International Federation of Clinical Chemistry, Scientific Committee: Drug interferences and drug effects in clinical chemistry. Part 3. Evaluation of biological effects of drugs.
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Biomedical subjects
Publications and source records attributed to J G Salway.
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myo-Inositol, 500 mg twice a day, given to seven diabetic patients for two weeks, increased the amplitude of the evoked action potentials of the median, sural, and popliteal nerves by an average of 76%, 160%, and 40%, respectively. There was no significant change in the conduction velocities of these nerves, myo-Inositol may be valuable in the treatment of diabetic neuropathy.
In pregnancies with a normal outcome the oestrogen:creatinine ratio in early morning samples of urine showed a smaller day-to-day variation than the ratio in 24-h urine or the 24-h total oestrogen excretion, and a significant fall could be detected more easily. Patients admitted to hospital who eventually delivered a healthy baby provided a reference range which, after logarithmic transformation, increased linearly with period of gestation. A fall in log10 oestrogen:creatinine ratio exceeding 40% of this range is unusual in pregnancies with a healthy outcome, and suggest impaired fetoplacental function.
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In a series of patients with chronic renal failure managed conservatively, the rise in the plasma-myo-inositol (myoinositol) concentration has been found to be related to depression of sural-nerve conduction velocity. There was no correlation with motor-nerve conduction velocity in the peroneal nerve, or with either of these variables in a series of patients receiving chronic haemodialysis. Despite the negative correlation with sural-nerve conduction velocity, there was no correlation between the plasma-myoinositol concentration and the presence of peripheral neuropathy as assessed clinically. It is concluded that hypermyoinositolaemia may depress nerve conduction velocity, but there is no evidence that it is responsible for the development of uraemic polyneuropathy.
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A case of bilateral phaeochromocytoma with catecholamine-induced myocarditis is described. The two operations needed allowed comparison of the use of alpha-methyl-p-tyrosine alone and in conjunction with adrenergic blocks in the management of the patient. The combination of both drugs was particularly successful in the relief of symptoms and reduction of catecholamine metabolism as monitored by 4-hydroxy-3-methoxymandelic acid (HMMA) excretion. As myocarditis is a potentially fatal complication, further investigation of the combined use of alpha-methyl-p-tyrosine and adrenergic blocking drugs is suggested in the pre-operative management of patients with phaeochromocytoma.
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