The transillumination technique as a method for the assessment of spermatogenesis using medicinal plants: the effect of extracts of black maca (Lepidium meyenii) and camu camu (Myrciaria dubia) on stages of the spermatogenic cycle in male rats

Abstract

Transillumination technique for assessment of stages of spermatogenic cycle is a useful tool for toxicological studies. This study was designed to determine the effect of two medicinal plants on spermatogenesis in male rats using the transillumination technique. For this, the effect of the combination of a fruit with highest content of ascorbic acid (Myrciaria dubia, camu camu) and extract of black maca (Lepidium meyenii) on seminiferous tubule stages scored by transillumination on intact tubules in adult male rats was assessed. Animals were treated during seven days with vehicle, black maca, camu camu or a mixture of black maca?+?camu camu and assessed for daily sperm production (DSP), stages of spermatogenic cycle as well as antioxidant activity and levels of flavonoids and polyphenols. Black maca increased stages of spermiation (VII–VIII) and mitosis of germ cells (IX–XI), whereas camu camu increased stages of mitosis (IX–XI) and meiosis (XII). Mixture of maca?+?camu camu increased stages of spermiation, mitosis and meiosis. All treatments increased DSP (p?<?0.05) and epididymal sperm count (p?<?0.05). Total polyphenols, flavonoids levels and antioxidant activity were higher in camu camu (p?<?0.001) than in black maca. In conclusion, M. dubia (camu camu) has potential effects improving spermatogenesis and co-administered with maca increase stages of mitosis, meiosis and spermiation of the spermatogenic cycle as assessed by the transillumination technique. This technique is becoming increasingly a useful tool for assessment spermatogenesis.     

儿童序贯疗法与传统三联疗法根除儿童幽门螺杆菌的疗效比较

目的探讨儿童序贯疗法在儿童幽门螺杆菌（H.pylori）感染根治治疗中的临床疗效及可行性。方法将有上消化道症状,并经13碳-尿素呼气试验（13C-UBT）检测H.pylori为阳性的患儿150例随机分为治疗组和对照组,每组75例,治疗组采用10d序贯疗法,对照组采用传统三联疗法,两组患儿疗程结束停药4周后复查13C-UBT,并判断H.pylori的根除率。结果治疗组与对照组的总有效率分别为93.33%和82.67%,H.pylori根除率分别为93.33%和62.67%,两组差异均有统计学意义（P〈0.05）;治疗组的不良反应发生率为13.33%,对照组为14.67%,差异无统计学意义（P〉0.05）。结论儿童序贯疗法根除H.pylori的临床疗效明显优于传统三联疗法,且不良反应少,是目前根除H.pylori感染的首选新方案。     

中医清胰通腑泄热消胀特色疗法结合西医治疗急性胰腺炎的研究

目的：探讨中医“清胰通腑泄热消胀”特色疗法与西医疗法结合治疗急性胰腺炎（AP）的疗效。方法选取66例AP患者随机分为观察组与对照组,各33例,对照组予以常规西医治疗,观察组在对照组的基础上实施中医清胰通腑泄热消胀特色疗法,比较两组的疗效。结果观察组的治疗总有效率为93.9%,显著高于对照组的75.8%;主要症状消失时间、淀粉酶（AMS）恢复时间、首次排便时间、禁食时间、住院时间均较对照组显著缩短,差异具统计学意义（P＜0.05）。结论中医清胰通腑泄热消胀特色疗法与西医疗法结合治疗AP能够有效缓解临床症状,不良反应少,疗效显著,值得推广应用。     

Quetiapine for the treatment of acute bipolar mania,mixed episodes and maintenance therapy

Introduction: Bipolar disorder is characterized by mood instability, which can be challenging to manage. First-line pharmacological approaches usually involve lithium, anticonvulsants and antipsychotics. Over the past fifteen years, several second-generation antipsychotics have demonstrated benefits for various phases of this disorder.

Areas covered: This article examines the pharmacodynamics and pharmacokinetics of quetiapine; its evidence base as an acute and maintenance monotherapy or adjunctive therapy for bipolar manic or mixed episodes is also discussed, along with the related issues of its safety and tolerability.

Expert opinion: In the context of bipolar disorder, quetiapine is the only agent approved as a monotherapy or adjunct therapy for acute manic/mixed episodes in adults and adolescents; as a monotherapy for acute depressive episodes in adults; and as an adjunctive maintenance therapy for bipolar I and II disorder in adults. In addition to its antipsychotic properties, this broad mood-stabilizing potential may simplify the management of select patients.     

莫西沙星治疗慢性支气管炎细菌感染急性发作的临床疗效观察

目的：观察莫西沙星短疗程治疗慢性支气管炎细菌感染急性发作（ABECB）N临床疗效。方法：将74例ABF22B患者随机分为两组，治疗组用莫西沙星400mg，po．qd，治疗5d；对照组用克拉霉素500mg，Do．bid，治疗5d。观察临床指标、细菌学、临床疗效及安全性。结果：治疗组与对照组的有效率分别为91．9％和78．4％，细菌清除率为89．2％和75．7％，两组比较差异有显著性（P〈0．05）。结论：莫西沙星在短疗程下治疗慢性支气管炎急性细菌加重的疗效显著，是一种广谱、安全的抗菌药物。     

Lenvatinib for use in combination with everolimus for the treatment of patients with advanced renal cell carcinoma following one prior anti-angiogenic therapy

Introduction: In patients with mRCC options for second line therapies, following progression on anti-angiogenic agents, that demonstrate a survival advantage in clinical trials have been limited. Recently a number of agents have demonstrated efficacy in this setting. Here in we profile one such therapy, the combination of lenvatinib and everolimus, and discuss the expanded options for therapy available in this setting.

Areas covered: In this review, we discuss current algorithms for treatment of mRCC in both the first-line and second-line setting. We discuss the recent addition of cabozantinib and nivolumab, in the second line setting, to the market. Lenvatinib’s pharmacology, clinical efficacy and toxicity profile is discussed. A comprehensive literature review was performed using PUBMED.

Expert commentary: The current treatment algorithms for mRCC will likely see significant change in the coming years. The addition of immunotherapy to our treatment options in mRCC is of particular importance. Future trials examining the use of immunotherapy, both as monotherapy and in combination with VEGF targeted therapy, will likely be a dominant influence in the therapeutic landscape of mRCC. Progress in terms of the rapid expansion of available active therapies in mRCC needs to be balanced with current deficiencies in terms of predictive biomarkers.     

综合消肿治疗联合中药外治法治疗恶性肿瘤术后下肢淋巴水肿的临床疗效及超声显像评估研究

目的 研究综合消肿治疗联合中药外治法治疗恶性肿瘤术后下肢淋巴水肿的临床疗效,并对其超声显像进行评估.方法 选取2016年7月至2020年7月收治的恶性肿瘤术后下肢淋巴水肿患者共计78例,随机分为治疗组和对照组,每组各39例.对照组采取综合消肿治疗,治疗组在综合消肿治疗基础上,联合中药外治法.两疗程后,比较两组总有效率、...     

Combination therapy for the treatment of multiple sclerosis: challenges and opportunities

ABSTRACT

Objective: Multiple sclerosis (MS) is a complex, heterogeneous disease. Standard treatment of relapsing MS includes interferon beta (IFNβ) and glatiramer acetate. These agents reduce relapse rates, and IFNβ?1a is associated with a slowing of disease progression. Despite treatment, many patients experience disease progression, prompting neurologists to use combination therapies to delay this progression. Agents that may be considered for combination therapy are those with unique mechanisms of action that exert additive or synergistic efficacy. This article reviews combination treatment with immunosuppressive therapies and new agents for the management of MS.

Methods: The Medline and EMBASE databases were searched for clinical trials using the following search terms: multiple sclerosis, interferon, Avonex, Betaseron, Rebif, glatiramer, copolymer 1, Copaxone, immuno­suppressant, cytotoxic, corticosteroid, azathioprine, cyclo­phosphamide, methotrexate, mitoxantrone, natalizumab, combination therapy. The National MS Society website was searched for clinical trials of combination therapies.

Results: Several small studies have analyzed the effects of immunosuppressive therapy added to IFNβ treatment, and some encouraging results have been obtained. Few data are available on combination therapy with new drug classes; however, current data suggest that combination therapy with new agents is effective. Although the available data on combination regimens are promising, interpretation is limited by lack of controlled study design, small patient population, and short study duration.

Conclusions: Combination of standard therapies with immunosuppressive agents or with new therapies may provide synergistic effects that will likely benefit patients with MS. Larger, well-controlled trials need to be conducted.     

Rituximab: novel B-cell depletion therapy for the treatment of rheumatoid arthritis

Significant numbers of patients with rheumatoid arthritis (RA) suffer from disease that is refractory to both conventional therapy and newer biological agents such as TNF-α inhibitors. These patients may respond insufficiently, lose an effective response, develop toxicity or carry contraindications to such agents. Rituximab, a chimeric monoclonal antibody against CD20 that effectively depletes B cells in peripheral blood, has been licensed for the treatment of certain haematological malignancies for almost 10 years. B cells are now known to have multiple key roles in the pathogenesis of RA. Data is now available that indicates efficacy and safety of B-cell depletion with rituximab in the treatment of RA in a variety of patient groups. The clinical outcomes from these studies, together with its safety profile, have led to rituximab being licensed for the treatment of patients with RA who have failed to obtain benefit from anti-TNF-α agents.     

小儿唇裂修复中粘合剂粘合与传统缝合的对比研究

目的对比研究爱必肤粘合剂与传统缝合方法对唇裂修复术白唇手术切口的作用。方法将同期的小儿唇裂手术随机分组,32例白唇切口皮肤予爱必肤粘合,32例白唇切口皮肤按传统方法予丝线缝合,观察切口疼痛程度、愈合情况、感染率及美观效果。结果爱必肤组切口疼痛率低（χ^2=9.69,P〈0.01）,切口及针眼疤痕不明显（χ^2=7.59,P〈0.01）,切口甲级愈合率及感染率两组差异无统计学意义。结论爱必肤作为关闭切口皮肤的一种方法,在小儿唇裂手术中值得大力推广。     

Evaluating current and emerging antithrombotic therapy currently available for the treatment of acute coronary syndrome in geriatric populations

Introduction: Acute coronary syndromes (ACS) represent one of the most perilous presentations of ischemic heart disease. Temporal trends clearly demonstrate that ACS occur later and later in life. Elderly patients with ACS comprise a populous and growing group, with more than half of individuals presenting with myocardial infarction being 75 years or older. Nevertheless, geriatric patients are greatly underrepresented in the landmark ACS trials evaluating innovative pharmacological strategies.

Areas covered: The authors critically summarize recently published research on contemporary and emerging antithrombotic therapy for the treatment of ACS in geriatric patients.

Expert opinion: Elderly ACS patients are characterized by simultaneously increased risk of cardiovascular events and bleeding. Very few studies assessing the efficacy and safety of novel ACS pharmacotherapy in geriatric patients are currently available. Guidelines on the treatment of ACS are based on the overall results of major randomized clinical trials (RCTs), and data supporting the recommended therapy in elderly mainly derive from subanalyses of these RCTs. Properly designed and powered RCTs are necessary to properly evaluate the net effect of current and emerging pharmacotherapy in geriatric patients. Until such data are available, elderly ACS patients should receive treatment according to the general recommendations.     

胸腺五肽辅助治疗慢性阻塞性肺疾病临床有效性及安全性的Meta分析

目的：采用Meta分析方法对胸腺五肽辅助治疗慢性阻塞性肺疾病（COPD）的临床疗效及安全性进行评价,为临床应用及辅助用药管理提供循证参考。方法：计算机检索PubMed、Embase、Cochrane Library、中国期刊全文数据库（CNKI）、万方数据库、维普数据库（VIP）、中国生物医学文献数据库（各数据库检索时间均从建库至2016年1月）,收集胸腺五肽辅助治疗COPD的随机对照试验。由2名研究者按照纳入与排除标准独立筛选试验、提取资料、评价方法学质量,采用RevMan 5.3软件进行统计分析。结果：共纳入16 项研究,对研究进行合并分析,结果显示,胸腺五肽辅助治疗COPD,有效性高于常规治疗组[RR=1.18, 95%CI（1.05, 1.32）,P=0.004],可使患者FEV₁得到显著改善[SMD=0.64, 95%CI（0.20,1.09）,P=0.005],使患者外周血CD4⁺水平[WMD=6.25,95%CI（3.02,9.48）,P=0.000 1]及CD8⁺水平显著降低[WMD=-4.60,95%CI（-7.26,-1.94）,P=0.000 7],CD4⁺/CD8⁺水平显著升高[WMD=0.42,95%CI（0.24,0.59）,P<0.000 01]。结论：基于现有临床证据,胸腺五肽辅助治疗COPD具有一定临床疗效,但由于纳入研究证据强度较低,存在一定的偏倚风险,本研究结论尚需设计严格的临床对照试验进一步验证。     

Therapy for pruritus in the elderly: a review of treatment developments

Introduction: The prevalence of chronic pruritus (CP) in the general population is high and increases with age. Owing to high rates of comorbidities and polypharmacy in patients aged 65 or older, the clinical management of these patients is challenging.

Areas covered: In this review, the authors discuss the available therapy options for patients aged ≥ 65 with CP, including emollients for dry skin, topical therapies, phototherapy and systemic agents for CP of various origins.

Expert opinion: For multimorbid patients, topical substances and phototherapy constitute the best initial options. If systemic drugs are needed, the potential side-effects need to be closely monitored. In elderly patients, multiple possible factors for CP, including dermatological and systemic diseases, may be found, complicating the treatment of the underlying cause. In these cases, or when the origin remains unknown, a step-wise symptomatic therapy is recommended. The therapeutic choices should be made on an individual basis after carefully outweighing possible risks and benefits. Novel agents such as neurokinin-1 receptor antagonists and opioid-targeting drugs show promising antipruritic effects on refractory CP and seem to be well tolerated. They may be useful for elderly patients, who cannot tolerate conventional systemic agents.     

Moxifloxacin versus levofloxacin for treatment of acute rhinosinusitis: a retrospective database analysis of treatment duration,outcomes, and charges

ABSTRACT

Objective: Antibiotics are clinically indicated for acute bacterial rhinosinusitis, but they may be prescribed inappropriately. This retrospective study examined how labeled recommendations for duration of moxifloxacin and levofloxacin treatment of acute bacterial rhinosinusitis compare with real-world practice, and compared the failure and recurrence rates, and associated charges.

Methods and main outcome measures: The PharMetrics Patient-Centric claims database was searched over a 3‐year period for episodes of acute rhinosinusitis treated within 5 days with moxifloxacin or levofloxacin. The duration of antibiotic treatment prescribed was compared with the labeled recommendation. Failure rates (a second antibiotic claim to treat acute rhinosinusitis within 30 days of the first claim), recurrence rates (subsequent antibiotic claims to treat any rhinosinusitis more than 30 days after the original or second [in the case of failure] claim), and treatment charges from the perspective of the payer (health insurer) were also compared using multivariate analysis.

Results: The initial duration prescribed of moxifloxacin was shorter than for levofloxacin (–1.65 days, p < 0.0001), reflecting the shorter labeled recommendation (10 days versus 10–14 days). The durations of monotherapy (–2.06 days, p < 0.0001) and of all antibiotic treatment (–1.97 days, p < 0.0001) were also significantly shorter for episodes treated initially with moxifloxacin. The odds ratio for treatment failure (0.718; 95% confidence interval = 0.598–0.863; p = 0.0004) and the hazard ratio for recurrence (0.652; p = 0.0005) were both significantly lower for moxifloxacin than for levofloxacin, and resulted in lower total treatment charges (–$37.94 ± 13.65; p = 0.0055).

Conclusion: The shorter treatment durations seen for moxifloxacin in this database of real-world care reflect the label-recommended duration for acute rhinosinusitis. Despite this shorter duration of therapy, moxifloxacin resulted in better outcomes than levofloxacin in terms of the risk of treatment failure and recurrence. In addition, the total charges were lower for patients treated with moxifloxacin.     

Beyond standard therapy: drugs under investigation for the treatment of gastrointestinal stromal tumor

Introduction: Gastrointestinal stromal tumor (GIST) is the most common nonepithelial malignancy of the GI tract. With the discovery of KIT and later platelet-derived growth factor α (PDGFRA) gain-of-function mutations as factors in the pathogenesis of the disease, GIST was the quintessential model for targeted therapy. Despite the successful clinical use of imatinib mesylate, a selective receptor tyrosine kinase (RTK) inhibitor that targets KIT, PDGFRA and BCR-ABL, we still do not have treatment for the long-term control of advanced GIST.

Areas covered: This review summarizes the drugs that are under investigation or have been assessed in trials for GIST treatment. The article focuses on their mechanisms of actions, the preclinical evidence of efficacy, and the clinical trials concerning safety and efficacy in humans.

Expert opinion: It is known that KIT and PDGFRA mutations in GIST patients influence the response to treatment. This observation should be taken into consideration when investigating new drugs. RECIST was developed to help uniformly report efficacy trials in oncology. Despite the usefulness of this system, many questions are being addressed about its validity in evaluating the true efficacy of drugs knowing that new targeted therapies do not affect the tumor size as much as they halt progression and prolong survival.     

Use of asenapine as add-on therapy in the treatment of bipolar disorder: a comprehensive review and case series

Introduction: Several randomized controlled trials (RCTs), conducted in schizophrenic and bipolar patients, have documented the efficacy and tolerability of asenapine as monotherapy both for short- and long-term treatment. However, evidence on its augmentative use is more limited and related to the manic/mixed phase of bipolar disorder (BD).

Areas covered: The present article reviews augmentative asenapine efficacy and safety/tolerability in the treatment of BD. It also includes some original cases of bipolar patients treated with add-on asenapine in the short- and long-term.

Expert opinion: To date, only a single RCT with manic/mixed patients with partial response to mood-stabilizer monotherapy supports the efficacy and safety/tolerability of augmentative asenapine to lithium/valproate, both in acute and long-term treatment. Additionally, two case reports confirm the overall effectiveness of augmentative asenapine to clozapine and valproate. Our case series, consisting of 4 bipolar patients treated with adjunctive asenapine to mood stabilizers and atypical antipsychotics – with treatment duration ranging from 1 to 14 months – provided clinical results that are consistent with literature data. Taken as a whole, available evidence seems to support the efficacy and safety of adjunctive asenapine in bipolar patients, though additional studies with active comparators are requested to confirm the current body of evidence.     

Comparison of rofecoxib and a multidose oxycodone/acetaminophen regimen for the treatment of acute pain following oral surgery: a randomized controlled trial

SUMMARY

Objective: To compare the efficacy of a single dose of rofecoxib 50?mg with a single dose of oxycodone/acetaminophen 10/650?mg over 6?h as well as with a multidose regimen of oxycodone/acetaminophen 10/650?mg followed by oxycodone/acetaminophen 5/325?mg over 24?h.

Research design and methods: In this double-blind, randomized, two-phase study, patients with moderate to severe pain after surgical extraction of ≥ 2 third molars, including one mandibular impaction, were treated with rofecoxib 50?mg, oxycodone/acetaminophen 10/650?mg (single-dose phase) followed by 5/325?mg every 6?h as needed (multidose phase), or placebo. Patients rated their pain relief and intensity at 18 time points over 24?h. Efficacy was measured over 6 and 24?h by total pain relief (TOPAR), sum of pain intensity difference (SPID), and patient global assessment of response to therapy (PGART). Primary endpoint for the single dose comparison was TOPAR over 6?h; SPID was the key 24-h endpoint. Onset of analgesic effect, peak analgesic effect, and duration of analgesic effect were also evaluated. Adverse experiences were recorded.

Results: 271 patients were randomized to treatment with rofecoxib (n = 121), oxycodone/acetaminophen (n = 120), or placebo (n = 30). For the single dose comparison, rofecoxib-treated patients achieved pain relief at least as effective as oxycodone/acetaminophen-treated patients as assessed by TOPAR6 (12.9 vs 11.3, 95% CI on difference = [–0.1, 3.2], p = 0.059). Patients also rated a single dose of rofecoxib as at least as effective as multidose oxycodone/acetaminophen over 24?h on SPID24 (21.9 vs 18.1, 95% CI on difference = [–1.0, 8.8], p = 0.122). Patients treated with oxycodone/acetaminophen had a shorter time to onset of analgesia than patients treated with rofecoxib (24 vs 35?min, p < 0.05). Patients in the active treatment groups achieved similar peak effects during the single-dose phase. Individuals treated with rofecoxib demonstrated a longer duration of analgesic effect than those treated with a single dose of oxycodone/acetaminophen. Patients on active treatment demonstrated better efficacy than patients on placebo on these prespecified endpoints (?p < 0.001 for both comparisons). Fewer rofecoxib than oxycodone/acetaminophen patients experienced adverse events (47.9 vs 75.8%, p < 0.001), including nausea (19.0 vs 42.5%, p < 0.001), vomiting (9.9 vs 24.2%, p < 0.01), and dizziness (7.4 vs 31.7%, p < 0.001).

Conclusion: Patients treated with a single dose of rofecoxib 50?mg achieved an overall analgesic effect at least as effective as patients treated with a single-dose of oxycodone/acetaminophen 10/650?mg over 6?h and multidose oxycodone/acetaminophen over 24?h, with fewer adverse experiences of nausea (?p < 0.001), vomiting (?p < 0.01), and dizziness (?p < 0.001).     

Vapreotide: a somatostatin analog for the treatment of acute variceal bleeding

Background: Portal hypertension is a clinically important consequence of cirrhosis that can lead to morbidities such as variceal bleeding, hepatic encephalopathy and ascites. All of these outcomes carry high mortality rates. There have been several drugs created to assist with endoscopic therapy for the treatment of acute variceal bleeding. Recently, vapreotide has been studied in patients to evaluate its efficacy as treatment for acute variceal hemorrhage. Although no comparisons have been made between vapreotide and other somatostatin analogues, this drug has been shown to have efficacy in the control of acute variceal bleeding as well as reducing the risk of recurrent bleeding and death, especially when started prior to endoscopy. Objective: This paper reviews the literature regarding the basic science and clinical efficacy of vapreotide in acute variceal bleeding. Methods: We used a PubMed/Medline search in order to review the literature regarding the drug, vapreotide. Results/conclusions: Vapreotide appears to have benefit in the control of acute variceal bleeding. It is easy to administer and has few side effects, which are minor. These findings endorse the need for future trials to evaluate vapreotide and its use in acute variceal hemorrhage, a morbidity among patients with cirrhosis.     

Comparison of rofecoxib and a multidose oxycodone/ acetaminophen regimen for the treatment of acute pain following oral surgery: a randomized controlled trial

OBJECTIVE: To compare the efficacy of a single dose of rofecoxib 50 mg with a single dose of oxycodone/acetaminophen 10/650 mg over 6 h as well as with a multidose regimen of oxycodone/acetaminophen 10/650 mg followed by oxycodone/acetaminophen 5/325 mg over 24 h. Research design and methods: In this double-blind, randomized, two-phase study, patients with moderate to severe pain after surgical extraction of >or= 2 third molars, including one mandibular impaction, were treated with rofecoxib 50 mg, oxycodone/acetaminophen 10/650 mg (singledose phase) followed by 5/325 mg every 6h as needed (multidose phase), or placebo. Patients rated their pain relief and intensity at 18 time points over 24 h. Efficacy was measured over 6 and 24 h by total pain relief (TOPAR), sum of pain intensity difference (SPID), and patient global assessment of response to therapy (PGART). Primary endpoint for the single dose comparison was TOPAR over 6 h; SPID was the key 24-h endpoint. Onset of analgesic effect, peak analgesic single dose of oxycodone/acetaminophen. effect, and duration of analgesic effect were also evaluated. Adverse experiences were recorded. RESULTS: 271 patients were randomized to treatment with rofecoxib (n = 121), oxycodone/acetaminophen (n = 120), or placebo (n = 30). For the single dose comparison, rofecoxib-treated patients achieved pain relief at least as effective as oxycodone/acetaminophentreated patients as assessed by TOPAR6 (12.9 vs 11.3, 95% CI on difference = [-0.1, 3.2], p = 0.059). Patients also rated a single dose of rofecoxib as at least as effective as multidose oxycodone/acetaminophen over 24 h on SPID24 (21.9 vs 18.1, 95% CI on difference = [-1.0, 8.8], p = 0.122). Patients treated with oxycodone/ acetaminophen had a shorter time to onset of analgesia than patients treated with rofecoxib (24 vs 35 min, p < 0.05). Patients in the active treatment groups achieved similar peak effects during the single-dose phase. Individuals treated with rofecoxib demonstrated a longer duration of analgesic effect than those treated with a Patients on active treatment demonstrated better efficacy than patients on placebo on these prespecified endpoints (p < 0.001 for both comparisons). Fewer rofecoxib than oxycodone/acetaminophen patients experienced adverse events (47.9 vs 75.8%, p < 0.001), including nausea (19.0 vs 42.5%, p < 0.001), vomiting (9.9 vs 24.2%, p < 0.01), and dizziness (7.4 vs 31.7%, p < 0.001). CONCLUSION: Patients treated with a single dose of rofecoxib 50 mg achieved an overall analgesic effect at least as effective as patients treated with a single-dose of oxycodone/acetaminophen 10/650 mg over 6 h and multidose oxycodone/acetaminophen over 24 h, with fewer adverse experiences of nausea (p < 0.001), vomiting (p < 0.01), and dizziness (p < 0.001).     

Clevudine: a promising therapy for the treatment of chronic hepatitis B

Chronic hepatitis B virus (HBV) infection, affecting ～ 350 million people worldwide, is associated with significant morbidity and mortality. In the past 10 years, hepatitis B therapy research has led to a multitude of available antiviral therapies: IFN-α, pegylated IFN-α_2a, lamivudine, adefovir, entecavir, telbivudine and tenofovir. To further improve reductions in viral load and resistance profiles, development of new HBV therapeutic strategies has been an important focus. One such therapy is clevudine, an analogue of the β-L configuration. Clevudine is already licensed in Korea for anti-HBV therapy (Bukwang Pharmaceuticals, Seoul, Korea). Unique to clevudine is its ability to maintain antiviral activity following discontinuation of therapy. Typically, hepatitis B treatment requires continuous therapy to prevent reactivation. Sustained response is uncommon except in hepatitis B antigen (HBeAg)-positive patients who developed HBeAg seroconversion. This article reviews chronic HBV and its therapy options. Specifically, it describes clevudine's potent and sustained antiviral activity as observed in vitro and in vivo.