We detected higher levels of MDA and PINP in primary aldosteronism patients, suggesting increased oxidative stress and myocardial fibrosis in these individuals. Treating primary aldosteronism patients reduced MDA and PINP levels, which may reflect the direct effect of aldosterone greater than endothelial oxidative stress and myocardial fibrosis, possibly mediated by a mineralocorticoid receptor.
Background
The authors have implemented a process of pharmaceutical care in the pharmacy hospital in patients with anaemia and chronic kidney disease in predialysis patients in treatment with erythropoiesis stimulating factors (ESF), due to ongoing safety reviews and reports published in the last years.
Purpose
Assessing the follow-up of the pharmacy care process.
GRP093 Table 1
Year
2009
2010
Number of patients (Nop.)
100
79
Nop. insufficient monitoring of clinical information
31 (31%)
17 (21,5%)
Number of interventions
72
24
Accepted
86% (62)
33% (8)
Rejected
14% (10)
67%(16)
Effective treatment
20
39
GRP093 Table 2
Number of interventions/year
Reasons for intervenning
2009
2010
Recommendations
Hb increases more than 2 g/dl in 4 weeks
9
1
Changing dose or frequency of ESF administration
Hb>12†
29
8
Hb≥13†
0
3
Discontinuing drug, for safety
Hb<11† to high doses*
34
8
Discontinuing, inefficiency
Beginnings treatment Hb>10†
0
4
Not beginning
*Epoetin α doses>300 units/kg/week or darbepoetin α>1, 5 εg/kg/week.
†Hb levels (g/dl).
Materials and methods
The authors have put in place two transverse courts for 7 months in 2009 and 2010, including 100% of sensitive patients. The information was recorded in the Dispensation of Silicon (Grifols) Program. If haemoglobin (Hb) levels were maintained between 10 and 12 g/dl, treatment was considered to be effective.
Results
Conclusions
A decrease in the number of patients treated with ESF and the need of interventions was observed. Accepted interventions were fewer also, probably due to an increase in awareness when complying with the recommendations, motivated by the follow-up. It was showed that medical checks were not too close, involving an insufficient monitoring of clinical data and difficulty to establish the effectiveness of many treatments. This data will be reported to nephrology department in order to implement possible solutions.
Atrial fibrillation (AF) is prevalent arrhythmia in adult population. Inflammation is a risk factor for AF and might have important in its occurrence. Increased C‐reactive protein plasma levels (CRP) have been found in AF and they could be determined by polymorphisms in the CRP gene. We investigate here if the G219A polymorphism in CRP gene is associated to AF occurrence. In this study, 116 patients with elective CABG were included. Systemic inflammatory markers were measured at baseline and 72 h after surgery. G219A polymorphism in the CRP gene, located 219‐bp downstream of exon 2 in the 3′ flanking sequence, was determined by PCR and we correlated with plasma CPR levels and AF occurrence. This study was approved by the Ethics Committee of each participating health center. All patient gave signed an informed consent. Mean age of patients was 61±11 years and 85% of them were male and 48% had a history of hypertension. Allelic frequencies for allele G and A were 0.57 and 0.43, respectively. There were no differences between genotypes with regard to diagnosis, risk factors, smoking, medical history and medications at entry. Postoperative FA incidence was 13%. Mean preoperative and postoperative PCR levels were 3.35 and 75.6 mg/L, respectively. We concluded that no association between G219A polymorphism in the CRP gene, CRP levels and AF were found.DI‐06‐09‐2, FONDECYT 1070641
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