Stabilization of the Skyrmion.
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Biomedical subjects
Publications and source records attributed to A Abdalla.
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Severe renal artery stenosis (RAS) is a relatively uncommon complication following renal transplantation but is a curable cause of hypertension which demands reliable early diagnosis to reduce morbidity, mortality and graft loss. Captopril renography has been used for a number of years as a method of detecting RAS mainly in native kidneys, with only a few studies concerning the transplant situation. Controversy still exists as to the diagnostic accuracy of this test and as to the most appropriate interpretation criteria with which to establish a positive result. This paper reports the evaluation of 26 captopril renography investigations on hypertensive renal transplant patients with a suspected diagnosis of RAS. Each renogram study was correlated with an arteriogram as the 'gold standard' which was undertaken within 28 days of the renography. A sensitivity of 92%, a specificity of 86% and an accuracy of 88% were achieved by including a consideration of the change in perfusion to the kidney between pre- and post-challenge studies. It is concluded that captopril renography is a useful screening test for the detection of transplant renal artery stenosis (TRAS).
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The efficacy of allapinin, ethacizine, ritmilen, kinilentin, obsidan and finoptin given alone and in different combinations was studied in 44 patients with paroxysmal atrial fibrillation provoked by transesophageal pacing. The use of the combinations of the drugs belonging to the first group as well of those of the first group combined with the drugs belonging to the 2nd-4th group permitted one to significantly enhance the treatment efficacy, to reduce drug doses in a lot of patients and, therefore, to minimize the rate of side effects. The data obtained promoted the choosing of the therapy algorithm to prevent paroxysms of atrial fibrillation. While designing the algorithm, account was taken of the rate of paroxysms and of the initial sinus rhythm as was of the results of estimating the comparative efficacy of the drugs under study.
The efficacy of 7 well-known Class I antiarrhythmic agents were retrospectively and by+crossover compared in 2 groups of patients treated in hospital in different years for ventricular arrhythmias. Class IC agents proved to be the most potent in the two groups of patients. The following algorithm is proposed to choose Class I agents: if quinidine or mexiletine is beneficial in the same patients, the other drugs will be also effective. If disopyramide fails to be beneficial, allapinin , ethacizine , propaphenon will be the most effective. When allapinin produces effects, ethacizine and propaphenon show their highest potency, but when each of them fails, a combination of antiarrhythmic agents should be used.
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An immunogenetic study of the response to streptococcal carbohydrate antigen of the cell wall was carried out on members of 15 multiplex families each having more than one sib affected with rheumatic heart disease. They comprised 30 parents and 61 sibs (32 with rheumatic disease and 29 without). Fifty healthy unrelated subjects served as controls. A history was taken and clinical examination carried out. Rheumatic activity was determined and HLA typing was carried out for nine A antigens, 15 B antigens, and six DR antigens. The immune response of lymphocytes to streptococcal polysaccharide antigen of the cell wall of group A beta haemolytic streptococci in vitro was studied by tritiated thymidine uptake. The results were statistically and genetically analysed. It was found that (a) all subjects with rheumatic disease were highly responsive to the streptococcal polysaccharide antigen of the cell wall, the sib pairs being mostly HLA identical; (b) all low responders had no rheumatic disease and their phenotypes were mostly different from those of the rheumatic member of their sib pair; (c) correlation of immune responsiveness (high or low) between HLA-identical sibs was significant, but insignificant between haplotype identical and non-identical sibs; (d) the gene responsible for high responsiveness to the streptococcal polysaccharide antigen of the cell wall is recessive and closely linked to HLA. In conclusion, it was found that exposure to pharyngeal infection with group A beta haemolytic streptococci may lead to acute rheumatic fever in those with an inherited recessive gene responsible for high responsiveness to the streptococcal polysaccharide antigen of the cell wall.
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Pharmacokinetics of allapinin tablets, used as a single dose, alone or in combination with other antiarrhythmic drugs (cordarone, mexitil, ritmilen) were assessed in 11 patients with frequent extrasystoles. Allapinin pharmacokinetic pattern was basically similar in patients in whom it was very effective and those in whom it had no effect. Combined use of the above-mentioned antiarrhythmic drugs and allapinin did not affect the latter's pharmacokinetic parameters. Allapinin pharmacokinetics can be described using a one-part model.
Safety and the effectiveness of combined therapy of arrhythmia was studied in 27 patients in prolonged (up to 4 months) administration of a combination of medicinal agents specially chosen during pharmacodynamic investigation. The obtained anti-arrhythmic effect was stable and there were no new side effects in prolonged administration of combinations of ethmozine with chinidin, ritmilen, obsidan, cordaron (amiodaron) and of allapinin with chinidin, ritmilen (disopyramide) and obsidan (propronalol). Tolerance to drugs was adequate and the ECG parameters remained unaffected.
Allapinine (Class IC), a new antiarrhythmic agent, was studied in 76 patients with premature contraction. Allapinine was found to be beneficial both in ventricular and supraventricular premature beats. Oral allapinine usually showed its effect 40-60 minutes following its administration, its maximum action being 4-5 hours later, its duration was some 8 hours. The optimal dose of the drug amounted to 75 mg/day. Larger-dose allapinine produced adverse effects, its lower dosage had no antiarrhythmic effect. The drug failed to affect blood pressure, heart rate, QT interval length. The PQ interval and QRS complex were increased. The side effects were dose-dependent. There was a risk of the drug's arrhythmogenic effect.
Oral prolecohen (LEK, Yugoslavia) was given in a single dose of 300 mg to 15 patients with extrasystole of various genesis. The drug produced an antiarrhythmic effect in 50% of patients with ventricular extrasystole, but in those with supraventricular extrasystole. Prolecophenum showed a good tolerance. In 20% of the patients the adverse reactions appeared as mild headache, dizziness, dry mouth, malaise in the epigastric region. There is also evidence for efficacy of other antiarrhythmic agents used in this group of patients.
The study included three groups of children: (a) 38 with active rheumatic fever (ARF) and active carditis; 21 seen during their first attack and 17 during recurrence of activity, (b) 47 with inactive rheumatic fever (IARF); the period since activity was less than 3 years in 31 cases and more than 3 years in 16 cases. Using monoclonal antibodies and T lymphocyte blast transformation induced by PHA, we found: (1) low total T lymphocytes, helper-inducer cells and helper-inducer/suppressor-cytotoxic ratio which persisted for years; and (2) reduced lymphoblast transformation in active disease.
The efficiency of various combinations of antiarrhythmic agents (quinidine, etmozin, disopyramide, mexitil, and allapinine) was assessed in 24 cases of frequent ventricular and supraventricular extrasystoles, where treatment with one of the above listed drugs had been ineffective. Combined use of the drugs produced anti-arrhythmic effect in 22 of the patients. Mechanisms of the combined action are discussed.
The efficiency of a number of antiarrhythmic drugs (etmozin, quinidine, mexytil, allapinin, cordarone), used alone and in combinations, was assessed in 13 patients with refractory continuous extrasystoles of varying origins. Antiarrhythmic effect of the drugs was evaluated by means of Holter ECG monitoring. Monotherapies were only effective in 3 patients, and developing side effects limited the possibilities of long-term use. Combined treatment produced a greater effect, while smaller doses of individual drugs making up the combination resulted in a better tolerance due to reduced side effects.
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