[Asthenia in advanced cancer and the use of psychostimulants]. / Astenia en cáncer avanzado y uso de psicoestimulantes.

Asthenia is the most frequent symptom in patients with advanced cancer and is probably what most affects the quality of life of oncology patients since it interferes in their physical and social activity. Treatment in the majority of cases is symptomatic. There is growing interest in the use of psychostimulants for treating asthenia. Methylphenidate and modafinil are two psychostimulants that have already been tested in controlled studies on asthenia of the patient with advanced cancer; they have proved to be efficient, particularly in patients in very advanced stages who are very tired.

First asymmetric hetero Diels-Alder reaction of 1-sulfinyl dienes with nitroso derivatives. A new entry to the synthesis of optically pure 1,4-imino-L-ribitol derivatives.

Hetero Diels-Alder (HDA) cycloaddition of chiral 1-p-tolylsulfinyl-1,3-pentadiene with benzyl nitrosoformate, under mild conditions, yields 2H-1,2-oxazine 3 with complete regioselectivity and pi-facial diastereoselectivity. Sequential osmylation and protection of the resulting glycol gives the oxazine 5 which is directly transformed into enantiomerically pure 1,4,5-trideoxy-1,4-imino-L-ribitol 8 by reduction under Pd/C.

Immediate adverse reaction to aminophylline.

We present a patient who experienced an immediate adverse reaction following intravenous administration of aminophylline. Skin prick, intradermal, and patch tests, RAST and indirect ELISA assays with aminophylline, theophylline and ethylenediamine were negative. A positive histamine release test was found only with ethylenediamine. Single-blind placebo-controlled challenges were positive with aminophylline and negative with theophylline. Our results suggest the reaction was a type I hypersensitivity reaction to ethylenediamine, but a nonimmune mechanism could not be excluded.