Fat and carbohydrate metabolism during and following hemorrhagic shock in puppies: A comparison of different resuscitation protocols

Shock states continue to carry a high mortality rate in the pediatric age group. Using a puppy model, we measured the initial metabolic response to hemorrhagic shock and to 3 resuscitation regimens: whole blood 1∶1 (replacement∶shed), lactated Ringer's 3∶1, and 5% albumin in lactated Ringer's 1∶1. Despite the immature nature of the puppy's enzyme, cardiovascular, and nervous systems, responses very similar to those in adult animals were seen. Serum glucose and free fatty acids rose during shock and declined with resuscitation as cardiac output returned toward normal. Serum lactate levels rose similarly but continued to rise for a short period after resuscitation and were associated with a further fall in pH consistent with “hidden acidosis.” Only small changes were noted in triglyceride and cholesterol levels. The metabolic responses noted following each of the 3 resuscitation protocols were similar. This study suggests that the immature animal responds to hemorrhagic shock in ways similar to the adult. The better initial hemodynamic response to resuscitation with high-volume lactated Ringer's or lactated Ringer's with 5% albumin was offset by the better buffering capacity of blood resuscitation. All 3 regimens were equally efficacious in providing initial metabolic recovery in this experimental hemorrhagic shock model. Les états de choc s'accompagnent d'une mortalité élevée chez les enfants. En ayant recours à l'expérimentation chez le chiot, les auteurs ont mesuré les modifications métaboliques initiales en réponse au choc hémoragique et à sa correction par 3 agents différents: sang complet (1∶1), solution de Ringer (3∶1) et solution de Ringer enrichie de 5% d'albumine. Malgré la nature immature des enzymes du chiot, du système cardio-vasculaire et du système nerveux, les réponses furent identiques à celles observées chez le chien adulte. Le glucose et les acides gras libres s'élevèrent au cours du choc et s'abaissèrent lors de la réanimation dès que le débit cardiaque revint à la normale. Les niveaux du lactate sanguin s'élevèrent de la même manière mais l'élévation continua pendant une courte période après la réanimation, cependant que le pH s'abaissait, démasquant une “acidose cachée”. Les taux des triglycérides et du cholestérol furent seulement discrètement altérés. Les réponses métaboliques étudiées en fonction des 3 méthodes de réanimation furent identiques. Cette étude suggère que le chiot répond de la même façon que le chien adulte au choc hémorragique et que les 3 méthodes de réanimation employant chacune des agents différents ont une efficacité identique. Los estados shock mantienen una elevada mortalidad en los grupos de edad pediátrica. Utilizando un modelo de shock en cachorros, se determinó la respuesta metabólica inicial al shock hemorrágico y a tres diferentes regimenes de resucitación: sangre total 1∶1 (reemplazo: pérdida), lactato de Ringer 3∶1, y albúmina al 5% en lactato de Ringer 1∶1. A pesar de la naturaleza inmadura de los sistemas enzimático, cardiovascular y nervioso del cachorro, las respuestas fueron muy similares a las observadas en animales adultos. La glucosa sérica y los ácidos grasos libres ascendieron durante el shock y declinarion en la medida que el débito cardiaco retornaba a lo normal. Los niveles de lactato sérico ascendieron en forma similar, pero continuaron su ascenso por un corto periodo de tiempo después de la resucitación, encontrándose asociados con una caida adicional del pH consistente con “acidosis oculta”. Sólo se presentaron cambios leves en los niveles de triglicéridos y colesterol. Las respuestas metabólicas observadas en cada uno de los tres protocolos de resucitación fueron similares. Este estudio sugiere que el animal inmaduro responde al shock hemorrágico de manera similar al adulto. La mejor respuesta hemodinámica inicial a la resucitación con altos volúmenes de lactato de Ringer o con lactato de Ringer con albúmina al 5%, fue compensada con una mejor capacidad de amortiguación observada en la resucitación con sangre. Los tres regimenes fueron igualmente eficaces en lograr la recuperación metabólica inicial en este modelo experimental de shock hemorrágico.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41311/1/268_2005_Article_BF01655348.pd

Hypothalamic-pituitary-adrenal axis function in ankylosing spondylitis

Objective: To assess basal function and responsiveness of the hypothalamic-pituitary-adrenal (HPA) axis in patients with ankylosing spondylitis during dynamic testing. Methods: Insulin induced hypoglycaemia (IIH) (Actrapid HM 0.1 IU/kg, as intravenous bolus) was induced in 17 patients and 11 healthy controls matched for age, sex, and body mass index. Concentrations of glucose, adrenocorticotrophic hormone (ACTH), cortisol, insulin, dehydroepiandrosterone sulphate (DHEAS), 17α-hydroxyprogesterone, interleukin 6 (IL-6), and tumour necrosis factor α (TNFα) were determined in plasma. Results: Comparable basal cortisol levels were found in the two groups, with a trend to be lower in ankylosing spondylitis. In the ankylosing spondylitis group, there were higher concentrations of IL-6 (mean (SEM): 16.6 (2.8) pg/ml v 1.41 (0.66) pg/ml in controls; p<0.001) and TNFα (8.5 (1.74) pg/ml v 4.08 (0.42) pg/ml in controls; p<0.01). Glucose, insulin, ACTH, DHEAS, and 17α-hydroxyprogesterone did not differ significantly from control. The IIH test was carried out successfully in 11 of the 17 patients with ankylosing spondylitis, and the ACTH and cortisol responses were comparable with control. General linear modelling showed a different course of glycaemia (p = 0.041) in the ankylosing spondylitis patients who met the criteria for a successful IIH test compared with the controls. Conclusions: The results suggest there is no difference in basal HPA axis activity and completely preserved responsiveness of the HPA axis in patients with ankylosing spondylitis. The interpretation of the different course of glycaemia during IIH in ankylosing spondylitis requires further investigation

In Vivo Discharge Properties of Hypothalamic Paraventricular Nucleus Neurons With Axonal Projections to the Rostral Ventrolateral Medulla

The hypothalamic paraventricular nucleus (PVN) and rostral ventrolateral medulla (RVLM) are key components of a neural network that generates and regulates sympathetic nerve activity (SNA). Although each region has been extensively studied, little is presently known about the in vivo discharge properties of individual PVN neurons that directly innervate the RVLM. Here extracellular recording was performed in anesthetized rats, and antidromic stimulation was used to identify single PVN neurons with axonal projections to the RVLM (n = 94). Neurons were divided into two groups that had either unbranched axons terminating in the RVLM (i.e., PVN-RVLM neurons, n = 65) or collateralized axons targeting both the RVLM and spinal cord [i.e., PVN-RVLM/intermediolateral cell column (IML) neurons, n = 29]. Many PVN-RVLM (32/65, 49%) and PVN-RVLM/IML (17/29, 59%) neurons were spontaneously active. The average firing frequency was not different across groups. Spike-triggered averaging revealed that spontaneous discharge of most neurons was temporally correlated with renal SNA (PVN-RVLM: 12/21, 57%; PVN-RVLM/IML: 6/9, 67%). Time histograms triggered by the electrocardiogram (ECG) R-wave indicated that discharge of most cells was also cardiac rhythmic (PVN-RVLM: 25/32, 78%; PVN-RVLM/IML: 10/17, 59%). Raising and lowering arterial blood pressure to increase and decrease arterial baroreceptor input caused a corresponding decrease and increase in firing frequency among cells of both groups (PVN-RVLM: 9/13, 69%; PVN-RVLM/IML: 4/4, 100%). These results indicate that PVN-RVLM and PVN-RVLM/IML neurons are both capable of contributing to basal sympathetic activity and its baroreflex modulation

Cortisol elimination from plasma in premenopausal women with rheumatoid arthritis

Methods: Twelve premenopausal female patients with RA (39.8 (1.8) years) and nine healthy control women matched for age and body mass index (42 (3.3) years) were enrolled in the study. None of the patients had previously been receiving treatment with glucocorticoids. After dexamethasone suppression (2 mg by mouth) the evening before the study, 20 mg of hydrocortisone was given. Blood and saliva samples were drawn six hours after injection of hydrocortisone. Plasma and salivary cortisol were measured. Results: Dexamethasone administration suppressed plasma cortisol concentrations to an almost undetectable level in all subjects, except one with RA. In this subject, a raised concentration of plasma cortisol was verified by repeated analysis despite the fact that cortisol concentration in the saliva sample measured simultaneously was not raised. No significant difference in the disappearance curve of cortisol in plasma or in salivary cortisol levels was found between the patients with RA and the healthy controls. Conclusions: The profile of disappearance of total cortisol from plasma, and salivary cortisol levels during the elimination phase after its intravenous administration, are unchanged in premenopausal women with RA. Alterations in cortisol clearance are not likely to have a role in cortisol availability in patients with RA

Validação da bioacústica como alternativa à avaliação visual para monitoramento do comportamento ingestivo de bovinos em pastagens.

A observação visual do comportamento ingestivo em ruminantes, principalmente naqueles mantidos em pastagens, apesar de comumente utilizada com diferentes finalidades de estudo, é trabalhosa, pouca precisa e empenha grande quantidade de mão-de-obra. Com o avanço da tecnologia em geral, outras metodologias, que fazem uso de sensores mecânicos, ópticos e sonoros, mostram grande potencial de uso em ruminantes. A bioacústica, em particular, adequa-se em experimentos que necessitam tanto de macro quanto de microatividades, otimizando mão-de-obra e com custo relativamente baixo em comparação à outras metodologias automatizadas. Entretanto, por ser um campo de estudo recente na produção animal, as operações de captura e análise dos sons ainda precisam ser refinadas. Dado o exposto, objetivou-se avaliar a acurácia do método acústico, em relação ao método visual, para a quantificação de macroeventos do comportamento ingestivo de bovinos a pasto. Para isso, foram realizados testes-piloto visando superar questões importantes para a utilização da mesma em animais em capo, como a identificação do melhor local para fixação do microfone e o modo de gravação de maior qualidade, entre outros. Alcançadas as configurações ideais, realizou-se observação visual individual instantânea das atividades comportamentais (pastejo, ruminação e outras atividades) de doze fêmeas Nelore em intervalos de dez minutos, por dois dias consecutivos. Após análise estatística, verificou-se que não há diferença estatística entre os métodos visual e acústico para determinação das atividades de pastejo, ruminação e outras atividades. Assim, a bioacústica pode ser utilizada para identificar as atividades de comportamento ingestivo de bovinos a pasto com precisão semelhante ao método visual, com ganhos adicionais em relação ao método de observação visual.bitstream/item/189191/1/Validacao-da-bioacustica-como-alternativa-a-avaliacao.pd