We have studied the modulation of circulating soluble interleukin-2 receptor (sIL-2R) levels by glucocorticoids in subjects with different states of immune activation. In contrast to normal subjects, 40 mg methylprednisolone administration over 6 days resulted in a significant fall of elevated circulating sIL-2R levels (p < 0.05) in patients with active atopic dermatitis, most pronounced in those patients showing the highest pre-treatment levels of sIL-2R and scores of disease activity. Following administration of 1 mg dexamethasone, sIL-2R levels remained unchanged both in normal subjects and patients with atopic dermatitis. Circulating sIL-2R levels were significantly decreased in patients with long-term hypercortisolism due to Cushing's disease (p < 0.05) and significantly elevated (p < 0.05) in hypocortisolemic patients. Blockade of adrenal cortisol secretion by 1.5 g metyrapone did not change sIL-2R levels in normal subjects and sIL-2R levels were not affected in depressive patients, either before or after clinical remission or following 1.5 g metyrapone administration. These data suggest that the effect of glucocorticoid administration on circulating sIL-2R levels depends on the state of immune activation and the duration of glucocorticoid exposure. The circulating sIL-2R levels show significant changes in patients with chronic alterations of endogenous glucocorticoid secretion and in response to prolonged glucocorticoid therapy in disorders with immune activation.

Addison Disease↗

PubMedDate not supplied

Taxines: a review of the mechanism and toxicity of yew (Taxus spp.) alkaloids.

This literature review summarizes relevant information and recent progress regarding the scientific investigations of taxine alkaloids. Taxines are the active, poisonous constituents in yew plants (Taxus spp.) and have been implicated in animal and human poisonings. Several taxine alkaloids have been isolated and characterized through the use of high performance liquid chromatography, mass spectroscopy, and nuclear magnetic resonance. Recently, as a result of electrophysiological investigations, significant progress has been made with regard to their pharmacological and toxicological mechanisms of action. Current investigations suggest that their chief action is on cardiac myocytes resulting in heart failure and death in instances of animal and human poisoning.

Alkaloids↗

PubMedDate not supplied

[Risk factors for the determination of transfusion requirements during implantation of hip endoprostheses].

AIM: We have carried out an observational study to determine the pre-operative risk factors for transfusion in patients undergoing implantation of a hip prosthesis. METHOD: 47 patients were recruited to the study. The following parameters were recorded: peri-operative transfusions, infusions, blood and secretion losses, re-transfusions and other operative variables. In addition, patient-specific data (age, body mass index, co-existing conditions, haemoglobin) were determined. The data were grouped by transfusions and re-transfusions and submitted to statistical analysis. RESULTS: The transfusion incidence in knee endoprosthesis implantation procedures was low at 25.5 %. Age above 74 years, ASA 3 and 4 were identified as significant risk factors for transfusion. If the significant risk groups identified in this study are left aside, a transfusion incidence of 5.6 % is found. CONCLUSION: For the implantation of an artificial hip joint, we recommend autologous blood donation only for patients with ASA 3. For other patients it is recommended that homologous banked blood (2 units of cross-matched concentrated red cells) be held in readiness.

Aged↗