To evaluate the evolution of adrenergic baroreflex sensitivity (BRSa) over 2-year follow-up and t... more To evaluate the evolution of adrenergic baroreflex sensitivity (BRSa) over 2-year follow-up and to investigate the effect of baseline BRSa indices on blood pressure values after 2 years in people with multiple sclerosis (pwMS). The following data were analysed at baseline and after 2 years: BRSa measured with BRSa1, α-BRSa and β-BRSa, supine and tilted levels of epinephrine and norepinephrine, supine and tilted systolic and diastolic blood pressure levels. Compared to baseline values, there was no change in α-BRSa (6.96 ± 2.56 vs. 6.64 ± 2.24, p = 0.379) at month 24. α-BRSa at month 24 positively correlated with tilted levels of norepinephrine at month 24 (rp = 0.357, p = 0.005). Univariable linear regression analysis revealed that α-BRSa at baseline predicts the value of tilted systolic and diastolic blood pressure at month 24 (B = 2.724, 95% CI 1.357–4.091, p < 0.001 and B = 1.489, 95% CI 0.459–2.519, p = 0.005). This study provides further evidence for possible role of α-BRSa as a marker of adrenergic hyperactivity in pwMS. These results may explain increased risk for cardiovascular diseases in pwMS.
Kontinuirano uvođenje novih dijagnostickih metoda i novih biomarkera uglavnom podrazumijevaju nov... more Kontinuirano uvođenje novih dijagnostickih metoda i novih biomarkera uglavnom podrazumijevaju nove i složene laboratorijske procese. Otvoreni analiticki sustavi poput elektroforetskih i kromatografskih sustava omogucavaju razvoj novih postupaka te uvođenje novih, klinicki relevantnih biomarkera u razlicita klinicka podrucja. Poznavanje takvih tehnika i fizikalno-kemijskih nacela na kojima se te tehnike temelje osigurava svrhovitost, tj. stvarnu potrtrebu za odgovarajucim strucnjacima.
Introduction: Oxcarbazepine (Trileptal) is a keto-derivative of carbamazepine. It was developed b... more Introduction: Oxcarbazepine (Trileptal) is a keto-derivative of carbamazepine. It was developed by introducing minimal changes in the structure of carbamazepine, which altered the metabolism to avoid the production of epoxide metabolite. Oxcarbazepine is rapidly metabolized to a pharmacologically active monohydroxy metabolite (MDH ; 10-hydroxy-carbazepine, licarbazepine). 10-hydroxy-carbazepine has independent anticonvulsant properties and is mainly responsible for the effect of oxcarbazepine. The aim of this study was to develop and validate a HPLC method for measuring oxcarbazepine and 10-hydroxy-carbazepine simultaneously with other antiepileptics (lamotrigine, carbamazepine, phenobarbitone, phenytoin) which are already in routine use in our laboratory. Materials and Methods: Serum sample (250 _L) pretreatment was based on liquid extraction with ethylacetate/hexane, evaporated and desolved in 200 _L mobile phase. The separation was obtained on reverse-phase column (C18, 250X4, 6 ...
Sve sira primjena propolisa u medicini, kozmetici i industriji hrane zahtijeva nove pristupe u ko... more Sve sira primjena propolisa u medicini, kozmetici i industriji hrane zahtijeva nove pristupe u kontroli kvalitete bilo da se radi o sirovini ili gotovom proizvodu. Propolis je prirodni proizvod koji ima varijabilan sastav ovisan o vise faktora među kojima su i ekoloski cimbenici. Zahtjevi kvalitete okrecu se standardizaciji propolisa u odnosu na određene flavonoide, provjeru oneciscenja i određivanje roka valjanosti. Tekucinska kromatografija visoke djelotvornosti (HPLC) uz photodiode array detector (DAD) omogucuje brzu i jednostavnu kvantifikaciju slijedecih flavonoida: kvercetina, krizina, naringenina, pinocembrina i galangina te identifikaciju oneciscenja, ali i drugih sastavnica propolisa. Metoda omogucuje stabilne i reproducibilne uvjete te koristenje vlastite UV baze podataka ili specijalne HPLC-DAD baze podataka. Identifikacija navedenih flavonoida u analiziranim uzorcima propolisa i gotovim farmaceutskim oblicima koji ga sadrže, provedena je usporedbom s retencijskim vremeno...
Background: The epidemiological incidence of oxalate nephrolithiasis is higher in men than in wom... more Background: The epidemiological incidence of oxalate nephrolithiasis is higher in men than in women. Oxalate is predominantly produced in the liver and then released into the systemic circulation by sat1, a sulfate anion transporter, which is localized in the sinusoidal membrane of hepatocytes, where it mediates exit of oxalate in exchange for sulfate. In renal proximal tubules, sat1 is responsible for basolateral uptake of oxalate into the cell and release of sulfate into systemic circulation. Finally, oxalate is extruded into the urine by the luminal chloride-formate exchanger, CFEX, which also accepts oxalate as a substrate. Methods: The model of ethylene glycol (EG)-induced oxalate nephrolithiasis in adult male and female rats was used to monitor changes in sat1, CFEX, and the rate-limiting enzymes of oxalate synthesis, alcohol dehydrogenase (Adh1) and hydroxy acid oxidase (Hao1). Protein and mRNA expression was studied by immunochemistry and real time RT-PCR. Results: As compar...
Background and Purpose: Anticonvulsant drug phenytoin exhibits non linear pharmacokinetics with l... more Background and Purpose: Anticonvulsant drug phenytoin exhibits non linear pharmacokinetics with large interindividual differences. Phenytoin is a substrate of CYP2C9 and CYP2C19, and the P- glycoprotein encoded by the MDR1 gene. We assessed the polymorphisms of CYP2C9, CYP2C19 and MDR1, and their effects on the phenytoin disposition by evaluating the correlation of phenytoin (PHT) and phenytoin metabolic ratio (PMR) with polymo)phisms of CYP2C9, CYP2C19 and C3435T in the MDR1 gene. Materials and Methods: Sixty-four healthy volunteers were included in the study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were performed for the most frequent alleles: CYP2C9*1, *2, *3, CYP2C19*1*2, *3, and C3435T - MDR1. The 12h-serum concentrations after 300 mg oral dose of phenytoin were used for phenotype analysis. Phenytoin (PHT) and main metabolite (p-HPPH) were analyzed by HPLC. Results: The highest phenytoin serum concentrations (6.52 +/- 0.56 mg/L) were in sub...
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2016
Background/Aims: Postural orthostatic tachycardia syndrome (POTS) is often identified as being cl... more Background/Aims: Postural orthostatic tachycardia syndrome (POTS) is often identified as being clinically underdiagnosed and undertreated, resulting in unnecessary costs and poorer patient outcomes. Method: Through a literature search, the information has been synthesized, supporting the creation of a POTS diagnostic screening tool that can be implemented within the psychiatric outpatient clinic. Results: POTS patients are often referred to psychiatry for the treatment of chronic fatigue and anxiety disorders. Psychiatric professionals are in a position to prescreen for POTS in patients with orthostatic intolerance. Conclusion: A diagnostic prescreening tool helps to identify patients with POTS so they can be referred for proper treatment, improving their functionality and quality of life, and decreasing the healthcare burden.
Archives of Industrial Hygiene and Toxicology, 2009
Genetic Polymorphism of Metabolic Enzymes P450 (CYP) as a Susceptibility Factor for Drug Response... more Genetic Polymorphism of Metabolic Enzymes P450 (CYP) as a Susceptibility Factor for Drug Response, Toxicity, and Cancer RiskThe polymorphic P450 (CYP) enzyme superfamily is the most important system involved in the biotransformation of many endogenous and exogenous substances including drugs, toxins, and carcinogens. Genotyping forCYPpolymorphisms provides important genetic information that help to understand the effects of xenobiotics on human body. For drug metabolism, the most important polymorphisms are those of the genes coding for CYP2C9, CYP2C19, CYP2D6, and CYP3A4/5, which can result in therapeutic failure or severe adverse reactions. Genes coding for CYP1A1, CYP1A2, CYP1B1, and CYP2E1 are among the most responsible for the biotransformation of chemicals, especially for the metabolic activation of pre-carcinogens. There is evidence of association between gene polymorphism and cancer susceptibility. Pathways of carcinogen metabolism are complex, and are mediated by activities...
Clinical Journal of the American Society of Nephrology, 2007
M ycophenolic acid (MPA)-based therapies are widely used in combination with calcineurin inhibito... more M ycophenolic acid (MPA)-based therapies are widely used in combination with calcineurin inhibitors as maintenance immunosuppression for kidney transplant recipients (1). The two MPA therapies used in clinical transplantation are mycophenolate mofetil (MMF [brand name CellCept, Roche Pharmaceuticals, Nutley, NJ]) and mycophenolate sodium (MPS [brand name Myfortic, Norvartis Pharmaceuticals, Nutley, NJ]). MMF has been used for more than a decade and is a prodrug of MPA. The standard dosage of MMF in combination with cyclosporine (CsA) is 1 g given twice daily, although the dosage may be somewhat lower when co-administered with tacrolimus. MPS is an enteric coated form of MPA that was more recently introduced into the clinical arena. A dosage of 720 mg of MPS provides bioequivalence to a dosage of 1000 mg of MMF in kidney transplant patients (2). Immunosuppression afforded by MPA is achieved via reversible and uncompetitive inhibition of inosine monophosphate dehydrogenase (IMPDH), resulting in inhibition of guanine nucleotide biosynthesis (3,4). This consequently leads to suppression of both new DNA synthesis and other pathways that depend on a continuous supply of guanine nucleotide pool, such as T cell surface antigens and other glycosylated membrane proteins (4). Although there has been increased interest to incorporate MPA therapeutic drug monitoring into routine clinical practice (5-9), this has not yet become widespread in the United States for several possible reasons, including (1) lack of availability of US Food and Drug Administration-approved automated simple assays, (2) attainment of low rejection rates using empiric dosing of MMF in many maintenance immunosuppression regimens, (3) the complex pharmacokinetics (PK) of MPA, and (4) absence of overt organ toxicity. Here we discuss and review the pertinent information and study data regarding (1) our current understanding of MPA PK and major factors that can influence MPA clearance, (2) the performance characteristics of MPA analysis methods and prospects for more widespread availability of simple automated methods, (3) results and limitations of clinical outcome studies in renal transplant patients, (4) the status of ongoing prospective trials to evaluate various concentration-control approaches for dosing MMF in renal transplant patients under a variety of contemporary maintenance immunosuppression protocols, and (5) suggested rationale and guidelines for monitoring MPA. Renal and Liver Dysfunction Kidney or liver disease can influence clearance by increasing the free fraction of MPA. Thus in kidney recipients who receive concomitant CsA and have poor renal function in the first days after transplant surgery, there can be a two-to threefold increase in the free fraction (12). It is important to appreciate that
Background The aim of this study was to determine if there is a difference in the frequency of po... more Background The aim of this study was to determine if there is a difference in the frequency of postural orthostatic tachycardia syndrome (POTS) in patients with multiple sclerosis (MS) compared to patients with symptoms of orthostatic intolerance and with no evidence of MS or other neurological illness. Methods We analyzed data gathered from 293 patients who underwent the head-up tilt table test protocol. Group 1 included prospectively analyzed 112 with MS and group 2 included retrospectively analyzed 181 patients who were evaluated because of symptoms of orthostatic intolerance, and with no evidence of MS or other neurological illness. If POTS was identified the head-up tilt table test was repeated and supine as well as standing serum epinephrine and norepinephrine were determined. Results POTS was identified in 39 patients: 21(19%) in the MS group comparing to 18 (10%) in the non MS group (p=0.035). There was no difference between groups in the occurrence of POTS associated syncope (p=0.52). There was no difference between groups in the epinephrine or norepinephrine in supine and standing positions. While both standing epinephrine and norepinephrine levels were significantly higher compared to levels in the supine position in the non MS group, only standing norepinephrine levels were significantly higher in the MS group. Conclusions The results of this study suggest that POTS is associated with MS.
We analyzed children with urolithiasis with age- and gender-matched healthy children. Calcium (mm... more We analyzed children with urolithiasis with age- and gender-matched healthy children. Calcium (mmol/mmol creatinine) and the calcium/citrate ratio (mol/mmol) are the only variables that differentiate children before puberty from healthy children (ROC analysis confirmed only calcium/citrate as a significant variable with cut-off value > 0.84). Peri-pubertal children are distinguished from age- and gender-matched healthy children by the following variables: citrate (mmol/mol creatinine), calcium/citrate (mol/mmol), oxalate/glycosaminoglycans (mmol/g), oxalate/citrate ratios (mmol/mmol) and oxalate/(citrate × glycosaminoglycans) (mol oxalate × mol creatinine)/(mol citrate × g glycosaminoglycans). All variables were confirmed by ROC analysis with cut-off values ≤ 327.87, >1.02, >11.24, >0.12 and >0.03, respectively. These results indicate a different risk of urinary stones development before puberty vs. pubertal/postpubertal children and increasing importance (deficiency)...
To evaluate the evolution of adrenergic baroreflex sensitivity (BRSa) over 2-year follow-up and t... more To evaluate the evolution of adrenergic baroreflex sensitivity (BRSa) over 2-year follow-up and to investigate the effect of baseline BRSa indices on blood pressure values after 2 years in people with multiple sclerosis (pwMS). The following data were analysed at baseline and after 2 years: BRSa measured with BRSa1, α-BRSa and β-BRSa, supine and tilted levels of epinephrine and norepinephrine, supine and tilted systolic and diastolic blood pressure levels. Compared to baseline values, there was no change in α-BRSa (6.96 ± 2.56 vs. 6.64 ± 2.24, p = 0.379) at month 24. α-BRSa at month 24 positively correlated with tilted levels of norepinephrine at month 24 (rp = 0.357, p = 0.005). Univariable linear regression analysis revealed that α-BRSa at baseline predicts the value of tilted systolic and diastolic blood pressure at month 24 (B = 2.724, 95% CI 1.357–4.091, p < 0.001 and B = 1.489, 95% CI 0.459–2.519, p = 0.005). This study provides further evidence for possible role of α-BRSa as a marker of adrenergic hyperactivity in pwMS. These results may explain increased risk for cardiovascular diseases in pwMS.
Kontinuirano uvođenje novih dijagnostickih metoda i novih biomarkera uglavnom podrazumijevaju nov... more Kontinuirano uvođenje novih dijagnostickih metoda i novih biomarkera uglavnom podrazumijevaju nove i složene laboratorijske procese. Otvoreni analiticki sustavi poput elektroforetskih i kromatografskih sustava omogucavaju razvoj novih postupaka te uvođenje novih, klinicki relevantnih biomarkera u razlicita klinicka podrucja. Poznavanje takvih tehnika i fizikalno-kemijskih nacela na kojima se te tehnike temelje osigurava svrhovitost, tj. stvarnu potrtrebu za odgovarajucim strucnjacima.
Introduction: Oxcarbazepine (Trileptal) is a keto-derivative of carbamazepine. It was developed b... more Introduction: Oxcarbazepine (Trileptal) is a keto-derivative of carbamazepine. It was developed by introducing minimal changes in the structure of carbamazepine, which altered the metabolism to avoid the production of epoxide metabolite. Oxcarbazepine is rapidly metabolized to a pharmacologically active monohydroxy metabolite (MDH ; 10-hydroxy-carbazepine, licarbazepine). 10-hydroxy-carbazepine has independent anticonvulsant properties and is mainly responsible for the effect of oxcarbazepine. The aim of this study was to develop and validate a HPLC method for measuring oxcarbazepine and 10-hydroxy-carbazepine simultaneously with other antiepileptics (lamotrigine, carbamazepine, phenobarbitone, phenytoin) which are already in routine use in our laboratory. Materials and Methods: Serum sample (250 _L) pretreatment was based on liquid extraction with ethylacetate/hexane, evaporated and desolved in 200 _L mobile phase. The separation was obtained on reverse-phase column (C18, 250X4, 6 ...
Sve sira primjena propolisa u medicini, kozmetici i industriji hrane zahtijeva nove pristupe u ko... more Sve sira primjena propolisa u medicini, kozmetici i industriji hrane zahtijeva nove pristupe u kontroli kvalitete bilo da se radi o sirovini ili gotovom proizvodu. Propolis je prirodni proizvod koji ima varijabilan sastav ovisan o vise faktora među kojima su i ekoloski cimbenici. Zahtjevi kvalitete okrecu se standardizaciji propolisa u odnosu na određene flavonoide, provjeru oneciscenja i određivanje roka valjanosti. Tekucinska kromatografija visoke djelotvornosti (HPLC) uz photodiode array detector (DAD) omogucuje brzu i jednostavnu kvantifikaciju slijedecih flavonoida: kvercetina, krizina, naringenina, pinocembrina i galangina te identifikaciju oneciscenja, ali i drugih sastavnica propolisa. Metoda omogucuje stabilne i reproducibilne uvjete te koristenje vlastite UV baze podataka ili specijalne HPLC-DAD baze podataka. Identifikacija navedenih flavonoida u analiziranim uzorcima propolisa i gotovim farmaceutskim oblicima koji ga sadrže, provedena je usporedbom s retencijskim vremeno...
Background: The epidemiological incidence of oxalate nephrolithiasis is higher in men than in wom... more Background: The epidemiological incidence of oxalate nephrolithiasis is higher in men than in women. Oxalate is predominantly produced in the liver and then released into the systemic circulation by sat1, a sulfate anion transporter, which is localized in the sinusoidal membrane of hepatocytes, where it mediates exit of oxalate in exchange for sulfate. In renal proximal tubules, sat1 is responsible for basolateral uptake of oxalate into the cell and release of sulfate into systemic circulation. Finally, oxalate is extruded into the urine by the luminal chloride-formate exchanger, CFEX, which also accepts oxalate as a substrate. Methods: The model of ethylene glycol (EG)-induced oxalate nephrolithiasis in adult male and female rats was used to monitor changes in sat1, CFEX, and the rate-limiting enzymes of oxalate synthesis, alcohol dehydrogenase (Adh1) and hydroxy acid oxidase (Hao1). Protein and mRNA expression was studied by immunochemistry and real time RT-PCR. Results: As compar...
Background and Purpose: Anticonvulsant drug phenytoin exhibits non linear pharmacokinetics with l... more Background and Purpose: Anticonvulsant drug phenytoin exhibits non linear pharmacokinetics with large interindividual differences. Phenytoin is a substrate of CYP2C9 and CYP2C19, and the P- glycoprotein encoded by the MDR1 gene. We assessed the polymorphisms of CYP2C9, CYP2C19 and MDR1, and their effects on the phenytoin disposition by evaluating the correlation of phenytoin (PHT) and phenytoin metabolic ratio (PMR) with polymo)phisms of CYP2C9, CYP2C19 and C3435T in the MDR1 gene. Materials and Methods: Sixty-four healthy volunteers were included in the study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were performed for the most frequent alleles: CYP2C9*1, *2, *3, CYP2C19*1*2, *3, and C3435T - MDR1. The 12h-serum concentrations after 300 mg oral dose of phenytoin were used for phenotype analysis. Phenytoin (PHT) and main metabolite (p-HPPH) were analyzed by HPLC. Results: The highest phenytoin serum concentrations (6.52 +/- 0.56 mg/L) were in sub...
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2016
Background/Aims: Postural orthostatic tachycardia syndrome (POTS) is often identified as being cl... more Background/Aims: Postural orthostatic tachycardia syndrome (POTS) is often identified as being clinically underdiagnosed and undertreated, resulting in unnecessary costs and poorer patient outcomes. Method: Through a literature search, the information has been synthesized, supporting the creation of a POTS diagnostic screening tool that can be implemented within the psychiatric outpatient clinic. Results: POTS patients are often referred to psychiatry for the treatment of chronic fatigue and anxiety disorders. Psychiatric professionals are in a position to prescreen for POTS in patients with orthostatic intolerance. Conclusion: A diagnostic prescreening tool helps to identify patients with POTS so they can be referred for proper treatment, improving their functionality and quality of life, and decreasing the healthcare burden.
Archives of Industrial Hygiene and Toxicology, 2009
Genetic Polymorphism of Metabolic Enzymes P450 (CYP) as a Susceptibility Factor for Drug Response... more Genetic Polymorphism of Metabolic Enzymes P450 (CYP) as a Susceptibility Factor for Drug Response, Toxicity, and Cancer RiskThe polymorphic P450 (CYP) enzyme superfamily is the most important system involved in the biotransformation of many endogenous and exogenous substances including drugs, toxins, and carcinogens. Genotyping forCYPpolymorphisms provides important genetic information that help to understand the effects of xenobiotics on human body. For drug metabolism, the most important polymorphisms are those of the genes coding for CYP2C9, CYP2C19, CYP2D6, and CYP3A4/5, which can result in therapeutic failure or severe adverse reactions. Genes coding for CYP1A1, CYP1A2, CYP1B1, and CYP2E1 are among the most responsible for the biotransformation of chemicals, especially for the metabolic activation of pre-carcinogens. There is evidence of association between gene polymorphism and cancer susceptibility. Pathways of carcinogen metabolism are complex, and are mediated by activities...
Clinical Journal of the American Society of Nephrology, 2007
M ycophenolic acid (MPA)-based therapies are widely used in combination with calcineurin inhibito... more M ycophenolic acid (MPA)-based therapies are widely used in combination with calcineurin inhibitors as maintenance immunosuppression for kidney transplant recipients (1). The two MPA therapies used in clinical transplantation are mycophenolate mofetil (MMF [brand name CellCept, Roche Pharmaceuticals, Nutley, NJ]) and mycophenolate sodium (MPS [brand name Myfortic, Norvartis Pharmaceuticals, Nutley, NJ]). MMF has been used for more than a decade and is a prodrug of MPA. The standard dosage of MMF in combination with cyclosporine (CsA) is 1 g given twice daily, although the dosage may be somewhat lower when co-administered with tacrolimus. MPS is an enteric coated form of MPA that was more recently introduced into the clinical arena. A dosage of 720 mg of MPS provides bioequivalence to a dosage of 1000 mg of MMF in kidney transplant patients (2). Immunosuppression afforded by MPA is achieved via reversible and uncompetitive inhibition of inosine monophosphate dehydrogenase (IMPDH), resulting in inhibition of guanine nucleotide biosynthesis (3,4). This consequently leads to suppression of both new DNA synthesis and other pathways that depend on a continuous supply of guanine nucleotide pool, such as T cell surface antigens and other glycosylated membrane proteins (4). Although there has been increased interest to incorporate MPA therapeutic drug monitoring into routine clinical practice (5-9), this has not yet become widespread in the United States for several possible reasons, including (1) lack of availability of US Food and Drug Administration-approved automated simple assays, (2) attainment of low rejection rates using empiric dosing of MMF in many maintenance immunosuppression regimens, (3) the complex pharmacokinetics (PK) of MPA, and (4) absence of overt organ toxicity. Here we discuss and review the pertinent information and study data regarding (1) our current understanding of MPA PK and major factors that can influence MPA clearance, (2) the performance characteristics of MPA analysis methods and prospects for more widespread availability of simple automated methods, (3) results and limitations of clinical outcome studies in renal transplant patients, (4) the status of ongoing prospective trials to evaluate various concentration-control approaches for dosing MMF in renal transplant patients under a variety of contemporary maintenance immunosuppression protocols, and (5) suggested rationale and guidelines for monitoring MPA. Renal and Liver Dysfunction Kidney or liver disease can influence clearance by increasing the free fraction of MPA. Thus in kidney recipients who receive concomitant CsA and have poor renal function in the first days after transplant surgery, there can be a two-to threefold increase in the free fraction (12). It is important to appreciate that
Background The aim of this study was to determine if there is a difference in the frequency of po... more Background The aim of this study was to determine if there is a difference in the frequency of postural orthostatic tachycardia syndrome (POTS) in patients with multiple sclerosis (MS) compared to patients with symptoms of orthostatic intolerance and with no evidence of MS or other neurological illness. Methods We analyzed data gathered from 293 patients who underwent the head-up tilt table test protocol. Group 1 included prospectively analyzed 112 with MS and group 2 included retrospectively analyzed 181 patients who were evaluated because of symptoms of orthostatic intolerance, and with no evidence of MS or other neurological illness. If POTS was identified the head-up tilt table test was repeated and supine as well as standing serum epinephrine and norepinephrine were determined. Results POTS was identified in 39 patients: 21(19%) in the MS group comparing to 18 (10%) in the non MS group (p=0.035). There was no difference between groups in the occurrence of POTS associated syncope (p=0.52). There was no difference between groups in the epinephrine or norepinephrine in supine and standing positions. While both standing epinephrine and norepinephrine levels were significantly higher compared to levels in the supine position in the non MS group, only standing norepinephrine levels were significantly higher in the MS group. Conclusions The results of this study suggest that POTS is associated with MS.
We analyzed children with urolithiasis with age- and gender-matched healthy children. Calcium (mm... more We analyzed children with urolithiasis with age- and gender-matched healthy children. Calcium (mmol/mmol creatinine) and the calcium/citrate ratio (mol/mmol) are the only variables that differentiate children before puberty from healthy children (ROC analysis confirmed only calcium/citrate as a significant variable with cut-off value > 0.84). Peri-pubertal children are distinguished from age- and gender-matched healthy children by the following variables: citrate (mmol/mol creatinine), calcium/citrate (mol/mmol), oxalate/glycosaminoglycans (mmol/g), oxalate/citrate ratios (mmol/mmol) and oxalate/(citrate × glycosaminoglycans) (mol oxalate × mol creatinine)/(mol citrate × g glycosaminoglycans). All variables were confirmed by ROC analysis with cut-off values ≤ 327.87, >1.02, >11.24, >0.12 and >0.03, respectively. These results indicate a different risk of urinary stones development before puberty vs. pubertal/postpubertal children and increasing importance (deficiency)...
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