Rediscovery of penicillin of psychiatry: haloperidol decanoate

BACKGROUND: Haloperidol has been used as an effective antipsychotic for many years and continues to be one of the first options in difficult patients who require parenteral therapy in the acute phase. However, the depot form is less preferred in the treatment of patients with non-adherence among these patients whose clinical stabilization has been achieved by using parenteral haloperidol in the acute phase. Therefore, updating the information about the side effects of the depot form of haloperidol, which is still an effective treatment option, will be useful in reconsidering the position of this medicine among new and different options. METHODS: A total of 54 schizophrenic patients with severe symptoms and poor adherence to treatment who were hospitalized and treated with depot haloperidol following an acute stabilization period were included in this study. First, the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-CV) was used to confirm the diagnosis, the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) to assess the clinical severity and Global Assessment of Functioning (GAF) to assess the functionality. The Simpson-Angus Scale (SAS) was used to assess extrapyramidal side effects. With the exception of Visit 0, plasma haloperidol levels were measured at all visits. Also, measurements of waist circumference and weight, plasma fasting blood glucose, triglyceride, HDL, iron, haemoglobin (Hgb), prolactin (PRL) and HbA1c were also used for evaluation of the metabolic effects. RESULTS: Significant improvements were observed in the BPRS, SANS, SAPS scores in the long-term follow-up with the depot haloperidol treatment. While the dosage decreased over time, the plasma levels remained changed, and symptom improvement was maintained. No signs such as neuroleptic malignant syndrome or acute dystonia were observed and SAS scores were within acceptable limits during the treatment (mu = 1.40 +/- 2.55). There is no statistically significant difference between measurements of the weight even there was a significant difference between three of the waist circumference values (p = 0.987). The first measurement of the waist circumference is statistically significantly higher than both the mid-measurement and the final measurement, interestingly (p = 0.002). When fasting blood glucose, triglyceride, HDL, iron, Hgb, PRL and HbA1c were measured at different times throughout the study, only prolactin levels increased significantly over time with the use of haloperidol (p < 0.001). At the end of a year, 50% of the patients participating in the study still continued to use the haloperidol decanoate. This means also that half of the patients had stopped to use haloperidol decanoate. However, only 18.5% of them (n = 5) discontinued use of this drug because of extrapyramidal side effects. CONCLUSION: Depot haloperidol remains an effective treatment option that improves treatment compliance in challenging schizophrenia patients with severe symptoms. The long-term metabolic and extrapyramidal side effect profile of the patients were generally within the safe limits with the use of haloperidol depot. According to the obtained data, the depot haloperidol continues to be a reliable treatment option in terms of adverse effects in the maintenance treatment of schizophrenia patients with severe symptoms and poor adherence to treatment

Synthesis of magnesium silicate from wheat husk ash: Effects of parameters on structural and surface properties

In the present study, magnesium silicate was produced by using wheat husk ash. Wheat husk was burned at 600 °C to obtain an amorphous ash structure, and the ash was processed with sodium hydroxide solution with heat to extract silica. Sodium silicate solution and magnesium salts were used to synthesize magnesium silicate. The present study investigates effects of the feeding rate on magnesium silicate production (0.6 mL/min, 35 mL/min, 70 mL/min), the type of magnesium salt (MgSO4 • 7H2O or MgCl2 • 6H2O), temperature (25 °C or 50 °C), and the washing agent (water and acetone) on the chemical composition and surface characteristics of magnesium silicate. The results demonstrated that all of the variables affected the surface characteristics of magnesium silicate, such as surface area, particle size, and pore volume. However, it was also observed that the studied parameters did not affect the chemical composition of magnesium silicate. The wheat husk ash-based magnesium silicates obtained in the experimental study had a BET surface area ranging from 79 to 91 m2/g and a particle size varying from 42 to 63 µm

Graphene oxide and zinc oxide decorated chitosan nanocomposite biofilms for packaging applications

Recently, due to sustainable development and environmental protection policies, there is increasing interest in the development of new biodegradable polymer-based multifunctional composites. Chitosan is one of the most remarkable and preferred biopolymers, which is environmentally friendly as well as renewable, biocompatible, and inexpensive. Though it has a wide range of potential applications, the major limitation of chitosan - the problem of poor mechanical performance needs to be solved. In this work, graphene oxide was first produced and then used to manufacture a chitosan/graphene oxide/zinc oxide composite film through a casting method. The properties of the chitosan film and the chitosan/graphene oxide/zinc oxide composite film were investigated using Fourier transform infrared spectroscopy, mechanical, thermal gravimetric, and ultraviolet (UV)-visible spectroscopy analyses. The results showed that the incorporation of graphene oxide and zinc oxide into the chitosan matrix resulted in enhanced mechanical properties and thermal stability of chitosan biocomposite films. The graphene oxide- and zinc oxide-reinforced chitosan film showed 2527 MPa and 55.72 MPa of Young's modulus and tensile strength, respectively, while neat chitosan showed only 1549 MPa and 37.91 MPa of Young's modulus and tensile strength, respectively. Conversely, the addition of graphene oxide decreased the transmittance, notably in the UV region

8-methyl-4-morpholinoethyl-1-thia-4-azaspiro[4.5]decan-3-one

In the title compound, C(15)H(26)N(2)O(2)S, the cyclohexane and morpholine rings adopt chair conformations, while the thiazole ring has a twist conformation. An intramolecular C H center dot center dot center dot S hydrogen-bond interaction forms a five-membered ring. The crystal packing involves C-H center dot center dot center dot O=C intermolecular interactions where carbonyl O atoms act as double acceptors to two symmetrically related H atoms

rac-2-hydroxy-2,8-dimethyl-4-morpholinoethyl-1-thia-4-azaspiro[4.5]decan-3-one

The title compound, C(16)H(28)N(2)O(3)S, is dimerized by inversion symmetry-related intermolecular O-H center dot center dot center dot N hydrogen bonding, forming an R(2)(2)(16) motif. The dimers are also linked through intermolecular C-H center dot center dot center dot O hydrogen bonding. The compound is chiral with a stereogenic centre located in the thiazole ring, but in the crystal structure it forms a racemate. The thiazole ring has an envelope conformation, while the cyclohexane and morpholine rings adopt chair conformations

A Multicenter Pilot Study of Burden Among Caregivers of Geriatric Rehabilitation Patients With Neuromusculoskeletal Diseases

WOS: 000406937200005PubMed: 27080048Purpose: In this study, we aimed to describe the sociodemographic characteristics of caregivers of patients in a geriatric unit and to clarify the relationship between caregiver burden and specific clinical variables in the patients and the characteristics of the caregivers. Design: Cross-sectional multicenter study. Methods: One hundred twenty-three patients and 123 caregiver dyads, with mean ages of 72.5 +/- 7.7 years and 51 +/- 14.7 years, respectively, were included. The functional, psychological, and cognitive statuses of the patients were determined, and the sociodemographic characteristics of the caregivers as well as the type and duration of caregiving were recorded. Caregivers completed the Caregiver Burden Inventory (CBI) to measure the perceived burden of care. Most patients were female and generally lived with their family. Findings: Most of the caregivers were family members (90%), female (73.2%), primary school graduates (52.8%), and first-degree relatives (73.1%). The average CBI score was 33, and the highest CBI subscores were for time, developmental, and physical burdens. Caregiver burden correlated with the patient's ambulatory, psychological, and cognitive status and with the caregiver's age, gender, income level, and duration of caregiving. Conclusions: We have highlighted the relationship between caregiver and patient characteristics in a cohort of elderly Turkish patients with neurological and musculoskeletal disorders. In particular, we have highlighted the heavy caregiver burden in a developing country. Clinical Relevance: Our results may guide the nurses to understand the requirements of caregivers and to help them find suitable resources that would meet their needs to cope with their burden

The effects of amniotic fluid and foetal cord blood cotinine concentrations on pregnancy complications and the anthropometric measurements of newborns.

Our objective was determining the effects of amniotic fluid (AF) and fetal cord blood (FCB) cotinine concentrations on pregnancy complications and the anthropometric measurements in the newborns whose mothers underwent amniocentesis. This study was conducted as a case-control study, in Turkey. A total of 250 pregnant women with amniocentesis indication were recruited into the study and the cotinine levels in the AF and FCB were determined. A smoking habit did not statistically affect the incidence of pregnancy complications (>.05). The birth weights of the newborns were negatively correlated with the AF cotinine levels. The incidences of low birth weight, low Apgar scores and RDS were positively correlated with higher levels of cotinine in AF and FCB. It is important for healthcare staff to provide training and consultancy services for the health improvement of pregnant women and the prevention of smoking during pregnancy. Impact statement The pre-pregnancy smoking habit usually continues during the pregnancy. A significant negative correlation was present between the foetal cord blood cotinine levels and the birth weight. The anthropometric measurements of the newborns born from mothers with high AF cotinine levels were lower than newborns born from mothers with low amniotic fluid cotinine levels. Respiratory Distress syndrome is more often determined in newborns born from mothers with high AF cotinine levels. Future studies should be performed to investigate the effects of cigarette smoking on the health problems, the growth characteristics and the neurological development of newborns and infants within the first year of life

The Effects of Hyperbaric Oxygen Treatment on Total Antioxidant Capacity and Prolidase Activity after Bile Duct Ligation in Rats

Background: Hyperbaric oxygen (HBO) therapy may improve cholestasis, increase hepatic regeneration, and decrease oxidative stress in liver. In this study, we aimed to investigate the effects of HBO therapy on hepatic oxidative stress parameters, such as total thiol groups (T-SH), protein carbonyl (PCO), and total antioxidant capacity (TAC) as well as the predictive value of the noninvasive biochemical marker, sialic acid (SA), and prolidase activity in bile duct ligation (BDL)-induced oxidative damage and fibrosis in rats. Methods: We divided 32 adult male Sprague Dawley rats into four groups: sham, sham + HBO, BDL, and BDL + HBO; each group contained eight animals. We placed the sham + HBO and BDL + HBO groups in an experimental hyperbaric chamber, in which we administered pure oxygen at 2.5 atmospheres for 90 min on 14 consecutive days. Results: The application of BDL significantly increased PCO levels and prolidase activity, and decreased T-SH and TAC levels. HBO significantly decreased PCO levels and prolidase activity and increased T-SH and TAC levels in the liver tissues. There was no significant difference in sialic acid levels between any groups. Conclusions: These results indicate that HBO therapy has hepatoprotective effects on BDL-induced injury by decreasing PCO and prolidase activity and increasing antioxidant activities. We therefore suggest that HBO therapy may be useful after BDL-induced injury

In Vivo Performance of Poly(epsilon-caprolactone) Constructs Loaded with Gentamicin Releasing Composite Microspheres for Use in Bone Regeneration

For materials used in the production of dental and orthopedic implants or scaffolds for bone tissue regeneration, the properties such as capacity to enhance cell attachment and proliferation, and antimicrobial activity to prevent biofilm formation are very important to improve the clinical utility of the material. In this study, poly(epsilon-caprolactone) (PCL) sponges with antimicrobial activity were prepared by incorporating gentamicin loaded beta-tricalcium phosphate (beta-TCP)-Gelatin microspheres, and in vivo performances were studied. These composite systems are expected to enhance bone regeneration due to beta-TCP and prevent a possible infection by releasing gentannicin in the host location. The effects of gentamicin and beta-TCP/Gelatin microspheres in the sponge structure were studied in vivo by applying them on iliac crest defects of rabbits. Histological analyses after 8 weeks of implantation showed that the composite constructs performed significantly better in bone healing than those with antibiotic-free microspheres. Also, the PCL constructs carrying beta-TCP/Gelatin microspheres led to better bone formation than the pristine PCL scaffolds. Push-out tests demonstrated better integration of the constructs with the tissue indicating high level of material-tissue integration. This study indicates the importance of the presence of antibiotics and beta-TOP/Gelatin in the scaffolds to achieve better and faster healing in bone defects than pristine scaffolds