Study on extraction and isolation of thiophen compounds from root of Pluchea pteropoda Hemsl., collected at Dien Chau, Nghe An province showed that: 2- (pent-1,3-diynyl)-5-(3, 4-dihidroxybut-1-ynyl)-thiophene was isolated from the roots of Plucea Pteropoda Hemsl. This compound was needle-shaped crystal, no color, soluble in clorofoc; insoluble in n-hexan, research temperature 95-960C, its structure was identified by EI-MS, 1HNMR, 13C-NMR and DEPT. This is the first time, the thiophen derivatives were found in Pluchea pteropoda Hemsl
Thiophenes ; Plant Roots ; Plants ; medicinal

The pathophysiology of functional gastrointestinal disorder(FGID) is not completely understood, but the importance of the 'Brain-Gut Axis(BGA)' model in FGID is being increasingly recognized. The BGA model is a bidirectional, hard-wired and homeostatic relationship between the central nervous system(CNS) and the enteric nervous system(ENS) via neural, neurohormonal and neuroimmunological pathways. In addition, the BGA model would provide a rationale for the use of psychotropics on FGID. The authors experienced two cases in which duloxetine, a serotonin-norepinephrine reuptake inhibitor, was effective in relieving FGID symptoms as well as psychiatric symptoms such as depression and hypochondriacal anxiety. Therefore we discuss the vignettes from the perspective of BGA theory. Duloxetine showed efficacy in these two patients by reducing visceral hypersensivity (bottom-up regulation) and by relieving depression and anxiety(top-down regulation).
Anxiety ; Depression ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Thiophenes

Advanced Parkinson's disease is often characterized by poor control of motor features with rapid oscillations between being on, being on with severe dyskinesias, and being off or frozen. As PD progresses, effective symptom control becomes more challenging, and a more complicated drug-regimen may be needed.
OBJECTIVE: The objective was to perform a meta-analysis of randomized controlled trials of Rotigotine patch as treatment of advanced Parkinson's disease (PD).
METHODS: A systemic literature search was conducted through August 2009. Both the efficacy and srlery endpoints were evaluated.
RESULTS: The use of Rotigotine patch resulted in higher responder rates compared to placebo OR 0.37 (95% CI 0.35, 0.39). However, Rotigotine showed an adverse event profile similar to other dopamine agonists.
CONCLUSION: The use of Rotigotine patch is an effective treatment option for the management of advanced PD but demands more study.

Dopamine Agonists ; Dyskinesias ; Parkinson Disease ; Tetrahydronaphthalenes ; Thiophenes ; Treatment Outcome

PURPOSE: To compare the hematologic changes and the rates of transfusion of patients using rivaroxaban or aspirin for venous thromboembolism prophylaxis after a total knee arthroplasty. MATERIALS AND METHODS: Among patients with total knee arthroplasty from July 2010 to March 2011, two groups of 100 consecutive cases were enrolled in this study, 50 patients with Rivaroxaban group and 50 patients with Aspirin group for venous thromboembolism prophylaxis after a total knee arthoplasty. Hematologic changes and transfusion rates were calculated in each group. RESULTS: The mean of decreased hemoglobin was 4.7 (3.1-6.6) in the Rivaroxaban group and 3.6 (2.0-5.1) in the Aspirin group (p<0.05). The number of patients with decreased hemoglobin of less than 8 g/dl was observed in 23 cases (46%) in the Rivaroxaban group, and 9 cases (18%) in the Aspirin group. The numbers of patients who needed transfusion were 12 in the Rivaroxaban group, and 2 in the Aspirin group (p<0.05). CONCLUSION: Rivaroxaban group revealed more significant decrease of hemoglobin and needed more transfusion than the Aspirin group did. For the prevention of venous thromboembolism after total knee arthroplasty, we should be careful using Rivaroxaban for the standard risk patients of venous thromboembolism.
Arthroplasty ; Aspirin ; Hemoglobins ; Humans ; Knee ; Morpholines ; Thiophenes ; Venous Thromboembolism ; Rivaroxaban

Duloxetine is a balanced serotonin-norepinephrine reuptake inhibitor. Duloxetine-induced liver injury in patients with preexisting liver disease or chronic alcohol use is known. However, we have found that duloxetine can also induce liver injury in cases without those risk factors. We recommend that clinicians should monitor liver function carefully following duloxetine treatment.
Depressive Disorder, Major ; Humans ; Liver ; Liver Diseases ; Organothiophosphorus Compounds ; Risk Factors ; Thiophenes ; Duloxetine Hydrochloride

Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain and various accompanying symptoms including fatigue, sleep disturbances, and cognitive dysfunction. While the etiology of fibromyalgia is unclear, accumulating data suggest that disordered central pain processing likely plays a role in the pathogenesis of symptoms. Although the 1990 American College of Rheumatology (ACR) classification criteria for FMS were originally developed for research purposes and were not intended for clinical diagnosis, the criteria have become the de facto diagnostic criteria in clinical settings. Recently, an improved clinical case definition for FMS was proposed by ACR in 2010 to overcome several limitations of 1990 ACR criteria. Further studies are needed to assess the acceptance, reliability, and validity of the new criteria in epidemiologic and clinical studies. Many randomized controlled trials and meta-analyses confirm the therapeutic efficacy of pregabalin, duloxetine, and milnacipran, in the treatment of FMS. In view of the currently available evidence, a combination of pregabalin, duloxetine, or milnacipran as pharmacological interventions and aerobic exercise or CBT as non-pharmacological interventions seems most promising.
Cyclopropanes ; Exercise ; Fatigue ; Fibromyalgia ; gamma-Aminobutyric Acid ; Rheumatology ; Thiophenes ; Duloxetine Hydrochloride ; Pregabalin

Here we report a case of serotonin syndrome caused by fluoxetine 20 mg and duloxetine 60 mg independently eight week apart. A 65-year old man developed fever, agitation and change of mental status after two weeks treatment with 20 mg of fluoxetine for depressive disorder. He was diagnosed unknown fever origin and discharged when fever subsided as antidepressant stopped. Eight weeks later he was prescribed 60 mg of duloxetine for the treatment of depressed mood. After 18 days on duloxetine he developed fever, agitation, myoclonus and change in mental status again. He improved rapidly after discontinuation of offending drug with supportive care. Despite serotonin syndrome is usually caused by poly-pharmacy of serotonergic drugs, this case shows unusual serotonin syndrome developed by therapeutic dose of two drugs of different classes independently.
Depressive Disorder ; Dihydroergotamine ; Fever ; Fluoxetine ; Humans ; Myoclonus ; Serotonin ; Serotonin Agents ; Serotonin Syndrome ; Thiophenes ; Duloxetine Hydrochloride

Duloxetine is a relatively balanced selective serotonin and noradrenaline reuptake inhibitor. We report a case of hyponatremia induced by duloxetine developed rapidly after starting the medication in a middle-aged male with multiple somatic symptoms and depression. Two days after discontinuation of duloxetine and management with hypertonic saline as well as fluid restriction, the serum sodium level normalized. The patient had two risk factors for developing hyponatremia, such as severe body weight loss and pneumonia. Therefore, when treating patients with depression and somatic symptoms, especially with risk factors for developing hyponatremia, close monitoring for clinical and laboratory evidence of hyponatremia may be essential.
Body Weight ; Depression ; Humans ; Hyponatremia ; Male ; Norepinephrine ; Pneumonia ; Risk Factors ; Serotonin ; Sodium ; Thiophenes ; Duloxetine Hydrochloride

Stent thrombosis is a very serious problem after drug-eluting stent (DES) implantation even though its incidence is about or less than 1%. As the clopidogrel resistance is expected to play an important role in the occurrence of stent thrombosis, new anti-platelet agents overcoming this issue can give us another choice. We experienced a case of a 58-year-old male with successful prasugrel rescue therapy in a patient with clopidogrel resistance who had recurrent stent thrombosis following DES implantation.
Drug-Eluting Stents ; Humans ; Incidence ; Male ; Piperazines ; Stents ; Thiophenes ; Thrombosis ; Ticlopidine ; Prasugrel Hydrochloride

INTRODUCTIONNovel oral anticoagulants (NOACs) have at least equivalent efficacy compared to standard anticoagulants with similar bleeding risk. Optimal management strategies for bleeding complications associated with NOACs are currently unestablished.

MATERIALS AND METHODSA working group comprising haematologists and vascular medicine specialists representing the major institutions in Singapore was convened to produce this consensus recommendation. A Medline and EMBASE search was conducted for articles related to the 3 available NOACs (dabigatran, rivaroxaban, apixaban), bleeding and its management. Additional information was obtained from the product monographs and bibliographic search of articles identified.

RESULTSThe NOACs still has substantial interactions with a number of drugs for which concomitant administration should best be avoided. As they are renally excreted, albeit to different degrees, NOACs should not be prescribed to patients with creatinine clearance of <30 mLs/min. Meticulous consideration of risk versus benefits should be exercised before starting a patient on a NOAC. In patients presenting with bleeding, risk stratification of the severity of bleeding as well as identification of the source of bleeding should be performed. In life-threatening bleeds, recombinant activated factor VIIa and prothrombin complex may be considered although their effectiveness is currently unsupported by firm clinical evidence. The NOACs have varying effect on the prothrombin time and activated partial thromboplastin time which has to be interpreted with caution. Routine monitoring of drug level is not usually required.

CONCLUSIONNOACs are an important advancement in antithrombotic management and careful patient selection and monitoring will permit optimisation of their potential and limit bleeding events.

Administration, Oral ; Anticoagulants ; therapeutic use ; Benzimidazoles ; Consensus ; Dabigatran ; Hemorrhage ; prevention & control ; Humans ; Singapore ; Thiophenes