Aprepitant in the Treatment of Subacute Sclerosing Panencephalitis: A Randomized, Double-Blind, Placebo-Controlled Study.

BACKGROUND: Aprepitant is a neurokinin-1 receptor antagonist approved for the treatment of chemotherapy-induced nausea. We aimed to investigate the safety and efficacy of aprepitant in patients with subacute sclerosing panencephalitis. METHODS: A randomized, double-blind, placebo-controlled study was conducted in patients with subacute sclerosing panencephalitis assigned to receive two courses of aprepitant 250 mg/day orally or placebo for 15 days with an interval of two months between courses. Primary end points were safety and tolerability, and secondary end point was clinical improvement or stabilization assessed by subacute sclerosing panencephalitis scoring system. Electroencephalography (EEG), brain magnetic resonance imaging, and cerebrospinal fluid measles-specific immunoglobulin G index were evaluated before and after treatment. RESULTS: Sixty-two patients with subacute sclerosing panencephalitis were allocated to aprepitant (n = 31, median age 18 years) or placebo (n = 31, median age 22 years) group. Fifteen patients left the study within the first six months and 12 patients left between six and 12 months. Aprepitant was well tolerated and treatment-associated adverse events were similar to those described in the treatment of nausea. Clinical status at six and 12 months' follow-up did not differ between aprepitant and placebo groups. Post-treatment EEG scores at 12 months were better in the aprepitant group (P = 0.015). Cerebral atrophy on magnetic resonance imaging increased in both groups, whereas measles-specific immunoglobulin G index decreased in the placebo group. CONCLUSIONS: In this first clinical trial of aprepitant treatment in patients with subacute sclerosing panencephalitis, the drug was safe and well tolerated. No clinical effect was observed. A modest improvement in EEG findings might justify trials for longer periods because EEG changes can precede clinical findings in subacute sclerosing panencephalitis.

The examination of vegetable- and mineral oil-based inks' effects on print quality: Green printing effects with different oils.

INTRODUCTION: Printing inks oil selection is related to the desired nature of the varnish in the ink production. Petroleum-derived mineral oils and vegetable oils can be used in offset inks. METHODS: In this study, the behaviors of vegetable- and mineral oil-based inks on uncoated and coated paper surfaces were investigated in terms of printability. Solid tone test prints were done with offset printing of these inks. Print gloss of the printed samples was measured and a light fastness test was implemented on these samples in order to determine the resistance to fading. Absorption behavior and contact angles of the ink-printed films on the test papers were measured with the sessile water drop method depending on time, and surface energies were calculated. RESULTS: On both paper types, linseed-soybean oil-based vegetable ink gave the highest brightness value. The lowest print gloss results on the paper were obtained from soybean oil-based inks. The lowest color change was recorded with mineral oil-based inks on gloss-coated papers. According to the ink-film-surface relation, when the contact angle is high, surface energy decreases and the absorbency of the ink-film is lower. CONCLUSIONS: In this study, the behaviors of vegetable- and mineral oil-based inks on different paper surfaces, and the effect on the quality of printability as well as differences, have been evaluated, taking environmental and health factors into consideration.