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PubMedDate not supplied

[Role of hepatic monooxygenase activity study in optimization of immunosuppressive therapy and optimal use of ketoconazole in patients with transplanted kidney].

The aim of the study is to evaluate the activity of hepatic monooxidase enzymic system (MOS) in patients with chronic renal failure before and after transplantation of the kidney, to elucidate the relationship between MOS activity and clinical features of the disease, to validate effective dose of MOS inhibitor ketokonasole. MOS activity was measured by antipirine half-life. By initial MOS activity, three groups of oxidizers were recognized: fast, moderate, slow. Native population of the North and some ethnic groups prevailed among fast "oxidizers". MOS activity measured 2 months after transplantation of the kidney was characterized by a spontaneous fall of MOS activity, recovery of renal elimination. Fast "oxidizers" demonstrated greater frequency of acute rejection, less frequent episodes of cyclosporine nephrotoxicity, higher cumulative dose of steroid hormones and weak response to azatioprin. Effective dose of ketokonasole was within 100-200 mg/day under the same pharmacodynamic effect. It was found reasonable to measure MOS activity for decision about administration of optimal immunosuppressive therapy and ketokonasole.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2003

Optimizing long-term cardiac management after major vascular surgery: Role of beta-blocker therapy, clinical characteristics, and dobutamine stress echocardiography to optimize long-term cardiac management after major vascular surgery.

BACKGROUND: Survivors of major vascular surgery are at increased risk of late cardiac complications. OBJECTIVE: To examine the cardioprotective effect of beta-blockers. METHODS: A follow-up study was conducted in 1286 patients who survived surgery for at least 30 days. Patients were screened for cardiac risk factors and dobutamine stress echocardiography (DSE) results; 1034 patients (80%) underwent preoperative DSE, and 370 (29%) received beta-blockers. The main outcome measure was late cardiac death or myocardial infarction. RESULTS: Seventy-four patients (5.8%) had late cardiac events. Cardiac event rates in patients with 0, 1 to 2, and 3 or more risk factors were 1.6%, 4.7%, and 19.2%, respectively. In patients without risk factors, beta-blockers were associated with improved event-free survival (2.8% vs 0%), and DSE had no additional prognostic value. In patients with 1 to 2 risk factors, the presence of ischemia during DSE increased cardiac events from 3.9% to 9.8%. However, if patients with ischemia were treated with beta-blockers, the risk decreased to 7.2%. In patients with 3 or more risk factors, DSE and beta-blockers stratified patients into intermediate- and high-risk groups. In patients without ischemia, beta-blockers reduced the cardiac event rate from 15.1% to 9.5%, whereas the cardioprotective effect was limited in patients with 3 or more risk factors and positive DSE findings. CONCLUSIONS: Long-term beta-blocker use is associated with a reduction in the cardiac event rate, except for patients with 3 or more risk factors and positive findings on DSE.

Adrenergic beta-Antagonists↗
PubMed1989

Intra-arterial thrombolysis using recombinant tissue plasminogen activator (r-TPA): the optimal agent, at the optimal dose?

Thirteen patients received 15 separate courses of intra-arterial (IA) r-TPA for acute and subacute peripheral arterial thromboses. Two patients received second courses: one following rethrombosis 2 weeks after the angioplasty of a residual stenosis, the other following rethrombosis 4 months after the initially successful thrombolysis. There were 10 men and 3 women with a mean age of 75.3 yrs (+/- 12.2). The median duration of ischaemia was 18 days (range 1-60), with five patients having severe ischaemia. All patients received IA r-TPA at a dose of 0.5 mg/h for a mean period of 26.2 hrs (+/- 12.6). Angiographic evidence of lysis was seen in all patients, however, this was insufficient to reperfuse the distal limb in two patients due to absence of run-off. Early rethrombosis occurred in both of these patients (less than 24 hrs, 11 days). There were no major complications, and minor groin haematomata occurred in four patients (three of whom underwent angioplasty). A further two patients rethrombosed despite angioplasty. One was successfully retreated and remains patent 5 months later, the other underwent surgical reconstruction. A partial systemic effect was confirmed by a reduction of plasminogen and fibrinogen to 66% of initial levels, and a reduction of alpha - 2-antiplasmin to 40% of initial levels. Haemoglobin was reduced by a mean 1.28 g/dl (+/- 0.82), however no transfusions were required, and no hypotensive periods occurred. Mean ankle/brachial systolic index (ABSI) was increased by 0.43 (+/- 0.24) overall.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1999

The cryopreservation protocol optimal for progenitor recovery is not optimal for preservation of marrow repopulating ability.

The efficiency of five different cryopreservation protocols (our original controlled-rate and noncontrolled-rate protocols) was evaluated on the basis of the recovery after thawing of very primitive pluripotent hemopoietic stem cells (MRA(CFU-GM), pluripotent progenitors (CFU-Sd12) and committed granulocyte-monocyte progenitors (CFU-GM) in mouse bone marrow. Although the nucleated cell recovery and viability determined immediately after the thawing and washing of the cells were found to be similar, whether controlled-rate or noncontrolled-rate cryopreservation protocols were used, the recovery of MRA(CFU-GM), CFU-Sd12 and CFU-GM varied depending on the type of protocol and the cryoprotector (DMSO) concentrations used. It was shown that the controlled-rate protocol was more efficient, enabling better MRA(CFU-GM), CFU-Sd12 and CFU-GM recovery from frozen samples. The most efficient was the controlled-rate protocol of cryopreservation designed to compensate for the release of fusion heat, which enabled a better survival of CFU-Sd12 and CFU-GM when combined with a lower (5%) DMSO concentration. On the contrary, a satisfactory survival rate of very primitive stem cells (MRA(CFU-GM)) was achieved only when 10% DMSO was included with a five-step protocol of cryopreservation. These results point to adequately used controlled-rate freezing as essential for a highly efficient cryopreservation of some of the categories of hematopoietic stem and progenitor cells. At the same time, it was obvious that a higher DMSO concentration was necessary for the cryopreservation of very primitive stem cells, but not, however, for more mature progenitor cells (CFU-S, CFU-GM). These results imply the existence of a mechanism that decreases the intracellular concentration of DMSO in primitive MRA cells, which is not the case for less primitive progenitors.

Animals↗
PubMed2006

Optimizing antigen cocktails for detection of Mycobacterium bovis in herds with different prevalences of bovine tuberculosis: ESAT6-CFP10 mixture shows optimal sensitivity and specificity.

Bovine tuberculosis is a major problem in many countries; hence, new and better diagnostic tools are urgently needed. In this work, we have tested ESAT6, CFP10, PE13, PE5, MPB70, TB10.4, and TB27.4 for their potentials as diagnostic markers in field animals from Northern Ireland, Mexico, and Argentina, regions with low, medium, and high prevalences of bovine tuberculosis, respectively. At all three sites, ESAT6 and CFP10 were superior diagnostic antigens, while their combination performed even better at the two sites where the combination was tested, providing the best coverage for the detection of diseased populations. The high sensitivity in the skin test reactor groups, combined with the high specificity in the tuberculosis-free groups, indicated that a diagnosis could correctly be made for 85% of the infected animals, based on their responses to these two antigens. Furthermore, TB10.4, PE13, and PE5 have the potential to supplement ESAT6 and CFP10 in a future five-component diagnostic cocktail.

Animals↗