Effect of a new quinolone, sparfloxacin, on the pharmacokinetics of theophylline in asthmatic patients.

Recently, it has become evident that some quinolones affect the processing of theophylline in the human system. The effect of a new quinolone, sparfloxacin, on the pharmacokinetics and metabolism of theophylline was investigated in six asthmatic patients receiving chronic theophylline therapy (a sustained-release theophylline tablet formulation of 200 to 300 mg twice daily at 12-h intervals). To these patients, sparfloxacin (200 mg once daily) was coadministered for 1 week. Plasma and urine samples were analyzed by high-performance liquid chromatography for theophylline and its metabolites. Plasma theophylline concentration-time curves and the urinary excretion of theophylline and its major metabolites before and after coadministration of sparfloxacin were compared. The total body clearance of theophylline after coadministration of sparfloxacin, 42.81 +/- 6.64 ml/h/kg (mean +/- standard error of the mean), was not significantly different from that after the administration of theophylline alone, 47.11 +/- 7.61 ml/h/kg. Also, no significant change in the urinary excretion of theophylline and its metabolites was observed for subjects receiving or not receiving sparfloxacin. These findings indicate that a once-daily dose of 200 mg of sparfloxacin has no significant effect on the pharmacokinetics and metabolism of theophylline and that it would be safe to coadminister this quinolone to asthmatic patients receiving chronic theophylline therapy.     

Citations of Brazilian physical therapy journals in national publications

Background

Quotations in Brazilian journals are mainly obtained from national articles (articles from Brazilian journals); thus, it is essential to determine how frequently these articles reference Brazilian journals.

Objective

This study sought to verify how frequently national papers are cited in the references of three Brazilian physical therapy journals.

Method

All references for articles published in Fisioterapia em Movimento, Fisioterapia e Pesquisa and Revista Brasileira de Fisioterapia between 2010 and 2012 were evaluated. In particular, the numbers of national articles and international articles (articles from international journals) cited in these references were determined.

Results

A total of 13,009 references cited by 456 articles were analyzed, and 2,924 (22.47%) of the cited works were national articles. There were no significant differences among the three examined years. A total of 36 (7.89%) articles did not cite national articles, whereas 65 (13.25%) articles cited more national articles than international articles.

Conclusion

On average, 22.47% of the works cited by the evaluated articles were national articles. No significant differences were detected among the three analyzed years.     

Secundum atrial septal defect with severe pulmonary hypertension. Open lung biopsy diagnosis of operative indication

In 14 of 15 patients ranging in age from 1 to 62 years (mean of 34) with secundum atrial septal defect (ASD) and pulmonary hypertension over 60 mm Hg peak pressure, operative indication was determined by morphometric diagnosis of open biopsy of lung specimens. In one patient, open lung biopsy was also performed during corrective surgery. Pulmonary arterial changes in the 15 patients were grouped into four classifications as follow: (1) plexogenic pulmonary arteriopathy (six patients); (2) thromboembolism in small pulmonary arteries (three patients); (3) "musculoelastosis," intimal proliferation of longitudinal smooth muscle bundles and elastic fibers (three patients); and (4) combinations of (1), (2) or (1), (3) (three patients). We conclude concerning the operative indication that group 2 patients are operable in all cases and group 1 patients with Yamaki's index of pulmonary vascular disease of 2.2 or less; group 3 patients with the absence of complete occlusion of the small pulmonary arterial lumen are operable, and patients with clear evidence of severe plexogenic pulmonary arteriopathy in group 4 are not operable. Comparative analysis of pulmonary pathology and hemodynamic performance revealed that open lung biopsy should be performed to determine operative candidacy in cases with a pulmonary vascular resistance greater than 8 unit X m2, which is considered to represent the borderline of operability.     

Indications for open lung biopsy in patients with ventricular septal defect and/or patent ductus arteriosus with pulmonary hypertension

Summary In a previous paper, it was stated that open lung biopsy for determination of operative indications could be recommended if pulmonary vascular resistance (PVR) were higher than 8 units · m² in patients with ventricular septal defect (VSD) and/or patent ductus arteriosus (PDA) with severe pulmonary hypertension. In the present study, oxygen inhalation or Tolazoline administration tests with or without occlusion of ductus arteriosus were performed during cardiac catheterization in 47 patients with VSD and/or PDA with severe pulmonary hypertension. The results obtained were compared with the operability based on our histopathological diagnostic criteria. There was no correlation between the oxygen, Tolazoline, or ductus occlusion hemodynamics and the baseline hemodynamics for better prediction of the biopsy results. It was concluded that open lung biopsy should be performed for the determination of operative indication when patients with VSD and/or PDA have a PVR higher than 8 units.m², and if the PVR is greater than 4 units.m² with the oxygen inhalation test or 7 units.m² with the Tolazoline test.     

Severe unilateral pulmonary vascular changes in child with polysplenia

A 12-year-old boy with polysplenia and single ventricle experienced recurrent episodes of pneumonia, hemoptysis, and pulmonary hypertension. Unilateral pulmonary vein obstruction was diagnosed, and a left pneumonectomy was performed. Microscopy of the resected specimen revealed pulmonary veno-occlusive disease in the small pulmonary venules, and old arteritis in the small pulmonary arteries.     

Adaptive Servoventilation Improves Cardiorenal Function and Prognosis in Heart Failure Patients With Chronic Kidney Disease and Sleep-Disordered Breathing

BackgroundChronic kidney disease (CKD) and sleep-disordered breathing (SDB) play critical roles in the progression of chronic heart failure (CHF). However, it still remains unclear whether adaptive servoventilation (ASV) improves cardiorenal function and the prognosis of CHF patients with CKD and SDB.Methods and ResultsEighty CHF patients with CKD (estimated glomerular filtration rate of <60 mL min^?1 1.73 cm^?2) and SDB (apnea-hypopnea index >15/h) were enrolled and divided into 2 groups: 36 patients were treated with usual care plus ASV (ASV group) and 44 patients were treated with usual care alone (Non-ASV group). Levels of B-type natriuretic peptide, glomerular filtration rate, cystatin C, C-reactive protein, noradrenaline, and left ventricular ejection fraction were measured before treatment and 6 months after treatment. Patients were followed to register cardiac events occurring after enrollment. Six months of ASV therapy reduced levels of B-type natriuretic peptide, cystatin C, C-reactive protein, and noradrenaline and improved the glomerular filtration rate and ejection fraction (all P < .05). However, none of these parameters changed in the Non-ASV group. Thirty-two events (14 deaths and 18 rehospitalizations) occurred during the follow-up period (mean 513 days). Importantly, the event-free rate was significantly higher in the ASV group than in the Non-ASV group (77.8% vs 45.5%; log rank P < .01).ConclusionsASV improves the prognosis of CHF patients with CKD and SDB, with favorable effects such as the improvement of cardiorenal function and attenuation of inflammation and sympathetic nervous activity.     

Rapidly growing aneurysm

A rare case of rapidly growing intracranial aneurysm is reported. The enlarged aneurysmal wall was extirpated and studied histologically. The cause of the rapid growth of the aneurysm is discussed.     

Repair of complete atrioventricular septal defect with severe pulmonary hypertension -effect of re-pulmonary artery banding and analysis of lung biopsy a case report-

We report a case complete atrioventricular defect with severe pulmonary hypertension. The patient was a girl aged 2 years and 6 months with Down’s syndrome who had undergone pulmonary artery banding (PAB) 2 years previously. Postoperative catheterization after PAB showed severe pulmonary hypertension. Pulmonary resistance values were 9.3 and 7.3 units at 1 year and 5 months and 1 year and 9 months respectively. We performed re-PAB and lung biopsy when the patient was 2 years and 6 months old. The biopsy specimen at re-PAB classified as Heath-Edwards grade 3 and had an IPVD score of 1.7, indicating tolerance to radical operation. Six months after re-PAB, pulmonary vascular resistance decreased a level at which radical operation could be performed safely. Radical operation was performed 1 year and 4 months after re-PAB. The post operative course was uneventful, and pulmonary hypertensive crisis did not occur. The lung biopsy at the final operation was classified as Heath-Edwards grade 3, had an IPVD score of 1.1, and showed improvement when compared with the pathological findings at re-PAB. (J Jpn Assn Thorac Surg 1998; 46: 579-582)