The effects of favipiravir on hematological parameters of covid-19 patients

SUMMARY INTRODUCTION This study aims to evaluate changes in hematological parameters after the follow-up of patients who received treatment with favipiravir due to COVID-19 infections. METHODS Sixty-two cases receiving favipiravir treatment for at least five days due to COVID-19 infection were evaluated retrospectively. Parameters including age, gender, nasopharyngeal swab positivity, and chronic diseases were analyzed. Hematologic parameters were analyzed before and after the treatment. RESULTS The mean age of the patients receiving treatment with favipiravir was 63.7±12.3 years. Nasopharyngeal swab positivity was detected in 67.7%. The most common comorbid conditions detected in patients were hypertension in 25 cases (40.3%) and diabetes in 16 cases (25.8%). In the statistical analysis of the hematological parameters before and after treatment with favipiravir, WBC, PT-PTT-INR levels were found to be unaffected; the mean RBC was found to have decreased from 4.33 ± 0.58 M/uL to 4.16 ± 0.54 M/uL (p:0.003); the median hemoglobin level was found to have decreased from 12.3 g/dl to 11.9 g/dl (p:0.041); the hematocrit level decreased from 38.1% ± 4.8 to 36.9% ± 4.2 (p:0.026); the median neutrophil count decreased from 4.57 K/uL to 3.85 K/uL (p:0.001); the mean lymphocyte count increased from 1.22 ± 0.53 K/uL to 1.84 ± 1.19 K/uL (p:0.000); and the mean platelet count increased from 244.1 ± 85.1 K/uL to 281.9 ± 103.3 K/uL (p:0.005). CONCLUSION We concluded that the pathological effect of treatment with favipiravir on the hematologic system was the suppression in the erythrocyte series, and there were no adverse effects in other hematologic parameters.

RESUMO INTRODUÇÃO Este estudo tem como objetivo avaliar as alterações nos parâmetros hematológicos após o acompanhamento de pacientes que receberam tratamento com favipiravir devido à infecção por Covid-19. MÉTODOS Sessenta e dois casos em tratamento com favipiravir por pelo menos cinco dias devido à infecção por Covid-19 foram avaliados retrospectivamente. Parâmetros como idade, sexo, positividade do swab nasofaríngeo e doenças crônicas foram analisados. Os parâmetros hematológicos foram analisados antes e após o tratamento. RESULTADOS A idade média dos pacientes que receberam tratamento com favipiravir foi de 63,7±12,3 anos. A positividade do swab nasofaríngeo foi detectada em 67,7%. As condições comórbidas mais comuns detectadas nos pacientes foram hipertensão em 25 casos (40,3%) e diabetes em 16 casos (25,8%). Na análise estatística dos parâmetros hematológicos antes e após o tratamento com favipiravir, os níveis de leucócitos, PT-PTT-INR não foram afetados. Verificou-se que o RBC médio diminuiu de 4,33±0,58 M/uL para 4,16±0,54 M/uL (p=0,003); o nível médio de hemoglobina foi reduzido de 12,3 g/dl para 11,9 g/dl (p=0,041); o nível de hematócrito diminuiu de 38,1%±4,8 para 36,9%±4,2 (p=0,026); a contagem mediana de neutrófilos diminuiu de 4,57 K/uL para 3,85 K/uL (p=0,001); a contagem média de linfócitos aumentou de 1,22±0,53 K/uL para 1,84±1,19 K/uL (p=0,000); a contagem média de plaquetas aumentou de 244,1±85,1 K/uL para 281,9±103,3 K/uL (p=0,005). CONCLUSÃO Concluiu-se que o efeito patológico do tratamento com favipiravir no sistema hematológico foi a supressão na série eritrocitária e que não houve efeitos adversos em outros parâmetros hematológicos.

Beneficial effects of Oltipraz, nuclear factor - erythroid - 2 - related factor 2 (Nrf2), on renal damage in unilateral ureteral obstruction rat model

ABSTRACT Introduction: We investigated whether Oltipraz (OPZ) attenuated renal fibrosis in a unilateral ureteral obstruction (UUO) rat model. Materials and Methods: We randomly divided 32 rats into four groups, each consisting of eight animals as follows: Rats in group 1 underwent a sham operation and received no treatment. Rats in group 2 underwent a sham operation and received OPZ. Rats in group 3 underwent unilateral ureteral ligation and received no treatment. Group 4 rats were subjected to unilateral ureteral ligation plus OPZ administration. Transforming growth factor beta-1 (TGF-β1), E-cadherin, nitric oxide (NO) and hydroxyproline levels were measured. Histopathological and immunohistochemical examinations were carried out. Results: TGF-β1, NO and E-cadherin levels in the UUO group were significantly higher than the sham group and these values were significantly different in treated groups compared to the UUO group. In rats treated with UUO + OPZ, despite the presence of mild tubular degeneration and less severe tubular necrosis, glomeruli maintained a better morphology when compared to the UUO group. Expressions of α-SMA in immunohistochemistry showed that the staining positivity decreased in the tubules of the OPZ-treated group. Conclusions: While the precise mechanism of action remains unknown, our results demonstrated that OPZ exerted a protective role in the UUO-mediated renal fibrosis rat model highlighting a promising therapeutic potency of Nrf2-activators for alleviating the detrimental effects of unilateral obstruction in kidneys.

Hydrogen sulfide in posthemorrhagic shock mesenteric lymph drainage alleviates kidney injury in rats

Posthemorrhagic shock mesenteric lymph (PHSML) is a key factor in multiple organ injury following hemorrhagic shock. We investigated the role of hydrogen sulfide (H2S) in PHSML drainage in alleviating acute kidney injury (AKI) by administering D,L-propargylglycine (PPG) and sodium hydrosulfide hydrate (NaHS) to 12 specific pathogen-free male Wistar rats with PHSML drainage. A hemorrhagic shock model was established in 4 experimental groups: shock, shock+drainage, shock+drainage+PPG (45 mg/kg, 0.5 h prehemorrhage), and shock+drainage+NaHS (28 µmol/kg, 0.5 h prehemorrhage). Fluid resuscitation was performed after 1 h of hypotension, and PHMSL was drained in the last three groups for 3 h after resuscitation. Renal function and histomorphology were assessed along with levels of H2S, cystathionine-γ-lyase (CSE), Toll-like receptor 4 (TLR4), interleukin (IL)-10, IL-12, and tumor necrosis factor (TNF)-α in renal tissue. Hemorrhagic shock induced AKI with increased urea and creatinine levels in plasma and higher H2S, CSE, TLR4, IL-10, IL-12, and TNF-α levels in renal tissue. PHSML drainage significantly reduced urea, creatinine, H2S, CSE, and TNF-α but not TLR4, IL-10, or IL-12. PPG decreased creatinine, H2S, IL-10, and TNF-α levels, but this effect was reversed by NaHS administration. In conclusion, PHSML drainage alleviated AKI following hemorrhagic shock by preventing increases in H2S and H2S-mediated inflammation.

Effect of treatment with sitagliptin on somatosensory-evoked potentials and metabolic control in patients with type 2 diabetes mellitus / Efeito do tratamento com sitagliptina sobre os potenciais evocados somatossensoriais e controle metabólico de pacientes com diabetes melito tipo 2

Objective: To evaluate the effect of sitagliptin on somatosensory-evoked potentials (SEPs) and metabolic control in patients with type 2 diabetes mellitus without clinical diabetic neuropathy. Materials and methods: Interventional, prospective, and open study. Patients with less than six months from the diagnosis were included. Examinations of SEPs and laboratory tests at fasting and after food stimulation were performed before and after three months of treatment with sitagliptin (100 mg/day). Results: There was a reduction in the mean levels of HbA1c (P < 0.0001), fasting glucose (P = 0.001), total cholesterol (P = 0.019), and ALT (P = 0.022). An increase in active GLP-1 was found at the end of the study (P = 0.0025). Several SEPs showed statistically significant differences when analyzed before and after treatment with sitagliptin. Conclusion: The results give a glimpse of the possible use of sitagliptin in the treatment of some neurodegenerative conditions of the peripheral nervous system, in addition to its already established role in glycemic control. .

Objetivo: Avaliar o efeito da sitagliptina nos potenciais evocados somatossensoriais (PESS) e controle metabólico de pacientes com diabetes melito tipo 2, sem neuropatia diabética. Materiais e métodos: Estudo de intervenção, prospectivo e aberto. Os pacientes com menos de seis meses de diagnóstico foram incluídos. Exames dos PESS e testes laboratoriais em jejum e após a estimulação com alimentos foram realizados antes e depois de três meses de tratamento com sitagliptina (100 mg/dia). Resultados: Houve redução nos níveis médios de HbA1c (P < 0,0001), glicemia de jejum (P = 0,001), colesterol total (P = 0,019) e ALT (P = 0,022). Verificou-se aumento de GLP-1 ativo (P = 0,0025). Vários PESS mostraram diferenças estatisticamente significativas quando os valores foram analisados antes e após o tratamento com sitagliptina. Conclusão: Os resultados vislumbram a possível utilização de sitagliptina no tratamento de algumas condições neurodegenerativas do sistema nervoso periférico, em adição ao seu papel no controle glicêmico. .

Use of Bortezomib as Anti-Humoral Therapy in Kidney Transplantation

This study aimed to investigate the effect of bortezomib in the desensitization and treatment of acute antibody mediated rejection (AAMR) in kidney transplantation. Nine patients who received bortezomib therapy for desensitization (DSZ group, n = 3) or treatment of AAMR (AAMR group, n = 6) were included in this study. In the DSZ group, 2 patients required DSZ owing to positive cross match and 1 owing to ABO mismatch with high baseline anti-ABO antibody titer (1:1,024). Bortezomib was used at 1, 3, 8, and 11 days from the start of the treatment. In the AAMR group, 3 patients showed full recovery of allograft function after bortezomib use and decrease in donor specific anti-HLA antibody (HLA-DSA). However, 3 patients did not respond to bortezomib and experienced allograft failure. In the DSZ group, negative conversion of T-CDC (complement-dependent cytotoxicity) was achieved, and HLA-DSA was decreased to lower than a weak level (median fluorescence intensity [MFI] < 5,000) in 2 patients. In the case of ABO mismatch kidney transplantation, the anti-A/B antibody titer decreased to below the target (< or = 1:16) after bortezomib therapy. Therefore, bortezomib could be an alternative therapeutic option for desensitization and treatment of AAMR that is unresponsive to conventional therapies.

Diagnosis and therapy of multiple myeloma

Many advances in the treatment of multiple myeloma have been made due to the use of transplantation and the introduction of novel agents including thalidomide, lenalidomide, and bortezomib. The first step is recognizing the symptoms and starting prompt treatment. Different strategies should be selected for young and elderly subjects. Young patients are commonly eligible for transplantation, which is now considered the standard approach for this setting, and various inductions therapies containing novel agents are available before transplantation. Elderly patients are usually not eligible for transplantation, and gentler approaches with new drugs combinations are used for their treatment.

Clinical Characteristics of the Responders to Dipeptidyl Peptidase-4 Inhibitors in Korean Subjects with Type 2 Diabetes

We investigated characteristics associated with the efficacy of dipeptidyl peptidase-4 inhibitors (DPP4i) in Korean patients with type 2 diabetes. We reviewed medical records of 477 patients who had taken sitagliptin or vildagliptin longer than 40 weeks. Response to DPP4i was evaluated with HbA1c change after therapy (DeltaHbA1c). The Student's t-test between good responders (GR: DeltaHbA1c > 1.0%) and poor responders (PR: DeltaHbA1c < 0.5%), a correlation analysis among clinical parameters, and a linear multivariate regression analysis were performed. The mean age was 60 yr, duration of diabetes 11 yr and HbA1c was 8.1%. Baseline fasting plasma glucose (FPG), HbA1c, C-peptide, and creatinine were significantly higher in the GR compared to the PR. Duration of diabetes, FPG, HbA1c, C-peptide and creatinine were significantly correlated with DeltaHbA1c. In the multivariate analysis, age (r2 = 0.006), duration of diabetes (r2 = 0.019), HbA1c (r2 = 0.296), and creatinine levels (r2 = 0.024) were independent predictors for the response to DPP4i. Body mass index and insulin resistance were not associated with the response to DPP4i. In conclusion, better response to DPP4i would be expected in Korean patients with type 2 diabetes who have higher baseline HbA1c and creatinine levels with shorter duration of diabetes.

Early Response to Bortezomib Combined Chemotherapy Can Help Predict Survival in Patients with Multiple Myeloma Who Are Ineligible for Stem Cell Transplantation

Novel agents to treat multiple myeloma (MM) have increased complete respone (CR) rates compared with conventional chemotherapy, and the quality of the response to treatment has been correlated with survival. The purpose of our study was to show how of early response to bortezomib combined chemotherapy influences survival in patients with newly diagnosed MM who are ineligible for stem cell transplantation. We assessed patient responses to at least four cycles of bortezomib using the International Myeloma Working Group response criteria. The endpoints were comparisons of progression free survival (PFS) and overall survival (OS) between early good response group (A group) and poor response group (B group). We retrospectively analyzed data from 129 patients registered by the Korean Multiple Myeloma Working Party, a nationwide registration of MM patients. The 3 yr PFS for the A and B groups was 55.6% and 18.4%, respectively (P < 0.001). The 3 yr OS for the A and B groups was 65.3% and 52.9%, respectively (P = 0.078). The early response to at least four cycle of bortezomib before next chemotherapy may help predict PFS in patients with MM who are ineligible stem cell transplantation.

Determinants of Acute Dystonia in First Episode of Psychotic Patients Treated with Haloperidol and Centbutindole.

Objectives: To assess the factors affecting of acute dystonia in first episode psychotic patients taken haloperidol and centbutindole Method and Procedure: Total 54 patients (Schizophrenia, manic, psychotic) taken for the study from the psychiatry O.P.D. K.G.M.C Lucknow. The age group of patients were between the 17 to 55 years. This study was double blind and prospective. Patients were randomly administered Holoperidol (5 mg) TDS or Centbutindole (1.5 mg) TDS. The total period of study was 2 weeks, if any abnormal movements developed during this period the criteria for acute dystonia was applied. Tools: Semi structured proforma, International Classification of Disease — 10. Diagnostic and research criteria for neuroleptic induced acute dystonia, Scale for assessment of torsion dystonia. Beck and Refaelsen Mania Rating Scale: for manic patient only, Brief Psychiatric Rating Scale: On all patients was used. Result: The results show that acute dystonia was higher among the manic patients, younger age, married, male between the age group 17-25 year and duration of illness 1-3 months. It was also higher among those patients who have psychiatric family history.

Newer therapeutic molecules for multiple myeloma.

Therapeutic management of multiple myeloma (MM) for the last several decades has mainly involved regimens based on use of glucocorticoids and cytotoxic chemotherapeutics. Despite progress in delineating the activity of such regimens, at either conventional or high doses, MM has remained an incurable disease. This has sparked major interest in the development of novel therapies that in part capitalize on recent advances in our understanding of the biology of MM, including the molecular mechanisms by which MM cell-host bone marrow (BM) interactions regulate tumor-cell growth, survival, and drug resistance in the BM milieu. Herein, we review the latest progress in the development of these novel anti-MM therapies, with major focus on therapies which have translated from preclinical evaluation to clinical application, including thalidomide and its more potent immunomodulatory derivatives (IMiD), the first-in-class proteasome inhibitor bortezomib (formerly known as PS-341). Search strategy included Medline using the terms 'Myeloma and Newer Drugs' citations relevant to treatment guidelines issued in 1999 and 2008 were screened.

Incretin mimetics and dipeptidyl peptidase-4 inhibitors: innovative treatment therapies for type 2 diabetes / Incretinomiméticos e inibidores da dipeptidil peptidase-4: terapias inovadoras para o tratamento do diabetes tipo 2

The prevalence of diabetes and impaired glucose tolerance is predicted to dramatically increase over the next two decades. Clinical therapies for type 2 diabetes mellitus (T2DM) have traditionally included lifestyle modification, oral anti-diabetic agents, and ultimately insulin initiation. In this report, we review the clinical trial results of two innovative T2DM treatment therapies that are based on the glucoregulatory effects of incretin hormones. Incretin mimetics are peptide drugs that mimic several of the actions of glucagon-like peptide-1 (GLP-1) and have been shown to lower glycated hemoglobin (A1C) levels in patients with T2DM. Additionally, incretin mimetics lower postprandial and fasting glucose, suppress elevated glucagon release, and are associated with progressive weight reduction. Dipeptidyl peptidase-4 (DPP-4) inhibitors increase endogenous GLP-1 levels by inhibiting the enzymatic degradation of GLP-1. Clinical studies in patients with T2DM have shown that DPP-4 inhibitors reduce elevated A1C, lower postprandial and fasting glucose, suppress glucagon release, and are weight neutral. Collectively, these new drugs, given in combination with other antidiabetic agents, such as metformin, sulfonylureas, and/or thiazolidinediones, can help restore glucose homeostasis in poorly controlled patients with T2DM.

É previsto que a prevalência de diabetes e a intolerância à glicose aumente dramaticamente ao longo das próximas duas décadas. As terapias clínicas para diabetes melito tipo 2 (DM2) têm tradicionalmente incluído modificação do estilo de vida, agentes antidiabéticos orais e, por último, o início da insulina. Neste artigo, revisamos os resultados dos estudos clínicos de duas terapias inovadoras no tratamento do DM2 baseadas nos efeitos glicorregulatórios dos hormônios incretina. Os incretinomiméticos são medicamentos peptídeos que mimetizam várias das ações do peptídeo semelhante ao glucagon-1 (GLP-1) e têm demonstrado reduzir níveis de hemoglobina glicada (A1C) em pacientes com DM2. Adicionalmente, incretinomiméticos reduzem as glicemias pós-prandial e de jejum, suprimem a liberação elevada do glucagon, e são associados com redução de peso. Os inibidores da dipeptidil peptidase-4 (DPP-4) aumentam os níveis de GLP-1 endógeno pela inibição da degradação enzimática do GLP-1. Estudos clínicos em pacientes com DM2 têm demonstrado que inibidores da DPP-4 reduzem A1C elevada, reduzem as glicemias pós-prandial e de jejum, suprimem a liberação elevada do glucagon e são neutros quanto ao peso. Coletivamente, estas novas medicações, administradas em combinação com outros agentes antidiabéticos, como metformina, sulfoniluréias e/ou tiazolidinedionas (TZDs), podem ajudar a recuperar a homeostase glicêmica de pacientes com DM2 não-controlados.

Serum Free Light Chains for Diagnosis and Follow-up of Multiple Myeloma / 대한진단검사의학회지

BACKGROUND: Free light chain (FLC) is widely used to evaluate B-cell proliferative diseases. Herein, we estimated the clinical usefulness of serum FLC in multiple myeloma (MM). METHODS: Fifty-one patients were enrolled. We performed FLC analysis, protein electrophoresis (PEP), and immunofixation electrophoresis (IFE). FLC was measured using Toshiba 200 FR Neo with FREELITE(TM), and kappa/lambda (kappa/lambda) ratio was calculated. We compared these parameters in 41 patients with increased FLC before and after bortezomib treatment. Complete response (CR) was defined as the disappearance of monoclonal (M) protein in serum and/or urine as measured by IFE. Partial response (PR) was defined as > or =50% reduction of serum M protein. Early objective response (EOR) included both CR and PR. Minimal response (MR) was defined as 25-49% reduction of M protein and stable disease (SD) as <25% reduction. RESULTS: Forty-one (80.4%) of the 51 patients studied revealed increment of FLC and the five patients with no increment revealed an abnormal kappa/lambda ratio. Especially, all of the light chain myeloma and non-secretory myeloma showed increased FLC concentrations. Among the patients with EOR, 72.4% (21/29) showed a normal or subnormal FLC concentration after the first cycle of treatment. Otherwise, PEP and IFE normalized in 24.1% (7/29) and 24.1% (7/29), respectively. The ratio of decreased FLC after the first cycle of treatment was significantly different between EOR and other response groups (MR, SD) (90.6% vs 51.8%, P=0.011). CONCLUSIONS: FLC was considered as a good diagnostic method in complement with PEP and IFE in MM, especially in light chain myeloma or non-secretory myeloma. Moreover, FLC is a useful monitoring tool because it reflects therapy results more rapidly owing to a short serum half-life.

Ascaris lumbricoides en vías biliares / Ascaris lumbricoides in the bile ducts

El Ascaris Lumbricoides, es un helminto endémico de los países de clima cálido, como los es el nuestro. La infestación masiva de diversos órganos por este parásito es mundialmente conocida. Incluyendo el alojamiento de grandes cantidades de Ascaris Lumbricoides de las vías biliares, sobre todo en pacientes pediátricos, siendo ésto más infrecuente en pacientes adultos. En el Servicio de Cirugía General del C.H.M. nos tocó operar una paciente de 38 años, residente en la capital por 29 años, quien ingresó con un cuadro típico de Colecistitis aguda. Durante su estudio se evidenció la presencia de un Ascaris Lumbricoides en el interior del colédoco. Fue llevada al salón de operaciones, donde se le practicó coledocotomía lagrándose extraer el helminto del radical izquierdo hepático. Efectuándose drenaje del colédoco con tubo en "T" número 18 y a continuación una colecistectomía de cuello a fondo. Se evolución fue satisfactoria y se complementó con tratamiento a base de Piperazina oral. El objeto de este trabajo es llamar la atención de los colegas, sobre todo de los que trabajan en áreas rurales, ya que siendo un parásito muy conocido en nuestro medio, no se reportan muchos casos similares. Nos llama la atención que en el Continente Africano la segunda causa de abdómenes agudos son las complicaciones por la presencia masiva del Ascaris en diversos órganos abdominales

Avaliaçäo terapêutica do oltipraz na infecçäo humana pelo S. mansoni / Therapeutic evaluation of oltipraz in human infection due to S. monsoni

Foram tratados com oltipraz, dose oral única de 30 mg/kg de peso, 72 indivíduos com esquistossomose mansoni, matriculados na Clínica de Doenças Infecciosas e Parasitárias do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo. As idades dos pacientes variaram de 7 a 58 anos, sendo que 8 (11,1%) eram menores de 15 anos. Os principais efeitos colaterais consistiram em tonturas 22,2%, sonolência 22,2%, naúseas 22,2%, cefaléia, 9,7%, astenia 9,7%, parestesia 8,3%, vômitos 8,3%, cólicas 7,0%, diarréia 4,2%, escotomas 2,8%, sialosquese 2,8%, nódulos dolorosos em extremidades 2,8% e outras manifestaçöes clínicas em menor frequência. A toxicidade do medicamento foi avaliada mediante a realizaçäo pré e pós-tratamento, de exames hamatimétricos, de funçäo renal (uréia e creatinina), hepática (enzimas de liberaçäo hepato-canalicular e bilirrubinas), cardíaca (ECG) e neuropsiquiátrica (EEG). Näo foram encontrados nos controles laboratoriais alteraçöes relevantes ou que determinasse alguma repercussäo clínica. O controle de cura verificou-se em 49 indivíduos, através de 8 coproscopias (no período de 6 meses subseqüente ao tratamento) utilizando-se duas técnicas (Hoffman e Kato/Katz) para cada amostra de fezes. Dos 29 indivíduos que tiveram as 8 coproscopias negativas, 20 realizaram biopsia retal, mostrando-se positiva em uma oportunidade, indicando 5% de "falsos negativos" com relaçäo às coproscopias. O índice de cura para todas as faixas etárias foi de 59,2%. Os resultados obtidos demonstraram ser o oltipraz de relativa eficácia e determinante de efeitos tóxicos-colaterais sistêmicos no tratamento da esquistossomose mansoni

Estudio de la eficacia y seguridad de un tratamiento a largo plazo con acipimox en hiperlipogroteinemia / Efficacy and security of a long-term treatment with acipimox in hyperlipoproteinemia

Diseño experimental: Abierto, no controlado. Número de pacientes: 117 pacientes externos (64 varones, 53 mujeres) con hiperlipoproteinemia tipo 2a, (35), 2b (38) y 4 (44). Horario de tratamiento: Los pacientes fueron instruidos para que tomaran una cápsula de 250 mg. o 400 mg. t. i. d. por un período de 6 - 24 meses. Evaluación: Mensualmente los primeros dos meses y de allí en adelante bi-mensualmente: peso corporal, ritmo cardíaco, presión sanguínea sistólica y diastólica, lípidos plasmáticos, (colesterol) total y triglicéridos). Con el mismo horario mencionado para el primer año y luego por lo menos una vez cada seis meses hemograma y bioquímica sanguínea (glicemia, uricemia, BUN, creatinina, proteínas totales, bilirrubina total, SGOT, SGPT, fosfatasa alcalina, RBC, hemoglobina, hematocrito, WBC total y diferencial, trombocitos, tiempo de protrombina), urianálisis. La electroforesis lipoproteína se hizo sólo en el momento de admisión y en algunos controles durante el estudio. Resultados: 15 pacientes interrumpieron el tratamiento: 10 debido a motivos adversos, 1 debido a enfermedad intercurrente, 1 por mejoramiento definitivo, 1 debido a empeoramiento de enfermedad concomitante y 2 se perdieron en el seguimiento. De los pacientes restantes 45, 18 y 39 completaron 6, 12 y 24 meses de tratamiento, respectivamente. Durante la prueba el peso corporal de los pacientes no cambió significativamente. a) Eficacia. Los niveles medios de triglicéridos bajaron alrededor de 57% en pacientes hiperlipoproteinémicos del tipo 4 y casi 39% en pacientes del tipo 2b con diferencias muy significativas en comparación con los valores básicos. En los pacientes del tipo 2a. la trigliceridemia bajó alrededor de 13%. Los niveles medios de colesterol total bajaron 17% en pacientes de tipo 2a y 2b y 16% en pacientes de tipo 4 con diferencias muy significativas en comparación con los valores básicos...

Tratamiento da hiperlipidemia primária com ácido 5-metil-pirazina-2-carbocilico (acipimox) / Treatment of primary hyperlipidemia with 5-methylpyrazinecarboxylic acid (acipimox)

Após período controle de 2 meses, 14 pacientes hiperlipidêmicos foram tratados com acipimox (geralmente 750 mg/dia) durante aproximadamente 12 meses. Ocorreu reduçäo média de colesterolemia de 17%, sem que diminuisse significantemente a trigliceridemia, exceto nos casos de hipertrigliceridemia acima de 600 mg/100 ml. Por outro lado a colesterolemia descreveu 23% nos casos de hiperlipidemia combinada (hipercolesterolemia com hipertrigliceridemia), mas apenas 13% nos casos de hipercolesterolemia isolada. Houve diminuiçäo porcentual das beta-lipoproteínas de 49,3% para 43,5% com simultâneo aumento desejável das alfa-LP de 18,5% para 25,9%, mas as pré-beta-LP ficaram estáveis. O incremento de uricemia foi de 13,7%, porém a glicemia, os testes orais de tolerância à glicose, a funçäo hepática e a renal näo se alteraram. Efeitos colaterais foram despresíveis e a tolerância foi consideravelmente melhor do que aquela atribuída ao ácido nicotínico