, Amerongen AVN. Interdialytic weight gain in patients on hemodialysis is associated with dry mouth and thirst. Kidney Int 2004; 66:1662-8. [PMID: 15458464 DOI: 10.1111/j.1523-1755.2004.00933.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patients receiving hemodialysis (HD) have to maintain a fluid-restricted diet. Severe thirst can induce noncompliance to this diet, resulting in an increase of interdialytic weight gain (IWG = weight predialysis - postdialysis) associated with poor patient outcomes. Because oral dryness may contribute to experienced thirst, we investigated the possible relation between thirst, salivary flow rate, xerostomia, and IWG. METHODS Unstimulated (UWS) and stimulated (CH-SWS) whole saliva were collected from 94 HD patients (64 men, 54.8 +/- 15.5 years; 30 women, 59.5 +/- 18.7 years). Secretion rates of saliva were determined gravimetrically. Xerostomia was assessed with a validated Xerostomia Inventory (XI), and thirst with a newly developed Dialysis Thirst Inventory (DTI). RESULTS Before dialysis, 36.2% of the patients had hyposalivation (UWS < or =0.15 mL/min). The XI scores had a positive relation with IWG (r=.250, P < 0.001). Gender and age differences were observed for thirst, salivary flow rates, and xerostomia. The prevalence and severity of thirst and xerostomia were greater in younger subjects. Patients with urine output did not differ from those without urine output with respect to thirst, xerostomia, and IWG. Correlations were found between thirst (DTI) and both IWG and xerostomia (XI) (r=.329, P < 0.001, respectively; r=.740, P < 0.001). Other correlations were observed between xerostomia and both the salivary flow rate and total number of medications (r=-.252, P < 0.05, respectively; r=.235, P <.05). CONCLUSION In HD patients, xerostomia (XI) and thirst (DTI) are associated with a higher IWG. Our data provide evidence that, in HD patients, xerostomia is related to both salivary flow rate and thirst (DTI).
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Affiliation(s)
- Casper P Bots
- Department of Dental Basic Sciences, Oral Biochemistry Section, Academic Centre for Dentistry, Amsterdam, The Netherlands.
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Brunstrom JM, Yates HM, Witcomb GL. Dietary restraint and heightened reactivity to food. Physiol Behav 2004; 81:85-90. [PMID: 15059687 DOI: 10.1016/j.physbeh.2004.01.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2003] [Revised: 01/06/2004] [Accepted: 01/12/2004] [Indexed: 11/17/2022]
Abstract
Previously, studies have explored the relationship between dietary behavior and salivary reactivity to food. Despite this, it remains unclear which behaviors are associated with enhanced reactivity. One problem is that measures of behavior have not been compared directly. In particular, it is unclear whether elevated reactivity is associated with measures of dietary restraint or with measures of failed dietary control and a tendency to overeat. To address this problem, we compared the association between salivary reactivity and scores on the subscales of the Three-Factor Eating Questionnaire (restraint, disinhibition, and hunger). Estimates of reactivity were derived from the difference between a baseline saliva measure and a similar measure taken in close proximity to hot pizza. Our second aim was to explore how salivary reactivity changes after a meal. Female participants (N=40) were tested before and after a lunch (cheese sandwiches). All tended to show reactivity to pizza before but not after lunch. No significant differences were associated with the disinhibition or hunger subscales. However, prelunch reactivity was significantly greater in those participants with high scores on the restraint scale. This does not appear to be related to reported levels of hunger before lunch. Rather, it may reveal an intrinsic difference between the reaction of restrained and unrestrained eaters to food.
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Affiliation(s)
- Jeffrey M Brunstrom
- Department of Human Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK.
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34
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Maier H, Tisch M. [Mouth dryness and burning sensation of the oral mucosa: causes and possibilities for treatment]. HNO 2003; 51:739-47. [PMID: 14504789 DOI: 10.1007/s00106-003-0918-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Both sets of complaints, mouth dryness and a burning sensation of the oral mucosa, can have a variety of causes. Local and regional as well as systemic causes can be responsible for burning mouth syndrome. Diseases of the oral mucosa can have genetic, inflammatory, or neoplastic origins. Autoimmune diseases and allergies as well as different afflictions relating to internal medicine can be accompanied by a burning sensation in the oral mucosa. Neurological and psychiatric illnesses must be clarified during interdisciplinary diagnostics in order to identify idiopathic forms. The causes of mouth dryness are similarly complex. In addition to inadequate fluid intake, particularly in elderly patients, drug side effects or systemic diseases are frequently also responsible. Treatment is directed at the underlying disease; in ambiguous cases, symptomatic therapy can provide relief for medical complaints.
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Affiliation(s)
- H Maier
- Abteilung Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Bundeswehrkrankenhaus Ulm.
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