The use of specific quenched fluorescent substrates (QFS) provides a rapid and sensitive method to measure peptidase activity, and is readily adaptable to high-throughput screening of potential peptidase inhibitors. In this chapter, we discuss general considerations for the development of QFS assays, and describe in detail an assay protocol for the mammalian metallopeptidase, endothelin-converting enzyme.
This paper provides an overview of object relations concepts, applying them specifically to combined psychoterapy-pharmacotherapy of anxiety disorders. Anxiety in this clinical theory is conceptualized as arising from threatened loss of the self- and object-relationship. At a rudimentary level, individuals can attempt to manage potential loss through splitting and projective identification. As benign and loving experiences accumulate and ego functions neurophysiologically develop, whole object relations provide alternate and more modulated ways of coping with anxiety. In anxiety disorders, these more mature coping styles break down. Treatment combining object relations approaches to psychotherapy with pharmacotherapy pay particular attention to the relationship aspects and meanings of medication and prescribing. These approaches use the concepts of empathy, containment, countertransference, splitting, projective identification, and transitional object formation to help patients come to terms with their anxiety and with the treatment relationship.
SUMMARY
Effective and appropriate control of blood glucose can significantly reduce the risk of diabetic complications and all‐cause mortality in patients with diabetes mellitus and recent years have seen a number of new anti‐diabetic medications marketed. However, approximately 30% of patients with diabetes mellitus develop progressive chronic kidney disease (CKD) limiting the selection of agents that can safely be used. Whilst older agents such as metformin and the sulphonylureas remain the mainstay of initial treatment, the elimination and adverse effects profile of a number of these drugs can be a concern in patients with CKD. Additionally, use of the newer agents is often limited by a lack of long‐term safety data, particularly in this patient group. Treatment guidelines for anti‐diabetic therapy rarely consider safe and efficacious management of those patients with CKD.
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