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1.
Hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone associated with the use of selective serotonin reuptake inhibitors: a review of spontaneous reports. 总被引:6,自引:1,他引:5 下载免费PDF全文
OBJECTIVE: To review reported cases of hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) associated with the use of selective serotonin reuptake inhibitors (SSRIs). DATA SOURCES: A search of MEDLINE for reports of hyponatremia and SIADH associated with the use of fluoxetine, fluvoxamine, paroxetine or sertraline published between January 1980 and May 1995. Unpublished reports of cases were requested from the pharmaceutical industry, the Ontario Medical Association, the Health Protection Branch of Health Canada, the US Food and Drug Administration and the World Health Organization. DATA SELECTION AND EXTRACTION: Spontaneous reports from postmarketing surveillance. DATA SYNTHESIS: A total of 736 cases of hyponatremia [corrected] and SIADH associated with SSRI use were reported. Fluoxetine was involved in 554 (75.3%) of the cases, paroxetine in 91 (12.4%), sertraline in 86 (11.7%) and fluvoxamine in 11 (1.5%). Reports of 30 cases were published. The remaining 706 cases were reported to monitoring bodies and the pharmaceutical industry. According to information in the published reports, the median time to onset of hyponatremia was 13 days (range 3 to 120 days). Most (83%) of the published cases involved patients 65 years of age or more, as compared with 74% of the unpublished cases. CONCLUSION: Elderly people may be at increased risk for hyponatremia associated with SSRI use. Physicians caring for elderly patients should be aware of this potentially serious but reversible adverse effect. Further research is required to determine the incidence of this adverse effect, the relative risk of hyponatremia and SIADH in different age groups and the risk associated with different SSRI drugs. 相似文献
2.
Analysis of gene expression patterns in small amounts of human ventricular myocardium by a multiplex RNase protection assay 总被引:3,自引:0,他引:3
C. Mittmann Ursula Münstermann Joachim Weil Michael Böhm Stefan Herzig Christoph Nienaber Thomas Eschenhagen 《Journal of molecular medicine (Berlin, Germany)》1998,76(2):133-140
End-stage human heart failure is associated with changes in expression of steady-state messenger RNA (mRNA) levels. These
changes correspond to alterations in protein levels and myocardial function and may have clinical implications regarding etiology,
clinical state, or prognosis. However, analysis of mRNA levels in endomyocardial biopsies can be accomplished only by the
quantitative polymerase chain reaction, which is difficult to standardize. The aim of the study was to evaluate whether the
RNase protection assay is applicable to measure mRNAs of multiple genes simultaneously in small amounts of ventricular myocardium
comparable to myocardial biopsies. Total RNA was prepared from left ventricular myocardium from terminally failing hearts
with idiopathic (n=9) or ischemic cardiomyopathy (n=7) and from nonfailing control hearts (n=10). mRNA was measured by an optimized RNase protection assay for the β1-adrenoceptor, the stimulatory G protein α-subunit (Gsα), phospholamban, the calcium ATPase of the sarcoplasmic reticulum (SERCA), β-myosin heavy chain (β-MHC), and the atrial natriuretic
peptide (ANP). We extracted 10.7±2.1 μg total RNA from three myocardial biopsies taken in vitro. All of the six genes were
measurable in duplicate in a total of 7 μg RNA. mRNAs of β1-adrenoceptor, phospholamban, and SERCA were lower in failing than in nonfailing myocardium by 50%, 33%, and 42% respectively,
whereas β-MHC and Gsα mRNAs were unchanged. mRNA of ANP was expressed at high levels only in the failing myocardium, providing a highly specific
and sensitive marker for discriminating nonfailing and failing hearts. A direct comparison with ANP and Gsα levels obtained by Northern blot analysis with 7.5 μg total RNA showed a good correlation between the two methods. The RNase
protection assay is thus a suitable method for simultaneous measurements of multiple mRNA levels in human myocardial biopsies.
Changes in mRNA levels closely reflected those identified by other methods using larger amounts of RNA. Increased myocardial
ANP mRNA levels determined by the RNase protection assay may serve as a molecular marker of heart failure.
Received: 12 May 1997 / Accepted: 8 September 1997 相似文献
3.
Evaluation of the extent of under-reporting of serious adverse drug reactions: the case of toxic epidermal necrolysis. 总被引:2,自引:0,他引:2
Nicole Mittmann Sandra R Knowles Manuel Gomez Joel S Fish Robert Cartotto Neil H Shear 《Drug safety》2004,27(7):477-487
INTRODUCTION: Toxic epidermal necrolysis (TEN) is a life-threatening adverse drug reaction (ADR) that is primarily the result of drug exposure (incidence 0.4-1.3 per million person-years). Life-threatening ADRs such as TEN should be reported to ADR monitoring programmes, which collect reports for suspected ADRs and alert the public and medical practitioners to new drug hazards. In Canada, reports are made to the Canadian Adverse Drug Reaction Monitoring Program (CADRMP). OBJECTIVE: To examine the extent of under-reporting for TEN in Canada. DESIGN: A retrospective case series design was used to collect all TEN cases for the period January 1995 to December 2000. METHODS: The CADRMP and 22 burn centres across Canada were contacted for all TEN patients treated during the specified time period. PATIENT GROUPS STUDIED: The study population consisted of patients admitted to burn treatment sites across Canada, patient cases reported to the CADRMP and patient cases recorded by the Canadian Institute for Health Information (CIHI) hospital discharge summaries as the International Classification of Diseases Version 9 Clinical Modification (ICD-9-CM) code 695.1. RESULTS: Twenty-five TEN cases (six fatal) were reported to CADRMP from January 1995 to December 2000. During this period, 14 (63.6%) burn treatment sites reported admission of 250 TEN cases. Hospital discharge summaries using the ICD-9-CM code 695.1 indicated that 4349 cases were admitted to hospital during this time period and it was estimated that 15.5% (n = 674) of these cases were TEN. Using the burn facility data as the denominator, 10% (25 of 250) of TEN cases were reported to CADRMP. Using CIHI data as a denominator, only 4% (25 of 674) of TEN cases were reported to CADRMP. CONCLUSIONS: There is serious under-reporting of TEN. Lack of reporting of life-threatening ADRs can compromise population safety. There is a need to increase awareness of ADR reporting programmes. 相似文献
4.
Irene Geisner Angela Mittmann Elisa Sheng Tracy Herring Melissa Lewis Christine Lee 《Addiction Research & Theory》2015,23(3):238-245
Research has documented normative perceptions of others' alcohol use and how these related to increased rates of drinking and related problems among college students. Recently, research has expanded this concept to specific events (21st birthday drinking and tailgating). No studies to date examine the construct of normative perceptions of alcohol use for spring break (SB). SB is a known time of risk for increased alcohol use, and understanding whether students overestimate SB drinking norms, variables that influence norms perceptions (gender, ethnicity and travel) and whether SB norms relate to one's own drinking can inform future prevention and intervention efforts. We extend the literature by examining SB normative perceptions: (1) whether or not these perceptions are accurate and (2) the relationship to students' own drinking and related consequences. A random sample (N?=?1583) of students were asked about their SB drinking, consequences and norm perceptions. Students' SB drinking in this study was lower than their perception of typical student SB drinking (p?<?0.001), and women's perceptions were higher than men's (p?<?0.001). After adjusting for demographics and typical drinking, SB norms were significantly associated with SB drinking among those taking a trip over SB (p?<?0.001). After controlling for SB drinking, SB drinking norms were unrelated to consequences. Similar misperceptions exist for SB drinking. Prevention and intervention efforts aimed at reducing SB drinking and consequences, particularly for those planning a trip, may incorporate SB specific social norms education. 相似文献
5.
6.
Mittmann C Pinkepank G Stamatelopoulou S Wieland T Nürnberg B Hirt S Eschenhagen T 《Journal of molecular and cellular cardiology》2003,35(10):1241-1249
Muscarinic acetylcholine receptors (mAChRs) mediate their main cardiac effects via pertussis toxin-sensitive G-proteins. Physiological effects differ considerably between atrium and ventricle, and it is unknown to which extent these differences derive from selective receptor-G-protein coupling or further downstream events. We have characterized specific coupling between mAChRs and Gi/Go-protein isoforms in atrial and ventricular myocardium by agonist-dependent photoaffinity labeling with [(32)P]azidoanilido GTP (aaGTP) and immunoprecipitation in sarcolemmal membranes from terminally failing human hearts. The total amount of mAChRs, as determined by specific binding of [(3)H]QNB, was significantly higher in right-atrial (RA +/- SEM, 959 +/- 68 fmol/mg, n = 4) than in left-ventricular membranes (LV, 582 +/- 53 fmol/mg, n = 6). Standardized immunoblots revealed that Gialpha-2 was the predominant subtype in both regions. A 40-kDa splice variant of Goalpha (Goalpha-1 and/or Goalpha-3) was almost exclusively detectable in RA. Levels of Gialpha-3 and a 39-kDa splice variant of Goalpha (Goalpha-2) were also higher in RA. Basal aaGTP binding was higher in RA than in LV for all Gialpha/Goalpha subtypes. The carbachol (10 micromol/l)-induced increase in aaGTP binding was significantly higher in RA than in LV for Goalpha-1/3 (336 +/- 95% of LV, n = 4) and for Gialpha-3 (211 +/- 83%), lower for Gialpha-2 (42 +/- 5%), and was similar in both regions for Goalpha-2 (130 +/- 62%). The differential coupling of mAChRs in human RA and LV suggests that the initiation of different physiological responses to mAChR stimulation starts with signal sorting at the receptor-G-protein level. 相似文献
7.
8.
9.
Ingo Todt Grit Rademacher Sven Mutze Ravi Ramalingam Selene Wolter Philipp Mittmann 《Acta oto-laryngologica》2015,135(8):781-785
Conclusion: Cochlear implant electrode position has an impact on the rate of tinnitus suppression and generation. Objective: Suppression of pre-operative tinnitus or a generation of a new tinnitus in cochlear implantees is a known effect of cochlear implantation. The aim of the current study was to evaluate different cochlear implant electrode positions and their relationship with tinnitus suppression and tinnitus generation. Method: This study retrospectively evaluated four groups of CI recipients with radiologically evaluated electrode positions in relation to their subjective tinnitus quality, as evaluated by an analogue loudness scale (ALS) and a questionnaire. Group 1 consisted of 19 patients with a scalar change of the electrode position. Group 2 consisted of 18 patients with a scala tympani position and a perimodiolar electrode. Group 3 consisted of 10 patients with a scala tympani position and a lateral wall electrode. Group 4 consisted of eight patients with a scala vestibuli position. Results: An overall tinnitus suppression rate of 45.9% and a generation of a new tinnitus or the deterioration of an existing one of 5.6% were observed. A significant difference in tinnitus suppression was found between groups 1 and groups 2, 3, and 4 in tinnitus suppression and tinnitus generation. 相似文献
10.
Monica Patten Jan Bünemann Bryan Thoma Elisabeth Kr?mer Martin Thoenes Sabine Stübe Clemens Mittmann Thomas Wieland 《Cardiovascular research》2002,53(1):156-164
OBJECTIVE: Endotoxin (LPS)-induced acute cardiac failure during sepsis is associated with alterations in G protein mediated signal transduction. We therefore examined the expression of the G proteins G(i), G(q), and G(s) and of four 'regulators of G protein signaling' (RGS) proteins, RGS1, RGS4, RGS5, and RGS16 in rat hearts. METHODS: For in vivo experiments, Wistar rats were treated with 600 microg/day E. coli LPS, intravenously) and hearts were excised after 6, 24 and 72 h. Cultured neonatal rat cardiomyocytes were treated with 4 microg/ml LPS for 24 and 72 h. Isolated membrane proteins were used for Western blot analysis and for evaluation of phospholipase C (PLC) activity. RGS16 mRNA was detected by RNAse protection. RESULTS: LPS induced G(i) protein 1.4-fold 72 h after in vivo administration of LPS, whereas expression of G(s) and G(q) was unaltered. After 6 h of LPS treatment, RGS16 mRNA was transiently up-regulated 3.7-fold, followed by transient protein induction (24 h: 2.5-fold; 72 h: 1.5-fold). Similarly, RGS4 protein was transiently induced (24 h: 3.1-fold; 72 h: 1.5-fold), whereas expression of RGS1 and RGS5 was not altered. Similar to the LPS-treated rat hearts, RGS16 expression was transiently induced by LPS in cultured neonatal rat cardiomyocytes (24 h: 1.6-fold, 72 h: 0.9-fold). To determine the functional consequences of the RGS protein induction phospholipase C (PLC) activity was analyzed in membranes obtained from solvent and LPS-treated hearts. Basal and endothelin-1-stimulated PLC activity was transiently repressed by LPS with a maximum after 24 h although no apparent changes in PLCbeta1 or endothelin receptor expression could be detected. CONCLUSION: These data suggest that the rapid up-regulation of cardiac RGS4 and RGS16 is associated with a desensitization of endothelin-1 receptor signaling. Up-regulation of these RGS proteins may thus be involved in the early onset of cardiac failure during sepsis. 相似文献