The Effect of Ibuprofen on Serum Digoxin Concentrations

1983 ◽  
Vol 17 (4) ◽  
pp. 286-288 ◽  
Author(s):  
Frank P. Quattrocchi ◽  
J. Daniel Robinson ◽  
R. Whit Curry ◽  
Mario L. Grieco ◽  
Stephen G. Schulman

This study was undertaken to determine the effects of ibuprofen (Motrin), in daily doses of at least 1600 mg, on steady-state digoxin concentrations. A total of 12 ambulatory patients (10, female; 2, male), with a mean age of 66 years (38–81 yr), completed the study. An initial baseline serum digoxin level was obtained, with follow-up levels at 7 days and, whenever possible, 28 days after ibuprofen initiation. Serum creatinine concentrations were not significantly different from baseline to 7 or 28 days of ibuprofen therapy. Results show a statistically significant (p < 0.05) increase in digoxin levels after seven days of ibuprofen. The mean increase was 59 percent (range, 10.7–325.4 percent), with 10 of the 12 patients displaying increased seven-day levels. Digoxin levels drawn 28 days after ibuprofen initiation were not statistically different from baseline or seven-day digoxin levels.

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Imen El Meknassi ◽  
Zellema Dorsaf ◽  
Azzabi Awatef ◽  
Sahtout Wissal ◽  
Ben Aicha Narjes ◽  
...  

Abstract Background and Aims Plasmapheresis (PP) have been used in kidney transplant (KT) patients for multiple immunological renal diseases. Focal segmental glomerulosclerosis (FSGS) is one of the most prevalent indication for PP. It can be used either for curative or preventive treatment of its recurrence. The aim of our study was to assess the outcomes of PP among KT patients with FSGS. Method We performed a retrospective study including all KT patients with FSGS who underwent PP during the period from December 2007 to December 2018. PP was performed using a filtration technique by a Prismaflex machine. Results Among 275 KT patients, we have identified 5 patients with FSGS who underwent PP either before or after transplantation. The mean age was 26.4 years. All patients but one received a living-donor kidney with number of mismatches between 3 and 5. All patients were under corticosteroids, mycophenolate mofetil and cyclosporine. Two patients presented recurrent FSGS within 3 days following the transplantation. Mean serum creatinine level and proteinuria before PP were 517 ±191 µmol/l and 17.7 ±7.5 g/day respectively. The PP was used basing on Canaud protocol combined to rituximab. The mean number of PP sessions was 29. Only one patient required hemodialysis. None of the patients had lost his graft. The mean serum creatinine level was 172±55 µmol/l. One patient died of septic shock. PP was used in two other patients before transplantation in order to prevent the recurrence of FSGS. They have preserved a normal kidney function after a period of follow-up (37 months and 7 years). No rejection or recurrence of FSGS was noted during the follow-up period. Another patient aged 20, underwent 5 sessions of PP on alternate days immediately after transplantation to prevent the recurrence of FSGS. His baseline serum creatinine level was at 136 µmol/l. The recurrence of his initial renal disease occurred after 21 months requiring other sessions of PP. Rituximab was tried but stopped in front of allergy reaction. His renal function remained stable. Overall, PP was well tolerated in all patients with no incident. Conclusion Recurrence of the FSGS after transplantation is a concern for nephrologists due to the difficulty of treatment. Our study shows the efficacy of plasmapheresis before kidney transplantation to prevent recurrence of FSGS.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Negreanu ◽  
Michael Gagnon ◽  
anh nguyen ◽  
Samer Mansour ◽  
Michel T Nguyen ◽  
...  

Background: The incidence and predictors of contrast-induced nephropathy (CIN) in patients with normal glomerular filtration rate (GFR) are not well ascertained. We aim to determine the incidence and predictors for CIN after coronary catheterization (CATH) for acute coronary syndromes (ACS). Methods: We combined the datasets of two studies. The AMI-QUEBEC was an observational cohort of patients with ST-segment elevation myocardial infarctions in 2003. The AMI-OPTIMA was a study of patients hospitalized with ACS in 2009 and 2012. For this analysis, we retained only patients with GFR > 60 ml/min who underwent CATH. We defined “hyperfiltrators” as patients with GFR above the 95th percentile age and sex-adjusted value. CIN was defined as an increase in serum creatinine >0.5 mg/dL (44.2 μmols/L) or > 50% from baseline serum creatinine. Results: There were 3,188 patients with GFR > 60 ml/min : 39 hyperfiltrators and 3,149 without hyperfiltration. The mean age was similar between the two groups of patients (62 years); 21% and 27% females in hyperfiltrators and non-hyperfiltrators (p<0.0001). The prevalences of diabetes mellitus and hypertension were 36% and 64%, respectively in hyperfiltrators compared to 20% and 46%, respectively in non-hyperfiltrators. The mean baseline GFR and creatinine were 112 ml/min and 50 μmols/L, respectively in hyperfiltrators; 84.2 ml/min and 80 μmols/L in non-hyperfiltrators. There were 225 CIN following CATH; 7.1% of the whole cohort with 35.9% in the hyperfiltrators and 6.7% in non-hyperfiltrators. Hyperfiltration was independently associated with a 13-fold increase in the risk of CIN (Table 1). Each year of increase in age was associated with a 5% increase in the risk of CIN. Shock was also associated with an 11-fold increase in the risk of CIN. Conclusion: Hyperfiltrators may be at high risk of CIN following CATH in ACS. The risk of CIN associated with hyperfiltration should be evaluated in other populations.


1976 ◽  
Vol 8 (4) ◽  
pp. 690-711 ◽  
Author(s):  
Marcel F. Neuts

There are many queueing models in which there appears a semi-Markov matrix G(·), whose entries are absorption-time distributions in a Markov renewal branching process. The role of G(·) is similar to that of the busy period in the simple M/G/1 model. The computation of various quantities associated with G(·) is however much more complicated. The moment matrices, and particularly the mean matrix of G(·), are essential in the construction of general and mathematically well-justified algorithms for the steady-state distributions of such queues.This paper discusses the moment matrices of G(·) and algorithms for their numerical computation. Its contents are basic to the algorithmic solutions to several queueing models, which are to be presented in follow-up papers.


Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4899-4899
Author(s):  
William F. Clark ◽  
A. Keith Stewart ◽  
Gail A. Rock ◽  
Marion Sternbach ◽  
David M. Sutton ◽  
...  

Abstract In myeloma, plasma exchange (PE) has been suggested to prevent rapidly progressive kidney failure by reducing exposure to nephrotoxic light chains. We carried out a randomized controlled multi-centre trial comparing PE or no PE in 104 patients of whom 101 met the inclusion, exclusion criteria and 4 were lost to follow-up. We compared baseline characteristics as well as renal outcomes and performed a futility analysis to determine the sample size necessary for potential statistical significance for the changes noted. Thirty-nine patients were randomized to the control group and 58 to the PE group with a 6-month follow-up. The baseline characteristics of these 2 groups were similar including serum creatinine, dialysis dependence, age, gender, serum calcium, serum albumin, 24 -hour urine for protein levels and Durie-Salmon myeloma staging. Thirteen (33.3%) of the control group and 19 (33.3%) of the PE group died within 6 months of follow up. Ten patients (31%) in the control and 10 patients (21%) in the PE arm were dialysis dependent at 6 months. Seven patients (47%) came off dialysis in the control and 13 patients (59%) in the PE arm with the mean number of dialysis days from 0–6 months being 45.7±67.6 in the control versus 29.2±56.1 in the PE arm at 6 months. The mean serum creatinine in the control group was 314.6±256.1 μmol/L versus 215.4±215.3 μmol/L in the PE group and the composite end point of death, dialysis or serum creatinine >254 μmol/L occurred in 12 (30.8%) in the control and 11 (19.3%) in the PE arm. The futility analysis to indicate the per group sample size necessary to achieve statistical significance at 6 months for the difference we observed was infinite for cumulative mortality, 805 for dialysis dependence, 2418 for coming off dialysis, 321 for number of dialysis days, 132 for creatinine difference of 100 μmol/L and for the composite outcome of death, dialysis or creatinine>354 μmol/L, 737. We did not observe a statistically significant difference in mortality or renal morbidity for PE versus no PE in patients with myeloma and rapidly progressive kidney failure.


2016 ◽  
Vol 27 (2) ◽  
pp. 193-197 ◽  
Author(s):  
Masako Tsukanaka ◽  
Ragnhild Ø. Støen ◽  
Wender Figved ◽  
Frede Frihagen ◽  
Lars Nordsletten ◽  
...  

Introduction Cartilage wear is a concern after hemiarthroplasty. The precise pattern of the progression of wear has not been evaluated. We previously reported the application of radiostereonetric analysis (RSA) for the measurement of cartilage wear in patients. The purpose of this study was to report the amount and the orientation of the steady state wear of cartilage between 1 and 3 years after bipolar hemiarthroplasty. Methods 22 patients with a bipolar hemiarthroplasty for displaced femoral neck fracture were included. 10 patients completed the mean follow up of 37 months. The cartilage wear was evaluated by calculating the migration of the bipolar head in reference to the markers in the acetabulum using RSA. Results The mean age of the patients at the final follow-up was 80 (range 67-91) years. The 3-D migration was -0.02 mm (SD 0.30) between 1 and 3 years. The migration in each direction was 0.03 mm (SD 0.49) in medial, 0.03 mm (SD 0.14) in proximal and 0.11 mm (SD 0.29) in posterior directions. 2 patients showed migration of more than 0.2 mm. The large initial migration seen in some patients up to 1 year did not progress further. Total wear after 37 months was 0.43 mm (SD 0.17). Conclusions Cartilage wear progressed slowly in 2 of 10 patients from 1 to 3 years. No pelvic penetration was seen. We believe that RSA will give a basic knowledge about the development and the progression of cartilage wear after hemiarthroplasty.


Molecules ◽  
2021 ◽  
Vol 27 (1) ◽  
pp. 79
Author(s):  
Karolina Woziwodzka ◽  
Jolanta Małyszko ◽  
Ewa Koc-Żórawska ◽  
Marcin Żórawski ◽  
Paulina Dumnicka ◽  
...  

Transgelin is a 22-kDa protein involved in cytoskeletal organization and expressed in smooth muscle tissue. According to animal studies, it is a potential mediator of kidney injury and fibrosis, and moreover, its role in tumorigenesis is emerging in a variety of cancers. The study included 126 ambulatory patients with multiple myeloma (MM). Serum transgelin-2 concentrations were measured by enzyme-linked immunoassay. We evaluated associations between baseline transgelin and kidney function (serum creatinine, estimated glomerular filtration rate—eGFR, urinary markers of tubular injury: cystatin-C, neutrophil gelatinase associated lipocalin—NGAL monomer, cell cycle arrest biomarkers IGFBP-7 and TIMP-2) and markers of MM burden. Baseline serum transgelin was also evaluated as a predictor of kidney function after a follow-up of 27 months from the start of the study. Significant correlations were detected between serum transgelin-2 and serum creatinine (R = 0.29; p = 0.001) and eGFR (R = −0.25; p = 0.007). Transgelin significantly correlated with serum free light chains lambda (R = 0.18; p = 0.047) and serum periostin (R = −0.22; p = 0.013), after exclusion of smoldering MM patients. Patients with decreasing eGFR had higher transgelin levels (median 106.6 versus 83.9 ng/mL), although the difference was marginally significant (p = 0.05). However, baseline transgelin positively correlated with serum creatinine after the follow-up period (R = 0.37; p < 0.001) and negatively correlated with eGFR after the follow-up period (R = −0.33; p < 0.001). Moreover, higher baseline serum transgelin (beta = −0.11 ± 0.05; p = 0.032) significantly predicted lower eGFR values after the follow-up period, irrespective of baseline eGFR and follow-up duration. Our study shows for the first time that elevated serum transgelin is negatively associated with glomerular filtration in MM and predicts a decline in renal function over long-term follow-up.


2019 ◽  
Vol 20 (1) ◽  
pp. 18-23
Author(s):  
Md Jamal E Rabby ◽  
Md Masud Zaman ◽  
Mohammad Ali ◽  
Md Kabirul Hassan ◽  
Md Shohidul Lslam ◽  
...  

Background: Urolithiasis may be associated with various degree of renal impairment secondaryto a combination of obstruction, urinary infection, long standing calculus, stone burden,frequent surgical intervention, and co-existing medical diseases. Objective: The purpose of the study is to predict the factors those have a significant impact foroutcome of the patients with renal impairment following treatment of urolithiasis. Methods: Fifty patients of urolithiasis with renal impairment were enrolled in this prospectivestudy, carried out between 1st July, 2008 and 30th June, 2009, at department of Surgery,Shaheed Ziaur Rahman Medical College Hospital, Bogra. Patients with renal impairment wasdefined as a baseline serum creatinine of >1.2mg/dl and/or on the basis of DTPA isotoperenogram findings (mild, moderate or severe impairment). Definite management was carriedout by means of open surgery, ESWL or in combinations available at study place. Follow-up after3 months, the postoperative renal functional outcome was defined as improved (>20% fall inserum creatinine), stabilized (<20% rise or <20% fall in serum creatinine), or deteriorated(>20% rise in serum creatinine). Renal function was also assessed by the impression madefrom the graph of DTPA isotope renogram (normal functioning or mild, moderate and severeimpairment). Predictive factors to be evaluated for the stone clearance and renal functionaloutcome were age of the patients, duration of symptomatology and urolithiasis, associateddiseases (hypertension and diabetes mellitus), stone burden, stone number and associatedurinary infection. Results: After 3 months of follow-up, the overall stone clearance rate was 76%. Out of 50patients, 27 patients (54%) showed improvement, 19 patients (38%) showed stabilization, and04 patients (08%) showed deterioration in their renal function. Age <40 years, duration ofsymptoms <6 months, stone burden <5 cm2 and single urinary stone were significant predictorsof subsequent good renal functional outcome. Conclusion: The renal recoverability rate after treatment of urinary stone disease could bepredicted by age, duration of symptoms, stone burden and stone number Journal of Surgical Sciences (2016) Vol. 20 (1) : 18-23


1986 ◽  
Vol 12 (3) ◽  
pp. 261-266
Author(s):  
HIROSHI HISHIDA ◽  
SEIICHI KOYAMA ◽  
AKIRA TAKAHASHI ◽  
YASUHARU ABE ◽  
TATUO SUZUKI ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document