Accelerated Blood Clearance (ABC) Phenomenon Favors the Accumulation of Tartar Emetic in Pegylated Liposomes in BALB/c Mice Liver

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Lopes, Tamara C. M.; Silva, Débora F.; Costa, Walyson C.; Barichello, José M.; Silva-Barcellos, Neila M.; de Lima, Wanderson G.

2018-01-01

Tartar emetic (TE) was the first drug used to treat leishmaniasis. However, its use was discontinued due to high toxicity. Association of TE with liposomes is a strategy to reduce its side effects. Pegylated liposomes (Lpeg) present lower rates of uptake by macrophages and prolonged circulation compared to their nonpegylated counterparts. However, repeated administration of Lpeg can cause an Accelerated Blood Clearance (ABC) phenomenon, whereby recognition of liposomes by antibodies results in faster phagocytosis. This work evaluated the effect of TE administration on histopathological aspects and the effect of the ABC phenomenon on targeting and toxicity in mice. Our results show that treatment with free or liposomal TE had no effect on the erythrocyte count, on liver and spleen weight, and on hepatic, splenic, and cardiac histology in mice. Severe lesions were observed on the kidneys of animals treated with a single dose of free TE. Treatment with TE in Lpeg after induction of ABC phenomenon caused a significant increase in Sb level in the liver without toxicity. Furthermore, mice treated with TE in liposomes showed normal renal histopathology. These results suggest site-specific targeting of Sb to the liver after induction of ABC phenomenon with no toxicity to other organs. PMID:29593857

Accelerated Blood Clearance (ABC Phenomenon Favors the Accumulation of Tartar Emetic in Pegylated Liposomes in BALB/c Mice Liver

Directory of Open Access Journals (Sweden)

Tamara C. M. Lopes

2018-01-01

Full Text Available Tartar emetic (TE was the first drug used to treat leishmaniasis. However, its use was discontinued due to high toxicity. Association of TE with liposomes is a strategy to reduce its side effects. Pegylated liposomes (Lpeg present lower rates of uptake by macrophages and prolonged circulation compared to their nonpegylated counterparts. However, repeated administration of Lpeg can cause an Accelerated Blood Clearance (ABC phenomenon, whereby recognition of liposomes by antibodies results in faster phagocytosis. This work evaluated the effect of TE administration on histopathological aspects and the effect of the ABC phenomenon on targeting and toxicity in mice. Our results show that treatment with free or liposomal TE had no effect on the erythrocyte count, on liver and spleen weight, and on hepatic, splenic, and cardiac histology in mice. Severe lesions were observed on the kidneys of animals treated with a single dose of free TE. Treatment with TE in Lpeg after induction of ABC phenomenon caused a significant increase in Sb level in the liver without toxicity. Furthermore, mice treated with TE in liposomes showed normal renal histopathology. These results suggest site-specific targeting of Sb to the liver after induction of ABC phenomenon with no toxicity to other organs.

Elaboration and validation of the method for the quantification of the emetic toxin of Bacillus cereus as described in EN-ISO 18465 - Microbiology of the food chain - Quantitative determination of emetic toxin (cereulide) using LC-MS/MS.

Science.gov (United States)

In 't Veld, P H; van der Laak, L F J; van Zon, M; Biesta-Peters, E G

2018-04-12

A method for the quantification of the Bacillus cereus emetic toxin (cereulide) was developed and validated. The method principle is based on LC-MS as this is the most sensitive and specific method for cereulide. Therefore the study design is different from the microbiological methods validated under this mandate. As the method had to be developed a two stage validation study approach was used. The first stage (pre-study) focussed on the method applicability and the experience of the laboratories with the method. Based on the outcome of the pre-study and comments received during voting at CEN and ISO level a final method was agreed to be used for the second stage the (final) validation of the method. In the final (validation) study samples of cooked rice (both artificially contaminated with cereulide or contaminated with B. cereus for production of cereulide in the rice) and 6 other food matrices (fried rice dish, cream pastry with chocolate, hotdog sausage, mini pancakes, vanilla custard and infant formula) were used. All these samples were spiked by the participating laboratories using standard solutions of cereulide supplied by the organising laboratory. The results of the study indicate that the method is fit for purpose. Repeatability values were obtained of 0.6 μg/kg at low level spike (ca. 5 μg/kg) and 7 to 9.6 μg/kg at high level spike (ca. 75 μg/kg). Reproducibility at low spike level ranged from 0.6 to 0.9 μg/kg and from 8.7 to 14.5 μg/kg at high spike level. Recovery from the spiked samples ranged between 96.5% for mini-pancakes to 99.3% for fries rice dish. Copyright © 2018. Published by Elsevier B.V.

Class side effects: decreased pressure in the lower oesophageal and the pyloric sphincters after the administration of dopamine antagonists, neuroleptics, anti-emetics, L-NAME, pentadecapeptide BPC 157 and L-arginine.

Science.gov (United States)

Belosic Halle, Zeljka; Vlainic, Josipa; Drmic, Domagoj; Strinic, Dean; Luetic, Kresimir; Sucic, Mario; Medvidovic-Grubisic, Maria; Pavelic Turudic, Tatjana; Petrovic, Igor; Seiwerth, Sven; Sikiric, Predrag

2017-05-17

The ulcerogenic potential of dopamine antagonists and L-NAME in rats provides unresolved issues of anti-emetic neuroleptic application in both patients and experimental studies. Therefore, in a 1-week study, we examined the pressures within the lower oesophageal and the pyloric sphincters in rats [assessed manometrically (cm H 2 O)] after dopamine neuroleptics/prokinetics, L-NAME, L-arginine and stable gastric pentadecapeptide BPC 157 were administered alone and/or in combination. Medication (/kg) was given once daily intraperitoneally throughout the 7 days, with the last dose at 24 h before pressure assessment. Given as individual agents to healthy rats, all dopamine antagonists (central [haloperidol (6.25 mg, 16 mg, 25 mg), fluphenazine (5 mg), levomepromazine (50 mg), chlorpromazine (10 mg), quetiapine (10 mg), olanzapine (5 mg), clozapine (100 mg), sulpiride (160 mg), metoclopramide (25 mg)) and peripheral(domperidone (10 mg)], L-NAME (5 mg) and L-arginine (100 mg) decreased the pressure within both sphincters. As a common effect, this decreased pressure was rescued, dose-dependently, by BPC 157 (10 µg, 10 ng) (also note that L-arginine and L-NAME given together antagonized each other's responses). With haloperidol, L-NAME worsened both the lower oesophageal and the pyloric sphincter pressure, while L-arginine ameliorated lower oesophageal sphincter but not pyloric sphincter pressure, and antagonized L-NAME effect. With domperidone, L-arginine originally had no effect, while L-NAME worsened pyloric sphincter pressure. This effect was opposed by L-arginine. All these effects were further reversed towards a stronger beneficial effect, close to normal pressure values, by the addition of BPC 157. In addition, NO level was determined in plasma, sphincters and brain tissue. Thiobarbituric acid reactive substances (TBARS) were also assessed. Haloperidol increased NO levels (in both sphincters, the plasma and brain), consistently producing increased

Transdermal scopolamine: an alternative to ondansetron and droperidol for the prevention of postoperative and postdischarge emetic symptoms.

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White, Paul F; Tang, Jun; Song, Dajun; Coleman, Jayne E; Wender, Ronald H; Ogunnaike, Babatunde; Sloninsky, Alexander; Kapu, Rajani; Shah, Mary; Webb, Tom

2007-01-01

Given the controversy regarding the use of droperidol and the high cost of the 5-HT3 antagonists, a cost-effective alternative for routine use as a prophylactic antiemetic would be desirable. We designed two parallel, randomized, double-blind sham and placebo-controlled studies to compare the early and late antiemetic efficacy and adverse event profile of transdermal scopolamine (TDS) 1.5 mg, to ondansetron 4 mg IV, and droperidol 1.25 mg IV for antiemetic prophylaxis as part of a multimodal regimen in "at risk" surgical populations. A total of 150 patients undergoing major laparoscopic (n = 80) or plastic (n = 70) surgery procedures received either an active TDS patch (containing scopolamine 1.5 mg) or a similar appearing sham patch 60 min before entering the operating room. All patients received a standardized general anesthetic technique. A second study medication was administered in a 2-mL numbered syringe containing either saline (for the two active TDS groups), droperidol, 1.25 mg, or ondansetron, 4 mg (for the sham patch groups), and was administered IV near the end of the procedure. The occurrence of postoperative nausea and vomiting/retching, need for rescue antiemetics, and the complete response rates (i.e., absence of protracted nausea or repeated episodes of emesis requiring antiemetic rescue medication) was reported. In addition, complaints of visual disturbances, dry mouth, drowsiness, and restlessness were noted up to 72 h after surgery. There were no significant differences in any of the emetic outcomes or need for rescue antiemetics among the TDS, droperidol, and ondansetron groups in the first 72 h after surgery. The complete response rates varied from 41% to 51%, and did not significantly differ among the treatment groups. The overall incidence of dry mouth was significantly more frequent in the TDS groups than in the droperidol and ondansetron groups (21% vs 3%). Premedication with TDS was as effective as droperidol (1.25 mg) or ondansetron (4

Design and dosimetry of a few leaf electron collimator for energy modulated electron therapy

International Nuclear Information System (INIS)

Al-Yahya, Khalid; Verhaegen, Frank; Seuntjens, Jan

2007-01-01

Despite the capability of energy modulated electron therapy (EMET) to achieve highly conformal dose distributions in superficial targets it has not been widely implemented due to problems inherent in electron beam radiotherapy such as planning dosimetry accuracy, and verification as well as a lack of systems for automated delivery. In previous work we proposed a novel technique to deliver EMET using an automated 'few leaf electron collimator' (FLEC) that consists of four motor-driven leaves fit in a standard clinical electron beam applicator. Integrated with a Monte Carlo based optimization algorithm that utilizes patient-specific dose kernels, a treatment delivery was incorporated within the linear accelerator operation. The FLEC was envisioned to work as an accessory tool added to the clinical accelerator. In this article the design and construction of the FLEC prototype that match our compact design goals are presented. It is controlled using an in-house developed EMET controller. The structure of the software and the hardware characteristics of the EMET controller are demonstrated. Using a parallel plate ionization chamber, output measurements were obtained to validate the Monte Carlo calculations for a range of fields with different energies and sizes. Further verifications were also performed for comparing 1-D and 2-D dose distributions using energy independent radiochromic films. Comparisons between Monte Carlo calculations and measurements of complex intensity map deliveries show an overall agreement to within ±3%. This work confirms our design objectives of the FLEC that allow for automated delivery of EMET. Furthermore, the Monte Carlo dose calculation engine required for EMET planning was validated. The result supports the potential of the prototype FLEC for the planning and delivery of EMET

Impact and management of chemotherapy/radiotherapy-induced nausea and vomiting and the perceptual gap between oncologists/oncology nurses and patients: a cross-sectional multinational survey.

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Vidall, Cheryl; Fernández-Ortega, Paz; Cortinovis, Diego; Jahn, Patrick; Amlani, Bharat; Scotté, Florian

2015-11-01

Chemotherapy/radiotherapy-induced nausea and vomiting (CINV/RINV) can affect half of oncology patients, significantly impacting daily life. Nausea without vomiting has only recently been thought of as a condition in its own right. As such, the incidence of nausea is often underestimated. This survey investigated the incidence and impact of CINV/RINV in patients compared with estimations of physicians/oncology nurses to determine if there is a perceptual gap between healthcare professionals and patients. An online research survey of physicians, oncology nurses and patients was conducted across five European countries. Participants had to have experience prescribing/recommending or have received anti-emetic medication for CINV/RINV treatment. Questionnaires assessed the incidence and impact of CINV/RINV, anti-emetic usage and compliance, and attribute importance of anti-emetic medication. A total of 947 (375 physicians, 186 oncology nurses and 386 patients) participated in this survey. The incidence of nausea was greater than vomiting: 60 % of patients reported nausea alone, whereas 18 % reported vomiting. Physicians and oncology nurses overestimated the incidence of CINV/RINV but underestimated its impact on patients' daily lives. Only 38 % of patients reported full compliance with physicians'/oncology nurses' guidelines when self-administering anti-emetic medication. Leading factors for poor compliance included reluctance to add to a pill burden and fear that swallowing itself would induce nausea/vomiting. There is a perceptual gap between healthcare professionals and patients in terms of the incidence and impact of CINV/RINV. This may lead to sub-optimal prescription of anti-emetics and therefore management of CINV/RINV. Minimising the pill burden and eliminating the requirement to swallow medication could improve poor patient compliance with anti-emetic regimens.

Reducing radiation induced emesis in abdominal radiotherapy

International Nuclear Information System (INIS)

Griffin, K.

1994-01-01

In patients with seminoma testes, a comparison was made between radiation induced emesis suffered by patients receiving 'dogleg' radiotherapy with those suffered by patients who received para-aortic radiotherapy. The same comparisons were made between the effects suffered by those patients who received the anti-emetic, Ondansetron, and those suffered by patients who received conventional anti-emetics. (UK)

Energy modulated electron therapy: Design, implementation, and evaluation of a novel method of treatment planning and delivery

Science.gov (United States)

Al-Yahya, Khalid

Energy modulated electron therapy (EMET) is a promising treatment modality that has the fundamental capabilities to enhance the treatment planning and delivery of superficially located targets. Although it offers advantages over x-ray intensity modulated radiation therapy (IMRT), EMET has not been widely implemented to the same level of accuracy, automation, and clinical routine as its x-ray counterpart. This lack of implementation is attributed to the absence of a remotely automated beam shaping system as well as the deficiency in dosimetric accuracy of clinical electron pencil beam algorithms in the presence of beam modifiers and tissue heterogeneities. In this study, we present a novel technique for treatment planning and delivery of EMET. The delivery is achieved using a prototype of an automated "few leaf electron collimator" (FLEC). It consists of four copper leaves driven by stepper motors which are synchronized with the x-ray jaws in order to form a series of collimated rectangular openings or "fieldlets". Based on Monte Carlo studies, the FLEC has been designed to serve as an accessory tool to the current accelerator equipment. The FLEC was constructed and its operation was fully automated and integrated with the accelerator through an in-house assembled control unit. The control unit is a portable computer system accompanied with customized software that delivers EMET plans after acquiring them from the optimization station. EMET plans are produced based on dose volume constraints that employ Monte Carlo pre-generated and patient-specific kernels which are utilized by an in-house developed optimization algorithm. The structure of the optimization software is demonstrated. Using Monte Carlo techniques to calculate dose allows for accurate modeling of the collimation system as well as the patient heterogeneous geometry and take into account their impact on optimization. The Monte Carlo calculations were validated by comparing them against output

Prophylaxis and management of antineoplastic drug induced nausea and vomiting in children with cancer

Directory of Open Access Journals (Sweden)

Sidharth Totadri

2016-10-01

Full Text Available Antineoplastic drug induced nausea and vomiting (AINV is a major adverse event which deeply impacts the quality of life of children with cancer. It additionally causes distress to parents and negatively impacts compliance to therapy. A robust AINV prophylaxis regimen is essential to achieve complete control; and prevent anticipatory, breakthrough and refractory AINV. With a wide array of available anti-emetics, standard guidelines for their use are crucial to ensure uniform and optimum prophylaxis. Chemotherapeutic agents are classified as having high, moderate, low or minimal emetic risk based on their potential to cause emesis in the absence of prophylaxis. Three drug regimen with aprepitant, ondansetron/granisetron and dexamethasone is recommended for protocols with high emetic risk. Although approved in children ≥12 years, there is mounting evidence for the use of aprepitant in younger children too. In protocols with moderate and low emetic risk, combination of ondansetron/granisetron and dexamethasone; and single agent ondansetron/granisetron are recommended, respectively. Metoclopramide is an alternative when steroids are contraindicated. Olanzapine and lorazepam are useful drugs for breakthrough AINV and anticipatory AINV. Knowledge of pediatric dosage, salient adverse events, drug interactions as well as cost of drugs is essential to prescribe anti-emetics accurately and safely in resource constrained settings. Non pharmacological interventions such as hypnosis, acupressure and psychological interventions can benefit a sub-group of patients without significant risk of adverse events.

Pattern of prophylaxis administration for chemotherapy-induced nausea and vomiting: an analysis of city-based health insurance data.

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Nakamura, Fumiaki; Higashi, Takahiro

2013-12-01

Chemotherapy-induced nausea and vomiting (CINV) substantially affects patient quality of life. Although several guidelines have recommended the use of 5-hydroxytryptamine 3 (5HT3) receptor antagonists with glucocorticoids to alleviate acute CINV, studies in other countries have reported that these recommendations were often not followed. We aimed to assess antiemetic use in community practices just before the Japanese Guidelines for the Appropriate Use of Antiemetics were published. Using the insurance claims submitted to a public insurance program that covers residents up to 75 years old operated by a city with a population of 250,000, we examined the concurrent use of 5HT3 receptor antagonists and glucocorticoids with high or moderate emetic risk chemotherapy. Overall, 448 patients received high or moderate emetic risk chemotherapy 1,342 times during the study period. The recommended antiemetic therapy was provided in 61.9 % (95 % confidence interval 55.5-68.3 %) of the treated patients, but the moderate emetic risk chemotherapy group received the recommended antiemetic therapy less frequently than the high emetic risk chemotherapy group (55.5 vs. 82.1 %, P chemotherapy were associated with the recommended antiemetic therapy. Breast and lung cancer patients receiving high emetic risk chemotherapy received the recommended antiemetics in 100 % of cases, while only 67 % of patients with other cancer types received the recommended antiemetics. Despite several limitations associated with analysis of insurance claims, our study indicates that substantial room for improvement exists in the practice of preventing CINV.

Acute Radiation Sickness Amelioration Analysis

Science.gov (United States)

1994-05-01

Emetic Drugs 16. PRICE CODE Antagonists 17. SECURITY CLASSIFICATION 18. SECURITY CLASSIFICATION 19, SECURITY CLASSIFICATION 20. LIMITATION OF ABSTRACT OF...102 UNCLASSIFIED mcuIw IA IIIcaIIin or Isis PAW CLASSFIED BY: N/A since Unclassified. DECLASSIFY ON: N/A since Unclassified. SECURITY CLASSIFICATION OF...Approximately 2000 documents relevant to the development of the candidate anti-emetic drugs ondansetron (Zofran, Glaxo Pharmaceuticals) and granisetron

Evaluation of an every-other-day palonosetron schedule to control emesis in multiple-day high-dose chemotherapy.

Science.gov (United States)

Mirabile, Aurora; Celio, Luigi; Magni, Michele; Bonizzoni, Erminio; Gianni, Alessandro Massimo; Di Nicola, Massimo

2014-12-01

Efficacy of intermittent palonosetron dosing in patients undergoing multiple-day, high-dose chemotherapy (HDC) was investigated. Fifty-eight patients received palonosetron (0.25 mg intravenous [iv.]) every other day plus daily dexamethasone (8 mg iv. twice daily) dosing. The primary end point was complete control (CC; no emesis, no rescue anti-emetics, and no more than mild nausea) in the overall acute-period (until 24 h after chemotherapy completion). Acute-period CC occurred in 81% and 50% of patients receiving palonosetron and ondansetron (historical control cohort), respectively. Palonosetron (odds ratio [OR]: 4.37; p = 0.001) and a longer duration of HDC regimen (OR: 3.47; p = 0.011) independently predicted a better anti-emetic outcome. Palonosetron every other day plus daily dexamethasone is an effective anti-emetic coverage in patients undergoing HDC.

A randomized double-blind trial to compare the clinical efficacy of granisetron with metoclopramide, both combined with dexamethasone in the prophylaxis of chemotherapy-induced delayed emesis

OpenAIRE

Aapro, M. S.; Thuerlimann, B.; Sessa, C.; de Pree, C.; Bernhard, J.; Maibach, R.

2017-01-01

Background: The prophylactic use of 5-HT3 receptor antagonists (setrons), after the first 24 h (acute phase) of exposure to emetic chemotherapy, to decrease the incidence of ‘delayed phase' emesis increases costs. We designed a study to evaluate the efficacy of a setron (granisetron) in the delayed phase, compared with metoclopramide, each combined with a corticosteroid. Patients and methods: Patients on their first course of single-day emetic chemotherapy (cisplatin, carboplatin, doxorubicin...

Bacillus cereus and related species.

OpenAIRE

Drobniewski, F A

1993-01-01

Bacillus cereus is a gram-positive aerobic or facultatively anaerobic spore-forming rod. It is a cause of food poisoning, which is frequently associated with the consumption of rice-based dishes. The organism produces an emetic or diarrheal syndrome induced by an emetic toxin and enterotoxin, respectively. Other toxins are produced during growth, including phospholipases, proteases, and hemolysins, one of which, cereolysin, is a thiol-activated hemolysin. These toxins may contribute to the pa...

Characterization of radiation-induced emesis in the ferret

International Nuclear Information System (INIS)

King, G.L.

1988-01-01

Forty-eight ferrets (Mustela putorius furo) were individually head-shielded and radiated with bilateral 60 Co gamma radiation at 100 cGy min-1 at doses ranging between 49 and 601 cGy. The emetic threshold was observed at 69 cGy, the ED50 was calculated at 77 cGy, and 100% incidence of emesis occurred at 201 cGy. With increasing doses of radiation, the latency to first emesis after radiation decreased dramatically, whereas the duration of the prodromal period increased. Two other sets of experiments suggest that dopaminergic mechanisms play a minor role in radiation-induced emesis in the ferret. Twenty-two animals were injected either intravenously or subcutaneously with 30 to 300 micrograms/kg of apomorphine. Fewer than 50% of the animals vomited to 300 micrograms/kg apomorphine; central dopaminergic receptor activation was apparent at all doses. Another eight animals received 1 mg/kg domperidone prior to either 201 (n = 4) or 401 (n = 4) cGy radiation and their emetic responses were compared with NaCl-injected-irradiated controls (n = 8). At 201 cGy, domperidone significantly reduced only the total time in emetic behavior. At 401 cGy, domperidone had no salutary effect on radiation-induced emesis. The emetic responses of the ferret to radiation and apomorphine are compared with these responses in other vomiting species

Randomised clinical trial of Levonantradol and Chlorpromazine in the prevention of radiotherapy-induced vomiting

Energy Technology Data Exchange (ETDEWEB)

Lucraft, H H; Palmer, M K [Christie Hospital and Holt Radium Inst., Manchester (UK)

1982-11-01

Levonantradol is a cannabis derivative. Cannabinoid anti-emetics are being assessed in cancer chemotherapy but have been little used in radiotherapy to date. A pilot study and randomised trial compared the anti-emetic effect of a standard drug (Chlorpromazine 25 mg) with Levonantradol at two doses (0.5 and 0.75 mg) in patients receiving palliative single fraction radiotherapy to sites likely to cause nausea and vomiting. Most patients were out-patients. Both drugs were well tolerated. The frequency of vomiting was similar in all three groups in both the pilot study and randomised trial.

Evaluation of domperidone as a modifier of gamma-radiation-induced emesis

International Nuclear Information System (INIS)

Cordts, R.E.; Yochmowitz, M.G.; Hardy, K.A.

1987-01-01

The D2 antidopaminergic drug domperidone was evaluated, singly and in combination with synthetic adrenocorticoid and an H2 antihistamine, for its ability to reduce the acute emetic effects of 60 Co whole-body radiation. Random-source adult male dogs were fasted 12 hr, fed a standard meal, injected 44 min later, and irradiated 47 min after that. Four groups of dogs were irradiated after drug injections as follows: saline (Con), domperidone (Dom), cimetidine + thiethylperazine (Cim + Thi), and dexamethasone + domperidone + cimetidine (Dex + Dom + Cim). Drug quantities given the dogs represented 10 mg Dom, 10 mg Thi, 20 mg Dex, and 300 mg Cim for an average human (70 kg, 1.8 m2). Subjects were exposed on an up-down schedule to determine the radiation necessary to produce vomiting in 50% (ED50) of each group. Emesis onset and offset times and number of episodes were recorded. The Dom group had more emetic episodes than any other. The Dex + Dom + Cim combination significantly raised the emetic threshold while maintaining episodes at a low incidence

Randomised clinical trial of Levonantradol and Chlorpromazine in the prevention of radiotherapy-induced vomiting

International Nuclear Information System (INIS)

Lucraft, H.H.; Palmer, M.K.

1982-01-01

Levonantradol is a cannabis derivative. Cannabinoid anti-emetics are being assessed in cancer chemotherapy but have been little used in radiotherapy to date. A pilot study and randomised trial compared the anti-emetic effect of a standard drug (Chlorpromazine 25 mg) with Levonantradol at two doses (0.5 and 0.75 mg) in patients receiving palliative single fraction radiotherapy to sites likely to cause nausea and vomiting. Most patients were out-patients. Both drugs were well tolerated. The frequency of vomiting was similar in all three groups in both the pilot study and randomised trial. (author)

Efficacy of ondansetron in the management of radiotherapy induced emesis: a review. Efficacite de l'ondansetron dans les nausees et vomissements radio-induits: revue de la litterature

Energy Technology Data Exchange (ETDEWEB)

Levy, E. (Hopital Henri-Mondor, 94 - Creteil (France)); Paillarse, J.M.; Votan, B. (Laboratoires Glaxo, 75 - Paris (France))

1994-01-01

Radiotherapy-induced emesis depends on the site of irradiation, the field size and the dose per fraction and is generally less intense than chemotherapy-induced emesis. Established anti-emetic drugs offer only limited symptom control (50%). Ondansetron, a 5HT[sub 3] receptors antagonist, had proven a complete or a major control efficacy (0-2 emetic episodes) of 68 to 95% in three pilot studies (fractionated, single-dose and total body irradiations). In controlled studies, ondansetron efficacy was significantly higher than placebo, metoclopramide and prochlorperazine. The treatment was well tolerated in the different studies. (authors). 23 refs., 2 figs., 1 tab.

Efficacy of ondansetron in the management of radiotherapy induced emesis: a review

International Nuclear Information System (INIS)

Levy, E.; Paillarse, J.M.; Votan, B.

1994-01-01

Radiotherapy-induced emesis depends on the site of irradiation, the field size and the dose per fraction and is generally less intense than chemotherapy-induced emesis. Established anti-emetic drugs offer only limited symptom control (50%). Ondansetron, a 5HT 3 receptors antagonist, had proven a complete or a major control efficacy (0-2 emetic episodes) of 68 to 95% in three pilot studies (fractionated, single-dose and total body irradiations). In controlled studies, ondansetron efficacy was significantly higher than placebo, metoclopramide and prochlorperazine. The treatment was well tolerated in the different studies. (authors). 23 refs., 2 figs., 1 tab

Efficacy of 5-HT3 receptor antagonists in radiotherapy-induced nausea and vomiting: A quantitative systematic review

International Nuclear Information System (INIS)

Tramer, M.R.; Reynolds, D.J.M.; Stoner, N.S.; Moore, R.A.; McQuay, H.J.

1998-01-01

5-HT 3 receptor antagonists are used to treat radiation-induced sickness. The purpose of this study was to define anti-emetic efficacy and potential for harm of these drugs in radiotherapy. A systematic search, critical appraisal and quantitative analysis of relevant data using the number-needed-to-treat or harm (NNT/H) were conducted. Acute (0 to 24 h) and delayed (beyond 24 h) anti-emetic efficacy were analysed separately. Data from 1,404 patients were found in 40 trials published in 36 reports. Data from 197 patients receiving ondansetron or granisetron in five randomised trials were regarded as valid according to preset criteria. One placebo-controlled trial had 10 patients per group and in this ondansetron was not significantly different from placebo. In a larger (n=105) placebo-controlled trial, ondansetron was significantly more efficacious than metoclopramide for complete control of acute vomiting (NNT 2.2, 95% confidence interval (CI) 1.7-3.3) and acute nausea (NNT 3.6, 95% CI 2.2-10.2). Three trials reported delayed outcomes with ondansetron or granisetron: there was no evidence of any difference compared with placebo or other anti-emetics. Two trials reported no acute or delayed but a 'worst day' outcome; in these ondansetron's antivomiting effect was significantly better than placebo (NNT 4.4, 95% CI 2.5-23) or prochlorperazine (NNT 3.8, 95% CI 2.4-10.3), but not its antinausea effect. Constipation and headache were associated significantly with 5-HT 3 receptor antagonists compared with other anti-emetics or placebo (NNH 6.4 and 17.1, respectively). Only 14% of published data enabled valid estimation of the anti-emetic efficacy of 5-HT 3 receptor antagonists in radiotherapy. There was some evidence that these drugs prevent acute vomiting: 40% of treated patients will benefit (NNT approximately 2.5). The evidence for nausea was less clear. There was no evidence that these drugs are of any benefit beyond 24 h. There was evidence that they produce specific

Efficacy of 5-HT{sub 3} receptor antagonists in radiotherapy-induced nausea and vomiting: A quantitative systematic review

Energy Technology Data Exchange (ETDEWEB)

Tramer, M.R. [Pain Research and Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, The Churchill, Headington, Oxford (United Kingdom); Reynolds, D.J.M. [Department of Clinical Pharmacology, Radcliffe Infirmary, Oxford, Radcliffe Hospital (United Kingdom); Stoner, N.S. [ICRF Department of Medical Oncology, Oxford Radcliffe Hospital (United Kingdom); Moore, R.A.; McQuay, H.J. [Pain Research and Nuffield Department of Anaesthetics, University of Oxford, Oxford Radcliffe Hospital, The Churchill, Headington, Oxford (United Kingdom)

1998-11-01

5-HT{sub 3} receptor antagonists are used to treat radiation-induced sickness. The purpose of this study was to define anti-emetic efficacy and potential for harm of these drugs in radiotherapy. A systematic search, critical appraisal and quantitative analysis of relevant data using the number-needed-to-treat or harm (NNT/H) were conducted. Acute (0 to 24 h) and delayed (beyond 24 h) anti-emetic efficacy were analysed separately. Data from 1,404 patients were found in 40 trials published in 36 reports. Data from 197 patients receiving ondansetron or granisetron in five randomised trials were regarded as valid according to preset criteria. One placebo-controlled trial had 10 patients per group and in this ondansetron was not significantly different from placebo. In a larger (n=105) placebo-controlled trial, ondansetron was significantly more efficacious than metoclopramide for complete control of acute vomiting (NNT 2.2, 95% confidence interval (CI) 1.7-3.3) and acute nausea (NNT 3.6, 95% CI 2.2-10.2). Three trials reported delayed outcomes with ondansetron or granisetron: there was no evidence of any difference compared with placebo or other anti-emetics. Two trials reported no acute or delayed but a 'worst day' outcome; in these ondansetron's antivomiting effect was significantly better than placebo (NNT 4.4, 95% CI 2.5-23) or prochlorperazine (NNT 3.8, 95% CI 2.4-10.3), but not its antinausea effect. Constipation and headache were associated significantly with 5-HT{sub 3} receptor antagonists compared with other anti-emetics or placebo (NNH 6.4 and 17.1, respectively). Only 14% of published data enabled valid estimation of the anti-emetic efficacy of 5-HT{sub 3} receptor antagonists in radiotherapy. There was some evidence that these drugs prevent acute vomiting: 40% of treated patients will benefit (NNT approximately 2.5). The evidence for nausea was less clear. There was no evidence that these drugs are of any benefit beyond 24 h. There was

A prospective randomized comparative clinical trial comparing the efficacy between ondansetron and metoclopramide for prevention of nausea and vomiting in patients undergoing fractionated radiotherapy to the abdominal region

International Nuclear Information System (INIS)

Park, Hee Chul; Suh, Chang Ok; Seong, Jin Sil; Cho, Jae Ho; Lim, John Jihoon; Park, Won; Song, Jae Seok; Kim, Gwi Eon

2001-01-01

This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy at ondansetron(Zofran) 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg tid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tables including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was 52.9± 11.2 in group M, 46.5±9.6 in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly

A prospective randomized comparative clinical trial comparing the efficacy between ondansetron and metoclopramide for prevention of nausea and vomiting in patients undergoing fractionated radiotherapy to the abdominal region

Energy Technology Data Exchange (ETDEWEB)

Park, Hee Chul; Suh, Chang Ok; Seong, Jin Sil; Cho, Jae Ho; Lim, John Jihoon; Park, Won; Song, Jae Seok; Kim, Gwi Eon [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

2001-06-01

This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy at ondansetron(Zofran) 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg tid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tables including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was 52.9{+-} 11.2 in group M, 46.5{+-}9.6 in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of

Mechanisms of Broad-Spectrum Antiemetic Efficacy of Cannabinoids against Chemotherapy-Induced Acute and Delayed Vomiting

Directory of Open Access Journals (Sweden)

Nissar A. Darmani

2010-09-01

Full Text Available Chemotherapy-induced nausea and vomiting (CINV is a complex pathophysiological condition and consists of two phases. The conventional CINV neurotransmitter hypothesis suggests that the immediate phase is mainly due to release of serotonin (5-HT from the enterochromaffin cells in the gastrointestinal tract (GIT, while the delayed phase is a consequence of release of substance P (SP in the brainstem. However, more recent findings argue against this simplistic neurotransmitter and anatomical view of CINV. Revision of the hypothesis advocates a more complex, differential and overlapping involvement of several emetic neurotransmitters/modulators (e.g. dopamine, serotonin, substance P, prostaglandins and related arachidonic acid derived metabolites in both phases of emesis occurring concomitantly in the brainstem and in the GIT enteric nervous system (ENS [1]. No single antiemetic is currently available to completely prevent both phases of CINV. The standard antiemetic regimens include a 5-HT3 antagonist plus dexamethasone for the prevention of acute emetic phase, combined with an NK1 receptor antagonist (e.g. aprepitant for the delayed phase. Although NK1 antagonists behave in animals as broad-spectrum antiemetics against different emetogens including cisplatin-induced acute and delayed vomiting, by themselves they are not very effective against CINV in cancer patients. Cannabinoids such as D9-THC also behave as broad-spectrum antiemetics against diverse emetic stimuli as well as being effective against both phases of CINV in animals and patients. Potential side effects may limit the clinical utility of direct-acting cannabinoid agonists which could be avoided by the use of corresponding indirect-acting agonists. Cannabinoids (both phyto-derived and synthetic behave as agonist antiemetics via the activation of cannabinoid CB1 receptors in both the brainstem and the ENS emetic loci. An endocannabinoid antiemetic tone may exist since inverse CB1

Why can't rodents vomit? A comparative behavioral, anatomical, and physiological study.

Directory of Open Access Journals (Sweden)

Charles C Horn

Full Text Available The vomiting (emetic reflex is documented in numerous mammalian species, including primates and carnivores, yet laboratory rats and mice appear to lack this response. It is unclear whether these rodents do not vomit because of anatomical constraints (e.g., a relatively long abdominal esophagus or lack of key neural circuits. Moreover, it is unknown whether laboratory rodents are representative of Rodentia with regards to this reflex. Here we conducted behavioral testing of members of all three major groups of Rodentia; mouse-related (rat, mouse, vole, beaver, Ctenohystrica (guinea pig, nutria, and squirrel-related (mountain beaver species. Prototypical emetic agents, apomorphine (sc, veratrine (sc, and copper sulfate (ig, failed to produce either retching or vomiting in these species (although other behavioral effects, e.g., locomotion, were noted. These rodents also had anatomical constraints, which could limit the efficiency of vomiting should it be attempted, including reduced muscularity of the diaphragm and stomach geometry that is not well structured for moving contents towards the esophagus compared to species that can vomit (cat, ferret, and musk shrew. Lastly, an in situ brainstem preparation was used to make sensitive measures of mouth, esophagus, and shoulder muscular movements, and phrenic nerve activity-key features of emetic episodes. Laboratory mice and rats failed to display any of the common coordinated actions of these indices after typical emetic stimulation (resiniferatoxin and vagal afferent stimulation compared to musk shrews. Overall the results suggest that the inability to vomit is a general property of Rodentia and that an absent brainstem neurological component is the most likely cause. The implications of these findings for the utility of rodents as models in the area of emesis research are discussed.

Investigation of impact of water type on borate ore flotation.

Science.gov (United States)

Ozkan, S G; Acar, A

2004-04-01

In this work, the impact of water type on borate ore flotation was investigated, while various physical parameters during flotation were considered in order to compare the results. Two different colemanite samples from Emet deposits of Turkey, named as Emet-A and Emet-B contained 44% B(2)O(3) and 40% B(2)O(3), respectively. The flotation tests were performed at feed particle size range of -210 +20 microm. Optimal consumption values for the reagents were determined as 2000 gt(-1) for AeroPromoter R825 from Cytec Company, a sulphonate type collector, 1500 gt(-1) for Procol CA927 from Allied Colloids Company, a sulphosuccinamate type collector and 100 gt(-1) for AeroFrother 70 from Cytec Company, an alcohol-type frother. In the tests, the impeller speed of the Denver-type flotation machine was set to 1200 rpm and the samples were fed into a litre cell at 25% solid/liquid ratio and at natural pH value of the slurry at room temperature. The flotation results obtained from the tests with use of tap water, demineralised water and the artificial water prepared with Ca(2+) and Mg(2+) cations deliberately added into demineralised water were compared to each other in optimal flotation conditions.

Projekt projekteerib jätkusuutlikku turismi / Aime Jaagus

Index Scriptorium Estoniae

Jaagus, Aime

2012-01-01

Tartu Kutsehariduskeskuse turismiosakond osales aastatel 2008-2010 rahvusvahelise Comeniuse programmi projektis "EMET - EnvironMentally Educated Tourist", mille eesmärk oli teadmiste ja kogemuste hankimine jätkusuutliku turismi arendamiseks

Profile of Antiemetic Activity of Netupitant Alone or in Combination with Palonosetron and Dexamethasone in Ferrets and Suncus murinus (house musk shrew

Directory of Open Access Journals (Sweden)

John A Rudd

2016-08-01

Full Text Available Background and Aims: Chemotherapy-induced acute and delayed emesis involves the activation of multiple pathways, with 5-hydroxytryptamine (5-HT; serotonin playing a major role in the initial response. Substance P tachykinin NK1 receptor antagonists can reduce emesis induced by disparate emetic challenges and therefore have a clinical utility as broad inhibitory anti-emetic drugs. In the present studies, we investigate the broad inhibitory anti-emetic profile of a relatively new NK1 receptor antagonist, netupitant, alone or in combination with the long acting 5-HT3 receptor antagonist, palonosetron, for a potential to reduce emesis in ferrets and shrews.Materials and Methods: Ferrets were pretreated with netupitant and/or palonosetron, or their combination, and then administered apomorphine (0.125 mg/kg, s.c., morphine (0.5 mg/kg, s.c., ipecacuanha (1.2 mg/kg, p.o., copper sulphate (100 mg/kg, intragastric, or cisplatin (5-10 mg/kg, i.p.; in other studies netupitant was administered to Suncus murinus before motion (4 cm horizontal displacement, 2 Hz for 10 min.Results: Netupitant (3 mg/kg, p.o. abolished apomorphine-, morphine-, ipecacuanha- and copper sulphate-induced emesis. Lower doses of netupitant (0.03-0.3 mg/kg, p.o. dose-dependently reduced cisplatin (10 mg/kg, i.p.-induced emesis in an acute (8 h model, and motion-induced emesis in Suncus murinus. In a ferret cisplatin (5 mg/kg, i.p.-induced acute and delayed emesis model, netupitant administered once at 3 mg/kg, p.o., abolished the first 24 h response and reduced the 24-72 h response by 94.6 %; the reduction was markedly superior to the effect of a three times per day administration of ondansetron (1 mg/kg, i.p.. A single administration of netupitant (1 mg/kg, p.o. plus palonosetron (0.1 mg/kg, p.o. combined with dexamethasone (1 mg/kg, i.p., once per day, also significantly antagonized cisplatin-induced acute and delayed emesis and was comparable with a once-daily regimen of

Autoradiographic localization of peptide YY and neuropeptide Y binding sites in the medulla oblongata

International Nuclear Information System (INIS)

Leslie, R.A.; McDonald, T.J.; Robertson, H.A.

1988-01-01

Peptide YY is a highly potent emetic when given intravenously in dogs. We hypothesized that the area postrema, a small brain stem nucleus that acts as a chemoreceptive trigger zone for vomiting and lies outside the blood-brain barrier, might have receptors that PYY would bind to, in order to mediate the emetic response. We prepared [ 125 I]PYY and used autoradiography to show that high affinity binding sites for this ligand were highly localized in the area postrema and related nuclei of the dog medulla oblongata. Furthermore, the distribution of [ 125 I]PYY binding sites in the rat medulla oblongata was very similar to that in the dog; the distribution of [ 125 I]PYY binding sites throughout the rat brain was seen to be similar to the distribution of [ 125 I]NPY binding sites

Dgroup: DG00486 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available agonist ... DG01467 ... Dopamine D1-receptor agonist ... DG01468 ... Dopamine D2-receptor agonist ... DG01967 ... Antiparkinson... agent ATC code: G04BE07 N04BC07 Antiparkinsonian, Emetic, Dopamine receptor

New approaches to chemotherapy-induced nausea and vomiting: from neuropharmacology to clinical investigations.

Science.gov (United States)

Rubenstein, Edward B; Slusher, Barbara S; Rojas, Camilo; Navari, Rudolph M

2006-01-01

Nausea and vomiting are considered to be among the most distressing consequences of cytotoxic chemotherapies. Currently, there are several novel 5-HT(3) receptor antagonists for the treatment of chemotherapy-induced nausea and vomiting (CINV), including ondansetron, granisetron, and dolasetron. These agents provide significant improvement in the management of acute emesis but are ineffective at preventing delayed emesis. In 2003, a new 5-HT(3) receptor antagonist, palonosetron HCL (Aloxi), was introduced to the U.S. market. Palonosetron was found to be effective in preventing delayed CINV. Indeed, palonosetron was the first and only 5-HT(3) receptor antagonist approved by the FDA for the prevention of both acute and delayed CINV. More recently, studies on the role of substance P in the emetic process led to the development of aprepitant (Emend) for the prevention of delayed emesis in combination with 5-HT(3) receptor antagonists. Despite these major advances, CINV remains uncontrolled in some patients. Current efforts are focused on treating refractory emesis and include both the clinical evaluation of compounds marketed for other indications and the preclinical evaluation of novel molecules targeting other transmitters in the emetic pathway. Ongoing work in pharmacogenomics has postulated several candidate genes that could be involved in emetic sensitivity and responsiveness to antiemetic therapy. Investigations into the pharmacogenomics of CINV may someday be able to aid in the identification of high risk patients and patients unlikely to respond to conventional therapies.

Addition of 3-day aprepitant to ondansetron and dexamethasone for prophylaxis of chemotherapy-induced nausea and vomiting among patients with diffuse large B cell lymphoma receiving 5-day cisplatin-based chemotherapy

Directory of Open Access Journals (Sweden)

Raafat Abdel-Malek

2017-09-01

Conclusion: This triple anti-emetic regimen showed efficacy in controlling the multi-day cisplatin-induced nausea and vomiting. Further randomized controlled trials are needed to compare between 3-day and 7-day aprepitant for multi-day cisplatin regimens.

Liquid Fuels From Plants

Indian Academy of Sciences (India)

cultivation would not put pressure on the land used for food crops. However ... trunk or branch, a fluid oozes. This 'latex' is .... Department of Mechanical Engineering, IISc, Bangalore 560012, Email:udipi@sutra.iisc.emet.in important food items ...

Aromatherapy for treatment of postoperative nausea and vomiting.

Science.gov (United States)

Hines, Sonia; Steels, Elizabeth; Chang, Anne; Gibbons, Kristen

2012-04-18

Postoperative nausea and vomiting is a common and unpleasant phenomenon and current therapies are not always effective for all patients. Aromatherapy has been suggested as a possible addition to the available treatment strategies. This review sought to establish what effect the use of aromatherapy has on the severity and duration of established postoperative nausea and vomiting and whether aromatherapy can be used with safety and clinical effectiveness comparable to standard pharmacological treatments. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3); MEDLINE; EMBASE; CINAHL; CAM on PubMed; Meditext; LILACS; and ISI Web of Science as well as grey literature sources and the reference lists of retrieved articles. We conducted database searches up to August 2011. We included all randomized controlled trials (RCTs) and controlled clinical trials (CCTs) where aromatherapy was used to treat postoperative nausea and vomiting. Interventions were all types of aromatherapy. Aromatherapy was defined as the inhalation of the vapours of any substance for the purposes of a therapeutic benefit. Primary outcomes were the severity and duration of postoperative nausea and vomiting. Secondary outcomes were adverse reactions, use of rescue anti-emetics and patient satisfaction with treatment. Two review authors assessed risk of bias in the included studies and extracted data. As all outcomes analysed were dichotomous, we used a fixed-effect model and calculated relative risk (RR) with associated 95% confidence interval (95% CI). The nine included studies comprised six RCTs and three CCTs with a total of 402 participants. The mean age and range data for all participants were not reported for all studies. The method of randomization in four of the six included RCTs was explicitly stated and was adequate. Incomplete reporting of data affected the completeness of the analysis. Compared with placebo, isopropyl alcohol vapour

Estimation of body surface area in the musk shrew ( Suncus murinus): a small animal for testing chemotherapy-induced emesis.

Science.gov (United States)

Eiseman, Julie L; Sciullo, Michael; Wang, Hong; Beumer, Jan H; Horn, Charles C

2017-10-01

Several cancer chemotherapies cause nausea and vomiting, which can be dose-limiting. Musk shrews are used as preclinical models for chemotherapy-induced emesis and for antiemetic effectiveness. Unlike rats and mice, shrews possess a vomiting reflex and demonstrate an emetic profile similar to humans, including acute and delayed phases. As with most animals, dosing of shrews is based on body weight, while translation of such doses to clinically equivalent exposure requires doses based on body surface area. In the current study body surface area in musk shrews was directly assessed to determine the Meeh constant (K m ) conversion factor (female = 9.97, male = 9.10), allowing estimation of body surface area based on body weight. These parameters can be used to determine dosing strategies for shrew studies that model human drug exposures, particularly for investigating the emetic liability of cancer chemotherapeutic agents.

Dexamethasone enhances the anti-emetic effect of metoclopramide ...

African Journals Online (AJOL)

Ninety patients, ASA I or II, aged 21-64years were randomly selected to either the dexamethasone-metoclopramide group, metoclopramide group or dexamethasone group using computer-generated random numbers . Spinal anaesthesia was induced in the sitting position under strict aseptic technique with hyperbaric ...

5-HT3-receptorantagonisten als vervangers van metoclopramide en domperidon

NARCIS (Netherlands)

Mouch, Ikrame; Brouwers, J R B J; van 't Riet, E; Nieboer, Peter; Otten, Marten H; Jansman, Frank G A

2016-01-01

OBJECTIVE: To investigate whether the anti-emetics metoclopramide and domperidone can be replaced by 5-HT3-antagonists, as side effects restrict use of these dopamine antagonists. DESIGN: Systematic review. METHOD: We searched the Embase and PubMed databases for articles published in the period

2016 Updated MASCC/ESMO Consensus Recommendations

DEFF Research Database (Denmark)

Olver, Ian; Ruhlmann, Christina H.; Jahn, Franziska

2017-01-01

the MASCC antiemetic guidelines. A subgroup performed a systematic literature review on antiemetics for low emetogenic chemotherapy (LEC) and chemotherapy of minimal emetic potential and the chair presented the update recommendation to the whole group for discussion. They then voted with an aim of achieving...

Radiogenic hepatitis

Energy Technology Data Exchange (ETDEWEB)

Rey, G; Woellgens, P; Haase, W [Katharinenhospital, Stuttgart (F.R. Germany). Strahlenklinik

1976-08-01

The article is about a patient who developed hepatitis after post-operative radiotherapy of a hypernephroma on the right side with /sup 60/Co ..gamma.. radiation. The scintigraph showed a normal-sized liver with parenchymal defects. Therapy consisted of anti-emetics and vitamin preparations.

Structural basis of ligand recognition in 5-HT(3) receptors

NARCIS (Netherlands)

Kesters, D.; Thompson, A.J.; Brams, M.; van Elk, R.; Spurny, R.; Geitmann, M.; Villalgordo, J.M.; Guskov, A.; Danielson, U.H.; Lummis, S.C.R.; Smit, A.B.; Ulens, C.

2013-01-01

The 5-HT 3 receptor is a pentameric serotonin-gated ion channel, which mediates rapid excitatory neurotransmission and is the target of a therapeutically important class of anti-emetic drugs, such as granisetron. We report crystal structures of a binding protein engineered to recognize the agonist

A probability model for enterotoxin production of Bacillus cereus as a function of pH and temperature

Science.gov (United States)

Bacillus cereus is frequently isolated from a variety of foods including vegetables, dairy products, meat, and other raw and processed foods. The bacterium is capable of producing enterotoxin and emetic toxin that can cause severe nausea, vomiting and diarrhea. The objectives of this study were to a...

Alcohol-Aversion Therapy: Relation Between Strength of Aversion and Abstinence.

Science.gov (United States)

Cannon, Dale S.; And Others

1986-01-01

Assessed degree of alcohol aversion in 60 alcoholics who received emetic alcohol-aversion therapy. Results revealed changes in response to alcoholic, but not to nonalcoholic, flavors, including decreased consumption in taste tests, more negative flavor ratings, overt behavioral indicants of aversion and increased tachycardiac response. (Author/NB)

Action of Bacopa monnieri to antagonize cisplatin-induced emesis in Suncus murinus (house musk shrew

Directory of Open Access Journals (Sweden)

Ihsan Ullah

2017-04-01

Full Text Available Bacopa monnieri (BM, family Scrophulariaceae is used in several traditional systems of medicine for the management of epilepsy, depression, neuropathic pain, sleep disorders and memory deficits. The present study investigated the potential of BM methanol (BM-MetFr and BM n-butanol fractions (BM-ButFr to reduce chemotherapy-induced emesis in Suncus murinus (house musk shrew. Cisplatin (30 mg/kg, i.p. reliably induced retching and/or vomiting over a 2 day period. BM-MetFr (10–40 mg/kg, s.c. and BM-ButFr (5–20 mg/kg, s.c. antagonized the retching and/or vomiting response by ∼59.4% (p  0.05. In conclusion, the n-butanol fractions of BM have anti-emetic activity comparable with palonosetron and MPG. BM may be useful alone or in combination with other anti-emetic drugs for the treatment of chemotherapy-induced emesis in man.

Hollow silicon microneedle array based trans-epidermal antiemetic patch for efficient management of chemotherapy induced nausea and vomiting

Science.gov (United States)

Kharbikar, Bhushan N.; Kumar S., Harish; Kr., Sindhu; Srivastava, Rohit

2015-12-01

Chemotherapy Induced Nausea and Vomiting (CINV) is a serious health concern in the treatment of cancer patients. Conventional routes for administering anti-emetics (i.e. oral and parenteral) have several drawbacks such as painful injections, poor patient compliance, dependence on skilled personnel, non-affordability to majority of population (parenteral), lack of programmability and suboptimal bioavailability (oral). Hence, we have developed a trans-epidermal antiemetic drug delivery patch using out-of-plane hollow silicon microneedle array. Microneedles are pointed micron-scale structures that pierce the epidermal layer of skin to reach dermal blood vessels and can directly release the drug in their vicinity. They are painless by virtue of avoiding significant contact with dermal sensory nerve endings. This alternate approach gives same pharmacodynamic effects as par- enteral route at a sparse drug-dose requirement, hence negligible side-effects and improved patient compliance. Microneedle design attributes were derived by systematic study of human skin anatomy, natural micron-size structures like wasp-sting and cactus-spine and multi-physics simulations. We used deep reactive ion etching with Bosch process and optimized recipe of gases to fabricate high-aspect-ratio hollow silicon microneedle array. Finally, microneedle array and polydimethylsiloxane drug reservoir were assembled to make finished anti-emetic patch. We assessed microneedles mechanical stability, physico-chemical properties and performed in-vitro, ex- vivo and in-vivo studies. These studies established functional efficacy of the device in trans-epidermal delivery of anti-emetics, its programmability, ease of use and biosafety. Thus, out-of-plane hollow silicon microneedle array trans-epidermal antiemetic patch is a promising strategy for painless and effective management of CINV at low cost in mainstream healthcare.

Why are chillies pungent?

Indian Academy of Sciences (India)

ultrapotent analogue of capsaicin, resiniferatoxin, is found in the latex of the succulent spiny shrub. Euphorbia resinifera, and its use in pain mediation has been known since Roman times (Appendino and Szallasi 1997). Resiniferatoxin has been shown to have acute emetic effects in the house musk shrew (Andrews et al ...

Effect of modified atmosphere and temperature abuse on the growth from spores and cereulide production of Bacillus weihenstephanensis in a cooked chilled meat sausage

DEFF Research Database (Denmark)

Thorsen, Line; Budde, Birgitte Bjørn; Koch, Anette Granly

2009-01-01

demonstrates that MAP can be used to inhibit growth of a psychrotolerant toxin producing Bacillus spp. during chill storage at 8 °C, and substantially reduce the risk of emetic food poisoning at abuse condition. Results are of relevance for improving safety of ready to eat processed chilled foods of extended...

Health Effects of Hexachloroethane (HC) Smoke

Science.gov (United States)

1994-02-08

stomach. Ingestion can also cause corrosive gastritis and liver necrosis (Hill et al., 1978). Concentrations of 225-450 mg of zinc salts are emetic and...et. al, (1983) and noted that the histological effects seen by Marrs et al, were more pronounced, suggesting the differences were due to the 10 times

Dispersión sísmica por presencia de capas someras de alta velocidad: modelamiento con diferencias finitas

Directory of Open Access Journals (Sweden)

Céspedes Sandra

2002-08-01

Full Text Available

Through finite difference modelling, we studied the effects of seismic scattering due near surface high velocity layers, with varied contrasts and thickness, and their influence on seismic data. Despite conventional methods to eliminate noise mainly based in a mathematical approach, i.e., F-K analysis, Radon transform, we apply a deterministic scheme based on the modeling of wave propagation, generating the unwanted signals (Ernst <em>et al., 1998; Blonk <em>et al., 1995; Blonk and Hermann, 1994.

The detailed understanding of the backscattering phenomenon allows to discern what can be considered noise and therefore to define attenuation' s strategies (Lamer <em>et al., 1983. In presence of near surface high velocity layers, part of the original seismic energy is scattered in these layers and only a smaller fraction is transmitted to the Earth' s interior, generating coherent noise that masks the information comming from the deeper reflectors (Leslie and Evans, 1999. A 20 model was designed to obtain synthetic seismograms. The simulation shows the scattering mechanism related with velocity inversions in the near surface layers, allowing to characterize their influence on seismic records. The unwanted signal is subtracted from that considered information. The results obtained in this work are bounded to the analysis of synthetic data.

Mediante el modelamiento con diferencias finitas, se

Suppression of Cisplatin-Induced Vomiting by Cannabis sativa in Pigeons: Neurochemical Evidences

Directory of Open Access Journals (Sweden)

Ihsan Ullah

2018-03-01

Full Text Available Cannabis sativa (CS, family Cannabinaceae has been reported for its anti-emetic activity against cancer chemotherapy-induced emesis in animal models and in clinics. The current study was designed to investigate CS for potential effectiveness to attenuate cisplatin-induced vomiting in healthy pigeons and to study the impact on neurotransmitters involved centrally and peripherally in the act of vomiting. High-performance liquid chromatography system coupled with electrochemical detector was used for the quantification of neurotransmitters 5-hydroxytryptamine (5HT, dopamine (DA and their metabolites; Di-hydroxy Phenyl Acetic acid (Dopac, Homovanillic acid (HVA, and 5-hydroxy indole acetic acid (5HIAA centrally in specific brain areas (area postrema and brain stem while, peripherally in small intestine. Cisplatin (7 mg/kg i.v. induce emesis without lethality across the 24 h observation period. CS hexane fraction (CS-HexFr; 10 mg/kg attenuated cisplatin-induced emesis ∼ 65.85% (P < 0.05; the reference anti-emetic drug, metoclopramide (MCP; 30 mg/kg, produced ∼43.90% reduction (P < 0.05. At acute time point (3rd h, CS-HexFr decreased (P < 0.001 the concentration of 5HT and 5HIAA in the area postrema, brain stem and intestine, while at 18th h (delayed time point CS-HexFr attenuated (P < 0.001 the upsurge of 5HT caused by cisplatin in the brain stem and intestine and dopamine in the area postrema. CS-HexFr treatment alone did not alter the basal neurotransmitters and their metabolites in the brain areas and intestine except 5HIAA and HVA, which were decreased significantly. In conclusion the anti-emetic effect of CS-HexFr is mediated by anti-serotonergic and anti-dopaminergic components in a blended manner at the two different time points, i.e., 3rd and 18th h in pigeons.

Comparison of the Effect of Ondansetrone - Dexamethasone, Dexamethasone – Metoclopeamide and Ondansetron - Normal Saline in Decreasing Post Operative Nausa and Vomitting (PONV after Middle Ear Surgery

Directory of Open Access Journals (Sweden)

Haddadi Soudabeh

2009-09-01

Full Text Available Background: The incidence of post-operative nausea and vomitting (PONV is increased after middle ear surgery and it may complicate and interact with reconstruction after surgery, so prevention and treatment of these complications are necessary.The aim of this study was to evaluate the efficacy of anti-emetic combinations in decreasing the PONV after middle ear surgery.Materials and methods: This double blind clinical trial was carried out during 2007-2008 on 111 patients of 15-45 years old with ASA I-II who were candidates for elective middle ear surgery under general anesthesia. The patients were divided into three groups. Patients in the ON group received Ondansetrone 0.1mg/kg + Nacl 0.9% 2cc, OD group received Ondansetrone 0.1mg/kg + Dexamethasone 0.15mg/kg and MD group received Dexamethasone 0.15mg/kg+ Metoclopramide 0.15mg/kg intravenously just before the end of surgery. The patients were evaluated for nausea, vomiting, need of anti-emetic drugs and drug dosage in recovery, 1-6, 6-12 and 12-24 hours after operation and then all data were statistically analyzed by SPSS software, Chi-square, ANOVA and t- Test. P<0.05 was significant.Results: There were no significant differences among three groups in age and sex. The incidence of PONV among 3 groups was not significantly different during 24 hours after operation. (P=0.271 but the incidence of PONV in the first six hours was different among 3 groups (P=0.007 (ON: 8.1%, OD: 0%, MD: 21.6%. Also Metoclopramide consumption was significant between three groups. Conclusion: This study showed that the need to anti-emetic drugs in first 6 hours was the least in OD group, but the difference in the incidence of PONV was not significant otherwise.

Browse Title Index

African Journals Online (AJOL)

Vol 7, No 17 (2008), Anti-emetic activity of Grewia lasiodiscus root extract and fractions, Abstract PDF. AY Tijani, SE Okhale, FE Oga, SZ Tags, OA Salawu, BA Chindo. Vol 13, No 27 (2014), Antifouling potential of seaweed, sponge and cashew nut oil extracts against biofilm bacteria and green mussel Perna viridis from ...

Ergometrine given during caesarean section and incidence of delayed postpartum haemorrhage due to uterine atony.

Science.gov (United States)

Lourens, R; Paterson-Brown, S

2007-11-01

Delayed postpartum haemorrhage due to uterine atony after caesarean section was occurring in women in our recovery area despite many of them already having an oxytocin infusion running to prevent such a problem. We therefore decided to compare the incidence of such problems for a 2-month period before and after altering our uterotonic policy: in addition to the routine bolus dose of 5 units of oxytocin after delivery of the baby, we added 500 microg of intramuscular ergometrine during abdominal closure. We noticed a reduced number of massive postpartum haemorrhages due to an atonic uterus in the recovery room but an increased incidence of nausea and vomiting. No prophylactic anti-emetic was given during this pilot study. This small study suggests that 50 women would need to be given ergometrine at caesarean section to prevent one delayed massive haemorrhage from uterine atony and four extra women would suffer with vomiting. We feel this is reasonable and now use a prophylactic anti-emetic as well as delaying the ergometrine until closure of the rectus sheath which reduces the incidence of nausea and vomiting.

A prospective randomized double-blind trial comparing ondansetron versus prochlorperazine for the prevention of nausea and vomiting in patients undergoing fractionated radiotherapy

International Nuclear Information System (INIS)

Priestman, T.J.; Roberts, J.T.; Upadhyaya, B.K.

1993-01-01

In a multicentre, international double-blind trial, patients undergoing courses of five or more daily radiotherapy treatments to the upper abdomen were randomized to receive either oral ondansetron 8 mg t.d.s. or oral prochlorperazine 10 mg t.d.s. throughout their radiation course in order to try to prevent nausea and vomiting. A total of 192 patients were recruited, 135 of whom were included in the efficacy analysis; of these, 70 received ondansetron and 65 prochlorperazine. Forty-three (61%) of the patients prescribed ondansetron and 23 (35%) of those given prochlorperazine had a complete response, with no emetic episodes throughout their treatment course. There was, however, no significant difference between the two groups with respect to the incidence and severity of nausea. Seventeen (24%) of the patients on ondansetron and 19 (29%) of those given prochlorperazine were treatment failures, experiencing more than five emetic episodes on their worst day during the study. Both drugs were well tolerated, although constipation was seen more commonly with ondansetron. (author)

Antiemetic therapy for non-anthracycline and cyclophosphamide moderately emetogenic chemotherapy.

Science.gov (United States)

Inui, Naoki

2017-05-01

Although antiemetic management in cancer therapy has improved, chemotherapy-induced nausea and vomiting remain common and troubling adverse events. Chemotherapeutic agents are classified based on their emetogenic effects, and appropriate antiemetics are recommended according to this categorization. Chemotherapy categorized as moderately emetogenic is associated with a wide spectrum of emetic risks. Combined anthracycline and cyclophosphamide regimens have been recently reclassified as highly emetogenic chemotherapy regimen. This review focuses on antiemetic pharmacotherapy in patients receiving non-anthracycline and cyclophosphamide-based moderately emetogenic chemotherapy regimens. Combination therapy with a 5-hydroxytryptamine-3 receptor agonist, preferably palonosetron, and dexamethasone is the standard therapy in moderately emetogenic chemotherapy, although triple therapy with add-on neurokinin-1 receptor antagonist is used as an alternative treatment strategy. Among moderately emetogenic chemotherapy regimens, carboplatin-containing chemotherapy has considerable emetic potential, particularly during the delayed phase. However, the additional of a neurokinin-1 receptor antagonist to the standard antiemetic therapy prevents carboplatin-induced nausea and vomiting. For regimens including oxaliplatin, the benefit of adding neurokinin-1 receptor antagonist requires further clarification.

Emesis, radiation exposure, and local cerebral blood flow in the ferret

International Nuclear Information System (INIS)

Tuor, U.I.; Kondysar, M.H.; Harding, R.K.

1988-01-01

We examined the sensitivity of the ferret to emetic stimuli and the effect of radiation exposure near the time of emesis on local cerebral blood flow. Ferrets vomited following the administration of either apomorphine (approx 45% of the ferrets tested) or peptide YY (approx 36% of those tested). Exposure to radiation was a very potent emetic stimulus, but vomiting could be prevented by restraint of the hindquarters of the ferret. Local cerebral blood flow was measured using a quantitative autoradiographic technique and with the exception of several regions in the telencephalon and cerebellum, local cerebral blood flow in the ferret was similar to that in the rat. In animals with whole-body exposure to moderate levels of radiation (4 Gy of 137 Cs), mean arterial blood pressure was similar to that in the control group. However, 15-25 min following irradiation there was a general reduction of local cerebral blood flow ranging from 7 to 33% of that in control animals. These cerebral blood flow changes likely correspond to a reduced activation of the central nervous system

Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy.

Science.gov (United States)

Smith, Lesley A; Azariah, Fredric; Lavender, Verna T C; Stoner, Nicola S; Bettiol, Silvana

2015-11-12

Cannabis has a long history of medicinal use. Cannabis-based medications (cannabinoids) are based on its active element, delta-9-tetrahydrocannabinol (THC), and have been approved for medical purposes. Cannabinoids may be a useful therapeutic option for people with chemotherapy-induced nausea and vomiting that respond poorly to commonly used anti-emetic agents (anti-sickness drugs). However, unpleasant adverse effects may limit their widespread use. To evaluate the effectiveness and tolerability of cannabis-based medications for chemotherapy-induced nausea and vomiting in adults with cancer. We identified studies by searching the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and LILACS from inception to January 2015. We also searched reference lists of reviews and included studies. We did not restrict the search by language of publication. We included randomised controlled trials (RCTs) that compared a cannabis-based medication with either placebo or with a conventional anti-emetic in adults receiving chemotherapy. At least two review authors independently conducted eligibility and risk of bias assessment, and extracted data. We grouped studies based on control groups for meta-analyses conducted using random effects. We expressed efficacy and tolerability outcomes as risk ratio (RR) with 95% confidence intervals (CI). We included 23 RCTs. Most were of cross-over design, on adults undergoing a variety of chemotherapeutic regimens ranging from moderate to high emetic potential for a variety of cancers. The majority of the studies were at risk of bias due to either lack of allocation concealment or attrition. Trials were conducted between 1975 and 1991. No trials involved comparison with newer anti-emetic drugs such as ondansetron. Comparison with placebo People had more chance of reporting complete absence of vomiting (3 trials; 168 participants; RR 5.7; 95% CI 2.6 to 12.6; low quality evidence

Metabolism of clebopride in vitro. Mass spectrometry and identification of products of amide hydrolysis and N-debenzylation.

Science.gov (United States)

Huizing, G; Beckett, A H; Segura, J; Bakke, O M

1980-03-01

1. Electron impact and field desorption mass spectrometry is described and discussed for clebopride, a newly developed benzamide with anti-emetic and anti-dopaminergic properties, and for some related compounds. 2. When clebopride was incubated with liver homogenates of rabbits, 4-amino-5-chloro-2-methoxybenzoic acid and N-(4'-piperidyl)-4-amino-5-chloro-2-methoxybenzamide were identified as metabolites.

Current Status of Treatment of Radiation Injury in the United States

Science.gov (United States)

2005-01-01

images. 14. ABSTRACT see report 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 15 19a. NAME...emetic agents including the serotonin receptor antagonists ondansetron (ZofranTM) or granisetron (KytrilTM). Although treating acute symptoms is...with long half-lives, and potentially are dangerous for that reason. Medical sources sometimes suffered inadequate security and inappropriate

Anti-emetic activity of Grewia lasiodiscus root extract and fractions

African Journals Online (AJOL)

STORAGESEVER

2008-09-03

Sep 3, 2008 ... peptic ulcer, drug toxicity, myocardial infarction, renal failure, and ... Anhydrous copper sulphate and metoclopramide were obtained from Sigma ... saline/kg. Groups 2, 3, and 4 ... Extract produced significant (P<0.05) dose dependent shortening ... GABA, have been implicated in sleep mechanisms. (Osuide ...

Characterization of Emetic Bacillus weihenstephanensis, a New Cereulide-Producing Bacterium

DEFF Research Database (Denmark)

Thorsen, Line; Munk Hansen, Bjarne; Nielsen, Kristian Fog

2006-01-01

Cereulide production has until now been restricted to the species Bacillus cereus. Here we report on two psychrotolerant Bacillus weihenstephanensis strains, MC67 and MC118, that produce cereulide. The strains are atypical with regard to pheno- and genotypic characteristics normally used for iden......Cereulide production has until now been restricted to the species Bacillus cereus. Here we report on two psychrotolerant Bacillus weihenstephanensis strains, MC67 and MC118, that produce cereulide. The strains are atypical with regard to pheno- and genotypic characteristics normally used...

USA armee uus digitaalmustriline välivorm / Liisa Mäemets

Index Scriptorium Estoniae

Mäemets, Liisa

2005-01-01

Ameeriklaste uue mustriga sõdurite universaalsest välivormist, mis võimaldab sulanduda metsa-, kõrbe- kui ka linnakeskkonda. Kommenteerib kaitseväe peastaabi logistikaosakonna ülem Raivo Tamm. Art. on koost. internetiallikate põhjal

Genetic diversity of clinical isolates of Bacillus cereus using multilocus sequence typing

Directory of Open Access Journals (Sweden)

Pruckler James M

2008-11-01

Full Text Available Abstract Background Bacillus cereus is most commonly associated with foodborne illness (diarrheal and emetic but is also an opportunistic pathogen that can cause severe and fatal infections. Several multilocus sequence typing (MLST schemes have recently been developed to genotype B. cereus and analysis has suggested a clonal or weakly clonal population structure for B. cereus and its close relatives B. anthracis and B. thuringiensis. In this study we used MLST to determine if B. cereus isolates associated with illnesses of varying severity (e.g., severe, systemic vs. gastrointestinal (GI illness were clonal or formed clonal complexes. Results A retrospective analysis of 55 clinical B. cereus isolates submitted to the Centers for Disease Control and Prevention between 1954 and 2004 was conducted. Clinical isolates from severe infections (n = 27, gastrointestinal (GI illness (n = 18, and associated isolates from food (n = 10 were selected for analysis using MLST. The 55 isolates were diverse and comprised 38 sequence types (ST in two distinct clades. Of the 27 isolates associated with serious illness, 13 clustered in clade 1 while 14 were in clade 2. Isolates associated with GI illness were also found throughout clades 1 and 2, while no isolates in this study belonged to clade 3. All the isolates from this study belonging to the clade 1/cereus III lineage were associated with severe disease while isolates belonging to clade1/cereus II contained isolates primarily associated with severe disease and emetic illness. Only three STs were observed more than once for epidemiologically distinct isolates. Conclusion STs of clinical B. cereus isolates were phylogenetically diverse and distributed among two of three previously described clades. Greater numbers of strains will need to be analyzed to confirm if specific lineages or clonal complexes are more likely to contain clinical isolates or be associated with specific illness, similar to B. anthracis and

Efficacy of tropisetron in patients with advanced non-small-cell lung cancer receiving adjuvant chemotherapy with carboplatin and taxanes.

Science.gov (United States)

Tsavaris, N; Kosmas, C; Kopterides, P; Vadiaka, M; Kosmas, N; Skopelitis, H; Karadima, D; Kolliokosta, G; Tzima, E; Loukeris, D; Pagouni, E; Batziou, E; Xyla, V; Koufos, C

2008-03-01

Even though significant progress has been made, chemotherapy-induced emesis remains a challenging problem. Few studies focus on emesis in patients treated with carboplatin and the observation period is limited to the initial 24 h following chemotherapy. Thus, we investigated if tropisetron (T) monotherapy can adequately prevent acute and delayed emesis in non-small-cell lung cancer (NSCLC) patients receiving a moderately emetogenic chemotherapy (MEC) (carboplatin-containing) regimen. Furthermore, we explored the merits of adding dexamethasone (D) or alprazolam (A) to T, especially in the setting of a pre-existing high level of stress. We studied 60 patients with advanced NSCLC receiving carboplatin and taxanes in three consecutive cycles. During the first cycle, patients received 5 mg of T intravenously before chemotherapy and the same dose per os on each of the following 3 days. In the second cycle, T was co-administered with 8 mg of D once a day, while, during the third cycle, T was combined with per os A 0.25 mg every 12 h and continued over the following 3 days. Finally, we evaluated the impact of stress on the anti-emetic response achieved with the previously described regimens. The combination of T + A was superior to T monotherapy and the combination of T + D, regarding the prevention of acute and delayed emesis. Both T + A and T + D combinations led to appetite improvement, while patients receiving T + A experienced sedation more frequently. Interestingly, subgroup analysis revealed that patients without underlying stress obtained no further benefit by the addition of A or D, while both T + A and T + D combinations led to a better anti-emetic response in patients with stress. In conclusion, T monotherapy provides a satisfactory result in controlling nausea and emesis caused by a MEC regimen in patients without stress. However, the addition of D and, mainly, A improves its anti-emetic effect in patients with obvious stress.

Emesis and Defecations Induced by the 5-Hydroxytryptamine (5-HT3) Receptor Anatagonist Zacopride in the Ferret

Science.gov (United States)

1990-02-16

TERMS 8. NUMBER OF PAGES 8 16. PRICE CODE 17 SECURITY CLASSIFICATION is. SECURITY CLASSIFICATION 19. SECURITY CLASSIFICATION 20. LIMITATION OF OP...the Defense Nuclear erties, i.e., granisetron [BRL43694; Endo-N-[9-methyl-9-aza- Agency has been given or should be inferred. Research was conducted...BMY25801, batanopride; BRL43694, granisetron ; GI, gastrointestinal; ACh, acetylcholine. 1034 1990 Emetic Properties of Zacopnde 1035 benzamide HCI; Gylys et

Direct detection of toxigenic Bacillus cereus in dietary complement for children and cassava starch

Directory of Open Access Journals (Sweden)

Jnnifer A. Sánchez

2014-05-01

Full Text Available Bacillus cereus is a food contaminant and a known human pathogen that can cause emetic and diarrheal syndromes. In this study we evaluated the presence of toxigenic B. cereus by multiplex PCR directly in dietary complement for children and cassava starch samples collected on Medellin, Colombia. Of 75 dietary complement for children samples evaluated, 70.7% were contaminated with toxigenic B. cereus and four different toxigenic consortia were detected: I: nheA, hblC, cytK (9.8%, II: nheA, hblC (2%, III: hblC, cytK (41.2%, IV: hblC (47%. Of 75 cassava starch samples, 44% were contaminated with toxigenic B. cereus and four different toxigenic consortia were determined: I: nheA, hblC, cytK (48.5%, II: nheA, hblC, cytK, cesB (3%, III: hblC, cytK (30.3%, IV: hblC (18.2%. In general, in dietary complement for children only enterotoxigenic consortia were detected while in cassava starch the enterotoxigenic consortia predominated over the emetic. Multiplex PCR was useful to detect toxigenic B. cereus contamination allowing direct and imultaneous detection of all toxin genes in foods. This study is the first in Colombia to evaluate toxigenic B. cereus, providing information of importance for microbiological risk evaluation in dried foods.

Nausea and vomiting in fractionated radiotherapy: a prospective on-demand trial of tropisetron rescue for non-responders to metoclopramide

International Nuclear Information System (INIS)

Miralbell, R.; Behrouz, F.; Coucke, P.

1995-01-01

A prospective trial was performed to better assess the risk of nausea and vomiting and the rescue value of tropisetron (TRO), a 5-HT 3 receptor antagonist, in 88 patients undergoing fractionated radiotherapy to the abdomen or to large supradiaphragmatic fields and failing a first anti-emetic trial with metoclopramide (MET). Nausea was graded 0 (absent), 1 (mild), 2 (moderate) and 3 (severe). Nausea requiring anti-emetics (≥ grade 2) was present in 64% of the patients. MET was able to control nausea (≤ grade 1) in 26 of 58 patients (45%) who developed ≥ grade 2 nausea during radiation treatment (2 patients vomiting without nausea included). 34 patients required TRO, and 31 experienced immediate relief. However, nausea (≥ grade 2) recurred in 7 patients from 1 to 3 weeks after starting TRO. Sex, age, field type and field size (cm 2 ) did not influence the incidence and severity of nausea and vomiting. Only 24/88 patients vomited after starting radiotherapy. MET helped to eliminate emesis in one third of these patients. TRO helped to control vomiting in 73% of the salvaged patients. Constipation was observed in 8 patients on TRO and was a reason to stop the medication in 4 cases. (author)

Final Remedial Investigation Report Area of Contamination (AOC) 57. Volume III. Appendices E through Q

Science.gov (United States)

2000-06-01

hydrocarbon (PAH) contamination from parking lot runoff. Although some residual TPHC and PAH concentrations remained in Area 1 soils after the removal...formulations and has industrial uses in tanneries, as well as the glass and wine making industries. Toxicity depends on its chemical form. Arsenic is an...nature and is an essential element. Copper deficiency is characterized by anemia and is used for medicinal purposes as an emetic and an astringent . Acute

Food restriction, refeeding, and gastric fill fail to affect emesis in musk shrews

OpenAIRE

Horn, Charles C.; Still, Liz; Fitzgerald, Christiana; Friedman, Mark I.

2009-01-01

Nausea and emesis are common side effects of gastrointestinal disease. Reports indicate that ghrelin and endocannabinoids, agents that stimulate appetite, also reduce emesis evoked by chemotherapy treatment, which suggests that stimulation of feeding inhibits the emetic system. In the following study we conducted a more direct test of this hypothesis by determining the impact of manipulating the motivation to eat on emesis, using food restriction and refeeding. Emesis was induced in musk shre...

Palonosetron as an anti-emetic and anti-nausea agent in oncology.

Science.gov (United States)

Aapro, Matti S

2007-12-01

Palonosetron (Aloxi(®), Onicit(®), Paloxi(®)) is a second-generation 5-HT(3) receptor antagonist (RA) with an extended half-life of ~40 hours and high binding affinity for the 5-HT₃ receptor that is markedly different from other 5-HT(3) RAs. Phase III trials demonstrate that a single dose of palonosetron compared with traditional 5-HT₃ RAs is more effective in preventing chemotherapy-induced nausea and vomiting (CINV) during the first 24 hours following chemotherapy (acute CINV), and also exhibits prolonged efficacy to provide significantly better protection from CINV in the delayed and overall phases. This superior and extended protection from CINV conferred by palonosetron following a single intravenous dose before chemotherapy simplifies dosing schedules. Recent research has focused on optimization of palonosetron-based antiemetic regimens, particularly in combination with steroids and neurokinin-1 RAs. The available clinical data indicate high control rates for palonosetron, suggesting a synergistic potential for protection in patients scheduled to receive emetogenic drug regimens.

Brain Activation by H1 Antihistamines Challenges Conventional View of Their Mechanism of Action in Motion Sickness: A Behavioral, c-Fos and Physiological Study in Suncus murinus (House Musk Shrew

Directory of Open Access Journals (Sweden)

Longlong Tu

2017-06-01

Full Text Available Motion sickness occurs under a variety of circumstances and is common in the general population. It is usually associated with changes in gastric motility, and hypothermia, which are argued to be surrogate markers for nausea; there are also reports that respiratory function is affected. As laboratory rodents are incapable of vomiting, Suncus murinus was used to model motion sickness and to investigate changes in gastric myoelectric activity (GMA and temperature homeostasis using radiotelemetry, whilst also simultaneously investigating changes in respiratory function using whole body plethysmography. The anti-emetic potential of the highly selective histamine H1 receptor antagonists, mepyramine (brain penetrant, and cetirizine (non-brain penetrant, along with the muscarinic receptor antagonist, scopolamine, were investigated in the present study. On isolated ileal segments from Suncus murinus, both mepyramine and cetirizine non-competitively antagonized the contractile action of histamine with pKb values of 7.5 and 8.4, respectively; scopolamine competitively antagonized the contractile action of acetylcholine with pA2 of 9.5. In responding animals, motion (1 Hz, 4 cm horizontal displacement, 10 min increased the percentage of the power of bradygastria, and decreased the percentage power of normogastria whilst also causing hypothermia. Animals also exhibited an increase in respiratory rate and a reduction in tidal volume. Mepyramine (50 mg/kg, i.p. and scopolamine (10 mg/kg, i.p., but not cetirizine (10 mg/kg, i.p., significantly antagonized motion-induced emesis but did not reverse the motion-induced disruptions of GMA, or hypothermia, or effects on respiration. Burst analysis of plethysmographic-derived waveforms showed mepyramine also had increased the inter-retch+vomit frequency, and emetic episode duration. Immunohistochemistry demonstrated that motion alone did not induce c-fos expression in the brain. Paradoxically, mepyramine increased c

Effect of olanzapine for breast cancer patients resistant to triplet antiemetic therapy with nausea due to anthracycline-containing adjuvant chemotherapy.

Science.gov (United States)

Sato, Junya; Kashiwaba, Masahiro; Komatsu, Hideaki; Ishida, Kazushige; Nihei, Satoru; Kudo, Kenzo

2016-05-01

Triplet antiemetic therapy with neurokinin 1 receptor blocker, 5-hydroxytryptamine receptor blocker and steroids is commonly used in patients who are highly emetic after chemotherapy. However, an alternative antiemetic therapy for patients who are resistant to triplet antiemetic therapy is not established. Olanzapine is recommended in the guidelines as an optional antiemetic drug. However, the effectiveness of adding olanzapine to triplet antiemetic therapy is unknown. In this study, the effectiveness and safety of adding olanzapine to triplet antiemetic therapy with aprepitant, palonosetron and dexamethasone as highly emetic anthracycline-containing adjuvant chemotherapy for primary breast cancer patients were prospectively investigated. Forty-five patients with breast cancer who experienced >Grade 1 nausea or any vomiting after the first cycle of chemotherapy using both epirubicin and cyclophosphamide were included. Low-dose olanzapine (2.5 mg/day) was administered orally from the first day of chemotherapy for 4 days, and the number of episodes of vomiting, scale of nausea, dietary intake and somnolence were compared with the symptoms after the first cycle. As the primary endpoint, the nausea grade was significantly improved by adding olanzapine (P effectiveness and tolerability of adding low-dose olanzapine for patients with insufficient nausea relief with triplet antiemetic therapy consisting of palonosetron, steroid and aprepitant. Published by Oxford University Press 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Direct detection of toxigenic Bacillus cereus in dietary complement for children and cassava starch

OpenAIRE

Jnnifer A. Sánchez; Margarita M. Correa; Ángel E. Aceves Dies; Laura M. Castañeda Sandoval

2014-01-01

Bacillus cereus is a food contaminant and a known human pathogen that can cause emetic and diarrheal syndromes. In this study we evaluated the presence of toxigenic B. cereus by multiplex PCR directly in dietary complement for children and cassava starch samples collected on Medellin, Colombia. Of 75 dietary complement for children samples evaluated, 70.7% were contaminated with toxigenic B. cereus and four different toxigenic consortia were detected: I: nheA, hblC, cytK (9.8%), II: nheA, hbl...

Critical Review of Selected Components of RIPD (Radiation-Induced Performance Decrement)

Science.gov (United States)

2012-12-01

The response of the emetic centers elicits the signs and symptoms of UG distress. The levels of A are converted to a measure of severity of emesis ...Mean n Mean n developmen ms as emes cally and ph y need an a emesis bec antifying it i odel f cell loss in rotracted rad he lethal/po n, the prolif...210. Andrews, P.L.R., and Horn C.C., 2006. “Signals for nausea and emesis : Implications for models of upper gastrointestinal diseases,” Auton

Caratterizzazione genetica di alcune popolazioni di cinghiale (Sus scrofa dell'Italia meridionale

Directory of Open Access Journals (Sweden)

M.F. Caliendo

2003-10-01

Full Text Available In Italia il Cinghiale ha subito varie oscillazioni numeriche per immissioni d?esemplari provenienti soprattutto dall'est europeo o da paesi vicini (Massei & Toso, 1993 e incrocio con esemplari di maiale domestico, allevato allo stato brado o semi brado in molte zone d'Italia (Apollonio <em>et al., 1988. Questi fattori sono stati responsabili anche di un impoverimento genetico della forma autoctona italiana Sus scrofa meridionalis e majori che sembrano persistere solo in Sardegna e Maremma (Apollonio <em>et al., 1988. Tra le riserve in cui si ritiene possano trovarsi popolazioni ancora integre, figura la tenuta presidenziale di Castelporziano (Roma. Prendendo spunto da questo lavoro, con il nostro contributo riportiamo i risultati, a livello genetico, della ibridazione con il maiale da parte di cinghiali della Campania, basato sul DNA microsatellite di 4 loci polimorfi. Sono state studiate 9 popolazioni (allevate e libere, usando per riferimenti maiali allo stato brado e cinghiali di Castelporziano. Dall?analisi delle frequenze alleliche è stato eseguito il test di assignment (implementato in una sub routine del software Arlequin 2.0 che individua la possibile origine di un individuo, rispetto ad una rosa di probabili popolazioni di riferimento (Paetkau <em>et al., 1998. Con i risultati del test di assignment si è costruito il grafico log-log genotype, rappresentato da un piano individuato dalle due variabili di riferimento (cinghiale e maiale brado. Le popolazioni esaminate evidenziano una generalizzata distribuzione a cavallo tra i due riferimenti con individui geneticamente simili al cinghiale ed altri al maiale. Questa ripartizione simmetrica è molto evidente nel caso dei cinghiali catturati a Punta Licosa e in quelli dell?allevamento di Polla. La distribuzione dei genotipi sul piano è spesso dispersa, ad eccezione dei cinghiali della Valle del Vento e quelli di Monteverde (individui

Comparison of the effects of sugammadex and neostigmine on postoperative nausea and vomiting.

Science.gov (United States)

Yağan, Özgür; Taş, Nilay; Mutlu, Tuğçe; Hancı, Volkan

The aim of our study is to compare the effects of sugammadex and neostigmine, used for neuromuscular blockage antagonism, on postoperative nausea and vomiting (PONV). Our study was completed with 98 ASA I-II risk patients undergoing endotracheal intubation under general anesthesia. At the end of the surgery patients were randomly divided into two groups given 2mgkg -1 sugammadex (Group S) or 50μgkg -1 neostigmine plus 0.2mgkg -1 atropine (Group N). Monitoring and recording times were set as 1 hour postoperative and from 1-6, 6-12, and 12-24hours. The anti-emetic amounts administered were recorded. In the first hour postoperative 13 patients in Group N (27%) and 4 in Group S (8%) were observed to have nausea and/or vomiting and the difference was statistically significant (p=0.0016). During the 24 hours of monitoring there was no significant difference in the incidence and severity of PONV (p>0.05), however the number of patients given ondansetron for PONV treatment in Group N was statistically significantly higher than the number in Group S (16 in Group N, 6 in Group S, psugammadex for neuromuscular blockage antagonism, we found use of sugammadex had lower incidence of PONV in the postoperative 1st hour and less anti-emetic use in 24 hours of monitoring. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Comparison of the effects of sugammadex and neostigmine on postoperative nausea and vomiting

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Özgür Yağan

Full Text Available Abstract Background and objectives: The aim of our study is to compare the effects of sugammadex and neostigmine, used for neuromuscular blockage antagonism, on postoperative nausea and vomiting (PONV. Methods: Our study was completed with 98 ASA I-II risk patients undergoing endotracheal intubation under general anesthesia. At the end of the surgery patients were randomly divided into two groups given 2 mg kg-1 sugammadex (Group S or 50 µg kg-1 neostigmine plus 0.2 mg kg-1 atropine (Group N. Monitoring and recording times were set as 1 hour postoperative and from 1-6, 6-12, and 12-24 hours. The anti-emetic amounts administered were recorded. Results: In the first hour postoperative 13 patients in Group N (27% and 4 in Group S (8% were observed to have nausea and/or vomiting and the difference was statistically significant (p = 0.0016. During the 24 hours of monitoring there was no significant difference in the incidence and severity of PONV (p > 0.05, however the number of patients given ondansetron for PONV treatment in Group N was statistically significantly higher than the number in Group S (16 in Group N, 6 in Group S, p < 0.011. Conclusions: At the end of our study comparing neostigmine with sugammadex for neuromuscular blockage antagonism, we found use of sugammadex had lower incidence of PONV in the postoperative 1st hour and less anti-emetic use in 24 hours of monitoring.

Bacillus cereus and related species.

Science.gov (United States)

Drobniewski, F A

1993-10-01

Bacillus cereus is a gram-positive aerobic or facultatively anaerobic spore-forming rod. It is a cause of food poisoning, which is frequently associated with the consumption of rice-based dishes. The organism produces an emetic or diarrheal syndrome induced by an emetic toxin and enterotoxin, respectively. Other toxins are produced during growth, including phospholipases, proteases, and hemolysins, one of which, cereolysin, is a thiol-activated hemolysin. These toxins may contribute to the pathogenicity of B. cereus in nongastrointestinal disease. B. cereus isolated from clinical material other than feces or vomitus was commonly dismissed as a contaminant, but increasingly it is being recognized as a species with pathogenic potential. It is now recognized as an infrequent cause of serious nongastrointestinal infection, particularly in drug addicts, the immunosuppressed, neonates, and postsurgical patients, especially when prosthetic implants such as ventricular shunts are inserted. Ocular infections are the commonest types of severe infection, including endophthalmitis, panophthalmitis, and keratitis, usually with the characteristic formation of corneal ring abscesses. Even with prompt surgical and antimicrobial agent treatment, enucleation of the eye and blindness are common sequelae. Septicemia, meningitis, endocarditis, osteomyelitis, and surgical and traumatic wound infections are other manifestations of severe disease. B. cereus produces beta-lactamases, unlike Bacillus anthracis, and so is resistant to beta-lactam antibiotics; it is usually susceptible to treatment with clindamycin, vancomycin, gentamicin, chloramphenicol, and erythromycin. Simultaneous therapy via multiple routes may be required.

Detection of toxin genes and RAPD analysis of bacillus cereus isolates from different soil types

Directory of Open Access Journals (Sweden)

Savic Dejana

2015-01-01

Full Text Available The aim of this study was to detect genes for enterotoxins (hbla, entFM and bceT and for emetic toxin (cer, to determine antibiotic resistance, and to estimate intraspecies diversity in B. cereus isolates by RAPD analysis. B. cereus was identified in 12 out of 117 indigenous Bacillus spp. using the classical microbiological methods and PCR. All isolates were resistant to penicillin and ampicillin, two to tetracyclin and four to trimethoprim-sulphamethoxazole. Also, all isolates produced inducible penicillinases and β-lactamase. Toxin genes were detected with PCR. EntFM and cer genes were present in all isolates, hbla in all, but two, and bceT in none. RAPD analysis was performed with four different primers, two of them designed for this study. The intraspecies diversity revealed 10 different patterns at the 90% similarity level. Two separate clusters were formed regardless of a soil type or utilization. The detection of genes encoding toxins in all B. cereus isolates indicated these bacteria as potentially pathogenic and seriously for human health. Regardless of a soil type or utilization, the RAPD analysis showed high intraspecies heterogeneity in B. cereus isolates. To the best of our knowledge, this is the first study to analyse the presence of entero- and emetic toxin genes and genetic heterogeneity in B. cereus isolates from different soil types and different soil utilization in Serbia. [Projekat Ministarstva nauke Republike Srbije, br. TR37006

In vitro anticancer screening of South African plants

CSIR Research Space (South Africa)

Fouché, Gerda

2008-10-01

Full Text Available , coughs, asthma and pneumonia (Van Wyk and Gericke, 2000). Vhavenda use leaf infusions as anthelmintics for respiratory d as A d roo r a decoctio Cadab powde The ro C d for ) C D E Go Heli Ipomoe K K Leucoside Kigeli Lippi Oncosipho P... Dryand. Leaf infusions ar in emetics taken chrysum nudifolium Less. Roots decoction reported to be u Africa roots are us 1996) a cairica (L.) Sweet Leaves are traditional crushed in a cup alanchoe paniculata Harv. Ash from leaves et al., 1996...

Author Neomythonyms and Mythappellatives

OpenAIRE

Vlada V. Belousova

2017-01-01

It has been carried out an analysis of the author neomythonyms ans mythappelatives. It is given examples of Russian and foreign onyms and appellatives and also enumerated some mythonyms in literature of the 20th century. The material for this work are fiction genres, namely: novel by D.A. Emets “Methodius Buslaev. Magician of the midnight”, novel by S. Antonov “Dark tunnels”, novel by A.D. Glukhovsky “Metro 2033” and a collection of Max Frei “Russian foreign fairy tale – 1”. Language units we...

Isolation of Bacillus cereus Group from the Fecal Material of Endangered Wood Turtles.

Science.gov (United States)

Nfor, Nancy Ngvumbo; Lapin, Carly N; McLaughlin, Richard William

2015-10-01

Members of the Bacillus cereus group are opportunistic human pathogens. They can be found in a broad range of foods. Diarrheal food poisoning and/or emetic type syndromes can result from eating contaminated food. In this study, seven B. cereus group members were isolated from the fecal material of Wood Turtles (Glyptemys insculpta). The isolates were then assessed for the presence of enterotoxin genes (nheA, entFM, hblC, and cytK) using PCR. The most prevalent is the nonhemolytic enterotoxin gene which was found in all seven isolates.

Casopitant: a novel NK(1)-receptor antagonist in the prevention of chemotherapy-induced nausea and vomiting

DEFF Research Database (Denmark)

Ruhlmann, Christina; Herrstedt, Jørn

2009-01-01

Chemotherapy-induced nausea and vomiting (CINV) are among the most feared and distressing symptoms experienced by patients with cancer. The knowledge of the pathogenesis and neuropharmacology of CINV has expanded enormously over the last decades, the most significant discoveries being the role of 5......-hydroxytryptamine (5-HT)(3)- and neurokinin (NK)(1) receptors in the emetic reflex arch. This has led to the development of two new classes of antiemetics acting as highly selective antagonists at one of these receptors. These drugs have had a huge impact in the protection from chemotherapy-induced vomiting...

Nevasic audio program for the prevention of chemotherapy induced nausea and vomiting: A feasibility study using a randomized controlled trial design.

Science.gov (United States)

Moradian, Saeed; Walshe, Catherine; Shahidsales, Soodabeh; Ghavam Nasiri, Mohammad Reza; Pilling, Mark; Molassiotis, Alexander

2015-06-01

Pharmacological therapy is only partially effective in preventing or treating chemotherapy induced nausea and vomiting (CINV). Therefore, exploring the complementary role of non-pharmacological approaches used in addition to pharmacological agents is important. Nevasic uses specially constructed audio signals hypothesized to generate an antiemetic reaction. The aim of this study was to examine the feasibility of conducting a randomized controlled trial (RCT) to evaluate the effectiveness of Nevasic to control CINV. A mixed methods design incorporating an RCT and focus group interviews. For the RCT, female breast cancer patients were randomized to receive either Nevasic plus usual care, music plus usual care, or usual care only. Data were analysed using descriptive statistics and linear mixed-effects models. Five focus group interviews were conducted to obtain participants' views regarding the acceptability of the interventions in the trial. 99 participants were recruited to the RCT and 15 participated in focus group interviews. Recruitment targets were achieved. Issues of Nevasic acceptability were highlighted as weaknesses of the program. This study did not detect any evidence for the effectiveness of Nevasic; however, the results showed statistically significant less use of anti-emetics (p = 0.003) and borderline non-significant improvement in quality of life (p = 0.06). Conducting a non-pharmacological intervention using such an audio program is feasible, although difficulties and limitations exist with its use. Further studies are required to investigate the effectiveness of Nevasic from perspectives such as anti-emetic use, as well as its overall effect on the levels of nausea and vomiting. Copyright © 2014 Elsevier Ltd. All rights reserved.

The lesser of two adverse reactions.

Science.gov (United States)

Chakraborti, Chayan; Egan, John

2010-01-01

Fundamental to complex systems are interconnected processes involved in providing high-quality patient care. A case study and a root cause analysis (RCA) illustrate a patient safety effort with unintended consequences. A 38-year-old woman presented to the hospital for odynophagia and vomiting. The patient developed Mobitz type 2, second-degree heart block temporally associated with the administration of intravenous ondansetron. RESPONSE TO THE EVENT: An Ishikawa, or fishbone, diagram conducted to enumerate potential contributing factors indicated that a key factor appeared to be an institutional restriction against using intravenous (i.v.) promethazine, which resulted in ondansetron being the only readily available i.v. anti-emetic on formulary. The anesthesia department requested that i.v. promethazine be removed from all operating and recovery room automated medication dispensing machines. The pharmacy department, given the realization that individual departments were taking independent action regarding promethazine, discussed the matter with the medical director, who issued a memo banning the use of i.v. promethazine. An institutional ban on i.v. anti-emetics such as promethazine may have resulted in an increase in the use of ondansetron and contributed to this adverse reaction. The reason to restrict promethazine is not well reported in the literature. In limiting the use of promethazine for patient safety concerns, the inadvertent increase in adverse reactions of the alternative medication, ondansetron, may have been overlooked. The resultant RCA underscores the need for careful cataloguing of adverse medication effects. Stakeholders should anticipate as many "downstream effects" of quality and patient safety improvements as possible. Comprehensive reporting of adverse medication effects will augment the emerging science of patient safety.

The effect of crystalloid versus Low molecular weight colloid solution on post-operative nausea and vomiting after ambulatory gynecological surgery - a prospective randomized trial

LENUS (Irish Health Repository)

Hayes, Ivan

2012-07-31

AbstractBackgroundIntravenous fluid is recommended in international guidelines to improve patient post-operative symptoms, particularly nausea and vomiting. The optimum fluid regimen has not been established. This prospective, randomized, blinded study was designed to determine if administration of equivolumes of a colloid (hydroxyethyl starch 130\\/0.4) reduced post operative nausea and vomiting in healthy volunteers undergoing ambulatory gynecologic laparoscopy surgery compared to a crystalloid solution (Hartmann’s Solution).Methods120 patients were randomized to receive intravenous colloid (N = 60) or crystalloid (N = 60) intra-operatively. The volume of fluid administered was calculated at 1.5 ml.kg-1 per hour of fasting. Patients were interviewed to assess nausea, vomiting, anti-emetic use, dizziness, sore throat, headache and subjective general well being at 30 minutes and 2, 24 and 48 hours post operatively. Pulmonary function testing was performed on a subgroup.ResultsAt 2 hours the proportion of patients experiencing nausea (38.2 % vs 17.9%, P = 0.03) and the mean nausea score were increased in the colloid compared to crystalloid group respectively (1.49 ± 0.3 vs 0.68 ± 0.2, P = 0.028). The incidence of vomiting and anti-emetic usage was low and did not differ between the groups. Sore throat, dizziness, headache and general well being were not different between the groups. A comparable reduction on post-operative FVC and FEV-1 and PEFR was observed in both groups.ConclusionsIntra-operative administration of colloid increased the incidence of early postoperative nausea and has no advantage over crystalloid for symptom control after gynaecological laparoscopic surgery.

Experimental study of the role of blocking of 5-HT3 serotonin receptors and D2 dophamin receptors in the mechanism of early radiation vomiting in monkeys

International Nuclear Information System (INIS)

Martirosov, K.S.; Grigor'ev, Yu.G.; Zorin, V.V.; Andrianova, I.E.

2000-01-01

Specific activity of Latranum and Dimetphramidum is studied using experimental model of early radiation vomiting on 17 monkeys, mass 6-9 kg inherent on usual ration of vivarium. The experiments with M. fasciculata monkeys exposed to 137 Cs γ-radiation with a dose of 6.9 Gy showed that Latranum, a blocker of serotonin 5-HT 3 receptors, is a more efficient antimetric than Dimetphramidum, a D 2 dophamin lytic. This suggested by fewer animals with emetic reaction of by less severe vomiting in case they have any. The results agree well with a hypothesis that serotonin receptors are dominant in the chemoreceptor trigger zone of monkeys [ru

Emesis in monkeys following exposure to ionizing radiation

International Nuclear Information System (INIS)

Middleton, G.R.; Young, R.W.

1975-01-01

There were 129 male rhesus monkeys (Macaca mulatta) exposed to prompt radiations (neutron/gamma = 0.4 and pulse width = 50 ms) ranging from 700 to 5600 rad (midhead dose). The animals were fasted 18 h preexposure and observed for incidence of vomiting for 2 h postexposure. For doses less than 1000 rads, the number of animals that vomited increased directly with dose. Above 1000 rads, the number of animals that vomited decreased with increasing dose. The total number of vomits per dose group followed a nearly identical pattern to the incidence of emesis. In all dose groups, most of the emetic episodes occurred between 20 and 50 min postirradiation

Consensus recommendations for the prevention of vomiting and nausea following high-emetic-risk chemotherapy

DEFF Research Database (Denmark)

Kris, Mark G; Tonato, Maurizio; Bria, Emilio

2011-01-01

selective 5-HT(3) receptor antagonists. We conclude that, for each of these five drugs, there is a plateau in therapeutic efficacy above which further dose escalation does not improve outcome. In trials designed to prove the equivalence of palonosetron to ondansetron and granisetron, palonosetron proved...

Creating Centralized Reporting for Microsoft Host Protection Technologies:The Enhanced Mitigation Experience Toolkit (EMET)

Science.gov (United States)

2016-08-11

patching are helpful, though they offer little or no protection for attacks using specialized malware or unpatched “zero-day” exploits. 2.1 Benefits...that all host-based and net- work firewalls allow communications between Windows endpoints and hosts acting in the collec- tion service role. Define a

Neural Connectivity and Immunocytochemical Studies of Anatomical Sites Related to Nauseogenic and Emetic Reflexes

Science.gov (United States)

Fox, Robert A. (Principal Investigator)

1992-01-01

The studies conducted in this research project examined several aspects of neuroanatomical structures and neurochemical processes related to motion sickness in animal models. A principle objective of these studies was to investigate neurochemical changes in the central nervous system that are related to motion sickness with the objective of defining neural mechanisms important to this malady. For purposes of exposition, the studies and research finding have been classified into five categories. These are: immunoreactivity in the brainstem, vasopressin effects, lesion studies of area postrema, role of the vagus nerve, and central nervous system structure related to adaptation to microgravity.

Selezione invernale dell'habitat e densità del cervo (Cervus elaphus e del capriolo (Capreolus capreolus nel Parco Nazionale d'Abruzzo

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R. Latini

2003-10-01

Full Text Available Nel Parco Nazionale d'Abruzzo è stata studiata la selezione dell'habitat invernale di cervo e capriolo da aprile a maggio del 2000 e del 2002, in un'area caratterizzata da boschi di faggio, rimboschimenti a pino nero e pascoli. È stata utilizzata la tecnica del pellet group count, su transetti lineari larghi 2 metri, individuati ogni 100 m di quota, lungo le isoipse da 1350 a 1950 m s.l.m. Sono stati percorsi 61 km ed è stata campionata un'area di 12 ha. Per ogni gruppo di escrementi (1583 per il cervo e 946 per il capriolo sono state rilevate l'altitudine, la pendenza, l'esposizione e il tipo di vegetazione. È stato assunto che tutti gli habitat fossero ugualmente disponibili ed accessibili e che le disponibilita fossero conosciute (Alldredge <em>et al., 1998. I dati raccolti sono stati elaborati applicando il test del Χ², la statistica di Bonferroni (Neu <em>et al., 1974 e l'indice Jacobs (Jacobs, 1974. Il cervo ha selezionato aree comprese tra 1300 e 1500 m s.l.m. (p<0.01, un range altimetrico più ristretto rispetto al capriolo che seleziona anche le quote piu elevate, comprese cioè tra 1300 e 1700 m s.l.m. (p<0.01. Entrambi i cervidi selezionano le zone più scoscese (21°-60° (p<0.01: Il cervo seleziona le classi d'esposizione comprese tra sud-est ed ovest (p<0.01, mentre il capriolo i versanti sud-ovest e ovest (p<0.01. Entrambe le specie preferiscono ambienti di transizione ed evitano le zone di bosco maturo ed i pascoli d'alta quota (p<0.01. Utilizzando il tasso di defecazione è stata calcolata la densità delle due specie (Mayle, 1999 che è risultata di 2.7 cervi/100 ha e 1.0 caprioli/100 ha. Le due specie selezionano le stesse risorse, suggerendo, così come riscontrato da altri autori (Welch, 1989, una convergenza per quanto riguarda l'uso invernale dell'habitat. La scelta d'aree poste a quote medio-basse, di zone scoscese e di versanti meridionali potrebbe essere legata alla minore altezza e persistenza

Effects of zacopride and BMY25801 (batanopride) on radiation-induced emesis and locomotor behavior in the ferret

International Nuclear Information System (INIS)

King, G.L.; Landauer, M.R.

1990-01-01

The antiemetic and locomotor effects of two substituted benzamides, zacopride and batanopride (BMY25801), were compared in ferrets after bilateral 60Co irradiation at 2, 4 or 6 Gy. Both zacopride and BMY25801 were effective against emesis and related signs. Zacopride, tested at several doses (0.003, 0.03 and 0.3 mg/kg), appeared to be more potent because it abolished emesis at 100-fold lower doses than did BMY25801 (3 mg/kg). The ED50 value for the antiemetic effect of zacopride was 0.026 mg/kg (confidence levels = 0.0095, 0.072 mg/kg). However, analysis of emetic parameters recorded from vomiting animals (e.g., latency to first emesis) demonstrated that BMY25801 provided greater antiemetic protection in this population than zacopride without any apparent side effects. Locomotor activity was significantly depressed by both radiation (all doses) and zacopride alone (0.03 mg/kg and 0.3 mg/kg). BMY25801 alone did not affect locomotor activity, and protected against the radiation-induced locomotor decrement. Although zacopride potentiated the locomotor decrement to radiation, no clear dose-response relationship was evident. Bilateral abdominal vagotomy significantly increased the latency to the first emetic episode and significantly reduced the number of retches, but did not alter the duration of the prodromal response to 4-Gy irradiation. Unilateral vagotomies had no effect. Zacopride (at 0.03 mg/kg and 0.3 mg/kg) remained an effective antiemetic in animals that received a bilateral vagotomy, abolishing emesis in four of eight and two of eight ferrets, respectively. These data suggest that the antiemetic action of zacopride does not fully depend on intact vagal innervation and also acts via other pathways

Aperçu sur la composition phytochimique et les activités biologiques de Retama monosperma L Bois. (Fabacée

Directory of Open Access Journals (Sweden)

BELMOKHTAR Zoubir

2016-06-01

Full Text Available An overeview on phytochemical composition and biological activities of Retama monosperma L Bois. (Fabaceae The phytochemical study of Retama monosperma is little discussed in Algeria. This article is a summary of the data and scientific articles published on these phytochemicals properties. In traditional herbal medicine, this species is considered toxic in high doses, but in small doses, it is used as an emetic, purgative, vermifuge, vulnerary, sedative, anthelmintic and antiseptic Alkaloids, flavonoids and terpene compounds are the main phytochemicals known in Retama monosperma. In the last five years, several scientific studies have been published to explain the activity of the extracts of this species, particularly anti - inflammatory, anticancer and antioxidant.

Cathodic adsorptive stripping voltammetry of an anti-emetic agent Granisetron in pharmaceutical formulation and biological matrix

Directory of Open Access Journals (Sweden)

Rajeev Jain

2012-12-01

Full Text Available Granisetron showed one well-defined reduction peak at Hanging Mercury Drop Electrode (HMDE in the potential range from −1.3 to −1.5 V due to reduction of C=N bond. Solid-phase extraction technique was employed for extraction of Granisetron from spiked human plasma. Granisetron showed peak current enhancement of 4.45% at square-wave voltammetry and 5.33% at cyclic voltammetry as compared with the non stripping techniques. The proposed voltammetric method allowed quantification of Granisetron in pharmaceutical formulation over the target concentration range of 50–200 ng/mL with detection limit 13.63 ng/mL, whereas in human plasma 50–225 ng/mL with detection limit 11.75 ng/mL. Keywords: Granisetron, Human plasma, Solid-phase extraction, Pharmaceutical formulation, Voltammetry, Hanging mercury drop electrode

The Neurobiological Mechanism of Chemical Aversion (Emetic Therapy for Alcohol Use Disorder: An fMRI Study

Directory of Open Access Journals (Sweden)

Ralph L. Elkins

2017-09-01

Full Text Available A recent NIH epidemiology study found the lifetime prevalence of alcohol use disorder in the United States to be 29%. Alcohol drinking behavior is strongly “learned” via pleasure center activation/reinforcement. Alcohol craving is a powerful desire to drink alcoholic beverages. Craving was added as one of the defining criteria for alcohol use disorder in DSM5, and craving reduction is becoming an increasingly important treatment goal. In the current study, patients with alcohol use disorder received 10 days of inpatient multi-modal treatments at Schick Shadel Hospital (SSH of Seattle. The treatments included five chemical aversion conditioning sessions that associated alcohol cues (and alcohol with nausea and emesis. All patients met DSM4 criteria for alcohol use disorder, were heavy drinkers, and reported craving alcohol pre-treatment. Craving reduction was one of the primary treatment goals. This is the first fMRI study to measure the effects of chemical aversion therapy on alcohol craving-related brain activity. Patients were recruited as subjects for the University of Washington (UW brain scan study following SSH admission but before treatment onset. Prior to treatment, patients reported craving/desire for alcohol. After treatment (after four SSH chemical aversion treatments, again after five SSH chemical treatments, 30 and 90-days post-discharge, these same patients reported avoidance/aversion to alcohol. Most of the participants (69% reported being still sober 12 months post-treatment. Consistent with a craving reduction mechanism of how chemical aversion therapy facilitates sobriety, results of the UW fMRI brain scans showed significant pre- to post-treatment reductions in craving-related brain activity in the occipital cortex. Additional fMRI brain scan studies are needed to further explore the neurobiological mechanism of chemical aversion therapy treatment for alcohol use disorder, and other substance use disorders for which chemical aversion therapy is used (e.g., opioid dependence and cocaine dependence. Substance use disorders are estimated to affect well over one billion people worldwide.

Improvement of spatial memory function in APPswe/PS1dE9 mice after chronic inhibition of phosphodiesterase type 4D.

Science.gov (United States)

Sierksma, A S R; van den Hove, D L A; Pfau, F; Philippens, M; Bruno, O; Fedele, E; Ricciarelli, R; Steinbusch, H W M; Vanmierlo, T; Prickaerts, J

2014-02-01

Phosphodiesterase type 4 inhibitors (PDE4-Is) have received increasing attention as cognition-enhancers and putative treatment strategies for Alzheimer's disease (AD). By preventing cAMP breakdown, PDE4-Is can enhance intracellular signal transduction and increase the phosphorylation of cAMP response element-binding protein (CREB) and transcription of proteins related to synaptic plasticity and associated memory formation. Unfortunately, clinical development of PDE4-Is has been seriously hampered by emetic side effects. The new isoform-specific PDE4D-I, GEBR-7b, has shown to have beneficial effects on memory at non-emetic doses. The aim of the current study was to investigate chronic cognition-enhancing effects of GEBR-7b in a mouse model of AD. To this extent, 5-month-old (5M) APPswe/PS1dE9 mice received daily subcutaneous injections with GEBR-7b (0.001 mg/kg) or vehicle for a period of 3 weeks, and were tested on affective and cognitive behavior at 7M. We demonstrated a cognition-enhancing potential in APPswe/PS1dE9 mice as their spatial memory function at 7M in the object location test was improved by prior GEBR-7b treatment. APPswe/PS1dE9 mice displayed lower levels of CREB phosphorylation, which remained unaltered after chronic GEBR-7b treatment, and higher levels of tau in the hippocampus. Hippocampal brain-derived neurotrophic factor levels and synaptic densities were not different between experimental groups and no effects were observed on hippocampal GSK3β and tau phosphorylation or Aβ levels. In conclusion, GEBR-7b can enhance spatial memory function in the APPswe/PS1dE9 mouse model of AD. Although the underlying mechanisms of its cognition-enhancing potential remain to be elucidated, PDE4D inhibition appears an interesting novel therapeutic option for cognitive deficits in AD. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ginger effects on control of chemotherapy induced nausea and vomiting

Directory of Open Access Journals (Sweden)

Seyyed Meisam Ebrahimi

2013-09-01

Full Text Available Background : Chemotherapy-induced nausea (CIN in the anticipatory and acute phase is the most common side effect in cancer therapy. The purpose of this study was to investigate the effect of ginger capsules on the alleviation of this problem. Methods : This randomized, double-blind, placebo-controlled clinical trial was performed on 80 women with breast cancer between August till December 2009 in Imam Khomeini Hospital, Tehran, Iran. These patients underwent one-day chemotherapy regime and suffering from chemotherapy-induced nausea. After obtaining written consent, samples were randomly assigned into intervention and control groups. Two groups were matched based on the age and emetic effects of chemotherapy drugs used. The intervention group received ginger capsules (250 mg, orally four times a day (1 gr/d and the same samples from the placebo group received starch capsules (250 mg, orally for three days before to three days after chemotherapy. To measure the effect of capsules a three-part questionnaire was used, so the samples filled every night out these tools. After collecting the information, the gathered data were analyzed by statistical tests like Fisher’s exact, Kruskal-Wallis and Chi-square using version 8 of STATA software. Results : The mean ± SD of age in the intervention and placebo groups were 41.8 ± 8.4 and 45.1 ± 10 years, respectively. Results indicated that the severity and number of nausea in the anticipatory phase were significantly lower in the ginger group compared with placebo group (P=0.0008, P=0.0007, respectively. Also, the intensity (P=0.0001 and number (P=0.0001 of nausea in the acute phase were significantly lower in the ginger group. On the other hand, taking ginger capsules compared with placebo did not result in any major complications. Conclusion: Consuming ginger root powder capsules (1 gr/d from three days before chemotherapy till three days after it in combination with the standard anti-emetic regimen can

Os hotéis como pólos geradores de viagens

Directory of Open Access Journals (Sweden)

Lenise Grando Goldner

2010-11-01

Full Text Available

Resumo: Os estudos sobre hotéis analisados como Pólos Geradores de Viagens são escassos tanto no Brasil quanto no exterior. Neste artigo desenvolve-se uma análise e compilação de alguns trabalhos realizados nos EUA sobre o tema, com destaque para os modelos do ITE- Institute of Transportation Engineers - para diferentes categorias de hotéis. Para o Brasil são analisados os estudos de Feitosa (2003 e de Goldner <em>et al (2006 sobre os padrões de viagens, bem como os de Goldner e Inocêncio (2007 sobre taxas e modelos de geração de viagens para os hotéis da cidade de Florianópolis. Uma análise comparativa entre os principais modelos é realizada, buscando verificar a adequação dos modelos do ITE à realidade brasileira. Os resultados ratificam a importância do desenvolvimento de novos modelos com base em dados que caracterizam a especificidade da geração de viagens no caso do Brasil.

Abstract: Studies analyzing hotels and their role as trip generation hubs are rare in Brazil and abroad. In this paper, an analysis and compilation of some work linked to the subject, developed in the USA, is carried out, with emphasis on the ITE - Institute of Transportation Engineers - models, to different hotel categories. In the case of Brazil, the studies of Feitosa (2003 and Goldner <em>et al. (2006 assessing trip patterns and also those of Goldner and Inocencio (2007, who analyzed rates and trip generation models to hotels located in Florianopolis. A comparative analysis among the main models is also carried out, aiming at the verification of the adequacy of ITE models to the Brazilian reality. The comparison ratifies the importance to develop models based on data that characterize the specificity of trip generation in the case of Brazil.

Toxin production ability of Bacillus cereus strains from food product of Ukraine

Directory of Open Access Journals (Sweden)

I. Pylypenko

2017-10-01

Full Text Available Potential pathogens of foodborne toxic infections – bacterial contaminants Bacillus cereus isolated from plant raw materials and food products from the Ukrainian region were investigated. When determining of the proportion of isolated bacilli from the plant samples, it was established that the epidemiologically significant microorganisms of Bacillus cereus as agents of food poisoning are the second largest. The average value of contaminated samples of Ukrainian plant raw materials and processed products with Bacillus cereus is 36,2 %. The ability of Bacillus cereus strains identified by a complex of morphological, tinctorial, cultural and biochemical properties, to produce specific emetic and enterotoxins was studied. Molecular genetic diagnosis and detection of the toxin-producing ability of isolated 42 Bacillus cereus strains showed both the possibility of their rapid identification and the presence of specific toxicity genes. Multiplex polymerase chain reaction (PCR was carried out with specific primers to detect toxicity determined of various bacilli genes: nheA, hblD, cytK, cesВ. The distribution of toxigenic genes is significantly different among the Bacillus cereus isolates from various sources. The nheA, hblD and cytK enterotoxin genes were detected in 100, 83,3 and 61,9 % of the investigated strains of Bacillus cereus, respectively. The cesB gene encoding emetic toxin was detected in 4,8 % of  strains. Molecular-genetic PCR-method confirmed that all the isolated strains belong to the Bacillus cereus group, and the ability to produce toxins can be attributed to five groups. The main toxins that produce the investigated Bacillus cereus strains were nhe and hbl enterotoxins encoded by the corresponding genes of nheA and hblD. The enterotoxic type of Bacillus cereus was predominant in Ukrainian region.  Studies of domestic plant food raw materials and products have confirmed the need to improve microbiological control of product safety

Inhibition of radioemesis by disruption of catecholamines in dogs

International Nuclear Information System (INIS)

Luthra, Y.K.; Mattsson, J.L.; Yochmowitz, M.G.

1981-01-01

Dogs were treated 30 min to 1 h before x irradiation with α-methyl-p-tyrosine or 6-hydroxydopamine. A third group of dogs was given a known antiradioemetic drug, haloperidol to verify the sensitivity of the procedure. Irradiated but untreated controls were also used. Light methoxyflurane anesthesia was used for restraint during the exposure. Exposure dose was 800 rad kerma delivered at 50 rad/min to a 10 x 10-cm area covering the abdominal area from xiphoid to pubis. Haloperidol and 6-hydroxydopamine significantly reduced the number of emetic episodes and delayed the onset time to the first episode, α-Methyl-p-tyrosine caused no significant changes. The effectiveness of 6-hydroxydopamine indicates that catecholaminergic neurons are involved in radioemesis, whereas haloperidol and phenothiazine-derivative tranquilizers inhibit radiomesis by blocking catecholamine receptor neurons

Technical presentation - KEITHLEY Instruments - CANCELLED

CERN Multimedia

FI Department

2009-01-01

10 March 2009 13:30 – 15:30, Council Chamber, Bldg. 503 Keithley markets highly accurate instruments and data acquisition products, as well as complete system solutions for high-volume production and assembly testing. Keithley Instruments, Inc. designs, develops, manufactures and markets complex electronic instruments and systems geared to the specialized needs of electronics manufacturers for high-performance production testing, process monitoring, product development and research. Products and Services: Digital Multimeters and Data Acquisition Systems Current / Voltage Source and Measure Products Low Current / High Resistance Measurement Products Function/Pulse/Arbitrary/Pattern Generators Low Voltage/Low Resistance Measurement Products RF Spectrum Analyzer / RF Signal Generator / RF Switching Semiconductor Device Characterization Program: Topic 1: Welcome and short overview of new Products SMU 26XXA / ARB Generator 3390 / DMM 3706 / E-Meter 6517B Topic 2a: Te...

Distonia aguda relacionada ao uso de bromoprida em pacientes pediátricos Acute dystonia after use of bromopride in pediatric patients

Directory of Open Access Journals (Sweden)

Eliane Roseli Barreira

2009-03-01

Full Text Available OBJETIVO: Descrever dois casos de distonia aguda após uso de bromoprida em crianças e realizar revisão da literatura em relação aos mecanismos fisiopatológicos de indução de liberação extrapiramidal, sua sintomatologia e tratamento. DESCRIÇÃO DO CASO: Caso 1: adolescente de 13 anos com quadro de dor e hipertonia cervical associados a febre, náuseas e vômitos, com hipótese inicial de meningite. A investigação subsequente revelou que o quadro iniciou-se após ingestão de uma única dose de bromoprida. O paciente apresentou boa resposta ao tratamento com difenidramina, sem necessidade de coleta de líquor. Caso 2: Lactente de seis meses que desenvolveu sintomas graves de liberação extrapiramidal relacionados à superdosagem de bromoprida, com reversão rápida dos sintomas após administração de biperideno. COMETÁRIOS: Este é o primeiro relato de distonia aguda após uso de bromoprida em crianças. Embora muito utilizada no Brasil como agente pró-cinético e antiemético, nenhum estudo clínico até o momento demonstrou melhor perfil de segurança da bromoprida em relação aos demais antieméticos antagonistas da dopamina. Até que tais estudos sejam realizados, sugere-se cautela na prescrição de bromoprida. Medidas não-farmacológicas devem ser recomendadas no tratamento de vômitos e da doença do refluxo gastresofágico. Quando o tratamento farmacológico for indispensável, deve-se dar preferência a drogas com perfil de segurança mais bem estabelecido.OBJECTIVE: To report the case of two patients with acute dystonia induced by bromopride in children, followed by a review of the mechanisms of induction of movement disorders by antidopaminergic anti-emetic drugs, its clinical symptoms and treatment. CASE DESCRIPTION: Case 1: a 13 years old teenager who developed acute hypertonia and neck pain associated to fever and vomiting, suggestive of meningitis. Further investigation revealed that symptoms were associated with

Early oral feeding after elective abdominal surgery--what are the issues?

DEFF Research Database (Denmark)

Bisgaard, Thue; Kehlet, Henrik

2002-01-01

This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdomin...... surgical programs in abdominal surgery provide a rational basis for future studies to investigate and facilitate enforced oral feeding after major abdominal procedures.......This review analyzes the literature and the historical concerns (restrictions, traditions, nasogastric tube) and pathophysiologic factors (postoperative ileus, risk of anastomotic dehiscence, nausea and vomiting, loss of appetite) invoked for not instituting early oral feeding after major abdominal...... procedures. It appears that several factors may promote postoperative oral feeding such as thoracic epidural analgesia, multimodal anti-emetic treatment, opioid-sparing analgesia, selective peripheral opioid antagonists, and enforced oral nutrition. Recent data from multimodal fast-track rehabilitation...

RANDOMNESS of Numbers DEFINITION(QUERY:WHAT? V HOW?) ONLY Via MAXWELL-BOLTZMANN CLASSICAL-Statistics(MBCS) Hot-Plasma VS. Digits-Clumping Log-Law NON-Randomness Inversion ONLY BOSE-EINSTEIN QUANTUM-Statistics(BEQS) .

Science.gov (United States)

Siegel, Z.; Siegel, Edward Carl-Ludwig

2011-03-01

RANDOMNESS of Numbers cognitive-semantics DEFINITION VIA Cognition QUERY: WHAT???, NOT HOW?) VS. computer-``science" mindLESS number-crunching (Harrel-Sipser-...) algorithmics Goldreich "PSEUDO-randomness"[Not.AMS(02)] mea-culpa is ONLY via MAXWELL-BOLTZMANN CLASSICAL-STATISTICS(NOT FDQS!!!) "hot-plasma" REPULSION VERSUS Newcomb(1881)-Weyl(1914;1916)-Benford(1938) "NeWBe" logarithmic-law digit-CLUMPING/ CLUSTERING NON-Randomness simple Siegel[AMS Joint.Mtg.(02)-Abs. # 973-60-124] algebraic-inversion to THE QUANTUM and ONLY BEQS preferentially SEQUENTIALLY lower-DIGITS CLUMPING/CLUSTERING with d = 0 BEC, is ONLY VIA Siegel-Baez FUZZYICS=CATEGORYICS (SON OF TRIZ)/"Category-Semantics"(C-S), latter intersection/union of Lawvere(1964)-Siegel(1964)] category-theory (matrix: MORPHISMS V FUNCTORS) "+" cognitive-semantics'' (matrix: ANTONYMS V SYNONYMS) yields Siegel-Baez FUZZYICS=CATEGORYICS/C-S tabular list-format matrix truth-table analytics: MBCS RANDOMNESS TRUTH/EMET!!!

A review of chemistry and biological activities of the genus Aerva--a desert plant.

Science.gov (United States)

Chawla, Payal; Chawla, Amit; Vasudeva, Neeru; Sharma, Surendra Kumar

2012-01-01

There are approximately 28 species of Aerva genus, but only a few species are medicinal of which A. persica, A. lanata and A. javanica are of great value. A number of flavonol glycosides (e.g., aervanone, kaempferol-3-galactoside, isorhamnetin-3-O-β-D-glucoside) have been reported from Aerva persica as major phytoconstituents and the minor constituents are β-cyanins (glycine betaine and trigonelline), sterols and carbohydrates. This plant is used as medicinal herb in several traditional systems of medicine all over the world, like diuretic, demulcent, purgative, emetic and tinder. Aerva plants are used to cure ulcer, lithiasis, dropsical affections, eye affection, toothache, headache, in disorders of abdomen and inflammation of internal organs. Roots and flowers are reported to possess hypoglycemic, antioxidant, anthelmintic, analgesic, antimalarial, antivenin activities and medicinal properties against rheumatism and kidney troubles.

Perioperative solutions for rapid recovery joint arthroplasty: get ahead and stay ahead.

Science.gov (United States)

Sculco, Peter K; Pagnano, Mark W

2015-04-01

Rapid recovery after total joint arthroplasty requires patients to get ahead and stay ahead or the four impediments to early rehabilitation and discharge: volume depletion, blood loss, pain, and nausea. Adequate volume resuscitation starts before entering the operating room and focuses on intravenous fluids rather than red blood cell transfusion. Tranexamic acid limits blood loss and reduces the need for most other blood management systems. Rapid recovery pain management focuses on minimizing parenteral opioids. A short-acting spinal with a peri-articular local anesthetic injection is reliable, reproducible, and safe. Patients at risk for post-operative nausea are treated with anti-emetic medications and perioperative dexamethasone. These interventions reflect a transition from the sick-patient model to the well-patient model and make rapid recovery joint arthroplasty a reality in 2015. Copyright © 2015 Elsevier Inc. All rights reserved.

Control of radiation-induced emesis with promethazine, cimetidine, thiethylperazine, or naloxone

International Nuclear Information System (INIS)

Cooper, J.R.; Mattsson, J.L.

1979-01-01

Promethazine (2 mg/kg), cimetidine (4 mg;kg), thiethylperazine (0.86 mg/kg), and naloxone (0.08 mg/kg) were each evaluated for their ability to increase the threshold of radiation-induced emesis in the dog. Each dog was fed a can of dog food (ca 0.4 kg) and then injected IM with the appropriate drug 1 hour before being irradiated by a 60 Co teletherapy unit. Dogs were then observed continuously for 10 hours while the number, time of onset, and duration of each emetic episode were monitored. The dose of radiation causing emesis in 50% control dogs was 170 rad. The ED50 was increased to 402 rad by promethazine, to 331 rad by cimetidiene, and to 320 rad by thiethylperazine. The ED50 for naloxone was 262.5 rad, which was not a statistically significant increase in threshold

Action of (R)-sila-venlafaxine and reboxetine to antagonize cisplatin-induced acute and delayed emesis in the ferret

International Nuclear Information System (INIS)

Warneck, Julie B.; Cheng, Frankie H.M.; Barnes, Matthew J.; Mills, John S.; Montana, John G.; Naylor, Robert J.; Ngan, Man-P.; Wai, Man-K.; Daiss, Juergen O.; Tacke, Reinhold; Rudd, John A.

2008-01-01

The chemotherapeutic drug cisplatin is associated with severe gastrointestinal toxicity that can last for several days. A recent strategy to treat the nausea and emesis includes the combination of a 5-HT 3 receptor antagonist, a glucocorticoid, and an NK 1 receptor antagonist. The present studies explore the use of the selective noradrenaline reuptake inhibitors, (R)-sila-venlafaxine, (R,R)-reboxetine and (S,S)-reboxetine to prevent cisplatin (5 mg/kg, i.p.)-induced acute (0-24 h) and delayed (24-72 h) emesis in ferrets. The positive control regimen of ondansetron and dexamethasone, both at 1 mg/kg/8 h, reduced acute and delayed emesis by 100 (P 0.05). In conclusion, the studies provide the first evidence for an anti-emetic potential of noradrenaline reuptake inhibitors to reduce chemotherapy-induced acute and delayed emesis

Anti emetic effect of 5HT3 receptor antagonists in macaques exposed to a neutron-gamma radiation

International Nuclear Information System (INIS)

Agay, D.; Martin, C.; Martin, S.; Roman, V.; Fatome, M.

1994-01-01

Ondansetron and granisetron were tested as antiemetics in cynomolgus macaques weighing 4 kg and submitted to a neutron-gamma irradiation with a high neutronic component. Compounds were delivered by oral way, each administration dose being 4 mg of ondansetron or 1 mg of granisetron. The effect was complete when were delivered before and after the irradiation. It was incomplete when there was a single administration be fore or after the exposure. No adverse side-effects were noted. (author)

Anti-emetic mechanisms of Zingiber officinale against cisplatin induced emesis in the pigeon; behavioral and neurochemical correlates.

Science.gov (United States)

Ullah, Ihsan; Subhan, Fazal; Ayaz, Muhammad; Shah, Rehmat; Ali, Gowhar; Haq, Ikram Ul; Ullah, Sami

2015-02-26

Zingiber officinale (ZO, family Zingiberaceae) has been reported for its antiemetic activity against cancer chemotherapy induced emesis in animal models and in clinics. Current study was designed to investigate ZO for potential usefulness against cisplatin induced vomiting in pigeon and its effects on central and peripheral neurotransmitters involved in the act of vomiting. Zingiber officinale acetone fraction (ZO-ActFr) was investigated for attenuation of emesis induced by cisplatin in healthy pigeons. Neurotransmitters DA, 5HT and their metabolites DOPAC, HVA and 5HIAA were analyzed using High Performance Liquid Chromatography system coupled with electrochemical detector in area postrema, brain stem and intestine. Antiemetic effect of ZO-ActFr was correlated with central and intestinal neurotransmitters levels in pigeon. Cisplatin (7 mg/kg i.v.) induced emesis without lethality upto the observation period. ZO-ActFr (25, 50 & 100 mg/kg) attenuated cisplatin induced emesis ~ 44.18%, 58.13% (P < 0.05) and 27.9%, respectively; the reference drug, metoclopramide (MCP; 30 mg/kg), produced ~ 48.83% reduction (P < 0.05). ZO-ActFr reduced (P < 0.05 - 0.001) 5-hydroxytryptamine (5HT) concentration in the area postrema, brain stem and intestine at 3(rd) hour of cisplatin administration, while at the 18(th) hour ZO treatments attenuated the dopamine upsurge (P < 0.001) caused by cisplatin in the area postrema and 5HT concentration (P < 0.01 - 0.001) in the brain stem and intestine. ZO treatments alone did not altered the basal neurotransmitters and their metabolites in the brain areas and intestine. The behavioral study verify the antiemetic profile of ZO against cisplatin induced emesis in the pigeon, where central and peripheral neural evidences advocate the involvement of serotonergic mechanism at initial time point (3(rd) hr), while the later time point (18(th) hr) is associated with serotonergic and dopaminergic component in the mediation of its antiemetic effect.

The Endospore-Forming Pathogen Bacillus cereus Exploits a Small Colony Variant-Based Diversification Strategy in Response to Aminoglycoside Exposure.

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Frenzel, Elrike; Kranzler, Markus; Stark, Timo D; Hofmann, Thomas; Ehling-Schulz, Monika

2015-12-08

Bacillus cereus is among the microorganisms most often isolated from cases of food spoilage and causes gastrointestinal diseases as well as nongastrointestinal infections elicited by the emetic toxin cereulide, enterotoxins, and a panel of tissue-destructive virulence factors. This opportunistic pathogen is increasingly associated with rapidly fatal clinical infections especially linked to neonates and immunocompromised individuals. Fatality results from either the misdiagnosis of B. cereus as a contaminant of the clinical specimen or from failure of antibiotic therapy. Here we report for the first time that exposure to aminoglycoside antibiotics induces a phenotype switching of emetic B. cereus subpopulations to a slow-growing small colony variant (SCV) state. Along with altered antibiotic resistance, SCVs showed distinct phenotypic and metabolic properties, bearing the risk of antibiotic treatment failure and of clinical misdiagnosis by standard identification tests used in routine diagnostic. The SCV subpopulation is characterized by enhanced production of the toxin cereulide, but it does not secrete tissue-destructive and immune system-affecting enzymes such as sphingomyelinase and phospholipase. SCVs showed significantly prolonged persistence and decreased virulence in the Galleria mellonella model for bacterial infections, indicating diversification concerning their ecological lifestyle. Importantly, diversification into coexisting wild-type and SCV subpopulations also emerged during amikacin pressure during in vivo infection experiments. This study shows for the first time that pathogenic spore-forming B. cereus strains are able to switch to a so far unreported slow-growing lifestyle, which differs substantially in terms of developmental, phenotypic, metabolic, and virulence traits from the wild-type populations. This underpins the necessity of molecular-based differential diagnostics and a well-chosen therapeutic treatment strategy in clinical

Identification, genetic diversity and cereulide producing ability of Bacillus cereus group strains isolated from Beninese traditional fermented food condiments

DEFF Research Database (Denmark)

Thorsen, Line; Azokpota, Paulin; Hansen, Bjarne Munk

2010-01-01

Bacillus cereus sensu lato is often detected in spontaneously fermented African foods but is rarely identified to species level. Only some of the B. cereus group species are reported to be pathogenic to humans and identification to species level is necessary to estimate the safety of these products...... (cluster 1). Highly similar PM13 profiles were obtained for seven of the isolates, one from afitin, one from iru and five from sonru (cluster 2). Four of the isolates, one from afitin and three from sonru, did not form any particular cluster. The PM13 profiles of cluster 2 isolates were identical to those...... which are specific to emetic toxin producers. Cereulide production of these isolates was confirmed by liquid chromatography mass spectrometry/mass spectrometry. This is the first report on cereulide producing B. cereus in African fermented foods. Occurrence of the opportunistic human pathogen B. cereus...

Positioning of nasobiliary tube using magnet-loaded catheters.

Science.gov (United States)

Watanabe, Seitaro; Sato, Takamitsu; Kato, Shingo; Hosono, Kunihiro; Kobayashi, Noritoshi; Nakajima, Atsushi; Kubota, Kensuke

2013-10-01

In endoscopic nasobiliary drainage (ENBD), repositioning the catheter from the mouth to the nose is complicated. We devised a method using catheters with magnets and verified its utility and safety. We prospectively enrolled 20 patients undergoing ENBD at Yokohama City University Hospital. The procedures were successful in all 20 cases and no case required a change of operators to a senior doctor. The mean time for the procedure was 36.6 seconds. The emetic reflex was induced 0.5 times on average using the magnet method. The mean X-ray exposure time was 29.6 seconds. No complications occurred. The magnet-loaded catheter method for positioning the ENBD catheter before finally leading it through the nose took little time and was performed successfully and safely. Therefore, the magnet method could become the first choice among techniques for ENBD catheter placement. © Georg Thieme Verlag KG Stuttgart · New York.

Application of medical cannabis in patients with the neurodegeneration disorders

Directory of Open Access Journals (Sweden)

Lidia Kotuła

2014-04-01

Full Text Available Medical cannabis is the dried flowers of the female Cannabis sativa L. plant. Cannabis contains a number of active elements, including dronabinol (THC and cannabidiol (CBD. Dronabinol is usually the main ingredient. The body’s own cannabinoid system has been identified. The discovery of this system, which comprises endocannabinoids and receptors, confirmed that cannabis has a positive effect on certain illnesses and conditions. Two types of cannabinoid receptors have been identified: CB1 and CB2 receptors. The first type CB1 is mostly found in the central nervous system, modulate pain. It also has an anti-emetic effect, and has influence on the memory and the motor system. The second type of receptors CB2 is peripheral, and it is primarily found in immune system cells and it is responsible for the immunomodulatory effects of cannabinoids. Medical cannabis can help in cases of the neurodegeneration disorders, for example Parkinson’s disease, Huntington’s Disease, Amyotrophic Lateral Sclerosis. Patients generally tolerate medical cannabis well.

The prevention and treatment of radiotherapy induced nausea and vomiting

International Nuclear Information System (INIS)

Van Zyl, A.J.

1992-11-01

Nausea and vomiting are side-effects that are associated with chemo- and radiotherapy. A single-blind study to compare the efficacy and safety of intravenous granisetron (G) with metoclopramide (M) plus dexamethasone (D) in the prophylaxis and control of nausea and emesis in patients undergoing hemi-body irradiation (HBI) was performed. G (3 mg) or M (20 mg) plus D (12 mg) were given intravenously, thirty minutes prior to the start of radiotherapy. Patients were monitored for nausea, vomiting and side-effects. Thirty-five patients were treated, 28 men and 7 women. A total of 21 (60%) patients did not vomit during the first 24 hours after the start of radiotherapy. Both G and M plus D offer safe and effective anti-emetic regimes for the prophylaxis and control of radiotherapy induced nausea and vomiting. However, granisetron was found to be more effective than metoclopramide plus dexamethasone in preventing nausea and vomiting. 101 refs., 40 tabs., 8 figs

The Analgesic Potential of Cannabinoids

Science.gov (United States)

Elikottil, Jaseena; Gupta, Pankaj; Gupta, Kalpna

2013-01-01

Historically and anecdotally cannabinoids have been used as analgesic agents. In recent years, there has been an escalating interest in developing cannabis-derived medications to treat severe pain. This review provides an overview of the history of cannabis use in medicine, cannabinoid signaling pathways, and current data from preclinical as well as clinical studies on using cannabinoids as potential analgesic agents. Clinical and experimental studies show that cannabis-derived compounds act as anti-emetic, appetite modulating and analgesic agents. However, the efficacy of individual products is variable and dependent upon the route of administration. Since opioids are the only therapy for severe pain, analgesic ability of cannabinoids may provide a much-needed alternative to opioids. Moreover, cannabinoids act synergistically with opioids and act as opioid sparing agents, allowing lower doses and fewer side effects from chronic opioid therapy. Thus, rational use of cannabis based medications deserves serious consideration to alleviate the suffering of patients due to severe pain. PMID:20073408

姜酚的研究进展%Research Advance in Gingerols

Institute of Scientific and Technical Information of China (English)

刘伟; 周春丽; 赵婧; 李全宏

2014-01-01

姜酚是生姜中的主要辛辣呈味物质和活性成分，具有多种药理学和生理学的功能。本文综述了姜酚的性质、组成、分离提取、测定以及降低血糖、血压、血脂、抗癌、抗氧化、抗炎、治疗老年痴呆、抑制血管增生、抗催吐、缓解体温等功能。%Gingerols are the major spicy flavor substances and active ingredients of ginger , with a variety of pharmacological and physiological functions. This paper reviews the research progress of quality, composition, separation, extraction, determination, reduing blood sugar, blood pressure, blood lipids,, anti-cancer, anti-oxidation, anti-inflammatory, treating senile dementia, inhibiton of angiogenesis,anti-emetic,relieving body temperature and other functions of gingerols.

Formation of cereulide and enterotoxins by Bacillus cereus in fermented African locust beans

DEFF Research Database (Denmark)

Thorsen, Line; Azokpota, Paulin; Munk Hansen, Bjarne

2011-01-01

Afitin, iru and sonru are three spontaneously fermented African locust bean Benin condiments. The fermentation processes are exothermic, with temperatures mostly being above 40 °C. A total of 19 predominant Bacillus cereus isolates from afitin, iru and sonru, were investigated. The enterotoxin...... genes nhe (A, B, C) were present in all 19 isolates, the hbl (A, C, D) in one (afitin), and the cytK gene in three isolates (afitin). Levels of cytotoxicity to Vero cells and NheA production in BHI-broth was within the range of known diarrheal outbreak strains. Autoclaved cooked African locust beans...... inoculated with emetic (cereulide producing) B. cereus Ba18H2/RIF supported growth at 25, 30 and 40 °C with highly different maximum cereulide productions of 6 ± 5, 97 ± 3 and 0.04 ± 0.02 μg/g beans, respectively (48 h). For non-autoclaved cooked beans inoculated with 2, 4 and 6 log10 B. cereus Ba18H2/RIF...

Evidence that 5-hydroxytryptamine/sub 3/ receptors mediate cytotoxic drug and radiation-evoked emesis

Energy Technology Data Exchange (ETDEWEB)

Miner, W.D.; Sanger, G.J.; Turner, D.H.

1987-08-01

The involvement of 5-hydroxytryptamine (5-HT) 5-HT/sub 3/ receptors in the mechanisms of severe emesis evoked by cytotoxic drugs or by total body irradiation have been studied in ferrets. Anti-emetic compounds tested were domperidone (a dopamine antagonist), metoclopramide (a gastric motility stimulant and dopamine antagonist at conventional doses, a 5-HT/sub 3/ receptor antagonist at higher doses) and BRL 24924 (a potent gastric motility stimulant and a 5-HT/sub 3/ receptor antagonist). Domperidone or metoclopramide prevented apomorphine-evoked emesis, whereas BRL 24924 did not. Similar doses of domperidone did not prevent emesis evoked by cis-platin or by total body irradiation, whereas metoclopramide or BRL 24924 greatly reduced or prevented these types of emesis. Metoclopramide and BRL 24924 also prevented emesis evoked by a combination of doxorubicin and cyclophosphamide. These results are discussed in terms of a fundamental role for 5-HT/sub 3/ receptors in the mechanisms mediating severely emetogenic cancer treatment therapies.

[Acute poisoning in patients over 65 years of age].

Science.gov (United States)

Miranda Arto, P; Ferrer Dufol, A; Ruiz Ruiz, F J; Menao Guillén, S; Civeira Murillo, E

2014-01-01

There are few Spanish studies on acute poisoning in the elderly despite the associated risk factors of this group of patients. Retrospective descriptive study of acute poisonings treated in the Emergency Service of the University Hospital of Zaragoza from 1995 to 2009 on patients 65 years old or older. A total of 762 patients were selected in the study (4.74% of all acute poisonings) with a mean age of 74.16 (SD ± 6) years. Ingestion was the major route of exposure (85%) and alcohol overdose (28,7%) was the most frequent type of poisoning. A trend was also observed showing a lower emetic treatment and gastric lavage and an increase in activated charcoal. Benzodiazepines (14.3%) and toxic household products (11%) with caustic properties were also the main toxics found in the study. Acute poisonings in the elderly required more hospitalizations, have a higher mortality and more autolytic attempts which result in death.

Antitumor action of temozolomide, ritonavir and aprepitant against human glioma cells.

Science.gov (United States)

Kast, Richard E; Ramiro, Susana; Lladó, Sandra; Toro, Salvador; Coveñas, Rafael; Muñoz, Miguel

2016-02-01

In the effort to find better treatments for glioblastoma we tested several currently marketed non-chemotherapy drugs for their ability to enhance the standard cytotoxic drug currently used to treat glioblastoma- temozolomide. We tested four antiviral drugs- acyclovir, cidofovir, maraviroc, ritonavir, and an anti-emetic, aprepitant. We found no cytotoxicity of cidofovir and discussed possible reasons for discrepancy from previous findings of others. We also found no cytotoxicity from acyclovir or maraviroc also in contradistinction to predictions. Cytotoxicity to glioma cell line GAMG for temozolomide alone was 14%, aprepitant alone 7%, ritonavir alone 14%, while temozolomide + aprepitant was 19%, temozolomide + ritonavir 34%, ritonavir + aprepitant 64 %, and all three, temozolomide + ritonavir + aprepitant 78%. We conclude that a remarkable synergy exists between aprepitant and ritonavir. Given the long clinical experience with these two well-tolerated drugs in treating non-cancer conditions, and the current median survival of glioblastoma of 2 years, a trial is warranted of adding these two simple drugs to current standard treatment with temozolomide.

Indigenous knowledge of medicinal plants of Chagharzai valley, district Buner, Pakistan

International Nuclear Information System (INIS)

Alam, N.; Shinwari, Z.K.; Ilyas, M.; Ullah, Z.

2011-01-01

Indigenous knowledge of medicinal plants was recorded during summer 2004, in 22 villages of Chagharzai valley, District Buner. The study revealed 141 plant species belonging to 120 genera and 26 families are being used as medicine. The local people know the prospect and nature of the plant utilization, through personal experiences and ancestral prescriptions. The study also revealed that old aged people particularly women posses strong folk love of medicinal plants in comparison to young people. It was concluded that some plants are used singly while many other are used in combination. Similarly few plant species are used for the treatment of a specific disease, while several other have multiple uses. The plants were mainly used as stomachic, anti-allergic, antineuralgia, vermifuge, narcotic, laxative, anti jaundice, emollient, hypnotic, diuretic, digestive, demulcent, carminative, astringent, aphrodisiac, anti-spasmodic, anti-emetic, anti-diabetic, anthelmentic, anodyne and alterative. The present investigation will help in the preservation of indigenous knowledge of the local people, which is depleting day by day. (author)

Molecular Bases of PDE4D Inhibition by Memory-Enhancing GEBR Library Compounds.

Science.gov (United States)

Prosdocimi, Tommaso; Mollica, Luca; Donini, Stefano; Semrau, Marta S; Lucarelli, Anna Paola; Aiolfi, Egidio; Cavalli, Andrea; Storici, Paola; Alfei, Silvana; Brullo, Chiara; Bruno, Olga; Parisini, Emilio

2018-05-01

Selected members of the large rolipram-related GEBR family of type 4 phosphodiesterase (PDE4) inhibitors have been shown to facilitate long-term potentiation and to improve memory functions without causing emetic-like behavior in rodents. Despite their micromolar-range binding affinities and their promising pharmacological and toxicological profiles, few if any structure-activity relationship studies have been performed to elucidate the molecular bases of their action. Here, we report the crystal structure of a number of GEBR library compounds in complex with the catalytic domain of PDE4D as well as their inhibitory profiles for both the long PDE4D3 isoform and the catalytic domain alone. Furthermore, we assessed the stability of the observed ligand conformations in the context of the intact enzyme using molecular dynamics simulations. The longer and more flexible ligands appear to be capable of forming contacts with the regulatory portion of the enzyme, thus possibly allowing some degree of selectivity between the different PDE4 isoforms.

Modelisation des emissions de particules microniques et nanometriques en usinage

Science.gov (United States)

Khettabi, Riad

La mise en forme des pieces par usinage emet des particules, de tailles microscopiques et nanometriques, qui peuvent etre dangereuses pour la sante. Le but de ce travail est d'etudier les emissions de ces particules pour fins de prevention et reduction a la source. L'approche retenue est experimentale et theorique, aux deux echelles microscopique et macroscopique. Le travail commence par des essais permettant de determiner les influences du materiau, de l'outil et des parametres d'usinage sur les emissions de particules. E nsuite un nouveau parametre caracterisant les emissions, nomme Dust unit , est developpe et un modele predictif est propose. Ce modele est base sur une nouvelle theorie hybride qui integre les approches energetiques, tribologiques et deformation plastique, et inclut la geometrie de l'outil, les proprietes du materiau, les conditions de coupe et la segmentation des copeaux. Il ete valide au tournage sur quatre materiaux: A16061-T6, AISI1018, AISI4140 et fonte grise.

Radiation-induced emesis in the dog: effects of lesions and drugs

International Nuclear Information System (INIS)

Carpenter, D.O.; Briggs, D.B.; Knox, A.P.; Strominger, N.L.

1986-01-01

Dogs exposed to 8 Gy 60 Co gamma mid-abdominal irradiation exhibited emesis with an average latency of 102 min and an average of 7.4 episodes over 96 min. There were no significant changes in dogs subjected to a chronic bilateral subdiaphragmatic vagotomy, but emesis was prevented by ablation of the area postrema. Indomethacin pretreatment also prevented radiation-induced emesis in two of seven dogs and in the remainder reduced the average number of episodes. Domperidone pretreatment prevented radiation-induced emesis in all of four dogs tested. In electrophysiological studies recording from the area postrema the chemosensitive neurons were found to be normally silent in anesthetized preparations but excitable by a variety of emetic agents. After irradiation of the abdomen spontaneously active neurons were found with a discharge pattern that mirrored the behavioral pattern of postirradiation emesis. These studies are consistent with radiation-induced emesis being humorally mediated in the dog and implicate dopamine and/or prostaglandins as possible mediators

Evidence that 5-hydroxytryptamine3 receptors mediate cytotoxic drug and radiation-evoked emesis

International Nuclear Information System (INIS)

Miner, W.D.; Sanger, G.J.; Turner, D.H.

1987-01-01

The involvement of 5-hydroxytryptamine (5-HT) 5-HT 3 receptors in the mechanisms of severe emesis evoked by cytotoxic drugs or by total body irradiation have been studied in ferrets. Anti-emetic compounds tested were domperidone (a dopamine antagonist), metoclopramide (a gastric motility stimulant and dopamine antagonist at conventional doses, a 5-HT 3 receptor antagonist at higher doses) and BRL 24924 (a potent gastric motility stimulant and a 5-HT 3 receptor antagonist). Domperidone or metoclopramide prevented apomorphine-evoked emesis, whereas BRL 24924 did not. Similar doses of domperidone did not prevent emesis evoked by cis-platin or by total body irradiation, whereas metoclopramide or BRL 24924 greatly reduced or prevented these types of emesis. Metoclopramide and BRL 24924 also prevented emesis evoked by a combination of doxorubicin and cyclophosphamide. These results are discussed in terms of a fundamental role for 5-HT 3 receptors in the mechanisms mediating severely emetogenic cancer treatment therapies. (author)

Rotavirus infection

Science.gov (United States)

Crawford, Sue E.; Ramani, Sasirekha; Tate, Jacqueline E.; Parashar, Umesh D.; Svensson, Lennart; Hagbom, Marie; Franco, Manuel A.; Greenberg, Harry B.; O’Ryan, Miguel; Kang, Gagandeep; Desselberger, Ulrich; Estes, Mary K.

2017-01-01

Rotavirus infections are a leading cause of severe, dehydrating gastroenteritis in children rotavirus over a decade ago, rotavirus infections still result in >200,000 deaths annually, mostly in low-income countries. Rotavirus primarily infects enterocytes and induces diarrhoea through the destruction of absorptive enterocytes (leading to malabsorption), intestinal secretion stimulated by rotavirus non-structural protein 4 and activation of the enteric nervous system. In addition, rotavirus infections can lead to antigenaemia (which is associated with more severe manifestations of acute gastroenteritis) and viraemia, and rotavirus can replicate in systemic sites, although this is limited. Reinfections with rotavirus are common throughout life, although the disease severity is reduced with repeat infections. The immune correlates of protection against rotavirus reinfection and recovery from infection are poorly understood, although rotavirus-specific immunoglobulin A has a role in both aspects. The management of rotavirus infection focuses on the prevention and treatment of dehydration, although the use of antiviral and anti-emetic drugs can be indicated in some cases. PMID:29119972

Determination of soil erosion risk in the Mustafakemalpasa River Basin, Turkey, using the revised universal soil loss equation, geographic information system, and remote sensing.

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Ozsoy, Gokhan; Aksoy, Ertugrul; Dirim, M Sabri; Tumsavas, Zeynal

2012-10-01

Sediment transport from steep slopes and agricultural lands into the Uluabat Lake (a RAMSAR site) by the Mustafakemalpasa (MKP) River is a serious problem within the river basin. Predictive erosion models are useful tools for evaluating soil erosion and establishing soil erosion management plans. The Revised Universal Soil Loss Equation (RUSLE) function is a commonly used erosion model for this purpose in Turkey and the rest of the world. This research integrates the RUSLE within a geographic information system environment to investigate the spatial distribution of annual soil loss potential in the MKP River Basin. The rainfall erosivity factor was developed from local annual precipitation data using a modified Fournier index: The topographic factor was developed from a digital elevation model; the K factor was determined from a combination of the soil map and the geological map; and the land cover factor was generated from Landsat-7 Enhanced Thematic Mapper (ETM) images. According to the model, the total soil loss potential of the MKP River Basin from erosion by water was 11,296,063 Mg year(-1) with an average soil loss of 11.2 Mg year(-1). The RUSLE produces only local erosion values and cannot be used to estimate the sediment yield for a watershed. To estimate the sediment yield, sediment-delivery ratio equations were used and compared with the sediment-monitoring reports of the Dolluk stream gauging station on the MKP River, which collected data for >41 years (1964-2005). This station observes the overall efficiency of the sediment yield coming from the Orhaneli and Emet Rivers. The measured sediment in the Emet and Orhaneli sub-basins is 1,082,010 Mg year(-1) and was estimated to be 1,640,947 Mg year(-1) for the same two sub-basins. The measured sediment yield of the gauge station is 127.6 Mg km(-2) year(-1) but was estimated to be 170.2 Mg km(-2) year(-1). The close match between the sediment amounts estimated using the RUSLE

Overweight/obesity and gastric fluid characteristics in pediatric day surgery: implications for fasting guidelines and pulmonary aspiration risk.

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Cook-Sather, Scott D; Gallagher, Paul R; Kruge, Lydia E; Beus, Jonathan M; Ciampa, Brian P; Welch, Kevin Conor; Shah-Hosseini, Sina; Choi, Jieun S; Pachikara, Reshma; Minger, Kim; Litman, Ronald S; Schreiner, Mark S

2009-09-01

The safety of 2-h preoperative clear liquid fasts has not been established for overweight/obese pediatric day surgical patients. Healthy children and obese adults who fasted 2 h have small residual gastric fluid volumes (GFVs), which are thought to reflect low pulmonary aspiration risk. We sought to measure the prevalence of overweight/obesity in our day surgery population. We hypothesized that neither body mass index (BMI) percentile nor fasting duration would significantly affect GFV or gastric fluid pH. In children who were allowed clear liquids up until 2 h before surgery, we hypothesized that overweight/obese subjects would not have increased GFV over lean/normal subjects and that emesis/pulmonary aspiration events would be rare. Demographics, medical history, height, and weight were recorded for 1000 consecutive day surgery patients aged 2-12 yr. In addition, 1000 day surgery patients (age 2-12 yr) undergoing general endotracheal anesthesia were enrolled. After tracheal intubation, a 14-18F orogastric tube was inserted and gastric contents evacuated. Medications, fasting interval, GFV, pH, and emetic episodes were documented. Age- and gender-specific Center for Disease Control and Prevention growth charts (2000) were used to determine ideal body weight (IBW = 50th percentile) and to classify patients as lean/normal (BMI 25th-75th percentile), overweight (BMI > or = 85th to obese (BMI > or = 95th percentile). Of all day surgery patients, 14.0% were overweight and 13.3% were obese. Obese children had lower GFV per total body weight (P fasting duration or age. Decreased gastric fluid acidity was associated with younger age (P = 0.005), increased BMI percentile (P = 0.036), and African American race (P = 0.033). Emesis on induction occurred in eight patients (50% of whom were obese, P = 0.052, and 75% of whom had obstructive sleep apnea, P = 0.061). Emesis was associated with increased ASA physical status (P = 0.006) but not with fasting duration. There were no

GÜNEY MARMARA BÖLGESİNDEKİ BÜYÜK VADİLERİN OLASI DEŞİLME ZAMANI

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Nizamettin KAZANCI

2014-06-01

Full Text Available Güney Marmara Bölgesi’nin (Susurluk drenaj havzası-SDH suları ve tortulları büyük ölçüde önce Manyas ve Ulubat göllerinde toplanır, sonra tek kanaldan Marmara Denizi’ne ulaşır.Mevcut akaçlama sistemi ile buradaki gözlem istasyonları SDH’ndaki aşınma hızını ve dolayısıyla buradaki büyük ölçekli vadilerin kazınma sürelerini araştırma olanağı vermektedir. Bu yönde veri elde etmek için, Ulubat Gölü’nün eski tortulları ve bunların kimyasal kapsamları sondajlar yardımıyla çalışılmıştır. Karotlarla kesilen göl tortulları içindeki bor iyonu alttan üste doğru 4 m seviyesinde aniden artmakta olup bu değişme Emet Vadisi’ndeki borat yataklarının aşınmaya başlamasıyla ortaya çıkmıştır. Aşınma-depolanma ilişkileri dikkate alınarak Emet Vadisi’ndeki deşilme hızı 1,4 cm/yıl, bu değerin tüm araziye uygulanmasıyla vadinin toplam kazılma süresi 75 bin yıl olarak hesaplanmaktadır. Jeolojik süreçlerin tekdüze olmadığı dikkate alınarak, bu yaşın mutlak olmayacağı, ancak mevcut taşınma ve depolanma hızlarına göre vadilerin kazılma süresinin 300 bin yıldan daha da geriye gitmeyeceği söylenebilir. Öyle anlaşılıyor ki, hızlı aşınmanın önemli nedenlerinden birisi Marmara Denizi’nin son Buzul Çağında göl halinde oluşudur. Alçak taban düzeyi, kaynak alan ile birikim yeri arasında belirgin yükseklik farkı yaratmış ve erozyonun hızlanmasına yol açmıştır..

Phytochemical and pharmacological review of Lagenaria sicereria.

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Prajapati, Rakesh P; Kalariya, Manisha; Parmar, Sachin K; Sheth, Navin R

2010-10-01

Lagenaria siceraria (Molina) standley (LS) (Family: Cucurbitaceae) is an annual herbaceous climbing plant with a long history of traditional medicinal uses in many countries, especially in tropical and subtropical regions. Since ancient times the climber has been known for its curative properties, and has been utilized for treatment of various ailments, including jaundice, diabetes, ulcer, piles, colitis, insanity, hypertension, congestive cardiac failure (CCF), and skin diseases. Its fruit pulp is used both as an emetic and purgative, and for its cooling, diuretic, antibilious, and pectoral properties. Boiled in oil this pulp is used to treat rheumatism and insomnia. A wide range of chemical compounds including sterols, terpenoids, flavonoids, and saponins have been isolated from the species. Its extracts have been found to possess various pharmacological activities. Below, we give a comprehensive review of its ethnomedical uses, chemical constituents, and pharmacological profile as a medicinal plant. Particular attention is given to its analgesic, anti-inflammatory, antihyperlipidemic, diuretic, hepatoprotective, anthelmintic, and antibacterial effects so that its potential uses in pharmaceutics can be better evaluated.

Phytochemical and pharmacological review of Lagenaria sicereria

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Rakesh P Prajapati

2010-01-01

Full Text Available Lagenaria siceraria (Molina standley (LS (Family: Cucurbitaceae is an annual herbaceous climbing plant with a long history of traditional medicinal uses in many countries, especially in tropical and subtropical regions. Since ancient times the climber has been known for its curative properties, and has been utilized for treatment of various ailments, including jaundice, diabetes, ulcer, piles, colitis, insanity, hypertension, congestive cardiac failure (CCF, and skin diseases. Its fruit pulp is used both as an emetic and purgative, and for its cooling, diuretic, antibilious, and pectoral properties. Boiled in oil this pulp is used to treat rheumatism and insomnia. A wide range of chemical compounds including sterols, terpenoids, flavonoids, and saponins have been isolated from the species. Its extracts have been found to possess various pharmacological activities. Below, we give a comprehensive review of its ethnomedical uses, chemical constituents, and pharmacological profile as a medicinal plant. Particular attention is given to its analgesic, anti-inflammatory, antihyperlipidemic, diuretic, hepatoprotective, anthelmintic, and antibacterial effects so that its potential uses in pharmaceutics can be better evaluated.

Efficacy of granisetron in the prevention of GIT problems in patients undergoing total body irradiation

International Nuclear Information System (INIS)

Feuvret, L.; Jammet, P.; Campana, F.; Cosset, J.M.; Fourquet, A.

1994-01-01

From december 1991 to september 1992, 20 patients due to receive total body irradiation (TBI) prior to allogeneic or autologous bone marrow transplantation were given granisetron (Kytril) in order to prevent intestinal (nausea and vomiting) early intolerance, TBI regimen was delivered on a fractional basis of six fractions, over 3 days. Twelve grays were delivered with a lung protection decreasing the pulmonary dose to 9 Gy Granisetron (3 mg) was administered by a 5-min intravenous infusion, 1 h before TBI. Up to two further infusions were given if nausea or vomiting occurred. The pretreatment perfusion was sufficient to prevent nausea and vomiting in 10/20 patients, one additional post-treatment perfusion was necessary in 7/20 patients, and two in 1/20 patients. In 2/20 cases, nausea and vomiting persisted in spite of three perfusions. Excellent or good efficacy was noted in 15/20 patients and a minor (or no) efficacy in five. Granisetron appears to be superior to the conventional anti emetic schemes to prevent nausea and vomiting in patients receiving TBI for bone marrow transplantation. 15 Refs

[Preventive efficacy of ondansetron and granisetron for postoperative nausea and vomiting in high risk patients].

Science.gov (United States)

Quan, Xiang; Zhu, Bo; Ye, Tie-hu

2011-08-01

To compare the efficacy of ondansetron and granisetron in the prevention of postoperative nausea and vomiting (PONV) in high-risk patients. Totally 200 patients with three key risk factors for PONV (female, non-smoking and postoperative opioid use) were equally randomized into ondansetron group and granisetron group. Ondansetron (4 mg) or granisetron (3 mg) was intravenously administered upon the completion of surgery. The episodes of nausea and vomiting were observed for 24 hours after surgery. A significantly greater proportion of patients in granisetron group achieved a complete response (i.e., no PONV or rescue medication) during the first 24 hours postoperatively versus those in ondansetron group (62.6% vs. 46.9%, respectively; P=0.048). There were no significant differences in terms of postoperative nausea incidences (42.9% vs. 34.3%, respectively), postoperative vomiting incidences (25.5% vs. 20.2%, respectively) and postoperative rescue anti-emetics incidences (19.4% vs. 15.2%, respectively) (P>0.05). Granisetron is more effective than ondansetron in preventing PONV in high-risk patients during the first 24 hours postoperatively.

A randomized, double-blinded comparison of ondansetron, granisetron, and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy.

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Jain, Virendra; Mitra, Jayanta K; Rath, Girija P; Prabhakar, Hemanshu; Bithal, Parmod K; Dash, Hari H

2009-07-01

Postoperative nausea and vomiting (PONV) are frequent and distressing complications after neurosurgical procedures. We evaluated the efficacy of ondansetron and granisetron to prevent PONV after supratentorial craniotomy. In a randomized double-blind, placebo controlled trial, 90 adult American Society of Anesthesiologists I, II patients were included in the study. A standard anesthesia technique was followed. Patients were divided into 3 groups to receive either placebo (saline), ondansetron 4 mg, or granisetron 1 mg intravenously at the time of dural closure. After extubation, episodes of nausea and vomiting were noted for 24 hours postoperatively. Statistical analysis was performed using chi2 test and 1-way analysis of variance. Demographic data, duration of surgery, intraoperative fluids and analgesic requirement, and postoperative pain (visual analog scale) scores were comparable in all 3 groups. It was observed that the incidence of vomiting in 24 hours, severe emetic episodes, and requirement of rescue antiemetics were less in ondansetron and granisetron groups as compared with placebo (Pgranisetron 1 mg are comparably effective at preventing emesis after supratentorial craniotomy. However, neither drugs prevented nausea effectively.

Efficacy of granisetron in the prevention of GIT problems in patients undergoing total body irradiation. Interet du granisetron dans la prevention des troubles digestifs lors des irradiations corporelles totales

Energy Technology Data Exchange (ETDEWEB)

Feuvret, L.; Jammet, P.; Campana, F.; Cosset, J.M.; Fourquet, A. (Institut Curie, 75 - Paris (France))

1994-01-01

From december 1991 to september 1992, 20 patients due to receive total body irradiation (TBI) prior to allogeneic or autologous bone marrow transplantation were given granisetron (Kytril) in order to prevent intestinal (nausea and vomiting) early intolerance, TBI regimen was delivered on a fractional basis of six fractions, over 3 days. Twelve grays were delivered with a lung protection decreasing the pulmonary dose to 9 Gy Granisetron (3 mg) was administered by a 5-min intravenous infusion, 1 h before TBI. Up to two further infusions were given if nausea or vomiting occurred. The pretreatment perfusion was sufficient to prevent nausea and vomiting in 10/20 patients, one additional post-treatment perfusion was necessary in 7/20 patients, and two in 1/20 patients. In 2/20 cases, nausea and vomiting persisted in spite of three perfusions. Excellent or good efficacy was noted in 15/20 patients and a minor (or no) efficacy in five. Granisetron appears to be superior to the conventional anti emetic schemes to prevent nausea and vomiting in patients receiving TBI for bone marrow transplantation. 15 Refs.

Pharmacological and biological activities of Mirabilis jalapa L.

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Rozina Rozina

2016-05-01

Full Text Available AbstractPlants have been used for health care and medical purposes for several thousands of years. The number of higher plant species on earth is about 250000. It is estimated that 35000 to 70000 species have, at one time or another, been used in some cultures for medicinal purposes. One of these is Mirabilis jalapa L. which is traditionally used as Purgative and emetic, for treatment of many gastrointestinal disorders, including dysentery, diarrhea, muscle pain and abdominal colic. Besides this it also exhibits certain useful activities like Antiviral activity, Antimicrobial activity, Antimalarial activity, Anthelmintic activity, Antioxidant activity, Aytotoxic activity Anti-tubercular drugs induced hepatotoxicity, Antinociceptive activity, Antifungal activity, Anti-corrosion activity, Antispasmodic activity, Anti-inflammatory activity and many others. Pharmacologically active compounds include active alcoholic extract, ether compound-3,3’-Methylenebis (4- hydroxycoumarin N-D-alpha-Phenylyglycinelaminaribiitol-3-(4-(dimethylamino cinnamoyl 4hydroxycoumarin. The purpose of my review is to find out the areas of scope and to give the detail of the work done on Mirabilis Jalapa L. for future research work.

Pharmacodynamic and pharmacokinetic effects of the intravenous CB1 receptor agonist Org 26828 in healthy male volunteers.

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Zuurman, Lineke; Passier, Paul C C M; de Kam, Marieke L; Kleijn, Huub J; Cohen, Adam F; van Gerven, Joop M A

2010-11-01

An ideal drug for outpatient treatments under conscious sedation would have both sedative and analgesic properties. CB1/CB2 agonists are expected to have sedative, amnestic, analgesic and anti-emetic properties. The main objective of this first study in humans was to assess the sedative properties of intravenous Org 26828. In addition, pharmacokinetics, amnestic properties, postural stability, and behavioural and cardiovascular effects were studied. Midazolam intravenous 0.1 mg/kg and placebo were used as controls. The pharmacokinetic parameters (Cmax and AUC0-inf) of the main metabolite Org 26761 were proportional to dose. No effects were observed after doses up to 0.3 μg/kg of Org 26828. Dose-related effects were observed at higher doses. Although subjects reported subjective sedation after administration of Org 26828 at 3 and 6 μg/kg, the observed sedation was considerably less than after midazolam. Doses higher than the maximum tolerated dose of 1 μg/kg of Org 26828 caused unpleasant central nervous system effects (anxiety, paranoia, hallucinations). Therefore, Org 26828 is not suitable for providing sedation for outpatient surgical procedures.

Hesperetin, a Selective Phosphodiesterase 4 Inhibitor, Effectively Suppresses Ovalbumin-Induced Airway Hyperresponsiveness without Influencing Xylazine/Ketamine-Induced Anesthesia

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Chung-Hung Shih

2012-01-01

Full Text Available Hesperetin, a selective phosphodiesterase (PDE4 inhibitor, is present in the traditional Chinese medicine, “Chen Pi.” Therefore, we were interested in investigating its effects on ovalbumin- (OVA- induced airway hyperresponsiveness, and clarifying its rationale for ameliorating asthma and chronic obstructive pulmonary disease (COPD. Hesperetin was revealed to have a therapeutic (PDE4H/PDE4L ratio of >11. Hesperetin (10 ~ 30 μmol/kg, intraperitoneally (i.p. dose-dependently and significantly attenuated the airway hyperresponsiveness induced by methacholine. It also significantly suppressed the increases in total inflammatory cells, macrophages, lymphocytes, neutrophils, and eosinophils, and levels of cytokines, including interleukin (IL-2, IL-4, IL-5, interferon-γ, and tumor necrosis factor-α in bronchoalveolar lavage fluid (BALF. It dose-dependently and significantly suppressed total and OVA-specific immunoglobulin E levels in the BALF and serum. However, hesperetin did not influence xylazine/ketamine-induced anesthesia, suggesting that hesperetin has few or no emetic effects. In conclusion, the rationales for ameliorating allergic asthma and COPD by hesperetin are anti-inflammation, immunoregulation, and bronchodilation.

Beneficial Effects of Bioactive Compounds in Mulberry Fruits against Cisplatin-Induced Nephrotoxicity

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Dahae Lee

2018-04-01

Full Text Available Mulberry, the fruit of white mulberry tree (Morus alba L., Moraceae, is commonly used in traditional Chinese medicines as a sedative, tonic, laxative, and emetic. In our continuing research of the bioactive metabolites from mulberry, chemical analysis of the fruits led to the isolation of five compounds, 1–5. The compounds were identified as butyl pyroglutamate (1, quercetin 3-O-β-d-glucoside (2, kaempferol 3-O-β-d-rutinoside (3, rutin (4, and 2-phenylethyl d-rutinoside (5 by spectroscopic data analysis, comparing their nuclear magnetic resonance (NMR data with those in published literature, and liquid chromatography–mass spectrometry analysis. The isolated compounds 1–5 were evaluated for their effects on anticancer drug-induced side effects by cell-based assays. Compound 1 exerted the highest protective effect against cisplatin-induced kidney cell damage. This effect was found to be mediated through the attenuation of phosphorylation of c-Jun N-terminal kinase, extracellular signal-regulated kinase, p38, mitogen-activated protein kinase, and caspase-3 in cisplatin-induced kidney cell damage.

Casopitant: a novel NK1-receptor antagonist in the prevention of chemotherapy-induced nausea and vomiting

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Christina Ruhlmann

2009-05-01

Full Text Available Christina Ruhlmann, Jørn HerrstedtOdense University Hospital, Department of Oncology, Odense, DenmarkAbstract: Chemotherapy-induced nausea and vomiting (CINV are among the most feared and distressing symptoms experienced by patients with cancer. The knowledge of the pathogenesis and neuropharmacology of CINV has expanded enormously over the last decades, the most significant discoveries being the role of 5-hydroxytryptamine (5-HT3- and neurokinin (NK1 receptors in the emetic reflex arch. This has led to the development of two new classes of antiemetics acting as highly selective antagonists at one of these receptors. These drugs have had a huge impact in the protection from chemotherapy-induced vomiting, whereas the effect on nausea seems to be limited. The first NK1 receptor antagonist, aprepitant, became clinically available in 2003, and casopitant, the second in this class of antiemetics, has now completed phase III trials. This review delineates the properties and clinical use of casopitant in the prevention of CINV.Keywords: casopitant, GW679769, NK1 receptor antagonist, chemotherapy, emesis

Contribution to the chromatography of atmospheric gases (1963); Contribution a la chromatographie des gaz de l'air (1963)

Energy Technology Data Exchange (ETDEWEB)

Ghalamsiah, A [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1963-06-15

In the first part, the author studies the gas-phase chromatographic separation of the atmospheric rare gases, of hydrogen, and of some gaseous compounds of carbon (CO, CO{sub 2}, CH{sub 4}) using inactive gases to obtain the most favourable operational conditions far this separation. In the second part, the optimum conditions for detecting non-active gases using an ionisation chamber and a {sup 239}Pu radioactive source emitting 5.15 MeV {alpha} particles are determined. (author) [French] Dans une premiere partie, l'auteur etudie la separation par chromatographie en phase gazeuse des gaz rares de l'air, de l'hydrogene, et de quelques composes gazeux du carbone (CO, CO{sub 2}, CH{sub 4}) en utilisant des gaz inactifs an vue d'obtenir les conditions experimenales les plus favorables en vue de cette separation. Dans une deuxieme partie, les conditions optimales de detection de gaz non actifs a l'aide d'une chambre d'ionisation, en utilisant comme source radioactive du {sup 239}Pu qui emet des particules {alpha} de 5,15 MeV, sont determinees. (auteur)

Lessons learnt from a birthday party: a Bacillus cereus outbreak, Bari, Italy, January 2012

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Domenico Martinelli

2013-12-01

Full Text Available INTRODUCTION: Bacillus cereus, a ubiquitous bacterium, can be isolated in various starchy food items, causing both emetic and diarrhoeal disease. The real burden of B. cereus outbreaks is actually poorly known in Italy. We report a B. cereus foodborne outbreak that occurred in a pub in Bari (Italy on January 22nd 2012 during a birthday party, promptly reported by the pub owner. MATERIALS AND METHODS: Between January 22nd and 24th 2012, we performed a retrospective cohort study among the guests of the party to identify risk factors associated with illness. Leftovers of different meals were available for microbiological analysis. Faecal specimens were collected from cases. RESULTS: A total of 12 cases among the 13 customers (attack rate: 92% were reported. All cases had consumed basmati rice and sweet and sour vegetables (aetiological fraction: 100%. B. cereus was isolated from both basmati rice served during the party and faecal specimens. DISCUSSION: The close collaboration between the pub owner and the public health officers and the possibility to test food leftovers and stool samples contributed to prevent further cases.

Design and Optimization of Domperidone Fast Dissolving Tablet Using Central Composite Design.

Science.gov (United States)

Shailendra, Bhatt; Shailendra, Mandge; Manish, Jaimini; Singh, Tanwar Yuveraj; Priti, Trivedi

2015-01-01

The main aim present work was to optimize fast dissolving tablet (FDT) formulation using response surface approach. The variables studied were sodium bicarbonate (X1), citric acid (X2), and superdisintegrant, Ac-Di-Sol (X3). The main aspect of present work was to develop FDT of Domperidone which possesses fast disintegration and high mechanical strength. It was found that the response was affected by all the three factors studied. The statistical models were successfully used to prepare FDT of Domperidone with fast disintegration (31.08 seconds) and adequate hardness (4.1 kg/cm(2)). Pharmacokinetic studies in rats showed statistically insignificant difference (p>0.05) between Domperidone fast dissolving tablet (DFDT) and market product. This concluded that optimized FDT is bioequivalent with the marketed formulation. The values of Tmax were found to be 0.5 h and 0.75 h for DFDT and reference product, respectively. Conditioned place aversion study was performed on Swiss Albino mice and the study showed the better anti emetic potency of optimized FDT in nauseated condition over market product (pdisintegration and high mechanical strength.

[The Effectiveness of Epidural Droperidol for Prophylaxis of Postoperative Nausea and Vomiting: A Comparative Study of Droperidol and Adrenaline].

Science.gov (United States)

Toyonaga, Shinya; Shinozuka, Norihiro; Dobashi, Tamae; Iiyori, Nao; Sudo, Tomoko

2016-05-01

Intravenous droperidol has strong evidence for antiemetic efficacy in high risk patients for prevention of postoperative nausea and vomiting (PONV). However it is not clear whether continuous epidural administration of doroperidol prevent PONV. It has been reported that epidural adrenaline decreases PONV; therefore we prospectively compared the effectiveness of epidural droperidol and adrenaline for prophylaxis of PONV. Eighty-six patients were scheduled for abdominal gynecological surgery under general-epidural anesthesia in the study. Patients were randomly assigned to droperidol group or adrenaline group. We investigated the incidences of PONV, the frequency of using the antiemetics. There was no statistical difference between the groups. The incidences of PONV were 27.9% (doropeidol group) and 58.1% (adrenaline group), respectively (P = 0.0046). The frequency of the anti-emetics use were 18.6% and 41.9%, respectively (P = 0.0189). There was one patient who needed cancellation of continuous epidural administration for vomiting in adrenaline group, but no patient in doropeidol group. The results suggest that epidural droperidol effectively decreases PONV in high risk patients. However epidural adrenaline might be ineffective.

The anti emetic effect of oral administration of ondansetron or granisetron in macacus cynomolgus exposed to mixed neutron-gamma irradiation

International Nuclear Information System (INIS)

Martin, C.; Roman, V.; Martin, S.; Janodet, D.; Fatome, M.

1995-01-01

Nausea and vomiting are the most often observed symptoms in the course of the early radiation syndrome. Their prevention has long been difficult because of the low effectiveness and side-effects of most antiemetics. There is a clear evidence that 5HT 3 receptor antagonists such as ondansetron and granisetron are highly effective to prevent radiation-induced emesis without any side-effect. We studied the prophylactic effectiveness of their oral administration to macacus cynomolgus, for mixed neutron-gamma whole-body exposure, tat high dose rates. Doses of 4 mg of ondansetron or 1 mg of granisetron were administered before, or after, or both before and after irradiation. The treatment was effective when administered both before and after radiation exposure. It was significant but incomplete if administered once. Post-irradiation administration is interesting, particularly in case of accident. Both antiemetic drugs were well tolerated. Their effectiveness and tolerance are apparently comparable. The 5HT 3 receptor antagonists represent a much improved treatment for radiation-induced nausea and vomiting by completely inhibiting emesis, if administered before and after irradiation. Unwanted sedation and extra-pyramidal side-effects, usually associated with the clinical use of D 2 receptor antagonists, were not observed. (authors). 40 refs., 5 tabs

Epidemiology, Clinical Characteristics, and Associations for Rome IV Functional Nausea and Vomiting Disorders in Adults.

Science.gov (United States)

Aziz, Imran; Palsson, Olafur S; Whitehead, William E; Sperber, Ami D; Simrén, Magnus; Törnblom, Hans

2018-05-29

Functional nausea and vomiting disorders (FNVDs) are classified as chronic nausea and vomiting syndrome (CNVS) or cyclic vomiting syndrome (CVS) - CVS includes cannabinoid hyperemesis syndrome. We investigated the population prevalence of FNVDs, their characteristics, and associated factors. In the year 2015, an Internet cross-sectional health survey was completed by 5931 adults in the general populations of 3 English-speaking countries; 2100 participants were in the United States, Canada, or the United Kingdom. Quota-based sampling was used to generate demographically balanced and population-representative samples. The survey collected data on demographics, healthcare visits, medications, somatic symptom severity, quality of life, and symptom-based diagnostic criteria for Rome IV FNVDs as well as for irritable bowel syndrome and functional dyspepsia. Subsequent comparisons were made between Rome IV FNVD subjects and individuals without FNVDs (controls). Overall, 2.2% of the population (n=131) fulfilled symptom-based diagnostic criteria for Rome IV FNVDs - the United States (3%) had a greater prevalence than Canada (1.9%) or the United Kingdom (1.8%) (P=.02). The prevalence of CNVS was similar among the countries, ranging from 0.8% to 1.2%. However, the prevalence of CVS was higher in the United States (2%) than in Canada (0.7%) or the United Kingdom (1%) (P=.03). The proportion of subjects with CVS taking cannabis did not differ significantly among countries (P=.31), although the 7 cases of cannabinoid hyperemesis syndrome were in the United States. A significantly higher proportion of subjects with CVS reported a compulsive need for hot water bathing to alleviate emetic symptoms than subjects with CNVS (44% vs. 19%, P=.03); this behaviour was independent of cannabis but augmented by its use. Subjects with FNVDs had significantly greater health impairment and health care utilization than controls. On multivariate analysis, independent factors associated with FNVDs

Can treatment with Cocculine improve the control of chemotherapy-induced emesis in early breast cancer patients? A randomized, multi-centered, double-blind, placebo-controlled Phase III trial

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Pérol David

2012-12-01

Full Text Available Abstract Background Chemotherapy induced nausea and vomiting (CINV remains a major problem that seriously impairs the quality of life (QoL in cancer patients receiving chemotherapy regimens. Complementary medicines, including homeopathy, are used by many patients with cancer, usually alongside with conventional treatment. A randomized, placebo-controlled Phase III study was conducted to evaluate the efficacy of a complex homeopathic medicine, Cocculine, in the control of CINV in non-metastatic breast cancer patients treated by standard chemotherapy regimens. Methods Chemotherapy-naïve patients with non-metastatic breast cancer scheduled to receive 6 cycles of chemotherapy including at least three initial cycles of FAC 50, FEC 100 or TAC were randomized to receive standard anti-emetic treatment plus either a complex homeopathic remedy (Cocculine, registered in France for treatment of nausea and travel sickness or the matching placebo (NCT00409071 clinicaltrials.gov. The primary endpoint was nausea score measured after the 1st chemotherapy course using the FLIE questionnaire (Functional Living Index for Emesis with 5-day recall. Secondary endpoints were: vomiting measured by the FLIE score, nausea and vomiting measured by patient self-evaluation (EVA and investigator recording (NCI-CTC AE V3.0 and treatment compliance. Results From September 2005 to January 2008, 431 patients were randomized: 214 to Cocculine (C and 217 to placebo (P. Patient characteristics were well-balanced between the 2 arms. Overall, compliance to study treatments was excellent and similar between the 2 arms. A total of 205 patients (50.9%; 103 patients in the placebo and 102 in the homeopathy arms had nausea FLIE scores > 6 indicative of no impact of nausea on quality of life during the 1st chemotherapy course. There was no difference between the 2 arms when primary endpoint analysis was performed by chemotherapy stratum; or in the subgroup of patients with susceptibility

Variabilità microsatellitare in popolazioni italiane di martora, Martes martes

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Licia Colli

2003-10-01

Full Text Available La martora, Martes martes, è un mustelide storicamente presente su gran parte del territorio italiano, soprattutto dove siano presenti foreste mature altamente strutturate e ricche di risorse. Nel corso dei decenni passati, cause quali la deforestazione con conseguente frammentazione dell'habitat, la caccia e la persecuzione da parte dell'uomo hanno portato ad un sensibile declino sia nel numero d'individui sia di popolazioni in tutta l'Europa. Frammentazione degli areali e diminuzione del numero di soggetti costituiscono le cause principali di un limitato flusso genico con conseguente formazione di popolazioni isolate di martora e perdita di variabilità genetica (Kyle <em>et al., 2003. Per queste ragioni la martora risulta attualmente tutelata secondo quanto previsto dalla Convenzione di Berna (appendice III e dalla Direttiva europea 92/43/CEE "Habitats & Species". Di fronte a prospettive di tipo conservazionistico, diventa necessario disporre di metodologie per la valutazione della variabilità residua nella specie a livello d'individui e di popolazioni. Secondo numerosi Autori, i microsatelliti costituiscono marcatori molto efficaci nella descrizione della struttura genetica e della storia demografica di specie (Beaumont & Bruford, 1999; Linares, 1999. Il presente lavoro propone i risultati ottenuti attraverso il confronto di due campioni costituiti da individui di Martes martes provenienti dalla Sardegna (25 esemplari e dal territorio italiano (6 esemplari. L'analisi è stata condotta a livello di 7 loci microsatellitari dinucleotidici polimorfici. Il valore di F_ST calcolato dal confronto dei due gruppi è risultato pari a 0,102 e ricade nel range di variazione identificato di recente in popolazioni nord-europee di martora (Kyle <em>et al., 2003. L'analisi della varianza molecolare (AMOVA, condotta a due livelli gerarchici, ha permesso in particolare di ripartire la varianza del campione

Effectivness of dexametasone vs. Magnesium sulphate in postoperative analgesia: Dexametasone vs. Magnesium sulphate

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Dautaj Brikena

2016-01-01

Full Text Available Introduction: Preoperative use of additive substances may be very helpful in perioperative acute pain management. Intravenous administration of dexametasone in preoperative period prevents postoperative nausea and vomiting but also provides better pain relief. It is also well known that magnesium sulphate (the NMDA receptor's antagonist by its central mechanism of action may be effective in postoperative pain control. Aim: The purpose of this study was to evaluate the effect of dexametasone and magnesium sulphate on postoperative pain management in patients undergoing abdominal surgery (open cholecystectomy. Methods: Seventy eight patients scheduled for elective surgery (open cholecystectomy were included in this study. This was the prospective cohort randomized placebo- controlled study. A total of 78 patients were randomized into three groups. Each group had twenty six patients. The group D, received dexametasone 0.1 mg/ kg iv 30 minutes before surgery. The group M received magnesium sulphate 3 mg/kg iv 30 minutes before surgery. The third group S was placebo group and patients in this group received saline in the same volume for each patient. For pain control after surgery all patients received tramadol 0.9-1.2 mg/kg and diklophenac 1.76 mg/kg. When necessary (VAS ≥ 7, morphine sulphate in dose 0.15 mg/kg was administred subcutaneously For treatment of emetic episodes metoclopramid 10 mg iv. was used. The patients were observed for intensity of pain measured VAS 0-10, pain relief and satisfaction with therapy, sedation, adverse events, emetic episodes and hemodynamic parameters. Results: There was no difference between groups regarding demographic data (age, gender, body weight, ASA score, comorbidity, duration of surgery and anesthesia and amount of fentanyl received during surgery. In group D 11.54% of patients received additional analgesia (morphine sulphate 0.15 mg/kg sc in the first 4 hours and 27% of patients in the first 24 hours

A novel lipid nanoemulsion system for improved permeation of granisetron.

Science.gov (United States)

Doh, Hea-Jeong; Jung, Yunjin; Balakrishnan, Prabagar; Cho, Hyun-Jong; Kim, Dae-Duk

2013-01-01

A new lipid nanoemulsion (LNE) system containing granisetron (GRN) was developed and its in vitro permeation-enhancing effect was evaluated using Caco-2 cell monolayers. Particle size, polydispersity index (PI) and stability of the prepared GRN-loaded LNE systems were also characterized. The mean diameters of prepared LNEs were around 50 nm with PI<0.2. Developed LNEs were stable at 4°C in the dark place over a period of 12 weeks. In vitro drug dissolution and cytotoxicity studies of GRN-loaded LNEs were performed. GRN-loaded LNEs exhibited significantly higher drug dissolution than GRN suspension at pH 6.8 for 2h (P<0.05). In vitro permeation study in Caco-2 cell monolayers showed that the LNEs significantly enhanced the drug permeation compared to GRN powder. The in vivo toxicity study in the rat jejunum revealed that the prepared GRN-loaded LNE was as safe as the commercial formulation (Kytril). These results suggest that LNE could be used as a potential oral liquid formulation of GRN for anti-emetic treatment on the post-operative and chemotherapeutic patients. Copyright © 2012 Elsevier B.V. All rights reserved.

[Methods of preventing phlebitis induced by infusion of fosaprepitant].

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Kohno, Emiko; Kanematsu, Sayaka; Okazaki, Satoshi; Ogata, Makoto; Kanemitsu, Meiko; Yamashita, Hiromi; Syuntou, Kaori; Sekita, Masako; Nishioka, Ryoko; Yoshida, Hideyuki

2015-03-01

At our hospital, we use aprepitant for nausea and vomiting when administering highly emetic anticancer agents, according to "Guidelines for the Appropriate Use of Antiemetic Agents" given by the Japan Society of Clinical Oncology. We initiated the intravenous administration of fosaprepitant for better compliance compared with aprepitant; however, we observed phlebitis after the infusion of fosaprepitant. Therefore, we investigated measures to reduce phlebitis associated with the infusion of fosaprepitant. For the first premedication, fosaprepitant (150 mg) was dissolved in 100 mL of saline and administered for 30 minutes; 1 of 2 patients showed grade 4 phlebitis. For the modified premedication, fosaprepitant, dexamethasone, and 5- HT(3) antagonist were dissolved in 100 mL of saline and administered for 30 minutes. The modified premedication was administered to a total of 27 patients; 5 patients developed mild phlebitis (grade 1), but infusion could be continued by treating their phlebitis with a hot pack. We used a combination of dexamethasone and 5-HT(3) antagonist with fosaprepitant as a modified premedication in order to avoid drug-induced vascular damage, which resulted in the pH decreasing to 6.20-7.55 (close to neutral) and a shorter infusion time.

EFFERVESCENT TABLETS FORMULATION OF GINGER RHIZOME (Zingiber officinale Rosc. WITH VARIATION OF CITRIC ACID AND TARTARIC ACID LEVEL

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Mufrod Mufrod

2015-11-01

Full Text Available Ginger (Zingiber officinale Rosc. has efficacy as an anti-emetic. Ginger rhizome is usually consumed as instant beverages, so that need to be made into a dosage form that more effective, efficient and attractive. This research aims to formulate ginger into effervescent tablets by using variation of the levels of citric acid and tartaric acid. Dried extract of ginger was made with percolation method using ethanol 70% and evaporated using spray dryer. Extract was made for 5 formulas with variation of acid source using smelting method. Granules were tested its physical properties include flow time, tap index, angle of repose, water absorption, compactibility, mass density, water content, and total phenolic level. Granules were compressed become tablets and tested for physical properties include weight uniformity, friability, hardness, dissolve time, flavor response test and total phenolic level. Data were analyzed with Anova One Way using 95% confidence level. The result shown that formula III was the best formula because it meets the physical requirements of granules and tablets. While the formula V (100% tartaric acid was a formula that provides the greatest stability phenolic levels.

Prevalence, isolation and characterization of Bacillus cereus strains from rice of local cultivators of Sabah, Sarawak, and Peninsular Malaysia

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Sawei, Jelin; Sani, Norrakiah Abdullah

2016-11-01

Bacillus cereus is a spore-forming, facultative anaerobic, motile microorganism that has been identified as a causative agent of two types of gastrointestinal diseases such as emetic and diarrhea. This foodborne pathogen is found in both vegetative cells and endospores form in foods such as rice either raw or cooked. The aim of this study is to investigate and determine the prevalence, characterize and identify the isolation of vegetative cells and endospores of B. cereus in thirty varieties (n=3) of raw rice from Sabah, Sarawak and Peninsular Malaysia. A total of 90 (n=90) raw rice were examined and 84 (93.33%) samples were positive to vegetative cells of B. cereus. However, only 32 (35.56%) samples were positive for endospore cells that able to germinate after samples were heated at 75°C for 15 mins. The mean log cfu/g for vegetative cells were higher range (0.00 - 4.1533) than visible endospores (0.00 - 3.7533 mean log cfu/g). Sample of raw red rice (UKMRC9) had significantly higher contamination by both vegetative cells and endospores at p<0.05, than the other raw rice samples.

Detection of coding genes for enterotoxins in Bacillus cereus by PCR and their products by BCET-RPLA and ELISA Assay

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Marcela Vyletělová

2010-01-01

Full Text Available Determination of enterotoxin production, diarrhoeal and emetic gene identification was studied in 41 Bacillus cereus strains isolated from raw cows’ and raw goats’ milk, pasteurized milk, dairy products during technological processing and from dairy plant equipment. Presence of enterotoxins was detected by BCET-RPLA (HBL and ELISA immunoassay (NHE. Gene identification (nheA, nheB, nheC, hblA, hblC, hblD, bceT, cytK-1, cytK-2, entFM and ces was achieved by means of PCR. Enterotoxin HBL was detected in 32 strains, enterotoxin NHE in all 41 strains. Presence of all three genes nheA, nheB and nheC was confirmed in 40 strains and genes hblA, hblC and hblD in 29 strains. Comparison of used methods was as follow: 1 BCET-RPLA (which detects L2 component and PCR (positive or negative all three hblA, hblC and hblD gene detection were identical in 30 (73%; 2 ELISA (NheA and PCR (all three nheC, nheB and nheA gene expression were identical in 40 (98% cases isolated strains.

Radiation-induced emesis in cats prevented by 24-hour prior exposure but not by ablation of the area postrema

International Nuclear Information System (INIS)

McCarthy, L.E.; Borison, H.L.; Douple, E.B.

1985-01-01

The acute emetic response induced by whole body exposure to cobalt radiation was quantified in cats at doses ranging from 1500 to 9000 rad (100 rad/min). Emesis occurred in a dose-related manner with a maximum incidence of 94% at 4500 rad (11 of 12 cats, mean latency of 98 min). At 6000 rad emesis occurred in 7 of 10 cats (mean latency of 69 min); however, a second exposure to this dose on the following day failed to induce vomiting in all of 5 cats (difference between groups significant at p = .01). After chronic ablation of the area postrema (chemoreceptor trigger zone for vomiting), 4 of 5 cats vomited in response to 4500 rad with a mean latency of 48 min. As was the case with the normal cats, all the postrema-ablated animals failed to vomit in response to a repeated dose of radiation delivered on the next day. The suppression of emesis observed on the second exposure was radiation-specific because 11 of 12 normal cats vomited appropriately in response to xylazine (0.6 mg/kg, im) during the period of refractoriness to radiation

DIFFUSIVE-Magnetoresistance(DMR) Proton(PMR)/Hydrogen-ion WATER: PRE-``Fert''/``Grunberg'' GMR[and CMR]: Quo-Vadis ``Honesty''???: PLAGIARISM!!!

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Fart, Albart; Gruntbug, Peter; Siegel, Edward

2011-03-01

Proton/Hydrogen-ion Diffusive-Magnetoresistance(DMR) of Siegel[APS March-Mtgs.(70s)] based upon Siegel[Int'l. Conf. Mag.-Alloys and Oxides("ICMAO"), The Technion(77); J. Mag. Mag. Mtls. 7, 312(78)] FIRST experimental-discovery of GMR and FIRST theoretical prediction of CMR[ibid. 7, 338 (78)], facilitates NEW water production in global-warming exacerbated dry arid/semi-arid regions: Only HYDROGEN is/can be "FLYING-WATER"!!! (aka "chemical-rain-in-pipelines"). EMET/TRUTH-in-the-``SEANCES'', would-be "Sciences": C. Perelman-Corredoira [Against the Tide(07)] featuring Martin-Bradshaw ["Healing the SHAME That BINDS You"(80s)] systemic sociological-dysfunctionality(S-D), and Grigory Perelman's HEROIC ETHICS (refusal of both pure-maths Poincare-conjecture proof 2007 Fields-medal and 2010 Clay-Institute so-called/media-hyped/P.Red/spin-doctored millennium-prize million-dollar would-be award, militates as well in the current "SEANCE" of physics/maths politics/media-hype/P.R /spin-doctoring VS. Siegel FIRST experimental GMR a never-acknowledged full decade PRE-"Fert"(88) /"Grunberg(89)" ``Phales-GroPE''/Thompson-CSF/ KFZ-JEWlich 2007 physics Wolf/Japan/Nobel-prizes!!!

New insights into selective PDE4D inhibitors: 3-(Cyclopentyloxy)-4-methoxybenzaldehyde O-(2-(2,6-dimethylmorpholino)-2-oxoethyl) oxime (GEBR-7b) structural development and promising activities to restore memory impairment.

Science.gov (United States)

Brullo, Chiara; Ricciarelli, Roberta; Prickaerts, Jos; Arancio, Ottavio; Massa, Matteo; Rotolo, Chiara; Romussi, Alessia; Rebosio, Claudia; Marengo, Barbara; Pronzato, Maria Adelaide; van Hagen, Britt T J; van Goethem, Nick P; D'Ursi, Pasqualina; Orro, Alessandro; Milanesi, Luciano; Guariento, Sara; Cichero, Elena; Fossa, Paola; Fedele, Ernesto; Bruno, Olga

2016-11-29

Phosphodiesterase type 4D (PDE4D) has been indicated as a promising target for treating neurodegenerative pathologies such as Alzheimer's Disease (AD). By preventing cAMP hydrolysis, PDE4 inhibitors (PDE4Is) increase the cAMP response element-binding protein (CREB) phosphorylation, synaptic plasticity and long-term memory formation. Pharmacological and behavioral studies on our hit GEBR-7b demonstrated that selective PDE4DIs could improve memory without causing emesis and sedation. The hit development led to new molecule series, herein reported, characterized by a catechol structure bonded to five member heterocycles. Molecular modeling studies highlighted the pivotal role of a polar alkyl chain in conferring selective enzyme interaction. Compound 8a showed PDE4D3 selective inhibition and was able to increase intracellular cAMP levels in neuronal cells, as well as in the hippocampus of freely moving rats. Furthermore, 8a was able to readily cross the blood-brain barrier and enhanced memory performance in mice without causing any emetic-like behavior. These data support the view that PDE4D is an adequate molecular target to restore memory deficits in different neuropathologies, including AD, and also indicate compound 8a as a promising candidate for further preclinical development. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Antiemetic effects of granisetron versus dexamethasone in clonidine premedicated children undergoing strabismus surgery

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Indu Sen

2007-01-01

Full Text Available In a prospective, double blind, randomized trial, 120 children, aged 3-8 years,ASAI-II, undergoing strabismus repair were randomly divided into three groups (n = 40 each. Oral clonidine premedication (4gg.kg-1 was administered to all the patients two hours prior to surgery. Soon after induction of anaesthesia, Group G patients were administered intravenous granisetron (40gg.kg-1 , Group D intravenous dexamethasone (150gg.kg-1 and group S received 4ml normal saline. Postoperatively, children were continuously monitored and assessed half-hourly till discharge and then after 24 hours for vomiting and pain. The overall incidence of postoperative emesis was lower (15.4% in the Group G compared with the Group D (21.6% in the first 24 hours (P>0.05. The Group S had a highest incidence of postoperative vomiting ((37% P value < 0.0324 compared to group G. The frequency of early vomiting was highest in the S group. Both G and D groups showed better control of delayed emetic episodes. We observed that in children who were premedicated with clonidine, both IV granisetron or dexamethasone were efficacious in reducing the incidence and severity of POV in day-care strabismus surgery.

Comparative trial of two intravenous doses of granisetron (1 versus 3 mg) in the prevention of chemotherapy-induced acute emesis: a double-blind, randomized, non-inferiority trial.

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Tsuji, Daiki; Kim, Yong-Il; Taku, Keisei; Nakagaki, Shigeru; Ikematsu, Yoshito; Tsubota, Hiromi; Maeda, Masato; Hashimoto, Naoya; Kimura, Masayuki; Daimon, Takashi

2012-05-01

A single 3 mg or 40 μg/kg intravenous dose of granisetron combined with dexamethasone is routinely used in several countries, although the antiemetic guidelines have recommended granisetron at the dose of 1 mg or 10 μg/kg. A randomized, multicenter trial was conducted to determine the optimal intravenous granisetron dose, 1 or 3 mg, in cancer patients receiving emetogenic chemotherapy. We enrolled 365 patients and randomly assigned them to receive intravenous granisetron 3 mg (3-mg group) or 1 mg (1-mg group), combined with dexamethasone at an adequate dose fixed as per the emetic risk category. The primary end point was the proportion of patients with a complete response during the first 24 h after chemotherapy. The study demonstrated that 1 mg of granisetron was not inferior in effect to 3 mg. For the primary end point, 359 patients were evaluable according to the modified intention-to-treat (ITT) analysis. Complete protection was achieved in the modified ITT population, 90.6% and 88.8% for the 3- and 1-mg groups, respectively (p granisetron is not inferior to 3 mg when both doses are combined with dexamethasone. Therefore, 1-mg dose of intravenous granisetron should be the recommended prophylactic regimen for the prevention of acute emesis.

Effect of petroleum ether and ethanol fractions of seeds of Abrus precatorius on androgenic alopecia

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Sukirti Upadhyay

2012-04-01

Full Text Available Seeds of Abrus precatorius L., Fabaceae, are commonly used as purgative, emetic, aphrodisiac and in nervous disorder in traditional and folk medicines. In present study petroleum ether and ethanolic extracts of A. precatorius seeds are evaluated for reversal of androgen (testosterone by i.m route induced alopecia in male albino wistar rats and compared to topical administration of standard antiandrogenic drug finasteride for 21 days. The results were reflected from visual observation and histological study of several skin sections via various parameters as anagen to telogen ratio and follicle density/mm area of skin surface. The animal of group 1 who were treated with only testosterone became alopecic on visual observation. Animals of Group 2, 3 and 4 who were treated with finasteride, petroleum ether and ethanolic extract of seed respectively topically along with testosterone (i.m did not developed alopecia. To investigate the mechanism of observed activity, in vitro experiments were performed. Inhibition of 5α-reductase activity by extracts and finasteride suggest that they reversed androgen induced alopecia by inhibiting conversion of testosterone to dihydrotestosterone (potent androgen responsible for androgenic alopecia. So it may be concluded that petroleum ether and ethanolic extract of A. precatorius seed posses anti androgenic alopecia activity due to inhibition of 5α-reductase enzyme.

Effect of petroleum ether and ethanol fractions of seeds of Abrus precatorius on androgenic alopecia

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Sukirti Upadhyay

2011-12-01

Full Text Available Seeds of Abrus precatorius L., Fabaceae, are commonly used as purgative, emetic, aphrodisiac and in nervous disorder in traditional and folk medicines. In present study petroleum ether and ethanolic extracts of A. precatorius seeds are evaluated for reversal of androgen (testosterone by i.m route induced alopecia in male albino wistar rats and compared to topical administration of standard antiandrogenic drug finasteride for 21 days. The results were reflected from visual observation and histological study of several skin sections via various parameters as anagen to telogen ratio and follicle density/mm area of skin surface. The animal of group 1 who were treated with only testosterone became alopecic on visual observation. Animals of Group 2, 3 and 4 who were treated with finasteride, petroleum ether and ethanolic extract of seed respectively topically along with testosterone (i.m did not developed alopecia. To investigate the mechanism of observed activity, in vitro experiments were performed. Inhibition of 5α-reductase activity by extracts and finasteride suggest that they reversed androgen induced alopecia by inhibiting conversion of testosterone to dihydrotestosterone (potent androgen responsible for androgenic alopecia. So it may be concluded that petroleum ether and ethanolic extract of A. precatorius seed posses anti androgenic alopecia activity due to inhibition of 5α-reductase enzyme.

Management of intestinal obstruction in advanced malignancy

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Henry John Murray Ferguson

2015-09-01

Full Text Available Patients with incurable, advanced abdominal or pelvic malignancy often present to acute surgical departments with symptoms and signs of intestinal obstruction. It is rare for bowel strangulation to occur in these presentations, and spontaneous resolution often occurs, so the luxury of time should be afforded while decisions are made regarding surgery. Cross-sectional imaging is valuable in determining the underlying mechanism and pathology. The majority of these patients will not be suitable for an operation, and will be best managed in conjunction with a palliative medicine team. Surgeons require a good working knowledge of the mechanisms of action of anti-emetics, anti-secretories and analgesics to tailor early management to individual patients, while decisions regarding potential surgery are made. Deciding if and when to perform operative intervention in this group is complex, and fraught with both technical and emotional challenges. Surgery in this group is highly morbid, with no current evidence available concerning quality of life following surgery. The limited evidence concerning operative strategy suggests that resection and primary anastomosis results in improved survival, over bypass or stoma formation. Realistic prognostication and involvement of the patient, care-givers and the multidisciplinary team in treatment decisions is mandatory if optimum outcomes are to be achieved.

Gastroprokinetic effect of a new benzamide derivative itopride and its action mechanisms in conscious dogs.

Science.gov (United States)

Iwanaga, Y; Miyashita, N; Saito, T; Morikawa, K; Itoh, Z

1996-06-01

The novel benzamide derivative itopride was assayed for its effect on gastrointestinal motility in conscious dogs when it was administered intraduodenally (i.d.). Gastrointestinal motility was measured by means of chronically implanted force transducers, and itopride at a dose of 10 mg/kg, i.d. or more increased the gastric contractile force during the digestive state. Intraduodenal cisapride, domperidone and metoclopramide also stimulated gastric motility, and their threshold doses were 1, 3 and 1 mg/kg, respectively. Dopamine infusion (1 mg/kg/hr, i.v.) caused the postprandial gastric motility to disappear, but it was immediately restored by itopride at a dose of 3 mg/kg, i.d. With itopride at 1 and 3 mg/kg, i.d., acetylcholine (0.05 mg/kg/min)-induced contractions were greatly enhanced. In addition to its gastric stimulation, itopride at doses of 10-100 mg/kg, p.o. inhibited apomorphine (0.1 mg/kg, s.c.)-induced vomiting in dogs. In conclusion, intraduodenal itopride stimulates gastric motility through both anti-dopaminergic and anti-acetylcholinesterase actions. Its gastroprokinetic threshold dose was as large as 3-10 times those of cisapride, domperidone and metoclopramide. These findings suggest that itopride is an orally active gastroprokinetic with a moderate anti-emetic action.

Hepatitis C in Egypt – past, present, and future

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Elgharably A

2016-12-01

Full Text Available Ahmed Elgharably,1,2 Asmaa I Gomaa,2 Mary ME Crossey,1,2 Peter J Norsworthy,1 Imam Waked,2 Simon D Taylor-Robinson1 1Division of Digestive Health, Department of Surgery and Cancer, St Mary’s Hospital, Imperial College London, London, UK; 2National Liver Institute, Menoufiya University, Shebeen El Kom, Egypt Abstract: Hepatitis C viral infection is endemic in Egypt with the highest prevalence rate in the world. It is widely accepted that the implementation of mass population antischistosomal treatment involving administration of tartar emetic injections (from 1950s to 1980s led to widespread infection. What is less well known, however, is that these schemes were implemented by the Egyptian Ministry of Health on the advice of the World Health Organization. There has been a spectrum of treatments to target the public health disaster represented by the hepatitis C problem in Egypt: from the use of PEGylated interferon to the recent use of direct acting antiviral drugs. Some new treatments have shown >90% efficacy. However, cost is a key barrier to access these new medicines. This is coupled with a growing population, limited resources, and a lack of infection control practices which means Egypt still faces significant disease control issues today. Keywords: hepatitis C, Egypt, schistosomiasis

Safety and efficacy of intravenous administration for tranexamic acid-induced emesis in dogs with accidental ingestion of foreign substances.

Science.gov (United States)

Orito, Kensuke; Kawarai-Shimamura, Asako; Ogawa, Atsushi; Nakamura, Atsushi

2017-12-22

A prospective observational study was performed in canine clinical medicine to evaluate the emetic action and adverse effects of tranexamic acid. Veterinarians treated 137 dogs with a single dose of tranexamic acid (50 mg/kg, IV) after accidental ingestion of foreign substances. If needed, a second (median, 50 mg/kg; range, 20-50 mg/kg, IV) or third dose (median, 50 mg/kg; range, 25-50 mg/kg, IV) was administered. Tranexamic acid induced emesis in 116 of 137 (84.7%) dogs. Median time to onset of emesis was 116.5 sec (range, 26-370 sec), median duration of emesis was 151.5 sec (range, 30-780 sec), and median number of emesis episodes was 2 (range, 1-8). Second and third administrations of tranexamic acid induced emesis in 64.7 and 66.7% of dogs, respectively. In total, IV administration of tranexamic acid successfully induced emesis in 129 of 137 (94.2%) dogs. Adverse effects included a tonic-clonic convulsion and hemostatic disorder in two different dogs, both of which recovered after receiving medical care. Tranexamic acid induced emesis in most dogs following a single-dose. When a single dose was not sufficient, an additional dosage effectively induced emesis. Overall, adverse effects were considered low and self-limiting.

What to expect from immersive virtual environment exposure: influences of gender, body mass index, and past experience.

Science.gov (United States)

Stanney, Kay M; Hale, Kelly S; Nahmens, Isabelina; Kennedy, Robert S

2003-01-01

For those interested in using head-coupled PC-based immersive virtual environment (VE) technology to train, entertain, or inform, it is essential to understand the effects this technology has on its users. This study investigated potential adverse effects, including the sickness associated with exposure and extreme responses (emesis, flashbacks). Participants were exposed to a VE for 15 to 60 min, with either complete or streamlined navigational control and simple or complex scenes, after which time measures of sickness were obtained. More than 80% of participants experienced nausea, oculomotor disturbances, and/or disorientation, with disorientation potentially lasting > 24 hr. Of the participants, 12.9% prematurely ended their exposure because of adverse effects; of these, 9.2% experienced an emetic response, whereas only 1.2% of all participants experienced emesis. The results indicate that designers may be able to reduce these rates by limiting exposure duration and reducing the degrees of freedom of the user's navigational control. Results from gender, body mass, and past experience comparisons indicated it may be possible to identify those who will experience adverse effects attributable to exposure and warn such individuals. Applications for this research include military, entertainment, and any other interactive systems for which designers seek to avoid adverse effects associated with exposure.

Efficacy of intravenous ondansetron to prevent vomiting episodes in acute gastroenteritis: a randomized, double blind, and controlled trial

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Sanguansak Rerksuppaphol

2010-09-01

Full Text Available Acute gastroenteritis is one of the most common infectious diseases of childhood. Its symptoms are vomiting, diarrhea, and dehydration. In the emergency ward, intravenous rather than oral rehydration is usually preferred because of the high likelihood of emesis. Treatments to reduce emesis are of value in improving the rehydration procedure. Our study is a double-blind randomized trial and proposes the use of ondansetron as an anti-emetic drug to treat children with acute gastroenteritis. Seventy-four in-patients, aged 3 months to 15 years, were enrolled and randomly assigned to an ondansetron or placebo group. Inclusion criteria were the diagnosis of acute gastroenteritis and the absence of other diseases or allergies to drugs. A single bolus (0.15 mg/kg of ondansetron was injected intravenously; normal 0.9% saline solution was used as a placebo. This treatment induced vomiting cessation in the ondansetron group significantly in comparison to the placebo group. The length of the hospital stay and the oral rehydration fluid volume were similar in the two groups and no adverse effects were noticed. Thus, safety, low cost, and overall bene­fit of ondansetron treatment suggests that this drug can be administered successfully to children with acute gastroenteritis.

Odisolane, a Novel Oxolane Derivative, and Antiangiogenic Constituents from the Fruits of Mulberry (Morus alba L.).

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Lee, Seoung Rak; Park, Jun Yeon; Yu, Jae Sik; Lee, Sung Ok; Ryu, Ja-Young; Choi, Sang-Zin; Kang, Ki Sung; Yamabe, Noriko; Kim, Ki Hyun

2016-05-18

Mulberry, the fruit of Morus alba L., is known as an edible fruit and commonly used in Chinese medicines as a warming agent and as a sedative, tonic, laxative, odontalgic, expectorant, anthelmintic, and emetic. Systemic investigation of the chemical constituents of M. alba fruits led to the identification of a novel oxolane derivative, (R*)-2-((2S*,3R*)-tetrahydro-2-hydroxy-2-methylfuran-3-yl)propanoic acid (1), namely, odisolane, along with five known heterocyclic compounds (2-6). The structure of the new compound was elucidated on the basis of HR-MS, 1D and 2D NMR ((1)H-(1)H COSY, HSQC, HMBC, and NOESY) data analysis. Compound 1 has a novel skeleton that consists of 8 carbon units with an oxolane ring, which until now has never been identified in natural products. The isolated compounds were subjected to several activity tests to verify their biological function. Among them, compounds 1, 3, and 5 significantly inhibited cord formation in HUVECs. The action mechanism of compound 3, which had the strongest antiangiogenic activity, was mediated by decreasing VEGF, p-Akt, and p-ERK protein expression. These results suggest that compounds isolated from M. alba fruits might be beneficial in antiangiogenesis therapy for cancer treatment.

Novel method of determination of D9-tetrahydrocannabinol(THC) in human serum by high-performance liquid chromatography with electrochemical detection.

Science.gov (United States)

Kokubun, Hideya; Uezono, Yasuhito; Matoba, Motohiro

2014-04-01

In Europe and the United States, D9-tetrahydrocannabinol(THC, dronabinol), one of the psychoactive constituents of cannabis, has been used for both its anti-emetic and orexigenic effects in cancer patient receiving chemotherapy.However, dronabinol has not yet been launched in the market in Japan.In the future, it is necessary to ascertain the pharmacokinetics of dronabinol in cancer paitient.Therefore, we developed an HPLC procedure using electrochemical detection(ECD)for quan- titation of the concentrations of dronabinol in blood.An eluent of 50mM KH2PO4/CH3CN(9:16)was used as the mobile phase.The column was used the XTerra®RP18, and the voltage of the electrochemical detector in dronabinol was set at 400 mV.As a result, the calibration curve was linear in the range of 10 ng/mL to 100 ng/mL(y=964.85x -3,419, r=0.997).The lower limit of quantification was 0.5 ng/mL(S/N=3).The relative within-runs and between-runs standard deviations for the assay dronabinol were less than 4.7%. The method reported here is superior to previously reported methods in cancer patient.

Algeria facing the challenges of Europe natural gas supply and the respect of the environment.; L'Algerie face aux defis de l'approvisionnement de l'Europe en gaz naturel et le respect de l'environnement

Energy Technology Data Exchange (ETDEWEB)

Ali, Nadia Nait

2010-09-15

Taking into account the expectations, for the next decades, of a strong increase in the demand for gas in Europe, Algeria has committed to large structuring projects, adding to the two gas pipeline linking Algeria to Spain via Morocco and Algeria to Italy via Tunisia. Two more undertakings are added linking Algeria directly to two European partners. Sonatrach will play an important role in global environment protection, natural gas being less polluting than oil and coal and emitting less co2. Substitution of coal by natural gas will generate socio economical advantages and will preserve the environment. [French] Compte tenu des attentes, pour les decennies prochaines, d'une forte croissance de la demande de gaz en Europe, l'Algerie s'est engagee dans de grands projet structurants s'ajoutant aux deux gazoducs reliant l'Algerie a l'Espagne via le Maroc et l'Algerie a l'Italie via la Tunisie, viennent s'ajouter deux autres ouvrages reliant directement l'Algerie a deux partenaires europeens. Sonatrach Jouera un role important dans la protection de l'environnement a l'echelle mondiale, le gaz naturel est moins polluants que le petrole, le charbon et emet moins de co2. La substitution du charbon par le gaz naturel generera des avantages socio-economiques, preservation de l'environnement.

Pharmacological treatment of bowel obstruction in cancer patients.

LENUS (Irish Health Repository)

O'Connor, Brenda

2012-02-01

INTRODUCTION: Malignant bowel obstruction (MBO) is a common complication of advanced cancer, occurring most frequently in gynaecological and colorectal cancer. Its management remains complex and variable. This is in part due to the lack of evidence-based guidelines for the clinicians involved. Although surgery should be considered the primary treatment, this may not be feasible in patients with a poor performance status or advanced disease. Advances have been made in the medical management of MBO which can lead to a considerable improvement in symptom management and overall quality of life. AREAS COVERED: This review emphasizes the importance of a prompt diagnosis of MBO with early introduction of pharmacological agents to optimize symptom control. The authors summarize the treatment options available for bowel obstruction in those patients for whom surgical intervention is not a feasible option. The authors also explore the complexities involved in the introduction of parenteral hydration and total parenteral nutrition in this group of patients. EXPERT OPINION: It is not always easy to distinguish reversible from irreversible bowel obstruction. Early and aggressive management with the introduction of pharmacological agents including corticosteroids, octreotide and anti-cholinergic agents have the potential to maintain bowel patency, and allow for more rapid recovery of bowel transit. A combination of analgesics, anti-emetics and anti-cholinergics with or without anti-secretory agents can successfully improve symptom control in patients with irreversible bowel obstruction.

Food-Borne Outbreak Investigation and Molecular Typing: High Diversity of Staphylococcus aureus Strains and Importance of Toxin Detection

Science.gov (United States)

Denayer, Sarah; Nia, Yacine; Botteldoorn, Nadine

2017-01-01

Staphylococcus aureus is an important aetiological agent of food intoxications in the European Union as it can cause gastro-enteritis through the production of various staphylococcal enterotoxins (SEs) in foods. Reported enterotoxin dose levels causing food-borne illness are scarce and varying. Three food poisoning outbreaks due to enterotoxin-producing S. aureus strains which occurred in 2013 in Belgium are described. The outbreaks occurred in an elderly home, at a barbecue event and in a kindergarten and involved 28, 18, and six cases, respectively. Various food leftovers contained coagulase positive staphylococci (CPS). Low levels of staphylococcal enterotoxins ranging between 0.015 ng/g and 0.019 ng/g for enterotoxin A (SEA), and corresponding to 0.132 ng/g for SEC were quantified in the food leftovers for two of the reported outbreaks. Molecular typing of human and food isolates using pulsed-field gel electrophoresis (PFGE) and enterotoxin gene typing, confirmed the link between patients and the suspected foodstuffs. This also demonstrated the high diversity of CPS isolates both in the cases and in healthy persons carrying enterotoxin genes encoding emetic SEs for which no detection methods currently exist. For one outbreak, the investigation pointed out to the food handler who transmitted the outbreak strain to the food. Tools to improve staphylococcal food poisoning (SFP) investigations are presented. PMID:29261162

Effects and Mechanisms of Transcutaneous Electroacupuncture on Chemotherapy-Induced Nausea and Vomiting

Directory of Open Access Journals (Sweden)

Xing Zhang

2014-01-01

Full Text Available Nausea and vomiting are one of the major complications of chemotherapy for cancers. The aim of this study is to investigate the emetic effects and mechanisms involving serotonin and dopamine of needleless transcutaneous electroacupuncture (TEA at Neiguan (PC6 and Jianshi (PC5 on chemotherapy-induced nausea and vomiting in patients with cancers. Seventy-two patients with chemotherapy were randomly divided into sham-TEA group (sham-TEA, n=34 and TEA group (n=38. TEA was performed at PC 6 and PC 5 (1 h, bid in combination with granisetron. Sham-TEA was delivered at nonacupoints using the same parameters. We found the following. (1 In the acute phase, the conventional antiemetic therapy using Ondansetron effectively reduced nausea and vomiting; the addition of TEA did not show any additive effects. In the delayed phase, however, TEA significantly increased the rate of complete control (P<0.01 and reduced the nausea score (P<0.05, compared with sham-TEA. (2 TEA significantly reduced serum levels of 5-HT and dopamine in comparison with sham-TEA. Those results demonstrate that needleless transcutaneous electroacupuncture at PC6 using a watch-size digital stimulator improves emesis and reduces nausea in the delayed phase of chemotherapy in patients with cancers. This antiemetic effect is possibly mediated via mechanisms involving serotonin and dopamine.

Geranisetron versus gabapentin in preventing postoperative nausea and vomiting after middle ear surgery in adults: A double-blinded randomized clinical trial study

Directory of Open Access Journals (Sweden)

Morteza Heidari

2015-01-01

Full Text Available Background: The incidence of postoperative nausea and vomiting (PONV after middle ear surgery is high. In this study we want to compare the effects of intravenous granisetron and oral gabapentin as a premedication before surgery on the incidence and severity of PONV after middle ear surgery in adult patents. Materials and Methods: We enrolled 90 patients that were randomly divided into the three groups of 30 in each. Group I received granisetron 3 mg iv 2 minutes before induction of anesthesia; Group II received oral gabapentin 300 mg 1 hour before anesthesia and Group III received placebo. The incidence and severity of PONV were recorded each 15 minutes in the post-anesthesia care unit (PACU and each 8 hours until 24 hours after discharge from the PACU. Result: The incidence and severity of nausea and vomiting at different time intervals in Groups I and Group II was significantly lower compared with Group III (P < 0.05. There was no significant difference in the incidence of side effects of study drug administration including respiratory depression, apnea, extra pyramidal disorders, drowsiness, dizziness, vertigo and headache in three groups. Conclusion: The study was shown that using gabapentin and granisetron have equal anti-emetic effects, but significant differences were seen between these two groups compared to the control group. These submit the efficiency of these drugs in preventing PONV.

Hindbrain GLP-1 receptor mediation of cisplatin-induced anorexia and nausea.

Science.gov (United States)

De Jonghe, Bart C; Holland, Ruby A; Olivos, Diana R; Rupprecht, Laura E; Kanoski, Scott E; Hayes, Matthew R

2016-01-01

While chemotherapy-induced nausea and vomiting are clinically controlled in the acute (anorexia, nausea, fatigue, and other illness-type behaviors during the delayed phase (>24 h) of chemotherapy are largely uncontrolled. As the hindbrain glucagon-like peptide-1 (GLP-1) system contributes to energy balance and mediates aversive and stressful stimuli, here we examine the hypothesis that hindbrain GLP-1 signaling mediates aspects of chemotherapy-induced nausea and reductions in feeding behavior in rats. Specifically, hindbrain GLP-1 receptor (GLP-1R) blockade, via 4th intracerebroventricular (ICV) exendin-(9-39) injections, attenuates the anorexia, body weight reduction, and pica (nausea-induced ingestion of kaolin clay) elicited by cisplatin chemotherapy during the delayed phase (48 h) of chemotherapy-induced nausea. Additionally, the present data provide evidence that the central GLP-1-producing preproglucagon neurons in the nucleus tractus solitarius (NTS) of the caudal brainstem are activated by cisplatin during the delayed phase of chemotherapy-induced nausea, as cisplatin led to a significant increase in c-Fos immunoreactivity in NTS GLP-1-immunoreactive neurons. These data support a growing body of literature suggesting that the central GLP-1 system may be a potential pharmaceutical target for adjunct anti-emetics used to treat the delayed-phase of nausea and emesis, anorexia, and body weight loss that accompany chemotherapy treatments. Copyright © 2015 Elsevier Inc. All rights reserved.

Diet of the Fuscous Flycatcher Cnemotriccus fuscatus (Wied, 1831 – Aves, Tyrannidae - in three habitats of the northern Pantanal, Mato Grosso, Brazil

Directory of Open Access Journals (Sweden)

MG Gaiotti

Full Text Available The Fuscous Flycatcher (Cnemotriccus fuscatus is a medium-sized Tyrannidae widespread in South America. Despite its large distribution, there have been very few studies on its diet, especially in different habitats. This study presents data on diet variation in three habitats in the Pantanal wetlands in the state of Mato Grosso, Brazil. The specimens were captured through a mist-netting programme between February 2000 and May 2010, in the Retiro Novo Farm, in the Poconé municipality. Birds were captured in three vegetation types: Landizal, Cambarazal and Cordilheira. Tartar emetic was used to obtain the regurgitation samples identified at order level. We captured 61 individuals (21, 26 and 14 in the above described habitats, respectively. Diet of C. fuscatus differed between the three habitats. Ants and beetles were the most relevant prey items either in numerical frequency (NF or in frequency of occurrence (OF, in terms of the overall diet (NF = 27.34% and 37.89%; OF = 36.06% and 75.4%, respectively. However, in Cordilheira, seeds and beetles dominated the NF (21.8% and 38.1%, respectively and OF (28.5% and 85.7%, respectively. Cnemotriccus fuscatus was found to have an omnivorous diet, although in Cambarazal, individuals preyed exclusively on arthropods. The present study provides an important contribution to the knowledge of the diet of a poorly studied Neotropical bird.

An introduction to fast dissolving oral thin film drug delivery systems: a review.

Science.gov (United States)

Kathpalia, Harsha; Gupte, Aasavari

2013-12-01

Many pharmaceutical companies are switching their products from tablets to fast dissolving oral thin films (OTFs). Films have all the advantages of tablets (precise dosage, easy administration) and those of liquid dosage forms (easy swallowing, rapid bioavailability). Statistics have shown that four out of five patients prefer orally disintegrating dosage forms over conventional solid oral dosages forms. Pediatric, geriatric, bedridden, emetic patients and those with Central Nervous System disorders, have difficulty in swallowing or chewing solid dosage forms. Many of these patients are non-compliant in administering solid dosage forms due to fear of choking. OTFs when placed on the tip or the floor of the tongue are instantly wet by saliva. As a result, OTFs rapidly hydrate and then disintegrate and/or dissolve to release the medication for local and/or systemic absorption. This technology provides a good platform for patent non- infringing product development and for increasing the patent life-cycle of the existing products. The application of fast dissolving oral thin films is not only limited to buccal fast dissolving system, but also expands to other applications like gastroretentive, sublingual delivery systems. This review highlights the composition including the details of various types of polymers both natural and synthetic, the different types of manufacturing techniques, packaging materials and evaluation tests for the OTFs.

Phase II, Open Label, Randomized Comparative Trial of Ondansetron Alone versus the Combination of Ondansetron and Aprepitant for the Prevention of Nausea and Vomiting in Patients with Hematologic Malignancies Receiving Regimens Containing High-Dose Cytarabine

Directory of Open Access Journals (Sweden)

Talha Badar

2015-01-01

Full Text Available Background. Aprepitant is a P/neurokinin-1 receptor antagonist approved for the prevention of CINV in moderate emetic risk chemotherapy. We explored its effectiveness in patients with leukemia receiving cytarabine-based chemotherapy. Methods. Patients were randomized to ondansetron (OND 8 mg IV 30 minutes before cytarabine followed by 24 mg IV continuous infusion daily until 6–12 hours after the last dose of chemotherapy alone or with aprepitant (APREP oral 125 mg 6–12 hrs before chemotherapy and 80 mg daily until 1 day after the last dose of chemotherapy. Results. Forty-nine patients were enrolled in each arm; 42 in OND and 41 in OND + APREP arm were evaluable for efficacy. The ORR with OND + APREP was 80% compared to 67% with OND alone (P=0.11. On days 6 and 7, higher proportion of patients treated with OND + APREP were free from nausea (74%, 74% versus 68%, 67%; P=0.27 and 0.18, resp.. Requirement of rescue medications on days 2 and 3 was fewer in OND + APREP arm 7% and 5% compared to 21% and 16% in the OND arm, respectively (P=0.06 and P=0.07. Conclusions. There was a trend for overall improvement in emesis with ondansetron plus aprepitant. The potential benefit of this approach with specific chemotherapy combinations remains to be determined.

Natural Plant Alkaloid (Emetine Inhibits HIV-1 Replication by Interfering with Reverse Transcriptase Activity

Directory of Open Access Journals (Sweden)

Ana Luiza Chaves Valadão

2015-06-01

Full Text Available Ipecac alkaloids are secondary metabolites produced in the medicinal plant Psychotria ipecacuanha. Emetine is the main alkaloid of ipecac and one of the active compounds in syrup of Ipecac with emetic property. Here we evaluated emetine’s potential as an antiviral agent against Human Immunodeficiency Virus. We performed in vitro Reverse Transcriptase (RT Assay and Natural Endogenous Reverse Transcriptase Activity Assay (NERT to evaluate HIV RT inhibition. Emetine molecular docking on HIV-1 RT was also analyzed. Phenotypic assays were performed in non-lymphocytic and in Peripheral Blood Mononuclear Cells (PBMC with HIV-1 wild-type and HIV-harboring RT-resistant mutation to Nucleoside Reverse Transcriptase Inhibitors (M184V. Our results showed that HIV-1 RT was blocked in the presence of emetine in both models: in vitro reactions with isolated HIV-1 RT and intravirion, measured by NERT. Emetine revealed a strong potential of inhibiting HIV-1 replication in both cellular models, reaching 80% of reduction in HIV-1 infection, with low cytotoxic effect. Emetine also blocked HIV-1 infection of RT M184V mutant. These results suggest that emetine is able to penetrate in intact HIV particles, and bind and block reverse transcription reaction, suggesting that it can be used as anti-HIV microbicide. Taken together, our findings provide additional pharmacological information on the potential therapeutic effects of emetine.

[The myth of virgin cleansing: Latest news on an archaic magico-religious practice].

Science.gov (United States)

Charlier, P; Bou Abdallah, F; Brun, L; Hoang-Oppermann, V; Deo, S; Mostefai-Dulac, Y; Mamzer, M-F; Hervé, C

2018-03-01

In the medical anthropology section of the Nanterre Hospital (France) for migrants and refugees, three cases were recorded of "virgin cleansing" in sub-Saharan African countries. These consisted of sexual assaults (2 instances of rape and 1 of sexual interference) on sexually immature females (young girls) by patients with sexually transmitted infections (mainly HIV, syphilis) hoping they might thereby be cured. These particularly atrocious hetero-aggressive sexual practices based on magical arguments are unfortunately universal and are not limited to a specific culture. At the medical anthropology level, the belief in cleansing by virgins is based on the notion that the patient is dirty and impure. In the same way that emetics and/or laxatives are prescribed in the case of intestinal disorders (to "eliminate" the disease), some subjects use diuretics for urinary abnormalities or, literally, "clean vaginas (or anuses)" to purge their own miasma. The rising tide of population migrations (some of whom carry chronic infections), refugee camps, prolonged incarcerations, etc., makes observations of such phenomena increasingly frequent. Belief in cleansing by virgins (and the fatal consequences thereof) will be difficult to eradicate. The education of populations and health professionals should promote absolute respect for the body of children, and, more generally, of others, particularly since at this time of increasingly marked migratory flows, this problem sadly risks becoming widespread. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Efficacy of promethazine suppositories dispensed to outpatient surgical patients.

Science.gov (United States)

Wright, C. D.; Jilka, J.; Gentry, W. B.

1998-01-01

Postoperative nausea and vomiting frequently complicate outpatient anesthesia and surgery. The duration of treatment for this complication must occasionally extend beyond discharge from the hospital. In this study, we evaluated the commonly used anti-emetic promethazine for its efficacy in the post-discharge period. Adult outpatient surgical patients who had excessive postoperative nausea and vomiting in the recovery room, or who were at risk for postoperative nausea and vomiting following discharge were given two promethazine suppositories (25 mg) for home use. All patients were contacted by our recovery room nurses on the first business day after their surgery and questioned as to their use of the suppositories and, if used, their efficacy. We found that 55 percent of patients given promethazine suppositories for home use had nausea and vomiting in the post-discharge period. Of the patients given promethazine, 89 percent used the suppositories. All of these patients reported improvement in their symptoms following use of the suppositories. None reported adverse effects from the promethazine suppositories. In conclusion, we found promethazine suppositories to be an inexpensive and efficacious treatment for nausea and vomiting in adult outpatient surgical patients following discharge from the hospital. Side-effects were minimal, and our patients voiced no complaints about this mode of therapy. We recommend this therapy for treatment of nausea and vomiting after hospital discharge following adult outpatient surgery. PMID:10527366

The Effect of a Standardized Ginger Extract on Chemotherapy-Induced Nausea-Related Quality of Life in Patients Undergoing Moderately or Highly Emetogenic Chemotherapy: A Double Blind, Randomized, Placebo Controlled Trial.

Science.gov (United States)

Marx, Wolfgang; McCarthy, Alexandra L; Ried, Karin; McKavanagh, Dan; Vitetta, Luis; Sali, Avni; Lohning, Anna; Isenring, Elisabeth

2017-08-12

Ginger supplementation could be an effective adjuvant treatment for chemotherapy-induced nausea (CIN). The aim of this clinical trial was to address significant methodological limitations in previous trials. Patients (N = 51) were randomly allocated to receive either 1.2 g of standardised ginger extract or placebo per day, in addition to standard anti-emetic therapy, during the first three cycles of chemotherapy. The primary outcome was CIN-related quality of life (QoL) measured with the Functional Living Index- Emesis (FLIE) questionnaire. Secondary outcomes included acute and delayed nausea, vomiting, and retching as well as cancer-related fatigue, nutritional status, and CIN and vomiting-specific prognostic factors. Over three consecutive chemotherapy cycles, nausea was more prevalent than vomiting (47% vs. 12%). In chemotherapy Cycle 1, intervention participants reported significantly better QoL related to CIN ( p = 0.029), chemotherapy-induced nausea and vomiting (CINV)-related QoL ( p = 0.043), global QoL ( p = 0.015) and less fatigue ( p = 0.006) than placebo participants. There were no significant results in Cycle 2. In Cycle 3, global QoL ( p = 0.040) and fatigue ( p = 0.013) were significantly better in the intervention group compared to placebo. This trial suggests adjuvant ginger supplementation is associated with better chemotherapy-induced nausea-related quality of life and less cancer-related fatigue, with no difference in adverse effects compared to placebo.

Pain Management in Ambulatory Surgery—A Review

Directory of Open Access Journals (Sweden)

Jan G. Jakobsson

2014-07-01

Full Text Available Day surgery, coming to and leaving the hospital on the same day as surgery as well as ambulatory surgery, leaving hospital within twenty-three hours is increasingly being adopted. There are several potential benefits associated with the avoidance of in-hospital care. Early discharge demands a rapid recovery and low incidence and intensity of surgery and anaesthesia related side-effects; such as pain, nausea and fatigue. Patients must be fit enough and symptom intensity so low that self-care is feasible in order to secure quality of care. Preventive multi-modal analgesia has become the gold standard. Administering paracetamol, NSIADs prior to start of surgery and decreasing the noxious influx by the use of local anaesthetics by peripheral block or infiltration in surgical field prior to incision and at wound closure in combination with intra-operative fast acting opioid analgesics, e.g., remifentanil, have become standard of care. Single preoperative 0.1 mg/kg dose dexamethasone has a combined action, anti-emetic and provides enhanced analgesia. Additional α-2-agonists and/or gabapentin or pregabalin may be used in addition to facilitate the pain management if patients are at risk for more pronounced pain. Paracetamol, NSAIDs and rescue oral opioid is the basic concept for self-care during the first 3–5 days after common day/ambulatory surgical procedures.

Food-Borne Outbreak Investigation and Molecular Typing: High Diversity of Staphylococcus aureus Strains and Importance of Toxin Detection.

Science.gov (United States)

Denayer, Sarah; Delbrassinne, Laurence; Nia, Yacine; Botteldoorn, Nadine

2017-12-20

Staphylococcus aureus is an important aetiological agent of food intoxications in the European Union as it can cause gastro-enteritis through the production of various staphylococcal enterotoxins (SEs) in foods. Reported enterotoxin dose levels causing food-borne illness are scarce and varying. Three food poisoning outbreaks due to enterotoxin-producing S. aureus strains which occurred in 2013 in Belgium are described. The outbreaks occurred in an elderly home, at a barbecue event and in a kindergarten and involved 28, 18, and six cases, respectively. Various food leftovers contained coagulase positive staphylococci (CPS). Low levels of staphylococcal enterotoxins ranging between 0.015 ng/g and 0.019 ng/g for enterotoxin A (SEA), and corresponding to 0.132 ng/g for SEC were quantified in the food leftovers for two of the reported outbreaks. Molecular typing of human and food isolates using pulsed-field gel electrophoresis (PFGE) and enterotoxin gene typing, confirmed the link between patients and the suspected foodstuffs. This also demonstrated the high diversity of CPS isolates both in the cases and in healthy persons carrying enterotoxin genes encoding emetic SEs for which no detection methods currently exist. For one outbreak, the investigation pointed out to the food handler who transmitted the outbreak strain to the food. Tools to improve staphylococcal food poisoning (SFP) investigations are presented.

Double-blind comparative study of droperidol, granisetron and granisetron plus dexamethasone as prophylactic anti-emetic therapy in patients undergoing abdominal, gynaecological, breast or otolaryngological surgery

NARCIS (Netherlands)

Janknegt, R; Pinckaers, JWM; Rohof, MHC; Ausems, MEM; Arbouw, MEL; van der Velden, RW; Brouwers, JRBJ

In this double-blind study the clinical efficacy of a single pre-operative intravenous dose of droperidol 1.25 mg (137 patients), granisetron 1 mg (130 patients) and granisetron 1 mg plus dexamethasone 5 mg (130 patients) was investigated for the prevention of postoperative nausea and vomiting after

Enterotoxins and emetic toxins production by Bacillus cereus and other species of Bacillus isolated from Soumbala and Bikalga, African alkaline fermentedfood condiments

DEFF Research Database (Denmark)

Ouoba, Labia Irene I.; Thorsen, Line; Varnam, Alan H.

2008-01-01

The ability of various species of Bacillus from fermented seeds of Parkia biglobosa known as African locust bean(Soumbala) and fermented seeds of Hibiscus sabdariffa (Bikalga) was investigated. The study included screening of the isolates by haemolysis on blood agar, detection of toxins in broth...

Conducting polymer based DNA biosensor for the detection of the Bacillus cereus group species

Science.gov (United States)

Velusamy, Vijayalakshmi; Arshak, Khalil; Korostynska, Olga; Oliwa, Kamila; Adley, Catherine

2009-05-01

Biosensor designs are emerging at a significant rate and play an increasingly important role in foodborne pathogen detection. Conducting polymers are excellent tools for the fabrication of biosensors and polypyrrole has been used in the detection of biomolecules due to its unique properties. The prime intention of this paper was to pioneer the design and fabrication of a single-strand (ss) DNA biosensor for the detection of the Bacillus cereus (B.cereus) group species. Growth of B. cereus, results in production of several highly active toxins. Therefore, consumption of food containing >106 bacteria/gm may results in emetic and diarrhoeal syndromes. The most common source of this bacterium is found in liquid food products, milk powder, mixed food products and is of particular concern in the baby formula industry. The electrochemical deposition technique, such as cyclic voltammetry, was used to develop and test a model DNA-based biosensor on a gold electrode electropolymerized with polypyrrole. The electrically conducting polymer, polypyrrole is used as a platform for immobilizing DNA (1μg) on the gold electrode surface, since it can be more easily deposited from neutral pH aqueous solutions of pyrrolemonomers. The average current peak during the electrodeposition event is 288μA. There is a clear change in the current after hybridization of the complementary oligonucleotide (6.35μA) and for the noncomplementary oligonucleotide (5.77μA). The drop in current after each event was clearly noticeable and it proved to be effective.

Prophylactic antiemetic effects of midazolam, dexamethasone, and its combination after middle ear surgery

International Nuclear Information System (INIS)

Makhdoom, Naeem K; Farid, Magdy F

2009-01-01

To evaluate and compare the efficacy of the combination of midazolam and dexamethasone, with midazolam and dexamethasone alone, for the prevention of postoperative nausea and vomiting (PONV) in female patients undergoing middle ear surgery. A prospective, randomized, double-blind, placebo-controlled study in 80 female patients (mean age 32.6 years), undergoing middle ear surgery with general anesthesia at Ohud Hospital, Madina, Kingdom of Saudi Arabia from May 2007 to May 2008. Patients were classified into 4 groups. They received intravenous normal saline (S group), midazolam 0.075 mg/kg (M group), or dexamethasone 10 mg (D group), or a combination of midazolam and dexamethasone (MD group), before the induction of anesthesia. Postoperatively for 24 hours observation and assessment of nausea, vomiting, rescue anti-emetics, and side effects of the study drugs such as headache and drowsiness were carried out. There was a significant difference between the 4 groups. The MD group was the least to develop PONV compared to other groups (p<0.01). Regarding nausea, there was a non-significant difference between the 4 groups, although the MD group developed the least symptoms among the 4 groups, there were no significant differences in pain intensity and side effects such as, headache, dizziness, and drowsiness between the 4 groups. The combination of midazolam 0.075 mg/kg and dexamethasone 10 mg intravenously is better than either drug alone in reducing the incidence of PONV in female patients after middle ear surgery. (author)

The Rise, Fall and Subsequent Triumph of Thalidomide: Lessons Learned in Drug Development

Science.gov (United States)

Rehman, Waqas; Arfons, Lisa M.; Lazarus, Hillard M.

2011-01-01

Perhaps no other drug in modern medicine rivals the dramatic revitalization of thalidomide. Originally marketed as a sedative, thalidomide gained immense popularity worldwide among pregnant women because of its effective anti-emetic properties in morning sickness. Mounting evidence of human teratogenicity marked a dramatic fall from grace and led to widespread social, legal and economic ramifications. Despite its tragic past thalidomide emerged several decades later as a novel and highly effective agent in the treatment of various inflammatory and malignant diseases. In 2006 thalidomide completed its remarkable renaissance becoming the first new agent in over a decade to gain approval for the treatment of plasma cell myeloma. The catastrophic collapse yet subsequent revival of thalidomide provides important lessons in drug development. Never entirely abandoned by the medical community, thalidomide resurfaced as an important drug once the mechanisms of action were further studied and better understood. Ongoing research and development of related drugs such as lenalidomide now represent a class of irreplaceable drugs in hematological malignancies. Further, the tragedies associated with this agent stimulated the legislation which revamped the FDA regulatory process, expanded patient informed consent procedures and mandated more transparency from drug manufacturers. Finally, we review recent clinical trials summarizing selected medical indications for thalidomide with an emphasis on hematologic malignancies. Herein, we provide a historic perspective regarding the up-and-down development of thalidomide. Using PubMed databases we conducted searches using thalidomide and associated keywords highlighting pharmacology, mechanisms of action, and clinical uses. PMID:23556097

Domperidone prolongs oral to duodenal transit time in video capsule endoscopy.

Science.gov (United States)

Mcfarlane, Michael; Liu, B; Nwokolo, C

2018-04-01

Domperidone is thought to accelerate gastric emptying via D2 receptor antagonism at the gastro-oesophageal and gastro-duodenal junctions. Listed in the BNF as a prokinetic anti-emetic, it has been used in video capsule endoscopy (VCE) to accelerate capsule delivery to the small intestine. We audited VCEs performed at UHCW from 2011, when as standard practice, domperidone was given pre-VCE, to 2012, after its discontinuation due to doubts about its effectiveness. Thirty-one patients received oral domperidone 20 mg pre-VCE. Thirty-three patients underwent VCE without domperidone pre-treatment. After 2 h, if the capsule remained intra-gastric, gastroscopy-assisted duodenal delivery was performed. Data was analysed using Mann-Whitney testing. Median oro-duodenal transit was 13 and 30 min in the untreated and domperidone groups, respectively (p = 0.01). Median oro-caecal transit was 242 and 267 min in the untreated and domperidone groups, respectively (p = 0.02). No difference in duodenal-caecal transit was seen (p = 0.60). Six percent of untreated and 13% of domperidone VCEs required gastroscopy-assisted duodenal capsule delivery (p = 0.65). Unexpectedly domperidone delayed VCE gastric transit. Most studies on domperidone prokinetic effects have been in diabetic gastroparesis, demonstrating that domperidone can achieve good symptomatic relief, but with mixed results for gastric emptying. Our study suggests that any antiemetic effects of domperidone are not mediated through accelerated gastric transit.

A comparison of the effects of droperidol and the combination of droperidol and ondansetron on postoperative nausea and vomiting for patients undergoing laparoscopic cholecystectomy.

LENUS (Irish Health Repository)

Awad, Imad T

2012-02-03

STUDY OBJECTIVES: To compare the prophylactic antiemetic efficacy of the combination of ondansetron and droperidol with that of droperidol alone in patients undergoing elective laparoscopic cholecystectomy. DESIGN: Randomized, double-blind controlled trial. University affiliated teaching hospital after induction of standardized general anesthesia. PATIENTS: 64 ASA physical status I or II patients aged 18 to 80 years, undergoing elective laparoscopic cholecystectomy. INTERVENTION: Following induction of general anesthesia, patients received either droperidol 1.25 mg intravenously (IV; n = 30; Group D) or the combination of droperidol 1.25 mg IV and ondansetron 4 mg IV (n = 34; Group D+O). MEASUREMENTS: Number and severity of nausea episodes, number of emetic episodes, total analgesic consumption, and rescue antiemetic administration were assessed at 1, 3, and 24 hours after admission to the recovery room. Data were analyzed using Fisher\\'s Exact test and unpaired Student\\'s t-test; a p-value <0.05 was considered significant. RESULTS: The proportions of patients who experienced nausea (70% and 53% for D and D+O groups, respectively) and vomiting (30% and 19% for D and D+O groups, respectively) were similar in the two groups. The frequency of moderate and severe nausea (requiring administration of antiemetic) was less in group D + O (7%) compared with group D (19%; p < 0.05). CONCLUSIONS: Patients who received the combination of droperidol and ondansetron experienced less severe nausea compared with patients who received droperidol alone.

Beer and wine in antiquity: beneficial remedy or punishment imposed by the Gods?

Science.gov (United States)

Rosso, Ana Maria

2012-01-01

Different types of alcoholic beverages such as wine and beer were used in ancient times for various medicinal purposes. Being the oldest and probably the most widely used drugs, they were known to have some therapeutic value, in addition to the vital part they played in the daily life of people. Ethanol is produced by fermentation of a variety of plants and consumed either in a diluted form or concentrated by distillation to concoct alcoholic beverages. Beer made of fermented barley is an alcoholic drink that was believed to contain a spirit or a god. It is a drink of relatively low alcohol content with supernatural properties. The same was believed for wine. Considered to be divine, these beverages were the long sought elixirs of life and appeared in religious ceremonies, in mythology, and in social meals, such as the Greek symposia. In addition, these alcoholic drinks were considered to be a remedy for practically every disease and, therefore, were a common ingredient in ancient prescriptions. They were used as anaesthetics that dull the pain, as stimulants, as analgesics, as antiseptics to cleanse wounds and relieve pain, as emetics, as digestives, as antidotes for plant poisoning, for bites and stings, and as purifiers. However, we should not overlook the harmful effects of alcohol abuse such as drunkenness, chronic liver disease and, in modern terminology, infirmities that included pancreatitis, cardiomyopathy, peripheral neuropathy, dementia, and central nervous system disorders.

Anisotropies of the neutron emission of the 'Focus' discharge compared with different theoretical models; Anisotropies de l'emission neutronique de la decharge 'Focus' comparees a divers modeles theoriques

Energy Technology Data Exchange (ETDEWEB)

Patou, Claude; Simonnet, Alain

1969-08-06

When a plasma emits enough neutrons to make an analysis of this neutrons possible, the study of emission characteristics allows the mechanism governing fusion reaction to be specified. The experimental study of neutron flow and energy anisotropies is herein compared with various possible theoretical models. It seems that the 'Boiler' model (thermal plasma in movement) matches the obtained results. Only observed flow values in the discharge axis remain unexplained. Although the study approach does not allow to be sure of plasma thermalization in the strict meaning of the term, it seems that there is a relatively well established anisotropy of the speed distribution function of reacting ions [French] Lorsqu'un plasma emet suffisamment de neutrons pour les soumettre a l'analyse, l'etude des caracteristiques de l'emission permet de preciser le mecanisme responsable des reactions de fusion. L'etude experimentale des anisotropies du flux et de l'energie des neutrons est comparee a divers modeles theoriques possibles. Il semble que le modele du 'Boiler' - plasma thermique en mouvement - s'accorde avec nos resultats. Seules les valeurs des flux observes selon l'axe de la decharge restent sans explication. Bien que ce moyen d'etude ne permette pas d'etre certain de la thermalisation du plasma au sens strict du terme, il semble cependant qu'on se trouve en presence d'une isotropie relativement bien realisee de la fonction de distribution des vitesses des ions qui entrent en reaction. (auteurs)

Multi-Sensor Fusion of Infrared and Electro-Optic Signals for High Resolution Night Images

Directory of Open Access Journals (Sweden)

Victor Lawrence

2012-07-01

Full Text Available Electro-optic (EO image sensors exhibit the properties of high resolution and low noise level at daytime, but they do not work in dark environments. Infrared (IR image sensors exhibit poor resolution and cannot separate objects with similar temperature. Therefore, we propose a novel framework of IR image enhancement based on the information (e.g., edge from EO images, which improves the resolution of IR images and helps us distinguish objects at night. Our framework superimposing/blending the edges of the EO image onto the corresponding transformed IR image improves their resolution. In this framework, we adopt the theoretical point spread function (PSF proposed by Hardie <em>et al. for the IR image, which has the modulation transfer function (MTF of a uniform detector array and the incoherent optical transfer function (OTF of diffraction-limited optics. In addition, we design an inverse filter for the proposed PSF and use it for the IR image transformation. The framework requires four main steps: (1 inverse filter-based IR image transformation; (2 EO image edge detection; (3 registration; and (4 blending/superimposing of the obtained image pair. Simulation results show both blended and superimposed IR images, and demonstrate that blended IR images have better quality over the superimposed images. Additionally, based on the same steps, simulation result shows a blended IR image of better quality when only the original IR image is available.

Dexamethasone Modifies Cystatin C-Based Diagnosis of Acute Kidney Injury During Cisplatin-Based Chemotherapy

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Timothy J. Pianta

2017-03-01

Full Text Available Background/Aims: Plasma cystatin C (pCysC may be superior to serum creatinine (sCr as a surrogate of GFR. However, the performance of pCysC for diagnosing acute kidney injury (AKI after cisplatin-based chemotherapy is potentially affected by accompanying corticosteroid anti-emetic therapy and hydration. Methods: In a prospective observational study pCysC, sCr, urinary kidney injury molecule-1 (KIM-1, and urinary clusterin were measured over 2 weeks in 27 patients given first-cycle chemotherapy. The same variables were measured over 2 weeks in Sprague–Dawley rats given a single intraperitoneal injection of dexamethasone, cisplatin, or both, and in controls. Results: In patients, pCysC increases were greater than sCr 41% vs. 16%, mean paired difference 25% (95% CI: 16–34%], relative increases were ≥ 50% in 9 patients (35% for pCysC compared with 2 (8% for sCr (p = 0.04 and increases in sCr were accompanied by increased KIM-1 and clusterin excretion, but increases in pCysC alone were not. In rats, dexamethasone administration produced dose-dependent increases in pCysC (and augmented cisplatin-induced increases in pCysC, but did not augment histological injury, increases in sCr, or KIM-1 and clusterin excretion. Conclusions: In the presence of dexamethasone, elevation of pCysC does not reliably diagnose AKI after cisplatin-based chemotherapy.

Author Neomythonyms and Mythappellatives

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Vlada V. Belousova

2017-03-01

Full Text Available It has been carried out an analysis of the author neomythonyms ans mythappelatives. It is given examples of Russian and foreign onyms and appellatives and also enumerated some mythonyms in literature of the 20th century. The material for this work are fiction genres, namely: novel by D.A. Emets “Methodius Buslaev. Magician of the midnight”, novel by S. Antonov “Dark tunnels”, novel by A.D. Glukhovsky “Metro 2033” and a collection of Max Frei “Russian foreign fairy tale – 1”. Language units were selected by continuous sampling. The paper also considers such notions as neologisms, potebtial words and occasionalisms. Differences between neomythonyms and author neomythonyms, as well as between appellatives and mythappelatives are distinguished. The language of national fantasy and science fiction of 2021 centuries is marked by the criteria for determining author neomythonyms and mythappelatives: by the method of formation and functioning. According to the analysis of new lexical units it has been found an active expand of the vocabulary of the Russian language due to the appearance of new and onyms and appellatives that went beyond the occasional units and are widely used among fans of fantasy and science fiction. The emergence of such a large number of author units is due to the great creative potential of contemporary writers, and the active development of Russian science fiction and fantasy of 20-21 centuries.

Gastrinoma and Zollinger-Ellison syndrome in canids: a literature review and a case in a Mexican gray wolf.

Science.gov (United States)

Struthers, Jason D; Robl, Nick; Wong, Valerie M; Kiupel, Matti

2018-06-01

Gastrinoma, an infrequent diagnosis in middle-aged dogs, occurs with nonspecific gastrointestinal morbidity. Laboratory tests can yield a presumptive diagnosis, but definitive diagnosis depends on histopathology and immunohistochemistry. We describe a malignant pancreatic gastrinoma with lymph node metastases and corresponding Zollinger-Ellison syndrome in a Mexican gray wolf ( Canis lupus baileyi) and review this endocrine neoplasm in domestic dogs. A 12-y-old, captive, male Mexican gray wolf developed inappetence and weight loss. Abdominal ultrasonography revealed a thickened duodenum and peritoneal effusion. Two duodenal perforations were noted on exploratory celiotomy and were repaired. Persisting clinical signs led to a second celiotomy that revealed a mesenteric mass, which was diagnosed histologically as a neuroendocrine carcinoma. During the following 16 mo, the wolf received a combination of H 2 -receptor antagonists, proton-pump inhibitors, gastroprotectants, and anti-emetics, but had recurrent episodes of anorexia, nausea, acid reflux, and remained underweight. Worsening clinical signs and weakness prompted euthanasia. The antemortem serum gastrin concentration of 414 ng/L (reference interval: 10-40 ng/L) corroborated hypergastrinemia. Autopsy revealed a mass expanding the right pancreatic limb; 3 parapancreatic mesenteric masses; duodenal ulcers; focal duodenal perforation with septic fibrinosuppurative peritonitis; chronic-active ulcerative esophagitis; and poor body condition. The pancreatic mass was diagnosed histologically as a neuroendocrine carcinoma and the parapancreatic masses as lymph node metastases. Immunohistochemistry of the pancreatic mass was positive for gastrin and negative for glucagon, insulin, pancreatic polypeptide, serotonin, somatostatin, and vasoactive intestinal peptide.

Basis of Virulence in Enterotoxin-Mediated Staphylococcal Food Poisoning

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Emilie L. Fisher

2018-03-01

Full Text Available The Staphylococcus aureus enterotoxins are a superfamily of secreted virulence factors that share structural and functional similarities and possess potent superantigenic activity causing disruptions in adaptive immunity. The enterotoxins can be separated into two groups; the classical (SEA-SEE and the newer (SEG-SElY and counting enterotoxin groups. Many members from both these groups contribute to the pathogenesis of several serious human diseases, including toxic shock syndrome, pneumonia, and sepsis-related infections. Additionally, many members demonstrate emetic activity and are frequently responsible for food poisoning outbreaks. Due to their robust tolerance to denaturing, the enterotoxins retain activity in food contaminated previously with S. aureus. The genes encoding the enterotoxins are found mostly on a variety of different mobile genetic elements. Therefore, the presence of enterotoxins can vary widely among different S. aureus isolates. Additionally, the enterotoxins are regulated by multiple, and often overlapping, regulatory pathways, which are influenced by environmental factors. In this review, we also will focus on the newer enterotoxins (SEG-SElY, which matter for the role of S. aureus as an enteropathogen, and summarize our current knowledge on their prevalence in recent food poisoning outbreaks. Finally, we will review the current literature regarding the key elements that govern the complex regulation of enterotoxins, the molecular mechanisms underlying their enterotoxigenic, superantigenic, and immunomodulatory functions, and discuss how these activities may collectively contribute to the overall manifestation of staphylococcal food poisoning.

Haloperidol dose combined with dexamethasone for PONV prophylaxis in high-risk patients undergoing gynecological laparoscopic surgery: a prospective, randomized, double-blind, dose-response and placebo-controlled study.

Science.gov (United States)

Joo, Jin; Park, Yong Gyu; Baek, Jungwon; Moon, Young Eun

2015-07-08

Low-dose haloperidol is known to be effective for the prevention of postoperative nausea and vomiting (PONV). However, precise dose-response studies have not been completed, especially in patients at high risk for PONV who require combination therapy. This study sought to identify which dose of haloperidol 1mg or 2mg could be combined with dexamethasone without adverse effects in high-risk patients undergoing gynecological laparoscopic surgery. Female adults (n = 150) with three established PONV risk factors based on Apfel's score were randomized into one of three study groups. At the end of anesthesia, groups H0, H1, and H2 were given intravenous (IV) saline, haloperidol 1 mg, and haloperidol 2 mg, respectively. All patients were given dexamethasone 5 mg during the induction of anesthesia. The overall early (0-2 h) and late (2-24 h) incidences of nausea, vomiting, rescue anti-emetic administration, pain, and adverse effects (cardiac arrhythmias and extrapyramidal effects) were assessed postoperatively. The sedation score was recorded in the postanesthesia care unit (PACU). The total incidence of PONV over 24 h was significantly lower in groups H1 (29 %) and H2 (24 %) than in group H0 (54 %; P = 0.003), but there was no significant difference between groups H1 and H2. In the PACU, group H2 had a higher sedation score than groups H1 and H0 (P haloperidol was equally effective as 2 mg in terms of preventing PONV with the less sedative effect. ClinicalTrials.gov ( NCT01639599 ).

A targetted intervention research on traditional healer perspectives of sexually transmitted illnesses in urban Zambia. Current research.

Science.gov (United States)

Masauso Nzima, M; Romano, K; Anyangwe, S; Wiseman, J; Macwan'gi, M; Kendall, C; Green, E C

1996-07-01

Interviews with 81 traditional healers from 4 Copperbelt towns in Zambia (Chililabombwe, Chingola, Luanshya, and Mufulira) investigated healers' understanding of, attitudes toward, and management of sexually transmitted diseases (STDs). In general, Zambian traditional healers had detailed constructs of the physiology and infective processes underlying syphilis, gonorrhea, chancroid, and AIDS. STDs were considered to be caused by "dirt" or contamination residing in sperm or vaginal fluids and were closely linked to violations of moral codes. Healers shared complex nosologies based on distinctions between symptoms of different STD pathologies that were more inclusive than biomedical categories. Although condom use was not promoted, healers understood the importance of preventing an infective agent from passing from one person to another. Except for AIDS, STDs were considered curable by expelling the dirt through purgatives or emetics. Modern medicine was perceived as treating only STD symptoms, not curing. Most traditional healers insisted that the infected partner bring the other partner for consultation or treatment was withheld. Since these findings identified some areas of compatibility between indigenous and biomedical models of STDs, the Traditional Medicine Unit of the Ministry of Health and the HIV/AIDS Prevention Project of the Morehouse School of Medicine (Lusaka) established a program in which traditional healers receive AIDS training and learn to counsel clients on safer sex behaviors. Follow-up entails monthly meetings between health professionals and traditional healers. Since program initiation in June 1994, 800 traditional healers and 70 health professionals have participated. Traditional healers now sell condoms to their clients through a social marketing program.

Iridoids as chemical markers of false ipecac (Ronabea emetica), a previously confused medicinal plant.

Science.gov (United States)

Berger, Andreas; Fasshuber, Hannes; Schinnerl, Johann; Robien, Wolfgang; Brecker, Lothar; Valant-Vetschera, Karin

2011-12-08

Several roots or rhizomes of rubiaceous species are reportedly used as the emetic and antiamoebic drug ipecac. True ipecac (Carapichea ipecacuanha) is chemically well characterized, in contrast to striated or false ipecac derived from the rhizomes of Ronabea emetica (syn. Psychotria emetica). Besides its previous use as substitute of ipecac, the latter species is applied in traditional medicine of Panama and fruits of its relative Ronabea latifolia are reported as curare additives from Colombia. Compounds of Ronabea emetica were isolated using standard chromatographic techniques, and structurally characterized by NMR spectroscopy and mass spectrometry. Organ specific distribution in Ronabea emetica as well as in Ronabea latifolia was further assessed by comparative HPLC analysis. Four iridoid-glucosides, asperuloside (1), 6α-hydroxygeniposide (2), deacetylasperulosidic acid (3) and asperulosidic acid (4) were extracted from leaves of Ronabea emetica. Rhizomes, used in traditional medicine, were dominated by 3. HPLC profiles of Ronabea latifolia were largely corresponding. These results contrast to the general tendency of producing emetine-type and indole alkaloids in species of Psychotria and closely related genera and merit chemotaxonomic significance, characterizing the newly delimited genus Ronabea. The aim of the work was to resolve the historic problem of adulteration of ipecac by establishing the chemical profile of Ronabea emetica, the false ipecac, as one of its less known sources. The paper demonstrates that different sources of ipecac can be distinguished by their phytochemistry, thus contributing to identifying adulterations of true ipecac. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study

International Nuclear Information System (INIS)

Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

2015-01-01

The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT 3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV

Ramosetron compared with granisetron for the prevention of vomiting following strabismus surgery in children

Science.gov (United States)

Fujii, Y.; Tanaka, H.; Ito, M.

2001-01-01

BACKGROUND/AIMS—Postoperative vomiting occurs frequently after strabismus surgery in children. Granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, is effective for the prevention of vomiting following paediatric strabismus surgery. Ramosetron, another new antagonist of 5-hydroxytryptamine type 3 receptor, has more potent and longer acting properties than granisetron against cisplatin induced emesis. This study was undertaken to compare the efficacy and safety of granisetron and ramosetron for the prevention of vomiting following strabismus surgery in children.
METHODS—In a randomised, double blinded manner 80 children, aged 4-10 years, received intravenously granisetron 40 µg/kg or ramosetron 6 µg/kg (n=40 each) at the end of surgery. A standard general anaesthetic technique and postoperative analgesia were used. Emetic episodes and safety assessment were performed during the first 24 hours and the next 24 hours after anaesthesia.
RESULTS—The percentage of patients who were emesis free during 0-24 hours after anaesthesia was 85% with granisetron and 90% with ramosetron, respectively (p = 0.369); the corresponding rate during 24-48 hours after anaesthesia was 70% and 95% (p = 0.003). No clinically serious adverse events caused by the study drug were observed in any of the groups.
CONCLUSION—Prophylactic antiemetic therapy with ramosetron is comparable with granisetron for the prevention of vomiting during 0-24 hours after anaesthesia in children undergoing strabismus surgery. During 24-48 hours after anaesthesia, ramosetron is more effective than granisetron for prophylaxis against postoperative vomiting.

 PMID:11371485

Impact of group psychotherapy in chemotherapy induced vomiting for treatment of advanced breast and lungs cancer

International Nuclear Information System (INIS)

Pervez, T.; Mein, F.D.; Alharbi, T.M.

2007-01-01

To assess the effect of group psychotherapy in the management of the side effects of chemotherapy treatment in advanced breast and lung cancer. One hundred patients treated with chemotherapy for advanced stage (IIIB and IV) breast and lung cancer were selected with ECOG performance status of 0 or 1. All patients received anti-emetic medications half an hour before chemotherapy. All those patients in this category who completed fist line chemotherapy with 6 cycles were included. Fifty were subjected to group discussions with other patients, family members and medical staff. This was labeled group A. The other 50 were not included in group discussion and were labeled group B. Both the group received similar standard chemotherapy and pre-medication for vomiting as per their disease and chemotherapy schedule. Breast and lung cancer patients were 29 and 21 in each arm respectively. At the end of the discharge, grade 2 and above of vomiting, according to common terminology criteria for adverse events (CTCAE) was counted for all patients in both the arms A and B, over full length of treatment for 6 cycles, and then were compared statistically. Mean with standard deviation for adverse event (vomiting) in group A and B was 6.2 + 2.6 and 13.4 + 3.8 respectively per cycle of treatment. It was observed that group psychotherapy had statistically significant effect (p-value <0.05) on the management of vomiting. Group psychotherapy can be used to reduce the incidence of vomiting in advanced breast and lung cancer patients treated with chemotherapy. (author)

Systemic lupus erythematosus pancreatitis: an uncommon presentation of a common disease.

Science.gov (United States)

Rodriguez, Eduardo A; Sussman, Daniel A; Rodriguez, Vanessa R

2014-11-17

Acute pancreatitis is uncommon in systemic lupus erythematosus (SLE). When recognized early and properly treated with IV steroids and hydration, the course may be benign, as exemplified in the following report. A 21-year-old woman with history of SLE and stage IV lupus nephritis, was admitted to the Sergio Bernales Hospital ICU (Lima, Peru), complaining of worsening epigastric pain radiating to the back, and nausea and vomiting for 1 week. She denied prior cholelithiasis, alcohol use, or recent medication changes. On examination, she was tachycardic and normotensive, with a slightly distended abdomen and epigastric tenderness on deep palpation, without signs of peritoneal irritation. Laboratory results demonstrated leukocytosis without left shift, creatinine of 2.26 mg/dL, amylase of 750 U/L, and lipase of 1038 U/L. Liver chemistries, calcium, lactic acid, triglycerides, and IgG4 were normal and alcohol level was undetectable. Ultrasound did not show cholelithiasis, biliary sludge, or common bile duct dilation. CT of the abdomen showed pancreas head (parenchyma) stranding with uniform enhancement consistent with interstitial pancreatitis. Despite receiving IV fluids, opiates, anti-emetics, and nothing by mouth, her clinical condition deteriorated, prompting the use of IV methylprednisolone. After completing 1 week of IV steroids, she was transferred to the medical floor clinically improved. The patient was discharged with an oral steroid taper and complete resolution of symptoms. After ruling out common causes, such as hepatobiliary pathology or toxin-related insults like alcohol, hypercalcemia, hypertriglyceridemia or medications, steroids may be used in SLE pancreatitis because they might improve the overall prognosis.

Patients' and parents' views regarding supportive care in childhood cancer.

Science.gov (United States)

Tenniglo, L J A; Loeffen, E A H; Kremer, L C M; Font-Gonzalez, A; Mulder, R L; Postma, A; Naafs-Wilstra, M C; Grootenhuis, M A; van de Wetering, M D; Tissing, W J E

2017-10-01

Intensive therapies in pediatric malignancies increased survival rates but also occurrence of treatment-related morbidities. Therefore, supportive care fulfills an increasingly important role. In planning development of guidelines with incorporation of shared decision making, we noticed that little is known about the needs and preferences of patients and their parents. Our goals were therefore to investigate (1) which supportive care topics patients and parents regard as most important and (2) the preferred role they wish to fulfill in decision making. This qualitative study consisted of three focus groups (two traditional, one online) with patients and parents of two Dutch pediatric oncology centers. Data were transcribed as simple verbatim and analyzed using thematic analysis. Eleven adolescent patients and 18 parents shared detailed views on various aspects of supportive care. Themes of major importance were communication between patient and physician (commitment, accessibility, proactive attitude of physicians), well-timed provision of information, and the suitability and accessibility of psychosocial care. In contrast to prioritized supportive care topics by medical professionals, somatic issues (e.g., febrile neutropenia) were infrequently addressed. Patients and parents preferred to be actively involved in decision making in selected topics, such as choice of analgesics and anti-emetics, but not in, e.g., choice of antibiotics. Children with cancer and parents were provided a valuable insight into their views regarding supportive care and shared decision making. These results have important implications towards improving supportive care, both in selecting topics for guideline development and incorporating preferences of patients and parents herein.

A Randomized Controlled Pilot Study Comparing the Impact of Aprepitant and Fosaprepitant on Chemotherapy Induced Nausea and Vomiting in Patients Treated for Gynecologic Cancer.

Science.gov (United States)

Micha, John P; Rettenmaier, Mark A; Brown, John V; Mendivil, Alberto; Abaid, Lisa N; Lopez, Katrina L; Goldstein, Bram H

2016-02-01

The purpose of this pilot study was to compare the response rates and daily living activities of patients with newly diagnosed gynecologic cancer treated with fosaprepitant or aprepitant in the management of chemotherapy-induced nausea and vomiting. Eligible participants were randomized to either intravenous fosaprepitant (150 mg, day 1) or oral aprepitant (125 mg on day 1 and 80 mg on days 2-3) before undergoing weekly paclitaxel (80 mg/2)(2) and monthly carboplatin (AUC 6)-based chemotherapy. In addition, standard premedications (eg, ranitidine, dexamethasone, and diphenhydramine) were administered intravenously on day 1. Response evaluation and impact on daily life were measured throughout the acute phase (0-24 hours), delayed period (days 2-4), and overall phase (0-120 hours) of the patients' initial chemotherapy cycle via the Functional Living Index-Emesis. In the current investigation, 20 gynecologic cancer subjects were treated with either fosaprepitant (n = 10) or aprepitant (n = 10) before their first chemotherapy cycle. We observed 7 overall complete responses (70%, no emetic episodes or rescue medications) in the aprepitant group and 6 (60%) in the fosaprepitant cohort (P = 0.660). In addition, both treatment groups reported similarly, favorable rates of daily living activities throughout the acute (P = 0.626) and delayed (P = 0.648) phases of cycle 1 chemotherapy. The findings from the current analysis suggest that intravenous fosaprepitant and oral aprepitant confer beneficial antiemetic prevention. Moreover, the 2 medications theoretically afford a favorable impact on daily living, thereby potentially facilitating the completion of a patient's clinically prescribed chemotherapy regimen.

Efficacy and safety of acupuncture for dizziness and vertigo in emergency department: a pilot cohort study.

Science.gov (United States)

Chiu, Chih-Wen; Lee, Tsung-Chieh; Hsu, Po-Chi; Chen, Chia-Yun; Chang, Shun-Chang; Chiang, John Y; Lo, Lun-Chien

2015-06-09

Dizziness and vertigo account for roughly 4% of chief symptoms in the emergency department (ED). Pharmacological therapy is often applied for these symptoms, such as vestibular suppressants, anti-emetics and benzodiazepines. However, every medication is accompanied with unavoidable side-effects. There are several research articles providing evidence of acupuncture treating dizziness and vertigo but few studies of acupuncture as an emergent intervention in ED. We performed a pilot cohort study to evaluate the efficacy and safety of acupuncture in treating patients with dizziness and vertigo in ED. A total of 60 participants, recruited in ED, were divided into acupuncture and control group. Life-threatening conditions or central nervous system disorders were excluded to ensure participants' safety. The clinical effect of treating dizziness and vertigo was evaluated by performing statistical analyses on data collected from questionnaires of Dizziness Handicap Inventory (DHI), Visual Analog Scale (VAS) of dizziness and vertigo, and heart rate variability (HRV). The variation of VAS demonstrated a significant decrease (p-value: 0.001 and p-value: 0.037) between two groups after two different durations: 30 mins and 7 days. The variation of DHI showed no significant difference after 7 days. HRV revealed a significant increase in high frequency (HF) in the acupuncture group. No adverse event was reported in this study. Acupuncture demonstrates a significant immediate effect in reducing discomforts and VAS of both dizziness and vertigo. This study provides clinical evidence on the efficacy and safety of acupuncture to treat dizziness and vertigo in the emergency department. ClinicalTrials.gov ID: NCT02358239 . Registered 5 February 2015.

RF photo-injector beam energy distribution studies by slicing technique

Science.gov (United States)

Filippetto, D.; Bellaveglia, M.; Musumeci, P.; Ronsivalle, C.

2009-07-01

The SPARC photo-injector is an R&D facility dedicated to the production of high brightness electron beams for radiation generation via FEL or Thomson scattering processes. It is the prototype injector for the recently approved SPARX project, aiming at the construction in the Frascati/University of Rome Tor Vergata area of a new high brightness electron linac for the generation of SASE-FEL radiation in the 1-10 nm wavelength range. The first phase of the SPARC project has been dedicated to the e-beam source characterization; the beam transverse and longitudinal parameters at the exit of the gun have been measured, and the photo-injector settings optimized to achieve best performance. Several beam dynamics topics have been experimentally studied in this first phase of operation, as, for example, the effect of photocathode driver laser beam shaping and the evolution of the beam transverse emittance. These studies have been made possible by the use of a novel diagnostic tool, the " emittance-meter" which enables the measurement of the transverse beam parameters at different positions along the propagation axis in the very interesting region at the exit of the RF gun. The new idea of extending the e-meter capabilities came out more recently. Information on the beam longitudinal phase space and correlations with the transverse planes can be retrieved by the slicing technique. In this paper, we illustrate the basic concept of the measurement together with simulations that theoretically validate the methodology. Some preliminary results are discussed and explained with the aid of code simulations.

Cold pearl surfactant-based blends.

Science.gov (United States)

Crombie, R L

1997-10-01

Pearlizing agents have been used for many years in cosmetic formulations to add a pearlescent effect. Cold pearl surfactant-based blends are mixtures of glycol stearates and surfactants which can be blended in the cold into a wide range of personal-care formulations to create a pearlescent lustre effect. Under controlled manufacturing conditions constant viscosities and crystalline characteristics can be obtained. The development of these blends has been driven by efforts to improve the economics of adding solid pearlizing agents directly into a hot mix formulation. This paper summarizes the history of pearlizers, describes their advantages and physical chemistry of the manufacturing process. Finally some suggestions for applications are given. Les agents nacrants sont utilises depuis de nombreuses annees dans les formulations cosmetiques pour ajouter un effet nacre. Les melanges a froid a base de tensioactif nacre sont des melanges de stearates de glycol et de tensioactifs qui peuvent etre melanges a froid dans une large gamme de formulations d'hygiene personnelle pour creer un effet de lustre nacre. On peut obtenir des viscosites et des proprietes cristallines constantes avec des conditions de fabrication maitrisees. Le developpement de ces melanges a ete porte par les efforts pour ameliorer les couts de l'ajout d'agents nacrants solides directement dans une formulation melangee de l'ajout d'agents nacrants solides directement dans une formulation melangee a chaud. Cet article resume l'histoire des agents nacrants, decrit leurs avantages et al physico-chimie du procede de fabrication. On emet a la fin cetaines suggestions d'applications.

Postoperative analgesia and antiemetic efficacy after intrathecal neostigmine in patients undergoing abdominal hysterectomy during spinal anesthesia.

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Lauretti, G R; Mattos, A L; Gomes, J M; Pereira, N L

1997-01-01

Postoperative analgesia and antiemetic efficacy after intrathecal neostigmine were investigated in a randomized, double-blind, placebo-controlled trial of 100 patients undergoing abdominal hysterectomy. The patients were assigned to one of five groups (n = 20), and received intravenous prior to the spinal block the antiemetic test drug (except propofol) and 0.05 mg/kg midazolam. The control group (group C), the neostigmine group (group N), and the propofol group (group P) received saline as the test drug. The droperidol group (group D) received 0.5 mg intravenous droperidol, and the metoclopramide group (group M) 10 mg intravenous metoclopramide. Group P was single-blinded and had an intravenous continuous propofol infusion (2-4 mg/kg/h) turned on 10 minutes after the spinal injection. The intrathecal drugs administered were 20 mg hyperbaric bupivacaine (0.5%) associated with either 100 microg neostigmine or saline (for group C). Nausea, emetic episodes, and the need for rescue medication were recorded for the first 24 hours postoperative and scored by the Visual Analog Scale (VAS). Time-to-first-rescue medication and rescue medications in 24 hours were similar among the groups (P = .2917 and P = .8780, respectively). Intrathecal 100 microg neostigmine was associated with a high incidence of nausea and vomiting perioperative, leading to a high consumption of antiemetics (P antiemetic test drugs were effective in preventing nausea and vomiting after 100 microg neostigmine. Intrathecal neostigmine (100 microg) was ineffective for postoperative analgesia after abdominal hysterectomy due to side effects of nausea and vomiting.

Contrasting effects of lithium chloride and CB1 receptor blockade on enduring changes in the valuation of reward.

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Giovanni eHernandez

2011-09-01

Full Text Available When an organism has been trained to respond for a reward, its learned behavior can be characterized as goal-directed or habitual based on whether or not it is susceptible to reward devaluation. Here, we evaluated whether instrumental responding for brain stimulation reward (BSR can devalued using a paradigm traditionally used for natural rewards. Rats were trained to lever press for BSR. Subsequently, BSR was paired with either lithium chloride (LiCl, 5 mg/kg, i.p, a pro-emetic, or AM251, a CB1 receptor antagonist (3 mg/kg, i.p.. Pairings of BSR with these two compounds or their respective vehicle were performed in a novel environment so that only unconditional effects of BSR were affected by the pharmacological manipulations. Subsequently, in a probe test, all rats were returned in the drug-free state to the boxes where they had received training instrumental responding was reassessed in the absence of BSR delivery. LiCl produced enduring decreases in the number of responses during the test session, whereas AM251 had no effect. These results show that instrumental responding for BSR is susceptible to devaluation, in accord with the proposal that this behavior is supported at least in part by associations between the response and the rewarding outcome. Furthermore, they suggest that the reward modulation observed in studies involving the use of CB1 receptor antagonists arises from changes in the organism’s motivation rather than due to drug-induced changes in the intrinsic value of reward.

Co-administration of dexamethasone increases severity and accelerates onset day of neutropenia in bladder cancer patients on methotrexate, vinblastine, adriamycin and cisplatin chemotherapy: a retrospective cohort study.

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Itai, Shingo; Suga, Yukio; Hara, Yusuke; Izumi, Kouji; Maeda, Yuji; Kitagawa, Yasuhide; Ishizaki, Junko; Shimada, Tsutomu; Mizokami, Atsushi; Sai, Yoshimichi

2017-01-01

Bladder cancer patients receiving methotrexate, vinblastine, adriamycin and cisplatin (MVAC) chemotherapy are co-administered with dexamethasone as an anti-emetic. We examined whether or not dexamethasone affects the severity and onset day of MVAC-induced severe neutropenia. This was a retrospective study of bladder cancer patients treated with MVAC chemotherapy with or without dexamethasone as an antiemetic at Kanazawa University Hospital during January 2005 - December 2009. Patients were categorized into three groups; no dexamethasone use (Dex (-)), dexamethasone on day 2 (Dex 1 day), and dexamethasone on days 2, 3 and 4 (Dex multiday). We evaluated the incidence of grade 3/4 neutropenia and the day of onset of first severe neutropenic episode during the first course of MVAC chemotherapy. Logistic regression was used to investigate whether co-administration of dexamethasone was a risk factor for severe neutropenia. Episodes of grade 3/4 neutropenia occurred in 3 out of 6 (50.0%), 11 out of 12 (91.7%) and 6 out of 6 (100%) patients in the Dex (-), Dex 1 day, and Dex multiday groups, respectively. The appearance day of first severe neutropenia in the Dex multiday group (13.2 ± 1.0) was significantly accelerated compared to the Dex (-) group (17.7 ± 2.1). Univariate logistic regression analysis revealed that dexamethasone is a risk factor for severe neutropenia (OR 17.0; 95%CI: 1.3-223.1). Co-administration of dexamethasone for anti-emesis brings forward the first appearance of neutropenia, and increases the severity of neutropenia, in bladder cancer patients receiving MVAC chemotherapy.

Comparison of the use of sodium carbonate (washing soda crystals) and apomorphine for inducing emesis in dogs.

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Yam, E; Hosgood, G; Smart, L

2016-12-01

To describe the use of sodium carbonate and apomorphine in a historical cohort of dogs, compare the occurrence of emesis and report any adverse effects recorded. This historical, observational study included information from medical records of dogs that received an emetic agent. The occurrence of emesis with apomorphine or sodium carbonate was calculated and the association between emesis and agent was explored, with the odds ratio and 95% confidence interval (CI) reported. A non-inferiority analysis of the occurrence of emesis for sodium carbonate was performed against an equivalence range of ±7% of the estimated occurrence of emesis with apomorphine. Owners were emailed a short survey about their dog's health after their visit to the hospital for induced emesis. Records for 787 dogs seen from January 2007 to December 2013 were included. For apomorphine, 382/392 dogs showed emesis (97%, 95% CI 95-100%). For sodium carbonate, 320/395 dogs showed emesis (81%, 95% CI 77-85%), which fell below the equivalence range for apomorphine (97 ± 7%, 90-100%) and was considered inferior. The odds ratio of emesis with apomorphine to sodium carbonate was 9.0 (95% CI 4.6-17.6). Of 18 responses to the survey, 5 reported abnormalities after emesis (3 with sodium carbonate, 2 with apomorphine). The occurrence of emesis with sodium carbonate was high but inferior to apomorphine. However, the advantages of sodium carbonate, including less expense and ease of accession compared with apomorphine, make it a viable choice in emergency medicine. © 2016 Australian Veterinary Association.

Contrasting Effects of Lithium Chloride and CB1 Receptor Blockade on Enduring Changes in the Valuation of Reward.

Science.gov (United States)

Hernandez, Giovanni; Bernstein, David; Schoenbaum, Geoffrey; Cheer, Joseph F

2011-01-01

When an organism responds for a reward, its learned behavior can be characterized as goal-directed or habitual based on whether or not it is susceptible to reward devaluation. Here, we evaluated whether instrumental responding for brain stimulation reward (BSR) can be devalued using a paradigm traditionally used for natural rewards. Rats were trained to lever press for BSR; afterward, BSR was paired with either lithium chloride (LiCl, 5 mg/kg, i.p.), a pro-emetic, or AM251, a CB1 receptor antagonist (3 mg/kg, i.p.) or the vehicle of these compounds. Pairings of BSR with these compounds and their vehicles were performed in a novel environment so that only unconditional effects of BSR would be affected by the pharmacological manipulations. Subsequently, in a probe test, all rats were returned in the drug-free state to the boxes where they had received training and instrumental responding was reassessed in the absence of BSR delivery. When compared to control, LiCl produced a significant decrease in the number of responses during the test session, whereas AM251 did not. These results show that instrumental responding for BSR is susceptible to devaluation, in accord with the proposal that this behavior is supported at least in part by associations between the response and the rewarding outcome. Further, they suggest that reward modulation observed in studies involving the use of CB1 receptor antagonists arises from changes in the organism's motivation rather than drug-induced changes in the intrinsic value of reward.

Hepatic artery embolization for treatment of patients with hereditary hemorrhagic telangiectasia and symptomatic hepatic vascular malformations

Energy Technology Data Exchange (ETDEWEB)

Chavan, Ajay [Hannover Medical School, Department of Diagnostic Radiology, Hannover (Germany); Klinikum Oldenburg, Department of Radiology and Nuclear Medicine, Oldenburg (Germany); Caselitz, Martin; Wagner, Siegfried; Manns, Michael [Hannover Medical School, Department of Gastroenterology and Hepatology, Hannover (Germany); Gratz, Karl-Friedrich [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Lotz, Joachim; Kirchhoff, Timm; Galanski, Michael [Hannover Medical School, Department of Diagnostic Radiology, Hannover (Germany); Piso, Plinio [Hannover Medical School, Department of Abdominal and Transplantation Surgery, Hannover (Germany)

2004-11-01

At present there is no established therapy for treating patients with hereditary hemorrhagic telangiectasia (HHT) and symptomatic hepatic involvement. We present the results of a prospective study with 15 consecutive patients who were treated with staged hepatic artery embolization (HAE). Branches of the hepatic artery were selectively catheterized and embolized in stages using polyvinyl alcohol particles (PVA) and platinum microcoils or steel macrocoils. Prophylactic antibiotics, analgesics and anti-emetics were administered after every embolization. Clinical symptomatology and cardiac output were assessed before and after therapy as well as at the end of follow-up (median 28 months; range 10-136 months). Five patients had abdominal pain and four patients had symptoms of portal hypertension. The cardiac output was raised in all patients, with cardiac failure being present in 11 patients. After treatment, pain resolved in all five patients, and portal hypertension improved in two of the four patients. The mean cardiac output decreased significantly (P<0.001) from 12.57{+-}3.27 l/min pre-treatment to 8.36{+-}2.60 l/min at the end of follow-up. Symptoms arising from cardiac failure resolved or improved markedly in all but one patient. Cholangitis and/or cholecystitis occurred in three patients of whom two required a cholecystectomy. One patient with pre-existent hepatic cirrhosis died as a complication of the procedure. Staged HAE yields long-term relief of clinical symptoms in patients with HHT and hepatic involvement. Patients with pre-existing hepatic cirrhosis may be poor candidates for HAE. (orig.)

Comparison of treatment patterns and economic outcomes among metastatic pancreatic cancer patients initiated on nab-paclitaxel plus gemcitabine versus FOLFIRINOX.

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McBride, Ali; Bonafede, Machaon; Cai, Qian; Princic, Nicole; Tran, Oth; Pelletier, Corey; Parisi, Monika; Patel, Manish

2017-10-01

The economic burden of metastatic pancreatic cancer (mPC) is substantial while treatment options are limited. Little is known about the treatment patterns and healthcare costs among mPC patients who initiated first-line gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-P + G) and FOLFIRINOX. The MarketScan® claims databases were used to identify adults with ≥2 claims for pancreatic cancer, 1 claim for a secondary malignancy, completed ≥1 cycle of nab-P + G or FOLFIRINOX during 4/1/2013 and 3/31/2015, and had continuous plan enrollment for ≥6 months pre- and 3 months after the first-line treatment. Duration of therapy, per patient per month (PPPM) costs of total healthcare, mPC-related treatment, and supportive care were measured during first-line therapy. 550 mPC patients met selection criteria (nab-P + G, n = 294; FOLFIRINOX, n = 256). There was no difference in duration of therapy (p = 0.60) between nab-P + G and FOLFIRINOX. Compared with FOLFIRINOX, patients with nab-P + G had higher chemotherapy drug costs but lower treatment administration costs and supportive care costs (all p < 0.01). Patients treated with nab-P + G (vs FOLFIRINOX) had similar treatment duration but lower costs of outpatient prescriptions, treatment administration and supportive care. Lower supportive care costs in the nab-P + G cohort were mainly driven by lower utilization of pegfilgrastim and anti-emetics.

Comparing nonsynergistic gamma models with interaction models to predict growth of emetic Bacillus cereus when using combinations of pH and individual undissociated acids as growth-limiting factors

NARCIS (Netherlands)

Biesta-Peters, E.G.; Reij, M.W.; Gorris, L.G.M.; Zwietering, M.H.

2010-01-01

A combination of multiple hurdles to limit microbial growth is frequently applied in foods to achieve an overall level of protection. Quantification of hurdle technology aims at identifying synergistic or multiplicative effects and is still being developed. The gamma hypothesis states that

Methicillin sensitive Staphylococcus aureus producing Panton-Valentine leukocidin toxin in Trinidad & Tobago: a case report

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Rao AV

2011-04-01

Full Text Available Abstract Introduction Certain Staphylococcus aureus strains produce Panton-Valentine leukocidin, a toxin that lyses white blood cells causing extensive tissue necrosis and chronic, recurrent or severe infection. This report documents a confirmed case of methicillin-sensitive Staphylococcus aureus strain harboring Panton-Valentine leukocidin genes from Trinidad and Tobago. To the best of our knowledge, this is the first time that such a case has been identified and reported from this country. Case presentation A 13-year-old Trinidadian boy of African descent presented with upper respiratory symptoms and gastroenteritis-like syptoms. About two weeks later he was re-admitted to our hospital complaining of pain and weakness affecting his left leg, where he had received an intramuscular injection of an anti-emetic drug. He deteriorated and developed septic arthritis, necrotizing fasciitis and septic shock with acute respiratory distress syndrome, leading to death within 48 hours of admission despite intensive care treatment. The infection was caused by S. aureus. Bacterial isolates from specimens recovered from our patient before and after his death were analyzed using microarray DNA analysis and spa typing, and the results revealed that the S. aureus isolates belonged to clonal complex 8, were methicillin-susceptible and positive for Panton-Valentine leukocidin. An autopsy revealed multi-organ failure and histological tissue stains of several organs were also performed and showed involvement of his lungs, liver, kidneys and thymus, which showed Hassal's corpuscles. Conclusion Rapid identification of Panton-Valentine leukocidin in methicillin-sensitive S. aureus isolates causing severe infections is necessary so as not to miss their potentially devastating consequences. Early feedback from the clinical laboratories is crucial.

Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study.

Science.gov (United States)

Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

2015-03-01

The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

From Chemotherapy-Induced Emesis to Neuroprotection: Therapeutic Opportunities for 5-HT3 Receptor Antagonists.

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Fakhfouri, Gohar; Mousavizadeh, Kazem; Mehr, Sharam Ejtemaei; Dehpour, Ahmad Reza; Zirak, Mohammad Reza; Ghia, Jean-Eric; Rahimian, Reza

2015-12-01

5-HT3 receptor antagonists are extensively used as efficacious agents in counteracting chemotherapy-induced emesis. Recent investigations have shed light on other potential effects (analgesic, anxiolytic, and anti-psychotic). Some studies have reported neuroprotective properties for the 5-HT3 receptor antagonists in vitro and in vivo. When administered to Aβ-challenged rat cortical neurons, 5-HT3 receptor antagonists substantially abated apoptosis, elevation of cytosolic Ca(2), glutamate release, reactive oxygen species (ROS) generation, and caspase-3 activity. In addition, in vivo studies show that 5-HT3 receptor antagonists possess, alongside their anti-emetic effects, notable immunomodulatory properties in CNS. We found that pretreatment with tropisetron significantly improved neurological deficits and diminished leukocyte transmigration into the brain, TNF-α level, and brain infarction in a murine model of embolic stroke. Our recent investigation revealed that tropisetron protects against Aβ-induced neurotoxicity in vivo through both 5-HT3 receptor-dependent and -independent pathways. Tropisetron, in vitro, was found to be an efficacious inhibitor of the signaling pathway leading to the activation of pro-inflammatory NF-κB, a transcription factor pivotal to the upregulation of several neuroinflammatory mediators in brain. This mini review summarizes novel evidence concerning effects of 5-HT3 antagonists and their possible mechanisms of action in ameliorating neurodegenerative diseases including Alzheimer, multiple sclerosis, and stroke. Further, we discuss some newly synthesized 5-HT3 receptor antagonists with dual properties of 5-HT3 receptor blockade/alpha-7 nicotinic receptor activator and their potential in management of memory impairment. Since 5-HT3 receptor antagonists possess a large therapeutic window, they can constitute a scaffold for design and synthesis of new neuroprotective medications.

Proximate compositions and bioactive compounds of edible wild and cultivated mushrooms from Northeast Thailand

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Amporn Srikram

2016-11-01

Full Text Available Mushrooms are known as an excellent source of nutrients including macronutrients and bioactive compounds. Nutritional values were investigated involving proximate analysis, total antioxidant capacity (TAC, total phenol content (TPC and total flavonoid content (TFC of 10 edible wild mushroom species—Amanita calyptroderma Ark. et al., Amanita princeps Corner et Bas, A., Astraeus odoratus, Heimiella retispora (Pat. et. Bak. Boedijn., Mycoamaranthus cambodgensis (Pat. Trappe, Russula alboareolata Hongo, Russula cyanoxantha Schaeff.ex.Fr., Russula emetic (Schaeff. ex Fr. S.F.Gray., Russula virescens (Schaeff. fr., Termitomyces clypeatus Heim—and five cultivated mushroom species—Auricularia auricula-judae, Lentinus polychrous Lev., Lentinus squarrosulus Mont., Pleurotus sajor-caju (Fr. Sing, Volvariella vovacea (Bull. Ex.Fr. Sing. From the proximate analysis, the moisture contents of both wild and cultivated mushrooms ranged from 84.15% fresh weight (FW to 90.21% FW. The ash, crude protein, fat, crude fiber and carbohydrate contents of both wild and cultivated mushrooms were in the dry weight ranges 2.56–13.96%, 11.16–50.29%, 1.43–21.94%, 2.11–38.11% and 9.56–59.73%, respectively, and the contents of macronutrients in the mushrooms varied by variety. Wild mushrooms had a high fiber content compared to cultivated mushrooms. The contents of biologically active compounds of both wild and cultivated mushrooms also varied depending on the variety. Values for the TAC, TPC and TFC of wild mushrooms were higher than those of cultivated mushrooms. In conclusion, the proximate analysis for both wild and cultivated mushrooms was variety dependent and wild mushrooms contained a higher fiber content and more biologically active compounds than cultivated mushrooms.

Cannabinoid-Induced Hyperemesis: A Conundrum—From Clinical Recognition to Basic Science Mechanisms

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Nissar A. Darmani

2010-07-01

Full Text Available Cannabinoids are used clinically on a subacute basis as prophylactic agonist antiemetics for the prevention of nausea and vomiting caused by chemotherapeutics. Cannabinoids prevent vomiting by inhibition of release of emetic neurotransmitters via stimulation of presynaptic cannabinoid CB1 receptors. Cannabis-induced hyperemesis is a recently recognized syndrome associated with chronic cannabis use. It is characterized by repeated cyclical vomiting and learned compulsive hot water bathing behavior. Although considered rare, recent international publications of numerous case reports suggest the contrary. The syndrome appears to be a paradox and the pathophysiological mechanism(s underlying the induced vomiting remains unknown. Although some traditional hypotheses have already been proposed, the present review critically explores the basic science of these explanations in the clinical setting and provides more current mechanisms for the induced hyperemesis. These encompass: (1 pharmacokinetic factors such as long half-life, chronic exposure, lipid solubility, individual variation in metabolism/excretion leading to accumulation of emetogenic cannabinoid metabolites, and/or cannabinoid withdrawal; and (2 pharmacodynamic factors including switching of the efficacy of Δ9-THC from partial agonist to antagonist, differential interaction of Δ9-THC with Gs and Gi signal transduction proteins, CB1 receptor desensitization or downregulation, alterations in tissue concentrations of endocannabinoid agonists/inverse agonists, Δ9-THC-induced mobilization of emetogenic metabolites of the arachidonic acid cascade, brainstem versus enteric actions of Δ9-THC, and/or hypothermic versus hyperthermic actions of Δ9-THC. In addition, human and animal findings suggest that chronic exposure to cannabis may not be a prerequisite for the induction of vomiting but is required for the intensity of emesis.

Enhanced tolerability of the 5-hydroxytryptophane challenge test combined with granisetron.

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Jacobs, G E; Kamerling, I M C; de Kam, M L; Derijk, R H; van Pelt, J; Zitman, F G; van Gerven, J M A

2010-01-01

A recently developed oral serotonergic challenge test consisting of 5-Hydroxytryptophane (5-HTP, 200 mg) combined with carbidopa (CBD, 100 mg + 50 mg) exhibited dose-related neuroendocrine responsiveness and predictable pharmacokinetics. However, its applicability is limited by nausea and vomiting. A randomized, double-blind, placebo-controlled, four-way crossover trial was performed in 12 healthy male volunteers. The 5-HTP/CBD-challenge was combined with two oral anti-emetics (granisetron, 2 mg or domperidone, 10 mg) to investigate its reliability when side-effects are suppressed. The neuroendocrine response (serum cortisol and prolactin), the side-effect profile [Visual Analogue Scale Nausea (VAS)] and vomiting subjects per treatment were the main outcome measures. Compared to 5-HTP/CBD/placebo, 5-HTP/CBD/ granisetron had no impact on cortisol [% change with 95% confidence interval: -7.1% (18.9; 6.5)] or prolactin levels [-9.6% (-25.1; 9.1)]; 5-HTP/CBD/domperidone increased cortisol [+13.0% (-4.2; 33.4)], and increased prolactin extensively [+336.8% (245.7; 451.9)]. Compared to placebo, VAS Nausea increased non-significantly with granisetron [+7.6 mm (-1.3; 16.5)], as opposed to domperidone [+16.2 mm (7.2; 25.2)] and 5-HTP/CBD/placebo [+14.7 mm (5.5; 23.8)]. No subjects vomited with granisetron, compared to two subjects treated with 5-HTP/CBD/placebo and five subjects with domperidone. Compared with 5-HTP/CBD/placebo, granisetron addition decreased C(max) of 5-HTP statistically significantly different (from 1483 to 1272 ng/ml) without influencing AUC(0- infinity). Addition of granisetron to the combined 5-HTP/CBD challenge suppresses nausea and vomiting without influencing the neuroendocrine response or pharmacokinetics, enhancing its clinical applicability in future psychiatric research and drug development.

A Paramedic-staffed Helicopter Emergency Medical Service's Response to Winch Missions in Victoria, Australia.

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Meadley, Ben; Heschl, Stefan; Andrew, Emily; de Wit, Anthony; Bernard, Stephen A; Smith, Karen

2016-01-01

Winching emergency medical care providers from a helicopter to the scene enables treatment of patients in otherwise inaccessible locations, but is not without risks. The objective of this study was to define characteristics of winch missions undertaken by Intensive Care Flight Paramedics (ICFP) in Victoria, Australia with a focus on extraction methods and clinical care delivered at the scene. A retrospective data analysis was performed to identify all winch missions between November 2010 and March 2014. Demographic data, winch characteristics, physiological parameters, and interventions undertaken on scene by the ICFP were extracted. Out of 5,003 missions in the study period, 125 were identified as winch operations. Winter missions were significantly less frequent than those of any other season. Patients were predominantly male (78.4%) and had a mean age of 38 years (±17.6). A total of 109 (87.2%) patients were identified as experiencing trauma with a mean Revised Trauma Score of 7.5288, and isolated limb fractures were the most frequently encountered injury. Falls and vehicle-related trauma were the most common mechanisms of injury. The total median scene duration was 49 minutes (IQR 23-91). Sixty-three patients (50.4%) were extracted using a stretcher, 45 (36.0%) using a hypothermic strop, and 6 (4.8%) via normal rescue strop. Eleven patients (8.8%) were not winched to the helicopter. Vascular access (38.4%), analgesia (44.0%), and anti-emetic administration (28.8%) were the most frequent clinical interventions. Forty-nine patients (39.2%) did not receive any clinical intervention prior to winch extraction. Winch operations in Victoria, Australia consisted predominantly of patients with minor to moderate traumatic injuries. A significant proportion of patients did not require any clinical treatment prior to winching, and among those who did, analgesia was the most frequent intervention. Advanced medical procedures were rarely required prior to winch extraction.

Simultaneous determination of domperidone and Itopride in pharmaceuticals and human plasma using RP-HPLC/UV detection: Method development, validation and application of the method in in-vivo evaluation of fast dispersible tablets.

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Khan, Amjad; Iqbal, Zafar; Khadra, Ibrahim; Ahmad, Lateef; Khan, Abad; Khan, Muhammad Imran; Ullah, Zia; Ismail

2016-03-20

Domperidone and Itopride are pro-kinetic agents, regulating the gastric motility and are commonly prescribed as anti emetic drugs. In the present study a simple, rapid and sensitive RP-HPLC/UV method was developed for simultaneous determination of Domperidone and Itopride in pharmaceutical samples and human plasma, using Tenofavir as internal standard. Experimental conditions were optimized and method was validated according to the standard guidelines. Combination of water (pH 3.0) and acetonitrile (65:35 v/v) was used as mobile phase, pumped at the flow rate of 1.5 ml/min. Detector wavelength was set at 210 nm and column oven temperature was 40oC. Unlike conventional liquid-liquid extraction, simple precipitation technique was applied for drug extraction from human plasma using acetonitrile for deprotienation. The method showed adequate separation of both the analytes and best resolution was achieved using Hypersil BDS C8 column (150 mm × 4.6 mm, 5 μm). The method was quite linear in the range of 20-600 ng/ml. Recovery of the method was 92.31% and 89.82% for Domperidone and Itopride, respectively. Retention time of both the analytes and internal standard was below 15 min. The lower limit of detection (LLOD) and lower limit of quantification (LLOQ) for Domperidone were 5 and 10 ng/ml while for Itopride was 12 and 15 ng/ml, respectively. The developed method was successfully applied for in-vivo analysis of fast dispersible tablets of Domperidone in healthy human volunteer. The proposed method was a part of formulation development study and was efficiently applied for determination of the two drugs in various pharmaceutical products and human plasma. Copyright © 2015 Elsevier B.V. All rights reserved.

A Study To Assess the Numbers and Prevalence of Bacillus cereus and Its Toxins in Pasteurized Fluid Milk.

Science.gov (United States)

Saleh-Lakha, Saleema; Leon-Velarde, Carlos G; Chen, Shu; Lee, Susan; Shannon, Kelly; Fabri, Martha; Downing, Gavin; Keown, Bruce

2017-07-01

Bacillus cereus is a pathogenic adulterant of raw milk and can persist as spores and grow in pasteurized milk. The objective of this study was to determine the prevalence of B. cereus and its enterotoxins in pasteurized milk at its best-before date when stored at 4, 7, and 10°C. More than 5.5% of moderately temperature-abused products (stored at 7°C) were found to contain >10 5 CFU/mL B. cereus , and about 4% of them contained enterotoxins at a level that may result in foodborne illness; in addition, more than 31% of the products contained >10 5 CFU/mL B. cereus and associated enterotoxins when stored at 10°C. Results from a growth kinetic study demonstrated that enterotoxin production by B. cereus in pasteurized milk can occur in as short as 7 to 8 days of storage at 7°C. The higher B. cereus counts were associated with products containing higher butterfat content or with those produced using the conventional high-temperature, short-time pasteurization process. Traditional indicators, aerobic colony counts and psychrotrophic counts, were found to have no correlation with level of B. cereus in milk. The characterization of 17 representative B. cereus isolates from pasteurized milk revealed five toxigenic gene patterns, with all the strains carrying genes encoding for diarrheal toxins but not for an emetic toxin, and with one strain containing all four diarrheal enterotoxin genes (nheA, entFM, hblC, and cytK). The results of this study demonstrate the risks associated even with moderately temperature-abused pasteurized milk and the necessity of a controlled cold chain throughout the shelf life of fluid milk to enhance product safety and minimize foodborne illness.

Contrôle de vira-cabeça do tomate pela destruição do vetor

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A. S. Costa

1950-01-01

Full Text Available Vários inseticidas foram ensaiados no contrôle da moléstia de vírus do tomateiro denominada vira-cabeça, transmitida por um tripes do gênero Frankliniella. Os resultados obtidos nestes ensaios mostraram que, dos inseticidas ensaiados, Rhodiatox e Hexason 2540M foram os mais eficientes. Os dados obtidos permitem que se sugira o seguinte programa de pulverização de tomateiros, para o contrôle de vira-cabeça. Na sementeira: Pulverizações de 3 a 5 dias com Rhodiatox (0,25 a 0,50% ou Hexason 2540M (0,15%. No canteiro de repicagem: Pulverizações cada 3 a 5 dias com Rhodiatox (0,50% ou Hexason 2540M (0,15%. Na plantação definitiva: Pulverizações cada 5 a 7 dias com Rhodiatox (0,50% a 1% ou Hexason 2540M (0,25% até cêrca de 40 dias após a transplantação.Spraying tests were made with several insecticides in an attempt to control the "vira-cabeça" disease of tomatoes (tomato spotted wilt by killing the insect vector, a species of thrips belonging to the genus Frankliniella. The results obtained indicate that Rhodiatox (Brazilian trade name for a commercial preparation similar to Parathion, containing 5 per cent of p-nitrophenyl diethyl thiosphosphate and Hexason 2540 M (a mixture of BHC with 2% gamma isomer, 5 per cent DDT and 40 per cent wettable sulfur were better than tartar emetic or toxaphene, although these were somewhat effective. Based on the results of these tests a tentative spraying program for the control of the disease in local tomato plantings is suggested.

Combination of gabapentin and ramosetron for the prevention of postoperative nausea and vomiting after gynecologic laparoscopic surgery: a prospective randomized comparative study.

Science.gov (United States)

Kim, Kyung Mi; Huh, Jin; Lee, Soo Kyung; Park, Eun Young; Lee, Jung Min; Kim, Hyo Ju

2017-05-19

As a drug originally introduced for its anticonvulsant effects, gabapentin has been recently shown to be effective in the treatment of nausea and vomiting in various clinical settings. This study compared the antiemetic efficacy of oral gabapentin, intravenous ramosetron and gabapentin plus ramosetron in patients receiving fentanyl-based patient-controlled analgesia after laparoscopic gynecologic surgery. One hundred and thirty two patients undergoing laparoscopic gynecologic surgery under general anesthesia were allocated randomly into three groups: group G received 300 mg oral gabapentin 1 h before anesthesia, group R received 0.3 mg intravenous ramosetron at the end of surgery, and group GR received a combination of 300 mg oral gabapentin 1 h before anesthesia and 0.3 mg intravenous ramosetron at the end of surgery. Postoperative nausea, retching, vomiting, rescue antiemetic drug use, pain, rescue analgesic requirements and adverse effects were assessed at 0-2, 2-24 and 24-48 h after surgery. Postoperative nausea and vomiting (PONV) was defined as the presence of nausea, retching or vomiting. The incidence of complete response (no PONV and no rescue antiemetics up to 48 h postoperatively) was significantly higher in group GR (26/40, 65%) than group G (16/40, 40%; P = 0.025) and group R (18/44, 41%; P = 0.027), whereas there was no significant difference between group G and group R (P = 0.932). There were no significant between-group differences in the incidence of emetic episodes, use of rescue antiemetics, severe emesis, use of rescue analgesics or any adverse effects. Postoperative pain scores were also similar among groups. The combination with gabapentin and ramosetron is superior to either drug alone for prevention of PONV after laparoscopic gynecologic surgery. ClinicalTrials.gov NCT02617121 , registered November 25, 2015.

Synthesis, Pharmacological Profile and Docking Studies of New Sulfonamides Designed as Phosphodiesterase-4 Inhibitors.

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Isabelle Karine da Costa Nunes

Full Text Available Prior investigations showed that increased levels of cyclic AMP down-regulate lung inflammatory changes, stimulating the interest in phosphodiesterase (PDE4 as therapeutic target. Here, we described the synthesis, pharmacological profile and docking properties of a novel sulfonamide series (5 and 6a-k designed as PDE4 inhibitors. Compounds were screened for their selectivity against the four isoforms of human PDE4 using an IMAP fluorescence polarized protocol. The effect on allergen- or LPS-induced lung inflammation and airway hyper-reactivity (AHR was studied in A/J mice, while the xylazine/ketamine-induced anesthesia test was employed as a behavioral correlate of emesis in rodents. As compared to rolipram, the most promising screened compound, 6a (LASSBio-448 presented a better inhibitory index concerning PDE4D/PDE4A or PDE4D/PDE4B. Accordingly, docking analyses of the putative interactions of LASSBio-448 revealed similar poses in the active site of PDE4A and PDE4C, but slight unlike orientations in PDE4B and PDE4D. LASSBio-448 (100 mg/kg, oral, 1 h before provocation, inhibited allergen-induced eosinophil accumulation in BAL fluid and lung tissue samples. Under an interventional approach, LASSBio-448 reversed ongoing lung eosinophilic infiltration, mucus exacerbation, peribronchiolar fibrosis and AHR by allergen provocation, in a mechanism clearly associated with blockade of pro-inflammatory mediators such as IL-4, IL-5, IL-13 and eotaxin-2. LASSBio-448 (2.5 and 10 mg/kg also prevented inflammation and AHR induced by LPS. Finally, the sulfonamide derivative was shown to be less pro-emetic than rolipram and cilomilast in the assay employed. These findings suggest that LASSBio-448 is a new PDE4 inhibitor with marked potential to prevent and reverse pivotal pathological features of diseases characterized by lung inflammation, such as asthma.

Comparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section.

LENUS (Irish Health Repository)

McMorrow, R C N

2012-02-01

BACKGROUND: Transversus abdominis plane (TAP) block is an alternative to spinal morphine for analgesia after Caesarean section but there are few data on its comparative efficacy. We compared the analgesic efficacy of the TAP block with and without spinal morphine after Caesarean section in a prospective, randomized, double-blinded placebo-controlled trial. METHODS: Eighty patients were randomized to one of four groups to receive (in addition to spinal anaesthesia) either spinal morphine 100 microg (S(M)) or saline (S(S)) and a postoperative bilateral TAP block with either bupivacaine (T(LA)) 2 mg kg(-1) or saline (T(S)). RESULTS: Pain on movement and early morphine consumption were lowest in groups receiving spinal morphine and was not improved by TAP block. The rank order of median pain scores on movement at 6 h was: S(M)T(LA) (20 mm)emetic use and pruritus were highest in the S(M)T(LA) group. CONCLUSIONS: Spinal morphine-but not TAP block-improved analgesia after Caesarean section. The addition of TAP block with bupivacaine 2 mg kg(-1) to spinal morphine did not further improve analgesia.

Review article: clinical implications of enteric and central D2 receptor blockade by antidopaminergic gastrointestinal prokinetics.

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Tonini, M; Cipollina, L; Poluzzi, E; Crema, F; Corazza, G R; De Ponti, F

2004-02-15

Antidopaminergic gastrointestinal prokinetics (bromopride, clebopride, domperidone, levosulpiride and metoclopramide) have been exploited clinically for the management of motor disorders of the upper gastrointestinal tract, including functional dyspepsia, gastric stasis of various origins and emesis. The prokinetic effect of these drugs is mediated through the blockade of enteric (neuronal and muscular) inhibitory D2 receptors. The pharmacological profiles of the marketed compounds differ in terms of their molecular structure, affinity at D2 receptors, ability to interact with other receptor systems [5-hydroxytryptamine-3 (5-HT3) and 5-HT4 receptors for metoclopramide; 5-HT4 receptors for levosulpiride) and ability to permeate the blood-brain barrier (compared with the other compounds, domperidone does not easily cross the barrier). It has been suggested that the serotonergic (5-HT4) component of some antidopaminergic prokinetics may enhance their therapeutic efficacy in gastrointestinal disorders, such as functional dyspepsia and diabetic gastroparesis. The antagonism of central D2 receptors may lead to both therapeutic (e.g. anti-emetic effect due to D2 receptor blockade in the area postrema) and adverse (including hyperprolactinaemia and extrapyramidal dystonic reactions) effects. As the pituitary (as well as the area postrema) is outside the blood-brain barrier, hyperprolactinaemia is a side-effect occurring with all antidopaminergic prokinetics, although to different extents. Extrapyramidal reactions are most commonly observed with compounds crossing the blood-brain barrier, although with some differences amongst the various agents. Prokinetics with a high dissociation constant compared with that of dopamine at the D2 receptor (i.e. compounds that bind loosely to D2 receptors in the nigrostriatal pathway) elicit fewer extrapyramidal signs and symptoms. A knowledge of central and peripheral D2 receptor pharmacology can help the clinician to choose between the

Prescription Patterns and the Cost of Migraine Treatments in German General and Neurological Practices.

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Jacob, Louis; Kostev, Karel

2017-07-01

The aim of this study was to analyze prescription patterns and the cost of migraine treatments in general practices (GPs) and neurological practices (NPs) in Germany. This study included 43,149 patients treated in GPs and 13,674 patients treated in NPs who were diagnosed with migraine in 2015. Ten different families of migraine therapy were included in the analysis: triptans, analgesics, anti-emetics, beta-blockers, antivertigo products, gastroprokinetics, anti-epileptics, calcium channel blockers, tricyclic antidepressants, and other medications (all other classes used in the treatment of migraine including homeopathic medications). The share of migraine therapies and their costs were estimated for GPs and NPs. The mean age was 44.4 years in GPs and 44.1 years in NPs. Triptans and analgesics were the 2 most commonly prescribed families of drugs in all patients and in the 9 specific subgroups. Interestingly, triptans were more commonly prescribed in NPs than in GPs (30.9% to 55.0% vs. 30.0% to 44.7%), whereas analgesics were less frequently given in NPs than in GPs (11.5% to 17.2% vs. 35.3% to 42.4%). Finally, the share of patients who received no therapy was higher in NPs than in GPs (33.9% to 58.4% vs. 27.5% to 37.9%). The annual cost per patient was €66.04 in GPs and €94.71 in NPs. Finally, the annual cost per patient increased with age and was higher in women and in individuals with private health insurance coverage than in men and individuals with public health insurance coverage. Triptans and analgesics were the 2 most commonly prescribed drugs for the treatment of migraine. Furthermore, approximately 30% to 40% of patients did not receive any therapy. Finally, the annual cost per patient was higher in NPs than in GPs. © 2016 World Institute of Pain.

Bacillus cereus un patógeno importante en el control microbiológico de los alimentos / Bacillus cereus an important pathogen the microbiological control of food

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Jennifer Sánchez

2016-05-01

Full Text Available Resumen Bacillus cereus es una bacteria genéticamente diversa que se encuentra comúnmente en el ambiente. Contamina los alimentos afectando la salud humana, al ingerir el microorganismo y/o sus toxinas, la emética o las enterotoxinas. En Colombia son escasos los reportes de intoxicación por B. cereus y se estima que hay un gran subregistro. Por lo anterior, se recomienda aumentar la vigilancia de este patógeno y realizar estudios sobre aspectos relevantes que permitan aplicar medidas de control para disminuir las intoxicaciones por B. cereus. El objetivo de esta revisión bibliográfica es presentar información actualizada sobre B. cereus, que incluye aspectos de su biología, taxonomía, toxinas, alimentos que contamina y metodologías para detectar, prevenir y controlar este microorganismo. La información presentada es de utilidad para el público en general, especialmente personas vinculadas al sector de alimentos, inocuidad alimentaria y control de procesos. / Abstract Bacillus cereus is a genetically diverse bacterium commonly found in the environment. It contaminates food, thus affecting human health upon ingestion of the microorganism and/or its toxins, the emetic or enterotoxins. In Colombia, reports of intoxication by B. cereus are scarce and under-registration is presumed. Because of this, it is recommended to increase surveillance of this pathogen and to develop studies on relevant aspects that allow the application of control measures to reduce intoxications by B. cereus. The aim of this review is to present current information on B. cereus, including aspects of its biology, taxonomy, toxins, food that it contaminates and methodologies for the detection, prevention and control of this microorganism. This information is useful for the general public, especially people involved with the food sector, food safety and process control.

Taste-aversion-prone (TAP) rats and taste-aversion-resistant (TAR) rats differ in ethanol self-administration, but not in ethanol clearance or general consumption.

Science.gov (United States)

Orr, T Edward; Whitford-Stoddard, Jennifer L; Elkins, Ralph L

2004-05-01

Taste-aversion (TA)-prone (TAP) rats and TA-resistant (TAR) rats have been developed by means of bidirectional selective breeding on the basis of their behavioral responses to a TA conditioning paradigm. The TA conditioning involved the pairing of an emetic-class agent (cyclophosphamide) with a novel saccharin solution as the conditioned stimulus. Despite the absence of ethanol in the selective breeding process, these rat lines differ widely in ethanol self-administration. In the current study, blood alcohol concentrations (BACs) were determined after 9 days of limited (2 h per day) access to a simultaneous, two-bottle choice of a 10% ethanol in water solution [volume/volume (vol./vol.)] or plain water. The BACs correlated highly with ethanol intake among TAR rats, but an insufficient number of TAP rats yielded measurable BACs to make the same comparison within this rat line. The same rats were subsequently exposed to 24-h access of a two-bottle choice (10% ethanol or plain water) for 8 days. Ethanol consumption during the 24-h access period correlated highly with that seen during limited access. Subsequent TA conditioning with these rats yielded line-typical differences in saccharin preferences. In a separate group of rats, ethanol clearance was determined by measuring BACs at 1, 4, and 7 h after injection of a 2.5-g/kg dose of ethanol. Ethanol clearance was not different between the two lines. Furthermore, the lines did not differ with respect to food and water consumption. Therefore, the TAP rat-TAR rat differences in ethanol consumption cannot be attributed to line differences in ethanol metabolism or in general consummatory behavior. The findings support our contention that the line differences in ethanol consumption are mediated by differences in TA-related mechanisms. The findings are discussed with respect to genetically based differences in the subjective experience of ethanol.

Mice deficient in phosphodiesterase-4A display anxiogenic-like behavior.

Science.gov (United States)

Hansen, Rolf T; Conti, Marco; Zhang, Han-Ting

2014-08-01

Phosphodiesterases (PDEs) are a super family of enzymes responsible for the halting of intracellular cyclic nucleotide signaling and may represent novel therapeutic targets for treatment of cognitive disorders. PDE4 is of considerable interest to cognitive research because it is highly expressed in the brain, particularly in the cognition-related brain regions. Recently, the functional role of PDE4B and PDE4D, two of the four PDE4 subtypes (PDE4A, B, C, and D), in behavior has begun to be identified; however, the role of PDE4A in the regulation of behavior is still unknown. The purpose of this study was to characterize the functional role of PDE4A in behavior. The role of PDE4A in behavior was evaluated through a battery of behavioral tests using PDE4A knockout (KO) mice; urine corticosterone levels were also measured. PDE4A KO mice exhibited improved memory in the step-through-passive-avoidance test. They also displayed anxiogenic-like behavior in elevated-plus maze, holeboard, light-dark transition, and novelty suppressed feeding tests. Consistent with the anxiety profile, PDE4A KO mice had elevated corticosterone levels compared with wild-type controls post-stress. Interestingly, PDE4A KO mice displayed no change in object recognition, Morris water maze, forced swim, tail suspension, and duration of anesthesia induced by co-administration of xylazine and ketamine (suggesting that PDE4A KO may not be emetic). These results suggest that PDE4A may be important in the regulation of emotional memory and anxiety-like behavior, but not emesis. PDE4A could possibly represent a novel therapeutic target in the future for anxiety or disorders affecting memory.

Frequency of cardiac defects among children at echocardiography centre in a teaching hospital

International Nuclear Information System (INIS)

Malik, A.S.; Majeed, R.; Channer, M.S.; Saleem, M.I.

2010-01-01

Objective: To assess frequency of cardiac defects among children from birth to 12 years of age on each Methodology: A cross sectional study was conducted at echocardiography centre in coronary care unit at Bahawal Victoria Hby Paediatric Transthoracic echo probe; 2-D colour Doppler, Acuson CV-70 and Niemo-30 echocardiography machines. Mothers of children with cardiac defects were interviewed at the echocardiography centre. Variables included were A- Muscular plus Vascular defects; B- Valvular defects; C-Pericardial effusion; D- Dextrocardia and E- Congestive cardiac failure. History of children for sore throat followed by joint pains; history of mothers for drug intake (antihypertensive, antipyretic, anti-emetic, hypoglycaemic) as well as chronic diseases (diabetes mellitus, hypertension, anaemia) during pregnancy were surveyed. Parity of mothers, their cousin marriages, and family socio-economic status was also inquired. The results were tabulated, analyzed and finally subjected to suitable test of significant (SR of proportion) to find out statistical significant if any. Results: It was found that out of 150 patients, 76 (50.66%) were suffering from Cardiac muscular and Vascular defects, 61 (40.66%) Valvular defects, 7 (4.66%) Pericardial effusion, 2 (1.33%) Dextrocardia and 4 (2.66%) from Congestive Cardiac Failure. According to age, 54 (36%) were from birth to 3 years of age and 51 (34%) from 10 to 12 years. There was history of Rheumatic fever among 45 (30%) children. There were 106 (70.6%) children from lower socio-economic class and 79 (52.6%) parents had history of cousin marriages. Conclusion: Frequency of cardiac defects was more in children of male sex, lower socio-economic group, from birth to three years age and children from primipara mothers in our specified locality. Rheumatic fever, cousin's marriage, and prescribed drugs intake during pregnancy (for metabolic and hormonal disorders) were other contributors to cardiac defects. (author)

International Patterns of Practice in the Management of Radiation Therapy-induced Nausea and Vomiting

International Nuclear Information System (INIS)

Dennis, Kristopher; Zhang Liying; Lutz, Stephen; Baardwijk, Angela van; Linden, Yvette van der; Holt, Tanya; Arnalot, Palmira Foro; Lagrange, Jean-Léon; Maranzano, Ernesto; Liu, Rico; Wong, Kam-Hung; Wong, Lea-Choung; Vassiliou, Vassilios; Corn, Benjamin W.; De Angelis, Carlo; Holden, Lori; Wong, C. Shun; Chow, Edward

2012-01-01

Purpose: To investigate international patterns of practice in the management of radiation therapy-induced nausea and vomiting (RINV). Methods and Materials: Oncologists prescribing radiation therapy in the United States, Canada, The Netherlands, Australia, New Zealand, Spain, Italy, France, Hong Kong, Singapore, Cyprus, and Israel completed a Web-based survey that was based on 6 radiation therapy-only clinical cases modeled after the minimal-, low-, moderate-, and high-emetic risk levels defined in the antiemetic guidelines of the American Society of Clinical Oncology and the Multinational Association of Supportive Care in Cancer. For each case, respondents estimated the risks of nausea and vomiting separately and committed to an initial management approach. Results: In total, 1022 responses were received. Risk estimates and management decisions for the minimal- and high-risk cases varied little and were in line with guideline standards, whereas those for the low- and moderate-risk cases varied greatly. The most common initial management strategies were as follows: rescue therapy for a minimal-risk case (63% of respondents), 2 low-risk cases (56% and 80%), and 1 moderate-risk case (66%); and prophylactic therapy for a second moderate-risk case (75%) and a high-risk case (95%). The serotonin (5-HT) 3 receptor antagonists were the most commonly recommended prophylactic agents. On multivariate analysis, factors predictive of a decision for prophylactic or rescue therapy were risk estimates of nausea and vomiting, awareness of the American Society of Clinical Oncology antiemetic guideline, and European Society for Therapeutic Radiology and Oncology membership. Conclusions: Risk estimates and management strategies for RINV varied, especially for low- and moderate-risk radiation therapy cases. Radiation therapy-induced nausea and vomiting are under-studied treatment sequelae. New observational and translational studies are needed to allow for individual patient risk

International Patterns of Practice in the Management of Radiation Therapy-induced Nausea and Vomiting

Energy Technology Data Exchange (ETDEWEB)

Dennis, Kristopher; Zhang Liying [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Lutz, Stephen [Blanchard Valley Health Systems, Findlay, Ohio (United States); Baardwijk, Angela van [Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands); Linden, Yvette van der [Leiden University Medical Center, Leiden (Netherlands); Holt, Tanya [Radiation Oncology Mater Centre, Princess Alexandra Hospital, Brisbane (Australia); Arnalot, Palmira Foro [Parc de Salut Mar. Universitat Pompeu Fabra Barcelona (Spain); Lagrange, Jean-Leon [AP-HP Hopital Henri-Mondor, Universite Paris Est Creteil, Creteil (France); Maranzano, Ernesto [' S. Maria' Hospital, Terni (Italy); Liu, Rico [Queen Mary Hospital, Hong Kong (China); Wong, Kam-Hung [Queen Elizabeth Hospital, Hong Kong (Hong Kong); Wong, Lea-Choung [National University Cancer Institute (Singapore); Vassiliou, Vassilios [Bank of Cyprus Oncology Centre, Nicosia (Cyprus); Corn, Benjamin W. [Tel Aviv Medical Center, Tel Aviv (Israel); De Angelis, Carlo; Holden, Lori; Wong, C. Shun [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: Edward.Chow@sunnybrook.ca [Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

2012-09-01

Purpose: To investigate international patterns of practice in the management of radiation therapy-induced nausea and vomiting (RINV). Methods and Materials: Oncologists prescribing radiation therapy in the United States, Canada, The Netherlands, Australia, New Zealand, Spain, Italy, France, Hong Kong, Singapore, Cyprus, and Israel completed a Web-based survey that was based on 6 radiation therapy-only clinical cases modeled after the minimal-, low-, moderate-, and high-emetic risk levels defined in the antiemetic guidelines of the American Society of Clinical Oncology and the Multinational Association of Supportive Care in Cancer. For each case, respondents estimated the risks of nausea and vomiting separately and committed to an initial management approach. Results: In total, 1022 responses were received. Risk estimates and management decisions for the minimal- and high-risk cases varied little and were in line with guideline standards, whereas those for the low- and moderate-risk cases varied greatly. The most common initial management strategies were as follows: rescue therapy for a minimal-risk case (63% of respondents), 2 low-risk cases (56% and 80%), and 1 moderate-risk case (66%); and prophylactic therapy for a second moderate-risk case (75%) and a high-risk case (95%). The serotonin (5-HT){sub 3} receptor antagonists were the most commonly recommended prophylactic agents. On multivariate analysis, factors predictive of a decision for prophylactic or rescue therapy were risk estimates of nausea and vomiting, awareness of the American Society of Clinical Oncology antiemetic guideline, and European Society for Therapeutic Radiology and Oncology membership. Conclusions: Risk estimates and management strategies for RINV varied, especially for low- and moderate-risk radiation therapy cases. Radiation therapy-induced nausea and vomiting are under-studied treatment sequelae. New observational and translational studies are needed to allow for individual patient risk

Prevalence, Virulence Genes, Antimicrobial Susceptibility, and Genetic Diversity of Bacillus cereus Isolated From Pasteurized Milk in China

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Tiantian Gao

2018-03-01

Full Text Available Bacillus cereus is a common and important food-borne pathogen that can be found in various food products. Due to low-temperature sterilization for a short period of time, pasteurization is not sufficient for complete elimination of B. cereus in milk, thereby cause severe economic loss and food safety problems. It is therefore of paramount importance to perform risk assessment of B. cereus in pasteurized milk. In this study, we isolated B. cereus from pasteurized milk samples in different regions of China, and evaluated the contamination situation, existence of virulence genes, antibiotic resistance profile and genetic polymorphism of B. cereus isolates. Intriguingly, 70 samples (27% were found to be contaminated by B. cereus and the average contamination level was 111 MPN/g. The distribution of virulence genes was assessed toward 10 enterotoxigenic genes (hblA, hblC, hblD, nheA, nheB, nheC, cytK, entFM, bceT, and hlyII and one emetic gene (cesB. Forty five percent strains harbored enterotoxigenic genes hblACD and 93% isolates contained nheABC gene cluster. The positive rate of cytK, entFM, bceT, hlyII, and cesB genes were 73, 96, 75, 54, and 5%, respectively. Antibiotic susceptibility assessment showed that most of the isolates were resistant to β-lactam antibiotics and rifampicin, but susceptible to other antibiotics such as ciprofloxacin, gentamicin and chloramphenicol. Total multidrug-resistant population was about 34%. In addition, B. cereus isolates in pasteurized milk showed a high genetic diversity. In conclusion, our findings provide the first reference on the prevalence, contamination level and characteristics of B. cereus isolated from pasteurized milk in China, suggesting a potential high risk of B. cereus to public health and dairy industry.

The value of integrating pre-clinical data to predict nausea and vomiting risk in humans as illustrated by AZD3514, a novel androgen receptor modulator

Energy Technology Data Exchange (ETDEWEB)

Grant, Claire, E-mail: claire.grant@astrazeneca.com [Drug Safety and Metabolism, AstraZeneca, Alderley Park, Macclesfield SK10 4TG (United Kingdom); Ewart, Lorna [Drug Safety and Metabolism, AstraZeneca, Da Vinci Building, Melbourn Science Park, Cambridge Road, Melbourn, Royston SG8 6HB (United Kingdom); Muthas, Daniel [Respiratory, Inflammation and Autoimmunity iMED, AstraZeneca, Pepparedsleden 1, 431 83 Mölndal (Sweden); Deavall, Damian [Drug Safety and Metabolism, AstraZeneca, Alderley Park, Macclesfield SK10 4TG (United Kingdom); Smith, Simon A. [Oncology Translational Medicine Unit, Early Clinical Development, AstraZeneca, Da Vinci Building, Melbourn Science Park, Melbourn, Royston SG8 6HB (United Kingdom); Clack, Glen [Translational Medicine Unit, Early Clinical Development, AstraZeneca, Alderley Park, Macclesfield SK10 4TG (United Kingdom); Newham, Pete [Drug Safety and Metabolism, AstraZeneca, Darwin Building, Cambridge Science Park, Milton Road, Cambridge CB4 0WG (United Kingdom)

2016-04-01

Nausea and vomiting are components of a complex mechanism that signals food avoidance and protection of the body against the absorption of ingested toxins. This response can also be triggered by pharmaceuticals. Predicting clinical nausea and vomiting liability for pharmaceutical agents based on pre-clinical data can be problematic as no single animal model is a universal predictor. Moreover, efforts to improve models are hampered by the lack of translational animal and human data in the public domain. AZD3514 is a novel, orally-administered compound that inhibits androgen receptor signaling and down-regulates androgen receptor expression. Here we have explored the utility of integrating data from several pre-clinical models to predict nausea and vomiting in the clinic. Single and repeat doses of AZD3514 resulted in emesis, salivation and gastrointestinal disturbances in the dog, and inhibited gastric emptying in rats after a single dose. AZD3514, at clinically relevant exposures, induced dose-responsive “pica” behaviour in rats after single and multiple daily doses, and induced retching and vomiting behaviour in ferrets after a single dose. We compare these data with the clinical manifestation of nausea and vomiting encountered in patients with castration-resistant prostate cancer receiving AZD3514. Our data reveal a striking relationship between the pre-clinical observations described and the experience of nausea and vomiting in the clinic. In conclusion, the emetic nature of AZD3514 was predicted across a range of pre-clinical models, and the approach presented provides a valuable framework for predicition of clinical nausea and vomiting. - Highlights: • Integrated pre-clinical data can be used to predict clinical nausea and vomiting. • Data integrated from standard toxicology studies is sufficient to make a prediction. • The use of the nausea algorithm developed by Parkinson (2012) aids the prediction. • Additional pre-clinical studies can be used

Clinical evaluation of the hypoxic cytotoxin tirapazamine (SR-4233): phase I experience with repeated dose administration during fractionated irradiation

International Nuclear Information System (INIS)

Hancock, Steven L.; Spencer, Sharon; Mariscal, Carol; Wooten, Ann; Wheeler, Richard; Brown, J. Martin; Fisher, Cheryl; Roemeling, Reinhard von

1996-01-01

Purpose: Regions of chronic or transient hypoxia are common in many human tumors and are thought to limit tumor cell killing and tumor control with conventional irradiation and some chemotherapeutic agents. Tirapazamine (3-amino-1,2,4-benzotriazine-1,4-di-N-oxide) forms a cytotoxic free radical during reductive metabolism in regions of hypoxia. In well oxygenated regions, the tirapazamine radical reacts with molecular oxygen to form the inactive parent drug. This results in markedly greater toxicity for hypoxic cells than for the well oxygenated cells that comprise most normal tissues. Tirapazamine increased the anti-tumor effects of single dose or fractionated irradiation or cis-platin chemotherapy in murine tumors,in vivo . This study evaluated the ability to repeat the administration of Tirapazamine during courses of fractionated irradiation in humans after an earlier phase I trial established a maximum tolerated dose of 390 mg per square meter of body surface area (mg/m 2 ) when given as a single dose with radiotherapy. Materials and Methods: Between December 1993 and August 1995 22 patients with locally advanced or metastatic tumors of varying histology, normal renal, hepatic, and hematologic functions, and Karnofsky performance status ≥ 60 received repeated doses of Tirapazamine during a planned, 6 weeks course of standardly fractionated radiotherapy. After anti-emetic treatment with ondansetron (32 mg) and dexamethasone (16 mg), Tirapazamine was administered during a 2 hour intravenous infusion that ended from 30 to 90 minutes before a radiation treatment. Patients were monitored for acute toxicity during the course of treatment and for a minimum of one month after radiotherapy. Results: The study was initiated with three, biweekly doses of Tirapazamine at 330 mg/m 2 . Four of 7 patients who initiated treatment at this dose refused the second (1 patient) or third dose of Tirapazamine (3 patients). Two of the three patients who received three doses

Anti emetic effect of 5HT3 receptor antagonists in macaques exposed to a neutron-gamma radiation; Effet antiemetique d`antiserotoninergiques de type 3 chez le macaque soumis a une irradiation neutron-gamma

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Agay, D.; Martin, C.; Martin, S.; Roman, V.; Fatome, M.

1994-12-31

Ondansetron and granisetron were tested as antiemetics in cynomolgus macaques weighing 4 kg and submitted to a neutron-gamma irradiation with a high neutronic component. Compounds were delivered by oral way, each administration dose being 4 mg of ondansetron or 1 mg of granisetron. The effect was complete when were delivered before and after the irradiation. It was incomplete when there was a single administration be fore or after the exposure. No adverse side-effects were noted. (author). 4 refs.

Inhibition of Phosphodiesterase 4 by FCPR03 Alleviates Lipopolysaccharide-Induced Depressive-Like Behaviors in Mice: Involvement of p38 and JNK Signaling Pathways

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Hui Yu

2018-02-01

Full Text Available Inflammatory responses induced by peripheral administration of lipopolysaccharide (LPS triggers depressive-like behavioral syndrome in rodents. Inhibition of phosphodiesterase 4 (PDE4 produces a robust anti-inflammatory effect in inflammatory cells. Unfortunately, archetypal PDE4 inhibitors cause intolerable gastrointestinal side-effects, such as vomiting and nausea. N-isopropyl-3-(cyclopropylmethoxy-4-difluoromethoxy benzamide (FCPR03 is a novel, selective PDE4 inhibitor with little, or no, emetic potency. Our previous studies show that FCPR03 is effective in attenuating neuroinflammation in mice treated with LPS. However, whether FCPR03 could exert antidepressant-like effect induced by LPS is largely unknown. In the present study, mice injected intraperitoneally (i.p. with LPS was established as an in vivo animal model of depression. The antidepressant-like activities of FCPR03 were evaluated using a tail suspension test, forced swimming test, and sucrose preference test. We demonstrated that administration of FCPR03 (1 mg/kg produced antidepressant-like effects in mice challenged by LPS, as evidenced by decreases in the duration of immobility in the forced swim and tail suspension tests, while no significant changes in locomotor activity were observed. FCPR03 also increased sucrose preference in mice treated with LPS. In addition, treatment with FCPR03 abolished the downregulation of brain-derived neurotrophic factor induced by LPS and decreased the level of corticosterone in plasma. Meanwhile, periphery immune challenge by LPS induced enhanced phosphorylation of p38-mitogen activated protein kinase (p38 and c-Jun N-terminal kinase (JNK in both the cerebral cortex and hippocampus in mice. Interestingly, treatment with FCPR03 significantly blocked the role of LPS and reduced the levels of phosphorylated p38 and JNK. Collectively, these results indicate that FCPR03 shows antidepressant-like effects in mice challenged by LPS, and the p38/JNK

Intra-operative lidocaine in the prevention of vomiting after elective tonsillectomy in children: A randomised controlled trial.

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Echevarría, Ghislaine C; Altermatt, Fernando R; Paredes, Sebastian; Puga, Valentina; Auad, Hernán; Veloso, Ana M; Elgueta, María F

2018-05-01

Postoperative vomiting (POV) is a frequent complication of tonsillectomy in children. In adult patients undergoing abdominal surgeries, the use of intravenous lidocaine infusion can prevent POV. To evaluate the anti-emetic effect of an intravenous lidocaine infusion used as an adjuvant to general anaesthesia, in children undergoing elective ear, nose and throat surgery. Double-blind, randomised, controlled study. Hospital-based, single-centre study in Chile. ASA I-II children, aged 2 to 12 years, scheduled for elective tonsillectomy. We standardised the induction and maintenance of anaesthesia. Patients were randomly allocated to lidocaine (1.5 mg kg intravenous lidocaine over 5 min followed by 2 mg kg h) or 0.9% saline (at the same rate and volume). Infusions were continued until the end of the surgery. Presence of at least one episode of vomiting, retching or both in the first 24 h postoperatively (POV). Plasma concentrations of lidocaine and postoperative pain. Ninety-two children were enrolled. Primary outcome data were available for 91. In the Lidocaine group, 28 of 46 patients (60.8%) experienced POV, compared with 37 of 45 patients (82.2%) in the Saline group [difference in proportions 21.3% (95% confidence interval (CI) 2.8 to 38.8), P = 0.024]. The intention-to-treat analysis showed that when we assumed that the patient in the Saline group lost to follow-up did not have POV, the difference in proportions decreased to 19.6% (95% CI, 0.9 to 37.2), with an unadjusted odds ratio of 0.38 (95% CI, 0.15 to 0.97, P = 0.044). The odds of having POV were 62% less likely in those patients receiving lidocaine compared with patients in the Saline group. The mean lidocaine plasma concentration was 3.91 μg ml (range: 0.87 to 4.88). Using an intravenous lidocaine infusion as an adjuvant to general anaesthesia decreased POV in children undergoing elective tonsillectomy. ClinicalTrials.gov Identifier: NCT01986309.

Efficacy of oral palonosetron compared to intravenous palonosetron for the prevention of chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapy: a phase 3 trial.

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Boccia, Ralph; Grunberg, Steven; Franco-Gonzales, Edwin; Rubenstein, Edward; Voisin, Daniel

2013-05-01

Palonosetron (Aloxi(®), Onicit(®)) is a pharmacologically unique 5-HT3 receptor antagonist (RA) approved as a single IV injection for the prevention of nausea and vomiting induced by chemotherapy (CINV) of either moderate or highly emetogenic potential (MEC and HEC, respectively). An oral palonosetron formulation has been developed and compared to the IV formulation. In this multinational, multicenter, double-blind, double-dummy, dose-ranging trial, 651 patients were randomly assigned to receive one of the following as a single dose prior to moderately emetogenic chemotherapy: oral palonosetron 0.25, 0.50, and 0.75 mg or IV palonosetron 0.25 mg. Patients were also randomized (1:1) to receive dexamethasone 8 mg IV or matched placebo on day 1. The primary endpoint was complete response (CR; no emesis, no rescue therapy) during the acute phase (0-24 h). Acute CR rates were 73.5, 76.3, 74.1, and 70.4 % for all patients receiving the palonosetron 0.25, 0.50, and 0.75 mg oral doses, and for IV palonosetron 0.25 mg, respectively; delayed CR (24-120 h) rates were 59.4, 62.5, 60.1, and 65.4 %, and overall CR (0-120 h) rates were 53.5, 58.8, 53.2, and 59.3 %, respectively. The addition of dexamethasone improved emetic control (acute CR rate) by at least 15 % for all groups except oral palonosetron 0.25 mg, where the acute CR improvement was approximately 7 %. Adverse events were similar in nature, incidence, and intensity for all oral and IV palonosetron groups, and were the expected adverse events for 5-HT3 RAs (primarily headache and constipation). Oral palonosetron has a similar efficacy and safety profile as IV palonosetron 0.25 mg and may be the preferred formulation in certain clinical situations. Among the tested oral treatments, a palonosetron 0.50-mg oral dose has been favored for the prevention of CINV in patients receiving moderately emetogenic chemotherapy due to a numerical gain in efficacy without a side effect disadvantage.

Management of acute gastroenteritis in healthy children in Lebanon - A national survey.

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Alameddine, Aouni; Mourad, Sawsan; Rifai, Nahida

2010-11-01

Acute gastroenteritis remains a common condition among infants and children throughout the world. In 1996, The American Academy of Pediatrics (AAP) revised its recommendations for the treatment of infants and children with acute gastroenteritis. The purpose of this survey was to determine how closely current treatment among Lebanese pediatricians compares with the AAP recommendations and to determine the impact of such management on the healthcare system. The outline of the study was based on a telephone questionnaire that addressed the management of healthy infants and children below five years of age with acute gastroenteritis complicated by mild to moderate dehydration. In addition, the costs of medical treatment and requested laboratory studies were calculated. A total of 238 pediatricians completed the questionnaire. Most pediatricians prescribed Oral Rehydration Solutions (ORS) for rehydration (92.4%), advised breastfeeding during acute gastroenteritis (81.5%), and avoided parenteral rehydration for mild to moderate dehydration (89.1%). In addition to ORS, oral fluids such as soda, juices, and rice water were allowed for rehydration by 43.7% of pediatricians. Thirty-one percent of pediatricians delayed re-feeding for more than 6 hours after initiation of rehydration. Only 32.8% of pediatricians kept their patients on regular full-strength formulas, and only 21.8% permitted full-calorie meals for their patients. 75.4% of pediatricians did not order any laboratory studies in cases of mild dehydration and 50.4% did not order any laboratory studies for moderate dehydration. Stool analysis and culture were ordered by almost half of the pediatricians surveyed. Seventy-seven percent prescribed anti-emetics, 61% prescribed probiotics, 26.3% prescribed antibiotics systematically and local antiseptic agents, 16.9% prescribed zinc supplements, and 11% percent prescribed antidiarrheal agents. Pediatricians in Lebanon are aware of the importance of ORS and the positive

POST OPERATIVE RECOVERY RESTLESSNESS FOLLOWING ENT SURGERIES IN THE PEDIATRIC AGE GROUP - A CLINICAL STUDY OF 246 CHILDREN

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Nagula

2015-10-01

Full Text Available INTRODUCTION: Post - operative restlessness is observed commonly among children following Ear Nose Throat surgeries. This post anesthetic problem is also termed as Emergence Agitation (EA which interferes with patient’s recovery, presenting a challenging task to the ane sthetist in terms of assessment and convincing the parents. Many factors play a role singly or in combination in producing EA. EA consist of restlessness, excessive crying and spells of breath holding, head banging and incoherent speech. In this prospectiv e clinical study the incidence of post - operative recovery restlessness EA in children aged between 3 to 12 years, enumeration of the causes, and prediction of EA in Indian population. MATERIALS AND METHODS: 246 Children undergoing elective surgeries of Ear Nose and throat are selected and their demographic data, socio - economic back ground and emotional attachment with parents were elicited. Parents of the children were interviewed prior to surgery using a questionnaire enquiring of their children’s personal ity, and emotional attachment and meekness. Their preoperative clinical data are documented. Their post - operative general condition, behavior, time taken for awakening, period of total recovery and treatment factors are recorded and analyzed. RESULTS: The incidence of EA was found in 23.6% of the children. EA lasted between 21 minutes to 52 minutes with a mean period of 28.4±9.5 minutes. 67% of the children required medication with sedatives, analgesics and anti - emetics. Post - operative stay in the Surgical ICU ranged between Hrs . 3.12±0.36mts to Hrs . 8.39±2.10mts in the children showing restlessness, compared to those not showing agitation. CONCLUSIONS: The factors associated with EA were, age, emotional attachment, meekness, adaptability, previous surgery, analgesics, sedatives, dose of pentothal sodium for induction, time taken for awakening and duration of surgery. Shorter was the time of awakening

Identification of Additional Anti-Persister Activity against Borrelia burgdorferi from an FDA Drug Library

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Jie Feng

2015-09-01

Full Text Available Lyme disease is a leading vector-borne disease in the United States. Although the majority of Lyme patients can be cured with standard 2–4 week antibiotic treatment, 10%–20% of patients continue to suffer from prolonged post-treatment Lyme disease syndrome (PTLDS. While the cause for this is unclear, persisting organisms not killed by current Lyme antibiotics may be involved. In our previous study, we screened an FDA drug library and reported 27 top hits that showed high activity against Borrelia persisters. In this study, we present the results of an additional 113 active hits that have higher activity against the stationary phase B. burgdorferi than the currently used Lyme antibiotics. Many antimicrobial agents (antibiotics, antivirals, antifungals, anthelmintics or antiparasitics used for treating other infections were found to have better activity than the current Lyme antibiotics. These include antibacterials such as rifamycins (3-formal-rifamycin, rifaximin, rifamycin SV, thiostrepton, quinolone drugs (sarafloxacin, clinafloxacin, tosufloxacin, and cell wall inhibitors carbenicillin, tazobactam, aztreonam; antifungal agents such as fluconazole, mepartricin, bifonazole, climbazole, oxiconazole, nystatin; antiviral agents zanamivir, nevirapine, tilorone; antimalarial agents artemisinin, methylene blue, and quidaldine blue; antihelmintic and antiparasitic agents toltrazuril, tartar emetic, potassium antimonyl tartrate trihydrate, oxantel, closantel, hycanthone, pyrimethamine, and tetramisole. Interestingly, drugs used for treating other non-infectious conditions including verteporfin, oltipraz, pyroglutamic acid, pidolic acid, and dextrorphan tartrate, that act on the glutathione/γ-glutamyl pathway involved in protection against free radical damage, and also the antidepressant drug indatraline, were found to have high activity against stationary phase B. burgdorferi. Among the active hits, agents that affect cell membranes, energy

NEPA, a new fixed combination of netupitant and palonosetron, is a cost-effective intervention for the prevention of chemotherapy-induced nausea and vomiting in the UK

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Helene Cawston

2017-03-01

Full Text Available Background: The objective was to evaluate the cost-effectiveness of NEPA, an oral fixed combination netupitant (NETU, 300 mg and palonosetron (PA, 0.5 mg compared with aprepitant and palonosetron (APPA or palonosetron (PA alone, to prevent chemotherapy-induced nausea and vomiting (CINV in patients undergoing treatment with highly or moderately emetogenic chemotherapy (HEC or MEC in the UK. Scope: A systematic literature review and meta-analysis were undertaken to compare NEPA with currently recommended anti-emetics. Relative effectiveness was estimated over the acute (day 1 and overall treatment (days 1–5 phases, taking complete response (CR, no emesis and no rescue medication and complete protection (CP, CR and no more than mild nausea [VAS scale <25 mm] as primary efficacy outcomes. A three-health-state Markov cohort model, including CP, CR and incomplete response (no CR for HEC and MEC, was constructed. A five-day time horizon and UK NHS perspective were adopted. Transition probabilities were obtained by combining the response rates of CR and CP from NEPA trials and odds ratios from the meta-analysis. Utilities of 0.90, 0.70 and 0.24 were defined for CP, CR and incomplete response, respectively. Costs included medications and management of CINV-related events and were obtained from the British National Formulary and NHS Reference Costs. The expected budgetary impact of NEPA was also evaluated. Findings: In HEC patients, the NEPA strategy was more effective than APPA (quality-adjusted life days [QALDs] of 4.263 versus 4.053; incremental emesis-free and CINV-free days of +0.354 and +0.237, respectively and was less costly (£80 versus £124, resulting in NEPA being the dominant strategy. In MEC patients, NEPA was cost effective, cumulating in an estimated 0.182 extra QALDs at an incremental cost of £6.65 compared with PA. Conclusion: Despite study limitations (study setting, time horizon, utility measure, the results suggest NEPA is cost

Emetogenicity-risk procedures in same day surgery center of an academic university hospital in United States: a retrospective cost-audit of postoperative nausea vomiting management.

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Gupta, Deepak; Haber, Halim

2014-06-01

Despite the variable results of published studies, it is imperative for ambulatory surgery centers to self-audit local cost-implications for post-operative nausea and vomiting (PONV) management. Our retrospective cost-audit assessed if there were comparative peri-anesthesia care cost-trends among patients who had undergone Low-Emetogenicity-Risk Procedures (LERP), Moderate-Emetogenicity-Risk Procedures (MERP) and Severe-Emetogenicity-Risk Procedures (SERP). This study was a review of Same Day Surgery Center practices in an academic university hospital setting during a three-year period (2010-2012). The patient lists were accessed from CIS and CITRIX App Bar for time audit and OR (operating room) schedule reports. Subsequently, OR pharmacy department ran a search for peri-operative anti-emetics and opioids that were billed for the patients at Same Day Surgery Center for the review period. The primary outcomes were the comparative costs/charges of these medications and comparative durations/ charges for these patients' stay in the post-anesthesia care unit (PACU). Secondary outcomes analyzed in the study included peri-anesthesia durations. A total of 8,657 patient records were analyzed. Almost all analyzed variables revealed statistically significant inter-variable positive correlations. The patients' age was significantly (P < 0.001) different among LERP/MERP/SERP patients (LERP: 48.8 +/- 14.7 years; MERP: 61.8 +/- 14.6 years; SERP: 51.3 +/- 14.5 years). In regards to primary and secondary outcomes, the statistical significant differences among LERP/MERP/SERP patients (after correcting for both patients' age as well as patients' sex) were only achieved for preoperative times (P = 0.002; Power = 0.9), operating room recovery times (P = 0.003; Power = 0.9), PACU stay times (P < 0.001; Power = 1.0), and PACU charges (P < 0.001; Power = 1.0). PACU stay times and PACU charges were significantly higher in patients who had undergone SERP as compared to patients who had

Centrally located GLP-1 receptors modulate gastric slow waves and cardiovascular function in ferrets consistent with the induction of nausea.

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Lu, Zengbing; Yeung, Chi-Kong; Lin, Ge; Yew, David T W; Andrews, P L R; Rudd, John A

2017-10-01

Glucagon-like peptide-1 (GLP-1) receptor agonists are indicated for the treatment of Type 2 diabetes and obesity, but can cause nausea and emesis in some patients. GLP-1 receptors are distributed widely in the brain, where they contribute to mechanisms of emesis, reduced appetite and aversion, but it is not known if these centrally located receptors also contribute to a modulation of gastric slow wave activity, which is linked causally to nausea. Our aim was to investigate the potential of the GLP-1 receptor agonist, exendin-4, administered into the 3rd ventricle to modulate emesis, feeding and gastric slow wave activity. Thermoregulation and cardiovascular parameters were also monitored, as they are disturbed during nausea. Ferrets were used as common laboratory rodents do not have an emetic reflex. A guide cannula was implanted into the 3rd ventricle for delivering a previously established dose of exendin-4 (10nmol), which had been shown to induce emesis and behaviours indicative of 'nausea'. Radiotelemetry recorded gastric myoelectric activity (GMA; slow waves), blood pressure and heart rate variability (HRV), and core temperature; food intake and behaviour were also assessed. Exendin-4 (10nmol, i.c.v.) decreased the dominant frequency of GMA, with an associated increase in the percentage of bradygastric power (lasting ~4h). Food intake was inhibited in all animals, with 63% exhibiting emesis. Exendin-4 also increased blood pressure (lasting ~24h) and heart rate (lasting ~7h), decreased HRV (lasting ~24h), and caused transient hyperthermia. None of the above parameters were emesis-dependent. The present study shows for the first time that gastric slow waves may be modulated by GLP-1 receptors in the brain through mechanisms that appear independent from emesis. Taken together with a reduction in HRV, the findings are consistent with changes associated with the occurrence of nausea in humans. Copyright © 2017 Elsevier Ltd. All rights reserved.

Can ginger ameliorate chemotherapy-induced nausea? Protocol of a randomized double blind, placebo-controlled trial.

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Marx, Wolfgang; McCarthy, Alexandra L; Ried, Karin; Vitetta, Luis; McKavanagh, Daniel; Thomson, Damien; Sali, Avni; Isenring, Liz

2014-04-09

Preliminary research shows ginger may be an effective adjuvant treatment for chemotherapy-induced nausea and vomiting but significant limitations need to be addressed before recommendations for clinical practice can be made. In a double-blinded randomised-controlled trial, chemotherapy-naïve patients will be randomly allocated to receive either 1.2 g of a standardised ginger extract or placebo per day. The study medication will be administrated as an adjuvant treatment to standard anti-emetic therapy and will be divided into four capsules per day, to be consumed approximately every 4 hours (300 mg per capsule administered q.i.d) for five days during the first three cycles of chemotherapy. Acute, delayed, and anticipatory symptoms of nausea and vomiting will be assessed over this time frame using a valid and reliable questionnaire, with nausea symptoms being the primary outcome. Quality of life, nutritional status, adverse effects, patient adherence, cancer-related fatigue, and CINV-specific prognostic factors will also be assessed. Previous trials in this area have noted limitations. These include the inconsistent use of standardized ginger formulations and valid questionnaires, lack of control for anticipatory nausea and prognostic factors that may influence individual CINV response, and the use of suboptimal dosing regimens. This trial is the first to address these issues by incorporating multiple unique additions to the study design including controlling for CINV-specific prognostic factors by recruiting only chemotherapy-naïve patients, implementing a dosing schedule consistent with the pharmacokinetics of oral ginger supplements, and independently analysing ginger supplements before and after recruitment to ensure potency. Our trial will also be the first to assess the effect of ginger supplementation on cancer-related fatigue and nutritional status. Chemotherapy-induced nausea and vomiting are distressing symptoms experienced by oncology patients; this

Identification of Additional Anti-Persister Activity against Borrelia burgdorferi from an FDA Drug Library.

Science.gov (United States)

Feng, Jie; Weitner, Megan; Shi, Wanliang; Zhang, Shuo; Sullivan, David; Zhang, Ying

2015-09-16

Lyme disease is a leading vector-borne disease in the United States. Although the majority of Lyme patients can be cured with standard 2-4 week antibiotic treatment, 10%-20% of patients continue to suffer from prolonged post-treatment Lyme disease syndrome (PTLDS). While the cause for this is unclear, persisting organisms not killed by current Lyme antibiotics may be involved. In our previous study, we screened an FDA drug library and reported 27 top hits that showed high activity against Borrelia persisters. In this study, we present the results of an additional 113 active hits that have higher activity against the stationary phase B. burgdorferi than the currently used Lyme antibiotics. Many antimicrobial agents (antibiotics, antivirals, antifungals, anthelmintics or antiparasitics) used for treating other infections were found to have better activity than the current Lyme antibiotics. These include antibacterials such as rifamycins (3-formal-rifamycin, rifaximin, rifamycin SV), thiostrepton, quinolone drugs (sarafloxacin, clinafloxacin, tosufloxacin), and cell wall inhibitors carbenicillin, tazobactam, aztreonam; antifungal agents such as fluconazole, mepartricin, bifonazole, climbazole, oxiconazole, nystatin; antiviral agents zanamivir, nevirapine, tilorone; antimalarial agents artemisinin, methylene blue, and quidaldine blue; antihelmintic and antiparasitic agents toltrazuril, tartar emetic, potassium antimonyl tartrate trihydrate, oxantel, closantel, hycanthone, pyrimethamine, and tetramisole. Interestingly, drugs used for treating other non-infectious conditions including verteporfin, oltipraz, pyroglutamic acid, pidolic acid, and dextrorphan tartrate, that act on the glutathione/γ-glutamyl pathway involved in protection against free radical damage, and also the antidepressant drug indatraline, were found to have high activity against stationary phase B. burgdorferi. Among the active hits, agents that affect cell membranes, energy production, and reactive

Prophylaxis of Radiation-Induced Nausea and Vomiting Using 5-Hydroxytryptamine-3 Serotonin Receptor Antagonists: A Systematic Review of Randomized Trials

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Salvo, Nadia; Doble, Brett [Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Canada); Khan, Luluel [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Amirthevasar, Gayathri [Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Canada); Dennis, Kristopher [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Pasetka, Mark; DeAngelis, Carlo [Department of Oncology Pharmacy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Tsao, May [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: Edward.Chow@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

2012-01-01

Purpose: To systematically review the effectiveness and safety of 5-hydroxytryptamine-3 receptor antagonists (5-HT3 RAs) compared with other antiemetic medication or placebo for prophylaxis of radiation-induced nausea and vomiting. Methods and Materials: We searched the following electronic databases: MEDLINE, Embase, the Cochrane Central Register of Controlled Clinical Trials, and Web of Science. We also hand-searched reference lists of included studies. Randomized, controlled trials that compared a 5-HT3 RA with another antiemetic medication or placebo for preventing radiation-induced nausea and vomiting were included. We excluded studies recruiting patients receiving concomitant chemotherapy. When appropriate, meta-analysis was conducted using Review Manager (v5) software. Relative risks were calculated using inverse variance as the statistical method under a random-effects model. We assessed the quality of evidence by outcome using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: Eligibility screening of 47 articles resulted in 9 included in the review. The overall methodologic quality was moderate. Meta-analysis of 5-HT3 RAs vs. placebo showed significant benefit for 5-HT3 RAs (relative risk [RR] 0.70; 95% confidence interval [CI] 0.57-0.86 for emesis; RR 0.84, 95% CI 0.73-0.96 for nausea). Meta-analysis comparing 5-HT3 RAs vs. metoclopramide showed a significant benefit of the 5-HT3 RAs for emetic control (RR 0.27, 95% CI 0.15-0.47). Conclusion: 5-Hydroxytryptamine-3 RAs are superior to placebo and other antiemetics for prevention of emesis, but little benefit was identified for nausea prevention. 5-Hydroxytryptamine-3 RAs are suggested for prevention of emesis. Limited evidence was found regarding delayed emesis, adverse events, quality of life, or need for rescue medication. Future randomized, controlled trials should evaluate different 5-HT3 antiemetics and new agents with novel mechanisms of action such at the NK

Prophylaxis of Radiation-Induced Nausea and Vomiting Using 5-Hydroxytryptamine-3 Serotonin Receptor Antagonists: A Systematic Review of Randomized Trials

International Nuclear Information System (INIS)

Salvo, Nadia; Doble, Brett; Khan, Luluel; Amirthevasar, Gayathri; Dennis, Kristopher; Pasetka, Mark; DeAngelis, Carlo; Tsao, May; Chow, Edward

2012-01-01

Purpose: To systematically review the effectiveness and safety of 5-hydroxytryptamine-3 receptor antagonists (5-HT3 RAs) compared with other antiemetic medication or placebo for prophylaxis of radiation-induced nausea and vomiting. Methods and Materials: We searched the following electronic databases: MEDLINE, Embase, the Cochrane Central Register of Controlled Clinical Trials, and Web of Science. We also hand-searched reference lists of included studies. Randomized, controlled trials that compared a 5-HT3 RA with another antiemetic medication or placebo for preventing radiation-induced nausea and vomiting were included. We excluded studies recruiting patients receiving concomitant chemotherapy. When appropriate, meta-analysis was conducted using Review Manager (v5) software. Relative risks were calculated using inverse variance as the statistical method under a random-effects model. We assessed the quality of evidence by outcome using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: Eligibility screening of 47 articles resulted in 9 included in the review. The overall methodologic quality was moderate. Meta-analysis of 5-HT3 RAs vs. placebo showed significant benefit for 5-HT3 RAs (relative risk [RR] 0.70; 95% confidence interval [CI] 0.57–0.86 for emesis; RR 0.84, 95% CI 0.73–0.96 for nausea). Meta-analysis comparing 5-HT3 RAs vs. metoclopramide showed a significant benefit of the 5-HT3 RAs for emetic control (RR 0.27, 95% CI 0.15–0.47). Conclusion: 5-Hydroxytryptamine-3 RAs are superior to placebo and other antiemetics for prevention of emesis, but little benefit was identified for nausea prevention. 5-Hydroxytryptamine-3 RAs are suggested for prevention of emesis. Limited evidence was found regarding delayed emesis, adverse events, quality of life, or need for rescue medication. Future randomized, controlled trials should evaluate different 5-HT3 antiemetics and new agents with novel mechanisms of action such at

SEPHIROT: Scenario for Universe-Creation AUTOMATICALLY from Digits On-Average Euler-Bernoulli-Kummer-Riemann-Newcomb-Poincare-Weyl-Benford-Kac-Raimi-Hill-Antonoff-Siegel ``Digit-Physics'' Logarithm-Law: ``It's a Jack-in-the-Box Universe'': EMET/TRUTH!!!

Science.gov (United States)

Siegel, Edward Carl-Ludwig; Young, Frederic; Wignall, Janis

2013-04-01

SEPHIROT: Siegel[http://fqxi.org/community/forum/topic/1553]: Ten-[0->9]-Digits; Average Log-Law SCALE-Invariance; Utter-Simplicity: ``Complexity'' (vs. ``Complicatedness''); Zipf-law/Hyperbolicity/ Inevitability SCENARIO AUTOMATICALLY CREATES & EVOLVES a UNIVERSE: inflation, a big-bang, bosons(E)->Mellin-(c2)-tranform->fermions(m), hidden-dark-energy(HDE), hidden-dark-matter (HDM), cosmic-microwave-background(CMB), supersymmetry(SUSY), PURPOSELY NO: theories,models,mechanisms,processes, parameters,assumptions,WHATSOEVER: It's a ``Jack-in-the-Box'' Universe!!!: ONLY VIA: Newcomb [Am.J.Math.4(1),39(1881)]QUANTUM-discovery!!!-Benford-Siegel-Antonoff[AMS.Joint-Mtg.(02)-Abs.#973-60-124!!!] inversion to ONLY BEQS with d=0 BEC: ``Digit-Physics''!; Log fixed-point invariance(s): [base=units=SCALE] of digits classic (not classical!) average [CAUSING] log statistical-correlations =log(1+1/d), with physics-crucial d=0 BEC singularity/pole, permits SEPHIROT!!!: ``digits are quanta are bosons because bosons are and always were digits!!!'': Digits = Bosons with d=0 BEC(!!!) & expansion to Zipf-law Hyperbolicity INEVITABILITY CMB!

[Comparison of antiemesis effects of granisetron, aprepitant and dexamethasone to palonosetron, aprepitant and dexamethasone in treatment of high-emetic risk chemotherapy-induced nausea and vomiting - a retrospective study for efficacy and safety in a single institute].

Science.gov (United States)

Osawa, Hiroshi; Goto, Hiroaki; Myojo, Tomohiro

2013-05-01

Nausea and vomiting are among the most problematic symptoms experienced by patients with cancer who are receiving chemotherapy. 5-hydroxytryptamine 3(5-HT3)-receptor antagonists, NK1 receptor antagonists(aprepitant)and dexamethasone are now the standard therapies for preventing chemotherapy-induced nausea and vomiting(CINV)that follow highly emetogenic chemotherapy, such as cisplatin and anthracycline. However, since it is not cleared which 5-HT3-recepter antagonist is a proper treatment for combined use with aprepitant and dexamethasone, we conducted a questionnaire survey, which used the numerical rating scale(NRS), for comparing palonosetron with granisetron in the same patient. Palonosetron showed a significant improvement of nausea for both acute(within 24 hours)and delayed phase(24-120 hours later), regardless of the type of chemotherapy(cisplatin or anthracycline-based regimen). Furthermore, palonosetron had a tolerable safety profile. Our study suggests that palonosetron-based antiemetic treatment will be a preferred choice for preventing CINV following highly emetogenic chemotherapy.

Accidental poisoning in childhood: a multicentre survey. 2. The role of packaging in accidents involving medications.

Science.gov (United States)

Wiseman, H M; Guest, K; Murray, V S; Volans, G N

1987-07-01

To assess the effectiveness of child-resistant closures (CRCs) and unit dose packaging in preventing childhood poisoning with medications, a survey by 14 hospitals of accidental suspected poisoning in children under 5-years-old, was compared with a survey of a representative sample of households with children under 5 living in the catchment areas of the hospitals. Nine hundred and thirty-eight medications thought to have been ingested by 877 children were compared with 5827 medications found in households with children. The relationship between availability of packs or medications in the home and their involvement in accidents was quantified by means of an Accident Association Index (AAI). A low AAI indicated that the involvement of a pack or medication was less than expected from availability and therefore safe. A high AAI indicated that involvement was greater than expected and therefore unsafe. Medications involved in suspected poisoning were most frequently packed in containers without CRCs (63%) or transparent blisters (20%); both had high AAIs. CRCs, strips, sachets and opaque blisters had low AAIs. Analgesics, expectorants and gastrointestinal medications, had low AAIs, while oral contraceptives, hypnotics, sedative/tranquillizers, antidepressants, anticonvulsants, anti-emetics, and anti-infectives had high AAIs. Prescription medications were more frequently involved in accidents than over-the-counter (OTC) medications and had a higher AAI. Comparison of the AAIs of different kinds of medication in each of their various pack types showed that safe packaging reduced the risk from medications which had a high average AAI. Only 40% of medications were in their normal storage place at the time of the accident. Medicine and bathroom cabinets, and kitchen cupboards and drawers were the safest places to store medications. Handbags, fridges, and shelves or ledges in the bathroom were the most unsafe places. No pack had a low AAI when stored on open shelves

Transdermal granisetron versus palonosetron for prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: a multicenter, randomized, open-label, cross-over, active-controlled, and phase IV study.

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Seol, Young Mi; Kim, Hyo Jeong; Choi, Young Jin; Lee, Eun Mi; Kim, Yang Soo; Oh, Sung Yong; Koh, Su Jin; Baek, Jin Ho; Lee, Won Sik; Joo, Young Don; Lee, Hyun Gi; Yun, Eun Young; Chung, Joo Seop

2016-02-01

Palonosetron is the second-generation 5-hydroxytryptamine 3 receptor antagonist (5-HT3RA) that has shown better efficacy than the first-generation 5-HT3RA for prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately emetogenic chemotherapy (MEC). Granisetron transdermal delivery system (GTDS), a novel transdermal formulation, was developed to deliver granisetron continuously over 7 days. This study compared the efficacy and tolerability of the GTDS to palonosetron for the control of CINV following MEC. A total of 196 patients were randomized to GP or PG group. In this multicenter, randomized, open-label, cross-over, active-controlled, Phase IV study, GP group was assigned to receive transdermal granisetron (one GTDS patch, 7 days) in the first chemotherapy cycle, palonosetron (iv 0.25 mg/day, 1 days) in the second chemotherapy cycle before receiving MEC, and PG group was assigned to receive palonosetron in the first cycle and GTDS in the second cycle. Primary endpoint was the percentage of chemotherapy cycles achieving complete response (CR; defined as no emetic episodes and no rescue medication use) during the acute phase (0-24 h in post-chemotherapy; non-inferiority comparison with palonosetron). Total 333 cycles (165 in GTDS and 168 in palonosetron) were included in the per protocol analysis. The GTDS cycles showed non-inferiority to palonosetron cycles during the acute phase: CR was achieved by 124 (75.2 %) patients in the GTDS cycles and 134 (79.8 %) patients in the palonosetron cycles (treatment difference, -4.6 %; 95 % confidence interval, -13.6-4.4). There was no significant difference in CR rate during acute phase after the end of the first and second chemotherapy cycle between GP and PG group (p = 0.405, p = 0.074). Patients' satisfaction, assessed using Functional Living Index-Emesis (FLI-E), GTDS cycle were higher than those of palonosetron cycle in GP group (FLI-E score; median 1549.5 in GTDS cycle, median 1670

Antioxidant activities and phenolic contents of the methanol extracts of the stems of Acokanthera oppositifolia and Adenia gummifera

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Afolayan Anthony J

2008-09-01

Full Text Available Abstract Background Acokanthera oppositifolia Lam (family: Apocynaceae is a shrub or small tree with white latex, and the leaves of this plant are used in the form of a snuff to treat headaches and in infusions for abdominal pains and convulsions and septicaemia. Adenia gummifera Harv of the family Passifloraceae is a distinctive woody climber whose infusions are used as emetics and are said to help with some forms of depression. Lipid peroxidation has gained more importance today because of its involvement in pathogenesis of many diseases. Free radicals are the main agents in lipid peroxidation. Antioxidants thus play an important role of protecting the human body against damage by the free radicals. Plants containing phenolic compounds have been reported to possess strong antioxidant properties. Methods The antioxidant activities and phenolic contents of the methanol extracts of the stems of Acokanthera oppositifolia and Adenia gummifera were evaluated using in vitro standard procedures. Spectrophotometry was the basis for the determinations of total phenol, total flavonoids, flavonols, and proanthocyanidins. Tannins, quercetin and catechin equivalents were used for these parameters. The antioxidant activities of the stem extract of Acokanthera oppositifolia were determined by the 2,2'-azinobis-3- ethylbenzothiazoline-6-sulfonic acid (ABTS, 1,1-Diphenyl-2-picrylhydrazyl (DPPH, and ferrous reducing antioxidant property (FRAP methods. Results The results from this study showed that the antioxidant activities of the stem extract of Acokanthera oppositifolia as determined by the 1,1-Diphenyl-2-picrylhydrazyl (DPPH, and ferrous reducing antioxidant property (FRAP methods, were higher than that of Adenia gummifera. The levels of total phenols and flavonols for A. oppositifolia were also higher. On the other hand, the stem extract of Adenia gummifera had higher level of total flavonoids and proanthocyanidins than that of Acokanthera oppositifolia

Bladder cancer: The combination of chemotherapy and irradiation in the treatment of patients with muscle-invading tumors

International Nuclear Information System (INIS)

Shipley, William U.; Zietman, Anthony L.

1996-01-01

In the USA the recommended treatment for patients with muscle-invading transitional cell cancer of the bladder is usually radical cystectomy. Conservative surgery irradiation, and cisplatin-based systemic chemotherapy are, however, each effective for some patients. Although they provide the opportunity for bladder preservation, each modality, when used alone, is inferior to radical cystectomy in terms of local control and, perhaps, survival. Many recent publications have now documented the efficacy of combined modality treatment protocols employing all three of these modalities together. All employ a selective approach in which the patients only receive full-dose radiation if they have had a complete response to induction CMT. Overall survival data for T2-T3a patients are certainly as good as any reported cystectomy series of similarly clinically staged and similar aged patients. Radiation adds very significantly to the transurethral resection and systemic chemotherapy to maintain the bladder free of tumor. Substantially higher rates of pathologic confirmation of complete response are found following transurethral surgery and chemoradiation when compared with transurethral surgery and chemotherapy omitting the radiation. Overall survival is as good as cystectomy based approaches at 48-54% and over 80% of these long-term survivors keep their bladders. Following such therapies, 20-30% will subsequently develop superficial tumors. These patients may still be well treated by standard methods using transurethral resection and intravesical drugs. The concern of urologists that the conserved irradiated bladder functions poorly has also been answered by recent reports using modern radiation techniques. The instance of cystectomy for bladder shrinkage is repeatedly below 2%. Furthermore, sexual function is commonly preserved. The systemic morbidity of the chemotherapy is relatively high, but new approached using anti-emetics and GCSF now allow this to be reduced. In many

Estudo comparativo de antieméticos e suas associações, na prevenção de náuseas e vômitos pós-operatórios, em pacientes submetidas a procedimentos cirúrgicos ginecológicos Estudio comparativo de antieméticos y sus asociaciones, en la prevención de náusea y vómito postoperatorios, en pacientes sometidas a procedimientos quirúrgicos ginecológicos Comparative study of anti-emetics and their association, in the prevention of postoperative nausea and vomiting in patients undergoing gynecologic surgeries

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Taylor Brandão Schnaider

2008-12-01

. MÉTODO: Setenta pacientes, ASA I y II, fueron sometidas a procedimientos quirúrgicos ginecológicos, bajo bloqueo epidural asociado a la anestesia general. En el Grupo Metoclopramida (GM, se administró 20 mg; en el Grupo Dexametasona (GDe, se inyectó 8 mg; en el Grupo Droperidol (GDr se administró 1,25 mg; en el Grupo Ondansetron (GO se inyectó 8mg; en el Grupo Dexametasona-Ondansetron (GDeO se administró respectivamente 8 mg y 4mg; en el Grupo Droperidol-Ondansetron (GDrO se inyectó 1,25 mg y 4 mg; en el Grupo Dexametasona-Droperidol-Ondansetron (GDeDrO se administró 8mg, 0,625 mg y 4mg. La presencia de náuseas y vómitos fue observada en los momentos de 6, 12, 24 y 36 horas después del término de la operación. RESULTADOS: La incidencia total de episodios de náuseas fue de 4 en el GDeDrO, 6 en el GO, 6 en el GDrO, 11 en el GDe, 11 en el GDeO, 18 en el GM y 22 en el GDr. Al aplicar el test del Chi-cuadrado o el test de Fisher, se comprobó la diferencia estadística significativa entre el GDr y los grupos GDe, GDO, GDrO, GDeO, GDeDrO; entre el GM y los grupos GO, GDrO y GDeDrO; entre el GDeO y el grupo GDeDrO. La incidencia total de episodios de vómitos fue de 3 en el GO, 3 en el GDeDrO, 6 en el GDrO, 7 en el GDe, 7 en el GDeO, 10 en el GDr y 13 en el G. Se comprobó así mismo, la diferencia estadística significativa entre el GDr y los grupos GO y GDeDrO; entre el GM y los grupos GO y GDeDrO. CONCLUSIONES: La asociación dexametasona-droperidol-ondansetron y el ondansetron fueron más eficaces en la profilaxis de náuseas y vómitos.BACKGROUND AND OBJECTIVES: Prophylaxis of postoperative nausea and vomiting has been the subject of several studies. The objective of the present study was to compare anti-emetics, and their association, in the prevention of postoperative nausea and vomiting. METHODS: Seventy patients, ASA I and II, underwent epidural block associated with general anesthesia for gynecologic surgeries. Patients in the Metochlopramide Group

Availability of medicines in public sector health facilities of two North Indian States.

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Prinja, Shankar; Bahuguna, Pankaj; Tripathy, Jaya Prasad; Kumar, Rajesh

2015-12-23

Access to free essential medicines is a critical component of universal health coverage. However availability of essential medicines is poor in India with more than two-third of the people having limited or no access. This has pushed up private out-of-pocket expenditure due to medicines. The states of Punjab and Haryana are in the process of institutionalizing drug procurement models to provide uninterrupted access to essential medicines free of cost in all public hospitals and health centres. We undertook this study to assess the availability of medicines in public sector health facilities in the 2 states. Secondly, we also ascertained the quality of storage and inventory management systems in health facilities. The present study was carried out in 80 public health facilities across 12 districts in Haryana and Punjab states. Overall, within each state 1 MC, 6 DHs, 11 CHCs and 22 PHCs were selected for the study. Drug procurement mechanisms in both the states were studied through document reviews and in-depth interviews with key stakeholders. Stock registers were reviewed to collect data on availability of a basket of essential medicines -92 at Primary Health Centre (PHC) level, 132 at Community Health Centre (CHC) level and 160 at tertiary care (District Hospital/Medical College) level. These essential medicines were selected based on the Essential Medicine List (EML) of the Department of Health (DOH). Overall availability of medicines was 45.2% and 51.1% in Punjab and Haryana respectively. Availability of anti-hypertensives was around 60% in both the states whereas for anti-diabetics it was 44% and 47% in Punjab and Haryana respectively. Atleast one drug in each of the categories including analgesic/antipyretic, anti-helminthic, anti-spasmodic, anti-emetic, anti-hypertensive and uterotonics were nearly universally available in public sector facilities. On the contrary, medicines such as thrombolytics, anti-cancer and endocrine medicines were available in less

Biochemical and molecular characterization of Bacillus pumilus isolated from coastal environment in Cochin, India Caracterização bioquímica e molecular de Bacillus pumilus isolado do ambiente costeiro de Cochin, Índia

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Ammini Parvathi

2009-06-01

Full Text Available Bacillus species constitute a diverse group of bacteria widely distributed in soil and the aquatic environment. In this study, Bacillus strains isolated from the coastal environment of Cochin, India were identified by detailed conventional biochemical methods, fatty acid methyl ester (FAME analysis and partial 16S rDNA sequencing. Analysis of the data revealed that Bacillus pumilus was the most predominant species in the region under study followed by B. cereus and B. sphaericus. The B. pumilus isolates were further characterized by arbitrarily primed PCR (AP-PCR, antibiotic sensitivity profiling and PCR screening for known toxin genes associated with Bacillus spp. All B. pumilus isolates were biochemically identical, exhibited high protease and lipase activity and uniformly sensitive to antibiotics tested in this study. One strain of B. pumilus harboured cereulide synthetase gene cesB of B. cereus which was indistinguishable from rest of the isolates biochemically and by AP-PCR. This study reports, for the first time, the presence of the emetic toxin gene cesB in B. pumilus.As espécies de Bacillus constituem um grupo diversificado de bactérias amplamente distribuídas no solo e no ambiente aquático. Neste estudo, cepas de Bacillus isoladas do ambiente costeiro de Cochin, Índia, foram identificadas através de métodos bioquímicos convencionais, análise de ésteres metílicos de ácidos graxos (FAME e sequenciamento de 16S rDNA. A análise dos dados revelou que Bacillus pumilus foi a espécie predominante na região estudada, seguido de B. cereus e B. sphaericus. Os isolados de B. pumilus foram caracterizados através da reação em cadeia da polimerase com primers arbitrários (AP-PCR, perfil de sensibilidade a antibióticos e triagem por PCR de genes de toxinas associadas com Bacillus spp. Todos os isolados de B. pumilus foram bioquimicamente idênticos, apresentaram elevada atividade de protease e lipase e foram uniformemente sens

Sodium exchange process in lower vertebrates studies by means of {sup 24}Na. Their interpretation as a 'purification' of radioactive water; Les echanges de sodium des vertebres inferieurs etudies a l'aide du {sup 24}Na. Leur interpretation comme une 'epuration' d'eau radioactive

Energy Technology Data Exchange (ETDEWEB)

Maetz, J [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1958-07-01

Fresh-water fish and amphibians live in an aquatic medium which is very hypotonic with respect to their internal medium. By osmosis the water passes through their permeable teguments (gills, mucous membranes, skin). It is known from the work of Krogh (1937-1939) that this water is eliminated by the kidney, which emits a copious diluted urine. Yet however great the dilution, the urinary excretion results in a loss of salts for the organism. This loss is compensated, even in the absence of any nourishment, by active absorption of ions. Some recent workers have attempted, by using radioactive isotopes, to establish the balance between the input and output flows of ions through the permeable membranes in vivo, whereas chemical analytical methods only allow the net result of these exchanges to be obtained. We have attempted to present here a new method for the simultaneous measurement of the sodium flow takes over the whole animal. This method has been applied to the fresh-water fish Carassius auratus and to the frog Rana esculenta. In the course of this investigation we have considered interpreting it as a 'purification of radioactive water'. (author) [French] Les poissons d'eau douce et les amphibiens vivent dans un milieu aquatique tres hypotonique par rapport a leur milieu interieur. Par osmose, l'eau penetre a travers leurs teguments permeables (branchies, muqueuses, peau). On sait depuis les travaux de Krogh (1937-1939) que cette eau est eliminee par le rein qui emet une urine abondante et diluee. Mais si diluee soit-elle, l'excretion uranaire entraine une perte de sels pour l'organisme. Cette perte est compensee, meme en l'absence de toute alimentation, par une absorption active d'ions. Quelques travaux recents ont tente, grace a l'utilisation des isotopes radioactifs, de dresser le bilan des flux d'entree et de sortie des ions a travers les membranes permeables in vivo, alors que les methodes d'analyse chimique permettent seulement de dresser le bilan net de ces

The Comparative Accuracy of the 4 {pi} Liquid Scintillation Counting Method of Radioisotope Standardization; L'exactitude comparee de la methode de comptage 4 {pi} a scintillateurs liquides pour l'etalonnage des radioisotopes; Sravnitel'naya tochnost' 4 {pi} zhidkogo stsintillatsionnogo metoda podscheta standartiziruemykh radioizotopov; Exactitud del metodo de recuento con centelleador liquido 4 {pi} para normalizar radioisotopos, comparada con la de otros metodos

Energy Technology Data Exchange (ETDEWEB)

Steyn, J [National Physical Research Laboratory, Pretoria (South Africa)

1960-06-15

The accuracy of the 4 {pi} liquid scintillation counting method of standardizing {beta} emitters was compared to 4 l{pi} {beta}-{gamma} coincidence counting for the nuclides Co{sup 60}, I{sup 131} and Au{sup 198}. For P{sup 32} the liquid counting results were compared to 4 {pi} proportional counting. The efficiency of the liquid scintillation counting method was found to be energy dependent, dropping to about 97.5% for Co{sup 60} which was the lowest energy {beta} emitter investigated. (author) [French] La precision de la methode de comptage 4 {pi} a scintillateurs liquides pour l'etalonnage des emetteurs {beta} a ete comparee au comptage par coincidences 4 {pi} {beta}-{gamma} pour le So{sup 60}, le I{sup 131} et le Au{sup 198}. Dans le cas du P{sup 32}, les resultats du comptage au liquide ont ete compares a ceux du comptage 4 {pi} proportionnel. On a constate que le rendement de la methode de comptage a scintillateurs liquides variait en fonction de l'energie emise et qu'il descendait a environ 97.5% pour le Co{sup 60} qui, de tous les emetteurs {beta} etudies, emet l'energie la plus faible. (author) [Spanish] El autor compara la precision del metodo de recuento con centelleador iquido 4 {pi} para normalizar emisores {beta} con la del metodo de coincidencias {beta}-{gamma} 4 {pi}, para los siguientes nuclidos: So{sup 60}, I{sup 131} y Au{sup 198}. En el caso del P{sup 32}, confronta los resultados del primer metodo con los obtenidos mediante el recuento proporcional 4 {pi}. Comprueba que la eficacia del metodo de recuento con centelleador liquido depende de la energia y desciende al 97.5%, aproximadamente, para el Co{sup 60}, que fue el emisor {beta} mas debil que se investigo. (author) [Russian] Tochnost' 4 {pi} zhidkogo stsintillyatsionnog o metoda podscheta standartiziruemogo {beta}-izluchatelya sravnivalas' s 4 {pi} {beta}-{gamma} metodom podscheta na sovpadeniyakh dlya izotopov So{sup 60}, I{sup 131} i Au{sup 198}. Dlya R{sup 32} rezultaty zhidkogo

Glutamate Receptors in the Central Nucleus of the Amygdala Mediate Cisplatin-Induced Malaise and Energy Balance Dysregulation through Direct Hindbrain Projections.

Science.gov (United States)

Alhadeff, Amber L; Holland, Ruby A; Nelson, Alexandra; Grill, Harvey J; De Jonghe, Bart C

2015-08-05

thousands of patients undergo chemotherapies each year, the neural mechanisms mediating their side effects are unknown. The current data outline a neural circuit activated by cisplatin chemotherapy and demonstrate that glutamate signaling in the amygdala, arising from hindbrain projections, is required for the full expression of cisplatin-induced malaise, anorexia, and body weight loss. Together, these data help to characterize the neural circuits and neurotransmitters mediating chemotherapy-induced energy balance dysregulation, which will ultimately provide an opportunity for the development of well tolerated cancer and anti-emetic treatments. Copyright © 2015 the authors 0270-6474/15/3511094-11$15.00/0.

Glutamate Receptors in the Central Nucleus of the Amygdala Mediate Cisplatin-Induced Malaise and Energy Balance Dysregulation through Direct Hindbrain Projections

Science.gov (United States)

Alhadeff, Amber L.; Holland, Ruby A.; Nelson, Alexandra; Grill, Harvey J.

2015-01-01

). Although hundreds of thousands of patients undergo chemotherapies each year, the neural mechanisms mediating their side effects are unknown. The current data outline a neural circuit activated by cisplatin chemotherapy and demonstrate that glutamate signaling in the amygdala, arising from hindbrain projections, is required for the full expression of cisplatin-induced malaise, anorexia, and body weight loss. Together, these data help to characterize the neural circuits and neurotransmitters mediating chemotherapy-induced energy balance dysregulation, which will ultimately provide an opportunity for the development of well tolerated cancer and anti-emetic treatments. PMID:26245970

Avaliação de xaropes contendo cloridrato de metoclopramida, pelo método de Bratton-Marshall Evaluation of metoclopramide syrups by Bratton-Marshall method

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Beatriz Resende Freitas

2005-06-01

Full Text Available Atualmente, a maioria dos fármacos apresenta grupamento amínico. Estes quando associados a açúcares redutores ou a outros adjuvantes farmacêuticos contendo carbonila, freqüentemente produzem problemas de estabilidade, comprometendo a idoneidade do produto. A Reação de Maillard pode explicar tal ocorrência. Neste trabalho estudou-se o comportamento de xarope contendo amina aromática, tendo em vista a associação de açúcares e aminas, a Reação de Maillard e problemas de estabilidade. O protótipo escolhido foi o cloridrato de metoclopramida, benzamida com atividade farmacológica antiemética. Amostras dos xaropes de cloridrato de metoclopramida foram mantidas em estufa a 40 °C por seis meses. Em intervalos regulares de tempo alíquotas foram retiradas e submetidas à análise pelo método de Bratton-Marshall, seguida de leitura espectrofotométrica. Não houve grande variação no teor do cloridrato de metoclopramida em relação ao teor de açúcar, sendo que foram preparadas amostras padronizadas dos xaropes de cloridrato de metoclopramida em diferentes concentrações de açúcar. Houve diminuição do teor do cloridrato de metoclopramida, da ordem de 50%, tanto para amostras padronizadas como para amostra comercial.Nowadays, most of the drugs have amine group in their structure. These drugs, when associated to sugar reducers, or other carbonyl excipients frequently produce dark stains or fading. The Maillard reaction can explain such occurrence. In this work, we have studied the behavior of syrups containing aromatic amines. It is known that association of sugars and amines can generate problems of stability. The chosen prototype was the metoclopramide hydrochloride, a benzamide, with anti-emetic pharmacological activity. Samples of the metoclopramide syrups were maintained in stove at 40 °C for six months. In regular time intervals aliquots were removed and submitted to quantitative determination by the Bratton

A case of severe anorexia, excessive weight loss and high peptide YY levels after sleeve gastrectomy.

Science.gov (United States)

Pucci, Andrea; Cheung, Wui Hang; Jones, Jenny; Manning, Sean; Kingett, Helen; Adamo, Marco; Elkalaawy, Mohamed; Jenkinson, Andrew; Finer, Nicholas; Doyle, Jacqueline; Hashemi, Majid; Batterham, Rachel L

2015-01-01

Sleeve gastrectomy (SG) is the second most commonly performed bariatric procedure worldwide. Altered circulating gut hormones have been suggested to contribute post-operatively to appetite suppression, decreased caloric intake and weight reduction. In the present study, we report a 22-year-old woman who underwent laparoscopic SG for obesity (BMI 46 kg/m(2)). Post-operatively, she reported marked appetite reduction, which resulted in excessive weight loss (1-year post-SG: BMI 22 kg/m(2), weight loss 52%, >99th centile of 1-year percentage of weight loss from 453 SG patients). Gastrointestinal (GI) imaging, GI physiology/motility studies and endoscopy revealed no anatomical cause for her symptoms, and psychological assessments excluded an eating disorder. Despite nutritional supplements and anti-emetics, her weight loss continued (BMI 19 kg/m(2)), and she required nasogastric feeding. A random gut hormone assessment revealed high plasma peptide YY (PYY) levels. She underwent a 3 h meal study following an overnight fast to assess her subjective appetite and circulating gut hormone levels. Her fasted nausea scores were high, with low hunger, and these worsened with nutrient ingestion. Compared to ten other post-SG female patients, her fasted circulating PYY and nutrient-stimulated PYY and active glucagon-like peptide 1 (GLP1) levels were markedly elevated. Octreotide treatment was associated with suppressed circulating PYY and GLP1 levels, increased appetite, increased caloric intake and weight gain (BMI 22 kg/m(2) after 6 months). The present case highlights the value of measuring gut hormones in patients following bariatric surgery who present with anorexia and excessive weight loss and suggests that octreotide treatment can produce symptomatic relief and weight regain in this setting. Roux-en-Y gastric bypass and SG produce marked sustained weight reduction. However, there is a marked individual variability in this reduction, and post-operative weight loss

Extending the cereus group genomics to putative food-bornepathogens of different toxicity

Energy Technology Data Exchange (ETDEWEB)

Lapidus, Alla; Goltsman, Eugene; Auger, Sandrine; Galleron,Nathalie; Segurens, Beatrice; Dossat, Carole; Land, Miriam L.; Broussole,Veronique; Brillard, Julien; Guinebretiere, Marie-Helene; Sanchis,Vincent; Nguen-the, Christophe; Lereclus, Didier; Richardson, Paul; Winker, Patrick; Weissenbach, Jean; Ehrlich, S.Dusko; Sorokin, Alexei

2006-08-24

The cereus group represents sporulating soil bacteriacontaining pathogenic strains which may cause diarrheic or emetic foodpoisoning outbreaks. Multiple locus sequence typing revealed a presencein natural samples of these bacteria of about thirty clonal complexes.Application of genomic methods to this group was however biased due tothe major interest for representatives closely related to B. anthracis.Albeit the most important food-borne pathogens were not yet defined,existing dataindicate that they are scattered all over the phylogenetictree. The preliminary analysis of the sequences of three genomesdiscussed in this paper narrows down the gaps in our knowledge of thecereus group. The strain NVH391-98 is a rare but particularly severefood-borne pathogen. Sequencing revealed that the strain must be arepresentative of a novel bacterial species, for which the name Bacilluscytotoxis is proposed. This strain has a reduced genome size compared toother cereus group strains. Genome analysis revealed absence of sigma Bfactor and the presence of genes encoding diarrheic Nhe toxin, notdetected earlier. The strain B. cereus F837/76 represents a clonalcomplex close to that of B. anthracis. Including F837/76, three such B.cereus strains had been sequenced. Alignment of genomes suggests that B.anthracis is their common ancestor. Since such strains often emerge fromclinical cases, they merit a special attention. The third strain, KBAB4,is a typical psychrotrophe characteristic to unbiased soil communities.Phylogenic studies show that in nature it is the most active group interms of gene exchange. Genomic sequence revealed high presence ofextra-chromosomal genetic material (about 530 kb) that may account forthis phenomenon. Genes coding Nhe-like toxin were found on a big plasmidin this strain. This may indicate a potential mechanism of toxicityspread from the psychrotrophic strain community. The results of thisgenomic work and ecological compartments of different strains incite

MATHEMATICAL-Universe-Hypothesis(MUH) BECOME SCENARIO(MUS)!!! (NOT YET A THEORY) VIA 10-DIGITS[ 0 --> 9] SEPHIROT CREATION AUTOMATICALLY from DIGITS AVERAGED-PROBABILITY Newcomb-Benford LOG-Law; UTTER-SIMPLICITY!!!: It's a Jack-in-the-Box Universe: Accidental?/Purposeful?; EMET/TRUTH!!!

Science.gov (United States)

Siegel, Edward Carl-Ludwig

2015-04-01

Siegel(2012) 10-DIGITS[0 --> 9] AVERAGE PROBABILITY LOG-Law SCALE-INVARIANCE UTTER-SIMPLICITY: Kabbala SEPHIROT SCENARIO AUTOMATICALLY CREATES a UNIVERSE: (1) a big-bang[bosons(BEQS) created from Newcomb[Am.J.Math.4(1),39(1881;THE discovery of the QUANTUM!!!)-Poincare[Calcul des Probabilites,313(12)]-Weyl[Goett.Nach.(14);Math.Ann.77,313(16)] DIGITS AVERAGE STATISTICS LOG-Law[ = log(1 +1/d) = log([d +1]/d)] algebraic-inversion, (2)[initial (at first space-time point created) c = ∞ elongating to timelike-pencil spreading into finite-c light-cone] hidden-dark-energy (HDE)[forming at every-spacetime-point], (3) inflation[logarithm algebraic-inversion-to exponential], (4) hidden[in Siegel(87) ``COMPLEX quantum-statistics in (Nottale-Linde)FRACTAL-dimensions'' expansion around unit-circle/roots-of-unity]-dark-matter(HDM), (4)null massless bosons(E) --> Mellin-(light-speed squared)-transform/Englert-Higgs ``mechanism'' -->(timelike) massive fermions(m), (5) cosmic-microwave-background (CMB)[power-spectrum] Zipf-law HYPERBOLICITY, (6) supersymmetry(SUSY) [projective-geometry conic-sections/conics merging in R/ C projective-plane point at ∞]. UTTER-SIMPLICITY!!!

The anti emetic effect of oral administration of ondansetron or granisetron in macacus cynomolgus exposed to mixed neutron-gamma irradiation; Effet antiemetique de l`ondansetron ou du granisetron administres oralement chez le macaque soumis a une irradiation mixte neutron-gamma

Energy Technology Data Exchange (ETDEWEB)

Martin, C.; Roman, V.; Martin, S.; Janodet, D.; Fatome, M. [Centre de Recherches du Service de Sante des Armees, 38 - La Tronche (France)

1995-10-01

Nausea and vomiting are the most often observed symptoms in the course of the early radiation syndrome. Their prevention has long been difficult because of the low effectiveness and side-effects of most antiemetics. There is a clear evidence that 5HT{sub 3} receptor antagonists such as ondansetron and granisetron are highly effective to prevent radiation-induced emesis without any side-effect. We studied the prophylactic effectiveness of their oral administration to macacus cynomolgus, for mixed neutron-gamma whole-body exposure, tat high dose rates. Doses of 4 mg of ondansetron or 1 mg of granisetron were administered before, or after, or both before and after irradiation. The treatment was effective when administered both before and after radiation exposure. It was significant but incomplete if administered once. Post-irradiation administration is interesting, particularly in case of accident. Both antiemetic drugs were well tolerated. Their effectiveness and tolerance are apparently comparable. The 5HT{sub 3} receptor antagonists represent a much improved treatment for radiation-induced nausea and vomiting by completely inhibiting emesis, if administered before and after irradiation. Unwanted sedation and extra-pyramidal side-effects, usually associated with the clinical use of D{sub 2} receptor antagonists, were not observed. (authors). 40 refs., 5 tabs.

Hesperetin-5,7,3'-O-triacetate suppresses airway hyperresponsiveness in ovalbumin-sensitized and challenged mice without reversing xylazine/ketamine-induced anesthesia in normal mice.

Science.gov (United States)

Yang, You-Lan; Chen, Chi-Li; Chen, Chi-Ming; Ko, Wun-Chang

2017-05-30

We recently reported that hesperetin-5,7,3'-O-triacetate (HTA) dually inhibited phosphodiesterase (PDE)3/4 with a therapeutic ratio of 20.8. The application and development of PDE4 inhibitors for treating asthma or COPD are limited by their side effects, such as nausea, vomiting and gastric hypersecretion. PDE4 inhibitors were reported to reverse xylazine/ketamine-induced anesthesia in rats and triggered vomiting in ferrets. Thus the reversing effect of HTA on xylazine/ketamine-induced anesthesia in mice was studied to assess emetic effect of HTA. The aim of this study was to prove the therapeutic effect of HTA without vomiting effect at an effective dose for treating COPD. Ten female BALB/c mice in each group were sensitized by ovalbumin (OVA) on days 0 and 14. On day 21, these mice were emphasized the sensitization by Freund's complete adjuvant. Mice were challenged by 1% OVA nebulization on days 28, 29, and 30. Airway hyperresponsiveness (AHR) was assessed on day 32 in each group, using the FlexiVent system to determine airway resistance (R L ) and lung dynamic compliance (C dyn ) in anesthetized ovalbumin (OVA)-sensitized and challenged mice. Each group was orally administered HTA (10 ~ 100 μmol/kg), roflumilast (1 and 5 mg/kg) or vehicles (controls) 2 h before and 6 and 24 h after OVA provocation. For comparison, sham-treated mice were challenged with saline instead of 1% OVA. The ability to reverse xylazine/ketamine-induced anesthesia by HTA or roflumilast for 3 h was determined in normal mice. We used roflumilast, a selective PDE4 inhibitor and bronchodilator for severe COPD approved by the US Food and Drug Administration, as a reference drug. In the results, HTA (100 μmol/kg, p.o.) or roflumilast (5 mg/kg, p.o.) significantly suppressed all R L values of MCh at 0.78 ~ 25 mg/mL and enhanced C dyn values of MCh at 3.125 ~ 25 mg/mL compared to OVA-sensitized and -challenged control mice. Orally administered 1, 3 or 10 mg/kg roflumilast

Factores de riesgo asociados al sexting como umbral de diversas formas de victimización. Estudio de factores correlacionados con el sexting en una muestra universitaria

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Jose R. Agustina

2016-07-01

Full Text Available

En los últimos años, la irrupción del fenómeno del sexting ha generado una significativa preocupación mediática y social. La práctica del sexting se ha revelado problemática, en tanto que puede producir graves consecuencias psicológicas y jurídicas, especialmente en adolescentes. La aparición de tales consecuencias ha puesto de manifiesto la urgente necesidad de desarrollar estrategias de prevención adecuadas. Más aún, mediante el envío de mensajes, imágenes o vídeos de sexting, menores (y también adultos cruzan inadvertidamente un umbral de riesgo que los expone sin vuelta atrás a diversas formas de victimización (chantajes, venganzas o simples indiscreciones altamente perjudiciales. Asimismo, puede suponer el inicio de delitos sexuales iniciados a través de las TIC (Wolak <em>et al., 2004.

En un primer momento, la mayoría de las investigaciones realizadas se centraron en analizar la prevalencia del fenómeno y los motivos que decían tener los encuestados para obrar de este modo. A pesar de las diferencias en los diversos estudios —en función del tipo de muestra y de los parámetros para definir las conductas objeto de cuantificación—, las investigaciones realizadas apuntan sin duda hacia la presencia global de un fenómeno similar. Sin embargo, la investigación apenas ha iniciado la exploración de posibles factores asociados al sexting. El presente estudio pretende —más allá de medir la prevalencia del fenómeno o describir los motivos aparentes de los encuestados— contrastar algunas hipótesis sobre factores asociados al sexting basándose en una muestra de 149 estudiantes universitarios en Barcelona (España. Los resultados obtenidos muestran una tasa relativamente alta de comportamientos de sexting en jóvenes-adultos y sugieren una relación positiva significativa con los siguientes factores: bajos estándares de

Infracommunities of intestinal helminths of the Red Fox Vulpes vulpes (Linnaeus, 1758 from Italian Alps

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Anna Rita Di Cerbo

2003-10-01

software GRASS rel. 5.1. The species recorded belong to Cestoda (Mesocestoides lineatum, Taenia spp., Echinococcus multilocularis, Nematoda (Uncinaria stenocephala, Toxocara canis, Pterygodermatites affinis, Molineus legerae, Trichuris vulpis, Subulurinae and Trematoda (Pharingostomum cordatum. The most part of foxes captured harboured intestinal helminths (over 80 %. Taenidae (except for E. multilocularis U. stenocephala and T. canis constitute the core species of the helminthic community. The others behave as satellite species. The nematode belonging to the subfamily Subulurinae and the trematode P. cordatum were found for the first time in Italian foxes. Our data confirm also the presence of E. multilocularis in Italy already reported by Manfredi <em>et al. (2002.

Attitude and practice of medical students studying in Hungary and India toward health during overseas and domestic travel.

Science.gov (United States)

Sweni, Shah; Muthusundari, Arunachalam; Meenakshisundaram, Ramachandran; Uma, Alagappan; Thirumalaikolundusubramanian, Ponniah

2010-01-01

It is presumed that medical students are travelers who can take care of their health, and thus the present study was conducted to elicit the attitude and practice [AP] of medical students from two different countries toward travel health issues. To elicit the attitude and practice of medical students from two different countries toward travel health issues and identify the reasons for any variations. An anonymous pre-tested structured questionnaire consisting of socio-demographic details, travel aspects, travel health issues, and precautions [medicines carried, vaccination history, and pre-travel consultation] adopted was distributed to 250 foreign medical students studying at the University of Debrecen, Hungary [Group I] and another 250 native medical students in India [Group II]. Data were analyzed by simple descriptive statistics and Student t-test. A total of 428 students responded among total eligible population of 500; 228 [90.2%] in group I and 200 [80%] in group II. In 2008, 188 [82%] of the former and 33 [16.5%] of the latter groups traveled to international destinations. Among groups I and II, health problems were experienced by 73 [32%] and 65 [32.5%] students, respectively. During hospitalization, students of group I were admitted for one of the following illnesses such as severe asthma, dehydration, malaria, and tibial fracture, while two other students were admitted to the hospital with deep vein thrombosis [DVT]. During travel, the category of medicines carried by students belonging to group I/II were anti-diarrhoeal [75/19], anti-emetics [53/39], anti-giddiness [49/7], anti-histamines [55/12], anti-pyretics plus analgesics [197/70], anti-spasmodics [55/11], antibiotics [33/10], vitamin pills [84/0], and laxatives [47/6]; supportive items such as adhesive plaster [64/3], and thermometer [37/1]; personal protective materials viz., mineral water [165/88], hygienic food [100/132], insect repellents [86/14], special clothes such as full sleeves and cap

Poaia [Psychotria ipecacuanha (Brot. Stoves]: aspectos da memória cultural dos poaieiros de Cáceres - Mato Grosso, Brasil Ipecac [Psychotria ipecacuanha (Brot. Stoves]: aspects of cultural memory of "poaieiros" in Cáceres - Mato Grosso, Brazil

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V.A. Teixeira

2012-01-01

Full Text Available O Brasil está entre os principais exportadores de poaia [Psychotria ipecacuanha (Brot. Stoves] seguido do Panamá e Costa Rica. A poaia brasileira apresenta alto valor farmacológico das raízes devido aos teores de emetina e cefalina. Este trabalho teve como objetivo descrever como as famílias de poaieiros mantém a memória cultural sobre a Psychotria ipecacuanha (Brot. Stoves. As informações foram coletadas no município de Cáceres, Mato Grosso, através de entrevista estruturada e observação participante com 20 homens e 10 mulheres, de faixa etária de 45 a 86 anos. Foram citadas as formas de utilização na alimentação para animais, inseticida, carrapaticida, emético, contra diarréias, para alívio de dor de cabeça, contra malária, bronquite e dor no estômago. A raiz é a parte mais usada e a forma de preparo é tintura ou misturada ao fumo, ao vinho ou à cachaça. Poucos entrevistados passaram aos filhos o conhecimento sobre a P. ipecacuanha. A memória cultural sobre a P. ipecacuanha deve-se a vivência, extração e comercialização da planta, e por ouvir as conversas dos pais com amigos. A perda de conhecimento associado a poaia é causada pelo êxodo rural, destruição do habitat com o desmatamento e ocupação agrícola. A extinção da espécie na região contribui para a erosão cultural.Brazil is among the leading exporters of ipecac [Psychotria ipecacuanha (Brot. Stoves], followed by Panama and Costa Rica. The roots of Brazilian ipecac have high pharmacological value due to their levels of emetine and cephalin. This study aimed to describe how families of "poaieiros" maintain the cultural memory of Psychotria ipecacuanha (Brot. Stoves. Information was collected in the city of Cáceres, Mato Grosso State, Brazil, through structured interviews and participating observation involving 20 men and 10 women aged from 45 to 86 years. The cited forms of use were in animal nutrition, as insecticide, acaricide, emetic

Historical development of modern anesthesia.

Science.gov (United States)

Robinson, Daniel H; Toledo, Alexander H

2012-06-01

in 1937. He was the first to describe the routinely placing of the tip of his newly re-designed laryngoscope in the epiglottic vallecula which is attached to the base of the tongue, thus when lifted exposed the entire larynx. Macintosh was genuinely astonished at what a great view he could achieve with his new blade and technique. The use of barbiturates as an intravenous anesthetic began in 1932. Sodium thiopental gained popularity after its use was described in detail by a Dr. John Lundy (1894-1973) of the Mayo Clinic. Other I.V. medications were tried over the past seventy years, but the newest induction drug which provided for a substantially shorter recovery period and seemed to actually suppress laryngeal reflexes has brought with it many benefits. Propofol, introduced clinically in 1977, demonstrated many positive effects even as an anti-emetic compound. Before October of 1846, surgery and pain were synonymous but not thereafter. As we entered the information age where the infrastructure of evidence based medicine and newer fields of genetics, transplantation, imaging radiology and even stem cells became quickly integrated into mainstream medicine, we can predict an excellent future on the progress to be made in anesthesia.

Phytochemistry and pharmacology of the genus Drypetes: A review.

Science.gov (United States)

Wansi, Jean Duplex; Wandji, Jean; Sewald, Norbert; Nahar, Lutfun; Martin, Claire; Sarker, Satyajit Dey

2016-08-22

, phenylpropanoids and steroids, as well as some thiocyanates, were isolated. Several crude extracts of these plants, and isolated compounds displayed significant analgesic, anthelmintic, antidiabetic, anti-emetic anti-inflammatory, antioxidant, antiparasitic, central nervous system depressant, cytotoxic, and insecticidal activities both in vitro and in vivo. Some toxicities associated with the stem, bark, seed and leaf extracts of D. roxburghii, and the flavonoid, amentoflavone, isolated from the stem extract of D. littoralis as well as D. gerrardii, were confirmed in the animal models and in the rat skeletal myoblast cells assays. As a consequence, traditional medicine from this genus should in future be applied with care. Plants of this genus have offered bioactive samples, both from crude extracts and pure compounds, partly validating their effectivity in traditional medicine. However, most of the available scientific literatures lacks information on relevant doses, duration of the treatment, storage conditions and positive controls for examining bioefficacy of extract and its active compounds. Additional toxicological studies on the species used in local pharmacopeia are urgently needed to guarantee safe application due to high toxicity of some crude extracts. Interestingly, this review also reports 10 pimarane dinorditerpenoids structures with the aromatic ring C, isolated from the species collected in Asia Drypetes littoralis (Taiwan), D. perreticulata (China), and in Africa D. gerrardii (Kenya), D. gossweileri (Cameroon). These compounds might turn out to be good candidates for chemotaxonomic markers of the genus. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A COMPARATIVE STUDY OF THE EFFICACY OF GRANISETRON AND ONDANSETRON IN THE PREVENTION OF POST OPERATIVE NAUSEA AND VOMITING IN LSCS PATIENTS UNDER SPINAL ANAESTHESIA

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Jagadeesh Babu

2015-08-01

grade I, they were divided into three groups. 25 patients (group – P received 10ml inj. Normal saline I.V, 25 patients (group – O received inj. Ondansetron 4 m g diluted in 10ml normal saline I.V & 25 patients (group - G inj. Granisetron 1mg I.V diluted in 10 ml normal saline . These drugs were administered 10 minutes before the administration of spinal anaesthesia. There were no significant differences between the three groups regarding patient characteristics (age, body weight, height and previous history of motion sickness and PONV, type of surgery, type of anaesthesia, and duration of pre - operative starvation, duration of surgery and administration of post - oper ative analgesics. Patient data were analysed by chi - square test and standard error or difference between proportions. P value of 0.05 or less was considered significant. CONCLUSION : By our placebo controlled clinical trial it has been proved that the incid ence of PONV is nearly 60% in caesarean deliveries performed under spinal anaesthesia. On the basis of the present study it can be concluded that injection Granisetron in a dose of 1 mg. I.V. is much more effective in minimizing severe nausea and vomiting than ondansetron in a dose of 4 mg. I.V. and is free from the side effect headache which is a drawback of ondansetron. The use of granisetron as prophylactic antiemetic for high risk group may be recommended. Granisetron seems to be useful alternative and relatively safe drug for effective anti - emetic prophylaxis.

Masaje Tuina en el tratamiento de la dispepsia funcional en los niños Tuina massage in the treatment of functional dyspepsia in children

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Lesbia Infante Tamayo

2008-03-01

the Chinese traditional medicine. The aim of this paper was to show the efficacy of the Tuina massage in the treatment of functional dyspepsia in children. METHODS. A controlled clinical trial was conducted among patients with functional dyspepsia that met the previously established inclusion criteria. The sample consisted of 100 patients divided into 2 groups: group A with patients that were applied massage, and group B that was made up of patients that received conventional treatment. The technique used was push and massage (tonification and dispersion. The stimulated zones were Ban Men, Zhong Wan (Vc12, ZusanLi (E36, San Guan, Liu Fu. The conventional treatment consisted in the administration of metoclopramide at doses of 0.1 mg/kg every 8 hours by intramuscular route. Once the emetic picture was controlled, the same drug was orally administered and with the same frequency. Both groups were evaluated at 12, 24, 48, 72 h of the initial treatment. RESULTS. The response to the conventional treatment was higher in the study group (48; 96 % compared with the control group (46; 92 %, but the differences were not statistically significant. The complications found were extrapyramidal reactions and skin irritation, but the differences between the 2 groups were not marked either. The length of hospital stay of most of the patients was between 25 and 48 hours. CONCLUSIONS. It was concluded that the Tuina massage is as efficient as the conventional treatment for controlling functional dyspepsia in children.

Organization and methodology applied to the control of commissioning tests to guarantee safe operation of nuclear units; Organisation et methodologie appliquees au controle des essais de mise en service pour assurer la surete de fonctionnement des tranches electronucleaires

Energy Technology Data Exchange (ETDEWEB)

Clausner, J P; Jorel, M

1990-12-01

This paper describes the activities of the Safety Analysis Department (DAS), which provides technical support for the French safety authorities in the specific context of analysis and control of startup test programme quality at each of the different stages of the programme. These activities combine to ensure that the objective of the startup tests is reached, in particular that the functions of each safety-related system are guaranteed in all operating configurations, that the performance levels of all components in the system comply with design criteria and that defects revealed during previous tests have been dealt with correctly. The special case of French nuclear facilities, linked to unit standardization, has made it possible to acquire a large amount of experience with the startup of the 900 MWe units and has illustrated the importance of defining a startup test programme. In 1981, a working group, comprising operating organization and safety authority representatives, studied the lessons which had to be learned from 900 MWe unit startup and the improvements which could be made and taken into account in the 1300 MWe unit startup programme. To illustrate the approach adopted by the DAS, we go on to describe the lessons learned from startup of the first 1300 MWe (P4) units. (author) [French] Au sein de l'Institut de Protection et de Surete Nucleaire (IPSN), le Departement d'Analyse de Surete (DAS) constitue le support technique du Service Central de Surete des Installations Nucleaires (SCSIN) qui est l'autorite de surete francaise. A ce titre, il evalue les programmes d'essais de demarrage et emet un avis sur le traitement des problemes survenus au cours des essais. Pour ce faire, le DAS assure l'analyse du programme d'essais depuis l'elaboration des documents jusqu'a la montee du reacteur a sa puissance nominale. L'evaluation du DAS commence par une analyse approfondie des programmes de principe d'essais (PPE) qui sont etablis par Electricite de France (EDF

GEOLOGICAL FEATURES OF NEOGENE BASINS HOSTING BORATE DEPOSITS: AN OVERVIEW OF DEPOSITS AND FUTURE FORECAST, TURKEY

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Cahit HELVACI

2015-12-01

Full Text Available The geometry, stratigraphy, tectonics and volcanic components of the borate bearing Neogene basins in western Anatolia offer some important insights into on the relationship between basin evolution, borate formation and mode of extension in western Anatolia. Some of the borate deposits in NE-SW trending basins developed along the İzmir-Balıkesir Transfer Zone (İBTZ (e.g. Bigadiç, Sultançayır and Kestelek basins, and other deposits in the NE-SW trending basins which occur on the northern side of the Menderes Core Complex (MCC are the Selendi and Emet basins. The Kırka borate deposit occurs further to the east and is located in a completely different geological setting and volcanostratigraphic succession. Boron is widely distributed; including in soil and water, plants and animals. The element boron does not exist freely by itself in nature, but rather it occurs in combination with oxygen and other elements in salts, commonly known as borates. Approximately 280 boron-bearing minerals have been identified, the most common being sodium, calcium and magnesium salts. Four main continental metallogenic borate provinces are recognized at a global scale. They are located in Anatolia (Turkey, California (USA, Central Andes (South America and Tibet (Central Asia. The origin of borate deposits is related to Cenozoic volcanism, thermal spring activity, closed basins and arid climate. Borax is the major commercial source of boron, with major supplies coming from Turkey, USA and Argentina. Colemanite is the main calcium borate and large scale production is restricted to Turkey. Datolite and szaibelyite are confined to Russia and Chinese sources. Four Main borax (tincal deposits are present in Anatolia (Kırka, California (Boron, and two in the Andes (Tincalayu and Loma Blanca. Kırka, Boron and Loma Blanca have similarities with regard to their chemical and mineralogical composition of the borate minerals. Colemanite deposits with/without probertite and

MUTIRÕES DE COLECISTECTOMIA POR VIDEOLAPAROSCOPIA EM REGIME DE CIRURGIA AMBULATORIAL INTENSIVE PROGRAM OF VIDEOLAPAROSCOPY CHOLECYSTECTOMY ON AN AMBULATORY SURGERY BASIS

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J.S. Santos

2001-01-01

and II (Group A and 79 records of the 80 patients operated upon in the intensive programs III and IV (Group B. Statistical analysis was concluded using the Wilcoxon and Fisher's exact tests, with the level of significance of p=0.05. Results: Co-morbidities were recorded for 48 patients of Group A (60.8% and for 31 of Group B (39.8%, p=0.007. Acute inflammation and scleroatrophy of the gallbladder were observed in 10 patients of group A (12.7% and in 2 patients of group B (2.6%. The mean duration of surgery was 90 minutes (25-240 for group A and 68.2 minutes (20-180 for group B, p=0.002. There was one conversion in each group (1.3%. Prophylaxis for pain and vomiting was performed in 13 (16.4% and 2 (2.5% patients of group A, respectively. In group B, 63 patients (79.7% received prophylaxis with analgesics and 73 (92.5% with anti-emetics. Abdominal pain, vomiting and cardiorespiratory symptoms during post-anesthetic recovery involved 34 (43%, 18 (22.6% and 10 (12.6% of the patients in group A and 18 (22.8%, 14 (17.7% and 3 (3.8% of the patients in group B. The need for an overnight stay was greater in group A: 45 patients (50.7% with a mean hospital stay of 18.3 hours (2.2-26, while in group B 5 patients stayed overnight and the mean permanence time was 7.8 hours (4-24, p=0.000. Five hospital admissions occurred in group A (6.3% and 2 in group B (2.5%. Medical re-evaluation during the first week was necessary for 8 patients of group A (10.2% and resulted in 3 readmissions (3.8%. In group B, 2 patients (2.6% sought health services but did not require readmission. In group A, 2 patients presented coliperitoneum and 1 was re-operated upon. No death occurred in either group. Conclusion: As experience was gained in these programs, the process of patient selection and the offer of preoperative care were improved, demonstrating that intensive programs of videolaparoscopic cholecystectomy are a possible strategy for the reduction of waiting lists.

Interpretation of Bioassay Data; Interpretation des Donnees de l'Analyse d'Echantillons Biologiques; Interpretatsiya dannykh biologicheskikh issledovanij; Interpretacion de Datos Obtenidos por Bioanalisis

Energy Technology Data Exchange (ETDEWEB)

Dolphin, G. W.; Jackson, S. [Health Physics and Medical Division, Atomic Energy Research Establishment, Harwell, Berkshire (United Kingdom)

1964-10-15

routine surveillance of a group of personnel. The data available about metabolism of the radionuclide are used to evaluate an investigation level, namely, the urinary excretion rate corresponding to a chosen level of body content. It is important that measurements for routine surveillance should be made with maximum accuracy and carer fully recorded. These measurements may be used much later in making an assessment of .the chronically- acquired body content. A summary is presented of the human data available on metabolism and urinary excretion of tritium, caesium, uranium, strontium, radium and plutonium. (author) [French] Afin d'evaluer la dose de rayonnements a l'organe critique due a la contamination interne par un radionucleide, il faut mesurer la quantite du radionucleide dans le corps. Quand le radionucleide emet des rayons gamma ou X, ou des rayonnements beta donnant.naissance a un rayonnement de freinage convenable, on peut proceder a-desmesures directes de la charge corporelle de ce radionucleide dans un anthroporadiametre, mais lorsque le radionucleide n'emet pas de rayonnements convenables, on est oblige d'evaluer la charge corporelle d'apres les mesures de la quantite du radionucleide contenue dans les excreta, le sang, l'haleine ou des tampons provenant du nez ou de la bouche. Certaines etudes ont ete faites sur l'elimination urinaire des radionucleides, consideree comme un indice de la contamination interne, et l'analyse de l'urine est la forme la plus repandue de l'analyse d'echantillons biologiques. Cependant, le caractere fragmentaire des donnees de reference dont on dispose sur le metabolisme des radionucleides constitue toujours une faiblesse tres grave et il faut faire d'urgence beaucoup de travaux de recherche dans ce domaine. Dans cette etude, on a classe les differents modes de metabolisme des divers radionucleides en trois grandes categories. Le premier groupe comprend les radionucleides repartis dans l'ensemble du corps de facon assez uniforme. Le

Estudo de um foco de Leishmaniose muco-cutânea na Baixada Fluminense (Estado do Rio de Janeiro

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F. Nery-Guimarães

1955-05-01

lesions (10,3%, 16 presented multiple lesions (41,0%, and 19 were female (48,7%. There was an absolute predominance of lesions on bare parts of the body. About one third of the cases were children of 10 years or less, confirming the intense domiciliary transmission. Some houses had 2 to 6 patients. On basis of informations furnished by the patients of by their relatives as to the time elapsed since the beginning of the infection, and admitting an incubation period of 2 months, it is possible to conclude that the great majority of infections probably occurred between July and December, coinciding with the great felling of trees already referred to. In 36 cases Montenegro's intradermo-reaction was made, with 2 doubtful and 34 positive results of variable intensity. Eighteen biopsies were made, the epidermis presenting hyperacanthosis, and frquently pseudoepitheliomatosis with corneous globules and micro-abscesses. The dermis showed two characteristic pictures: an infiltration with predominance of plasmocytes or a granulomatous lesion with epithelioid and giant cells. In general, granulomatosis occurred in older cases, isolated or associated to infiltration with plasmocytes. It seems that granulomatosis represents a hyperergic condition of the infected organism, as the patients who showed it had the disease for a longer time and reponded strongly to the intradermo-reaction. Leishmaniae were not numerous in sections. Three patients showed spontaneous cure. Twenty six patients were treated, 16 with tartar emetic, 4 with "fuadin" and 4 with both these drugs. Some of the patients treated with tartar showed toxic symptoms, although the results were as good as those obtained with "fuadin". Two patients with nasal mucous lesions were not cured, notwithstanding the use of both these drugs. Five years after this survey, muco-cutaneous leishmaniasis was absent from the region, probably as a consequence of several preiodical DDT house sprayings to combate malaria during the intervening

The Technique and Dosimetry of Pituitary Implantation Using Sources of Y{sup 90}; Technique et Dosimetrie de l'Implantation de Sources d'Yttrium-90 dans l'Hypophyse; ДОЗИМЕТРИЯ ИМПЛАНТИРОВАННЫХ В ГИПОФИЗ ИГЛ ИТТРИЯ-90; Dosimetria de la Implantacion de Fuentes de {sup 90}Y en la Hipofisis

Energy Technology Data Exchange (ETDEWEB)

Duggan, Mary H.; Jones, E.; Mallard, J. R. [Department of Physics, Hammersmith Hospital, London (United Kingdom); Joplin, G. F. [Department of Medicine, Postgraduate Medical School, London (United Kingdom)

1963-03-15

car il n'emet que des particules beta, dont le parcours maximum (7 mm) equivaut aux dimensions de la glande. Si l'on implante des aiguilles d'activite standard dans la glande sans tenir compte de ses dimensions, on ne peut pas administrer a la glande une dose standard; il convient donc d'adapter les dimensions et l'activite de la source aux dimensions de la glande. On peut ainsi s'efforcer de rationaliser la methode d'une implantation a l'autre. Etant donne la forme de la glande et son mode d'acces, il est possible d'obtenir une destruction totale par implantation de deux sources. Chacune de ces sources est constituee par une aiguille de Y{sub 2}O{sub 3} fritte, d*un diametre de 1 mm et d'une longueur adaptee aux dimensions de la glande. L'activite de l'aiguille est egalement determinee en fonction des dimensions de la glande: elle est en general de 2 a 3 me. La dose de rayonnement a ete calculee experimentalement d'apres la geometrie et l'activite. On a utilise de la cire 'Mix D ' comme absorbant equivalent au tissu, un film comme detecteur et une source au strontium-90 etalonnee- dont l'yttrium- 90 est un descendant-comme etalon. L'une des conclusions auxquelles les presents travaux ont abouti est que la necrose et l'ablation de l'hypophyse exigent une dose de rayonnement comprise entre 100 000 a 200 000 rad. (author) [Spanish] En el tratamiento del cancer mamario y de la prostata,de las retinopatias diabeticas, de la enfermedad de Cushing, de la acromegalia y, ocasionalmente, delas exoftalmia en la enfermedad de Graves, se recurre cada vez mas a la ablacion de la hipofisis por implantacion de agujas de soy. Este radioisotopo es el mas adecuado cuando se procura lograr la ablacion completa, porque solo emite particulas {beta} cuyo alcance maximo (7 mm) es comparable con las dimensiones de la glandula. Si se implantan en la glandula varillas de actividad normalizada, independientemente de su tamano, no se le puede administrar una dosis standard, de modo que el metodo

Memorizing circuit for long pulses; Circuit de memoire pour impulsions longues; Zapominayushchee ustrojstvo dlya dlitel'nykh impul'sov; Circuito memorizador para impulsos de larga duracion

Energy Technology Data Exchange (ETDEWEB)

Coli, M; Horn, G [Sorin Centro Ricerche Nucleari di Saluggia (Italy)

1962-04-15

de decroissance retenus par l'oscilloscope sont les temps propres au circuit de memorisation. On peut considerer le circuit comme etant forme essentiellement de deux circuits d'allongement qui transforment la largeur a l'entree de t en t + {tau}. On additionne les impulsions allongees de phases opposees pour obtenir a la sortie, une impulsion d'amplitude A et de largeur t. Le retard {tau} est commande a l'aide de deux circuits monostables, declenches a un intervalle t (circuit de la commande de retard) par un amplificateur sature qui donne a l'impulsion d'entree une forme rectangulaire et emet deux impulsions par l'intermediaire d'un circuit de differentiation (circuit de mesure du retard). L'impulsion de sortie est retransmise a l'entree par un attenuateur et une ligne a retard. Le cycle est repete avec une frequence de repetition de {approx} 1/{tau}. L'impulsion memorisee a une largeur comprise entre 50 {mu}s et 10 ms ou davantage. La frequence de repetition peut varier de 10{sup 4} Hz a 30 Hz et en dessous. Les auteurs decrivent egalement un autre circuit fonde sur le meme principe et capable de memoriser, en plus de l'amplitude et de la largeur, la forme de l'impulsion d'entree. (author) [Spanish] El circuito permite el almacenaje ilimitado de un impulso positivo de cualquier forma, conservando tanto la amplitud como el ancho del impulso. En teoria, un impulso rectangular de amplitud A y anchura t producido como impulso aislado en un tiempo t = 0 puede ser reproducido en su propia area despues de un tiempo cualquiera {tau}, de forma que puede ser retenido en un osciloscopio sincronizado a una frequencia de repeticion {approx_equal} 1/{tau}. El circuito no memoriza la forma de elevacion del impulso, asi que los tiempos de elevacion y de caida del impulso que retiene el osciloscopio son los inherentes al propio circuito memorizador. En esencia, se puede considerar que el circuito esta formado por dos circuitos alargadores que amplian la anchura de entrada desde ra

Detection of Beta-Emitting Nuclides of Energy >1 Mev in Urine After an Accident by Means of Measurement of the Cerenkov Effect in a Liquid Scintillation Counting System; Detection des Radioelements Emetteurs Beta d'une Energie Superieure a 1 Mev dans l'Urine Apres un Accident, par la Mesure de l'Effet Cerenkov Avec un Ensemble de Comptage a Scintillation Liquide; 041e 0411 041d 0414 ; Deteccion en la Orina de Emisores Beta de Energia Superior a 1 Mev, Despues de un Accidente, por Medicion del Efecto Cerenkov en un Contador de Centelleador Liquido

Energy Technology Data Exchange (ETDEWEB)

Narrog, J. [Landesinstitut fuer Arbeitsschutz und Arbeitsmedizin, Karlsruhe, Federal Republic of Germany (Germany)

1965-06-15

procede a des experiences a l'Institut de Karlsruhe pour appliquer cette methode a l'urine. Si l'on utilise l'urine telle quelle, les mesures manquent de sensibilite a cause d'un effet d'absorption prononce. Par consequent, l'urine doit etre clarifiee l'auteur a essaye de l'oxyder par KMnO{sub 4} et a obtenu un liquide parfaitement clair. Mais le bruit de fond restait tres fort parce que le potassium du permanganate contient normalement du potassium-40 radioactif qui emet lui aussi des rayons beta d'une energie superieure a 1 MeV (1,32 MeV). Il a obtenu de meilleurs resultats avec le permanganate de soude (MnO{sub 4} Na). Le bruit de fond tombe a 30 cpm, la limite inferieure (mesuree avec un melange de sosr et de {sup 90}Y) etant d'environ 1 pc/ml d'urine. S'il n'est pas possible, apres un accident, d'evaluer la teneur de l'urine en 4 Degree-Sign K (par exemple par mesure photometrique a la flamme de la quantite de potassium contenue dans l'urine), la methode preconisee par l'auteur a la meme sensibilite (plus de 2 pc/ml) que les autres methodes (par exemple par calcination et mesure a l'aide d'un compteur proportionnel a grande surface). Certes, la mesure avec un compteur proportionnel a grande surface completee par l'evaluation de l'activite beta du {sup 40}K de l'urine constitue une methode plus sensible et plus precise. Mais le procede preconise par l'auteur permet une mesure rapide des charges corporelles elevees (et apres l'excretion) de nucleides emetteurs beta d'une energie superieure a 1 MeV, mesure qui est indispensable en cas d'accident. (author) [Spanish] Las particulas beta de energia superior a 1 MeV pueden medirse por aplicacion del efecto Cerenkov en contadores de centelleador liquido, sin necesidad de mas preparativos. Desde que Hoffmann comunico esta posibilidad en un simposio de la Gesellschaft Deutscher Chemiker, celebrado el 1 y 2 de abril de 1964 en Karlsruhe- Leopoldshafen, el autor ha realizado experimentos en el instituto de Karlsruhe con el fin

Design Experience on a Multi-Mecacurie Radiation Facility; Etudes et experiences concernant un emetteur de rayonnements de plusieurs megacuries; Opytnoe proektirovani e ustanovki, obladayushchej sverkhmoshchnym izlucheniem; Estudios sobre el proyecto de un dispositivo de irradiacion de varios megacuries

Energy Technology Data Exchange (ETDEWEB)

Brunton, D C; Donovan, J; Voyvodic, L [Curtiss-Wright Corporation, Princeton, NJ (United States); Armour Research Foundation, 10 W. 35th Street, Chicago 10, IL (United States)

1960-07-15

securite et les organes de commande de l'installation sont egalement etudies. Enfin, le memoire decrit la preparation du produit qui emet les rayonnements, y compris sa mesure, sa mise en capsule et la verification pour prevenir les fuites. (author) [Spanish] Los autores describen los trabajos de investigacion y perfeccionamiento realizados con miras a la construccion de fuentes adecuadas para el ''Irradiador de elevada intensidad para alimentos''. Los problemas que estudian son los comunes a todos los irradiadores transportables de gran tamano. La primera fase de los trabajos consistio en adquirir conocimientos mas exactos sobre las fuentes de placa y de los efectos que las variaciones de los parametros constructivos ejercen sobre el rendimiento de esas instalaciones. En primer lugar, se llevo a cabo un estudio teorico, experimental y mediante maquinas de calcular del rendimiento de los irradiadores de placa unica. Los parametros considerados han sido el tamano y la actividad especifica de la fuente, su espesor y revestimiento, la densidad del blanco y factores geometricos tales como la altura, longitud y anchura de la fuente y del blanco, asi como las dimensiones del volumen de aire que separa la fuente del blanco. Se ha estudiado el rendimiento en funcion de la capacidad del irradiador, del tiempo de exposicion, de la uniformidad de la dosis, de la eficacia de la instalacion y de los costes totales. Se han propuesto formulas simplificadas para calcular el rendimiento de los irradiadores; la validez de esas formulas se ha comprobado experimentalmente. Se ha establecido un codigo tridimensional que permite aplicar el metodo denominado de ''Monte Carlo'' al calculo del rendimiento de los irradiadores; los resultados obtenidos estan en armonia con los datos determinados por via experimental. El programa de estudio se ha extendido a los dispositivos de varias placas y de varios pasos, y abarca por consiguiente tanto las fuentes de tres dimensiones como los irradiadores de

Personnel Dosimeters with Radiation Elements; Dosimetres Individuels Comportant des Elements Emetteurs; 0418 041d 0414 0418 0412 0418 0414 ; Dosimetros Individuales Provistos de Elementos Emisores

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Hosemann, R.; Warrikhoff, H. F.H. [Fritz-Haber-Institut der Max-Planck-Gesellschaft, Berlin-Dahlem, Federal Republic of Germany (Germany)

1965-06-15

'electrons differents par unite d'irradiation. Etant donne que l'une des electrodes emet des electrons ayant une energie elevee, on peut obtenir a l'autre electrode des tensions proportionnelles sans faire appel a une source d'energie auxiliaire. En raison de cette propriete, ces appareils a lecture directe ont recu le nom d'elements emetteurs. Pour mesurer les rayons X ou y, il faut que l'une des electrodes soit en plomb et l'autre en carbone. En vue de rendre l'unite de mesure en roentgen independante de la longueur d'onde, on a utilise la methode des electrons filtres. La sensibilite est de l'ordre de 0, 5 V/r {+-} 8% entre 80 keV et 1, 25 MeV. (L'echelle complete de 200 a 2000 r est soit lineaire, soit quasi-logarithmique.) Pour la mesure des neutrons lents et rapides, l'electrometre incorpore est charge par l'activite 6 induite des electrodes. Il est possible de mesurer les rayons y et les neutrons en rem a l'aide d'un seul instrument. La sensibilite d'un element y aux neutrons peut etre pratiquement reduite a zero, mais celle d'un element neutronique aux rayons y suscite certaines difficultes. Les principaux avantages de ces instruments sont les suivants : 1. Sources d'energie autonomes, toujours pretes a fonctionner, duree d'entreposage illimitee, absence de piles electriques ou autres sources d'alimentation; 2. Evanouissement tres faible du fait que l'fsolement est assure par le vide et le quartz; 3. Mesure quantitative des debits de dose les plus eleves, en raison de l'absence de tout effet de recombinaison (vide) ; 4. Lecture directe ou indirecte, selon les modeles. Dans l'instrument a lecture directe, l'element emetteur et l'electrometre se trouvent dans la meme chambre a vide. L'instrument ne comporte aucun contact electrique a l'exterieur; il doit avoir de preference une forme cylindrique ou spherique. Les dimensions exterieures de l'instrument sont les memes que celles des stylo-dosimetres classiques. Chaque type d'instrument comporte un commutateur de decharge et un

Tritium and Autoradiography in Cell Biology; Tritium et Autoradiographie en Biologie Cellulaire; 0422 0440 0438 0414 ; El Tritio 0443 la Tecnica Autorradiografica en Citobiologia

Energy Technology Data Exchange (ETDEWEB)

Taylor, J. H. [Departments of Botany and Zoology, Columbia University, New York, NY (United States)

1962-02-15

control of the sequence are being sought along with other related processes that involve the synthesis of chromosomal proteins and the other class of nucleic acids, ribonucleic acids. (author) [French] Du fait qu'il emet des rayons beta de faible energie, le tritium est l'isotope le plus utile pour l'autoradiographie a resolution elevee. Etant donne l'abondance relative de l'hydrogene dans la plupart des substances importantes du point de vue biologique et la periode radioactive assez courte du tritium, on peut marquer des constituants cellulaires a des activites specifiques qui sont souvent decelables au niveau intracellulaire a l'aide d'emulsions nucleaires. Les cellules sont fixees sur du verre par divers procedes cytologiques et, apres fixation, on applique directement a la surface de la cellule une emulsion photographique, humide ou fluide, qu'on laisse secher. Apres exposition, l'emulsion est developpee alors qu'elle se trouve encore en contact avec le specimen biologique. Lorsque la preparation, qui constitue un autoradiogramme, est examinee au microscope, on peut observer les structures cellulaires et l'emplacement de l'isotope, avec une resolution inferieure a un micron. On a pu ainsi determiner pendant deux ou trois divisions cellulaires la repartition de l'acide desoxyribonucleique (ADN) tritie de divers chromosomes. Ces etudes ont ete rendues possibles par la preparation de thymidine tritiee qui est un indicateur hautement selectif pour l'ADN et dont l'activite diminue rapidement lorsque l'on retire la cellule du milieu qui contient la thymidine marquee. On a egalement obtenu des renseignements sur le mecanisme de renouvellement de l'ADN, sur la structure et la reproduction des chromosomes, la cinetique de la division cellulaire et, plus recemment, sur les schemas et les phases de la reproduction des differents chromosomes d'un meme noyau ainsi que sur les differentes parties d'un meme chromosome. Dans tous les chromosomes etudies jusqu'a present on a constate