Reduction of acute-phase proteins with tenidap sodium, a cytokine-modulating anti-rheumatic drug.

Four independent studies have investigated and compared the effects of tenidap sodium, naproxen and placebo on CRP in patients with active RA. One of these studies also investigated the effects of tenidap and naproxen on serum amyloid A (SAA) concentrations and ESR. The duration of the four studies ranged between 2 weeks and 24 weeks, and depending on the study, tenidap sodium was administered orally in doses of 40-120 mg/day and naproxen in doses of 1000 mg/day. In all four studies serum CRP concentrations in tenidap-treated patients had decreased significantly from baseline at the time of final assessment. The decrease in CRP concentration in tenidap-treated patients was observed as early as 1 week after initiation of therapy and was sustained for up to 6 months, the last assessment timepoint. CRP concentrations in naproxen-treated and placebo patients were essentially unchanged. The decreases from baseline observed in tenidap-treated patients were significantly greater than the changes observed in naproxen-treated or placebo patients. After 24 weeks of tenidap treatment the decrease in CRP was paralleled by significant decreases in SAA concentration and ESR. The finding that tenidap sodium rapidly, consistently and significantly lowered CRP serum concentrations differentiates tenidap sodium from the NSAID, naproxen. This could possibly have important therapeutic implications given that other long-term investigations have shown that reducing serum CRP and SAA concentrations correlates with a reduction in radiographically-assessed disease progression.

[Clinical evaluation of hydroxy-ethylated starch (preparation HAES)]. / Ocena kliniczna skrobi hydroksyetylowanej (preparatu HAES).

Hydroxy-ethylated starch (HAES-Fresenius) has been evaluated clinically at the Department of Anesthesiology and Intensive Care, Medical Academy in Warsaw. This plasma substitute is used in several countries as plasma substitute similar to dextran but of better properties. Results of our studies have shown, that HAES is worth its opinion. It is quite good plasma substitute of favourable effect on tissue perfusion. The above features together with a wide therapeutical margin and the lack of any effect on blood coagulation place HAES over dextran plasma substitutes. This preparation should have wider use in Poland.

[A case of ventricular free wall rupture in acute myocardial infarction treated conservatively with success]. / Przypadek pekniecia wolnej sciany lewej komory w przebiegu swiezego zawalu serca skutecznie leczony zachowawczo.

A sixty year old man developed clinical signs of pericardial tamponade on fifth day of acute myocardial infarction. An echocardiogram showed a pericardial effusion and rupture of left ventricular free wall. After pericardial puncture and four days pericardial drainage, the fissure of rupture was closed by formation of thrombus and pseudoaneurysm. After six weeks patient was discharged in good condition.

[Prognostic value of QT-QS2 index in the assessment of sudden coronary death]. / Wartosc prognostyczna wskaznika QT-QS2 w ocenie wystepowania naglych zgonów w chorobie wiencowej.

200 patients aged 49 +/- 8 with coronary artery disease underwent selective coronarography, left ventriculography as well as performed every year laboratory, polycardiography, ECG exercise test, 24-hour ECG Holter monitoring and X-ray chest examinations. Mean follow-up period was 34 +/- 10 months. For QT-QS2 index monitoring patients were divided into two groups: I--with abnormal index QT greater than QS2 (61-30%) and II--with the normal one QT less than QS2 (139-70%). Lown's classification was applied for ventricular premature beats assessment. Left ventricular contractility was estimated in hemodynamic examination. 28 patients died due to cardiac reasons during follow-up (14%). Among 19 suddenly died patients (9.5%) 7 had a normal and 12 an abnormal QT-QS2 index. Sudden mortality rate was 5% in the normal QT less than or equal to QS2 subgroup, and 20% in the abnormal QT greater than QS2 one. These differences are statistically significant.

[Ventricular arrhythmias and the ATc index in patients with ischemic heart disease]. / Komorowe zaburzenia rytmu serca a wskaznik QTc u chorych z choroba niedokrwienna serca.

In this multicenter study a group of 1,011 patients (233 females and 778 males, aged 23-68 years, mean 53) with ischaemic heart disease was included. Only nitrates, nifedipine and diuretics were administered during the investigation. Presence of other chronic disease excluded the patients from study group. In all patients a standard 12-lead electrocardiogram was obtained, from which the QT interval was measured, and its corrected value according to the Bazett's formula calculated [formula: see text] values greater than 440 ms were regarded to be abnormal. A 24-hour ecg ambulatory monitoring was also performed in each patient, and the detected ventricular ectopic activity was classified using the Lown's criteria. Mean QTc values were compared between each class of ventricular arrhythmia. No significant differences were disclosed. All the means were below 440 ms. Also the percentages of patients with a prolonged QTc were similar for all Lown classes of arrhythmia. The patients were then divided into two larger groups: Those with low grade (class 0-2) and high grade (class 3-5) arrhythmia. The portion of patients with the pathologic QTc was not significantly different (21% vs. 28%, NS). Such incidence of QTc prolongation was described for clinically healthy population. Since a 24-hour ecg fails to disclose the entire spectrum of arrhythmia in each individual, the fraction of patients with documented VT/VF in the past was analyzed separately. This subgroup was characterized by more frequent occurrence of QTc prolongation than other patients (35% vs. 20%, p = 0.043). Thus, no firm relationship was found between QTc prolongation and ventricular arrhythmias, but increased QTc favoured the occurrence of VT/VF.

[Value of two-dimensional and Doppler echocardiography in the diagnosis of rupture of the interventricular septum in myocardial infarction]. / Wartosc echokardiograffii dwuwymiarowej i dopplerowskiej w diagnostyce chorych z peknieciem przegrody komorowej w przebiegu zawalu serca.

Usefulness of two-dimensional and Doppler echocardiography in diagnosis of the ruptured interventricular septum in a course of myocardial infarction was evaluated basing on own material consisted of 6 cases. Ventricular septal defect was visualized in 5 patients. The blood flow through the ventricular septum was detected in all of 6 patients. Obtained results were concordant with intraoperative and anatomicopathologic findings as for as the localization of the rupture is concerned.

Nontricyclic antidepressant agents derived from cis- and trans-1-amino-4-aryltetralins.

The need for drugs that lack the obtrusive and limiting side effects of the tricyclic antidepressants has prompted the search for agents with greatly enhanced selectivity for specific mechanisms believed to be essential for antidepressant efficacy. The potential role of derangements of 5-HT pathways in the etiology of depression has long been suspected and has given impetus to the development of newer compounds that accentuate inhibition of serotonin reuptake. This paper presents structure-activity relationships for a series of cis-1-amino-4-(substituted-aryl)tetralins, which are surprisingly potent and selective inhibitors of serotonin uptake in in vitro models. These compounds are pharmacologically distinct from corresponding members of the trans series, which also potently block uptake of dopamine and norepinephrine. The activity in both cis and trans series is stereospecific, being restricted to the cis-(1S,4S) and the trans-(1R,4S) enantiomers.

[Inhalation therapy of upper respiratory tract diseases in metallurgists at the Ciechocinek health resort]. / Leczenie inhalacyjne schorzen górnych dróg oddechowych u hutników w uzdrowisku Ciechocinek.

Since 1972, 265 metallurgists of the Warsaw Steel-works have been treated at the ENT Department, Research Centre in Ciechocinek, for chronic atropic catarrh of upper respiratory tract mucous membrane. The treatment involved saline inhalations, respiratory exercises at a saline pool and in the open air near chimney coolers. Pathological changes were found in the mucous membrane of the metallurgists working over 5 years at high temperature and in great dustiness, and the ailments were getting intensified with the length of employment. The treatment was effective. Analysis of the collected material demonstrates that the treatment should be started already during the first 5 years of metallurgist's work. It should be meant as prophylaxis of upper respiratory tract diseases.

Delayed cutaneous hypersensitivity to oxazolone in mice with tumors.

A murine model of immune responsiveness had been adapted to study anergic conditions associated with neoplasia. Marked anergy observed in mice bearing L1210 leukemia and P-388 lymphoma is contrasted to the minimal immune depression associated with B-16 melanotic melanoma and Sarcoma 180J. The ability of N,N-bis(2-chloroethyl)-N-nitrosourea chemotherapy to reduce tumor burden without prolonged suppression of delayed cutaneous hypersensitivity is compared to the profound suppression of the cutaneous response observed with Adriamycin cytoreductive therapy. The applications of our model are discussed in relation to tumor-associated anergy, new approaches to the evaluation of pharmaceuticals, and studies of combined chemoimmunotherapy regimens.