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Aripiprazole-Induced Enuresis in a Child with Autistic Disorder Case Report
Hasan Bozkurt,Osman Abal?
N?ropsikiyatri Ar?ivi , 2011,
Abstract: Aripiprazole is being increasingly reported to be effective in treating behavioral problems of children with autism. It has fewer side effects with respect to other atypical antipsychotics. However, to our knowledge, in the literature, there is no report on aripiprazole-induced enuresis in children and adolescents diagnosed with autism, although enuresis has been a very rare adverse event observed during the premarketing evaluation of oral aripiprazole. Here, we present a sixteen-year-old boy with diagnosis of autism and epilepsy who developed enuresis after starting aripiprazole and had rapid remission after the discontinuation of the drug. (Archives of Neuropsychiatry 2011; 48: 164-6)
Effect of Aripiprazole on Methamphetamine-Induced Disruption of Latent Inhibition in Rats  [PDF]
Hisae Matsuo, Hiroshi Abe, Tetsuya Ikeda, Kosuke Ebihara, Ryuichiro Takeda, Toshikazu Nishimori, Yasushi Ishida
Journal of Behavioral and Brain Science (JBBS) , 2011, DOI: 10.4236/jbbs.2011.13022
Abstract: Objectives: To elucidate the pharmacological profile of aripiprazole, we examined its ameliorating effect on the methamphetamine-induced disruption of latent inhibition (LI) in rats. Method: The effect was measured using a conditioned emotional response procedure. The conditioned stimulus was a tone (2.8 kHz, 90 dB), and the unconditioned stimulus was a mild foot shock delivered through a floor grid. The conditioning procedure was repeated five times. Results: Methamphetamine-induced (1.0 mg/kg, i.p.) disruption of LI was ameliorated by the administration of haloperidol (0.2 mg/kg, i.p.) and by a moderate dose of aripiprazole (0.3 mg/kg, i.p.) but not by a lower or higher dose (0.1 or 3.0 mg/kg, i.p.) of aripiprazole. However, immunohistochemical examination showed increased levels of c-Fos expression in the shell of the nucleus accumbens after the administration of haloperidol (0.2 mg/kg, i.p.) but not of aripiprazole (0.3 mg/kg, i.p.). Conclusions: It is suggested that aripiprazole has an ameliorating effect on methamphetamine-induced disruption of latent inhibition within only a marginal therapeutic window.
Adjunctive Aripiprazole Versus Placebo for Antipsychotic-Induced Hyperprolactinemia: Meta-Analysis of Randomized Controlled Trials  [PDF]
Xianbin Li, Yilang Tang, Chuanyue Wang
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0070179
Abstract: Objective To compare the safety and efficacy of adjunctive aripiprazole versus placebo for antipsychotic-induced hyperprolactinemia. Methods Population: adult patients presenting with antipsychotic-induced hyperprolactinemia diagnosed by prolactin level with or without prolactin-related symptoms. Interventions: adjunctive aripiprazole vs. adjunctive placebo. Outcome measures: adverse events and efficacy of treatment. Studies: randomized controlled trials. Results Five randomized controlled trials with a total of 639 patients (326 adjunctive aripiprazole, 313 adjunctive placebo) met the inclusion criteria. Adjunctive aripiprazole was associated with a 79.11% (125/158) prolactin level normalization rate. Meta-analysis of insomnia, headache, sedation, psychiatric disorder, extrapyramidal symptom, dry mouth, and fatigue showed no significant differences in the adjunctive aripiprazole treatment group compared with the placebo group (risk difference (Mantel-Haenszel, random or fixed) ?0.05 to 0.04 (95% confidence interval ?0.13 to 0.16); I2 = 0% to 68%, P = 0.20 to 0.70). However, sedation, insomnia, and headache were more frequent when the adjunctive aripiprazole dose was higher than 15 mg/day. Meta-analysis of the prolactin level normalization indicated adjunctive aripiprazole was superior to placebo (risk difference (Mantel-Haenszel, random) 0.76 (95% confidence interval 0.67 to 0.85); I2 = 43%, P<0.00001). The subgroup analysis confirmed that the subjects who received adjunctive aripiprazole 5 mg/day showed a degree of prolactin normalization similar to that of all participants. No significant differences between groups in discontinuation and improvements of psychiatric symptoms. Conclusion Adjunctive aripiprazole is both safe and effective as a reasonable choice treatment for patients with antipsychotic-induced hyperprolactinemia. The appropriate dose of adjunctive aripiprazole may be 5 mg/day.
CONTROL OF HYPERTENSION
GHULAM RASOOL BHURGRI,HUSSAIN BUX KOREJO,MUHAMMAD ALI QURESHI
The Professional Medical Journal , 2010,
Abstract: Objective: To compare the efficacy and tolerability of Losartan and Atenolol in alone and combination in treatment of hypertension. Study Design: Comparative study. Setting: Medical out patients department of Jinnah Postgraduate Medical Centre Karachi from January 2007 to June 2007. Methods: There were 60 patients previously untreated with mild and moderate essential hypertensions were registered for study. The selected patients were divided into three groups. Group A was given atenolol, Group B was given Losartan, and Group C was given both drugs. The target blood pressure was 120-140/80-90 mmHg. There were 42 males and 18 females with age range 25-65 years. Results: The mean baseline score of groups A, B and C were showed systolic blood pressure 182±19, 174 ± 20 and 168 ± 12 respectively. The diastolic blood pressure was 104.5±11, 102.5±9 and 104.5±10 respectively. The difference in mean systolic and diastolic blood pressure was not significant statistically as P = 0.06 and 0.76 respectively. After 4 months of treatment with atenolol, systolic blood pressure decreased to 147±17, and diastolic blood pressure fell to 87±4. Losartan decreased systolic blood pressure 138±13 and diastolicblood pressure 87±4 in 4 months of treatment. The combined therapy decreased systolic blood pressure 115±4.6 and diastolic blood pressure75±4.7. The effect of treatments on systolic and diastolic blood pressure was significantly different as (p < 0.001) and ( p = 0.036) respectively. Side effects observed in 2 (10%) patients from group C, 8 (40%) in group A and 4 (20%) in group B. Combination therapy proved more effective in controlling hypertension than mono therapy and also fewer side effects. Patients showed better control on combination therapy as compared to mono therapy. Losartan proved a little better in controlling hypertension then atenolol and was more expensive.Conclusion: Patients showed better results with combination therapy for hypertension compared to individual drug.
A STUDY ON INSULIN LEVELS IN PREGNANCY INDUCED HYPERTENSION  [PDF]
V.M. VINODHINI,V. DEVISRI,W. EBENEZER WILLIAM
International Journal of Pharmaceutical and Biological Research , 2012,
Abstract: Context: Pregnancy induced hypertension occurs in about 5-10% of pregnancies. Many features of insulin resistance syndrome like hyperinsulinemia and dyslipidemia have been identified in these patients. Aim: To analyse the levels of insulin and lipid profile in patients with pregnancy induced hypertension. Methods: We measured insulin levels and lipid profile in 50 patients with pregnancy induced hypertension in their 3rd trimester. 25 normotensive pregnant women in 3rd trimester 15 non pregnant non hypertensive femalesformed the control groups. Results: Compared with controls, the patients with pregnancy induced hypertension had significantly elevated levels of insulin (p<0.01) and triglycerides (p<0.01).Conclusion: These observations indicate that insulin resistance may play a role in the pathogenesis of pregnancy induced hypertension.
Lysophosphatidic Acid-Induced Transcriptional Profile Represents Serous Epithelial Ovarian Carcinoma and Worsened Prognosis  [PDF]
Mandi M. Murph, Wenbin Liu, Shuangxing Yu, Yiling Lu, Hassan Hall, Bryan T. Hennessy, John Lahad, Marci Schaner, ?slaug Helland, Gunnar Kristensen, Anne-Lise B?rresen-Dale, Gordon B. Mills
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0005583
Abstract: Background Lysophosphatidic acid (LPA) governs a number of physiologic and pathophysiological processes. Malignant ascites fluid is rich in LPA, and LPA receptors are aberrantly expressed by ovarian cancer cells, implicating LPA in the initiation and progression of ovarian cancer. However, there is an absence of systematic data critically analyzing the transcriptional changes induced by LPA in ovarian cancer. Methodology and Principal Findings In this study, gene expression profiling was used to examine LPA-mediated transcription by exogenously adding LPA to human epithelial ovarian cancer cells for 24 h to mimic long-term stimulation in the tumor microenvironment. The resultant transcriptional profile comprised a 39-gene signature that closely correlated to serous epithelial ovarian carcinoma. Hierarchical clustering of ovarian cancer patient specimens demonstrated that the signature is associated with worsened prognosis. Patients with LPA-signature-positive ovarian tumors have reduced disease-specific and progression-free survival times. They have a higher frequency of stage IIIc serous carcinoma and a greater proportion is deceased. Among the 39-gene signature, a group of seven genes associated with cell adhesion recapitulated the results. Out of those seven, claudin-1, an adhesion molecule and phenotypic epithelial marker, is the only independent biomarker of serous epithelial ovarian carcinoma. Knockdown of claudin-1 expression in ovarian cancer cells reduces LPA-mediated cellular adhesion, enhances suspended cells and reduces LPA-mediated migration. Conclusions The data suggest that transcriptional events mediated by LPA in the tumor microenvironment influence tumor progression through modulation of cell adhesion molecules like claudin-1 and, for the first time, report an LPA-mediated expression signature in ovarian cancer that predicts a worse prognosis.
Benefits from Treatment and Control of Patients with Resistant Hypertension  [PDF]
Michael Doumas,Vasilios Papademetriou,Stella Douma,Charles Faselis,Konstantinos Tsioufis,Eugene Gkaliagkousi,Konstantinos Petidis,Chrysanthos Zamboulis
International Journal of Hypertension , 2011, DOI: 10.4061/2011/318549
Abstract: Resistant hypertension is commonly found in everyday clinical practice. However, the risks of resistant hypertension, as well as the benefits of treatment and control of blood pressure in patients with resistant hypertension remain vaguely clarified. Data from small clinical studies and observational cohorts suggest that patients with resistant hypertension are at increased cardiovascular risk, while control of blood pressure offers substantial benefits. It has to be noted however that data from appropriate large randomized studies are missing, and resistant hypertension remains remarkably understudied. Resistant hypertension has attracted significant scientific interest lately, as new therapeutic modalities become available. The interventional management of resistant hypertension either by carotid baroreceptor stimulation or renal sympathetic denervation is currently under investigation with promising preliminary results. This review presents available evidence regarding the benefits of treatment and control of blood pressure in patients with resistant hypertension and offers a critical evaluation of existing data in this field. 1. Introduction Resistant hypertension is defined as uncontrolled blood pressure despite the use of optimal doses of three antihypertensive medications, of which one is a diuretic [1]. Although this definition encompasses a large number of patients, many of these patients can be controlled with more careful adjustment of their regimen and implementation of good practices. Several factors have been identified as contributors to resistant hypertension: poor patient adherence, physician inertia, inadequate doses or inappropriate combinations of antihypertensive drugs, secondary forms of hypertension, drug-induced hypertension, excess alcohol intake, and volume overload [2]. Lifestyle modifications including salt restriction are very important in these patients [3]. Addressing some of the comorbid conditions, such as sleep apnea, primary aldosteronism [4], or addition of adjunct therapies such as spironolactone [5–11] can achieve blood pressure control. However, many patients remain uncontrolled despite the use of four, five, or six antihypertensive drugs, especially in everyday clinical practice, outside the “sterile” environment of clinical trials. It is surprising to realize that although hypertension is among the most studied diseases, resistant hypertension which denotes the most severe, high-risk, and probably more scientifically interesting subgroup remains so much understudied. Unfortunately, data regarding the natural
WOMEN WITH PREGNANCY INDUCED HYPERTENSION
NOREEN AKMAL
The Professional Medical Journal , 2006,
Abstract: Objective: To identify the epidemiological differences betweennormotensive pregnant women and women in pregnancy induced hypertension. Designs: A descriptive analytical casecontrol study. Setting: Department of Obs and Gynae of Sir Ganga Ram Hospital Lahore. Period: From January toDecember 2004. Materials & Methods: 2 groups with 100 patients in each were studied. Results: PIH is morecommon in young, obese, primigravidas with a family or past history of PIH or hypertension and in those with poorsocioeconomic status and no regular dietary calcium supplementation.
MANAGEMENT OF PREGNANCY INDUCED HYPERTENSION  [PDF]
Sharma Anjana,Mahendra Poonam,Bisht Shradha
International Journal of Research in Ayurveda and Pharmacy , 2010,
Abstract: Pregnancy induced hypertension (PIH) is a global problem and complicates approximately 10-17% of pregnancies and is therefore most common medical problem requiring special attention in the intrapartum period. Hypertension may, of course, precede pregnancy, but more commonly develops during it in which case blood pressure levels can change very quickly. The increase of BP rarely starts before 20 weeks, but may be a major problem by the third trimester (24-36 weeks). Pregnancy induced hypertension, although a common complication of pregnancy must not be taken lightly. It becomes very essential for a treating physician to know in detail about this particular complication of pregnancy. If PIH is detected early with prompt and effective treatment, the features disappear completely and the prognosis is not unfavourable, both for the mother and the baby. The primary objective of treatment in women with severe hypertension and preeclampsia is to prevent cerebral complications such as encephalopathy and haemorrhage. The threshold for treatment is usually a sustained diastolic blood pressure of 110 mm Hg or higher. Antihypertensive drugs can affect the foetus either indirectly, by lowering uteroplacental blood flow, or directly, by influencing the umbilical or foetal cardiovascular circulation. In patients with mild to moderate hypertension, both chronic and pregnancy induced, methyldopa treatment improves the maternal outcome. Among the different antihypertensive drugs that have been reported to be effective, safe and well tolerated during pregnancy, many clinical trials and studies conclusively state that methyldopa represents the more suitable option in pregnancy induced hypertension. In this article we have briefly gone through the various aspects of hypertension, stressing importance on its rising incidence globally and in India.
Association between pregnancy-induced hypertension and post-partum infection in the Instituto Materno Infantil, Bogotá, Colombia: case control study
Gómez,Pio Iván; Gaitán,Hernando Guillermo;
Revista Colombiana de Obstetricia y Ginecología , 2004,
Abstract: introduction. post-partum infection is one of the main causes of maternal morbidity-mortality in developing countries. identifying factors predisposing to infection will allow intervention for preventing them or (if they cannot be prevented) using other means for reducing their impact. toxaemia seems to increase the risk of infection developing due to alterations in cell and humoral immunity. the present work?s object is to evaluate whether patients having preeclampsia have a greater risk of presenting post-partum infection. materials and methods. a matched case control study was carried out. pairing by day of birth was done. inclusion criteria: women giving birth in the instituto materno infantil aged between 15 and 45. exclusion criteria: clinical patients having infection on being admitted, immunosuppression, second stage of delivery greater than two hours, antibiotic-therapy one week before birth, post-partum eclampsia. sample size: 95% level of confidence, 80% power, 1:1 ratio, 8% frequency of controls? exposure, estimated or 2. it was determined that 369 patients would be required per group. the two groups were compared by using t student test paired or wilcoxon signed ranks test (according to normality in continuous variables) and mcnemar?s test for percentages. bivariable analysis was done on stratifying by birth route. crude and adjusted or were estimated for controlling confounders using conditional logistical regression.results. the risk of infection was increased in mild preeclampsia (or 8.28, 95%ci 2.04-33.5) and severe preeclampsia (or 9.42, 95%ci 2.10-41.3). the risk of infection was also increased in adolescents (or 3.87, 95%ci 1.75 - 8.54) and who underwent caesarean section (or 8.17, 95%ci 2.71 - 24.62). conclusions. using prophylactic antibiotics must be evaluated in vaginal birth and alternatives should be evaluated in terms of duration and currently considered first-choice antibiotic schemes for prophylaxis in caesarean section in patients suffe
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