Results of a union-based smoking cessation intervention for apprentice iron workers (United States)

OBJECTIVE

Blue-collar workers are more likely to smoke, smoke more heavily, and have less success in quitting compared to white-collar workers, and this occupational gap is growing over time. Effective smoking cessation interventions among blue-collar workers are needed to address growing class-based disparities.

METHODS

We used a pre-post study design to test feasibility and effect size of a smoking cessation trial in a union apprenticeship training program for iron workers (n = 337). The 4-month intervention drew upon a health promotion-health protection model for smoking cessation among blue-collar workers. We conducted pairwise analyses to assess pre-post intervention differences in 7-day point prevalence smoking abstinence measured 1 month after intervention was completed. Additional secondary outcomes, including smoking frequency, intensity, intention and self-efficacy to quit, were also assessed.

RESULTS

Baseline smoking prevalence was 41%. We observed a 19.4% post-intervention quit rate among baseline smokers. There were statistically significant positive changes pre- and post-intervention in intention to quit smoking, self-efficacy to quit, and a reduction in the number of days smoked. Participation in pro-active intervention components was associated with a three-fold (OR = 3.0, 1.15, 7.83) increase in the likelihood of quitting. Overall, participation in intervention components was low.

CONCLUSIONS

Labor union apprenticeship programs represent a promising venue for smoking cessation interventions, particularly those that draw upon a health promotion-health protection model.

In vitro lipid metabolism in the rat pancreas. I. Basal lipid metabolism

1. The in vitro basal lipid metabolism of rat pancreatic fragments was compared with that in adipose tissue fragments and liver slices. 2. [1-14C]Acetate added to the media was mostly incorporated into palmitic acid and to a lesser extent into oleic acid. In addition, pancreatic tissue exhibited a marked capacity for elongation of polyunsaturated fatty acids by [1-14C]acetate and resulting desaturation when compared to adipose tissue and liver. 3. Data obtained in the presence of [U-14C]glucose, [1-14C]palmitate and 3H20 indicate that acetyl-CoA derived from glucose and from beta-oxidation of fatty acids contributed to de novo lipogenesis. 4. Oxidation of [1-14C]palmitic acid was 9-13 times higher in the pancreas than in adipose tissue or liver when expressed on a wet weight basis. 5. The fatty acid moiety of pancreatic glycerolipids could be derived from de novo synthesis, fatty acids added to the medium, or from fatty acids formed from the hydrolysis of endogenous lipids. The glycerol moiety could be derived either from glucose, or directly from glycerol through participation of glycerol kinase.

Finger retronychias detected early by 3D ultrasound examination

BACKGROUND

A new pattern of ingrown nail, called retronychia is involved in the posterior translation of the whole nail unit producing paronychia.

OBJECTIVE

To demonstrate an unusual case of paronychia that affected three of the fingers on the right hand.

METHODS

We used 3D ultrasound to study the whole nail unit in the fingers of both the affected (right) and non affected (left) hand.

RESULTS

Backward motion of the nail unit with decreased distance between the origin of the nail plates and the distal interphalangeal joint was clearly demonstrated by 3D ultrasound in the affected fingers.

CONCLUSION

3D ultrasound provides non invasive and more understandable information about the physiopathological changes in retronychia.

Arterial reactivity, blood pressure, and plasma levels of atrial natriuretic peptides in normotensive and hypertensive rats: effects of acute and chronic administration of atriopeptin III

We compared acute and chronic effects of atriopeptin III in normotensive and spontaneously hypertensive rats. Atriopeptin III relaxed isolated aortae and intrarenal microarteries but not coronary and mesenteric microarteries of normotensive rats. Effects on arterial smooth muscle were comparable in hypertensive and normotensive rats and were not affected by long-term treatment of the animals with the peptide. Acute administration of atriopeptin III (4-400 nmol/kg, intravenously) reduced systolic blood pressure in conscious spontaneously hypertensive and renal hypertensive rats but not in normotensive rats. In spontaneously hypertensive rats, nephrectomy increased the sensitivity to and the duration of the acute antihypertensive effect. Renal subcellular fractions rapidly inactivated atriopeptin III in vitro. This atriopeptinase activity was comparable for normotensive and spontaneously hypertensive rats and was not affected by long-term treatment of the rats with the peptide. Continuous administration of low doses of atriopeptin III (0.4 and 4.0 nmol/kg/h, intravenously (i.v.) during 7 days) caused a progressive reduction in systolic blood pressure in spontaneously hypertensive but not in normotensive rats. It did not affect plasma levels of aldosterone or renin and resulted in less than a doubling of the plasma levels of atrial natriuretic peptides. These findings confirm that atrial natriuretic peptides preferentially relax the renal microvasculature. They demonstrate that although atriopeptin III comparably relaxes arterial smooth muscle of normotensive and spontaneously hypertensive rats, both acute and chronic administration of the peptide preferentially lower blood pressure in hypertensive rats. Rather than contributing to the effects on blood pressure, the kidneys modulate the duration of action of atrial natriuretic peptides.

Evaluation of minimum interdental threshold ability in dentate female temporomandibular disorder patients

Minimum interdental threshold is the smallest thickness that can be detected between teeth during an occlusion and has an influence on the occlusal force and on the control of mandibular movements. The aim of this study was to assess the possible association of the signs and symptoms of temporomandibular disorders (TMD) with the ability to detect a minimum interdental threshold. Two hundred women were equally divided into four groups: asymptomatic (control), subjects with masticatory muscle pain, with articular [temporomandibular joint (TMJ)] pain and mixed (muscular and articular pain). Evaluation of the ability to detect a minimum interdental threshold was performed using aluminium foils with 0.010, 0.024, 0.030, 0.050, 0.080 and 0.094 mm of thickness in the premolar region. A total of 20 tests with each thickness for each patient were performed, starting with the thickest foil (0.094 mm) and ending with the thinnest one. The myogenic pain and articular groups presented significantly higher threshold values (0.020 and 0.022 mm, respectively), when compared to the control. Both groups reached the level of certain perceptiveness only at 0.030 mm. No significant correlation was found between minimum interdental threshold and age. These results suggest that discrimination of thicknesses can be disturbed as a consequence of TMD manifestations and not the cause of it. Clinicians should, therefore, be aware that changes on muscles and TMJ can secondarily lead to occlusion changes. The mechanisms involved in this process, however, are not well understood and warrant further investigation.

In vitro lipid metabolism in the rat pancreas. III. Effects of carbamylcholine and pancreozymin on the turnover of phosphatidylinositols, 1,2-diacylglycerols and phosphatidylcholines

1. The turnover of phosphatidylinositols and other glycerolipids was examined in rat pancreatic fragments incubated in the presence of carbamylcholine and pancreozymin used at a concentration inducing maximal alpha-amylase hypersecretion. 2. In stimulated tissue, [1-14C]acetate-labeled fatty acids were incorporated into phosphatidylinositols, 1,2-diacylglycerols, and phosphatidic acids in preference to phosphatidylcholines, phosphatidylethanolamines, triacylglycerols, monoacylglycerols, and free fatty acids. Variations in the percent distribution of 14C among fatty acids and in specific activity of individual fatty acids in each lipid class suggested that the secretagogues reduced selection of newly synthesized 1,2-diacylglycerols which occurred in the resting state before their incorporation into phosphatidylinositols. Secretagogues also promoted recycling of endogenous 1,2-diacylglycerols (produced from hydrolysis of unlabeled glycerolipids) for the biosynthesis of phosphatidylinositols. 3. Increased rate of incorporation of [1-14C]palmitate, [1-14C]linoleate, [1-14C]arachidonate and [1(3)(n)-3H]glycerol into phosphatidylinositols was detrimental to phosphatidylcholines. 4. The lipolytic effects of carbamylcholine and pancreozymin as illustrated by the release of 1,2-diacylglycerols and free fatty acids, were markedly inhibited in calcium-free medium enriched with 1 mM EGTA but increased turnover of phosphatidylinositols as determined from incorporation of radioactive precursors was only moderately affected.

Survey of the growth characteristics and body composition of Fulani children in a rural hamlet in northern Nigeria

This paper reports the results of a cross-sectional study of the growth of Fulani children, aged 1-16 years, living in the Jos Plateau of northern Nigeria. This particular population of Fulani are semi-nomadic pastoralists whose economy and culture are centered on cattle. We measured the heights and weights of 176 girls and 164 boys and determined their body composition parameters (fat content, fat-free mass, and phase angle) using bioelectrical impedance analysis. The body mass index values for the boys and girls were 14.9 and 15.0 kg/m2, respectively. When the heights and weights of the Fulani children were compared against World Health Organization standards, the incidence of stunting and underweight was high: 46 per cent of the girls and 57 per cent of the boys, respectively, had weight Z-scores below -1.0, and 42 per cent and 57 per cent had height Z-scores below -1.0. Even when weight was adjusted for height, the boys and girls fell well below their age- and gender-matched standards. The percentage fat content of the children declined with age such that by age 16 years the fat content of the boys was 10 per cent and that of the girls 20 per cent. Although the Fulani children were significantly shorter and lighter than the international standards, their phase angle value (determined by bioelectrical impedance analysis), which is a measure of body cell mass and the overall vitality and health of tissue membranes, was comparable to those of similarly aged healthy children in the United States. These results indicate that although a large proportion of the Fulani children who inhabit the Jos Plateau are stunted and underweight, the bioelectrical properties of their tissue membranes suggest that they are relatively healthy. It is not known if the slow growth of the Fulani children has a genetic basis or if it is the result of nutritional shortcomings.

In vitro lipid metabolism in the rat pancreas. II. Effects of secretagogues on fatty acid metabolism, net lipolysis and ATP levels

1. The concentration of carbamylcholine, bombesin, pancreozymin, pentagastrin and secretin evoking a similar 4--5-fold maximal increase in amylase secretion from rat pancreatic fragments were 3.10(-6), 10(-7), 10(-8), 3.10(-6), and 3.10(-6) M, respectively. The maximal concentration of vasoactive intestinal peptide tested (3.10(-6) M) increased amylase secretion by 250%. The six secretagogues could be separated into two groups according to their effects on lipid metabolism and ATP levels. 2. When used at their optimal concentrations, carbamylcholine, bombesin, pancreozymin, and pentagastrin lowered pancreatic ATP levels by 18-26% and increased net release of free fatty acids by 68-105%. 3. The effects of 3.10(-6) M carbamylcholine and 10(-8) M pancreozymin on the metabolism of 3H2O, D-[U-14C]glucose and [1-14C]acetate were similar; the incorporation of radioactivity in the fatty acid moiety of glycerolipids decreased by 20--50% whereas the incorporation of 3H from 3H2O and of 14C from [U-14C]glucose increased by 20--35% in the glycerol moiety. In addition, the oxidation of [U-14C]glucose, [1-14C]acetate and [1-14C]palmitate to 14CO2 increased by 15--32% while the esterification of [1-14C]palmitate, [1-14C]-linoleate, and [1-14C]arachidonate was inhibited by 14--23%. The spectrum of fatty acids labeled with [1-14C]acetate indicated an inhibition of the malonic acid pathway whereas the elongation of polyenoic fatty acids was unaltered.

Effect of paediatric early warning systems (PEWS) implementation on clinical deterioration event mortality among children with cancer in resource-limited hospitals in Latin America: a prospective, multicentre cohort study

BACKGROUND

Paediatric early warning systems (PEWS) aid in the early identification of clinical deterioration events in children admitted to hospital. We aimed to investigate the effect of PEWS implementation on mortality due to clinical deterioration in children with cancer in 32 resource-limited hospitals across Latin America.

METHODS

Proyecto Escala de Valoración de Alerta Temprana (Proyecto EVAT) is a quality improvement collaborative to implement PEWS in hospitals providing childhood cancer care. In this prospective, multicentre cohort study, centres joining Proyecto EVAT and completing PEWS implementation between April 1, 2017, and May 31, 2021, prospectively tracked clinical deterioration events and monthly inpatient-days in children admitted to hospital with cancer. De-identified registry data reported between April 17, 2017, and Nov 30, 2021, from all hospitals were included in analyses; children with limitations on escalation of care were excluded. The primary outcome was clinical deterioration event mortality. Incidence rate ratios (IRRs) were used to compare clinical deterioration event mortality before and after PEWS implementation; multivariable analyses assessed the correlation between clinical deterioration event mortality and centre characteristics.

FINDINGS

Between April 1, 2017, and May 31, 2021, 32 paediatric oncology centres from 11 countries in Latin America successfully implemented PEWS through Proyecto EVAT; these centres documented 2020 clinical deterioration events in 1651 patients over 556 400 inpatient-days. Overall clinical deterioration event mortality was 32·9% (664 of 2020 events). The median age of patients with clinical deterioration events was 8·5 years (IQR 3·9-13·2), and 1095 (54·2%) of 2020 clinical deterioration events were reported in male patients; data on race or ethnicity were not collected. Data were reported per centre for a median of 12 months (IQR 10-13) before PEWS implementation and 18 months (16-18) after PEWS implementation. The mortality rate due to a clinical deterioration event was 1·33 events per 1000 patient-days before PEWS implementation and 1·09 events per 1000 patient-days after PEWS implementation (IRR 0·82 [95% CI 0·69-0·97]; p=0·021). In the multivariable analysis of centre characteristics, higher clinical deterioration event mortality rates before PEWS implementation (IRR 1·32 [95% CI 1·22-1·43]; p<0·0001), being a teaching hospital (1·18 [1·09-1·27]; p<0·0001), not having a separate paediatric haematology-oncology unit (1·38 [1·21-1·57]; p<0·0001), and having fewer PEWS omissions (0·95 [0·92-0·99]; p=0·0091) were associated with a greater reduction in clinical deterioration event mortality after PEWS implementation; no association was found with country income level (IRR 0·86 [95% CI 0·68-1·09]; p=0·22) or clinical deterioration event rates before PEWS implementation (1·04 [0·97-1·12]; p=0·29).

INTERPRETATION

PEWS implementation was associated with reduced clinical deterioration event mortality in paediatric patients with cancer across 32 resource-limited hospitals in Latin America. These data support the use of PEWS as an effective evidence-based intervention to reduce disparities in global survival for children with cancer.

FUNDING

American Lebanese Syrian Associated Charities, US National Institutes of Health, and Conquer Cancer Foundation.

TRANSLATIONS

For the Spanish and Portuguese translations of the abstract see Supplementary Materials section.

Phosphatidylinositol turnover and calcium movement in the rat pancreas

Carbamylcholine, bombesin, pancreozymin, and pentagastrin elicited a similar increase in amylase secretion and phosphatidylinositol turnover in rat pancreatic fragments. The concentration of each secretagogue that provoked half-maximal stimulation of amylase secretion was three to six times lower than that which induced half-maximal stimulation of phosphatidylinositol turnover. The increased turnover of phosphatidylinositols due to carbamylcholine or pancreozymin, but not the secretory response, persisted in a calcium-free medium or in 90% heavy water. The replacement of the media Na+ with Li+ increased an atropine-resistant turnover of phosphatidylinositols, but did not stimulate secretion. The ionophore A-23187 (in a medium containing 2.5 mM Ca2+) and 10 mM NaF induced a high secretory response, but exerted no effect on phosphatidylinositol turnover. K+ at a 70 mM concentration provoked a phosphatidylinositol effect and hypersecretion. Secretin, vasoactive intestinal peptide, dibutyryl cAMP, dibutyryl cGMP, 8-bromo cGMP, and N2-monobutyryl cGMP stimulated amylase secretion without an increased turnover of phosphatidylinositols. It is concluded that, in the rat pancreas, the increased turnover of phosphatidylinositols was directly associated with secretagogues inducing calcium movements.

Effect of Silicon Carbide Coating on Osteoblast Mineralization of Anodized Titanium Surfaces

The objective of this study was to evaluate the influence of the titanium nanotube diameter and the effect of silicon carbide (SiC) coating on the proliferation and mineralization of pre-osteoblasts on titanium nanostructured surfaces. Anodized titanium sheets with nanotube diameters of 50 and 100 nm were used. The following four groups were tested in the study: (1) non-coated 50 nm nanotubes; (2) SiC-coated 50 nm titanium nanotubes; (3) non-coated 100 nm nanotubes and (4) SiC-coated 100 nm nanotubes. The biocompatibility and cytotoxicity of pre-osteoblasts were evaluated using a CellTiter-BlueCell Viability assay after 1, 2, and 3 days. After 3 days, cells attached to the surface were observed by SEM. Pre-osteoblast mineralization was determined using Alizarin-Red staining solution after 21 days of cultivation. Data were analyzed by a Kruskal−Wallis test at a p-value of 0.05. The results evidenced biocompatibility and non-cytotoxicity of both 50 and 100 nm diameter coated and non-coated surfaces after 1, 2 and 3 days. The statistical analysis indicates a statistically significant higher cell growth at 3 days (p < 0.05). SEM images after 3 days demonstrated flattened-shaped cells without any noticeable difference in the phenotypes between different diameters or surface treatments. After 21 days of induced osteogenic differentiation, the statistical analysis indicates significantly higher osteoblast calcification on coated groups of both diameters when compared with non-coated groups (p < 0.05). Based on these results, we can conclude that the titanium nanotube diameter did not play any role on cell viability or mineralization of pre-osteoblasts on SiC-coated or non-coated titanium nanotube sheets. The SiC coating demonstrated biocompatibility and non-cytotoxicity and contributed to an increase in osteoblast mineralization on titanium nanostructured surfaces when compared to non-coated groups.

Use of erythropoietin in emergencies: massive intoxication by chloramines

Recombinant human Erythropoietin (rHuEPO) is normally used to correct anaemia in patients with End Stage Renal Disease (ESRD), that are in Regular Dialysis Treatment (RDT). This anaemia is usually due to the existence of two factors: A decrease in the erythropoiesis of the bone marrow and an increase in peripheral haemolysis and, consequently, a decrease in the life span of the red cells.

Primary central nervous system germ cell tumors in Central America and the Caribbean Region: an AHOPCA 20-year experience

Background

Primary central nervous system germ cell tumors (GCT) are rare neoplasms in pediatrics. Treatment depends on the histological subtype and extent of the disease. Overall survival (OS) is above 90% for germinomas and 70%-80% for nongerminomatous GCT (NGGCT) in high-income countries (HIC) while data are usually lacking for patients in Low-Middle Income country (LMIC).

Objective

This study aims to describe the experience of treating patients with CNS GCT in four of eight countries, members of the Asociación de Hemato-Oncología Pediátrica de Centro América (AHOPCA), and determine their 5-year OS.

Design/methods

We conducted a retrospective chart review of patients treated for CNS GCT. Epidemiological and clinical characteristics, histology, treatment modalities, and outcomes were analyzed.

Results

From 2001 to 2021, 48 patients were included: 22 from Guatemala, 18 from Nicaragua, three from the Dominican Republic, and five from El Salvador. Thirty-one (64.6%) were boys; the median age at diagnosis was 10.2 years (range: 1 to 17 years). Presenting symptoms were headaches (n = 24, 50%), visual disturbances (n = 17, 35.4%), vomiting (n = 12, 25%), nausea (n = 8, 16.7%), and diabetes insipidus (n = 7, 14.6%). Two patients with NGGCT presented with precocious puberty. Biopsy or tumor resection was performed in 38 cases (79.2%): 23 (88.4%) germinomas, 11 (78.6%) NGGCT, and four (50%) CNS GCT. Eight patients were diagnosed and treated based on CSF tumor marker elevation; four germinomas (BHCG 11.32-29.41 mUI/mL) and four NGGCT (BHCG 84.43-201.97 mUI/mL or positive AFP > 10 UI/mL). Tumor locations included suprasellar (n = 17, 35.4%), pineal (n = 13, 27.1%), thalamus/basal ganglia (n = 5, 10.4%), other (n = 12, 25%), and one bifocal. Four (8.3%) had metastatic disease, and six had positive CSF; staging data were incomplete in 25 patients (52%). Patients were treated with varied chemotherapy and radiotherapy modalities. Nine patients had incomplete data regarding treatment. Five-year OS was 65% (68% for germinoma, 50.6% for NGGCT, and 85.7% for unclassified GCT).

Conclusions

Germinoma was the most common histology, and there was a male predominance. More than half of patients had incomplete staging data and treatment was variable across the region. OS is lower compared to HIC. Standardized treatment protocols will aid in adequate staging and treatment planning, prevent complications, and improve survival.

Familial focal segmental glomerulosclerosis

We have observed the nephrotic syndrome in more than one sibling in three unrelated hispanic families. The histological lesion in the involved children was either focal segmental glomerulosclerosis or IgM nephropathy evolving into focal sclerosis. Tissue typing revealed the presence of HLA DRw8 in six out of eight patients. The frequency of this antigen in our patients, when compared with its frequency in a group of unrelated normal hispanic children was highly significant (p less than 0.0001). Our study suggests that there may be a genetic predilection towards developing focal segmental glomerulosclerosis.

Exploratory study of the decongestive effect of Rhinopront syrup in adults and in children with acute rhinitis

The decongestive effect of Rhinopront syrup was assessed in 18 adults and 18 children with acute rhinitis, by comparison to a matching placebo syrup and to a commercial standard decongestant (Triaminic tablets or drops). The evolution of symptoms following single dose administration of each treatment was estimated both by objective measurements of nasal resistance using bilateral rhinomanometry and by subjective evaluation of nasal congestion and aspect of the mucosa. In children, the treatment was continued over the next 4 days and the global clinical efficacy of the formulations was subjectively evaluated by the parents. In adult patients, a significant decrease in nasal resistance was obtained after a single dose of Rhinopront (15 g). The effect was already important after 0.5 h and reached a minimum of approximately 50% of baseline within 1 to 2 h; the drop in nasal resistance was significantly less intense for Triaminic (p < 0.05; 0.5-1-h period) and for the placebo (p < 0.05; 0.5-2-h period). In children, the scatter of rhinomanometric measurements precluded the observation of any significant within- or between-group differences; however, a significantly lower nasal congestion score was observed for Rhinopront than placebo, between 4 and 10 h after single dose administration (1 g per year of age). The present work suggests that Rhinopront is an effective nasal decongestant in adults and children with acute congestive rhinitis and supports the adequacy of the proposed twice-daily dosing rate.

Osteoblast Growth in Quaternized Silicon Carbon Nitride Coatings for Dental Implants

The demand for dental implants has increased, establishing them as the standard of care for replacing missing teeth. Several factors contribute to the success or failure of an implant post-placement. Modifications to implant surfaces can enhance the biological interactions between bone cells and the implant, promoting better outcomes. Surface coatings have been developed to electrochemically alter implant surfaces, aiming to reduce healing time, enhance bone growth, and prevent bacterial adhesion. Quaternized silicon carbon nitride (QSiCN) is a novel material with unique electrochemical and biological properties. This study aimed to assess the influence of QSiCN, silicon carbide nitride (SiCN), and silicon carbide (SiC) coatings on the viability of osteoblast cells on nanostructured titanium surfaces. The experiment utilized thirty-two titanium sheets with anodized TiO2 nanotubes featuring nanotube diameters of 50 nm and 150 nm. These sheets were divided into eight groups (n = 4): QSiCN-coated 50 nm, QSiCN-coated 150 nm, SiCN-coated 50 nm, SiCN-coated 150 nm, SiC-coated 50 nm, SiC-coated 150 nm, non-coated 50 nm, and non-coated 150 nm. Preosteoblast MC3T3-E1 Subclone 4 cells (ATCC, USA) were used to evaluate osteoblast viability. After three days of cell growth, samples were assessed using scanning electron microscopy (SEM). The results indicated that QSiCN coatings significantly increased osteoblast proliferation (p < 0.005) compared to other groups. The enhanced cell adhesion observed with QSiCN coatings is likely due to the positive surface charge imparted by N+.

In vitro vasorelaxing activity of suloctidil

The vasorelaxing effect of suloctidil was evaluated in isolated rat and rabbit aorta and in isolated rabbit mesenteric and saphenous artery. Suloctidil inhibited contractions induced by increasing extracellular calcium in depolarized arteries, mainly in a competitive way. In the rat aorta, the pA2 value was 7.50 for suloctidil, while pA2 values of 9.96, 7.90 and 8.10 were obtained for nifedipine, cinnarizine and verapamil, respectively. Suloctidil more potently inhibited calcium-induced contractions in small arteries (mesenteric and saphenous artery), than in the aorta. Suloctidil also reduced the tonic component of the responses to norepinephrine. In contrast to the effects on calcium-induced contractions, the effects of suloctidil on norepinephrine-induced responses was mainly noncompetitive. In addition, and unlike cinnarizine and verapamil, high concentration of suloctidil also reduced the phasic component of contractile responses to norepinephrine. Furthermore, unlike nifedipine, verapamil, diltiazem and cinnarizine, suloctidil was devoid of a negative inotropic effect in spontaneously beating guinea-pig atria. In conclusion, suloctidil behaves as a Ca2+-channel blocker in arteries and displays an additional mode of action that could include receptor-operated Ca2+-channels or an intracellular site of action. In addition, suloctidil was found to affect small arteries more than the aorta, and not to affect the atria.

Pharmacokinetics of nitazoxanide after single oral dose administration in 6 healthy volunteers

The objective of this study was to gather first information on the time course of plasma concentrations and urinary excretion of the antiprotozoal nitazoxanide (N) and to identify potential metabolites in healthy subjects after a single oral dose of 500 mg of nitazoxanide. The clinical trial was conducted as an open single oral dose study in 6 healthy male subjects. After a standardized continental breakfast the subjects took a single oral dose of 500 mg nitazoxanide (coated tablet) with 100 ml tap water. The plasma concentration and the urinary excretion of nitazoxanide (N), desacetyl-nitazoxanide (DN), aminonitrothiazole (ANT), acetylsalicylate (AS), salicylate (S), gentisate (G) and salicylurate (SU) were monitored up to 72 h after administration. The only measurable species in plasma was DN, which reached a Cmax of 1.9 mg/l (range 1.1-2.5) 2-6 h after dosing, and an AUC of 3.9-11.3 mg x h/l. Its terminal half-life ranged from 1.03 to 1.6 h. DN was extensively bound to plasma proteins (> 97.5%). Only 8% of the dose was recovered in the urine, in the form of DN (5%), SU (3%), and traces of ANT (0.1%). In vitro N was very rapidly hydrolyzed to DN by plasma esterases.