scholarly journals High and low doses of clarithromycin treatment are associated with different clinical efficacies and immunomodulatory properties in chronic rhinosinusitis

2014 ◽  
Vol 128 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Y Fan ◽  
R Xu ◽  
H Hong ◽  
Q Luo ◽  
W Xia ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Clinical Efficacy ◽  
Low Dose ◽  
Symptom Assessment ◽  
Nasal Symptom ◽  
High Dose ◽  
Life Questionnaire ◽  
Short Term ◽  
Interleukin 5 ◽  
Cytokine Levels

AbstractBackground:Low-dose clarithromycin has been recommended for the treatment of chronic rhinosinusitis without nasal polyps. However, it is uncertain whether a high dose of clarithromycin is more effective than a low dose.Methods:Forty-three chronic rhinosinusitis patients were randomised to low-dose or high-dose clarithromycin groups, and clinical efficacy was evaluated. Pre- and post-treatment measures included: nasal symptom assessment, endoscopic inspection (Lund–Kennedy system), a quality of life questionnaire (the Sino-Nasal Outcome Test 20) and examination of cytokine levels (interleukin-5 and -8) in nasal secretions.Results:The high dose of clarithromycin was significantly better in terms of clinical efficacy than the low dose for the treatment of chronic rhinosinusitis (p < 0.025). Significant differences in nasal cytokine levels (interleukin-5 and -8) were also observed between the low-dose and high-dose groups after short-term clarithromycin treatment (p < 0.025).Conclusion:Short-term, high-dose clarithromycin appears to be more effective for the treatment of chronic rhinosinusitis than low-dose clarithromycin.

Methylphenidate in Hyperkinetic Children: Differences in Dose Effects on Impulsive Behavior

PEDIATRICS ◽  
1979 ◽  
Vol 64 (4) ◽  
pp. 408-411
Author(s):  
Ronald T. Brown ◽  
Esther K. Sleator
Keyword(s):  
Low Dose ◽  
Short Term Memory ◽  
Memory Task ◽  
High Dose ◽  
Impulsive Behavior ◽  
Short Term ◽  
Dose Effects ◽  
Hyperactive Children ◽  
Matching Familiar Figures Test ◽  
Primary Index

This research tested the hypothesis that in hyperactive children a low dose of methylphenidate (0.3 mg/kg) would produce scores superior to those with a high dose (1.0 mg/kg) or placebo on the matching familiar figures test (MFF), a primary index of impulsivity. The hypothesis was based on an earlier finding that the highest percentage of correct responses on a short-term memory task were found in hyperactive subjects who were receiving 0.3 mg/kg of methylphenidate whereas at 1.0 mg/kg the percentage correct returned to the placebo level. The hypothesis was verified in that the low dose reduced the number of errors on the MFF significantly more than did placebo or the high dose. This work demonstrates that, for both learning and impulsivity in hyperactive children, the lower dose of the two doses of methylphenidate studied produced the preferable effect.

Abstract 12540: High-Dose Statins Reduce the Risk of Contrast-Induced Nephropathy in Patients Undergoing Angiography: Meta-Analysis of 27 Randomized Controlled Trials

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Firas Rabbat ◽  
Shadi Al Halabi ◽  
Mehdi H Shishehbor
Keyword(s):  
Randomized Controlled Trials ◽  
Low Dose ◽  
Random Effect Model ◽  
Controlled Trials ◽  
High Dose ◽  
Short Term ◽  
Contrast Induced Nephropathy ◽  
Coronary Syndrome ◽  
Randomized Controlled ◽  
Significant Difference

Introduction: Contrast-induced nephropathy (CIN) is a common complication of contrast administration during angiography. Short-term high-dose statins have been suggested for the prevention of CIN in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Hypothesis: Multiple randomized controlled trials (RCT) have examined the role of statin in preventing CIN with conflicting results. We expanded on previous meta-analyses by including additional RCTs to provide a better outlook on the efficacy of statins in the prevention of CIN. Methods: We searched Pubmed, Medline, Embase, Cochrane, and conference abstracts for prospective RCTs that compared short-term high-dose statins to low-dose statins or placebo in patients undergoing CAG, PCI, computed tomography angiography, or peripheral angiography. High-dose statin was defined as Atorvastatin 40-80 mg, Simvastatin 40 mg, and Rosuvastatin 10-40 mg. Study quality was assessed using the Jadad score. Heterogeneity of the studies was analyzed by Cochran’s Q statistics. Mantel Haenszel relative risk was calculated using the random effect model. Results: Twenty seven trials (N=9559) were included in the analysis. Eight of the included trials enrolled patients with acute coronary syndrome (ACS) exclusively. High-dose statin was associated with statistically significant reduction in the incidence of CIN (RR=0.56; 95% CI 0.46, 0.69; P<001) compared to low-dose statin or placebo. This protective effect remained significant upon looking on trials that enrolled patients with ACS only (RR=0.40; 95% CI 0.29, 0.56; P<001). Subgroup analysis based on the type of statin showed no significant difference between simvastatin, atorvastatin, or rosuvastatin. No heterogeneity was detected among the studied outcomes (I2=0%). Conclusions: Peri-procedural Short-term high-dose statin administration significantly reduces the incidence of CIN in patients undergoing angiography.

scholarly journals Similar short-term clinical response to high-dose versus low-dose methotrexate in monotherapy and combination therapy in patients with rheumatoid arthritis

2017 ◽  
Vol 19 (1) ◽  
Author(s):  
Sytske Anne Bergstra ◽  
Cornelia F. Allaart ◽  
Rosaline van den Berg ◽  
Arvind Chopra ◽  
Nimmisha Govind ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Combination Therapy ◽  
Clinical Response ◽  
Low Dose ◽  
High Dose ◽  
Short Term ◽  
Dose Methotrexate

scholarly journals Bone turnover biomarkers in COPD patients randomized to either a regular or shortened course of corticosteroids: a substudy of the randomized controlled CORTICO-COP trial

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Pradeesh Sivapalan ◽  
Niklas R. Jørgensen ◽  
Alexander G. Mathioudakis ◽  
Josefin Eklöf ◽  
Therese Lapperre ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Dose Group ◽  
Low Dose ◽  
Corticosteroid Treatment ◽  
High Dose ◽  
Short Term ◽  
Copd Patients ◽  
Dose Corticosteroid

Abstract Background Long-term treatment with corticosteroids causes loss of bone density, but the effects of using short-term high-dose systemic-corticosteroid therapy to treat acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are unclear. Our aim was to determine whether high-dose corticosteroid therapy affected bone turnover markers (BTMs) to a greater extent compared to low-dose corticosteroid therapy. Methods The CORTICO-COP trial (NCT02857842) showed that an eosinophil-guided corticosteroid intervention led to approximately 60% lower accumulated corticosteroid dose for hospitalized patients with AECOPD (low-dose group) compared with 5-day standard corticosteroid treatment (high-dose group). We compared the levels of BTMs C-terminal telopeptide of type 1 collagen (CTX) and procollagen type 1 N-terminal propeptide (P1NP) in 318 participants during AECOPD and at 1- and 3-month follow-up visits. Results CTX decreased and P1NP increased significantly over time in both treatment groups. There were no significant differences between the groups at 1- or 3-months follow-up for P1NP. A significant drop in CTX was seen at 3 months (down Δ24% from the baseline, p = 0.017) for the high dose group. Conclusion Short-term, high-dose systemic corticosteroid treatment caused a rapid suppression of biomarkers of bone resorption. Corticosteroids did not suppress biomarkers of bone formation, regardless of patients receiving low or high doses of corticosteroids. This therapy was, therefore, harmless in terms of bone safety, in our prospective series of COPD patients. Trial registration ClinicalTrials.gov Identifier: NCT02857842. Submitted August 2nd, 2016.

Elevated T-helper 2 cytokine levels in high fat diet-fed C57BL/6 mice are attenuated by short-term 6-week treatment with a combination of low-dose aspirin and metformin

Cytokine ◽  
2020 ◽  
Vol 128 ◽  
pp. 154999 ◽  
Author(s):  
Thabsile J. Mahlangu ◽  
Phiwayinkosi V. Dludla ◽  
Vuyolwethu Mxinwa ◽  
Zibusiso Mkandla ◽  
Luca Tiano ◽  
...  
Keyword(s):  
High Fat Diet ◽  
Low Dose ◽  
T Helper ◽  
High Fat ◽  
Short Term ◽  
T Helper 2 ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Cytokine Levels

Neuroimmunological Effects of Exposure to Methylmercury Forms in the Sprague-Dawley Rats. Activation of the Hypothalamic-Pituitary-Adrenal Axis and Lymphocyte Responsiveness

1997 ◽  
Vol 13 (1) ◽  
pp. 57-66 ◽  
Author(s):  
Hector G. Ortega ◽  
Manuel Lopez ◽  
Atsushi Takaki ◽  
Qin-Heng Huang ◽  
Akira Arimura ◽  
...  
Keyword(s):  
Hpa Axis ◽  
Low Dose ◽  
Fold Increase ◽  
Exposed Group ◽  
Blood Levels ◽  
High Dose ◽  
Sprague Dawley ◽  
Short Term ◽  
Hypothalamic Pituitary Adrenal ◽  
Short Term Exposure

The effects of different methylmercury (MeHg) forms on the immune system and the hypothalamic pituitary adrenal (HPA) axis were assessed. The lymphocyte response to Concanavalin A (Con A) stimulation, blood levels of interleukin-6 (IL-6), adrenocorticotrophin hormone (ACTH), and corticosterone in the presence of different MeHg compounds was measured. Rats were exposed to methylmercury sulfide [(MeHg)2S] and methylmercury chloride (MeHgCl) at concentrations of 5 and 500 μg per liter in the drinking water for 8 or 16 weeks. Short-term exposure (8 weeks) at both, low- and high-doses of (MeHg)2S significantly enhanced lymphocyte responsiveness. MeHgCl only induced increased lymphocyte responsiveness at the low-dose exposure. Circulating levels of IL-6 after short-term exposure were increased in the MeHgCl-exposed group. The HPA axis activation was demonstrated by increased levels of ACTH and corticosterone levels. This response was predominant in low-dose exposed animals. Long-term (16 weeks) exposure resulted in a reduction in lymphocyte proliferation after both low- and high-dose MeHgCl exposures. The (MeHg)2S exposure resulted in a 3-fold increase in the proliferative response. Levels of ACTH were elevated 3-fold in the (MeHg)2S-exposed group, and no increase of corticosterone was observed in the high-dose exposed group at 8 weeks, no effect of(MeHg)2S was observed at 16 weeks. The MeHgCl exposed group showed an increase in ACTH and corticosterone levels at 8 weeks; this response was not observed at 16 weeks. These data indicate that exposure to MeHg compounds enhances T-cell proliferation in most of the cases, in a dose- and time-dependent fashion. Release of IL-6 also depends on the length of exposure. Early increases in circulating ACTH at 8 weeks also suggest activation of the HPA axis. This may contribute to the production of IL-6 and surveillance of regulatory homeostatic responses against environmental agents that mimic stress-like responses.

scholarly journals Immunomodulatory and Clinical Effects of Long-Term Low-Dose Macrolide Treatment of Chronic Rhinosinusitis with Nasal Polyposis

2011 ◽  
Vol 30 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Aleksandar Perić ◽  
Danilo Vojvodić ◽  
Nenad Baletić ◽  
Aneta Perić ◽  
Olivera Miljanović
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyposis ◽  
Low Dose ◽  
Nasal Symptom ◽  
Clinical Effects ◽  
Flow Cytometric Method ◽  
Tnf Α ◽  
Before And After ◽  
Nasal Fluid

Immunomodulatory and Clinical Effects of Long-Term Low-Dose Macrolide Treatment of Chronic Rhinosinusitis with Nasal PolyposisImmunomodulatory treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP) by macrolide antibiotics represents a challenging alternative to conventional therapy and surgery, still being at the very beginning. Immune and inflammatory processes in nasal and paranasal sinus mucosa, crucial in the etiopathogenesis of nasal polyps (NPs) are reflected in levels of various local mediators, found both in mucosa and nasal fluid. In this prospective study, we assessed the immunomodulatory and clinical effects of longterm low-dose oral macrolide treatment in the management of CRSwNP. Twenty-two (n = 22) nonasthmatic, nonallergic patients with CRSwNP were administered clarithromycin (CAM) 500 mg/day single oral dose for eight weeks. We measured the levels of proinflammatory cytokines TNF-α, TNF-β, and IL-1β, Th1 cytokines IL-2, IL-12, and IFN-γ, Th2 cytokines IL-4, IL-5, IL-6, and IL-10, and chemokine IL-8 in the nasal fluid samples, before and after treatment, using a flow cytometric method. We also scored each of the 22 patients before and after therapy according to Tsicopoulos' global nasal symptom score and Malm's endoscopic score. Following treatment, we found significantly reduced levels of IL-8 (p<0.01) and TNF-α (p<0.01) in nasal secretions. Macrolide therapy decreased the size of polyps in 45.45% of the patients. We concluded that long-term low-dose treatment with CAM was effective in the management of CRSwNP. We suggest that macrolides can be an alternative to topical and systemic corticosteroids in the management of CRSwNP.

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