Management of atypical uremic hemolytic syndrome in pregnant patient.

Atypical uremic haemolytic syndrome is a variant of thrombotic micro-andiopathy characterized by non-autoimmune hemolytic anemia, thrombocytopenia and acute renal failure as a result of excessive activation of the complement. Up to 60% of patients have mutations in the genes that encode the complement system. A disensing factor is required for its manifestation, including gestation. It is an entity with a high morbidity, which can decrease drastically if an early diagnosis is made and appropriate treatment is initiated. Administration of ecuilizumab has demonstrated rapid process disruption, reducing the need for extrarenal purification therapies and improving renal function and patient prognosis.

Diagnostic-therapeutic algorithm for thrombotic microangiopathy. A report of two cases.

Thrombotic microangiopathies (TMA) are a group of clinical syndromes associated with haemolytic anaemia, thrombocytopenia and organ dysfunction, mainly renal or neurological. They are associated with significant morbidity and mortality, so early diagnosis and treatment are essential. In this article we report two cases of TMA; a patient with thrombotic thrombocytopenic purpura (TTP) and a patient with atypical haemolytic uraemic syndrome (aHUS).

Diagnostic-therapeutic algorithm for thrombotic microangiopathy. A report of two cases. / Algoritmo diagnóstico-terapéutico de las microangiopatías trombóticas. A propósito de 2 casos.

Thrombotic microangiopathies (TMA) are a group of clinical syndromes associated with haemolytic anaemia, thrombocytopenia and organ dysfunction, mainly renal or neurological. They are associated with significant morbidity and mortality, so early diagnosis and treatment are essential. In this article we report two cases of TMA; a patient with thrombotic thrombocytopenic purpura (TTP) and a patient with atypical haemolytic uraemic syndrome (aHUS).

Management of atypical uremic hemolytic syndrome in pregnant patient. / Manejo de síndrome hemolítico urémico atípico en la paciente gestante.

Atypical uremic haemolytic syndrome is a variant of thrombotic micro-andiopathy characterized by non-autoimmune hemolytic anemia, thrombocytopenia and acute renal failure as a result of excessive activation of the complement. Up to 60% of patients have mutations in the genes that encode the complement system. A disensing factor is required for its manifestation, including gestation. It is an entity with a high morbidity, which can decrease drastically if an early diagnosis is made and appropriate treatment is initiated. Administration of ecuilizumab has demonstrated rapid process disruption, reducing the need for extrarenal purification therapies and improving renal function and patient prognosis.

Contactless diamagnetic trapping of living cells onto a micromagnet array.

This paper focuses on the application of magnetophoresis to a new cell patterning method. The principle was demonstrated by using a CoPt micromagnet array, producing regularly spaced magnetic traps where cells were confined without any contact under the effect of negative magnetophoresis. To obtain this effect, yeast cells (Saccharomyces cerevisiae), which are diamagnetic, were placed in an aqueous solution enriched in paramagnetic ions. Unlabeled (non-magnetic) cell manipulation by magnetophoresis requires the production of high magnetic field gradients, ensuring significant forces. Therefore, micromagnets are particularly interesting for our application, since the field gradient increases as magnet dimensions are reduced.

Selecting an electrode structure for cell sorting by differential dielectric affinity.

This paper focuses on the application of dielectrophoresis to on-chip cell sorting. Differential dielectric affinity separation is a "binary" technique, dividing a cell mixture into two distinct sub-populations. The principle and efficiency of this method are illustrated by potential energy plots of cells exposed to negative and positive dielectrophoresis. This paper aims at comparing several microelectrode structures, either bipolar or quadrupolar, in order to guide the choice of a geometry facilitating the sorting operation. This comparison relies on a 3D finite-elements calculation of the potential energy profiles obtained for each electrode shape.

Development of a rectal nicotine delivery system for the treatment of ulcerative colitis.

The aims of this investigation were: i. to develop a rectal nicotine delivery system with bioadhesives for the treatment of ulcerative colitis and ii. to evaluate nicotine transport and cytotoxicity of the delivery system using Caco-2 cell culture systems. Rectal nicotine suppository formulations were prepared in semi-synthetic glyceride bases (Suppocire AM and AI, Gattefosse Inc.) by fusion method. The in vitro release of nicotine was carried out in modified USP dissolution apparatus 1. Differential scanning calorimetry (DSC) and powder X-ray diffraction were used to study the polymorphic changes if any in the formulations. An LC method was used for the assay of nicotine. The effect of bioadhesives (glyceryl monooleate (GMO), and Carbopol) on the nicotine flux was evaluated using Caco-2 cell permeability studies and Caco-2 cell viability was determined using the MTT toxicity assay. In vitro release studies indicated that the low melting AI base was superior to that of the AM base. Presence of GMO in the formulation enhanced the release of nicotine whereas Carbopol showed an opposite effect. The enhanced release of nicotine in the presence of GMO was found to be partly due to the melting point lowering effect of this compound. Caco-2 cell absorption studies showed that there was a decrease in the flux of nicotine in the presence of both the bioadhesives. The flux of the fluorescein marker which is used to study the integrity of the cell monolayers was found to be slightly higher only in the presence of 10% (w/w) Carbopol. Nicotine, Carbopol, and GMO do not have any cytotoxic effect on these cell monolayers within the concentration range used in the formulations. Rectal nicotine formulations containing bioadhesives were developed and characterized. Both in vitro release and cell culture studies have indicated that one can manipulate the nicotine release from these rectal delivery systems by incorporation of various bioadhesives or the use of different bases in the formulation. Nicotine concentration below 2% (w/v) and bioadhesive concentration below 10% (w/w) do not have any cytotoxic effect on Caco-2 cells.

Compritol 888 ATO: an innovative hot-melt coating agent for prolonged-release drug formulations.

The aim of the present study was to assess the coating of drug-loaded sugar beads and lactose granules with Compritol 888 (National Formulary (NF)--Glyceryl Behenate). Theophylline was used as tracer and layered onto the beads, or granulated with lactose and sugar. Coating conditions (temperature, spray-rate, air pressure, etc.) were investigated for the production of prolonged release beads or granules, and dissolution kinetic curves were discussed. The study confirms the satisfactory coating potential of the hot-melt fluid-bed coating process on large spherules or granules. The optimized conditions confirm previous work, underscoring the considerable importance of the temperature of molten coating materials and the atomization air pressures. More sophisticated equipment would undoubtedly produce more efficient coating but the technique nevertheless seems promising. Practical data is now available for standard top spray equipment for fine and coarse granules. (1) Granule and spherule surface adhesion is controlled and consistent; (2) the coating is homogeneous, with continuous atomization and spraying onto the support; and (3) the release profile is directly related to the quantity of wax applied. Several competing mechanisms are also involved, including a diffusion-controlled process and a dissolution mechanism. Dissolution profiles appear to be consistent from one batch to another.

Identification of kappa- and delta-opioid receptor transcripts in immune cells.

To investigate the role of opioids as direct modulators of the immune response, we have searched for expression of the recently cloned delta, mu and kappa opioid receptors in immune cells. We have devised a reverse transcriptase-polymerase chain reaction strategy which specifically detects a region spanning putative transmembrane regions 2 to 7 for each transcript in both human and mouse immune cells. In human peripheral blood lymphocyte and monocyte preparations, delta was undetectable while the kappa transcript was present. The analysis of human cell lines revealed low but significant levels of delta opioid receptor transcripts in T, B or monocyte cell lines while the kappa transcript was found in B cell lines only. Investigation of murine cells showed the presence of transcript for the delta receptor in splenocytes and in some T and B cell lines. Unexpectedly, no expression of the mu receptor was detected. Sequence analysis of PCR products demonstrated nucleotide identity between immune and neuronal transcripts, indicating that they derive from the same genes. In conclusion, our results lead to the identification of kappa and delta opioid receptor transcripts in immune cells.

[Arterial hypertension during treatment with estro-progestative drugs]. / L'hypertension artérielle au cours du traitement par les oestro-progestatfs.

PIP: 3 cases of women becoming hypertensive while taking oral contraceptives are presented. The first was a 35-year-old mother of 4 who had developed hypertensive kidney disease in her last pregnancy. Before contraception her blood pressure was 130/75; it rose to 140/80 in 3 months and 160/100 in 6 months after taking Ovariostat (2.5-mg lynestrenol and .075-mg mestranol, combined). 2 months after discontinuing usage her pressure was 140/80. The second was a 45-year-old mother of 2 whose pressure climbed from 120/70 to 180/120 within 3 months of starting Planor (2-mg norgestrienone and .05-mg ethinyl estradiol, combined), and fell to 130/80 3 weeks after discontinuing usage. The third was a 32-year-old woman with blood pressure of 120/70 before taking Ovaristat. Within 15 days her pressure was 170/90, accompanied by severe headaches. 1 month after discontinuing usage it returned to 120/70. The discussants mention several cases in their experience, and agree with the authors that women with hypertension in pregnancy, obesity, or diabetes should not be given the pill. Normal patients should be followed carefully and advised to keep a low salt diet and normal weight.^ieng