Adsorption of NO on Co-ZSM-5 leads to formation of dinitrosyls at 1895 cm~1 and Co2`(NO) 2 [l s (NO) at 1812 cm~1], Co3`ÈNO linear species [l(NO) at 1950 and 1937 cm~1] and NO`occupying cationic l as (NO) zeolite positions [l(NO) at 2133 cm~1]. The NO`and Co3`ÈNO species are of low stability and can be removed by evacuation at ambient temperature. The species start to decompose at 200 ¡C, thus Co2`(NO) 2 forming Co2`ÈNO compounds [l(NO) at 1857 cm~1]. The latter are stable up to 350 ¡C. Water strongly suppresses the formation of NO`and Co3`ÈNO. Its e †ect on the dinitrosyls is, however, weaker Co2`(NO) 2 and even small amounts of water favour the formation of species. The dinitrosyls of Co2`do not Co2`(NO) 2 react with oxygen at ambient temperature but are oxidized in an atmosphere above 100 ¡C. However, they O 2 react easily with a mixture forming surface nitrates as Ðnal products. This process is almost NO ] O 2 una †ected by water. The species start to interact with ethane at 100 ¡C and water has been Co2`(NO) 2 detected as a reaction product. These results account for the (although low) activity of Co-ZSM-5 in the reduction of NO in the absence of oxygen. The only stable species formed in a atmosphere are NO ] O 2 di †erent kinds of surface nitrates (observed in the 1650È1500 cm~1 region). The latter start to interact with ethane at 100 ¡C and nitriles are suggested as interaction intermediates. The role of di †erent surface species and the e †ect of the reactants and reaction products on the SCR of NO over Co-ZSM-5 are discussed.

Nausea and vomiting are portrayed in the specialist palliative care literature as common and distressing symptoms affecting the majority of patients with advanced cancer and other life-limiting illnesses. However, recent surveys indicate that these symptoms may be less common and bothersome than has previously been reported. The standard palliative care approach to the assessment and treatment of nausea and vomiting is based on determining the cause and then relating this back to the “emetic pathway” before prescribing drugs such as dopamine antagonists, antihistamines, and anticholinergic agents which block neurotransmitters at different sites along the pathway. However, the evidence base for the effectiveness of this approach is meager, and may be in part because relevance of the neuropharmacology of the emetic pathway to palliative care patients is limited. Many palliative care patients are over the age of 65 years, making these agents difficult to use. Greater awareness of drug interactions and QTc prolongation are emerging concerns for all age groups. The selective serotonin receptor antagonists are the safest antiemetics, but are not used first-line in many countries because there is very little scientific rationale or clinical evidence to support their use outside the licensed indications. Cannabinoids may have an increasing role. Advances in interventional gastroenterology are increasing the options for nonpharmacological management. Despite these emerging issues, the approach to nausea and vomiting developed within palliative medicine over the past 40 years remains relevant. It advocates careful clinical evaluation of the symptom and the person suffering it, and an understanding of the clinical pharmacology of medicines that are available for palliating them.

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Work may be an important issue for some palliative care patients. Additional research is needed to facilitate ongoing employment for those who wish or need to continue working.

Context: Primary hyperparathyroidism (PHPT) is commonly associated with reduced bone mineral density (BMD) presenting with osteoporosis, increasing the risk of bone fragility fractures in these patients. Bisphosphonates, due to their anti-resorptive action, are known to improve the BMD and reduce the risk of bone fragility fractures. Therefore, bisphosphonates are considered as an alternative to surgical treatment in managing osteoporosis in PHPT patients. Aim: The aim of this observational study was to assess the effect of long term bisphosphonate therapy on BMD, bone fragility fracture and biochemical markers of bone metabolism in patients with PHPT. Methodology: Fifty patients (mean age 74 years) with PHPT who were treated with long term bisphosphonate therapy were studied retrospectively. The mean baseline (before commencing bisphosphonate therapy) BMD T-scores for lumbar spine (L2-L4) and left femoral neck were −2.5 and −2.1, respectively. Fourteen patients had bone fragility fractures before initiation of bisphosphonate therapy. Results: After an average of 5 years of bisphosphonate treatment, there was a significant increase in lumbar BMD T-score (−2.5 to −2.1, p = 0.013) and a non-significant change in left femoral neck BMD T-score (−2.1 to −2.2, p = 0.497). There was no increase in bone fragility fracture rate (p = 0.167). Serum corrected calcium reduced from 2.74 mmol/L to 2.60 mmol/L (p < 0.001) and urine calcium to creatinine ratio from 0.70 to 0.55 (p < 0.0001), both within the reference range. Conclusions: Our study suggests that long term bisphosphonate therapy improves lumbar BMD and prevents increase in bone fragility fracture rate. Additionally it improves hypercalcaemia in PHPT.