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Cureus Apr 2022Hyponatraemia is the most common electrolyte abnormality encountered in the inpatient setting and is associated with increased morbidity, mortality, and length of...
Hyponatraemia is the most common electrolyte abnormality encountered in the inpatient setting and is associated with increased morbidity, mortality, and length of hospital stay. Syndrome of inappropriate anti-diuresis (SIAD) remains the most common cause. Hyponatraemia due to SIAD presents various challenges in treatment approaches, including poor concordance (e.g., to fluid restriction), medication intolerance (e.g., demeclocycline), and risk of rapid sodium shifts (e.g., with vaptan therapy). The use of oral sodium chloride (NaCl) tablets is a recognised treatment approach. However, it is not commonly advocated. We present the cases of two elderly patients in whom the temporary use of NaCl tablets, as an adjunct to fluid restriction, led to safe and effective correction of SIAD-related hyponatraemia with resultant reduced length of hospital admission.
PubMed: 35475246
DOI: 10.7759/cureus.24367 -
Frontiers in Pediatrics 2021Suprasellar arachnoid cysts represent a rare occurrence in the pediatric population and usually cause symptoms related to mass effect and can occasionally cause...
Suprasellar arachnoid cysts represent a rare occurrence in the pediatric population and usually cause symptoms related to mass effect and can occasionally cause endocrine dysfunctions. The association between SAC and the syndrome of inappropriate antidiuretic hormone (SIADH) in the pediatric population has rarely been described previously. In most cases, SIADH is temporary and resolves by treating the underlying cause. The first-line treatment consists of fluid restriction in asymptomatic children. Oral urea and demeclocycline are other effective treatment options. Vaptans are a new class of medication for the management of SIADH. These agents are a nonpeptide vasopressin V2 receptor antagonist that selectively antagonizes the antidiuretic effect of AVP, resulting in excretion of diluted urine or "aquaresis." Their efficacy has been shown in adult patients with euvolemic or hypervolemic hyponatremia. However, evidence is lacking in pediatric patients with SIADH. We report the case of a 9-year-old female child with a SAC, who underwent endoscopic fenestration at the age of 2 years. After surgery she developed chronic hyponatremia due to SIADH. Hyponatremia was refractory to treatment with fluid restriction, oral sodium, and urea. In order to normalize serum sodium levels, tolvaptan treatment was started on a compassionate-use basis; 24-48 h later serum sodium levels returned to normal. To date, tolvaptan has been used regularly for 6 years with no side effects occurring during the treatment period. This is the first case of a child with chronic SIADH secondary to SAC successfully treated with tolvaptan. Further studies are needed to demonstrate its usefulness on a broader case series.
PubMed: 34336740
DOI: 10.3389/fped.2021.684131 -
Food Frontiers Jun 2020Angiotensin converting enzyme 2 (ACE2) and main protease (M) are significant target proteins, mainly involved in the attachment of viral genome to host cells and aid in...
Angiotensin converting enzyme 2 (ACE2) and main protease (M) are significant target proteins, mainly involved in the attachment of viral genome to host cells and aid in replication of severe acute respiratory syndrome-coronaviruses or SARS-CoV genome. In the present study, we identified 11 potent bioactive compounds from ethanolic leaf extract of (L.) by using GC-MS analysis. These potential bioactive compounds were considered for molecular docking studies against ACE2 and M target proteins to determine the antiviral effects against SARS-COV. Results exhibits that among 11 compounds from (L.), urso-deoxycholic acid, demeclocycline, tetracycline, chlorotetracycline, and ethyl iso-allocholate had potential viral inhibitory activity. Hence, the present findings suggested that chemical constitution present in (L.) will address inhibition of corona viral replication in host cells.
PubMed: 32838301
DOI: 10.1002/fft2.29 -
ADMET & DMPK 2020The bioavailability of tetracyclines is markedly decreased when co-administered with antacids, milk, or food containing Ca. Previously, it was suggested that the...
The bioavailability of tetracyclines is markedly decreased when co-administered with antacids, milk, or food containing Ca. Previously, it was suggested that the effective intestinal permeation of tetracycline (TC) was decreased due to Ca linked mucin binding in the mucosal side. In the present study, we investigated the effect of Ca, Mg, and mucin on the membrane permeation of six tetracyclines (TC, oxytetracycline (OTC), minocycline (MINO), doxycycline (DOXY), demeclocycline (DMCTC), and chlortetracycline (CTC)). The membrane permeability values (P) of tetracyclines were measured by the parallel artificial membrane permeation assay (PAMPA) using soybean lecithin - decane (SL-PAMPA) and octanol (OCT-PAMPA) membranes. In SL-PAMPA, Ca markedly decreased the P values of all tetracyclines. In OCT-PAMPA, Ca increased the P values of TC, CTC, and DMCTC, but not DOXY, OTC, and MINO. Mg decreased the P values of all tetracyclines in both SL-PAMPA and OCT-PAMPA (except for CTC in OCT-PAMPA). The addition of mucin had little or no effect in all cases. In contrast to the previously suggested mechanism, the results of the present study suggested that Ca chelate formation decreased the membrane permeation of tetracyclines, irrespective of Ca linked mucin binding. Molecular speciation analysis suggested that the permeation of TC - metal chelates was negligibly small in SL-PAMPA.
PubMed: 35300369
DOI: 10.5599/admet.797 -
Sheng Wu Gong Cheng Xue Bao = Chinese... Dec 2020Streptomyces aureofaciens DM-1 is a high-yielding 6-demethylchlortetracycline producer. The genome sequencing of DM-1 reveals a linear chromosome containing 6 824 334...
Streptomyces aureofaciens DM-1 is a high-yielding 6-demethylchlortetracycline producer. The genome sequencing of DM-1 reveals a linear chromosome containing 6 824 334 bps nucleotides with GC content of 72.6%. In this genome, a total of 6 431 open reading frames were predicted by using glimmer 3.02, Genemark and Z-Curve softwares. Twenty-eight secondary metabolite biosynthetic gene clusters were uncovered by using AntiSMASH gene prediction software, including the complete 6-demethylchlortetracycline biosynthetic gene cluster. A frame-shift mutation in methyltransferase coding region was detected, which may result in the demethylation of chlortetracycline. The complete genome sequence of S. aureofaciens DM-1 provides basic information for functional genomics studies and selection of high-yielding strains for 6-demethylchlortetracycline.
Topics: Base Sequence; Chlortetracycline; Demeclocycline; Multigene Family; Streptomyces aureofaciens
PubMed: 33398964
DOI: 10.13345/j.cjb.200317