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To evaluate the feasibility of an acupuncture protocol in the prevention of late diarrhea due to irinotecan in pediatric patients with solid tumors, a pre-post pilot study will be conducted.
Pre-post pilot study non-randomized, open label, single arm study. There will be a single study group that will be used at the same time as your own control. The intervention will take place for approximately one year.
Pre-post pilot study non-randomized, open label, single arm study.
The objective of this pilot study is to demonstrate that cancer acupuncture pediatric treatment is a safe and feasible treatment in the prevention of late-onset diarrhea related to with irinotecan.
This pilot study will include patients between 0 and 18 years of age with a solid tumor (nephroblastoma, neuroblastoma, central nervous system tumors and rhabdomyosarcoma) receiving their first cycle of irinotecan, in our center, at 50 mg/m2/intravenous dose daily for five days (cumulative dose weekly = 250 mg/m2) and who do not receive concomitant abdominal radiotherapy. Acupuncture will be applied as a complementary treatment along with the usual regimen of prophylaxis and treatment of late diarrhea.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental | Experimental | Pre-Post feasibility treatment On the first cycle of irinotecan, the patient does not receive any intervention, we only collect data. This is the control cycle. There will be a single study group that will be used at the same time as your own control. On the second cycle of irinotecan, the patient receives acupuncture. There will be a single study group that will be used at the same time as your own control. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Acupuncture | Other | 13 Indwelling, sterile and disposable needles (SEIRIN NEW PYONEX® from 0.9 mm in length and 0.22 mm in diameter) on day 1 and 5 of the second cycle of irinotecan leaving them inserted for 4 days. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity during the procedure | Evaluation of pain intensity during the insertion procedure of the indwelling needles. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 1 |
| Pain intensity during the procedure | Evaluation of pain intensity during the insertion procedure of the indwelling needles. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 5 |
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity during the intervention | Evaluation of the intensity of the pain during the days that the indwelling needles remain inserted. It will be evaluated with the same tools as the variable major. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Esther Martinez, MD | Hospital Sant Joan de Deu | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Sant Joan de Deu | Esplugues de Llobregat | Barcelona | 08950 | Spain |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D003967 | Diarrhea |
| ID | Term |
|---|---|
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D015670 | Acupuncture Therapy |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
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Pre-post feasibility
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| Day 1 |
| Pain intensity during the intervention | Evaluation of the intensity of the pain during the days that the indwelling needles remain inserted. It will be evaluated with the same tools as the variable major. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 2 |
| Pain intensity during the intervention | Evaluation of the intensity of the pain during the days that the indwelling needles remain inserted. It will be evaluated with the same tools as the variable major. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 3 |
| Pain intensity during the intervention | Evaluation of the intensity of the pain during the days that the indwelling needles remain inserted. It will be evaluated with the same tools as the variable major. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 4 |
| Pain intensity during the intervention | Evaluation of the intensity of the pain during the days that the indwelling needles remain inserted. It will be evaluated with the same tools as the variable major. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 5 |
| Pain intensity during the intervention | Evaluation of the intensity of the pain during the days that the indwelling needles remain inserted. It will be evaluated with the same tools as the variable major. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 6 |
| Pain intensity during the intervention | Evaluation of the intensity of the pain during the days that the indwelling needles remain inserted. It will be evaluated with the same tools as the variable major. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 7 |
| Pain intensity during the intervention | Evaluation of the intensity of the pain during the days that the indwelling needles remain inserted. It will be evaluated with the same tools as the variable major. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 8 |
| Pain intensity during the intervention | Evaluation of the intensity of the pain during the days that the indwelling needles remain inserted. It will be evaluated with the same tools as the variable major. The scales will be used: crying scale (0-8) (<3 years), Wong-Baker scale of faces for cooperative children (0-10) (>3 years) and numerical scale (0-10) for collaborating children (>6 years). Higher scores mean a worse result. | Day 9 |
| Side effects | Registry of other local adverse effects of acupuncture. will be delivered families recorded some items on day 9 of the second cycle (intervention cycle): local infection, hematoma, and skin damage. | Day 9 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 1 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 2 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 3 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 4 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 5 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 6 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 7 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 8 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 9 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 10 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 11 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 12 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 13 |
| Degree of severity of diarrhea | Degree of severity of diarrhea according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 (1-5). It will be evaluated after collection of data from the registration tables that families fill out. Higher scores mean a worse result. Grade 1: Increase of <4 stools per day over baseline. Grade 2: Increase of 4 - 6 stools per day over baseline Grade 3: Increase of >=7 stools per day over baseline; hospitalization indicated Grade 4: Life-threatening consequences; urgent intervention indicated Grade 5: Death | Day 14 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 1 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 2 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 3 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 4 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 5 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 6 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 7 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 8 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 9 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 10 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 11 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 12 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 13 |
| Dose of antidiarrheal drugs | Dose of antidiarrheals: the number of daily doses of loperamide (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 14 |
| Prophylactic regimen of cefixime | Prophylactic regimen of cefixime before starting the cycle of irinotecan and the use of regimen prolonged 10 days. (Yes/No) | Day 1 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 1 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 2 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 3 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 4 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 5 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 6 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 7 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 8 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 9 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 10 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 11 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 12 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 13 |
| Abdominal pain treatment-related | Degree of abdominal pain assessed with a visual analog scale of 0-10. Higher scores mean a worse result. | Day 14 |
| Satisfaction degree | Degree of satisfaction with acupuncture through a qualitative survey. Three items Yes/No and free comments | Day 15 |
| Determination of the UGT1A1 polymorphism | Determination of the UGT1A1 polymorphism by blood sample in the analysis of routine performed on day 1 of the first cycle of irinotecan (control cycle). | Day 1 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 1 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 2 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 3 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 4 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 5 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 6 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 7 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 8 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 9 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 10 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 11 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 12 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 13 |
| Nausea | Record whether or not the patient has nausea (YES/NO) | Day 14 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 1 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 2 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 3 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 4 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 5 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 6 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 7 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 8 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 9 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 10 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 11 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 12 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 13 |
| Vomiting | Record whether or not the patient has vomiting (YES/NO) | Day 14 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 1 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 2 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 3 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 4 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 5 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 6 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 7 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 8 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 9 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 10 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 11 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 12 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 13 |
| Dose of antiemetic drugs (ondasentron) | Dose of antidiarrheals: the number of daily doses of ondasentron (0-4 doses/day) will be recorded. Higher scores mean a worse result. | Day 14 |