Metabolic alterations related to resting energy expenditure (REE) and fat metabolism have been noted during sepsis, and often depend on the causative agent and the stage and severity of the illness. We studied the effect of IL-1, the protein mediator of the 'acute phase' response during infection, on REE, respiratory quotient (RQ), and fat metabolism in male rats (210 g), who were infused over an 8-h period with (1-14C)-palmitate (PALM), (2-3H)-glycerol (GLY) and either saline or interleukin-1 (IL-1). At 7-8 h post infusion, the IL-1 group showed a significant increase in REE but no change in RQ. The IL-1 group also exhibited a significant decrease in serum free fatty acid (FFA) and an increase in FFA clearance. Free fatty acid flux, %PALM oxidation, serum (GLY), glycerol clearance, and glycerol flux (a measure of lipolytic rate) were not significantly different between the two groups. We conclude that IL-1 can mimic the increase in REE seen during infection; the increase in REE is not due to a selective increase in fat oxidation only, although the unchanged RQ and increased REE suggest that there is a proportional increase in net FFA oxidation.
The use of propofol for conscious sedation during colonoscopy is associated with greater patient satisfaction and less pain when compared with midazolam/fentanyl, as perceived by the patient and endoscopist.
Age-related effects on endogenous pyrogen-mediated febrile and acute-phase responses to endotoxin and Salmonella typhimurium challenge were investigated in young adult and aged Fisher 344 rats. After injection of endotoxin, the febrile response over 6 h and the fall in plasma iron and zinc after 6 h were determined in 14 young adult and 14 aged rats in their thermoneutral zone (26 degrees C) and in 14 young adult and 14 aged rats maintained in a cold environment (15 degrees C). Although at 26 degrees C aged rats showed only a slightly diminished febrile response compared with that of young adult rats, at 15 degrees C they had a markedly diminished febrile response compared with that of young adult rats. At both 26 and 15 degrees C, the injection of endotoxin led to a fall in iron and zinc concentrations in the plasma of both young adult and aged rats. The intact trace metal response diminished but febrile response suggest that aged rats are able to produce endogenous pyrogen but have a reduced capacity to respond to this substance. In 22 aged and 22 young adult rats maintained at 26 degrees C and challenged with S. typhimurium, the febrile response was significantly less in the aged rats but the survival rate was virtually identical. When 10 young adult and 10 aged rats were placed at a temperature of 15 degrees C after injection with S. typhimurium, the febrile response in the aged rats was significantly lower than that in the young adult rats at only one time point, and the survival rate did not differ between the two age groups. Survival after challenge with S. typhimurium was not influenced adversely by the diminished febrile response.
Percent survival was measured in male rats injected intravenously with live Salmonella typhimurium when plasma and tissue zinc levels were manipulated. Alzet pumps implanted intraperitoneally infused zinc gluconate or sodium gluconate (controls) from the onset of infection to 72 h postinfection. Plasma and tissue zinc levels were manipulated by infusing (i) 180 ,ig of Zn per h to achieve supranormal plasma and tissue zinc concentrations, (ii) 120 ,ug of Zn per h to prevent the infection-induced fall and to maintain plasma zinc levels at noninfection levels while raising tissue levels above that of infected controls, and (iii) 30 ,ug of Zn per h to increase tissue zinc levels while allowing the infection-induced decrease in plasma zinc. Preventing the fall in plasma zinc while raising liver zinc to supranormal levels enhanced rather than reduced percent survival; raising plasma and liver zinc to supranormal levels returned survival to control levels. Loading the liver with an excess of zinc without changing plasma zinc (30 ,ug of Zn per h) did not increase percent survival in the infected host. Pretreatment or administration of zinc at the time of infection led to increased percent survival compared with administration of zinc 4 h after the onset of infection.
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