• Title/Summary/Keyword: diarrhea incidence

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Efficacy and Safety of Neurokinin-1 Receptor Antagonists for Prevention of Chemotherapy-Induced Nausea and Vomiting: Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Yuan, Dong-Mei;Li, Qian;Zhang, Qin;Xiao, Xin-Wu;Yao, Yan-Wen;Zhang, Yan;Lv, Yan-Ling;Liu, Hong-Bin;Lv, Tang-Feng;Song, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1661-1675
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    • 2016
  • Objectives: Can addition of neurokinin-1 receptor antagonists (NK1-RAs) be considered as an ideal strategy for the prevention of chemotherapy-induced nausea and vomiting (CINV)? Researchers differ on this question. Materials and Methods: Electronic databases were searched for randomized control trials (RCTs) that evaluated the effectiveness and safety of NK1-RAs in preventing CINV. The primary end point was complete response (CR) in the acute, delayed, and overall phases after chemotherapy. Subgroup analyses evaluated the types of NK1-RAs, routines of administration, types of malignancies, regimens used in combination with NK1-RAs, and age of patients included in the studies. The incidences of different types of adverse events were also extracted to estimate the safety of NK1-RAs. Results: A total of 38 RCTs involving 13,923 patients were identified. The CR rate of patients receiving NK-RAs was significantly higher than patients in the control groups during overall phase (70.8% vs 56.0%, P<0.001), acute phase (85.1% vs 79.6%, P<0.001), and delayed phase (71.4% vs 58.2%, P<0.001). There were three studies including patients of children or adolescents, the CR rate was also significantly higher in the treatment group (overall phase: OR=2.807, P<0.001; acute phase: OR=2.863, P =0.012; delayed phase: OR=2.417, P<0.001). For all the other outcomes, patients in the NK1-RAs groups showed improvements compared to the control groups (incidence of nausea: 45.2% vs 45.9%, P<0.001; occurrence of vomiting: 22.6% vs 38.9%, P<0.001; usage of rescue drugs: 23.5% vs 34.1%, P<0.001). The pooled side effects from NK1-RAs did not significantly differ from previous reports and the toxicity rates in patients less than eighteen years old also did not diff between the two groups (P=0.497). However, we found that constipation and insomnia were more common in the patients of control groups, whereas diarrhea and hiccups were more frequently detected in patients receiving NK1-RAs. Conclusions: NK1-RAs improved the CR rate of CINV. They are effective for both adults and children. The use of NK1-RAs might be associated with the appearance of diarrhea and hiccups, while decreasing the possibility of constipation and insomnia.

The UGT1A9*22 genotype identifies a high-risk group for irinotecan toxicity among gastric cancer patients

  • Lee, Choong-kun;Chon, Hong Jae;Kwon, Woo Sun;Ban, Hyo-Jeong;Kim, Sang Cheol;Kim, Hyunwook;Jeung, Hei-Cheul;Chung, Jimyung;Rha, Sun Young
    • Genomics & Informatics
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    • v.20 no.3
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    • pp.29.1-29.12
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    • 2022
  • Several studies have shown associations between irinotecan toxicity and UGT1A genetic variations in colorectal and lung cancer, but only limited data are available for gastric cancer patients. We evaluated the frequencies of UGT1A polymorphisms and their relationship with clinicopathologic parameters in 382 Korean gastric cancer patients. Polymorphisms of UGT1A1*6, UGT1A1*27, UGT1A1*28, UGT1A1*60, UGT1A7*2, UGT1A7*3, and UGT1A9*22 were genotyped by direct sequencing. In 98 patients treated with irinotecan-containing regimens, toxicity and response were compared according to the genotype. The UGT1A1*6 and UGT1A9*22 genotypes showed a higher prevalence in Korean gastric cancer patients, while the prevalence of the UG1A1*28 polymorphism was lower than in normal Koreans, as has been found in other studies of Asian populations. The incidence of severe diarrhea after irinotecan-containing treatment was more common in patients with the UGT1A1*6, UGT1A7*3 and UGT1A9*22 polymorphisms than in controls. The presence of the UGT1A1*6 allele also showed a significant association with grade III-IV neutropenia. Upon haplotype and diplotype analyses, almost every patient bearing the UGT1A1*6 or UGT1A7*3 variant also had the UGT1A9*22 polymorphism, and all severe manifestations of UGT1A polymorphism-associated toxicity were related to the UGT1A9*22 polymorphism. By genotyping UGT1A9*22 polymorphisms, we could identify high-risk gastric cancer patients receiving irinotecan-containing chemotherapy, who would experience severe toxicity. When treating high-risk patients with the UGT1A9*22 polymorphism, clinicians should closely monitor them for signs of toxicity such as severe diarrhea or neutropenia.

Review on Clinical Studies of Traditional Herbal Medicine and Acupuncture Treatments for Colorectal Cancer Patients (대장암 환자의 한약 및 침치료에 대한 국내외 임상연구 결과에 대한 고찰 - Pubmed를 중심으로)

  • Kang, Yun Hwan;Hong, Mi-na;Han, Chang Woo;Choi, Jun Yong;Park, Seong Ha;Kim, So Yeon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.30 no.4
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    • pp.219-228
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    • 2016
  • The aim of this study was to collect and analyze the clinical studies of traditional herbal medicine and acupuncture treatments for colorectal cancer patients searched in Pubmed and Cochrane library in English. We collected the clinical studies, including randomized controlled trial, case control study and cohort study, in the PubMed and Cochrane library using keywords 'Colorectal Cancer', 'Korean Medicine', 'Traditional Chinese Medicine', 'Kampo' and 'Acupuncture'. Then we analyzed them according to the objective of the therapy, i.e. improving therapy prognosis, reducing chemotherapy's adverse event and reducing operational adverse event. In case RCT, we evaluate the quality of the study with jadad scale. Total 18 studies were selected. There were 3 studies about improving therapy prognosis, 6 studies about reducing chemotherapy's adverse event and 9 studies about reducing operational adverse event. Traditional medicine might improve therapy prognosis in terms of the survival rate, relapse/metastasis rate, quality of life and immune function. The specific herbal formula, 'Goshajinkigan' might not be successful about reducing chemotherapy's adverse event, peripheral neurotoxicity. 'Hangeshanshinto' might reduce the duration of oral mucositis but it is not clear to reduce the incidence of that. 'PHY906' might reduce the incidence of diarrhea. Acupuncture might reduce operational adverse event such as gastrointestinal dysfunction and pain. And 'Daikenchuto' might not be successful in reducing operational adverse event, gastrointestinal dysfunction. Further studies are needed to clarify the efficacy of traditional herbal medicine and acupuncture for colorectal cancer patients.

Single dose toxicity study of CKD-602, a new camptothecin anticancer agent, in Beagle dogs (개에서 새로운 캄토테신계 항암제 CKD-602의 단회투여독성시험)

  • Kim, Jong-Choon;Shin, Dong-Ho;Park, Seung-Chun;Son, Woo-Chan;Cha, Shin-Woo;Han, Junghee;Bae, Joo-Hyun;Suh, Jeong-Eun;Chung, Moon-Koo
    • Korean Journal of Veterinary Research
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    • v.44 no.1
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    • pp.49-55
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    • 2004
  • The present study was carried out to investigate the potential acute toxicity of CKD-602 by a single intravenous dose in Beagle dogs. The test chemical was administered intravenously to male and female Beagle dogs at dose levels of 0.3, 0.5, or 2.5 mg/kg. Mortalities, clinical findings, and body weight changes were monitored for the 14-day period following the administration. At the end of 14-day observation period, all animals were sacrificed and complete gross postmortem examinations were performed. All males and females of the 2.5 mg/kg dose group were found dead between the fourth and seventh day after the injection. Treatment related clinical signs, including vomiting, anorexia, mucous stool, diarrhea, and no stool were observed. Decrease or suppression of body weight was observed in a dose-dependent manner. In autopsy, dark red discoloration of the gastrointestinal tract, atrophy of the thymus, paleness of the spleen, sporadic dark red spots of the lung and petechia of the heart were observed in dead animals of the 2.5 mg/kg dose group. There were no specific adverse effects on males and females of the 0.3 and 0.5 mg/kg dose groups, except for the transient clinical signs such as anorexia, vomiting, and mucus/no stool. On the basis of the results, it was concluded that a single intravenous injection of CKD-602 to Beagle dogs resulted in increased incidence of abnormal clinical signs and death, decreased body weight, and increased incidence of abnormal gross findings. The absolute toxic dose of this chemical was 2.5 mg/kg for both genders. The $LD_{50}$ value was 1.1 mg/kg (95% confidence limit not specified) for both genders. The no-observed-effect level (NOEL) was considered to be below 0.3 mg/kg for both genders.

Antioxidative and Cytotoxic Effects of Ethanol Extracts from Elaeagnus multiflora (뜰보리수 에탄올 추출물의 산화적 스트레스 억제 효과와 암세포 증식 억제 효과)

  • Oh, Se-In;Lee, Mee-Sook
    • The Korean Journal of Food And Nutrition
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    • v.21 no.4
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    • pp.403-409
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    • 2008
  • Elaeagnus multiflora, generally referred to as the cherry silverberry, is a plant. Elaeagnus multiflora fruit, leaves, and roots have been traditionally utilized in China as a treatment for cough, diarrhea, itch, and foul sores, and even cancer. More importantly, it is being investigated as a food that is capable of reducing the incidence of cancer, and also as a means of halting or reversing the growth of cancers. Considering the dearth of information regarding the medicinal properties of Elaeagnus multiflora, we assessed the antioxidative and cytotoxic effects of Elaeagnus multiflora by examining its scavenging effects on the 1,1-diphenyl-2-picryl-hydrazyl(DPPH) radical, its inhibitory effects on lipid peroxidation, and its inhibitory effects on cancer cell proliferation in HeLa cells, MCF-7 cells, and SNU-638 cells via MTT assay. Ethanol extracts of Elaeagnus multiflora flesh and seed inhibited DPPH radical production($36.91{\pm}1.00$, $94.17{\pm}0.37$) and lipid peroxidation ($28.18{\pm}5.02$, $40.30{\pm}1.45$, respectively). The Elaeagnus multiflora seed is believed to exert a possible antioxidative effects against the DPPH radical. The ethanol extracts of Elaeagnus multiflora flesh and seed exerted the cytotoxic effects on Hela cells ($6.93{\pm}1.92$, $84.97{\pm}0.47$), MCF-7 cells($5.45{\pm}0.41$, $84.97{\pm}0.47$), and SNU-638 cells($19.39{\pm}0.43$, $76.84{\pm}0.63$) used in this study. This result suggests that Elaeagnus multiflora seeds in contrast to its flesh, is believed to exert a possible anticancer effect. Elaeagnus multiflora seeds are considered to be a the candidate for preventative and dietetic treatment as an anticancer functional food.

Changes in Nutritional Status of General Medical Patients During Hospitalization (내과 환자의 입원후 영양상태 변화 연구)

  • 양영희;최스미;김은경
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.49-60
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    • 1997
  • The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular. renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment : patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of days of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements. including weight body mass index, lean body mass, body fat. and skin fold thickness. were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization, almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia. Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.

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Incidence of Buxtonella sulcata from cattle in Kyonggi-do (경기지방 소의 Buxtonella sulcata 감염 실태)

  • 홍기옥;윤희정
    • Parasites, Hosts and Diseases
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    • v.33 no.2
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    • pp.135-138
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    • 1995
  • In order to survey the prevalence of Buxtonelln sulcatc in Kyonggi-do in 1984 and 1994, the feces of cattle were collected and examined. Of 792 cattle in 1984 and 293 in 1994, cysts of B. sulcata were detected from 266 (33.6%) and 101 (34.5%) cattle respectively. The positive rates were 85.9% and 64.2% in breeder cattle, 44.8% and 9.4% in dairy cattle, 7.5% and 14.9% in Korean cattle and 1.8% in beef cattle. In spring, the cyst positive rates were 62.5% in 1984 and 27.8% in 1994; 20.1% and 66.7% in summer; 21.3% and 0% in autumn; and 34.8% 64.6% in winter. More cattle, 69.1%(184) and 55.5% (56) in 1984 and 1994, had diarrhea among the cyst postive cattle than those of cyst negative, 37.6% (198) and 32.3% (62).

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A Case of Intestinal Tuberculosis Concurring with Endobronchial and Laryngeal Tuberculosis (장결핵과 동반된 기관지 내 및 후두 결핵 1례)

  • Kim, Su Jin;Park, Su Eun;Lee, Min Gi;Kim, Gun Il;Lee, Chang Hun;Park, Jae Hong
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.714-717
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    • 2003
  • Although the incidence of tuberculosis has been reduced recently because of the advance of anti-tuberculosis chemotherapy, improvements of public health, and early diagnosis, it is still high in developing countries. Intestinal tuberculosis can occur at any age, but young adults and female are more affected. Early diagnosis of childhood intestinal tuberculosis is difficult, largely because of vague symptoms and nonspecific signs. Recently, tuberculosis of the larynx combined with pulmonary tuberculosis has become quite a rare disease since anti-tuberculous chemotherapy and preventive activities are prevalent. Laryngeal tuberculosis, while relatively well recognized in the adult population, is a rare disease in chidren and adolescents. There are few reports of intestinal tuberculosis combined with endobronchial and laryngeal tuberculosis in children. We have experienced a case of intestinal tuberculosis which concurred with endobronchial and laryngeal tuberculosis in an 18-year-old girl who presented with abdominal pain, diarrhea, weight loss, a brassy cough, and anemia, which was diagnosed by a colonoscopy and bronchoscopy with biopsy.

A Rare and Often Unrecognized Brain Meningitis and Hepatopneumonic Congestion are a Major Cause of Sudden Death in Somatic Cloned Piglets

  • 박미령;조성근;임여정;박종주;김진회
    • Proceedings of the KSAR Conference
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    • 2003.06a
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    • pp.18-18
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    • 2003
  • In human, sudden infant death syndrome(SIDS) is synonyms for the sudden, unexpected and unexplained death of an infant. The incidence of SIDS has been estimated to be from 1 to 3%. Cloning has a relatively high rate of late abortion and early postnatal death, particularly when somatic cells are used as donors of nuclei and rates as high as 40 to 70% have been reported. However, the mechanisms for SIDS in cloned animals are not known yet. To date, few reports provide detailed information regarding phenotypic abnormality of cloned pigs. In this study, most of the cloned piglets were alive at term and readily recovered respiration. However, approximately 82% of male cloned piglets (81/22) died within a week after birth. Significant findings from histological examinations showed that 42% of somatic cloned male piglets died earlier than somatic cloned female piglets, most probably due to severe congestion of lung and liver or neutrophilic inflammation in brain, which indicates that unexpected phenotypes can appear as a result of somatic cell cloning. No anatomical defects in cloned female piglets were detected, but three of the piglets had died by diarrhea due to bacterial infection within 15 days after birth. Although most of male cloned piglets can be born normal in terms of gross anatomy, they develop phenotypic anomalies that include leydig cell hypoplasia and growth retardation post-delivery under adverse fetal environment and depigmentation of hair- and skin-color form puberty onset. This may provide a mechanism for development of multiple organ system failure in some cloned piglets. Th birth weights of male cloned pig in comparison with those of female cloned piglets are significantly reduced(0.8 vs 1.4kg) and showed longer gestational day(120 vs 114). In conclusion, brain meningitis and hepatopneumonic congestion are a major risk factor for SIDS and such pregnancy in cloned animals requires close and intensive antenatal monitoring.

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A Study of Adverse Events that Occurred after Taking Herbal Medicine - Focused on Children and Adolescents (한약 복용 후 발생한 유해사례에 대한 연구 - 소아·청소년을 중심으로)

  • Lee, Ji Hong;Yu, Sun Ae;Lee, Seung Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.28 no.3
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    • pp.1-16
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    • 2014
  • Objectives The purpose of this study is to investigate the incidence and clinical features of adverse events associated with herbal medicine, and to analyze their causality and severity. Methods This study was carried out from 159 children and adolescents who took herbal medicine in the Department of Pediatrics, ${\bigcirc}{\bigcirc}$ Korean Medical Hospital from december, 2013 to april, 2014. The data was collected by survey in person or telephone. The World Health Organization (WHO)-Uppsala Monitoring Center (UMC) criteria was used to analyze causality for each adverse events. Results 1. 207 cases were surveyed from 159 children and adolescents who took one or more kinds of herbal medicine. 2. A total of 12 general adverse events (5.8%) were reported from the study. Among these adverse events, 8 cases (3.9%) were associated with herbal medicine. 3. Gastro-intestinal system disorders were most frequently reported (70%) as adverse events, which is followed by psychiatric disorders (15%), skin and appendages disorders (10%), urinary system disorders (5%). 4. The most common clinical symptom was abdominal pain (20%), followed by diarrhea (15%), loose stools (10%), vomiting (10%) and borborygmus (10%). 5. The severity of adverse drug reactions was mostly mild (87.5%), and moderate (12.5%). There was no severe case. Conclusions The adverse events from herbal medicine on children and adolescents were mostly minor, most of them could continue herbal medicines.