Methods. Retrospective
reviewed consecutive medical records of patients undergoing opioid switching to methadone were evaluated. Patients who were HDAC cancer switched from different opioids to methadone, because of poor pain relief in the presence of adverse effects limiting further dose increases despite symptomatic treatment, were selected. After the initial oral dose, the subsequent doses were flexible and were changed timely to fit the patients’ needs in an attempt to find the best balance between pain and opioid-related symptoms.
Results. Three hundred forty-five patients underwent switching to methadone. Twenty-seven patients were not considered feasible for analysis. Only one patient required the use of naloxone for the occurrence of bradypnea. A total of 77.4% substitutions for methadone were considered successful. The median time to achieve daily dose stabilization in patients successfully switched was 3 days. Fifty-one substitutions failed. Nepicastat For all previous opioids, no significant differences between initial
conversion ratios and ratios achieved after stabilization were found (P = 0.42). No significant correlation between the previous opioid dose and the final conversion ratio was found (P = 0.19).
Conclusions. Switching to methadone from different opioids, using an initial fixed ratio followed by a flexible dosing, according to the clinical need, is highly effective and safe when performed in an acute pain relief and palliative care unit. eFT-508 manufacturer Further studies should assess this approach in other settings.”
“Background: The purpose of the study was the application and evaluation of array Comparative Genomic Hybridization (array CGH) in selected
cases during prenatal diagnosis. Array CGH was applied in 25 fetal samples out of which 15 had normal karyotypes and abnormal ultrasound findings and 10 had apparently balanced structural aberrations with or without abnormal ultrasound findings. DNA was extracted from peripheral blood, chorionic villi samples (CV) and amniotic fluid. Bacterial Artificial Chromosome (BAC) array CGH (Cytochip, BlueGnome Ltd.) of 1 Mb was applied and results were confirmed with either Fluorescence In Situ Hybridization (FISH), Multiplex Ligation-dependant Probe Amplification (MLPA) or Real-Time PCR.
Results: Three out of 25 samples (12%), referred for prenatal array CGH, were found to carry copy number alterations. The number of cases with clinically significant alterations was 2/25 (8%), while one (4%) was of uncertain clinical significance. Two benign Copy Number Variations (CNVs) were also found in 1/25 cases (4%).
Conclusions: The outcome of this study indicates the ability of array CGH to identify chromosomal abnormalities which cannot be detected during routine prenatal cytogenetic analysis, therefore increasing the overall detection rate.