1.
Disorders of water and salt metabolism associated with pituitary disease.
Loh, JA, Verbalis, JG
Endocrinology and metabolism clinics of North America. 2008;(1):213-34, x
Abstract
Disorders of water and sodium homeostasis are very common problems encountered in clinical medicine. Disorders of water metabolism are divided into hyperosmolar and hypoosmolar states, with hyperosmolar disorders characterized by a deficit of body water in relation to body solute and hypoosmolar disorders characterized by an excess of body water in relation to total body solute. This article briefly reviews the physiology of hyperosmolar and hypoosmolar syndromes, then focuses on a discussion of the pathophysiology, evaluation, and treatment of specific pre- and postoperative disorders of water metabolism in patients with pituitary lesions.
2.
Macronutrients, aluminium from drinking water and foods, and other metals in cognitive decline and dementia.
Solfrizzi, V, Colacicco, AM, D'Introno, A, Capurso, C, Parigi, AD, Capurso, SA, Torres, F, Capurso, A, Panza, F
Journal of Alzheimer's disease : JAD. 2006;(2-3):303-30
Abstract
A possible role of the macronutrients and the basic elements of carbohydrates (glucose administration or depletion), proteins (amino acids such as tryptophan and tyrosine), and fat (unsaturated fatty acids) was recently proposed for age-related changes of cognitive function, and the cognitive decline of degenerative (AD) or vascular origin. The availability and utilization of glucose has been implicated in cognitive function not only as a result of nutritional and systemic metabolic conditions, but also, although speculatively, as a crucial phase of the mechanism of action of molecules used as cognitive-enhancers. Furthermore, many lines of evidence have focused on the importance of oxidative stress mechanisms and free radical damage in AD pathogenesis. In addition, epidemiological studies have recently reported an association between alcohol and the incidence of AD and predementia syndromes. Foods with large amounts of aluminium-containing additives or aluminium from drinking water may affect the risk of developing AD, aluminium more likely acting as a cofactor somewhere in the cascade of events leading to the demented brain. A role for other metals in dementia have been speculated, given the encouraging results reported from studies on peripheral zinc concentrations, zinc supplementation, serum copper, either bound with ceruloplasmin or not, and iron metabolism in AD. Nonetheless, more data are needed to support a possible role of these metals in dementing diseases. Healthy diets, antioxidant supplements, and the prevention of nutritional deficiencies or exposure to foods and water with high content of metals could be considered the first line of defence against the development and progression of cognitive decline.
3.
Management of disorders of water metabolism in patients with pituitary tumors.
Verbalis, JG
Pituitary. 2002;(2):119-32
Abstract
Disorders of body fluids, notably central diabetes insipidus (CDI) and the syndrome of inappropriate antidiuretic hormone secretion (SIADH), are relatively uncommon as a presenting symptom of sellar and suprasellar masses, but quite common following surgical resection of such lesions. It therefore behooves clinicians treating such patients to have a good understanding of the pathophysiology, the differential diagnosis and the management of these disorders. This review discusses some general issues concerning the pathogenesis, differential diagnosis, clinical manifestations and therapy of hyperosmolar and hypoosmolar syndromes, including CDI and SIADH, and then more specifically addresses the evaluation and treatment of pre- and postoperative disorders of water metabolism in patients with pituitary adenomas.