Toxic-hygienic characteristics of the production of levomycetin (chloramphenicol)

Pharmaceutical Chemistry Journal -     

A randomized controlled trial of a new fetal acoustic stimulation test for fetal well-being

OBJECTIVES: Our purpose was to determine (1) whether a fetal acoustic stimulation test results in more palpable fetal movement compared with a mock test (control) and (2) whether palpated fetal movements after a fetal acoustic stimulation test are accompanied by a reactive nonstress test.STUDY DESIGN: In a randomized controlled trial we studied women seen in the labor and delivery suite for various indications. Women were excluded for multiple gestation, <31 weeks' gestational age, treatment with magnesium sulfate or narcotics, or ruptured membranes. Informed consent was obtained from eligible women, who were then randomized to a test or control group. We placed an acoustic stimulator on the abdomen of each woman, but only the test group was stimulated. We assessed fetal movement by a grading system: 0 = no fetal movement felt by patient or tester, 1 = fetal movement felt by patient only, 2 = fetal movement felt by tester, 3 = visual movement seen by tester. A positive fetal acoustic stimulation test result was defined as one with any fetal movement felt or seen by the tester (grades 2 or 3). We then performed a nonstress test. We compared rates of a positive fetal acoustic stimulation test in the test and control groups with the χ² test. A p value <0.05 was considered significant.RESULTS: We randomized 297 women to the test group and 280 women to the control (mock test) group. Of women tested with the fetal acoustic stimulation test, 81% had fetal movement by palpation or visualization (grades 2 or 3) compared with 19% of the control group (p < 0.0001, odds ratio 19.29, 95% confidence interval 12.42 to 30.07). Of the test group, 283 (95%) had a reactive nonstress test and 14 (5%) had nonreactive tests; the control group had 267 (95%) reactive and 13 (5%) nonreactive nonstress tests. Of 242 patients in the test group with a positive fetal acoustic stimulation test, 236 (98%) had a reactive nonstress test. Of those in the test group with fewer than three contractions per 10 minutes, 164 (89%) had a positive fetal acoustic stimulation test. Of these, 162 (99%) had a reactive nonstress test.CONCLUSION: The fetal acoustic stimulation test evokes significantly more palpated or visualized fetal movement than in controls. Palpated or visualized fetal movement after acoustic stimulation was almost always accompanied by a reactive nonstress test. (Am J Obstet Gynecol 1997;176:1386-8.)     

新疆一枝蒿新倍半萜成分——一枝蒿酮酸的结构

从新疆一枝蒿(Artemisia rupestris L.)脂溶性部分分得一种新倍半萜晶体,根据紫外光谱,红外光谱、质谱,核磁共振氢谱及碳谱等分析,确定了结构,命名为一枝蒿酮酸。     

Can subjective global assessment of nutritional status predict survival in ovarian cancer?

Background

Malnutrition is a significant problem in patients with ovarian cancer. The goal of this study was to investigate the prognostic role of Subjective Global Assessment (SGA) in patients with ovarian cancer treated in an integrative cancer treatment setting.

Methods

We evaluated a case series of 132 ovarian cancer patients treated at Cancer Treatment Centers of America^® from Jan 2001 to May 2006. SGA was used to assess nutritional status at baseline. Using SGA, patients were classified as well nourished (SGA A), moderately malnourished (SGA B) or severely malnourished (SGA C). Kaplan Meier method was used to calculate survival. Cox proportional hazard models were constructed to evaluate the prognostic effect of SGA independent of other factors.

Results

Of 132 patients, 24 were newly diagnosed while 108 had received prior treatment. 15 had stage I disease at diagnosis, 8 stage II, 85 stage III and 17 stage IV. The median age at presentation was 54.4 years (range 25.5 – 82.5 years). 66 patients were well-nourished (SGA A), 35 moderately malnourished (SGA B) and 31 severely malnourished (SGA C). Well nourished patients had a median survival of 19.3 months (95% CI: 14.1 to 24.5), moderately malnourished 15.5 months (95% CI: 5.8 to 25.1), and severely malnourished 6.7 months (95% CI: 4.1 to 9.3); the difference being statistically significant (p = 0.0003). Multivariate Cox modeling, after adjusting for stage at diagnosis and prior treatment history found that moderately malnourished and severely malnourished status were associated with a relative risk of 2.1 (95% CI: 1.2 to 3.6, p = 0.008) and 3.4 (95% CI: 1.9 to 5.8, p < 0.001) respectively as compared to well nourished status.

Conclusion

Univariate and multivariate survival analyses found that low SGA scores (i.e. well-nourished status) are associated with better survival outcomes. This study lends support to the role of aggressive nutritional intervention in improving patient outcomes in cancer care.     

Enrichment of spreadable fats with polyunsaturated fatty acids omega-3 using fish oil

Polyunsaturated fatty acids of the omega-3 series, especially very long chain – eicosapenta- and docosahexaenoic acid (EPA, DHA) – exert a strongly desirable influence on health. However, their intake with the western-style diet is usually too low which favours development of many diseases (CVD, cancers, allergies, etc.). Nowadays elevation of EPA and DHA intake is commonly recommended, but almost the only dietary source of them is seafoods, especially fish. A new way to increase the intake of long-chain omega-3 without radical changes of eating patterns is enrichment of regularly consumed foods with unhydrogenated fish oil. The aim of this study was to establish sensory and nutritionally acceptable enrichment level of low-calorie spreadable fats (soft margarine and mix of butter and vegetable oil) with EPA and DHA by addition of fish oil preparations (ROPUFA – 30% EPA, DHA and MARITEX – 10%), and evaluation of the stability of enriched spreads during storage (sensory and chemical). It was shown that tested spreadable fats might be enriched up to 1% EPA, DHA (i.e. 3% ROPUFA, 8% MARITEX), and that this had no significant influence on sensory acceptability. Both used fish oils which exerted similar influence on the quality of fats. An enriched mix of butter and vegetable oil and margarine may be stored up to 3 and 6 weeks respectively without significant decrease of quality. Peroxide value and acid numbers were not much affected by enrichment and storage. Daily portion (25–30 g/day) of spreadable fats enriched on the level established in the study may provide 0.2–0.3 g EPA, DHA, significantly increasing the amount of long-chain omega-3 in the diet above those eaten normally.