Appreciation of trimetazidine treatment in experimental sepsis rat model.

INTRODUCTION: Our aim was to determine the efficacy of trimetazidine on experimental sepsis rat model. MATERIAL AND METHODS: Sixty rats were randomized into three groups. In Group 1, sepsis was induced. In Group 2, sepsis was induced and as a therapeutic agent trimetazidine was given. In Group 3, rats were sham operated. Serum interleukin-1 beta (IL-1ß), tumor necrosis factor alfa (TNF-α), superoxide dismutase (SOD), glutathion peroxidase (GSH-Px) and malondialdehyde (MDA) levels were determined in all groups. RESULTS: In Group 2, serum GSH-Px and SOD levels were statistically significantly higher than in Group 1 (p< 0.05) and serum MDA levels were statistically significantly lower than in group 1 (p < 0.05). Trimetazidine also significantly decreased the levels of IL-1ß and TNF-a which are the proinflammatory cytokines (p < 0.05). CONCLUSION: Trimetazidine treatment significantly improved inflammation, oxidative stress and membrane destruction in LPS-induced sepsis. As the proinflammatory cytokines are supposed to play a primary role in the pathogenesis of sepsis, we assumed that the trimetazidine treatment would give new insights into the treatment of sepsis (Tab. 1, Fig. 5, Ref. 29).

ADMA, proteinuria, and insulin resistance in non-diabetic stage I chronic kidney disease.

The rationale of this study is based on the fact that, both proteinuria and elevated asymmetric dimethyl arginine (ADMA) levels have been linked to the progression of vascular disease. Currently, there is not enough knowledge about any association between the levels of proteinuria and ADMA levels. Seventy-eight non-diabetic patients (42 men, 36 women, mean age of 26.1+/-5.2 years) with proteinuria having normal glomerular filtration rate were enrolled along with 38 healthy subjects (20 men, 18 women, mean age of 26.9+/-5.9 years). Proteinuria was below 3.5 g/day in 40 patients and above 3.5 g/day in 38 patients. Both groups had similar age, gender, and body mass index distributions. Serum ADMA, symmetric dimethyl arginine (SDMA), immunoreactive insulin, and high sensitivity C reactive protein (hsCRP) levels were measured. Insulin resistance was determined by homeostasis model assessment (HOMA). Serum ADMA, SDMA, insulin, hsCRP levels, and HOMA indexes were significantly higher in patients than in healthy control subjects. The above parameters were higher in the nephrotic range proteinuria group when compared to patients having protein levels below 3.5 g/day. There were significant correlations between the levels of proteinuria and the above parameters. According to the regression analysis, levels of proteinuria and hsCRP were significant determinants of serum ADMA levels. Our results indicate that, independent of other risk factors, ADMA is directly associated with proteinuria. Further studies are recommended to find out whether elevated ADMA levels are implicated in the high cardiovascular risk of proteinuric nephropathies.

Ontario gold miners with lung cancer. Occupational exposure assessment in establishing work-relatedness.

Because of inherent errors in exposure data as well as a requirement in the Workers' Compensation Act of Ontario that all claims must be considered on the merits and justice of the individual case, the criteria for assessing work-relatedness of Ontario gold miners who had primary lung cancer could not be based upon any strict occupational exposure criteria. However, a relationship between exposure to silica, arsenic, and radon progeny was derived from results of the epidemiologic studies. A retrospective occupational exposure assessment of silica dust, arsenic, and radon decay products was made in individual cases presented in this paper. The assessment results of 11 gold miners presented in this paper illustrate that the exposure parameters could provide persuasive evidence when the data were consistent with the key epidemiologic findings, eg, the miner's age at first exposure, length of dusty exposure, and latency.

Hand-arm vibration syndrome: a guide to medical impairment assessment.

Hand-arm vibration syndrome is a complex condition with vascular, sensorineural, and musculoskeletal components. Workers who handle vibratory tools suffer from it, and the severity of this syndrome is now graded internationally using the Stockholm classification. For compensation purposes the severity must be translated into impairment and this paper proposes how this may be done using the AMA Guides to the Evaluation of Permanent Impairment. The case history of a typical claimant is presented to demonstrate how an impairment rating might be derived.

Pulmonary histoplasmosis: a review of 50 cases.

Histoplasmosis is a systemic fungal infection caused by Histoplasma capsulatum. Infection, identified by skin testing, has been found in more than 50 countries. In Canada the disease is endemic in the St. Lawrence River Valley. Fifty patients with positive reaction to histoplasmin skin tests were reviewed at the Provincial Chest Clinic in Windsor, Ontario. All were asymptomatic; 27 had a history of present or previous involvement in farming or poultry rearing.

Pulmonary manifestations in patients with malignant melanoma during BCG immunotherapy. A preliminary report.

Ten patients with malignant melanoma who were treated with bacillus Calmette-Guérin (BCG) were studied with chest roentgenograms, scintiscans with radioactive 67gallium citrate, and the single-breath diffusing capacity of carbon monoxide (Dsb). Three patients (stage 1B) with normal findings had no evidence of progression of disease. Seven patients had abnormal findings on at least one test. Two patients (stage 3B and stage 4B) with focal uptake in the lungs on the scintiscan had metastatic melanoma. Three patients (stage 3B) with diffuse uptake on the scintiscan and a reduced Dsb had no evidence of progression of disease. One patient (stage 1B) with an abnormal chest roentgenogram had a benign pleural effusion, and one patient (stage 4B) with a reduced Dsb was free of melanoma. A diffuse increase in the uptake of radioactive 67gallium in the lungs and a low Dsb may not indicate progression of melanoma. On the other hand, a focal uptake of 67gallium in the lungs is highly suggestive of metastatic disease.

Cardiovascular effects of tricyclic and tetracyclic antidepressants.

This article reviews all available studies on the cardiovascular effects of tri- and tetracyclic antidepressants at therapeutic and toxic levels. There is growing evidence that tricyclics, even at therapeutic levels, can be cardiotoxic. Plasma TCA levels are too variable to define a safe therapeutic range. Any patient showing cardiovascular side effects should have an ECG before continuing medication.

Relation between pulsus paradoxus and pulmonary function in patients with chronic airways obstruction.

The relation of pulsus paradoxus to chronic, stable obstructive disease of the airways has not previously been described. Pulsus paradoxus was observed in 66% of 68 patients with such disease but in none of 14 healthy individuals. There was a significant correlation between the degree of pulsus paradoxus and the forced expiratory volume in 1 second (FEV1) in the subgroup of patients with bronchial asthma but not in the subgroup with chronic bronchitis or emphysema, or both. There was no correlation between the degree of pulsus paradoxus and the degree of hyperinflation in either group. Hence factors other than hyperinflation contribute importantly to the decrease in systolic pressure that occurs at full inflation of the lungs.

Long Term Follow up of 'Coronary Mimic Syndrome'.

Twenty-two female patients (mean age 42.3 years) with chest pain and normal coronary artery angiogram have been followed from April 1966 to March 1975 (mean follow-up period 56 months). Long term follow up data are presented. Treatment consisted of reassurance.