Negative symptoms in drug-naive patients with a first-episode psychosis (FEP)

INTRODUCTION

Negative symptoms are nuclear features of schizophrenia that may be present from the onset of the disease. In recent years, it has been described 2 subdomains of negative symptoms: experiential and expressive deficits. The aim of the study is to examine the relationship between negative symptoms and demographic and clinical variables in patients with first-episode psychosis. Also, to explore whether there are differences in the association among these variables and negative symptoms when divided into both subdomains.

MATERIAL AND METHODS

A cross-sectional study was performed in 160 patients (52 females and 108 males) with a diagnosis of a first episode psychosis. A questionnaire was administered to collect demographic and clinical variables.

RESULTS

A backward stepwise linear regressions analysis was performed in order to observe potential associations between demographic and clinical variables and the presence of negative symptoms. All three models are predicted by worse PSP score, a higher CDSS, a higher disorganized factor score and a lower excited factor score. A longer duration of untreated psychosis (DUP) is associated to a higher score in the experiential deficit subdomain only.

CONCLUSIONS

Our work highlights some clinical and phenomenological differences between experiential and expressive deficits. We think that taking into account both subdomains in future studies may lead to more accurate clinical assessment and interventions.

Sexual dysfunction in drug- naïve first episode nonaffective psychosis patients. Relationship with prolactin and psychotic symptoms. Gender differences

BACKGROUND

Our aim is to examine differences in sexual functioning (SF) between patients with drug-naïve first episode psychosis (FEP) and healthy controls (HC). We will also examine correlations between prolactin levels, testosterone levels and psychotic symptomatology with SF from a gender perspective.

METHODS

Cross-sectional study. We included 68 FEP patients and 50 HC. A blood sample was extracted. We used the Positive and Negative Syndrome Scale to assess symptom severity, using the five factor structure according to Emsley. The Changes in Sexual Function Questionnaire (CSFQ) was administered.

RESULTS

We found significantly better SF in HC than in patients (in CSFQ total score (p = 0.032) and in CSFQ Desire (p = 0.032)). A significant correlation between prolactin or testosterone and SF was not observed. We found a negative significant correlation between the disorganised subscale of the EMSLEY and total CSFQ (p = 0.027; r = -0.329), CSFQ Desire (p = 0.028; r = -0.329) and CSFQ Arousal (p = 0.026; r = -0.332) in the patient sample. In a regression model, we found sex (p = 0.003) and disorganized symptoms (p = 0.034) as significant predictors.

CONCLUSIONS

We found evidence for better SF in HC than in FEP patients. We could not confirm an association between prolactin or testosterone and SF. Disorganized symptomatology could be a relevant factor in SF.

Predictive capacity of prodromal symptoms in first-episode psychosis of recent onset

BACKGROUND

Both the nature and number of a wide range of prodromal symptoms have been related to the severity and type of psychopathology in the psychotic phase. However, at present there is an incomplete picture focused mainly on the positive pre-psychotic dimension.

AIM

To characterize the prodromal phase retrospectively, examining the number and nature of prodromal symptoms as well as their relationship with psychopathology at the onset of first-episode psychosis.

METHODS

Retrospective study of 79 patients experiencing a first-episode psychosis of less than 1 year from the onset of full-blown psychosis. All patients were evaluated with a comprehensive battery of instruments including socio-demographic and clinical questionnaire, IRAOS interview, PANSS, stressful life events scale (PERI) and WAIS/WISC (vocabulary subtest). Bivariate associations and multiple regression analysis were performed.

RESULTS

Regression models revealed that several prodromal dimensions of IRAOS (delusions, affect, language, behaviour and non-hallucinatory disturbances of perception) predicted the onset of psychosis, with positive (22.4% of the variance) and disorganized (25.6% of the variance) dimensions being the most widely explained.

CONCLUSION

In addition to attenuated positive symptoms, other symptoms such as affective, behavioural and language disturbances should also be considered in the definitions criteria of at-high-risk people.

Cannabis Use in a First Onset Psychosis Sample: Prevalence and Clinical Differences in Relation to Age of Onset

Introduction

There is a wide range of studies focusing on the use of cannabis in first episode psychosis (PEP). Literature using child and adolescent samples is scarce.

Objectives and aims

To determine the prevalence and clinical differences between cannabis users and non-cannabis users of early onset first episode psychosis (EOP), and adult onset first episode psychosis (AOP).

Method

One hundred and forty patients were recruited in adult (AOP subsample, n = 69) and child and adolescent (EOP subsample, n = 71) mental health services. The Positive and Negative Syndrome Scale was used for psychotic symptoms and the Calgary Scale for affective symptoms. The Chi2 test analysed clinical differences between users and nonusers within subsamples, and in the total sample a Pearson correlation was used for the relationship between age at cannabis use and PEP.

Results

The prevalence of lifetime use of cannabis and the average age at first use were 48% and 13.82 years (± 1.15) in the EOP subsample, and 58% and 17.78 years (± 3.93) in the AOP subsample. Within EOP, cannabis users were older (P = .001), had fewer negative symptoms (P = .045) and less depressive symptoms (P = .005). Within AOP, cannabis users were younger (P = .018) and had greater severity of positive symptoms (P = .021). Age at first cannabis use and age at PEP were positively correlated.

Conclusions

Cannabis use is prevalent in adult and early onset psychosis. Cannabis users differ clinically from non-users, and the earlier the use of cannabis, the earlier the onset of psychosis.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Influence of shear rate and concentration ratio on viscous synergism. Application to xanthan—Iocust bean gum— NaCMC mixtures Influencia de la velocidad de cizalla y la relación de concentraciones en la sinergia viscosa. Aplicación a mezclas de xantana-garrofín-CMCNa

A method is described that allows the development of an empirical approach to quantify synergistic interactions and their variations with shear rate. The approach is based on the definition of a viscous synergism index, Iv. The method is applied to xanthan-locust bean gum gels, and an equation is developed for relating the synergism index to shear rate, γ, and the locust bean gum/xanthan gum concentration ratio, z. The value of at which that function has a maximum, IMV, is calculated. This value of z provided an estimation of the proportion of gums at which maximum synergism occurs. A decreasing exponential dependence of these IMV on γ is shown. The influence of the addition of a fixed proportion of a third gum (NaCMC) is also analyzed. The results obtained for the higher γ values are analogous to those of other authors.

Viscous Synergism in Carrageenans (κ and λ) and Locust Bean Gum Mixtures: Influence of Adding Sodium Carboxymethylcellulose

Synergistic interactions between locust bean gum (LBG) and two types of carrageenans (κ and λ) are studied. Viscous synergism index, Iv as a function of concentration ratio z=ćLBG/ćcar, and shear rate were obtained for every mixture. In both binary systems the values of this index decrease with increasing shear rate. For the LBG + κ mixtures, Ivpresented a maximum at a concentration ratio z≅60/40, which would be considered the optimum proportion of gums in the mixture. However, for the LBG + λ system, I vincreased with z in the whole interval considered, i.e., the highest synergism corresponded to the lowest proportion of carrageenan. The addition of sodium carboxymethylcellulose (NaCMC) to the binary systems modified the above results. For LBG + κ + NaCMC mixtures, the maximum Ivvalues were similar to those corresponding to LBG + κ system, but the concentration ratio at which these maxima are produced shifted to a lesser proportion of locust bean gum ( z ≅40/60). Moreover, the presence of NaCMC in the other ternary system totally eliminated the possible interaction between LBG and λ-carrageenan.

Heavy cannabis use impairs verbal memory of first psychotic episode patients

Introduction

Cannabis consumption is known to be increased in both schizophrenic and first psychotic episode patients. Contrary to what has been reported in studies with healthy people, all published studies so far have reported no impairments or even beneficial effects on neurocognition associated with cannabis consumption in schizophrenia and first psychotic episode patients. However, these studies did not address the effects of very high cannabis consumption.

Objective

Our aim in this study was to assess the effects on neurocognition of regular and heavy cannabis consumption in first psychotic episode patients.

Methods

A total of 74 patients were included in the study and assigned to 3 different groups according to their mean cannabis consumption during the last year (non-users, regular users, and heavy users). Participants were administered verbal memory, attention, processing speed, working memory, vocabulary, arithmetic and spatial orientation tasks.

Results

Our results showed the heavy cannabis group of first psychotic episode patients to be significantly impaired in all the verbal memory measures with respect to the non-users group. There were no significant differences between regular users and non-users. Moreover, regular cannabis consumption was associated with an improvement in some attention and processing speed measures.

Conclusions

Our data showed heavy cannabis consumption to impair verbal memory in first psychotic episode patients and suggest a dose-related effect of cannabis consumption, since regular consumption did not impair verbal memory and may be beneficial for other tasks.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Birth weight and obstetric complications determine age at onset in first episode of psychosis

BACKGROUND

Earlier age at onset of psychosis (AOP) has been associated with poor social adjustment and clinical outcome. Genetic and environmental factors such as obstetric complications, parental history of psychosis, advanced paternal age at time of birth, low birth weight and gestational age, and use of drugs have been described as bringing AOP forward. This study aims to evaluate the relationship between AOP and these factors in a sample of first episode of psychosis (FEP) patients.

METHODS

Clinical and sociodemographic data, age at FEP, age of parents at birth, parental history of psychosis, drug-use habits of the mother during pregnancy and of the patient before psychotic onset, and Lewis and Murray obstetric complication scale were obtained from 90 patients with FEP. Statistical analysis was performed by means of Pearson correlations, Chi-square tests, Student T-test analyses and a linear regression model using SPSS version 22.

RESULTS

Pre-eclampsia, need for incubator at birth, use of forceps, parental history of psychosis, and low birth weight were associated with an earlier AOP. Use of forceps and birth weight are the variables which best predict AOP in FEP. Stimulant drugs, which were mostly used together with cannabis and cocaine, were the only substances associated with an earlier AOP.

CONCLUSIONS

Our findings are consistent with previous study results and underline the role of the prenatal period in the development of psychosis and the importance of careful monitoring of pregnancy and delivery, especially in cases with familial history.

Prospective study on the efficacy of optokinetic training in the treatment of seasickness

OBJECTIVES

Seasickness corresponds to all of the clinical symptoms experienced by a subject at sea related to boat movements. The objective of this study was to evaluate the efficacy of optokinetic training versus placebo in the treatment of seasickness.

MATERIAL AND METHODS

Fifteen subjects were randomized to either an optokinetic training arm or a placebo arm. The impact of seasickness was evaluated for each subject before and after optokinetic training using the Graybiel scale.

RESULTS

Among the trained subjects, 71.4% were improved by optokinetic training versus 12.5% of control subjects. A significant difference was observed for Graybiel scores before and after optokinetic training in the training arm.

CONCLUSION

Optokinetic training appears to be an effective modality for the management of disabling seasickness. This training can be further improved by more global patient management.

Predicting ovarian reserve and reproductive outcome using antimüllerian hormone (AMH) and antral follicle count (AFC) in patients with previous assisted reproduction technique (ART) failure

PURPOSE OF INVESTIGATION

The main objective of our prospective, observational, analytical research work was to determine whether Anti-Müllerian hormone (AMH) and antral follicle count (AFC) could be effectively used as predictors of ovarian reserve and, possibly, of reproductive outcome with ART.

METHODS

We studied 143 IVF/ET cycles in patients with a previous history of ART failure, all of them supposed to be of poor prognosis, who had agreed to another ART attempt after knowing their AMH, AFC, and base hormone (FSH, LH, 17 beta-estradiol) levels.

RESULTS

AMH and AFC showed a positive correlation with the number of oocytes retrieved (p = 0.0016) and (p < 0.0001), respectively and with percentage of MII oocytes, (p = 0.00756) and (p < 0.001). The combined use of these markers showed an area under the curve of 82.2% for oocytes retrieved. Our results shows a very high cancelation (22% of started cycles) and very low pregnancy rates (6.7% and 9.8%) in low and normoresponders, respectively.

CONCLUSIONS

AMH levels and AFC are reliable indicators of ovarian reserve. Patients with ovarian reserve levels that predict a very low probability of success should be informed that the poor prognosis associated with these values may not justify the expense of IVF/ET.

The GK rat beta-cell: a prototype for the diseased human beta-cell in type 2 diabetes?

Increasing evidence indicates that decreased functional beta-cell mass is the hallmark of type 2 diabetes (T2D) mellitus. Nowadays, the debate focuses on the possible mechanisms responsible for abnormal islet microenvironment, decreased beta-cell number, impaired beta-cell function, and their multifactorial aetiologies. This review is aimed to illustrate to what extend the Goto-Kakizaki rat, one of the best characterized animal models of spontaneous T2D, has proved be a valuable tool offering sufficient commonalities to study these aspects. We propose that the defective beta-cell mass and function in the GK model reflect the complex interactions of multiple pathogenic players: (i) several independent loci containing genes responsible for some diabetic traits (but not decreased beta-cell mass); (ii) gestational metabolic impairment inducing an epigenetic programming of the pancreas (decreased beta-cell neogenesis and/or proliferation) which is transmitted to the next generation; and (iii) loss of beta-cell differentiation due to chronic exposure to hyperglycemia/hyperlipidemia, inflammatory mediators, oxidative stress and to perturbed islet microarchitecture.

High doses of GnRH antagonists are efficient in the management of severe ovarian hyperstimulation syndrome

OBJECTIVE

To determine whether treatment of severe ovarian hyperstimulation syndrome (OHSS) with high-dose gonadotropin-releasing hormone (GnRH) antagonist, due to its luteolytic effect, is an effective method of management.

METHODS

Six infertile patients who had been scheduled for embryo transfer and developed early-onset severe OHSS with ascites and hemoconcentration were chosen for treatment with 3.0 mg of a GnRH antagonist (Cetrotide; Cetrorelix, Serono, Madrid, Spain). The response of these patients was compared with five patients with severe early-onset OHSS who received support therapy alone. All patients were evaluated clinically, echographically, and hematologically.

RESULTS

Estradiol (E2) levels dropped significantly a few days after treatment. Peritoneal fluid regression measured by ultrasound was faster on the study group compared with controls. Hematocrit remained comparable in both groups during follow-up. In two cases a second bolus of GnRH-antagonist was used due to clinical and biochemical findings during the four days of observation following the initial dose. None of the patients treated with GnRH antagonists required paracentesis.

CONCLUSIONS

Treatment with high doses of GnRH antagonists seems to be effective in the management of severe OHSS.

Defective functional β-cell mass and Type 2 diabetes in the Goto-Kakizaki rat model

Increasing evidence indicates that decreased functional β-cell mass is the hallmark of Type 2 diabetes mellitus. Therefore, the debate focuses on the possible mechanisms responsible for abnormal islet microenvironment, decreased β-cell number, impaired β-cell function and their multifactorial etiologies. The information available on the Goto-Kakizaki/Par rat line, one of the best characterized animal models of spontaneous Type 2 diabetes mellitus, are reviewed in such a perspective. We propose that the defective β-cell mass and function in the Goto-Kakizaki/Par model reflect the complex interactions of multiple pathogenic players, including several independent loci containing genes responsible for some diabetic traits (but not decreased β-cell mass), gestational metabolic impairment inducing an epigenetic programming of the pancreas (decreased β-cell neogenesis), which is transmitted to the next generation, and loss of β-cell differentiation due to chronic exposure to hyperglycemia, inflammatory mediators, oxidative stress and perturbed islet microarchitecture.

[Mental health care use in the Spanish general populations. Results of the ESEMeD-Spain study]

INTRODUCTION

Between 17% and 30% of the world population suffers from a mental disorder in a given year and only a small proportion of them established contact with health services. This information is not available concerning the Spanish population. This study aims to describe the health services utilization related with mental disorders in Spain, as well as to identify factors related with such utilization.

METHODS

The ESEMeD-Spain is an epidemiological study carried out on a representative sample of the Spanish adult general population, with a sample size of 5,473 individuals. We used the Composite International Diagnostic Interview (version 3.0) to collect information concerning mental disorders symptoms, health services utilization related with mental health, and administered treatments, with a 12 months time frame.

RESULTS

57% of those suffering from a mood disorder, 30.3 % of those suffering from an anxiety disorder and 71.7% of those suffering from both contacted health services in the year they suffered the disorder. Psychiatrists were the most frequently consulted professionals when a 12 month mental disorder was present, with the exception of anxiety disorders or comorbid mood-anxiety disorders. A 30.8% of those with any 12 month mental disorder who did consult were not prescribed with any treatment. Variables significantly related to 12 month health services utilization were age, gender, marital status, and mental disorders.

CONCLUSIONS

A large proportion of individuals suffering from mental disorders do not use health services or, if indeed use them, do not receive any type of treatment.

A halocin acting on Na+/H+ exchanger of haloarchaea as a new type of inhibitor in NHE of mammals

The capability of halocin H6 (a bacteriocin-like protein produced by haloarchaea Haloferax gibbonsii) to inhibit Na+/H+ exchanger (NHE) in mammalian cells and its cardio-protective efficacy on the ischemic and reperfused myocardium were evaluated in the present study. H6 inhibits NHE activity (measured by a flow cytometry method) in a dose-dependent form of cell lines of mammalian origin (HEK293, NIH3T3, Jurkat and HL-1) as well as in primary cell culture from human skeletal muscle (myocytes and fibroblasts). In vivo, an ischemia-reperfusion model in dogs by coronary arterial occlusion was used (two hours of regional ischemia and three hours of reperfusion). In animals treated with halocin H6 there was a significant reduction of premature ventricular ectopic beats and infarct size, whereas blood pressure and heart rate remained unchanged. Up to date, halocin H6 is the only described biological molecule that exerts a specific inhibitory activity in NHE of eukaryotic cells.

Acyclovir Delivery Matrices Based on Poly(Ethylene Glycol)/Chitosan Semi-Interpenetrating Networks

Chitosan matrix systems have been studied as potential vehicles for the prolonged release of acyclovir (ACV). The influence of chitosan concentration (from 0.83% to 1.67%) on viscoelastic properties of formulations with and without glyoxal was analyzed. For chitosan-poly(ethylene glycol) 400 formulations loss modulus (G'') are greater than storage modulus (G'). This corresponds to the characteristic behavior of nonstructured systems. When glyoxal was added to the chitosan-poly(ethylene glycol) 400 formulations, gelled matrix was obtained (i.e., G' is higher than G''), except for the lowest chitosan concentration. ACV release rates for the both types of systems, with and without glyoxal, were also determined. The ACV diffusion coefficient values from matrices are less than for the respective formulation without glyoxal and it was found to depend on the crosslink density within the matrices. Viscoelastic parameters, dynamic moduli (G', G''), and complex viscosity (eta*), were correlated with the ACV diffusion coefficients (D). The complex viscosity (eta*) could be used as a parameter of predictive value for the release rate of drugs.

Site-bond percolation of polyatomic species

A generalization of the classical monomer site-bond percolation problem is studied in which linear k-uples of nearest neighbor sites (site k-mers) and linear k-uples of nearest neighbor bonds (bond k-mers) are independently occupied at random on a square lattice. We called this model the site-bond percolation of polyatomic species or k-mer site-bond percolation. Motivated by considerations of cluster connectivity, we have used two distinct schemes (denoted as S intersection of B and S union of B) for k-mer site-bond percolation. In S intersection of B(S union of B), two points are said to be connected if a sequence of occupied sites and (or) bonds joins them. By using Monte Carlo simulations and finite-size scaling theory, data from S intersection of B and S union of B are analyzed in order to determine the critical curves separating the percolating and nonpercolating regions.

[Influence of blood pressure profile on erythropoietin levels in diabetics]

The purpose of this study was to investigate the relationships between 24-h BP profil and erythropoietin level in diabetics.

PATIENTS AND METHODS

This study included 58 patients (26 women and 32 men, mean age: 58.7 +/- 14.6 yrs, diabetes duration: 16 +/- 11.2 yrs). Patients were divided by 24 hrs ABPM into 2 groups, one in which night-time pressures dipped by more than 10% (dippers, n = 16) and the other in which pressures dipped by less than 10% (non-dippers, n = 42) when compared to daytime pressures. Haemoglobin (Hb) and erythropoietin (EPO) levels where compared between diabetics and a control group (n = 110) and between dippers and non-dippers.

RESULTS

Hb concentration of diabetics was significantly lower than those of control subjects (13.5 +/- 1.5 vs 14.5 +/- 1 g/dL; p < 0.0001) but EPO levels did not differ from significant manner between these two groups. EPO concentrations were lower in dippers than in control subjects (13.7 +/- 5.4 vs 17.9 +/- 5 mU/mL; p < 0.01), but there was not significant difference in Hb levels. Non-dippers had a Hb level lower than dippers (13.1 +/- 1.5 vs 14.6 +/- 1.1 g/dL, p < 0.0001), but EPO concentrations did not differ from significant manner. Hb was correlated with between daytime and night-time BP difference (SBP: r = 0.262; p < 0.05 and DBP: r = 0.396; p < 0.002). Hb was negatively correlated with albumin excretion rate (r = -0.335, p < 0.01) and with creatinine level (r = -0.419: p < 0.001).

CONCLUSION

These data indicated that EPO production could be impaired in diabetics with abnormal diurnal BP variation. Nephropathy and cardiac autonomic dysfunction could explain these results.

A time-dependent expression for thixotropic areas. Application to aerosil 200 hydrogels

Experimental determination of the areas enclosed under the up curve, sigma = sigma(;gamma), corresponding to time zero, and the down curve, which would be obtained following complete rheodestruction of the system structure, is not an easy matter. In the present study a semi-empirical procedure for calculating the hypothetical values of these parameters is proposed. With these parameters it is possible to obtain a time-dependent expression for the thixotropic areas, S(T). This procedure has been applied to the study of the thixotropic behavior of Aerosil 200 hydrogels at different concentrations. The comparative analysis of these systems has been realized by studying the relative thixotropic areas and relative thixotropic rates that are obtained from S(T).

A simplified method for postmortem coronary angiography using gastrograffin

OBJECTIVE

To assess the adequacy of perfusion of the heart at autopsy with a gastrograffin and dye mixture to obtain rapid postmortem angiograms while simultaneously documenting the vascular distribution of the myocardium.

BACKGROUND

Postmortem coronary angiography is occasionally used in the evaluation of suspected cardiac deaths. Angiography provides legal documentation and can serve to guide subsequent cardiac dissection. Multiple techniques have been suggested in the literature for coronary angiography using infusion of radio-opaque silicone or gelatin. These techniques are cumbersome and require equipment generally not available in autopsy suites.

METHODS

Following removal of the heart, a mixture of gastrograffin and colored dyes is injected into each coronary artery via a syringe. The coronary arteries are ligated and radiographs are obtained. After fixation, the heart is dissected in the usual manner.

RESULTS

Adequate postmortem coronary angiograms are routinely obtained with this method. The coronary arterial distribution within the myocardium is easily documented at both the gross and microscopic levels because of the presence of differential coloration.

CONCLUSIONS

The aforementioned technique using a gastrograffin and dye mixture provides a simplified approach to postmortem angiography. The novelty of the procedure stems from the low cost, ease of implementation, dual ability to assess vascular anatomy radiologically (gastrograffin), and gross distribution and histologic findings of dependent tissue using the light microscope (colored dye). This technique is inexpensive, rapid, and easily used, making it more suitable for general hospital practice and medical examiners' offices than previously described methods.

Polycystic ovarian syndrome: assessment with color Doppler angiography and three-dimensional ultrasonography

We conducted a three-dimensional ultrasonographic evaluation of the size and structure of the ovaries of women who had clinical and biochemical findings suggestive of polycystic ovary syndrome. We carried out a comparative color Doppler frequency and color Doppler amplitude study of the vascular patterns of these ovaries. This study involved 65 women of reproductive age with polycystic ovary syndrome and 25 eumenorrheic women who were not taking hormonal contraceptives and who had a body mass index below 25 kg/m2. Compared to controls, women with polycystic ovary syndrome had larger ovaries and thicker stroma, increased impedance in the uterine arteries, increased stromal vascularity with decreased impedance that persisted throughout the menstrual cycle, and a lack of luteal conversion.

Thixotropy of highly viscous sodium (carboxymethyl)cellulose hydrogels

A general method to quantify the thixotropic behavior of systems with very low thixotropy is proposed. The areas enclosed by the rheograms tau = f(gamma) must be fitted to functions with well-determined boundary conditions. From these equations the corresponding thixotropic areas are obtained, together with the theoretical area enclosed by the rheogram corresponding to the maximum rheodestruction. The proposed method is applied to high viscosity sodium (carboxymethyl)cellulose gels.

Shear stress synergism index and relative thixotropic area

Shear stress synergism index and relative thixotropic area are introduced as quantifiers of viscous synergism and comparative thixotropy. The utility of these terms is demonstrated by their application to microcrystalline cellulose-sodium carboxymethyl cellulose (MCC-NaCMC) hydrogel, a starch of different botanical origins hydrogels and their combinations.

The influence of polymer concentration on the 5-fluorouracil release rate from carbopol hydrogels

5-Fluorouracil (5-FU) release kinetics from Carbopol 940 hydrogels prepared at pH 5.5 and five different polymer concentrations (0.0010, 0.0015, 0.0020, 0.0025 and 0.0030 w/w) were determined using Franz diffusion cells. Higuchi's equation for release from solutions was used to calculate the diffusion coefficients of 5-FU in the hydrogels. An empirical equation was obtained for the estimation of diffusivity of 5-FU as a function of polymer concentration, which from a practical view point can be considered useful in preformulation studies. Furthermore, the values of viscosity for all hydrogels assayed were determined. The diffusivity-viscosity relationship resembles the Stokes-Einstein equation for small solutes in liquid phases and provides a factor indicative of additional resistance offered by the gelling agent for drug diffusion.

[Transient polyuria in pregnancy in diabetes insipidus and gestational diabetes]

Two pregnant women developed overt polyuria (up to 11 l/day) and polydipsia during their second and third trimesters of pregnancy. In one patient hydronephrosis was present. Both patients suffered from mild gestational diabetes mellitus. Plasma sodium was 145 and 162 mmol/l. Polyuria and urinary hypo-osmolality responded well to desmopressin acetate. After delivery, polyuria and polydipsia disappeared in one patient and significantly improved in the other. Infusion of hypertonic saline one and two weeks respectively after delivery led to plasma hyper-osmolality (294 mosmol/kg and 305 mosmol/kg) without detectable stimulation of arginine vasopressin (AVP). Anterior pituitary function was normal. No stimulation of AVP occurred following insulin-induced hypoglycemia. AVP plasma disappearance after i.v. pulse injection of 1 microgram AVP as well as AVP plasma concentration after continuous infusion of 10 ng AVP/min was studied two weeks after delivery in one patient. The results suggested markedly elevated degradation of AVP compared to control subjects, probably due to an increased vasopressin activity. Eight months after delivery, hypertonic saline infusion in one patient led to a plasma-osmolality of 312 mosmol/kg without stimulation of AVP. In the second patient, AVP was not detectable (less than 0.2 pg/ml) six months after delivery when plasma osmolality was 290 mosmol/kg. Our studies demonstrate that a subclinical compensated diabetes insipidus was preexistent in both patients. Exacerbation occurred due to an increased AVP-clearance and presumably due to the hemodynamic and hormonal alterations during pregnancy, including a mild gestational diabetes mellitus.