Multifocal cortical myoclonus and cerebral amyloid beta-peptide angiopathy.
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Aged↗
Biomedical subjects
H Mehta
Publications and source records attributed to H Mehta.
Combining aspirin with angiotensin converting enzyme inhibitors in heart failure: how safe is it?
The above discussion on the interaction of aspirin and ACE inhibitors seems to suggest that aspirin in high doses may have adverse interaction with ACE inhibitors in patients with heart failure but the data obtained is not sufficient or conclusive to recommended omission of aspirin in patients with heart failure. This raises a query in the mind of the physician whether to use a combination or not? The role of aspirin in the early period after myocardial infarction is well established so is the role of ACE inhibitors. Hence in patients with myocardial infarction and preserved left ventricular function it would not be wrong to administer combination of ACE inhibitors and aspirin. Albeit at a lower dose. In patients with large myocardial infarction or heart failure, warfarin may be an option but still needs to be documented in large trials. As suggested long term use of aspirin after infarction is still ambiguous and may be harmful in patients with heart failure with its anticedent side effects. But long term benefits of ACE inhibitors in heart failure are well documented. Hence if a choice has to be made whether to discontinue either of the two drugs it would be preferable to stop the aspirin. To answer the issue of use of aspirin in patients with heart failure it would be essential to conduct a double blind randomized trial comparing known anti-thrombotic treatment, aspirin and anti-coagulants on mortality in patients with heart failure, especially caused by coronary artery disease. Such a trial is underway at the present and till the results are available it should be left to clinical judgement of the physician whether to administer aspirin in patients with heart failure after weighing the benefits versus risk.
Angiotensin-Converting Enzyme Inhibitors↗
Effects of dexamethasone on acute virus-induced airway dysfunction in adult rats.
Respiratory viral infections have been associated with airway obstruction and hyperresponsiveness, and exacerbations of asthma. Although virus-induced asthma is thought to be precipitated by airway inflammation, the clinical efficacy and rationale for using antiinflammatory treatment during such exacerbations remains controversial. The purpose of this study was to use a well characterized animal model of respiratory viral illness to test the hypothesis that the inflammatory response to viral infection is responsible for the development of airway dysfunction. Adult rats were inoculated with either Sendai virus or sterile vehicle and treated with daily injections of dexamethasone or saline. At postinoculation d 4, 5, or 6, rats were evaluated for airway obstruction, hyperresponsivenes, inflammation, and lung viral titers. Saline-treated infected rats had significant airway obstruction (increased resistance, decreased dynamic compliance), hyperresponsiveness (i.v. methacholine), and inflammation (increased bronchoalveolar lavage leukocytes) compared with noninfected controls. In contrast, dexamethasone-treated infected rats had no increase in bronchoalveolar lavage leukocytes and significantly smaller changes in airway physiology, but had increased lung viral titers compared with saline-treated infected rats. We conclude that glucocorticoid suppression of the inflammatory response to respiratory viral infection largely prevents virus-associated airway dysfunction.
Animals↗
Carcinoma of the prostate--state at initial presentation.
In this retrospective study an attempt is made to document the stage at initial presentation of prostatic cancer. Of the 142 patients seen, 84% presented in an advanced stage and this explains why radical prostatectomies are rarely done in India. Hence efforts are required to screen the population for early diagnosis of the disease.
Humans↗
Pholedrine: a substitute for hydroxyamphetamine as a diagnostic eyedrop test in Horner's syndrome.
Mydriatic responses to eyedrops containing the indirect acting sympathomimetic amines tyramine, hydroxyamphetamine, and pholedrine have been compared in 10 healthy subjects. Pholedrine, the n-methyl derivative of hydroxyamphetamine, at a concentration of 1% had effects similar to those produced by 0.5% hydroxyamphetamine itself. Pretreatment with topical guanethidine attenuated its responses and in 13 patients with unilateral Horner's syndrome it distinguished clearly those five patients who had preganglionic from the eight with postganglionic lesions. It is concluded that 1% pholedrine may be substituted for 0.5% hydroxyamphetamine, which is no longer available, as a diagnostic agent for use in Horner's syndrome.
Adolescent↗
GAD65 autoantibodies increase the predictability but not the sensitivity of islet cell and insulin autoantibodies for developing insulin dependent diabetes mellitus.
The clinical onset of insulin-dependent diabetes (IDD) can be predicted by determination of autoantibodies to several pancreatic-islet cell antigens. Islet-cell autoantibodies (ICA) and insulin autoantibodies (AA) are most commonly used. We have developed a recombinant human glutamic acid decarboxylase (GAD65) radioimmunoassay and measured autoantibodies to GAD65 (GAD65A) in the sera of 73 documented prediabetic individuals, 76 newly-diagnosed patients, 103 relatives of IDD probands at increased risk for the development of IDD because they were positive for ICA and/or IAA, 72 ICA and IAA negative relatives, and 207 healthy controls. Our data demonstrate that GAD65A are strongly associated with the currently established autoantibody markers of IDD. Their presence in prediabetic subjects with only ICA or IAA enhances their risk for progression to IDD, yet does not much enhance the screening sensitivity already available through conventional ICA and IAA for IDD prediction.
Adolescent↗
Complications in a personal series of one hundred and five radical cystectomies: specific problems in a developing country.
During the 6-year period 1986-1992, 105 patients with muscle invasive bladder cancer underwent radical cystectomy in our department. All the operations were done by the principal author using the same standard technique. Herein we analyse our perioperative complication rate and highlight some of the surgical steps which contribute to this low complication rate.
Adult↗
Eosinophil as a therapeutic target in allergic disease.
The eosinophil appears to be a key cell in the development of active symptoms in both allergic diseases and asthma. Its involvement in inflammation seems to be mediated in part by release of its mediators ECP, MBP, EPO, and EDN. Therefore, the eosinophil and its inflammatory mediators would make ideal targets for pharmacological manipulation. In designing therapeutics to modify eosinophil participation, it will be helpful to keep the pharmacologic regulation as eosinophil-specific as possible. In this way, The function of other granulocytes is not affected and the patient is still able to fight infections.
Asthma↗
Mirizzi syndrome (hepatic duct obstruction).
The Mirizzi syndrome is an uncommon cause of obstructive jaundice. In 1948, Mirizzi characterized a syndrome in which common hepatic duct obstruction occurs because of impacted stones in the gallbladder neck or cystic duct. The authors report a case demonstrating this syndrome. They discuss the radiographic features and report the features found on a computed tomographic cholangiogram that have not been previously described. Computed tomography-cholangiography may be helpful in evaluating patients with suspected Mirizzi syndrome.
Cholangiopancreatography, Endoscopic Retrograde↗
Atrial septal defect presenting as recurrent primary amoebic lung abscess.
A middle-aged female with an atrial septal defect (secundum type) presented with a primary pulmonary amoebic abscess. She was successfully treated with antiamoebic therapy. One year later she presented with a similar lung abscess which again responded to antiamboebic treatment. Attention is drawn to the fact that a patient with a left to right shunt can present with a recurrent rare primary parasitic infection of the lung.
Amebicides↗
Concentrations of Na+ and K+ in serum and uterine flushings of ovariectomized, pregnant and cyclic rats when treated with extracts of Hibiscus rosa sinensis flowers.
The effect of 50% ethanol and benzene extracts of Hibiscus rosa sinensis flowers was studied on the concentration of Na+ and K+ in the serum and uterine flushings of ovariectomized, mated and cyclic rats. In ovariectomized rats, both extracts given alone did not alter the K+ content of the uterine flushings but when administered with estradiol dipropionate (EDP), a partial antagonism was observed when compared to EDP given alone. Conjoint treatment of extracts with EDP plus progesterone did not induce any significant change. In mated rats, both extracts did not alter the concentration of Na+ on the day of implantation but decreased significantly the concentration of K+ in uterine fluid. In cyclic rats, the administration of the extracts for 6 and 12 days did not cause any significant change in the concentration of K+ of uterine flushings but their administration for 18 days caused a significant decrease. In all three experiments, the concentration of Na+ in uterine flushings and of Na+ and K+ of serum did not show any significant changes.
Animals↗
Sulfated proteoglycans produced by rat dorsal root ganglion cells.
Primary organotypic cultures of embryonic rat dorsal root ganglia, which contain sensory neurons, Schwann cells, and fibroblasts, produce an extensive extracellular matrix. These cultures actively incorporated 35SO4 into glycosaminoglycans, of which 30% were heparan sulfate, 65% chondroitin sulfate, and 5% dermatan sulfate. Sulfate-labeled proteoglycans made by these cells were extracted with 4 M guanidine-hydrochloride and purified by CsCl density gradient centrifugation, gel filtration chromatography, and DEAE-cellulose chromatography. Eight individual species were resolved, of which five were subjected to further analysis. One low-density (less than 1.35 g/ml) proteoglycan, with a Kav on Sepharose Cl-4B = 0.34 contained heparan sulfate chains of Mr = 20,000. The other four proteoglycans, with Kav on Sepharose Cl-4B of 0.04, 0.35 (two), and 0.44, contained predominantly chondroitin sulfate chains with Mr ranging from 30,000 to 40,000. To determine possible functions of these proteoglycans, cultures were grown in medium containing 1 mM 4-methyl-umbelliferyl-beta-D-xyloside. The drug inhibited 35SO4 proteoglycan accumulation in the cell layer by approximately 90%. Drug-treated cultures exhibited several developmental abnormalities, including decreased migration of fibroblast-like cells, abnormal morphology of these cells, and decreased myelination of axons by Schwann cells.
Animals↗
Synthesis by Schwann cells of basal lamina and membrane-associated heparan sulfate proteoglycans.
Primary cultures that contain only Schwann cells and sensory nerve cells synthesize basal lamina. The assembly of this basal lamina appears to be essential for normal Schwann cell development. In this study, we demonstrate that Schwann cells synthesize two major heparan sulfate-containing proteoglycans. Both proteoglycans band in dissociative CsCl gradients at densities less than 1.4 g/ml, and therefore, presumably, have relatively low carbohydrate-to-protein ratios. The larger of these proteoglycans elutes from Sepharose CL-4B in 4 M guanidine hydrochloride (GuHCl) at a Kav of 0.21 and contains heparan sulfate and chondroitin sulfate chains of Mr 21,000 in a ratio of approximately 3:1. This proteoglycan is extracted from cultures by 4 M GuHCl but not Triton X-100 and accumulates only when Schwann cells are actively synthesizing basal lamina. The smaller proteoglycan elutes from Sepharose CL-4B at a Kav of 0.44 and contains heparan sulfate and chondroitin sulfate chains of Mr 18,000 in a ratio of approximately 4:1. This proteoglycan is extracted by 4 M GuHCl or by Triton X-100. The accumulation of this proteoglycan is independent of basal lamina production.
Animals↗
Hepatic dysfunction due to intravenous abuse of methylphenidate hydrochloride.
Methylphenidate-induced hepatic injury was documented by abnormal liver function tests including a markedly elevated serum bilirubin, serum glutamic oxaloacetic transaminase, and serum glutamic pyruvic transaminase. Liver biopsy confirmed portal inflammation and hepatocellular disarray. Enzyme changes were reproducible with rechallenge of the drug (Ritalin). The drug is capable of producing hepatic injury, particularly when given in nonstandard doses intravenously.
Adult↗
Treatment of acute alcoholic pancreatitis: the roles of cimetidine and nasogastric suction.
A double-blind prospective controlled study designed to determine the effectiveness of the addition of cimetidine to standard treatment of acute alcoholic pancreatitis and to determine the importance of nasogastric suction in this disorder was undertaken. Forty-five patients were randomized to one of four treatment groups: 1) group I received intravenous cimetidine plus a blinded nasogastric tube, 2) group II received intravenous cimetidine plus nasogastric suction, 3) group III received nasogastric suction plus cimetidine placebo, and 4) group IV received a blinded nasogastric tube plus cimetidine placebo. Patients were evaluated via both biochemical and clinical parameters. It was concluded that 1) cimetidine added to more traditional therapy does not hasten improvement in patients with acute alcoholic pancreatitis, 2) cimetidine may delay recovery as measured by both clinical and biochemical measurements, 3) nasogastric suction appears indicated, under most circumstances, only in those patients with ileus and/or nausea and emesis.
Acute Disease↗
Model-independent procedure for area estimation and intergroup comparisons.
A method is provided for estimating the area under a response-time curve for an experimental situation where independent observations are made at each time point. The procedure utilizes least-squares spline functions and the jackknife technique to provide area estimates, standard errors, and a statistical test for intergroup comparisons. The method is based on an empirical model and provides a means of analysis when no prior model can be specified or if the incorrect specification of a model will produce invalid results. The method is illustrated using data from a study comparing the pharmacokinetic behavior of a fasciolicide in rats having either a young or old parasitic infestation. The results obtained are comparable with those generated by a model-dependent approach.
Animals↗
Iron therapy after cardiac operation: one prescription less?
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Anemia, Hypochromic↗