Rates and determinants of antibiotics and probiotics prescription to children in Asia-Pacific countries.

Antibiotic therapy may have important side effects. Guidelines recommend the administration of specific probiotics to reduce the risk of antibiotic-associated diarrhoea (AAD). The rates and determinants of antibiotics and co-prescription of probiotics in children remain poorly known in Asia-Pacific countries, which are very heterogenous in terms of economic development, health care organization and health policies. A survey among general practitioners (GPs) and paediatricians was performed in seven countries of the Asia-Pacific area (Australia, Japan, Indonesia, India, China, Singapore, and South Korea). Physicians completed an online questionnaire that explored their current habits and the determinants for prescribing antibiotics and probiotics. For the 731 physicians who completed the questionnaire (390 paediatricians and 341 GPs), 37% of all consultations for a child led to the prescription of antibiotics (ranging from 17% in Australia to 47% in India). A large majority of physicians (84%) agreed that antibiotics disrupted gut microbiota and considered probiotics an effective intervention to prevent AAD (68%). However, only 33% co-prescribed probiotics with antibiotics (ranging from 13% in Japan to 60% in South Korea). The main reasons for prescribing probiotics were previous episodes of AAD (61%), presence of diarrhoea (55%), prolonged antibiotic treatment (54%) or amoxicillin-clavulanic acid therapy (54%). Although current local guidelines recommend the use of selected probiotics in children receiving antibiotics in Asia-Pacific area, the rates of antibiotics and probiotics prescription significantly vary among countries and are deeply affected by country-related cultural and organisational issues.

Nicardipine versus nitroprusside infusion as antihypertensive therapy in hypertensive emergencies.

This prospective study compared the efficacy of nicardipine and nitroprusside for treating hypertensive emergencies by measuring haemodynamic indices and serum catecholamine levels. Patients admitted to the emergency department with a hypertensive crisis and acute pulmonary oedema received intravenous infusions of nitroprusside (starting dose 1 microgram/kg per min, n = 20) or nicardipine (starting dose 3 micrograms/kg per min, n = 20). Both groups experienced significant declines in systolic and diastolic blood pressure after treatment, but there were no significant time-dependent differences between the groups. Heart rate decreased in the nicardipine group and increased in the nitroprusside group, but neither change was significant. Respiration rate decreased and capillary oxygen saturation rate increased after treatment in both groups. Adrenaline and noradrenaline levels decreased significantly after treatment in both groups; noradrenaline levels were significantly decreased in the nicardipine-treated group compared with the nitroprusside-treated group. Injectable nicardipine is easy to use and as effective as nitroprusside for treating hypertensive crisis with acute pulmonary oedema.

In the search for new anticancer drugs. XXV: Role of N-nitrosated amadori compounds derived from glucose-amino acid conjugates in cancer promotion or inhibition.

Earlier investigators found that some N-nitrosated Amadori compounds, derived from glucose and amino acid condensation reactions, exhibit mutagenic properties and theorized that these potentially carcinogenic compounds might be formed in the human digestive system. To further investigate these compounds, N-nitrosated Amadori compounds [i.e., N-(1-deoxy-D-fructos-1-yl)-L-N-nitroso-glycine (5a), -threonine (5b), -methionine (5c), -valine (5d), -phenylalanine (5e), and -tryptophan (5f)] were synthesized by modifications of known methods. Acute toxicity tests of 5a, 5b, 5c, 5d, 5e, and 5f in male Swiss mice produced the following lowest lethal limits of toxicity: 2000, 2000, 4000, 3000, 2000, and 6000 mg/kg, respectively, whereas the highest tolerated doses were 1750, 1500, 3000, 1500, and 5000 mg/kg, respectively. The 50% lethal dose (intraperitoneally) for 5b in mice was approximately 1777 mg/kg. This value is at least three times higher than that for the over-the-counter drug ibuprofen (i.e., 495 mg/kg, intraperitoneally, in mice). Compounds 5b, 5c, 5d, and 5f were evaluated in vitro by the National Cancer Institute primary antitumor screen consisting of 60 cell lines. None of the four compounds caused a significant inhibition of cell growth, even at the maximum dosage of 10(-4) M. Compounds 5a-f were tested in vivo against the lymphocytic leukemia P388, and 5b and 5f were tested against the lymphoid leukemia L1210 in CDF1 male mice following the National Cancer Institute protocol. There were no significant differences in results between the control and drug-treated mice.(ABSTRACT TRUNCATED AT 250 WORDS)