Biomedicine & pharmacotherapy = Biomédecine & pharmacothérapie
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Biomed. Pharmacother. · Oct 2010
Relationship between N-terminal pro-B-type natriuretic peptide (Nt-proBNP) and cardiac cycle efficiency in cardiac surgery.
N-terminal pro-B-type natriuretic peptide (Nt-proBNP) is a peptide released from myocardium in response to ventricular wall stress and dysfunction. Nt-proBNP plasma levels are elevated in a variety of cardiovascular disorders and are largely used for diagnosis and treatment of cardiac diseases. The cardiac cycle efficiency (CCE) is a haemodynamic variable that represents the left ventricle wall stress and the heart's effort to maintain an adequate blood flow to tissues. ⋯ Correlations between CCE and Nt-proBNP were -0.91, -0.83 and -0.88, at t0, t1 and t2, respectively (p<0.01). Nt-proBNP levels reflect the severity of left ventricle dysfunction in patients undergoing cardiac surgery. CCE correlated well with serum Nt-proBNP levels and seems to be a useful variable to monitor the left ventricular stress and recovery during the various phases of surgery.
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Biomed. Pharmacother. · May 2010
Total parathyroidectomy without autotransplantation for the treatment of secondary hyperparathyroidism associated with chronic kidney disease: clinical and laboratory long-term follow-up.
Forty-six consecutive patients who underwent total parathyroidectomy (tPTX) for hyperparathyroidism associated with end-stage kidney disease (CKD5) in a University Hospital from 1990 to 1999 were included in a long-term observational study. Outcome parameters included symptoms (bone pain, pruritus and muscle weakness evaluated by visual analog scales [VAS]) and laboratory data (intact parathyroid hormone [iPTH], total calcium, and alkaline phosphatase) assessed before, shortly postoperatively and then at a later time point: 40 patients were on maintenance hemodialysis and six on conservative medical therapy. Forty-four patients had four glands removed, while only three glands were found in the remaining two. ⋯ Eleven patients underwent successful renal transplantation and 23 died during the period of observation. iPTH decreased from a mean of 1084+/-505 pg/ml to 120+/-381 pg/ml (p < 0.0001). No subsequent bone fractures, persistent bone pain or disability were reported; this includes patients who later received a functioning renal graft. tPTX was able to correct hyperparathyroidism in most of the patients and was associated with a low long-term relapse rate. iPTH levels remained low in 17 cases without symptoms and no clinically significant side effects. The beneficial effects of tPTX occurred in the majority of patients while renal transplantation was performed in a minority of patients. tPTX should be considered a safe and successful procedure for the treatment of severe secondary hyperparathyroidism associated with chronic kidney disease.
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Biomed. Pharmacother. · Dec 2009
Controlled Clinical TrialInflammatory markers and cardiac function in acute coronary syndrome: difference in ST-segment elevation myocardial infarction (STEMI) and in non-STEMI models.
No studies have been addressed to the differences in inflammation kinetics between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). ⋯ These observations suggest a differential inflammatory pattern in STEMI and NSTEMI patients. The absence of significant correlations between inflammatory indexes and myocardial infarction in NSTEMI supports the hypothesis that a different pattern of inflammation occurs in these patients. CD40L may have an important role as a marker for risk stratification in patients with ACS.
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Biomed. Pharmacother. · Sep 2009
Comparative Study Controlled Clinical TrialComparison of collagen versus adenosine diphosphate in detecting antiplatelet effect in patients with coronary artery disease.
Widely varying methods of assessing platelet aggregation have resulted in the absence of an established standard approach to assess the effects of antiplatelet drugs. The objective of this study was to compare the roles of collagen and adenosine diphosphate (ADP) in the assessment of effects of aspirin or clopidogrel on platelet aggregation. Sixty patients with documented coronary artery disease were assigned to receive aspirin alone (ASA 100 mg/d) (n=30) or aspirin-plus-clopidogrel (ASA 100 mg/d+C 75 mg/d) (n=30). ⋯ When compared with the control group, therapy with ASA or ASA+C resulted in significant inhibition of collagen-induced platelet aggregation (P<0.001 for each), but there was no statistically significant difference in the results between the ASA and ASA+C groups. When platelet aggregation was induced by ADP, the combined therapy with aspirin and clopidogrel decreased platelet aggregation significantly when compared with aspirin alone (P<0.001), and no significant difference in the results between the ASA and normal groups was observed. In conclusion, collagen may prove useful to study the effect of aspirin and ADP may be appropriate for assessing the inhibitory effect of clopidogrel.