bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nitric Oxide Regulates Renin Release During Salt Depletion but Does Not Alter Angiotensin Responses in Normal Humans
Authors: Davidson Neil C. , Struthers Allan D. 
Published: November 2007

Background: Animal studies suggest that nitric oxide regulates the renin-angiotensin- aldosterone system, but this effect varies among species. The effects of nitric oxide on the renin-angiotensin-aldosterone system in humans were assessed using L-nitrosomonomethyl arginine (L-NMMA), an antagonist of nitric oxide synthase. Methods and Results: In experiment 1, subjects were pretreated with furosemide to induce salt depletion and received placebo-controlled infusions of L-NMMA followed by measure ments of plasma renin activity. In experiment 2, subjects were given angiotensin I and II intravenously with and without L-NMMA to assess the effects of nitric oxide on systemic pressor and aldosterone responses. In experiment 3, brachial arterial infusions of angio tensin I and II were given with and without L-NMMA, and forearm blood flow was mea sured to assess the effects of nitric oxide on vascular responses to the angiotensin peptides. During salt depletion, L-NMMA infusion resulted in significantly higher plasma renin activ ity. L-NMMA had no effect on systemic or forearm pressor responses or aldosterone responses to angiotensin I and II infusions. Conclusions: These results indicate that nitric oxide regulates the renin response to salt depletion in healthy humans but does not affect responses to angiotensin.
Effects of Palmitoyl Carnitine on Perfused Heart and Papillary Muscle
Authors: Patel Manoj K. , Economides Apollo P. , Byrne Nicholas G. 
Published: November 2007

Background: Palmitoyl carnitine accumulation during ischemia causes profound electro physiological changes, resulting in arrhythmias. We studied the electrophysiological and contractile effects of palmitoyl carnitine.Methods and Results: Extracellular recordings made by using the endocardial unipolar paced evoked response (PER) in isolated perfused rabbit hearts were compared with action potentials (AP) recorded from septal artery perfused rabbit papillary muscle. Left ventricu lar pressure was monitored in isolated hearts. In perfused hearts palmitoyl carnitine (30 μmol/L, 30 minutes) significantly ( P < .001) increased the latency of activation (St-R inter val) by 58% ± 8% and reduced repolarization time (R-E interval) by 39% ± 4%. PER duration (St-E interval), was reduced by 30% ± 3%. Palmitoyl carnitine (30 μmol/L) signif icantly ( P < .001) decreased resting membrane potential (19 ± 2 mV) of AP, reduced peak amplitude (33.5 ± 8 mV) and rate of rise of phase 0 (41 ± 8 V/s). Significant reductions ( P < .001) in the action potential duration 50% (129.4 ± 28 ms) and 90% (139.8 ± 32 ms) were also observed. An initial positive inotropic effect, which declined as irreversible con tracture developed, was also observed. Verapamil (1 μmol/L), nifedipine (1 μmol/L), and caffeine (10 mmol/L) failed to abolish the positive inotropy.Conclusions: We suggest that palmitoyl carnitine disrupts intracellular calcium homeostasis leading to disturbances in electrical and contractile activity. Its accumulation during myo cardial ischemia could contribute to calcium overloading and initiate lethal arrhythmias.
Hypoxic Hypoperfusion Fails to Induce Myocardial Hibernation in Anesthetized Swine
Authors: Schwarz Ernst R. , Reffelmann Thorsten , Schoendube Friedrich , Herrmanns Benita , Chakupurakal Raj , Doerge Hilmar , Schuetz Thorsten , Foresti Mike , Messmer Bruno J. , Radke Peter W. , vom Dahl Juergen , Hanrath Peter 
Published: November 2007

Background: Congenital origin of the left coronary artery from the pulmonary artery (ALCAPA) results in chronically dysfunctional myocardium with the partial ability to recover after revascularization. We attempted to establish an ALCAPA syndrome in anes thetized pigs for 24 hours and to compare it with stunned and infarcted myocardium. Methods and Results: In group 1 (n = 12), a bypass graft was interposed between the pul monary artery and the left anterior descending coronary artery (LAD). Reduction of flow in the LAD with gradual increases in flow from the pulmonary artery resulted in an incre mental reduction of segment shortening (8.9 ± 5.3% at 24 hours vs 26.6 ± 10% at baseline, P < .005). In group 2 (n = 5), 2 cycles of 10-minute LAD occlusion resulted in decreased segment shortening with slow recovery (at 24 hours 18.7 ± 1.3% vs 24.2 ± 4% at bascline, P < .05). In group 3 (n = 6), 1-hour LAD occlusion reduced segment shortening at 24 hours to 4.7 ± 5.2% ( P < .005 vs baseline). Histological analysis of the LAD territory revealed severe degeneration, myolysis, and alteration of the chromatin structure in group 1 compa rable to ischemic cell death in group 3, whereas control areas and the LAD area in group 2 showed only minor structural alterations. Infarct size/risk area, as measured by tetrazolium staining, was 49.8 ± 11.2% in group 1,9.3 ± 8.1 % in group 2 ( P < .005), and 60.3 ± 9% in group 3. Conclusion: Hypoxic myocardial hypoperfusion from the pulmonary artery results in myo cardial necrosis in anesthetized pigs. These findings are in contrast to the concept of myocar dial hibernation in the ALCAPA syndrome because in this model, hypoxic hypoperfusion failed to induce adaptation to preserve myocardial structure.
Review : Viagra and Cardiovascular Disease
Authors: Speakman Mark T. , Kloner Robert A. 
Published: November 2007

Background: The introduction of the drug sildenafil (Viagra; Pfizer, New York, NY) into the armamentarium for treatment of erectile dysfunction is a major advance. Many of the patients who will benefit from its use have cardiovascular disease. Erectile dysfunction and cardiovascular disease share common risk factors. Although the metabolic demands of sex ual activity are modest and the associated risk for coronary events is low, the clinician car ing for cardiac patients needs to be aware of the pharmacology and hemodynamic profile of sildenafil in those with heart disease who use cardioactive drugs. Methods and Results: We reviewed the current literature relating to the pharmacology, hemodynamic profile, efficacy, safety, and clinical application of sildenafil in patients with cardiovascular disease. Sildenafil is highly effective in the treatment of erectile dysfunction. The overall incidence of cardiovascular adverse events is low and similar to placebo. Cur rent postmarketing data do not suggest an increase in cardiovascular death in sildenafil users. The drug is contraindicated in those taking organic nitrates. It should be used with caution and on an individual basis in patients who have active coronary ischemia and heart failure with tenous blood pressure and volume status. Conclusion: When used with discretion, sildenafil is safe, effective, and has the potential to greatly enhance quality of life in the relatively large proportion of the population with heart disease.
An evaluation of six infusion devices for the continuous infusion of cytotoxic drugs in ambulatory patients
Authors: Hardy E.M. , Williamson C. , Sewell G.J. 
Published: November 2007

Introduction. The clinical, economic, and user attributes of six ambulatory infusion devices were evaluated for their inclusion into the Home Oncol ogy Program, Exeter (HOPE). Methods. Devices evaluated included; Graseby MS-26 syringe driver, Graseby 9100, Pharmacia CADD-1, Parker-Strato 2100 micropump (now un available), Baxter Multiday Infusor, and Infu-med 300. Criteria evaluated included accuracy, preci sion, in-use observations, capital cost, consumable cost, estimated monthly cost, degree of patient intervention, and patient comfort. A quality of life evaluation was undertaken in a more detailed assessment on the Graseby MS-26 and Infu-Med 300 device used routinely in the HOPE pro gramme. Results. On the basis of these studies, the Parker-Strato 2100 pump was the preferred device although this has subsequently been withdrawn from the market. However, the newly developed Graseby 9000 series device was found to possess many of the qualities of the Parker-Strato pump and has been selected for further trials in this institu tion.
An extemporaneous itraconazole suspension for pediatric use
Authors: Seay Russell E. , Sommers Nancy L. 
Published: November 2007

Objective. To report the use of an extemporane ously prepared acidic suspension of itraconazole for pediatric oncology patients. Case Summary. Itraconazole was adminis tered to a 4-year-old AML patient with Alternaria sp sinusitis. An acidic itraconazole suspension was prepared using 0.1 N hydrochloric acid and cherry syrup. Bioassay for serum itraconazole suggested the product achieved adequate peak serum con centrations. Discussion. Fasting and reduced gastric acid ity will decrease the absorption of itraconazole. The use of an acidic suspension provides more accurate dosing for pediatric patients, allows pro vision of itraconazole in an acidic media, and allows dosing in patients unable or unwilling to swallow capsules. Conclusions. Itraconazole prepared in an acidic suspension appears to be absorbed. Further study is needed to establish stability of this prepa ration, as well as, the extent and consistency of its absorption.
Review : Amifostine and other chemoprotective agents in cancer chemotherapy: A brief review
Authors: Summerhayes Maxwell 
Published: November 2007

Objective. Cytotoxic chemotherapy is a frequently, and increasingly, used treatment for malignant disease and is associated with substantial toxicity. A number of drugs have been developed in recent years for the prevention and treatment of chemotherapy-induced toxicity. Most are specific to one group of drugs, eg, mesna and the oxazophosphorines, or one type of toxicity, eg, the 5-HT3 antagonist antiemetics. The first multiorgan cytoprotective, amifostine, recently was launched, and another, glutathione, is under development. The purpose of this review is to con sider the agents currently available for the manage ment of cytotoxic drug-induced toxicity and their place in treatment. Special attention is directed to amifostine and drugs in development, including glu tathione, Ossirene (Baker Norton), ORG-2766, and dexrazoxane and less to agents in routine clinical use. Data sources. A variety of sources were used, including manual and on-line (Medline) literature searching. Approved and other drug names were used as the primary search terms, linked with cytotoxic chemotherapy where limitation was required. Medi cal information departments of drug companies also were used where appropriate. Study selection. Particular attention was directed to randomized clinical trials, but nonrandomised and animal studies were considered where appropriate. Conclusions. Over the past decade significant advances have been made in the control of chemo therapy-induced toxicity and new agents promise even greater control. This is important, not only because they may improve the quality of life of conventionally treated cancer patients, but also be cause they should allow the dose-response relation ship for cytotoxic drug treatment to be fully explored. Unfortunately, the data available at present are insuf ficient to determine the extent to which this promise will be fulfilled.
Review : Purine nucleoside analogues: Fludarabine, pentostatin, and cladribine
Authors: Kolesar Jill M. , Morris Ashley K. , Kuhn John G. 
Published: November 2007

Purpose. An introductory template for an extensive discussion of the pharmacology, pharmacokinetics, clinical use and adverse effects of the currently ap proved adenosine analogues: fludarabine, pentostatin, and cladribine is profiled. This is part one of a three-part series. Data Sources. We reviewed the literature through a MEDLINE search from 1986 to 1996. Relevant articles cited in literature obtained by MEDLINE searching were also considered. We searched the following terms: fludarabine, cladribine, pentostatin, apoptosis and adenosine ana logues. The search was restricted to the English language. We have incorporated pricing information from our prac tice sites as well as the average wholesale price for the purpose of cost comparison. Data Extraction. We have reviewed the current literature with regard to the chemistry, mechanisms of action and pharmacology, pharmacokinetics, clinical use, adverse effects, drug interactions, indications, formulation, dosage, administration, pharmaceutical issues and a cost comparison of the currently approved adenosine ana logues, fludarabine, pentostatin, and cladribine. Data Synthesis. The adenosine analogues are struc turally similar agents used in the management of hemato logical malignancies. Fludarabine and cladribine exhibit significant activity in CLL (chronic lymphocytic leukemia) and NHL (non-Hodgkin's lymphoma) and pentostatin and cladribine are both active in the treatment of hairy cell leukemia. There are no comparative clinical trials between the agents and we have provided comparisons based on pharmacology, clinical experience, adverse effects and cost as well as reviewing the clinical use of these agents. Conclusion. The adenosine analogues, fludarabine, pentostatin, and cladribine, represent an important ad vance in the treatment of indolent lymphoid malignancies. Although response rates for fludarabine and cladribine in chronic lymphocytic leukemia and for pentostatin and cladribine in hairy cell leuemia are improved over standard therapy, the true clinical impact of these agents has not yet been realized. Additional studies in larger populations of both previously treated and untreated patients, as well as comparative trials between the deoxyadenosine analogues themselves need to be carried out. Moreover, combination chemotherapy trials with deoxyadenosine analogues and other cytotoxic agents need to be performed to determine the efficacy and toxicity of these combinations in various lymphoid malignancies.
Purine nucleoside analogues: fludarabine, pentostatin, and cladribine
Authors: Kolesar Jill M. , Morris Ashley K. , Kuhn John G. 
Published: November 2007

Purpose. The primary objective of this article is to continue the discussion of the pharmacology, phar macokinetics, clinical use, and adverse effects of the currently approved adenosine analogues, focusing on pentostatin. This is part two of a three part series. Data Sources. We reviewed the literature through a MEDLINE search from 1986 to 1996. Rele vant articles cited in the literature obtained by MED LINE searching also were considered. We searched the following terms: fludarabine, cladribine, pentosta tin, apoptosis, and adenosine analogues. The search was restricted to the English language. Data Extraction. We have reviewed the current literature in regard to the chemistry, mechanisms of action and pharmacology, pharmacokinetics, clinical use, adverse effects, drug interactions, indications, formulation, dosage, administration, and pharmaceu tical issues of the currently approved adenosoine analogues, focusing on pentostatin. Data Synthesis. The adenosine analogues are structurally similar agents used in the management of hematological malignancies. Pentostatin and cladrib ine are both active agents in the treatment of hairy cell leukemia. There are no comparative clinical trials between the agents, and we have provided compari sons based on pharmacology, clinical experience, adverse effects, and cost.
Standardizing the expression and nomenclature of cancer treatment regimens
Authors: Kohler David R. , Montello Michael J. , Green Laurence , Huntley Carl , High Joseph L. , Fallavollita Alfred , Goldspiel Barry R. 
Published: November 2007

Guidelines for describing cancer chemotherapy regi mens in all aspects of drug development, including treatment protocols, order forms, and product labels, are proposed. To complement the approaches to reducing medication errors that have been recommended by the American Society of Health-System Pharmacists and others, pharmacists at the National Institutes of Health and the National Cancer Institute, with the input of oncology pharmacists from diverse areas of practice, developed guidelines for expressing chemo therapy dosage schedules and treatment regimens. The guidelines present standards that are broadly applicable and can be adopted by other institutions. Clear and unambiguous expression of all medication orders and consistency of treatment descriptions are suggested. Written treatment plans and orders should contain enough information to allow health care providers from diverse disciplines to compare them with published treatment descriptions and investiga tional protocols and must therefore include planned dosages and schedules expressed in patient-specific units. In general, drug dosages should be expressed as the amount of drug administered from a single con tainer. When ordering drugs that are part of complex or combination-drug regimens, prescribers should write as many of the orders at one time as is possible so that continuity might be preserved. Standard rules are proposed for describing che motherapy regimens.
Urinary excretion of paclitaxel and metabolites in a large series study
Authors: Panday Vinodh R Nannan , Rosing Hilde , Huizing Manon T , Koopman Francesca J , van Warmerdam Laurence JC , ten Bokkel Huinink Wim W , Beijnen Jos H 
Published: November 2007

Objective. Paclitaxel is an antineoplastic agent with significant activity against several tumour types. The major portion of the drug disposition (80-90%) in volves metabolism and biliary excretion. The purpose of this study was to investigate the relationships between the mean urinary paclitaxel excretion frac tion and the administered dose, creatinine clearance, or the measured paclitaxel area under the plasma concentration versus time curve. Design. The design used was a retrospective convenience sample study. Setting. The setting for this study was a hospi talised care center. Patients. A total of 103 24-hour urine collections from 60 patients treated with paclitaxel were used to investigate these relationships. Results. In this large series study, the paclitaxel urinary fraction was 5 ± 3% (mean ± SD) as a fraction of the administered paclitaxel dose. No correlations were found between the paclitaxel urinary excretion fraction and the administered dose, creatinine clear ance, and plasma concentration-time curve. In addi tion, the paclitaxel metabolites 6α-hydroxypaclitaxel, 3'- p-hydroxypaclitaxel and some unidentified com pounds were detected in the 24-hour urine samples of two patients, of whom one had a mild impaired renal function. Conclusions. Considering the low urinary ex cretion of paclitaxel, it is anticipated that patients with renal dysfunction require no dose adjustments. Metabolites were found in the urine.
Anomalous Coronary Artery Origin and Bicuspid Aortic Valve
Authors: Schang Steven J. , Pepine Carl J. , Bemiller Carl R. 
Published: November 2007

A patient presenting with signs and symptoms suggesting myocardial ischemia was found to have anomalous origin of his right coronary artery from the left aortic sinus of valsalva associated with a bicuspid aortic valve. Abnormal left ventricular function with anaerobic myocardial metabolism was documented in the absence of significant coronary artery disease or aortic obstruction. The possible relationship of these findings to the coronary artery anomaly and bicuspid aortic valve is considered. The necessity of identifica tion of the origin of the coronary arteries is re-emphasized in the evaluation of patients with bicuspid aortic valves coming to cardiac catheterization. Anomalous origin of a coronary artery is a rare occurrence. The association of this anomaly with a bicuspid aortic valve has not been emphasized and the possible clinical consequences of this combination of malformations have not been described. We recently evaluated a patient with anomalous origin of right coronary artery from the left coronary ostium and a bicuspid aortic valve. A description of these findings follows.
The Role of Autotransplantation in the Treatment of Severe Arteriorenal Hypertension: Ten Case Reports
Authors: Hadjiyannakis E.J. 
Published: November 2007

This report summarizes our experience with 10 kidney autotransplanta tions performed from November 1972 to October 1978 in 9 patients with extended stenosis of renal arteries following fibromuscular hyperplasia. One of the cases involved a 5-year-old girl with a single kidney. Five of the 9 patients had presented with obviously decreased renal function. There were no deaths. In the first patient the graft was removed after 10 months and a successful allotransplantation was performed with a mother donor, 5 years ago. In 2 of the 9 patients single kidney aortorenal bypass had been unsuccessfully performed elsewhere. All the patients now have a normal blood pressure without having to take any antihypertensive agents, 3 to 70 months after the autotransplantation.
Giant Hemangioma with Coagulopathy
Authors: Pen J. , Mahler C. , Parizel G. , Hermans C. 
Published: November 2007

The association of giant hemangioma with an increased tendency to bleed was first recognized in 1940 by Kasabach and Merritt.1 Since then 132 additional cases have been published. Most of them show a combination of benign hemangioma, thrombocytopenia, and hemorrhagic diathesis. The purpose of this paper is to present a patient with a truly giant heman gioma, associated with a bleeding tendency. A review of the relevant literature is given.
The Influence of the Smooth Muscle of the Tibial Artery on Local Arterial Pressure-Flow Relation
Authors: Bardou A.L. , Levy B.I. , Tedgui A. , Bazire J.M. , Saumont R. 
Published: November 2007

Arterial smooth muscle response to direct electrical stimulation or stimulation of sciatic nerve, has been studied on the tibial artery of the dog. A segment of this artery was catheterized in two points separated by about 5 cm. Response of this segment to stimulation has been studied at constant arterial volume and at constant arterial flow-rate. At constant arterial volume, initial pressure was adjusted between 25 to 120 mm Hg. Direct electrical stimulation was always followed by an important arterial pressure increase (158 to 183 mm Hg). Stimulation of the sciatic nerve also provoked an important increase of pressure (150 to 177 mm Hg). At constant perfusion flow-rate, the pressure of the arterial segment was adjusted from 50 to 250 mm Hg (flow-rates included between 10 to 20 ml/min.). Direct stimulation was followed by a maximal vaso-constriction. Initial pressures of 50, 100, 150, 200 or 250 mm Hg all yielded very similar values (217 ± 17 mm Hg). Stimulation of the sciatic nerve produced an increase of pressure to 272 ± 17 mm Hg with a different response chronology. These results show that, on tibial artery (generally considered as musculoelastic), smooth vascular muscle may considerably modify the hemo-dynamic conditions.
The Versatility of Gore Tex® Grafts for Extra-Anatomic Bypass
Authors: Garcia-Rinaldi Raul , Revuelta Jose M. , Vaughan G. Dennis , Johnston Robert H. , Bonnington Lucy 
Published: November 2007

Fifty six patients underwent fifty nine complex extra-anatomic revascular ization procedures using Gore Tex®. Nine grafts (15%) occluded. We opted not to revise 2 grafts and other two grafts thrombectomized ultimately failed. Five grafts were declotted and have remained patent. The other patients have patent grafts or died of their primary illness with patent grafts (overall patency 93%). The surviving patients have been followed for an average period of 27.7 months (0.5-56 mo.). Based on this experience we conclude that Gore Tex®, is a suitable conduit for complex extra-anatomic bypass in patients whose condition contraindicates direct vascular reconstruction.