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constipation treatment

Ryosuke Watari, Akihiro Matsuda, Shuichi Ohnishi, Hiroshi Hasegawa
Naldemedine tosylate, a peripherally acting μ-opioid receptor antagonist, is indicated for treatment of opioid induced constipation in both Japan and US. Naldemedine has limited ability to affect the central analgesic effect of opioid analgesics. In this study, we investigated the contribution of P-glycoprotein (P-gp) on the brain distribution of naldemedine. Naldemedine tosylate showed acceptable oral absorption in rats. Following a single oral administration of [14 C]-naldemedine tosylate to rats and ferrets, little radioactivity was detected in the region protected by the blood-brain barrier (BBB)...
December 23, 2018: Drug Metabolism and Pharmacokinetics
Mitsuru Watanabe, Tetsuo Sumi, Ryutaro Udou, Masaya Enomoto, Takaaki Matsudo, Shingo Tachibana, Akihiro Mimuro, Kenji Katsumata, Akihiko Tsuchida
A 61-year-old man with a diagnosis of rectal cancer underwent assisted laparoscopic rectal amputation. Recurrence occurred, and treatment with FOLFIRI plus bevacizumab was initiated at our department. After 12 treatment courses, he developed abdominal pain at home. Emergency surgery was performed for the stoma perforation. We confirmed the diverticular perforation in the resected specimen. In our case, we found a para-stoma hernia and considered it to be the cause of perforation together with bevacizumab administration...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Shih-Yu Chen, Gopi Ravindran, Qichen Zhang, Steve Kisely, Dan Siskind
BACKGROUND: Clozapine is the most effective medication for treatment-refractory schizophrenia. However, it has a high burden of adverse events, including common adverse events such as sialorrhea. Sialorrhea can lead to severe physical complications such as aspiration pneumonia, as well as psychological complications including embarrassment and low self-esteem. Compromised adherence and treatment discontinuation can occur due to intolerability. There have been no meta-analyses examining strategies to mitigate clozapine-induced sialorrhea...
February 13, 2019: CNS Drugs
Suyapa Bejarano, Meghan E Freed, Darwin Zeron, Rennie Medina, Julio Cesar Zuniga-Moya, Linda Kennedy, Martha L Bruce, Lisa Zubkoff, Marie A Bakitas, Kathleen Doyle Lyons
Evidence-based interventions often need to be adapted to maximize their implementation potential in low-to middle-income countries. A single-arm feasibility study was conducted to determine the feasibility and acceptability of a telephone-delivered, nurse-led, symptom management intervention for adults undergoing chemotherapy in Honduras. Over the course of 6 months, nurses engaged 25 patients undergoing chemotherapy in the intervention. Each participant received an average of 16.2 attempts to contact them for telephone sessions ( SD = 8...
February 12, 2019: Western Journal of Nursing Research
Johann S de Bono, Nicole Concin, David S Hong, Fiona C Thistlethwaite, Jean-Pascal Machiels, Hendrik-Tobias Arkenau, Ruth Plummer, Robert Hugh Jones, Dorte Nielsen, Kristian Windfeld, Srinivas Ghatta, Brian M Slomovitz, James F Spicer, Jeffrey Yachnin, Joo Ern Ang, Paul Morten Mau-Sørensen, Martin David Forster, Dearbhaile Collins, Emma Dean, Reshma A Rangwala, Ulrik Lassen
BACKGROUND: Tisotumab vedotin is a first-in-human antibody-drug conjugate directed against tissue factor, which is expressed across multiple solid tumour types and is associated with poor clinical outcomes. We aimed to establish the safety, tolerability, pharmacokinetic profile, and antitumour activity of tisotumab vedotin in a mixed population of patients with locally advanced or metastatic (or both) solid tumours known to express tissue factor. METHODS: InnovaTV 201 is a phase 1-2, open-label, dose-escalation and dose-expansion study done at 21 centres in the USA and Europe...
February 7, 2019: Lancet Oncology
Maria Gustafsson, Kristina Lämås, Ulf Isaksson, Per-Olof Sandman, Hugo Lövheim
BACKGROUND: Constipation is a common condition among older people, particularly among people living in nursing homes, and the use of drugs such as opioids is one of many factors that contribute to its high prevalence. The aim of this study was to compare the prevalence of constipation and the use of laxatives between 2007 and 2013, to analyze constipation and laxative use among people who are prescribed opioids, and to identify factors associated with constipation. METHODS: In 2007 and 2013, two surveys were performed in the county of Västerbotten in Northern Sweden, comprising all those living in nursing homes...
February 8, 2019: BMC Geriatrics
Melissa S Y Thong, Lena Koch-Gallenkamp, Lina Jansen, Heike Bertram, Andrea Eberle, Bernd Holleczek, Mechthild Waldeyer-Sauerland, Annika Waldmann, Sylke Ruth Zeissig, Hermann Brenner, Volker Arndt
BACKGROUND: Previous research suggests an age differential in health-related quality of life (HRQOL) among long-term (5-10 years post-diagnosis, LTS) colorectal cancer (CRC) survivors. Few studies have specifically addressed the association of age differentials with HRQOL for very long-term CRC survivors (>10 years post-diagnosis, VLTS) and non-cancer population controls. We aimed to assess possible deficits in HRQOL of disease-free CRC-LTS and CRC-VLTS in comparison with non-cancer population controls, and whether the observed pattern varies by age and time since diagnosis...
February 8, 2019: Acta Oncologica
Jing Zhou, Yan Liu, Kehua Zhou, Baoyan Liu, Tongsheng Su, Weiming Wang, Zhishun Liu
Background: Acupuncture has been found to be effective for treating chronic constipation. Objective: The objective of this exploratory study was to evaluate the efficacy of electroacupuncture (EA) in the subgroup of women with chronic severe functional constipation. Methods: This is a subgroup analysis of the multicenter, randomized, sham-acupuncture (SA) controlled trial. The efficacy of 822 (76%) female patients of the 1075 randomized patients with chronic severe functional constipation was evaluated...
2019: BioMed Research International
Giorgia Battipaglia, Florent Malard, Marie Therése Rubio, Annalisa Ruggeri, Anne Claire Mamez, Eolia Brissot, Federica Giannotti, Remy Dulery, Anne Christine Joly, Minh Tam Baylatry, Marie Jeanne Kossman, Jaques Tankovic, Laurent Beaugerie, Harry Sokol, Mohamad Mohty
Fecal microbiota transplantation is an effective treatment in recurrent Clostridium difficile infection. Promising results to eradicate multidrug-resistant bacteria have also been reported with this procedure, but there are safety concerns in immunocompromised patients. We report results in 10 adult patients colonized with multidrug-resistant bacteria, undergoing fecal microbiota transplantation before (n=4) or after (n=6) allogeneic hematopoietic stem cell transplantation for hematologic malignancies. Stools were obtained from healthy related or unrelated donors...
February 7, 2019: Haematologica
Ji Eun Kim, Woo Bin Yun, Mi Lim Lee, Jun Young Choi, Jin Ju Park, Hye Ryeong Kim, Bo Ram Song, Jin Tae Hong, Hyun Keun Song, Dae Youn Hwang
Constipation is an acute or chronic illness attributed to various causes, ranging from lifestyle habits to side effects of a disease. To improve the laxative effects of some traditional medicines, herbal mixtures of Liriope platyphylla, Glycyrrhiza uralensis, and Cinnamomum cassia (LGC) were evaluated for their mechanism of action and therapeutic effects in loperamide (Lop)-induced constipated Sprague Dawley rats by examining alterations in excretion parameters, histological structure, mucin secretion, and related protein levels...
February 6, 2019: Journal of Medicinal Food
A Giannini, M Caretto, E Russo, P Mannella, T Simoncini
Pelvic floor dysfunctions are a complex condition in elderly women; pelvic organ prolapse, urinary or fecal incontinence, constipation, pelvic pain, and sexual dysfunction are common problems. The goal of surgical treatment is functional reconstruction with symptom management and repair of anatomic defects. The recent advancements in surgical treatment of pelvic floor dysfunction allow several good options for choosing the best surgery for each patient. The vaginal procedure is traditionally the gold standard approach for elderly patients, but abdominal surgery is increasing as a mini-invasive approach and the robotic approach is gaining acceptance for treatment of pelvic floor dysfunctions...
February 2019: Climacteric: the Journal of the International Menopause Society
Angeliki Chorti, Samer AbuFarha, Antonios Michalopoulos, Theodosios S Papavramidis
We present an unusual case of a trocar site incision hernia at a 5-mm trocar port occurring approximately 2 weeks post-operatively after a laparoscopic cholecystectomy. The patient, in her mid-60s, reported diffuse abdominal pain, constipation, nausea and vomiting. An abdominal X-ray demonstrated dilated small bowel loops with gas-fluid levels. Abdominal computed tomography revealed the small bowel herniation through the 5-mm port site. Laparotomy confirmed a Richter's hernia of the small bowel in the fascia defect...
2019: SAGE Open Medical Case Reports
Baojian Liu, Yan Wang, Ming Bai, Di Wang, Jin Zhao, Ming Zhang, Shiren Sun
PURPOSE: At present, a diverse array of treatment regimens are available for systemic amyloid light-chain (AL) amyloidosis. Both cyclophosphamide + thalidomide + dexamethasone (CTD) and melphalan + dexamethasone (MD) regimens have been recommended as first-line therapies, but no detailed comparative studies of the two have been performed. This study is the first to compare the efficacy and tolerability of the CTD and MD regimens in the treatment of AL amyloidosis. METHODS: We retrospectively reviewed data from consecutive patients with AL amyloidosis who were treated with MD or CTD as the initial regimen between June 2012 and January 2018...
February 1, 2019: Clinical Therapeutics
Ju Young Eor, Pei Lei Tan, Sei Mi Lim, Da Hye Choi, Seok Min Yoon, Si Young Yang, Sae Hun Kim
The fecal morphology, defecation frequency, bowel function, intestinal motility, and fecal bacterial composition were evaluated to investigate the laxative effect of probiotic chocolate containing Streptococcus thermophilus MG510 and Lactobacillus plantarum LRCC5193 (LYC) on loperamide-induced constipated rats. Daily oral administration of LYC in constipated rats for two weeks was shown to significantly increase (n = 14) the defecation frequency, fecal moisture content, and relative abundance of fecal Lactobacillus and Faecalibacterium prausnitzii...
February 2019: Food Research International
Matthew Corbitt, Jagadeesh Kurtkoti, Muddassir Rashid, Sonu Nigam
A 17-year-old man presented to the emergency department 10 days postlaparoscopic appendicectomy with ongoing lower abdominal pain. The pain was associated with fevers, chills, sweating and constipation. There were no other associated symptoms. On examination, there was suprapubic and right lower quadrant tenderness and an elevated blood pressure (140/90 mm Hg). The patient later developed severe bilateral flank pain. Investigations revealed elevated C reactive protein, leukocyturia and microscopic haematuria...
February 1, 2019: BMJ Case Reports
Quanfu Li, Yungaowa Wu, Wenjuan Wang, Shuqin Deng, Caihong Jiang, Feng Chen, Jun Zhao, Hui Li, Xiaojun Bai, Jixiang Hou, Lenggaowa Da, Lanzhen Zhao, Jiali Gao, Gaowa Jin
OBJECTIVE: To assess the safety and efficacy of combined neurokinin-1 antagonist aprepitant treatment for multiple-day anthracycline chemotherapy-induced nausea and vomiting. METHODS: One hundred patients with breast cancer from department of Medical Oncology of Ordos Central Hospital from June 2015 to February 2018 were selected and randomize subdivided into 2 groups. All cases received anthracycline (30 mg/m2 /d for pirarubicin or 45 mg/m2 /d for epirubicin) and cyclophosphamide adjuvant chemotherapy, along with either the standard therapy (dexamethasone and tropisetron) or the combined aprepitant therapy (aprepitant plus dexamethasone and tropisetron)...
January 23, 2019: Current Problems in Cancer
Emilie Eiselt, Jérôme Côté, Jean-Michel Longpré, Véronique Blais, Philippe Sarret, Louis Gendron
Opioid and neurotensin (NT) receptors are expressed in both central and peripheral nervous systems where they modulate nociceptive responses. Nowadays, opioid analgesics like morphine remain the most prescribed drugs for the treatment of moderate to severe pain. However, despite their daily used, opioids can produce life-threatening side effects, such as constipation or respiratory depression. Besides, NT analogs exert strong opioid-independent analgesia. Here, we thus hypothesized that the combined use of opioid and NT agonists would require lower doses to produce significant analgesic effects, hence decreasing opioid-induced adverse effects...
January 29, 2019: European Journal of Pharmacology
Victoria Wilkinson-Smith, Neele Dellschaft, Juliet Ansell, Caroline Hoad, Luca Marciani, Penny Gowland, Robin Spiller
BACKGROUND: Chronic constipation affects approximately 17% of the population worldwide and remains an important unmet need since patients are often dissatisfied with treatment. Kiwifruit may offer an alternative to traditional laxatives and have been shown to increase stool volume, frequency and improve consistency. AIMS: Using non-invasive MRI techniques, we assessed the effect of ingestion of kiwifruit on fluid distribution in the intestines and bowel function...
January 31, 2019: Alimentary Pharmacology & Therapeutics
Z F Xu, T J Qin, H L Zhang, L W Fang, L J Pan, N B Hu, S Q Qu, B Li, Z J Xiao
Objective: To evaluate the efficacy and tolerability of ruxolitinib combined with prednisone, thalidomide and danazol for treatment of in myelofibrosis (MF). Methods: Patients of MF according to the WHO 2016 criteria, received ruxolitinib (RUX) combined with prednisone, thalidomide and danazol (PTD). The response, changes of blood counts and adverse events were evaluated. Results: Six PMF and one post-ET MF patients were enrolled. Four patients presented JAK2V617F mutation, one CALR mutation, one MPL mutation, one triple-negative...
January 14, 2019: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
vN P Chernus, N P Vanchakova, S K Sivkova, A S Sivkov, R V Gorenkov
AIM: Analysis of the treatment response rates of different therapy regimens of functional constipation, including Ipidacrine, a cholinesterase inhibitor, based on assessment of adaptation and compensatory mechanisms in the therapy forecast. MATERIALS AND METHODS: 77 functional slow-transit constipation patients were examined after therapy regimens of functional constipation, the mean age is 44.30±14.58 y.o. RESULTS: The treatment response rates of different therapies with Ipidacrine depends on the patient's initial adaptation and compensatory mechanisms (ACM index); certain aspects allowing to predict the expected result depending on the current mental state were identified; the severity of the state of functional constipation, ACM index and MMPI test psychometric indicators are correlated; adaptation and compensatory mechanisms of functional constipation patients were found to be reduced; the prognosis of the treatment response rates and, accordingly, the choice of the therapy regimen depend on the patient's adaptation potential (index)...
December 30, 2018: Terapevticheskiĭ Arkhiv
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