“
“Objective: To describe the epidemiology, patient presentation, and clinical management associated with dextromethorphan (DM) abuse.

Data sources: PubMed/Medline search using terms dextromethorphan and abuse through July 2008, bibliographies of selected publications, epidemiology tracking databases.

Study selection: By the authors.

Data extraction: English language-published review articles, clinical trials, and case reports that described the epidemiologic and toxicologic profile of DM were included.

Data synthesis: DM is a relatively inexpensive and

easily accessible Smoothened inhibitor over-the counter (OTC) medication intended for use as an antitussive. Increasingly, illicit use of the drug has been reported. At clinical doses, the drug produces few adverse effects. However, when abused in large quantities (>2 mg/kg), the drug has been associated with a dissociative effect similar to those described by ketamine and phencyclidine abusers. Massive ingestions of the drug may be associated with untoward effects, including tachycardia, hypertension, and respiratory depression. Overdose symptoms may also be associated with coformulated PRIMA-1MET products such as antihistamines and sympathomimetic amines. Management is primarily supportive. Naloxone has been used to manage DM toxicity but with conflicting reports of effectiveness.

Conclusion: Recent reports indicate that DM is often abused by individuals seeking its dissociative effects. Clinicians should be aware

of the abuse potential of DM. Pharmacists might be particularly cognizant of the risks involved with DM abuse as they control OTC access to the drug.”
“This review describes effects of miso with reference to prevention of radiation injury, cancer and hypertension with a twin focus on epidemiological and experimental evidence. Miso with a longer fermentation time Baf-A1 inhibitor increased crypt survival against radiation injury in mice. When evaluating different types of miso provided by different areas in Japan, miso fermented for a longer period increased the number of surviving

crypts, and 180 days of fermentation was the most significant. Dietary administration of 180-day fermented miso inhibits the development of azoxymethane (AOM)-induced aberrant crypt foci (ACF) and rat colon cancers in F344 rats. Miso was also effective in suppression of lung tumors, breast tumors in rats and liver tumors in mice. The incidence of gastric tumors of groups of rats given NaCl was higher than those of the groups given miso fermented for longer periods. Moreover, the systolic blood pressure of the Dahl male rat on 2.3% NaCl was significantly increased but that of the SD rat was not. However, the blood pressures of the rats on a diet of miso or commercial control diet (MF) did not increase. Even though miso contains 2.3% NaCl, their blood pressures were as stable as those of rats fed commercial diet containing 0.3% salt. So we considered that sodium in miso might behave differently compared with NaCl alone.