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Sikiric P, Kokot A, Kralj T, Zlatar M, Masnec S, Lazic R, Loncaric K, Oroz K, Sablic M, Boljesic M, Antunovic M, Sikiric S, Strbe S, Stambolija V, Beketic Oreskovic L, Kavelj I, Novosel L, Zubcic S, Krezic I, Skrtic A, Jurjevic I, Boban Blagaic A, Seiwerth S, Staresinic M. Stable Gastric Pentadecapeptide BPC 157-Possible Novel Therapy of Glaucoma and Other Ocular Conditions. Pharmaceuticals (Basel) 2023; 16:1052. [PMID: 37513963 PMCID: PMC10385428 DOI: 10.3390/ph16071052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/01/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Recently, stable gastric pentadecapeptide BPC 157 therapy by activation of collateral pathways counteracted various occlusion/occlusion-like syndromes, vascular, and multiorgan failure, and blood pressure disturbances in rats with permanent major vessel occlusion and similar procedures disabling endothelium function. Thereby, we revealed BPC 157 cytoprotective therapy with strong vascular rescuing capabilities in glaucoma therapy. With these capabilities, BPC 157 therapy can recover glaucomatous rats, normalize intraocular pressure, maintain retinal integrity, recover pupil function, recover retinal ischemia, and corneal injuries (i.e., maintained transparency after complete corneal abrasion, corneal ulceration, and counteracted dry eye after lacrimal gland removal or corneal insensitivity). The most important point is that in glaucomatous rats (three of four episcleral veins cauterized) with high intraocular pressure, all BPC 157 regimens immediately normalized intraocular pressure. BPC 157-treated rats exhibited normal pupil diameter, microscopically well-preserved ganglion cells and optic nerve presentation, normal fundus presentation, nor- mal retinal and choroidal blood vessel presentation, and normal optic nerve presentation. The one episcleral vein rapidly upgraded to accomplish all functions in glaucomatous rats may correspond with occlusion/occlusion-like syndromes of the activated rescuing collateral pathway (azygos vein direct blood flow delivery). Normalized intraocular pressure in glaucomatous rats corresponded to the counteracted intra-cranial (superior sagittal sinus), portal, and caval hypertension, and aortal hypotension in occlusion/occlusion-like syndromes, were all attenuated/eliminated by BPC 157 therapy. Furthermore, given in other eye disturbances (i.e., retinal ischemia), BPC 157 instantly breaks a noxious chain of events, both at an early stage and an already advanced stage. Thus, we further advocate BPC 157 as a therapeutic agent in ocular disease.
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Affiliation(s)
- Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Antonio Kokot
- Department of Anatomy and Neuroscience, Faculty of Medicine, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Tamara Kralj
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Mirna Zlatar
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Sanja Masnec
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ratimir Lazic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Kristina Loncaric
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Katarina Oroz
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Sablic
- Department of Anatomy and Neuroscience, Faculty of Medicine, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Marta Boljesic
- Department of Anatomy and Neuroscience, Faculty of Medicine, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Marko Antunovic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Suncana Sikiric
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Sanja Strbe
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Vasilije Stambolija
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | | | - Ivana Kavelj
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Luka Novosel
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Slavica Zubcic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivan Krezic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Anita Skrtic
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivana Jurjevic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Alenka Boban Blagaic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Mario Staresinic
- Department of Surgery, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Gamulin O, Oroz K, Coric L, Krajacic M, Skrabic M, Dretar V, Strbe S, Talapko J, Juzbasic M, Krezic I, Lozic M, Stambolija V, Zizek H, Jurca I, Jurjevic I, Blagaic AB, Skrtic A, Seiwerth S, Sikiric P. Fourier Transform Infrared Spectroscopy Reveals Molecular Changes in Blood Vessels of Rats Treated with Pentadecapeptide BPC 157. Biomedicines 2022; 10:biomedicines10123130. [PMID: 36551886 PMCID: PMC9775416 DOI: 10.3390/biomedicines10123130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Recently, it was found that when confronted with major vessel occlusion and vascular failure, stable gastric pentadecapeptide BPC 157 therapy might rapidly functionally improve minor vessels to take over the function of disabled major vessels, reorganize blood flow, and compensate failed vessel function. We focused on the BPC 157 therapy effect obtained by giving 10 ng/kg ip to rats 5 min before sacrifice on the rat thoracic aorta, which we assessed with Fourier transform infrared spectroscopy (FTIR) 90 min thereafter. We applied a principal component analysis (PCA). The PCA model showed, with a clear distinction being mostly due to the PC1 score, differences between the spectra of BPC 157- and saline-treated rats. The comparison of the averaged spectra of these two groups with their differential spectrum and PC loadings allowed us to identify the parts of the FTIR spectra that contributed the most to the spectral separation of the two observed groups. The PC1 loadings and the differential spectrum showed that the main bands affecting the separation were the amid I band around 1650 cm-1, the amid II band around 1540 cm-1, and the vibrational band around 1744 cm-1. Fitting the spectral range between 1450 and 1800 cm-1 showed changes in protein conformation and confirmed the appearance of the vibrational band at 1744 cm-1. Controls had a substantially more intense vibrational band at 1744 cm-1. These spectral results showed the cells from saline-treated (control) rats to be in the early stage of cell death, while the samples from BPC 157-rats were protected. Thus, BPC 157 therapy changed the lipid contents and protein secondary structure conformation, with a rapid effect on vessels, within a short time upon application.
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Affiliation(s)
- Ozren Gamulin
- Department of Physics and Biophysics, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Katarina Oroz
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Luka Coric
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Maria Krajacic
- Department of Physics and Biophysics, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marko Skrabic
- Department of Physics and Biophysics, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Vilim Dretar
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Sanja Strbe
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Jasminka Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Martina Juzbasic
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Ivan Krezic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marin Lozic
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Anesthesiology, Resuscitation and Intensive Care, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Vasilije Stambolija
- Department of Anesthesiology, Resuscitation and Intensive Care, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Helena Zizek
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivana Jurca
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivana Jurjevic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Alenka Boban Blagaic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Anita Skrtic
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Correspondence: (A.S.); (P.S.); Tel.: +385-1-4566-980 (A.S.); +385-1-4566-833 (P.S.); Fax: +385-1-4920-050 (A.S. & P.S.)
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Correspondence: (A.S.); (P.S.); Tel.: +385-1-4566-980 (A.S.); +385-1-4566-833 (P.S.); Fax: +385-1-4920-050 (A.S. & P.S.)
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Špiljak B, Brailo V, Janković B, Gabrić D, Lozić M, Stambolija V, Vidović Juras D, Karlović Z, Verzak Ž. Satisfaction of Parents and Caregivers with Dental Treatment of Children Under General Anesthesia in a Day Care Surgery Setting. Acta Stomatol Croat 2022; 56:376-386. [PMID: 36713271 PMCID: PMC9873004 DOI: 10.15644/asc56/4/4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/09/2022] [Indexed: 12/29/2022] Open
Abstract
Objective The aim of this study was to examine the satisfaction of parents and caregivers of patients who underwent dental treatment in general anesthesia (GA) in a day-care surgery setting. Material and Methods Anonymous questionnaire was sent to parents/caregivers of patients who underwent full mouth restoration in GA. The survey consisted of 4 parts: general data, data about procedure, satisfaction with various aspects of care and the perception of parents/caregivers about the condition of their child in relation to the time before dental treatment in GA. Results 66 parents/caregivers (30.5%) responded to the questionnaire. Overall satisfaction with the treatment was high (4.69). Respondents expressed the highest degree of satisfaction with communication with nurses (4.92), and the lowest with the waiting time for the procedure (3.89). Parents/caregivers of patients who reported difficulty eating expressed significantly lower overall satisfaction than the subjects whose children did not report difficulty eating. Also, the more treatments the patients underwent, the lower was the overall satisfaction than of those subjects whose children were never treated in such a manner before. Conclusions Since patient satisfaction has a beneficial impact on treatment outcome and adherence to preventive recommendations, all health care providers should strive to achieve it.
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Affiliation(s)
- Bruno Špiljak
- 6th year student, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Vlaho Brailo
- Department of Oral Medicine, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Bernard Janković
- Department of Endodontics and Restorative Dentistry, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Dragana Gabrić
- Department of Oral Surgery, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Marin Lozić
- Clinic for Anesthesiology, Reanimatology and Intensive Care, University Clinical Hospital Zagreb, Zagreb, Croatia
| | - Vasilije Stambolija
- Clinic for Anesthesiology, Reanimatology and Intensive Care, University Clinical Hospital Zagreb, Zagreb, Croatia
| | - Danica Vidović Juras
- Department of Oral Medicine, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Zoran Karlović
- Department of Endodontics and Restorative Dentistry, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Željko Verzak
- Department of Pediatric Dentistry, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
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Zemba Cilic A, Zemba M, Cilic M, Strbe S, Ilic S, Vukojevic J, Zoricic Z, Filipcic I, Kokot A, Smoday IM, Rukavina I, Boban Blagaic A, Tvrdeic A, Duplancic B, Stambolija V, Marcinko D, Skrtic A, Seiwerth S, Sikiric P. BPC 157, L-NAME, L-Arginine, NO-Relation, in the Suited Rat Ketamine Models Resembling “Negative-Like” Symptoms of Schizophrenia. Biomedicines 2022; 10:biomedicines10071462. [PMID: 35884767 PMCID: PMC9313087 DOI: 10.3390/biomedicines10071462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/13/2022] [Accepted: 06/19/2022] [Indexed: 12/30/2022] Open
Abstract
We attempted throughout the NO-system to achieve the particular counteraction of the ketamine-induced resembling “negative-like” schizophrenia symptoms in rats using pentadecapeptide BPC 157, and NO-agents, NG-nitro-L-arginine methylester (L-NAME), and/or L-arginine, triple application. This might be the find out the NO-system organized therapy (i.e., simultaneously implied NO-system blockade (L-NAME) vs. NO-system over-stimulation (L-arginine) vs. NO-system immobilization (L-NAME+L-arginine)). The ketamine regimen (intraperitoneally/kg) included: 3 mg (cognitive dysfunction, novel object recognition test), 30 mg (anxiogenic effect (open field test) and anhedonia (sucrose test)), and 8 mg/3 days (social withdrawal). Medication (mg/kg intraperitoneally) was L-NAME (5), L-arginine (100), and BPC 157 (0.01), alone and/or together, given immediately before ketamine (L-NAME, L-arginine, and combination) or given immediately after (BPC 157 and combinations). BPC 157 counteracted ketamine-cognition dysfunction, social withdrawal, and anhedonia, and exerted additional anxiolytic effect. L-NAME (antagonization, social withdrawal) and L-arginine (antagonization, cognitive dysfunction, anhedonia) both included worsening cognitive dysfunction, anhedonia, and anxiogenic effect (L-NAME), social withdrawal, and anxiogenic effect (L-arginine). Thus, ketamine-induced resembling “negative-like” schizophrenia symptoms were “L-NAME non-responsive, L-arginine responsive” (cognition dysfunction), “L-NAME responsive, L-arginine non-responsive” (social withdrawal), “L-NAME responsive, L-arginine responsive, opposite effect” (anhedonia) and “L-NAME responsive, L-arginine responsive, parallel effect” (both anxiogening). In cognition dysfunction, BPC 157 overwhelmed NO-agents effects. The mRNA expression studies in brain tissue evidenced considerable overlapping of gene overexpression in healthy rats treated with ketamine or BPC 157. With the BPC 157 therapy applied immediately after ketamine, the effect on Nos1, Nos2, Plcg1, Prkcg, and Ptgs2 (increased or decreased expression), appeared as a timely specific BPC 157 effect on ketamine-specific targets.
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Affiliation(s)
- Andrea Zemba Cilic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
| | - Mladen Zemba
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
| | - Matija Cilic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
| | - Sanja Strbe
- Department of Psychiatry, University of Zagreb School of Medicine, University Clinical Centre Zagreb, 10000 Zagreb, Croatia; (S.S.); (I.F.); (D.M.)
| | - Spomenko Ilic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
| | - Jaksa Vukojevic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
| | - Zoran Zoricic
- University Department of Psychiatry, University Hospital Sestre Milosrdnice, 10000 Zagreb, Croatia;
| | - Igor Filipcic
- Department of Psychiatry, University of Zagreb School of Medicine, University Clinical Centre Zagreb, 10000 Zagreb, Croatia; (S.S.); (I.F.); (D.M.)
| | - Antonio Kokot
- Department of Anatomy and Neuroscience, Faculty of Medicine, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Ivan Maria Smoday
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
| | - Iva Rukavina
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
| | - Alenka Boban Blagaic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
| | - Ante Tvrdeic
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
| | | | - Vasilije Stambolija
- Department of Anesthesiology, Resuscitation and Intensive Care, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Darko Marcinko
- Department of Psychiatry, University of Zagreb School of Medicine, University Clinical Centre Zagreb, 10000 Zagreb, Croatia; (S.S.); (I.F.); (D.M.)
| | - Anita Skrtic
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Correspondence: (A.S.); (P.S.); Tel.: +385-1-4566-980 (A.S.); +385-1-4566-833 (P.S.); Fax: +385-1-4920-050 (A.S. & P.S.)
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (A.Z.C.); (M.Z.); (M.C.); (S.I.); (J.V.); (I.M.S.); (I.R.); (A.B.B.); (A.T.)
- Correspondence: (A.S.); (P.S.); Tel.: +385-1-4566-980 (A.S.); +385-1-4566-833 (P.S.); Fax: +385-1-4920-050 (A.S. & P.S.)
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5
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Brailo V, Janković B, Gabrić D, Lozić M, Stambolija V, Vidović Juras D, Verzak Ž. Post-Discharge Complications of Dental Treatment in General Anesthesia Performed in a Day-Care Service. Acta Stomatol Croat 2021; 55:168-176. [PMID: 34248150 PMCID: PMC8255043 DOI: 10.15644/asc55/2/6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/21/2021] [Indexed: 11/13/2022] Open
Abstract
Objective To review the frequency and management of post-discharge complications in patients who underwent dental treatment in general anesthesia (GA) in a day-care surgery setting and identify the factors that increase the risk for these complications. Material and methods Anonymous questionnaire was sent to parents/caregivers of patients who underwent full mouth restoration in GA at our institution between 1st January 2017 and 31st July 2019. Demographic and clinical data of patients as well as the data about the occurrence and management of complications were collected. Results Sixty-six parents/caregivers (30.5%) responded to the questionnaire. Most frequent complications were drowsiness and pain in 40(60.6%) patients. Complications were managed by parents or caregivers with conservative measures at home in 57(91.9%) cases. Phone consultation with dentist was required in 5(8.1%) cases. One patient (1.6%) was readmitted. Younger age and diagnosis were associated with increased risk for drowsiness. Conclusion Post discharge complications of dental treatment in GA in a day-care service are common and they can be managed by parent/caregiver with conservative measures at home. The rate of readmission is low. Dental treatment in GA in a day-care service is a safe procedure that can be performed with acceptable risk in carefully selected patients.
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Affiliation(s)
- Vlaho Brailo
- Department of Oral Medicine, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Bernard Janković
- Department of Endodontics and Restorative Dentistry, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Dragana Gabrić
- Department of Oral Surgery, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Marin Lozić
- Clinic for Anesthesiology, Reanimatology and Intensive Care, University Clinical Hospital Zagreb, Zagreb, Croatia
| | - Vasilije Stambolija
- Clinic for Anesthesiology, Reanimatology and Intensive Care, University Clinical Hospital Zagreb, Zagreb, Croatia
| | - Danica Vidović Juras
- Department of Oral Medicine, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Željko Verzak
- Department of Pediatric Dentistry, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
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Mirković I, Kralj T, Lozić M, Stambolija V, Kovačević J, Vrdoljak L, Zlatar M, Milanović K, Drmić D, Predović J, Masnec S, Jurjević M, Bušić M, Seiwerth S, Kokot A, Sikirić P. Pentadecapeptide BPC 157 shortens duration of tetracaine- and oxybuprocaine-induced corneal anesthesia in rats. Acta Clin Croat 2020; 59:394-406. [PMID: 34177048 PMCID: PMC8212645 DOI: 10.20471/acc.2020.59.03.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We focused on the relationship of 0.5% tetracaine- and 0.4% oxybuprocaine-induced corneal anesthesia in rats, and pentadecapeptide BPC 157 (0.4 µg/eye), along with nitric oxide synthase (NOS) inhibitor N(gamma)-nitro-L-arginine methyl ester (L-NAME) (0.1 mg/eye) and/or NOS substrate L-arginine (2 mg/eye), applied in the form of eye drops. We assessed corneal sensitivity recovery (Cochet-Bonnet esthesiometer), corneal lesion elimination (staining with 10% fluorescein) and decrease in tear volume (Schirmer test). BPC 157 administration had a full counteracting effect. Recovery also occurred in the presence of NOS blockade and NOS substrate application. L-arginine eventually shortened duration of corneal insensitivity and exerted corneal lesion counteraction (and counteraction of tetracaine-induced decrease of tear volume) only in earlier but not in later period. L-NAME application led to longer duration of corneal insensitivity, increase in corneal lesions and decrease in tear volume. When L-NAME and L-arginine were applied together, they antagonized each other’s effect. These distinctions may indicate particular NOS involvement (corneal insensitivity vs. corneal lesion along with tear production), distinctively affected by the administration of NO agents. However, additional BPC 157 co-administration would re-establish counteraction over topical ophthalmic anesthetic-induced effect, be it in its early or late course. We suggest BPC 157 as an antidote to topical ophthalmic anesthetics.
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Affiliation(s)
| | - Tamara Kralj
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Marin Lozić
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Vasilije Stambolija
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Josip Kovačević
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Luka Vrdoljak
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Mirna Zlatar
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Kristina Milanović
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Domagoj Drmić
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Jurica Predović
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Sanja Masnec
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Matija Jurjević
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Mladen Bušić
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Sven Seiwerth
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Antonio Kokot
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Predrag Sikirić
- 1Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia; 2Department of Anatomy and Neuroscience, Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department of Ophthalmology, Sveti Duh University Hospital, Zagreb, Croatia; 4Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
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Lozic M, Stambolija V, Kovacevic J, Zivanovic‐Posilovic G, Suran J, Duplancic B, Mirkovic I, Kokot A, Drmic D, Seiwerth S, Sikiric P. Stable Gastric Pentadecapeptide BPC 157 Antagonized Local Anesthetic Effect of Lidocaine. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.822.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marin Lozic
- PaharmacologySchool of Medicine, University of ZagrebZagrebCroatia
| | | | - Josip Kovacevic
- PaharmacologySchool of Medicine, University of ZagrebZagrebCroatia
| | | | - Jelena Suran
- PaharmacologySchool of Medicine, University of ZagrebZagrebCroatia
| | | | - Ivan Mirkovic
- PaharmacologySchool of Medicine, University of ZagrebZagrebCroatia
| | - Antonio Kokot
- PaharmacologySchool of Medicine, University of ZagrebZagrebCroatia
| | - Domagoj Drmic
- PaharmacologySchool of Medicine, University of ZagrebZagrebCroatia
| | - Sven Seiwerth
- PathologySchool of Medicine, University of ZagrebZagrebCroatia
| | - Predrag Sikiric
- PaharmacologySchool of Medicine, University of ZagrebZagrebCroatia
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Brailo V, Janković B, Lozić M, Gabrić D, Kuna T, Stambolija V, Verzak Ž. Dental Treatment Under General Anesthesia in a Day Care Surgery Setting. Acta Stomatol Croat 2019; 53:64-71. [PMID: 31118534 PMCID: PMC6508932 DOI: 10.15644/asc53/1/7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective To analyze data on full-mouth rehabilitation under general anesthesia (GA) performed at the University Clinical Hospital Zagreb with emphasis on patient characteristics, type of procedure and postoperative complications. Materials and methods Retrospective chart review of 100 patients treated under GA at the Dental clinic’s day care surgery. Patient’s demographic (sex, age) and clinical data (diagnosis, GA technique, intubation type, procedure duration, number of carious teeth, presence of visible calculus, number of sealed teeth, fillings, extractions and endodontic treatments, discharge time, postoperative complications) were registered. Results Eighty patients were treated under GA because of noncompliance due to different reasons and twenty patients because of either their poor physical condition or extensive dental procedure. Median DMFT per patient was 9(0-21). Eighty nine patients underwent full-mouth dental restoration and 11 patients underwent other types of procedures. Ninety-six patients were safely discharged the same day. Four patients experienced postoperative complications and three of them were hospitalized for another 24-48 hours for postoperative follow-up. Conclusion Patients with physical and/or intellectual disabilities have higher caries activity and increased dental treatment needs compared to the general population. Dental treatment under GA in day care service is a safe and effective way of providing dental care for noncompliant patients.
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Affiliation(s)
- Vlaho Brailo
- Department of Oral Medicine, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Bernard Janković
- Department of Endodontics and Restorative Dentistry, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Marin Lozić
- Clinic for Anesthesiology, Reanimatology and Intensive Care, University Clinical Hospital Zagreb, Zagreb, Croatia
| | - Dragana Gabrić
- Department of Oral Surgery, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Tihomir Kuna
- Department of Oral Surgery, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
| | - Vasilije Stambolija
- Clinic for Anesthesiology, Reanimatology and Intensive Care, University Clinical Hospital Zagreb, Zagreb, Croatia
| | - Željko Verzak
- Department of Pediatric Dentistry, Dental Clinic, University Clinical Hospital Zagreb/University of Zagreb, School of Dental Medicine, Zagreb, Croatia
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Stambolija V, Bublic MM, Lozic M, Paladino J, Šcap M. Etomidate in neuroanesthesia for aneurysmal clipping in child with confirmed allergies to general anesthetics. Surg Neurol Int 2018; 9:200. [PMID: 30386670 PMCID: PMC6194727 DOI: 10.4103/sni.sni_159_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/28/2018] [Indexed: 12/02/2022] Open
Abstract
Background: Etomidate may be given in continuous infusion for maintenance of general anesthesia, although that practice is rarely seen due to beliefs that it has possibility of interfering with cortisol synthesis. However, etomidate is sometimes preferable choice as it has least influence on hemodynamics and rarely causes allergic reactions. Case Description: We describe a case of 13-year-old boy with aneurysm of left middle cerebral artery, planned for aneurysmal clipping, and previously treated for ruptured aneurysm of right middle cerebral artery. As he was tested and proved allergic to most of the anesthetic drugs, and stable hemodynamic conditions were of most importance during planned neurosurgery, general anesthesia was maintained with etomidate infusion. He was prepared with metilprednisolon, antihistaminic, and ranitidine before the surgery. Cortisol and adrenocorticotropic hormone levels were measured on three consecutive postoperative days. Only cortisol value, in the morning the day after the surgery, was below reference range, with the values back to normal until that evening. He was dismissed from the intensive care unit with Glasgow Coma Score 15. Conclusion: Etomidate may be a choice for neuroanesthesia in specific group of people. We have good experience with our algorithm for continuous infusion of etomidate, with serum cortisol values in the reference range, if corticosteroids were not given before the surgery. Administration of metilprednisolon may diminish influence of perioperative stress on cortisol synthesis inhibition.
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Affiliation(s)
- Vasilije Stambolija
- Department of Anesthesiology, Reanimatology and Intensive Care, Division of Neuroanesthesia, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Martina Miklic Bublic
- Department of Anesthesiology, Reanimatology and Intensive Care, Division of Neuroanesthesia, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Marin Lozic
- Department of Anesthesiology, Reanimatology and Intensive Care, Division of Neuroanesthesia, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Josip Paladino
- Department of Neurosurgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Miroslav Šcap
- Department of Anesthesiology, Reanimatology and Intensive Care, Division of Neuroanesthesia, University Hospital Centre Zagreb, Zagreb, Croatia
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Mrak G, Nemir J, Brgic K, Baric H, Paladino J, Stambolija V. Cerebral Bypass Surgery for Internal Carotid Artery Occlusion, Complex Supraclinoid Carotid Artery Aneurysm, and Tumors: A Report of Four Cases. Asian J Neurosurg 2018; 13:938-942. [PMID: 30283588 PMCID: PMC6159086 DOI: 10.4103/ajns.ajns_26_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Despite growing popularity of endovascular techniques, certain subsets of patients with cerebrovascular compromise may benefit from bypass surgery. We present four cases in which pending ischemic lesion was prevented by (1) A3 resection and reanastomosis following falx meningioma removal, (2) rescue superficial temporal artery–middle cerebral artery (STA-MCA) bypass after pituitary adenoma surgery, (3) STA-MCA bypass for chronic internal carotid artery occlusion, and (4) external carotid artery-MCA bypass using radial artery grafting. Following the procedure, there were no further clinical or radiological deteriorations and long-term patency was confirmed in all four cases.
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Affiliation(s)
- Goran Mrak
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Jakob Nemir
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Klara Brgic
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Hrvoje Baric
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Josip Paladino
- Department of Neurosurgery, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Vasilije Stambolija
- Department of Anesthesiology, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
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Stambolija V, Miklić Bublić M, Lozić M, Nemir J, Ščap M. PbtO 2monitoring in normobaric hyperoxia targeted therapy in acute subarachnoidal hemorrhage. Surg Neurol Int 2018. [PMID: 29541487 PMCID: PMC5843971 DOI: 10.4103/sni.sni_363_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Stambolija V, Mrak G, Lozic M, Ljevak J, Miklic Bublic M, Scap M. Intraoperative Eptifibatide Administration During Urgent Arterial Bypass in Neurosurgery. World Neurosurg 2017; 103:952.e5-952.e9. [PMID: 28435115 DOI: 10.1016/j.wneu.2017.04.083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND In some cases when risk of occlusion of a blood vessel is greater than risk of bleeding when patients undergo urgent or unplanned bypass during neurosurgery, the use of eptifibatide may be an option. We describe 2 patients who underwent arterial bypass in whom eptifibatide was used successfully intraoperatively during neurosurgery for prevention of bypass occlusion. CASE DESCRIPTION The first patient presented with a right middle cerebral artery (MCA) aneurysm with subocclusive stenosis of the M1 branch. After right-sided osteoplastic frontotemporal craniotomy, the MCA bifurcation was exposed with a bifurcational 6-mm aneurysm with a wide neck. Prebifurcation stenosis was found, with yellow calcification of the vessel wall, and postbifurcation calcification was found on the upper M2 branch. Superficial temporal artery-MCA bypass and occlusion of the MCA aneurysm was done. Before the bypass, continuous intravenous infusion of eptifibatide 1 μg/kg/minute was administered. The patient recovered normally without hemorrhage or neurologic deficit. The second patient presented with a left-sided lateral sphenoid wing meningioma. Left-sided frontotemporal craniotomy was performed, and the tumor was completely removed from the arachnoid layer. The temporal M3 branch was invaded by the meningioma. As there was no flow through the invaded segment of the aforementioned artery, termino-terminal M3 arterial anastomosis was done. Continuous intravenous infusion of eptifibatide 1 μg/kg/minute was administered. Indocyanine green angiography showed normal flow through the anastomosis, and the patient recovered normally. CONCLUSIONS Future studies are needed to test the safety and potential efficacy of eptifibatide in intraoperative settings.
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Affiliation(s)
- Vasilije Stambolija
- Division of Neuroanesthesia and Neurocritical Care, University Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Zagreb, Croatia.
| | - Goran Mrak
- University Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marin Lozic
- Division of Neuroanesthesia and Neurocritical Care, University Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Zagreb, Croatia
| | - Josip Ljevak
- University Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Martina Miklic Bublic
- Division of Neuroanesthesia and Neurocritical Care, University Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Zagreb, Croatia
| | - Miroslav Scap
- Division of Neuroanesthesia and Neurocritical Care, University Department of Anesthesiology, Reanimatology and Intensive Care, University Hospital Center Zagreb, Zagreb, Croatia
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Medvidovic-Grubisic M, Stambolija V, Kolenc D, Katancic J, Murselovic T, Plestina-Borjan I, Strbe S, Drmic D, Barisic I, Sindic A, Seiwerth S, Sikiric P. Hypermagnesemia disturbances in rats, NO-related: pentadecapeptide BPC 157 abrogates, L-NAME and L-arginine worsen. Inflammopharmacology 2017; 25:439-449. [PMID: 28210905 DOI: 10.1007/s10787-017-0323-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/02/2017] [Indexed: 12/22/2022]
Abstract
AIM Stable gastric pentadecapeptide BPC 157, administered before a high-dose magnesium injection in rats, might be a useful peptide therapy against magnesium toxicity and the magnesium-induced effect on cell depolarization. Moreover, this might be an NO-system-related effect. Previously, BPC 157 counteracts paralysis, arrhythmias and hyperkalaemia, extreme muscle weakness; parasympathetic and neuromuscular blockade; injured muscle healing and interacts with the NOS-blocker and NOS-substrate effects. MAIN METHODS Assessment included magnesium sulfate (560 mg/kg intraperitoneally)-induced muscle weakness, muscle and brain lesions, hypermagnesemia, hyperkalaemia, increased serum enzyme values assessed in rats during and at the end of a 30-min period and medication (given intraperitoneally/kg at 15 min before magnesium) [BPC 157 (10 µg, 10 ng), L-NAME (5 mg), L-arginine (100 mg), alone and/or together]. In HEK293 cells, the increasing magnesium concentration from 1 to 5 mM could depolarize the cells at 1.75 ± 0.44 mV. KEY FINDINGS L-NAME + magnesium-rats and L-arginine + magnesium-rats exhibited worsened severe muscle weakness and lesions, brain lesions, hypermagnesemia and serum enzymes values, with emerging hyperkalaemia. However, L-NAME + L-arginine + magnesium-rats exhibited all control values and normokalaemia. BPC 157 abrogated hypermagnesemia and counteracted all of the magnesium-induced disturbances (including those aggravated by L-NAME or L-arginine). Thus, cell depolarization due to increasing magnesium concentration was inhibited in the presence of BPC 157 (1 µM) in vitro. SIGNIFICANCE BPC 157 likely counteracts the initial event leading to hypermagnesemia and the life-threatening actions after a magnesium overdose. In contrast, a worsened clinical course, higher hypermagnesemia, and emerging hyperkalaemia might cause both L-NAME and L-arginine to affect the same events adversely. These events were also opposed by BPC 157.
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Affiliation(s)
- Maria Medvidovic-Grubisic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia
| | - Vasilije Stambolija
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia
| | - Danijela Kolenc
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Jadranka Katancic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia
| | - Tamara Murselovic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia
| | - Ivna Plestina-Borjan
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia
| | - Sanja Strbe
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia
| | - Domagoj Drmic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia
| | - Ivan Barisic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia
| | - Aleksandra Sindic
- Department of Physiology and Immunology, School of Medicine, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, P.O. Box 916, 10000, Zagreb, Croatia.
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Zivanovic-Posilovic G, Balenovic D, Barisic I, Strinic D, Stambolija V, Udovicic M, Uzun S, Drmic D, Vlainic J, Bencic ML, Sindic A, Seiwerth S, Sikiric P. Stable gastric pentadecapeptide BPC 157 and bupivacaine. Eur J Pharmacol 2016; 793:56-65. [PMID: 27815173 DOI: 10.1016/j.ejphar.2016.10.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 10/24/2016] [Accepted: 10/26/2016] [Indexed: 12/13/2022]
Abstract
Bupivacaine toxicity following accidental overdose still lacks therapeutic solution. However, there are major arguments for testing BPC 157 against bupivacaine toxicity in vivo in rats, in particular, and then finally, in vitro. These are: the lack of any known BPC 157 toxicity, a lifesaving effect via the mitigation of arrhythmias in rats underwent hyperkalemia or digitalis toxicity, the elimination of hyperkalemia and arrhythmias in rats underwent succinylcholine toxicity and finally, the reduction of potassium-induced depolarization in vitro (in HEK293 cells) in severe hyperkalemia. Most importantly, BPC 157 successfully prevents and counteracts bupivacaine cardiotoxicity; BPC 157 is effective even against the worst outcomes such as a severely prolonged QRS complex. Here, rats injected with bupivacaine (100mg/kg IP) exhibited bradycardia, AV-block, ventricular ectopies, ventricular tachycardia, T-wave elevation and asystole. All of the fatalities had developed T-wave elevation, high-degree AV-block, respiratory arrest and asystole. These were largely counteracted by BPC 157 administration (50µg/kg, 10µg/kg, 10ng/kg, or 10pg/kg IP) given 30min before or 1min after the bupivacaine injection. When BPC 157 was given 6min after bupivacaine administration, and after the development of prolonged QRS intervals (20ms), the fatal outcome was markedly postponed. Additionally, the effect of bupivacaine on cell membrane depolarization was explored by measuring membrane voltages (Vm) in HEK293 cells. Bupivacaine (1mM) alone caused depolarization of the cells, while in combination with BPC 157 (1µm), the bupivacaine-induced depolarization was inhibited. Together, these findings suggest that the stable gastric pentadecapeptide BPC 157 should be a potential antidote for bupivacaine cardiotoxicity.
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Affiliation(s)
| | - Diana Balenovic
- Department of Internal Medicine, County Hospital "Dr. Ivo Pedisic", Sisak, Croatia
| | - Ivan Barisic
- Department of Internal Medicine, County Hospital "Pozega", Pozega, Croatia
| | - Dean Strinic
- Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Vasilije Stambolija
- Department of Anesthesiology and Resuscitation, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Mario Udovicic
- Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Sandra Uzun
- Department of Anesthesiology and Resuscitation, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Domagoj Drmic
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Josipa Vlainic
- Laboratory of Molecular Neuropharmacology, Division of Molecular Medicine, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Martina Lovric Bencic
- Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Aleksandra Sindic
- Department of Physiology and Immunology, Croatian Institute for Brain Research, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia.
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Stambolija V, Stambolija TP, Holjevac JK, Murselovic T, Radonic J, Duzel V, Duplancic B, Uzun S, Zivanovic-Posilovic G, Kolenc D, Drmic D, Romic Z, Seiwerth S, Sikiric P. BPC 157: The counteraction of succinylcholine, hyperkalemia, and arrhythmias. Eur J Pharmacol 2016; 781:83-91. [PMID: 27060013 DOI: 10.1016/j.ejphar.2016.04.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/31/2016] [Accepted: 04/04/2016] [Indexed: 12/13/2022]
Abstract
After the demonstration of its life-saving effect in severe hyperkalemia and the recovery of skeletal muscle after injury, pentadecapeptide BPC 157 has been shown to attenuate the local paralytic effect induced by succinylcholine, in addition to systemic muscle disability (and consequent muscle damage). Hyperkalemia, arrhythmias and a rise in serum enzyme values, were counteracted in rats. Assessments were made at 3 and 30min and 1, 3, 5, and 7 days after succinylcholine administration (1.0mg/kg into the right anterior tibial muscle). BPC 157 (10µg/kg, 10ng/kg) (given intraperitoneally 30min before or immediately after succinylcholine or per-orally in drinking water through 24h until succinylcholine administration) mitigated both local and systemic disturbances. BPC 157 completely eliminated hyperkalemia and arrhythmias, markedly attenuated or erradicated behavioral agitation, muscle twitches, motionless resting and completely eliminated post-succinylcholine hyperalgesia. BPC 157 immediately eliminated leg contractures and counteracted both edema and the decrease in muscle fibers in the diaphragm and injected/non-injected anterior tibial muscles. Therefore, the depolarizing neuromuscular blocker effects of succinylcholine were successfully antagonized.
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Affiliation(s)
- Vasilije Stambolija
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | | | - Tamara Murselovic
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Jelena Radonic
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Viktor Duzel
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Bozidar Duplancic
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Sandra Uzun
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Danijela Kolenc
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Domagoj Drmic
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zeljko Romic
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia.
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Zemba M, Cilic AZ, Balenovic I, Cilic M, Radic B, Suran J, Drmic D, Kokot A, Stambolija V, Murselovic T, Holjevac JK, Uzun S, Djuzel V, Vlainic J, Seiwerth S, Sikiric P. BPC 157 antagonized the general anaesthetic potency of thiopental and reduced prolongation of anaesthesia induced by L-NAME/thiopental combination. Inflammopharmacology 2015; 23:329-36. [PMID: 26563892 DOI: 10.1007/s10787-015-0249-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 09/28/2015] [Indexed: 02/06/2023]
Abstract
AIM We hypothesized that certain effects of the general anaesthetic thiopental are dependent on NO-related mechanisms, which were consequently counteracted by stable gastric pentadecapeptide BPC 157. MAIN METHODS (1) All rats intraperitoneally received thiopental (20, 30, 40, and 50 mg/kg) while medication BPC 157 (10 μg/kg, 10 ng/kg, and 10 pg/kg) was given intraperitoneally at 5 min before thiopental. (2) To determine NO-related mechanisms, all rats received intraperitoneally thiopental 40 mg/kg while BPC 157 (10 μg/kg), L-NAME (10 mg/kg) and L-arginine (30 mg/kg) were applied alone and/or combined. BPC 157 was given at 25 min before thiopental while L-NAME, L-arginine, alone and/or combined, were applied at 20 min before thiopental. KEY FINDINGS (1) BPC 157 own effect on thiopental anaesthesia: BPC 157 (10 ng/kg and 10 μg/kg) caused a significant antagonism of general anaesthesia produced by thiopental with a parallel shift of the dose-response curve to the right. (2) L-NAME-L-arginine-BPC 157 interrelations: L-NAME: Thiopental-induced anaesthesia duration was tripled. L-arginine: Usual thiopental anaesthesia time was not influenced. Active only when given with L-NAME or BPC 157: potentiating effects of L-NAME were lessened, not abolished; shortening effect of BPC 157: abolished. BPC 157 and L-NAME: Potentiating effects of L-NAME were abolished. BPC 157 and L-NAME and L-arginine: BPC 157 +L-NAME +L-arginine rats exhibited values close to those in BPC 157 rats. SIGNIFICANCE Thiopental general anaesthesia is simultaneously manipulated in both ways with NO system activity modulation, L-NAME (prolongation) and BPC 157 (shortening/counteraction) and L-arginine (interference with L-NAME and BPC 157).
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Affiliation(s)
- Mladen Zemba
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Andrea Zemba Cilic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Igor Balenovic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Matija Cilic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Bozo Radic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Jelena Suran
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Domagoj Drmic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Antonio Kokot
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Vasilije Stambolija
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Tamara Murselovic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Jadranka Katancic Holjevac
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Sandra Uzun
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Viktor Djuzel
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Josipa Vlainic
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Predrag Sikiric
- Department of Pharmacology, School of Medicine, University of Zagreb, Salata 11, PO Box 916, 10000, Zagreb, Croatia.
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Mrak G, Paladino J, Stambolija V, Nemir J, Sekhar LN. Treatment of giant and large fusiform middle cerebral artery aneurysms with excision and interposition radial artery graft in a 4-year-old child: case report. Neurosurgery 2014; 10 Suppl 1:E172-7; discussion E177. [PMID: 24509498 DOI: 10.1227/neu.0000000000000168] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND IMPORTANCE We report an unusual case of complex giant and large fusiform aneurysms not amenable for clipping or coiling in a 4-year-old child managed with aneurysm resection and radial artery interposition graft. CLINICAL PRESENTATION A 4-year-old child presented with repeated severe headache and vomiting. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography and digital subtraction angiography showed a giant fusiform aneurysm on the right middle cerebral artery (MCA). Because of the complex shape, endovascular treatment or clip reconstruction was not possible, and a bypass procedure was planned. Right frontotemporal craniotomy and orbitotomy was performed. Two aneurysms involving the M1 segment of the MCA were found in line, 1 giant, and the other large in size. The aneurysms were resected and treated with short radial artery interposition graft, which was narrower than the proximal or distal MCA. The child recovered normally, and the bypass was patent after 1 year. CONCLUSION Large fusiform MCA aneurysms may be difficult to treat, but there are treatment options that include a bypass procedure. Resection and short interposition radial artery graft is an excellent but rare treatment option in a very young child. This was a very successful treatment in this child.
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Affiliation(s)
- Goran Mrak
- *Department of Neurosurgery, Clinical Hospital Centre Zagreb- Rebro, School of Medicine Zagreb, Zagreb, Croatia; ‡Department of Neurological Surgery, University of Washington, Harborview Medical Center, Seattle, Washington
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Radonić J, Mihaljević L, Radonić R, Rogić D, Sekulić A, Katancić-Holjevac J, Murselović T, Stambolija V. Peripheral arterial catheter related infections in the neurosurgical intensive care unit. Coll Antropol 2014; 38:665-669. [PMID: 25145004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Intravascular device infections could be serious complications with significant contributable morbidity and mortality. The aim of this prospective clinical study is to demonstrate the infection rate related to peripheral arterial catheters and their clinical significance in neurosurgical intensive care unit (ICU) patients. After removal, all arterial catheter tips were cultivated by semiquantitative method and clinical data were collected. During a period of two years, 186 arterial catheters were placed in 105 neurosurgical ICU patients. In 6 cases (3.2%) infection was presumably related to the arterial catheter. The rate of such probable catheter related infections was found to be 5/1000 catheter days. The isolated microorganisms were: Methicillin resistant Staphylococcus epidermidis (MRSE) in 4 cases, Corynebacterium species and Candida albicans each in one case respectively. Thirteen cases (7.0%) were interpreted as contamination and one as colonization. An association was found between the presence of infection from different sources and significant bacterial growth on the catheter. Patients with positive catheter culture had a significantly longer ICU stay, more cumulative catheter days, and a higher mortality rate than those with sterile catheters. We can conclude that the rate of probable peripheral arterial catheter related infection is low. A higher mortality rate in patients who experienced probable catheter related infection does not seem to be a consequence of the aforementioned infection. A more suitable explanation would be that patients with nosocomial infections and higher mortality risk have prolonged ICU stays. There is an increased chance of developing a catheter related infection in those patients who have more cumulative catheter days.
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Duplancic B, Stambolija V, Katancic Holjevac J, Zemba M, Balenovic I, Drmic I, Suran J, Radic B, Filipovic M, Boban Blagaic A, Brcic L, Kolenc D, Seiwerth S, Sikiric P, Grabarevic Z. Pentadecapeptide BPC 157 and anaphylactoid reaction in rats and mice after intravenous dextran and white egg administration (1056.7). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.1056.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | - Mladen Zemba
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Igor Balenovic
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Ivan Drmic
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Jelena Suran
- Pharmacology Faculty of Veterinary MedicineUniversity of ZagrebZagrebCroatia
| | - Bozo Radic
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | | | | | - Luka Brcic
- Pathology Medical facultyUniversity of ZagrebZagrebCroatia
| | | | - Sven Seiwerth
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Predrag Sikiric
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Zeljko Grabarevic
- Pathology Faculty of Veterinary MedicineUniversity of ZagrebZagrebCroatia
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Zemba M, Zemba Cilic A, Balenovic I, Cilic M, Radic B, Suran J, Drmic I, Stambolija V, Murselovic T, Katancic Holjevac J, Uzun S, Djuzel V, Seiwerth S, Sikiric P. BPC 157 antagonized the general anesthetic potency of thiopental and reduced prolongation of anesthesia time induced by L‐NAME/thiopental combination (1061.3). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.1061.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mladen Zemba
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | | | - Igor Balenovic
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Matija Cilic
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Bozo Radic
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Jelena Suran
- Pharmacology Faculty of Veterinary MedicineUniversity of ZagrebZagrebCroatia
| | - Ivan Drmic
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | | | | | | | - Sandra Uzun
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Viktor Djuzel
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Sven Seiwerth
- Pathology Medical facultyUniversity of ZagrebZagrebCroatia
| | - Predrag Sikiric
- Pharmacology Medical facultyUniversity of ZagrebZagrebCroatia
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Duplancic B, Stambolija V, Holjevac J, Zemba M, Balenovic I, Drmic D, Suran J, Radic B, Filipovic M, Blagaic AB, Brcic L, Kolenc D, Grabarevic Z, Seiwerth S, Sikiric P. Pentadecapeptide BPC 157 and anaphylactoid reaction in rats and mice after intravenous dextran and white egg administration. Eur J Pharmacol 2014; 727:75-9. [PMID: 24486708 DOI: 10.1016/j.ejphar.2014.01.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 01/21/2014] [Accepted: 01/23/2014] [Indexed: 02/07/2023]
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Mrak G, Paladino J, Stambolija V, Nemir J, Sekhar LN. Treatment of Giant and Large Fusiform MCA Aneurysms With Excision and Interposition Radial Artery Graft in a Four Year Old Child. Neurosurgery 2013. [DOI: 10.1227/neu.0000000000000169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Handzić J, Radić B, Bagatin T, Savić A, Stambolija V, Nevajda B. Hearing in children with otitis media with effusion--clinical retrospective study. Coll Antropol 2012; 36:1273-1277. [PMID: 23390821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Hearing loss accompanied with middle ear effusion was analyzed according to audiometric frequencies for different age group. Results for left and right ears were compared in/and between study and control group. Pure tone audiometry for bone and air conduction and tympanometry was performed in study group of ninety-eight children with conductive hearing loss and otitis media with effusion. Control group included fifty-seven children with hearing loss, enlarged adenoids, dysfunction of Eustachian tube and no present middle ear effusion served. Means of hearing loss thresholds for 250 Hz-4 kHz were established and compared between groups of right vs. left ears of tested vs. control ears according to age subgroups: 1-3 yr, 4-6 yr, 7-9 yr, 10-12 yr, 13-15 yr. At age 1-3 yr otitis media with effusion children showed no ear side difference in hearing loss. Age groups of 4-6 and 7-9 yr otitis media with effusion children showed left ears with higher threshold of hearing loss across all of the tested frequencies than right ears in study and control ears. Right ears showed smaller hearing loss in study and control group and no age group predicted for hearing impairment. Higher hearing loss threshold for 4 kHz in adolescence in otitis media with effusion ears is early sign of sequels after repetitive episodes of middle ear effusion. Control groups showed no ear side or age group dependent difference of hearing loss threshold. Age group of 4-6 and 7-9 y have faster craniofacial structural change in soft tissue than bone base so ear side differences suggest being developmentally determined.
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Affiliation(s)
- Jadranka Handzić
- University of Zagreb, Zagreb University Hospital Center, Department of Ear, Nose and Throat, Zagreb, Croatia.
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Sikiric P, Seiwerth S, Rucman R, Turkovic B, Rokotov DS, Brcic L, Sever M, Klicek R, Radic B, Drmic D, Ilic S, Kolenc D, Stambolija V, Zoricic Z, Vrcic H, Sebecic B. Focus on ulcerative colitis: stable gastric pentadecapeptide BPC 157. Curr Med Chem 2012; 19:126-32. [PMID: 22300085 DOI: 10.2174/092986712803414015] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 11/04/2011] [Accepted: 11/07/2011] [Indexed: 12/18/2022]
Abstract
Stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, M.W. 1419) may be the new drug stable in human gastric juice, effective both in the upper and lower GI tract, and free of side effects. BPC 157, in addition to an antiulcer effect efficient in therapy of inflammatory bowel disease (IBD) (PL 14736) so far only tested in clinical phase II, has a very safe profile, and exhibited a particular wound healing effect. It also has shown to interact with the NO-system, providing endothelium protection and angiogenic effect, even in severely impaired conditions (i.e., it stimulated expression of early growth response 1 gene responsible for cytokine and growth factor generation and early extracellular matrix (collagen) formation (but also its repressor nerve growth factor 1-A binding protein-2)), important to counteract severe complications of advanced and poorly controlled IBD. Hopefully, the lessons from animal studies, particularly advanced intestinal anastomosis healing, reversed short bowel syndrome and fistula healing indicate BPC 157's high significance in further IBD therapy. Also, this supportive evidence (i.e., no toxic effect, limit test negative, LD1 not achieved, no side effect in trials) may counteract the problems commonly exercised in the use of peptidergic agents, particularly those used on a long-term basis.
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Affiliation(s)
- P Sikiric
- Department of Pharmacology, Medical Faculty University of Zagreb, Salata 11, POB 916, 10000 Zagreb, Croatia.
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Ilic S, Drmic D, Franjic S, Kolenc D, Coric M, Brcic L, Klicek R, Radic B, Sever M, Djuzel V, Filipovic M, Djakovic Z, Stambolija V, Blagaic AB, Zoricic I, Gjurasin M, Stupnisek M, Romic Z, Zarkovic K, Dzidic S, Seiwerth S, Sikiric P. Pentadecapeptide BPC 157 and its effects on a NSAID toxicity model: diclofenac-induced gastrointestinal, liver, and encephalopathy lesions. Life Sci 2011; 88:535-42. [PMID: 21295044 DOI: 10.1016/j.lfs.2011.01.015] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 12/23/2010] [Accepted: 01/05/2011] [Indexed: 02/07/2023]
Abstract
AIMS We attempted to fully antagonize the extensive toxicity caused by NSAIDs (using diclofenac as a prototype). MAIN METHODS Herein, we used the stable gastric pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419), an anti-ulcer peptide shown to be efficient in inflammatory bowel disease clinical trials (PL 14736) and various wound treatments with no toxicity reported. This peptide was given to antagonize combined gastrointestinal, liver, and brain toxicity induced by diclofenac (12.5mg/kg intraperitoneally, once daily for 3 days) in rats. KEY FINDINGS Already considered a drug that can reverse the toxic side effects of NSAIDs, BPC 157 (10 μg/kg, 10 ng/kg) was strongly effective throughout the entire experiment when given (i) intraperitoneally immediately after diclofenac or (ii) per-orally in drinking water (0.16 μg/mL, 0.16 ng/mL). Without BPC 157 treatment, at 3h following the last diclofenac challenge, we encountered a complex deleterious circuit of diclofenac toxicity characterized by severe gastric, intestinal and liver lesions, increased bilirubin, aspartate transaminase (AST), alanine transaminase (ALT) serum values, increased liver weight, prolonged sedation/unconsciousness (after any diclofenac challenge) and finally hepatic encephalopathy (brain edema particularly located in the cerebral cortex and cerebellum, more in white than in gray matter, damaged red neurons, particularly in the cerebral cortex and cerebellar nuclei, Purkinje cells and less commonly in the hippocampal neurons). SIGNIFICANCE The very extensive antagonization of diclofenac toxicity achieved with BPC 157 (μg-/ng-regimen, intraperitoneally, per-orally) may encourage its further use as a therapy to counteract diclofenac- and other NSAID-induced toxicity.
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Affiliation(s)
- Spomenko Ilic
- Department of Pharmacology and Pathology Medical Faculty, University of Zagreb, Zagreb, Croatia
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