Excessive thirst manifested by excessive fluid intake. It is characteristic of many diseases such as DIABETES MELLITUS; DIABETES INSIPIDUS; and NEPHROGENIC DIABETES INSIPIDUS. The condition may be psychogenic in origin.
A clinical disorder characterized by excessive fluid intake (polydipsia); HYPONATREMIA; and POLYURIA in SCHIZOPHRENIA and other psychiatric disorders. Impaired water metabolism in psychogenic polydipsia can result in WATER INTOXICATION.
A drive stemming from a physiological need for WATER.
Urination of a large volume of urine with an increase in urinary frequency, commonly seen in diabetes (DIABETES MELLITUS; DIABETES INSIPIDUS).
A condition resulting from the excessive retention of water with sodium depletion.
The consumption of liquids.
A disease that is characterized by frequent urination, excretion of large amounts of dilute URINE, and excessive THIRST. Etiologies of diabetes insipidus include deficiency of antidiuretic hormone (also known as ADH or VASOPRESSIN) secreted by the NEUROHYPOPHYSIS, impaired KIDNEY response to ADH, and impaired hypothalamic regulation of thirst.
A genetic or acquired polyuric disorder caused by a deficiency of VASOPRESSINS secreted by the NEUROHYPOPHYSIS. Clinical signs include the excretion of large volumes of dilute URINE; HYPERNATREMIA; THIRST; and polydipsia. Etiologies include HEAD TRAUMA; surgeries and diseases involving the HYPOTHALAMUS and the PITUITARY GLAND. This disorder may also be caused by mutations of genes such as ARVP encoding vasopressin and its corresponding neurophysin (NEUROPHYSINS).
The withholding of water in a structured experimental situation.
Deficiency of sodium in the blood; salt depletion. (Dorland, 27th ed)
The ability of the kidney to excrete in the urine high concentrations of solutes from the blood plasma.
A genetic or acquired polyuric disorder characterized by persistent hypotonic urine and HYPOKALEMIA. This condition is due to renal tubular insensitivity to VASOPRESSIN and failure to reduce urine volume. It may be the result of mutations of genes encoding VASOPRESSIN RECEPTORS or AQUAPORIN-2; KIDNEY DISEASES; adverse drug effects; or complications from PREGNANCY.
A synthetic analog of the pituitary hormone, ARGININE VASOPRESSIN. Its action is mediated by the VASOPRESSIN receptor V2. It has prolonged antidiuretic activity, but little pressor effects. It also modulates levels of circulating FACTOR VIII and VON WILLEBRAND FACTOR.
Carrier proteins for OXYTOCIN and VASOPRESSIN. They are polypeptides of about 10-kDa, synthesized in the HYPOTHALAMUS. Neurophysin I is associated with oxytocin and neurophysin II is associated with vasopressin in their respective precursors and during transportation down the axons to the neurohypophysis (PITUITARY GLAND, POSTERIOR).
Neural tissue of the pituitary gland, also known as the neurohypophysis. It consists of the distal AXONS of neurons that produce VASOPRESSIN and OXYTOCIN in the SUPRAOPTIC NUCLEUS and the PARAVENTRICULAR NUCLEUS. These axons travel down through the MEDIAN EMINENCE, the hypothalamic infundibulum of the PITUITARY STALK, to the posterior lobe of the pituitary gland.
The balance of fluid in the BODY FLUID COMPARTMENTS; total BODY WATER; BLOOD VOLUME; EXTRACELLULAR SPACE; INTRACELLULAR SPACE, maintained by processes in the body that regulate the intake and excretion of WATER and ELECTROLYTES, particularly SODIUM and POTASSIUM.
Disturbances in the body's WATER-ELECTROLYTE BALANCE.
Antidiuretic hormones released by the NEUROHYPOPHYSIS of all vertebrates (structure varies with species) to regulate water balance and OSMOLARITY. In general, vasopressin is a nonapeptide consisting of a six-amino-acid ring with a cysteine 1 to cysteine 6 disulfide bridge or an octapeptide containing a CYSTINE. All mammals have arginine vasopressin except the pig with a lysine at position 8. Vasopressin, a vasoconstrictor, acts on the KIDNEY COLLECTING DUCTS to increase water reabsorption, increase blood volume and blood pressure.
Disorders involving either the ADENOHYPOPHYSIS or the NEUROHYPOPHYSIS. These diseases usually manifest as hypersecretion or hyposecretion of PITUITARY HORMONES. Neoplastic pituitary masses can also cause compression of the OPTIC CHIASM and other adjacent structures.
A schedule prescribing when the subject is to be reinforced or rewarded in terms of temporal interval in psychological experiments. The schedule may be continuous or intermittent.
Aquaporin 2 is a water-specific channel protein that is expressed in KIDNEY COLLECTING DUCTS. The translocation of aquaporin 2 to the apical PLASMA MEMBRANE is regulated by VASOPRESSIN, and MUTATIONS in AQP2 have been implicated in a variety of kidney disorders including DIABETES INSIPIDUS.
The predominant form of mammalian antidiuretic hormone. It is a nonapeptide containing an ARGININE at residue 8 and two disulfide-linked cysteines at residues of 1 and 6. Arg-vasopressin is used to treat DIABETES INSIPIDUS or to improve vasomotor tone and BLOOD PRESSURE.
Diseases of the domestic dog (Canis familiaris). This term does not include diseases of wild dogs, WOLVES; FOXES; and other Canidae for which the heading CARNIVORA is used.
Specific molecular sites or proteins on or in cells to which VASOPRESSINS bind or interact in order to modify the function of the cells. Two types of vasopressin receptor exist, the V1 receptor in the vascular smooth muscle and the V2 receptor in the kidneys. The V1 receptor can be subdivided into V1a and V1b (formerly V3) receptors.
An increase in the excretion of URINE. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)
The strengthening of a conditioned response.
The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per liter of solution. Osmolality is expressed in terms of osmoles of solute per kilogram of solvent.

Risperidone treatment for polydipsia and hyponatremia in schizophrenia: a case report. (1/2)

Psychogenic polydipsia with associated hyponatremia is a potentially fatal condition observed in patients with chronic psychiatric illness, especially schizophrenia. Recognition and management of this condition are difficult, as patients are uncooperative and secretive about their water intake, but are important in terms of the associated complications. Different strategies, including involuntary fluid restriction and use of various pharmacological agents, such as demeclocycline, propranolol, captopril, and naloxone, have been used for the treatment of this condition with inconsistent results. Antipsychotics have also been used in the treatment of polydipsia; however, their role is not clear as there are reports of antipsychotics both improving and causing polydipsia. Typical antipsychotics have been associated with exacerbation of polydipsia, whereas clozapine has been associated with its improvement. The efficacy of risperidone in the treatment of this condition is controversial, as negative results have been reported. Herein we present a schizophrenia case with polydipsia and hyponatremia that was successfully treated with risperidone.  (+info)

Brain structural changes and neuropsychological impairments in male polydipsic schizophrenia. (2/2)

 (+info)

Polydipsia is a medical term that describes excessive thirst or an abnormally increased desire to drink fluids. It is often associated with conditions that cause increased fluid loss, such as diabetes insipidus and diabetes mellitus, as well as certain psychiatric disorders that can lead to excessive water intake. Polydipsia should not be confused with simple dehydration, where the body's overall water content is reduced due to inadequate fluid intake or excessive fluid loss. Instead, polydipsia refers to a persistent and strong drive to drink fluids, even when the body is adequately hydrated. Prolonged polydipsia can lead to complications such as hyponatremia (low sodium levels in the blood) and may indicate an underlying medical issue that requires further evaluation and treatment.

Psychogenic polydipsia is a condition characterized by excessive fluid intake (polydipsia) due to psychological factors rather than physical causes. It is often seen in individuals with mental health disorders such as schizophrenia, affective disorders, or dementia. In these cases, the individual may have a fixed belief that they are thirsty and need to drink large amounts of water or other fluids, even when their body does not require it. This can lead to dilution of the sodium levels in the blood (hyponatremia), which can cause serious health complications if left untreated. It is important to note that psychogenic polydipsia should be distinguished from physical causes of polydipsia, such as diabetes insipidus or diabetes mellitus, which require different treatment approaches.

Thirst, also known as dry mouth or polydipsia, is a physiological need or desire to drink fluids to maintain fluid balance and hydration in the body. It is primarily regulated by the hypothalamus in response to changes in osmolality and volume of bodily fluids, particularly blood. Thirst can be triggered by various factors such as dehydration, excessive sweating, diarrhea, vomiting, fever, burns, certain medications, and medical conditions affecting the kidneys, adrenal glands, or other organs. It is a vital homeostatic mechanism to ensure adequate hydration and proper functioning of various bodily systems.

Polyuria is a medical term that describes the production of large volumes of urine, typically defined as exceeding 2.5-3 liters per day in adults. This condition can lead to frequent urination, sometimes as often as every one to two hours, and often worsens during the night (nocturia). Polyuria is often a symptom of an underlying medical disorder such as diabetes mellitus or diabetes insipidus, rather than a disease itself. Other potential causes include kidney diseases, heart failure, liver cirrhosis, and certain medications. Proper diagnosis and treatment of the underlying condition are essential to manage polyuria effectively.

Medical Definition of Water Intoxication:

Water intoxication, also known as hyponatremia, is a condition that occurs when an individual consumes water in such large quantities that the body's electrolyte balance is disrupted. This results in an abnormally low sodium level in the blood (hyponatremia), which can cause symptoms ranging from mild to severe, including nausea, headache, confusion, seizures, coma, and even death in extreme cases. It's important to note that water intoxication is rare and typically only occurs in situations where large amounts of water are consumed in a short period of time, such as during endurance sports or when someone is trying to intentionally harm themselves.

The term "drinking" is commonly used to refer to the consumption of beverages, but in a medical context, it usually refers to the consumption of alcoholic drinks. According to the Merriam-Webster Medical Dictionary, "drinking" is defined as:

1. The act or habit of swallowing liquid (such as water, juice, or alcohol)
2. The ingestion of alcoholic beverages

It's important to note that while moderate drinking may not pose significant health risks for some individuals, excessive or binge drinking can lead to a range of negative health consequences, including addiction, liver disease, heart disease, and increased risk of injury or violence.

Diabetes Insipidus is a medical condition characterized by the excretion of large amounts of dilute urine (polyuria) and increased thirst (polydipsia). It is caused by a deficiency in the hormone vasopressin (also known as antidiuretic hormone or ADH), which regulates the body's water balance.

In normal physiology, vasopressin is released from the posterior pituitary gland in response to an increase in osmolality of the blood or a decrease in blood volume. This causes the kidneys to retain water and concentrate the urine. In Diabetes Insipidus, there is either a lack of vasopressin production (central diabetes insipidus) or a decreased response to vasopressin by the kidneys (nephrogenic diabetes insipidus).

Central Diabetes Insipidus can be caused by damage to the hypothalamus or pituitary gland, such as from tumors, trauma, or surgery. Nephrogenic Diabetes Insipidus can be caused by genetic factors, kidney disease, or certain medications that interfere with the action of vasopressin on the kidneys.

Treatment for Diabetes Insipidus depends on the underlying cause. In central diabetes insipidus, desmopressin, a synthetic analogue of vasopressin, can be administered to replace the missing hormone. In nephrogenic diabetes insipidus, treatment may involve addressing the underlying kidney disease or adjusting medications that interfere with vasopressin action. It is important for individuals with Diabetes Insipidus to maintain adequate hydration and monitor their fluid intake and urine output.

Neurogenic diabetes insipidus is a condition characterized by the production of large amounts of dilute urine (polyuria) and increased thirst (polydipsia) due to deficiency of antidiuretic hormone (ADH), also known as vasopressin, which is produced by the hypothalamus and stored in the posterior pituitary gland.

Neurogenic diabetes insipidus can occur when there is damage to the hypothalamus or pituitary gland, leading to a decrease in ADH production or release. Causes of neurogenic diabetes insipidus include brain tumors, head trauma, surgery, meningitis, encephalitis, and autoimmune disorders.

In this condition, the kidneys are unable to reabsorb water from the urine due to the lack of ADH, resulting in the production of large volumes of dilute urine. This can lead to dehydration, electrolyte imbalances, and other complications if not properly managed. Treatment typically involves replacing the missing ADH with a synthetic hormone called desmopressin, which can be administered as a nasal spray, oral tablet, or injection.

Water deprivation is a condition that occurs when an individual is deliberately or unintentionally not given access to adequate water for a prolonged period. This can lead to dehydration, which is the excessive loss of body water and electrolytes. In severe cases, water deprivation can result in serious health complications, including seizures, kidney damage, brain damage, coma, and even death. It's important to note that water is essential for many bodily functions, including maintaining blood pressure, regulating body temperature, and removing waste products from the body. Therefore, it's crucial to stay hydrated by drinking an adequate amount of water each day.

Hyponatremia is a condition characterized by abnormally low sodium levels in the blood, specifically levels less than 135 mEq/L. Sodium is an essential electrolyte that helps regulate water balance in and around your cells and plays a crucial role in nerve and muscle function. Hyponatremia can occur due to various reasons, including certain medical conditions, medications, or excessive water intake leading to dilution of sodium in the body. Symptoms may range from mild, such as nausea, confusion, and headache, to severe, like seizures, coma, or even death in extreme cases. It's essential to seek medical attention if you suspect hyponatremia, as prompt diagnosis and treatment are vital for a favorable outcome.

Kidney concentrating ability refers to the capacity of the kidneys to increase the concentration of solutes, such as urea and minerals, and remove waste products while reabsorbing water to maintain fluid balance in the body. This is primarily regulated by the hormone vasopressin (ADH), which signals the collecting ducts in the nephrons of the kidneys to absorb more water, resulting in the production of concentrated urine. A decreased kidney concentrating ability may indicate a variety of renal disorders or diseases, such as diabetes insipidus or chronic kidney disease.

Nephrogenic diabetes insipidus is a type of diabetes insipidus that occurs due to the inability of the kidneys to respond to the antidiuretic hormone (ADH), also known as vasopressin. This results in excessive thirst and the production of large amounts of dilute urine.

In nephrogenic diabetes insipidus, the problem lies in the kidney tubules, which fail to absorb water from the urine due to a defect in the receptors or channels that respond to ADH. This can be caused by genetic factors, certain medications, kidney diseases, and electrolyte imbalances.

Treatment for nephrogenic diabetes insipidus typically involves addressing the underlying cause, if possible, as well as managing symptoms through a low-salt diet, increased fluid intake, and medications that increase water reabsorption in the kidneys.

Desmopressin, also known as 1-deamino-8-D-arginine vasopressin (dDAVP), is a synthetic analogue of the natural hormone arginine vasopressin. It is commonly used in medical practice for the treatment of diabetes insipidus, a condition characterized by excessive thirst and urination due to lack of antidiuretic hormone (ADH).

Desmopressin works by binding to V2 receptors in the kidney, which leads to increased water reabsorption and reduced urine production. It also has some effect on V1 receptors, leading to vasoconstriction and increased blood pressure. However, its primary use is for its antidiuretic effects.

In addition to its use in diabetes insipidus, desmopressin may also be used to treat bleeding disorders such as hemophilia and von Willebrand disease, as it can help to promote platelet aggregation and reduce bleeding times. It is available in various forms, including nasal sprays, injectable solutions, and oral tablets or dissolvable films.

Neurophysins are small protein molecules that are derived from the larger precursor protein, pro-neurophysin. They are synthesized in the hypothalamus of the brain and are stored in and released from neurosecretory granules, along with neurohypophysial hormones such as oxytocin and vasopressin.

Neurophysins serve as carrier proteins for these hormones, helping to stabilize them and facilitate their transport and release into the bloodstream. There are two main types of neurophysins, neurophysin I and neurophysin II, which are associated with oxytocin and vasopressin, respectively.

Neurophysins have been studied for their potential role in various physiological processes, including water balance, social behavior, and reproductive functions. However, their precise mechanisms of action and functional significance are still not fully understood.

The posterior pituitary gland, also known as the neurohypophysis, is the posterior portion of the pituitary gland. It is primarily composed of nerve fibers that originate from the hypothalamus, a region of the brain. These nerve fibers release two important hormones: oxytocin and vasopressin (also known as antidiuretic hormone or ADH).

Oxytocin plays a role in social bonding, sexual reproduction, and childbirth. During childbirth, it stimulates uterine contractions to help facilitate delivery, and after birth, it helps to trigger the release of milk from the mother's breasts during breastfeeding.

Vasopressin, on the other hand, helps regulate water balance in the body by controlling the amount of water that is excreted by the kidneys. It does this by increasing the reabsorption of water in the collecting ducts of the kidney, which leads to a more concentrated urine and helps prevent dehydration.

Overall, the posterior pituitary gland plays a critical role in maintaining fluid balance, social bonding, and reproduction.

Water-electrolyte balance refers to the regulation of water and electrolytes (sodium, potassium, chloride, bicarbonate) in the body to maintain homeostasis. This is crucial for various bodily functions such as nerve impulse transmission, muscle contraction, fluid balance, and pH regulation. The body maintains this balance through mechanisms that control water intake, excretion, and electrolyte concentration in various body fluids like blood and extracellular fluid. Disruptions in water-electrolyte balance can lead to dehydration or overhydration, and imbalances in electrolytes can cause conditions such as hyponatremia (low sodium levels) or hyperkalemia (high potassium levels).

Water-electrolyte imbalance refers to a disturbance in the balance of water and electrolytes (such as sodium, potassium, chloride, and bicarbonate) in the body. This imbalance can occur when there is an excess or deficiency of water or electrolytes in the body, leading to altered concentrations in the blood and other bodily fluids.

Such imbalances can result from various medical conditions, including kidney disease, heart failure, liver cirrhosis, severe dehydration, burns, excessive sweating, vomiting, diarrhea, and certain medications. Symptoms of water-electrolyte imbalance may include weakness, fatigue, muscle cramps, seizures, confusion, and in severe cases, coma or even death. Treatment typically involves addressing the underlying cause and correcting the electrolyte and fluid levels through appropriate medical interventions.

Vasopressin, also known as antidiuretic hormone (ADH), is a hormone that helps regulate water balance in the body. It is produced by the hypothalamus and stored in the posterior pituitary gland. When the body is dehydrated or experiencing low blood pressure, vasopressin is released into the bloodstream, where it causes the kidneys to decrease the amount of urine they produce and helps to constrict blood vessels, thereby increasing blood pressure. This helps to maintain adequate fluid volume in the body and ensure that vital organs receive an adequate supply of oxygen-rich blood. In addition to its role in water balance and blood pressure regulation, vasopressin also plays a role in social behaviors such as pair bonding and trust.

Pituitary diseases refer to a group of conditions that affect the pituitary gland, a small endocrine gland located at the base of the brain. The pituitary gland is responsible for producing and secreting several important hormones that regulate various bodily functions, including growth and development, metabolism, stress response, and reproduction.

Pituitary diseases can be classified into two main categories:

1. Pituitary tumors: These are abnormal growths in or around the pituitary gland that can affect its function. Pituitary tumors can be benign (non-cancerous) or malignant (cancerous), and they can vary in size. Some pituitary tumors produce excess hormones, leading to a variety of symptoms, while others may not produce any hormones but can still cause problems by compressing nearby structures in the brain.
2. Pituitary gland dysfunction: This refers to conditions that affect the normal function of the pituitary gland without the presence of a tumor. Examples include hypopituitarism, which is a condition characterized by decreased production of one or more pituitary hormones, and Sheehan's syndrome, which occurs when the pituitary gland is damaged due to severe blood loss during childbirth.

Symptoms of pituitary diseases can vary widely depending on the specific condition and the hormones that are affected. Treatment options may include surgery, radiation therapy, medication, or a combination of these approaches.

A reinforcement schedule is a concept in behavioral psychology that refers to the timing and pattern of rewards or reinforcements provided in response to certain behaviors. It is used to shape, maintain, or strengthen specific behaviors in individuals. There are several types of reinforcement schedules, including:

1. **Fixed Ratio (FR):** A reward is given after a fixed number of responses. For example, a salesperson might receive a bonus for every 10 sales they make.
2. **Variable Ratio (VR):** A reward is given after an unpredictable number of responses. This schedule is commonly used in gambling, as the uncertainty of when a reward (winning) will occur keeps the individual engaged and motivated to continue the behavior.
3. **Fixed Interval (FI):** A reward is given after a fixed amount of time has passed since the last reward, regardless of the number of responses during that time. For example, an employee might receive a paycheck every two weeks, regardless of how many tasks they completed during that period.
4. **Variable Interval (VI):** A reward is given after an unpredictable amount of time has passed since the last reward, regardless of the number of responses during that time. This schedule can be observed in foraging behavior, where animals search for food at irregular intervals.
5. **Combined schedules:** Reinforcement schedules can also be combined to create more complex patterns, such as a fixed ratio followed by a variable interval (FR-VI) or a variable ratio followed by a fixed interval (VR-FI).

Understanding reinforcement schedules is essential for developing effective behavioral interventions in various settings, including healthcare, education, and rehabilitation.

Aquaporin 2 (AQP2) is a type of aquaporin, which is a water channel protein found in the membranes of cells. Specifically, AQP2 is located in the principal cells of the collecting ducts in the kidneys. It plays a crucial role in regulating water reabsorption and urine concentration by facilitating the movement of water across the cell membrane in response to the hormone vasopressin (also known as antidiuretic hormone). When vasopressin binds to receptors on the cell surface, it triggers a cascade of intracellular signals that lead to the translocation of AQP2 water channels from intracellular vesicles to the apical membrane. This increases the permeability of the apical membrane to water, allowing for efficient reabsorption of water and concentration of urine. Dysfunction in AQP2 has been implicated in various kidney disorders, such as nephrogenic diabetes insipidus.

Arginine vasopressin (AVP), also known as antidiuretic hormone (ADH), is a hormone produced in the hypothalamus and stored in the posterior pituitary gland. It plays a crucial role in regulating water balance and blood pressure in the body.

AVP acts on the kidneys to promote water reabsorption, which helps maintain adequate fluid volume and osmotic balance in the body. It also constricts blood vessels, increasing peripheral vascular resistance and thereby helping to maintain blood pressure. Additionally, AVP has been shown to have effects on cognitive function, mood regulation, and pain perception.

Deficiencies or excesses of AVP can lead to a range of medical conditions, including diabetes insipidus (characterized by excessive thirst and urination), hyponatremia (low sodium levels in the blood), and syndrome of inappropriate antidiuretic hormone secretion (SIADH).

There is no medical definition for "dog diseases" as it is too broad a term. However, dogs can suffer from various health conditions and illnesses that are specific to their species or similar to those found in humans. Some common categories of dog diseases include:

1. Infectious Diseases: These are caused by viruses, bacteria, fungi, or parasites. Examples include distemper, parvovirus, kennel cough, Lyme disease, and heartworms.
2. Hereditary/Genetic Disorders: Some dogs may inherit certain genetic disorders from their parents. Examples include hip dysplasia, elbow dysplasia, progressive retinal atrophy (PRA), and degenerative myelopathy.
3. Age-Related Diseases: As dogs age, they become more susceptible to various health issues. Common age-related diseases in dogs include arthritis, dental disease, cancer, and cognitive dysfunction syndrome (CDS).
4. Nutritional Disorders: Malnutrition or improper feeding can lead to various health problems in dogs. Examples include obesity, malnutrition, and vitamin deficiencies.
5. Environmental Diseases: These are caused by exposure to environmental factors such as toxins, allergens, or extreme temperatures. Examples include heatstroke, frostbite, and toxicities from ingesting harmful substances.
6. Neurological Disorders: Dogs can suffer from various neurological conditions that affect their nervous system. Examples include epilepsy, intervertebral disc disease (IVDD), and vestibular disease.
7. Behavioral Disorders: Some dogs may develop behavioral issues due to various factors such as anxiety, fear, or aggression. Examples include separation anxiety, noise phobias, and resource guarding.

It's important to note that regular veterinary care, proper nutrition, exercise, and preventative measures can help reduce the risk of many dog diseases.

Vasopressin receptors are a type of G protein-coupled receptor that bind to and are activated by the hormone vasopressin (also known as antidiuretic hormone or ADH). There are two main types of vasopressin receptors, V1 and V2.

V1 receptors are found in various tissues throughout the body, including vascular smooth muscle, heart, liver, and kidney. Activation of V1 receptors leads to vasoconstriction (constriction of blood vessels), increased heart rate and force of heart contractions, and release of glycogen from the liver.

V2 receptors are primarily found in the kidney's collecting ducts. When activated, they increase water permeability in the collecting ducts, allowing for the reabsorption of water into the bloodstream and reducing urine production. This helps to regulate fluid balance and maintain normal blood pressure.

Abnormalities in vasopressin receptor function can contribute to various medical conditions, including hypertension, heart failure, and kidney disease.

Diuresis is a medical term that refers to an increased production of urine by the kidneys. It can occur as a result of various factors, including certain medications, medical conditions, or as a response to a physiological need, such as in the case of dehydration. Diuretics are a class of drugs that promote diuresis and are often used to treat conditions such as high blood pressure, heart failure, and edema.

Diuresis can be classified into several types based on its underlying cause or mechanism, including:

1. Osmotic diuresis: This occurs when the kidneys excrete large amounts of urine in response to a high concentration of solutes (such as glucose) in the tubular fluid. The high osmolarity of the tubular fluid causes water to be drawn out of the bloodstream and into the urine, leading to an increase in urine output.
2. Forced diuresis: This is a medical procedure in which large amounts of intravenous fluids are administered to promote diuresis. It is used in certain clinical situations, such as to enhance the excretion of toxic substances or to prevent kidney damage.
3. Natriuretic diuresis: This occurs when the kidneys excrete large amounts of sodium and water in response to the release of natriuretic peptides, which are hormones that regulate sodium balance and blood pressure.
4. Aquaresis: This is a type of diuresis that occurs in response to the ingestion of large amounts of water, leading to dilute urine production.
5. Pathological diuresis: This refers to increased urine production due to underlying medical conditions such as diabetes insipidus or pyelonephritis.

It is important to note that excessive diuresis can lead to dehydration and electrolyte imbalances, so it should be monitored carefully in clinical settings.

Osmolar concentration is a measure of the total number of solute particles (such as ions or molecules) dissolved in a solution per liter of solvent (usually water), which affects the osmotic pressure. It is expressed in units of osmoles per liter (osmol/L). Osmolarity and osmolality are related concepts, with osmolarity referring to the number of osmoles per unit volume of solution, typically measured in liters, while osmolality refers to the number of osmoles per kilogram of solvent. In clinical contexts, osmolar concentration is often used to describe the solute concentration of bodily fluids such as blood or urine.

"Psychogenic polydipsia - Management - Emerging treatments". British Medical Journal. May 5, 2016. Retrieved October 28, 2016. ... Dundas, Brian; Harris, Melissa; Narasimhan, Meera (2007-07-03). "Psychogenic polydipsia review: Etiology, differential, and ... may also be used to help decrease excessive water consumption in people with schizophrenia resulting in psychogenic polydipsia ... Greendyke, R. M.; Bernhardt, A. J.; Tasbas, H. E.; Lewandowski, K. S. (1998-04-01). "Polydipsia in chronic psychiatric patients ...
Another cause is psychogenic polydipsia. A third group of people with hyponatremia are often said to be "hypervolemic". They ... Congestive heart failure Hypothyroidism and hypocortisolism Liver cirrhosis Nephrotic syndrome Psychogenic polydipsia Placing ...
... and psychogenic polydipsia are forms of polydipsia characterised by excessive fluid intake in the absence of ... Some forms of polydipsia are explicitly non-psychogenic. Primary polydipsia is a diagnosis of exclusion. Signs and symptoms of ... Although primary polydipsia is usually categorised as psychogenic, there are some rare non-psychogenic causes. An example is ... The terms primary polydipsia and psychogenic polydipsia are sometimes incorrectly used interchangeably - to be considered ...
Furthermore, enalapril is an emerging treatment for psychogenic polydipsia. A double-blind, placebo-controlled trial showed ... Greendyke RM, Bernhardt AJ, Tasbas HE, Lewandowski KS (April 1998). "Polydipsia in chronic psychiatric patients: therapeutic ...
"Role of Naltrexone in Improving Compulsive Drinking in Psychogenic Polydipsia". Cureus. 11 (8): e5320. doi:10.7759/cureus.5320 ... Primary polydipsia, or excessive fluid intake, is relatively common in people with chronic schizophrenia. This may lead to ...
This includes both psychogenic primary polydipsia and non-psychogenic primary polydipsia, such as in patients with autoimmune ... Psychogenic polydipsia is an excessive water intake seen in some patients with mental illnesses such as schizophrenia, or with ... While psychogenic polydipsia is generally not found outside the population of serious mental disorders, there is some anecdotal ... As discussed in the entry on diabetes insipidus, "Habit drinking (in its severest form termed psychogenic polydipsia) is the ...
... is effective in treating psychogenic polydipsia and the acute exacerbations of schizophrenia. Studies evaluating ...
Common rule outs include: diabetes mellitus, chronic kidney disease, hypokalemia, hypercalcemia, and psychogenic polydipsia. ... Specifically, other more common causes of polyuria and polydipsia are ruled out. ...
"Urinary excretion of aquaporin-2 water channel differentiates psychogenic polydipsia from central diabetes insipidus". The ...
In schizophrenic patients with psychogenic polydipsia, inadequate thirst reception leads to excessive water intake, severely ... primary polydipsia) although this is difficult to determine because such patients are often institutionalised and have a long ... in this scenario the central pontine myelinolysis is caused by polydipsia leading to low blood sodium levels (hyponatremia).[ ...
... psychogenic polydipsia, psychogenic tremor, and psychogenic pain. The term psychogenic disease is often used in a similar way ... Examples of diseases that are believed by many to be psychogenic include psychogenic seizures, ... Psychology portal Functional symptom Habit cough Mass psychogenic illness Psychogenic amnesia Psychological trauma ... physicians typically diagnose a patient's symptoms as being psychogenic. Research into understanding psychogenic disorders has ...
Psychogenic polydipsia is the psychiatric condition in which patients feel compelled to drink excessive quantities of water, ... Hyponatremia Gastroenteritis Oral rehydration therapy Polydipsia Water urticaria Dihydrogen monoxide hoax Electrolyte imbalance ...
In these rare psychogenic cases, the patients have normal levels of urine osmolality as well as typical ADH activity. Dopamine ... Polydipsia - excessive thirst, the opposite of adipsia Thirst Osmoregulation "adipsia , pathology". Encyclopædia Britannica. ... Harrington, C.; Grossman, J.; Richman, K. (2014). "Psychogenic adipsia presenting as acute kidney injury: case report and ... Some doctors have reported success in treating psychogenic adipsic patients with electroconvulsive therapy, although the ...
... neurogenic/central diabetes insipidus and psychogenic polydipsia. They may be differentiated by using the water deprivation ... This improves the blood osmolarity and prevents hypernatremia.[citation needed] High serum osmolarity stimulates polydipsia in ... presenting with polydipsia (excessive thirst) and polyuria (excretion of a large amount of dilute urine). Dehydration is common ...
... psychogenic polydipsia). Osmolality is normally used for more detailed analysis, but USG remains popular for its convenience. ...
... theory Psychodynamic therapy Psychodynamics Psychogenesis Psychogenic amnesia Psychogenic pain Psychogenic polydipsia ...
... a molecule Psychogenic polydipsia, excessive water intake with a psychiatric or pharmaceutical cause Postharvest physiological ...
... disease Bell's palsy Burning mouth syndrome Chronic recurrent multifocal osteomyelitis Long COVID Psychogenic polydipsia ... "primary polydipsia - General Practice Notebook". www.gpnotebook.co.uk. Retrieved 2016-11-22.{{cite web}}: CS1 maint: multiple ...
... may refer to: Psychogenic polydipsia - compulsive drinking of water in the absence of physiological stimuli ...
... phobias Aggressive behavior of patients with brain injuries Treating the excessive drinking of fluids in psychogenic polydipsia ...
... elasticum Pseudo-Zellweger syndrome Psittacosis Psoriasis Psoriatic arthritis Psoriatic rheumatism Psychogenic polydipsia ...
General polydipsia psychogenic polydipsia diuretic drugs, osmotic diuresis Urinary system interstitial cystitis urinary tract ... Primary polydipsia may lead to polyuria. Polyuria is usually viewed as a symptom or sign of another disorder (not a disease by ... Polyuria often appears in conjunction with polydipsia (increased thirst), though it is possible to have one without the other, ... primary polydipsia (excessive fluid drinking), central diabetes insipidus and nephrogenic diabetes insipidus. Polyuria may also ...
Psychogenic" by people in this website by year, and whether "Polydipsia, Psychogenic" was a major or minor topic of these ... "Polydipsia, Psychogenic" is a descriptor in the National Library of Medicines controlled vocabulary thesaurus, MeSH (Medical ... Below are the most recent publications written about "Polydipsia, Psychogenic" by people in Profiles. ... Below are MeSH descriptors whose meaning is more general than "Polydipsia, Psychogenic". ...
Access full-text academic articles: J-STAGE is an online platform for Japanese academic journals.
The term "primary polydipsia" is often termed "psychogenic polydipsia." Others have classified primary polydipsia into ... Primary polydipsia is a state of markedly increased fluid intake in the setting of a normal vasopressin system and normal renal ... There is no significant response to exogenous desmopressin in primary polydipsia.. Are There Any Factors That Might Affect the ... In primary polydipsia, urine osmolality increases with water restriction so that urine-to-plasma osmolality exceeds 1.0.. ...
"Psychogenic polydipsia - Management - Emerging treatments". British Medical Journal. May 5, 2016. Retrieved October 28, 2016. ... Dundas, Brian; Harris, Melissa; Narasimhan, Meera (2007-07-03). "Psychogenic polydipsia review: Etiology, differential, and ... may also be used to help decrease excessive water consumption in people with schizophrenia resulting in psychogenic polydipsia ... Greendyke, R. M.; Bernhardt, A. J.; Tasbas, H. E.; Lewandowski, K. S. (1998-04-01). "Polydipsia in chronic psychiatric patients ...
Psychogenic polydipsia (a mental disorder). Home Care. Because thirst is the bodys signal to replace water loss, it is most ...
Psychogenic polydipsia (rare if acute). * Burns (infrequent, and often in context of hypernatremia) ... Water intoxication due to intravenous (IV) therapy, tap-water enema, or psychogenic water drinking ...
Polydipsia (excessive thirst), habitual or psychogenic-Use with caution. May cause side effects to become worse. ...
The condition may be psychogenic in origin.. Synonyms:. exact_synonym: Polydipsias. primary_id: MESH:D059606. ...
Psychogenic polydipsia. *Hypercalcaemia. *Hyperadrenocorticism. When diagnosing diabetes it is also important that any drugs ...
Psychogenic polydipsia (a mental disorder). Home Care. Because thirst is the bodys signal to replace water loss, it is most ...
Polyuria-polydipsia: a practical approach to a common clinical problem. The treatment of renal diseases with ACE inhibitors: ... The symptoms of CRF with uraemia are mostly non-specific and include polyuria/polydipsia, dullness, poor appetite, weight loss ... the most important one being polyuria/polydipsia (Table 3). If PU/PD is present, the initial diagnostic work-up should be ...
Hyponatremia with euvolemia (eg, psychogenic polydipsia, syndrome of inappropriate antidiuretic hormone (SIADH), hypothyroidism ... Possible causes of hypotonic hyponatremia include psychogenic polydipsia, SIADH, hypothyroidism, or states of volume overload ( ...
Get free answers on any health question about the medication Furosemide from top U.S. doctors. Or, video or text chat with a U.S. doctor 24/7 on demand for advice, prescriptions and more for an affordable fee.
Get free answers on any health question about the test Urine osmolality from top U.S. doctors. Or, video chat with a U.S. doctor on-demand for advice, prescriptions and more for an affordable fee.
March 17 Psychogenic polydipsia. March 24 Lumateperone: an overview of a promising new drug. March 31 Atypical Hallucinations. ...
Psychogenic polydipsia is an uncommon clinical disorder characterized by excessive water-drinking in the absence of a ...
Habitual or psychogenic polydipsia (resulting in a urine production exceeding 40 ml/kg/24 hours) ...
And he had developed psychogenic polydipsia, a mental quirk that convinced him he was always thirsty. As he looked up at us ...
An uncommon cause of dogs drinking more is called psychogenic polydipsia. It is a behavioral condition with a physical ... Primary polydipsia is used to describe excessive water drinking that is not due to illness or psychosis: bored puppies or water ... If your dog is drinking excessively (polydipsia) it is possibly because he is losing excess amounts of water for any of a ...
Psychogenic Polydipsia (as in a true behavioral disorder with a compulsive element). 21. Primary Non-Medical Polydipsia (AKA "I ... PolyDipsia is defined as the consistent drinking of more than 100ml of water per kilogram of weight per day (,100mls/kg/day). ... Increased water consumption or increased urination is call PU/PD or PolyUria/PolyDipsia in the medical realm. Remember what ...
Acute psychogenic polydipsia. *. Use of the drug methylenedioxymethamphetamine Methylenedioxymethamphetamine (MDMA) MDMA (3,4- ... Primary polydipsia can cause hyponatremia only when water intake overwhelms the kidneys ability to excrete water. Because ... Patients affected include those with psychosis or more modest degrees of polydipsia plus renal insufficiency. ... normal kidneys can excrete up to 25 L urine a day, hyponatremia due solely to polydipsia results only from the ingestion of ...
Other conditions which will current in an analogous method embrace diabetes mellitus, hypercalcaemia and psychogenic polydipsia ...
A Rare case of Primary Polydipsia in Child. Read more about developmental coordination problems on Pediatric Oncall ... A RARE CASE OF PRIMARY POLYDIPSIA IN CHILD` ... psychiatric diagnosis for children with psychogenic polydipsia ... Reply to "A Rare Case of Primary Polydipsia in Child". Ahmad Ghanizadeh.. Research Center for Psychiatry and Behavioral ... Kamath M, Nayak D, Nayak C D. A Rare case of Primary Polydipsia in Child. Pediatric Oncall [serial online] 2011 [cited 2011 ...
Compulsive water drinking is known as psychogenic polydipsia. This is most often associated with either mental illness or ...
... and psychogenic polydipsia. For cats, the owner should measure the animals 24-hour water intake 2-3 days before the ... Again, all other causes of polyuria and polydipsia should initially be excluded, limiting the differential diagnosis to central ... These conditions include nephrogenic diabetes insipidus (an inability of the kidneys to respond to ADH), psychogenic diabetes ... insipidus (a polydipsia in response to some psychological disturbance but a normal response to ADH), and hypercortisolism ( ...
Desmopressin acetate should be used with caution in patients with habitual or psychogenic polydipsia who may be more likely to ... therapy in the management of central diabetes insipidus and for the management of the temporary polyuria and polydipsia ... for monitoring the patient with central diabetes insipidus or post-surgical or head trauma-related polyuria and polydipsia ...
There are a few possibilities for the persons behavior, but we need to consider psychogenic polydipsia or primary polydipsia. ... Psychogenic polydipsia (PP) is common, and its usually associated with schizophrenia but can occur in other psychotic, mood, ... The urine will be dilute, but the serum sodium level will be high not low separating it from psychogenic polydipsia. ... Medications have also been associated with worsening of psychogenic polydipsia. Its thought to be related to the ...
Falk, J. L. (1969). Conditions producing psychogenic polydipsia in animals. Annals of the New York Academy of Sciences, 157, ...
What Is Psychogenic Polydipsia In German Shepherds. When there is no reason for the increased water intake, the condition is ... known as psychogenic polydipsia. In this case, veterinarians have run tests for diseases that commonly cause increased drinking ... Health Issues- Health conditions such as polydipsia, kidney failure, and diabetes mellitus may cause an increase in water ...
Pseudocyesis or Psychogenic Polydipsia" comment.. *The Flawless Harper Collins´ Edition: Nothing is better than a handbook you ...
  • If a patient has partial or incomplete central diabetes insipidus or partial nephrogenic diabetes insipidus, fluid deprivation might result in a modest concentration of the urine, producing an effect similar to that encountered in primary polydipsia. (cancertherapyadvisor.com)
  • [ 3 ] The differential diagnosis of polyuria includes central diabetes insipidus, congenital or acquired nephrogenic diabetes insipidus, psychogenic polydipsia, high protein or hyperglycemic osmotic diuresis, salt-wasting nephropathies, mixed polyuria due to excess solute and water intake, and postobstructive diuresis following recovery from urinary obstruction. (medscape.com)
  • All patients manifest hyperosmolar symptoms like polyuria and polydipsia within 3 to 12 weeks following temozolomide initiation. (fortunejournals.com)
  • We describe a case of a woman who presented with concerns regarding polyuria and polydipsia of more than one year duration. (medscape.com)
  • ACE inhibitors may also be used to help decrease excessive water consumption in people with schizophrenia resulting in psychogenic polydipsia. (wikipedia.org)
  • Psychogenic polydipsia (PP) is common, and it's usually associated with schizophrenia but can occur in other psychotic, mood, and anxiety disorders. (shrinksinsneakers.com)
  • Stats reveal that individuals with psychogenic polydipsia are 80% females with a history of anxiety, depression or schizophrenia. (healthystripe.com)
  • Raja M, Azzoni A, Giammarco V. Diabetes insipidus and polydipsia in a patient with Asperger's disorder and an empty sella: a case report. (pediatriconcall.com)
  • In primary polydipsia, urine osmolality increases with water restriction so that urine-to-plasma osmolality exceeds 1.0. (cancertherapyadvisor.com)
  • The urine will be dilute, but the serum sodium level will be high not low separating it from psychogenic polydipsia. (shrinksinsneakers.com)
  • CDI is characterized by decreased antidiuretic hormone secretion from posterior pituitary, thereby the inability to concentrate the urine with variable degrees of polyuria and compensatory polydipsia. (fortunejournals.com)
  • Beer drinker's potomania and Tea and Toast stand alone with psychogenic polydipsia as the only ADH independent causes of hyponatremia. (renalfellow.org)
  • It manifests as polyuria, bothersome nocturia, and compensatory polydipsia for urinary water losses. (fortunejournals.com)
  • Psychogenic polydipsia is a behavioral obsession with drinking water in adult dogs. (suntrustblog.com)
  • This increase may be significant, but may be modest, since prolonged polydipsia "washes out" the renal inner medullary urea gradient and prolonged suppression of vasopressin decreases aquaporin expression in collecting duct cells. (cancertherapyadvisor.com)
  • Since signs and symptoms are often vague, CRF has to be included in many differential diagnoses, the most important one being polyuria/polydipsia (Table 3). (vin.com)
  • The term "primary polydipsia" is often termed "psychogenic polydipsia. (cancertherapyadvisor.com)
  • Others have classified primary polydipsia into dipsogenic (inappropriate thirst caused by a disturbed osmoreceptor mechanism), psychogenic (obsessive water consumption due to disordered thinking), or even iatrogenic (increased water drinking due to supposed health benefits). (cancertherapyadvisor.com)
  • It is not clear that these subsets can really be distinguished, thus, primary polydipsia is preferred. (cancertherapyadvisor.com)
  • There is no significant response to exogenous desmopressin in primary polydipsia. (cancertherapyadvisor.com)
  • Primary polydipsia is used to describe excessive water drinking that is not due to illness or psychosis: bored puppies or water loving breeds may tank up on water occasionally or consistently. (pethealthnetwork.com)
  • Kamath et al reported a 2 year 11 months old boy with primary polydipsia. (pediatriconcall.com)
  • Kamath M, Nayak D, Nayak C D. A Rare case of Primary Polydipsia in Child. (pediatriconcall.com)
  • There are a few possibilities for the persons behavior, but we need to consider psychogenic polydipsia or primary polydipsia. (shrinksinsneakers.com)
  • Finally, a fourth type of DI is called primary polydipsia. (amazonaws.com)
  • Primary polydipsia is further divided into two types. (amazonaws.com)
  • Abnormal intense thirst caused by mental disorders (psychogenic polydipsia). (lynchspharmacy.com)
  • The symptoms of CRF with uraemia are mostly non-specific and include polyuria/polydipsia, dullness, poor appetite, weight loss, vomiting, a poor hair coat, and diarrhoea (Table 2). (vin.com)
  • Psychogenic polydipsia is an uncommon clinical disorder characterized by excessive water-drinking in the absence of a physiologic stimulus to drink. (dailymail.co.uk)
  • Therefore, it is suggested that one of the psychiatric diagnosis for children with psychogenic polydipsia can be pervasive developmental disorder. (pediatriconcall.com)
  • Impaired water metabolism in psychogenic polydipsia can result in WATER INTOXICATION. (umassmed.edu)
  • If your dog is drinking excessively (polydipsia) it is possibly because he is losing excess amounts of water for any of a number of reasons. (pethealthnetwork.com)
  • Increased water consumption or increased urination is call PU/PD or PolyUria/PolyDipsia in the medical realm. (pets.ca)
  • Compulsive water drinking is known as psychogenic polydipsia. (draxe.com)
  • Only by ruling out other medical disorders and measuring the daily water requirement and seeing if the puppy exceeds it can they can diagnose psychogenic polydipsia. (suntrustblog.com)
  • Psychogenic Polydipsia- Some people find themselves compulsively reaching out for glass after glass of water. (healthystripe.com)
  • Social Polydipsia- This occurs when individuals drink too much water for the health benefits of hydration. (healthystripe.com)
  • Psychogenic polydipsia, a mental problem where you have excessive thirst and drink excessive amount of water. (niroginepal.com)
  • The calcluation is 750 mosm/( 50 mosm/L)= 15 L. This is the classic form of psychogenic polydipsia and this is why a quantity of 15 liters is often quoted when asked about the maximum amount of water one can drink in a day before becoming hyponatremic. (renalfellow.org)
  • Polydipsia, Psychogenic" is a descriptor in the National Library of Medicine's controlled vocabulary thesaurus, MeSH (Medical Subject Headings) . (umassmed.edu)
  • This graph shows the total number of publications written about "Polydipsia, Psychogenic" by people in this website by year, and whether "Polydipsia, Psychogenic" was a major or minor topic of these publications. (umassmed.edu)
  • Below are the most recent publications written about "Polydipsia, Psychogenic" by people in Profiles. (umassmed.edu)
  • The condition may be psychogenic in origin. (mcw.edu)
  • Herein, considering that the patient was with polydipsia, a significant gross motor developmental delay in early infancy, and head circumference of above the mean, another possible differential diagnosis should be mentioned. (pediatriconcall.com)
  • ACE inhibitors may also be used to help decrease excessive water consumption in people with schizophrenia resulting in psychogenic polydipsia. (wikipedia.org)
  • Risperidone is effective in treating psychogenic polydipsia and the acute exacerbations of schizophrenia. (synthinkchemicals.com)
  • Psychiatric conditions such as schizophrenia (primary polydipsia or psychogenic polydipsia) can also cause compulsive water drinking. (thegoldenliving.com)
  • Hereditary nephrogenic diabetes insipidus (NDI) is characterized by inability to concentrate the urine, which results in polyuria (excessive urine production) and polydipsia (excessive thirst). (nih.gov)
  • Diabetes and hyperthyroidism are often also associated with excess thirst (polydipsia) and excessive urination (polyuria. (pethealthnetwork.com)
  • In clinical practice, it needs to be distinguished from renal resistance to the antidiuretic effects of AVP (nephrogenic DI), and abnormalities of thirst appreciation (primary polydipsia). (nih.gov)
  • In addition, the measurement of thirst ratings can help the differentiation between CDI and primary polydipsia. (nih.gov)
  • Psychogenic polydipsia (PP), also known as primary polydipsia and potomania, was first described in the 1930s. (thecarlatreport.com)
  • Primary causes of polyphagia can be behavioral or psychogenic. (pethealthnetwork.com)
  • Compulsive water drinking, or psychogenic polydipsia, is surprisingly common on inpatient psychiatric units. (thecarlatreport.com)
  • There was no history of psychiatric disease to support psychogenic polydipsia. (bmj.com)
  • Compulsive water drinking or psychogenic polydipsia is now increasingly seen in psychiatric populations. (insidegistblog.com)
  • The interesting case of a patient with a psychiatric history of schizoaffective disorder bipolar type and psychogenic polydipsia Poster presentation. (ecu.edu)
  • Her death came as a result of Hyponatraemic Encephalopathy, caused by Acute Hyponatraemia, caused by Psychogenic Polydipsia. (judiciary.uk)
  • Psychogenic or behavioral polyphagia and secondary obesity as in other animals must be managed using a combination of increased exercise and decreased calorie intake using a calorie reduced diet as well as a change in feeding patterns. (pethealthnetwork.com)
  • Deficiency of the Kidney-Q. Main Symptoms: Polydipsia, frequent and profuse urination, emaciation, aching pain in the lumbus, lassitude. (thetole.org)
  • In this context, the acute over hydration was caused by Psychogenic Polydipsia, a feature of Michelle's mental ill health which had not been diagnosed. (judiciary.uk)
  • During the past two years, compulsive use has become associated with frequent attacks of anxiety, depersonalization, periods of psychogenic polydipsia and virtually complete inactivity. (gizmodo.com)
  • An uncommon cause of dogs drinking more is called psychogenic polydipsia. (dog-forums.com)
  • With polyuria (PU) the body makes more urine than normal, which in turn causes a condition called polydipsia (PD), which means your dog or cat is extra thirsty because they are trying to stay hydrated. (vin.com)