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In vitro studies have shown that glucocorticoids may increase atrial natriuretic-hormone (ANH) synthesis and/or release. This action of glucocorticoids has also been suggested in vivo in patients with Cushing's syndrome. However, in this circumstance, plasma AH elevation might be due to humoral disturbances associated with cortisol overproduction. We studied 16 patients with endogenous hypercorticism and 11 of them after successful treatment. Plasma levels of ANH, plasma renin activity (PRA), aldosterone, desoxycorticosterone (DOC), angiotensin II (All), cortisol, osmolarity, sodium and potassium, urinary free cortisol (UFC), and blood pressure were measured. Before treatment the mean plasma ANH concentration in patients with Cushing's syndrome was significantly higher than in controls (11.3 ± 2.6 vs. 4.9 ± 2.3 pmol/l; p < 0.001). ANH was correlated with cortisol and UFC (r = 0.715, r = 0.700; p < 0.05). There was no significant correlation between plasma ANH, PRA, aldosterone, DOC, All, osmolarity, sodium or blood pressure. After recovery, ANH concentration decreased in all patients and was not different from that of normal subjects (4.9 ± 2.3 vs. 4.3 ± 2.6 pmol/l). These results suggest that in Cushing's syndrome, ANH secretion is mainly dependent on the severity of hypercortisolism and independent of the other associated disturbances that we studied.
OBJECTIVES To compare complication rates and outcomes after removal of oesophageal foreign bodies by endoscopy or by oesophagotomy. METHODS Retrospective evaluation of medical records of dogs with oesophageal foreign bodies treated by endoscopy and/or oesophagotomy. Postoperative clinical signs, management, length of hospitalisation, type and rate of complications, and time interval to return to eating conventional diet were compared. RESULTS Thirty‐nine dogs diagnosed with oesophageal foreign bodies between 1999 and 2011 were included in the study. Most common breeds included West Highland white terrier, Jack Russell terrier and shih‐tzu. Successful endoscopic removal was possible in 24 out of 32 cases (Group 1), while surgical removal was successful in 15 out of 15 cases (7 of which had unsuccessful attempts at endoscopic removal) (Group 2). Length of hospitalisation, time to removal of gastrostomy tube and time to eat conventional diet did not differ between the groups. After foreign body removal, the incidence of oesophagitis, oesophageal stricture and perforation observed during repeated endoscopy were similar between the groups. CLINICAL SIGNIFICANCE In this retrospective study, removal of oesophageal foreign bodies either by oesophagoscopy or oesophagotomy had a similar outcome.
OBJECTIVE Leptin concentrations in humans are known to decrease in response to fasting. The aim of this work was to investigate whether leptin levels might also be modified by exercise‐induced negative energy balance. SUBJECTS Eight male runners reported in the morning from 0800 to 1200 h for (i) one resting session (sitting) and (ii) one exercise‐and‐rest session (2 h run and 2 h rest). MEASUREMENTS Plasma leptin, free fatty acids (FFA), glycerol, cortisol and salivary cortisol were assayed in both sessions at 1200 h. RESULTS After exercise‐and‐rest the leptin concentrations were lower than after rest (1.7 ± 0.1 vs 2.5 ± 0.2 μg/l, P < 0.05), i.e. a mean decrease of 30.3 ± 4.5% (range 9.5–45.8). Plasma FFA, glycerol and cortisol concentrations increased: FFA 0.78 ± 0.08 vs 0.18 ± 0.04 mmol/l, glycerol 0.13 ± 0.01 vs 0.04 ± 0.01 mmol/l, and cortisol 428 ± 36 vs 279 ± 27 nmol/l. A negative correlation was found between plasma FFA and leptin levels ( r = − 0.5, P < 0.05) and between plasma glycerol and leptin levels ( r = − 0.5, P < 0.05). No correlation was found between leptin and cortisol levels. CONCLUSIONS In normal subjects with low body fat, a strenuous exercise‐and‐rest lowers leptin levels by a mean of 30%. A role of lipolysis possibly via increased plasma free fatty acids and glycerol levels is suggested. Cortisol does not seem to be involved.
