Antonis S. Manolis

Effects of two nebulization regimens on heart rate variability during acute asthma exacerbations in children.

Analysis of heart rate variability (HRV) has been used to evaluate changes in sympathovagal balance. The present study was designed to investigate the influence of two therapeutic regimens on autonomic cardiovascular regulation during acute asthma exacerbations (AAE). Twenty children, 7–13 years of age, with moderate or severe AAE were randomized in two equal groups to receive either 0.15 mg/kg/dose salbutamol (group 1) or a combination of lower-dose salbutamol (0.10 mg/kg/dose) and ipratropium bromide (5 mcg/kg/dose) (group 2). Exacerbations were treated with three nebulizations (Tx) of either regimen given 20 minutes apart. HRV indices [total power, high-frequency component (HF), low-frequency component (LF), and LF:HF ratio] were analyzed at specific time intervals during the management of AAE. Therapy had a significant time-dependent main effect on total power (p = 0.001), LF (p < 0.0001), and HF (p = 0.005) but reached only borderline significance for LF:HF ratio (p = 0.053). The decrease in LF was more pronounced in group 2 vs. group 1 at 10 minutes post-Tx1 (p = 0.034) and at 10 minutes post-Tx2 (p = 0.05), but there was no significant difference between groups at 10 and 20 minutes post-Tx3. There were no significant differences between groups in any of the other HRV indices. Both regimens improved FEV1 (p = 0.0001) to the same magnitude. During AAE, three consecutive inhalation treatments with either high-dose salbutamol-only or lower-dose salbutamol plus ipratropium bromide combination, resulting in similar FEV1 improvement, cause domination of sympathetic over parasympathetic nervous system of similar overall magnitude but distinct patterns of HRV indices.

Enzyme Replacement Therapy in Severe Fabry Disease with Renal Failure: A 1-year Follow-up

We present here the course of clinical response of a 53-year-old haemodialysed Fabry patient who received recombinant human alpha-galactosidase A at a dose of 1 mg/kg every other week over a period of 1 year. The therapy was well tolerated by the patient, who revealed an impressive favourable cutaneous, gastrointestinal, neurological and psychiatric response and a dramatic improvement in his quality of life, but no improvement in cardiac and renal function.

Lack of association between α2B-adrenergic receptor polymorphism and risk of restenosis following coronary angioplasty and stent implantation – preliminary report

Abstract Background: A genetic association/prospective follow-up study was conducted to investigate whether genetic variation of the α2B-adrenergic receptor gene was associated with the risk of restenosis in 96 Greek coronary artery disease patients undergoing coronary angioplasty and stent implantation. Methods: For comparison of genotype frequency, a control group of 83 asymptomatic individuals was also studied. The end-point of the current study was the incidence of restenosis at 7 months of clinical follow-up. Results: The majority of patients (70/96) had the insertion/insertion genotype, fewer patients (23/96) had the insertion/deletion genotype and only 3/96 had the deletion/deletion genotype; overall the frequency distribution was not different from that of the control subjects. Restenosis occurred in 15 of the 96 patients. Conclusions: In the population studied, α2B-adrenoreceptor polymorphisms were not found to predispose patients to an increased incidence of restenosis. Nevertheless, these findings should be considered as preliminary, taking into account the small number of patients that were studied and the rarity of the deletion/deletion genotype. Clin Chem Lab Med 2006;44:807–12.