Acute pseudogout - Measure serum magnesium.

We report a 49-year-old woman with an acute swollen left knee due to acute pseudogout with chondrocalcinosis as a presenting feature of Gitelman syndrome due a novel homozygous mutation of the SLC12A3 gene. This report highlights the under-recognized importance of excluding metabolic disease, including Gitelman syndrome, in younger patients whose sole presenting feature may be chondrocalcinosis with or without pseudogout, as this may impact on management and risk of further episodes. We also suggest that chondrocalcinosis and hypomagnesaemia with or without hypokalaemia are diagnostic of Gitelman syndrome.

Study of sunless tanning formulas using molted snake skin as an alternative membrane model.

Sunless tanning formulas have become increasingly popular in recent years for their ability to give people convincing tans without the dangers of skin cancer. Most sunless tanners currently on the market contain dihydroxyacetone (DHA), a keto sugar with three carbons. The temporary pigment provided by these formulas is designed to resemble a UV-induced tan. This study evaluated the effectiveness of carbomer gels and cold process self emulsifying bases on skin pigmentation, using different concentrations of a chemical system composed of DHA and N-acetyl tyrosine, which are found in moulted snake skins and their effectiveness was tested by Mexameter(®) MX 18. Eight different sunless tanning formulas were developed, four of which were gels and four of which were emulsions (base, base plus 4.0%, 5.0% and 6.0% (w/w) of a system of DHA and N-acetyl tyrosine). Tests to determine the extent of artificial tanning were done by applying 30 mg cm(-2) of each formula onto standard sizes of moulted snake skin (2.0 cm × 3.0 cm). A Mexameter(®) MX 18 was used to evaluate the extent of coloration in the moulted snake skin at T(0) (before the application) and after 24, 48, 72, 168, 192 and 216 h. The moulted snake skins can be used as an alternative membrane model for in vitro sunless tanning efficacy tests due to their similarity to the human stratum corneum. The DHA concentration was found to influence the initiation of the pigmentation in both sunless tanning systems (emulsion and gel) as well as the time required to increases by a given amount on the tanning index. In the emulsion system, the DHA concentration also influenced the final value on the tanning index. The type of system (emulsion or gel) has no influence on the final value in the tanning index after 216 h for samples with the same DHA concentration.

Antimicrobial and cytotoxic activities of some crude drug extracts from Mexican medicinal plants.

31 crude extracts derived from 28 plants highly valued as anti-infective agents in Mexican folk medicine have been screened for antimicrobial activity against four bacteria, a yeast and two molds. The results of the quantitative study indicated that the extracts derived from five species (Malmea depressa, Heliopsis longipes, Datura lanosa, Cnidosculus tehuacanensis and Helianthella quinquenervis) possessed significant antiseptic properties, therefore supporting the ethnomedical uses of these species. The cytotoxic activity was assayed against three cell lines HT-29 (Colon adenocarcinoma), MCF-7 (Breast carcinoma), A-549 (Lung carcinoma) and only the extract of Helianthella quinquenervis possessed significant activity against the MCF-7 cell line.

Is serum creatine kinase:aspartate aminotransferase ratio useful for diagnosing acute myocardial infarction in elderly patients?

AIM: To evaluate the usefulness of the serum creatine kinase: aspartate aminotransferase (CK:AST) ratio in differentiating between myocardial and non-myocardial increases in serum creatine kinase activity in the elderly. METHODS: A three month prospective study of all patients admitted to an acute geriatric unit who were clinically assessed and investigated with electrocardiograms and measurement of CK, AST, and lactate dehydrogenase (LDH) activities on the first three days of admission. Excluding those with liver disease and alcohol misuse, patients with increased CK activity were then classified into four groups depending on whether they had fallen or had an acute myocardial infarction (AMI), or both. RESULTS: 270 patients were evaluated. CK activity was raised in 86 (31%) patients on any of the first three days of admission. Of these, 31 had fallen, 19 had an AMI, and five had both fallen and sustained an AMI. The CK:AST ratio, on all days, was higher (p < 0.05) in those who had fallen. On the second and third days, the CK:AST ratio was higher (p < 0.01) in those patients who did not have an AMI. The overlap, however, between these groups was large. CONCLUSIONS: These results did not allow discrimination to be made between myocardial and skeletal sources for increased CK activity. The CK:AST ratio is, therefore, of limited use when applied to the diagnosis of AMI in elderly patients. Clinical evaluation rather than the pattern of enzyme change is more likely to determine the cause of increased CK activity.