A Freshwater clam (Corbicula fluminea) extract reduces cholesterol level and hepatic lipids in normal rats and xenobiotics-induced hypercholesterolemic rats

We investigated whether a freshwater clam (Corbicula fluminea) extract (FCE) could improve cholesterol metabolism and hepatic lipids accumulation in rats fed xenobiotics such as chloretone. Feeding chloretone resulted in hypercholesterolemia and fatty liver. An increase in serum cholesterol, high density lipoproteins (HDL) in particular, after intake of chloretone was observed. Serum cholesterol was decreased by supplementation with FCE. Accumulation of the hepatic lipids including triacylglycerol, cholesterol, and phospholipid was significantly suppressed by supplementation with FCE. The excretion of neutral and acidic sterols into the feces was enhanced by FCE. The hepatic gene expression of cholesterol 7alpha-hydroxylase was enhanced in rats fed a FCE-containing diet. Apolipoprotein A-I gene expression in the liver, which is a major apolipoprotein of HDL, was suppressed by FCE. These results demonstrated that FCE reduced cholesterol level and hepatic lipids in normal rats and hypercholesterolemic rats fed chloretone.

[Efficacy of an antiseptic dialysis of purulent wounds in the dentofacial region with hyvalix]

The article presents data proving the possibility of using the solutions of "Hyvalix" medication for an antiseptic preparation of septic cavities after lancing of abscesses and phlegmons of dentofacial region. It was shown the efficacy of "Hyvalix" medication in comparison with traditional solutions of antiseptic means.

[The treatment of hyperemesis gravidarum with chlorobutanol-caffeine rectal suppositories in Denmark: practice and evidence]

INTRODUCTION

In Denmark chlorobutanol-caffeine rectal suppositories are prescribed by some obstetric departments for the treatment of hyperemesis gravidarum.

MATERIALS AND METHODS

We have investigated the extent of this use by questionnaire, and we have performed a literature review on the evidence of efficacy and safety.

RESULTS

The use of chlorobutanol-caffeine rectal suppositories was reported by 5 out of 28 obstetric departments in Denmark. The literature search revealed that there is very sparse information on chlorobutanol. No evidence was found of safety during pregnancy in humans or efficiency as antiemetic treatment in hyperemesis gravidarum.

CONCLUSION

There is no evidence of the efficacy or safety of chlorobutanol-caffeine suppositories for the treatment of hyperemesis gravidarum.

Randomized Clinical Trial of Docusate, Triethanolamine Polypeptide, and Irrigation in Cerumen Removal in Children

BACKGROUND

Cerumen obstructing visualization of the tympanic membrane in children is a common and frustrating problem. Docusate sodium, triethanolamine polypeptide, and saline were compared to determine their effectiveness in relieving cerumen obstruction in children.

METHODS

A randomized, controlled, double-blind trial was performed on pediatric patients aged 6 months through 5 years with cerumen obstruction. The enrolling physician determined whether the cerumen completely or partially obstructed visualization of the tympanic membrane. One milliliter of docusate sodium, triethanolamine polypeptide, or normal saline as control was placed into the patient's ear canal. If the tympanic membrane was not completely visualized after 15 minutes, the ear was irrigated with 50 mL of tepid water. Irrigation was repeated a second time if needed. The main outcome was the proportion of tympanic membranes that were completely visualized after cerumeno-eblytic agents or control saline, alone or with irrigation if needed.

RESULTS

Of 92 patients enrolled, 34 received docusate sodium; 30, triethanolamine polypeptide; and 28, saline. Mean +/- SD patient age was 34.7 +/- 18.1 months, and 50 (54%) of the patients were girls. Groups were similar in age, race, sex, ear enrolled, wax consistency, and degree of obstruction. There was no significant difference in the proportion of tympanic membranes completely visualized after treatment with docusate (18/34; 53%), triethanolamine polypeptide (13/30; 43%), or saline (19/28; 68%) (P =.17).

CONCLUSION

Application of docusate sodium or triethanolamine polypeptide did not significantly improve the proportion of tympanic membranes that were completely visualized vs application of the saline control.

Chlorobutanol: maternal serum levels and placental transfer in the mouse

Chlorobutanol (CB) is a pharmaceutical preservative and the active ingredient in certain sedatives and anesthetics and produces adverse effects in adult tissues and mouse embryos in vitro. Chlorobutanol is slowly eliminated in humans, but little is known about its serum levels in other species or placental transfer in any species. Pregnant mice gavaged with 80 mg CB/kg on gestational day (gd) 9.5 provided serum at 10 min to 36 h post-dosing for a time course study. Additional mice gavaged with 0, 8, 40 or 80 mg CB/kg on gd 9.5 provided maternal serum and embryos 2 h post-dosing for a placental transfer study, and CB levels were measured using capillary gas chromatography with electron capture detection. Dosing with 80 mg CB/kg produced maternal serum levels between 30.8 micrograms/mL (10 min) and < 1 microgram/mL (36 h), with a half-life of 7.45 h. Embryonic CB levels increased with maternal dose and were correlated with maternal serum levels. Serum levels of CB in the mouse appeared to follow a time course similar to humans, with rapid absorption and slow elimination. Placental transfer, as demonstrated here in the mouse, may allow embryonic accumulation of CB to potentially toxic levels.

Acute effects of chlorobutanol- or benzalkonium chloride-containing artificial tears on the surface features of rabbit corneal epithelial cells

I examined the epithelial surface, by high resolution scanning electron microscopy, after its recovery from the instillation of artificial tears containing chlorobutanol or benzalkonium chloride. Is the mild epithelial surface compromise observed after occasional use of a chlorobutanol-containing artificial tear more substantial after use of a benzalkonium-containing artificial tear? Two drops of a chlorobutanol- or benzalkonium chloride-containing artificial tear were instilled into the right eye of 6 female gray rabbits (2 kg) at 9:00 p.m. and 9:00 a.m. At the same time six control animals received no eyedrops. All animals were euthanized at 3:00 p.m. and the central region of the corneal epithelium quantitatively assessed using a digitizer pad/computer system. There were up to 5% exfoliating cells evident at the ocular surface in treated rabbits but with no difference between the two products. Controls had no cell exfoliation (< 0.5%). The distribution of surface areas of the squamous cells in the treated eyes was shifted to slightly larger values than in the controls after use of the chlorobutanol-containing product but the number of epithelial cell craters/cell was unchanged from that of the controls. Cell surface areas were shifted to significantly smaller values than controls after use of the benzalkonium chloride-containing product and there were much fewer epithelial cell craters/cell. The results reveal differences in the effects of preservative-containing artificial tears on the squamous cells of the corneal epithelium in a clinically relevant situation.

Is ketamine or its preservative responsible for neurotoxicity in the rabbit?

BACKGROUND

Although ketamine has been administered spinally in humans, previous neurotoxicity studies have shown that it can induce spinal cord lesions in various animal models. The aim of this work was to evaluate by histologic and blood-brain barrier studies whether different components of the commercial ketamine solution might be responsible for the microscopic lesions observed.

METHODS

Forty white New Zealand rabbits were randomly assigned to four groups of 10. One-percent preservative-free ketamine (0.3 ml), 1% d-ketamine, 0.05% chlorobutanol, and 1% lidocaine were intrathecally injected through the atlantooccipital membrane. Laminectomy was performed on day 8, and the dura was preserved using paraformaldehyde-glutaraldehyde fixative. Light and fluorescence microscopy were performed on transverse spinal cord sections by a neuropathologist unaware of injected agents used. Specimens were then graded as normal or abnormal as compared with a control group receiving lidocaine.

RESULTS

Isomers of ketamine did not induce spinal cord lesions in either study, but chlorobutanol (the preservative used in the ketamine solution) induced significant severe spinal cord lesions in both studies.

CONCLUSIONS

The appearance of spinal cord lesions after intrathecal chlorobutanol strongly suggests that this preservative is responsible for apparent toxicity of ketamine and therefore should not be used in any solution intrathecally injected into humans.

An open multiple dose study of Optrex Eye Lotion in eye irritation due to hayfever

Twenty-four patients consulting their general practitioner with eye irritation due to hayfever entered a seven-day open, multiple dose study of a newly formulated Optrex Eye Lotion. Patients self-administered Optrex by irrigation into their left eye three times daily for seven days, with an option to use the same preparation in their right eye if they thought this to be of benefit. Assessment was by means of daily diary cards completed by the patient each evening for the seven-day period. Following the first instillation, the treated eye felt significantly better at 20 seconds and at four minutes when compared with the untreated eye. Differences between the eyes for degree of redness, comfort and clearness of vision were not significant, but 15 patients (63 per cent) optionally used Optrex in their right eye. Seventeen patients (71 per cent) reported that they derived overall benefit from the use of Optrex Eye Lotion during the study period. Two patients reported side effects during the study but, in each case, the investigator did not consider the event to be therapy related. One patient withdrew on Day 7 of the trial due to worsening of their allergic conjunctivitis. It can be concluded that some subjective benefit was gained by the majority of patients in that a considerable number of them chose to treat both eyes for the duration of the study.

Cardiovascular effects of oxytocin

Oxytocin, 5 to 10 units, is frequently given as a bolus injection following term delivery or elective termination of pregnancy. It is not general knowledge that this has any untoward effects. In the present study in young, healthy women undergoing elective termination of pregnancy, mean arterial blood pressure decreased approximately 30% and the total peripheral resistence 50%, 40 seconds after injection. However, heart rate increased 30% and stroke volume 25%, so that the cardiac output was elevated more than 50% above control. Oxytocin given as a dilute solution produced no circulatory change; hence, we suggest that this drug be administered in such fashion rather than by bolus injection.