Tazarotene gel with narrow-band UVB phototherapy: a synergistic combination in psoriasis

Abstract: BACKGROUND: Narrow-band UVB (NB-UVB) has been shown to be one of the most effective treatment modalities for psoriasis. Tazarotene, a known effective anti-psoriatic modality, when combined with NB-UVB may enhance the therapeutic success. OBJECTIVE: To study clinical efficacy and safety of combination of NB-UVB with topical tazarotene 0.05% gel in psoriasis. METHOD: Thirty patients with plaque psoriasis having symmetrical lesions were enrolled for 12 weeks. All patients were instructed to apply tazarotene gel on target plaque on left side of body once daily. In addition, the whole body was irradiated with NB-UVB twice weekly. Efficacy was assessed by target plaque scoring and number of treatment sessions for clearance. RESULT: Our study resulted in 3 key findings: Firstly, therapeutic efficacy of NB-UVB was enhanced by addition of tazarotene. This enhanced efficacy was more apparent in decreasing scaling and thickness as compared to decrease in erythema. Secondly, combination therapy showed faster clearance of target plaques, with reduction in mean number of treatment sessions. Thirdly, mean cumulative NB-UVB dose needed to achieve clearance of target plaques was significantly reduced with combination therapy. STUDY LIMITATIONS: The study was not randomized or controlled, but an open-label trial. The study period was relatively short, i.e., 12 weeks, without any follow-up period. CONCLUSION: Tazarotene gel significantly enhances the therapeutic efficacy of NB-UVB irradiation with faster clearance and without serious side effects.

Mejoría de la insulinosensibilidad asociada al uso prolongado de acipimox en un obeso mórbido / Improvement of insulin sensitivity associated to the large use of acipimox in a morbidly obese patient

Insulin sensitivity was estimated in a morbidity obese, insulin-resistant, glucose-intolerant patient before and after 4 weeks of treatment with acipimox (250 mg t.i.d), an orally-administred, long-acting antilypolitic drug. The ensuing fall in circulating levels of fasting free fatty acids was associated with a clear amelioration of insulin resistance, as assessed by a minimal model analysis of a frequently sampled intravenous glucose tolerance test as well as by an oral glucose tolerance test. Similarly, this treatment brought about a reappearence of GH response to oral stimulation with clonidine. The evidence showing acipimox-induced amelioration of insulin resistance in this patient without diet, exercise or weight loss should encourage exploring the potential utility of this drug in this type of patient

Tratamiento de la hiperlipidemia primaria con acipimox / Treatment of primary hyperlipidemia with acipimox

La hipertrigliceridemia es un trastorno frecuente del metabolismo de las lipoproteínas. En los pacientes con hipertrigliceridemia se deben identificar y corregir las causas secundarias como la obesidad, la diabetes mellitus descompensada, o la excesiva ingestión etílica. Cuando la hipertrigliceridemia es de origen primario y no se alcanzan concentraciones deseables de triglicéridos, a pesar de haber modificado los factores secundarios, se recomienda la terapia farmacológica, en particular en aquellos casos en los que coexistan otras condiciones de riesgo coronario. En este informe, se presenta el efecto del acipimox (derivado del ácido nicotínico), sobre el perfil de los lípidos y lipoproteínas en pacientes con hipertrigliceridemias primarias, en quienes la dieta y la pérdida de peso no logró reducir las concentraciones anormales de lípidos. De 40 sujetos que iniciaron el estudio 29 lo finalizaron (21 hombres con edad de 44,9 +- 2,0 a¿os; peso de 74,7 +- 2,3 kilos, presión arterial de 125,0/81,0 mmHg y 8 mujeres, con edad de 49, +- 3,0 a¿os, peso de 65,0 +- 3,0 kilos, presión arterial de 130,0/86,0 mmHg). Al final del período de dieta, en los hombres, la concentración del colesterol, triglicéridos y colesterol HDL fue de 206,9 +- 8,1;386,6 +- 28,1 +- 0,98 mg/dl, respectivamente. Dieciséis hombres presentaban un fenotipo IV y 5 fenotipo llb. En las mujeres, la concentración del colesterol, triglicéridos y col HDL fue de 244,6 +- 13,9;249,4 +- 37,9; y 42,9 +- 5,0 mg/dl, respectivamente. Había 3 mujeres con fenotipo lla, 2 con fenotipo llb y 3 con el tipo IV. En los pacientes con fenotipo llb, la dismunución en la concentración del colesterol total fue en promedio de 23 mg/dl, y los triglicéridos bajaron 30% en ambos sexos. En los casos de hiperlipidemia tipo IV, la respuesta fundamentalmente se observó en una reducción de los triglicéridos, alcanzando cambios de 19 y 26% al mes y dos meses de tratamiento, respectivamente. Los resultado de este estudio mostraron el acipimox disminuye significativamente la concentración del colesterol ligado a las lipoproteínas de muy baja densidad y de los triglicéridos plasmáticos, sin modificar significativamente la del colesterol HDL.

Application of high performance liquid chromatography to the analysis of some non-volatile coffee components

High performance liquid chromatography (HPLC) was applied to the analysis of caffeine, trigonelline, nicotinic acid and sucrose in Arabica an Robusta coffee. Green and roasted coffee samples were used in this study and the degradation of sucrose and trigonelline, with the formation of nicotinic acid, was followed during roasting. Caffeine did not undergo significant degradation with only 5.4% being lost under severe roasting. Sucrose was degraded rapidly during processing with light roasting producing a 97% loss and dark roasting degrading it completely. Loss of trigonelline was strongly dependent on the degree of roasting being higher in the Robusta coffee. Trigonelline degradation was associated with nicotinic acid formation both in the Arabica and Robusta coffees as a consequence of the roasting process. Trigonelline and sucrose were determined simultaneously by partition chromatography and detection with the mass detector. Determination of caffeine was carried out using reversed phase chromatography and nicotinic acid by ion-pair reversed phase chromatography. Detection in both cases was achieved using an ultraviolet detector at 272nm or 254nm, respectively. HPLC showed adequate precision and accuracy for routine analyses. In addition, the methods used were more rapid and simple than traditional procedures. HPLC appears to be a suitable technique for quality control in the coffee industry, and for fundamental investigation on the mechanisms involved in the roasting process (AU) s

Influência do ácido nicotínico ministrado na dieta e por intubagem gástrica sobre a incidência de cárie em ratos submetidos à dieta cariogênica e à ração de laboratório / The influence of nicotinic acid administered in the diet or by gastric intubation on the incidence of dental caries in rats submitted to cariogenic diet and laboratory chow

Foi estudado o efeito do ácido nicotínico ministrado na dieta e por intubagem gástrica sobre a incidência de cárie em ratos submetidos à dieta cariogênica e à ração de laboratório. Ratos que receberam ácido nicotínico misturado na dieta cariogênica ou na ração normal sofreram um aumento na incidência de cárie, porém não estatisticamente significante da dos controles sem tratamento. Por outro lado, ratos que receberam ácido nicotínico por intubagem gástrica apresentaram uma diminuição na incidência de cárie, estatisticamente significante com relação aos seus controles, sem tratamento. Os resultados demonstram que o ácido nicotínico teve uma atuação sistêmica sobre a incidência de cárie, porém a razão pela qual esta vitamina diminuiu a incidência de cárie ainda não é conhecida

Structure-activity relationship of reversible cholinesterase inhibitors: activation, channel blockade and stereospeceficity of the nicotinic acetylcholine receptor-ion channel complex

We have shown that alt cholinesterase (ChE) inhibitors, in addition to their well-known anti-ChE activity, have multiple effects on the nicotinic acetylcholine receptor-ion channel (AChR) macromolecule resulting from interactions with the agonist recognition site and with sites located at the ion channel component. Activation, competitive antagonism and different types of noncompetitive blockade occurring at similar concentration ranges and contributing in different proportions result in complex and somewhat unpredictable alterations inn AChR function. The question is now raised as to how each effect of these compounds contributes to their antidotal property against organophosphorus (OP) poisoning, and what set of actions makes one reversible ChE inhibitor a better antidote. Many lines of evidence support the importance of direct interactions with various sites on the AChR: 1) morphological and toxicological studies with (+) physostigmine showed that anti-ChE activity is not essential to protect animals against toxicity by irreversible ChE inhibitors; 2) (-) physostigmine is far more effective against OP poisoning; 3) open channel blockers such as mecamylamine with no significant anti-ChE activity enhance the protective action of (-) physostigmine; 4) neostigmine, pyridostigmine, (-) physostigmine and (+) physostigmine showed qualitatively and quantitatively distinct toxicity and damage to endplate morphology and function. In prophylaxis and during the very early phase of OP poisoning, carbamates, especially (-) physostigmine combined with mecamylamine and atropine, could protect almost 100% of the animals exposed to multiple lethal doses of OPs...

Acido pipemidico em dose unica no tratamento das infeccoes urinarias nao complicadas. Estudo clinico prospectivo. / Single dose pipemidic acid in the treatment of uncomplicated urinary tract infections. Clinical prospective essay

Este ensaio clinico prospectivo consistiu na observacao de 30 pacientes portadores de infeccao urinaria aguda, de instalacao recente, na maioria dos casos cistites e uretrites. O criterio de inclusao foi baseado principalmente no quadro sintomatologico, independentemente do resultado das uroculturas. Pacientes de ambos os sexos foram tratados ambulatorialmente com acido pipemidico, um derivado quinolonico em dose unica de 1.600 mg por via oral. Obtivemos a remissao dos sintomas na maioria dos casos tratados, isto e, em 27 pacientes (90%), independentemente do resultado da cultura pre ou pos-medicacao. Concluimos que o tratamento com o acido pipemicico e eficaz nos casos agudos incipientes de infeccao urinaria

Estudio de la seguridad y eficacia comparativas del acido piromidico con el acido nalidixico en el tratamiento de las infecciones agudas, altas y bajas del tracto urinario. / Comparative study of the safety and efficacy of piromidic acid and the nalidixic acid in the treatment of acute, upper and lower urinary tract infections

Treinta pacientes adultos de ambos sexos, con edades entre 19 y 70 anos y con diagnostico de cistitis o pielonefritis agudas de origen bacteriano, fueron divididos em 2 grupos y tratados uno com 1500 mg de acido piromidico por dia durante 7 dias y el otro con 4 g de acido nalidixico por dia durante 7 dias. Se les practicaron diversos analisis de laboratorio con fines de seleccion y control y se hospitalizaron, valorandose clinicamente a los 2, 4 y 8 dias, asi como 25 a 30 dias despues de terminado el tratamiento. Los resultados se valoraron de acuerdo a la desaparicion de la sintomatologia, negativizacion del urocultivo y tolerancia a la droga (clinica y biologica). Se llego a la conclusion de que el acido piromidico mostro ser tan eficaz como el acido nolidixico en el tratamiento de los padecimientos senalados, encontrando una mejor tolerancia clinica al acido piromidico, la cual se hizo evidente por la menor incidencia de los efectos secundarios, sobre todo pirosis

Hiperlipemia y pancreatitis. / Hyperlipidemia and pancreatitis

Se hace una revision de 120 casos de pancreatitis aguda y cronica, con el hallazgo de 12 pacientes con dosificacion de lipidos, de ellos, la mitad presentaban hiperllipidemia. Se analizan sus caracteristicas y se revisa la literatura al respecto.Concluimos que en todo caso de pancreatitis debe ser investigada la presencia o ausencia de hiperlipidemia