6 research outputs found
Ticagrelor as an Alternative for Clopidogrel-Associated Acute Arthritis
No full textA 65-year-old Caucasian man was hospitalized for a non-ST-elevation myocardial infarction. On discharge, the patient was started on multiple new medications, including clopidogrel and atorvastatin. Twenty-six days after discharge, he presented to the Emergency Department (ED) with polyarthralgias. He was instructed to stop atorvastatin and to follow up with rheumatology and cardiology clinic. At cardiology clinic follow-up 43 days after ED discharge, clopidogrel was discontinued and patient was switched to ticagrelor. On follow-up one month later, his symptoms had completely resolved. During the next 4 months, patient had routine follow-up due to participation in Cardiopulmonary Rehab and he had no cardiac events or recurrence of joint symptoms. Our patient had no history of arthritis. Because he initially presented with 2 medication classes associated with arthritis, each was withdrawn separately. The temporal association of patient’s symptomatic improvement strongly suggests that the arthritis was caused by clopidogrel. Our patient was able to tolerate ticagrelor with complete resolution of his arthritis and no cardiac events. Clopidogrel-induced arthritis is a rare adverse drug event. For patients with a recent drug-eluting stent, alternative antiplatelet therapy with ticagrelor may provide positive cardiac outcomes without similar adverse effects.</jats:p
Nutrient analysis of ten raw U.S. beef variety meat items and beef flavor myology
No full text2018 Summer.Includes bibliographical references.Many factors play a role in decision-making related to food and diet; these are closely linked to preferences and personal values in populations with access to a safe and affordable food supply. Many consumers value both nutrition and flavor preferences when making individual choices that ultimately comprise their overall diet pattern. Therefore, it is critical to maintain current, valid information regarding both the sensory profile and nutrient content of foods in the marketplace. Two studies were performed on edible portions of beef carcasses; the first evaluated nutritional value of beef variety meat items in order to update the United States Department of Agriculture (USDA) Food Composition Database. Nutrition information in databases maintained by the USDA is used as groundwork by various groups for several purposes, including nutrition monitoring activities, research, policy creation, and nutritional labeling. However, up-to-date nutrition information is not available for beef variety meat items. Therefore, the objective of this study was to expand availability of nutrient data for beef variety meat items. Beef heart, liver, kidney, tongue, honeycomb tripe, oxtail, marrow bones, testicles, blood, and bone broth were obtained from facilities in the United States. Standardized procedures were used to dissect and homogenize samples. Nutrient analysis occurred at USDA-Agricultural Research Service (ARS) approved laboratories using validated methods and standards. Each of the variety meat items in this study qualifies for at least one "Good Source" or "Excellent Source" labeling claim as defined by the USDA based on the proportion of separable lean component. "Good source" indicates that a product contains 10-19% of the Daily Value (DV) or Recommended Daily Intake (RDI) per Reference Amount Customarily Consumed (RACC) for that nutrient, while "Excellent Source" designates that the food contains at least 20% of the DV or RDI per RACC for that nutrient. Additionally, Vitamin K2 has been studied recently to ascertain beneficial effects on human health, and this nutrient was present in all samples analyzed. This study provides current, analytically-derived nutrient information for U.S. beef variety meat items. Results reflect that these variety meat items could be beneficial in providing essential vitamins and minerals as a component of a healthy diet. This data will be valuable for use by the meat industry, those selling variety meats, researchers, dietetic professionals, and consumers. The objective of the second experiment was to evaluate effects of quality grade, final internal temperature, and cooking method on sensory profile of five beef muscles: rectus femoris, gluteus medius, infraspinatus, triceps brachii, and teres major, in order to characterize sensory characteristics of these cuts. Two quality grades (USDA Select, Upper 2/3 Choice/Top Choice), three cooking methods (grill, pan grill, oven roast), and three final internal temperatures (58.3°C, 70°C, and 80°C) were included; each of 102 unique treatment combinations were replicated six times. Vacuum packaged beef was purchased directly from a commercial beef harvest facility, fabricated 14 days post-production, and frozen at -20°C until analysis. Each sample was rated by a trained sensory panel for flavor, tenderness, and juiciness factors. Although muscles were not compared directly, muscle differences did exist relative to treatment effects. Degree of doneness had the greatest impact across all muscles evaluated, with higher final temperatures related to greater (P < 0.05) beef ID, browned, and roasted notes in most muscles and decreased (P < 0.05) tenderness. Additionally, panelists rated samples as having greater amounts of bloody/serumy, metallic, and sour flavors (P < 0.05) when cooked to lower end-point temperatures. Cooking method affected flavor note ratings for all muscles, with oven roasting producing increased (P < 0.05) cardboardy, earthy/musty, and sour flavors, whereas pan grilling resulted in more intense bitter and burnt flavors (P < 0.05). Quality grade had a minimal impact on the muscles included in the study. Association of volatile aromatic compounds with specific treatments also varied based on muscle. Overall, the 80°C and pan grilling treatments were related to the most volatile compounds compared to other treatments; primarily pyrazines, alkanes, and alkenes. These results highlighted the importance of understanding the properties of individual cuts in order to best utilize them for a positive eating experience. In combination with previous research, these data will be used to develop a resource that characterizes sensory characteristics of lesser-utilized beef cuts to benefit the meat industry, foodservice operations, in-home cooks, and ultimately beef consumers
A phase II study of paclitaxel for the treatment of ovarian stromal tumors: An NRG Oncology/ Gynecologic Oncology Group Study
No full textTo estimate the probability of complete clinical response and toxicity of paclitaxel as second-line chemotherapy in measurable disease patients with malignant tumors of the ovarian stroma, and to evaluate the value of inhibin for predicting response
Abnormal adaptations to stress and impaired cardiovascular function in mice lacking corticotropin-releasing hormone receptor-2
No full textPharmacokinetic/pharmacodynamic modelling approaches in paediatric infectious diseases and immunology
No full textPharmacokinetic/pharmacodynamic (PKPD) modelling is used to describe and quantify dose-concentration-effect relationships. Within paediatric studies in infectious diseases and immunology these methods are often applied to developing guidance on appropriate dosing. In this paper, an introduction to the field of PKPD modelling is given, followed by a review of the PKPD studies that have been undertaken in paediatric infectious diseases and immunology. The main focus is on identifying the methodological approaches used to define the PKPD relationship in these studies. The major findings were that most studies of infectious diseases have developed a PK model and then used simulations to define a dose recommendation based on a pre-defined PD target, which may have been defined in adults or in vitro. For immunological studies much of the modelling has focused on either PK or PD, and since multiple drugs are usually used, delineating the relative contributions of each is challenging. The use of dynamical modelling of in vitro antibacterial studies, and paediatric HIV mechanistic PD models linked with the PK of all drugs, are emerging methods that should enhance PKPD-based recommendations in the future
Modulació farmacològica de l'oleoil-estrona sobre la ingesta i la composició corporal
No full text[cat] La finalitat d'aquest treball ha estat continuar caracteritzant els efectes aprimadors de l'oleoïl-estrona (OE), aprofundint en el coneixement del seu mecanisme d'acció, i de com els seus efectes sobre la ingesta, la composició corporal i la millora de la sensibilitat a la insulina, poden ser modulats al ser combinada amb altres fàrmacs, comprovant especialment la seguretat d'aquestes combinacions. El nostre grup de treball, basant-se en el model homeostàtic postulat per Kennedy per explicar la complexitat dels mecanismes de regulació del pes corporal, va descobrir l'oleoïl-estrona, una molècula que indueix una pèrdua de pes de manera dosi depenent deguda a la disminució de la ingestió d'aliment mantenint la despesa energètica i facilitant així la mobilització de greixos. L'OE va ser proposada com a possible senyal ponderòstat i com a possible base d'una teràpia farmacològica per a l'obesitat. En un primer objectiu es pretenia demostrar si els efectes de la OE sobre el balanç energètic eren mitjançats a través dels receptors d'estrògens, pel que es va realitzar un estudi en el que s'administrava un ampli rang de dosis d'estrona lliure comprovant la diferència d'efectes metabòlics existents entre aquesta i l'OE. Continuant amb la mateixa línia, es va realitzar una administració conjunta de l'OE amb el tamoxifè, un antagonista dels receptors d'estrògens àmpliament utilitzat, el que ens permetria confirmar que el tamoxifè no evita els efectes aprimadors de l'OE, suggerint que el bloqueig d'aquests receptors no impedeix l'acció de l'OE, i per tant, que aquesta no actua a través de les vies estrogèniques. En un segon objectiu es va combinar l'OE amb altres agents aprimadors (sibutramina, dexfenfluramina, fentermina, un agonista dels receptors beta-3-adrenèrgics (CL316,243), i rimonabant), fet que ens va permetre caracteritzar una possible teràpia farmacològica combinada efectiva i segura per al tractament de l'obesitat i aproximar-nos de manera indirecta al coneixement del mecanisme d'acció de l'OE. En un tercer objectiu, mitjançant la combinació de l'OE amb la rosiglitazona es va estudiar els mecanismes a través dels quals aquests dos compostos milloren la sensibilitat a la insulina. Malgrat que la rosiglitazona i l'OE presenten efectes metabòlics pràcticament oposats, la seva combinació es presenta con una bona alternativa per al tractament de la diabetis mellitus de tipus 2 en els pacients que presenten obesitat. Finalment, per tal d'aprofundir en els efectes moduladors de l'OE sobre la ingesta, es van analitzar els efectes d'aquesta sobre l'expressió dels principals pèptids gastrointestinals que regulen la ingestió d'aliments a curt termini. Es va comprovar com l'administració d'OE provoca una ràpida i marcada inhibició de l'expressió del pèptid orexigènic ghrelina, amb efectes pràcticament nuls sobre l'expressió dels pèptids anorexigènics CCK, PYY i GLP-1.[eng] SUMMARU: The aim of this work was to continue the characterization of the the slimming effects of oleoyl-estrone (OE) studying its mechanism of action and whether its effects on food intake, energy balance and insulin sensitivity could be modulated by its combination with other drugs. Possible synergisms and risks of the combination of OE with known drugs were studied. Our research group discovered OE, a molecule synthesized in white adipose tissue that elicits a marked dose-dependent loss of body weight. OE treatment reduces food intake while maintaining energy expenditure thus creating an energy gap filled by the expense of body fat stores. OE was proposed as a possible ponderostat signal and a possible agent for obesity treatment. Initially, we focused our study in determining if OE's effects were mediated by the estrogen receptor. First, a wide range of estrone doses were tested in order to evaluate differences between estrone and OE on the energetic balance. Later, we studied the combined effects of OE and tamoxifen, a estrogen receptor antagonist, in order to prove that OE does not act through estrogenic pathways. Tamoxifen does not prevent the mobilization of body lipids elicited by OE. Secondly, OE was combined with other drugs regularly used to treat obesity (sibutramine, dexfenfluramine, phentermine, a specific b3-adrenergic receptor agonist (CL316,243) and rimonabant), in order to characterize an effective and safe pharmacological therapy. This set of experiments also provided insights regarding the mechanism of action of OE. Afterwards, we combined OE and rosiglitazone in order to study how these two agents improve insulin sensitivity. Despite their diverging effects on body mass fat, the combination of OE and rosiglitazone may be positive for type 2 diabetics that are obese or show a marked predisposition to the accumulation of fat. Finally, in order to elucidate the effects of OE on food intake we analyzed the expression of several gut peptides that affect short-term feeding behavior. Results showed that the ghrelin expression was markedly reduced by OE administration. However its effects on the anorexigenic peptides studied (CCK, GLP-1 and PYY) are practically non-existent
