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Greater Rise (greater + rise)
Selected AbstractsThe efficacy of dantrolene sodium in controlling exertional rhabdomyolysis in the Thoroughbred racehorseEQUINE VETERINARY JOURNAL, Issue 7 2003J. G. T. Edwards Summary Reasons for performing study: Dantrolene sodium (Dantrium) has been used extensively for the treatment of myopathies in man and anecdotal evidence suggests it is of clinical benefit in the control of exercise-induced rhabdomyolysis (ER) in racehorses, although data to support this are currently lacking. Objectives: To investigate the efficacy of oral dantrolene sodium in controlling ER in a randomised, double-blind, placebo-controlled crossover trial involving 77 Thoroughbred racehorses in Newmarket, UK. Methods: Horses were treated on 2 occasions 1 week apart, with treatment days coinciding with a return to exercise following 2 days box rest on each occasion. For the first treatment, each horse was randomly selected to receive either 800 mg dantrolene sodium or a colour- matched placebo administered orally 1 h before exercise. This was followed by crossover to the other treatment on the second occasion, with each horse thereby acting as its own control. Degree of ER was assessed using rising serum creatine kinase (CK) levels, by subtracting pre-exercise blood CK levels from those measured in 6 h post exercise blood samples. For each horse, the difference in change between pre- and post exercise CK values between placebo and dantrolene treatments was calculated, with positive values indicating a greater rise with placebo than with dantrolene sodium treatment. Results: The overall mean difference for all horses was +104.8 iu/l and the null hypothesis, that there was no true difference in non-normally distributed post exercise rises in CK values between placebo and dantrolene treatments, was rejected (P = 0.0013) using the nonparametric Wilcoxon signed rank test. Additionally, no horses given dantrolene sodium showed clinical signs of ER, whereas 3 horses given the placebo developed ER following exercise. The incidence of ER in the study was 4% (3/77). Conclusions: The results confirmed that oral administration of dantrolene sodium, 1 h before exercise, had a statistically significant effect on reducing the difference between pre - and post exercise plasma CK levels compared with a placebo in the same animals, and preventing clinical ER in susceptible individuals. Potential relevance: This study suggested that dantrolene sodium is of use in controlling ER in the Thoroughbred racehorse. Further investigation into pre- and post exercise myoplasmic calcium levels and the repeat of the study late in the season when horses receive a much higher energy ration and more strenuous exercise would appear to be warranted. [source] Increases in peritoneal small solute transport in the first month of peritoneal dialysis predict technique survivalNEPHROLOGY, Issue 6 2004KATHRYN J WIGGINS SUMMARY: Background: Peritoneal transport of small solutes generally increases during the first month of peritoneal dialysis (PD). The aim of this study was to prospectively evaluate the ability of the peritoneal equilibration test (PET), carried out 1 and 4 weeks after the commencement of PD, to predict subsequent technique survival. Methods: Fifty consecutive patients commencing PD at the Princess Alexandra Hospital between 1 February 2001 and 31 May 2003 participated in the study. Paired 1 week and 1 month PET data were collated and correlated with subsequent technique survival. Results: A significant increase was observed in the dialysate : plasma creatinine ratio at 4 h (D/P Cr) between 1 and 4 weeks after the onset of PD (0.55 ± 0.12 vs 0.66 ± 0.11, P < 0.001). Mean death-censored technique survival was superior in patients who experienced ,20% rise in D/P Cr during the first month of PD compared with those who did not (2.3 ± 0.2 vs 1.6 ± 0.2 years, P < 0.05). Using a multivariate Cox proportional hazards model analysis, the significant independent predictors of death-censored technique survival were an increase in D/P Cr of greater than 20% during the first month (adjusted hazard ratio [HR] 0.20, 95% CI 0.05,0.75), the absence of diabetes mellitus, the absence of ischaemic heart disease, body mass index and baseline peritoneal creatinine clearance. Conclusions: A 20% or greater rise in D/P Cr during the first month of commencing PD is independently predictive of PD technique survival. Further investigations of the mechanisms underlying this phenomenon are warranted. [source] Mycoplasma pneumoniae infection in a clinical settingPEDIATRICS INTERNATIONAL, Issue 5 2008Norlijah Othman Abstract Background: Mycoplasma pneumoniae infection predominantly affects the respiratory tract, although the other organs may also be involved. Previous studies compared the clinical features of patients with M. pneumonia pneumonia to other pathogens and these studies were predominantly adult case series rather than involving children. The objectives of the present study were to compare the clinical features, laboratory, and radiographic findings in children seropositive for M. pneumoniae infection with children tested for suspected M. pneumoniae infection who were seronegative. Methods: Using a retrospective review of children who had complement fixation test (CFT) performed for suspected M. pneumoniae infection, children were classified as seropositive if the acute phase serum titer was ,64, or paired samples taken 2,4 weeks apart showed a fourfold or greater rise in serum titer. In contrast, a patient with an antibody titer <64 or with paired sera showing less than a fourfold rise in titer was considered seronegative. Results: One hundred and fifty-one children were included. Seventy-six children had serological evidence of M. pneumoniae infection and the remaining 75 were seronegative. Children with M. pneumoniae infection were more likely to have fever >6 days duration prior to admission, crackles on auscultation, radiographic consolidation and thrombocytosis at presentation. In addition, M. pneumoniae infection was associated with pneumonia whereas seronegative children were more likely to have upper respiratory tract infection or asthma. Conclusions: Certain clinical parameters could assist in gauging the likelihood of M. pneumoniae infection in children, and thus direct whether antibiotic treatment is needed. [source] Epidemiology of influenza-associated encephalitis-encephalopathy in Hokkaido, the northernmost island of JapanPEDIATRICS INTERNATIONAL, Issue 2 2000Takehiro Togashi AbstractBackground: It is well known that acute onset brain dysfunction, which usually is diagnosed as encephalitis or encephalopathy, occurs in association with influenza. However, this may have been underestimated as a rather infrequent event. Sixty-four infants and children developed encephalitis-encephalopathy during the five recent influenza seasons in Hokkaido, the northernmost island of Japan. Methods: Inquiries were sent at the end of each season, from October 1994 to March 1999, to 94 hospitals and institutes in Hokkaido which accept pediatric age patients, asking if there were any admitted cases of encephalitis or encephalopathy. Results: The patients were 42 boys and 22 girls and 47 (73.4%) were 4 years of age or younger. None of them had received an influenza vaccine nor had an oral administration of aspirin. Most of the patients became comatose with or without convulsions within a few days of the onset of fever. Twenty-eight (43.8%) patients died and 13 (20.3%) had neurological sequelae. Patients with clotting disorders, elevations of serum creatine kinase and/or aspartate aminotransferase and alanine aminotransferase, and brain CT abnormalities had a poor prognosis compared with patients without. Among these affected patients, the influenza genome (H3) was detected by polymerase chain reaction in nine cerebrospinal fluid samples, influenza virus A (H3N2) was isolated in 18 nasopharyngeal swab samples and a four-fold or greater rise in serum hemagglutinin inhibition antibody titer against H3N2 was observed in seven patients. Conclusions: It appears urgent to promote vaccination against influenza in young children to prevent these devastating disease conditions. [source] The apo A-I gene promoter region polymorphism determines the severity of hyperlipidemia after heart transplantationCLINICAL TRANSPLANTATION, Issue 1 2003Angel González-Amieva Abstract: Background: To study whether the Apolipoprotein A-I (apo A-I) promoter region gene polymorphism produces changes in the lipid profile of heart transplant recipients. Methods: One hundred and three heart transplant recipients (93 men and 10 women, with a mean age of 47 ± 13 yr) receiving triple immunosuppressive therapy were submitted to a genetic study of the apo A-I gene promoter region. Anthropometric and analytical data, including lipid profile, arterial blood pressure, were collected prior to transplantation and 3, 6, 12, and 24 months after transplantation. Results: Sixty-three subjects had the GG genotype and 40 the GA genotype. Carriers of the GA genotype had higher triglyceride levels at 6 months and 2 yr (2.50 ± 1.20 versus 1.93 ± 0.98 mmol/L and 2.46 ± 1.58 versus 1.60 ± 0.68 mmol/L, respectively, p < 0.001), and a greater rise in LDL-cholesterol at 1 yr than the GG subjects (4.57 ± 1.16 versus 4.16 ± 1.18 mmol/L, p < 0.05). Multiple regression analyses showed that genetic variants at the apo A-I promoter region are responsible for 11% of the variability in triglyceride levels at 6 months (p = 0.005). Conclusions: The GA genotype of the apo A-I promoter region produces a greater rise in plasma triglyceride and LDL-cholesterol levels in heart transplant patients. [source] | ||||||||||