Outcome of combination antiviral therapy in chronic hepatitis C virus infection during therapy of acute lymphoblastic leukemia

Chronic hepatitis C virus [HCV] infection is not uncommon in patients with acute leukemia due to frequent blood transfusions. The treatment of HCV in patients with acute leukemia can produce profound immune dysfunction with the risk of severe cytopenia. We report the case of a young man who was treated with combined therapy of peginterferon alpha 2a and ribavirin for HCV while he was on maintenance anti-leukemic treatment. The patient required reduction in the dose of peginterferon alpha 2a and the addition of filgrastim due to neutropenia. Therapy for HCV was continued for 72 weeks and at the end of therapy, the patient had undetectable HCV RNA. The patient maintained a sustained viral response two years after the end of therapy and developed complete remission of leukemia, whereupon his anti-leukemic therapy was also discontinued. We recommend conducting further large prospective studies in HCV patients treated for leukemia to determine the safety and efficacy of antiviral therapy in this group of patients

Successful treatment of chronic hepatitis C virus infection with peginterferon alpha-2a and ribavirin in patients with sickle cell disease

The objective of this case series was to determine the efficacy and safety of combined treatment with ribavirin and peginterferon alpha-2a in sickle cell disease [SCD] patients with chronic hepatitis C virus [HCV] hepatitis. Eight patients in King Abdulaziz Hospital and Oncology Center, Jeddah, Kingdom of Saudi Arabia from 2003 and 2006 with chronic HCV infection were treated with peginterferon alpha-2a and ribavirin for one year. All 8 patients had a complete early virological response. Seven out of 8 had an end of treatment response with undetectable HCV RNA at the end of therapy, 5 of whom also maintained a sustained virological response when assessed 6 months after the end of treatment. Hemoglobin concentrations measured at one, 3, 6, 9, and 12 months of treatment showed no significant changes from that measured as baseline. Treatment of chronic HCV hepatitis in patients with SCD with peginterferon alpha-2a and ribavirin seems safe and effective

effect of agents acting on NMDA and dopamine receptors on the responses of phrenic nerve-diaphram preparations from aged rats

Alzheimer's Dementia [AD] and Parkinsonism are common in geriatric patients. The skeletal muscles are important in the proper function of aging animals and humans. This study focuses on the influence of memantine [used for moderate to severe AD] and levodopalcarbidopa [LDICD] [a corner stone in the treatment of Parkinsonism] on responses of isolated phrenic nerve-diaphragms [IPNDs] of aged male rats. From 100 aged male albino rats twenty were untreated to study in vitro effects of memantine and LD/CD on 1PNDs. Eighty rats were divided into: Group-I [Control], Group II [oral meman tine, 1 .5mg/KgId], Group-Ill, [twice daily intraperitoneal LD/CD, 25/2.5mg/kg], Group-lV [both drugs]. After three weeks of treatment, animals were sacrificed; ten rats from each group were used to harvest IPNDs to study the effect of alIamine; 10 rats were used to measure nAchR [nicotinic acetyicholine receptor] alpha subunit mRNA by PCR. Heights of indirectly elicited contractions: 63.1 +/- 4, 6. 41.5 +/- 4.5, 70.6 +/- 4.7, 53.9 +/- 3.3mm for Groups I through IV respectively, all differences were statistically significant K0.05]. Memantine treatment caused a leftward shift of sallamine log-concentration-response curve, LD/CD caused ri.htward shift. Reversal of neuromuscular block required ier neostigmine concentrations in the memantine group it smaller concentrations in the LD/CD group. In Vitro m.antine inhibited diaphragmatic responses to indirect stam1ation. Values of nAchR alpha subunit mRNA [micro g/dl]: 1 +/- f116 [control], 0.13 +/- 0.11 [memnatine], 2.3 +/- 0.94 [LD/CD], 1.18 +/- 0.71 [both drugs] [p<0.05]. Memnatine inhibits neuromuscular transmission in vitro and with in vivo treatment. LD/CD treatment rtaaces neuiomuscular transmission. Clinical implications a1 further investigation

influence of L-carnitine among other agents on the functional recovery of the isolated rat heart exposed to hypoxic cold cardioplegia

L-carnitine, is an amino acid derivative, that has previously shown a beneficial effect on skeletal and cardiac muscle function through favorable metabolic effects. This study aims to test for a possible protective effect of L-carnitine in face of cold hypoxic cardioplegia of the isolated rat heart. Sixty male albino rats were used in this study and were divided into six study groups. Isolated rat hearts from all the study groups were exposed to hyperkalemic, hypoxic cold cardioplegia for two hours with the following changes in the cardioplegic solution: Group I served as a control group with no special additions to the cardioplegic solution; for Group II, glucose in the cardioplegic solution was increased to a concentration of 22millimole [mM] for Group III methylprednisolone sodium succinate [MPSS] was added to a concentration of 100mg per liter; Group IV received verapamil in the cardioplegic solution at a concentration of 1.1 micromol/L; Group V had L-carnitine at a concentration of 1mM and for Group VI, L-carnitine was added to the cardioplegic solution a t a concentration of 4Mm. The heart rate [HR], Dp/dt, the left ventricular developed pressure [LVDP], and rate pressure product [RPP] were recorded at baseline, and at 15 and 60 minutes after the start of re-warming. Epinephrine was given to the working hearts at doses of 0.5, 1.0 and 2.0 micromol before cardioplegia and after re-warming and the changes in cardiac function parameters in response to epinephrine were recorded. Creatine phosphokinase [CPK] was measured in samples from the coronary effluent taken before cardioplegia and 15 minutes after re-warming. The control group showed a significant reduction in all cardiac function parameters after cardioplegia and re-warming [dp/dt[max], LVDP and RPP reached 40.2%, 18.8% and 8.4% of their baseline values respectively]. Significant cardiac protection was noted in the groups exposed to glucose and carnitine. Functional recovery with glucose reached 66.2% of the baseline value for the dp/dt[max], 55.2% for the LVDP and 17.5% for the RPP [p<0.01 as compared to control]. Functional recovery with carnitine 4mM reached 98.7% of the baseline value of dp/dt[max], 89.9% for the LVDP, 48.1% for the RPP [p<0.05 as compared to all the other groups]. For carnitine at the 4mM concentration the dp/dt[max] values at the end of the experiment showed no significant difference from the baseline values. Also the percentage increase in dp/dt[max] and LVDP in response to post-cardioplegic epinephrine showed no significant difference from that recorded before cardioplegia [p>0.05]. MPSS provided only transient cardiac improvement compared to the control group, while verapamil showed no protective action on cardiac function parameters. CPK results showed significantly lower post re-warming CPK with all the tested drugs