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1.
Mar Environ Res ; 61(5): 471-93, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16616361

RESUMO

Fecal indicator bacteria concentrations measured in the surf zone off Huntington Beach, CA from July 1998-December 2001 were analyzed with respect to their spatial patterns along 23 km of beach, and temporal variability on time scales from hourly to fortnightly. The majority of samples had bacterial concentrations less than, or equal to, the minimum detection limit, but a small percentage exceeded the California recreational water standards. Areas where coliform bacteria exceeded standards were more prevalent north of the Santa Ana River, whereas enterococci exceedances covered a broad area both north and south of the river. Higher concentrations of bacteria were associated with spring tides. No temporal correspondence was found between these bacterial events and either the timing of cold water pulses near shore due to internal tides, or the presence of southerly swell in the surface wave field. All three fecal indicator bacteria exhibited a diel cycle, but enterococci rebounded to high nighttime values almost as soon as the sun went down, whereas coliform levels were highest near the nighttime low tide, which was also the lower low tide.


Assuntos
Enterobacteriaceae/isolamento & purificação , Fezes/microbiologia , Água do Mar/microbiologia , Microbiologia da Água , Poluentes da Água/análise , Fenômenos Fisiológicos Bacterianos , Praias/normas , California , Contagem de Colônia Microbiana/métodos , Demografia , Enterobacteriaceae/crescimento & desenvolvimento , Enterobacteriaceae/fisiologia , Geografia , Humanos , Saúde Pública , Recreação , Fatores de Tempo , Movimentos da Água
2.
Mar Environ Res ; 61(5): 494-510, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16644005

RESUMO

Fecal indicator bacteria (FIB) were measured approximately 5 days a week in ankle-depth water at 19 surfzone stations along Huntington Beach and Newport Beach, California, from 1998 to the end of 2003. These sampling periods span the time before and after treated sewage effluent, discharged into the coastal ocean from the local outfall, was disinfected. Bacterial samples were also taken in the vicinity of the outfall during the pre- and post-disinfection periods. Our analysis of the results from both data sets suggest that land-based sources, rather than the local outfall, were the source of the FIB responsible for the frequent closures and postings of local beaches in the summers of 2001 and 2002. Because the annual cycle is the dominant frequency in the fecal and total coliform data sets at most sampling stations, we infer that sources associated with local runoff were responsible for the majority of coliform contamination along wide stretches of the beach. The dominant fortnightly cycle in enterococci at many surfzone sampling stations suggests that the source for these relatively frequent bacteria contamination events in summer is related to the wetting and draining of the land due to the large tidal excursions found during spring tides. Along the most frequently closed section of the beach at stations 3N-15N, the fortnightly cycle is dominant in all FIBs. The strikingly different spatial and spectral patterns found in coliform and in enterococci suggest the presence of different sources, at least for large sections of beach. The presence of a relatively large enterococci fortnightly cycle along the beaches near Newport Harbor indicates that contamination sources similar to those found off Huntington Beach are present, though not at high enough levels to close the Newport beaches.


Assuntos
Bactérias/isolamento & purificação , Desinfecção , Água do Mar/microbiologia , Microbiologia da Água , Poluentes da Água/análise , Bactérias/classificação , Praias/normas , California , Enterobacteriaceae/isolamento & purificação , Fezes/microbiologia , Geografia , Humanos , Fatores de Tempo , Movimentos da Água
6.
Endocrinol Metab Clin North Am ; 30(3): 671-94, vii, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11571936

RESUMO

In humans and most other mammals, the antidiuretic hormone (ADH) is a nonapeptide often referred to as arginine vasopressin (AVP). It is produced by large neurons that originate in the supraoptic and paraventricular nucleus of the hypothalamus and project through the pituitary stalk to terminate on capillary plexuses scattered throughout the posterior pituitary. These plexuses drain into the systemic circulation by way of the cavernous sinus and superior vena cava.


Assuntos
Vasopressinas/fisiologia , Arginina Vasopressina/deficiência , Arginina Vasopressina/metabolismo , Arginina Vasopressina/fisiologia , Humanos , Hipernatremia/etiologia , Hipernatremia/fisiopatologia , Hipernatremia/terapia , Síndrome de Secreção Inadequada de HAD/etiologia , Síndrome de Secreção Inadequada de HAD/fisiopatologia , Síndrome de Secreção Inadequada de HAD/terapia , Vasopressinas/deficiência , Vasopressinas/metabolismo
7.
J Expo Anal Environ Epidemiol ; 9(5): 427-34, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10554145

RESUMO

The objective of the National Human Exposure Assessment Survey (NHEXAS) in Arizona is to determine the multimedia distribution of total human exposure to environmental pollutants in the classes of metals, pesticides, and volatile organic compounds (VOCs) for the population of Arizona. This was accomplished by studying a probability-based sample of the total population in Arizona with a nested design for the different stages of sampling (954 Stage I, 505 Stage II, and 179 Stage III participants). This report compares the study population demographics with those from the U.S. Census and provides preliminary data on the distributions of the example pollutant for each class, lead for metals, chlorpyrifos for pesticides, and benzene for metals. The probability-based sample age and gender demographics compare reasonably well with the Census data (1990 Census and 1996 Census Estimate). The race/ethnicity compared less well with 21% Hispanics in the 1996 Census Estimate and 42% Hispanics in the entire NHEXAS-Arizona sample and 30% Hispanics as Stage III participants for this study. The chemical analyses of the various media (yard soil, foundation soil, house dust, indoor air, outdoor air, drinking water, food, and beverage) show generally low levels of the representative pollutants. The 50th percentiles of the distributions are generally near or below the analytical detection limits, and applicable Federal action limits were rarely exceeded.


Assuntos
Monitoramento Ambiental/métodos , Poluentes Ambientais/análise , Poluentes Ambientais/metabolismo , Programas de Rastreamento/métodos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Arizona , Benzeno/análise , Biomarcadores/sangue , Biomarcadores/urina , Criança , Pré-Escolar , Clorpirifos/análise , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Inseticidas/análise , Chumbo/análise , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Distribuição por Sexo , Absorção Cutânea , Inquéritos e Questionários
8.
J Expo Anal Environ Epidemiol ; 9(5): 446-55, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10554147

RESUMO

Within the context of the National Human Exposure Assessment Survey (NHEXAS), metals were evaluated in the air, soil, dust, water, food, beverages, and urine of a single respondent. Potential doses were calculated for five metals including arsenic. In this paper, we seek to validate the potential dose calculations through spatial analysis of the data. Others report elevated arsenic concentrations in biological and environmental samples from residents of mining towns, particularly Ajo, Arizona. These reports led us to expect potential arsenic doses above the 90th percentile of the NHEXAS exposure distribution to be from residents of mining communities. Arsenic dose was calculated using media concentrations, time activity patterns, and published exposure factors. Of the 179 homes evaluated, 54 were in mining communities; 11 of these were considered separately for reasons of population bias. Of the 17 homes with the greatest potential arsenic doses, almost half (47%) were in mining communities. We evaluated the potential doses by media from nonmining and mining areas using the nonparametric Mann-Whitney U test. Statistically significant (p = 0.05) differences were found between mining (n = 43) and nonmining sites (n = 122) for total exposure and for each of the following media: house dust, yard soil, outdoor air, beverage consumed, and water consumed. No differences were found in either food or indoor air of mining and nonmining areas. We eliminated outliers and repeated the test for all media; significance increased. Dietary, organic arsenic from fish consumption contributed to elevated arsenic exposure among people from nonmining communities and acted as an initial confounder. When controlling for fish consumption, we were able to validate our potential dose model using arsenic, particularly in Ajo. Further, we identified three mining communities lacking elevated arsenic exposure. Additional work is needed speciating the arsenic and evaluating health risks. The utilization of Geographic Information System facilitated spatial this project and paves the way for more sophisticated future spatial analyses.


Assuntos
Arsênio/análise , Exposição Ambiental/análise , Mineração , Características de Residência , Adulto , Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Animais , Arizona , Biomarcadores/análise , Criança , Poeira/análise , Feminino , Peixes , Contaminação de Alimentos/análise , Humanos , Masculino , Prontuários Médicos , Solo/análise , Estatísticas não Paramétricas , Inquéritos e Questionários , Poluentes da Água/análise
9.
J Clin Endocrinol Metab ; 84(8): 2933-41, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10443701

RESUMO

The autosomal dominant form of familial neurohypophyseal diabetes insipidus (adFNDI) is a rare disease characterized by postnatal onset of polyuria and a deficient neurosecretion of the antidiuretic hormone, arginine vasopressin (AVP). Since 1991, adFNDI has been linked to 31 different mutations of the gene that codes for the vasopressin-neurophysin II (AVP-NPII) precursor. The aims of the present study were to relate the clinical phenotype to the specific genotype and to the molecular genetic effects of the most frequently reported adFNDI mutation located at the cleavage site of the signal peptide of AVP-NPII [Ala(-1)Thr]. Genetic analysis and clinical studies of AVP secretion, urinary AVP, and urine output were performed in 16 affected and 16 unaffected family members and 11 spouses of a Danish adFNDI kindred carrying the Ala(-1)Thr mutation. Mutant complementary DNA carrying the same mutation was expressed in a neurogenic cell line (Neuro2A), and the cellular effects were studied by Western blotting, immunocytochemistry, and AVP measurements. The clinical studies showed a severe progressive deficiency of plasma and urinary AVP that manifested during childhood. The expression studies demonstrated that the Ala(- 1)Thr mutant cells produced 8-fold less AVP than wild-type cells and accumulated excessive amounts of 23-kDa NPII protein corresponding to uncleaved prepro-AVP-NPII. Furthermore, a substantial portion of the intracellular AVP-NPII precursor appeared to be colocalized with an endoplasmic reticulum antigen (Grp78). These results provide independent confirmation that this Ala(-1)Thr mutation produces adFNDI by directing the production of a mutant preprohormone that accumulates in the endoplasmic reticulum, because it cannot be cleaved from the signal peptide and transported to neurosecretory vesicles for further processing and secretion.


Assuntos
Arginina Vasopressina/genética , Diabetes Insípido/genética , Mutação de Sentido Incorreto , Neurofisinas/genética , Precursores de Proteínas/genética , Vasopressinas/genética , Adolescente , Adulto , Idoso , Arginina Vasopressina/metabolismo , Criança , Pré-Escolar , Retículo Endoplasmático/química , Retículo Endoplasmático/metabolismo , Chaperona BiP do Retículo Endoplasmático , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Neurofisinas/análise , Neurofisinas/metabolismo , Precursores de Proteínas/metabolismo , Vasopressinas/metabolismo
10.
Mol Genet Metab ; 67(1): 89-92, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10329029

RESUMO

Autosomal-dominant familial neurohypophyseal diabetes insipidus (adFNDI) is caused by heterozygous mutations in the gene encoding vasopressin-neurophysin II (AVP-NPII) on chromosome 20p13. We analyzed the AVP-NP II gene in a family with adFNDI by direct sequencing. A novel C to T transition (289C-->T in the cDNA, resulting in the substitution of Arg 97 by Cys (R97C) in the prepro-AVP-NPII precursor molecule) was identified in the gene region encoding neurophysin II in the index patient. This amino acid change is thought to result in the formation of an incorrectly folded hormone precursor, which may lead to chronic neurotoxicity and explain the dominant inheritance of the disease.


Assuntos
Arginina Vasopressina/genética , Diabetes Insípido/genética , Genes Dominantes , Mutação , Neurofisinas/genética , Ocitocina , Precursores de Proteínas/genética , Análise Mutacional de DNA , Feminino , Humanos , Masculino , Modelos Genéticos , Linhagem
11.
Am J Kidney Dis ; 31(1): 19-27, 1998 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9428447

RESUMO

Dietary potassium restriction increases sodium and chloride retention, whereas potassium administration promotes both diuresis and natriuresis. In epidemiologic and clinical studies, potassium intake is inversely related to blood pressure and is lower in blacks than in whites. The present studies examined the mechanism by which potassium restriction fosters sodium conservation and the impact of race on this response. Twenty-one healthy black and white men and women ingested an isocaloric, potassium-restricted diet (20 mmol/d) containing 180 mmol/d of sodium with and without a potassium supplement (80 mmol/d) for 9 days on two occasions. Additionally, eight of these subjects ingested the same diets for 3 days followed by a water load to determine free water clearance before and during the early phase of dietary potassium restriction. During potassium restriction, mean arterial pressure (MAP) derived from 24-hour blood pressure measurements was higher (85.7 +/- 1.6 mm Hg v 82.0 +/- 1.3 mm Hg; P < 0.001), cumulative sodium excretion lower (984 +/- 59 mmol/d v 1,256 +/- 58 mmol/d; P < 0.001), and weight greater (71.1 +/- 2.1 kg v 69.3 +/- 2.2 kg; P < 0.001). Blacks displayed no greater increase in MAP, although they excreted less sodium overall and less potassium on the potassium-supplemented diet. After a water load, minimum urine osmolality (Uosm) was lower (53.0 +/- 3.0 mOsm/L v 65.6 +/- 3.5 mOsm/L; P = 0.01) and free water clearance greater (4.44 +/- 0.59 mL/min v3.72 +/- 0.58 mL/min; P = 0.009) during potassium restriction. In conclusion, in healthy, normotensive subjects, potassium restriction was associated with an increase in blood pressure and volume expansion effected by increased renal sodium and chloride retention. Potassium restriction was also associated with increased free water clearance and enhanced diluting capacity consistent with augmentation of Na+, K+:2Cl- cotransporter activity in the thick ascending limb of Henle. This mechanism may play an important role in the renal adaptation required for potassium conservation, but at the expense of sodium chloride retention and an elevation in blood pressure.


Assuntos
Pressão Sanguínea/fisiologia , Natriurese/fisiologia , Potássio na Dieta/administração & dosagem , Equilíbrio Hidroeletrolítico/fisiologia , Adulto , População Negra , Monitorização Ambulatorial da Pressão Arterial , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Potássio/metabolismo , Potássio na Dieta/farmacologia , Sódio/metabolismo , Cloreto de Sódio na Dieta/administração & dosagem , Cloreto de Sódio na Dieta/farmacologia , Água , População Branca
12.
Mol Endocrinol ; 11(12): 1806-13, 1997 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9369448

RESUMO

Biochemical properties of mutant type 2 vasopressin receptors (V2Rs) causing a partial phenotype of nephrogenic diabetes insipidus were investigated in transiently transfected HEK 293 cells. Cell surface expression of the V2R was not altered by substituting Asp85 in the second transmembrane region by Asn as determined by saturation binding assays. Although the affinity of the mutant V2R for arginine vasopressin (AVP) was reduced only 6-fold, the response of adenylyl cyclase activity to AVP revealed a 50-fold right shift in EC50 and a decreased maximum response for the mutant V2R. These data indicated that replacement of Asp85 by Asn affected coupling of the receptor to Gs, a conclusion substantiated by a 20-fold decrease in the calculated coupling efficiency of this receptor. The Gly201Asp mutation in the second extracellular loop, also found associated with an NDI partial phenotype, decreased cell surface expression of the V2R with minor reduction in ligand-binding affinity and coupling efficiency to Gs. A pronounced difference was observed for this mutant V2R between the stimulation of adenylyl cyclase activity promoted by AVP and the V2 vasopressin receptor agonist deamino[Cys1,D-Arg8]-vasopressin, suggesting an involvement of Gly201 in the selectivity of the receptor for different ligands. These data demonstrated that while decreased ligand-binding affinity and decreased coupling to Gs are responsible for the attenuation of response to ligand in the Asp85Asn mutant V2R, cell surface expression of the V2R is the major factor reducing cellular responses to ligand for the Gly201Asp mutant V2R.


Assuntos
Diabetes Insípido Nefrogênico/genética , Fenótipo , Substituição de Aminoácidos/genética , Linhagem Celular , Humanos , Mutação Puntual , Receptores de Vasopressinas/química , Receptores de Vasopressinas/genética
13.
Arch Gen Psychiatry ; 54(5): 443-9, 1997 May.
Artigo em Inglês | MEDLINE | ID: mdl-9152098

RESUMO

BACKGROUND: For unclear reasons, life-threatening water intoxication often coincides with acute psychosis in polydipsic schizophrenic patients with chronic hyponatremia. In contrast, most polydipsic schizophrenic patients are normonatremic and never manifest hyponatremia. To explore whether the effect of acute psychosis on water balance differs in these 2 schizophrenic subgroups, we compared their responses to drug-induced psychotic exacerbations. METHODS: Matched polydipsic schizophrenic patients with (n = 6) and without (n = 8) hyponatremia were identified based on past and current indexes of fluid intake and hydration. A transient psychotic exacerbation was induced with an infusion of the psychotomimetic methylphenidate hydrochloride (0.5 mg/kg of body weight over a 60-second period). Antidiuretic hormone levels, subjective desire for water, and factors known to influence water balance were measured at 15-minute intervals for 2 hours. RESULTS: Except for the expected differences in plasma osmolality and sodium, basal measures were similar in the 2 groups. Following methylphenidate administration, antidiuretic hormone levels increased more in the hyponatremic patients (P < .02), despite their consistently lower plasma osmolality (P < .007). No known or putative antidiuretic hormone stimulus could account for this finding. Only basal positive psychotic symptoms (P < .09) and plasma sodium (P < .18) were even marginally associated with the peak antidiuretic hormone responses, but neither factor could explain the difference in the response by the 2 groups. CONCLUSION: Psychotic exacerbations are associated with enhanced antidiuretic hormone secretion, for unknown reasons, in schizophrenic patients with hyponatremia and polydipsia, thereby placing them at increased risk of life-threatening water intoxication.


Assuntos
Ingestão de Líquidos , Hiponatremia/sangue , Esquizofrenia/metabolismo , Psicologia do Esquizofrênico , Vasopressinas/sangue , Intoxicação por Água/sangue , Doença Aguda , Adulto , Arginina Vasopressina/sangue , Pressão Sanguínea/efeitos dos fármacos , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Hidrocortisona/sangue , Síndrome de Secreção Inadequada de HAD/sangue , Masculino , Metilfenidato/farmacologia , Concentração Osmolar , Escalas de Graduação Psiquiátrica , Esquizofrenia/induzido quimicamente , Sódio/sangue , Sede , Intoxicação por Água/diagnóstico
14.
Trends Endocrinol Metab ; 8(9): 363-72, 1997 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18406826

RESUMO

Familial neurohypophyseal diabetes insipidus (FNDI) is an autosomal dominant (adFNDI) or X-linked recessive (xrFNDI) disorder characterized by the development in early childhood of an irreversible deficiency of arginine vasopressin (AVP) secretion. Autopsy data in adFNDI reveal selective destruction of the posterior pituitary magnocellular neurons that normally produce the hormone. These abnormalities are due to a variety of mutations in the gene that encodes the AVP-neurophysin II precursor. Each one predicts a change in the primary structure of the preprohormone, and all but one are of a type known or reasonably presumed to impair the folding and cellular trafficking of the preprohormone. This pattern and the uniform clinical characteristics of adFNDI suggest that the disease is due to the production of a mutant precursor that is toxic for magnocellular neurons, because it cannot be folded, processed, or otherwise disposed of efficiently. Although the gene responsible for xrFNDI has not yet been cloned, the striking clinical similarities between adFNDI and xrFNDI suggest that similar pathophysiologic mechanisms may be involved.

15.
J Clin Endocrinol Metab ; 81(4): 1465-70, 1996 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-8636352

RESUMO

To determine whether polydipsia is responsible for the altered water excretion in the subset of polydipsic schizophrenic patients who develop hyponatremia, the regulation of antidiuretic function was assessed in polydipsic schizophrenic patients with hyponatremia (n = 5), polydipsic schizophrenic patients without hyponatremia (n = 5), nonpolydipsic schizophrenic patients (n = 6), and normal controls (n = 8). The severity and duration of polyuria were similar in the two polydipsic groups. After oral water loading, maximal free water clearance was similar across all four groups. Free water clearance diminished, however, at lower plasma osmolalities in the hyponatremic polydipsics (P < 0.02) and at higher plasma osmolalities in the normonatremic polydipsics (P < 0.05) relative to that in the nonpolydipsic schizophrenics and normal subjects. The increase in plasma vasopressin after osmotic stimulation with hypertonic saline was slightly, but significantly (P < 0.02), blunted in both polydipsic groups. Hyponatremia occurs in some polydipsic schizophrenics because the relationship between free water clearance to plasma osmolality/sodium is shifted to the left. Polydipsia per se is not responsible for this still unexplained shift.


Assuntos
Hiponatremia/urina , Esquizofrenia/urina , Sede/fisiologia , Adulto , Glicemia/metabolismo , Pressão Sanguínea , Creatinina/metabolismo , Feminino , Humanos , Hiponatremia/sangue , Hiponatremia/complicações , Masculino , Pessoa de Meia-Idade , Poliúria/fisiopatologia , Esquizofrenia/sangue , Esquizofrenia/complicações , Psicologia do Esquizofrênico , Sódio/metabolismo , Ureia/sangue , Urina/fisiologia , Vasopressinas/sangue
16.
Am J Hum Genet ; 58(1): 107-17, 1996 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8554046

RESUMO

Familial neurohypophyseal diabetes insipidus (FNDI) is an autosomal dominant disorder characterized by progressive postnatal deficiency of arginine vasopressin as a result of mutation in the gene that encodes the hormone. To determine the extent of mutations in the coding region that produce the phenotype, we studied members of 17 unrelated kindreds with the disorder. We sequenced all 3 exons of the gene by using a rapid, direct dye-terminator method and found the causative mutation in each kindred. In four kindreds, the mutations were each identical to mutations described in other affected families. In the other 13 kindreds each mutation was unique. There were two missense mutations that altered the cleavage region of the signal peptide, seven missense mutations in exon 2, which codes for the conserved portion of the protein, one nonsense mutation in exon 2, and three nonsense mutations in exon 3. These findings, together with the clinical features of FNDI, suggest that each of the mutations exerts an effect by directing the production of a pre-prohormone that cannot be folded, processed, or degraded properly and eventually destroys vasopressinergic neurons.


Assuntos
Arginina Vasopressina/genética , Diabetes Insípido/genética , Neurofisinas/genética , Mutação Puntual , Arginina Vasopressina/deficiência , Arginina Vasopressina/metabolismo , Sequência de Bases , Primers do DNA , Éxons , Feminino , Genes Dominantes , Humanos , Masculino , Dados de Sequência Molecular , Conformação de Ácido Nucleico , Linhagem , Neuro-Hipófise , Reação em Cadeia da Polimerase , Precursores de Proteínas/genética , Estrutura Secundária de Proteína , Mapeamento por Restrição , Deleção de Sequência , Regiões Terminadoras Genéticas
17.
Clin Endocrinol (Oxf) ; 44(1): 31-7, 1996 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8706290

RESUMO

OBJECTIVE: Disordered water balance causes substantial morbidity in a subset of schizophrenics and is the consequence of unexplained defects in the regulation of fluid intake and antidiuretic function. We aimed to determine whether oropharyngeal regulation of water balance is altered in these patients. DESIGN: A 2-hour infusion of 3% saline, followed 35 minute later by an oral water load (10 ml/kg over 3 minutes). PATIENTS: Age and sex-matched polydipsic schizophrenics with (n = 5) and without (n = 8) hyponatraemia; non-polydipsic schizophrenics (n = 6); and normal controls (n = 13). MEASUREMENTS: Plasma osmolality, sodium, AVP, and reported desire for water (expressed in cups), determined prior to, and for 30 minutes following, the water load. RESULTS: Plasma osmolality and sodium were consistently lower in the hyponatraemics (P < 0.01). Significant changes did not occur until 20 and 25 minutes, respectively, after oral water loading, and were similar across the four groups. AVP levels were consistently lower in the two polydipsic groups (P < 0.001), fell within 5 minutes after drinking and then levelled off. Neither the acute fall nor the overall pattern of the responses differed across groups. Subjective desire for water also decreased within 5 minutes of drinking, and also to a similar extent, in the four groups. Subsequent levels remained suppressed in the non-polydipsic groups, but rebounded toward baseline in the two polydipsic groups. Thus the overall patterns differed (P < 0.05). At the end of the study, ad lib intake correlated significantly with reported desire for water (r = 0.51, P < 0.002). CONCLUSIONS: The oropharyngeal regulation of water intake is disrupted in polydipsic schizophrenics with and without hyponatraemia. In contrast, the oropharyngeal regulation of AVP secretion appears preserved in the hyponatraemic subset. Previously observed elevations in plasma AVP in this subset are thus unlikely to be related to defects in oropharyngeal regulation.


Assuntos
Ingestão de Líquidos/fisiologia , Orofaringe/fisiopatologia , Esquizofrenia/fisiopatologia , Equilíbrio Hidroeletrolítico , Adulto , Arginina Vasopressina/sangue , Feminino , Humanos , Hiponatremia/sangue , Hiponatremia/fisiopatologia , Masculino , Concentração Osmolar , Esquizofrenia/sangue , Sódio/sangue , Cloreto de Sódio/administração & dosagem , Fatores de Tempo , Água/administração & dosagem
18.
Endocrinol Metab Clin North Am ; 24(3): 549-72, 1995 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8575409

RESUMO

Diabetes insipidus, characterized by the excretion of copious volumes of unconcentrated urine, results from a deficiency in the action of the antidiuretic hormone arginine vasopressin and can be caused by any of four fundamentally different defects, including impaired secretion (neurohypophyseal diabetes insipidus), impaired renal response (nephrogenic diabetes insipidus), excessive fluid intake (primary polydipsia), or increased metabolism of the hormone (gestational diabetes insipidus). Differentiation between their causes, pathophysiology, and treatment methods is essential for effective management and is best achieved by a combination of hormonal, clinical, and neuroradiologic observations. Understanding of the genetic forms has advanced greatly and may soon lead to improved methods of prevention, diagnosis, and treatment.


Assuntos
Diabetes Insípido , Diabetes Insípido/diagnóstico , Diabetes Insípido/etiologia , Diabetes Insípido/fisiopatologia , Diabetes Insípido/terapia , Diabetes Insípido Nefrogênico/diagnóstico , Diabetes Insípido Nefrogênico/etiologia , Diabetes Insípido Nefrogênico/fisiopatologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Concentração Osmolar , Poliúria/diagnóstico , Poliúria/fisiopatologia , Gravidez , Vasopressinas/sangue
19.
Am J Physiol ; 268(2 Pt 2): R349-57, 1995 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-7864228

RESUMO

To determine the effect of sustained hypovolemia on vasopressin secretion, we studied rats after 1-32 h of diuretic therapy. We found that an injection of furosemide (10 mg/kg) produced a transient marked increase in urine output, a moderate 7-10% reduction in blood volume, and a three- to fourfold rise in plasma vasopressin from 1.6 +/- 0.2 to 5.6 +/- 1.0 pmol/l. When the hypovolemia was maintained by repeated injections of the diuretic, plasma vasopressin remained elevated for > or = 8 h but returned almost to normal by 32 h, even though plasma electrolytes, blood pressure, hematocrit, and the other measures of hypovolemia were unchanged. At this time, pituitary vasopressin was undiminished, and plasma vasopressin rose normally or even supranormally when an acute hypovolemic or osmotic stimulus (intraperitoneal polyethylene glycol or hypertonic saline) was superimposed. However, the lines describing the relationship of log plasma vasopressin to plasma volume and plasma sodium in the rats treated with furosemide for 32 h lay to the left of the same relationships in the rats treated for 8 h or the sham-treated controls. We conclude that, in rats, the vasopressin response to sustained hypovolemia persists for > or = 8 h but is markedly diminished by 32 h. The decline in plasma vasopressin during this interval appears to be due to adaptive resetting of the volume control mechanism.


Assuntos
Volume Sanguíneo/fisiologia , Vasopressinas/metabolismo , Adaptação Fisiológica , Animais , Diuréticos/farmacologia , Furosemida/farmacologia , Masculino , Polietilenoglicóis/farmacologia , Ratos , Ratos Sprague-Dawley , Fatores de Tempo , Vasopressinas/sangue , Equilíbrio Hidroeletrolítico/efeitos dos fármacos
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