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Radan Stojanović

Publications and source records attributed to Radan Stojanović.

12 recordsLinked to original sources

Single-dose intravenous simvastatin treatment attenuates renal injury in an experimental model of ischemia-reperfusion in the rat.

The effect of acute pretreatment with a single dose of simvastatin (1 mg/kg, i.v.; 30 min before ischemia) on renal dysfunction caused by ischemia-reperfusion (I/R) injury in the rat was investigated. I/R injury was induced by clamping both renal vascular pedicles for 45 min, followed by 4 h of reperfusion with saline (2 ml/kg per hour). Simvastatin significantly improved both parameters of glomerular and tubular dysfunction (e.g., creatinine levels and fractional excretion of Na(+), respectively) and especially improved the histological score, compared to control I/R-injured rats treated with saline or 10% DMSO only.

Animals↗

Homocysteine serum levels and MTHFR C677T genotype in patients with Parkinson's disease, with and without levodopa therapy.

Both methylenetetrahydrofolate (MTHFR) C677T genotype and levodopa treatment may give rise to elevated serum homocysteine levels in parkinsonian patients. We aimed to clarify the interplay of these factors in pathogenesis of Parkinson's disease (PD)-related hyperhomocysteinemia. Total serum levels of homocysteine (tHcy) and MTHFR C677T genotype were investigated in levodopa-treated and -untreated parkinsonian ("de novo") patients, as well as in control healthy subjects matched by age and gender (N=83, 30 and 53, respectively). MTHFR C677T genotypes were equally distributed in PD patients and control subjects, the T allele homozygosity being observed in app. 12-17% cases. tHcy concentrations were significantly higher in both levodopa-treated and -untreated PD patients than in control subjects, and in TT homozygotes than in CT or CC genotype carriers. tHcy levels significantly correlated with the duration of the disease in PD treated patients only, reaching the maximum after 3-6 years. However, there was no correlation between tHcy levels and total daily intake of levodopa in the same group of PD patients. In conclusion, MTHFR C677T genotype is a significant factor for hyperhomocysteinemia in patients with PD, levodopa-untreated and probably even more in levodopa-treated PD patients.

Adult↗

Pattern of utilization of benzodiazepines in patients with hypertension: a pilot study.

BACKGROUND/AIM: The analysis of drug prescribing in general practice in Serbia showed that the use of benzodiazepines is most frequently associated with hypertension. The aim of this study was to establish the correlation of the characteristics of patients with hypertension to antihypertensive drug therapy, and the intake of benzodiazepines. METHODS: A special questionnaire was used for interviewing the patients (n = 171) chronically treated for hypertenson. Statistical tests used were chi2-test and Student's t-test. RESULTS: No differences were noted in terms of age, gender, education, body weight, smoking habits and blood pressure (155 +/- 4.9/100 +/- 2.7 mmHg vs. 160 +/- 2.2/105 +/- 3.7 mmHg), between the group I (antihypertensive drugs+benzodiazepines: n = 79), and the group II (antihypertensives only: n = 92). The patients taking benzodiazepines received a lower number of different antihypertensive drugs (2.3 +/- 0.09 vs. 2.7 +/- 0.10; p < 0.01), but the total antihypertensive drug load was significantly greater than in the group II (2.6 +/- 0.10 vs. 1.9 +/- 0.15 defined daily doses (DDD)/patient/day; p < 0.01). Benzodiazepines were taken for anxiety (62%) and hypertension (21%), rarely for insomnia, mostly once a day, at bedtime. About half the patients took benzodiazepines regularly for months or years aware of the risk for addiction. Diazepam was used by 82% of the patients. The average daily exposure to benzodiazepines was 0.45 +/- 0.05 DDD/patient/day. The drug was bought without prescription in 25% of the patients, and without consulting a physician in 12% of them. CONCLUSION: The study confirmed a close association of hypertension with the use of benzodiazepines. The frequent use of benzodiazepines in the patients with hypertension might be caused by an inadequate response to antihypertensive drug therapy, besides anxiety and insomnia. The therapeutic efficacy of a long-term use of low doses of benzodiazepines in hypertension requires further investigation.

Anti-Anxiety Agents↗

NG-nitro-L-arginine methyl ester potentiates the effect of aminophylline on the isolated rat hemidiaphragm.

The effects of different concentrations of N(G)-nitro-L-arginine methyl ester (L-NAME) (0.3, 1, 3, and 10 mM), a non-selective inhibitor of NOS, on the effect of aminophylline on the isometric contraction of the isolated rat hemidiaphragm were investigated. The muscle contractions were induced by direct subtetanic electrical stimulation. Aminophylline (0.36 - 3.60 mM) produced a typical concentration-dependent increase in both parameters of the isometric contraction: tension developed (Td) and the maximum rate of rise of tension (dT/dt max). The second series of additions of aminophylline produced a more pronounced effect. L-NAME (0.3, 1, 3, and 10 mM, 30 min of incubation without stimulation) itself did not change Td and dT/dt max. However, L-NAME (1, 3, and 10 mM) produced a statistically significant potentiation of the effect of aminophylline on Td and dT/dt max.

Aminophylline↗

[Nitric oxide and lung diseases].

INTRODUCTION: All three isoforms of nitric oxide synthase (NOS) are identified within various tissues of the respiratory system. ISOFORMS OF NOS: Under physiological conditions, small amounts of NO, produced by constitutive isoforms of NOS, appear to be important in regulation of basal pulmonary vascular tone and in mediating transition from fetal to neonatal circulation; also, NO exerts antiinflammatory actions, and modulates the respiratory smooth muscle tone. NO AND RESPIRATORY TRACT DISEASES: Under pathological conditions, inducible NOS-derived NO may produce lung damage. In addition, increased or decreased production of NO is found in chronic obstructive pulmonary disease, cystic fibrosis, asthma and related inflammatory disorders, and exhaled NO level measurement is a useful tool in diagnostics of respiratory disorders. CONCLUSION: It has been shown that NO modulates contractility of the isolated diaphragm, and there are important interactions between NOS inhibitors and drugs for respiratory disorders (e.g. aminophylline).

Humans↗

[Antibiotic resistance].

INTRODUCTION: After six decades of antibiotic use, the prevalence of antibiotic-resistant bacteria is increasing, and organisms resistant to almost all antibiotics have been identified. ANTIBIOTIC RESISTANCE: It is important to understand why antibiotic resistance develops, in order to design strategies for its prevention. Factors that promote antibiotic resistance in community and hospital settings are: antibiotic selective pressure, prolonged antibiotic treatment, inadequate doses, prior use of a less effective drug of the same antibiotic class, protected sites or foreign bodies, and poor infection control practice. The best available ways to decrease and control antibiotic resistance are: rational use of antibiotics (e.g. appropriate selection of drug, dose, duration of treatment), good infection control procedures (hygienic practice and isolation), as well as local, national and global surveillance networks for monitoring dissemination of antimicrobial resistance and detection of new resistance mechanisms. CONCLUSION: Clinical guidelines, direct education, and regular reports on antibiograms may contribute to more prudent use of antibiotics. Overall, the problem of antibiotic resistance is global. However, measures need to be taken at an individual, institutional, and ultimately at national healthcare level.

Drug Resistance, Bacterial↗

[Psychiatric adverse effects induced by recombinant interferon alfa in patients with chronic hepatitis C].

INTRODUCTION: Hepatitis C virus infection is a slowly progressive chronic disease and the most common cause of chronic liver disease. Presently, interferon alfa based therapies, with or without ribavirin, are standard treatment for chronic hepatitis C virus infection. The most troublesome psychiatric side effects of interferon therapy in our patients are: insomnia, irritability, anxiety, mood changes, short temper, emotional and affective lability, impaired cognitive function, apathy, loss of motivation and the most serious depression with or without suicidal ideas. MATERIAL AND METHODS: In our study we treated 82 patients chronically infected with HCV divided into 3 groups: the first group of 31 patients (20 male and 11 female) received IFN-alfa in standard doses of 3 MU three times a week (t.i.w) during 24 weeks; the second group of 36 patients (25 male and 11 female) received IFN-alfa, 3 MU t.i.w plus ribavirin 1000-1200 mg per day during 24 weeks; the third group of 15 patients (11 male and 4 female) received IFN-alfa, 3 MU t.i.w plus ribavirin 1000-1200 mg per day during 48 weeks. The follow-up period after therapy in all groups lasted 24 weeks. RESULTS: During treatment, we observed at least one psychiatric side effect in 21 (26%) patients: insomnia in 11 (13%), emotional and affective lability in 9 (11%), anxiety, irritability and short temper in 8 (10%), impaired cognitive function in 7 (8%) apathia and loss of motivation in 6 (7%) treated patients. Depression, the most serious side effect, was established in 8 (10%) patients. All of these side effects were observed during later stages of treatment (between 5th and 22nd weeks of treatment). The incidence of all psychiatric side effects was significantly higher in women than in men (p < 0.01). We observed higher prevalence of depression among patients with history of alcohol and drug abuse. Treatment was temporarily discontinued (from 2 to 4 weeks) in all patients with depression, but it was not permanently discontinuated in any patient due to psychiatric side effects. CONCLUSION: Interferon causes psychiatric disorders that are usually mild and reversible. They disappear either spontaneously, while patients are still receiving therapy or after temporary cessation of interferon alfa therapy.

Adolescent↗

[Opioid analgesics].

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Analgesics, Opioid↗

High-dose streptokinase in the treatment of acute massive pulmonary embolism complicated with cardiogenic shock, respiratory arrest and ventricular fibrillation.

BACKGROUND: Despite advances in prophylaxis, diagnostic modalities, and therapeutic options, pulmonary embolism remains a commonly undiagnosed entity with lethal outcome. Clinically, pulmonary embolism ranges from massive thromboembolism with cardiogenic shock to asymptomatic, microebolism with anatomically small emboli without hemodynamic, respiratory or other disturbances. CASE REPORT: A patient with massive pulmonary embolism complicated with ventricular fibrillation, respiratory arrest and cardiogenic shock was treated with a total dose of 3 750 000 IU of intravenous streptokinase in the 8-hour time period. After successful cardiopulmonary resuscitation, and thrombolytic therapy, the patient regained hemodynamic stability six hours after admission; all clinical and electrocardiographic signs of the right ventricle insufficiency disappeared. CONCLUSION: This case report suggested that treatment with the high-dose of streptokinase could be beneficial in the patients with massive pulmonary embolism complicated with cardiogenic shock, which must be confirmed by further randomized trials.

Acute Disease↗