Morphine and P2Y12 receptor inhibitors are both recommended in patients with acute myocardial infarction. Morphine may impede gastrointestinal absorption of several oral drugs including P2Y12 platelet receptor inhibitors. The aim of this review was to critically discuss drug-drug interactions between oral P2Y12 receptor inhibitors and morphine according to currently available knowledge based on the findings of experimental, observational and randomized clinical studies. The morphine-clopidogrel pharmacodynamic interaction has been observed in numerous trials and it has been proposed as an explanation for the negative impact of morphine on the clinical outcomes in patients with acute coronary syndromes. An analogous morphine interaction with ticagrelor and prasugrel was found in several observational studies and finally proven in randomized trials in healthy volunteers and acute myocardial infarction patients. Morphine delays and attenuates exposure and antiplatelet action of oral P2Y12 receptor inhibitors in patients with myocardial infarction. Although this interaction may have potentially harmful consequences, routine avoidance of morphine cannot be recommended until clinically powered trials are completed.
We derived quantum trajectories for a system interacting with the environment prepared in a continuous mode single photon state as the limit of discrete filtering model with an environment defined as series of independent qubits prepared initially in the entangled state being an analogue of a continuous mode state. The environment qubits interact with the quantum system and they are subsequently measured. The initial correlation between the bath qubits is the source of the non-Markovianity. The conditional evolutions of the quantum system for limit of the continuous in time observations together with the formulas for the photon counting probabilities are given.
We derive stochastic master equation for a quantum system interacting with an environment prepared in a continuous-mode N -photon state. To determine the conditional evolution of the quantum system depending on continuous in time measurements of the output field the model of repeated interactions and measurements is applied. The environment is defined as an infinite chain of harmonic oscillators which do not interact between themselves and they are prepared initially in an entangled state being a discrete analogue of a continuous-mode N -photon state. We provide not only the quantum trajectories but also the analytical formulae for the whole statistics of the output photons and the solution to the master equation. The solution in the continuous case is represented by a simple diagrammatic technique with very transparent "Feynman rules". This technique considerably simplifies the structure of the solution and enables one to find physical interpretation for the solution in terms of a few elementary processes.
IntroductionChronic obstructive pulmonary disease (COPD) is an inflammatory disorder of the airways. An important element of COPD assessment is the evaluation of immune mechanisms involved in non-specific and specific response to ongoing inflammation.Aim of the studyTo evaluate the level of selected inflammatory and immunological parameters in patients with COPD, including C-reactive protein (CRP) and circulating immune complexes (CIC), as well as CRP/CIC index.Material and methodsThe study group consisted of 49 patients with obstructive pulmonary diseases (COPD, asthma, and asthma-COPD overlap syndrome) hospitalised in the Department of Pulmonary Diseases, Kuyavian-Pomeranian Pulmonology Centre in Bydgoszcz. Patients with COPD were divided into two subgroups, taking into account the severity of the disease according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD; stages B and D). The control group consisted of 30 healthy persons. Levels of CIC were determined by the method of Hasková, and the concentration of CRP in serum by the standard immunoturbidimetric method.ResultsThe median values of examined parameters (neutrophils, lymphocytes, platelets, neutrophil/lymphocyte ratio – NLR, platelet/lymphocyte ratio – PLR, CRP, CIC, and CRP/CIC index) were significantly higher among patients with obstructive diseases than in the control group. A tendency towards higher lymphocyte count, CRP, and CRP/CIC index in COPD stage D, compared to stage B, was observed.ConclusionsBased on our results, we suggest that the role of non-specific inflammatory mechanisms may increase in more advanced COPD stages (D), compared to less advanced stages (B).
BackgroundTuberculosis (TB) is one of the most dangerous infectious diseases and has one of the highest mortality rates. For decades a strong association has been evident between certain socio-economic factors and TB adverse events and failure of treatment, yet there is a limited quantity of literature available on this subject, especially in the Polish literature.Material/MethodsWe examined epidemiological data from 2025 TB patients treated at the Regional Centre of Pulmonology in Bydgoszcz, Poland between 2001 and 2010. This article focuses on the association between all forms of unsuccessful TB treatment outcomes or adverse drug reaction (ADR) and socio-demographic characteristics, condition on admission, and other biological, clinical, social, and healthcare access factors.ResultsThe rate of TB-ADR during hospitalization was 38.9%. Multivariate logistic regression analysis showed that age (P<0.001) and alcohol abuse (P=0.007) were independently associated with the occurrence of TB-ADR. The rate of unsuccessful TB treatment was 10.5%. After adjusting for confounding variables, age (P<0.001), alcohol abuse (P=0.002), and education (P=0.01) were significantly associated with unsuccessful treatment. Smoking did not have any significant influence on occurrence of either TB-ADR during hospitalization or unsuccessful treatment.ConclusionsAmong our TB patients treated between 2001 and 2010, alcohol abuse significantly worsened the treatment outcome. This information will be crucial in developing strategies targeted at this demographic group.
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