Assessment of the effects of 2 sedation regimens on cardiopulmonary parameters in pediatric dental patients: a retrospective study

PURPOSE: The purpose of this study was to evaluate the cardiopulmonary effects of 2 sedation regimens during treatment: (1) oral meperidine and hydroxyzine with nitrous oxide (N2O); and (2) oral diazepam and hydroxyzine, submucosal meperidine, and N2O. Nitrous oxide was tapered to oxygen (O2) only 10 minutes following submucosal meperidine administration. METHODS: Sixty-two children were evaluated who met the following criteria: (1) history of uncooperative behavior; (2) ASA I or II; (3) nothing to eat or drink after midnight the night before the appointment; (4) an initial/recall exam prior to the sedation appointment; and (4) patients who met the American Academy of Pediatric Dentistry guidelines for sedation. Regimens I and II included 32 and 30 patients, respectively. A single clinician treated all patients. A Criticare monitor recorded the following at 5-minute intervals: (1) O2 saturation; (2) respiratory rate; (3) heart rate; (4) systolic and diastolic blood pressures; (5) end tidal carbon dioxide concentration; and (6) mean arterial blood pressure. RESULTS: The t test indicated significant differences between the 2 regimens for: (1) heart rate; (2) systolic blood pressure; and (3) diastolic blood pressure (regimen II had higher values). Using the general linear model, no significant differences were found. All cardiopulmonary parameters were within normal limits. CONCLUSION: Regimens I and II had similar cardiopulmonary effects.     

Olanzapine and breast-feeding: changes of plasma concentrations of olanzapine in a breast-fed infant over a period of 5 months

We here report on a psychotic mother and her breast-fed infant who was treated with olanzapine. Consecutively olanzapine concentrations in the milk and plasma of the mother and in the infant were measured with tandem mass spectroscopy over a period of five month. The results show a relatively high plasma level in the infant aged four month, probably referring to an immature hepatic transformation system, especially CYP1A2. In the following four months plasma levels of olanzapine decreased to very low, even undetectable concentrations in the infant. The infant developed normally and showed no side effects during the treatment period.     

Frequency-dependent electrophysiological remodeling of the AV node by hydroalcohol extract of Crocus sativus L. (saffron) during experimental atrial fibrillation: the role of endogenous nitric oxide

The study assessed the hydroalcohol extract effects of Crocus sativus L. (saffron) on (i) the basic and rate‐dependent electrophysiological properties of the AV node, (ii) remodeling of the AV node during experimental atrial fibrillation (AF) and (iii) the role of nitric oxide (NO) in the effects of saffron on the AV node. Stimulation protocols in isolated AV node were used to quantify AV nodal recovery, facilitation and fatigue in four groups of rabbits (n = 8–16 per group). In addition, the nodal response to AF was evaluated at multiple cycle lengths and during AF. Saffron had a depressant effect on AV nodal rate‐dependent properties; further, it increased Wenckebach block cycle length, functional refractory period, facilitation and fatigue (p < 0.05). A NO‐synthase inhibitor (L‐NAME) prevented the depressant effects of saffron on the AV node (p < 0.05). Saffron increased the zone of concealment in experimental AF (p < 0.05). The present research showed, for the first time, established electrophysiological remodeling of the AV node during AF by saffron. Saffron increased the AV nodal refractoriness and zone of concealment. These depressant effects of saffron were mediated by endogenous NO. Copyright © 2011 John Wiley & Sons, Ltd.     

Evaluation of the effect of food on the pharmacokinetics of axitinib in healthy volunteers

Purpose

To evaluate the effect of food on axitinib pharmacokinetics in healthy volunteers with two different crystal polymorphs.

Methods

Two separate open-label, randomized, single-dose, three-period, crossover trials were conducted. Study I, conducted first using 5-mg axitinib Form IV film-coated immediate-release (FCIR) tablets, enrolled 18 subjects to compare fed versus fasted states and 24 subjects to evaluate the effect of timing of food consumption on axitinib pharmacokinetics. Study II enrolled 30 subjects to assess the effect of food using 5-mg axitinib Form XLI FCIR tablets. Subjects received axitinib after overnight fasting, with limited fasting or, depending on the study design, after consuming high-fat, high-calorie or moderate-fat, standard-calorie meals.

Results

For Form IV FCIR, compared with overnight fasting, axitinib plasma exposure [area under the concentration curve (AUC)] was decreased 23?% when administered with food. For Form XLI FCIR, mean axitinib plasma AUC and maximum plasma concentration (C _max) were 19 and 11?% higher, respectively, with a high-fat, high-calorie meal compared with overnight fasting. When Form XLI FCIR was administered with moderate-fat, standard-calorie meal, AUC and C _max were 10 and 16?% lower compared with overnight fasting. Both formulations were well tolerated. Adverse events, mostly gastrointestinal (7?% with Form IV FCIR and 13?% with Form XLI FCIR), were mild to moderate in both studies.

Conclusions

While axitinib Form IV FCIR was associated with higher plasma exposure after overnight fasting, axitinib Form XLI FCIR can be administered with or without food as differences in axitinib pharmacokinetics under the two conditions were not clinically meaningful.     

Urine macrophage migration inhibitory factor in pediatric systemic lupus erythematosus

We reported a series of ten patients with lupus nephritis (five patients in the relapse phase and five in the remission phase) and measured the macrophage migration inhibitory factor (MIF), an important pro-inflammatory cytokine with probable role in the pathogenesis of many inflammatory diseases, in their urine samples. MIF/creatinine (Cr) ratio directly correlated with disease activity and it does not have any significant difference between inactive disease and normal ones. We found that the urine MIF/Cr ratio not only differentiates active disease from inactive disease and normal ones but also correlates with the activity indices of renal pathology.