Preliminary information has suggested that megestrol acetate leads to appetite stimulation and nonfluid weight gain in patients with breast cancer, other cancers, and AIDS. Pursuant to this, we developed a randomized, double-blind, placebo-controlled trial of megestrol acetate in patients with cancer-associated anorexia and cachexia. We randomly assigned 133 eligible patients to receive 800 mg of megestrol acetate per day or a placebo. Patients assigned to megestrol acetate more frequently reported improved appetite (P = .003) and food intake (P = .009) when compared with patients receiving the placebo. A weight gain of 15 lb or more over baseline was seen in 11 of 67 (16%) patients receiving megestrol acetate compared with one of 66 (2%) given the placebo (P = .003). Patients receiving megestrol acetate reported significantly less nausea (13% vs. 38%; P = .001) and emesis (8% vs. 25%, P = .009). No clinically or statistically significant toxic reactions were ascribed to megestrol acetate, with the exception of mild edema. This study convincingly demonstrated that megestrol acetate can stimulate appetite and food intake in patients with anorexia and cachexia associated with cancer, leading to significant weight gain in a proportion of such patients.
A topical capsaicin cream decreases postsurgical neuropathic pain and, despite some toxicities, is preferred by patients over a placebo by a three-to-one margin among those expressing a preference.
Pineal serotonin N-acetyltransferase (EC 2.3.1.5) is a neurally regulated enzyme. It is detectable in the rat as early as 4 days prior to birth. A circadian rhythm in enzyme activity appears on the fourth day after birth. It develops most rapidly during the second week and achieves an adult magnitude by the end of the third week at which time nocturnal values are more than 30-fold greater than daytime values. Norepinephrine, which appears to be the neurotransmitter regulating this enzyme, can cause a 2-to 3-fold stimulation of N-acetyltransferase in organ cultures of pineal glands from 4-day-old animals and a 17-fold increase in the activity of glands from 15-day-old animals. Apparently the norepinephrinesensitive system controlling pineal N-acetyltransferase activity also develops most rapidly during the first few weeks of life. The circadian rhythm in the activity of serotonin N-acetyltransferase develops in the pineal glands of both male and female rats at the same rate. A similar rhythm for the enzyme was not observed in twelve other tissues of the rat.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.