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- The effect of sodium nitrite infusion on renal function, brachial and central blood pressure during enzyme inhibition by allopurinol, enalapril or acetazolamide in healthy subjects: a randomized, double-blinded, placebo-controlled, crossover study. [Journal Article]
- BNBMC Nephrol 2018 Sep 21; 19(1):244
- CONCLUSIONS: This study showed a robust BP lowering, natriuretic and anti-aquaretic effect of intravenous NaNO2 regardless of preceding enzyme inhibition. None of the three enzyme inhibitors used convincingly modified the pharmacological effects of NaNO2. The steady cGMP indicates little or no conversion of nitrite to NO. Thus the effect of NaNO2 may not be mediated by NO generation.
- Effect of hyperbaric oxygen treatment in central retinal artery occlusion. [Journal Article]
- UHUndersea Hyperb Med 2018 Jul-Aug; 45(4):421-425
- CONCLUSIONS: HBO2 treatment is an efficacious method with few side effects and can be used in the treatment of CRAO patients. During acute and subacute periods a certain number of HBO2 treatment sessions may be beneficial. Stopping treatments before eight completed HBO2 sessions for a patient who did not show improvement until that time may miss a patient who would have benefited from HBO2 treatment.
- Possible Role of Glymphatic System of the Brain in the Pathogenesis of High-Altitude Cerebral Edema. [Journal Article]
- HAHigh Alt Med Biol 2018 Sep 21
- Simka, Marian, Paweł Latacz, and Joanna Czaja. Possible role of glymphatic system of the brain in the pathogenesis of high-altitude cerebral edema. High Alt Med Biol 00:000-000, 2018.-In this article...
Simka, Marian, Paweł Latacz, and Joanna Czaja. Possible role of glymphatic system of the brain in the pathogenesis of high-altitude cerebral edema. High Alt Med Biol 00:000-000, 2018.-In this article, we suggest that the glymphatic system of the brain can play an important role in the pathogenesis of high-altitude cerebral edema (HACE). Water enters the intercellular space of the brain primarily through aquaporin-4 (AQP-4) water channels, the main component of the glymphatic system, whereas acetazolamide, pharmacological agent used in the prevention of HACE, is the blocker of the AQP-4 molecule. In animal experiments, cerebral edema caused by hypobaric hypoxia was associated with an increased expression of AQP-4 by astrocytes. Also, the glymphatic system is primarily active during sleep, although sleep at high altitude is a well-known risk factor of developing HACE. All these findings support our hypothesis. We suggest that future research on the prevention and treatment of HACE should involve factors that are already known to modify activity of the glymphatic system, such as angiotensin-converting enzyme inhibitors or other pharmaceutical agents affecting noradrenergic system of the brain, body posture during sleep, anatomy of the veins draining the cranial cavity, and the influence of physical activity before and during exposure to high altitude, especially in relation to sleep.
- Rationale and design of the ADVOR (Acetazolamide in Decompensated Heart Failure with Volume Overload) trial. [Journal Article]
- EJEur J Heart Fail 2018 Sep 21
- CONCLUSIONS: ADVOR will investigate if acetazolamide combined with loop diuretic therapy improves decongestion in AHF with volume overload.
- Attenuation of human hypoxic pulmonary vasoconstriction by acetazolamide and methazolamide. [Journal Article]
- JAJ Appl Physiol (1985) 2018 09 20
- CONCLUSIONS: Although acetazolamide only had plasma antioxidant properties, methazolamide led to similar improvements in oxygenation and reduction in HPV at a dose causing less metabolic acidosis than acetazolamide in humans.
- Acetazolamide Mitigates Intracranial Pressure Spikes Without Affecting Functional Outcome After Experimental Hemorrhagic Stroke. [Journal Article]
- TSTransl Stroke Res 2018 Sep 17
- Increased intracranial pressure (ICP) after stroke can lead to poor outcome and death. Novel treatments to combat ICP rises are needed. The carbonic anhydrase inhibitor acetazolamide diminishes cereb...
Increased intracranial pressure (ICP) after stroke can lead to poor outcome and death. Novel treatments to combat ICP rises are needed. The carbonic anhydrase inhibitor acetazolamide diminishes cerebrospinal fluid (CSF) production, reduces ICP in healthy animals, and is beneficial for idiopathic intracranial hypertension patients. We tested whether acetazolamide mitigates ICP elevations by presumably decreasing CSF volume after collagenase-induced striatal hemorrhage in rats. We confirmed that acetazolamide did not adversely affect hematoma formation in this model or physiological variables, such as temperature. Then, we assessed the effects of acetazolamide on ICP. Lastly, we tested the effects of acetazolamide on behavioral and histological outcome. Acetazolamide reduced the magnitude and occurrence of short-timescale ICP spikes, assessed as disproportionate increases in ICP (sudden ICP increases > 10 mmHg), 1-min peak ICP, and the magnitude of spikes > 20 mmHg. However, mean ICP was unaffected. In addition, acetazolamide reduced ICP variability, reflecting improved intracranial compliance. Compliance measures were strongly correlated with high peak and mean ICP, whereas ipsilateral hemisphere water content was not correlated with ICP. Despite effects on ICP, acetazolamide did not improve behavioral function or affect lesion size. In summary, we show that intracerebral hemorrhage creates an impaired compliance state within the cranial space that can result in large, transient ICP spikes. Acetazolamide ameliorates intracranial compliance and mitigates ICP spikes, but does not improve functional outcome, at least for moderate-severity ICH in rats.
- Optical Coherence Tomography Angiography Findings in X-Linked Retinoschisis. [Journal Article]
- OSOphthalmic Surg Lasers Imaging Retina 2018 Sep 01; 49(9):e20-e31
- CONCLUSIONS: OCTA shows reduced macular deep vessel density in patients with XLRS probably related to vessel displacement and disruption due to schitic cysts. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e20-e31.].
- Bacterial distribution, changes of drug susceptibility and clinical characteristics in patients with diabetic foot infection. [Journal Article]
- ETExp Ther Med 2018; 16(4):3094-3098
- The present study aimed to investigate the bacterial distribution, changes in drug susceptibility and clinical characteristics in patients with diabetic foot infection (DFI). A retrospective analysis...
The present study aimed to investigate the bacterial distribution, changes in drug susceptibility and clinical characteristics in patients with diabetic foot infection (DFI). A retrospective analysis of 216 patients with DFI treated at Xinxiang Central Hospital between 2013 and 2016 was carried out to analyze the bacterial distribution, changes of susceptibility and clinical characteristics. A total of 262 pathogenic strains were isolated from 216 patients with DFI. Among them, 43.13% exhibited Gram-positive (G+) bacteria, 45.04% exhibited Gram-negative (G-) bacteria and 11.83% was other. Between 2013 and 2016, the susceptibility of pathogenic bacteria to common antibacterial drugs showed a declining trend year by year. G+ bacteria had high susceptibility to vancomycin and acetazolamide; while G- bacteria showed high susceptibility to dibekacin, panipenem and biapenem. The main clinical symptoms of the 216 patients included edema (98.61%), purulent secretions (62.96%) and lower extremity sepsis (58.80%). The top three complications of the 216 cases were lower extremity vascular disease (58.80%), peripheral neuropathy (39.81%) and kidney disease (26.39%). Logistic regression analysis showed that age [odds ratio (OR), 2.708; P=0.005], previous use of antibacterial drugs (OR, 3.816; P=0.007) and application of the third generation cephalosporins (OR, 3.014; P=0.008) were the independent risk factors of drug resistance in patients with DFI (P<0.05). There were numerous types of pathogens in patients with DFI, and all of them had certain drug resistance. The drug susceptibility was decreasing year by year. The pathogens and drug resistance in patients with DFI should be monitored to reduce the incidence of related complications and improve the prognosis of patients.
- Sudden hearing loss after cialis (tadalafil) use: A unique case of cochlear hydrops. [Journal Article]
- LLaryngoscope 2018 Sep 12
- We discuss a unique case of sudden sensorineural hearing loss after Cialis (tadalafil) use, a phosphodiesterase 5 (PDE5) inhibitor, and the implication of ipsilateral cochlear hydrops seen on magneti...
We discuss a unique case of sudden sensorineural hearing loss after Cialis (tadalafil) use, a phosphodiesterase 5 (PDE5) inhibitor, and the implication of ipsilateral cochlear hydrops seen on magnetic resonance imaging (MRI). We report a case of a 53-year-old male with unilateral low-frequency sudden sensorineural hearing loss (SSNHL) after ingestion of tadalafil. The SSNHL occurred 1 day after ingestion and was associated with aural fullness and tinnitus. There were no symptoms of vertigo. He received oral prednisone immediately after the onset of hearing loss without improvement. Delayed intravenous contrast-enhanced three-dimensional Fluid-attenuated inversion recovery MRI revealed ipsilateral dilation of the cochlear duct without any hydronic change in the vestibular system. Acetazolamide therapy was initiated, and his symptoms improved. A posttreatment audiogram revealed an increase in threshold of 15 dB. To the best of our knowledge, this is the first case of cochlear hydrops visualized on imaging after a PDE5 inhibitor induced SSNHL. Tadalafil and other PDE5 inhibitors have a known association with SSNHL. Despite several proposed mechanisms, there is inconclusive evidence of a causal relationship. Our presented case suggests that cochlear hydrops may be one possible mechanism of PDE5 inhibitor-associated SSNHL. MRI should be considered in the evaluation of such patients who do not respond to oral steroids as initial treatment. Laryngoscope, 2018.
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- Phase contrast mapping MRI measurements of global cerebral blood flow across different perfusion states - A direct comparison with 15O-H2O positron emission tomography using a hybrid PET/MR system. [Journal Article]
- JCJ Cereb Blood Flow Metab 2018 Sep 11; :271678X18798762
- Phase-contrast mapping (PCM) magnetic resonance imaging (MRI) provides easy-access non-invasive quantification of global cerebral blood flow (gCBF) but its accuracy in altered perfusion states is not...
Phase-contrast mapping (PCM) magnetic resonance imaging (MRI) provides easy-access non-invasive quantification of global cerebral blood flow (gCBF) but its accuracy in altered perfusion states is not established. We aimed to compare paired PCM MRI and 15O-H2O positron emission tomography (PET) measurements of gCBF in different perfusion states in a single scanning session. Duplicate combined gCBF PCM-MRI and 15O-H2O PET measurements were performed in the resting condition, during hyperventilation and after acetazolamide administration (post-ACZ) using a 3T hybrid PET/MR system. A total of 62 paired gCBF measurements were acquired in 14 healthy young male volunteers. Average gCBF in resting state measured by PCM-MRI and 15O-H2O PET were 58.5 ± 10.7 and 38.6 ± 5.7 mL/100 g/min, respectively, during hyperventilation 33 ± 8.6 and 24.7 ± 5.8 mL/100 g/min, respectively, and post-ACZ 89.6 ± 27.1 and 57.3 ± 9.6 mL/100 g/min, respectively. On average, gCBF measured by PCM-MRI was 49% higher compared to 15O-H2O PET. A strong correlation between the two methods across all states was observed (R2 = 0.72, p < 0.001). Bland-Altman analysis suggested a perfusion dependent relative bias resulting in higher relative difference at higher CBF values. In conclusion, measurements of gCBF by PCM-MRI in healthy volunteers show a strong correlation with 15O-H2O PET, but are associated with a large and non-linear perfusion-dependent difference.