Nimesulide is a relatively new non-steroidal anti-inflammatory drug that is gaining popularity in many countries because it is a selective cyclooxygenase 2 inhibitor. Occasionally, treatment is ...associated with mild elevation of liver enzymes, which return to normal upon discontinuation of the drug. Several cases of nimesulide-induced symptomatic hepatitis were also recently reported, but these patients all recovered.
To report the characteristics of liver injury induced by nimesulide.
We report retrospectively six patients, five of them females with a median age of 59 years, whose aminotransferase levels rose after they took nimesulide for joint pains. In all patients nimesulide was discontinued, laboratory tests for viral and autoimmune causes of hepatitis were performed, and sufficient follow-up was available.
One patient remained asymptomatic. Four patients presented with symptoms, including fatigue, nausea and vomiting, which had developed several weeks after they began taking nimesulide (median 10 weeks, range 2-13). Hepatocellular injury was observed with median peak serum alanine aminotransferase 15 times the upper limit of normal (range 4-35), reversing to normal 2-4 months after discontinuation of the drug. The remaining patient developed symptoms, but continued taking the drug for another 2 weeks. She subsequently developed acute hepatic failure with encephalopathy and hepatorenal syndrome and died 6 weeks after hospitalization. In none of the cases did serological tests for hepatitis A, B and C, Epstein-Barr virus and cytomegalovirus, as well as autoimmune hepatitis reveal findings.
Nimesulide may cause liver damage. The clinical presentation may vary from abnormal liver enzyme levels with no symptoms, to fatal hepatic failure. Therefore, monitoring liver enzymes after initiating therapy with nimesulide seems prudent.
RECENT DEVELOPMENTS IN ADMIRALTY AND MARITIME LAW Martyn, Jessica Link; Brickman, Philip C.; Chancey, Asher Brooks ...
Tort trial & insurance practice law journal,
09/2012, Letnik:
48, Številka:
1
Journal Article
Punitive Damages and Attorney Fees One of the more significant maritime cases of the year was the Washington Supreme Court's decision in Clausen v. Icicle Seafoods, Inc.1 In Clausen, die Court ...examined under general maritime law whether (1) the court and not the jury determines the amount of attorney fees related to die jury's punitive damage award for the employer's willful withholding of maintenance and cure and (2) whether punitive damages for willful withholding of maintenance and cure must be capped.2 Plaintiff Dana Clausen sustained serious injuries while working on board defendant Icicle Seafoods' vessel and was unable to get Icicle to meet its obligation to pay him maintenance and cure.3 With regard to maintenance (living expenses), Icicle paid Clausen $20 per day and Clausen resorted to living in a recreational vehicle with a leaking roof and without heat, air conditioning, running water, or a toilet.4 With regard to cure (medical expenses), Icicle delayed or refused to pay for doctor-recommended treatment.5 After Icicle filed a federal court action seeking to terminate Clausen's right to maintenance and cure, Clausen filed a state court action seeking damages for Icicle's negligence under the Jones Act,6 unseaworthiness of the vessel, and wrongful withholding of maintenance and cure.7 The jury found in Clausen's favor and awarded him compensatory and punitive damages. ...for state title under the equal footing doctrine, navigability is based on the "natural and ordinary condition" of the water.203 Importantly, a river is considered on a "segment-by-segment" basis in assessing whether the segment of the river, under which the riverbed in dispute lies, is navigable.204 The Court acknowledged "significant likelihood" that segments of the disputed rivers would fail the navigability test because they contained significant drops, rocks, or rapids that obstructed navigation.205 Also, for the purpose of determining riverbed title, evidence of present-day use may inform whether the river segment was susceptible for use for commercial navigation at the time of statehood.206 At a minimum, the party seeking to use present-day evidence for title purposes must show (1) the watercraft are meaningfully similar to those in customary use for trade and travel at the time of statehood and (2) the river's post-statehood condition is not materially different from its physical condition at statehood.207 Furthermore, with respect to "seasonal variations" in a waterway, while "a river need not be susceptible of navigation at every point during the year, neither can that susceptibility be so brief that is not a commercial reality.
Four patients with hypersensitivity reaction to carboplatin of variable severity, after previous uneventful cisplatin and carboplatin treatment, are described. Skin testing performed in two of the ...patients suggests a cross-reaction with cisplatin but was negative with carboplatin in one of them. The mechanism of hypersensitivity reaction to carboplatin is poorly understood and the issue of retreatment with carboplatin is controversial. Physicians should be aware of the possible hypersensitivity reaction to carboplatin and appropriate precautions should be taken.
Occasional reports have appeared linking hereditary angioedema (HAE) with autoimmune diseases. We have systematically evaluated 157 patients for manifestations of autoimmuniry. Nineteen of these ...patients (12%) had clinical immunoregulatory diseases including glomerulonephritis (five patients), Sjögren's syndrome (three), inflammatory bowel disease (three), thyroiditis (two), systemic lupus erythematosus (one), drug-induced lupus (one), rheumatoid arthritis (one), juvenile rheumatoid arthritis with IgA deficiency (one), incipient pernicious anemia (one), and sicca syndrome (one). All eight patients with HAE who developed an autoimmune disease with a known human histocompatibility antigen association developed a disease associated with their histocompatibility antigen haplotype (p = 0.014). Although only f our patients developed Sjögren's syndrome or sicca syndrome, an additional nine manifested part of the sicca complex. We also found patients with HAE with features suggestive of an immune-based abnormality. These features included idiopathic pancreatitis (three patients), Raynaud's disease (two), partial lipodystrophy (one), chronic chorioretinitis (one), and alopecia universalis (one).
Peripheral blood monocyte receptors for the Fc portion of IgG were quantitatively studied in 43 normal subjects, in 14 patients with warm antibody autoimmune hemolysis (AIHA), and in nine individuals ...with nonantibody-mediated hemolysis. Monocytes of normal females expressed significantly greater numbers of Fc gamma receptors than did similar cells from male subjects, with no difference in affinity for the IgG1 probe. Monocyte Fc gamma receptor number was increased in patients of both sexes with AIHA; a similar, but smaller, increase in monocyte Fc gamma receptor number was noted in patients with nonantibody-mediated hemolysis. Glucocorticoid administration was associated with a dose-dependent decrease in monocyte Fc gamma receptor number in normal volunteers and patients. Possible etiologic mechanisms and pathogenetic consequences of enhanced monocyte Fc gamma binding in AIHA are discussed.
Brickman seeks to investigate the racial subtext of Sigmund Freud's psychoanalysis as it relates to the question of religion by exploring the influence and implications of the colonialist inheritance ...of psychoanalytic thought. Religion and race both figured as indices of primitivity in the evolutionary hypotheses that developed in Europe over the course of the centuries following the Age of Discovery, hypotheses that culminated in 19th-century theories of sociocultural evolutionism.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NMLJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, ZRSKP
The ability of fixed macrophages of the reticuloendothelial system to clear circulating immune complexes was studied in 6 patients with primary sclerosing cholangitis, 5 patients with various other ...forms of chronic liver disease, and 12 normal control subjects. Autologous red cells were radiolabeled with 51Cr and sensitized with anti-Rh(D) immunoglobulin G in vitro. After intravenous infusion of the labeled antibody-coated red cells, the radioactivity content of timed blood specimens was measured. The time required by the reticuloendothelial system to clear one-half the labeled cells from the circulation (t1/2) was then determined. The t1/2 clearance times were significantly prolonged in all 6 patients with primary sclerosing cholangitis, whereas the clearance times in 4 of the 5 liver disease control patients were either normal or shortened. Serum immunoglobulin G and immunoglobulin M immune complex levels did not correlate with t1/2 clearance times. These results suggest that in primary sclerosing cholangitis there is a defect in the ability of fixed macrophages of the reticuloendothelial system to mediate clearance of circulating particles that have been opsonized with immunoglobulin G. This finding further supports recent data that incriminates the immune system in the pathogenesis of primary sclerosing cholangitis.
Over 25 episodes of severe chronic and recurrent mucocutaneous herpes simplex virus infections in five immunodeficient patients were successfully treated with intravenous or oral acyclovir treatment. ...Acyclovir was shown to inhibit viral shedding rapidly, to be well tolerated, and to permit the complete healing of lesions. As expected, a course of acyclovir did not prevent later recurrences of the herpes virus infections. However, symptomatic recurrences were successfully suppressed during long (up to 65-day) courses of oral acyclovir.
Binding of normal human IgG to embryonic rat brain neurons was quantitated by flow cytometry. IgG binding was linear between 0.05 and 1.5 mg/ml; slight binding was detectable even at normal ...cerebrospinal fluid concentrations. Similar binding curves were obtained for purified Fc and F(ab')2 fragments from normal human IgG. Normal human IgG also bound to synaptosomes (resealed nerve terminals) from human cerebral cortex. However, competition assays utilizing 125I-IgG showed no evidence for specific binding. This study indicates that the specificity of putative anti-neuronal antibodies should be confirmed by competition assays as for other receptor-ligand binding.
