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Biomedical subjects

A Toledano

Publications and source records attributed to A Toledano.

At least 19 recordsLinked to original sources
PubMed1997

Administration of H1 and H2 antagonists for chemoprophylaxis: a double-blind, placebo-controlled study in healthy volunteers.

A double-blind, placebo-controlled trial was performed to establish the duration of action of antihistamines and their ability to attenuate the adverse affects associated with histamine release. Thirty volunteers were assigned randomly to receive either placebo or a combination of the H1 blocker dimetindene maleate (0.1 mg/kg) and the H2 blocker cimetidine (5 mg/kg). A bolus dose of histamine (450 ng/kg) was given 15 minutes after antihistamine or placebo treatment and repeated after 2, 4, and 6 hours. Cardiovascular variables, plasma histamine levels, cutaneous manifestations, and objective and subjective signs and symptoms associated with histamine release were determined before and after each histamine injection. Although many of the signs of histamine release, including erythema and metallic taste, could be attenuated effectively for 6 hours with antihistamine treatment, the protection against histamine-induced flush and headache diminished after 2 hours. Statistically significant protection against histamine-mediated tachycardia persisted for only 2 hours. Antihistamine treatment significantly reduced the increase in plasma histamine levels after the first histamine injection but did not alter the levels after subsequent histamine injections. The currently recommended administration regimen for prophylaxis with antihistamines is insufficient to prevent histamine-mediated side effects, and additional doses may be required after 4 hours to achieve appropriate chemoprophylaxis.

Adult↗
PubMed1996

Methylnaltrexone prevents morphine-induced delay in oral-cecal transit time without affecting analgesia: a double-blind randomized placebo-controlled trial.

Methylnaltrexone is a quaternary opioid antagonist with limited ability to cross the blood-brain barrier and the potential to antagonize the peripherally mediated effects of opioids. The effectiveness of methylnaltrexone in preventing morphine-induced changes in gastrointestinal motility and transit without affecting analgesia was evaluated in humans. Twelve healthy volunteers were given intravenous placebo, placebo plus 0.05 mg/kg morphine, or 0.45 mg/kg methylnaltrexone plus 0.05 mg/kg morphine. Oral-cecal transit time was assessed by the pulmonary hydrogen measurement technique, and analgesia was measured with use of the cold-pressor test. Morphine significantly increased oral-cecal transit time from 104.6 +/- 31.1 minutes (mean +/- SD) to 163.3 +/- 39.8 minutes (p < 0.01). Methylnaltrexone prevented 97% of morphine-induced increase in oral-cecal transit time (106.3 +/- 39.8 minutes; not significant compared with baseline; p < 0.01 compared with morphine alone). Methylnaltrexone did not affect the analgesic effect of morphine on both pain intensity and pain bothersomeness ratings. At a higher dose of morphine (0.1 mg/kg), our preliminary results indicated that 0.45 mg/kg methylnaltrexone also prevented the morphine-induced delay in oral-cecal transit time, with no effect on analgesia. Methylnaltrexone may be a useful adjunct to opioids for the relief of opioid-induced constipation.

Adolescent↗
PubMed1996

Assessing myocardial perfusion with Albunex during coronary artery bypass surgery: technical considerations and safety of aortic root injections.

OBJECTIVE: To test the safety and report on limiting technical considerations, including optimal dosing of Albunex (Molecular Biosystems, Inc, Mallinckrodt Medical, St. Louis, MO) for myocardial opacification after intra-aortic root injections during cardiac surgery. DESIGN: This was a prospective randomized study with a control group who did not receive Albunex and a group who received intra-aortic root injections of Albunex. SETTING: Multicenter (two) independent university hospitals. PARTICIPANTS: 32 patients scheduled for elective coronary artery bypass surgery were evaluated after individual informed consent was obtained. INTERVENTIONS: 2 to 8 mL of Albunex were injected before and after coronary revascularization. MEASUREMENTS AND MAIN RESULTS: Quality of enhancement in each of four regions of the left ventricle was assessed from a short-axis mid-papillary ultrasound image by three experienced observers blinded to dose. Electrocardiogram (ECG), creatine phosphokinase (CPK) (MB fraction), and hemodynamics were evaluated at baseline and throughout the study period for up to 72 hours. No differences were noted between groups with respect to preoperative and postoperative CPK enzymes (CPK-MB fraction), ECG changes, hemodynamics, requirements for separation from CPB, need for postoperative inotropes, time to extubation, and time to discharge from the intensive care unit. The average total dose of Albunex injected was 19 mL +/- 4 (0.25 mL/kg). A single dose of 4.2 +/- 1.2 mL (0.05 mL/kg) appeared to offer optimal enhancement of contrast effect for myocardial perfusion assessment. CONCLUSION: Albunex is safe and easy to use for myocardial opacification when administered via an antegrade cardioplegia catheter into the aortic root during CPB.

Aged↗
PubMed1996

Aged murine T-lymphocytes are more resistant to oxidative damage due to the predominance of the cells possessing the memory phenotype.

Glutathione (GSH) is the most important cytosolic antioxidant. Since GSH levels are decreased with age, we hypothesized that T-lymphocytes from old mice would be more sensitive to oxidative stress. T-lymphocytes from young and old mice were exposed to hypoxanthine/xanthine oxidase, and lymphocyte viability, proliferation, GSH content, and calcium signaling were measured. Before exposure, proliferation of T-lymphocytes from young mice was greater than that of old; following exposure, the converse was true. This was in spite of the fact that old mice had lower total GSH levels and greater levels of glutathione disulfide. After oxidative challenge, intracellular calcium responses to anti-CD3 were decreased in naive T-lymphocytes from all mice, while memory lymphocytes were less affected. Higher proportions of memory lymphocytes in old mice resulted in their greater overall preservation of lymphocyte function following oxidative injury, contrary to expectations that lower lymphocyte GSH content with age would increase susceptibility to oxidative stress.

Aging↗
PubMed1996

Sedation of critically ill patients during mechanical ventilation. A comparison of propofol and midazolam.

Propofol (P) and midazolam (M) are frequently given by continuous infusion for sedation in critically ill, mechanically ventilated patients. We compared these drugs with regard to: (1) time-to-awaken; (2) reproducibility of bedside assessments of level of sedation; (3) time-to-sedation; and (4) change in oxygen consumption (V O2) from awake to sedated state. Seventy-three patients were prospectively randomized to receive either P (n=37) or M (n=36). Wake-up times after stopping the drug were assessed by blinded and unblinded observers, by asking patients to perform simple tasks. Times to sedate were assessed by consensus agreement among nurses and investigators. Demographics and APACHE II scores were not different between P and M. The P group had a significantly narrower range of wake-up times with a higher likelihood of waking in less than 60 min. Blinded versus unblinded observations had excellent correlation. Average time to sedate and decrease in V O2 were not different. We conclude that in this patient population: (1) both P and M achieved optimal sedation in a large fraction of patients when administered by specified dosing protocols; (2) P had a faster, more reliable, wake-up time; (3) assessments of time-to-awaken were objective and reproducible; (4) time to sedation was not significantly different; (5) V O2 decreased similarly with both.

APACHE↗
PubMed1996

Distribution of glyoxylate dehydrogenase activity in cortical and subcortical regions of the rat brain. A light microscopic histoenzymological study.

The distribution of the glyoxylate dehydrogenase (GLYO-DH) (Glyoxylate oxidoreductase) activity has been investigated in rat brain using the corresponding histochemical method. The results have demonstrated a positive histochemical reaction in neurons of several cortical and subcortical areas. These neurons are located in the same regions in which operate monoaminergic neurotransmitters. These facts suggest a possible interaction between glyoxylic acid and monoaminergic neurotransmission.

Aldehyde Oxidoreductases↗
PubMed1996

Radiation can inhibit tumor growth indirectly while depleting circulating leukocytes.

The growth of certain UV-radiation-induced tumors is suppressed by T lymphocytes, but it has been proposed that non-T lymphocytes stimulate the growth of several of these tumors. In this study, the indirect effects of X irradiation on the growth of one such tumor in T-cell-deficient nude mice was tested. Even when the site of tumor cell injection was shielded, whole-body irradiation with 6 Gy before tumor challenge inhibited subsequent tumor growth significantly. The interval during which this indirect inhibition was observed correlated with the depletion of circulating leukocytes, which did not return to normal levels until 12-21 days after irradiation. These data are consistent with earlier results using an antibody to deplete Gr-1+ leukocytes and indicate that radiation can inhibit the growth of certain tumors indirectly without direct effects on the tumor cells or the tumor bed.

Animals↗
PubMed1996

Neuronal and non-neuronal localization of acid sulfated glycosaminoglycans (sGAG) and chondroitin proteoglycans in the rat medulla oblongata.

Acid sulfated glycosaminoglycans (sGAG) and chondroitin proteoglycans have been biochemically and immunohistochemically demonstrated in certain cortical areas of the CNS. Such molecules display an important role in cerebral function, modulating cell adhesion, migration and signal neuromediation. In the present study we have evidenced the presence of sGAG using the colloidal iron method and C0S, C4S- and C6S-proteoglycans by the immunohistochemical pre-embedding PAP method. Our results have demonstrated the presence of such molecules in several structures of nervous (axon terminals, neuronal bodies, dendrites) and non-nervous nature (glial processes, capillaries). This fact led us to suggest that the chondroitin localizations advocate for their different functions. In their various localization exist distinct proteoglycans constituted by chondroitins with diverse concentrations and other attached radicals.

Animals↗
PubMed1996

Bowel resection and neurotensin treatment. Histochemical study of neurotensin-like and somatostatin-like immunoreactivities and receptors.

The influence of a bowel-trophic neurotensin (NT) treatment (13 days, 300 micrograms/kg/every 12 hrs.) on neurotensin-like immunopositive structures (neurons, fibres and epithelial-N-cells) and the neurotensin receptors (NTr) in the residual bowel after resection (90% small bowel or 75% colon) in the rat was studied using histochemical methods. Somatostatin-like (ST) immunopositive structures (neurons, fibres and epithelial-D-cells) and somatostatin receptors (STr) were also studied, comparatively. The results displayed a general increase of N-cells (11-17%) but not of D-cells, and a higher degree of variability section-to-section in the NT and ST immunopositive nervous structures (without increased density) after both resections, both with or without NT treatment. Receptors did not change after the small bowel resection but the colon resection and/or the NT treatment produced variations in the NT binding (from -24.3 to +16.85) in different intestinal regions. In a general sense, the variations among 1) the controls, 2) the resected animals, and 3) the resected and NT-treated animals, were of less extent (< or = 24%) than previously supposed for explaining the trophic effect of NT. Our results: a) confirm the autonomy, injury-resistance and tendency to maintain the physiological features of the bowel in very diverse situations; b) open new questions on both, the neurotensinergic changes after bowel resection and the mechanisms of the trophic effect of NT treatment, and c) suggest that, when neurotensin was applied as a trophic treatment in the cases of the need of a bowel resection, no important neurotensinergic or somatostatinergic side effects should be expected in the remaining bowel. However, the higher degree of variability section-to-section after surgery in the nervous structures was not modified by the NT treatment. This fact, and the different response of various intestinal regions to the NT treatment, suggest that functional problems in the remaining bowel could be maintained despite the growth of the mucosa induced by the NT treatment.

Animals↗
PubMed1995

Spatial and temporal control of gene therapy using ionizing radiation.

Activation of transcription of the Egr-1 gene by X-rays is regulated by the promoter region of this gene. We linked the radiation-inducible promoter region of the Egr-1 gene to the gene encoding the radiosensitizing and tumoricidal cytokine, tumour necrosis factor-alpha (TNF-alpha) and used a replication-deficient adenovirus to deliver the Egr-TNF construct to human tumours growing in nude mice. Combined treatment with Ad5.Egr-TNF and 5,000 cGy (rad) resulted in increased intratumoral TNF-alpha production and increased tumour control compared with treatment with Ad5.Egr-TNF alone or with radiation alone. The increase in tumour control was achieved without an increase in normal tissue damage when compared to tissue injury from radiation alone. Control of gene transcription by ionizing radiation in vivo represents a novel method of spatial and temporal regulation of gene-based medical treatments.

Animals↗
PubMed1994

Pyritinol facilitates the recovery of cortical cholinergic deficits caused by nucleus basalis lesions.

The effect of a nootropic, Pyritinol, on the recovery of cortical cholinergic deficits induced by injury of the nucleus basalis has been tested on two groups of unilateral quisqualic acid nbM-lesioned rats. The first group had a 30 nmol lesion producing a cortical cholinergic impairment at 21 days, with a spontaneous recovery at 45 days. The second group had a 50 nmol lesion that produced a deeper cholinergic deficit, which did not recover at 45 days. Pyritinol enhanced the recovery in the 30 nmol group of animals on the 21st day after surgery. The recovery was measured as an increase in the activities of acetylcholinesterase (AChE), choline acetyltransferase (ChAT) and the high affinity choline uptake system, and the histochemical densities of the cortical AChE network and the M2 receptor. Histochemical analysis of the nbM enabled cortical recovery to be related to the number of surviving neurons and also to their hypertrophy and AChE-ChAT hyperactivity. Pyritinol enhanced recovery in 30 nmol lesioned animals but in the other group, with a lower number of surviving neurons and a lower ability of the cells to become hypertrophic, the drug was unable to promote cortical recovery.

Animals↗
PubMed1994

Pulmonary carcinoma metastatic to the larynx.

Metastases to the larynx from distant primaries are rare. We report a case of a pulmonary epidermoid carcinoma metastatic to the larynx that simulated a primary cancer. A review of the literature showed nine previously reported cases of pulmonary metastases to the larynx--only two of them were epidermoid carcinomas. Treatment of a secondary lesion in the larynx is justified only when other organs have not been affected. The diagnostic and therapeutic considerations of this condition are discussed.

Carcinoma, Squamous Cell↗
PubMed1994

Volatile anesthetics decrease peristalsis in the guinea pig ureter.

BACKGROUND: The origin of renal dysfunction associated with anesthesia and surgery is complex and incompletely understood. The effects of the volatile anesthetic agents isoflurane, enflurane, and halothane on the renal pacemaker and ureteral peristalsis may play an important role. METHODS: Guinea pig ureter and pelvis were dissected and placed in a sample chamber that allowed immersion in a temperature-controlled bath with gas (O2 with or without volatile agent) bubbled through the chamber continuously. The baseline frequency and amplitude of peristaltic contractions were measured on a polygraph recorder. The preparations were then exposed to up to 4 vol% volatile agent incrementally to generate a cumulative dose-response curve, and the subsequent frequency of peristaltic contractions was determined. The concentration of the volatile agent in solution was measured by gas chromatography. RESULTS: There was a significant dose-related decrease in the frequency of ureteral contractions for all three agents. A statistical model relating percentage baseline frequency to millimolar concentrations of volatile anesthetics showed that halothane produced a more pronounced decrease in frequency than did isoflurane or enflurane. However, the decrease was directly related to the MAC multiples and did not differ for the three agents. CONCLUSIONS: Ureteral peristaltic contractions are decreased in a dose-dependent manner by enflurane, halothane and isoflurane.

Animals↗
PubMed1992

Morphometric and neurosecretory changes in supraoptic neurons after D-amphetamine treatment.

Several morphological and immunochemical characteristics of the neurosecretory neurons of the supraoptic nucleus (SON) have been studied of rats treated for 1 month with D-amphetamine sulfate (AMP) (8 mg/kg weight, daily). An increase of SON volume (11%) has been observed as a consequence of the growth of the dorsoventral axis. Neurosecretory neurons increased their nucleolar area (11.4%), their nuclear area (8.3%), and their cytoplasmatic area (18.3%). Vasopressin immunoreaction did not show any differences between treated and control animals, but oxytocin immunostaining displayed an important increase (23.7%) in the neuronal cytoplasm of the treated rats. The SON hypertrophy of the AMP-treated rats corresponded to the hypertrophy/hyperfunction of its oxytocinergic neurons, and could be considered as a new mechanism of the action of the AMP. The results are discussed in relation to the plastic features of the SON and its central (neuronal) and peripheral (hormonal) function.

Animals↗