In a controlled clinical trial, the elimination of caffeine was examined in 20 healthy women prior to and during one cycle of treatment with either of two oral contraceptive formulations, one containing 0.075 mg gestodene and 0.03 mg ethinylestradiol and one containing 0.125 mg levonorgestrel and 0.03 mg ethinylestradiol. In addition, caffeine clearance was determined 1 month after the last intake of the oral contraceptives. Compared with pretreatment values, the clearance of caffeine was reduced by about 54% and 55% after one treatment cycle with gestodene- and the levonorgestrel-containing oral contraceptive, respectively. Other pharmacokinetic parameters of caffeine, such as tmax and Cmax, were not affected. Clearance values returned to pretreatment values 1 month after the last administration of the oral contraceptives. There was no difference in the reduction of caffeine clearance between contraceptive formulations. A small, but significant difference in the AUC(0-24 h) values of ethinylestradiol was noted between both preparations. There was no correlation between the AUC(model) values of caffeine and the AUC(0-24 h) values of ethinylestradiol. In the present study, a somewhat more pronounced effect on the elimination of caffeine was observed than in previous investigations, where several contraceptive steroids were administered only for a period of 2 weeks.
Objectives. Patients with minimal myocardial injuries who present clinically with unstable angina, early stages of myocardial infarction or myocarditis require different therapy strategies to those without. The newer diagnostic assays for detecting myocardial lesions (cardiac Troponin T and cardiac Troponin I [cTnT, cTnI], glycogenphosphorylase – BB [GPBB]) are reported to be more sensitive and specific than common biochemical markers such as CK and myoglobin. Our study tested whether the recently developed four assays cTnT‐ELISA (in vitro), cTnT rapid bedside assay, cTnI rapid bedside assay, and GPBB (Immunoenzymetric assay) are effective in detecting minimal myocardial injuries caused by endomyocardial biopsy. We compared them with CK activity (CK‐cat), CK‐MB activity (CK‐MBcat), CK‐MB‐concentration (CK‐MB‐mass) and Myoglobin concentration (Myo‐conc.).
Patients and methods. Twenty‐four patients [six female, 18 male, age (mean): 47 years (20–65)] underwent diagnostic endomyocardial biopsy. Between four and six biopsies were taken from the mid‐right ventricular aspect of the interventricular septum of the heart. Blood was drawn before catheterization (baseline), 10 min after the biopsy, in the next morning, and in the morning of the second day after (days 1 and 2).
Results and Conclusion. Because of very low CKcat it was not possible to analyse CK‐MBcat with reliable precision. The assay for GPBB and cTnI rapid bedside assay did not indicate this minimal myocardial injury. The CK cat, CK‐MB mass, and myoglobin assays indicated significant increase at 10 min after biopsy but remained within reference range. cTnT rapid bedside assay indicated this minimal myocardial injury in 50% (P < 0.05). cTnT‐ELISA (in vitro) was increased above the reference limit in 54%. This increase was 3.6‐fold the upper reference limit (P < 0.01). In our study, due to superior discriminating power, cTnT‐ELISA (in vitro) was the most sensitive assay for minimal myocardial injuries.
IGF-I is considered to be one of the most important growth factors during puberty. Information concerning its correlation to thyroid hormones (T3, T4), adrenal and sex steroids is limited to puberty and the elderly. The presented study included 455 subjects (among them 259 children) ranging in age from newborn to 100 years. Serum IGF-I concentrations increase from childhood to the end of puberty (2 years earlier in girls). There are close positive correlations between IGF-I concentrations and age, height and weight and between IGF-I and estradiol or testosterone concentration in girls and boys respectively, and the DHEA-S level in boys during puberty. Correlations also exist with T3, aldosterone and 17 OH-progesterone in boys and girls in the pubertal stages I-V and with T4 in stages I-IV. Compared to 20-30 year-old subjects IGF-I concentrations amounted to 59% after 60 years, 43% in men and 54% in women after 70 years and 29% after 90 years. It is suggested that increasing adrenal DHEA-S concentrations stimulate IGF-I synthesis and by means of gonadal steroidogenesis, increase the pubertal GH secretion and the further pubertal IGF-I increase. The low IGF-I concentrations in patients > 60 years reflect the more catabolic metabolism of the elderly.
ABSTRACT— Consequences of bilateral nephrectomy (NX) for liver functions and for hepatic excretion of various endogenous substances were characterized in rats 24 h after NX. Plasma concentrations of urea, creatinine, fibrinogen, and glutathione increased significantly after NX, whereas the concentrations of total protein, albumin, and lipids decreased. The hepatic excretion of urea, creatinine, phospholipids, cholesterol, and aldosterone significantly increased in uremia, and excretions of protein and glutathione diminished. Active biliary transport can be diminished after NX by the effects of uremic toxins on the liver cells or by the competition phenomena between endogenous substances, which are normally excreted in urine, at the hepatocellular level. Reduced glutathione content and increased lipid peroxidation in hepatocytes have been found. Changes in lipid and protein metabolism after NX can be proved.
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