The benzodiazepine partial receptor agonist, bretazenil, provokes a strong hyperphagic response: a meal pattern analysis in free feeding rats

In this report we characterize the effects of the benzodiazepine receptor partial agonist bretazenil (0.1-3mg/kg) on meal patterning and satiety sequences of male rats. Experiment 1 indicated that bretazenil (0.3-1.0mg/kg) doubled the size of the first meal; there was no concurrent increase in feeding rate and effects on water intake were smaller. Experiment 2 showed that the benzodiazepine receptor antagonist ZK93426 (10mg/kg) blocked this effect on meal size; in addition ZK93426 reduced water intake in the first 2h following drug administration, which we attribute to its weak inverse agonist action. Experiment 3 examined satiety sequences after bretazenil treatment. Food intake and feeding behaviour were enhanced; in the following behavioural sequence, active and grooming behaviour patterns were reduced and resting was greatly increased. The data are discussed in relation to current theories of benzodiazepine action on food intake and the processing of taste stimuli.     

Exploring the decision-making preferences of people with colorectal cancer

OBJECTIVES: To explore patient views on participation in treatment, physical care and psychological care decisions and factors that facilitate and hinder patients from making decisions. DESIGN: Qualitative study using semi-structured interviews with patients. SETTING AND PARTICIPANTS: Three NHS Trusts in the north-west of England. Theoretical sampling including 41 patients who had been treated for colorectal cancer. RESULTS: For patients, participation in the decision-making process was about being informed and feeling involved in the consultation process, whether patients actually made decisions or not. The perceived availability of treatment choices (surgery, radiotherapy, chemotherapy) was related to type of treatment. Factors that impacted on whether patients wanted to make decisions included a lack of information, a lack of medical knowledge and trust in medical expertise. Patients perceived that they could have a more participatory role in decisions related to physical and psychological care. CONCLUSION: This study has implications for health professionals aiming to implement policy guidelines that promote patient participation and shared partnerships. Patients in this study wanted to be well informed and involved in the consultation process but did not necessarily want to use the information they received to make decisions. The presentation of choices and preferences for participation may be context specific and it cannot be assumed that patients who do not want to make decisions about one aspect of their care and treatment do not want to make decisions about other aspects of their care and treatment.     

Epstein-Barr virus-associated smooth muscle tumors in immunocompromised patients: Six case reports

BACKGROUNDEpstein-Barr virus associated smooth muscle tumor (EBV-SMT) is a rare oncological entity. However, there is an increasing incidence of EBV-SMTs, as the frequency of organ transplantation and immunosuppression grows. EBV-SMT diagnosis relies on histopathology and immunochemical staining to distinguish it from post-transplant lymphoproliferative disorder (PTLD). There is no clear consensus on the treatment of EBV-SMTs. However, surgical resection, chemotherapy, radiation therapy, and immunosuppression reduction have been explored with varying degrees of success. CASE SUMMARYOur case series includes six cases of EBV-SMTs across different age groups, with different treatment modalities, adding to the limited existing literature on this rare tumor. The median latency time between immunosuppression and disease diagnosis is four years. EBV-SMTs present with variable degrees of aggressiveness and seem to have worse clinical outcomes in patients with tumor multiplicity and worse immunocompetency.CONCLUSIONIt is imperative to continue building on this knowledge and keeping EBV-SMTs on the differential in immunocompromised individuals.