Thermoregulatory and soporific effects of very low dose melatonin injection

1999 ◽  
Vol 276 (2) ◽  
pp. E249-E254 ◽  
Author(s):  
Cameron J. van den Heuvel ◽  
David J. Kennaway ◽  
Drew Dawson

The effect of a rapid increase in circulating melatonin on body temperatures and sleepiness was investigated in eight young adults at 1000. Melatonin administered intravenously at 10- and 30-μg doses, but not 3 μg, resulted in elevated plasma and saliva levels consistent with endogenous levels measured in adults at night. Melatonin at 10 and 30 μg significantly attenuated the daytime increase in rectal core temperature ( P < 0.05 for both). The mean maximum rectal core temperature differences between saline and melatonin treatment were 0.11 ± 0.03°C, 0.16 ± 0.04°C, and 0.18 ± 0.04°C after the 3-, 10-, and 30-μg melatonin doses, respectively. All three doses significantly increased hand temperature compared with saline ( P < 0.05) within 30 min. The mean maximum hand temperature differences were 0.72 ± 0.12°C (3 μg), 0.95 ± 0.15°C (10 μg), and 0.65 ± 0.11°C (30 μg). Foot temperature and subjective sleepiness measures did not change at any melatonin dose. The results suggest that daytime intravenous injection of melatonin to achieve normal nocturnal levels in young adults may produce significant thermoregulatory changes without soporific effects.

Author(s):  
Ab Rahman A F ◽  
Md Sahak N. ◽  
Ali A. M.

Objective: Once daily dosing (ODD) aminoglycoside is gaining wide acceptance as an alternative way of dosing. In our setting it is the regimen of choice whenever gentamicin is indicated. The objective of this study was to evaluate the practice of gentamicin ODD in a public hospital in Malaysia. Methods: We conducted a retrospective review of medical records of patients on gentamicin ODD who were admitted to Hospital Melaka during January 2002 until March 2010. All adult patients who were on ODD gentamicin with various level of renal function were included in the study. Patients on gentamicin less than 72 hours and pregnant women were excluded. Results: From 110 patients, 75 (68.2%) were male and 35 (31.8%) were female. Indications for ODD gentamicin included pneumonia, 34 (31.0%) neutropenic sepsis, 27 (24.5%) and sepsis, 11 (10.0%). The mean dose and duration of gentamicin was 3.2 mg/kg/day and 7 days, respectively. Almost all patients were on gentamicin combined with other antibiotics. Clinical cure based on fever resolution was found in 89.1% of patients treated with ODD. Resolution of fever took an average of 48 hours after initiation of therapy. The evaluation for bacteriologic cure could not be performed because of insufficient data on culture and sensitivity. Out of 38 patients with analyzable serum creatinine data, four patients might have developed nephrotoxicity. Conclusion: In our setting, lower dosages of ODD gentamicin when used in combination with other antibiotics seemed to be effective and safe in treating most gram negative infections.


2021 ◽  
Vol 13 ◽  
pp. 251584142098821
Author(s):  
Kamal A.M. Solaiman ◽  
Ashraf Mahrous ◽  
Hesham A. Enany ◽  
Ashraf Bor’i

Purpose: To evaluate the efficacy of the drain fluid cryo-explant (DFCE) technique for the management of uncomplicated superior bullous rhegmatogenous retinal detachment (RRD) in young adults. Patients and methods: A retrospective study that included eyes with uncomplicated superior bullous RRD in patients ⩽40 years old. DFCE technique consists of sequential drainage of subretinal fluid, intravitreal fluid injection, cryotherapy, and placement of a scleral explant(s). The primary outcome measure was anatomical reposition of the retina after a single surgery. Secondary outcome measures included improvement in best corrected visual acuity (BCVA) and any reported complication related to the procedure. Results: The study included 51 eyes which met the study eligibility criteria. The mean duration of detachment was 19.7 ± 6.4 days. A single retinal break was found in 31 eyes (60.8%), and more than one break were found in 20 eyes (39.2%). The mean number of breaks per eye was 1.72 ± 1.04. The mean detached area per eye was 7.21 ± 3.19 clock hours, and the macula was detached in 22 eyes (43.1%). Flattening of the retina and closure of all retinal breaks was achieved in all eyes after a single surgery. Late recurrence of retinal detachment occurred in two eyes (3.9%) due to proliferative vitreoretinopathy (PVR). No complicated cataract or iatrogenic retinal breaks were detected in all eyes. Conclusion: DFCE technique could be effectively used for treatment of uncomplicated superior bullous RRD in adults ⩽40 years. It is safe and provides good visualization during surgery with no iatrogenic retinal breaks or complicated cataract.


1987 ◽  
Vol 17 (4) ◽  
pp. 869-873 ◽  
Author(s):  
C. Schmauss ◽  
J.-C. Krieg

SynopsisIn 17 benzodiazepine (BDZ) dependent in-patients a CT scan was performed before initiation of withdrawal therapy. The evaluation of the ventricular to brain ratio (VBR) by standardized and computerized measurements revealed significantly higher mean VBRs for both high-and low-dose BDZ-dependent patients compared to the mean VBR of an age- and sex-matched control group. In addition, the mean VBR of high-dose BDZ-dependent patients (N = 8) was significantly higher than the mean VBR of low-dose BDZ-dependent patients (N = 9). This difference could not be accounted for by the age of the patients or duration of BDZ-dependency and, therefore, suggests a dose-dependent effect of BDZs on the enlargement of internal CSF-spaces. On the other hand, higher values for the width of external CSF-spaces were found to be related to increasing age of the patients and duration of BDZ-dependency.


PLoS ONE ◽  
2014 ◽  
Vol 9 (10) ◽  
pp. e108180 ◽  
Author(s):  
Baohui Lou ◽  
Min Chen ◽  
Xiaojie Luo ◽  
Yongming Dai

2000 ◽  
Vol 53 (1) ◽  
pp. 271-279 ◽  
Author(s):  
Yvonne Harrison ◽  
James A. Horne

Historical evidence suggests that sleep deprivation affects temporal memory, but this has not been studied systematically. We explored the effects of 36 hr of sleep deprivation on a neuropsychological test of temporal memory. To promote optimal performance, the test was short, novel, and interesting, and caffeine was used to reduce “sleepiness”. A total of 40 young adults were randomized into four groups: control + caffeine (Cc), control + placebo (Cp), sleep deprived + caffeine (SDc), and sleep deprived + placebo (SDp). Controls slept normally. Caffeine (350 mg) or placebo were given just prior to testing. The task comprised colour photographs of unknown faces and had two components: recognition memory (distinction between previously presented and novel faces), and recency discrimination (temporal memory), when a previously shown face was presented. An interpolated task, self-ordered pointing, acted as a distraction. Caffeine had no effects within control conditions, but significantly reduced subjective sleepiness in SDc. Recognition was unaffected by sleep deprivation, whereas for recency, sleep deprivation groups scored significantly lower than controls. There was no significant improvement of recency with caffeine in the SDc group. Both sleep deprivation groups had poorer insight into their performance with recency. Self-ordered pointing remained unchanged. In conclusion, sleep deprivation impairs temporal memory (i.e. recency) despite other conditions promoting optimal performance.


2016 ◽  
Vol 46 (6) ◽  
pp. 1014-1018 ◽  
Author(s):  
Charline Zaratin Alves ◽  
Lennis Afraire Rodrigues ◽  
Carlos Henrique Queiroz Rego ◽  
Josué Bispo da Silva

ABSTRACT: Crambe is a rapeseed with high oil content and can be used as a winter cover or as a source of raw material for the production of biodiesel, however espite the growing interest in the culture, research on the subject is still incipient, especially concerning the seed production and analysis technology. The purpose of this study is to evaluate the physiological quality of crambe seeds, 'FMS Brilhante' cultivar, by testing the pH of exudate. Five seed lots were submitted to the determination of water content and the tests of germination and vigor (first count, emergence and tetrazolium). In the conduction of pH exudate test, temperatures (25 and 30oC), and periods of seed imbibition in water (15, 30 and 45 minutes) were tested. The experiment was conducted in a completely randomized manner, with four replicates, and the mean values were compared by the Tukey test at 5% probability; Pearson correlation between the pH of the exudate and initial tests was also made. Testing the pH of exudate is promising for separating lots of crambe seeds and the following combinations of 25°C/30 minutes or 30°C/45 minutes can be used.


2021 ◽  
Vol 12 (4) ◽  
pp. 395-397
Author(s):  
Sertaç Şener ◽  
Fadime Kilinç ◽  
Ayşe Akbaş

Background: Notalgia paresthetica (NP) is a sensory neuropathic syndrome characterized by chronic itching of the unilateral mid-back. Topical and systemic symptomatic treatments have been used to date. In recent years, neuropathic pain medicine has been used to relieve the symptoms of the disease. The aim of this study was to determine the effectiveness of pregabalin in notalgia paresthetica. Materials and Methods: In this study, the files of the patients with a diagnosis of NP and treated with pregabalin for at least one month in the period between 2016 and 2018 were evaluated retrospectively. Results: Thirteen cases of NP treated with low-dose (up to 150 mg/day) pregabalin were evaluated, and 9 (70%) patients exhibited a good response in this retrospective study. All patients were female and the mean age was 53.5 (31–71) ± 10.3 years. The mean disease duration was 6.1 (1–10) ± 4.1 years. Conclusion: Treatment with low-dose pregabalin may be a good option for the symptomatic treatment of NP.


2020 ◽  
Vol 18 (2) ◽  
pp. 12-17
Author(s):  
Muhammad Tayeb ◽  
Md Hasanuzzaman ◽  
Abul Mansur Md Rezaul Karim ◽  
Mohammad Sanaullah ◽  
Md Ashraful Islam

Background : Migraine is primary headache disorder characterized by recurring attacks of pain and associated symptoms. The management modality is still unsatisfactory due to poor understanding of its cause and pathogenesis. To assess the efficacy and safety of low dose Topiramate vs Propranolol in migraine prophylaxis. Materials and methods : A randomized clinical trial including 130 patients with frequent migraine headache >5 attacks per month was performed in the out patients Department of Medicine and Neurology, CMCH for a period of 12 weeks. The patients were randomly divided into two treatment groups – treated by Topiramate 50mg/day and Propranolol 80mg/day respectively. Topiramate started with 25mg/day for 7 days then increased up to 50mg/day in two divided dose. Propranolol started with 40mg/day for 7 days then increased up to 80mg/day in two divided dose. The patients were assessed at 0, 8 and 12 weeks of the study. Results: The Topiramate group showed a reduction in the mean (±SD) of frequency of migraine attack from 6.95(±2.88) to 1.75(±1.08) episode per month, headache days per month from 7.62(±4.14) to 1.83(±1.10), intensity of headache per attack from 8.98(±1.05) to 6.10(±2.50) based on VAS scale, duration of headache per episode from 11.56(±9.16) to 5.40(±2.97) per hour and MIDAS score from 16.19(±3.91) to 8.14(±3.93). In patient treated with Propranolol, the mean (±SD) of monthly frequency of migraine attack declined from 7.09(±2.87) to 1.92(±0.98) episode per month, headache days per month from 8.17(±4.52) to 1.86(±o.83), intensity of headache per attack from 8.47(±1.10) to 6.03(±2.05) based on VAS scale, duration of headache per episode from 11.16(±8.08) to 5.97(±3.45), MIDAS score from 15.48(±3.55) to7.77(±3.49). Pre- and post-treatment values were significantly different for individual groups but no significant difference observed between groups. Conclusion: This study demonstrated that both low dose Topiramate and propranolol could significantly reduce migraine frequency, intensity and duration. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 12-17


Author(s):  
Erdem Fadiloglu ◽  
Atakan Tanacan ◽  
Canan Unal ◽  
Mehmet Sinan Beksac

<p><strong>Objective:</strong> To evaluate the subsequent pregnancy outcomes of women who have experienced unexplained stillbirth in their previous gestations.</p><p><strong>Study Design:</strong> This retrospective cohort consisted of 14 pregnancies who had stillbirth (without known risk factors) in their previous pregnancies. These patients had been included in a special preconceptional care program to be evaluated in terms of etiological risk factors for stillbirth. At least one of the risk factors, such as methylenetetrahydrofolate reductase (MTHFR) polymorphisms, hereditary thrombophilias and autoimmune problems, were defined in this study population. After detection of pregnancy, the patients were administered low-dose low-molecular-weight heparin (LMWH) (enoxaparin, 1×2000 Anti-XA IU/0.2 mL/day), low-dose salicylic acid (100 mg/day) and low-dose corticosteroid (methylprednisolone, 1×4 mg/day orally) in necessary cases.</p><p><strong>Results:</strong> Out of 14 pregnancies, 4 (28.5%) ended up with miscarriages at 9, 11, 11 and 15 gestational weeks, respectively. The remaining 10 pregnancies ended up with alive deliveries. The mean gestational week at birth was 36.4±0.51, while the mean birthweight was 2882±381.01 g. Out of 10 pregnancies, only one was diagnosed as IUGR. Only two newborn necessitated hospitalization in the neonatal intensive care unit (NICU) due to respiratory problems. Both newborns were discharged from the NICU without any further complication at the post-partum 5th day. </p><p><strong>Conclusion:</strong> Patients with a prior stillbirth should be screened for MTHFR polymorphisms, autoimmune problems and hereditary thrombophilias, especially in case of absence of any etiological factor. Management of these patients with low-dose aspirin, low-dose low molecular weight heparin and corticosteroids seemed to be beneficial for increasing live birth rates and avoiding obstetric complications.</p>


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Gaston Rodriguez Granillo ◽  
Juan José Cirio ◽  
Ivan Lylyk ◽  
Nicolas Perez ◽  
Maria L Caballero ◽  
...  

Background: The COVID-19 pandemic has promoted adaptations in diagnostic algorithms. We explored the feasibility and accuracy of delayed phase (DP) chest computed tomography (CT) performed immediately after brain CT perfusion (CTP) for the identification of thrombotic complications and myocardial fibrosis among patients admitted with acute ischemic stroke (AIS). Methods: Since July, we have incorporated the use of low dose chest CT scans using a spectral CT scanner in all patients admitted with AIS, encouraging acquisitions, five min after brain CTP. All scans were non gated and comprised low dose chest CT scans, without additional contrast. Using virtual monochromatic imaging and iodine maps, we evaluated the presence of thrombotic complications, myocardial late enhancement, and myocardial extracellular volume (ECV), as a surrogate of edema and interstitial fibrosis. Results: We included 22 patients. The mean age was 66.2±19.6 years. In 5 patients, a cardioembolic (CE) source was later identified by transesophageal echocardiogram (TEE), [left atrial appendage (LAA) thrombus, n=1], transthoracic echocardiogram with agitated saline injection (patent foramen ovale n=2), or by EKG (atrial fibrillation). Seven patients further underwent either TEE or cardiac CT to identify CE sources. DP non gated chest CT had a sensitivity and specificity of 100% to identify CE sources, 1 LAA thrombus correctly detected. Chest CT identified pulmonary thromboembolism (PE), later confirmed with CT angiography. Chest CT identified myocardial late enhancement in 16 patients (80% in CE vs. 71% in non CE, p=0.68), myocardial fat in 1, and coronary calcification in 77% [with 2.6±2.2 vs 3.8±3.6 coronary calcified segments in CE vs. non CE strokes, p=0.36). The mean ECV was 35±4% in CE vs 32±6% in non CE strokes (p=0.17). The 2 patients with a positive PCR test for COVID-19 showed evidence of myocardial late iodine enhancement, and incremented ECV of the septal wall (38% and 40%, respectively). Conclusions: In this pilot study, DP, non ECG gated, low dose chest CT scan performed 5 min after brain CTP with a spectral scanner; enabled straightforward identification of CE sources among patients with AIS. This approach allowed detection of PE and myocardial injury.


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