Rifampin-induced nonresponsiveness of giant cell arteritis to prednisone treatment.

Rifampin is an enzymatic inducer known to increase steroid metabolism. We studied two patients with giant cell arteritis in whom rifampin caused nonresponsiveness to prednisone treatment. A prednisone pharmacokinetics study was done. When rifampin-prednisone treatment must be used in giant cell arteritis, we propose increasing the prednisone dosage to 2 mg/kg per day.

Acute effect of 1,25-dihydroxyvitamin D3, prednisone, and 1,25-dihydroxyvitamin D3 plus prednisone on serum osteocalcin in normal individuals.

Suppression of osteoblastic function plays an important pathogenic role for the development of glucocorticosteroid-induced osteoporosis. Serum osteocalcin (OC) is a sensitive marker of bone formation. The diurnal rhythm in serum OC can be changed by administration of single doses of either 1,25-(OH)2D3 or prednisone. However, the two steroids have opposing effects: 1,25-(OH)2D3 increases and prednisone decreases serum OC. The aim of the present study was to examine whether 1,25-(OH)2D3 can oppose the acute suppressive effect of prednisone on serum OC in normal subjects. We compared the effect of a combined dose of 2 micrograms 1,25-(OH)2D3 and 10 mg prednisone on the diurnal rhythm of serum OC with the effect of 2 micrograms 1,25-(OH)2D3 + placebo in a crossover study. Seven normal subjects aged 23-36 years were investigated twice at an interval of 1 week. Blood samples were collected every 60 minutes from 1900 until 1100 h the following day. Study drugs were given at 2000 h. The data from the present investigation were compared with data obtained from a similar study with placebo and prednisone in the same subjects. After administration of 1,25-(OH)2D3 serum OC followed the placebo curve during the first 8 h, but in contrast to the placebo curve it then continued to increase and remained elevated throughout the observation period (p less than 0.05). Prednisone inhibited and reversed the nocturnal rise in serum OC levels (p less than 0.01). The course of serum OC after administration of 1,25-(OH)2D3 + prednisone almost paralleled the course after placebo. We conclude that 1,25-(OH)2D3 and prednisone have opposing effects on serum OC.

Immunostimulating effect of pule (Alstonia scholaris L. R.Br., Apocynaceae) bark extracts.

The immunostimulating effect of "Pule" (Alstonia scholaris (L.) R.Br., Apocynaceae) bark extracts was studied in BALB/c mouse. The extracts were administered orally, once a day for 7 consecutive days. The results showed that at the same doses (50, 100 and 200 mg/kg b.w.) the aqueous extract had higher phagocytic index (1.39-1.79) than the ethanolic extracts (0.81-0.93) in normal mice. The aqueous extract at 50 mg/kg b.w. also enhanced phagocytic activity of immunosuppressed mice significantly (P < 0.01). At 50 and 100 mg/kg b.w. the extract prevents the decrease of immune system induced by prednisone. The aqueous extract at 100 mg/kg b.w. increased lytic activity of peritoneal exudate cells against Escherichia coli significantly (P < 0.05). At the doses of 50 and 100 mg/kg b.w. the aqueous extract had no effect on primary antibody level. The aqueous extract at 50 mg/kg b.w. induced the cellular immune response while at 100 mg/kg b.w. inhibited the delayed type of hypersensitivity reaction.

Relative sensitivity of Tc-99m WBC versus In-111 WBC in a patient with Crohn disease and steroid use.

Numerous studies have shown that chemotaxis is affected by certain antibiotics and steroids. The authors present the case of a patient with Crohn disease relapse with multiple small-bowel fistulae and mesenteric abscesses. Whereas the Tc-99m WBC scan failed to show the intra-abdominal inflammatory foci, an In-111 WBC scan performed within a week delineated the abscesses very well, and these were later confirmed at surgery. This case is presented not only to illustrate the relative sensitivities of a Tc-99m WBC versus an In-111 WBC scan, but also to discuss the impediment to polymorphonuclear chemotaxis by steroids, which may be a contributory factor to the sensitivities of the different radiopharmaceuticals selected for detection of intra-abdominal septic foci.

[Clinico-biochemical aspects of the polychemotherapy of disseminated lymphogranulomatosis resistant to the COPP protocol]. / Kliniko-biokhimicheskie aspekty polikhimioterapii rasprostranennogo limfogranulematoza, rezistentnogo k programme TsOPP.

With a purpose of providing efficient treatment of extended lymphogranulomatosis resistant to the routine COPP program, new programs of polychemotherapy including the use of an antibiotic, plant alkaloid, alkylating agent and glucocorticoid were developed and studied. The optimal rhythm and regimen of the drug administration were developed. The study was based on the treatment of 65 patients. The clinical trials showed that the ALVP program including the use of adriablastin, lofenal, vinblastin and prednisolone was the most efficient. Its use provided a significant therapeutic effect in 77 per cent of the patients. The BrLVP program including the use of bruneomycin, lofenal, vinblastin and prednisolone, the RLVP program including the use of rubomycin, lofenal, vinblastin and prednisolone, the DLVP program including the use of dactinomycin, lofenal, vinblastin and prednisolone and the BlLVP program including the use of bleomycin, lofenal, vinblastin and prednisolone were less efficient and provided the therapeutic effect in 66, 63, 60 and 60 per cent of the patients respectively. The direction of shifts in the spectrum of the blood serum enzymes mainly corresponded to the results of clinical trials. This first of all referred to the ALVP and BrLVP programs. The use of these programs provided normalization of the hexokinase and lactate dehydrogenase activity of the serum and positive shifts in the isoenzyme spectrum.

Effect of O-(beta-hydroxyethyl)-rutoside on wound healing in the rat.

The administration of O-(beta-hydroxyethyl)-rutoside in 11 daily doses of 300--400 mg/kg p.o. stimulates wound healing by granulation in the rat. The preparation may counteract the inhibitory effect of prednisone on the formation of granulation tissue. In five doses of 300--1,000 mg/kg daily p.o. it augments the tensile strength of cicatricial tissue to a statistically significant degree.

[Comparison of the effects of sodium fluoride and calcidiol on the remodeling of the endosteal surface of the rib cortex in dogs after administration of prednisone]. / Porównanie wplywu fluorku sodu i kalcidiolu na przebudowe powierzchni sródkostnej kory zeber psów otrzymujacych prednizon.

The effects were compared of sodium fluoride and calcidiol on the remodeling of the rib cortical-endosteal surface of dogs treated with prednisone for long time periods. The study used a histomorphometric and tetracycline labeling methods. It was found that administration of sodium fluoride with calcidiol and calcium carbonate limited in a higher degree than the treatment with calcidiol and calcium carbonate the development of the osteoporotic changes induced by glucocorticoids. This included reduced enhancement of the bone resorption surface, increased bone formation surface and osteoid thickness connected with acceleration of mineralization rate. The changes induced by sodium fluoride had a favorable effect on the ratio of the resorption to the formation process at the sites of bone remodeling.

Treatment of children with steroid refractory idiopathic nephrotic syndrome: the Kuwaiti experience.

Data on the treatment and outcome of Kuwaiti children with steroid refractory idiopathic glomerulonephritis (SRIGN), i.e. nephrotic syndrome who failed an eight-week course of prednisone, were collected retrospectively from the records of children attending the two renal centers of Kuwait between January 1, 1990 to December 31, 1996. During those seven years, a total of 34 Kuwaiti children were diagnosed to have SRIGN. Histologically, 22 (65%) of those patients had minimal change, 5 (15%) focal segmental GN, 2 (6%) non-IgA mesangioproliferative GN and one membranous GN. Twenty-two patients had manifested frequent relapses, six were steroid-dependent and six were steroid-resistant. Treatment options were in the following order: (a) small maintenance-dose of corticosteroids (< 0.5 mg/kg/alternate days); (b) cyclophosphamide and or chlorambucil for a single eight week-course or eight then 12 week courses (c) cyclosporin A for three months. The response to therapy was as follows: nine children were cured with low-dose corticosteroids; 17 with chlorambucil and/or cyclophosphamide; and five with cyclosporin A. At the end of study, only three children failed such drug therapy, two of who had focal segmental glomerulosclerosis.