Osteopathic Cranial Manipulation for a Patient With Whiplash-Associated Disorder: A Case Report.

Objective: The purpose of this case report is to describe the immediate effects of osteopathic cranial manipulation on pain and cervical motion in a patient with whiplash-associated disorder. Clinical Features: A 74-year-old man reported daily cervicogenic headaches after a whiplash injury caused by a traffic accident 3 months prior. Physical examination and osteopathic assessment identified tissue texture alteration, positional asymmetry, limited range of motion, and tenderness. The resulting diagnosis was somatic dysfunction of the head and the cervical region. Intervention and Outcome: Osteopathic manipulative treatment was administered to the occipital area. The patient reported an immediate improvement in pain. Accessory movement of the cervical spine was improved. Conclusion: This patient responded favorable to osteopathic cranial manipulation with improved symptoms and ranges of motion.

High Penetration of Paclitaxel in Abdominal Wall of Rabbits after Hyperthermic Intraperitoneal Administration of Nab-Paclitaxel Compared to Standard Paclitaxel Formulation.

PURPOSE: Paclitaxel (PTX) is currently used in combination with cisplatin for Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for the treatment of peritoneal carcinomatosis. Albumin-bound PTX is a promising new drug for HIPEC because of its easy solubility in aqueous perfusion medium and possibly because of the tendency of albumin to cross physiological barriers and accumulate in tumor tissue. METHODS: We tested the feasibility of using nab-paclitaxel in rabbits treated by HIPEC for 60 min compared with the classical formulation at an equivalent PTX dose. Samples of perfusate and blood were collected at different time points and peritoneal tissues were collected at the end of perfusion. PTX concentrations were determined by HPLC. The depth of paclitaxel penetration through the peritoneal barrier was assessed by mass spectrometry imaging. RESULTS: PTX after nab-paclitaxel treatment penetrated up to 0.63 mm in the peritoneal wall, but after CRE-paclitaxel, it was not detectable in the peritoneum. Moreover, the peritoneal concentration after nab-paclitaxel was five times that after paclitaxel classical formulation. Despite the high levels reached in the peritoneum, systemic exposure of PTX was low. CONCLUSIONS: Our results show that nab-paclitaxel penetrates into the abdominal wall better than CRE-paclitaxel, in terms of effective penetration and peritoneal tissue concentration.