The role of adenosine receptors and endogenous adenosine in citalopram-induced cardiovascular toxicity

Aim:

We investigated the role of adenosine in citalopram-induced cardiotoxicity.

Materials and Methods:

Protocol 1: Rats were randomized into four groups. Sodium cromoglycate was administered to rats. Citalopram was infused after the 5% dextrose, 8-Cyclopentyl-1,3-dipropylxanthine (DPCPX; A₁ receptor antagonist), 8-(-3-chlorostyryl)-caffeine (CSC; A_2a receptor antagonist), or dimethyl sulfoxide (DMSO) administrations. Protocol 2: First group received 5% dextrose intraperitoneally 1 hour prior to citalopram. Other rats were pretreated with erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA; inhibitor of adenosine deaminase) and S-(4-Nitrobenzyl)-6-thioinosine (NBTI; inhibitor of facilitated adenosine transport). After pretreatment, group 2 received 5% dextrose and group 3 received citalopram. Adenosine concentrations, mean arterial pressure (MAP), heart rate (HR), QRS duration and QT interval were evaluated.

Results:

In the dextrose group, citalopram infusion caused a significant decrease in MAP and HR and caused a significant prolongation in QRS and QT. DPCPX infusion significantly prevented the prolongation of the QT interval when compared to control. In the second protocol, citalopram infusion did not cause a significant change in plasma adenosine concentrations, but a significant increase observed in EHNA/NBTI groups. In EHNA/NBTI groups, citalopram-induced MAP and HR reductions, QRS and QT prolongations were more significant than the dextrose group.

Conclusions:

Citalopram may lead to QT prolongation by stimulating adenosine A₁ receptors without affecting the release of adenosine.KEY WORDS: Adenosine receptor, citalopram toxicity, endogenous adenosine, QT prolongation, rat     

Prevalence of atopy in rheumatoid arthritis in Sivas,Turkey. A prospective clinical study

Assumed mutual antagonism of T-helper cell (Th)1 and Th2 diseases suggests that the prevalence of atopy should be decreased in rheumatoid arthritis (RA). We tried to determine that prevalence. Sixty-two patients with RA and 61 with osteoarthritis (control group) were included in the study. A questionnaire was used concerning mainly the symptoms of atopy. Skin prick tests, pulmonary function tests, chest X-rays, immunoglobulin E levels, and eosinophil counts were obtained. The prevalences of asthma, hay fever, and eczema in the RA group were 3.2%, 14.5%, and 1.6%, respectively. In the control group, they were 6.5%, 22%, and 6.5%, respectively. There was no significant difference between groups. There was also no significant difference between immunoglobulin E levels. Eosinophil counts were higher in the control group, however these values were within the normal range. Skin prick tests were obtained in seven RA patients, and eight controls revealed increased positivity. The prevalence of atopy in rheumatoid arthritis was not different from that in the general population. Our study results cannot support the concept of Th1/Th2 mutual antagonism.     

Change of mean platelet volume values in asthmatic children as an inflammatory marker

BackgroundAsthma is the most common chronic disease of childhood in industrialised countries. T helper-2 (Th-2) cells, mast cells and eosinophils have a role in inflammation of asthma. Recently it was shown that platelets also play a role in asthma. Mean platelet volume shows platelet size and reflects platelet activation.ObjectiveThe aim of this retrospective study is to evaluate levels of mean platelet volume in asthmatic patients during asymptomatic periods and exacerbations compared with healthy controls.MethodsThe study consisted of 100 asthmatic patients (male/female: 55/45, mean age: 8.2 ± 3.3) and 49 age and sex matched healthy children as a control group.ResultsMean platelet volume values of asthmatic patients during asymptomatic period were 7.7 ± 0.8 fL while mean platelet volume values in asthmatics during exacerbation were 7.8 ± 0.9 fL. Comparison of mean platelet volume values of asthmatic patients and healthy controls both in acute asthmatic attack and asymptomatic period showed no difference (p > 0.05). Comparison of mean platelet volume values at asthmatic attack and asymptomatic period also had no difference (p > 0.05). The presence of atopy, infection, eosinophilia, elevated immunoglobulin E, and severity of acute asthmatic attack did not influence mean platelet volume values.ConclusionThe results of our study suggest that mean platelet volume values may not be used as a marker in bronchial asthma, although prospective studies with larger number of patients are needed to evaluate the role of mean platelet volume in asthma.     

氯硝柳胺杀虫丁和四聚乙醛杀螺效果比较研究

目的：筛选一种合适的杀螺锴物。方法：采用室内浸杀,喷洒,喷粉,上爬,毒性试验及现场浸杀,喷洒,喷粉,沿边浸杀试验,对氯硝柳胺与杀虫丁,四聚乙醛等进行平行比较试验,结果：在室内23－25℃气温条件下,氯硝柳胺杀螺作用优于杀虫丁和四聚乙醛,抑制钉螺上爬作用不及杀虫丁,鱼毒大于杀虫丁,在现场28－35℃气温条件下,氯硝柳胺和杀虫丁杀螺作用相仿。沿边浸杀氯硝柳胺优于四聚乙醛,喷粉杀螺氯硝柳胺与四聚乙醛相仿,结论：在现阶段氯硝柳胺仍是一种较好的杀螺药物。     

Impact of previous mesh hernia repair on the performance of open radical prostatectomy – complications and functional outcome

Study Type – Therapy (case series)
Level of Evidence 4

OBJECTIVES

To determine the impact of previous inguinal mesh hernia repair (IMHR) on the performance of subsequent open radical retropubic prostatectomy (ORRP).

PATIENTS AND METHODS

A total of 1466 patients underwent ORRP for clinically localized prostate cancer from 2004 to 2008; 51 patients (3.5%) presented with a history of IMHR. Body‐mass index (BMI), perioperative blood loss (PBL), operating time (OT), performance of pelvic lymph node dissection (PLD), positive resection‐margins (R1), continence and potency between the groups were analysed using Mann–Whitney U and χ² tests.

RESULTS

Fifty‐one patients with previous IMHR were compared with 1466 patients without previous mesh implantation (nMI) who underwent ORRP. Mean age was 66.8 years and mean BMI 25.7. No statistically difference in the mean OT (68 vs 72 min, P= 0.112), mean PBL (167 vs 156 ml, P= 0.089) or R1 was observed in the pT2‐stage tumors (3% vs 9.7%, P= 0.197), or in the pT3‐stage tumors (16% vs 21%, P= 0.386). After 3 months 85% showed full continence in the nMI group vs 83.9% MI group (P= 0.864) and after 12 months 94.5% of the nMI patients vs 97.6% with mesh (P= 0.610). The IIEF‐5 score after 3 months showed a median of 9.0 in the MI group and 4.5 in the nMI group (P= 0.116) and after 12 months 12.0 in the MI group and 9.0 in the nMI group (P= 0.511). PLD was significantly more feasible in patients that underwent only unilateral IMHR compared with bilateral IMHR (96% vs 40%, P= 0.001) and significantly less feasible if previous IMHR was operated laparoscopically than with an open access (47% vs 88%, P= 0.014).

CONCLUSION

No impairment of perioperative variables or functional outcome during ORRP was observed in patients with IMHR. PLD could be performed in a significantly fewer patients who underwent bilateral IMHR or laparoscopic IMHR.