RÉSUMÉ
We investigated the plasma levels of tumour necrosis factor-alpha [TNF-alpha], leptin and insulin, and their relation to body mass index [BMI] in 80 male patients who presented with chronic heart failure [mean age: 47 +/- 4 years] at Tanta University Hospital. Plasma leptin, TNF-alpha and insulin were significantly increased and BMI significantly decreased in New York Heart Association classes III and IV patients. TNF-alpha, leptin and insulin were positively correlated, and TNF-alpha and BMI and leptin and BMI were negatively correlated in stages III and IV of heart failure. We conclude that cytokine neuroendocrine activation may form part of advanced stage heart failure. It may also be responsible for worsening cachexia, and can be used as a marker to determine disease severity
Sujet(s)
Humains , Mâle , Adulte d'âge moyen , Indice de masse corporelle , Cachexie/diagnostic , Études cas-témoins , Maladie chronique , Défaillance cardiaque/sang , Hyperinsulinisme/sang , Techniques immunoenzymatiques , Insuline/sang , Leptine/sang , Système neuroendocrinien/physiopathologie , Pression artérielle pulmonaire d'occlusion , Dosage radioimmunologiqueRÉSUMÉ
The effect of intrathecal [IT] injection of morphine and fentanyl on the urinary bladder was studied by ascending cystogram in 18 anaesthetized dogs. Examinations were performed before and 60 and 120 minutes after IT injection of saline [group I], 0.03 mg/kg morphine [group II] and 1.5 microg/kg fentanyl [group III]. A significant increase in maximal volume and compliance and a decrease in voiding pressure were observed, indicating relaxation of the detrusor muscle after IT administration of morphine or fentanyl. IT morphine produced greater and more prolonged bladder relaxation than IT fentanyl. We conclude that IT morphine and fentanyl cause variable degrees of urinary retention. As fentanyl produced milder and shorter bladder relaxation than morphine, it may be useful in patients with urinary disturbances