Magdalena Piechota-Urbańska

Plasma Endothelin-1 Levels in Septic Patients

Dysfunction of the vascular endothelium (ET) causes an increase in serum ET-1 concentration, as observed in septic patients. It was assumed that in this patient population the ET-1 level correlates with the degree of sepsis severity, including the level of organ dysfunction and, in particular, the level of circulatory dysfunction. The aim of the present study was to assess the relationship between levels of ET-1 and levels of N-terminal brain natriuretic propeptide (NT-proBNP), procalcitonin (PCT), and C-reactive protein (CRP), as well as the Sepsis-related Organ Failure Assessment (SOFA) score in septic patients. PCT and CRP were used to estimate the level of sepsis severity; the SOFA score was used to estimate multiorgan dysfunction; and NT-proBNP was used as a marker of cardiac dysfunction. Twenty patients with sepsis and severe sepsis were included in the study. Blood serum ET-1, NT-proBNP, PCT, and CRP concentrations were determined at specific time intervals, and the SOFA score was calculated. Mean ET-1, NT-proBNP, PCT, and CRP concentrations were 8.39 pg/ml ± 6.39 pg/mL, 140.80 pg/mL ± 84.65 pg/mL, 22.32 ng/mL ± 97.41 ng/mL, and 128.51 mg/L ± 79.05 mg/L, respectively. Correlation between ET-1 levels and levels of NT-proBNP, PCT, and CRP was .3879 (P < .001), .358 (P < .001), and .225 (P = .011), respectively. Mean SOFA score was 6.31 pts ± 3.75 pts. Correlation between the ET-1 levels and SOFA score was .470 (P < .001). Six patients (30%) died during the observation period of 28 days. ET-1 levels correlate with levels of NT-proBNP, PCT, and CRP, as well as the SOFA score in septic patients.

N-terminal brain natriuretic propeptide levels correlate with procalcitonin and C-reactive protein levels in septic patients

The aim of this study was to find the relationship between N-terminal brain natriuretic propeptide (NT-proBNP), procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations in septic patients. This was a prospective study, performed at Medical University Hospital No. 5 in łódź. Twenty patients with sepsis and severe sepsis were included in the study. N-terminal brain natriuretic propeptide, procalcitonin and C-reactive protein concentrations, and survival were evaluated. In the whole studied group (128 measurements), the mean NT-proBNP, procalcitonin and C-reactive protein concentrations were, respectively: 140.80±84.65 pg/ml, 22.32±97.41 ng/ml, 128.51±79.05 mg/l. The correlations for the NT-proBNP level and procalcitonin and C-reactive protein levels were 0.3273 (p<0.001) and 0.4134 (p<0.001), respectively. NT-proBNP levels correlate with PCT and CRP levels in septic patients. In the survivor subgroup, the mean NT-proBNP plasma concentrations were significantly lower than in the non-survivor subgroup.

Rationale of statin therapy in septic patients

Statins are well-established and effective drugs in the treatment of hyperlipidemias. However the effects of statins extend beyond lipid-lowering. The pleiotropic effects of statins have been shown to modify inflammatory cell signaling of the immune response to infection. Statins have emerged as potential immunomodulatory and antioxidant agents that might impact on sepsis outcomes. It was postulated that statins may be candidates for the treatment of sepsis. Recent animal and human data suggest that statin therapy might be beneficial in patients before the onset of sepsis or in its initial period, but should be used with care when patients are diagnosed with severe sepsis or septic shock. Some analyses also provide evidence for statins as an adjuvant therapy in sepsis. Because of the divergent results of studies, the potential benefit needs to be validated in randomized, controlled trials. In this review, we describe current evidence on the use of statins in the prevention and treatment of sepsis.

The use of the Gelot emulsifier in diclofenac sodium semi-solid preparations

Abstract In topical formulations, the rheological parameters and pharmaceutical availability of many active agents have been improved by the addition of modern excipients. This translates into increased interest in the topical use of NSAIDs. The aim of this study was to create series of effective oil in water (O/W) diclofenac sodium cream formulations that differ in the applied fatty phase, utilizing Gelot TM64 (Gattefosse) (a modern non-ionic emulsifier). In the produced prescriptions, estimation was made of the effect of this on the rheological parameters and the pharmaceutical availability of the diclofenac sodium. Herein, the hydrophilic petrolatum-based cream demonstrated the highest rate of release of the active agent, as well as the best set of beneficial rheological parameters.

Teat tablet with sodium ibuprofen: the effect of sorbitol on therapeutic agent pharmaceutical availability and on physicochemical parameters of a drug form

Dosing pediatric drugs available on pharmaceutical markets of analgesic, antifebrile and anti-inflammatory activity to children up to 3 years of age is not precise and frequently causes problems. The aim of the study was to work out a pediatric teat form of a drug with sodium ibuprofen and to determine the effect of sorbitol content on pharmaceutical availability of the therapeutic agent. Three variants of tablets containing 50 mg of sodium ibuprofen differing in the percentage content of sorbitol (from 37% - batch I to 79% - batch III) were produced. Quality tests of the produced forms of drugs (PPVI) were performed and the tests of therapeutic agent pharmaceutical availability by spatula method and by a method with a teat. Tablets of all batches had a smooth surface and same shape. The content of the therapeutic agent was within the limit of 95-105% of the declared value. The highest value of Q coefficient in the release test by pharmacopeal method and the shortest disintegration time (12 minutes) were obtained for tablets with 79% content of sorbitol. In conclusion, teat tablets with sodium ibuprofen of the highest sorbitol content (79%) demonstrated the expected physicochemical parameters and high pharmaceutical availability.