Compatibility of nebulizer solution admixtures.
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Adrenergic beta-Agonists↗
Biomedical subjects
J C Joseph
Publications and source records attributed to J C Joseph.
Corticosteroid-induced osteoporosis.
The pathogenesis, prevention, and treatment of corticosteroid-induced osteoporosis are reviewed. Prolonged administration of corticosteroids causes osteoporosis, resulting in significant morbidity and mortality. Cumulative corticosteroid doses greater than 10 g, age greater than 50 years, and pre-existing low bone mass are risk factors for corticosteroid-induced osteoporosis. Long-term, prospective, controlled studies on prevention and treatment of corticosteroid-induced osteoporosis are limited. Measures for preventing corticosteroid-induced osteoporosis include correcting modifiable risk factors and using the lowest effective oral or inhaled corticosteroid dose for the shortest period of time. Routine use of fluoride, anabolic steroids, vitamin D, thiazide diuretics, injected calcitonin, or calcium supplements alone is not recommended. Intranasal calcitonin and pamidronate are possibilities for future treatment of corticosteroid-induced osteoporosis. Estrogen replacement therapy should be considered in postmenopausal women receiving corticosteroids. Deflazacort, a new synthetic corticosteroid, may provide a promising alternative to existing systemic corticosteroid therapy. More long-term, controlled, prospective trials are needed to determine the effectiveness of treatments for corticosteroid-induced osteoporosis and to develop improved methods for monitoring response to therapy.
Adrenal Cortex Hormones↗
Management of hypertension in the diabetic patient.
Therapeutic considerations regarding the treatment of hypertension in patients with diabetes mellitus are reviewed. Good blood pressure control is essential in diabetic patients to prevent morbidity and mortality associated with cardiovascular diseases. Hypertension may also accelerate complications of diabetic microvascular disease, nephropathy, and retinopathy. Diuretics (e.g., thiazides, furosemide, ethacrynic acid, bumetanide) and beta blockers have traditionally been used as initial therapy for most patients with hypertension; however, these agents may not be the best choice for diabetics. Adverse metabolic consequences include alteration of glucose metabolism and plasma lipids. Beta blockers may also blunt the ability of patients to recognize symptoms of hypoglycemia. Both diuretics and beta blockers can cause sexual dysfunction in men. Adrenergic agents and vasodilators are associated with a high prevalence of orthostatic hypotension in diabetic patients. The calcium-channel blockers are considered safe and well tolerated when given at low and moderate doses. The angiotensin-converting-enzyme (ACE) inhibitors are able to slow the progression of diabetic nephropathy by reducing the glomerular hypertension that causes it. For the treatment of mild hypertension in diabetic patients, the drugs of choice should include (in descending order) ACE inhibitors, calcium-channel blockers, diuretics, and beta blockers. Severe or resistant hypertension usually requires treatment with combinations of drugs, including a diuretic. Tailoring therapy to individual complications and close monitoring of the patient are essential for safe, effective treatment of hypertension in the diabetic patient.
Antihypertensive Agents↗
Moisture loss from small-volume polyvinyl chloride containers removed from overwraps.
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Drug Packaging↗
2-Aminoethylphosphonic acid metabolism in the rat.
Time course studies of the incorporation of radioactive 2-aminoethylphosphonic acid (AEP) into the tissues of rats demonstrated that maximum incorporation into the liver lipids occurred within 12 to 30 hr after injection, compared to 2 to 3 hr for the incorporation of phosphorylethanolamine. Little incorporation of AEP was observed in the other tissues investigated (heart, lung, spleen, adipose, kidney). The AEP was incorporated to the greatest extent into 1,2-diacylglyceryl-aminoethylphosphonate (diacylglyceryl-AEP), the phosphonate analogue of phosphatidylethanolamine, with some incorporation into the lyso derivative. Diacylglycerol-AEP apparently was not further metabolized by the rat; no methylation of diacylglyceryl-AEP to phosphonolecithin was observed. Subcellular fractionation was performed on the livers of rats who received (3)H-AEP 12,30,36, and 48 hr prior to sacrifice. The greatest amount of radioactivity was recovered in the soluble fractions. Lipid extraction was performed on the subcellular fractions, and most of the radioactivity present in the lipids was found in the microsomal fraction, with the next highest recovery in the mitochondrial and nuclear fractions
Aminoethylphosphonic Acid↗
[Apropos of 2 further cases of pigmentary glaucoma].
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Adult↗
Comparison of protein values in cerebrospinal fluid by nephelometry and radial immunodiffusion.
Various parameters of three radial immunodiffusion systems, a kinetic nephelometer and two laser nephelometers were compared in a measurement of IgG and albumin in cerebrospinal fluid. Greater precision for IgG and albumin determinations was found with two RID systems. Correlation coefficients between methods ranged from 0.71 to 0.94. The generally poor correlations of methods, combined with the results of accuracy studies employing WHO standard reference dilutions and proportional errors demonstrated by linear regression equations, illustrate graphically the need for standardization in the field of immunochemical determinations. Our preliminary studies of the IgG/Alb ratio in cerebrospinal fluid of multiple sclerosis patients agreed with the work of others. In each case, the ratio was elevated or borderline high.
Albumins↗
[Pathologic cataract and Dupuytren's disease].
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Cataract↗
Changes in plasma proteins during pregnancy.
Changes in maternal plasma proteins during pregnancy are now well documented. These changes may be quantitative, as seen in the electrophoretically separated fractions of serum and in the various binding globulins; or they may be represented by the appearance of a protein which is present only in the serum of pregnant women. These include the placental isoenzyme of alkaline phosphatase, oxytocinase, human chorionic gonadotropin and the "pregnancy-associated plasma proteins." Other constituents, such as alpha-fetoprotein, salivary amylase, prolactin and the proteins of the "pregnancy zone," which are present in small quantities in non-pregnant women as well as in men, show a substantial increase in concentration in the maternal circulation during pregnancy. An important factor in the etiology of protein changes is the effect of hormones, especially estrogen, on the synthesis and degradation of these proteins. While certain quantitative changes such as those seen in hormone binding proteins may interfere with diagnostic procedures, a number of pregnancy-associated changes in protein composition of the maternal circulation may be used to follow the course of pregnancy by monitoring placental function as well as fetal maturity and well being.
Blood Proteins↗