Nausea and vomiting associated with cancer chemotherapy: drug management in theory and in practice.

The function of cytotoxics is to damage cells, and it makes teleological sense for the body to expel them as soon after ingestion as possible. Ideally, from the body's point of view, they should simply be avoided, and it is not surprising that the experience of chemotherapy induced nausea and vomiting (CINV) is powerfully aversive. Nausea and vomiting were once among the most intractable and unpleasant experiences of a child undergoing treatment for cancer.     

Improving the quality of health information: the contribution of C-H-i-Q

The quality of information should be the key driver in communicating health messages to the public. Staff at The Centre for Health Information Quality (C‐H‐i‐Q) have worked with an extensive list of partner organizations from a range of disciplines. These stakeholders express a desire to see improvement in the standards of patient information, and display a willingness to embrace new approaches in order to achieve change. The result is an increasingly significant contribution in the development of the information‐exchange model of health‐care, where the aim is to maximize public confidence in health information. Key activities include defining principles of quality assurance, engaging with stakeholders, and developing tools and training for producers and providers of health information.     

瑞舒伐他汀与阿托伐他汀对高脂血症患者血糖影响的Meta分析

摘 要 目的：利用 Meta 分析方法评价瑞舒伐他汀与阿托伐他汀在降脂同时对非糖尿病高脂血症患者血糖的影响。方法：检索PubMed、ISI Web of Knowledge、中国知网、万方数据、维普数据库中有关瑞舒伐他汀与阿托伐他汀治疗高脂血症患者的随机对照试验（RCT）,文献检索年限为各数据库建库至2014年12月31日,对符合标准的RCT采用RevMan5.2软件进行Meta分析。结果：共纳入4个RCT,累计484例非糖尿病高脂血症患者。Meta分析结果显示,与阿托伐他汀相比,瑞舒伐他汀对空腹血糖的影响差异无统计意义（MD=-1.02, 95%CI:-2.10~0.06, P=0.07）,对糖化血红蛋白影响的差异有统计学意义（MD=-0.06, 95%CI:-0.10~-0.01, P=0.01）。结论：现有证据表明瑞舒伐他汀对高脂血症患者的血糖影响可能会比阿托伐他汀更加稳定,但是这个差别较小。     

Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses

Background  

Black elderberries (Sambucus nigra L.) are well known as supportive agents against common cold and influenza. It is further known that bacterial super-infection during an influenza virus (IV) infection can lead to severe pneumonia. We have analyzed a standardized elderberry extract (Rubini, BerryPharma AG) for its antimicrobial and antiviral activity using the microtitre broth micro-dilution assay against three Gram-positive bacteria and one Gram-negative bacteria responsible for infections of the upper respiratory tract, as well as cell culture experiments for two different strains of influenza virus.     

Fluorodeoxyglucose positron emission tomography in the initial staging of germ cell tumours

Testicular cancer is a rare tumour with the potential for cure at diagnosis. It is important, however, to identify those patients with metastases at presentation so as to ensure that the optimum treatment strategy is employed. Many criteria have been used to try to place patients into high- or low-risk groups, with variable success. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has the potential to identify active disease and thereby influence further management. Here we report on a retrospective study of the use of FDG-PET in the detection of metastatic testicular carcinoma at diagnosis. Thirty-one patients [13 with seminoma and 18 with non-seminomatous germ cell tumours (13 teratomas, 5 mixed)] were staged by FDG-PET scanning. The imaging was performed using a Siemens ECAT 951 scanner. All results were assessed on the basis of histology or clinical follow-up. FDG-PET scan identified metastatic disease in ten and was negative in 16; there were no false-positives and five false-negatives. There were six patients in whom FDG-PET was negative and computed tomography was regarded as suspicious but follow-up was inconclusive. The positive predictive value was 100%. The negative predictive value was 76% or 91%, depending on whether the aforementioned six cases were regarded as true-negatives or false-negatives. It may be concluded that FDG-PET is capable of detecting metastatic disease at diagnosis that is not identified by other imaging techniques. These preliminary results are sufficient to suggest that a large prospective study should be performed to evaluate the role of FDG-PET in primary staging of disease. Received 27 November 1999 and in revised form 21 January 2000     

Complex chromosomal abnormalities in utero, 5 years before leukaemia

Prenatal acquisition of leukaemia-associated gene rearrangements is a well-established phenomenon. This is the first report of a complex cytogenetic clone, in association with an ETV6/AML1 fusion, developing in utero. Identical twin girls, aged 4 years, developed ETV6/AML1-positive acute lymphoblastic leukaemia (ALL) within 3 months of one another. Both demonstrated an identical four way, variant t(12;21). There was gain of an AML1 signal in twin 1 and loss of an ETV6 one in twin 2 at interphase. This unique case study demonstrates that ETV6/AML1 fusion and the associated complex chromosomal rearrangements occurred in utero. Clonal expansion of the abnormal cell in one twin was followed by metastasis to the other. There was a prolonged preleukaemic phase, which lasted well into childhood. The short time between the two diagnoses of ALL suggests a common precipitating event. The significance of the different secondary markers remains unclear.     

Pharmacokinetic and pharmacodynamic study of morphine and morphine 6‐glucuronide after oral and intravenous administration of morphine in children with cancer

The aim of this study was to characterize the pharmacokinetics and pharmacodynamics of morphine and morphine 6‐glucuronide (M6G) in children with cancer. Serum concentrations of morphine and M6G in children who received single oral or short term continuous intravenous morphine were determined by HPLC and ELISA assays, respectively. The serum C_max of morphine and M6G after i.v. morphine administration was 560.5 and 309.0 nM and the T_max was 61 and 65 min, respectively. The elimination half‐life was 140.0 and 328.7 min, respectively. After oral administration of morphine, the serum C_max of morphine and M6G was 408.34 and 256.3 nM and the T_max was 40.0 and 60 min, respectively. The half‐life was 131.0 and 325.8 min, respectively. The side effects were: drowsiness (100%), nausea and/or vomiting (57%), pruritus (28%) and urinary retention (14%). There were no reports of respiratory complications. This study showed that pharmacokinetics factors of morphine and M6G in children were significantly different from adults. Therefore the required dose for children should be different from that of adults and should be based on studies performed on children rather than on studies on adults. Some adverse effects, particularly nausea and pruritus, may be commoner than is usually thought, while others, particularly respiratory problems did not occur. Copyright © 2009 John Wiley & Sons, Ltd.