Extemporaneous clobazam suspensions for paediatric use prepared from commercially available tablets and pure drug.

OBJECTIVE: Two clobazam aqueous suspensions for paediatric oral usage (5 mg/ml) were investigated to determinate its physicochemical stability under different storage conditions. METHOD: Formulations were stored at 4 and 25 °C and the clobazam content was determined by High Performance Liquid Chromatography. Each sample was analyzed by triplicate at different time points (0, 7, 14, 28 and 56 days). RESULTS: Liquid suspensions were successfully formulated from pure drug and commercially available tablets. In both cases, samples showed suitable physical stability. Clobazam was chemically stable in aqueous suspension during the 56 days of the study at the two storage temperatures. CONCLUSIONS: All the tried oral liquid formulations can be conserved at 4 and 25 °C at least 56-day period.

Objetivo: Dos suspensiones orales acuosas de clobazam para uso pediátrico (5 mg/ml) fueron evaluadas para determinar su estabilidad fisicoquimica bajo diferentes condiciones de almacenamiento. Métodos: Las formulaciones fueron conservadas a 4 y 25 °C y el contenido de clobazam fue determinado mediante Cromatografía Líquida de Alta Performance. Cada una de las muestras fue analizada por triplicado a diferentes tiempos (0, 7, 14, 28 y 56 días). Resultados: Las suspensiones fueron formuladas satisfactoriamente a partir del principio activo puro y de comprimidos disponibles comercialmente. En ambos casos, las muestras presentaron una adecuada estabilidad física. El clobazam fue químicamente estable en las suspensiones acuosas durante los 56 días de duración del estudio a las dos temperaturas elegidas para su conservación. Conclusiones: Todas las formulaciones orales líquidas formuladas y evaluadas en este estudio pueden ser conservadas a 4 y 25 °C por al menos 56 días.

Multiple bilateral pulmonary "fungus balls" in an immunocompetent patient unsuitable for surgical treatment: efficacy of azoles treatment.

Data guiding management of pulmonary mycetomas are based on uncontrolled trials and case reports. Surgical resection represents a definitive treatment associated with high mortality and sometimes not feasible due to clinical conditions. We report a case of an immunocompetent patient with multiple pulmonary mycetomas, suggestive for probable chronic aspergillosis, in which surgery was contraindicated. The patient experienced a good response to long-term oral voriconazole therapy with remarkable clinical and radiological improvement at three-month follow-up. In cases of probable chronic aspergillomas, when surgery is contraindicated, long-term antifungal therapy with voriconazole seems to be a valid alternative option.

Appropriateness: analysis of outpatient radiology requests.

PURPOSE: This study assessed radiology requests and the influence of previous radiological procedures on their specificity and appropriateness, evaluated diagnostic outcomes and recorded the economic impact of inappropriate examinations. MATERIALS AND METHODS: We prospectively analysed 4,018 outpatient requests, the appropriateness of which was assessed using an evaluation form. Economic analysis was based on costs listed in the Italian National Health Services (NHS) national tariff as established by the Ministerial Decree of 22 July 1996. Statistical analysis was carried out using Pearson's test and univariate and multivariate logistic regression models. RESULTS: Of 4,018 outpatient requests, 57% were not included in a follow-up protocol and 56% were found to be appropriate. The diagnostic question was confirmed in 66% of cases considered appropriate (p<0.001). The existence of previous investigations had a significant impact on appropriateness and diagnostic outcome (p<0.001). The total cost of the requests was 257,317 euro, with inappropriate requests accounting for 94,012 euro (36.5%). CONCLUSIONS: We found a 56% rate of appropriate requests and demonstrated that appropriate prescriptions provided with a specific clinical question led to significantly higher confirmation rates of the diagnostic hypothesis. In addition, inappropriate requests had a major negative economic impact.

Carvedilol stability in paediatric oral liquid formulations

Objective Two carvedilol aqueous solutions and one carvedilol aqueous suspension for paediatric oral use (1mg/ml) were studied to determine their stability. Method All samples were stored at 4, 25 and 40°C. Carvedilol content of each of the three formulations was tested using high performance liquid chromatography (HPLC). Each sample was analysed in triplicate at 0, 3, 7, 14, 28 and 56 days. Results Carvedilol stayed stable in the acidic aqueous solution at the three different temperatures during the 56 days of the study. In the alkaline solution, carvedilol was stable during 56 days at 25°C, but only 28 days at 4 and 40°C. In the aqueous suspension, carvedilol was stable during 56 days at 4 and 25°C, but only 28 days at 40°C.ConclusionsAll the formulations that were tested can be stored at 25°C for at least 56 days(AU)

Objetivo Se estudió la estabilidad de carvedilol (1mg/ml) en 2 soluciones acuosas y una suspensión acuosa para uso pediátrico. Método Las formulaciones fueron almacenadas a 4, 25 y 40°C. El contenido de carvedilol de cada una de las 3 formulaciones fue analizado por cromatografía líquida de alta eficacia (HPLC). Cada muestra fue analizada por triplicado a tiempos 0, 3, 7, 14, 28 y 56 días. Resultados Carvedilol se mantuvo estable en la solución acuosa de pH ácido durante los 56 días del ensayo a las 3 temperaturas estudiadas. En la solución alcalina fue estable 56 días a 25°C, pero sólo 28 días a 4 y 40°C. En la suspensión acuosa carvedilol fue estable 56 días a 4 y 25°C, y sólo 28 días a 40°C.ConclusionesTodas las formulaciones ensayadas pueden ser conservadas a 25°C al menos por un período de 56 días (AU)

Radiological findings of pneumonia in patients with swine-origin influenza A virus (H1N1).

PURPOSE: During spring 2009, a pandemic swine-origin influenza A (H1N1) virus (S-OIV) emerged and spread globally. We describe the chest X-ray and computed tomography (CT) findings of 40 patients with pneumonia due to S-OIV observed in our institution. MATERIAL AND METHODS: Among 534 patients with S-OIV, according to the US Centers for Disease Control and Prevention case definition, seen between June and November 2009, 121 underwent chest X-ray and 40 (median age 44 years, range 16-79) had pneumonia. The initial chest radiographs were evaluated for pattern, distribution and extent of lung abnormalities. Unenhanced chest CT scans were performed in two patients and were reviewed for the same findings. Underlying medical conditions were present in 42% of patients (17/40). RESULTS: Our patients had predominantly mild illness, and pneumonia was observed in 40 individuals (40/121 patients who had chest X-rays, 33%; and 40/534 patients with S-OIV, 7.5%). However, S-OIV can cause severe illness requiring admission to the intensive care unit for advanced mechanical ventilation and extracorporeal life support, including adult respiratory distress syndrome (ARDS) and death. The major radiological abnormalities observed were interstitial changes (60.0%), with (22.0%) or without patchy ground-glass appearance, mostly bilateral, and located in the lower lung zones (7.5%). Extensive disease was seen in 37.5% (15/40), and ARDS was observed in three individuals (0.30%)with underlying medical conditions. Subtle pleural effusion was noted in four patients. CONCLUSIONS: In our series, the most frequent pneumonia patterns observed during S-OIV (H1N1) virus were interstitial changes and patchy ground-glass appearance, mostly bilateral, and located in the lower lung zones. CT, performed in severely ill patients, confirmed the ARDS identified with chest X-rays, better depicting the features and extent of lung abnormalities.

Carvedilol stability in paediatric oral liquid formulations.

OBJECTIVE: Two carvedilol aqueous solutions and one carvedilol aqueous suspension for paediatric oral use (1mg/ml) were studied to determine their stability. METHOD: All samples were stored at 4, 25 and 40°C. Carvedilol content of each of the three formulations was tested using high performance liquid chromatography (HPLC). Each sample was analysed in triplicate at 0, 3, 7, 14, 28 and 56 days. RESULTS: Carvedilol stayed stable in the acidic aqueous solution at the three different temperatures during the 56 days of the study. In the alkaline solution, carvedilol was stable during 56 days at 25°C, but only 28 days at 4 and 40°C. In the aqueous suspension, carvedilol was stable during 56 days at 4 and 25°C, but only 28 days at 40°C. CONCLUSIONS: All the formulations that were tested can be stored at 25°C for at least 56 days.

Micro orientation and anisotropy of conductivity in liquid crystalline polymer films filled with carbon nanotubes.

In this communication we report the preferential orientation of single wall carbon nanotubes (SWNT) in a nematic liquid crystalline (LC) polymer matrix. The alignment of the nanotubes was characterized through anisotropy of electrical conductivity of the composite measured in directions parallel and perpendicular to the nematic director. The anisotropy of the nanocomposite films strongly depends on the nanotube concentration in the range from 1 to 10% and vanished at higher loads. The electrical conductivity of nanocomposites is related to their structural features revealed by atomic force microscopy and Raman spectroscopy experiments and is explained by a strong coupling between the nanotubes and the polymer matrix.

Microesferas biodegradables de poli(D, L-láctico) conteniendo progesterona / Biodegradable microspheres of poly(D, L-lactide) containing progesterone

Se obtuvieron microesferas de poli(D,L-láctico) conteniendo progesterona por medio de una emulsión simple aceite en agua empleando una técnica de evaporación de solvente. Se realizó un experimento con un diseño factorial 23 para estudiar el efecto de tres variables independientes (cantidad de principio activo, cantidad de polímero y concentración de alcohol polivinílico) sobre las variables dependientes (encapsulación de principio activo y tamaño de partícula). Las tres variables independientes influyeron significativamente sobre la encapsulación de progesterona. En el caso del tamaño de partícula, las variables que ejercieron una influencia significativa fueron la concentración de alcohol polivinílico y la cantidad de polímero. Los estudios de liberación in vitro han mostrado que de acuerdo al tamaño de partícula se pueden obtener formulaciones que logran liberar progesterona en pocos días u obtener una liberación sostenida durante 28 días. El estado físico del fármaco se investigó por calorimetría diferencial de barrido. Los estudios muestran que existe una interacción fisicoquímica entre la progesterona y el polímero

Microspheres of poly(D,L-lactide) containing progesterone were prepared by the solvent evaporation method using a simple oil water emulsion. 23 factorial design was used to determine the effect of three independent variables (amount of drug, amount of polymer and concentration of polyvinyl alcohol) over the dependent variables (drug content and particle size). The three independent variables influenced significantly over the percentage drug encapsulated. On the other hand, in the particle size case, the variables which produced a significantly influence were the polyvinyl alcohol concentration and the amount of polymer. The in vitro release studies have shown that according to the particle size, it can be obtained formulations which are able to release progesterone in a few days or a sustained release among 28 days. The physical state of drug has been examined by differential scanning calorimetric. The studies indicate that exists a physicochemical interaction between the progesterone and the polymer

Micropartículas de alginatoconteniendo paracetamol / Alginate microparticles containing paracetamol

Micropartículas conteniendo paracetamol (PCT) han sido obtenidas por emulsificación/gelificación interna de una solución de alginato dispersada en un aceite vegetal. La morfología y la distribución de tamaño de partícula fueron determinadas. Se estudió la concentración de ión calcio resultando ser un parámetro crítico en la producción de las micropartículas. Se observó que el incremento en la concentración de calcio produce un aumento en el rendimiento total de micropartículas y en el encapsulación de PCT. La técnica desarrollada permite obtener un sistema con características micrométricas óptimas y una mayor eficacia de encapsulación de PCT (AU)