N-Oleoyl-Phosphatidyl-Ethanolamine and Epigallo Catechin-3-Gallate Mitigate Oxidative Stress in Overweight and Class I Obese People on a Low-Calorie Diet.

Oxidative stress and lipid peroxidation are considered key factors linking obesity with its associated complications. Epigallo catechin-3-gallate (EGCG) and oleoylethanolamide, together with its phospholipid precursor N-oleoyl-phosphatidylethanolamine (NOPE), are nutritional compounds that might improve the oxidative stress status of obese people. Unfortunately, the bioavailability of these compounds is low; however, the coadministration of NOPE with EGCG has been shown to ameliorate both the plasma availability of EGCG and the intestinal levels of NOPE in rats. This double-blind placebo-controlled study investigated the effects of 2 months' supplementation with EGCG complexed with NOPE, combined with moderate energy restriction, on plasma oxidative status of overweight and class I obese subjects. A total of 138 subjects (body mass index: 25-35 kg/m2) were recruited and randomized into two groups: the first (n = 67) received caps of placebo and the second (n = 71) caps of an oily dispersion of EGCG complexed with NOPE for 2 months. Subjects' supplementation was combined with moderate energy restriction (-800 kcal/day). Plasma oxidative status was determined by measuring the levels of oxidized low-density lipoprotein (Ox-LDL), malondialdehyde and reactive oxygen metabolites, and by calculating the lag time and the slope of Cu-induced lipid peroxidation kinetics. In total 116 subjects (27 M/89 F) completed the supplementation period, 49 in the placebo group and 67 in the treated group. Treatment induced a similar significant weight reduction in the two groups. Moreover, we found the mean changes of Ox-LDL significantly lower and the mean changes of antioxidant capacity (lag time) significantly higher in NOPE-EGCG group than in placebo group (treatment effect mean difference: -3.15 UL, P < .044 and +5.37 min, P < .0347, respectively). EGCG plasma levels were detectable only after 2 months of NOPE-EGCG diet. The NOPE-EGCG integration to a low-energy diet seems, therefore, useful for ameliorating oxidative stress-related markers, which are concomitant causes of obesity-induced disorders.

Sclerotherapy of benign oral vascular lesions with non-diluted ethanolamine oleate / Escleroterapia de lesiones vasculares orales benignas con oleato de etanolamina no diluido

Benign oral vascular lesions are anomalies characterized by the blood vessels proliferation or malformation and the treatment with the sclerosing agent ethanolamine oleate acts irrigating the vessel producing a sterile inflammatory response. The objective of this study was to report and discuss the results from treatment of benign oral vascular lesions with non-diluted ethanolamine oleate through the analysis of clinical records. The sample was composed by the selection of twenty-six patients (12 male and 14 female), with oral vascular malformations. All lesions were treated with intralesional injections of undiluted ethanolamine oleate. These patients attended in Oral Medicine outpatient clinic of the Federal University of Paraná between the years of 2011 to 2015. The average age was 60.65 years, with a higher prevalence for women. The majority of the individuals had one lesion and its location was mostly in the lower lip. The main complaint was about a physical discomfort. The lesions had the average size of 6.52 mm and received a median number of 2.32 applications. Only one patient reported feeling pain in the postoperative week. In most cases the resolution of the lesion was considered partial. Follow-up was obtained up to one month after the end of treatment. The sclerotherapy with undiluted ethanolamine oleate shows acceptable results in the treatment of small benign oral vascular lesions with a few minor side effects.

Las lesiones vasculares orales benignas son anomalías caracterizadas por la proliferación o malformación de los vasos sanguíneos y el tratamiento con el agente esclerosante etanolamina oleato actúa irrigando el vaso produciendo una respuesta inflamatoria estéril. El objetivo de este estudio fue informar y discutir los resultados del tratamiento de lesiones vasculares orales benignas con oleato de etanolamina no diluido a través del análisis de historias clínicas. La muestra estuvo compuesta por la selección de veintiséis pacientes (12 hombres y 14 mujeres), con malformaciones vasculares orales. Todas las lesiones fueron tratadas con inyecciones intralesionales de oleato de etanolamina sin diluir. Estos pacientes acudieron a la clínica ambulatoria de Medicina Oral de la Universidad Federal de Paraná entre los años 2011 a 2015. La edad promedio fue de 60,65 años, con una mayor prevalencia para las mujeres. La mayoría de los individuos tenían una lesión y su ubicación era principalmente en el labio inferior. La queja principal era sobre una molestia física. Las lesiones tenían un tamaño promedio de 6,52 mm y recibieron una mediana de 2,32 aplicaciones. Solo un paciente informó haber sentido dolor en la semana postoperatoria. En la mayoría de los casos, la resolución de la lesión se consideró parcial. El seguimiento se obtuvo hasta un mes después del final del tratamiento. La escleroterapia con oleato de etanolamina sin diluir muestra resultados aceptables en el tratamiento de pequeñas lesiones vasculares orales benignas con algunos efectos secundarios menores.

Ethanolamines permeate slowly across human skin ex vivo, but cause severe skin irritation at low concentrations.

Skin exposures are common during cleaning activities, and may contribute to the overall body burden. Cleaning products may contain irritants such as monoethanolamine (MEA) and diethanol amine (DEA). The significance of the skin exposure route is unknown, as no estimates for MEA skin permeation are available. We used in vitro flow-through diffusion cells with excised fresh human skin to measure skin permeation, and assessed skin damage with histological methods. MEA(aq) by itself (2%) or as a constituent in cleaning products (0.25% working solution) did not permeate after 1 h or 24 h of exposure. MEA(aq) (10%) did not permeate skin after 1 h but after 24 h with a delay (Tlag; 7 h) and a moderate permeation rate (J; 26.6 µg/cm2/h). MEA permeation rate was 20-fold greater (544 µg/cm2/h) and » of the time lag (1.5 h) when applied as undiluted cleaning product (13% MEA) compared to 10% MEA(aq). DEA in cleaning products did not permeate skin after 24 h. MEA and DEA produced skin irritations at low concentrations (1% MEA) and severe skin irritations when tested as a constituent in cleaning products. Absorption increased from 0 to 3% after 24 h to 14-29% after 88 h of MEA exposure, and is likely explained by the increased damage of the skin barrier. Limitations of this study are the low number of skin donors (N = 5) available. Our results demonstrate that topically applied MEA permeates across human skin relatively slowly and not below 5% while relatively extensively as a constituent of a commercial cleaning product.

Bronchoscopic sclerosis of post-resectional bronchial fistulas.

BACKGROUND: Pulmonary resection is, by far, the primary cause of bronchial fistula. This is a severe complication because of its morbidity and mortality and the related consumption of resources. Definitive closure continues to be a challenge with several therapeutic options, but none are optimal. We describe our experience in bronchoscopic application of ethanolamine and lauromacrogol 400 for the treatment of post-resection bronchial fistulas. METHODS: Clinical records of 8 patients treated using this technique were collected prospectively. The diagnosis of a fistula was confirmed by flexible bronchoscopy. Sclerosis was indicated in the context of multimodal treatment. Sclerosant injection was performed under general anesthesia with a Wang 22G needle through a flexible bronchoscope. The procedure was repeated at 2-week intervals until definitive closure of the fistula was confirmed. RESULTS: Fistula closure was achieved in 7 (87.5%) of the 8 patients, with persistence of the fistula in one patient who could not complete the treatment because of recurrence of his neoplastic pathology. No recurrence or complications related to the technique were registered. CONCLUSIONS: Bronchoscopic sclerosis by means of submucosal injection of lauromacrogol 400 or ethanolamine should be part of the multimodal treatment of bronchopleural fistula after lung resection, pending further studies that contribute to the accurate establishment of optimal indications for this procedure.

Preclinical Development of a Nontoxic Oral Formulation of Monoethanolamine, a Lipid Precursor, for Prostate Cancer Treatment.

Purpose: Most currently available chemotherapeutic agents target rampant cell division in cancer cells, thereby affecting rapidly dividing normal cells resulting in toxic side-effects. This nonspecificity necessitates identification of novel cellular pathways that are reprogrammed selectively in cancer cells and can be exploited to develop pharmacologically superior and less toxic therapeutics. Despite growing awareness on dysregulation of lipid metabolism in cancer cells, targeting lipid biosynthesis is still largely uncharted territory. Herein, we report development of a novel nontoxic orally deliverable anticancer formulation of monoethanolamine (Etn) for prostate cancer by targeting the Kennedy pathway of phosphatidylethanolamine (PE) lipid biosynthesis.Experimental Design: We first evaluated gastrointestinal tract stability, drug-drug interaction liability, pharmacokinetic, and toxicokinetic properties of Etn to evaluate its suitability as a nontoxic orally deliverable agent. We next performed in vitro and in vivo experiments to investigate efficacy and mechanism of action.Results: Our data demonstrate that Etn exhibits excellent bioavailability, gastrointestinal tract stability, and no drug-drug interaction liability. Remarkably, orally fed Etn inhibited tumor growth in four weeks by approximately 67% in mice bearing human prostate cancer PC-3 xenografts without any apparent toxicity. Mechanistically, Etn exploits selective overexpression of choline kinase in cancer cells, resulting in accumulation of phosphoethanolamine (PhosE), accompanied by downregulation of HIF-1α that induces metabolic stress culminating into cell death.Conclusions: Our study provides first evidence for the superior anticancer activity of Etn, a simple lipid precursor formulation, whose nontoxicity conforms to FDA-approved standards, compelling its clinical development for prostate cancer management. Clin Cancer Res; 23(14); 3781-93. ©2017 AACR.

Amide-linked Ethanolamine Conjugate of Gemfibrozil as a Profound HDL Enhancer: Design, Synthesis, Pharmacological Screening and Docking Study.

Elevated concentration of any or all types of lipids in the plasma including hypertriglyceridemia and hypercholesterolemia leads to atherosclerotic cardiovascular disease. Effective medication needs multiple drug therapy as recommended cholesterol and triglyceride levels are difficult to achieve by monotherapy and frequently require the use of more than one lipid-lowering medication. Gemfibrozil lowers plasma triglyceride-rich lipoproteins mainly VLDL and increases HDL. It is associated with short plasma half-life (1.5h) and GIT distress on long term use. In a study it was found that ethanolamine decreases serum cholesterol, especially VLDL cholesterol and LDL cholesterol in rats fed an HF/HC diet. In the present work, we thought of exploring the effect of co-drug of gemfibrozil with ethanolamine (GE-I) as a potential combination therapy for the management of mixed hyperlipidemia. Synthesis of GE-I was effected by CDI coupling. Structure was confirmed spectrally. Interestingly kinetic studies revealed that GE-I resisted chemical and enzymatic hydrolysis. In tritoninduced hyperlipidemia, significant lowering of serum lipid levels was observed. The hallmark of GEI was its profound effect on HDL level which was raised above the normal level by 15%. Docking study also supported modulatory effect of GE-I (docking score -7.012) on PPAR-α which was comparable to docking score of gemfibrozil (-9.432). These preliminary observations prompt us to consider GE-I as a novel, serendipitous, hybrid anti-hyperlipidemic new chemical entity which needs be studied extensively to prove it as an HDL enhancing anti-hyperlipidemic agent.

N-palmitoylethanolamine and N-acetylethanolamine are effective in asteatotic eczema: results of a randomized, double-blind, controlled study in 60 patients.

BACKGROUND: Asteatotic eczema (AE) is characterized by itchy, dry, rough, and scaling skin. The treatments for AE are mainly emollients, usually containing urea, lactic acid, or a lactate salt. N-palmitoylethanolamine (PEA) and N-acetylethanolamine (AEA) are both endogenous lipids used as novel therapeutic tools in the treatment of many skin diseases. The purpose of this study was to compare a PEA/AEA emollient with a traditional emollient in the treatment of AE. METHODS: A monocentric, randomized, double-blind, comparative trial was conducted in 60 AE patients to evaluate and compare the efficacy of the two emollients. The level of skin dryness among the subjects ranged from mild to moderate. The subjects' skin barrier function and the current perception threshold were tested for 28 days by clinical scoring and bioengineering technology. RESULTS: The results showed that, although some aspects were improved in both groups, the group using the emollient containing PEA/AEA presented a better skin surface change in capacitance. However, the most impressive finding was the ability of the PEA/AEA emollient to increase the 5 Hz current perception threshold to a normal level after 7 days, with a significant difference between values at baseline and after 14 days. A current perception threshold of 5 Hz was positively and significantly correlated with skin surface hydration and negatively correlated with transepidermal water loss in the PEA/AEA emollient group. CONCLUSION: Compared with traditional emollients, regular application of a topical PEA/AEA emollient could improve both passive and active skin functions simultaneously.

Treatment of congenital pulmonary airway malformation induced hydrops fetalis via percutaneous sclerotherapy.

Large type II and III congenital pulmonary airway malformations (CPAMs) can cause pulmonary hypoplasia, non-immune hydrops fetalis and fetal demise. Fetal intervention is indicated if hydrops fetalis develops. In this report, we describe three cases of type II and III CPAMs complicated by hydrops and treated with percutaneous sclerotherapy by ethanolamine injection into the tumor. All 3 cases demonstrated reduction in size of the CPAM and resolution of the hydrops with subsequent delivery at term. We believe that fetal percutaneous sclerotherapy can be used as a minimally invasive palliative strategy to treat CPAM-induced hydrops fetalis. Further studies are needed to delineate the risks of this novel technique.

[Studies on spray of niclosamide ethanolamine salt II observation on prevention of Schistosoma japonicum infection in bovine].

OBJECTIVE: To investigate the spray of niclosamide ethanolamine salt on prevention of bovine schistosomiasis in the field so as to provide a technical support for the improvement of schistosomiasis control strategy. METHODS: A total of 160 buffalo were selected as experimental objects marked by ear-mark numbers. All the buffalo were administered with praziquantel and then randomly divided into 3 groups, which were sprayed with niclosamide ethanolamine salt (500 ml per head) every 15 d (Group A), every 30 d (Group B) and an agent without niclosamide ethanolamine salt every 15 d (Group C as the control), respectively. The buffalo's droppings were collected to examine the eggs of schistosome every 30 days during the trial. RESULTS: Ninety days after the spraying, the prevalence rates of schistosomiasis were 4.00%, 4.08%, and 24.49% in the Group A, Group B, and Group C, respectively. Compared with the control group (Group C), the decline prevalence rates of schistosomiasis were 83.67% and 83.34% in the Group A and Group B, respectively. CONCLUSIONS: The buffalo spraying with 1% niclosamide ethanolamine salt can reduce schistosomiasis prevalence in bovine, that is this intervention has an obvious protective effect.

[Studies on spray of niclosamide ethanolamine salt. I. development and effect assessment of spray of niclosamide ethanolamine salt].

OBJECTIVE: To develop a spray of niclosamide ethanolamine salt for prevention of bovine from Schistosoma japonicum infection, and explore its characteristics and effect. METHODS: The solubilizers, penetrating agents, emulsifiers were screened, and the spray of niclosamide ethanolamine salt was formulated according to the screening results. The niclosamide ethanolamine salt was determined by using a HPLC technique, and the stability was observed. The preventive effect of the spray was assessed by in-vitro trials against cercariae and protection trials in mice. RESULTS: The screened formulation was presented as following: 1% niclosamide ethanolamine salt was dissolved in 18% dimethyl sulfoxide, and then added with 1% azone and 2% span, together with 78% ethanol, to yield a 1% spray of niclosamide ethanolamine salt. The spray appeared golden flowing liquid, with 1% niclosamide ethanolamine salt in content (W/W), pH 7.4-7.8, and good thermal and cold stability. All cercariae died (100%) while exposed to the spray at a concentration of 1.00 mg/L for 2 min, and the similar effect was achieved while exposed to 0.50 mg/L of the spray for 5 min or 0.10 mg/L for 30 min. The spray at concentrations less than 0.05 mg/L had no evident toxicity to cercariae. A volume of 0.5 ml of the 1% spray was sprayed on the abdomen of mice, 1-3 d later, the mice were infected with S. japonicum cercariae on the spraying sites, no mice were infected, with a protection rate of 100%. Five days post-spraying, the protection rate was 40%, and the worm burden reduction rate was 65.87%. Ten days later, all the mice were infected, however, the worm burden reduction rate was 51.98%. The worm burdens on days 5 or 10 post-spraying were significantly lower than those of the control (P < 0.01). The spray exhibited a good preventive efficacy to mice from S. japonicum infection in lab. CONCLUSIONS: The spray of niclosamide ethanolamine salt has stable physical and chemical property, and is a novel liquid preventive agent against bovine schistosomiasis. In addition, it has a rapid activity against S. japonicum cercariae, so can prevent bovine from S. japonicum infection.

Effects of inhaled monoethanolamine on bronchoconstriction.

We previously reported a 65-year-old man who aspirated an alkaline detergent containing 3.3% w/v (weight of solute per volume of solution) monoethanolamine (MEA) into his lungs, causing asthma-like symptoms. We presently describe the mechanism of MEA-induced bronchoconstriction according to findings in guinea pigs. In anesthetized, artificially ventilated animals, changes in airway opening pressure (P(ao)) were measured as an index of bronchoconstriction. An aerosol of 3.3% MEA solution (0.1 ml kg(-1)) inhaled through a tracheal cannula induced significantly stronger bronchoconstriction than an aerosol of potassium hydroxide (KOH) solution (0.1 ml kg(-1)) at the same pH. MEA-induced bronchoconstriction was significantly suppressed by premedication with intravenously injected atropine sulfate (3 mg kg(-1)), a muscarinic receptor antagonist, or diphenhydramine hydrochloride (10 mg kg(-1)), a histamine-H(1) receptor antagonist. MEA-induced bronchoconstriction was not enhanced by premedication with an intravenous injection of neostigmine (0.1 mg kg(-1)), an acetylcholinesterase inhibitor. When bronchoconstriction was induced by MEA, histamine concentrations in bronchoalveolar lavage fluid (BALF) were not significantly greater than in BALF after KOH-induced bronchoconstriction or in BALF after inhalation of physiologic saline. In vitro, contraction of trachea denuded of epithelium during superfusion with MEA (10 mm) was suppressed by premedication with pyrilamine maleate, a histamine-H(1) receptor antagonist, at 10 and 100 microm. Contraction of trachea denuded of epithelium during superfusion with MEA (10 mm) was suppressed by premedication with atropine sulfate at 10 and 100 microm. These results suggest that asthma-like symptoms may result partly from agonistic MEA effects at histamine-H(1) receptors and muscarinic receptors.

Should balloon-occluded retrograde transvenous obliteration be the first-line interventional radiologic treatment for bleeding duodenal varices? A case report and review of the literature.

We report a 78-year-old woman who presented with repeated tarry stools, and having lower duodenal variceal bleeding caused by portal hypertension. Endoscopic therapy had been attempted, but was impossible because the endoscope could not be inserted into the lower duodenum. Thus, the lower duodenal variceal bleeding was treated with balloon-occluded retrograde transvenous obliteration in combination with embolization using microcoils. Complete hemostasis was achieved without complications, and neither the recurrence of varices nor rebleeding has occurred for the last 3 years. A review of the English-language literature reveals only 11 such cases. The world literature is reviewed.

Serum ethanolamine and hepatocyte proliferation in perinatal and partially hepatectomized rats.

It has been shown that the administration of ethanolamine (Etn) to partially hepatectomized rats enhances stimulation of DNA synthesis in regenerating hepatocytes. The present study aimed to test the hypothesis that the level of serum Etn in vivo may be regulated to control the growth of hepatocytes. Concentrations of serum Etn were determined in rats 1) of varying ages (from embryonic-19 (E-19) to 7-week-old), and 2) during regeneration following two-thirds hepatectomy (PH), to investigate whether serum Etn concentration correlates with the rate of proliferation of hepatocytes in growing animals or during regeneration. Serum Etn levels were 3 fold higher in E-19 fetuses and newborns than in adults, and were increased 2 fold 4 h after PH and remained high for at least 24 h. Results in both systems indicated a significant positive correlation between the rate of hepatocyte proliferation and serum Etn levels. Furthermore, Etn supplementation of 0.1 to 1 mmol immediately after PH promoted a significant weight gain and stimulated phosphatidylethanolamine (PE) and phosphatidylcholine (PC) synthesis in the regenerating liver. We also observed that whenever serum Etn levels were elevated, the metabolism of PE and PC in the liver changed dynamically, first by elevating the net synthesis of PE. Taken together, these results suggested that the levels of serum Etn might be regulated based on the physiological state of an animal, which consequently regulates the proliferation of hepatocytes.

Efficacy and tolerance of the cream containing structured physiological lipids with endocannabinoids in the treatment of uremic pruritus: a preliminary study.

Uremic pruritus is still a common phenomenon in patients with end-stage renal failure, however, there is no effective treatment of choice for this condition. This study was undertaken to evaluate the efficacy and tolerance of the cream with structured physiological lipids (DMS, Derma Membrane Structure) and endogenous cannabinoids in controlling pruritus in patients on maintenance hemodialysis. Twenty-one subjects with uremic pruritus completed the trial. All patients applied the tested cream twice daily for a period of three weeks. Pruritus was evaluated using two pruritus scoring methods: standard visual analog scale (VAS) and a questionnaire method. Moreover, all patients had dry skin scored according to the 5-point scale. Global pruritus and xerosis were examined before the trial, on study visits at weekly intervals, and on follow-up visit performed two weeks of study discontinuation. After 3-week therapy pruritus was completely eliminated in 8 (38.1%) patients. Pruritus evaluation by both scales revealed significant reduction of pruritus scores (p<0.0001) during the tested product application. At the beginning of the trial there was no significant correlation between the intensity of dry skin and severity of pruritus. The 3-week treatment period resulted in complete reduction of xerosis in 17 (81%) patients, while xerosis scores were significantly reduced (p=0.0001) throughout the study period. The test product was very well tolerated by all patients. The test product appeared to be effective in reducing both pruritus and xerosis in hemodialysis patients. It is very probable that the observed decrease of pruritus with the test product therapy was not only the result of dry skin improvement but that the addition of endocannabinoids may have also played a role. These preliminary results are encouraging, however, additional controlled studies are needed to clarify the exact usefulness of this product in therapy of uremic pruritus.

Hemostasia com injeção da solução de cianoacrilato em pacientes com ruptura de varizes gástricas: estudo de série de casos / Hemostasis with cyanoacrylate solution injection in patients with gastric varices bleeding: study of a series

A hemorragia digestiva alta (HDA) é uma patologia freqüente nas emergências hospitalares, responsável por cerca de 300.000 internamentos por ano e com a mortalidade global de 1 3,2%. As causas mais freqüentes de HDA são úlcera péptica e ruptura de varizes esofagogástricas (RVEG), variando de 9 a 46%. A mortalidade na HDA por RVEG é maior que a global, entre 30 e 50%. No caso da ruptura por varizes gástricas, a hemostasia com a injeção da solução de cianoacrilato mais lipiodol (SCl) é importante para reduzir a morbimortalidade aguda, o número de unidades de hemoderivados transfundidas e tempo de internação. Este estudo tem como objetivo verificar a eficácia da hemostasia com injeção da SCl na RVEG, nas primeiras 72 horas após o procedimento. Métodos: Estudo observacional, prospectivo, tipo série de casos, incluindo 30 pacientes com hipertensão portal, submetidos a obliteração com a injeção da SCl, no período de fevereiro de 2004 a março de 2005/ no SED-CHD-HGRS. Resultados: Obteve-se a hemostasia em 100% (30/30) dos pacientes nas primeiras 72 horas. A idade média foi de 50,07 anos, sexo masculino em 66,7% (20/30) e feminino em 33/9% (10/30). Dentre as causas da hemorragia, varizes gástricas tipo I corresponderam a 10% (3/30)/ tipo 11 a 46% (14 / 30)/ tipo 111 a 10% (3/30), tipo I e 11 a 13/3% (4/30)/ úlcera pós-esclerose a 3,3% (1/30) e variz subcárdica a 16/7% (5/30). A etiologia da hipertensão portal foi de 43,3% (13/30) para doença crônica parenquimatosa do fígado de etiologia não definida (DCPFND), de 23,3% (7/30) DPCF por doença alcoólica do fígado (DAF), de 20% (6/30) por esquistossomose e de 13/3% (4/30) DCPF por vírus C. A quantidade média injetada da SCl foi de 2/63ml. Não houve dano ao endoscópio; entretanto, houve dano em 53,4% dos cateteres injetores da SCl. Conclusão: A hemostasia com injeção da SCl para obliteração na ruptura de varizes gástricas na HDA é eficaz, tecnicamente segura e diminui o ressangramento nas primeiras horas do quadro agudo

Role of combination inhaled corticosteroids and long acting beta agonists in the treatment of adult asthma.

An inhaled corticosteroid (ICS) and a long acting beta agonist (LABA) are combined in an inhaler for treatment of persistent asthma. There is evidence that maintenance therapy with a combination ICS/LABA inhaler improves clinical outcomes and reduces airflow obstruction in patients with persistent asthma, who are not well controlled even when using ICS maintenance therapy. There is evidence that a combination ICS/LABA inhaler may also play a role in initial maintenance therapy for patients with mild persistent asthma, who have never used ICS therapy. There is no evidence regarding the use of combination therapy in intermittent asthma. Oral candidal infections, hoarseness and pharyngolaryngeal pain are the most frequently reported adverse events. Combination inhaler therapy can improve compliance with guidelines that recommend a LABA only be used with concurrent ICS administration.

Administration of myo-inositol plus ethanolamine elevates phosphatidylethanolamine plasmalogen in the rat cerebellum.

Plasmalogens are ether-linked phospholipids highly abundant in nervous tissue. Previously we demonstrated that acute administration of myo-inositol (myo-Ins) + [2-(13)C] ethanolamine ([2-(13)C]Etn) significantly elevated phosphatidylethanolamine plasmalogen (PlsEtn) in rat whole brain. Current experiments investigated the effects of acute myo-Ins+[2-(13)C]Etn administration on [PlsEtn] and the biosynthesis of new Etn lipids using NMR spectroscopy in rat cerebral cortex, hippocampus, brainstem, midbrain and cerebellum. Treated rats received a single dose of myo-Ins + [2-(13)C]Etn and controls received saline rather than myoIns. Data reveal that the cerebellum is the brain region most affected by treatment, which resulted in a 22% increase in [PlsEtn] and 89% increase in newly synthesized Etn lipids relative to controls (P < 0.05). Furthermore, the cerebellar PlsEtn/phosphatidylethanolamine ratio and molar percentage of PlsEtn were significantly elevated by 12% and 8%, respectively (P < 0.05). These data suggest that myo-Ins influences Etn lipid metabolism in brain, particularly in the cerebellum where there is a stimulation in the biosynthesis of new Etn lipids with a preference towards PlsEtn.

Food intake is inhibited by oral oleoylethanolamide.

Oleoylethanolamide (OEA) may be an endogenous regulator of food intake, and intraperitoneal injection of this compound decreases food intake in 24 h-starved rats. It is generally believed that this kind of lipid amide is rapidly catabolized in the gastrointestinal tract, thereby preventing its use as an oral antiobesity compound. We now show that oral OEA inhibits food intake dose dependently at 90 min after food presentation to starved rats. Food intake was reduced by 15.5% (P < 0.01) by administration of 10 mg/kg OEA. [(3)H]OEA was used to assess the degree of catabolism in the gastrointestinal tract. The endogenous level of this acylethanolamide was increased 11 times in the intestinal tissue (to 3.91 +/- 0.98 nmol/g tissue, mean +/- SEM) at 90 min after food presentation, based on the finding of 0.48% of the dose as intact OEA. These findings reveal unexpected properties of orally administered OEA, which may have potential as a cheap and safe antiobesity drug.

[The place of endoscopic treatment in hemorrhagic ulcers]. / Place du traitement endoscopique dans l'hémorragie ulcéreuse.

INJECTIONS OF ADRENALINE: More than one third of upper gastrointestinal haemorrhages are still of ulcerous origin. In the case of active bleeding ulcers or ulcers with non-haemorrhagic visible vessels, endoscopy should be performed to stop bleeding. Injections of adrenaline, which combine efficacy, simplicity and absence of morbidity represent the treatment of choice for many. THE USE OF THERMAL METHODS: Spurting haemorrhages are probably the only haemorrhages that would benefit from injections of adrenaline combined with another haemostatic method, notably thermal. THE NEED FOR ASSOCIATED MEDICAL TREATMENT: Whatever the haemostatic method used, a powerful anti-secretory treatment administered intravenously must be associated since it will enhance the effects of endoscopic treatment.