SUMMARY BackgroundMyelosuppression occurs in 2-7% of inflammatory bowel disease (IBD) patients treated with azathioprine, and can be associated with reduced activity of thiopurine methyltransferase (TPMT) in some patients. It has been proposed that pretreatment assessment of TPMT status reduces the incidence of toxicity and is cost-effective.

Summary In this prospective study, we investigated the effects of anxiety on the induction dose of propofol and subsequent cardiovascular changes in 197 patients. Pre‐operative state and trait anxiety scores were measured using the State Trait Anxiety Inventory. Propofol was administered at 40 mg.kg−1.h−1. Propofol dose was recorded at loss of verbal response and when EEG Bispectral Index decreased to 50. Thereafter, propofol infusion rate was reduced to 8 mg.kg−1.h−1. Cardiovascular data were collected for 15 min after starting induction. Maximum percentage decreases in heart rate and mean arterial pressure, and the point at which the latter occurred, were recorded. On multivariate analysis, anxiety scores did not significantly affect propofol dose or cardiovascular end‐points, although Bispectral Index at loss of verbal response decreased with increasing trait anxiety (p = 0.02). Anxiety, measured using State Trait Anxiety Inventory, does not appear independently to affect the induction characteristics of propofol.

The enzyme inosine triphosphate pyrophosphatase (ITPase) catalyses the pyrophosphohydrolysis of ITP to IMP. ITPase deficiency is a clinically benign autosomal recessive condition characterised by the abnormal accumulation of ITP in erythrocytes. A deficiency of ITPase may predict adverse reactions to therapy with the thiopurine drug 6-mercaptopurine and its prodrug azathioprine. In this study, we examine the frequencies of ITPA polymorphisms in 100 healthy Japanese individuals. The allele frequency of the 94C > A variant in the Japanese sample was 0.135 (Caucasian allele frequency 0.06). The IV2 + 21A > C polymorphism was not found in Japanese (Caucasian allele frequency 0.130). Allele frequencies of the 138G > A, 561G > A and 708G > A polymorphisms were 0.57, 0.18 and 0.06 respectively in the Japanese population, and with the exception of the 138G > A polymorphism, similar to allele frequencies in Caucasians.

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