Ultimo Aggiornamento: 31 Dicembre 2002

3 citations found

Effect of mitragynine, derived from Thai folk medicine, on gastric acid secretion through opioid receptor in anesthetized rats.

Tsuchiya S, Miyashita S, Yamamoto M, Horie S, Sakai SI, Aimi N, Takayama H, Watanabe K

Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, Chiba University, 263-8522, Chiba, Japan

[Record supplied by publisher]

Mitragynine, an indole alkaloid from Thai folk medicine Mitragyna speciosa, exerts agonistic effects on opioid receptors. Gastric acid secretion is proposed to be regulated by opioid receptors in the central nervous system (CNS). Previously, we reported the dual roles (inhibition via &mgr;-opioid receptors and stimulation via kappa-opioid receptors) of the opioid system in the central control of gastric acid secretion. We investigated whether mitragynine affects gastric acid secretion via opioid receptors in the CNS. Injection of mitragynine (30 &mgr;g) alone into the lateral cerebroventricle did not have a significant effect on basal gastric acid secretion in the perfused stomach of anesthetized rats. Injection of mitragynine (3-30 &mgr;g) into the fourth cerebroventricle, like morphine, inhibited 2-deoxy-D-glucose-stimulated gastric acid secretion. The inhibitory effect of mitragynine (30 &mgr;g) was reversed by naloxone (100 &mgr;g). These results suggest that mitragynine has a morphine-like action on gastric acid secretion in the CNS.

PMID: 12044808

Pediatr Dent 2002 Jan-Feb;24(1):6-10

Stretching the safety net too far waiting times for dental treatment.

Lewis CW, Nowak AJ

Department of Pediatrics, University of Washington, and Craniofacial Center, Children's Hospital, Seattle, USA.

PURPOSE: The objective of this study was to survey pediatric dentistry program directors on perceived resource needs and changes over the last 5 years in the characteristics of their patient population and on waiting times for dental treatment with sedation or general anesthesia (GA) for children with complex dental and medical histories in hospital- and dental school-based training programs. METHODS: A 47-question survey was sent electronically to all pediatric dentistry program directors in the United States using the University of Washington's Catalyst Tools program. Two reminder messages were sent. After 3 months, the data was downloaded and descriptive statistics were performed using the SPSS for Windows version 8.0. RESULTS: Twenty-eight of 54 program directors responded with 26 usable survey responses (48%). Thirty-one percent reported outpatient clinics located in a dental school, 31% reported that their clinics were in a hospital, and 38% had clinics in both settings. Program directors perceive that the number of new, recall and emergency patients and the number of pre-school aged children and children with special health care needs had increased in their programs in the last 5 years. Payment by Medicaid was the most common insurance for children cared for in these settings. The mean waiting time for scheduling treatment with GA for a child in pain is 28 days; without pain 71 days. The mean waiting time for scheduling treatment with sedation is 36 days. The majority of program directors reported they had an adequate number of faculty and residents (61% and 66%, respectively) even though 52% of the directors were presently actively recruiting faculty. CONCLUSIONS: 1. Dental school and hospital-based training programs are an important source for an increasing number of children with complex dental needs; 2. The majority of patients treated in the programs are Medicaid beneficiaries; 3. Average waiting times for complex dental care for children in pain is 28 days with GA; without pain and need for GA 71 days; 4. There was an average 36-day wait for treatment with sedation.

PMID: 11874063, UI: 21862747

Pediatrics 2002 Jun;109(6):1093-9

A Clinical Study to Evaluate the Efficacy of ELA-Max (4% Liposomal Lidocaine) as Compared With Eutectic Mixture of Local Anesthetics Cream for Pain Reduction of Venipuncture in Children.

Eichenfield LF, Funk A, Fallon-Friedlander S, Cunningham BB

Division of Pediatric and Adolescent Dermatology, Children's Hospital, San Diego, and Departments of Pediatrics and Medicine, University of California, San Diego School of Medicine, San Diego, California.

[Medline record in process]

OBJECTIVE: A double-randomized, blinded crossover trial was performed to assess the efficacy of ELA-Max (4% liposomal lidocaine) as compared with eutectic mixture of local anesthetics (EMLA) for pain relief during pediatric venipuncture procedures. Safety was assessed by evaluation for topical or systemic effects and measurement of serum lidocaine concentrations. METHODS: A total of 120 children who were scheduled for repeat venipuncture for non-study-related reasons at 2 sites participated in the study. Patients were doubly randomized to treatment regimen (study medication application time of either 30 or 60 minutes) and to the order of application of the topical anesthetics for each venipuncture. The primary outcome measures were the child's rating of pain immediately after the venipuncture procedures using a 100-mm visual analog scale (VAS) tool and the parent's and blinded research observer's Observed Behavioral Distress scores. RESULTS: Both ELA-Max and EMLA seemed to alleviate venipuncture pain. There was no clinically or statistically significant difference in the patient VAS scores within the 30-minute or 60-minute treatment groups, and there was no clinical or statistical difference in VAS scores between the 30-minute ELA-Max treatment without occlusion and the 60-minute EMLA treatment with occlusion. There were no clinically or statistically significant differences between treatment with ELA-Max and EMLA in parental or blinded researcher Observed Behavioral Distress scores, the most frequent response at any observation time being "no distress." CONCLUSION: This study demonstrates that a 30-minute application of ELA-Max without occlusion is as safe and as effective for ameliorating pain associated with venipuncture as a 60-minute application of the prescription product EMLA requiring occlusion.

PMID: 12042548, UI: 22038479