Vorstufen des Zervixkarzinoms (CIN) — Erleben und Krankheitsverarbeitung

Ohne Zusammenfassung     

Anterior segment surgery with use of a new type of sodium hyaluronate preparation IAL

Over a period of 1 year, a new sodium hyaluronate preparation (IAL) has been studied in eye surgery. The study included 18 cases of extracapsular cataract extraction with intraocular lens (IOL) implantation and 19 cases of penetrating keratoplasty. The trial has shown that this substance presents all the advantages described for use of viscoelastic substances in ocular surgery. The use of this sodium hyaluronate preparation appeared to decrease the risk of the postsurgical ocular hypertension described for analogous substances with different physicochemical characteristics.     

Prenatal diagnosis of Mohr syndrome by ultrasonography

A case of prenatal diagnosis of Mohr syndrome is presented. The ultrasound examination was indicated by the previous birth of an affected brother. The need for genetic counselling is stressed, when polydactyly is observed accidentally at ultrasound examination during pregnancy.     

Rat juxtaglomerular cells are endowed with DA-1 dopamine receptors mediating renin release

Under control conditions a primary culture containing about 80-90% of granular juxtaglomerular (JG) cells prepared from rat kidneys continuously released renin into the culture medium at a rate of 17.9 +/- 1.4 ng angiotensin I/h per mg of cell proteins per 30 min (n = 14). Dopamine (1.0 microM), the DA-1 dopamine receptor agonist fenoldopam (0.5 microM), and isoproterenol (1.0 microM) increased renin secretion markedly (130-200%). Propranolol (0.1 microM) reduced the effects of isoproterenol significantly (80%), but not those of dopamine or fenoldopam. In contrast, SCH 23390 (0.01 microM), a DA-1 dopamine receptor antagonist, inhibited markedly only the renin release evoked by the latter two agonists, whereas S-sulpiride (10 microM), a DA-2 dopamine receptor antagonist, and phentolamine (10 microM), a nonselective alpha-adrenoceptor antagonist, did not modify the effects of either dopamine or fenoldopam. In rats, pithed to eliminate reflexogenic mechanisms regulating renin release, at the end of a 15 min i.v. infusion of fenoldopam (20 micrograms/kg per min) there was a significant increase in plasma renin activity. This effect was completely prevented by SCH 23390 (0.1 mg/kg i.v.) but not significantly changed by S-sulpiride (0.3 mg/kg i.v.) or phentolamine (3.0 mg/kg i.v.) plus propranolol (0.75 mg/kg i.v.). In conclusion, these results indicate that DA-1 dopamine receptors are present in rat kidney JG cells and that pharmacological stimulation of these receptors with dopamine or fenoldopam leads to renin secretion.     

Effectiveness of N-acetylcysteine in protecting against mercuric chloride-induced nephrotoxicity.

Mercuric chloride (HgCl2)-induced nephrotoxicity, as measured by functional and biochemical parameters was evaluated in rats at different kidney non-protein sulfhydryls (NPS) levels. Diethylmaleate (DEM) induced a 75% of NPS diminution 1 h after the administration. Renal function (clearance) and biochemical measurements (gamma-glutamyltranspeptidase activity in urine, and lipoperoxides in kidney tissue) were impaired when the animals were HgCl2-treated. Values were highly impaired when the kidneys were NPS-depleted and were improved when NPS pools were previously increased although they were not similar to control values. DEM treatment promoted a higher accumulation of HgCl2 in both kidney and liver while NAC-treatment reduced significantly the metal content in these organs. These data are in favour of a positive relationship among mercury content and organ injury. On the other hand, mercury content increased while NPS levels diminished. NPS might play a role in the HgCl2 detoxification and thus avoids mercury accumulation and mercury effects.     

Biliary excretion and pharmacokinetics of 4'epidoxorubicin (epirubicin) in advanced cancer patients

Summary Plasma pharmacokinetics and biliary and urinary excretion of the new doxorubicin analogue, epirubicin, have been studied in three patients with extrahepatic obstruction and percutaneous biliary drainage.At variance with the reported observations concerning doxorubicin metabolism, conjugation of epirubicin and 13-dihydroepirubicin with glucuronic acid takes place, and corresponding amounts of 4'-o--D-glucuronyl-4'-epidoxorubicin and 4'-o--D-glucuronyl-13-dihydro-4'-epidoxorubicin can be found in the bile and urine.The total amount of unaltered drug and metabolites excreted in the bile in the first 4 days after treatment accounts for the 37%, 27%, and 40% of the administered dose; urinary excretion accounts for 19%, 16%, and 26%. Biliary clearance of epiDX (32.5, 8.1 and 21.6 l/h) is higher than renal clearance (15.2, 3.3 and 9.4 l/h).The relevance of the biliary disposition of epirubicin suggest prudent dose reduction in patients with impaired biliary drainage.Supported in part by contract, CNR, MO85.00710.44 (Progetto Finalizzato Oncologia, Italian National Council of Research)     

Low dose oral administration of 4-demethoxy-daunorubicin (idarubicin) in advanced cancer patients

Summary Data relating to 4-demethoxydaunorubicin (DMDR) pharmacokinetics after oral administration (10–15 mg/m² per day for 3 days) were collected in a total of 12 patients with advanced breast cancer and melanoma.Drug absorption took place in the first 2–4 h after administration. Plasma levels of the reduced metabolite DMDRol were higher than those of the parent compound: Peak levels were 4–10 ng/ml for DMDR and 15–40 ng/ml for DMDRol. The dose-corrected area under the timeconcentration curve (AUC) was consequently higher for DMDRol (12.3–74.7, mean 32.6 vs 2.4–7.4, mean 4.6 ng/ml.mg for DMDR).Apparent plasma terminal half-lives after the last dose administered were in the range of 13–36 (mean 23.7) h for DMDR and 30–81 (mean 58.9) h for DMDRol.Drug and the reduced metabolite accumulated in the blood cells; the ratio of AUC (blood) to AUC (plasma) was 1.40–3.75 (mean 2.80) for DMDR and 1.29–3.50 (mean 2.16) for DMDRol.The biliary excretion of the drug and of the fluorescent metabolites was studied in two additional patients with extrahepatic obstruction and percutaneous biliary drainage. In the first 7 days of therapy, biliary excretion (DMDR + DMDRol) accounted for 3.7%–4% of the administered dose.In contrast to our observations with doxorubicin and epirubicin, urinary excretion seems very likely to be more important for this drug than biliary excretion. In these patients urinary excretions were 2.2, 2.9 times (for DMDR) and 1.2, 3.4 times (for DMDRol) the biliary excretion.Supported in part by contract CNR, n.84.00710.44 (Progetto Finalizzato Oncologia, Italian National Council of Research)     

How multiple episodes of exclusive breastfeeding impact estimates of exclusive breastfeeding duration: report from the eight‐site MAL‐ED birth cohort study

The duration of exclusive breastfeeding (EBF) is often defined as the time from birth to the first non‐breast milk food/liquid fed (EBFLONG), or it is estimated by calculating the proportion of women at a given infant age who EBF in the previous 24 h (EBFDHS). Others have measured the total days or personal prevalence of EBF (EBFPREV), recognizing that although non‐EBF days may occur, EBF can be re‐initiated for extended periods. We compared breastfeeding metrics in the MAL‐ED study; infants' breastfeeding trajectories were characterized from enrollment (median 7 days, IQR: 4, 12) to 180 days at eight sites. During twice‐weekly surveillance, caretakers were queried about infant feeding the prior day. Overall, 101 833 visits and 356 764 child days of data were collected from 1957 infants. Median duration of EBFLONG was 33 days (95% CI: 32–36), compared to 49 days based on the EBFDHS. Median EBFPREV was 66 days (95% CI: 62–70). Differences were because of the return to EBF after a non‐EBF period. The median number of returns to EBF was 2 (IQR: 1, 3). When mothers re‐initiated EBF (second episode), infants gained an additional 18.8 days (SD: 25.1) of EBF, and gained 13.7 days (SD: 18.1) (third episode). In settings where women report short gaps in EBF, programmes should work with women to return to EBF. Interventions could positively influence the duration of these additional periods of EBF and their quantification should be considered in impact evaluation studies. © 2016 John Wiley & Sons Ltd