Fentanyl compared to buprenorphine for atrial fibrillation ablation analgesia and sedation: a retrospective cross-sectional study.

BACKGROUND: The effects of general anesthesia with deep sedation and conscious sedation have been compared for sedation management in the perioperative period for radiofrequency catheter ablation of the heart to treat atrial fibrillation. However, there is no consensus as to which drug to use for conscious sedation. This study aimed to investigate analgesic and sedative drugs suitable for perioperative ablation. METHODS: We retrospectively examined 93 patients who underwent atrial fibrillation ablation at Kariya Toyoda General Hospital between December 2017 and April 2019 and investigated differences in the outcomes, such as depth of sedation and postoperative adverse events between the buprenorphine hydrochloride (n = 46) and fentanyl citrate (n = 47) groups. RESULTS: The depth of sedation was similar between the two groups, without significant between-group differences in postoperative vomiting. The number of additional injections of thiamylal sodium to manage discomfort and pain during ablation were significantly lower in the fentanyl group. Additionally, the cumulative area product, cumulative total air kerma, 1-year postoperative atrial fibrillation recurrence rate, and postoperative complications were not significantly different between the two groups. CONCLUSIONS: Although there were no significant differences in the efficacy or safety between buprenorphine hydrochloride and fentanyl citrate as analgesics used during atrial fibrillation ablation, intraoperative body movements and patient discomfort could be reduced to a greater extent with the use of fentanyl.

Avian Filariasis in Backyard Chickens in Japan.

In May 2017, a hen in a backyard chicken flock in Japan exhibited mild clinical signs, and the bird was examined for diagnosis. Unexpectedly, many microfilariae were observed in the lung by histologic examination, although no adult worms were detected within the body. In a blood test performed in July, microfilaremia was confirmed in a few clinically normal chickens of the same flock. Molecular analysis of the nematode partial 18S ribosomal RNA gene revealed that the gene detected in the lung of the necropsied hen was positioned in the group of the family Onchocercidae in the phylogenetic tree. These data show that avian filarioids that can infect chickens inhabit Japan.

[Incidence of taste disorder associated with cancer patients undergoing chemotherapy on an ambulatory basis].

Taste disorders are a common complaint among cancer patients undergoing chemotherapy on an ambulatory basis. We conducted a survey on the incidence of such disorders among 74 patients, and 45.95% (34 of 74 patients) developed taste disorders. When stratified by medication into a regimen including 5-FU and one including taxanes, taste disorders were found in 59.0% (23 of 39 patients) of the former and 60.0% (9 of 15) of the latter. The survey also included the effects of taste disorders on patients appetites. Both regimens led to reduced appetite in a number of these patients (39.1% and 44.4%, respectively). Among patients on the 5-FU-containing regimen, the FOLFOX/FOLFIRI therapy was found to be responsible for loss of appetite. Regarding change in tastes, many patients stated that the medication dulled their taste sensation except for bitterness; their capacity to sense intensity of taste remained unchanged. It was found that acute taste disorders develop frequently among patients on a high dosage of 5-FU or a taxane-containing regimen.

[Multicenter investigation of preventive measures against FOLFOX-induced neurotoxicity-a project of the 4th Chapter of the Oncology Research Group, Aichi Prefectural Society of Hospital Pharmacists].

FOLFOX therapy is associated with a high incidence of neurotoxicity that is specific to oxaliplatin and liable to lead to marked deterioration in the patient's quality of life (QOL). Therefore, we conducted a survey on whether any prophylactic measures were taken to guard against the development of such neurotoxicity, and we investigated the incidence of the neurotoxicity and the efficacy of glutathione and Ca/Mg administration. The results of the survey indicated that 5 among 17 medical facilities engaged in prophylactic measures. The timing of the initial development of neurotoxicity was after 2.9 courses of FOLFOX therapy for those without prophylaxis, after 7.5 courses for those treated with glutathione, and 6.4 courses for those on Ca/Mg treatment. The glutathione or Ca/Mg treatment significantly delayed development of the neurotoxicity. The mean total number of cycles that had been given by the completion of FOLFOX therapy was 5, 9, 11.3 and 8.5, respectively, for no prophylactic treatment, treatment with glutathione and Ca/Mg, indicating that these prophylactic measures allow increases in the number of cycles of FOLFOX therapy given. It was concluded that glutathione or Ca/Mg administered with FOLFOX therapy can delay the development of neurotoxicity, thus contributing to an improvement in the patient's QOL.

[Development of taste disorders following FOLFOX-FOLFIRI therapy and its effects on the QOL of patients with colorectal cancer].

Taste disorders are frequent occurrences among those patients under the FOLFOX-FOLFIRI regimen for colorectal cancer. We conducted a study on the development of taste disorders among colorectal cancer patients under this regimen and the effect of such disorders on their QOL. Taste disorders occurred in 58.1%(18/31 cases)of these patients and the disorders affected appetites in 50%(9 cases). The changes in taste sensations were subtle in most but some described certain tastes as exaggerated. Others reported changes in all taste sensations, including sweet, salty, bitter and sour, as well as deliciousness. When tested via the QOL Survey Sheet(Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs: QOL-ACD), the QOL was found to have deteriorated significantly in those who stated that taste disorders affected their appetite, in comparison with those who were unaffected. In patients with colorectal cancers and treated with the FOLFOX-FOLFIRI regimen, taste disorders are frequent occurrences. The poor nutritional state due to a loss of appetite may constitute a factor responsible for a lowering QOL.

[Prevention of oxaliplatin-related neurotoxicity by glutathione infusions].

We have used glutathione for prevention of oxaliplatin-related neurotoxicity with reference to the article of Cascinu et al. We investigated oxaliplatin-related neurotoxicity in Kariya Toyota General Hospital(KTGH)and compared with the data described in the article of Gamelin about the severity of its neurotoxicity. Grade 3 neurotoxicity was observed in only 5 of 44 patients(11.4%). The median number of cycles and cumulative dose of oxaliplatin were 12 cycles(5-27 / cycles)and 802.2(273.2-1,952.4)mg/m(2), respectively, at Grade 3 neuropathy. We evaluated retrospectively neuro-toxicity grade at cumulative oxaliplatin doses of approximately 500-520 mg/m(2). The severity of neurotoxicity observed in KTGH was significantly lower than in the group without Ca/Mg. We found no difference between the group with glutathione and / with Ca/Mg. Glutathione infusions seemed to prevent oxaliplatin-related neurotoxicity.

[The effects of heat stimulation and cold stress on the rats with cervical sympathectomy].

BACKGROUND: To investigate the general action of stellate ganglion block (SGB), we examined the effects of heat stimulation and cold stress on the behavior and stress hormone of the bilateral cervical sympathectomy rats as a long-term and repeated SGB model. METHODS: Wistar's male rats were divided into three groups: control (C), sham operation (S) and sympathectomy (Sx) groups. After 2 weeks, two experiments were done. One was measurement of escape response time from the heat stimulus and the other was hormone measurement. Serum adrenocorticotropic hormone (ACTH), alpha-melanocyte stimulating hormone (alpha-MSH) and beta-endorphine (beta-END) levels were measured assigning 3 groups to 2 subgroups with and without cold stress. RESULTS: Escape response time was significantly extended in the Sx group. ACTH in the Sx group was significantly higher than in other groups, but changes of ACTH by cold stress were similar in 3 groups. In the Sx group alpha-MSH was hardly changed by cold stress while alpha-MSH was significantly decreased in the S group. Changes of beta-END by cold stress were similar in the S and Sx groups. CONCLUSIONS: These results suggest that SGB works systemically through hypothalamus endocrine system and affects stress hormone differently.