Combination gel of 2% amitriptyline and 0.5% ketamine to treat refractory erythromelalgia pain - a case report of pain control success.

Erythromelalgia (EM) is a rare autosomal dominant neuropathy characterized by the combination of severe burning pain and erythematous warm extremities. Chronic pain control is most often unsuccessful and a completely effective therapy is yet to be identified. Recent studies have reported significant improvements in pain management using a combination of amitriptyline and ketamine in a topical formulation. We describe a 1-year follow-up pain control success case of a male patient with EM, proposed for topical use of a 2% Amitriptyline and 0.5% Ketamine gel.

Gel tópico de amitriptilina al 2% y ketamina al 0, 5% para el tratamiento de la eritromelalgia: reporte de un caso con respuesta positiva al dolor / Combination gel of 2% amitriptyline and 0.5% ketamine to treat refractory erythromelalgia pain-a case report of pain control success

La eritromelalgia (EM) es una neuropatía inusual autosómica dominante caracterizada por la combinación de ardor intenso, extremidades eritematosas y cálidas. Con frecuencia el control del dolor crónico no tiene éxito, no habiéndose identificado aún una terapia efectiva. Los estudios recientes han identificado mejoras significativas en el manejo de dolor, utilizando una combinación de amitriptilina y ketamina en formulación tópica. Describimos un caso de respuesta positiva al dolor, con seguimiento de un año de un paciente con EM usando un gel tópico de combinación de amitriptilina al 2% y ketamina al 0,5%.(AU)

Erythromelalgia (EM) is a rare autosomal dominant neuropathy characterized by the combination of severe burning pain and erythematous warm extremities. Chronic pain control is most often unsuccessful and a completely effective therapy is yet to be identified. Recent studies have reported significant improvements in pain management using a combination of amitriptyline and ketamine in a topical formulation. We describe a 1-year follow-up pain control success case of a male patient with EM, proposed for topical use of a 2% Amitriptyline and 0.5% Ketamine gel.(AU)

Combination gel of 2% amitriptyline and 0.5% ketamine to treat refractory erythromelalgia pain - a case report of pain control success. / Gel tópico de amitriptilina al 2% y ketamina al 0,5% para el tratamiento de la eritromelalgia: reporte de un caso con respuesta positiva al dolor.

Erythromelalgia (EM) is a rare autosomal dominant neuropathy characterized by the combination of severe burning pain and erythematous warm extremities. Chronic pain control is most often unsuccessful and a completely effective therapy is yet to be identified. Recent studies have reported significant improvements in pain management using a combination of amitriptyline and ketamine in a topical formulation. We describe a 1-year follow-up pain control success case of a male patient with EM, proposed for topical use of a 2% Amitriptyline and 0.5% Ketamine gel.

Static headspace analysis using polyurethane phases--application to roasted coffee volatiles characterization.

Static headspace sorptive extraction using polyurethane foams (HSSE(PU)) followed by gas chromatography coupled to mass spectrometry is proposed for volatile analysis. The application of this novel analytical approach to characterize the volatiles profile from roasted coffee samples, selected as model system, revealed remarkable advantages under convenient experimental conditions. The comparison of HSSE(PU) with other well-established procedures, such as headspace sorptive extraction using polydimethylsiloxane (HSSE(PDMS)) and headspace solid phase microextraction using carboxen/polydimethylsiloxane fibers (HS-SPME(CAR/PDMS)), showed that the former presented much higher capacity, sensitivity and even selectivity, where larger abundance and number of roasted coffee volatile compounds (e.g. furans, pyrazines, ketones, acids and pyrroles) could be achieved, under similar experimental conditions. The data presented herein proved, for the first time, that PU foams present great performance for static headspace sorption-based procedures, showing to be an alternative polymeric phase for volatile analysis.

Development and application of stir bar sorptive extraction with polyurethane foams for the determination of testosterone and methenolone in urine matrices.

This work describes the development, validation, and application of a novel methodology for the determination of testosterone and methenolone in urine matrices by stir bar sorptive extraction using polyurethane foams [SBSE(PU)] followed by liquid desorption and high-performance liquid chromatography with diode array detection. The methodology was optimized in terms of extraction time, agitation speed, pH, ionic strength and organic modifier, as well as back-extraction solvent and desorption time. Under optimized experimental conditions, convenient accuracy were achieved with average recoveries of 49.7 8.6% for testosterone and 54.2 ± 4.7% for methenolone. Additionally, the methodology showed good precision (<9%), excellent linear dynamic ranges (>0.9963) and convenient detection limits (0.2-0.3 µg/L). When comparing the efficiency obtained by SBSE(PU) and with the conventional polydimethylsiloxane phase [SBSE(PDMS)], yields up to four-fold higher are attained for the former, under the same experimental conditions. The application of the proposed methodology for the analysis of testosterone and methenolone in urine matrices showed negligible matrix effects and good analytical performance.

[Usefulness of MBDS in detection of adverse drug events]. / Utilidad del CMBD para la detección de acontecimientos adversos por medicamentos.

OBJECTIVE: To analyze the incidence of adverse drug events (ADE) as noted in hospital discharge reports, as well as their potential avoidability, drugs involved, clinical symptoms and the type of medication errors that led to the preventable ADE. MATERIAL AND METHODS: A retrospective study for the January- December 2005 period of time, at a district hospital. ADE were detected in which patients with discharge reports including event codes as defined by the IDC-9-CM system, using the minimum basic data set (MBDS). RESULTS: ADEs were detected in 4.01% of all discharge reports in the study period (n = 160). 45% of ADEs were were detected at the Emergency Department (n = 72) and 55% (n = 88) were detected during hospitalization.62.3% of ADEs were considered potentially avoidable (n = 109). 38.1% of ADEs were serious, 40.0% moderate and 21.9% mild. Drugs most commonly involved in the ADEs sample studied included: antimicrobials (24.0%), systemic corticoids (15.4%), NSAIDs (11.4%), diuretics (10.3%), digoxin (9.1%), insulin and oral hypoglycaemic agents (5.7%), anticoagulants and heparin (5.7%). Inadequate therapy monitoring (47.7%), excessive dosage (28.5%), drug-drug interactions (10.1%) were the most common identified type of errors leading to preventable ADE. CONCLUSIONS: 3.2% of admissions was caused by ADEs. 2.2% of hospitalized patients experienced ADEs. 62% of ADEs were potentially preventable. A high proportion of preventable ADEs were around a small number of drugs. Effective safety practices directed to reduce the incidence of medication errors are needed.

Metabolic transition step from ethanol consumption to sugar/ethanol consumption by Saccharomyces cerevisiae.

The metabolic pathway shift between only ethanol consumption to both sugar/ethanol consumption was measured by on-line analysis of respiratory quotient of a Saccharomyces cerevisiae. The experiments were carried out in a fed-batch culture under aerobic conditions. During the transition phase, respiratory quotient (RQ) profile shows that sugar can be metabolized through the fermentative pathway even to values of RQ lower than 1.

Tapered optical fiber sensor using near-infrared fluorophores to assay hybridization.

We present an all-fiber hybridization assay sensor that relies on the evanescent field excitation of fluorescence from surface-bound fluorophores. The evanescent field is made accessible through the use of a long, adiabatically tapered single-mode fiber probe. A laser diode with a 785-nm wavelength is used in a pulsed mode of operation to excite fluorescence in the tapered region of a fiber probe using the near-infrared fluorophore IRD 41. We have used various chemical treatments to prepare the tapered fiber surface for chemical, as well as physical, binding of fluorophores. We have carried out real-time hybridization tests for IRD 41-labeled oligonucleotide, at various probe concentrations, binding to complementary oligonucleotide cross-linked to the tapered fiber surface. The biospecificity of our sensor is confirmed through hybridization tests with a control oligonucleotide. Short oligonucleotides (20-mer) bound to the fiber surface have been used to detect near-IR dye-labeled complementary sequences at subnanomolar levels. Sandwich assays with Helicobacter pylori total RNA were conducted to examine the capability of the biosensor for detecting bacterial cells using rRNA as the target. The results indicate that this fluorosensor is capable of detecting H. pylori in a sandwich assay at picomolar concentrations.

[Duodenal Crohn's disease: diagnostic and therapeutic complexity]. / Enfermedad de Crohn duodenal. Complejidad diagnóstica y terapéutica.

Crohn's disease may involve any area of the digestive tract, but its localization in the duodenum is rare. The clinical, radiological or endoscopic findings may simulate those of peptic ulcer and histologic examination is not diagnostic. In contrast with Crohn's disease of any other localization, the formation of fistulas is exceptional. The authors present one case of duodenal Crohn's disease the unspecific symptomatology of which deviated the original orientation towards the more common diseases. Steroid treatment was not sufficient to control the disease which led to complications with the formation of an enterocutaneous fistula. The association of azathioprine was very effective not only in achieving remission of the process, but also in resolving the complications.

[Splenoportal thrombosis: form of presentation of essential thrombocythemia]. / Trombosis esplenoportal: forma de presentación de trombocitemia esencial.

Splenoportal thrombosis may appear in subclinical way and it necessary te make a differential diagnosis with other pathologies-more common, like inflammatory of infection, processes conditions in which a decrease in portal-flow take place, space compromise or hypercoagulability conditions. Hear we present two cases with this pathology, and we make an extensive differential diagnosis, the final diagnosis was reached through a bone marrow aspirate, with the outcome of essential thrombocytosis.

[Waist/hip ratio and vascular risk factors in obese and not obese individuals]. / Indice cintura/cadera y factores de riesgo vascular en sujetos obesos y no obesos.

Three groups of men and three groups of women were studied, each one of the three corresponding to obese individuals, overweight and not overweight according to the ratio of corporal mass > or = 30, 25-29.9 and < 25 respectively. In each group two subgroups were made following the waist/hip ratio (< 1 and > or = 1 for men and < 0.8 and > or = 0.8 for women). In each subgroup arterial pressure, basal glucemia, cholesterol and plasmic triglycerides, lipoproteins and insulinemia after a higher than normal oral intake of glucose were determined, comparing results according to waist/hip ratio. Practically all the parameters studied showed greater levels of risk in subjects of both sexes with high waist/hip ratio, both in obese individuals and not obese individuals. This shows the possibility that high waist/hip ratio in associated with risk factors in individuals who are not obese, and this association is considered as a "metabolic lipopathy" present in the intraabdominal visceral adipocyte. The measurement of waist/hip ratio must be recommended in all patients and in medical examinations.