An ophthalmological complication: central serous chorioretinopathy in a renal transplant recipient.

BACKGROUND AND OBJECTIVE: Ophthalmological complications in transplanted recipients often due to underlying disorders or drug use consist of anterior segment and posterior segment complications. Among the posterior complications, Central serous chorioretinopathy (CSCR) is related to high-dose steroids, stress, or cyclosporine and usually has a good outcome. The aim of this study was to report a case of CSCR as an ophthalmologic complication of renal transplantation. CASE REPORT: A 36-year-old man hospitalized for the treatment of rejection suffered severe visual loss in both eyes. After examination and fluoresein angiography, we diagnosed CSCR due to high-dose steroid therapy for rejection. With tapering of the drug and after about 3 months, visual acuity became normal. CONCLUSION: Visual acuity changes must be followed up carefully in all transplant recipients, but CSCR usually has a good prognosis. If it does not improve, retinal laser therapy is needed.

Effect of orange and tangerine juice on cyclosporine levels in renal transplant recipients.

INTRODUCTION: Cyclosporine Neoral is a major immunosuppressive agent widely used in organ transplant populations. Its pharmacokinetics are influenced by various factors. The aim of this study was to investigate the effects of orange or tangerine juice on the pharmacokinetic pattern of cyclosporine Neoral among renal transplanted patients. MATERIALS AND METHODS: Ten renal transplant recipients on cyclosporine Neoral-based immunosuppressive therapy were included in this crossover controlled study. Patients were given their individualized morning dose of cyclosporine with either 250 mL water or 250 mL orange or tangerine juice; 12-hour cyclosporine pharmacokinetic investigations were performed. The three investigation days were separated by at least 7 days. RESULTS: The intake of orange juice did not have any significant influence on the area under the curve in the interval from 0 to 12 hours (AUC 0-12; 95% confidence interval [CI]: -769 to 734, P=.77), or the maximum whole blood concentration (Cmax; 95% CI: 264 to 74; P=.32). Similarly, after coadministration of cyclosporine Neoral with tangerine juice, no significant changes were observed in AUC 0-12 (95% CI: -453 to 1166; P=.28) or Cmax (95% CI: -239 to 179; P=.37). CONCLUSION: Coadministration of orange (var Tampson) or tangerine (var Unshiu) juice with cyclosporine compared with water did not influence exposure to cyclosporine in renal transplant recipients.

An assessment of air toxics in Minnesota.

We used monitoring and modeling to assess the concentrations of air toxics in the state of Minnesota. Model-predicted concentrations for 148 hazardous air pollutants were from the U.S. Environmental Protection Agency Cumulative Exposure Project (1990 data). Monitoring data consisted of samples of volatile organic compounds, carbonyls, and particulate matter [Less than and equal to] 10 microm in aerodynamic diameter collected at 25 sites throughout the state for varying periods of time (up to 8 years; 1991-1998). Ten pollutants exceeded health benchmark values at one or more sites by modeling, monitoring, or both (including acrolein, arsenic, benzene, 1,3-butadiene, carbon tetrachloride, chromium, chloroform, ethylene dibromide, formaldehyde, and nickel). Polycyclic organic matter also exceeded the benzo[a]pyrene health benchmark value assumed to represent this class of pollutants. The highest modeled and monitored concentrations of most pollutants were near the center of the Minneapolis-St. Paul metropolitan area; however, many smaller cities throughout the state also had elevated concentrations. Where direct comparisons were possible, monitored values often tended to exceed model estimates. Upper-bound excess lifetime inhalation cancer risks were estimated to range from 2.7 [times] 10(-5) to 140. 9 [times] 10(-5) (modeling) and 4.7 [times] 10(-5) to 11.0 [times] 10(-5) (using a smaller set of monitored carcinogens). Screening noncancer hazard indices summed over all end points ranged from 0.2 to 58.1 (modeling) and 0.6 to 2.0 (with a smaller set of monitored pollutants). For common sets of pollutants, the concentrations, cancer risks, and noncancer hazard indices were comparable between model-based estimates and monitored values. The inhalation cancer risk was apportioned to mobile sources (54%), area sources (22%), point sources (12%), and background (12%). This study provides evidence that air toxics are a public health concern in Minnesota.