Common features of anaphylaxis in children

Objective: We aimed to establish the characteristics of anaphylaxis in childhood. Methods: Forty-four patients who had experienced anaphylaxis in a period of 10 years (from 1999 to 2009), were included in the study. Parameters analysed were age, gender, concomitant allergic disease, trigger, setting, clinical symptoms, treatment, prognosis and prophylaxis. Results: The total numbers of anaphylaxis cases were 44 in a ten-year period. The ages of patients ranged from 3 to 14 years (11.50 ± 3.87 years) and the majority were male. 33 of the patients (75%) had a concomitant allergic disease. The trigger was determined in 93.2% of the cases, being most frequent: food (27.3%), and SIT (25%), followed by bee sting, medications and others. Respiratory (95.5%), dermatological (90.9%), cardiovascular (20.5%), neuropsychiatric (25%), and gastrointestinal (11.4%) symptoms were seen most frequently. For anaphylaxis triggered by food, the duration of anaphylactic episode was significantly longer (p < 0.05). No biphasic reaction was observed during these attacks. Of our patients, only one developed respiratory failure and cardiac arrest due to SIT, and intensive care support was required. Discussion: As a trigger for anaphylaxis, the frequency of SIT is so high that it cannot be described by the study group including patients who were followed up in an outpatient allergy clinic (AU)

Common features of anaphylaxis in children.

OBJECTIVE: We aimed to establish the characteristics of anaphylaxis in childhood. METHODS: Forty-four patients who had experienced anaphylaxis in a period of 10 years (from 1999 to 2009), were included in the study. Parameters analysed were age, gender, concomitant allergic disease, trigger, setting, clinical symptoms, treatment, prognosis and prophylaxis. RESULTS: The total numbers of anaphylaxis cases were 44 in a ten-year period. The ages of patients ranged from 3 to 14 years (11.50 ± 3.87 years) and the majority were male. 33 of the patients (75%) had a concomitant allergic disease. The trigger was determined in 93.2% of the cases, being most frequent: food (27.3%), and SIT (25%), followed by bee sting, medications and others. Respiratory (95.5%), dermatological (90.9%), cardiovascular (20.5%), neuropsychiatric (25%), and gastrointestinal (11.4%) symptoms were seen most frequently. For anaphylaxis triggered by food, the duration of anaphylactic episode was significantly longer (p<0.05). No biphasic reaction was observed during these attacks. Of our patients, only one developed respiratory failure and cardiac arrest due to SIT, and intensive care support was required. DISCUSSION: As a trigger for anaphylaxis, the frequency of SIT is so high that it cannot be described by the study group including patients who were followed up in an outpatient allergy clinic.

Electrochemical behavior of quinapril and its determination in pharmaceutical formulations by square-wave voltammetry at a mercury electrode.

The electrochemical behavior of the antihypertensive drug quinapril was investigated at a hanging mercury drop electrode using different voltammetric techniques such as cyclic voltammetry, square-wave voltammetry and chronoamperometry. A simple and sensitive square-wave voltammetric method for the electrochemical analysis of quinapril in its pharmaceutical formulations was developed and validated. The experimental and instrumental parameters affecting the peak current of quinapril were investigated. Various buffers such as Britton Robinson, borate and phosphate buffers at different pH values (3.0-11.0) were examined as supporting electrolyte. The optimum conditions were obtained using Britton Robinson buffer at pH 10.0 and frequency: 50 Hz, scan increment: 4 mV and pulse amplitude: 25 mV. A well-defined peak current was observed at the hanging mercury drop electrode at -1100 mV vs. Ag/AgCl reference electrode. This proposed method was validated by evaluating linearity, sensitivity, repeatability, accuracy, precision, selectivity, recovery, robustness and ruggedness. The linear calibration range was 0.50-8.68 microg mL-' (r = 0.9992). The detection and quantification limits of this method were 0.22 and 0.50 Ctg mL(-1) and intra-day and inter-day precision were between 0.81-4.32% (n = 7), respectively. The developed method was applied successfully for the determination of quinapril in its tablet dosage forms. The average amount of quinapril in tablets was found as 20.26 +/- 0.12 with RSD of 1.60% for 20 mg tabletsand 40.55 +/- 0.23 with RSD of 1.52% for 40 mg tablets.

Spectrophotometric determination of rosuvastatin calcium in tablets.

Rosuvastatin calcium is a synthetic lipid lowering agent which is used in hypercholesterolemia. It is a selective and competitive inhibitor of HMG-CoA reductase. In this study a simple, rapid and reliable spectrophotometric method was developed for the determination of rosuvastatin calcium in pharmaceutical preparations. The solutions of standard and pharmaceutical samples were prepared in methanol. 243 nm was chosen for measuring absorbances of rosuvastatin calcium. The developed method was validated with respect to linearity range, limit of detection and quantitation, accuracy, precision, specificity and ruggudness. The linearity range of the method was 1.0-60.0 microg mL(-1). The limit of detection was 0.33 microg mL(-1). The developed and validated method was applied to the determination of rosuvastatin calcium in pharmaceutical preparations.

Determination of olmesartan medoxomil in tablets by UV-Vis spectrophotometry.

A simple, rapid and reliable UV spectrophotometric method was developed for the determination of olmesartan medoxomil in pharmaceutical dosage forms. The solutions of standard, tablet and synthetic tablet were prepared in acetonitrile and in NaOH-Water. 258 nm and 250 nm were chosen for acetonitrile and for NaOH-Water solutions respectively. The developed method was validated with respect to stability, linearity, sensitivity, specificity, precision, accuracy, robustness and ruggedness. The linearity range of the method was 1.0-70.0 microg x mL(-1) for acetonitrile solutions and 1.0-75.0 microg x mL(-1) for NaOH-Water solutions. The developed and validated method was applied for the determination of olmesartan medoxomil in pharmaceutical dosage forms.

Validation of a rapid micellar electrokinetic capillary chromatographic method for the simultaneous determination of isoniazid and pyridoxine hydrochloride in pharmaceutical formulation.

An efficient and reliable micellar electrokinetic capillary chromatography (MEKC) method has been developed for the simultaneous determination of isoniazid (ISO) and pyridoxine hydrochloride (PYR) in pharmaceutical formulations. A chemometric two level full factorial design approach was used to search for the optimum conditions of separation. Three parameters were selected for this study: the buffer pH, the buffer concentration and sodium dodecyl sulphate (SDS) concentrations. Resolution, peak symmetry and analysis time were established as response. The two analytes were separated within 6 min with the optimized conditions: 50 mM borate buffer, 25 mM SDS pH 7.8, 35 degrees C, at 50 mbar 4s injection and 30 kV by using a fused silica capillary (72 cm effective length, 50 microm i.d.). The detection wavelength was set to 205 nm. Meloxicam was used as internal standard. The method was validated with respect to stability, linearity range, limit of quantitation and detection, precision, accuracy, specificity and robustness. The detection limits of the method were 1.0 microg mL(-1) for ISO and 0.40 microg mL(-1) for PYR and the method was linear at least in the range of 3.0-100 microg mL(-1) for ISO and 1.0-100 microg mL(-1) for PYR with excellent correlation coefficients (0.9995 for ISO and 0.9998 for PYR). Relative standard deviations (R.S.D.s) of the described method ranged between 0.54 and 2.27% for intra-day precision and between 0.65 and 2.69% for inter-day precision. The developed method was applied to the tablet form of ISO and PYR-containing the pharmaceutical preparations and the data were compared with obtained from the standard addition method. No statistically significant difference was found.

Urticaria and angioneurotic edema due to the temporary henna tattoo.

Temporary henna tattoo, which has become popular among young people, is obtained from the mixture of the plants Lawsonia alba or Lawsonia inermis and paraphenylenediamine (PPD). In forming reactions frequent development of anti-PPD substance is noticed. A 13-year old boy who started itching, erythema, enduration on the application area, increasingly urticarial rash, conjunctivitis and swelling of the lips 48 h after being applied the temporary henna tattoo was hospitalized. He had a local reaction to henna tattoo when he was 5-year old. He was treated with parenteral corticosteroids and oral antihistaminic drugs. Skin reactions persisted for 18 days. The patient showed no early reaction to henna 10% and PPD 1% concentration in saline solution but did late reaction (after 48 h) to PPD in diameter of 12x13 mm in prick test in 3 weeks after the reaction. A case who developed angioneurotic edema and urticaria to temporary henna tattoo noticed that the henna tattoo is not an innocent application and young people need to be informed on this subject.

Analysis of glimepiride by using derivative UV spectrophotometric method.

Glimepiride (Amaryl), which is a new oral antidiabetic drug in the sulfonylurea class, was analysed by using second order derivative UV spectrophotometry. The quantification of glimepiride in dimethylformamide was performed in the wavelength range of 245-290 nm at N = 6, ?lambda = 21. The second order derivative spectra was calculated using peak to peak (lambdaDMF = 263.3-268.2 nm), peak to zero (lambdaDMF = 268.2 nm) and tangent (lambdaDMF = 263.3-271.8 nm) method for calibration curves, the linearity range of 1.00-500.00 microg ml(-1) by using the second order derivative UV spectrophotometric method. The developed method was applied to directly and easily to the analysis of the pharmaceutical tablet preparations. R.S.D. were found to be 4.18% (Amaryl tablet; 1 mg) and 2.21% (Amaryl tablet; 2 mg). The method was completely validated and proven to be rugged. The limit of quantitation and the limit of detection were found as 1.00 and 0.4 microg ml(-1), respectively. This validated derivative UV spectrophotometric method is potentially useful for a routine laboratory because of its simplicity, rapidity, sensitivity, precision and accuracy.

Determination of mirtazapine in tablets by UV spectrophotometric and derivative spectrophotometric methods.

Mirtazapine, 1, 2, 3, 4, 10, 14b-hexahydro-2-methyl-pyrazino [2, 1-a] pyrido [2, 3-c] [G.L. Stimmel, J.A. Dopheide and S.M. Stahl, Pharmacotheraphy 17(1) (1997) 10] benzazepine, is a new and well tolerated antidepressant. It blocks pre-synaptic alpha2-adrenergic receptors and postsynaptic serotonin type 2 and type 3 receptors. The drug is rapid and completely absorbed after oral administration. Mirtazapine was analyzed by HPLC and gas chromatography with nitrogen-sensitive detection. In this study, mirtazapine was analyzed by using UV spectrophotometry, first and second order derivative spectrophotometry. The type of solvent, the degree of derivation, range of wavelength and n value were chosen in order to optimize the conditions. The concentration of mirtazapine in its methanolic solutions were determined between the wavelength range of 225-360 nm in the linearity range of 1-100, 2-100 and 1-120 microg ml(-1) by using the values obtained from UV. first-order derivative (n = 5, delta lambda = 17.5 nm) and second-order derivative (n = 9, delta lambda = 31.5 nm) spectrum of the substance, respectively. The developed UV Spectrophotometric, first-order and second-order derivative spectrophotometric methods were applied to a pharmaceutical preparation as tablet form. Developed UV and derivative UV spectrophotometric method in this study are accurate, sensitive, precise, reproducible and can be directly and easily applied to the pharmaceutical preparations.

Determination of nimesulide in pharmaceutical dosage forms by second order derivative UV spectrophotometry.

In this study, nimesulide which has been used as an analgesic, antipyretic and anti-inflammatory agent, was analyzed by using second order derivative UV spectrophotometry. The solvent, the degree of derivation, ranges of wavelength and n-value were chosen in order to optimize the conditions. The concentration of nimesulide in its solutions in ethanol and chloroform were determined between the wavelength ranges of 200 and 500 nm (n = 6, delta lambda = 21) and in the linearity ranges of 2.0-90.0 microg ml(-1) in ethanol and 2.0-50.0 microg ml(-1) in chloroform by using the values obtained from the second derivative UV spectrum of the substance. The developed second derivative UV spectrophotometric method was applied to the pharmaceutical preparations such as tablet, sachet (granule) and suspension. Tablet and sachet were analysed in ethanol while the suspension was analysed in chloroform. The results obtained from derivative UV spectrophotometry were compared with those obtained by using HPLC. It was found that the difference was not statistically important between these methods. It was concluded that developed derivative UV spectrophotometric method was accurate, sensitive, precise, reproducible and could be applied directly and easily to the pharmaceutical preparations.

Serum proteins with NAD+ glycohydrolase activity and anti-CD38 reactivity--elevated levels in serum of tumour patients.

NAD+ glycohydrolase activities in serum samples from cancer patients were two- to three-fold higher than the activities in samples from healthy controls. SDS-PAGE analysis of serum samples followed by Western blotting revealed the presence of two proteins of approximately 45 and approximately 21 kDa that were immunoreactive with human CD38-specific monoclonal antibodies T16, HIT2 and OKT 10. These proteins appeared to be more abundant in serum from cancer patients. NAD+ glycohydrolase activity in serum could be enriched by immunoaffinity chromatography by using T16-Sepharose 4B. The results suggest that the relative abundance of proteins immunologically related to CD38 may account for the elevated levels of glycohydrolase activities in serum of tumour patients.

Determination of ceftriaxone in aqueous humor and serum samples of differential-pulse adsorptive stripping voltammetry.

Differential-pulse adsorptive stripping voltammetry was used to determine ceftriaxone in serum and aqueous humour samples. The method involved extraction of the ceftriaxone from serum samples with an Amberlite XAD-2 column followed by elution with methanol. The recovery was 97.6% with a relative standard deviation of 3.3% at a ceftriaxone concentration of 90.9 microg 1(-1). Peak currents of ceftriaxone were measured with a hanging mercury drop electrode at -0.78 V versus an Ag-AgCl reference electrode in pH 3.0 Britton-Robinson buffer. The calibration graph was linear from 0.02 to 1300 microg 1(-1). The method was applied to cataract cases and ceftriaxone levels were measured in aqueous humour and serum samples from patients who had received 1 or 2 g of ceftriaxone intravenously. Aqueous humour was added to the polarographic cell directly. The amounts of ceftriaxone in the aqueous humour and serum samples with respect to time were measured. The pharmacokinetic profiles for 1 and 2 g were compared.

Determination of ceftriaxone in biological material by differential-pulse adsorptive stripping voltammetry.

Differential-pulse adsorptive stripping voltammetry was used to determine sub-micromolar concentrations of ceftriaxone in plasma. A hanging mercury drop electrode was chosen as the working electrode. A simple clean-up procedure was developed in which ceftriaxone was extracted from blood plasma with the non-ionic resin Amberlite XAD-2 and eluted with methanol. The recovery from plasma was 97.6% using a 1.52 x 10(-4) M stock ceftriaxone solution. The method was applied to caesarean cases, and total ceftriaxone levels were measured in the maternal and umbilical cord blood. The amount of ceftriaxone transmitted to the baby on administration of the drug to the mother before the caesarean operation was found to be in the range 0.067-0.17%.

Differential pulse adsorptive stripping voltammetric determination of ceftriaxone at a static mercury dropping electrode.

Ceftriaxone is a member of the "third generation" of cephalosporin antibiotics which adsorbs strongly onto a mercury electrode. By using this phenomenon and by accumulating this compound at a static mercury dropping electrode prior to differential pulse voltammetric measurements, very high sensitivities can be readily achieved. The influence of several variables (including accumulation time, modulation amplitude, rest period, scan rate, and drop size) on the adsorptive stripping response has been evaluated. Peak currents were measured with a hanging mercury dropping electrode at -0.78 V versus an Ag/AgCl reference electrode in pH 3.0 Britton-Robinson buffer. The linear calibration range was 3.31 x 10(-11) to 2.17 x 10(-6) M.