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Background and purpose:
Tecarfarin (ATI-5923) is a novel vitamin K epoxide reductase inhibitor that is metabolized by esterase (mainly human carboxylesterase 2) to a single major metabolite, ATI-5900, in rats, dogs and humans. Tecarfarin is not significantly metabolized by CYP450 enzymes. The objective of this study was to test and compare the efficacy of tecarfarin with that of warfarin, when administered either intravenously or once a day orally, to produce stable anticoagulation in beagle dogs.Experimental approach:
Effects on coagulation were assessed by measuring the activity levels of Factor VII and Factor X and thromboplastin-induced coagulation times, reported as prothrombin time (PT).Key results:
Continuous intravenous infusions and oral administration of tecarfarin and warfarin caused a dose-dependent decrease in activity of Factor VII and Factor X, and associated increase in PT. Intravenous fresh frozen canine plasma or subcutaneous vitamin K1 treatment reversed the anticoagulant effects of orally administered tecarfarin. Consistent with the inhibitory effects of amiodarone on CYP2C9, co-administration of amiodarone significantly increased the anticoagulation effect of warfarin and plasma warfarin concentrations. In contrast, amiodarone had no effect on the anticoagulation induced by tecarfarin or tecarfarin plasma concentrations in this model.Conclusions and implications:
Overall, the data presented herein indicate that tecarfarin, via a vitamin K-dependent mechanism, causes changes in key parameters of haemostasis in beagle dogs that are consistent with effective anticoagulation. Compared to warfarin it has a decreased potential to interact metabolically with drugs that inhibit CYP450 enzymes and, therefore, may offer an improved safety profile for patients. 相似文献Background and purpose:
This study investigates the role of α2-adrenoceptor subtypes, α2A, α2B and α2C, on catecholamine synthesis and catabolism in the central nervous system of mice.Experimental approach:
Activities of the main catecholamine synthetic and catabolic enzymes were determined in whole brains obtained from α2A-, α2B- and α2C-adrenoceptor knockout (KO) and C56Bl\7 wild-type (WT) mice.Key results:
Although no significant differences were found in tyrosine hydroxylase activity and expression, brain tissue levels of 3,4-dihydroxyphenylalanine were threefold higher in α2A- and α2C-adrenoceptor KO mice. Brain tissue levels of dopamine and noradrenaline were significantly higher in α2A and α2CKOs compared with WT [WT: 2.8 ± 0.5, 1.1 ± 0.1; α2AKO: 6.9 ± 0.7, 1.9 ± 0.1; α2BKO: 2.3 ± 0.2, 1.0 ± 0.1; α2CKO: 4.6 ± 0.8, 1.5 ± 0.2 nmol·(g tissue)−1, for dopamine and noradrenaline respectively]. Aromatic L-amino acid decarboxylase activity was significantly higher in α2A and α2CKO [WT: 40 ± 1; α2A: 77 ± 2; α2B: 40 ± 1; α2C: 50 ± 1, maximum velocity (Vmax) in nmol·(mg protein)−1·h−1], but no significant differences were found in dopamine β-hydroxylase. Of the catabolic enzymes, catechol-O-methyltransferase enzyme activity was significantly higher in all three α2KO mice [WT: 2.0 ± 0.0; α2A: 2.4 ± 0.1; α2B: 2.2 ± 0.0; α2C: 2.2 ± 0.0 nmol·(mg protein)−1·h−1], but no significant differences were found in monoamine oxidase activity between all α2KOs and WT mice.Conclusions and implications:
In mouse brain, deletion of α2A- or α2C-adrenoceptors increased cerebral aromatic L-amino acid decarboxylase activity and catecholamine tissue levels. Deletion of any α2-adrenoceptor subtypes resulted in increased activity of catechol-O-methyltransferase. Higher 3,4-dihydroxyphenylalanine tissue levels in α2A and α2CKO mice could be explained by increased 3,4-dihydroxyphenylalanine transport. 相似文献Methods: Twelve simulated acute intraoperative scenarios were designed to assess the performance of 64 residents and 35 anesthesiologists. The participants were divided into four groups based on their training and experience. There were 31 new CA-1, 12 advanced CA-1, and 22 CA-2/CA-3 residents as well as a group of 35 experienced anesthesiologists who participated in the assessment. Each participant managed a set of simulated events. The advanced CA-1 residents, CA-2/CA-3 residents, and 35 anesthesiologists managed 8 of 12 intraoperative simulation exercises. The 31 CA-1 residents each managed 3 intraoperative scenarios.
Results: The new CA-1 residents received lower scores on the simulated intraoperative events than the other groups of participants. The advanced CA-1 residents, CA-2/CA-3 residents, and anesthesiologists performed similarly on the overall assessment. There was a wide range of scores obtained by individuals in each group. A number of the exercises were difficult for the majority of participants to recognize and treat, but most events effectively discriminated among participants who achieved higher and lower overall scores. 相似文献
Objective This paper aims to characterize and study a series of cutaneous lymphomas showing a prominent granulomatous component.
Patients and methods The clinical, histopathological and evolutive features of granulomatous variants of mycosis fungoides (5 patients, 2 of them associating 'granulomatous slack skin' features), Sézary syndrome (1 patient), CD30
Results The observed features were clinically non-distinctive. Only those cases presenting with granulomatous slack skin features were clinically suspected (2 patients). Non-necrotizing granulomata (11 patients) and granuloma annulare-like (4 patients) were the most frequently observed histopathological patterns. In five cases, no diagnostic lymphomatous involvement was initially observed. From our series, no definite conclusions regarding prognosis could be established.
Conclusion The diagnosis of cutaneous lymphoma may be difficult when a prominent cutaneous granulomatous inflammatory infiltrate obscures the true neoplastic nature of the condition. However, the presence of concomitant lymphoid atypia may help to suspect the diagnosis. In doubtful cases, the clinical evolution and the demonstration of a monoclonal lymphoid B- or T-cell population may lead to a definite diagnosis.
Conflicts of interest
None declared. 相似文献