Efficacy of tropisetron (Navoban) in controlling emesis induced in children by anti-cancer therapy.

AIMS AND BACKGROUND: High doses of metoclopramide are contraindicated to prevent chemotherapy-induced emesis in pediatric patients, since the incidence of extrapyramidal reactions is increased in these patients. The aim of this small study was to evaluate the antiemetic activity and the safety of tropisetron (a new selective antagonist of 5-HT3 receptors) in children who suffered nausea and vomiting during previous chemotherapy courses, despite the administration of an anxiolytic agent (hydroxyzine hydrochloride). METHODS: The children with a malignant neoplasm were treated for emesis with tropisetron (5 mg o.a.d. or b.i.d.) during a total of 20 cycles of chemotherapy with carboplatin combined with other antitumor agents. RESULTS: In 14 cycles (70%), there was no vomiting. There were two or less episodes of vomiting in 2 cycles (10%), 3-4 episodes in 2 cycles (10%), and no inhibition of vomiting at all in 2 cycles (10%). In 8 cycles there were no episodes of nausea (40%), in 5 cycles (25%) there were episodes of moderate nausea, and in 4 (20%) there were episodes of severe nausea. One child had a mild headache during one cycle and moderate hypotension during another. CONCLUSIONS: The results suggest that tropisetron is both efficacious and safe for the treatment of pediatric patients.

[4 cases of Horton's temporal arteritis. Hypothesis on the possible correlations with rheumatic polymyalgia]. / Quattro casi di arterite temporale di Horton. Ipotesi sulle possibili correlazioni con la polimialgia reumatica.

Giant cell arteritis (GCA) or temporal arteritis is an entity of unknown aetiology and uncertain autonomy for the close relationship with polymyalgia rheumatica (PMR). This work describes four patients with GCA alone. All patients had clinical and laboratoristic evidence of the disease and were treated with steroids. The distribution of HLA antigens showed an increased occurrence of DR4 and B8 antigens. Unfortunately, the small number of patients and the short period of observation don't allow to prove the exact nature of the link between GCA and PMR.