Metabolism of a New Antiaggregant, Indolinone Derivative

Cytochrome p450-mediated metabolism of GRS (indolinone antiaggregant) and its effects on activities of cytochrome p450 isoenzymes were studied. Inhibition of 6 isomers of cytochrome p450 in human liver microsomes was studied with the use of specific substrates. It was found that human liver cytochrome p450 enzymes could not induce degradation of GRS and that GRS was not an inductor or inhibitor of cytochrome p450 family members 1A2, 2C9, 2C19, 2D6, 2C8, and 3A4. Hence, clinical use of the prospective antiaggregant would not involve the risk of uncontrolled fluctuations in GRS concentrations in the organism because of interactions between the drugs.

Congenital pulmonary tuberculosis

Congenital tuberculosis is a fatal disease in the absence of treatment. The diagnosis is difficult due to polymorphic and nonspecific symptoms in neonates, as well as the lack of alertness of neonatologists and pediatricians. Less than 500 confirmed cases of congenital tuberculosis have been described in the available literature. Mortality ranges from 15 to 33%. Early diagnosis and adequate therapy are essential to improve the prognosis of the disease. Two cases of pulmonary congenital tuberculosis in premature neonates with a positive maternal and familial history of tuberculosis is presented. The clinical symptoms and radiological features started on the days 24 and 48 of life, respectively. Shortness of breath, low blood oxygen level requiring oxygen therapy, fever, and impaired general well-being revealed. The chest X-ray revealed bilateral polysegmental infiltrative lesions with the formation of a cavity of destruction in one case. The diagnosis was established after the detection of M. tuberculosis DNA in gastric aspirates. Patients received therapy according to a regimen designed for multidrug-resistant tuberculosis, including conventional anti-TB drugs in combination with linezolid, fluoroquinolones, meropenem, and aminoglycosides. The infectious syndrome in a premature newborn associated with pneumonia resistant to standard antibiotic therapy, the presence of tuberculosis in the mother, relatives, or siblings require a work-up for the detection of M. tuberculosis and instrumental diagnostics. Early diagnosis and treatment are critical for improving the prognosis of the disease.