Possible interaction between cyclosporine and josamycin: a description of three cases.
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Biomedical subjects
Publications and source records attributed to J Honorato.
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Buspirone is a new drug with ansiolitic properties which chemical structure and mechanism of action is different from the classical drugs traditionally used for this symptom. Its farmacokinetic characteristics make it a convenient drug to be used for oral administration. Buspirone's double-blind controlled clinical studies contrasted with benzodiazepines have shown that buspirone has an ansiolitic effect close to them but without sedation or relaxation. Other secondary effects appear with a smaller incidence with buspirone. These properties make buspirone very efficient in anxiety treatment.
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Twenty one adult patients, both males and females, with 32 bacterial infections of several localizations and moderate to severe prognosis were treated with ciprofloxacin (200 mg every 12 hours), initially intravenously and then with 500 mg every 12 hours orally during 25 +/- 11 days. At the end of the evolution period it was found that 28 infections (87.5%) were cured in 24 of the 28 patients (85.7%), in three patients there was a definite clinical improvement and the treatment failed in the remaining patient. Adverse reactions were suspected in 2 patients, but their relation with the administration of ciprofloxacin was considered to be remote. In 3 patients mild leukopenia without clinical relevance was detected.
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Serial myocardial imaging using thallium Tl 201 was performed in the early follow-up of two patients with orthotopic cardiac transplantation. In one patient, non-homogeneous uptake, small defects and an irregular myocardial edge were observed during a moderately acute rejection crisis revealed by endomyocardial biopsy. The abnormal gammagraphic findings and histological changes were coincident and exhibited a parallel reversal. We emphasize the connection between these two events. The mechanisms which could explain these phenomena are discussed.
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We present a patient 52 years old with a symtomatology of three month's evolution with: rapid weight loss, weakness in legs fasciculated tremor increased by any physical effort, nervousness and anxiety. The isotopic exploration of thyroid in basal conditions and after estimulation with TSH shows a very small captation of iodide. The determination of T 4 shows a notable increase (24 U. U. Normal range is 7,5 to 10,5 U. U.). The clinical symtomatology biochemical and gammagraphic datum support the diagnostic of subacute thyroiditis and also the posterior evolution of symtomatology in spite of the absence of odynophagia and the increase of syze of the thyroid. We comment on the particularity of this clinical entity that could be confused with thireotoxicosis because of its atypical character of presentation.
Fosfomycin has been tested in 25 adult patients with bronchial or bronchopulmonary acute processes, of which 13 were simple acute processes of a greater or lesser severity, and 12 acutenesses of chronic bronchial processes. The germs found most frequently in the sputum cultures were Streptococcus pneumoniae and Klebsiella. Fosfomycin was used intramuscularly with doses of 4 g/day, for an average of 10 days. The results obtained were 16 cures, 7 improvements and 2 failures, which represents 92% success with 8% failures.
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The different laboratory technich for the determination of digoxin serum concentrations are analysed. Special emphasis is placed on the radioimmunoassay technic. The advantages and disadvantages of this technic are studied and the standard curves obtained in our determinations (n=39) are analysed. It can be seen that they can be reproduced in all cases with a high degree of similarity. The possible causes of error in this microtechnic are also analysed and a modification in the decanting fase, with which the number of repetitions in our laboratory has decreased, is suggested. Finally the criteria for the actual evaluation of the seric digoxin levels used in our laboratory are described and new possibilities in pharmacological investigation by this technic are mentioned.
A randomized, double-blind, 12 weeks comparison of Lovastatin and Gemfibrozil in the treatment of patients with primary hypercholesterolemia was performed in 31 patients. After a placebo and diet period (4 weeks), they were assigned to either Lovastatin 20 mg nightly or Gemfibrozil 600 mg twice daily, if their total serum cholesterol was < 300 mg/dl, and to either Lovastatin 40 mg nightly or Gemfibrozil 600 mg/12 if it was > 300 mg/dl. In both cases, the Lovastatin dose was doubled after 6 weeks, if serum cholesterol remained > 200 mg/dl. The dose of Gemfibrozil kept constant. Lovastatin reduced serum cholesterol from 354 +/- 91 mg/dl to 253 +/- 62 mg/dl (p < 0.001), LDL-cholesterol from 277 +/- 104 to 192 +/- 71 mg/dl (p < 0.001) and serum triglyceride level from 125 +/- 66 a 84 +/- 41 mg/dl. The corresponding reductions achieved by Gemfibrozil were: 343 +/- 86 to 290 +/- 72 mg/dl (p < 0.01), 264 +/- 89 to 217 +/- 67 mg/dl (p < 0.05) and 152 +/- 84 to 89 +/- 41 mg/dl (p < 0.001), respectively. Lovastatin therapy caused a 30.6% reduction in total cholesterol level, while Gemfibrozil achieved a 19.47%. There were no significant changes in HDL-cholesterol. Patients had no serious or clinically significant adverse effects. The current data suggest that Lovastatin (an inhibitor of HMG-Coa reductase) may provide one important means for lipid-lowering therapy in patients with primary hypercholesterolemia.
A randomized crossover study was designed in order to evaluate the bioequivalence of a sustained-release preparation (DR) of diclofenac sodium (Dolotrén RETARD) with respect to an enteric coated (D) tablet (Dolotren). For this purpose the bioavailability of both formulations, orally administered in single and multiple doses, was determined. Nine healthy volunteers were included in this study, receiving 100 mg of D and 100 mg of DR, firstly in single dose and then for 15 days b.i.d. for D group and once a day for DR group. For the analytical determination of diclofenac, blood samples at established time intervals, the day of the single dose and the 3rd, 7th and 15th day of multiple dose administration, were taken. The following kinetic parameters were determined: Cmac, tmax, alpha and beta, clearance, ka, area under the curve and absolute and relative bioavailability. When administered both endovenous and orally, the great interindividual variability in the kinetic characteristics of diclofenac sodium is evidenced. The lag time (tlag) for DR is 0.4 h, shorter than for D (2.2 h), which indicates a faster absorption in the upper sections of the gastrointestinal tract. Also tmax was shorter for Dr (1.9 h) than for D (4.3 h). Cmax obtained with D was higher tan with DR. The diclofenac sodium elimination process from plasma is significantly slower with DR than with D (t1/2 beta = 18.1 h and 2.5 h, respectively). In consequence, quantifiable plasmatic levels are maintained for at least 24 hours after administration of DR, but not of D. Absolute bioavailability of both preparations is about 80%, with great interindividual variations. Significant differences between the two preparations could not be demonstrated. Relative bioavailability between DR and D was 91.5%. None of the preparations when administered in repeated doses, D every 12 hours and DR every 24 hours, produced accumulation, neither their pharmacokinetic characteristics changed. Clinical and biological tolerance of both preparations were excellent, at doses used and for the period of time studied. Dolotren Retard is absorbed orally faster than Dolotren and maintains plasmatic levels longer, which allows it to be administered once a day, with a lesser incidence of undesirable effects related to Cmax.