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Sample records for antihypertensive regimens population

  1. High blood pressure, antihypertensive medication and lung function in a general adult population

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    Meisinger Christa

    2011-04-01

    Full Text Available Abstract Background Several studies showed that blood pressure and lung function are associated. Additionally, a potential effect of antihypertensive medication, especially beta-blockers, on lung function has been discussed. However, side effects of beta-blockers have been investigated mainly in patients with already reduced lung function. Thus, aim of this analysis is to determine whether hypertension and antihypertensive medication have an adverse effect on lung function in a general adult population. Methods Within the population-based KORA F4 study 1319 adults aged 40-65 years performed lung function tests and blood pressure measurements. Additionally, information on anthropometric measurements, medical history and use of antihypertensive medication was available. Multivariable regression models were applied to study the association between blood pressure, antihypertensive medication and lung function. Results High blood pressure as well as antihypertensive medication were associated with lower forced expiratory volume in one second (p = 0.02 respectively p = 0.05; R2: 0.65 and forced vital capacity values (p = 0.01 respectively p = 0.05, R2: 0.73. Furthermore, a detailed analysis of antihypertensive medication pointed out that only the use of beta-blockers was associated with reduced lung function, whereas other antihypertensive medication had no effect on lung function. The adverse effect of beta-blockers was significant for forced vital capacity (p = 0.04; R2: 0.65, while the association with forced expiratory volume in one second showed a trend toward significance (p = 0.07; R2: 0.73. In the same model high blood pressure was associated with reduced forced vital capacity (p = 0.01 and forced expiratory volume in one second (p = 0.03 values, too. Conclusion Our analysis indicates that both high blood pressure and the use of beta-blockers, but not the use of other antihypertensive medication, are associated with reduced lung function in a

  2. Pregnancy outcomes of anti-hypertensives for women with chronic hypertension: a population-based study.

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    Chen-Yi Su

    Full Text Available BACKGROUND: The impact of anti-hypertensive treatment on fetus was unclear, and hence, remains controversial. We set out in this study to estimate the prevalence of adverse pregnancy outcomes, including low birth weight, preterm delivery and small for gestational age amongst women with chronic hypertension, and to determine whether the use of anti-hypertensive drugs increases the risk of such adverse pregnancy outcomes. METHODOLOGY/PRINCIPAL FINDINGS: A total of 2,727 hypertension mothers and 8,181 matched controls were identified from the population-based cohort. These hypertension women were divided into seven sub-groups according to different types of prescribed anti-hypertensive drugs. Multivariable logistic regressions were conducted to estimate the risk of low birth weight, preterm birth and small for gestational age. Increased risk of low birth weight (OR = 2.29, 95% CI = 1.95-2.68, preterm birth (OR = 2.18, 95% CI = 1.89-2.52 and small for gestational age (OR = 1.62, 95% CI = 1.45-1.81 were all discernible within the hypertension group after adjusting for potential confounding factors. The increased ORs were found to differ with different types of anti-hypertensive drugs. Women who received vasodilators were associated with the highest risk of low birth weight (OR = 2.96, 95% CI = 2.06-4.26, preterm birth (OR = 2.92 95% CI = 2.06-4.15 and small for gestational age (OR = 2.12, 95% CI = 1.60-2.82. CONCLUSIONS/SIGNIFICANCE: This finding is important for practitioners, because it indicates the need for caution while considering the administration of anti-hypertensive drugs to pregnant women. These observations require confirmation in further studies that can better adjust for the severity of the underlying HTN.

  3. Antihypertensive treatment

    DEFF Research Database (Denmark)

    Christensen, Cramer; Mogensen, C E

    1987-01-01

    total protein excretion below 0.5 g/24 h) were first given metoprolol (200 mg daily) with the subsequent addition of hydroflumethiazide. At the start of antihypertensive treatment, mean patient age was 32 +/- 4.2 years (SD) and mean duration of diabetes was 18 +/- 1.2 years. The patients were followed...

  4. Population of Humic Acid Degrading Microorganisms in Andosols under Different Vegetation Types and Grassland Management Regimens.

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    Yanagi, Yukiko; Yoda, Kaori; Ogura, Kazuhiko; Fujitake, Nobuhide

    2008-01-01

    To examine the effect of vegetation type and grassland management regimen on the distribution of humus-degrading microorganisms, populations of humic acid-degrading (HAD) bacteria and fungi at three Andosol sites were investigated using the dilution plate method. Each site had three different vegetation types (Eulalia grassland, bamboo grassland, and coniferous plantations). Among the six grassland sites, two were maintained by burning and the others by cutting. HAD microorganisms were found in all soil samples. Low densities and small percentages of HAD bacteria were detected with no significant differences in the number of bacteria found between different vegetation types and grasslands managed in different ways. In contrast, the densities and percentages of HAD fungi differed according to vegetation type and management regimen. Specifically, the percentages of HAD fungi were significantly higher for burned grasslands. At burned sites, the numbers and percentages of HAD bacteria remained at a consistently low level, and no distinct seasonal changes were observed. In contrast, marked seasonal fluctuations in HAD fungi were detected. The percentages of these fungi remained relatively high between April and December. These fluctuations are likely due to the effects of burning on soil microorganisms. PMID:21558687

  5. The Use of Antihypertensive Medication and the Risk of Breast Cancer in a Case-Control Study in a Spanish Population: The MCC-Spain Study

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    Gómez-Acebo, Inés; Dierssen-Sotos, Trinidad; Palazuelos, Camilo; Pérez-Gómez, Beatriz; Lope, Virginia; Tusquets, Ignasi; Alonso, M. Henar; Moreno, Victor; Amiano, Pilar; Molina de la Torre, Antonio José; Barricarte, Aurelio; Tardon, Adonina; Camacho, Antonio; Peiro-Perez, Rosana; Marcos-Gragera, Rafael; Muñoz, Montse; Michelena-Echeveste, Maria Jesus; Ortega Valin, Luis; Guevara, Marcela; Castaño-Vinyals, Gemma; Aragonés, Nuria; Kogevinas, Manolis; Pollán, Marina; Llorca, Javier

    2016-01-01

    Introduction The evidence on the relationship between breast cancer and different types of antihypertensive drugs taken for at least 5 years is limited and inconsistent. Furthermore, the debate has recently been fueled again with new data reporting an increased risk of breast cancer among women with a long history of use of antihypertensive drugs compared with nonusers. Methods In this case-control study, we report the antihypertensive drugs–breast cancer relationship in 1,736 breast cancer cases and 1,895 healthy controls; results are reported stratifying by the women’s characteristics (i.e., menopausal status or body mass index category) tumor characteristics and length of use of antihypertensive drugs. Results The relationship among breast cancer and use of calcium channel blockers (CCB) for 5 or more years had odds ratio (OR) = 1.77 (95% CI, 0.99 to 3.17). Stratifying by BMI, the OR increased significantly in the group with BMI ≥ 25 (OR 2.54, 95% CI, 1.24 to 5.22). CCBs were even more strongly associated with more aggressive tumors, (OR for invasive tumors = 1.96, 95% CI = 1.09 to 3.53; OR for non ductal cancers = 3.97, 95% CI = 1.73 to 9.05; OR for Erbb2+ cancer = 2.97, 95% CI: 1.20 to 7.32). On the other hand, premenopausal women were the only group in which angiotensin II receptor blockers may be associated with breast cancer (OR = 4.27, 95% CI = 1.32 to 13.84) but this could not be identified with any type or stage. Use of angiotensin-converting-enzyme inhibitors, beta blockers and diuretics were not associated with risk. Conclusions In this large population-based study we found that long term use of calcium channel blockers is associated with some subtypes of breast cancer (and with breast cancer in overweight women). PMID:27508297

  6. [Antihypertensive treatment in pregnancy].

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    Souza, Alex R; Amorim, Melania R; Costa, Aurélio A R; Neto, Carlos N

    2010-01-01

    Pregnancy hypertensive disorders represent a frequent gestational pathology. It is one of the most important causes of maternal demise and perinatal morbidity/mortality in the world. Antihypertensive treatment is part of a vast therapeutic arsenal used for prevention of severe complications. However, data from literature research have been controversial about benefits of antihypertensive treatment. We performed a literature review about antihypertensive treatment in severe pre-eclampsia, describing drugs' pharmacological particularities and scientific evidences about their efficacy and safety. It is not controversial that treatment of hypertensive emergency must be instituted. The ideal medication used in those cases is not defined, therefore the real benefits of maintenance antihypertensive treatment in pre-eclampsia remains unclear. PMID:20353709

  7. Prescribing pattern of antihypertensive drugs in diabetic patients of Southern Province, Kingdom of Saudi Arabia

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    Sirajudeen Shaik Alavudeen

    2015-01-01

    Full Text Available Background: Hypertension is extremely prevalent in patients with diabetes. Limited data exist on utilization patterns of antihypertensive in this population are consistent with evidence-based practice guidelines. Objective: To evaluate utilization patterns of antihypertensive agents among diabetic patients with hypertension. Design: Retrospective descriptive cross sectional. Patients / Participants: 149 patients with diabetes and hypertension from outpatient department at Family Medicine Hospital, Ahaderfieda. Khamis Mushait, K.S.A. Results: Over 43% of patients were receiving calcium channel blockers (CCB, 36.2 % of received angiotensin converting enzyme inhibitors (ACEI, followed by angiotensin receptor blockers (ARBs (34.9%, diuretics (34.2% and β -blockers (16.2%. Patients on monotherapy were mostly receiving CCB (34.3% and ACEI (29.9%. The majority (55.03% of treated patients were on multidrug regimens. In patients with coronary artery disease (CAD, a diuretic with ACEI (25% and calcium channel blocker with angiotensin receptor blocker (25% was most commonly prescribed. Conclusions: Patterns of antihypertensive therapy were generally consistent with international guidelines. Areas of improvement include increasing ACEI/ARB and diuretic use, decreasing the number of untreated patients, and increasing the proportion of patients with controlled BP in this population.

  8. Population pharmacokinetics and pharmacodynamics of hydroxyurea in sickle cell anemia patients, a basis for optimizing the dosing regimen

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    Galactéros Frédéric

    2011-05-01

    Full Text Available Abstract Background Hydroxyurea (HU is the first approved pharmacological treatment of sickle cell anemia (SCA. The objectives of this study were to develop population pharmacokinetic(PK-pharmacodynamic(PD models for HU in order to characterize the exposure-efficacy relationships and their variability, compare two dosing regimens by simulations and develop some recommendations for monitoring the treatment. Methods The models were built using population modelling software NONMEM VII based on data from two clinical studies of SCA adult patients receiving 500-2000 mg of HU once daily. Fetal hemoglobin percentage (HbF% and mean corpuscular volume (MCV were used as biomarkers for response. A sequential modelling approach was applied. Models were evaluated using simulation-based techniques. Comparisons of two dosing regimens were performed by simulating 10000 patients in each arm during 12 months. Results The PK profiles were described by a bicompartmental model. The median (and interindividual coefficient of variation (CV of clearance was 11.6 L/h (30%, the central volume was 45.3 L (35%. PK steady-state was reached in about 35 days. For a given dosing regimen, HU exposure varied approximately fivefold among patients. The dynamics of HbF% and MCV were described by turnover models with inhibition of elimination of response. In the studied range of drug exposures, the effect of HU on HbF% was at its maximum (median Imax was 0.57, CV was 27%; the effect on MCV was close to its maximum, with median value of 0.14 and CV of 49%. Simulations showed that 95% of the steady-state levels of HbF% and MCV need 26 months and 3 months to be reached, respectively. The CV of the steady-state value of HbF% was about 7 times larger than that of MCV. Simulations with two different dosing regimens showed that continuous dosing led to a stronger HbF% increase in some patients. Conclusions The high variability of response to HU was related in part to pharmacokinetics and

  9. Cutaneous reactions due to antihypertensive drugs

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    Upadhayai J

    2006-01-01

    Full Text Available Out of a total of 1147 patients on antihypertensive drugs, 23 (2.04% developed adverse cutaneous drug reactions (ACDR. The commonest antihypertensive drug group causing ACDR was beta-blockers of which atenolol was the commonest culprit. The second most common group was calcium channel blockers with amlodipine as the commonest offender. The most common patterns of ACDR observed included urticaria followed by lichenoid drug eruption (LDE. We noted 2 new patterns of reactions; (i one patient developed brownish blue pigmentation of nails while on atenolol for 3 years, which resolved in 4 months after withdrawal and (ii another patient on amlodipine for 8 years developed Schamberg′s like purpuric pigmentation, which resolved on withdrawal of drug within 3 months. These findings have not been reported in the literature earlier. This study is presented for paucity of Indian data on ACDR due to antihypertensive drugs, and remarkable advancement in area of cardiovascular and antihypertensive pharmacology and a large number of population taking antihypertensive drugs.

  10. Antihypertensive and lipid lowering treatment in 70–74 year old individuals – predictors for treatment and blood-pressure control: a population based survey. The Hordaland Health Study (HUSK

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    Straand Jørund

    2006-10-01

    Full Text Available Abstract Background In an elderly, community based population we aimed at investigating antihypertensive and lipid lowering medication use in relation to own and familiar cardiovascular morbidity and diabetes mellitus, as well as to lifestyle factors and general health. We also examined levels of blood pressure in untreated and treated residents, to investigate factors correlating with blood pressure control. Methods A health survey carried out in 1997-9 in the county of Hordaland, Norway included a self-administered questionnaire mailed to 4 338 persons born in 1925-7. Drug use the day prior to filling in the questionnaire was reported. A health check-up was carried out, where their systolic and diastolic blood pressure (SBP and DBP, body mass index (BMI, and serum-cholesterol level were recorded. Results One third of respondents used one or more antihypertensive drugs, while 13% of men and women were treated with a statin. Diabetes mellitus, own or relatives'cardiovascular disease, having quit smoking, physical inactivity, and overweight correlated with antihypertensive treatment. Mean blood pressure was lower in respondents not on treatment. Among those on treatment, 38% of men and 29% of women had reached a target BP-level of lower than 140/90 mm Hg. Own cardiovascular disease and a low BMI correlated with good BP-control. Conclusion One third of 70–74 year old individuals living in the community used one or more antihypertensive drugs. Only around one third of those treated had reached a target BP-level of less than 140/90 mm Hg. Own cardiovascular disease and a low BMI correlated with good BP-control.

  11. Compliance to antihypertensive therapy

    International Nuclear Information System (INIS)

    Objective: To determine compliance, factors affecting compliance to antihypertensive therapy and to compare compliant and non-compliant groups, in a tertiary care setting. Study Design: Analytical (cross-sectional) study. Place and Duration of Study: The outpatient clinics at the Aga Khan University from May 2004 to February 2005. Patients and Methods: Two hundred patients presenting to the outpatients clinic were included. All patients 18 years and above, who had stage 1 and 2 hypertension, had one clinic visit to a medicine clinic, 6 months prior to presentation and started on antihypertensive medicines, were included. Results: Sixty-six percent were males and 33.5 % were females. Mean age was 58.1 ( +- 12) years and mean duration of hypertension was 7.2 (+- 6.7) years. Fifty-seven percent were compliant and 43% were noncompliant. In the noncompliant group, 53.4 % had mild noncompliance, 24.4 % had severe non-compliance, while 22% had moderate noncompliance. Factors of noncompliance were 56.8% missed doses due to forgetfulness, 12.7% deliberately missed their doses, 11.6% could not take the medicine due to side effects, 10.4% did not take the dose due to increased number of tablets, 4.6% were not properly counseled by the physician and 3.48% did not take medicines due to cost issues. The mean systolic blood pressure was 126 +- 19.2 mmHg in the compliant group while it was 133 +- 16.5 mmHg in the noncompliant group (p-value 0.004). The mean diastolic blood pressure in the compliant group was 76 +- 11.9 mmHg, while in the noncompliant group it was 81.9 +- 10.9 mmHg (p-value 0.001). Conclusion: Compliance to antihypertensive therapy in a tertiary care center is significantly good. Forgetfulness was the major reason for noncompliance. The mean blood pressure control was better in the compliant group. (author)

  12. Pharmacology of antihypertensive drugs.

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    Pepper, G A

    1999-01-01

    The wide variety of first-line agents available for managing high blood pressure include diuretics, beta adrenergic receptor blockers, alpha adrenergic receptor blockers, angiotensin converting enzyme inhibitors, and calcium channel blockers. Supplemental agents used for second-line therapy and special indications, such as pregnancy and hypertensive emergencies, include angiotensin receptor blockers, central-acting agents, direct vasodilators, and adrenergic neuron inhibitors. Selection of agents for particular patients requires consideration of research-based evidence for positive long-term outcomes and of the unique patient profile of age, race, co-morbidities, and lifestyle. A thorough understanding of the pharmacology (mechanism, pharmacokinetics, adverse effects and drug interactions, clinical use) of antihypertensive agents is an essential foundation for nursing practice in women's health. PMID:10584919

  13. Baseline natural killer and T cell populations correlation with virologic outcome after regimen simplification to atazanavir/ritonavir alone (ACTG 5201.

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    John E McKinnon

    Full Text Available Simplified maintenance therapy with ritonavir-boosted atazanavir (ATV/r provides an alternative treatment option for HIV-1 infection that spares nucleoside analogs (NRTI for future use and decreased toxicity. We hypothesized that the level of immune activation (IA and recovery of lymphocyte populations could influence virologic outcomes after regimen simplification.Thirty-four participants with virologic suppression ≥ 48 weeks on antiretroviral therapy (2 NRTI plus protease inhibitor were switched to ATV/r alone in the context of the ACTG 5201 clinical trial. Flow cytometric analyses were performed on PBMC isolated from 25 patients with available samples, of which 24 had lymphocyte recovery sufficient for this study. Assessments included enumeration of T-cells (CD4/CD8, natural killer (NK (CD3+CD56+CD16+ cells and cell-associated markers (HLA-DR, CD's 38/69/94/95/158/279.Eight of the 24 patients had at least one plasma HIV-1 RNA level (VL >50 copies/mL during the study. NK cell levels below the group median of 7.1% at study entry were associated with development of VL >50 copies/mL following simplification by regression and survival analyses (p = 0.043 and 0.023, with an odds ratio of 10.3 (95% CI: 1.92-55.3. Simplification was associated with transient increases in naïve and CD25+ CD4+ T-cells, and had no impact on IA levels.Lower NK cell levels prior to regimen simplification were predictive of virologic rebound after discontinuation of nucleoside analogs. Regimen simplification did not have a sustained impact on markers of IA or T lymphocyte populations in 48 weeks of clinical monitoring.ClinicalTrials.gov NCT00084019.

  14. Adherence to Antihypertensive Therapy and Elevated Blood Pressure: Should We Consider the Use of Multiple Medications?

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    Hedna, Khedidja; Hakkarainen, Katja M.; Gyllensten, Hanna; Jönsson, Anna K.; Andersson Sundell, Karolina; Petzold, Max; Hägg, Staffan

    2015-01-01

    Background Although a majority of patients with hypertension require a multidrug therapy, this is rarely considered when measuring adherence from refill data. Moreover, investigating the association between refill non-adherence to antihypertensive therapy (AHT) and elevated blood pressure (BP) has been advocated. Objective Identify factors associated with non-adherence to AHT, considering the multidrug therapy, and investigate the association between non-adherence to AHT and elevated BP. Methods A retrospective cohort study including patients with hypertension, identified from a random sample of 5025 Swedish adults. Two measures of adherence were estimated by the proportion of days covered method (PDC≥80%): (1) Adherence to any antihypertensive medication and, (2) adherence to the full AHT regimen. Multiple logistic regressions were performed to investigate the association between sociodemographic factors (age, sex, education, income), clinical factors (user profile, number of antihypertensive medications, healthcare use, cardiovascular comorbidities) and non-adherence. Moreover, the association between non-adherence (long-term and a month prior to BP measurement) and elevated BP was investigated. Results Non-adherence to any antihypertensive medication was higher among persons < 65 years (Odds Ratio, OR 2.75 [95% CI, 1.18–6.43]) and with the lowest income (OR 2.05 [95% CI, 1.01–4.16]). Non-adherence to the full AHT regimen was higher among new users (OR 2.04 [95% CI, 1.32–3.15]), persons using specialized healthcare (OR 1.63, [95% CI, 1.14–2.32]), and having multiple antihypertensive medications (OR 1.85 [95% CI, 1.25–2.75] and OR 5.22 [95% CI, 3.48–7.83], for 2 and ≥3 antihypertensive medications, respectively). Non-adherence to any antihypertensive medication a month prior to healthcare visit was associated with elevated BP. Conclusion Sociodemographic factors were associated with non-adherence to any antihypertensive medication while clinical

  15. Regulatory Cell Populations in Relapsing-Remitting Multiple Sclerosis (RRMS) Patients: Effect of Disease Activity and Treatment Regimens.

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    Rodi, Maria; Dimisianos, Nikolaos; de Lastic, Anne-Lise; Sakellaraki, Panagiota; Deraos, George; Matsoukas, John; Papathanasopoulos, Panagiotis; Mouzaki, Athanasia

    2016-01-01

    Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS) of autoimmune etiology that results from an imbalance between CNS-specific T effector cells and peripheral suppressive mechanisms mediated by regulatory cells (RC). In this research, we collected blood samples from 83 relapsing remitting MS (RRMS) patients and 45 healthy persons (HC), to assess the sizes of their RC populations, including CD4⁺CD25(high)Foxp3⁺ (nTregs), CD3⁺CD4⁺HLA(-)G⁺, CD3⁺CD8⁺CD28(-), CD3⁺CD56⁺, and CD56(bright) cells, and how RC are affected by disease activity (acute phase or remission) and types of treatment (methylprednisolone, interferon, or natalizumab). In addition, we isolated peripheral blood mononuclear cells (PBMC) and cultured them with peptides mapping to myelin antigens, to determine RC responsiveness to autoantigens. The results showed decreased levels of nTregs in patients in the acute phase ± methylprednisolone and in remission + natalizumab, but HC levels in patients in remission or receiving interferon. Patients + interferon had the highest levels of CD3⁺CD4⁺HLA(-)G⁺ and CD3⁺CD8⁺CD28(-) RC, and patients in the acute phase + methylprednisolone the lowest. Patients in remission had the highest levels of CD3⁺CD56⁺, and patients in remission + natalizumab the highest levels of CD56(bright) cells. Only nTregs responded to autoantigens in culture, regardless of disease activity or treatment. The highest suppressive activity was exhibited by nTregs from patients in remission. In conclusion, in RRMS disease activity and type of treatment affect different RC populations. nTregs respond to myelin antigens, indicating that it is possible to restore immunological tolerance through nTreg induction. PMID:27571060

  16. Differences in the rumen methanogen populations of lactating Jersey and Holstein dairy cows under the same diet regimen.

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    King, Erin E; Smith, Rachel P; St-Pierre, Benoit; Wright, André-Denis G

    2011-08-15

    In the dairy cattle industry, Holstein and Jersey are the breeds most commonly used for production. They differ in performance by various traits, such as body size, milk production, and milk composition. With increased concerns about the impact of agriculture on climate change, potential differences in other traits, such as methane emission, also need to be characterized further. Since methane is produced in the rumen by methanogenic archaea, we investigated whether the population structure of methanogen communities would differ between Holsteins and Jerseys. Breed-specific rumen methanogen 16S rRNA gene clone libraries were constructed from pooled PCR products obtained from lactating Holstein and Jersey cows, generating 180 and 185 clones, respectively. The combined 365 sequences were assigned to 55 species-level operational taxonomic units (OTUs). Twenty OTUs, representing 85% of the combined library sequences, were common to both breeds, while 23 OTUs (36 sequences) were found only in the Holstein library and 12 OTUs (18 sequences) were found only in the Jersey library, highlighting increased diversity in the Holstein library. Other differences included the observation that sequences with species-like sequence identity to Methanobrevibacter millerae were represented more highly in the Jersey breed, while Methanosphaera-related sequences and novel uncultured methanogen clones were more frequent in the Holstein library. In contrast, OTU sequences with species-level sequence identity to Methanobrevibacter ruminantium were represented similarly in both libraries. Since the sampled animals were from a single herd consisting of two breeds which were fed the same diet and maintained under the same environmental conditions, the differences we observed may be due to differences in host breed genetics. PMID:21705541

  17. The antihypertensive effect of cysteine

    OpenAIRE

    Vasdev, Sudesh; Singal, Pawan; Gill, Vicki

    2009-01-01

    Hypertension is a leading cause of morbidity and mortality worldwide. Individuals with hypertension are at an increased risk for stroke, heart disease and kidney failure. Essential hypertension results from a combination of genetic and lifestyle factors. One such lifestyle factor is diet, and its role in the control of blood pressure has come under much scrutiny. Just as increased salt and sugar are known to elevate blood pressure, other dietary factors may have antihypertensive effects. Stud...

  18. TOLERABILITY OF VARIOUS ANTIHYPERTENSIVE COMBINATIONS

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    S. V. Malchikova

    2016-01-01

    Full Text Available Aim. To compare tolerability of various antihypertensive combinations in patients with arterial hypertension (HT.Material and methods. 140 patients with HT with history of non-effective antihypertensive therapy were randomized in 4 groups, 35 patients in each. Patients of group A received indapamide retard/perindopril; group B - indapamide retard/amlodipine; group C – amlodipine/lisinopril; group D – amlodipine/bisoprolol. Therapy duration was 12 weeks.Results. 28 (20% patients dropped out of the study. All antihypertensive combinations significantly decreased blood pressure level. Patients of group A did not stop therapy because of adverse events. 6 (17,1% dropped out of the study because of ineffective therapy in maximal doses and therapy rejection. Palpitation was a reason of drug withdrawal in 3 (8,6% of 8 (22,9% dropped patients of group B. Low limb edema was a reason of drug withdrawal in 4 (11,4% of 8 (22,9% dropped patients of group D. Cough was a reason of drug withdrawal in 4 (11,4% of 5 dropped patients of group C. Dose reduction was needed in some patients of all groups because of hypotension.Conclusion. The adverse events were observed in 25% of patients during 12 weeks of therapy. The patients received indapamide retard/amlodipine and amlodipine/bisoprolol had the highest rate of drug withdrawal because of adverse events. Low limb edema, cough and palpitation were the most frequent adverse events needed therapy withdrawal.

  19. TOLERABILITY OF VARIOUS ANTIHYPERTENSIVE COMBINATIONS

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    S. V. Malchikova

    2009-01-01

    Full Text Available Aim. To compare tolerability of various antihypertensive combinations in patients with arterial hypertension (HT.Material and methods. 140 patients with HT with history of non-effective antihypertensive therapy were randomized in 4 groups, 35 patients in each. Patients of group A received indapamide retard/perindopril; group B - indapamide retard/amlodipine; group C – amlodipine/lisinopril; group D – amlodipine/bisoprolol. Therapy duration was 12 weeks.Results. 28 (20% patients dropped out of the study. All antihypertensive combinations significantly decreased blood pressure level. Patients of group A did not stop therapy because of adverse events. 6 (17,1% dropped out of the study because of ineffective therapy in maximal doses and therapy rejection. Palpitation was a reason of drug withdrawal in 3 (8,6% of 8 (22,9% dropped patients of group B. Low limb edema was a reason of drug withdrawal in 4 (11,4% of 8 (22,9% dropped patients of group D. Cough was a reason of drug withdrawal in 4 (11,4% of 5 dropped patients of group C. Dose reduction was needed in some patients of all groups because of hypotension.Conclusion. The adverse events were observed in 25% of patients during 12 weeks of therapy. The patients received indapamide retard/amlodipine and amlodipine/bisoprolol had the highest rate of drug withdrawal because of adverse events. Low limb edema, cough and palpitation were the most frequent adverse events needed therapy withdrawal.

  20. Neonatal Abstinence Syndrome: Influence of a Combined Inpatient/Outpatient Methadone Treatment Regimen on the Average Length of Stay of a Medicaid NICU Population

    Science.gov (United States)

    Hulman, Sonia; Musci, Michael; Stang, Ellen

    2015-01-01

    Abstract Prescription opioid and heroin abuse have been increasing steadily year after year, and continue to be a serious national problem. A sequela of the increase in opioid abuse has been an increase in the number of infants born with opioid dependence. These infants often require costly, prolonged stays in the neonatal intensive care unit (NICU) for drug withdrawal treatment. The authors studied a population of infants from a large Medicaid health plan who were born with neonatal abstinence syndrome (NAS) secondary to in utero opioid exposure to assess the average length of stay in the NICU, and to determine the variables that may account for differences in interinstitutional lengths of stay. The overall average length of stay for NAS was 21.1 days for the 139 infants included in the study. Analysis of the medication used for treatment revealed that infants who were treated with a combined inpatient/outpatient regimen with methadone had an average length of stay of 11.4 days versus 25.1 days for infants who were treated entirely as inpatients (PPopulation Health Management 2015;18:392–397) PMID:25803316

  1. Antihypertensive treatment and risk of atrial fibrillation

    DEFF Research Database (Denmark)

    Marott, Sarah C W; Nielsen, Sune F; Benn, Marianne;

    2014-01-01

    AIMS: To examine the associations between antihypertensive treatment with angiotensin-converting enzyme inhibitors (ACEis) or angiotensin receptor blockers (ARBs), β-blockers, diuretics, or calcium-antagonists, and risk of atrial fibrillation. We examined these associations using the entire Danish...... population from 1995 through 2010. METHODS AND RESULTS: Excluding medication used in atrial fibrillation, we matched individuals on ACEi monotherapy 1:1 with individuals on β-blocker (n = 48 658), diuretic (n = 69 630), calcium-antagonist (n = 57 646), and ARB monotherapy (n = 20 158). Likewise, individuals...... on ARB monotherapy were matched 1:1 with individuals on β-blocker (n = 20 566), diuretic (n = 20 832), calcium-antagonist (n = 20 232), and ACEi monotherapy (n = 20 158). All were free of atrial fibrillation and of predisposing diseases like heart failure, ischaemic heart disease, diabetes mellitus...

  2. Pediatric Antihypertensive Trial Failures: Analysis of Endpoints and Dose Range

    OpenAIRE

    Daniel K. Benjamin; Smith, P. Brian; Jadhav, Pravin; Gobburu, Jogarao V.; Murphy, M. Dianne; Hasselblad, Vic; Baker-Smith, Carissa; Califf, Robert M.; Li, Jennifer S.

    2008-01-01

    Historically, drugs prescribed for children have not been studied in pediatric populations. Since 1997, however, a 6-month extension of marketing rights is granted if manufacturers conduct Food and Drug Administration (FDA)-defined pediatric trials. In nearly half the drugs studied, there were unexpected results in dosing, safety, or efficacy compared to adult studies, including failure of half of antihypertensive dose-response trials, which are pivotal for deriving dosing recommendations. We...

  3. Risk Alteration for Atrial Fibrillation with DifferentAntihypertensive Drugs

    Directory of Open Access Journals (Sweden)

    Vivencio Barrios, MD, PhD

    2011-12-01

    Full Text Available A large percentage of patients with hypertension suffer from atrial fibrillation (AF. The concomitance of both conditions in the same patient markedly increases cardiovascular risk. Therefore, prevention of new-onset AF in hypertensive population should be a relevant target. High blood pressure promotes structural and electrophysiological changes in the heart that promote the develop- ment of AF. Thus, the most important therapeutic approach to prevent incident AF in hypertensive population is to reduce blood pressure values to recommended goals. However, in specific conditions, some antihypertensive agents may provide additional benefits beyond blood pressure reduction, such as in hypertension with left ven- tricular hypertrophy with renin angiotensin system blockade. On the other hand, in patients with hypertension and permanent AF, beta blockers and nondihydropiridine calcium antagonists (verapamil and diltiazem play an important role. Antihypertensive agents may provide beneficial effects on incident AF, regardless of the presence of hyperten- sion. Thus, renin angiotensin system inhibitors may reduce new-onset AF in patients with heart failure or after the cardioversion of persistent AF. On the other hand, the preoperative administration of beta blockers may re- duce the incidence of postoperative AF in some patients. In this manuscript, the available evidence about the effects of different antihypertensive agents on new-onset AF in different populations is reviewed.

  4. Antihypertensive drugs and glucose metabolism

    Institute of Scientific and Technical Information of China (English)

    Christos; V; Rizos; Moses; S; Elisaf

    2014-01-01

    Hypertension plays a major role in the development and progression of micro-and macrovascular disease.Moreover,increased blood pressure often coexists with additional cardiovascular risk factors such as insulin resistance.As a result the need for a comprehensive management of hypertensive patients is critical.However,the various antihypertensive drug categories have different effects on glucose metabolism.Indeed,angiotensin receptor blockers as well as angiotensin converting enzyme inhibitors have been associated with beneficial effects on glucose homeostasis.Calcium channel blockers(CCBs)have an overall neutral effect on glucose metabolism.However,some members of the CCBs class such as azelnidipine and manidipine have been shown to have advantageous effects on glucose homeostasis.On the other hand,diuretics andβ-blockers have an overall disadvantageous effect on glucose metabolism.Of note,carvedilol as well as nebivolol seem to differentiate themselves from the rest of theβ-blockers class,being more attractive options regarding their effect on glucose homeostasis.The adverse effects of some blood pressure lowering drugs on glucose metabolism may,to an extent,compromise their cardiovascular protective role.As a result the effects on glucose homeostasis of the various blood pressure lowering drugs should be taken into account when selecting an antihypertensive treatment,especially in patients which are at high risk for developing diabetes.

  5. 厄贝沙坦与美托洛尔的联合方案对男性高血压患者性功能的影响%Effect of different combined antihypertensive regimen on the erectile function in malehypertensive patients

    Institute of Scientific and Technical Information of China (English)

    杨陇权; 白锋; 余静; 马瑞新; 刘培君; 郭雪娅; 李秀丽; 常鹏; 胡浩; 赵锋

    2011-01-01

    Objective To compare the effects of felodipine combined irbesartan regimen with that of felodipine combined metoprolol regimen on the sexual function in male hypertensive patients. Method One handred and twenty-three male hypertensive paitients (age 25 to 60) were randomly assigned to felodipine (5 mg/d) plus irbesartan ( 150 mg/d, n=64) group and felodipine (5 mg/d) plus metoprolol (47.5 mg/d, n=59) group. Dosage of felodipine were doubled after 4 weeks if the blood pressure were ≥140/ 90 mm Hg (1 mm Hg=0.133 kPa). At the baseline and post 24th week treatment, sexual function of patients was assessed by the International Index of Erectile Function (IIEF) Questionaire. Serum testosterone (T), sex hormone binding globulin (SHBG), 4-hydroxynonenal (HNE), 8-hydroxy-2′-deoxyguanosine (8-OHdG) and Malonaldehyde (MDA) were measured by Radioimmunoassay (RIA), ELISA and TBA respectively. Results Total prevalence of erectile dysfunction (ED),T, SHBG and HNE were similar between pre- and post-treatment in two groups (P>0.05). On the other hand, the scores of the mild ED and sexual desire (SD) were improved and both serum 8-OHdG and MDA in patients with ED decreased [(146.02±60.54)ng/L vs. (139.89±62.03)ng/L, P=0.048 and (6.59±1.75)μmol/L vs. (5.51±1.65)μmol/L,P=0.039] in Felodipine plus Irbesartan group. Conclusion The results suggested that Felodipine + Irbesartan regimen may be superior to Felodipine + metoprolol regimen for male hypertensive patients with mild ED.%目的 探讨非洛地平联合厄贝沙坦或美托洛尔两种降压方案对男性高血压病患者性功能的影响.方法 123例高血压病患者随机分为两组:非洛地平(5 mg/d)+厄贝沙坦(150 mg/d)组(F+I组,64例);非洛地平(5 mg/d)+琥珀酸美托洛尔(47.5 mg/d)组(F+M组,59例).监测患者血压变化;治疗第0、24周用国际男性性功能问卷(IIEF)评价患者的性功能,同时用放射性免疫法测血清睾酮和性激素结合蛋白、硫代巴

  6. Gonzalez Regimen (PDQ)

    Science.gov (United States)

    ... humans. These preclinical studies are done before any testing in humans is begun. Animal studies of the Gonzalez regimen looked at the ... regimen as a whole. There has been preclinical testing on the effects of pancreatic enzymes ... In 1999, an animal study tested the effect of different doses of ...

  7. Lactotripeptides and antihypertensive effects: A critical review

    NARCIS (Netherlands)

    Boelsma, E.; Kloek, J.

    2009-01-01

    Hypertension or high blood pressure is a significant health problem worldwide. Typically, lifestyle changes, including adopting a healthy diet, are recommended for people with an elevated blood pressure. Lactotripeptides are bioactive milk peptides with potential antihypertensive properties in man.

  8. A study on prescribing patterns of antihypertensives in geriatric patients

    Directory of Open Access Journals (Sweden)

    Arshad H Mohd

    2012-01-01

    Full Text Available Objective: Hypertension is a leading contributor to the global burden of cardiovascular morbidity and mortality. The main objective of the present study was to assess the prescribing patterns for antihypertensives in geriatric patients. Materials and Methods: A Prospective observational study was carried out for the period of six months in an out-patient department. Elderly patients who have been diagnosed with hypertension as per JNC-7 guidelines and patients receiving or prescribed with antihypertensive drugs were included. Results: A total of 100 prescriptions were analyzed during the six-month study period. 72% of the patients were in the age group of 65-67 years and this was found to be higher in men 69%. During the study period 80% of the patients were Pre-Hypertensive systolic (80-89 mmHg and Diastolic (120-139 mmHg followed by Stage-I Hypertension and Stage-II Hypertension. The most common drug classes involved in the study was Calcium Channel Blockers 37% followed by Angiotensin II receptor antagonists 21% and the most commonly prescribed drugs in the study population were Amlodipine 37%, Losartan 11% and Telmisartan 10%. The most common anti-hypertensive fixed dose combination therapy involved in the study was Telmisartan + Hydrochlorothiazide 15% and most common two drug combination therapy involved in the study was Amlodipine + Atenolol 7% followed by Metoprolol + Amlodipine 1%. Conclusion: Our study shows that the most commonly prescribed drug classes involved were Calcium Channel Blockers followed by Angiotensin II receptor antagonists and the anti-hypertensive drug combinations among hypertensive patients were considerable and this practice positively impacted on the overall blood pressure control.

  9. Antihypertensive Peptides from Milk Proteins

    Directory of Open Access Journals (Sweden)

    Heikki Vapaatalo

    2010-01-01

    Full Text Available Dietary proteins possess a wide range of nutritional and functional properties. They are used as a source of energy and amino acids, which are needed for growth and development. Many dietary proteins, especially milk proteins, contain physiologically active peptides encrypted in the protein sequence. These peptides may be released during gastrointestinal digestion or food processing and once liberated, cause different physiological functions. Milk-derived bioactive peptides are shown to have antihypertensive, antimicrobial, immunomodulatory, antioxidative and mineral-binding properties. During the fermentation of milk with certain lactobacilli, two interesting tripeptides Ile-Pro-Pro and Val-Pro-Pro are released from casein to the final product. These lactotripeptides have attenuated the development of hypertension in several animal models and lowered blood pressure in clinical studies. They inhibit ACE in vitro at micromolar concentrations, protect endothelial function in vitro and reduce arterial stiffness in humans. Thus, milk as a traditional food product can after certain processing serve as a functional food and carry specific health-promoting effects, providing an option to control blood pressure.

  10. Classifying insulin regimens

    DEFF Research Database (Denmark)

    Neu, A; Lange, K; Barrett, T;

    2015-01-01

    Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1...... diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin...... variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the...

  11. Antihypertensive Therapies and Cognitive Function: a Review.

    Science.gov (United States)

    Kherada, Nisharahmed; Heimowitz, Todd; Rosendorff, Clive

    2015-10-01

    Increasing life expectancy has made old age-related health problems like dementia and cognitive decline more prevalent, and these are rapidly becoming important causes of disability and poor quality of life, causing significant add-ons to health-care costs worldwide. Hypertension is the most important modifiable vascular risk factor for the development and progression of both cognitive decline and dementia. In many observational and randomized studies, antihypertensive therapies have been shown to be beneficial in slowing cognitive decline. However, due to observed discrepancies by these studies, there is a lack of consensus on the best antihypertensive strategy for the prevention or slowing of cognitive decline. It is also not clear whether the beneficial effect of antihypertensive therapy is due to the use of a specific class of agents or combination therapy. Thus, we present a comprehensive review of overall antihypertensive therapies and cognition and of the individual antihypertensive therapy classes with their specific protective mechanisms and available clinical evidence behind their effect on cognitive function. PMID:26298567

  12. An economic evaluation of antihypertensive therapies based on clinical trials

    Directory of Open Access Journals (Sweden)

    Rosana Lima Garcia Tsuji

    2012-01-01

    Full Text Available OBJECTIVE: Hypertension is a major issue in public health, and the financial costs associated with hypertension continue to increase. Cost-effectiveness studies focusing on antihypertensive drug combinations, however, have been scarce. The cost-effectiveness ratios of the traditional treatment (hydrochlorothiazide and atenolol and the current treatment (losartan and amlodipine were evaluated in patients with grade 1 or 2 hypertension (HT1-2. For patients with grade 3 hypertension (HT3, a third drug was added to the treatment combinations: enalapril was added to the traditional treatment, and hydrochlorothiazide was added to the current treatment. METHODS: Hypertension treatment costs were estimated on the basis of the purchase prices of the antihypertensive medications, and effectiveness was measured as the reduction in systolic blood pressure and diastolic blood pressure (in mm Hg at the end of a 12-month study period. RESULTS: When the purchase price of the brand-name medication was used to calculate the cost, the traditional treatment presented a lower cost-effectiveness ratio [US$/mm Hg] than the current treatment in the HT1-2 group. In the HT3 group, however, there was no difference in cost-effectiveness ratio between the traditional treatment and the current treatment. The cost-effectiveness ratio differences between the treatment regimens maintained the same pattern when the purchase price of the lower-cost medication was used. CONCLUSIONS: We conclude that the traditional treatment is more cost-effective (US$/mm Hg than the current treatment in the HT1-2 group. There was no difference in cost-effectiveness between the traditional treatment and the current treatment for the HT3 group.

  13. Tolerability of Antihypertensive Medications in Older Adults.

    Science.gov (United States)

    Dharmarajan, Thiruvinvamalai S; Dharmarajan, Lekshmi

    2015-10-01

    Several guidelines for hypertension have recently undergone revisions to incorporate an approach providing choices of medications based on age, race, and specific situations where hypertension may co-exist with disorders such as diabetes, coronary artery disease, heart failure and chronic kidney disease. Initial recommendations include diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers; beta blockers are favored in some guidelines and are a choice in specific settings. Within the classes of drugs, several antihypertensive agents provide options. This review discusses antihypertensive drugs by class, including adverse effects and tolerability, with preferences in older adults and specific settings. Adverse drug events from antihypertensive medications are discussed by class and where applicable for specific agents. Data from select studies pertinent to tolerability and adverse effects are presented in tables for several classes of drugs. The rationale for nonadherence to medication is reviewed, including the roles played by tolerability and adverse drug effects. Antihypertensive therapy in typical settings in older adults is discussed; they include hypertension in association with impaired cognition, depression, diabetes, sexual dysfunction, and falls. The key to successful therapy and tolerability is to promote a healthy lifestyle in conjunction with medications as the approach, thereby also lowering the adverse drug effects. The eventual choice of the specific drug(s) is based on risks, benefits, and patient preferences, and is best tailored for each older adult. PMID:26442857

  14. Antihypertensive drugs and the sympathetic nervous system.

    Science.gov (United States)

    Del Colle, Sara; Morello, Fulvio; Rabbia, Franco; Milan, Alberto; Naso, Diego; Puglisi, Elisabetta; Mulatero, Paolo; Veglio, Franco

    2007-11-01

    Hypertension has been associated with several modifications in the function and regulation of the sympathetic nervous system (SNS). Although it is unclear whether this dysfunction is primary or secondary to the development of hypertension, these alterations are considered to play an important role in the evolution, maintenance, and development of hypertension and its target organ damage. Several pharmacological antihypertensive classes are currently available. The main drugs that have been clearly shown to affect SNS function are beta-blockers, alpha-blockers, and centrally acting drugs. On the contrary, the effects of ACE inhibitors (ACE-Is), AT1 receptor blockers (ARBs), calcium channel blockers (CCBs), and diuretics on SNS function remain controversial. These properties are pharmacologically and pathophysiologically relevant and should be considered in the choice of antihypertensive treatments and combination therapies in order to achieve, beyond optimal blood pressure control, a normalization of SNS physiology and the most effective prevention of target organ damage. PMID:18030057

  15. [The antihypertensive effect of fermented milks].

    Science.gov (United States)

    Domínguez González, Karina N; Cruz Guerrero, Alma E; Márquez, Humberto González; Gómez Ruiz, Lorena C; García-Garibay, Mariano; Rodríguez Serrano, Gabriela M

    2014-01-01

    There is a great variety of fermented milks containing lactic acid bacteria that present health-promoting properties. Milk proteins are hydrolyzed by the proteolytic system of these microorganisms producing peptides which may also perform other functions in vivo. These peptides are encrypted within the primary structure of proteins and can be released through food processing, either by milk fermentation or enzymatic hydrolysis during gastrointestinal transit. They perform different activities, since they act in the cardiovascular, digestive, endocrine, immune and nervous systems. Bioactive peptides that have an antihypertensive, antithrombotic, antioxidant and hypocholesterolemic effect on the cardiovascular system can reduce the risk factors for chronic disease manifestation and help improve human health. Most studied bioactive peptides are those which exert an antihypertensive effect by inhibiting the angiotensin-converting enzyme (ACE). Recently, the study of these peptides has focused on the implementation of tests to prove that they have an effect on health. This paper focuses on the production of ACEinhibitory antihypertensive peptides from fermented milks, its history, production and in vivo tests on rats and humans, on which its hypotensive effect has been shown. PMID:24721277

  16. Utility of a transdermal delivery system for antihypertensive therapy. Part 1.

    Science.gov (United States)

    Sclar, D A; Skaer, T L; Chin, A; Okamoto, M P; Gill, M A

    1991-07-18

    A retrospective evaluation of patient-level Medicaid claims data from two states was undertaken to discern the fiscal utility of transdermally delivered clonidine versus both the oral formulation of clonidine and oral formulations of eight other antihypertensive agents. In the first phase of our two-part study, we compared paid claims data (n = 1,135) from Florida for transdermal and oral clonidine. Multivariate regression analysis was used to evaluate the incremental impact of six variables on health-care expenditures in the first year after patients were given a diagnosis of hypertension. These variables were: age, gender, prior utilization of medical services, regimen complexity, and dosage formulation. Patients prescribed transdermal clonidine experienced a significant (p less than or equal to 0.001) increase in prescription expenditures and significant reductions in the use of physician (p less than or equal to 0.05), laboratory (p less than or equal to 0.10), and hospital (p less than or equal to 0.05) services. Moreover, savings were maximized (p less than or equal to 0.001) where multi-drug regimens incorporated the transdermal delivery system. In the second phase of our study we compared paid claims data (n = 8,894) from South Carolina for transdermal clonidine and for nine oral antihypertensive agents: atenolol, captopril, clonidine, diltiazem, enalapril, metoprolol, prazosin, terazosin, and verapamil-SR. Once again, regression analysis was used, this time to evaluate the incremental impact of five variables on health-care expenditures in the first year post diagnosis: age, gender, prior utilization of medical services, regimen complexity, and Medication Possession Ratio (MPR), an index of compliance. The data from part 2 of our study revealed that patients assigned a b.i.d. oral antihypertensive agent experienced a significant reduction (p less than or equal to 0.05) in MPR and a significant (p less than 0.05) increase in health-care expenditures when

  17. A Population Pharmacokinetic/Pharmacodynamic Model Predicts Favorable HDL Cholesterol Changes Over the First 5 Years in Children Treated With Current Efavirenz-Based Regimens.

    Science.gov (United States)

    Homkham, Nontiya; Cressey, Tim R; Ingsrisawang, Lily; Bouazza, Naïm; Ngampiyaskul, Chaiwat; Hongsiriwon, Suchat; Srirojana, Sakulrat; Kanjanavanit, Suparat; Bhakeecheep, Sorakij; Coeur, Sophie Le; Salvadori, Nicolas; Treluyer, Jean Marc; Jourdain, Gonzague; Urien, Saik

    2016-09-01

    Efavirenz use is associated with changes in cholesterol concentrations, but it is unclear whether this effect is related to drug concentrations. Using efavirenz and cholesterol plasma concentrations measured in 87 antiretroviral-naive children in Thailand, we assessed indirect response models to describe the evolution of high- and low-density lipoprotein (HDL, LDL) cholesterol concentrations in relation to efavirenz plasma concentrations over time where efavirenz was assumed to either stimulate cholesterol production or inhibit its elimination. Simulations of cholesterol evolution for children with different average efavirenz concentrations (Cav ) according to their assumed status of "fast" or "slow" metabolizers of efavirenz were performed. At treatment initiation, children's median (interquartile range, IQR) age was 8 years (5 to 10), body mass index z-score 0.01 (-1.05 to 1.44), HDL 31 mg/dL (24 to 44), and LDL 83 mg/dL (69 to 100). Median (IQR) efavirenz Cav was 1.7 mg/L (1.3 to 2.1) during the period of observation. The best model describing the evolution of HDL and LDL cholesterol concentrations over time assumed that efavirenz inhibited their elimination. HDL concentrations increase over 5 years, whereas LDL concentrations increased only during the first 4 months and then returned to baseline levels afterward. Simulations predicted that, after 3 years, HDL would increase to 63 mg/dL in "fast" metabolizers and 97 mg/dL in "slow" metabolizers of efavirenz. The population pharmacokinetic-pharmacodynamic (PK-PD) model shows that favorable HDL cholesterol changes can be expected in children with current efavirenz dosing guidelines over 5 years of treatment. PMID:26749102

  18. Effect of a regimen of optimal medical therapy on brain natriuretic peptide (BNP) levels in heart failure in the Pakistani population

    International Nuclear Information System (INIS)

    Objective: To document the effect of optimal medical therapy (OMT) on BNP levels in heart failure in Pakistani population. Methodology: In this Quasi experimental study, 75 consecutive stage C heart failure patients that had not been on OMT were included. These patients had been referred to AFIC-NIHD Heart Transplantation Department for assessment regarding heart transplantation. Initial assessments were carried out in hospital. Patients who were on OMT already were excluded. The prescription (carvedilol, lisinopril, spironolactone) was introduced as in patient as per pre defined protocol after clinical, imaging and lab evaluation. The patients were followed up in clinic and the dose escalation was done at regular intervals in out patients department. Clinical and lab variables were collected included BNP levels before starting treatment and 4 weeks after treatment. Results : Males were 75% and females were 25%. Mean age was 38.69 +- 12.98 years (range 18-70 years). Mean Ejection fraction was 23.9% (range 15 - 34%). At one month clinical status of all patients improved except one. The patients had improved from NYHA class-III to NYHA class-II of dyspnoea. The mean baseline BNP level was 1331 pg/ mL, and the BNP level 4 weeks after the OMT trial was 951.9 pg/mL. This reduction was statistically significant (p=0.016). Conclusion: OMT improves the BNP levels within a span of one month in patients with advanced systolic heart failure. This also correlated with the clinical improvement in the patients, and it was observed that BNP levels helped to monitor patients objectively and adjust OMT. (author)

  19. Antihypertensive Effect of an Aqueous Extract of Passiflora nepalensis Wall

    Directory of Open Access Journals (Sweden)

    S S Patel

    2011-06-01

    Full Text Available Summary: The present study was designed to investigate the antihypertensive effect of an aqueous extract of the whole plant of Passiflora nepalensis wall (APN in renal hypertensive rats. Hypertension in experimental animals was induced by renal ischemia and reperfusion (IR. The blood pressure, pulse pressure and heart rate fell dose-dependently in renal hypertensive and normotensive rats after intravenous administration of 80, 160 and 320 mg/kg APN, suggesting that APN possesses antihypertensive, hypotensive and negative chronotropic effects. Renal IR significantly increased the levels of thio-barbituric acid reactive substances and reduced the levels of superoxide dismutase, catalase, and glutathione peroxidase (p<0.001 versus control in kidney, which was altered after intravenous administration of 160 and 320 mg/kg of APN, suggesting that APN protect kidney from IR injury (p<0.001 versus renal IR. Histological evaluation showed that renal IR increased, whereas APN decreased the focal glomerular necrosis, degeneration of tubular epithelium, necrosis in tubular epithelium, interstitial inflammatory infiltration, and congestion of blood vessels.   Industrial relevance: Herbal medicines are getting more importance in the treatment of high blood pressure because the modern synthetic medicines have side effects. A large proportion of the Indian population for their physical and psychological health needs depend on traditional system of medicine. Medicinal plants have become the focus of intense study in term of conservation as to whether their traditional uses are supported by actual pharmacological effects or merely based on folklore. Herbal medicines are free from side effects and less costly when compared to synthetic drugs. The present study will help the industry to produce herbal drugs with fewer side effects, which are affordable and more effective in the treatment of hypertension.

  20. Prescription patterns of antihypertensives in a community health centre in Mexico City: a drug utilization study.

    Science.gov (United States)

    Alba-Leonel, Adela; Carvajal, Alfonso; Fierro, Immaculada; Castillo-Nájera, Fernando; Campos-Ramos, Oscar; Villa-Romero, Antonio; Molina-Guarneros, Juan

    2016-06-01

    Hypertension is highly prevalent; in Mexico, the 2012 National Health and Nutrition Survey reported a prevalence of hypertension of 31.5% in the adult population. Pharmacological treatment is the commonest intervention and has been shown to reduce cardiovascular mortality and morbidity, and total mortality. Accordingly, the type and number of antihypertensives used and the outcome - in terms of blood pressure (BP) control - are important. Therefore, our purpose is to learn the pattern of antihypertensive drug prescription and explore the determinants of BP control in an urban population in Mexico. A retrospective cross-sectional drug utilization study was conducted. Medical records from a community health centre were searched to identify those corresponding to patients diagnosed with hypertension; information upon antihypertensives used and control of the disease was carefully retrieved. A logistic regression model was built to know the main determinants of BP control. A sample of 345 clinical records of interest was identified. Most patients received antihypertensives (86.4%); the leading medications used were angiotensin-converting enzyme inhibitors, 63.8%; beta-blockers (26.5%), diuretics (19.8%), angiotensin-receptor blockers (15.8%) and calcium-channel blockers (6.4%). Only the age (≥55 years) and BMI (>30) of the patients, and the age of the doctors (≥55 years), had an important influence on BP control. Obesity is a particular and important determinant of uncontrolled hypertension; it is worth to act on body weight, on an individual basis. As lack of control has been also tied to elderly doctors, an education programme could be envisaged. PMID:26787266

  1. Antihypertensive therapy in patients on chronic lithium treatment for bipolar disorders.

    Science.gov (United States)

    Bisogni, Valeria; Rossitto, Giacomo; Reghin, Francesco; Padrini, Roberto; Rossi, Gian Paolo

    2016-01-01

    Bipolar disorders are chronic conditions treated with lithium, which exerts deleterious effects on the kidney, among which nephrogenic diabetes insipidus, tubular acidosis and ultimately chronic kidney disease. Conversely, drugs that alter renal function can modify its serum levels and lead to the potentially fatal lithium intoxication. A search in the main library databases from 1975 to 2015 to identify interactions between antihypertensive drugs and lithium using the Population Intervention Comparison Outcome strategy provided only 30 reports of lithium intoxication. A regression analysis showed that the severity of lithium intoxication was significantly predicted by female, age, and use of certain classes of antihypertensive agents. A model including certain albeit not all diuretics and/or inhibitors of the renin-angiotensin system, but not age, serum lithium or creatinine levels at baseline and/or on admission to the hospital, predicted lithium toxicity. The true incidence of lithium intoxication is unknown but probably low, albeit underestimated. Nonetheless, in patients treated with lithium, monitoring of the serum lithium levels and clinical conditions is mandatory after the introduction of antihypertensive drugs, as diuretics and renin-aldosterone system inhibitors. PMID:26630207

  2. Context-Awareness Based Personalized Recommendation of Anti-Hypertension Drugs.

    Science.gov (United States)

    Chen, Dexin; Jin, Dawei; Goh, Tiong-Thye; Li, Na; Wei, Leiru

    2016-09-01

    The World Health Organization estimates that almost one-third of the world's adult population are suffering from hypertension which has gradually become a "silent killer". Due to the varieties of anti-hypertensive drugs, patients are interested in how these drugs can be selected to match their respective conditions. This study provides a personalized recommendation service system of anti-hypertensive drugs based on context-awareness and designs a context ontology framework of the service. In addition, this paper introduces a Semantic Web Rule Language (SWRL)-based rule to provide high-level context reasoning and information recommendation and to overcome the limitation of ontology reasoning. To make the information recommendation of the drugs more personalized, this study also devises three categories of information recommendation rules that match different priority levels and uses a ranking algorithm to optimize the recommendation. The experiment conducted shows that combining the anti-hypertensive drugs personalized recommendation service context ontology (HyRCO) with the optimized rule reasoning can achieve a higher-quality personalized drug recommendation service. Accordingly this exploratory study of the personalized recommendation service for hypertensive drugs and its method can be easily adopted for other diseases. PMID:27473866

  3. Preparation and antihypertensive activity of peptides from Porphyra yezoensis

    Science.gov (United States)

    This research was to develop an antihypertensive peptide, an efficient angiotensin converting enzyme (ACE) inhibitor (ACEI), from Porphyra yezoensis. Seven commercial enzymes were screened and then enzymatic hydrolysis conditions were optimised. The results showed that alcalase was the most effectiv...

  4. Does fermented milk possess antihypertensive effect in humans?

    DEFF Research Database (Denmark)

    Usinger, Lotte; Ibsen, Hans; Jensen, Lars T

    2009-01-01

    , fermented milk products contain several proteins, peptides and minerals, all with possible different antihypertensive modes of actions. The burden of cardiovascular events in industrialized countries caused by hypertension is considerable. Diet modifications are one way to lower blood pressure, and......The putative antihypertensive effect of milk after fermentation by lactic bacteria has attracted attention over the past 20 years. Research on fermented milk and hypertension has mainly focused on the content of peptides with in-vitro angiotensin converting enzyme-inhibitor effect. However...... fermented milk could be a feasible way. In this review, interventional human studies of the possible antihypertensive effect of fermented milk are evaluated. The results are diverging, and the antihypertensive effect is still debatable. Additionally, present knowledge of bioavailability and in-vivo actions...

  5. Valsartan. Just a second-line antihypertensive drug.

    OpenAIRE

    1999-01-01

    Valsartan (Diovan) is an antihypertensive drug belonging to the family of angiotensin II receptor antagonists. At a dose of 40 mg/d, its antihypertensive effect is inconsistent. At 80 mg/d its effect on blood pressure, its adverse effects, and its contraindications (mainly pregnancy and renal artery stenosis) are similar to those of angiotensin-converting enzyme (ACE) inhibitors, except that coughing is rarer with valsartan than with ACE inhibitors. Valsartan has no demonstrated advantage ove...

  6. Antihypertensive Medication Selection in Essential Hypertension: Retrospective Studies Using COSTAR

    OpenAIRE

    Payne, Thomas H; Goodson, John D; Morgan, Mary M.; Barnett, G. Octo

    1989-01-01

    The choice of antihypertensive therapy for patients with uncomplicated essential hypertension has implications for quality of life, risk of long-term side effects, compliance, and expense. We have used the COSTAR database of the Massachusetts General Hospital Primary Care Program to study prescribing patterns of residents treating patients with uncomplicated essential hypertension and the associated medication costs. We found variation in the categories of antihypertensive agents selected. Th...

  7. Antihypertensive effects of angiotensin-(1-7

    Directory of Open Access Journals (Sweden)

    M.C. Chappell

    1998-09-01

    Full Text Available Accumulating evidence suggests that angiotensin-(1-7 (Ang-(1-7 is an important component of the renin-angiotensin system and that the actions of the peptide may either contribute to or oppose those of Ang II. Ang-(1-7 can be converted directly from Ang I bypassing prerequisite formation of Ang II. Formation of Ang-(1-7 is under the control of at least three endopeptidases depending on the tissue compartment and include neprilysin, thimet oligopeptidase and prolyl oligopeptidase. Both neprilysin and thimet oligopeptidase are also involved in the metabolism of bradykinin and the atrial natriuretic peptide. Moreover, recent studies suggest that in addition to Ang I and bradykinin, Ang-(1-7 is an endogenous substrate for angiotensin converting enzyme. These enzymatic pathways may contribute to a complex relationship between the hypertensive actions of Ang II and various vasodepressor peptides from either the renin-angiotensin system or other peptide systems. Ang-(1-7 is devoid of the vasoconstrictor, central pressor, or thirst-stimulating actions associated with Ang II. In fact, new findings reveal depressor, vasodilator, and antihypertensive actions that may be more apparent in hypertensive animals or humans. Thus, Ang-(1-7 may oppose the actions of Ang II directly or as a result of increasing prostaglandins or nitric oxide. In this review, we examine the mechanisms by which Ang-(1-7 may contribute to cardiovascular regulation.

  8. Can adherence to antihypertensive therapy be used to promote adherence to statin therapy?

    Directory of Open Access Journals (Sweden)

    Richard H Chapman

    2009-08-01

    Full Text Available Richard H Chapman1, Elise M Pelletier1, Paula J Smith1, Craig S Roberts21US Health Economics and Outcomes Research, IMS Health, Falls Church, VA, USA; 2Global Outcomes Research, Pfizer Inc, New York, NY, USAObjective: To compare adherence with statin therapy in patients switching to single-pill amlodipine besylate/atorvastatin calcium with patients adding a separate statin to their amlodipine regimen.Methods: We identified hypertensive patients prescribed amlodipine who switched to amlodipine/atorvastatin (switch or added a statin to their amlodipine regimen (add-on from July 2004 to June 2007. Propensity score matching (1 switch:3 add-on was applied based on ‘nearest neighbor’ approach. The primary adherence measure was patients with proportion of days covered (PDC ≥0.80 at 180 days; secondary measures included mean PDC and persistence. A sensitivity analysis was performed, accounting for total statin/amlodipine exposure.Results: Among 4556 matched patients (n = 1139 switch; n = 3417 add-on, mean age was 53.9 years and 52.1% were male. After 180 days, adherence with statin therapy was higher for the switch vs add-on cohort (50.8% vs 44.3%; P < 0.001. After adjusting for pre-index amlodipine adherence, the switch cohort was more likely to be adherent than the add-on cohort (odds ratio: 1.64 [95% confidence interval: 1.42 to 1.89]. Persistence was higher in the switch than the add-on cohort (127.6 vs 117 days; P < 0.001.Conclusion: Hypertensive patients taking amlodipine who initiated statin therapy via single-pill amlodipine/atorvastatin were more likely to remain adherent to their statin than patients adding a separate statin to their antihypertensive regimen.Keywords: adherence, amlodipine, atorvastatin, cardiovascular disease, persistence, single-pill

  9. Medication Regimen Complexity and Polypharmacy as Factors Associated With All-Cause Mortality in Older People

    OpenAIRE

    Wimmer, Barbara C.; Bell, J Simon; Fastbom, Johan; Wiese, Michael D; Johnell, Kristina

    2016-01-01

    Objectives: To investigate whether medication regimen complexity and/or polypharmacy are associated with all-cause mortality in older people. Methods: This was a population-based cohort study among community-dwelling and institutionalized people ≥60 years old (n = 3348). Medication regimen complexity was assessed using the 65-item Medication Regimen Complexity Index (MRCI) in 10-unit steps. Polypharmacy was assessed as a continuous variable (number of medications). Mortality data were obtaine...

  10. Influence of albuminuria and glomerular filtration rate on blood pressure response to antihypertensive drug therapy

    Directory of Open Access Journals (Sweden)

    John M Flack

    2008-01-01

    Full Text Available John M Flack1, Karl Duncan2, Suzanne E Ohmit3, Ruth Quah1, Xuefeng Liu1, Preeti Ramappa1, Sandra Norris1, Lowell Hedquist1, Amanda Dudley1, Samar A Nasser11Division of Translational Research and Clinical Epidemiology, Department of Internal Medicine, Wayne State University, Detroit, MI, USA; 2Department of Interventional Cardiology, Harper University Hospital, Detroit Medical Center, Detroit, MI, USA; 3School of Public Health, University of Michigan, Ann Arbor, MI, USABackground: Albuminuria and glomerular filtration rate (GFR, two factors linked to kidney and vascular function, may influence longitudinal blood pressure (BP responses to complex antihypertensive drug regimens.Methods: We reviewed the clinic records of 459 patients with hypertension in an urban, academic practice.Results: Mean patient age was 57-years, 89% of patients were African American, and 69% were women. Mean patient systolic/diastolic BP (SBP/DBP at baseline was 171/98 mmHg while taking an average of 3.3 antihypertensive medications. At baseline, 27% of patients had estimated (eGFR <60 ml/min/1.732, 28% had micro-albuminuria (30–300 mg/g and 16% had macro-albuminuria (300 mg/g. The average longitudinal BP decline over the observation period (mean 7.2 visits was 25/12 mmHg. In adjusted regression models, macro-albuminuria predicted a 10.3 mmHg lesser longitudinal SBP reduction (p < 0.001 and a 7.9 mmHg lesser longitudinal DBP reduction (p < 0.001; similarly eGFR <60 ml/min/1.732 predicted an 8.4 mmHg lesser longitudinal SBP reduction (p < 0.001 and a 4.5 lesser longitudinal DBP reduction (p < 0.001. Presence of either micro- or macro-albuminuria, or lower eGFR, also significantly delayed the time to attainment of goal BP.Conclusions: These data suggest that an attenuated decline in BP in drug-treated hypertensives, resulting in higher average BP levels over the long-term, may mediate a portion of the increased risk of cardiovascular-renal disease linked to elevated

  11. A controlled trial of antihypertensive therapy in systemic sclerosis (scleroderma).

    Science.gov (United States)

    Fries, J F; Wasner, C; Brown, J; Feigenbaum, P

    1984-06-01

    Antihypertensive treatment may be life saving in scleroderma renal crisis. Patients surviving such crises frequently have had dramatic improvement in the dermal manifestations of their scleroderma. To investigate the potential role of antihypertensive treatment in nonhypertensive patients we randomly assigned 28 patients with systemic sclerosis into drug (14) and placebo (14) groups, using blocked randomisation , and followed them up in a prospective, double-blind clinical trial for 24 months. Overall, both groups improved slightly, with both subjective and objective markers. There were no statistically significant differences and no clinically meaningful trends between the 2 groups, except that the blood pressure was reduced in the group on the active drug. PMID:6378105

  12. Prescription pattern of antihypertensive drugs in Family Practice Clinics at Jordan University Hospital

    OpenAIRE

    Al-Drabah, Essam; Irshaid, Yacoub; Yasein, Nada; Zmeili, Suheil

    2013-01-01

    The present study represents the current prescribing trend for antihypertensive drugs in family medicine clinics at Jordan University Hospital in Jordan. The study sample involved 416 male and female hypertensive Jordanian patients. Our results demonstrate that 2 hypertensive patients were not receiving any antihypertensive therapy at the time of evaluation, 192 patients were on a single antihypertensive therapy, 157 patients were on two antihypertensive drugs, 52 patients were on triple anti...

  13. Safety and immunogenicity of the Intradermal thai red cross (2-2-2-0-1-1) post exposure vaccination regimen in the Indian population using purified chick embryo cell rabies vaccine

    OpenAIRE

    Chhabra Mala; Ichhpujani R; Bhardwaj M; Tiwari K; Panda R; Lal S

    2005-01-01

    PURPOSE: To test the immunogenicity of the WHO recommended "2-2-2-0-1-1" post-exposure rabies vaccination regimen in Indian subjects to determine the feasibility of replacing crude sheep brain nerve tissue rabies vaccine with modern tissue culture rabies vaccine at major anti-rabies treatment centers throughout India. METHODS: Purified chick embryo cell vaccine (PCECV) was administered in the dosage of 0.1mL per site to 53 Indian subjects. RESULTS: All subjects produced rabies antibodies abov...

  14. Losartan versus atenolol-based antihypertensive treatment reduces cardiovascular events especially well in elderly patients

    DEFF Research Database (Denmark)

    Ruwald, Anne Christine H; Westergaard, Bo; Sehestedt, Thomas Berend;

    2012-01-01

    The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study has previously demonstrated a beneficial effect of losartan compared to atenolol-based antihypertensive treatment in patients with essential hypertension and left-ventricular hypertrophy (LVH). However, patient age often...... influences the choice of antihypertensive drugs. Therefore, we investigated the influence of age on the effects of losartan versus atenolol-based antihypertensive treatment....

  15. Safety and immunogenicity of the Intradermal thai red cross (2-2-2-0-1-1 post exposure vaccination regimen in the Indian population using purified chick embryo cell rabies vaccine

    Directory of Open Access Journals (Sweden)

    Chhabra Mala

    2005-01-01

    Full Text Available PURPOSE: To test the immunogenicity of the WHO recommended "2-2-2-0-1-1" post-exposure rabies vaccination regimen in Indian subjects to determine the feasibility of replacing crude sheep brain nerve tissue rabies vaccine with modern tissue culture rabies vaccine at major anti-rabies treatment centers throughout India. METHODS: Purified chick embryo cell vaccine (PCECV was administered in the dosage of 0.1mL per site to 53 Indian subjects. RESULTS: All subjects produced rabies antibodies above 0.5IU/mL by day 14 post-vaccination. Only minor adverse reactions including swelling (6.6%, erythema (5.4% and pain (1.4% were observed for which no treatment was required. CONCLUSIONS: This study demonstrated that PCECV is safe and highly immunogenic in Indian subjects when administered intradermally as 0.1mL/site using the "2-2-2-0-1-1" post-exposure regimen.

  16. A cohort study of possible risk factors for over-reporting of antihypertensive adherence

    Directory of Open Access Journals (Sweden)

    Lee Mei-Ling Ting

    2001-12-01

    Full Text Available Abstract Background The identification of poor medicinal adherence is difficult because direct observation of medication use is usually impractical. Up to 50% of individuals on chronic therapies may not be taking their medication as prescribed. This study is one of the first to explore possible risk factors for over-reporting of antihypertensive adherence using electronic medication monitoring. Methods The adherence of 286 individuals on single-drug antihypertensive therapy in a large managed care organization was electronically monitored for approximately three months. Questionnaires on socioeconomic background, adherence to therapy, health beliefs, and social support before and after adherence monitoring were completed. Over-reporting of antihypertensive adherence was assessed by comparing the self-reported frequency of noncompliance with that determined from electronic dosing records. Risk factors for over-reporting were identified by contingency table analysis and step-wise logistic regression. Results Although only 21% of participants acknowledged missing doses on one or more days per week, electronic monitoring documented nonadherence at this or a higher level in 42% of participants. The following variables were associated with over-reporting: >1 versus 1 daily dose (OR = 2.58; 95% CI = 1.50–4.41; p = .0006, lower perceived health risk from nonadherence (OR = 1.35; 95% CI = 1.10–1.64; p = .0035, and annual household income of $30,000 (OR = 2.64; 95% CI = 1.13–6.18; p = .025. Conclusions Over-reporting of adherence may be affected by factors related to dosing frequency, health beliefs and socioeconomic status. This topic deserves further investigation in other patient populations to elucidate possible underlying behavioral explanations.

  17. Individual and work-unit measures of psychological demands and decision latitude and the use of antihypertensive medication

    DEFF Research Database (Denmark)

    Daugaard, S; Andersen, JH; Grynderup, M B;

    2014-01-01

    PURPOSE: To analyse whether psychological demands and decision latitude measured on individual and work-unit level were related to prescription of antihypertensive medication. METHODS: A total of 3,421 women and 897 men within 388 small work units completed a questionnaire concerning psychological...... working conditions according to the job strain model. Mean levels of psychological demands and decision latitude were computed for each work unit to obtain exposure measures that were less influenced by reporting bias. Dispensed antihypertensive medication prescriptions were identified in The Danish...... National Prescription Registry. Odds ratios (OR) comparing the highest and lowest third of the population at individual and work-unit level, respectively, were estimated by multilevel logistic regression adjusted for confounders. Psychological demands and decision latitude were tested for interaction...

  18. Should Antihypertensive Treatment Recommendations Differ in Patients With and Without Coronary Heart Disease? (from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial [ALLHAT]).

    Science.gov (United States)

    Alderman, Michael H; Davis, Barry R; Piller, Linda B; Ford, Charles E; Baraniuk, M Sarah; Pressel, Sara L; Assadi, Mahshid A; Einhorn, Paula T; Haywood, L Julian; Ilamathi, Ekambaram; Oparil, Suzanne; Retta, Tamrat M

    2016-01-01

    recommendation to include a properly dosed diuretic (such as chlorthalidone 12.5 to 25 mg/day) in the initial antihypertensive regimen for most hypertensive patients. PMID:26589819

  19. Diabetic nephropathy and arterial hypertension. The effect of antihypertensive treatment

    DEFF Research Database (Denmark)

    Parving, H H; Andersen, A R; Smidt, U M;

    1983-01-01

    arterial blood pressure to a hypertensive level is an early feature; 43% of the patients had diastolic blood pressure greater than 100 mm Hg. Early and aggressive antihypertensive treatment reduces both albuminuria and the rate of decline in GFR in young patients with diabetic nephropathy....

  20. Invited review: Fermented milk as antihypertensive functional food.

    Science.gov (United States)

    Beltrán-Barrientos, L M; Hernández-Mendoza, A; Torres-Llanez, M J; González-Córdova, A F; Vallejo-Córdoba, B

    2016-06-01

    Over the past decade, interest has risen in fermented dairy foods that promote health and could prevent diseases such as hypertension. This biological effect has mainly been attributed to bioactive peptides encrypted within dairy proteins that can be released during fermentation with specific lactic acid bacteria or during gastrointestinal digestion. The most studied bioactive peptides derived from dairy proteins are antihypertensive peptides; however, a need exists to review the different studies dealing with the evaluation of antihypertensive fermented milk before a health claim may be associated with the product. Thus, the objective of this overview was to present available information related to the evaluation of fermented milk containing antihypertensive peptides by in vitro and in vivo studies, which are required before a fermented functional dairy product may be introduced to the market. Although commercial fermented milks with antihypertensive effects exist, these are scarce and most are based on Lactobacillus helveticus. Thus, a great opportunity is available for the development of functional dairy products with new lactic acid bacteria that support heart health through blood pressure- and heart rate-lowering effects. Hence, the consumer may be willing to pay a premium for foods with important functional benefits. PMID:26923047

  1. ASSESSMENT OF AMLODIPINE ANTIHYPERTENSIVE EFFECT HOMOGENEITY IN CONTROLLED TRIAL

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    V. M. Gorbunov

    2016-01-01

    Full Text Available Aim. To compare influence of amlodipine and spirapril on ambulatory blood pressure profile, including antihypertensive effect smoothness in patients with arterial hypertension (HT.Methods. 39 patients (aged 53,7±10,0 y.o. with HT were included in the open, randomized, cross-over study, 30 patients completed study. The duration of every therapies was 4 weeks, initial control period and wash-out period between therapies lasted 1 week. The initial daily dose of amlodipine was 5 mg, standard dose of spirapril (6 mg/daily was not changed during the trial. After 1-2 weeks of treatment amlodipine dose was increased up to 10 mg/daily as well as dihydrochlorothiazide was added, if necessary. Ambulatory blood pressure monitoring (ABPM was performed initially and at the end of both therapies.Results. Both drugs demonstrated good antihypertensive effect according to ABPM data. Decrease of systolic/diastolic blood pressure was 11,2±1,8/7,6±1,2 mm Hg in amlodipine therapy and 10,0±1,8/7,1±1,2 in spirapril therapy (p<0,0001. The smoothness indexes (SI were 0,65/0,45 and 0,55/0,45, respectively, differences between two therapies were not significant. However the individual analysis of the SI distribution (with SI=0,5 as a satisfactory criterion, showed that antihypertensive effect smoothness is better in amlodipine therapy than this in spirapril one.Conclusion. Amlodipine has prominent as well as smooth antihypertensive effect, that gives it advantages in the long-term antihypertensive therapy.

  2. Evaluation of a community pharmacy-based intervention for improving patient adherence to antihypertensives: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    McDowell Jenny

    2010-02-01

    Full Text Available Abstract Background The majority of patients using antihypertensive medications fail to achieve their recommended target blood pressure. Poor daily adherence with medication regimens and a lack of persistence with medication use are two of the major reasons for failure to reach target blood pressure. There is no single intervention to improve adherence with antihypertensives that is consistently effective. Community pharmacists are in an ideal position to promote adherence to chronic medications. This study aims to test a specific intervention package that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications - Hypertension Adherence Program in Pharmacy (HAPPY. Methods/Design The HAPPY trial is a multi-centre prospective randomised controlled trial. Fifty-six pharmacies have been recruited from three Australian states. To identify potential patients, a software application (MedeMine CVD extracted data from a community pharmacy dispensing software system (FRED Dispense®. The pharmacies have been randomised to either 'Pharmacist Care Group' (PCG or 'Usual Care Group' (UCG. To check for 'Hawthorne effect' in the UCG, a third group of patients 'Hidden Control Group' (HCG will be identified in the UCG pharmacies, which will be made known to the pharmacists at the end of six months. Each study group requires 182 patients. Data will be collected at baseline, three and six months in the PCG and at baseline and six months in the UCG. Changes in patient adherence and persistence at the end of six months will be measured using the self-reported Morisky score, the Tool for Adherence Behaviour Screening and medication refill data. Discussion To our knowledge, this is the first research testing a comprehensive package of evidence-based interventions that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient

  3. Association of Hypoglycemic Treatment Regimens With Cardiovascular Outcomes in Overweight and Obese Subjects With Type 2 Diabetes

    DEFF Research Database (Denmark)

    Ghotbi, Adam Ali; Køber, Lars; Finer, Nick;

    2013-01-01

    To assess the association of hypoglycemic treatment regimens with cardiovascular adverse events and mortality in a large population of type 2 diabetic patients at increased cardiovascular risk.......To assess the association of hypoglycemic treatment regimens with cardiovascular adverse events and mortality in a large population of type 2 diabetic patients at increased cardiovascular risk....

  4. Tuberculosis treatment and drug regimens.

    Science.gov (United States)

    Sotgiu, Giovanni; Centis, Rosella; D'ambrosio, Lia; Migliori, Giovanni Battista

    2015-05-01

    Tuberculosis is an airborne infectious disease treated with combination therapeutic regimens. Adherence to long-term antituberculosis therapy is crucial for maintaining adequate blood drug level. The emergence and spread of drug-resistant Mycobacterium tuberculosis strains are mainly favored by the inadequate medical management of the patients. The therapeutic approach for drug-resistant tuberculosis is cumbersome, because of the poor, expensive, less-effective, and toxic alternatives to the first-line drugs. New antituberculosis drugs (bedaquiline and delamanid) have been recently approved by the health authorities, but they cannot represent the definitive solution to the clinical management of drug-resistant tuberculosis forms, particularly in intermediate economy settings where the prevalence of drug resistance is high (China, India, and former Soviet Union countries). New research and development activities are urgently needed. Public health policies are required to preserve the new and old therapeutic options. PMID:25573773

  5. Complete reversal of hypertensive cardiomyopathy after initiating combined antihypertensive therapy.

    Science.gov (United States)

    Holl, Marijn J; van de Poll, Sweder W; Michels, Michelle

    2016-01-01

    Hypertensive cardiomyopathy is a common complication of hypertension, with a prevalence ranging from 12% to 26%. It is associated with an increased cardiac mortality and morbidity. Lifestyle changes and antihypertensive therapy usually have a significant, but relatively small effect on left ventricular hypertrophy (LVH), which is associated with a reduction in cardiovascular risk. In this paper, we describe a 39-year-old woman with severe LVH. On transthoracic echocardiogram there was concentric LVH, systolic function was a mildly reduced and there was diastolic dysfunction grade III. After only 6 months of therapy with a combination of antihypertensive agents, the left ventricular mass index was reduced by 29%, systolic function was normal and the diastolic dysfunction improved to grade I. This paper shows that in hypertensive cardiomyopathy, even severe LVH can be completely reversible. PMID:27060071

  6. Structural and Antihypertensive Properties of Enzymatic Hemp Seed Protein Hydrolysates

    OpenAIRE

    Malomo, Sunday; Onuh, John; Girgih, Abraham; Aluko, Rotimi

    2015-01-01

    The aim of this work was to produce antihypertensive protein hydrolysates through different forms of enzymatic hydrolysis (2% pepsin, 4% pepsin, 1% alcalase, 2% alcalase, 2% papain, and 2% pepsin + pancreatin) of hemp seed proteins (HSP). The hemp seed protein hydrolysates (HPHs) were tested for in vitro inhibitions of renin and angiotensin-converting enzyme (ACE), two of the enzymes that regulate human blood pressure. The HPHs were then administered orally (200 mg/kg body weight) to spontane...

  7. Effects of anti-hypertensive drugs on esophageal body contraction

    Institute of Scientific and Technical Information of China (English)

    Koichi; Yoshida; Kenji; Furuta; Kyoichi; Adachi; Shunji; Ohara; Terumi; Morita; Takashi; Tanimura; Shuji; Nakata; Masaharu; Miki; Kenji; Koshino; Yoshikazu; Kinoshita

    2010-01-01

    AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux disease.METHODS:Thirteen healthy male volunteers were enrolled. Esophageal body peristaltic contractions and lower esophageal sphincter (LES) pressure were measured using high resolution manometry. All subjects were randomly examined on four separate occasions following administrations of nifedipine,losartan,and atenolol,as well as without any drug administ...

  8. Resistant and Refractory Hypertension: Antihypertensive Treatment Resistance vs Treatment Failure.

    Science.gov (United States)

    Siddiqui, Mohammed; Dudenbostel, Tanja; Calhoun, David A

    2016-05-01

    Resistant or difficult to treat hypertension is defined as high blood pressure that remains uncontrolled with 3 or more different antihypertensive medications, including a diuretic. Recent definitions also include controlled blood pressure with use of 4 or more medications as also being resistant to treatment. Recently, refractory hypertension, an extreme phenotype of antihypertensive treatment failure has been defined as hypertension uncontrolled with use of 5 or more antihypertensive agents, including a long-acting thiazide diuretic and a mineralocorticoid receptor antagonist. Patients with resistant vs refractory hypertension share similar characteristics and comorbidities, including obesity, African American race, female sex, diabetes, coronary heart disease, chronic kidney disease, and obstructive sleep apnea. Patients with refractory vs resistant hypertension tend to be younger and are more likely to have been diagnosed with congestive heart failure. Refractory hypertension might also differ from resistant hypertension in terms of underlying cause. Preliminary evidence suggests that refractory hypertension is more likely to be neurogenic in etiology (ie, heightened sympathetic tone), vs a volume-dependent hypertension that is more characteristic of resistant hypertension in general. PMID:26514749

  9. Systematic review: antihypertensive drug therapy in patients of African and South Asian ethnicity.

    Science.gov (United States)

    Brewster, Lizzy M; van Montfrans, Gert A; Oehlers, Glenn P; Seedat, Yackoob K

    2016-04-01

    Despite the large differences in the epidemiology of hypertension across Europe, treatment strategies are similar for national populations of white European descent. However, hypertensive patients of African or South Asian ethnicity may require ethnic-specific approaches, as these population subgroups tend to have higher blood pressure at an earlier age that is more difficult to control, a higher occurrence of diabetes, and more target organ damage with earlier cardiovascular mortality. Therefore, we systematically reviewed the evidence on antihypertensive drug treatment in South Asian and African ethnicity patients. We used the Cochrane systematic review methodology to retrieve trials in electronic databases including CENTRAL, PubMed, and Embase from their inception through November 2015; and with handsearch. We retrieved 4596 reports that yielded 35 trials with 7 classes of antihypertensive drugs in 25,540 African ethnicity patients. Aside from the well-known blood pressure efficacy of calcium channel blockers and diuretics, with lesser effect of ACE inhibitors and beta-blockers, nebivolol was not more effective than placebo in reducing systolic blood pressure levels. Trials with morbidity and mortality outcomes indicated that lisinopril and losartan-based therapy were associated with a greater incidence of stroke and sudden death. Furthermore, 1581 reports yielded 16 randomized controlled trials with blood pressure outcomes in 1719 South Asian hypertensive patients. In contrast with the studies in African ethnicity patients, there were no significant differences in blood pressure lowering efficacy between drugs, and no trials available with mortality outcomes. In conclusion, in patients of African ethnicity, treatment initiated with ACE inhibitor or angiotensin II receptor blocker monotherapy was associated with adverse cardiovascular outcomes. We found no evidence of different efficacy of antihypertensive drugs in South Asians, but there is a need for trials

  10. Use of oral antihypertensive medication preceding blood pressure elevation in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Macedo Cristiano Ricardo Bastos de

    2001-01-01

    Full Text Available OBJECTIVE: To evaluate the frequency of oral antihypertensive medication preceding the increase in blood pressure in patients in a university hospital, the drug of choice, and the maintained use of antihypertensive medication. METHODS: Data from January to June 1997 from the University Hospital Professor Edgard Santos Pharmacy concerning the prescriptions of all inpatients were used. Variables included in the analysis were: antihypertensive medication prescription preceding increase in blood pressure, type of antihypertensive medication, gender, clinical or surgical wards, and the presence of maintained antihypertensive medication. RESULTS: The hospital admitted 2,532 patients, 1,468 in surgical wards and 818 in medical wards. Antihypertensive medication prescription preceding pressure increase was observed in 578 patients (22.8%. Nifedipine was used in 553 (95.7% and captopril in 25 (4.3%. In 50.7% of patients, prescription of antihypertensive medication was not associated with maintained antihypertensive medication. Prescription of antihypertensive drugs preceding elevation of blood pressure was significantly (p<0.001 more frequent on the surgical floor (27.5%; 405/1468 than on the medical floor (14.3%; 117/818. The frequency of prescription of antihypertensive drugs preceding elevation of blood pressure without maintained antihypertensive drugs and the ratio between the number of prescriptions of nifedipine and captopril were greater in surgical wards. CONCLUSION: The use of antihypertensive medication, preceding elevation of blood pressure (22.8% observed in admitted patients is not supported by scientific evidence. The high frequency of this practice may be even greater in nonuniversity hospitals.

  11. Risk factors of disturbances in carbohydrate and lipid metabolism and some pleiotropic effects of antihypertensive therapy in pregnant women

    Directory of Open Access Journals (Sweden)

    A V Padyganova

    2013-03-01

    Full Text Available The any kind of hypertension developing during the pregnancy, associated with high cardiovascular risk in the future. At the pregnancy complicated by development by arterial hypertension, there are more expressed changes of a carbohydrate and lipide metabolism, than it is peculiar to normally proceeding pregnancy, were by important pathogenetic links of obesity, diabetes, cardiovascular complications. Identification of new mechanisms of action of antihypertensive means associated with positive influences on exchange processes, is represented very demanded, considering pandemic nature of prevalence of metabolic violations in modern population.

  12. Prognostic value of microalbuminuria during antihypertensive treatment in essential hypertension.

    Science.gov (United States)

    Pascual, Jose Maria; Rodilla, Enrique; Costa, Jose Antonio; Garcia-Escrich, Miguel; Gonzalez, Carmen; Redon, Josep

    2014-12-01

    Whether changes over time of urinary albumin excretion have prognostic value is a matter of discussion. The objective was to assess the prognostic value of changes in urinary albumin excretion over time in cardiovascular risk during antihypertensive treatment. Follow-up study of 2835 hypertensives in the absence of previous cardiovascular disease (mean age 55 years, 47% men, BP 138/80 mm Hg, 19.1% diabetics, and calibrated systemic coronary risk estimation 5 or >10.6%). Usual-care of antihypertensive treatment was implemented to maintain blood pressurecreatinine ratio. Incidence of cardiovascular events, fatal and nonfatal, was recorded during the follow-up. During a median follow-up of 4.7 years (17 028 patients-year), 294 fatal and first nonfatal cardiovascular events were recorded (1.73 CVD per 100 patients/year). Independently of blood pressure, estimated glomerular filtration rate, level of cardiovascular risk, and antihypertensive treatment, microalbuminuria at baseline and at any time during the follow-up resulted in higher risk for events, hazard ratio (HR) 1.35 (95% confidence interval [CI], 1.08-1.79) and HR 1.49 (95% CI, 1.14-1.94), respectively. Likewise, development of microalbuminuria (HR 1.60; 95% CI, 1.04-2.46) or persistence from the beginning (1.53; 95% CI, 1.13-2.06) had a significantly higher rate of events than if remained normoalbuminuric (HR 1) or regress to normoalbuminuria (HR 1.37; 95% CI, 0.92-2.06) with an 18%, 18%, 8%, and 11% events, respectively, P<0.001. The study supports the value of urinary albumin excretion assessment as a prognostic factor for cardiovascular risk, but also opens the way to consider it as an intermediate objective in hypertension. PMID:25245391

  13. Adherence to the antihypertensive treatment: a conceptual analysis

    Directory of Open Access Journals (Sweden)

    Gilmara Barboza da Silva Araújo

    2006-08-01

    Full Text Available The arterial systemic hypertension occupies a prominent place in the epidemiological transition context and constitutes one of the main risk factors for the appearance of heart diseases. The control of hypertension is directly related to the degree of the patient’s adherence to the therapeutic regime. This study aims to analyze the concept of “Adherence to the antihypertensive treatment”, identifying the possible antecedent factors, the critical attributes and the consequences of the phenomenon; and also to elaborate a theoretical model which incorporates the findings of the conceptual analysis and offers subsidies for the construction of instruments to measure the concept, as well as a basis for educational activities planned to the patients with hypertension. The study has adopted the conceptual analysis methodology proposed by Lorraine O. Walker and Kay C. Avant, and it was carried out through a bibliographical survey of scientific articles on the medical and nursing field relating to this matter, published in the Portuguese and English languages, from January 1995 to July 2001. Several aspects related to the patient, to the therapeutic regime and to the Health System were identified as antecedents of the “Adherence to the antihypertensive treatment”. Two attributes were identified for the concept: the active participation in the treatment and the accomplishment of changes in the life style. The reduction in the incidence or the delay in the occurrence of complications, the controlled arterial pressure and the improvement of the quality of life of patients with hypertension were identified as consequences of the concept of “Adherence to the antihypertensive treatment”.

  14. VASCULAR REMODELING AND HEART RATE VARIABILITY IN DIFFERENT ANTIHYPERTENSIVE THERAPIES

    Directory of Open Access Journals (Sweden)

    E. D. Golovanova

    2008-01-01

    Full Text Available Aim. To study the effect of the long-term antihypertensive monotherapy with indapamide (Arifon Retard, 1,5 mg/d, metoprolol tartrate (Egilok Retard, 50 mg/d and combined therapy with indapamide and perindopril (Noliprel Forte, 1 tab/d: perindopril 4 mg and indapamide 1,25 mg on pulse wave velocity (PWV, cardio-ankle vascular index (CAVI and the sympathetic system activity.Material and methods. 88 patients, aged 30-59 y.o. (32 normotensive patients, 56 with arterial hypertension [HT] of 1-2 grades were examined. Biological age (BA was determined by the linear regression and the vascular wall age (VWA was estimated with the use of volume sphygmography (“VaSera-1000”, “Fucuda Denshi”, Japan. 39 patients with HT were randomized into 3 parallel groups with studied therapies lasted for 6 months. PWV, CAVI of the vessels of elastic, muscular and mixed types, blood pressure, measured in upper and lower extremities and heart rate variability (HRV were determined before and at the end of the therapies.Results. BA and VWA were elevated in all of patients with HT as compared with normotensive patients. The reduction in PWV and CAVI of the vessels of elastic and mixed types, HRV increase were found in patients with Arifon Retard monotherapy. Monotherapy with metoprolol significantly improved HVR without any influence on the vascular remodeling. Noliprel Forte significantly decreased in blood pressure in the upper and lower extremities, PWV and CAVI of the vessels of all types, decreased in VWA and increased in parasympathetic drive.Conclusion. Long-term therapy with Arifon Retard and Noliprel Forte resulted in decrease in vascular remodeling and increase in HRV simultaneously with significant antihypertensive effect in patients with HT. Metoprolol low doses therapy resulted in normalization of autonomic drive independently on antihypertensive action.

  15. ANTIHYPERTENSIVE TREATMENT IN ELDERLY PATIENTS WITH DIHYDROPYRIDINE CALCIUM ANTAGONISTS

    Directory of Open Access Journals (Sweden)

    Y. A. Karpov

    2016-01-01

    Full Text Available The proofs of necessity of active arterial hypertension (AH treatment in elderly patients are given. Peculiarities of pathogenesis of AH in elderly patients, connected predominantly with loss of big arteries elasticity and reasoning widely spread of isolated systolic AH in these patients, are discussed. Advantages of dihydropyridine calcium antagonists (DPCA for AH treatment in elderly patients are proved, safety of treatment with DPCA is discussed. Data of clinical studies is analyzed. Analysis of target levels of blood pressure for antihypertensive treatment in elderly hypertensive patients is made. As a conclusion DPCA are the medicines of choice for AH treatment in elderly patients.

  16. ANTIHYPERTENSIVE TREATMENT WITH COMBINED DRUG OF LOSARTAN AND HYDROCHLOROTHIAZIDE

    OpenAIRE

    R. M. Linchak; K. M. Shumilova; A. D. Martinyuk; T. A. Gusaim; E. V. Semyonova; L. G. Zhirova; S. A. Boitsov

    2016-01-01

    Aim:  to evaluate efficiency and safety of the combined antihypertensive drug Lozap Plus (50 mg losartan, 12,5 mg hydrochlorothiazide) in patients with arterial hypertension (AH) of I-III grade with high and very high cardiovascular risk. Material and methods: 30 patients with AH of I-III grade (13 men and 17 women aged 51.9±1.9) were observed. Patients received Lozan Plus (Zentiva, Czech Republic) 1 time in the morning during 12 weeks. Ambulatory blood pressure monitoring (ABPM), echocardiog...

  17. Populism

    OpenAIRE

    Abts, Koenraad; van Kessel, Stijn

    2015-01-01

    Populism is a concept applied to a wide range of political movements and actors across the globe. There is, at the same time, considerable confusion about the attributes and manifestation of populism, as well as its impact on democracy. This contribution identifies the defining elements of the populist ideology and discusses the varieties in which populism manifests itself, for instance as a component of certain party families. We finally discuss various normative interpretations of populism,...

  18. ON THE SELECTION OF DRUGS DOSAGE REGIMEN

    OpenAIRE

    E. N. Bochanova

    2015-01-01

    A complex system of hemostasis regulation, insufficient data on drugs pharmacokinetics, multiple factors effecting treatment, including patient’s adherence to therapy, that can lead to the need for the dosage regimen specification are presented.

  19. ON THE SELECTION OF DRUGS DOSAGE REGIMEN

    Directory of Open Access Journals (Sweden)

    E. N. Bochanova

    2015-09-01

    Full Text Available A complex system of hemostasis regulation, insufficient data on drugs pharmacokinetics, multiple factors effecting treatment, including patient’s adherence to therapy, that can lead to the need for the dosage regimen specification are presented.

  20. Insulin, hypertension and antihypertensive drugs in elderly patients : The Rotterdam Study

    NARCIS (Netherlands)

    Stolk, RP; Hoes, AW; Pols, HAP; Hofman, A; deJong, PTVM; Lamberts, SWJ; Grobbee, DE

    1996-01-01

    Objective To investigate the association between insulin, hypertension and antihypertensive drug use in elderly patients. Design and methods Blood pressure, use of antihypertensive drugs and glucose metabolism were examined in 5453 men and women (mean age 68.8 years). This was part of the baseline e

  1. Retrospective evaluation of adverse drug reactions induced by antihypertensive treatment

    Directory of Open Access Journals (Sweden)

    Pierandrea Rende

    2013-01-01

    Full Text Available The use of cardiovascular drugs is related to the development of adverse drug reactions (ADRs in about 24% of the patients in the Cardiovascular Care Unit. Here, we evaluated the ADRs in patients treated with antihypertensive drugs. The study was conducted in two phases: In the first phase, we performed a retrospective study on clinical records of Clinical Divisions (i.e., Internal Medicine Operative Unit and Geriatric Operative Unit from January 1, 2012 to December 31, 2012. Moreover from January 1, 2013 to March 30, 2013 we performed a prospective study on the outpatients attending the Emergency Department (ED of the Pugliese-Ciaccio Hospital of Catanzaro, by conducting patient interviews after their informed consent was obtained. The association between a drug and ADR was evaluated using the Naranjo scale. We recorded 72 ADRs in the Clinical Divisions and six in the ED, and these were more frequent in women. Using the Naranjo score, we showed a probable association in 92% of these reactions and a possible association in 8%. The most vulnerable age group involved in ADRs was that of the elderly patients. In conclusion, our results indicate that antihypertensive drugs may be able to induce the development of ADRs, particularly in elderly women receiving multiple drug treatment. Therefore, it is important to motivate the healthcare providers to understand their role and responsibility in the detection, management, documentation, and reporting of ADRs, as also all the essential activities for optimizing patient safety.

  2. THE COMPARATIVE COST-EFFICACY ANALYSIS OF VARIOUS ANTIHYPERTENSIVE THERAPIES

    Directory of Open Access Journals (Sweden)

    S. V. Malchikova

    2009-01-01

    Full Text Available Aim. To perform the comparative cost-efficacy analysis of various antihypertensive therapies in hypertensives patients.Material and methods. 140 hypertensive patients with history of ineffective antihypertensive therapy were randomized in to 4 groups, 35 patients in each one. Patients of Group A received indapamide retard plus perindopril; group B - indapamide retard plus amlodipine; group C - amlodipine plus lisinopril; group D - amlodipine plus bisoprolol. The Russian version of general questionnaire MOS-SF-36 was applied for quality of a life estimated. Endothelium function was evaluated with B-mode ultrasonography (Acuson 128 ХР/10. Albuminuria level was detected by immunoturbometric method (Integra-700, Roche.Results. The drug combination B had the least cost. The drug combination C was the most effective. The drug combination C was the most economically rational. The drug combination A was the least economically rational for BP reduction. However the drug combination A was comparable with drug combination C in effects on quality of life and on endothelium function, and it was the most economically rational for albuminuria reduction.Conclusion. Indapamide retard plus perindopril combination is the most economically rational in patients with target-organ lesions (nephropathy. Lisinopril plus amlodipine combination is economically rational in patients without target-organ lesions. 

  3. THE COMPARATIVE COST-EFFICACY ANALYSIS OF VARIOUS ANTIHYPERTENSIVE THERAPIES

    Directory of Open Access Journals (Sweden)

    S. V. Malchikova

    2016-01-01

    Full Text Available Aim. To perform the comparative cost-efficacy analysis of various antihypertensive therapies in hypertensives patients.Material and methods. 140 hypertensive patients with history of ineffective antihypertensive therapy were randomized in to 4 groups, 35 patients in each one. Patients of Group A received indapamide retard plus perindopril; group B - indapamide retard plus amlodipine; group C - amlodipine plus lisinopril; group D - amlodipine plus bisoprolol. The Russian version of general questionnaire MOS-SF-36 was applied for quality of a life estimated. Endothelium function was evaluated with B-mode ultrasonography (Acuson 128 ХР/10. Albuminuria level was detected by immunoturbometric method (Integra-700, Roche.Results. The drug combination B had the least cost. The drug combination C was the most effective. The drug combination C was the most economically rational. The drug combination A was the least economically rational for BP reduction. However the drug combination A was comparable with drug combination C in effects on quality of life and on endothelium function, and it was the most economically rational for albuminuria reduction.Conclusion. Indapamide retard plus perindopril combination is the most economically rational in patients with target-organ lesions (nephropathy. Lisinopril plus amlodipine combination is economically rational in patients without target-organ lesions. 

  4. Effects of meals on hemodynamics: implications for antihypertensive drug studies.

    Science.gov (United States)

    Fagan, T C; Conrad, K A; Mar, J H; Nelson, L

    1986-03-01

    The ingestion of food is known to affect blood pressure and heart rate, but food is often allowed in patients under observation for antihypertensive drug effects. Seventy-seven patients with essential hypertension were observed for 8 hours after a 16-hour fast. Thirty-six continued to fast, 20 ate a high-carbohydrate meal, and 21 ate a meal of their own choice. Blood pressure and heart rate did not change during fasting, but both meals lowered mean supine and standing diastolic blood pressures during the subsequent 4 hours by 3 to 7 mm Hg (P less than 0.001). The high-carbohydrate meal reduced supine systolic blood pressure by 6 mm Hg (P less than 0.0001). Both meals increased supine and standing heart rates by 5 to 8 bpm (P less than 0.001). After the self-selected meal, standing systolic blood pressure increased in younger patients but decreased in older patients. Food ingestion during antihypertensive drug studies may interfere with the interpretation of results and should be avoided whenever possible. PMID:3948465

  5. Effect of antihypertensive treatment on progression of incipient diabetic nephropathy

    DEFF Research Database (Denmark)

    Christensen, Cramer; Mogensen, C E

    The aim of the study was to clarify whether antihypertensive treatment with a selective beta blocker would have an effect on the progression rate of kidney disease in patients with incipient diabetic nephropathy. Six male patients with juvenile-onset diabetes with incipient nephropathy (urinary...... albumin excretion above 15 micrograms/min and total protein excretion below 0.5 g/24 hr) were treated with metoprolol (200 mg daily). At the start of the antihypertensive treatment the mean age was 32 years +/- 4.2 (SD). The patients were followed a mean 5.4 years +/- 3.1 (SD) with repeated measurements...... of urinary albumin excretion before and during 2.6 years +/- 1.0 (SD) of treatment. The blood pressure was depressed by the treatment (systolic blood pressure from 135 mm Hg +/- 8.6 to 124 mm Hg +/- 6.2, NS; mean blood pressure from 107 mm Hg +/- 7.6 to 97 mm Hg +/- 3.4, 2p less than 0.05; diastolic...

  6. The impact of ethnicity on response to antihypertensive therapy.

    Science.gov (United States)

    Jamerson, K; DeQuattro, V

    1996-09-30

    The aim of this review is to assess the prevalence of complications and responses to various antihypertensive drug therapies in ethnic minority groups in the United States. In some instances, these comments are extended to responses of citizens in their countries of origin. The incidence of hypertension, mortality from hypertensive heart disease, stroke, and hypertensive renal disease are higher in African Americans. Although some Hispanic Americans have a lesser risk for hypertension, they have a greater risk for other risk factors such as diabetes and dyslipidemia. There is a similar association between income and mortality for both African Americans and Hispanic Americans. When compared to European Americans and other ethnic minorities, African Americans respond less favorably to beta blockers and angiotensin-converting enzyme (ACE) inhibitors. Nevertheless, the observed response in African Americans to ACE inhibitors and beta blockers is clinically significant. The available literature indicates that Asian American responses to calcium antagonists seem to be more favorable than responses to ACE inhibitors and equivalent to their responses to diuretic and beta blocker therapy. Although there are few published studies of drug efficacy in Hispanic Americans, there appears to be no hierarchy in response to the various antihypertensive drug classes. Ethnicity is not an accurate criterion for predicting poor response to any class of antihypertensive therapy. Thus, there is little justification to use racial profiling as a criterion for the avoidance of selected drug classes because of presumed lack of efficacy. Observed differences in the incidence of hypertension and its poor outcomes have led some investigators to postulate that the etiology of hypertension in ethnic minority groups is intrinsically different from whites. Awareness of racial differences in hypertension outcomes evolved in the United States within a historical context that does not fully appreciate

  7. Prophylactic antibiotic regimens in tumour surgery (PARITY)

    DEFF Research Database (Denmark)

    Petersen, Michael Mørk; Hettwer, Werner H; Grum-Schwensen, Tomas

    2015-01-01

    conceal treatment allocation and sham antibiotics to blind participants, surgeons, and data collectors. We determined feasibility by measuring patient enrolment, completeness of follow-up, and protocol deviations for the antibiotic regimens. RESULTS: We screened 96 patients and enrolled 60 participants......-day regimen of post-operative antibiotics, in comparison to a 24-hour regimen, decreases surgical site infections in patients undergoing endoprosthetic reconstruction for lower extremity primary bone tumours. METHODS: We performed a pilot international multi-centre RCT. We used central randomisation to......% at one year (the remainder with partial data or pending queries). In total, 18 participants missed at least one dose of antibiotics or placebo post-operatively, but 93% of all post-operative doses were administered per protocol. CONCLUSIONS: It is feasible to conduct a definitive multi-centre RCT of...

  8. A BRIEF VIEW ON ANTIHYPERTENSIVE DRUGS DELIVERY THROUGH TRANSDERMAL PATCHES

    Directory of Open Access Journals (Sweden)

    V. Rastogi*, Pragya, P. Upadhyay

    2012-07-01

    Full Text Available Transdermal Drug Delivery System (TDDS is one of the systems lying under the category of controlled drug delivery, in which the aim is to deliver the drug through skin in a predetermined and controlled rate. Hypertension is one of the common disorder for the mankind. It is not a disease in itself, but is an important risk factor for cardiovascular mortality and morbidity. The present article delivers a brief view on the work been done to increase the bioavailability of various antihypertensive drugs by formulated and delivered as transdermal patches. The different drugs includes carvedilol, metoprolol, atenolol, propranolol, labetolol, verapamil, indapamide, losartan, bisoprolol, timolol maleate, nicardipine hydrochloride, captopril, clonidine, pinacidil, nitrendipine, nicorandil, diltiazem hydrochloride, lisinopril, nifedipine, amlodipine, valsartan, enalapril maleate.

  9. [Inhaled corticosteroids: Which regimens are appropriate?].

    Science.gov (United States)

    Giovannini-Chami, L; Piccini-Bailly, C; Albertini, M

    2016-06-01

    Inhaled corticosteroids are the cornerstone of asthma management. Inhaled corticosteroid regimens differ slightly in various international guidelines on asthma management but are based on the principles of continuous treatment and titration to the lowest effective dose. Several recent studies, nevertheless, appear to demonstrate the potential value of preemptive or "pro re nata" regimens in infants and children. These studies were included in GINA 2015 for children 5 years of age and younger in whom discontinuous treatment is proposed as a second-line option. Should we change our practices after a critical reading of these studies? PMID:27133372

  10. Comparative stydy of various drug regimens in vitiligo

    Directory of Open Access Journals (Sweden)

    Patel Indravadan

    1993-01-01

    Full Text Available 100 cases of vitiligo were treated with topical 0.25% fluocinolone acetonide and topical placental extract. To these we added levamisole (Regimen I; systemic betamethasone and levamisole (Regimen II, oral psoralen (Regimen III and oral psoralen plus oral betamethasone (Regimen IV. Treatment continued for 6-12 months. Results in the regimen II and IV were found be very good. Recurrence with oral steroid was noted. Levamisole showed marked response.

  11. Hypertension resistant to antihypertensive agents commonly occurs with the progression of diabetic nephropathy in Japanese patients with type 2 diabetes mellitus: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Ito Hiroyuki

    2012-06-01

    Full Text Available Abstract Background We investigated 1 the frequency of hypertension in patients with type 2 diabetes graded by the new classification of chronic kidney disease (CKD reported by the Kidney Disease: Improving Global Outcomes (KDIGO and 2 the number of antihypertensive agents needed to achieve treatment goals using a prospective observational study. Methods A population of 2018 patients with type 2 diabetes mellitus was recruited for the study. The CKD stage was classified according to the eGFR and the urinary albumin excretion levels. Results Hypertension was found in 1420 (70% of the patients, and the proportion of subjects showing a blood pressure  Conclusions Hypertension resistant to antihypertensive agents was common in the patients with type 2 diabetes mellitus and increased with the progression of CKD. Although powerful combination therapy using antihypertensive agents is considered necessary for the strict control of blood pressure, this became difficult in individuals who were in advanced stages as graded based on the eGFR and the urinary albumin excretion levels.

  12. EFFECT OF ANTIHYPERTENSIVE DRUGS ON QUALITY OF LIFE IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    G. F. Andreeva

    2016-01-01

    Full Text Available Aim. To study effect of antihypertensive drugs on quality of life (QoL of patients with stable arterial hypertension (HT.Material and methods. Results of some studies with similar design involving totally 170 patients with HT, aged 57,2±8,8 y.o., were analyzed. HT duration was 11,2±8,3 years. Patients received antihypertensive monotherapy with diltiazem, amlodipine, enalapril, lisinopril, metoprolol and telmisartan during 1-3 months. 24-hour blood pressure (BP monitoring, QoL was performed before and after treatment.Results. All antihypertensive drugs significantly reduced systolic and diastolic BP and did not affect QoL. ACE inhibitors similarly improved QoL.Conclusion. Antihypertensive drugs (diltiazem, amlodipine, enalapril, lisinnopril, metoprolol, telmisartan do not worsen QoL of patients with HT.

  13. Antihypertensive medication classes used among medicare beneficiaries initiating treatment in 2007-2010.

    Directory of Open Access Journals (Sweden)

    Shia T Kent

    Full Text Available After the 2003 publication of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 guidelines, there was a 5-10% increase in patients initiating antihypertensive medication with a thiazide-type diuretic, but most patients still did not initiate treatment with this class. There are few contemporary published data on antihypertensive medication classes filled by patients initiating treatment.We used the 5% random Medicare sample to study the initiation of antihypertensive medication between 2007 and 2010. Initiation was defined by the first antihypertensive medication fill preceded by 365 days with no antihypertensive medication fills. We restricted our analysis to beneficiaries ≥ 65 years who had two or more outpatient visits with a hypertension diagnosis and full Medicare fee-for-service coverage for the 365 days prior to initiation of antihypertensive medication. Between 2007 and 2010, 32,142 beneficiaries in the 5% Medicare sample initiated antihypertensive medication. Initiation with a thiazide-type diuretic decreased from 19.2% in 2007 to 17.9% in 2010. No other changes in medication classes initiated occurred over this period. Among those initiating antihypertensive medication in 2010, 31.3% filled angiotensin-converting enzyme inhibitors (ACE-Is, 26.9% filled beta blockers, 17.2% filled calcium channel blockers, and 14.4% filled angiotensin receptor blockers (ARBs. Initiation with >1 antihypertensive medication class decreased from 25.6% in 2007 to 24.1% in 2010. Patients initiated >1 antihypertensive medication class most commonly with a thiazide-type diuretic and either an ACE-I or ARB.These results suggest that JNC 7 had a limited long-term impact on the choice of antihypertensive medication class and provide baseline data prior to the publication of the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Panel

  14. Interactions between antihypertensive drugs and food Interacciones entre fármacos antihipertensivos y alimentos

    OpenAIRE

    B. Jáuregui-Garrido; Jáuregui-Lobera, I

    2012-01-01

    Objective: A drug interaction is defined as any alteration, pharmacokinetics and/or pharmacodynamics, produced by different substances, other drug treatments, dietary factors and habits such as drinking and smoking. These interactions can affect the antihypertensive drugs, altering their therapeutic efficacy and causing toxic effects. The aim of this study was to conduct a review of available data about interactions between antihypertensive agents and food. Methods: The purpose of this review...

  15. Do advertisements for antihypertensive drugs in Australia promote quality prescribing? A cross-sectional study

    OpenAIRE

    Spurling Geoffrey K; Mansfield Peter R; Montgomery Brett D; Ward Alison M

    2008-01-01

    Abstract Background Antihypertensive medications are widely prescribed by doctors and heavily promoted by the pharmaceutical industry. Despite strong evidence of the effectiveness and cost-effectiveness of thiazide diuretics, trends in both promotion and prescription of antihypertensive drugs favour newer, less cost-effective agents. Observational evidence shows correlations between exposure to pharmaceutical promotion and less ideal prescribing. Our study therefore aimed to determine whether...

  16. Antihypertensive Agents and Risk of Parkinson's Disease: A Nationwide Cohort Study

    OpenAIRE

    Lee, Yen-Chieh; Lin, Chin-Hsien; Wu, Ruey-Meei; Lin, Jou-Wei; Chang, Chia-Hsuin; Lai, Mei-Shu

    2014-01-01

    Background and Purpose Hypertension has been associated with Parkinson's disease (PD), but data on antihypertensive drugs and PD are inconclusive. We aim to evaluate antihypertensive drugs for an association with PD in hypertensive patients. Methods Hypertensive patients who were free of PD, dementia and stroke were recruited from 2005–2006 using Taiwan National Health Insurance Database. We examined the association between the use of calcium channel blockers (CCBs), angiotensin converting en...

  17. Cost analysis study of oral antihypertensive agents available in Indian market

    OpenAIRE

    Karve, Ashwini V.; Kanchan B. Chattar

    2014-01-01

    Background: Hypertension is one of the major causes of morbidity, mortality and needs lifelong treatment. There is a wide range of variation in the prices of antihypertensive drugs marketed in India. Thus, a study was planned to find out price variations in the oral antihypertensive drugs available either singly or in combination and number of manufacturing companies for each, also to evaluate the difference in cost of different brands of same active drug by calculating percentage variation o...

  18. Nonadherence to antihypertensive medications and associated factors in general medicine clinics

    Directory of Open Access Journals (Sweden)

    Al Ghobain M

    2016-08-01

    Full Text Available Mohammed Al Ghobain,1,2 H Alhashemi,1,2 A Aljama,3 S Bin Salih,1,2 Z Assiri,4 A Alsomali,4 Gamal Mohamed5 1Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, 2King Abdullah International Medical Research Centre, 3Department of Medicine, King Abdulaziz Medical City, 4College of Nursing, 5College of Public Health, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia Objectives: Nonadherence to antihypertensive medications has not been assessed in the Saudi population. The aim of this study was to address and evaluate the magnitude of nonadherence among hypertensive patients and the risk factors associated with it. Methods: A cross-sectional survey was conducted on hypertensive patients who attended the general internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia, using a questionnaire that was modified after reviewing the literature. Hypertensive patients were labeled as nonadherent if they missed their medications for a total of 7 days during the previous month. Results: A total of 302 patients participated in the study, of whom 63% were females with a mean age of 64 years, and 64% were illiterate. The prevalence of nonadherence to medications among hypertensive patients was found to be 12.3%. Poor disease knowledge was reported in 80% of patients, while 66% of the patients had poor monitoring of their disease. Younger age (≤65 years, poor monitoring, and uncontrolled blood pressure (BP ≥140/90 mmHg were the predictor factors associated with nonadherence (odds ratio [OR] =2.04, P=0.025; OR=2.39, P=0.004; and OR=2.86, P=0.003, respectively. Conclusion: Nonadherence to antihypertensive medications is lower than that previously reported in the literature. Younger age, uncontrolled BP, and poor monitoring are the main risk factors associated with nonadherence. Keywords: nonadherence, hypertension, Saudi Arabia, uncontrolled blood

  19. Polypharmacy and adverse drug reactions in Japanese elderly taking antihypertensives: a retrospective database study

    Directory of Open Access Journals (Sweden)

    Sato I

    2013-06-01

    Full Text Available Izumi Sato,1 Manabu Akazawa21Department of Epidemiology and Statistics, Graduate School of Medicine, The University of Tokyo Tokyo, Japan; 2Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Tokyo, JapanBackground: The concomitant use of multiple medications by elderly patients with hypertension is a relatively common and growing phenomenon in Japan. This has been attributed to several factors, including treatment guidelines recommending prescription of multiple medications and a continuing increase in the elderly population with multiple comorbidities.Objective: This study was aimed at investigating the association between polypharmacy, defined as the concomitant use of five or more medications, and risk of adverse drug reaction (ADR in elderly Japanese hypertensive patients to examine the hypothesis that risk of ADR increases with the administration of an increasing number of co-medications.Methods: Using a retrospective cohort design, the data regarding all hypertensive patients aged 65 years or older were extracted from the Risk/Benefit Assessment of Drugs – Analysis and Response Council antihypertensive medication database. The data were reviewed for classification of patients into one of three groups according to drug use at the initiation of therapy – a monotherapy group composed of patients who had taken the investigated drug only, a co-medication group composed of patients who had taken the investigated drug and a maximum of three other medications, and a polypharmacy group composed of patients who had taken the investigated drug and four or more other medications – and determination of the number of ADR events experienced. Estimated rate ratios (RRs and 95% confidence intervals (CIs were calculated using a Poisson regression model adjusted for drug category and patient age and sex. Various sensitivity analyses were performed to confirm the robustness of the study findings.Results: Of 61,661 elderly

  20. Structural and Antihypertensive Properties of Enzymatic Hemp Seed Protein Hydrolysates

    Directory of Open Access Journals (Sweden)

    Sunday A. Malomo

    2015-09-01

    Full Text Available The aim of this work was to produce antihypertensive protein hydrolysates through different forms of enzymatic hydrolysis (2% pepsin, 4% pepsin, 1% alcalase, 2% alcalase, 2% papain, and 2% pepsin + pancreatin of hemp seed proteins (HSP. The hemp seed protein hydrolysates (HPHs were tested for in vitro inhibitions of renin and angiotensin-converting enzyme (ACE, two of the enzymes that regulate human blood pressure. The HPHs were then administered orally (200 mg/kg body weight to spontaneously hypertensive rats and systolic blood pressure (SBP-lowering effects measured over a 24 h period. Size exclusion chromatography mainly showed a 300–9560 Da peptide size range for the HPHs, while amino acid composition data had the 2% pepsin HPH with the highest cysteine content. Fluorescence spectroscopy revealed higher fluorescence intensities for the peptides when compared to the unhydrolyzed hemp seed protein. Overall, the 1% alcalase HPH was the most effective (p < 0.05 SBP-reducing agent (−32.5 ± 0.7 mmHg after 4 h, while the pepsin HPHs produced longer-lasting effects (−23.0 ± 1.4 mmHg after 24 h. We conclude that an optimized combination of the fast-acting HPH (1% alcalase with the longer-lasting HPHs (2% and 4% pepsin could provide daily effective SBP reductions.

  1. Gender Differences in Antihypertensive Treatment: Myths or Legends?

    Science.gov (United States)

    Muiesan, Maria Lorenza; Salvetti, Massimo; Rosei, Claudia Agabiti; Paini, Anna

    2016-06-01

    In European countries and in the USA, hypertension represents an important risk factor for cardiovascular diseases (CVD) in men and women. Women do not perceive CVD as an important health problem, despite the evidence that women are more at risk to die from hypertension-related CVD than men. A correct prevention strategy should more widely acknowledge sex-specific risk factors, such as hypertension in pregnancy, and the benefit of treating hypertension in both men and women. In more recent years, hypertension awareness and treatment rates are higher in women than in men while blood pressure control rates are improving, but remain still lower in older hypertensive women. Differences have been described regarding the pattern of antihypertensive drug prescription and use in hypertensive men and women; women are more frequently treated with diuretics and less frequently with angiotensin-converting-enzyme (ACE)-inhibitors and angiotensin-receptors blockers. Calcium-antagonists appear to be particularly effective in women. Data from large clinical trials and meta-analyses offer strong evidence that the efficacy of the various drug classes in prevention of CV events does not differ by sex, and therefore the choice of the drug cannot be based only on this criterion in post- menopausal women. There are currently no specific blood pressure (BP) treatment goals for post-menopausal hypertension. PMID:27106810

  2. Structural and Antihypertensive Properties of Enzymatic Hemp Seed Protein Hydrolysates.

    Science.gov (United States)

    Malomo, Sunday A; Onuh, John O; Girgih, Abraham T; Aluko, Rotimi E

    2015-09-01

    The aim of this work was to produce antihypertensive protein hydrolysates through different forms of enzymatic hydrolysis (2% pepsin, 4% pepsin, 1% alcalase, 2% alcalase, 2% papain, and 2% pepsin + pancreatin) of hemp seed proteins (HSP). The hemp seed protein hydrolysates (HPHs) were tested for in vitro inhibitions of renin and angiotensin-converting enzyme (ACE), two of the enzymes that regulate human blood pressure. The HPHs were then administered orally (200 mg/kg body weight) to spontaneously hypertensive rats and systolic blood pressure (SBP)-lowering effects measured over a 24 h period. Size exclusion chromatography mainly showed a 300-9560 Da peptide size range for the HPHs, while amino acid composition data had the 2% pepsin HPH with the highest cysteine content. Fluorescence spectroscopy revealed higher fluorescence intensities for the peptides when compared to the unhydrolyzed hemp seed protein. Overall, the 1% alcalase HPH was the most effective (p alcalase) with the longer-lasting HPHs (2% and 4% pepsin) could provide daily effective SBP reductions. PMID:26378569

  3. A regimen for low-dose aspirin?

    OpenAIRE

    Hanley, S. P.; Bevan, J.; Cockbill, S. R.; Heptinstall, S

    1982-01-01

    The effects of different regimens of 40 mg aspirin on platelet thromboxane A2 synthesis and vascular prostacyclin synthesis were determined in patients who were undergoing elective surgery for removal of varicose veins. Aspirin 40 mg taken at intervals of 48 hours consistently reduced platelet thromboxane A2 synthesis to a level at which it failed to support platelet aggregation and the associated release reaction. This effect lasted for at least 36 hours. In contrast, aspirin 40 mg every 72 ...

  4. New Treatment Regimen for Latent Tuberculosis Infection

    Centers for Disease Control (CDC) Podcasts

    2012-03-15

    In this podcast, Dr. Kenneth Castro, Director of the Division of Tuberculosis Elimination, discusses the December 9, 2011 CDC guidelines for the use of a new regimen for the treatment of persons with latent tuberculosis infection.  Created: 3/15/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/15/2012.

  5. "Rescue" regimens after Helicobacter pylori treatment failure

    Institute of Scientific and Technical Information of China (English)

    Javier P Gisbert

    2008-01-01

    Helicobacter pylori (H pylori)infection is the main cause of gastritis,gastroduodenal ulcer disease,and gastric cancer.After more than 20 years of experience in Hpylori treatment,in my opinion,the ideal regimen to treat this infection is still to be found.Currently,apart from having to know first-line eradication regimens well,we must also be prepared to face lyeatment failures.Therefore,in designing a treatment strategy we should not focus on the results of primary therapy alone,but also on the final (overall) eradication rate.The choice of a "rescue" treatment depends on which treatment is used initially.If a clarithromycinbased regimen was used initially,a subsequent metronidazole-based treatment (quadruple therapy)may be used afterwards,and then a levofloxacinbased combination would be a third "rescue" option.Alternatively,it has recently been suggested that levofloxacin-based rescue therapy constitutes an encouraging second-line strategy,representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure,with the advantage of efficacy,simplicity and safety.In this case,a quadruple regimen may be reserved as a third-line rescue option.Finally,rifabutin-based rescue therapy constitutes an encouraging empirical fourthline strategy after multiple previous eradication failures with key antibiotics such as amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin.Even after two consecutive failures,several studies have demonstrated that H pylor/eradication can finally be achieved in almost all patients if several rescue therapies are consecutively given.Therefore,the attitude in H pylori eradication therapy failure,even after two or more unsuccessful attempts,should be to fight and not to surrender.

  6. The Cost-Effectiveness of Low-Cost Essential Antihypertensive Medicines for Hypertension Control in China: A Modelling Study.

    Directory of Open Access Journals (Sweden)

    Dongfeng Gu

    2015-08-01

    Full Text Available Hypertension is China's leading cardiovascular disease risk factor. Improved hypertension control in China would result in result in enormous health gains in the world's largest population. A computer simulation model projected the cost-effectiveness of hypertension treatment in Chinese adults, assuming a range of essential medicines list drug costs.The Cardiovascular Disease Policy Model-China, a Markov-style computer simulation model, simulated hypertension screening, essential medicines program implementation, hypertension control program administration, drug treatment and monitoring costs, disease-related costs, and quality-adjusted life years (QALYs gained by preventing cardiovascular disease or lost because of drug side effects in untreated hypertensive adults aged 35-84 y over 2015-2025. Cost-effectiveness was assessed in cardiovascular disease patients (secondary prevention and for two blood pressure ranges in primary prevention (stage one, 140-159/90-99 mm Hg; stage two, ≥160/≥100 mm Hg. Treatment of isolated systolic hypertension and combined systolic and diastolic hypertension were modeled as a reduction in systolic blood pressure; treatment of isolated diastolic hypertension was modeled as a reduction in diastolic blood pressure. One-way and probabilistic sensitivity analyses explored ranges of antihypertensive drug effectiveness and costs, monitoring frequency, medication adherence, side effect severity, background hypertension prevalence, antihypertensive medication treatment, case fatality, incidence and prevalence, and cardiovascular disease treatment costs. Median antihypertensive costs from Shanghai and Yunnan province were entered into the model in order to estimate the effects of very low and high drug prices. Incremental cost-effectiveness ratios less than the per capita gross domestic product of China (11,900 international dollars [Int$] in 2015 were considered cost-effective. Treating hypertensive adults with prior

  7. Postcesarean Thromboprophylaxis with Two Different Regimens of Bemiparin

    Directory of Open Access Journals (Sweden)

    Milagros Cruz

    2011-01-01

    Full Text Available Objectives. To compare the effectiveness of postcesarean thromboprophylaxis with two different regimens of bemiparin. Material and Methods. The study included 646 women with cesarean delivery in our hospital within a 1-year period, randomly assigned to one of two groups for prophylaxis with 3500 IU bemiparin once daily for 5 days or 3500 IU bemiparin once daily for 10 days. Results. There was one case of pulmonary embolism (first day following cesarean. An additional risk factor was present in 98.52% of the women, most frequently emergency cesarean, anemia, or obesity. The only risk factors for thromboembolic disease significantly related to pulmonary thromboembolism were placental abruption and prematurity. There were no differences in thromboembolic events among the two thromboprophylaxis regimens. Conclusions. Cesarean-related thromboembolic events were reduced in our study population due to the thromboprophylactic measures taken. Thromboprophylaxis with 3500 IU bemiparin once daily for 5 days following cesarean was sufficient to avoid thromboembolic events.

  8. Antihypertensive and cardioprotective effects of pumpkin seed oil.

    Science.gov (United States)

    El-Mosallamy, Aliaa E M K; Sleem, Amany A; Abdel-Salam, Omar M E; Shaffie, Nermeen; Kenawy, Sanaa A

    2012-02-01

    Pumpkin seed oil is a natural product commonly used in folk medicine for treatment of prostatic hypertrophy. In the present study, the effects of treatment with pumpkin seed oil on hypertension induced by the nitric oxide synthase inhibitor N(ω)-nitro-L-arginine methyl ester hydrochloride (L-NAME) (50 mg /kg/day) in rats were studied and compared with those of the calcium channel blocker amlodipine. Pumpkin seed oil (40 or 100 mg/kg), amlodipine (0.9 mg/kg), or vehicle (control) was given once daily orally for 6 weeks. Arterial blood pressure (BP), heart rate, electrocardiogram (ECG) changes, levels of serum nitric oxide (NO) (the concentrations of nitrite/nitrate), plasma malondialdehyde (MDA), blood glutathione, and erythrocytic superoxide dismutase activity were measured. Histopathological examination of heart and aorta was conducted as well. L-NAME administration resulted in a significant increase in BP starting from the second week. Pumpkin seed oil or amlodipine treatment significantly reduced the elevation in BP by L-NAME and normalized the L-NAME-induced ECG changes-namely, prolongation of the RR interval, increased P wave duration, and ST elevation. Both treatments significantly decreased the elevated levels of MDA and reversed the decreased levels of NO metabolites to near normal values compared with the L-NAME-treated group. Amlodipine also significantly increased blood glutathione content compared with normal (but not L-NAME-treated) rats. Pumpkin seed oil as well as amlodipine treatment protected against pathological alterations in heart and aorta induced by L-NAME. In conclusion, this study has shown that pumpkin seed oil exhibits an antihypertensive and cardioprotective effects through a mechanism that may involve generation of NO. PMID:22082068

  9. Clinical trials of antihypertensives: Nature of control and design

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    Bhaswat S Chakraborty

    2011-01-01

    Full Text Available This paper reviews the critical issues in the control and design of antihypertension (anti-HT clinical trials. The international guidelines and current clinical and biostatistical practices were reviewed for relevant clinical, design, end-point assessments and regulatory issues. The results are grouped mainly into ethical, protocol and assessment issues. Ethical issues arise as placebo-controlled trials (PCTs for HT-lowering agents in patients with moderate to severe HT are undertaken. Patients with organ damage due to HT should not be included in long-term PCT. Active-control trials, however, are suitable for all randomized subsets of patients, including men and women, and different ethnic and age groups. Severity subgroups must be studied separately with consideration to specific study design. Mortality and morbidity outcome studies are not required in anti-HT trials except when significant mortality and cardiovascular morbidity are suspected. Generally, changes in both systolic and diastolic blood pressures (BP at the end of the dosing interval from the baseline are compared between the active and the control arms as the primary endpoint of anti-HT effect. Onset of the anti-HT effect can be studied as the secondary endpoint. For maintenance of efficacy, long-term studies of ≥6 months need to be undertaken. Error-free measurement of BP is a serious issue as spontaneous changes in BP are large and active drug effect on diastolic BP is often small. Placebo-controlled short-term studies (of ~12 weeks for dose-response and titration are very useful. Safety studies must be very vigilant on hypotension, orthostatic hypotension and effects on heart. In dose-response studies, at least three doses in addition to placebo should be used to well characterize the benefits and side-effects.

  10. Characterization of HIV-1 from patients with virological failure to a boosted protease inhibitor regimen

    DEFF Research Database (Denmark)

    Lillemark, Marie Rathcke; Gerstoft, Jan; Obel, Niels;

    2011-01-01

    The use of highly active antiretroviral treatment (HAART) regimens with unboosted protease inhibitors (PIs) has resulted in a high level of virological failure primarily due to the development of resistant virus. Current boosted PI regimens combine successfully low-dose ritonavir (r) with a second...... PI. The aim of the study was to estimate the proportion of patients, in a population based setting, who develop virological failure on a PI/r regimen. Through The Danish HIV Cohort Study 1,007 patients who received PI/r based treatment between 1995 and 2008 were identified. Twenty-three (2.......3%) experienced virological failure, of whom 19 (83%) started PI/r treatment before 2001. Patients from Copenhagen (n=19) were selected to study the development of protease (PR) and gag cleavage site (CS) mutations during PI/r treatment and PI plasma levels at the time of virological failure. Three patients (16...

  11. Non-compliance to anti-hypertensive medication and its associated factors among hypertensives

    International Nuclear Information System (INIS)

    Non-compliance to anti-hypertensive drugs can have negative impact on cardiovascular outcome. Various studies have been conducted on the issue but the factors are not yet explored properly, particularly in Pakistan. This study was conducted to determine the frequency and factors associated with non-compliance to anti-hypertensive medications in Karachi. Methods: This descriptive cross sectional study was conducted on 113 indoor hypertensive patients included by purposive sampling, aged 30 years and above diagnosed at least 6 months back in public sector tertiary care institutes of Karachi from March to October 2011. Data was collected through a questionnaire in Urdu. Demographic data, hypertension diagnosis, medical co-morbidity, current number of anti-hypertensive medicines, frequency of missing prescribed antihypertensive therapy and other factors affecting compliance pertaining to medicines, patient, physician and health care centre were included in the questionnaire. Results: This study revealed that 68.14% patients were non-compliant. Non-compliance was found to be associated with gender and socioeconomic status. Duration of hypertension, duration between follow up visits to physician, number of drugs, careless attitude, role of physician and limiting access to health care center are found to be important factors in non-compliance. Conclusions: Multiple factors including patients, medicine and health care system related, which can be prevented with simple measures, were found responsible for higher prevalence of non-compliance against anti-hypertensive medicines. (author)

  12. Physician adherence to hypertension treatment guidelines and drug acquisition costs of antihypertensive drugs at the cardiac clinic: a pilot study

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    Abdulameer SA

    2012-01-01

    Full Text Available Shaymaa Abdalwahed Abdulameer1, Mohanad Naji Sahib1, Noorizan Abd Aziz1,2, Yahaya Hassan1,2, Hadeer Akram Abdul AlRazzaq1, Omar Ismail31School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia; 2Faculty of Pharmacy, Universiti Teknologi MARA (UiTM, 42300 Puncak Alam, Selangor, Malaysia; 3Hospital Pulau Pinang, 10900, Penang, MalaysiaAbstract: Prescribing pattern surveys are one of the pharmacoepidemiological techniques that provide an unbiased picture of prescribing habits. Prescription surveys permit the identification of suboptimal prescribing patterns for further evaluation. The aims of this study were to determine the prescribing trend, adherence of the prescribers to the guideline, and the impact of drug expenditure on drug utilization at the cardiac clinic of Penang Hospital, Malaysia. This was a cross-sectional study. Demographic data of the patients, diagnoses and the drugs prescribed were recorded. The average drug acquisition costs (ADAC were calculated for each antihypertensive drug class on a daily and annual basis. Adherence to the guideline was calculated as a percentage of the total number of patients. A total of 313 individuals fulfilled the inclusion criteria. The average age of the study population was 59.30 ± 10.35 years. The mean number of drugs per prescription in the study was 2.09 ± 0.78. There were no significant differences in the demographic data. Antihypertensive drugs were used in monotherapy and polytherapy in 20.8% and 79.2% of the patients, respectively. Adherence to the guideline regarding prescription occurred in 85.30% of the patients. The lowest priced drug class was diuretics and the highest was angiotensin-receptor blockers. In conclusion, the total adherence to the guideline was good; the adherence percentage only slightly decreased with a co-existing comorbidity (such as diabetes mellitus. The use of thiazide diuretics was encouraged because they are well tolerated and

  13. Antihypertensive Treatment and Change in Blood Pressure Are Associated With the Progression of White Matter Lesion Volumes: The Three-City (3C)-Dijon Magnetic Resonance Imaging Study

    International Nuclear Information System (INIS)

    Background-Blood pressure (BP) is recognized as a major risk factor for white matter lesions (WMLs), but longitudinal data are scarce, and there is insufficient evidence for the benefit of antihypertensive therapy on WML progression. We studied the relationship between BP change and WML volume progression over time in a sample of 1319 elderly individuals who had 2 cerebral magnetic resonance imaging examinations 4 years apart. We also examined the impact of antihypertensive treatment on WML progression. Methods and Results-Subjects were participants from the Three-City (3C)-Dijon Magnetic Resonance Imaging Study, a prospective population-based cohort of elderly ≥65 years of age. WML volumes and their progression were estimated with the use of a fully automatic procedure. We performed ANCOVA models first to assess the association between BP change and WML progression and second to estimate the relation between antihypertensive treatment and WML load progression. Baseline and change in BP were significant predictors of higher WML progression over time after controlling for potential confounders. Among subjects with high SBP (160 mm Hg) at baseline not treated by antihypertensive medication, antihypertensive treatment started within 2 years was related to a smaller increase in WML volume at a 4-year follow-up (0.24 cm3; SE0.44 cm3) than no hypertensive treatment (1.60 cm3; SE0.26 cm3; P0.0008) on multivariable modeling. Conclusions-Our findings reinforce the hypothesis that hypertension is a strong predictor of WML and that adequate treatment may reduce the course of WML progression. Because WMLs are linked to both dementia and stroke risks, these results could have implications for future preventive trials. (authors)

  14. PHARMACOEPIDEMIOLOGICAL STUDY OF DOCTORS HABITS IN PRESCRIPTIONS OF ANTIHYPERTENSIVE DRUGS IN TOWN OF OREL

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    G. I. Shvets

    2008-01-01

    Full Text Available Aim. To compare prescriptions of antihypertensive drugs in town of Orel with these in Russia in the whole.Material and methods. 23 cardiologists and 78 internists of Orel town were questioned about antihypertensive drug prescriptions in 2006.Results. ACE inhibitors, diuretics, beta-blockers, calcium channels antagonists were prescribed in order of popularity decreasing as mono- or combined therapy. About 70 % of doctors prescribed pharmacotherapy, which cost 100 to 500 rubles per months. Not rational combinations were prescribed in 4,7% of cases. Only 55,4% of respondents used blood pressure level less than 140/90 mm Hg as a target one.Conclusion. Antihypertensive drug prescription for mono- or combined therapy was in accordance to modern guidelines but in the some cases did not meet them.

  15. Antihypertensive and antioxidant effects of hydroalcoholic extract from the aerial parts of Kelussia odoratissima Mozaff. in dexamethasone-induced hypertensive rats

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    Leila Safaeian

    2016-01-01

    Conclusions: These results suggest antihypertensive and antioxidant effects of K. odoratissima extract in Dex-induced hypertension. Further studies are needed to elucidate the exact mechanism of the antihypertensive effect of this herbal medicine.

  16. Combined traditional medicine and pharmacological antihypertensive drugs in a rural community of West Java, Indonesia

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    Bastaman Basuki

    2004-12-01

    Full Text Available Some hypertensive subjects in Indonesia consume traditional herbal medicines in addition to the usual pharmacological drugs. This paper studied the relationship between several traditional herbal medicines, such as morinda, star fruit, garlic, or jamu, believed to control hypertension and the risk of current pharmacological antihypertensive drug users in subjects with stage 1 and 2 hypertension in a rural community West Java, Indonesia. The data were obtained from 3 field studies by the second year medical students of the Faculty of Medicine, University of Indonesia conducted in 2001, 2002, and 2003 in a subdistrict of the Bogor regency. The subjects were selected randomly from neighborhood clusters. Interviews and blood pressure measurements were conducted at the houses of the subjects by specially trained second year medical students supervised by faculty members. There were 496 subjects with stage 1 or 2 hypertension, with 11.5% under current antihypertensive drugs. Compared with the hypertension stage 1 subjects, hypertension stage 2 subjects were 5.4 times more likely to be currently taking pharmacological antihypertensive medication (adjusted odds ratio = 5.44; 95% confidence interval = 2.64-11.27. The combined of current antihypertensive medication with traditional medicines were cucumber which being the most dominant followed by star fruit and morinda. Reasons for this were probably the strong influence of culture, the limited medical facilities, and high cost of the antihypertensive drugs. It was concluded that in a rural Indonesia, it was common for hypertensive subjects to take pharmacological drugs as well as traditional medicine for antihypertensive therapy. (Med J Indones 2004; 13: 246-51Keywords: hypertension, pharmacological drugs, traditional medicine, Indonesia

  17. Do advertisements for antihypertensive drugs in Australia promote quality prescribing? A cross-sectional study

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    Spurling Geoffrey K

    2008-05-01

    Full Text Available Abstract Background Antihypertensive medications are widely prescribed by doctors and heavily promoted by the pharmaceutical industry. Despite strong evidence of the effectiveness and cost-effectiveness of thiazide diuretics, trends in both promotion and prescription of antihypertensive drugs favour newer, less cost-effective agents. Observational evidence shows correlations between exposure to pharmaceutical promotion and less ideal prescribing. Our study therefore aimed to determine whether print advertisements for antihypertensive medications promote quality prescribing in hypertension. Methods We performed a cross-sectional study of 113 advertisements for antihypertensive drugs from 4 general practice-oriented Australian medical publications in 2004. Advertisements were evaluated using a quality checklist based on a review of hypertension management guidelines. Main outcome measures included: frequency with which antihypertensive classes were advertised, promotion of thiazide class drugs as first line agents, use of statistical claims in advertisements, mention of harms and prices in the advertisements, promotion of assessment and treatment of cardiovascular risk, promotion of lifestyle modification, and targeting of particular patient subgroups. Results Thiazides were the most frequently advertised drug class (48.7% of advertisements, but were largely promoted in combination preparations. The only thiazide advertised as a single agent was the most expensive, indapamide. No advertisement specifically promoted any thiazide as a better first-line drug. Statistics in the advertisements tended to be expressed in relative rather than absolute terms. Drug costs were often reported, but without cost comparisons between drugs. Adverse effects were usually reported but largely confined to the advertisements' small print. Other than mentioning drug interactions with alcohol and salt, no advertisements promoted lifestyle modification. Few

  18. Use of antihypertensive medications in patients with type -2 diabetes in Ajman, UAE.

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    Mohammed Arifulla

    2015-02-01

    Full Text Available Optimal reduction in blood pressure with antihypertensive agents helps to prevent microvascular and macrovascular complications of diabetes. The objective of the study was to evaluate the current utilization pattern of antihypertensive medications among patients with diabetes and coexistent hypertension as per the JNC seventh report guidelines. A Cross-sectional survey was conducted among patients with diabetes attending outpatient department of Internal Medicine at a hospital at Ajman. Medical records of patients were used to obtain diagnostic, demographic and drug use information. Univariate analysis was performed using Chi-square and t- test followed by logistic regression to compute independent predictors. Of 132 patients with diabetes, uncomplicated hypertension (HTN was coexistent in 81% (107/132 of patients. Males constituted 49.5% (53/107 of the total. Mean (SD age of patients with HTN was 55.1(10.1 years higher than those without HTN 49.6 (9.9 years (P5 years (P=0.04. While adjusting the significant factors, only duration of diabetes was statistically significant (adjusted OR=1.06; CI 95% (1.003-1.116 P= 0.03 among patients with HTN. 63.6% (68/107 prescriptions contained one drug antihypertensive drug, 27.1 % (29/107 two drugs and 7.4% (8/107 no anti-hypertensive drug were prescribed. Angiotensin converting enzyme inhibitors/ Angiotensin receptor blockers (ACEI/ARBs followed by diuretics were commonly prescribed drugs. ARBs with diuretics were the most frequent two drug combinations. The antihypertensive utilization pattern was similar in both gender and age groups. Results represent the current prescribing trend for anti-hypertensive agents among patients with diabetes that is in accordance with JNC-7 recommendations.

  19. Change in antihypertensive drug prescribing after guideline implementation: a controlled before and after study

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    Helin-Salmivaara Arja

    2011-08-01

    Full Text Available Abstract Background Antihypertensive drug choices and treatment levels are not in accordance with the existing guidelines. We aimed to assess the impact of a guideline implementation intervention on antihypertensive drug prescribing. Methods In this controlled before and after study, the effects of a multifaceted (education, audit and feedback, local care pathway quality programme was evaluated. The intervention was carried out in a health centre between 2002 and 2003. From each health care unit (n = 31, a doctor-nurse pair was trained to act as peer facilitators in the intervention. All antihypertensive drugs prescribed by 25 facilitator general practitioners (intervention GPs and 53 control GPs were retrieved from the nationwide Prescription Register for three-month periods in 2001 and 2003. The proportions of patients receiving specific antihypertensive drugs and multiple antihypertensive drugs were measured before and after the intervention for three subgroups of hypertension patients: hypertension only, with coronary heart disease, and with diabetes. Results In all subgroups, the use of multiple concurrent medications increased. For intervention patients with hypertension only, the odds ratio (OR was 1.12 (95% CI 0.99, 1.25; p = 0.06 and for controls 1.13 (1.05, 1.21; p = 0.002. We observed no statistically significant differences in the change in the prescribing of specific antihypertensive agents between the intervention and control groups. The use of agents acting on the renin-angiotensin-aldosterone system increased in all subgroups (hypertension only intervention patients OR 1.19 (1.06, 1.34; p = 0.004 and controls OR 1.24 (1.15, 1.34; p Conclusions A multifaceted guideline implementation intervention does not necessarily lead to significant changes in prescribing performance. Rigorous planning of the interventions and quality projects and their evaluation are essential.

  20. Opportunities for Web-based Drug Repositioning: Searching for Potential Antihypertensive Agents with Hypotension Adverse Events

    Science.gov (United States)

    Wang, Kejian; Wan, Mei; Wang, Rui-Sheng

    2016-01-01

    Background Drug repositioning refers to the process of developing new indications for existing drugs. As a phenotypic indicator of drug response in humans, clinical side effects may provide straightforward signals and unique opportunities for drug repositioning. Objective We aimed to identify drugs frequently associated with hypotension adverse reactions (ie, the opposite condition of hypertension), which could be potential candidates as antihypertensive agents. Methods We systematically searched the electronic records of the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) through the openFDA platform to assess the association between hypotension incidence and antihypertensive therapeutic effect regarding a list of 683 drugs. Results Statistical analysis of FAERS data demonstrated that those drugs frequently co-occurring with hypotension events were more likely to have antihypertensive activity. Ranked by the statistical significance of frequent hypotension reporting, the well-known antihypertensive drugs were effectively distinguished from others (with an area under the receiver operating characteristic curve > 0.80 and a normalized discounted cumulative gain of 0.77). In addition, we found a series of antihypertensive agents (particularly drugs originally developed for treating nervous system diseases) among the drugs with top significant reporting, suggesting the good potential of Web-based and data-driven drug repositioning. Conclusions We found several candidate agents among the hypotension-related drugs on our list that may be redirected for lowering blood pressure. More important, we showed that a pharmacovigilance system could alternatively be used to identify antihypertensive agents and sustainably create opportunities for drug repositioning. PMID:27036325

  1. Endothelial effects of antihypertensive treatment: focus on irbesartan

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    Roberto Negro

    2008-03-01

    cells. In this view, the blockade of the renin-angiotensin system (RAS, has been shown to positively affect the endothelial function, beyond the antihypertensive action displayed by these compounds. In this review, attention has been specifically focused on an ARB, irbesartan, to examine its effects on endothelial function.Keywords: angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, endothelial dysfunction, irbesartan

  2. Effect of Discontinuation of Antihypertensive Treatment in Elderly People on Cognitive Functioning-the DANTE Study Leiden

    DEFF Research Database (Denmark)

    Moonen, Justine E F; Foster-Dingley, Jessica C; de Ruijter, Wouter;

    2015-01-01

    Antihypertensive Treatment in Elderly People (DANTE) Study Leiden from June 26, 2011, through August 23, 2013 (follow-up, December 16, 2013). Intention-to-treat analyses were performed from January 20 through April 11, 2014. INTERVENTIONS: Discontinuation (n = 199) vs continuation (n = 186) of antihypertensive...

  3. The antihypertensive effect of fermented milk in individuals with prehypertension or borderline hypertension

    DEFF Research Database (Denmark)

    Usinger, Lotte; Jensen, L T; Flambard, B;

    2010-01-01

    Fermented milk (FM) with putative antihypertensive effect in humans could be an easy applicable lifestyle intervention against hypertension. The mode of action is supposed to be through active milk peptides, shown to possess in vitro ACE-inhibitory effect. Blood pressure (BP) reductions upto 23¿mm......-blind placebo-controlled study of the antihypertensive effect of Lactobacillus helveticus FM in 94 prehypertensive and borderline hypertensive subjects. The participants were randomised into three treatment groups with a daily intake of 150¿ml of FM, 300¿ml of FM or placebo (chemically acidified milk). The...

  4. Cutaneous tuberculosis overview and current treatment regimens.

    Science.gov (United States)

    van Zyl, Lindi; du Plessis, Jeanetta; Viljoen, Joe

    2015-12-01

    Tuberculosis is one of the oldest diseases known to humankind and it is currently a worldwide threat with 8-9 million new active disease being reported every year. Among patients with co-infection of the human immunodeficiency virus (HIV), tuberculosis is ultimately responsible for the most deaths. Cutaneous tuberculosis (CTB) is uncommon, comprising 1-1.5% of all extra-pulmonary tuberculosis manifestations, which manifests only in 8.4-13.7% of all tuberculosis cases. A more accurate classification of CTB includes inoculation tuberculosis, tuberculosis from an endogenous source and haematogenous tuberculosis. There is furthermore a definite distinction between true CTB caused by Mycobacterium tuberculosis and CTB caused by atypical mycobacterium species. The lesions caused by mycobacterium species vary from small papules (e.g. primary inoculation tuberculosis) and warty lesions (e.g. tuberculosis verrucosa cutis) to massive ulcers (e.g. Buruli ulcer) and plaques (e.g. lupus vulgaris) that can be highly deformative. Treatment options for CTB are currently limited to conventional oral therapy and occasional surgical intervention in cases that require it. True CTB is treated with a combination of rifampicin, ethambutol, pyrazinamide, isoniazid and streptomycin that is tailored to individual needs. Atypical mycobacterium infections are mostly resistant to anti-tuberculous drugs and only respond to certain antibiotics. As in the case of pulmonary TB, various and relatively wide-ranging treatment regimens are available, although patient compliance is poor. The development of multi-drug and extremely drug-resistant strains has also threatened treatment outcomes. To date, no topical therapy for CTB has been identified and although conventional therapy has mostly shown positive results, there is a lack of other treatment regimens. PMID:26616847

  5. Twice-daily insulin regimens in management of severe diabetes.

    OpenAIRE

    Oakley, N; Mather, H; Hadley, L.; Lynch, J.; Pilkington, T

    1981-01-01

    Diurnal glucose profiles have been compared in ten insulin dependent diabetics receiving, firstly, a twice-daily soluble insulin (SI): isophane insulin (NPHI) insulin (30% SI, 70% NPHI). For each patient the two regimens gave similar profiles though nocturnal blood glucose control was better on Mixtard. HbA1 values were similar on the two regimens. The findings show that, using highly purified formulations, small changes in insulin proportions in twice-daily SI: NPHI regimens may be irrelevan...

  6. Systemic antihypertensive medication and incident open-angle glaucoma

    NARCIS (Netherlands)

    Muskens, Rogier P. H. M.; de Voogd, Simone; Wolfs, Roger C. W.; Witteman, Jacqueline C. M.; Hofman, Albert; de Jong, Paulus T. V. M.; Stricker, Bruno H. C.; Jansonius, Nomdo M.

    2007-01-01

    Purpose: To determine the association between systemic anti hypertensive medication and incident open-angle glaucoma. Design: Prospective population-based cohort study. Participants: The study population consisted of a subset of 3842 participants of the Rotterdam Study for whom data from identical o

  7. Antihypertensive drug use by children: are the drugs labeled and indicated?

    OpenAIRE

    Welch, W. Pete; Yang, Wenya; Taylor-Zapata, Perdita; Flynn, Joseph T

    2012-01-01

    As a result of the FDA Modernization Act and Best Pharmaceuticals for Children Act, the number of medications with FDA-approved pediatric labeling has increased. To assess the success of these initiatives, we examined whether antihypertensive drugs used by hypertensive children in 2008 had FDA-approved pediatric labeling and indications.

  8. How Do Antihypertensive Drugs Work? Insights from Studies of the Renal Regulation of Arterial Blood Pressure.

    Science.gov (United States)

    Digne-Malcolm, Holly; Frise, Matthew C; Dorrington, Keith L

    2016-01-01

    Though antihypertensive drugs have been in use for many decades, the mechanisms by which they act chronically to reduce blood pressure remain unclear. Over long periods, mean arterial blood pressure must match the perfusion pressure necessary for the kidney to achieve its role in eliminating the daily intake of salt and water. It follows that the kidney is the most likely target for the action of most effective antihypertensive agents used chronically in clinical practice today. Here we review the long-term renal actions of antihypertensive agents in human studies and find three different mechanisms of action for the drugs investigated. (i) Selective vasodilatation of the renal afferent arteriole (prazosin, indoramin, clonidine, moxonidine, α-methyldopa, some Ca(++)-channel blockers, angiotensin-receptor blockers, atenolol, metoprolol, bisoprolol, labetolol, hydrochlorothiazide, and furosemide). (ii) Inhibition of tubular solute reabsorption (propranolol, nadolol, oxprenolol, and indapamide). (iii) A combination of these first two mechanisms (amlodipine, nifedipine and ACE-inhibitors). These findings provide insights into the actions of antihypertensive drugs, and challenge misconceptions about the mechanisms underlying the therapeutic efficacy of many of the agents. PMID:27524972

  9. Anti-hypertensive drugs have different effects on ventricular hypertrophy regression

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    Celso Ferreira Filho

    2010-01-01

    Full Text Available OBJECTIVES: There is a direct relationship between the regression of left ventricular hypertrophy (LVH and a decreased risk of mortality. This investigation aimed to describe the effects of anti-hypertensive drugs on cardiac hypertrophy through a meta-analysis of the literature. METHODS: The Medline (via PubMed, Lilacs and Scielo databases were searched using the subject keywords cardiac hypertrophy, antihypertensive and mortality. We aimed to analyze the effect of anti-hypertensive drugs on ventricle hypertrophy. RESULTS: The main drugs we described were enalapril, verapamil, nifedipine, indapamina, losartan, angiotensin-converting enzyme inhibitors and atenolol. These drugs are usually used in follow up programs, however, the studies we investigated used different protocols. Enalapril (angiotensin-converting enzyme inhibitor and verapamil (Ca++ channel blocker caused hypertrophy to regress in LVH rats. The effects of enalapril and nifedipine (Ca++ channel blocker were similar. Indapamina (diuretic had a stronger effect than enalapril, and losartan (angiotensin II receptor type 1 (AT1 receptor antagonist produced better results than atenolol (selective β1 receptor antagonist with respect to LVH regression. CONCLUSION: The anti-hypertensive drugs induced various degrees of hypertrophic regression.

  10. Time course and mechanisms of the anti-hypertensive and renal effects of liraglutide treatment

    DEFF Research Database (Denmark)

    von Scholten, B J; Lajer, M; Goetze, J P;

    2015-01-01

    AIMS: Glucagon-like peptide-1 receptor agonist studies have revealed clinically significant reductions in systolic blood pressure (SBP). The aim was to investigate the time course of the anti-hypertensive effect of liraglutide treatment and potential underlying mechanisms. METHODS: We used an open...

  11. Effect of antihypertensive drugs on cardiac enzymes in hypertension with myocardial infarction in NIDDM

    OpenAIRE

    Kamble, M. M.; Vaidya, S. M.

    2002-01-01

    Enzymology is a diagnostic indicator for myocardial infarction and diabetes in hypertension patients. Therefore the selection of methods for measurement of cardiac enzyme, Aspartate transaminase (AST), Creatine kinase(CK), and isoenzyme of creatine kinase (MB form), determine the effectiveness of antihypertension drug would provide the physician with diagnostic and prognostic clinical evidence.

  12. The effects of antideperessant treatment on efficacy of antihypertensive therapy in elderly hypertension

    Institute of Scientific and Technical Information of China (English)

    才晓君

    2006-01-01

    Objective To explore the effect of antidepressant treatment on antihypertensive therapy of senile hypertension. Methods 138 cases of senile hypertension complicating with depression were studied. 103 senile hypertensive patients without depression in the same period served as controls. The patients were randomly divided into 3 groups as A, B and C for study. 12.5 mg/d

  13. One-Week Antihypertensive Effect of Ile-Gln-Pro in Spontaneously Hypertensive Rats

    NARCIS (Netherlands)

    Lu, Jun; Sawano, Yoriko; Miyakawa, Takuya; Xue, You-Lin; Cai, Mu-Yi; Egashira, Yukari; Ren, Di-Feng; Tanokura, Masaru

    2011-01-01

    The antihypertensive effect of an angiotensin I-converting enzyme (ACE) inhibitory peptide lie-Gin-Pro (IQP), whose sequence was derived from Spirulina platensis, was investigated in spontaneously hypertensive rats (SHRs) for 1 week. The weighted systolic blood pressure (SBP) and diastolic blood pre

  14. Factors affecting adherence to antihypertensive medication in Greece: results from a qualitative study

    Directory of Open Access Journals (Sweden)

    Vassiliki Tsiantou

    2010-08-01

    Full Text Available Vassiliki Tsiantou1, Polina Pantzou2, Elpida Pavi1, George Koulierakis2, John Kyriopoulos11Department of Health Economics, National School of Public Health, Athens, Greece; 2Department of Sociology, National School of Public Health, Athens, GreeceIntroduction: Although hypertension constitutes a major risk factor for cardiovascular morbidity and mortality, research on adherence to antihypertensive treatment has shown that at least 75% of patients are not adherent because of the combined demographic, organizational, psychological, and disease- and medication-related factors. This study aimed to elicit hypertensive patients’ beliefs on hypertension and antihypertensive treatment, and their role to adherence.Methods: Transcripts from semistructured interviews and focus groups were content analyzed to extract participants’ beliefs about hypertension and antihypertensive treatment, and attitudes toward patient–physician and patient–pharmacist relationships.Results: Hypertension was considered a very serious disease, responsible for stroke and myocardial infarction. Participants expressed concerns regarding the use of medicines and the adverse drug reactions. Previous experience with hypertension, fear of complications, systematic disease management, acceptance of hypertension as a chronic disease, incorporation of the role of the patient and a more personal relationship with the doctor facilitated adherence to the treatment. On the other hand, some patients discontinued treatment when they believed that they had controlled their blood pressure.Conclusion: Cognitive and communication factors affect medication adherence. Results could be used to develop intervention techniques to improve medication adherence.Keywords: hypertension, medication adherence, patient compliance, doctor–patient communication, antihypertensive medicine

  15. Cost analysis study of oral antihypertensive agents available in Indian market

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    Ashwini V. Karve

    2014-06-01

    Conclusion: The average percentage price variation of different brands of the same oral antihypertensive drug manufactured in India is very wide. The appraisal and management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative personal and economic consequences. [Int J Basic Clin Pharmacol 2014; 3(3.000: 479-483

  16. The antihypertensive effect of fermented milk in individuals with prehypertension or borderline hypertension

    DEFF Research Database (Denmark)

    Usinger, Lotte; Jensen, L T; Flambard, B;

    2010-01-01

    -blind placebo-controlled study of the antihypertensive effect of Lactobacillus helveticus FM in 94 prehypertensive and borderline hypertensive subjects. The participants were randomised into three treatment groups with a daily intake of 150 ml of FM, 300 ml of FM or placebo (chemically acidified milk). The...

  17. Cost-effectiveness analysis of guidelines for antihypertensive care in Finland

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    Reunanen Antti

    2007-10-01

    Full Text Available Abstract Background Hypertension is one of the major causes of disease burden affecting the Finnish population. Over the last decade, evidence-based care has emerged to complement other approaches to antihypertensive care, often without health economic assessment of its costs and effects. This study looks at the extent to which changes proposed by the 2002 Finnish evidence-based Current Care Guidelines concerning the prevention, diagnosis, and treatment of hypertension (the ACCG scenario can be considered cost-effective when compared to modelled prior clinical practice (the PCP scenario. Methods A decision analytic model compares the ACCG and PCP scenarios using information synthesised from a set of national registers covering prescription drug reimbursements, morbidity, and mortality with data from two national surveys concerning health and functional capacity. Statistical methods are used to estimate model parameters from Finnish data. We model the potential impact of the different treatment strategies under the ACCG and PCP scenarios, such as lifestyle counselling and drug therapy, for subgroups stratified by age, gender, and blood pressure. The model provides estimates of the differences in major health-related outcomes in the form of life-years and costs as calculated from a 'public health care system' perspective. Cost-effectiveness analysis results are presented for subgroups and for the target population as a whole. Results The impact of the use of the ACCG scenario in subgroups (aged 40–80 without concomitant cardiovascular and related diseases is mainly positive. Generally, costs and life-years decrease in unison in the lowest blood pressure group, while in the highest blood pressure group costs and life-years increase together and in the other groups the ACCG scenario is less expensive and produces more life-years. When the costs and effects for subgroups are combined using standard decision analytic aggregation methods, the ACCG

  18. Incidence of pregnancy induced hypertension and prescription pattern of antihypertensive drugs in pregnancy

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    MANJUSHA SAJITH

    2014-04-01

    Full Text Available Aim: To determine the frequency and distribution of different types of hypertensive disorders of pregnancy and to assess the drug utilization pattern of antihypertensive drugs in pregnancy. Method: A prospective study was conducted over a period of one year in inpatients of Gynaecology and Obstetrics Department at Bharati Hospital, Pune. Patients diagnosed as hypertensive disorder of pregnancy were taken for primary evaluation. The data regarding demographic details, presenting complaints, gestational age, obstetrics history, diagnosis, blood pressure monitoring, current medications, antihypertensive drugs prescribed were collected and the utilization of antihypertensive drugs in pregnancy was evaluated. Result: A total of 1330 pregnant women visited the OBG department, out of which 104 patients were diagnosed with hypertension. The overall prevalence of hypertensive disorders in pregnancy was 7.8%. The mean maternal age was 23.8 years during the hospital admission. The prevalence of Preeclampsia, gestational hypertension, chronic hypertension, and eclampsia were 5.6 %, 1.5%, 0.15 %, and 0.60 % respectively. Highest incidence of hypertension was occurred in age group of 18-22 years (41.3% and primigravidae patients (53.8%. A majority of patients 67.3 % were on combination therapy whereas 32.7% were on Monotherapy. Methyldopa was the commonest prescribed antihypertensive as monotherapy (17.3 % as well as in combination therapy (i.e. 28.8 % with methyldopa and Nifedipine. Conclusion: Our study concluded that the incidence of hypertensive disorders in pregnancy was high. Methyldopa was the commonest prescribed antihypertensive in monotherapy and combination, as it is safest during pregnancy.

  19. National Variation in Use of Immunosuppression for Kidney Transplantation: A Call for Evidence-Based Regimen Selection.

    Science.gov (United States)

    Axelrod, D A; Naik, A S; Schnitzler, M A; Segev, D L; Dharnidharka, V R; Brennan, D C; Bae, S; Chen, J; Massie, A; Lentine, K L

    2016-08-01

    Immunosuppression management in kidney transplantation has evolved to include an increasingly diverse choice of medications. Although informed by patient and donor characteristics, choice of immunosuppression regimen varies widely across transplant programs. Using a novel database integrating national transplant registry and pharmacy fill records, immunosuppression use at 6-12 and 12-24 mo after transplant was evaluated for 22 453 patients transplanted in 249 U.S. programs in 2005-2010. Use of triple immunosuppression comprising tacrolimus, mycophenolic acid or azathioprine, and steroids varied widely (0-100% of patients per program), as did use of steroid-sparing regimens (0-77%), sirolimus-based regimens (0-100%) and cyclosporine-based regimens (0-78%). Use of triple therapy was more common in highly sensitized patients, women and recipients with dialysis duration >5 years. Sirolimus use appeared to diminish over the study period. Patient and donor characteristics explained only a limited amount of the observed variation in regimen use, whereas center choice explained 30-46% of the use of non-triple-therapy immunosuppression. The majority of patients who received triple-therapy (79%), cyclosporine-based (87.6%) and sirolimus-based (84.3%) regimens continued them in the second year after transplant. This population-based study of immunosuppression practice demonstrates substantial variation in center practice beyond that explained by differences in patient and donor characteristics. PMID:26901466

  20. The Sex Res Non Naturales and the Regimen of Health

    DEFF Research Database (Denmark)

    Agerholm, Frank Juul

    The paper discusses the ethical and social soundness of the classical idea of diaita/regimen vis-à-vis the contemporary focus on healthy lifestyle......The paper discusses the ethical and social soundness of the classical idea of diaita/regimen vis-à-vis the contemporary focus on healthy lifestyle...

  1. Analysis of combination drug therapy to develop regimens with shortened duration of treatment for tuberculosis.

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    George L Drusano

    Full Text Available Tuberculosis remains a worldwide problem, particularly with the advent of multi-drug resistance. Shortening therapy duration for Mycobacterium tuberculosis is a major goal, requiring generation of optimal kill rate and resistance-suppression. Combination therapy is required to attain the goal of shorter therapy.Our objective was to identify a method for identifying optimal combination chemotherapy. We developed a mathematical model for attaining this end. This is accomplished by identifying drug effect interaction (synergy, additivity, antagonism for susceptible organisms and subpopulations resistant to each drug in the combination.We studied the combination of linezolid plus rifampin in our hollow fiber infection model. We generated a fully parametric drug effect interaction mathematical model. The results were subjected to Monte Carlo simulation to extend the findings to a population of patients by accounting for between-patient variability in drug pharmacokinetics.All monotherapy allowed emergence of resistance over the first two weeks of the experiment. In combination, the interaction was additive for each population (susceptible and resistant. For a 600 mg/600 mg daily regimen of linezolid plus rifampin, we demonstrated that >50% of simulated subjects had eradicated the susceptible population by day 27 with the remaining organisms resistant to one or the other drug. Only 4% of patients had complete organism eradication by experiment end.These data strongly suggest that in order to achieve the goal of shortening therapy, the original regimen may need to be changed at one month to a regimen of two completely new agents with resistance mechanisms independent of the initial regimen. This hypothesis which arose from the analysis is immediately testable in a clinical trial.

  2. Pharmacokinetic estimation for therapeutic dosage regimens (PETDR)--a software program designed to determine intravenous drug dosage regimens for veterinary applications.

    Science.gov (United States)

    Riviere, J E; Frazier, D L; Tippitt, W L

    1988-12-01

    Pharmacokinetic estimation for therapeutic dosage regimens (PETDR) is a soft-ware program used to design individualized intravenous dosage regimens, determine concentration-time profiles, predict serum concentrations at a specific time after intravenous dosing and predict the time after the last dose to achieve a specified concentration of drug. The reference pharmacokinetic parameters may be based on an individual animal's pharmacokinetic disposition of drug or on FARAD (Food Animal Residue Avoidance Databank) mean population kinetic parameters. An individual animal's kinetic parameters may be input for predetermined analysis or the program can calculate these values by input of raw serum concentration-time data. The program allows the user to specify certain parameters of the dosage regimen, then calculates the other parameters (given desired maximum and minimum serum concentrations, dose and interval are calculated; given desired maximum serum concentration and interval, dose is calculated, etc.). Given the kinetic parameters, the dose and dosing interval, the program calculates and plots the serum concentration-time profile of the drug for that animal. The time and the number of doses to reach steady state can be calculated as well as the determination of loading dose. The percentage of the time of a dosing interval at steady state that the serum concentration is above a specific minimum inhibitory concentration (MIC) allows evaluation of efficacy of an antimicrobial regimen. Similarly, the time to reach a specific concentration (e.g. residue tolerance) or the MIC of a drug can be calculated. Legal tissue tolerances can be accessed from FARAD to aid in predicting for what period of time illegal residues will remain in the animal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3210265

  3. Hybrid Therapy Regimen for Helicobacter Pylori Eradication

    Science.gov (United States)

    Song, Zhi-Qiang; Liu, Jian; Zhou, Li-Ya

    2016-01-01

    Objective: Helicobacter pylori (H. pylori) eradication remains a challenge with increasing antibiotic resistance. Hybrid therapy has attracted widespread attention because of initial report with good efficacy and safety. However, many issues on hybrid therapy are still unclear such as the eradication efficacy, safety, compliance, influencing factors, correlation with antibiotic resistance, and comparison with other regimens. Therefore, a comprehensive review on the evidence of hybrid therapy for H. pylori infection was conducted. Data Sources: The data used in this review were mainly from PubMed articles published in English up to September 30, 2015, searching by the terms of “Helicobacter pylori” or “H. pylori”, and “hybrid”. Study Selection: Clinical research articles were selected mainly according to their level of relevance to this topic. Results: Totally, 1871 patients of 12 studies received hybrid therapy. The eradication rates were 77.6–97.4% in intention-to-treat and 82.6–99.1% in per-protocol analyses. Compliance was 93.3–100.0%, overall adverse effects rate was 14.5–67.5%, and discontinued medication rate due to adverse effects was 0–6.7%. H. pylori culture and sensitivity test were performed only in 13.3% patients. Pooled analysis showed that the eradication rates with dual clarithromycin and metronidazole susceptible, isolated metronidazole or clarithromycin resistance, and dual clarithromycin and metronidazole resistance were 98.5%, 97.6%, 92.9%, and 80.0%, respectively. Overall, the efficacy, compliance, and safety of hybrid therapy were similar with sequential or concomitant therapy. However, hybrid therapy might be superior to sequential therapy in Asians. Conclusions: Hybrid therapy showed wide differences in the efficacy but consistently good compliance and safety across different regions. Dual clarithromycin and metronidazole resistance were the key factor to efficacy. Hybrid therapy was similar to sequential or concomitant

  4. Efficacy of 7-Day and 14-Day Triple Therapy Regimens for the Eradication of Helicobacter pylori: A Comparative Study in a Cohort of Romanian Patients

    Science.gov (United States)

    Arama, Stefan Sorin; Tiliscan, Catalin; Negoita, Cristina; Croitoru, Alexandru; Arama, Victoria; Mihai, Carmen Marina; Pop, Florinel

    2016-01-01

    Objective. This study compared the eradication rates of of Helicobacter pylori (HP) infection by a 7-day and 14-day anti-HP regimen. Materials and Methods. An open, randomized, prospective study was performed to evaluate the response to anti-HP treatment in adult HP-positive patients following a 7-day course (Regimen A) of a proton pump inhibitor in association with clarithromycin and amoxicillin compared to a 14-day course (Regimen B). Gastric biopsies were performed at baseline and two months after anti-HP treatment. Results. Seventy-eight patients aged 18–64 years (28 males, 50 females) diagnosed with HP infection were included. Fifty-two (66.7%) patients received Regimen B and 26 (33.3%) Regimen A. The overall eradication rate was 70.5%. Better treatment response (p duodenal lesions in both regimens. Younger patients ≤35 years had a better response to Regimen B. Better treatment response was seen in women, urban residents, and those with tertiary level of education in both groups. Conclusion. 14-day anti-HP regimen offered a significant better overall eradication of HP in study population. PMID:26858750

  5. Among once-daily regimens, single tablet regimens (STRs are associated with better adherence

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    R Murri

    2012-11-01

    Full Text Available Previous published evidences showed that taking HAART once-daily (OD is associated to better adherence when compared to BID or TID regimens. However, no further studies investigated whether, among OD regimens, adherence levels can be differently influenced. Aim of the study was to evaluate levels of self-reported adherence in HIV+ people according to type of HAART dosing (STR, OD with more than one pill or BID. To limit reporting biases, the study was performed in five different non-clinic settings covering North and Central Italy. A total of 230 patients on stable HAART were asked to complete a semi-structured, anonymous questionnaire reporting their attitude toward HAART, their adherence and the acceptability of their regimen. Self-perception of adherence was also investigated with a single item for comparison with real adherence behavior. Most of the subjects were males (66% with a mean age of 46 years, with higher education level (72% and a long history of HIV infection (mean 13.6 years. 17% of patients were on a first-line regimen. 21% reported to miss at least one dose during the past week (STR: 6%; OD >1 pill 23% and BID 21%; p<0.05. People taking STR and BID tend to report less discontinuations (all the drug of the day for at least 3 times in a month compared to OD>1 pill (6 and 4% vs 11%. People taking therapies other than HAART reported similar adherence levels of people taking only HAART, even when stratified for dosing groups. Even people judging their adherence as ‘optimal’ or ‘very good’, 10 and 17% respectively, reported having missed a dose during the last week. At stepwise regression model, optimal adherence was correlated to being male (OR: 2.38; 95% CI: 1.19–4.74, younger (OR: 3.04; 95% CI: 1.01–9.13 and with a shorter HIV infection (OR: 3.58; 95% CI: 1.04–12.38. People taking simpler once-daily STR tend to report better adherence than people taking OD>1 pill or BID. Perception of optimal adherence is largely

  6. Economic evaluation for first-line anti-hypertensive medicines: applications for the Philippines

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    Geroy Lester Sam Araneta

    2012-12-01

    Full Text Available Abstract Background Medicines to control hypertension, a leading cause of morbidity and mortality, are a major component of health expenditures in the Philippines. This study aims to review economic studies for first line anti-hypertensive medical treatment without co-morbidities; and discuss practical, informational and policy implications on the use of economic evaluation in the Philippines. Methods A systematic literature review was performed using the following databases: MEDLINE, EMBASE, BIOSIS, PubMed, The Cochrane Library, Health Economics Evaluations Database (HEED and the Centre for Reviews and Dissemination – NHS NICE. Six existing economic analytical frameworks were reviewed and one framework for critical appraisal was developed. Results Out of 1336 searched articles, 12 fulfilled the inclusion criteria. The studies were summarized according to their background characteristics (year, journal, intervention and comparators, objective/study question, target audience, economic study type, study population, setting and country and source of funding/conflict of interest and technical characteristics (perspective, time horizon, methodology/modeling, search strategy for parameters, costs, effectiveness measures, discounting, assumptions and biases, results, cost-effectiveness ratio, endpoints, sensitivity analysis, generalizability, strengths and limitations, conclusions, implications and feasibility and recommendations. The studies represented different countries, perspectives and stakeholders. Conclusions Diuretics were the most cost-effective drug class for first-line treatment of hypertension without co-morbidities. Although the Philippine Health Insurance Corporation may apply the recommendations given in previous studies (i.e. to subsidize diuretics, ACE inhibitors and calcium channel blockers, it is uncertain how much public funding is justified. There is an information gap on clinical data (transition probabilities, relative risks

  7. Toward a noncytotoxic glioblastoma therapy: blocking MCP-1 with the MTZ Regimen

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    Salacz ME

    2016-04-01

    Full Text Available Michael E Salacz,1,2 Richard E Kast,3 Najmaldin Saki,4 Ansgar Brüning,5 Georg Karpel-Massler,6 Marc-Eric Halatsch6 1Department of Internal Medicine, 2Department of Neurosurgery, University of Kansas, Kansas City, KS, USA; 3IIAIGC Study Center, Burlington, VT, USA; 4Health Research Institute, Research Center of Thalassemia and Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; 5Molecular Biology Laboratory, University Hospital Munich, Munich, Germany; 6Department of Neurosurgery, University of Ulm, Ulm, Germany Abstract: To improve the prognosis of glioblastoma, we developed an adjuvant treatment directed to a neglected aspect of glioblastoma growth, the contribution of nonmalignant monocyte lineage cells (MLCs (monocyte, macrophage, microglia, dendritic cells that infiltrated a main tumor mass. These nonmalignant cells contribute to glioblastoma growth and tumor homeostasis. MLCs comprise of approximately 10%–30% of glioblastoma by volume. After integration into the tumor mass, these become polarized toward an M2 immunosuppressive, pro-angiogenic phenotype that promotes continued tumor growth. Glioblastoma cells initiate and promote this process by synthesizing 13 kDa MCP-1 that attracts circulating monocytes to the tumor. Infiltrating monocytes, after polarizing toward an M2 phenotype, synthesize more MCP-1, forming an amplification loop. Three noncytotoxic drugs, an antibiotic – minocycline, an antihypertensive drug – telmisartan, and a bisphosphonate – zoledronic acid, have ancillary attributes of MCP-1 synthesis inhibition and could be re-purposed, singly or in combination, to inhibit or reverse MLC-mediated immunosuppression, angiogenesis, and other growth-enhancing aspects. Minocycline, telmisartan, and zoledronic acid – the MTZ Regimen – have low-toxicity profiles and could be added to standard radiotherapy and temozolomide. Re-purposing older drugs has advantages of established safety and low

  8. STUDY OF EFFICACY OF LOW DOSE MAGNESIUM SULPHATE REGIMEN (DHAKA REGIMEN AS COMPARED TO STANDARD REGIMEN (PRITCHARD IN THE MANAGEMENT OF ECLAMPSIA

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    Prosun

    2015-07-01

    Full Text Available BACKGROUND : Eclampsia is one of the most important cause of maternal mortality and morbidity worldwide Dr . J . A . Pritchard in 1955 , introduced magnesium sulphate for control of convulsions in eclampsia and now magnesium sulfate is the anticonvulsant drug of choice for both prevention and treatment of eclampsia , but due to its narrow therapeutic window its dose - related toxicity is a major concern . Considering the lower body weight of Indian women than wes tern counter part , different low dose magnesium sulphate regime has been formulated in different parts of India and Bangladesh and these modifications appeared to reduce drug toxicity . The Objective was to compare the efficacy of low dose magnesium sulphat e regimen ( Dhaka regimen with standard Pritchard’s regimen for management of eclampsia . METHODS: This was a hospital based prospective study conducted in the Dept . of O & G of VSSMCH , Burla from Oct . 2012 to S ept . 2014 . Total 300 patients with eclampsia were included in study and randomly distributed into two groups containing 150 patients each in both Dhaka & Pritchard groups . The statistical software SPSS version 20 has been used for the analysis . An alpha error of 5% has been taken as significant . RESU LTS: In the present study , there is no recurrence of convulsion among both the groups . The Dhaka regimen was associated with significantly lower deep tendon reflex loss ( 2 . 67% vs 8 . 0%; P =0 . 040 , significantly lower total amount of Mgso4 requirement , and lower maternal mortality ( 3 . 33% vs 6 . 67%; P = 0 . 185 as compared with the standerd Pritchard regimen . CONCLUSIONS : The maternal morbidity and mortality in the present study were comparable to those of standard Pritchard’s regimen . The Dhaka regimen was equ ally effective and more safe for the management of eclampsia in a region where most women are of low body weight KEYWORDS: Antepartum E clampsia ; Magnesium S ulphate; Dhaka R egimen; Pritchard R

  9. Trends in Antihypertensive Medication Discontinuation and Low Adherence Among Medicare Beneficiaries Initiating Treatment From 2007 to 2012.

    Science.gov (United States)

    Tajeu, Gabriel S; Kent, Shia T; Kronish, Ian M; Huang, Lei; Krousel-Wood, Marie; Bress, Adam P; Shimbo, Daichi; Muntner, Paul

    2016-09-01

    Low antihypertensive medication adherence is common. During recent years, the impact of low medication adherence on increased morbidity and healthcare costs has become more recognized, leading to interventions aimed at improving adherence. We analyzed a 5% sample of Medicare beneficiaries initiating antihypertensive medication between 2007 and 2012 to assess whether reductions occurred in discontinuation and low adherence. Discontinuation was defined as having no days of antihypertensive medication supply for the final 90 days of the 365 days after initiation. Low adherence was defined as having a proportion of days covered gap in the previous year. In conclusion, low adherence to antihypertensive medication has decreased among Medicare beneficiaries; however, rates of discontinuation and low adherence remain high. PMID:27432867

  10. The Impact of Antihypertensive Drugs on the Number and Risk of Death, Stroke and Myocardial Infarction in the United States

    OpenAIRE

    Genia Long; David Cutler; Berndt, Ernst R.; Jimmy Royer; Andrée-Anne Fournier; Alicia Sasser; Pierre Cremieux

    2006-01-01

    Estimating the value of medical innovation is a continual challenge. In this research, we quantify the impact of antihypertensive therapy on U.S. blood pressures, risk and number of heart attacks, strokes, and deaths. We also consider the potential for further improvements. We estimate the value of innovation using equations relating blood pressure to adverse outcomes from the Framingham Heart Study. Our results show that without antihypertensive therapy, 1999-2000 average blood pressure for ...

  11. Oral antidiabetic therapy in a large Italian sample: drug supply and compliance for different therapeutic regimens

    CERN Document Server

    Vittorino Gaddi, A; Capello, F; Di Pietro, C; Cinconze, E; Rossi, E; De Sando, V; Cevenini, M; D'Alò, G

    2014-01-01

    Objectives: To define the main features of patients treated with oral antidiabetics, evaluating monotherapy (MT), loose-dose combination therapy (LDCT) and fixed-dose combination therapy (FDCT); to describe medication adherence to the different therapies; and to evaluate the differences in compliance with the prescribed therapy regimen among prevalent and incident patient cohorts. Study design: This study was a retrospective cohort analysis based on the ARNO database, a national record that tracks reimbursable prescription claims submitted from selected pharmacies to the Italian national health system. In total, 169,375 subjects, from an overall population of 4,040,624 were included in this study. The patients represented 12 different local health units. Each patient had at least one oral antidiabetic prescription claim (A10B ATC code). Methods: Patients were divided into four groups according to their treatment regimen during the recruitment period (1 January 2008-31 December 2008): MT, FDCT, LDCT and swi...

  12. Antioxidant and antihypertensive activity of gelatin hydrolysate from Nile tilapia skin.

    Science.gov (United States)

    Choonpicharn, Sadabpong; Jaturasitha, Sanchai; Rakariyatham, Nuansri; Suree, Nuttee; Niamsup, Hataichanoke

    2015-05-01

    Fish skin, a by-product from fish processing industries, still contains a significant amount of protein-rich material. Gelatin was extracted from Nile tilapia skin with the yield 20.77 ± 0.80 % wet weight. Gelatin was then separately hydrolyzed by proteases, including bromelain, papain, trypsin, flavourzyme, alcalase and neutrase. Low molecular weight gelatin hydrolysate (bromelain hydrolysate has the highest ferrous ion chelating activity (86.895 ± 0.061 %). Evaluation of the angiotensin-I-converting enzyme's inhibitory activity indicates that all hydrolysates have great potency as an antihypertensive agent. All studied tilapia skin gelatin hydrolysates contain potent antioxidant and anti-hypertensive effects. PMID:25892821

  13. [The role of preventing nitric oxide deficiency in the antihypertensive effect of adaptation to hypoxia].

    Science.gov (United States)

    Mashina, S Iu; Smirin, B V; Pokidyshev, D A; Malyshev, I Iu; Liamina, N P; Senchikin, V N; Markov, Kh M; Manukhin, E B

    2001-01-01

    Shortage of endothelial nitric oxide (NO) manifested as decreased daily urinary excretion of nitrate and nitrite as well as attenuated endothelium-dependent relaxation of conduit and resistance vessels progresses with age-related increase of blood pressure (BP) in stroke-prone spontaneously hypertensive rats (SHRSP). Simultaneous NO-dependent suppression of vascular contractions is, apparently, due to the inducible NO synthase activity in vascular smooth muscle specific for spontaneously hypertensive rat. Adaptation of rats to hypobaric hypoxia initiated at early hypertensive stage (at the age of 5-6 weeks) decelerates hypertension progress. The antihypertensive effect of the adaptation was accompanied by stimulation of endothelial NO synthesis and prevention of impaired NO-dependent response in isolated blood vessels. Nitric oxide stores were formed in the vascular wall of SHRSP and WKY rats at the same time. The obtained data indicate a significant role of correction of endothelial NO deficiency in the antihypertensive effect of adaptation to hypoxia. PMID:15926321

  14. A Retrospective Longitudinal Cohort Study of Antihypertensive Drug Use and New-Onset Diabetes in Taiwanese Patients

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    Ching-Ya Huang

    2013-01-01

    Full Text Available Antihypertensive drugs have been linked to new-onset diabetes (NOD; however, data on the effect of these drugs on the development of NOD in hypertensive patients has not been well determined in a clinical setting. The aim was to investigate the association between antihypertensive drugs and NOD in Taiwan. We conducted a retrospective study of hypertensive Taiwanese patients receiving antihypertensive drugs treatment between January 2006 and December 2011. Clinical information and laboratory parameters were collected by reviewing the medical records. We estimated the odds ratios (ORs of NOD associated with antihypertensive drug use; nondiabetic subjects served as the reference group. A total of 120 NOD cases were identified in 1001 hypertensive patients during the study period. The risk of NOD after adjusting sex, age, baseline characteristics, and lipid profiles was higher among users of thiazide diuretics (OR, 1.65; 95% confidence interval (CI, 1.12–2.45 and nondihydropyridine (non-DHP calcium channel blockers (CCBs (OR, 1.96; 95% CI, 1.01–3.75 than among nonusers. Other antihypertensive drug classes were not associated with risk of NOD. Our results show that patients with hypertension who take thiazide diuretics and non-DHP CCBs are at higher risk of developing NOD than those who take other classes of antihypertensive drugs in Taiwan.

  15. Risk of Parkinson's Disease in the Users of Antihypertensive Agents: An Evidence from the Meta-Analysis of Observational Studies

    Science.gov (United States)

    Mullapudi, Amarnath; Gudala, Kapil; Boya, Chandra Sekhar

    2016-01-01

    Background. Antihypertensive agents have been shown to inhibit oxidative stress and inflammatory response and thus neuroprotection in Parkinson's disease (PD). Epidemiological evidence suggests inconsistency between use of antihypertensives and risk of PD. This study is aimed to examine the association between antihypertensive use and risk of PD. Methods. Literature search in PubMed, EMBASE, and PsycINFO database was undertaken through February 2012 looking for observational studies evaluating the association between antihypertensive drug use and risk of PD. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using random-effects model (DerSimonian and Laird method). Subgroup analyses and sensitivity analysis were also performed. Results. Seven relevant studies including a total of 28,32,991 subjects were included. Pooled RR of overall use of antihypertensive agents was found to be 0.95 (95% CI 0.84–1.05). A significant reduction in the risk of PD was observed among users of calcium channel blockers (RR 0.82, 95% CI 0.71–0.93). Significant heterogeneity (I2 = 76.2%) but no publication bias was observed. Conclusions. Overall use of antihypertensive agents showed no significant association with the risk of PD. CCBs provided significant protective role. However, studies with large sample size and dose relationships are required to strengthen our hypothesis. PMID:27516917

  16. Blood pressure reduction, persistence and costs in the evaluation of antihypertensive drug treatment – a review

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    Hasford Joerg

    2009-03-01

    Full Text Available Abstract Background Blood pressure lowering drugs are usually evaluated in short term trials determining the absolute blood pressure reduction during trough and the duration of the antihypertensive effect after single or multiple dosing. A lack of persistence with treatment has however been shown to be linked to a worse cardiovascular prognosis. This review explores the blood pressure reduction and persistence with treatment of antihypertensive drugs and the cost consequences of poor persistence with pharmaceutical interventions in arterial hypertension. Methods We have searched the literature for data on blood pressure lowering effects of different antihypertensive drug classes and agents, on persistence with treatment, and on related costs. Persistence was measured as patients' medication possession rate. Results are presented in the form of a systematic review. Results Angiotensin II receptor blocker (ARBs have a competitive blood pressure lowering efficacy compared with ACE-inhibitors (ACEi and calcium channel blockers (CCBs, beta-blockers (BBs and diuretics. 8 studies describing the persistence with treatment were identified. Patients were more persistent on ARBs than on ACEi and CCBs, BBs and diuretics. Thus the product of blood pressure lowering and persistence was higher on ARBs than on any other drug class. Although the price per tablet of more recently developed drugs (ACEi, ARBs is higher than that of older ones (diuretics and BBs, the newer drugs result in a more favourable cost to effect ratio when direct drug costs and indirect costs are also considered. Conclusion To evaluate drugs for the treatment of hypertension several key variables including the blood pressure lowering effect, side effects, compliance/persistence with treatment, as well as drug costs and direct and indirect costs of medical care have to be considered. ARBs, while nominally more expensive when drug costs are considered only, provide substantial cost savings

  17. From resistance to rescue – patients’ shifting attitudes to antihypertensives: A qualitative study

    OpenAIRE

    Hultgren, Fredrik; Jonasson, Grethe; Billhult, Annika

    2014-01-01

    Abstract Objective. The objective of this study was to gain a deeper knowledge and understanding of experiences of antihypertensive drug treatment. Design. Interview study. Setting. A primary health care centre in western Sweden. Method. Qualitative interviews and analyses through systematic text condensation described by Malterud. Subjects. Ten informants in pharmacological treatment for high blood pressure (six men and four women). Main outcome measure. Experiences of hypertension drug trea...

  18. Design and Characterization of Buccoadhesive Liquisolid System of an Antihypertensive Drug

    OpenAIRE

    Kala, Nilesh P.; Shastri, Divyesh H.; Pragna K. Shelat

    2015-01-01

    Nifedipine is an antihypertensive BCS class II drug which has poor bioavailability when given orally. The objective of the present study was to increase the bioavailability of nifedipine, by formulation and evaluation of a buccoadhesive liquisolid system using magnesium aluminium silicate (Neusilin) as both carrier and coating material and dissolution media were selected based on the solubility studies. A mixture of carboxymethylcellulose sodium and carbomer was used as mucoadhesive polymers....

  19. Hypertension, use of antihypertensive medications, and risk of epithelial ovarian cancer.

    Science.gov (United States)

    Huang, Tianyi; Poole, Elizabeth M; Eliassen, A Heather; Okereke, Olivia I; Kubzansky, Laura D; Sood, Anil K; Forman, John P; Tworoger, Shelley S

    2016-07-15

    Few studies have examined the associations of hypertension and antihypertensive medications with ovarian cancer. In particular, beta-blockers, one of the most commonly prescribed medications to treat hypertension, may reduce ovarian cancer risk by inhibiting beta-adrenergic signaling. We prospectively followed 90,384 women in the Nurses' Health Study (NHS) between 1988-2012 and 113,121 NHSII participants between 1989-2011. Hypertension and use of antihypertensive medications were self-reported biennially. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). We documented 948 ovarian cancer cases during follow-up. Similar results were observed in the two cohorts. While hypertension was not associated with ovarian cancer risk (Pooled HR = 1.01; 95% CI = 0.88, 1.16), current use of any antihypertensive medication was associated with slightly increased risk compared to never users (Pooled HR = 1.18; 95% CI: 1.02, 1.37). This increased risk was primarily due to use of thiazide diuretics (Pooled HR = 1.37; 95% CI: 1.13, 1.68). No associations were observed for beta-blockers or angiotensin-converting-enzyme inhibitors. Calcium channel blockers (CCBs) were associated with suggestively reduced risk (NHS HR = 0.73; 95% CI: 0.53, 1.01), after adjusting for all antihypertensive medications. Associations were similar among hypertensive women and stronger for longer use of thiazide diuretics and CCBs. In conclusion, our results provided no evidence that beta-blockers were associated with reduced ovarian cancer risk. In contrast, we observed an increased risk for use of thiazide diuretics that should be confirmed in other studies. PMID:26934358

  20. Comparing marginal structural models to standard methods for estimating treatment effects of antihypertensive combination therapy

    Directory of Open Access Journals (Sweden)

    Gerhard Tobias

    2012-08-01

    Full Text Available Abstract Background Due to time-dependent confounding by blood pressure and differential loss to follow-up, it is difficult to estimate the effectiveness of aggressive versus conventional antihypertensive combination therapies in non-randomized comparisons. Methods We utilized data from 22,576 hypertensive coronary artery disease patients, prospectively enrolled in the INternational VErapamil-Trandolapril STudy (INVEST. Our post-hoc analyses did not consider the randomized treatment strategies, but instead defined exposure time-dependently as aggressive treatment (≥3 concomitantly used antihypertensive medications versus conventional treatment (≤2 concomitantly used antihypertensive medications. Study outcome was defined as time to first serious cardiovascular event (non-fatal myocardial infarction, non-fatal stroke, or all-cause death. We compared hazard ratio (HR estimates for aggressive vs. conventional treatment from a Marginal Structural Cox Model (MSCM to estimates from a standard Cox model. Both models included exposure to antihypertensive treatment at each follow-up visit, demographics, and baseline cardiovascular risk factors, including blood pressure. The MSCM further adjusted for systolic blood pressure at each follow-up visit, through inverse probability of treatment weights. Results 2,269 (10.1% patients experienced a cardiovascular event over a total follow-up of 60,939 person-years. The HR for aggressive treatment estimated by the standard Cox model was 0.96 (95% confidence interval 0.87-1.07. The equivalent MSCM, which was able to account for changes in systolic blood pressure during follow-up, estimated a HR of 0.81 (95% CI 0.71-0.92. Conclusions Using a MSCM, aggressive treatment was associated with a lower risk for serious cardiovascular outcomes compared to conventional treatment. In contrast, a standard Cox model estimated similar risks for aggressive and conventional treatments. Trial registration Clinicaltrials

  1. ANTIHYPERTENSIVE MEDICATION PRESCRIBING PATTERNS IN A UNIVERSITY TEACHING HOSPITAL IN SOUTH DELHI

    OpenAIRE

    Fowad Khurshid et al.

    2012-01-01

    Study objective: To investigate the use of antihypertensive drugs in hypertensive patients and to identify whether such pattern of prescription is appropriate in accordance with international guidelines for management of hypertension. Methods: This was a prospective analysis. A prescription based survey among patients with established hypertension was conducted at the Medicine Out-Patient Department of University Teaching Hospital in South Delhi, India. Data were collected from patients’ medi...

  2. Effectiveness of malic acid 1% in patients with xerostomia induced by antihypertensive drugs

    OpenAIRE

    Gómez Moreno, Gerardo; Guardia, Javier; Aguilar Salvatierra, Antonio; Cabrera Ayala, Marible; Maté Sánchez de Val, José Eduardo; Calvo Guirado, José Luis

    2012-01-01

    Objectives: Assessing the clinical effectiveness of a topical sialogogue on spray (malic acid, 1%) in the treatment of xerostomia induced by antihypertensive drugs. Study Design: This research has been carried out through a randomized double-blind clinical trial. 45 patients suffering from hypertensive drugs-induced xerostomia were divided into 2 groups: the first group (25 patients) received a topical sialogogue on spray (malic acid, 1%) whereas the second group (20 patients) received a plac...

  3. PERSYVE - Design and validation of a questionnaire about adverse effects of antihypertensive drugs

    OpenAIRE

    Duarte-Silva D,; Figueiras A,; Herdeiro MT,; Teixeira Rodrigues A; Silva Branco F,; Polónia J; Figueiredo IV

    2014-01-01

    Objective: The aim of this study was to design and validate a questionnaire to measure perceived symptoms associated with antihypertensive drugs (PERSYVE). Methods: The PERSYVE development and validation included four stages: 1) item development (bibliographic review and questionnaire elaboration); 2) face and content validation; 3) field testing (pre-test); and 4) test-retest validation, assessment of internal consistency (Cronbach’s alpha) and reproducibility over time (intraclass correl...

  4. EFFECT OF ANTIHYPERTENSIVE THERAPY WITH RILMENIDINE ON COGNITIVE FUNCTION IN ELDERLY HYPERTENSIVE PATIENTS

    OpenAIRE

    S. V. Nedogoda; U. A. Brel; T. A. Tchalyaby; E. S. Kesareva; V. A. Tcoma

    2016-01-01

    Aim.  To assess antihypertensive efficacy of rilmenidine (Albarel, EGIS, Hungary) and its effect on cognitive function in elderly hypertensive patients. Material and methods. 30 elderly (in average 68 y.o.) hypertensive patients were observed. Each patient received therapy with rilmenidine 2 mg daily during 6 months. 24 hours monitoring of blood pressure before and after therapy was done in each patient. In order to assess cognitive disorders all patients passed neuropsychological tests, whic...

  5. Patient adherence and the choice of antihypertensive drugs: focus on lercanidipine

    OpenAIRE

    Burnier, Michel

    2008-01-01

    Menno T Pruijm, Marc P Maillard, Michel BurnierService of Nephrology and Hypertension, Department of Medicine, University Hospital, Lausanne, SwitzerlandAbstract: Despite the development of many effective antihypertensive drugs, target blood pressures are reached in only a minority of patients in clinical practice. Poor adherence to drug therapy and the occurrence of side effects are among the main reasons commonly reported by patients and physicians to explain the poor results of actual anti...

  6. Production of antihypertensive peptides by enzymatic zein hydrolysate from maize-zea mays ssp. mexicana introgression line

    International Nuclear Information System (INIS)

    Teosintes are essential gene reservoir for maize breeding improvement, among which Zea mays ssp. mexicana has many valuable traits deserved to be transferred into maize genetic background. In this study, one maize-teosinte introgression line SD00100 was selected from the population of Zea mays ssp. mexicana as wild parent. This introgression line manifested the outstanding agricultural traits similar to maize parent Ye 515 and alien genetic material was identified by genomic in situ hybridization (GISH). To produce bioactive peptides with potent angiotensin converting enzyme (ACE) inhibitory activity, zein extracted from endosperm meal was then undergone enzymatic hydrolysis with thermolysin and the hydrolysate was then filtered through a 3 kDa cut-off membrane. ACE inhibitory activity of permeate from Ye 515 and SD00100 was evaluated by RP-HPLC. The IC50 values of the peptides obtained from maize parent and the introgression line were 96.9 micro g/ml and 22.9 micro g/ml, respectively, with significant difference between them. Our results showed that an outstanding inbred maize line was obtained for production of antihypertensive peptides as well as for further development of functional food. (author)

  7. EVALUATION OF THE RELATIVE INCIDENCE OF ADVERSE EFFECTS LEADING TO TREATMENT DISCONTINUATION OF RECOMMENDED ANTIHYPERTENSIVE DRUGS

    Directory of Open Access Journals (Sweden)

    Yakubu Sani Ibn

    2013-06-01

    Full Text Available This study aimed at evaluating the incidence of adverse effects leading to treatment discontinuation of antihypertensive drugs within the same therapeutic class. Individual medical records were searched to identify those hypertensive patients who had been commenced on antihypertensive therapy during a 24-month period and who had subsequently for a reason(s discontinued the therapy. The results showed variation in discontinuation rates for drugs within same class, and that might be related to the relative frequency of specific adverse effects. Cough was the reason cited for discontinuation of angiotensin converting enzyme inhibitors, with linosopril appearing to be better tolerated than captopril (39% vs 48% ; peripheral oedema with calcium channel blockers, with amlodipine appearing to be better tolerated than nifedipine (29% vs 38% and bradycardia with beta adrenergic receptor blockers, with propranolol better tolerated than atenolol (0% vs 48%. Diuretics showed the lowest discontinuation rate (3.3% mainly due to hypokalemia, with thiazide better tolerated than frusemide (11% vs 43%. Prescribers should verify their use of antihypertensive drugs to ensure that they prescribe drugs with lower adverse effect rates, in order that patients with hypertension continue using the medication in the long term, thereby reducing the risk of developing cardiovascular complications associated with uncontrolled blood pressure.

  8. Antihypertensive Efficiency and Safety of L- & N- type Ca2+ Antagonists -cilnidipine

    Institute of Scientific and Technical Information of China (English)

    张向阳; 刘国树

    2003-01-01

    Objectives To evaluate antihypertensive efficiency and safety of a new domesticof L - & N - type Ca2+ antagonist - cilnidipine withimidapril as a positive control. Methods After 2weeks' placebo washingout, 22 patients were treatedwith cilnidipine 5 mg daily and 27 patients were treatedwith imidapril 5 mg daily. 4 weeks later, if patient'ssitting diastolic blood pressure is over 90 mmHg, his/her dosage was doubled for another 4 weeks, the othersmeasuring up remained their dosage unchanged foranother 4 weeks. Blood pressure, heart rate, blood andurine routine examination, serum glucose, serumchemical examination including total cholesterol,triglyceride, HDL, LDL, transaminase, creatine etcand side reactions were recorded before and after thetrial. Data were analyzed statistically. Results After8 weeks' treatment, blood pressure was significantlydecreased (P < 0.05) in both groups, and the twomedicines had similar antihypertensive effects. Fur-thermore, the reducing of heart rate was statisticallysignificant compared with baseline ( P < 0.01 ) in thecilnidipine group, but not in the imidapril group. Thenegative chronotropic effect of cilnidipine had little ef-fect on continuing the therapy. There were no changeson blood and urine routine examination and serumlipid, serum glucose, creatine, transaminase and etcin both groups. Their side reactions were mild and well-tolerated. Conclusions Cilnidipine has a con-vincing antihypertensive effect similar to that of imi-dapril. Especially cilnidipine may be administered topatients with relatively mild tachycardia.

  9. Patient adherence and the choice of antihypertensive drugs: focus on lercanidipine

    Directory of Open Access Journals (Sweden)

    Menno T Pruijm

    2008-11-01

    Full Text Available Menno T Pruijm, Marc P Maillard, Michel BurnierService of Nephrology and Hypertension, Department of Medicine, University Hospital, Lausanne, SwitzerlandAbstract: Despite the development of many effective antihypertensive drugs, target blood pressures are reached in only a minority of patients in clinical practice. Poor adherence to drug therapy and the occurrence of side effects are among the main reasons commonly reported by patients and physicians to explain the poor results of actual antihypertensive therapies. The development of new effective antihypertensive agents with an improved tolerability profile might help to partly overcome these problems. Lercanidipine is an effective dihydropyridine calcium channel blocker of the third generation characterized by a long half-life and its lipophylicity. In contrast to first-generation dihydropyridines, lercanidipine does not induce reflex tachycardia and induces peripheral edema with a lower incidence. Recent data suggest that in addition to lowering blood pressure, lercanidipine might have some renal protective properties. In this review we shall discuss the problems of drug adherence in the management of hypertension with a special emphasis on lercanidipine.Keywords: compliance, hypertension, calcium antagonists

  10. Left Ventricular Structure during Antihypertensive Treatment in Patients with Chronic Kidney Disease

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    Batir T. Daminov

    2016-03-01

    Full Text Available The aim of our study was to investigate the left ventricular (LV echocardiographic parameters and estimate the antiremodeling efficacy of eprosartan and lercanidipine in patients with CKD, depending on the presence or absence of diabetic nephropathy (DN. Materials and Methods: The study included 121 patients (mean age 52.4±5.7 years with CKD stage 3 (KDOQI, 2002. Patients were distributed in two groups according to the etiology of CKD. Group 1 consisted of 67 patients with non-diabetic CKD. Group 2 consisted of 54 CKD patients with DN. All patients had arterial hypertension grade 1 or 2 (ESH/ESC, 2013. All patients underwent clinical examination, echocardiography; GFR was estimated by the Cockcroft-Gault formula. Stages of chronic kidney disease (CKD were determined according to the KDOQI 2002 classification. Eprosartan and lercanidipine were prescribed to patients after one week of lavage from previous antihypertensive therapy. This 6-month follow-up study compared the effectiveness of two courses of treatment. Results: LVH was observed in all CKD patients regardless of the presence or absence of DN. Eprosartan and lercanidipine showed the high antihypertensive efficacy expressing a reliable decrease in absolute values of SBP and DBP. In CKD patients with DN, on the background of a comparable antihypertensive effect, eprosartan, in comparison with lercanidipine, showed a more pronounced effect on the LV echocardiographic parameters associated with LVH regression.

  11. Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension

    Directory of Open Access Journals (Sweden)

    Nita K. Patel

    2012-06-01

    Full Text Available Background: Pregnancy-induced hypertension is associated with various adverse fetal and maternal outcomes. The use of anti-hypertensive drugs in pregnancy is controversial. We conducted a prospective study to evaluate the comparative effectiveness and safety of nifedipine, methyldopa and labetalol monotherapy in patients with pregnancy-induced hypertension. Methods: A total of 60 pregnant women with blood pressure of 140/90 mm Hg or more with ≥1+ proteinuria between 20 and 38 weeks of gestation were randomly allocated to receive nifedipine (n=20, methyldopa (n=20 or labetalol (n=20. Blood pressure was measured at 0, 6, 24, 48 and 72 h of initiation of antihypertensive drugs. Patients were also followed up for development of adverse drug effects during this period. Results: Antihypertensive treatment with methyldopa was associated with reduction in systolic blood pressure (SBP by 50 mmHg and diastolic blood pressure (DBP by 30 mmHg at 72 h. For the same period treatment with nifedipine was associated with reduction in SBP by 54 mmHg and DBP by 30 mmHg. Treatment with labetalol was associated with reduction in SBP by 70 mmHg and DBP by 36 mmHg at 72 h. Conclusions: Labetalol was more effective than methyldopa and nifedipine in controlling blood pressure in patients with pregnancy-induced hypertension while methyldopa and nifedipine are equally effective in controlling blood pressure. [Int J Basic Clin Pharmacol 2012; 1(3.000: 174-177

  12. Molecular Targets of Antihypertensive Peptides: Understanding the Mechanisms of Action Based on the Pathophysiology of Hypertension

    Directory of Open Access Journals (Sweden)

    Kaustav Majumder

    2014-12-01

    Full Text Available There is growing interest in using functional foods or nutraceuticals for the prevention and treatment of hypertension or high blood pressure. Although numerous preventive and therapeutic pharmacological interventions are available on the market, unfortunately, many patients still suffer from poorly controlled hypertension. Furthermore, most pharmacological drugs, such as inhibitors of angiotensin-I converting enzyme (ACE, are often associated with significant adverse effects. Many bioactive food compounds have been characterized over the past decades that may contribute to the management of hypertension; for example, bioactive peptides derived from various food proteins with antihypertensive properties have gained a great deal of attention. Some of these peptides have exhibited potent in vivo antihypertensive activity in both animal models and human clinical trials. This review provides an overview about the complex pathophysiology of hypertension and demonstrates the potential roles of food derived bioactive peptides as viable interventions targeting specific pathways involved in this disease process. This review offers a comprehensive guide for understanding and utilizing the molecular mechanisms of antihypertensive actions of food protein derived peptides.

  13. Evaluation of nutritional and biochemical parameters in spontaneously hypertensive rats following antihypertensive treatment

    Directory of Open Access Journals (Sweden)

    Joanna Suliburska

    2014-03-01

    Full Text Available Introduction. One side effect of antihypertensive drugs is their impact on nutritional status and metabolism. The purpose of this study was to assess the nutritional and biochemical parameters in spontaneously hypertensive rats following treatment with antihypertensive drugs. Material and methods. The experiment was performed on 50 male spontaneously hypertensive rats (SHR, which were assigned to fi ve groups: control (C, with perindopril (PR, with metoprolol (MT, with indapamide (ID, and with amlodipine (AM. All rats were provided ad libitum standard diet (with or without drugs and distilled water. After 45 days, the animals were weighed and killed. Liver, kidney, heart, spleen, pancreas, and blood samples were collected. Concentrations of glucose, cholesterol, triglycerides, and albumin were assayed in serum. Morphology parameters, such as white blood cell, red blood cell, hematocrit, and lymphocyte counts were measured in the blood. Blood pressure was measured using a tail-cuff plethysmograph. Results. The results obtained indicate that the hypotensive drugs under investigation had no effect on the selected nutritional parameters. Perindopril signifi cantly decreased the relative mass of the heart and amlodipine markedly decreased the relative mass of the pancreas. A markedly higher concentration of glucose in the group with indapamid, and a signifi cantly lower concentration of triglycerides in the group with metoprolol, were observed. Indapamide and amlodipine markedly increased the value of red blood cells and hematocrit in the blood of SHR. Conclusions. Long-term therapy with antihypertension drugs may infl uence tissue mass and biochemical and morphological status in the body.

  14. [Discovering L-type calcium channels inhibitors of antihypertensive drugs based on drug repositioning].

    Science.gov (United States)

    Liang, Ying-xi; He, Yu-su; Jiang, Lu-di; Yue, Qiao-xin; Cui, Shuai; Bin, Li; Ye, Xiao-tong; Zhang, Xiao-hua; Zhang, Yang-ling

    2015-09-01

    This study was amid to construct the pharmacophore model of L-type calcium channel antagonist in the application of screening Drugbank and TCMD. This paper repositions the approved drugs resulting from virtual screening and discusses the relocation-based drug discovery methods, screening antihypertensive drugs with L-type calcium channel function from TCMD. Qualitative hypotheses wre generated by HipHop separately on the basis of 12 compounds with antagonistic action on L-type calcium channel expressed in rabbit cardiac muscle. Datebase searching method was used to evaluate the generated hypotheses. The optimum hypothesis was used to search Drugbank and TCMD. This paper repositions the approved drugs and evaluates the antihypertensive effect of the chemical constituent of traditional Chinese medicine resulting from virtual screening by the matching score and literature. The results showed that optimum qualitative hypothesis is with six features, which were two hydrogen-bond acceptors, four hydrophobic groups, and the CAI value of 2.78. Screening Drugbank achieves 93 approved drugs. Screening TCMD achieves 285 chemical constituents of traditional Chinese medicine. It was concluded that the hypothesis is reliable and can be used to screen datebase. The approved drugs resulting from virtual screening, such as pravastatin, are potentially L-type calcium channels inhibitors. The chemical constituents of traditional Chinese medicine, such as Arctigenin III and Arctigenin are potentially antihypertensive drugs. It indicates that Drug Repositioning based on hypothesis is possible. PMID:26983215

  15. Chemotherapy Regimen Extends Survival in Advanced Pancreatic Cancer Patients

    Science.gov (United States)

    A four-drug chemotherapy regimen has produced the longest improvement in survival ever seen in a phase III clinical trial of patients with metastatic pancreatic cancer, one of the deadliest types of cancer.

  16. Predictors of nonadherence with blood pressure regimens in hemodialysis

    OpenAIRE

    Kauric-Klein Z

    2013-01-01

    Zorica Kauric-KleinCollege of Nursing, Wayne State University, Detroit, MI, USABackground: Hypertension is very poorly controlled in patients on hemodialysis (HD). Demographic and psychosocial predictors of nonadherence with blood pressure (BP) regimens in HD have not been investigated. A study of 118 HD patients from six outpatient HD units was conducted to determine the relationship between demographic/psychosocial factors and adherence with BP-related regimens, ie, fluid restriction, BP me...

  17. Efficacy of a Morinda citrifolia Based Skin Care Regimen

    OpenAIRE

    West, Brett J.; Rachel A. Sabin

    2012-01-01

    A six week clinical trial of a Morinda citrifolia (noni) based skin care regimen was conducted with 49 women, ages 38 to 55 years. Daily application of three product formulations to the face and neck resulted in significant reductions in lateral canthal fine lines and wrinkles (crow’s feet), as measured by technician scoring and digital image analysis. Use of the regimen also improved skin elasticity and firmness Cutometer® measurements. No evidence of skin irritation was present in any parti...

  18. “Rescue” regimens after Helicobacter pylori treatment failure

    OpenAIRE

    Javier P Gisbert

    2008-01-01

    Helicobacter pylori (H pylori) infection is the main cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. After more than 20 years of experience in H pylori treatment, in my opinion, the ideal regimen to treat this infection is still to be found. Currently, apart from having to know first-line eradication regimens well, we must also be prepared to face treatment failures. Therefore, in designing a treatment strategy we should not focus on the results of primary therapy alone,...

  19. Antihypertensive medications and sexual function in women: Baseline data from the Systolic Blood Pressure Intervention Trial (SPRINT)

    Science.gov (United States)

    Thomas, Holly N.; Evans, Gregory W.; Berlowtiz, Dan R.; Chertow, Glenn M.; Conroy, Molly B.; Foy, Capri G.; Glasser, Stephen P.; Lewis, Cora E.; Riley, William T.; Russell, Laurie; Williams, Olubunmi; Hess, Rachel

    2016-01-01

    Objectives Hypertension is a risk factor for the development of cardiovascular and kidney disease, but treatment can substantially reduce risks. Many patients avoid antihypertensive medications due to fear of side effects. While associations between antihypertensives and sexual dysfunction in men have been documented, it remains unclear whether antihypertensives are associated with sexual dysfunction in women. We conducted a cross-sectional analysis of baseline data from women in the Systolic Blood Pressure Intervention Trial (SPRINT) to evaluate the relations among class of antihypertensive medication and the outcomes (a) sexual activity and (b) sexual function. Methods SPRINT enrolled individuals 50 and older with hypertension at high risk for cardiovascular disease. A subset of participants completed questionnaires regarding quality of life (QoL), including sexual function. Antihypertensive class was determined by medications taken at baseline. Results Of 690 women in the QoL subset of SPRINT, 183 (26.5%) were sexually active. There were no significant differences in sexual activity among women taking one or more antihypertensives and women not taking any. Women taking an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) had higher odds of sexual activity [OR 1.66 (1.12-4.27), p=0.011]. Among sexually active women, the prevalence of sexual dysfunction was high (52.5%). No class of medication was associated with sexual dysfunction in the multivariable model. Conclusions ACEI/ARB use was associated with higher odds of sexual activity. While prevalence of sexual dysfunction was high, no single class of antihypertensive medication was associated with sexual dysfunction. PMID:27032074

  20. Pharmacokinetics and safety of voriconazole intravenous-to-oral switch regimens in immunocompromised Japanese pediatric patients.

    Science.gov (United States)

    Mori, Masaaki; Kobayashi, Ryoji; Kato, Koji; Maeda, Naoko; Fukushima, Keitaro; Goto, Hiroaki; Inoue, Masami; Muto, Chieko; Okayama, Akifumi; Watanabe, Kenichi; Liu, Ping

    2015-02-01

    The aim of this study was to investigate the pharmacokinetics, safety, and tolerability of voriconazole following intravenous-to-oral switch regimens used with immunocompromised Japanese pediatric subjects (age 2 to oral switch regimens based on a recent population pharmacokinetic modeling; they were given 9 mg/kg of body weight followed by 8 mg/kg of intravenous (i.v.) voriconazole every 12 h (q12h), and 9 mg/kg (maximum, 350 mg) of oral voriconazole q12h (for patients age 2 to voriconazole q12h and 200 mg of oral voriconazole q12h (for patients age 12 to oral regimens were 51.1 μg · h/ml (68%) and 45.8 μg·h/ml (90%), respectively; there was a high correlation between AUC0-12,ss and trough concentration. Although the average exposures were higher in the Japanese patients than those in the Western pediatric subjects, the overall voriconazole exposures were comparable between these two groups due to large interindividual variability. The exposures in the 2 cytochrome P450 2C19 poor metabolizers were among the highest. Voriconazole was well tolerated. The most common treatment-related adverse events were photophobia and abnormal hepatic function. These recommended doses derived from the modeling appear to be appropriate for Japanese pediatric patients, showing no additional safety risks compared to those with adult patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT01383993.). PMID:25451051

  1. Interactions between antihypertensive drugs and food Interacciones entre fármacos antihipertensivos y alimentos

    Directory of Open Access Journals (Sweden)

    B. Jáuregui-Garrido

    2012-12-01

    Full Text Available Objective: A drug interaction is defined as any alteration, pharmacokinetics and/or pharmacodynamics, produced by different substances, other drug treatments, dietary factors and habits such as drinking and smoking. These interactions can affect the antihypertensive drugs, altering their therapeutic efficacy and causing toxic effects. The aim of this study was to conduct a review of available data about interactions between antihypertensive agents and food. Methods: The purpose of this review was to report an update of main findings with respect to the interactions between food and antihypertensive drugs by way of a search conducted in PubMed, which yielded a total of 236 articles initially. Results: After excluding different articles, which were not focusing on the specific objective, the main results refer to interactions between antihypertensive drugs and food (in general as well as between antihypertensive agents and grapefruit juice. Discussion: Food may affect the bioavailability of antihypertensive drugs and this should be carefully considered. Advising patients to remove the grapefruit juice from their diet when treatment with these drugs seems to be the best recommendation. Given these interactions and the associated potential adverse effects the anamnesis must include detailed information about the specific eating habits of the patients.Objetivo: la interacción de medicamentos se define como cualquier alteración, farmacocinética y/o farmacodinámica, producida por diferentes sustancias, otros tratamientos, factores dietéticos y hábitos como beber y fumar. Estas interacciones pueden afectar a los fármacos antihipertensivos, alterando su eficacia terapéutica y causando efectos tóxicos. El objetivo de este estudio fue realizar una revisión de los datos disponibles acerca de las interacciones entre los fármacos antihipertensivos y los alimentos. Métodos: El objetivo de esta revisión fue proporcionar una puesta al día sobre los

  2. ANTIHYPERTENSIVE MEDICATION PRESCRIBING PATTERNS IN A UNIVERSITY TEACHING HOSPITAL IN SOUTH DELHI

    Directory of Open Access Journals (Sweden)

    Fowad Khurshid et al.

    2012-07-01

    Full Text Available Study objective: To investigate the use of antihypertensive drugs in hypertensive patients and to identify whether such pattern of prescription is appropriate in accordance with international guidelines for management of hypertension. Methods: This was a prospective analysis. A prescription based survey among patients with established hypertension was conducted at the Medicine Out-Patient Department of University Teaching Hospital in South Delhi, India. Data were collected from patients’ medical records as well as patients’ interviews.Results: A total of 192 hypertensive patients fulfilled the criteria for inclusion in the study analysis. Combination therapy was used more commonly than monotherapy (54.6% vs 45.4. Among the monotherapy category, the various classes of drugs used were as follows: beta- blockers (28.8%, diuretics (24.1%, calcium channel blockers (21.8%, ACE inhibitors (18.4%, angiotensin II receptor blockers (5.7% and α 1- blocker (1.1%. With respect to overall utilization pattern, diuretics (42.2% were the most frequently prescribed class, beta- blockers (41.2% ranked second followed by calcium channel blockers (39.1%, ACE inhibitors (26.0%, angiotensin II receptor blockers (23.4% and α 1- blocker (9.4%. As for individual medicines, amlodipine (35.4% was the most commonly prescribed antihypertensive drug followed by atenolol (17.8%, ramipril (17.2 % and furosemide (13.0 %. Among the combination therapies, 2- drug treatment was preferred for 75% of the hypertensive patients with CCB and β-blocker being the most frequent drug combination (22.4%.Conclusion: The general pattern of antihypertensive utilization seems to be in accordance with the international guidelines for management of hypertension.

  3. Efficacy, safety and tolerability of sildenafil in Brazilian hypertensive patients on multiple antihypertensive drugs

    Directory of Open Access Journals (Sweden)

    Denilson C. Albuquerque

    2005-08-01

    Full Text Available OBJECTIVE: To evaluate the efficacy, safety and tolerability of sildenafil among Brazilian patients with hypertension treated with combinations of anti-hypertensive drugs. MATERIALS AND METHODS: One hundred twenty hypertensive men aged 30 to 81 years old under treatment with 2 or more anti-hypertensive drugs and with erectile dysfunction (ED lasting for at least 6 months were enrolled at 7 research centers in Brazil. Patients were randomized to receive treatment with either sildenafil or placebo taken 1 hour before sexual intercourse (initial dose of 50 mg, adjusted to 25 mg or 100 mg according to efficacy and toxicity. During the following 8 weeks, patients were evaluated regarding vital signs, adverse events, therapeutic efficacy, satisfaction with treatment and use of concurrent medications. RESULTS: The primary evaluation of efficacy, which was based on responses to questions 3 and 4 of the International Index of Erectile Function, showed significant differences regarding treatment with sildenafil (p = 0.0002 and p < 0.0001, respectively. In the assessment of global efficacy, 87% of the patients treated with sildenafil reported improved erections, as compared with 37% of patients given placebos (p < 0.0001. The other secondary evaluations supported the results favoring sildenafil. The most frequent adverse events among patients treated with sildenafil were headaches (11.4%, vasodilation (11.4% and dyspepsia (6.5%. There were no significant changes in blood pressure measurements in both groups. CONCLUSION: Sildenafil is efficacious and safe for the treatment of hypertensive patients with ED who receive concurrent combinations of anti-hypertensive drugs.

  4. Antihypertension medication adherence and associated factors at Dessie Hospital, North East Ethiopia, Ethiopia

    Directory of Open Access Journals (Sweden)

    Legese Chelkeba

    2013-06-01

    Full Text Available Hypertension is an overwhelming global challenge. Despite the development of many effective anti hypertensive drugs, target to reduce morbidity and mortality due to high blood pressures are reached in only a minor of patients in clinical practice. Poor adherence is one of the biggest obstacles in therapeutic control of blood pressures. There are complaints from patients and physicians that the poor result of actual antihypertensive drug therapies. Many people with age indifference are attacked by this “silent killer” or which results in target organ damage as a complication. The aim of this study was to assess the magnitude of adherence and the factors associated with non-adherence to anti-hypertensive medication. Cross sectional exclusively convenient study was conducted by using structured questionnaires consisting of open and closed-ended questions on patients diagnosed for hypertension and have already been on anti hypertensive medications at least for three months at Dessie Referral hospital from 20/01/2012 to 29/01/2012. A total of hundred hypertensive patients were screened from hundred six cases by the exclusive criteria and the overall incidence of anti-hypertensive medication non adherence was 26%. The study identifies reasons why patients don’t adherent with the drug regiments. Among Factors associated with non adherence were health system and health care provider poor interaction with patient and therapy factors like frustration and unwanted effect of the medication in the long run. There was indication of non adherence from the study area. Great emphasis should be placed on intervention strategies such as patient counseling and increasing awareness of the physicians, all other prescribers and health care providers at large about the non adherence of anti hypertensive drugs as well as the complication what comes due to this medication non adherence. [Int J Res Med Sci 2013; 1(3.000: 191-197

  5. Analgesic regimens for third molar surgery: pharmacologic and behavioral considerations.

    Science.gov (United States)

    Moore, P A; Werther, J R; Seldin, E B; Stevens, C M

    1986-11-01

    The level of pain following the extraction of impacted third molars was evaluated in 75 patients. Participants were administered acetaminophen 1,000 mg or a placebo before surgery. After surgery, acetaminophen 650 mg was administered either at fixed intervals or as needed to relieve pain. When acetaminophen was administered before surgery, the onset of peak pain was delayed and patient discomfort was decreased 3, 4, and 5 hours after surgery. Patients following the fixed interval regimen after surgery experienced more pain overall and requested the backup narcotic analgesic more frequently. Of the regimens tested, patients preferred the regimen of acetaminophen 1,000 mg administered before surgery with acetaminophen administered as needed for pain after surgery. PMID:3465787

  6. Drug Development for Hypertension: Do We Need Another Antihypertensive Agent for Resistant Hypertension?

    Science.gov (United States)

    Pimenta, Eduardo; Calhoun, David A

    2016-04-01

    The prevalence of resistant hypertension is seemingly much lower than had been reported in early studies. Recent analyses suggest that <5 % of treated hypertensive patients remain uncontrolled if fully adherent to an optimized antihypertensive treatment. However, these patients do have increased cardiovascular risk and need effective therapeutic approaches. Drug development is a high-risk, complex, lengthy, and very expensive process. In this article, we discuss the factors that should be considered in the process of developing a new agent for treatment of resistant hypertension. PMID:26949263

  7. Long-term antihypertensive effect of a soluble cocoa fiber product in spontaneously hypertensive rats

    OpenAIRE

    Fernández-Vallinas, Sandra; Miguel, Marta; Aleixandre, Amaya

    2016-01-01

    Background and Methods: This study evaluates the antihypertensive effect of long-term intake of a soluble cocoa fiber product (SCFP). Different doses of SCFP were evaluated (200, 400, and 800 mg/kg/day) and a dose of 800 mg/kg/day of beta-glucan 0.75 (BETA-G) was used as a standard fiber. Water, a neutral vehicle, was used as negative control, and 50 mg/kg/day captopril was used as positive control. Systolic blood pressure (SBP) was measured weekly by the tail cuff method. Body weight, food, ...

  8. Combining antihypertensive and antihyperlipidemic agents – optimizing cardiovascular risk factor management

    Directory of Open Access Journals (Sweden)

    Zamorano J

    2011-11-01

    Full Text Available José Zamorano1, Jonathan Edwards21Hospital Clinico San Carlos, Madrid, Spain; 2UBC Scientific Solutions, 5 North Street, Horsham, West Sussex, UKAbstract: Clinical guidelines now recognize the importance of a multifactorial approach to managing cardiovascular (CV risk. This idea was taken a step further with the concept of the Polypill™. There are, however, considerable patent, pharmacokinetic, pharmacodynamic, registration, and cost implications that will need to be overcome before the Polypill™ or other single-pill combinations of CV medications become widely available. However, a medication targeting blood pressure (BP and lipids provides much of the proposed benefits of the Polypill™. A single-pill combination of the antihypertensive amlodipine besylate and the lipid-lowering medication atorvastatin calcium (SPAA is currently available in many parts of the world. This review describes the rationale for this combination therapy and the clinical trials that have demonstrated that these two agents can be combined without the loss of efficacy for either agent or an increase in the incidence of adverse events. The recently completed Cluster Randomized Usual Care vs Caduet Investigation Assessing Long-term-risk (CRUCIAL trial is discussed in detail. CRUCIAL was a 12-month, international, multicenter, prospective, open-label, parallel design, cluster-randomized trial, which demonstrated that a proactive intervention strategy based on SPAA in addition to usual care (UC had substantial benefits on estimated CV risk, BP, and lipids over continued UC alone. Adherence with antihypertensive and lipid-lowering therapies outside of the controlled environment of clinical trials is very low (~30%–40% at 12 months. Observational studies have demonstrated that improving adherence to lipid-lowering and antihypertensive medications may reduce CV events. One means of improving adherence is the use of single-pill combinations. Real-world observational

  9. Characteristics of HIV antiretroviral regimen and treatment adherence

    Directory of Open Access Journals (Sweden)

    Vera Lúcia da Silveira

    2003-06-01

    Full Text Available The relationship between characteristics of HIV antiretroviral regimens and treatment adherence was studied in adolescent and adult patients who underwent antiretroviral therapy from January 1998 to September 2000, at the Service for Specialized Assistance in Pelotas. The patients were interviewed on two occasions, and the use of antiretrovirals during the previous 48 hours was investigated by a self-report. Adherence was defined as use of 95% or more of the prescribed medication. Social-demographic variables were collected through direct questionnaires. The antiretroviral regimen and clinical data were copied from the patients' records. Associations between the independent variables and adherence were analyzed by means of logistic regression. The multivariate analysis included characteristics of the antiretroviral regimens, social-demographic variables, as well as perception of negative effects, negative physiological states, and adverse effects of the treatment. Among the 224 selected patients, 194 participated in our study. Their ages varied from 17 to 67 years; most patients were men, with few years of schooling and a low family income. Only 49% adhered to the treatment. Adherence to treatment regimens was reduced when more daily doses were indicated: three to four doses (odds ratio of adherence to treatment (OR=0.47, 95% confidence interval (CI 0.22-1.01 and five to six (OR=0.24, 95% CI 0.09-0.62; two or more doses taken in a fasting state (OR=0.59, 95% CI 0.11-0.68, and for patients who reported adverse effects to the treatment (OR=0.39, 95% CI 0.19-0.77. Most of the regimens with more than two daily doses of medication included at least one dose apart from mealtimes. The results suggest that, if possible, regimens with a reduced number of doses should be chosen, with no compulsory fasting, and with few adverse effects. Strategies to minimize these effects should be discussed with the patients.

  10. Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS)

    DEFF Research Database (Denmark)

    Bath, Philip M W; Woodhouse, Lisa; Scutt, Polly;

    2015-01-01

    BACKGROUND: High blood pressure is associated with poor outcome after stroke. Whether blood pressure should be lowered early after stroke, and whether to continue or temporarily withdraw existing antihypertensive drugs, is not known. We assessed outcomes after stroke in patients given drugs to......), started within 48 h of stroke onset, or to no glyceryl trinitrate (control group). A subset of patients who were taking antihypertensive drugs before their stroke were also randomly assigned to continue or stop taking these drugs. The primary outcome was function, assessed with the modified Rankin Scale...... significantly reduced on day 1 in 2000 patients allocated to glyceryl trinitrate compared with 2011 controls (difference -7·0 [95% CI -8·5 to -5·6] mm Hg/-3·5 [-4·4 to -2·6] mm Hg; both p<0·0001), and on day 7 in 1053 patients allocated to continue antihypertensive drugs compared with 1044 patients randomised...

  11. THE EVALUATION OF COMPLIANCE TO ANTIHYPERTENSIVE THERAPY IN PATIENTS AFTER STROKE AND POSTSTROKE DEPRESSION DURING ANTIDEPRESSANT THERAPY

    Directory of Open Access Journals (Sweden)

    B. B. Fishman

    2016-01-01

    Full Text Available Aim. To study the effect of the antidepressant paroxetine on the compliance to antihypertensive therapy in patients with arterial hypertension (HT and post-stroke depression.Material and methods. Patients (n=24 aged 55-73 with controlled HT (blood pressure, BP<140/90 mm Hg and with subclinical poststroke depression after rehabilitation course were included into the study. Patients were split into two groups. Patients of group 1 (n=12 received adequate antihypertensive therapy and selective serotonin reuptake inhibitor paroxetine. Patients of group 2 (n=12 received antihypertensive therapy only. The study duration was 16 weeks. Patient compliance to antihypertensive therapy, BP and severity of depressive disorders, motor and intellectual functions was evaluated initially and after 16 weeks.Results. BP>140/80 mmHg after 16 weeks was found in 10 (41.6% patients. Clinical post-stroke depression was found in 7 (30.4% patients, 5 (41.6% of them were from group 2 (OR=0.35, 95% CI 0.12-0.78. High treatment compliance was in 15 (65.2% patients, and 9 (81.8% of them were from group 1. Nine (39.1% patients did not receive an adequate antihypertensive therapy, 5 (41.6% of them were from group 2 and could not explain their refusal from medication. General index of intellectual function was higher in patients of group 1 (p=0.034 than this in group 2; index of motor function did not change significantly (p>0.05.Conclusion. Reduction of compliance to antihypertensive therapy and rehabilitation in hypertensive patients after stroke is associated with unmotivated refusal from treatment because of clinical post-stroke depression.

  12. Antihypertensive drugs and risk of cancer: network meta-analyses and trial sequential analyses of 324,168 participants from randomised trials

    DEFF Research Database (Denmark)

    Bangalore, Sripal; Kumar, Sunil; Kjeldsen, Sverre E; Makani, Harikrishna; Grossman, Ehud; Wetterslev, Jørn; Gupta, Ajay K; Sever, Peter S; Gluud, Christian; Messerli, Franz H

    2011-01-01

    The risk of cancer from antihypertensive drugs has been much debated, with a recent analysis showing increased risk with angiotensin-receptor blockers (ARBs). We assessed the association between antihypertensive drugs and cancer risk in a comprehensive analysis of data from randomised clinical tr...

  13. Adherence to treatment of chronic hepatitis C: from interferon containing regimens to interferon and ribavirin free regimens

    Science.gov (United States)

    Younossi, Zobair M.; Stepanova, Maria; Henry, Linda; Nader, Fatema; Younossi, Youssef; Hunt, Sharon

    2016-01-01

    Abstract Patients’ experience during treatment may affect treatment adherence. Our aim was to assess the impact of patient-reported outcomes (PROs) on adherence to different anti-hepatitis C virus (HCV) regimens. Clinical, demographic, and PRO data (short form-36 [SF-36], chronic liver disease questionnaire-hepatitis C version [CLDQ-HCV], functional assessment of chronic illness therapy-fatigue [FACIT-F], work productivity and activity impairment: specific health problem [WPAI:SHP]) from 13 multinational clinical trials of anti-HCV treatment were available. Treatment adherence was defined as >80% of prescribed doses taken. Included were 4825 HCV patients. Regimens were grouped into: interferon- and ribavirin (RBV)-containing (±sofosbuvir [SOF]), interferon-free RBV-containing (RBV + SOF ± ledipasvir [LDV]), and interferon-free RBV-free (LDV/SOF). The adherence to these regimens were 77.6%, 84.3%, and 96.2%, respectively (P  0.05) for the small number of patients who were nonadherent to LDV/SOF. In multivariate analysis, being treatment-naive, longer treatment duration, and receiving an interferon- or RBV-containing regimen were associated with a lower likelihood of adherence (all P < 0.003). Better baseline and on-treatment PRO scores were associated with a higher likelihood of adherence to interferon and RBV. The use of interferon and/or RBV, longer duration of treatment, and lower baseline and on-treatment PRO scores were linked to a decreased likelihood of being adherent to interferon + RBV-containing or interferon-free RBV-containing antiviral regimens. Interferon- and RBV-free regimens were associated with excellent adherence. PMID:27428205

  14. Comparative study of the antihypertensive activity of Marrubium vulgare and of the dihydropyridine calcium antagonist amlodipine in spontaneously hypertensive rat.

    Science.gov (United States)

    El Bardai, Sanae; Lyoussi, Badiaa; Wibo, Maurice; Morel, Nicole

    2004-08-01

    Water extract of Marrubium vulgare is widely used as antihypertensive treatment in folk medicine. We have compared the effect of 10-week-long treatment with amlodipine or Marrubium water extract on systolic blood pressure (SBP), cardiovascular remodeling and vascular relaxation in spontaneously hypertensive rats (SHR). Both treatments produced similar decrease in SBP. Amlodipine treatment reduced left ventricle, aortic and mesenteric artery weight. Marrubium treatment had a significant antihypertrophic effect in aorta only. Relaxation to acetylcholine (ACh) of mesenteric artery was improved by Marrubium but not by amlodipine treatment. These results demonstrate that, in addition to its antihypertensive effect, Marrubium water extract improved the impaired endothelial function in SHR. PMID:15554450

  15. Experimental study on the antihypertensive effect of different antihypertensive system%不同降压体系降压效果实验研究

    Institute of Scientific and Technical Information of China (English)

    宋文玲; 赵丽娟; 高钥洪

    2014-01-01

    北一区三类油层储层物性变化大、剩余油分布零散,导致其水驱挖潜难度大,在水驱开发过程中往往出现注水井注入压力高,吸水能力差的问题,针对上述问题进行实验室降压增注实验研究,对比不同配方降压剂对水驱提高采收率的影响,并根据北一区三类油层注入水有严重的结垢趋势,提出在降压剂配方中加入阻垢剂的措施。纳米聚硅和生物酶体系的降压率分别为18.79%,16.86%,4种活性剂体系的降压率分别是22.09%,25.47%、20.20%,21.55%,活性体系的降压率会随着注入量的增加出现小幅度的上升。综合分析实验结果提出两种可供现场使用的方案:注入甜菜碱一元活性体系,注入浓度为0.2%,注入量为0.1 PV;由0.2%石油磺酸盐和0.6%阻垢剂组成二元体系,优选0.15 PV的注入量。%For the stray remaining oil distribution and great physical properties of tertiary-main layers on North One area, which is hard to tap the potential. Duing waterflooding injection wells are characterized by poor absorption and high injection pressure. Aimed at the problem the experiments of depressurization and augmented injection were developed in the laboratory. Comparing different formulations antihypertensive agents on the impact of injection rate on waterflooding enhanced oil recovery. As the injected water of tertiary-main layers on North One area has serious scaling trends, inhibitor can be added in the formulation of Antihypertensive agent. Nanometer silicon polymer and Enzymes system depressurization rate were 18.79%and 16.86%, Four kinds of surfactant system depressurization rate are 22.09,25.47,20.20,21.55%. Antihypertensive rate of betaine activity system can be rised at a small amplitude with the increase of injection. By analyzing the experimental results,get the following two options for site use:Injection of betaine is unary yuan activity system,injection concentration is 0

  16. Divided dose intramuscular regimen and single dose subcutaneous regimen for chloroquine: plasma concentrations and toxicity in patients with malaria

    OpenAIRE

    1986-01-01

    Adults with malaria in Sri Lanka were treated with parenteral chloroquine diphosphate, either 2.5 mg base/kg intramuscularly at 0, 1, 12, 13, 24, and 25 hours or 5 mg base/kg subcutaneously at 0, 12, and 24 hours. Both regimens were completed with oral chloroquine phosphate, 5 mg base/kg, at 36 and 48 hours. Mean peak chloroquine concentrations in the first 12 hours, which were 0.5 (range 0.3-0.6) mg/l (1.4 (0.9-1.7) mu mol/l) [corrected] with the intramuscular regimen and 0.3 (0.2-0.4) mg/l ...

  17. Once-daily dose regimen of ribavirin is interchangeable with a twice-daily dose regimen: randomized open clinical trial

    Directory of Open Access Journals (Sweden)

    Balk JM

    2015-08-01

    Full Text Available Jiska M Balk,1 Guido RMM Haenen,1 Özgür M Koc,2 Ron Peters,3 Aalt Bast,1 Wim JF van der Vijgh,1 Ger H Koek,4 1Department of Toxicology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, 2Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 3DSM Resolve, Geleen, 4Department of Internal Medicine, Division of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, the Netherlands Background: The combination of ribavirin (RBV and pegylated interferon (PEG-IFN is effective in the treatment of chronic hepatitis C infection. Reducing the frequency of RBV intake from twice to once a day will improve compliance and opens up the opportunity to combine RBV with new and more specific direct-acting agents in one pill. Therefore, the purpose of this study was to evaluate the pharmacokinetic profile of RBV in a once-daily to twice-daily regimen. The secondary aim was to determine tolerability as well as the severity and differences in side effects of both treatment regimens. Methods: In this randomized open-label crossover study, twelve patients with chronic type 1 hepatitis C infection and weighing more than 75 kg were treated with 180 µg of PEG-IFN weekly and 1,200 mg RBV daily for 24 weeks. The patients received RBV dosed as 1,200 mg once-daily for 12 weeks followed by RBV dosed as 600 mg twice-daily for 12 weeks, or vice versa. In addition to the pharmacokinetic profile, the hematological profile and side effects were recorded. The RBV concentrations in plasma were determined using liquid chromatography-tandem mass spectrometry. Results: Eight of twelve patients completed the study. Neither the time taken for RBV to reach peak plasma concentration nor the AUC0-last (adjusted for difference in dose was significantly different between the two groups (P>0.05. Furthermore, the once-daily regimen did not give more side effects than the twice-daily regimen (P>0

  18. A pharmacovigilance study of antihypertensive medicines at a South Delhi hospital

    Directory of Open Access Journals (Sweden)

    Hussain A

    2009-01-01

    Full Text Available The aim of the present study was to monitor adverse drug reactions associated with antihypertensive drugs. The study was conducted in medicine out patient department of 150-bed Majeedia Hospital at Hamdard University Campus in New Delhi. The study was conducted by way of one to one patient interview by a registered pharmacist using a questionnaire-based Adverse Drug Reaction Monitoring Form drafted according to the World Health Organisation Monitoring Guidelines. A total of 34 adverse drug reactions were observed in 250 hypertensive patients during the four month study. A high percentage of adverse drug reactions occurred in middle aged and female patients. Of the 34 adverse drug reactions, 18 (52.9% were mild, 14 (41.2% moderate and only 2 (5.8% were classified as severe. Combination therapy was associated with significantly high occurrence (P < 0.05 of adverse drug reactions, with a total of 21 (61.8% as compared to monotherapy (n=13, 38.2%. Cardiovascular adverse drug reactions constituted a major component, followed by gastrointestinal and respiratory complaints. Beta-blockers were the drug category associated with majority of adverse drug reactions, followed by angiotensin-converting enzyme inhibitors and calcium channel blockers. The above pharmacovigilance study presents the adverse drug reaction profile of antihypertensive medicines prescribed in our University Teaching Hospital. It was concluded that calcium channel blockers were the most frequently prescribed drug category but beta blockers were associated with higher frequency of adverse drug reactions.

  19. Analytical Methods, Preformulation Study and Physicochemical Evaluation Techniques for Transdermal Patches of Antihypertensive Drug

    Directory of Open Access Journals (Sweden)

    Vilegave Kailash

    2013-01-01

    Full Text Available Since early 1980s, this dosage form of transdermal therapeutic system has been available in the pharmaceutical market. The discovery of transdermal drug delivery systems (TDDS is a breakthrough in the field of controlled drug delivery systems. The ability of TDDS to deliver drugs for systemic effect through intact skin while bypassing first pass metabolism has accelerated transdermal drug delivery research in the field of pharmaceutics. Over a decade of such extensive research activities, many transdermal patches have been developed and successfully commercialized. The present study was carried out to evaluate transdermal formulation containing carvedilol with different ratios of hydrophilic (Eudragit RL100,HPMC and hydrophobic polymeric (Eudragit RS100,Ethyl Cellulose combinations plasticized with triethyl Citrate and dibutyl phthalate by the solvent evaporation technique. The prepared patches were tested for their physicochemical characteristics such as thickness, weight and drug content uniformity, water vapour transmission, folding endurance, and tensile strength.In vitro release studies of carvedilol-loaded patches in 30% v/v Methanolic Isotonic Phosphate Buffer(MIPB of pH 7.4 . The antihypertensive activity of the patches was studied using methyl prednisolone acetate induced hypertensive rats. This article describes various methods of evaluation of transdermal dosage form containing Antihypertensive drug Carvedilol.

  20. Pharmacoeconomics of antihypertensive drugs prescribed in a multispecialty hospital in South India

    Directory of Open Access Journals (Sweden)

    P S Dhivya

    2014-01-01

    Full Text Available The main objective of this study is to evaluate the most cost-effective therapy among the different group of antihypertensive prescribed in a multispecialty hospital. According to inclusion and exclusion criteria, 104 hypertensive patients were selected. Participants were interviewed at about the demographic data. Initial clinical assessment of blood pressure (BP and pulse rate were done. They were prescribed monotherapy either with angiotensin receptor blocker (ARB (n = 7 or beta blocker (BB (n = 23 or calcium channel blocker (CCB (n = 9. Angiotensin converting enzyme with BB (n = 27, ARB with CCB (n = 17 and ARB with BB (n = 21 were prescribed in combination therapy. The cost of antihypertensive drugs was calculated using incremental cost for "per mmHg" reduction and cost for "per patient" reaching target BP. The data are analyzed using suitable statistical methods. ARB with BB shows significant reduction in BP. To maintain the targeted BP, BB is found to be cost-effective in both systolic BP (SBP and diastolic BP (DBP as well as in the reduction of "per mmHg" of DBP. In case of reduction of "per mmHg" of SBP ARB is cost-effective. Treatment of hypertension with BBs is cost-effective.

  1. Evaluation of antihyperglycemia and antihypertension potential of native Peruvian fruits using in vitro models.

    Science.gov (United States)

    Pinto, Marcia Da Silva; Ranilla, Lena Galvez; Apostolidis, Emmanouil; Lajolo, Franco Maria; Genovese, Maria Inés; Shetty, Kalidas

    2009-04-01

    Local food diversity and traditional crops are essential for cost-effective management of the global epidemic of type 2 diabetes and associated complications of hypertension. Water and 12% ethanol extracts of native Peruvian fruits such as Lucuma (Pouteria lucuma), Pacae (Inga feuille), Papayita arequipeña (Carica pubescens), Capuli (Prunus capuli), Aguaymanto (Physalis peruviana), and Algarrobo (Prosopis pallida) were evaluated for total phenolics, antioxidant activity based on 2, 2-diphenyl-1-picrylhydrazyl radical scavenging assay, and functionality such as in vitro inhibition of alpha-amylase, alpha-glucosidase, and angiotensin I-converting enzyme (ACE) relevant for potential management of hyperglycemia and hypertension linked to type 2 diabetes. The total phenolic content ranged from 3.2 (Aguaymanto) to 11.4 (Lucuma fruit) mg/g of sample dry weight. A significant positive correlation was found between total phenolic content and antioxidant activity for the ethanolic extracts. No phenolic compound was detected in Lucuma (fruit and powder) and Pacae. Aqueous extracts from Lucuma and Algarrobo had the highest alpha-glucosidase inhibitory activities. Papayita arequipeña and Algarrobo had significant ACE inhibitory activities reflecting antihypertensive potential. These in vitro results point to the excellent potential of Peruvian fruits for food-based strategies for complementing effective antidiabetes and antihypertension solutions based on further animal and clinical studies. PMID:19459727

  2. Nutraceutical Value of Black Cherry Prunus serotina Ehrh. Fruits: Antioxidant and Antihypertensive Properties

    Directory of Open Access Journals (Sweden)

    Francisco J. Luna-Vázquez

    2013-11-01

    Full Text Available In Mexico black cherry (Prunus serotina Ehrh. fruits are consumed fresh, dried or prepared in jam. Considering the evidence that has linked intake of fruits and vegetables rich in polyphenols to cardiovascular risk reduction, the aim of this study was to characterize the phenolic profile of black cherry fruits and to determine their antioxidant, vasorelaxant and antihypertensive effects. The proximate composition and mineral contents of these fruits were also assessed. Black cherry fruits possess a high content of phenolic compounds and display a significant antioxidant capacity. High-performance liquid chromatography/mass spectrometric analysis indicated that hyperoside, anthocyanins and chlorogenic acid were the main phenolic compounds found in these fruits. The black cherry aqueous extract elicited a concentration-dependent relaxation of aortic rings and induced a significant reduction on systolic blood pressure in L-NAME induced hypertensive rats after four weeks of treatment. Proximate analysis showed that black cherry fruits have high sugar, protein, and potassium contents. The results derived from this study indicate that black cherry fruits contain phenolic compounds which elicit significant antioxidant and antihypertensive effects. These findings suggest that these fruits might be considered as functional foods useful for the prevention and treatment of cardiovascular diseases.

  3. Short-term antihypertensive therapy lowers the C-reactive protein level

    Directory of Open Access Journals (Sweden)

    Andrzej Madej

    2012-02-01

    Full Text Available Introduction:There is a growing body of data concerning significant interactions between markers of inflammation and cardiovascular diseases such as hypertension accompanied by elevated levels of plasma C-reactive protein (CRP. Therefore CRP is thought to be an independent risk factor of cardiovascular diseases.Material/Methods:The aim of this study was to evaluate the effects of antihypertensive therapy (perindopril, bisoprolol and combined therapy on plasma CRP concentration in 67 subjects with mild or moderate hypertension who have been treatment-naive and otherwise healthy.Results:The results show a correlation between CRP level and blood pressure values. BP reduction was associated with a decrease in CRP concentration. The CRP-lowering effect of perindopril and bisoprolol was comparable and the degree of reduction might reflect their similar influence on blood pressure. Combined treatment influenced the CRP level to a greater extent than both monotherapies.Conclusions:Plasma CRP level was lowered by antihypertensive therapy independently of the drug applied. The CRP level did not normalize completely in moderate hypertensive patients.

  4. COMBINED ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION AFTER THE STROKE

    Directory of Open Access Journals (Sweden)

    O. A. Ageenkova

    2010-01-01

    Full Text Available Aim. To evaluate influence of the combined therapy with ACE inhibitor (perindopril, diuretic (indapamide and dihydropyridine calcium channel blocker (amlodipine on ambulatory blood pressure (BP monitoring indices and heart rate variability in hypertensive patients during early recovery period of stroke.Material and methods. 39 patients (28 men, 11 women with arterial hypertension of 1-3 degrees during early recovery period after stroke were examined. They received perindopril 10 mg QD, indapamide — 1.5 mg QD. Calcium channel blocker amlodipine (5 mg QD was added in case of insufficient effect of the ACE inhibitor plus diuretic combination.Results. The combined antihypertensive therapy in hypertensive patients after the stroke led to significant decrease of systolic and diastolic BP (by 23.5% and 18.9%, respectively, normalization of BP daily profile (a number of «dippers» enlarged by 42.2%, improvement of the wall vessel rigidity (decrease in pulse wave velocity by 12.9% and heart rhythm variability (increase in SDNN, PNN50 and RMSSD by 7%, 20% and 25%, respectively.Conclusion. Advantages of the combined antihypertensive therapy (ACE inhibitor, diuretic, calcium channel blocker in treatment of hypertensive patients after the stroke are shown.

  5. Effect of antihypertensive agents - captopril and nifedipine - on the functional properties of rat heart mitochondria

    Science.gov (United States)

    Kancirová, Ivana; Jašová, Magdaléna; Waczulíková, Iveta; Ravingerová, Táňa; Ziegelhöffer, Attila; Ferko, Miroslav

    2016-01-01

    Objective(s): Investigation of acute effect on cellular bioenergetics provides the opportunity to characterize the possible adverse effects of drugs more comprehensively. This study aimed to investigate the changes in biochemical and biophysical properties of heart mitochondria induced by captopril and nifedipine antihypertensive treatment. Materials and Methods: Male, 12-week-old Wistar rats in two experimental models (in vivo and in vitro) were used. In four groups, the effects of escalating doses of captopril, nifedipine and combination of captopril + nifedipine added to the incubation medium (in vitro) or administered per os to rat (in vivo) on mitochondrial ATP synthase activity and membrane fluidity were monitored. Results: In the in vitro model we observed a significant inhibitory effect of treatment on the ATP synthase activity (Pactivity and the membrane fluidity in rats receiving captopril, nifedipine, and combined therapy. Conclusion: In vitro kinetics study revealed that antihypertensive drugs (captopril and nifedipine) directly interact with mitochondrial ATP synthase. In vivo experiment did not prove any acute effect on myocardial bioenergetics and suggest that drugs do not enter cardiomyocyte and have no direct effect on mitochondria.

  6. Nonsteroidal anti-inflammatory drugs and antihypertensives: how do they relate?

    Science.gov (United States)

    Khatchadourian, Zovinar Der; Moreno-Hay, Isabel; de Leeuw, Reny

    2014-06-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely available as over-the-counter medications, despite their numerous side effects and drug interactions. The aim of this article is to increase awareness of the hypertensive potential of NSAIDs and their interference with antihypertensives. Patients with hypertension appear to be more susceptible than normotensive individuals to the blood pressure-increasing effect of NSAIDs. Most studies have found that short-term use of NSAIDs does not pose a major risk for hypertension or increase in cardiovascular disease in healthy individuals. The calcium channel blockers and β-blockers seem to be least affected by the concomitant use of NSAIDs. A dentist must weigh the benefits and disadvantages of using NSAIDs in patients taking antihypertensive drugs. For those who may be at greater risk, such as patients with hypertension and the elderly, careful selection of the class of NSAID and close monitoring are appropriate measures, especially if long-term use is anticipated. PMID:24755117

  7. Comparison of different insulin regimens in elderly patients with NIDDM

    NARCIS (Netherlands)

    Wolffenbuttel, B H; Sels, J P; Rondas-Colbers, G J; Menheere, P P; Nieuwenhuijzen Kruseman, A C

    1996-01-01

    OBJECTIVE: To compare the metabolic effects of three different frequently used regimens of insulin administration on blood glucose control and serum lipids, and the costs associated with this treatment, in subjects with NIDDM, who were poorly controlled with oral antihyperglycemic agents. RESEARCH D

  8. Prescription Pattern of Antihypertensive Agents in T2DM Patients Visiting Tertiary Care Centre in North India

    Directory of Open Access Journals (Sweden)

    Ethiraj Dhanaraj

    2012-01-01

    Full Text Available Background. Hypertension management is of a paramount importance in diabetic patients for cardiovascular risk reduction. Aim. To evaluate prescribing pattern of antihypertensive in T2DM (type 2 diabetes patients and compare with existing recent guidelines. Methods. A cross-sectional study involving evaluation of all T2DM patients referred to endocrinology unit at tertiary care centre for hypertension, comorbid complications, and recording prescription. Utilization of 5 different antihypertensive drug classes was compared for all patients receiving 1, 2, 3, 4, or more drugs. Logistical regression was used to assess likelihood of prescription of drugs and/or therapy for specific conditions mentioned in the guidelines. Results. Out of 1358, T2DM enrolled patients 1186 (87% had hypertension (males 52%, females 48%. The median duration (IQ of hypertension diabetics was 4 (1–10 years. A total of 25% patients had controlled BP and 75% with uncontrolled blood pressure (13% isolated systolic hypertension, 6% isolated diastolic hypertension, and 55% both elevated. Overall, ACE inhibitors (ACEIs were prescribed the highest (59% followed by angiotensin receptor blockers (ARBs (52%, calcium channel blockers (CCBs (29%, diuretics (27%, and beta-blockers (14%. Overall, 55% of T2DM patients were on polytherapy, 41% on monotherapy, and 4% had no antihypertensive treatment. Polytherapy was more predominant with age, duration of diabetes, duration of hypertension, and comorbid complications. Conclusion. Although prescribing pattern of antihypertensive showed adherence to existing evidence-based guidelines, higher proportion of uncontrolled hypertensive patients was found.

  9. Protective effect of anti-hypertensive treatment on cognitive function in essential hypertension: analysis of published clinical data.

    Science.gov (United States)

    Amenta, Francesco; Mignini, Fiorenzo; Rabbia, Franco; Tomassoni, Daniele; Veglio, Franco

    2002-11-15

    Hypertension is a risk factor for stroke and may also contribute to the development of vascular cognitive impairment (VCI) and vascular dementia (VaD). Cognitive complications of hypertension and the influence of anti-hypertensive treatment were underestimated until recently. In this paper, trials investigating the effect of anti-hypertensive treatment on cognitive function were evaluated. Analysis of these studies revealed that until approximately 1990-1995 investigations have assessed primarily if anti-hypertensive treatment impaired cognitive function. Only more recent studies have investigated positive effects on cognition of anti-hypertensive medication. Drugs more extensively evaluated were diuretics, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, sartanes and Ca(2+) channel blockers. Available studies have confirmed that elevated diastolic blood pressure or pulse pressure and isolated systolic hypertension play an important role in the development of cognitive impairment. Randomized placebo-controlled trials have provided evidence that reduction of hypertension safely and effectively decreases morbidity and mortality rates and cognitive complications of hypertension. Ca(2+) channel blockers and ACE inhibitors have been shown to be effective and probably better than diuretics and beta-blockers on cognitive domains of hypertension. More extensive investigations could contribute to establishing optimal choice and drug dosage for the treatment of cognitive complications of hypertension. PMID:12417374

  10. INFLUENCE OF COMBINED ANTIHYPERTENSIVE AND ANTIDEPRESSANT THERAPY ON LEFT VENTRICULAR REMODELING IN PATIENTS WITH ARTERIAL HYPERTENSION, ANXIETY AND DEPRESSION

    Directory of Open Access Journals (Sweden)

    Y. A. Vasyuk

    2016-01-01

    Full Text Available Aim. To assess influence of combined antihypertensive (captopril or metoprolol and antidepressant (thianeptin or sertralin therapy on clinical status, blood pressure (BP and myocardial function in patients with arterial hypertension (HT and affective disorders (AD.Material and methods. 106 patients with HT were involved in the study. 64 patients (60,4% had concomitant AD. All patients were divided into 3 groups. 46 patients with HT and AD were included in the 1-st group. They received metoprolol or captopril in combination with tianeptine or sertaline. The 2-nd group included 18 patients with HT and AD who received only antihypertensive therapy. The 3-rd group consisted of 42 patients with HT without AD. They also received only antihypertensive therapy.Results. After 6 month therapy patients of the 1-st and the 3-rd groups had more significant clinical improvement and BP reduction (according to 24- hour BP monitoring as well as more farourable structural and functional changes of left ventricular in comparison with patients of the 2-nd group.Conclusion. In patients with HT and concomitant AD combined antihypertensive and antidepressant therapy result in favourable clinical changes, effectively reduce BP, improve left ventricular structure and function.

  11. A study on prescribing pattern of antihypertensives in adult patients attending in a tertiary care hospital of Assam, India

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    Pavel Sikidar

    2016-06-01

    Conclusions: Our study shows that the most commonly prescribed drug classes involved were angiotensin II receptor antagonists followed by calcium channel blocker and the anti-hypertensive drug combinations among hypertensive patients were considerable and this practice positively impacted on the overall blood pressure control. [Int J Basic Clin Pharmacol 2016; 5(3.000: 975-978

  12. Performance of coupled enzymatic hydrolysis and membrane separation bioreactor for antihypertensive peptides production from Porphyra yezoensis protein

    Science.gov (United States)

    To explore more efficient production methods of antihypertensive peptides from Porphyra yezoensis protein, three methods of coupling of enzymatic hydrolysis and membrane separation (CEH-MS) were studied and compared with the traditional EH and offline MS method. The results showed that the conversio...

  13. Laurate Biosensors Image Brain Neurotransmitters In Vivo: Can an Antihypertensive Medication Alter Psychostimulant Behavior?

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    Vivek Murthy

    2008-07-01

    Full Text Available Neuromolecular Imaging (NMI with novel biosensors enables the selective detection of neurotransmitters in vivo within seconds, on line and in real time. Biosensors remain in place for continuing studies over a period of months. This biotechnological advance is based on conventional electrochemistry; the biosensors detect neurotransmitters by electron transfer. Simply stated, biosensors adsorb electrons from each neurotransmitter at specific oxidation potentials; the current derived from electron transfer is proportional to neurotransmitter concentration. Selective electron transfer properties of these biosensors permit the imaging of neurotransmitters, metabolites and precursors. The novel BRODERICK PROBE® biosensors we have developed, differ in formulation and detection capabilities from biosensors/electrodes used in conventional electrochemistry/ voltammetry. In these studies, NMI, specifically, the BRODERICK PROBE® laurate biosensor images neurotransmitter signals within mesolimbic neuronal terminals, nucleus accumbens (NAc; dopamine (DA, serotonin (5-HT, homovanillic acid (HVA and Ltryptophan (L-TP are selectively imaged. Simultaneously, we use infrared photobeams to monitor open-field movement behaviors on line with NMI in the same animal subjects. The goals are to investigate integrated neurochemical and behavioral effects of cocaine and caffeine alone and co-administered and further, to use ketanserin to decipher receptor profiles for these psychostimulants, alone and co-administered. The rationale for selecting this medication is: ketanserin (a is an antihypertensive and cocaine and caffeine produce hypertension and (b acts at 5-HT2A/2C receptors, prevalent in NAc and implicated in hypertension and cocaine addiction. Key findings are: (a the moderate dose of caffeine simultaneously potentiates cocaine's neurochemical and behavioral responses. (b ketanserin simultaneously inhibits cocaine-increased DA and 5-HT release in

  14. Identification of validated questionnaires to measure adherence to pharmacological antihypertensive treatments

    Directory of Open Access Journals (Sweden)

    Pérez-Escamilla B

    2015-04-01

    Full Text Available Beatriz Pérez-Escamilla,1 Lucía Franco-Trigo,1 Joanna C Moullin,2 Fernando Martínez-Martínez,1 José P García-Corpas1 1Academic Centre in Pharmaceutical Care, Faculty of Pharmacy, University of Granada, Granada, Spain; 2Graduate School of Health, Faculty of Pharmacy, University of Technology Sydney, Sydney, NSW, Australia Background: Low adherence to pharmacological treatments is one of the factors associated with poor blood pressure control. Questionnaires are an indirect measurement method that is both economic and easy to use. However, questionnaires should meet specific criteria, to minimize error and ensure reproducibility of results. Numerous studies have been conducted to design questionnaires that quantify adherence to pharmacological antihypertensive treatments. Nevertheless, it is unknown whether questionnaires fulfil the minimum requirements of validity and reliability. The aim of this study was to compile validated questionnaires measuring adherence to pharmacological antihypertensive treatments that had at least one measure of validity and one measure of reliability. Methods: A literature search was undertaken in PubMed, the Excerpta Medica Database (EMBASE, and the Latin American and Caribbean Health Sciences Literature database (Literatura Latino-Americana e do Caribe em Ciências da Saúde [LILACS]. References from included articles were hand-searched. The included papers were all that were published in English, French, Portuguese, and Spanish from the beginning of the database’s indexing until July 8, 2013, where a validation of a questionnaire (at least one demonstration of the validity and at least one of reliability was performed to measure adherence to antihypertensive pharmacological treatments. Results: A total of 234 potential papers were identified in the electronic database search; of these, 12 met the eligibility criteria. Within these 12 papers, six questionnaires were validated: the Morisky

  15. Gemcitabine Based Combination Regimens for Treatment of Refractory Advanced Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    CHE Li; DI Li-jun; SONG Guo-hong; JIA Jun; YU Jing; WANG Xiao-li; ZHU Yu-lin; JIANG Han-fang; LIANG Xu

    2008-01-01

    Objective:Anthracycline and taxane are the standard agents in combined chemotherapy of advanced breast cancer.However,when these agents based chemotherapy is failure,the selection of salvage regimen is still of problem.Gemcitabine,an active agent in both lung cancer and pancreas cancer,is demonstrated effective in breast caner.But there have been relatively less data of gemcitabine in anthracycline and/or taxane-resistant breast cancer.Therefore we employe this study to explore the efficacy and safety of gemcitabine based combination regimen in this population.Methods:From May 2002 to March 2006,28 patients with measurable lesion of advanced metastatic breast cancer who were resistant to prior anthracycline and taxane based chemotherapy were enrolled.Patients were treated with gemcitabine based combination chemotherapy with a median cycles of 3(range 2-6).Results:The overall response rate was 28.6%(8/28),with 1 CR(Complete response 3.5%)and 7 PRs(Partial response 25%).Stable disease was seen in 8 patients(28.6%)while disease progressed in 12 patiens(42.8%).The median time to progression was 4.5 m(range,2-23 m).The main toxicity included bone marrow depression,alopecia,mucositis and peripheral neurotoxicity.The grade 3 to 4 clinical adverse effect was leukopenia in 5 cases(17.9%)and thrombocytopenia in 8 cases(30%).Conclusion:Gemcitabine based combination regimens is feasible in anthracycline and taxane-resistant advanced breast cancer.The clinical response and TTP is acceptable with limited toxicity pattern.

  16. The choice of regimens based on bortezomib for patients with newly diagnosed multiple myeloma.

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    Jingsong He

    Full Text Available INTRODUCTION: Bortezomib has significantly improved multiple myeloma (MM response rates, but strategies for choosing bortezomib-based regimens for initial MM therapy are not standardized. Here, we describe four bortezomib-based therapies in Chinese MM patients to determine the optimal chemotherapeutic approach. METHODS: Newly diagnosed symptomatic MM patients at three hematological centers between February 1, 2006 and May 31, 2013 were treated with therapies including bortezomib plus dexamethasone (PD or combinations of PD with either adriamycin (PAD, cyclophosphamide (PCD or thalidomide (PTD for every 28 days. RESULTS: The overall response rate of all the 215 eligible patients was 90.2%. The ORR for PCD, PAD, PTD and PD were 97.4%, 93.2%, 85.3% and 77.8% while the effects with VGPR or better were 63.7%, 62.7%, 44.2% and 37.8%, respectively. The effect of ORR, VGPR and CR/nCR for the PCD regimen was better than the PD protocol. Median PFS for all patients was 29.0 months with significant differences observed among treatment groups. Median OS of all the patients was not reached, but three-drug combinations were superior to PD alone. Frequently observed toxicities were neutropenia, thrombocytopenia, fatigue, infection, herpes zoster, and peripheral neuropathy. The incidence of peripheral neuropathy (PN in PTD group was significantly higher than other three groups, especially grade 2-3 PN. Treatment with anti-viral agent acyclovir significantly reduced the incidence of herpes zoster. CONCLUSIONS: Our experience indicated that bortezomib-based regimens were effective and well-tolerated in the Chinese population studied; three-drug combinations PCD, PAD were superior to PD, especially with respect to PCD.

  17. Comparison of the safety and efficacy of a fixed-dose combination regimen and separate formulations for pulmonary tuberculosis treatment

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    Jiun-Ting Wu

    2015-06-01

    Full Text Available OBJECTIVES: Fixed-dose combination formulations, which simplify the administration of drugs and prevent the development of drug resistance, have been recommended as a standard anti-tuberculosis treatment regimen. However, the composition and dosage recommendations for fixed-dose combination formulations differ from those for separate formulations. Thus, questions about the effectiveness and side effects of combination formulations remain. The aim of this study was to compare the safety and efficacy of these two types of anti-tuberculosis regimens for pulmonary tuberculosis treatment. METHOD: A prospective, randomized controlled study was conducted using the directly observed treatment short-course strategy. Patients were randomly allocated to one of two short-course regimens. One year after completing the treatment, these patients’ outcomes were analyzed. ClinicalTrials.gov: NCT00979290. RESULTS: A total of 161 patients were enrolled, 142 of whom were evaluable for safety assessment. The two regimens had a similar incidence of adverse effects. In the per-protocol population, serum bilirubin concentrations at the peak level, at week 4, and at week 8 were significantly higher for the fixed-dose combination formulation than for the separate formulations. All patients had negative sputum cultures at the end of the treatment, and no relapse occurred after one year of follow-up. CONCLUSIONS: In this randomized study, transient higher serum bilirubin levels were noted for the fixed-dose combination regimen compared with the separate formulations during treatment. However, no significant difference in safety or efficacy was found between the groups when the directly observed treatment short-course strategy was used.

  18. Apparent pharmacogenetics in antihypertensive therapy%高血压表观遗传药理学研究进展

    Institute of Scientific and Technical Information of China (English)

    匡泽民; 黄志军; 阳国平; 袁洪

    2013-01-01

    With the development of pharmacogenetics, people gradually realize that gene polymorphism cannot fully explain the antihypertensive drugs curative effect of individual differences. At the molecular level,many antihypertensive drugs related metabolic enzyme, receptors, transporter are subject to the influence of the regulation of gene expression,and play an important role in differences of antihypertensive treatment. Therefore, from the perspective of epigenetics genetic factors and the relationship between the antihypertensive drugs, will help to better explain the clinical drug reaction from the individual differences. This review summarizes the DNA methylation, histone modification and microRNAs,apparent genetic control way for antihypertensive related drugs coding genetic effects.%伴随着遗传药理学的发展,人们逐渐认识到基因多态性不能完全解释降压药物疗效的个体差异.在分子水平上,高血压药物相关代谢酶、受体、转运体都受到基因表达调控的影响,并在降压疗效差异中起着重要的作用.因此,从表观遗传学的角度研究遗传因素与降压药物之间的关系,将有助于更好地解释临床上药物反应产生的个体差异.本文综述总结了DNA甲基化、组蛋白修饰和microRNAs等表观遗传调控方式对高血压相关药物编码基因的影响.

  19. Lifestyle Modifications Versus Antihypertensive Medications in Reducing Cardiovascular Events in an Aging Society: A Success Rate-oriented Simulation.

    Science.gov (United States)

    Ohno, Yoichi; Shibazaki, Satomi; Araki, Ryuichiro; Miyazaki, Takashi; Sato, Makiko; Takahashi, Sachiko; Suwa, Emi; Takenaka, Tsuneo; Suzuki, Hiromichi

    2016-01-01

    Objective It is difficult to compare directly the practical effects of lifestyle modifications and antihypertensive medications on reducing cardiovascular disease (CVD). The purpose of this study was to compare the hypothetical potential of lifestyle modifications with that of antihypertensive medications in reducing CVD in an aging society using a success rate-oriented simulation. Methods We constructed a simulation model for virtual Japanese subpopulations according to sex and age at 10-year intervals from 40 years of age as an example of an aging society. The fractional incidence rate of CVD was calculated as the product of the incidence rate at each systolic blood pressure (SBP) level and the proportion of the SBP frequency distribution in the fractional subpopulations of each SBP. The total incidence rate was calculated by the definite integral of the fractional incidence rate at each SBP level in the sex- and age-specific subpopulations. Results If we consider the effects of lifestyle modifications on metabolic factors and transfer them onto SBP, the reductions in the total incidence rate of CVD were competitive between lifestyle modifications and antihypertensive medications in realistic scenarios. In middle-aged women, the preventive effects of both approaches were limited due to a low incidence rate. In middle-aged men and extremely elderly subjects whose adherence to antihypertensive medications is predicted to be low, lifestyle modifications could be an alternative choice. Conclusion The success rate-oriented simulation suggests that the effectiveness of lifestyle modifications or antihypertensive medications in preventing cardiovascular events largely depends on the baseline incidence rate and sex- and age-specific behavioral factors. PMID:27522993

  20. Efficacy of a Morinda citrifolia Based Skin Care Regimen

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    Brett J. West

    2012-04-01

    Full Text Available A six week clinical trial of a Morinda citrifolia (noni based skin care regimen was conducted with 49 women, ages 38 to 55 years. Daily application of three product formulations to the face and neck resulted in significant reductions in lateral canthal fine lines and wrinkles (crow’s feet, as measured by technician scoring and digital image analysis. Use of the regimen also improved skin elasticity and firmness Cutometer® measurements. No evidence of skin irritation was present in any participant at any time during the trial. A study questionnaire revealed that the measured improvements were visibly perceptible to more than 90% of the participants. The trial results substantiate traditional uses of the noni plant to improve skin health.

  1. Nanotechnology Based Approaches for Enhancing Oral Bioavailability of Poorly Water Soluble Antihypertensive Drugs.

    Science.gov (United States)

    Sharma, Mayank; Sharma, Rajesh; Jain, Dinesh Kumar

    2016-01-01

    Oral administration is the most convenient route among various routes of drug delivery as it offers high patient compliance. However, the poor aqueous solubility and poor enzymatic/metabolic stability of drugs are major limitations in successful oral drug delivery. There are several approaches to improve problems related to hydrophobic drugs. Among various approaches, nanotechnology based drug delivery system has potential to overcome the challenges associated with the oral route of administration. Novel drug delivery systems are available in many areas of medicine. The application of these systems in the treatment of hypertension continues to broaden. The present review focuses on various nanocarriers available in oral drug administration for improving solubility profile, dissolution, and consequently bioavailability of hydrophobic antihypertensive drugs. PMID:27239378

  2. Small artery structure adapts to vasodilatation rather than to blood pressure during antihypertensive treatment

    DEFF Research Database (Denmark)

    Mathiassen, Ole N; Buus, Niels H; Larsen, Mogens L; Mulvany, Michael J; Christensen, Kent L

    2007-01-01

    OBJECTIVE: Correction of the abnormal structure of resistance arteries in essential hypertension may be an important treatment goal in addition to blood pressure (BP) reduction. We investigated how this may be achieved in a prospective clinical study. METHODS: Plethysmography was used to measure....... RESULTS: In group A, mean ambulatory blood pressure (ABP) fell from 119 +/- 2 (SE) to 103 +/- 2 mmHg (P < 0.01), whereas mean ABP was unchanged in group B (100 +/- 1 to 99 +/- 1 mmHg, P = NS). Both groups showed similar reductions in Rrest (-33.4 and -28.5%, respectively) and in Rmin (-15.4 and -15...... forearm resting vascular resistance (Rrest) and minimum vascular resistance (Rmin) as a measure of vascular structure. Two different groups of patients with essential hypertension were examined at baseline and after 6 months of antihypertensive treatment. In group A, 21 patients with never...

  3. Nanotechnology Based Approaches for Enhancing Oral Bioavailability of Poorly Water Soluble Antihypertensive Drugs

    Directory of Open Access Journals (Sweden)

    Mayank Sharma

    2016-01-01

    Full Text Available Oral administration is the most convenient route among various routes of drug delivery as it offers high patient compliance. However, the poor aqueous solubility and poor enzymatic/metabolic stability of drugs are major limitations in successful oral drug delivery. There are several approaches to improve problems related to hydrophobic drugs. Among various approaches, nanotechnology based drug delivery system has potential to overcome the challenges associated with the oral route of administration. Novel drug delivery systems are available in many areas of medicine. The application of these systems in the treatment of hypertension continues to broaden. The present review focuses on various nanocarriers available in oral drug administration for improving solubility profile, dissolution, and consequently bioavailability of hydrophobic antihypertensive drugs.

  4. Effect of antihypertensive agents - captopril and nifedipine - on the functional properties of rat heart mitochondria

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    Ivana Kancirová

    2016-06-01

    Full Text Available Objective(s: Investigation of acute effect on cellular bioenergetics provides the opportunity to characterize the possible adverse effects of drugs more comprehensively. This study aimed to investigate the changes in biochemical and biophysical properties of heart mitochondria induced by captopril and nifedipine antihypertensive treatment. Materials and Methods: Male, 12-week-old Wistar rats in two experimental models (in vivo and in vitro were used. In four groups, the effects of escalating doses of captopril, nifedipine and combination of captopril + nifedipine added to the incubation medium (in vitro or administered per os to rat (in vivo on mitochondrial ATP synthase activity and membrane fluidity were monitored. Results: In the in vitro model we observed a significant inhibitory effect of treatment on the ATP synthase activity (P

  5. Impact of overweight and obesity on cardiac benefit of antihypertensive treatment

    DEFF Research Database (Denmark)

    Gerdts, E; de Simone, G; Lund, Birthe; Okin, P M; Wachtell, K; Boman, K; Nieminen, M S; Dahlöf, B; Devereux, R B

    2011-01-01

    BACKGROUND AND AIMS: Increased body mass index (BMI) has been associated with increased cardiovascular morbidity and mortality in hypertension. Less is known about the impact of BMI on improvement in left ventricular (LV) structure and function during antihypertensive treatment. METHODS AND RESULTS...... normal (n = 282), overweight (n = 405), obese (n = 150) and severely obese groups (n = 38) (BMI =24.9, 25.0-29.9, 30.0-34.9, and =35.0 kg/m(2), respectively). At study end, residual LV hypertrophy was present in 54% of obese and 79% of severely obese patients compared to 31% of normal weight patients...

  6. A comparative study of various therapeutic regimens in urticaria

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    Mukhopadhyay Amiyakumar

    1995-01-01

    Full Text Available 127 patients of urticaria were treated with chlorpheniramine maleate alone and in combination with cyproheptadine hydrochloride, ranitidine and doxepin and levamisole. Chlorpheniramine and doxepin combination showed a satisfactory result in 88.46% of patients. Overall study showed that a combination regimen is better than the antihistaminics alone. Drowsiness was the commonest side effect. Levamisole and chlorpheniramine maleate combination was found to be more effective than the antihimstamine alone.

  7. Principles for designing future regimens for multidrug-resistant tuberculosis

    OpenAIRE

    2014-01-01

    Fewer than 20% of patients with multidrug-resistant (MDR) tuberculosis are receiving treatment and there is an urgent need to scale up treatment programmes. One of the biggest barriers to scale-up is the treatment regimen, which is lengthy, complex, ineffective, poorly tolerated and expensive. For the first time in over 50 years, new drugs have been developed specifically to treat tuberculosis, with bedaquiline and potentially delamanid expected to be available soon for treatment of MDR cases...

  8. Recent advances in tuberculosis: New drugs and treatment regimens

    OpenAIRE

    Sloan, Derek J; Davies, Geraint R.; Khoo, Saye H.

    2013-01-01

    The current treatment regimen against drug susceptible tuberculosis (DS-TB) was defined by the 1980s. Since then the emergence of the global HIV pandemic and the escalation of drug resistant (DR−) forms of TB have presented new challenges for therapeutic research. Priority goals include shortening DS-TB treatment, improving DR-TB treatment and making combined TB-HIV therapy easier. To help achieve these goals, a range of new drugs and treatment strategies are currently being evaluated. Phase ...

  9. Pharmacoeconomic Consequences of Variable Patient Compliance With Prescribed Drug Regimens

    OpenAIRE

    John Urquhart

    1999-01-01

    Variable compliance with prescribed drug regimens is a leading source of variability in drug response. Specifics differ by drug and disease. The role of variable compliance was clearly defined in 2 trials of lipid-lowering agents, cholestyramine and gemfibrozil, in which exceptionally careful measurements of compliance were made, which has not been done in later trials. Economic consequences of variable compliance are estimated by converting dose-dependent changes in absolute risk of incident...

  10. Characteristics of HIV antiretroviral regimen and treatment adherence

    OpenAIRE

    2003-01-01

    The relationship between characteristics of HIV antiretroviral regimens and treatment adherence was studied in adolescent and adult patients who underwent antiretroviral therapy from January 1998 to September 2000, at the Service for Specialized Assistance in Pelotas. The patients were interviewed on two occasions, and the use of antiretrovirals during the previous 48 hours was investigated by a self-report. Adherence was defined as use of 95% or more of the prescribed medication. Social-demo...

  11. Effect of lipid-lowering and anti-hypertensive drugs on plasma homocysteine levels

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    Jutta Dierkes

    2007-03-01

    Full Text Available Jutta Dierkes, Claus Luley, Sabine WestphalInstitute of Clinical Chemistry and Biochemistry, University Hospital Magdeburg, Germany Abstract: Elevated plasma concentrations of homocysteine, a sulfur-containing amino acid, are a risk factor for coronary, cerebral and peripheral artery disease. Next to other factors, drugs used for the prevention or treatment of cardiovascular disease may modulate plasma homocysteine levels. Thus, a drug induced homocysteine increase may counteract the desired cardioprotective effect. The aim is to summarize the current knowledge on the effect of two important classes of drugs, lipid-lowering drugs and anti-hypertensive drugs, on homocysteine metabolism. Among the lipid-lowering drugs, especially the fibric acid derivatives, which are used for treatment of hypertriglyceridemia and low HDL-cholesterol, are associated with an increase of homocysteine by 20%–50%. This increase can be reduced, but not totally avoided by the addition of folic acid, vitamin B12 and B6 to fibrates. HMG-CoA reductase inhibitors (statins do not influence homocysteine concentrations substantially. The effects of nicotinic acid and n3-fatty acids on the homocysteine concentrations are less clear, more studies are necessary to clarify their influence on homocysteine. Antihypertensive drugs have also been studied with respect to homocysteine metabolism. A homocysteine increase has been shown after treatment with hydrochlorothiazide, a lowering was observed after treatment with ß-blockers, but no effect with ACE-inhibitors. The clinical significance of the homocysteine elevation by fibrates and thiazides is not clear. However, individual patients use these drugs for long time, indicating that even moderate increases may be important.Keywords: homocysteine, fibrates, diuretics, cardiovascular disease

  12. Effects of centrally acting antihypertensive drugs on the microcirculation of spontaneously hypertensive rats

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    Estato V.

    2004-01-01

    Full Text Available We investigated the acute effects of centrally acting antihypertensive drugs on the microcirculation of pentobarbital-anesthetized spontaneously hypertensive rats (SHR. The effects of the sympatho-inhibitory agents clonidine and rilmenidine, known to activate both alpha2-adrenoceptors and nonadrenergic I1-imidazoline binding sites (I1BS in the central nervous system, were compared to those of dicyclopropylmethyl-(4,5-dimethyl-4,5-dihydro-3H -pyrrol-2-yl-amine hydrochloride (LNP 509, which selectively binds to the I1BS. Terminal mesenteric arterioles were observed by intravital microscopy. Activation of the central sympathetic system with L-glutamate (125 µg, ic induced marked vasoconstriction of the mesenteric microcirculation (27 ± 3%; N = 6, P < 0.05. In contrast, the marked hypotensive and bradycardic effects elicited by intracisternal injection of clonidine (1 µg, rilmenidine (7 µg and LNP 509 (60 µg were accompanied by significant increases in arteriolar diameter (12 ± 1, 25 ± 10 and 21 ± 4%, respectively; N = 6, P < 0.05. The vasodilating effects of rilmenidine and LNP 509 were two-fold higher than those of clonidine, although they induced an identical hypotensive effect. Central sympathetic inhibition elicited by baclofen (1 µg, ic, a GABA B receptor agonist, also resulted in vasodilation of the SHR microvessels. The acute administration of clonidine, rilmenidine and LNP 509 also induced a significant decrease of cardiac output, whereas a decrease in systemic vascular resistance was observed only after rilmenidine and LNP 509. We conclude that the normalization of blood pressure in SHR induced by centrally acting antihypertensive agents is paralleled by important vasodilation of the mesenteric microcirculation. This effect is more pronounced with substances acting preferentially (rilmenidine or exclusively (LNP 509 upon I1BS than with those presenting important alpha2-adrenergic activity (clonidine.

  13. The Metabolic Syndrome and the immediate antihypertensive effects of aerobic exercise: a randomized control design

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    Maresh Carl M

    2008-06-01

    Full Text Available Abstract Background The metabolic syndrome (Msyn affects about 40% of those with hypertension. The Msyn and hypertension have a common pathophysiology. Exercise is recommended for their treatment, prevention and control. The influence of the Msyn on the antihypertensive effects of aerobic exercise is not known. We examined the influence of the Msyn on the blood pressure (BP response following low (LIGHT, 40% peak oxygen consumption, VO2peak and moderate (MODERATE, 60% VO2peak intensity, aerobic exercise. Methods Subjects were 46 men (44.3 ± 1.3 yr with pre- to Stage 1 hypertension (145.5 ± 1.6/86.3 ± 1.2 mmHg and borderline dyslipidemia. Men with Msyn (n = 18 had higher fasting insulin, triglycerides and homeostasis model assessment (HOMA and lower high density lipoprotein than men without Msyn (n = 28 (p Results Systolic BP (SBP was reduced 8 mmHg (p 2 = 0.123, p = 0.020, Msyn (β = 0.277, r2 = 0.077, p = 0.069, and HOMA (β = -0.124, r2 = 0.015, p = 0.424. Msyn (r2 = 0.096, p = 0.036 was the only significant correlate of the DBP response after LIGHT. Conclusion Men without the Msyn respond more favorably to the antihypertensive effects of lower intensity, aerobic exercise than men with the Msyn. If future work confirms our findings, important new knowledge will be gained for the personalization of exercise prescriptions among those with hypertension and the Msyn.

  14. Long-term antihypertensive effect of a soluble cocoa fiber product in spontaneously hypertensive rats

    Directory of Open Access Journals (Sweden)

    Sandra Fernández-Vallinas

    2016-05-01

    Full Text Available Background and Methods: This study evaluates the antihypertensive effect of long-term intake of a soluble cocoa fiber product (SCFP. Different doses of SCFP were evaluated (200, 400, and 800 mg/kg/day and a dose of 800 mg/kg/day of beta-glucan 0.75 (BETA-G was used as a standard fiber. Water, a neutral vehicle, was used as negative control, and 50 mg/kg/day captopril was used as positive control. Systolic blood pressure (SBP was measured weekly by the tail cuff method. Body weight, food, and liquid intake were also registered weekly in the rats from 10 to 24 weeks of life. Glucose, total cholesterol, and triglyceride levels; redox status; and the angiotensin-converting enzyme activity were also studied in the plasma samples of these animals. Results: Throughout the 10 weeks of treatment, captopril and SCFP (400 mg/kg/day demonstrated blood pressure lowering effects in the spontaneously hypertensive rats (p0.05; n=8. When the corresponding antihypertensive treatment, was disrupted the SBP values of the 400 mg/kg/day SCFP treated animals returned to control values (p>0.05; n=8. In addition, the SCFP significantly decreased (p<0.05; n=4 the glucose, cholesterol, and triglyceride levels and also the liver and plasma malondaldehyde levels. Moreover, the SCFP slightly increased the reduced glutathione levels in the liver. Conclusion: The SCFP could be used to control the blood pressure of hypertensive subjects for a long period of time and could improve metabolic complications associated to cardiovascular diseases.

  15. ANTIHYPERTENSIVE AND ANTIOXIDATIVE EFFECTS OF CARVEDILOL AND METOPROLOL IN HYPERTENSIVE PATIENTS WITH OVERWEIGHT/OBESITY

    Directory of Open Access Journals (Sweden)

    V. A. Nevzorova

    2016-01-01

    Full Text Available Aim. To evaluate an efficacy of the 24-week antihypertensive therapy based on the carvedilol or metoprolol and its influence on markers of blood oxidative status in hypertensive patients with overweight/obesity.Material and methods. The observation data of 20 hypertensive patients (aged 40-65 y.o. with overweight/obesity were analyzed. Blood pressure (BP dynamics at each visit and a rate of target BP achievement were evaluated. Blood oxidative status was evaluated by plasma malondialdehyde (MDA level and erythrocyte superoxide dismutase (SOD activity. Therapy safety was evaluated by adverse events registration.Results. Significant reduction in both systolic and diastolic BP compared with baseline values was found. BP targets were achieved in all patients in both groups. The therapy based on carvedilol had a greater effect on blood oxidative status in comparison with metoprolol therapy. Plasma MDA level reduced from 7.03 [6.49;7.41] to 3.23 [2.88;3.57] μM/l (p<0.05 vs from 6.95 [6.51;7.39] to 6.08 [5.46;6.71] μM/l, respectively, and erythrocyte SOD activity increased from 27,89 [25.29;30.49] to 40.18 [35.89;44.45]% (p<0.05 vs from 28.41 [25.18;31.64] to 33.45 [30.65;36.23]%, respectively.Conclusion. The high antihypertensive efficacy, positive effect on blood oxidative status and well tolerability of therapy based on carvedilol in everyday clinical practice is presented.

  16. Care of Patients With HIV Infection: Antiretroviral Drug Regimens.

    Science.gov (United States)

    Bolduc, Philip; Roder, Navid; Colgate, Emily; Cheeseman, Sarah H

    2016-04-01

    The advent of combination antiretroviral drug regimens has transformed HIV infection from a fatal illness into a manageable chronic condition. All patients with HIV infection should be considered for antiretroviral therapy, regardless of CD4 count or HIV viral load, for individual benefit and to prevent HIV transmission. Antiretroviral drugs affect HIV in several ways: entry inhibitors block HIV entry into CD4 T cells; nucleotide and nucleoside reverse transcriptase inhibitors prevent reverse transcription from RNA to DNA via chain-terminating proteins; nonnucleoside reverse transcriptase inhibitors prevent reverse transcription through enzymatic inhibition; integrase strand transfer inhibitors block integration of viral DNA into cellular DNA; protease inhibitors block maturation and production of the virus. Current guidelines recommend six combination regimens for initial therapy. Five are based on tenofovir and emtricitabine; the other uses abacavir and lamivudine. Five include integrase strand transfer inhibitors. HIV specialists should assist with treating patients with complicated HIV infection, including patients with treatment-resistant HIV infection, coinfection with hepatitis B or C virus, pregnancy, childhood infections, severe opportunistic infections, complex drug interactions, significant drug toxicity, or comorbidities. Family physicians can treat most patients with HIV infection effectively by choosing appropriate treatment regimens, monitoring patients closely, and retaining patients in care. PMID:27092564

  17. Compliance with Xylitol and Sorbitol Chewing Gum Regimens in Clinical Trials

    Science.gov (United States)

    BRETZ, WALTER A.; ROSA, ODILA P. S.; SILVA, SALETE M. B.; CORBY, PATRICIA M. A.; MILANDA, MARCELO; LOESCHE, WALTER J.

    2011-01-01

    Objective The purpose of this study was to investigate compliance of long-term xylitol and sorbitol chewing gum regimens in adult women participating in a double-blind randomized controlled clinical trial. Design The participants included 122 mothers (age range: 16–35 years) residing in the city of Bauru, São Paulo, Brazil. Compliance with the xylitol and sorbitol chewing gum regimens was assessed by weighing, with a precision balance, all used gums returned in zip-lock bags during the study period of 33 months. The total number of returned bags in both chewing gum groups was computed and the differences between groups were determined by one-way ANOVA. Compliance was further categorized into excellent, good, fair or poor based on the distribution of the combined data for both groups by quartiles. These distributions for the xylitol and sorbitol groups were subjected to chi-square analysis. Results Compliance was always superior for the xylitol group in all categories. These distributions were, however, not significantly different in statistical terms. Average compliance in the xylitol chewing gum group was significantly higher when compared to the sorbitol chewing gum group (p=0.0481). Conclusions The results suggest that compliance, and possibly acceptance in this population, was superior for xylitol chewing gum than for sorbitol chewing gum. PMID:22241940

  18. Standardised nomenclature for glucocorticoid dosages and glucocorticoid treatment regimens : current questions and tentative answers in rheumatology

    NARCIS (Netherlands)

    Buttgereit, F; da Silva, JAP; Burmester, GR; Cutolo, M; Jacobs, J; Kirwan, J; Kohler, L; van Riel, P; Vischer, T; Bijlsma, JWJ

    2002-01-01

    In rheumatology and other medical specialties there is a discrepancy between the widespread use and the imprecise designation of glucocorticoid treatment regimens. Verbal descriptions of glucocorticoid treatment regimens used in various phases of diseases vary between countries and institutions. Giv

  19. COMPARISON OF CONDITIONING REGIMENS FOR ALVEOLAR MACROPHAGE RECONSTITUTION AND INNATE IMMUNE FUNCTION POST BONE MARROW TRANSPLANT

    OpenAIRE

    Hubbard, Leah L. N.; Ballinger, Megan N.; Wilke, Carol A.; Moore, Bethany B.

    2008-01-01

    The authors compared efficiency of alveolar macrophage (AM) reconstitution from donor bone marrow post transplant following 4 chemotherapy conditioning regimens and 2 total body irradiation (TBI) regimens. TBI regimens are more effective in inducing AM reconstitution from donor marrow. However, mice conditioned with 13 Gy split-dose TBI or a dual-chemotherapy regimen (25 mg/kg busulfan × 4 days plus cyclophosphamide 100 mg/kg × 2 days) both demonstrate significant AM repopulation from donor m...

  20. Rifaximin Plus Levofloxacin-Based Rescue Regimen for the Eradication of Helicobacter pylori

    OpenAIRE

    Yun, Sang-Pil; Seon, Han Gyung; Ok, Chang Soo; Yoo, Kwang Ho; Kang, Min Kyung; Kim, Won Hee; Kwon, Chang Il; Ko, Kwang Hyun; Hwang, Seong Gyu; Park, Pil Won; Hong, Sung Pyo

    2012-01-01

    Background/Aims This study assessed the efficacy of a rifaximin plus levofloxacin-based rescue regimen in patients that had failed both triple and quadruple standard regimens for the eradication of Helicobacter pylori. Methods We treated patients for H. pylori between August 2009 and April 2011. The triple regimen consisted of combined treatment with amoxicillin, clarithromycin, and pantoprazole for 1 week. For failed cases, a quadruple regimen of tetracycline, metronidazole, bismuth dicitrat...

  1. The Development of a Myeloablative, Reduced-Toxicity, Conditioning Regimen for Cord Blood Transplantation

    OpenAIRE

    Mehta, Rohtesh S.; Di Stasi, Antonio; Andersson, Borje S.; Nieto, Yago; Jones, Roy; Lima, Marcos; Hosing, Chitra; Popat, Uday; Kebriaei, Partow; Oran, Betul; Alousi, Amin; Rezvani, Katayoun; Qazilbash, Muzaffar; Bashir, Qaiser; Bollard, Catherine

    2013-01-01

    Cord blood transplantation is being used with increasing frequency for patients with high-risk hematologic malignancies. Myeloablative preparative regimens provide anti-tumor efficacy and facilitate engraftment but are associated with higher morbidity and non-relapse mortality than nonablative regimens. We evaluated three sequential myeloablative regimens in the cord blood transplant setting. Regimen-1 melphalan, fludarabine and thiotepa produced prompt engraftment and minimal engraftment fai...

  2. Open-label observational study to assess the efficacy and safety of aprepitant for chemotherapy-induced nausea and vomiting prophylaxis in Indian patients receiving chemotherapy with highly emetogenic chemotherapy/moderately emetogenic chemotherapy regimens

    OpenAIRE

    Hingmire Sachin; Raut Nirmal

    2015-01-01

    Context: Currently, there is limited data on the prevention of chemotherapy-induced nausea and vomiting (CINV) in Indian population with aprepitant containing regimens. Aims: The aim was to assess the Efficacy and Safety of Aprepitant for the prevention of nausea and vomiting associated with highly emetogenic chemotherapy/moderately emetogenic chemotherapy (HEC/MEC) regimens. Settings and Design: Investigator initiated, multicentric, open-label, prospective, noncomparative, observational tria...

  3. Medication regimen complexity in adults and the elderly in a primary healthcare setting: determination of high and low complexities

    Directory of Open Access Journals (Sweden)

    Ferreira JM

    2015-12-01

    Full Text Available Background: The complexity of a medication regimen is related to the multiple characteristics of the prescribed regimen and can negatively influence the health outcomes of patients. Objective: To propose cut-off points in the complexity of pharmacotherapy to distinguish between patients with low and high complexities seen in a primary health care (PHC setting to enable prioritization of patient management. Methods: This is a cross-sectional study, which included 517 adult and elderly patients, analyzing different cut-off points to define the strata of low and high pharmacotherapy complexities based on percentiles of the population evaluated. Data collection began with the solicitation of prescriptions, followed by a questionnaire that was administered by an interviewer. The complexity of a medication regimen was estimated from the Medication Regimen Complexity Index (MRCI. High complexity pharmacotherapy scores were analyzed from patient profiles, the use of health services, and pharmacotherapy. The criteria for subject inclusion in the sample population were as follows: inhabitant of the area covered by the municipality, 18 years or older, and being prescribed at least one drug during the collection period. Exclusion criteria at the time of collection were the use of any medication whose prescription was not available. All medications were accessed through the Primary Healthcare Service (PHS. Results: The median total pharmacotherapy complexity score was 8.5. High MRCI scores were correlated with age, medications taken with in the Brazilian PHS, having at least one potential drug-related problem, receiving up to eight years of schooling, number of medications and polypharmacy (five or more medicines, number of medical conditions, number of medical appointments, and number of cardiovascular diseases and endocrine metabolic diseases. We suggest different complexity tracks according to age (e.g., adult or elderly that consider the pharmacotherapy

  4. The Association Between Antihypertensive Medication Nonadherence and Visit-to-Visit Variability of Blood Pressure: Findings From the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.

    Science.gov (United States)

    Kronish, Ian M; Lynch, Amy I; Oparil, Suzanne; Whittle, Jeff; Davis, Barry R; Simpson, Lara M; Krousel-Wood, Marie; Cushman, William C; Chang, Tara I; Muntner, Paul

    2016-07-01

    Low adherence to antihypertensive medication has been hypothesized to increase visit-to-visit variability (VVV) of blood pressure (BP). We assessed the association between antihypertensive medication adherence and VVV of BP in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). VVV of BP was calculated using SD independent of mean, SD, and average real variability across study visits conducted 6 to 28 months after randomization. Participants who reported taking <80% of their antihypertensive medication at ≥1 study visits were categorized as nonadherent. Participants were followed up for cardiovascular events and mortality after the assessment of adherence and VVV of BP. SD independent of mean of BP was higher for nonadherent (n=2912) versus adherent (n=16 878) participants; 11.4±4.9 versus 10.5±4.5 for systolic BP; 6.8±2.8 versus 6.2±2.6 for diastolic BP (each P<0.001). SD independent of mean of BP remained higher among nonadherent than among adherent participants after multivariable adjustment (0.8 [95% confidence interval, 0.7-1.0] higher for systolic BP and 0.4 [95% confidence interval, 0.3-0.5] higher for diastolic BP]. SD and average real variability of systolic BP and diastolic BP were also higher among nonadherent than among adherent participants. Adjustment for nonadherence did not explain the association of VVV of BP with higher fatal coronary heart disease or nonfatal myocardial infarction, stroke, heart failure, or mortality risk. In conclusion, improving medication adherence may lower VVV of BP. However, VVV of BP is associated with cardiovascular outcomes independent of medication adherence. PMID:27217410

  5. Paclitaxel based vs oxaliplatin based regimens for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Xiao-Dong Li; Hua Shen; Jing-Ting Jiang; Han-Ze Zhang; Xiao Zheng; Yong-Qian Shu; Chang-Ping Wu

    2011-01-01

    AIM:To compare the efficacy and safety of paclitaxel combined with fluorouracil plus cisplatin (PCF),and oxaliplatin combined with fluorouracil plus leucovorin (FOLFOX-4) regimens for advanced gastric cancer (AGC). METHODS:Ninety-four patients with AGC were randomly assigned to receive paclitaxel (50 mg/m2 iv) on days 1,8 and 15,cisplatin (20 mg/m2 iv) and fluorouracil (750 mg/m2 iv) on days 1-5,or oxaliplatin (85 mg/m2 iv) and leucovorin (200 mg/m2 iv) on day 1,followed by bolus fluorouracil (400 mg/m2 iv) and fluorouracil (600 mg/m2 iv) on days 1 and 2.The primary end point was the 1-year survival time. RESULTS:The overall response rate (ORR) of the patients was 48.0% and 45.5% to PCF and FOLFOX-4, respectively.The disease control rate (DCR) of PCF and FOLFOX-4 was 82.0% and 81.8%,respectively. The median survival times (MSTs) of the patients were 10.8 and 9.9 mo,respectively,after treatment with PCF and FOLFOX-4.The 1-year survival rate of the patients was 36.0% and 34.1%,respectively,after treatment with PCF and FOLFOX-4.No significant difference was observed in ORR,DCR,MST or 1-year survival rate between the two groups.The most common adverse events were anemia,nausea and vomiting,and grade 3/4 alopecia in PCF treatment group,and anemia,grade 1/2 neurotoxic effect and grade 3/4 neutropenia in FOLFOX-4 treatment group.CONCLUSION:Patients with AGC have a similar response rate to PCF and FOLFOX-4 regimens with a similar survival rate.The PCF and FOLFOX-4 regimens are efficacious and tolerable as a promising therapy for AGC.

  6. Management of patients using unproven regimens for arthritis.

    Science.gov (United States)

    Wolman, P G

    1987-09-01

    Such treatments as vegetarian diets, fresh or raw diets, allergy diets, no-dairy-products diets, fasting, vitamin and mineral supplementation, apple cider vinegar, and honey drinks are touted in the popular press as effective for the treatment of arthritis. In contrast to conventional therapies, the unproven treatments promise not only relief from symptoms but freedom from the disease as long as the diet regimen is followed. Several of the remedies appear to be harmless, but others are dangerous, especially if followed for prolonged periods. Nutrition professionals should be aware of the nature of these treatments and be prepared to offer sound, scientifically based but nonjudgmental care and information. PMID:3624710

  7. Establishment of TCM Standardized Therapeutic Regimen for Treating Tumor

    Institute of Scientific and Technical Information of China (English)

    林洪生

    2004-01-01

    @@ It has been of a long long history to treat tumor with traditional Chinese medicine (TCM), in the last 50years, Chinese medicine (CM) has been accepted by more and more medical professionals and patients, and used as one of the principal methods for treating tumor in China. But, tumor is a kind of disease with rapid progress and complicated causes, and applying CM in treating tumor has to meet some requirement, as improper application could induce contrary effects. To reduce the chance of blind and improper application of CM in the treatment of tumor, it is vital to work out a standardized therapeutic regimen that can be used as the guideline.

  8. Estimation of drug dosage regimens with a pharmacokinetic slide rule.

    Science.gov (United States)

    Straughn, A B; Cruze, C A; Meyer, M C

    1977-02-01

    A pharmacokinetic slide rule to facilitate the computations based on relatively simple pharmacokinetic principles involved in the development of individualized drug dosage regimens is described. The calculations are based on the assumption that the body can be conceived as a one-compartment open model with drug elimination proceeding by apparent first-order kinetics. Examples are presented (1) to illustrate the clinical application of a slide rule to compute the time-course of drug in the body, (2) to calculate steady-state maximum and minimum levels, and accumulation during multiple dosage and (3) to estimate appropriate maintenance doses and intravenous infusion rates. PMID:842548

  9. Use of Antihypertensives in Patients Having Associated Renal Parenchymal Disorders: Cross Sectional Prescription Pattern Study in a Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Supratim Datta

    2011-07-01

    Full Text Available Hypertension is both a cause and a consequence of renal parenchymal disease. Once detected, formulation of an appropriate therapeutic strategy is imperative to not only control hypertension, but also to retard the progression of the renal pathology. Judicious and optimal use of the available antihypertensive agents is of utmost importance. This study aims at analyzing the influence of current guidelines on prescribing in this particular subset of patients. Case history of patients having hypertension comorbid with renal pathological disorders was noted down from the medical records department. A total of 58 prescriptions thus noted were analysed on the basis of antihypertensive agents that were prescribed. The CCB’s were the group of drugs prescribed the most in renal disease associated hypertension (79% followed by the diuretics (48%.The ACE‐inhibitors and ARB’s were prescribed in around 34% of the patients. Amlodipine and Frusemide were the most frequently used individual agents.

  10. Validity and Reliability of a Self-Reported Measure of Antihypertensive Medication Adherence in Uganda

    Science.gov (United States)

    Nasasira, Benson; Muiru, Anthony Ndichu Wa; Muyingo, Anthony

    2016-01-01

    Background The Morisky Medication Adherence scale (MMAS-8) is a widely used self-reported measure of adherence to antihypertensive medications that has not been validated in hypertensive patients in sub-Saharan Africa. Methods We carried out a cross-sectional study to examine psychometric properties of a translated MMAS-8 (MMAS-U) in a tertiary care hypertension clinic in Uganda. We administered the MMAS-U to consecutively selected hypertensive adults and used principal factor analysis and Cronbach’s alpha to determine its validity and internal consistency respectively. Then we randomly selected one-sixth of participants for a 2-week test-retest telephone interview. Lastly, we used ordinal logistic regression modeling to explore factors associated with levels of medication adherence. Results Of the 329 participants, 228 (69%) were females, median age of 55 years [Interquartile range (IQR) (46–66)], and median duration of hypertension of 4 years [IQR (2–8)]. The adherence levels were low (MMAS-U score ≤ 5) in 85%, moderate (MMAS-U score 6–7) in 12% and high (MMAS-U score ≥8) in 3%. The factor analysis of construct validity was good (overall Kaiser’s measure of sampling adequacy for residuals of 0.72) and identified unidimensionality of MMAS-U. The internal consistency of MMAS-U was moderate (Cronbach α = 0.65), and test-retest reliability was low (weighted kappa = 0.36; 95% CI -0.01, 0.73). Age of 40 years or greater was associated with low medication adherence (p = 0.02) whereas a family member buying medication for participants (p = 0.02) and purchasing medication from a private clinic (p = 0.02) were associated with high adherence. Conclusion The Ugandan version of the MMAS-8 (MMAS-U) is a valid and reliable measure of adherence to antihypertensive medication among Ugandan outpatients receiving care at a public tertiary facility. Though the limited supply of medication affected adherence, this easy to use tool can be adapted to assess medication

  11. Antihypertensive combination therapy in primary care offices: results of a cross-sectional survey in Switzerland

    Directory of Open Access Journals (Sweden)

    Roas S

    2014-12-01

    Full Text Available Susanne Roas,1 Felix Bernhart,2 Michael Schwarz,3 Walter Kaiser,4 Georg Noll5 1Department of Internal Medicine, University Hospital, Zurich, 2Private Practice, Biberist, 3Ambulatorium Wiesendamm, Basel, 4Healthworld (Schweiz AG, Steinhausen, 5HerzKlinik Hirslanden, Zurich, Switzerland Background: Most hypertensive patients need more than one substance to reach their target blood pressure (BP. Several clinical studies indicate the high efficacy of antihypertensive combinations, and recent guidelines recommend them in some situations even as initial therapies. In general practice they seem widespread, but only limited data are available on their effectiveness under the conditions of everyday life. The objectives of this survey among Swiss primary care physicians treating hypertensive patients were: to know the frequency of application of different treatment modalities (monotherapies, free individual combinations, single-pill combinations; to see whether there are relationships between prescribed treatment modalities and patient characteristics, especially age, treatment duration, and comorbidities; and to determine the response rate (percentage of patients reaching target BP of different treatment modalities under the conditions of daily practice. Methods: This cross-sectional, observational survey among 228 randomly chosen Swiss primary care physicians analyzed data for 3,888 consecutive hypertensive patients collected at one single consultation. Results: In this survey, 31.9% of patients received monotherapy, 41.2% two substances, 20.9% three substances, and 4.7% more than three substances. By combination mode, 34.9% took free individual combinations and 30.0% took fixed-dose single-pill combinations. Combinations were more frequently given to older patients with a long history of hypertension and/or comorbidities. In total, 67.8% of patients achieved their BP target according to their physician's judgment. When compared, single

  12. EFFECT OF ANTIHYPERTENSIVE THERAPY WITH RILMENIDINE ON COGNITIVE FUNCTION IN ELDERLY HYPERTENSIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    S. V. Nedogoda

    2016-01-01

    Full Text Available Aim.  To assess antihypertensive efficacy of rilmenidine (Albarel, EGIS, Hungary and its effect on cognitive function in elderly hypertensive patients. Material and methods. 30 elderly (in average 68 y.o. hypertensive patients were observed. Each patient received therapy with rilmenidine 2 mg daily during 6 months. 24 hours monitoring of blood pressure before and after therapy was done in each patient. In order to assess cognitive disorders all patients passed neuropsychological tests, which allowed revealing damages of memory, attention, concentration, mental efficiency and psychomotor functions. Raten tests, Veksler test, vocal activity, memory (10 words, serial counting and kinetic probes were used. Results. After 24 weeks of monotherapy with rilmenidine, decrease in daily average systolic blood pressure (SBP by 7.2% (p<0.01 and diastolic blood pressure (DBP by 5.5% (p<0.05 was observed. Therapy with rilmenidine showed decrease in daily average burden by SBP and by DBP (by 25.3% and 18.8% respectively; p<0.05 and daily average time index of hypertension for SBP and DBP (by 32.5 and 60.6% respectively; p<0.05 According to the results of neuropsychological tests at the end of treatment, average time for Raten test completion decreased by 16.7% (p<0.05, and for Veksler test completion – by 15.6% (p<0.05. At the same time significant increase in vocal activity of patients is noted: number of words at free associations tests, verbs and plants denomination have grown by 5.8%, 5.1% and 6.3% respectively (p<0.05; number of mistakes in these tests decreased respectively by 71.4%, 50% and 33.3% (p<0.05. Positive dynamics in characteristics of memory: number of words at first and last immediate and postponed reproduction increased respectively by 36.4%, 21.6% and 14.1% (p<0.05,  average time of serial counting and average time of memorization decreased respectively by 13.2% and 31.8% (p<0.05. Velocity in both hands increased, which was observed both

  13. INFLUENCE OF CHRONOTHERAPY WITH DIFFERENT ANTIHYPERTENSIVE DRUGS ON CIRCADIAN BLOOD PRESSURE PATTERN

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    V. M. Gorbunov

    2016-01-01

    Full Text Available Aim. To determine the value of different blood pressure (BP measurement methods for arterial hypertension (HT chronotherapy efficacy assessment. Material and methods. Two similar open, randomized, cross-over studies (morning vs evening intake were carried out. Duration of the initial wash-out period was 2 weeks; duration of both treatment courses — 3 weeks; the interval between courses — 1 week. Only patients with stable HT (mean day-time BP>135/85 mm Hg were included. Ambulatory BP monitoring (ABPM was carried out prior to treatment and at the end of both treatment courses. The patients performed home BP monitoring (HBPM throughout the study. Pharmacokinetics of verapamil (n=14, mean daily dose — 240.0±16.3 mg was studied to assess compliance with verapamil therapy. In ramipril trial (n=30 its mean daily dose was 8.9±0.7 mg. The following main ABPM variables were analyzed: ABPM means and variability, maximal and minimal values, nocturnal BP fall, parameters of Fourier transformation and smoothness index. The morning and evening BP means and morning BP surge (morning – evening BP were assessed by HBPM. Student’s t-value and Mahalanobis distance were used to evaluate individual value of each variable (“morning” vs “evening” effect. This analysis was first done separately for each trial. After that, combined data were analyzed. Results. Overall antihypertensive effect was more intense with morning ramipril (p<0.05 intake and evening verapamil intake. The t-values ranged 2.2-2.3 for nocturnal BP fall; 2.0-2.1 for night-time BP variability; 3.8-4.3 for morning BP surge. The t-values of office and 24-hour BP were low (0.2-1.7. Conclusion. Morning BP surge based on HBPM is a good instrument for chronotherapy effect assessment. Evening administration of antihypertensive drugs causes nocturnal BP fall shift towards “dipper” status.

  14. Influence of combined antihypertensive and antidepressant therapy on left ventricular remodeling in patients with arterial hypertension, anxiety and depression

    OpenAIRE

    Y. A. Vasyuk; T.V. Dovzenko; E.A. Nesterova; I.A. Sadulaeva; K.V. Tarasova

    2008-01-01

    Aim. To assess influence of combined antihypertensive (captopril or metoprolol) and antidepressant (thianeptin or sertralin) therapy on clinical status, blood pressure (BP) and myocardial function in patients with arterial hypertension (HT) and affective disorders (AD).Material and methods. 106 patients with HT were involved in the study. 64 patients (60,4%) had concomitant AD. All patients were divided into 3 groups. 46 patients with HT and AD were included in the 1-st group. They received m...

  15. Analysis of prescribing pattern of antihypertensive drugs during pregnancy and neonatal outcome in a tertiary care centre

    OpenAIRE

    Soundarya Yamakanamardi; Anuradha HV; Sujani BK; Shivamurthy MC

    2016-01-01

    Background: Hypertensive disorders are the most common medical complications of pregnancy with an incidence of 2-8%. Maternal hypertension, even of the mild to moderate category, can lead to adverse perinatal outcomes like low birth weight, prematurity, stillbirth and intrauterine growth retardation. Though hypertension occurs up to 8% of pregnancies, yet information on the safety of antihypertensive medication use during pregnancy is limited. The objective of this study was to analyse the pr...

  16. A study on prescribing pattern of antihypertensives in adult patients attending in a tertiary care hospital of Assam, India

    OpenAIRE

    Pavel Sikidar; Pinaki Chakravarty; Ayan Purkayastha; Rohit Tigga

    2016-01-01

    Background: Hypertension is one of the most common chronic medical problems prompting visits to health care providers. It has been estimated that hypertension accounts for 13% of deaths worldwide. The main objective of the present study was to assess the pattern of drug utilisation and to evaluate whether the prescribing patterns for anti-hypertensive in our institution is in adherence with JNC 8 guidelines for treatment of hypertension. Methods: A prospective, observational, non-intervent...

  17. Digestion Pattern of Antihypertensive Angiotensin I-Converting Enzyme Inhibitory Peptides from Saccharomyces cerevisiae in a Successive Simulated Gastricintestinal Bioreactor

    OpenAIRE

    Jang, Jeong-Hoon; Jeong, Seung-Chan; Lee, Jung-Kee; Lee, Jong-Soo

    2011-01-01

    A cell-free extract of Saccharomyces cerevisiae containing the angiotensin I-converting enzyme (ACE) inhibitory peptide was treated in a successive simulated gastric-intestinal bioreactor (step 1: amylase digestion, step 2: gastric fluid digestion, step 3: intestinal fluid digestion) to illustrate the absorption pattern of antihypertensive ACE inhibitory peptide, and the ACE inhibitory activities of each step were determined. Total ACE inhibitory activities of step 1, step 2, and step 3 were ...

  18. PRESCRIBING PATTERN OF ANTIHYPERTENSIVES IN INDIVIDUALS WITH HYPERTENSION ALONE AND WITH COEXISTING DIABETES MELLITUS – A COMPARATIVE STUDY

    OpenAIRE

    J. Keerthi Sagar*, S. Narendranath, H.S. Somashekar, S.R. Reshma, Susheela Somappa Halemani and Prabhakar Adake

    2012-01-01

    Objective: Analysis of prescribing pattern of antihypertensives in patients with hypertension alone and with coexisting diabetes mellitus. Materials and Methods: A cross sectional study was conducted in an outpatient and inpatient department of general medicine at JJM Medical College hospital for a period of 3 months (July 2011 to September 2011). Prescriptions of the patients were collected and relevant data was entered in the preformed proforma and analyzed.Results: A total of 210 prescript...

  19. Attenuated levels of pro-inflammatory markers in diabetic retinopathy patients undergoing treatment with antihyperglycemic and antihypertensive drugs

    OpenAIRE

    Zhi Xiang Ng; Kek Heng Chua; Iqbal Tajunisah; Rokiah Pendek; Umah Rani Kuppusamy

    2013-01-01

    OBJECTIVE: This study aimed to assess the circulating levels of activated nuclear factor kappa B p65 and monocyte chemotactic protein-1 in diabetic retinopathy patients who were taking antihyperglycemic and antihypertensive drugs. METHODS: In total, 235 healthy controls and 371 Type 2 diabetic patients [171 without retinopathy (DNR) and 200 patients with retinopathy (diabetic retinopathy)] were recruited for this study. Plasma and the nuclear fraction of peripheral blood mononuclear c...

  20. Effectiveness of Antiretroviral Therapy in Individuals Who for Economic Reasons Were Switched From a Once-Daily Single-Tablet Regimen to a Triple-Tablet Regimen

    DEFF Research Database (Denmark)

    Engsig, Frederik N; Gerstoft, Jan; Helleberg, Marie;

    2014-01-01

    BACKGROUND: To assess the impact on virological outcomes of a switch from branded single-tablet regimen (STR) including tenofovir, efavirenz, and emtricitabine (STR-TEE) to generic triple-tablet regimen (TTR), including tenofovir, efavirenz, and lamivudine (TTR-TEL), which was implemented on Apri...

  1. Fludarabine and melphalan conditioning with tacrolimus as GVHD prophylaxis for allogeneic stem cell transplant recipients is an effective reduced-intensity combination regimen compared to the conventional regimen

    International Nuclear Information System (INIS)

    As a reduced-intensity stem-cell transplantation (RIST) regimen, the combination of fludarabine and melphalan (FM) with an appropriate immunosuppressant reduces nonrelapse mortality (NRM). We retrospectively compared the efficacy of a RIST regimen with FM with that of a conventional stem cell transplantation (CST) regimen. Eighty-two consecutive hematological patients who underwent allogeneic stem-cell transplantation (SCT) at our hospital were enrolled. Preparation for RIST consisted of 25 mg/m2 fludarabine and melphalan 70 mg/m2. The conventional regimen employed high-dose cyclophosphamide and total-body irradiation (12 Gy) or busulfan and high-dose cyclophosphamide. Graft-versus-host disease (GVHD) prophylaxis for RIST consisted of tacrolimus alone or in conjunction with short-term methotrexate for unrelated donors. Of the 82 patients, 42 received the conventional CST regimen (median age, 35 years) and 40 received the RIST regimen (median age, 51 years). The probability of NRM was 17% (7/42) in the CST group and 8% (3/40) in the RIST group. Grade II to IV GVHD occurred in significantly more CST patients (38%) than RIST patients (28%). However, the overall survival was the same in the two groups (43%). The RIST regimen with FM incorporating tacrolimus and methotrexate demonstrated low treatment-related mortality (TRM) incidence and moderate control of GVHD and had efficacy comparable to that of the CST regimen, despite the advanced age of the RIST patient group. (author)

  2. Single nucleotide polymorphisms in the apolipoprotein B and low density lipoprotein receptor genes affect response to antihypertensive treatment

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    Kahan Thomas

    2004-09-01

    Full Text Available Abstract Background Dyslipidemia has been associated with hypertension. The present study explored if polymorphisms in genes encoding proteins in lipid metabolism could be used as predictors for the individual response to antihypertensive treatment. Methods Ten single nucleotide polymorphisms (SNP in genes related to lipid metabolism were analysed by a microarray based minisequencing system in DNA samples from ninety-seven hypertensive subjects randomised to treatment with either 150 mg of the angiotensin II type 1 receptor blocker irbesartan or 50 mg of the β1-adrenergic receptor blocker atenolol for twelve weeks. Results The reduction in blood pressure was similar in both treatment groups. The SNP C711T in the apolipoprotein B gene was associated with the blood pressure response to irbesartan with an average reduction of 19 mmHg in the individuals carrying the C-allele, but not to atenolol. The C16730T polymorphism in the low density lipoprotein receptor gene predicted the change in systolic blood pressure in the atenolol group with an average reduction of 14 mmHg in the individuals carrying the C-allele. Conclusions Polymorphisms in genes encoding proteins in the lipid metabolism are associated with the response to antihypertensive treatment in a drug specific pattern. These results highlight the potential use of pharmacogenetics as a guide for individualised antihypertensive treatment, and also the role of lipids in blood pressure control.

  3. The effects of angiotensinogen gene polymorphisms on cardiovascular disease outcomes during antihypertensive treatment in the GenHAT study

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    AnhN.Do

    2014-09-01

    Full Text Available Previous studies have reported that risk of cardiovascular morbidity and mortality substantially increases in hypertensive patients, especially among those with inadequate blood pressure control. Two common antihypertensive drug classes including thiazide diuretics and angiotensinogen converting enzyme (ACE inhibitors affect different enzymes in the renin angiotensinogen aldosterone system (RAAS. In the RAAS, angiotensinogen is converted into angiotensin II which increases blood pressure through vasoconstriction. Using a case-only design with 3,448 high-risk hypertensive individuals from the Genetics of Hypertension Associated Treatment (GenHAT study, we examined whether 7 single nucleotide polymorphisms (SNPs in the angiotensinogen gene (AGT interact with three classes of antihypertensive drugs including chlorthalidone (a thiazide diuretic, lisinopril (an ACE inhibitor, and amlodipine (a calcium channel blocker to modify the risk of incident coronary heart disease (CHD and heart failure (HF among Caucasian and African American participants, separately. We found no gene by treatment interactions to be statistically significant after correction for multiple testing. However, some suggestive results were found. African American participants with the minor allele of rs11122576 had over two-fold higher risk of CHD when using chlorthalidone compared to using amlodipine, or lisinopril compared to amlodipine (p=0.006, and p=0.01, respectively. Other marginal associations are also reported among both race groups. The findings reported here suggest that rs11122576 could contribute to future personalization of antihypertensive treatment among African Americans though more studies are needed.

  4. Attenuated levels of pro-inflammatory markers in diabetic retinopathy patients undergoing treatment with antihyperglycemic and antihypertensive drugs

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    Zhi Xiang Ng

    2013-01-01

    Full Text Available OBJECTIVE: This study aimed to assess the circulating levels of activated nuclear factor kappa B p65 and monocyte chemotactic protein-1 in diabetic retinopathy patients who were taking antihyperglycemic and antihypertensive drugs. METHODS: In total, 235 healthy controls and 371 Type 2 diabetic patients [171 without retinopathy (DNR and 200 patients with retinopathy (diabetic retinopathy] were recruited for this study. Plasma and the nuclear fraction of peripheral blood mononuclear cells were isolated for the quantification of the monocyte chemotactic protein-1 and nuclear factor kappa B p65 levels, respectively. RESULTS: Non-medicated diabetic retinopathy patients had significantly higher levels of activated nuclear factor kappa B p65 and plasma monocyte chemotactic protein-1 than DNR patients. Diabetic retinopathy patients who were taking antihyperglycemic and antihypertensive drugs showed significant reductions in both the nuclear factor kappa B p65 and monocyte chemotactic protein-1 levels compared with the non-medicated patients. CONCLUSION: This study demonstrated the significant attenuation of both the nuclear factor kappa B p65 and circulating monocyte chemotactic protein-1 levels in diabetic retinopathy patients taking antihyperglycemic and antihypertensive drugs.

  5. Logistics of therapy with the ibritumomab tiuxetan regimen

    International Nuclear Information System (INIS)

    Radioimmunotherapy is an important new modality for treating patients with B-cell non-Hodgkin's lymphoma (NHL). Clinical trials have shown the safety and efficacy of agents that deliver radiation directly to malignant cells by attaching the 131I or 9Y radionuclide to monoclonal antibodies against CD20. In clinical trials, 9Y ibritumomab tiuxetan has produced rates of response as high as 83% in patients with relapsed or refractory CD20+ NHL. The ibritumomab tiuxetan regimen is conveniently given in an outpatient setting over the course of 7-9 days. This article describes the logistics for initiating treatment, coordinating a multidisciplinary team, identifying eligible patients, and delivering the imaging and therapeutic doses of ibritumomab tiuxetan. The standard radiation safety procedures to protect family members and healthcare professionals involved in the care of patients treated with 9Y ibritumomab tiuxetan are also reviewed. Treatment with the ibritumomab tiuxetan regimen involves only standard precautions needed to minimize radiation exposure to other persons

  6. Regimen of ovarian stimulation affects oocyte and therefore embryo quality.

    Science.gov (United States)

    Bosch, Ernesto; Labarta, Elena; Kolibianakis, Efstratios; Rosen, Mitchell; Meldrum, David

    2016-03-01

    Without any doubt the regimen used to mature multiple capable oocytes for IVF impacts IVF outcomes. Studies have indicated that the inclusion of LH activity, adjuvant agents such as growth hormone (GH), and regimens providing for simultaneous action of both LH and FSH during final oocyte maturation may have beneficial effects on IVF outcomes. Because of the difficulty in improving IVF outcomes in poor responders, the studies on GH are of particular interest. As pointed out in this review, the apparent beneficial effects of GH on oocyte competence may also apply to older women or to normal responders with reduced embryo quality. A much more difficult question is whether and how much ovarian stimulation impacts on oocyte competence. Paradoxically it seems that there are not demonstrated differences between the stimulated and the natural unstimulated cycle, whereas studies in laboratory animals and IVF patients have shown deleterious effects of higher compared with lower doses of gonadotropins. Recent studies suggest that the use of high doses of gonadotropins as an independent factor correlates negatively with the probability of live birth, whereas a high ovarian response per se is associated with better cumulative pregnancy rates, owing to the availability of more euploid and good-quality embryos. Although adjunctive use of androgens has not been discussed here, it is briefly covered in the first review of this series. PMID:26826273

  7. Adherence With Therapeutic Regimens: Behavioral and Pharmacoeconomic Perspectives.

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    Giannetti, Vincent J; Kamal, Khalid M

    2016-04-01

    There is an extensive literature regarding nonadherence with both therapeutic regimens and medication. This literature includes reviews of empirical research regarding the factors associated with nonadherence. Health care system, provider, and patient factors as well as the nature of the illness and therapeutic regimen all effect adherence rates. Different behavioral models for adherence counseling such as the Health Belief Model, the Theory of Reasoned Action, the Medication Interest Model, and Motivational Interviewing have also been reported in the research literature. This article will discuss the development of a brief model for patient counseling with specific techniques illustrated for pharmacists based on empirical findings that have demonstrated effectiveness in the adherence research literature. In addition, the article will address the measurement of the economic impact of medication nonadherence and propose a framework for assessing the cost-effectiveness of pharmacist counseling to increase adherence. The problem of nonadherence has significant effects upon health care expenditures through increase in physician's visits, emergency department incidents, rehospitalizations, and nursing home readmissions. Thus, the overall goal is to assist the pharmacist in developing a brief adherence counseling program in community pharmacy and evaluating the economic feasibility of the intervention demonstrating the value-added proposition of pharmacist intervention. PMID:25292442

  8. New anti-tuberculosis drugs and regimens: 2015 update

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    Lia D'Ambrosio

    2015-05-01

    Full Text Available Over 480 000 cases of multidrug-resistant (MDR tuberculosis (TB occur every year globally, 9% of them being affected by extensively drug-resistant (XDR strains of Mycobacterium tuberculosis. The treatment of MDR/XDR-TB is unfortunately long, toxic and expensive, and the success rate largely unsatisfactory (<20% among cases with resistance patterns beyond XDR. The aim of this review is to summarise the available evidence-based updated international recommendations to manage MDR/XDR-TB, and to update the reader on the role of newly developed drugs (delamanid, bedaquiline and pretomanid as well as repurposed drugs (linezolid and meropenem clavulanate, among others used to treat these conditions within new regimens. A nonsystematic review based on historical trials results as well as on recent literature and World Health Organization (WHO guidelines has been performed, with special focus on the approach to managing MDR/XDR-TB. The new, innovative global public health interventions, recently approved by WHO and known as the “End TB Strategy”, support the vision of a TB-free world with zero death, disease and suffering due to TB. Adequate, universally accessed treatment is a pre-requisite to reach TB elimination. New shorter, cheap, safe and effective anti-TB regimens are necessary to boost TB elimination.

  9. Comparing Different Antiemetic Regimens for Chemotherapy Induced Nausea and Vomiting

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    Sayantani Ghosh

    2010-05-01

    Full Text Available Background: Chemotherapy Induced Nausea and Vomiting (CINV is a major problem for all cancer patients. 5-hydroxytryptamine 3 (5-HT3-receptor antagonists or serotonin antagonists used along with dexamethasone is the most widely used antiemetic regimen in chemotherapy. But the best drug of the different serotonin antagonists, which is both efficacious and economic, remains a matter of debate. Aims & Objectives: To compare the relative efficacies and safeties of ondansetron, granisetron and palonosetron, when used along with equal dose of dexamethasone, in moderately to highly emetogenic chemotherapy by a double blind, randomized controlled trial in order to obtain the most potent and cost effective drug. Methods: 1213 adult patients, 487 on highly and 726 on moderately emetogenic chemotherapy, admitted in various departments of a teaching hospital in India from November 05, 2007 to September 30, 2009 were included in the study. Patients were randomly assigned to receive ondansetron 8 mg or granisetron 3mg or palonosetron 0.75 mg (single dose, 30 min before receiving chemotherapy, along with 16 mg of intravenous dexamethasone on Day 1 and 4mg on Day 2 and 3. The observation period started with the initiation of chemotherapy (0 h and continued for 24 h after completion of the chemotherapy for acute emesis and up to Day 5 for delayed nausea and vomiting. Results: For highly emetogenic regimens, 52 of 64 patients (81.2% had complete response during the acute phase in palonosetron group compared with 181 of 237 patients (76.4% in the ondansetron group and 130 of 186 patients (69.9% in granisetron group. During the delayed phase, 41 patients (64% had complete response in the palonosetron group compared with 133 patients (56.1% in the ondansetron group and 114 patients (61.2% in granisetron group. For moderately emetogenic regimens, 86 of 93 patients (92.5% had complete response during the acute phase in palonosetron group compared with 291 of 379

  10. Pilot study on the efficacy of an ondansetron-versus palonosetron-containing antiemetic regimen prior to highly emetogenic chemotherapy

    Science.gov (United States)

    Wenzell, Candice M.; Berger, Michael J.; Blazer, Marlo A.; Crawford, Brooke S.; Griffith, Niesha L.; Wesolowski, Robert; Lustberg, Maryam B.; Phillips, Gary S.; Ramaswamy, Bhuvaneswari; Mrozek, Ewa; Flynn, Joseph M.; Shapiro, Charles L.; Layman, Rachel M.

    2013-01-01

    Purpose Nausea and vomiting are among the most feared complications of chemotherapy reported by patients. The objective of this study was to establish the overall complete response (CR; no emesis or use of rescue medication 0–120 h after chemotherapy) with either ondansetron- or palonosetron-containing antiemetic regimens in patients receiving highly emetogenic chemotherapy (HEC). Methods This was a prospective, open-label, randomized, single-center, pilot study that enrolled patients receiving their first cycle of HEC. Patients were randomized to receive either palonosetron 0.25 mg IV (PAD) or ondansetron 24 mg orally (OAD) on day 1 prior to HEC. All patients received oral aprepitant 125 mg on day 1, then 80 mg on days 2 and 3, and oral dexamethasone 12 mg on day 1, then 8 mg on days 2, 3, and 4. Descriptive statistics were used to summarize the data. Results A total of 40 patients were enrolled, 20 in each arm. All patients were female, and 39 received doxorubicin/cyclophosphamide chemotherapy for breast cancer. For the primary endpoint, 65 % (95 % CI, 40.8–84.6 %) of patients in the PAD arm and 40 % (95 % CI, 19.1–63.9 %) of patients in the OAD arm achieved an overall CR. Conclusions While CR rates for aprepitant and dexamethasone plus palonosetron or ondansetron-containing regimens have been published previously, this is the first documentation of CR rates with these regimens in the same patient population. These results may be used to design a larger, adequately powered, prospective study comparing these regimens. PMID:23748485

  11. Colistin and Polymyxin B Dosage Regimens against Acinetobacter baumannii: Differences in Activity and the Emergence of Resistance.

    Science.gov (United States)

    Cheah, Soon-Ee; Li, Jian; Tsuji, Brian T; Forrest, Alan; Bulitta, Jürgen B; Nation, Roger L

    2016-07-01

    Infections caused by multidrug-resistant Acinetobacter baumannii are a major public health problem, and polymyxins are often the last line of therapy for recalcitrant infections by such isolates. The pharmacokinetics of the two clinically used polymyxins, polymyxin B and colistin, differ considerably, since colistin is administered as an inactive prodrug that undergoes slow conversion to colistin. However, the impact of these substantial pharmacokinetic differences on bacterial killing and resistance emergence is poorly understood. We assessed clinically relevant polymyxin B and colistin dosage regimens against one reference and three clinical A. baumannii strains in a dynamic one-compartment in vitro model. A new mechanism-based pharmacodynamic model was developed to describe and predict the drug concentrations and viable counts of the total and resistant populations. Rapid attainment of target concentrations was shown to be critical for polymyxin-induced bacterial killing. All polymyxin B regimens achieved peak concentrations of at least 1 mg/liter within 1 h and caused ≥4 log10 killing at 1 h. In contrast, the slow rise of colistin concentrations to 3 mg/liter over 48 h resulted in markedly reduced bacterial killing. A significant (4 to 6 log10 CFU/ml) amplification of resistant bacterial populations was common to all dosage regimens. The developed mechanism-based model explained the observed bacterial killing, regrowth, and resistance. The model also implicated adaptive polymyxin resistance as a key driver of bacterial regrowth and predicted the amplification of preexisting, highly polymyxin-resistant bacterial populations following polymyxin treatment. Antibiotic combination therapies seem the most promising option for minimizing the emergence of polymyxin resistance. PMID:27067324

  12. Egg-derived tri-peptide IRW exerts antihypertensive effects in spontaneously hypertensive rats.

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    Kaustav Majumder

    Full Text Available BACKGROUND: There is a growing interest in using functional food components as therapy for cardiovascular diseases such as hypertension. We have previously characterized a tri-peptide IRW (Ile-Arg-Trp from egg white protein ovotransferrin; this peptide showed anti-inflammatory, anti-oxidant and angiotensin converting enzyme (ACE inhibitor properties in vitro. Given the pathogenic roles played by angiotensin, oxidative stress and inflammation in the spontaneously hypertensive rat (SHR, we tested the therapeutic potential of IRW in this well-established model of hypertension. METHODS AND RESULTS: 16-17 week old male SHRs were orally administered IRW at either a low dose (3 mg/Kg BW or a high dose (15 mg/Kg BW daily for 18 days. Blood pressure (BP and heart rate were measured by telemetry. Animals were sacrificed at the end of the treatment for vascular function studies and measuring markers of inflammation. IRW treatment attenuated mean BP by ~10 mmHg and ~40 mmHg at the low- and high-dose groups respectively compared to untreated SHRs. Heart rate was not affected. Reduction in BP was accompanied by the restoration of diurnal variations in BP, preservation of nitric oxide dependent vasorelaxation, as well as reduction of plasma angiotensin II, other inflammatory markers and tissue fibrosis. CONCLUSION: Our results demonstrate anti-hypertensive effects of IRW in vivo likely mediated through ACE inhibition, endothelial nitric oxide synthase and anti-inflammatory properties.

  13. Critical appraisal of the differential effects of antihypertensive agents on arterial stiffness

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    Francesca Kum

    2010-06-01

    Full Text Available Francesca Kum, Janaka KarallieddeUnit for Metabolic Medicine, Cardiovascular Division, Kings College-Waterloo Campus, King’s College London, United KingdomAbstract: Increased central arterial stiffness, involving accelerated vascular ageing of the aorta, is a powerful and independent risk factor for early mortality and provides prognostic information above and beyond traditional risk factors for cardiovascular disease (CVD. Central arterial stiffness is an important determinant of pulse pressure; therefore, any pathological increase may result in left ventricular hypertrophy and impaired coronary perfusion. Central artery stiffness can be assessed noninvasively by measurement of aortic pulse wave velocity, which is the gold standard for measurement of arterial stiffness. Earlier, it was believed that changes in arterial stiffness, which are primarily influenced by long-term pressure-dependent structural changes, may be slowed but not reversed by pharmacotherapy. Recent studies with drugs that inhibit the renin–angiotensin–aldosterone system, advanced glycation end products crosslink breakers, and endothelin antagonists suggest that blood pressure (BP-independent reduction and reversal of arterial stiffness are feasible. We review the recent literature on the differential effect of antihypertensive agents either as monotherapy or combination therapy on arterial stiffness. Arterial stiffness is an emerging therapeutic target for CVD risk reduction; however, further clinical trials are required to confirm whether BP-independent changes in arterial stiffness directly translate to a reduction in CVD events.Keywords: aortic pulse wave velocity, augmentation index, blood pressure, renin–angiotensin–aldosterone system

  14. Photostabilization studies of antihypertensive 1,4-dihydropyridines using polymeric containers.

    Science.gov (United States)

    De Luca, Michele; Ioele, Giuseppina; Spatari, Claudia; Ragno, Gaetano

    2016-05-30

    1,4-dihydropyridine antihypertensives (DHPs) are almost all dispensed in solid pharmaceutical formulations for their easy lability when exposed to light. This paper reports a study on the photoprotective effect of containers in different glassy or polymeric matrices with regard to four known DHPs when in solutions. The samples were subjected to forced degradation by means of a Xenon lamp, in accordance with the international rules on drug stability evaluation. The simultaneous determination of the drugs and their photoproducts was carried out by applying the multivariate curve resolution (MCR) methodology to the spectral data recorded along the irradiation test. This technique was able to determine the kinetic parameters and resolve the spectra of the photoproducts. The time required to reduce by 10% the concentration of the drug (t0.1) was adopted as a criterion to compare the protective ability of the containers. A significant photoprotection for all drugs tested was obtained by the use of polyethylene terephthalate (PET) containers. The best result was achieved for the felodipine solution in blue PET transparent bottle of 0.6mm thickness, reaching an almost complete stabilization up to six hours under stressing irradiation. In contrast, the glass containers, whether or not coloured, did not provide a satisfactory photoprotection of the drugs, showing in any case t0.1 values under 24min. These results can be a good opportunity to design new photoprotective pharmaceutical packaging for DHPs in liquid dosage form. PMID:27085645

  15. Vascular Reactivity Concerning Orthosiphon stamineus Benth-Mediated Antihypertensive in Aortic Rings of Spontaneously Hypertensive Rats

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    Nurul Maizan Manshor

    2013-01-01

    Full Text Available Orthosiphon stamineus Benth has been traditionally used to treat hypertension. The study aimed to investigate the vascular reactivity of water extract (WOS and water : methanolic (1 : 1 extract (WMOS of Orthosiphon stamineus Benth and AT1 receptors blocker in the mechanisms of antihypertensive mediated by α1-adrenergic receptor and EDNO and PGI2 releases in the SHR aortic rings. SHR (230–280 g were divided into four groups: control, WOS, WMOS, and losartan. After being fed orally for 14 days, the aorta was harvested and subjected to PE (10−9 to 10−5 M and ACh (10−9 to 10−5 M with and without L-NAME (100 µM and indomethacin (10 µM, respectively. WOS, WMOS, and losartan significantly reduced the contractile responses to PE intact suggesting the importance of endothelium in vasorelaxation. Losartan significantly enhanced the ACh-induced vasorelaxation. L-NAME significantly inhibited the ACh-induced relaxation in all groups. Indomethacin enhanced ACh-induced vasorelaxation in WMOS. Collectively, Orthosiphon stamineus leaves extract reduced vasoconstriction responses by the alteration of α1-adrenergic and AT1 receptors activities. The involvement of EDNO releases was clearly observed in this plant. In WOS, PGI2 releases might not participate in the ACh-induced vasorelaxation. However, in WMOS, enhancement of vasorelaxation possibly due to continuous release of PGI2.

  16. Polyionic hybrid nano-engineered systems comprising alginate and chitosan for antihypertensive therapeutics.

    Science.gov (United States)

    Niaz, Taskeen; Nasir, Habib; Shabbir, Saima; Rehman, Asma; Imran, Muhammad

    2016-10-01

    Hydrophobic nature of virtually all antihypertensive (AHT) drugs is the major hindrance towards their oral administration. Current study focuses on the development of polyionic hybrid nano drug delivery systems comprising sodium alginate and chitosan, loaded with distinct AHT drugs (captopril, amlodipine and valsartan). Encapsulation efficiency of hybrid NCS increased in the order of amlodipine>valsartan>captopril with average value of 42±0.9%, 91±1.5% and 96±1.9%, respectively. Scanning electron microscopy revealed hybrid NCS with smooth topography and round appearance in case of captopril. FTIR analysis confirmed the cross-linking between amino and carboxylate group of chitosan and alginate to form polyionic structures at nano-scale. Zeta-sizer experiments revealed that particle size distribution had increased from 197±12nm to 341±15nm for void and captopril loaded NCS. However, highly positive zeta potential of +32±1.6mV was not decreased significantly. In vitro sustained release assays reflected excellent retention of AHT drug in hybrid nanoparticles at 4°C and 37°C in physiological buffer, as less than 8% of the total drug was released in first 24h. Thus, carbohydrate-based hybrid NCS offering high loading capacity, stability and sustained release of hydrophobic drugs can be excellent alternative to current AHT therapeutics. PMID:27212217

  17. Impact of Elicitation on Antioxidant and Potential Antihypertensive Properties of Lentil Sprouts.

    Science.gov (United States)

    Peñas, Elena; Limón, Rocío I; Martínez-Villaluenga, Cristina; Restani, Patrizia; Pihlanto, Anne; Frias, Juana

    2015-12-01

    The aim of this study was to investigate the application of elicitors (500 μM ascorbic acid, 50 μM folic acid, 5 mM glutamic acid and 50 ppm chitosan in 5 mM glutamic acid) during lentil germination up to 8 days as a strategy to increase germination rate and to enhance the accumulation of γ-aminobutyric acid (GABA) and phenolic compounds. The effect of elicitation on the protein profile and antioxidant and angiotensin I converting enzyme (ACE) inhibitory activities of sprouted lentils was also evaluated. The application of elicitors did not negatively affect the germination yield of lentils and no significant changes on the protein pattern of lentils germinated in the presence of elicitors were observed. Chitosan/glutamic acid increased by 1.6-fold the GABA content in lentil sprouts, whilst ascorbic and folic acids as well as chitosan/glutamic acid were highly effective to enhance the total content of phenolic compounds and the antioxidant activity of sprouted lentils. All elicited lentil sprouts showed ability to inhibit ACE activity (IC50: 9.5-11.9 μg peptides/mL). Therefore, elicitation can be considered a promising approach to improve the content of compounds with antioxidant and potential antihypertensive activities in lentil sprouts. PMID:26433888

  18. Recent Research in Antihypertensive Activity of Food Protein-derived Hydrolyzates and Peptides.

    Science.gov (United States)

    Saleh, Ahmed S M; Zhang, Qing; Shen, Qun

    2016-04-01

    Year to year obesity prevalence, reduced physical activities, bad habits/or stressful lifestyle, and other environmental and physiological impacts lead to increase in diseases such as coronary heart disease, stroke, cancer, diabetes, and hypertension worldwide. Hypertension is considered as one of the most common serious chronic diseases; however, discovery of medications with high efficacy and without side effects for treatment of patients remains a challenge for scientists. Recent trends in functional foods have evidenced that food bioactive proteins play a major role in the concepts of illness and curing; therefore, nutritionists, biomedical scientists, and food scientists are working together to develop improved systems for the discovery of peptides with increased potency and therapeutic benefits. This review presents a recent research carried out to date for the purpose of isolation and identification of bioactive hydrolyzates and peptides with angiotensin I converting enzyme inhibitory activity and antihypertensive effect from animal, marine, microbial, and plant food proteins. Effects of food processing and hydrolyzation conditions as well as some other impacts on formation, activity, and stability of these hydrolyzates and peptides are also presented. PMID:25036695

  19. Molecular structure of antihypertensive drug perindopril, its active metabolite perindoprilat and impurity F

    Science.gov (United States)

    Remko, M.; Bojarska, J.; Ježko, P.; Maniukiewicz, W.; Olczak, A.

    2013-03-01

    The molecular structure of the antihypertensive drug perindopril (2S,3aS,7aS)-1-[(2S)-2-[[(2S)-1-ethoxy-1-oxopentan-2-yl]amino]propanoyl]-2,3,3a,4,5,6,7,7a-octahydroindole-2 carboxylic acid), its active metabolite perindoprilat ((2S,3aS,7aS)-1-[(2S)-2-[[(2S)-1-carboxybutyl]amino]propanoyl]-2,3,3a,4,5,6,7,7a-octahydroindole-2-carboxylic acid), and impurity F (ethyl (2S)-2-((3S,5aS,9aS,10aS)-3-methyl-1,4-dioxodecahydropyrazino[1,2-a]indol-2(1H)-yl) pentanoate) has been investigated using B3LYP/6-31g(d) and B3LYP/6-311+g(d,p) model chemistry. It has been found that solid state conformations of perindoprilat occur close to, but not actually at minima on the computed gas-phase potential energy surfaces. Both, neutral and zwitterionic structures of perindopril and perindoprilat have been investigated. Relative stability of individual ionized species of this drug has been determined. Water has a remarkable effect on the geometry of the perindopril species studied.

  20. Design and Characterization of Buccoadhesive Liquisolid System of an Antihypertensive Drug

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    Nilesh P. Kala

    2015-01-01

    Full Text Available Nifedipine is an antihypertensive BCS class II drug which has poor bioavailability when given orally. The objective of the present study was to increase the bioavailability of nifedipine, by formulation and evaluation of a buccoadhesive liquisolid system using magnesium aluminium silicate (Neusilin as both carrier and coating material and dissolution media were selected based on the solubility studies. A mixture of carboxymethylcellulose sodium and carbomer was used as mucoadhesive polymers. Buccoadhesive tablets were prepared by direct compression. FTIR studies confirmed no interaction between drug and excipients. XRD studies indicated change/reduction in crystallinity of drug. The powder characteristics were evaluated by different flow parameters to comply with pharmacopoeial specifications. The dissolution studies for liquisolid compacts and tablet formulations were carried out and it was found that nifedipine liquisolid tablets formulated from bioadhesive polymers containing 49% liquisolid system, 17.5% carbomer, and 7.5% carboxymethylcellulose sodium showed the best results in terms of dissolution properties. Prepared formulation batches were evaluated for swelling, bioadhesion strength, ex vivo residence time, and permeability studies. The optimized batch was showing promising features of the system. Formulating nifedipine as a buccoadhesive tablet allows reduction in dose and offers better control over the plasma levels.

  1. Extracts and Fractions from Edible Roots of Sechium edule (Jacq. Sw. with Antihypertensive Activity

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    Galia Lombardo-Earl

    2014-01-01

    Full Text Available Sechium edule is traditionally used in Mexico as a therapeutic resource against renal diseases and to control high blood pressure. The purpose of this work is to evaluate the antihypertensive effect of the hydroalcoholic extract obtained from the roots of this plant, including its fractions and subfractions, on different hypertension models induced with angiotensin II (AG II. The hydroalcoholic extract was tested on an in vitro study of isolated aorta rings denuded of endothelial cells, using AG II as the agonist; this assay proved the vasorelaxant effect of this extract. Vagotomized rats were administered different doses of AG II as well as the Hydroalcoholic extract, which reduced blood pressure in 30 mmHg approximately; subsequently this extract was separated into two fractions (acetone and methanol which were evaluated in the acute hypertension mouse model induced with AG II, where the acetone fraction was identified as the most effective one and was subsequently subfractioned using an open chromatographic column packed with silica gel. The subfractions were also evaluated in the acute hypertension model. Finally, the extract, fraction, and active subfraction were analyzed by MS-PDA-HPLC, identifying cinnamic derivative compounds like cinnamic acid methyl ester.

  2. Pharmacological basis for the empirical use of Eugenia uniflora L. (Myrtaceae) as antihypertensive.

    Science.gov (United States)

    Consolini, A E; Baldini, O A; Amat, A G

    1999-07-01

    The rational basis for the use of Eugenia uniflora L. (Myrtaceae) as antihypertensive in Northeastern Argentina was assessed in normotensive rats. Intraperitoneal administration of the aqueous crude extract (ACE) decreased blood pressure (BP) of normotensive rats dose-dependently until 47.1 +/- 8.2% of control. The effective-dose 50 was 3.1 +/- 0.4 mg dried leaves/kg (d.l./kg) (yielding of ACE: 17% w/w). To determine the origin of hypotensive activity. Alpha-adrenergic antagonistic and vasorelaxant ACE activities were tested. The dose-response curve for phenylephrine on BP was inhibited non-competitively until 80% of its maximal effect (at 8 mg d.l. ACE/kg). Perfusion pressure (PP) of rat hindquarters (previously vasoconstricted by high-K+) was decreased by ACE in a concentration-dependent manner until -32.3 +/- 11.5% of tonic contraction at 1.2 g d.l. ACE/100 ml. In addition, A.C.E demonstrated diuretic activity at a dose (120 mg d.l./kg) higher than the hypotensive one. It was almost as potent as amiloride, but while amiloride induced loss of Na+ and saving of K+, ACE induced decrease in Na+ excretion. The results suggest that the empirical use of Eugenia uniflora L. (Myrtaceae) is mostly due to a hypotensive effect mediated by a direct vasodilating activity, and to a weak diuretic effect that could be related to an increase in renal blood flow. PMID:10432205

  3. Honey Supplementation in Spontaneously Hypertensive Rats Elicits Antihypertensive Effect via Amelioration of Renal Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Omotayo O. Erejuwa

    2012-01-01

    Full Text Available Oxidative stress is implicated in the pathogenesis and/or maintenance of elevated blood pressure in hypertension. This study investigated the effect of honey on elevated systolic blood pressure (SBP in spontaneously hypertensive rats (SHR. It also evaluated the effect of honey on the amelioration of oxidative stress in the kidney of SHR as a possible mechanism of its antihypertensive effect. SHR and Wistar Kyoto (WKY rats were randomly divided into 2 groups and administered distilled water or honey by oral gavage once daily for 12 weeks. The control SHR had significantly higher SBP and renal malondialdehyde (MDA levels than did control WKY. The mRNA expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2 and glutathione S-transferase (GST were significantly downregulated while total antioxidant status (TAS and activities of GST and catalase (CAT were higher in the kidney of control SHR. Honey supplementation significantly reduced SBP and MDA levels in SHR. Honey significantly reduced the activities of GST and CAT while it moderately but insignificantly upregulated the Nrf2 mRNA expression level in the kidney of SHR. These results indicate that Nrf2 expression is impaired in the kidney of SHR. Honey supplementation considerably reduces elevated SBP via amelioration of oxidative stress in the kidney of SHR.

  4. A quasi-experimental test of an intervention to increase the use of thiazide-based treatment regimens for people with hypertension

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    Beyth Rebecca J

    2007-02-01

    Full Text Available Abstract Background Despite recent high-quality evidence for their cost-effectiveness, thiazides are underused for controlling hypertension. The goal of this study was to design and test a practice-based intervention aimed at increasing the use of thiazide-based antihypertensive regimens. Methods This quasi-experimental study was carried out in general medicine ambulatory practices of a large, academically-affiliated Veterans Affairs hospital. The intervention group consisted of the practitioners (13 staff and 215 trainees, nurses, and patients (3,502 of the teaching practice; non-randomized concurrent controls were the practitioners (31 providers and patients (18,292 of the non-teaching practices. Design of the implementation intervention was based on Rogers' Diffusion of Innovations model. Over 10.5 months, intervention teams met weekly or biweekly and developed and disseminated informational materials among themselves and to trainees, patients, and administrators. These teams also reviewed summary electronic-medical-record data on thiazide use and blood pressure (BP goal attainment. Outcome measures were the proportion of hypertensive patients prescribed a thiazide-based regimen, and the proportion of hypertensive patients attaining BP goals regardless of regimen. Thirty-three months of time-series data were available; statistical process control charts, change point analyses, and before-after analyses were used to estimate the intervention's effects. Results Baseline use of thiazides and rates of BP control were higher in the intervention group than controls. During the intervention, thiazide use and BP control increased in both groups, but changes occurred earlier in the intervention group, and primary change points were observed only in the intervention group. Overall, the pre-post intervention difference in proportion of patients prescribed thiazides was greater in intervention patients (0.091 vs. 0.058; p = 0.0092, as was the proportion

  5. Acute and chronic antihypertensive effects of Cinnamomum zeylanicum stem bark methanol extract in L-NAME-induced hypertensive rats

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    Nyadjeu Paulin

    2013-01-01

    Full Text Available Abstract Background Previous study showed that the aqueous extract of the stem bark of Cinnamomum zeylanicum possesses antihypertensive and vasodilatory properties. The present work investigates the acute and chronic antihypertensive effects of the methanol extract of Cinnamomum zeylanicum stem bark (MECZ in L-NAME-induced hypertensive rats. Methods The acute antihypertensive effects of MECZ (5, 10 and 20 mg/kg administered intravenously were evaluated in rats in which acute arterial hypertension has been induced by intravenous administration of L-NAME (20 mg/kg. For chronic antihypertensive effects, animals were treated with L-NAME (40 mg/kg/day plus the vehicle or L-NAME (40 mg/kg/day in combination with captopril (20 mg/kg/day or MECZ (300 mg/kg/day and compared with control group receiving only distilled water. All drugs were administered per os and at the end of the experiment that lasted for four consecutive weeks, blood pressure was measured by invasive method and blood samples were collected for the determination of the lipid profile. The heart and aorta were collected, weighed and used for both histological analysis and determination of NO tissue content. Results Acute intravenous administration of C. zeylanicum extract (5, 10 and 20 mg/kg to L-NAME-induced hypertensive rats provoked a long-lasting decrease in blood pressure. Mean arterial blood pressure decreased by 12.5%, 26.6% and 30.6% at the doses of 5, 10 and 20 mg/kg, respectively. In chronic administration, MECZ and captopril significantly prevented the increase in blood pressure and organs’ weights, as well as tissue histological damages and were able to reverse the depletion in NO tissue’s concentration. The MECZ also significantly lower the plasma level of triglycerides (38.1%, total cholesterol (32.1% and LDL-cholesterol (75.3% while increasing that of HDL-cholesterol (58.4% with a significant low atherogenic index (1.4 versus 5.3 for L-NAME group. Conclusion MECZ

  6. Disparate access to treatment regimens in chronic hepatitis C patients: data from the TRIO network.

    Science.gov (United States)

    Younossi, Z M; Bacon, B R; Dieterich, D T; Flamm, S L; Kowdley, K; Milligan, S; Tsai, N; Nezam, A

    2016-06-01

    Despite the clinical success in the real-world of all oral hepatitis C virus (HCV) therapy with response rates approaching that seen in the clinical trials, access has been limited by many payers with discussion of prioritization of treatment based upon AASLD guidelines. We evaluated patients in the TRIO network who were prescribed sofosbuvir (SOF)-based regimens to determine reasons for not starting treatment. Trio Health is a disease management company that works in partnership with academic medical centres, community physicians and specialty pharmacies in the United States to optimize care for HCV. Data for 3841 patients prescribed a sofosbuvir-containing regimen between December 2013 and September 2014 were obtained through this programme. Of the entire group, 315 (8%) patients did not start the prescribed sofosbuvir-containing therapy. A total of 141 (45%) of the nonstart patients had a commercial plan as their primary insurance, 137 (44%) were primarily covered by Medicaid, 17 (5%) were primarily covered by Medicare, and 20 (6%) were either without coverage or coverage was not specified. Reasons for nonstarts were varied and overlapping. Only 15 patients (5% of nonstarts) did not start because they were unreachable or failed to complete required testing. Another 39 patients who did not start (12%) were following their physicians' direction to either wait for new treatment options or to hold treatment for an unspecified reason. Insurance-related processes and financial reasons accounted for 254 (81%) of the 315 nonstarts. The remaining 7 (2%) patients did not have a specified reason for not starting treatment. Nonstart rates were highest in the Medicaid-covered population at 35%. Medicare and Commercial nonstart rates were 2% and 6%, respectively. In a matched comparison, patients with commercial coverage were 6.5 times as likely to start SOF-based therapy compared to patients with Medicaid. Despite high SVR rates of SOF-based regimens in clinical practice

  7. Comparison of antiplatelet regimens in secondary stroke prevention

    DEFF Research Database (Denmark)

    Christiansen, Christine Benn; Pallisgaard, Jannik; Gerds, Thomas Alexander; Olesen, Jonas Bjerring; Jørgensen, Mads Emil; Numé, Anna Karin; Carlson, Nicholas; Kristensen, Søren Lund; Gislason, Gunnar; Torp-Pedersen, Christian

    2015-01-01

    stroke associated with these three treatments. METHODS: Patients who were discharged with first-time ischemic stroke from 2007-2010, with no history of atrial fibrillation were identified from Danish nationwide registries. Hazard ratios (HRs) and 1-year risks of recurrent ischemic stroke and bleeding......BACKGROUND: In patients with ischemic stroke of non-cardioembolic origin, acetylsalicylic acid, clopidogrel, or a combination of acetylsalicylic acid and dipyridamole are recommended for the prevention of a recurrent stroke. The purpose of this study was to examine the risk of bleeding or recurrent...... were calculated for each antiplatelet regimen. RESULTS: Among patients discharged after first-time ischemic stroke, 3043 patients were treated with acetylsalicylic acid, 12,295 with a combination of acetylsalicylic acid and dipyridamole, and 3885 with clopidogrel. Adjusted HRs for clopidogrel versus...

  8. Predictive tools for designing new insulins and treatment regimens

    DEFF Research Database (Denmark)

    Klim, Søren

    The thesis deals with the development of "Predictive tools for designing new insulins and treatments regimens" and consists of two parts: A model based approach for bridging properties of new insulin analogues from glucose clamp experiments to meal tolerance tests (MTT) and a second part that...... 24-hour glucose profiles from a MTT with treatments based on the new insulin analogue that previously only has been tested in clamps. The bridge between insulin analogue properties determined in clamp experiments to meal tolerance test outcomes in Phase II trials is not simple and is complicated by...... approach based on ordinary differential equations. The absence of such a program motivated the development of new a tool with PK/PD features, SDEs and mixed effects. Part II presents a software package which was developed in order to be able to handle SDEs with mixed effects. The package was implemented in...

  9. Cost-effectiveness of an aprepitant regimen for prevention of chemotherapy-induced nausea and vomiting in patients with breast cancer in the UK

    Directory of Open Access Journals (Sweden)

    Humphreys S

    2013-08-01

    Full Text Available Samantha Humphreys,1 James Pellissier,2 Alison Jones3 1Market Access Department, Merck Sharp and Dohme Ltd, Hoddesdon, Hertfordshire, UK; 2Health Economic Statistics, Merck Research Laboratories, Upper Gwynedd, PA, USA; 3Department of Medical Oncology, University College Hospital, London, UK Purpose: Prevention of chemotherapy-induced nausea and vomiting (CINV remains an important goal for patients receiving chemotherapy. The objective of this study was to define, from the UK payer perspective, the cost-effectiveness of an antiemetic regimen using aprepitant, a selective neurokinin-1 receptor antagonist, for patients receiving chemotherapy for breast cancer. Methods: A decision-analytic model was developed to compare an aprepitant regimen (aprepitant, ondansetron, and dexamethasone with a standard UK antiemetic regimen (ondansetron, dexamethasone, and metoclopramide for expected costs and health outcomes after single-day adjuvant chemotherapy for breast cancer. The model was populated with results from patients with breast cancer participating in a randomized trial of CINV preventative therapy for cycle 1 of single-day chemotherapy. Results: During 5 days after chemotherapy, 64% of patients receiving the aprepitant regimen and 47% of those receiving the UK comparator regimen had a complete response to antiemetic therapy (no emesis and no rescue antiemetic therapy. A mean of £37.11 (78% of the cost of aprepitant was offset by reduced health care resource utilization costs. The predicted gain in quality-adjusted lifeyears (QALYs with the aprepitant regimen was 0.0048. The incremental cost effectiveness ratio (ICER with aprepitant, relative to the UK comparator, was £10,847/QALY, which is well below the threshold commonly accepted in the UK of £20,000–£30,000/QALY. Conclusion: The results of this study suggest that aprepitant is cost-effective for preventing CINV associated with chemotherapy for patients with breast cancer in the UK health

  10. Eradication of Helicobacter pylori: are rifaximin-based regimens effective?

    Science.gov (United States)

    Gasbarrini, Antonio; Gasbarrini, Giovanni; Pelosini, Iva; Scarpignato, Carmelo

    2006-01-01

    Rifaximin is a non-absorbed semisynthetic rifamycin derivative with a broad spectrum of antibacterial activity including Gram-positive and Gram-negative bacteria, both aerobes and anaerobes. Although originally developed for the treatment of infectious diarrhea, the appreciation of the pathogenic role of gut bacteria in several organic and functional gastrointestinal diseases has increasingly broadened its clinical use. Being the antibiotic active against Helicobacter pylori, even towards clarithromycin-resistant strain, and being the primary resistance very rare, several investigations explored its potential use for eradication of the microorganism. Rifaximin alone proved to be effective, but even the highest dose (1,200 mg daily) gave a cure rate of only 30%. Dual and triple therapies were also studied, with the better results obtained with rifaximin-clarithromycin and rifaximin-clarithromycin-esomeprazole combinations. However, the eradication rates (60-70%) obtained with these regimens were still below the standard set by the Maastricht Consensus guidelines. Although rifaximin-based eradication therapies are promising, new antimicrobial combinations (with and without proton pump inhibitors) need to be explored in well-designed clinical trials including a large cohort of H. pylori-infected patients. The remarkable safety of rifaximin will allow high-dose regimens of longer duration (e.g. 10 or 14 days) to be tested with confidence in the hope of achieving better eradication rates. A drawback of rifaximin could be its inability to reach sufficiently high concentrations in the gastric mucus layer under and within which H. pylori is commonly located and this would likely affect eradication rate. Taking these considerations into account, bioadhesive rifaximin formulations able to better and persistently cover gastric mucosa, or combination with mucolytic agents, such as pronase or acetylcysteine, need to be evaluated in order to better define the place of this

  11. Chemotherapy and survival in advanced breast cancer: the inclusion of doxorubicin in Cooper type regimens.

    OpenAIRE

    A'Hern, R P; Smith, I. E.; Ebbs, S R

    1993-01-01

    The value of the inclusion of doxorubicin hydrochloride (dox) in Cooper type regimens in advanced breast cancer was assessed by performing an overview employing summary statistics derived from published papers of randomised clinical trials comparing Cooper type regimens that contain dox with regimens in which dox was replaced by one or more compounds. Trials were selected which published data on survival, time to treatment failure and response rate. This study suggests that dox confers advant...

  12. Congenital syphilis after treatment of maternal syphilis with a penicillin regimen exceeding CDC guidelines.

    OpenAIRE

    Conover, C S; Rend, C A; Miller, G B; Schmid, G P

    1998-01-01

    BACKGROUND: Although congenital syphilis usually occurs as a result of a failure to detect and treat syphilis in pregnant women, failures of the currently recommended regimen to prevent congenital syphilis have been reported. CASE: This report describes an infant with congenital syphilis despite maternal treatment with a regimen exceeding current CDC guidelines. CONCLUSION: Regardless of the regimen used to treat syphilis during pregnancy, clinicians should recognize the possibility of occasi...

  13. Genetic evolution of HIV in patients remaining on a stable HAART regimen despite insufficient viral suppression

    DEFF Research Database (Denmark)

    Kristiansen, Thomas B; Pedersen, Anders; Eugen-Olsen, Jesper;

    2005-01-01

    Our objective was to investigate whether steadily increasing resistance levels are inevitable in the course of a failing but unchanged Highly Active Antiretroviral Therapy (HAART) regimen. Patients having an unchanged HAART regimen and a good CD4 response (100 cells/microl above nadir) despite co...... cause a mutational deadlock where the evolutionary benefit of further resistance mutation is limited if the patient is kept on a stable HAART regimen....

  14. Effects of smoking regimens and test material format on the cytotoxicity of mainstream cigarette smoke.

    Science.gov (United States)

    Li, Xiang; Shang, Pingping; Peng, Bin; Nie, Cong; Zhao, Le; Liu, Huimin; Xie, Jianping

    2012-03-01

    The purpose of this study was to evaluate the effects of test material format and smoking regimens on comparative toxicity testing of cigarette smoke. Total particulate matter (TPM) or whole smoke (WS) generated from three test cigarettes under International Organization for Standardization (ISO) or Health Canada Intensive (HCI) regimens were assessed for cytotoxicity using the neutral red uptake (NRU) cytotoxicity assay. Under both ISO and HCI regimens, the relative differences of cytotoxicity among the test cigarettes indicated by the EC50 values in WS were significantly higher than those in TPM. For TPM testing, cytotoxicity was decreased going from ISO regimen to HCI regimen, consistent with the reported reductions of toxicant output on a per unit of TPM basis under the HCI regimen. For WS, cytotoxicity increased for the two lower TPM cigarettes, and decreased for the higher TPM cigarette going from HCI regimen to ISO regimen. Results from this study demonstrated WS should be the preferable test material format for smoke toxicity testing whenever possible. Intensive smoking regimens, such as HCI, are less likely to underestimate smoke toxicant intakes by smokers, and should be included in the comparative toxicological testing strategy. PMID:22198610

  15. Enhanced Toxicity Potential of a Regimen on Addition of Doxorubicin in Combination Chemo-therapy

    Directory of Open Access Journals (Sweden)

    Pai Ganesh

    1997-01-01

    Full Text Available A comparative study of cutaneous toxicities of two different commonly used combination chemotherapeutic regimens was conducted on 16 patients of non-Hodgkin′s lymphoma. The common drugs in the two regimens were cyclophosphamide, vincristine and prednisone. One of the regimens which was administered to 10 patients, included doxorubicin as an additional drug. This combination is preferred in high grade malignancy. However, the addition of doxorubicin resulted in enhanced severity and multiplicity of cutaneous manifestations. If it is possible to choose between two or more regimens for a given malignancy, the risk-benefit ratio can be weighed to choose the appropriate and least toxic drugs.

  16. DIFFERENCES IN EFFECTIVENESS OF ANTIHYPERTENSIVE THERAPY IN MEN AND WOMEN: LOSARTAN VERSUS ENALAPRIL

    Directory of Open Access Journals (Sweden)

    E. I. Tarlovskaya

    2016-01-01

    Full Text Available Aim. To evaluate gender differences in effectiveness of antihypertensive therapy with losartan in comparison with enalapril therapy. Material and methods. Open-label controlled crossover study in parallel groups was conducted during 3 months. A total of 120 patients aged 20-45 years with arterial hypertension (HT of 1 and 2 degree were split into 4 groups with 30 patients in each: 1A, 1B – men; 2A, 2B – women. For the first 6 weeks patients of the 1A, 2A groups received enalapril 5-20 mg while patients of 1B, 2B – received losartan 50-100 mg. Then the therapy was crosswise changed. Results. Initial blood pressure (BP levels did not differ significantly in men and women. In women start therapy with losartan decreased systolic BP (BPs more effectively than enalapril therapy did (18.2±5.4% vs 15.2±4.3%, р=0.02. In men enalapril and losartan start therapies did not show significant differences in BP reduction (13.8±4.5% vs 14.6±4.6%, р=0.539. Follicule-stimulating hormone (FSH level in women correlated positively with age (r=0.826; p=0.0001, HT duration (r=0.498; p=0.0001, BPs level (r=0.466; p=0.001, microalbuminuria level (r=0.583; p=0.0001 and negatively – with glomerular filtration rate (r=-0.58; p=0.0001. Conclusion. Losartan is more effective than enalapril as a start therapy in 20-45-year-old women. In women FSH level correlates with age, HT duration, BPs and microalbuminuria levels, glomerular filtration rate.

  17. Characterizing weekly self-reported antihypertensive medication nonadherence across repeated occasions

    Directory of Open Access Journals (Sweden)

    Voils CI

    2014-05-01

    Full Text Available Corrine I Voils,1,2 Heather A King,1 Brian Neelon,1,2 Rick H Hoyle,3 Bryce B Reeve,4 Matthew L Maciejewski,1,2 William S Yancy Jr1,21Health Services Research and Development, Durham Veterans Affairs Medical Center; 2Department of Medicine, Duke University; 3Department of Psychology and Neuroscience, Duke University; 4Department of Health Policy and Management, University of North Carolina at Chapel Hill, NC, USABackground: Little is known about weekly variability in medication nonadherence both between and within persons.Purpose: To characterize medication nonadherence across repeated, closely spaced occasions.Methods: This prospective cohort study comprised four unannounced telephone assessment occasions, each separated by approximately 2 weeks. On each occasion, adult outpatients taking at least a single antihypertensive medication completed a measure of extent of, and reasons for, nonadherence.Results: Two hundred and sixty-one participants completed 871 (83% of 1,044 occasions. Nonadherence was reported on 152 (17.5% of 871 occasions by 93 (36% of 261 participants. The most commonly endorsed reasons for nonadherence were forgetting (39.5%, being busy (23.7%, and traveling (19.7%. Among 219 participants completing at least three occasions, 50% of the variability in extent of nonadherence was a result of within-person fluctuations, and 50% was a result of between-person differences.Conclusion: Interventions to reduce nonadherence should be informed by variability in the extent of nonadherence and specific reasons for nonadherence.Keywords: adherence, compliance, hypertension, intraindividual variability

  18. Interaction of antihypertensive drug amiloride with metal ions in micellar medium using fluorescence spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Gujar, Varsha; Pundge, Vijaykumar; Ottoor, Divya, E-mail: divya@chem.unipune.ac.in

    2015-05-15

    Steady state and life time fluorescence spectroscopy have been employed to study the interaction of antihypertensive drug amiloride with biologically important metal ions i.e. Cu{sup 2+}, Fe{sup 2+}, Ni{sup 2+} and Zn{sup 2+} in various micellar media (anionic SDS (sodium dodecyl sulfate), nonionic TX-100 (triton X-100) and cationic CTAB (cetyl trimethyl ammonium bromide)). It was observed that fluorescence properties of drug remain unaltered in the absence of micellar media with increasing concentration of metal ions. However, addition of Cu{sup 2+}, Fe{sup 2+} and Ni{sup 2+} caused fluorescence quenching of amiloride in the presence of anionic micelle, SDS. Binding of drug with metal ions at the charged micellar interface could be the possible reason for this pH-dependent metal-mediated fluorescence quenching. There were no remarkable changes observed due to metal ions addition when drug was present in cationic and nonionic micellar medium. The binding constant and bimolecular quenching constant were evaluated and compared for the drug–metal complexes using Stern–Volmer equation and fluorescence lifetime values. - Highlights: • Interaction of amiloride with biologically important metal ions, Fe{sup 2+}, Cu{sup 2+}, Ni{sup 2+} and Zn{sup 2+}. • Monitoring the interaction in various micelle at different pH by fluorescence spectroscopy. • Micelles acts as receptor, amiloride as transducer and metal ions as analyte in the present system. • Interaction study provides pH dependent quenching and binding mechanism of drug with metal ions.

  19. Repurposing and Rescuing of Mibefradil, an Antihypertensive, for Cancer: A Case Study.

    Science.gov (United States)

    Krouse, Andrew J; Gray, Lloyd; Macdonald, Timothy; McCray, John

    2015-12-01

    The expanding "valley of death" in drug development is leaving potentially life-saving new chemical entities and molecular targets fallow. This situation is forcing early-stage companies to think creatively about moving their technologies forward, especially as institutional investors show more interest in later stages of development. Drug repurposing, a strategy to examine existing drugs for therapeutic value against different diseases, is an emerging method to bring an off-market drug back onto the market. Tau Therapeutics LLC identified the role of T-type calcium channel blockers (Cav3) in cancer proliferation, but the company was unable to attract funding while having both a nonvalidated drug target and new chemical entities. To change the risk profile of the company, Tau set out to repurpose the known Cav3 drug mibefradil as a proof of concept for the treatment of cancer. Mibefradil was launched for hypertension in the 1990s but withdrawn because of drug-drug interactions. A new sequential combination treatment, termed Interlaced Therapy™, uses short-term administration of mibefradil to enhance the overall therapeutic potential of conventional anticancer agents. Mibefradil is currently in a phase Ib clinical trial with the National Cancer Institute (NCI) Adult Brain Tumor Consortium. Mibefradil has been repurposed from an abandoned antihypertensive to a targeted solid tumor treatment, and it has been rescued from drug-drug interactions by using short-term dose exposure. Tau is using the early success of mibefradil as a proof of concept to build a platform technology of Cav3 blockers for broad antitumor applications in combination with new targeted cancer therapies, well-established chemotherapies, and radiation. PMID:26690767

  20. Antihypertensive nano-ceuticales based on chitosan biopolymer: Physico-chemical evaluation and release kinetics.

    Science.gov (United States)

    Niaz, Taskeen; Shabbir, Saima; Manzoor, Shahid; Rehman, Asma; Rahman, Abdur; Nasir, Habib; Imran, Muhammad

    2016-05-20

    Prime risk factor behind cardiovascular associated mortality and morbidity is hypertension. The main challenge with antihypertensive (AHT) drug therapy is their extreme hydrophobic nature and very low oral bio-availability; which result into higher dosage/frequency and associated side effects of drugs. The main objective of this study was to fabricate AHT nano-ceuticals in hydrophilic carriers of natural origin to improve drugs' solubility, protection and sustained release. AHT nano-carrier systems (NCS) encapsulating captopril, amlodipine and valsartan were fabricated using chitosan (CS) polymer by ionic gelation assisted ultra-sonication method. Drug encapsulation efficiencies of 92±1.6%, 91±0.9% and 87±0.5% were observed for captopril, valsartan and amlodipine respectively. Scanning electron microscopy (SEM) based analysis had revealed that captopril loaded polymeric NCS were regular, smooth and without any agglomeration. FTIR analyses of drug loaded and empty NCS demonstrated that drugs were molecularly dispersed inside the nanoparticles via week hydrogen bonding. Captopril and valsartan have demonstrated grafting reaction with N-H group of chitosan. Zeta sizer results had confirmed that average size of chitosan nanoparticles was below 100 nm. Encapsulation of captopril had reduced the surface charge value from +52.6±4.8 to +46.5±5.2 mV. Controlled release evaluation of highly encapsulated drug captopril had revealed a slow release in vitro from NCS in physiological buffer. Thus, here reported innovative AHT nano-ceuticals of polymeric origin can improve the oral administration of currently available hydrophobic drugs while providing the extended-release function. PMID:26917399

  1. Antihypertensive and antioxidant effects of dietary black sesame meal in pre-hypertensive humans

    Directory of Open Access Journals (Sweden)

    Teerajetgul Yaovalak

    2011-08-01

    Full Text Available Abstract Background It has been known that hypertension is an independent risk factor for cardiovascular disease (CVD. CVD is the major cause of morbidity and mortality in developed and developing countries. Elevation of blood pressure (BP increases the adverse effect for cardiovascular outcomes. Prevention of increased BP plays a crucial role in a reduction of those outcomes, leading to a decrease in mortality. Therefore, the purpose of this study was to investigate the effects of dietary black sesame meal on BP and oxidative stress in individuals with prehypertension. Methods Twenty-two women and eight men (aged 49.8 ± 6.6 years with prehypertension were randomly divided into two groups, 15 subjects per group. They ingested 2.52 g black sesame meal capsules or placebo capsules each day for 4 weeks. Blood samples were obtained after overnight fasting for measurement of plasma lipid, malondialdehyde (MDA and vitamin E levels. Anthropometry, body composition and BP were measured before and after 4-week administration of black sesame meal or a placebo. Results The results showed that 4-week administration of black sesame meal significantly decreased systolic BP (129.3 ± 6.8 vs. 121.0 ± 9.0 mmHg, P P P R = 0.50, P = 0.05, while the change in DBP was negatively related to the change in vitamin E (R = -0.55, P Conclusions These results suggest the possible antihypertensive effects of black sesame meal on improving antioxidant status and decreasing oxidant stress. These data may imply a beneficial effect of black sesame meal on prevention of CVD.

  2. Effects of aerobic dance training on blood pressure in individuals with uncontrolled hypertension on two antihypertensive drugs: a randomized clinical trial.

    Science.gov (United States)

    Maruf, Fatai Adesina; Akinpelu, Aderonke Omobonike; Salako, Babatunde Lawal; Akinyemi, Joshua Odunayo

    2016-04-01

    There is a dearth of reports on possible additive blood pressure (BP)-reducing effect of aerobic exercise on antihypertensive drug in humans. This study investigated the additive BP-reducing effect of aerobic exercise on BP in individuals with uncontrolled hypertension. In this 12-week double-blind study, 120 new-diagnosed individuals with mild-to-moderate hypertension were randomized to receive coamilozide + 5/10 mg of amlodipine + aerobic dance or coamilozide + 5/10 mg of amlodipine alone. Forty-five and 43 participants in exercise and control groups, respectively, completed the 12-week intervention. Addition of aerobic exercise to antihypertensive drug therapy significantly reduced systolic BP (7.1 mm Hg [95% confidence interval: 5.0, 9.3]; P dance and antihypertensive drugs reduces number of antihypertensive drugs needed to achieve BP control and enhances BP control in individuals with hypertension on two antihypertensive drugs. PMID:26948962

  3. Effects of Hypertension and Anti-Hypertensive Treatment on Amyloid-β (Aβ) Plaque Load and Aβ-Synthesizing and Aβ-Degrading Enzymes in Frontal Cortex.

    Science.gov (United States)

    Ashby, Emma L; Miners, James S; Kehoe, Patrick G; Love, Seth

    2016-01-01

    Epidemiological data associate hypertension with a predisposition to Alzheimer's disease (AD), and a number of postmortem and in vivo studies also demonstrate that hypertension increases amyloid-β (Aβ) pathology. In contrast, anti-hypertensive medications reportedly improve cognition and decrease the risk of AD, while certain classes of anti-hypertensive drugs are associated with decreased AD-related pathology. We investigated the effects of hypertension and anti-hypertensive treatment on Aβ plaque load in postmortem frontal cortex in AD. Aβ load was significantly increased in hypertensive (n = 20) relative to normotensive cases (n = 62) and was also significantly higher in treated (n = 9) than untreated hypertensives (n = 11). We then looked into mechanisms by which hypertension and treatment might increase Aβ load, focusing on Aβ-synthesizing enzymes, β- and γ-secretase, and Aβ-degrading enzymes, angiotensin-converting enzyme (ACE), insulin-degrading enzyme (IDE) and neprilysin. ACE and IDE protein levels were significantly lower in hypertensive (n = 21) than normotensive cases (n = 64), perhaps translating to decreased Aβ catabolism in hypertensives. ACE level was significantly higher in treated (n = 9) than untreated hypertensives (n = 12), possibly reflecting feedback upregulation of the renin-angiotensin system. Prospective studies in larger cohorts stratified according to anti-hypertensive drug class are needed to confirm these initial findings and to elucidate the interactions between hypertension, anti-hypertensive treatments, and Aβ metabolism. PMID:26836178

  4. Hepatic safety of RPV/FTC/TDF single tablet regimen in HIV/HCV-coinfected patients. Preliminary results of the hEPAtic Study

    OpenAIRE

    Karin Neukam; Nuria Espinosa; Dolores Merino; Antonio Rivero-Juárez; Ana Carrero; María José Ríos; Josefa Ruiz-Morales; Ana Gómez-Berrocal; Francisco Téllez; Marta Díaz-Menéndez; Antonio Collado; Inés Pérez-Camacho; Marcial Delgado-Fernández; Francisco Vera-Méndez; Pineda, Juan A.

    2014-01-01

    Introduction: Although hepatotoxicity related to antiretroviral treatment (ART) has become less frequent, hepatotoxic events, such as transaminase elevations (TE), are still a matter of concern. RPV/FTC/TDF (EPA) is a new single tablet regimen which is widely used in real life practice. Clinical trials showed an adequate profile of liver safety in the sub-population of HIV/HCV-coinfected patients receiving rilpivirine. However, the number of individuals included in these analyses is low (1). ...

  5. ENDOTHELIAL-TROPIC AND NEPHROPROTECTIVE EFFECTS OF COMBINED ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    M. E. Statsenko

    2015-09-01

    Full Text Available Aim. To assess the effect of the 24-week antihypertensive therapy with fixed-dose drug combination (lisinopril plus amlodipine on endothelial dysfunction and renal function in patients with arterial hypertension (HT and diabetes mellitus (DM type 2.Material and methods. 30 hypertensive patients with DM type 2 (aged 40-65 years were included into the study. Endothelial function (plasma and vascular components and renal function were studied.Results. Combined antihypertensive therapy significantly improved parameters of endothelial function in patients with HT and DM type 2: production of nitric oxide (NO in blood serum and urine increased by 122.8% and 65.8%, respectively. Along with these secretion of endothelin (ET-1 in serum and urine decreased by 26.1% and by 76.1%, respectively, p<0.05. A statistically significant redistribution of patients by type of microcirculation was established: the share of patients with normal type of microcirculation increased by 73.4%. There was a statistically significant reduction of proteinuria and albuminuria by 58% and 43.6%, respectively. The share of patients with chronic kidney disease with an estimated GFR 30-60 ml/min/1.73 m2 decreased by 16.7%.Conclusions. It has been shown that the prescription of a long-term antihypertensive therapy with dose-fixed combination (lisinopril plus amlodipine is safe and effective for endothelial function improvement, including renal endothelium, with no negative effect on glucose and lipid metabolism in patients with HT and DM type 2.

  6. Aggressive regimens for multidrug-resistant tuberculosis decrease all-cause mortality.

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    Carole D Mitnick

    Full Text Available RATIONALE: A better understanding of the composition of optimal treatment regimens for multidrug-resistant tuberculosis (MDR-TB is essential for expanding universal access to effective treatment and for developing new therapies for MDR-TB. Analysis of observational data may inform the definition of an optimized regimen. OBJECTIVES: This study assessed the impact of an aggressive regimen-one containing at least five likely effective drugs, including a fluoroquinolone and injectable-on treatment outcomes in a large MDR-TB patient cohort. METHODS: This was a retrospective cohort study of patients treated in a national outpatient program in Peru between 1999 and 2002. We examined the association between receiving an aggressive regimen and the rate of death. MEASUREMENTS AND MAIN RESULTS: In total, 669 patients were treated with individualized regimens for laboratory-confirmed MDR-TB. Isolates were resistant to a mean of 5.4 (SD 1.7 drugs. Cure or completion was achieved in 66.1% (442 of patients; death occurred in 20.8% (139. Patients who received an aggressive regimen were less likely to die (crude hazard ratio [HR]: 0.62; 95% CI: 0.44,0.89, compared to those who did not receive such a regimen. This association held in analyses adjusted for comorbidities and indicators of severity (adjusted HR: 0.63; 95% CI: 0.43,0.93. CONCLUSIONS: The aggressive regimen is a robust predictor of MDR-TB treatment outcome. TB policy makers and program directors should consider this standard as they design and implement regimens for patients with drug-resistant disease. Furthermore, the aggressive regimen should be considered the standard background regimen when designing randomized trials of treatment for drug-resistant TB.

  7. Comparative effects of different anesthetic regimens on the oculocardiac reflex

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    MR Safavi

    2007-11-01

    Full Text Available Background: The oculocardiac reflex (OCR, which is most oftenencountered during strabismus surgery in children, may cause bradycardia,arrhythmias, and cardiac arrest following a variety of stimuli arising in ornear the eyeball. The main purpose of this study was to evaluate the effects ofvarious anesthetic regimens on modulation of the cardiovascular response of theOCR during strabismus surgery.Patients and Methods: Three hundred American Society of Anesthesia (ASAphysical status I-II patients, scheduled for elective strabismus surgery undergeneral anesthesia, randomly allocated in a double blind fashion to one of threeanesthetic regimens of group P ( propofol 2 mg/kg, alfentanil 0.02 mg/kg, andatracurium 0.5 mg/kg at induction , group K (ketamine racemate 2mg/kg,alfentanil 0.02 mg/kg, and atracurium 0.5 mg/kg at induction and group T(thiopental 5mg/kg, alfentanil 0.02 mg/kg, and atracurium 0.5 mg/kg atinduction. Mean arterial pressure (MAP and heart rate (HR were recorded justbefore and at 1, 15, 30, 45, and 60 min after induction. OCR was defined as a 20beats/min change in HR induced by traction compared with basal value.Results: Mean heart rate (± SD during the course of surgery in group Pwas significantly slower than in the K group (111.90 ± 1.10 vs. 116.7 ± 0.70respectively, P<0.05 .Mean HR changes (± SD in group K was significantlyhigher than in P group (11.2 ± 1.44 vs. 8.7 ± 1.50 respectively, P<0.05. Meanarterial pressure changes (± SD were significantly lower in group P than ingroup K or T patients (12.5 ± 1.13 vs. 19.3±0.80 or 18.9±0.91 respectively,P<0.05. Frequency of OCR was significantly lower in group K than group T or Ppatients (9% vs. 16% or 13% respectively, P<0.05.Conclusion: Induction of anesthesia with ketamine is associated withleast cardiovascular changes induced by OCR during strabismus surgery.

  8. INFLUENCE OF THE COMBINED ANTIHYPERTENSIVE THERAPY ON METABOLIC PROFILE AND CEREBRAL BLOOD FLOW IN PATIENTS WITH METABOLIC SYNDROME

    OpenAIRE

    E. M. Idrisova; T. P. Kalashnikova; I. Yu. Efimova

    2016-01-01

    Aim. To study influence of the combined antihypertensive therapy on blood pressure (BP), glucose and lipid metabolism as well as cerebral blood flow in patients with metabolic syndrome (МS)Material and methods. 60 patients with MS aged of 35-65 y.o. were included in the study. 29 patients of the 1st group received verapamil SR (240 mg once daily) and indapamide retard (1,5 mg once daily). 31 patients of the 2nd group received verapamil SR (240 mg once daily) and enalapril (12,2±5,9 mg BID). A...

  9. STRike - characteristics of HIV-1-infected patients treated with a single-tablet regimen in daily clinical practice

    Directory of Open Access Journals (Sweden)

    S Esser

    2012-11-01

    Full Text Available The life-long antiretroviral treatment of HIV-1 infection requires effective and well tolerated medications complemented by high rates of adherence in order to achieve viral suppression, immunologic reconstitution and to prevent the development of resistance. Single-tablet regimens (STRs, combining a full antiretroviral regimen in one tablet taken once daily, have been designed to achieve high adherence and better long-term outcomes. “STRike” is the first cohort study, describing the use of various STRs in routine clinical practice in Germany. In this observational cohort study 800 participants will be included in 4 treatment arms, treated with the STRs of TDF/FTC/EFV (a retrospective and prospective arm, TDF/FTC/RPV or TDF/FTC/COBI/EVG after regulatory approval. Patients are followed for at least two years, and reasons for choice of medications and treatment satisfaction will be collected, in addition to safety, demographic, effectiveness data. To date 344 patients on TDF/FTC/EFV and 123 patients on TDF/FTC/RPV are being followed. In general, the spectrum of patients in the study reflects the German HIV-1 infected population with regards to gender (88%/89% male, age (median 40/38 years of age and mode of infection (71%/63% MSM. However, patients starting TDF/FTC/RPV are less progressed in their disease according to their CDC stage compared with patients on TDF/FTC/EFV (74.5% stage “A” vs. 53.2%. Patients starting TDF/FTC/RPV show less comorbidities (54% vs. 82% with a spectrum different from patients on TDF/FTC/EFV. Pre-existing neuropsychiatric comorbidities are relatively more common (10% more among patients starting TDF/FTC/RPV than TDF/FTC/EFV. The decision to use an STR is mostly driven by patient preference to start with a more convenient ART regimen (56% or to simplify their current ART regimen (75%. STRs aim to make treatment of HIV more convenient, more efficacious and more durable and by that allowing for earlier initiation of

  10. Shifting trends in the pharmacologic treatment of hypertension in a Nigerian tertiary hospital: a real-world evaluation of the efficacy, safety, rationality and pharmaco-economics of old and newer antihypertensive drugs.

    Science.gov (United States)

    Adigun, A Q; Ishola, D A; Akintomide, A O; Ajayi, A A L

    2003-04-01

    The current prescription patterns for essential hypertension and the efficacy, safety, tolerability and cost-effectiveness of the newer antihypertensive drugs were evaluated in Nigerian patients. The findings were compared with that of a previous study conducted in the same tertiary hospital 10 years earlier. A cross-sectional evaluation of blood pressure (BP) control in a hypertension clinic was undertaken among 150 Nigerian patients aged 61 +/- 12 years (55% females), with a duration of treatment on a particular drug class or combination of 9 +/- 3 months. The initial blood pressure was 176 +/- 20/108 +/- 11 mmHg and 22% of the patient had concurrent diabetes mellitus. Thiazide diuretics (D) alone or in combination remained the most commonly prescribed drugs in 56% of all patients. There were significant increases in the prescriptions of calcium channel blockers (CCBs) (51%), P essential hypertension, was significantly reduced (P economic comparison of the drug classes revealed that for every US dollar (dollar) spent per month, the percentage of treated patients attaining normotension was 18.6 for D, 4.73 for CCB, 3.5 for ACEI + D and 13.6 for methyldopa + thiazides. A combination of ACEI + CCB or D was the preferred treatment for hypertensive-diabetic Nigerians, but only 24% attained a BP < 130/85 mmHg. These results demonstrate a shift in trend to a more rational and efficacious treatment of hypertension over a 10 year period. This may be associated, at least in part, with the intensive and continuous education of the prescribers in rational drug use and the introduction of a hospital formulary. Methyldopa is still a highly efficacious and cost-effective drug in this population. Black HT-DM Africans still constitute a subgroup who not only require more and costlier antihypertensive drugs, but whose BP control is suboptimal, and exhibit a poor therapeutic response to other risk factors (pulse pressure) that constitute a continuing risk for cardiovascular

  11. NEW DRUG REGIMENS FOR OLD DISEASE TUBERCULOSIS: A REVIEW

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    Gupta Sandeep

    2011-02-01

    Full Text Available Today ‘Tuberculosis (TB is acknowledged as a global health threat. As resistant strains of Mycobacterium tuberculosis have emerged slowly and due to lack and treatment failure many countries have to adapt long term and costly treatment for the patients. Due to TB 1.8 million people die every year and 5000 every day. By this data we can analyze that there is an urgent need to improve its treatment by enhancing the activity of existing agents and introducing new agents. The new regimens should have better drug tolerability profile and longer duration of action and great patient acceptability. The new agents should be more effective against MDR/XDR TB and in HIV co infected patients and active against latent TB. This review presents the drug currently used and also the advanced drug undergoing clinical trials for the treatment of tuberculosis. A short description on their mechanism of action and inhibitors acting on related biochemical targets is also provided. The focus of this review is to consider the challenges in the development of new anti TB drugs and provide an up- to-date evaluation of current therapy status and progress of the developing new agents in the phase of clinical testing as one of the strategies for the improvement of TB treatment.

  12. Pharmacoeconomic consequences of variable patient compliance with prescribed drug regimens.

    Science.gov (United States)

    Urquhart, J

    1999-03-01

    Variable compliance with prescribed drug regimens is a leading source of variability in drug response. Specifics differ by drug and disease. The role of variable compliance was clearly defined in 2 trials of lipid-lowering agents, cholestyramine and gemfibrozil, in which exceptionally careful measurements of compliance were made, which has not been done in later trials. Economic consequences of variable compliance are estimated by converting dose-dependent changes in absolute risk of incident coronary disease into the unicohort format, which designates how many patients must be treated to prevent, in a given time, a defined 'coronary event'. Two strong influences on the costs of treatment are: (i) the shape of the relation between drug intake and risk reduction; and (ii) the strength of the linkage between intake and prescription refills. The intake-effect relation for cholestyramine is linear, making compliance-neutral the cost to prevent 1 coronary event, provided that refills match intake. If refills exceed intake, treatment costs rise. The intake-effect relation for gemfibrozil is more typically nonlinear, so poorer compliers purchase and take the drug in amounts that have little benefit, increasing the cost to prevent 1 coronary event. If refills run at a higher rate than intake, costs increase still further. A key question for future study is: do policies that encourage timely refills increase compliance enough to offset their potential to waste money in the purchasing of an untaken drug? PMID:10537430

  13. Oxygen regimen in the human peripheral tissue during space flights.

    Science.gov (United States)

    Haase, H; Kovalenko, E A; Vacek, A; Bobrovnickij, M P; Jarsumbeck, B; Semencov, V N; Sarol, Z; Hideg, J; Zlatarev, K

    1986-05-01

    A survey of the results of the experiment "Oxygen," carried out within the scope of the INTER-KOSMOS program in members of the permanent crews and of international visiting expeditions to the Soviet orbital station Salyut-6, is given. During the 7-day space flights of the international visiting expeditions a significant decrease in pO2ic by 3.28 kPa was observed. Local oxygen utilization reduced significantly by 0.44 kPa. During hyperventilation testing after return to earth a statistically significant decrease in the peak value by 1.39 kPa was noted. In the long-term crews of the orbital station Salyut-6 the highest decrease in pO2ic of 3.8 kPa and the absolutely lowest value of 3.4 -/+ 0.5 kPa during space flight were observed. The decrease in local oxygen utilization during the flight of 0.8 kPa/min was greater than that of the visiting crews. The results indicate the importance of investigating the dynamics of the oxygen regimen for medical control of the crew members both during the space flight and during the readaptation phase after return to earth. PMID:11542832

  14. Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines

    Science.gov (United States)

    HIV Treatment Following an HIV Regimen: Steps to Take Before and After Starting HIV Medicines (Last updated 3/1/2016; last reviewed 3/1/2016) ... maintain long-term medication adherence. Before starting an HIV regimen, talk to your health care provider about ...

  15. Isoniazid or Moxifloxacin in Rifapentine-based Regimens for Experimental Tuberculosis?

    OpenAIRE

    Rosenthal, Ian M; Zhang, Ming; Almeida, Deepak; Jacques H Grosset; Eric L Nuermberger

    2008-01-01

    Rationale: Recent studies have demonstrated that combined substitutions of rifapentine for rifampin and moxifloxacin for isoniazid in the standard, daily, short-course regimen of rifampin, isoniazid, and pyrazinamide produces stable cure in 12 weeks or less. This study was designed to more precisely evaluate the contribution of moxifloxacin and isoniazid to rifapentine-based regimens.

  16. Dietary regimens of athletes competing at the Delhi 2010 Commonwealth Games.

    Science.gov (United States)

    Pelly, Fiona E; Burkhart, Sarah J

    2014-02-01

    The aim of this study was to investigate the dietary regimens reported by athletes competing at a major international competition and report whether these were based on nutrient composition, religious beliefs, cultural eating style, food intolerance or avoidance of certain ingredients. A questionnaire was randomly distributed to 351 athletes in the main dining hall of the athletes' village over the three main meal periods during the Delhi 2010 Commonwealth Games (23rd Sept-14th Oct, 2010). The majority (n = 218, 62%) of athletes reported following one or more dietary regimens, with 50% (n = 174) following a diet based on the nutrient composition of the food. Significantly more athletes from weight category and aesthetic sports (28%, p = .005) and from power/sprint sports (41%, p = .004) followed low fat and high protein regimens respectively. Other specialized dietary regimens were followed by 33% of participants, with avoidance of red meat (13%), vegetarian (7%), Halal (6%), and low lactose regimens (5%) reported most frequently. Significantly more athletes from non-Western regions followed a vegetarian diet (p eating was the most commonly reported cultural regimen (72% of total with 23% from non-Western regions). Those following a Western diet were significantly more likely to report following a regimen based on nutrient composition (p = .02). As a high proportion of athletes from differing countries and sports follow specialized dietary regimens, caterers and organizers should ensure that adequate nutrition support and food items are available at similar events. PMID:23918635

  17. Efficacy of adjusted BACOD regimen on the treatment of relapsed refractory diffuse large B cell lymphoma

    Institute of Scientific and Technical Information of China (English)

    龚格格

    2014-01-01

    Objective To compare the efficacy and adverse events of adjusted BACOD(bleomycin,doxorubicin,cyclophosphamide,vincristine,dexamethasone)regimen(continuous intravenous infusion)and conventional BACOD regimen(conventional intravenous drip)in the treatment of relapsed and refractory diffuse large B cell lymphoma(DLBCL).Methods Retrospective analysis of63 cases of relapsed or refractory DLBCL patients was performed,32 patients received conventional BACOD

  18. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled

    DEFF Research Database (Denmark)

    Dahlöf, Björn; Sever, Peter S; Poulter, Neil R;

    2005-01-01

    The apparent shortfall in prevention of coronary heart disease (CHD) noted in early hypertension trials has been attributed to disadvantages of the diuretics and beta blockers used. For a given reduction in blood pressure, some suggested that newer agents would confer advantages over diuretics an...... and beta blockers. Our aim, therefore, was to compare the effect on non-fatal myocardial infarction and fatal CHD of combinations of atenolol with a thiazide versus amlodipine with perindopril....

  19. Open-label observational study to assess the efficacy and safety of aprepitant for chemotherapy-induced nausea and vomiting prophylaxis in Indian patients receiving chemotherapy with highly emetogenic chemotherapy/moderately emetogenic chemotherapy regimens

    Directory of Open Access Journals (Sweden)

    Hingmire Sachin

    2015-01-01

    Full Text Available Context: Currently, there is limited data on the prevention of chemotherapy-induced nausea and vomiting (CINV in Indian population with aprepitant containing regimens. Aims: The aim was to assess the Efficacy and Safety of Aprepitant for the prevention of nausea and vomiting associated with highly emetogenic chemotherapy/moderately emetogenic chemotherapy (HEC/MEC regimens. Settings and Design: Investigator initiated, multicentric, open-label, prospective, noncomparative, observational trial. Subjects and Methods: Triple drug regimen with aprepitant, palonosetron, and dexamethasaone administration was assessed for the prevention of CINV during acute, delayed, and the overall phase (OP for HEC/MEC Regimens. The primary endpoint was complete response (CR; no emesis and no use of rescue medication and the key secondary endpoint was the complete control (CC; no emesis, no rescue medication and no more than mild nausea during the OP. Statistical Analysis Used: Perprotocol efficacy was analyzed for the first cycle with results represented in terms of CR/CC rates using descriptive statistics. Results: Seventy-five patients were included in the study with median age of 49.7 years and 89.7% being females. The CR rate (OP for patients administered HEC or MEC regimens during the first cycle were 92% and 90.9%, respectively. Similarly, the CC rates (OP were 75% and 90% for these regimens, respectively. 7 (9.2% patients reported adverse drug reactions that were mild and transient with no reports of any serious adverse events. Conclusions: Use of aprepitant containing regimen for patients receiving HEC/MEC regimen resulted in significantly high CR and CC response rates, which further consolidate its potential role to improve patient quality of life and compliance to disease management.

  20. Effect of regimen complexity on patient satisfaction and compliance with warfarin therapy.

    Science.gov (United States)

    Hixson-Wallace, J A; Dotson, J B; Blakey, S A

    2001-01-01

    This study sought to determine patient satisfaction with anticoagulation care in a pharmacist-managed clinic and assess the effect of warfarin regimen complexity on patient satisfaction, compliance, and international normalized ratios (INRs). Retrospective chart reviews of 476 anticoagulation clinic patients were conducted. Patients were divided into groups by complexity of warfarin regimen (whole tablet, split tablet, alternating dose) for comparisons of compliance and INRs. An oral Likert scale satisfaction survey was administered to a convenience sample of 100 patients. Degree of satisfaction was compared based on warfarin regimen. Compliant patients were more likely to have therapeutic INRs (p pharmacist-managed clinic. There was a significantly (p < 0.025) higher score for patients on split tablet regimens, indicating a greater likelihood for agreement that alternating doses made taking their medication more difficult. A relationship exists between patient compliance and prescribed dosage regimen, as well as with therapeutic INR values. PMID:11190902

  1. Anti-Resorptive Activity of Anti-Hypertensive Agent ACEi in Older Men

    Science.gov (United States)

    Rianon, Nahid; Edwards, BeJier; Nhonthachit, Phetsamong; Messick, Amanda; Gagel, Robert; Smith, Scott M.

    2016-01-01

    Hypertension (HTN) is associated with bone loss due to activation of the renin- angiotensin system (RAS) which in turn affects bone turnover. Animal studies have shown decreased bone resorption (up to 19%) and increased bone mass (up to 2%) following treatment with RAStargeted antihypertensive medications (e.g., angiotensin converting enzyme inhibitors, ACEi). Cross-sectional human studies have documented greater femoral neck BMD in older hypertensive men and women treated with ACEi compared to those not-treated with ACEi (nor other RAS-targeted medications). These findings raise the potential for ACEi use in preventing, or at a minimum slowing bone loss due to age or even microgravity. Based on this, we conducted a cohort study to investigate if ACEi treatment would decrease bone resorption in humans. We investigated changes in serum CTX and P1NP in 10 hypertensive men (45 years or older) treated with (N=5) without (N=5) exposure to ACEi for 3-months. Lisinopril was the ACEi used, and dose was adjusted as deemed appropriate by the attending physicians. Participants did not have any known skeletal health problem and were not exposed to any bisphosphonates or hydrochlorothiazides. A small sample size prevented detailed statistical analysis and hence, we present a preliminary descriptive report of our findings. Participants' age was 57+/-7 years (mean +/-SD), baseline body mass index was 27+/-5 kg/sq m, serum concentration of 25-hydroxyvitamin D was 66+/-17 nmol/L and parathyroid hormone was 30+/-13 pg/ml. After Lisinopril treatment, men demonstrated a 10% decrease in the bone resorption marker C-terminal telopeptide (CTX) and 5% decrease in formation marker procollagen type 1 amino-terminal pro-peptide (P1NP). On the contrary, serum CTX increased 41% and P1NP increased 10% in those who were not treated with ACEi. This is the first human study to report reduction in bone resorptive activity following ACEi treatment for hypertension in older men. Our results indicates

  2. Antihypertensive therapy: nocturnal dippers and nondippers. Do we treat them differently?

    Directory of Open Access Journals (Sweden)

    Mahabala C

    2013-03-01

    Full Text Available Chakrapani Mahabala,1 Padmanabha Kamath,2 Unnikrishnan Bhaskaran,3 Narasimha D Pai,2 Aparna U Pai41Department of Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka State, India; 2Department of Cardiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka State, India; 3Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka State, India; 4Department of Radiodiagnosis, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal State, IndiaAbstract: Hypertension is a major independent risk factor for cardiovascular diseases. Management of hypertension is generally based on office blood pressure since it is easy to determine. Since casual blood pressure readings in the office are influenced by various factors, they do not represent basal blood pressure. Dipping of the blood pressure in the night is a normal physiological change that can be blunted by cardiovascular risk factors and the severity of hypertension. Nondipping pattern is associated with disease severity, left ventricular hypertrophy, increased proteinuria, secondary forms of hypertension, increased insulin resistance, and increased fibrinogen level. Long-term observational studies have documented increased cardiovascular events in patients with nondipping patterns. Nocturnal dipping can be improved by administering the antihypertensive medications in the night. Long-term clinical trials have shown that cardiovascular events can be reduced by achieving better dipping patterns by administering medications during the night. Identifying the dipping pattern is useful for decisions to investigate for secondary causes, initiating treatment, necessity of chronotherapy, withdrawal or reduction of unnecessary medications, and monitoring after treatment initiation. Use of this concept at the primary care level has been limited because 24-hour ambulatory blood pressure monitoring has been the only method

  3. INFLUENCE OF ANTIHYPERTENSIVE THERAPY ON PSYCHOLOGICAL STATUS OF CHERNOBYL NUCLEAR POWER PLANT ACCIDENT CONSEQUENCES LIQUIDATORS

    Directory of Open Access Journals (Sweden)

    E. M. Manoshkina

    2016-01-01

    Full Text Available Aim. To study psychological status and influence of antihypertensive therapy (AHT on it in Chernobyl nuclear power plant (NPP accident consequences liquidators, who suffer arterial hyper-tension (AH, with controlled treatment compared to the standard treatment in out-patient clinic. Material and methods. 81 liquidators with AH (all men were included into open compara-tive randomized study. Study duration was 12 months. Patients were randomized into main group (MG and control group (CG. Patients of MG received strictly regulated stepped AHT based on ACE inhibitor spirapril 6 mg daily (Quadropril®, Pliva-AVD, hypothiazide was added if necessary (12.5-25 mg daily and afterwards – atenolol (12.5-100 mg daily. In CG AHT and its correction was set by physician in polyclinic. Brief multifactor questionnaire for personality analysis was used to study psychological status. Results. 57 patients completed the study, 28 in MG and 29 in CG. In MG target blood pres-sure (BP levels were reached in 22 (78.6% patients, in CG – in 11 (38% patients (p<0.01. The main feature of psychological status of liquidators with AH was hypochondriac, depressive and anxious disorders. Controlled AHT made it possible to reach improvement in psychological status, i.e. growth of optimism and activity of patients, more often, than standard treatment in out-patient clinics. Increase in number of patients with pronounced anxious changes was observed in CG. Effi-ciency of AHT in liquidators with AH is connected with severity of depressive disturbances: in subgroups with inefficient treatment patients had the highest level of depression. In liquidators with AH, possessing neurotic disturbances, spirapril was efficient both as monotherapy, and in combina-tion with diuretic hydrochlorothiazide and beta-blocker atenolol. Conclusion. Controlled AHT in liquidators with AH has advantages over standard treatment in out-patient clinic and results in more frequent target BP level

  4. EFFICACY OF COMBINED ANTIHYPERTENSIVE THERAPY IN ACHIEVEMENT OF TARGET BLOOD PRESSURE IN DIABETIC PATIENTS

    Directory of Open Access Journals (Sweden)

    O. A. Koshel'skaya

    2015-12-01

    Full Text Available Aim. To evaluate the efficacy of long-term combined antihypertensive therapy (AHT based on renin-angiotensin-aldosterone system (RAAS blockers, indapamide and calcium channel blocker (CCB in hypertensive patients with diabetes mellitus (DM in accordance with target blood pressure (BP <130/80 mm Hg achievement rate, dynamics of 24-hour BP profile, metabolic indices, and local stiffness of the main arteries. Besides, to study the effects of the CCB addition to dual therapy on these parameters. Material and methods. Patients (16 men, 31 women, 57.2±6.6 years old with arterial hypertension degrees 1–3 and mild to moderate DM type 2 were included into the study. The patients were treated with perindopril (5–10 mg/day or valsartan (80–160 mg/day in combination with indapamide SR (1.5 mg/day and amlodipine (5–10 mg/day. Examination included office BP measurement and ambulatory BP monitoring (ABPM, common carotid arteries sonarography , evaluation of serum levels of potassium, creatinine, uric acid, glucose metabolism and lipid profile parameters, calculation of insulin resistance index (HOMA at baseline and after 30–32 weeks of treatment. Results. Target BP was achieved in 86.7% of patients. Evenly reduction of day and night BP without reflex tachycardia and hypotension episodes was observed. Office BP decreased from 149.5±12.0/90.0±8.3 to 125.0±7.6/76.8±4.9 mm Hg (p<0.05 and average daily BP (ABPM decreased to 120.1±10.0/71.7±6.9 mmHg. Three drugs were needed to achieve target BP in baseline systolic BP >150 mm Hg (office or >134 mmHg (ABPM. Marked beneficial effect on the morphological and functional characteristics of the vascular wall and its elastic properties, improvement of glycemic control, tissue insulin sensitivity and lipids profile were found. These effects were associated mainly with amlodipine inclusion into the therapy. Conclusion. The combined AHT based on RAAS blockers, indapamide SR and CCB provides achievement of

  5. EFFICACY OF COMBINED ANTIHYPERTENSIVE THERAPY IN ACHIEVEMENT OF TARGET BLOOD PRESSURE IN DIABETIC PATIENTS

    Directory of Open Access Journals (Sweden)

    O. A. Koshel'skaya

    2012-01-01

    Full Text Available Aim. To evaluate the efficacy of long-term combined antihypertensive therapy (AHT based on renin-angiotensin-aldosterone system (RAAS blockers, indapamide and calcium channel blocker (CCB in hypertensive patients with diabetes mellitus (DM in accordance with target blood pressure (BP <130/80 mm Hg achievement rate, dynamics of 24-hour BP profile, metabolic indices, and local stiffness of the main arteries. Besides, to study the effects of the CCB addition to dual therapy on these parameters. Material and methods. Patients (16 men, 31 women, 57.2±6.6 years old with arterial hypertension degrees 1–3 and mild to moderate DM type 2 were included into the study. The patients were treated with perindopril (5–10 mg/day or valsartan (80–160 mg/day in combination with indapamide SR (1.5 mg/day and amlodipine (5–10 mg/day. Examination included office BP measurement and ambulatory BP monitoring (ABPM, common carotid arteries sonarography , evaluation of serum levels of potassium, creatinine, uric acid, glucose metabolism and lipid profile parameters, calculation of insulin resistance index (HOMA at baseline and after 30–32 weeks of treatment. Results. Target BP was achieved in 86.7% of patients. Evenly reduction of day and night BP without reflex tachycardia and hypotension episodes was observed. Office BP decreased from 149.5±12.0/90.0±8.3 to 125.0±7.6/76.8±4.9 mm Hg (p<0.05 and average daily BP (ABPM decreased to 120.1±10.0/71.7±6.9 mmHg. Three drugs were needed to achieve target BP in baseline systolic BP >150 mm Hg (office or >134 mmHg (ABPM. Marked beneficial effect on the morphological and functional characteristics of the vascular wall and its elastic properties, improvement of glycemic control, tissue insulin sensitivity and lipids profile were found. These effects were associated mainly with amlodipine inclusion into the therapy. Conclusion. The combined AHT based on RAAS blockers, indapamide SR and CCB provides achievement of

  6. Extent of use of immediate-release formulations of calcium channel blockers as antihypertensive monotherapy by primary care physicians: multicentric study from Bahrain.

    Directory of Open Access Journals (Sweden)

    Sequeira R

    2002-07-01

    Full Text Available BACKGROUND: The issue of cardiovascular safety of calcium channel blockers (CCBs has been widely debated in view of reflex increase in sympathetic activity induced by immediate release (IR / short acting formulations. It is generally agreed that such CCBs should not be used alone in the management of hypertension. AIMS: We have determined the extent to which primary care physicians prescribe CCBs as monotherapy, especially the immediate release formulations, in the management of uncomplicated hypertension and diabetic hypertension - with an emphasis upon the age of the patients. SETTING, DESIGN AND METHODS: A retrospective prescription-based study was carried out in seven out of 18 Health Centres in Bahrain. The study involved a registered population of 229,300 representing 46% of registered individuals, and 35 physicians representing 43% of all primary care physicians. The data was collected between November 1998 and January 1999 using chronic dispensing cards. RESULTS: In all categories CCBs were the third commonly prescribed antihypertensive as monotherapy, with a prescription rate of 11.1% in uncomplicated hypertension, 18% in diabetic hypertension and 20.1% in elderly patients above 65 years of age. Nifedipine formulations were the most extensively prescribed CCBs. Almost half of the CCB-treated patients were on IR-nifedipine, whereas IR-diltiazem and IR-verapamil, and amlodipine were infrequently prescribed. CONCLUSION: Prescription of IR-formulations of CCBs as monotherapy by primary care physicians does not conform with recommended guidelines. In view of concerns about the safety of such practice, measures to change the prescribing pattern are required.

  7. Effect of weaning status and implant regimen on growth, performance, and carcass characteristics of steers.

    Science.gov (United States)

    Schoonmaker, J P; Fluharty, F L; Loerch, S C; Turner, T B; Moeller, S J; Wulf, D M

    2001-05-01

    One hundred forty-three Angus x Simmental crossbred steers (initial BW = 155.1 +/- 4.5 kg) were used in a 2-yr study (yr 1, n = 67; yr 2, n = 76) to determine the effects of weaning age, implant regimen, and the weaning age x implant regimen interaction on steer growth and performance, organ mass, carcass characteristics, and cooked beef palatability. Steers were early-weaned at an average age of 108 d (EW) or normally weaned at an average age of 202 d (NW) and allotted by weight to an aggressive or nonaggressive implant regimen. On their respective weaning dates, EW and NW steers were penned individually and fed a grain-based diet until they were slaughtered at a final BW of 546 kg. A subsample of steers (n = 2 per treatment) were slaughtered at 254 kg. At 254 kg, EW steers implanted with the aggressive implant regimen had 64% greater backfat depth than those implanted with the nonaggressive implant regimen; conversely, NW steers implanted with the aggressive implant regimen had 52% lower backfat depth than those implanted with the nonaggressive implant regimen (weaning status x implant regimen interaction; P 0.37) or feed efficiency (P > 0.15). Weaning status did not affect carcass characteristics (P > 0.14), final empty body composition (P > 0.25), or final longissimus muscle composition (P > 0.18); however, steaks from EW steers had higher (P 0.86) compared to the nonaggressive implant regimen. Placing early-weaned steers on an aggressive implant regimen is a viable management option. PMID:11374527

  8. An intraoperative irrigation regimen to reduce the surgical site infection rate following adolescent idiopathic scoliosis surgery.

    Science.gov (United States)

    Herwijnen, B van; Evans, N R; Dare, C J; Davies, E M

    2016-05-01

    Introduction The aim of this study was to compare the efficacy of a gentamicin antibiotic intraoperative irrigation regimen (regimen A) with a povidone-iodine intraoperative irrigation regimen (regimen B) and to evaluate the ability of adjunctive local vancomycin powder (regimen C) to reduce the surgical site infection (SSI) rate following idiopathic scoliosis correction. Methods This was a retrospective, single centre, two-surgeon cohort study of paediatric scoliosis procedures involving 118 patients under the age of 18 years who underwent correction for idiopathic scoliosis over a period of 42 months. Patients' baseline characteristics, pseudarthrosis and rates of SSI were compared. Results Baseline characteristics were comparable in all three groups, with the exception of sex distribution. Over a quarter (27%) of patients with regimen B were male compared with 13% and 6% for regimens A and C respectively. Patients were mostly followed up for a minimum of 12 months. The SSI rate for both superficial and deep infections was higher with regimen A (26.7%) than with regimens B and C (7.0% and 6.3% respectively). The SSI rates for regimens B and C were comparable. No patients developed complications related to vancomycin toxicity, metalwork failure or pseudarthrosis. Conclusions Wound irrigation with a povidone-iodine solution reduces SSIs following adolescent idiopathic scoliosis surgery. The direct application of vancomycin powder to the wound is safe but does not reduce the SSI rate further in low risk patients. Additional studies are needed to elucidate whether it is effective at higher doses and in high risk patient groups. PMID:27087324

  9. Lipophilic and hydrophilic esters of 4-acetyl-2-(2-hydroxyethyl)-5,6-bis(4-chlorophenyl)-2H-pyridazin-3-one as antihypertensive agents.

    Science.gov (United States)

    Fogt, S W; Scozzie, J A; Heilman, R D; Powers, L J

    1980-12-01

    In an attempt to enhance the antihypertensive activity of 4-acetyl-2-(2-hydroxyethyl)-5,6-bis(4-chlorophenyl)-2H-pyridazin-3-one, 1, a series of lipophilic and hydrophilic esters was synthesized. These derivatives possessed increased lipid and aqueous solubility, respectively. The esters, in general, cause a larger blood-pressure drop than 1 when tested at high doses in the spontaneously hypertensive rat (SHR) model. At lower doses the antihypertensive activity is the same as with 1. PMID:7452699

  10. The right choice of antihypertensives protects primary human hepatocytes from ethanol- and recombinant human TGF-β1-induced cellular damage

    Directory of Open Access Journals (Sweden)

    Ehnert S

    2013-03-01

    Full Text Available Sabrina Ehnert,1 Teresa Lukoschek,2 Anastasia Bachmann,2 Juan J Martínez Sánchez,1 Georg Damm,3 Natascha C Nussler,4 Stefan Pscherer,5 Ulrich Stöckle,1 Steven Dooley,2 Sebastian Mueller,6 Andreas K Nussler11Eberhard Karls Universität Tübingen, BG Trauma Center, Tübingen, Germany; 2Mol Hepatology - Alcohol Associated Diseases, Department of Medicine II, Medical Faculty, Mannheim, Germany; 3Department of General, Visceral, and Transplantation Surgery, Charité University Medicine, Berlin, Germany; 4Clinic for General, Visceral, Endocrine Surgery and Coloproctology, Clinic Neuperlach, Städtisches Klinikum München GmbH, Munich, Germany; 5Department of Diabetology, Klinikum Traunstein, Kliniken Südostbayern AG, Traunstein, Germany; 6Department of Medicine, Salem Medical Center, Ruprecht-Karls-Universität, Heidelberg, GermanyBackground: Patients with alcoholic liver disease (ALD often suffer from high blood pressure and rely on antihypertensive treatment. Certain antihypertensives may influence progression of chronic liver disease. Therefore, the aim of this study is to investigate the impact of the commonly used antihypertensives amlodipine, captopril, furosemide, metoprolol, propranolol, and spironolactone on alcohol-induced damage toward human hepatocytes (hHeps.Methods: hHeps were isolated by collagenase perfusion. Reactive oxygen species (ROS were measured by fluorescence-based assays. Cellular damage was determined by lactate-dehydrogenase (LDH-leakage. Expression analysis was performed by reverse-transcription polymerase chain reaction and Western blot. Transforming growth factor (TGF-β signaling was investigated by a Smad3/4-responsive luciferase-reporter assay.Results: Ethanol and TGF-β1 rapidly increased ROS in hHeps, causing a release of 40%–60% of total LDH after 72 hours. All antihypertensives dose dependently reduced ethanol-mediated oxidative stress and cellular damage. Similar results were observed for TGF-β1-dependent

  11. Long-term effects of antihypertensive medications on bone mineral density in men older than 55 years

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    Ağaçayak KS

    2014-03-01

    Full Text Available Kamil Serkan Ağaçayak,1 Sedat Güven,2 Mahmut Koparal,1 Nedim Güneş,1 Yusuf Atalay,3 Serhat Atilgan11Department of Oral and Maxillofacial Surgery, 2Department of Prosthodontics, School of Dentistry, University of Dicle, Diyarbakir, Turkey; 3Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Afyon Kocatepe, Afyon, TurkeyIntroduction: In this study, we investigated the effects of long-term antihypertensive treatment with calcium channel blockers or beta blockers on the bone mineral density of maxilla, as determined by cone-beam computed tomography (CBCT.Material and methods: This retrospective study was conducted on CBCT images of men older than 55 years who had received different dental indications. Data were grouped into three categories according to the antihypertensive medication history of the patients: group A included patients who had been taking beta-blocker treatment for more than 5 years, group B included patients who had been taking calcium channel blocker treatment for more than 5 years, and the control group included patients who had never used any hypertensive medications before.Results: Statistically significant differences were observed between the beta blocker and calcium channel blocker groups.Conclusion: In hypertension treatment, beta blockers may be preferred to calcium channel blockers in patients at high risk for osteoporosis and bone resorption.Keywords: bone mineral density, CBCT, beta blockers, calcium channel blockers

  12. EFFECT OF ANTIHYPERTENSIVE THERAPY BASED ON NEW METHOD OF INDIVIDUAL CHOICE OF DRUGS ON LEFT VENTRICULAR HYPERTROPHY IN ELDERLY PATIENTS

    Directory of Open Access Journals (Sweden)

    K. I. Pshenichkin

    2015-12-01

    Full Text Available Aim. To study the effects of antihypertensive therapy based on consideration of individual heart rhythm variability (HRV on left ventricular hypertrophy (LVH in hypertensive elderly patients.Material and methods. 60 hypertensive elderly patients with LVH were included in the study. They were split in two groups (30 people in each one. Patients of the group-I had common antihypertensive therapy. Patients of group-II received medications prescribed with consideration of individual heart rate variability. Holter monitoring with analysis of HRV, 24-hour blood pressure monitoring and ultrasonography were conducted initially and 18 months after treatment beginning.Results. BP control was reached in the majority of patients of both groups. The patients of group-II in comparison with patients of group-I had reduction of low- high frequency power ratio (LF/HF and higher rate of LVH reduction. Relationship between LVH dynamics and ratio LF/HF was found.Conclusion. Arterial hypertension therapy considering individual HRV contributes in LVH reduction in elderly patients.

  13. Vasorelaxant activity of extracts obtained from Apium graveolens:Possible source for vasorelaxant molecules isolation with potential antihypertensive effect

    Institute of Scientific and Technical Information of China (English)

    Vergara-Galicia Jorge; Jimenez-Ramirez Luis ngel; Tun-Suarez Adrin; Aguirre-Crespo Francisco; Salazar-Gmez Anuar; Estrada-Soto Samuel; Sierra-Ovando ngel; Hernandez-Nuez Emmanuel

    2013-01-01

    Objective:To investigate the vasorelaxant effect of organic extracts from Apium graveolens (A. graveolens) which is a part of a group of plants subjected to pharmacological and phytochemical study with the purpose of offering it as an ideal source for obtaining lead compounds for designing new therapeutic agents with potential vasorelaxant and antihypertensive effects. Methods:An ex vivo method was employed to assess the vasorelaxant activity. This consisted of using rat aortic rings with and without endothelium precontracted with norepinephrine. Results:All extracts caused concentration-dependent relaxation in precontracted aortic rings with and without endothelium;the most active extracts were Dichloromethane and Ethyl Acetate extracts from A. graveolens. These results suggested that secondary metabolites responsible for the vasorelaxant activity belong to a group of compounds of medium polarity. Also, our evidence showed that effect induced by dichloromethane and ethyl acetate extracts from A. graveolens is mediated probably by calcium antagonism. Conclusions: A. graveolens represents an ideal source for obtaining lead compounds for designing new therapeutic agents with potential vasorelaxant and antihypertensive effects.

  14. Interactions between the adducin 2 gene and antihypertensive drug therapies in determining blood pressure in people with hypertension

    Directory of Open Access Journals (Sweden)

    Barkley Ruth

    2007-09-01

    Full Text Available Abstract Background As part of the NHLBI Family Blood Pressure Program, the Genetic Epidemiology Network of Arteriopathy (GENOA recruited 575 sibships (n = 1583 individuals from Rochester, MN who had at least two hypertensive siblings diagnosed before age 60. Linkage analysis identified a region on chromosome 2 that was investigated using 70 single nucleotide polymorphisms (SNPs typed in 7 positional candidate genes, including adducin 2 (ADD2. Method To investigate whether blood pressure (BP levels in these hypertensives (n = 1133 were influenced by gene-by-drug interactions, we used cross-validation statistical methods (i.e., estimating a model for predicting BP levels in one subgroup and testing it in a different subgroup. These methods greatly reduced the chance of false positive findings. Results Eight SNPs in ADD2 were significantly associated with systolic BP in untreated hypertensives (p-value Conclusion Our findings suggest that hypertension candidate gene variation may influence BP responses to specific antihypertensive drug therapies and measurement of genetic variation may assist in identifying subgroups of hypertensive patients who will benefit most from particular antihypertensive drug therapies.

  15. N-Phenyl indole derivatives as AT1 antagonists with anti-hypertension activities: Design, synthesis and biological evaluation.

    Science.gov (United States)

    Zhu, Weibo; Bao, Xiaolu; Ren, He; Da, Yajing; Wu, Dan; Li, Fuming; Yan, Yijia; Wang, Li; Chen, Zhilong

    2016-06-10

    The design, synthesis, in vitro and in vivo evaluation of 6-substituted benzimidazole with 1, 4-disubsituted or 1, 5-disubsituted indole derivatives as novel angiotensin II receptor antagonists are outlined. Radioligand binding assays showed that several 6-substituted benzimidazole derivatives displayed high affinities binding to the angiotensin II type 1 receptor at the same order of magnitude to telmisartan. The biological evaluation on spontaneously hypertensive rats showed that 2-[4-[[2-n-propyl-4-methyl-6-(1-methylbenzimidazol-2-yl)benzimidazole-1-yl]methyl]-1H-indol-1-yl]benzoic acid, 1c, could cause significant decrease on MBP in a dose dependent manner. Its maximal response lowered 53 mmHg of MBP at 5 mg/kg and 64 mmHg of MBP at 10 mg/kg after oral administration, and the significant antihypertensive effect lasted beyond 24 h, which was better than both losartan and telmisartan. A study designed to determine acute toxicity showed that 1c had low acute toxicity with no significant changes in the weight and no obvious untoward reactions. The encouraging results make 1c an effective and durable anti-hypertension drug candidate and deserve further investigation for therapeutic application. PMID:27017546

  16. Calcium antagonist antihypertensive treatment of non-insulin-dependent diabetics: efficacy and safety of lacidipine versus nifedipine SR.

    Science.gov (United States)

    Gulizia, M; Valenti, R; Platania, F; D'Onofrio, V; Rizzini, P; Circo, A

    1994-01-01

    Arterial hypertension is a chronic condition regarded as one of the main risk factors for development of coronary atherosclerosis. As dyslipidemia and reduced glucose tolerance are also risk factors for coronary disease, it is considered important to use antihypertensive drugs having no negative effects on lipid and glucose metabolism when diabetic patients are treated for hypertension. Lacidipine, a new dihydropyridine-like calcium antagonist, has been shown in in vivo and in vitro preclinical studies to possess potent, long-lasting antihypertensive activity. The present study compared the efficacy and safety of once-daily treatment with lacidipine versus nifedipine SR given twice-daily in non-insulin-dependent diabetic patients. Results have shown a similar efficacy of the two treatments: 6 months later, both drugs had reduced blood pressure values [lacidipine from 184.8/105.2 mm Hg to 144.4/87.1 mm Hg; nifedipine slow-release (SR) from 182.3/106.8 mm Hg to 143.6/89.4 mmHg]. However, lacidipine exhibited a lower incidence of adverse events (particularly ankle edema and tachycardia) than nifedipine SR. Finally, both treatments showed no negative effect on metabolic parameters (total cholesterol, high-density lipoprotein cholesterol, triglycerides, and blood glucose). PMID:7609494

  17. Antihypertensive effects of fargesin in vitro and in vivo via attenuating oxidative stress and promoting nitric oxide release.

    Science.gov (United States)

    Sha, Sha; Xu, Dandan; Wang, Yanwei; Zhao, Weifang; Li, Xiaoni

    2016-08-01

    Fargesin, a bioactive neolignan isolated from magnolia plants, is widely used in the treatment of managing rhinitis, inflammation, histamine, sinusitis, and headache. To provide more biological information about fargesin, we investigated the effects of fargesin on rat aortic rings and 2-kidney, 1-clip (2K1C) hypertensive rats. In vitro, fargesin caused concentration-dependent vasorelaxation in rat isolated aortic rings induced by KCl and norepinephrine. The effect was weakened by endothelium denudation and nitric oxide (NO) synthesis inhibition. In vivo, the evolution of systolic blood pressure (SBP) was followed by weekly measurements. Angiotensin II (Ang II) and endothelin (ET) levels, NO and nitric oxide synthase (NOS), and plasma and liver oxidative stress markers were determined at the end of the experimental period. After 5 weeks of fargesin treatment, we found that fargesin treatment reduced SBP, cardiac hypertrophy, and Ang II and ET levels of hypertensive rats. Increased NOS activity and NO level were observed in fargesin-treated rats. Normalisation of plasma MDA concentrations and improvement of the antioxidant defence system in plasma and liver accompanied the antihypertensive effect of fargesin. Taken together, these results provided substantial evidences that fargesin has antihypertensive effect in 2K1C hypertensive rats via inhibiting oxidative stress and promoting NO release. PMID:27409158

  18. WILLIAMS SYNDROME PREDISPOSES TO VASCULAR STIFFNESS MODIFIED BY ANTI-HYPERTENSIVE USE AND COPY NUMBER CHANGES IN NCF1

    Science.gov (United States)

    Kozel, Beth A.; Danback, Joshua; Waxler, Jessica; Knutsen, Russell H.; Fuentes, Lisa de las; Reusz, Gyorgy S.; Kis, Eva; Bhatt, Ami; Pober, Barbara R

    2014-01-01

    Williams syndrome, is caused by the deletion of 26-28 genes, including elastin, on human chromosome 7. Elastin insufficiency leads to the cardiovascular hallmarks of this condition, namely focal stenosis and hypertension. Extrapolation from the Eln+/− mouse suggests that affected persons may also have stiff vasculature, a risk factor for stroke, myocardial infarction and cardiac death. NCF1, one of the variably deleted Williams genes, is a component of the NAD(P)H oxidase complex and is involved in the generation of oxidative stress, making it an interesting candidate modifier for vascular stiffness. Using a case-control design, vascular stiffness was evaluated by pulse wave velocity in 77 Williams cases and matched controls. Cases had stiffer conducting vessels than controls (p<0.001), with increased stiffness observed in even the youngest Williams children. Pulse wave velocity increased with age at comparable rates in cases and controls and, although the degree of vascular stiffness varied, it was seen in both hypertensive and normotensive Williams participants. Use of anti-hypertension medication and extension of the Williams deletion to include NCF1 were associated with protection from vascular stiffness. These findings demonstrate that vascular stiffness is a primary vascular phenotype in Williams syndrome and that treatment with anti-hypertensives and/or agents inhibiting oxidative stress may be important in managing patients with this condition, potentially even those who are not overtly hypertensive. PMID:24126171

  19. A Tricholoma matsutake Peptide with Angiotensin Converting Enzyme Inhibitory and Antioxidative Activities and Antihypertensive Effects in Spontaneously Hypertensive Rats

    Science.gov (United States)

    Geng, Xueran; Tian, Guoting; Zhang, Weiwei; Zhao, Yongchang; Zhao, Liyan; Wang, Hexiang; Ng, Tzi Bun

    2016-01-01

    Hypertension is a major risk factor for cardiovascular disease. A crude water extract of the fruiting bodies of a highly prized mushroom Tricholoma matsutakei exerted an antihypertensive action on spontaneously hypertensive rats (SHRs) at a dosage of 400 mg/kg. An angiotensin converting enzyme (ACE) inhibitory peptide with an IC50 of 0.40 μM was purified from the extract and designated as TMP. Its amino acid sequence was elucidated to be WALKGYK through LC-MS/MS analysis. The Lineweaver-Burk plot suggested that TMP was a non-competitive inhibitor of ACE. A short-term assay of antihypertensive activity demonstrated that TMP at the dosage of 25 mg/kg could significantly lower the systolic blood pressure (SBP) of SHRs. TMP exhibited remarkable stability over a wide range of temperatures and pH values. It also demonstrated 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity. The aforementioned activities of TMP were corroborated by utilizing the synthetic peptide. Hence T. matsutake can be used as a functional food to help prevent hypertension- associated diseases. PMID:27052674

  20. New reduced volume preparation regimen in colon capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Yasuo Kakugawa; Kazuhide Higuchi; Shinji Tanaka; Hideki Ishikawa; Hisao Tajiri; Yutaka Saito; Shoichi Saito; Kenji Watanabe; Naoki Ohmiya; Mitsuyuki Murano; Shiro Oka; Tetsuo Arakawa; Hidemi Goto

    2012-01-01

    AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.METHODS:A pilot,multicenter,randomized controlled trial compared our proposed "reduced volume method" (group A) with the "conventional volume method" (group B) preparation regimens.Group A did not drink polyethylene glycol electrolyte lavage solution (PEGELS) the day before the capsule procedure,while group B drank 2 L.During the procedure day,groups A and B drank 2 L and 1 L of PEG-ELS,respectively,and swallowed the colon capsule (PillCam COLON(R) capsule).Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups,and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that time.Capsule videos were reviewed for grading of cleansing level.RESULTS:Sixty-four subjects were enrolled,with results from 60 analyzed.Groups A and B included 31 and 29 subjects,respectively.Twenty-nine (94%) subjects in group A and 25 (86%) subjects in group B had adequate bowel preparation (ns).Twenty-two (71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16 (55%) of the 29 subjects in group B (ns).Of the remaining 22 subjects whose capsules were not excreted within the battery life,all of the capsules reached the left side colon before they stopped functioning.A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS,due to ingesting the PEG-ELS faster than recommended.CONCLUSION:Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.

  1. Population Pharmacokinetics of Abacavir in Pregnant Women

    OpenAIRE

    Fauchet, Floris; Treluyer, Jean-Marc; Préta, Laure-Helene; Valade, Elodie; Pannier, Emmanuelle; Urien, Saik; Hirt, Déborah

    2014-01-01

    For the first time, a population approach was used to describe abacavir (ABC) pharmacokinetics in HIV-infected pregnant and nonpregnant women. A total of 266 samples from 150 women were obtained. No covariate effect (from age, body weight, pregnancy, or gestational age) on ABC pharmacokinetics was found. Thus, it seems unnecessary to adapt the ABC dosing regimen during pregnancy.

  2. Changing convention in combination oral contraceptives: estradiol and nomegestrol acetate in a monophasic 24/4 regimen.

    Science.gov (United States)

    Shulman, Lee P

    2013-07-01

    Initial oral contraceptive regimens were characterised by high doses of ethinylestradiol (EE) and a progestogen in a 21-day regimen that either included seven additional hormone-free tablets or simply the 21 days of combination hormonal tablets. These regimens were developed to ensure high contraceptive effectiveness, regular and predictable withdrawal bleeding episodes to mimic a menstrual cycle, and minimal unscheduled vaginal bleeding. However, these regimens were associated with adverse tolerability and safety issues resulting from the dose and characteristics of their hormonal components. Attempts to ameliorate these adverse issues included the development of lower-dose EE regimens, the incorporation of new progestogens, multiphasic regimens, and reduced hormone-free interval regimens. However, the EE component has remained a constant until the recent approval of combination oral contraceptives with an estrogen component other than EE. The development and introduction of an estradiol-based oral contraceptive regimen is presented in this review. PMID:23709606

  3. Superiority of home blood pressure measurements over office measurements for testing antihypertensive drugs.

    Science.gov (United States)

    Vaur; Dubroca; Dutrey-Dupagne; Genès; Chatellier; Bouvier-d'Yvoire; Elkik; Ménard

    1998-04-01

    ). Thus, no antihypertensive effect of trandolapril was demonstrated. The fall lin home blood pressure with trandolapril treatment was significant (systolic by 10.7 +/- 8 mmHg, diastolic by 5.8 +/- 5 mmHg; both P = 0.0001, versus single-blind placebo period) and was significantly greater (P = 0.0004/0.004) than the minimal change observed with placebo (systolic fell by 0.2 +/- 5mmHg, diastolic fell by 0.6 +/- 4 mmHg; P = 0.90/0.62, respectively, versus single-blind placebo period). The evening decrease in home blood pressure was similar to the morning decrease in home blood pressure in members of the trandolapril-treated group. The resulting morning:evening decrease in blood pressure ratio was 0.83 for diastolic blood pressure and 0.95 for systolic blood pressure. For the subgroup of responders, mean of individual ratios was 0.77 +/- 0.43 for diastolic blood pressure and 0.70 +/- 0.39 for systolic blood pressure. CONCLUSION: The placebo effect observed with office blood pressure measurements does not occur with home blood pressure measurements. Expected treatment effect can alter a physician's blood pressure readings. The precision of measurements is greater with home blood pressure (there is a lower SD). Use of home blood pressure measurements increases the power of comparative trials, allowing one either to study fewer subjects or to detect a smaller difference in blood pressure. PMID:10212339

  4. [Experimental evidence of an antihypertensive and hypocholesterolemic effect of oil of argan, Argania sideroxylon].

    Science.gov (United States)

    Berrada, Y; Settaf, A; Baddouri, K; Cherrah, A; Hassar, M

    2000-01-01

    The chronic ingestion of 5 ml/kg/d of Argan oil by spontaneously hypertensive rats restores normal blood pressure and induces hypocholesterolaemia. In order to confirm these results Meriones shawi, a rodent of the Gerbillideae family, was tested as a second animal model. Meriones submitted to a hypercaloric diet and physical inactivity became fat, and exhibited hypertension, dyslipidaemia and hyperinsulinaemia. When treated for two months with the same dosage regimen, decreases in glycaemia, total plasmatic cholesterol, LDL, insulinaemia and systolic and diastolic blood pressures of 4.4 per cent, 14.4 per cent, 32.5 per cent, 26.8 per cent, 28.8 per cent and 30.5 per cent were simultaneously observed. Increases in LDH and of TG of 27.9 per cent and 16.2 per cent respectively were also observed. No effect on body weight occurred. The action of polyunsatured fatty acids of the Argan oil is predominant, but in addition, other constituents play an active part. PMID:10967715

  5. Association between Regimen Composition and Treatment Response in Patients with Multidrug-Resistant Tuberculosis: A Prospective Cohort Study

    OpenAIRE

    Yuen, Courtney M.; Kurbatova, Ekaterina V.; Tupasi, Thelma; Caoili, Janice Campos; Van der Walt, Martie; Kvasnovsky, Charlotte; Yagui, Martin; Bayona, Jaime; Carmen CONTRERAS; Leimane, Vaira; Ershova, Julia; Laura E. Via; Kim, Heejin; Akksilp, Somsak; Kazennyy, Boris Y.

    2015-01-01

    Background For treating multidrug-resistant tuberculosis (MDR TB), the World Health Organization (WHO) recommends a regimen of at least four second-line drugs that are likely to be effective as well as pyrazinamide. WHO guidelines indicate only marginal benefit for regimens based directly on drug susceptibility testing (DST) results. Recent evidence from isolated cohorts suggests that regimens containing more drugs may be beneficial, and that DST results are predictive of regimen effectivenes...

  6. Daily feeding regimen impacts pig growth and behavior.

    Science.gov (United States)

    Colpoys, Jessica D; Johnson, Anna K; Gabler, Nicholas K

    2016-05-15

    A primary swine production goal is to increase efficiency of lean tissue gains. While many swine production systems currently utilize ad libitum feeding, recent research suggests that altering feeding patterns may impact feed efficiency. Therefore, the objective of this study was to compare two feeding patterns and evaluate their impact on whole body tissue accretion, feeding behavior and activity in growing pigs. Forty eight individually housed gilts (55.9±5.2kg on test BW) were assigned into one of two feeding treatments: 1) Free access to the feeder (Free Access) or 2) twice daily access where gilts were allowed to eat ad libitum between 08:00-09:00h and again from 17:00-18:00h (2×). Pig performance was recorded weekly for 55days and average daily gain (ADG), average daily feed intake (ADFI), and gain:feed (G:F) was calculated. Body composition was assessed in 12 gilts per treatment using dual X-ray absorptiometry (DXA) at day -3 and 55 of treatment, and tissue accretion rates were calculated. Gilt behaviors were assessed via video analysis during week 7 and included time spent eating, feeding rate, enrichment interaction, postural changes, standing, sitting, and lying behaviors. Gilts fed 2× had lower ADG and ADFI compared to Free Access gilts (P≤0.01); however, no treatment difference in G:F was observed (P=0.83). At day 55 gilts fed 2× had a lower fat:protein compared to Free Access gilts (P=0.05). Fat, lean, and protein accretion rates were lower in gilts fed 2× compared to those fed Free Access (P=0.01). Gilts fed 2× ate less frequently and for a shorter duration of time, interacted with enrichment more frequently (P≤0.005), and tended to have less frequent postural changes compared to Free Access gilts (P=0.08). No treatment differences were observed in duration of time spent standing, sitting, or lying (P≥0.39). Although feed regimen did not alter feed efficiency, these data indicate that twice daily feeding reduced gilt adiposity and growth

  7. The relationship between changes in health behaviour and initiation of lipid-lowering and antihypertensive medications in individuals at high risk of ischaemic heart disease

    DEFF Research Database (Denmark)

    Hempler, Nana Folmann; Krasnik, Allan; Pisinger, Charlotta;

    2012-01-01

    It has been hypothesised that health conscious individuals tend to take better care of themselves by greater adherence to preventive medications. We examined, whether long-term changes in dietary habits and physical activity were associated with initiation of lipid-lowering and antihypertensive...

  8. Population Pharmacokinetics of Voriconazole in Adults

    OpenAIRE

    Hope, William W.

    2012-01-01

    Voriconazole is a first-line agent for the treatment of invasive fungal infections. The pharmacology of voriconazole is characterized by extensive interindividual variability and nonlinear pharmacokinetics. The population pharmacokinetics of voriconazole in 64 adults is described. The patient population consisted of 21 healthy volunteers, who received a range of intravenous (i.v.) and oral voriconazole regimens, and 43 patients with proven or probable invasive aspergillosis, who received the ...

  9. Pharmacokinetics and Safety of Voriconazole Intravenous-to-Oral Switch Regimens in Immunocompromised Japanese Pediatric Patients

    OpenAIRE

    Mori, Masaaki; Kobayashi, Ryoji; Kato, Koji; Maeda, Naoko; Fukushima, Keitaro; Goto, Hiroaki; Inoue, Masami; Muto, Chieko; Okayama, Akifumi; Watanabe, Kenichi; Liu, Ping

    2014-01-01

    The aim of this study was to investigate the pharmacokinetics, safety, and tolerability of voriconazole following intravenous-to-oral switch regimens used with immunocompromised Japanese pediatric subjects (age 2 to

  10. Varying efficacy of Helicobacter pylori eradication regimens: cost effectiveness study using a decision analysis model

    OpenAIRE

    Duggan, A E; Tolley, K.; Hawkey, C. J.; Logan, R F A

    1998-01-01

    Objective: To determine how small differences in the efficacy and cost of two antibiotic regimens to eradicate Helicobacter pylori can affect the overall cost effectiveness of H pylori eradication in duodenal ulcer disease.

  11. Once-Daily, Single-Tablet Regimens For the Treatment of HIV-1 Infection

    OpenAIRE

    Truong, William R.; Schafer, Jason J.; Short, William R.

    2015-01-01

    Once-daily, single-tablet regimens have become integral to the management of human immunodeficiency virus type 1 infection, partly because they may improve adherence due to a lower pill burden. This article reviews the single-tablet options.

  12. Using Clinical Data, Hypothesis Generation Tools and PubMed Trends to Discover the Association between Diabetic Retinopathy and Antihypertensive Drugs

    Energy Technology Data Exchange (ETDEWEB)

    Senter, Katherine G [ORNL; Sukumar, Sreenivas R [ORNL; Patton, Robert M [ORNL; Chaum, Ed [University of Tennessee, Knoxville (UTK)

    2015-01-01

    Diabetic retinopathy (DR) is a leading cause of blindness and common complication of diabetes. Many diabetic patients take antihypertensive drugs to prevent cardiovascular problems, but these drugs may have unintended consequences on eyesight. Six common classes of antihypertensive drug are angiotensin converting enzyme (ACE) inhibitors, alpha blockers, angiotensin receptor blockers (ARBs), -blockers, calcium channel blockers, and diuretics. Analysis of medical history data might indicate which of these drugs provide safe blood pressure control, and a literature review is often used to guide such analyses. Beyond manual reading of relevant publications, we sought to identify quantitative trends in literature from the biomedical database PubMed to compare with quantitative trends in the clinical data. By recording and analyzing PubMed search results, we found wide variation in the prevalence of each antihypertensive drug in DR literature. Drug classes developed more recently such as ACE inhibitors and ARBs were most prevalent. We also identified instances of change-over-time in publication patterns. We then compared these literature trends to a dataset of 500 diabetic patients from the UT Hamilton Eye Institute. Data for each patient included class of antihypertensive drug, presence and severity of DR. Graphical comparison revealed that older drug classes such as diuretics, calcium channel blockers, and -blockers were much more prevalent in the clinical data than in the DR and antihypertensive literature. Finally, quantitative analysis of the dataset revealed that patients taking -blockers were statistically more likely to have DR than patients taking other medications, controlling for presence of hypertension and year of diabetes onset. This finding was concerning given the prevalence of -blockers in the clinical data. We determined that clinical use of -blockers should be minimized in diabetic patients to prevent retinal damage.

  13. Study of polymorphism of Atenolol and Captopril antihypertensives using x-ray powder diffraction and Rietveld refinement

    Science.gov (United States)

    Sato, Juliana; Ferreira, Fabio

    2013-03-01

    Characterization of bulk drugs has become increasingly important in the pharmaceutical industry. X-ray powder diffractometry is an effective technique for the identification of crystalline solid-phase drugs. The technique is unique, since it combines specificity with a high degree of accuracy for the characterization of pharmaceuticals in solid state and is an especially useful method to describe the possible polymorphic behavior of drugs substances. In this work X-ray diffraction data have been obtained for two well-known antihypertensive drugs currently being administered in tablet form. They include atenolol and captopril. Atenolol and captopril were purchased from drugstore. The characterizations of the atenolol and captopril samples were carried out by FTIR spectroscopy and X-ray powder diffraction (XRPD). We would like to thank the Brazilian agencies CNPq and FAPESP for their financial support.

  14. Antihypertensive Properties of a Pea Protein Hydrolysate during Short- and Long-Term Oral Administration to Spontaneously Hypertensive Rats.

    Science.gov (United States)

    Girgih, Abraham T; Nwachukwu, Ifeanyi D; Onuh, John O; Malomo, Sunday A; Aluko, Rotimi E

    2016-05-01

    This study investigated short-term (24 h) and long-term (5 wk) systolic blood pressure (SBP)-lowering effects in spontaneously hypertensive rats (SHR) of a 5 kDa membrane pea protein hydrolysate permeate (PPH-5) produced through thermoase hydrolysis of pea protein isolate (PPI). Amino acid analysis showed that the PPH-5 had lower contents of sulfur-containing amino acids than the PPI. Size-exclusion chromatography indicated mainly low molecular weight (pea products decreased in the 4th and 5th wk, though SBP values of the treated rats were still lower than the untreated control. We conclude that the antihypertensive potency of PPH-5 may have been due to the presence of easily absorbed hydrophilic peptides. PMID:27037677

  15. Experience with a novel efalizumab-based immunosuppressive regimen to facilitate single donor islet cell transplantation

    OpenAIRE

    Turgeon, NA; Avila, JG; Cano, JA; Hutchinson, JJ; Badell, IR; Page, AJ; Adams, AB; Sears, MH; Bowen, PH; Kirk, AD; Pearson, TC; Larsen, CP

    2010-01-01

    Islet transplantation is an experimental therapy for selected patients with type 1-diabetes (T1DM). It remains limited by immunosuppressive drug toxicity, progressive loss of insulin independence, allosensitization, and the need for multiple islet donors. We describe our experience with an efalizumab-based immunosuppressive regimen as compared to the prevailing standard regimen, the Edmonton protocol. Twelve patients with T1DM received islet transplants: 8 were treated with the Edmonton proto...

  16. Cost description of chemotherapy regimens for the treatment of metastatic pancreas cancer.

    Science.gov (United States)

    Goldstein, Daniel A; Krishna, Kavya; Flowers, Christopher R; El-Rayes, Bassel F; Bekaii-Saab, Tanios; Noonan, Anne M

    2016-05-01

    Multiple chemotherapy regimens are available for the treatment of metastatic pancreas cancer (mPCA). Choice of regimen is based on the patient's performance status and toxicity profile of the regimen. The objective of this study was to analyze the costs of first-line regimens to further aid in decision-making and develop a platform upon which to assess value. We calculated the monthly cost for individual standard regimens (gemcitabine, gemcitabine/nab-paclitaxel, gemcitabine/erlotinib and FOLFIRINOX) and the overall treatment cost for a course of therapy based on the median progression-free survival achieved in published studies. In addition to cost of drugs, we included administration costs and costs of toxicities (including growth factor support, blood product transfusion and hospitalization for toxicities). Costs for administration and management of adverse events were based on Medicare reimbursement rates for hospital and physician services. Drug costs were based on Medicare average sale prices (all 2014 US$). The monthly costs for gemcitabine, FOLFIRINOX, gemcitabine/erlotinib and gemcitabine/nab-paclitaxel were $1363, $7234, $8007 and $12,221, respectively. The overall treatment costs for a course of the same regimens based on median PFS were $5043, $46,298, $51,004 and $67,216, respectively. The choice of chemotherapy regimen for mPCA should be based on tolerability and efficacy of the regimen individualized to patient's performance status. Healthcare systems have finite resources; thus, there is increasing emphasis on metrics to define value in health care when outcomes of therapy are similar or produce marked differences in value. These data provide useful financial information to incorporate into the decision-making process. PMID:27067436

  17. Effective Antimicrobial Regimens for Use in Humans for Therapy of Bacillus anthracis Infections and Postexposure Prophylaxis†

    OpenAIRE

    Deziel, Mark R.; Heine, Henry; Louie, Arnold; Kao, Mark; Byrne, William R.; Basset, Jennifer; Miller, Lynda; Bush, Karen; Kelly, Michael; Drusano, G L

    2005-01-01

    Expanded options for treatments directed against pathogens that can be used for bioterrorism are urgently needed. Treatment regimens directed against such pathogens can be identified only by using data derived from in vitro and animal studies. It is crucial that these studies reliably predict the efficacy of proposed treatments in humans. The objective of this study was to identify a levofloxacin treatment regimen that will serve as an effective therapy for Bacillus anthracis infections and p...

  18. Novel Kivexa-based regimens in early courses of treatment for HIV infection

    OpenAIRE

    Conway, B; Alenezi, O; Wong, L; Wang, J.; Qian, C; H Tossonian

    2012-01-01

    Background: As the long-term efficacy of antiretroviral therapy regimens is confirmed, we need to identify additional combinations with long-term safety and potency, while also favoring simplicity of administration. In this light, we have undertaken a review of the use of abacavir/lamivudine (Kivexa, KVX)-based regimens using integrase or CCR5 inhibitors as the third agent. Methods: A retrospective chart review was undertaken, with informed patient consent. We identified all the patients in w...

  19. PHARMACOECONOMIC ASSESSMENT OF USING INTERFERON-FREE REGIMENS FOR CHRONIC HEPATITIS C AFTER LIVER TRANSPLANTATION

    OpenAIRE

    A. A. Sukhoruk; E. V. Esaulenko

    2016-01-01

    This article contains analysis of current combination treatment regimens for chronic hepatitis C after liver transplantation. Antiviral therapy with long-acting interferons and ribavirin is of low efficiency and high costs. The clinical and economic benefits of interferon-free treatment regimen for patients infected with genotype 1 HCV using dasabuvir, paritaprevir boosted with ritonavir, ombitasvir (Viekira Pak) and ribavirin have been shown. Registration and introduction into clinical pract...

  20. Un analisis de los desequilibrios del tipo de cambio real argentino bajo cambios de regimen

    OpenAIRE

    Daniel Aromi; Marcos Dal Bianco

    2014-01-01

    En este trabajo estudiamos para Argentina la presencia de diferentes regimenes en la media y la varianza de los desequilibrios del TCR respecto de su equilibrio, utilizando un modelo de cambios de regimen tipo Markov con probabilidades de transicion variables. Nuestras estimaciones reconocen dos estados persistentes en la media de los desequilibrios del TCR argentino asociadas a apreciaciones y depreciaciones reales, siendo las depreciaciones reales mas persistentes que las apreciaciones. Por...

  1. Raltegravir use in special populations

    Directory of Open Access Journals (Sweden)

    Johnson Margaret

    2009-11-01

    Full Text Available Abstract Raltegravir, the first approved integrase inhibitor, has been shown to be virologically effective in Phase II and Phase III clinical trials in both treatment naïve and triple class resistant patients. It also has an excellent tolerability profile and lacks significant drug-drug interactions making it an important drug in the treatment of a number of special patient populations. In this review its use in patients undergoing solid organ and bone marrow transplantation and patients receiving cancer chemotherapy, will be discussed. In addition other indications including patients with metabolic complications of existing antiretroviral drugs as well as patients with side effects on current HAART regimens. Other groups of patients where raltegravir may play an important role are patients with renal disease and tuberculosis. Finally, although not licensed for use in pregnancy, raltegravir may need to be considered in some pregnant women with antiretroviral resistance or tolerability issues with current HAART regimens.

  2. Anti-hypertensive treatment in pheochromocytoma and paraganglioma: current management and therapeutic features.

    Science.gov (United States)

    Mazza, Alberto; Armigliato, Michela; Marzola, Maria Cristina; Schiavon, Laura; Montemurro, Domenico; Vescovo, Giorgio; Zuin, Marco; Chondrogiannis, Sotirios; Ravenni, Roberta; Opocher, Giuseppe; Colletti, Patrick M; Rubello, Domenico

    2014-04-01

    Pheochromocytoma (PH) and paraganglioma (PG) are neuroendocrine neoplasms arising from chromaffin cells of the adrenal medulla and the sympathetic ganglia, respectively. Although are unusual cause of hypertension (HT) accounting for at most 0.1-0.2 % of cases, they may lead to severe and potentially lethal hypertensive crisis due to the effects of the released catecholamines. However, both PH and PG may be asymptomatic as ~30 % of subjects are normotensive or have orthostatic hypotension and in these cases the 24 h ambulatory blood pressure (BP) monitoring is an important toll to diagnose and treat HT. HT treatment may be difficult when PH or PG occurs in pregnancy or in the elderly subjects and in these cases a multidisciplinary team is required. When surgical excision is mandatory the perioperative management requires the administration of selective α1-adrenergic blocking agents (i.e., doxazosin, prazosin or terazosin) followed by a β-adrenergic blockade (i.e., propranolol, atenolol). This latter should never be started first because blockade of vasodilatory peripheral β-adrenergic receptors with unopposed α-adrenergic receptor stimulation can lead to a further elevation of BP. Although labetalol is traditionally considered the ideal agent due to its α- and β-adrenergic antagonism, experimental studies do not support its use in this clinical setting. As second regimen, the administration of vasodilators as calcium channel blockers (i.e., nicardipine, nifedipine) may be required to control BP. Oral and sublingual short-acting nifedipine are potentially dangerous in patients with hypertensive emergencies and are not recommend. The latest evidences into the diagnosis and treatment of hypertensive crisis due to PH and PG are reviewed here. PMID:23817839

  3. Transdermal delivery of Diltiazem HCl from matrix film: Effect of penetration enhancers and study of antihypertensive activity in rabbit model.

    Science.gov (United States)

    Parhi, Rabinarayan; Suresh, Padilam

    2016-05-01

    The present investigation focused on the development of Diltiazem HCl (DTH) matrix film and its characterization by in-vitro, ex-vivo and in-vivo methods. Films were prepared by solvent casting method by taking different ratios of hydroxypropyl methylcellulose K4M (HPMC K4M) and Eudragit RS100. Various parameters of the films were analyzed such as mechanical property using tensile tester, interaction study by Fourier transform infrared spectroscopy (FTIR) and Thermogravimetric analysis (TGA), in-vitro drug release through cellulose acetate membrane, ex-vivo permeation study using abdominal skin of rat employing Franz diffusion cell, and in-vivo antihypertensive activity using rabbit model. The FTIR studies confirmed the absence of interaction between DTH and selected polymers. Thermal analysis showed the shifting of endothermic peak of DTH in film, indicating the dispersion of DTH in molecular form throughout the film. Incorporation of 1,8-cineole showed highest flux (89.7 μg/cm(2)/h) of DTH compared to other penetration enhancers such as capsaicin, dimethyl sulfoxide (DMSO), and N-methyl pyrrolidone (NMP). Photomicrographs of histology study on optimized formulation (DF9) illustrated disruption of stratum corneum (SC) supporting the ex-vivo results. The in-vivo antihypertensive activity results demonstrated that formulation DF9 was effective in reducing arterial blood pressure in normotensive rabbits. SEM analysis of films kept for stability study (40 ± 2 °C/75% ± 5%RH for 3 months) revealed the formation of drug crystals which may be due to higher temperature. The findings of the study provide a better alternative dosage form of DTH for the effective treatment of hypertension with enhanced patient compliance. PMID:27222758

  4. Preparation and in vitro/in vivo characterization of enteric-coated nanoparticles loaded with the antihypertensive peptide VLPVPR

    Directory of Open Access Journals (Sweden)

    Sun HY

    2014-04-01

    Full Text Available Haiyan Sun, Dong Liu, Yan Li, Xuwei Tang, Yanli Cong Shenzhen Key Laboratory of Fermentation, Purification and Analysis, Shenzhen Polytechnic, Guangdong, People's Republic of China Abstract: Our previous study revealed that the peptide Val-Leu-Pro-Val-Pro-Arg (VLPVPR, which was prepared using deoxyribonucleic acid recombinant technology, effectively decreased the blood pressure of spontaneous hypertensive rats; however, the effect only lasts 6 hours, likely due to its low absorption in the gastrointestinal tract. To overcome this problem, the purpose of this study was to characterize (methoxy-polyethylene glycol-b-poly(D,L-lactide-co-glycolide-b-poly(L-lysine nanoparticles as in vitro and in vivo carriers for the effective delivery of VLPVPR. In our study, the VLPVPR nanoparticles were prepared using a double emulsion method, coated with Eudragit S100, and freeze-dried to produce enteric-coated nanoparticles. The optimized parameters from the double emulsion method was obtained from orthogonal experiments, including drug loading (DL and encapsulated ratio (ER at 6.12% and 86.94%, respectively, and the average particle size was below 100 nm. The release experiment demonstrated that the nanoparticles were sensitive to pH: almost completely released at pH 7.4 after 8 hours, but demonstrated much less release at pH 4.5 or pH 1.0 in the same amount of time. Therefore, the nanoparticles are suitable for enteric release. In vivo compared with the untreated group, the medium and high doses of orally administered VLPVPR nanoparticles reduced blood pressure for more than 30 hours, demonstrating that these nanoparticles have long-lasting and significant antihypertensive effects in spontaneously hypertensive rats. Keywords: mPEG-PLGA-PLL, in vivo studies, Val-Leu-Pro-Val-Pro-Arg peptide, enteric-coated, nanoparticle, antihypertensive peptide

  5. Monitoring of Adverse Drug Reactions Associated with Antihypertensive Medicines at a University Teaching Hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    Fowad Khurshid

    2012-09-01

    Full Text Available Aim To monitor the adverse drug reactions (ADRs caused by antihypertensive medicines prescribed in a university teaching hospital.Methods:he present work was an open, non-comparative, observational study conducted on hypertensive patients attending the Medicine OPD of Majeedia Hospital, Jamia Hamdard, New Delhi, India by conducting patient interviews and recording the data on ADR monitoring form as recommended by Central Drugs Standard Control Organization (CDSCO, Government of India.Results:A total of 21 adverse drug reactions were observed in 192 hypertensive patients. Incidence of adverse drug reactions was found to be higher in patients more than 40 years in age, and females experienced more ADRs (n = 14, 7.29 % than males, 7 (3.64 %. Combination therapy was associated with more number of adverse drug reactions (66.7 % as against monotherapy (33.3 %. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n = 7, followed by diuretics (n = 5, and beta- blockers (n = 4. Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 7, followed by torasemide (n = 3. Adverse drug reactions associated with central nervous system were found to be the most frequent (42.8 % followed by musculo-skeletal complaints (23.8 % and gastro-intestinal disorders (14.3 %. Conclusions:The present pharmacovigilance study represents the adverse drug reaction profile of the antihypertensive medicines prescribed in our university teaching hospital. The above findings would be useful for physicians in rational prescribing. Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions.

  6. Practical considerations in choosing a factor VIII prophylaxis regimen: Role of clinical phenotype and trough levels.

    Science.gov (United States)

    Ljung, Rolf; Fischer, Kathelijn; Carcao, Manuel; Santagostino, Elena; Manco-Johnson, Marilyn J; Mathew, Prasad

    2016-05-01

    Current therapy for haemophilia A is guided by severity of the disease, which in turn is best reflected in patients' endogenous factor VIII activity levels. For patients with severe haemophilia (particularly children), prophylaxis with continuous routine factor replacement has become standard of care in developed countries and is gradually becoming the standard of care in developing countries. The question arises then: what is an appropriate prophylaxis regimen to prevent bleeding events and arthropathy, while also maximizing patient quality of life and taking into consideration the costs of prophylaxis? Should all patients be treated with one standard, fixed prophylaxis regimen, or should prophylaxis be individualised for each patient? If so, what factors need to be considered in choosing the appropriate dose and frequency of factor administration? If prophylaxis is tailored to the individual patient, then patient-related factors (bleeding phenotype, activity profiles, age, joint status) and product-specific factors (half-life of the replacement factor in the individual patient) will determine the choice of regimen, whether it be a fixed-regimen prophylaxis or prophylaxis that is tailored to patient activity and bleeding risk. Regardless of the choice of prophylaxis regimen, for any regimen to be effective, adherence to therapy is key to optimising outcomes. PMID:26791493

  7. A preliminary evaluation of comparative effectiveness of riluzole in therapeutic regimen for irritable bowel syndrome

    Institute of Scientific and Technical Information of China (English)

    Surya Prakash Mishra; Sunit Kumar Shukla; Bajrang Lal Pandey

    2014-01-01

    Objective: To develop agents that are specifically effective in controlling the key disturbance of visceral hyperalgesia besides abating of associated multiple symptoms, and evaluate comparative effectiveness for IBS symptom relief for standard regimen (antispasmodic and probiotic) and add-on amitriptyine or riluzole regimens following two weeks administration.Methods:groups were studied. First group received standard treatment (mebeverine 200 mg twice daily and probiotic 200 mg twice daily). Second group received add-on amitriptyline 25 mg before bedtime, while the third group got add-on riluzole 50 mg twice daily. Overall gastrointestinal symptom rating scale improving symptoms and hospital anxiety depression scale improving associated psychological morbidity were employed as measures at induction and at two-week follow-up period. Individual symptom scores were also examined to define the outcome profiles.Results:108 patients with visceral hypersensitivity accompanying IBS, divided into three rating scale score, not the other two regimens. Pain relief was seen with both riluzole and amitriptyline regimens significantly superior to standard treatment regimen, but riluzole effect appeared specific and independent anxiolytic effect. Amitriptyline caused relief in diarrhea and did not benefit in constipation point to non-specific remedial role in IBS. Riluzole regimen resulted in significant reduction of overall gastrointestinal symptom Conclusions: Riluzole specifically relieves visceral hypersensitivity and is proved to be superior to current treatments in IBS patients. It appears a lead remedy based on glutamate transporter mechanisms in visceral hypersensititvity.

  8. Thalidomide-based induction regimens are as effective as bortezomib-based regimens in elderly patients with multiple myeloma with cereblon expression.

    Science.gov (United States)

    Jung, Sung-Hoon; Choi, Hyun-Jung; Shin, Myung-Geun; Lee, Seung-Shin; Hwang, Eu Chang; Jung, Tae-Young; Cho, Min-Seok; Yang, Deok-Hwan; Ahn, Jae-Sook; Kim, Yeo-Kyeoung; Kim, Hyeoung-Joon; Lee, Je-Jung

    2016-10-01

    Cereblon (CRBN) has been identified as a primary target of immunomodulatory drugs and is considered a biomarker for the prediction of outcomes after thalidomide- or lenalidomide-based treatments. In this study, we evaluated CRBN expression in bone marrow (BM) tissue at diagnosis and investigated the relationship between CRBN expression and treatment outcomes after thalidomide- or bortezomib-based front-line therapies in 89 elderly patients with multiple myeloma (MM). CRBN expression at the time of diagnosis was evaluated with immunohistochemical (IHC) staining for myeloma cells in paraffin wax-embedded BM tissue. CRBN-immunostained slides were scored by intensity and diffuseness, and a total score of >6 was defined as CRBN-positive (CRBN(+)). Thirty-eight patients (45.2 %) were CRBN(+). Among patients treated with thalidomide-based regimens, CRBN(+) patients showed a better treatment response than did CRBN-negative patients (35.0 vs. 11.8 % complete response rate, respectively; HR = 4.038, P = 0.137). During a median follow-up of 31.8 months, patients treated with bortezomib-based regimens had a longer time to progression (TTP) than did patients treated with thalidomide-based regimens (15.6 vs. 13.2 months, respectively; P = 0.047), but early mortality occurred frequently in patients treated with bortezomib-based regimens. Additionally, there was no significant difference in survival outcomes between thalidomide- and bortezomib-based regimens in CRBN(+) patients (median TTP, 13.8 vs. 15.6 months, respectively; P = 0.842 and median OS, 39.3 vs. 30.1 months, respectively; P = 0.074). These data suggest that thalidomide-based regimens are as effective as bortezomib-based regimens in elderly patients with MM who are CRBN(+). Thus, CRBN positivity, by IHC staining, may be useful in deciding appropriate treatment options in elderly patients with MM. PMID:27365142

  9. Different antivascular endothelial growth factor treatments and regimens and their outcomes in neovascular age-related macular degeneration: a literature review.

    Science.gov (United States)

    Lanzetta, Paolo; Mitchell, Paul; Wolf, Sebastian; Veritti, Daniele

    2013-12-01

    Antivascular endothelial growth factor (anti-VEGF) therapy has revolutionised the treatment of wet age-related macular degeneration (wAMD). Recent research has focused on evaluating competing agents and alternative dosage regimens, providing evidence to help determine optimal treatment strategies. We therefore conducted a review of clinical research studies in wAMD published since 2008 that compared anti-VEGF dosing regimens and therapies; seven studies met our inclusion criteria. Data on baseline disease characteristics, disease outcomes, safety (ocular and systemic) and treatment burden (injection and visit frequencies) were extracted on patients treated with ranibizumab 0.5 mg, bevacizumab 1.25 mg or aflibercept 2.0 mg for up to 2 years. For ranibizumab and bevacizumab, visual and anatomical outcomes at 1 and 2 years were superior using scheduled monthly (or 4 weekly (q4w)) compared with as needed or scheduled quarterly dosing regimens. Treatment outcomes were generally better for both drugs when more aggressive retreatment criteria were used, which resulted in more frequent injections. Bevacizumab, however, was associated with a 30-35% elevated rate of serious systemic adverse events compared with ranibizumab, regardless of dosing interval; further study in larger patient populations will be required to determine the validity of this finding. Intravitreal aflibercept injection every 8 weeks was non-inferior to ranibizumab q4w on all visual and anatomical endpoints at week 52, had a similar safety profile and required five fewer anti-VEGF injections. PMID:23929309

  10. Long-term efficacy and safety of etravirine-containing regimens in a real-life cohort of treatment-experienced HIV-1-infected patients.

    Science.gov (United States)

    Allavena, Clotilde; Katlama, Christine; Cotte, Laurent; Roger, Pierre Marie; Delobel, Pierre; Cheret, Antoine; Duvivier, Claudine; Poizot-Martin, Isabelle; Hoen, Bruno; Cabie, André; Cheret, Arnaud; Lahoulou, Rima; Raffi, François; Pugliese, Pascal

    2016-05-01

    Objectives Etravirine (ETR) was approved in France in September 2008 and is used in combination with a boosted protease inhibitor (bPI) and other anti-retrovirals (ART) in HIV-infected pre-treated patients. This study aimed to report in a real-life setting the efficacy and tolerability of ETR-based regimens and factors associated with virological response. Methods The study population included all treatment-experienced patients who initiated an ETR-based regimen between September 2008 and July 2013 from the French Dat'AIDS cohort. Analyses were performed in ART-experienced patients starting ETR after virological failure (VF) or as a maintenance therapy (MT), with or without bPI. Results A total of 2006 patients (VF, n = 1014 (51%); MT, n = 992 (49%)) were included. At M12, the proportion of patients with HIV RNA ART-experienced patients ETR is well tolerated with a high efficacy when combined with other active drugs, even when the regimen does not include a bPI. PMID:26757613

  11. Outcome after Transplantation According to Reduced-Intensity Conditioning Regimen in Patients Undergoing Transplantation for Myelofibrosis.

    Science.gov (United States)

    Robin, Marie; Porcher, Raphael; Wolschke, Christine; Sicre de Fontbrune, Flore; Alchalby, Haefaa; Christopeit, Maximilian; Cassinat, Bruno; Zabelina, Tatjana; Peffault de Latour, Régis; Ayuk, Francis; Socié, Gérard; Kröger, Nicolaus

    2016-07-01

    Allogeneic hematopoietic stem cell transplantation remains the sole curative option for myelofibrosis. Many transplantation recipients receive a reduced-intensity conditioning (RIC) regimen owing to age or comorbidities; however, there is little published evidence to guide the choice of RIC regimen. In this study, we compared outcomes in patients who received 1 of 2 frequently used RIC regimens for patients with myelofibrosis: fludarabine-busulfan (FB) and fludarabine-melphalan (FM). A total of 160 patients underwent a RIC allograft procedure (FB group, n = 105; FM group, n = 55). We have developed a complex statistical model involving weighting and adjustment to permit comparison between these 2 groups. After weighting, the incidence of acute graft-versus-host disease (GVHD) was 62% in the FM group and 31% in the FB group (P = .001), and the corresponding incidence of chronic GVHD was 49% and 53%, respectively. The 7-year progression-free survival was were 52% in the FM group versus 33% in the FB group, and the 7-year overall survival rate 52% in the FM group versus 59% in the FB group. Nonrelapse mortality (NRM) was 43% in the FM group and 31% in the FB group. Multivariable analyses revealed no significant differences in PFS between the 2 groups; however, the relapse rate was significantly lower in the FM group (hazard ratio, 9.21; P = .008), whereas a trend toward reduced NRM was seen in the FB group (hazard ratio, 0.51; P = .068). In conclusion, both regimens appear to be efficient in mediating disease control and can be used to successfully condition patients with myelofibrosis. The FM regimen appears to induce more NRM than the FB regimen, but with augmented control of disease, leading to comparable overall survival rates for both regimens. PMID:26970380

  12. Hematopoietic stem cell transplantation with conditioning regimens containing melphalan in pediatric patients with acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    A multicenter comparative study was carried out to investigate the efficacy and safety of hematopoietic stem cell transplantation with conditioning regimens containing melphalan in pediatric patients with acute lymphoblastic leukemia. One hundred twenty three patients at a variety of remission stages were eligible for study participation. Eighty-nine were transplanted with allogeneic grafts and 34 patients with autologous grafts (23 cases with bone marrow and 11 cases with peripheral blood stem cells). Conditioning regimens used were as follows: melphalan and busulfan for 40 patients, melphalan, busulfan and TBI for 44 patients, other regimens for 39 patients. To accelerate engraftment G-CSF (lenograstim) was administered as a 1-hour or 24-hour drip infusion daily at 5 μg/kg from day 5 until hematological recovery. The five year disease free survival (DFS) was 63% for 42 patients at CR1, 41% for 41 patients at CR2 and 33% for 40 patients at other stages. There was no significant difference in the DFS between allogeneic-transplantation and autologous-transplantation in all disease stages. In patients at remission stage for CR1 and CR2, the 5-year DFS by conditioning regimen was 63% for regimen with melphalan and busulfan, 54% for regimen with melphalan, busulfan and TBI and 54% for regimens with melphalan and TBI. There was no significant difference in the DFS between the groups. Serious complications such as renal failure were observed in 11%, veno-occlusive disease in 9%, and interstitial pneumonia in 9%. The most dominating cause of death was relapse in the disease (48% of deaths) which was most commonly observed in autologous transplantation. Contrary to that, treatment related toxic death was the most frequent cause of deaths in allogeneic-transplantation. (author)

  13. Hematopoietic stem cell transplantation with conditioning regimens containing melphalan in pediatric patients with acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Matsuyama, Takaharu; Kato, Koji [Nagoya First Red Cross Hospital (Japan). Children' s Medical Center; Hanada, Ryoji [Saitama Children' s Medical Center, Iwatsuki (Japan)] [and others

    2002-07-01

    A multicenter comparative study was carried out to investigate the efficacy and safety of hematopoietic stem cell transplantation with conditioning regimens containing melphalan in pediatric patients with acute lymphoblastic leukemia. One hundred twenty three patients at a variety of remission stages were eligible for study participation. Eighty-nine were transplanted with allogeneic grafts and 34 patients with autologous grafts (23 cases with bone marrow and 11 cases with peripheral blood stem cells). Conditioning regimens used were as follows: melphalan and busulfan for 40 patients, melphalan, busulfan and TBI for 44 patients, other regimens for 39 patients. To accelerate engraftment G-CSF (lenograstim) was administered as a 1-hour or 24-hour drip infusion daily at 5 {mu}g/kg from day 5 until hematological recovery. The five year disease free survival (DFS) was 63% for 42 patients at CR1, 41% for 41 patients at CR2 and 33% for 40 patients at other stages. There was no significant difference in the DFS between allogeneic-transplantation and autologous-transplantation in all disease stages. In patients at remission stage for CR1 and CR2, the 5-year DFS by conditioning regimen was 63% for regimen with melphalan and busulfan, 54% for regimen with melphalan, busulfan and TBI and 54% for regimens with melphalan and TBI. There was no significant difference in the DFS between the groups. Serious complications such as renal failure were observed in 11%, veno-occlusive disease in 9%, and interstitial pneumonia in 9%. The most dominating cause of death was relapse in the disease (48% of deaths) which was most commonly observed in autologous transplantation. Contrary to that, treatment related toxic death was the most frequent cause of deaths in allogeneic-transplantation. (author)

  14. HER2 over-expression and response to different chemotherapy regimens in breast cancer

    Institute of Scientific and Technical Information of China (English)

    Jin ZHANG; Yan LIU

    2008-01-01

    Purpose: To exam the relationship between HER2 over-expression and different adjuvant chemotherapies in breast cancer. Patients and Methods: A total of 1625 primary breast cancer patients who received post-surgery adjuvant chemotherapy in Tianjin Cancer Hospital, China, from July 2002 to November 2005 were included in the study. Among them, 600 patients were given CMF (CTX+MTX+5-Fu) regimen, 600 given CEF (CTX+E-ADM+5-Fu) regimen, and 425 given anthracyclines plus taxanes regimen, with mean follow-up time of 42 months. Results: In CMF treatment group, the 3-year disease free survival (DFS)in HER2 over-expressed patients was lower than that of the HER2-negative ones (89.80% vs 91.24%, P=0.0348); in node-positive subgroup, the 3-year DFS was 84.72% in HER2 over-expressed patients, and 90.18% in the HER-2-negative ones (P=0.0271).Compared to CMF regimen, anthracyclines and anthracyclines plus taxanes regimens are more effective (P<0.05) in node-positive HER2 over-expression than those in the node-negative. Conclusion: HER2 over-expression is an independent index for predicting poor prognosis and short DFS for breast cancer patients. HER2 over-expressed patients are resistant to CMF regimen chemotherapy, but sensitive to anthracyclines-based or anthracyclines plus taxanes regimen. HER2 expression can be taken as a marker for therapies in breast cancer.

  15. The Importance of G Protein-Coupled Receptor Kinase 4 (GRK4 in Pathogenesis of Salt Sensitivity, Salt Sensitive Hypertension and Response to Antihypertensive Treatment

    Directory of Open Access Journals (Sweden)

    Brian Rayner

    2015-03-01

    two major hypertension studies, the 65Leu/142Val heterozygote predicted a significantly decreased response to atenolol treatment, and the 65Leu/142Val heterozygote and 486Val homozygote were associated in an additive fashion with adverse cardiovascular outcomes, independent of BP. In conclusion, there is considerable evidence that GRK4 variants are linked to impaired Na excretion, hypertension in animal models and humans, therapeutic response to dietary Na restriction and response to antihypertensive drugs. It may also underlie the difference in hypertension between different geographically derived population groups, and form a basis for pharmacogenomic approaches to treatment of hypertension.

  16. Polypharmacy: correlations with sex, age and drug regimen

    DEFF Research Database (Denmark)

    Bjerrum, L; Søgaard, J; Hallas, J;

    1998-01-01

    and anti-ulcer drugs were predominant among young individuals exposed to PP. The odds ratio (OR) for major PP was substantially increased for individuals treated for cardiovascular diseases (OR, 4.5), anaemia (OR, 4.1) and respiratory diseases (OR, 3.6). CONCLUSIONS: PP is widespread in the population....... Clinicians and organisers who are responsible for quality assurance programmes should intensify their surveillance of the groups most prone to PP (the elderly and those using analgesics or drugs for cardiovascular disease, anaemia, asthma and diabetes)....... by inhabitants in the county of Funen (n = 466567). The number of individuals concurrently using two to four drugs (minor PP) and five or more drugs (major PP) was calculated on a random day in 1994. Drugs were classified according to the Anatomical Therapeutical Chemical (ATC) classification index. The main...

  17. A retrospective study of cardio toxicities induced by 5-Fluouracil (5-FU) and 5-FU based chemotherapy regimens in Pakistani adult cancer patients at Shaukat Khanum Memorial Cancer Hospital and Research Center

    International Nuclear Information System (INIS)

    Objective: To study cardio toxicities, especially bradycardia in cancer patients treated with 5-Fluouracil and 5-Fluouracil based chemotherapy regimens in Pakistani population. Methods: Data was extracted from the medical records of all diagnosed cancer patients at Shaukat Khanum Memorial Cancer Hospital and Research Center registered between January 2002 and December 2004 receiving 5- Fluouracil based chemotherapy regimens. The data was analysed retrospectively, including electrocardiogram and cardiac markers. Pearson's Correlation coefficient was calculated to see any possible correlation between 5-Fluouracil alone and 5-Fluouracil based regimens and cardiotoxicity, and other variables. Results: Symptomatic cardiotoxicity was observed in 60 (19.93%) out of 301 patients whose cases were part of the study. Bradycardia was the most common cardiotoxicity and was observed in 36 (11.96%) patients. Nine (2.99%) mortalities were also observed. The incidence of cardiotoxicity was not significantly different between the patients with and without pre-existing cardiovascular disease (p = 0.095) and having negative correlation -0.305. Cardio toxicities were more common with Continuous Infusion (CI) of 5-Fluouracil, radiotherapy concurrent with 5-Fluouracil and when 5-Fluouracil was used in combination with Cisplatinum (CDDP). Conclusion: Cardio toxicities were more prevalent when 5-Fluouracil was used along with concurrent radiotherapy and with Cisplatinum and when administered in continuous infusion pattern. Hence, 5-Fluouracil and 5-Fluouracil based chemotherapy regimens cause cardio toxicities, especially bradycardia, in a significant number of cancer patients in Pakistani population. (author)

  18. Effect of different bleaching regimens on the flexural strength of hybrid composite resin

    Science.gov (United States)

    Feiz, Atiyeh; Samanian, Noushmehr; Davoudi, Amin; Badrian, Hamid

    2016-01-01

    Background: The entire effects of different bleaching regimens on the mechanical properties of composite resins have remained unknown. The purpose of this study was to evaluate the effects of different bleaching regimens on the flexural strength (FS) of hybrid composite resins. Materials and Methods: In this in vitro study, 80 bar-shaped specimens of hybrid composite resins were fabricated and randomly divided into four groups, 20 specimens in each group. First group (C) was considered as control. The other groups were treated by home bleaching (HB) agent, in-office bleaching (IB) agent, and the combination regimens (HIB), respectively. The FS was evaluated by three-point bending test by using a Universal Testing Machine. All data were analyzed by using Statistical Package for the Social Sciences (SPSS) software version 18, analysis of variance (ANOVA), and Turkey's post hoc statistical tests (α = 0.05). Results: The maximum mean value of FS was seen in HB group with significant differences to other groups (P < 0.05). Also, the minimum FS was observed in group HIB. Conclusion: Application of different bleaching regimens does not have any adverse effect on the FS of hybrid composite resins. However, the administration of HB regimens seemed to have lesser negative impact on the FS. PMID:27099423

  19. Cleansing the colon in gallium-67 scintigraphy: a prospective comparison of regimens

    International Nuclear Information System (INIS)

    Colonic accumulation of gallium-67 frequently complicates the interpretation of gallium-67 scintigrams. Although various modes of cleansing the colon prior to scintigraphy have been suggested, there is controversy over their efficacy and none have been tested prospectively. Three hundred nine patients undergoing gallium-67 scintigraphy were randomly assigned to one of four cleansing regimens: (1) a high fiber diet (78 patients); (2) castor oil (76); (3) milk of magnesia and cascara (76); and (4) not preparation (79). Patient compliance rates for the four regimens were 17%, 32%, 36%, and 46%, respectively. After noncompliant patients were excluded, gallium-67 scintigrams were graded for colonic activity on a scale of 0-3 by three independent, experienced observers. Gallium-67 activity in the colon was significantly less after administration of castor oil than after no preparation (p . 0.047). A high fiber diet also resulted in a substantial reduction of colonic activity when compared with no preparation; the difference, however, was not statistically significant (p . 0.083). Regimen 3 did not produce significantly better results than regimen 4 (p . 0.42). A major impediment to the success of any cleansing regimen seems to be poor compliance of patients

  20. Effect of different bleaching regimens on the flexural strength of hybrid composite resin

    Directory of Open Access Journals (Sweden)

    Atiyeh Feiz

    2016-01-01

    Full Text Available Background: The entire effects of different bleaching regimens on the mechanical properties of composite resins have remained unknown. The purpose of this study was to evaluate the effects of different bleaching regimens on the flexural strength (FS of hybrid composite resins. Materials and Methods: In this in vitro study, 80 bar-shaped specimens of hybrid composite resins were fabricated and randomly divided into four groups, 20 specimens in each group. First group (C was considered as control. The other groups were treated by home bleaching (HB agent, in-office bleaching (IB agent, and the combination regimens (HIB, respectively. The FS was evaluated by three-point bending test by using a Universal Testing Machine. All data were analyzed by using Statistical Package for the Social Sciences (SPSS software version 18, analysis of variance (ANOVA, and Turkey′s post hoc statistical tests (α = 0.05. Results: The maximum mean value of FS was seen in HB group with significant differences to other groups (P < 0.05. Also, the minimum FS was observed in group HIB. Conclusion: Application of different bleaching regimens does not have any adverse effect on the FS of hybrid composite resins. However, the administration of HB regimens seemed to have lesser negative impact on the FS.

  1. The rationale and design of the antihypertensives and vascular, endothelial, and cognitive function (AVEC trial in elderly hypertensives with early cognitive impairment: Role of the renin angiotensin system inhibition

    Directory of Open Access Journals (Sweden)

    Hart Meaghan

    2009-11-01

    Full Text Available Abstract Background Prior evidence suggests that the renin angiotensin system and antihypertensives that inhibit this system play a role in cognitive, central vascular, and endothelial function. Our objective is to conduct a double-blind randomized controlled clinical trial, the antihypertensives and vascular, endothelial, and cognitive function (AVEC, to compare 1 year treatment of 3 antihypertensives (lisinopril, candesartan, or hydrochlorothiazide in their effect on memory and executive function, cerebral blood flow, and central endothelial function of seniors with hypertension and early objective evidence of executive or memory impairments. Methods/Design The overall experimental design of the AVEC trial is a 3-arm double blind randomized controlled clinical trial. A total of 100 community eligible individuals (60 years or older with hypertension and early cognitive impairment are being recruited from the greater Boston area and randomized to lisinopril, candesartan, or hydrochlorothiazide ("active control" for 12 months. The goal of the intervention is to achieve blood pressure control defined as SBP 20 and without clinical diagnosis of dementia or Alzheimer's disease. Individuals who are currently receiving antihypertensives are eligible to participate if the participants and the primary care providers are willing to taper their antihypertensives. Participants undergo cognitive assessment, measurements of cerebral blood flow using Transcranial Doppler, and central endothelial function by measuring changes in cerebral blood flow in response to changes in end tidal carbon dioxide at baseline (off antihypertensives, 6, and 12 months. Our outcomes are change in cognitive function score (executive and memory, cerebral blood flow, and carbon dioxide cerebral vasoreactivity. Discussion The AVEC trial is the first study to explore impact of antihypertensives in those who are showing early evidence of cognitive difficulties that did not reach the

  2. Chinese Patent Medicine Liu Wei Di Huang Wan Combined with Antihypertensive Drugs, a New Integrative Medicine Therapy, for the Treatment of Essential Hypertension: A Systematic Review of Randomized Controlled Trials

    OpenAIRE

    Jie Wang; Kuiwu Yao; Xiaochen Yang; Wei Liu; Bo Feng; Jizheng Ma; Xinliang Du; Pengqian Wang; Xingjiang Xiong

    2012-01-01

    Objectives. To assess the beneficial and adverse effects of Liu Wei Di Huang Wan (LWDHW), combined with antihypertensive drugs, for essential hypertension. Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of LWDHW combined with antihypertensive drugs for essential hypertension reported in any language, with main outcome measures as blood pressure. The quality of the i...

  3. Novel pharmaceutical composition of bradykinin potentiating penta peptide with beta-cyclodextrin: physical-chemical characterization and anti-hypertensive evaluation.

    Science.gov (United States)

    Denadai, Angelo M L; Ianzer, Danielle; Alcântara, Antônio Flávio de C; Santoro, Marcelo M; Santos, Cynthia F F; Lula, Ivana Silva; de Camargo, Antônio C M; Faljoni-Alario, Adelaide; dos Santos, Robson A S; Sinisterra, Rubén D

    2007-05-01

    This work describes chemical properties and anti-hypertensive activity of an oral pharmaceutical formulation obtained from the complexation of beta-cyclodextrin (beta-CD) with bradykinin potentiating penta peptide (BPP-5a) founded in the Bothrops jararaca poison. Physical chemistry characterizations were recorded in order to investigate the intermolecular interactions between species in complex. Circular dichroism data indicated conformational changes of BPP-5a upon complexation with beta-CD. ROESY and theoretical calculations showed a selective approximation of triptophan moiety into cavity of beta-CD. Isothermal titration calorimetry data indicated an exothermic formation of the complex, which is accomplished by reduction of entropy. The anti-hypertensive activity of the BPP-5a/beta-CD complex has been evaluated in spontaneous hypertensive rats, showing better results than pure BPP-5a. PMID:17196774

  4. Validation of Heart Failure Events in the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT Participants Assigned to Doxazosin and Chlorthalidone

    Directory of Open Access Journals (Sweden)

    Leenen Frans HH

    2002-11-01

    Full Text Available Abstract Background The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT is a randomized, double-blind, active-controlled trial designed to compare the rate of coronary heart disease events in high-risk hypertensive participants initially randomized to a diuretic (chlorthalidone versus each of three alternative antihypertensive drugs: alpha-adrenergic blocker (doxazosin, ACE-inhibitor (lisinopril, and calcium-channel blocker (amlodipine. Combined cardiovascular disease risk was significantly increased in the doxazosin arm compared to the chlorthalidone arm (RR 1.25; 95% CI, 1.17–1.33; P P Methods and Results Baseline characteristics (age, race, sex, blood pressure did not differ significantly between treatment groups (P P = 0.83. Conclusion Results of the validation process supported findings of increased heart failure in the ALLHAT doxazosin treatment arm compared to the chlorthalidone treatment arm.

  5. A retrospective comparison of cyclophosphamide plus antithymocyte globulin with cyclophosphamide plus busulfan as the conditioning regimen for severe aplastic anemia

    Directory of Open Access Journals (Sweden)

    L.V.M. Ommati

    2009-03-01

    Full Text Available Allogeneic hematopoietic stem cell transplantation (AHSCT is the treatment of choice for young patients with severe aplastic anemia (SAA. The association of antithymocyte globulin (ATG and cyclophosphamide (CY is the most frequently used conditioning regimen for this disease. We performed this retrospective study in order to compare the outcomes of HLA-matched sibling donor AHSCT in 41 patients with SAA receiving cyclophosphamide plus ATG (ATG-CY, N = 17 or cyclophosphamide plus busulfan (BU-CY, N = 24. The substitution of BU for ATG was motivated by the high cost of ATG. There were no differences in the clinical features between the two groups, including age, gender, cytomegalovirus status, ABO match, interval between diagnosis and transplant, and number of total nucleated cells infused. No differences were observed in the time to neutrophil and platelet engraftment, or in the risk of veno-occlusive disease and hemorrhage. However, there was a higher risk of mucositis in the BU-CY group (71 vs 24%, P = 0.004. There were no differences in the incidence of neutrophil and platelet engraftment, acute and chronic graft-versus-host disease, and transplant-related mortality. There was a higher incidence of late rejection in the ATG-CY group (41 vs 4%, P = 0.009. Although the ATG-CY group had a longer follow-up (101 months than the BU-CY group (67 months, P = 0.04, overall survival was similar between the groups (69 vs 58%, respectively, P = 0.32. We conclude that the association BU-CY is a feasible option to the conventional ATG-CY regimen in this population.

  6. Probiotics Blunt the Anti-Hypertensive Effect of Blueberry Feeding in Hypertensive Rats without Altering Hippuric Acid Production.

    Directory of Open Access Journals (Sweden)

    Cynthia Blanton

    Full Text Available Previously we showed that feeding polyphenol-rich wild blueberries to hypertensive rats lowered systolic blood pressure. Since probiotic bacteria produce bioactive metabolites from berry polyphenols that enhance the health benefits of berry consumption, we hypothesized that adding probiotics to a blueberry-enriched diet would augment the anti-hypertensive effects of blueberry consumption. Groups (n = 8 of male spontaneously hypertensive rats were fed one of four AIN '93G-based diets for 8 weeks: Control (CON; 3% freeze-dried wild blueberry (BB; 1% probiotic bacteria (PRO; or 3% BB + 1% PRO (BB+PRO. Blood pressure was measured at weeks 0, 2, 4, 6, and 8 by the tail-cuff method, and urine was collected at weeks 4 and 8 to determine markers of oxidative stress (F2-isoprostanes, nitric oxide synthesis (nitrites, and polyphenol metabolism (hippuric acid. Data were analyzed using mixed models ANOVA with repeated measures. Diet had a significant main effect on diastolic blood pressure (p = 0.046, with significantly lower measurements in the BB- vs. CON-fed rats (p = 0.035. Systolic blood pressure showed a similar but less pronounced response to diet (p = 0.220, again with the largest difference between the BB and CON groups. Absolute increase in blood pressure between weeks 0 and 8 tended to be smaller in the BB and PRO vs. CON and BB+PRO groups (systolic increase, p = 0.074; diastolic increase, p = 0.185. Diet had a significant main effect on hippuric acid excretion (p<0.0001, with 2- and ~1.5-fold higher levels at weeks 4 and 8, respectively, in the BB and BB+PRO vs. PRO and CON groups. Diet did not have a significant main effect on F2-isoprostane (p = 0.159 or nitrite excretion (p = 0.670. Our findings show that adding probiotics to a blueberry-enriched diet does not enhance and actually may impair the anti-hypertensive effect of blueberry consumption. However, probiotic bacteria are not interfering with blueberry polyphenol metabolism into hippuric

  7. Tailored antihypertensive drug therapy prescribed to older women attenuates circulating levels of interleukin-6 and tumor necrosis factor-α

    Directory of Open Access Journals (Sweden)

    Toledo JO

    2015-01-01

    Full Text Available Juliana O Toledo,1 Clayton F Moraes,2,3 Vinícius C Souza,2 Audrey C Tonet-Furioso,2 Luís CC Afonso,4 Cláudio Córdova,3 Otávio T Nóbrega1,2 1Graduate Program in Health Sciences, 2Graduate Program in Medical Sciences, University of Brasília, Brasília, 3Graduate Program in Gerontology, Catholic University of Brasília, Brasília, 4Research Center in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil Objective: To test the hypothesis that antihypertensive drug therapy produces anti-inflammatory effects in clinical practice, this study investigated circulating levels of selected proinflammatory mediators (interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α], and interferon-γ [INF-γ] in response to multivariate drug directions for blood pressure (BP control.Methods: Prospective study involving 110 hypertensive, community-dwelling older women with different metabolic disorders. A short-term BP-lowering drug therapy was conducted according to current Brazilian guidelines on hypertension, and basal cytokine levels were measured before and after intervention.Results: Interventions were found to represent current hypertension-management practices in Brazil and corresponded to a significant reduction in systolic and diastolic BP levels in a whole-group analysis, as well as when users and nonusers of the most common therapeutic classes were considered separately. Considering all patients, mean IL-6 and TNF-α levels showed a significant decrease in circulating concentrations (P<0.01 at the endpoint compared with baseline, whereas the mean INF-γ level was not significantly different from baseline values. In separate analyses, only users of antagonists of the renin–angiotensin system and users of diuretics exhibited the same significant treatment-induced reduction in serum IL-6 and TNF-α observed in the whole group.Conclusion: Our data demonstrates that a clinically guided antihypertensive treatment is effective in

  8. Prevalence of residual left ventricular structural changes after one year of antihypertensive treatment in patients of African descent: role of 24-hour pulse pressure

    OpenAIRE

    Essop, Mohammed R; Libhaber, Carlos D; Candy, Geoffrey P; Libhaber, Elena N; Norton, Gavin R.; Woodiwiss, Angela J; Sareli, Pinhas

    2012-01-01

    Objectives One year of antihypertensive therapy may normalise left ventricular (LV) structure in 51% of hypertensive patients of European descent. Whether similar effects can be achieved in patients of African descent, who have a high prevalence of concentric LV hypertrophy (LVH) and remodelling, is unknown. Methods In 103 hypertensive patients in the Baragwanath Hypertension study we evaluated the prevalence of residual LV structural changes (echocardiography) after four and 13 months of ste...

  9. Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS):a partial-factorial randomised controlled trial

    OpenAIRE

    Bath, Philip M. W.; Woodhouse, Lisa; Scutt, Polly; Krishnan, Kailash; Wardlaw, Joanna M; Bereczki, Daniel; Sprigg, Nikola; Berge, Eivind; Beridze, Maia; Caso, Valeria; Chen, Christopher; Christensen, Hanne; Collins, Ronan; El Etribi, Anwar; Laska, Ann Charlotte

    2015-01-01

    BACKGROUND: High blood pressure is associated with poor outcome after stroke. Whether blood pressure should be lowered early after stroke, and whether to continue or temporarily withdraw existing antihypertensive drugs, is not known. We assessed outcomes after stroke in patients given drugs to lower their blood pressure.METHODS: In our multicentre, partial-factorial trial, we randomly assigned patients admitted to hospital with an acute ischaemic or haemorrhagic stroke and raised systolic blo...

  10. In-vitro study of the effect of anti-hypertensive drugs on placental hormones and angiogenic proteins synthesis in pre-eclampsia.

    Directory of Open Access Journals (Sweden)

    Subrata Gangooly

    Full Text Available INTRODUCTION: Antihypertensive drugs lower the maternal blood pressure in pre-eclampsia (PE by direct or central vasodilatory mechanisms but little is known about the direct effects of these drugs on placental functions. OBJECTIVE: The aim of our study is to evaluate the effect of labetolol, hydralazine, α-methyldopa and pravastatin on the synthesis of placental hormonal and angiogenic proteins know to be altered in PE. DESIGN: Placental villous explants from late onset PE (n = 3 and normotensive controls (n = 6 were cultured for 3 days at 10 and 20% oxygen (O2 with variable doses anti-hypertensive drugs. The levels of activin A, inhibin A, human Chorionic Gonadotrophin (hCG, soluble fms-like tyrosine kinase-1 (sFlt-1 and soluble endoglin (sEng were measured in explant culture media on day 1, 2 and 3 using standard immunoassays. Data at day 1 and day 3 were compared. RESULTS: Spontaneous secretion of sEndoglin and sFlt-1 were higher (p < 0.05 in villous explants from PE pregnancies compared to controls. There was a significant time dependent decrease in the secretion of sFlt-1 and sEndoglin in PE cases, which was seen only for sFlt-1 in controls. In both PE cases and controls the placental protein secretions were not affected by varying doses of anti-hypertensive drugs or the different O2 concentration cultures, except for Activin, A which was significantly (p < 0.05 higher in controls at 10% O2. INTERPRETATION: Our findings suggest that the changes previously observed in maternal serum hormones and angiogenic proteins level after anti-hypertensive treatment in PE could be due to a systemic effect of the drugs on maternal blood pressure and circulation rather than a direct effect of these drugs on placental biosynthesis and/or secretion.

  11. Factors associated with the use of hypoglycemic and antihypertensive drugs among the elderly, living in a south-eastern capital city of Brazil

    OpenAIRE

    Gontijo, Mônica F.; Andréia Q. Ribeiro; Carlos H. Klein; Rozenfeld, Suely; Francisco A. Acurcio

    2012-01-01

    Age-related transformations make the elderly more susceptible to medicine adverse events, and knowledge of factors associated with drug use are essential to develop national strategies of prescription. To estimate the prevalence of use of antihypertensive and hypoglycemic agents and investigate the factors associated with their consumption. Household survey among 667 elderly living in Belo Horizonte/MG, interviewed regarding socio-demographic indicator of health conditions and medication use....

  12. Gastric S-nitrosothiol formation drives the antihypertensive effects of oral sodium nitrite and nitrate in a rat model of renovascular hypertension.

    Science.gov (United States)

    Pinheiro, Lucas C; Amaral, Jefferson H; Ferreira, Graziele C; Portella, Rafael L; Ceron, Carla S; Montenegro, Marcelo F; Toledo, Jose Carlos; Tanus-Santos, Jose E

    2015-10-01

    Many effects of nitrite and nitrate are attributed to increased circulating concentrations of nitrite, ultimately converted into nitric oxide (NO(•)) in the circulation or in tissues by mechanisms associated with nitrite reductase activity. However, nitrite generates NO(•) , nitrous anhydride, and other nitrosating species at low pH, and these reactions promote S-nitrosothiol formation when nitrites are in the stomach. We hypothesized that the antihypertensive effects of orally administered nitrite or nitrate involve the formation of S-nitrosothiols, and that those effects depend on gastric pH. The chronic effects of oral nitrite or nitrate were studied in two-kidney, one-clip (2K1C) hypertensive rats treated with omeprazole (or vehicle). Oral nitrite lowered blood pressure and increased plasma S-nitrosothiol concentrations independently of circulating nitrite levels. Increasing gastric pH with omeprazole did not affect the increases in plasma nitrite and nitrate levels found after treatment with nitrite. However, treatment with omeprazole severely attenuated the increases in plasma S-nitrosothiol concentrations and completely blunted the antihypertensive effects of nitrite. Confirming these findings, very similar results were found with oral nitrate. To further confirm the role of gastric S-nitrosothiol formation, we studied the effects of oral nitrite in hypertensive rats treated with the glutathione synthase inhibitor buthionine sulfoximine (BSO) to induce partial thiol depletion. BSO treatment attenuated the increases in S-nitrosothiol concentrations and antihypertensive effects of oral nitrite. These data show that gastric S-nitrosothiol formation drives the antihypertensive effects of oral nitrite or nitrate and has major implications, particularly to patients taking proton pump inhibitors. PMID:26159506

  13. Antiretroviral regimen and suboptimal medication adherence are associated with low-level human immunodeficiency virus viremia.

    Science.gov (United States)

    Konstantopoulos, Christina; Ribaudo, Heather; Ragland, Kathleen; Bangsberg, David R; Li, Jonathan Z

    2015-01-01

    Episodes of human immunodeficiency virus low-level viremia (LLV) are common in the clinical setting, but its association with antiretroviral therapy (ART) regimen and adherence remains unclear. Antiretroviral therapy adherence was evaluated in participants of the Research on Access to Care in the Homeless cohort by unannounced pill counts. Factors associated with increased risk of LLV include treatment with a protease inhibitor (PI)-based regimen (ritonavir-boosted PI vs nonnucleoside reverse-transcriptase inhibitor: adjusted hazard ratio [HR], 3.1; P = .01) and lower ART adherence over the past 3 months (HR, 1.1 per 5% decreased adherence, adjusted; P = .050). Patients with LLV may benefit from ART adherence counseling and potentially regimen modification. PMID:25884007

  14. Poor response to tuberculosis treatment with regimens without rifampicin in immunosuppressed AIDS patients

    Directory of Open Access Journals (Sweden)

    O'Donnel M.M.

    2002-01-01

    Full Text Available A prospective study was conducted on 79 advanced immunosuppressed AIDS patients from 1997 to 1999, during which nine cases of tuberculosis (TB were diagnosed. The main clinical and laboratory characteristics and the response to TB treatment were reviewed. The clinical manifestations of TB were: pulmonary (six cases, extrapulmonary (two cases and disseminated (one case. These patients were being treated with highly active antiretroviral treatment (HAART and were not responding. In three cases an optional regimen without rifampicin (RMP was indicated to maintain HAART during TB treatment. A clinical response to TB treatment (disappearance of fever was observed in 6/9 patients during a mean of 73 days (SD = 96. The three unresponsive patients were those treated without RMP. A switch to TB regimens containing RMP was proposed and successful. In our study, though it was limited by a small sample size, the response to TB regimens without rifampin was poor in immunossupressed patients failing HAART.

  15. Treatment regimens for rifampicin-resistant tuberculosis: highlighting a research gap.

    Science.gov (United States)

    Stagg, H R; Hatherell, H-A; Lipman, M C; Harris, R J; Abubakar, I

    2016-07-01

    Treatment guidance for non-multidrug-resistant (MDR) rifampicin-resistant (RMP-R) tuberculosis (TB) is variable. We aimed to undertake a systematic review and meta-analysis of the randomised controlled trial (RCT) data behind such guidelines to identify the most efficacious treatment regimens. Ovid MEDLINE, the Web of Science and EMBASE were mined using search terms for TB, drug therapy and RCTs. Despite 12 604 records being retrieved, only three studies reported treatment outcomes by regimen for patients with non-MDR RMP-R disease, preventing meta-analysis. Our systematic review highlights a substantial gap in the literature regarding evidence-based treatment regimens for RMP-R TB. PMID:27287636

  16. Comparative Effectiveness of First Antiretroviral Regimens in Clinical Practice Using a Causal Approach.

    Science.gov (United States)

    Cuzin, Lise; Pugliese, Pascal; Allavena, Clotilde; Katlama, Christine; Cotte, Laurent; Cheret, Antoine; Cabié, André; Rey, David; Chirouze, Catherine; Bani-Sadr, Firouze; Flandre, Philippe

    2015-09-01

    The objective of this study was to estimate the cumulative incidences of failure by months 12 (M12) and 24 (M24) for the most prescribed first-line anti-retroviral regimens (ART). It is retrospective analysis of a prospectively collected database. All patients who initiated their first ART with the most prescribed regimens between 1st January 2004 and 30th June 2013 in 12 large HIV reference centers in France were included. The outcome was treatment failure--defined by any treatment modification for virological or tolerability reasons--and comparisons between regimens were carried out at M12 and M24. Adjusted and weighted methods via the propensity score (PS) were used to compare the effectiveness of the first antiretroviral regimens. Potential confounders of the treatment-outcome association were used to estimate PS with multinomial logistic regression. Overall, 3128 and 2690 patients were included in the M12 and M24 analyses, respectively. Patients received 5 different regimens (ABC/3TC with ATV/r or DRV/r, TDF/FTC with ATV/r, DRV/r, or EFV). Failure was reported in 25% and 42% at M12 and M24, respectively. Patients who received TDF/FTC/EFV had a significantly higher proportion of failure at M12 by comparison with TDF/FTC with DRV/r (reference), but not at M24. Patients in the 3 other groups had a trend toward a higher proportion of failure at M12 although not statistically significant. No difference was found at M24. Using data from a large prospective cohort, we found that boosted atazanavir and darunavir had comparable effectiveness, whatever the associated NRTIs, whereas efavirenz-based regimens were relatively less performing on the short term. PMID:26426666

  17. Sterilizing activity of second-line regimens containing TMC207 in a murine model of tuberculosis.

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    Nicolas Veziris

    Full Text Available RATIONALE: The sterilizing activity of the regimen used to treat multidrug resistant tuberculosis (MDR TB has not been studied in a mouse model. OBJECTIVE AND METHODS: Swiss mice were intravenously inoculated with 6 log10 of Mycobacterium tuberculosis (TB strain H37Rv, treated with second-line drug combinations with or without the diarylquinoline TMC207, and then followed without treatment for 3 more months to determine relapse rates (modified Cornell model. MEASUREMENTS: Bactericidal efficacy was assessed by quantitative lung colony-forming unit (CFU counts. Sterilizing efficacy was assessed by measuring bacteriological relapse rates 3 months after the end of treatment. MAIN RESULTS: The relapse rate observed after 12 months treatment with the WHO recommended MDR TB regimen (amikacin, ethionamide, pyrazinamide and moxifloxacin was equivalent to the relapse rate observed after 6 months treatment with the recommended drug susceptible TB regimen (rifampin, isoniazid and pyrazinamide. When TMC207 was added to this MDR TB regimen, the treatment duration needed to reach the same relapse rate dropped to 6 months. A similar relapse rate was also obtained with a 6-month completely oral regimen including TMC207, moxifloxacin and pyrazinamide but excluding both amikacin and ethionamide. CONCLUSIONS: In this murine model the duration of the WHO MDR TB treatment could be reduced to 12 months instead of the recommended 18-24 months. The inclusion of TMC207 in the WHO MDR TB treatment regimen has the potential to further shorten the treatment duration and at the same time to simplify treatment by eliminating the need to include an injectable aminoglycoside.

  18. Short communication: Measuring the angiotensin-converting enzyme inhibitory activity of an 8-amino acid (8mer) fragment of the C12 antihypertensive peptide.

    Science.gov (United States)

    Paul, Moushumi; Phillips, John G; Renye, John A

    2016-05-01

    An 8-AA (8mer) fragment (PFPEVFGK) of a known antihypertensive peptide derived from bovine αS1-casein (C12 antihypertensive peptide) was synthesized by microwave-assisted solid-phase peptide synthesis and purified by reverse phase HPLC. Its ability to inhibit angiotensin-converting enzyme (ACE) was assessed and compared with that of the parent 12mer peptide (FFVAPFPEVFGK) to determine the effect of truncating the sequence on overall hypotensive activity. The activity of the truncated 8mer peptide was found to be almost 1.5 times less active than that of the 12mer, with ACE-inhibiting IC50 (half-maximal inhibitory concentration) values of 108 and 69μM, for the 8mer and 12mer, respectively. Although the 8mer peptide is less active than the original 12mer peptide, its overall activity is comparable to activities reported for other small proteins that elicit physiological responses within humans. These results suggest that microbial degradation of the 12mer peptide would not result in a complete loss of antihypertensive activity if used to supplement fermented foods and that the stable 8mer peptide could have potential as a blood pressure-lowering agent for use in functional foods. PMID:26971162

  19. Effects of antihypertensive drugs losartan and levamlodipine besylate on insulin resistance in patients with essential hypertension combined with isolated impaired fasting glucose.

    Science.gov (United States)

    Xiao, Wei-Yin; Ning, Ning; Tan, Ming-Hong; Jiang, Xue-Shu; Zhou, Liang; Liu, Ling; Yi, Dong; Wei, Ping

    2016-05-01

    The objective of this study was to observe the antihypertensive effect of losartan and levamlodipine besylate on insulin resistance in patients with essential hypertension (EH) combined with isolated impaired fasting glucose (i-IFG). Patients (n=244) were randomly assigned to losartan potassium tablets (50-100 mg per day) or levamlodipine besylate tablets (2.5-5.0 mg per day) for intensive antihypertensive treatment with no lifestyle interventions for 3 years. The changes in fasting plasma glucose, fasting insulin (FINS) and insulin sensitivity index (ISI) from before to after treatment were observed. Blood pressure (BP) in each group was significantly reduced by treatment (P0.05). The incidence of new-onset diabetes mellitus was not significantly different between two groups. The antihypertensive effect of losartan and levamlodipine besylate could amoliorate insulin resistance in patients with EH combined with i-IFG. The improvement of insulin resistance by losartan potassium at 12 months might be better than that by levamlodipine besylate; however, after 24 and 36 months of follow-up, both agents significantly alleviated insulin resistance. These results suggest that the effects of these two drugs on insulin resistance are not significantly different. PMID:26763851

  20. [Should hypertensive patients adapt their antihypertensive drugs during high altitude exposure?].

    Science.gov (United States)

    Wuerzner, G; Allemann, Y

    2015-09-01

    High altitude exposure during leisure time is becoming more and more frequent. Due to the high prevalence of hypertension in the general population, high altitude exposure in hypertensive patients may not be uncommon. The increase in blood pressure with altitude has been confirmed by ambulatory blood pressure measurement in normotensive as well as in hypertensive patients. Compared to a placebo, most hypertensive drugs keep their blood pressure lowering effect up to a certain altitude. It is recommended that hypertensive patients measure their blood pressure during high altitude, exposure and plan a possible adaptation of treatment with their physician before their sojourn. PMID:26540993

  1. Application of Radial Basis Network Model for HIV/AIDs Regimen Specifications

    CERN Document Server

    Balasubramanie, P

    2009-01-01

    HIV/AIDs Regimen specification one of many problems for which bioinformaticians have implemented and trained machine learning methods such as neural networks. Predicting HIV resistance would be much easier, but unfortunately we rarely have enough structural information available to train a neural network. To network model designed to predict how long the HIV patient can prolong his/her life time with certain regimen specification. To learn this model 300 patient's details have taken as a training set to train the network and 100 patients medical history has taken to test this model. This network model is trained using MAT lab implementation.

  2. Increased risk of breast cancer following different regimens of hormone replacement therapy frequently used in Europe

    DEFF Research Database (Denmark)

    Stahlberg, Claudia; Pedersen, Anette Tønnes; Lynge, Elsebeth;

    2004-01-01

    Epidemiologic studies have shown an increased risk of breast cancer following hormone replacement therapy (HRT). The aim of this study was to investigate whether different treatment regimens or the androgenecity of progestins influence the risk of breast cancer differently. The Danish Nurse Cohort...... was established in 1993, where all female nurses aged 45 years and above received a mailed questionnaire (n = 23,178). A total of 19,898 women returned the questionnaire (86%). The questionnaire included information on HRT types and regimens, reproductive history and lifestyle-related factors. Breast cancer cases...

  3. A randomized trial evaluating a block-replacement regimen during radioiodine therapy

    DEFF Research Database (Denmark)

    Bonnema, Steen J; Grupe, Peter; Boel-Jørgensen, Henrik;

    2011-01-01

    Eur J Clin Invest 2010 ABSTRACT: Background  Lack of consensus regarding the antithyroid drug regimen in relation to radioiodine ((131) I) therapy of hyperthyroidism prompted this randomized trial comparing two strategies. Design  Patients with Graves' disease (GD, n = 51) or toxic nodular goitre...... (TNG, n = 49) were randomized to (131) I either 8 days following discontinuation of methimazole (-BRT, n = 52, median dose: 5 mg) or while on a continuous block-replacement regimen (+BRT, n = 48, median dose 15 mg methimazole and 100 μg levothyroxine). Results  Patients in the +BRT group required more...

  4. PHARMACOECONOMIC ASSESSMENT OF USING INTERFERON-FREE REGIMENS FOR CHRONIC HEPATITIS C AFTER LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    A. A. Sukhoruk

    2016-01-01

    Full Text Available This article contains analysis of current combination treatment regimens for chronic hepatitis C after liver transplantation. Antiviral therapy with long-acting interferons and ribavirin is of low efficiency and high costs. The clinical and economic benefits of interferon-free treatment regimen for patients infected with genotype 1 HCV using dasabuvir, paritaprevir boosted with ritonavir, ombitasvir (Viekira Pak and ribavirin have been shown. Registration and introduction into clinical practice of new direct-acting antiviral drugs will significantly expand the arsenal of tools for the treatment of recurrent HCV infections, in particular in patients infected with hepatitis C virus genotypes 2 and 3. 

  5. Antiretroviral therapy in HIV-infected patients: a proposal to assess the economic value of the single-tablet regimen

    Directory of Open Access Journals (Sweden)

    Colombo GL

    2013-02-01

    Full Text Available Giorgio L Colombo,1,2 Sergio Di Matteo,2 Franco Maggiolo31University of Pavia, Department of Drug Sciences, School of Pharmacy, Pavia, Italy, 2Studi Analisi Valutazioni Economiche, Milan, Italy, 3Division of Infectious Diseases, Ospedali Riuniti, Bergamo, ItalyBackground: The aim of this study was to assess the economic value of a reduced number of pills in patients infected with the immunodeficiency virus (HIV and on highly active antiretroviral therapy by a cost-effectiveness model.Methods: An incremental cost-effectiveness analysis of efavirenz, tenofovir, and emtricitabine (TDF-FTC-EFV as a single-tablet regimen versus a multipill regimen, with reference to untreated HIV-infected patients, was carried out from the perspective of the Italian National Health Service. The comparisons were performed with the help of a Markov decision model over a 10-year time horizon. Based on the ADONE (ADherence to ONE pill study, it was then possible to identify the utility score increment in patients switching from a multipill regimen of TDF-FTC + EFV therapy to a single-tablet regimen.Results: The single-tablet regimen (0.755 quality-adjusted life-years [QALYs]/year resulted in better patient quality of life, with a higher number of QALYs than for the TDF-FTC + EFV multipill regimen (0.716 QALYs/year. The single-tablet regimen was the most cost-effective treatment strategy, with an incremental cost-effectiveness ratio of €22,017.00 versus €26,558.00 for the multipill regimen. A 24% decrease in cost of the multipill regimen determined equivalence with the single-tablet regimen in terms of the incremental cost-effectiveness ratio. Univariate sensitivity and probabilistic analysis carried out on the main variables did not highlight significant variations with respect to the base case scenario.Conclusion: The single-tablet regimen resulted in better adherence, and therefore better quality of life as perceived by patients, corresponding to a €4541.00 lower

  6. Antihypertensive Efficacy of Carvedilol and Amlodipine in Patients of Mild to Moderate Hypertension – A Comparative Study.

    Directory of Open Access Journals (Sweden)

    Ujala Verma, Gulshan Bano, Mohan Lal, B. Kapoor, P. Sharma, Rashmi Sharma

    2004-10-01

    Full Text Available In this prospective randomized parallel study, the antihypertensive effect of oral carvedilol andamlodipine was evaluated on systolic blood pressure (SBP and diastolic blood pressure(DBP inpatients of mild to moderate hypertension over a period of 12 weeks. Eighty two patients whofulfilled the inclusion criteria were randomized to receive amlodipine (n=42 5-10mg/day and carvedilol(n=40 25-50mg/day. Blood pressure was recorded in the sitting and standing position during followup visits at 2,4,8 and 12 weeks using mercury sphygmomanometer. Dosage adjustments if neededwere made at 4 and 8 weeks of study. Both carvedilol and amlodipine produced a statisticallysignificant (P<0.001 and dose related fall in SBP and DBP , which became evident at two weeks ofinitiation of therapy and continued till 12 weeks. On comparative analysis of the effect of carvedilol andamlodipine on BP, amlodipine produced a greater fall in sitting and standing SBP at all study intervals ascompared to carvedilol, with statistically significant fall at 8 and 12 weeks (P<0.01. However, the fall insitting and standing DBP was statistically comparable with both the drugs. The findings of the presentstudy indicate that carvedilol has become an alternative treatment for mild to moderate hypertension.

  7. Effect of Clonidine (an Antihypertensive Drug Treatment on Oxidative Stress Markers in the Heart of Spontaneously Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Nik Syamimi Nik Yusoff

    2013-01-01

    Full Text Available Hypertension is a risk factor for several cardiovascular diseases and oxidative stress suggested to be involved in the pathophysiology. Antihypertensive drug Clonidine action in ameliorating oxidative stress was not well studied. Therefore, this study investigate the effect of Clonidine on oxidative stress markers and nitric oxide (NO in SHR and nitric oxide synthase inhibitor, N-nitro-L-arginine methyl ester (L-NAME administered SHR. Male rats were divided into four groups [SHR, SHR+Clonidine (SHR-C, SHR+L-NAME, SHR+Clonidine+L-NAME(SHRC+L-NAME]. Rats (SHRC were administered with Clonidine (0.5 mg kg−1 day−1 from 4 weeks to 28 weeks in drinking water and L-NAME (25 mg kg−1 day−1 from 16 weeks to 28 weeks to SHRC+L-NAME. Systolic blood pressure (SBP was measured. At the end of 28 weeks, all rats were sacrificed and in their heart homogenate, oxidative stress parameters and NO was assessed. Clonidine treatment significantly enhanced the total antioxidant status (TAS (P<0.001 and reduced the thibarbituric acid reactive substances (TBARS (P<0.001 and protein carbonyl content (PCO (P<0.05. These data suggest that oxidative stress is involved in the hypertensive organ damage and Clonidine not only lowers the SBP but also ameliorated the oxidative stress in the heart of SHR and SHR+L-NAME.

  8. The novel analogue of hirsutine as an anti-hypertension and vasodilatary agent both in vitro and in vivo.

    Directory of Open Access Journals (Sweden)

    Kai Zhu

    Full Text Available In this paper, an analogue of hirsutine (compound 1 has been synthesized and evaluated as an anti-hypertension agent, which exhibits extraordinary effects on the contractile response of thoracic aorta rings from male SD rats in vitro (IC50 = 1.129×10(-9±0.5025 and the abilities of reducing the systolic blood pressure (SBP and heart rate (HR of SHR in vivo. The mechanism investigation reveals that the vasodilatation induced by compound 1 is mediated by both endothelium-dependent and -independent manners. The relaxation in endothelium-intact aortic rings induced by compound 1 can be inhibited by L-NAME (1×10(-6 mol•L(-1 and ODQ (1×10(-6 mol•L(-1. Moreover, compound 1 can also block Ca2+ influx through L-type Ca2+ channels and inhibit intracellular Ca2+ release while no effect on K+ channel has been observed. All these data demonstrated that the NO/cyclic GMP pathway can be involved in endothelium-dependent manner induced by compound 1. Meanwhile the mechanism on the vasodilatation of compound 1 probably also related to blockade of Ca2+ influx through L-type Ca2+ channels and inhibition of intracellular Ca2+ release may have no relationship with K+ channels.

  9. Occurrence and fate of select psychoactive pharmaceuticals and antihypertensives in two wastewater treatment plants in New York State, USA.

    Science.gov (United States)

    Subedi, Bikram; Kannan, Kurunthachalam

    2015-05-01

    The fates of psychoactive pharmaceuticals, including two antischizophrenics, six sedative-hypnotic-anxiolytics, four antidepressants, four antihypertensives, and their select metabolites, were determined in two wastewater treatment plants (WWTPs) in the Albany area of New York. All target psychoactive pharmaceuticals and their metabolites were found at a mean concentration that ranged from 0.98 (quetiapine) to 1220 ng/L (atenolol) in wastewater and from 0.26 (lorazepam) to 1490 ng/g dry weight (sertraline) in sludge. In this study, the fraction of psychoactive pharmaceuticals that was sorbed to suspended particulate matter (SPM) was calculated for the first time. Over 50% of the total mass of aripiprazole, norquetiapine, norsertraline, citalopram, desmethyl citalopram, propranolol, verapamil, and norverapamil was found sorbed to SPM in the influent. The mass loadings, i.e., influx, of target psychoactive pharmaceuticals in WWTPs ranged from 0.91 (diazepam) to 347 mg/d/1000 inhabitants (atenolol), whereas the environmental emissions ranged from 0.01 (dehydro-aripiprazole) to 316 mg/d/1000 inhabitants (atenolol). The highest calculated removal efficiencies were found for antischizophrenics (quetiapine=88%; aripiprazole=71%). However, the removal of some psychoactive pharmaceuticals through adsorption onto sludge was minimal (<1% of the initial mass load), which suggests that bio-degradation and/or chemical-transformation are the dominant mechanisms of removal of these pharmaceuticals in WWTPs. PMID:25666287

  10. Antihypertensive effect of angiotensin i converting enzyme-inhibitory peptide from hydrolysates of Bigeye tuna dark muscle, Thunnus obesus.

    Science.gov (United States)

    Qian, Zhong-Ji; Je, Jae-Young; Kim, Se-Kwon

    2007-10-17

    Angiotensin I converting enzyme (ACE) inhibitory peptide was isolated from tuna dark muscle hydrolysate prepared by alcalase, neutrase, pepsin, papain, alpha-chymotrypsin, and trypsin, respectively. Among hydrolysates, the pepsin-derived hydrolysate exhibited the highest ACE I inhibitory activity versus those of other enzyme hydrolysates. The structure of the peptide was identified to be Trp-Pro-Glu-Ala-Ala-Glu-Leu-Met-Met-Glu-Val-Asp-Pro (molecular weight 1581 Da) by time of flight mass spectrometry/mass spectrometry analysis, and the IC 50 value of the peptide was 21.6 microM. The Lineweaver-Burk plots revealed that the peptide acts as a noncompetitive inhibitor, and the inhibitor constant ( K i) was calculated as 26.6 microM using the secondary plots. The peptide had an antihypertensive effect according to the time-course measurement after oral administration to spontaneously hypertensive rats. Maximal reduction was detected 3 h after oral administration at a dose of 10 mg/kg of body weight. These results suggest that the peptide derived from tuna dark muscle would be a beneficial ingredient for functional food or pharmaceuticals against hypertension and its related diseases. PMID:17894458

  11. Reduction of left ventricular mass by short-term antihypertensive treatment with isradipine: a double-blind comparison with enalapril.

    Science.gov (United States)

    Galderisi, M; Celentano, A; Garofalo, M; Tammaro, P; Oliviero, M; Petrocelli, A; de Divitiis, O

    1994-06-01

    The aim of the present study was to evaluate the effect of dihydropyridine calcium antagonist isradipine on left ventricular (LV) structure and function in patients with essential hypertension. Cuff blood pressure and Doppler echocardiographic variables were assessed in 26 patients with mild to moderate hypertension (diastolic blood pressure range 95-110 mmHg) before and after 12 weeks of therapy with either isradipine 5 mg daily or enalapril 20 mg daily. The study was of double-blind, parallel design, with a placebo run-in period of 15 days. Three subjects withdrew from isradipine treatment because of flushing and 2 from enalapril treatment due to cough before completing the study. Both drugs significantly reduced cuff systolic and diastolic blood pressure (p affecting heart rate. By virtue of the decrease in both septal wall (p height (p < 0.001) in comparison with placebo; also LV end-systolic dimension showed a slight decrease (p < 0.05). Enalapril induced a similar reduction in LV end-systolic dimension (p < 0.05) but the changes of wall thickness and LV mass did not reach statistical significance. In conclusion, our results indicate that isradipine treatment improves LV systolic function and causes a significant reduction in LV mass. This reduction is observed early in the course of antihypertensive treatment and is effective in both patients with and without LV hypertrophy. PMID:7921533

  12. BIOASSAY-GUIDED FRACTIONATION AND ANTIHYPERTENSIVE PROPERTIES OF FRACTIONS AND CRUDE EXTRACTS OF PERISTROPHE BICALYCULATA (RETZ) NEES.

    Science.gov (United States)

    Abdulazeez, Mansurah A; Ibrahim, Sani; Ameh, Danladi A; Ameh, Danladi Amodu; Ayo, Joseph O; Carvalho, Luiz J C B; Manosroi, Jiradej; Ibrahim, Abdulrazak B

    2015-01-01

    Hypertension is an important public health issue in both developed and developing countries due to its high incidence and morbidity. This has motivated researchers especially in developing countries to search for strategies for the treatment using different plant parts. The use of the aqueous decoction of the leaves of Peristiophe bicalyculata in the treatment of hypertension has been documented. This study was designed to carry out a bioassay-guided isolation of the antihypertensive components of the leaves of Peristrophe bicalyculata in L-NAME hypertensive rats, determine the angiotensin-converting enzyme inhibitory activity of the extracts and fractions obtained and identify the constituent(s) present. From our results, L-NAME hypertensive rats given the cold water extract had significantly (p present work demonstrates the hypotensive effect of the cold water extract of Peiistiophe bicalyculata on L-NAME hypertensive rats, which further justifies the folkloric application of extracts of the plant in the management as well as treatment of hypertension. PMID:26642682

  13. COMPARATIVE EFFICACY OF LONG-TERM ANTIHYPERTENSIVE MONOTHERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION AT THE WORK PLACE

    Directory of Open Access Journals (Sweden)

    О. N. Antropova

    2016-01-01

    Full Text Available Aim. To compare effects of 12-month monotherapy with nebivolol, enalapril and indapamide on blood pressure (BP, left ventricular hypertrophy and quality of life in the locomotive engineers and their assistants with stress-associated hypertension at the work place (HTwp.Material and methods. 96 locomotive engineers (20- 53 y.o and their assistants with HTwp were observed. The patients were randomized to receive nebivolol (1 group, enalapril (2 group or indapamide (3 group. 24-hour BP monitoring, echocardiography and quality of life interview with SF–36 questionnaire were performed at the start and after 12 months of the treatment.Results. Long-term therapy lead to achievement of target BP level, improved quality of life and reduced in left ventricular hypertrophy in patients with HTwp. Nebivolol reduced systolic “BP load” more significantly than indapamide did, exerted favorable influence on circadian BP rhythm and reduced heart rate. Monotherapy with nebivolol showed benefits in effect on quality of life.Conclusion. Nebivolol has some advantages in comparison with indapamide and enalapril in antihypertensive therapy of patients with stress-associated HT.

  14. Péptidos antihipertensivos derivados de proteínas de leche y huevo Peptides with antihypertensive activity from milk and egg proteins

    Directory of Open Access Journals (Sweden)

    A. Aleixandre

    2008-08-01

    Full Text Available Algunos fragmentos de proteínas alimentarias, una vez liberados mediante hidrólisis, pueden producir un descenso del tono arterial. Son importantes los hidrolizados y péptidos provenientes de proteínas lácteas. Destacan los hidrolizados de caseína con tripsina, y los productos antihipertensivos obtenidos por fermentación de la leche con Lactobacillus helveticus. Estos productos contienen secuencias como Val-Pro-Pro (VPP e Ile-Pro-Pro (IPP, que inhiben la enzima convertidora de la angiotensina (ECA. Algunas cepas de Enterococcus faecalis también producen péptidos antihipertensivos inhibidores de la ECA. Entre estos péptidos destaca la secuencia LHLPLP. Existen asimismo péptidos e hidrolizados antihipertensivos derivados de proteínas de huevo. Podemos citar las secuencias FRADHPFL (ovokinina y RADHPF (ovokinina 2-7 con actividad vasodilatadora endotelio-dependiente, y algunos hidrolizados de clara de huevo que inhiben la ECA. Los productos mencionados podrían utilizarse como ingredientes en alimentos funcionales. Algunos han probado ya su eficacia y seguridad en pacientes hipertensos.Antihypertensive hydrolysates and peptides have been isolated from food proteins. Among them, there are of particular interest the antihypertensive casein hydrolysates, and some antihypertensive products obtained when milk was fermented by Lactobacillus helveticus. The sequences Val-Pro-Pro (VPP and Ile-Pro-Pro (IPP, with angiotensin-converting enzyme (ACE inhibitory activity, have been isolated from these fermented products. Selected Enterococcus faecalis strains can also produce milk derived peptides with ACE inhibitory and antihypertensive activities. The main of them is the sequence LHLPLP. Some studies also describe the production of antihypertensive hydrolysates and peptides from egg proteins. The sequences FRADHPFL (ovokinin and RADHPFL (ovokinin 2-7, that have shown endothelium-dependent vasodilator activity, were obtained at first. Some egg white

  15. Metabolic drug interactions - the impact of prescribed drug regimens on the medication safety.

    NARCIS (Netherlands)

    Fialova, D.; Vrbensky, K.; Topinkova, E.; Vlcek, J.; Soerbye, L.W.; Wagner, C.; Bernabei, R.

    2005-01-01

    Background and objective: Risk/benefit profile of prescribed drug regimens is unkown. Over 60% of commonly used medications interact on metabolic pathways (cytochrom P450 (CYP450), uridyl-glucuronyl tranferasis (UGT I, II) and P-glycoprotein (PGP) transport). Using an up-to-date knowledge on metabo

  16. Outcomes of Patients With Burkitt Lymphoma Older Than Age 40 Treated With Intensive Chemotherapeutic Regimens

    NARCIS (Netherlands)

    Kelly, Jennifer L.; Toothaker, Stephen R.; Ciminello, Lauren; Hoelzer, Dieter; Holte, Harald; LaCasce, Ann S.; Mead, Graham; Thomas, Deborah; Van Imhoff, Gustaaf W.; Kahl, Brad S.; Cheson, Bruce D.; Magrath, Ian T.; Fisher, Richard I.; Friedberg, Jonathan W.

    2009-01-01

    Burkitt lymphoma is a highly curable disorder when treated with modern intensive chemotherapy regimens. The majority of adult patients with Burkitt lymphoma in the United States are over age 40 years. Older patients have historically been underrepresented in published clinical trials of modern inten

  17. Treatment of nail psoriasis with a modified regimen of steroid injections

    International Nuclear Information System (INIS)

    To evaluate the efficacy of a modified regimen of intralesional steroid injection therapy for the treatment of nail psoriasis and assess the side effects of this regimen. Patients having psoriatic nail dystrophy, reporting to the skin department of Military Hospital, Rawalpindi were registered. The features accounted for were pitting, onycholysis, subungual hyperkeratosis, ridging, thickening and color change. The affected digits were scored from 0 to 3 for the severity of each of these features. Similar number of control digits was also selected. Injection of triamcinolone acetonide (10 mg/ml) was given into the nail bed and matrix following ring block anesthesia. The features were re-scored after two months. A second injection was given after 02 months if warranted by poor response. The follow-up period ranged upto 06 months. A total of 100 nails were injected in 35 subjects. Pitting was the commonest presenting feature seen in 71 digits (71%) and improved in 41 digits (57.7%). Onycholysis was seen in 37 digits (37%) and improved in 15 digits (40.5%). Subungual hyperkeratosis was seen in 57 digits (57%) and improved in all the cases. Other features like longitudinal ridging, thickening and yellow oil drop-like discoloration showed marked improvement. The side effects of this regimen were minimal and included painless subungual hematoma. The modified regimen of steroid was found to be effective and safe for the treatment of psoriatic nail deformities in this series. (author)

  18. Treatment for syphilis in antenatal care: compliance with the three dose standard treatment regimen

    OpenAIRE

    Mullick, S; Beksinksa, M; Msomi, S

    2005-01-01

    Background: In South Africa, three doses of benzathine penicillin 2.4 MU at weekly intervals are recommended for treating syphilis in pregnancy. Limited information is available on compliance with the recommended regimen, in terms of time to starting treatment, number of doses, and timing of treatment.

  19. Optimal regimen of low-dose heparin prophylaxis in gastrointestinal surgery.

    Science.gov (United States)

    Törngren, S

    1979-01-01

    Four low-dose heparin regimens were compared with respect to the postoperative frequency of deep venous thrombosis (DVT) diagnosed with the 125I-fibrinogen method and other thrombosis variables as well as to peroperative and postoperative bleeding. The study comprised 204 patients undergoing gastrointestinal surgery who received 5,000 IU of either calcium heparin or sodium heparin (Vitrum AB) subcutaneously 2 hours before the operation and either every 8 or every 12th hours afterwards for 6--8 days. DVT was diagnosed in 17 and 16% of the patients who received calcium heparin every 8th or 12th hour respectively and in 11 and 10% respectively of those given sodium heparin every 8th or 12th hour. The differences in the incidence of DVT between the four groups were not statistically significant. An 8-hourly regimen was not accompanied by more bleeding incidents than a 12-hourly regimen. Sodium heparin was associated with a significantly increased number of patients who required blood transfusion and had more bruising at the injection site. It is concluded that the safest, most practical and still effective of the four investigated low-dose heparin regimens is calcium heparin 5,000 IU/ml administered 2 hours before the operation and every 12 hours afterwards for the first postoperative week. PMID:463444

  20. Rituximab and new regimens for indolent lymphoma: a brief update from 2012 ASCO Annual Meeting

    Directory of Open Access Journals (Sweden)

    Zhao Jiangning

    2012-08-01

    Full Text Available Abstract Indolent lymphoma (IL, the second most common lymphoma, remains incurable with chemotherapy alone. While R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone remains the standard frontline regimen for diffuse Large B –cell lymphoma, the optimal chemotherapy regimen for frontline therapy of advanced IL remains uncertain. FCR (fludarabine, cyclophosphamide, rituximab has been shown to be better than fludarabine alone and fludarabine plus cyclophosphamide for IL. In FOLL05 trial, R-CHOP was compared with R-CVP (cyclophosphamide, vincristine, prednisone and R-FM (fludarabine, mitoxantrone. The study showed that R-CHOP appears to have the best risk-benefit ratio for IL. The StiL NHL1 trial showed that BR (bendamustine, rituximab has longer progression free survival and is better tolerated than R-CHOP. Long-term complications with secondary malignancies between the two regimens appear to be comparable. In this review, new combination regimens reported at 2012 ASCO annual meeting were evaluated for frontline and salvage therapy of indolent lymphoma.

  1. Evidence-Based Nursing of the 3C Therapeutic Regimen for Type 1 Diabetes.

    Science.gov (United States)

    Wu, Jianya; Zou, Ling

    2015-05-01

    The aim of this study is to explore the efficacy of the 3C therapeutic regimen for type 1 diabetes. Thirty-nine patients with type 1 diabetes, who were hospitalized from January 2013 to April 2014, were included to receive 3C therapeutic regimen. Evidence-based nursing was performed in the treatment period and the efficacy was observed 6 days after therapy. Six days after the administration of the 3C therapeutic regimen, the fasting glucose levels in all 39 patients were controlled to be 4.4-6.0 mmol/L and 2h-postprandial glucose levels to be 4.4-7.8 mmol/L. Three patients had a glucose level <3.9 mmol/L, which was corrected after adjusting the dose of insulin infusion. Evidence-based nursing was provided in the treatment period and no nursing-associated complication occurred. All patients were satisfied with the nursing service. The efficacy of the 3C therapeutic regimen for type 1 diabetes is satisfactory. The evidence-based nursing can help to ensure the efficacy and improve the quality of nursing service. PMID:25424358

  2. Plasma concentrations of caspofungin at two different dosage regimens in a patient with hepatic dysfunction

    NARCIS (Netherlands)

    van der Elst, K. C. M.; Bruggemann, R. J. M.; Rodgers, M. G. G.; Alffenaar, J. W. C.

    2012-01-01

    The currently recommended dosage regimen of caspofungin (50 mg/day) was developed for patients with invasive candidiasis. With invasive aspergillosis, successful outcomes occur in less than half the patients. We evaluate the pharmacokinetics in a patient with elevated liver enzyme levels after liver

  3. Comparative Study on Three Chemotherapeutic Regimens for the Treatment of Advanced Epithelial Ovarian Cancer

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    To investigate the best first-line chemotherapy regimen for the treatment of advanced epithelial ovarian cancer (AEOC), the efficacy of three chemotherapy regimens for treatment of the patients with AEOC in our hospital during Jan. 1992- Jan. 1999 was retrospectively analyzed. The therapeutic effects were compared with the supplement of Melphalan + Hexamethylme (PAM + HMM), cisplatin + adriamycin +cyclophosphamide or isofamide (PAC) or cisplatin + cyclophosphamide or isofamide (PC), Taxol+cisplatin (TP) combined chemotherapy after cytoreductive surgery. The results showed that the overall effective rate of TP was significantly higher than that of PAM+ HMM (P<0. 05); The complete remission rate of TP was significantly higher than that of PAM+ HMM and PAC or PC (all P<0.05);The 2-year survival rate free of tumor of TP was obviously higher than that of PAM+HMM and PAC or PC(all P<0. 05). It was concluded that the therapeutic effect of TP regimen in the treatment of AEOC was better than PAM +HMM and PAC or PC and TP regimen could be recommended currently as the preferred first-line one for the treatment of AEOC.

  4. Hematological side-effect profiles of individualized chemotherapy regimen for recurrent ovarian cancer.

    Science.gov (United States)

    Breidenbach, Martina; Rein, Daniel T; Schöndorf, Thomas; Schmidt, Torsten; König, Ellen; Valter, Markus; Kurbacher, Christian M

    2003-06-01

    The long-term results for patients with recurrent ovarian cancer (ROC) are poor. There is a need to optimize treatment strategies to improve outcome by avoiding ineffective regimens which are often associated with exacerbated side-effects. Individualized chemotherapy regimens guided by a chemosensitivity assay (ATP-tumor chemosensitivity assay) have already been used successfully to direct chemotherapy. Taking the results of this assay into account, application of drug combinations appears more advisable. Here we present a systematic evaluation of toxicities seen with individualized chemotherapy for ROC. A total of 62 patients who received 314 cycles of antineoplastic therapies were evaluated. Three single agents (topotecan, paclitaxel and gemcitabine) and five combinations (cisplatin/gemcitabine, carbopatin/gemcitabine, gemcitabine/treosulfan, mitoxantrone/paclitaxel and carboplatin/paclitaxel) were examined. With respect to myelotoxicity, most single agents except topotecan revealed favorable results in comparison to drug combinations. However, this observation lacks statistical significance. Generally, severe myelosuppression was rare. The highest incidence of leukopenia was seen in regimens with mitoxantrone/paclitaxel or gemcitabine/treosulfan, respectively. Thrombocytopenia accompanied most commonly a topotecan therapy. In the present study combination regimens tend to be more toxic than monotherapies. When response rates are comparable, empirically chosen treatment combination therapies should only be practiced in carefully planned clinical studies. PMID:12782939

  5. Effects of an Aerobic Rowing Training Regimen in Young Adults with Down Syndrome.

    Science.gov (United States)

    Varela, Ana Maria; Sardinha, Luis Bettencount; Pitetti, Kenneth H.

    2001-01-01

    Eight young adult males with Down syndrome received a 16-week rowing ergometry training regimen. Following training, no changes in cardiovascular fitness were found but participants did achieve significantly higher levels of work performance on both treadmill and rowing ergometer tests than did a control group. (Contains references.) (Author/DB)

  6. Efficacy of homecare regimens for mechanical plaque removal in managing gingivitis: a meta review

    NARCIS (Netherlands)

    F.A. van der Weijden; D.E. Slot

    2015-01-01

    Focused question Based on evidence as presented in systematic reviews what is the efficacy and safety of available homecare toothbrush regimens for mechanical plaque removal on plaque and gingivitis in adults? Material & Methods Three Internet sources were used (up to and including August 2014) to s

  7. Non comparative study on various pulse regimens (DCP, DAP and DMP in pemphigus: Our experience

    Directory of Open Access Journals (Sweden)

    Iffat Hassan

    2014-01-01

    Full Text Available Background: Pemphigus has been treated with Dexamethasone Cyclophosphamide Pulse (DCP Therapy since 1981.Various modifications have been suggested in the original regimen. These include Dexamethasone Azathioprine Pulse (DAP and Dexamethasone Methotrexate Pulse (DMP therapies. Aims: To report our experience on the noncomparative study of various Pulse regimens DCP, DAP AND DMP therapies in patients with Pemphigus. Materials and Methods: The patients were put on three regimens depending upon the situation-Conventional DCP, DAP in the reproductive age group, DMP in patients who showed prolonged Phase I more than 12 months while on DCP. Results: 30 patients were put on DCP therapy. The duration of phase I was on an average six months. Relapse was seen in 3 patients in phase IV. 12 patients on DAP therapy were considered. In Phase III 5 patients relapsed in phase IV four patients relapsed. Five patients were put on the DMP. Disease activity was poorly controlled and in three DMP was discontinued. Conclusion: DCP remains the most effective regimen with quickest onset of remission and continuance of remission. In DAP therapy fixation of dose of azathioprine at 50 mgs daily may be counterproductive. DMP does not fulfil the promise of a viable treatment option in recalcitrant pemphigus and this lacunae needs to be plugged.

  8. The physiological response of instructors and participants to three aerobics regimens.

    Science.gov (United States)

    Clapp, J F; Little, K D

    1994-08-01

    This study was designed to test the hypothesis that there are regimen-specific differences in the thermal, metabolic, and cardiovascular responses of nonpregnant women when they perform their chosen type of aerobics at their usual performance level. Thirty-six instructors and 53 participants were studied while performing their chosen aerobics regimen under simulated field conditions using oxygen consumption as the index of exercise intensity. Under these conditions no significant differences were observed in the physiological response to low impact, high impact, or step regimens. However, although their ratings of perceived exertion were lower, the participants worked at a much higher exercise intensity than the instructors (76 +/- 1 vs 62 +/- 2% VO2max). As a result they attained a higher respiratory exchange ratio (0.96 vs 0.90), rectal temperature (38.62 vs 38.12 degrees C), and blood levels of glucose (5.70 vs 4.95 mmol.l-1), lactate (3.65 vs 1.60 mmol.l-1), and norepinephrine (2656 vs 1191 pg.ml-1). We conclude that both intensity and physiological response to aerobics are individual specific not regimen specific and that participants consistently underestimate their level of performance. PMID:7968422

  9. Novel Kivexa-based regimens in early courses of treatment for HIV infection

    Directory of Open Access Journals (Sweden)

    B Conway

    2012-11-01

    Full Text Available Background: As the long-term efficacy of antiretroviral therapy regimens is confirmed, we need to identify additional combinations with long-term safety and potency, while also favoring simplicity of administration. In this light, we have undertaken a review of the use of abacavir/lamivudine (Kivexa, KVX-based regimens using integrase or CCR5 inhibitors as the third agent. Methods: A retrospective chart review was undertaken, with informed patient consent. We identified all the patients in whom KVX was prescribed (following appropriate HLA-B5701 screening with either raltegravir (RGV or maraviroc (MVC as initial therapy or as a switch from another regimen for reasons other than virologic failure. Virologic efficacy over 48 weeks was evaluated, along with specific drug-associated toxicity, adherence, and regimen modifications. Results: A total of 38 patients (5 women were evaluated, 24 on KVX/RGV, 13 on KVX/MVC, 1 on KVX/RGV/MVC. This was used as initial therapy in drug-naïve subjects in three cases, and was selected as a modification of previous (current or not therapy in 35 cases. Switches included replacement of the third agent with RGV or MVC (n=13, replacement of the NRTI backbone with KVX (n=13 or both. In all cases, the change was implemented to address a current or previous medication-associated toxicity, most commonly to address jaundice (n=8, diarrhea (n=5 or reduced renal function (n=5. Patients were predominantly MSMs (n=17 or IDUs (n=13 with a mean baseline CD4 cell count of 363 cells/mm3, and plasma viral load of 46407 copies/mL (20 with full suppression at time of study entry. At 48 weeks, 34/38 (89% achieved or maintained full suppression, with a mean CD4 count of 553 cells/mm3. Virologic failure with the development of the M184V mutation was observed in 3/4 non-suppressed patients, and a loss of CCR5 tropism and RGV resistance were observed in one case each, all in the context of reduced adherence. There were no treatment

  10. Impact of adverse events of antiretroviral treatment on regimen change and mortality in Ugandan children

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    Ntambwe Malangu

    2010-03-01

    Full Text Available Background: Outcomes of antiretroviral treatment have been documented in both developed and developing countries. It has been reported consistently that the treatment is associated with many adverse events. However, little is known about their impact on the quality of life, clinical management, and survival in children aged less than 6 years in Uganda.Objectives: The purpose of this study was to determine the prevalence of the adverse events of antiretroviral treatment, their impact on mortality and the change in regimens prescribed to children treated at Mildway Centre in Uganda.Method: A retrospective chart review was performed for children younger than 6 years, treated since the Mildway Centre was opened in 1999. In order to achieve a larger sample, the records of children treated from January 2000 to July 2005 were included in the study. A pre-tested data collection form was used to collate socio-demographic and clinical data of the patients. These included the documented adverse events, causes of death, stage of infection, duration of treatment, regimen prescribed, year of enrolment into the treatment program, as well as whether or not they were still alive. Descriptive statistics were used in the analysis of data.Results: Of the 179 children, the majority were males and had a median age of 4 years. The majority (58.8% of children had suffered from severe immune depression since they met the WHO clinical stage III and IV, 73.8% had a baseline CD4T of less than 15%. Four regimens were prescribed to the children. The most common was a regimen containing zidovudine, lamivudine, and nevirapine (34.6%, followed by a regimen containing stavudine, lamivudine, and nevirapine (27.9%. Eleven children (6.1% had their regimen changed, of which six (54.5% were due to adverse events. The prevalence of adverse events was 8%; of the 14 documented adverse events, the most common were severe anaemia (3, vomiting (3, and skin rashes (3. After 12 months on

  11. Dentine microhardness changes following conventional and alternate irrigation regimens: An in vitro study

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    Anusree Das

    2014-01-01

    Full Text Available Aim: To compare the changes in microhardness of root dentin caused by two novel irrigation regimens with conventional irrigation. Materials and Methods: Forty extracted human permanent incisor teeth were selected. Decoronated roots were separated longitudinally to get 80 specimens that were embedded in autopolymerizing acrylic resin and grounded flat with silicon carbide abrasive papers. Of these, 60 root segments without any cracks or defects were selected and divided into four groups according to the irrigation regimen used (n = 15. Group I: 5% sodium hypochlorite (NaOCl + 17% ethylenediaminetetraacetic acid (EDTA + 0.2% chlorhexidine digluconate (CHX (conventional. Group II: 6% Morinda Citrifolia Juice + 17% EDTA (MCJ. Group III: 5% NaOCl + Q Mix 2 in 1 (QMix. Group IV: Distilled water (control. Irrigation regimens were performed for 5 minutes. Dentin microhardness was measured with a Vickers indenter under a 200-g load and a 20-s dwell time at the midroot level of root dentin. The data were analyzed using Kruskal Wallis test and Dunn′s multiple comparison tests. Results: A significant difference was seen in the median values of the four groups. The control group showed the least reduction in microhardness when comparison with the other groups. Except for Group III (Q Mix, the other groups that were tested (MCJ and conventional regimens showed statistically significant difference from the control group. Conclusion: Within the limitation of this study, it was concluded that NaOCl + Q Mix were least detrimental to root dentin microhardness when compared with MCJ and conventional irrigation regimens.

  12. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Stuart A. [University College Hospital, Department of Specialist Radiology, London (United Kingdom); University College Hospital, Department of Imaging, London (United Kingdom); Slater, Andrew [John Radcliffe Hospital, Oxford (United Kingdom); Burling, David N.; Tam, Emily; Gartner, Louise; Scarth, Julia; Bassett, Paul [St Mark' s Hospital, Northwick Park (United Kingdom); Greenhalgh, Rebecca; Pearce, Robert; Halligan, Steve [University College Hospital, Department of Specialist Radiology, London (United Kingdom)

    2008-01-15

    To establish the optimum barium-based reduced-laxative tagging regimen prior to CT colonography (CTC). Ninety-five subjects underwent reduced-laxative (13 g senna/18 g magnesium citrate) CTC prior to same-day colonoscopy and were randomised to one of four tagging regimens using 20 ml 40%w/v barium sulphate: regimen A: four doses, B: three doses, C: three doses plus 220 ml 2.1% barium sulphate, or D: three doses plus 15 ml diatriazoate megluamine. Patient experience was assessed immediately after CTC and 1 week later. Two radiologists graded residual stool (1: none/scattered to 4: >50% circumference) and tagging efficacy for stool (1: untagged to 5: 100% tagged) and fluid (1: untagged, 2: layered, 3: tagged), noting the HU of tagged fluid. Preparation was good (76-94% segments graded 1), although best for regimen D (P = 0.02). Across all regimens, stool tagging quality was high (mean 3.7-4.5) and not significantly different among regimens. The HU of layered tagged fluid was higher for regimens C/D than A/B (P = 0.002). Detection of cancer (n = 2), polyps {>=}6 mm (n = 21), and {<=}5 mm (n = 72) was 100, 81 and 32% respectively, with only four false positives {>=}6 mm. Reduced preparation was tolerated better than full endoscopic preparation by 61%. Reduced-laxative CTC with three doses of 20 ml 40% barium sulphate is as effective as more complex regimens, retaining adequate diagnostic accuracy. (orig.)

  13. The Role of Health Beliefs in the Regimen Adherence and Metabolic Control of Adolescents and Adults with Diabetes Mellitus.

    Science.gov (United States)

    Brownlee-Duffeck, Martha; And Others

    1987-01-01

    Examined the role of health beliefs in diabetic regimen adherence and metabolic control. Health beliefs accounted for a statistically significant portion of the variance in both. For older patients perceived benefits of adhering to the diabetic regimen was most significant. For younger patients costs figured prominently in adherence and perceived…

  14. Rituximab in Combination with CHOP, an Effective and Well-tolerated Salvage Regimen for Diffuse Large B-Cell Lymphoma

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To evaluate the clinical effect of the R-CHOP regimen (rituximab in combination with cyclophosphamide, epirubicin, vincristine and prednisone) in treating refractory or relapsed diffuse large B-cell lymphoma (DLBCL), as a salvage therapy for DLBCL.METHODS Eighteen patients with refractory or relapsed DLBCL who were treated with the R-CHOP regimen from 2001 to 2006 in hospitals in Jilin Province were analyzed retrospectively. The response rate, change of serum lactate dehydrogenase (LDH), time to progression (TTP) and toxicity were observed.RESULTS The R-CHOP regimen can achieve a higher response rate, decrease serum LDH to a larger extent and obtain longer TTP than a conventional secondary regimen. The main adverse effects were similar to conventional chemotherapy.CONCLUSION The R-CHOP regimen is one of the most effective secondary therapies for DLBCL.

  15. PRESCRIBING PATTERN OF ANTIHYPERTENSIVES IN INDIVIDUALS WITH HYPERTENSION ALONE AND WITH COEXISTING DIABETES MELLITUS – A COMPARATIVE STUDY

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    J. Keerthi Sagar*, S. Narendranath, H.S. Somashekar, S.R. Reshma, Susheela Somappa Halemani and Prabhakar Adake

    2012-06-01

    Full Text Available Objective: Analysis of prescribing pattern of antihypertensives in patients with hypertension alone and with coexisting diabetes mellitus. Materials and Methods: A cross sectional study was conducted in an outpatient and inpatient department of general medicine at JJM Medical College hospital for a period of 3 months (July 2011 to September 2011. Prescriptions of the patients were collected and relevant data was entered in the preformed proforma and analyzed.Results: A total of 210 prescriptions were analyzed using chi square test. Out of which 126 prescriptions were of patients with hypertension alone which contain calcium channel blockers (30%, beta blockers (26%, angiotensin receptor blockers (15%, angiotensin converting enzyme inhibitors (4% and fixed dose combinations of angiotensin receptor blockers with hydrochlorothiazide (11% and combination of amlodipine with hydro-chlorothiazide (2.5%.84 Prescriptions of hypertension with coexisting diabetes mellitus had calcium channel blockers (24%, angiotensin converting enzyme inhibitors (19%, angiotensin receptor blockers (13%, beta blockers (13%, and fixed dose combinations of angiotensin receptor blockers with hydrochlorothiazide (18% and combination of amlodipine with hydrochlorothiazide (6%.[χ2=17.01, p=o.oo4] Conclusion- The present study shows that angiotensin converting enzyme inhibitors because of its beneficial effects which are well known are more commonly prescribed drugs in individuals with hypertension with coexisting diabetes mellitus. Calcium channel blockers and newly introduced angiotensin receptor blockers alone or in combination with hydrochlorothiazide are preferred drugs in both the study groups. Beta blockers are less preferred in patients of hypertension with coexisting diabetes mellitus for obvious reasons.

  16. Radical curative efficacy of tafenoquine combination regimens in Plasmodium cynomolgi-infected Rhesus monkeys (Macaca mulatta

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    Kenworthy David

    2011-07-01

    Full Text Available Abstract Background Tafenoquine is an 8-aminoquinoline being developed for radical cure (blood and liver stage elimination of Plasmodium vivax. During monotherapy treatment, the compound exhibits slow parasite and fever clearance times, and toxicity in glucose-6-phosphate dehydrogenase (G6PD deficiency is a concern. Combination with other antimalarials may mitigate these concerns. Methods In 2005, the radical curative efficacy of tafenoquine combinations was investigated in Plasmodium cynomolgi-infected naïve Indian-origin Rhesus monkeys. In the first cohort, groups of two monkeys were treated with a three-day regimen of tafenoquine at different doses alone and in combination with a three-day chloroquine regimen to determine the minimum curative dose (MCD. In the second cohort, the radical curative efficacy of a single-day regimen of tafenoquine-mefloquine was compared to that of two three-day regimens comprising tafenoquine at its MCD with chloroquine or artemether-lumefantrine in groups of six monkeys. In a final cohort, the efficacy of the MCD of tafenoquine against hypnozoites alone and in combination with chloroquine was investigated in groups of six monkeys after quinine pre-treatment to eliminate asexual parasites. Plasma tafenoquine, chloroquine and desethylchloroquine concentrations were determined by LC-MS in order to compare doses of the drugs to those used clinically in humans. Results The total MCD of tafenoquine required in combination regimens for radical cure was ten-fold lower (1.8 mg/kg versus 18 mg/kg than for monotherapy. This regimen (1.8 mg/kg was equally efficacious as monotherapy or in combination with chloroquine after quinine pre-treatment to eliminate asexual stages. The same dose of (1.8 mg/kg was radically curative in combination with artemether-lumefantrine. Tafenoquine was also radically curative when combined with mefloquine. The MCD of tafenoquine monotherapy for radical cure (18 mg/kg appears to be biologically

  17. Chinese patent medicine liu wei di huang wan combined with antihypertensive drugs, a new integrative medicine therapy, for the treatment of essential hypertension: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Wang, Jie; Yao, Kuiwu; Yang, Xiaochen; Liu, Wei; Feng, Bo; Ma, Jizheng; Du, Xinliang; Wang, Pengqian; Xiong, Xingjiang

    2012-01-01

    Objectives. To assess the beneficial and adverse effects of Liu Wei Di Huang Wan (LWDHW), combined with antihypertensive drugs, for essential hypertension. Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of LWDHW combined with antihypertensive drugs for essential hypertension reported in any language, with main outcome measures as blood pressure. The quality of the included studies was assessed with the Jadad scale and a customized standard quality assessment scale. Results. 6 randomized trials were included. The methodological quality of the trials was evaluated as generally low. The pooled results showed that LWDHW combined with antihypertensive drugs was more effective in blood pressure and the scale for TCM syndrome and symptom differentiation scores compared with antihypertensive drugs alone. Most of the trials did not report adverse events, and the safety is still uncertain. Conclusions. LWDHW combined with antihypertensive drugs appears to be effective in improving blood pressure and symptoms in patients with essential hypertension. However, the evidence remains weak due to the poor methodological quality of the included studies. PMID:23258998

  18. Chinese Patent Medicine Liu Wei Di Huang Wan Combined with Antihypertensive Drugs, a New Integrative Medicine Therapy, for the Treatment of Essential Hypertension: A Systematic Review of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2012-01-01

    Full Text Available Objectives. To assess the beneficial and adverse effects of Liu Wei Di Huang Wan (LWDHW, combined with antihypertensive drugs, for essential hypertension. Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of LWDHW combined with antihypertensive drugs for essential hypertension reported in any language, with main outcome measures as blood pressure. The quality of the included studies was assessed with the Jadad scale and a customized standard quality assessment scale. Results. 6 randomized trials were included. The methodological quality of the trials was evaluated as generally low. The pooled results showed that LWDHW combined with antihypertensive drugs was more effective in blood pressure and the scale for TCM syndrome and symptom differentiation scores compared with antihypertensive drugs alone. Most of the trials did not report adverse events, and the safety is still uncertain. Conclusions. LWDHW combined with antihypertensive drugs appears to be effective in improving blood pressure and symptoms in patients with essential hypertension. However, the evidence remains weak due to the poor methodological quality of the included studies.

  19. Trends in hypertension control among the older population of Spain from 2000 to 2001 to 2008 to 2010: Role of frequency and intensity of drug treatment

    OpenAIRE

    Banegas, José R; Navarro-Vidal, Beatriz; Luis M Ruilope; de la Cruz, Juan J.; López-García, Esther; Rodríguez-Artalejo, Fernando; Graciani, Auxiliadora

    2015-01-01

    This is the prepint version of the following article: Circulation: Cardiovascular Quality and Outcomes 8.1 (2015) , which has been published in final form at http://dx.doi.org/10.1161/CIRCOUTCOMES.114.001191 Background—The use of antihypertensive medication and hypertension control has significantly increased during recent decades in some developed countries, but the impact of improved drug treatment on blood pressure (BP) control in the population is unknown. Methods and Results—...

  20. Universal combination antiretroviral regimens to prevent mother-to-child transmission of HIV in rural Zambia: a two-round cross-sectional study

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    Benjamin H Chi

    2014-08-01

    Full Text Available Objective To evaluate if a pilot programme to prevent mother-to-child transmission (PMTCT of the human immunodeficiency virus (HIV was associated with changes in early childhood survival at the population level in rural Zambia. Methods Combination antiretroviral regimens were offered to pregnant and breastfeeding, HIV-infected women, irrespective of immunological status, at four rural health facilities. Twenty-four-month HIV-free survival among children born to HIV-infected mothers was determined before and after PMTCT programme implementation using community surveys. Households were randomly selected and women who had given birth in the previous 24 months were asked to participate. Mothers were tested for HIV antibodies and children born to HIV-infected mothers were tested for viral deoxyribonucleic acid. Multivariable models were used to determine factors associated with child HIV infection or death. Findings In the first survey (2008–2009, 335 of 1778 women (18.8% tested positive for HIV. In the second (2011, 390 of 2386 (16.3% tested positive. The 24-month HIV-free survival in HIV-exposed children was 0.66 (95% confidence interval, CI: 0.63–0.76 in the first survey and 0.89 (95% CI: 0.83–0.94 in the second. Combination antiretroviral regimen use was associated with a lower risk of HIV infection or death in children (adjusted hazard ratio: 0.33, 95% CI: 0.15–0.73. Maternal knowledge of HIV status, use of HIV tests and use of combination regimens during pregnancy increased between the surveys. Conclusion The PMTCT programme was associated with an increased HIV-free survival in children born to HIV-infected mothers. Maternal utilization of HIV testing and treatment in the community also increased.

  1. Grassland Management Regimens Reduce Small-Scale Heterogeneity and Species Diversity of β-Proteobacterial Ammonia Oxidizer Populations

    OpenAIRE

    Webster, Gordon; Embley, T Martin; Prosser, James I.

    2002-01-01

    The impact of soil management practices on ammonia oxidizer diversity and spatial heterogeneity was determined in improved (addition of N fertilizer), unimproved (no additions), and semi-improved (intermediate management) grassland pastures at the Sourhope Research Station in Scotland. Ammonia oxidizer diversity within each grassland soil was assessed by PCR amplification of microbial community DNA with both ammonia oxidizer-specific, 16S rRNA gene (rDNA) and functional, amoA, gene primers. P...

  2. Modelling and analysis of the feeding regimen induced entrainment of hepatocyte circadian oscillators using petri nets.

    Directory of Open Access Journals (Sweden)

    Samar Hayat Khan Tareen

    Full Text Available Circadian rhythms are certain periodic behaviours exhibited by living organism at different levels, including cellular and system-wide scales. Recent studies have found that the circadian rhythms of several peripheral organs in mammals, such as the liver, are able to entrain their clocks to received signals independent of other system level clocks, in particular when responding to signals generated during feeding. These studies have found SIRT1, PARP1, and HSF1 proteins to be the major influencers of the core CLOCKBMAL1:PER-CRY circadian clock. These entities, along with abstracted feeding induced signals were modelled collectively in this study using Petri Nets. The properties of the model show that the circadian system itself is strongly robust, and is able to continually evolve. The modelled feeding regimens suggest that the usual 3 meals/day and 2 meals/day feeding regimens are beneficial with any more or less meals/day negatively affecting the system.

  3. Triple Active Antiretroviral Regimen Including Enfuvirtide Via the Biojector is Effective and Safe

    Directory of Open Access Journals (Sweden)

    Mona Loutfy

    2007-01-01

    Full Text Available For full HIV virological suppression, three fully active antiretroviral agents are required. New drug classes should be included to ensure that agents are fully active. The addition of enfuvirtide and efavirenz to the present patient’s new antiretroviral regimen ensured that two fully active agents were in use in the setting of a moderate degree of nucleoside resistance and a high level of protease resistance, and where non-nucleoside reverse transcriptase inhibitors were still fully active. Both viral load and CD4 count responded favourably to this regimen. The patient received support from physicians and clinic staff in the introduction and use of enfuvirtide. To reduce injection site reactions, a needle-free injection system (Biojector proved effective.

  4. REGIMENS OF ECOLOGICAL FLOW RATES ON THE PILÓN RIVER

    Directory of Open Access Journals (Sweden)

    Juan Antonio Vidales-Contreras

    2014-08-01

    Full Text Available Two methods have been applied in this study to determine the ecological flow rates regimens of the Pilón River, in the section of the Hydrometric Station, Montemorelos, N. L., Mexico. These methods were based on hydrological indexes: minimum flow rates (Qmin to dry years and means flow rates (Qmed to wet years. The criteria proposed to evaluate the ecological flow rates regimens are: the average minimum monthly flow (min, 90% of the average minimum monthly flow (90% min and the average means monthly flow ( med of the series of registered measurements during the years 1940- 2004. These are more feasible because they are coherent with seasonal variations of the distribution of circulating flow rates for this section, taking into account that the biological riverside community has evolved with relationship to the regimes of mentioned flow rates.

  5. Irinotecan-based regimens for recurrent glioblastoma multiforme: [corrected] a systematic review.

    Science.gov (United States)

    Abdel-Rahman, Omar; Fouad, Mona

    2015-01-01

    This systematic review aims to assess irinotecan-based salvage regimens for patients with recurrent glioblastoma multiforme (GBM) beyond first line treatment. Eligible trials were identified using databases search and 25 studies were included in the final analysis. Among the 25 studies, PFS-6 rate was reported in 15 studies and it ranged from 16% to 63%. Median PFS was reported in 18 studies and it ranged from 1 to 7.6 months. While for median OS, it was reported in 17 studies and it ranged from 5.8 months to 17.9 months. The available data suggests that routine use of irinotecan-based salvage regimens cannot be recommended outside the setting of well-controlled prospective randomized studies investigating novel combinations of irinotecan. PMID:26469869

  6. An evaluation of the impact of patient cost sharing for antihypertensive medications on adherence, medication and health care utilization, and expenditures

    Directory of Open Access Journals (Sweden)

    Pesa JA

    2012-01-01

    Full Text Available Jacqueline A Pesa1, Jill Van Den Bos2, Travis Gray2, Colleen Hartsig2, Robert Brett McQueen3, Joseph J Saseen3, Kavita V Nair31Janssen Scientific Affairs, LLC, Louisville, CO, USA; 2Milliman, Inc, Denver, CO, USA; 3University of Colorado Anschutz Medical Campus, Aurora, CO, USAObjective: To assess the impact of patient cost-sharing for antihypertensive medications on the proportion of days covered (PDC by antihypertensive medications, medical utilization, and health care expenditures among commercially insured individuals assigned to different risk categories.Methods: Participants were identified from the Consolidated Health Cost Guidelines (CHCG database (January 1, 2006–December 31, 2008 based on a diagnosis (index claim for hypertension, continuous enrollment ≥12 months pre- and post-index, and no prior claims for antihypertensive medications. Participants were assigned to: low-risk group (no comorbidities, high-risk group (1+ selected comorbidities, or very high-risk group (prior hospitalization for 1+ selected comorbidities. The relationship between patient cost sharing and PDC by antihypertensive medications was assessed using standard linear regression models, controlling for risk group membership, and various demographic and clinical factors. The relationship between PDC and health care service utilization was subsequently examined using negative binomial regression models.Results: Of the 28,688 study patients, 66% were low risk. The multivariate regression model supported a relationship between patient cost sharing per 30-day fill and PDC in the following year. For every US$1.00 increase in cost sharing, PDC decreased by 1.1 days (P < 0.0001. Significant predictors of PDC included high risk, older age, gender, Charlson Comorbidity Index score, geography, and total post-index insurer- and patient-paid costs. An increase in PDC was associated with a decrease in all-cause and hypertension-related inpatient, outpatient, and emergency

  7. ANTIHYPERTENSIVE EFFICACY AND INFLUENCE ON SEXUAL FUNCTION OF VALSARTAN AND VALSARTAN AND HYDROCHLOROTHIAZIDE COMBINATION IN SMOKERS VERSUS NON-SMOKERS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    V. I. Podzolkov

    2015-09-01

    Full Text Available Aim. To study antihypertensive efficacy and safety of valsartan-based therapy as well as influence of treatment on several aspects of sexual function.Material and methods. Hypertensive patients (n=650 in 53 medical institutions of Russia were enrolled to the prospective multicenter observation study, 37.5% of smokers and 62.5% non-smokers. The evaluation of therapy efficacy was based on analysis of systolic (SBP and diastolic (DBP blood pressure (BP changes. Safety and compliance of treatment was also analyzed. The evaluation of sexual function was performed with 5 universal questions selected form the International Index of Erectile Function. These ques- tions could be asked in both men and women. The valsartan dose was 80–320 mg OD. A combination of the valsartan with hydrochlorothiazide (12.5–25 mg/d, amlodipine (5–10 mg/d or any other antihypertensive was allowed.Results. Significant similar decrease of SBP and DBP was observed in smoking and non-smoking patients (37.4/17.8 and 36.7/16.5 mm Hg respectively, р<0.01 vs baseline. Differences in SBP and DBP changes were not significant between groups. Target BP level (<140/90 mmHg was reached in 81.9% smokers and 76.0% non-smokers.After 20 weeks of treatment the number of patients without sexual activity and with 1–2 successful sexual attempts in the last 4 weeks significantly decreased from 44.7 to 32.8% and from 29.1% to 23.2%, respectively (р<0.05. Significant increase in the number of patients with 5–6 and 7–10 successful sexual attempts was observed (from 6.1 to 13.6% and from 3.2 to 5.9% respectively, р<0.05. The treatment resulted in significant increase in the number of patients, who evaluated their sexual life satisfaction as ″very satisfied″ (from 8.2 to 14.8%, <0.01.Conclusion. Comparable antihypertensive efficacy and safety were demonstrated for valsartan based therapy in smoking and non-smoking patients. During the course of treatment there was a significant

  8. Comparison of three different regimens of oral azithromycin in the treatment of acne vulgaris

    OpenAIRE

    Naieni Farahnaz; Akrami Hooman

    2006-01-01

    Background: Acne vulgaris is a common skin disease that involves pilosebaceous units. Oral antibiotics are the most widely administered drugs, which are prescribed as systemic therapy for treatment of moderate to severe acne vulgaris. Azithromycin is one of the antibiotics that has been recently used for acne treatment. There are several protocols of oral azithromycin in the treatment of acne. Objective: To compare three various regimens of oral azithromycin in the treatment of acne. Mate...

  9. Different dosing regimens of repeated ketamine administration have opposite effects on novelty processing in rats.

    Science.gov (United States)

    Schumacher, Anett; Sivanandan, Brindan; Tolledo, Edgor Cole; Woldegabriel, Jacob; Ito, Rutsuko

    2016-08-01

    Repeated exposure to sub-anesthetic doses of ketamine in rats has been shown to induce cognitive deficits, as well as behavioral changes akin to the negative symptoms of schizophrenia, giving much face validity to the use of ketamine administration as a pharmacological model of schizophrenia. This study sought to further characterize the behavioral effects of two different ketamine pre-treatment regimens, focusing primarily on the effects of repeated ketamine administration on novelty processing, a capacity that is disrupted in schizophrenia. Rats received 5 or 14 intra-peritoneal injections of 30mg/kg ketamine or saline across 5 or 7days, respectively. They were then tested in an associative mismatch detection task to examine their ability to detect novel configurations of familiar audio-visual sequences. Furthermore, rats underwent a sequential novel object and novel object location exploration task. Subsequently, rats were also tested on the delayed matching to place T-maze task, sucrose preference task and locomotor tests involving administering a challenge dose of amphetamine (AMPH). The high-dose ketamine pre-treatment regimen elicited impairments in mismatch detection and working memory. In contrast, the low-dose ketamine pre-treatment regimen improved performance of novelty detection. In addition, low-dose ketamine pre-treated rats showed locomotor sensitization following an AMPH challenge, while the high-dose ketamine pre-treated rats showed an attenuated locomotor response to AMPH, compared to control rats. These findings demonstrate that different regimens of repeated ketamine administration induce alterations in novelty processing in opposite directions, and that differential neural adaptations occurring in the mesolimbic dopamine system may underlie these effects. PMID:27064663

  10. Metabolic drug interactions - the impact of prescribed drug regimens on the medication safety.

    OpenAIRE

    Fialova, D.; Vrbensky, K.; Topinkova, E.; J. Vlcek; Soerbye, L.W.; Wagner, C; Bernabei, R.

    2005-01-01

    Background and objective: Risk/benefit profile of prescribed drug regimens is unkown. Over 60% of commonly used medications interact on metabolic pathways (cytochrom P450 (CYP450), uridyl-glucuronyl tranferasis (UGT I, II) and P-glycoprotein (PGP) transport). Using an up-to-date knowledge on metabolic drug interactions, we aimed the study to determine the medication risk of commonly prescribed drug combinations. Design: A mathematical model was created to estimate the medication risk in vario...

  11. Practical Strategies for Enhancing Adherence to Treatment Regimen in Inflammatory Bowel Disease

    OpenAIRE

    Greenley, Rachel N.; Kunz, Jennifer H.; Walter, Jennifer; Hommel, Kevin A.

    2013-01-01

    Promoting adherence to treatment among pediatric and adult patients with inflammatory bowel disease (IBD) is a critical yet challenging task for health care providers. Several existing interventions to enhance adherence among individuals with IBD offer useful information about practical strategies to enhance adherence. The current review article has 3 goals. First, the review provides a context for understanding treatment regimen adherence in IBD by reviewing key definitional, measurement, an...

  12. Which endpoints should we use in evaluating the use of novel fluoropyrimidine regimens in colorectal cancer?

    OpenAIRE

    Twelves, C. J.; Cassidy, J

    2002-01-01

    Although significant advances have been made in the treatment of advanced/metastatic colorectal cancer, 5-fluorouracil (5-FU) still forms the basis of chemotherapy. Recently, new 5-FU schedules and novel fluoropyrimidines have been developed, but there are no trials directly comparing these regimens. The current review describes the mechanisms of action, pre-clinical and phase I/II studies of two oral fluoropyrimidine therapies, capecitabine and uracil with tegafur plus leucovorin. It also co...

  13. Comparison between intramuscular and intravenous regimen of magnesium sulfate in management of severe preeclampsia and eclampsia

    Directory of Open Access Journals (Sweden)

    Vaibhav Kanti

    2015-02-01

    Conclusion:Intramuscular magnesium sulfate regimen is as safe as intravenous magnesium sulfate . Intra muscular magnesium sulfate should be given without any fear and delay in those low resource setups where monitoring only by clinical signs can be done and where patient and institute cannot bear the extra burden of monitoring serum magnesium levels at frequent intervals. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 195-201

  14. In vivo biofilm formation on stainless steel bonded retainers during different oral health-care regimens

    OpenAIRE

    Jongsma, Marije A.; van der Mei, Henny C.; Atema-Smit, Jelly; Busscher, Henk J.; Ren, Yijin

    2015-01-01

    Retention wires permanently bonded to the anterior teeth are used after orthodontic treatment to prevent the teeth from relapsing to pre-treatment positions. A disadvantage of bonded retainers is biofilm accumulation on the wires, which produces a higher incidence of gingival recession, increased pocket depth and bleeding on probing. This study compares in vivo biofilm formation on single-strand and multi-strand retention wires with different oral health-care regimens. Two-centimetre wires we...

  15. Intestinal microbiota of broiler chickens as affected by litter management regimens

    Directory of Open Access Journals (Sweden)

    Zhongtang eYu

    2016-05-01

    Full Text Available Poultry litter is a mixture of bedding materials and enteric bacteria excreted by chickens, and it is typically reused for multiple growth cycles in commercial broiler production. Thus, bacteria can be transmitted from one growth cycle to the next via litter. However, it remains poorly understood how litter reuse affects development and composition of chicken gut microbiota. In this study, the effect of litter reuse on the microbiota in litter and in chicken gut was investigated using 2 litter management regimens: fresh vs. reused litter. Samples of ileal mucosa and cecal digesta were collected from young chicks (10 days of age and mature birds (35 days of age. Based on analysis using DGGE and pyrosequencing of bacterial 16S rRNA gene amplicons, the microbiota of both the ileal mucosa and the cecal contents was affected by both litter management regimen and age of birds. Faecalibacterium, Oscillospira, Butyricicoccus, and one unclassified candidate genus closely related to Ruminococcus were most predominant in the cecal samples, while Lactobacillus was predominant in the ileal samples at both ages and in the cecal samples collected at day 10. At days 10 and 35, 8 and 3 genera, respectively, in the cecal luminal microbiota differed significantly in relative abundance between the 2 litter management regimens. Compared to the fresh litter, reused litter increased predominance of halotolerant/alkaliphilic bacteria and Faecalibacterium prausnitzii, a butyrate-producing gut bacterium. This study suggests that litter management regimens affect the chicken GI microbiota, which may impact the host nutritional status and intestinal health.

  16. Adherence with single-pill amlodipine/atorvastatin vs a two-pill regimen

    OpenAIRE

    Patel, Bimal V; Scott Leslie, R; Thiebaud, Patrick; Michael B. Nichol; Tang, Simon SK; Solomon, Henry; Honda, Dennis; Foody, JoAnne M.

    2008-01-01

    While clinical trials demonstrate the benefits of blood pressure and cholesterol reduction, medication adherence in clinical practice is problematic. We hypothesized that a single-pill would be superior to a 2-pill regimen for achieving adherence. In this retrospective, cohort study based on pharmacy claims data, patients newly initiated on a calcium channel blocker (CCB) or statin simultaneously or within 30 days, regardless of sequence, were followed (N = 4703). Adherence was measured over ...

  17. Daclatasvir-containing all-oral regimens for the treatment of hepatitis C virus infection.

    Science.gov (United States)

    Yang, Sheng-Shun; Kao, Jia-Horng

    2016-03-01

    The treatment of chronic hepatitis C is revolutionizing rapidly. The aim of this study is to review the efficacy and safety of daclatasvir (DCV)-containing all-oral regimens in clinical studies for chronic hepatitis C treatment. Using PubMed and search terms of 'DCV,' 'hepatitis C virus (HCV) treatment,' and 'HCV NS5A inhibitors,' literature on the clinical development of DCV, as well as abstracts presented at the April 2015 annual meeting of the European Association for the Study of the Liver (EASL) and November 2014 annual meeting of the American Association for the Study of Liver Diseases were reviewed. The final search was undertaken on 14 July 2015. With its potent antiviral activity to all HCV genotypes (GT) demonstrated in preclinical, phases 1-3 studies, DCV has been acting as a very competent team player in clinical trials of all-oral regimens. It is generally safe and well tolerated with a low genetic barrier to resistance and low potential for drug-drug interaction. Administered with a non-structural protein 3 (NS3) protease inhibitor (asunaprevir, ASV) with or without a non-nucleoside NS5B polymerase inhibitor (beclabuvir, BCV), or a nucleotide NS5B polymerase inhibitor (sofosbuvir, SOF), DCV is able to achieve greater than a 90-% HCV eradication rate in both treatment-naïve and treatment-experienced patients with GT 1. A triple combination regimen with DCV/ASV/BCV results in 100% sustained virologic response (SVR) rates in HCV GT 4 treatment-naïve subjects. DCV/SOF combination also had demonstrated up to 90-% SVR rates in GT 3-infected non-cirrhotic patients. The efficacy and safety of DCV-containing all-oral regimens highlight a new era of interferon-free therapy for chronic hepatitis C. PMID:26542068

  18. A meta analysis of cetuximab plus oxaliplatin based chemotherapy regimen for metastatic colorectal cancer

    Directory of Open Access Journals (Sweden)

    Y L Zhu

    2014-01-01

    Full Text Available Background: Oxaliplatin based chemotherapy regimen was one of the most used chemotherapy modality for metastatic colorectal cancer. The purpose of this meta-analysis was to assess the clinical activity and toxicities of cetuximab plus oxaliplatin-based chemotherapy regimen for metastatic colorectal Cancer. Methods: We searched the clinical studies about the cetuximab plus oxaliplatin-based chemotherapy regimen versus oxaliplatin-based chemotherapy alone for metastatic colorectal cancer in the databases of PubMed, EMBASE, Cochran, and CNKI. The data of response and toxicities were extracted and pooled by random or fixed effects model. And publication bias was evaluated by begg′s funnel plot and egger′s regression test. Results: Seven papers were included in this study. Adding cetuximab to oxaliplatin-based chemotherapy regime can significant increase response rate in K-RAS mutation metastatic colorectal patients (odds ratio [OR]: 1.45, 95% confidence interval [CI]: 1.17-1.80, Z = 3.38, P = 0.001 and metastatic colorectal patients without knowing the K-RAS status (OR: 1.36, 95% CI: 1.11-1.65, Z = 1.89, P = 0.003. But for patients with mutated K-RAS, the improvement for objective response rate was not statistical significant (OR: 0.70, 95% CI: 0.49-1.01, Z = 3.00, P = 0.058 when adding cetuximab to oxaliplatin-based chemotherapy regime. The pooled results indicating the rash and diarrhea risk was significantly increased in the combined treatment group (P 0.05. Significant publication bias was found in toxicities evaluation. Conclusion: Cetuximab plus oxaliplatin-based chemotherapy regimen significant increase the response rate for metastatic colorectal cancer. But the some toxicities such rash and diarrhea risk was also increased.

  19. Intestinal Microbiota of Broiler Chickens As Affected by Litter Management Regimens

    Science.gov (United States)

    Wang, Lingling; Lilburn, Mike; Yu, Zhongtang

    2016-01-01

    Poultry litter is a mixture of bedding materials and enteric bacteria excreted by chickens, and it is typically reused for multiple growth cycles in commercial broiler production. Thus, bacteria can be transmitted from one growth cycle to the next via litter. However, it remains poorly understood how litter reuse affects development and composition of chicken gut microbiota. In this study, the effect of litter reuse on the microbiota in litter and in chicken gut was investigated using 2 litter management regimens: fresh vs. reused litter. Samples of ileal mucosa and cecal digesta were collected from young chicks (10 days of age) and mature birds (35 days of age). Based on analysis using DGGE and pyrosequencing of bacterial 16S rRNA gene amplicons, the microbiota of both the ileal mucosa and the cecal contents was affected by both litter management regimen and age of birds. Faecalibacterium, Oscillospira, Butyricicoccus, and one unclassified candidate genus closely related to Ruminococcus were most predominant in the cecal samples, while Lactobacillus was predominant in the ileal samples at both ages and in the cecal samples collected at day 10. At days 10 and 35, 8 and 3 genera, respectively, in the cecal luminal microbiota differed significantly in relative abundance between the 2 litter management regimens. Compared to the fresh litter, reused litter increased predominance of halotolerant/alkaliphilic bacteria and Faecalibacterium prausnitzii, a butyrate-producing gut bacterium. This study suggests that litter management regimens affect the chicken GI microbiota, which may impact the host nutritional status and intestinal health. PMID:27242676

  20. The mortality and response rate after FLANG regimen in patients with refractory/relapsed acute leukemia

    Directory of Open Access Journals (Sweden)

    Vali A Mehrzad

    2012-01-01

    Full Text Available Background: Oncologists today are greatly concerned about the treatment of relapsed/refractory acute leukemia. FLANG regimen, combination of novantron, cytarabine, fludarabine, and granulocyte-colony stimulating factor, has been used in treatment of refractory/relapsed acute leukemia since 1990s. The present study has evaluated mortality and response rate of this regimen. Materials and Methods: In this study, 25 patients with refractory/relapsed acute leukemia aged 15-55 years underwent FLANG regimen at Seyed-Al-Shohada Hospital, Isfahan, Iran during 2008-2009. One month later, bone marrow samples were taken to evaluate the responsiveness to treatment. Participants were followed for a year. The data was analyzed by student-t and chi-square tests, logistic, and Cox regression analysis, and Kaplan-Meier curves in SPSS 19. Results: Out of the 25 patients, 8 patients (32% had acute lymphoblastic leukemia (5 refractory and 3 relapsed cases and 17 subjects had acute myeloid leukemia (7 refractory and 10 relapsed cases. According to the bone marrow biopsies taken one month after FLANG regimen, 10 patients (40% had responded to treatment. Five patients of the 10 responders underwent successful bone marrow transplantation (BMT. On the other hand, 13 patients (52%, who had not entered the CR period, died during the follow-up. Logistic regression analysis did not reveal any significant associations between disease type and responsiveness to treatment. Conclusion: This study indicated higher rates of unresponsiveness to treatment while its mortality rate was comparable with other studies. Overall, according to limitations for BMT (as the only chance for cure in Iran, it seems that FLANG therapy is an acceptable choice for these patients.

  1. Community-Dwelling Elderly: Ineffective Management of Drug Regimen and Risk Fall

    OpenAIRE

    Costa, Tânia; Pinto, Catarina; Afonso, Diogo; Almeida, Armando; Silva, Rosa; Coelho, Patrícia; Alves, Paulo

    2014-01-01

    Introduction: Drugs intake is common in the elderly, but pharmacodynamics/pharmacokinetic changes associated with multiple pathologiy amplifys the drug interactions and adverted effects. Objectives: Evaluate the management of drug regimen for the elderly residing at home (N=37), relating it to falls. Methods: Data collection was carried out by semi-structured interview (using instruments validated for the Portuguese reality) followed by descriptive/inferential analysis. Insured informe...

  2. Evaluation of Blood Regimen on the Survival of Cimex lectularius L. Using Life Table Parameters

    Directory of Open Access Journals (Sweden)

    Edwin G. Rajotte

    2013-06-01

    Full Text Available Knowledge of bed bug development under varying conditions can lead to more sophisticated management techniques. Development rate, age and stage-specific life tables were compared for a laboratory strain (HS and field strain (ECL-05 of bed bug Cimex lectularius L. (Hemiptera: Heteroptera reared on two blood regimens: human or rabbit blood. Harlan and ECL-05 bed bugs reared on human blood had a life expectancy of 207 and 208 days respectively from the egg stage. Egg to adult development of HS bed bugs reared on human blood (~35 days was significantly longer than that of the ECL-05 strain (~33 days in the third, fourth, and fifth instars. The HS and ECL-05 bed bugs reared on rabbit blood had a life expectancy of 149 and 174 days respectively. Egg to adult development time of HS on rabbit blood (~52 days was significantly longer than ECL-05 (~37 days in every instar, and HS total life span was significantly shorter compared to ECL-05. Developmental differences based on strain and blood regimen suggest rabbit blood is an inferior blood source for colony maintenance, and strain has variable effects on bed bug development. Findings suggest that blood regimen should strongly be considered in bed bug colony maintenance.

  3. Effects of an overfeeding regimen--the affective component of the sweet sensation.

    Science.gov (United States)

    Fantino, M; Baigts, F; Cabanac, M; Apfelbaum, M

    1983-09-01

    In some isolated parts of North Africa, there persists an ancient Berber custom of imposing an overfeeding regimen on young girls before marriage, to achieve an obesity which is regarded as aesthetically pleasing. We have studied the effect of such a regimen, lasting 12--16 weeks, on blood lipids and on the affective reactions to sweet tastes in nine subjects. It is known that the pleasantness of alimentary cues i.e., the feeding behaviour, depends on the subject's nutritional state. Only three subjects gained weight (by 3,5 and 8 kg), in spite of the strong pressure to overeat. No change in plasma lipid concentrations were observed. Nevertheless, at the end of the regimen every subject showed a highly significant decrease in the rated pleasantness of sweet stimuli when they were tested fasting. However, the reduction in sweet pleasantness induced by ingestion of a 200 ml load of 1.4 M glucose solution was not changed by the overfeeding. Thus, pressure to overfeed can reduce hunger, as seen in the attractiveness of sweet foods in fasted subjects, without modifying glucose-induced satiety. PMID:6582799

  4. Law of regimens of Li Yu%李渔的养生思想

    Institute of Scientific and Technical Information of China (English)

    胡伟; 刘琴

    2014-01-01

    Li Yu's law of regimens can be attributed to his medical family background, the influence of traditional culture and his accumulation of life experience and understanding. He puts forward the idea that inner peace promotes the well-being of the whole body, and thinks that regimen should be changed seasonally and developed with some regularity under the proper time, contemporary situation, cheerful mind and gentle disposition. Li Yu's law of regimens, of course, provides the ordinaries the science of health and philosophy of life.%李渔养生思想的形成,得益于其医学世家的家庭背景,传统文化的熏染和对生活经验的积累与体悟。李渔提出,“心和则百体皆和”,认为养生需遵循事物变化发展的规律,依据四时变化分别处之,顺时而为,顺势而为,顺心而为,顺性而为。李渔的养生思想,提供普通百姓以养生之理、生活哲学。

  5. Outcomes of HIV-infected Patients Treated for Recurrent Tuberculosis with the Standard Retreatment Regimen

    Science.gov (United States)

    McGreevy, Jolion; Juste, Marc Antoine Jean; Severe, Patrice; Collins, Sean; Koenig, Serena; Pape, Jean William; Fitzgerald, Daniel W

    2013-01-01

    SETTING AIDS and tuberculosis center in Port-au-Prince, Haiti. OBJECTIVE To measure the effectiveness of tuberculosis retreatment with the standard regimen (2HRZES/1HRZE/5HRE) in HIV-infected adults. DESIGN Cohort study. RESULTS Of 1,318 HIV-infected patients with access to antiretroviral therapy following World Health Organization guidelines, 56 were diagnosed with recurrent pulmonary tuberculosis and retreated with the standard regimen. Ten patients (18%) died during retreatment, 3 patients (5%) defaulted, and 2 patients (4%) failed. Forty-one patients (73%) had a good retreatment outcome (cure, treatment completed). Of these, 8 patients (20%) died during follow-up, 5 patients (12%) were lost, and 5 patients (12%) had a second recurrence of tuberculosis. Only 26 (46%) of the 56 patients remained alive, in-care, and TB-free after a median of 36 months follow-up. CONCLUSION HIV-infected patients treated for recurrent tuberculosis with the standard retreatment regimen have a high mortality and poor long-term outcomes. PMID:22507948

  6. Evaluating the effect of zingiber officinalis on nausea and vomiting in patients receiving Cisplatin based regimens.

    Science.gov (United States)

    Fahimi, Fanak; Khodadad, Kian; Amini, Somayeh; Naghibi, Farzaneh; Salamzadeh, Jamshid; Baniasadi, Shadi

    2011-01-01

    Ginger, the rhizome of Zingiber officinalis, has long been used as herbal medicine for its antiemetic effect. For evaluating the effect of zingiber officinalis on nausea and vomiting (N and V) in patients receiving cisplatin based regimens, a randomized double-blind placebo-controlled cross-over clinical trial was carried out in patients receiving cisplatin in combination with other chemotherapeutic agents. The patients were randomly assigned to receive ginger capsules (rhizome of zingiber officinalis) or placebo in their first cycle of the study. All patients received standard antiemetics for chemotherapy induced nausea and vomiting (CINV). The patients were crossed-over to receive ginger or placebo in their next cycle of chemotherapy. Among 36 eligible patients who received both cycles of treatment, there were no difference in prevalence, severity, and duration of both acute and delayed N and V. Addition of ginger to the standard antiemetic regimen has shown no advantage in reducing acute and delayed N and V in patients with cisplatin-based regimen in this study. PMID:24250368

  7. Common toxicities and objective response rate in metastatic colorectal cancer patients treated with irinotecan based regimens

    Institute of Scientific and Technical Information of China (English)

    Liu Huang; Xin Liao; Qianqian Yu; Qiang Fu; Kai Qin; Huanlei Wu; Lihong Zhang; Xianglin Yuan

    2013-01-01

    Objective: The aim of our study was to investigate if common toxicities are correlated to objective response rate (ORR) in metastatic colorectal cancer (mCRC) patients treated by irinotecan based regimens. Methods: Univariate and multivariate logistic regression analyses were performed to evaluate correlations between common toxicities and binary ORR in 106 mCRC patients from a prospective cohort treated with irinotecan based regimens. Results: The most frequent severe toxicities (Grade 3/4) were as follows: neutropenia (27.4%), diarrhea (16.9%), leucopenia (12.6%), vomiting (3.2%) and thrombocytopenia (2.1%). Thrombocytosis was observed in 25 (26.3%) patients. ORR was 25.3%. Thrombocytopenia (P = 0.014), line of chemotherapy (P = 0.028) and thrombocytosis (P = 0.033) were correlated with ORR in univariate analysis. In multivariate analysis, thrombocytopenia (odds ratio [OR] = 8.600, 95% confidence interval [CI] = 1.705–43.385, P = 0.009) and first line chemotherapy (OR = 5.155, 95% CI = 1.153–23.256, P = 0.032) positively related to ORR. Conclusion: Throm-bocytopenia may be an indicator of ORR in mCRC patients treated by irinotecan plus 5-fluorouracil/capecitabine. Evidence is not strong enough to prove that irinotecan based regimens-induced diarrhea, leucopenia, neutropenia or vomiting is associ-ated with ORR.

  8. Helicobacter pylori:Effect of coexisting diseases and update on treatment regimens

    Institute of Scientific and Technical Information of China (English)

    Shen-Shong; Chang; Hsiao-Yun; Hu

    2015-01-01

    The presence of concomitant diseases is an independentpredictive factor for non-Helicobacter pylori(H. pylori) peptic ulcers. Patients contracting concomitant diseases have an increased risk of developing ulcer disease through pathogenic mechanisms distinct from those of H. pylori infections. Factors other than H. pylori seem critical in peptic ulcer recurrence in end stage renal disease(ESRD) and cirrhotic patients. However, early H. pylori eradication is associated with a reduced risk of recurrent complicated peptic ulcers in patients with ESRD and liver cirrhosis. Resistances to triple therapy are currently detected using culture-based and molecular methods. Culture susceptibility testing before first- or second-line therapy is unadvisable. Using highly effective empiric first-line and rescue regimens can yield acceptable results. Sequential therapy has been included in a recent consensus report as a valid first-line option for eradicating H. pylori in geographic regions with high clarithromycin resistance. Two novel eradication regimens, namely concomitant and hybrid therapy, have proven more effective in patients with dual-(clarithromycin- and metronidazole-) resistant H. pylori strains. We aim to review the prevalence of and eradication therapy for H. pylori infection in patients with ESRD and cirrhosis. Moreover, we summarized the updated H. pylori eradication regimens.

  9. In vivo prostacyclin biosynthesis and effects of different aspirin regimens in patients with essential thrombocythaemia.

    Science.gov (United States)

    Cavalca, V; Rocca, B; Squellerio, I; Dragani, A; Veglia, F; Pagliaccia, F; Porro, B; Barbieri, S S; Tremoli, E; Patrono, C

    2014-07-01

    Essential thrombocythaemia (ET) is characterised by enhanced platelet generation and thrombosis. Once daily (od) aspirin incompletely inhibits platelet thromboxane (TX)A2 production in ET. A twice daily (bid) dosing is necessary to fully inhibit TXA2. Whether this dosing regimen affects in vivo prostacyclin (PGI2) biosynthesis is unknown. PGI2 biosynthesis was characterised in 50 ET patients on enteric-coated (EC) aspirin 100 mg od, by measuring its urinary metabolite, 2,3-dinor-6-keto-PGF1α (PGI-M). Moreover, in a crossover study 22 patients poorly responsive to standard aspirin based on serum TXB2 levels (≥4 ng/ml) were randomised to different seven-day aspirin regimens: EC aspirin 100 mg od, 100 mg bid, 200 mg od, or plain aspirin 100 mg od. PGI-M measured 24 hours after the last aspirin intake (EC, 100 mg od) was similar in patients and healthy subjects both on (n=10) and off (n=30) aspirin. PGI-M was unrelated to in vivo TXA2 biosynthesis, and not affected by EC aspirin 100 mg bid or 200 mg od as compared to EC 100 mg od. PGI2 biosynthesis in aspirin-treated ET patients appears unrelated to TXA2 biosynthesis, and not affected by an improved aspirin regimen, demonstrating its vascular safety for future trials. PMID:24671522

  10. Contribution of Oxazolidinones to the Efficacy of Novel Regimens Containing Bedaquiline and Pretomanid in a Mouse Model of Tuberculosis.

    Science.gov (United States)

    Tasneen, Rokeya; Betoudji, Fabrice; Tyagi, Sandeep; Li, Si-Yang; Williams, Kathy; Converse, Paul J; Dartois, Véronique; Yang, Tian; Mendel, Carl M; Mdluli, Khisimuzi E; Nuermberger, Eric L

    2016-01-01

    New regimens based on two or more novel agents are sought to shorten or simplify treatment of tuberculosis (TB). Pretomanid (PMD) is a nitroimidazole in phase 3 trials that has significant bactericidal activity alone and in combination with bedaquiline (BDQ) and/or pyrazinamide (PZA). We previously showed that the novel combination of BDQ+PMD plus the oxazolidinone sutezolid (SZD) had sterilizing activity superior to that of the first-line regimen in a murine model of TB. The present experiments compared the activity of different oxazolidinones in combination with BDQ+PMD with or without PZA in the same model. The 3-drug regimen of BDQ+PMD plus linezolid (LZD) had sterilizing activity approaching that of BDQ+PMD+SZD and superior to that of the first-line regimen. The addition of PZA further enhanced activity. Reducing the duration of LZD to 1 month did not significantly affect the activity of the regimen. Halving the LZD dose or replacing LZD with RWJ-416457 modestly reduced activity over the first month but not after 2 months. AZD5847 and tedizolid also increased the bactericidal activity of BDQ+PMD, but they were less effective than the other oxazolidinones. These results provide optimism for safe, short-course oral regimens for drug-resistant TB that may also be superior to the current first-line regimen for drug-susceptible TB. PMID:26503656

  11. Antioxidative and antihypertensive activities of pig meat before and after cooking and in vitro gastrointestinal digestion: Comparison between Italian autochthonous pig Suino Nero Lucano and a modern crossbred pig.

    Science.gov (United States)

    Simonetti, Amalia; Gambacorta, Emilio; Perna, Annamaria

    2016-12-01

    The aim of this study was to evaluate and compare antioxidative and antihypertensive activities of Longissimus dorsi muscle from Suino Nero Lucano (SNL) and a modern crossbred (CG) pigs, before and after cooking and in vitro gastrointestinal digestion. Pig meat showed antioxidative and antihypertensive activities, heat treatment decreased the thiols content but at the same time increased angiotensin I-converting enzyme (ACE) inhibitory activity, and in vitro gastrointestinal digestion enhanced the biological activity of meat. Autochthonous SNL meat showed a higher nutraceutical quality compared to CG meat, highlighting a greater potential beneficial physiological effect on human health. The results of this study indicate that the pig meat, in particular autochthonous pig meat, may be considered a functional food since it is a good source of antioxidative and antihypertensive peptides. PMID:27374572

  12. Continuous controversy about radiation oncologists’ choice of treatment regimens for bone metastases: should we blame doctors, cancer-related features, or design of previous clinical studies?

    International Nuclear Information System (INIS)

    Recent studies from Italy, Japan and Norway have confirmed previous reports, which found that a large variety of palliative radiotherapy regimens are used for painful bone metastases. Routine use of single fraction treatment might or might not be the preferred institutional approach. It is not entirely clear why inter-physician and inter-institution differences continue to persist despite numerous randomized trials, meta-analyses and guidelines, which recommend against more costly and inconvenient multi-fraction regimens delivering total doses of 30 Gy or more in a large number of clinical scenarios. In the present mini-review we discuss the questions of whether doctors are ignoring evidence-based medicine or whether we need additional studies targeting specifically those patient populations where recent surveys identified inconsistent treatment recommendations, e.g. because of challenging disease extent. We identify open questions and provide research suggestions, which might contribute to making radiation oncology practitioners more confident in selecting the right treatment for the right patient

  13. Safety and effectiveness of divalproex sodium extended release containing regimen in Indian patients with bipolar I disorder in continuation phase: Results of EASED registry.

    Science.gov (United States)

    Shah, Nilesh; Reddy, M S; Vohra, Sandeep; Chaudhuri, Uday; Mohanasundaram, Senthilnathan

    2016-04-01

    The study was conducted to evaluate the safety and effectiveness of divalproex sodium XR containing regimen in patients with bipolar disorder (BPD) who are in continuation phase. It was an open-label, prospective, observational study conducted from July 2010 to December 2011 at 48 sites across India. Adult patients with bipolar I disorder of manic or mixed type fulfilling the DSM-IV criteria and who were in the continuation phase were included. Safety (primary outcome) was assessed by incidence of treatment emergent adverse events (AEs). Effectiveness (secondary outcome), was evaluated by proportion of patients who did not have a relapse, change in Clinical Global Impression Score-BP version-Severity of Illness (CGI-BP) and Young's Mania Rating Scale (YMRS) score. Data was recorded at three visits: visit-1 (baseline), visit-2 (end of 2 months ± 7 days) and visit-3 (end of 4 months ± 14 days), and summarised using descriptive statistics. pYMRS and CGI-BP scores from baseline to visit-3. Our study confirms the results of earlier studies in terms of good tolerability and effectiveness of divalproex sodium XR containing regimen in this study population. PMID:27025469

  14. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging

    OpenAIRE

    Stuart A Taylor; Slater, Andrew; Burling, David N.; Tam, Emily; Greenhalgh, Rebecca; Gartner, Louise; Scarth, Julia; Pearce, Robert; Bassett, Paul; Halligan, Steve

    2007-01-01

    To establish the optimum barium-based reduced-laxative tagging regimen prior to CT colonography (CTC). Ninety-five subjects underwent reduced-laxative (13 g senna/18 g magnesium citrate) CTC prior to same-day colonoscopy and were randomised to one of four tagging regimens using 20 ml 40%w/v barium sulphate: regimen A: four doses, B: three doses, C: three doses plus 220 ml 2.1% barium sulphate, or D: three doses plus 15 ml diatriazoate megluamine. Patient experience was assessed immediately af...

  15. Nephrolithiasis and renal failure among patients exposed to atazanavir, other PIs and PI-free regimens

    Directory of Open Access Journals (Sweden)

    Ella Nkhoma

    2014-11-01

    Full Text Available Introduction: Recent single-site studies and case reports have linked atazanavir (ATV with the occurrence of nephrolithiasis. The purpose of this study was to estimate and compare the incidence rate of nephrolithiasis and to characterize the occurrence of subsequent renal failure among patients on ATV, other protease inhibitors (PIs and PI-free regimens using real world data. Materials and Methods: This was a retrospective cohort analysis using claims data from a US commercial and a US public health insurance database (Medicaid spanning 2003–2011 and 2006–2011, respectively. We identified adult HIV patients who were prescribed ATV, other PIs or PI-free regimens with at least 6 months of continuous enrolment prior to the index claim. Nephrolithiasis was defined as an inpatient or outpatient ICD-9 diagnosis code for nephrolithiasis or an associated condition, plus an imaging/corrective procedure code. Renal failure was also identified using diagnosis codes among patients experiencing nephrolithiasis. Hazard ratios were estimated using propensity score (PS adjusted Cox regression, crude and adjusted for demographics, baseline comorbidities and comedications. Results: A total of 14,477 patients (ATV: 4,150; other PIs: 4,153; PI-free: 6,174 were identified in the commercial database: 83% male and 20% age ≥50 years. In the Medicaid database, 9,104 patients (ATV: 3,460; other PIs: 3,117; PI-free: 2,527 were identified: 53% male and 25% age ≥50 years. There were significant baseline differences in demographics, comorbidities and concomitant medications among the three cohorts. In adjusted analyses, ATV use was not significantly associated with nephrolithiasis when compared to other PIs. When ATV was compared to PI-free regimens, a positive association was observed in the commercial insurance but not the Medicaid database. In both databases, previous history of nephrolithiasis was the strongest predictor of nephrolithiasis in the ATV

  16. Evaluation of hippuric acid content in goat milk as a marker of feeding regimen.

    Science.gov (United States)

    Carpio, A; Bonilla-Valverde, D; Arce, C; Rodríguez-Estévez, V; Sánchez-Rodríguez, M; Arce, L; Valcárcel, M

    2013-09-01

    Organic producers, traders, and consumers must address 2 issues related to milk: authentication of the production system and nutritional differentiation. The presence of hippuric acid (HA) in goat milk samples has been proposed as a possible marker to differentiate the feeding regimen of goats. The objective of this work is to check the hypothesis that HA could be a marker for the type of feeding regimen of goats by studying the influence of production system (conventional or organic) and feeding regimen (with or without grazing fodder). With this purpose, commercial cow and goat milk samples (n=27) and raw goat milk samples (n=185; collected from different breeds, localizations, and dates) were analyzed. Samples were grouped according to breed, feeding regimen, production system, and origin to compare HA content by ANOVA and honestly significant difference Tukey test at a confidence level of ≥95%. Hippuric acid content was obtained by analyzing milk samples with capillary electrophoresis. This method was validated by analyzing part of the samples with HPLC as a reference technique. Sixty-nine raw goat milk samples (of the total 158 samples analyzed in this work) were quantified by capillary electrophoresis. In these samples, the lowest average content for HA was 7±3 mg/L. This value corresponds to a group of conventional raw milk samples from goats fed with compound feed. The highest value of this group was 28±10 mg/L, corresponding to goats fed compound feed plus grass. Conversely, for organic raw goat milk samples, the highest concentration was 67±14 mg/L, which corresponds to goats fed grass. By contrast, the lowest value of this organic group was 26±10 mg/L, which belongs to goats fed organic compounds. Notice that the highest HA average content was found in samples from grazing animals corresponding to the organic group. This result suggests that HA is a good marker to determine the type of goats feeding regimen; a high content of HA represents a diet

  17. Response of broiler chickens to different dietary crude protein and feeding regimens

    Directory of Open Access Journals (Sweden)

    JO Oyedeji

    2005-09-01

    Full Text Available Five isocaloric (3200kcal/kg diets were used in an experiment designed to investigate the effects of dietary crude protein (CP and feeding regimens on broiler performance. Day-old broilers were randomly distributed into four groups using a completely randomized design. Each group was replicated three times with ten broiler chicks per replicate. The experiment lasted for eight weeks. Broilers in group 1 received 23% CP from 0 to 3 weeks, 20% CP from 3 to 6 weeks and 18% CP from 6 to 8 weeks, while broilers in group 2 received 23% CP between 0 and 6 weeks and 18% CP between 6 and 8 weeks. Besides, broilers in group 3 were fed 23% CP from 0 to 4 weeks and 16% CP from 4 to 8 weeks, whereas group 4 was given 18% CP from 0 to weeks. Water was supplied ad libitum for broilers in the different dietary groups. A metabolic trial was carried out on the third week of the experiment using a total collection method. Proximate analyses of diets and faecal samples were performed according to the methods outlined by the Association Of the Official Analytical Chemists. Results at market age showed that broiler performance with respect to feed intake, weight gain, feed to gain ratio and water intake were not significantly influenced by CP regimens (p>0.05. Furthermore, CP regimens did not significantly influence broilers liveability (p>0.05. Protein retention, fat utilization and available fiber were not significantly influenced among treatments (p> 0.05. Economic data showed that cost to benefit ratio of producing broilers was comparable among broilers for all CP regimens used in this trial (p>0.05. It was concluded that a single diet of 18% CP and 3200kcal/kg metabolizable energy would be most suitable and convenient for farmers who are engaged in on-farm feed production for broilers as compared with the standard feeding regimens of broiler starter and broiler finisher diets.

  18. Switch to raltegravir-based regimens and HIV DNA decrease in patients with suppressed HIV RNA

    Directory of Open Access Journals (Sweden)

    Claudia Bianco

    2014-11-01

    Full Text Available Introduction: Raltegravir intensification is associated with an increase in 2-LTR episomal HIV DNA= circles, indicating a persistent low-level replication, in some individuals in ART with suppressed HIV RNA. We aimed at monitoring residual plasma HIV RNA and cellular HIV DNA in virologically suppressed patients switching to a raltegravir-based regimen. Materials and Methods: Forty-six HIV-infected subjects on PI or NNRTI based-regimens, with plasma HIV RNA level 200 cells/µL for ≥12 months were enrolled. Thirty-four patients switched to raltegravir-based regimen (RASTA study group and 12 continued a PI or NNRTI based-regimen (control group. Ultrasensitive HIV residual viremia and total PBMC HIV DNA were assessed at baseline (W0, 24 (W24 and 48 (W48 weeks. HIV RNA levels were determined by an ultrasensitive test derived from a commercial real time PCR (limit of detection 5 copies/ml. A real time PCR was used to quantify HIV DNA copy numbers in PBMCs. Results: At W0, HIV DNA was detected in all patients while at W48 it was detectable in 82.3% of RASTA group vs 100% of controls (p=0.01. The difference between the average values of HIV DNA log10 copies/10°6 CD4 at W0 (median 3.11, IQR 2.70–3.45 and W48 (median 2.87, IQR 2.24–3.38 was statistically significant for RASTA group (p=0.035. Male gender (mean difference −0.37 log10 copies/10°6 PBMC, p=0.023 and previous PI based-ART (mean difference +0.39 log10 copies/10°6 PBMC, p=0.036 were predictive of HIV DNA level at W0. After adjusting for previous PI based-ART, male gender was the only variable independently associated with HIV DNA size at W0 (mean difference −0.326 log10 copies/10°6 PBMC, 95% CI −0.641, −0.011 p=0.043. Ultrasensitive HIV-1 RNA was detectable at W0 in 50% of RASTA group versus 66.7% of controls and at W48 in 32.4% versus 45.5%, respectively. No differences were found between HIV RNA levels at W0 and W48 within and between the two groups. Conclusions: Switching to

  19. Development of a capillary high performance liquid chromatography-ion trap-mass spectrometry method for the determination of VLIVP antihypertensive peptide in soybean crops.

    Science.gov (United States)

    Puchalska, Patrycja; García, M Concepción; Marina, M Luisa

    2014-04-18

    Soybean peptide VLIVP presents a very high antihypertensive activity (IC50 value 1.69μM), even higher than extensively studied IPP and VPP peptides from milk. Nevertheless, no much attention has been paid to this peptide and there is no method enabling its determination in soybeans. The aim of this work was the development of an analytical methodology for this purpose. A methodology consisting of the extraction of soybean proteins, their digestion with Protease P enzyme, their chromatographic separation using capillary-HPLC, and IT-MS detection was optimized. Protein extraction was performed by the use of high intensity focused ultrasounds to obtain a reduced extraction time. Optimization of chromatographic and mass spectrometry parameters enabled the separation of VLIVP peptide within just 7min and its sensitive detection. The analytical characteristics of the capillary-HPLC-IT-MS method were evaluated through the study of linearity, LOD, LOQ, study of the presence of matrix interferences, precision, and recovery. The method enabled to detect as low as 3.6ng of peptide and to determine as low as 12ng of peptide in 1g of soybean (as dry basis). Finally, the developed method was applied to the determination of the antihypertensive peptide VLIVP in different soybean varieties. The results showed the highest yield of VLIVP peptide in variety Mazowiecka II from Poland. PMID:24630980

  20. In vivo Antihypertensive and Antihyperlipidemic Effects of the Crude Extracts and Fractions of Moringa stenopetala (Baker f.) Cufod. Leaves in Rats

    Science.gov (United States)

    Geleta, Bekesho; Makonnen, Eyasu; Debella, Asfaw; Tadele, Ashenif

    2016-01-01

    Background: Moringa stenopetala (Baker f.) Cufod. is a medicinal plant that has been used in Ethiopian traditional medicine as a remedy for treatment of hypertension and diabetes. The aim of this study was to evaluate antihypertensive and antihyperlipidemic effect in fructose induced hypertensive rats. Methods: Rats were randomly divided into control and treatment groups (n = 6). Treatment groups were given daily extracts (250, 500, and 1000 mg/kg) orally with fructose. Whereas, positive, negative and normal control groups were received captopril (20 mg/kg/day with fructose), only fructose (66% w/v ad libitum) and distilled water ad libitum for 15 days, respectively. The blood pressure was measured every 5th day using tail cuff blood pressure analyzer, and on the 16th day the blood was sampled to evaluate antihyperlipidemic effect using clinical chemistry analyzer. Results: The study showed that aqueous and 70% ethanol extracts significantly prevented blood pressure increment in a dose dependent manner comparable to that of the standard drug. Similarly, the extracts suppressed increment in lipid profile (cholesterol, glucose, and triglycerides) compared with negative control. The biochemical test revealed that extracts produced a rise in liver but no effect on kidney function indicators compared with normal control. Conclusion: These findings revealed that both crude extracts of M. stenopetala (Baker f.) Cufod. possess antihypertensive and antihyperlipidemic effect.

  1. A COMPARATIVE STUDY OF ACE-INHIBITORS WITH OTHER ANTI-HYPERTENSIVE DRUGS IN HYPERTENSIVE DIABETIC PATIENTS IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Shrinivas

    2014-06-01

    Full Text Available The incidence of hypertension and diabetes mellitus is rising on an alarming rate in the developing countries; these two disorders frequently occur together in a patient. Hypertension is the most important modifiable risk factor for coronary heart disease, stroke, CHF, end stage renal disease and peripheral vascular disease. Drugs like ACE inhibitors used in the treatment of hypertension are known to have beneficial effects in reducing complications associated with diabetes mellitus. In this study an attempt is made to see the rationality among the prescriptions and also to compare the efficacy, safety and tolerability of ACE-inhibitors with other anti-hypertensive drugs among diabetic hypertensive patient and to see the rationality among the prescriptions. METHODS AND MATERIALS: This 15 month prospective study was conducted on 100 diabetic-hypertensive patients attending Basaveshwar Teaching and General Hospital, Gulbarga. CONCLUSION: We summarize the overall effectiveness of all our anti-hypertensive drugs based on the results obtained from this data. The fall in both average SBP and average DBP reflects the effectiveness of the treatment employed by the physicians in the hospital. We also observed a general decline in the blood sugar values. The results of this study indicate that by re-establishing the dominance of ACE inhibitors in the treatment of diabetic-hypertensive

  2. In vivo antihypertensive and antidyslipidemic effects of the crude extracts and fractions of Moringa stenopetala (Baker f. Cufod. leaves in rats.

    Directory of Open Access Journals (Sweden)

    Bekesho eGeleta

    2016-04-01

    Full Text Available Moringa stenopetala (Baker f. Cufod. is a medicinal plant that has been used in Ethiopian traditional medicine as a remedy for treatment of hypertension and diabetes. The aim of this study was to evaluate antihypertensive and antihyperlipidemic effect in fructose induced hypertensive rats.Rats were randomly divided into control and treatment groups (n=6. Treatment groups were given daily extracts (250, 500, and 1000 mg/kg orally with fructose. Whereas, positive, negative and normal control groups were received captopril (20 mg/kg/day with fructose, only fructose (66% w/v ad libitum and distilled water ad libitum for 15 days, respectively. The blood pressure was measured every 5th day using tail cuff blood pressure analyzer, and on the 16th day the blood was sampled to evaluate antihyperlipidemic effect using clinical chemistry analyzer. The study showed that aqueous and 70% ethanol extracts significantly prevented blood pressure increment in a dose dependent manner comparable to that of the standard drug. Similarly, the extracts suppressed increment in lipid profile (cholesterol, glucose and triglycerides compared with negative control. The biochemical test revealed that extracts produced a rise in liver but no effect on kidney function indicators compared with normal control.These findings revealed that both crude extracts of Moringa stenopetala (Baker f. Cufod. possess antihypertensive and antihyperlipidemic effect.

  3. Antihypertensive Properties of a Novel Morphologic Derivative (4-tert-buthyl-2,6-bis(thiomorpholine-4-ilmethyl)phenol).

    Science.gov (United States)

    Martínez-Aguilar, Luisa; Lezama-Martínez, Diego; Orozco-Cortés, Nancy V; González-Espinosa, Claudia; Flores-Monroy, Jazmin; Valencia-Hernández, Ignacio

    2016-03-01

    We evaluated the antihypertensive properties of 4-tert-buthyl-2,6-bis(thiomorpholine-4-ilmethyl)phenol (TBTIF). Spontaneously hypertensive rats were treated with TBTIF or captopril (both at 1 mg·kg·d intramuscularly for 4 days), and their blood pressure (BP) was assessed. In some experiments, concentration response curves to angiotensin I or angiotensin II were generated in rat aortic rings and in the absence or presence of Ang-(1-7), N-monomethyl L-arginine, or both; additionally, the angiotensin-converting enzyme (ACE) and ACE2 mRNA levels were quantified in the aortic rings using reverse transcription-polymerase chain reaction. TBTIF diminished BP and reduced angiotensin I- or angiotensin II-induced vasoconstriction. The presence of Ang-(1-7) induced a greater reduction in vasoconstriction, and this effect was reversed by L-N-monomethyl arginine. Moreover, TBTIF decreased the mRNA of ACE and increased the mRNA of ACE2. In conclusion, TBTIF diminished rat BP through nitric oxide-dependent and nitric oxide-independent mechanisms. In contrast to captopril, TBTIF exhibits better antihypertensive properties through mechanisms that involve ACE2. PMID:26566152

  4. Novel four-drug salvage treatment regimens after failure of a human immunodeficiency virus type 1 protease inhibitor-containing regimen: antiviral activity and correlation of baseline phenotypic drug susceptibility with virologic outcome.

    Science.gov (United States)

    Deeks, S G; Hellmann, N S; Grant, R M; Parkin, N T; Petropoulos, C J; Becker, M; Symonds, W; Chesney, M; Volberding, P A

    1999-06-01

    Twenty human immunodeficiency virus-infected patients experiencing virologic failure of an indinavir- or ritonavir-containing treatment regimen were evaluated in a prospective, open-label study. Subjects received nelfinavir, saquinavir, abacavir, and either another nucleoside analog (n=10) or nevirapine (n=10). Patients treated with the nevirapine-containing regimen experienced significantly greater virologic suppression at week 24 than those not treated with nevirapine (P=.04). Baseline phenotypic drug susceptibility was strongly correlated with outcome in both treatment arms. Subjects with baseline virus phenotypically sensitive to 2 or 3 drugs in the salvage regimen experienced significantly greater virus load suppression than those with baseline virus sensitive to 0 or 1 drug (median week-24 change=-2.24 log and -0.35 log, respectively; P=.01). In conclusion, non-nucleoside reverse transcriptase inhibitors may represent a potent drug in salvage therapy regimens after failure of an indinavir or ritonavir regimen. Phenotypic resistance testing may provide a useful tool for selecting more effective salvage regimens. PMID:10228057

  5. Antihypertensive neutral lipid

    Energy Technology Data Exchange (ETDEWEB)

    Snyder, F.L.; Blank, M.L.

    1986-06-17

    A method is described for treating a warm-blooded animal comprising administering to the animal a neutral glycerolipid with a 12 to 20 carbon alkyl group at the sn-1 position, a short carbon chain acyl group at the sn-2 position and a hydroxyl group at the sn-3 position in an amount sufficient to lower the arterial blood pressure of the animal. A method is also described for treating a warm-blooded animal comprising administering a composition consisting essentially of a 1-alkyl-2-acetyl (or propionyl)-sn glycerol in combination with a 1-alkyl-2-acetyl-sn-glycero-3-phosphocholine, wherein the 1-alkyl groups contain 12 to 20 carbon atoms, dissolved in an inert pharmaceutically acceptable solvent in amounts sufficient to lower the arterial blood pressure of the animal.

  6. Compliance with Antihypertensive Medication

    OpenAIRE

    Evans, C. Edward

    1985-01-01

    Although we have efficacious treatment for hypertension many patients do not take their medication or even follow through with their physician visits, thereby negating potential benefits. Detecting patients who do not take their medications is as important as diagnosing and treating the hypertension itself. This paper outlines methods of detecting and ‘treating’ non-compliance and discusses the role of the physician/patient relationship in compliance.

  7. Antihypertensive effects of astaxanthin

    OpenAIRE

    Hiroshi Yoshida; Kumie Ito; Hidekatsu Yanai; Norio Tada

    2008-01-01

    Hidekatsu Yanai1,2, Kumie Ito1,2, Hiroshi Yoshida2,3, Norio Tada1,21Department of Internal Medicine; 2Institute of Clinical Medicine and Research; 3Department of Laboratory Medicine, The Jikei University School of Medicine, Chiba, JapanAbstract: Astaxanthin is a biological antioxidant naturally found in a wide variety of aquatic living organisms, and has shown various pharmacological activities, such as anti-inflammatory and antidiabetic activities. A recent study reported that the administra...

  8. Intensified regimen containing rifampicin and moxifloxacin for tuberculous meningitis: an open-label, randomised controlled phase 2 trial.

    NARCIS (Netherlands)

    Ruslami, R.; Ganiem, A.R.; Dian, S.; Apriani, L.; Achmad, T.H.; Ven, A.J.A.M. van der; Borm, G.F.; Aarnoutse, R.E.; Crevel, R. van

    2013-01-01

    BACKGROUND: Intensified antibiotic treatment might improve the outcome of tuberculous meningitis. We assessed pharmacokinetics, safety, and survival benefit of several treatment regimens containing high-dose rifampicin and moxifloxacin in patients with tuberculous meningitis in a hospital setting. M

  9. Effect of yoga regimen on lung functions including diffusion capacity in coronary artery disease patients: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Asha Yadav

    2015-01-01

    Conclusions: Yoga regimen was found to improve lung functions and diffusion capacity in CAD patients besides improving cardiovascular functions. Thus, it can be used as a complimentary or adjunct therapy along with the conventional medicine for their treatment and rehabilitation.

  10. Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe

    NARCIS (Netherlands)

    L.M. Hofstra (L. Marije); N. Sauvageot (Nicolas); J. Albert (Jan); I. Alexiev (Ivailo); F. Garcia (Federico); D. Struck (Daniel); D.A.M.C. van de Vijver (David); B. Asjö (Birgitta); D. Beshkov (Danail); S. Coughlan (Suzie); D. Descamps (Diane); A. Griskevicius (Algis); O. Hamouda (Osamah); A. Horban (Andrzej); M. Van Kasteren (Marjo); T. Kolupajeva (Tatjana); L.G. Kostrikis (Leondios); K. Liitsola (Kirsi); M. Linka (Marek); O. Mor (Orna); C. Nielsen (Claus); D. Otelea (Dan); D. Paraskevis (Dimitrios); R. Paredes (Roger); M. Poljak (Mario); E. Puchhammer-Stockl E. (E.); A. Sonnerborg (Anders); D. Stanekova (Danica); M. Stanojevic (Maja); K. Van Laethem (Kristel); M. Zazzi (Maurizio); S. Zidovec Lepej (Snjezana); C.A.B. Boucher (Charles A. B.); J.-C. Schmit (Jean-Claude); A.M.J. Wensing (Annemarie); E. Puchhammer-Stöckl (Elisabeth); M. Sarcletti (M.); B. Schmied (B.); M. Geit (M.); G. Balluch (G.); A.-M. Vandamme; J. Vercauteren (Jurgen); I. Derdelinckx; A. Sasse; M. Bogaert; H. Ceunen (H.); A. de Roo (Annie); S. De Wit; F. Echahidi (F.); K. Fransen; J.-C. Goffard (J.); P. Goubau; E. Goudeseune (E.); J.-C. Yombi (J.); P. Lacor; C. Liesnard (C.); M. Moutschen; L.A. Pierard; R. Rens (R.); J. Schrooten; D. Vaira; L.P.R. Vandekerckhove; A. van den Heuvel (A.); B. van der Gucht (B.); M. Van Ranst; E. Van Wijngaerden; B. Vandercam; M. Vekemans; C. Verhofstede; N. Clumeck (N.); K. van Laethem (Kristel); D. Beshkov; I. Alexiev; S.Z. Lepej (Snjezana); J. Begovac; L.G. Kostrikis (Leondios); I. Demetriades (I.); I. Kousiappa (Ioanna); V.L. Demetriou (Victoria); J. Hezka (Johana); M. Linka; M. Maly; L. MacHala; C. Nielsen; L.B. Jørgensen; J. Gerstoft (J.); L. Mathiesen (L.); C. Pedersen (Court); H. Nielsen; A. Laursen (A.); B. Kvinesdal (B.); K. Liitsola (Kirsi); M. Ristola (M.); J. Suni; J. Sutinen (J.); D. Descamps; L. Assoumou; G. Castor; M. Grude; P. Flandre; A. Storto; O. Hamouda (Osamah); C. K̈ucherer (C.); T. Berg; P. Braun; G. Poggensee; M. Daumer (Martin); J. Eberle; H. Heiken; R. Kaiser; H. Knechten (H.); K. Korn; H. Müller; S. Neifer; B. Schmidt; H. Walter; B. Gunsenheimer-Bartmeyer (B.); T. Harrer (T.); D. Paraskevis (Dimitrios); A. Hatzakis (Angelos); A. Zavitsanou (A.); A. Vassilakis; M. Lazanas; L. Chini; A. Lioni; V. Sakka (V.); S. Kourkounti (S.); V. Paparizos (V.); A. Antoniadou (A.); A. Papadopoulos; G. Poulakou; I. Katsarolis; K. Protopapas; G. Chryssos (G.); S. Drimis (S.); P. Gargalianos; G. Xylomenos; G. Lourida; M. Psichogiou (M.); G.L. Daikos (G.); N.V. Sipsas; A. Kontos (Angelos); M.N. Gamaletsou; G. Koratzanis (G.); H. Sambatakou; H. Mariolis; A. Skoutelis; V. Papastamopoulos; O. Georgiou; P. Panagopoulos (P.); E. Maltezos; S. Coughlan (Suzie); C. de Gascun (Cillian); C. Byrne; M. Duffy; P. Bergin; D. Reidy; G. Farrell; J. Lambert; E. O'Connor; A. Rochford; J. Low; P. Coakely (P.); S. O'Dea; W. Hall; O. Mor; I. Levi (I.); D. Chemtob (D.); Z. Grossman (Zehava); M. Zazzi; A. de Luca (Andrea); C. Balotta (Claudia); C. Riva (Chiara); C. Mussini (C.); I. Caramma (I.); A. Capetti (A.); M. Colombo (Massimo); C. Rossi; F. Prati (Francesco); F. Tramuto; F. Vitale (F.); M. Ciccozzi; G. Angarano (Guiseppe); G. Rezza (G.); T. Kolupajeva; O. Vasins; A. Griskevicius (Algis); V. Lipnickiene; J.C. Schmit; D. Struck (Daniel); N. Sauvageot; R. Hemmer (R.); V. Arendt (V.); C. Michaux; T. Staub (T.); C. Sequin-Devaux; A.M.J. Wensing (Annemarie); C.A.B. Boucher (Charles); D.A.M.C. van de Vijver (David); A. Van Kessel; P.H.M. Van Bentum; K. Brinkman; B.J. Connell; M.E. van der Ende (Marchina); I.M. Hoepelman (Ilja Mohandas); M.E.E. van Kasteren (Marjo); M. Kuipers; N. Langebeek (Nienke); C. Richter; R.M.W.J. Santegoets (R. M W J); L. Schrijnders-Gudde (L.); R. Schuurman; B.J.M. van de Ven (B. J M); B. Åsjö (Birgitta); A.-M.B. Kran (A.-M. Bakken); V. Ormaasen (Vidar); P. Aavitsland (P.); A. Horban (Andrzej); J. Stanczak (J.); G.P. Stanczak (G.); E. Firlag-Burkacka (E.); A. Wiercinska-Drapalo; E. Jablonowska (E.); E. Maolepsza; M. Leszczyszyn-Pynka (M.); W. Szata (W.); R.J. Camacho (Ricardo Jorge); A. de Palma (Andre); F. Borges (F.); T. Paixão; V. Duque (V.); F. Araújo; D. Otelea; C. Paraschiv (Corina); A.M. Tudor; R. Cernat; C. Chiriac; F. Dumitrescu; L.J. Prisecariu; M. Stanojevic (Maja); D.J. Jevtovic (D.); D. Salemovic (D.); D. Stanekova; M. Habekova (M.); Z. Chabadová; T. Drobkova; P. Bukovinova; A. Shunnar; P. Truska; M. Poljak (Mario); M.M. Lunar (Maja M.); D. Babic; J. Tomazic (J.); S. Vidmar (Suzanna); T. Vovko; P. Karner (P.); F. Garcia; R. Paredes (Roger); S. Monge; S. Moreno; J. Del Amo; V. Asensi; J.L. Sirvent; C. de Mendoza (Carmen); R. Delgado; F. Gutiérrez; J. Berenguer; S. Garcia-Bujalance; N. Stella; I. De Los Santos; J.R. Blanco; D. Dalmau; M. Rivero; F. Segura; M.J.P. Elías (M. J. Pcrossed); M. Alvarez; N. Chueca; C. Rodríguez-Martín; C. Vidal; J.C. Palomares; I. Viciana; P. Viciana; J. Cordoba; A. Aguilera; P. Domingo; M.J. Galindo; C. Miralles; M.A. Del Pozo; E. Ribera; C. Iribarren (Carlos); L. Ruiz; J. De La Torre; F. Vidal; B. Clotet (Bonaventura); J. Albert; A. Heidarian; K. Aperia-Peipke (K.); M. Axelsson; M. Mild; A. Karlsson; A. Sonnerborg (Anders); A. Thalme; L. Navénr; G. Bratt (G.); A. Karlsson; A. Blaxhult; M. Gisslénn; B. Svennerholm; I.-M. Bergbrant (I.); P. Bj̈orkman (P.); C. Säll; A. Mellgren; A. Lindholm; N. Kuylenstierna; R. Montelius; F. Azimi; B. Johansson; M. Carlsson; E. Johansson; B. Ljungberg; H. Ekvall; A. Strand; S. Mäkitalo; S. Öberg; P. Holmblad; M. Höfer; H. Holmberg; P. Josefson; U. Ryding

    2016-01-01

    textabstractBackground. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, the

  11. Treatment of mid-late stage NSCLC using sodium cantharidinate/vitamin B6/GP regimen in clinic

    Directory of Open Access Journals (Sweden)

    Baoli Wang

    2014-01-01

    Conclusion: Sodium cantharidinate/vitamin B6/GP regimen had fair effectiveness and synergistically improved the clinical outcomes. It lowered the toxic/adverse effects and its application is worth further investigation and promotion.

  12. The potential biomarkers in predicting pathologic response of breast cancer to three different chemotherapy regimens: a case control study

    International Nuclear Information System (INIS)

    Preoperative chemotherapy (PCT) has become the standard of care in locally advanced breast cancer. The identification of patient-specific tumor characteristics that can improve the ability to predict response to therapy would help optimize treatment, improve treatment outcomes, and avoid unnecessary exposure to potential toxicities. This study is to determine whether selected biomarkers could predict pathologic response (PR) of breast tumors to three different PCT regimens, and to identify a subset of patients who would benefit from a given type of treatment. 118 patients with primary breast tumor were identified and three PCT regimens including DEC (docetaxel+epirubicin+cyclophosphamide), VFC (vinorelbine/vincristine+5-fluorouracil+cyclophosphamide) and EFC (epirubicin+5-fluorouracil+cyclophosphamide) were investigated. Expression of steroid receptors, HER2, P-gp, MRP, GST-pi and Topo-II was evaluated by immunohistochemical scoring on tumor tissues obtained before and after PCT. The PR of breast carcinoma was graded according to Sataloff's classification. Chi square test, logistic regression and Cochran-Mantel-Haenszel assay were performed to determine the association between biomarkers and PR, as well as the effectiveness of each regimen on induction of PR. There was a clear-cut correlation between the expression of ER and decreased PR to PCT in all three different regimens (p < 0.05). HER2 expression is significantly associated with increased PR in DEC regimen (p < 0.05), but not predictive for PR in EFC and VFC groups. No significant correlation was found between biomarkers PgR, Topo-II, P-gp, MRP or GST-pi and PR to any tested PCT regimen. After adjusted by a stratification variable of ER or HER2, DEC regimen was more effective in inducing PR in comparison with VFC and EFC regimens. ER is an independent predictive factor for PR to PCT regimens including DEC, VFC and EFC in primary breast tumors, while HER2 is only predictive for DEC regimen. Expression of

  13. Pilot Study of 15 Patients Receiving a New Treatment Regimen for Androgenic Alopecia: The Effects of Atopy on AGA

    OpenAIRE

    Rafi, A. W.; Katz, R. M.

    2011-01-01

    Background. We examined the efficacy of a new regimen to treat AGA, with attention to male patients who are atopic. Objective. To assess the efficacy of a four-part regimen for the treatment of AGA in atopic and nonatopic patients. NuH Hair is a novel topical combination of finasteride, dutasteride, and minoxidil, which is blended in a hypoallergenic lotion. The other three components included Rogaine foam, Propecia, and ketoconazole shampoo. Methods. A prospective pilot study was conducted i...

  14. Development of optimal infusion regimens for epoprostenol using radio labelled platelet uptake over atherosclerotic lesions in man.

    OpenAIRE

    Sinzinger, H.; Fitscha, P; Kaliman, J; Silberbauer, K; O'Grady, J.

    1987-01-01

    1. Epoprostenol (prostacyclin, PGI2) has been evaluated in clinical trials in peripheral vascular disease and other conditions chiefly on the basis of its platelet inhibitory properties. These therapeutic evaluations have proceeded in the absence of evidence as to the optimum infusion regimen for epoprostenol and the choice of schedules of administration has been arbitrary. We have tried to establish an optimum infusion regimen in patients with peripheral vascular disease in terms of maximal ...

  15. Efficacy and safety of the HAA regimen as induction chemotherapy in 236 de novo acute myeloid leukemia

    Institute of Scientific and Technical Information of China (English)

    叶佩佩

    2013-01-01

    Objective To evaluate the efficacy and safety of the HAA regimen (homoharringtonine,cytarabine and aclarubicin) as induction chemotherapy in de novo acute myeloid leukemia (AML) .Methods The efficacy and safety of 236 de novo AML patients who received the HAA regimen as induction chemotherapy were retrospectively analyzed.The complete remission (CR) rate was assayed.Kaplan-Meier method was used to estimate overall survival (OS) and relapse free survival (RFS) ,and the differ-

  16. Clinical study of COAD-B regimen in treatment of patients with relapsed /refractory nonHodgkin lymphoma

    Institute of Scientific and Technical Information of China (English)

    李明会

    2013-01-01

    Objective To investigate the efficacy,adverse events and long-term survival of cyclophosphamide,vindesine,cytarabine,dexamethasone and bleomycin (COAD-B) regimen for relapsed and refractory nonHodgkin lymphoma (NHL) .Methods Eighty six patients diagnosed with relapsed or refractory NHL were included in our study from January 2007 to January 2013.The chemotherapy regimen was COAD-B,the therapeutic efficacy was evaluated every 2 courses.Once the stable disease (SD) or progress of the disease (PD) achieved,

  17. Pharmacokinetic study of praziquantel administered alone and in combination with cimetidine in a single-day therapeutic regimen.

    OpenAIRE

    H. Jung; Medina, R; Castro, N.; Corona, T; Sotelo, J.

    1997-01-01

    A brief therapeutic regimen of praziquantel, reduced to a single day, has been effective for treatment of neurocysticercosis. To study its pharmacokinetic characteristics, levels of praziquantel in plasma were determined for eight healthy volunteers after the administration of three oral doses of 25 mg/kg of body weight given at 2-h intervals, alone and with the simultaneous administration of cimetidine. Each volunteer received both regimens in a randomized crossover design. Blood samples wer...

  18. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging

    International Nuclear Information System (INIS)

    To establish the optimum barium-based reduced-laxative tagging regimen prior to CT colonography (CTC). Ninety-five subjects underwent reduced-laxative (13 g senna/18 g magnesium citrate) CTC prior to same-day colonoscopy and were randomised to one of four tagging regimens using 20 ml 40%w/v barium sulphate: regimen A: four doses, B: three doses, C: three doses plus 220 ml 2.1% barium sulphate, or D: three doses plus 15 ml diatriazoate megluamine. Patient experience was assessed immediately after CTC and 1 week later. Two radiologists graded residual stool (1: none/scattered to 4: >50% circumference) and tagging efficacy for stool (1: untagged to 5: 100% tagged) and fluid (1: untagged, 2: layered, 3: tagged), noting the HU of tagged fluid. Preparation was good (76-94% segments graded 1), although best for regimen D (P = 0.02). Across all regimens, stool tagging quality was high (mean 3.7-4.5) and not significantly different among regimens. The HU of layered tagged fluid was higher for regimens C/D than A/B (P = 0.002). Detection of cancer (n = 2), polyps ≥6 mm (n = 21), and ≤5 mm (n = 72) was 100, 81 and 32% respectively, with only four false positives ≥6 mm. Reduced preparation was tolerated better than full endoscopic preparation by 61%. Reduced-laxative CTC with three doses of 20 ml 40% barium sulphate is as effective as more complex regimens, retaining adequate diagnostic accuracy. (orig.)

  19. Outcome of a glucocorticoid discontinuation regimen in patients with inactive systemic sclerosis.

    Science.gov (United States)

    Iudici, Michele; Vettori, Serena; Russo, Barbara; Giacco, Veronica; Capocotta, Domenico; Valentini, Gabriele

    2016-08-01

    Glucocorticoids (GC) are widely used to treat systemic sclerosis (SSc). The lack of efficacy data and patient/physician concerns may prompt therapy discontinuation. The aim of this study is to identify factors hampering GC discontinuation in patients with stable disease on oral GC for longer than 12 months. Consecutive patients fulfilling the 2013 ACR/EULAR criteria for SSc and with stable disease were prescribed a slow tapering GC regimen to achieve discontinuation. At study entry and 6 months later (T6), patients were assessed for disease activity and severity. Moreover, the Short-Form-36; the Health Assessment Questionnaire Disability Index (HAQ-DI); and visual analog scales for fatigue, pain, and general health were completed. Reasons for stopping the discontinuation regimen were recorded. Forty-eight patients (46 females, 9 diffuse SSc), with a mean ± SD age of 56±14 years and a median disease duration of 10 years (range 2-22), were enrolled. The median daily GC dose was 5 mg (range 5-10; all patients treated with prednisone). At T6, 33 (68.7 %) patients had discontinued GC. The remaining 15 patients could not discontinue GC because of arthralgia in eight, arthritis in two, puffy fingers in two, increased creatine-kinase in two, and bursitis in one patient. At multiple logistic analysis, a higher baseline HAQ-DI was the only independent factor associated with GC need (OR 2.98, 95 % CI 1.20-7.41; p = 0.01). About one third of SSc patients did not achieve a GC-free regimen. Disability as assessed by HAQ-DI was the leading factor hindering GC discontinuation. A low HAQ-DI score can identify candidates for GC discontinuation. PMID:27184047

  20. A novel approach to pharmacodynamic assessment of antimicrobial agents: new insights to dosing regimen design.

    Directory of Open Access Journals (Sweden)

    Vincent H Tam

    Full Text Available Pharmacodynamic modeling has been increasingly used as a decision support tool to guide dosing regimen selection, both in the drug development and clinical settings. Killing by antimicrobial agents has been traditionally classified categorically as concentration-dependent (which would favor less fractionating regimens or time-dependent (for which more frequent dosing is preferred. While intuitive and useful to explain empiric data, a more informative approach is necessary to provide a robust assessment of pharmacodynamic profiles in situations other than the extremes of the spectrum (e.g., agents which exhibit partial concentration-dependent killing. A quantitative approach to describe the interaction of an antimicrobial agent and a pathogen is proposed to fill this unmet need. A hypothetic antimicrobial agent with linear pharmacokinetics is used for illustrative purposes. A non-linear functional form (sigmoid Emax of killing consisted of 3 parameters is used. Using different parameter values in conjunction with the relative growth rate of the pathogen and antimicrobial agent concentration ranges, various conventional pharmacodynamic surrogate indices (e.g., AUC/MIC, Cmax/MIC, %T>MIC could be satisfactorily linked to outcomes. In addition, the dosing intensity represented by the average kill rate of a dosing regimen can be derived, which could be used for quantitative comparison. The relevance of our approach is further supported by experimental data from our previous investigations using a variety of gram-negative bacteria and antimicrobial agents (moxifloxacin, levofloxacin, gentamicin, amikacin and meropenem. The pharmacodynamic profiles of a wide range of antimicrobial agents can be assessed by a more flexible computational tool to support dosing selection.