Effects of Trimetazidine and Selenium on High-Frequency Fatigue in Isolated Rat Diaphragm Muscle

Trimetazidine (TMZ), which has been used in numerous experimental studies, is applied nowadays with the aim of reducing myocardial ischemia. The aim of this study was to determine the prefatigue and postfatigue contractile characteristics associated with the relationship between the force and frequency of contraction in muscle. The study was conducted using diaphragm muscle isolated from 40 male Wistar rats weighing 230 to 270 g. The rats were divided into 4 groups of 10 animals each: controls and TMZ-, selenium (Se)-, and TMZ+Se-treated groups. The rats in the control group were treated with 2 mL of physiologic serum (SF), those in the second group with Se 30 µg/kg in 2mL of SF, those in the third group with TMZ 5 mg/kg in 2 mL of SF, and those in the fourth group with a combination of TMZ 5 mg/kg + Se 30 µg/kg in 2 mL of SF. All rats were treated twice daily for 15 days by means of gastric lavage. The rats were then killed by cervical dislocation. The diaphragm muscle bands were removed and placed in an organ bath. After a 2-hour thermoregulatory period, muscles were fatigued with 5-ms pulses at a frequency of 40 Hz. Force-frequency relationships were studied after the application of 10, 50, and 100 Hz and the development of contraction curves. Contraction forces for the groups treated with TMZ, Se, and TMZ+Se (16.1±1.2, 13.2±1.3, and 14.9±1.0 g, respectively) were significantly lower than for the control group (17.0±1.4 g) during the prefatigue period (P<.001). Similarly, postfatigue contraction forces for the treated groups (15.7±1.3, 8.8±1.0, and 12.0±1.4 g, respectively) were significantly lower than for the control group (12.4±1.2 g, P<.001, P<.001, and P<.05, respectively). A significant decrease was noted in postfatigue contraction forces and contraction and relaxation rates in the Se- and TMZ+Se-treated groups compared with prefatigue values (P<.001), but the difference was not significant. Force-frequency relationships were evaluated at 10, 50, and 100 Hz. The tetanic contraction forces for the control, Se-, TMZ-, and TMZ+Se-treated groups at 100 Hz were 81.3±5.7, 91.6±6.8, 65.3±5.0, and 84.9±7.5 g, respectively. In the TMZ-treated group, a significant increase was observed in tetanic contraction forces at 100 Hz compared with controls (P<.001); no significant changes were seen in the force-frequency relationships at 10 and 50 Hz. The decrease in the contraction force in the postfatigue period was prevented to a larger extent in the TMZ-treated group than in the TMZ+Se- and Se-treated groups

Severe acute renal failure due to tubulointerstitial nephritis, pancreatitis, and hyperthyroidism in a patient during rifampicin therapy

It is well known that rifampicin can cause nephrotoxicity. Rifampicin-related pancreatitis and hyperthyroidism are rarely reported in the same patient in the presence of tubulointerstitial nephritis. Reported herein is the medical management of a patient with hemolytic anemia, acute renal failure, pancreatitis, and hyperthyroidism during with rifampicin therapy. A 50-year-old man was admitted to the hospital owing to abdominal colic and acute renal failure. He was treated with 2 courses of tetracycline-rifampicin for brucellosis 3 weeks and 4 months prior to admission. Physical examination showed blood pressure of 130/70 mm Hg, pulmonary crackles, and edema. Laboratory findings are detailed in the case report. Findings of abdominal ultrasonography suggested edematose pancreatitis and thyroid ultrasonography showed several solid nodules. Renal biopsy showed tubulointerstitial nephritis. Although rifampicin-related tubulointerstitial nephritis and acute renal failure are not uncommon during rifampicin therapy, the convergence of hyperthyroidism, pancreatitis, tubulointerstitial nephritis, and acute renal failure rarely presents in the same patient. Although pancreatitis, tubulointerstitial nephritis, and acute renal failure were ameliorated with corticoid therapy within 2 months, hyperthyroidism continued and required antithyroid therapy. In conclusion, rifampicin may trigger hyperthyroidism in patients with goiter. © 2005 Health Communications Inc

Loss of vision and renal function in a patient with miliary tuberculosis

PubMedID: 15770343Introduction: Visual loss is a rare complication of tuberculosis; it can be related to anti-tuberculous drugs or to the infection itself. For the treatment of visual loss, differential diagnosis is important between infection and adverse effect of anti-tuberculous drugs. Case: A 48-year-old male patient with a history of tuberculosis and visual loss during anti-tuberculous drug therapy was admitted to our hospital. Anti-tuberculous drugs had been stopped on the 2nd day of therapy due to development of optic neuritis secondary to ethambutol administration at another hospital. He had miliary tuberculosis, renal failure requiring dialysis and visual disturbances. Anti-tuberculous drugs, including ethambutol, were initiated at our clinic because the period between the ethambutol therapy and visual loss was too short and the dose of ethambutol was not very high. Computed brain tomography was normal. Fundoscopic examination revealed only hypertensive retinopathy. Our diagnosis was tuberculosis-related visual loss, which could be due to neuroretinitis, intraocular tuberculosis or chiasmal tuberculoma. In addition, ethambutol rarely causes visual loss during the early period or when given at lower doses. In our case no complications developed from the treatment and the patient's visual loss and renal function improved. At his last visit, 12 months later, his vision had improved and his serum creatinine was lower, at 2.2 mg/dL. Conclusion: With anti-tuberculous treatment, renal functions and visual disturbances were improved in a patient with miliary tuberculosis. During the anti-tuberculous therapy, visual loss can be related to ethambutol toxicity or the tuberculosis infection itself. Differential diagnosis is very important and anti-tuberculous drugs must be continued if the diagnosis is tuberculosis. © The Mount Sinai Journal of Medicine

Nephrotic syndrome in two cases with sickle cell nephropathy?

PubMedID: 8883045[No abstract available

Report of a renal transplanted patient with fibroadenoma occurring in a short time

The incidence of breast cancer in renal transplant patients is similar to that of general population. But fibroadenomas may be seen as a result of exposure to cyclosporine (CyA). Herein we report the case of a 32-year-old woman who received a renal transplant and had a breast fibroadenoma. She had been prescribed CyA, azathioprine, and steroids for 4 years. At the end of the first year a palpable mass had been detected in her right breast; the pathologic diagnosis was fibroadenoma. At the 4th year after transplantation, immunosuppressive treatment was switched to CyA and mycopholate mofetil (MMF) because of an increased serum creatinine level. Two years later seven breast nodes from both breasts were detected by ultrasonography. Totally excision was performed revealing a histopathologic diagnosis of fibroademata as before. In this case, the combination of CyA and MMF administration seemed to cause an increase in the number of nodules in a short time. The cause of fibroadenomas may be related to drug-induced secretion of proliferative or anti-apoptotic cytokines.Indications:Kidney graft rejection prevention in 1 patient who underwent kidney transplantation.Results:At the end of the first year of immunosuppressive therapy, a palpable mass was detected in her right breast. Excisional biopsy showed a fibroadenoma. Two years after renal transplantation multiple masses were detected in both breasts by mammography; needle biopsy demonstrated fibroadenoma. During the fourth year after transplantation the serum creatinine levels increased and immunosuppressive treatment was switched to Sandimmun and MMF, leading to a decrease in serum creatinine to 1.5 mg/dL. She menstruated regularly and her blood pressure was normal. Her breast examination revealed two nodes approximately 2 2 cm in her right breast and a 3 3 cm hard node in her left breast. Laboratory investigation was significant for a hemoglobin 9.6 g/dL an hematocrit 28.7%, a blood urea nitrogen 20 mg/dL, and a serum creatinine 1.4 mg/dL. Additional biochemical tests were normal. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and progesterone were also within normal limits. Two-hour (C2) Sandimmun level was 776.17 ng/mL followed by subsequent levels of 600 ng/mL and 500 ng/mL. Breast ultrasonography showed multiple and various-sized hypoechoic solid nodes bilaterally. Seven breast nodes from both breasts were totally excised; the histopathologic diagnosis was fibroadenoma.Patients:One 32 year old woman.TypeofStudy:Case report of a renal transplanted patient who developed breast fibroadenoma after treatment with Sandimmun, azathioprine and steroids.DosageDuration:Dosage not stated. Duration was for 5 years.AdverseEffects:The patient developed breast fibroadenoma.AuthorsConclusions:In conclusion, although we cannot exclude the possibility of coincidental occurrence, the development of fibroadenomas in the breast may be due to immunosuppressive agents. Cyclosporin-related development of fibroadenoma is well known. However, in this case, the temporal relation of the CyA and MMF combination and the clear increase in the number of nodules suggests that these drugs may cause fibroadenomas by inducing secretion of proliferative and anti-apoptotic cytokines.FreeText:The patient had a 4-month history of hemodialysis and underwent renal transplantation. Sandimmun, AZA, and steroids were used for immunosupression for 4 years. During the fourth year after transplantation the serum creatinine levels increased and immunosuppressive treatment was switched to Sandimmun and MMF. Tests: serum creatinine, hemoglobin, hematocrit, blood urea nitrogen, Sandimmun blood level, breast ultrasonography, breast biopsy

A unique form of polycythemia associated with minimal change disease

PubMedID: 15467313Objective: To present a case with nephrotic syndrome due to minimal change disease and polycythemia. Clinical Presentation and Intervention: A 20-year-old female was admitted to our clinic for edema and severe proteinuria present with minimal change disease since the age of 7 years. Polycythemia was found during the last activation of nephrotic syndrome. The patient was placed on glucocorticoid therapy that caused disappearance of edema, proteinuria and polycythemia. Ten months later both hemoglobin and hematocrit levels were within normal range. Conclusion: This patient with nephrotic syndrome due to minimal change disease and polycythemia was successfully treated with glucocorticoid. Copyright © 2004 S. Karger AG, Basel

Different glomerular pathologies in sickle cell anemia

WOS: 000224863300014PubMed ID: 15571189

Different glomerular pathologies in sickle cell anemia [1]

PubMedID: 15571189[No abstract available