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Contains fulltext : 47837.pdf (Publisher’s version ) (Closed access) The therapeutic activity and toxicity profile of gemtuzumab ozogamicin were assessed in 40 patients >60 years of age with acute myeloid leukemia (AML) who were not considered eligible for conventional chemotherapy because of advanced age or poor performance status. The drug was administered at the dose of 9 mg/m2 as a single 2-h i.v. infusion on days 1 and 15. Patients who achieved a complete remission (CR/CRp) were to receive a consolidation with two additional injections of the immunotoxin at the same dose. The overall CR/CRp rate was 17% (95% CI, 8-32%). The CR/CRp rate in patients 61-75 years old was 33% (6/18), and 5% (1/22) in patients older than 75 years. Induction death occurred in seven patients (17%), all aged above 75 years. Overall survival was significantly longer in patients aged 61-75 years than in older individuals (P=0.05), and in CD33+ cases than in CD33- cases (P=0.05). We conclude that the dose/schedule of gemtuzumab ozogamicin used in this trial is too toxic in the age group over 75 years. For these patients, additional studies with reduced doses of the immunotoxin are warranted.

Background: Allergic rhinitis was recently classified by the ARIA guidelines as persistent or intermittent. Levocetivizine was shown to improve symptoms and health-related quality of life of patients with persistent allergic rhinitis in the XPERT™ study, a 6-month randomized double blind placebo-controlled trial. Objective: To assess the total costs of persistent allergic rhinitis, and the effect of long-term treatment with levocetirizine on these costs from several perspectives (societal, social security system, and employers). Methods: Direct medical cost parameters (medications, physician visits and hospitalizations) and time lost parameters (workdays and Usual Daily Activities (UDA) lost) related to persistent allergic rhinitis and its comorbidities (asthma, sinusitis, otitis and upper respiratory infection) were measured. A cost analysis was performed using 2002 French costing data. Results: From a societal perspective, the total cost of persistent allergic rhinitis without long-term treatment was estimated at €355.06/patient/month. From a social security perspective, levocetirizine treatment yielded an additional cost of €2.78/patient/month, compared to no-treatment. However, levocetirizine reduced the total cost of persistent allergic rhinitis and its comorbidities by €152.93/patient/month from a societal perspective and by €64.70/patient/month from an employer perspective. Most gains resulted from a decrease in the lost workdays and UDA in the levocetirizine group. Conclusion: The cost of persistent allergic rhinitis is substantial. Treatment with levocetirizine reduces the cost of persistent allergic rhinitis and its comorbidities to the society by €152.93/patient/month while improving symptoms and health-related quality of life. Copyright © Blackwell Munksgaard 2005. Chemicals / CAS: cromoglycate disodium, 15826-37-6, 16110-51-3, 93356-79-7, 93356-84-4; levocetirizine, 130018-77-8; prednisolone, 50-24-8; Cetirizine, 83881-51-0; Histamine H1 Antagonists, Non-Sedating; levocetirizine, 130018-77-8; Piperazines

The authors present a global overview on the issue of drugs and driving covering four major areas: (1) Epidemiology and Prevalence-which reviews epidemiological research, summarizes available information, discusses the methodological shortcomings of extant studies, and makes recommendations for future research to better define prevalence and epidemiology; (2) Effects of Medicinal and Illegal Drugs on Driving Performance-focuses on the six classes of drugs most often found in impaired and injured drivers, draws conclusions regarding the risk of these drugs to traffic safety and discusses the need for additional research; (3) Toxicological Issues-discusses ways to identify drug users via behavioral testing and analytical techniques, reviews the approaches used by different countries, screening and confirmation techniques, alternative specimens (e.g., urine, oral fluid, sweat), and how rapid roadside testing could be coupled with behavioral and laboratory testing in an effective approach to identifying and prosecuting drugged drivers; (4) Driving Under the Influence of Drugs [DUID] Laws-provides an overview of DUID laws in the United States and Europe, discusses the basic tenets of these laws, the various types of DUID statutes, the reasons why many existing laws hinder the prosecution of drugged drivers and the rationale for developing per se legislation as a strategy to more effectively manage the drugged driver problem.

Sustained vigilance is required by pilots and crew during flight; therefore, the use of antihistamines with sedating properties is widely prohibited. The purpose of this study was to determine the effects of desloratadine, a long-acting, nonsedating antihistamine, on healthy volunteers placed under conditions of simulated cabin pressure. Methods: In a double-blind crossover study, 21 subjects randomly received single doses of desloratadine 5 mg, diphenhydramine 50 mg (active control), and placebo on different days separated by washout periods of 7 d. On test days, predose levels of alertness and fatigue were determined, as were post-dose levels at 1, 2, 3, 5, and 6 h. Measurements included vigilance and tracking, a multi-attribute task battery, the Stanford Sleepiness Scale, and pulse oximetry. Results: Desloratadine had no detrimental effects on sleepiness or performance of tasks associated with flying ability. Conversely, diphenhydramine (active control) caused significantly more sleepiness than did the placebo [F (2,40) = 6.52, p < 0.01], as well as impaired performance (tracking performance p < 0.05 at 3 h post dose), and an increased percentage of omissions (p < 0.05 at 2 h post dose). Conclusion: A single dose of desloratadine 5 mg did not cause sleepiness and did not impair the performance of tasks associated with flying ability.

Sustained vigilance is required by pilots and crew during flight; therefore, the use of antihistamines with sedating properties is widely prohibited. The purpose of this study was to determine the effects of desloratadine, a long-acting, nonsedating antihistamine, on healthy volunteers placed under conditions of simulated cabin pressure. Methods: In a double-blind crossover study, 21 subjects randomly received single doses of desloratadine 5 mg, diphenhydramine 50 mg (active control), and placebo on different days separated by washout periods of 7 d. On test days, predose levels of alertness and fatigue were determined, as were post-dose levels at 1, 2, 3, 5, and 6 h. Measurements included vigilance and tracking, a multi-attribute task battery, the Stanford Sleepiness Scale, and pulse oximetry. Results: Desloratadine had no detrimental effects on sleepiness or performance of tasks associated with flying ability. Conversely, diphenhydramine (active control) caused significantly more sleepiness than did the placebo [F (2,40) = 6.52, p < 0.01], as well as impaired performance (tracking performance p < 0.05 at 3 h post dose), and an increased percentage of omissions (p < 0.05 at 2 h post dose). Conclusion: A single dose of desloratadine 5 mg did not cause sleepiness and did not impair the performance of tasks associated with flying ability.

Background: Recently, UVB lamps with a peak emission around 311 nm have been used successfully for the treatment of many dermatologic diseases known to be treated with psoralen plus UVA ( PUVA). Narrowband UVB (NBUVB) radiation causes less erythema and carcinogenicity with lower cumulative doses than PUVA, while the treatment response remains high. Lichen planus ( LP) is a cell-mediated immune response of unknown origin. Methods: We present our results of NBUVB therapy administered to 10 LP patients. The sessions were administered three to four times weekly with an average cumulative dose of 17.7 +/- 1.6 J/cm(2). Results: Five patients responded completely, and four were partially responsive at the end of the 30th session. Three of the partially responsive cases responded completely at the 31st, 36th and 51st sessions, respectively. Conclusion: Clinical improvements observed in our study as well as the potential advantages of NBUVB imply that it is an inevitable treatment alternative for resistant cases of LP.

Background: Drug selection for optimal treatment of allergic rhinitis may be difficult and involve many diverse factors. Objective: To evaluate montelukast, in the treatment of patients with seasonal allergic rhinitis, as an adjuvant to mainstay therapies, i.e., antihistamines and corticosteroids. Methods: The study was a prospective, three-phased (per lasted 2 weeks) clinical trial. In phase I, patients were separated into two groups, based on the predominating symptoms: (1) runners (patients with moderate to severe sneezing/itchy, watery nose/itchy, watery eyes), and (2) blockers (patients with moderate to severe nasal congestion). The runners received antihistamine loratidine 10mg daily, and the blockers received intranasal corticosteroid mometasone furoate 200 μg. In phase II, if patients were dissatisfied with the initial treatment, they were assigned to receive another study drug additionally. In phase III, for the patients unsatisfied with the treatment of loratidine plus mometasone furoate, montelukast 10 mg once daily was added. Results: Of the 169 patients who entered phase I, 150 could be evaluated for treatment efficacy and safety. There were 108 runners and 42 blockers. Physicians' and patients' assessments indicated that in phase I 58 runners (60.0% of 50 runners) and 36 blockers (33.3% of six blockers) were satisfied with their therapy. In phase II, 30 runners (27.7%) and two blockers (4.7%) were satisfied with the addition of other study drug. Totally 62.6% of patients were satisfied at the end of phase I, and 84.0% at the end of phase II. Sixteen patients (66.6% of 24 patients) were satisfied with the addition of montelukast to the previous two drugs (in total, 10.6% of patients). Fourteen patients (12.2%) treated with loratadine, and three patients (0.3%) treated with mometasone, reported side-effect. Conclusion: The results of this trial indicate that 10% of patients with seasonal allergic rhinitis may be treated with the supplement of montelukast to mainstay therapy.

Purpose: To compare the therapeutic effects of two ophthalmic solutions (0.1% olopatadine hydrochloride and 0.5% ketorolac tromethamine) with different pharmacological mechanisms on the clinical signs and Symptoms of seasonal allergic conjunctivitis (SAC). Methods: Forty patients with the signs and symptoms of SAC (i.e. hyperaemia, itching, mucus discharge, tearing) were included in this placebo-controlled, randomized, parallel group, single centre study. In group 1 (20 patients) one eye of each patient was treated with olopatadine and the other with placebo. In group 2 (20 patients) one eye of each patient was treated with ketorolac solution and the other with placebo. The principal signs and symptoms of SAC (hyperaemia and itching) were evaluated at 30 mins and at 2, 7 and 15 days. Results: In group 1, both parameters improved significantly in eyes treated with olopatadine compared with those receiving placebo at all control examinations (all p0.05). However, the itching score was significantly lower in the olopatadine group from the second day through to the end of the study (p

Recently, two importance articles about St. John's wort (Hypericum perforatum) appeared in the medical literature: a randomised clinical trial comparing St. John's wort with placebo and imipramine and a commentary about interactions between St. John's wort and registered medicines. These publications are discussed in the broader perspective of a benefit-risk assessment.

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The benzodiazepines take an important place in the treatment of anxiety and sleep-disorders. The pharmacokinetic, pharmacodynamic and therapeutic properties of these drugs are shortly dealt with, whereafter the development of tolerance and dependence is considered in more detail. The clinical manifestations and their causes are explained, as well as possible procedures to restrict their occurrence.

A 67-year-old Caucasian male with lung cancer was presented to the Emergency Department with asthenia, anorexia, jaundice and choluria. The patient's lung cancer was being treated medically by a combination of paclitaxel/carboplatin with bi-monthly frequency. The patient was also self-medicating with several natural products, including Chlorella (520 mg/day), Silybum marianum (total of 13.5 mg silymarin/day), zinc sulphate (5.5 mg), selenium (50 μg) and 15 g/day of Curcuma longa. In first chemotherapy cycle no toxicity was observed even he was taking other medications as budesonide and sitagliptin. The toxic events started only after the introduction of the dietary products. Chlorella had contamination with cyanobacteria (Oscillatoriales) and 1.08 μg of cyanotoxin Microcystin-LR (MC-LR) per gram of biomass was found. Patient was consuming ca 0.01 μg MC-LR/kg/day. This case report describes the first known case of paclitaxel toxicity probably related to pharmacokinetic interaction with Turmeric and a contaminated Chlorella supplement resulting in an acute toxic hepatitis and the impact on oncologic patient health. © 2018 Elsevier This work was supported by QREN , under the scope of POFC – COMPETE, Project n°16872 & FCT Project - PEst-OE/SAU/UI0177/2011 & FCT Project UID/Multi/04423/2013 & FCT UID/QUI/00313/2013 and by the Structured Program of R&D&I INNOVMAR - Innovation and Sustainability in the Management and Exploitation of Marine Resources (reference NORTE-01-0145-FEDER-000035 , Research Line NOVELMAR), funded by the Northern Regional Operational Program ( NORTE2020 ) through the European Regional Development Fund (ERDF). The authors are grateful to Cátia Costa that did the figure n° 1 for this publication.

The benzodiazepines take an important place in the treatment of anxiety and sleep-disorders. The pharmacokinetic, pharmacodynamic and therapeutic properties of these drugs are shortly dealt with, whereafter the development of tolerance and dependence is considered in more detail. The clinical manifestations and their causes are explained, as well as possible procedures to restrict their occurrence.