Sample records for ergotamine

  1. Ergotamine-Induced Takotsubo Cardiomyopathy. (United States)

    Ozpelit, Ebru; Ozpelit, Mehmet E; Akdeniz, Bahri; Göldeli, Özhan


    Takotsubo cardiomyopathy (TC) is a recently increasing diagnosed disease showed by transient apical or mid-apical left ventricular dysfunction. It is known as a disease of postmenopausal women, which is usually triggered by emotional or physical stress. Although the trigger is mostly endogenous, some drugs have also been reported as the cause. Published case reports of TC associated with drug usage consist of sympathomimetic drugs, inotropic agents, thyroid hormone, cocaine, and 5-fluorouracil. We present an unusual case of TC in which the possible trigger is ergotamine toxicity.

  2. History of the use of ergotamine and dihydroergotamine in migraine from 1906 and onward

    DEFF Research Database (Denmark)

    Koehler, P.J.; Tfelt-Hansen, Peer


    as an adrenolytic agent in 1943. It is still in use parenterally and by the nasal route. Before the triptan era ergotamine and DHE had widespread use as the only specific antimigraine drugs. From 1950 the world literature on ergotamine was dominated by two adverse events: ergotamine overuse headache...... and the relatively rare overt ergotism. Recently, oral ergotamine, which has an oral bioavailability of drug of first choice. In an American review of 2003 it was suggested...

  3. Ergotamine-induced upper extremity ischemia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk; Lee, Gun [Bundang CHA General Hospital, Pochon (China); Shin, Sung Wook [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)


    Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.

  4. Generalised brain edema and brain infarct in ergotamine abuse: Visualization by CT, MR and angiography

    International Nuclear Information System (INIS)

    Toedt, C.; Hoetzinger, H.; Salbeck, R.; Beyer, H.K.


    Abuse of ergotamine can release a generalised brain edema and brain infarctions. This can be visualized by CT, MR and angiography. The reason, however, can only be found in the patients history. (orig.) [de

  5. Dopamine D2-receptor imaging with [sup 123]I-iodobenzamide SPECT in migraine patients abusing ergotamine: does ergotamine cross the blood brain barrier

    Energy Technology Data Exchange (ETDEWEB)

    Verhoeff, N.P.; Visser, W.H.; Ferrari, M.D.; Saxena, P.R.; Royen, E.A. van (Erasmus Univ., Rotterdam (Netherlands))


    Two migraine patients were studied by in vivo SPECT using the dopamine D2-receptor specific radioligand [sup 123]I-3-iodo-6-methoxybenzamide ([sup 123]I-IBZM) during ergotamine abuse and after withdrawal. Results were compared with 15 healthy controls. Striatum/cerebellum and striatum/occipital cortex ratios of count rate density were calculated as a semiquantitative measurement for striatal dopamine D2-receptor binding potential. No differences were found in striatal uptake of [sup 123]I-IBZM between healthy controls and the patients when on or off ergotamine. Preliminary evidence suggests that ergotamine may not occupy striatal dopamine D2-receptors to a large extent and thus may not cross the blood brain barrier in large quantities. 23 refs., 3 figs.

  6. Ergotamin-induced disturbances of peripheral arterial circulation - a case report

    International Nuclear Information System (INIS)

    Creutzig, A.; Kamin, K.; Floege, J.; Wannske, M.; Alexander, K.; Wagner, H.H.; Medizinische Hochschule Hannover; Medizinische Hochschule Hannover


    Ergotism with severe arterial circulatory disorders, sometimes leading to amputation of the leg, is a severe complication following application of drugs containing ergotamine. Often the diagnosis is made by the typical angiographic findings. The history, clinical course and a new treatment in a very severe case is reported. (orig.) [de

  7. Contractile responses to ergotamine and dihydroergotamine in the perfused middle cerebral artery of rat

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer; Nilsson, Elisabeth; Edvinsson, Lars


    mmHg and luminally perfused. All vessels used attained spontaneous contractile tone (34.9+/-1.8% of resting tone) and responded to luminal adenosine triphosphate (ATP) with dilatation (24.1+/-4.0%), which showed functioning endothelium. Luminally added ergotamine or DHE induced maximal contractions...

  8. Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis

    Directory of Open Access Journals (Sweden)

    Nodari Franco


    Full Text Available Abstract Background The ergotamine tartrate associated with certain categories of drugs can lead to critical ischemia of the extremities. Discontinuation of taking ergotamine is usually sufficient for the total regression of ischemia, but in some cases it could be necessary thrombolytic and anticoagulant therapy to avoid amputation. Case report A woman of 62 years presented with a severe pain left forearm appeared 10 days ago, with a worsening trend. The same symptoms appeared after 5 days also in the right forearm. Physical examination showed the right arm slightly hypothermic, with radial reduced pulse in presence of reduced sensitivity. The left arm was frankly hypothermic, pulse less on radial and with an ulnar humeral reduced pulse, associated to a decreased sensitivity and motility. Clinical history shows a chronic headache for which the patient took a daily basis for years Cafergot suppository (equivalent to 3.2 mg of ergotamine. From about ten days had begun therapy with itraconazole for vaginal candidiasis. The Color-Doppler ultrasound shown arterial thrombosis of the upper limbs (humeral and radial bilateral, with minimal residual flow to the right and no signal on the humeral and radial left artery. Results Angiography revealed progressive reduction in size of the axillary artery and right humeral artery stenosis with right segmental occlusions and multiple hypertrophic collateral circulations at the elbow joint. At the level of the right forearm was recognizable only the radial artery, decreased in size. Does not recognize the ulnar, interosseous artery was thin. To the left showed progressive reduction in size of the distal subclavian and humeral artery, determined by multiple segmental steno-occlusion with collateral vessels serving only a thin hypotrophic interosseous artery. Arteriographic findings were compatible with systemic drug-induced disease. The immediate implementation of thrombolysis, continued for 26 hours, with

  9. Contractile Response of Bovine Lateral Saphenous Vein to Ergotamine Tartrate Exposed to Different Concentrations of Molecularly Imprinted Polymer

    Directory of Open Access Journals (Sweden)

    Manoj B. Kudupoje


    Full Text Available Ergot alkaloids, in their active isomeric form, affect animal health and performance, and adsorbents are used to mitigate toxicities by reducing bioavailability. Adsorbents with high specificity (molecularly imprinted polymers: MIP adsorb ergot alkaloids in vitro, but require evaluation for biological implications. Using ex vivo myography, synthetic polymers were evaluated for effects on the bioactivity of ergotamine tartrate (ETA. Polymers were first evaluated using isotherms. Lateral saphenous veins were collected from 17 steers for four independent studies: dose response of ETA, adsorbent dose response, validation of pre-myograph incubation conditions and MIP/ non-molecularly imprinted polymer (NIP comparison. Norepinephrine normalized percent contractile response to increasing ETA exhibited a sigmoidal dose response (max: 88.47 and log of the effective molar concentration (EC50 (−log [ETA] of 6.66 ± 0.17 M. Although sample preparation time affected contractile response (p < 0.001, pre-myograph incubation temperature (39 vs. 21 °C, 1 h had no effect (p > 0.05. Isothermal adsorption showed a maximum adsorption of 3.27E-008 moles·mg−1 and affinity between 0.51 and 0.57 mg (R2: 0.83–0.92 for both polymers, with no significant difference between polymers (p > 0.05. No significant differences in maximum inhibitory (p = 0.96 and IC50 responses (p = 0.163 between MIP and NIP were noticed. Normalized percent contraction could be predicted from the in vitro adsorption data (R2 = 0.87, p < 0.01, for both polymers. These studies indicate that synthetic polymers are potentially effective adsorbents to mitigate ergot toxicity caused by ergot alkaloids, with little evidence of significant differences between MIP and NIP in aqueous media.

  10. Ergotamine and Caffeine (United States)

    ... tablet to take by mouth and as a suppository to insert rectally. It is usually taken at ... need more, call your doctor. To use the suppositories, follow these steps: If the suppository feels soft, ...

  11. Modulatory effect of the 5-HT1A agonist buspirone and the mixed non-hallucinogenic 5-HT1A/2A agonist ergotamine on psilocybin-induced psychedelic experience. (United States)

    Pokorny, Thomas; Preller, Katrin H; Kraehenmann, Rainer; Vollenweider, Franz X


    The mixed serotonin (5-HT) 1A/2A/2B/2C/6/7 receptor agonist psilocybin dose-dependently induces an altered state of consciousness (ASC) that is characterized by changes in sensory perception, mood, thought, and the sense of self. The psychological effects of psilocybin are primarily mediated by 5-HT2A receptor activation. However, accumulating evidence suggests that 5-HT1A or an interaction between 5-HT1A and 5-HT2A receptors may contribute to the overall effects of psilocybin. Therefore, we used a double-blind, counterbalanced, within-subject design to investigate the modulatory effects of the partial 5-HT1A agonist buspirone (20mg p.o.) and the non-hallucinogenic 5-HT2A/1A agonist ergotamine (3mg p.o.) on psilocybin-induced (170 µg/kg p.o.) psychological effects in two groups (n=19, n=17) of healthy human subjects. Psychological effects were assessed using the Altered State of Consciousness (5D-ASC) rating scale. Buspirone significantly reduced the 5D-ASC main scale score for Visionary Restructuralization (VR) (ppsilocybin-induced 5D-ASC main scale scores. The present finding demonstrates that buspirone exerts inhibitory effects on psilocybin-induced effects, presumably via 5-HT1A receptor activation, an interaction between 5-HT1A and 5-HT2A receptors, or both. The data suggest that the modulation of 5-HT1A receptor activity may be a useful target in the treatment of visual hallucinations in different psychiatric and neurological diseases. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

  12. O padrão biológico da cefaléia cervicogênica pode ser alterado pelo uso excessivo de ergotamínicos ou pela sua retirada? Can the biologic pattern of cervicogenic headache change after overuse or withdrawal of the ergotamine derivatives?

    Directory of Open Access Journals (Sweden)



    Full Text Available A transformação de uma cefaléia primária em cefaléia crônica diária (CCD pode ou não estar relacionada com o abuso de analgésicos, pois a influência desse abuso sobre os mecanismos fisiopatológicos permanecem inconclusivos. Descrevemos três pacientes (mulher, 65 e 39 anos e homem, 46 anos com cefaléia cervicogênica (CC que abusavam de analgésicos (derivados da ergotamina e foram submetidos a infiltração do nervo occipital maior (NOM. Ao final de três dias do tratamento, melhora total dos sintomas álgicos foram registrados, o que permitiu retirada completa dos derivados da ergotamina. A CC não pode ser classificada dentro das cefaléias crônica diárias visto que apresenta uma etiologia orgânica; entretanto, se a dor for diária e o diagnóstico tardio, o uso indiscriminado e abusivo de analgésicos pode ocorrer. Nos casos descritos o uso abusivo de analgésicos não influenciou a evolução natural desta cefaléia após o tratamento com a infiltração do NOM, uma vez que todos os pacientes submetidos a infiltração apresentaram melhora total de seus sintomas dolorosos sem cefaléia rebote ou tampouco dependência farmacológica. Esta é uma evidência que a CC apresenta uma etiológia orgânica, não sendo influenciada em sua fisiopatologia pelo uso abusivo de derivados da ergotamina.The transformation of a primary headache into a chronic daily headache (CDH may or may not be related to the overuse of painkillers, as their influence on the pathophysiological mechanisms remain inconclusive. We describe three patients (female, aged 65 and 39 years, and male, 46 affected by cervicogenic headache (CH and CDH linked to the overuse of painkillers (ergotamine derivatives that were submitted to the infiltration of the greater occipital nerve (GON. At the end of three days of treatment, a total improvement of the pain symptoms was recorded, which allowed for the withdrawal of the ergotamine derivatives. The CH cannot be ranked

  13. Contractile response of bovine lateral saphenous vein to ergotamine tartrate exposed to different concentrations of molecularly imprinted polymers (United States)

    Ergot alkaloids, in their active isomeric form, affect animal health and performance and adsorbents are used to mitigate toxicities by reducing bioavailability. Adsorbents with high specificity (molecularly imprinted: MIP and non-imprinted: NIP polymers) adsorb ergot alkaloids in vitro, but require ...

  14. Ergotamine-derived dopamine agonists and left ventricular function in Parkinson patients: systolic and diastolic function studied by conventional echocardiography, tissue Doppler imaging, and two-dimensional speckle tracking. (United States)

    Rasmussen, Vibeke Guldbrand; Poulsen, Steen Hvitfeldt; Dupont, Erik; Ostergaard, Karen; Safikhany, Gholamhossein; Egeblad, Henrik


    Ergot-derived dopamine agonists (EDDA) induce fibrotic heart valve disease. We aimed to investigate whether EDDA treatment also affects left ventricular (LV) function. Myocardial function was evaluated in 110 Parkinson patients [mean age (63.4 +/- 9.0 years)] treated for at least 6 months with either EDDA (n = 71) or non-EDDA (n = 39). LV ejection fraction did not differ between EDDA and non-EDDA patients [63 +/- 4% vs. 65 +/- 4% (ns)]. There was no difference in prevalence of diastolic dysfunction between EDDA and non-EDDA patients [7% vs. 8% (ns)]. Finally, averaged LV systolic myocardial strain and longitudinal displacement analysed by means of two-dimensional speckle tracking showed no difference between EDDA and non-EDDA patients [strain: 19 +/- 3% vs. 19 +/- 2% (ns) and longitudinal displacement: 12 +/- 2 mm vs. 12 +/- 2 mm (ns)]. Elevated p-NT-proBNP was found in 38% of EDDA patients and in 59% of non-EDDA patients (ns). In contrast to the well-established association between EDDA treatment and valvular fibrosis, EDDA did not have a detectable adverse impact on myocardial systolic and diastolic function.

  15. Non-invasive method for recognition of coronary artery spasm

    International Nuclear Information System (INIS)

    Mathey, D.; Montz, R.; Hanrath, P.; Kuck, K. H.; Bleifeld, W.; Hamburg Univ.


    For evaluation of coronary artery spasm 201 thallium sequential scintigraphy of the myocardium after ergotamine provocation was performed in 10 patients with recurrent angina pectoris at rest and normal exercise ECG. In 9 out of the 10 patients ergotamine administration in the same dosage was repeated during the coronary angiography. A reversible defect in the 201 thallium scintigram representative of regional myocardial ischaemia developed in 9 patients after ergotamine. Only in 4 out of the 9 patients angina pectoris and ST elevation were present at the same time. In all cases coronary spasm after ergotamine was demonstrable in the coronary angiogram; in the 4 patients with ergotamine-induced Prinzmetal angina pectoris it consisted of complete vascular occlusion, in the asymptomatic patients of incomplete vascular narrowing of a higher degree. In all cases the spasm could be relieved by ergotamine antidotes within a few minutes. (orig.) [de

  16. Untitled

    African Journals Online (AJOL)

    Ergotamine and ergometrine standard curVEs were ~ drawn from stock solutions{ by dilution with distilled water and ... samples was determined using direct plating of 100 grain kernels or flour on PDA (10). The alkaloids ... curve was drawn by taking the absorbance value of. difi'erent dilutions of standard ergotamine and".

  17. Rhodococcus erythropolis MTHt3 biotransforms ergopeptines to lysergic acid. (United States)

    Thamhesl, Michaela; Apfelthaler, Elisabeth; Schwartz-Zimmermann, Heidi Elisabeth; Kunz-Vekiru, Elisavet; Krska, Rudolf; Kneifel, Wolfgang; Schatzmayr, Gerd; Moll, Wulf-Dieter


    Ergopeptines are a predominant class of ergot alkaloids produced by tall fescue grass endophyte Neotyphodium coenophialum or cereal pathogen Claviceps purpurea. The vasoconstrictive activity of ergopeptines makes them toxic for mammals, and they can be a problem in animal husbandry. We isolated an ergopeptine degrading bacterial strain, MTHt3, and classified it, based on its 16S rDNA sequence, as a strain of Rhodococcus erythropolis (Nocardiaceae, Actinobacteria). For strain isolation, mixed microbial cultures were obtained from artificially ergot alkaloid-enriched soil, and provided with the ergopeptine ergotamine in mineral medium for enrichment. Individual colonies derived from such mixed cultures were screened for ergotamine degradation by high performance liquid chromatography and fluorescence detection. R. erythropolis MTHt3 converted ergotamine to ergine (lysergic acid amide) and further to lysergic acid, which accumulated as an end product. No other tested R. erythropolis strain degraded ergotamine. R. erythropolis MTHt3 degraded all ergopeptines found in an ergot extract, namely ergotamine, ergovaline, ergocristine, ergocryptine, ergocornine, and ergosine, but the simpler lysergic acid derivatives agroclavine, chanoclavine, and ergometrine were not degraded. Temperature and pH dependence of ergotamine and ergine bioconversion activity was different for the two reactions. Degradation of ergopeptines to ergine is a previously unknown microbial reaction. The reaction end product, lysergic acid, has no or much lower vasoconstrictive activity than ergopeptines. If the genes encoding enzymes for ergopeptine catabolism can be cloned and expressed in recombinant hosts, application of ergopeptine and ergine degrading enzymes for reduction of toxicity of ergot alkaloid-contaminated animal feed may be feasible.

  18. Coronary spasm: 201Tl scintiscanning following pharmacological provocation

    International Nuclear Information System (INIS)

    Montz, R.; Mathey, D.; Bleifeld, W.; Hamburg Univ.


    According to the authors' experience so far, 201 Tl myocardial scintiscanning is a sufficiently sensitive non-invasive method for detection of coronary vasospasm provoked by ergotamine administration. Mild incomplete and asymptotic forms of coronary vasospasm were detected by scintiscanning. Indications for myocardial scintiscanning of ergotamine-provoked vasospasm are: Cases of angina pectoris at rest in which electrocardiograms during spasm are not available; elleviated symptoms after nitroglycerine administration; exercise electrocardiograms without any sign of ischaemia; negative results of exercise 201 Tl myocardial scintiscanning. (orig.) [de

  19. Degradation and epimerization of ergot alkaloids after baking and in vitro digestion. (United States)

    Merkel, Stefan; Dib, Baha; Maul, Ronald; Köppen, Robert; Koch, Matthias; Nehls, Irene


    The degradation and epimerization of ergot alkaloids (EAs) in rye flour were investigated after baking cookies and subsequently subjecting them to an in vitro digestion model. Different steps of digestion were analyzed using salivary, gastric, and duodenal juices. The degradation and bidirectional conversion of the toxicologically relevant (R)-epimers and the biologically inactive (S)-epimers for seven pairs of EAs were determined by a HPLC method coupled with fluorescence detection. Baking cookies resulted in degradation of EAs (2-30 %) and a shift in the epimeric ratio toward the (S)-epimer for all EAs. The applied digestion model led to a selective toxification of ergotamine and ergosine, two ergotamine-type EAs. The initial percentage of the toxic (R)-epimer in relation to the total toxin content was considerably increased after digestion of cookies. Ergotamine and ergosine increased from 32 to 51 % and 35 to 55 %, respectively. In contrast, EAs of the ergotoxine type (ergocornine, α- and β-ergocryptine, and ergocristine) showed an epimeric shift toward their biologically inactive (S)-epimers. Further experiments indicated that the selective epimerization of ergotamine EAs occurs in the duodenal juice only. These results demonstrate that toxification of EAs in the intestinal tract should be taken into consideration.

  20. Subclinical ergotism

    DEFF Research Database (Denmark)

    Dige-Petersen, H; Lassen, N A; Noer, Ivan


    The systolic blood-pressure at the ankle and the first toe was measured in 30 patients, mean age 42, who had taken ergotamine regularly for more than a year. With one exception, the patients had no symptoms or signs of arterial insufficiency in the limbs, but all had low-normal or abnormal foot...

  1. CNS active ergot alkaloid dihydro derivatives. Tritium labelling and characterization

    International Nuclear Information System (INIS)

    Egan, J.A.; Nugent, R.P.; Filer, C.N.


    The ergot alkaloids are an important class of medicinally useful substances and this report describes the high specific activity tritium labelling of two dihydro derivatives; namely, dihydroergotamine and dihydrobromocriptine. The former was prepared by the direct tritiation of ergotamine itself. However, efforts to perform an analogous direct tritiation on bromocriptine were unsuccessful and a multistep synthesis was required. (author)


    NARCIS (Netherlands)



    An HPLC method for the determination of lisuride hydrogen maleate in plasma is described. After addition of ergotamine tartrate as internal standard, plasma is extracted with diethyl ether. Following evaporation of the solvent and redissolving in methanol the extract is injected on a silica HPLC

  3. 76 FR 17778 - Control of Ergocristine, a Chemical Precursor Used in the Illicit Manufacture of Lysergic Acid... (United States)


    ... 1117-AB24 Control of Ergocristine, a Chemical Precursor Used in the Illicit Manufacture of Lysergic... for the List I chemicals ergotamine and ergonovine to illicitly manufacture the schedule I controlled..., due to growing concerns regarding its use for the illicit manufacture of LSD. [[Page 17779...

  4. Ergotism in Thailand caused by increased access to antiretroviral drugs: a global warning. (United States)

    Avihingsanon, Anchalee; Ramautarsing, Reshmie A; Suwanpimolkul, Gompol; Chetchotisakd, Ploenchan; Bowonwatanuwong, Chureeratana; Jirajariyavej, Supunnee; Kantipong, Patcharee; Tantipong, Hutsaya; Ohata, June Pirapon; Suankratay, Chusana; Ruxrungtham, Kiat; Burger, David M


    Ergotism is a toxic condition resulting from overexposure to the ergot compounds produced by various fungi of the genus Claviceps. Traditionally, such exposure was due to ingestion of infected grains, but long-term or excessive use of medications containing ergot derivatives or drug-drug interactions between these medications can result in ergotism. Ergotamine, typically used to treat migraine, has less than 5% bioavailability due to extensive first-pass metabolism by cytochrome P450 3A4 (CYP3A4). Concurrent intake of ergotamine and strong CYP3A4 inhibitors, such as the HIV protease inhibitors (PIs), can lead to clinical ergotism. A total of 13 cases of clinical ergotism in HIV-infected patients has been published since 1997 (most recently reviewed by Frohlich et al).

  5. RIA for indol alkaloids

    International Nuclear Information System (INIS)

    Arens, H.


    The technique of RIAs for indol alkaloids (ajmaline, ergotamine, ergocristine, ergometrine, and lysergic acid) is described, and applications for this RIA and the RIA for raubasine and serpentine are mentioned. The indol alkaloide RIAs are shown to be suitable both for alkaloid distribution measurements in Catharantus and Rauwolfia plants and C. purpurea sclerotia as well as for the selection of high-efficiency strains and the optimisation of cultures of plant tissues and saprophytic fungi. (orig./MG) [de

  6. Electrospray[+] tandem quadrupole mass spectrometry in the elucidation of ergot alkaloids chromatographed by HPLC: screening of grass or forage samples for novel toxic compounds. (United States)

    Lehner, Andreas F; Craig, Morrie; Fannin, Neil; Bush, Lowell; Tobin, Tom


    Ergot alkaloids are mycotoxins generated by grass and grain pathogens such as Claviceps, for example. Ergot alkaloid-poisoning syndromes, such as tall fescue toxicosis from endophyte-infected tall fescue grass, are important veterinary problems for cattle, horses, sheep, pigs and chickens, with consequent impact on food, meat and dairy industries. Damage to livestock is of the order of a billion dollars a year in the United States alone. HPLC with UV and fluorescence detection are the predominant means of ergot alkaloid determination, with focus on quantitation of the marker compound ergovaline, although ELISA methods are undergoing investigation. These techniques are excellent for rapid detection, but of poor specificity in defining new or poorly characterized ergot alkaloids and related compounds. This paper demonstrates the facility of using electrospray(+) mass spectrometry with multiple reaction monitoring (MRM) detection during chromatographic examination of ergot alkaloid standards of lysergic acid, lysergol, ergonovine, ergovaline, ergotamine, ergocornine, ergocryptine and ergocrystine by HPLC. Ergoline-8 position epimers could be separated on the gradient HPLC system for ergocornine, ergocrystine and ergonovine and appeared as shoulders for ergotamine and ergovaline; epimers generally showed different patterns of relative intensity for specific MRM transitions. There was reasonable correspondence between retention of standards on the 2-mm ESI(+)MS phenyl-hexyl-based reverse phase column and those on the 4-mm C18-based column. Since up to 10% of clinical cases involving toxin exposure display unidentified chromatographic peaks, 11 samples of feed components associated with such cases were studied with developed MRM methods to attempt elucidation of crucial components if possible. Ergotamine appeared in all, ergovaline appeared in five and ergocornine appeared in six; ergonovine, ergocryptine, ergocrystine and lysergol also appeared in several. In addition

  7. The diagnosis and treatment of non-occlusive gut ischaemia. Aktueller Stand der Diagnostik und Therapie der nicht-okklusiven Darmischaemie (NOD)

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    Schindler, G.; Bruch, H.P. (Wuerzburg Univ. (Germany). Abt. fuer Roentgendiagnostik Wuerzburg Univ. (Germany). Chirurgische Universitaetsklinik)


    Non-occlusive gut ischaemia is a disease of advanced age. Its causes are reduced cardiac output or shock, facilitated by digitalis, adrenaline, ergotamine and diuretics. The persisting microcirculation and development of gut necrois leads to an increase in certain serum enzymes, such as lactate, LDH and CK-NB. The early application of mesenteric angiography using a DSA technique reveals four grades of under-perfusion. Early and correct diagnosis of the disease should lead to intra-arterial treatment with prostaglandin. In 10 out of 42 cases, conservative therapy led to re-perfusion of the gut. (orig.).

  8. Cerebral blood flow changes in cluster headache

    International Nuclear Information System (INIS)

    Norris, J.W.; Hachinski, V.C.; Cooper, P.W.


    Serial cerebral blood flod studies performed by the intra-carotid 133 Xenon method were fortuitously determined during the course of a cluster headache in a 32 year old man. The initial study was performed about 10 min after the headache began and showed values at the upper limit of normal. Twenty min after the headache started a second procedure showed that the autoregulatory response on hyperventilation was normal. Ergotamine tartrate was given intra-muscularly 23 min after the headache began and there was partial relief. A third cerebral blood flow estimation showed abnormally high values. The probable reasons for this are discussed. (author)

  9. The diagnosis and treatment of non-occlusive gut ischaemia

    International Nuclear Information System (INIS)

    Schindler, G.; Bruch, H.P.; Wuerzburg Univ.


    Non-occlusive gut ischaemia is a disease of advanced age. Its causes are reduced cardiac output or shock, facilitated by digitalis, adrenaline, ergotamine and diuretics. The persisting microcirculation and development of gut necrois leads to an increase in certain serum enzymes, such as lactate, LDH and CK-NB. The early application of mesenteric angiography using a DSA technique reveals four grades of under-perfusion. Early and correct diagnosis of the disease should lead to intra-arterial treatment with prostaglandin. In 10 out of 42 cases, conservative therapy led to re-perfusion of the gut. (orig.) [de

  10. [Vaginal misoprostol in the prevention of postpartum hemorrhage]. (United States)

    Quiroga Díaz, Ricardo; Esparza Arechiga, Miguel; Batiza Reséndiz, Víctor; Coronado López, Oscar; Hernández Ayup, Samuel; Martínez Cuervo, Jesús


    To show the advantages of the use of vaginal misoprostol, a prostaglandine E1 analogue, in the prevention of the post-partum haemorrhage. This was a prospective, observational, comparative study. The study included 400 patients with high risk of postpartum haemorrhage at our center between January 1999 and may 2001. Patients were divided in two groups. In group I (208 patients) misoprostol was used in a dose of 800 ugr and in group II (192 patients) in whom misoprostol was not used. Both groups were treated initially with our conventional oxytocin protocol. We evaluated the use of additional oxytocin or ergotamine, haemoglobin levels pre and post-partum, the amount of blood loss, and the need for blood transfusion or hysterectomy. The need for additional oxytocin or ergotamine was reduced to less than 10% in group I when compared to group II; the drop in haemoglobin levels and the amount of blood loss were also less in group I (p: 0.03). In this group only one patient needed for blood transfusion and no patient needed hysterectomy. In group II six patients need a blood transfusion and there was the need for two hysterectomies. The use of vaginal misoprostol is effective to control the postpartum bleeding, reducing the blood loss after birth in women with high risk of post-partum haemorrhage as well as the need for blood transfusion. It's use has mild side effects and is of low cost.

  11. [A method for the determination of ergot alkaloids in food]. (United States)

    Klug, C; Baltes, W; Krönert, W; Weber, R


    A suitable method has been developed for the routine analysis of the ergot alkaloids ergometrine, ergometrinine, ergosine, ergosinine, ergotamine, ergotaminine, ergocornine, ergocorninine, alpha-ergocryptine, alpha-ergocryptinine, beta-ergocryptine, beta-ergocryptinine, ergocristine and ergocristinine in cereal products. The method consists of food extraction, cleaning of the crude extract by a modified form of the Extrelut method, and identification and quantitative determination of the alkaloids by high pressure liquid chromatography (HPLC). The results are confirmed by thin layer chromatography (TLC) and gas-chromatography/mass spectrometry (GC/MS). Market investigations have shown contaminations in ecological as well as in conventional products, with rye products mainly being contaminated. Within the EEC, a maximum value of 0.05% ergot respectively a total alkaloid content of 1 mg/kg in cereals used for food production is prescribed. This value was not exceeded in any of the investigated samples.

  12. The role of the Oregon State University Endophyte Service Laboratory in diagnosing clinical cases of endophyte toxicoses. (United States)

    Craig, A Morrie; Blythe, Linda L; Duringer, Jennifer M


    The Oregon State University Colleges of Veterinary Medicine and Agricultural Sciences instituted the Endophyte Service Laboratory to aid in diagnosing toxicity problems associated with cool-season grasses in livestock. The endophyte (Neotyphodium coenophalum) present in tall fescue (Festuca arundinacea) produces ergopeptine alkaloids, of which ergovaline is the molecule used to determine exposure and toxicity thresholds for the vasoconstrictive conditions "fescue foot" and "summer slump". Another vasoconstrictive syndrome, "ergotism," is caused by a parasitic fungus, Claviceps purpurea, and its primary toxin, ergotamine. "Ryegrass staggers" is a neurological condition that affects livestock consuming endophyte (Neotyphodium lolii)-infected perennial ryegrass (Lolium perenne) with high levels of lolitrem B. HPLC-fluorescent analytical methods for these mycotoxins are described and were used to determine threshold levels of toxicity for ergovaline and lolitrem B in cattle, sheep, horses, and camels. In addition, six clinical cases in cattle are presented to illustrate diagnosis of these three diseases.

  13. Quantitative determination of the dopamine agonist lisuride in plasma using high-performance liquid chromatography with fluorescence detection. (United States)

    Wolthers, B G; Verhagen Kamerbeek, W D; van Beusekom, C M; Elshof, F; de Ruyter Buitenhuis, A W; Brunt, E P; Lakke, J P


    An HPLC method for the determination of lisuride hydrogen maleate in plasma is described. After addition of ergotamine tartrate as internal standard, plasma is extracted with diethyl ether. Following evaporation of the solvent and redissolving in methanol the extract is injected on a silica HPLC column and lisuride is monitored by fluorescence detection using an excitation wavelength of 322 nm and an emission wavelength of 405 nm. The method is sufficiently accurate and precise with a detection limit of 20 pg/ml lisuride in plasma. The usefulness of the method is demonstrated by measurements of lisuride levels after oral intake of a 0.6 mg dose of the drug by a healthy male volunteer, showing a peak level of 1266 pg/ml, 45 min after intake.

  14. Clinical and Demographical Characteristics of Patients with Medication Overuse Headache in Argentina and Chile: Analysis of the Latin American Section of COMOESTAS Project. (United States)

    Shand, Beatriz; Goicochea, Maria Teresa; Valenzuela, Raul; Fadic, Ricardo; Jensen, Rigmor; Tassorelli, Cristina; Nappi, Giuseppe


    Data on the characteristics of Medication Overuse Headache (MOH) in Latin American (LA) are scarce. Here we report the demographic and clinical features of the MOH patients from Argentina and Chile enrolled in the multinational COMOESTAS project in the period 2008-2010. The LA population was formed by 240 MOH subjects, 110 from Chile and 130 from Argentina, consecutively attending the local headache centres. In each centre, specifically trained neurologist interviewed and confirmed the diagnosis according to the ICHD-II criteria. A detailed history was collected on an electronic patient record form. The mean patient age was 38.6 years, with a female/male ratio of 8:2. The mean time since onset of the primary headache was 21 years, whereas duration of MOH was 3.9 years. The primary headache was migraine without aura in 77.5 % and migraine with aura in 18.8 %. Forty two % of the patients self-reported emotional stress associated with the chronification of headache; 43.8 % reported insomnia. The most overused medications were acute drug combinations containing ergotamine (70 %), NSAIDs (33.8 %) and triptans (5.4 %). Though little described, MOH is present also in LA, where it affects mostly women, in the most active decades of life. Some differences emerge as regards the demographic and clinical characteristics of MOH in this population as compared to Europe or Northern America. What seems more worrying about MOH in Argentina and Chile is that most patients overuse ergotamine, a drug that may cause serious adverse events when used chronically. These findings once more underscore the importance of properly diagnose and treat MOH.

  15. A dynamic view of molecular switch behavior at serotonin receptors: implications for functional selectivity.

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    Maria Martí-Solano

    Full Text Available Functional selectivity is a property of G protein-coupled receptors that allows them to preferentially couple to particular signaling partners upon binding of biased agonists. Publication of the X-ray crystal structure of serotonergic 5-HT1B and 5-HT2B receptors in complex with ergotamine, a drug capable of activating G protein coupling and β-arrestin signaling at the 5-HT1B receptor but clearly favoring β-arrestin over G protein coupling at the 5-HT2B subtype, has recently provided structural insight into this phenomenon. In particular, these structures highlight the importance of specific residues, also called micro-switches, for differential receptor activation. In our work, we apply classical molecular dynamics simulations and enhanced sampling approaches to analyze the behavior of these micro-switches and their impact on the stabilization of particular receptor conformational states. Our analysis shows that differences in the conformational freedom of helix 6 between both receptors could explain their different G protein-coupling capacity. In particular, as compared to the 5-HT1B receptor, helix 6 movement in the 5-HT2B receptor can be constrained by two different mechanisms. On the one hand, an anchoring effect of ergotamine, which shows an increased capacity to interact with the extracellular part of helices 5 and 6 and stabilize them, hinders activation of a hydrophobic connector region at the center of the receptor. On the other hand, this connector region in an inactive conformation is further stabilized by unconserved contacts extending to the intracellular part of the 5-HT2B receptor, which hamper opening of the G protein binding site. This work highlights the importance of considering receptor capacity to adopt different conformational states from a dynamic perspective in order to underpin the structural basis of functional selectivity.

  16. Influence of tryptophan and related compounds on ergot alkaloid formation in Claviceps purpurea (FR.) Tul. (United States)

    Erge, D; Schumann, B; Gröger, D


    L-Tryptophan did not exert any influence on peptide alkaloid formation in an ergotamine and in an ergosine-accumulating C. purpurea strain. A different picture was observed in a series of related C. purpurea strains. Tryptophan showed a slight stimulatory effect on the ergotoxine producer Pepty 695/S. A blocked mutant of it, designated as Pepty 695/ch which was able to accumulate secoclavines gave similar results. In a high-yielding elymoclavine strain Pepty 695/e, the progeny of the former one, tryptophan up to a concentration of 25 mM stimulated remarkably clavine biosynthesis. Furthermore, tryptophan could overcome the block of synthesis by inorganic phosphate. Increased specific activities of chanoclavine cyclase but not DMAT synthetase were observed in cultures of strain Pepty 695/e supplemented with tryptophan. 5-Methyltryptophan and bioisosteres of tryptophan were ineffective in alkaloid stimulation. These results are compared with those obtained with the grass ergot strain SD 58 and discussed with the relation to other induction phenomena.

  17. Triptans, serotonin agonists, and serotonin syndrome (serotonin toxicity): a review. (United States)

    Gillman, P Ken


    The US Food and Drug Administration (FDA) have suggested that fatal serotonin syndrome (SS) is possible with selective serotonin reuptake inhibitors (SSRIs) and triptans: this warning affects millions of patients as these drugs are frequently given simultaneously. SS is a complex topic about which there is much misinformation. The misconception that 5-HT1A receptors can cause serious SS is still widely perpetuated, despite quality evidence that it is activation of the 5-HT2A receptor that is required for serious SS. This review considers SS involving serotonin agonists: ergotamine, lysergic acid diethylamide, bromocriptine, and buspirone, as well as triptans, and reviews the experimental foundation underpinning the latest understanding of SS. It is concluded that there is neither significant clinical evidence, nor theoretical reason, to entertain speculation about serious SS from triptans and SSRIs. The misunderstandings about SS exhibited by the FDA, and shared by the UK Medicines and Healthcare products Regulatory Agency (in relation to methylene blue), are an important issue with wide ramifications.

  18. Diagnostic and Therapeutic Problems of Geriatric Headache

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    Kaviyan Ghandehari


    Full Text Available There is no difference in clinical characteristics of headache between old individuals and younger’s. However, differential diagnosis of migrainous aura and transient ischemic attacks may be difficult in old people who frequently have vascular risk factors. Old people have less headache than the young’s. Chronic tension headache is the most common primary type of headache in the elderly. Chronic paroxismal hemicrania and headache due to giant cell arterities are specified to the elderly, Secondary headaches; e.g headache due to cervical spondylosis and brain tumors is more common in the old people than young. Old people poorly tolerate headache drugs, i.e. Ergotamine, Triptans and Tricyclics. Trigeminal neuralgia is often seen in the elderly and is resistant to medical therapy in the old people. Headache could be the main manifestation of depression in old people. Headaches secondary to disorders of internal medicine; i.e. hypertension and chronic obstructive pulmonary disease have importance in the elderly. Subarachnoid hemorrhage is considered in every old person with sudden onset explosive headache especially in cases with decreased consciousness and neck stiffness. Old individuals use a collection of different drugs due to suffering various diseases and commonly have drug induced headaches. Neuroimaging should be performed in a geriatric patient with new onset sever headache without medical disorder or consumption of drug induced headache. Some of the old people suffer of multiple types of headache.

  19. Magnetic resonance imaging of the brain in patients with migraine

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    Igarashi, H.; Sakai, F.; Kan, S.; Okada, J.; Tazaki, Y. (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine)


    Magnetic resonance imaging (MRI) was studied in 91 patients with migraine and in 98 controls. Risk factors known to cause MRI lesions were carefully examined. In 36 patients with migraine (39.6%), small foci of high intensity on T{sub 2}-weighted and proton-density-weighted images were seen in the white matter. Of patients with migraine who were less than 40 years old and without any risk factor, 29.4% showed lesions on MRI; this was singificantly higher than the 11.2% for the group of age-matched controls (n=98). The lesions were distributed predominantly in the centrum semiovale and frontal white matter in young patients, but extended to the deeper white matter at the level of basal ganglia in the older age group. The side of the MRI lesions did not always correspond to the side of usual aura or headache. Migraine-related variables such as type of migraine, frequency, duration or intensity of headache or consumption of ergotamine showed no significant correlation with the incidence om MRI abnormalities. The data indicated that migraine may be associated with early pathologic changes in the brain. 26 refs., 4 figs., 3 tabs.

  20. Magnetic resonance imaging of the brain in patients with migraine

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    Igarashi, H.; Sakai, F.; Kan, S.; Okada, J.; Tazaki, Y.


    Magnetic resonance imaging (MRI) was studied in 91 patients with migraine and in 98 controls. Risk factors known to cause MRI lesions were carefully examined. In 36 patients with migraine (39.6%), small foci of high intensity on T 2 -weighted and proton-density-weighted images were seen in the white matter. Of patients with migraine who were less than 40 years old and without any risk factor, 29.4% showed lesions on MRI; this was singificantly higher than the 11.2% for the group of age-matched controls (n=98). The lesions were distributed predominantly in the centrum semiovale and frontal white matter in young patients, but extended to the deeper white matter at the level of basal ganglia in the older age group. The side of the MRI lesions did not always correspond to the side of usual aura or headache. Migraine-related variables such as type of migraine, frequency, duration or intensity of headache or consumption of ergotamine showed no significant correlation with the incidence om MRI abnormalities. The data indicated that migraine may be associated with early pathologic changes in the brain. 26 refs., 4 figs., 3 tabs

  1. Coronary spasm induced by dipyridamole

    International Nuclear Information System (INIS)

    Wartski, M.; Caussin, C.; Lancelin, B.


    A 59 years old man was admitted at hospital for recurrent instable angina 1 month after coronary artery bypass surgery. Coronary artery disease started with a transmural antero-septo-apical myocardial infarction without thrombolysis and a percutaneous angioplasty with endo-prothesis on proximal left anterior descendant artery (LAD) is performed Because of recurrent rest angina and subacute stent thrombosis, a coronary artery bypass surgery (CABG) is performed with anastomosis of the left internal thoracic artery on LAD. The patient is admitted for recurrent rest angina one month after CABG. On ECG performed during chest pain, a ST-T segment elevation occurred on inferior leads. Coronary angiography showed no significant stenosis on endo-prothesis and no bypass graft dysfunction. Dipyridamole scintigraphy was realized. 2 minutes after the beginning of Dipyridamole infusion, a ST-T elevation occurred on inferior leads and two marked antero-septal and inferior defects were noticed on myocardial scintigraphy. Images at rest showed a clear improvement in the anterior wall and the inferior wall became normally perfused Patient was treated with anti-spastic drugs and a new coronarography with methyl-ergotamine test was performed inducing chest pain, ST-T elevation on inferior leads and tri-truncular coronary spasm. Patient's treatment was then modified with introduction of Nifedipine. The patient did not experienced new recurrent chest pain and remained totally asymptomatic few months later. (authors)

  2. Detection of Total Ergot Alkaloids in Cereal Flour and in Bread by a Generic Enzyme Immunoassay Method. (United States)

    Gross, Madeleine; Curtui, Valeriu; Usleber, Ewald


    Four sets of polyclonal antibodies against ergot alkaloids ergometrine, ergotamine, α-ergocryptine, and ergocornine were produced and characterized in a competitive direct or indirect enzyme immunoassay (EIA). Standard curve LODs were 0.03 ng/mL (ergometrine EIA) to 2.0 ng/mL (ergocornine EIA). Three EIAs were highly specific, whereas the ergometrine EIA had a broad specificity pattern and reacted, albeit weakly, with all seven major ergot alkaloids and their epimeric forms. Using the ergometrine EIA, a generic test system was established in which total ergot alkaloids are quantified by a standard curve for a toxin mixture composed of three alkaloids that matched the ergot alkaloid composition in naturally contaminated rye and wheat products. Sample extraction with acetonitrile-phosphate-buffered saline at pH 6.0 without further cleanup was sufficient for EIA analysis. The LODs for total ergot alkaloids were 20 ng/g in rye and wheat flour and 14 ng/g in bread. Recoveries were 85-110% (RSDs of 0.1-11.7%) at a concentration range of 50-1000 ng/g. The total ergot alkaloid EIA was validated by comparison with HPLC-fluorescence detection. Although some under- and overestimation by the total ergot alkaloid EIA was observed, it was suitable for the reliable identification of positive samples at 10-20 ng/g and for the determination of total ergot alkaloids in a concentration range between 100 and 1000 ng/g.

  3. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. (United States)

    Orr, Serena L; Aubé, Michel; Becker, Werner J; Davenport, W Jeptha; Dilli, Esma; Dodick, David; Giammarco, Rose; Gladstone, Jonathan; Leroux, Elizabeth; Pim, Heather; Dickinson, Garth; Christie, Suzanne N


    There is a considerable amount of practice variation in managing migraines in emergency settings, and evidence-based therapies are often not used first line. A peer-reviewed search of databases (MEDLINE, Embase, CENTRAL) was carried out to identify randomized and quasi-randomized controlled trials of interventions for acute pain relief in adults presenting with migraine to emergency settings. Where possible, data were pooled into meta-analyses. Two independent reviewers screened 831 titles and abstracts for eligibility. Three independent reviewers subsequently evaluated 120 full text articles for inclusion, of which 44 were included. Individual studies were then assigned a US Preventive Services Task Force quality rating. The GRADE scheme was used to assign a level of evidence and recommendation strength for each intervention. We strongly recommend the use of prochlorperazine based on a high level of evidence, lysine acetylsalicylic acid, metoclopramide and sumatriptan, based on a moderate level of evidence, and ketorolac, based on a low level of evidence. We weakly recommend the use of chlorpromazine based on a moderate level of evidence, and ergotamine, dihydroergotamine, lidocaine intranasal and meperidine, based on a low level of evidence. We found evidence to recommend strongly against the use of dexamethasone, based on a moderate level of evidence, and granisetron, haloperidol and trimethobenzamide based on a low level of evidence. Based on moderate-quality evidence, we recommend weakly against the use of acetaminophen and magnesium sulfate. Based on low-quality evidence, we recommend weakly against the use of diclofenac, droperidol, lidocaine intravenous, lysine clonixinate, morphine, propofol, sodium valproate and tramadol. © International Headache Society 2014 Reprints and permissions:

  4. Ergot alkaloid transport across ruminant gastric tissues. (United States)

    Hill, N S; Thompson, F N; Stuedemann, J A; Rottinghaus, G W; Ju, H J; Dawe, D L; Hiatt, E E


    Ergot alkaloids cause fescue toxicosis when livestock graze endophyte-infected tall fescue. It is generally accepted that ergovaline is the toxic component of endophyte-infected tall fescue, but there is no direct evidence to support this hypothesis. The objective of this study was to examine relative and potential transport of ergoline and ergopeptine alkaloids across isolated gastric tissues in vitro. Sheep ruminal and omasal tissues were surgically removed and placed in parabiotic chambers. Equimolar concentrations of lysergic acid, lysergol, ergonovine, ergotamine, and ergocryptine were added to a Kreb's Ringer phosphate (KRP) solution on the mucosal side of the tissue. Tissue was incubated in near-physiological conditions for 240 min. Samples were taken from KRP on the serosal side of the chambers at times 0, 30, 60, 120, 180, and 240 min and analyzed for ergot alkaloids by competitive ELISA. The serosal KRP remaining after incubation was freeze-dried and the alkaloid species quantified by HPLC. The area of ruminal and omasal tissues was measured and the potential transportable alkaloids calculated by multiplying the moles of transported alkaloids per square centimeter of each tissue type by the surface area of the tissue. Studies were conducted to compare alkaloid transport in reticular, ruminal, and omasal tissues and to determine whether transport was active or passive. Ruminal tissue had greater ergot alkaloid transport potential than omasal tissue (85 vs 60 mmol) because of a larger surface area. The ruminal posterior dorsal sac had the greatest potential for alkaloid transport, but the other ruminal tissues were not different from one another. Alkaloid transport was less among reticular tissues than among ruminal tissues. Transport of alkaloids seemed to be an active process. The alkaloids with greatest transport potential were lysergic acid and lysergol. Ergopeptine alkaloids tended to pass across omasal tissues in greater quantities than across ruminal

  5. Impacts of cereal ergot in food animal production

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    Stephanie eCoufal-Majewski


    Full Text Available The negative impacts of ergot contamination of grain on the health of humans and animals were first documented during the 5th century AD. Although ergotism is now rare in humans, cleaning contaminated grain concentrates ergot bodies in screenings which are used as livestock feed. Ergot is found worldwide, with even low concentrations of alkaloids in the diet (<100 ppb total reducing the growth efficiency of livestock. Extended periods of increased moisture and cold during flowering promote the development of ergot in cereal crops. Furthermore, the unpredictability of climate change may have detrimental impacts to important cereal crops such as wheat, barley and rye, favouring ergot production. Allowable limits for ergot in livestock feed are confusing as they may be determined by proportions of ergot bodies or by total levels of alkaloids, measurements which may differ widely in their estimation of toxicity. The proportion of individual alkaloids including ergotamine, ergocristine, ergosine, ergocornine and ergocryptine is extremely variable within ergot bodies and the relative toxicity of these alkaloids has yet to be determined. This raises concerns that current recommendations on safe levels of ergot in feeds may be unreliable. Furthermore, the total ergot alkaloid content is greatly dependent on the geographic region, harvest year, cereal species, variety and genotype. Considerable animal to animal variation in the ability of the liver to detoxify ergot alkaloids also exists and the impacts of factors such as pelleting of feeds or use of binders to reduce bioavailability of alkaloids require study. Accordingly, unknowns greatly outnumber the knowns for cereal ergot and further study to help better define allowable limits for livestock would be welcome.

  6. [Headache and immigration. A study in the outpatient department of the Hospital de la Santa Creu i Sant Pau in Barcelona]. (United States)

    Vidal-Jordana, A; Barroeta-Espar, I; Sainz-Pelayo, M P; Sala, I; Roig, C


    The immigrant population (IP) is visiting neurology departments on an increasingly more frequent basis. Research has still not made it clear whether there are geographical differences in the prevalence of primary headaches and the possible influence of emigration. We conducted a retrospective (12 months) and prospective study (18 months) of the first visits to the Headache Unit at the Hospital de la Santa Creu i Sant Pau. Data collected included the country of birth, time parameters of the headache and of the immigration, diagnoses according to the criteria of the IHS and treatments that had been used. Related headaches were considered to be those that began within one year of having immigrated. The IP represents 13.6% (n = 142) of the total number of first visits because of headaches (n = 1044). Immigrants came mostly from Latin America (83.9%). Headaches began after immigration in 40.1% of cases without the existence of any temporal relation with immigration. The distribution of the diagnoses of headache is similar to those of the local population, the most frequent being migraine (57.7%) and tension-type headache (15.5%). On comparing treatments prior to and following immigration, we find differences in the use of triptans (2.1% versus 46.2%), ergotamine (9.8% versus 2.1%) and in the use of preventive treatments (2% versus 45%). The IP accounts for 13% of all first visits due to headaches and their diagnoses are similar to those of the local population. Emigration is neither a precipitating nor an aggravating factor for headaches in our series. There is a significant difference in symptomatic and preventive treatment between the period prior to immigration and afterwards.

  7. Cabergoline decreases alcohol drinking and seeking behaviors via glial cell line-derived neurotrophic factor. (United States)

    Carnicella, Sebastien; Ahmadiantehrani, Somayeh; He, Dao-Yao; Nielsen, Carsten K; Bartlett, Selena E; Janak, Patricia H; Ron, Dorit


    Cabergoline is an ergotamine derivative that increases the expression of glial cell line-derived neurotrophic factor (GDNF) in vitro. We recently showed that GDNF in the ventral tegmental area (VTA) reduces the motivation to consume alcohol. We therefore set out to determine whether cabergoline administration decreases alcohol-drinking and -seeking behaviors via GDNF. Reverse transcription polymerase chain reaction (RT-PCR) and Enzyme-Linked ImmunoSorbent Assay (ELISA) were used to measure GDNF levels. Western blot analysis was used for phosphorylation experiments. Operant self-administration in rats and a two-bottle choice procedure in mice were used to assess alcohol-drinking behaviors. Instrumental performance tested during extinction was used to measure alcohol-seeking behavior. The [35S]GTPgammaS binding assay was used to assess the expression and function of the dopamine D2 receptor (D2R). We found that treatment of the dopaminergic-like cell line SH-SY5Y with cabergoline and systemic administration of cabergoline in rats resulted in an increase in GDNF level and in the activation of the GDNF pathway. Cabergoline treatment decreased alcohol-drinking and -seeking behaviors including relapse, and its action to reduce alcohol consumption was localized to the VTA. Finally, the increase in GDNF expression and the decrease in alcohol consumption by cabergoline were abolished in GDNF heterozygous knockout mice. Together, these findings suggest that cabergoline-mediated upregulation of the GDNF pathway attenuates alcohol-drinking behaviors and relapse. Alcohol abuse and addiction are devastating and costly problems worldwide. This study puts forward the possibility that cabergoline might be an effective treatment for these disorders.

  8. Fungi and mycotoxins: Food contaminants

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    Kocić-Tanackov Sunčica D.


    Full Text Available The growth of fungi on food causes physical and chemical changes which, further affect negatively the sensory and nutritive quality of food. Species from genera: Aspergillus, Penicillium, Fusarium, Alternariа, Cladosporium, Mucor, Rhizopus, Eurotium and Emericella are usually found. Some of them are potentially dangerous for humans and animals, due to possible synthesis and excretion of toxic secondary metabolites - mycotoxins into the food. Their toxic syndroms in animals and humans are known as mycotoxicoses. The pathologic changes can be observed in parenhimatic organs, and in bones and central nervous system also. Specific conditions are necessary for mycotoxin producing fungi to synthetize sufficient quantities of these compounds for demonstration of biologic effects. The main biochemical paths in the formation of mycotoxins include the polyketide (aflatoxins, sterigmatocystin, zearalenone, citrinine, patulin, terpenic (trichothecenes, aminoacid (glicotoxins, ergotamines, sporidesmin, malformin C, and carbonic acids path (rubratoxins. Aflatoxins are the most toxigenic metabolites of fungi, produced mostly by Aspergillus flavus and A. parasiticus species. Aflatoxins appear more frequently in food in the tropic and subtropic regions, while the food in Europe is more exposed to also very toxic ochratoxin A producing fungi (A. ochraceus and some Penicillium species. The agricultural products can be contaminated by fungi both before and after the harvest. The primary mycotoxicoses in humans are the result of direct intake of vegetable products contaminated by mycotoxins, while the secondary mycotoxicoses are caused by products of animal origin. The risk of the presence of fungi and mycotoxin in food is increasing, having in mind that some of them are highly thermoresistent, and the temperatures of usual food sterilization is not sufficient for their termination. The paper presents the review of most important mycotoxins, their biologic effects

  9. Primary Headache in Yemen: Prevalence and Common Medications Used

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    Salah A. Abdo


    Full Text Available Background and Objective. Primary headaches is a major medical concern in certain Arabic countries, for example Oman, Jordan, and Qatar. This study was aimed at increasing understanding of the prevalence of headache in Arabic countries and identifying common medications used for treatment because of the lack of research done in this field in Yemen. Methods. This is a cross-sectional observational study conducted by recruiting case-series of adults and elderly who have primary headache within the age group from 18 to 85 years. 12640 subjects received a simple explanation for the aim of the study as ethical issue. The subjects were allowed to complete a self-conducted screening questionnaire. The data were diagnosed according to the International Headache Society’s diagnostic criteria (2004. Results. The results showed that 76.5% of the primary headache is prevalent at least once per year, 27.1% of the tension type headache (TTH was the maximum percentage of type of headache, and 14.48% of the migraine headache (MH was the minimum percentage. On the other hand, the relationship between the primary headache and age of subjects was statistically significant (P0.05. In addition, 70.15% of the subjects said that headache attacks affected their activity of daily livings (ADL. 62.26% of the subjects used the medications without medical advice regarding their headache. 37.73% of the subjects relied on medical professionals (physicians and pharmacist regarding analgesics use. The most common agent used among the medications was paracetamol (38.4%. Others included ibuprofen, aspirin, diclofenac sodium, naproxen, mefenamic acid, ergotamine and (11.45% were unknown agents. Conclusion. We concluded that absence of health attention from the Yemeni Community and education from the health system in the country regarding analgesics use and their potential risk led to abuse of such medications and could be a reason beyond high prevalence of headache in Yemen.

  10. Prophylactic interventions after delivery of placenta for reducing bleeding during the postnatal period. (United States)

    Yaju, Yukari; Kataoka, Yaeko; Eto, Hiromi; Horiuchi, Shigeko; Mori, Rintaro


    There are several Cochrane systematic reviews looking at postpartum haemorrhage (PPH) prophylaxis in the third stage of labour and another Cochrane review investigating the timing of prophylactic uterotonics in the third stage of labour (i.e. before or after delivery of the placenta). There are, however, no Cochrane reviews looking at the use of interventions given purely after delivery of the placenta. Ergometrine or methylergometrine are used for the prevention of PPH in the postpartum period (the period after delivery of the infant) after delivery of the placenta in some countries. There are, furthermore, no Cochrane reviews that have so far considered herbal therapies or homeopathic remedies for the prevention of PPH after delivery of the placenta. To assess the effectiveness of available prophylactic interventions for PPH including prophylactic use of ergotamine, ergometrine, methylergometrine, herbal therapies, and homeopathic remedies, administered after delivery of the placenta, compared with no uterotonic agents as well as with different routes of administration for prevention of PPH after delivery of the placenta. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2013), The Food and Drug Administration (FDA) (USA),  Medicines and Healthcare Products Regulatory Agency (MHRA) (UK), European Medicines Agency (EMA) (EU), Pharmaceuticals and Medical Devices Agency (PMDA) (Japan),  Therapeutic Goods Administration (TGA) (Australia),, Current Controlled Trials, WHO International Clinical Trials Registry Platform (ICTRP), University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; Japan), Japan Pharmaceutical Information Center Clinical Trials Information (Japic-CTI; Japan), Japan Medical Association Clinical Trial Registration (JMACCT CTR; Japan) (all on 30 April 2013) and reference lists of retrieved studies All randomised or quasi-randomised controlled trials comparing prophylactic

  11. Effects of clay on toxin binding capacity, ruminal fermentation, diet digestibility, and growth of steers fed high-concentrate diets. (United States)

    Antonelo, D S; Lancaster, N A; Melnichenko, S; Muegge, C R; Schoonmaker, J P


    Three experiments were conducted to determine the effect of increasing concentrations of a smectite clay on toxin binding capacity, ruminal fermentation, diet digestibility, and growth of feedlot cattle. In Exp. 1, 72 Angus × Simmental steers were blocked by BW (395 ± 9.9 kg) and randomly allotted to 3 treatments (4 pens/treatment and 6 steers/pen) to determine the effects of increasing amounts of clay (0, 1, or 2%) on performance. The clay was top-dressed on an 80% concentrate diet at a rate of 0, 113, or 226 g/steer daily to achieve the 0, 1, and 2% treatments, respectively. Steers were slaughtered at a target BW of 606 kg. In Exp. 2, 6 steers (596 ± 22.2 kg initial BW) were randomly allotted to the same 3 treatments in a replicated 3 × 3 Latin square design (21-d periods) to determine the effects of increasing amounts of clay on ruminal pH, VFA, and nutrient digestibility. In Exp. 3, 150 mg of clay was incubated in 10 mL of rumen fluid with 3 incremental concentrations (6 replicates per concentration) of aflatoxin B (AFB) or ergotamine tartate (ET) to determine binding capacity. During the first 33-d period, there was a quadratic effect of clay on ADG ( clay and then decreasing from 1 to 2% clay. However, during the second 30-d period, clay linearly decreased ADG and G:F ( ≤ 0.03) and overall ADG, DMI, and G:F were not impacted ( ≥ 0.46). Clay linearly decreased marbling score ( = 0.05). Hepatic enzyme activity did not differ among treatments on d 0 or at slaughter ( ≥ 0.15). Clay linearly decreased ruminal lactate and propionate, linearly increased formate and the acetate:propionate ratio ( ≤ 0.04), and tended ( = 0.07) to linearly increase butyrate. Clay tended to linearly increase ( = 0.06) OM and CP apparent digestibility. Ruminal pH, urine pH, and other digestibility measures did not differ among treatments ( ≥ 0.15). Clay was able to effectively bind AFB and ET at concentrations above the normal physiological range (52 and 520 μg/mL), but

  12. Cytotoxicity and accumulation of ergot alkaloids in human primary cells. (United States)

    Mulac, Dennis; Humpf, Hans-Ulrich


    Ergot alkaloids are secondary metabolites produced by fungi of the species Claviceps. Toxic effects after consumption of contaminated grains are described since mediaeval times. Of the more than 40 known ergot alkaloids six are found predominantly. These are ergotamine, ergocornine, ergocryptine, ergocristine, ergosine and ergometrine, along with their corresponding isomeric forms (-inine-forms). Toxic effects are known to be induced by an interaction of the ergot alkaloids as neurotransmitters, like dopamine or serotonin. Nevertheless data concerning cytotoxic effects are missing and therefore a screening of the six main ergot alkaloids was performed in human primary cells in order to evaluate the toxic potential. As it is well known that ergot alkaloids isomerize easily the stability was tested in the cell medium. Based on these results factors were calculated to correct the used concentration values to the biologically active lysergic (-ine) form. These factors range from 1.4 for the most stable compound ergometrine to 5.0 for the most unstable ergot alkaloid ergocristine. With these factors, reflecting the instability, several controverse literature data concerning the toxicity could be explained. To evaluate the cytotoxic effects of ergot alkaloids, human cells in primary culture were used. These cells remain unchanged in contrast to cell lines and the data allow a better comparison to the in vivo situation than using immortalized cell lines. To characterize the effects on primary cells, renal proximal tubule epithelial cells (RPTEC) and normal human astrocytes (NHA) were used. The parameters necrosis (LDH-release) and apoptosis (caspase-3-activation, DNA condensation and fragmentation) were distinguished. The results show that depending on the individual structure of the peptide ergot alkaloids the toxic properties change. While ergometrine as a lysergic acid amide did not show any effect, the peptide ergot alkaloids revealed a different toxic potential. Of

  13. Rectal drug administration: clinical pharmacokinetic considerations. (United States)

    de Boer, A G; Moolenaar, F; de Leede, L G; Breimer, D D


    The human rectum represents a body cavity in which drugs can be easily introduced and retained and from which absorption is well possible. There are important therapeutic reasons why it is sometimes preferable to give a drug rectally rather than orally, e.g. in cases of nausea and vomiting. Drawbacks of rectal drug administration include the interruption of absorption by defaecation and lack of patient acceptability. The mechanism of drug absorption from the rectum is probably no different to that in the upper part of the gastrointestinal tract, despite the fact that the physiological circumstances (e.g. pH, fluid content) differ substantially, Absorption from aqueous and alcoholic solutions may occur very rapidly, which has proved to be of considerable therapeutic value in the rapid suppression of acute convulsive attacks by diazepam (e.g. in children), but absorption from suppositories is generally slower and very much dependent on the nature of the suppository base, the use of surfactants or other additives, particle size of the active ingredient, etc. There is some evidence that hepatic first-pass elimination of high clearance drugs is partially avoided after rectal administration, e.g. lignocaine. This can be explained by the rectal venous blood supply: the upper part is connected with the portal system, whereas the lower part is directly connected with the systemic circulation. Plasma concentration data following rectal administration of representatives of several classes of drugs are reviewed: anticonvulsants, non-narcotic analgesics and non-steroidal anti-inflammatory agents, hypnosedatives and anaesthetics, strong analgesics, theophylline and derivatives, corticosteroids, antibacterial agents, thiazinamium, promethazine, hyoscine-N-butyl-bromide, streptokinase, progesterone, ergotamine tartrate and levodopa. Only limited number of cases has it been adequately shown that the rectal route of administration gives plasma concentrations which are comparable to

  14. Impact of newer pharmacological treatments on quality of life in patients with Parkinson's disease. (United States)

    Gallagher, David A; Schrag, Anette


    Parkinson's disease is a common progressive neurodegenerative condition with multiple motor and nonmotor features contributing to impairment of health-related quality of life (HR-QOL). Pharmacological treatments have been directed primarily at dopamine replacement with levodopa and agents to improve its bioavailability, including DOPA decarboxylase inhibitors, catechol-O-methyltransferase (COMT) inhibitors and monoamine oxidase B (MAO-B) inhibitors, as well as synthetic dopamine agonists. These treatments to restore motor function are often very successful in early Parkinson's disease, with objective improvement and concomitant improvement in subjective HR-QOL scores. However, as the disease progresses, motor complications and nonmotor symptoms predominate and are often refractory to therapeutic interventions. Antiparkinsonian medications have been shown to improve motor severity and motor complications of advancing disease, and there is increasing evidence that this can be translated into subjective improvement of HR-QOL from a patient's point of view. However, the degree of improvement is less marked on HR-QOL scores than on motor scores, and some studies do not show improvement of HR-QOL in parallel to motor improvements. A number of explanations are possible, including limitations of the scales used, trial designs and lack of clinical improvement from the patients' point of view. This review concentrates on clinical trials with an index of HR-QOL as an outcome measure, with particular emphasis on well designed, randomized, double-blind, placebo-controlled or active comparator-controlled methodology. Drugs that have been more recently added to the armamentarium of Parkinson's disease, including the oral (pramipexole, ropinirole and piribedil) and transdermal (rotigotine) non-ergotamine-derived dopamine agonists, the novel MAO-B inhibitor rasagiline and the COMT inhibitors tolcapone and entacapone, were included. The effect of each of these agents on overall HR

  15. Semiquantitative determination of ergot alkaloids in seed, straw, and digesta samples using a competitive enzyme-linked immunosorbent assay. (United States)

    Schnitzius, J M; Hill, N S; Thompson, C S; Craig, A M


    Ergot alkaloids present in endophyte-infected (E+) tall fescue cause fescue toxicosis and other toxic effects in livestock that consume infected plant tissue, leading to significant financial losses in livestock production each year. The predominant method currently in use for quantifying ergot alkaloid content in plant tissue is through high-performance liquid chromatography (HPLC), which quantifies the amount of ergovaline, one of many ergot alkaloids in E+ plant tissue. The enzyme-linked immunosorbent assay (ELISA) method used in this study detects quantities of nonspecific ergot alkaloids and therefore accounts for greater amounts of the total ergot alkaloid content in E+ tissue than does HPLC. The ELISA can also be used to more expediently analyze a larger number of forage samples without sophisticated and costly analytical equipment and therefore could be more desirable in a diagnostic setting. The purpose of this study was to evaluate the between-day and within-run variability of the ELISA and to determine the binding efficiency of 6 ergot alkaloids to the 15F3.E5 antibody used in the competitive ELISA to ascertain its feasibility as a quick analysis tool for ergot alkaloids. Straw samples had an average coefficient of variation (CV) for concentration of 10.2% within runs and 18.4% between runs, and the seed samples had an average CV for concentration of 13.3% within runs and 24.5% between runs. The grass tissue-based lysergic acid standard curve calculated from the ELISA had an average r2 of 0.99, with a CV of 2.1%. Ergocryptine, ergocristine, ergocornine, and ergotamine tartrate did not bind strongly to the 15F3.E5 antibody because of the presence of large side groups on these molecules, which block their binding to the antibody, whereas ergonovine and ergonovine maleate were bound much more efficiently because of their structural similarity to lysergic acid. Clarified rumen fluid was tested as an additional matrix for use in the ergot alkaloid competitive

  16. Fern-synthesized nanoparticles in the fight against malaria: LC/MS analysis of Pteridium aquilinum leaf extract and biosynthesis of silver nanoparticles with high mosquitocidal and antiplasmodial activity. (United States)

    Panneerselvam, Chellasamy; Murugan, Kadarkarai; Roni, Mathath; Aziz, Al Thabiani; Suresh, Udaiyan; Rajaganesh, Rajapandian; Madhiyazhagan, Pari; Subramaniam, Jayapal; Dinesh, Devakumar; Nicoletti, Marcello; Higuchi, Akon; Alarfaj, Abdullah A; Munusamy, Murugan A; Kumar, Suresh; Desneux, Nicolas; Benelli, Giovanni


    Malaria remains a major public health problem due to the emergence and spread of Plasmodium falciparum strains resistant to chloroquine. There is an urgent need to investigate new and effective sources of antimalarial drugs. This research proposed a novel method of fern-mediated synthesis of silver nanoparticles (AgNP) using a cheap plant extract of Pteridium aquilinum, acting as a reducing and capping agent. AgNP were characterized by UV-vis spectrophotometry, Fourier transform infrared (FTIR) spectroscopy, energy-dispersive X-ray spectroscopy (EDX), and X-ray diffraction (XRD). Phytochemical analysis of P. aquilinum leaf extract revealed the presence of phenols, alkaloids, tannins, flavonoids, proteins, carbohydrates, saponins, glycosides, steroids, and triterpenoids. LC/MS analysis identified at least 19 compounds, namely pterosin, hydroquinone, hydroxy-acetophenone, hydroxy-cinnamic acid, 5, 7-dihydroxy-4-methyl coumarin, trans-cinnamic acid, apiole, quercetin 3-glucoside, hydroxy-L-proline, hypaphorine, khellol glucoside, umbelliferose, violaxanthin, ergotamine tartrate, palmatine chloride, deacylgymnemic acid, methyl laurate, and palmitoyl acetate. In DPPH scavenging assays, the IC50 value of the P. aquilinum leaf extract was 10.04 μg/ml, while IC50 of BHT and rutin were 7.93 and 6.35 μg/ml. In mosquitocidal assays, LC50 of P. aquilinum leaf extract against Anopheles stephensi larvae and pupae were 220.44 ppm (larva I), 254.12 ppm (II), 302.32 ppm (III), 395.12 ppm (IV), and 502.20 ppm (pupa). LC50 of P. aquilinum-synthesized AgNP were 7.48 ppm (I), 10.68 ppm (II), 13.77 ppm (III), 18.45 ppm (IV), and 31.51 ppm (pupa). In the field, the application of P. aquilinum extract and AgNP (10 × LC50) led to 100 % larval reduction after 72 h. Both the P. aquilinum extract and AgNP reduced longevity and fecundity of An. stephensi adults. Smoke toxicity experiments conducted against An. stephensi adults showed that P. aquilinum leaf-, stem-, and root-based coils

  17. Sumatriptan (oral route of administration) for acute migraine attacks in adults (United States)

    Derry, Christopher J; Derry, Sheena; Moore, R Andrew


    the mild pain phase, gave significantly better NNTs for pain-free at two hours and sustained pain-free during 24 hours than did treating established attacks with moderate or severe pain intensity. Relief of associated symptoms, including nausea, photophobia, and phonophobia, was greater with sumatriptan than with placebo, and use of rescue medication was lower with sumatriptan than with placebo. For the most part, adverse events were transient and mild and were more common with the sumatriptan than with placebo, with a clear dose response relationship (25 mg to 100 mg). Sumatriptan was compared directly with a number of active treatments, including other triptans, paracetamol (acetaminophen), acetylsalicylic acid, non-steroidal anti-inflammatory drugs (NSAIDs), and ergotamine combinations. Authors’ conclusions Oral sumatriptan is effective as an abortive treatment for migraine attacks, relieving pain, nausea, photophobia, phonophobia, and functional disability, but is associated with increased adverse events. PMID:22336849