Effect of Acute Ketamine Treatment on Sympathetic Regulation Indexed by Electrodermal Activity in Adolescent Major Depression.

Ketamine is a potential rapid-onset antidepressant characterized by sympathomimetic effects. However, the question of ketamine's use in treating adolescents' major depressive disorder (MDD) is still discussed. Thus, we aimed to study the acute effect of ketamine infusion treatment on sympathetic regulation using electrodermal activity (EDA) in addition to an assessment of depressive symptomatology in MDD adolescents. Twenty hospitalized adolescent girls with MDD (average age: 15.0 ± 1.46 yrs.) were examined before and two hours after a single intravenous infusion of ketamine. EDA was continuously recorded for 6 min, and depressive symptoms were assessed before and two hours after ketamine administration. The evaluated parameters included skin conductance level (SCL), nonspecific electrodermal responses (NS-SCRs), MADRS (questions no. 1-10, total score), and CDI (items A-E, total score). EDA parameters showed no significant changes after the ketamine treatment, and depressive symptoms were significantly reduced after the ketamine infusion. The analysis revealed a significant negative correlation between index SCL and CDI-A, CDI-E, and the total CDI score and between index NS-SCRs and MADRS no. 4 before the ketamine treatment. In conclusion, ketamine improved depressive symptomatology without a significant effect on EDA, indicating its potential safety and efficiency as an acute antidepressant intervention in adolescent MDD.

Does Erector Spinae Plane Block Decrease Analgesia Requirements After Minimal-Invasive Posterior Transpedicular Stabilization in Patients With Vertebral Body Fracture? A Prospective, Randomized, Double-Blind Controlled Study.

STUDY DESIGN: Prospective randomized placebo controlled double blind trial. OBJECTIVE: To examine the effect of ESP block after minimally invasive posterior stabilization for vertebral fractures on opioid consumption, pain, blood loss, disability level, and wound healing complications. METHODOLOGY: Patients indicated for minimal invasive posterior stabilisation were included to the study. Our primary outcome was the opioid consumption and Visual Analogue Scale (VAS) measured during the first 48 hours. Secondary outcomes used to measure the short-term outcome included Oswestry Disability Index (ODI) and Patient Reported Outcome Spine Trauma (PROST). RESULTS: In total, 60 patients were included with a 93.3% follow-up. Average morphine consumption during the PACU (Post Anaesthesia Care Unit) period was 5.357 mg in ESP group and 8.607 mg in placebo group (P = .004). Average VAS during first 24 hour was 3.944 in ESP group and 5.193 in placebo group (P = .046). Blood loss was 14.8 g per screw in ESP group and 15.4 g in placebo group (P = .387). The day2 PROST value was 33.9 in ESP group and 28.8 in placebo group (P = .008) and after 4 weeks 55.2 in ESP group and 49.9 in placebo group (P = .036). No significant differences in ODI were detected. CONCLUSION: The use of ESP block in minimally invasive spinal surgery for posterior fracture stabilization leads to a significant reduction of opioid consumption during PACU stay by 37.7%. Reduction of opioid consumption was accompanied with lower pain (VAS). We found positive effect of the ESP block on short term outcome scores, but no effect on perioperative blood loss and wound healing.

Antitussive activity of alcoxyphenyl carbamic acid analogues.

In this study we report pharmacological evaluation of four newly synthetized analogues of alcoxyphenyl carbamic acid, structurally related to butamirate citrate that is frequently used as cough suppressing drug, and marked as ATK 231, ATK 241, ATK 251 and ATK 261. These agents with various modifications of the molecular structure have been tested for antitussive activity in cough induced by inhalation of aerosol of citric acid (0.3 M) over 3 minutes using conscious guinea pigs. Results revealed significant cough suppressing activity without significant influence on specific airways resistances in all tested substances. ATK 231 and ATK241 showed significantly higher total antitussive activities when compared to both codeine phosphate and butamirate citrate, while ATK 251 only comparing to butamirate citrate. We did not observe any notable adverse effects and these compounds could thus potentially represent promising new non-narcotic antitussives suitable for further studies.

Extracted polysaccharide from Nyctanthes arbor-tristis leaves: chemical and antitussive properties.

The prevalence of cough is reflected in antitussives being one of the most widely used therapies in the world; however no new class of drugs has been introduced into the market for many years. Water decoction of the leaves of Nyctanthes arbor-tristis L. is used in Indian Ayurvedic system to alleviate a wide range of diseases including cough. Herein, we have isolated a carbohydrate polymer (CP) containing fraction from its leaves by aqueous extraction method. CP is a branched polysaccharide containing, amongst others, 1,3-/1,3,6-linked galactopyranosyl, 1,5-/1,3,5-linked arabinofuranosyl and 1,2-/1,2,4-linked rhamnopyranosyl residues. Oral administration of CP fraction in doses of 25 and 50 mg kg(-1) body weight significantly inhibited the number of citric acid-induced cough efforts in guinea pigs in a dose dependent manner. Remarkably, CP did not altered specific airway resistance of animals significantly. Consequently, aqueous extraction method provided a molecular entity, which exhibited the cough suppressive activity: this could symbolize an attractive approach in phytotherapeutic treatment.

In vivo antitussive activity of a pectic arabinogalactan isolated from Solanum virginianum L. in Guinea pigs.

ETHNOPHARMACOLOGICAL RELEVANCE: Solanum virginianum L. is used for the management of fever, bronchial asthma and cough for thousands of years. While the link to a particular indication has been established in human, the active principle of the formulation remains unknown. Herein, we have investigated a polysaccharide isolated from its leaves. MATERIALS AND METHODS: Utilizing traditional aqueous extraction protocol and using chemical, chromatographic, spectroscopic and biological methods we have analysed an antitussive pectic arabinogalactan isolated from its leaves. RESULTS: The water extracted polymer (WEP) is a highly branched arabinogalactan containing, inter alia, (1,3)-, (1,6)- and (1,3,6)-linked ß-Galp residues, terminal-, (1,5)- and (1,3,5)-linked units of α-Araf together with (1,2)- and (1,2,4)-linked Rhap. In vivo investigation on the citric-acid induced cough efforts in guinea pigs shows that the antitussive activity of the orally administered pectic arabinogalactan is greater than codeine phosphate. Remarkably, this macromolecule neither altered specific airway smooth muscle reactivity significantly nor it induced considerable change on levels of NO in expiratory flow in guinea pigs. CONCLUSIONS: Thus, traditional aqueous extraction method provides a molecular entity, which induces antitussive activity without addiction: this could represent an attractive approach in phytotherapeutic management.

Antitussive Activity of the Water-Extracted Carbohydrate Polymer from Terminalia chebula on Citric Acid-Induced Cough.

Terminalia chebula, a medicinal plant, is widely used in the management of various diseases. As the water extract of its dried ripe fruit is a frequently used preparation, we decided to look for bioactive polysaccharide in this extract. We demonstrate that the obtained polysaccharide fraction, CP, contained a highly branched arabinogalactan protein having a (1 → 3)-, (1 → 6)- and (1 → 3, 6)-linked ß -D-Galp together with (1 → 5)- and (1 → 3)-linked α -L-Araf and nonreducing end units of α -L-Araf. This polymer possesses strong antitussive property. Our results showed that the number of citric acid-induced cough efforts decreased significantly after the oral application of polysaccharide fraction in a dose of 50 mg kg(-1) body weight. Its antitussive efficacy was higher than cough suppressive effect of standard drug codeine. Therefore, traditional aqueous extraction method provides a major polysaccharide, which induces a pharmacological effect: this could represent an attractive approach in phytotherapeutic managements.

Antitussive activity of an extracellular Rhodella grisea proteoglycan on the mechanically induced cough reflex.

A mucilagineous extracellular proteoglycan (EPG) composed of xylose and its 3-O-and 4-O-methyl-derivates (55%), glucuronic acids (17%), rhamnose (14%), galactose (8%), glucose (4%) and minor amounts of other sugars (∼2%) has been isolated from culture medium of Rhodella grisea. A white fluffy algal biopolymer of molecular mass over 8.1×105 contained protein (13%), methoxyl (6%), acetyl and succinyl groups. EPG was tested in vivo on mechanically induced cough in non-anaesthetized cats as a test system. The biopolymer showed a cough suppressing effect on laryngopharyngeal type of cough while the cough from tracheobronchial mucous area was slightly or not affected. Further, the intensity of maximal cough efforts from laryngopharyngeal and tracheobronchial parts in expirium and inspirium were influenced slightly only indicating that the expectoration effect was not suppressed by biopolymer application.

Severe quadriparesis caused by wasp sting.

Besides the typical symptoms of allergic reaction after wasp sting, unusual and unexpected reactions may also develop. In this report, a case of severe peripheral quadriparesis and sphincteric disorder (urinary incontinence) in a 10-year-old boy occurring within 24 hours after wasp sting is presented. Corticosteroids had very good therapeutic effect, and improvement in clinical status was observed within 72 hours. The exact pathogenic mechanism of peripheral nervous system damage is not very well known. Several studies have suggested that besides the neurotoxic effect of wasp venom, delayed immunological response to wasp antigens followed by an allergy-triggered autoimmune reaction is possible. Wasp venom may activate an allergic reaction or effects by toxic impacts; however, typical clinical symptoms of allergic reaction are not necessarily present.