ABSTRACT
AIM: Vitamin D plays an important role in water and salt homeostasis. The aim of our study was to investigate the underlying relationship of Vitamin D and Aquaporins (AQP). METHODS: The behaviors of 1α (OH)-ase knockout mice and wild type mice were observed before analysis. The ICR mice were treated with vehicle or paricalcitol, a vitamin D analogue, followed by animals receiving a standard diet and free access to drinking water either with aliskiren (renin blocker; 37.5 mg aliskiren in 100 ml water), or telmisartan (a angiotensin II type I receptor blocker; 40 mg telmisartan in 100 ml water) a week before study. The expressions of AQP-1, AQP-4, and renin in mice kidneys were detected by western bolting, immunohistochemistry, and immunofluorescence. RESULTS: Diuresis and polydipsia were observed in 1α (OH)-ase knockout mice, and a decreased water intake and urine output in ICR mice was observed after paricalcitol treatment. Compared with wild type, the AQP-1 expressions were increased in renal papilla and AQP-4 expressions were decreased in renal proximal tubule of 1α(OH) ase knockout mice. In addition, AQP-1 was decreased in renal papilla and AQP-4 expressions were increased in proximal tubule by suppressing renin activity or supplement of Vitamin D analogue. After injecting renin into the lateral ventricle of the 1α(OH)ase knockout mice, the renin expression level was decreased in the kidney, followed by the decrease of AQP-1 in renal papilla and increase of AQP-4 in proximal tubule. CONCLUSIONS: Overall, Vitamin D and renin inhibitors have synergistic effects in regulating water channels in mice kidneys.
Subject(s)
Aquaporin 1/genetics , Aquaporin 4/genetics , Renin/genetics , Vitamin D/analogs & derivatives , Vitamin D/metabolism , Amides/administration & dosage , Angiotensin II Type 1 Receptor Blockers/administration & dosage , Animals , Fumarates/administration & dosage , Gene Expression Regulation/drug effects , Humans , Kidney/drug effects , Kidney/metabolism , Kidney/pathology , Kidney Tubules, Proximal/drug effects , Kidney Tubules, Proximal/metabolism , Mice , Mice, Knockout , Receptor, Angiotensin, Type 1/drug effects , Renin/administration & dosage , Renin/antagonists & inhibitors , Renin-Angiotensin System/drug effects , Telmisartan/administration & dosage , Vitamin D/genetics , Water/chemistryABSTRACT
This study was aimed to evaluate the effects of organic acid (OA) and medium-chain fatty acid (MCFA) blends on production performance of sows and their litters. A total of 36 sows (Landrace × Yorkshire, average parity is 3.3, SE = 0.2) were randomly allocated to three treatments with 12 replicates. Dietary treatments were as follows: CON, basal diet; MC1, CON + 0.1% OA, and MCFA blends; MC2, CON + 0.2% OA, and MCFA blends. During lactation, no differences were observed in body weight (BW) loss, average daily feed intake, backfat thickness, digestibility of dry matter, nitrogen, or energy of sows. There were linear increase (p < 0.05) in BW and average daily gain of sucking piglets. On parturition and weaning day, there was a linear increase (p < 0.05) in fecal Lactobacillus counts, as well as a linear decrease (p < 0.05) in fecal Escherichia coli counts of sows on weaning day. The sucking piglets also had a linear increase (p < 0.05) in fecal Lactobacillus counts and a linear decrease (p < 0.05) in fecal E. coli counts. In conclusion, dietary supplementation of OA and MCFA blends in sows exerts beneficial effects to sows shifted fecal microbiota by increasing Lactobacillus and decreased E. coli counts. It also improved the performance of piglets.
Subject(s)
Animal Feed , Citric Acid/administration & dosage , Diet/veterinary , Dietary Supplements , Digestion , Fatty Acids/administration & dosage , Fumarates/administration & dosage , Malates/administration & dosage , Nutrients/metabolism , Swine/growth & development , Swine/metabolism , Animals , Bacterial Load , Escherichia coli , Feces/microbiology , Female , Lactation , Lactobacillus , Male , Swine/microbiologyABSTRACT
ABSTRACT Two experiments (E) were carried out to evaluate the effects of fumaric acid and an acidifier blend [composed by calcium formate, calcium lactate and medium-chain fatty acids (capric and caprylic)] in piglet diets containing colistin (40 ppm) or halquinol (120 ppm) on performance, diarrhea incidence (E1), organs relative weight, pH values, intestinal morphometry and microbiota (E2). In E1, 192 and E2, 24 piglets weaned at 21-day-old were randomly assigned to blocks with 2x2 factorial arrangement of treatments [absence or presence of fumaric acid x absence or presence of acidifier blend], six replicates of eight (E1) and one piglet per pen (E2). For E1, the treatments were control (CD): no acidifier product + 40 ppm of colistin, FA: fumaric acid in absence of acidifier blend, AB: acidifier blend in absence of fumaric acid and, AF+AB: presence of fumaric acid and acidifier blend. For E2, the pre-starter I diet were used and the same treatments as E1 evaluated. No treatment effects (P>0.05) were observed on performance, diarrhea incidence (E1), gut pH values and duodenum morphometry of piglets (E2). However, the addition of AB increased (P<0.05) large intestine relative weight and, FA addition decreased (P<0.05) pancreas relative weight, jejunum villi height and, total coliform and E. coli counts in cecum. The inclusion of FA and AB in diets containing colistin or halquinol did not improve performance, although FA exerted an inhibitory effect on cecum microbiota.
Subject(s)
Animals , Male , Swine/growth & development , Chloroquinolinols/administration & dosage , Colistin/administration & dosage , Dietary Supplements/analysis , Gastrointestinal Tract/physiology , Diarrhea/veterinary , Animal Feed/analysis , Swine/physiology , Chloroquinolinols/adverse effects , Colistin/adverse effects , Dietary Supplements/adverse effects , Diarrhea/chemically induced , Fumarates/administration & dosage , Intestinal Mucosa/drug effects , Animal Feed/adverse effects , Anti-Bacterial Agents/administration & dosageABSTRACT
Two experiments (E) were carried out to evaluate the effects of fumaric acid and an acidifier blend [composed by calcium formate, calcium lactate and medium-chain fatty acids (capric and caprylic)] in piglet diets containing colistin (40 ppm) or halquinol (120 ppm) on performance, diarrhea incidence (E1), organs relative weight, pH values, intestinal morphometry and microbiota (E2). In E1, 192 and E2, 24 piglets weaned at 21-day-old were randomly assigned to blocks with 2x2 factorial arrangement of treatments [absence or presence of fumaric acid x absence or presence of acidifier blend], six replicates of eight (E1) and one piglet per pen (E2). For E1, the treatments were control (CD): no acidifier product + 40 ppm of colistin, FA: fumaric acid in absence of acidifier blend, AB: acidifier blend in absence of fumaric acid and, AF+AB: presence of fumaric acid and acidifier blend. For E2, the pre-starter I diet were used and the same treatments as E1 evaluated. No treatment effects (P>0.05) were observed on performance, diarrhea incidence (E1), gut pH values and duodenum morphometry of piglets (E2). However, the addition of AB increased (P<0.05) large intestine relative weight and, FA addition decreased (P<0.05) pancreas relative weight, jejunum villi height and, total coliform and E. coli counts in cecum. The inclusion of FA and AB in diets containing colistin or halquinol did not improve performance, although FA exerted an inhibitory effect on cecum microbiota.
Subject(s)
Animal Feed/analysis , Chloroquinolinols/administration & dosage , Colistin/administration & dosage , Diarrhea/veterinary , Dietary Supplements/analysis , Gastrointestinal Tract/physiology , Swine/growth & development , Animal Feed/adverse effects , Animals , Anti-Bacterial Agents/administration & dosage , Chloroquinolinols/adverse effects , Colistin/adverse effects , Diarrhea/chemically induced , Dietary Supplements/adverse effects , Fumarates/administration & dosage , Intestinal Mucosa/drug effects , Male , Swine/physiologyABSTRACT
Necrobiosis lipoidica (NL) is a rare granulomatous disease of hitherto unclear etiology frequently seen in patients with diabetes. Characterized by its potential for ulcerations, it often presents a serious burden for those affected. There are currently neither German nor European guidelines for the treatment of NL. At the same time, standard treatment with topical or intralesional corticosteroids does not always show satisfactory results. We therefore set out to evaluate whether the various treatment regimens published since 2000 have actually expanded the therapeutic armamentarium in a relevant manner. Included were all publications that described more than one patient being treated with any given therapeutic modality. Overall, we analyzed data for 16 different treatment regimens reported in 49 publications. The largest amount of data exists for topical PUVA therapy, photodynamic therapy (PDT), and systemic treatment with fumaric acid esters. Remarkably, our analysis showed that with an increase in the number of documented patients treated with a given therapeutic modality, the proportion of those achieving a complete or partial response actually decreased. This was interpreted as publication bias. Thus, no clear recommendation can be given for second-line therapy in case topical or intralesional corticosteroids fail.
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Fumarates/administration & dosage , Necrobiosis Lipoidica/diagnosis , Necrobiosis Lipoidica/therapy , PUVA Therapy/methods , Photochemotherapy/methods , Administration, Cutaneous , Combined Modality Therapy , Evidence-Based Medicine , Humans , Treatment OutcomeABSTRACT
The aim of this study was to compare an aliskiren/amlodipine combination with high-dose amlodipine monotherapy on ambulatory blood pressure monitoring (ABPM) and organ protection. The study was a prospective, randomized, multicenter, open-label trial in elderly essential hypertensive patients. A total of 105 patients with clinic BP (CBP) ≥140/90 mm Hg with amlodipine 5 mg were randomly allocated to aliskiren (150-300 mg)/amlodipine (5 mg) (ALI/AML group, n=53) or high-dose amlodipine (10 mg) (h-dAML group, n=52) and treated for 16 weeks. Each patient's CBP, ABPM, urine albumin-to-creatinine ratio (UACR), and brachial-ankle pulse wave velocity (baPWV) were measured at baseline and at the end of the study. The ALI/AML and h-dAML groups showed similarly reduced mean 24-hour SBP, daytime SBP, nighttime SBP, and baPWV. However, UACR reduction was significantly greater in the ALI/AML group (P=.02). ALI/AML was significantly less effective in reducing early-morning BP (P=.002) and morning BP surge (P=.001) compared with h-dAML.
Subject(s)
Amides/administration & dosage , Amlodipine/administration & dosage , Antihypertensive Agents/administration & dosage , Calcium Channel Blockers/administration & dosage , Fumarates/administration & dosage , Hypertension/drug therapy , Aged , Aged, 80 and over , Blood Pressure/drug effects , Blood Pressure/physiology , Blood Pressure Monitoring, Ambulatory , Creatinine/blood , Drug Therapy, Combination , Female , Humans , Hypertension/blood , Hypertension/physiopathology , Japan/epidemiology , Male , Organ Sparing Treatments/methods , Prospective Studies , Renin/blood , Serum Albumin/metabolismABSTRACT
BACKGROUND: At least a third of patients with a colorectal carcinoma who are candidate for surgery, are anaemic preoperatively. Preoperative anaemia is associated with increased morbidity and mortality. In general practice, little attention is paid to these anaemic patients. Some will have oral iron prescribed others not. The waiting period prior to elective colorectal surgery could be used to optimize a patients' physiological status. The aim of this study is to determine the efficacy of preoperative intravenous iron supplementation in comparison with the standard preoperative oral supplementation in anaemic patients with colorectal cancer. METHODS/DESIGN: In this multicentre randomized controlled trial, patients with an M0-staged colorectal carcinoma who are scheduled for curative resection and with a proven iron deficiency anaemia are eligible for inclusion. Main exclusion criteria are palliative surgery, metastatic disease, neoadjuvant chemoradiotherapy (5 × 5 Gy = no exclusion) and the use of Recombinant Human Erythropoietin within three months before inclusion or a blood transfusion within a month before inclusion. Primary endpoint is the percentage of patients that achieve normalisation of the haemoglobin level between the start of the treatment and the day of admission for surgery. This study is a superiority trial, hypothesizing a greater proportion of patients achieving the primary endpoint in favour of iron infusion compared to oral supplementation. A total of 198 patients will be randomized to either ferric(III)carboxymaltose infusion in the intervention arm or ferrofumarate in the control arm. This study will be performed in ten centres nationwide and one centre in Ireland. DISCUSSION: This is the first randomized controlled trial to determine the efficacy of preoperative iron supplementation in exclusively anaemic patients with a colorectal carcinoma. Our trial hypotheses a more profound haemoglobin increase with intravenous iron which may contribute to a superior optimisation of the patient's condition and possibly a decrease in postoperative morbidity. TRIAL REGISTRATION: ClincalTrials.gov: NCT02243735 .
Subject(s)
Anemia, Iron-Deficiency/drug therapy , Colorectal Neoplasms/surgery , Ferric Compounds/administration & dosage , Ferrous Compounds/administration & dosage , Fumarates/administration & dosage , Hematinics/administration & dosage , Maltose/analogs & derivatives , Preoperative Care/methods , Administration, Oral , Adolescent , Adult , Aged , Aged, 80 and over , Anemia, Iron-Deficiency/etiology , Clinical Protocols , Colorectal Neoplasms/complications , Dietary Supplements , Female , Ferric Compounds/therapeutic use , Ferrous Compounds/therapeutic use , Fumarates/therapeutic use , Hematinics/therapeutic use , Humans , Infusions, Intravenous , Male , Maltose/administration & dosage , Maltose/therapeutic use , Middle Aged , Treatment Outcome , Young AdultABSTRACT
UNLABELLED: The lichen Cladonia verticillaris produces bioactive secondary metabolites, such as fumarprotocetraric (FUM) and protocetraric acids. Species of the genus Cladonia demonstrate anti-tumor, anti-inflammatory and antipyretic activities and have been used in folk medicine to treat respiratory diseases (throat irritation, cough, asthma and tuberculosis). The aim of the present study was to evaluate the expectorant and mucolytic activities of fumarprotocetraric acid in albino Swiss mice. FUM was extracted and purified from an acetone extract of C. verticillaris. The phenol red quantification method was used on the bronchoalveolar lavage fluid following the administration of FUM (25, 50 or 100 mg/kg orally or intraduodenally and 12.5, 25 or 50 mg/kg, intraperitoneally) for the evaluation of expectorant activity. Control groups received either saline solution (7.5 mL/kg) or ambroxol (1 mg/kg) through the same administration routes. Antioxidant activity was evaluated using the thiobarbituric acid reactive species assay in mouse lung tissue treated with the FUM at 25, 50 or 100 mg/kg orally, followed by a lipopolysaccharide solution at 1 mg/kg intrapleurally. The same protocol was used for the control groups using either saline solution (7.5 mL/kg, orally) or N-acetylcysteine (20 mg/kg, orally). RESULTS: Orally administered FUM at doses of 25 and 50 mg/kg promoted significantly greater dose-dependent phenol red activity in the bronchoalveolar lavage and expectorant activity in comparison to the controls (p < 0.05). Lipid peroxidation (malondialdehyde equivalent) was reduced by 50% in the lung tissue. CONCLUSION: The results confirm the expectorant and antioxidant properties of fumarprotocetraric acid produced by the lichen C. verticillaris.
Subject(s)
Antioxidants/pharmacology , Ascomycota/metabolism , Expectorants/pharmacology , Fumarates/pharmacology , Administration, Oral , Animals , Antioxidants/administration & dosage , Antioxidants/isolation & purification , Bronchoalveolar Lavage Fluid , Dose-Response Relationship, Drug , Expectorants/administration & dosage , Expectorants/isolation & purification , Fumarates/administration & dosage , Fumarates/isolation & purification , Lipid Peroxidation/drug effects , Male , Mice , Secondary Metabolism , Thiobarbituric Acid Reactive Substances/metabolismABSTRACT
BACKGROUND: The aim of this study was to compare the effects of direct renin inhibitor, aliskiren, and amlodipine combination therapy with those of high-dose amlodipine monotherapy on endothelial function in elderly hypertensive patients. METHODS: Participants included 105 patients (mean age 77 years) who had receive 5mg amlodipine for 4 weeks. Patients were allocated to the aliskiren/amlodipine group (AL/AM) or the high-dose amlodipine (AM) group. The AL/AM group received 150mg aliskiren in addition to 5mg amlodipine for 8 weeks; then the dose of aliskiren was doubled to 300mg for another 8 weeks. The AM group received 10mg amlodipine for 16 weeks. Of the 105 patients, 87 who underwent measurements of brachial flow-mediated vasodilation (FMD) and nitroglycerin-mediated vasodilation (NMD) before and after the study were included in the analysis. RESULTS: Blood pressure-lowering effects were similar in the 2 groups. Plasma renin activity significantly decreased in the AL/AM group (P < 0.001) but increased in the AM group (P < 0.001). Improvement of FMD was found in the AL/AM group (2.6% to 3.7%, P = 0.001) but not in the AM group, while NMD did not change in either group. The changes in 24-hour systolic blood pressure (r = -0.60, P < 0.001) and diastolic blood pressure (r = -0.46, P = 0.004) were significantly correlated with improvement of FMD in the AL/AM group but not in the AM group. CONCLUSION: Addition of aliskiren improved endothelial function in elderly hypertensive patients treated with amlodipine. CLINICAL TRIAL REGISTRY NUMBER: UMIN000010163.
Subject(s)
Amides/administration & dosage , Amlodipine/administration & dosage , Antihypertensive Agents/administration & dosage , Blood Pressure/drug effects , Calcium Channel Blockers/administration & dosage , Endothelium, Vascular/drug effects , Fumarates/administration & dosage , Hypertension/drug therapy , Vasodilation/drug effects , Vasodilator Agents/administration & dosage , Aged , Aged, 80 and over , Drug Therapy, Combination , Endothelium, Vascular/physiopathology , Female , Humans , Hypertension/blood , Hypertension/diagnosis , Hypertension/physiopathology , Japan , Male , Renin/antagonists & inhibitors , Renin/blood , Time Factors , Treatment OutcomeABSTRACT
INTRODUCTION: Hypertension is a leading cause of cardiovascular morbidity and mortality, and uncontrolled hypertension remains common despite the availability of several classes of effective antihypertensive medications. Combination therapy with antihypertensive agents of complementary actions has been advocated in the management of hypertension to maximize efficacy and minimize side effects. AREAS COVERED: This review summarizes the current data on the triple combination therapy of aliskiren with amlodipine and hydrochlorothiazide, and discusses the clinical use of single pill triple combination of aliskiren, amlodipine and hydrochlorothiazide in the treatment of hypertension and associated cardiovascular conditions. EXPERT OPINION: Combination therapy with antihypertensive agents of complementary actions is more effective than monotherapy in the management of hypertension. Combining an agent in renin-angiotensin blockade with a dihydropyridine calcium channel blocker (CCB) and a thiazide diuretic has plausibility in maximizing blood pressure reduction and minimizing side effects. The combination of aliskiren with amlodipine and hydrochlorothiazide has shown effective blood pressure lowering and noteworthy tolerability. The single pill triple combination of aliskiren, amlodipine, and hydrochlorothiazide offers five different formulations of escalating dosages of the three agents, allowing dosing flexibility. The decreased pill burden and simplified treatment options with the single pill triple combination provide an opportunity to improve blood pressure control through improved adherence and reduced treatment inertia.
Subject(s)
Amides/administration & dosage , Amlodipine/administration & dosage , Antihypertensive Agents/administration & dosage , Fumarates/administration & dosage , Hydrochlorothiazide/administration & dosage , Hypertension/drug therapy , Amides/adverse effects , Amlodipine/adverse effects , Antihypertensive Agents/adverse effects , Drug Combinations , Fumarates/adverse effects , Humans , Hydrochlorothiazide/adverse effects , Treatment OutcomeABSTRACT
This study was conducted to investigate effects of disodium fumarate (DF) on fermentation characteristics and microbial populations in the rumen of Hu sheep fed on high-forage diets. Two complementary feeding trials were conducted. In Trial 1, six Hu sheep fitted with ruminal cannulae were randomly allocated to a 2 × 2 cross-over design involving dietary treatments of either 0 or 20 g DF daily. Total DNA was extracted from the fluid- and solid-associated rumen microbes, respectively. Numbers of 16S rDNA gene copies associated with rumen methanogens and bacteria, and 18S rDNA gene copies associated with rumen protozoa and fungi were measured using real-time PCR, and expressed as proportion of total rumen bacteria 16S rDNA. Ruminal pH decreased in the DF group compared with the control (P < 0.05). Total volatile fatty acids increased (P < 0.001), but butyrate decreased (P < 0.01). Addition of DF inhibited the growth of methanogens, protozoa, fungi and Ruminococcus flavefaciens in fluid samples. Both Ruminococcus albus and Butyrivibrio fibrisolvens populations increased (P < 0.001) in particle-associated samples. Trial 2 was conducted to investigate the adaptive response of rumen microbes to DF. Three cannulated sheep were fed on basal diet for 2 weeks and continuously for 4 weeks with supplementation of DF at a level of 20 g/day. Ruminal samples were collected every week to analyze fermentation parameters and microbial populations. No effects of DF were observed on pH, acetate and butyrate (P > 0.05). Populations of methanogens and R. flavefaciens decreased in the fluid samples (P < 0.001), whereas addition of DF stimulated the population of solid-associated Fibrobacter succinogenes. Population of R. albus increased in the 2nd to 4th week in fluid-associated samples and was threefold higher in the 4th week than control week in solid samples. Analysis of denaturing gradient gel electrophoresis fingerprints revealed that there were significant changes in rumen microbiota after adding DF. Ten of 15 clone sequences from cut-out bands appearing in both the 2nd and the 4th week were 94% to 100% similar to Prevotella-like bacteria, and four sequences showed 95% to 98% similarity to Selenomonas dianae. Another 15 sequences were obtained from bands, which appeared in the 4th week only. Thirteen of these 15 sequences showed 95% to 99% similarity to Clostridium sp., and the other two showed 95% and 100% similarity to Ruminococcus sp. In summary, the microorganisms positively responding to DF addition were the cellulolytic bacteria, R. albus, F. succinogenes and B. fibrisolvens as well as proteolytic bacteria, B. fibrisolvens, P. ruminicola and Clostridium sp.
Subject(s)
Animal Nutritional Physiological Phenomena , Diet , Fermentation/drug effects , Fumarates/pharmacology , Metagenome/drug effects , Rumen/physiology , Sheep , Acetates/metabolism , Animals , Butyrates/metabolism , Cross-Over Studies , DNA, Ribosomal/genetics , Dietary Supplements , Fermentation/physiology , Fumarates/administration & dosage , Hydrogen-Ion Concentration , Metagenome/genetics , Real-Time Polymerase Chain Reaction/veterinary , Rumen/microbiology , Species SpecificityABSTRACT
The effect of organic acids and mannanoligosaccharide addition to the diet was assessed in pigs orally inoculated with Salmonella typhimurium. Forty-six growers were distributed among four treatments: Basal Diet (BD); BD+encapsulated organic acids; BD+free organic acids; BD+mannanoligosaccharide. Seroconversion was monitored, and feces and tissue samples were tested for Salmonella isolation. No treatment prevented the carrier state, but a tendency of lower fecal excretion was observed in the group treated with mannanoligosaccharide.
Subject(s)
Feces/microbiology , Salmonella Infections, Animal/microbiology , Salmonella typhimurium/drug effects , Swine Diseases/microbiology , Animals , Carrier State/microbiology , Carrier State/prevention & control , Citric Acid/administration & dosage , Citric Acid/therapeutic use , Diet/veterinary , Dietary Supplements , Formates/administration & dosage , Formates/therapeutic use , Fumarates/administration & dosage , Fumarates/therapeutic use , Malates/administration & dosage , Malates/therapeutic use , Mannans/administration & dosage , Mannans/therapeutic use , Oligosaccharides/administration & dosage , Oligosaccharides/therapeutic use , Phosphoric Acids/administration & dosage , Phosphoric Acids/therapeutic use , Propionates/administration & dosage , Propionates/therapeutic use , Salmonella Infections, Animal/prevention & control , Swine/microbiology , Swine Diseases/prevention & controlABSTRACT
AIM: To study the clinical aspects of using the furasidine potassium in combination with basic magnesium carbonate (furamag) and phosphomycin trometamol (monural) as antimicrobial agents most frequently used in outpatient practice during combination therapy for acute and chronic urinary tract (UT) diseases. SUBJECTS AND METHODS: To study the specific features of therapy for UT infections, 60 patients were randomized to 2 groups: 1) 30 patients received a course therapy with furasidine potassium (furamag) in a dose of 50 mg t.i.d. for 7 days (a study group) and 2) 30 had phosphomycin trometamol (monural) in a single dose of 3 g for pulse therapy (a comparison group). The clinical efficacy of the drugs, symptom disappearance rates, bacterial changes, and laboratory and instrumental findings were assessed. The patient's opinion was mainly used to evaluate outpatient pharmacoeconomic efficiency. Patient compliance with the given therapy was estimated by taking into account the specific features of prehospital care. RESULTS: During therapy, both groups showed positive clinical changes. In the study group, the symptoms of dysuria resolved 0.5 days more quickly and a complete clinical remission was achieved 0.8 days more promptly; the latter within the first 72 hours was achieved by 7.5% more of the patients; the symptoms of bacteriuria resolved 0.6 days more rapidly. With the similar average price of the packs of furasidine potassium (furamag) 50 mg (30 capsules) and phosphomycin trometamol (monural) 1 g (a sachet) being 350 and 370 rubles, the average costs of required treatment were 482 and 546 rubles, respectively. No case of adverse reactions was recorded during the study. CONCLUSION: Patients with infectious and inflammatory diseases of UT should be given furasidine potassium in the standard dose of 50 mg t.i.d for 7 days.
Subject(s)
Anti-Infective Agents , Bacteria/drug effects , Fosfomycin , Reproductive Tract Infections , Urinary Tract Infections , Adult , Ambulatory Care/economics , Ambulatory Care/methods , Ambulatory Care/standards , Anti-Infective Agents/administration & dosage , Anti-Infective Agents/adverse effects , Anti-Infective Agents/economics , Attitude of Health Personnel , Bacteria/classification , Bacteria/isolation & purification , Bacteriological Techniques/methods , Drug Costs , Drug Therapy, Combination , Female , Fosfomycin/administration & dosage , Fosfomycin/adverse effects , Fosfomycin/economics , Fumarates/administration & dosage , Fumarates/adverse effects , Fumarates/economics , Humans , Male , Medication Adherence , Microbial Sensitivity Tests/methods , Outcome Assessment, Health Care , Reproductive Tract Infections/drug therapy , Reproductive Tract Infections/microbiology , Reproductive Tract Infections/physiopathology , Treatment Outcome , Urinary Tract Infections/drug therapy , Urinary Tract Infections/microbiology , Urinary Tract Infections/physiopathology , Urogenital System/microbiology , Urogenital System/physiopathologyABSTRACT
Hypertension (HTN) affects an estimated 76.4 million US adults. Despite improvements in blood pressure (BP) control rates and the availability of effective antihypertensive agents, only 50% of these individuals achieve BP control. It is now recognized that many patients will require ≥ 2 antihypertensive agents to achieve BP control. Both the current US and reappraisal of the 2007 European guidelines include dual-combination regimens among recommended treatments for initial HTN therapy. For patients requiring 3 drugs, the combination of agents with complementary mechanisms of action (ie, renin-angiotensin-aldosterone system blocker, calcium channel blocker, and diuretic) has been recognized as rational and effective. Three single-pill triple-drug combinations have recently been approved for use in HTN in the United States: valsartan (VAL)/amlodipine (AML)/hydrochlorothiazide (HCTZ); olmesartan medoxomil (OM)/AML/HCTZ; and aliskiren (ALI)/VAL/HCTZ. Triple-combination regimens have resulted in a greater proportion of patients achieving BP control compared with dual-combination regimens, with significantly lower BP levels documented after only 2 weeks at maximum doses. Single-pill combinations offer convenience to address barriers to BP control such as poor adherence to therapy and therapeutic inertia. Additional benefits of combining antihypertensive agents from different classes include improved efficacy, safety, and reduction of cardiovascular risk. In patients with essential HTN for whom dual therapy is inadequate, single-pill triple-drug therapy can offer a simplified and effective treatment strategy.
Subject(s)
Amides/administration & dosage , Amlodipine/therapeutic use , Antihypertensive Agents/administration & dosage , Fumarates/administration & dosage , Hydrochlorothiazide/administration & dosage , Hypertension/drug therapy , Imidazoles/administration & dosage , Tetrazoles/administration & dosage , Valine/analogs & derivatives , Amlodipine/administration & dosage , Drug Combinations , Drug Design , Humans , Medication Adherence , Olmesartan Medoxomil , Practice Guidelines as Topic , Practice Patterns, Physicians' , Valine/administration & dosage , ValsartanSubject(s)
Dermatologic Agents/administration & dosage , Dermatologic Agents/adverse effects , Education , Fumarates/administration & dosage , Fumarates/adverse effects , Psoriasis/drug therapy , Administration, Oral , Alopecia Areata/drug therapy , Alopecia Areata/epidemiology , Alopecia Areata/psychology , Autoimmune Diseases/drug therapy , Autoimmune Diseases/epidemiology , Autoimmune Diseases/psychology , Biological Availability , Clinical Trials as Topic , Comorbidity , Dermatologic Agents/pharmacokinetics , Dimethyl Fumarate , Dose-Response Relationship, Drug , Drug Administration Schedule , Etanercept , Follow-Up Studies , Fumarates/pharmacokinetics , Humans , Immunoglobulin G/administration & dosage , Immunoglobulin G/adverse effects , Metabolic Clearance Rate/physiology , PUVA Therapy/methods , Pilot Projects , Prospective Studies , Psoriasis/epidemiology , Psoriasis/psychology , Quality of Life , Receptors, Tumor Necrosis Factor/administration & dosage , Registries , Sick RoleABSTRACT
Two similar experiments were conducted to assess the effect of diallyl disulfide (DADS), yucca powder (YP), calcium fumarate (CAFU), an extruded linseed product (UNSAT), or a mixture of capric and caprylic acid (MCFA) on methane production, energy balance, and dairy cow performance. In experiment 1, a control diet (CON1) and diets supplemented with 56 mg of DADS/kg of dry matter (DM), 3g of YP/kg of DM, or 25 g of CAFU/kg of DM were evaluated. In experiment 2, an inert saturated fat source in the control diet (CON2) was exchanged isolipidically for an extruded linseed source (100g/kg of DM; UNSAT) or a mixture of C8:0 and C10:0 (MCFA; 20.3g/kg of DM). In experiment 2, a higher inclusion level of DADS (200mg/kg of DM) was also tested. Both experiments were conducted using 40 lactating Holstein-Friesian dairy cows. Cows were adapted to the diet for 12 d and were subsequently kept in respiration chambers for 5 d to evaluate methane production, diet digestibility, energy balance, and animal performance. Feed intake was restricted to avoid confounding effects of possible differences in ad libitum feed intake on methane production. Feed intake was, on average, 17.5 and 16.6 kg of DM/d in experiments 1 and 2, respectively. None of the additives reduced methane production in vivo. Methane production in experiment 1 was 450, 453, 446, and 423 g/d for CON1 and the diets supplemented with DADS, YP, and CAFU, respectively. In experiment 2, methane production was 371, 394, 388, and 386 g/d for CON2 and the diets supplemented with UNSAT, MCFA, and DADS, respectively. No effects of the additives on energy balance or neutral detergent fiber digestibility were observed. The addition of MCFA increased milk fat content (5.38% vs. 4.82% for control) and fat digestibility (78.5% vs. 59.8% for control), but did not affect milk yield or other milk components. The other products did not affect milk yield or composition. Results from these experiments emphasize the need to confirm methane reductions observed in vitro with in vivo data.
Subject(s)
Allyl Compounds/pharmacology , Cattle/physiology , Diet/veterinary , Disulfides/pharmacology , Flax , Fumarates/pharmacology , Methane/biosynthesis , Yucca , Allyl Compounds/administration & dosage , Animal Nutritional Physiological Phenomena , Animals , Caprylates/administration & dosage , Caprylates/pharmacology , Decanoic Acids/administration & dosage , Decanoic Acids/pharmacology , Dietary Supplements , Digestion/drug effects , Disulfides/administration & dosage , Energy Metabolism/drug effects , Female , Fumarates/administration & dosage , Lactation/drug effects , Milk/chemistry , Milk/metabolismABSTRACT
Optimal antihypertensive therapy requires a multimodal approach based on lifestyle modification and, for most individuals, combination drug therapy. Recommendations from experts suggest that a combination of an agent that blocks the renin-angiotensin system (RAS), together with a vasodilator (generally a calcium-channel blocker or a thiazide-type diuretic), is most likely to control blood pressure and provide the widest overall cardiovascular protection. Understanding the opportunities afforded by the combination of RAS blockade with a calcium-channel blocker requires a discussion of basic and clinical science data. One new concept is that of 'global' or total RAS blockade. The impact of the RAS can be diminished or blocked by several different classes of drugs (central sympatholytics, ß-blockers, renin inhibitors, ACE inhibitors or ARBs); what is most important is how effectively the overall impact of angiotensin II is blunted. A second new concept is that the complementary actions of RAS blockers and calcium-channel blockers are best explained on the basis of diminished intracellular calcium availability in excitable tissue (sympathetic neurons and vascular smooth muscle cells) via parallel actions that reduce angiotensin II type-1 receptor stimulation and L-channel-mediated calcium flux. Aliskiren is the first of the direct renin inhibitors, the newest subclass of RAS blockers. In both short- and long-term studies, aliskiren has been shown to be similar in efficacy and tolerability compared with other RAS blockers, with the added benefit that its effects persist longer. Outcome studies with aliskiren are currently underway.
Subject(s)
Amides/administration & dosage , Amlodipine/administration & dosage , Antihypertensive Agents/administration & dosage , Fumarates/administration & dosage , Hypertension/drug therapy , Drug Therapy, Combination , Humans , Treatment OutcomeABSTRACT
Two experiments were conducted to assess the effects of a mixture of dietary additives on enteric methane production, rumen fermentation, diet digestibility, energy balance, and animal performance in lactating dairy cows. Identical diets were fed in both experiments. The mixture of feed additives investigated contained lauric acid, myristic acid, linseed oil, and calcium fumarate. These additives were included at 0.4, 1.2, 1.5, and 0.7% of dietary dry matter, respectively (treatment ADD). Experimental fat sources were exchanged for a rumen inert source of fat in the control diet (treatment CON) to maintain isolipidic rations. Cows (experiment 1, n=20; experiment 2, n=12) were fed restricted amounts of feed to avoid confounding effects of dry matter intake on methane production. In experiment 1, methane production and energy balance were studied using open-circuit indirect calorimetry. In experiment 2, 10 rumen-fistulated animals were used to measure rumen fermentation characteristics. In both experiments animal performance was monitored. The inclusion of dietary additives decreased methane emissions (g/d) by 10%. Milk yield and milk fat content tended to be lower for ADD in experiment 1. In experiment 2, milk production was not affected by ADD, but milk fat content was lower. Fat- and protein-corrected milk was lower for ADD in both experiments. Milk urea nitrogen content was lowered by ADD in experiment 1 and tended to be lower in experiment 2. Apparent total tract digestibility of fat, but not that of starch or neutral detergent fiber, was higher for ADD. Energy retention did not differ between treatments. The decrease in methane production (g/d) was not evident when methane emission was expressed per kilogram of milk produced. Feeding ADD resulted in increases of C12:0 and C14:0 and the intermediates of linseed oil biohydrogenation in milk in both experiments. In experiment 2, ADD-fed cows tended to have a decreased number of protozoa in rumen fluid when compared with that in control cows. Total volatile fatty acid concentrations were lower for ADD, whereas molar proportions of propionate increased at the expense of acetate and butyrate.
Subject(s)
Cattle/physiology , Diet/veterinary , Digestion/drug effects , Food Additives/pharmacology , Lactation/drug effects , Methane/biosynthesis , Animal Feed , Animals , Cattle/metabolism , Energy Metabolism/drug effects , Female , Fermentation/drug effects , Food Additives/administration & dosage , Fumarates/administration & dosage , Fumarates/pharmacology , Lauric Acids/administration & dosage , Lauric Acids/pharmacology , Linseed Oil/administration & dosage , Linseed Oil/pharmacology , Myristic Acid/administration & dosage , Myristic Acid/pharmacology , Rumen/metabolismABSTRACT
The number of well-controlled hypertensives is unacceptably low worldwide. Respecting the circadian variation of blood pressure, nontraditional antihypertensives, and treatment in early stages of hypertension are potential ways to improve hypertension therapy. First, prominent variations in circadian rhythm are characteristic for blood pressure. The revolutionary MAPEC (Ambulatory Blood Pressure Monitoring and Cardiovascular Events) study, in 3000 adult hypertensives investigates, whether chronotherapy influences the cardiovascular prognosis beyond blood pressure reduction per se. Second, melatonin, statins and aliskiren are hopeful drugs for hypertension treatment. Melatonin, through its scavenging and antioxidant effects, preservation of NO availability, sympatholytic effect or specific melatonin receptor activation exerts antihypertensive and anti-remodeling effects and may be useful especially in patients with nondipping nighttime blood pressure pattern or with nocturnal hypertension and in hypertensives with left ventricular hypertrophy (LVH). Owing to its multifunctional physiological actions, this indolamine may offer cardiovascular protection far beyond its hemodynamic benefit. Statins exert several pleiotropic effects through inhibition of small guanosine triphosphate-binding proteins such as Ras and Rho. Remarkably, statins reduce blood pressure in hypertensive patients and more importantly they attenuate LVH. Addition of statins should be considered for high-risk hypertensives, for hypertensives with LVH, and possibly for high-risk prehypertensive patients. The direct renin inhibitor, aliskiren, inhibits catalytic activity of renin molecules in circulation and in the kidney, thus lowering angiotensin II levels. Furthermore, aliskiren by modifying the prorenin conformation may prevent prorenin activation. At present, aliskiren should be considered in hypertensive patients not sufficiently controlled or intolerant to other inhibitors of renin-angiotensin system. Third, TROPHY (Trial of Preventing Hypertension) is the first pharmacological intervention for prehypertensive patients revealing that treatment with angiotensin II type 1 receptor blocker attenuates hypertension development and thus decreases the risk of cardiovascular events.
Subject(s)
Chronotherapy/methods , Hypertension/therapy , Melatonin/administration & dosage , Amides/administration & dosage , Animals , Antihypertensive Agents/administration & dosage , Circadian Rhythm/physiology , Fumarates/administration & dosage , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hypertension/drug therapy , Hypertension/physiopathology , Hypertension/prevention & controlABSTRACT
Supplementation of some organic acids to a P-deficient diet has been shown to improve phytate P utilization. Two experiments were conducted from 0 to 16 d in battery brooders to determine the effect of various organic acids supplementation on phytate P utilization. In both experiments, birds were fed P-deficient corn and soybean meal-based diets. In experiment 1, citric acid, malic acid, fumaric acid, and EDTA were supplemented. Experiment 2 had a 2 x 2 factorial design with 2 sources of Met, 2-hydroxy-4-(methylthio) butanoic acid (HMB) and dl-Met, with or without 500 U/kg of phytase. In experiment 1, the addition of citric, malic, and fumaric acids increased percentage of bone ash, but only the effect of citric acid was significant. The addition of citric and malic acids also significantly increased the retention of P and phytate P (P<0.05). In experiment 2, the addition of phytase to the diet significantly increased 16-d BW gain, feed intake, percentage of bone ash, milligrams of bone ash, phytate P disappearance, and decreased the incidence of P-deficiency rickets. Methionine source did not affect 16-d BW gain, feed intake, feed efficiency, milligrams of bone ash, or P rickets incidence. However, the birds fed HMB had a higher percentage of bone ash and phytate P disappearance compared with the groups fed dl-Met only when phytase was added to the diets. The additions of citric acid and HMB improved phytate P utilization. However, the reason why some organic acids are effective whereas others are not is not apparent.