8-month Therapy Research Articles

Safe administration of S-1 after 5-fluorouracil-induced cardiotoxicity in a patient with colorectal cancer

Cardiotoxicity is a rare but challenging complication of 5-fluorouracil (5-FU) therapy. Compared with 5-FU, after application of S-1 lower plasma levels of the cardiotoxic metabolite alpha-fluoro-beta-alanine have been reported. Evidence...

Effect of rosuvastatin on the progress of arteriosclerosis and cardiac function in patients with essential hypertension

Objective To explore the effect of rosuvastatin on the progress of arteriosclerosis and cardiac function in patients with essential hypertension. Methods 178 clinic patients were randomly as signed to receive rosuvastatin (Astrazeneca) of 10 mg daily (91 patients, rosuvastatin group), or fluvastatin (Lescol) of 40 mg dialy (87 patients, fluvastatin group) for 8 months. Ultrasonography and cardiac function examinatin were performed and serum levels of matrix metalloproteinase (MMPs) and TNF-α, were detected before and after treatment. Results The baseline findings were similar in the two groups. After 8-month therapy, serum levels of total cholesterol, LDL, TNF-α, MMPs-2, and MMPs-9 were decreased and the intima media thickness of the common carotid artery and the plaque size in the coronary artery were declined in both groups, especially in rosuvastatin group (P<0.01 for all comparisons). LVPFR increased markedly in rosuvastatin group. LVEF and LVPFR were higher in rosuvastatin group than in fluvastatin group. Conclu sions Rosuvastatin therapy can relieve plaque formation and improve left ventricular function in patients with hyertension, whose mechanism may be involved in the decrease in serum levels of TNF-α, and MMPs. Key words: Hypertension; Arteriosclerosis; Cardiac function; Rosuvastatin; Fluvastatin

Angioödeme bei familiärem Mangel von Komplement-Faktor-1-Esterase-Inhibitor und α1-Antitrypsin

A 15-year-old girl had suffered from episodic, sometimes threatening angioedema of the face, nasopharyngeal space and distal extremities beginning at age 13. A C1-esterase inhibitor (C1-INH) deficiency was revealed protein-chemically and functionally. There was also an alpha (1)-antitrypsin (AAT) deficiency with heterocygotic phenotype PiMZ. The combination of C1-INH and AAT deficiency was also found in the patient's mother and brother. Under 8-month therapy with 200 mg/d danazol per os (reduction of the dosis in the last month to 100 mg/d), there was no further edema, the C1-INH concentration normalized and there was also an increase in C1-INH function. During the observation period, use of the emergency set with C1-INH concentrate was not required. This is the first reported case of angioedema in combination of two hereditary enzyme defects C1-INH deficiency (autosomal-dominant genetics) and AAT deficiency (autosomal-recessive). In addition to a survey of current literature, the current state of diagnostics and therapy of the hereditary angioedema is presented.

Control of tuberculosis by community health workers in Bangladesh

Tuberculosis remains a major public-health problem in Bangladesh, despite national efforts to improve case identification and treatment compliance. In 1984, BRAC (formerly the Bangladesh Rural Advancement Committee), a national, non-governmental organisation, began an experimental tuberculosis-control programme in one thana (subdistrict). Community health workers screened villagers for chronic cough and collected sputum samples for acid-fast bacillus (AFB) microscopy (phase one). Positive patients received 12 months of directly observed therapy. Phase two (1992-94) included another nine thanas and, in phase three (1995), eight more thanas were included. From 1995, the treatment was an 8-month oral regimen. In 1995-96, we analysed all programme data from 1992 to 1995. First we analysed phases two (12-month therapy) and three (8-month therapy) separately for proportion cured, died, treatment, failed, defaulted, migrated, and referred. Second, we did a cross-sectional survey of tuberculosis cases in more than 9000 randomly selected households in two phase-two thanas and one non-programme thana, and analysed the follow-up of all patients treated in the programme thanas. In the phase-two analysis, 3497 (90%) of 3886 cases identified had accepted 12-month treatment. In phase three, all of 1741 identified cases accepted the 8-month regimen. 2833 (81.0%) and 1496 (85.9%) in phases two and three, respectively, were cured; 336 (9.6%) and 133 (7.6%) died. The relapse rate 2 or more years after treatment was discontinued was higher than the early relapse rate. The drop-out rate was 3.1%. In the cross-sectional survey, the prevalence of tuberculosis in the two programme thanas was half of that in the comparison thana, where only government services were available (0.07 vs 0.15 per 100 [corrected]). The BRAC tuberculosis-control programme has successfully achieved high rates of case detection and treatment compliance, with a cure rate of at least 85% and a drop-out rate of 3.1%. The prevalence survey suggested that at least half of all existing cases had been detected by the programme.