Recurrence of severe steroid dependency in cyclosporin A-treated childhood idiopathic nephrotic syndrome

Background. In patients with steroid-dependent nephrotic syndrome (SDNS), long-term remission (LTR) can usually be achieved with cyclosporin A (CSA), after alternative treatment with cytotoxic drugs or levamisole has failed. Nevertheless, severe SDNS recurs in some patients despite CSA maintenance therapy. Few data are available on the clinical course and treatment strategies in these patients. Methods. We carried out a retrospective chart analysis of 46 patients with SDNS treated with CSA, after failure of cyctotoxic treatment with cyclophosphamide (CPO). Median age at primary manifestation was 3.0 years (range 0.8-6.9) and median current age is 20.4 years (range 8.6-29.1). Patients were recruited from three centres caring for a total of 186 patients with steroid-sensitive nephrotic syndrome. Results. In 14 of the 46 patients (30%; 10 male), severe SDNS recurred again despite CSA maintenance therapy. Seven patients relapsed beyond the age of 18 years. Nine of 14 patients received a further course of cytotoxic treatment as first intervention: six were treated with chlorambucil (CLA) and three with CPO. Four of the CLA-treated patients remained in LTR in contrast to none after CPO. Five patients received levamisole after CSA: only one went into LTR, while in one other CSA could be discontinued although further relapses occurred. One further patient was switched to CLA after levamisole, finally inducing LTR. Overall, six patients required two or more drugs, and in four of these CSA maintenance ultimately had to be restarted. Conclusion. We conclude that SDNS can recur in patients despite CSA maintenance therapy. Treatment strategies for this subgroup of patients are complex and should be standardized to optimize long-term outcome. A subgroup of patients with childhood SDNS continues to relapse into adulthoo

Quality of meat of rabbits after application of epicatechin and patulin

The aim of the present study was to determinate the effect of epicatechin and patulin on selected parameters of meat quality of rabbits. Adult female rabbits (n=25), maternal albinotic line (crossbreed Newzealand white, Buskat rabbit, French silver) and paternal acromalictic line (crossbreed Nitra's rabbit, Californian rabbit, Big light silver) were used in experiment. Animals were divided into five groups: control group (C) and experimental groups E1, E2, E3, and E4. Animals from experimental groups E1, E2, E3, E4 received patulin through intramuscular injection (10 µg.kg-1) twice a week and animals from groups E2, E3, E4 received epicatechin three times a week through intramuscular injection. After 30 days animals were slaughtered. For analysing of meat quality the samples of Musculus longissimus dorsi (50 g) were used. Application of  epicatechin and patulin to rabbits had slight or no effect on the pH levels in stomach, small intestine, large intestine and urinary bladder contents, however differences among the groups were insignificant (p ˃0.05). Application of epicatechin and patulin to rabbits had slight or no effect on total water, protein, fat   and differences among the groups were insignificant (p >0.05). The values of amino acids concentrations were not influenced after application of epicatechin and patulin. The fatty acid profiles in animals after application of different doses of epicatechin and 10 µg.kg-1 patulin were similar (p >0.05). Concentration of cholesterol increased in experimental groups in comparison with the control group, but differences were insignificant (p >0.05). pH levels of meat of rabbits in experimental group E3 was lower when compared with the control group, but differences was not significant (p >0.05).  Electric conductivity parameter was increased in each experimental group (in E3 the highest) against the control but without significant differences (p >0.05). Colour L parameter was slightly decreased in experimental groups with comparison to the control group (in E3 the lowest). Generally we can conclude that intramuscular application of epicatechin or patulin did not affect parameters of meat quality as well as pH values of internal organs content. Further investigations are needed to prove the final answer concerning the health promoting effects of epicatechin and patulin

Data mining methods for the prediction of different forms of asthma

The article examines the diagnosis of bronchial asthma, cites the classification of the disease, proves the relevance of this research, and represents the result of primary data analysis by using a powerful tool for data analysis - Rapid Miner

Efficacy and safety of basiliximab in pediatric renal transplant patients receiving cyclosporine, mycophenolate mofetil, and steroids

BACKGROUND: Basiliximab, a monoclonal CD25 antibody has proofed effective in reducing acute rejection episodes in adults in various immunosuppressive regimens. The effect of basiliximab in the pediatric population is controversial. METHODS: In a 12-month, double-blind, placebo-controlled trial, renal transplant patients aged 1 to 18 years were randomized to basiliximab or placebo with cyclosporine microemulsion, mycophenolate mofetil, and corticosteroids. The intent-to-treat population comprised 192 patients (100 basiliximab and 92 placebo). RESULTS: The primary efficacy endpoint, time to first biopsy-proven acute rejection episode, or treatment failure by month 6, occurred in 16.7% of basiliximab-treated patients and 21.7% of placebo-treated patients (Kaplan-Meier estimates; hazard ratio 0.72, two-sided 90% confidence interval 0.416-1.26, n.s.). The rate and severity of subclinical rejections in protocol biopsies performed at 6 months posttransplant was higher in the basiliximab group (25.0%) than in the placebo group (11.7%). Patient and death-censored graft survival at 12 months was 97% and 99%, respectively, in the basiliximab cohort, and 100% and 99% among placebo-treated patients (n.s.). Renal function was similar in both treatment groups, and there were no significant between-treatment differences in the incidence of adverse events or infections. CONCLUSIONS: Addition of basiliximab induction to a regimen of cyclosporine microemulsion, mycophenolate mofetil, and steroids resulted in a numerically lower but not significant incidence of biopsy-proven acute rejection versus placebo and excellent graft and patient survival at 1 year in pediatric renal transplant recipients. Whether this numerical difference is a true therapeutic benefit in view of the higher rate and severity of subclinical rejections in the basiliximab group in the protocol biopsy will be investigated in a long-term follow-up study

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes