Pseudomembranous colitis with Clostridium difficile during treatment by moxifloxacine (quinolone)

Poster (2005, October 27)

C. difficile is the most frequently pathogenic agent isolated in colitis associated with antibiotics and pseudomembranous colitis (PMC). C. difficile takes advantage of the disturbance of the intestinal ... [more ▼]

C. difficile is the most frequently pathogenic agent isolated in colitis associated with antibiotics and pseudomembranous colitis (PMC). C. difficile takes advantage of the disturbance of the intestinal flora to settle. We report a case of PMC appeared during treatment with moxifloxacine in a pulmonary infection in an emphysematous patient. The diarrhea is generally benign, but can be severe, with toxic megacolon or even the extreme case of colic perforation. The diagnosis is based on the research of toxins of C. difficile (A and/or B) in the intestinal stools or liquids (collected at the time of the endoscopic examination) to which is associated the anaerobic culture on selective agar. The reference method is the measurement of the cytotoxic effect of the B-toxin on a cell culture. Metronidazole or vancomycine constitutes the treatment. The prevention of relapses is very important, hygiene measures and probiotic agents must be associated to the antibiotic treatment. [less ▲]

Strontium Ranelate (Fujisawa/Servier)

in Current Opinion in Investigational Drugs (London, England : 2000) (2005), 6(4), 435-44

Strontium ranelate (PROTELOS), a divalent strontium salt, has been developed and launched by Servier for the treatment of osteoporosis. Fujisawa Pharmaceutical is developing the drug in Japan; in November ... [more ▼]

Strontium ranelate (PROTELOS), a divalent strontium salt, has been developed and launched by Servier for the treatment of osteoporosis. Fujisawa Pharmaceutical is developing the drug in Japan; in November 2004, phase II Japanese trials were ongoing. [less ▲]

One-year increase of Coll 2-1, a new marker of type II collagen degradation, in urine is highly predictive of radiological OA progression.

in Osteoarthritis and Cartilage (2005), 13(12), 1059-65

OBJECTIVE: To analyse the relationship between the levels of urinary biochemical markers of type II collagen degradation and the clinical and radiological severity and progression of knee osteoarthritis ... [more ▼]

OBJECTIVE: To analyse the relationship between the levels of urinary biochemical markers of type II collagen degradation and the clinical and radiological severity and progression of knee osteoarthritis (OA). METHOD: Seventy-five patients with primary knee OA were included in this 3-year follow-up study. Mean joint space width (JSW) of the medial compartment of the femorotibial joint was measured with a computer assisted method on standardized radiographs taken at baseline and after a 3-year follow-up. Pain, stiffness, and physical function subscales of the Western Ontario and McMaster Universities (WOMAC) were assessed at the same time points. Type II collagen peptides Coll 2-1 and Coll 2-1 NO(2), as well as pyridinoline (Pyr) and deoxypyridinoline (D-Pyr) were measured in urines at baseline, after 1 year and 3 years, with specific immunoassays. RESULTS: At baseline, significant correlations were found between the urinary Coll 2-1 and Coll 2-1 NO(2) levels and the global WOMAC score (Coll 2-1: r=0.28, P=0.01; Coll 2-1 NO(2): r=0.27, P=0.02) and its subscales for pain (Coll 2-1: r=0.27, P=0.01; Coll 2-1 NO(2): r=0.30, P=0.01) and function (Coll 2-1: r=0.29, P=0.01; Coll 2-1 NO(2): r=0.27, P=0.02). Pyr and D-Pyr levels were not significantly correlated with the WOMAC scores. One-year change in Coll 2-1 and Coll 2-1 NO(2) urinary levels were negatively correlated with a 3-year change in JSW (Coll 2-1: r=-0.31, P=0.03; Coll 2-1 NO(2): r=-0.31, P=0.03), indicating that an increase of Coll 2-1 or Coll 2-1 NO(2) over 1 year is predictive of subsequent joint space narrowing. Neither Pyr nor D-Pyr was correlated with radiological OA progression. CONCLUSIONS: At baseline, Coll 2-1 and Coll 2-1 NO(2) urinary levels were indicative of the clinical activity of knee OA and the increase of these peptides over 1 year was predictive of the radiological progression of knee OA. [less ▲]

Reduction in PINP, a marker of bone metabolism, with raloxifene treatment and its relationship with vertebral fracture risk

in BONE (2004), 34(2), 344-351

In the Multiple Outcomes of Raloxifene Evaluation (MORE) trial, 7705 postmenopausal women with osteoporosis, defined by low bone mineral density and/or prevalent vertebral fractures (VF), were randomized ... [more ▼]

In the Multiple Outcomes of Raloxifene Evaluation (MORE) trial, 7705 postmenopausal women with osteoporosis, defined by low bone mineral density and/or prevalent vertebral fractures (VF), were randomized to placebo or raloxifene (60 or 120 mg/day). All women received daily calcium (500 mg) and vitamin D (400-600 IU) supplements. Our previous analyses found that changes in BMD and biochemical markers of bone turnover are poorly predictive of the reduction in VF risk observed with raloxifene. This present study evaluated the effects of raloxifene on type I procollagen N-terminal propeptide (PINP), a new marker of bone turnover. Logistic regression analysis models evaluated the relationships between the changes at 1 year in PINP, serum osteocalcin (OC), bone-specific alkaline phosphatase (BSAP), and urinary excretion of type I collagen C-telopeptide fragments normalized to creatinine (CTx/Cr), and the risk of new VF at 3 years for placebo and pooled raloxifene. A subset of 967 women (mean age = 68 years) from the MORE cohort had PINP, OC, BSAP, and CTx evaluated at baseline. Both doses of raloxifene significantly decreased (P < 0.001) all biochemical markers of bone turnover from baseline. Compared to baseline, PINP levels were decreased by medians of 11.0% and 40.8% in the placebo and pooled raloxifene groups, respectively. In addition, the placebo and pooled raloxifene groups decreased serum OC by 8.5% and 31.8%, BSAP by 15.8% and 34.6%, and urinary CTx/Cr excretion by 5.6% and 46.5%, respectively, from baseline. In the pooled raloxifene group, the logistic regression relationship between 3-year VF risk and 1-year percentage change for each biochemical marker was statistically significant with PINP (slope estimate = 0.0085, P = 0.009), OC (slope estimate = 0.0068, P = 0.035), and BSAP (slope estimate = 0.0056, P = 0.039), but not with CTx/Cr (slope estimate = 0.0027, P = 0.192). Furthermore, the percent decrease in PINP at 1 year could account for 28% of the total reduction in vertebral fracture risk. In conclusion, a 1-year decrease in PINP, BSAP, or OC, but not CTx/Cr, may be predictive of the 3-year VF risk reduction with raloxifene therapy in this subset of postmenopausal women with osteoporosis. [less ▲]

Pharmacodynamics of follicle stimulating hormone (FSH) in postmenopausal women during pulsed estrogen therapy: Evidence that FSH release and synthesis are controlled by distinct pathways

in Journal of Clinical Endocrinology and Metabolism (2003), 88(11), 5405-5413

17beta-Estradiol (E2) exerts negative feedback effects at the hypothalamo-pituitary level on serum FSH. This study investigated the effects of repeated daily administration of intranasal E2 (S21400) on ... [more ▼]

17beta-Estradiol (E2) exerts negative feedback effects at the hypothalamo-pituitary level on serum FSH. This study investigated the effects of repeated daily administration of intranasal E2 (S21400) on the pharmacokinetics (PK) of E2 and estrone (E1) and the pharmacodynamics (PD) of FSH and assessed the PK/PD relationship between E2 and FSH using population model-dependent analysis. Postmenopausal volunteers (n = 24) received according to a balanced cross-over design, two 28-d treatments separated by a 2-month wash-out period: 300 mug E2, either alone or combined with oral dydrogesterone (20 mg/d) during the last 14 d of one of the treatments. Absorption of E2 was rapid, with maximal plasma concentrations at 10-30 min, returning to postmenopausal levels within 12 h. Over the 24-h period, FSH levels showed a U curve, with a minimum around 8 h after E2 administration. Moreover, over the treatment period, FSH basal values decreased by 17% between d 1 and 14 and an additional 5% between d 14 and 28. A PK/PD model described these short- and mid-term effects, possibly reflecting separate regulation mechanisms by E2 on FSH release and biosynthesis, respectively. The administration of progestin had no influence on E1, E2, and FSH model parameters. This study suggests that daily transient tissue exposure to E2 after pulsed estrogen therapy elicits short- and mid-term effects on the gonadotropin axis. [less ▲]

Effects of bazedoxifene (TSE-424), a novel tissue selective estrogen receptor modulator (SERM), on biochemical markers of bone metabolism in a chinese population

in Osteoporosis International (2003, November), 14(Suppl. 7), 97-98

Biochemical markers of bone and cartilage remodeling in prediction of longterm progression of knee osteoarthritis

in Journal of Rheumatology (2003), 30(5), 1043-50

OBJECTIVE: To investigate the relationship between biochemical markers of bone and cartilage remodeling and severity or progression (symptoms and structure) of knee osteoarthritis (OA). METHODS: Mean and ... [more ▼]

OBJECTIVE: To investigate the relationship between biochemical markers of bone and cartilage remodeling and severity or progression (symptoms and structure) of knee osteoarthritis (OA). METHODS: Mean and minimal joint space width (JSW) of the femorotibial joint were measured from standardized radiographs taken at baseline and at the end of a 3-year longitudinal study of patients with knee OA. Pain, stiffness, and physical function subscales of the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index were assessed at the same time points. Biochemical markers [serum keratan sulfate (KS), serum hyaluronic acid (HA), urine pyridinoline (PYD) and deoxypyridinoline (DPD), serum osteocalcin (OC), cartilage oligomeric matrix protein (COMP)] were assessed at baseline and after 1 year. RESULTS: At baseline, no significant correlations were observed between values of biochemical markers and JSW or any of the WOMAC scores. Baseline markers were not correlated with 3-year percentage changes observed in mean or minimal JSW and WOMAC scores. Changes observed after 1 year in OC and HA were significantly correlated with 3-year progression in mean JSW (r = -0.24, p = 0.04 and r = 0.27, p = 0.02, respectively) and in minimal JSW (r = -0.31, p = 0.01 and r = 0.24, p = 0.04, respectively). In patients from the lowest quartile of 1-year changes in HA (< -21.22 ng/ml), mean JSW decreased after 3 years by 0.76 (1.23) mm compared to an increase of 0.11 (0.83) mm in patients in the highest quartile (> +14.34 ng/ml) (p = 0.03). CONCLUSION: The 3-year radiological progression of knee OA could be predicted by a 1-year increase in OC or a 1-year decrease in HA levels. [less ▲]

Prevention of early postmenopausal bone loss by strontium ranelate: The randomized, two-year, double-masked, dose-ranging, placebo-controlled PREVOS trial

in Osteoporosis International (2002), 13(12), 925-931

Early postmenopausal women (n = 160) were randomised to receive placebo or strontium ranelate (SR) 125 mg/day, 500 mg/day or 1 g/day for 2 years (40 participants per group). All participants received ... [more ▼]

Early postmenopausal women (n = 160) were randomised to receive placebo or strontium ranelate (SR) 125 mg/day, 500 mg/day or 1 g/day for 2 years (40 participants per group). All participants received calcium 500 mg/day. The primary efficacy parameter was the percent variation in lumbar bone mineral density (BMD), measured using dual-energy X-ray absorptiometry. Secondary efficacy criteria included hip BMD and biochemical markers of bone turnover. At month 24, SR I g/day significantly increased lumbar BMD compared with placebo [mean (SD) +5.53% (5.12); p < 0.001] for measured values and [mean (SD) + 1.41% (5.33%); p < 0.05] for values adjusted for bone strontium content. The annual increase for adjusted values was +0.66% compared with -0.5% with placebo, with an overall beneficial effect after 2 years of about 2.4% with SR I g/day relative to placebo. There were no other significant between-group differences in adjusted lumbar BMD. Femoral neck and total hip BMD were also significantly increased at month 24 with SR I g/day compared with placebo [mean (SD): +2.46% (4.78) and +3.21% (4.68), respectively; both p < 0.001)]. SR 1 g/day significantly increased bone alkaline phosphatase at all time points (p < 0.05) compared with baseline and between-group analysis showed a significant increase, compared with placebo, at month 18 (p = 0.048). No effect on markers of bone resorption was observed. SR was as well tolerated as placebo. The minimum does at which SR is effective in preventing bone loss in early postmenopausal non-osteoporotic women is therefore 1 g/day. [less ▲]

Baseline measurement of urine pyridinoline and deoxypyridinoline is correlated with 3-year hip osteoarthritis progression

in Osteoporosis International (2002, November), 13(Suppl.3), 51

Correlation between biochemical markers of bone and cartilage metabolism and structural progression of hand osteoarthritis. A three year prospective study

in Arthritis and Rheumatism (2002, September), 46(number 9 (suppl.)), 152-3