ABSTRACT
The use of calcineurin inhibitors (CNIs) and vitamin D deficiency may contribute to the pathogenesis of post-transplant bone disease. CNIs and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) are substrates of the drug-metabolizing enzyme CYP3A4. This review summarizes the indications for the use of activated vitamin D analogs in post-transplant care and the current knowledge on the impact of CNIs on bone. We searched for clinical evidence of the interaction between CNIs and 1,25(OH)2D3. We also provide an overview of the literature on the interplay between vitamin D metabolism and CYP3A4 in experimental and clinical settings and discuss its possible implications for solid organ transplant recipients. In conclusion, there is a body of evidence on the interplay between vitamin D and the drug-metabolizing enzyme CYP3A4, which may have therapeutic implications.
Subject(s)
Calcineurin Inhibitors/metabolism , Cytochrome P-450 CYP3A/metabolism , Organ Transplantation , Osteoporosis/metabolism , Vitamin D/analogs & derivatives , Vitamin D/metabolism , Animals , Bone Density , Calcineurin Inhibitors/administration & dosage , Drug Interactions , Humans , Vitamin D/administration & dosageABSTRACT
UNLABELLED: Pulmonary N-butyl-2-cyanoacrylate embolism is one of the potential risks associated with endoscopic obliteration of fundic gastric varices. Due to its uncommon nature, especially in children, no consensus has been proposed on its optimal management. CASE REPORT: An 11-year-old boy with a longstanding history of lung- and liver fibrosis with portal hypertension causing haematemesis underwent endoscopic therapy for fundic varices. Shortly after injection of 0.5 ml of a N-butyl-2-cyanoacrylate (Histoacryl) and lipid soluble ethiodized oil (Lipiodol) mixture, he desaturated with secondary hypotension and bradycardia. Pulmonary embolism was confirmed on chest X-ray. The boy was successfully treated conservatively. Clinical symptoms subsided and he was discharged after three days. Pulmonary infiltrations persisted for two weeks. CONCLUSION: Patients including children undergoing obliteration of gastric varices with Histoacryl and Lipiodol should be subjected to a close follow-up. Coexisting lung conditions may enhance the risk of pulmonary embolism and can also influence the outcome.
Subject(s)
Contrast Media/adverse effects , Enbucrilate/adverse effects , Esophageal and Gastric Varices/therapy , Iodized Oil/adverse effects , Pulmonary Embolism/etiology , Sclerotherapy , Child , Endoscopy , Gastric Fundus , Humans , Male , Pulmonary Embolism/diagnosis , Pulmonary Embolism/therapyABSTRACT
A method for rapid screening of isolates of pathogenic members of the family Enterobacteriaceae is described. Flow charts are used in conjunction with triple sugar iron agar, o-nitrophenyl-beta-D-galactopyranoside-phenylalanine-motility sulfate screening media, oxidase test, and six rapid biochemical tests, namely, lysine decarboxylase, urease, indole, esculin hydrolysis, malonate, and xylose. This scheme is used to provide an inexpensive but rapid presumptive identification of Salmonella, Shigella, Edwardsiella, Aeromonas, Plesiomonas, Vibrio, and Yersinia isolates from stool cultures.
Subject(s)
Enterobacteriaceae Infections/microbiology , Enterobacteriaceae/classification , Gastroenteritis/microbiology , Culture Media , Enterobacteriaceae Infections/diagnosis , Feces/microbiology , Humans , MicrochemistryABSTRACT
A rapid carbohydrate utilization procedure for the confirmation of Neisseria gonorrhoeae and identification of other Neisseria species has been developed. This method utilizes both preformed enzymes, introduced in a heavy inoculum, and enzymes formed by the microorganisms as a result of growth in a small volume of super-enriched medium. Expected carbohydrate reactions were produced by 383 clinical isolates of neisseriae and were clearly visible within 4 h of incubation. The combined use of disposable glass tubes (6 by 50 mm) and microamounts of media (0.05 ml) make this method not only rapid, but also low in cost.
Subject(s)
Bacteriological Techniques , Neisseria gonorrhoeae/isolation & purification , Carbohydrate Metabolism , Humans , Neisseria/metabolism , Neisseria gonorrhoeae/metabolism , Species SpecificityABSTRACT
A simple (2% oxgall) agar medium is described for the production of both germ tubes and chlamydospores by over 500 clinical isolates of Candida albicans. In comparison studies between the 2% oxgall agar and the more complex "cream of rice" infusion-oxgall-Tween 80 agar (RIOT), germ tubes were formed by 478 isolates in both media, by 9 isolates in only the oxgall medium and by 11 isolates in only the RIOT medium. Chlamydospores were formed by 481 isolates in both media, by 2 isolates in only the oxgall medium and by 9 isolates in only the RIOT medium. The data also show that both the germ tubes and chlamydospores were needed for the presumptive clinical identification of C. albicans.
