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Sample records for effects aldosterone infused

  1. Disparate effects of eplerenone, amlodipine and telmisartan on podocyte injury in aldosterone-infused rats

    NARCIS (Netherlands)

    Liang, Wei; Chen, Cheng; Shi, Jing; Ren, Zhilong; Hu, Fengqi; van Goor, Harry; Singhal, Pravin C.; Ding, Guohua

    Background. Several studies in patients with primary aldosteronism (PA) have suggested that aldosterone (ALD) is directly contributing to albuminuria. However, there are limited data pertaining to the direct role of ALD in (EPL), telmisartan (TEL) and amlodipine (AML) on ALD-induced renal structural

  2. Saline Infusion Test highly associated with the incidence of cardio- and cerebrovascular events in primary aldosteronism.

    Science.gov (United States)

    Hayashi, Reiko; Tamada, Daisuke; Murata, Masahiko; Mukai, Kosuke; Kitamura, Tetsuhiro; Otsuki, Michio; Shimomura, Iichiro

    2017-05-30

    Primary aldosteronism (PA) is caused by excess secretion of aldosterone and is an independent risk factor for cardio-cerebro-vascular (CCV) events. The goal of treatment of PA should include prevention of CCV events. A definitive diagnosis of PA is established by confirmatory tests [saline infusion test (SIT), furosemide upright test (FUT) and captopril challenge test (CCT)]. However, there is no information on whether the hormone levels measured by these confirmatory tests are associated with CCV events. The aim of this retrospective study was to elucidate the relationship between the results of the above confirmatory tests and prevalence of CCV disease in patients with PA. The study subjects were 292 PA patients who were assessed for past history of CCV events at the time of diagnosis of PA. CCV events were significantly higher in patients with positive than negative SIT (12.8% vs. 3.3%, p=0.04). There were no differences in the incidences of CCV events between patients with positive and negative CCT and FUT (CCT: 11.0% vs. 3.9%, p=0.13, FUT: 6.1% vs. 5.7%, p=0.93). Our results demonstrated a higher incidence of CCV disease in PA SIT-positive patients compared to those with negative test. SIT is a potentially useful test not only for the diagnosis of PA but also assessment of the risk of CCV events.

  3. Systemic effects of angiotensin III in conscious dogs during acute double blockade of the renin-angiotensin-aldosterone-system

    DEFF Research Database (Denmark)

    Gammelgaard, Iben; Wamberg, Søren; Bie, Peter

    2006-01-01

    by radioimmunoassay using a cross-reacting antibody to AngII. During ongoing peptide infusion, candesartan (2 mg kg(-1)) was administered to block the AT1-receptors. RESULTS: Angiotensin immunoactivity in plasma increased to 60 +/- 10 pg mL(-1) during infusion of AngII or infusion of AngIII. AngII significantly...... was statistically indistinguishable from those of AngII. All measured effects of both peptides were blocked by candesartan. CONCLUSION: At the present arterial plasma concentrations, AngIII is equipotent to AngII with regard to effects on blood pressure, aldosterone secretion and renal functions, and these Ang...

  4. Mechanisms underlying rapid aldosterone effects in the kidney.

    LENUS (Irish Health Repository)

    Thomas, Warren

    2011-03-17

    The steroid hormone aldosterone is a key regulator of electrolyte transport in the kidney and contributes to both homeostatic whole-body electrolyte balance and the development of renal and cardiovascular pathologies. Aldosterone exerts its action principally through the mineralocorticoid receptor (MR), which acts as a ligand-dependent transcription factor in target tissues. Aldosterone also stimulates the activation of protein kinases and secondary messenger signaling cascades that act independently on specific molecular targets in the cell membrane and also modulate the transcriptional action of aldosterone through MR. This review describes current knowledge regarding the mechanisms and targets of rapid aldosterone action in the nephron and how aldosterone integrates these responses into the regulation of renal physiology.

  5. Mechanisms underlying rapid aldosterone effects in the kidney.

    LENUS (Irish Health Repository)

    Thomas, Warren

    2012-02-01

    The steroid hormone aldosterone is a key regulator of electrolyte transport in the kidney and contributes to both homeostatic whole-body electrolyte balance and the development of renal and cardiovascular pathologies. Aldosterone exerts its action principally through the mineralocorticoid receptor (MR), which acts as a ligand-dependent transcription factor in target tissues. Aldosterone also stimulates the activation of protein kinases and secondary messenger signaling cascades that act independently on specific molecular targets in the cell membrane and also modulate the transcriptional action of aldosterone through MR. This review describes current knowledge regarding the mechanisms and targets of rapid aldosterone action in the nephron and how aldosterone integrates these responses into the regulation of renal physiology.

  6. Prothrombotic aldosterone action – a new side of the hormone

    Directory of Open Access Journals (Sweden)

    Anna Gromotowicz

    2010-10-01

    Full Text Available Recent studies have focused on a new wave of interest in aldosterone due mainly to its growing profile as a local messenger in pathology of the cardiovascular system, rather than its hormonal action. In the last few years strong evidence for a correlation between raised aldosterone level and haemostasis disturbances leading to increased risk of cardiovascular events has been provided. It has been demonstrated that aldosterone contributes to endothelial dysfunction, fibrinolytic disorders and oxidative stress augmentation. It was also shown that chronic aldosterone treatment results in enhanced experimental arterial thrombosis. Our study in a venous model of thrombosis in normotensive rats confirmed that even a short-lasting increase in aldosterone level intensified thrombus formation. One-hour aldosterone infusion shortened bleeding time; increased platelet adhesion to collagen; reduced tissue factor, thrombin activatable fibrinolysis inhibitor, and plasminogen activator inhibitor; and increased plasminogen activator plasma level. A fall in plasma nitric oxide metabolite concentration with a decrease in aortic nitric oxide synthase mRNA level was also observed. Moreover, aldosterone increased hydrogen peroxide and malonyl dialdehyde plasma concentration and augmented NADPH oxidase and superoxide dismutase aortic expression. Therefore, the mechanism of aldosterone prothrombotic action is multiple and involves primary haemostasis activation, procoagulative and antifibrinolytic action, NO bioavailability impairment and oxidative stress augmentation. The effects of aldosterone were not fully abolished by mineralocorticoid receptor blockade, suggesting the involvement of alternative mechanisms in the prothrombotic aldosterone action.

  7. Proteinuria-lowering effect of heparin therapy in diabetic nephropathy without affecting the renin-angiotensin-aldosterone system.

    Science.gov (United States)

    Benck, Urs; Haeckel, Sarah; Clorius, John H; van der Woude, Fokko J

    2007-01-01

    Angiotensin-converting enzyme inhibitors and angiotensin II (AngII) type 1 receptor blockers lower proteinuria and preserve renal function in diabetic nephropathy (DN). The antiproteinuric effects are greater than their blood pressure reduction, involving the sieving properties of the glomerular filter. In DN, glomerular staining for heparan sulfate proteoglycans is decreased. AngII inhibits heparan sulfate synthesis. Also, heparins modulate AngII signaling in glomerular cells, inhibiting aldosterone synthesis and lowering proteinuria in DN. Is the antiproteinuric effect of heparins due to its interference with the renin-angiotensin-aldosterone system? Ten volunteers each with DN and glomerulonephritis and control subjects were examined before and after low-dosage enoxaparin. Renal hemodynamics were determined with (99m)Tc-DTPA and (131)I-hippurate clearance. Glomerular filtration rate (GFR), effective renal plasma flow, mean arterial pressure, and heart rate were measured at baseline and during AngII infusion before and after enoxaparin while on normal salt and salt restriction. Enoxaparin did not lower aldosterone levels. GFR remained stable in all groups. AngII caused a significant decrease in effective renal plasma flow, whereas mean arterial pressure and heart rate increased significantly. Enoxaparin did not influence the AngII-induced changes of renal hemodynamics during normal salt intake or salt restriction. All groups showed identical responses to AngII before and after enoxaparin. In patients with diabetes, enoxaparin caused a significant decrease in proteinuria. It is concluded that the antiproteinuric effect of heparins in DN cannot be explained via interaction with the renin-angiotensin-aldosterone system. The absence of hemodynamic changes combined with reduced proteinuria point to intrinsic alterations in the glomerular filter. The effects were seen only in DN, not in glomerulonephritis.

  8. The potential of ACTH in the genesis of primary aldosteronism.

    Directory of Open Access Journals (Sweden)

    John Watson Funder

    2016-05-01

    Full Text Available Aldosterone is a homeostatic hormone, rising in volume depletion, sodium deficiency and potassium loading, in response to angiotensin11 and elevation of plasma potassium. Pathophysiologically, in primary aldosteronism (PA aldosterone levels are inappropriate for the patient’s sodium and potassium status, and thus outside the normal feedback loop. ACTH is equivalent with A11 and [K+] in elevating aldosterone: its effects differ from those of the other secretagogues in four ways. First, it is not sustained; second, it raises aldosterone and cortisol secretion with equal potency; third it is outside the normal feedback loops, reflecting the epithelial action of aldosterone; and finally its possible role in driving inappropriate aldosterone secretion (aka Primary Aldosteronism is not widely recognised. Thirty years ago it was shown that on a fixed sodium intake of 175meq/d 36 of 100 unselected hypertensives, in whom PA has been excluded on contemporary criteria, had 24 hour urinary aldosterone levels above the upper limit of normotensive controls. More recently, the dexamethasone enhanced fludrocortisone suppression test (FDST showed 29% of unselected hypertensives to have plasma aldosterone concentrations above the upper limit of normotensive controls. In subjects negative for PA on the FDST, 27% were extremely hyper-responsive to ultra-low dose ACTH infusion; the remaining 73% showed minimal aldosterone elevation, as did normotensive controls: all three groups had negligible cortisol responses. On treadmill testing no differences were found between groups in (minimally altered ACTH and cortisol levels: hyper-responders to ultra-low ACTH, however showed a major elevation in plasma aldosterone concentration. The implications of these studies,

  9. The Potential of ACTH in the Genesis of Primary Aldosteronism.

    Science.gov (United States)

    Funder, John W

    2016-01-01

    Aldosterone is a homeostatic hormone, rising in volume depletion, sodium deficiency, and potassium loading, in response to angiotensin11 and elevation of plasma potassium. Pathophysiologically, in primary aldosteronism (PA) aldosterone levels are inappropriate for the patient's sodium and potassium status, and thus outside the normal feedback loop. ACTH is equivalent with A11 and [K(+)] in elevating aldosterone: its effects differ from those of the other secretagogues in four ways. First, it is not sustained; second, it raises aldosterone and cortisol secretion with equal potency; third, it is outside the normal feedback loops, reflecting the epithelial action of aldosterone; and finally its possible role in driving inappropriate aldosterone secretion (aka PA) is not widely recognized. Thirty years ago, it was shown that on a fixed sodium intake of 175 meq/day 36 of 100 unselected hypertensives, in whom PA has been excluded on contemporary criteria, had 24 h urinary aldosterone levels above the upper limit of normotensive controls. More recently, the dexamethasone enhanced fludrocortisone suppression test (FDST) showed 29% of unselected hypertensives to have plasma aldosterone concentrations above the upper limit of normotensive controls. In subjects negative for PA on the FDST, 27% were extremely hyper-responsive to ultra-low dose ACTH infusion; the remaining 73% showed minimal aldosterone elevation, as did normotensive controls: all three groups had negligible cortisol responses. On treadmill testing, no differences were found between groups in (minimally altered) ACTH and cortisol levels: hyper-responders to ultra-low ACTH, however, showed a major elevation in PAC. The implications of these studies, when validated, are substantial for PA, in that approximately half of hypertensive patients appear to show inappropriate aldosterone levels for their sodium status. The physiological role(s) of ACTH as an acute aldosterone secretagogue, and the mechanisms whereby

  10. Effects of dietary sodium restriction and posture on plasma levels of atrial natriuretic peptide, aldosterone and free aldosterone in normal human pregnancy.

    Science.gov (United States)

    Steegers, E A; Benraad, T J; Jongsma, H W; Tan, A C; Hein, P R

    1990-03-01

    The effects of dietary sodium restriction and posture on plasma concentrations of atrial natriuretic peptide (ANP), aldosterone and free aldosterone were investigated in ten women between weeks 29 and 33 of normal pregnancy. Hormone levels were studied during unrestricted sodium intake and on day 6 of a low sodium diet. On both occasions venous blood was obtained in the sitting as well as in the left lateral tilt position. Plasma concentrations of ANP during the unrestricted sodium intake were not raised compared with control values in healthy non-pregnant females. Recovery experiments showed no differences in the degradation of ANP in blood from pregnant and non-pregnant women. Plasma concentrations of ANP significantly decreased (by 32%) in response to the low sodium regime in both positions. Concentrations of aldosterone and free aldosterone (in women in the sitting position) increased twofold after sodium restriction. Mean values of ANP were higher in women in the left lateral tilt position that in those in the sitting position, but the difference was not significant. Concentrations of aldosterone and free aldosterone were significantly lower (by around 30%) in women in the left lateral tilt position compared with those in the sitting posture.

  11. Mutual effects of melatonin and activin on induction of aldosterone production by human adrenocortical cells.

    Science.gov (United States)

    Hara, Takayuki; Otsuka, Fumio; Tsukamoto-Yamauchi, Naoko; Inagaki, Kenichi; Hosoya, Takeshi; Nakamura, Eri; Terasaka, Tomohiro; Komatsubara, Motoshi; Makino, Hirofumi

    2015-08-01

    Melatonin has been reported to suppress adrenocorticotropin (ACTH) secretion in the anterior pituitary and cortisol production in the adrenal by different mechanisms. However, the effect of melatonin on aldosterone production has remained unknown. In this study, we investigated the role of melatonin in the regulation of aldosterone production using human adrenocortical H295R cells by focusing on the activin system expressed in the adrenal. Melatonin receptor MT1 mRNA and protein were expressed in H295R cells and the expression levels of MT1 were increased by activin treatment. Activin increased ACTH-induced, but not angiotensin II (Ang II)-induced, aldosterone production. Melatonin alone did not affect basal synthesis of either aldosterone or cortisol. However, melatonin effectively enhanced aldosterone production induced by co-treatment with ACTH and activin, although melatonin had no effect on aldosterone production induced by Ang II in combination with activin. These changes in steroidogenesis became apparent when the steroid production was evaluated by the ratio of aldosterone/cortisol. Melatonin also enhanced dibutyryl-AMP-induced aldosterone/cortisol levels in the presence of activin, suggesting a functional link to the cAMP-PKA pathway for induction of aldosterone production by melatonin and activin. In accordance with the data for steroids, ACTH-induced, but not Ang II-induced, cAMP synthesis was also amplified by co-treatment with melatonin and activin. Furthermore, the ratio of ACTH-induced mRNA level of CYP11B2 compared with that of CYP17 was amplified in the condition of treatment with both melatonin and activin. In addition, melatonin increased expression of the activin type-I receptor ALK-4 but suppressed expression of inhibitory Smads6/7, leading to the enhancement of Smad2 phosphorylation. Collectively, the results showed that melatonin facilitated aldosterone production induced by ACTH and activin via the cAMP-PKA pathway. The results also

  12. Effect of Dual Blockade of Renin-Angiotensin Aldosterone System ...

    African Journals Online (AJOL)

    Methods: Patients with diabetes of > 5 years duration, proteinuria at a nephrotic level and serum creatinine > 1.5 mg/dL were enrolled in ... nephropathy, Azotemia, Proteinuria, Aldosterone, Renin, Blood pressure. Tropical Journal of Pharmaceutical ..... significantly from 150 ± 22 / 91 ± 13 mmHg to. 132 ± 17 / 79 ± 10 mmHg.

  13. Evaluation of the effects of occupational noise exposure on serum aldosterone and potassium among industrial workers

    Directory of Open Access Journals (Sweden)

    Sajad Zare

    2016-01-01

    Full Text Available The existing literature indicates that occupational exposure to noise may have adverse effects on workers′ health. The aim of this study was to evaluate the possible effects of exposure to different sound pressure levels (SPLs on serum aldosterone and potassium concentration among Iranian blue collar workers in Golgohar Mining and Industrial Company in Sirjan, Kerman Province, Iran. This case-control study was performed on 45 workers of Golgohar Mining and Industrial Company. The subjects consisted of 30 workers from manufacturing departments and 15 office employees of the mining company. The controls, mainly with administrative jobs were exposed to 72 dBA SPL. Cases, in two separate groups, were exposed to noise levels of 88 dBA and 103 dBA, respectively. Noise intensity was measured at the desired locations. Noise measurements were performed according to the International Organization for Standardization (ISO 9612. To measure the serum aldosterone and potassium concentrations, a 5 mL blood sample was taken from each worker at the specified time intervals and aldosterone concentration was determined using enzyme-linked immunosorbent assay (ELISA test in the laboratory. Repeated measurement and Spearman′s correlation coefficient analysis were used with α = 0.05. Exposure to the different levels of sound pressure resulted in different aldosterone concentrations and meanwhile an increase in the SPL did not affect the concentration of potassium. From 10:00 AM to 10:30 AM, as SPL increased, aldosterone concentrations did not increase significantly but from 13:30 PM to 14:00 PM, raised SPL led to a significant increase in aldosterone concentration. However, there was no correlation between the concentration of potassium and different factors. This study indicated that increases in SPLs affect aldosterone concentration but at the same time do not have significant effects on serum potassium level.

  14. Effect of felodipine on myocardial and renal injury induced by aldosterone-high salt hypertension in uninephrectomized rats

    Directory of Open Access Journals (Sweden)

    B.B. Matsubara

    2010-05-01

    Full Text Available It has been recently shown that calcium channel blockers might have a protective effect on cardiac fibrogenesis induced by aldosterone. The objective of this study was to evaluate the protective effect of felodipine, a dihydropyridine calcium channel blocker, against heart and kidney damage caused by aldosterone-high sodium intake in uninephrectomized rats. Wistar rats were divided into three groups: CNEP (uninephrectomized + 1% NaCl in the drinking water, N = 9; ALDO (same as CNEP group plus continuous infusion of 0.75 µg/h aldosterone, N = 12; ALDOF (same as ALDO group plus 30 mg·kg-1·day-1 felodipine in the drinking water, N = 10. All results were compared with those of age-matched, untreated rats (CTL group, N = 10. After 6 weeks, tail cuff blood pressure was recorded and the rats were killed for histological analysis. Blood pressure (mmHg was significantly elevated (P < 0.05 in ALDO (180 ± 20 and ALDOF (168 ± 13 compared to CTL (123 ± 12 and CNEP (134 ± 13. Heart damage (lesion scores - median and interquartile range was 7.0 (5.5-8.0 in ALDO and was fully prevented in ALDOF (1.5; 1.0-2.0. Also, left ventricular collagen volume fraction (% in ALDOF (2.9 ± 0.5 was similar to CTL (2.9 ± 0.5 and CNEP (3.4 ± 0.4 and decreased compared to ALDO (5.1 ± 1.6. Felodipine partially prevented kidney injury since the damage score for ALDOF (2.0; 2.0-3.0 was significantly decreased compared to ALDO (7.5; 4.0-10.5, although higher than CTL (null score. Felodipine has a protective effect on the myocardium and kidney as evidenced by decreased perivascular inflammation, myocardial necrosis and fibrosis.

  15. The effect of enalapril on furosemide-activated renin-angiotensin-aldosterone system in healthy dogs.

    Science.gov (United States)

    Lantis, A C; Ames, M K; Werre, S; Atkins, C E

    2015-10-01

    Studies in our laboratory have revealed that furosemide-induced RAAS activation, evaluated via the urine aldosterone-to-creatinine ratio (UAldo:C), was not attenuated by the coadministration of benazepril, while enalapril successfully suppressed amlodipine-induced urinary aldosterone excretion. This study was designed to evaluate the efficacy of enalapril in suppressing ACE activity and furosemide-induced circulating RAAS activation. Failure to do so would suggest that this failure may be a drug class effect. We hypothesized that enalapril would suppress ACE activity and furosemide-induced circulating RAAS activation. Sixteen healthy hound dogs. The effect of furosemide (2 mg/kg PO, q12 h; Group F) and furosemide plus enalapril (0.5 mg/kg PO, q12 h; Group FE) on circulating RAAS was determined by plasma ACE activity, 4-6 h post-treatment, and urinary A:C on days -1, -2, 1, 4, and 7. There was a significant increase in the average urine aldosterone-to-creatinine ratio (UAldo:C) after administration of furosemide (P furosemide-induced RAAS activation, as determined by the UAldo:C. While enalapril blunts ACE activity, the absence of circulating RAAS suppression may be due to angiotensin II reactivation, alternative RAAS pathways, and furosemide overriding concurrent ACE inhibition, all indicating the existence of aldosterone breakthrough (ABT). Along with similar findings with benazepril, it appears that failure to suppress aldosterone suppression with furosemide stimulation may be a drug class effect. The discrepancy between the current data and the documented benefits of enalapril likely reflects the efficacy of this ACE inhibitor in suppressing tissue RAAS, variable population responsiveness to ACE-inhibition, and/or providing additional survival benefits, possibly through as yet unknown mechanisms. © 2015 John Wiley & Sons Ltd.

  16. Effect of Moxonidine on the Aldosterone/Renin Ratio in Healthy Male Volunteers.

    Science.gov (United States)

    Ahmed, Ashraf H; Gordon, Richard D; Ward, Gregory; Wolley, Martin; McWhinney, Brett C; Ungerer, Jacobus P; Stowasser, Michael

    2017-06-01

    The most popular screening test for primary aldosteronism is the plasma aldosterone/renin ratio (ARR). Medications, dietary sodium, posture, and time of day all affect renin and aldosterone levels and can result in false-negative or false-positive ARRs if not controlled. Most antihypertensive medications affect the ARR and can interfere with interpretation of results. To our knowledge, no study has been undertaken to evaluate the effects of moxonidine on the ARR. Normotensive, nonmedicated male volunteers (n = 20) underwent measurement (seated, midmorning) of plasma aldosterone (by high-performance liquid chromatography-tandem mass spectrometry), direct renin concentration (DRC), plasma renin activity (PRA), cortisol, electrolytes and creatinine; and urinary aldosterone, cortisol, electrolytes and creatinine at baseline and after 1 week of moxonidine at 0.2 mg/d and a further 5 weeks at 0.4 mg/d. Compared with baseline, despite the expected significant falls in both systolic and diastolic blood pressure, levels of plasma aldosterone [median, 134 (range, 90 to 535) pmol/L], DRC [20 (10 to 37) mU/L], PRA [2.2 (1.0-3.8) ng/mL/h], and ARR using either DRC [8.0 (4.4 to 14.4)] or PRA [73 (36 to 218)] were not significantly changed after either 1 [135 (98-550) pmol/L, 20 (11-35) mU/L, 2.0 (1.2-4.1) ng/mL/h, 8.8 (4.2 to 15.9), and 73 (32-194), respectively] or 6 weeks [130 (90-500) pmol/L, 22 (8 to 40) mU/L, 2.1 (1.0 to 3.2) ng/mL/h, 7.7 (4.3 to 22.4), and 84 (32 to 192), respectively] of moxonidine. There were no changes in any urinary measurements. Moxonidine was associated with no significant change in the ARR and may therefore be a good option for maintaining control of hypertension when screening for primary aldosteronism.

  17. Aldosterone-induced kidney injury is mediated by NFκB activation.

    Science.gov (United States)

    Fukuda, Seiichi; Horimai, Chihiro; Harada, Kaori; Wakamatsu, Toshifumi; Fukasawa, Hiroshi; Muto, Susumu; Itai, Akiko; Hayashi, Matsuhiko

    2011-02-01

    Aldosterone induces inflammation and fibrosis in the kidney, while nuclear factor κB (NFκB) plays key roles in inflammation mediated by various cytokines. Here, we determined the roles of NFκB activation in aldosterone-induced kidney injury. We used unilaterally nephrectomized rats with or without continuous aldosterone infusion and 0.9% saline as drinking water for 3 weeks. IMD-1041, an IKKβ inhibitor, and spironolactone were orally administered to inhibit NFκB and mineralocorticoid receptor, respectively. The aldosterone-infused rats exhibited severe kidney injury, hypertension, and increased expression of pro-inflammatory and fibrotic proteins, osteopontin, fibrinogen, collagen type I, and PAI-1. Western blotting confirmed NFκB activation by aldosterone by the increased amount of p65 in the nuclear fraction of the kidney, and oral IMD-1041 prevented the kidney injury and lessened the increase in pro-inflammatory and fibrotic proteins without significant changes in blood pressures. In addition, changes in angiotensin-converting enzyme 2 (ACE2), which has been found to act as a protective factor in various kidney injury models, were examined. Immunofluorescence studies revealed the presence of ACE2 in the brush-border membrane of the proximal convoluted tubules and markedly blunted ACE2 staining in aldosterone-infused rats. The decrease in amount of ACE2 protein was confirmed by Western blotting, and IMD-1041 also prevented the decrease in ACE2. The administration of spironolactone also abolished the effects of aldosterone. Our results suggest that aldosterone induces kidney injury via activation of NFκB and mineralocorticoid receptor, and that decreased ACE2 expression may play an important role in aldosterone-induced kidney injury.

  18. Effects of treatment with β-blocker and aldosterone antagonist on central and peripheral haemodynamics and oxygenation in cirrhosis

    DEFF Research Database (Denmark)

    Winkler, Christine; Hobolth, Lise; Krag, Aleksander

    2011-01-01

    Patients with cirrhosis often exhibit abnormalities in cardiovascular regulation and oxygenation. Many of these patients are treated with β-blockers and aldosterone antagonists that may influence the regulation of systemic haemodynamics, but the specific effects on systemic haemodynamics and oxyg......Patients with cirrhosis often exhibit abnormalities in cardiovascular regulation and oxygenation. Many of these patients are treated with β-blockers and aldosterone antagonists that may influence the regulation of systemic haemodynamics, but the specific effects on systemic haemodynamics...

  19. Effect of Combined Hormonal Replacement Therapy on the Aldosterone/Renin Ratio in Postmenopausal Women.

    Science.gov (United States)

    Ahmed, Ashraf H; Gordon, Richard D; Ward, Gregory; Wolley, Martin; McWhinney, Brett C; Ungerer, Jacobus P; Stowasser, Michael

    2017-07-01

    Plasma aldosterone/renin ratio (ARR) is the most popular screening test for primary aldosteronism (PA). Because both estrogen and progesterone (including in oral contraceptive agents) affect aldosterone and renin levels, we studied the effects of combined hormonal replacement therapy (HRT) on ARR; renin was measured as both direct renin concentration (DRC) and plasma renin activity (PRA). Fifteen normotensive, healthy postmenopausal women underwent measurement (seated, midmorning) of plasma aldosterone, DRC, PRA, electrolytes, and creatinine and urinary aldosterone, cortisol, electrolytes, and creatinine at baseline and after 2 weeks and 6 weeks of treatment with combined HRT (conjugated estrogens 0.625 mg and medroxyprogesterone 2.5 mg daily). Combined HRT was associated with statistically significant increases in aldosterone [median (range): baseline, 150 (85 to 600); 2 weeks, 230 (129 to 790); 6 weeks, 434 (200 to 1200) pmol/L; P < 0.001 (Friedman test)] and PRA [2.3 (1.2 to 4.3), 3.8 (1.4 to 7.0), 5.1 (1.4 to 10.8) ng/mL/h, respectively; P < 0.001] but decreases in DRC [21 (10 to 31), 21 (10 to 39), and 14 (8.0 to 30) mU/L, respectively; P < 0.01], leading to increases in ARR calculated by DRC [7.8 (3.6 to 34.8), 11.4 (5.4 to 48.5), and 30.4 (10.5 to 90.2), respectively; P < 0.001]. The ARR calculated by DRC exceeded the cutoff value (70) in three patients after 6 weeks. There were no significant changes in ARR calculated by PRA [79 (26 to 184), 91 (23 to 166), and 88 (50 to 230), respectively; P = 0.282], plasma electrolytes and creatinine, or any urinary measurements. The combined oral HRT used in this study is capable of significantly increasing ARR with a risk of false-positive results during screening for PA but only if DRC (and not PRA) is used to calculate the ratio.

  20. Effect of Melatonin on the Renin-Angiotensin-Aldosterone System in l-NAME-Induced Hypertension.

    Science.gov (United States)

    Simko, Fedor; Baka, Tomas; Krajcirovicova, Kristina; Repova, Kristina; Aziriova, Silvia; Zorad, Stefan; Poglitsch, Marko; Adamcova, Michaela; Reiter, Russel J; Paulis, Ludovit

    2018-01-29

    The renin-angiotensin-aldosterone system (RAAS) is a dominant player in several cardiovascular pathologies. This study investigated whether alterations induced by l-NAME, (NLG)-nitro-l-arginine methyl ester, a nitric oxide synthase inhibitor, and the protective effect of melatonin are associated with changes in the RAAS. Four groups of 3-month-old male Wistar rats ( n = 10) were treated as follows for four weeks: untreated controls, rats treated with melatonin (10 mg/kg/day), rats treated with l-NAME (40 mg/kg/day), and rats treated with l-NAME + melatonin. l-NAME administration led to hypertension and left ventricular (LV) fibrosis in terms of enhancement of soluble, insoluble and total collagen concentration and content. Melatonin reduced systolic blood pressure enhancement and lowered the concentration and content of insoluble and total collagen in the LV. The serum concentration of angiotensin (Ang) 1-8 (Ang II) and its downstream metabolites were reduced in the l-NAME group and remained unaltered by melatonin. The serum aldosterone level and its ratio to Ang II (AA2-ratio) were increased in the l-NAME group without being modified by melatonin. We conclude that l-NAME-hypertension is associated with reduced level of Ang II and its downstream metabolites and increased aldosterone concentration and AA2-ratio. Melatonin exerts its protective effect in l-NAME-induced hypertension without affecting RAAS.

  1. Synergic effects of renin and aldosterone on right ventricular function in hypertension: a tissue Doppler study.

    Science.gov (United States)

    Gregori, Mario; Giammarioli, Benedetta; Tocci, Giuliano; Befani, Alberto; Ciavarella, Giuseppino Massimo; Ferrucci, Andrea; Paneni, Francesco

    2015-12-01

    Right ventricular dysfunction (RVD) is associated with poor cardiovascular outcome. The renin-angiotensin-aldosterone system is involved in alterations of the left ventricular geometry and function. Detrimental effects of the renin-angiotensin-aldosterone system on the right ventricular function are being postulated, but data supporting this assumption are still lacking. The aim of the study was to assess the impact of hyperreninemia, hyperaldosteronism or their combination on right ventricular function in hypertensive individuals. Plasma renin activity (PRA) and plasma aldosterone concentrations (PACs) were measured in 116 hypertensive patients, divided as follows: normal PRA and PAC (n = 38); high PRA and normal PAC (hypereninemia) (n = 26); normal PRA and high PAC (hyperaldosternism) (n = 27); high PRA and PAC (HRA) (n = 25). Echocardiographic evaluation of the left and right ventricles (RV), including tissue Doppler imaging, was performed. RVD was identified by tissue Doppler Imaging-derived Myocardial Performance Index, calculated with a multisegmental approach. Indices of the right ventricular structure and function, as well as the prevalence of RVD, were higher in hyperreninemia and hyperaldosternism groups as compared with the normal group, and a further increase was observed in the HRA patients. Regression models showed a similar risk of RVD in the hyperreninemia and hyperaldosternism patients, regardless of systemic and pulmonary pressure, as well as left ventricular dysfunction. Notably, patients with both hyperreninemia and hyperaldosternism exhibited the strongest association with RVD as compared with patients with only hyperreninemia or hyperaldosternism. Isolated hyperreninemia or hyperaldosternism determines a similar impairment of the right ventricular function, whereas their combination is further detrimental. Renin and aldosterone may represent early biomarkers of right ventricular dysfunction in hypertension.

  2. Aldosterone in Metabolic Alkalosis*

    Science.gov (United States)

    Kassirer, Jerome P.; Appleton, Frederick M.; Chazan, Joseph A.; Schwartz, William B.

    1967-01-01

    Studies have been carried out in human volunteer subjects to evaluate the role of aldosterone in the development, maintenance, and correction of metabolic alkalosis induced by selective depletion of hydrochloric acid. During the first phase of our study the rate of aldosterone secretion was measured before the induction of alkalosis (while the subjects were on a low salt diet) and again after a steady state of metabolic alkalosis had been established. The data demonstrate a fall in aldosterone secretion from a value of approximately 500 μg/day to a value of approximately 200 μg/day. Thus, it appears that an increased rate of aldosterone secretion is not a prerequisite to the elevation of the renal bicarbonate threshold. During the second phase of our study, aldosterone was administered to the alkalotic subjects in doses of 1000 μg/day (or deoxycorticosterone acetate in doses of 40 mg/day) in order to determine the effects of a persistent steroid excess on the ability of sodium chloride to correct the acid-base disturbance. The data demonstrate that despite the administration of steroid, the ingestion of sodium chloride led to a reduction in plasma bicarbonate concentration from 39 to 29 mEq/liter, accompanied by a suppression of renal acid excretion. This reduction in plasma bicarbonate concentration occurred without a concomitant retention of potassium, a deficit of as much as 400-500 mEq of potassium persisting during repair of the acid-base disturbance. Our findings suggest that “saline-resistant” alkalosis, when it occurs in the absence of primary hyperadrenalism, cannot be attributed to aldosterone excess and/or potassium depletion of the magnitude seen in our study. We also suggest the need for a reappraisal of the way in which aldosterone excess contributes to the genesis and maintenance of alkalosis in primary aldosteronism. PMID:6061733

  3. Mizoribine ameliorates renal injury and hypertension along with the attenuation of renal caspase-1 expression in aldosterone-salt-treated rats.

    Science.gov (United States)

    Doi, Toshiki; Doi, Shigehiro; Nakashima, Ayumu; Ueno, Toshinori; Yokoyama, Yukio; Kohno, Nobuoki; Masaki, Takao

    2014-01-01

    Aldosterone-salt treatment induces not only hypertension but also extensive inflammation that contributes to fibrosis in the rat kidney. However, the mechanism underlying aldosterone-salt-induced renal inflammation remains unclear. Pyroptosis has recently been identified as a new type of cell death that is accompanied by the activation of inflammatory cytokines. We hypothesized that aldosterone-salt treatment could induce inflammation through pyroptosis and that mizoribine, an effective immunosuppressant, would ameliorate the renal inflammation that would otherwise cause renal fibrosis. Ten days after recovery from left uninephrectomy, rats were given drinking water with 1% sodium chloride. The animals were divided into three groups (n = 7 per group): (1) vehicle infusion group, (2) aldosterone infusion group, or (3) aldosterone infusion plus oral mizoribine group. Aldosterone-salt treatment increased the expression of the nucleotide-binding oligomerization domain, leucine-rich repeat and pyrin domain containing 3 and caspase-1, and also increased the number of terminal deoxynucleotidyl transferase dUTP nick end labeling-positive cells. However, the oral administration of mizoribine attenuated these alterations. Furthermore, mizoribine inhibited hypertension and renal fibrosis, and also attenuated the aldosterone-induced expression of serum/glucocorticoid-regulated kinase and α epithelial sodium channel. These results suggest that caspase-1 activation plays an important role in the development of inflammation induced by aldosterone-salt treatment and that it functions as an anti-inflammatory strategy that protects against renal injury and hypertension.

  4. Quality of Life in Primary Aldosteronism: a Comparative Effectiveness Study of Adrenalectomy and Medical Treatment.

    Science.gov (United States)

    Velema, Marieke; Dekkers, Tanja; Hermus, Ad; Timmers, Henri; Lenders, Jacques; Groenewoud, Hans; Schultze Kool, Leo; Langenhuijsen, Johan; Prejbisz, Aleksander; van der Wilt, Gert-Jan; Deinum, Jaap

    2017-11-01

    In primary aldosteronism (PA) two subtypes are distinguished: aldosterone-producing adenoma and bilateral adrenal hyperplasia. In general these are treated by adrenalectomy and mineralocorticoid receptor antagonists respectively. To compare the effects of surgical treatment and medical treatment on quality of life (QoL). Post-hoc comparative effectiveness study within the SPARTACUS trial. Twelve Dutch hospitals and one Polish hospital. Patients with PA (n=184). Adrenalectomy or mineralocorticoid receptor antagonists. At baseline, six months and one year follow-up we assessed QoL by two validated questionnaires. At baseline, seven out of eight RAND SF-36 subscales and both summary scores and three out of five EQ-5D dimensions and the visual analogue scale were lower in PA patients compared to the general population, especially in women. The beneficial effects of adrenalectomy were larger than for mineralocorticoid receptor antagonists for seven RAND SF-36 subscales, both summary scores, and health change. For the EQ-5D, we detected a difference in favor of adrenalectomy in two dimensions and the visual analogue scale. Most differences in QoL between both treatments exceeded the minimally clinically important difference. After one year almost all QoL measures had normalized for adrenalectomized patients. For patients on medical treatment most QoL measures had improved, but not all to the level of the general population. Both treatments improve QoL in PA, underscoring the importance of identifying these patients. QoL improved more after adrenalectomy for suspected aldosterone-producing adenoma than after initiation of medical treatment of suspected bilateral adrenal hyperplasia.

  5. Beneficial long-term effect of aldosterone antagonist added to a traditional blockade of the renin-angiotensin-aldosterone system among patients with obesity and proteinuria.

    Science.gov (United States)

    Morales, Enrique; Gutiérrez, Eduardo; Caro, Jara; Sevillano, Angel; Rojas-Rivera, Jorge; Praga, Manuel

    2015-01-01

    Over the past decade, obesity has become a risk factor for developing chronic kidney disease. Proteinuria is known to be an independent determinant of the progression of chronic kidney disease, and adipose tissue is a recognized source of components of the renin-angiotensin-aldosterone system (RAAS). Recent studies have shown that plasma aldosterone levels are disproportionately higher in patients with obesity. Drugs that block the RAAS are unable to inhibit aldosterone in the long term. The aim of our study was to analyze the renoprotective effect of an aldosterone antagonist in combination with RAAS blockers in patients with obesity and proteinuric nephropathy. This study is a substudy of previously published study on the renoprotective effect of mineralocorticoid receptor blockers in patients with proteinuric nephropathies. Patients with proteinuria levels >1g/24h who were taking spironolactone and were being treated with other RAAS blockers were divided according to body mass index (BMI) into an obesity group (BMI ≥30kg/m2) and a control group. Seventy-one patients were included in the study, with a mean age of 56.7±15.1 years. More than 50% of the patients in both groups had diabetes. Thirty-two patients were included in the obesity group and 39 were included in the control group. There were no significant differences in renal function, proteinuria, blood pressure, serum potassium levels and the percentage of RAAS blockers in both groups. After a follow-up of 28.9 (14-84) months, there was a 59.4% reduction in proteinuria in the obesity group (2.8±2.1 vs. 1.3±1.6g/24h, p<.05). The reduction in proteinuria was greater than 50% in 22 (68.8%) cases, and the mean blood pressure showed a significant decrease (from 100.6±9 to 92.1±7.4mm Hg, p<.05). The control group showed a 69.6% reduction in proteinuria (1.9±1.4 to 0.8±0.5, p<0.05). The reduction of proteinuria was higher than 50% in 22 (68.8%) cases in obese patients and in 33 (84.6%) cases in non

  6. Effect of Dual Blockade of Renin-Angiotensin Aldosterone System ...

    African Journals Online (AJOL)

    Purpose: To investigate the dual effect of angiotensin blockade by irbesartan and enalapril on proteinuria in diabetic patients with azotemia. Methods: Patients with diabetes of > 5 years duration, proteinuria at a nephrotic level and serum creatinine > 1.5 mg/dL were enrolled in the study. Forty-five enrolled patients were ...

  7. Effects of Dobutamine Infusion on Mitral Regurgitation.

    Science.gov (United States)

    Sonoda, Makoto; Takenaka, Katsu; Sakamoto, Tsuguya; Watanabe, Fumiyoshi; Nakajima, Yoshie; Yang, Wei Dong; Omata, Masao

    1998-01-01

    Both intensity of mitral regurgitant murmur and color-coded Doppler regurgitant signal area have been reported to correlate with the degree of regurgitation. To evaluate the relationship between the intensity of regurgitant murmur and severity of mitral regurgitation, phonocardiography, echocardiography, and Doppler ultrasound were performed in 18 patients with mitral regurgitation before and during dobutamine infusion. Mitral regurgitation was due to mitral valve prolapse with ruptured chordae tendineae in 8 patients, rheumatic change in 5 patients, and dilated cardiomyopathy in 5 patients. With intravenous dobutamine infusion, heart rate (77-103 beats/min), systolic blood pressure (119-144 mmHg), peak mitral regurgitant jet velocity (4.5-5.4 m/sec), intensity of mitral regurgitant murmur (to 201% of that before infusion in early systole) increased, while left ventricular end-diastolic volume (124-102 mm), left ventricular end-systolic volume (57-42 mm), mitral anular diameter (33-28 mm), and color Doppler mitral regurgitant signal area (704-416 mm(2)) decreased (P flow/beat, regardless of etiology of mitral regurgitation, which was probably due to the decrease of left ventricular size and mitral annular diameter. Although total (forward + backward) left ventricular stroke volume was unchanged, dobutamine effectively increased forward left ventricular stroke volume by decreasing backward regurgitation. Mitral regurgitant murmur became louder despite the decrease of mitral regurgation, indicating the uselessness of auscultation in the grading of the severity of mitral regurgitation.

  8. Evaluation of the effects of various sound pressure levels on the level of serum aldosterone concentration in rats

    Directory of Open Access Journals (Sweden)

    Parvin Nassiri

    2017-01-01

    Full Text Available Introduction: Noise exposure may have anatomical, nonauditory, and auditory influences. Considering nonauditory impacts, noise exposure can cause alterations in the automatic nervous system, including increased pulse rates, heightened blood pressure, and abnormal secretion of hormones. The present study aimed at examining the effect of various sound pressure levels (SPLs on the serum aldosterone level among rats. Materials and Methods: A total of 45 adult male rats with an age range of 3 to 4 months and a weight of 200 ± 50 g were randomly divided into 15 groups of three. Three groups were considered as the control groups and the rest (i.e., 12 groups as the case groups. Rats of the case groups were exposed to SPLs of 85, 95, and 105 dBA. White noise was used as the noise to which the rats were exposed. To measure the level of rats’ serum aldosterone, 3 mL of each rat’s sample blood was directly taken from the heart of anesthetized animals by using syringes. The taken blood samples were put in labeled test tubes that contained anticoagulant Ethylenediaminetetraacetic acid. In the laboratory, the level of aldosterone was assessed through Enzyme-linked immunosorbent assay protocol. The collected data were analyzed by the use of Statistical Package for Social Sciences (SPSS version 18. Results: The results revealed that there was no significant change in the level of rats’ serum aldosterone as a result of exposure to SPLs of 65, 85, and 95 dBA. However, the level of serum aldosterone experienced a remarkable increase after exposure to the SPL of 105 dBA (P < 0.001. Thus, the SPL had a significant impact on the serum aldosterone level (P < 0.001. In contrast, the exposure time and the level of potassium in the used water did not have any measurable influence on the level of serum aldosterone (P = 0.25 and 0.39. Conclusion: The findings of this study demonstrated that serum aldosterone can be used as a biomarker in the face of sound

  9. Evaluation of the effects of various sound pressure levels on the level of serum aldosterone concentration in rats.

    Science.gov (United States)

    Nassiri, Parvin; Zare, Sajad; Monazzam, Mohammad R; Pourbakht, Akram; Azam, Kamal; Golmohammadi, Taghi

    2017-01-01

    Noise exposure may have anatomical, nonauditory, and auditory influences. Considering nonauditory impacts, noise exposure can cause alterations in the automatic nervous system, including increased pulse rates, heightened blood pressure, and abnormal secretion of hormones. The present study aimed at examining the effect of various sound pressure levels (SPLs) on the serum aldosterone level among rats. A total of 45 adult male rats with an age range of 3 to 4 months and a weight of 200 ± 50 g were randomly divided into 15 groups of three. Three groups were considered as the control groups and the rest (i.e., 12 groups) as the case groups. Rats of the case groups were exposed to SPLs of 85, 95, and 105 dBA. White noise was used as the noise to which the rats were exposed. To measure the level of rats' serum aldosterone, 3 mL of each rat's sample blood was directly taken from the heart of anesthetized animals by using syringes. The taken blood samples were put in labeled test tubes that contained anticoagulant Ethylenediaminetetraacetic acid. In the laboratory, the level of aldosterone was assessed through Enzyme-linked immunosorbent assay protocol. The collected data were analyzed by the use of Statistical Package for Social Sciences (SPSS) version 18. The results revealed that there was no significant change in the level of rats' serum aldosterone as a result of exposure to SPLs of 65, 85, and 95 dBA. However, the level of serum aldosterone experienced a remarkable increase after exposure to the SPL of 105 dBA (P < 0.001). Thus, the SPL had a significant impact on the serum aldosterone level (P < 0.001). In contrast, the exposure time and the level of potassium in the used water did not have any measurable influence on the level of serum aldosterone (P = 0.25 and 0.39). The findings of this study demonstrated that serum aldosterone can be used as a biomarker in the face of sound exposure.

  10. Aldosterone blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003704.htm Aldosterone blood test To use the sharing features on this page, please enable JavaScript. The aldosterone blood test measures the level of the hormone aldosterone in ...

  11. Rapid non-genomic effects of aldosterone on rodent vascular function

    DEFF Research Database (Denmark)

    Uhrenholt, T R; Schjerning, J; Rasmussen, L E

    2004-01-01

    The main role of aldosterone is to maintain body sodium homeostasis by promoting salt reabsorption in the collecting ducts of the kidney. In the cardiovascular system, aldosterone may be harmful in a number of disease states by inducing fibrosis and vascular dysfunction. The present review...

  12. Effect of Insulin Infusion on Liver Protein Synthesis during Hemodialysis

    DEFF Research Database (Denmark)

    Reinhard, Mark; Frystyk, Jan; Jespersen, Bente

    2011-01-01

    Background Hemodialysis (HD) is a catabolic procedure that may contribute to the high frequency of protein-energy wasting among patients receiving maintenance HD. The present study investigated the additional effect of glucose and glucose-insulin infusion on liver protein synthesis during HD...... compared with a meal alone. Methods In a randomized cross-over study with three arms, 11 non-diabetic HD patients were assigned to receive a conventional HD session with either: • no treatment (NT) • IV infusion of glucose (G) • IV infusion of glucose-insulin (GI) During infusions blood glucose levels were...... maintained at 8.0-10.0 mmol/L by additional glucose infusion. Glucose and glucose-insulin infusions were commenced 2 h prior to HD and continued throughout the HD session. Fasting blood samples were collected at baseline before infusion and followed by the only meal allowed during the study. Results Blood...

  13. Esmolol infusion versus propranolol infusion: effects on heart rate and blood pressure in healthy volunteers.

    Science.gov (United States)

    Muller, Matthew D; Ahmad, Tariq Ali; Vargas Pelaez, Alvaro F; Proctor, David N; Bonavia, Anthony S; Luck, J Carter; Maman, Stephan R; Ross, Amanda J; Leuenberger, Urs A; McQuillan, Patrick M

    2017-03-01

    Despite its widespread clinical use, the β1-adrenergic receptor antagonist esmolol hydrochloride is not commonly used in human physiology research, and the effective dose of esmolol (compared with the nonselective β-blocker propranolol) is unclear. In four separate studies we used cycle ergometry exercise and infusions of isoproterenol and epinephrine to test the heart rate (HR)-lowering effect of esmolol compared with propranolol and saline in healthy humans. In cohort 1, both esmolol (ΔHR 57 ± 6 beats/min) and propranolol (ΔHR 56 ± 7 beats/min) attenuated exercise tachycardia compared with saline (ΔHR 88 ± 17 beats/min). In cohort 2, we found that the HR response to exercise was similar at 5 min (ΔHR 57 ± 9 beats/min) and 60 min (ΔHR 55 ± 9 beats/min) after initiation of the esmolol maintenance infusion. In cohort 3, we confirmed that the HR-lowering effect of esmolol disappeared 45 min after termination of the maintenance infusion. In cohort 4, changes in femoral blood flow and hematological parameters in response to epinephrine infusion were not different between esmolol and saline infusion, indicating that our esmolol infusion paradigm does not block β2-receptors. Collectively, our data indicate that infusion of ~160 mg of esmolol (range 110-200 mg in the 5 min before exercise) acutely and selectively blocks β1-receptors in healthy humans. Additionally, β1-receptors remain blocked 60 min later if a maintenance infusion of ~0.2 mg·kg total body mass-1·min-1 continues. The current data lay the foundation for future studies to evaluate β1- vs. β2-receptor control of the circulation in humans.NEW & NOTEWORTHY We used cycle ergometry exercise and infusions of isoproterenol and epinephrine to test the heart rate-lowering effect of esmolol compared with propranolol and saline in healthy humans. Collectively, our data indicate that infusion of ~160 mg of esmolol (range 110-200 mg in the 5 min before exercise) acutely and selectively blocks β1

  14. Moderate inappropriately high aldosterone/NaCl constellation in mice: cardiovascular effects and the role of cardiovascular epidermal growth factor receptor.

    Science.gov (United States)

    Schreier, Barbara; Rabe, Sindy; Winter, Sabrina; Ruhs, Stefanie; Mildenberger, Sigrid; Schneider, Bettina; Sibilia, Maria; Gotthardt, Michael; Kempe, Sabine; Mäder, Karsten; Grossmann, Claudia; Gekle, Michael

    2014-12-11

    Non-physiological activation of the mineralocorticoid receptor (MR), e.g. by aldosterone under conditions of high salt intake, contributes to the pathogenesis of cardiovascular diseases, although beneficial effects of aldosterone also have been described. The epidermal growth factor receptor (EGFR) contributes to cardiovascular alterations and mediates part of the MR effects. Recently, we showed that EGFR is required for physiological homeostasis and function of heart and arteries in adult animals. We hypothesize that moderate high aldosterone/NaCl, at normal blood pressure, affects the cardiovascular system depending on cardiovascular EGFR. Therefore we performed an experimental series in male and female animals each, using a recently established mouse model with EGFR knockout in vascular smooth muscle cells and cardiomyocytes and determined the effects of a mild-high aldosterone-to-NaCl constellation on a.o. marker gene expression, heart size, systolic blood pressure, impulse conduction and heart rate. Our data show that (i) cardiac tissue of male but not of female mice is sensitive to mild aldosterone/NaCl treatment, (ii) EGFR knockout induces stronger cardiac disturbances in male as compared to female animals and (iii) mild aldosterone/NaCl treatment requires the EGFR in order to disturb cardiac tissue homeostasis whereas beneficial effects of aldosterone seem to be independent of EGFR.

  15. Aldosterone and pressor responses to angiotensin II in primary hyperparathyroidism.

    Science.gov (United States)

    Fallo, F; Rocco, S; Pagotto, U; Zangari, M; Luisetto, G; Mantero, F

    1989-12-01

    The aim of this study was to assess the effect of hypercalcaemia due to primary hyperparathyroidism on the pressor and aldosterone responses to angiotensin II (Ang II) infusion. Five patients with hyperparathyroidism were studied, before and after parathyroidectomy, and were compared with five normal subjects. After 30 min of equilibration, Asp1-Val5 Ang II was infused in all subjects at stepwise increasing dose rates of 2 and 4 ng/kg per min for 30 min each. In the hyperparathyroid patients the baseline levels of plasma parathyroid hormone and calcium were significantly higher than in the controls, and returned to normal after the parathyroidectomy; plasma aldosterone and renin activity were normal both before and after the parathyroidectomy. Two hyperparathyroid patients had high blood pressure levels, which were normalized after surgery. The increase in the aldosterone response from baseline at each time point of the Ang II infusion was greater in the hyperparathyroid patients before than after the operation (P less than 0.05), and greater than in the normals (P less than 0.05). No difference in the increased response of systolic or diastolic blood pressure was observed between the hyperparathyroid patients, either before or after the parathyroidectomy, and the normal subjects. High levels of extracellular calcium or parathyroid hormone, or both, might play a primary role in the aldosterone hyper-responsiveness to Ang II in the hyperparathyroid patients. The similar pressor response to Ang II in hyperparathyroid patients and the normal subjects suggests that hypercalcaemia does not potentiate the vasoconstrictive action of Ang II.

  16. Effects of low-sodium diet vs. high-sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride (Cochrane Review)

    DEFF Research Database (Denmark)

    Graudal, Niels A; Hubeck-Graudal, Thorbjørn; Jürgens, Gesche

    2012-01-01

    The question of whether reduced sodium intake is effective as a health prophylaxis initiative is unsolved. The purpose was to estimate the effects of low-sodium vs. high-sodium intake on blood pressure (BP), renin, aldosterone, catecholamines, and lipids.......The question of whether reduced sodium intake is effective as a health prophylaxis initiative is unsolved. The purpose was to estimate the effects of low-sodium vs. high-sodium intake on blood pressure (BP), renin, aldosterone, catecholamines, and lipids....

  17. Diuretic effect of compounds from Hibiscus sabdariffa by modulation of the aldosterone activity.

    Science.gov (United States)

    Jiménez-Ferrer, Enrique; Alarcón-Alonso, Javier; Aguilar-Rojas, Arturo; Zamilpa, Alejandro; Jiménez-Ferrer C, Itzia; Tortoriello, Jaime; Herrera-Ruiz, Maribel

    2012-12-01

    Recent studies of Hibiscus sabdariffa Linn. have demonstrated that it presents diuretic, natriuretic, and potassium sparing effects. However, the mechanism that induces these effects has not yet been elucidated. The aim of this study was to explore the possible mechanism of action for the diuretic effect of Hibiscus sabdariffa extract and its fractions.The aqueous extract from this plant and the fractions obtained with solvents of different polarities were administered to adrenalectomized rats, and the diuretic effect was measured in the presence of deoxycorticosterone acetate (aldosterone analog).The effect on renal filtration was also evaluated in an in situ kidney model, and finally, the effect of diuretic active extracts on gene expression of the alpha subunit from the transporter (αENaC) of renal epithelial cell was quantified. The subsequent results were obtained: The aqueous extract of Hibiscus sabdariffa presented the following chemical composition, 32.4 mg/g delphinidin-3-O-sambubioside, 11.5 mg/g cyanidin-3-O-sambubioside, 11.5 mg/g quercetin, and chlorogenic acid 2.7 mg/g. The concentration of anthocyanins was diminished until disappearance due to decrease of the polarity of the solvents used in the extraction process, in contrast to the flavonoids and chlorogenic acid, which had their concentration increased. The diuretic effect caused by adrenalectomy in rats was reversed by deoxycorticosterone acetate activity. However, the effect of deoxycorticosterone acetate was antagonized by spironolactone, the aqueous extract of Hibiscus sabdariffa, and the acetonitrile : methanol 5 : 5 mixture extract, administered orally. A similar effect was observed on renal filtration obtained from the isolated kidney model.When the gene expression levels of αENaC was measured in adrenalectomized rats, it was observed that spironolactone, the aqueous extract of Hibiscus sabdariffa, the acetonitrile : methanol 5 : 5 mixture, as well as the

  18. Effect of perioperative insulin infusion on surgical morbidity and mortality

    DEFF Research Database (Denmark)

    Gandhi, Gunjan Y; Murad, M Hassan; Flynn, Errol David

    2008-01-01

    To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients.......To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients....

  19. Suppressive effects of RXR agonist PA024 on adrenal CYP11B2 expression, aldosterone secretion and blood pressure.

    Directory of Open Access Journals (Sweden)

    Dai Suzuki

    Full Text Available The effects of retinoids on adrenal aldosterone synthase gene (CYP11B2 expression and aldosterone secretion are still unknown. We therefore examined the effects of nuclear retinoid X receptor (RXR pan-agonist PA024 on CYP11B2 expression, aldosterone secretion and blood pressure, to elucidate its potential as a novel anti-hypertensive drug. We demonstrated that PA024 significantly suppressed angiotensin II (Ang II-induced CYP11B2 mRNA expression, promoter activity and aldosterone secretion in human adrenocortical H295R cells. Human CYP11B2 promoter functional analyses using its deletion and point mutants indicated that the suppression of CYP11B2 promoter activity by PA024 was in the region from -1521 (full length to -106 including the NBRE-1 and the Ad5 elements, and the Ad5 element may be mainly involved in the PA024-mediated suppression. PA024 also significantly suppressed the Ang II-induced mRNA expression of transcription factors NURR1 and NGFIB that bind to and activate the Ad5 element. NURR1 overexpression demonstrated that the decrease of NURR1 expression may contribute to the PA024-mediated suppression of CYP11B2 transcription. PA024 also suppressed the Ang II-induced mRNA expression of StAR, HSD3β2 and CYP21A2, a steroidogenic enzyme group involved in aldosterone biosynthesis. Additionally, the PA024-mediated CYP11B2 transcription suppression was shown to be exerted via RXRα. Moreover, the combination of PPARγ agonist pioglitazone and PA024 caused synergistic suppressive effects on CYP11B2 mRNA expression. Finally, PA024 treatment significantly lowered both the systolic and diastolic blood pressure in Tsukuba hypertensive mice (hRN8-12 x hAG2-5. Thus, RXR pan-agonist PA024 may be a candidate anti-hypertensive drugs that acts via the suppression of aldosterone synthesis and secretion.

  20. Effect of volume loading with 1 liter intravenous infusions of 0.9% saline, 4% succinylated gelatine (Gelofusine) and 6% hydroxyethyl starch (Voluven) on blood volume and endocrine responses: a randomized, three-way crossover study in healthy volunteers.

    Science.gov (United States)

    Lobo, Dileep N; Stanga, Zeno; Aloysius, Mark M; Wicks, Catherine; Nunes, Quentin M; Ingram, Katharine L; Risch, Lorenz; Allison, Simon P

    2010-02-01

    To study the changes in blood volume and hormones controlling sodium and water homeostasis after infusions of 0.9% saline, Gelofusine (4% succinylated gelatin in 0.7% saline, weight-average molecular weight 30 kD), and Voluven (6% hydroxyethyl starch in 0.9% saline, weight-average molecular weight 130 kD) in healthy volunteers. Randomized, three-way crossover study. University teaching hospital. Ten healthy adult male volunteers. Volunteers received 1-L infusions of 0.9% saline, Gelofusine, and Voluven over 1 hr on three occasions. Body weight, hematocrit, serum biochemistry, and plasma concentrations of vasopressin, aldosterone, brain natriuretic peptide, and total renin were measured before infusion and hourly thereafter for 6 hrs. Changes in body water, blood volume, and extravascular fluid volume were calculated. Although changes in body weight (total body water) after the infusions were similar, blood volume expansion by the two colloids was significantly greater than that produced by 0.9% saline (p < .01). At the end of infusions, 68%, 21%, and 16% of the infused volumes of 0.9% saline, Gelofusine, and Voluven, respectively, had escaped from the intravascular space to the extravascular space. Over the 6 hrs, the magnitude and duration of blood volume expansion by the two colloids were similar (p = .70). There were no significant differences in urinary volume, osmolality, and sodium content after the three infusions. Hormonal changes were similar after the three infusions, with the increase in natriuretic peptide being transient. The reduction in aldosterone and total renin concentrations was more sustained. The effects of Gelofusine and Voluven were similar despite the 100 kD difference in weight-average molecular weight. Excretion of an acute fluid load containing sodium and chloride may be dependent on a sustained suppression of the renin-angiotensin-aldosterone system rather than on natriuretic peptides.

  1. Increased microparticle production and impaired microvascular endothelial function in aldosterone-salt-treated rats: protective effects of polyphenols.

    Directory of Open Access Journals (Sweden)

    Natalia López Andrés

    Full Text Available We aimed to characterize circulating microparticles in association with arterial stiffness, inflammation and endothelial dysfunction in aldosterone-salt-induced hypertension in rats and to investigate the preventive effects of red wine polyphenols. Uninephrectomized male Sprague-Dawley rats were treated with aldosterone-salt (1 µg.h(-1, with or without administration of either red wine polyphenols, Provinols™ (20 mg.kg(-1.day(-1, or spironolactone (30 mg.kg(-1.day(-1 for 4 weeks. Microparticles, arterial stiffness, nitric oxide (NO spin trapping, and mesenteric arterial function were measured. Aldosterone-salt rats showed increased microparticle levels, including those originating from platelets, endothelium and erythrocytes. Hypertension resulted in enhanced aortic stiffness accompanied by increased circulating and aortic NO levels and an upregulation of aortic inducible NO-synthase, NFκB, superoxide anions and nitrotyrosine. Flow-induced dilatation was reduced in mesenteric arteries. These effects were prevented by spironolactone. Provinols™ did not reduce arterial stiffness or systolic hypertension but had effects similar to those of spironolactone on endothelial function assessed by flow-mediated vasodilatation, microparticle generation, aortic NO levels and oxidative stress and apoptosis in the vessel wall. Neither the contractile response nor endothelium-dependent relaxation in mesenteric arteries differed between groups. The in vivo effects of Provinols™ were not mediated by mineralocorticoid receptors or changes in shear stress. In conclusion, vascular remodelling and endothelial dysfunction in aldosterone-salt-mediated hypertension are associated with increased circulating microparticles. Polyphenols prevent the enhanced release of microparticles, macrovascular inflammation and oxidative stress, and microvascular endothelial dysfunction independently of blood pressure, shear stress and mineralocorticoid receptor activation in a

  2. Beneficial long-term effect of aldosterone antagonist added to a traditional blockade of the renin–angiotensin–aldosterone system among patients with obesity and proteinuria

    Directory of Open Access Journals (Sweden)

    Enrique Morales

    2015-11-01

    Conclusion: Aldosterone antagonist treatment in obese patients with proteinuric nephropathies induces a drastic and sustained reduction in proteinuria but not more than the non-obese group. There was a trend toward slowing progression of renal failure with few adverse events.

  3. The Aldosterone-Mineralocorticoid Receptor Pathway Exerts Anti-Inflammatory Effects in Endotoxin-Induced Uveitis

    Science.gov (United States)

    Ly, André; Leroux les Jardins, Guillaume; Goldenberg, Brigitte; Naud, Marie-Christine; Jonet, Laurent; Besson-Lescure, Bernadette; Jaisser, Frederic; Farman, Nicolette; De Kozak, Yvonne; Behar-Cohen, Francine

    2012-01-01

    We have previously shown that the eye is a mineralocorticoid-sensitive organ and we now question the role of mineralocorticoid receptor (MR) in ocular inflammation. The endotoxin-induced uveitis (EIU), a rat model of human intraocular inflammation, was induced by systemic administration of lipopolysaccharide (LPS). Evaluations were made 6 and 24 hours after intraocular injection of aldosterone (simultaneous to LPS injection). Three hours after onset of EIU, the MR and the glucocorticoid metabolizing enzyme 11-beta hydroxysteroid dehydrogenase type 2 (11β-HSD2) expression were down-regulated in iris/ciliary body and the corticosterone concentration was increased in aqueous humor, altering the normal MR/glucocorticoid receptor (GR) balance. At 24 hours, the GR expression was also decreased. In EIU, aldosterone reduced the intensity of clinical inflammation in a dose-dependent manner. The clinical benefit of aldosterone was abrogated in the presence of the MR antagonist (RU26752) and only partially with the GR antagonist (RU38486). Aldosterone reduced the release of inflammatory mediators (6 and 24 hours: TNF-α, IFN-γ, MIP-1α) in aqueous humor and the number of activated microglia/macrophages. Aldosterone partly prevented the uveitis-induced MR down-regulation. These results suggest that MR expression and activation in iris/ciliary body could protect the ocular structures against damages induced by EIU. PMID:23152847

  4. Aldosterone as a renal growth factor.

    LENUS (Irish Health Repository)

    Thomas, Warren

    2011-04-05

    Aldosterone regulates blood pressure through its effects on the cardiovascular system and kidney. Aldosterone can also contribute to the development of hypertension that leads to chronic pathologies such as nephropathy and renal fibrosis. Aldosterone directly modulates renal cell proliferation and differentiation as part of normal kidney development. The stimulation of rapidly activated protein kinase cascades is one facet of how aldosterone regulates renal cell growth. These cascades may also contribute to myofibroblastic transformation and cell proliferation observed in pathological conditions of the kidney. Polycystic kidney disease is a genetic disorder that is accelerated by hypertension. EGFR-dependent proliferation of the renal epithelium is a factor in cyst development and trans-activation of EGFR is a key feature in initiating aldosterone-induced signalling cascades. Delineating the components of aldosterone-induced signalling cascades may identify novel therapeutic targets for proliferative diseases of the kidney.

  5. Effect of intravenous dexmedetomidine infusion on some ...

    African Journals Online (AJOL)

    Ahmed G. Yacout

    2011-12-17

    Dec 17, 2011 ... a. , Mohamed M. Elsawy b a Anaesthesia and Surgical Intensive Care Department, Faculty of Medicine, Alexandria University, Egypt ... idine infusion in patients undergoing major abdominal surgery on stress response markers as plasma interleukin-6 ..... scopic bariatric surgery. J Gastrointest Surg 2007 ...

  6. Aldosterone and Renin Test

    Science.gov (United States)

    ... You may be instructed to follow a high-salt diet for three days, then have your aldosterone and ... aldosterone level measured. You may follow a high-salt diet and be administered a synthetic corticosteroid called fludrocortisone, ...

  7. Accelerated infliximab infusions for inflammatory bowel disease improve effectiveness.

    Science.gov (United States)

    McConnell, John; Parvulescu-Codrea, Simona; Behm, Brian; Hill, Beth; Dunkle, Elizabeth; Finke, Karen; Snyder, Kathryn; Tuskey, Anne; Cox, Debbie; Woodward, Beth

    2012-10-06

    To study the safety and effectiveness associated with accelerated infliximab infusion protocols in patients with inflammatory bowel disease (IBD). Original protocols and infusion rates were developed for the administration of infliximab over 90-min and 60-min. Then the IBD patients on stable maintenance infliximab therapy were offered accelerated infusions. To be eligible for the study, patients needed a minimum of four prior infusions. An initial infusion of 90-min was given to each patient; those tolerating the accelerated infusion were transitioned to a 60-min infusion protocol at their next and all subsequent visits. Any patient having significant infusion reactions would be reverted to the standard 120-min protocol. A change in a patient's dose mandated a single 120-min infusion before accelerated infusions could be administered again. The University of Virginia Medical Center's Institutional Review Board approved this study. Fifty IBD patients treated with infliximab 5 mg/kg, 7.5 mg/kg and 10 mg/kg were offered accelerated infusions. Forty-six patients consented to participate in the study. Nineteen (41.3%) were female, five (10.9%) were African American and nine (19.6%) had ulcerative colitis. The mean age was 42.6 years old. Patients under age 18 were excluded. Ten patients used immunosuppressive drugs concurrently out of which six were taking azathioprine, three were taking 6-mercaptopurine and one was taking methotrexate. One of the 46 study patients used corticosteroid therapy for his IBD. Seventeen of the patients used prophylactic medications prior to receiving infusions; six patients received corticosteroids as pre-medication. Four patients had a history of distant transfusion reactions to infliximab. These reactions included shortness of breath, chest tightness, flushing, pruritus and urticaria. These patients all took prophylactic medications before receiving infusions. 46 patients (27 males and 19 females) received a total of fifty 90-min infusions

  8. Effect of occupational lead-exposure on blood pressure, serum aldosterone level and plasma renin activity.

    Science.gov (United States)

    Shouman, A E; El-Safty, I A

    2000-01-01

    Numerous observations have indicated a relationship between lead exposure and elevated blood pressure. The present study aims to investigate the association between occupational lead-exposure and elevated blood pressure as well as serum aldosterone level and plasma renin activity as parameters affecting blood pressure. Fifty occupationally lead-exposed (16 males and 34 females) and 50 non-exposed (15 males and 34 females) workers were selected after application of certain exclusion criteria. All workers were admitted to complete clinical examination, including standard blood pressure measurement. Also, blood lead level, serum aldosterone concentration and plasma renin activity were estimated. The results of both occupationally lead-exposed males and females demonstrated no significant differences regarding age, work duration, systolic and diastolic blood pressures when compared to occupationally non-exposed males and females; respectively. In addition, occupationally lead-exposed males and females revealed a significant increase in blood lead level and serum aldosterone concentration in comparison to their controls. Moreover, plasma renin activity is significantly decreased among the lead-exposed male workers while it is significantly increased among the lead-exposed female workers in comparison to their controls. It is concluded that serum aldosterone level and plasma renin activity are affected by occupationally low-level of lead exposure, and the present study provide further support for the association between blood lead exposure and blood pressure related hormones.

  9. Effect of postural changes on aldosterone to plasma renin ratio in patients with suspected secondary hypertension.

    Science.gov (United States)

    Barigou, M; Ah-Kang, F; Orloff, E; Amar, J; Chamontin, B; Bouhanick, B

    2015-06-01

    To study the influence of postural changes on aldosterone to renin ratio (ARR) in patients with suspected secondary hypertension and to evaluate the sensitivity and specificity of the recommended seated ARR compared to supine and upright ARR for primary aldosteronism screening. Fifty-three hypertensive patients were prospectively hospitalized for secondary hypertension exploration (age: 51 ± 12, 66% males). After withdrawal of drugs interfering with renin angiotensin system, plasma aldosterone and direct renin concentration were measured in the morning, at bed after an overnight supine position, then out of bed after 1 hour of upright position and finally 2 hours later after 15 minutes of seating. Minimal renin value was set at 5 μUI/mL. Referring to ARR cut-off of 23 pg/μUI, the sensitivity of seated ARR was 57.1% and specificity was 92.3%. The negative and positive predictive values were 95.1% and 45.2% respectively. Compared to these results, a cut-off of 19 improved sensitivity to 85.7% with a specificity of 89.7%. Negative and positive predictive values were 98.3% and 41.1% respectively. Seated ARR mean value was lower than supine and upright ARR mean values, due to an overall increase in renin at seating compared to the supine position by factor 1.9 while aldosterone just slightly increased by factor 1.2. Seated ARR correlated to supine and upright ARR: correlation coefficients (r) 0.90 and 0.93 respectively (P<0.001). Current recommended measurement of ARR in the seating position is fairly correlated to supine and upright ARR. A suggested cut-off value of 19 instead of 23 pg/μUI increased the discriminating power of this test. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. Aldosterone in uremia - beyond blood pressure.

    Science.gov (United States)

    Ritz, Eberhard; Koleganova, Nadezda

    2010-01-01

    Aldosterone was in the past considered only as a prohypertensinogenic agent. It has recently become clear that apart from the classical endocrine action, i.e. causing blood pressure elevation as a result of salt retention, aldosterone has numerous blood-pressure-independent actions on nonepithelial tissue. Under conditions of high salt concentration, aldosterone is injurious to the kidney, heart and vasculature. Of particular interest are recent observations that aldosterone is a permissive factor for the effect of minor increases in plasma sodium concentration on endothelial cell dysfunction. Despite surprising effects of aldosterone blockade on blood pressure of anuric dialysis patients, the potential role of mineralocorticoid receptor blockade in dialysis patients is currently unclear and requires controlled investigation to define the risk of potential hazards, specifically hyperkalemia. Copyright (c) 2010 S. Karger AG, Basel.

  11. Plasma aldosterone and renin activity.

    OpenAIRE

    Scammell, A M; Diver, M J

    1989-01-01

    Eight infants had paired measurements of plasma aldosterone and plasma renin activity while being treated for congestive heart failure. There is parallelism with aldosterone and renin activity in the presence of a hyperactive renin-angiotensin-aldosterone system. Six patients had plasma renin activity and plasma aldosterone measured after commencing captopril and we have shown biochemical blockade of the renin-angiotensin-aldosterone system.

  12. Effects of warming yang and invigorating qi prescription on renin-angiotensin-aldosterone system in rats with heart failure after myocardial infarction

    Directory of Open Access Journals (Sweden)

    Lihua HAN

    Full Text Available Abstract This study investigated the effects of warming yang and invigorating qi prescription on renin-angiotensin-aldosterone system (RAAS in rats with heart failure after myocardial infarction. 126 rats were randomly divided into model group, sham operation, warming yang, invigorating qi, warming yang+invigorating qi, digoxin and captopril group for respective treatment. After intervention for 6, 8 and 10 weeks, the left ventricular ejection fraction (LVEF was calculated, and the plasma renin, angiotensin II and aldosterone levels were measured. Results showed that, after 6, 8 and 10 weeks, LVEF in warming yang, invigorating qi, warming yang+invigorating qi and captopril group was significantly higher than model group (P < 0.05, and the plasma renin, angiotensin II and aldosterone levels in warming yang, invigorating qi, warming yang+invigorating qi and captopril groups were significantly lower than model group (P < 0.05. Renin angiotensin II and aldosterone levels in invigorating qi, warming yang+invigorating qi and captopril groups after 10 weeks was significantly lower than after 6 weeks (P < 0.05; aldosterone level in captopril groups after 10 weeks was significantly lower than after 6 weeks (P < 0.05. Warming yang and invigorating qi prescription can improve LVEF in rats with heart failure after myocardial infarction, which may be related with the inhibition of RAAS activation.

  13. Continuous indomethacin infusion may be less effective than bolus infusions for ductal closure in very low birth weight infants

    NARCIS (Netherlands)

    de Vries, NKS; Jagroep, FK; Jaarsma, AS; Elzenga, NJ; Bos, AF

    The effectiveness of continuous indomethacin (INDO) infusion versus bolus infusions for closure of patent ductus arteriosus (PDA) was investigated. The study design was an open-label case series (continuous INDO) with historic controls matched for gestational age (bolus INDO). Ductal closure rates

  14. Effect of animal facility construction on basal hypothalamic-pituitary-adrenal and renin-aldosterone activity in the rat.

    Science.gov (United States)

    Raff, Hershel; Bruder, Eric D; Cullinan, William E; Ziegler, Dana R; Cohen, Eric P

    2011-04-01

    Although loud noise and intense vibration are known to alter the behavior and phenotype of laboratory animals, little is known about the effects of nearby construction. We studied the effect of a nearby construction project on the classic stress hormones ACTH, corticosterone, renin, and aldosterone in rats residing in a barrier animal facility before, for the first 3 months of a construction project, and at 1 month after all construction was completed. During some of the construction, noise and vibrations were not obvious to investigators inside the animal rooms. Body weight matched for age was not altered by nearby construction. During nearby construction, plasma ACTH, corticosterone, and aldosterone were approximately doubled compared with those of pre- and postconstruction levels. Expression of CRH mRNA in the paraventricular nucleus of the hypothalamus, CRH receptor and POMC mRNA in the anterior pituitary, and most mRNAs for steroidogenic genes in the adrenal gland were not significantly changed during construction. We conclude that nearby construction can cause a stress response without long-term effects on hypothalamic-pituitary-adrenal axis gene expression and body weight.

  15. Moderate antiproteinuric effect of add-on aldosterone blockade with eplerenone in non-diabetic chronic kidney disease. A randomized cross-over study

    DEFF Research Database (Denmark)

    Boesby, Lene; Elung-Jensen, Thomas; Klausen, Tobias Wirenfeldt

    2011-01-01

    Reduction of proteinuria and blood pressure (BP) with blockers of the renin-angiotensin system (RAS) impairs the progression of chronic kidney disease (CKD). The aldosterone antagonist spironolactone has an antiproteinuric effect, but its use is limited by side effects. The present study evaluated...

  16. Assessment of the effect of Artemisia annua leave extract infusion ...

    African Journals Online (AJOL)

    Objectives: The influence of abiotic factors of water which may affect Artemesia annua (A. annua) efficiency as a disinfectant is not clearly elucidated. This study aimed to assess the potential effects of various water pH values of the infusion of A. annua leaves extract on some bacteria of hygiene and sanitary evaluation.

  17. Assessment of the effect of Artemisia annua leave extract infusion ...

    African Journals Online (AJOL)

    SARAH

    2013-02-27

    Feb 27, 2013 ... bacteria. 4595. Assessment of the effect of Artemisia annua leave extract infusion pH under dark conditions on Staphylococcus aureus, Salmonella ... among bacteria in some cases and stimulate the production of inhibitory substances in other cases. ...... under certain conditions, amino acids (glutamine,.

  18. Effects of Dietary Sodium Restriction in Kidney Transplant Recipients Treated With Renin-Angiotensin-Aldosterone System Blockade: A Randomized Clinical Trial

    NARCIS (Netherlands)

    de Vries, Laura V.; Dobrowolski, Linn C.; van den Bosch, Jacqueline J. O. N.; Riphagen, Ineke J.; Krediet, C. T. Paul; Bemelman, Frederike J.; Bakker, Stephan J. L.; Navis, Gerjan

    2016-01-01

    In patients with chronic kidney disease receiving renin-angiotensin-aldosterone system (RAAS) blockade, dietary sodium restriction is an often-used treatment strategy to reduce blood pressure (BP) and albuminuria. Whether these effects extend to kidney transplant recipients is unknown. We therefore

  19. Effects of Dietary Sodium Restriction in Kidney Transplant Recipients Treated With Renin-Angiotensin-Aldosterone System Blockade : A Randomized Clinical Trial

    NARCIS (Netherlands)

    de Vries, Laura V; Dobrowolski, Linn C; van den Bosch, Jacqueline J O N; Riphagen, Ineke J; Krediet, C T Paul; Bemelman, Frederike J; Bakker, Stephan J L; Navis, Gerjan

    BACKGROUND: In patients with chronic kidney disease receiving renin-angiotensin-aldosterone system (RAAS) blockade, dietary sodium restriction is an often-used treatment strategy to reduce blood pressure (BP) and albuminuria. Whether these effects extend to kidney transplant recipients is unknown.

  20. Cardiovascular effects of intravenous ghrelin infusion in healthy young men

    DEFF Research Database (Denmark)

    Vestergaard, Esben Thyssen; Andersen, Niels Holmark; Hansen, Troels Krarup

    2007-01-01

    Ghrelin infusion improves cardiac function in patients suffering from cardiac failure, and bolus administration of ghrelin increases cardiac output in healthy subjects. The cardiovascular effects of more continuous intravenous ghrelin exposure remain to be studied. We therefore studied the cardio......Ghrelin infusion improves cardiac function in patients suffering from cardiac failure, and bolus administration of ghrelin increases cardiac output in healthy subjects. The cardiovascular effects of more continuous intravenous ghrelin exposure remain to be studied. We therefore studied...... the cardiovascular effects of a constant infusion of human ghrelin at a rate of 5 pmol/kg per minute for 180 min. Fifteen healthy, young (aged 23.2 ± 0.5 yr), normal-weight (23.0 ± 0.4 kg/m2) men volunteered in a randomized double-blind, placebo-controlled crossover study. With the subjects remaining fasting, peak...... myocardial systolic velocity S′, tissue tracking TT, left ventricular ejection fraction EF, and endothelium-dependent flow-mediated vasodilatation were measured. Ghrelin infusion increased S′ 9% (P = 0.002) and TT 10% (P

  1. Pharmacological treatment of aldosterone excess

    NARCIS (Netherlands)

    Deinum, J.; Riksen, N.P.; Lenders, J.W.M.

    2015-01-01

    Primary aldosteronism, caused by autonomous secretion of aldosterone by the adrenals, is estimated to account for at least 5% of hypertension cases. Hypertension explains the considerable cardiovascular morbidity caused by aldosteronism only partly, calling for specific anti-aldosterone drugs. The

  2. Effects of cilnidipine on sympathetic nerve activity and cardiorenal function in hypertensive patients with type 2 diabetes mellitus: association with BNP and aldosterone levels.

    Science.gov (United States)

    Tanaka, Masami; Sekioka, Risa; Nishimura, Takeshi; Ichihara, Atsuhiro; Itoh, Hiroshi

    2014-12-01

    Hypertension stimulates the sympathetic nervous system and this phenomenon is exacerbated by diabetes mellitus. We investigated the effects of cilnidipine, an N/L-type calcium channel blocker, on aspects of this system in patients with type 2 diabetes mellitus. In 33 hypertensive patients with type 2 diabetes mellitus treated with a calcium channel blocker other than cilnidipine, we evaluated the influence of switching to cilnidipine on blood pressure, heart rate, catecholamine, plasma renin and aldosterone concentration, brain natriuretic peptide, urine liver-type fatty acid binding protein, and urinary albumin excretion ratio in the same patients by a cross-over design. Other biochemical parameters were also evaluated. Switching to cilnidipine did not change blood pressure but caused reduction in catecholamine concentrations in blood and urine and plasma aldosterone concentration, accompanied by significant reduction in brain natriuretic peptide, urine liver-type fatty acid binding protein, and albumin excretion ratio. These parameters other than brain natriuretic peptide were significantly increased after cilnidipine was changed to the original calcium channel blocker. In 33 hypertensive patients with type 2 diabetes mellitus, compared to other calcium channel blockers, cilnidipine suppressed sympathetic nerve activity and aldosterone, and significantly improved markers of cardiorenal disorders. Therefore, cilnidipine may be an important calcium channel blocker for use in combination with renin-angiotensin-aldosterone system inhibitors when dealing with hypertension complicated with diabetes mellitus. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Effect of glucose infusion on endurance performance after beta-adrenoceptor blocker administration

    NARCIS (Netherlands)

    van Baak, M.A.; Mooij, J.M.

    1994-01-01

    Effect of glucose infusion on endurance performance after beta-adrenoceptor blocker administration. Van Baak MA, Mooij JM. Department of Human Biology, University of Limburg, Maastricht, The Netherlands. To investigate the effect of glucose (Glc) infusion on endurance performance after

  4. Effect of intravenous dexmedetomidine infusion on some ...

    African Journals Online (AJOL)

    Conclusion: Dexmedetomidine is safe and effective in blunting the postoperative rise of the proinflammatory cytokine interleukin-6 and resulted in lower levels of markers of stress response to surgery as cortisol and blood glucose. Dexmedetomidine also reduces the postoperative pain score without delaying recovery from ...

  5. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride

    DEFF Research Database (Denmark)

    Graudal, Niels Albert; Hubeck-Graudal, Thorbjorn; Jurgens, Gesche

    2017-01-01

    levels of renin, aldosterone, catecholamines, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides. Search methods: The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials up to March 2016: the Cochrane...

  6. Long‐term safety and effectiveness of levodopa‐carbidopa intestinal gel infusion

    National Research Council Canada - National Science Library

    De Fabregues, Oriol; Dot, Joan; Abu‐Suboh, Monder; Hernández‐Vara, Jorge; Ferré, Alex; Romero, Odile; Ibarria, Marta; Seoane, José Luis; Raguer, Nuria; Puiggros, Carolina; Gómez, Maria Rosa; Quintana, Manuel; Armengol, Josep Ramon; Alvarez‐Sabín, José

    2017-01-01

    ...) infusion in advanced Parkinson's disease patients with motor fluctuations and its effect in nonmotor symptoms concludes that LCIG infusion is a safe and efficacious treatment for the control of motor...

  7. Effects of voluntary exercise on blood pressure, angiotensin II, aldosterone, and renal function in two-kidney, one-clip hypertensive rats

    Directory of Open Access Journals (Sweden)

    Waldman BM

    2017-11-01

    studies show that voluntary dynamic exercise in 2K-1C rats decreases plasma Ang II and aldosterone, which contribute to the lower arterial pressure without deleterious effects on GFR. The effects on sodium excretion underscore the impact of pressure natriuresis despite elevated plasma Ang II and aldosterone in sedentary 2K-1C rats. In contrast, potassium excretion is primarily regulated by circulating aldosterone and distal sodium delivery. Keywords: glomerular filtration rate, Goldblatt kidney, sodium excretion, potassium excretion, sympathetic nervous system

  8. Screening for primary aldosteronism- normal ranges for aldosterone ...

    African Journals Online (AJOL)

    Objective. To establish normal ranges for plasma aldosterone, renin and aldosterone / renin (A/ R) ratio in South African normotensives under typical ou tpatient conditions, and to estimate the prevalence of primary aldosteronism (PA) among hypertensives in primary care settings. Design and methods. One hundred and ...

  9. Aldosterone promotes autoimmune damage by enhancing Th17-mediated immunity.

    Science.gov (United States)

    Herrada, Andrés A; Contreras, Francisco J; Marini, Natacha P; Amador, Cristian A; González, Pablo A; Cortés, Claudia M; Riedel, Claudia A; Carvajal, Cristián A; Figueroa, Fernando; Michea, Luis F; Fardella, Carlos E; Kalergis, Alexis M

    2010-01-01

    Excessive production of aldosterone leads to the development of hypertension and cardiovascular disease by generating an inflammatory state that can be promoted by T cell immunity. Because nature and intensity of T cell responses is controlled by dendritic cells (DCs), it is important to evaluate whether the function of these cells can be modulated by aldosterone. In this study we show that aldosterone augmented the activation of CD8(+) T cells in a DC-dependent fashion. Consistently, the mineralocorticoid receptor was expressed by DCs, which showed activation of MAPK pathway and secreted IL-6 and TGF-beta in response to aldosterone. In addition, DCs stimulated with aldosterone impose a Th17 phenotype to CD4(+) T cells, which have recently been associated with the promotion of inflammatory and autoimmune diseases. Accordingly, we observed that aldosterone enhances the progression of experimental autoimmune encephalomyelitis, an autoimmune disease promoted by Th17 cells. In addition, blockade of the mineralocorticoid receptor prevented all aldosterone effects on DCs and attenuated experimental autoimmune encephalomyelitis development in aldosterone-treated mice. Our data suggest that modulation of DC function by aldosterone enhances CD8(+) T cell activation and promotes Th17-polarized immune responses, which might contribute to the inflammatory damage leading to hypertension and cardiovascular disease.

  10. Evaluation of cardiac sympathetic nerve activity and aldosterone suppression in patients with acute decompensated heart failure on treatment containing intravenous atrial natriuretic peptide

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Shu [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Toyama, Takuji; Kurabayashi, Masahiko [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Iwasaki, Toshiya; Sumino, Hiroyuki; Kumakura, Hisao; Minami, Kazutomo; Ichikawa, Shuichi [Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Matsumoto, Naoya [Nihon University School of Medicine, Department of Cardiology, Tokyo (Japan); Nakata, Tomoaki [Sapporo Medical University School of Medicine, Second (Cardiology) Department of Internal Medicine, Sapporo, Hokkaido (Japan)

    2014-09-15

    Aldosterone prevents the uptake of norepinephrine in the myocardium. Atrial natriuretic peptide (ANP), a circulating hormone of cardiac origin, inhibits aldosterone synthase gene expression in cultured cardiocytes. We evaluated the effects of intravenous ANP on cardiac sympathetic nerve activity (CSNA) and aldosterone suppression in patients with acute decompensated heart failure (ADHF). We studied 182 patients with moderate nonischemic ADHF requiring hospitalization and treated with standard therapy containing intravenous ANP and 10 age-matched normal control subjects. ANP was continuously infused for >96 h. In all subjects, delayed total defect score (TDS), heart to mediastinum ratio, and washout rate were determined by {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy. Left ventricular (LV) end-diastolic volume, end-systolic volume, and ejection fraction were determined by echocardiography. All patients with acute heart failure (AHF) were examined once within 3 days and then 4 weeks after admission, while the control subjects were examined only once (when their hemodynamics were normal). Moreover, for 62 AHF patients, plasma aldosterone concentrations were measured at admission and 1 h before stopping ANP infusion. {sup 123}I-MIBG scintigraphic and echocardiographic parameters in normal subjects were more favorable than those in patients with AHF (all p < 0.001). After treatment, all these parameters improved significantly in AHF patients (all p < 0.001). We also found significant correlation between percent changes of TDS and aldosterone concentrations (r = 0.539, p < 0.001) in 62 AHF patients. The CSNA and LV performance were all improved in AHF patients. Furthermore, norepinephrine uptake of myocardium may be ameliorated by suppressing aldosterone production after standard treatment containing intravenous ANP. (orig.)

  11. Is pomegranate peels infusion effective for disinfection of toothbrushes?

    Directory of Open Access Journals (Sweden)

    Priscila Lima de Luna FREIRE

    Full Text Available Abstract Introduction Methods of decontamination or sanitization of toothbrushes have been questioned. Objective This study assessed the effectiveness of pomegranate peels infusion as a disinfectant of toothbrushes against Streptococcus mutans. Material and method A sample of 16 schoolchildren aged between 7 and 9 years performed brushing 5 days/week, with a careful brushing once a day. After each day of brushing, the toothbrushes were washed and sprayed with one disinfectant solution. This procedure was repeated for 4 weeks using one of the different solutions per week: distilled water (G1; negative control, pomegranate (Punica granatum Linn peels infusion (G2, 1% sodium hypochlorite (G3 and 0.12% chlorhexidine digluconate (G4. After the fifth day, toothbrushes were collected for laboratory analysis. Toothbrushes heads were subjected to agitation in saline dilution of 10–1, 10–2,10–3, and 25 μL of each dilution were seeded in mitis salivarius agar culture medium for S. mutans colony-forming unit (CFU counting. One calibrated examiner (Kappa = 0.91 performed the CFU (mL–1 × 104 counts. Kruskal-Wallis and Dunn Multiple Comparison tests were used at a significance level of 5%. Result G1 presented the highest number of CFU (3.9 ± 8.4, followed by G2 (3.2 ± 4.0. No S. mutans growth was observed in G3 and G4. There was no statistically significant difference between G1 and G2 and between G3 and G4 (p>0.05. Conclusion Pomegranate infusion was completely ineffective for the disinfection of toothbrushes against S. mutans when compared with 1% sodium hypochlorite and 0.12% chlorhexidine digluconate solutions.

  12. Low plasma aldosterone despite normal plasma renin activity in uncomplicated type 1 diabetes mellitus : effects of RAAS stimulation

    NARCIS (Netherlands)

    Luik, PT; Kerstens, MN; Hoogenberg, K; Navis, GJ; Dullaart, RPF

    Background Data on levels and responsiveness of PRA and aldosterone in type 1 diabetes mellitus are conflicting. Earlier studies were not standardized with respect to the type of diabetes mellitus, the presence of diabetic complications or sodium intake. Therefore, we studied plasma renin activity

  13. The effect of blood collection procedure on plasma renin activity (PRA) and concentrations of direct renin (DRC) and aldosterone.

    Science.gov (United States)

    Glinicki, Piotr; Jeske, Wojciech; Gietka-Czernel, Małgorzata; Bednarek-Papierska, Lucyna; Kruszyńska, Aleksandra; Słowińska-Srzednicka, Jadwiga; Zgliczyński, Wojciech

    2015-06-01

    Performing measurements of plasma renin activity (PRA) or direct renin concentration (DRC) and aldosterone concentration, we should be well informed about requirements concerning blood sample processing. Forty-seven patients had blood collected in the supine and upright positions. Blood was withdrawn into two EDTA2K tubes and one with clot activator. One EDTA2K tube was cooled at +4 °C and centrifuged at +4 °C whereas the other was prepared at room temperature. PRA and DRC were measured by radioimmunoassay (RIA) and radioimmunometry (IRMA), respectively, in both cooled and not cooled plasma samples, and aldosterone was measured by RIA in not cooled plasma and in serum. In all the groups, with low, medium, and high values of PRA and direct renin, the temperature of sample processing within 30 minutes had no marked influence on the final result (correlation coefficient for renin was 0.9994, and for PRA, 0.8297). The measured concentrations of aldosterone also showed high correlation (r = 0.9790) but were markedly higher in plasma. The measurements of DRC, and to a lesser extent PRA, were similar regardless of temperature condition during the 20-30 minutes necessary for blood sample processing. Aldosterone concentrations in plasma vs serum samples appeared to be markedly higher. © The Author(s) 2013.

  14. Aldosterone and mineralocorticoid receptors in the cardiovascular system.

    Science.gov (United States)

    Funder, John W

    2010-01-01

    Aldosterone is currently thought to exert its physiologic effects by activating epithelial mineralocorticoid receptors, and its pathologic effects on the cardiovascular system via mineralocorticoid receptors in the heart and blood vessels. Recent studies have extended this understanding to include a reevaluation of the roles of aldosterone and mineralocorticoid receptor activation in blood pressure control; the rapid, nongenomic effects of aldosterone; the role of cortisol as a mineralocorticoid receptor agonist under conditions of redox change/tissue damage/reactive oxygen species generation; the growing consensus that primary aldosteronism accounts for approximately 10% of all essential hypertension; recent new insights into the cardioprotective role of spironolactone; and the development of third- and fourth-generation mineralocorticoid receptor antagonists for use in cardiovascular and other inflammatory disease. These findings on aldosterone action and mineralocorticoid receptor blockade are analyzed in the context of the prevention and treatment of cardiovascular disease. Copyright 2010. Published by Elsevier Inc.

  15. Aldosterone Antagonists or Renin-Guided Therapy for Treatment-Resistant Hypertension: A Comparative Effectiveness Pilot Study in Primary Care.

    Science.gov (United States)

    Egan, Brent M; Laken, Marilyn A; Sutherland, Susan E; Qanungo, Suparna; Fleming, Douglas O; Cook, Anne G; Hester, William H; Jones, Kelly W; Jebaily, Gerard C; Valainis, Gregory T; Way, Charles F; Wright, Mary Beth; Davis, Robert A

    2016-08-01

    Uncontrolled treatment-resistant hypertension (TRH), i.e., blood pressure (BP, mm Hg) ≥140/≥90mm Hg in and out of office on ≥3 different BP medications at optimal doses, is common and has a poor prognosis. Aldosterone antagonist (AA) and renin-guided therapy (RGT) are effective strategies for improving BP control in TRH but have not been compared. A comparative effectiveness TRH pilot study of AA vs. RGT was conducted in 4 primary care clinics with 2 each randomized to AA or RGT. The primary outcome was change in clinic BP defined by means of 5 automated office BP values. Eighty-nine patients with apparent TRH were screened and 44 met criteria for true TRH. Baseline characteristics of 20 patients in the AA (70% Black, 45% female, mean age: 57.4 years) and 24 patients in RGT (79% Black, 50% female, 57.8 years) arms were similar with baseline BP 162±5/90±3 vs. 153±3/84±3, respectively, P = 0.11/0.20. BP declined to 144±5/86±4 in AA vs. 132±4/75±3 in RGT, P = 0.07/0.01; BP was controlled to JNC7 (Seventh Joint National Committee Report) goal in 25% vs. 62.5%, respectively, P primary outcome, were not different (-17.6±5.1/-4.0±3.0 AA vs. -20.4±3.8/-9.7±2.0 RGT, P = 0.65/0.10.), more BP medications were added with AA than RGT (+0.9±0.1 vs. +0.4±0.1 per patient, P primary care. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Regulation of Adrenal Aldosterone Production by Serine Protease Prostasin

    Directory of Open Access Journals (Sweden)

    Takehiro Ko

    2010-01-01

    Full Text Available A serine protease prostasin has been demonstrated to have a pivotal role in the activation of the epithelial sodium channel. Systemic administration of adenovirus carrying human prostasin gene in rats resulted in an increase in plasma prostasin and aldosterone levels. However, the mechanism by which the elevation of prostasin levels in the systemic circulation stimulated the plasma aldosterone levels remains unknown. Therefore, we examined if prostasin increases the aldosterone synthesis in a human adrenocortical cell line (H295R cells. Luciferase assay using CYP11B2 promoter revealed that prostasin significantly increased the transcriptional activity of CYP11B2. Prostasin significantly increased both CYP11B2 mRNA expression and aldosterone production in a dose-dependent manner. Surprisingly, treatment with camostat mesilate, a potent prostasin inhibitor, had no effect on the aldosterone synthesis by prostasin and also a protease-dead mutant of prostasin significantly stimulated the aldosterone production. A T-type/L-type calcium channel blocker and a protein kinase C (PKC inhibitor significantly reduced the aldosterone synthesis by prostasin. Our findings suggest a stimulatory effect of prostasin on the aldosterone synthesis by adrenal gland through the nonproteolytic action and indicate a new role of prostasin in the systemic circulation.

  17. The regulation of cell growth and survival by aldosterone.

    LENUS (Irish Health Repository)

    Dooley, Ruth

    2012-02-01

    The steroid hormone aldosterone is synthesized from cholesterol, mainly in the zona glomerulosa of the adrenal cortex. Aldosterone exerts its effects in the epithelial tissues of the kidney and colon and in non-epithelial tissues such as the brain and cardiovasculature. The genomic response to aldosterone involves dimerization of the mineralocorticoid receptor (MR), dissociation of heat shock proteins from MR, translocation of the aldosterone-MR complex to the nucleus and the concomitant regulation of gene expression. Rapid responses to aldosterone occur within seconds to minutes, do not involve transcription or translation and can modulate directly or indirectly the later genomic responses. Aside from the well-known effects of aldosterone on the regulation of sodium and water homeostasis, aldosterone can also produce deleterious structural changes in tissues by inducing hypertrophy and the dysregulation of proliferation and apoptosis, leading to fibrosis and tissue remodelling. Here we discuss the involvement of aldosterone-mediated rapid signalling cascades in the development of disease states such as chronic kidney disease and heart failure, and the antagonists that can inhibit these pathophysiological responses.

  18. The regulation of cell growth and survival by aldosterone.

    LENUS (Irish Health Repository)

    Dooley, Ruth

    2011-01-01

    The steroid hormone aldosterone is synthesized from cholesterol, mainly in the zona glomerulosa of the adrenal cortex. Aldosterone exerts its effects in the epithelial tissues of the kidney and colon and in non-epithelial tissues such as the brain and cardiovasculature. The genomic response to aldosterone involves dimerization of the mineralocorticoid receptor (MR), dissociation of heat shock proteins from MR, translocation of the aldosterone-MR complex to the nucleus and the concomitant regulation of gene expression. Rapid responses to aldosterone occur within seconds to minutes, do not involve transcription or translation and can modulate directly or indirectly the later genomic responses. Aside from the well-known effects of aldosterone on the regulation of sodium and water homeostasis, aldosterone can also produce deleterious structural changes in tissues by inducing hypertrophy and the dysregulation of proliferation and apoptosis, leading to fibrosis and tissue remodelling. Here we discuss the involvement of aldosterone-mediated rapid signalling cascades in the development of disease states such as chronic kidney disease and heart failure, and the antagonists that can inhibit these pathophysiological responses.

  19. Hyperparathyroidism and the calcium paradox of aldosteronism.

    Science.gov (United States)

    Chhokar, Vikram S; Sun, Yao; Bhattacharya, Syamal K; Ahokas, Robert A; Myers, Linda K; Xing, Zhiqing; Smith, Richard A; Gerling, Ivan C; Weber, Karl T

    2005-02-22

    Aldosteronism may account for oxi/nitrosative stress, a proinflammatory phenotype, and wasting in congestive heart failure. We hypothesized that aldosterone/1% NaCl treatment (ALDOST) in rats enhances Ca2+ and Mg2+ excretion and leads to systemic effects, including bone loss. At 1, 2, 4, and 6 weeks of ALDOST, we monitored Ca2+ and Mg2+ excretion, ionized [Ca2+]o and [Mg2+]o, parathyroid hormone and 1-antiproteinase activity in plasma, bone mineral density, bone strength, Ca2+ and Mg2+ content in peripheral blood mononuclear cells (PBMCs) and ventricular tissue, and lymphocyte H2O2 production. A separate group received spironolactone (Spiro), an aldosterone receptor antagonist. Age- and gender-matched unoperated and untreated rats served as controls. ALDOST induced a marked (Phyperparathyroidism and bone resorption. Ca2+ overloading of PBMCs and cardiac tissue leads to oxi/nitrosative stress and a proinflammatory phenotype.

  20. The enhancing effects of hippocampal infusions of glucose are not restricted to spatial working memory.

    Science.gov (United States)

    Krebs, Desiree L; Parent, Marise B

    2005-03-01

    Extensive evidence shows that hippocampal infusions of glucose enhance spontaneous alternation (SA) performance or reverse deficits in this task. The current experiments determined whether the enhancing effects of hippocampal infusions of glucose are restricted to spatial working memory. Specifically we tested whether hippocampal infusions of glucose would reverse deficits in an emotional reference memory task (continuous multiple trial inhibitory avoidance [CMIA]) produced by septal infusions of the gamma-aminobutyric acid agonist muscimol. Male Sprague-Dawley rats were given septal infusions of vehicle or muscimol (0.15 nmol: SA; 5 nmol: CMIA) combined with hippocampal infusions of vehicle or glucose (50 nmol) 15 min prior to assessing SA or CMIA training. CMIA retention was tested 48 h later. Muscimol infusions decreased percent alternation scores and avoidance retention latencies. Importantly, hippocampal infusions of glucose reversed the deficits produced by the septal muscimol infusions on both tasks. These findings show for the first time that hippocampal glucose infusions also influence emotional memory, indicating that the enhancing effects of glucose generalize to memory tasks that vary in motivational and cognitive demand.

  1. Differential effects of insulin injections and insulin infusions on levels ...

    African Journals Online (AJOL)

    Studies have shown that while injections of insulin cause an increase in fat mass, infusions of insulin increase fat mass. The aim of this paper was to test the hypothesis that if an increase in glycogen is an indicator of an impending increase in adipose mass, then insulin infusions should not increase glycogen, while insulin ...

  2. Hemodynamic effects of mannitol infusion in patients with acute intracerebral hemorrhage

    OpenAIRE

    Ye,Hong; Su,Yingying

    2013-01-01

    PURPOSE: To evaluate hemodynamic effects of mannitol infusion in patients with acute intracerebral hemorrhage. METHODS: Thirty patients with acute intracerebral hemorrhage were enrolled. Transcranial doppler was used to detect variables of bilateral middle cerebral arteria (MCA) including mean velocity (Vm) and pulsitility index (PI) before and after125ml and 250ml mannitol infusion (0, 30, 60, 90, 120, 180, 240 min). RESULTS: When 125ml or 250ml mannitol was infused in patients with acute in...

  3. Haplotype association and synergistic effect of human aldosterone synthase (CYP11B2) gene polymorphisms causing susceptibility to essential hypertension in Indian patients.

    Science.gov (United States)

    Vamsi, Uppuluri Mohana; Swapna, Nagalingam; Padma, Gunda; Vishnupriya, Satti; Padma, Tirunilai

    Aldosterone synthase (CYP11B2) is a key enzyme involved in the terminal steps of aldosterone biosynthesis. Genetic variability in CYP11B2 gene has been associated with heterogeneous aldosterone production, which can affect sodium homeostasis and thereby regulation of blood pressure. Hence, the present study was aimed to explore the single-locus variations, haplotype and epistasis patterns of CYP11B2 (C-344T, intron-2 gene conversion and Lys173Arg) gene polymorphisms, and the risk contributed by them to the development of essential hypertension (EHT). A total of 279 hypertensive patients and 200 normotensive controls were enrolled in this study. C-344T and Lys173Arg polymorphisms of CYP11B2 gene were genotyped by PCR-RFLP method and intron-2 gene conversion (IC) polymorphism by allele-specific PCR analysis. Single-locus analysis revealed significant association of CYP11B2 C-344T and Lys173Arg polymorphisms with EHT (p < 0.05). Considering the sexes, Lys173 allele was found to be at risk for hypertension in males (OR 1.40; 95% CI = 1.01-1.96). Unphased haplotype analysis revealed H1 (T-Conv-Lys; p = 0.0017) to have significant risk for EHT, while haplotype H4 (T-Wt-Arg) had a significant protective effect. Multifactor dimensionality reduction (MDR) interaction analysis found the overall best model with C-344T and IC polymorphisms exhibiting strong synergistic effect. The present study revealed a strong synergistic effect of CYP11B2 C-344T and IC polymorphisms causing susceptibility to EHT and haplotype H1 (-344T-Conv-Lys173) as the risk-conferring factor for hypertension predisposition.

  4. A systematic review and economic evaluation of the clinical effectiveness and cost-effectiveness of aldosterone antagonists for postmyocardial infarction heart failure.

    Science.gov (United States)

    McKenna, C; Burch, J; Suekarran, S; Walker, S; Bakhai, A; Witte, K; Harden, M; Wright, K; Woolacott, N; Lorgelly, P; Fenwick, L; Palmer, S

    2010-05-01

    Two aldosterone inhibitors are currently licensed for heart failure (HF) in the UK: spironolactone and eplerenone. Recent clinical guidelines recommend eplerenone after an acute myocardial infarction (MI) for patients with symptoms and/or signs of HF and left ventricular dysfunction. The primary objective was to evaluate relative clinical effectiveness and cost-effectiveness of spironolactone and eplerenone in patients with postMI HF and explore the possibility of conducting an indirect comparison of spironolactone and eplerenone. A second objective was to undertake value-of-information (VOI) analyses to determine the need for further research to identify research questions critical to decision-making and to help inform the design of future studies. Relevant databases including MEDLINE, EMBASE and CENTRAL were searched between September and December 2008. Randomised controlled trials (RCTs) of spironolactone, eplerenone, canrenone or potassium canrenoate were included if conducted in a postMI HF population. Trials of general HF patients with a subgroup of postMI HF patients were considered if they had at least 100 ischaemic participants per arm and the authors provided subgroup data when contacted. Adverse events summary data were sought from recognised reference sources and RCTs or observational studies in any population that recruited more than 100 participants. The comparative clinical effectiveness and cost-effectiveness of spironolactone and eplerenone was derived using Bayesian meta-regression drawing on a wider 'network' of aldosterone trials to those considered in the main clinical effectiveness review. An alternative scenario was also considered assuming a 'class effect' for the aldosterone antagonists in terms of major clinical events, but allowing for potential differences in side effect profiles. Cost-effectiveness was assessed using incremental cost-effectiveness ratios (ICERs) where appropriate. Uncertainty in cost-effectiveness results was also

  5. Effect of steel and teflon infusion catheters on subcutaneous adipose tissue blood flow and infusion counter pressure in humans

    DEFF Research Database (Denmark)

    Højbjerre, Lise; Skov-Jensen, Camilla; Kaastrup, Peter

    2009-01-01

    BACKGROUND: Subcutaneous tissue is an important target for drug deposition or infusion. A local trauma may induce alterations in local microcirculation and diffusion barriers with consequences for drug bioavailability. We examined the influence of infusion catheters' wear time on local...... microcirculation and infusion counter pressure. METHODS: One steel catheter and one Teflon (Dupont, Wilmington, DE) catheter were inserted in subcutaneous, abdominal adipose tissue (SCAAT) in 10 healthy, lean men. The catheters were infused with isotonic saline at a rate of 10 microL/h for 48 h. Another steel...... catheter and a Teflon catheter were inserted contralateral to the previous catheters after 48 h. The infusion counter pressure was measured during a basal infusion rate followed by a bolus infusion. The measurements during a basal rate infusion were repeated after the bolus infusion. Adipose tissue blood...

  6. The effectiveness of a military pre-hospital fluid infusion strategy.

    Science.gov (United States)

    O'Meara, M; Wood, P; Thurgood, A; Porter, K

    2007-09-01

    We performed a study to assess the effectiveness of a fluid infusion strategy currently used in the military pre-hospital environment using the patient's own body weight as an infusion device. Thirteen healthy volunteers were cannulated and 0.9% sodium chloride infused over a period of ten minutes. The volumes infused were measured and flow rates derived. A mean flow rate of 40 ml per minute was seen through an 18 g cannula. This strategy generates reasonable flow rates, but whether this is sufficient to the clinical aim of fluid resuscitation in pre-hospital settings is unknown.

  7. [Renin and aldosterone determinations in hypertensive patients].

    Science.gov (United States)

    Hussein, Tamás; Mezősi, Emese; Bódis, Beáta; Nemes, Orsolya; Rucz, Károly; Bajnok, László

    2016-05-22

    The diagnostic algorithm of primary aldosteronism is burdened with uncertainties and, recently, it has been suggested that the sensitivity of the aldosterone/renin ratio used as a screening test - based on the suppression aldosterone - is low. The primary aim was to test the accuracy of aldosterone/renin ratio. In a retrospective analysis of 309 hypertensive patients supine and ambulatory aldosterone levels were independently examined. Aldosterone/renin ratio was elevated in 99 patients of whom 31 exhibited elevated supine aldosterone, as well. In 34 cases supine aldosterone was increased without elevation of the aldosterone/renin ratio. However, only 3 of them had concomitant low renin levels indicating that primary aldosteronism could not be ruled out. Abnormally increased renin was found in 69 patients, but only 59% of them had increased aldosterone level. Sensitivity of aldosterone/renin ratio is high (91%) if used only in justified cases.

  8. Aldosterone inhibits the fetal program and increases hypertrophy in the heart of hypertensive mice.

    Directory of Open Access Journals (Sweden)

    Feriel Azibani

    Full Text Available BACKGROUND: Arterial hypertension (AH induces cardiac hypertrophy and reactivation of "fetal" gene expression. In rodent heart, alpha-Myosin Heavy Chain (MyHC and its micro-RNA miR-208a regulate the expression of beta-MyHC and of its intronic miR-208b. However, the role of aldosterone in these processes remains unclear. METHODOLOGY/PRINCIPAL FINDINGS: RT-PCR and western-blot were used to investigate the genes modulated by arterial hypertension and cardiac hyperaldosteronism. We developed a model of double-transgenic mice (AS-Ren with cardiac hyperaldosteronism (AS mice and systemic hypertension (Ren. AS-Ren mice had increased (x2 angiotensin II in plasma and increased (x2 aldosterone in heart. Ren and AS-Ren mice had a robust and similar hypertension (+70% versus their controls. Anatomical data and echocardiography showed a worsening of cardiac hypertrophy (+41% in AS-Ren mice (P<0.05 vs Ren. The increase of ANP (x 2.5; P<0.01 mRNA observed in Ren mice was blunted in AS-Ren mice. This non-induction of antitrophic natriuretic peptides may be involved in the higher trophic cardiac response in AS-Ren mice, as indicated by the markedly reduced cardiac hypertrophy in ANP-infused AS-Ren mice for one month. Besides, the AH-induced increase of ßMyHC and its intronic miRNA-208b was prevented in AS-Ren. The inhibition of miR 208a (-75%, p<0.001 in AS-Ren mice compared to AS was associated with increased Sox 6 mRNA (x 1.34; p<0.05, an inhibitor of ßMyHC transcription. Eplerenone prevented all aldosterone-dependent effects. CONCLUSIONS/SIGNIFICANCE: Our results indicate that increased aldosterone in heart inhibits the induction of atrial natriuretic peptide expression, via the mineralocorticoid receptor. This worsens cardiac hypertrophy without changing blood pressure. Moreover, this work reveals an original aldosterone-dependent inhibition of miR-208a in hypertension, resulting in the inhibition of β-myosin heavy chain expression through the induction

  9. Relationship between aldosterone and the metabolic syndrome in patients with obstructive sleep apnea hypopnea syndrome: effect of continuous positive airway pressure treatment.

    Directory of Open Access Journals (Sweden)

    Antonia Barceló

    Full Text Available BACKGROUND: Metabolic syndrome (MS occurs frequently in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS. We hypothesized that aldosterone levels are elevated in OSAHS and associated with the presence of MS. METHODS: We studied 66 patients with OSAHS (33 with MS and 33 without MS and 35 controls. The occurrence of the MS was analyzed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III clinical criteria. Measurements of plasma renin activity (PRA, aldosterone, aldosterone:PRA ratio, creatinine, glucose, triglycerides, cholesterol and HDL cholesterol were obtained at baseline and after CPAP treatment. RESULTS: Aldosterone levels were associated with the severity of OSAHS and higher than controls (p = 0.046. Significant differences in aldosterone levels were detected between OSAHS patients with and without MS (p = 0.041. A significant reduction was observed in the aldosterone levels in patients under CPAP treatment (p = 0.012. CONCLUSION: This study shows that aldosterone levels are elevated in OSAHS in comparison to controls, and that CPAP therapy reduces aldosterone levels. It also shows that aldosterone levels are associated with the presence of metabolic syndrome, suggesting that aldosterone excess might predispose or aggravate the metabolic and cardiovascular complications of OSAHS. TRIAL REGISTRATION: The study is not a randomized controlled trial and was not registered.

  10. Acute Aldosterone-mediated Signaling Networks in Distal Convoluted Tubules

    DEFF Research Database (Denmark)

    Cheng, Lei; Wu, Qi; Olesen, Emma T. B.

    2017-01-01

    The kidney distal convoluted tubule (DCT) plays an important role in modulating body sodium balance and blood pressure. Long-term effects of aldosterone to increase sodium reabsorption in the DCT are well described. However, potential effects of aldosterone to acutely modulate DCT function via non...... to map global changes in protein phosphorylation in mpkDCT cells following 30 min aldosterone treatment. A total of 8136 unique proteins, containing 14838 different phosphopeptides were identified. Of these, 148 phosphopeptides were significantly up regulated, and 96 phosphopeptides were downregulated...

  11. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride.

    Science.gov (United States)

    Graudal, Niels Albert; Hubeck-Graudal, Thorbjorn; Jurgens, Gesche

    2017-04-09

    In spite of more than 100 years of investigations the question of whether a reduced sodium intake improves health is still unsolved. To estimate the effects of low sodium intake versus high sodium intake on systolic and diastolic blood pressure (SBP and DBP), plasma or serum levels of renin, aldosterone, catecholamines, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides. The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials up to March 2016: the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 3), MEDLINE (from 1946), Embase (from 1974), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the reference lists of relevant articles. Studies randomising persons to low-sodium and high-sodium diets were included if they evaluated at least one of the above outcome parameters. Two review authors independently collected data, which were analysed with Review Manager 5.3. A total of 185 studies were included. The average sodium intake was reduced from 201 mmol/day (corresponding to high usual level) to 66 mmol/day (corresponding to the recommended level).The effect of sodium reduction on blood pressure (BP) was as follows: white people with normotension: SBP: mean difference (MD) -1.09 mmHg (95% confidence interval (CI): -1.63 to -0.56; P = 0.0001); 89 studies, 8569 participants; DBP: + 0.03 mmHg (MD 95% CI: -0.37 to 0.43; P = 0.89); 90 studies, 8833 participants. High-quality evidence. Black people with normotension: SBP: MD -4.02 mmHg (95% CI:-7.37 to -0.68; P = 0.002); seven studies, 506 participants; DBP: MD -2.01 mmHg (95% CI:-4.37 to 0.35; P = 0.09); seven studies, 506 participants. Moderate-quality evidence. Asian people with normotension: SBP: MD -0.72 mmHg (95% CI: -3.86 to 2.41; P = 0.65); DBP: MD -1.63 mmHg (95% CI:-3.35 to 0

  12. Role of the Renin-Angiotensin System and Aldosterone on Cardiometabolic Syndrome

    Science.gov (United States)

    Stiefel, P.; Vallejo-Vaz, A. J.; García Morillo, S.; Villar, J.

    2011-01-01

    Aldosterone facilitates cardiovascular damage by increasing blood pressure and through different mechanisms that are independent of its effects on blood pressure. In this respect, recent evidence involves aldosterone in the pathogenesis of metabolic syndrome. Although this relationship is complex, there is some evidence suggesting that different factors may play an important role, such as insulin resistance, renin-angiotensin-aldosterone system, oxidative stress, sodium retention, increased sympathetic activity, levels of free fatty acids, or inflammatory cytokines and adipokines. In addition to the classical pathway by which aldosterone acts through the mineralocorticoid receptors leading to sodium retention, aldosterone also has other mechanisms that influence cardiovascular tissue remodelling. Finally, overweight and obesity promote the adrenal secretion of aldosterone, increasing the predisposition to type 2 diabetes mellitus. Further studies are needed to better establish therapeutic strategies that act on the blockade of mineralocorticoid receptor in the treatment and prevention of cardiovascular diseases related to the excess of aldosterone and the metabolic syndrome. PMID:21785705

  13. Role of the Renin-Angiotensin System and Aldosterone on Cardiometabolic Syndrome

    Directory of Open Access Journals (Sweden)

    P. Stiefel

    2011-01-01

    Full Text Available Aldosterone facilitates cardiovascular damage by increasing blood pressure and through different mechanisms that are independent of its effects on blood pressure. In this respect, recent evidence involves aldosterone in the pathogenesis of metabolic syndrome. Although this relationship is complex, there is some evidence suggesting that different factors may play an important role, such as insulin resistance, renin-angiotensin-aldosterone system, oxidative stress, sodium retention, increased sympathetic activity, levels of free fatty acids, or inflammatory cytokines and adipokines. In addition to the classical pathway by which aldosterone acts through the mineralocorticoid receptors leading to sodium retention, aldosterone also has other mechanisms that influence cardiovascular tissue remodelling. Finally, overweight and obesity promote the adrenal secretion of aldosterone, increasing the predisposition to type 2 diabetes mellitus. Further studies are needed to better establish therapeutic strategies that act on the blockade of mineralocorticoid receptor in the treatment and prevention of cardiovascular diseases related to the excess of aldosterone and the metabolic syndrome.

  14. Effects of aqueous extract of Hibiscus sabdariffa on the renin-angiotensin-aldosterone system of Nigerians with mild to moderate essential hypertension: A comparative study with lisinopril.

    Science.gov (United States)

    Nwachukwu, Daniel Chukwu; Aneke, Eddy Ikemefuna; Obika, Leonard Fidelis; Nwachukwu, Nkiru Zuada

    2015-01-01

    The present study investigated the effects of aqueous extract of Hibiscus sabdariffa (HS) on the three basic components of renin-angiotensin-aldosterone system: Plasma renin, serum angiotensin-converting enzyme (ACE), and plasma aldosterone (PA) in mild to moderate essential hypertensive Nigerians and compared with that of lisinopril, an ACE inhibitor. A double-blind controlled randomized clinical study was used. Seventy-eight newly diagnosed but untreated mild to moderate hypertensive subjects attending Medical Outpatients Clinic of Enugu State University Teaching Hospital, Enugu were recruited for the study. Those in Group A received placebo (150 mg/kg/day), Group B were given lisinopril (10 mg once daily) while those in Group C received aqueous extract of HS (150 mg/kg/day). After 4 weeks of treatment, the levels of plasma renin, serum ACE, and PA were determined. HS and lisinopril significantly (P < 0.001) reduced PA compared to placebo by 32.06% and 30.01%, respectively. Their effects on serum ACE and plasma renin activity (PRA) were not significant compared to placebo; they reduced ACE by 6.63% and 5.67% but increased plasma PRA by 2.77% and 5.36%, respectively. HS reduced serum ACE and PA in mild to moderate hypertensive Nigerians with equal efficacy as lisinopril. These actions are possibly due to the presence of anthocyanins in the extract.

  15. Effect of steel and teflon infusion catheters on subcutaneous adipose tissue blood flow and infusion counter pressure in humans.

    Science.gov (United States)

    Højbjerre, Lise; Skov-Jensen, Camilla; Kaastrup, Peter; Pedersen, Per Elgård; Stallknecht, Bente

    2009-05-01

    Subcutaneous tissue is an important target for drug deposition or infusion. A local trauma may induce alterations in local microcirculation and diffusion barriers with consequences for drug bioavailability. We examined the influence of infusion catheters' wear time on local microcirculation and infusion counter pressure. One steel catheter and one Teflon (Dupont, Wilmington, DE) catheter were inserted in subcutaneous, abdominal adipose tissue (SCAAT) in 10 healthy, lean men. The catheters were infused with isotonic saline at a rate of 10 microL/h for 48 h. Another steel catheter and a Teflon catheter were inserted contralateral to the previous catheters after 48 h. The infusion counter pressure was measured during a basal infusion rate followed by a bolus infusion. The measurements during a basal rate infusion were repeated after the bolus infusion. Adipose tissue blood flow (ATBF) was measured in SCAAT continuously. A significant increase in ATBF was observed with wear time for Teflon but not for steel catheters. Mean infusion pressure during the bolus phase increased significantly from 0 to 48 h for Teflon but not for steel catheters. ATBF and infusion counter pressure was similar between Teflon and steel catheters after acute catheter implantation and after wear time of 48 h. The maximum value of pressure during the bolus phase increased with wear time of a catheter. ATBF and bolus mean infusion pressure increased significantly with a wear time of 48 h in Teflon but not in steel catheters. The maximal pressure required to deliver a bolus infusion increased with wear time of a catheter. A higher maximal pressure was required to deliver a bolus infusion through a Teflon than through a steel catheter. We propose that the difference in infusion counter pressure and ATBF between Teflon and steel catheters with wear time may be explained by better biocompatibility of steel than Teflon.

  16. Evaluation of Vasopressin for Septic Shock in Patients on Chronic Renin-Angiotensin-Aldosterone System Inhibitors.

    Science.gov (United States)

    Erwin, Beth L; Denaburg, Michael A; Barker, Andrew B; McArdle, Philip J; Windham, Samuel T; Morgan, Charity J

    2017-12-01

    To compare the hemodynamic response in septic shock patients receiving vasopressin who were on chronic renin-angiotensin-aldosterone system inhibitor therapy with those who were not. Single-center, retrospective cohort study. Medical and surgical ICUs at a 1,100-bed academic medical center. Medical and surgical ICU patients with septic shock who received vasopressin infusion added to at least one concomitant vasopressor agent between January 2014 and December 2015, then divided into two cohorts: 1) patients who were on chronic renin-angiotensin-aldosterone system inhibitor therapy as outpatients and 2) patients who were not on chronic renin-angiotensin-aldosterone system inhibitor therapy as outpatients. None. Mean arterial pressure at 6 hours was 72.2 mm Hg in the renin-angiotensin-aldosterone system inhibitor group versus 69.7 mm Hg in the non-renin-angiotensin-aldosterone system inhibitor group (p = 0.298). There was no difference in mean arterial pressure at 1, 24, or 48 hours between groups. Total concomitant vasopressor requirements, based on norepinephrine equivalents excluding vasopressin, were significantly lower at 24 hours in the renin-angiotensin-aldosterone system inhibitor group versus the non-renin-angiotensin-aldosterone system inhibitor group (10.7 vs 18.1 µg/min, respectively; p = 0.007), but no significant differences were seen at the other time points assessed. There were no significant differences in ICU or hospital length of stay or mortality. There was no significant difference in the primary outcome of 6-hour mean arterial pressure in septic shock patients receiving vasopressin who were on chronic renin-angiotensin-aldosterone system inhibitor therapy versus those receiving vasopressin who were not on chronic renin-angiotensin-aldosterone system inhibitor therapy. Renin-angiotensin-aldosterone system inhibitor patients had lower total concomitant vasopressor requirements at 24 hours compared with non-renin-angiotensin-aldosterone system

  17. The effect of tubing dwell time on insulin adsorption during intravenous insulin infusions.

    Science.gov (United States)

    Thompson, Cecilia D; Vital-Carona, Jessica; Faustino, E Vincent S

    2012-10-01

    Insulin adsorbs to plastic tubing, which decreases the concentration of an insulin solution delivered from an intravenous infusion set. Dwelling insulin within tubing before starting the infusion decreases adsorption but delays treatment initiation and wastes time in infusion preparation. The lack of data on dwell time effects results in wide variability in practice. We aim to determine the effect of dwell time on insulin concentration from intravenous infusion tubing. In this in vitro study, we used insulin solutions with concentrations of 0.1 unit/mL, 1 unit/mL, and 10 units/mL. Each solution dwelled in intravenous infusion sets for 0, 15, 30, or 60 min. After the dwell, we measured insulin concentrations from the solution bags and tubing. We repeated each insulin concentration-dwell time combination five times. Comparisons were performed using analyses of variance. For each of the three insulin concentrations, the mean insulin concentrations from the tubing were not significantly different between dwell times. Duration of dwell time did not affect insulin adsorption in polypropylene intravenous infusion sets. We recommend that following a 20-mL flush, insulin infusions can be started without any dwell time. Removal of dwell times may improve clinical practice by minimizing preparation time and will allow faster initiation of insulin infusion therapy.

  18. Effects of methacholine infusion on desflurane pharmacokinetics in piglets

    Directory of Open Access Journals (Sweden)

    Alf Kozian

    2015-12-01

    We measured airway pressures, pulmonary resistance, and mean paO2 as well as hemodynamic variables in all pigs before desflurane application and at plateau in both healthy state and during methacholine administration by infusion. By MIGET, fractional alveolar ventilation and pulmonary perfusion in relation to the V.A/Q. compartments, data of logSDQ̇ and logSDV̇ (the second moments describing global dispersion, i.e. heterogeneity of distribution were estimated prior to and after MCh infusion. The uptake and elimination of desflurane was determined by MMIMS.

  19. Effects of chronic intrahippocampal infusion of lipopolysaccharide in the rat.

    Science.gov (United States)

    Szczepanik, A M; Fishkin, R J; Rush, D K; Wilmot, C A

    1996-01-01

    Astrogliosis and microglial activation are associated with many neurodegenerative disorders including multiple sclerosis, its animal model experimental allergic encephalomyelitis, and Alzheimer's disease. To address the hypothesis that chronic astroglial or microglial activation could be contributing factors to neuronal death or injury, the immunostimulant lipopolysaccharide was infused into the hippocampus for 16 days using Alzet mini-osmotic pumps attached to a cannula. Placement of the cannula and infusion of vehicle for 16 days caused a hippocampal lesion with a volume of 0.5 +/- 0.1 mm3. Infusion of lipopolysaccharide at the dose of 2.0 micrograms/day produced a lesion of 4.9 +/- 1.3 mm3 (P < 0.01, Newman-Keuls), whereas, a lower dose of 0.2 microgram/day caused a lesion of 1.3 +/- 0.3 mm3 (P < 0.05). The lesion was defined as a focal necrotic reaction with fibrin deposits outlining an area at an early stage of encapsulation. No apparent neuronal loss was observed by Cresyl Violet staining outside the encapsulated necrotic area. There was a pronounced astrogliosis and an increase in activated macrophages throughout the lipopolysaccharide-infused hippocampus as determined by glial fibrillary acidic protein and ED-1 immunohistochemistry, respectively. Choline acetyltransferase and glutamic acid decarboxylase enzyme activities, used as functional measures of neuronal viability for cholinergic and GABAergic neurons, respectively, were unaffected in the hippocampus following a 16 day infusion of lipopolysaccharide at the doses of 0.2, 0.6 and 2.0 micrograms/day. In addition, unilateral infusion of lipopolysaccharide into the hippocampus did not affect 24 h locomotion when tested on day 13, body temperature or weight gain. Under the experimental conditions employed in the present study, chronic infusion of lipopolysaccharide into the hippocampus resulted in a dose-dependent focal necrotic lesion at the site of infusion. In tissue surrounding the encapsulated lesion

  20. The effects of lactose infusion on the pathological manifestations of ...

    African Journals Online (AJOL)

    The finding further supports the safety use of lactose without causing any damage to body organs. As such, its incoporation with other chemotherapeutic agents for treatment of trypanosomiasis is, therefore strongly recommended. Keywords: Trypanosoma vivax, cattle, lactose infusion, lectin, erythrophagocytosis, anaemia

  1. Continuous infusion of vancomycin : Effective, efficient and safe

    NARCIS (Netherlands)

    Van Maarseveen, E.; Touw, D.; Bouma, A.; Van Zanten, A.

    Aims: Vancomycin is an antibiotic which is used in (suspected or proven) bacteriaemia, peritonitis or osteomyelitis with grampositive micro-organisms. Currently in most Dutch hospitals vancomycin is administered as an intermittent infusion. As the killing of vancomycin is dependent of the AUC/MIC

  2. The effects of incisional bupivacaine infusions on postoperative ...

    African Journals Online (AJOL)

    2010-11-24

    Nov 24, 2010 ... Keywords: incisional bupivacaine infusions, total abdominal hysterectomy, postoperative pain control. Abstract. Background: The aim of this study was to determine opioid requirements and pain intensity scores in patients after a total .... complained of nausea or vomiting, prochlorperazine. 12.5 mg was ...

  3. Effect of insulin pump infusion on comprehensive stress state of ...

    African Journals Online (AJOL)

    Purpose: To assess changes in the comprehensive stress state of patients with diabetic ketoacidosis. (DKA) following treatment with insulin infusion pump. Methods: A total of 240 patients suffering from DKA who received treatment at The First Affiliated. Hospital of Zhengzhou University from Feb. 2011 to Feb. 2014 were ...

  4. Effect of insulin pump infusion on comprehensive stress state of ...

    African Journals Online (AJOL)

    Purpose: To assess changes in the comprehensive stress state of patients with diabetic ketoacidosis (DKA) following treatment with insulin infusion pump. Methods: A total of 240 patients suffering from DKA who received treatment at The First Affiliated Hospital of Zhengzhou University from Feb. 2011 to Feb. 2014 were ...

  5. Effects of infused methionine, lysine and rumen-protected ...

    African Journals Online (AJOL)

    goethe (1991) suggested that minimal or no response, as in the case of AL supplementation, may occur because the sec- ond limiting amino acid is also close to being limiting or because the amino acid provided is not the most limiting amino acid. This might also imply that the infusion of lysine alone may have caused an ...

  6. Differential sleep-promoting effects of five sleep substances nocturnally infused in unrestrained rats.

    OpenAIRE

    Inoué, S.; Honda, K; Komoda, Y.; Uchizono, K; Ueno, R.; Hayaishi, O

    1984-01-01

    Sleep-inducing and sleep-maintaining effects of five different putative sleep substances were compared by the same nocturnal 10-hr intracerebroventricular infusion technique in otherwise saline-infused, freely moving male rats. Delta-sleep-inducing peptide (2.5 nmol), which induces electroencephalogram delta (slow)-wave patterns, was rapidly effective in increasing both slow-wave sleep and paradoxical sleep but the effects were not long-lasting. Muramyl dipeptide (2 nmol) induced excessive sl...

  7. The Effect of Low-Dose Oxytocin Infusion on Cerebral Hemodynamics in Pregnant Women

    NARCIS (Netherlands)

    van Veen, Teelkien R.; Belfort, Michael A.; Zeeman, Gerda G.

    We investigated the cerebrovascular effects of continuous infusion of low-dose oxytocin in normal pregnant women undergoing induction of labor. In our prospective observational study, middle cerebral artery velocity was measured with transcranial Doppler ultrasound in 25 healthy, normotensive,

  8. Albuminuria is associated with an increased prostasin in urine while aldosterone has no direct effect on urine and kidney tissue abundance of prostasin

    DEFF Research Database (Denmark)

    Stolzenburg Oxlund, Christina; Kurt, Birgül; Schwarzensteiner, Ilona

    2017-01-01

    The proteinase prostasin is a candidate mediator for aldosterone-driven proteolytic activation of the epithelial sodium channel (ENaC). It was hypothesized that the aldosterone-mineralocorticoid receptor (MR) pathway stimulates prostasin abundance in kidney and urine. Prostasin was measured in pl...

  9. Effect of tumor necrosis factor-alpha infusion on the incretin effect in healthy volunteers

    DEFF Research Database (Denmark)

    Nielsen, Signe Tellerup; Lehrskov-Schmidt, Louise; Krogh-Madsen, Rikke

    2013-01-01

    Type 2 diabetes mellitus (T2DM) is associated with peripheral insulin resistance, impaired incretin effect, and increased plasma levels of tumor necrosis factor-alpha (TNF-α). Whereas TNF-α infusion at a dose that induces systemic inflammation in healthy volunteers has been demonstrated to induce...

  10. Effect of intravenous zoledronic acid infusion on electrocardiographic parameters in patients with osteoporosis.

    Science.gov (United States)

    Aktas, I; Nazikoglu, C; Kepez, A; Ozkan, F U; Kaysin, M Y; Akpinar, P; Dogan, Z; Ileri, C; Saymaz, S; Erdogan, O

    2016-12-01

    We evaluated the effects of zoledronic acid (ZA) therapy on electrocardiographic (ECG) parameters for the first time in the literature. Measurements were performed on ECGs obtained before and after ZA infusion on the same day as well as 1 month after the infusion. ZA infusion did not have any short- or long-term effect on any parameter that might be associated with the tendency for atrial fibrillation or ventricular arrhythmias. The aim of the present study was to evaluate the early and late effects of ZA therapy on ECG parameters which might be associated with the tendency for atrial and ventricular arrhythmias. Consecutive patients with osteoporosis who were admitted to our clinic between December 2013 and December 2014 and who were scheduled to receive ZA infusion constituted our study population. Twelve-lead surface ECGs were obtained from all patients before and after ZA infusion on the same day as well as 1 month after the infusion. All ECG parameters were measured and compared with each other for each patient. Data of 100 patients were used in the analysis (9 male; 70.5 ± 11.6 years of age). There were no significant differences between repeated measurements regarding pmax, pmin, and p dispersion values. QT max and QT min values were significantly increased after infusion; however, there were no significant changes in QT dispersion, Tp-e interval, and Tp-e dispersion values. ZA infusion did not affect P wave dispersion both at the immediate post-infusion period and 1 month after infusion. QT values were significantly increased early after ZA infusion; however, there were no significant differences in parameters reflecting disparity of ventricular recovery times and transmural dispersion of ventricular repolarization. Based on these observations, it may be suggested that ZA infusion did not have any short- or long-term effect on any parameter that might be associated with the tendency for atrial fibrillation or ventricular arrhythmias.

  11. Equine sweat composition: effects of adrenaline infusion, exercise and training.

    Science.gov (United States)

    McConaghy, F F; Hodgson, D R; Evans, D L; Rose, R J

    1995-11-01

    Significant alterations in plasma electrolyte concentrations have been reported in horses following prolonged exercise, resulting from loss of hypertonic sweat. Sweat was collected from 10 horses undergoing a 10 week training programme; 5 at moderate intensity, to speeds of 10 m/s and 5 at low intensity, to speeds of 5 m/s. Sweat was collected from 2 sites in response to a submaximal exercise test (30 min at 50% VO2max and during an adrenaline infusion (dose mean +/- s.d.; 0.3 +/- 0.05 g/kg over 30 min). Sweat samples were analysed for sodium, chloride, potassium, protein, magnesium, calcium and urea concentrations. Sweat produced in response to exercise and adrenaline infusion was hypertonic and showed no significant differences in composition following training. However, the [NaCl] of sweat rose with increased duration of sweating. Sweat produced in response to adrenaline infusion was more dilute than that produced in response to exercise, which may be related to sympathetic outflow during exercise.

  12. Hemodynamic, renal, and hormonal effects of ghrelin infusion in patients with chronic heart failure.

    Science.gov (United States)

    Nagaya, N; Miyatake, K; Uematsu, M; Oya, H; Shimizu, W; Hosoda, H; Kojima, M; Nakanishi, N; Mori, H; Kangawa, K

    2001-12-01

    Ghrelin is a novel GH-releasing peptide that may also induce vasodilation and a positive energy balance through GH-independent mechanisms. However, the hemodynamic, renal, and hormonal effects of ghrelin in patients with chronic heart failure (CHF) remain unknown. Accordingly, 12 patients with CHF were given an iv infusion of human ghrelin (0.1 microg/kg.min) or placebo. Ghrelin significantly decreased mean arterial pressure (-9 mm Hg, P Ghrelin significantly increased cardiac index (+25%, P ghrelin induced a marked increase in serum GH level (15-fold), associated with slight increases in circulating epinephrine, ACTH, cortisol, and PRL. Infusion of ghrelin did not significantly alter urine volume, urinary sodium excretion, or creatinine clearance. These hemodynamic, renal and hormonal parameters remained unchanged during placebo infusion. In summary, iv infusion of ghrelin, a potent GH-releasing peptide, had beneficial hemodynamic effects in patients with CHF in the absence of renal effects.

  13. Effects of methacholine infusion on desflurane pharmacokinetics in piglets.

    Science.gov (United States)

    Kozian, Alf; Kretzschmar, Moritz; Baumgardner, James E; Schreiber, Jens; Hedenstierna, Göran; Larsson, Anders; Hachenberg, Thomas; Schilling, Thomas

    2015-12-01

    The data of a corresponding animal experiment demonstrates that nebulized methacholine (MCh) induced severe bronchoconstriction and significant inhomogeneous ventilation and pulmonary perfusion (V̇A/Q̇) distribution in pigs, which is similar to findings in human asthma. The inhalation of MCh induced bronchoconstriction and delayed both uptake and elimination of desflurane (Kretzschmar et al., 2015) [1]. The objective of the present data is to determine V̇A/Q̇ matching by Multiple Inert Gas Elimination Technique (MIGET) in piglets before and during methacholine- (MCh-) induced bronchoconstriction, induced by MCh infusion, and to assess the blood concentration profiles for desflurane (DES) by Micropore Membrane Inlet Mass Spectrometry (MMIMS). Healthy piglets (n=4) under general anesthesia were instrumented with arterial, central venous, and pulmonary artery lines. The airway was secured via median tracheostomy with an endotracheal tube, and animals were mechanically ventilated with intermittent positive pressure ventilation (IPPV) with a FiO2 of 0.4, tidal volume (V T)=10 ml/kg and PEEP of 5cmH2O using an open system. The determination of V.A/Q. was done by MIGET: before desflurane application and at plateau in both healthy state and during MCh infusion. Arterial blood was sampled at 0, 1, 2, 5, 10, 20, and 30 min during wash-in and washout, respectively. Bronchoconstriction was established by MCH infusion aiming at doubling the peak airway pressure, after which wash-in and washout of the anesthetic gas was repeated. Anesthesia gas concentrations were measured by MMIMS. Data were analyzed by ANOVA, paired t-test, and by nonparametric Friedman׳s test and Wilcoxon׳s matched pairs test. We measured airway pressures, pulmonary resistance, and mean paO2 as well as hemodynamic variables in all pigs before desflurane application and at plateau in both healthy state and during methacholine administration by infusion. By MIGET, fractional alveolar ventilation and

  14. Effects of methacholine infusion on desflurane pharmacokinetics in piglets☆

    Science.gov (United States)

    Kozian, Alf; Kretzschmar, Moritz; Baumgardner, James E.; Schreiber, Jens; Hedenstierna, Göran; Larsson, Anders; Hachenberg, Thomas; Schilling, Thomas

    2015-01-01

    The data of a corresponding animal experiment demonstrates that nebulized methacholine (MCh) induced severe bronchoconstriction and significant inhomogeneous ventilation and pulmonary perfusion (V̇A/Q̇) distribution in pigs, which is similar to findings in human asthma. The inhalation of MCh induced bronchoconstriction and delayed both uptake and elimination of desflurane (Kretzschmar et al., 2015) [1]. The objective of the present data is to determine V̇A/Q̇ matching by Multiple Inert Gas Elimination Technique (MIGET) in piglets before and during methacholine- (MCh-) induced bronchoconstriction, induced by MCh infusion, and to assess the blood concentration profiles for desflurane (DES) by Micropore Membrane Inlet Mass Spectrometry (MMIMS). Healthy piglets (n=4) under general anesthesia were instrumented with arterial, central venous, and pulmonary artery lines. The airway was secured via median tracheostomy with an endotracheal tube, and animals were mechanically ventilated with intermittent positive pressure ventilation (IPPV) with a FiO2 of 0.4, tidal volume (VT)=10 ml/kg and PEEP of 5cmH2O using an open system. The determination of V.A/Q. was done by MIGET: before desflurane application and at plateau in both healthy state and during MCh infusion. Arterial blood was sampled at 0, 1, 2, 5, 10, 20, and 30 min during wash-in and washout, respectively. Bronchoconstriction was established by MCH infusion aiming at doubling the peak airway pressure, after which wash-in and washout of the anesthetic gas was repeated. Anesthesia gas concentrations were measured by MMIMS. Data were analyzed by ANOVA, paired t-test, and by nonparametric Friedman׳s test and Wilcoxon׳s matched pairs test. We measured airway pressures, pulmonary resistance, and mean paO2 as well as hemodynamic variables in all pigs before desflurane application and at plateau in both healthy state and during methacholine administration by infusion. By MIGET, fractional alveolar ventilation and

  15. Eggplant (Solanum melongena infusion has a modest and transitory effect on hypercholesterolemic subjects

    Directory of Open Access Journals (Sweden)

    Guimarães P.R.

    2000-01-01

    Full Text Available Eggplant (Solanum melongena is consumed extensively in Brazil. It has been believed that infusion of a powdered preparation of the fruit may reduce serum cholesterol. However, there are few documented reports on its effects on cholesterol metabolism and its possible hypocholesterolemic effect has not been proved by well-controlled studies. The aim of the present study was to observe the effects of S. melongena on the serum cholesterol and triglycerides of 38 hypercholesterolemic human volunteers ingesting S. melongena infusion for five weeks. Thirty-eight hypercholesterolemic subjects receiving either S. melongena infusion (N = 19 or placebo (N = 19 participated in two clinical experiments in which the effect of S. melongena infusion was studied with (N = 16 or without (N = 38 dietary orientation. Total cholesterol and its fractions, triglycerides, and apolipoproteins A and B were measured in blood at the beginning of the experiment and three and five weeks thereafter. No differences were observed compared to control. Intraindividual analysis showed that S. melongena infusion significantly reduced the blood levels of total and LDL cholesterol and of apolipoprotein B. After dietary orientation, no intra- or intergroup differences were seen for any of the parameters analyzed. The results suggest that S. melongena infusion had a modest and transitory effect, which was not different from that obtained with standard orientation for dyslipidemia patients (diet and physical activities.

  16. Are we missing a mineralocorticoid in teleost fish? Effects of cortisol, deoxycorticosterone and aldosterone on osmoregulation, gill Na+,K+-ATPase activity and isoform mRNA levels in Atlantic salmon

    Science.gov (United States)

    McCormick, S.D.; Regish, A.; O'Dea, M. F.; Shrimpton, J.M.

    2008-01-01

    It has long been held that cortisol, acting through a single receptor, carries out both glucocorticoid and mineralocorticoid actions in teleost fish. The recent finding that fish express a gene with high sequence similarity to the mammalian mineralocorticoid receptor (MR) suggests the possibility that a hormone other than cortisol carries out some mineralocorticoid functions in fish. To test for this possibility, we examined the effect of in vivo cortisol, 11-deoxycorticosterone (DOC) and aldosterone on salinity tolerance, gill Na+,K+-ATPase (NKA) activity and mRNA levels of NKA α1a and α1b in Atlantic salmon. Cortisol treatment for 6–14 days resulted in increased, physiological levels of cortisol, increased gill NKA activity and improved salinity tolerance (lower plasma chloride after a 24 h seawater challenge), whereas DOC and aldosterone had no effect on either NKA activity or salinity tolerance. NKA α1a and α1b mRNA levels, which increase in response to fresh water and seawater acclimation, respectively, were both upregulated by cortisol, whereas DOC and aldosterone were without effect. Cortisol, DOC and aldosterone had no effect on gill glucocorticoid receptor GR1, GR2 and MR mRNA levels, although there was some indication of possible upregulation of GR1 by cortisol (p = 0.07). The putative GR blocker RU486 inhibited cortisol-induced increases in salinity tolerance, NKA activity and NKA α1a and α1b transcription, whereas the putative MR blocker spironolactone had no effect. The results provide support that cortisol, and not DOC or aldosterone, is involved in regulating the mineralocorticoid functions of ion uptake and salt secretion in teleost fish.

  17. A Model to Determine the Level of Serum Aldosterone in the Workers Attributed to the Combined Effects of Sound Pressure Level, Exposure Time and Serum Potassium Level: A Field-Based Study

    Directory of Open Access Journals (Sweden)

    Parvin Nassiri

    2016-09-01

    Full Text Available Background Occupational exposure to excessive noise is one of the biggest work-related challenges in the world. This phenomenon causes the release of stress-related hormones, which in turn, negatively affects cardiovascular risk factors. Objectives The current study study aimed to determine the level of workers’ serum aldosterone in light of the combined effect of sound pressure level, exposure time and serum potassium level. Methods This cross-sectional, descriptive, analytical study was conducted on 45 workers of Gol-Gohar Mining and Industrial Company in the fall of 2014. The subjects were divided into three groups (one control and two case groups, each including 15 workers. Participants in the control group were selected from workers with administrative jobs (exposure to the background noise. On the other hand, participants in the case groups were selected from the concentrator and pelletizing factories exposed to excessive noise. Serum aldosterone and potassium levels of participants were assessed at three different time intervals: at the beginning of the shift and before exposure to noise (7:30 - 8:00 AM, during exposure to noise (10:00 - 10:30 AM, and during continuous exposure (1:30 - 2:00 PM. The obtained data were transferred into SPSS ver. 18. Repeated measures analysis of variance (ANOVA was used to develop the statistical model of workers’ aldosterone level in light of the combined effect of sound pressure level, exposure time, and serum potassium level. Results The results of the final statistical model to determine the level of serum aldosterone based on the combined effect of sound pressure level, exposure time and serum potassium level indicated that the sound pressure level had a significant influence on the human’s serum aldosterone level (P = 0.04. In addition, the effects of exposure time and serum potassium on aldosterone level were statistically significant with P-values of 0.008 and 0.001, respectively. Conclusions

  18. Effect of intravenous iron-dextran (Imferon) infusion on antigen induced monarticular arthritis in rabbits.

    OpenAIRE

    Kind, C N; Blackham, A; Morris, C J

    1992-01-01

    The effect of intravenously infused iron-dextran (Imferon) on the progression of antigen induced monarticular arthritis in rabbits was studied. A rapid deposition of iron and apoferritin in the synovia of arthritis joints occurred after infusion of iron-dextran during either the acute or chronic phases of the disease. This coincided with the appearance of catalytic (bleomycin reactive) iron in the synovial fluid. There was no evidence, however, for an exacerbation of the antigen induced arthr...

  19. Infusion of hypertonic saline before elective hysterectomy: effects on cytokines and stress hormones

    DEFF Research Database (Denmark)

    Kølsen-Petersen, Jens Aage; Bendtzen, Klaus; Tønnesen, Else Kirstine

    2008-01-01

    with the other groups (Psaline before hysterectomy appears to have limited effect on the postoperative concentration of selected plasma cytokines and the hormonal stress......BACKGROUND: Infusion of hypertonic saline provides early haemodynamic benefits and may affect the immune system. It is unknown if infusion of hypertonic saline affects plasma cytokines and stress hormones after surgery. METHODS: Sixty-two women undergoing abdominal hysterectomy were randomized...

  20. Update in diagnosis and management of primary aldosteronism.

    Science.gov (United States)

    Dick, Sofia M; Queiroz, Marina; Bernardi, Bárbara L; Dall'Agnol, Angélica; Brondani, Letícia A; Silveiro, Sandra P

    2017-08-28

    Primary aldosteronism (PA) is a group of disorders in which aldosterone is excessively produced. These disorders can lead to hypertension, hypokalemia, hypervolemia and metabolic alkalosis. The prevalence of PA ranges from 5% to 12% around the globe, and the most common causes are adrenal adenoma and adrenal hyperplasia. The importance of PA recognition arises from the fact that it can have a remarkably adverse cardiovascular and renal impact, which can even result in death. The aldosterone-to-renin ratio (ARR) is the election test for screening PA, and one of the confirmatory tests, such as oral sodium loading (OSL) or saline infusion test (SIT), is in general necessary to confirm the diagnosis. The distinction between adrenal hyperplasia (AH) or aldosterone-producing adenoma (APA) is essential to select the appropriate treatment. Therefore, in order to identify the subtype of PA, imaging exams such as computed tomography or magnetic ressonance imaging, and/or invasive investigation such as adrenal catheterization must be performed. According to the subtype of PA, optimal treatment - surgical for APA or pharmacological for AH, with drugs like spironolactone and amiloride - must be offered.

  1. Effect of magnesium infusion on thoracic epidural analgesia

    Directory of Open Access Journals (Sweden)

    Sampa Dutta Gupta

    2011-01-01

    Full Text Available Introduction: Patients of lung volume reduction surgery (LVRS having an ASA status III or more are likely to be further downgraded by surgery to critical levels of pulmonary function. Aim: To compare the efficacy of thoracic epidural block with (0.125% bupivacaine, fentanyl combination and (0.125% bupivacaine, fentanyl combination with adjunctive intravenous magnesium infusion for the relief of postoperative pain in patients undergoing LVRS. Methods: Patients were operated under general anesthesia. Thirty minutes before the anticipated completion of skin closure in both groups, (Group A and Group B 7 ml of (0.125% bupivacaine calculated as 1.5 ml/thoracic segment space for achieving analgesia in dermatomes of T4, T5, T6, T7, and T8 segments, along with fentanyl 50 ΅g (0.5 ml, was administered through the catheter, activating the epidural block, and the time was noted. Thereafter, in patients of Group A, magnesium sulfate injection 30 mg/kg i.v. bolus was followed by infusion of magnesium sulfate at 10 mg/kg/hr and continued up to 24 hours. Group B was treated as control. Results and Analysis: A significant increase in the mean and maximum duration of analgesia in Group A in comparison with Group B (P<0.05 was observed. Total epidural dose of fentanyl and bupivacaine required in Group A was significantly lower in comparison with Group B in 24 hours. Discussion: Requirement of total doses of local anesthetics along with opioids could be minimized by magnesium infusion; therefore, the further downgradation of patients of LVRS may be prevented. Conclusion: Intravenous magnesium can prolong opioid-induced analgesia while minimizing nausea, pruritus, and somnolence.

  2. Aldosterone and Mineralocorticoid Receptors—Physiology and Pathophysiology

    Directory of Open Access Journals (Sweden)

    John W. Funder

    2017-05-01

    Full Text Available Aldosterone is a uniquely terrestrial hormone, first appearing in lungfish, which have both gills and lungs. Mineralocorticoid receptors (MRs, on the other hand, evolved much earlier, and are found in cartilaginous and bony fish, presumptive ligand cortisol. MRs have equivalent high affinity for aldosterone, progesterone, and cortisol; in epithelia, despite much higher cortisol circulating levels, aldosterone selectively activates MRs by co-expression of the enzyme 11β-hydroxysteroid dehydrogenase, Type 11. In tissues in which the enzyme is not expressed, MRs are overwhelmingly occupied but not activated by cortisol, which normally thus acts as an MR antagonist; in tissue damage, however, cortisol mimics aldosterone and acts as an MR agonist. The risk profile for primary aldosteronism (PA is much higher than that in age-, sex-, and blood pressure-matched essential hypertensives. High levels of aldosterone per se are not the problem: in chronic sodium deficiency, as seen in the monsoon season in the highlands of New Guinea, plasma aldosterone levels are extraordinarily high, but cause neither hypertension nor cardiovascular damage. Such damage occurs when aldosterone levels are out of the normal feedback control, and are inappropriately elevated for the salt status of the individual (or experimental animal. The question thus remains of how excess salt can synergize with elevated aldosterone levels to produce deleterious cardiovascular effects. One possible mechanism is through the agency of the elusive ouabain-like factors (OLFs. Such factors are secreted from the adrenal in response to ACTH (adrenalocortical tropic hormone, to angiotensin via AT2R, and—the polar opposite of aldosterone—to sodium loading. They act on blood vessels to cause vasoconstriction and thus elevate blood pressure to dump excess sodium through pressure natriuresis. Their levels are chronically elevated in PA in response to the continually elevated sodium status, and

  3. Hemodynamic effects of mannitol infusion in patients with acute intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Hong Ye

    2013-02-01

    Full Text Available PURPOSE: To evaluate hemodynamic effects of mannitol infusion in patients with acute intracerebral hemorrhage. METHODS: Thirty patients with acute intracerebral hemorrhage were enrolled. Transcranial doppler was used to detect variables of bilateral middle cerebral arteria (MCA including mean velocity (Vm and pulsitility index (PI before and after125ml and 250ml mannitol infusion (0, 30, 60, 90, 120, 180, 240 min. RESULTS: When 125ml or 250ml mannitol was infused in patients with acute intracerebral hemorrhage, Vm of bilateral MCA elevated, and reached the top at 30min, and then decreased. PI decreased in the affected MCA (250ml and in the unaffected MCA (125ml and 250ml. CONCLUSION: Mannitol infusion in patients with acute intracerebral hemorrhage can improve cerebral blood flow in bilateral hemispheres and decrease intracranial pressure in the hemorrhagic hemisphere (250ml and in the nonhemorrhagic hemisphere (125ml and 250ml.

  4. Rapid actions of aldosterone in vascular health and disease - friend or foe?

    DEFF Research Database (Denmark)

    Skøtt, Ole; Uhrenholt, Torben Rene; Schjerning, Jeppe

    2006-01-01

    The mineralocorticoid receptor (MR) and the enzyme 11betahydroxysteroid dehydrogenase type 2, which confers aldosterone specificity to the MR, are present in endothelium and vascular smooth muscle. In several pathological conditions aldosterone promotes vascular damage by formation of reactive...... oxygen species. The effect of aldosterone on vascular function, however, is far from clear. By rapid non-genomic mechanisms aldosterone may cause calcium mobilization and vasoconstriction, or may stimulate nitric oxide formation through the PI-3 kinase/Akt pathway and thereby counteract vasoconstriction...... production, therefore depends on the ambient level of oxidative stress. Thus, in situations with low levels of oxidative stress aldosterone may promote vasodilatation, while at higher oxidative stress (high NaCl intake, pre-existing vascular pathological conditions, high oxygen tension in vitro) aldosterone...

  5. Effect of increasing intraperitoneal infusion rates on bupropion hydrochloride-induced seizures in mice

    Directory of Open Access Journals (Sweden)

    Fleming Rosanna

    2008-12-01

    Full Text Available Abstract Background It is not known if there is a relationship between input rate and incidence of bupropion-induced seizures. This is important, since different controlled release formulations of bupropion release the active drug at different rates. Methods We investigated the effect of varying the intraperitoneal infusion rates of bupropion HCl 120 mg/kg, a known convulsive dose50 (CD50, on the incidence and severity of bupropion-induced convulsions in the Swiss albino mice. A total of 69 mice, approximately 7 weeks of age, and weighing 21.0 to 29.1 g were randomly assigned to bupropion HCl 120 mg/kg treatment by intraperitoneal (IP administration in 7 groups (9 to 10 animals per group. Bupropion HCl was infused through a surgically implanted IP dosing catheter with infusions in each group of 0 min, 15 min, 30 min, 60 min, 90 min, 120 min, and 240 min. The number, time of onset, duration and the intensity of the convulsions or absence of convulsions were recorded. Results The results showed that IP administration of bupropion HCl 120 mg/kg by bolus injection induced convulsions in 6 out of 10 mice (60% of convulsing mice in group 1. Logistic regression analysis revealed that infusion time was significant (p = 0.0004; odds ratio = 0.974 and increasing the IP infusion time of bupropion HCl 120 mg/kg was associated with a 91% reduced odds of convulsions at infusion times of 15 to 90 min compared to bolus injection. Further increase in infusion time resulted in further reduction in the odds of convulsions to 99.8% reduction at 240 min. Conclusion In conclusion, the demonstration of an inverse relationship between infusion time of a fixed and convulsive dose of bupropion and the risk of convulsions in a prospective study is novel.

  6. Effect of abomasal ferrous lactate infusion on phosphorus absorption in lactating dairy cows.

    Science.gov (United States)

    Feng, X; Knowlton, K F; Dietrich, A D; Duncan, S

    2013-07-01

    The objective of this study was to evaluate the effect of ferrous lactate infusion on postruminal P absorption in lactating dairy cows. Four ruminally cannulated lactating cows were used in a 4×4 Latin square design with 14 d per period. Cows were fed a basal diet containing 0.39% P, providing 100% of the calculated P requirement. On d 8 to 14 of each period, each cow was infused with 0, 200, 500, or 1,250mg of Fe/d in the form of ferrous lactate solution (ferrous lactate in 1L of double-distilled water) into the abomasum. Infusate was formulated to approximate 0, 2, 5, or 12.5mg of Fe/L in drinking water with 100L of water intake/d. Total fecal collection was conducted in the last 4 d of each period to measure nutrient digestion and excretion. Dry matter intake, milk yield, and milk composition were not affected by treatment. Digestibility of DM, NDF, and nitrogen decreased linearly with increasing ferrous lactate infusion. Infusion of ferrous lactate did not affect intake and digestibility of total P, inorganic P, or phytate P. In lactating cows, P absorption was not negatively influenced by abomasally infused ferrous lactate up to 1,250mg of Fe/d. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  7. Aldosterone-induced signalling and cation transport in the distal nephron.

    LENUS (Irish Health Repository)

    Thomas, Warren

    2008-10-01

    Aldosterone is an important regulator of Na(+) and K(+) transport in the distal nephron modulating the surface expression of transporters through the action of the mineralocorticoid receptor as a ligand-dependent transcription factor. Aldosterone stimulates the rapid activation of protein kinase-based signalling cascades that modulate the genomic effects of the hormone. Evidence is accumulating about the multi-factorial regulation of the epithelial sodium channel (ENaC) by aldosterone. Recent published data suggests that the activation of a novel PKC\\/PKD signalling pathway through the c-Src-dependent trans-activation of epidermal growth factor receptor contributes to early ENaC trafficking in response to aldosterone.

  8. Bactericidal effects of deep ultraviolet light-emitting diode for solutions during intravenous infusion.

    Science.gov (United States)

    Omotani, Sachiko; Tani, Katsuji; Aoe, Mai; Esaki, Seiji; Nagai, Katsuhito; Hatsuda, Yasutoshi; Mukai, Junji; Teramachi, Hitomi; Myotoku, Michiaki

    2018-01-01

    Background: Ultraviolet irradiation is effectively used as a disinfection method for inactivating microorganisms. Methods: We investigated the bactericidal effects by irradiation with a deep-ultraviolet light-emitting diode (DUV-LED) on the causative microorganisms of catheter related blood stream infection contaminating the solution for intravenous infusion. For irradiation, prototype modules for water disinfection with a DUV-LED were used. Experiments were conducted on five kinds of microorganisms. We examined the dependence of bactericidal action on eleven solutions. Administration sets were carried out three types. Results: When the administration set JY-PB343L containing the infusion tube made of polybutadiene was used, the bactericidal action of the DUV-LED against all tested microorganisms in the physiological saline solutions was considered to be effective. We confirmed that the number of viable bacteria decreased in 5% glucose solution and electrolyte infusions with DUV-LED irradiation. Conclusions: These results indicate that the DUV-LED irradiation has bactericidal effects in glucose infusion and electrolyte infusions by irradiating via a plasticizer-free polybutadiene administration set. We consider DUV-LED irradiation to be clinically applicable.

  9. A Rare Cause of Hypokalemia: Aldosterone-Secreting Adrenocortical Carcinoma Dear Editor,

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    Ethem Turgay Cerit

    2014-03-01

    Full Text Available Adrenocortical carcinoma (ACC is a rare malignancy accounting for 0.05-0.2% of all cancers (1. Determinants of prognosis are the stage of disease and completeness of resection(2. Approximately 60% of ACCs are hormonally active and glucocorticoids and/or androgens are most frequently over-secreted (2. Rapid development of signs and symptoms of Cushing’s syndrome is the most frequent presentation (3. Aldosterone-secreting ACC is extremely uncommon, comprising 0% to 7% of all functioning ACCs and presents with severe hypertension and profound hypokalemia (4. Here we report a case diagnosed as aldosterone producing adrenocortical carcinoma presented with severe hypokalemia and hypertension. A 32-year-old man referred to our instution because of pain and marked weakness especially in his lower extremities for 2 months. On admission his blood pressure was 180 mmHg systolic and 110 mmHg diastolic. Laboratory investigation revealed severe hypokalemia (2.6 mmol/l (normal: 3.5-5.5 mmol/l, elevated serum aldosterone (39.0 ng/dl (normal: 0.8-13 ng/dl with suppressed plasma renin activity (0.07 ng/ml/h. Serum sodium level was 142 mmol/l (normal: 135-146 mmol/l. Serum aldosterone level was not supressed (38.2 ng/dl after saline infusion test. Serum dehydroepiandrosterone sulfate (DHEA-SO4 was 150 mcg/dl (normal: 80-560, Δ4-androstenedione was 1.91 ng/ml (normal: 0.5-4.8 and total testosterone was 447.3 ng/dl (normal: 229.8-799.8 (Table 1. Suppressed renin levels, increased aldosterone levels with an aldosterone/renin ratio >30 were suggestive findings of aldosterone-producing adenoma of the adrenal gland or bilateral adrenal hyperplasia. Computed tomography demonstrated a large (4.6 cm left-sided adrenal tumour which is heterogeneous and has lobulated margin without a contrasting pattern of adenoma (Figure 1. 24-h urinary catecholamines and low-dose dexamethasone-suppressed plasma cortisol concentrations were all normal. At surgery, an adrenal mass (70

  10. Effects of glucose infusion on neuroendocrine and cognitive parameters in Addison disease.

    Science.gov (United States)

    Klement, Johanna; Hubold, Christian; Hallschmid, Manfred; Loeck, Cecilia; Oltmanns, Kerstin M; Lehnert, Hendrik; Born, Jan; Peters, Achim

    2009-12-01

    Sucrose intake has been shown to suppress increased adrenocorticotropic hormone (ACTH) levels in adrenalectomized rats, suggesting that increased cerebral energy supply can compensate for the loss of glucocorticoid feedback inhibition of the hypothalamo-pituitary-adrenal axis. We hypothesized that glucose infusion might acutely down-regulate increased ACTH secretion in patients with Addison disease. We studied 8 patients with primary adrenal insufficiency (Addison group) with short-term discontinuation of hydrocortisone substitution and 8 matched healthy controls in 2 randomized conditions. Subjects received either intravenous glucose infusion (0.75 g glucose per kilogram body weight for 2.5 hours) or placebo. Concentrations of ACTH, cortisol, catecholamines, growth hormone, glucagon, and insulin were measured; and cognitive functions as well as neuroglycopenic and autonomic symptoms were assessed. The ACTH concentrations were not affected by glucose infusion either in the Addison or in the control group. Likewise, concentrations of cortisol, epinephrine, norepinephrine, growth hormone, and glucagon remained unchanged in both groups. Neurocognitive performance and symptom scores were likewise not affected. Independent of glucose infusion, attention of the Addison patients was impaired in comparison with the control group. Our study in patients with Addison disease was not able to support the assumption of a compensatory effect of intravenous glucose infusion on hormonal parameters and neurocognitive symptoms in states of chronic cortisol deficiency. Further studies should examine whether different regimens of glucose administration are more effective.

  11. Fluctuating functions related to quality of life in advanced Parkinson disease: effects of duodenal levodopa infusion.

    Science.gov (United States)

    Isacson, D; Bingefors, K; Kristiansen, I S; Nyholm, D

    2008-12-01

    To assess fluctuations in quality of life (QoL) and motor performance in patients with advanced Parkinson disease (PD) treated with continuous daytime duodenal levodopa/carbidopa infusion or conventional therapy. Of 18 patients completing a 6-week trial (DIREQT), 12 were followed for up to 6 months and assessed using electronic diaries and the PD Questionnaire-39 (PDQ-39). During the trial and follow-up, major diurnal fluctuations were observed, especially for hyperkinesia, 'off' time, ability to walk and depression. Duodenal infusion was associated with significantly more favourable outcomes compared with conventional treatment for satisfaction with overall functioning, 'off' time and ability to walk, with improved outcomes with PDQ-39. Relative to conventional treatment, infusion therapy may stabilize and significantly improve motor function and patient's QoL. The potential for daily fluctuation in PD symptoms means single measures of treatment effectiveness can result in bias in effect estimates and hence repeated measures are recommended.

  12. Molecular and cellular mechanisms of aldosterone producing adenoma development

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    Sheerazed eBoulkroun

    2015-06-01

    Full Text Available Primary aldosteronism (PA is the most common form of secondary hypertension with an estimated prevalence of ~10% in referred patients. PA occurs as a result of a dysregulation of the normal mechanisms controlling adrenal aldosterone production. It is characterized by hypertension with low plasma renin and elevated aldosterone and often associated with hypokalemia. The two major causes of PA are unilateral aldosterone producing adenoma (APA and bilateral adrenal hyperplasia, accounting together for ~95% of cases. In addition to the well-characterized effect of excess mineralocorticoids on blood pressure, high levels of aldosterone also have cardiovascular, renal and metabolic consequences. Hence, long-term consequences of PA include increased risk of coronary artery disease, myocardial infarction, heart failure and atrial fibrillation. Despite recent progress in the management of patients with PA, critical issues related to diagnosis, subtype differentiation and treatment of non-surgically correctable forms still persist. A better understanding of the pathogenic mechanisms of the disease should lead to the identification of more reliable diagnostic and prognostic biomarkers for a more sensitive and specific screening and new therapeutic options. In this review we will summarize our current knowledge on the molecular and cellular mechanisms of APA development. On one hand, we will discuss how various animal models have improved our understanding of the pathophysiology of excess aldosterone production. On the other hand, we will summarize the major advances made during the last few years in the genetics of APA due to transcriptomic studies and whole exome sequencing. The identification of recurrent and somatic mutations in genes coding for ion channels (KCNJ5 and CACNA1D and ATPases (ATP1A1 and ATP2B3 allowed highlighting the central role of calcium signaling in autonomous aldosterone production by the adrenal.

  13. Anti-albuminuric effect of the aldosterone blocker eplerenone in non-diabetic hypertensive patients with albuminuria: a double-blind, randomised, placebo-controlled trial.

    Science.gov (United States)

    Ando, Katsuyuki; Ohtsu, Hiroshi; Uchida, Shunya; Kaname, Shinya; Arakawa, Yoshihiro; Fujita, Toshiro

    2014-12-01

    Renin-angiotensin system inhibitors have renoprotective effects in patients with chronic kidney disease, but most patients treated with these drugs have residual urinary albumin excretion. Some small clinical studies show that mineralocorticoid receptor blockade reduces albuminuria. Our study aimed to examine the beneficial effects of addition of a selective aldosterone antagonist, eplerenone, to renin-angiotensin system inhibitors in hypertensive patients with non-diabetic chronic kidney disease. In this double-blind, randomised, placebo-controlled trial, we enrolled hypertensive patients, aged 20–79 years, with albuminuria (urinary albumin-to-creatinine ratio [UACR] in the first morning void urine of 30–599 mg/g), an estimated glomerular filtration rate of 50 mL/min per 1·73 m2 or more, and who had received an angiotensin-converting enzyme inhibitor, an angiotensin receptor blocker, or both, for at least 8 weeks. Participants were from 59 clinics and hospitals in Japan. Eligible patients were randomly assigned (1:1), stratified by baseline characteristics, to either low-dose eplerenone (50 mg/day) or placebo, with continuation of standard antihypertensive treatment to attain therapeutic goals (5·5 mmol/L) was not recorded in either group. Addition of low-dose eplerenone to renin-angiotensin system inhibitors might have renoprotective effects through reduction of albuminuria in hypertensive patients with non-diabetic chronic kidney disease, without serious safety concerns. Pfizer.

  14. The effect of glutamine infusion on the inflammatory response and HSP70 during human experimental endotoxaemia

    DEFF Research Database (Denmark)

    Andreasen, Anne Sofie; Pedersen-Skovsgaard, Theis; Mortensen, Ole Hartvig

    2009-01-01

    INTRODUCTION: Glutamine supplementation has beneficial effects on morbidity and mortality in critically ill patients, possibly in part through an attenuation of the proinflammatory cytokine response and a stimulation of heat shock protein (HSP)70. We infused either alanine-glutamine or saline...... an infusion of alanine-glutamine at a rate of 0.025 g/(kg body weight x hour) or saline for 10 hours. After 2 hours, an intravenous bolus of Escherichia coli endotoxin (0.3 ng/kg) was administered. Blood samples were collected hourly for the following 8 hours. HSP70 protein content in isolated blood...... mononuclear cells (BMNCs) was measured by Western blotting. RESULTS: Plasma glutamine increased during alanine-glutamine infusion. Endotoxin reduced plasma glutamine during both trials, but plasma glutamine levels remained above baseline with alanine-glutamine supplementation. Endotoxin injection...

  15. Effect of abomasal glucose infusion on plasma concentrations of gut peptides in periparturient dairy cows

    DEFF Research Database (Denmark)

    Larsen, Mogens; Relling, A E; Reynolds, C K

    2010-01-01

    was a randomized block design with repeated measurements. Cows were assigned to one of 2 treatments: control or infusion of 1,500 g of glucose/d into the abomasum from the day of parturition to 29 d in milk. Cows were sampled 12 ± 6 d prepartum and at 4, 15, and 29 d in milk. Concentrations of glucose......Six Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the portal vein, hepatic vein, mesenteric vein, and an artery were used to study the effects of abomasal glucose infusion on splanchnic plasma concentrations of gut peptides. The experimental design...

  16. Effects Of Perineural Pregabalin Infusion On Peripheral Neuropathy In Sprague Dawley Rats (rattus norvegicus)

    Science.gov (United States)

    2012-04-06

    34· UA 1 t::. ,.;uvt:nt:u . .. 06 April2012 Final 01/2011-04/2012 ... I liLt: ANU :tUDIIILt: ~a. ,.;uN I nA,.; I NUMDt:t1 Effects of Perineural Pregabalin ...neuropathic pain. Methods: Forty male Sprague Dawley rats were randomized into four study groups: Sciatic nerve crush injury with perineural pregabalin ...infusion (T), sciatic crush injury with perineural saline infusion (SA), nerve crush injury with subcutaneous pregabalin (SC), and a sham group without

  17. Effects of fixed-dose isosorbide dinitrate/hydralazine on diastolic function and exercise capacity in hypertension-induced diastolic heart failure.

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    Wilson, Richard M; De Silva, Deepa S; Sato, Kaori; Izumiya, Yasuhiro; Sam, Flora

    2009-09-01

    Hypertension-induced diastolic heart failure accounts for a large proportion of all heart failure presentations. Hypertension also induces left ventricular (LV) hypertrophy. Fixed-dose isosorbide dinitrate/hydralazine (HISDN) decreased mortality in human systolic heart failure but it is unknown whether it improves maladaptive myocardial remodeling. We sought to test the hypothesis that chronic HISDN modulates LV hypertrophy and myocardial remodeling in hypertension-induced diastolic heart failure. FVB mice underwent either saline (n=18) or aldosterone (n=28) infusion. All underwent uninephrectomy and drank 1% salt water for 4 weeks. Mice were randomized after surgery to regular chow or chow containing HISDN (isosorbide dinitrate: 26 mg/kg per day; hydralazine: 50 mg/kg per day) for 4 weeks. Aldosterone infusion increased tail-cuff blood pressure (161+/-3 mm Hg) versus saline-infused mice (129+/-2 mm Hg). Aldosterone induced LV hypertrophy versus saline-infused mice (LV:body weight ratio: 4.2+/-0.1 versus 3.6+/-0.1 mg/g). HISDN attenuated the aldosterone-induced increased in systolic blood pressure (137+/-5 mm Hg) and also lowered blood pressure in saline-infused mice (114+/-2 mm Hg). However, HISDN did not cause LV hypertrophy regression in aldosterone-infused mice. Aldosterone increased LV end-diastolic dimensions that were not attenuated by HISDN. Similarly, neither aldosterone infusion nor HISDN affected LV end-systolic dimensions. LV ejection fraction and wet:dry lung ratio were not different between aldosterone-untreated and aldosterone-HISDN mice. However, mitral Doppler E/A ratio (a measure of diastolic function), exercise capacity, and plasma soluble vascular cell adhesion molecule 1 levels were improved in aldosterone-HISDN hearts. In conclusion, fixed-dose HISDN improved hypertension, diastolic function, and exercise capacity and reduced soluble vascular cell adhesion molecule 1 levels. There were no reductions in LV hypertrophy, cardiac fibrosis, or

  18. Effect of Insulin Infusion on insulin-like growth factor I (IGF-I) during Hemodialysis

    DEFF Research Database (Denmark)

    Reinhard, Mark; Frystyk, Jan; Bjerre, Mette

    2012-01-01

    Background: Hemodialysis (HD) is a catabolic procedure probably contributing to the high frequency of protein-energy wasting among patients on maintenance HD. The aim was to investigate the effect of insulin infusion on insulin-like growth factor I (IGF-I) during HD compared with a meal alone...

  19. Effect of abomasal glucose infusion on splanchnic amino acid metabolism in periparturient dairy cows

    DEFF Research Database (Denmark)

    Larsen, Mogens; Kristensen, Niels Bastian

    2009-01-01

    Six Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the portal vein, hepatic vein, mesenteric vein, and an artery were used to study the effects of abomasal glucose infusion on splanchnic AA metabolism. The experimental design was a split plot, with cow as the who...

  20. Adipocytes, aldosterone and obesity-related hypertension.

    Science.gov (United States)

    Dinh Cat, Aurelie Nguyen; Friederich-Persson, Malou; White, Anna; Touyz, Rhian M

    2016-07-01

    Understanding the mechanisms linking obesity with hypertension is important in the current obesity epidemic as it may improve therapeutic interventions. Plasma aldosterone levels are positively correlated with body mass index and weight loss in obese patients is reported to be accompanied by decreased aldosterone levels. This suggests a relationship between adipose tissue and the production/secretion of aldosterone. Aldosterone is synthesized principally by the adrenal glands, but its production may be regulated by many factors, including factors secreted by adipocytes. In addition, studies have reported local synthesis of aldosterone in extra-adrenal tissues, including adipose tissue. Experimental studies have highlighted a role for adipocyte-secreted aldosterone in the pathogenesis of obesity-related cardiovascular complications via the mineralocorticoid receptor. This review focuses on how aldosterone secretion may be influenced by adipose tissue and the importance of these mechanisms in the context of obesity-related hypertension. © 2016 Society for Endocrinology.

  1. Does the aldosterone: renin ratio predict the efficacy of spironolactone over bendroflumethiazide in hypertension? A clinical trial protocol for RENALDO (RENin-ALDOsterone study

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    McInnes Gordon T

    2007-05-01

    Full Text Available Abstract Background High blood pressure is an important determinant of cardiovascular disease risk. Treated hypertensives do not attain a risk level equivalent to normotensives. This may be a consequence of suboptimal blood pressure control to which indiscriminate use of antihypertensive drugs may contribute. Indeed the recent ALLHAT1study suggests that thiazides should be given first to virtually all hypertensives. Whether this is correct or whether different antihypertensive therapies should be targeted towards different patients is a major unresolved issue, which we address in this study. The measurement of the ratio of aldosterone: renin is used to identify hypertensive subjects who may respond well to treatment with the aldosterone antagonist spironolactone. It is not known if subjects with a high ratio have aldosteronism or aldosterone-sensitive hypertension is debated but it is important to know whether spironolactone is superior to other diuretics such as bendroflumethiazide in this setting. Methods/design The study is a double-blind, randomised, crossover, controlled trial that will randomise 120 hypertensive subjects to 12 weeks treatment with spironolactone 50 mg once daily and 12 weeks treatment with bendroflumethiazide 2.5 mg once daily. The 2 treatment periods are separated by a 2-week washout period. Randomisation is stratified by aldosterone: renin ratio to include equal numbers of subjects with high and low aldosterone: renin ratios. Primary Objective – To test the hypothesis that the aldosterone: renin ratio predicts the antihypertensive response to spironolactone, specifically that the effect of spironolactone 50 mg is greater than that of bendroflumethiazide 2.5 mg in hypertensive subjects with high aldosterone: renin ratios. Secondary Objectives – To determine whether bendroflumethiazide induces adverse metabolic abnormalities, especially in subjects with high aldosterone: renin ratios and if baseline renin measurement

  2. Higher serum aldosterone correlates with lower hearing thresholds: a possible protective hormone against presbycusis.

    Science.gov (United States)

    Tadros, Sherif F; Frisina, Susan T; Mapes, Frances; Frisina, D Robert; Frisina, Robert D

    2005-11-01

    Aldosterone hormone is a mineralocorticoid secreted by adrenal gland cortex and controls serum sodium (Na(+)) and potassium (K(+)) levels. Aldosterone has a stimulatory effect on expression of sodium-potassium ATPase (Na, K-ATPase) and sodium-potassium-chloride cotransporter (NKCC) in cell membranes. In the present investigation, the relation between serum aldosterone levels and age-related hearing loss (presbycusis) and the correlation between these levels versus the degree of presbycusis in humans were examined. Serum aldosterone concentrations were compared between normal hearing and presbycusic groups. Pure-tone audiometry, transient evoked otoacoustic emissions (TEOAE), hearing in noise test (HINT) and gap detection were tested for each subject and compared to the serum aldosterone levels. A highly significant difference between groups in serum aldosterone concentrations was found (p = 0.0003, t = 3.95, df = 45). Highly significant correlations between pure-tone thresholds in both right and left ears, and HINT scores versus serum aldosterone levels were also discovered. On the contrary, no significant correlations were seen in the case of TEOAEs and gap detection. We conclude that aldosterone hormone may have a protective effect on hearing in old age. This effect is more peripheral than central, appearing to affect inner hair cells more than outer hair cells.

  3. Effects of chimerism on the mice heart transplanted survival with the bone marrow infusion.

    Science.gov (United States)

    Jiang, Hong; Tu, Haiyan; Chen, Zhimin; Chen, Rongjun; Wang, Yucheng; Wang, Minmin; Jin, Juan; Feng, Shi; Chen, Wenqing; Bi, Yan; Wang, Huiping; Mao, Youying; Shou, Zhangfei; Chen, Jianghua

    2011-12-01

    To evaluate the effects of chimerism on the mice heart transplanted survival with the bone marrow infusion. Bone marrow cells (BMCs) were obtained from BALB/c mice. These BMCs were injected into the irradiated (2Gy-Co60) C57BL/6 mice through femoral vein. Then Group A mice were treated with Cyclosporine (1mg/kg) for 21days and Group B were not treated with Cyclosporine. Group C were treated as the control group without BMCs infusion. Group D were treated with Cyclosporine (1mg/kg) for 21days pre-hearttransplantation without BMCs infusion. After 21days, the C57BL/6 mice received heart allografts from BALB/c. To determine the degree of chimerism in BMCs infusion recipients, peripheral blood were isolated on day 7, 14, 21. Allografts were harvested 10days after heart transplantation for the histological analysis. (1) Chimerism detected in the peripheral blood of Group A mice on day 7 after BMCs infusion was 6.1±2.5%, on day 14 was 15.4±2.9% and on day 21 was 10.7±2.6%. For the Group B mice on day 7 after BMCs infusion, the chimerism was 2.8±1.1%, on day 14 was 11.2±4.8% and on day 21 was 7.4±3.7%. For the Groups C and D mice, no chimerism was observed. Group A mice had the tendency toward improved level of chimerism than Group B mice. (2) The survival time of Group A (n=6) was 13.0±1.4days which was significantly longer than Group B (n=6) with the survival time was 8.5±1.3days (ptransplanted heart. There was no obvious evidence showed that the chimerism alone could improve the survival time of cardiac allografts in mice. Published by Elsevier B.V.

  4. In vitro viability effects on apheresis and buffy-coat derived platelets administered through infusion pumps

    Directory of Open Access Journals (Sweden)

    Sandgren P

    2014-12-01

    Full Text Available Per Sandgren,1,2 Veronica Berggren,3 Carl Westling,1,2 Viveka Stiller1 1Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, 2Department of Laboratory Medicine, Karolinska Institutet, 3Department of Neonatology, Karolinska University Hospital, Stockholm, SwedenBackground: Different infusion pump systems as well as gravity infusion have been widely used in neonatal transfusion. However, the limited number of published studies describing the use of infusion pumps on platelets illustrates the necessity for more robust data.Methods: To evaluate the potential in vitro effects on the cellular, metabolic, functional and phenotypic properties of platelets, we set up a four-arm paired study simultaneously comparing the use of different infusion pumps (Alaris® CC/GP with unexposed platelets. The platelet units (n=8 were either produced by the apheresis technique and suspended in 100% plasma or derived from buffy coats to yield platelet units stored in approximately 30% plasma and 70% SSP+. Fresh and 5-day old platelets were tested.Results: Regardless of the production system or storage time used, no significant differences were observed in glucose and lactate concentration, pH, adenosine triphosphate levels, response to extent of shape change, hypotonic shock response reactivity, and CD62P expression. Similarly, no differences were observed in expression of the conformational epitope on glycoprotein IIb/IIIa, determined using procaspase-activating compound 1, or in the expression of CD42b and platelet-endothelial cell adhesion molecule-1 in a comparison between platelets administered through infusion pumps versus unexposed platelets.Conclusion: Using Alaris CC/GP infusion pumps had no influence on the cellular, functional, and phenotypic in vitro properties of platelets. This fact seems not to be affected by different production systems or storage time.Keywords: platelets, neonatal platelet transfusion

  5. Effectiveness of Piper betle leaf infusion as a palpebral skin antiseptic

    Directory of Open Access Journals (Sweden)

    Husnun Amalia

    2016-02-01

    Full Text Available The goal of an antiseptic is to eliminate or greatly reduce the number of microorganisms in the surgical field at the time of the surgery. The objective of this study was to verify the effectiveness of 20% Piper betle leaf infusion as an antiseptic solution in pre-surgery cataract patients. A clinical trial with partner-matching design was conducted on 31 pairs of eyelids. From each pair of eyelids, one eyelid was asigned to the Piper betle infusion group and the opposite one to the povidone-iodine group. The microorganisms were collected by swab from the patient’s palpebral skin, inoculated on nutrient agar, and incubated at 37oC for 20 hours. The antiseptic effectiveness was measured by counting the microbial colonies before and after administration of the antiseptic solutions. This study demonstrates that the mean colony counts after application of 20% Piper betle leaf infusion showed a significant reduction of 27-100% compared with those before administration (p=0.001. Mean colony counts after 10% povidone-iodine administration showed a significant reduction of 88-100% compared with the mean counts before the solution was applied (p=0.000. The 20% Piper betle infusion has an antiseptic potential. Nevertheless, the 10% povidone-iodine solution has more effective antiseptic capability.

  6. Improving continuous wound infusion effectiveness for postoperative analgesia after cesarean delivery: a randomized controlled trial.

    Science.gov (United States)

    Rackelboom, Thibaut; Le Strat, Solenn; Silvera, Stephane; Schmitz, Thomas; Bassot, Agnes; Goffinet, François; Ozier, Yves; Beaussier, Marc; Mignon, Alexandre

    2010-10-01

    To evaluate in which anatomical layer (above the fascia or below the fascia) continuous wound infusion of local anesthetic, combined with nonsteroidal antiinflammatory drugs, through a multiorifice catheter has the best effectiveness during the first 48 hours on postoperative pain intensity after elective cesarean delivery. Fifty-six women undergoing elective cesarean delivery under spinal anesthesia were randomly allocated to receive 48-hour continuous wound infusion either above the fascia or below the fascia using ropivacaine and ketoprofene through a multiholed wound catheter. No other systemic analgesics were used, except for rescue patient-controlled intravenous morphine. Evaluation by a blinded investigator included visual analog scale scores at rest and at movement, morphine consumption, patient satisfaction, residual pain at 1 and 6 months, and undesirable side effects. Continuous wound infusion below the fascia resulted in significantly reduced pain at rest and total postoperative morphine consumption (15.7 mg, 95% confidence interval 9.7-20.7 mg) compared with wound administration above the fascia (26.4 mg, 95% confidence interval 18.1-34.7). No undesirable side effects or residual pain requiring treatment were recorded in both groups, whereas analgesia and satisfaction were excellent. After cesarean delivery, continuous wound infusion over 48 hours with ropivacaine and ketoprofene through a multiholed wound catheter inserted below the fascia results in better analgesia when compared with administration above the fascia. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01160913. I.

  7. Effectiveness of Piper betle leaf infusion as a palpebral skin antiseptic

    Directory of Open Access Journals (Sweden)

    Husnun Amalia

    2009-08-01

    Full Text Available The goal of an antiseptic is to eliminate or greatly reduce the number of microorganisms in the surgical field at the time of the surgery. The objective of this study was to verify the effectiveness of 20% Piper betle leaf infusion as an antiseptic solution in pre-surgery cataract patients. A clinical trial with partner-matching design was conducted on 31 pairs of eyelids. From each pair of eyelids, one eyelid was asigned to the Piper betle infusion group and the opposite one to the povidone-iodine group. The microorganisms were collected by swab from the patient’s palpebral skin, inoculated on nutrient agar, and incubated at 37oC for 20 hours. The antiseptic effectiveness was measured by counting the microbial colonies before and after administration of the antiseptic solutions. This study demonstrates that the mean colony counts after application of 20% Piper betle leaf infusion showed a significant reduction of 27-100% compared with those before administration (p=0.001. Mean colony counts after 10% povidone-iodine administration showed a significant reduction of 88-100% compared with the mean counts before the solution was applied (p=0.000. The 20% Piper betle infusion has an antiseptic potential. Nevertheless, the 10% povidone-iodine solution has more effective antiseptic capability.

  8. Pantoprazole before Endoscopy in Patients with Gastroduodenal Ulcer Bleeding: Does the duration of Infusion and Ulcer Location Influence the Effects?

    Directory of Open Access Journals (Sweden)

    Istvan Rácz

    2012-01-01

    Full Text Available The aim of this study was to investigate the effect of preemptive pantoprazole infusion on early endoscopic findings in patients with acute ulcer bleeding. Records of 333 patients admitted with acute ulcer bleeding were analyzed. Ulcer bleeders were given either 80 mg bolus of pantoprazole followed by continuous infusion of 8 mg per hour or saline infusion until endoscopy. In 93 patients saline infusion whereas in 240 patients bolus plus infusion of pantoprazole was administrated with mean (±SD durations of 5.45±12.9 hours and 6.9±13.2 hours, respectively (P=0.29. Actively bleeding ulcers were detected in 46/240 (19.2% of cases in the pantoprazole group as compared with 23/93 (24.7% in the saline infusion group (P=0.26. Different durations of pantoprazole infusion (0–4 hours, >4 hours, and >6 hours had no significant effect on endoscopic and clinical outcome parameters in duodenal ulcer bleeders. Gastric ulcer bleeders on pantoprazole infusion longer than 4 and 6 hours before endoscopy had actively bleeding ulcers in 4.3% and 5% compared to the 19.5% active bleeding rate in the saline group (P=0.02 and P=0.04. Preemptive infusion of high-dose pantoprazole longer than 4 hours before endoscopy decreased the ratio of active bleeding only in gastric but not in duodenal ulcer patients.

  9. Salt, Aldosterone, and Parathyroid Hormone: What Is the Relevance for Organ Damage?

    Directory of Open Access Journals (Sweden)

    Cristiana Catena

    2017-01-01

    Full Text Available Structured interventions on lifestyle have been suggested as a cost-effective strategy for prevention of cardiovascular disease. Epidemiologic studies demonstrate that dietary salt restriction effectively decreases blood pressure, but its influence on cardiovascular morbidity and mortality is still under debate. Evidence gathered from studies conducted in patients with primary aldosteronism, essential hypertension, or heart failure demonstrates that long-term exposure to elevated aldosterone results in cardiac structural and functional changes that are independent of blood pressure. Animal experiments and initial clinical studies indicate that aldosterone damages the heart only in the context of an inappropriately elevated salt status. Recent evidence suggests that aldosterone might functionally interact with the parathyroid hormone and thereby affect calcium homeostasis with important sequelae for bone mineral density and strength. The interaction between aldosterone and parathyroid hormone might have implications also for the heart. Elevated dietary salt is associated on the one hand with increased urinary calcium excretion and, on the other hand, could facilitate the interaction between aldosterone and parathyroid hormone at the cellular level. This review summarizes the evidence supporting the contribution of salt and aldosterone to cardiovascular disease and the possible cardiac and skeletal consequences of the mutual interplay between aldosterone, parathyroid hormone, and salt.

  10. Aldosterone breakthrough with benazepril in furosemide-activated renin-angiotensin-aldosterone system in normal dogs.

    Science.gov (United States)

    Lantis, A C; Ames, M K; Atkins, C E; DeFrancesco, T C; Keene, B W; Werre, S R

    2015-02-01

    Pilot studies in our laboratory revealed that furosemide-induced renin-angiotensin-aldosterone system (RAAS) activation was not attenuated by the subsequent co-administration of benazepril. This study was designed to evaluate the effect of benazepril on angiotensin-converting enzyme (ACE) activity and furosemide-induced circulating RAAS activation. Our hypothesis was that benazepril suppression of ACE activity would not suppress furosemide-induced circulating RAAS activation, indicated by urinary aldosterone concentration. Ten healthy hound dogs were used in this study. The effect of furosemide (2 mg/kg p.o., q12h; Group F; n = 5) and furosemide plus benazepril (1 mg/kg p.o., q24h; Group FB; n = 5) on circulating RAAS was determined by plasma ACE activity, 4-6 h posttreatment, and urinary aldosterone to creatinine ratio (UAldo:C) on days -1, -2, 1, 3, and 7. There was a significant increase in the average UAldo:C (μg/g) after the administration of furosemide (Group F baseline [average of days -1 and -2] UAldo:C = 0.41, SD 0.15; day 1 UAldo:C = 1.1, SD 0.56; day 3 UAldo:C = 0.85, SD 0.50; day 7 UAldo:C = 1.1, SD 0.80, P furosemide-induced RAAS activation, indicating aldosterone breakthrough (escape). This is particularly noteworthy in that breakthrough is observed at the time of initiation of RAAS suppression, as opposed to developing after months of therapy. © 2014 John Wiley & Sons Ltd.

  11. Effect of hypovolemia, infusion, and oral rehydration on gradual onset +Gz acceleration tolerance

    Science.gov (United States)

    Greenleaf, J. E.; Brock, P. J.; Haines, R. F.; Rositano, S. A.; Montgomery, L. D.; Keil, L. C.

    1976-01-01

    The purpose of this study was to determine the effect of blood withdrawal, blood infusion, and oral fluid intake on +Gz tolerance at an acceleration rate of 0.5 G/min. Six healthy men aged 21-27 yr were centrifuged after the withdrawal of 400 ml of blood (hypovolemia) from each man; they were centrifuged again following blood infusion (Phase I). Three weeks later the men were accelerated after similar hypovolemia and again after consuming 800 ml of an isotonic NaCl drink (Phase II). Phase I hypovolemia resulted in a reduction in tolerance in all subjects from a mean control level of 6.42 + or - 0.35 min to 5.45 + or - 0.17 min (-15.1%, p less than 0.05). Both infusion and drinking returned tolerances to control levels. During acceleration there were significant (p less than 0.05) increases in plasma vasopressin levels to 35 pg/ml; these were not influenced appreciably by infusion or drinking. In all acceleration runs there was an obligatory shift (loss) of plasma volume and electrolytes, especially potassium, regardless of the experimental treatments. Oral rehydration is shown to be as effective as blood replacement in restoring +Gz acceleration tolerance decrements due to hypovolemia.

  12. Recurrence of primary aldosteronism after percutaneous ethanol injection

    Directory of Open Access Journals (Sweden)

    Fan-Chi Chang

    2012-03-01

    Full Text Available Adrenalectomy is the definite treatment for aldosterone-producing adenoma (APA. Percutaneous ethanol or acetic acid injection with computed tomography (CT guidance has been described as a safe, noninvasive, and effective alternative treatment modality in patients with high surgical risk. We report on a man who was 49 years of age and presented with treatment-resistant hypertension and was later diagnosed with APA. CT-guided percutaneous ethanol injection (PEI was performed for this high surgical risk patient. He had aldosteronism recurrence 4 years after the ethanol injection, so a second PEI was performed. The tumor size was reduced and his blood pressure was normalized. Therefore, we suggest that clinicians should closely check aldosterone to renin ration and potassium level if percutaneous chemical ablation is considered in functioning adrenal adenomas.

  13. P53/Drp1-dependent mitochondrial fission mediates aldosterone-induced podocyte injury and mitochondrial dysfunction.

    Science.gov (United States)

    Yuan, Yanggang; Zhang, Aiqing; Qi, Jia; Wang, Hui; Liu, Xi; Zhao, Min; Duan, Suyan; Huang, Zhimin; Zhang, Chengning; Wu, Lin; Zhang, Bo; Zhang, Aihua; Xing, Changying

    2017-06-28

    Mitochondrial dysfunction is increasingly recognized as an important factor in glomerular diseases. Previous study showed that mitochondrial fission contributed mitochondrial dysfunction. However, the mechanism of mitochondrial fission on mitochondrial dysfunction in aldosterone-induced podocyte injury remains ambiguous. This study aimed to investigate the pathogenic effect of mitochondrial fission both in vivo and in vitro. In an animal model of aldosterone-induced nephropathy, inhibition of the mitochondrial fission protein Drp1 (dynamin-related protein 1) suppressed aldosterone-induced podocyte injury. In cultured podocytes, aldosterone dose-dependently induced Drp1 expression. Knockdown of Drp1 inhibited aldosterone-induced mitochondrial fission, mitochondrial dysfunction and podocyte apoptosis. Furthermore, aldosterone dose-dependently induced p53 expression. Knockdown of p53 inhibited aldosterone-induced Drp1 expression, mitochondrial dysfunction and podocyte apoptosis. These findings implicated that aldosterone-induced mitochondrial dysfunction and podocyte injury mediated by p53/Drp1-dependent mitochondrial fission, which may provide opportunities for therapeutic intervention for podocyte injury. Copyright © 2017, American Journal of Physiology-Renal Physiology.

  14. Investigation of aldosterone-synthase inhibition in rats.

    Science.gov (United States)

    Ménard, Joël; Gonzalez, Marie-Françoise; Guyene, Thanh-Tam; Bissery, Alvine

    2006-06-01

    In-vivo investigation of aldosterone-synthase inhibitors requires experimental models to characterize the biological effects of these compounds. Seven successive experiments were performed in groups of 2-month-old male spontaneously hypertensive rats. Urinary free aldosterone was the main end-point measured during two contrasted diets: low sodium-high potassium (LS), inducing high urinary aldosterone (839 pmol/24 h, 95% confidence interval 654-1077), and high sodium-normal potassium (HS), inducing low urinary aldosterone (38.1 pmol/24 h; 95% confidence interval, 32.4-44.9). FAD 286 A (10 and 30 mg/kg) decreased urinary free aldosterone by 53 and 87% on the LS diet, and 50 and 75% on the HS. Plasma renin concentration increased three-fold after a 4-week treatment of 30 mg/kg FAD 286 A on the LS diet and did not change on the HS. The combination of FAD 286 A (30 mg/kg) and spironolactone (30 mg/kg) on the LS diet induced a biological picture of severe hypoaldosteronism and was not tolerated, whereas the HS diet prevented these abnormalities. The combination of FAD 286 A (30 mg/kg) and furosemide (30 mg/kg) on the HS diet corrected the diuretic-induced hypokalemia (4.1 +/- 0.2 versus 3.7 +/- 2.2 mEq/l, P < 0.033). This experimental model will be useful to screen future aldosterone-synthase inhibitors and study their biological effects in various experimental conditions.

  15. Effect of teapot materials on the chemical composition of oolong tea infusions.

    Science.gov (United States)

    Liao, Zih-Hui; Chen, Ying-Jie; Tzen, Jason Tze-Cheng; Kuo, Ping-Chung; Lee, Maw-Rong; Mai, Fu-Der; Rairat, Tirawat; Chou, Chi-Chung

    2018-01-01

    The flavor and quality of tea are widely believed to be associated with the pot in which the tea is made. However, this claim is mostly by experiences and lacks solid support from scientific evidence. The current study investigated and compared the chemical compositions of oolong tea made with six different teapot materials, namely Zisha, Zhuni, stainless steel, ceramic, glass and plastic. For each tea sample, polyphenols and caffeine were examined by HPLC-UV, volatile compounds by GC/MS, amino acids by LC/MS and minerals by ICP-MS. The results suggested that tea infusions from Zisha and Zhuni pots contain higher levels of EGC, EGCG and total catechins and less caffeine than those from ceramic, glass and plastic pots and tend to have the lowest total mineral contents, potassium and volatile compounds in tea soup. The statistical differences were not all significant among Zisha, Zhuni and stainless steel pots. Based on the overall chemical composition of the tea infusion, Yixing clay pots (Zisha and Zhuni) produce tea infusions that are presumably less bitter and more fragrant and tend to contain more healthful compounds than tea infusions from other pots. The results could partially explain why Yixing clay pots are among the most popular teapots. The beneficial effects of long-term repeated use of these teapots warrants further study. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  16. Effect of burst swimming and adrenaline infusion on O2 consumption and CO2 excretion in rainbow trout, Salmo gairdneri

    DEFF Research Database (Denmark)

    Steffensen, J F; Tufts, B L; Randall, D J

    1987-01-01

    control values. 2. Infusion of adrenaline into resting fish had no significant effect on oxygen consumption or carbon dioxide excretion and therefore there was no significant change in the respiratory exchange ratio. 3. This infusion of adrenaline caused a significant elevation in the red blood cell p...

  17. Anti-Aging Effects of the Hanwoo Leg Bone, Foot and Tail Infusions (HLI, HFI and HTI) on Skin Fibroblast

    Science.gov (United States)

    Yoon, Ji Young; Jeong, Hee Sun; Joo, Nami

    2016-01-01

    Many researchers revealed that collagen contribute to maintaining the skin’s elasticity and inhibit wrinkling of skin. Korean native cattle (Hanwoo) bone (leg bone, foot and tail) infusion contains the various inorganic materials, collagen and chondroitin sulfate. All of this, a large quantity of collagen is included in Hanwoo infusion. Therefore, this study emphasized on the effects of collagen in the Hanwoo bone infusion. For the first time, Hanwoo bone infusions were directly added to the media of Human Dermal Fibroblast (NHDF-c) to test anti-aging effects. First, it was identified that growth rate of skin fibroblast was increased. Furthermore, the Hanwoo bone infusion increased a 50% of fibroblast collagen synthesis. Also, suppression of skin fibroblast aging was confirmed by treatment Hanwoo bone infusion. In conclusion, this study demonstrates the effects of infusion made from Hanwoo leg bone, foot and tail on anti-aging, wrinkle inhibiting and skin fibroblast elasticity maintaining. Therefore, this study identified that traditional infusion has effects that are good for skin elasticity. PMID:27194933

  18. Evaluation of Patient Satisfaction, Preference and Side Effects after Annual Zoledronic Acid Infusion in Patients with Osteoporosis

    Directory of Open Access Journals (Sweden)

    Banu Dilek

    2017-04-01

    Full Text Available Objective: In this study it was aimed to evaluate the patient satisfaction, therapy preference and side-effect profile in patients who receive annual zoledronic acid (ZA infusion. Materials and Methods: In this study, 59 patients who had ZA infusion were enrolled. Their demographic and osteoporosis characteristics and the number of received ZA infusions were recorded. A seven-item questionnaire was used to assess the patients’ therapy preference. General patient satisfaction, satisfaction during ZA infusion and its effects on life quality were assessed with a Likert scale. Results: The mean age of the 59 patients (50 females, 9 males was 68.49±8.65 years. Of the patients 86.4% (51 wanted to continue the same therapy, 64.4% (36 stated that the mode of administration was very convenient and 61% (36 stated that it was well-suited with their lifestyle. The most important factors for the continued usage were the annual administration convenience and the physician’s recommendation. Mild side effects (myalgia, arthralgia, flu-like syndrome, fever, headache and pruritus were reported in 23.7% of the patients (14 subsequent to the first infusion. ZA infusion was quite satisfying for 37.3% of the patients (22 and very satisfying for 40.7% of the patients (24. When the treatment effect on the quality of life was investigated, 42.4% of the patients (25 found it very effective, while 37.3% of them (22 found it extremely effective. Among these patients, 47.5% received their first ZA infusion (28, while 52.5% received multiple (2-4 infusions before (31. The increasing number of infusions did not have any influence on the patient’s life quality, satisfaction or therapy preference. Conclusion: ZA infusion is a preferable, highly satisfactory, convenient therapy and its side effects are well-tolerated, it affects the quality of life favourably.

  19. Cerebral vascular effects of hypovolemia and dopamine infusions

    DEFF Research Database (Denmark)

    Holst Hahn, Gitte; Heiring, Christian; Pryds, Ole

    2012-01-01

    Despite widespread use, effects of volume boluses and dopamine in hypotensive newborn infants remain controversial. We aimed to elucidate if hypovolemia alone impairs cerebral autoregulation (CA) and if dopamine affects cerebral vasculature....

  20. Bactericidal effects of deep ultraviolet light-emitting diode for solutions during intravenous infusion

    OpenAIRE

    Omotani, Sachiko; Tani, Katsuji; Aoe, Mai; Esaki, Seiji; Nagai, Katsuhito; Hatsuda, Yasutoshi; Mukai, Junji; Teramachi, Hitomi; Myotoku, Michiaki

    2018-01-01

    Background: Ultraviolet irradiation is effectively used as a disinfection method for inactivating microorganisms. Methods: We investigated the bactericidal effects by irradiation with a deep-ultraviolet light-emitting diode (DUV-LED) on the causative microorganisms of catheter related blood stream infection contaminating the solution for intravenous infusion. For irradiation, prototype modules for water disinfection with a DUV-LED were used. Experiments were conducted on five kinds of microor...

  1. Effect of low-dose naloxone infusion on fentanyl requirements in critically ill children.

    Science.gov (United States)

    Darnell, Cindy Maria; Thompson, Jennifer; Stromberg, Daniel; Roy, Lonnie; Sheeran, Paul

    2008-05-01

    Sedating critically ill patients often involves prolonged opioid infusions causing opioid tolerance. Naloxone has been hypothesized to limit opioid tolerance by decreasing adenylate cyclase/cyclic adenosine monophosphate activation. The study purpose was to investigate the effect of low-dose naloxone on the maximum cumulative daily fentanyl dose in critically ill children. We conducted a double-blinded, randomized, placebo-control trial from December 2002 through July 2004 in a university PICU. We enrolled 82 children age 1 day to 18 years requiring mechanical ventilation and fentanyl infusions anticipated to last for >4 days were eligible for enrollment. Those receiving additional oral analgesia or sedation, having a history of drug dependence or withdrawal, or having significant neurologic, renal, or hepatic disease were excluded. In addition to fentanyl infusions, patients received low-dose naloxone or placebo infusions. Medications were adjusted using the Modified Motor Activity Assessment Scale. Withdrawal was monitored using the Modified Narcotic Withdrawal Scale. Intervention was a low-dose naloxone infusion (0.25 microg/kg per hour) and the main outcome variable was the maximum cumulative daily fentanyl dose (micrograms per kilogram per day). There was no difference in the maximum cumulative daily fentanyl dose between patients treated with naloxone (N = 37) or those receiving placebo (N = 35). Adjustment for the starting fentanyl dose also failed to reveal group differences. Total fentanyl dose received throughout the study in the naloxone group (360 microg/kg) versus placebo (223 microg/kg) was not statistically different. Placebo patients trended toward fewer rescue midazolam boluses (10.7 vs 17.8), lower total midazolam dose (11.6 mg/kg vs 23.9 mg/kg), and fewer rescue fentanyl boluses (18.5 vs 23.9). We conclude that administration of low-dose naloxone (0.25 microg/kg per hour) does not decrease fentanyl requirements in critically ill, mechanically

  2. Effects of herbal infusions, tea and carbonated beverages on alcohol dehydrogenase and aldehyde dehydrogenase activity.

    Science.gov (United States)

    Li, Sha; Gan, Li-Qin; Li, Shu-Ke; Zheng, Jie-Cong; Xu, Dong-Ping; Li, Hua-Bin

    2014-01-01

    Various alcoholic beverages containing different concentrations of ethanol are widely consumed, and excessive alcohol consumption may result in serious health problems. The consumption of alcoholic beverages is often accompanied by non-alcoholic beverages, such as herbal infusions, tea and carbonated beverages to relieve drunk symptoms. The aim of this study was to supply new information on the effects of these beverages on alcohol metabolism for nutritionists and the general public, in order to reduce problems associated with excessive alcohol consumption. The effects of 57 kinds of herbal infusions, tea and carbonated beverages on alcohol dehydrogenase and aldehyde dehydrogenase activity were evaluated. Generally, the effects of these beverages on alcohol dehydrogenase and aldehyde dehydrogenase activity are very different. The results suggested that some beverages should not be drank after excessive alcohol consumption, and several beverages may be potential dietary supplements for the prevention and treatment of problems related to excessive alcohol consumption.

  3. The aphrodisiac effect and toxicity of combination Piper retrofractum L, Centella asiatica, and Curcuma domestica infusion

    Directory of Open Access Journals (Sweden)

    Nuning Rahmawati

    2012-09-01

    is a plant that acts as a stimulant on the body. A preliminary study showed that administration of infusion of 2.1 mg/10 g body weight had androgenic and anabolic effects in white mice. Piperine is the main alkaloid suspected to have an aphrodisiac effect. Centella asiatica and Curcuma domestica are the excipients. The objective of this research was to determine the toxicity and the aphrodisiac effect of a combination infusion of Piper retrofractum L, Centella asiatica and Curcuma domestica on Sprague-Dawley strain male rats.Methods: Parameters for aphrodisiac effect were the frequency of introduction, climbing, and coitus of male rats. The concentration of pre and post-treatment of male rat testosterone hormone was determined using rat testosterone ELISA kit. Sub-chronic toxicity was determined from SGOT, SGPT, urea, and kreatinin concentrations of pre and post treatment of rats orally administered the combination infusion everyday for 3 months.Results: There were signifi cant differences in coitus and climbing frequencies between the male rat group administered combination infusion of Piper retrofractum L., Centella asiatica, and Curcuma domestica and the group not given the infusion (P=0.032. There was no signifi cant difference between testosterone levels of the group administered the infusion and kontrol (P=0.248. Administering high dose (5000 mg/200 g BW of infusion caused a signifi cant difference in levels of SGOT and SGPT between pre and post-treatment.Conclusion: The infusion of 1000 mg/200 g body weight had safe aphrodisiac effect on male Sprague-Dawley rats libido. (Health Science Indones 2012;1:19-22 

  4. Differential effects of sodium acetoacetate and acetoacetic acid infusions on alanine and glutamine metabolism in man.

    Science.gov (United States)

    Féry, F; Balasse, E O

    1980-08-01

    It has been suggested that ketone bodies might participate in the nitrogen-sparing process occurring during prolonged starvation by inhibiting the muscular production of alanine and glutamine, which are the main gluconeogenic amino acids. The results of the ketone infusion studies on which this theory is based have been reevaluated in this study by following the plasma levels of ketone bodies, alanine, glutamine, and other substrates during 11.5 h in five groups of normal overnight-fasted subjects. Subjects of groups I, II, and III were infused for 3 h, respectively, with Na acetoacetate, Na bicarbonate, or free acetoacetic acid administered in comparable amounts (about 20 mumol/kg per min), whereas group IV was infused with hydrochloric acid (7.0 mumol/kg per min). A control group (V) received no infusion. Na acetoacetate induced a rise in blood pH (+0.1+/-0.003) and a fall in the plasma levels of alanine (-41.8+/-4.6%) and glutamine (-10.6+/-1.4%), whereas free acetoacetic acid had a barely detectable lowering effect on blood pH and induced a rise in alanine (+22.5+/-8.0%) and glutamine (+14.6+/-3.2%) levels. Both infusions were associated with a lowering of plasma glucose, which therefore seems independent of the changes in alanine and glutamine concentrations. Sodium bicarbonate reproduced the alkalinizing effect and the hypoalaninemic action of Na acetoacetate, which seems thus unrelated to hyperketonemia. On the other hand, acidification of blood with hydrochloric acid did not mimic the effects of acetoacetic acid. If the hyperalaninemic and hyperglutaminemic effects of ketone bodies infused in their physiological form (free acids) reflect a stimulation of the muscular output of these amino acids, the participation of ketone bodies in the nitrogen-sparing process of prolonged fasting seems very unlikely. On the other hand, during brief starvation, when both ketogenesis and gluconeogenesis are markedly stimulated, ketone bodies might indirectly contribute in

  5. The Effects of Preoperative Oral Pregabalin and Perioperative Intravenous Lidocaine Infusion on Postoperative Morphine Requirement in Patients Undergoing Laparatomy

    Directory of Open Access Journals (Sweden)

    Senniye Ulgen Zengin

    2015-01-01

    Full Text Available OBJECTIVES: To evaluate and compare the effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement, adverse effects, patients’ satisfaction, mobilization, time to first defecation and time to discharge in patients undergoing laparotomy.

  6. Interrelated aldosterone and parathyroid hormone mutually modify cardiovascular mortality risk

    NARCIS (Netherlands)

    Tomaschitz, Andreas; Pilz, Stefan; Rus-Machan, Jutta; Meinitzer, Andreas; Brandenburg, Vincent M; Scharnagl, Hubert; Kapl, Martin; Grammer, Tanja; Ritz, Eberhard; Horina, Jörg H; Kleber, Marcus E; Pieske, Burkert; Kraigher-Krainer, Elisabeth; Hartaigh, Bríain Ó; Toplak, Hermann; van Ballegooijen, Adriana J; Amrein, Karin; Fahrleitner-Pammer, Astrid; März, Winfried

    2015-01-01

    BACKGROUND: Inappropriate aldosterone and parathyroid hormone (PTH) secretion is associated with increased cardiovascular risk. Accumulating evidence suggests bidirectional interplay between aldosterone and PTH. METHODS: We evaluated the cross-sectional relationship between plasma aldosterone

  7. Infusion of hypertonic saline before elective hysterectomy: effects on cytokines and stress hormones

    DEFF Research Database (Denmark)

    Kolsen-Petersen, J A; Bendtzen, K; Tonnesen, E

    2008-01-01

    Infusion of hypertonic saline provides early haemodynamic benefits and may affect the immune system. It is unknown if infusion of hypertonic saline affects plasma cytokines and stress hormones after surgery.......Infusion of hypertonic saline provides early haemodynamic benefits and may affect the immune system. It is unknown if infusion of hypertonic saline affects plasma cytokines and stress hormones after surgery....

  8. How does delayed testing reduce effects of implicit memory: context infusion or cuing with context?

    Science.gov (United States)

    Nelson, Douglas L; Goodmon, Leilani B; Ceo, David

    2007-07-01

    Studying a word implicitly activates related associates that affect its recall in the extralist cuing task. Recall is more likely when one of these associates becomes the test cue and when other associates of the studied word activate this associate. Context disruptions occurring between study and test reduce these effects, suggesting that implicitly activated memories are linked to context. The context infusion hypothesis assumes that context information spreads throughout a word's associative network during study, decreasing with distance from the studied word. Interactive cuing assumes that context is linked only to the studied word and that recall is based on retrieving information from the test cue and the context. The infusion hypothesis predicts that effects of disruptions will depend on link distance whereas interactive cuing predicts that distance will have no effect. The experiments evaluate these explanations by manipulating target-to-cue strength, associate-to-cue strength, and context disruption. Experiment 1 varies disruption by testing under the same or different conditions (room, modality, experimenter). Experiment 2 tests recall immediately or after 5 m, 10 m, or 20 m of multiplication. The results are inconsistent with context infusion and support the interactive cuing explanation.

  9. Mitochondria-Targeted Antioxidant Mito-Tempo Protects Against Aldosterone-Induced Renal Injury In Vivo

    Directory of Open Access Journals (Sweden)

    Wei Ding

    2017-11-01

    Full Text Available Background/Aims: Growing evidence suggests mitochondrial dysfunction (MtD and the Nlrp3 inflammasome play critical roles in chronic kidney disease (CKD progression. We previously reported that Aldosterone (Aldo-induced renal injury in vitro is directly caused by mitochondrial reactive oxygen species (mtROS-mediated activation of the Nlrp3 inflammasome. Here we aimed to determine whether a mitochondria-targeted antioxidant (Mito-Tempo could prevent Aldo-induced kidney damage in vivo. Methods: C57BL/6J mice were treated with Aldo and/or Mito-Tempo (or ethanol as a control for 4 weeks. Renal injury was evaluated by Periodic Acid-Schiff reagent or Masson’s trichrome staining and electron microscopy. ROS were measured by DCFDA fluorescence and ELISA. MtD was determined by real-time PCR and electron microscopy. Activation of the Nlrp3 inflammasome and endoplasmic reticulum stress (ERS was detected via western blot. Results: Compared with control mice, Aldo-infused mice showed impaired renal function, increased mtROS production and MtD, Nlrp3 inflammasome activation, and elevated ERS. We showed administration of Mito-Tempo significantly improved renal function and MtD, and reduced Nlrp3 inflammasome activation and ERS in vivo. Conclusion: Mitochondria-targeted antioxidants may attenuate Aldo-infused renal injury by inhibiting MtD, the Nlrp3 inflammasome, and ERS in vivo. Therefore, targeting mtROS might be an effective strategy for preventing CKD.

  10. The effect of ambient temperature on cold saline during simulated infusion to induce therapeutic hypothermia.

    Science.gov (United States)

    Mader, T J

    2009-07-01

    This study was done to determine the effect of ambient temperature on cold saline during simulated infusion to induce therapeutic hypothermia. The study hypothesis was that cold saline would warm rapidly during simulated infusion and that an insulating SIGG neoprene pouch would slow the process. Paired 1-l bags of normal saline [with or without an insulating SIGG neoprene pouch (NEO+ and NEO- respectively)] were refrigerated together for at least 24h. With an ambient room temperature (RT) between 32 and 34 degrees C, the fluid was allowed to flow unrestricted through standard tubing connected to a 20-guage angiocath while the line reservoir temperature was monitored every 30s. The order of the bags was pre-determined and alternated for each session. During 5 sessions, ten 1-l bags were included (5 NEO+ and 5 NEO-). The data were analyzed descriptively using Stata SE v8.1 for Macintosh. The average ambient RT during the experimental sessions was 32.6 degrees C (StDev: 0.8 degrees C). The relative humidity was a constant 16%. The average low saline temperature at the beginning of infusion was 6.2 degrees C (StDev: 2.7 degrees C). The average rate of infusion was 48.2cm(3)/min (StDev: 3.7cm(3)/min). The average rise in saline temperature during the first 15min of the infusion was 2.9 degrees C (StDev: 1.2 degrees C). The average high saline temperature reached near the end of the infusion was 13.4 degrees C (StDev: 4.1 degrees C). The average temperature change during infusion was 7.2 degrees C (StDev: 3.5 degrees C). The baseline data for the NEO+ and NEO- samples were not statistically different. The average temperature change over the first 15min for the NEO+ group was 2.0 degrees C (95% CI: 1.4 degrees C and 2.5 degrees C) and for the NEO- group it was 3.9 degrees C (95% CI: 2.6 degrees C and 5.1 degrees C). The average change over the entire infusion for the NEO+ group was 4.3 degrees C (95% CI: 3.1 degrees C and 5.5 degrees C) and for the NEO- group it was 10

  11. Abomasal protein infusion in postpartum transition dairy cows: Effect on performance and mammary metabolism

    DEFF Research Database (Denmark)

    Larsen, Mogens; Lapierre, H; Kristensen, Niels Bastian

    2014-01-01

    The effect of increasing the postpartum metabolizable protein (MP) supply on performance and mammary metabolism was studied using 8 Holstein cows in a complete randomized design. At parturition, cows were assigned to abomasal infusion of water (CTRL) or casein (CAS). Arterial and epigastric venous...... blood samples were taken 14 d before expected parturition and at 4, 15, and 29 d in milk (DIM). To compensate previously estimated deficiency of essential AA and to avoid oversupply, casein protein infusion was graduated with 696 ± 1, 490 ± 9, and 212 ± 10 g/d at 4, 15 and 29 DIM, respectively. Dry...... indicated that Lys, Leu, and Tyr were the first-limiting AA at 4 DIM with CTRL. Mammary plasma flow was unaffected by treatment, indicating similar perfusion of mammary tissue. The greater milk yield with CAS was associated with greater mammary uptake of individual essential AA, tendencies to greater uptake...

  12. Effects of 4 hours magnesium sulfate infusion on fetal heart rate variability and reactivity in a goat model.

    Science.gov (United States)

    Sameshima, H; Ikenoue, T; Kamitomo, M; Sakamoto, H

    1998-01-01

    Effects of magnesium sulfate were investigated on fetal heart rate (FHR) baseline, variability, and reactivity in goats. Six chronically catheterized fetuses of Japanese Saanen goat at 125 to 130 days' gestation (term = 147 days) were used. Magnesium sulfate was directly infused to the fetuses. Short-term variability and long-term variability were obtained according to Huey et al. The baseline, reactivity, short-term variability and long-term variability of the FHR were compared between those receiving magnesium sulfate infusions and those receiving vehicle infusions without magnesium sulfate for 4 hr. Two-way analysis of variance (ANOVA) and Duncan's multiple range test was applied for statistical significance. Four hours magnesium sulfate infusion significantly increased fetal plasma concentration of magnesium from 2.4-6.6 mg/dL, without significant changes in fetal respiratory gases and pH values. The baseline FHR was significantly decreased by magnesium infusion compared with that receiving vehicle infusion. The incidence of acceleration, short-term variability, and long-term variability during the fourth hour of magnesium infusion was also significantly decreased compared to a controlled infusion. The time spent by high amplitude phase of short-term variability and that of long-term variability were also significantly reduced. Significant correlation was obtained between the magnesium concentration and incidence of acceleration at fourth hour of magnesium infusion. Four hours infusion of magnesium sulfate significantly decreases baseline FHR, short-term variability, long-term variability, and reactivity in fetal goats at 0.85 gestation.

  13. Does aldosterone play a significant role for regulation of vascular tone?

    DEFF Research Database (Denmark)

    Lyngsø, Kristina Sanne; Assersen, Kasper Bostlund; Dalgaard, Emil Geertsen

    2016-01-01

    receptors (MR) are present in endothelial and vascular smooth muscle cells and MR-independent pathways are also involved. The vascular effects of aldosterone are complex, both concentration, temporal and spatial aspects are relevant. The acute response includes vasodilation through endothelial nitric oxide...... of reactive oxygen radicals, endothelia Na-influx and smooth muscle calcium channel expression and perivascular cells, e.g. mast cells, also participate. Moreover, the vascular effect of aldosterone depends on the status of the endothelium which is likely cause of the very different responses to aldosterone...

  14. Renal effects of long-term leptin infusion and preventive role of losartan treatment in rats.

    Science.gov (United States)

    Gunduz, Zubeyde; Dursun, Nurcan; Akgun, Hulya; Ozturk, Figen; Okur, Hamit; Koc, Nedret

    2005-12-15

    Leptin has direct and indirect effects on renal pathophysiological characteristics. In the present study, the effects of long-term leptin infusion on the renal hemodynamics, renal excretory functions, and the expression of transforming growth factor-beta (TGF-beta), plasma endothelin-1 (ET-1) levels, and preventive effects of the angiotensin II type 1 receptor antagonist, losartan, on these renal changes were evaluated. The study was performed by using forty Wistar albino rats. On day 0, osmotic mini-pumps filled with leptin or placebo were intraperitoneally placed under sterile conditions. The rats in Group L (Leptin group, n=15) and Group LL (Leptin-losartan group, n=15) were given recombinant murine leptin at a rate of 250 ng per hour for 28 days. Control rats (Group C, n=10) were administered placebo at the same infusion rate. The rats in Group LL were also administered losartan (10 mg kg(-1) d(-1)) perorally for 28 days. On day 28, the rats were placed in metabolic cages, and the food and water intakes were determined, and the urine was collected for 24 h. At the end of the study, systolic blood pressure (SBP), diastolic blood pressure (DBP) were determined directly from the left femoral artery, and renal blood flow (RBF) was recorded indirectly using a laser Doppler flow module. Leptin infusion did not produce any changes in systemic arterial blood pressures and urinary flow rate. The rates of creatinine (Cr), sodium (Na), and protein excretions of the animals infused leptin were significantly increased. The urinary Cr and Na excretions were decreased, while the urinary protein excretion was normalized with the losartan treatment. The rats infused leptin had also higher circulating ET-1 levels. ET-1 levels were also reversed to the normal values with the losartan treatment. Renal TGF-beta1 expression was determined immunohistochemically, and it was more prominent in the renal tubules from the rats treated with leptin. The losartan treatment had no effect on

  15. Effect of chronic oral administration of a low dose of captopril on sodium appetite of hypothyroid rats: Influence of aldosterone treatment

    Directory of Open Access Journals (Sweden)

    Ventura R.R.

    2001-01-01

    Full Text Available Rats rendered hypothyroid by treatment with methimazole develop an exaggerated sodium appetite. We investigated here the capacity of hypothyroid rats (N = 12 for each group to respond to a low dose of captopril added to the ration, a paradigm which induces an increase in angiotensin II synthesis in cerebral areas that regulate sodium appetite by increasing the availability of circulating angiotensin I. In addition, we determined the influence of aldosterone in hypothyroid rats during the expression of spontaneous sodium appetite and after captopril treatment. Captopril significantly increased (P<0.05 the daily intake of 1.8% NaCl (in ml/100 g body weight in hypothyroid rats after 36 days of methimazole administration (day 36: 9.2 ± 0.7 vs day 32: 2.8 ± 0.6 ml, on the 4th day after captopril treatment. After the discontinuation of captopril treatment, daily 1.8% NaCl intake reached values ranging from 10.0 ± 0.9 to 13.9 ± 1.0 ml, 48 to 60 days after treatment with methimazole. Aldosterone treatment significantly reduced (P<0.05 saline intake before (7.3 ± 1.6 vs day 0, 14.4 ± 1.3 ml and after captopril treatment. Our results demonstrate that, although hypothyroid rats develop a deficiency in the production of all components of the renin-angiotensin-aldosterone system, their capacity to synthesize angiotensin II at the cerebral level is preserved. The partial reversal of daily 1.8% NaCl intake during aldosterone treatment suggests that sodium retention reduces both spontaneous and captopril-induced salt appetite.

  16. A comparison of the effectiveness of dexmedetomidine versus propofol target-controlled infusion for sedation during fibreoptic nasotracheal intubation

    National Research Council Canada - National Science Library

    Tsai, C.-J; Chu, K.-S; Chen, T.-I; Lu, D. V; Wang, H.-M; Lu, I.-C

    2010-01-01

    Summary Fibreoptic intubation is a valuable modality for airway management. This study aimed to compare the effectiveness of dexmedetomidine vs target controlled propofol infusion in providing sedation during fibreoptic intubation...

  17. Metabolic and hemodynamic effects of saline infusion to maintain volemia on temporary abdominal aortic occlusion

    Directory of Open Access Journals (Sweden)

    Fábio Ferreira Amorim

    2002-10-01

    Full Text Available OBJECTIVE: To analyze hemodynamic and metabolic effects of saline solution infusion in the maintenance of blood volume in ischemia-reperfusion syndrome during temporary abdominal aortic occlusion in dogs. METHODS: We studied 20 dogs divided into 2 groups: the ischemia-reperfusion group (IRG, n=10 and the ischemia-reperfusion group with saline solution infusion aiming at maintaining mean pulmonary arterial wedge pressure between 10 and 20 mmHg (IRG-SS, n=10. All animals were anesthetized with sodium thiopental and maintained on spontaneous ventilation. Occlusion of the supraceliac aorta was obtained with inflation of a Fogarty catheter inserted through the femoral artery. After 60 minutes of ischemia, the balloon was deflated, and the animals were observed for another 60 minutes of reperfusion. RESULTS: IRG-SS dogs did not have hemodynamic instability after aortic unclamping, and the mean systemic blood pressure and heart rate were maintained. However, acidosis worsened, which was documented by a greater reduction of arterial pH that occurred especially due to the absence of a respiratory response to metabolic acidosis that was greater with the adoption of this procedure. CONCLUSION: Saline solution infusion to maintain blood volume avoided hemodynamic instability after aortic unclamping. This procedure, however, caused worsening in metabolic acidosis in this experimental model.

  18. Aldosterone induces fibrosis, oxidative stress and DNA damage in livers of male rats independent of blood pressure changes

    Energy Technology Data Exchange (ETDEWEB)

    Queisser, Nina; Happ, Kathrin; Link, Samuel [Institute of Pharmacology and Toxicology, University of Würzburg, Würzburg (Germany); Jahn, Daniel [Division of Hepatology, Department of Medicine II, University Hospital Würzburg, Würzburg (Germany); Zimnol, Anna [Institute of Pharmacology and Toxicology, University of Würzburg, Würzburg (Germany); Geier, Andreas [Division of Hepatology, Department of Medicine II, University Hospital Würzburg, Würzburg (Germany); Schupp, Nicole, E-mail: schupp@uni-duesseldorf.de [Institute of Pharmacology and Toxicology, University of Würzburg, Würzburg (Germany)

    2014-11-01

    Mineralocorticoid receptor blockers show antifibrotic potential in hepatic fibrosis. The mechanism of this protective effect is not known yet, although reactive oxygen species seem to play an important role. Here, we investigated the effects of elevated levels of aldosterone (Ald), the primary ligand of the mineralocorticoid receptor, on livers of rats in a hyperaldosteronism model: aldosterone-induced hypertension. Male Sprague–Dawley rats were treated for 4 weeks with aldosterone. To distinguish if damage caused in the liver depended on increased blood pressure or on increased Ald levels, the mineralocorticoid receptor antagonist spironolactone was given in a subtherapeutic dose, not normalizing blood pressure. To investigate the impact of oxidative stress, the antioxidant tempol was administered. Aldosterone induced fibrosis, detected histopathologically, and by expression analysis of the fibrosis marker, α-smooth muscle actin. Further, the mRNA amount of the profibrotic cytokine TGF-β was increased significantly. Fibrosis could be reduced by scavenging reactive oxygen species, and also by blocking the mineralocorticoid receptor. Furthermore, aldosterone treatment caused oxidative stress and DNA double strand breaks in livers, as well as the elevation of DNA repair activity. An increase of the transcription factor Nrf2, the main regulator of the antioxidative response could be observed, and of its target genes heme oxygenase-1 and γ-glutamylcysteine synthetase. All these effects of aldosterone were prevented by spironolactone and tempol. Already after 4 weeks of treatment, aldosteroneinfusion induced fibrosis in the liver. This effect was independent of elevated blood pressure. DNA damage caused by aldosterone might contribute to fibrosis progression when aldosterone is chronically increased. - Highlights: • Aldosterone has direct profibrotic effects on the liver independent of blood pressure. • Fibrosis is mediated by the mineralocorticoid receptor and

  19. Effects of intrapartum intravenous infusion of 5% dextrose or Hartmann's solution on maternal and cord blood glucose.

    Science.gov (United States)

    Loong, E P; Lao, T T; Chin, R K

    1987-01-01

    The effects of intrapartum infusion of dextrose or Hartmann's solution on maternal and cord blood glucose were studied. Patients with and without infusion of intravenous fluids during labor were randomly selected and allocated to one of three groups. Group I received 5% dextrose solution as a vehicle for oxytocin (dextrose group), group II received Hartmann's solution (Hartmann group) and group III did not receive any intravenous infusion (control group). Each group consisted of 16 patients. Routine labor ward procedures were followed. Maternal and cord blood samples were taken at delivery. Maternal blood glucose concentrations were significantly lower in the Hartmann group than in the dextrose and control groups, showing a dilution effect of Hartmann's solution. Cord blood glucose concentrations did not differ significantly between the three groups, indicating that maternal infusion of dextrose or Hartmann's solution in routine intrapartum management would have no adverse effects on fetal blood glucose.

  20. Alpha-h-ANP injection in normals, low renin hypertension and primary aldosteronism.

    Science.gov (United States)

    Mantero, F; Rocco, S; Pertile, F; Carpené, G; Fallo, F; Menegus, A

    1987-01-01

    Atrial natriuretic peptide, a hormone secreted by the heart, is involved in salt and fluid homeostasis and also exerts an inhibitory effect on aldosterone production in vitro. In order to elucidate if this effect is also present in man, 6 normal volunteers, 5 low renin hypertensive patients (LRH) and 7 patients with primary aldosteronism (PA) have received 100 micrograms of alpha-h-Anp as bolus i.v. (The decrease in blood pressure was mild and transient in all groups, whereas a marked diuretic effect was observed in all hypertensives even in PA where high levels of endogenous ANP have been found. In normals we observed a significant decrease of plasma aldosterone values while in PA and LRH this effect was not evident. This phenomenon associated with a greater natriuretic effect in LRH and PA, as compared with normals, demonstrates the lack of the correlation between ANP-induced diuresis and aldosterone inhibiting properties.

  1. Mutation in Aldosterone Producing Adenoma

    Directory of Open Access Journals (Sweden)

    Jian-Jhong Wang

    2017-09-01

    Full Text Available Discoveries of somatic mutations permit the recognition of subtypes of aldosterone-producing adenomas (APAs with distinct clinical presentations and pathological features. Catenin β1 (CTNNB1 mutation in APAs has been recently described and discussed in the literature. However, significant knowledge gaps still remain regarding the prevalence, clinical characteristics, pathophysiology, and outcomes in APA patients harboring CTNNB1 mutations. Aberrant activation of the Wnt/β-catenin signaling pathway will further modulate tumorigenesis. We also discuss the recent knowledge of CTNNB1 mutation in adrenal adenomas.

  2. Epidermal growth factor receptor signaling mediates aldosterone-induced profibrotic responses in kidney

    Energy Technology Data Exchange (ETDEWEB)

    Sheng, Lili; Yang, Min; Ding, Wei [Department of Nephrology, Shanghai Fifth People' s Hospital, Fudan University, Shanghai 200240 (China); Zhang, Minmin [Department of Nephrology, Shanghai Huashan Hospital, Fudan University, Shanghai 200240 (China); Niu, Jianying [Department of Nephrology, Shanghai Fifth People' s Hospital, Fudan University, Shanghai 200240 (China); Qiao, Zhongdong [School of Life Science and Biotechnology, Shanghai Jiaotong University, Shanghai 200240 (China); Gu, Yong, E-mail: yonggu@vip.163.com [Department of Nephrology, Shanghai Fifth People' s Hospital, Fudan University, Shanghai 200240 (China); Department of Nephrology, Shanghai Huashan Hospital, Fudan University, Shanghai 200240 (China)

    2016-08-01

    Aldosterone has been recognized as a risk factor for the development of chronic kidney disease (CKD). Studies have indicated that enhanced activation of epidermal growth factor receptor (EGFR) is associated with the development and progression of renal fibrosis. But if EGFR is involved in aldosterone-induced renal fibrosis is less investigated. In the present study, we examined the effect of erlotinib, an inhibitor of EGFR tyrosine kinase activity, on the progression of aldosterone-induced renal profibrotic responses in a murine model underwent uninephrectomy. Erlotinib-treated rats exhibited relieved structural lesion comparing with rats treated with aldosterone alone, as characterized by glomerular hypertrophy, mesangial cell proliferation and expansion. Also, erlotinib inhibited the expression of TGF-β, α-SMA and mesangial matrix proteins such as collagen Ⅳ and fibronectin. In cultured mesangial cells, inhibition of EGFR also abrogated aldosterone-induced expression of extracellular matrix proteins, cell proliferation and migration. We also demonstrated that aldosterone induced the phosphorylation of EGFR through generation of ROS. And the activation of EGFR resulted in the phosphorylation of ERK1/2, leading to the activation of profibrotic pathways. Taken together, we concluded that aldosterone-mediated tissue fibrosis relies on ROS induced EGFR/ERK activation, highlighting EGFR as a potential therapeutic target for modulating renal fibrosis. - Highlights: • EGFR was involved in aldosterone-induced renal profibrotic responses. • Aldosterone-induced EGFR activation was mediated by MR-dependent ROS generation. • EGFR activated the MAPK/ERK1/2 signaling to promote renal fibrosis.

  3. Effects of intraluminal infusion of short-chain fatty acids on the healing of colonic anastomosis in the rat.

    Science.gov (United States)

    Rolandelli, R H; Koruda, M J; Settle, R G; Rombeau, J L

    1986-08-01

    The effects of an intracolonic infusion of short-chain fatty acids (SCFA) on the healing of colonic anastomosis in the rat were investigated. Thirty-three Sprague-Dawley rats underwent transection and anastomosis of the descending colon and transection and diversion of the ascending colon. The proximal limb of the ascending colon was exteriorized as an end colostomy, and the distal (defunctionalized) limb was cannulated for continuous infusion. Rats received either no infusion (N = 11) or an infusion of either electrolytes (N = 11) or SCFA (acetate, propionate, and butyrate; N = 11) into the defunctionalized colonic segment. On the sixth postoperative day bursting pressure (BP) and bowel wall tension (BWT) were determined. The occurrence of spontaneous anastomotic dehiscence was significantly less for the SCFA group (0/11) compared with the no infusion group (5/11, p less than 0.01). The anastomotic suture line burst in significantly fewer colons from the SCFA group (1/11) than either the electrolyte infusion (8/11, p less than 0.003) or the no infusion (6/6, p less than 0.001) groups. BP and BWT were significantly higher for the SCFA group (BP: 147 +/- 10 mm Hg; BWT: 59 +/- 1.0 dyne 10(3)/cm) than for either the electrolyte (BP: 99 +/- 30 mm Hg, p less than 0.002; BWT: 45 +/- 19, p less than 0.03) or no infusion (BP: 111 +/- 42, p less than 0.02; BWT 36 +/- 15, p less than 0.007) groups. The results of this study indicate that intracolonic infusion of SCFA resulted in significantly stronger colonic anastomosis in the rat.

  4. Salt, Aldosterone, and Parathyroid Hormone: What Is the Relevance for Organ Damage?

    OpenAIRE

    Catena, Cristiana; Colussi, Gian Luca; Brosolo, Gabriele; Bertin, Nicole; Novello, Marileda; Palomba, Andrea; Sechi, Leonardo A.

    2017-01-01

    Structured interventions on lifestyle have been suggested as a cost-effective strategy for prevention of cardiovascular disease. Epidemiologic studies demonstrate that dietary salt restriction effectively decreases blood pressure, but its influence on cardiovascular morbidity and mortality is still under debate. Evidence gathered from studies conducted in patients with primary aldosteronism, essential hypertension, or heart failure demonstrates that long-term exposure to elevated aldosterone ...

  5. Continuum of Renin-Independent Aldosteronism in Normotension.

    Science.gov (United States)

    Baudrand, Rene; Guarda, Francisco J; Fardella, Carlos; Hundemer, Gregory; Brown, Jenifer; Williams, Gordon; Vaidya, Anand

    2017-05-01

    Primary aldosteronism is a severe form of autonomous aldosteronism. Milder forms of autonomous and renin-independent aldosteronism may be common, even in normotension. We characterized aldosterone secretion in 210 normotensives who had suppressed plasma renin activity (renin, and potassium handling were investigated. Severe autonomous aldosterone secretion that was consistent with confirmed primary aldosteronism was defined based on accepted criteria of an aldosterone excretion rate >12 μg/24 hours with urinary sodium excretion >200 mmol/24 hours. Across the population, there were strong and significant associations between higher aldosterone excretion rate and higher urinary potassium excretion, higher angiotensin II-stimulated aldosterone, and lower plasma renin activity, suggesting a continuum of renin-independent aldosteronism and mineralocorticoid receptor activity. Autonomous aldosterone secretion that fulfilled confirmatory criteria for primary aldosteronism was detected in 29 participants (14%). Normotensives with evidence suggestive of confirmed primary aldosteronism had higher 24-hour urinary aldosterone excretion rate (20.2±12.2 versus 6.2±2.9 μg/24 hours; Prenin ratio, blood pressure, or renal plasma flow between the 2 groups. These findings indicate a continuum of renin-independent aldosteronism and mineralocorticoid receptor activity in normotension that ranges from subtle to overtly dysregulated and autonomous. Longitudinal studies are needed to determine whether this spectrum of autonomous aldosterone secretion contributes to hypertension and cardiovascular disease. © 2017 American Heart Association, Inc.

  6. The effect of glucagon infusion on kidney function in short-term insulin-dependent juvenile diabetics

    DEFF Research Database (Denmark)

    Parving, H H; Christiansen, J S; Noer, I

    1980-01-01

    Kidney function was studied in nine, metabolically well controlled, short-term insulin-dependent male diabetics before and during glucagon infusion of 4 to 5 and 8 to 10 ng/kg/min. Glomerular filtration rate, effective renal plasma flow (steady-state infusion technique, with urinary collections......, using 125I-iothalamate and 131I-iodohippurate), and urinary albumin and beta 2-microglobulin excretion rates were measured. The mean plasma glucagon concentration increased during infusion from 254 +/- 19 pg/ml to 440 +/- 31 pg/ml (low dose) and 730 +/- 52 pg/ml (high dose). Glomerular filtration rate...... increased in all subjects from 133 +/- 5 before the glucagon infusion to 141 +/- 4 with the low dose, and 148 +/- 7 ml/min/1.73 m2 with the high dose (p

  7. Effects of local alpha2-adrenergic receptor blockade on adipose tissue lipolysis during prolonged systemic adrenaline infusion in normal man

    DEFF Research Database (Denmark)

    Simonsen, Lene; Enevoldsen, Lotte H; Stallknecht, Bente

    2008-01-01

    During prolonged adrenaline infusion, lipolysis peaks within 30 min and thereafter tends to decline, and we hypothesized that the stimulation of local adipose tissue alpha2-adrenergic receptors accounts for this decline. The lipolytic effect of a prolonged intravenous adrenaline infusion combined...... with local infusion of the alpha2-blocker phentolamine in superficial and deep abdominal subcutaneous adipose tissue and in preperitoneal adipose tissue was studied in seven healthy subjects. The interstitial glycerol concentration in the three adipose tissue depots was measured by the microdialysis method....... Regional adipose tissue blood flow was measured by the (133)Xe clearance technique. Regional glycerol output (lipolytic rate) was calculated from these measurements and simultaneous measurements of arterial glycerol concentrations. Adrenaline infusion increased lipolysis in all three depots (data...

  8. [Diuretic effect of an infusion of the herbal plant, Salvia scutellarioides, in rats].

    Science.gov (United States)

    Ramírez, Jorge Hernán; Palacios, Mauricio; Gutiérrez, Oscar

    2006-03-01

    In the Colombian traditional medicine, an infusion made of the entire plant Salvia scutellarioides (known locally as mastranto or oreja de perro (dog's ear)) is used for its antihypertensive and diuretic effects. However, experimental studies have never been done to validate the reported effects. In the current study, a rat model was used to determine the effect of S. scutellarioides on rat diuresis and urinary electrolytes concentration. Twenty-four male Sprague-Dawley rats were distributed in four groups: Group 1--normal saline solution, Group 2--furosemide (10 mg/kg), Groups 3 and 4 with S. scutellarioides infusion, 1 g/kg and 2 g/kg respectively. All treatments were administered in a volume of 25 ml/kg of rat weight. After treatment, the rats were placed in a metabolic cage for 6 hours. During this period, urinary excretion was monitored and quantified. At the end of 6 hours, the urinary electrolyte concentrations were measured. The administration of S. scutellarioides at doses of 1 and 2 g/kg produced a significant increase in diuresis when compared to the control group (p < 0.01). The administration of S. scutellarioides at these doses also increased the urinary excretion of potassium and chloride. These results corroborate the apparent diuretic activity of S. scutellarioides described by traditional herbalists and possibly explains its reported antihypertensive effect. Further studies are required to determine the pharmacological and toxicological profile of the plant.

  9. The effective concentration of red betel leaf (Piper crocatum infusion as root canal irrigant solution

    Directory of Open Access Journals (Sweden)

    Fani Pangabdian

    2012-03-01

    Full Text Available Background: Smear layer is a debris consisting of organic and inorganic particles of calcified tissue, necrotic tissue, pulp tissue, and dentinoblast and microorganism processes that can close the entrance to the dentin tubuli. Smear layer, will not only inhibit the penetration of disinfection materials and sealers to the dentin tubuli, but will also reduce the attachment of root canal filling material so that root canal irrigation solution is needed to dissolve the smear layer. Red betel leaf (Piper crocatum infusion, on the other hand, contains saponin characterized as “surfactants” which can dissolve smear layer. Nevertheless, the effective concentration of the red betel leaf infusion has still not been known clearly. Purpose: This study is aimed to determine the effective concentration of the red betel leaf infusion for cleaning root canal walls from smear layer. Methods: Fiveteen extracted human teeth with straight single roots were randomized into 5 groups (n=3. The specimens were then shaped by using rotary instruments up to a size of 25/.07. During instrumentation, each canal was irrigated with 10, 20, 30 and, 40% red betel leaf infusion for treatment groups, while another was irrigated with aquadest for the control group. Root canal cleanliness was observed by using scanning electron microscope (SEM. Results: There were significant differences among treatment groups (p<0.05, except in the treatment groups irrigated with red betel leaf infusion with concentrations of 30% and 40% (p>0.05. Conclusion: It can be concluded that red betel leaf infusion with a concentration of 30% is effective for cleaning the root canal walls from the smear layer.Latar belakang: Smear layer adalah suatu debris yang mengandung partikel organik dan anorganik dari jaringan terkalsifikasi, jaringan nekrotik, proses dentinoblas, jaringan pulpa dan mikroorganisme yang dapat menutup jalan masuk ke tubuli dentin. Smear layer akan menghalangi penetrasi dari bahan

  10. Effect of intra arterial nimodipine infusion for the treatment of symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Young; Shin, Hwa Seon; Choi, Hye Young; Chung, Sung Hoon; You, Jin Jong; Choi, Dae Seob; Son, Seung Nam [Gyeongsang National Univ. Hospital/Gyeongsang National Univ. School of Medicine, Jinju (Korea, Republic of); Ryu, Jae Wook [Samsung Seoul Hospital, Seoul (Korea, Republic of)

    2012-06-15

    Symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage (SAH) is one of the major factors which cause morbidity and mortality of patients. The purpose of this study was to evaluate the effectiveness of intra-arterial nimodipine (IAN) infusion therapy in patients with symptomatic cerebral vasospasm. Between February 2005 and April 2011, fifty patients with symptomatic cerebral vasospasm following an aneurysmal SAH were treated with IAN infusion. After selective arterial catheterization, nimodipine was infused at a rate of 0.1 mg/min and a total of 2-3 mg per vessel was infused. We retrospectively reviewed the immediate angiographic results and clinical outcome at discharge. A grade of 5 and 4 in the Glasgow Outcome Scale (GOS) were considered favorable outcomes. In 50 patients, 117 procedures of IAN infusion (1-7; mean, 2.3)were done. After the treatment, immediate angiographic improvement was achieved in 113 (96.6%) of 117 procedures. No major complications occurred. At discharge, 38 (76%) patients showed a favorable clinical outcome in the GOS. IAN infusion therapy is safe and effective for the treatment of cerebral vasospasm following an aneurysmal SAH. However, the limitation is that repeated treatment is needed.

  11. Cardiovascular, Antinociceptive and Sedative Effects of Medetomidine Infusion in Sevoflurane Anesthesia in Puppies

    Directory of Open Access Journals (Sweden)

    J Morgaz*, JM Domínguez, R Navarrete, JA Fernández-Sarmiento, P Muñoz-Rascón, RJ Gómez-Villamandos and MM Granados

    2013-07-01

    Full Text Available The objective of this study was to determine the effect of a constant rate infusion of medetomidine in the cortical brain activity and hemodynamic parameters in sevoflurane anesthetized puppies. Six puppies of the age of two weeks old were included in the study and were anaesthetized three times with sevoflurane. On the first anesthesia, each dog’s minimum alveolar concentration (MAC for sevoflurane was determined by the use of the tail clamp method. On the second anesthesia (sevoflurane, the puppies were anesthetized at each of five multiples of their individual’s MAC, 0.75, 1, 1.25, 1.5 and 1.75 MAC, and bispectral index and cardiorespiratory parameters were registered. On the third anesthesia (sevoflurane+ medetomidine, puppies were anesthetized at each of five multiples of their individual’s MAC, and medetomidine (5 µg/kg+2µg/kg/h was administered. Mild cardiovascular depression was observed in sevoflurane+medetomidine in comparison with sevoflurane. Cortical and antinociceptive effects were not observed with medetomidine infusion although a mature EEG response to noxious stimulation would not have developed in puppies. Central alpha-2 adrenoreceptors would be immature in puppies during the first two weeks of life, and for this reason, medetomidine would not produce sedative and analgesic effects in young puppies. More studies have to be performed to support this statement.

  12. Ischemic Postconditioning and Subanesthetic S(+)-Ketamine Infusion: Effects on Renal Function and Histology in Rats

    Science.gov (United States)

    de Resende, Marco A. C.; Pantoja, Alberto V.; Barcellos, Bruno M.; Reis, Eduardo P.; Consolo, Thays D.; Módolo, Renata P.; Domingues, Maria A. C.; Assad, Alexandra R.; Cavalcanti, Ismar L.; Castiglia, Yara M. M.; Módolo, Norma S. P.

    2015-01-01

    Background. Ischemic postconditioning (IP) in renal Ischemia reperfusion injury (IRI) models improves renal function after IRI. Ketamine affords significant benefits against IRI-induced acute kidney injury (AKI). The present study investigated the effects of IP and IP associated with subanesthetic S(+)-ketamine in ischemia-reperfusion-induced AKI. Methods. Forty-one Wistar rats were randomized into four groups: CG (10), control; KG (10), S(+)-ketamine infusion; IPG (10), IP; and KIPG (11), S(+)-ketamine infusion + IP. All rats underwent right nephrectomy. IRI and IP were induced only in IPG and KIPG by left kidney arterial occlusion for 30 min followed by reperfusion for 24 h. Complete reperfusion was preceded by three cycles of 2 min of reocclusion followed by 2 min of reperfusion. Renal function was assessed by measuring serum neutrophil gelatinase-associated lipocalin (NGAL), creatinine, and blood urea nitrogen (BUN). Tubular damage was evaluated by renal histology. Results. Creatinine and BUN were significantly increased. Severe tubular injury was only observed in the groups with IRI (IPG and KIPG), whereas no injury was observed in CG or KG. No significant differences were detected between IPG and KIPG. Conclusions. No synergic effect of the use of subanesthetic S(+)-ketamine and IP on AKI was observed in this rat model. PMID:26413552

  13. Effects of Gelofusine Infusion Applied Before Spinal Anaesthesia on Hypotension and Coagulation

    Directory of Open Access Journals (Sweden)

    Sedat Kaya

    2006-01-01

    Full Text Available Hypotension is one of the most important complications of spinal anaesthesia. Hypotension may cause catastrophic side effects in hemodynamically unstable and/or old patients. Gelofusine has been used widely for many years for volume replacement therapies. But, it has disadvantages such as coagulopathy or trombositopenia.The aim of this study was to compare three different doses of gelofusine applied prophylactically before spinal anaesthesia for prevention of hypotension induced by spinal anaesthesia.The study was implemented 45 American Society of Anaesthesiologist physical status I-II orthopaedic patients. Fourty-five patients were allocated randomly into three groups. Gelofusine 5,10,15 mg/kg were infused intravenously in15 minutes in Group I,II and III respectively. Hypotension was observed in one patient for each group, which were treated with efedrin. Gelofusine prevented hypotension successfully in all three doses. Moreover, even the dose of 15mg/kg cause neither coagulopathy nor trombositopenia.We concluded that 5 mg/kg gelofusine is enough to avoid hypotension. Infusion of gelofusine in up to15 mg/kg was found to be safe for spinal anaesthesia; it does not have such side effect as coagulopathy or trombositopenia this doses.

  14. Tumour necrosis factor-alpha infusion produced insulin resistance but no change in the incretin effect in healthy volunteers.

    Science.gov (United States)

    Nielsen, Signe Tellerup; Lehrskov-Schmidt, Louise; Krogh-Madsen, Rikke; Solomon, Thomas P J; Lehrskov-Schmidt, Lars; Holst, Jens Juul; Møller, Kirsten

    2013-11-01

    Type 2 diabetes mellitus (T2DM) is associated with peripheral insulin resistance, impaired incretin effect, and increased plasma levels of tumour necrosis factor-alpha (TNF-α). Although TNF-α infusion at a dose that induces systemic inflammation in healthy volunteers has been demonstrated to induce peripheral insulin resistance, the influence of this cytokine on the incretin effect is unknown. We investigated whether systemic inflammation induced by TNF-α infusion in healthy volunteers alters the incretin hormone response to oral and intravenous glucose loads in a crossover study design with ten healthy male volunteers (mean age 24 years, mean body mass index 23.7 kg/m(2) ). The study consisted of four study days: days 1 and 2, 6-h infusion of saline; days 3 and 4, 6-h infusion of TNF-α; days 1 and 3, 4-h oral glucose tolerance test; and days 2 and 4, 4-h corresponding intravenous isoglycaemic glucose tolerance test. Glucose tolerance tests were initiated after 2 h of saline/TNF-α infusion. Plasma concentrations of TNF-α, interleukin 6, glucose, incretin hormones, and cortisol, and serum concentrations of C-peptide and insulin were measured throughout the study days. Insulin sensitivity was estimated by the Matsuda index and homeostasis model assessment of insulin resistance (HOMA-IR). Prehepatic insulin secretion rates were calculated. TNF-α infusion induced symptoms of systemic inflammation; increased plasma levels of cortisol, TNF-α, and interleukin 6; and increased the HOMA-IR. The secretion of incretin hormones as well as the incretin effect remained unchanged. In healthy young male volunteers, acute systemic inflammation induced by infusion of TNF-α is associated with insulin resistance with no change in the incretin effect. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Larvicidal activity and in vitro effects of green tea (Camellia sinensis L. water infusion

    Directory of Open Access Journals (Sweden)

    Žabar, A.

    2013-12-01

    Full Text Available In this study green tea water infusion was tested on Drosophila melanogaster wild-type larvae in vivo, also an in vitro antihemolytic and hemolytic tests were performed. Three different concentrations were used 7.5 mg/ml, 37.5 mg/ml and 75 mg/ml, the lowest dose representing the recommended dose followed by five times and ten times higher doses. Effect of these three concentrations was monitored and tested in vivo on Drosophila melanogaster (Meigen, 1830 wt (wild type larval development and surviving. All three concentrations showed toxic effect for larvae, with toxicity being increased in dose – depended manner. The time needed for larvae to fully develop was delayed. This decrease of developmental time was in dose – dependent manner, too. Amount of hemolysis caused by the lowest concentration was very small when compared with the percent of spontaneous hemolysis. Other two higher concentrations, 37.5 mg/ml and 75 mg/ml, showed higher hemolytic effect. During the four hour incubation period percent of hemolysis grew in time – dependent manner. The highest hemolytic effect was recorded for the concentration of 37.5 mg/ml. Antihemolytic test showed that the lowest concentration had the highest inhibitory effect to H2O2 induced hemolysis. The 37.5 mg/ml and 75 mg/ml concentrations had lower inhibitory effect when compared with the dose of 7.5 mg/ml. According to our study it can be concluded that the high concentrations of green tea water infusion exhibit larvicidal activity against D. melanogaster larvae, don't have protective effect to RBC membrane and cause greater hemolysis.

  16. Evaluation of the Hemodynamic Effects of Intravenous Amiodarone Formulations During the Maintenance Phase Infusion.

    Science.gov (United States)

    Lindquist, Desirae E; Rowe, A Shaun; Heidel, Eric; Fleming, Travis; Yates, John R

    2015-12-01

    Two of the excipients in intravenous formulations of amiodarone, polysorbate 80 and benzyl alcohol, have been shown to cause hypotension. A newer formulation of amiodarone, which contains cyclodextrin, is devoid of these excipients. To evaluate the change in mean arterial pressure when utilizing 2 intravenous amiodarone formulations. This was a retrospective cohort analysis conducted at an academic medical center. Patients received intravenous amiodarone containing either polysorbate 80/benzyl alcohol (control) or cyclodextrin (cyclodextrin). Patients received these formulations based on a standard institutional protocol of 1 mg/min for 6 hours, followed by 0.5 mg/min for at least 18 hours or until discontinued by the provider. All data were collected from the medical record and included changes in blood pressures, time to lowest systolic blood pressure, concurrent antihypertensive use, and number of patients requiring treatment for hypotension. A total of 160 patients (120 control, 40 cyclodextrin) were included. There was a statistically significant difference in mean arterial pressure between the groups receiving the control formulation of amiodarone compared with the cyclodextrin formulation across the 24-hour maintenance phase infusion (P amiodarone may have a significant role in the hypotensive effects seen throughout the duration the maintenance phase infusion. © The Author(s) 2015.

  17. Gastroprotective effect of Cymbopogon citratus infusion on acute ethanol-induced gastric lesions in rats.

    Science.gov (United States)

    Sagradas, Joana; Costa, Gustavo; Figueirinha, Artur; Castel-Branco, Maria Margarida; Silvério Cabrita, António Manuel; Figueiredo, Isabel Vitória; Batista, Maria Teresa

    2015-09-15

    Treatment of gastric ulcers with medicinal plants is quite common in traditional medicine worldwide. Cymbopogon citratus (DC) Stapf. leaves infusion has been used in folk medicine of many tropical and subtropical regions to treat gastric disturbances. The aim of this study was to assess the potential gastroprotective activity of an essential oil-free infusion from C. citratus leaves in acute gastric lesions induced by ethanol in rat. The study was performed on adult male Wistar rats (234.0±22.7g) fasted for 24h but with free access to water. The extract was given orally before (prevention) or after (treatment) intragastric administration of absolute ethanol. Effects of dose (28 or 56mg/kg of body weight) and time of contact of the extract with gastric mucosa (1 or 2h) were also assessed. Animals were sacrificed, being the stomachs removed and the lesions were assessed by macroscopic observation and histopathology. C. citratus extract, given orally before or after ethanol, significantly (Pcitratus extract on experimental gastric lesions induced by ethanol, contributing for the pharmacological validation of its traditional use. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Increased aldosterone: mechanism of hypertension in obesity.

    Science.gov (United States)

    Flynn, Colleen

    2014-05-01

    The prevalence of both obesity and hypertension are increasing worldwide. Hypertension is a common consequence of obesity. Increased central adiposity is associated with increased aldosterone levels and blood pressure in human beings. A number of small studies have shown an association between obesity-mediated hypertension and mechanisms directly linked to increased levels of aldosterone. These studies have shown a trend toward relatively greater blood pressure reduction using aldosterone-receptor blockers compared with other classes of antihypertensive agents. Other than treatment for weight loss, treatment of hypertension with specific antihypertensive medications that block or reduce aldosterone action are appropriate in obese patients. Further research is needed to understand the exact role of the adipocyte in obesity-mediated hypertension. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Aldosterone response to angiotensin II during hypoxemia

    Energy Technology Data Exchange (ETDEWEB)

    Colice, G.L.; Ramirez, G.

    1986-07-01

    Exercise stimulates the renin-angiotensin-aldosterone system (RAAS). However, increases in plasma aldosterone concentrations (PAC) are suppressed when exercise is performed at high altitude or under hypoxemic conditions. As the angiotensin-II response to high-altitude exercise is normal, it is speculated that an inhibitor, discharged during hypoxemia, acted to suppress angiotensin-II-mediated aldosterone release. A study was conducted to test this hypothesis, taking into account the measurement of the aldosterone response to exogenous angiotensin II during normoxemia and hypoxemia. It was found that the dose-response curve of PAC to angiotensin II was not significantly inhibited by the considered model of hypoxemia. The hypoxemia-mediated release of an angiotensin II inhibitor does, therefore, not explain the previous observations of PAC suppression during hypoxemic exercise. 28 references.

  20. Aldosterone-producing adenoma and other surgically correctable forms of primary aldosteronism

    Directory of Open Access Journals (Sweden)

    Steichen Olivier

    2010-05-01

    Full Text Available Abstract Surgically correctable forms of primary aldosteronism are characterized by unilateral aldosterone hypersecretion and renin suppression, associated with varying degrees of hypertension and hypokalemia. Unilateral aldosterone hypersecretion is caused by an aldosterone-producing adenoma (also known as Conn's adenoma and aldosteronoma, primary unilateral adrenal hyperplasia and rare cases of aldosterone-producing adrenocortical carcinoma. In these forms, unilateral adrenalectomy can cure aldosterone excess and hypokalemia, but not necessarily hypertension. The prevalence of primary aldosteronism in the general population is not known. Its prevalence in referred hypertensive populations is estimated to be between 6 and 13%, of which 1.5 to 5% have an aldosterone-producing adenoma or primary unilateral adrenal hyperplasia. Taking into account referral biases, the prevalence of surgically correctable primary aldosteronism is probably less than 1.5% in the hypertensive population and less than 0.3% in the general adult population. Surgically correctable primary aldosteronism is sought in patients with hypokalemic, severe or resistant forms of hypertension. Recent recommendations suggest screening for primary aldosteronism using the aldosterone to renin ratio. Patients with a raised ratio then undergo confirmatory suppression tests. The differential diagnosis of hypokalemic hypertension with low renin includes mineralocorticoid excess, with the mineralocorticoid being cortisol or 11-deoxycorticosterone, apparent mineralocorticoid excess, pseudo-hypermineralocorticoidism in Liddle syndrome or exposure to glycyrrhizic acid. Once the diagnosis is confirmed, adrenal computed tomography is performed for all patients. If surgery is considered, taking into consideration the clinical context and the desire of the patient, adrenal vein sampling is performed to detect whether or not aldosterone hypersecretion is unilateral. Laparoscopic surgery for

  1. Maternal adverse effects with different loading infusion rates of antenatal magnesium sulphate for preterm fetal neuroprotection: the IRIS randomised trial.

    Science.gov (United States)

    Bain, E S; Middleton, P F; Yelland, L N; Ashwood, P J; Crowther, C A

    2014-04-01

    To evaluate a slower (compared with a standard) infusion rate of the loading dose of magnesium sulphate for preterm fetal neuroprotection as a strategy to reduce maternal adverse effects. Randomised controlled trial. South Australian maternity hospital. Fifty-one women at magnesium sulphate over either 60 or 20 minutes (followed by maintenance of 1 g/hour until birth, or for up to 24 hours). Any maternal adverse effects associated with the infusion. Overall, 71% of women experienced adverse effects during the first hour of their infusion; the difference between groups was not significant [15/25 (60%) 60-minute loading; 21/26 (81%) 20-minute loading; risk ratio (RR) 0.74; 95% confidence interval (95% CI) 0.51-1.08]. Although no serious maternal complications occurred, adverse effects led to three women ceasing the loading treatment (1/25 in the 60-minute loading group; 2/26 in the 20-minute loading group; RR 0.52; 95% CI 0.05-5.38). Women in the 60-minute loading group experienced significantly less warmth and flushing at 20 minutes into the infusion (7/25 in the 60-minute loading group; 15/26 in the 20-minute loading group; RR 0.49; 95% CI 0.24-0.99). No other differences between groups for maternally reported and clinical adverse effects were shown. A slower rate of administering the loading dose of magnesium sulphate did not reduce the occurrence of maternal adverse effects overall. Flushing and warmth at 20 minutes into the infusion was reduced with a slower infusion. © 2014 Royal College of Obstetricians and Gynaecologists.

  2. Simultaneous infusion of glutamine and branched-chain amino acids (BCAA) to septic rats does not have more favorable effect on protein synthesis in muscle, liver, and small intestine than separate infusions.

    Science.gov (United States)

    Holecek, Milan; Muthny, Tomas; Kovarik, Miroslav; Sispera, Ludek

    2006-01-01

    Glutamine and branched-chain amino acids (BCAA; valine, leucine, and isoleucine) are used as nutrition supplements in the treatment of proteocatabolic illness. We hypothesized that simultaneous administration of BCAA and glutamine affects protein metabolism more significantly than separate administration. In the present study, we evaluated their effect on protein synthesis in skeletal muscle, liver, and jejunum of septic rats. Twenty-four hours after induction of sepsis by subcutaneous injection of turpentine, the rats were infused for 6 hours with 5 mL of 1.75% glutamine, 1.75% BCAA, 1.75% glutamine+BCAA, or saline solution. The control group consisted of intact rats infused with saline. Protein synthesis was measured at the end of infusion by a "flooding method" with [3,4,5-(3)H]phenylalanine. In turpentine-treated animals, we observed a decrease in glutamine concentration in blood plasma and skeletal muscle, a decrease in BCAA concentration in liver and jejunum, and a decrease in protein synthesis in all tissues. Glutamine or glutamine+BCAA infusion increased glutamine concentration in plasma and muscle and stimulated protein synthesis in the liver. The BCAA infusion enhanced concentrations of BCAA in plasma and tissues, but the effect of BCAA on protein synthesis was insignificant. Synergistic effect of simultaneous infusion of glutamine and BCAA on protein synthesis was not observed. We conclude that glutamine infusion to rats with septic injury may significantly improve impaired protein synthesis in the liver and that there is no synergistic effect of glutamine and BCAA infusion on protein synthesis in skeletal muscle, liver, and jejunum.

  3. Cytotoxic effects of infusions (tea of Solidago microglossa DC. (Asteraceae on the cell cycle of Allium cepa

    Directory of Open Access Journals (Sweden)

    Margarete Dulce Bagatini

    Full Text Available The medicinal specie Solidago microglossa DC., which is native from South America, is used as infusion (tea for stomach disorders in popular medicine. This study aimed to evaluate the potential cytotoxic effect of these infusions on the cell cycle of Allium cepa. In natura leaves of three populations of this species were used in preparing infusions at two concentrations: 1.75 mg/mL and 14 mg/mL. Onion (Allium cepa root-tip cells were used as test system in in vivo assays. Slides were done through smashing technique. Cells were analyzed in all cell cycles of A. cepa, totalizing 6000 cells for each group of bulbs. The mitotic index (MI was calculated, and the statistical analysis was carried out through the Chi-square test (χ2 = 0.05. The results show that the infusions of S. microglossa at a highest concentration (14 mg/mL caused a significant reduction in the MI compared with control in the studied populations. In concentrations commonly used by people there was a significant increase of MI in relation to controlled populations 1 and 3 and a decrease in population 2. In conclusion, infusions of S. microglossa presented antiproliferative effect at a highest concentration.

  4. Effect of interleukin-2 + pirarubicin infusion chemotherapy combined with systemic chemotherapy on the malignant biological behavior of advanced bladder cancer

    Directory of Open Access Journals (Sweden)

    Hong-Mei Zhang

    2017-09-01

    Full Text Available Objective: To study the effect of interleukin-2 + pirarubicin infusion chemotherapy combined with systemic chemotherapy on the malignant biological behavior of advanced bladder cancer. Methods: Patients with advanced bladder cancer who were treated in Tongcheng People’s Hospital between April 2015 and July 2016 were selected as the research subjects and randomly divided into group A who received interleukin-2 + pirarubicin infusion chemotherapy combined with systemic chemotherapy and the group B who received pirarubicin infusion chemotherapy combined with systemic chemotherapy. The contents of tumor markers and cytokines and the expression of apoptosis molecules in the urine were detected before and after chemotherapy. Results: 8 weeks after chemotherapy, BLCA-1, BLCA-4, CYFRA21-1, TGF-β1, VEGF, EGF, HGF and IGF-2 contents in urine of both groups of patients were significantly lower than those before treatment, Fas, Bad, PTEN and Beclin-1 mRNA expression in urine were significantly higher than those before treatment and BLCA-1, BLCA-4, CYFRA21-1, TGF-β1, VEGF, EGF, HGF and IGF-2 contents in urine of group A were significantly lower than those of group B, Fas, Bad, PTEN and Beclin-1 mRNA expression in urine were significantly higher than those of group B. Conclusion: Interleukin-2 + pirarubicin infusion chemotherapy combined with systemic chemotherapy can be more effective than pirarubicin infusion chemotherapy combined with systemic chemotherapy in inhibiting the malignant biological behavior of advanced bladder cancer.

  5. Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy.

    Science.gov (United States)

    Schulten, Ron J; Piet, Jessica; Bruijning, Patricia Cjl; de Waal, Wouter J

    2017-02-01

    The aim of our study was to explore a possible relationship between proportion of basal insulin dose (%BD/T) and glycaemic control in children with type I diabetes on continuous subcutaneous insulin infusion (CSII) therapy. All patients under the age of 18 with type I diabetes mellitus, treated in a general hospital in Utrecht, The Netherlands, who were on CSII therapy between 2000 and 2011 were selected for inclusion. All data as recorded during outpatient visits were retrospectively collected from patients' charts. Analyses were performed using R Statistical Software. Data of 847 outpatient visits of 78 patients [31 males (39.7%) and 47 females (60.3%)] were analyzed. Mean age at diagnosis was 7.1 ± 3.7 yr, mean age at start of pump therapy 10.1 ± 3.8 yr. Mean HbA1c before pump start was 8.3 ± 1.0%, median BMI standard deviation score for age and gender was 0.64 (-1.89-3.79). Median follow-up time per patient was 29 months with an average of 10 visits (range: 3-25). Multivariate analysis revealed that a change of 10% in %BD/T resulted in a decrease or increase of HbA1c of 0.22% [95% confidence interval (CI): 0.15-0.29). No significant effect was observed from SDS BMI, sex, or duration of diabetes. Low dose basal insulin infusion as a percentage of total insulin dose has a positive effect on metabolic outcome as expressed in HbA1c-levels. A change of 10% in %BD/T results in a decrease or increase of HbA1c of 0.22%. This supports the tendency to aim at the lowest basal insulin requirements in pump setting strategy. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Effect of abomasal glucose infusion on splanchnic and whole-body glucose metabolism in periparturient dairy cows

    DEFF Research Database (Denmark)

    Larsen, Mogens; Kristensen, Niels Bastian

    2009-01-01

    Six periparturient Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the hepatic portal vein, hepatic vein, mesenteric vein, and an artery were used to study the effects of abomasal glucose infusion on splanchnic and whole-body glucose metabolism.......Six periparturient Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in the hepatic portal vein, hepatic vein, mesenteric vein, and an artery were used to study the effects of abomasal glucose infusion on splanchnic and whole-body glucose metabolism....

  7. The effect of a subcutaneous infusion of GLP-1, OXM and PYY on Energy intake and Expenditure in Obese volunteers

    DEFF Research Database (Denmark)

    Tan, Tricia; Behary, Preeshila; Tharakan, George

    2017-01-01

    the effect of a continuous infusion of GLP-1, OXM and PYY (GOP) on energy intake and expenditure in obese volunteers. Methods: Obese volunteers were randomised to receive an infusion of GOP or placebo in a single-blinded randomised placebo-controlled cross-over study for 10.5 hours a day. This was delivered...... subcutaneously using a pump device, allowing volunteers to remain ambulatory. Ad Libitum food intake studies were performed during the infusion and energy expenditure measured using a ventilated hood calorimeter. Results: Post-prandial levels of GLP-1, OXM and PYY seen post RYGB were successfully matched using 4......Background: Roux-en-Y gastric bypass (RYGB) surgery is currently the most effective treatment for obesity, although limited by availability and operative risk. The gut hormones Glucagon-like peptide-1 (GLP-1), Peptide YY (PYY) and Oxyntomodulin (OXM) are elevated post-prandially after RYGB, which...

  8. Localization of aldosterone-producing tumours in primary aldosteronism by adrenal and renal vein catheterization

    DEFF Research Database (Denmark)

    Lund, J O; Nielsen, M D; Giese, Jacob

    1980-01-01

    Regional venous plasma aldosterone concentrations were determined and assessed against concurrent arterial levels in 16 patients with primary aldosteronism. The results obtained by sampling from the left adrenal vein or the left renal vein allowed correct side prediction of the presupposed adenoma...

  9. Die Rolle von Aldosteron im Knochenstoffwechsel

    Directory of Open Access Journals (Sweden)

    Tomaschitz A

    2012-01-01

    Full Text Available Das Steroidhormon Aldosteron wird in der Zona glomerulosa (ZG der Nebennierenrinde produziert. Kalzium spielt als gemeinsamer „Second Messenger“ eine zentrale Rolle in der durch Angiotensin II, ACTH und Kalium regulierten Aldosteronsynthese. Zahlreiche Studien der vergangenen Jahre dokumentierten die bedeutende Rolle des Aldosterons in der Pathogenese kardiovaskulärer Erkrankungen. Effekte von Aldosteron auf den Knochenstoffwechsel wurden bisher kaum untersucht. In humanen fetalen und adulten Knochenzellen wurde jedoch eine ausgeprägte Expression des Mineralokortikoidrezeptors (MR detektiert. In experimentellen Tierstudien wurden sowohl eine spezifische Aldosteron-MR-Interaktion im Knochengewebe als auch die osteoprotektive Wirkung der MR-Blockade mit Spironolakton beobachtet. Aldosteron kann durch die Hemmung der alkalischen Phosphatase indirekt eine gesteigerte Osteoblastenproliferation induzieren. Die wechselseitige Beeinflussung von Aldosteron und Parathormon (PTH könnte eine bedeutende Rolle in der Pathophysiologie kardiovaskulärer Erkrankungen und des Knochenstoffwechsels spielen. PTH kann sowohl über die Aktivierung spannungsabhängiger Kalziumkanäle als auch durch Bindung an den PTH/PTH-rP-Rezeptor der Zona-glomerulosa- Zellen eine Stimulation der Aldosteronsynthese induzieren. Dies bestätigt sich mit einem signifikanten Rückgang der Plasmaaldosteronkonzentration nach einer Parathyreoidektomie bei Patienten mit einem primären Hyperparathyreoidismus. In Tiermodellen der Herzinsuffizienz führt der relative Aldosteronüberschuss über eine verstärkte renale Kalziumexkretion zu einem sekundären Hyperparathyreoidismus, der durch die gesteigerte Kalziummobilisation aus dem Knochengewebe zu einem erhöhten Frakturrisiko in dieser Patientengruppe beiträgt. Der im Rahmen des primären Hyperaldosteronismus beobachtete sekundäre Hyperparathyreoidismus kann durch eine Hemmung der Aldosteronwirkung/Aldosteronsynthese supprimiert

  10. Rapid and Longer-Term Antidepressant Effects of Repeated Ketamine Infusions in Treatment-Resistant Major Depression

    NARCIS (Netherlands)

    Murrough, James W.; Perez, Andrew M.; Pillemer, Sarah; Stern, Jessica; Parides, Michael K.; aan het Rot, Marije; Collins, Katherine A.; Mathew, Sanjay J.; Charney, Dennis S.; Iosifescu, Dan V.

    2013-01-01

    Background: Ketamine is reported to have rapid antidepressant effects; however, there is limited understanding of the time-course of ketamine effects beyond a single infusion. A previous report including 10 participants with treatment-resistant major depression (TRD) found that six ketamine

  11. Effect of Infusion Method and Parameters on Mass Transfer in Blueberries

    Science.gov (United States)

    In order to obtain optimal processing conditions for producing infused blueberries with high solid gain, we investigated the infusion characteristics of blueberries under various processing parameters in sugar solutions with 1:1 ratio of solution and berries. Static batch constant concentration inf...

  12. Effects of norepinephrine infusion and exercise on blood pressure in rats.

    Science.gov (United States)

    Chi, M S; Vander Tuig, J G; Chi, C H; Norman, A; Chapman, L; Blanks, T

    1997-06-01

    Two experiments were conducted to test the hypotheses that norepinephrine (NE) infusion would increase blood pressure and wheel running activity level, and, secondly, that voluntary exercise would lower NE-induced increases in blood pressure. NE-bitartrate was infused into male Sprague-Dawley rats using an implanted osmotic pump (3.75 micrograms/kg/min in 0.9% saline). Control rats received the vehicle solution. Systolic blood pressure was measured by the tail-cuff method. Voluntary wheel running activity expressed as wheel revolutions per 24 hr was measured on the 5th, 9th, and 13th day. Blood pressure on the 13th day and wheel running activity on the 9th day were significantly higher in NE-infused rats. The NE content of heart tissue was not altered, but urinary excretion of NE and epinephrine was increased in the NE-infused animals. Food intake, body weight gain, and kidney weight per 100 g body wt were not changed but heart weight per 100 g body wt was increased by NE infusion. Urinary total calcium excretion was higher in the NE-infused rats. Spontaneous voluntary exercise in running wheels attenuated increases of blood pressure in NE-infused rats. The results of the present study suggest that rats receiving exogenous NE exhibit increased blood pressure and voluntary wheel running activity. Voluntary wheel running exercise also reduces blood pressure in NE-infused rats.

  13. Aldosterone-producing adenoma--variable serum aldosterone response to postural change: a case report.

    Science.gov (United States)

    Lee, S P; Lin, H D; Chen, M T; Wang, G G; Ching, K N; Chiang, B N

    1991-11-01

    A 25-year-old female was admitted for evaluation of hypertension and hypokalemia. Plasma renin activity was suppressed and plasma aldosterone level was higher than normal. The CT scan of adrenal gland revealed a 2.5cm in size low density tumor mass over right adrenal area, and NP-59 adrenal scan showed early and persistent uptake of radioactivity in the right adrenal gland. Interestingly, the plasma aldosterone level was elevated, decreased and unchanged to postural change on three different occasions. After right adrenalectomy, the plasma aldosterone level decreased to 4.77ng/dl, blood pressure, serum potassium, and plasma aldosterone returned to normal response to postural change. Histologically, it was compatible with the picture of cortical adenoma. However, the tumor cell may not have reached autonomous function yet, since different responses of plasma aldosterone to postural change were observed clinically.

  14. Effects of lidocaine and esmolol infusions on hemodynamic changes, analgesic requirement, and recovery in laparoscopic cholecystectomy operations.

    Science.gov (United States)

    Dogan, Serpil Dagdelen; Ustun, Faik Emre; Sener, Elif Bengi; Koksal, Ersin; Ustun, Yasemin Burcu; Kaya, Cengiz; Ozkan, Fatih

    2016-01-01

    We compared the effects of lidocaine and esmolol infusions on intraoperative hemodynamic changes, intraoperative and postoperative analgesic requirements, and recovery in laparoscopic cholecystectomy surgery. The first group (n=30) received IV lidocaine infusions at a rate of 1.5mg/kg/min and the second group (n=30) received IV esmolol infusions at a rate of 1mg/kg/min. Hemodynamic changes, intraoperative and postoperative analgesic requirements, and recovery characteristics were evaluated. In the lidocaine group, systolic arterial blood pressures values were lower after the induction of anesthesia and at 20min following surgical incision (plidocaine group (plidocaine group (plidocaine group at 10 and 20min after extubation (plidocaine group (plidocaine infusion had superiorities over esmolol infusions regarding the suppression of responses to tracheal extubation and postoperative need for additional analgesic agents in the long run, while esmolol was more advantageous with respect to rapid recovery from anesthesia, attenuation of early postoperative pain, and modified Aldrete recovery (MAR) scores and time to reach MAR score of 9 points. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  15. Investigation on the effects of guava (Psidium guajava L.) infusions on germination, root tips and meristematic cells of Latuca sativa.

    Science.gov (United States)

    Luber, Jaquelini; Palmieri, Marcel J; Botelho, Carolina M; Rinaldo, Daniel; Andrade-Vieira, Larissa F

    2015-01-01

    Guava (Psidium guajava L.) is a plant often employed in popular medicine. Recently several studies have alerted about the toxicity of substances present in medicinal plants, which can pose risks to the human health. In this sense, the present work aimed to investigate the phytotoxic, cytotoxic and genotoxic action of three guava varieties - Paluma, Pedro Sato and Roxa ("purple") - on the plant test system Lactuca sativa L. Thus, macro- and microscopic evaluations were carried out for five infusion concentrations (2.5, 5.0, 10.0, 20.0 and 40.0 g.L(-1)) prepared from each variety. Distilled water was used as negative control. Chromatographic and spectroscopic analysis by HPLC-PAD indicated that the chemical composition of the infusion of Roxa is different than that of the infusions of the varieties Paluma and Pedro Sato. It was observed that seed germination and root growth in L. sativa exposed to infusions decreased with increasing infusion concentration, regardless of the tested cultivar. For the mitotic index, no statistical differences were observed. On the other hand, a significant increase in the frequency of cell cycle alterations was verified, especially for the highest concentrations tested. The cytogenotoxic effect was significant. Therefore, guava should not be used indiscriminately in popular medicine.

  16. Renal damage in primary aldosteronism: results of the PAPY Study.

    Science.gov (United States)

    Rossi, Gian Paolo; Bernini, Giampaolo; Desideri, Giovambattista; Fabris, Bruno; Ferri, Claudio; Giacchetti, Gilberta; Letizia, Claudio; Maccario, Mauro; Mannelli, Massimo; Matterello, Mee-Jung; Montemurro, Domenico; Palumbo, Gaetana; Rizzoni, Damiano; Rossi, Ermanno; Pessina, Achille Cesare; Mantero, Franco

    2006-08-01

    Primary aldosteronism (PA) has been associated with cardiovascular hypertrophy and fibrosis, in part independent of the blood pressure level, but deleterious effects on the kidneys are less clear. Likewise, it remains unknown if the kidney can be diversely involved in PA caused by aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). Hence, in the Primary Aldosteronism Prevalence in Italy (PAPY) Study, a prospective survey of newly diagnosed consecutive patients referred to hypertension centers nationwide, we sought signs of renal damage in patients with PA and in comparable patients with primary hypertension (PH). Patients (n = 1180) underwent a predefined screening protocol followed by tests for confirming PA and identifying the underlying adrenocortical pathology. Renal damage was assessed by 24-hour urine albumin excretion (UAE) rate and glomerular filtration rate (GFR). UAE rate was measured in 490 patients; all had a normal GFR. Of them, 31 (6.4%) had APA, 33 (6.7%) had IHA, and the rest (86.9%) had PH. UAE rate was predicted (P body mass index, age, urinary Na+ excretion, serum K+, and mean blood pressure. Covariate-adjusted UAE rate was significantly higher in APA and IHA than in PH patients; there were more patients with microalbuminuria in the APA and IHA than in the PH group (P = 0.007). Among the hypertensive patients with a preserved GFR, those with APA or IHA have a higher UAE rate than comparable PH patients. Thus, hypertension because of excess autonomous aldosterone secretion features an early and more prominent renal damage than PH.

  17. Aldosterone and aldosterone receptor antagonists in patients with chronic heart failure.

    Science.gov (United States)

    Nappi, Jean M; Sieg, Adam

    2011-01-01

    Aldosterone is a mineralocorticoid hormone synthesized by the adrenal glands that has several regulatory functions to help the body maintain normal volume status and electrolyte balance. Studies have shown significantly higher levels of aldosterone secretion in patients with congestive heart failure compared with normal patients. Elevated levels of aldosterone have been shown to elevate blood pressure, cause left ventricular hypertrophy, and promote cardiac fibrosis. An appreciation of the true role of aldosterone in patients with chronic heart failure did not become apparent until the publication of the Randomized Aldactone Evaluation Study. Until recently, the use of aldosterone receptor antagonists has been limited to patients with severe heart failure and patients with heart failure following myocardial infarction. The Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF) study added additional evidence to support the expanded use of aldosterone receptor antagonists in heart failure patients. The results of the EMPHASIS-HF trial showed that patients with mild-to-moderate (New York Heart Association Class II) heart failure had reductions in mortality and hospitalizations from the addition of eplerenone to optimal medical therapy. Evidence remains elusive about the exact mechanism by which aldosterone receptor antagonists improve heart failure morbidity and mortality. The benefits of aldosterone receptor antagonist use in heart failure must be weighed against the potential risk of complications, ie, hyperkalemia and, in the case of spironolactone, possible endocrine abnormalities, in particular gynecomastia. With appropriate monitoring, these risks can be minimized. We now have evidence that patients with mild-to-severe symptoms associated with systolic heart failure will benefit from the addition of an aldosterone receptor antagonist to the standard therapies of angiotensin-converting enzyme inhibitors and beta

  18. Systemic and regional hemodynamic effects of enalaprilat infusion in experimental normotensive sepsis

    Directory of Open Access Journals (Sweden)

    L. Rahal

    Full Text Available Angiotensin-converting enzyme inhibitors have been shown to improve splanchnic perfusion in distinct shock states. We hypothesized that enalaprilat potentiates the benefits of early fluid resuscitation in severe experimental sepsis, particularly in the splanchnic region. Anesthetized and mechanically ventilated mongrel dogs received an intravenous infusion of live Escherichia coli over a period of 30 min. Thereafter, two interventions were performed: fluid infusion (normal saline, 32 mL/kg over 30 min and enalaprilat infusion (0.02 mg kg-1 min-1 for 60 min in randomized groups. The following groups were studied: controls (fluid infusion, N = 4, E1 (enalaprilat infusion followed by fluid infusion, N = 5 and E2 (fluid infusion followed by enalaprilat infusion, N = 5. All animals were observed for a 120 min after bacterial infusion. Mean arterial pressure, cardiac output (CO, portal vein blood flow (PVBF, systemic and regional oxygen-derived variables, and lactate levels were measured. Rapid and progressive reductions in CO and PVBF were induced by the infusion of live bacteria, while minor changes were observed in mean arterial pressure. Systemic and regional territories showed a significant increase in oxygen extraction and lactate levels. Widening venous-arterial and portal-arterial pCO2 gradients were also detected. Fluid replacement promoted transient benefits in CO and PVBF. Enalaprilat after fluid resuscitation did not affect systemic or regional hemodynamic variables. We conclude that in this model of normotensive sepsis inhibition of angiotensin-converting enzyme did not interfere with the course of systemic or regional hemodynamic and oxygen-derived variables.

  19. Systemic and regional hemodynamic effects of enalaprilat infusion in experimental normotensive sepsis

    Directory of Open Access Journals (Sweden)

    L. Rahal

    2006-09-01

    Full Text Available Angiotensin-converting enzyme inhibitors have been shown to improve splanchnic perfusion in distinct shock states. We hypothesized that enalaprilat potentiates the benefits of early fluid resuscitation in severe experimental sepsis, particularly in the splanchnic region. Anesthetized and mechanically ventilated mongrel dogs received an intravenous infusion of live Escherichia coli over a period of 30 min. Thereafter, two interventions were performed: fluid infusion (normal saline, 32 mL/kg over 30 min and enalaprilat infusion (0.02 mg kg-1 min-1 for 60 min in randomized groups. The following groups were studied: controls (fluid infusion, N = 4, E1 (enalaprilat infusion followed by fluid infusion, N = 5 and E2 (fluid infusion followed by enalaprilat infusion, N = 5. All animals were observed for a 120 min after bacterial infusion. Mean arterial pressure, cardiac output (CO, portal vein blood flow (PVBF, systemic and regional oxygen-derived variables, and lactate levels were measured. Rapid and progressive reductions in CO and PVBF were induced by the infusion of live bacteria, while minor changes were observed in mean arterial pressure. Systemic and regional territories showed a significant increase in oxygen extraction and lactate levels. Widening venous-arterial and portal-arterial pCO2 gradients were also detected. Fluid replacement promoted transient benefits in CO and PVBF. Enalaprilat after fluid resuscitation did not affect systemic or regional hemodynamic variables. We conclude that in this model of normotensive sepsis inhibition of angiotensin-converting enzyme did not interfere with the course of systemic or regional hemodynamic and oxygen-derived variables.

  20. A Case of Glucocorticoid Remediable Aldosteronism and Thoracoabdominal Aneurysms

    Directory of Open Access Journals (Sweden)

    Anahita Shahrrava

    2016-01-01

    Full Text Available Glucocorticoid remediable aldosteronism (GRA is rare familial form of primary aldosteronism characterized by a normalization of hypertension with the administration of glucocorticoids. We present a case of GRA and thoracoabdominal aneurysm complicated by multiple aortic dissections requiring complex surgical and endovascular repairs. Registry studies have shown a high rate of intracranial aneurysms in GRA patients with high case fatality rates. The association of thoracoabdominal aneurysms with GRA has not been described, thus far, in literature. Studies have shown that high tissue aldosterone levels concomitant with salt intake have a significant role in the pathogenesis of aneurysms and this may explain the formation of aneurysms in the intracranial vasculature and aorta. The association of GRA with thoracic aortic aneurysms needs to be further studied to develop screening recommendations for early identification and optimal treatment. Also, the early use of mineralocorticoid antagonists may have a significant preventive and attenuating effect in aneurysm formation, an association which needs to be confirmed in future studies.

  1. Abomasal amino acid infusion in postpartum dairy cows: Effect on whole-body, splanchnic, and mammary amino acid metabolism

    DEFF Research Database (Denmark)

    Larsen, Mogens; Galindo, C; Ouellet, D R

    2015-01-01

    Nine Holstein cows with rumen cannulas and indwelling catheters in splanchnic blood vessels were used in a generalized randomized incomplete block design with repeated measures to study the effect of increased early postpartum AA supply on splanchnic and mammary AA metabolism. At calving, cows were...... blocked according to parity (second and third or greater) and allocated to 2 treatments: abomasal infusion of water (CTRL; n=4) or free AA with casein profile (AA-CN; n=5) in addition to a basal diet. The AA-CN infusion started with half of the maximal dose at the calving day (1 d in milk; DIM...

  2. Antinociceptive effects, metabolism and disposition of ketamine in ponies under target-controlled drug infusion

    Science.gov (United States)

    Knobloch, M.; Portier, C.J.; Levionnois, O.L.; Theurillat, R.; Thormann, W.; Spadavecchia, C.; Mevissen, M.

    2007-01-01

    Ketamine is widely used as an anesthetic in a variety of drug combinations in human and veterinary medicine. Recently, it gained new interest for use in long-term pain therapy administered in sub-anesthetic doses in humans and animals. The purpose of this study was to develop a physiologically based pharmacokinetic (PBPk) model for ketamine in ponies and to investigate the effect of low-dose ketamine infusion on the amplitude and the duration of the nociceptive withdrawal reflex (NWR). A target-controlled infusion (TCI) of ketamine with a target plasma level of 1 μg/ml S-ketamine over 120 min under isoflurane anesthesia was performed in Shetland ponies. A quantitative electromyographic assessment of the NWR was done before, during and after the TCI. Plasma levels of R-/S-ketamine and R-/S-norketamine were determined by enantioselective capillary electrophoresis. These data and two additional data sets from bolus studies were used to build a PBPk model for ketamine in ponies. The peak-to-peak amplitude and the duration of the NWR decreased significantly during TCI and returned slowly toward baseline values after the end of TCI. The PBPk model provides reliable prediction of plasma and tissue levels of R- and S-ketamine and R- and S-norketamine. Furthermore, biotransformation of ketamine takes place in the liver and in the lung via first-pass metabolism. Plasma concentrations of S-norketamine were higher compared to R-norketamine during TCI at all time points. Analysis of the data suggested identical biotransformation rates from the parent compounds to the principle metabolites (R- and S-norketamine) but different downstream metabolism to further metabolites. The PBPk model can provide predictions of R- and S-ketamine and norketamine concentrations in other clinical settings (e.g. horses). PMID:16919695

  3. Antinociceptive effects, metabolism and disposition of ketamine in ponies under target-controlled drug infusion.

    Science.gov (United States)

    Knobloch, M; Portier, C J; Levionnois, O L; Theurillat, R; Thormann, W; Spadavecchia, C; Mevissen, M

    2006-11-01

    Ketamine is widely used as an anesthetic in a variety of drug combinations in human and veterinary medicine. Recently, it gained new interest for use in long-term pain therapy administered in sub-anesthetic doses in humans and animals. The purpose of this study was to develop a physiologically based pharmacokinetic (PBPk) model for ketamine in ponies and to investigate the effect of low-dose ketamine infusion on the amplitude and the duration of the nociceptive withdrawal reflex (NWR). A target-controlled infusion (TCI) of ketamine with a target plasma level of 1 microg/ml S-ketamine over 120 min under isoflurane anesthesia was performed in Shetland ponies. A quantitative electromyographic assessment of the NWR was done before, during and after the TCI. Plasma levels of R-/S-ketamine and R-/S-norketamine were determined by enantioselective capillary electrophoresis. These data and two additional data sets from bolus studies were used to build a PBPk model for ketamine in ponies. The peak-to-peak amplitude and the duration of the NWR decreased significantly during TCI and returned slowly toward baseline values after the end of TCI. The PBPk model provides reliable prediction of plasma and tissue levels of R- and S-ketamine and R- and S-norketamine. Furthermore, biotransformation of ketamine takes place in the liver and in the lung via first-pass metabolism. Plasma concentrations of S-norketamine were higher compared to R-norketamine during TCI at all time points. Analysis of the data suggested identical biotransformation rates from the parent compounds to the principle metabolites (R- and S-norketamine) but different downstream metabolism to further metabolites. The PBPk model can provide predictions of R- and S-ketamine and norketamine concentrations in other clinical settings (e.g. horses).

  4. Splenectomy enhances the therapeutic effect of adipose tissue-derived mesenchymal stem cell infusion on cirrhosis rats.

    Science.gov (United States)

    Tang, Wei-Ping; Akahoshi, Tomohiko; Piao, Jing-Shu; Narahara, Sayoko; Murata, Masaharu; Kawano, Takahito; Hamano, Nobuhito; Ikeda, Tetsuo; Hashizume, Makoto

    2016-08-01

    Clinical studies suggest that splenectomy improves liver function in cirrhotic patients, but the influence of splenectomy on stem cell transplantation is poorly understood. This study investigated the effect of splenectomy on stem cell infusion and elucidated its mechanism. Rat adipose tissue-derived mesenchymal stem cells were infused into cirrhosis rats with or without splenectomy, followed by the assessment of the in vivo distribution of stem cells and pathological changes. Stromal cell-derived factor-1 and hepatocyte growth factor expression were also investigated in splenectomized cirrhosis patients and rats. Splenectomy, prior to cell infusion, improved liver function and suppressed fibrosis progression more efficiently than cell infusion alone in the experimental cirrhosis model. Stromal cell-derived factor-1 and hepatocyte growth factor levels after splenectomy were increased in patients and rats. These upregulated cytokines significantly facilitated stem cell motility, migration and proliferation in vitro. C-X-C chemokine receptor type 4 neutralization weakened the promotion of cell migration by these cytokines. The infused cells integrated into liver fibrosis septa and participated in regeneration more efficiently in splenectomized rats. Direct coculture with stem cells led to inhibition of hepatic stellate cell proliferation. In addition, hepatocyte growth factor induced hepatic stellate cell apoptosis via the c-jun N-terminal kinase-p53 pathway. Splenectomy prior to cell infusion enhanced the therapeutic effect of stem cells on cirrhosis, which involved upregulation of stromal cell-derived factor-1 and hepatocyte growth factor after splenectomy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Different effects of continuous infusion of interleukin-1 and interleukin-6 on the hypothalamic-hypophysial-thyroid axis

    NARCIS (Netherlands)

    G.A.C. van Haasteren (Goedele); M.J. van der Meer; A.R.M.M. Hermus (Ad); E. Linkels; W. Klootwijk (Willem); E. Kaptein (Ellen); H. van Toor (Hans); C.G. Sweep; T.J. Visser (Theo); W.J. de Greef

    1994-01-01

    textabstractThe cytokines interleukin-1 (IL-1) and IL-6 are thought to be important mediators in the suppression of thyroid function during nonthyroidal illness. In this study we compared the effects of IL-1 and IL-6 infusion on the hypothalamus-pituitary-thyroid

  6. Effect of perioperative insulin infusion on surgical morbidity and mortality: systematic review and meta-analysis of randomized trials.7

    DEFF Research Database (Denmark)

    Gandhi, G.Y.; Murad, M.H.; Flynn, D.N.

    2008-01-01

    OBJECTIVE: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of perioperative insulin infusion on outcomes important to patients. PATIENTS AND METHODS: We used 6 search strategies including an electronic database search of MEDLINE, EMBA...

  7. Discordant gene expression in skeletal muscle and adipose tissue of patients with type 2 diabetes: effect of interleukin-6 infusion

    DEFF Research Database (Denmark)

    Carey, A.; Wolsk, Emil; Bruce, C.

    2006-01-01

    was to determine the effect of Interleukin-6 (IL6) infusion on circulating adipokines and on gene expression in human adipose tissue. To do this we used real-time RT-PCR. Methods  Both diabetic and control subjects underwent basal skeletal muscle and subcutaneous adipose tissue biopsies. A subset...

  8. Effects of low-dose dopamine on renal and systemic hemodynamics during incremental norepinephrine infusion in healthy volunteers

    NARCIS (Netherlands)

    Hoogenberg, K; Smit, AJ; Girbes, ARJ

    Objectives: To assess the effects of low-dose dopamine on norepinephrine induced renal and systemic vasoconstriction in normotensive healthy subjects. Design: On separate days, either a low-dose dopamine (4 mu g/kg/min) or a placebo (5% glucose) infusion was added in a single, blinded, randomized

  9. Paricalcitol Inhibits Aldosterone-Induced Proinflammatory Factors by Modulating Epidermal Growth Factor Receptor Pathway in Cultured Tubular Epithelial Cells

    Directory of Open Access Journals (Sweden)

    Jose L. Morgado-Pascual

    2015-01-01

    Full Text Available Chronic kidney disease is characterized by Vitamin D deficiency and activation of the renin-angiotensin-aldosterone system. Increasing data show that vitamin D receptor agonists (VDRAs exert beneficial effects in renal disease and possess anti-inflammatory properties, but the underlying mechanism remains unknown. Emerging evidence suggests that “a disintegrin and metalloproteinase” (ADAM/epidermal growth factor receptor (EGFR signalling axis contributes to renal damage. Aldosterone induces EGFR transactivation regulating several processes including cell proliferation and fibrosis. However, data on tubular epithelial cells is scarce. We have found that, in cultured tubular epithelial cells, aldosterone induced EGFR transactivation via TGF-α/ADAM17. Blockade of the TGF-α/ADAM17/EGFR pathway inhibited aldosterone-induced proinflammatory gene upregulation. Moreover, among the potential downstream mechanisms, we found that TGF-α/ADAM17/EGFR inhibition blocked ERK and STAT-1 activation in response to aldosterone. Next, we investigated the involvement of TGF-α/ADAM17/EGFR axis in VDRA anti-inflammatory effects. Preincubation with the VDRA paricalcitol inhibited aldosterone-induced EGFR transactivation, TGF-α/ADAM-17 gene upregulation, and downstream mechanisms, including proinflammatory factors overexpression. In conclusion, our data suggest that the anti-inflammatory actions of paricalcitol in tubular cells could depend on the inhibition of TGF-α/ADAM17/EGFR pathway in response to aldosterone, showing an important mechanism of VDRAs action.

  10. Effect of leptin infusion on insulin sensitivity and lipid metabolism in diet-induced lipodystrophy model mice

    Science.gov (United States)

    Nagao, Koji; Inoue, Nao; Ujino, Yoko; Higa, Kouki; Shirouchi, Bungo; Wang, Yu-Ming; Yanagita, Teruyoshi

    2008-01-01

    Background Lipodystrophies are rare acquired and genetic disorders characterized by the complete or partial absence of body fat with a line of metabolic disorders. Previous studies demonstrated that dietary conjugated linoleic acid (CLA) induces hepatic steatosis and hyperinsulinemia through the drastic reduction of adipocytokine levels due to a paucity of adipose tissue in mice and the pathogenesis of these metabolic abnormalities in CLA-fed mice is similar to that in human lipodystrophy. The present study explores the effect of leptin infusion on the pathogenesis of diet-induced lipodystrophy in mice. C57BL/6N mice were assigned to three groups: (1) mice were fed a semisynthetic diet supplemented with 6% corn oil and infused PBS intraperitoneally (normal group), (2) mice were fed a semisynthetic diet supplemented with 4% corn oil plus 2% CLA and infused PBS intraperitoneally (lipodystrophy-control group), and (3) mice were fed a semisynthetic diet supplemented with 4% corn oil plus 2% CLA and infused recombinant murine leptin intraperitoneally (lipodystrophy-leptin group). All mice were fed normal or lipodystrophy model diets for 4 weeks and were infused intrapeneally 0 or 5 μg of leptin per day from third week of the feeding period for 1 week. Results The results indicate that leptin infusion can attenuate hepatic steatosis and hyperinsulinemia through the reduction of hepatic triglyceride synthesis and the improvement of insulin sensitivity in diet-induced lipodystrophy model mice. Conclusion We expect the use of this model for clarifying the pathophysiology of lipodystrophy-induced metabolic abnormalities and evaluating the efficacy and safety of drug and dietary treatment. PMID:18348717

  11. Fate and Effect of Intravenously Infused Mesenchymal Stem Cells in a Mouse Model of Hepatic Ischemia Reperfusion Injury and Resection

    Directory of Open Access Journals (Sweden)

    T. C. Saat

    2016-01-01

    Full Text Available Liver ischemia reperfusion injury (IRI is inevitable during transplantation and resection and is characterized by hepatocellular injury. Therapeutic strategies to reduce IRI and accelerate regeneration could offer major benefits. Mesenchymal stem cells (MSC are reported to have anti-inflammatory and regeneration promoting properties. We investigated the effect of MSC in a model of combined IRI and partial resection in the mouse. Hepatic IRI was induced by occlusion of 70% of the blood flow during 60 minutes, followed by 30% hepatectomy. 2 × 105 MSC or PBS were infused 2 hours before or 1 hour after IRI. Six, 48, and 120 hours postoperatively mice were sacrificed. Liver damage was evaluated by liver enzymes, histology, and inflammatory markers. Regeneration was determined by liver/body weight ratio, proliferating hepatocytes, and TGF-β levels. Fate of MSC was visualized with 3D cryoimaging. Infusion of 2 × 105 MSC 2 hours before or 1 hour after IRI and resection showed no beneficial effects. Tracking revealed that MSC were trapped in the lungs and did not migrate to the site of injury and many cells had already disappeared 2 hours after infusion. Based on these findings we conclude that intravenously infused MSC disappear rapidly and were unable to induce beneficial effects in a clinically relevant model of IRI and resection.

  12. Abomasal protein infusion in postpartum transition dairy cows: effect on performance and mammary metabolism.

    Science.gov (United States)

    Larsen, M; Lapierre, H; Kristensen, N B

    2014-09-01

    The effect of increasing the postpartum metabolizable protein (MP) supply on performance and mammary metabolism was studied using 8 Holstein cows in a complete randomized design. At parturition, cows were assigned to abomasal infusion of water (CTRL) or casein (CAS). Arterial and epigastric venous blood samples were taken 14 d before expected parturition and at 4, 15, and 29 d in milk (DIM). To compensate previously estimated deficiency of essential AA and to avoid oversupply, casein protein infusion was graduated with 696±1, 490±9, and 212±10g/d at 4, 15 and 29 DIM, respectively. Dry matter intake was unaffected by CAS. Compared with CTRL, MP supply was greater at 4 DIM with CAS but did not differ by 29 DIM. Milk yield was greater with CAS (+7.2±1.3kg/d from 1 to 29 DIM). Milk protein yield was greater with CAS at 4 DIM and averaged 1,664±39g/d compared with 1,212±86g/d for CTRL, but did not differ at 29 DIM (1,383±48g/d). The ratio of MP total supply to requirement was numerically greater at 4 DIM for CAS compared with CTRL, indicating less postpartum protein deficiency. In contrast, a greater net energy deficiency tended to be induced with CAS, but the greater milk yield allowed a large part of mobilized fat to be secreted in milk. Arterial concentration of total essential AA increased sharply after parturition for CAS compared with slight decreases for CTRL. The patterns of arterial concentrations combined with arterial-mammary venous concentration differences indicated that Lys, Leu, and Tyr were the first-limiting AA at 4 DIM with CTRL. Mammary plasma flow was unaffected by treatment, indicating similar perfusion of mammary tissue. The greater milk yield with CAS was associated with greater mammary uptake of individual essential AA, tendencies to greater uptake of glucose, lactate, and β-hydroxybutyrate, whereas uptakes of volatile fatty acids were unaffected. Despite similar MP supply by 29 DIM, milk and lactose yields were greater with CAS

  13. Direct intratumoral infusion of liposome encapsulated rhenium radionuclides for cancer therapy: Effects of nonuniform intratumoral dose distribution

    Energy Technology Data Exchange (ETDEWEB)

    Hrycushko, Brian A.; Li Shihong; Goins, Beth; Otto, Randal A.; Bao, Ande [Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 (United States); Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 (United States); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 and Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229 (United States)

    2011-03-15

    Purpose: Focused radiation therapy by direct intratumoral infusion of lipid nanoparticle (liposome)-carried beta-emitting radionuclides has shown promising results in animal model studies; however, little is known about the impact the intratumoral liposomal radionuclide distribution may have on tumor control. The primary objective of this work was to investigate the effects the intratumoral absorbed dose distributions from this cancer therapy modality have on tumor control and treatment planning by combining dosimetric and radiobiological modeling with in vivo imaging data. Methods: {sup 99m}Tc-encapsulated liposomes were intratumorally infused with a single injection location to human head and neck squamous cell carcinoma xenografts in nude rats. High resolution in vivo planar imaging was performed at various time points for quantifying intratumoral retention following infusion. The intratumoral liposomal radioactivity distribution was obtained from 1 mm resolution pinhole collimator SPECT imaging coregistered with CT imaging of excised tumors at 20 h postinfusion. Coregistered images were used for intratumoral dosimetric and radiobiological modeling at a voxel level following extrapolation to the therapeutic analogs, {sup 186}Re/{sup 188}Re liposomes. Effective uniform dose (EUD) and tumor control probability (TCP) were used to assess therapy effectiveness and possible methods of improving upon tumor control with this radiation therapy modality. Results: Dosimetric analysis showed that average tumor absorbed doses of 8.6 Gy/MBq (318.2 Gy/mCi) and 5.7 Gy/MBq (209.1 Gy/mCi) could be delivered with this protocol of radiation delivery for {sup 186}Re/{sup 188}Re liposomes, respectively, and 37-92 MBq (1-2.5 mCi)/g tumor administered activity; however, large intratumoral absorbed dose heterogeneity, as seen in dose-volume histograms, resulted in insignificant values of EUD and TCP for achieving tumor control. It is indicated that the use of liposomes encapsulating

  14. Specific effect of the infusion of glucose on blood volume during haemodialysis

    NARCIS (Netherlands)

    R.W. Nette (Robert); H.P. Krepel; A.H. van den Meiracker (Anton); W. Weimar (Willem); R. Zietse (Bob)

    2002-01-01

    textabstractBACKGROUND: Intradialytic morbid events such as hypotension and cramps during haemodialysis are generally treated by infusion of iso- or hypertonic solutions. However, differences may exist between solutions with respect to plasma refilling and vascular reactivity.

  15. The effect of methylprednisolone intravenous infusion on the expression of ciliary neurotrophic factor in a rat spinal cord injury model.

    Science.gov (United States)

    Del Gaizo, Daniel J; Regan, Conor M; Graff, Ronald D; Mathur, Sameer

    2013-04-01

    Methylprednisolone (MP) infusion after acute spinal cord injury (SCI) remains controversial despite large randomized studies, including the National Acute Spinal Cord Injury Studies (NASCIS). To determine the effect of NASCIS protocol MP infusion on the expression of ciliary neurotrophic factor (CNTF), a neuroprotective cytokine, in a rat model after SCI. Animal laboratory study. Thirty rats were randomized into an MP infusion group (intravenous [IV]-MP) versus normal saline (NS) control group (IV-NS) after a standardized SCI. Ciliary neurotrophic factor expression was measured by reverse transcription-polymerase chain reaction at 6, 12, 24, 48, and 72 hours post-SCI. Mean CNTF expression was diminished in the MP group at 12 (p=.006) and 24 (p=.008) hours postinjury compared with the control group. Expression of CNTF was not significantly different between the groups at 6, 48, and 72 hours post-SCI. Standardized MP infusion post-SCI reduces CNTF activation in a rat SCI model. Further study is needed to determine if this effect is seen in human SCIs. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Effects of intraoperative diltiazem infusion on flow changes in arterial and venous grafts in coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Ozan Erdem

    2015-08-01

    Full Text Available Abstract Objective: This study aimed to show the effects of intra-operative diltiazem infusion on flow in arterial and venous grafts in coronary artery bypass graft surgery. Methods: Hundred fourty patients with a total of 361 grafts [205 (57% arterial and 156 (43% venous] underwent isolated coronary surgery. All the grafts were measured by intraoperative transit time flow meter intra-operatively. Group A (n=70 consisted of patients who received diltiazem infusion (dose of 2.5 microgram/kg/min, and Group B (n=70 didn't receive diltiazem infusion. Results: Mean graft flow values of left internal mammary artery were 53 ml/min in Group A and 40 ml/min in Group B (P<0.001. Pulsatility index (PI values of left internal mammary artery for Group A and Group B were 2.6 and 3.0 respectively (P<0.001. No statistically significant difference was found between venous graft parameters. Conclusion: We recommend an effect of diltiazem infusion in increasing graft flows in coronary artery bypass graft operations.

  17. Very low-density lipoprotein (VLDL)-induced signals mediating aldosterone production.

    Science.gov (United States)

    Tsai, Ying-Ying; Rainey, William E; Bollag, Wendy B

    2017-02-01

    Aldosterone, secreted by the adrenal zona glomerulosa, enhances sodium retention, thus increasing blood volume and pressure. Excessive production of aldosterone results in high blood pressure and contributes to cardiovascular and renal disease, stroke and visual loss. Hypertension is also associated with obesity, which is correlated with other serious health risks as well. Although weight gain is associated with increased blood pressure, the mechanism by which excess fat deposits increase blood pressure remains unclear. Several studies have suggested that aldosterone levels are elevated with obesity and may represent a link between obesity and hypertension. In addition to hypertension, obese patients typically have dyslipidemia, including elevated serum levels of very low-density lipoprotein (VLDL). VLDL, which functions to transport triglycerides from the liver to peripheral tissues, has been demonstrated to stimulate aldosterone production. Recent studies suggest that the signaling pathways activated by VLDL are similar to those utilized by AngII. Thus, VLDL increases cytosolic calcium levels and stimulates phospholipase D (PLD) activity to result in the induction of steroidogenic acute regulatory (StAR) protein and aldosterone synthase (CYP11B2) expression. These effects seem to be mediated by the ability of VLDL to increase the phosphorylation (activation) of their regulatory transcription factors, such as the cAMP response element-binding (CREB) protein family of transcription factors. Thus, research into the pathways by which VLDL stimulates aldosterone production may identify novel targets for the development of therapies for the treatment of hypertension, particularly those associated with obesity, and other aldosterone-modulated pathologies. © 2017 Society for Endocrinology.

  18. Prognostic Impact of Loop Diuretics in Patients With Chronic Heart Failure - Effects of Addition of Renin-Angiotensin-Aldosterone System Inhibitors and β-Blockers.

    Science.gov (United States)

    Miura, Masanobu; Sugimura, Koichiro; Sakata, Yasuhiko; Miyata, Satoshi; Tadaki, Soichiro; Yamauchi, Takeshi; Onose, Takeo; Tsuji, Kanako; Abe, Ruri; Oikawa, Takuya; Kasahara, Shintaro; Nochioka, Kotaro; Takahashi, Jun; Shimokawa, Hiroaki

    2016-05-25

    It remains to be elucidated whether addition of renin-angiotensin-aldosterone system (RAAS) inhibitors and/or β-blockers to loop diuretics has a beneficial prognostic impact on chronic heart failure (CHF) patients. From the Chronic Heart failure Analysis and Registry in the Tohoku district 2 (CHART-2) Study (n=10,219), we enrolled 4,134 consecutive patients with symptomatic stage C/D CHF (mean age, 69.3 years, 67.7% male). We constructed Cox models for composite of death, myocardial infarction, stroke and HF admission. On multivariate inverse probability of treatment weighted (IPTW) Cox modeling, loop diuretics use was associated with worse prognosis with hazard ratio (HR) 1.28 (Pdiuretics were associated with worse prognosis with HR 1.32 and 1.56, respectively (both Pdiuretics. Chronic use of loop diuretics is significantly associated with worse prognosis in CHF patients in a dose-dependent manner, whereas the triple combination of RAAS inhibitor(s), MRA, and β-blocker(s) is associated with better prognosis when combined with low-dose loop diuretics. (Circ J 2016; 80: 1396-1403).

  19. FAD286, an aldosterone synthase inhibitor, reduced atherosclerosis and inflammation in apolipoprotein E-deficient mice.

    Science.gov (United States)

    Gamliel-Lazarovich, Aviva; Gantman, Anna; Coleman, Raymond; Jeng, Arco Y; Kaplan, Marielle; Keidar, Shlomo

    2010-09-01

    Aldosterone is known to be involved in atherosclerosis and cardiovascular disease and blockade of its receptor was shown to improve cardiovascular function. It was, therefore, hypothesized that inhibition of aldosterone synthesis would also reduce atherosclerosis development. To test this hypothesis, we examined the effect of FAD286 (FAD), an aldosterone synthase inhibitor, on the development of atherosclerosis in spontaneous atherosclerotic apolipoprotein E-deficient mice. Mice were divided into three treatment groups: normal diet, low-salt diet (LSD) and LSD treated with FAD at 30 mg/kg per day (LSD + FAD) for 10 weeks. Histomorphometry of the aortas obtained from these mice showed that atherosclerotic lesion area increased by three-fold under LSD compared with normal diet and FAD significantly reduced lesion area to values similar to normal diet. Changes in atherosclerosis were paralleled by changes in the expression of the inflammation markers (C-reactive protein, monocyte chemotactic protein-1, interleukin-6, nuclear factor kappa B and intercellular adhesion molecule-1) in peritoneal macrophages obtained from these mice. Surprisingly, whereas LSD increased serum or urine aldosterone levels, FAD did not alter these levels when evaluated at the end of the study. In J774A.1 macrophage-like cell line stimulated with lipopolysaccharide, FAD was shown to have a direct dose-dependent anti-inflammatory effect. In apolipoprotein E-deficient mice, FAD reduces atherosclerosis and inflammation. However, these actions appeared to be dissociated from its effect on inhibition of aldosterone synthesis.

  20. Fibroblast growth factor 23 and the antiproteinuric response to dietary sodium restriction during renin-angiotensin-aldosterone system blockade.

    NARCIS (Netherlands)

    Humalda, J.K.; Lambers Heerspink, H.J.; Kwakernaak, A.J.; Slagman, M.C.; Waanders, F.; Vervloet, M.G.; Wee, P.M. Ter; Navis, G.; Borst, M.H. de; Wee, P.M. ter; Vervloet, M.; Bindels, R.J.; Hoenderop, J.G.J.; Hillebrands, J.L.

    2015-01-01

    BACKGROUND: Residual proteinuria during renin-angiotensin-aldosterone system (RAAS) blockade is a major renal and cardiovascular risk factor in chronic kidney disease. Dietary sodium restriction potentiates the antiproteinuric effect of RAAS blockade, but residual proteinuria remains in many

  1. Fibroblast Growth Factor 23 and the Antiproteinuric Response to Dietary Sodium Restriction During Renin-Angiotensin-Aldosterone System Blockade

    NARCIS (Netherlands)

    Humalda, Jelmer K; Lambers Heerspink, Hiddo J; Kwakernaak, Arjan J; Slagman, Maartje C J; Waanders, Femke; Vervloet, Marc G; Ter Wee, Pieter M; Navis, Gerarda; de Borst, Martin H

    Background: Residual proteinuria during renin-angiotensin-aldosterone system (RAAS) blockade is a major renal and cardiovascular risk factor in chronic kidney disease. Dietary sodium restriction potentiates the antiproteinuric effect of RAAS blockade, but residual proteinuria remains in many

  2. Effect of hypovolemia, infusion, and oral rehydration on plasma electrolytes, ADH, renin activity, and +G/z/ tolerance

    Science.gov (United States)

    Greenleaf, J. E.; Brock, P. J.; Haines, R. F.; Rositano, S. A.; Montgomery, L. D.; Keil, L. C.

    1977-01-01

    Effects on plasma volume, electrolyte shifts, and +G(z) tolerance induced by: (1) blood withdrawal; (2) blood infusion; and (3) oral fluid intake, were determined at 0.5 G/min in centrifugation tests of six ambulatory male patients, aged 21 to 27 yrs. Hypovolemia induced by withdrawal of 400 ml blood, blood infusion followed by repeated centrifugation, effects of consuming an isotonic drink (0.9% NaCl) to achieve oral rehydration, and donning of red adaptation goggles were studied for effects on acceleration tolerance, pre-acceleration and post-acceleration plasma renin activity (PRA) and plasma vasopressin levels. No significant changes in post-acceleration PRA compared to pre-acceleration PRA were found, and administration of oral rehydration is found as effective as blood replacement in counteracting hypovolemic effects.

  3. Twenty-Four-Hour Urinary Aldosterone Predicts Inappropriate Left Ventricular Mass Index in Patients with Primary Aldosteronism

    Directory of Open Access Journals (Sweden)

    Chi-Sheng Hung

    2013-01-01

    Full Text Available Objective. Primary aldosteronism (PA is associated with inappropriate left ventricular hypertrophy (LVH in relation to a given gender and body size. There is no ideal parameter to predict the presence of LVH or inappropriate LVH in patients with PA. We investigate the performance of 24-hour urinary aldosterone level, plasma renin activity and aldosterone-to-renin ratio on this task. Methods. We performed echocardiography in 106 patients with PA and 31 subjects with essential hypertension (EH in a tertiary teaching hospital. Plasma renin activity, aldosterone concentration, and 24-hour urinary aldosterone level were measured. Results. Only 24-hour urinary aldosterone was correlated with left ventricular mass index (LVMI and excess LVMI among these parameters. The multivariate analysis revealed the urinary aldosterone level as an independent predictor for LVMI and excess LVMI. Analyzing the ability of urinary aldosterone, plasma aldosterone concentration, and plasma aldosterone-to-renin ratio to identify the presence of LVH (ROC AUC = 0.701, 0.568, 0.656, resp. and the presence of inappropriate LV mass index (defined as measured LVMI in predicting LVMI ratio >135% (ROC area under curve = 0.61, 0.43, 0.493, resp. revealed the better performance of 24-hour urinary aldosterone. Conclusions. In conclusion, 24-hour urinary aldosterone level performed better to predict the presence of LVH and inappropriate LVMI in patients with PA.

  4. Effect of intravenous glucose infusion on renal function in normal man and in insulin-dependent diabetics

    DEFF Research Database (Denmark)

    Frandsen, M; Parving, H H; Christiansen, JS

    1981-01-01

    The effect of intravenous glucose infusion on glomerular filtration rate and renal plasma flow (constant infusion technique using 125I-iothalamate and 131I-hippuran) and on urinary excretion of albumin and beta-2-microglobulin were studied in ten normal subjects and seven metabolically well......-controlled insulin-dependent diabetics. Following glucose infusion in normal subjects (n = 10) blood glucose increased from 4.7 +/- 0.1 to 10.9 +/- 0.4 mmol/l (SEM) (p less than or equal to 0.01). Glomerular filtration rate increased from 116 +/- 2 to 123 +/- 3 ml/mi x 1.73 m2 (p less than or equal to 0.01), while...... no change in renal plasma flow was seen - 552 +/- 11 versus 553 +/- 18 ml/min x 1.73 m2. Volume expansion with intravenous saline infusion in six of the normal subjects induced no changes in blood glucose or kidney function. In seven strictly controlled insulin-dependent diabetics, blood glucose values were...

  5. Aldosterone and aldosterone receptor antagonists in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Nappi J

    2011-06-01

    Full Text Available Jean M Nappi, Adam SiegClinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy, Medical University of South Carolina Campus, Charleston, SC, USAAbstract: Aldosterone is a mineralocorticoid hormone synthesized by the adrenal glands that has several regulatory functions to help the body maintain normal volume status and electrolyte balance. Studies have shown significantly higher levels of aldosterone secretion in patients with congestive heart failure compared with normal patients. Elevated levels of aldosterone have been shown to elevate blood pressure, cause left ventricular hypertrophy, and promote cardiac fibrosis. An appreciation of the true role of aldosterone in patients with chronic heart failure did not become apparent until the publication of the Randomized Aldactone Evaluation Study. Until recently, the use of aldosterone receptor antagonists has been limited to patients with severe heart failure and patients with heart failure following myocardial infarction. The Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF study added additional evidence to support the expanded use of aldosterone receptor antagonists in heart failure patients. The results of the EMPHASIS-HF trial showed that patients with mild-to-moderate (New York Heart Association Class II heart failure had reductions in mortality and hospitalizations from the addition of eplerenone to optimal medical therapy. Evidence remains elusive about the exact mechanism by which aldosterone receptor antagonists improve heart failure morbidity and mortality. The benefits of aldosterone receptor antagonist use in heart failure must be weighed against the potential risk of complications, ie, hyperkalemia and, in the case of spironolactone, possible endocrine abnormalities, in particular gynecomastia. With appropriate monitoring, these risks can be minimized. We now have evidence that patients with mild-to-severe symptoms

  6. Active renin mass concentration to determine aldosterone-to-renin ratio in screening for primary aldosteronism

    Directory of Open Access Journals (Sweden)

    Corbin F

    2011-07-01

    Full Text Available François Corbin1, Pierre Douville2, Marcel Lebel3 1Division of Biochemistry, l'Université de Sherbrooke, Sherbrooke, Quebec, Canada; 2Division of Biochemistry; 3Division of Nephrology, L'Hôtel-Dieu de Québec Hospital and l'Université Laval, Quebec, CanadaBackground: Active renin mass concentration (ARC is independent of the endogenous level of angiotensinogen, and less variable and more reproducible than plasma renin activity. Reference values for the aldosterone-to-renin ratio (ARR using ARC are still undefined. The objective of the present study was to determine the threshold of ARR using ARC measurement to screen for primary aldosteronism.Methods: A total of 211 subjects were included in the study, comprising 78 healthy normotensive controls, 95 patients with essential hypertension, and 38 patients with confirmed primary aldosteronism (20 with surgery-confirmed aldosterone-producing adenoma and 18 with idiopathic adrenal hyperplasia. Blood samples were drawn from ambulatory patients and volunteers in the mid-morning without specific dietary restriction for measuring plasma aldosterone concentration, ARC, and serum potassium.Results: Most normotensive controls and essential hypertension patients had ARR results below 100 pmol/ng, a value which corresponded to 3.3 times the median of these two groups.Conclusion: Patients with ARR values above this level should be considered for further investigation (confirmatory tests or for repeat testing should ARR values be borderline. This study indicates that ARC can be used reliably in determining ARR for primary aldosteronism screening.Keywords: primary aldosteronism, active renin mass concentration, aldosterone-to-renin ratio

  7. Effects of lidocaine and esmolol infusions on hemodynamic changes, analgesic requirement, and recovery in laparoscopic cholecystectomy operations

    Directory of Open Access Journals (Sweden)

    Serpil Dagdelen Dogan

    2016-04-01

    Full Text Available ABSTRACT OBJECTIVE: We compared the effects of lidocaine and esmolol infusions on intraoperative hemodynamic changes, intraoperative and postoperative analgesic requirements, and recovery in laparoscopic cholecystectomy surgery. METHODS: The first group (n = 30 received IV lidocaine infusions at a rate of 1.5 mg/kg/min and the second group (n = 30 received IV esmolol infusions at a rate of 1 mg/kg/min. Hemodynamic changes, intraoperative and postoperative analgesic requirements, and recovery characteristics were evaluated. RESULTS: In the lidocaine group, systolic arterial blood pressures values were lower after the induction of anesthesia and at 20 min following surgical incision (p < 0.05. Awakening time was shorter in the esmolol group (p < 0.001; Ramsay Sedation Scale scores at 10 min after extubation were lower in the esmolol group (p < 0.05. The modified Aldrete scores at all measurement time points during the recovery period were relatively lower in the lidocaine group (p < 0.05. The time to attain a modified Aldrete score of ≥9 points was prolonged in the lidocaine group (p < 0.01. Postoperative resting and dynamic VAS scores were higher in the lidocaine group at 10 and 20 min after extubation (p < 0.05, p < 0.01, respectively. Analgesic supplements were less frequently required in the lidocaine group (p < 0.01. CONCLUSION: In laparoscopic cholecystectomies, lidocaine infusion had superiorities over esmolol infusions regarding the suppression of responses to tracheal extubation and postoperative need for additional analgesic agents in the long run, while esmolol was more advantageous with respect to rapid recovery from anesthesia, attenuation of early postoperative pain, and modified Aldrete recovery (MAR scores and time to reach MAR score of 9 points.

  8. [Effects of lidocaine and esmolol infusions on hemodynamic changes, analgesic requirement, and recovery in laparoscopic cholecystectomy operations].

    Science.gov (United States)

    Dogan, Serpil Dagdelen; Ustun, Faik Emre; Sener, Elif Bengi; Koksal, Ersin; Ustun, Yasemin Burcu; Kaya, Cengiz; Ozkan, Fatih

    2016-01-01

    We compared the effects of lidocaine and esmolol infusions on intraoperative hemodynamic changes, intraoperative and postoperative analgesic requirements, and recovery in laparoscopic cholecystectomy surgery. The first group (n=30) received IV lidocaine infusions at a rate of 1.5mg/kg/min and the second group (n=30) received IV esmolol infusions at a rate of 1mg/kg/min. Hemodynamic changes, intraoperative and postoperative analgesic requirements, and recovery characteristics were evaluated. In the lidocaine group, systolic arterial blood pressures values were lower after the induction of anesthesia and at 20min following surgical incision (p<0.05). Awakening time was shorter in the esmolol group (p<0.001); Ramsay Sedation Scale scores at 10min after extubation were lower in the esmolol group (p<0.05). The modified Aldrete scores at all measurement time points during the recovery period were relatively lower in the lidocaine group (p<0.05). The time to attain a modified Aldrete score of ≥9 points was prolonged in the lidocaine group (p<0.01). Postoperative resting and dynamic VAS scores were higher in the lidocaine group at 10 and 20min after extubation (p<0.05, p<0.01, respectively). Analgesic supplements were less frequently required in the lidocaine group (p<0.01). In laparoscopic cholecystectomies, lidocaine infusion had superiorities over esmolol infusions regarding the suppression of responses to tracheal extubation and postoperative need for additional analgesic agents in the long run, while esmolol was more advantageous with respect to rapid recovery from anesthesia, attenuation of early postoperative pain, and modified Aldrete recovery (MAR) scores and time to reach MAR score of 9 points. Copyright © 2014. Publicado por Elsevier Editora Ltda.

  9. Nicotinic mechanisms of memory: effects of acute local DHbetaE and MLA infusions in the basolateral amygdala.

    Science.gov (United States)

    Addy, Nii A; Nakijama, Aya; Levin, Edward D

    2003-03-01

    Nicotine has been shown to improve working memory. The neural mechanisms underlying this effect are still being determined. The ventral hippocampus is critical for nicotinic effects on memory. Local ventral hippocampal infusions of either the nicotinic alpha7 nicotinic receptor antagonist methyllycaconitine (MLA) or the alpha4beta2 nicotinic receptor antagonist dihydro-beta-erythroidine (DHbetaE) caused working memory impairments, but no additive effects were seen. Other areas, such as the amygdala, also likely play important roles in nicotinic effects on memory. Amygdalar lesions cause memory impairment and there is a dense concentration of nicotinic receptors in the basolateral amygdala. The current study used local basolateral amygdalar infusions of the nicotinic antagonists MLA and DHbetaE to determine the involvement of alpha7 and alpha4beta2 nicotinic receptors in spatial working and reference memory. Rats (n=8) were trained in the 16-arm radial maze and were implanted with bilateral infusion cannulae into the basolateral amygdala. Acute infusions of MLA (6.75 micro g/side, PMLA and DHbetaE did not produce an additive effect. In fact, the 6.75 micro g/kg dose of DHbetaE produced a significant (PMLA-induced working memory impairment. Significant effects were not seen with reference memory or response latency. Nicotinic systems in the basolateral amygdala, as in the ventral hippocampus, are important for spatial working memory. In both the basolateral amygdala and the ventral hippocampus, MLA and DHbetaE individually caused working memory impairments. The lowest effective dose of DHbetaE was lower in the basolateral amygdala than in the ventral hippocampus. In both the basolateral amygdala and the ventral hippocampus, combined MLA and DHbetaE treatment did not produce additive working memory deficits. Unlike in the ventral hippocampus, the addition of DHbetaE to MLA in the basolateral amygdala significantly reduced the MLA-induced working memory deficit.

  10. Actions of aldosterone in the cardiovascular system: the good, the bad, and the ugly?

    Science.gov (United States)

    Gekle, Michael; Grossmann, Claudia

    2009-06-01

    Aldosterone and its receptor, the mineralocorticoid receptor (MR), play a key role in the regulation of reno-cardiovascular function as well as in the regulation of normal and abnormal reno-cardiovascular function, which are responsible for the variety of its functional responses. The underlying mechanisms are of genomic and nongenotropic nature. Prevention of critical arterial hypotension by NaCl retention and regulation of potassium homeostasis, which is of eminent importance for cardiovascular electrophysiology and rhythmogenesis, represent the good face of aldosterone in the cardiovascular system. Triggering of persistent arterial hypertension with all the detrimental secondary effects on heart, kidney, vessels, and brain represents the bad face of aldosterone/MR in the cardiovascular system. Blood pressure-independent reno-cardiovascular end organ damage represents the ugly face of MR activation and does not depend on elevated aldosterone concentrations. In this way, aldosterone/MR induces or facilitates inflammatory and fibrotic processes in a permissive milieu, created for example by angiotensin II or NaCl and characterized by enhanced oxidative stress, in vascular walls.

  11. Effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function in healthy humans

    DEFF Research Database (Denmark)

    Madsen, Jan Lysgård; Fuglsang, Stefan; Graff, J

    2006-01-01

    : To examine the effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function after a meal in healthy humans. METHODS: Nine healthy volunteers participated in a placebo-controlled, double-blind, crossover study. Each volunteer was examined during intravenous infusion......BACKGROUND: Glyceryl trinitrate is a donor of nitric oxide that relaxes smooth muscle cells of the gastrointestinal tract. Little is known about the effect of glyceryl trinitrate on gastric emptying and no data exist on the possible effect of glyceryl trinitrate on small intestinal transit. AIM...... of glyceryl trinitrate 1 microg/kg x min or saline. A gamma camera technique was used to measure gastric emptying and small intestinal transit after a 1600-kJ mixed liquid and solid meal. Furthermore, duodenal motility was assessed by manometry. RESULTS: Glyceryl trinitrate did not change gastric mean...

  12. Effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function in healthy humans

    DEFF Research Database (Denmark)

    Madsen, Jan Lysgård; Fuglsang, Stefan; Graff, J

    2006-01-01

    BACKGROUND: Glyceryl trinitrate is a donor of nitric oxide that relaxes smooth muscle cells of the gastrointestinal tract. Little is known about the effect of glyceryl trinitrate on gastric emptying and no data exist on the possible effect of glyceryl trinitrate on small intestinal transit. AIM......: To examine the effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function after a meal in healthy humans. METHODS: Nine healthy volunteers participated in a placebo-controlled, double-blind, crossover study. Each volunteer was examined during intravenous infusion...... of glyceryl trinitrate 1 microg/kg x min or saline. A gamma camera technique was used to measure gastric emptying and small intestinal transit after a 1600-kJ mixed liquid and solid meal. Furthermore, duodenal motility was assessed by manometry. RESULTS: Glyceryl trinitrate did not change gastric mean...

  13. Hypertension: Renin-Angiotensin-Aldosterone System Alterations

    NARCIS (Netherlands)

    L. te Riet (Luuk); J.H.M. Esch, van (Joep); A.J.M. Roks (Anton); A.H. van den Meiracker (Anton); A.H.J. Danser (Jan)

    2015-01-01

    textabstractBlockers of the renin-angiotensin-aldosterone system (RAAS), that is, renin inhibitors, angiotensin (Ang)-converting enzyme (ACE) inhibitors, Ang II type 1 receptor antagonists, and mineralocorticoid receptor antagonists, are a cornerstone in the treatment of hypertension. How exactly

  14. The ratios of aldosterone / plasma renin activity (ARR) versus aldosterone / direct renin concentration (ADRR).

    Science.gov (United States)

    Glinicki, Piotr; Jeske, Wojciech; Bednarek-Papierska, Lucyna; Kruszyńska, Aleksandra; Gietka-Czernel, Małgorzata; Rosłonowska, Elżbieta; Słowińska-Srzednicka, Jadwiga; Kasperlik-Załuska, Anna; Zgliczyński, Wojciech

    2015-12-01

    Primary aldosteronism (PA) is estimated to occur in 5-12% of patients with hypertension. Assessment of aldosterone / plasma renin activity (PRA) ratio (ARR) has been used as a screening test in patients suspected of PA. Direct determination of renin (DRC) and calculation of aldosterone / direct renin concentration ratio (ADRR) could be similarly useful for screening patients suspected of PA. The study included 62 patients with indication for evaluation of the renin-angiotensin-aldosterone system and 35 healthy volunteers. In all participants we measured concentrations of serum aldosterone, plasma direct renin, and PRA after a night's rest and again after walking for two hours. The concentrations of aldosterone, direct renin, and PRA were measured by isotopic methods (radioimmunoassay (RIA) / immunoradiometric assay (IRMA)). Correlations of ARR with ADRR in the supine position were r = 0.9162, r(2) = 0.8165 (p 80% and 100%, respectively) appeared for the ratios ≥ 30. We suggest that for practical and economic reasons ARR can be replaced by ADRR. © The Author(s) 2014.

  15. The Aldosterone Renin Ratio (ARR) APP as Tool to Enhance the Detection Rate of Primary Aldosteronism.

    Science.gov (United States)

    Rossi, Gian Paolo; Bisogni, Valeria

    2016-06-01

    Primary aldosteronism is one of the most common forms of secondary hypertension, but it is often under diagnosed, which leads to the development of cardiovascular damage, and excess costs for long-term drug treatment and management of complications. The aldosterone to renin ratio (ARR) is a key step for early detection of primary aldosteronism, but unfortunately is not easily estimated. This is because plasma aldosterone and renin are measured with different assays, which provide results in different units of measure, with ensuing difficulty of obtaining the calculation of the ARR in the proper units and impossibility of interpreting results with reference to established cut off values. Therefore, doctors are often unable to draw unambiguous conclusions to be used for the clinical decision-making. To the aim of making the diagnostic work-up easier, we have developed an Application that provide a swift calculation of the ARR regardless of the units of measure used for plasma aldosterone and renin values. If the concomitant serum potassium level is available the App also provides the patient's probability of having an aldosterone-producing adenoma based on a validated logistic discriminant analysis.

  16. The effect of short-term glucagon infusion on kidney function in normal man

    DEFF Research Database (Denmark)

    Parving, H H; Noer, J; Kehlet, H

    1977-01-01

    Kidney function was studied in six normal males before and during a 2 h glucagon (10 ng/kg/min) infusion. The following variables were determined during each 20 min clearance period; glomerular filtration rate (GFR), renal plasma-flow (RPF) , filtration fraction (FF), urinary albumin and beta2......-microglobulin-excretion rates. Glucagon infusion resulted in a fourfold increase in plasma glucagon concentration. The infusion induced a significant increase in GFR (+9%), FF (+9%) and urinary beta2-microglobulin excretion rate (+32%), (p less than 0.01). RPF and urinary albumin excretion rates were...... not significantly changed. We suggest that glucagon may contribute to the reversible kidney function alterations typically found in poorly regulated juvenile diabetes, a state with relative or absolute hyperglucagonaemia....

  17. Effects of equine metabolic syndrome on inflammatory responses of horses to intravenous lipopolysaccharide infusion.

    Science.gov (United States)

    Tadros, Elizabeth M; Frank, Nicholas; Donnell, Robert L

    2013-07-01

    To test the hypothesis that inflammatory responses to endotoxemia differ between healthy horses and horses with equine metabolic syndrome (EMS). Animals-6 healthy horses and 6 horses with EMS. Each horse randomly received an IV infusion of lipopolysaccharide (20 ng/kg [in 60 mL of sterile saline {0.9% NaCl} solution]) or saline solution, followed by the other treatment after a 7-day washout period. Baseline data were obtained 30 minutes before each infusion. After infusion, a physical examination was performed hourly for 9 hours and at 15 and 21 hours; a whole blood sample was collected at 30, 60, 90, 120, 180, and 240 minutes for assessment of inflammatory cytokine gene expression. Liver biopsy was performed between 240 and 360 minutes after infusion. Results-Following lipopolysaccharide infusion in healthy horses and horses with EMS, mean rectal temperature, heart rate, and respiratory rate increased, compared with baseline findings, as did whole blood gene expression of interleukin (IL)-1β, IL-6, IL-8, IL-10, and tumor necrosis factor-α. The magnitude of blood cytokine responses did not differ between groups, but increased expression of IL-6, IL-8, IL-10, and tumor necrosis factor-α persisted for longer periods in EMS-affected horses. Lipopolysaccharide infusion increased liver tissue gene expressions of IL-6 in healthy horses and IL-8 in both healthy and EMS-affected horses, but these gene expressions did not differ between groups. Results supported the hypothesis that EMS affects horses' inflammatory responses to endotoxin by prolonging cytokine expression in circulating leukocytes. These findings are relevant to the association between obesity and laminitis in horses with EMS.

  18. Cardiorespiratory and antinociceptive effects of two different doses of lidocaine administered to horses during a constant intravenous infusion of xylazine and ketamine

    National Research Council Canada - National Science Library

    Nóbrega Neto, Pedro I; Luna, Stelio P L; Queiroz-Williams, Patricia; Mama, Khursheed R; Steffey, Eugene P; Carregaro, Adriano B

    2013-01-01

    This study investigated the antinociceptive effects of a constant rate infusion (CRI) of lidocaine during xylazine and ketamine anesthesia in horses and aimed to correlate these effects with cardiorespiratory variables, bispectral index...

  19. Clinical effects of thermotherapy in combination with intracavitary infusion of traditional Chinese medicine in the treatment of malignant pleural effusion.

    Science.gov (United States)

    Gu, Y; Jiang, L; Miao, J H; Liang, T S; Kan, Q C; Yang, D K

    2016-01-01

    Malignant fluid, a commonly seen tumor associated complication, mainly includes peritoneal effusion, malignant pleural effusion and pericardial effusion. It can produce huge negative influence on the quality of life of patients and even lead to death. Treatment of malignant effusion is one of the effective measures for improving life expectancy of patients. To evaluate the effect of thermotherapy in combination with intracavitary infusion of Kangai injection in treating malignant pleural effusion, 195 patients who received treatment from April 2010 to October 2014 in the First Affiliated Hospital of Zhengzhou University were selected and divided into an observation group and two control groups (group A and B). The observation group was treated by thermotherapy in combination with intracavitary infusion of kangai injection. Control group A was treated by intracavitary infusion of kangai injection and control group B was treated by hyperthermal perfusion in combination with intracavity chemotherapy. Clinical effects, quality of life, treatment safety and untoward reactions were compared between the groups. It was found that differences of WBC, RBC and PLT levels before and after treatment had no statistical significance comparisons within group and comparisons between groups (P>0.05); hepatic and renal functions of the groups had no remarkable difference before or after treatment (P>0.05). The clinical effect of the observation group was superior to that of control groups A and B (P less than 0.05); the Karnofsky performance status (KPS) score of the observation group was much higher than that of control groups A and B (79.34±10.58 vs 71.11±9.64), but the difference of the ZPS score between groups had no statistical significance (P>0.05). It can be concluded that thermotherapy in combination with intracavitary infusion of traditional Chinese medicine can be safely applied as it has positive effects and remarkably improves quality of life, therefore it is clinically

  20. Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy

    NARCIS (Netherlands)

    Schulten, Ron J; Piet, Jessica; Bruijning-Verhagen, Patricia; de Waal, Wouter J

    2017-01-01

    Objective: The aim of our study was to explore a possible relationship between proportion of basal insulin dose (%BD/T) and glycaemic control in children with type I diabetes on continuous subcutaneous insulin infusion (CSII) therapy. Methods: All patients under the age of 18 with type I diabetes

  1. Eplerenone: a selective aldosterone receptor antagonist for hypertension and heart failure.

    Science.gov (United States)

    Moore, Tera D; Nawarskas, James J; Anderson, Joe R

    2003-01-01

    Aldosterone has been implicated for many years as an important substance in the pathogenesis of heart disease. Elevated aldosterone concentrations have been documented in patients with hypertension and heart failure, leading to the use of aldosterone antagonists for the treatment of these conditions. Spironolactone has been used for nearly 2 decades for the treatment of hypertension, and more recently, has become a standard agent for the treatment of systolic heart failure. Spironolactone, however, is a nonselective antagonist of the aldosterone receptor, binding also to other steroid receptors and causing a significant percentage of patients to have sex hormone-related adverse effects such as gynecomastia. Eplerenone is the first of a new class of drugs known as selective aldosterone receptor antagonists, which selectively block the aldosterone receptor with minimal effect at other steroid receptors, thereby minimizing many of the hormonal side effects seen with spironolactone. Eplerenone has been shown to be beneficial both as monotherapy and combination therapy for lowering elevated blood pressure in patients with hypertension. The antihypertensive efficacy of eplerenone is roughly similar to that of other antihypertensive agents, although in 1 study black patients responded better with eplerenone than losartan. In addition, eplerenone has demonstrated some renoprotective effects in diabetic patients with hypertension. Recently, eplerenone was shown to significantly reduce mortality and cardiovascular morbidity in post-myocardial infarction patients with systolic heart failure currently taking standard heart failure medications. Eplerenone is generally well tolerated, although hyperkalemia with this agent is of some concern. Eplerenone is metabolized by CYP3A4 and administration with potent inhibitors of this enzyme is contraindicated because of the risk of hyperkalemia. In summary, eplerenone has proven to be beneficial in treating hypertension and post

  2. The Opioid-Sparing Effect of Perioperative Dexmedetomidine Combined with Oxycodone Infusion during Open Hepatectomy: A Randomized Controlled Trial

    OpenAIRE

    Benhou Zhang; Benhou Zhang; Guifang Wang; Xiaopeng Liu; Tian-Long Wang; Ping Chi

    2018-01-01

    Background: A large right subcostal incision performed by open hepatectomy is associated with significant post-operative pain and distress. However, post-operative analgesia solutions still need to be devised. We investigated the effects of intra- and post-operative infusion of dexmedetomidine (Dex) combined with oxycodone during open hepatectomy.Methods: In this prospective, randomized and double-blind investigation, 52 patients undergoing selective open hepatectomy were divided into Dex gro...

  3. Neuroprotective effect of intracarotid cold saline infusion following cardiopulmonary resuscitation in a hypothermic cardiac arrest canine model

    OpenAIRE

    Wei-zheng SHUAI; Yuan, Rui; Zhang, Zhi-cheng; Duan, Yun-You

    2017-01-01

    Objective To evaluate the effect of intracarotid cold saline infusion (ICSI) on neurological outcomes in canines with cardiac arrest (CA) introduced by severe hypothermia. Methods Restoration of spontaneous circulation (ROSC) after hypothermic CA was induced in 10 Beagle dogs. These 10 dogs were randomly divided into 2 groups (5 each). Dogs in control group were rewarmed using warn water bath, and dogs in experimental group received the bath rewarming plus ICSI for 6 hours to maintain the b...

  4. Cost-effectiveness evaluations of spinal neuromodulation with ziconotide continuous infusion in cancer pain in a real clinical practice

    OpenAIRE

    Orietta Zaniolo; Sergio Iannazzo; Gian Piero Patrucco; Roberto Bellini

    2011-01-01

    Introduction and objective: ziconotide is the first-in-class drug of selective N-type voltage-sensitive calcium-channel blockers used to control severe chronic pain. The present study is developed in order to analyze clinical and economical outcomes of spinal neuromodulation with ziconotide continuous infusion in cancer pain in a real clinical practice.Methods: costs and effects of ziconotide are compared with those of traditional neuromodulation with morphine and adjuvant drugs, administered...

  5. Effects of erythrocyte infusion on VO2max at high altitude

    DEFF Research Database (Denmark)

    Young, Jette Feveile; Sawka, M N; Muza, S R

    1996-01-01

    This study investigated whether autologous erythrocyte infusion would ameliorate the decrement in maximal O2 uptake (VO2max) experienced by lowlanders when they ascend to high altitude. VO2max was measured in 16 men (treadmill running) at sea level (SL) and on the 1st (HA1) and 9th (HA9) days...... of high-altitude (4,300 m) residence. After VO2max was measured at SL, subjects were divided into two matched groups (n = 8). Twenty-four hours before ascent to high altitude, the experimental group received a 700-ml infusion of autologous erythrocytes and saline (42% hematocrit), whereas the control...... group received only saline. The VO2max of erythrocyte-infused [54 +/- 1 (SE) ml.kg-1.min-1] and control subjects (52 +/- 2 ml.kg-1.min-1) did not differ at SL before infusion. The decrement in VO2max on HA1 did not differ between groups, averaging 26% overall, despite higher (P

  6. Effects of intravenous lipopolysaccharide infusion on glucose and insulin dynamics in horses with equine metabolic syndrome.

    Science.gov (United States)

    Tadros, Elizabeth M; Frank, Nicholas; De Witte, Fiamma Gomez; Boston, Raymond C

    2013-07-01

    To test the hypothesis that glucose and insulin dynamics during endotoxemia differ between healthy horses and horses with equine metabolic syndrome (EMS). 6 healthy adult mares and 6 horses with EMS. Each horse randomly received an IV infusion of lipopolysaccharide (20 ng/kg [in 60 mL of sterile saline {0.9% NaCl} solution]) or saline solution, followed by the other treatment after a 7-day washout period. Baseline insulin-modified frequently sampled IV glucose tolerance tests were performed 27 hours before and then repeated at 0.5 and 21 hours after infusion. Results were assessed via minimal model analysis and area under the curve values for plasma glucose and serum insulin concentrations. Lipopolysaccharide infusion decreased insulin sensitivity and increased area under the serum insulin concentration curve (treatment × time) in both healthy and EMS-affected horses, compared with findings following saline solution administration. The magnitude of increase in area under the plasma glucose curve following LPS administration was greater for the EMS-affected horses than it was for the healthy horses. Horses with EMS that received LPS or saline solution infusions had decreased insulin sensitivity over time. Glucose and insulin responses to endotoxemia differed between healthy horses and horses with EMS, with greater loss of glycemic control in EMS-affected horses. Horses with EMS also had greater derangements in glucose and insulin homeostasis that were potentially stress induced. It may therefore be helpful to avoid exposure of these horses to stressful situations.

  7. Critical Thinking Disposition: The Effects of Infusion Approach in Engineering Drawing

    Science.gov (United States)

    Darby, Norazlinda Mohd; Rashid, Abdullah Mat

    2017-01-01

    Critical Thinking Disposition is known as an important factor that drives a student to use Higher Order Thinking Skills (HOTS) in order to solve engineering drawing problems. Infusing them while teaching the subject may enhance students' disposition and higher order thinking skills. However, no research has been done in critical thinking…

  8. Effects of erythrocyte infusion on VO2max at high altitude

    DEFF Research Database (Denmark)

    Young, Jette Feveile; Sawka, M N; Muza, S R

    1996-01-01

    This study investigated whether autologous erythrocyte infusion would ameliorate the decrement in maximal O2 uptake (VO2max) experienced by lowlanders when they ascend to high altitude. VO2max was measured in 16 men (treadmill running) at sea level (SL) and on the 1st (HA1) and 9th (HA9) days of ...

  9. Intraperitoneal insulin infusion : treatment option for type 1 diabetes resulting in beneficial endocrine effects beyond glycaemia

    NARCIS (Netherlands)

    van Dijk, P R; Logtenberg, S J J; Gans, R O B; Bilo, H J G; Kleefstra, N

    2014-01-01

    Continuous intraperitoneal insulin infusion (CIPII) is a treatment option for patients with type 1 diabetes mellitus who fail to reach adequate glycaemic control despite intensive subcutaneous (SC) insulin therapy. CIPII has clear advantages over SC insulin administration in terms of pharmacokinetic

  10. Fluctuating functions related to quality of life in advanced Parkinson disease: effects of duodenal levodopa infusion

    DEFF Research Database (Denmark)

    Isacson, D; Bingefors, K; Sønbø Kristiansen, Ivar

    2008-01-01

    OBJECTIVE: To assess fluctuations in quality of life (QoL) and motor performance in patients with advanced Parkinson disease (PD) treated with continuous daytime duodenal levodopa/carbidopa infusion or conventional therapy. METHODS: Of 18 patients completing a 6-week trial (DIREQT), 12 were...

  11. Effect of continuous subcutaneous insulin infusion on kidney function and size in IDDM patients

    DEFF Research Database (Denmark)

    Christensen, Cramer; Christiansen, J S; Schmitz, A

    1987-01-01

    insulin infusion (CSII) (n = 12) or unchanged conventional insulin treatment (CIT) (n = 12). GFR, RPF, and kidney volume were identical but significantly increased above normal values in the two groups at the start of the study. After 24 months of CSII treatment, significant reduction in GFR was seen...

  12. Behavioural and neurotoxic effects of ayahuasca infusion (Banisteriopsis caapi and Psychotria viridis) in female Wistar rat.

    Science.gov (United States)

    Pic-Taylor, Aline; da Motta, Luciana Gueiros; de Morais, Juliana Alves; Junior, Willian Melo; Santos, Alana de Fátima Andrade; Campos, Leandro Ambrósio; Mortari, Marcia Renata; von Zuben, Marcus Vinicius; Caldas, Eloisa Dutra

    2015-09-01

    Ayahuasca, a psychoactive beverage used by indigenous and religious groups, is generally prepared by the coction of Psychotria viridis and Banisteriopsis caapi plants containing N,N-dimethyltryptamine (DMT) and β-carboline alkaloids, respectively. To investigate the acute toxicity of ayahuasca, the infusion was administered by gavage to female Wistar rats at doses of 30X and 50X the dose taken during a religious ritual, and the animals observed for 14 days. Behavioural functions were investigated one hour after dosing at 15X and 30X using the open field, elevated plus maze, and forced swimming tests. Neuronal activation (c-fos marked neurons) and toxicity (Fluoro-Jade B and Nissl/Cresyl staining) were investigated in the dorsal raphe nuclei (DRN), amygdaloid nucleus, and hippocampal formation brain areas of rats treated with a 30X ayahuasca dose. The actual lethal oral dose in female Wistar rats could not be determined in this study, but was shown to be higher than the 50X (which corresponds to 15.1mg/kg bw DMT). The ayahuasca and fluoxetine treated groups showed a significant decrease in locomotion in the open field and elevated plus-maze tests compared to controls. In the forced swimming test, ayahuasca treated animals swam more than controls, a behaviour that was not significant in the fluoxetine group. Treated animals showed higher neuronal activation in all brain areas involved in serotoninergic neurotransmission. Although this led to some brain injury, no permanent damage was detected. These results suggest that ayahuasca has antidepressant properties in Wistar female at high doses, an effect that should be further investigated. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Effect of intragastric FODMAP infusion on upper gastrointestinal motility, gastrointestinal, and psychological symptoms in irritable bowel syndrome vs healthy controls.

    Science.gov (United States)

    Masuy, I; Van Oudenhove, L; Tack, J; Biesiekierski, J R

    2017-08-01

    The low fermentable oligo-, di-, mono-saccharides and polyol (FODMAP) diet is a treatment strategy to reduce symptoms of irritable bowel syndrome (IBS). Acute effects of FODMAPs on upper gastrointestinal motility are incompletely understood. Our objectives were to assess the acute effects of intragastric FODMAP infusions on upper gastrointestinal motility and gastrointestinal and psychological symptoms in healthy controls (HC) and IBS patients. A high-resolution solid-state manometry probe and an infusion tube were positioned into the stomach. Fructans, fructose, FODMAP mix, or glucose was intragastrically administered to HC, and fructans or glucose was administered to IBS patients until full satiation (score 0-5), in a randomized crossover fashion. Manometric measurements continued for 3 hours. Gastrointestinal and psychological symptoms were assessed by questionnaires at predefined time points. The study was registered on www.clinicaltrials.gov (NCT02980406). Twenty HC and 20 IBS patients were included. Fructans induced higher postprandial gastric pressures compared with glucose over both groups (P<.001). Bloating, belching, and pain increased more in IBS over both carbohydrates (P<.041). In addition, IBS patients reported more flatulence and cramps compared with HC following fructans (P<.001). Glucose induced more fatigue and dominance compared with fructans (P=.028, P=.001). Irritable bowel syndrome patients reported a higher increase in anger (P=.030) and a stronger decrease in positive affect (P=.021). The upper gastrointestinal motility response varies between carbohydrates. Irritable bowel syndrome patients are more sensitive to fructan infusion, reflected in their higher gastrointestinal symptom scores. Acute carbohydrate infusion can have differential psychological effects in IBS and HC. © 2017 John Wiley & Sons Ltd.

  14. Protein kinase D stabilizes aldosterone-induced ERK1/2 MAP kinase activation in M1 renal cortical collecting duct cells to promote cell proliferation.

    LENUS (Irish Health Repository)

    McEneaney, Victoria

    2010-01-01

    Aldosterone elicits transcriptional responses in target tissues and also rapidly stimulates the activation of protein kinase signalling cascades independently of de novo protein synthesis. Here we investigated aldosterone-induced cell proliferation and extra-cellular regulated kinase 1 and 2 (ERK1\\/2) mitogen activated protein (MAP) kinase signalling in the M1 cortical collecting duct cell line (M1-CCD). Aldosterone promoted the proliferative growth of M1-CCD cells, an effect that was protein kinase D1 (PKD1), PKCdelta and ERK1\\/2-dependent. Aldosterone induced the rapid activation of ERK1\\/2 with peaks of activation at 2 and 10 to 30 min after hormone treatment followed by sustained activation lasting beyond 120 min. M1-CCD cells suppressed in PKD1 expression exhibited only the early, transient peaks in ERK1\\/2 activation without the sustained phase. Aldosterone stimulated the physical association of PKD1 with ERK1\\/2 within 2 min of treatment. The mineralocorticoid receptor (MR) antagonist RU28318 inhibited the early and late phases of aldosterone-induced ERK1\\/2 activation, and also aldosterone-induced proliferative cell growth. Aldosterone induced the sub-cellular redistribution of ERK1\\/2 to the nuclei at 2 min and to cytoplasmic sites, proximal to the nuclei after 30 min. This sub-cellular distribution of ERK1\\/2 was inhibited in cells suppressed in the expression of PKD1.

  15. Novel Approach to Establishing an Aldosterone: Renin Ratio Cutoff for Primary Aldosteronism.

    Science.gov (United States)

    Leung, Alexander A; Orton, Dennis J; Chin, Alex; Sadrzadeh, Hossein; Kline, Gregory A

    2017-03-01

    Direct renin concentration is replacing plasma renin activity in many laboratories for the investigation of primary aldosteronism, which may have a significant impact on the resulting aldosterone:renin ratios. We sought to develop a population-based approach to establishing an aldosterone:renin ratio cutoff when transitioning between assays. A population-based study was performed in Calgary, Alberta, Canada of 4301 individuals who received testing from January 2012 to November 2015. In 2014, direct renin concentration replaced plasma renin activity in routine testing. We described the prevalence of primary aldosteronism in our population before the change and, using the assumption of disease prevalence stability, determined the corresponding ratio cutoffs after the introduction of the new assay. During the initial portion of the study (using plasma renin activity), 4.9% of those screened were classified as highly probable cases, whereas 10.4% were considered probable and 28.9% possible using locally validated cutoffs. Aldosterone:renin ratio cutoffs were then determined for the direct renin concentration assay. A highly probable case of primary aldosteronism corresponded to a cutoff of >100 pmol L(-1) mIU(-1) L(-1) with hypokalemia. A probable case corresponded to a cutoff of >100 and a possible case to >35 pmol L(-1) mIU(-1) L(-1) In contrast, cutoffs derived using a conversion factor resulted in significantly higher cutoffs and the potential for missed cases. In conclusion, using large population data, historically consistent aldosterone:renin ratio cutoffs can be established when transitioning between assays. Population-derived cutoffs may be more appropriate for clinical use and less likely to result in false-negative classification than those obtained from conventional direct method comparisons. © 2017 American Heart Association, Inc.

  16. The haemodynamic effects of the perioperative terlipressin infusion in living donor liver transplantation: A randomised controlled study

    Directory of Open Access Journals (Sweden)

    Nagwa Ibrahim

    2015-01-01

    Full Text Available Background and Aims: Liver disease is usually accompanied with a decline in systemic vascular resistance (SVR. We decided to assess effects of the peri-operative terlipressin infusion on liver donor liver transplantation recipients with respect to haemodynamics and renal parameters. Methods: After Ethical Committee approval for this prospective randomised controlled study, 50 recipients were enrolled and allotted to control (n = 25 or terlipressin group (n = 25 with simple randomisation method. Terlipressin was infused at 1.0 μg/kg/h and later titrated 1.0-4.0 μg/kg/h to maintain mean arterial pressure (MAP >65 mmHg and SVR index 0.05 and was sustained post-operatively. Conclusion: Terlipressin improved SVR and MAP with less need for catecholamines particularly post-reperfusion. Terlipressin reduced PPV without hepatic artery vasoconstriction and improved post-operative UOP.

  17. The Effectiveness of Intravenous Morphine Infusion as Preemptive Analgesia in Preventing Phantom Limb Pain Following Lower Limb Amputation

    Directory of Open Access Journals (Sweden)

    KC Chong

    2010-11-01

    Full Text Available hantom limb pain may reduce ambulation and mobility in amputees, resulting in diminished quality of life. We conducted a prospective study to compare the perioperative analgesic use of intravenous morphine infusion in 27 patients (Group A and intramuscular diclofenac sodium in 28 patients (Group B in patients undergoing lower limb amputation. All patients underwent amputation under spinal anaesthesia and reported a Modified Verbal Numerical Pain Score of less than two prior to the procedure. Presence of phantom pain was assessed on the first, second, third and seventh day as well as at the third month and sixth month post-operatively. Twelve (44 % patients from group A and 21 patients (75 % from group B developed phantom limb pain following amputation, a statistically significant difference between groups (p<0.05. We conclude that intravenous morphine infusion is more effective than intramuscular diclofenac sodium in preventing the occurrence of phantom limb pain following amputation.

  18. Effect of Oxyntomodulin, Glucagon, GLP-1 and Combined Glucagon +GLP-1 Infusion on Food Intake, Appetite and Resting Energy Expenditure

    DEFF Research Database (Denmark)

    Bagger, Jonatan I; Holst, Jens J; Hartmann, Bolette

    2015-01-01

    ], and glucagon+GLP-1 688 [606, 769]). Oxygen uptake did not change significantly from baseline in response to any peptide infusion compared with saline. Conclusions: Oxyntomodulin, GLP-1, and glucagon decreased food intake but with no additional effect of combining GLP-1 and glucagon. - See more at: http.......86 pmol × kg−1 × min−1), oxyntomodulin (3 pmol × kg−1 × min−1), or glucagon+GLP-1 (same doses). Main Outcome Measures: We evaluated resting energy expenditure (measured as oxygen uptake, gastric emptying (GE), composite appetite scores (CAS), and food intake. Results: Oxyntomodulin, GLP-1, and GLP-1......+glucagon slowed GE and reduced CAS, whereas glucagon did not affect GE and CAS. All infusions caused a similar decrease in food intake compared with saline (total intake (g [95% confidence interval]), saline 811 [729, 892], GLP-1 669 [586, 750], glucagon 686 [604, 768], oxyntomodulin 689 [608, 771...

  19. Effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function in healthy humans

    DEFF Research Database (Denmark)

    Madsen, Jan Lysgård; Fuglsang, Stefan; Graff, J

    2006-01-01

    : To examine the effect of intravenous infusion of glyceryl trinitrate on gastric and small intestinal motor function after a meal in healthy humans. METHODS: Nine healthy volunteers participated in a placebo-controlled, double-blind, crossover study. Each volunteer was examined during intravenous infusion...... of glyceryl trinitrate 1 microg/kg x min or saline. A gamma camera technique was used to measure gastric emptying and small intestinal transit after a 1600-kJ mixed liquid and solid meal. Furthermore, duodenal motility was assessed by manometry. RESULTS: Glyceryl trinitrate did not change gastric mean...... trinitrate 1 microg/kg x min does not induce major changes in gastric or small intestinal motor function after a 1600-kJ meal in healthy volunteers....

  20. Effects of L-Carnitine Theraphy On Methabolic and Biochemical Changes Caused By Propofol Infusion in Rabbits Undergoing Mechanical Ventilation

    Directory of Open Access Journals (Sweden)

    Savaş Yılbaş

    2011-08-01

    Full Text Available Objective: Increased lipid mass in the body secondary to long term and high doses of propofol infusion may cause carnitine deficiency. In this study; we aimed to investigate the effects of carnitine, given for treatment purposes and have not been analyzed before, during high doses of propofol infusion in rabbits. Materials and Methods: Following ethical committee approval; 2500-3500 grams weight, 3-4 months-old, healthy, male, white 20 New Zealand rabbits were included in the study. The rabbits were premedicated with xsilazine and atropine. After the preparation period including tracheostomy, monitorization, catheterization of the ear arteries and veins and urinary vesical; basal blood samples for biochemical and metabolic parameters included in the study were taken and rabbits were divided into 4 groups, 5 rabbits in each,randomly (Group P, Group PC, Group S, Group SC. For sedation 20 mg/kg/h propofol infusion was given to Group P, 20 mg/kg/h propofol and 100 mg/kg L-carnitine infusions were given simultaneously to Group PC, sevoflurane for sedation was given to Group S, sevoflurane and L-carnitine infusion were given simultaneously to Group SC. Their sedation levels were evaluated every 30 minutes and their vital signs were reported every 15 minutes. Every 2 hours arterial blood gases analysis and every 12 hours electrolytes and metabolic parameters were repeated. Euthanasia with high doses (60 mg/kg of ketamin is performed for rabbits that were alive at the end of 24 hours. Results: All groups were similar in weight, vital parameters, all parameters searched in arterial blood gases, life time, liver enzymes, lactate dehydrogenase, serum electrolytes, creatine kinase and renal function tests (p>0.05. However; amylase levels before death or euthanasia were lower in Group PC compared to other groups;myoglobin and CK-MB levels in Group P were higher compared to other groups; cholesterol levels at 12th hour, before death or euthanasia were higher

  1. Effect of programmed intermittent epidural boluses and continuous epidural infusion on labor analgesia and obstetric outcomes: a randomized controlled trial.

    Science.gov (United States)

    Ferrer, Leopoldo E; Romero, David J; Vásquez, Oscar I; Matute, Ednna C; Van de Velde, Marc

    2017-11-01

    Continuous epidural infusion and programmed intermittent epidural boluses are analgesic techniques routinely used for pain relief in laboring women. We aimed to assess both techniques and compare them with respect to labor analgesia and obstetric outcomes. After Institutional Review Board approval, 132 laboring women aged between 18 and 45 years were randomized to epidural analgesia of 10 mL of a mixture of 0.1% bupivacaine plus 2 µg/mL of fentanyl either by programmed intermittent boluses or continuous infusion (66 per group). Primary outcome was quality of analgesia. Secondary outcomes were duration of labor, total drug dose used, maternal satisfaction, sensory level, motor block level, presence of unilateral motor block, hemodynamics, side effects, mode of delivery, and newborn outcome. Patients in the programmed intermittent epidural boluses group received statistically less drug dose than those with continuous epidural infusion (24.9 vs 34.4 mL bupivacaine; P = 0.01). There was no difference between groups regarding pain control, characteristics of block, hemodynamics, side effects, and Apgar scores. Our study evidenced a lower anesthetic consumption in the programmed intermittent boluses group with similar labor analgesic control, and obstetric and newborn outcomes in both groups.

  2. [Effectiveness of continuous infusion of tizanidine (Ternelin) via a feeding tube for patients with the mixed type of tetraplegia].

    Science.gov (United States)

    Hiejima, Ikuko; Kumada, Tomohiro; Nozaki, Fumihito; Hayasi, Anri; Miyajima, Tomoko; Fujii, Tatsuya

    2015-01-01

    Severe muscle hypertonia in patients with the mixed type of tetraplegia may be associated with significant deterioration in the quality of life of the patients. Intermittent use of oral muscle relaxant drugs, for example, Tizanidine (Ternelin), which is a fast-acting muscle relaxant, can provide relief from the severe hypertonia in these patients, but only for short durations. We conducted a retrospective study of the effect of continuous infusion of tizanidine via a feeding tube on the severe systemic muscle hypertonia in patients with the mixed type of tetraplegia. We mixed tizanidine with milk or other enteral nutrients and administered the mixture via a naso-duodenal tube at a constant infusion rate several hours to 5 patients with the mixed type of tetraplegia showing severe uncontrolled systemic hypertonia under intermittent treatment with oral muscle relaxant drugs. Significant relief from the systemic muscle hypertonia was obtained in 4 of the 5 patients with improvement of the quality of life of the patients, e. g., they could get adequate sleep. There were no serious side effects in any of the cases. We consider that continuous infusion of tizanidine via a feeding tube would be useful for the treatment of severe systemic hypertonia in patients in whom the symptom cannot be adequately controlled by intermittent use of oral muscle relaxant drugs.

  3. Aldosterone alters the participation of endothelial factors in noradrenaline vasoconstriction differently in resistance arteries from normotensive and hypertensive rats.

    Science.gov (United States)

    Xavier, Fabiano E; Blanco-Rivero, Javier; Avendaño, María Soledad; Sastre, Esther; Yela, Rubén; Velázquez, Kyra; Salaíces, Mercedes; Balfagón, Gloria

    2011-03-11

    This study analyzed the effect of aldosterone (0.05mg/kg per day, 3 weeks) on vasoconstriction induced by noradrenaline in mesenteric resistance arteries from WKY rats and SHR. Contraction to noradrenaline was measured in mesenteric resistance arteries from untreated and aldosterone-treatedrats from both strains. Participation of nitric oxide (NO), superoxide anions, thromboxane A(2) (TxA(2)) and prostacyclin in this response was determined. 6-keto-prostaglandin (PG)F1alpha and thromboxane B(2) (TxB(2)) releases were determined by enzyme immunoassay. NO and superoxide anion release were also determined by fluorescence and chemiluminiscence, respectively. Aldosterone did not modify noradrenaline-induced contraction in either strain. In mesenteric resistance arteries from both aldosterone-treated groups, endothelium removal or preincubation with NO synthesis inhibitor L-NAME increased the noradrenaline-induced contraction, while incubation with the superoxide anion scavenger tempol decreased it. Preincubation with either the COX-1/2 or COX-2 inhibitor (indomethacin and NS-398, respectively) decreased the noradrenaline contraction in aldosterone-treated animals, while this response was not modified by COX-1 inhibitor SC-560. TxA(2) synthesis inhibitor (furegrelate), or TxA2 receptor antagonist (SQ 29 548) also decreased the noradrenaline contraction in aldosterone-treated animals. In untreated SHR, but not WKY rats, this response was increased by L-NAME, and reduced by tempol, indomethacin, NS-398 or SQ 29 548. Aldosterone treatment did not modify NO or TxB(2) release, but it did increase superoxide anion and 6-keto-PGF(1alpha) release in mesenteric resistance arteries from both strains. In conclusion, chronic aldosterone treatment reduces smooth muscle contraction to alpha-adrenergic stimuli, producing a new balance in the release of endothelium-derived prostanoids and NO. Copyright © 2011. Published by Elsevier B.V.

  4. Rationale for an early aldosterone blockade in acute myocardial infarction and design of the ALBATROSS trial.

    Science.gov (United States)

    Beygui, Farzin; Vicaut, Eric; Ecollan, Patrick; Machecourt, Jacques; Van Belle, Eric; Zannad, Faiez; Montalescot, Gilles

    2010-10-01

    Aldosterone is at its highest levels at presentation for acute myocardial infarction (AMI). High aldosterone levels are predictive of poor outcome regardless of heart failure. Angiotensin-converting enzyme inhibitors have delayed partial and temporary effects on aldosterone levels. We hypothesize that aldosterone receptor blockade, early after AMI onset on top of standard therapy, may improve clinical outcome. ALBATROSS is a nationwide, multicenter, open-labeled, randomized trial designed to assess the superiority of aldosterone blockade by a 200-mg intravenous bolus of potassium canrenoate followed by a daily 25-mg dose of spirinolactone for 6 months, on top of standard therapy compared to standard therapy alone among 1,600 patients admitted for ST-segment elevation or high risk non-ST-segment elevation acute AMI -TIMI score ≥3-within 72 hours after symptom onset regardless of heart failure and treatment strategy. The primary efficacy end point of the study is the 6-month rate of the composite of death, resuscitated cardiac arrest, significant ventricular arrhythmia, class IA American College of Cardiology/American Heart Association/European Society of Cardiology indication for implantable cardioverter device, and new or worsening heart failure. Secondary end points include each of the components of the primary end point, different combinations of such components, the primary end point assessed at hospital discharge and 30-day follow-up, and rates of acute renal failure. Safety end points include rates of hyperkalemia and premature drug discontinuation. ALBATROSS will assess the cardiovascular benefit of a low-cost aldosterone receptor blocker on top of standard therapy in all-coming AMI patients. Copyright © 2010 Mosby, Inc. All rights reserved.

  5. Race, obesity, and the renin-angiotensin-aldosterone system: treatment response in children with primary hypertension.

    Science.gov (United States)

    South, Andrew M; Arguelles, Lester; Finer, Gal; Langman, Craig B

    2017-04-14

    Pediatric primary hypertension (HTN) is increasingly recognized, but the effect of patient characteristics such as obesity and race on treatment outcomes is not well described. The renin-angiotensin-aldosterone system (RAAS) may also contribute to HTN. We hypothesized patient parameters of these factors, including baseline RAAS, influence blood pressure (BP) response to pharmacological treatment in HTN. This was a retrospective cohort of 102 consecutive patients with HTN. Primary outcomes were changes per year in systolic and diastolic BP (SBP, DBP). Secondary outcome was change per year in left ventricular mass index (LVMI). We evaluated whether baseline plasma renin activity (PRA), aldosterone, renin-to-aldosterone ratio, overweight/obesity, race, initial drug choice, and multidrug therapy were associated with the outcomes using general linear regression models adjusted for confounding variables. Racially diverse (43% Hispanic, 28% black, 25% white) and predominantly overweight/obese (75%) patients were studied. Median length of follow-up was 14.5 months. Higher baseline aldosterone was associated with decreased SBP (-1.03 mmHg/year), DBP (-0.95 mmHg/year), and DBP z score (-0.07/year) during the study period. Higher baseline PRA was associated with decreased SBP z score (-0.04/year) and LVMI (-2.89 g/m2.7/year). Stratified analyses revealed the relationships between baseline aldosterone and PRA, and annual reductions in outcomes were strengthened in nonobese and white patients. Pretreatment aldosterone and PRA predicted short-term follow-up BP and LVMI, especially in nonobese and white patients. The RAAS profile could guide treatment of HTN and suggests consideration of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers as first-line treatment options.

  6. Anesthetic recovery and hemodynamic effects of continuous thiopental infusion versus halothane for maintenance anesthesia in patients undergoing ocular surgery.

    Science.gov (United States)

    Shoroghi, Mehrdad; Farahbakhsh, Farshid; Sheikhvatan, Mehrdad; Sheikhfathollahi, Mahmood; Abbasi, Ali; Talebi, Azam

    2011-06-01

    To investigate anesthesia recovery and hemodynamic status in patients under thiopental infusion or halothane maintenance anesthesia undergoing ocular surgery. Fifty-nine voluntary patients undergoing ocular surgery in Farabi hospital were allocated to one of two maintenance anesthesia groups: inhaled halothane, 0.8 to 1 per cent, (group I, n=37) and thiopental infusion, 10 to 12 mg/kg/hour, (group II, n=22). Hemodynamic parameters were recorded at the time of patient entrance to the operation room and at the 1, 2, 5, 10, 15, 20, 25, 30, 35, and 40 minutes following anesthesia. Anesthesia recovery variables were also compared between the two groups. In group I, arterial blood pressure at 10 to 40 min and heart rate at 1 and 25 min after the administration of anesthetics were significantly lower when compared with group II (W ²= 25.10, p= 0.005). Arterial oxygen saturation was similar in the two groups over the whole points of time. The time intervals between the end of surgery and beginning of the first body movements and respiratory efforts were significantly longer in group received halothane (p<0.001). Continuous infusion of thiopental can be applied effectively and safely for maintenance of anesthesia. In comparison with halothane, it is associated with lower changes of intraoperative hemodynamics and faster anesthesia recovery.

  7. Effectiveness of aromatherapy in decreasing maternal anxiety for a sick child undergoing infusion in a paediatric clinic.

    Science.gov (United States)

    Ueki, Shingo; Niinomi, Kazuteru; Takashima, Yuko; Kimura, Ryoko; Komai, Kazuyo; Murakami, Kiyotaka; Fujiwara, Chieko

    2014-12-01

    We examined whether aromatherapy involving inhalation of yuzu (Citrus ichangensis×Citrus reticulata) oil was effective in decreasing mothers' anxiety for her sick child receiving an infusion at a paediatric clinic. Controlled clinical trial. Mothers of sick children who arrived at the hospital were asked to complete an anonymous questionnaire. After a doctor examined the child and confirmed the necessity for infusion, the mothers who agreed to participate in our study were allocated to an aromatherapy or a control group. A diffuser was filled with yuzu oil before the subjects entered the aromatherapy room. The mother was shown how to use the aromatherapy diffuser while the child was receiving an infusion in the same room. Fifteen minutes after entering the room, the mothers were asked to complete an another questionnaire. We measured the mother's anxiety with the state anxiety score from the State-Trait Anxiety Inventory. There were 60 subjects in the aromatherapy group and 61 in the control group. Both groups were well balanced in terms of demographic characteristics. Using analysis of variance, we demonstrated a significant difference in two-factor interactions between the control and aromatherapy groups. Maternal state anxiety was significantly lower in the aromatherapy than in the control group. Inhalation of yuzu oil was shown to decrease maternal anxiety for a sick child. A multicentre randomized controlled trial or double-blind study is necessary to obtain objective evidence of this benefit of aromatherapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Case Reports Showing a Long-Term Effect of Subanesthetic Ketamine Infusion in Reducing L-DOPA-Induced Dyskinesias

    Directory of Open Access Journals (Sweden)

    Scott J. Sherman

    2016-02-01

    Full Text Available Ketamine is an FDA-approved drug with a known safety profile. Low-dose subanesthetic intravenous ketamine infusion treatment has led to long-term reduction of treatment-resistant depression and of chronic pain states. We report on low-dose subanesthetic intravenous ketamine infusion treatment in Parkinson's disease (PD patients by 5 case studies and show a long-lasting therapeutic benefit to reduce L-DOPA-induced dyskinesia (LID, improve on time, and reduce depression. Based on the literature we hypothesize that low-dose ketamine may act as a ‘chemical deep brain stimulation', by desynchronizing hypersynchronous oscillatory brain activity, including in the basal ganglia and the motor cortex. The presented PD case reports indicate tolerability, safety and long-term beneficial effects of low-dose ketamine infusion that should be further investigated in a properly controlled prospective clinical trial for treatment of LID, as well as the prevalent nonmotor features pain and depression in PD patients.

  9. Differential Effects of Sodium Acetoacetate and Acetoacetic Acid Infusions on Alanine and Glutamine Metabolism in Man

    OpenAIRE

    Féry, Françoise; Balasse, Edmond O.

    1980-01-01

    It has been suggested that ketone bodies might participate in the nitrogen-sparing process occurring during prolonged starvation by inhibiting the muscular production of alanine and glutamine, which are the main gluconeogenic amino acids. The results of the ketone infusion studies on which this theory is based have been reevaluated in this study by following the plasma levels of ketone bodies, alanine, glutamine, and other substrates during 11.5 h in five groups of normal overnight-fasted sub...

  10. Effective Infusion Therapy of Drug-Induced Liver and Pancreas Injuries in Patients with Pulmonary Tuberculosis

    Directory of Open Access Journals (Sweden)

    N.B. Gubergrits

    2013-08-01

    Full Text Available The authors examined 328 patients with pulmonary tuberculosis who had drug-induced hepatitis and drug-induced pancreatitis due to polychemotherapy. Patients had metabolic intoxication syndrome associated with increasing level of «average molecules» in the blood. Not only reliable decrease of this indicator but also its normalization was achieved under the influence of treatment with a usage of succinic acid preparation for infusion therapy.

  11. Effect of intravenous N-acetylcysteine infusion on haemostatic parameters in healthy subjects

    DEFF Research Database (Denmark)

    Knudsen, T T; Thorsen, S; Jensen, S A

    2005-01-01

    volunteers. METHODS: Haemostatic parameters in 10 healthy subjects were analysed before and following intravenous infusion of therapeutic doses of N-acetylcysteine, as well as in vitro. RESULTS: N-acetylcysteine induced significant decreases in plasma levels of vitamin K dependent haemostatic proteins...... in vivo, being maximal at one hour following the start of infusion, with maximal decreases from 1.00 to 0.73 (0.67-0.79) (mean (95% confidence interval)), 0.66 (0.58-0.73), 0.81 (0.73-0.90), 0.64 (0.57-0.70), 0.74 (0.65-0.82), and 0.61 (0.54-0.67) for factor II, VII, IX, and X activities, protein C...... activity, and free protein S reactivity, respectively. These data suggest that N-acetylcysteine induces protein modifications affecting activity. Five subjects developed an adverse reaction to infusion of N-acetylcysteine and these were associated with a rapid increase in levels of factor VIII and its...

  12. Hypertension in the course of primary aldosteronism during pregnancy

    Directory of Open Access Journals (Sweden)

    Magdalena Wyskida

    2015-02-01

    Full Text Available Hypertension is one of the most common cardiovascular diseases during pregnancy. Primary hyperaldosteronism (PHA is the most frequent endocrinological, secondary cause of hypertension, rarely diagnosed in pregnant women. In the available literature about 50 cases of PHA in pregnant women have been described. PHA is often a cause of resistant hypertension. PHA can cause life-threatening complications both for the pregnant woman and the fetus. Diagnosis of PHA in pregnancy is difficult due to the antagonistic effect of progesterone on aldosterone, physiological increase of aldosterone release during gestation and frequent normokalaemic clinical course. Typical pharmacological treatment of PHA is limited due to the anti‑androgenic effect of spironolactone, lack of data concerning the safety of eplerenone and limited access to amiloride in Poland. Surgical treatment is a therapeutic option only in early pregnancy. This paper presents the current state of knowledge on diagnostic methods and treatment of PHA in pregnant women and a systematic review of cases described in the literature.

  13. Aldosterone aggravates glucose intolerance induced by high fructose

    OpenAIRE

    Sherajee, Shamshad J.; Rafiq,Kazi; Nakano, Daisuke; Mori, Hirohito; Kobara, Hideki; Hitomi, Hirofumi; Fujisawa, Yoshihide; Kobori, Hiroyuki; Masaki, Tsutomu; Nishiyama, Akira

    2013-01-01

    We previously reported that aldosterone impaired vascular insulin signaling in vivo and in vitro. Fructose-enriched diet induces metabolic syndrome including hypertension, insulin resistance, hyperlipidemia and diabetes in animal. In the current study, we hypothesized that aldosterone aggravated fructose feeding-induced glucose intolerance in vivo. Rats were divided into five groups for six-week treatment; uninephrectomy (Unx, n=8), Unx+aldosterone (aldo, 0.75 μg/h, s.c., n=8), Unx+fructose (...

  14. Effect of prolonged intravenous glucose and essential amino acid infusion on nitrogen balance, muscle protein degradation and ubiquitin-conjugating enzyme gene expression in calves

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    Scaife Jes R

    2008-02-01

    Full Text Available Abstract Background Intravenous infusions of glucose and amino acids increase both nitrogen balance and muscle accretion. We hypothesised that co-infusion of glucose (to stimulate insulin and essential amino acids (EAA would act additively to improve nitrogen balance by decreasing muscle protein degradation in association with alterations in muscle expression of components of the ubiquitin-proteasome proteolytic pathway. Methods We examined the effect of a 5 day intravenous infusions of saline, glucose, EAA and glucose + EAA, on urinary nitrogen excretion and muscle protein degradation. We carried out the study in 6 restrained calves since ruminants offer the advantage that muscle protein degradation can be assessed by excretion of 3 methyl-histidine and multiple muscle biopsies can be taken from the same animal. On the final day of infusion blood samples were taken for hormone and metabolite measurement and muscle biopsies for expression of ubiquitin, the 14-kDa E2 ubiquitin conjugating enzyme, and proteasome sub-units C2 and C8. Results On day 5 of glucose infusion, plasma glucose, insulin and IGF-1 concentrations were increased while urea nitrogen excretion and myofibrillar protein degradation was decreased. Co-infusion of glucose + EAA prevented the loss of urinary nitrogen observed with EAA infusions alone and enhanced the increase in plasma IGF-1 concentration but there was no synergistic effect of glucose + EAA on the decrease in myofibrillar protein degradation. Muscle mRNA expression of the ubiquitin conjugating enzyme, 14-kDa E2 and proteasome sub-unit C2 were significantly decreased, after glucose but not amino acid infusions, and there was no further response to the combined infusions of glucose + EAA. Conclusion Prolonged glucose infusion decreases myofibrillar protein degradation, prevents the excretion of infused EAA, and acts additively with EAA to increase plasma IGF-1 and improve net nitrogen balance. There was no evidence of

  15. Aldosterone and Cortisol affect the risk of sudden cardiac death in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    2012-06-01

    Conclusions: The joint presence of high aldosterone and high cortisol levels strongly increased the incidence of sudden cardiac death as well as all-cause mortality in hemodialyzed type 2 diabetic patients. Whether blockade of the mineralocorticoid receptor decreases the risk of sudden death without causing side effects must be examined in future trials.

  16. Differential effects of dopaminergic drugs on spontaneous motor activity in the common marmoset following pretreatment with a bilateral brain infusion of 6-hydroxydopamine

    OpenAIRE

    Ando, Kiyoshi; NISHIME, CHIYOKO; Inoue, Ryo; Nishinaka, Eiko; Kawai, Kenji; Urano, Koji; Tsutsumi, Hideki

    2017-01-01

    The differential effects of dopaminergic drugs with different pharmacological profiles were investigated with respect to spontaneous motor activity in the common marmoset following pretreatment with a bilateral brain infusion of 6-hydroxydopamine (6-OHDA). Three marmosets received infusions of 6-OHDA (either 30 or 40 μg/side) into the bilateral dopamine-rich area running from the substantia nigra to the striatum. The motor activity of the 6-OHDA marmosets was compared with that of three intac...

  17. Activating children's thinking skills (ACTS): the effects of an infusion approach to teaching thinking in primary schools.

    Science.gov (United States)

    Dewey, Jessica; Bento, Janet

    2009-06-01

    Recent interest in the teaching of thinking skills within education has led to an increase in thinking skills packages available to schools. However many of these are not based on scientific evaluation (DfEE, 1999). This paper endeavours to examine the effectiveness of one approach, that of infusion, to teaching thinking. To investigate the impact of an infusion methodology, activating children's thinking skills (ACTS), on the cognitive, social, and emotional development of children in Year 4-6 in primary schools. This is a sister project to research being conducted in Northern Ireland (McGuinness, 2006). The study involved 404 children from 8 primary schools in one local authority. These were divided into 160 in the experimental group and 244 in the waiting list control group. A quasi-experimental design was used with pre-, post-, and delayed post-tests to ascertain changes in children's cognitive abilities, self-perceptions, and social/behavioural skills using quantitative measures. In addition qualitative techniques were used with pupils and teachers to evaluate effectiveness. The experimental group made significantly greater gains in cognitive ability skills over a 2 year period compared to the waiting list control. Qualitative data demonstrated a positive impact on children's social and emotional development. In addition teacher professional development was reported to be enhanced. This research indicated that children's cognitive abilities can be developed following a 2 year period of the ACTS infusion intervention. While some positive effects were evidenced on the social and emotional development of children, further study will be necessary to examine these in more detail.

  18. Effects of dose ranging of adenosine infusion on electrocardiographic findings during and after general anesthesia.

    Science.gov (United States)

    Sun, Yan-Xia; Habib, Ashraf S; Wenger, Tom; Gratz, Irwin; Glick, David; Adsumelli, Rishimani; Creed, Mary R; Gan, Tong J

    2012-10-01

    To assess changes in the electrocardiogram (ECG) associated with intraoperative infusion of adenosine in patients undergoing open abdominal gynecological surgery. One hundred and sixty-six patients undergoing gynecological surgery were randomly assigned to receive one of four doses of adenosine infusion (25, 50, 100, or 200 μg/kg/min) or matching placebo. Study drug administration was started at skin incision and discontinued at end of surgery. A standardized general anesthetic regimen was used and adjusted based on hemodynamic and bispectral index values. Heart rate and rhythm variables, and PR, QRS, QT, and QTc intervals were recorded from 12-lead ECGs before anesthesia and immediately after patient arrival in the postanesthesia care unit. In addition, a rhythm strip was obtained during administration of the loading dose of the study drug. ECG variables were compared within and between groups. Incidence of ECG and hemodynamic abnormalities was recorded. One hundred and fifty-one subjects had a full set of electrocardiographic data: placebo (n = 38), group adenosine 25 μg/kg/min (n = 31), group adenosine 50 μg/kg/min (n = 29), group adenosine 100 μg/kg/min (n = 28), and group adenosine 200 μg/kg/min (n = 25). Statistically significant postoperative QTc prolongation was observed in all study groups when compared with baseline except for the adenosine 200 μg/kg/min group. However, these changes from baseline were not different among the groups. There were also no significant differences in PR, QRS, and QT intervals between the treatment groups. There was no difference in QTc prolongation following intraoperative administration of adenosine infusion compared with placebo during isoflurane general anesthesia. However, QTc prolongation is common following general anesthesia.

  19. The Effect of Intraoperative Infusion of Dexmedetomidine on Quality of Recovery after Major Spinal Surgery

    Science.gov (United States)

    Bekker, Alex; Haile, Michael; Kline, Richard; Didehvar, Sorosch; Babu, Ramesh; Martiniuk, Frank; Urban, Michael

    2013-01-01

    Background Surgery induces a variety of metabolic, endocrine and immune changes collectively known as the “stress response”, which often may lead to prolonged post-operative convalescence. Anesthetic management may modulate this physiological response thus affecting the postoperative course. We hypothesized that the intraoperative administration of dexmedetomidine (DEX), a sympatholytic agent, would reduce the stress response and improve the quality of recovery in patients undergoing major surgery. Methods We conducted a prospective randomized double-blinded study of 54 patients undergoing multilevel spinal fusion. Anesthesia was maintained with either propofol/fentanyl/dexmedetomidine (PFD) or propofol/fentanyl/placebo-saline (PFS). The quality of recovery (a primary end point) was assessed using a 40-item quality of recovery questionnaire (QoR40) and a 9 questions fatigue scale (FFS). The tests were administered preoperatively, on postoperative days (POD) 1, 2, 3 and 30. Blood samples were collected at baseline, in the post-anesthesia care unit (PACU) and POD 1 and were analyzed for levels of cortisol, C-reactive proteins (CRP) as well as the cytokines IL-1α, IL-1β, IL-1ra, IL-2, IL-6, IL-8, IL-10, and TNFα. Data were analyzed with SPSS software (version 18) using multivariate and mixed model approach to test for the effect of surgery and drug group. Pairwise comparisons were assessed with t-test or rank tests after correcting for multiple comparisons. Results The global QoR40 scores showed a significant effect of time (F4, 114= 22.63, p < 0.001), and drug ((F1, 51= 4.368, p = 0.042) with average scores falling to lower values on POD 1 (163.63 ± 2.47) and POD 2 (170.94 ± 2.38) than on baseline (180.56 ± 1.588, mean ± SE, 2-tailed t-tests, p<0.001). By POD 3, scores were significantly lower (−13.74 point difference, p=0.005) in the PFS group (169.3 ± 3.87) than in the PFD group (183.04 ± 2.76). All patients reported significantly higher levels of

  20. Modulation of Immunity and Inflammation by the Mineralocorticoid Receptor and Aldosterone

    Directory of Open Access Journals (Sweden)

    N. Muñoz-Durango

    2015-01-01

    Full Text Available The mineralocorticoid receptor (MR is a ligand dependent transcription factor. MR has been traditionally associated with the control of water and electrolyte homeostasis in order to keep blood pressure through aldosterone activation. However, there is growing evidence indicating that MR expression is not restricted to vascular and renal tissues, as it can be also expressed by cells of the immune system, where it responds to stimulation or antagonism, controlling immune cell function. On the other hand, aldosterone also has been associated with proinflammatory immune effects, such as the release of proinflammatory cytokines, generating oxidative stress and inducing fibrosis. The inflammatory participation of MR and aldosterone in the cardiovascular disease suggests an association with alterations in the immune system. Hypertensive patients show higher levels of proinflammatory mediators that can be modulated by MR antagonism. Although these proinflammatory properties have been observed in other autoimmune and chronic inflammatory diseases, the cellular and molecular mechanisms that mediate these effects remain unknown. Here we review and discuss the scientific work aimed at determining the immunological role of MR and aldosterone in humans, as well as animal models.

  1. The effects of ProAlgaZyme novel algae infusion on metabolic syndrome and markers of cardiovascular health

    Directory of Open Access Journals (Sweden)

    Hildreth DeWall J

    2007-09-01

    Full Text Available Abstract Background Metabolic Syndrome, or Syndrome X, is characterized by a set of metabolic and lipid imbalances that greatly increases the risk of developing diabetes and cardiovascular disease. The syndrome is highly prevalent in the United States and worldwide, and treatments are in high demand. ProAlgaZyme, a novel and proprietary freshwater algae infusion in purified water, has been the subject of several animal studies and has demonstrated low toxicity even with chronic administration at elevated doses. The infusion has been used historically for the treatment of several inflammatory and immune disorders in humans and is considered well-tolerated. Here, the infusion is evaluated for its effects on the cardiovascular risk factors present in metabolic syndrome in a randomized double-blind placebo-controlled study involving 60 overweight and obese persons, ages 25–60. All participants received four daily oral doses (1 fl oz of ProAlgaZyme (N = 22 or water placebo (N = 30 for a total of 10 weeks, and were encouraged to maintain their normal levels of physical activity. Blood sampling and anthropometric measurements were taken at the beginning of the study period and after 4, 8 and 10 weeks of treatment. Eight participants did not complete the study. Results ProAlgaZyme brought about statistically significant (p Conclusion ProAlgaZyme (4 fl oz daily consumption resulted in significant reductions in weight and blood glucose levels, while significantly improving serum lipid profiles and reducing markers of inflammation, thus improving cardiovascular risk factors in overweight and obese subjects over a course of 10 weeks with an absence of adverse side effects. Trial Registration US ClinicalTrials.gov NCT00489333

  2. The effect of low-dose ketamine infusion on the remifentanil induced hemodynamic changes during general anesthesia

    Directory of Open Access Journals (Sweden)

    Beigmohamadi M T

    2008-05-01

    Full Text Available Background: Remifentanil is known to produce side-effects of hypotension and bradycardia. In this study, we examine the effect of low-dose ketamine infusion on the heart rate and blood pressure of patients anesthetized with remifentanil.Methods: In a randomized clinical trial, 54 patients aged 20-50 years old, with ASA physical status Ι, were studied in two groups (n=27, Ketamine- Remifentanil (K-R group and Placebo- Remifentanil (P-R group. Exclusion criteria were ASA physical status >1, gastroesophageal reflux, tachycardia, bradycardia, systemic diseases, use of antihypertensive drugs, difficult intubations, risk of aspiration and contraindications of ketamine. Remifentanil was started at a rate of 0.5 µg. kg-1. min-1 and anesthesia was induced with thiopental sodium 2 mg.kg-1. Maintenance of anesthesia included halothane and nitrous oxide/oxygen mixture. Remifentanil infusion was continued in both groups at a rate of 0.5 µg.kg-1.min-1. In the K-R group, ketamine was started with an infusion rate of 10 µg.kg-1. min-1, 10 minutes after intubation, while in the P-R group, normal saline was started with the same dose of remifentanil. Heart rate, systolic, diastolic and mean arterial blood pressure were measured and compared at 1, 3, 5, 10, 15, 20, 25 and 30 minutes.Results: No significant differences were found between basic patient characteristics of mean of age, sex, weight, systolic, diastolic and mean arterial blood pressure and heart rate (p>0.2 in the two groups. However, the rate of systolic, diastolic and mean arterial blood pressure changes in the P-R group was significantly greater than that of the K-R group (p<0.006. Heart rate changes were similar between the two groups (p=0.6. Incident of severe hypotension (a decrease of more than 25% of the basic value was less in the K-R group than that of the P-R group (11% vs. 89%; p=0.000.Conclusion: Low-dose ketamine infusion modulates the effect of remifentanil-induced hypotension and

  3. Effects of Fat and Sugar, Either Consumed or Infused toward the Brain, on Hypothalamic ER Stress Markers

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    Evita Belegri

    2017-05-01

    Full Text Available Protein-folding stress at the Endoplasmic Reticulum (ER occurs in the hypothalamus during diet-induced obesity (DIO and is linked to metabolic disease development. ER stress is buffered by the activation of the unfolded protein response (UPR, a controlled network of pathways inducing a set of genes that recovers ER function. However, it is unclear whether hypothalamic ER stress during DIO results from obesity related changes or from direct nutrient effects in the brain. We here investigated mRNA expression of UPR markers in the hypothalamus of rats that were exposed to a free choice high-fat high-sugar (fcHFHS diet for 1 week and then overnight fed ad libitum, or fasted, or fat/sugar deprived (i.e., switched from obesogenic diet to chow. In addition, we determined the direct effects of fat/sugar on mRNA expression of hypothalamus UPR markers by intracarotic infusions of intralipids and/or glucose in chow-fed rats that were fasted overnight. Short term (1 week exposure to fcHFHS diet increased adiposity compared to chow-feeding. Short term exposure to a fcHFHS diet, followed by mild food restriction overnight, induced hypothalamic ER stress in rats as characterized by an increase in spliced to unspliced X-box binding protein 1 mRNA ratio in hypothalamus of fcHFHS fed rats compared to chow fed rats. Moreover, infused lipids toward the brain of overnight fasted rats, were able to induce a similar response. Non-restricted ad libitum fcHFHS-diet fed or totally fasted rats did not show altered ratios. We also observed a clear increase in hypothalamic activating transcription factor 4 mRNA in rats on the fcHFHS diet while being ad libitum fed or when infused with intralipid via the carotic artery compared to vehicle infusions. However, we did not observe induction of downstream targets implying that this effect is a more general stress response and not related to ER stress. Overall, we conclude that the hypothalamic stress response might be a sensitive

  4. COMPARISON OF THE EFFECTS OF INTERCOSTAL NERVE BLOCK WITH ROPIVACAINE AND INTRAVENOUS PARACETAMOL INFUSION TO INTRAVENOUS PARACETAMOL INFUSION ALONE FOR PAIN CONTROL AFTER OPEN CHOLECYSTECTOMY

    Directory of Open Access Journals (Sweden)

    Somnath Dey

    2017-11-01

    Full Text Available BACKGROUND Postoperative pain after open cholecystectomy is associated with respiratory dysfunction, increased stress response and prolonged hospital stay. We compare intravenous paracetamol (7.5 mg/kg plus intercostal nerve block with local anaesthetic ropivacaine 0.5% to intravenous paracetamol (15 mg/kg on pain control after open cholecystectomy. MATERIALS AND METHODS 140 patients, who underwent for open cholecystectomy, were randomly divided into two groups of 70. The patients were randomly allocated to any of the following two groups depending upon the drug used for analgesia (Group P or Group I Intravenous paracetamol 15 mg/kg was given to patients of group P and paracetamol 7.5 mg/kg with Intercostal nerve block in right side 6-10 intercostal nerves with 2 ml local anaesthetic ropivacaine 0.5% in each space was given to patients of group I just after intubation before incision. When the patients were transferred to postoperative recovery room, intensity of pain was recorded by response from the patients using 100 mm linear visual analogue scale ranging from 0 to 100. The pain scoring was done in the immediate postoperative period (when the patient was able to communicate in the post anaesthesia care unit, at 30 minutes, 1 hr. then hourly up to 24 hrs. till patient complained of pain with VAS score 40 or more. RESULTS The severity of pain in VAS score was lower in immediate postoperative period, at 30 minutes, 1 hour and 2 hours postoperatively in group I than the group P and those were statistically significant (p<0.001. Duration of analgesia also significantly lower in group I. Mean duration of analgesia in group P is 161.9 ± 42.6 min and in group I is 241.3 ± 44.2 min (p<0.001. CONCLUSION Adding Intercostal nerve block to intravenous infusion of Paracetamol infusion (7.5 mg/kg is better than sole intravenous infusion of Paracetamol (15 mg/kg in controlling pain severity even after reducing dose of paracetamol after open

  5. Serum aldosterone and cortisol concentrations before and after suppression with fludrocortisone in cats: a pilot study.

    Science.gov (United States)

    Matsuda, Mayu; Behrend, Ellen N; Kemppainen, Robert; Refsal, Kent; Johnson, Aime; Lee, Hollie

    2015-05-01

    Primary hyperaldosteronism is an increasingly recognized syndrome in cats, and diagnosis can be difficult. A potential diagnostic method has been reported, utilizing oral fludrocortisone administered twice daily for 4 days followed by collection of urine. In the current study, we sought to determine if blood sampling and a shorter dosing period would provide a possible means to test for primary hyperaldosteronism. Also, cortisol concentrations were measured to assess the potential of fludrocortisone to act as a glucocorticoid in cats. In phase I, 8 healthy laboratory cats were studied in a placebo-controlled, crossover design. Serum aldosterone and cortisol concentrations were measured before and on the second, third, and fourth day of treatment and compared within groups. In phase II, based on the results obtained in phase I, 8 healthy client-owned cats were administered 3 doses of fludrocortisone or placebo. Serum aldosterone and cortisol concentrations were compared before and after treatment within groups. In both phases, serum aldosterone and cortisol concentrations were significantly suppressed in fludrocortisone-treated cats. Thus, it was determined that oral administration of fludrocortisone causes suppression of serum aldosterone in healthy adult cats after only 3 doses. Further research is needed to determine the effects of oral fludrocortisone in cats with primary hyperaldosteronism and cats with other disorders causing hypertension and/or hypokalemia to determine if this protocol can be used as a tool for the definitive diagnosis of primary hyperaldosteronism. © 2015 The Author(s).

  6. Renin-angiotensin-aldosterone genotype influences ventricular remodeling in infants with single ventricle.

    Science.gov (United States)

    Mital, Seema; Chung, Wendy K; Colan, Steven D; Sleeper, Lynn A; Manlhiot, Cedric; Arrington, Cammon B; Cnota, James F; Graham, Eric M; Mitchell, Michael E; Goldmuntz, Elizabeth; Li, Jennifer S; Levine, Jami C; Lee, Teresa M; Margossian, Renee; Hsu, Daphne T

    2011-05-31

    We investigated the effect of polymorphisms in the renin-angiotensin-aldosterone system (RAAS) genes on ventricular remodeling, growth, renal function, and response to enalapril in infants with single ventricle. Single ventricle infants enrolled in a randomized trial of enalapril were genotyped for polymorphisms in 5 genes: angiotensinogen, angiotensin-converting enzyme, angiotensin II type 1 receptor, aldosterone synthase, and chymase. Alleles associated with renin-angiotensin-aldosterone system upregulation were classified as risk alleles. Ventricular mass, volume, somatic growth, renal function using estimated glomerular filtration rate, and response to enalapril were compared between patients with ≥2 homozygous risk genotypes (high risk), and those with SCPC) and at age 14 months. Of 230 trial subjects, 154 were genotyped: Thirty-eight were high risk, and 116 were low risk. Ventricular mass and volume were elevated in both groups pre-SCPC. Ventricular mass and volume decreased and estimated glomerular filtration rate increased after SCPC in the low-risk (PSCPC surgery, less improvement in renal function, and impaired somatic growth, the latter especially in patients receiving enalapril. Renin-angiotensin-aldosterone system genotype may identify a high-risk subgroup of single ventricle patients who fail to fully benefit from volume-unloading surgery. Follow-up is warranted to assess long-term impact. http://www.clinicaltrials.gov. Unique identifier: NCT00113087.

  7. Cold saline infusion and ice packs alone are effective in inducing and maintaining therapeutic hypothermia after cardiac arrest.

    Science.gov (United States)

    Larsson, Ing-Marie; Wallin, Ewa; Rubertsson, Sten

    2010-01-01

    Hypothermia treatment with cold intravenous infusion and ice packs after cardiac arrest has been described and used in clinical practice. We hypothesised that with this method a target temperature of 32-34 degrees C could be achieved and maintained during treatment and that rewarming could be controlled. Thirty-eight patients treated with hypothermia after cardiac arrest were included in this prospective observational study. The patients were cooled with 4 degrees C intravenous saline infusion combined with ice packs applied in the groins, axillae, and along the neck. Hypothermia treatment was maintained for 26 h after cardiac arrest. It was estimated that passive rewarming would occur over a period of 8h. Body temperature was monitored continuously and recorded every 15 min up to 44 h after cardiac arrest. All patients reached the target temperature interval of 32-34 degrees C within 279+/-185 min from cardiac arrest and 216+/-177 min from induction of cooling. In nine patients the temperature dropped to below 32 degrees C during a period of 15 min up to 2.5h, with the lowest (nadir) temperature of 31.3 degrees C in one of the patients. The target temperature was maintained by periodically applying ice packs on the patients. Passive rewarming started 26 h after cardiac arrest and continued for 8+/-3h. Rebound hyperthermia (>38 degrees C) occurred in eight patients 44 h after cardiac arrest. Intravenous cold saline infusion combined with ice packs is effective in inducing and maintaining therapeutic hypothermia, with good temperature control even during rewarming. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  8. The effects of inhibition of plasma cholinesterase activity on systemic toxicity and blood catecholamine levels from cocaine infusion in pigs.

    Science.gov (United States)

    Kambam, J; Mets, B; Hickman, R; Janicki, P; James, M F; Kirsch, R

    1993-08-01

    We investigated systemic effects and possible mechanisms for lethality of intravenously infused cocaine in spontaneously breathing and mechanically ventilated unconscious Landrace male pigs weighing about 26 kg (25.75 +/- 0.25 kg) that were pretreated with either saline solution (groups 1 and 3) or iso-ompa (tetraisopropyl pyrophosphoramide), a specific plasma cholinesterase inhibitor (groups 2 and 4). Pigs were made unconscious with sodium thiopental and ventilated with 70% nitrous oxide and 30% oxygen. A carotid arterial cannula and a Swan-Ganz catheter were inserted for hemodynamic monitoring. Pigs in groups 1 and 2 were then allowed to breathe spontaneously and groups 3 and 4 were mechanically ventilated. After obtaining a stable state, as judged by cardiovascular and respiratory parameters, the pigs were infused intravenously with cocaine hydrochloride (0.8 mg/kg/min) until the time of cardiac arrest. Respiratory and cardiovascular parameters, blood temperature, and sodium and potassium levels were monitored. The times of occurrence of respiratory arrests (RA), cardiac arrests (CA), and convulsions were recorded. Our results showed that RA is the primary cause of death in spontaneously breathing pigs and that mechanical ventilation significantly delayed the occurrence of CA (p < 0.05). Significant decreases in cardiac output, mean blood pressure, and heart rate as well as significant increases in systemic and pulmonary vascular resistances, central venous and pulmonary wedge pressures, and blood K+ levels were noted in mechanically ventilated pigs (p < 0.05). Variable hemodynamic responses were noticed in spontaneously breathing pigs. Our results also showed that no significant changes occurred in blood catecholamine levels when compared with baseline values associated with the infusion of toxic doses of cocaine.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Effect of negative emotion on tumor load and anti-tumor immune response in bladder cancer infusion chemotherapyn

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    Zun-Jun Wang

    2017-09-01

    Full Text Available Objective: To study the effect of negative emotion on tumor load and anti-tumor immune response in bladder cancer infusion chemotherapy. Methods: Patients with advanced bladder cancer who received bladder infusion chemotherapy in the First People’s Hospital of Ziyang between May 2014 and December 2016 were selected and divided into the control group without negative emotions, the anxiety group with anxiety, the depression group with depression and the anxiety depression group with both anxiety and depression according to the assessment results of HAMA scale and HAMD scale. The contents of tumor markers in serum, the contents of immune cells in peripheral blood and the expression of apoptosis genes in urine were detected during chemotherapy. Results: DKK-1, DKK-3, OPN and CYFRA21-1 contents in serum as well as PD-1+CD4+T cell, PD-1+CD8+T cell and B7-H1+CD11c+DC cell contents in peripheral blood of anxiety group, depression group and anxiety depression group were significantly higher than those of control group while DAP2IP, Fas, FasL, Caspase-8 and PTEN protein expression in urine were significantly lower than those of control group, and DKK-1, DKK-3, OPN and CYFRA21-1 contents in serum as well as PD-1+CD4+T cell, PD- 1+CD8+T cell and B7-H1+CD11c+DC cell contents in peripheral blood of anxiety depression group were significantly higher than those of anxiety group and depression group while DAP2IP, Fas, FasL, Caspase-8 and PTEN protein expression in urine were significantly lower than those of anxiety group and depression group. Conclusion: The anxiety and depression in bladder cancer infusion chemotherapy can suppress the expression of apoptosis genes and the anti-tumor immune response to lead to more vigorous proliferation of cancer cells.

  10. Aldosterone and parathyroid hormone: a precarious couple for cardiovascular disease

    NARCIS (Netherlands)

    Tomaschitz, A.; Ritz, E.; Pieske, B.; Fahrleitner-Pammer, A.; Kienreich, K.; Horina, J.H.; Drechsler, C.; Marz, W.; Ofner, M.; Pieber, T.R.; Pilz, S.

    2012-01-01

    Animal and human studies support a clinically relevant interaction between aldosterone and parathyroid hormone (PTH) levels and suggest an impact of the interaction on cardiovascular (CV) health. This review focuses on mechanisms behind the bidirectional interactions between aldosterone and PTH and

  11. Aldosterone synthase C-344T, angiotensin II type 1 receptor ...

    Indian Academy of Sciences (India)

    Analysis of genetic and biochemical data revealed that in this population the CT and TT genotypes of aldosterone synthase C-344T polymorphism, frequency of alcohol consumption and aldosterone levels were significantly high among the total as well as male hypertensives, while the AC and CC genotypes of angiotensin ...

  12. The relationship between aldosterone to renin ratio and RI value of the uterine artery in the preeclamptic patient vs. normal pregnancy.

    Science.gov (United States)

    Kim, Euy Hyuk; Lim, Jay Hak; Kim, Young Han; Park, Yong Won

    2008-02-29

    Plasma levels of renin, angiotensin II and aldosterone are increased during normal pregnancy. However, these values in preeclampsia are decreased to nearly that of a nonpregnant subject, and vascular sensitivity to angiotensin II is increased. In preeclampsia, aldosterone is decreased less than rennin. Therefore current studies were undertaken to determine the relationship between aldosterone to renin ratio (ARR) and uterine artery perfusion via RI value. In this study, the relationship between plasma aldosterone and renin concentration was determined in 27 preeclamptic women and 50 normal pregnant women, whose gestational weeks were matched. The aldosterone to renin ratio was calculated and compared between the two groups. Doppler velocimetry of the uterine artery, which was used to calculate resistance index (RI), was performed on all subjects. The relationship between ARR and RI value was reviewed. In the preeclampsia group, RI value of the uterine artery was significantly higher than that of normal pregnant women. Both plasma renin and aldosterone concentrations were lower in the preeclampsia group. However, the ratio of these two parameters was significantly higher (38.3 vs. 16.1, p RI of the uterine artery (r2 = 0.053, p = 0.048). This study demonstrates that a high aldosterone to renin ratio may have a negative effect on perfusion of the uterine artery and play an important role in the pathophysiology of preeclampsia.

  13. Human red blood cells alterations in primary aldosteronism.

    Science.gov (United States)

    Bordin, Luciana; Donà, Gabriella; Sabbadin, Chiara; Ragazzi, Eugenio; Andrisani, Alessandra; Ambrosini, Guido; Brunati, Anna Maria; Clari, Giulio; Armanini, Decio

    2013-06-01

    Aldosterone (Aldo) effects include NADPH oxidase activation involved in Aldo-related oxidative stress. Red blood cells (RBCs) are particularly sensitive to oxidative assault, and both the formation of high molecular weight aggregates (HMWAs) and the diamide-induced Tyr phosphorylation (Tyr-P) level of membrane band 3 can be used to monitor their redox status. The Aldo-related alterations in erythrocytes were evaluated by comparing in vitro evidence. This was a multicenter comparative study. The study included 12 patients affected by primary aldosteronism (PA) and 6 healthy control subjects (HCs), whose RBCs were compared with those of patients with PA. For in vitro experiments, RBCs from HCs were incubated with increasing Aldo concentrations. The Tyr-P level, band 3 HMWA formation, and autologous IgG binding were evaluated. In patients with PA, both Tyr-P levels and band 3 HMWAs were higher than those in HCs. RBCs from HCs were treated with increasing Aldo concentrations in both platelet-poor plasma (PPP) and charcoal-stripped (CS)-PPP. Results showed that Aldo had dose- and time-dependent effects on band 3 Tyr-P and HMWA formation in CS-PPP more than in PPP. These effects were almost completely prevented by canrenone or cortisol. Aldo-related membrane alterations led to increased autologous IgG binding. Erythrocytes from patients with PA show oxidative-like stress evidenced by increased HMWA content and diamide-induced band 3 Tyr-P level. Aldo effects are mediated by the mineralocorticoid receptor, as suggested by the inhibitory effects of canrenone, an antagonist of Aldo. In CS-PPP, in which Aldo induces remarkable membrane alterations leading to IgG binding, Aldo may be responsible for premature RBC removal from circulation.

  14. UPDATES OF THE RENIN‐ANGIOTENSIN‐ALDOSTERON SYSTEM

    Directory of Open Access Journals (Sweden)

    Minela MĂRĂNDUCA

    2013-07-01

    Full Text Available The renin‐angiotensin‐aldosteron system (RAAS is a hormonal system that contributes to regulation of blood pressure and volume of extracellular fluids, in both nor‐ motensive and hypertensive individuals. Hypertension affects the target organs (kidneys and leads to a vicious circle that contributes to maintaining a high arterial pre‐ ssure. Besides the hemodynamic effects of RAAS/Ang II, Ang II has direct impact on structure/function of kidneys, leading to renal injury. Recently, the proinflammatory effect of Ang II has been discovered. Low renal inflamma‐ tion determined by excessive circulating RAAS, mostly at renal level, promotes and continues the renal disease. This review presents the inflammatory mechanisms initiated by Ang II at renal level, which induce development of renal injury. Identification of such mechanisms might lead to the discovery of new therapeutic approaches for hyperten‐ sion/target organs damage.

  15. Effect of the perioperative infusion of dexmedetomidine on chronic pain after breast surgery

    Directory of Open Access Journals (Sweden)

    Gaurav Jain

    2015-04-01

    Full Text Available Background: This prospective double-blind trial was undertaken to analyze the role of perioperatively administered dexmedetomidine on the occurrence of chronic pain in cases undergoing surgery for breast cancer. Subjects and Methods: Eighty-six cases were randomly assigned to two groups to receive either dexmedetomidine (2 μg/ml in group D or saline in group C, in a loading dose of 0.5 ml/kg, intravenous (IV, 30 min prior to induction, followed by a continuous infusion of 0.25 ml/kg/h IV till the completion of surgery, and then the dose tapered to 0.1 ml/kg/h for up to 24 h. The standardized questionnaires that measured chronic pain (Brief Pain Inventory, BPI; Short Form McGill Pain Questionnaire, SF-MPQ2 and quality of life (Quality of Life Scale, QOLS were gathered after 3 months of surgery as a primary outcome. Pain (verbal numerical score, VNS, sedation scores (Ramsay scoring, and analgesic requirements were also assessed for 72 h postoperatively. Results: In total, 84 cases (n=42 were analyzed for acute pain and 69 (34 in group D and 35 in group C for chronic pain. The consumption of isoflurane/fentanyl intra-operatively and paracetamol postoperatively was significantly lower in Group D. The sedation scores were non-significant between the groups. The VNS at rest and after movement was significantly lower in group D at corresponding times (except at 60 min throughout the assessment period. The BPI and SF-MPQ2 scores were significantly lower in group D in most of the factors. The QOLS score was significantly better in group D in all items except for relationships, friends, and learning. Conclusion: The perioperative infusion of dexmedetomidine has a pivotal role in attenuating the incidence and severity of chronic pain and improving the quality of life in cases undergoing breast cancer surgery.

  16. Somatotropin as the non-ACTH factor of anterior pituitary origin for the maintenance of enhanced aldosterone secretory responsiveness of dietary sodium restriction in chronically hypophysectomized rats

    NARCIS (Netherlands)

    Lee, T.C.; Wied, D. de

    1968-01-01

    Somatotropin treatment in chronically hypophysectomized, sodium-deprived rats effectively restored to treated animals the distinct and enhanced aldosterone secretory responsiveness of the adrenal which characterizes the adrenals of intact rats subjected to dietary sodium restriction, but absent in

  17. Aldosterone-to-renin ratio acts as the predictor distinguishing the primary aldosteronism from chronic kidney disease.

    Science.gov (United States)

    Chen, Wei-Guo; Zhou, Ting-Ting; Zhou, Peng; Li, Xiao-Wei; Wu, Zhun; Zhang, Kai-Yan; Xing, Jin-Chun

    2015-01-01

    Aldosterone-to-renin ratio (ARR) is a screening test for primary aldosteronism, but it was impacted by a bunch of clinical covariates. The ARR is associated with chronic kidney disease (CKD), renal artery stenosis, renin adenoma. This study aims to investigate relationship between ARR and primary aldosteronism in CKD patients. A retrospective observational analysis involves 253 attendees from Urology Department of Chengdu Military General Hospital (China), comprising 146 patients with confirmed primary aldosteronism, 56 patients with essential hypertension, and 55 patients with chronic kidney disease accounting for primary kidney disease. Blood samples were drawn from patients with particular restriction for measuring serum aldosteronism, plasma renin activity, and serum potassium. Receiver operating characteristic (ROC) curve of ARR was tested to establish cutoff values and to assess sensitivity and specificity. The results showed that LogARR values were significantly higher (P renin were observed in CKDs compared with the other two groups (P renin activity, logARR, and serum aldosterone are 0.855, 0.84, and 0.501, respectively. ROC curve of logARR and plasma renin activity in detection of primary aldosteronism with higher sensitivity and specificity. In conclusion, this study indicated that the ARR act as the biomarker for the primary aldosteronism, and could distinguish from chronic kidney disease.

  18. Effects of Maytenus ilicifolia Mart. and Bauhinia candicans Benth infusions on onion root-tip and rat bone-marrow cells

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    Marjori Leiva Camparoto

    2002-01-01

    Full Text Available Medicinal plants are widely used to treat various diseases, and in Brazil the plants Maytenus ilicifolia Mart. and Bauhinia candicans Benth are commonly used in popular medicine. However, there are a large number of compounds in plants which can produce alterations in genetic material, and this study was conducted to investigate any possible mutagenic and cytotoxic effects that M. ilicifolia and B. candicans infusions may have on the cell cycle and chromosomes. Infusions were prepared with in natura leaves to give two concentrations of infusions, one at the concentration normally used by the population in general and the other at 10 times this value (i.e. 3.5 and 35 mg/mL for M. ilicifolia and 0.465 and 4.65 mg/mL for B. candicans. Onion (Allium cepa L. root-tip cells (RTC and Wistar rat bone-marrow cells (BMC were used as test systems in in vivo assays. The M. ilicifolia infusions at both concentrations, and the B. candicans infusion at the lower concentration, had no statistically significant depressive mitotic effect on RTC. A statistically significant depressive mitotic effect on RTC was found with the more concentrated (4.65 mg/mL B. candicans infusion as compared with a negative control. In BMC, infusions of B. candicans and M. ilicifolia produced no statistically significant increase in the number of chromosome alterations or rates of cell division as compared to controls. The significance of these findings are discussed in the light of the use of these plants as therapeutic agents.

  19. Infusion of low dose glyceryl trinitrate has no consistent effect on burrowing behavior, running wheel activity and light sensitivity in female rats.

    Science.gov (United States)

    Christensen, Sarah L T; Petersen, Steffen; Sørensen, Dorte B; Olesen, Jes; Jansen-Olesen, Inger

    2016-01-01

    Glyceryl trinitrate induces headache during infusion to man and migraine patients develop an additional migraine attack a few hours after the infusion. Recently, we have moved this model into rat with the intention of developing an animal model predictive of migraine therapy. In the current paper we have studied the effect of glyceryl trinitrate infusion on three different rat behaviors. The stability of burrowing behavior, running wheel activity and light sensitivity towards repeated testing was evaluated also with respect to estrous cycle. Finally, the effect of glyceryl trinitrate on these behaviors in female rats was observed. Burrowing behavior and running wheel activity were stable in the individual rat between experiments. The burrowing behavior was significantly affected by the stage of estrous cycle. The other assays were stable throughout the cycle. None of the three behavioral tests were altered by glyceryl trinitrate infusion. In the light-dark box, some batches of rats showed light sensitivity after treatment with glyceryl trinitrate but it could not be repeated in other batches of rats. We have investigated the stability towards repeated testing and the effect of i.v. glyceryl trinitrate infusion to awake rats in three behavioral assays. Of the assays evaluated, only light sensitivity was capable of detecting changes after glyceryl trinitrate infusion but, this was not repeatable. Thus, the infusion of a low dose glyceryl trinitrate to concious rats together with the chosen behavioral tests is not a robust setup for studying immediate GTN induced headache behavior in rats. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Effects of music on target-controlled infusion of propofol requirements during combined spinal-epidural anaesthesia.

    Science.gov (United States)

    Zhang, X W; Fan, Y; Manyande, A; Tian, Y K; Yin, P

    2005-10-01

    The sedative effects of music were evaluated using the bispectral index (BIS) during target-controlled infusion (TCI) propofol. A total of 110 women undergoing hysterectomy were randomly allocated to receive either music or no music. Propofol was administered using target-controlled infusion and the concentration adjusted gradually to achieve an observer's assessment of alertness/sedation (OAA/S) score of 3 intra-operatively. The haemodynamic and bispectral index values during the sedation phase were recorded. Interleukin-6 was evaluated before, immediately after and 1 h following intervention. The music group had a significant reduction in mean (SD) induction time of sedation: 12 (12) min vs. 18 (12) min, p concentration: 1.6 (0.3) microg.ml(-1) vs. 2.4 (0.4) microg.ml(-1), p levels of satisfaction with their peri-operative care: 9.6 (0.6) compared to the control group: 8.1 (1.0), p music on the induction time of sedation, concentration and level of propofol during surgery, and suggest sedative benefits of music.

  1. Study of effects of simulated space flight factors and use of infusion liquids on human hemodynamics with the use of the Cardiocode method

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    Olga K. Voronova

    2013-05-01

    Full Text Available Aims The aim is to study the effect of simulated space flight factors on the human central hemodynamics and evaluate the effectiveness of colloid and crystalloid infusions in microgravity simulation using the Cardiocode method. Materials and methods Test subjects were six men aged 20 to 35 without chronic somatic diseases. Antiorthostatic hypokinesia with an angle of 15° (ANOH-15 simulated the weightlessness was used. Diuretics were used to simulate hypovolemia in the test individuals. During ANOH-15 the colloid and crystalloid intravenous infusions were applied. Central hemodynamics parameters were measured by Cardiocode method. Results Background quantitative and qualitative central hemodynamics parameters were obtained, several individual characteristics of blood flow regulation were identified. The effects of space flight factors, ground-based simulated with antiorthostatic hypokinesia, on the human hemodynamics were investigated. The efficacy of crystalloid and colloid infusions for the correction of central hemodynamics abnormalities in test subjects with hypovolemia in microgravity was studied. Conclusion The Cardiocode method allowed obtaining the information about the effects of simulated space flight factors and different infusion fluids on the human central hemodynamics. The efficacy of crystalloid and colloid infusions for the correction of central hemodynamics abnormalities in test subjects in microgravity was positively evaluated.

  2. Effects of a single bilateral infusion of R-ketamine in the rat brain regions of a learned helplessness model of depression.

    Science.gov (United States)

    Shirayama, Yukihiko; Hashimoto, Kenji

    2017-03-01

    Effects of a single bilateral infusion of R-enantiomer of ketamine in rat brain regions of learned helplessness model of depression were examined. A single bilateral infusion of R-ketamine into infralimbic (IL) portion of medial prefrontal cortex (mPFC), CA3 and dentate gyrus (DG) of the hippocampus showed antidepressant effects. By contrast, a single bilateral infusion of R-ketamine into prelimbic (PL) portion of mPFC, shell and core of nucleus accumbens, basolateral amygdala and central nucleus of the amygdala had no effect. This study suggests that IL of mPFC, CA3 and DG of hippocampus might be involved in the antidepressant actions of R-ketamine.

  3. Efeitos da infusão contínua de propofol ou etomidato sobre variáveis intracranianas em cães Effects of propofol or etomidate intravenous infusion on intracranial variables in dogs

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    D.P. Paula

    2010-04-01

    Full Text Available Avaliaram-se os efeitos da infusão contínua de propofol ou de etomidato sobre as variáveis intracranianas em cães nomocapneicos. Foram utilizados 20 cães adultos distribuídos aleatoriamente em dois grupos: grupo propofol (GP e grupo etomidato (GE. Para o GP, os animais foram induzidos à anestesia com propofol (10mg/kg e, ato contínuo, iniciaram-se a infusão do fármaco (0,6mg/kg/min e a ventilação controlada. No GE, o etomidato foi usado para indução (5mg/kg e manutenção empregando-se a dose de 0,5mg/kg/min nos 10 minutos iniciais e, em seguida, de 0,2mg/kg/min. Após 30 minutos da implantação do cateter de fibra óptica do monitor de pressão intracraniana (PIC na superfície do córtex cerebral direito, realizaram-se as primeiras mensurações (M1 da PIC, da pressão de perfusão cerebral (PPC, da temperatura intracraniana (TIC, de temperatura corpórea (TC, da pressão arterial média (PAM e da frequência cardíaca (FC. As demais mensurações ocorreram em intervalos de 20 minutos (M2, M3 e M4. O propofol e o etomidato não ocasionaram alterações significativas nas variáveis estudadas com exceção da TC e TIC. Concluiu-se que a infusão contínua desses fármacos em cães mantém a perfusão cerebral e a autorregulação cerebral. Cães anestesiados com etomidato apresentam efeitos adversos intensos e redução gradativa da temperatura corpórea e intracraniana.The effects of total intravenous infusion of propofol or etomidate on intracranial variables in normocapneic dogs were evaluated. Twenty adult mongrel dogs were randomly allotted to: propofol group (GP or etomidate group (GE. In GP animals, the propofol was used for induction (10mg/kg, followed by immediate continuous infusion of the drug (0.6mg/kg/min and controlled ventilation. In GE dogs, the etomidate was used for induction (5mg/kg, followed by a continuous rate infusion (CRI at 0.5mg/kg/min during the first ten minutes and, right after, it was changed to 0

  4. Mild hyperparathyroidism: a novel surgically correctable feature of primary aldosteronism.

    Science.gov (United States)

    Maniero, Carmela; Fassina, Ambrogio; Seccia, Teresa M; Toniato, Antonio; Iacobone, Maurizio; Plebani, Mario; De Caro, Raffaele; Calò, Lorenzo A; Pessina, Achille C; Rossi, Gian P

    2012-02-01

    The parathyroid hormone (PTH) stimulates aldosterone secretion and cell proliferation in human adrenocortical cells; moreover, in rats hyperaldosteronism was associated with hyperparathyroidism. Hence, PTH could drive aldosterone excess in human primary aldosteronism. To test this hypothesis, we recruited 105 consecutive hypertensive patients, of whom 44 had primary aldosteronism due to an aldosterone-producing adenoma (APA) and 61 had primary (essential) hypertension. We measured the plasma levels of (1-84)-PTH, 25(OH)D, 1,25(OH)2D, and serum Ca (total and ionized), inorganic P, Mg, K, and the 24-h urinary excretion of Ca, P, and deoxypyridinoline. In primary aldosteronism patients, these measurements were repeated after adrenalectomy or mineralocorticoid receptor blockade. We also sought for PTH receptor (PTHR-1) mRNA and protein in APA tissue. Compared with primary (essential) hypertension patients, those with primary aldosteronism showed significantly higher plasma PTH (+31%), despite comparable urinary Ca excretion and similarly deficient 25(OH) vitamin D levels. In APA patients, who showed the PTHR-1 transcript and protein in tumor tissue, adrenalectomy normalized PTH levels (from 118 ± 13 to 76 ± 12 ng/l; P = 0.002) and increased ionized Ca(from 1.17 ± 0.04 to 1.22 ± 0.03 mmol/l; P hyperparathyroidism by acting on PTHR-1 in APA might contribute to maintaining hyperaldosteronism despite suppression of angiotensin II formation.

  5. Obesity, hypertension and aldosterone: is leptin the link?

    Science.gov (United States)

    Xie, Ding; Bollag, Wendy B

    2016-07-01

    Obesity is a serious health hazard with rapidly increasing prevalence in the United States. In 2014, the World Health Organization estimated that nearly 2 billion people worldwide were overweight with an estimated 600 million of these obese. Obesity is associated with many chronic diseases, including cardiovascular disease and hypertension. Data from the Framingham Heart study suggest that approximately 78% of the risk for hypertension in men and 65% in women is related to excess body weight, a relationship that is further supported by studies showing increases in blood pressure with weight gain and decreases with weight loss. However, the exact mechanism by which excess body fat induces hypertension remains poorly understood. Several clinical studies have demonstrated elevated plasma aldosterone levels in obese individuals, especially those with visceral adiposity, with decreased aldosterone levels measured in concert with reduced blood pressure following weight loss. Since aldosterone is a mineralocorticoid hormone that regulates blood volume and pressure, serum aldosterone levels may link obesity and hypertension. Nevertheless, the mechanism by which obesity induces aldosterone production is unclear. A recent study by Belin de Chantemele and coworkers suggests that one adipose-released factor, leptin, is a direct agonist for aldosterone secretion; other adipose-related factors may also contribute to elevated aldosterone levels in obesity, such as very low-density lipoprotein (VLDL), the levels of which are elevated in obesity and which also directly stimulates aldosterone biosynthesis. This focused review explores the possible roles of leptin and VLDL in modulating aldosterone secretion to underlie obesity-associated hypertension. © 2016 Society for Endocrinology.

  6. Cost-effectiveness evaluations of spinal neuromodulation with ziconotide continuous infusion in cancer pain in a real clinical practice

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    Orietta Zaniolo

    2011-06-01

    Full Text Available Introduction and objective: ziconotide is the first-in-class drug of selective N-type voltage-sensitive calcium-channel blockers used to control severe chronic pain. The present study is developed in order to analyze clinical and economical outcomes of spinal neuromodulation with ziconotide continuous infusion in cancer pain in a real clinical practice.Methods: costs and effects of ziconotide are compared with those of traditional neuromodulation with morphine and adjuvant drugs, administered by intrathecal infusion.Effectiveness and resources consumption data were retrospectively collected in 22 patients with severe complex cancer pain followed by one Italian centre from the day of port implantation to drop-out , due to death or consent withdrawal. 11 patients received morphine regimens and the other 11 were treated with ziconotide. The evaluation of the number of days with controlled pain (i.e., with an at least 30% reduction on the Numeric Rating Scale-Pain Intensity, NRSPI is the primary outcome of the analysis. The evaluated consumed health resources include drugs, visits, port maintenance, and pump recharge and amortization. Current Italian prices, real practice acquisition and remuneration costs borne by the third payer are applied.Results: patients receiving ziconotide lived significantly more days with controlled pain (78% vs 40%; p < 0.05. Average weekly cost is about 232 € for ziconotide and 120 € for morphine; the main driver being the pharmaceutical cost (respectively 81% and 65% of the total. Higher ziconotide acquisition costs are partially offset by minor expenses for adjuvant therapies, as ziconotide-treated patients on average receive a lower number of drugs than those receiving a traditional regimen. The incremental cost for one further day with controlled pain resulted of 42,30 €.Conclusions: ziconotide permits effective treatment of extremely difficult-to-manage pain, with a mild increment of cost, as compared to

  7. Effect of abomasal infusion of oligofructose on portal-drained visceral ammonia and urea-nitrogen fluxes in lactating Holstein cows

    DEFF Research Database (Denmark)

    Røjen, Betina Amdisen; Larsen, Mogens; Kristensen, Niels Bastian

    2012-01-01

    Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in major splanchnic blood vessels were used in an unbalanced crossover design with 14-d periods. Treatments were continuous abomasal infusion of water or 1,500 g/d of oligofructose. The same basal diet was fed with both......The effects of abomasal infusion of oligofructose in lactating dairy cows on the relationship between hindgut fermentation and N metabolism, and its effects on NH3 absorption and transfer of blood urea-N across the portal-drained viscera versus ruminal epithelia were investigated. Nine lactating...... by reduced NH3 input to hepatic urea-N synthesis caused by increased sequestration of NH3 in the hindgut and excretion in feces. Increasing the hindgut fermentation in lactating dairy cows by abomasal infusion of 1,500 g/d of oligofructose shifted some N excretion from the urine to feces and possibly reduced...

  8. Modification of the liver fatty acids by Hibiscus sabdariffa Linnaeus (Malvaceae) infusion, its possible effect on vascular reactivity in a metabolic syndrome model.

    Science.gov (United States)

    Pérez-Torres, Israel; Zúñiga Muñoz, Alejandra; Beltrán-Rodríguez, Ulises; Díaz-Díaz, Eulises; Martínez-Memije, Raúl; Guarner Lans, Verónica

    2014-01-01

    We investigated the effects of Hibiscus sabdariffa Linnaeus (HSL)-fed infusion on the fatty acid (FA) profile in liver of metabolic syndrome (MS) rats and its possible effect on vascular reactivity. Body mass, intra-abdominal fat, triglycerides, insulin, blood pressure, saturated, monounsaturated FA, NEFAs, Δ(9)-, Δ(6)-desaturases and vasoconstriction were increased, while vasorelaxation, polyunsaturated FA, endothelial nitric oxide and [Formula: see text]/[Formula: see text] ratio decreased in MS versus Control, but HSL infusion modified it and increased Δ(5)-desaturase. The results suggest that the alteration in FA liver metabolism in the MS contributes to impaired vascular reactivity, but treatment with of HSL infusion can improve this condition.

  9. HEMODYNAMIC AND STRUCTURAL MODIFICATIONS IN CONTINUOUS INFUSION WITH ANGIOTENSIN. II. AN EXPERIMENTAL STUDY

    Directory of Open Access Journals (Sweden)

    Minela Aida Maranduca

    2011-09-01

    Full Text Available The renin-angiotensin-aldosterone system (RAAS is a hormonal system which contributes to the regulation of both arterial pressure and extra cellular fluids volume. The increase of RAAS, especially at angiotensin II (Ang II level, affects the target organs and increases the risk of cardio-vascular issues, by increasing arterial pressure and through the direct effect of Ang II upon the vascular endothelium and the renal and cardiac tissue. Ang II reduces the renal capacity of sodium excretion and initiates a set of events which increase arterial pressure. Increase of arterial pressure is necessary for re-establishing sodium excretion, being realized by the pressure-natriuresis relationship. Arterial hypertension affects the target organs (heart, kidneys and leads to a vicious circle which contributes to maintaining a high arterial pressure. Materials and Method: Male Wistar rats subjected on a normal diet, received either a sham operation (n=9 or continuous angiotensin II (Ang II infusion (300ng/kgc/ min subcutaneously, via mini pumps. Water ingestion and systolic blood pressure were measured for 14 days, after which the animals were sacrificed under anesthesia with ketamin, and the xylasin body weight, water ingestion, heart mass, right and left ventricular mass, right and left kidney mass were measured. Results: After 14 days of Ang II infusion, bodily weight decreased, systolic blood pressure increased, heart and left ventricular mass indexed to body weight were significantly enhanced compared with the sham group, and kidneys mass indexed to body weight was similar in the two groups.

  10. SFE/SFHTA/AFCE consensus on primary aldosteronism, part 5: Genetic diagnosis of primary aldosteronism.

    Science.gov (United States)

    Zennaro, Maria-Christina; Jeunemaitre, Xavier

    2016-07-01

    While the majority of cases of primary aldosteronism (PA) are sporadic, four forms of autosomal-dominant inheritance have been described: familial hyperaldosteronism (FH) types I to IV. FH-I, also called glucocorticoid-remediable aldosteronism, is characterized by early and severe hypertension, usually before the age of 20 years. It is due to the formation of a chimeric gene between the adjacent CYP11B2 and CYP11B1 genes (coding for aldosterone synthase and 11β-hydroxylase, respectively). FH-I is often associated with family history of stroke before 40years of age. FH-II is clinically and biochemically indistinguishable from sporadic forms of PA and is only diagnosed on the basis of two or more affected family members. No causal genes have been identified so far and no genetic test is available. FH-III is characterized by severe and early-onset hypertension in children and young adults, resistant to treatment and associated with severe hypokalemia. Mild forms, resembling FH-II, have been described. FH-III is due to gain-of-function mutations in the KCNJ5 gene. Recently, a new autosomal-dominant form of familial PA, FH-IV, associated with mutations in the CACNA1H gene, was described in patients with hypertension and PA before the age of 10years. In rare cases, PA may be associated with complex neurologic disorder involving epileptic seizures and cerebral palsy (Primary Aldosteronism, Seizures, and Neurologic Abnormalities [PASNA]) due to de novo germline CACNA1D mutations. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Intracarotid Infusion of Mesenchymal Stem Cells in an Animal Model of Parkinson's Disease, Focusing on Cell Distribution and Neuroprotective and Behavioral Effects.

    Science.gov (United States)

    Cerri, Silvia; Greco, Rosaria; Levandis, Giovanna; Ghezzi, Cristina; Mangione, Antonina Stefania; Fuzzati-Armentero, Marie-Therese; Bonizzi, Arianna; Avanzini, Maria Antonietta; Maccario, Rita; Blandini, Fabio

    2015-09-01

    Mesenchymal stem cells (MSCs) have been proposed as a potential therapeutic tool for Parkinson's disease (PD) and systemic administration of these cells has been tested in preclinical and clinical studies. However, no information on survival and actual capacity of MSCs to reach the brain has been provided. In this study, we evaluated homing of intraarterially infused rat MSCs (rMSCs) in the brain of rats bearing a 6-hydroxydopamine (6-OHDA)-induced lesion of the nigrostriatal tract, to establish whether the toxin-induced damage is sufficient to grant MSC passage across the blood-brain barrier (BBB) or if a transient BBB disruption is necessary. The rMSC distribution in peripheral organs and the effects of cell infusion on neurodegenerative process and motor deficits were also investigated. rMSCs were infused 14 days after 6-OHDA injection. A hyperosmolar solution of mannitol was used to transiently permeabilize the BBB. Behavioral impairment was assessed by adjusting step test and response to apomorphine. Animals were sacrificed 7 and 28 days after cell infusion. Our work shows that appreciable delivery of rMSCs to the brain of 6-OHDA-lesioned animals can be obtained only after mannitol pretreatment. A notable percentage of infused cells accumulated in peripheral organs. Infusion of rMSCs did not modify the progression of 6-OHDA-induced damage or the motor impairment at the stepping test, but induced progressive normalization of the pathological response (contralateral turning) to apomorphine administration. These findings suggest that many aspects should be further investigated before considering any translation of MSC systemic administration into the clinical setting for PD treatment. This study demonstrates that mesenchymal stem cells infused through the carotid artery do not efficiently cross the blood-brain barrier in rats with a Parkinson's disease-like degeneration of nigrostriatal neurons, unless a permeabilizing agent (e.g., mannitol) is used. The infusion

  12. Effect of 4 years subcutaneous insulin infusion treatment on albuminuria, kidney function and HbA1c compared with multiple daily injections

    DEFF Research Database (Denmark)

    Vestergaard Rosenlund, Signe; Hansen, Tine Willum; Andersen, Steen

    2015-01-01

    AIM: The effect of insulin pump [continuous subcutaneous insulin infusion (CSII)] treatment on diabetes complications in a modern clinical setting is largely unknown. We investigated the effect of 4 years CSII treatment on HbA1c, albuminuria and kidney function compared with multiple daily...

  13. Dexmedetomidine versus morphine infusion following laparoscopic bariatric surgery : effect on supplemental narcotic requirement during the first 24 h

    NARCIS (Netherlands)

    Abu-Halaweh, Sami; Obeidat, Firas; Absalom, Anthony R.; AlOweidi, Abdelkareem; Abu Abeeleh, Mahmood; Qudaisat, Ibrahim; Robinson, Fay; Mason, Keira P.

    The primary aim of this pilot study was to determine whether the dexmedetomidine infusion initiated immediately after laparoscopic bariatric surgery, offers an advantage over a morphine infusion with respect to rescue morphine and paracetamol requirements over the first 24 post-operative hours.

  14. Abomasal amino acid infusion in postpartum dairy cows: Effect on whole-body, splanchnic, and mammary glucose metabolism

    DEFF Research Database (Denmark)

    Galindo, C; Larsen, Mogens; Ouellet, D R

    2015-01-01

    -OH-butyrate (BHBA) in postpartum dairy cows according to a generalized randomized incomplete block design with repeated measures in time. At calving, cows were blocked according to parity (second and third or greater) and were allocated to 2 treatments: abomasal infusion of water (n=4) or abomasal infusion of free...

  15. The effects of intragastric infusion of umami solutions on amygdalar and lateral hypothalamic neurons in rats

    Science.gov (United States)

    Davaasuren, Munkhzul; Matsumoto, Jumpei; Chinzorig, Choijiljav; Nakamura, Tomoya; Takamura, Yusaku; Patrono, Enrico; Kondoh, Takashi; Ono, Taketoshi; Nishijo, Hisao

    2015-01-01

    Previous behavioral studies have suggested that l-glutamate, an umami substance, is detected in the gut, and that this information regarding glutamate is conveyed from the gut to the amygdala and the lateral hypothalamus (LH) through the vagus nerve to establish glutamate preference. In this study, we investigated the roles of the amygdala and LH in the information processing of gut glutamate. We recorded the activity of amygdalar and LH neurons during the intragastric administration of five test solutions (monosodium l-glutamate [MSG, 60 mmol/L]; inosine monophosphate [IMP, 60 mmol/L]; a mixture of MSG and IMP; NaCl [60 mmol/L]; or physiological saline) in intact and subdiaphragmatic vagotomized awake rats. In intact rats, 349 and 189 neurons were recorded from the amygdala and LH, respectively, while in vagotomized rats, 104 and 90 neurons were recorded from the amygdala and LH, respectively. In intact rats, similar percentages of neurons (30–60%) in the amygdala and LH responded to the intragastric infusion of the solutions. Vagotomy significantly altered responses to the MSG and NaCl solutions. In particular, vagotomy suppressed the inhibitory responses to the NaCl solution. Furthermore, vagotomy increased the response similarity between the MSG and NaCl solutions, suggesting that vagotomy impaired the coding of the postingestive consequences of the MSG solution in the amygdala and LH, which are unique for glutamate. The present results provide the first neurophysiological evidence that amygdalar and LH neurons process glutamate signals from the gut. PMID:26438732

  16. Dose-effects of aorta-infused clenbuterol on spinal cord ischemia-reperfusion injury in rabbits.

    Directory of Open Access Journals (Sweden)

    Binbin Chen

    Full Text Available BACKGROUND: The β2 adrenergic receptor (β2AR plays an important role in ischemia-reperfusion (I/R injury in various organs. Recently, a selective β2AR agonist clenbuterol was suggested to protect against cerebral I/R injury. This study was designed to investigate changes of β2ARs after spinal cord I/R injury and dose-effects of aorta-infused clenbuterol on spinal cord I/R injury in rabbits. METHODS: Spinal cord ischemia was induced in New Zealand white rabbits by infrarenal abdominal aortic occlusion with a balloon catheter for 30 minutes except the sham group. During occlusion, nothing (I/R group, normal saline (NS group or clenbuterol at different doses of 0.005, 0.01, 0.05, 0.1, 0.5, or 1 mg/kg (C0.005, C0.01, C0.05, C0.1, C0.5, and C1 groups was infused into the occluded aortic segments. The hemodynamic data, blood glucose and serum electrolytes were measured during experimental period. Neurological function was assessed according to the modified Tarlov scales until 48 hours after reperfusion. After that, the lumbar spinal cord was harvested for β2AR immunohistochemistry and histopathologic evaluation in the anterior horns. RESULTS: The β2AR expression in the anterior horns of the spinal cord was significantly higher in the I/R group than in the sham group. Tarlov scores and the number of viable α-motor neurons were higher in C0.01-C0.5 groups than in the NS group, C0.005 and C1 groups and were highest in the C0.1 group. Hypotension and hyperglycemia were found in the C1 group. CONCLUSION: β2ARs in the anterior horn were upregulated after spinal cord I/R injury. Aortic-infused clenbuterol (0.01-0.5 mg/kg can attenuate spinal cord I/R injury dose-dependently during the ischemic period. The Optimal dosage was 0.1 mg/kg. Activation of β2AR could be a new therapeutic strategy for the treatment of spinal cord I/R injury.

  17. Aldosterone/direct renin concentration ratio as a screening test for primary aldosteronism: A meta-analysis.

    Science.gov (United States)

    Li, Xiyue; Goswami, Richa; Yang, Shumin; Li, Qifu

    2016-07-01

    The accuracy of aldosterone/direct renin concentration ratio (ADRR) as a screening test in patients with primary aldosteronism (PA) varies widely across the studies. Therefore, we conducted a meta-analysis to assess the accuracy of ADRR. A literature search was performed in PubMed, Embase, and the Cochrane library published between April 1971-February 2016. Studies focusing on the accuracy of ADRR for PA screening were included. Two authors independently extracted information regarding patient characteristics, antihypertensives status, true positives, true negatives, false positives, and false negatives. The random-effects model was used for statistical analysis. Heterogeneity was explored by subgroup analysis and meta-regression. Nine studies involving 974 patients were included. The overall sensitivity, specificity, area under the curve, and diagnostic odds ratio of ADRR were 0.89 (95% confidence interval (CI) 0.84-0.93), 0.96 (95% CI 0.95-0.98), 0.985 and 324 respectively, with substantial heterogeneity. Meta-regression showed that antihypertensive status affects the ADRR and may account for the heterogeneity (p=0.03). Subgroup analysis of patients who discontinued the antihypertensives revealed a sensitivity of 0.99 (95% CI, 0.95-1.00) and a specificity of 0.98 (95% CI, 0.96-0.99). This study demonstrates the efficacy of ADRR as a screening test for PA. However, as antihypertensive drugs can interfere with the interpretation of ADRR, it is recommended to interrupt therapy or at least replace with analogues that do not significantly affect the ADRR value. © The Author(s) 2016.

  18. Scientific validation of synergistic antioxidant effects in commercialised mixtures of Cymbopogon citratus and Pterospartum tridentatum or Gomphrena globosa for infusions preparation.

    Science.gov (United States)

    Roriz, Custódio Lobo; Barros, Lillian; Carvalho, Ana Maria; Santos-Buelga, Celestino; Ferreira, Isabel C F R

    2015-10-15

    Pterospartum tridentatum (L.) Willk., Gomphrena globosa L. and Cymbopogon citratus (DC) Stapf. are examples of medicinal plants with antioxidant properties on their own, but that can be improved when mixed. In the present work, the antioxidant activity and phenolic compounds were determined in the infusions prepared from the individual plants, and from mixtures of these plants in different proportions. P. tridentatum > C. citratus > G. globosa was the order observed for antioxidant efficacy, which can be related to their different composition in phenolic compounds. Synergism was the main effect observed among the tested mixtures, mainly for the infusions prepared from the plants in proportion 40%:60% (either P. tridentatum and C. citratus; or G. globosa and C. citratus). The infusion obtained with 40% of P. tridentatum and 60% of C. citratus gave the highest antioxidant properties. The present study validates the commercialisation of the studied plants combined in specific proportions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Effect of calcitriol infusions on serum aluminum in vitamin D-depleted rabbits fed an aluminum-supplemented ration.

    Science.gov (United States)

    Long, J F; Renkes, G; Steinmeyer, C L; Nagode, L A

    1991-10-01

    Three dosages of calcitriol (10, 30 and 60 IU/day) were given to rabbits by subcutaneously implanted osmotic pumps. The purpose was to compare the dosages with regard to their putative effect in elevating serum aluminum levels by mechanisms such as enhancing intestinal absorption, diminishing renal excretion, or others. To establish uniform levels of endogenous calcitriol and its precursors, all rabbits had been depleted of vitamin D. The depletion was demonstrated by their serum calcidiol and calcitriol levels declining to unmeasurable levels, following the regimen of a vitamin D-free diet. The 8 rabbits were then placed on an aluminum-supplemented (aluminum lactate) ration. The amount of feed (and aluminum) consumed was determined at daily intervals. Serum aluminum levels were determined at intervals during the 7 days on this regimen. In a second test, the same 8 rabbits received the same regimen but in addition were infused with 10, 30 or 60 IU calcitriol per day. It was found that the aluminum-fed rabbits receiving 60 IU/day and 30 IU/day calcitriol infusions showed statistically significantly elevated serum aluminum levels as compared to their levels without calcitriol (p = 0.0208 and p = 0.434, respectively). Rabbits receiving pumps delivering 10 IU/day while receiving the aluminum-supplemented ration showed no rise in serum aluminum with time or treatment during the 7 day study. Likewise rabbits receiving aluminum-supplemented rations without calcitriol showed only an early minimal rise in mean serum aluminum which returned to the pre-test level by the end of a week in spite of continued consumption of aluminum-supplemented rations.

  20. Comparison of effects on the oxidant/antioxidant system of sevoflurane, desflurane and propofol infusion during general anesthesia

    Directory of Open Access Journals (Sweden)

    Mesut Erbas

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Desflurane and sevoflurane are frequently used for maintenance of anesthesia and studies have shown that these anesthetics cause a variety of changes to the oxidative stress and antioxidative defense mechanisms. This study aims to compare the effects of sevoflurane, desflurane and propofol infusion anesthesia on the oxidant and antioxidant systems of patients undergoing laparoscopic cholecystectomy. METHODS: 45 patients between 18 and 50 years with planned laparoscopic cholecystectomy under general anesthetic were included in the study. Patients were divided into three groups on the way to surgery: propofol (group P n: 15, sevoflurane (group S n: 15 and desflurane (group D n: 15. All groups were given hypnotic 2 mg/kg propofol IV, 1 mcg/kg fentanyl IV and 0.1 mg/kg vecuronium IV for induction. For maintenance of anesthesia group S were ventilated with 2% sevoflurane, group D cases were given 6% desflurane and group P were given propofol infusions of 12 mg/kg/h for the first 10 min, 9 mg/kg/h for the second 10 min and 6 mg/kg/h after that. Before induction and after the operation venous blood samples were taken to evaluate the levels of glutation peroxidase, total oxidants and antioxidants. RESULTS AND CONCLUSIONS: The 45 patients included in the study were 22 male and 23 female patients. The demographic characteristics of the groups were similar. In the postoperative period we observed that while sevoflurane and propofol increased antioxidants by a statistically significant level, desflurane increased the total oxidants level by a significant amount compared to levels before the operation.

  1. Angiotensin II, Aldosterone, and Anti-Inflammatory Lymphocytes: Interplay and Therapeutic Opportunities

    Directory of Open Access Journals (Sweden)

    Daniel Arthur B. Kasal

    2012-01-01

    Full Text Available Inflammation is recognized as an important factor in the pathophysiology of hypertension, with the renin-angiotensin-aldosterone system (RAAS playing a key role in the disease. Initially described because of its contribution to extracellular fluid and electrolyte homeostasis, the RAAS has been implicated in endothelial dysfunction, vascular remodeling, oxidative stress, proinflammatory cytokine production, and adhesion molecule synthesis by the vascular wall. Both angiotensin II and aldosterone are involved in these systemic effects, activating innate and adaptive immune responses. This paper highlights some aspects connecting RAAS to the hypertensive phenotype, based on experimental and clinical studies, with emphasis on new findings regarding the contribution of an increasingly studied population of T lymphocytes: the T-regulatory lymphocytes. These cells can suppress inflammation and may exert beneficial vascular effects in animal models of hypertension.

  2. Abomasal amino acid infusion in postpartum dairy cows: Effect on whole-body, splanchnic, and mammary amino acid metabolism.

    Science.gov (United States)

    Larsen, M; Galindo, C; Ouellet, D R; Maxin, G; Kristensen, N B; Lapierre, H

    2015-11-01

    Nine Holstein cows with rumen cannulas and indwelling catheters in splanchnic blood vessels were used in a generalized randomized incomplete block design with repeated measures to study the effect of increased early postpartum AA supply on splanchnic and mammary AA metabolism. At calving, cows were blocked according to parity (second and third or greater) and allocated to 2 treatments: abomasal infusion of water (CTRL; n=4) or free AA with casein profile (AA-CN; n=5) in addition to a basal diet. The AA-CN infusion started with half of the maximal dose at the calving day (1 d in milk; DIM) and then steadily decreased from 791 to 226 g/d until 29 DIM. On 5, 15, and 29 DIM, 6 sample sets of arterial, portal, hepatic, and mammary blood were taken at 45-min intervals. Over the whole period, increasing AA supply increased milk (+7.8 ± 1.3 kg/d) and milk protein yields (+220 ± 65 g/d) substantially. The increased milk yield was not supported by greater dry matter intake (DMI) as, overall, DMI decreased with AA-CN (-1.6 ± 0.6 kg/d). Arterial concentrations of essential AA were greater for AA-CN compared with CTRL. The net portal-drained viscera (PDV) release of His, Met, and Phe was greater for AA-CN compared with CTRL, and the net PDV recovery of these infused AA ranged from 72 to 102% once changes in DMI were accounted for. The hepatic removal of these AA was increased equivalently to the increased net PDV release, resulting in an unaltered net splanchnic release. The net PDV release of Ile, Leu, Val, and Lys tended to be greater for AA-CN, and the net PDV recovery of these infused AA ranged from 69 to 73%, indicating increased PDV metabolism with AA-CN. The fractional hepatic removal of these AA did not differ from zero and was unaffected by the increased supply. Consequently, the splanchnic release of these AA was approximately equivalent to their net PDV release for both CTRL and AA-CN. Overall, greater early postpartum AA supply increased milk and milk protein

  3. Delayed Infusion Reactions to Enzyme Replacement Therapies.

    Science.gov (United States)

    Karimian, Zahra; Whitley, Chester B; Rudser, Kyle D; Utz, Jeanine R Jarnes

    2017-01-01

    There are currently ten intravenous enzyme replacement therapy (ERT) products available for the treatment of eight different lysosomal diseases (LD) in the USA. Additional ERT products are in clinical trials. The most common ERT adverse events are infusion reactions (IR). While IR are often defined as hypersensitivity or anaphylactoid reactions occurring concurrently with (i.e., during) infusion administration (CIR), there exists the potential for delayed infusion reactions (DIR), which present after completion of infusion administration. Concurrent infusion reactions (CIR) are not the only infusion reactions associated with enzyme therapy. This study evaluated the occurrence of infusion reactions in 46 patients with LD who had received ERT for a minimum of 2 years. Infusion reactions were evaluated according to symptoms, time of onset, and duration of reactions. The frequency of infusion reactions with each ERT product was compared to that reported in the FDA-approved product package insert. In this study, DIR were observed and occurred as often as CIR in the study population, despite not being characterized or reported in most ERT product package inserts. Effective methods for managing DIR and CIR differed, thus emphasizing the importance of monitoring for both types of infusion reactions in order to optimize outcomes for patients using ERT.

  4. Intra-VTA anandamide infusion produces dose-based biphasic effects on male rat sexual behavior expression.

    Science.gov (United States)

    Canseco-Alba, Ana; Rodríguez-Manzo, Gabriela

    Sexual behavior is a natural reward and the mesolimbic (MSL) system is involved in the processing of its motivational component and reinforcing properties. Endocannabinoids control rewarding behaviors through the modulation of MSL system's activity. The endocannabinoid anandamide (AEA), systemically administered, produces dose-based, biphasic effects on male rat copulation, facilitating its expression at low doses in both, sexually experienced and sexually exhausted male rats. We hypothesized that AEA's sexual facilitative effects might be exerted at the MSL circuit. Therefore, in this work different AEA doses were bilaterally infused into the VTA of sexually experienced or sexually exhausted animals and their copulatory behavior recorded. Results showed that the lowest AEA dose tested lacked an effect, intermediate doses facilitated specific sexual parameters, and the highest dose inhibited copulation of sexually experienced males. In sexually exhausted animals low AEA doses reversed the sexual inhibition that characterizes sexual satiety, but this effect was lost at higher doses. Together, these data show that the VTA is a target for AEA's biphasic sexual effects suggesting a role of the MLS system in the actions of endocannabinoids on male rat sexual behavior. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Model-Based Evaluation of Exenatide Effects on the QT Interval in Healthy Subjects Following Continuous IV Infusion.

    Science.gov (United States)

    Cirincione, Brenda; LaCreta, Frank; Sager, Philip; Mager, Donald E

    2017-08-01

    Investigation of the cardiovascular proarrhythmic potential of a new chemical entity is now an integral part of drug development. Studies suggest that meals and glycemic changes can influence QT intervals, and a semimechanistic model has been developed that incorporates the effects of changes in glucose concentrations on heart rate (HR) and QT intervals. This analysis aimed to adapt the glucose-HR-QT model to incorporate the effects of exenatide, a drug that reduces postprandial increases in glucose concentrations. The final model includes stimulatory drug effects on glucose elimination and HR perturbations. The targeted and constant exenatide plasma concentrations (>200 pg/mL), via intravenous infusions at multiple dose levels, resulted in significant inhibition of glucose concentrations. The exenatide concentration associated with 50% of the stimulation of HR production was 584 pg/mL. After accounting for exenatide effects on glucose and HR, no additional drug effects were required to explain observed changes in the QT interval. Resulting glucose, HR, and QT profiles at all exenatide concentrations were adequately described. For therapeutic agents that alter glycemic conditions, particularly those that alter postprandial glucose, the QT interval cannot be directly compared to that with placebo without first accounting for confounding factors (eg, glucose) either through mathematical modeling or careful consideration of mealtime placement in the study design. © 2017, The Authors. The Journal of Clinical Pharmacology published by Wiley Periodicals, Inc. on behalf of American College of Clinical Pharmacology.

  6. No evidence of a clinically important effect of adding local infusion analgesia administrated through a catheter in pain treatment after total hip arthroplasty

    DEFF Research Database (Denmark)

    Specht, K.; Leonhardt, Jane Schwartz; Revald, Peter

    2011-01-01

    with local infusion analgesia (LINFA) into the soft tissue in the hip region through a catheter in the first postoperative days has gained major interest in THA fast-track settings within a short period of time. LIA at the time of surgery is a validated treatment. We investigated the additional effect...

  7. Intravenous nicotine self-administration and cue-induced reinstatement in mice: Effects of nicotine dose, rate of drug infusion and prior instrumental training

    Science.gov (United States)

    Fowler, Christie D.; Kenny, Paul J.

    2011-01-01

    Intravenous nicotine self-administration is the most direct measure of nicotine reinforcement in laboratory animals, but this procedure has proven difficult to establish in mice. We found that stable responding for nicotine in C57BL6/J mice was facilitated by prior instrumental training for food reward, initial exposure of mice to a lower unit dose of nicotine (0.03 mg/kg/infusion) before access to higher doses, a slower rate of drug delivery (3-sec versus 1-sec infusion), consistency in schedule of daily testing, and low extraneous noise during testing. Under these conditions, we found that mice lever-pressing for nicotine (0.03–0.4 mg/kg/infusion; 60-min test sessions) under a fixed-ratio 5 time-out 20-sec (FR5TO20) reinforcement schedule consumed the drug according to an inverted ‘U’-shaped dose-response curve. Mice switched their responding onto a previously non-reinforced lever to continue earning nicotine infusions when the active/inactive lever assignment was reversed. The nicotinic acetylcholine receptor (nAChR) antagonist mecamylamine decreased responding for nicotine, but not food rewards, verifying that nAChRs regulate nicotine self-administration in mice. The cue-light paired with nicotine delivery did not support responding when delivered independently of nicotine infusions, further verifying that mice responded selectivity for the drug. Nicotine-seeking responses extinguished when nicotine infusions and the cue-light were withheld, and exposure to the cue-light reinstated responding. Finally, mice without prior instrumental food training acquired stable responding for nicotine under the FR5TO20 schedule, but required a greater number of sessions. These data demonstrate that nicotine is an effective reinforcer in mice and establish conditions under which the drug is reliably self-administered by mice. PMID:21640128

  8. Immune system alterations by aldosterone during hypertension: from clinical observations to genomic and non-genomic mechanisms leading to vascular damage.

    Science.gov (United States)

    Muñoz-Durango, N; Barake, M F; Letelier, N A; Campino, C; Fardella, C E; Kalergis, A M

    2013-07-01

    Hypertension is traditionally considered a disease in which elevated blood pressure contributes to inflammation and activation of the immune system, leading to cardiovascular injury and end-organ damage. Here, we discuss the effects of aldosterone on the immune system and aldosterone's contribution to vascular pathogenesis. Studies in human have suggested a broader role for aldosterone, beyond elevating blood pressure. Recent clinical data support the notion that aldosterone can directly alter the function of the immune system and cause vascular-damaging inflammation. Clinical observations have been reproduced in experimental models of hypertension, further supporting the idea that an aberrant immune response contributes to the onset of hypertension. Such studies have shown that myeloid cells are required to induce the disease and IL-17-producing CD4(+) T cells may contribute to maintaining aldosterone-mediated hypertension. In addition, regulatory T cells diminish the inflammatory damage caused by aldosterone during hypertension. This is a very active area of research that could lead to new therapeutic targets for treating hypertension.

  9. Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

    Directory of Open Access Journals (Sweden)

    Torbica Aleksandra

    2010-05-01

    Full Text Available Abstract Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases and patients without CLABSI (controls were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143; 56% of the cases and 57% of the controls were females (p = 0.922. The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

  10. Impact of Aldosterone-Producing Adenoma on Endothelial Function and Rho-Associated Kinase Activity in Patients With Primary Aldosteronism

    Science.gov (United States)

    Matsumoto, Takeshi; Oki, Kenji; Kajikawa, Masato; Nakashima, Ayumu; Maruhashi, Tatsuya; Iwamoto, Yumiko; Iwamoto, Akimichi; Oda, Nozomu; Hidaka, Takayuki; Kihara, Yasuki; Kohno, Nobuoki; Chayama, Kazuaki; Goto, Chikara; Aibara, Yoshiki; Noma, Kensuke; Liao, James K.; Higashi, Yukihito

    2016-01-01

    The purpose of this study was to evaluate vascular function and activity of Rho-associated kinases in patients with primary aldosteronism. Vascular function, including flow-mediated vasodilation and nitroglycerine-induced vasodilation, and Rho-associated kinase activity in peripheral leukocytes were evaluated in 21 patients with aldosterone-producing adenoma, 23 patients with idiopathic hyperaldosteronism, and 40 age-, gender-, and blood pressure-matched patients with essential hypertension. Flow-mediated vasodilation was significantly lower in the aldosterone-producing adenoma group than in the idiopathic hyperaldosteronism and essential hypertension groups (3.2±2.0% vs. 4.6±2.3% and 4.4±2.2%, P<0.05, respectively), whereas there was no significant difference in flow-mediated vasodilation between the idiopathic hyperaldosteronism and essential hypertension groups. There was no significant difference in nitroglycerine-induced vasodilation in the three groups. Rho-associated kinase activity was higher in the aldosterone-producing adenoma group than in the idiopathic hyperaldosteronism and essential hypertension groups (1.29±0.57 vs. 1.00±0.46 and 0.81±0.36, P<0.05, respectively), whereas there was no significant difference in Rho-associated kinase activity between the idiopathic hyperaldosteronism and essential hypertension groups. Flow-mediated vasodilation correlated with age (r=−0.31, P<0.01), plasma aldosterone concentration (r=−0.35, P<0.01) and aldosterone to renin ratio (r=−0.34, P<0.01). Rho-associated kinase activity correlated with age (r=−0.24, P=0.04), plasma aldosterone concentration (r=0.33, P<0.01) and aldosterone to renin ratio (r=0.46, P<0.01). After adrenalectomy, flow-mediated vasodilation and Rho-associated kinase activity were restored in aldosterone-producing adenoma patients. Aldosterone-producing adenoma was associated with both endothelial dysfunction and increased Rho-associated kinase activity compared with those in

  11. Anesthetic recovery and hemodynamic effects of continuous thiopental infusion versus halothane for maintenance anesthesia in patients undergoing ocular surgery

    NARCIS (Netherlands)

    Shoroghi, Mehrdad; Farahbakhsh, Farshid; Sheikhvatan, Mehrdad; Sheikhfathollahi, Mahmood; Abbasi, Ali; Talebi, Azam

    2011-01-01

    Purpose: To investigate anesthesia recovery and hemodynamic status in patients under thiopental infusion or halothane maintenance anesthesia undergoing ocular surgery. Methods: Fifty-nine voluntary patients undergoing ocular surgery in Farabi hospital were allocated to one of two maintenance

  12. A mouse mastitis model to study the effects of the intramammary infusion of a food-grade Lactococcus lactis strain

    National Research Council Canada - National Science Library

    Cristina Camperio; Federica Armas; Elena Biasibetti; Paolo Frassanito; Carlo Giovannelli; Liliana Spuria; Claudia D’Agostino; Sabrina Tait; Maria Teresa Capucchio; Cinzia Marianelli

    2017-01-01

    ...) and is encountered in a wide range of environments. Recently, the use of the intramammary infusion of a live culture of LAB has been investigated as a new antibiotic alternative for treating mastitis in dairy ruminants...

  13. The Opioid-Sparing Effect of Perioperative Dexmedetomidine Combined with Oxycodone Infusion during Open Hepatectomy: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Benhou Zhang

    2018-01-01

    Full Text Available Background: A large right subcostal incision performed by open hepatectomy is associated with significant post-operative pain and distress. However, post-operative analgesia solutions still need to be devised. We investigated the effects of intra- and post-operative infusion of dexmedetomidine (Dex combined with oxycodone during open hepatectomy.Methods: In this prospective, randomized and double-blind investigation, 52 patients undergoing selective open hepatectomy were divided into Dex group (DEX infusion at an initial loading dose of 0.5 μg⋅kg-1 over 10 min before intubation then adjusted to a maintenance dose of 0.3 μg⋅kg-1⋅h-1 until incision suturing or control (Con group (0.9% sodium chloride was administered. Patient-controlled analgesia was administered for 48 h after surgery (Dex group: 60 mg oxycodone and 360 μg DEX diluted to 120 ml and administered at a bolus dose of 2 ml, with 5 min lockout interval and a 1 h limit of 20 ml. Con group: 60 mg oxycodone alone with the same regimen. The primary outcome was post-operative oxycodone consumption. The secondary outcomes included requirement of narcotic and vasoactive drugs, hemodynamics, incidence of adverse effects, satisfaction, first exhaust time, pain intensity, and the Ramsay Sedation Scale.Results: Post-operative oxycodone consumption was significantly reduced in Dex group from 4 to 48 h after surgery (P < 0.05. Heart rate in Dex group was statistically decreased from T1 (just before intubation to T6 (20 min after arriving at the post-anesthesia care unit, while mean arterial pressure was significantly decreased from T1 to T3 (during surgical incision; P < 0.05. The consumption of propofol and remifentanil were significantly decreased in Dex group (P < 0.05. The VAS scores at rest at 1, 4, and 8 h and with cough at 24, and 48 h after surgery were lower, the first exhaust time were shorter, satisfaction with pain control was statistically higher and the incidence of nausea

  14. Effect of short-term intralipid infusion on the immune response during low-dose endotoxemia in humans

    DEFF Research Database (Denmark)

    Krogh-Madsen, R.; Plomgaard, P.; Åkerström, Thorbjörn

    2008-01-01

    on the inflammatory response to a low dose of endotoxin. Fourteen healthy male volunteers underwent the following two trials in a randomized crossover design: 1) continuous infusion of 20% Intralipid [0.7 ml.kg(-1).h(-1) (1.54 g/kg)] for 11 h, and 2) infusion of isotonic saline for 11 h (control). In each trial......, heparin was given to activate lipoprotein lipase, and an intravenous bolus of endotoxin (0.1 ng/kg) was given after 6 h of Intralipid/saline infusion. Blood samples and muscle and fat biopsies were obtained before the Intralipid/saline infusion and before as well as after infusion of an endotoxin bolus....... Plasma levels of FFA, triglycerides, and glycerol were markedly increased during the Intralipid infusion. Endotoxin exposure induced an increase in plasma levels of TNF-alpha, IL-6, and neutrophils and further stimulated gene expression of TNF-alpha and IL-6 in both skeletal muscle and adipose tissue...

  15. Can aldosterone break your heart? Takotsubo cardiomyopathy in a patient with newly diagnosed primary aldosteronism.

    Science.gov (United States)

    Zoltowska, Dominika M; Agrawal, Yashwant; Kalavakunta, Jagadeesh K

    2018-02-05

    We report a case of a 47-year-old Caucasian woman with medical history of hypertension and hypokalemia, who presented to Emergency Room with symptoms resembling acute coronary syndrome ST-segment elevation myocardial infarction. Coronary angiogram revealed clear coronary arteries and left ventriculogram confirmed the diagnosis of Takotsubo cardiomyopathy. She was treated conservatively with good clinical outcome. Subsequent testing revealed underlying primary aldosteronism. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Matrix Effect Compensation in Small-Molecule Profiling for an LC-TOF Platform Using Multicomponent Postcolumn Infusion.

    Science.gov (United States)

    González, Oskar; van Vliet, Michael; Damen, Carola W N; van der Kloet, Frans M; Vreeken, Rob J; Hankemeier, Thomas

    2015-06-16

    The possible presence of matrix effect is one of the main concerns in liquid chromatography-mass spectrometry (LC-MS)-driven bioanalysis due to its impact on the reliability of the obtained quantitative results. Here we propose an approach to correct for the matrix effect in LC-MS with electrospray ionization using postcolumn infusion of eight internal standards (PCI-IS). We applied this approach to a generic ultraperformance liquid chromatography-time-of-flight (UHPLC-TOF) platform developed for small-molecule profiling with a main focus on drugs. Different urine samples were spiked with 19 drugs with different physicochemical properties and analyzed in order to study matrix effect (in absolute and relative terms). Furthermore, calibration curves for each analyte were constructed and quality control samples at different concentration levels were analyzed to check the applicability of this approach in quantitative analysis. The matrix effect profiles of the PCI-ISs were different: this confirms that the matrix effect is compound-dependent, and therefore the most suitable PCI-IS has to be chosen for each analyte. Chromatograms were reconstructed using analyte and PCI-IS responses, which were used to develop an optimized method which compensates for variation in ionization efficiency. The approach presented here improved the results in terms of matrix effect dramatically. Furthermore, calibration curves of higher quality are obtained, dynamic range is enhanced, and accuracy and precision of QC samples is increased. The use of PCI-ISs is a very promising step toward an analytical platform free of matrix effect, which can make LC-MS analysis even more successful, adding a higher reliability in quantification to its intrinsic high sensitivity and selectivity.

  17. Production of aldosterone in cardiac tissues of healthy dogs and with dilated myocardiopathy

    Directory of Open Access Journals (Sweden)

    Alejandro Reynoso Palomar

    2017-11-01

    Full Text Available Background and Aim: Aldosterone is a hormone, belonging to the group of mineralocorticoids, mainly synthesized in the adrenal cortex, basically its function is to regulate blood pressure and sodium potassium levels in the body; high levels of this hormone have harmful effects in the organism and mainly in the heart in chronic form. Dilated cardiomyopathy is a progressive disease of heart muscle that is characterized by ventricular chamber enlargement and contractile dysfunction, is one of the most common cardiac conditions in dogs of medium and large breeds. The aim of the study was to determine and quantify if a dog's cardiac cells possess the capacity to synthesize aldosterone, as well as, the differences that appear between a healthy heart and with dilated myocardiopathy (DMC. Materials and Methods: Cardiac tissues were used from six healthy dogs and six with DMC. Enzyme linked immunosorbent assay was performed to determine if the dog's heart cells synthesized this mineralocorticoid in a similar way to rat, rabbit, and human tissues, as well as quantitative differences between the healthy heart and DMC. Results: In healthy dog hearts, aldosterone values were 62.5 pG for both the atria and right ventricle and 125 pG for the left ventricle. As for dog hearts' with DMC, results were 125 pG in all four cavities. Conclusion: Both the healthy and DMC dog hearts produce aldosterone in all four cavities, observing that production increases in the atria and right ventricle of those hearts with DMC, as an intrinsic mechanism of cardiac remodeling.

  18. The effect of a pre-anesthetic infusion of amino acids on body temperature, venous blood pH, glucose, creatinine, and lactate of healthy dogs during anesthesia.

    Science.gov (United States)

    Clark-Price, Stuart C; Dossin, Olivier; Ngwenyama, Thandeka R; O'Brien, Mauria A; McMichael, Maureen; Schaeffer, David J

    2015-05-01

    To evaluate the effect of preanesthetic, intravenous (IV) amino acids on body temperature of anesthetized healthy dogs. Randomized, experimental, crossover study. Eight mixed-breed dogs approximately 2 years of age weighing 20.7 ± 2.1 kg. Dogs received 10% amino acid solution (AA) or 0.9% saline (SA) IV at 5 mL kg(-1) over 60 minutes. Body temperature (BT) was recorded at 5 minute intervals during infusions. Dogs were then anesthetized with sevoflurane for 90 minutes. BT was recorded at 5 minute intervals during anesthesia. Jugular blood samples were analyzed for pH, glucose, creatinine, and lactate concentrations at baseline, after infusion, after anesthesia and after 24 hours. BT at conclusion of infusion decreased -0.34 ± 0.42 °C in group AA and -0.40 ± 0.38 °C in group SA and was not different between groups (p = 0.072). BT decreased 2.72 ± 0.37 °C in group AA and 2.88 ± 0.26 °C in group SA after anesthesia and was different between groups (p dogs, preanesthetic IV infusion of amino acids attenuated heat loss compared to controls, however, the amount attenuated may not be clinically useful. Further studies are warranted to determine if nutrient-induced thermogenesis is beneficial to dogs undergoing anesthesia. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  19. Effect of barbatimão [Stryphnodendron adstringens (Mart. Coville] infusion on the labling of blood elements with technetium-99m

    Directory of Open Access Journals (Sweden)

    Thadeu E. M. Maramaldo Costa

    Full Text Available The Barbatimão is a tree which bark is rich in tannin. It is used on popular medicine as a wound healing agent, in the treatment of gastric lesions, as anti-leishmanial agent and as anti-inflammatory. Red blood cells (RBC are labeled with technetium-99m (Tc-99m and are utilized in many procedures in nuclear medicine. Some authors have reported that drugs (natural and synthetic can alter the labeling of RBC with Tc-99m. This study evaluates the effect of barbatimão infusion on the labeling of red blood cells (RBC and plasma (P proteins with Tc-99m. Heparinized blood from Wistar rats was incubated with NaCl 0.9% as control and different concentrations of barbatimão infusion. Following the addition of stannous chloride (SnCl2, as reducing agent, and Tc-99m, as sodium pertechnetate, the blood samples were centrifuged. P and RBC were separated and were also precipitated with trichloroacetic acid 5%. Insoluble (IF-P and IF-RBC fractions were isolated. The percentage of radioactivity in all the samples was determined. All the barbatimão infusion concentrations decreased the labeling of RBC, IF-P and IF-RBC. We can speculate that the barbatimão infusion interfered on the labeling of RBC due to the redox properties and/or it can also act as a chelator of the stannous ion.

  20. Intraportal versus Systemic Pentoxifylline Infusion after Normothermic Liver Ischemia: Effects on Regional Blood Flow Redistribution and Hepatic Ischemia-Reperfusion Injury

    Directory of Open Access Journals (Sweden)

    Edson A. Ribeiro

    2013-01-01

    Full Text Available Pentoxifylline (PTX has been shown to have beneficial effects on microcirculatory blood flow. In this study we evaluate the potential hemodynamic and metabolic benefits of PTX during hepatic ischemia. We also test the hypothesis that portal PTX infusion can minimize the I/R injury when compared to systemic infusion. Methods. Twenty-four dogs ( kg were subjected to portal triad occlusion (PTO for 45 min. The animals were assigned to 3 groups: CT (control, PTO, , PTX-syst (PTO + 25 mg/Kg of PTX IV, , and PTX-pv (PTO + 25 mg/Kg of PTX in the portal vein, . Animals were followed for 120 min. Systemic hemodynamics, gastrointestinal tract perfusion, oxygen-derived variables, and liver enzymes were evaluated throughout the experiment. Results. Animals treated with PTX presented significantly higher CO in the first hour after reperfusion, when compared to the CT (~3.7 vs. 2.1 L/min, . Alanine aminotransferase (ALT was similar in the PTX groups two hours after reperfusion but significantly higher in the CT (227 vs. ~64 U/L, . Conclusion. PTX infusion was associated with hemodynamic benefits and was able to minimize liver injury during normothermic hepatic I/R. However, local PTX infusion was not associated with any significant advantage over systemic route.

  1. Effects of cecal oxytetracycline infusion, and dietary avidin and biotin supplementation on the biotin status of nongravid gilts.

    Science.gov (United States)

    Hamilton, C R; Veum, T L

    2012-11-01

    The objective of this 49-d experiment was to test effects of cecal oxytetracycline (OTC) infusion, and dietary avidin and biotin supplementation on the biotin status of nongravid gilts. Twenty-eight crossbred gilts with an initial age of 160 d and BW of 120 kg were surgically fitted with a T-cannula in the terminal ileum, a cecal fistula, and an indwelling catheter in the anterior vena cava, and allotted to 7 dietary treatments. Treatments with the basal semipurified (SP) diet fed at 1.86 kg/d were: SP-1, negative control; SP-2, positive control with 270 μg of biotin/kg; SP-3, with spray-dried egg albumen (EA, 100 g/d) and OTC (2.56 g/d by cecal infusion); and SP-4, with EA, OTC, and 700 μg of biotin/kg. Treatments with the basal corn-soybean meal (CS) diet fed at 1.80 kg/d were: CS-1, negative control; CS-2, with EA and OTC; and CS-3, with EA, OTC, and 700 μg of biotin/kg. Response criteria were: fecal bacteria counts; plasma concentrations of biotin, glucose, and urea N (PUN); liver pyruvate carboxylase (PC) activity; kidney and epithelial tissue histology; ileal and fecal biotin concentrations; ileal and total tract N and energy utilization; daily gilt observation; and BW gain. Blood samples were collected every 7 d with serial samples collected on d 49. Total urine collections and fecal grab samples were made twice daily from d 44 to 49. Gilts were killed on d 50 and liver, kidney, and skin samples were collected. No gilts had symptoms of biotin deficiency. There were no treatment differences in BW gain, plasma glucose concentrations, liver PC activity, kidney and epithelial tissue histology, or fecal bacteria counts. Ileal and total tract N and energy digestibilities (%) did not differ among treatments within the same protein source, with greater (P ≤ 0.05) values for gilts on the SP treatments than the CS treatments. However, N retained/N absorbed and N retained/N intake (%) were less (P ≤ 0.05) and PUN concentrations were greater (P ≤ 0.05) for SP

  2. Hydrocortisone Infusion Exerts Dose- and Sex-Dependent Effects on Attention to Emotional Stimuli

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    Breitberg, Alaina; Drevets, Wayne C.; Wood, Suzanne E.; Mah, Linda; Schulkin, Jay; Sahakian, Barbara J.; Erickson, Kristine

    2013-01-01

    Glucocorticoid administration has been shown to exert complex effects on cognitive and emotional processing. In the current study we investigated the effects of glucocorticoid administration on attention towards emotional words, using an Affective Go/No-go task on which healthy humans have shown an attentional bias towards positive as compared to…

  3. Effect of abomasal infusion of oligofructose on portal-drained visceral ammonia and urea-nitrogen fluxes in lactating Holstein cows.

    Science.gov (United States)

    Røjen, B A; Larsen, M; Kristensen, N B

    2012-12-01

    The effects of abomasal infusion of oligofructose in lactating dairy cows on the relationship between hindgut fermentation and N metabolism, and its effects on NH(3) absorption and transfer of blood urea-N across the portal-drained viscera versus ruminal epithelia were investigated. Nine lactating Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in major splanchnic blood vessels were used in an unbalanced crossover design with 14-d periods. Treatments were continuous abomasal infusion of water or 1,500 g/d of oligofructose. The same basal diet was fed with both treatments. Eight sample sets of arterial, portal, hepatic, and ruminal vein blood, ruminal fluid, and urine were obtained at 0.5h before the morning feeding and at 0.5, 1.5, 2.5, 3.5, 4.5, 5.5, and 6.5 h after feeding. It was hypothesized that an increased supply of fermentable substrate to the hindgut would increase the uptake of urea-N from blood to the hindgut at the expense of urea-N uptake to the forestomach. The study showed that abomasal oligofructose infusion decreased the total amount of urea-N transferred from the blood to the gut, NH(3) absorption, and arterial blood urea-N concentration. Subsequently, hepatic NH(3) uptake and urea-N production also decreased with oligofructose infusion. Additionally, urea-N concentration in milk and urinary N excretion decreased with oligofructose treatment. The oligofructose infusion did not affect ruminal NH(3) concentrations or any other ruminal variables, nor did it affect ruminal venous - arterial concentration differences for urea-N and NH(3). The oligofructose treatment did not affect milk yield, but did decrease apparent digestibility of OM, N, and starch. Nitrogen excreted in the feces was greater with the oligofructose infusion. In conclusion, the present data suggest that increased hindgut fermentation did not upregulate urea-N transfer to the hindgut at the expense of urea-N uptake by the rumen, and the observed reduction

  4. Effects of dexmedetomidine infusion on laryngeal mask airway removal and postoperative recovery in children anaesthetised with sevoflurane.

    Science.gov (United States)

    He, L; Wang, X; Zheng, S; Shi, Y

    2013-05-01

    We investigated the effects of dexmedetomidine infusion on the end-tidal concentration of sevoflurane required for smooth removal of the laryngeal mask airway (LMA) and on the incidence of respiratory complications during postoperative recovery in paediatric patients anaesthetised with sevoflurane. Eighty-seven patients (ASA 1 or 2, aged 3-7 years) were randomly allocated to receive saline (Group C), 0.5 µg/kg dexmedetomidine (Group D(1)), or 1 µg/kg dexmedetomidine (Group D(2)) after LMA insertion. A predetermined end-tidal sevoflurane concentration for each patient was determined using the Dixon's up-and-down method (starting at 2.2% and step was 0.2%). The LMA was removed after the predetermined concentration had been maintained stable for five minutes. Sevoflurane minimum alveolar concentration for smooth LMA removal and postoperative recovery were assessed. The end-tidal concentration of sevoflurane required for smooth LMA removal in 50% of children (MAC(LMA-RM)) in Group D(2) (0.84±0.15%) was significantly lower than in Group D(1) (1.39±0.20%; P=0.003), the latter being significantly lower than in Group C (1.73±0.14%; P children and was associated less agitation in the post-anaesthetic care unit.

  5. Acute effects of testosterone infusion on the serum luteinizing hormone profile in eumenorrheic and polycystic ovary syndrome adolescents.

    Science.gov (United States)

    Ropelato, María Gabriela; Rudaz, María Cecilia García; Escobar, María Eugenia; Bengolea, Sonia Viviana; Calcagno, María Luján; Veldhuis, Johannes D; Barontini, Marta

    2009-09-01

    Little is known about the neuroendocrine effects of androgens on the GnRH-LH unit in females. Our objective was to evaluate androgen negative feedback on the GnRH-LH axis in eumenorrheic and polycystic ovary syndrome (PCOS) adolescents. We conducted a prospective, longitudinal, randomized, double-blind study at a pediatric endocrinology clinical research center. Seven nonobese PCOS adolescents and seven matched controls (C) were studied in the early follicular phase of three consecutive menstrual cycles or in three consecutive months. Pulsatile LH release was determined during saline [baseline (B)] and constant testosterone (T) infusions: low dose (T-LD) 0.75 and high dose (T-HD) 2.5 mg/12 h iv. Blood samples were drawn every 20 min overnight. LH (immunofluorometric assay) and T (electrochemiluminescence immunoassay) were determined at B, and during both T-LD and T-HD. LH profiles were analyzed by deconvolution and approximate entropy analyses. On T-LD, C and PCOS serum T levels increased 2- to 3-fold vs. B. On T-HD, T values doubled in both groups vs. T-LD. Controls on T-LD had greater 12-h pulsatile LH secretion rate (P adolescents have impaired suppression of pulsatile LH secretion rate consistent with reduced androgen negative feedback. Attenuation of T feedback in nonobese adolescents with PCOS extends the pathophysiology of this syndrome.

  6. Local effect of progesterone infusion into the porcine ovarian artery on androgen and estrogen secretion during the middle luteal phase.

    Science.gov (United States)

    Wasowska, Barbara; Stefańczyk-Krzymowska, Stanisława

    2009-07-01

    The present study was undertaken to elucidate whether an increased, but physiological, amount of progesterone (P(4)) supplied to the porcine corpus luteum (CL) affects luteal secretion of androgens and estrogens in freely moving gilts. On day 9 of the estrous cycle, the jugular veins as well as both ovarian arteries and both ovarian veins of gilts were cannulated. Progesterone was infused into the right ovarian arteries of experimental gilts (n=5) on days 10, 11 and 12 of the estrous cycle at a rate adequate to physiological retrograde transfer found during the middle luteal phase of the cycle. The left ovarian arteries of the experimental gilts were infused with saline. Both ovarian arteries of the control gilts (n=5) were infused with saline. The P(4) infusion rate was 0.62 microg/min (10 day), 2x0.62 microg/min (11 day) and 3x0.62 microg/min (12 day). Blood samples were collected from the jugular vein and both ovarian veins of the experimental and control gilts on days 10-12 of the estrous cycle before and after P(4) or saline infusion. The mean plasma androstenedione (A(4)) level in the ovarian vein ipsilateral to the P(4)-infused ovary was higher (pgilts as well as the control gilts. The ovarian venous level of testosterone (T) in the ovarian vein ipsilateral to the P(4)-infused ovary on days 10-12 of the estrous cycle was not significantly different (p>0.05) from those found in the contralateral ovarian vein of the experimental gilts and ovarian vein of the control gilts. However, on day 12, a decrease in T concentration was demonstrated in the ovarian vein ipsilateral to the P4-infused ovary in comparison to those of the contralateral and control ovarian veins. The mean plasma 17beta-estradiol (E(2)) level in the ovarian vein ipsilateral to the P(4)-infused ovary was lower on days 10-12 than those found in the contralateral ovarian vein of the experimental gilts and in the ovarian vein of the control gilts (pfeedback for A(4) secretion and a negative

  7. Effects of nicotine infusion on striatal glutamate and cortical non-protein-bound iron in hypoxic newborn piglets.

    Science.gov (United States)

    Andresen, Jannicke Hanne; Saugstad, Ola Didrik

    2008-01-01

    Perinatal asphyxia triggers a large cascade of mechanisms leading to brain damage. Release of glutamate and increased oxidative stress play substantial roles. Non-protein-bound iron (NPBI), which contributes to the production of free radical species through the Fenton reaction, increases in hypoxic-ischemic brain damage. Results from in vitro and adult animal studies show that nicotine can decrease extracellular levels of NPBI and glutamate. Nicotine's effects have further been shown to be dose-dependent, with lower doses showing neuroprotective, and higher doses showing neurotoxic effects. We wished to assess nicotine's effect on levels of NPBI and glutamate in an animal model of neonatal hypoxic-ischemic brain damage. 47 anesthetized newborn piglets were randomized to one of four infusions after hypoxia (nicotine 130 microg/kg/h, 260 microg/kg/h, adrenaline 0.05 microg/kg/min, saline 2.6 ml/kg/h). Glutamate in striatum and NPBI in cortex were analyzed in microdialysate. Striatal glutamate presented a significant rise for all the animals from baseline to the end of hypoxia (p nicotine 130 microg/kg/h versus saline (p = 0.002) 2 h after hypoxia. Cortical NPBI presented a significant rise from baseline to the end of hypoxia for all the animals (p nicotine 130 microg/kg/h versus saline 2 h after hypoxia (p = 0.013). Our findings support the hypothesis that nicotine can decrease extracellular levels of glutamate and NPBI in a neonatal model of hypoxic-ischemic brain damage. This suggests possible neuroprotective effects of a low dose of nicotine in neonates, as it has already been shown in adult models. Copyright 2008 S. Karger AG, Basel.

  8. Effect of prolonged nicotine infusion on response of rat catecholamine biosynthetic enzymes to restraint and cold stress.

    Science.gov (United States)

    Cheng, Shu-Yuan; Glazkova, Dina; Serova, Lidia; Sabban, Esther L

    2005-11-01

    There is a paradoxical relationship between nicotine and stress. To help elucidate their relationship on catecholamine biosynthesis, rats were infused with nicotine for 7-14 days before exposure to cold or restraint stress. Nicotine (5 mg/kg/day, 14 days) did not alter basal plasma corticosterone or its elevation with 24 h cold stress, but prevented corticosterone elevation following 2 h restraint stress. In adrenal medulla (AM), response of dopamine beta-hydroxylase (DBH), but not tyrosine hydroxylase (TH) mRNA, to both stressors was attenuated in nicotine-infused rats. In locus coeruleus (LC), restraint stress elevated TH and DBH mRNA in saline-, but not in nicotine-infused rats. Cold stress triggered a similar response of TH and DBH mRNAs in LC with and without nicotine infusion. With shorter nicotine infusion (8 mg/kg/day, 7 days), TH mRNA in AM was not induced by restraint stress on one (1x) or two (2x) consecutive days nor was DBH mRNA in AM or LC by 2x. The findings demonstrate that constant release of nicotine can modulate, or even prevent, some stress responses at the level of the HPA axis and gene expression of catecholamine biosynthetic enzymes in LC and AM.

  9. Effect of glucose and insulin infusion on the myocardial extraction of a radioiodinated methyl-substituted fatty acid

    Energy Technology Data Exchange (ETDEWEB)

    Bianco, J.A.; Elmaleh, D.R.; Leppo, J.A.; King, M.A.; Moring, A.; Livni, E.; Espinoza, E.; Alpert, J.S.; Strauss, H.W.

    1986-07-01

    We investigated the one-way. An extraction of 14-iodophenyl-tetradecanoic acid (BMTDA) in the canine heart under fasting conditions and during infusion of glucose plus insulin in eight an esthetized greyhound dogs. Myocardial extraction measurements were made with dual tracer approach, using Tc-99m albumin as reference tracer. Prior to, and during, infusion of 10% glucose and 25 units of regular insulin, heart rate, blood pressure, plasma glucose, insulin and free fatty acid levels were measured. Myocardial blood flow was determined using Sn-113 and Ru-103 radioactive microspheres. The mean extraction fraction of BMTDA was 0.38+-SEM 0.06 at baseline and increased to 0.44+-0.06 during hyperglycemia plus insulin. Plasma glucose and insulin were higher during the infusion while plasma free fatty acids significantly declined. There were no changes in hemodynamics or myocardial blood flow during the infusion. We conclude that glucose and insulin infusion result in increased first-pass extraction fraction of radioiodinated BMTDA unaccompanied by changes in coronary flow or hemodynamics, implying an insulin-mediated augmented transport of BMTDA.

  10. Freezing and thawing effects on fat, protein, and lactose levels of human natural milk administered by gavage and continuous infusion

    Directory of Open Access Journals (Sweden)

    Andrea D. Abranches

    2014-07-01

    Full Text Available OBJECTIVES: to analyze the changes in human milk macronutrients: fat, protein, and lactose in natural human milk (raw, frozen and thawed, after administration simulation by gavage and continuous infusion. METHOD: an experimental study was performed with 34 human milk samples. The infrared spectrophotometry using the infrared analysis equipment MilkoScan Minor(r (Foss, Denmark equipment was used to analyze the macronutrients in human milk during the study phases. The analyses were performed in natural (raw samples and after freezing and fast thawing following two steps: gavage and continuous infusion. The non-parametric Wilcoxon test for paired samples was used for the statistical analysis. RESULTS: the fat content was significantly reduced after administration by continuous infusion (p < 0.001 during administration of both raw and thawed samples. No changes in protein and lactose content were observed between the two forms of infusion. However, the thawing process significantly increased the levels of lactose and milk protein. CONCLUSION: the route of administration by continuous infusion showed the greatest influence on fat loss among all the processes required for human milk administration.

  11. Freezing and thawing effects on fat, protein, and lactose levels of human natural milk administered by gavage and continuous infusion.

    Science.gov (United States)

    Abranches, Andrea D; Soares, Fernanda V M; Junior, Saint-Clair G; Moreira, Maria Elisabeth L

    2014-01-01

    to analyze the changes in human milk macronutrients: fat, protein, and lactose in natural human milk (raw), frozen and thawed, after administration simulation by gavage and continuous infusion. an experimental study was performed with 34 human milk samples. The infrared spectrophotometry using the infrared analysis equipment MilkoScan Minor® (Foss, Denmark) equipment was used to analyze the macronutrients in human milk during the study phases. The analyses were performed in natural (raw) samples and after freezing and fast thawing following two steps: gavage and continuous infusion. The non-parametric Wilcoxon test for paired samples was used for the statistical analysis. the fat content was significantly reduced after administration by continuous infusion (p<0.001) during administration of both raw and thawed samples. No changes in protein and lactose content were observed between the two forms of infusion. However, the thawing process significantly increased the levels of lactose and milk protein. the route of administration by continuous infusion showed the greatest influence on fat loss among all the processes required for human milk administration. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  12. LC-DAD-ESI-MS/MS characterization of phenolic constituents in Turkish black tea: Effect of infusion time and temperature.

    Science.gov (United States)

    Kelebek, Hasim

    2016-08-01

    The influence of different infusion times and temperatures on phenolic, antioxidant, and color properties of black teas (Camellia sinensis L.) was investigated in the present study. The teas were prepared using infusion times of 3, 6, and 10min at 80 and 100°C. Liquid chromatography coupled to diode array detection and electrospray ionization tandem mass spectrometry (LC-DAD-ESI-MS/MS), whereby the two purine alkaloids were detected using positive ESI, and the other 33 phenolic compounds were detected using negative ESI. A total of 35 phenolic compounds were identified and quantified in the tea infusions, with the most abundant being gallic acid, (-)-epicatechin-gallate, 4-p-coumaroylquinic acid, quercetin-3-O-galactosyl-rhamnosyl-glucoside, kaempferol-3-O-glucosyl-rhamnosyl-glucoside, theaflavin, and theobromine. The antioxidant capacity of the tea infusions was determined using two different methods: DPPH (2,2-diphenyl-1-picryl hydrazyl) and ABTS (2,2'-azino-bis-3-ethyl-benzothiazoline-6-sulfonic acid) assays. DPPH and the ABTS values varied largely among the tea preparations. The increment in infusion times and temperature led to increase in the tea's antioxidant capacities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Aldosterone breakthrough during aliskiren, valsartan, and combination (aliskiren + valsartan) therapy.

    Science.gov (United States)

    Bomback, Andrew S; Rekhtman, Yelena; Klemmer, Philip J; Canetta, Pietro A; Radhakrishnan, Jai; Appel, Gerald B

    2012-01-01

    Aldosterone levels increase in 30%-40% of patients on angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers over the long term. This "aldosterone breakthrough" may carry important clinical consequences given aldosterone's nonepithelial, pro-fibrotic actions. The renin inhibitor, aliskiren, by suppressing the renin-angiotensin-aldosterone system (RAAS) proximally, may limit breakthrough compared to conventional RAAS blockade. This open-label study (NCT01129557) randomized subjects to aliskiren 300 mg daily (A), valsartan 320 mg daily (V), or aliskiren 150 mg + valsartan 160 mg daily (A+V) for 9 months. Eligible subjects had proteinuria >300 mg/day, estimated glomerular filtration rate (eGFR) >45 mL/min/1.73 m(2), and systolic blood pressure (BP) >130 or diastolic BP >80 mm Hg. Serum and 24-hour urine aldosterone (indexed to 24-hour urine Na) were checked before initiation of therapy and at 3, 6, and 9 months. Aldosterone breakthrough was defined as a sustained increase from baseline aldosterone by study end. The study was intended to enroll 120 subjects but was terminated early by the sponsor. We present here the results of 33 subjects who completed the protocol, of which 12 were randomized to A, 11 were randomized to V, and 10 were randomized to A+V. Mean baseline eGFR was 75.5 (±23.3) mL/min/1.73 m(2); baseline proteinuria was 3104 (±2943) mg/day; and baseline BP was 134.7 (±10.5)/84.8 (±8.4) mm Hg. Three (27%) subjects on V, three (25%) subjects on A, and three (30%) subjects on A+V had aldosterone breakthrough. Mean proteinuria reduction was 31% from baseline in all subjects: 30% in subjects with breakthrough vs. 32% in subjects without breakthrough. Mean BP reduction was 11.0/8.8 mm Hg in all subjects: 8.4/6.1 mm Hg in subjects with breakthrough vs. 12.0/9.8 mm Hg in subjects without breakthrough. Aliskiren, alone or in combination with valsartan, did not reduce the incidence of aldosterone breakthrough in subjects with hypertension

  14. Effects of continuous prostacyclin infusion on regional blood flow and cerebral vasospasm following subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Juhler, Marianne; Wetterslev, Jørn

    2014-01-01

    BACKGROUND: One of the main causes of mortality and morbidity following subarachnoid hemorrhage (SAH) is the development of cerebral vasospasm, a frequent complication arising in the weeks after the initial bleeding. Despite extensive research, no effective treatment of vasospasm exists to date. ...

  15. Infusing Physical Activities into the Classroom: Effects on Preschool Children's Geography Learning

    Science.gov (United States)

    Mavilidi, Myrto-Foteini; Okely, Anthony D.; Chandler, Paul; Paas, Fred

    2016-01-01

    In this intervention study, we investigated the effects of physical activities that were integrated into a geography task on preschool children's learning performance and enjoyment. Eight childcare centers with 87 four-to-five-year-old children were randomly assigned across an integrated physical activity condition, an unintegrated physical…

  16. The effects of continuous prostacyclin infusion on regional blood flow and cerebral vasospasm following subarachnoid haemorrhage

    DEFF Research Database (Denmark)

    Rasmussen, Rune; Wetterslev, Jørn; Stavngaard, Trine

    2012-01-01

    One of the main causes of mortality and morbidity following subarachnoid haemorrhage (SAH) is the development of cerebral vasospasm, a frequent complication arising in the weeks after the initial bleeding. Despite extensive research, to date no effective treatment of vasospasm exists. Prostacycli...

  17. 1-Sarcosine-angiotensin II infusion effects on food intake, weight loss, energy expenditure, and skeletal muscle UCP3 gene expression in a rat model.

    Science.gov (United States)

    Cichello, S A; Weisinger, R S; Schuijers, J; Jois, M

    2014-09-01

    There are a myriad of proteins responsible for modulation of expenditure of energy. Angiotensin II (Ang II) is a vital component of renin-angiotensin system that affects blood pressure and also linked to both cachexia and obesity via fat and muscle metabolism. Previous research suggests that the direct action of Ang II is on the brain, via angiotensin II type 1 receptor protein, affecting food intake and energy expenditure. The objective of the study is to investigate the effect of 1-sarcosine (SAR)-Ang II infusion on energy expenditure and metabolism in a rat model of congestive heart failure cachexia. Adult female rats of the Sprague Dawley strain (n = 33) were used (11 pair-fed control, 12 ad libitum and 10, 1-sarcosine-angiotensin II-infused rats). Body weight, faecal excretion, feed intake (in grams), water intake (in milliliters) and urine excreted were recorded daily. The measurements were recorded in three different periods (4 days prior to surgery, "pre-infusion"; day of surgery and 5 days postsurgery, "infusion period"; days 7 to 14, "recovery" period). Different analytical methods were used to measure energy expenditure per period, uncoupling protein 3 mRNA expression, crude protein and adipose tissue body composition. During the infusion period, the SAR-Ang II group experienced rapid weight loss (p fat content (in percent) than the controls. There was also increased (p weight by wasting predominantly adipose tissue, which may be due to elevated energy expenditure via mitochondrial uncoupling (UCP3 protein activity).

  18. The effects of aminophylline infusion in the treatment of children with acute asthma exacerbation. Evaluation with {sup 81m}Kr ventilation scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Matsubara, Yasuko; Shimada, Takao [Jikei Univ., Tokyo (Japan). School of Medicine

    1998-09-01

    The use of intravenous aminophylline in the treatment of children with acute asthma remains controversial. Most authors suggest that aminophylline be used with caution because of its poor efficacy with adverse reactions and instead recommend other drugs, such as {beta}{sub 2}-adrenergic agonists and glucocorticoids. However other studies have reported the benefits of aminophylline, and current Japanese guidelines for the management of asthma recommend its use. Here, we have evaluated the efficacy of aminophylline infusion in children with acute asthma exacerbations. Twenty children with acute asthma exacerbations were given an infusion of 5 mg/kg of aminophylline over 5 minutes, 30 minutes after the same volume of normal saline had been infused as a control. {sup 81m}Kr ventilation scintigraphy was done sequentially, and lung function was measured with spirometry before and after each infusion. Side effects were also evaluated with a questionnaire. Ventilation images obtained with {sup 81m}Kr scintigraphy, which initially showed widespread ventilatory defects caused by bronchoconstriction, decreased 54.9% after aminophylline infusion (p<0.0001). Ventilatory defects, caused by both central and peripheral airway disturbances and confirmed with the {sup 81m}Kr bolus inhalation procedure, also showed significant improvement (p<0.0001). These improvement were accompanied by improvements in lung function as assessed with forced expiratory volume in 1 second (p<0.01) and maximum expiratory flow rates at 25% (p<0.001) and 50% (p<0.001). No serious adverse reactions were recognized in any subjects. Our results show that aminophylline is a useful bronchodilator which decreased ventilatory imbalance and improves lung function in both central and peripheral airways. (author)

  19. Local effect of progesterone infusion into ovarian artery on activin A and inhibin alpha-subunit secretion during the middle luteal phase in gilts.

    Science.gov (United States)

    Wasowska, B; Stefańczyk-Krzymowska, S

    2010-01-01

    The present study was undertaken to elucidate whether an increased, but physiological, amount of progesterone (P4) supplied to the porcine corpus luteum affects luteal secretion of activin A and inhibin alpha-subunit (Inhalpha) in freely moving gilts. On day 9 of the estrous cycle (EC), both ovarian arteries and both ovarian veins of gilts (n = 5) were cannulated. Progesterone was infused into the right ovarian arteries in gilts on days 10, 11 and 12 of the EC at a rate adequate to its physiological retrograde transfer found during the middle luteal phase of the EC. The P4 infusion rate was 0.62 microg/min (day 10), 2 x 0.62 microg/min (day 11) and 3 x 0.62 microg/min (day 12). The left ovarian arteries were infused with saline (control). Blood samples were collected from both ovarian veins on days 10-12 of the EC before and after P4 or saline infusion. The mean plasma activin A level in the ovarian vein ipsilateral to the P4-infused ovary was higher (P 0.05) than this found in the contralateral ovarian vein. The results of the present study indicate that a local elevation of P4 concentration in blood supplying the ovary during the middle luteal phase of the porcine EC affects ovarian secretion of activin A. The effect of P4 on the secretion of activin A suggested the existence of a short regulatory loop of a positive feedback between P4 being retrogradely transferred into the ovary and the secretion of this peptide.

  20. The Role of Aldosterone in Obesity-Related Hypertension.

    Science.gov (United States)

    Kawarazaki, Wakako; Fujita, Toshiro

    2016-04-01

    Obese subjects often have hypertension and related cardiovascular and renal diseases, and this has become a serious worldwide health problem. In obese subjects, impaired renal-pressure natriuresis causes sodium retention, leading to the development of salt-sensitive hypertension. Physical compression of the kidneys by visceral fat and activation of the sympathetic nervous system, renin-angiotensin systems (RAS), and aldosterone/mineralocorticoid receptor (MR) system are involved in this mechanism. Obese subjects often exhibit hyperaldosteronism, with increased salt sensitivity of blood pressure (BP). Adipose tissue excretes aldosterone-releasing factors, thereby stimulating aldosterone secretion independently of the systemic RAS, and aldosterone/MR activation plays a key role in the development of hypertension and organ damage in obesity. In obese subjects, both salt sensitivity of BP, enhanced by obesity-related metabolic disorders including aldosterone excess, and increased dietary sodium intake are closely related to the incidence of hypertension. Some salt sensitivity-related gene variants affect the risk of obesity, and together with salt intake, its combination is possibly associated with the development of hypertension in obese subjects. With high salt levels common in modern diets, salt restriction and weight control are undoubtedly important. However, not only MR blockade but also new diagnostic modalities and therapies targeting and modifying genes that are related to salt sensitivity, obesity, or RAS regulation are expected to prevent obesity and obesity-related hypertension. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Aldosterone aggravates glucose intolerance induced by high fructose.

    Science.gov (United States)

    Sherajee, Shamshad J; Rafiq, Kazi; Nakano, Daisuke; Mori, Hirohito; Kobara, Hideki; Hitomi, Hirofumi; Fujisawa, Yoshihide; Kobori, Hiroyuki; Masaki, Tsutomu; Nishiyama, Akira

    2013-11-15

    We previously reported that aldosterone impaired vascular insulin signaling in vivo and in vitro. Fructose-enriched diet induces metabolic syndrome including hypertension, insulin resistance, hyperlipidemia and diabetes in animal. In the current study, we hypothesized that aldosterone aggravated fructose feeding-induced glucose intolerance in vivo. Rats were divided into five groups for six-week treatment; uninephrectomy (Unx, n=8), Unx+aldosterone (aldo, 0.75 µg/h, s.c., n=8), Unx+fructose (fruc, 10% in drinking water, n=8), Unx+aldo+fruc, (aldo+fruc, n=8), and Unx+aldo+fruc+spironolactone, a mineralocorticoid receptor antagonist (aldo+fruc+spiro, 20mg/kg/day, p.o., n=8). Aldo+fruc rats manifested the hypertension, and induced glucose intolerance compared to fruc intake rats assessed by oral glucose tolerance test, homeostasis model assessment of insulin resistance and hyperinsulinemic-euglycemic clamp study. Spironolactone, significantly improved the aldosterone-accelerated glucose intolerance. Along with improvement in insulin resistance, spironolactone suppressed upregulated mineralocorticoid receptor (MR) target gene, serum and glucocorticoid-regulated kinases-1 mRNA expression in skeletal muscle in aldo+fruc rats. In conclusion, these data suggested that aldosterone aggravates fructose feeding-induced glucose intolerance through MR activation. © 2013 Published by Elsevier B.V.

  2. [PHARMACOLOGICAL TREATMENT IN PALLIATIVE CARE. DRUG ADMINISTRATION ROUTE, CONTINUOUS SUBCUTANEOUS INFUSION, ADVERSE SIDE EFFECTS, SYMPTOM MANAGEMENT].

    Science.gov (United States)

    Dominguez Álvarez, Rocío; Calderón Carrasco, Justo; García Colchero, Francisco; Postigo Mota, Salvador; Alburquerque Medina, Eulalia

    2015-01-01

    To achieve well-being in patients in Palliative Care is required to know which are the most common symptoms, which are the drugs used for relief, which are the routes of administration of drugs that are suitable, how effective the drugs are and what incompatibilities, interactions and adverse effects occur. The aim of this article is to review the relevant issues in the management of the drugs commonly used by nursing in Palliative Care and presenting recommendations to clinical practice. Management interventions drugs for nurses in Palliative Care recommended by the scientific literature after a search of Scopus, CINAHL, Medline, PubMed, UpToDate and Google Scholar are selected. The oral route is the choice for patients in palliative situation and subcutaneous route when the first is not available. The symptoms, complex, intense and moody, should be systematically reevaluated by the nurse, to predict when a possible decompensation of it needing extra dose of medication. Nurses must be able to recognize the imbalance of well-being and act quickly and effectively, to get relief to some unpleasant situations for the patient as the pain symptoms, dyspnea or delirium. For the proper administration of rescue medication, the nurse should know the methods of symptomatic evaluation, pharmacokinetics and pharmacodynamics of drugs, the time intervals to elapse between different rescues and nccocc rocnnnco t thocm

  3. Effects of Intracoronary Infusion of Escalating Doses of Cardiac Stem Cells in Rats With Acute Myocardial Infarction.

    Science.gov (United States)

    Tang, Xian-Liang; Rokosh, Gregg; Sanganalmath, Santosh K; Tokita, Yukichi; Keith, Matthew C L; Shirk, Gregg; Stowers, Heather; Hunt, Gregory N; Wu, Wenjian; Dawn, Buddhadeb; Bolli, Roberto

    2015-07-01

    Although c-kit(pos) cardiac stem cells (CSCs) preserve left ventricular (LV) function and structure after myocardial infarction, CSC doses have been chosen arbitrarily, and the dose-effect relationship is unknown. Rats underwent a 90-minute coronary occlusion followed by 35 days of reperfusion. Vehicle or CSCs at 5 escalating doses (0.3×10(6), 0.75×10(6), 1.5×10(6), 3.0×10(6), and 6.0×10(6) cells/heart) were given intracoronarily 4 h after reperfusion. The lowest dose (0.3×10(6)) had no effect on LV function and morphology, whereas 0.75, 1.5, and 3.0×10(6) significantly improved regional and global LV function (echocardiography and hemodynamic studies). These 3 doses had similar effects on echocardiographic parameters (infarct wall thickening fraction, LV end-systolic and end-diastolic volumes, LV ejection fraction) and hemodynamic variables (LV end-diastolic pressure, LV dP/dtmax, preload adjusted maximal power, end-systolic elastance, preload recruitable stroke work) and produced similar reductions in apoptosis, scar size, infarct wall thinning, and LV expansion index and similar increases in viable myocardium in the risk region (morphometry). Infusion of 6.0×10(6) CSCs markedly increased postprocedural mortality. Green fluorescent protein and 5-bromo-2'-deoxyuridine staining indicated that persistence of donor cells and formation of new myocytes were negligible with all doses. Surprisingly, in this rat model of acute myocardial infarction, the dose-response relationship for intracoronary CSCs is flat. A minimal dose between 0.3 and 0.75×10(6) is necessary for efficacy; above this threshold, a 4-fold increase in cell number does not produce greater improvement in LV function or structure. Further increases in cell dose are harmful. © 2015 American Heart Association, Inc.

  4. [Effect of intravenous infusion of KCl on the electrocardiogram and serum potassium in dogs with normal renal function].

    Science.gov (United States)

    Bravo-Zúñiga, Jessica; Huapaya, Julio; Valencia, Cesar; Bezada, Sandra; Leon, Cristian; Ferrandiz-Espadin, Renato; Cieza, Javier

    2015-01-01

    Variations in serum potassium (K+) and electrocardiographic changes at different infusion speeds of intravenous K+ were studied in dogs. Solutions of 20, 40, 60 and 80 mEq of K+ were infused in one hour to dogs with normal renal function and normal serum K+. Nine dogs were studied: three without prior hydration and six with previous hydration. Infusing 20 mEq/hour of K+ produced an increase in heart rate without changes in the electrocardiogram. With 40 mEq/hour there were changes in the "t" and "p" waves, and with 60 and 80 mEq/hour, alterations consistent with cardiac ischemia and ventricular tachycardia. Dogs without hydration had more obvious and fatal electrocardiographic changes. Doses of 20 mEq/hour of K + caused no morbidity or mortality in the animals studied. Higher doses showed various complications which depended on the hydration status of the animal, its urinary flow and potassium level.

  5. The effect of unilateral progesterone infusion into the ovarian artery during the middle luteal phase on progesterone secretion in gilts.

    Science.gov (United States)

    Wasowska, Barbara; Stefańczyk-Krzymowska, Stanisława

    2009-03-01

    The aim of the study was to determine, in an experiment performed on conscious gilts, whether an increased amount of progesterone (P4) supplied to the porcine corpus luteum (CL), maintained within a physiological systemic concentration would influence its own secretion. On day 9 of the estrous cycle the jugular veins as well as both ovarian arteries and both ovarian veins were cannulated. In the experimental gilts (n=5), P4 was infused into the right ovarian arteries on days 10, 11 and 12 of the estrous cycle at a rate adequate for physiological retrograde transfer found during the middle luteal phase. The left ovarian arteries of these gilts were infused with saline. Both ovarian arteries of the control gilts (n=5) were infused with saline. The P4 infusion rate was 0.62 microg/min (10 day), 2 x 0.62 microg/min ( 11 day) and 3 x 0.62 microg/min (12 day) and physiological levels of the steroid were maintained. Blood samples were collected from the jugular vein and both ovarian veins in the experimental and control animals on days 10, 11 and 12 of the estrous cycle during two periods on each day: before and after P4 or saline infusion. The mean plasma P4 level in the ovarian vein ipsilateral to the P4-infused ovary was significantly (pgilts and in the ovarian vein of the control gilts. This was also true for day 12 of the estrous cycle (p0.05) among the particular days of the experiment. In contrast, mean P4 levels in the contralateral ovarian vein of the experimental gilts as well as in the ovarian vein of the control gilts tended to decrease (pfeedback between P4 being retrograde transferred into the ovary and P4 ovarian secretion.

  6. A study of the cost-effectiveness of providing psychomotor practice in teaching intravenous infusion techniques.

    Science.gov (United States)

    Hegstad, L N; Zsohar, H

    1986-01-01

    Does psychomotor practice affect the student's ability to perform venipuncture? This was the primary question in a study conducted to compare two versions of an instructional program--a no-practice version and a costly version that involved practice on the simulated arm. The initial study was composed of 40 (20 each group) Junior nursing students enrolled in a baccalaureate program. The instructional program for both groups included a handout of the task-by-task description of the procedure; a performance check list, a 10-minute color videotape demonstrating the entire process, and a live demonstration on a simulated arm. Each group took a post test which covered the cognitive aspects of the task. The practice group was able to practice on the simulated arm prior to evaluation on a live subject. The cognitive scores for both groups were near 90% and the performance scores above 80%. Since there was no significant difference between the groups the study was repeated with another group of students from the same school. This group differed slightly from the original group in that they had no experience with venipuncture. The second study contained 34 students and the cognitive scores were 91% for both groups and above 80% for the performance scores. The results indicated that the least costly version was equally effective and presents nursing education with an opportunity to evaluate skills teaching to determine the most effective, efficient and/or economical method to teach skills.

  7. Sedative effects of oral pregabalin premedication on intravenous sedation using propofol target-controlled infusion.

    Science.gov (United States)

    Karube, Noriko; Ito, Shinichi; Sako, Saori; Hirokawa, Jun; Yokoyama, Takeshi

    2017-08-01

    The sedative effects of pregabalin during perioperative period have not been sufficiently characterized. The aim of this study was to verify the sedative effects of premedication with pregabalin on intravenous sedation (IVS) using propofol and also to assess the influences of this agent on circulation, respiration, and postanesthetic complications. Ten healthy young volunteers underwent 1 h of IVS using propofol, three times per subject, on separate days (first time, no pregabalin; second time, pregabalin 100 mg; third time, pregabalin 200 mg). The target blood concentration (C T) of propofol was increased in a stepwise fashion based on the bispectral index (BIS) value. Ramsay's sedation score (RSS) was determined at each propofol C T. Propofol C T was analyzed at each sedation level. Circulation and respiration during IVS and complications were also verified. Propofol C T was reduced at BIS values of 60 and 70 in both premedicated groups (100 mg: p = 0.043 and 0.041; 200 mg: p = 0.004 and 0.016, respectively) and at a BIS value of 80 in the pregabalin 200 mg group (p pregabalin 100 mg group (RSS 4: p = 0.047; RSS 5: p = 0.007; RSS 6: p = 0.014), and at RSS 3-6 in the pregabalin 200 mg group (RSS 3-5: p pregabalin reduces the amount of propofol required to obtain an acceptable and adequate sedation level.

  8. [Continuous-infusion ketamine].

    Science.gov (United States)

    Mancini, P G; Caggese, G; Di Fabio, A; Di Nino, G F; Cocchi, V

    1980-08-01

    An investigation was made of the employment of ketamin as the sole anaesthetic in general surgery, using continuous infusion of a 1% solution for both induction and maintenance in 118 cases. ECG was monitored and arterial pressure was measured invasively. Central venous pressure was also determined in 10 cases. Changes in serum enzyme values during and after surgery were examined in 35 patients. Blood samples were withdrawn before induction, after the return to consciousness, and 24 hr after the operation. Side-effects were common, but slight. Five patients suffered from nightmares, but these were persons with marked imaginative activity and a melancholic nature. Cardiocirculatory function was satisfactory. In particular, peripheral perfusion was excellent in all cases.

  9. Effectiveness and safety of nicardipine and labetalol infusion for blood pressure management in patients with intracerebral and subarachnoid hemorrhage.

    Science.gov (United States)

    Ortega-Gutierrez, Santiago; Thomas, Jiz; Reccius, Andres; Agarwal, Sachin; Lantigua, Hector; Li, Min; Carpenter, Amanda M; Mayer, Stephan A; Schmidt, J Michael; Lee, Kiwon; Claassen, Jan; Badjatia, Neeraj; Lesch, Christine

    2013-02-01

    Nicardipine and labetalol are two commonly used antihypertensives for treating elevated blood pressures in the setting of intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). There are no studies comparing these two agents as continuous infusions. A retrospective chart review was conducted of patients admitted between November 2009 and January 2011 with ICH and SAH to compare effectiveness and safety between both agents. Percent time spent at goal was set as the primary outcome. The secondary outcomes included blood pressure variability, time to goal, incidence of bradycardia, tachycardia, and hypotension. A total of 81 patients were available for analysis, 10 initiated on labetalol (LAB), 57 on nicardipine (NIC), and 14 required the combination of these agents (COMB) to reach goal. We found no difference between NIC, LAB, and the COMB groups in the median percent time at goal [88 % (61-98); 93 % (51-99); 66 % (25-95), (p = NS)]. Median percentage of blood pressure variability, hypotension, and bradycardia were also comparable between groups, however, more tachycardia was observed in the COMB group versus both LAB and NIC groups (45 vs. 0 vs. 3 %; p < 0.001). Mean time to goal SBP in 24 patients who had BP readings available at 1st h of initiation was 32 ± 34 min in the NIC group and 53 ± 42 min in the LAB group (p = 0.03). Both agents appear equally effective and safe for blood pressure control in SAH and ICH during the initial admission hours. A prospective study is needed to validate these findings.

  10. Direct effects of locally administered lipopolysaccharide on glucose, lipid, and protein metabolism in the placebo-controlled, bilaterally infused human leg

    DEFF Research Database (Denmark)

    Buhl, Mads; Bosnjak, Ermina; Vendelbo, Mikkel H.

    2013-01-01

    discrimination between direct and indirect effects impossible. Objective: We sought to define the direct, placebo-controlled effects of LPS on insulin resistance and protein and lipid metabolism in the infused human leg without systemic interference from cytokines and stress hormones. Design......Context: Accumulating evidence suggests that chronic exposure to lipopolysaccharide (LPS, endotoxin) maycreate a constant low-grade inflammation, leading to insulin resistance and diabetes. All previous human studies assessing the metabolic actions of LPS have used systemic administration, making......: This was a randomized, placebo-controlled, single-blinded study. Participants and Intervention: We studied 8 healthy volunteers with bilateral femoral vein and artery catheters during a 3-hour basal and 3-hour hyperinsulinemic-euglycemic clamp period with bilateral muscle biopsies in each period during infusion...

  11. Effect of water deprivation, desmopressin (DDAVP) infusion, and oral loads of water, Na+ and NH4+ on urinary excretion of epidermal growth factor in the rat

    DEFF Research Database (Denmark)

    Jørgensen, P E; Poulsen, Steen Seier; Nexø, Ebba

    1993-01-01

    Epidermal growth factor (EGF) is synthesized in the kidneys and excreted in urine. Administration of exogenous EGF modulates the reabsorption of Na+ and the vasopressin stimulated reabsorption of water in the collecting tubules. In order to clarify whether this reflects a physiological role...... for urinary EGF we examined the effects of changes in the oral loads of water, Na+ and NH4+ as well as the effect of infusion of the vasopressin analogue, desmopressin (DDAVP) on the endogenous urinary EGF excretion in the rat. Water deprivation for 48 h reduced the urinary excretion of EGF by 25......% and the urinary EGF/creatinine ratio by 8%. Also, urinary volume, Na+ excretion, and urinary pH were reduced by water deprivation. Infusion of DDAVP, low plasma vasopressin induced by polydipsia, and changes in the renal excretion of Na+ and H+ did not affect the urinary excretion of EGF. In conclusion: it seems...

  12. Renin aldosterone system and potassium levels in chronic lead intoxication.

    Science.gov (United States)

    Gonzalez, J J; Werk, E E; Thrasher, K; Behar, R; Loadholt, C B

    1979-04-01

    Renin activity and aldosterone were evaluated relative to potassium levels and lead intoxication in 33 patients with a history of "moonshine" ingestion. Patients were divided into three groups: I, lead intoxicated with hyperkalemia; II, lead intoxicated without hyperkalemia; and III, not lead intoxicated without hyperkalemia. Those in group I demonstrated suppressed plasma renin activity, baseline and after furosemide, and blunted aldosterone responsiveness to furosemide. Plasma renin activity was not different in groups II and III, whereas aldosterone responsiveness was less in group II than in III. Group I patients tended to be older, had lower creatinine clearances, and six of nine had mild hyperchloremic acidosis. Diabetes and cortisol insufficiency were not present. Chronic lead intoxication due to illicit alcohol ingestion is associated with hyporeninemic hypoaldosteronism and hyperkalemia which appear to develop as the lead nephropathy progresses with duration and/or aging.

  13. Effects of different parenteral nutrition infusions in a patient with short bowel syndrome.

    Science.gov (United States)

    Weng, Chia-Chee; Chen, Yun

    2015-01-01

    In this case study, we demonstrate the effects of different lipid emulsions on liver function in a 52-year-old woman with short bowel syndrome who was totally dependent on parenteral nutrition. Over a 13-month period after small bowel resection and jejunostomy, we followed the patient's plasma triglycerides and liver enzyme levels as well as body weight and discomfort levels. During the first 3 months when parenteral nutrition including a lipid emulsion containing 50% soybean oil/50% medium-chain triglyerides was administered daily, the patient reported feeling unwell (experiencing dizziness and palpitations) and her triglycerides and liver enzyme levels rose to 366 mg/dL and 145 U/L (alanine aminotransferase [ALT]), respectively; these levels recovered when this emulsion was discontinued. For the following 9 months, an emulsion containing 80% olive oil and 20% soybean oil was administered, and the patient's triglycerides (182 mg/dL) did not increase to abnormal levels and liver enzyme levels were only mildly elevated (109 U/L). The patient felt well and her body weight increased from 51 kg to 55 kg during this period. These results suggest that parenteral nutrition with a reduced soybean oil content may better preserve liver function in patients with short bowel syndrome.

  14. Effects on diameter and morphology of polycaprolactone nanofibers infused with various concentrations of selenium nanoparticles

    Science.gov (United States)

    Kamaruzaman, Nurul Asyikin; Yusoff, Abdull Rahim Mohd; Buang, Nor Aziah; Salleh, Nik Ghazali Nik

    2017-12-01

    Electrospinning is one of the techniques used in the fabrication of nanofibers. Polycaprolactone (PCL), is a biodegradable polymer which was commonly electrospun without the presence of nanoparticles as additives and/or filler in the applications such as tissue engineering, biosensors, filtration, wound dressings, drug delivery and enzyme immobilization. In this study, via FESEM analyses, the effects on the diameter and morphology of PCL nanofibers was investigated with respect to various concentration of selenium nanoparticles (SeNP). Increasing the concentration of SeNP from 0.2 to 1.0% (w/v) resulted in increased of fiber diameter as well as the density of the nanofiber networking. Consequently, the formation of beads have also increased with the increment of the concentration of SeNP. The images from FESEM micrographs showed the formation of "aligned fibers" with the average size of less than 550 nm. The optimized concentration of SeNP obtained was 0.4 % w/v for the formation of aligned fibers with a uniform diameter in size and the least formation of beads in the matrices. Aligned nanofibers are biocompatible and can be used in tissue engineering and wound dressing applications. Meanwhile, nanofibers with beads are suitable for filtration design in water and gaseous applications.

  15. Effects of nutritionally induced metabolic acidosis with or without glutamine infusion on acid-base balance, plasma amino acids, and plasma nonesterified fatty acids in sheep.

    Science.gov (United States)

    Odongo, N E; Greenwood, S L; Or-Rashid, M M; Radford, D; Alzahal, O; Shoveller, A K; Lindinger, M I; Matthews, J C; McBride, B W

    2009-03-01

    This study characterized the effects of nutritionally induced metabolic acidosis with or without Gln infusion on acid-base balance, plasma AA, and plasma NEFA in sheep. In a randomized complete block design with a 2 x 2 factorial arrangement of treatments, 24 fully fleeced sheep (Rideau-Arcott, 63.6 +/- 5.9 kg of BW) were fed a control supplement (CS; 300 g/d of canola meal) or an acidosis supplement (AS; 300 g/d of NutriChlor; HCl-treated canola meal), offered twice daily at 0700 and 1100 h. Sheep were infused at 1400 h daily with 0.3 g of L-glutamine per kg of BW or saline via jugular vein catheters for 7 d. The sheep were individually housed and limit-fed a basal diet of dehydrated alfalfa pellets (1.75 kg/d; 90% DM, 22% CP, and 1.2 Mcal of NE(g)/kg on a DM basis) offered twice daily at 1000 and 1300 h. Blood and urine was sampled daily between 1100 and 1130 h, and blood samples were analyzed for hematocrit, plasma pH, gases, strong ions, AA, and NEFA, whereas urine was analyzed for pH. The AS reduced (P < 0.01) DMI, urine and plasma pH, blood urea, partial pressure of CO(2), strong ion difference, and plasma HCO(3)(-), and increased (P < 0.01) plasma K(+), Ca(2+), and Cl(-). The AS with saline infusion increased (P infusion reduced (P < 0.01) partial pressure of O(2) and plasma glucose. The AS increased (P < 0.01) plasma lysine and reduced (P < 0.01) plasma taurine. Glutamine infusion increased (P = 0.04) plasma leucine with the CS treatment but had no effect (P = 0.89) with the AS treatment. Plasma 16:0, 18:2n-6, 18:3n-3, 20:4n-6, and total NEFA were increased and 18:0 was decreased (P < 0.001) in AS sheep compared with CS sheep. Infusion of Gln decreased (P < 0.05) 16:0, 18:2n-6, 18:3n-3, 20:4n-6, and total NEFA compared with saline infusion. Plasma cis-9, trans-11 CLA was elevated (P = 0.001) in AS sheep, whereas plasma cis-9, trans-11 CLA, regardless of the diets, was decreased (P

  16. Genotype-Specific Steroid Profiles Associated With Aldosterone-Producing Adenomas

    NARCIS (Netherlands)

    Williams, T.A.; Peitzsch, M.; Dietz, A.S.; Dekkers, T.; Bidlingmaier, M.; Riester, A.; Treitl, M.; Rhayem, Y.; Beuschlein, F.; Lenders, J.W.M.; Deinum, J.; Eisenhofer, G.; Reincke, M.

    2016-01-01

    Primary aldosteronism comprises 2 main subtypes: unilateral aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia. Somatic KCNJ5 mutations are found in APA at a prevalence of around 40% that drive and sustain aldosterone excess. Somatic APA mutations have been described in other

  17. Pain Management, Local Infection, Satisfaction, Adverse Effects and Residual Pain after Major Open Abdominal Surgery: Epidural versus Continuous Wound Infusion (PAMA Trial)

    OpenAIRE

    Rita Araújo; Céline Marques; David Fernandes; Emanuel Almeida; Joana Alves; Mariana Rodrigues; Miguel Ferreira; Ricardo Bernardo; Rita Santa-Bárbara; Sara de Freitas; Célia Xavier; Isabel Neves

    2017-01-01

    Introduction: The Management of postoperative pain after abdominal surgery is a major challenge to the anesthesiologist. The optimization of postoperative analgesia improves prognosis contributing also to patient satisfaction and reducing morbidity and mortality. The aim of this randomized control study is to perform the comparative analysis in terms of effectiveness of an unconventional and still poorly technique implemented, continuous wound infusion, and the currently most applied and gold...

  18. Myocardial ultrasonic backscatter in hypertension: relation to aldosterone and endothelin.

    Science.gov (United States)

    Kozàkovà, Michaela; Buralli, Simona; Palombo, Carlo; Bernini, Giampaolo; Moretti, Angelica; Favilla, Stefania; Taddei, Stefano; Salvetti, Antonio

    2003-02-01

    A disproportionate accumulation of fibrillar collagen is a characteristic feature of hypertensive heart disease, but the extent of myocardial fibrosis may differ in different models of hypertension. In experimental studies, aldosterone and endothelins emerge as important determinants of myocardial fibrosis. Changes in myocardial extracellular matrix and collagen deposition can be estimated noninvasively by analysis of the ultrasonic backscatter signal, which arises from tissue heterogeneity within the myocardium and describes myocardial texture. This study was designed to investigate the relations between myocardial integrated backscatter and circulating aldosterone and immunoreactive endothelin in human hypertension. The study population consisted of 56 subjects: 14 healthy normotensive volunteers and 42 hypertensive patients (14 with primary aldosteronism, 7 with renovascular hypertension, and 21 with essential hypertension). The patients with essential and secondary hypertension were matched for age, gender, body mass index, and blood pressure. Myocardial integrated backscatter at diastole was 19.8+/-2.0 and 20.8+/-2.9 decibels in normotensive control subjects and patients with essential hypertension and significantly higher in patients with primary aldosteronism (27.4+/-3.8 decibels, P<0.01) and renovascular hypertension (26.8+/-4.8 decibels, P<0.01). In the population as a whole, as well as in the hypertensive subpopulation, myocardial integrated backscatter was directly related to plasma aldosterone (r=0.73 and 0.71, P<0.01 for both) and immunoreactive endothelin (r=0.60 and 0.56, P<0.01 for both). The data of this study suggest that in human hypertension, circulating aldosterone and immunoreactive endothelin may induce alterations in left ventricular myocardial texture, possibly related to increased myocardial collagen content.

  19. Raised Plasma Aldosterone and Natriuretic Peptides in Atrial Fibrillation

    DEFF Research Database (Denmark)

    Dixen, Ulrik; Ravn, Lasse Steen; Soeby-Rasmussen, Christian

    2006-01-01

    with earlier, documented AF in relation to present heart rhythm, clinical data, and the left ventricular ejection fraction (LVEF). We hypothesized that increased levels of aldosterone and natriuretic peptides were significantly associated with present AF as markers of RAAS activation during the arrhythmia....... METHODS: We studied 158 patients with earlier ECG-documented AF followed by restored sinus rhythm (SR) attending a follow-up visit 2.6 years (mean) after primary inclusion. RESULTS: At follow-up, 93 patients had SR. Heart rhythm at follow-up visit (SR/AF), plasma aldosterone, plasma N-terminal pro Brain...

  20. EFFECTS OF GLUCOSE-INFUSION ON HORMONE-SECRETION AND HEPATIC GLUCOSE-PRODUCTION DURING HEAVY EXERCISE

    NARCIS (Netherlands)

    WIERSMA, MML; VISSING, J; STEFFENS, AB; GALBO, H

    1993-01-01

    Blood-borne metabolic feedback vs. neural feedforward regulation of glucose homeostasis during exercise was investigated by infusing glucose and [H-3]glucose for glucose appearance determination intravenously in rats running for 20 min at 28 m/min [almost-equal-to 85% of maximal 02 consumption

  1. Distinctive effect of 6% hydroxyethyl starch 130/0.4 (Voluven) infusion on pediatric patients with congenital heart disease.

    Science.gov (United States)

    Zhang, J-Z; Liu, J-S; Zhang, S-H; Huang, S-Y; Zhang, J-J; Zhou, J; Zhou, J-H

    2017-03-01

    It has not been clear that Voluven (6% hydroxyethyl starch 130/0.4) may be administered in pediatric patients safely. The purpose of this study was to determine if Voluven could be used for blood volume expansion and hypovolemia prevention in pediatric patients with congenital heart disease. 50 pediatric patients with congenital heart disease were recruited in the study. Circulatory and respiratory parameters were determined to monitor the responses to intravenous infusion of Voluven in the patients. Intravenous infusion of Voluven significantly increased levels of colloid osmotic pressure and central venous pressure, but decreased levels of hemoglobin in the patients. Voluven infusion did not significantly affect colloid osmotic pressure, central venous pressure, hemoglobin and heart rate in the preschool children (heart rate in the young child patients. Also, there was the similar response, i.e. increased colloid osmotic pressure, to Voluven infusion in both female child patients and patients with atrial septal defect. Voluven may be used in pediatric patients with congenital heart disease, but not in the preschool child patients. Furthermore, special attention should be paid to the intravenous administration of Voluven for blood volume expansion and hypovolemia prevention in female pediatric patients and child patients with atrial septal defect.

  2. Continuous intraperitoneal insulin infusion versus subcutaneous insulin therapy in the treatment of type 1 diabetes: effects on glycemic variability

    NARCIS (Netherlands)

    van Dijk, Peter R.; Groenier, Klaas H.; DeVries, J. Hans; Gans, Reinold O. B.; Kleefstra, Nanno; Bilo, Henk J. G.; Logtenberg, Susan J. J.

    2015-01-01

    As continuous intraperitoneal insulin infusion (CIPII) results in a more physiologic action of insulin than subcutaneous (SC) insulin administration, we hypothesized that CIPII would result in less glycemic variability (GV) than SC insulin therapy among type 1 diabetes mellitus (T1DM) patients. Data

  3. Time-dependent effects of neuropeptide Y infusion in the paraventricular hypothalamus on ingestive and associated behaviors in rats

    NARCIS (Netherlands)

    van Dijk, G; Strubbe, JH

    In this study the role of neuropeptide Y (NPY) in the paraventricular nucleus of the hypothalamus (PVN) in the daily regulation of feeding, drinking, locomotor activity, and nestbox occupation was investigated. These behaviors were recorded during and after bilateral infusion of NPY into the PVN of

  4. Effect of purified wastewater from the city of Settat (Morocco on the quality of Lippia citriodora essential oil and infusion

    Directory of Open Access Journals (Sweden)

    Fatima Bensabah

    2015-06-01

    The infusion of L. citriodora prepared by the fresh and dried leaves irrigated with wastewater contains a high concentration of NH4+, Ca2+, Mg2+, and the concentration of NO2–N (mg/L exceeds 100% of the concentration of waste water.

  5. Effects of a research-infused botanical curriculum on undergraduates' content knowledge, STEM competencies, and attitudes toward plant sciences.

    Science.gov (United States)

    Ward, Jennifer Rhode; Clarke, H David; Horton, Jonathan L

    2014-01-01

    In response to the American Association for the Advancement of Science's Vision and Change in Undergraduate Biology Education initiative, we infused authentic, plant-based research into majors' courses at a public liberal arts university. Faculty members designed a financially sustainable pedagogical approach, utilizing vertically integrated curricular modules based on undergraduate researchers' field and laboratory projects. Our goals were to 1) teach botanical concepts, from cells to ecosystems; 2) strengthen competencies in statistical analysis and scientific writing; 3) pique plant science interest; and 4) allow all undergraduates to contribute to genuine research. Our series of inquiry-centered exercises mitigated potential faculty barriers to adopting research-rich curricula, facilitating teaching/research balance by gathering publishable scholarly data during laboratory class periods. Student competencies were assessed with pre- and postcourse quizzes and rubric-graded papers, and attitudes were evaluated with pre- and postcourse surveys. Our revised curriculum increased students' knowledge and awareness of plant science topics, improved scientific writing, enhanced statistical knowledge, and boosted interest in conducting research. More than 300 classroom students have participated in our program, and data generated from these modules' assessment allowed faculty and students to present 28 contributed talks or posters and publish three papers in 4 yr. Future steps include analyzing the effects of repeated module exposure on student learning and creating a regional consortium to increase our project's pedagogical impact. © 2014 J. R. Ward et al. CBE—Life Sciences Education © 2014 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http

  6. Immunological effects of donor lymphocyte infusion in patients with chronic myelogenous leukemia relapsing after bone marrow transplantation

    Directory of Open Access Journals (Sweden)

    Castro F.A.

    2004-01-01

    Full Text Available Allogeneic bone marrow transplantation (alloBMT is the only curative therapy for chronic myelogenous leukemia (CML. This success is explained by the delivery of high doses of antineoplastic agents followed by the rescue of marrow function and the induction of graft-versus-leukemia reaction mediated by allogeneic lymphocytes against host tumor cells. This reaction can also be induced by donor lymphocyte infusion (DLI producing remission in most patients with CML who relapse after alloBMT. The immunological mechanisms involved in DLI therapy are poorly understood. We studied five CML patients in the chronic phase, who received DLI after relapsing from an HLA-identical BMT. Using flow cytometry we evaluated cellular activation and apoptosis, NK cytotoxicity, lymphocytes producing cytokines (IL-2, IL-4 and IFN-gamma, and unstimulated (in vivo lymphocyte proliferation. In three CML patients who achieved hematological and/or cytogenetic remission after DLI we observed an increase of the percent of activation markers on T and NK cells (CD3/DR, CD3/CD25 and CD56/DR, of lymphocytes producing IL-2 and IFN-gamma, of NK activity, and of in vivo lymphocyte proliferation. These changes were not observed consistently in two of the five patients who did not achieve complete remission with DLI. The percent of apoptotic markers (Fas, FasL and Bcl-2 on lymphocytes and CD34-positive cells did not change after DLI throughout the different study periods. Taken together, these preliminary results suggest that the therapeutic effect of DLI in the chronic phase of CML is mediated by classic cytotoxic and proliferative events involving T and NK cells but not by the Fas pathway of apoptosis.

  7. Intramammary infusion of Escherichia coli lipopolysaccharide negatively affects feed intake, chewing, and clinical variables, but some effects are stronger in cows experiencing subacute rumen acidosis.

    Science.gov (United States)

    Aditya, S; Humer, E; Pourazad, P; Khiaosa-Ard, R; Huber, J; Zebeli, Q

    2017-02-01

    somatic cell counts, protein, and fat contents in milk as well as decreased lactose contents and pH following the LPS infusion, whereby the changes in milk constituents were more pronounced in SARA-LPS than CON-LPS cows. Rectal temperature and pulse rate were highest 6 h after LPS infusion, but rumen contractions were not affected by the LPS infusion. The data suggest that a single intramammary LPS infusion induced fever and negatively affected feed intake, chewing activity, rectal temperature, and milk yield and composition, whereby these effects were more pronounced in SARA cows. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  8. Patient Controlled Epidural Analgesia during Labour: Effect of Addition of Background Infusion on Quality of Analgesia & Maternal Satisfaction

    Directory of Open Access Journals (Sweden)

    Uma Srivastava

    2009-01-01

    Full Text Available Patient controlled epidural analgesia (PCEA is a well established technique for pain relief during labor. But the inclusion of continuous background infusion to PCEA is controversial. The aim of this study was to assess whether the use of continuous infusion along with PCEA was beneficial for laboring women with regards to quality of analgesia, maternal satisfaction and neonatal outcome in comparison to PCEA alone. Fifty five parturients received epidural bolus of 10ml solution containing 0.125% bupivacaine +2 ìg.ml-1 of fentanyl. For maintenance of analgesia the patients of Group PCEA self administered 8 ml bolus with lockout interval of 20 minutes of above solution on demand with no basal infusion. While the patients of Group PCEA + CI received continuous epidural infusion at the rate of 10 ml.hr-1 along with self administered boluses of 3 ml with lockout interval of 10 minutes of similar epidural solution. Patients of both groups were given rescue boluses by the anaesthetists for distressing pain. Verbal analogue pain scores, incidence of distressing pain, need of supplementary/rescue boluses, dose of bupivacaine consumed, maternal satisfaction and neonatal Apgar scores were recorded. No significant difference was observed between mean VAS pain scores during labor, maternal satisfaction, mode of delivery or neonatal Apgar scores. But more patients (n=8 required rescue boluses in PCEA group for distressing pain. The total volume consumed of bupivacaine and opioid was slightly more in PCEA + CI group. In both the techniques the highest sensory level, degree of motor block were comparable& prolongation of labor was not seen. It was concluded that both the techniques provided equivalent labor analgesia, maternal satisfaction and neonatal Apgar scores. PCEA along with continuous infusion at the rate of 10 ml/ hr resulted in lesser incidence of distressing pain and need for rescue analgesic. Although this group consumed higher dose of bupivacaine

  9. Effects of a 7-day continuous infusion of octreotide on circulating levels of growth factors and binding proteins in growth hormone (GH)-treated GH-deficient patients

    DEFF Research Database (Denmark)

    Laursen, Torben; Møller, Jens; Fisker, Sanne

    1999-01-01

    were studied for 24 h after each of the following treatment regimens (each of 1 weeks duration): (a) daily s.c. GH injection (2 IU/m(2)); (b) as (a) + continuous s.c. infusion of OCT (200 microg/24 h) by means of a portable pump (Nordic Infuser); (c) no treatment. Serum GH binding protein (GHBP) levels......-II, IGFBP-3, and ALS were recorded (Pinsulin levels (pmol/l) were significantly higher after GH alone as compared with no GH (P...' administration of OCT to GH-treated GHD patients slightly attenuated serum IGF-I generation, and tended to decrease levels of the other components of the 150 kDa ternary complex. Whether these effects are mediated directly by OCT or indirectly via the accompanying changes in insulin levels remains...

  10. Effect of continuous subcutaneous insulin pump infusion on glucolipid metabolism as well as inflammation and oxidative stress in placenta of patients with GDM

    Directory of Open Access Journals (Sweden)

    Liu Jie

    2017-05-01

    Full Text Available Objective: To study the effect of continuous subcutaneous insulin pump infusion on glucolipid metabolism as well as inflammation and oxidative stress in placenta of patients with gestational diabetes mellitus (GDM. Methods: Patients with GDM who received insulin therapy between March 2013 and May 2016 were selected as the research subjects and randomly divided into multiple subcutaneous insulin injection (MSII group and continuous subcutaneous insulin pump infusion (CSII group. Before and after treatment, serum glucolipid metabolism as well as inflammation and oxidative stress inexes in placenta were determined respectively. Results: 2 weeks and 4 weeks after treatment, FBG, 1hPBG, 2hPBG, Chemerin, Vaspin and Visfatin levels of both groups of patients were significantly lower than those before treatment and FBG, 1hPBG, 2hPBG, Chemerin, Vaspin and Visfatin levels of CSII group were significantly lower than those of MSII group; after delivery, TNF-α, IL-6, ROS and AGEs levels in placenta of CSII group were significantly lower than those of MSII group. Conclusion: Continuous subcutaneous insulin infusion can more effectively improve the glucolipid metabolism and inhibit the inflammation and oxidative stress in placenta of patients with GDM than multiple subcutaneous insulin injection.

  11. Effects of injection-site splinting on the incidence of phlebitis in patients taking peripherally infused amiodarone: A randomized clinical trial.

    Science.gov (United States)

    Ayat-Isfahani, Farah; Pashang, Mina; Davoudi, Bita; Sadeghian, Saeed; Jalali, Arash

    2017-03-01

    Intravenous amiodarone is considered an effective treatment option for cardiac ventricular and atrial arrhythmias. Peripheral infusion of amiodarone may cause blood vessels irritation and phlebitis that is the most common complication of this drug by this route even when it is administered within recommended dosing limits. The effect of injection-site splinting on the occurrence of phlebitis among a group of cardiac arrhythmia patients receiving peripherally infused amiodarone. This research is a clinical trial on patients of Tehran Heart Center who were hospitalized due to cardiac arrhythmias. A sample of 60 patients with mean age 65 ± 14 years were randomly divided into control and test groups. In the experimental group with close splint and restrict the movement of the injection site until the end of the infusion and control groups without closing brace, at the same time received amiodarone. Injection protocol was similar for both groups. The results were analyzed with Spss18. The results of this research still significantly reduced the incidence of amiodarone injection-site phlebitis in the injection time (P = .005). Copyright © 2016 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

  12. Effect of Perioperative Intravenous Lidocaine Infusion on Acute and Chronic Pain after Breast Surgery: A Meta-Analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Chang, Yuan-Ching; Liu, Chien-Liang; Liu, Tsang-Pai; Yang, Po-Sheng; Chen, Ming-Jen; Cheng, Shih-Ping

    2017-03-01

    Intravenous lidocaine infusion has been shown to reduce postoperative pain among patients undergoing abdominal surgery. This study aimed to evaluate the effects of perioperative lidocaine administration in breast surgery. A meta-analysis of randomized controlled trials comparing lidocaine infusion vs. placebo/routine treatment was performed. Standardized mean difference (SMD) or risk ratio (RR) with 95% confidence intervals (CIs) was calculated from pooled data. Random-effects models were used, and heterogeneity was assessed. A total of 4 reports (3 primary studies and 1 extension) with 84 patients randomized to the lidocaine group and 83 patients randomized to the control group were included. There was no difference in pain scores at rest or during activity between the 2 groups from postoperative 2 hours to 3 days. At postoperative 72 hours, the lidocaine group had fewer analgesics consumed (SMD, -0.479; 95% CI, -0.914 to -0.043; P = 0.031). Chronic pain was assessed 3 to 6 months after breast surgery in 51 patients of the lidocaine group and 46 patients of the control group. Patients in the lidocaine group had significantly lower risk for the development of chronic pain (RR, 0.332; 95% CI, 0.141 to 0.781; P = 0.012). The results indicate no significant benefits of intravenous lidocaine infusion in terms of acute postoperative pain. Although lidocaine seems to attenuate the risk of chronic pain after breast surgery, there is insufficient evidence to conclude that lidocaine infusion is of proved benefit because the results were based on a limited number of small trials. © 2016 World Institute of Pain.

  13. Calcium gluconate infusion is as effective as the vascular endothelial growth factor antagonist cabergoline for the prevention of ovarian hyperstimulation syndrome

    Directory of Open Access Journals (Sweden)

    Nikita Naredi

    2013-01-01

    Full Text Available Background: Ovarian hyperstimulation syndrome (OHSS is an iatrogenic and potentially life-threatening disease process, which may occur in healthy young women undergoing controlled ovarian hyperstimulation for assisted reproduction. As the treatment is largely empirical, prevention forms the mainstay of management. Objective: The present study was aimed to evaluate the effectiveness of intravenous (IV calcium gluconate infusion in comparison to the dopamine agonist cabergoline (Cb2 in preventing OHSS in high risk patients undergoing assisted reproductive technique cycles. Materials and Methods: It was a comparative study wherein the 202 high risk patients undergoing in vitro-fertilization over a period of 18 months after meeting the strict inclusion and the exclusion criteria, were randomly divided into two groups (98 subjects in Group I and 104 in Group II. Women in Group I were administered IV calcium gluconate while the remaining 104 received the dopamine agonist Cb2. The 104 patients belonging to Group II were started Cb2 0.5 mg/day from the day of ovulation trigger and continued until the next 8 days while the 98 high risk patients from Group I were infused with 10 ml of 10% calcium gluconate solution in 200 ml physiologic saline within 30 min of ovum pick up and continued thereafter on day 1, day 2 and day 3. Results: The occurrence of OHSS was seen in only nine patients (in the calcium infusion group, when compared with 16 patients (9.2% vs. 15.4% who were administered Cb2, but it was not statistically significant. However, only one had severe OHSS in Group I, whereas two women were diagnosed as severe OHSS belonging to the Cb2 arm. Conclusion: Our results document that calcium infusion can effectively prevent severe OHSS and decreases OHSS occurrence rates when used for high-risk patients, but does not suggest its superiority over Cb2. With comparable success rates, either of them can be employed as a preventive strategy for OHSS.

  14. Effects of low dietary cation-anion difference induced by ruminal ammonium chloride infusion on performance, serum, and urine metabolites of lactating dairy cows.

    Science.gov (United States)

    Wang, Kun; Nan, Xuemei; Zhao, Puyi; Liu, Wei; Drackley, James; Liu, Shijie; Zhang, Kaizhan; Bu, Dengpan

    2017-11-03

    The objective of the present study was to determine ammonium chloride tolerance of lactating dairy cows, by examining effects of negative DCAD induced by ruminal ammonium chloride infusion on performance, serum and urine minerals, serum metabolites and enzymes of lactating dairy cows. Four primiparous lactating Chinese Holstein cows fitted with ruminal cannulas were infused with increasing amounts (0, 150, 300, or 450 g/d) of ammonium chloride in a crossover design. The DCAD of the base diet was 279 mEq/kg DM using the DCAD formula (Na + K - Cl - S)/kg of DM. Ammonium chloride infusion added the equivalent of 0, 128, 330, and 536 mEq/kg DM of Cl in treatments. According to the different dry matter intakes, the resulting actual DCAD of the four treatments was 279, 151, -51 and -257 mEq/kg DM, respectively. DMI decreased linearly as DCAD decreased. Yields of milk, 4% FCM, ECM, milk fat, and milk protein decreased linearly as DCAD decreased. Concentrations of milk protein and MUN increased linearly with decreasing DCAD. Concentration of Cl- in serum increased linearly and concentration of PO43- in serum increased quadratically as DCAD decreased. Urine pH decreased linearly and calculated urine volume increased linearly with decreasing DCAD. Linear increases in daily urinary excretion of Cl-, Ca2+, PO43-, urea N, and ammonium were observed as DCAD decreased. Activities of alanine aminotransferase, aspartate aminotransferase, and γ-glutamyl transferase in serum and urea N concentration in serum increased linearly as DCAD decreased. In conclusion, negative DCAD induced by ruminal ammonium chloride infusion resulted in a metabolic acidosis, had a negative influence on performance, and increased serum enzymes indicating potential liver and kidney damage in lactating dairy cows. Daily ammonium chloride intake by lactating dairy cows should not exceed 300 g, and 150 g/d per cow may.

  15. Effect of infusion of spices into the oil vs. combined malaxation of olive paste and spices on quality of naturally flavoured virgin olive oils.

    Science.gov (United States)

    Caponio, Francesco; Durante, Viviana; Varva, Gabriella; Silletti, Roccangelo; Previtali, Maria Assunta; Viggiani, Ilaria; Squeo, Giacomo; Summo, Carmine; Pasqualone, Antonella; Gomes, Tommaso; Baiano, Antonietta

    2016-07-01

    Olive oil flavouring with aromatic plants and spices is a traditional practice in Mediterranean gastronomy. The aim of this work was to compare the influence of two different flavouring techniques (infusion of spices into the oil vs. combined malaxation of olives paste and spices) on chemical and sensory quality of flavoured olive oil. In particular, oxidative and hydrolytic degradation (by routine and non-conventional analyses), phenolic profiles (by HPLC), volatile compounds (by SPME-GC/MS), antioxidant activity, and sensory properties (by a trained panel and by consumers) of the oils were evaluated. The obtained results evidenced that the malaxation method was more effective in extracting the phenolic compounds, with a significantly lower level of hydrolysis of secoiridoids. As a consequence, antioxidant activity was significantly lower in the oils obtained by infusion, which were characterized by a higher extent of the oxidative degradation. The volatile compounds were not significantly influenced by changing the flavouring method, apart for sulfur compounds that were more abundant in the oils obtained by the combined malaxation method. From a sensory point of view, more intense bitter and pungent tastes were perceived when the infusion method was adopted. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Effect of time duration of ruminal urea infusions on ruminal ammonia concentrations and portal-drained visceral extraction of arterial urea-N in lactating Holstein cows

    DEFF Research Database (Denmark)

    Røjen, Betina Amdisen; Kristensen, Niels Bastian

    2012-01-01

    investigated. Three Danish Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in major splanchnic blood vessels were randomly allocated to a 3 × 3 Latin square design with 21-d periods. Treatments were ventral ruminal infusion of water for 24h (water INF), 24-h infusion of 15g...... concentration was observed. The portal flux of urea-N was not affected by treatment (i.e., even the combination of low ruminal ammonia and high arterial urea-N concentration with 6-h INF was not used by the cow to increase the uptake of urea-N across the PDV). Arterial urea-N extraction across the PDV......The effects of a 6 versus 24h ruminal urea infusion in lactating dairy cows fed a basal diet deficient in N on ruminal ammonia concentration, arterial urea-N concentration, net portal-drained viscera (PDV) urea-N flux, arterial urea-N extraction across the PDV, and renal urea-N kinetics were...

  17. Effect of localised antibiotic infusions applied to the teat-canal and teat sinus at drying-off on mastitis in the dry-period and at calving.

    Science.gov (United States)

    Woolford, M W; Williamson, J H; Day, T M; Lacy-Hulbert, S J; Henderson, H V

    2001-11-01

    An experiment using three New Zealand herds and a total of 632 cows, examined the effect of localised prophylactic treatments with antibiotic at drying-off on the incidence of new intramammary infection during the dry period and at calving. Antibiotic was infused either into the teat canal (0.22 g of dry-cow formulation) or the teat sinus (3.1 g of lactating-cow formulation) of uninfected quarters to eliminate any bacteria present in these locations at the last milking of lactation. These treatments were compared with a negative control (nil treatment) and a positive antibiotic control (infusion of 3.6 g of dry-cow formulation). All antibiotic formulations used the same active ingredient, sodium cloxacillin. No significant reduction in new dry period clinical mastitis was observed for the two localised treatments whereas the positive control treatment achieved 100% reduction in new clinical mastitis compared with untreated control quarters. A 41% reduction (P < 0.05) in new Streptococcus uberis infections at calving was associated with the teat canal antibiotic treatment, compared with an 82% reduction (P < 0.001) for the positive antibiotic control. Both localised treatments showed a reduced incidence of new intramammary infection (P < 0.001) when pooled across periods and pathogens. Teats receiving either the teat canal antibiotic treatment or a full infusion of long acting dry-cow antibiotic had a lower incidence of open teat canals (P < 0.05) at 3 weeks after drying-off.

  18. Renin angiotensin aldosterone system in anaphylactic reactions induced by immunotherapy

    Directory of Open Access Journals (Sweden)

    Mehmet Karaayvaz

    1998-01-01

    Full Text Available Although patients with a history of hymenoptera venom anaphylaxis showed significantly reduced plasma levels of angiotensin-I and angiotensin-II compared to controls, there is no study in the literature to investigate the renin angiotensin aldosterone system (RAAS in patients with anaphylactic reaction induced by immunotherapy. The purpose of this study is to determine the role of the renin angiotensin aldosterone system in patients who had an anaphylactic reaction induced by allergen immunotherapy with pollen, house-dust and mold extracts. Plasma levels of angiotensin-I, angiotensin-II, angiotensin converting enzyme and aldosterone were measured in 20 patients who experienced anaphylaxis during allergen immunotherapy. The control group consisted of 15 immunotherapy patients without any history of anaphylaxis. The Mann–Whitney U-test was performed for comparison of the two groups, and a P value less than 0.05 was considered statistically significant. Angiotensin-I, angiotensin-II, angiotensin converting enzyme and aldosterone levels were similar in both the study and control groups and no statistical significance was found between the two groups (P > 0.05. The RAAS does not appear to play a role in the pathogenesis of anaphylactic reactions due to allergen immunotherapy with pollen, house-dust and mold extracts.

  19. 21 CFR 862.1045 - Aldosterone test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Aldosterone test system. 862.1045 Section 862.1045 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862...

  20. Effect of time duration of ruminal urea infusions on ruminal ammonia concentrations and portal-drained visceral extraction of arterial urea-N in lactating Holstein cows.

    Science.gov (United States)

    Røjen, B A; Kristensen, N B

    2012-03-01

    The effects of a 6 versus 24h ruminal urea infusion in lactating dairy cows fed a basal diet deficient in N on ruminal ammonia concentration, arterial urea-N concentration, net portal-drained viscera (PDV) urea-N flux, arterial urea-N extraction across the PDV, and renal urea-N kinetics were investigated. Three Danish Holstein cows fitted with ruminal cannulas and permanent indwelling catheters in major splanchnic blood vessels were randomly allocated to a 3 × 3 Latin square design with 21-d periods. Treatments were ventral ruminal infusion of water for 24h (water INF), 24-h infusion of 15 g of urea/kg of dry matter intake (DMI; 24-h INF), and 6-h infusion of 15 g of urea/kg of DMI (6-h INF). The 6-h INF was initiated 0.5h after the afternoon feeding, and ran until 2230 h. Eight sample sets of arterial, portal, and hepatic blood, ruminal fluid, and urine were obtained at 0.5h before the morning feeding and 0.5, 1.5, 2.5, 3.5, 4.5, 5.5, and 6.5h after feeding (i.e., 9 to 15.5h after the 6h infusion was terminated). A substantial decrease in DMI for 6-h INF compared with 24-h INF and water INF was observed, and it has to be recognized that DMI may have confounding effects. However, the experimental setting plan was met (i.e., to cause changes in the daily pattern of ruminal ammonia and blood urea-N concentrations). The arterial urea-N concentration for 24-h INF and 6-h INF were greater than the arterial urea-N concentration with water INF throughout the sampling window. However, the arterial urea-N concentration for 6-h INF decreased steadily with sampling time reflecting a carryover effect from the ruminal urea infusion. The ruminal ammonia concentration and net portal flux of ammonia for 6-h INF were not different from water INF; hence, no carryover effect on ruminal ammonia concentration was observed. The portal flux of urea-N was not affected by treatment (i.e., even the combination of low ruminal ammonia and high arterial urea-N concentration with 6-h INF was

  1. Deleterious Effects of High Dose Connexin 43 Mimetic Peptide Infusion After Cerebral Ischaemia in Near-Term Fetal Sheep

    Directory of Open Access Journals (Sweden)

    Alistair J. Gunn

    2012-05-01

    Full Text Available Hypoxic-ischaemic brain injury at birth is associated with 1–3/1000 cases of moderate to severe encephalopathy. Previously, we have shown that connexin 43 hemichannel blockade, with a specific mimetic peptide, reduced the occurrence of seizures, improved recovery of EEG power and sleep state cycling, and improved cell survival following global cerebral ischaemia. In the present study, we examined the dose response for intracerebroventricular mimetic peptide infusion (50 µmol/kg/h for 1 h, followed by 50 µmol/kg/24 h (low dose or 50 µmol/kg/h for 25 h (high dose or vehicle only (control group, starting 90 min after the end of ischaemia, following global cerebral ischaemia, induced by 30 min bilateral carotid artery occlusion, in near-term fetal sheep (128 ± 1 days gestation. Both peptide infusion groups were associated with a transient significant increase in EEG power between 2–12 h after ischaemia. The ischaemia-low dose group showed a significant recovery of EEG power from day five compared to the ischaemia-vehicle and -high dose groups. In contrast, the high dose infusion was associated with greater secondary increase in impedance (brain cell swelling, as well as a trend towards a greater increase in lactate concentration and mortality. These data suggest that higher doses of connexin mimetic peptide are not beneficial and may be associated with adverse outcomes, most likely attributable to uncoupling of connexin 43 gap junctions leading to dysfunction of the astrocytic syncytium.

  2. [Primary aldosteronism and pregnancy: report of 2 cases].

    Science.gov (United States)

    Germain, Alfredo M; Kottman, Cristián; Valdés, Gloria

    2002-12-01

    Based on two patients, we discuss the difficulties in diagnosing and managing primary aldosteronism in pregnancy, which derive from changes of the renin-angiotensin-aldosterone axis, from the uncertainty regarding blood pressure control along gestation and postpartum, and from the contraindication to the use of spironolactone. The first case is a 27 years old woman with a long standing refractory hypertension, a hemorrhagic stroke with left brachial hemiplegia and crural hemiparesia, two miscarriages, one stillbirth and one offspring with intrauterine growth retardation. Due to hypokalemia, a plasma aldosterone/renin activity ratio of 91, and a negative genetic screening for glucocorticoid remediable aldosteronism (GRA), a primary hyperaldosteronism with normal adrenals in CT scan was diagnosed, and good blood pressure control was attained with spironolactone. After two and a half years of normotension, a fifth pregnancy, managed with methyldopa evolved with satisfactory blood pressures, plasma potassium, fetal growth, uterine and umbilical arterial resistance indexes, and maternal endothelial function. At 37 1/2 weeks of pregnancy the patient delivered a healthy newborn weighing 2,960 g. Blood pressure rose during the 48 hours of postpartum in the absence of proteinuria and required i.v. hydralazine. The second patient is a 37 years old woman, with known refractory hypertension for 7 years, hypokalemia, plasma aldosterone/renin activity ratio greater than 40, normal adrenals in the CAT scan, and a negative genetic screening for GRA. She had normotensive pregnancies 5 and 3 years prior to the detection of hypertension, with hypertensive crisis in both postpartum periods, retrospectively considered as expressions of primary hyperaldosteronism.

  3. Aldosterone and renin in cardiac patients referred for catheterization.

    Science.gov (United States)

    Erne, Paul; Müller, Andrea; Rossi, Gian Paolo; Seifert, Burkhardt; Stehlin, Fabrice; Redondo, Maurice; Bauer, Peter T; Kobza, Richard; Resink, Therese J; Radovanovic, Dragana

    2017-06-01

    Little is known regarding alterations of the renin-angiotensin system in patients referred for cardiac catheterization. Here, we measured plasma levels of active renin and aldosterone in patients referred for cardiac catheterization in order to determine the prevalence of elevated renin, aldosterone, and the aldosterone-renin ratio.A chemiluminescence assay was used to measure plasma aldosterone concentration (PAC) and active renin levels in 833 consecutive patients, after an overnight fasting and without any medication for least 12 hours. We evaluated associations of the hormonal elevations in relation to hypertension, atrial fibrillation (AF), hypertensive cardiomyopathy, coronary artery disease (CAD), valvular disease, impaired left ventricular ejection fraction (LVEF 25 mm Hg).Hyperaldosteronism occurred in around one-third of all examined patients, without significant differences between patients with or without the named cardiac diseases. In a comparison between patients with or without any given cardiac disease condition, renin was significantly elevated in patients with either hypertension (36.4% vs 15.9%), CAD (33.9% vs 22.1%), or impaired LVEF (47.3% vs 24.8%). The angiotensin-renin ratio was elevated in AF patients and in patients with hypertensive cardiomyopathy. Patients with AF and coexisting hypertension had elevated renin more frequently than AF patients without coexisting hypertension (35.3% vs 16.5%; P  =  .005). Patients with persistent/permanent AF more frequently had elevated renin than patients with paroxysmal AF (34.1% vs 15.8%; P  =  .007).This prospective study of consecutive cardiac disease patients referred for cardiac catheterization has revealed distinct cardiac disease condition-associated differences in the frequencies of elevations in plasma renin, PAC, and the aldosterone-renin ratio.

  4. Infusion of low dose glyceryl trinitrate has no consistent effect on burrowing behavior, running wheel activity and light sensitivity in female rats

    DEFF Research Database (Denmark)

    Christensen, Sarah Louise T; Petersen, Steffen; Sørensen, Dorte Bratbo

    2016-01-01

    . In the current paper we have studied the effect of glyceryl trinitrate infusion on three different rat behaviors. Methods: The stability of burrowing behavior, running wheel activity and light sensitivity towards repeated testing was evaluated also with respect to estrous cycle. Finally, the effect of glyceryl...... trinitrate on these behaviors in female rats was observed. Results: Burrowing behavior and running wheel activity were stable in the individual rat between experiments. The burrowing behavior was significantly affected by the stage of estrous cycle. The other assays were stable throughout the cycle. None...

  5. No evidence of a clinically important effect of adding local infusion analgesia administrated through a catheter in pain treatment after total hip arthroplasty

    DEFF Research Database (Denmark)

    Specht, Kirsten; Leonhardt, Jane Schwartz; Revald, Peter

    2011-01-01

    with local infusion analgesia (LINFA) into the soft tissue in the hip region through a catheter in the first postoperative days has gained major interest in THA fast-track settings within a short period of time. LIA at the time of surgery is a validated treatment. We investigated the additional effect......Background and purpose Postoperative analgesia after primary total hip arthroplasty (THA) using opioids is associated with troublesome side effects such as nausea and dizziness, and epidural analgesic means delayed mobilization. Thus, local infiltration analgesia (LIA) during surgery prolonged...

  6. Neonatal Infusion Therapy

    Directory of Open Access Journals (Sweden)

    Ye. A. Zhukov

    2008-01-01

    compared with the control group (26±3.6 hours (p<0.001. In this group, generalized edema was also more rapidly abolished (on day 3 and blood protein stabilized to 54 g/l by day 4 of therapy. In the control group, these indices were achieved b days 7—9 of therapy. In addition, the duration of AV averaged 3 days in the study group and 7 days in the control group. It should be noted that in the study group the average volume of antishock infusion for BP stabilization was 70±7.3 ml or a third of daily liquid intake (DLI. In the control group, it was significantly higher: 180±9.5 ml or 1V4 of DLI (p<0.05. Conclusion. When highly concentrated albumin was used, no undesirable effects were observed in neonatal infants in the early postoperative period. In shock, 20% albumin promptly stabilized hemodynamic parameters, corrected hypoproteinemia, and reduced the duration of AV. With 20% albumin being used, the low volume of volemic load makes it possible to adequately correct electrolytic disorders and to initiate partial parenteral feeding as early as possible to compensate for energy expenditures. Key words: neonatal infants, shock, 20% albumin, hypovolemic states, neonatal intensive care, congenital malformations, neonatal surgery.

  7. Neuroprotective effects of hydrated fullerene C60: cortical and hippocampal EEG interplay in an amyloid-infused rat model of Alzheimer's disease.

    Science.gov (United States)

    Vorobyov, Vasily; Kaptsov, Vladimir; Gordon, Rita; Makarova, Ekaterina; Podolski, Igor; Sengpiel, Frank

    2015-01-01

    We studied the effects of fullerene C60 nanoparticles, namely hydrated fullerene C60 (C60HyFn), on interrelations between EEG frequency spectra from the frontal cortex and the dorsal hippocampus (CA1) on an amyloid-β (Aβ) rat model of Alzheimer's disease (AD). Infusion of Aβ1-42 protein (1.5 μl) into the CA1 region two weeks before EEG testing diminished hippocampal theta (3.8-8.4 Hz) predominance and eliminated cortical beta (12.9-26.2 Hz) predominance observed in baseline EEG of rats infused with saline (control) or with C60HyFn alone. In contrast, these Aβ1-42 effects were abolished in rats pretreated with C60HyFn, 30 min apart. Dopaminergic mediation in AD has been shown to be involved in neuronal plasticity and Aβ transformation in different ways. To clarify its role in the cortex-hippocampus interplay in the Aβ model of AD, we used peripheral injection of a dopamine agonist, apomorphine (APO), at a low dose (0.1 mg/kg). In rats infused with C60HyFn or Aβ1-42 alone, APO attenuated the cortical beta predominance, with immediate and delayed phases evident in the Aβ1-42-rats. Pretreatment with C60HyFn diminished the APO effect in the Aβ1-42-treated rats. Thus, we show that intrahippocampal injection of Aβ1-42 dramatically disrupts cortical versus hippocampal EEG interrelations and that pretreatment with the fullerene eliminates this abnormality. We suggest that some effects of C60HyFn may be mediated through presynaptic dopamine receptors and that water-soluble C60 fullerenes have a neuroprotective potential.

  8. Comparative study between fast and slow induction of propofol given by target-controlled infusion: expected propofol concentration at the effect site. Randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ricardo Francisco Simoni

    2015-04-01

    Full Text Available BACKGROUND AND OBJECTIVE: Studies have shown that the rate of propofol infusion may influence the predicted propofol concentration at the effect site (Es. The aim of this study was to evaluate the Es predicted by the Marsh pharmacokinetic model (ke0 0.26 min-1 in loss of consciousness during fast or slow induction. METHOD: The study included 28 patients randomly divided into two equal groups. In slow induction group (S, target-controlled infusion (TCI of propofol with plasma, Marsh pharmacokinetic model (ke0 0.26 min-1 with target concentration (Tc at 2.0-µg mL-1 were administered. When the predicted propofol concentration at the effect site (Es reached half of Es value, Es was increased to previous Es + 1 µg mL-1, successively, until loss of consciousness. In rapid induction group (R, patients were induced with TCI of propofol with plasma (6.0 µg mL-1 at effect site, and waited until loss of consciousness. RESULTS: In rapid induction group, Tc for loss of consciousness was significantly lower compared to slow induction group (1.67 ± 0.76 and 2.50 ± 0.56 µg mL-1, respectively, p = 0.004. CONCLUSION: The predicted propofol concentration at the effect site for loss of consciousness is different for rapid induction and slow induction, even with the same pharmacokinetic model of propofol and the same balance constant between plasma and effect site.

  9. Diet-dependent effects of insulin infusion on the hepatic lipoprotein receptors and the key enzymes of bile acid synthesis in the hamster.

    Science.gov (United States)

    Dubrac, S; Parquet, M; Gripois, D; Blouquit, M F; Sérougne, C; Loison, C; Lutton, C

    2001-10-12

    The effects of an induced hyperinsulinemia on both the cholesterol and bile acid metabolisms were analyzed in the hamster. The role of dietary sucrose as modulator of these effects was evaluated by feeding the animals with two semi-synthetic diets containing a low (SD, 20%) and a high (LD, 62.5%) sucrose proportion. Hamsters fed under basal nutritional conditions (chow diet, CD) were also used. LD enabled the consequences of an insulin infusion on cholesterol gallstone formation to be evaluated. Subcutaneous osmotic pumps were implanted in all the animals and delivered either 3 IU/day of insulin (insulin groups: CDI, SDI, LDI) or saline (control groups: CDC, SDC, LDC). Several parameters bound to lipid metabolism were measured. The plasma cholesterol concentration remained constant in all the insulin treated groups compared to the controls. Phospholipid and triglyceride concentrations decreased in both the plasma and liver in the CDI and SDI groups. A lower SR-BI mass (around 50%) was found in the liver of CDI and SDI hamsters with concomitant higher hydroxy-methyl-glutaryl coenzyme A reductase activity. The LDL-receptor mass and cholesterol 7alpha-hydroxylase activity in the LDI group were both decreased (-47%, -71% respectively). No variations in the cholesterol gallstone incidence were observed. In conclusion, chronic insulin infusion in growing hamsters induced similar effects on cholesterol metabolism in the CD and SD groups but different ones, between diets containing a low (SD) and a high (LD) sucrose proportion. The distribution of triglycerides and phospholipids in the plasma, liver and bile was also affected by the insulin infusion.

  10. Aldosterone induced galectin-3 secretion in vitro and in vivo: from cells to humans.

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    Yen-Hung Lin

    Full Text Available Patients with primary aldosteronism are associated with increased myocardial fibrosis. Galectin-3 is one of the most important mediators between macrophage activation and myocardial fibrosis.To investigate whether aldosterone induces galectin-3 secretion in vitro and in vivo.We investigated the possible molecular mechanism of aldosterone-induced galectin-3 secretion in macrophage cell lines (THP-1 and RAW 264.7 cells. Aldosterone induced galectin-3 secretion through mineralocorticoid receptors via the PI3K/Akt and NF-κB transcription signaling pathways. In addition, aldosterone-induced galectin-3 expression enhanced fibrosis-related factor expression in fibroblasts. We observed that galectin-3 mRNA from peripheral blood mononuclear cells and serum galectin-3 levels were both significantly increased in mice implanted with aldosterone pellets on days 7 and 14. We then conducted a prospective preliminary clinical study to investigate the association between aldosterone and galectin-3. Patients with aldosterone-producing adenoma had a significantly higher plasma galectin-3 level than patients with essential hypertension. One year after adrenalectomy, the plasma galectin-3 level had decreased significantly in the patients with aldosterone-producing adenoma.This study demonstrated that aldosterone could induce galectin-3 secretion in vitro and in vivo.

  11. Aldosterone Induced Galectin-3 Secretion In Vitro and In Vivo: From Cells to Humans

    Science.gov (United States)

    Lin, Yen-Hung; Chou, Chia-Hung; Wu, Xue-Ming; Chang, Yi-Yao; Hung, Chi-Sheng; Chen, Ying-Hsien; Tzeng, Yu-Lin; Wu, Vin-Cent; Ho, Yi-Lwun; Hsieh, Fon-Jou; Wu, Kwan-Dun

    2014-01-01

    Context Patients with primary aldosteronism are associated with increased myocardial fibrosis. Galectin-3 is one of the most important mediators between macrophage activation and myocardial fibrosis. Objective To investigate whether aldosterone induces galectin-3 secretion in vitro and in vivo. Methods and Results We investigated the possible molecular mechanism of aldosterone-induced galectin-3 secretion in macrophage cell lines (THP-1 and RAW 264.7 cells). Aldosterone induced galectin-3 secretion through mineralocorticoid receptors via the PI3K/Akt and NF-κB transcription signaling pathways. In addition, aldosterone-induced galectin-3 expression enhanced fibrosis-related factor expression in fibroblasts. We observed that galectin-3 mRNA from peripheral blood mononuclear cells and serum galectin-3 levels were both significantly increased in mice implanted with aldosterone pellets on days 7 and 14. We then conducted a prospective preliminary clinical study to investigate the association between aldosterone and galectin-3. Patients with aldosterone-producing adenoma had a significantly higher plasma galectin-3 level than patients with essential hypertension. One year after adrenalectomy, the plasma galectin-3 level had decreased significantly in the patients with aldosterone-producing adenoma. Conclusion This study demonstrated that aldosterone could induce galectin-3 secretion in vitro and in vivo. PMID:25180794

  12. Human adipose tissue blood flow during prolonged exercise, III. Effect of beta-adrenergic blockade, nicotinic acid and glucose infusion

    DEFF Research Database (Denmark)

    Bülow, J

    1981-01-01

    acid, during acute i.v. beta-adrenergic blockade by propranolol, and during continuous i.v. infusion of glucose. The most pronounced lipid mobilization and utilization during work was seen in the control experiments where ATBF rose 3-fold on average from the initial rest period to the third hour...... of work. No increase in lipolysis and no increase in ATBF were found when lipolysis was blocked by nicotinic acid (0.3 g/h). Propranolol treatment (0.15 mg/kg) reduced lipolysis and nearly abolished the increase in ATBF during exercise. Intravenous administration of glucose (about 0.25 g/min) did...

  13. Cardiovascular and metabolic effects of 48-h glucagon-like peptide-1 infusion in compensated chronic patients with heart failure

    DEFF Research Database (Denmark)

    Halbirk, Mads; Nørrelund, Helene; Møller, Niels

    2010-01-01

    )) and placebo infusion. At 0 and 48 h, LVEF, diastolic function, tissue Doppler regional myocardial function, exercise testing, noninvasive cardiac output, and brain natriuretic peptide (BNP) were measured. Blood pressure, heart rate, and metabolic parameters were recorded. Fifteen patients completed.......008) increased during GLP-1 treatment. Cardiac index (1.5 +/- 0.1 l.min(-1).m(-2) vs. 1.7 +/- 0.2 l.min(-1).m(-2); P = 0.54) and LVEF (30 +/- 2% vs. 30 +/- 2%; P = 0.93), tissue Doppler indexes, body weight, and BNP remained unchanged. Hypoglycemic events related to GLP-1 treatment were observed in eight...

  14. Modelling the Effect of Exercise on Insulin Pharmacokinetics in "Continuous Subcutaneous Insulin Infusion" Treated Type 1 Diabetes Patients

    DEFF Research Database (Denmark)

    Duun-Henriksen, Anne Katrine; Juhl, Rune; Schmidt, Signe

    infusion (CSII) treated patients by modelling the absorption rate as a function of exercise. Methods: Three models are estimated from 17 data sequences. All of them are based on a linear three-compartment base model. The models are based on stochastic differential equations to allow noise to enter...... the dynamics. In the first model, the insulin absorption rate parameter is replaced by a random walk. In the second model, the relationship between the absorption rate and exercise is modelled as a linear dependency, while in the third model this linear relationship depends on the intensity. A Lamperti...

  15. The effect of continuous low dose methylprednisolone infusion on inflammatory parameters in patients undergoing coronary artery bypass graft surgery: a randomized-controlled clinical trial.

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    Abbas Ghiasi

    2015-02-01

    Full Text Available This trial was performed to determine if a continuous low-dose infusion of methylprednisolone is as effective as its bolus of high-dose in reducing inflammatory response. The study was single-center, double-blinded randomized clinical trial and performed in a surgical intensive care unit of an academic hospital. In this study, 72 consecutive patients undergoing elective coronary artery bypass grafting (CABG were assigned to receive either a methylprednisolone loading dose (1mg/kg followed by continuous infusion (2mg/Kg/24 hours for 1 day (low-dose regime or a single dose of methylprednisolone (15 mg/kg before cardiopulmonary bypass (high dose regime. Serum concentrations of IL-6 and C- reactive protein (CRP were measured preoperatively and 6, 24 and 48 hours after surgery, and serum creatinine was measured before the operation and 24, 48 and 72 hours postoperatively. The measurements were then compared between the groups to evaluate the efficacy of each regimen. The basic characteristics and measurements were not different between the study groups. There was no significant difference in IL-6 and CRP elevation (P=0.52 and P=0.46, respectively. Early outcomes such as the length of stay in the intensive care unit, intubation time, changes in serum creatinine and blood glucose levels, inotropic support, insulin requirements, and rate of infection were also similar in both groups. A continuous low dose infusion of methylprednisolone was as effective as a single high dose methylprednisolone in reducing the inflammatory response after CABG with extracorporeal circulation with no significant difference in the postoperative measurements and outcomes.

  16. Analysis of the long term therapeutic effect of pre-operative installation of regional arterial infusion chemotherapy pump for advanced breast cancer

    Directory of Open Access Journals (Sweden)

    Jian-miao HE

    2014-10-01

    Full Text Available Objective To compare the long term therapeutic effects of the preoperative regional arterial infusion chemotherapy and the preoperative systemic venous chemotherapy in advanced breast cancer. Methods One hundred and eightysix patients with advanced breast cancer, admitted to the Department of General Surgery of PLA 309 Hospital from Jan. 2003 to Dec. 2008, were followed up for a long time. Of them 97 patients received preoperative regional arterial infusion chemotherapy (IAIC groups, and 89 patients received preoperative systemic vein chemotherapy (IVIC groups. The local recurrence rate, distant metastasis rate, overall survival rate (OS and disease free survival rate (DFS in the two groups were statistically analyzed, and the long term therapeutic effects of the two groups were compared. Results There were no statistically significant difference in distant metastasis rate (15.5% and14.6%, 1-year OS (99.0% and 96.6% and DFS (81.8% and 68.5%, and 3-year OS (88.7% and 79.8% between the two groups (P>0.05. While significant differences were found between the two groups (P<0.01 in post-operative local recurrence rate (7.2% and 18.0%, 3-year DFS (70.1% and 52.8%, and 5-year OS and DFS. Conclusion Compared with preoperative systemic venous chemotherapy, pre-operative regional arterial infusion chemotherapy can decrease the local recurrence rate, improve the 5-year total survival rate and disease free survival rate for advanced breast cancer. DOI: 10.11855/j.issn.0577-7402.2014.10.15

  17. Aldosterone breakthrough in dogs with naturally occurring myxomatous mitral valve disease.

    Science.gov (United States)

    Ames, M K; Atkins, C E; Eriksson, A; Hess, A M

    2017-06-01

    Aldosterone breakthrough (ABT) is the condition in which angiotensin converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers fail to effectively suppress the activity of the renin angiotensin aldosterone system. The objective of this study was to determine if ABT occurs in dogs with naturally occurring myxomatous mitral valve disease receiving an ACEI, using the urine aldosterone to creatinine ratio (UAldo:C) as a measure of renin angiotensin aldosterone system activation. This study includes 39 dogs with myxomatous mitral valve disease. A UAldo:C cut-off definition (derived from a normal population of healthy, adult, and client-owned dogs) was used to determine the prevalence of ABT in this population. Spearman analysis and univariate logistic regression were used to evaluate the relationship between UAldo:C and ABT (yes/no) and eight variables (age, serum K + concentration, serum creatinine concentration, ACEI therapy duration and ACEI dosage, furosemide therapy duration and furosemide dosage, and urine sample storage time). Finally, the UAldo:C in dogs receiving spironolactone, as part congestive heart failure (CHF) therapy, was compared to dogs with CHF that were not receiving spironolactone. The prevalence of ABT was 32% in dogs with CHF and 30% in dogs without CHF. There was no relationship between either the UAldo:C or the likelihood of ABT and the eight variables. Therapy with spironolactone lead to a significant elevation of the UAldo:C. Using the UAldo:C and a relatively stringent definition of ABT, it appears that incomplete RAAS blockade is common in dogs with MMVD receiving an ACEI. The prevalence of ABT in this canine population mirrors that reported in humans. While the mechanism of ABT is likely multifactorial and still poorly understood, the proven existence of ABT in dogs offers the potential to improve the prognosis for MMVD with the addition of a mineralocorticoid receptor blocker to current therapeutic regimens

  18. Effect of intramammary infusion of recombinant bovine GM-CSF and IL-8 on CMT score, somatic cell count, and milk mononuclear cell populations in Holstein cows with Staphylococcus aureus subclinical mastitis.

    Science.gov (United States)

    Kiku, Yoshio; Ozawa, Tomomi; Takahashi, Hideyuki; Kushibiki, Shiro; Inumaru, Shigeki; Shingu, Hiroyuki; Nagasawa, Yuya; Watanabe, Atsushi; Hata, Eiji; Hayashi, Tomohito

    2017-09-01

    The effect of intramammary infusion of recombinant bovine granulocyte-macrophage colony-stimulating factor (rbGM-CSF) and interleukin-8 (rbIL-8) on mononuclear cell populations in quarters, somatic cell count (SCC) and the California Mastitis Test (CMT) score were investigated. From the selected cows with naturally occurring Staphylococcus aureus subclinical mastitis, one quarter of each cow were selected for the infusions of rbGM-CSF (400 μg/5 mL/quarter, n = 9), rbIL-8 (1 mg/5 mL/quarter, n = 9), and phosphate-buffered saline (5 mL/quarter, n = 7). The CMT score of both cytokines post infusion temporarily increased between days 0 and 1 and significantly decreased between days 7 and 14 compared to the preinfusion level. The SCC on day 14 after infusions of rbGM-CSF tended to be lower than that of the control group. The percentage of CD14+ cells increased on days 1 and 2 post infusion of rbGM-CSF. The percentage of CD4+ and CD8+ cells also increased on days 2 and 3, suggesting that the infusion of rbGM-CSF enhanced cellular immunity in the mammary gland. In contrast, the percentage of CD14+ cells decreased on days 0.25 and 1 post infusion of rbIL-8. No significant changes in the percentages of CD4+ and CD8+ cells in milk after infusion of rbIL-8 were evident during the experimental period, which suggested that rbIL-8 had little effect on the function of T cells in the mammary gland. These results indicated that rbGM-CSF and rbIL-8 decreased the CMT score by a different mechanism and may have a potential as therapeutic agents for subclinical mastitis.

  19. Effect of carbohydrate counting using bolus calculators on glycemic control in type 1 diabetes patients during continuous subcutaneous insulin infusion.

    Science.gov (United States)

    Yamada, Eijiro; Okada, Shuichi; Nakajima, Yasuyo; Bastie, Claire C; Tagaya, Yuko; Osaki, Aya; Shimoda, Yoko; Shibusawa, Ryo; Saito, Tsugumichi; Ozawa, Atsushi; Yamada, Masanobu

    2017-07-01

    The present study examined the long-term efficacy of insulin pump therapy for type 1 diabetes patients when carried out using carbohydrate counting with bolus calculators for 1 year. A total of 22 type 1 diabetes patients who had just started continuous subcutaneous insulin infusion were examined and divided into two groups: one that was educated about carbohydrate counting using bolus calculators (n = 14); and another that did not use bolus calculators (n = 8). After 1 year, the hemoglobin A1c levels of the patient group that used bolus calculators decreased persistently and significantly (P = 0.0297), whereas those of the other group did not. The bodyweight, total daily dose of insulin and bolus percentage of both groups did not change. Carbohydrate counting using bolus calculators is necessary to achieve optimal and persistent glycemic control in patients undergoing continuous subcutaneous insulin infusion. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  20. Synthetic hydrogel scaffold is an effective vehicle for delivery of INFUSE (rhBMP2) to critical-sized calvaria bone defects in rats.

    Science.gov (United States)

    Mariner, Peter D; Wudel, Justin M; Miller, David E; Genova, E Erin; Streubel, Sven-Olrik; Anseth, Kristi S

    2013-03-01

    Medtronic's INFUSE Bone Graft provides surgeons with a potent tool for stimulating bone formation. Current delivery vehicles that rely on Absorbable Collagen Sponges (ACS) require excessive quantities of the active ingredient in INFUSE, recombinant human Bone Morphogenic Protein-2 (rhBMP2), to achieve physiologically relevant concentrations of the growth factor, driving up the cost of the product and increasing the likelihood of undesirable side effects in neighboring tissues. We demonstrate that a simple light-mediated, thiol-ene chemistry can be used to create an effective polymer delivery vehicle for rhBMP2, eliminating the use of xenographic materials and reducing the dose of rhBMP2 required to achieve therapeutic effects. Comprised entirely of synthetic components, this system entraps rhBMP2 within a biocompatible hydrogel scaffold that is degraded by naturally occurring remodeling enzymes, clearing the way for new tissue formation. When tested side-by-side with ACS in a critical-sized bone defect model in rats, this polymeric delivery system significantly increased bone formation over ACS controls. Copyright © 2012 Orthopaedic Research Society.

  1. Comparison of the effects of xylazine bolus versus medetomidine constant rate infusion on the stress response, urine production, and anesthetic recovery characteristics in horses anesthetized with isoflurane.

    Science.gov (United States)

    Creighton, Catherine M; Lemke, Kip A; Lamont, Leigh A; Horney, Barbara S; Doyle, Aimie J

    2012-04-15

    To compare the effect of xylazine bolus versus medetomidine constant rate infusion (MCRI) on serum cortisol and glucose concentrations, urine production, and anesthetic recovery characteristics in dorsally recumbent, spontaneously breathing, isoflurane-anesthetized horses. Prospective, randomized crossover study. 10 healthy Standardbreds. Horses were premedicated with xylazine or medetomidine IV. Anesthesia was induced with diazepam and ketamine and maintained with isoflurane for 150 minutes. For the xylazine treatment, end-tidal isoflurane concentration was maintained at 1.7% and xylazine (0.2 mg/kg [0.09 mg/lb]), IV) was administered as a bolus at the end of anesthesia. For the MCRI treatment, end-tidal isoflurane concentration was maintained at 1.4% and medetomidine (0.005 mg/kg/h [0.0023 mg/lb/h], IV) was infused throughout anesthesia. Serum cortisol and glucose concentrations were measured before, during, and after anesthesia. Urine specific gravity and volume were measured during anesthesia. Unassisted anesthetic recoveries were recorded by a digital video camera for later evaluation by 2 observers who were blinded to treatment. Serum cortisol concentration was lower and serum glucose concentration was higher with MCRI treatment, compared with xylazine treatment. Time to sternal recumbency was longer with MCRI treatment, but no difference was seen between treatments for times to extubation, first movement, or standing. Objective (mean attempt interval) and subjective (visual analog score) recovery scores were significantly better with MCRI treatment, compared with xylazine treatment. In isoflurane-anesthetized horses, premedication and administration of medetomidine as a constant rate infusion resulted in decreased serum cortisol concentration, increased serum glucose concentration, and superior anesthetic recovery characteristics, compared with conventional treatment with xylazine.

  2. Comparison of the effects of xylazine bolus versus medetomidine constant rate infusion on cardiopulmonary function and depth of anesthesia in horses anesthetized with isoflurane.

    Science.gov (United States)

    Creighton, Catherine M; Lemke, Kip A; Lamont, Leigh A; Horney, Barbara S; Riley, Christopher B

    2012-04-15

    To compare the effects of xylazine bolus versus medetomidine constant rate infusion (MCRI) on cardiopulmonary function and depth of anesthesia in dorsally recumbent, spontaneously breathing, isoflurane-anesthetized horses. Prospective, randomized crossover study. 10 healthy adult Standardbreds. Horses were premedicated with xylazine or medetomidine IV. Anesthesia was induced with diazepam and ketamine and maintained with isoflurane for 150 minutes. For the xylazine treatment, end-tidal isoflurane concentration was maintained at 1.7%, and xylazine (0.2 mg/kg [0.09 mg/lb], IV) was administered as a bolus at the end of anesthesia. For the MCRI treatment, end-tidal isoflurane concentration was maintained at 1.4%, and medetomidine (0.005 mg/kg/h [0.0023 mg/lb/h], IV) was infused throughout anesthesia. Physiologic data (ie, heart rate, respiratory rate, rectal temperature, bispectral index, and electromyographic values) were compared between treatments with xylazine bolus versus MCRI. Heart rate was lower, but mean arterial blood pressure was higher from 20 to 40 minutes with MCRI treatment, compared with conventional treatment with xylazine. Respiratory rate and rectal temperature were greater with MCRI treatment. Bispectral index was lower with MCRI treatment from 80 to 150 minutes, and electromyographic values were lower with MCRI treatment from 30 to 150 minutes. In isoflurane-anesthetized horses, premedication with medetomidine followed by administration of medetomidine as a constant rate infusion resulted in decreased heart rate, higher arterial blood pressure from 20 through 40 minutes after induction of anesthesia, and better preserved body temperature, compared with conventional treatment with xylazine. Greater depth of anesthesia and muscle relaxation were seen with MCRI treatment, despite the lower isoflurane concentration.

  3. Nicolaus Copernicus and the rapid vascular responses to aldosterone.

    Science.gov (United States)

    Barton, Matthias; Meyer, Matthias R

    2015-08-01

    For decades, rapid steroid responses initiated by membrane receptors have been a primary research focus. G protein-coupled estrogen receptor (GPER) is activated by 17β-estradiol and participates in functional crosstalk with other steroid receptors. With reference to the physician and astronomer Nicolaus Copernicus (1473-1543), who used rigorous scientific approaches to shift paradigms and change dogma, we discuss whether GPER can also be considered an aldosterone receptor. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Cardiovascular changes in patients with primary aldosteronism after surgical or medical treatment.

    Science.gov (United States)

    Bernini, G; Bacca, A; Carli, V; Carrara, D; Materazzi, G; Berti, P; Miccoli, P; Pisano, R; Tantardini, V; Bernini, M; Taddei, S

    2012-03-01

    Data on the cardiovascular middle-term follow-up of patients with primary aldosteronism (PA) are scanty. To detect the cardiovascular effects of surgery in patients with aldosterone (ALD)-producing adenoma (APA) and of pharmacotherapy in those with bilateral adrenal hyperplasia (BAH), a prospective study involving 60 consecutive patients with PA was performed. MATERIAL/ METHODS: Clinical, biochemical, and cardiovascular assessment was obtained before and after (31.5±4.4 months) surgery or proper medical treatment (32.1±5.0 months) in 19 and 41 patients, respectively. As expected, plasma ALD normalized in all operated patients, while in the other group it did not change. Systolic and diastolic blood pressure decreased (pbody mass index (p<0.0008), drug number (p<0.03), and ALD/plasma renin activity ratio (p<0.01). Allocating the patients according to plasma ALD and cardiac parameters, patients who presented ALD reduction during the study also had a decrement in cardiac mass (p<0.04). Our data indicate that in patients with PA the removal of ALD excess by surgery in APA is effective in reducing blood pressure and in improving cardiac parameters, while anti-hypertensive therapy in BAH shows less positive impact on cardiovascular system. © 2012, Editrice Kurtis.

  5. Mineralocorticoid receptor is involved in the aldosterone pathway in human red blood cells.

    Science.gov (United States)

    Bordin, Luciana; Saccardi, Carlo; Donà, Gabriella; Sabbadin, Chiara; Andrisani, Alessandra; Ambrosini, Guido; Plebani, Mario; Brunati, Anna Maria; Ragazzi, Eugenio; Gizzo, Salvatore; Armanini, Decio

    2016-01-01

    We have recently demonstrated that excessive aldosterone (Aldo) secretion in primary aldosteronism (PA) is associated with red blood cells (RBC) senescence. These alterations were prevented/inhibited by cortisol (Cort) or canrenone (Can) raising the hypothesis that Aldo effects in RBC may be mediated by mineralocorticoid receptor (MR), though to date MR has never been demonstrated in human RBC. The aim of this multicenter comparative study was to investigate whether Aldo effects were mediated by MR in these a-nucleated cells. We included 12 healthy controls (HC) and 22 patients with PA. MR presence and activation were evaluated in RBC cytosol by glycerol gradient sedimentation, Western blotting, immuno-precipitation and radioimmunoassay. We demonstrated that RBC contained cytosolic MR, aggregated with HSP90 and other proteins to form multiprotein complex. Aldo induced MR to release from the complex and to form MR dimers which were quickly proteolyzed. Cort induced MR release but not dimers formation while Can was not able to induce MR release. In addition, RBC cytosol from PA patients contained significantly higher amounts of both MR fragments (p<0.0001) and Aldo (p<0.0001) concentrations. In conclusion, in RBC a genomic-like Aldo pathway is proposed involving MR activation, dimerization and proteolysis, but lacking nuclear transcription. In addition, dimers proteolysis may ensure a sort of Aldo scavenging from circulation by entrapping Aldo in MR fragments.

  6. The effects of essential oils and aqueous tea infusions of oregano (Origanum vulgare L. spp. hirtum), thyme (Thymus vulgaris L.) and wild thyme (Thymus serpyllum L.) on the copper-induced oxidation of human low-density lipoproteins.

    Science.gov (United States)

    Kulisić, Tea; Krisko, Anita; Dragović-Uzelac, Verica; Milos, Mladen; Pifat, Greta

    2007-03-01

    In this study, the antioxidative capacity effect of essential oils and aqueous tea infusions obtained from oregano, thyme and wild thyme on the oxidation susceptibility of low-density lipoproteins (LDL) has been studied. The results indicate a dose-dependent protective effect of the tested essential oils and aqueous tea infusions on the copper-induced LDL oxidation. The protective effect of essential oils is assigned to the presence of phenolic monoterpenes, thymol and carvacrol, which are identified as the dominant compounds in these essential oils. The strong protective effect of aqueous tea infusions is proposed to be the consequence of large amounts of polyphenols, namely rosmarinic acid and flavonoids (quercetin, eriocitrin, luteolin-7-O-glucoside, apigenin-7-O-glucoside, luteolin, apigenin), with the most pronounced effect in the case of oregano. These findings may have implications for the effect of these compounds on LDL in vivo.

  7. [Elevated serum aldosterone levels in dialysis patients: Are we underusing renin-angiotensin-aldosterone system blockers?

    Science.gov (United States)

    Fernández-Reyes, M J; Velasco, S; Gutierrez, C; Gonzalez Villalba, M J; Heras, M; Molina, A; Callejas, R; Rodríguez, A; Calle, L; Lopes, V

    Serum aldosteronelevels (SA) are a marker of cardiovascular (CV) risk in the general population. To analyze SA levels in dialysis patients and its relationship with characteristics of dialysis; comorbidity; blood pressure and the use of blocking renin-angiotensin-aldosterone system agents (BSRAA). We determined SA in 102 patients: 81 on hemodialysis (HD) and 21 on peritoneal dialysis. Mean age 71.4±12 years; 54.9% male; 29.4% diabetics. Mean time on dialysis 59.3±67 months. In 44 HD patients plasma renin activity (PRA) was measured. Mean SA was 72.6±114.9ng/dl (normal range 1.17-23.6ng/dl). A total of 57.8% of patients had above normal levels which were not related to dialysis characteristics or comorbidity. Only 21% of patients with heart failure and 19.2% with ischemic heart disease used BSRAA. A number of 25 patients treated with BSRAA had significantly lower levels of SA. There was an inverse correlation between AS and systolic blood pressure (SBP), and direct with PRA. The logistic regression analysis conducted to find SA levels above the median associated factors showed that SBP was the only independent risk variable in the overall population (OR 0.97; P=.022); in the 44 patients in whom PRA was determined this was the only independent risk factor (OR 2.24; P=.012). A high percentage of dialysis patients have elevated levels of SA that are associated to diminished SBP and activated PRA and not to dialysis characteristics. In patients with a history of heart disease we underuse BSRAA. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Cardiovascular, endocrine and renal effects of urodilatin in normal humans

    DEFF Research Database (Denmark)

    Bestle, M.H.; Olsen, N.V.; Christensen, P.

    1999-01-01

    remained below 0.1%. The results indicate that even moderately natriuretic doses of urodilatin exert protracted effects on systemic hemodynamic, endocrine, and renal functions, including decreases in cardiac output and renal blood flow, without changes in arterial pressure or glomerular filtration rate...... highest doses. The renin-angiotensin-aldosterone system was inhibited by the three lowest doses but activated by the hypotensive dose of 40 ng. kg-1. min-1. Plasma vasopressin increased by factors of up to 5 during infusion of the three highest doses. Atrial natriuretic peptide immunoreactivity (including...

  9. Cardiovascular, endocrine, and renal effects of urodilatin in normal humans

    DEFF Research Database (Denmark)

    Bestle, M H; Olsen, N V; Christensen, P

    1999-01-01

    remained below 0.1%. The results indicate that even moderately natriuretic doses of urodilatin exert protracted effects on systemic hemodynamic, endocrine, and renal functions, including decreases in cardiac output and renal blood flow, without changes in arterial pressure or glomerular filtration rate...... highest doses. The renin-angiotensin-aldosterone system was inhibited by the three lowest doses but activated by the hypotensive dose of 40 ng. kg-1. min-1. Plasma vasopressin increased by factors of up to 5 during infusion of the three highest doses. Atrial natriuretic peptide immunoreactivity (including...

  10. Importance of the infusion rate for the plasma expanding effect of 5% albumin, 6% HES 130/0.4, 4% gelatin, and 0.9% NaCl in the septic rat.

    Science.gov (United States)

    Bark, Björn P; Persson, Johan; Grände, Per-Olof

    2013-03-01

    To compare the plasma volume (PV) expanding effect of a fast infusion rate with that of a slow infusion rate of a fixed volume of 5% albumin, of the synthetic colloids, 6% hydroxyethyl starch 130/0.4 and 4% gelatin, and of 0.9% NaCl in a rat sepsis model and to compare the plasma-expanding effect among these fluids. Prospective, randomized animal study. University hospital laboratory. One hundred and twelve adult male rats. Sepsis was induced by cecal ligation and incision followed by closure of the abdomen. After 3 hrs, an infusion of the PV expander under study was started at a volume of 12mL/kg for the colloids and of 48mL/kg for 0.9% NaCl, either for 15 mins or for 3 hrs. A control group underwent the same experimental procedure but no fluid was given. Three hours after start of the infusion (end of experiment), the plasma-expanding effect was better with a slow than a fast infusion rate for the colloids, especially albumin, but the NaCl groups did not differ significantly from the control group. The PV for the control group was 28.7±3mL/kg. In the slow and the fast infusion groups, it was 38.9±4.3 and 32.6±4.2mL/kg for albumin (p colloid was greater when given at a slow than at a fast infusion rate, an effect more pronounced for albumin. This difference was not seen for NaCl. The PV-expanding effect was poor for NaCl and better for albumin than for the other colloids.

  11. Correlation between Serum Aldosterone Level and Hearing Condition of Elderly Patients Referred to Otolaryngology Services of Hamadan, Western Iran

    Directory of Open Access Journals (Sweden)

    Dr. Farhad Farahani

    2010-06-01

    Full Text Available Background and Aim: Recently, more attention was paid to the direct protective effect of aldosterone against hearing impairment in elderly patients. The aim of this study was determination of possible correlation between serum aldosterone level and hearing condition of elderly patients that referred to the Otolaryngology services of Hamadan in 2005-2006.Methods: In this case control study 54 (27 males,27 females persons above 60 years old were evaluated. They contained twenty eight cases with normal hearing and 26 cases with presbycusis. Persons with any abnormal biochemical finding or history of conditions that predispose them to the sensorineural hearing loss (SNHL were excluded. In both groups serum level of sodium, potassium and aldosterone were measured and hearing condition evaluated by puretone, speech and immitance audiometry.Results: Statistical relationship between serum aldostrone level and hearing condition, sex, configuration of audiogram and speech discrimination score (SDS were not significant. In addition, no significant relationship between sodium and potassium levels with hearing condition was found (p>0.05.Conclusion: This study could not confirm protective effect of aldostrone against presbycusis. This discrepancy may originate from epidemiologic differences, laboratory errors or small sample size.

  12. Renal and cardiovascular effects of dopamine and 7.5% sodium chloride infusion: experimental study in dogs with water restriction

    OpenAIRE

    Marisa Aparecida Lima Verderese; Pedro Thadeu Galvão Vianna; Eliana Marisa Ganem; Luiz Antonio Vane

    2003-01-01

    JUSTIFICATIVA E OBJETIVOS: É controvertido o uso da infusão de dopamina na proteção renal. O objetivo desta pesquisa foi estudar o efeito da dopamina, da solução hipertônica e da associação de ambas em cães com restrição hídrica, simulando o jejum pré-operatório. MÉTODO: Foram estudados, em 32 cães anestesiados com tiopental sódico e fentanil, os seguintes parâmetros da função renal: fluxo plasmático efetivo renal (depuração de para-aminohipurato de sódio), ritmo de filtração glomerular (depu...

  13. Renin-angiotensin-aldosterone responsiveness to low sodium and blood pressure reactivity to angiotensin-II are unrelated to cholesteryl ester transfer protein mass in healthy subjects

    NARCIS (Netherlands)

    Krikken, Jan A.; Dallinga-Thie, Geesje M.; Navis, Gerjan; Dullaart, Robin P. F.

    2008-01-01

    Background: The blood pressure increase associated with the cholesteryl ester transfer protein (CETP) inhibitor, torcetrapib is probably attributable to an off-target effect but it is unknown whether activation of the renin-angiotensin-aldosterone system (RAAS) may be related to variation in the

  14. Malignant hypertension and hypertensive encephalopathy in primary aldosteronism caused by adrenal adenoma

    Directory of Open Access Journals (Sweden)

    Bortolotto Luiz Aparecido

    2003-01-01

    Full Text Available Two cases are reported as follows: 1 1 female patient with accelerated-malignant hypertension secondary to an aldosterone-producing adrenal adenoma; and 2 1 female patient with adrenal adenoma, severe hypertension, and hypertensive encephalopathy. This association is a rare clinical finding, and malignant hypertension may modify the hormonal characteristic of primary aldosteronism, making its diagnosis more difficult. The diagnosis of primary aldosteronism should be considered in patients with malignant hypertension or hypertensive encephalopathy if persistent hypokalemia occurs. Identification of primary aldosteronism is of paramount importance for the patient's evolution, because the surgical treatment makes the prognosis more favorable.

  15. Infusion Antihypoxants in Children with Critical Conditions

    Directory of Open Access Journals (Sweden)

    Yu. S. Aleksandrovich

    2014-01-01

    Full Text Available Hypoxia and mitochondrial damage are a key component of the pathogenesis and tanatogenesis of a critical condition, suggesting the need for its prevention and maximally rapid elimination. Objective: to analyze the efficacy and safety of infusion antihypoxants used in critically ill children from the results of researches. Materials and methods. Available investigations dealing with infusion therapy in children and papers on the use of infusion antihypoxants in adults in 2005 to 2013 were sought in the medical databases PubMed and Cochrane Library with their free availability and analyzed. Results. The analysis included 70 trials. The pathophysiology and pathobiochemistry of hypoxia in critically ill children are given; the current principles of its correction by infusion therapy are considered in detail. Particular emphasis is placed on trials evaluating the efficacy and safety of succinic acid solutions in children. Main indications for and contraindications to their use are demonstrated. Conclusion. The use of Krebs cycle substrate-based infusion antihypoxants (malate, succinate is an effective and promising procedure for the intensive therapy and correction of hypoxia in both adults and children with critical conditions. Considering the fact that papers on the use of infusion antihypoxants in children are scanty, there is a need for further investigations. 

  16. The use of plasma aldosterone and urinary sodium to potassium ratio as translatable quantitative biomarkers of mineralocorticoid receptor antagonism.

    Science.gov (United States)

    Eudy, Rena J; Sahasrabudhe, Vaishali; Sweeney, Kevin; Tugnait, Meera; King-Ahmad, Amanda; Near, Kristen; Loria, Paula; Banker, Mary Ellen; Piotrowski, David W; Boustany-Kari, Carine M

    2011-10-21

    Accumulating evidence supports the role of the mineralocorticoid receptor (MR) in the pathogenesis of diabetic nephropathy. These findings have generated renewed interest in novel MR antagonists with improved selectivity against other nuclear hormone receptors and a potentially reduced risk of hyperkalemia. Characterization of novel MR antagonists warrants establishing translatable biomarkers of activity at the MR receptor. We assessed the translatability of urinary sodium to potassium ratio (Na+/K+) and plasma aldosterone as biomarkers of MR antagonism using eplerenone (Inspra®), a commercially available MR antagonist. Further we utilized these biomarkers to demonstrate antagonism of MR by PF-03882845, a novel compound. The effect of eplerenone and PF-03882845 on urinary Na+/K+ and plasma aldosterone were characterized in Sprague-Dawley rats and spontaneously hypertensive rats (SHR). Additionally, the effect of eplerenone on these biomarkers was determined in healthy volunteers. Drug exposure-response data were modeled to evaluate the translatability of these biomarkers from rats to humans. In Sprague-Dawley rats, eplerenone elicited a rapid effect on urinary Na+/K+ yielding an EC50 that was within 5-fold of the functional in vitro IC50. More importantly, the effect of eplerenone on urinary Na+/K+ in healthy volunteers yielded an EC50 that was within 2-fold of the EC50 generated in Sprague-Dawley rats. Similarly, the potency of PF-03882845 in elevating urinary Na+/K+ in Sprague-Dawley rats was within 3-fold of its in vitro functional potency. The effect of MR antagonism on urinary Na+/K+ was not sustained chronically; thus we studied the effect of the compounds on plasma aldosterone following chronic dosing in SHR. Modeling of drug exposure-response data for both eplerenone and PF-03882845 yielded EC50 values that were within 2-fold of that estimated from modeling of drug exposure with changes in urinary sodium and potassium excretion. Importantly, similar

  17. The use of plasma aldosterone and urinary sodium to potassium ratio as translatable quantitative biomarkers of mineralocorticoid receptor antagonism

    Directory of Open Access Journals (Sweden)

    Eudy Rena J

    2011-10-01

    Full Text Available Abstract Background Accumulating evidence supports the role of the mineralocorticoid receptor (MR in the pathogenesis of diabetic nephropathy. These findings have generated renewed interest in novel MR antagonists with improved selectivity against other nuclear hormone receptors and a potentially reduced risk of hyperkalemia. Characterization of novel MR antagonists warrants establishing translatable biomarkers of activity at the MR receptor. We assessed the translatability of urinary sodium to potassium ratio (Na+/K+ and plasma aldosterone as biomarkers of MR antagonism using eplerenone (Inspra®, a commercially available MR antagonist. Further we utilized these biomarkers to demonstrate antagonism of MR by PF-03882845, a novel compound. Methods The effect of eplerenone and PF-03882845 on urinary Na+/K+ and plasma aldosterone were characterized in Sprague-Dawley rats and spontaneously hypertensive rats (SHR. Additionally, the effect of eplerenone on these biomarkers was determined in healthy volunteers. Drug exposure-response data were modeled to evaluate the translatability of these biomarkers from rats to humans. Results In Sprague-Dawley rats, eplerenone elicited a rapid effect on urinary Na+/K+ yielding an EC50 that was within 5-fold of the functional in vitro IC50. More importantly, the effect of eplerenone on urinary Na+/K+ in healthy volunteers yielded an EC50 that was within 2-fold of the EC50 generated in Sprague-Dawley rats. Similarly, the potency of PF-03882845 in elevating urinary Na+/K+ in Sprague-Dawley rats was within 3-fold of its in vitro functional potency. The effect of MR antagonism on urinary Na+/K+ was not sustained chronically; thus we studied the effect of the compounds on plasma aldosterone following chronic dosing in SHR. Modeling of drug exposure-response data for both eplerenone and PF-03882845 yielded EC50 values that were within 2-fold of that estimated from modeling of drug exposure with changes in urinary sodium

  18. Pathophysiological aspects of the renin-angiotensin-aldosterone system in acute myocardial infarction.

    Science.gov (United States)

    Dargie, H J; Byrne, J

    1995-10-01

    Our understanding of the renin-angiotensin-aldosterone system (RAAS) has advanced considerably in recent years. The RAAS plays a central role in the control of salt and water balance, and in the regulation of blood pressure and cardiovascular homeostasis. The haemodynamic changes in the period after myocardial infarction stimulate intense activation of both the circulating and the local RAAS. This acts through its end-products, angiotensin II and aldosterone, to promote sodium and fluid retention, and to increase cardiac contractility and systemic vascular tone. There is increasing evidence that, in the long term, this apparently adaptive response may be harmful, and might contribute to the development of some of the complications seen after infarction. Angiotensin II is capable of inducing coronary as well as systemic vasoconstriction, and may therefore prolong the duration of ischaemia. The response of the RAAS after infarction can be modified pharmacologically. Angiotensin converting enzyme (ACE) inhibitor drugs are already the mainstay of treatment in heart failure, and have now been shown to have a crucial role in the prevention of ventricular remodelling after myocardial infarction. Although the precise mechanism of this benefit is unclear, it provides further incentives to develop more effective strategies capable of suppressing neurohumoral activity following infarction.

  19. Clinical Utility of the Adrenocorticotropin Stimulation Test with/without Dexamethasone Suppression for Definitive and Subtype Diagnosis of Primary Aldosteronism

    Directory of Open Access Journals (Sweden)

    Kosuke Inoue

    2017-04-01

    Full Text Available The adrenocorticotropin (ACTH stimulation test (AST has been reported to be useful for diagnosing primary aldosteronism (PA, particularly for differentiating PA subtypes under 1-mg dexamethasone suppression (DS. The aim of our study was to clarify the effect of 1-mg DS on AST results. A retrospective cohort study was conducted using data for 48 patients (PA: 30/48. We estimated the difference in plasma aldosterone concentration (PAC responsiveness to ACTH stimulation with single (AST alone and combined (AST under 1-mg DS tests within the same patient. We compared the diagnostic accuracy of these two tests for PA and the laterality of hyperaldosteronism. We found no differences in PAC responsiveness to ACTH stimulation between single and combined tests, and observed a significant positive linear relationship (30 min, R2 = 0.75, p-value < 0.01. Both tests showed the highest diagnostic accuracy for PA following 30 min of ACTH stimulation. The ability to detect the laterality of hyperaldosteronism was inconsistent and differed according to the two definitions: lateralization ratio and the absolute aldosterone levels in adrenal venous sampling. PAC responsiveness to ACTH stimulation was similar for AST with and without 1-mg DS. AST can be performed under both conditions with similar accuracy to detect PA.

  20. Impact of priming the infusion system on the performance of target-controlled infusion of remifentanil.

    Science.gov (United States)

    Kim, Jong-Yeop; Moon, Bong-Ki; Lee, Jong Hyuk; Jo, Youn Yi; Min, Sang-Kee

    2013-05-01

    The start-up behavior of syringe and syringe pump is known to be one of the causes of inaccurate intravenous infusion. This study evaluated the method of priming the infusion system (PRIMING), and its impact on the target-controlled infusion (TCI) of two remifentanil diluents. PRIMING was performed using an evacuation of 2.0 ml to the atmosphere prior to TCI. Forty-eight TCI, using 50 µg/ml (Remi50) or 20 µg/ml (Remi20) of diluents, were performed targeting 4.0 ng/ml of effect-site concentration (Ceff), with PRIMING or not. The gravimetrical measurements of the delivered infusates reproduced actual Ceff. The bolus amount and time to reach 95% target were compared. Without PRIMING, Remi50 infused less bolus (43 ± 23 %) than Remi20 (19 ± 9 %) (P = 0.003), and showed more delayed increase of Ceff (11.2 ± 4.0 min) than Remi20 (7.4 ± 0.4 min) (P = 0.028). However, PRIMING significantly decreased the deficit of the bolus (2 ± 1%), as well as the delay of the increase of Ceff in Remi50 (1.2 ± 0.2 min) (both P phase of infusion, or the infusion of a more concentrated diluent.

  1. Effects of Dopamine Infusion on Cerebral Blood Flow, Brain Cell Membrane Function and Energy Metabolism in Experimental Escherichia coli Meningitis in the Newborn Piglet

    National Research Council Canada - National Science Library

    Park, Won Soon; Chang, Yun Sil; Shim, Jae Won; Kim, Mi Jung; Ko, Sun Young; Kim, Sung Shin; Hwang, Jong Hee; Choi, Chang Won; Lee, Munhyang

    2003-01-01

    .... The decreased cerebral cortical cell membrane Na+, K+ -ATPase activity and increased lipid peroxidation products, indicative of meningitis-induced brain damage, were significantly attenuated by dopamine infusion...

  2. Interval between Intra-Arterial Infusion Chemotherapy and Surgery for Locally Advanced Oral Squamous Cell Carcinoma: Impacts on Effectiveness of Chemotherapy and on Overall Survival

    Directory of Open Access Journals (Sweden)

    Chih-Fung Wu

    2014-01-01

    Full Text Available Background. The interval between intra-arterial infusion chemotherapy (IAIC and surgery was investigated in terms of its effects on survival in patients with locally advanced oral squamous cell carcinoma (OSCC. Methods. This retrospective study analyzed 126 patients who had completed treatment modalities for stage IV OSCC. All patients were followed up for 3 years. Kaplan-Meier and Cox regression methods were used to determine how survival was affected by general factors, primary tumor volume, TNM stage, and duration of neoadjuvant chemotherapy. Results. In 126 patients treated for locally advanced OSCC by preoperative induction IAIC using methotrexate, multivariate analysis of relevant prognostic factors showed that an IAIC duration longer than 90 days was significantly associated with poor prognosis (hazard ratio, 1.77; P=0.0259. Conclusions. Duration of IAIC is a critical factor in the effectiveness of multimodal treatment for locally advanced OSCC. Limiting the induction course to 90 days improves overall survival.

  3. [Comparative study between fast and slow induction of propofol given by target-controlled infusion: expected propofol concentration at the effect site. Randomized controlled trial].

    Science.gov (United States)

    Simoni, Ricardo Francisco; Miziara, Luiz Eduardo de Paula Gomes; Esteves, Luis Otávio; Silva, Diógenes de Oliveira; Ribeiro, Cristina Alves; Smith, Mariana Oki; Paula, Leonardo Ferreira de; Cangiani, Luis Henrique

    2015-01-01

    studies have shown that rate of propofol infusion may influence the predicted propofol concentration at the effect site (Es). The aim of this study was to evaluate the Es predicted by the Marsh pharmacokinetic model (ke0 0.26min(-1)) in loss of consciousness during fast or slow induction. the study included 28 patients randomly divided into two equal groups. In slow induction group (S), target-controlled infusion (TCI) of propofol with plasma, Marsh pharmacokinetic model (ke0 0.26min(-1)) with target concentration (Tc) at 2.0-μg.mL(-1) were administered. When the predicted propofol concentration at the effect site (Es) reached half of Es value, Es was increased to previous Es + 1μg.mL(-1), successively, until loss of consciousness. In rapid induction group (R), patients were induced with TCI of propofol with plasma (6.0μg.ml(-1)) at Es, and waited until loss of consciousness. in rapid induction group, Tc for loss of consciousness was significantly lower compared to slow induction group (1.67±0.76 and 2.50±0.56μg.mL(-1), respectively, p=0.004). the predicted propofol concentration at the effect site for loss of consciousness is different for rapid induction and slow induction, even with the same pharmacokinetic model of propofol and the same balance constant between plasma and effect site. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  4. Reliable and effective oxygen-ozone therapy at a crossroads with ozonated saline infusion and ozone rectal insufflation.

    Science.gov (United States)

    Bocci, Velio; Zanardi, Iacopo; Borrelli, Emma; Travagli, Valter

    2012-04-01

    This review aims to highlight the advantages and safety of oxygen-ozone therapy (OOT) and to suggest ways to enhance its acceptance. The treatment of a herniated disk by injecting a gaseous oxygen-ozone mixture inside the nucleus pulposus is a great clinical success. However, the use of OOT lags for a number of reasons, including lack of standardization, the need for numerous treatments, lack of knowledge and even denial. Anecdotally, several million treatments by OOT have been performed worldwide indicating its usefulness, mainly in peripheral arterial diseases and age-related macular degeneration. The scepticism that accompanies the systemic use of ozone can only be overcome by demonstrating the validity of OOT in controlled and randomized clinical trials. Cheaper and quicker methods, such as ozonating physiological saline with successive infusion as well as ozone rectal insufflations, are becoming popular, however, such alternative procedures are erratic, unstable and liable to be toxic, with deleterious consequences, and are likely to discredit the beneficial use of ozone. The approval of ozone in terms of both therapeutic efficacy and safety will depend on the results achieved by authoritative clinical trials. © 2011 The Authors. JPP © 2011 Royal Pharmaceutical Society.

  5. Effect of postprocedural full-dose infusion of bivalirudin on acute stent thrombosis in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: Outcomes in a large real-world population.

    Science.gov (United States)

    Wang, Heyang; Liang, Zhenyang; Li, Yi; Li, Bin; Liu, Junming; Hong, Xueyi; Lu, Xin; Wu, Jiansheng; Zhao, Wei; Liu, Qiang; An, Jian; Li, Linfeng; Pu, Fanli; Ming, Qiang; Han, Yaling

    2017-06-01

    This study aimed to evaluate the effect of prolonged full-dose bivalirudin infusion in real-world population with ST-elevation myocardial infarction (STEMI). Subgroup data as well as meta-analysis from randomized clinical trials have shown the potency of postprocedural full-dose infusion (1.75 mg/kg/h) of bivalirudin on attenuating acute stent thrombosis (ST) after primary percutaneous coronary intervention (PCI). In this multicenter retrospective observational study, 2047 consecutive STEMI patients treated with bivalirudin during primary PCI were enrolled in 65 Chinese centers between July 2013 and May 2016. The primary outcome was acute ST defined as ARC definite/probable within 24 hours after the index procedure, and the secondary endpoints included total ST, major adverse cardiac or cerebral events (MACCE, defined as death, reinfarction, stroke, and target vessel revascularization), and any bleeding at 30 days. Among 2047 STEMI patients, 1123 (54.9%) were treated with postprocedural bivalirudin full-dose infusion (median 120 minutes) while the other 924 (45.1%) received low-dose (0.25 mg/kg/h) or null postprocedural infusion. A total of three acute ST (0.3%) occurred in STEMI patients with none or low-dose prolonged infusion of bivalirudin, but none was observed in those treated with post-PCI full-dose infusion (0.3% vs 0.0%, P=.092). Outcomes on MACCE (2.1% vs 2.7%, P=.402) and total bleeding (2.1% vs 1.4%, P=.217) at 30 days showed no significant difference between the two groups, and no subacute ST was observed. Post-PCI full-dose bivalirudin infusion is safe and has a trend to protect against acute ST in STEMI patients undergoing primary PCI in real-world settings. © 2017 John Wiley & Sons Ltd.

  6. Cardiorespiratory and electrocardiographic effects of methadone or morphine in the perioperative period in anesthetized dogs with continuous rate infusion of propofol and submitted to ovariohysterectomy

    Directory of Open Access Journals (Sweden)

    Priscila Pavini Cintra

    2017-03-01

    Full Text Available The aims of this study were compare the electrocardiogram (ECG and cardiopulmonary effects of methadone or morphine, both injected intravenously (IV in dogs anesthetized with continuous infusion of propofol. Sixteen healthy female mongrel dogs were used in this study for elective ovariohysterectomy. The animals were allocated in random order into two groups assigned GME (methadone 0.3 mg kg-1, IV or GMO (morphine 0.3 mg kg-1, IV. Parameters were evaluated: heart rate (HR, P-wave amplitude (Ps and PmV, interval between Ps and R waves (PR, QRS duration (QRS, R-wave amplitude (R, duration the interval between the Q and T waves (QT, systolic blood pressure (SBP, rectal temperature (RT, respiratory rate (RR, end tidal of carbon dioxide (ETCO2 and periferic oxyhemoglobin saturation (SpO2. Postoperative analgesia was assessed by mechanical nociceptive stimulus based on the scale proposed by Firth and Haldane (1999 and rescue analgesia based on the visual analogue scale. HR was lower in GME in relation to GMO. The P, PmV, PR, QRS, R and QT values remained within their normality tracks, showing no clinical importance. Apnea and ETCO2 increased in both groups. There was no difference between groups of the analgesic effects. It can be concluded that methadone and morphine promote similar cardiovascular effects after IV injection during surgery in dogs anesthetized with propofol by continuous rate infusion, however, when methadone used, assisted ventilation is required. In addition, both drugs promote postoperative analgesia until six hours.

  7. Clinically relevant infusion rates of mu-opioid agonist remifentanil cause bradypnea in decerebrate dogs but not via direct effects in the pre-Bötzinger complex region.

    Science.gov (United States)

    Mustapic, Sanda; Radocaj, Tomislav; Sanchez, Antonio; Dogas, Zoran; Stucke, Astrid G; Hopp, Francis A; Stuth, Eckehard A E; Zuperku, Edward J

    2010-01-01

    Systemic administration of mu-opioids at clinical doses for analgesia typically slows respiratory rate. Mu-opioid receptors (MORs) on pre-Bötzinger Complex (pre-BötC) respiratory neurons, the putative kernel of respiratory rhythmogenesis, are potential targets. The purpose of this study was to determine the contribution of pre-BötC MORs to the bradypnea produced in vivo by intravenous administration of clinically relevant infusion rates of remifentanil (remi), a short-acting, potent mu-opioid analgesic. In decerebrate dogs, multibarrel micropipettes were used to record pre-BötC neuronal activity and to eject the opioid antagonist naloxone (NAL, 0.5 mM), the glutamate agonist D-homocysteic acid (DLH, 20 mM), or the MOR agonist [D-Ala(2), N-Me-Phe(4), gly-ol(5)]-enkephalin (DAMGO, 100 microM). Inspiratory and expiratory durations (T(I) and T(E)) and peak phrenic nerve activity (PPA) were measured from the phrenic neurogram. The pre-BötC was functionally identified by its rate altering response (typically tachypnea) to DLH microinjection. During intravenous remi-induced bradypnea (approximately 60% decrease in central breathing frequency, f(B)), bilateral injections of NAL in the pre-BötC did not change T(I), T(E), f(B), and PPA. Also, NAL picoejected onto single pre-BötC neurons depressed by intravenous remi had no effect on their discharge. In contrast, approximately 60 microg/kg of intravenous NAL rapidly reversed all remi-induced effects. In a separate group of dogs, microinjections of DAMGO in the pre-BötC increased f(B) by 44%, while subsequent intravenous remi infusion more than offset this DAMGO induced tachypnea. These results indicate that mu-opioids at plasma concentrations that cause profound analgesia produce their bradypneic effect via MORs located outside the pre-BötC region.

  8. Effect of Ziziphus jujube Fruit Infusion on Lipid Profiles, Glycaemic Index and Antioxidant Status in Type 2 Diabetic Patients: A Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Yazdanpanah, Zeinab; Ghadiri-Anari, Akram; Mehrjardi, Alireza Vahidi; Dehghani, Ali; Zardini, Hadi Zare; Nadjarzadeh, Azadeh

    2017-05-01

    This study was designed to assess the effects of Ziziphus jujube fruit (ZJF) infusion on lipid profiles, glycaemic control and antioxidant status in patients with type 2 diabetes mellitus (T2DM). In this randomized controlled clinical trial, 116 participants with T2DM (older than 30 years) were assigned to consume a balanced diet or diet plus ZJF infusion (10 g/100 mL boiling water) three times/day before main meals for 12 weeks. Diet was designed to be energy restricted (500 kcal/day deficit from estimated energy requirements), and macronutrient content was similar in both groups (55% carbohydrate, 15% protein and 30% fat). The consumption of ZJF infusion compared with the control group was associated with significant improvement in glycosylated haemoglobin (-0.68 ± 0.65 vs. -0.44 ± 0.55%; p = 0.03), total cholesterol (-24.29 ± 28.89 vs. -11.21 ± 29.98 mg/dL; p = 0.02), triglycerides (-43.3 ± 39.26 vs. -27.16 ± 46.84 mg/dL; p = 0.05), low-density lipoprotein cholesterol (-19.85 ± 27.62 vs. -6.55 ± 27.82 mg/dL; p = 0.01), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (-0.56 ± 0.80 vs. -0.2 ± 0.72; p = 0.01) and total cholesterol to high-density lipoprotein cholesterol ratios (-0.73 ± 0.94 vs. -0.35 ± 0.77; p = 0.02). ZJF had beneficial effects on glycosylated haemoglobin and lipid profile in T2DM patients. Further research is needed to identify the mechanism of ZJF action on glucose and lipid metabolism. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Relationships between postruminal casein infusion and milk production, and concentrations of plasma amino acids and blood urea in dairy cows: A multilevel mixed-effects meta-analysis.

    Science.gov (United States)

    Martineau, R; Ouellet, D R; Kebreab, E; White, R R; Lapierre, H

    2017-10-01

    The relationships between postruminal casein infusion and production variables and concentrations of plasma AA and blood urea were evaluated using multilevel mixed-effects models derived from literature data collected in dairy cows. The data set contained 147 treatment means [i.e., 66 controls (CTL) and 81 casein-infused (CAS) means]. Each CAS mean was paired with its corresponding CTL mean to create 81 mean differences (CAS minus CTL), which were analyzed as absolute and percentage-based units (i.e., percentage increase or decrease in CAS relative to CTL). The primary variable of interest was the difference in estimated metabolizable protein (MP) supply (ΔMP) between CAS and CTL. The other explanatory variables were based on levels in CTL: MP supply, MP balance, the ratio of duodenal microbial protein (MCP) to MP supply (MCPMP), the stage of lactation (early or mid/late) and the type of forage (grass/legume- or corn silage-based). The MP supply and MP balance influenced negatively the relationship between ΔMP and the response of true protein yield. Responses of milk urea, blood urea, and plasma urea cycle AA concentrations were associated positively with ΔMP, indicating that a large amount of infused AA was catabolized to urea. Responses of plasma essential AA concentrations were related positively to ΔMP. The relative effect of ΔMP was highest for responses of plasma His concentration in cows fed grass/legume-based diets and at high MCPMP ratios. This relationship suggests that positive responses of plasma His concentrations are associated with diets relying heavily on microbial protein synthesis (high MCP), low in crude protein (low estimated MP supply), or both. The relationship between ΔMP and responses of plasma group 2 AA (Ile, Leu, Lys, and Val) concentrations was approximately 2 times greater than that for group 1 AA (His, Met, and Phe+Tyr) at mean MCPMP and MP supply. This could reflect the low hepatic removal group 2 AA compared with group 1 AA in

  10. Aldosterone, From (Patho)Physiology to Treatment in Cardiovascular and Renal Damage

    NARCIS (Netherlands)

    Waanders, Femke; de Vries, Laura V.; van Goor, Harry; Hillebrands, Jan-Luuk; Laverman, Gozewijn D.; Bakker, Stephan J. L.; Navis, Gerjan

    Aldosterone, a steroid hormone with mineralocorticoid activity, is far more than merely a salt-and-water hormone. Aldosterone has a number of non-classical, mineralocorticoid receptor (MR)-mediated actions, including tissue remodeling, modulation of vascular tone and stimulating inflammation and

  11. Effects of the rate of insulin infusion during isoglycemic, hyperinsulinemic clamp procedures on measures of insulin action in healthy, mature thoroughbred mares.

    Science.gov (United States)

    Urschel, K L; Escobar, J; McCutcheon, L J; Geor, R J

    2014-04-01

    The objective of this study was to determine whether the rate of insulin infusion during isoglycemic hyperinsulinemic clamp procedures affected measures of insulin action, including glucose disposal and plasma non-esterified fatty acid, endothelin-1, and nitric oxide concentrations, in mature, healthy horses. Eight thoroughbred mares were studied during a 2-h hyperinsulinemic clamp procedure, conducted at each of 4 rates of insulin infusion: 0 (CON), 1.2 (LOWINS), 3 (MEDINS), and 6 (HIGHINS) mU · kg(-1) · min(-1). The infusion rate of a dextrose solution was adjusted throughout the clamp procedures to maintain blood glucose levels within 10% of baseline glucose concentrations. Plasma insulin concentrations were measured throughout the clamp procedures, and used with the rate of glucose infusion to calculate the plasma insulin concentration-to-rate of glucose infusion ratio, a measure of insulin action on glucose disposal. The rate of glucose infusion increased with rate of insulin infusion (P clamp procedures in the LOWINS, MEDINS, and HIGHINS treatments (P 0.05). The data indicate that it is important to standardize insulin infusion rate if data are to be compared between hyperinsulinemic clamp studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Design and performance evaluation of the "iTIVA" algorithm for manual infusion of intravenous anesthetics based on effect-site target

    NARCIS (Netherlands)

    D.E. Ramírez (David Eduardo); J.A. Calvache (Jose Andrés)

    2016-01-01

    textabstractIntroduction: Remifentanil and propofol infusion using TCI pumps has proven to be beneficial for the practice of anesthesia but the availability of these systems is limited. Objective: Designing a pharmacokinetic model-based algorithm for calculating manual infusion regimens to achieve

  13. Effect of intravenous ascorbic acid infusion on blood loss during laparoscopic myomectomy: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Lee, Banghyun; Kim, Kidong; Cho, Hye Yon; Yang, Eun Joo; Suh, Dong Hoon; No, Jae Hong; Lee, Jung Ryeol; Hwang, Jung Won; Do, Sang Hwan; Kim, Yong Beom

    2016-04-01

    Most interventions aimed at reducing bleeding during myomectomy lack sufficient evidence regarding their effectiveness. Recently, it was reported that intraoperative ascorbic acid administration effectively reduced blood loss during abdominal myomectomy. Therefore, this study aimed to investigate whether intravenous ascorbic acid infusion would affect intraoperative blood loss in women undergoing laparoscopic myomectomy. A randomized, double-blind, parallel-group, placebo-controlled trial including 50 women undergoing laparoscopic myomectomy was conducted. Women with ≤4 myomas, ≤9cm in maximum diameter were eligible. The study:control group ratio was 1:1. Starting 30minutes before anesthesia, 2g of ascorbic acid or a placebo were administered for 2hours intraoperatively. Intraoperative blood loss, the primary endpoint, was calculated as the difference between the volume of fluids acquired from suction and that used for irrigation of the abdominal cavity during surgery using constant values. Among the 50 randomized women, 1 and 3 in the study and control groups, respectively, were excluded due to withdrawal of consent, cancelation of surgery, or non-measurement of the primary endpoint. The baseline and operative characteristics were similar between the study and control groups, as was the intraoperative blood loss (193±204mL vs. 159±193mL, P=0.52). In addition, the operating time (95±29min vs. 110±52min; P=0.50) and decrease in hemoglobin level after surgery (1.9±1.31g/dL vs. 1.4±1.4g/dL; P=0.24) were similar between the study and control groups. Intravenous ascorbic acid infusion did not reduce intraoperative blood loss in women undergoing laparoscopic myomectomy. ClinicalTrials.gov, www.clinicaltrials.gov, NCT01715597. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Dose-dependent effects of chronic central infusion of oxytocin on anxiety, oxytocin receptor binding and stress-related parameters in mice.

    Science.gov (United States)

    Peters, Sebastian; Slattery, David A; Uschold-Schmidt, Nicole; Reber, Stefan O; Neumann, Inga D

    2014-04-01

    Chronic psychosocial stress is a recognized risk factor for various affective and somatic disorders. In an established murine model of chronic psychosocial stress, exposure to chronic subordinate colony housing (CSC) results in an alteration of physiological, behavioral, neuroendocrine and immunological parameters, including a long-lasting increase in anxiety, adrenal hypertrophy and thymus atrophy. Based on the stress-protective and anxiolytic properties of oxytocin (OXT) after acute administration