[Topical antiseptic agents]. / Antiseptische Wirkstoffe in Topika.

Topical therapy is an important domain in the treatment of dermatological diseases in the 21st century. Because multiresistant bacteria are becoming an increasing issue in medical care of chronic diseases, it is important to develop appropriate therapeutic management for acute and chronic dermatoses. The current discussion about the skin microbiota shows the importance of preserving the resident skin flora. There is a need for alternatives to topical antibiotics, e. g. topical antiseptics, which should be safe, fast, and effective but not allergenic or toxic. Even with frequent and prolonged application it is important that they do not develop a resistance. This article focusses on the use of antiseptics for medical indications. Mechanisms of action, tolerability, maximum concentrations, and possible contraindications are discussed and examples of extemporaneous antiseptic preparations are provided.

[New developments in extemporaneous formulations]. / Neue Entwicklungen der Magistralrezepturen.

Dermatology is in a state of flux, and systemic therapies have changed the prescription practice in the past few years. Nevertheless, topical therapy for dermatological illnesses is still the mainstay of dermatologists. Pharmaceutically manufactured drugs have a wide spectrum and allow for variability. Additionally, there are therapeutic niches that can be bridged by prescribing extemporaneous formulations. This is also true for the newly established basic therapies for many chronic dermatological illnesses which have become essential and are needed in large amounts. Unfortunately, neither during medical school, nor during residency training, not even the basic knowledge or the complexity of these extemporaneous formulations for topical therapy in dermatology is taught. This emphasizes why standardized, proven extemporaneous formulations are vital for physicians to achieve optimal and goal-oriented therapy for their patients. Sensible and effective prescriptions enhance the quality of formulations and the maintenance and well-being of our patients.

[Lipoid Pneumonia Associated with Lipid-Containing Nasal Sprays and Nose Drops]. / Lipidpneumonie durch Lipid-haltige Nasensprays und -tropfen.

BACKGROUND: Regularly updating the German pharmacopoeia on contemporary preparations DAC/NRF, chapter "Nasal Applications" and the recommendations on "Nasal Oils" as well as "Nasal Ointments and Emulsions", the issue of the risk of lipoid pneumonia associated with the use of plant oils and when compared to mineral oils arose. MATERIAL AND METHODS: We searched different databases: the "Grosse Deutsche Arzneimittelspezialitäten-Taxe" containing all products available in German pharmacies, the Cochrane Library, the pharmacovigilance-database of the BfArM, and Medline to evaluate the benefit/risk-ratio of plant oils in nasal drops and sprays. RESULTS: In German pharmacies, a number of both, mineral oil-containing drugs for nasal application and plant oil-containing medical devices are available. The risk of lipoid pneumonia described for mineral oil-containing nasal products can not entirely be transferred to plant oil-containing products. However, evidence from the literature suggests a risk for lipoid pneumonia, which needs to be considered given the non-proven efficacy of such medical devices in the majority of proposed indications. To minimize risks, recommendations are made for patient groups that should not use lipid-containing nasal products. CONCLUSIONS: Acknowledging the potential lethal outcome of lipoid pneumonia, a demanding diagnosis, and absence of a specific therapy, lipid-containing nasal products should be used only with great caution. Based on the current knowledge, the statements regarding the risk of lipoid pneumonia for lipid-containing nasal products in the DAC/NRF should not be modified.

Dominant rats are natural risk takers and display increased motivation for food reward.

Risk-taking behavior is a vital aspect mediating the formation of social structure in animals. Here, we utilized the visible burrow system (VBS), a model in which rats form dominance hierarchies, to test the hypothesis that dominant rats in the VBS are natural risk takers and display an increased motivational state after VBS exposure. In particular, we predicted that dominant rats would have attenuated anxiety-like behavior and augmented acquisition of operant responding for food reward relative to subordinate and controls. We further hypothesized that these behaviors would correlate with elevated mesocortical orexin signaling. Prior to burrow exposure, male Long-Evans rats were tested on the elevated plus maze (EPM), and subsequently exposed to the VBS for seven consecutive days. At the conclusion of burrow exposure body weight and plasma corticosterone were used to confirm social rank within each colony. Interestingly, rats that went on to become dominant in the VBS spent significantly more time in the open arms of the EPM prior to burrow exposure and displayed increased operant responding for food reward. This effect was present over a range of reinforcement schedules and also persisted for up to 1 month following VBS exposure. Moreover, dominant rats displayed increased orexin receptor mRNA in the medial prefrontal cortex (mPFC) relative to subordinate and control rats. These data support previous findings from our group and are consistent with the hypothesis that risk-taking behavior may precede dominance formation in social hierarchies.

Lentivirus-mediated downregulation of hypothalamic insulin receptor expression.

Regulation of feeding behavior and energy balance are among the central effects of insulin. For example, intracerebroventricular administration of insulin decreases food intake and body weight, whereas antisense oligodeoxynucleotide downregulation of insulin receptors (IRs) produces hyperphagia. To further examine the role of IRs in the central actions of insulin, we designed an IR antisense lentiviral vector (LV-IRAS) and injected this vector into the third ventricle to selectively decrease IR expression in the rat hypothalamus. Three weeks after LV-IRAS administration, the expression of IRs in the hypothalamus was significantly decreased, whereas no changes were observed in hippocampal IR levels. LV-IRAS administration decreased insulin-stimulated phosphorylation of hypothalamic IRs and translocation of the insulin-sensitive glucose transporter GLUT4 in the hypothalamus; no changes in IR signaling were observed in the hippocampus of LV-IRAS-treated rats. Lentivirus-mediated downregulation of IR expression and signaling produced significant increases in body weight, as well as increases in fat mass that were selective for the subcutaneous compartment. Conversely, lean muscle mass and water mass were not affected in LV-IRAS-treated rats compared to rats treated with control virus. Changes in peripheral adiposity were associated with increases in basal hypothalamic leptin signaling in the absence of changes in leptin receptor expression in LV-IRAS rats. Collectively, these data illustrate the important functional relationships between hypothalamic insulin and leptin signaling in the regulation of body composition and provide insight into the mechanisms through which decreases in IR expression and signaling dysregulates leptin activity, thereby promoting increases in peripheral adiposity.