Effects of Rooibos Tea, Bottled Water, and a Carbohydrate Beverage on Blood and Urinary Measures of Hydration After Acute Dehydration

2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.

2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations; a more comprehensive review was done in 2020. This latest summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation task force science experts. Topics covered by systematic reviews in this summary include resuscitation topics of video-based dispatch systems; head-up cardiopulmonary resuscitation; early coronary angiography after return of spontaneous circulation; cardiopulmonary resuscitation in the prone patient; cord management at birth for preterm and term infants; devices for administering positive-pressure ventilation at birth; family presence during neonatal resuscitation; self-directed, digitally based basic life support education and training in adults and children; coronavirus disease 2019 infection risk to rescuers from patients in cardiac arrest; and first aid topics, including cooling with water for thermal burns, oral rehydration for exertional dehydration, pediatric tourniquet use, and methods of tick removal. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, according to the Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations or good practice statements. Insights into the deliberations of the task forces are provided in Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces listed priority knowledge gaps for further research.

European Resuscitation Council Guidelines 2021: First aid

The European Resuscitation Council has produced these first aid guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics include the first aid management of emergency medicine and trauma. For medical emergencies the following content is covered: recovery position, optimal positioning for shock, bronchodilator administration for asthma, recognition of stroke, early aspirin for chest pain, second dose of adrenaline for anaphylaxis, management of hypoglycaemia, oral rehydration solutions for treating exertion-related dehydration, management of heat stroke by cooling, supplemental oxygen in acute stroke, and presyncope. For trauma related emergencies the following topics are covered: control of life-threatening bleeding, management of open chest wounds, cervical spine motion restriction and stabilisation, recognition of concussion, cooling of thermal burns, dental avulsion, compression wrap for closed extremity joint injuries, straightening an angulated fracture, and eye injury from chemical exposure.

Isoorientin: A dietary flavone with the potential to ameliorate diverse metabolic complications

Isoorientin is a natural C-glucosyl flavone that is generating a lot of interest due to its multiple pharmacological activities. Increasing experimental data have shown that the robust antioxidant and anti-inflammatory properties of isoorientin remain important in ameliorating a number of metabolic complications. In fact, plants rich in isoorientin have demonstrated strong ameliorative properties against complications such as hyperglycemia, hyperlipidemia, and insulin resistance. However, while such evidence is accumulating, it has not been reviewed to better inform on the therapeutic potential of this flavone in improving human health. This review examines and extrapolates available literature on the potential beneficial or detrimental effects associated with the use of isoorientin in mitigating metabolic diseases, with a specific focus on diabetes, obesity, and insulin resistance, including associated complications. The discussion includes effective doses in various experimental settings and proposed molecular mechanisms by which isoorientin may exert its therapeutic effects. In addition, the protective effects of extracts of a number of isoorientin-rich plants against metabolic complications will be highlighted.

Yogurt Drink Effectively Rehydrates Athletes After a Strenuous Exercise Session

Dehydration and electrolyte imbalance as a result of prolonged strenuous exercise leads to poor thermoregulation and impaired muscle performance. Thus, appropriate rehydration during and after exercise with a solution that has a balanced combination of nutrients including electrolytes, carbohydrates and proteins is crucial in preventing the side effects of dehydration. Yogurt drink as a traditional drink with an appropriate nutritious content could be used as an alternative to expensive commercially available drinks for rehydrating athletes after long exercises in warm and humid environments and in developing countries. In this cross-over trial we examined the rehydration potential of yogurt drink in comparison to water and a commercial drink after a strenuous exercise (cycling) session in a hot and humid environment. Blood measurements included blood osmolality, serum glucose, hematocrit and serum electrolytes. Urine measurements included urine volume, osmolality and electrolyte concentrations. The results showed that early after rehydration Yogurt drink compared to water significantly increased urine sodium (mmol/L) (138.8 ± 93.4 vs. 90.0 ± 50.7, P < 0.01), urine potassium (mmol/L) (105.6 ± 55.1 vs. 35.8 ± 22.0, P < 0.05) and urine chloride (mmol/L) (113.2 ± 28.4 vs. 35.8 ± 25.1 P < 0.01). This degree of improvement was the same as with the commercial drink for urine sodium, potassium, and chloride. Yogurt drink prevented dehydration-induced changes in the blood as it stabilized the hematocrit and serum sodium, potassium and osmolality within the normal range after exercise. Finally, our results indicated that yogurt drink, as a natural and affordable rehydration option, can be considered to restore fluid and electrolyte losses after strenuous exercises in hot and humid environments.

Urine specific gravity as an indicator of dehydration in Olympic combat sport athletes; considerations for research and practice

Urine specific gravity (U_SG) is the most commonly reported biochemical marker used in research and applied settings to detect fluid deficits in athletes, including those participating in combat sports. Despite the popularity of its use, there has been a growing debate regarding the diagnostic accuracy and the applicability of U_SG in characterizing whole-body fluid status and fluctuations. Moreover, recent investigations report universally high prevalence of hypohydration (∼90%) via U_SG assessment in combat sport athletes, often in spite of stable body-mass. Given the widespread use in both research and practice, and its use in a regulatory sense as a 'hydration test' in combat sports as a means to detect dehydration at the time of weigh-in; understanding the limitations and applicability of U_SG assessment is of paramount importance. Inconsistencies in findings of U_SG readings, possibly as a consequence of diverse methodological research approaches and/or overlooked confounding factors, preclude a conclusive position stand within current combat sports research and practice. Thus the primary aim of this paper is to critically review the literature regarding U_SG assessment of hydration status in combat sports research and practice. When taken on balance, the existing literature suggests: the use of laboratory derived benchmarks in applied settings, inconsistent sampling methodologies, the incomplete picture of how various confounding factors affect end-point readings, and the still poorly understood potential of renal adaptation to dehydration in combat athletes; make the utility of hydration assessment via U_SG measurement quite problematic, particularly when diet and training is not controlled.

The effect of acute fluid consumption following exercise-induced fluid loss on hydration status, percent body fat, and minimum wrestling weight in wrestlers

Acute fluid consumption (approximately 1 L) has been shown to reduce urine specific gravity (Usg) among subjects after an overnight fast, yet it is unknown if Usg may be reduced among subjects who have experienced exercise-induced fluid loss. The purpose of this study was to examine the effect of acute fluid consumption on Usg, body mass, percent body fat (%BF), and minimum wrestling weight (MWW) following an exercise-induced fluid loss protocol. National Collegiate Athletic Association coaches' perceptions of the weight certification program (WCP) were also evaluated. Twelve men wrestlers (19.8 ± 1.14 years) were tested prepractice (PRE), postpractice (POST), and 1 hour after consuming 1 L of water (PFC). Percent body fat was measured by skinfolds (SF), air displacement plethysmography (ADP), and multifrequency and leg-to-leg bioelectrical impedance analysis to calculate MWW. Urine specific gravity measurements significantly increased above PRE (1.013 ± 0.006) at the POST (1.019 ± 0.007; p = 0.017) and PFC (1.022 ± 0.008; p = 0.025) assessments; however, POST and PFC were not significantly different (p = 0.978) from one another. The %BF values were similar (p > 0.05) at each assessment point when using SF and ADP. When compared with PRE, MWW significantly reduced at the POST assessment when using SF (67.2 ± 8.4 vs. 65.7 ± 8.2 kg; p < 0.001) and ADP (66.6 ± 9.1 vs. 64.8 ± 9.0 kg; p = 0.001), reflecting the reduction in body mass observed after exercise. Forty-seven National Collegiate Athletic Association coaches completed the questionnaire and 2 central themes emerged: (a) concerns with the 1.5% weight loss plan and (b) wrestlers using strategies in an attempt to circumvent the WCP. Exercise-induced fluid loss followed by acute fluid consumption equal to 1 L was ineffective in reducing Usg.

The acute effects of fluid intake on urine specific gravity and fluid retention in a mildly dehydrated state

Many athletes arrive at training sessions and competitions in a mildly hypohydrated (HYPO) state and are instructed to drink fluids before exercise to reach a euhydrated (HYD) state. Ten recreational athletes (6 women, 4 men; 71.9 ± 4.6 kg, 25.2 ± 0.9 years) participated in the studies to examine (a) the day-to-day variability of morning urine specific gravity (USG), (b) the effects of consuming 600 ml of water on the hydration status of HYD and HYPO (USG > 1.020) subjects, and (c) the effects of consuming water (W), salt-water (SW, 40 mM Na), a carbohydrate-electrolyte solution with 3% or light carbohydrate (CES-L, 20 mM Na) or a CES with 6% carbohydrate (CES, 20 mM Na) on the hydration status of HYPO subjects. The hydration status was assessed with USG and body mass measures and urine volume collections. The day-to-day variability in morning USG (coefficient of variation = 0.2 ± 0.1%) was low and the responses to 600 ml of W ingestion were repeatable. Pretrial USG was 1.022 ± 0.001 in the HYPO trial and decreased <1.020 by 45 minutes (1.013 ± 0.003). In the CES study, HYPO subjects reached HYD status at 45 minutes in all conditions (W 1.013 ± 0.003, SW 1.013 ± 0.003, CES-L 1.011 ± 0.003, CES 1.017 ± 0.004) because salt or CES ingestion did not affect fluid retention (W 68%, SW 72%, CES-L 68%, CES 76%). This study demonstrated that mildly HYPO subjects could reach euhydration within 45 minutes of the ingestion of 600 ml of W or a combination of salt and CES solutions. Following this practice will minimize the incidence of starting a practice or competition hypohydrated.

Improvement of andropause symptoms by dandelion and rooibos extract complex CRS-10 in aging male

Many aging male suffer various andropause symptoms including loss of physical and mental activities. This study evaluated the putative alleviative effects of CRS-10 dandelion and rooibos extract complex (CRS-10) on the symptoms of andropause. The survival rate of TM3 Leydig cells (TM3 cells) treated with CRS-10 was measured based on typical physiological stress. After daily intake of CRS-10 for 4 weeks, the level of testosterone, physical activity and both the number and activity of sperm in older rats (18 weeks) were measured. Furthermore, thirty males were surveyed with AMS (Aging Males' Symptoms) questionnaire after intake of 400 mg of CRS-10. Overall, CRS-10 protected TM3 cells from serum restriction and oxidative stress via activation of ERK and Akt pathways. The level of testosterone and activation of spermatogenesis in rats were significantly enhanced. In addition, physical locomotion was markedly improved. Daily intake of 400 mg of CRS-10 improved the quality of life among agingmale respondents, according to a clinical survey using the AMS. The results indicate the potential of CRS-10 as a safe and efficacious natural substance for reducing or alleviating andropause symptoms.

The validity of multifrequency bioelectrical impedance measures to detect changes in the hydration status of wrestlers during acute dehydration and rehydration

The objective of this study was to examine the validity of multifrequency direct segmental bioelectrical impedance analysis (DSM-BIA) measures to detect changes in the hydration status of wrestlers after they underwent 3% acute dehydration and a 2-hour rehydration period. Fifty-six National Collegiate Athletic Association wrestlers: (mean ± SEM); age 19.5 ± 0.2 years, height 1.73 ± 0.01 m, and body mass (BM) 82.5 ± 2.3 kg were tested in euhydrated, dehydrated (-3.5%), and 2-hour rehydration conditions using DSM-BIA to detect the changes in hydration status. The hydration status was quantified by measuring the changes in plasma osmolality (P(osm)), urine osmolality (Uosm), urine specific gravity (U(sg)), BM, and weighted segmental impedance at frequencies of 5, 20, 50, 100, and 500 kHz. Weighted segmental impedance significantly increased after a 3.5% reduction in the body weight for all the 5 frequencies evaluated, but it did not return to baseline at 2-hour rehydration. P(osm) (303 ± 0.6 mOsm·L(-1)), Uosm (617 ± 47 mOsm·L(-1)), and U(sg) (1.017 ± 0.001) all significantly increased at postdehydration and returned to baseline at 2-hour rehydration. Estimations of extracellular water were significantly different throughout the trial, but there were no significant changes in the estimations of the total body water or intracellular water. The results of this study demonstrate the potential use of DSM-BIA as a field measure to assess the hydration status of wrestlers for the purpose of minimal weight certification before the competitive season. When employing DSM-BIA to assess the hydration status, the results indicated that the changes in weighted segmental impedance at the frequencies evaluated (5, 20, 50, 100, and 500 kHz) are sensitive to acute changes in dehydration but lag behind changes in the standard physiological (plasma and urinary) markers of hydration status after a 2-hour rehydration period.