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PubMed2002

Inducible nitric oxide synthase pathway in the central nervous system and vasopressin release during experimental septic shock.

BACKGROUND: Septic shock is characterized by arteriolar vasodilation and hypotension. We have tested the hypothesis that nitric oxide arising from inducible nitric oxide synthase in the central nervous system is responsible for the deficiency in vasopressin release and consequent hypotension during experimental septic shock. METHODS AND RESULTS: Septic shock was induced in male Wistar rats by intravenous injection of 1.5 mg/kg lipopolysaccharide. After lipopolysaccharide administration, we found a significant decrease in mean arterial pressure with a concomitant increase in heart rate, a significant decrease in diuresis, and a transitory decrease in body temperature. An increase in plasma vasopressin concentrations occurred in these animals and was present for 2 hrs after lipopolysaccharide administration, returning close to basal concentrations thereafter and remaining unchanged for the next 24 hrs. When lipopolysaccharide was combined with central administration of aminoguanidine, an inducible nitric oxide synthase inhibitor, we observed a sustained increase in plasma vasopressin concentration and in the maintenance of blood pressure at 4 and 6 hrs after lipopolysaccharide treatment compared with rats treated with lipopolysaccharide alone. CONCLUSION: These data indicate that central nitric oxide arising from the inducible nitric oxide synthase pathway plays an important inhibitory role in vasopressin release during experimental septic shock and may be responsible for the hypotension occurring in this vasodilatory shock.

Animals↗
PubMed1994

Methods to increase the success rate of artificial insemination with donor semen.

Donor insemination was performed in two fertility clinics using cryopreserved semen from the same sperm bank. Donors were selected in agreement with American Fertility Society recommendations. In the first clinic, cup insemination was combined with intra-uterine insemination in 321 cycles. Follicular development was closely monitored with vaginal echography and serum hormonal measurements. In the second clinic, 1287 insemination cycles were performed using intra-cervical insemination, timed only on basal body temperature. In the first clinic, a total of 53 pregnancies were obtained, of which seven were in 55 unstimulated cycles (12.5%), 21 in 159 cycles with clomiphene citrate stimulation (13.1%, P > 0.1), and 25 in 107 cycles stimulated with clomiphene plus human menopausal gonadotrophin (HMG) (23.9%, P < 0.03). No multiple pregnancies were observed in the latter group. In the second clinic, 159 pregnancies occurred during 1287 insemination cycles (12.4%). It is concluded that neither intra-uterine insemination, nor hormonal and echographic cycle monitoring, nor clomiphene citrate enhances the success rate of artificial insemination with donor semen, but HMG treatment probably exerts a favourable effect.

Adult↗
PubMedDate not supplied

Reliability of urine temperature as a measurement of basal body temperature.

Natural family planning is based on the recognition of physiologic signs and symptoms that identify fertile and infertile phases of the menstrual cycle. Identification of the onset of the infertile period can be determined when the upward shift in basal body temperature (BBT) has occurred. A study was conducted to determine if the temperature of the first-morning voided urine adequately represents BBT. In 22 subjects, vaginal temperature, taken immediately upon awakening, was compared with first-morning voided urine temperature as measured continuously by thermocouples mounted in either of two flow-through devices attached to a toilet bowl. A significant correlation was found between the two temperatures. The convenience and hygiene of the method together with the reliability of urine temperature as an estimator of BBT could reduce the generally high rate of noncompliance of women choosing this natural method of family planning.

Adult↗
PubMed1978

Pure crystalline estradiol pellet implantation for contraception.

The subcutaneous implantation of estradiol pellets was found to be a simple and effective contraceptive method with good patient acceptance and minimal untoward effects. The pellets (25 mg each) were implanted through a Kearn's trocar into the abdominal wall, 2.5 to 5 cm above and parallel to Poupart's ligament. The regimen began with four pellets, and the dose was maintained or decreased by one pellet every 6 months (four, three, two, one). A potent progestogen was utilized monthly for induction of withdrawal bleeding. Altogether, 236 patients were followed for a total of 1,060 courses in 6,360 cycles (489,02 woman-years). Two pregnancies occurred during therapy. Pearl's index was 0.37. No significant alterations occurred in body weight and blood pressure. Glucose tolerance test, standard blood profiles, and Papanicolaou smears were normal during therapy. No cases of thrombophlebitis, blurred vision, headaches, gastric symptoms, or amenorrhea-galactorrhea were observed. The suppression of ovulation was confirmed by endometrial biopsies, basal body temperature, and serum follicle-stimulating hormone, luteinizing hormone, estradiol, and progesterone in a selected group of patients.

Abdominal Muscles↗
PubMedDate not supplied

New technology in natural family planning.

In recent years, several new devices have been developed to help women achieve or avoid pregnancy. These devices include computerized basal body temperature thermometers, electronic fertility monitors, and chemical and hormonal ovulation detection kits. This article describes these new fertility devices and discusses their effectiveness and impact on helping women understand and control their fertility.

Body Temperature↗
PubMed1996

[How do self-observed cycle symptoms correlate with ovulation?].

The symptoms of self-observation of the menstrual cycle (basal body temperature, mucus symptom, autopalpation of the cervix) are often regarded as not reliable for ovulation detection. In a prospective study 87 NFP cycles are monitored additionally with ultrasound and LH tests to calculate the correlation of the ovulation-time with the symptoms of self-observation. Our results show that the symptoms of self-observation allow a reliable detection of the time of ovulation. Only a short introduction into the method of self-observation is a necessary precondition. The reliable detection of ovulation gives the opportunity of cycle analysis of large groups especially in long time investigations. In this way a large set of valuable and reliable data on normal and disturbed menstrual cycles will be available.

Adult↗
PubMed1980

Echographic study of follicular maturation and ovulation during the normal menstrual cycle.

Follicular development was followed by echography during 18 menstrual cycles in 10 women volunteers. Results were correlated with changes in serum hormone levels, basal body temperature curves, and cervical mucus changes. The average follicular growth as measured from the time of echographic visualization was 0.3 cm/day. The diameter of the follicle measured the day before disappearance was 2.7 +/- 0.3 cm. In all cases echography was shown to indicate accurately the time of ovulation. Given its inoffensive nature, the usefulness of echography in determining the physical event of ovulation is demonstrated. Possible applications in the surveillance of ovulation induction methods and in artificial insemination are discussed.

Adult↗
PubMed2002

High doses of vitamin C reverse Escherichia coli endotoxin-induced hyporeactivity to acetylcholine in the human forearm.

BACKGROUND: Acute inflammation causes endothelial vasodilator dysfunction that may be mediated by oxidative stress. METHODS AND RESULTS: In this randomized, double-blind, crossover study, forearm blood flow responses to acetylcholine (ACh) (endothelium-dependent dilator) and glyceryl-trinitrate (GTN) (endothelium-independent dilator) were assessed before and after induction of acute systemic inflammation by low doses of Escherichia coli endotoxin (LPS) (20 IU/kg IV) in 8 healthy volunteers. The acute effect of intra-arterial vitamin C (24 mg/min) or placebo was studied 4 hours after LPS, respectively. Vitamin C alone was administered in control experiments. LPS administration caused systemic vasodilation, increased white blood count, elevated body temperature, and reduced vitamin C plasma concentrations. LPS decreased the responses of forearm blood flow to ACh by 30% (P<0.05) but not to GTN. Vitamin C completely restored the response to ACh, which was comparable with that observed under baseline conditions. Vitamin C had no effect on basal blood flow or ACh- or GTN-induced vasodilation in control subjects. CONCLUSIONS: Our data demonstrate that impaired endothelial vasodilation caused by E coli endotoxemia can be counteracted by high doses of antioxidants in vivo. Oxidative stress may play an important role in the pathogenesis of endothelial dysfunction during inflammation.

Acetylcholine↗
PubMed2004

A comparison of the central effects of different progestins used in hormone replacement therapy.

OBJECTIVE: To evaluate the central effect exerted by different progestins used for hormone replacement therapy. METHODS: Randomised, placebo-controlled study. One hundred-twenty postmenopausal women on continuous hormonal replacement therapy with transdermal estradiol (50 microg per day) associated, for 10 days every 28 days, with four different progestins: dydrogesterone (DYD; 10 mg per day; n = 20), medroxyprogesterone acetete (MPA; 10 mg per day; n = 20), nomegestrol acetate (NMG; 5 mg per day; n = 20) or norethisterone acetate (NETA; 10 mg per day; n = 20). Other 40 women, 10 for each treatment group, were used as controls and were monitored for a single cycle of 28 days during the administration of transdermal estradiol plus placebo. Morning basal body temperature (BBT) was monitored for 28 days. Anxiety, by the state-trait anxiety inventory, and depression, by the self-evaluation depression scale of Zung, were evaluated just prior to and in the last 2 days of the 10-day progestins adjunct. RESULTS: All progestins except DYD increased (P < 0.0001) BBT by 0.3-0.5 degrees C. Anxiety was decreased by DYD (- 2.3 + 1.1; P < 0.01) and MPA (- 1.5 + 0.5; P < 0.01), but not by NMG or NETA. Depression did not significantly increase during progestins and actually decreased during MPA (- 3.0 + 0.7; P < 0.01). Only the effect of DYD on anxiety and that of MPA on depression were significant versus the control group (P < 0.05 ). CONCLUSIONS: Different progestins exert different central effects. DYD has the peculiarity of not increasing BBT and of decreasing anxiety, which is also decreased by MPA. Depression is not negatively affected by the tested progestins and it may be ameliorated by MPA. The present data may help to individualise the progestin choice of hormone replacement therapy.

Administration, Cutaneous↗
PubMed2000

A model to predict water intake of a pig growing in a known environment on a known diet.

A model to predict voluntary water intake (WI) of a pig fed a known diet in a known environment is described. The daily retentions of protein, lipid, water and ash were estimated over time using a published pig growth model. Food intakes were estimated using published methods. WI was estimated by adding the amounts required for digestion (WD), faecal excretion (Wfec), growth (WG), evaporation (WE), urinary excretion (WU) and by then subtracting the water arising from feed (WF), from nutrient oxidation (WO) and synthesis of body constituents (WS). WD was predicted assuming an absorption of water of 0.10, 0.16 and 0.07 kg/kg digestible carbohydrate, crude protein and lipid respectively. Wfec was estimated taking into account the water associated with the undigested protein (0.86 kg/kg), diethyl ether extract (-12.11 kg/kg), crude fibre (1.86 kg/kg), ash (-0.42 kg/kg) and N-free extract (4.4 kg/kg). The basal level of WE was estimated from the heat production of the pig fed ad libitum (MJ/d) as: 0.25 x (metabolizable energy - energy retained as protein and lipid) x 0.4, where 0.25 is the assumed proportion of the insensible heat loss at the comfort temperature and 0.4 is the water lost per MJ dissipated heat. WE in a hot environment was predicted by assuming that evaporation increased up to three times the basal level to offset the decreased sensible heat loss. To predict WU a water requirement for renal excretion of 2.05 and 3.40 kg/osmol excreted N as urea and minerals respectively was assumed. The urinary load of N and minerals was predicted from the intake of digestible nutrients and their retention. From the oxidation of 1 kg carbohydrate, protein, and fat it was assumed that 0.6, 0.42 and 1.07 kg water (WO) were released respectively. WS was predicted by assuming a release of 0.16, 0.07 and 0.57 kg water per kg retained protein, retained lipid coming from digestible lipid, and retained lipid coming from digestible carbohydrate respectively. The model is strongly rooted in a theoretical structure. When its predictions were compared with data from suitable experiments, the results were not significantly different. Both the pattern and the magnitude of responses of the model to changes in body weight, feed intake and environmental temperature are sensible and it allows a fuller prediction of voluntary water intake than the methods currently available.

Animal Feed↗
PubMedDate not supplied

Does it make sense to heat gases higher than body temperature for the treatment of cold water near-drowning or hypothermia? A point of view paper.

There appears to be several areas of concern relating to the continued use of heating gases higher than body temperature for the treatment of cold water near-drowning. The use of heated gases as a primary means to rewarm a hypothermic patient does not seem to be any more effective than doing nothing at all. These low rewarming rates translate into some very long resuscitations. Even Dr. Nemiroff, who was a strong advocate of using heated humidified gases for treating cold water near-drowning, did not consider the use of warm inspired gases to be a primary rewarming technique. He referred to the use of heated humidified gases as a, "stabilization technique". However, does it make sense to use a technique that is several times slower than other methods of similar complexity? Does it make sense to use a protocol that may in fact lower a hypothermic patient's basal metabolic rate? There are some major patient safety issues raised by heating gases to high levels. However, there have not been many patients with documented airway damage. I have several hypothesis about why this is so. Few people seem to know how to significantly heat their patient's circuit. If they devise a system that gets to the therapeutic range they usually have second thoughts when the bag-valve-mask is too hot to hold, or the plastic wide bore tubing begins to melt, they will reduce the system temperature on that basis alone. Many of the hypothermic patients who are intubated simply do not have good survival rates, and so we may underestimate the degree of airway damage that occurs. Spontaneously breathing patients will tend to refuse to breathe hot gases which limits their potential for airway damage. However, is this a risk we need to run? Would it not make more sense to heat the inspired gases to close to body temperature and avoid the problem? I feel that the time has come for the Respiratory Therapy community to come together and work on this problem. The researchers have done their jobs in providing us with reasonable data on which to base a clinical decision. It would seem to me that if a Clinical Practice Guideline for cold water near-drowning or hypothermia were in place it might provide the other groups impetus for updating their guidelines. The bottom line is that patients deserve the best care that we know how to provide, and a clear set of guidelines is an essential first step.

Attitude of Health Personnel↗
PubMed1992

The effect of hypothermia on transient middle cerebral artery occlusion in the rat.

We investigated the effect of moderate whole body hypothermia (30 degrees C) on transient middle cerebral artery occlusion (MCAO) in the rat. Male Wistar rats were subjected to 2 h of ischemia by inserting a suture into the lumen of the internal carotid artery and occluding the origin of the MCA. Experimental groups were (a) MCAO induced at 37 degrees C body temperature (n = 15); (b) 30 degrees C body temperature induced prior to ischemia and maintained for 2 h of MCAO and 1 h of reperfusion (n = 12); and (c) MCAO with regional brain and body temperatures measured in normothermic (n = 3) and hypothermic MCAO rats (n = 2). Histopathological evaluation was performed 96 h after reperfusion. All normothermic MCAO animals exhibited ischemic infarct involving the ipsilateral cortex and basal ganglia with infiltration of neutrophils, macrophages, and microvascular proliferation. Hypothermic MCAO animals exhibited minor ischemic damage ranging from selective neuronal injury to small focal areas of infarct with minimal inflammatory response. Our data demonstrate that transient ischemia induced by using the intra-arterial suture method to occlude the MCA results in a reproducible brain lesion and that moderate hypothermia has a profound protective effect on the brain injury after transient MCAO.

Animals↗
PubMed1994

No substantial reduction of the thermic effect of a meal during pregnancy in well-nourished Dutch women.

To investigate changes in the thermic effect of a meal (TEM) during pregnancy, metabolic rate was measured in the fasting state and during the first 180 min after consumption of a standardized test meal in twenty-seven women before, and in each trimester of pregnancy. Resting metabolic rate (RMR) showed a steady increase over pregnancy: values in weeks 24 and 35 of pregnancy were significantly higher than the prepregnancy baseline (Tukey's studentized range test). The pattern of changes of postprandial metabolic rate (PPMR) was similar to that of RMR. Consequently TEM, calculated as PPMR minus RMR, did not change over pregnancy; mean TEM values (kJ/180 min) before and in weeks 13, 24 and 35 of pregnancy were 117.3 (SD 19.4), 116.4 (SD 23.7), 111.6 (SD 24.4) and 111.5 (SD 26.7) respectively. We consider changes in TEM of less than 15% to be of little importance physiologically. If true changes in TEM over pregnancy are 15% or more we would have had a 90% chance of observing significant changes in TEM in the present study, given the number of subjects and the methods used. Therefore, we conclude that no substantial reduction in TEM occurs during pregnancy.

Adult↗
PubMed2002

The influence of body mass index on skin susceptibility to sodium lauryl sulphate.

BACKGROUND: The influence of nutrition on the physiological functions of man is well studied. Numerous diseases can be exacerbated by obesity. However, it has not yet been determined whether body weight and body mass index (BMI), as an indicator of a high body fat store, can influence skin sensitivity. OBJECTIVE: This study investigates the correlation between body mass index and the epidermal functions, evaluated by bioengineering methods, before and after an irritant patch test with sodium lauryl sulphate (SLS). METHODS: Epidermal functions were evaluated using an evaporimeter, chromameter and laser-Doppler-flowmeter. Patch testing was conducted for 48 h with two different concentrations of SLS (0.25% and 0.5%) on the forearms of healthy volunteers. Measurements were performed 24h after patch removal. RESULTS: Obese individuals showed significantly increased transepidermal water loss (TEWL), skin blood flow and skin colour (red) as compared to a control group. However, the degree of skin sensitivity to SLS was not correlated with BMI. CONCLUSION: Basal biophysical parameters of the skin are primarily correlated with the BMI. This may be caused by obesity-induced physiological changes, e.g. increased sweat gland activity, high blood pressure and physiological temperature-regulating system. The epidermal barrier function, as evaluated after SLS patch testing is, however, not correlated with a high BMI, indicating a normal skin barrier.

Adolescent↗
PubMed2002

Impact of temperature and humidity of carbon dioxide pneumoperitoneum on body temperature and peritoneal morphology.

BACKGROUND: The insufflation of cold gas during laparoscopic surgery exposes patients to the risk for hypothermia. The objectives of this study were to investigate whether heating or humidification of insufflation gas could prevent peroperative hypothermia in a rat model, and to assess whether the peritoneum was affected by heating or humidification of the insufflation gas. METHODS: Rats were exposed to insufflation with either cold, dry carbon dioxide CO2 (group I); cold, humidified CO2 (group II); warm, dry CO2 (group III); or warm, humidified CO2 (group IV); another group underwent gasless laparoscopy (group V). Core temperature and intraperitoneal temperature were registered in all animals during 120 minutes. Specimens of the parietal peritoneum were taken directly after desufflation and 2 and 24 hours after the procedure. All specimens were analyzed with scanning electron microscopy (SEM). RESULTS: During the 120-minute study period, core temperature and intraperitoneal temperature were significantly reduced in groups I, II, and III. In the animals that underwent warm, humidified insufflation (group IV) and the gasless controls (group V), intraoperative hypothermia did not develop. At SEM, retraction and bulging of mesothelial cells and exposure of the basal lamina were seen in the four insufflation groups (groups I-IV) and also in the gasless controls (group V). CONCLUSION: Insufflation with cold, dry CO2 may lower the body temperature during laparoscopic surgery. Hypothermia can be prevented by both heating and humidifying the insufflation gas. Changes of the peritoneal surface occur after CO2 insufflation, despite heating or humidifying, and also after gasless surgery.

Animals↗
PubMed2000

Effects of electro-acupuncture on anovulation in women with polycystic ovary syndrome.

BACKGROUND: The present study was designed to evaluate if electro-acupuncture (EA) could affect oligo-/anovulation and related endocrine and neuroendocrine parameters in women with polycystic ovary syndrome (PCOS). METHODS: Twenty-four women (between the ages of 24 and 40 years) with PCOS and oligo-/amenorrhea were included in this non-randomized, longitudinal, prospective study. The study period was defined as the period extending from 3 months before the first EA treatment, to 3 months after the last EA treatment (10-14 treatments), in total 8-9 months. The menstrual and ovulation patterns were confirmed by recording of vaginal bleedings and by daily registrations of the basal body temperature (BBT). Blood samples were collected within a week before the first EA, within a week after the last EA and 3 months after EA. RESULTS: Nine women (38%) experienced a good effect. They displayed a mean of 0.66 ovulations/woman and month in the period during and after the EA period compared to a mean of 0.15 before the EA period (p=0.004). Before EA, women with a good effect had a significantly lower body-mass index (BMI) (p<0.001), waist-to-hip circumference ratio (WHR) (p=0.0058), serum testosterone concentration (p=0.0098), serum testosterone/sex hormone binding globulin (SHBG) ratio (p=0.011) and serum basal insulin concentration (p=0.0054), and a significantly higher concentration of serum SHBG (p=0.040) than did those women with no effect. CONCLUSION: Repeated EA treatments induce regular ovulations in more than one third of the women with PCOS. The group of women with good effect had a less androgenic hormonal profile before treatment and a less pronounced metabolic disturbance compared with the group with no effect. For this selected group EA offers an alternative to pharmacological ovulation induction.

Adult↗
PubMed1980

[Timing of ovulation in clomiphene-induced cycles (author's transl)].

214 menstrual cycles, induced by clomiphene in 121 women desiring a family but manifesting disturbances of cycle, type WHO II (1976) were investigated with regard to pattern of cervical function. 184 were ovulatory cycles. The time of ovulation was predictable within a range of two days in 58.7% of cases by means of the cervical score, consisting of the dilatation of the cervical os, the degree of transparency, the quantity and the consistency of the cervical mucus. The occurence of the "LH peak" and the rise in basal body temperature (BBT) were set in relation to this. In 41.3% of cycles the cervical score, influenced by the antioestrogenic effect of clomiphene, gave only insufficient evidence. In subsequent treatment cycles the cervical function, in relation to the individual case and the inducible quality of the cycle, showed a similar response rate as in the first treatment cycle. Our results suggest that, after examination of the first clomiphene-induced cycle by the combined means of cervical score and hormoneanalytic methods, patients with a positive cervical response, can be investigated by any interested doctor, even if he doesn't have a laboratory at his disposal, in order to assess the timing of ovulation for therapeutic measures.

Body Temperature↗
PubMed1989

[Energy loss by the body during gastrectomy].

A method for calculation of the loss of energy by an organism of a patient at the time of gastric resection is presented. It is shown that for the 2h of operation, a patient losses the amount of energy which is almost equal to the basal metabolism for 24 hours.

Body Temperature Regulation↗