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The antioxidant enzyme system is an important defense mechanism to cope with Reactive Oxygen Species (ROS) produced due to exposure to heavy metals. In the present study lead (Pb), chromium (Cr), arsenic (As), cadmium (Cd) and nickel (Ni) in water and the antioxidant activity of superoxide dismutase (SOD), catalase (CAT) and peroxidase (POD) was investigated in three species (Metrocoris communis, Limnogonus fossarum fossarum, and Aquarius adelaidis) of water striders collected from the industrial triangle of Punjab, Pakistan. The results of present study revealed that Pb, Cr, As, Cd and Ni were according to the permissible amount of WHO. The antioxidant activity of SOD, CAT and POD was found significantly different among species against oxidative stress, but found the highest activity of determining parameters in A. adelaidis. This is one of the pioneer studies in Pakistan reporting the role of water striders as a bioindicator of heavy metals present in the water through antioxidants enzyme variations. The current results supported that variant level of antioxidant enzyme activities in different species of water strider were reflective of heavy metal pollution in the Industrial triangle of Punjab, Pakistan and will be a useful ecotoxicological tools to evaluate the detrimental effects of heavy metal pollutants in aquatic organisms.
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Heterópteros , Metales Pesados , Animales , Antioxidantes/farmacología , Cadmio , Biomarcadores Ambientales , Plomo/análisis , Plomo/farmacología , Metales Pesados/análisis , Metales Pesados/toxicidad , Estrés Oxidativo , Superóxido Dismutasa/metabolismo , Superóxido Dismutasa/farmacología , Agua , Contaminación del Agua/análisisRESUMEN
This paper studies the phenomena of warm inflation in a modified cosmological scenario within Rastall gravity. In this context, we modify the standard Friedmann equations using recently proposed Tsallis and Barrow holographic dark energy entropies, alternatively. For both entropies, the exact solutions including the inflaton field, potential required to produce inflation and the scale factor are obtained under slow-roll approximation for low- and high-dissipative regimes. We obtain exponentially growing scale factors for both dark energy models. To confront the theoretical predictions of these models with recent observational data, we calculate the slow-roll parameters, number of e-folds, scalar spectral index, running of scalar spectral index and the tensor-to-scalar ratio for both extremes of dissipation. The Planck bounds on inflationary trajectories are being used to constraint the free parameters. The results are interesting and physically viable up to 2 σ level.
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The clinical utility of molecular diagnostic approaches in allergy investigation is being recognized increasingly to play a significant role in the management of allergic patients. Determining the sensitization pattern, which is best achieved through the use of component resolved diagnostics (CRD), allows effective risk stratification, appropriate treatment and patient selection for immunotherapy. In order to assess the diagnostic service provisions for in-vitro allergy testing across Europe, a survey was carried out via the total immunoglobulin (Ig)E and specific IgE external quality assurance schemes run by UK National External Quality Assessment Service (NEQAS) Immunology, Immunochemistry and Allergy. This survey assessed allergy testing, and in particular allergen components offered by the laboratories, and found a wide variability in service provision, particularly between the United Kingdom and other European Union (EU) countries. Furthermore, there was lack of standardization for acquisition of clinical information to aid allergen (and component) selection, gating strategy, testing algorithms and clinical interpretation. Interestingly, a significant proportion of laboratories (the majority from EU) stated that they 'used' the results for peanut components for risk stratification. However, the vast majority of participants were unaware of guidelines relating to the use of allergen component testing, and agreed that further education would assist in reaching a common platform. Hence, this survey has highlighted that although CRD has been adopted into routine diagnostics across Europe, it is potentially compromised by lack of standardized protocols and guidance sources. Consequently, there is a need for local or national standards and education through External Quality Assurance services on the performance and application of CRD into allergy investigation.
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Hipersensibilidad/diagnóstico , Inmunoglobulina E/sangre , Pruebas Inmunológicas/normas , Técnicas de Diagnóstico Molecular/normas , Garantía de la Calidad de Atención de Salud , Alérgenos/inmunología , Alérgenos/aislamiento & purificación , Humanos , Hipersensibilidad/epidemiología , Guías de Práctica Clínica como Asunto , Encuestas y Cuestionarios , Reino UnidoRESUMEN
Nerve injuries after thoracic and cardiovascular surgery have been reported but generally concern the brachial plexus, phrenic nerve, recurrent laryngeal, and facial nerve. Common peroneal nerve injury (CPNI) following cardiopulmonary bypass has been reported in adults (4); however bilateral injury is extremely uncommon. Age, low body weight, co-morbidities such as peripheral arteriosclerotic disease, diabetes mellitus, and arrhythmias were associated with CPNI following cardiothoracic surgery in adults. Common peroneal nerve injury (CPNI) following cardiopulmonary by-pass has been reported in adults; however, bilateral injury is extremely uncommon. The superficial course of CPN makes it vulnerable to traction or compression. We report a 5-year-old girl manifesting with bilateral CPNI following prolonged cardiopulmonary by-pass. To the best of our knowledge, she is the first pediatric patient presenting with bilateral CPNI following cardiothoracic surgery and cardiopulmonary by-pass.
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BACKGROUND: Serum free light chain analysis is now well established in the investigation of monoclonal gammopathies. In the UK there has, until recently, been a single supplier of kits for such analysis. Recently, a second method using monoclonal antisera was introduced. We have compared the performance of these two kits in four routine laboratories. METHOD: Samples submitted for routine analysis (327 samples, 258 [79%] from patients with B-cell lymphoproliferative disease) for serum free light chains were tested by both technologies (Freelite, Binding Site and N Latex FLC, Siemens), according to the manufacturers' instructions. RESULTS: Qualitative data were available by both methods on 313 samples for serum free kappa chains and 324 samples for lambda free light chains. We found poor correspondence of 81% for kappa and 74% for lambda. Five percent of samples were significantly discordant in these assays. CONCLUSIONS: These assays perform very differently in clinical practice. They cannot be used interchangeably, especially if monitoring patient responses to therapy.
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Cadenas Ligeras de Inmunoglobulina/sangre , Cadenas kappa de Inmunoglobulina/sangre , Cadenas lambda de Inmunoglobulina/sangre , Trastornos Linfoproliferativos/sangre , Nefelometría y Turbidimetría/métodos , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales , Linfocitos B/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Paraproteinemias/sangre , Paraproteinemias/diagnóstico , Juego de Reactivos para Diagnóstico/normasRESUMEN
Genomes provide us with a blue print for the potential of a cell. However, the activity of a cell is expressed in its proteome. Full understanding of the complexity of cells demands a comprehensive view of the proteome; its interactions, activity states and organization. Comprehensive proteomic approaches applied to peroxisomes have yielded new insights into the organelle and its dynamic interplay with other cellular structures. As technologies and methodologies improve, proteomics hold the promise for new discoveries of peroxisome function and a full description of this dynamic organelle.
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Peroxisomas/metabolismo , Mapeo de Interacción de Proteínas , Proteómica , Arabidopsis/metabolismo , Saccharomyces cerevisiae/metabolismo , Espectrometría de Masa por Láser de Matriz Asistida de Ionización DesorciónRESUMEN
The forkhead domain (FHD)-containing developmental transcription factor FOXC1 is mutated in patients presenting with Axenfeld-Rieger malformations. In this paper, we report the introduction of positive, negative or neutral charged amino acids into critical positions within the forkhead domain of FOXC1 in an effort to better understand the essential structural and functional determinants within the FHD. We found that FOXC1 is intolerant of mutations at I87. Additionally, alterations of amino acids within alpha-helix 1 of the FOXC1 FHD affected both nuclear localization and transactivation. Amino acids within alpha-helix 3 were also found to be necessary for transactivation and can have roles in correct localization. Interestingly, changing amino acids within alpha-helix 3, particularly R127, resulted in altered DNA-binding specificity and granted FOXC1 the ability to bind to a novel DNA sequence. Given the limited topological variation of FHDs, due to the high conservation of residues, we anticipate that models of forkhead domain function derived from these data will be relevant to other members of the FOX family of transcription factors.
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Proteínas de Unión al ADN/química , Factores de Transcripción/química , Secuencia de Aminoácidos , Aminoácidos/fisiología , Animales , Western Blotting , Línea Celular , Núcleo Celular/química , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Factores de Transcripción Forkhead , Humanos , Modelos Moleculares , Datos de Secuencia Molecular , Mutación , Estructura Secundaria de Proteína , Estructura Terciaria de Proteína , Factores de Transcripción/genética , Factores de Transcripción/metabolismo , Activación TranscripcionalRESUMEN
The cliché 'a picture is worth a thousand words' is a testament to the power of the visual system in helping us deal with our physical environment. Rarely do perturbations to the visual system, even minor ones, go unnoticed. Major defects in eye development may occur in the absence of systemic problems which threaten health. Ocular anomalies offer a window into many developmental events which would otherwise be difficult to study.
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Ojo/embriología , Visión Ocular/genética , Genes Dominantes , Genotipo , Humanos , Modelos Genéticos , Mutación , Fenotipo , Retinitis Pigmentosa/genética , Cromosoma XRESUMEN
Hypotensive effects of aloeemodin, aloin A, elgonica dimer A and bisbenzopyran from Aloe barbadensis have been studied. Aloeemodin has emerged as a potent hypotensive agent in current pharmacological investigations and caused 26 %, 52 %, and 79 % falls in mean arterial blood pressure at the corresponding doses of 0.5, 1, and 3 mg/kg in rats. The paper also describes the absolute configuration of elgonica dimer A (1).
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Aloe/química , Antraquinonas/uso terapéutico , Antihipertensivos/uso terapéutico , Emodina/análogos & derivados , Emodina/uso terapéutico , Glucósidos/uso terapéutico , Hipertensión/tratamiento farmacológico , Fitoterapia , Preparaciones de Plantas/uso terapéutico , Animales , Antraquinonas/química , Antraquinonas/aislamiento & purificación , Presión Sanguínea/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Emodina/química , Emodina/aislamiento & purificación , Emodina/farmacología , Glucósidos/química , Glucósidos/aislamiento & purificación , Espectroscopía de Resonancia Magnética , Hojas de la Planta/química , Raíces de Plantas/química , RatasRESUMEN
BACKGROUND: Postoperative recovery of gastrointestinal function and resumption of oral intake are critical determinants of the length of hospital stay. Although opioids are effective treatments for postoperative pain, they contribute to the delayed recovery of gastrointestinal function. METHODS: We studied the effects of ADL 8-2698, an investigational opioid antagonist with limited oral absorption that does not readily cross the blood-brain barrier, on postoperative gastrointestinal function and the length of hospitalization. We randomly assigned 79 patients--including 1 whose surgery was canceled--to receive one capsule containing 1 mg or 6 mg of ADL 8-2698 or an identical-appearing placebo capsule two hours before major abdominal surgery and then twice daily until the first bowel movement or until discharge from the hospital. Data were analyzed for 26 patients in each of the three groups; all received opioids for postoperative pain relief. Observers who were unaware of the group assignments evaluated the outcomes. RESULTS: Fifteen patients underwent partial colectomy and 63 underwent total abdominal hysterectomy. Patients given 6 mg of ADL 8-2698 had significantly faster recovery of gastrointestinal function than those given placebo. The median time to the first passage of flatus decreased from 70 to 49 hours (P=0.03), the median time to the first bowel movement decreased from 111 to 70 hours (P=0.01), and the median time until patients were ready for discharge decreased from 91 to 68 hours (P=0.03). Effects in the group that received 1 mg of ADL 8-2698 were less pronounced. CONCLUSIONS: Selective inhibition of gastrointestinal opioid receptors by an antagonist with limited oral absorption that does not readily cross the blood-brain barrier speeds recovery of bowel function and shortens the duration of hospitalization.
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Obstrucción Intestinal/tratamiento farmacológico , Antagonistas de Narcóticos/uso terapéutico , Piperidinas/uso terapéutico , Complicaciones Posoperatorias/tratamiento farmacológico , Adolescente , Adulto , Anciano , Analgésicos Opioides/efectos adversos , Analgésicos Opioides/uso terapéutico , Colectomía , Defecación/efectos de los fármacos , Sistema Digestivo/efectos de los fármacos , Femenino , Flatulencia , Humanos , Histerectomía , Obstrucción Intestinal/etiología , Tiempo de Internación , Masculino , Meperidina/efectos adversos , Meperidina/uso terapéutico , Persona de Mediana Edad , Morfina/efectos adversos , Morfina/uso terapéutico , Antagonistas de Narcóticos/farmacología , Dolor Postoperatorio/tratamiento farmacológico , Piperidinas/farmacología , Complicaciones Posoperatorias/inducido químicamente , Receptores Opioides/efectos de los fármacos , Factores de TiempoRESUMEN
UNLABELLED: Anticoagulation with recombinant hirudin (r-hirudin) (Refludan) has been suggested as an alternative to heparin for patients with heparin-induced thrombocytopenia requiring cardiac surgery. We sought to develop a modified activated coagulation time (ACT) that would allow quantification of the levels of r-hirudin required during cardiopulmonary bypass (CPB). Twenty-one patients scheduled for elective cardiac surgical procedures requiring CPB were enrolled in this IRB-approved study. R-hirudin was added to blood specimens obtained before heparin administration (before CPB) and 30 min after heparin neutralization with protamine (after CPB) to result in concentrations of 0, 2, 4, 6, 7, or 8 microg/mL. Kaolin/ACT and complete blood count measurements were assayed in native specimens (first 10 patients, Phase I) or in specimens mixed with equal volumes of commercial normal plasma (second 11 patients, Phase II). In Phase I, good (r(2) = 0.83) linear relationships between ACT values and r-hirudin concentrations (< or =4 microg/mL) were observed in specimens obtained before CPB. However, ACT values were markedly prolonged (P < 0.0001) by r-hirudin in specimens obtained after CPB, with ACT values generally exceeding the ACT's detection limit (>999 s) at hirudin concentrations >2 microg/mL. In patient specimens mixed with normal plasma (Phase II), ACT/hirudin relationships (i.e., hirudin/ACT slope values obtained with hirudin concentration < or =4 microg/mL) in the post-CPB period (0.022 +/- 0.004 microg. mL(-1). s(-1)) were similar (P = 0.47) to those (0.019 +/- 0.004 microg. mL(-1). s(-1)) obtained in the pre-CPB period. Accordingly, a significant relationship between normal plasma-supplemented ACT values and predilution hirudin concentration was obtained in the post-CPB (hirudin = 0.039ACT - 4.34, r(2) = 0.91) period. Although our data demonstrate that the ACT test cannot be used to monitor hirudin during CPB, the addition of 50% normal plasma to post-CPB hemodiluted blood specimens yields a consistent linear relationship between hirudin concentration and ACT values up to a predilution concentration of 8 microg/mL. Plasma-modified ACT may be useful in monitoring hirudin anticoagulation during CPB. IMPLICATIONS: A modified activated clotting time test system that may be helpful in monitoring hirudin anticoagulation in patients with heparin-induced thrombocytopenia during cardiac surgery with cardiopulmonary bypass is described.
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Anticoagulantes/efectos adversos , Antitrombinas/farmacología , Puente Cardiopulmonar , Heparina/efectos adversos , Hirudinas/farmacología , Trombocitopenia/sangre , Trombocitopenia/inducido químicamente , Tiempo de Coagulación de la Sangre Total , Hematócrito , Humanos , Caolín , Recuento de PlaquetasRESUMEN
Five missense mutations of the winged-helix FOXC1 transcription factor, found in patients with Axenfeld-Rieger (AR) malformations, were investigated for their effects on FOXC1 structure and function. Molecular modeling of the FOXC1 forkhead domain predicted that the missense mutations did not alter FOXC1 structure. Biochemical analyses indicated that, whereas all mutant proteins correctly localize to the cell nucleus, the I87M mutation reduced FOXC1-protein levels. DNA-binding experiments revealed that, although the S82T and S131L mutations decreased DNA binding, the F112S and I126M mutations did not. However, the F112S and I126M mutations decrease the transactivation ability of FOXC1. All the FOXC1 mutations had the net effect of reducing FOXC1 transactivation ability. These results indicate that the FOXC1 forkhead domain contains separable DNA-binding and transactivation functions. In addition, these findings demonstrate that reduced stability, DNA binding, or transactivation, all causing a decrease in the ability of FOXC1 to transactivate genes, can underlie AR malformations.
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Proteínas de Unión al ADN , Anomalías del Ojo/genética , Iris/anomalías , Mutación Missense , Factores de Transcripción/química , Factores de Transcripción/genética , Secuencia de Aminoácidos , Sustitución de Aminoácidos , Animales , Secuencia de Bases , Núcleo Celular/metabolismo , Factores de Transcripción Forkhead , Humanos , Ratones , Modelos Moleculares , Datos de Secuencia Molecular , Conformación Proteica , Estructura Secundaria de Proteína , Ratas , Alineación de Secuencia , Homología de Secuencia de Aminoácido , Factores de Transcripción/metabolismo , Activación TranscripcionalRESUMEN
OBJECTIVE: This study was designed to compare results obtained with a new point-of-care hemocytometer with those of two established (point-of-care and laboratory-based) instruments. DESIGN: To compare CBC values between established laboratory-based and point-of-care instruments, measurements were performed on routinely obtained blood specimens for CBC analysis in our institutional laboratory (phase I) and on specimens from cardiac surgical patients before initiation of cardiopulmonary bypass and after discontinuation of cardiopulmonary bypass in phase II. SETTING: Surgical and hospitalized patients at a tertiary care center. PATIENTS: Measurements were obtained by using blood specimens obtained from 141 hospitalized patients from different services (phase I) or from a consecutive series of 204 patients undergoing cardiac operations (phase II). MEASUREMENTS AND MAIN RESULTS: Hemoglobin (HGB), platelet count (PLT), red blood cell count, and white blood cell count (WBC) were measured with two on-site and one laboratory-based instruments. Hematocrit (HCT) was calculated by using measured variables. Linear regression demonstrated good correlations between Ichor and T540 HGB (r2 = .95), HCT (r2 = .95), PLT (r2 = .94), and WBC (r2 = .95) results (n = 408); similarly, good correlations were observed with Coulter STKS HGB (r2 = .92), HCT (r2 = .91), and PLT (r2 = .94) results (n = 141). The relationship between Ichor and Coulter STKS WBC (r2 = .27) was poor; however, when two Ichor-derived outlier values (>50) were excluded, the relationship was very good (r2 = .99). Bias analysis (mean +/- SD) demonstrated similar results between Ichor and T540 HGB (0.003+/-0.5), HCT (-0.21+/-1.5), WBC (0.79+/-1.3), and PLT values (-9.2+/-16.6) as well as STKS HGB (-0.08+/-0.7), HCT (-0.69+/-2.3), WBC (-0.62+/-5.8), and PLT values (-10.2+/-21.4). CONCLUSIONS: The Ichor hemocytometer provides accurate hematologic results that can facilitate rapid quantitative assessment of CBC variables and thus may be clinically useful, especially in critically ill patients.
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Recuento de Células Sanguíneas/instrumentación , Sistemas de Atención de Punto , Sesgo , Procedimientos Quirúrgicos Cardíacos , Hematócrito , Hemoglobinas/análisis , Humanos , Análisis de los Mínimos Cuadrados , Modelos Lineales , Microcomputadores , Cuidados Preoperatorios/instrumentación , Cuidados Preoperatorios/estadística & datos numéricosRESUMEN
UNLABELLED: New point-of-care assays have been used to identify patients with heparin resistance (i.e. heparin dose response test; Medtronic Blood Management, Parker, CO) and who have platelet dysfunction (i.e. HemoSTATUS; Medtronic Blood Management). We examined the effect of epsilon-aminocaproic acid on results from these two point-of-care tests in patients undergoing cardiac surgery. Twenty patients scheduled for elective cardiac surgical procedures were enrolled in this prospective study. HemoSTATUS clot ratio (% maximal) values in Channels (Ch) 3-6 (Ch 3: 26 +/- 25, Ch 4: 66 +/- 23, Ch 5: 84 +/- 20, Ch 6: 106 +/- 18) obtained after the IV administration of epsilon-aminocaproic acid were similar to values obtained before the administration of this agent (Ch 3: 26 +/- 20, Ch 4: 69 +/- 23, Ch 5: 86 +/- 19, Ch 6: 109 +/- 14). Slope values (86 +/- 23 s x U(-1) x mL(-1)) and projected heparin concentrations (4 +/- 1 U/mL) obtained before the administration of epsilon-aminocaproic acid were similar to slope values (88 +/- 21 s x U(-1) x mL(-1)) and projected heparin concentrations (4 +/- 1 U/mL) values obtained after administration of this agent. Our data indicate that HemoSTATUS clot ratio values and heparin dose response values are not significantly affected after IV dosing of epsilon-aminocaproic acid. IMPLICATIONS: Values from two activated coagulation time-based test systems used to identify significant heparin resistance or platelet dysfunction after cardiopulmonary bypass were not significantly affected by epsilon-aminocaproic acid administered IV.
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Ácido Aminocaproico/farmacología , Antifibrinolíticos/farmacología , Coagulación Sanguínea/efectos de los fármacos , Caolín , Pruebas de Función Plaquetaria , Tiempo de Coagulación de la Sangre Total , Anciano , Aspirina/farmacología , Procedimientos Quirúrgicos Cardíacos , Femenino , Fibrina/efectos de los fármacos , Humanos , Masculino , Inhibidores de Agregación Plaquetaria/farmacologíaRESUMEN
We evaluated the effects of acute pretreatment with lamotrigine, a putative glutamate release inhibitor, on the physiological and behavioral responses to intranasal cocaine in cocaine-dependent volunteers (N = 8). The study employed a double-blind, placebo-controlled, within-subject design. Subjects participated in six experimental sessions. On each study day, placebo, lamotrigine 125 mg, or lamotrigine 250 mg was administered orally in the morning, followed 2 hours later by intranasal cocaine 120 mg/70 kg or placebo. Measurements of heart rate and blood pressure were acquired, and subjects responded to mood state questionnaires at predetermined time intervals. Cocaine alone produced increases in heart rate, blood pressure, and several measures of pleasurable mood and drug effects. Lamotrigine alone produced a mild relaxing effect. Lamotrigine pretreatment altered neither the physiological responses nor the subjective ratings of cocaine's pleasurable or aversive mood effects.
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Afecto/efectos de los fármacos , Nivel de Alerta/efectos de los fármacos , Presión Sanguínea/efectos de los fármacos , Trastornos Relacionados con Cocaína/psicología , Antagonistas de Aminoácidos Excitadores/farmacología , Frecuencia Cardíaca/efectos de los fármacos , Triazinas/farmacología , Administración Oral , Adulto , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Lamotrigina , Masculino , PremedicaciónRESUMEN
Family psychoeducational programs are efficacious adjuncts to pharmacotherapy for patients with schizophrenic and bipolar disorders, but little is known about what these programs change about families. The authors assessed changes in face-to-face interactional behavior over 1 year among families of bipolar patients who received a 9-month family-focused psychoeducational therapy (FFT; n = 22) or crisis management with naturalistic follow-up (CMNF; n = 22), both administered with maintenance pharmacotherapy. Members of families who received FFT showed more positive nonverbal interactional behavior during a 1-year posttreatment problem-solving assessment than families who received CMNF, although no corresponding decreases were seen in negative interactional behaviors. The positive effect of family treatment on patients' symptom trajectories over 1 year was partially mediated by increases in patients' positive nonverbal interactional behaviors during this same interval.
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Trastorno Bipolar/terapia , Comunicación , Relaciones Familiares , Terapia Familiar/métodos , Adolescente , Adulto , Antimaníacos/uso terapéutico , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/psicología , Salud de la Familia , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Distribución AleatoriaRESUMEN
BACKGROUND: Platelet dysfunction is a major cause of excessive microvascular bleeding after cardiac surgery. A new point-of-care test (hemoSTATUS) can identify patients at risk of excessive bleeding. We aimed to find out whether patients who can benefit from desmopressin during cardiac surgery can be identified by this test. METHODS: We enrolled 203 patients scheduled for elective cardiac surgery in a prospective, double-blind, placebo-controlled trial. Patients with abnormal hemoSTATUS clot-ratio results (<60% of maximum in channel 5) after discontinuation of cardiopulmonary bypass were randomly assigned desmopressin (n=50) or placebo (n=51). Patients with normal clot ratios were included in an untreated control group (n=72). FINDINGS: Intraoperative platelet counts and clot ratios were significantly higher in the untreated control group than in the study-drug groups. In intensive care, clot ratios in patients who received desmopressin were similar to those in the untreated control group, despite significantly lower platelet counts, but were lower in the placebo group than in the other two groups (p=0.0001). Compared with the placebo group, patients who received desmopressin had less blood loss in 24 h (mean 624 [SD 209] vs 1028 mL [682] p=0.0004) and required less transfusion of red blood cells (1.1 [022] vs 2.2 U [0.32] p=0.009), platelets (0.1 [0.04] vs 1.9 U [4.5] p=0.0001), and fresh-frozen plasma (0.1 [0.07] vs 0.75 U [0.21] p=0.0008), and had less total blood-donor exposures (1.56 [0.31] vs 5.2 [0.8] p=0.0001). Placebo patients also had substantially higher blood loss and transfusion requirements than untreated control patients. INTERPRETATION: Patients identified with hemoSTATUS as being at increased risk of excessive bleeding after cardiac surgery can benefit from administration of desmopressin. Further studies are, however, needed to confirm these findings as well as to identify the mechanism of action and safety of desmopressin in the clinical setting.
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Trastornos de la Coagulación Sanguínea/diagnóstico , Desamino Arginina Vasopresina/uso terapéutico , Hemostáticos/uso terapéutico , Complicaciones Posoperatorias/diagnóstico , Hemorragia Posoperatoria/prevención & control , Anciano , Trastornos de la Coagulación Sanguínea/tratamiento farmacológico , Transfusión de Componentes Sanguíneos , Puente de Arteria Coronaria , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Sistemas de Atención de Punto , Complicaciones Posoperatorias/tratamiento farmacológico , Estudios Prospectivos , Tiempo de Coagulación de la Sangre TotalRESUMEN
Shamimin, a C-flavonol glucoside from Bombax ceiba leaves showed significant potency as a hypotensive agent at the doses of 15 mg/kg, 3 mg/kg, 1 mg/kg and significant hypoglycaemic activity at 500 mg/kg in Sprague-Dawley rats. Further studies revealed that it did not cause any mortality in mice at the dose of 1 g/kg but in rats 500 mg/kg is a lethal dose. Aqueous and methanolic extracts of Bombax ceiba leaves and one of its fractions were also subjected to pharmacological and toxicological screening.
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Antihipertensivos/farmacología , Flavonoides/farmacología , Glucosa/análogos & derivados , Hipoglucemiantes/farmacología , Plantas/química , Animales , Flavonoides/toxicidad , Glucosa/farmacología , Glucosa/toxicidad , Ratones , Ratas , Ratas Sprague-DawleyRESUMEN
The present study was undertaken to characterize the variables that influence parental perception of metabolic disorders and their genetic origin before and after genetic counselling, the effect of counselling on parental attitudes towards prenatal diagnosis and pregnancy termination, and the factors affecting parental coping with burden. Parents of children with metabolic diseases from 32 Arab-Muslim families were interviewed, answering a pre-structured questionnaire. These interviews indicate the following. (1) Traditional belief and religious commitment are more important determinants than education in parental perception of inherited metabolic diseases. (2) The number of affected children has a greater impact on parental evaluation of the burden than the number of healthy children. The social component, i.e. the way families are viewed by society, is the most significant factor of the burden. (3) Parents use different techniques to divide responsibility regarding reproduction. Having a healthy child and the availability of prenatal diagnosis and pregnancy termination were the two most important factors in parental reproductive decision making. In the absence of a healthy child and when the burden was perceived as too heavy, parents tended 'not to decide'. (4) Parental attitude to pregnancy termination was dependent on two factors: religious commitment (leading to objection) and severity of disease (leading to flexibility and approval). (5) In almost all families, genetic counselling altered parental perception of the disease and its hereditary origin. We conclude that genetic counselling and population education may be helpful in the prevention of consanguineous marriages and in family planning, even in a society that values traditional beliefs very highly.
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Asesoramiento Genético , Errores Innatos del Metabolismo , Padres/psicología , Aborto Inducido , Adulto , Actitud , Toma de Decisiones , Femenino , Enfermedades Genéticas Congénitas , Humanos , Masculino , Persona de Mediana Edad , Percepción , Embarazo , Diagnóstico Prenatal , Recurrencia , Reproducción , RiesgoRESUMEN
The predictive validity of expressed emotion (EE) may derive in part from its relationship to important interactional processes in families of patients with major psychiatric disorders. The authors examined the relationship between relatives' EE attitudes, assessed during patients' bipolar, manic, or mixed episodes, and the interactional behavior of bipolar patients (n = 48) and their relatives as revealed in problem-solving discussions during the postepisode period. High-EE relatives were more verbally negative than low-EE relatives in these discussions. Patients from high-EE families were more nonverbally negative than those from low-EE families, whereas patients from low-EE families were more nonverbally positive than those from high-EE families. Sequential analyses revealed that high-EE families engage in negative interchanges of up to 3 volleys. Thus, levels of EE are associated with stressful patterns of interaction between bipolar patients and their relatives during the postepisode period.