24 research outputs found
Alterations in the polysialylated neural cell adhesion molecule and retinal ganglion cell density in mice with diabetic retinopathy
AIM: To investigate the impact of polysialylated neural cell adhesion molecule (PSA-NCAM) on the survival of retinal ganglion cells (RGCs) in the experimentally induced diabetes in mice.
METHODS: Diabetes was induced in 2.5 months old Swiss Webster mice by intraperitoneal injection of streptozotocin (STZ, 90 mg/kg) once daily for two consecutive days. Examination of the proteins of interest in the retinas from diabetic mice at 2mo after diabetes induction was performed using immunohistochemistry and Western blot analysis. RGCs were counted in the wholemounted retinas, and Brn3a marker was used.
RESULTS: Examination of retinas from diabetic mice at 2mo after diabetes induction revealed a considerable reduction in RGC density. Our experiments also demonstrated a redistribution of PSA-NCAM in the retina of diabetic animals. PSA-NCAM immunoreactivity was diminished in the inner part of the retina where RGCs were located. In contrast, an enhanced PSA-NCAM immunoreactivity was detected in the outer layers of the retina. PSA-NCAM signal was co-localized with glial fibrillary acidic protein immunoreactivity in the Müller cell branches. Previous studies have shown that matrix metalloproteinase-9 (MMP-9) is responsible for the reduction in PSA-NCAM levels in neuronal cells. The reduced levels of PSA-NCAM in inner layers (nerve fiber layer, ganglion cell layer) were accompanied by the increased expression of MMP-9. In contrast, in the outer retinal layers, the expression of MMP-9 was much less pronounced.
CONCLUSION: MMP-9 induces PSA-NCAM shedding in the inner part of the retina and the decreased level of PSA-NCAM in the inner part of the retina might be, at least in part, responsible for the loss of RGCs in diabetic mice
Analysis of potential interactions between warfarin and prescriptions in Estonian outpatients aged 50 years or more
In Estonia, warfarin is widely prescribed by general
practitioners to prevent and treat thromboembolic
diseases. To date, there has been no systematic
analysis of the potential risk of warfarin interactions
with other drugs in the outpatient population.
Objective: The aim of the study was to analyze the
incidence of potential interactions in prescription
schemes in Estonia in a cohort of outpatients
receiving warfarin treatment.
Methods: The retrospective study population
included 203,646 outpatients aged 50 years or older
of whom 7,175 received warfarin therapy. Patients
who had used at least one prescription drug for a
minimum period of 7 days concomitantly with
warfarin were analyzed. Potential drug interactions
were analyzed using Epocrates online, Stockley�s
Drug Interactions and domestic drug interaction
databases.
Results: The average number of drugs used
concomitantly with warfarin was 4.8 (SD=1.9)
(males: 4.7 SD=2.0, females: 4.9 SD=2.0). No
potential interactions in treatment regimens were
found in 38% of patients, one potential interaction
was observed in 29% and two or more potential
interactions were observed in 33% of patients. The
mean number of all potential interactions was 1.2
per patient and about the same in men and women.
Potential interactions were associated with the
number of drugs. Warfarin-related interactions were
detected in 57% of patients, and the number of
interactions related to warfarin per patient varied
from 1 to 5. Most frequent were use of warfarin with
NSAIDs (14%), followed by simvastatin (9%) and
amiodarone (7%).
Conclusion: This study shows that 57% of
outpatients in Estonia receiving warfarin have drugs
potentially interacting with warfarin in their treatment
schemes. Most interactions (14%) with warfarin are
associated with the prescription of NSAIDs.En Estonia, la warfarina es prescrita por médicos
generales para tratar enfermedades
tromboembólicas. Hasta la fecha, no se ha realizado
un análisis sistemático del riesgo de interacciones
potenciales de la warfarina con otros medicamentos
en la población ambulatoria.
Objetivo: El objetivo de este estudio fue analizar la
incidencia de interacciones potenciales en los
esquemas prescritos en Estonia en una cohorte de
pacientes ambulatorios recibiendo warfarina.
Métodos: El estudio retrospectivo incluyó 203.646
pacientes ambulatorios de 50 o más años de los que
7.175 recibían tratamiento con warfarina. Se
analizó a los pacientes que usaron como mínimo un
medicamento de prescripción por un periodo
mínimo de 7 días concomitante con warfarina. Las
interacciones potenciales fueron analizadas usando
Epocrates online, Stockley�s Drug Interactions, y
bases de datos locales de interacciones.
Resultados: El numero medio de medicamentos
usados concomitantemente con warfarina fue de 4,8
(DE=1,9) (hombres 4,7 DE=2,0; mujeres 4,9
DE=2,0). No se encontraron interacciones
potenciales en el 38% de los pacientes, se observó
una interacción potencial en el 29%, y se
encontraron dos o más interacciones potenciales en
el 33% de pacientes. El número medio de
interacciones potenciales fue de 1,2 por paciente,
prácticamente igual en hombres y en mujeres. Las
interacciones potenciales estaban asociadas con el
número de medicamentos. Se detectaron
interacciones relacionadas con la warfarina en el
57% de los pacientes, y el número de interacciones
relacionadas con warfarina varió de 1 a 5. Las más
frecuentes fueron el uso de warfarina con AINE
(14%), seguidas de sinvastatina (9%) y amiodarona
(7%).
Conclusión: Este estudio muestra que el 57% de
los pacientes ambulatorios que reciben warfarina en
estonia tienen medicamentos potencialmente
interaccionando con la warfarina en sus esquemas
terapéuticos. La mayoría de las interacciones (14%)
con warfarina estaban asociadas a los AINE
Potential drug interactions with statins: Estonian register-based study
In Estonia, HMG-CoA reductase inhibitors are
widely used to modify lipid levels but there are no current
data on additional medicines prescribed alongside the
statins. The aim of this study was to identify the frequency
of potential clinically relevant interactions at a national
level among an outpatient population treated with statins
between January and June 2008, based on the prescription
database of the Estonian Health Insurance Fund. This retrospective
prevalence study included 203,646 outpatients
aged 50 years or older, of whom 29,367 received statin
therapy. The study analysed individuals who had used at
least one prescription medicine for a minimum of 7 days
concomitantly with statins. Potential drug interactions
were analysed using Epocrates online, Stockley’s Drug
Interactions, and the drug interaction database developed
in Estonia. Statins metabolised by the CYP3A4 isoenzyme
were prescribed to 64% of all statin users. Medicines
known to have potentially clinically significant interactions
with statins were prescribed to 4.6% of patients