ABSTRACT
Allogeneic hematopoietic stem cell transplantation [HSCT] is a curative treatment option for hematological disorders. Cyclosporine [CsA] is one of the major immunosuppressive agents for the prophylaxis against graft versus host disease [GvHD]. In this retrospective study, we evaluated the effects of CsA serum levels on the incidence of acute GvHD and transplant outcomes. 103 adult patients received Hematopoitic Stem Cell Transplantation[HSCT] in the Hematology-Oncology, Bone Marrow Transplantation center at Shariati Hospital in Tehran, Iran. All participants received prophylactic regimen of cyclosporine plus methotrexate. CsA dose titration was done according to patients' serum levels and drug toxicity. Serum levels tested on the twice weekly basis in first 4 weeks after transplantation.Acute GvHD [grades II-IV] developed in 44 patients [43%, 95%CI: 33%-52%]. The median time to ANC and PLT recovery was 13 days [range: 9-31 days] and 16 days [range: 0-38 days], respectively. Univariate analysis of risk factors related to aGvHD [grade II-IV] development showed a higher risk of incidence of aGvHD [grades II-IV] for patients having the lowest blood CSA concentration [<200ng/ml] in the third weeks after transplantation [36% vs. 12%, P=0.035]. The only risk factors related to incidence of aGvHD grades III-IV was also blood CsA concentration at 3rd week post transplant [15% vs. 3%, P=0.047]. The CsA concentration at 3rd week was not related to disease free survival and overall survival [P=0.913 vs. P=0.81] respectively. Higher CsA serum levels in the third week post HSCT significantly decreased incidence of acute GvHD.
ABSTRACT
Heparin and enoxaparin possess anti-inflammatory properties. We compared the effects of these drugs on inflammatory biomarkers in patients with ST-segment Elevated Myocardial Infarction [STEMI]. Thirty four patients with STEMI randomly separated in two groups and received standard doses of heparin and enoxaparin. The serum concentration of Serum Amyloid A [SAA], C-Reactive Protein [CRP], Interleukin [IL]-6. ferritin and Myeloperoxidase [MPO] were measured at baseline ,12 .24 and 48 hours after drug administration. Serum concentrations of SAA [P: 0.02], CRP [P: 0.02] and ferritin [P: 0.01] significantly reduced in heparin group during measurements compared to baseline, circulating levels of IL-6 [P: 0.002], SAA [P: 0.009], CRP [P: 0.01] were significantly decreased in enoxaparin group. The overall difference in inflammatory biomarkers between heparin and enoxaparin group was not significant. Both heparin and enoxaparine reduced serum levels of inflammatory biomarkers in patients with STEMI. This effect may provide additional clinical benefit of these drugs in the treatment of STEMI patients
ABSTRACT
This study was conducted to clarify the expectations of the health care professionals [professors, residents, interns, nurses and head nurses] in Dr. shariati Hospital regarding the services of the Drug and Poison Information Center in this Hospital. Data was collected from a questionnaire which was distributed among 400 people in April 2009. Only 157 respondents fulfilled the questionnaire. So a return rate of 39% was achieved. According to the results, medical reference books and drug information textbooks [36.7%] and expert colleagues [29.7%] were the [most commonly] used drug information resources. 77.8% of respondents [almost never] use DPICs. According to the results, 77.5% of respondents were non- acquainted with these centers' activities. 44.4% of respondents included [adverse drug reactions] and 33.3% included [availability of drugs in pharmacy] in the blank space considered for them to mention any expectation [s] they rank as the most important. In addition, 74% of them rank [incompatibility of injectable drugs] and [70.1% rank] drug interactions [as the [extremely important] issues. Being non acquaintance with services of DPIC centers can be considered as the most important reason of not using them. Even after 13 years of opening of the first DPIC in IRAN, the health care professionals are not familiar with these centers' services and activities yet. It shows an urgent need for culture building activities to introduce them these centers services