Capsule-related dysphagia and the use of netupitant/palonosetron (Akynzeo™) capsules – A report of two cases and a solution

Netupitant/palonestron (NEPA, Akynzeo™) is a fixed combination of netupitant 300 mg and palonosetron 0.5 mg that is indicated for the prevention of chemotherapy-induced nausea and vomiting (CINV). NEPA is supplied as a hard gelatin capsule and indicated to be administered whole with or without food. The efficacy of NEPA was maintained when administered as an oral dose of netupitant given concomitantly (in separate formulations after removal from the hard gelatin capsule) with a single oral dose of palonosetron. At our institution, two patients experienced difficulty swallowing the capsule leading to opening the capsule and individual administration of the medications. We observed that the efficacy was maintained when the opened NEPA capsule was administered as individual medications. We report the details of these two patient cases.

Both Caffeine and Placebo Improve Vertical Jump Performance Compared With a Nonsupplemented Control Condition

Purpose: To compare the acute effects of caffeine and placebo ingestion with a control condition (ie, no supplementation) on vertical jump performance. Methods: The sample for this study consisted of 26 recreationally trained men. Following the familiarization visit, the subjects were randomized in a double-blind manner to 3 main conditions: placebo, caffeine, and control. Caffeine was administered in the form of a gelatin capsule in the dose of 6 mg·kg body weight−1. Placebo was also administered in the form of a gelatin capsule containing 6 mg·kg−1 of dextrose. Vertical jump performance was assessed using a countermovement jump performed on a force platform. Analyzed outcomes were vertical jump height and maximal power output. Results: For vertical jump height, significant differences were observed between placebo and control conditions (g = 0.13; 95% confidence interval [CI], 0.03–0.24; +2.5%), caffeine and control conditions (g = 0.31; 95% CI, 0.17–0.50; +6.6%), and caffeine and placebo conditions (g = 0.19; 95% CI, 0.06–0.34; +4.0%). For maximal power output, no significant main effect of condition (P = .638) was found. Conclusions: Ingesting a placebo or caffeine may enhance countermovement jump performance compared with the control condition, with the effects of caffeine versus control appearing to be greater than the effects of placebo versus control. In addition, caffeine was ergogenic for countermovement jump height compared with placebo. Even though caffeine and placebo ingestion improved vertical jump height, no significant effects of condition were found on maximal power output generated during takeoff.

Histological Examination of the Osteogenic Properties of White Acropora Coral Grainules Sized 50–150 μm Under Subcutaneous Administration in the Experiment

The aim of research was to study morphological characteristics of the osteogenic properties of the natural white Acropora coral skeleton granules when implanted under the skin.Material and methods. The study included 60 sexually mature male Wistar rats. The object of the morphological study was subcutaneous implants isolated for different periods of the experiment. The experimental animals were divided into three groups, 20 animals each. In the 1st and 2nd groups the granules were placed in a gelatin capsule, in the 3rd group – the granules were implanted directly under the skin of the animals. When preparing implants for the 1st group, the granules were treated with the blood of an animal taken from the tail vein during surgery. Implants for the 2nd group of animals were not treated with blood. Histological research methods (hematoxylin and eosin staining according to Mallory, Weigert–Van Gieson, and Masson–Goldner; staining to determine the age of fibrin (BioVitrum)) were used in the study; the results were statistically processed.Results. The results obtained demonstrated that heterotopic bone formation based on granules from the skeleton of natural coral was only possible when they were in wide contact with blood on the first day of the experiment. The results of the study also evidenced that blood clot elements, fibrocytes, and osteoblasts were the source for the development of newly formed bone tissues. The gelatin capsule allowed temporarily restricting coral granules from the surrounding tissues with peripheral venous blood cells inside; the fact contributing to the formation and accumulation of cellular elements and subsequently leading to the formation of young bone tissues.Conclusions. As demonstrated, subcutaneous implantation of coral granules in a gelatin capsule without blood did not result in osteogenesis. Due to the apparent osteoinductive potential, natural coral skeleton granules applied according to the proposed method are considered to be an alternative to other osteoplastic materials for the stimulation of de novo bone formation.