MR-pro-atrial natriuretic peptide (MR-proANP) predicts short- and long-term outcomes in respiratory tract infections: A prospective validation study

Chronic intravenous infusions of atrial natriuretic peptide (ANP) have been shown to lower mean arterial pressure (MAP) in both normal and hypertensive animals. However, the importance of the renal actions of ANP in mediating this hypotension is unknown. This study was designed to determine whether physiological or pathophysiological increases in intrarenal ANP levels influence long-term control of arterial pressure. ANP was infused into the renal artery of seven conscious, uninephrectomized, chronically instrumented dogs at 1, 2, and 4 ng.kg-1.min-1 for 7 days at each dose, followed by a recovery period. Then ANP was infused intravenously following the same protocol. MAP decreased from 88 +/- 3 to 78 +/- 3 mmHg during intrarenal infusion of 1 ng.kg-1.min-1 ANP; increasing the ANP infusion rate did not result in a further reduction in MAP. Systemic arterial plasma ANP concentration did not change from control (15 +/- 5 pg/ml) during 1 or 2 ng.kg-1.min-1 intrarenal ANP infusion but increased slightly during 4 ng.kg-1.min-1 intrarenal ANP infusion, averaging 53 +/- 11 pg/ml. Renal arterial plasma ANP concentrations were calculated to increase to approximately 120 +/- 5, 248 +/- 11, and 484 +/- 22 pg/ml during 1, 2, and 4 ng.kg-1.min-1 intrarenal ANP infusion, respectively. Intravenous ANP infusion did not alter MAP at 1 ng.kg-1.min-1, but MAP was slightly lower than control during 2 and 4 ng.kg-1.min-1 ANP infusion and remained below control during the postinfusion period.(ABSTRACT TRUNCATED AT 250 WORDS)

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Pro-atrial natriuretic peptide and pro-vasopressin for predicting short-term and long-term survival in community-acquired pneumonia: results from the German Competence Network CAPNETZ

Yearbook of Pulmonary Disease ◽

10.1016/j.ypdi.2010.11.036 ◽

2011 ◽

Vol 2011 ◽

pp. 158-160

Author(s):

J.R. Maurer

Keyword(s):

Atrial Natriuretic Peptide ◽

Natriuretic Peptide ◽

Community Acquired Pneumonia ◽

Competence Network ◽

Short Term ◽

Term Survival ◽

Long Term Survival ◽

Atrial Natriuretic

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Delayed prescribing of antibiotics for self-limiting respiratory tract infections in an urgent care out-of-hours setting

Journal of Prescribing Practice ◽

10.12968/jprp.2020.2.3.130 ◽

2020 ◽

Vol 2 (3) ◽

pp. 130-135

Author(s):

Justine Dexter ◽

Gerri Mortimore

Keyword(s):

Antimicrobial Resistance ◽

Respiratory Tract ◽

Respiratory Tract Infections ◽

Urgent Care ◽

Antibiotic Prescribing ◽

Out Of Hours ◽

Advantages And Disadvantages ◽

Health And Social Care ◽

Tract Infections

Long-term overuse of antibiotics and inappropriate prescribing has led to widespread development of antimicrobial resistance. The Department of Health and Social Care recently published a five-year national action plan to reduce antimicrobial resistance, with the aim of reducing inappropriate antibiotic prescribing. This is mirrored in the NHS Long Term Plan, which aims to reduce unintentional exposure through a combination of antibiotic stewardship and leadership at all levels. An acute respiratory tract infection is one of the most common presentations in primary care, with 16.7% of all prescriptions issued attributed to it. Therefore, out-of-hours prescribers contribute significantly to general antibiotic consumption. This article analyses the practice of delayed prescribing of antibiotics for the treatment of self-limiting respiratory tract infections in an out-of-hours service. The advantages and disadvantages associated with delayed prescribing, to safely treat patients whilst facilitating the reduction of antimicrobial resistance, are discussed. In addition, recommendations for future practice are offered. This article also focuses on the development of an advanced nurse practitioner, reflecting on the four pillars of advanced practice, which underpin advanced clinical practice and associated competencies.

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A short (3-day) course of azithromycin tablets versus a 10-day course of amoxycillin–clavulanic acid (co-amoxiclav) in the treatment of adults with lower respiratory tract infections and effects on long-term outcome

International Journal of Antimicrobial Agents ◽

10.1016/s0924-8579(97)00043-5 ◽

1998 ◽

Vol 9 (3) ◽

pp. 141-146 ◽

Cited By ~ 46

Author(s):

I.M Hoepelman ◽

M.J Möllers ◽

M.H van Schie ◽

A.P.M Greefhorst ◽

N.J.J Schlösser ◽

...

Keyword(s):

Respiratory Tract ◽

Clavulanic Acid ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Term Outcome ◽

Long Term Outcome ◽

Tract Infections

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Effects of an acute saline infusion on fluid and electrolyte metabolism in humans

AJP Renal Physiology ◽

10.1152/ajprenal.1992.262.5.f744 ◽

1992 ◽

Vol 262 (5) ◽

pp. F744-F754 ◽

Cited By ~ 14

Author(s):

C. Drummer ◽

R. Gerzer ◽

M. Heer ◽

B. Molz ◽

P. Bie ◽

...

Keyword(s):

Atrial Natriuretic Peptide ◽

Urinary Excretion ◽

Natriuretic Peptide ◽

Body Fluid ◽

Urine Flow ◽

Saline Infusion ◽

Electrolyte Excretion ◽

Renal Response ◽

Atrial Natriuretic

Several hormonal systems participating in body fluid and electrolyte homeostasis were investigated in six healthy volunteers in a supine body position during a period of 9 days and nights. Under strictly controlled conditions, striking circadian rhythms were observed for plasma levels of vasopressin, renin, aldosterone, guanosine 3',5'-cyclic monophosphate, cortisol, and epinephrine. Nocturnal decreases and diurnal increases in urine flow rate and urinary excretion of electrolytes were observed and closely paralleled the urinary excretion of urodilatin. During 48 h after an acute isotonic saline infusion (2 liters within 25 min) and after a 48-h control experiment the urinary excretion of H2O and electrolytes, and simultaneously the alterations in endocrine systems participating in body fluid homeostasis, were determined. Urine flow and urinary electrolyte excretion rates were significantly increased during 2 days after the saline infusion. The largest increase in urinary fluid and electrolyte excretion was observed between 3 and 22 h postinfusion. These long-term changes were paralleled by altered H2O and Na balances and also by elevated body weights that returned to baseline values with an approximate half-life of 7 h. These data suggest that vasopressin, atrial natriuretic peptide, and catecholamines are unlikely to be of major importance for the renal response to this hypervolemic stimulus. The renin-aldosterone system was suppressed during 2 days postinfusion. This suppression correlated with the effects of saline load on Na excretion. However, the closest relation with Na excretion was observed for the kidney-derived member of the atrial natriuretic peptide family, urodilatin, which was considerably increased during the long-term period up to 22 h postinfusion. Thus these data show that the human body in supine position requires approximately 2 days to regulate the amount of Na and H2O provided by an acute saline infusion. The data also suggest that urodilatin and the renin-aldosterone system might participate in the long-term renal response to an acute saline infusion and also in the mediation of circadian urinary excretion rhythms.

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