Systematic review with meta-analysis: ondansetron for vomiting in children with acute gastroenteritis.

BACKGROUND: Vomiting in children with acute gastroenteritis is a common symptom, and it is considered to be the main cause of failure of oral rehydration therapy. AIM: To systematically update evidence on the effects of ondansetron (5-HT3 serotonin antagonist) for vomiting in children with acute gastroenteritis. METHODS: The Cochrane Library, MEDLINE and EMBASE databases were searched up to April 2016, with no language restrictions, for randomised controlled trials (RCTs). Reference lists of reviews and included studies were examined. RESULTS: Ten RCTs involving 1215 participants were included. Treatment with ondansetron compared with placebo increased the chance for vomiting cessation up to 1 h after drug administration, relative risk, RR, 1.49 (95% confidence interval 1.17-1.89), but there was no difference between the groups after 4, 24 and 48 h. Treatment with ondansetron compared with placebo reduced the risk of failure of oral rehydration therapy, RR 0.5 (0.37-0.69), increased the intake of oral rehydration solution in 1 h and 4 h, mean difference: 43 mL/1 h (15.5-70.5), and 91 mL/4 h (35-147), respectively, reduced the risk of hospitalisation, RR 0.53 (0.29-0.97), and reduced the need for intravenous rehydration, RR 0.45 (0.31-0.63); however, it had no effect on the need for return visits to the emergency department, RR 1.14 (0.72-1.8). Adverse effects were similar in both groups. CONCLUSIONS: Compared with placebo, ondansetron administration for vomiting in children with acute gastroenteritis can improve the efficacy of oral rehydration therapy.

Effect of static handgrip on plasma adrenomedullin concentration in patients with heart failure and in healthy subjects.

Adrenomedullin (ADM) release is enhanced in pheochromocytoma, chronic heart failure (HF), hypertension and renal diseases. This study was designed to test the hypothesis that ADM secretion increases also in response to acute stimuli, such as static effort and to compare plasma ADM response to this stimulus in patients with chronic HF and healthy persons. Eight male HF patients (II/III class NYHA) and eight healthy subjects (C) performed two 3-min bouts of static handgrip at 30% of maximal voluntary contraction, alternately with each hand without any break between the bouts. At the end of both exercise bouts and in 5 min of the recovery period, plasma ADM and catecholamines were determined. In addition, heart rate, blood pressure, and stroke volume (SV) were measured. The baseline plasma ADM and noradrenaline levels were higher, whilst plasma adrenaline and SV were lower in HF patients than in C group. The 1st exercise bout caused an increase in plasma ADM from 3.32 +/- 0.57 to 4.98 +/- 0.59 pmol l(-1) (p<0.01) in C and from 6.88 +/- 0.58 to 7.80 +/- 0.43 pmol x l(-1) (p<0.02) in HF patients. The 2nd exercise bout did not produce further elevation in plasma ADM and during recovery the hormone concentration declined to pre-exercise or lower values. There were no differences between groups in exercise-induced increases in plasma ADM. Plasma ADM correlated with SV (r = -0.419) and with noradrenaline concentrations (r = 0.427). It is concluded that static exercise causes the short-lasting increase in plasma ADM concentration which is similar in healthy subjects and in patients with mild heart failure.

[Radiotherapy and coagulation system in women with cancer of the genital tract]. / Wplyw radioterapii na profil koagulologiczno-hematologiczny kobiet z nowotworami zlosliwymi narzadu rodnego.

UNLABELLED: The question in the study was whether radiotherapy of women with neoplasma of genital tract leads to coagulation activation. The study group consisted of 51 women with cervical carcinoma (20 cases), endometrial carcinoma (22 cases) or ovarian neoplasma (9 cases). Fractionated dose of ionic energy were applied as follows: 200 cGy per day, 5 days a week, therapeutic dose of 4,500-5,000 cGy. Five coagulological tests were used. Hypercoagulability was found out prior to radiotherapy: statistically significantly elevated level of fibrinogen and higher thrombin-antithrombin III complexes (TAT) than in the control group. After radiotherapy the level of fibrinogen, prothrombin index, aPTT and TAT level did not undergo statistically significant changes. IN CONCLUSION: Hypercoagulability in women with gynecological malignancy is an effect of the disease itself. Radiotherapy does not rise coagulation activation.

Children with acute lymphoblastic leukemia: is there any subgroup of children without elevated thrombin generation? A preliminary study utilizing measurements of thrombin-antithrombin III complexes.

UNLABELLED: The mechanisms contributing to thromboembolic complications in children with acute lymphoblastic leukemia (ALL) are complex, but it is believed that two factors are of critical importance, i.e. increased thrombin generation and decreased antithrombotic potential of the blood plasma. We evaluated generation of thrombin in three periods of observation of the children: a) prior to chemotherapy, b) after remission-inducing chemotherapy, and c) after infusion of L-asparaginase in the consolidation phase. The study group consisted of 23 children (x = 6.8 years of age), and a control group of 11 children (x = 7.3 years of age). Thrombin-antithrombin III complex (TAT) was selected as a marker of thrombin generation and it was measured by ELISA method. TAT levels prior to chemotherapy were found to be normal in a small subgroup of children (7/23--ca 30%), i.e. they were within the control range (1.5-4.5 micrograms/l), but all the levels increased following remission-inducing chemotherapy. In contrast, in the major subgroup of children whose TAT levels were elevated at presentation (16/23--ca 70%) no significant changes were observed following chemotherapy. CONCLUSION: There is a subgroup of children with ALL whose thrombin generation is normal as measured by its marker--thrombin-antithrombin III (TAT). Only in those children thrombin generation increases following chemotherapy.

Effect of a short-term dietary creatine supplementation on high-energy phosphates in the rat myocardium.

The aim of this study was to find out whether creatine (Cr) feeding affects total creatine (TCr), phosphocreatine (PCr), adenine nucleotide contents and beta-hydroxy-acyl-CoA-dehydrogenase (HAD) activity in myocardium as compared to red skeletal muscle. Ten adult Wistar rats received Cr (2.5% of diet weight) for 7 days. In Cr fed rats, PCr was increased (by approx. 20%) in cardiac and in soleus muscles with ATP elevated in myocardium and TCr and free Cr in soleus. In both muscles, Cr feeding enhanced HAD activity. It is concluded, that dietary Cr does increase cardiac muscle high energy phosphate reserves and its oxidative potential.

Physiological characteristics and hormonal profile of young normotensive men with exaggerated blood pressure response to exercise.

Exaggerated blood pressure (BP) response to exercise in normotensive subjects is considered as a predictor of future hypertension. The aim of the study was to find out whether elevated BP response to exercise is associated with any other haemodynamic, metabolic or hormonal abnormalities. Abnormal BP response to exercise, i.e. systolic BP (SBP) > 200 mmHg at 150 W or lower workload, was found in 37 out of 180 normotensive, male students, aged 20-24 years. Fifteen students with elevated exercise BP (group E) volunteered for further examinations. Their resting and ambulatory BP showed high normal values. Eight of them had a family history of hypertension. Four subjects met the criteria of cardiac hypertrophy. Significant correlations were found between exercise SBP and left ventricular mass index, average 24 h and daytime SBP recordings. In comparison with normal subjects of the same age (group N, n = 13), those from group E did not differ in body mass index, plasma lipid profile, fasting glucose, insulin and catecholamine (CA) concentrations, but had increased erythrocyte sodium content, slightly elevated plasma renin activity and cortisol level. During exercise, E subjects showed greater cardiac output (CO) increases with normal heart rate, total peripheral resistance (TPR) and plasma CA. There were no significant differences between groups in haemodynamic and plasma CA responses to posture change from supine to standing. Glucose ingestion (75 g) caused smaller increases in CO and smaller decreases in TPR in E than in N subjects without differences in BP, blood glucose plasma insulin and CA. It is concluded that young normotensive men with exaggerated BP response to exercise show some other characteristics that may be considered as markers of predisposition to hypertension or factors promoting the development of hypertension.

Linear features of Polish population in the years 1962-1992. Tendencies in changes.

Cross-sectional material gathered in the years 1962-1992 in a group of 7001 men and 3852 women served as a basis for some measurements of body height (V-B), trunk length (sst-sy), lower limb length (sy-B), upper limb length (a-da), and length of the head together with the neck (V-sst). On the basis of results of mean values obtained from an annual series of examinations--altogether 31 observations were carried out--some statistical methods of analysis were applied with reference to each feature, among others the method of a simple moving average and linear regression of smoothed trend curves. The obtained results allow an evaluation of the dimorphic differences in the size of changes of particular linear features and a determination of the direction of these changes. A greater dynamism of the growth of body height and trunk length as well as tendencies of decreasing the length of lower limbs were observed in men, whereas the dynamism of changes with reference to the length of the head together with the neck was smaller than in women. The pace of changes of the analyzed linear features indicates clearly the process of deepening the differences in the proportions of body build.

[Effect of isosorbide dinitrate (sorbonit) on the exercise reaction in patients with coronary disease and in healthy individuals]. / Wplyw dwuazotanu izosorbitu (Sorbonit) na obraz reakcji wysilkowej u ludzi z niewydolnoscia wiencowa oraz u zdrowych.

The study aimed at evaluating an effect of a single dose of isosorbide dinitrate (Sorbonit) on the exercise reaction in the patients with coronary disease of various degree and in healthy individuals. The study involved 20 male patients of mean age 54.0 +/- 4.5 years with history of myocardial infarction and 12 healthy males of mean age 45.6 +/- 5.0 years. Ergometric test has been performed twice: prior to and 15 minutes after sublingual administration of isosorbide dinitrate in the dose of 10-15 mg. The first test has been interrupted when horizontal ST load exceeded 1 mm or contractions rate was 60% of the maximum value. Similar loads have been used after the administration of Sorbonit. The following parameters have been evaluated: heart rate (HR), systolic blood pressure (BPS), HR x BPS, lactate level (LA), and cardiac index. The value of the load has been measured with the aid of oxygen consumption (VO2). Significant depression of ST segment (less than 3 mm) in the exercise ECG has been noted in 8 patients following isosorbide dinitrate. Exercise tolerance has increased in these patients - CI increased during exercise following drug administration (VO2 the same as prior to the drug administration), and VO2/CI has became closer - physiological.

Supplementary static effort during dynamic exercise. Its influence on electrocardiogram, haemodynamic and metabolic adaptation of circulation in coronary patients.

Twenty men with coronary heart disease underwent the following exercise tests: a) bicycle ergometry, b) 5 kilometre walk and c) short march with a 5 kilogram weight carried in one hand. In each performed test during maximal work the following parameters were determined: oxygen uptake (VO2), plasma noradrenaline (NA) and lactate (LA) concentrations. ECG was monitored continuously and blood pressure was measured. It was found that a supplementary static load added to the dynamic work during short march with a weight resulted in the highest NA concentration. In that test, the rate-pressure product (HR X BPs) also increased and a greater ST segment depression and aggravation of arrhythmia were noted as compared to the findings obtained during the 5 kilometer march and also in the classic ergometric test.