RESUMO
Paracetamol (acetaminophen) is a molecule recognized worldwide for its anti-inflammatory and analgesic properties. While side effects are rare, some patients have allergic or non-allergic hypersensitivity to this molecule. Anamnesis helps to guide the diagnosis. The sensitivity and specificity of the specific IgE assay for paracetamol, skin tests and other in vitro challenge tests have been poorly studied. The oral provocation test remains the gold standard to confirm the diagnosis. In case of confirmed hypersensitivity to paracetamol, it is important to search for an alternative treatment. In this article, we describe a clinical case and its management.
Le paracétamol (acétaminophène) est une molécule reconnue dans le monde entier pour ses vertus anti-inflammatoires et antalgiques. Alors que les effets secondaires sont rares, certains patients présentent une hypersensibilité allergique ou non allergique à cette molécule. L'anamnèse permet d'orienter le diagnostic. Les sensibilité et spécificité du dosage des IgE spécifiques pour le paracétamol, les tests cutanés et les autres tests de provocation in vitro ont été très peu étudiés. Le test de provocation orale reste l'examen de référence pour infirmer ou affirmer le diagnostic. En cas d'hypersensibilité confirmée au paracétamol, il est important de rechercher un traitement alternatif. Dans cet article, nous décrivons l'ensemble de la prise en charge à partir d'un cas clinique.
Assuntos
Acetaminofen , Analgésicos não Narcóticos , Hipersensibilidade a Drogas , Acetaminofen/efeitos adversos , Analgésicos não Narcóticos/efeitos adversos , Criança , Hipersensibilidade a Drogas/diagnóstico , HumanosRESUMO
Squamous cervical carcinoma (SCC) requires particular attention in diagnostic and clinical management. New diagnostic tools, such as (positron emission tomography-magnetic resonance imaging) PET-MRI, consent to ameliorate clinical staging accuracy. The availability of new technologies in radiation therapy permits to deliver higher dose lowering toxicities. In this clinical scenario, new surgical concepts could aid in general management. Lastly, new targeted therapies and immunotherapy will have more room in this setting. The aim of this narrative review is to focus both on clinical management and new therapies in the precision radiotherapy era.
Assuntos
Carcinoma de Células Escamosas , Neoplasias do Colo do Útero , Feminino , Humanos , Tomografia por Emissão de Pósitrons , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/radioterapia , Neoplasias do Colo do Útero/diagnóstico por imagem , Neoplasias do Colo do Útero/radioterapia , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Quimiorradioterapia/métodos , Estadiamento de NeoplasiasRESUMO
We report the case of a woman who has a parrot fever disease. The first manifestations were headache, fever and flu-like muscle pain. The diagnostic was finally suspected by the anamnesis, which revealed that the patient lived with parrots, and confirmed by serological analysis. Pulmonary symptoms occurred only at a later stage, with the development of lesions showed by the chest CT Scan. The treatment was based on specific antibiotics, with the successful use of oral clarythromycin.
Assuntos
Pneumonia Bacteriana/diagnóstico , Pneumonia Bacteriana/microbiologia , Psitacose/diagnóstico , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
A randomized two-period crossover study was conducted in 20 healthy male volunteers to assess the effect of food on the pharmacokinetics of gepirone (BMY-13805) and its metabolite, 1-(2-pyrimidinyl)-piperazine (1-PP) after a single 20-mg dose of gepirone either after fasting or after consumption of a standard high-fat breakfast. There was a 1-week washout period between treatments. Plasma samples were obtained predose and at specified time points after dosing and analyzed for gepirone and 1-PP content by a specific gas chromatographic-mass spectrometric method. Food did not significantly affect gepirone maximum peak plasma concentration (Cmax) and half-life (t1/2). The mean gepirone Cmax was 16.98 +/- 8.12 ng/mL (fed) and 18.73 +/- 10.30 ng/mL (fasted), with mean t1/2 of 3.32 +/- 1.84 hours (fed) and 2.94 +/- 0.90 hours (fasted). Food significantly increased the mean area under the curveinf (AUCinf) from 55.26 +/- 35.74 ng.hour/mL (fasted) to 75.69 +/- 42.79 ng.hour/mL (fed), and the mean residence timeinf (MRTinf) from 4.31 +/- 0.78 hours (fasted) to 5.37 +/- 1.21 hours (fed). The median time to maximum plasma concentration (tmax) for gepirone was also significantly increased in the presence of food, 2.0 hours, versus 0.75 hours in the absence of food. For 1-PP, food had no affect on Cmax, t1/2, or AUCinf. Mean t1/2 for 1-PP in the presence and absence of food was 6.06 +/- 1.75 and 5.76 +/- 1.75 hours, respectively. MRTinf, however, was increased significantly from 9.32 +/- 2.68 hours (fasted) to 10.53 +/- 2.89 hours (fed).(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Ansiolíticos/farmacocinética , Antidepressivos/farmacocinética , Alimentos , Pirimidinas/farmacocinética , Administração Oral , Adolescente , Adulto , Disponibilidade Biológica , Buspirona/análogos & derivados , Buspirona/sangue , Buspirona/farmacocinética , Jejum/sangue , Humanos , Masculino , Pirimidinas/administração & dosagem , Pirimidinas/sangueRESUMO
Changes in the refractive index of Ti:Al(2)O(3) induced by 10-nsec, 532-nm pump pulses from a frequency-doubled Nd:YAG laser have been measured interferometrically at 632.8 nm for signal polarizations parallel (pi) and perpendicular (sigma) to the c axis. The nonthermal portion of these changes decays on a 3-microsec time scale characteristic of the fluorescence lifetime of Ti(3+). For the sigma polarization, the nonthermal index change is equal to the concentration of excited Ti(3) ions times (4 +/- 2) x 10(-24) cm(3). The change for the pi polarization is lower by a factor of 3.7 +/- 0.6. The average change is consistent with the value estimated from a harmonic oscillator model that considers virtual transitions to a charge-transfer band.
RESUMO
Buspirone and a buspirone metabolite, 1-(2-pyrimidinyl)piperazine (1-PP), are extracted from matrix using C18 extraction columns. The metabolite and its internal standard (d4-1-PP) are derivatized with pentafluorobenzoyl chloride to the corresponding amides. The 1-PP derivatives, buspirone and the buspirone internal standard (5-fluorobuspirone) are co-chromatographed. Chromatography and detection are performed using capillary gas chromatography with a fused-silica column and selected-ion monitoring-mass spectrometry. Linear range of the standard curves in plasma is 0.1-14 ng/ml for buspirone and 0.2-25 ng/ml for 1-PP with lower limits of quantitation of 0.1 and 0.2 ng/ml, respectively. In urine the linear range of the standard curves is 0.2-14 ng/ml for buspirone and 8-500 ng/ml for 1-PP with lower limits of quantitation of 0.2 and 8.0 ng/ml, respectively. Intra-assay accuracies were within 14% for buspirone and 1-PP in plasma and urine. Intra-assay precision was within 12% for both compounds in both matrices.
Assuntos
Buspirona/análogos & derivados , Buspirona/análise , Buspirona/sangue , Buspirona/urina , Resíduos de Drogas/análise , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Indicadores e Reagentes , ComprimidosRESUMO
AIMS: In the recent decades many studies have been addressed in the literature to assess specific factors related to glioblastoma multiforme (GBM) invasion. However, few studies have evaluated tumour cell's interaction with specific extracellular matrix (ECM) components, and, moreover, there is a lack of information regarding the occurrence of these phenomena in paediatric GBM. METHODS AND RESULTS: ECM proteins were evaluated in six cases of paediatric GBM assessing the immunohistochemical expression of laminin, fibronectin, and type IV collagen. We used a semiquantitative scale, ranging from not detected (zero) to marked (3). Laminin expression was minimal in three cases, moderate in one case, marked and generalised in one patient and marked and focal in the last case. Fibronectin expression was minimal in three patients; moderate immunoreactivity was documented in one case. Conversely, one case was classified as marked with generalised distribution and the remaining case as marked with focal immunostaining. Type IV collagen expression was minimal in three cases, moderate in one, marked with focal reaction in one and marked with generalised reaction in the remaining case. CONCLUSIONS: This study provides additional insights into tumour invasion features of paediatric GBM, as ECM plays a pivotal role in numerous cellular functions during normal and pathological processes. Although based on a limited number of patients, this investigation may serve as a challenge for the management of paediatric GBM, stimulating trials with larger patient numbers aimed at documenting specific factors influencing GBM prognosis.