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Objective: To determine the efficacy of ademetionine (S-adenosylmethionine, SAME) administration in preventing hepatotoxicity in patients undergoing long-term cyclosporin treatment. Design: Randomised, controlled, double-blind trial followed up for 3 months. Setting: Subjects were studied for a period of 10 days in hospital and then followed up in the outpatient unit for 3 months. Patients: 72 male patients with psoriasis, of whom 36 were treated with cyclosporin and 36 with cyclosporin plus ademetionine. Interventions: Cyclosporin treatment alone (10 mg/kg/day) was compared with treatment with the same dosage of cyclosporin in combination with ademetionine 400 mg/day. Main outcome measures: Serum fractioned bilirubin, γ-glutamyltransferase, alkaline phosphatase and transaminases, plasma malondialdehyde and 4-hydroxynonenal, and erythrocyte glutathione peroxidase were determined. Results: Hepatotoxicity and cholestasis were observed in 15 of 36 patients treated with cyclosporin alone, whereas no cases of liver cytotoxicity were observed in the group treated with cyclosporin in combination with ademetionine (p < 0.005). Moreover, the study results revealed a significant difference in oxidation-reduction balance between the two groups, with more marked oxidative stress in patients on cyclosporin alone. Conclusions: Ademetionine may protect the liver against potentially hepatotoxic substances, such as cyclosporin, and coadministration of ademetionine should therefore be considered when hepatotoxic drugs are used. [ABSTRACT FROM AUTHOR]

It is know that oxidative stress can be able to induce cytotoxicity of blood cells, stimulate release of inflammatory cytokines, and induce the production of growth factors. The aim of this study was to investigate oxidative stress and endothelial dysfunction in patients with asymptomatic carotid artery disease and healthy controls. Native low-density lipoproteins, oxidised low-density lipoproteins, malondialdehyde, nitrates, glutathione peroxidase activity and endothelin-1 were determined in patients without severe (range between 30% and 50%) carotid artery stenosis. Native low-density lipoproteins, oxidized low-density lipoproteins, malondialdehyde, glutathione peroxydase, and endothelin-1 concentrations were higher in patients than in health controls ( P<0.001). No difference was observed in nitrate values ( P<0.8). Our results revealed oxidative stress in patients without severe carotid artery stenosis and clinical symptoms. This was shown by the elevated malondialdehyde and oxidized low-density lipoprotein levels. [ABSTRACT FROM AUTHOR]

The high incidence of cardiovascular morbidity and mortality in non-insulin-dependent diabetes mellitus with albuminuria cannot be fully explained by the presence of standard cardiovascular risk factors. We assessed some pathogenic factors of diabetic vascular atherosclerotic damage in 72 non-insulin-dependent diabetes mellitus patients controlled by diet alone and 60 healthy controls. Our study aim was to assess the early onset of these alterations and to correlate them with the presence of microalbuminuria. We determined their incidence in two carefully selected groups of diabetic patients without clinical signs of cardiovascular risk and complications, where diet alone achieved glycometabolic balance. Microalbuminuric patients had an alterated oxide-reductive balance and elevated values of plasminogen activator inhibitor, tissue plasminogen activator, von Willebrand factor, endothelin-1 and betathromboglobulin compared with the normoalbuminuric diabetics and controls. Our findings support the hypothesis that a state of endothelial dysfunction characterized by altered oxide-reductive balance, modified hemostasis and changes in the endothelial barrier properties occurs much earlier in non-insulin-dependent diabetic patient especially in diabetics with microalbuminuria. In addition, alterations in the oxide-reductive balance, and hemostasis occur early and may be an underlying cause of microangiopathic complications in microalbuminuric diabetics. [ABSTRACT FROM AUTHOR]

Details the case of a 60-year-old civil engineer diagnosed with a rare tendinopathy associated with fluoroquinolone treatment. Past medical history; Presenting signs and symptoms; Diagnostic procedures; Treatment.