Is ceftriaxone effective in experimental brain ischemia/reperfusion injury?

OBJECTIVE: The aim of the present study was to investigate the neuroprotective effect of ceftriaxone in a rat brain ischemia/reperfusion injury model. METHODS: The oxidative stress parameter, malondialdehyde (MDA) levels with or without ceftriaxone treatment in brain ischemia/reperfusion injured rats as well as in controls were measured in serum and brain tissue. Motor examinations of the rats were also performed. One-way Analysis of Variance (ANOVA) test was used for analysis. Duncan's Multiple Range Test was performed in multiple comparisons. p < 0.05 were considered statistically significant.  RESULTS: The data of this study showed that ceftriaxone treatment reduced the MDA levels in brain tissues in ischemia/reperfusion injured rats. Moreover, Bederson motor scores were higher in the ceftriaxone treated group as compared to the ischemia group (p = 0.092). CONCLUSION: These results suggest that ceftriaxone could be beneficial for the prevention of brain ischemia/reperfusion injury caused by acute arterial occlusion through reducing the tissue MDA level (Tab. 2, Fig. 5, Ref. 24).

Study to increase the pneumococcal vaccination rates of individuals aged 65 years and older.

BACKGROUND: In our study, we intended to observe the impact of recommending the pneumococcal vaccine to individuals who were called on the phone or interviewed face-to-face by their doctors on vaccination rates. METHODS: Two hundred individuals who were 65 years old and older were included in our study. They were questioned about their awareness regarding adult immunisation, and their knowledge level and vaccination statuses were determined regarding the tetanus, influenza, hepatitis, and pneumococcal vaccines. After they were given information about the pneumococcal vaccine, they were asked about their interest in being vaccinated. Those who agreed to be vaccinated were invited and vaccinated. RESULTS: According to the questionnaire, 150 people (75%) knew of the influenza vaccine, 130 people (65%) knew of the tetanus vaccine, 53 people (26.5%) knew of the hepatitis B vaccine, and 49 people (24.5%) knew of the pneumococcal vaccine. A total of five people (2.5%) had received the pneumococcal vaccine. Fifty-eight of 97 patients (59.8%) who completed the questionnaire during a phone call and 84 of 103 patients (81.6%) who completed the questionnaire during a face-to-face interview received the pneumococcal vaccine. As a result, the rates of pneumococcal vaccination increased from 2.5% before the study to 73.5% after the study. CONCLUSION: The findings show that the vaccination rates for pneumococcus were very low among our participants. The immunisation rates increased when doctors provided consultation to participants about adult immunisation.

Differences in nephrotoxicity risk and renal effects among anti-viral therapies against hepatitis B.

BACKGROUND: Results are conflicting with respect to the renal effects of anti-viral agents used for hepatitis B virus infection. AIM: To compare short and long-term renal effects in real-life settings and to determine risk factors for renal impairment during treatment. METHODS: 2221 treatment-naïve patients were enrolled. Among these, 895 (302 lamivudine, 27 telbivudine, 282 entecavir, 273 tenofovir and 11 adefovir initiated patients) had 'repeated measures' of creatinine (baseline, 1st, 6th, 12th and 24th month of treatment). Telbivudine and adefovir groups were excluded from further analysis because of the low number of patients. We calculated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) formula at each time point. Hypophosphataemia was also recorded. Risk factors for renal impairment were analysed. RESULTS: Tenofovir caused a decline in GFR at each time point when compared to baseline levels. However, lamivudine and entecavir did not change GFR. GFR-shifting from ≥90 to 60-89 mL/min/1.73 m(2) was comparable among groups. The proportion of patients whose baseline creatinine increased more than 25% was comparable among all anti-virals. GFR showed a decline in patients who switched from entecavir to tenofovir. One patient with compensated cirrhosis needed to change from tenofovir because of renal safety. Seven and three patients developed transient hypophosphataemia in the tenofovir and lamivudine groups, respectively. CONCLUSIONS: Although tenofovir caused a decline in GFR, differences between the anti-viral agents do not appear to be so impressive. In patients with and without renal risk factors at baseline, there is no impact of anti-virals, including tenofovir.