Quantitative Positron Emission Tomography Studies of the Serotonin Transporter in Humans Previously Treated with the Appetite Suppressants Fenfluramine or Dexfenfluramine

Purpose The appetite suppressants fenfluramine and dexfenfluramine were widely prescribed before being withdrawn from the market in 1997. Both drugs are known to have the potential to damage brain serotonin (5-HT) axons and axon terminals in animals, including nonhuman primates. This study used quantitative positron emission tomography (PET) with [¹¹C] McN5652, a serotonin transporter (SERT) ligand to determine whether humans previously exposed to fenfluramines showed reductions in SERT binding parameters. Procedures Subjects previously treated with fenfluramines for weight loss (N = 15) and age-matched controls (N = 17) underwent PET studies with [¹¹C] McN5652. Global and regional distribution volumes (DVs) of [¹¹C] McN5652 were compared in the two subject groups using parametric statistical analyses. Results Compared to controls, subjects previously exposed to fenfluramines had significant reductions in [¹¹C]McN5652 binding in 14 of 15 regions of interest, more than four years after drug discontinuation. Conclusions These results are the first to provide direct evidence for fenfluramine-induced 5-HT neurotoxicity in humans.     

Appetite and regulation of food intake in uremia

Anorexia, nausea and vomiting are common symptoms in patients with severe renal failure. Abnormalities in body fluids volume, serum electrolytes concentrations and acid-base balance and accumulations of uremic toxic substances might be primarily contributing to the suppression of appetite. However, the detailed mechanisms that cause appetite suppression in uremia are poorly understood. Impaired gastric emptying, constituents of peritoneal dialysate, plasma high leptin, high cholecystokinin and low neuropeptide Y are also considered to be contributing to appetite suppression in uremia.     

Effects of Menopause on Appetite and the Gastrointestinal System

This article includes a brief literature review and case example to explore the effects of menopause on hormones that influence appetite and the function of the gastrointestinal system. The importance of exercise and diet are discussed, as are implications for nursing practice.     

Uses and benefits of telemedicine

Summary. The true benefits of telemedicine are yet to be realized. The reasons are linked to business, economic and operational issues, not technology application. Telemedicine is an application of specific technologies designed to fill a health care delivery need, while expanding the geographic footprint of the overall delivery systems. It offers the opportunity for competitive advantage in a dynamic industry through improved quality, expanded care delivery and reduced cost. Telemedicine's true impact on the care delivery process will be fully realized once these opportunities have been optimized within a health care system.     

Appetite suppressants and cardiac valvulopathy. Current clinical perspectives

Primary pulmonary hypertension (PPH) in association with weight loss treatment was initially observed in the late 1960s and early 1970s with the diet pill aminorex fumarate. Recent data from large-scale studies and single sites have found prevalence rates of anorexic-associated valvulopathy ranging from 15% to 30%. But overall, no increased prevalence of VHD has been observed among case control groups. In March 1998, the American Heart Association and American College of Cardiology released guidelines for the management of valvular heart disease. A section of the report was dedicated to patients exposed to anorectic drugs, and those statements are outlined in this article.     

Uses of therapeutic hypothermia

Therapeutic hypothermia is used to preserve body function during major surgery. While it is a valuable therapeutic process, serious physiological harm can result if it is allowed to continue into the postoperative phase.     

Diagnostic and Therapeutic Uses of Intestinal Intubation

Intubation of the intestine is widely employed in the clinical management of patients. In this article are discussed some of the more important applications of this procedure in the diagnosis and treatment of intestinal, biliary and pancreatic diseases.     

Pulse Oximetry: Uses and Limitations

Pulse oximetry is a useful noninvasive tool in the assessment of a patient suspected of hypoxia. On literature review, few medical and nursing articles explain how to properly use this tool. This article reviews the basic physics of the pulse oximeter machine and proper use of the oximeter. Limitations and sources of error in pulse oximeter technology are also delineated. Finally, correct interpretation and application of information obtained by pulse oximetry are explained.