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PubMedDate not supplied

Post-emetic laceration and rupture of the gastroesophageal junction.

The experience of a major general hospital, over the last two decades, with the management of 50 patients presenting post-emetic lesions of the gastroesophageal junction is reviewed. The results of this study clarify the persistent confusion between the Mallory-Weiss syndrome and the Boerhaave's syndrome. The high incidences of upper gastro-intestinal mucosal lesions and hiatal hernia associated with the Mallory-Weiss syndrome, ignored in many previous studies, are emphasized in this report. Widespread utilization of fiberoptic endoscopy during the last 10 years has resulted in more accurate diagnosis of Mallory-Weiss lacerations, with more selective indications for surgical management of these cases of upper gastrointestinal bleeding. On the other hand, in the light of the results of this study, a strong plea is made in favor of early, aggressive surgical treatment for Boerhaave's syndrome. This entity remains one of the challenges of thoracic and abdominal surgery.

Aged↗
PubMed1995

Instrumental outcome devaluation is attenuated by the anti-emetic ondansetron.

In three experiments we assessed the effect of an anti-emetic, the selective 5-HT antagonist ondansetron, on (1) the conditioning of a taste aversion using lithium chloride (LiCl); (2) the expression of that aversion; and (3) instrumental outcome-devaluation effects. In Experiment 1 it was found that ondansetron reduced the aversion induced by LiCl when administered prior to the LiCl injection and also attenuated the expression of that aversion when administered prior to test sessions. In Experiments 2 and 3, thirsty rats were trained, in a single session, to lever press and chain pull for sucrose and saline solutions concurrently before being injected with LiCl. They were then re-exposed to both solutions, one after injection of vehicle and the other after injection of ondansetron. In a choice extinction test on the levers and chains, animals performed more of the action whose training outcome was re-exposed under ondansetron than the other action, whether the test was conducted after an injection of vehicle or after one of ondansetron.

Animals↗
PubMed1995

A comparison between effects of intraventricular insulin and intraperitoneal lithium chloride on three measures sensitive to emetic agents.

When low doses of insulin are infused directly into the third ventricle, rats reduce their food intake and lose weight. To determine whether these effects could be due to malaise induced by the treatment, the effects of intraventricular insulin were compared to the effects of the emetic agent lithium chloride to condition a taste aversion, to stimulate oxytocin secretion, and to reduce sodium appetite in response to furosemide treatment. For all three of these measures, lithium chloride treatment had a predictable effect compared to controls. Specifically, lithium caused a significant taste aversion, elevated plasma oxytocin, and attenuated sodium appetite. However, lithium did not produce a significant change in food intake or body weight. On the other hand, intraventricular insulin treatment did cause a significant reduction in body weight yet had no effect on these indices of malaise in the rat. These data are consistent with the hypothesis that intraventricular insulin does not reduce food intake and body weight by producing malaise but rather serves as a negative feedback signal of body adiposity to the central nervous system.

Animals↗
PubMed1995

[The efficacy of granisetron as a prophylactic anti-emetic agent used in conjunction with MCNU and VP16 chemotherapeutic regimens in the management of a pediatric case of hypothalamic anaplastic astrocytoma].

The management of a 12-year-old boy with hypothalamic anaplastic astrocytoma is reported herein. The pediatric patient underwent a subtotal removal of his brain tumor, and subsequently received multimodal treatment comprising radiotherapy (30.6 Gy to the whole brain and 50.4 Gy to the local lesion) and immunochemotherapy with MCNU (80 mg/m2, day 1), VP 16 (50 mg/day, days 2 to 6), and interferon-beta (3 x 10(6) units/day, initiating on day 2 for 4 weeks). The immunochemotherapy was given as of 4 weeks after radiotherapy. The administration of anti-cancer drugs caused severe nausea and vomiting, the intra-carotid infusion of MCNU being particularly emetogenic. The multi-modal treatment was then discontinued for a few weeks. A partial response was obtained, and the patient subsequently received 3 courses of maintenance therapy at six-month intervals using the same protocol as for the initial immunochemotherapy. During maintenance therapy, granisetron (40 micrograms/kg) was given intravenously 30 minutes before and one day after the injection of MCNU. Owing to the anti-emetic management of this patient, there were no complications throughout the chemotherapy. The patient has now survived for more than 3 years with a good quality of life, showing a Karnofsky performance score of 90.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

[Postoperative anti-emetic effects of low dose droperidol].

We studied the postoperative anti-emetic effects of low dose droperidol which was compared with that of metoclopramide in 60 gynecological patients. The effects at the third and 24th hours after surgery were evaluated by means of the nausea and vomiting score; 0 = none, 1 = discomfort, 2 = nausea, 3 = vomiting. The sores of postoperative nausea and vomiting within 3 hours after operation showed no significant difference between droperidol and metoclopramide groups (D: 0.2 +/- 0.4, M: 0.3 +/- 0.6). However, there was a significant difference between the two groups after 24 hours (D: 0.2 +/- 0.5, M: 0.8 +/- 1.0). We conclude that droperidol has a potent antiemetic effect that lasts after 24 hours.

Adult↗
PubMed1993

Emetic responses of Sorex unguiculatus.

We have shown previously that Suncus murinus, a species of the insectivore, can vomit in response to various emetogenic stimuli. In the present study we investigated whether or not Sorex unguiculatus, which belongs to different subfamily (Soricinae) of insectivore, vomits in response to emetogenic drugs. Subcutaneous injection of veratrine and oral administration of copper sulfate caused emesis in the animal. Histological study showed that bilateral structure of the area postrema was not important for the emetic reflex. Therefore, the capability of emesis may be common to the family of soricidae of the insectivore, and the Sorex unguiculatus is the smallest known mammal which can vomit.

Animals↗
PubMed1995

Retention behaviour of anti-emetic serotonin antagonists in reversed phase high performance liquid chromatography.

Granisetron, Ondansetron and Tropisetron, three 5-HT3 antagonists showing anti-emetic activity, were analysed by HPLC on lipophilic stationary phases. The addition of an amine or quaternary ammonium salt to the eluents was a powerful tool in the analysis of these basic substances. The influence on chromatographic parameters of pH, ionic strength and various counter-ions in the aqueous phase as well as of different organic modifiers is discussed. Some of the proposed experimental conditions allow a more strictly partition-based separation mechanism and can produce chromatographic parameters suitable for structure-activity studies. These experimental conditions are also suitable for analysis of the considered compounds in pharmaceutical dosage forms or in biological fluids.

Antiemetics↗
PubMed1997

Anti-emetic drug effects on pilot performance: granisetron vs. ondansetron.

BACKGROUND: The objectives of this study were to evaluate the effects of two anti-emetic drugs, granisetron (1 mg tablets/2 mg oral dose) and ondansetron (8 mg tablets/8 mg oral dose) on flying and mission performance in an F-16 research simulator. METHODS: The experimental approach, involving 9 pilots, was a placebo controlled, double blind, crossover design. Each pilot flew three defensive counter air missions. Data on nine measures of flying performance were collected via the simulator data recorder. In addition, ratings on mission and flying performance were recorded by simulator instructor pilots. Data were also collected on symptoms and side effects, mood, and vigilance. RESULTS: This study, carried out in the context of a simulated tactical air-to-air combat mission, produced no significant differences between the effects of the target drugs and placebo on any of the nine objective flying performance measures, including a composite measure of landing performance. There were no differences in evaluator ratings of routine mission flying or air combat performance. Pilots could not distinguish active drug from placebo and there were no differences on any of the mood scales. CONCLUSIONS: These results confirm our earlier findings that the drugs of interest are well tolerated and produce no cognitive, psychomotor or subjective state changes. In this study, there was no evidence of performance degradation caused by either granisetron or ondansetron when tested in a complex, military task environment.

Administration, Oral↗
PubMed1998

Anti-emetic effect of ondansetron and granisetron after exposure to mixed neutron and gamma irradiation.

The anti-emetic efficiency of orally administered ondansetron and granisetron has been tested in macaques exposed to a mixed y and neutron radiation (6 Gy) with a high neutron/gamma-ray ratio. Our experiments reveal that a single delivery of ondansetron (1 or 2 mg kg(-1)) or of granisetron (0.25 mg kg(-1)) 45-90 min before irradiation or 35-45 min after irradiation was not totally effective. Conversely, the delivery of two doses with the same delay prior to and after exposure led to a complete prevention of vomiting and retching. These observations can be explained by the dual mechanism of radiation-induced emesis: an early peripheral mechanism and a later central mechanism. Two deliveries of 5-HT3 receptor antagonists seem to disrupt serotonergic transmission at the brain stem structures and to affect the peripheral release of serotonin from the gut, thus completely preventing radiation-induced vomiting. This study confirms that the 5-HT3-dependent mechanisms that mediate emesis are similar for both neutron and gamma radiation.

Animals↗
PubMed1998

[Efficacy of granisetron as anti-emetic agent for emesis induced by intra-arterial injection therapy for hepatocellular carcinoma].

The effect of granisetron in preventing nausea and emesis induced by intraarterial chemotherapy was comparatively studied with a historical control group (46 cases) in 50 patients with hepatocellular carcinoma receiving intraarterial anti-tumor drugs such as cisplatin and doxorubicin. Emesis was perfectly controlled in 39 out of 50 patients in the treatment group (78%), in comparison to 33 out of 46 patients (71.7%) in the historical control group. This represented no statistical significance between the two groups. In terms of the severity of nausea, however, the granisetron group demonstrated significant superiority to the control group with 27 out of 50 patients (54%) being free of symptoms compared with 16 out of 46 patients (34.8%) in the control group. A stratified analysis of the data also demonstrated significant superiority of the granisetron group over the historical group in the number of emetic episodes and the severity of nausea in female patients, who are more predisposed to emesis. The above results confirm the usefulness of granisetron as an antiemetic agent used for the prevention of acute nausea and emesis induced by intraarterial chemotherapy.

Adult↗