Rhabdomyolysis associated with initiation of febuxostat therapy for hyperuricaemia in a patient with chronic kidney disease.

WHAT IS KNOWN AND OBJECTIVE: Febuxostat is now recommended as the first-line pharmacological urate-lowering therapy for gout in the American College of Rheumatology guidelines. There is no case of rhabdomyolysis associated with febuxostat among reported side effects of the drug. Our objective is to report on a case of rhabdomyolysis associated with initiation of febuxostat in a patient with chronic kidney disease (CKD). CASE SUMMARY: A 73-year-old male patient visited our emergency room due to progressive weakness in both lower extremities starting 3 days earlier. Ten days before presentation, his primary physician had changed his prescription from allopurinol to febuxostat (80 mg) because of poor control of uric acid levels. There was tenderness in both thighs. Initial creatinine kinase (CK) was 7652 U/L (0-170 U/L), and a bone scan using (99m) Tc-HDP revealed strong uptake in soft tissues in both thighs and buttocks. Electromyography (EMG) and nerve conduction velocity (NCV) showed abnormal spontaneous activities (ASA), suggesting myopathy, not nerve damage. On day 7 of admission, after conservative management and febuxostat withdrawal, he could walk on the ward. He is being followed in our clinic as an outpatient with no sequelae. WHAT IS NEW AND CONCLUSION: This report is first case of rhabdomyolysis associated with initiation of febuxostat. Febuxostat should be withdrawn when rhabdomyolysis is confirmed.

Preparation and characterization of W/O microemulsion for removal of oily make-up cosmetics.

OBJECTIVE: In the present study, W/O microemulsions (MEs) were prepared for efficient removal of oily make-up cosmetics and the detergency characteristics were studied. METHODS: The W/O MEs were prepared by mixing of a spontaneous emulsifier, cosurfactant and oil, and solubilizing the mixture during addition of water. The wettability and emulsifying activity were, respectively, evaluated by measuring contact angle and absorbance after preparing a total of 20 samples using three emulsifying systems and seven oils. RESULTS: Based on the results, a lower viscosity of the oil component is favourable for higher wettability, and the lower the viscosity of the emulsifying systems, the higher the wettability of the ME. Except in the case of oleic acid (OA), oils having high polarity showed significant emulsifying activity. The equation describing [detergency(ΔE)=98.1wettability(cosθ)+120.5EAI(emulsifyingactivityindex)-77.1] was derived from the detergency measurement results, and it was verified that the wettability contributed more significantly to the detergency than the emulsifying activity. CONCLUSION: These results suggest that the prepared W/O microemulsions can be utilized as cleaning agents for efficient removal of oily make-up cosmetics.

The development of PM emission factor for small incinerators and boilers.

This study is intended to develop the emission factors of particulate matter such as TPM (total particulate matter), PM-10 (particulate matter less than 10 micrometers in aerodynamic diameter), PM-2.5 (particulate matter less than 2.5 micrometers in aerodynamic diameters) and several types of inorganic matter from small-size incinerators (less than 250 kg hr(-1) capacity) and boilers (less than 5 ton hr(-1) capacity a s steam generation) for various compositions of wastes and fuels, respectively.The emission factors for particulate matter from boilers were similar to the US EPA data. However, the emission factors from small incinerators were higher than the emission factors developed in other countries because the emission characteristics were different, especially with respect to the combustor's capacity. Emission factors for heavy metals such as cadmium, manganese, chromium, magnesium, lead, zinc, and copper were also investigated. The emission factors in this study were higher than those in other studies. Particle size distribution of PM-10 and the ratio of submicron PM to TPM were observed and a mode (peak) of submicron size particles together with a higher concentration of them was found, which could be explained by the formation of fines from vaporized metals wastes.