Purpose: Nausea is a common distressing symptom experienced by advanced cancer patients. This study compared the clinical efficacy of haloperidol to hydroxyzine hydrochloride in combination with haloperidol in the management of nausea induced by continuous infusion of opioids. Methods: This retrospective study comprised 50 advanced cancer patients using continuous infusion of opioids who had been administered either haloperidol alone (haloperidol group) or hydroxyzine hydrochloride with haloperidol (hydroxyzine hydrochloride group); their nausea and characteristics were assessed using multivariate analysis. Results: After the continuous infusion of opioids, nausea occurred in 34% patients in the haloperidol group and 10% patients in the hydroxyzine hydrochloride group. No significant differences were observed in patient characteristics, except for the number of the patients using infusion of opioids. By multivariate analysis, nausea before using continuous infusion of opioids, ileus, and haloperidol without hydroxyzine hydrochloride were extracted as the risk factors of nausea. In both the groups, nausea occurred only in the patients using morphine; nausea occurred in 32.5% patients in the haloperidol group and in 4.5% patients in the hydroxyzine hydrochloride group. Conclusion: Hydroxyzine hydrochloride in combination with haloperidol was observed to be more effective than haloperidol alone in the management of nausea induced by continuous infusion of opioids.

Enrolled in our study were 16 seriously handicapped persons (9 males and 7 females) institutionalized in our medical center. They were 20 to 58 years of age (mean 35 yrs). In the previous study, we found they had no evidence, serological or clinical, of osteomalacia but were verified as having significantly low bone mineral density (BMD) at the calcaneus and lumbar vertebrae. Serum levels of 25-OH-vitamin D were low and positively correlated with the lumbar vertebral BMD. Thus we postulated that low BMD was at least partly due to the lack of ultraviolet exposure. In the present study, the lumbar vertebral BMD of the above subjects were measured before and after increasing their exposure to sunlight. We found that mean lumbar BMD increased signigicantly from 770 mg/cm² to 786 mg/cm² (P<0.05, Wilcoxon, paired test). The Z-score also increased significantlyfrom 78 ± 13% to 80 ± 12%(P<0.05, Wilcoxon, paired test).
These findings suggest low BMD could be corrected to some extent by increasing sunlight exposure of institutionalized persons. Former members of farming communities who are retired, handicapped, or otherwise limited to indoor activity, can also recover their BMD and prevent osteoporosis by an increased daily exposure to sunlight.