Stability of sulfadiazine sugar-free oral suspensions for the treatment of congenital toxoplasmosis

Abstract This study aimed to develop and evaluate the stability of sulfadiazine sugar-free extemporaneous oral suspensions, focusing on treating congenital toxoplasmosis. The excipients were carefully chosen to obtain safe products for the pediatric population. Sulfadiazine suspensions (100 mg/ mL) were prepared from the raw material or tablets, stored in amber glass bottles at 5±3ºC, and evaluated at 0, 14, and 30 days. An ultra-performance liquid chromatographic method was developed and validated to assay the drug. The particle size ranged from 29.3 to 50.6 µm, with some variation over the study; pH values around 7.0 and non-Newtonian behavior were observed without modification in the period. Formulations showed a fast dissolution rate (>80% in 15 minutes) without variation over the study. The drug assay was about 100% of the label claimed throughout the study, demonstrating the chemical stability and the preparations' dose homogeneity. The microbiological investigation indicated that both preparations met the requirements for the microbial count and absence of pathogens. In conclusion, the developed formulations can be used for 30 days when stored under refrigeration. The oral suspensions produced are easy to prepare and contain safe components, providing an alternative for congenital toxoplasmosis treatment in children.

Antibacterial and Wound Healing Activity of 2% Formulation of 2-Medpy-3-CN on Infected Burn Wounded Animal Model

@#Introduction: Humans have learned to recognize and process plants into medicinal forms through centuries. Burns can spread to other tissues, especially when infected with bacteria such as Methicillin-Resistant Staphylococcus aureus (MRSA). The study aimed to assess the in vivo antibacterial and wound healing activity of 2% formulation of 2-Medpy-3-CN on infected burn wounded animal model. Methods: In vitro antibacterial activity of the Alsti was done by broth dilution and disc diffusion methods. Alsti 2% ointment was prepared for the infected burn wound treatment. A total of 18 rats are grouped into A, B, C, and D, the first three groups (A-C) were injured thermally, and Group D was used as healthy controls. The three test Groups were exposed to MRSA ATCC 43300 at 105 CFU/mL. Group A was treated with 2% Alsti, Group B with Silver sulfadiazine 1% (SSD), and Group C was untreated. Wounds healing was assessed by the healed area and microscopic identification of hematoxylin and eosin (H&E)-stained skin tissue. Results: Wound healing progresses with application of Alsti 2% ointment as observed through wound diameter and histopathological changes of the skin. Wound diameter decreases with treatments, while the contrary was observed in the non-treated group. Microscopic observation of the stained skin showed that epidermal development, and collagen formation progress with treatment days. Untreated wounds showed marked inflammation, progressive ulceration, and necrosis. Conclusion: Alsti 2% formulation showed antibacterial and wound healing activities, hence, can be used as alternative in burn wound infections.

Study on quality standard of compound Yuhong suppository / 药学实践杂志

Objective To establish the quality standard of compound Yuhong suppository. Methods Angelica dahurica, colophony and Sophora flavescens Alt. were identified by thin layer chromatography（TLC）method. The contents of sulfadiazine and dyclonine hydrochloride were determined by HPLC with diode array detection method. The mobile phase was methanol-0.02 mol/L potassium dihydrogen phosphate (adjusted to pH 3.3 with phosphoric acid) for gradient elution. The detection wavelength was 280 nm for sulfadiazine and dyclonine hydrochloride. Results The three Chinese traditional medicines were identified by TLC with clear spots. The linear ranges of sulfadiazine and dyclonine hydrochloride were good in 12.40-99.20 μg/ml (r=0.999 9) and 2.56-20.48 μg/ml (r=0.999 9). The average recovery was (99.21±0.43) % (n=9) and (99.54±0.68) % (n=9). Conclusion This method is accurate, sensitive, and reproducible. It can be used as a standard method for the quality control of compound Yuhong suppository.

Development and Characterization of a Hydrogel Containing Silver Sulfadiazine for Antimicrobial Topical Applications. Part II: Stability, Cytotoxicity and Silver Release Patterns

Abstract Hydrogels are interesting for use in the treatment of topical wounds due to their virtually zero toxicity, and capacity for extended release of pharmaceuticals. Silver sulfadiazine (SSDZ) is the drug of choice in the treatment of skin burns. The aim of the study was to determine cytotoxicity, antimicrobial activity and stability of a PVA hydrogel with integrated silver sulfadiazine. SSDZ-hydrogels were prepared using 10% (w/w) PVA (either 89% or 99% hydrolyzed) and 1% (w/w) silver sulfadiazine. Cellular viability was assessed via MTS assays, antimicrobial activity via disk-diffusion and accelerated stability tests were carried out with analysis at 0, 30, 60, 90 and 180 days of storage at 40 ± 2 °C and a relative humidity of 75 ± 5%. The parameters evaluated included organoleptic characteristics, moisture, swelling ability, mechanical strength, FTIR, XRD, TGA and DSC, and silver release patterns via XRD and potentiometry. Cell viability tests indicated some cytotoxicity, although within acceptable levels. After 90 days of storage, SSDZ hydrogel samples exhibited a brown coloration, probably due to the formation of Ag or Ag2O nanoparticles. The SSDZ-loaded hydrogels suffered visual and physical changes; however, these changes did not compromise its use as occlusive wound dressings or its antimicrobial properties.

Extended Hildebrand solubility approach and Yalkowsky-Roseman mode l for estimating the solubility of sulfadiazine and sulfamethazine in some {ethylene glycol (1) + water (2)} mixtures at several temperatures

SUMMARY Aim: extended Hildebrand Solubility Approach (EHSA) and Yalkowsky Roseman (YR) were applied to evaluate the solubility of sulfadiazine, and sulfamethazine in ethylene glycol + water mixtures. Methodology: reported experimental equilibrium solubilities and some fusion properties of these drugs were used for the calculations. Results: a good predictive character of EHSA (with mean deviations lower than 3.0%) were found by using regular polynomials in order two correlating the inter-action parameter W with the Hildebrand solubility parameter of solvent mixtures without drug; however, the results obtained from YR model show relatively high deviations greater than 50%.

Objetivo: aplicar los enfoques de los modelos de Solubilidad Extendido de Hildebrand (EHSA) y Yalkowsky Roseman (YR) para evaluar la solubilidad de sulfadiazina y sulfametazina en mezclas de etilenglicol + agua. Metodología: para los cálculos se utilizaron las solubilidades experimentales en equilibrio reportadas y algunas propiedades de fusión de estos fármacos. Resultados: en particular, se encontró un buen carácter predictivo de EHSA (con desviaciones medias inferiores al 3,0%) utilizando polinomios regulares en orden dos correlacionando el parámetro de interacción W con el parámetro de solubilidad de Hildebrand de mezclas de disolventes sin fármaco; sin embargo, los resultados obtenidos del modelo YR muestran desviaciones relativamente altas superiores al 50%.

Objetivo: aplicar as abordagens dos modelos de Solubilidade Estendida de Hildebrand (EHSA) e Yalkowsky Roseman (YR) para avaliar a solubilidade de sulfadiazina e sulfametazina em misturas de etilenoglicol + água. Metodologia: as solubilidades de equilíbrio experimental relatadas e algumas propriedades de fusão dessas drogas foram usadas para os cálculos. Resultados: em particular, foi encontrado um bom caráter preditivo de EHSA (com desvios médios menores que 3,0%) usando polinômios regulares na ordem dois, correlacionando o parâmetro de interação W com o parâmetro de solubilidade de Hildebrand de misturas de solventes sem fármaco; no entanto, os resultados obtidos com o modelo YR mostram desvios relativamente altos superiores a 50%.

Utilidad del apósito liofilizado de piel de cerdo en el manejo de cicatrización de úlcera de pie diabético / Usefulness of lyophilized pig skin dressings in wound healing as treatment for diabetic foot ulcer

Resumen Objetivo: Mostrar la utilidad del apósito liofilizado de piel de cerdo comparado con el manejo conservador con sulfadiazina de plata en el proceso de cicatrización de la úlcera de pie diabético. Materiales y Método: Estudio cuasiexperimental en pacientes con diagnóstico de pie diabético, se establecieron 2 grupos de estudio utilizando una relación 2:1, el grupo de exposición (10 pacientes) tratado con apósito liofilizado de piel de cerdo y el grupo de control (5 pacientes) manejado con sulfadiazina de plata. La utilidad se midió con la cicatrización en semanas de tratamiento. El análisis estadístico incluyó prueba de t, prueba de z, regresión logística simple y cálculo de la probabilidad del evento. Resultados: El tiempo de cicatrización fue más corto en el grupo manejado con apósito liofilizado de piel de cerdo (10,20 semanas) que en el grupo con manejo a base de sulfadiazina de plata (13,8 semanas). A las 9 semanas de iniciado el tratamiento, la mitad de las pacientes con apósito de piel de cerdo ya habían cicatrizado comparado con la cicatrización en el grupo manejado con sulfadiazina de plata (20%). La probabilidad de cicatrización a las 11 semanas en paciente manejados con sulfadiazina de plata es 20% y con apósito liofilizado de piel de cerdo 80%. Conclusión: El apósito liofilizado de piel de cerdo tuvo mejores resultados en el estudio, comparado con el manejo estándar con sulfadiazina de plata. Es necesario realizar un estudio aleatorizado para determinar la efectividad de este material como herramienta terapéutica.

Aim: To demonstrate the usefulness of lyophilized pig skin dressings versus usual management with silver sulfadiazine in wound healing treatment for diabetic foot ulcers. Materials and Method: In this quasi-experimental study, we included patients diagnosed with diabetic foot. We established two groups with a distribution (2:1), the exposure group treated with lyophilized pig skin dressings (10 patients) and the control group (5 patients), the standard of care with silver sulfadiazine. Usefulness was measured with wound healing in treatment weeks. Statistical analysis included t-test, z-test, simple logistic regression, and calculation of probability of an event. Results: Wound healing time was shorter in the group treated with lyophilized pig skin dressing (10.20 weeks) than in the group treated with silver sulfadiazine (13.8 weeks). At 9 weeks after treatment started, 50% of patients treated with lyophilized pig skin dressings had complete wound healing compared with the patients in the group managed with silver sulfadiazine. (20%). The probability of wound healing been completed at 11 weeks in a patient managed with silver sulfadiazine is 20%, compared to lyophilized pig skin dressings is 80%. Conclusion: Lyophilized pig skin dressings had better outcomes than silver sulfadiazine in wound healing treatment for diabetic foot ulcers inside the study. Is mandatory develop another study with a randomized design to determinate the effectiveness as a therapeutic alternative.

Wound healing activity of Allium cepaL. bulbs in a second-degree burn wound model in Holtzman rats / Actividad cicatrizante de los bulbos de Allium cepa L. en un modelo de quemadura de segundo grado en ratas Holtzman

Background: The bulb of Allium cepa Linnaeus (onion) is used in traditional medicine as an antidiabetic, antioxidant, antihypertensive, anti-inflammatory, and antihyperlipidemic, among others. The lack of information or little knowledge about the effects of Allium cepa L. on skin lesions, specifically burn wounds, arouses interest in studying its effects on these skin disorders. Objective: This study assessed the wound healing activity of Allium cepa L. on second-degree burns induced in Holtzman rats. Method: Thirty-two albino rats were randomly distributed into four groups of 8 rats each, including the Healthy group, the Control group, the Experimental group (Alliumcepa L.), and the Standard group (1% silver sulfadiazine). Burn wounds were induced, and topical treatments were performed daily for 21 days. The reduction of the burned body area (mm2) was determined during the experimental time. Albino rats were sacrificed with an excess of surgical anesthesia to obtain tissue samples for histopathological analysis. Results: Standard and experimental groups significantly reduced burned body area (p<0.01) compared to the control group. Histopathological studies showed hyperemic chorion in the Control group, fibroblasts, and collagen in the Standard group, and dermis composed of a reticular stratum of fibroblasts, collagen, and few blood vessels in the Experimental group. Conclusion: Allium cepa L. revealed wound-healing activity on burns induced in Holtzman rats and reduced the damage produced by burns

Antecedentes: El bulbo de Alliumcepa L. (cebolla) se utiliza en medicina tradicional como antidiabético, antioxidante, antihipertensivo, antiinflamatorio, anti hiperlipidémico entre otros. La falta de información o muy poco conocimiento acerca de los efectos de Allium. cepa L. en lesiones cutáneas, específicamente en las heridas por quemaduras, despierta el interés por estudiar sus efectos en estas afectaciones cutáneas. Objetivo: El objetivo de este estudio fue evaluar la actividad cicatrizante de Allium. cepa L. en quemaduras de segundo grado inducidas en ratas Holtzman. Método: Se utilizaron treinta y dos ratas albinas distribuidas al azar en cuatro grupos de ocho ratas cada uno, incluyendo el Grupo sano, el Grupo Control, el Grupo Experimental (Allium cepa L.) y el Grupo Estándar (Sulfadiazina de plata al 1%). Se indujo la herida por quemadura, y los tratamientos tópicos se realizaron diariamente durante 21 días. La reducción del área corporal quemada (mm2) se determinó durante el tiempo de experimentación, luego los animales fueron sacrificados con exceso de anestesia quirúrgica para obtener las muestras de tejidos para el estudio histopatológico. Resultados: Los grupos estándar y experimental mostraron reducción significativa en el área corporal quemada (p<0,01) comparadas al grupo control. El estudio histopatológico evidenció corion hiperémico en el grupo control; fibroblastos y colágeno en el grupo estándar y dermis integrada por un estrato reticular de fibroblastos, colágeno y pocos vasos sanguíneos en el grupo experimental. Conclusión: Alliumcepa L. reveló actividad cicatrizante en quemaduras inducidas en ratas Holtzman, y disminuyó el daño producido por las quemaduras

The investigation of the stability of 8 commonly used reference solutions by HPLC / 药学实践杂志

Objective To investigate the stability of 8 commonly used reference solutions and determine the validity period of internal control. Methods The storage solutions of reference substances were prepared and stored in the refrigerator at 2 to 10 ℃. The content of the storage solutions and the newly prepared reference solutions were determined by HPLC on days 0, 1, 4, 7, 10, 14, 21, 28 and 35, and their change values of the content were calculated. Results During the inspection period, the appearance of each reference solution was consistent with the newly prepared reference solution. There was no significant impurity peak in the chromatography. For mixed references of metronidazole, chloramphenicol and salicylic acid stored for 7 days, vitamin E, mixed references of tinidazole and chlorhexidine acetate, sulfadiazine, dexamethasone phosphate for 35 days, their contents met the requirements. Conclusion Stored in the refrigerator at 2 to 10 ℃, the effective time period of vitamin E reference solution, mixed references solution of tinidazole and chlorhexidine acetate, sulfadiazine reference, dexamethasone phosphate reference solution can be 35 days, and the mixed references solution of metronidazole, chloramphenicol and salicylic acid defined can be 7 days.

Optimization of determination method for silver sulfadiazine cream and its stability under extreme conditions / 药学实践杂志

Objective To optimize the method of assay for silver sulfadiazine, and to investigate its stability in high temperature, humidity and salt environment. Methods Agilent ZORBAX SB-C18 column was used in HPLC for the determination of silver sulfadiazine with acetonitrile and 0.1% phosphoric acid as mobile phase.The flowing rate was 1.0 ml/min and column temperature was 30℃. Salt spray test chamber was used to simulate the high temperature, humidity and salt environment. The silver sulfadiazine content was assayed at 0, 2, 4, 6, 8, 10, 12 weeks. Results The calibration curve was linear within the range of 4.00～20.00 μg/ml (r=0.9999). The average recovery was 101.47% (RSD=2.33%). The content of silver sulfadiazine cream began to decrease significantly after 4 weeks. Conclusion This method is convenient, accurate and reliable. It can be used for the content determination of silver sulfadiazine in the cream.The results showed that the silver sulfadiazine cream was unstable in the environment of high temperature, humidity and salt. Therefore, environmental impact should be fully considered in transportation, storage and application. For the long-distance navigation mission, protective measures should be taken for its packaging or replace it with more stable products.

Prediction of sulfadiazine solubility in some cosolvent mixtures using non-ideal solution models / Predicción de la solubilidad de la sulfadiazina en algunas mezclas cosolventes utilizando modelos de solución no ideales

SUMMARY The experimental data of sulfadiazine in (methanol + water), (ethanol + water) and (1-propanol + water) cosolvent mixtures at some temperatures were correlated using non-ideal solution models, namely, the modified Apelblat and Buchowski-Ksiazaczak equations and the van't Hoff equation. The calculated results agreed well with the experimental data. According to the Buchowski equation, the solubility of sulfadiazine in the three co-solvent mixtures shows important deviations from ideality, which is consistent with the literature.

RESUMEN Los datos experimentales de sulfadiazina en mezclas de cosolvente de (metanol + agua), (etanol + agua) y (1-propanol + agua) a algunas temperaturas se correlacionaron utilizando modelos de solución no ideales, a saber, las ecuaciones modificadas de Apelblat y Buchowski y la ecuación de van't Hoff. Los resultados calculados coincidieron bien con los datos experimentales. Según la ecuación de Buchowski, la solubilidad de la sulfadiazina en las tres mezclas de cosolventes muestra importantes desviaciones de la idealidad, lo que concuerda con la literatura.

Effectiveness of chlorhexidine/silver sulfadiazine catheters in the prevention of catheter-related bloodstream infections: A traditional meta analysis / 解放军医学杂志

[Abstract] Objective To evaluate the effectiveness of chlorhexidine/silver sulfadiazine catheters vs. conventional standard catheters in the prevention of catheter-related bloodstream infections with bundles. Methods We searched the Cochrane Library, Embase, Medline, CINAHL and Web of Science databases from construction to March 2019 for randomized controlled trials to compare the use of chlorhexidine/silver sulfadiazine catheters and conventional standard catheters. Cochrane bias risk assessment tool was used to evaluate the included research, and the effective data was extracted. The set risk ratio (RR) was calculated with 95% confidence interval (CI), and the rate of CRBSI per 1000 catheter-days and bacterial colonization rate were measured. The primary outcome was CRBSI thousand day rate and the secondary outcome was bacterial colonization rate. The meta analysis was performed by R3.4.1 software. Results Seventeen trials included 4892 patients who received chlorhexidine/sulfadiazine silver coated catheters and conventional standard catheters were included. Compared with conventional standard catheters, chlorhexidine/ silver sulfadiazine catheters were associated with a lower incidence of catheter colonization (RR=0.55, 95%CI: 0.45-0.68, P=0.02). In addition, the the difference of the rate of CRBSI per 1000 catheter-days was not significant (RR=0.70, 95%CI: 0.48-1.02, P=0.32). Conclusion Compared with conventional standard catheters, the use of chlorhexidine/silver sulfadiazine-catheters with bundles can further reduce the incidence of catheter colonization, but does not reduce the rate of CRBSI per 1000 catheter-days.

Condução da toxoplasmose gestacional / Management of gestational toxoplasmosis

A toxoplasmose é uma doença proveniente do Toxoplasma gondii, um protozoário que tem os felinos como seu hospedeiro definitivo e os mamíferos e aves como seu hospedeiro intermediário. Tem um curso benigno e autolimitado quando acomete um indivíduo imunocompetente, no entanto a infecção durante a gestação acarreta até 50% de chance de toxoplasmose congênita, podendo causar danos severos ao feto. A virulência dos genótipos encontrados nas Américas Central e do Sul é a mais alta, comparada a Europa e América do Norte, tendo a doença um comportamento mais agressivo. Os estudos relatam a diminuição da infecção fetal em até 60% com o uso da espiramicina, usada ainda na profilaxia. Este artigo discute sobre a triagem materna pré-natal e sua necessidade, a profilaxia e o tratamento da infecção fetal ainda intraútero, com o objetivo de diminuir a transmissão vertical e as sequelas neonatais com suas implicações ao longo da vida.(AU)

Toxoplasmosis it is a disease originating from Toxoplasma gondii, a protozoan that has felines at as ultimate host and mammals and birds at as intermediate host. Has a benign and self-limiting course when affects immunocompetent individual, however, infection during pregnancy leads 50% chance of congenital toxoplasmosis and can cause severe damage to the fetus. The virulence of genotypes found in Central and South America is the highest compared to Europe and North America, having the disease a more aggressive behavior. Studies report a reduction in fetal infection 60% with the use spiramycin still used for prophylaxis. This article discusses prenatal maternal screening, prophylaxis and treatment of fetal infection still in utero with the objective of decreasing vertical transmission and neonatal sequelae with their lifelong implications.(AU)

Tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments: a systematic review and meta-analysis of randomized controlled trials

Abstract This study aims to evaluate tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments. This is a systematic literature review and meta-analysis of randomized clinical trials performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and PICO strategy, registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42017081057. The review found 71 studies in MEDLINE/Pubmed, 1 in Clinical Trials, 19 in the Cochrane Library, and 4 in LILACS in five manual searches. Of these, 81 studies were pre-selected. After independent analysis by two reviewers, only 11 studies met the inclusion criteria for the review. All studies (n = 11) using alternative treatments to silver sulfadiazine were shown to be superior in the mean time for complete wound healing, with statistically significant differences between experimental and control groups (p <0.00001); mean difference (- 4.26), 95% CI [- 5.96, - 2.56].

Comparison of Collage Dressing with Sulfadiazine Dressing in Management of Partial-thickness Burns

Introduction: Collagen is an endogenous substance, which forms an important structural component in connective tissue andis of special importance in the skin. The importance of collagen in healing has been appreciated for many years for the simplereason that the end result of wound healing is always a scar which is composed of collagenous fibers.Aims: This prospective randomized controlled study was designed to compare the effectiveness of collagen dressing and silversulfadiazine dressing in partial-thickness burns.Materials and Methods: This study was conducted at Government Royapettah Hospital, Chennai. A total of 60 patients withpartial-thickness burn wounds were included in this study, and they are divided into two groups. Group 1 consisted of 30 patientsin whom collagen dressing was done. Group 2 consisted of 30 patients in whom silver sulfadiazine dressing was done. Thevariables analyzed were pain score, infection rate, the rate of healing of the wound, resultant scar, and patient compliance.Patients with partial-thickness burns involving <40% of the total body surface area and wounds not older than 24 h are inclusioncriteria in the study, whereas patients with full-thickness burns, burns involving >40% of the total body surface area, woundsolder than 24 h, and facial burns are the exclusion criteria for this study.Results: The average pain score in the range of 0–10 was 7.10 in the silver sulfadiazine group and 2.87 in the collagen group.Infection was present in 40% of the patients in the silver sulfadiazine group, whereas it was only 13.3% in the collagen group. Insilver sulfadiazine group, healing was achieved on an average of 17.77 days, whereas in the collagen group, it took 11.80 days.Conclusion: Collagen sheet promotes early healing, decreases the need for analgesics, and reduces the incidence of associatedcomplications such as infection. The morbidity of the patients is reduced as the resultant scar is better in the majority of thepatients using collagen. Due to the simple application and good tolerance of the membrane, collagen can be advocated as atemporary biological dressing material in partial-thickness burns.

Toxoplasmosis congénita, una mirada en la actualidad del tratamiento; revisión de la literatura / Congenital toxoplasmosis, a look at contemporary treatment; literature review / Toxoplasmose congênita, um olhar atual no tratamento; revisão de literatura

Introducción. La Toxoplasmosis congénita constituye una causa significativa de morbi-mortalidad neonatal en países de bajos ingresos como Colombia. Puede originar prematuridad, secuelas patológicas y pérdida fetal. El tamizaje en las gestantes y, a su vez, un tratamiento oportuno y adecuado disminuye la transmisión vertical y sus nefastas secuelas. El objetivo es presentar evidencia científica actualizada sobre el tratamiento farmacológico de la Toxoplasmosis Congénita. Metodología. Se realizó una búsqueda no sistemática en bases de datos: Pubmed, Medline, Clinical Key y Springer. Se incluyeron artículos originales y de revisión de tema publicados desde enero de 2014 hasta abril de 2019. División de los temas tratados. se abordan la fisiopatología y clínica, el abordaje diagnóstico, alternativas de prevención y tratamiento. Conclusiones. En la actualidad la terapia farmacológica es limitada, los esquemas de manejos se basan en espiramicina o la combinación de sulfadiazina/pirimetamina y ácido folínico; estas moléculas no son del todo bien toleradas y presentan un amplio espectro de reacciones adversas secundario a sus efectos tóxicos; resulta necesario la ejecución de estudios aleatorizados para evaluar su efectividad. Cómo citar: Rueda-Paez YS, Valbuena-Ruiz L, Quintero-Pimiento N, Pinilla-Plata A, Sayago-Silva J. Toxoplasmosis congénita, una mirada en la actualidad del tratamiento; revisión de la literatura. MedUNAB. 2019;22(1):51-63. doi: 10.29375/01237047.2612

Introduction. Congenital Toxoplasmosis constitutes a significant cause of neonatal morbimortality in underdeveloped countries like Colombia. It can cause prematurity, pathological after-effects and fetal loss. Screening expectant mothers and in turn, a timely and adequate treatment, reduce vertical transmission and its devastating effects. The objective is to present up-to-date scientific evidence about the pharmacological treatment of Congenital Toxoplasmosis. Methodology. A non-systematic search of databases was conducted: Pubmed, Medline, Clinical Key and Springer. Original and topic review articles were included dating from January 2014 to April 2019. Division of topics covered. Physiopathology and clinical pathology, diagnostic approach, prevention and treatment alternatives were addressed. Conclusions. At this time, pharmacological therapy is limited, management schemes are based on spiramycin or a combination of sulfadiazine/pyrimethamine and folinic acid; these molecules are not very well tolerated and exhibit a wide spectrum of adverse reactions apart from their toxic effects, thus it is necessary to conduct randomized studies to evaluate its effectiveness. Cómo citar: Rueda-Paez YS, Valbuena-Ruiz L, Quintero-Pimiento N, Pinilla-Plata A, Sayago-Silva J. Toxoplasmosis congénita, una mirada en la actualidad del tratamiento; revisión de la literatura. MedUNAB. 2019;22(1):51-63. doi: 10.29375/01237047.2612

Introdução. A toxoplasmose congênita é uma causa significativa de morbidade e mortalidade neonatal em países de baixa renda, como a Colômbia. Pode causar prematuridade, sequelas patológicas e perda fetal. A triagem em gestantes e, por sua vez, um tratamento oportuno e adequado diminui a transmissão vertical e suas consequências desastrosas. O objetivo é apresentar evidências científicas atualizadas sobre o tratamento farmacológico da Toxoplasmose Congênita. Metodologia. Foi realizada uma revisão não sistemática nas bases de dados: Pubmed, Medline, Clinical Key e Springer. Foram incluídos tanto artigos originais, quanto revisões de tópicos publicados de janeiro de 2014 até abril de 2019. Divisão dos tópicos discutidos. foram abordadas a fisiopatologia e a clínica, a abordagem diagnóstica, alternativas para prevenção e tratamento. Conclusões. Atualmente, a terapia farmacológica é limitada, os esquemas terapéuticos baseiam-se na espiramicina ou na combinação de sulfadiazina/pirimetamina e ácido folínico; estas moléculas não são totalmente toleradas e apresentam um amplo espectro de reações adversas secundárias aos seus efeitos tóxicos. É necessário realizar estudos randomizados para avaliar sua eficácia. Cómo citar: Rueda-Paez YS, Valbuena-Ruiz L, Quintero-Pimiento N, Pinilla-Plata A, Sayago-Silva J. Toxoplasmosis congénita, una mirada en la actualidad del tratamiento; revisión de la literatura. MedUNAB. 2019;22(1):51-63. doi: 10.29375/01237047.2612

Comparative study of wound healing effect of topical Acacia catechu extract and silver sulfadiazine on excisional wound model in guinea pigs

Background: Impaired and aberrant wound healing imposes a huge financial burden and places an enormous drain in health care resources in the developed world and an insurmountable problem in the developing countries too. In this study, authors have compared the wound healing effect of topical application of Acacia catechu extract with silver sulfadiazine in excisional wound model in guinea pigs.Methods: Twelve guinea pigs were randomly divided into two groups (n=6). The wound healing was observed in excision model. The standard group is treated with silver sulfadiazine (group 1) and the test group with Acacia catechu extract (group 2). The mean wound size expressed in mm2 and the mean percentage of the wound healed was measured on day 0, 4, 8, 12, 16 and 19. Biopsy was done on day 21 for histopathological examination (HPE).Results: Statistical analysis was done by using unpaired t test for between the groups comparison and by using paired t test for within the group comparison. The mean percentage of the wound healed with-in the groups was found to be statistically highly significant (p value <0.001) and in between the groups was found to be statistically non-significant (p value >0.05). A comparable increase in collagen content and granulation tissue was found on HPE in both the groups on day 21.Conclusions: Wound healing effect of the Acacia catechu extract is equal to and comparable with that of silver sulfadiazine.

Comparación de dos técnicas de curación en pacientes quemados pediátricos / Comparison of two healing techniques in pediatric burned patients

Introducción: Existen varias curaciones para quemaduras. La sulfadiazina de plata se ha usado por años pero las membranas microporosas son cada vez más preferidas. Objetivos: Comparar la eficiencia de las membrana microporosa (Telfa Clear®) versus sulfadiazina de plata (Platsul®) en menores de 15 años hospitalizados por quemadura. Pacientes y Métodos: Estudio de cohorte retrospectivo de 87 pacientes, dividido en 2 grupos comparables en extensión y profundidad de la quemadura, edad y sexo. Durante enero a diciembre 2007 se curaron 52 pacientes con Platsul® y desde enero a octubre 2008 se curaron 35 con Telfa Clear®. Se evalúa tiempos y extensión de reepitelización, porcentaje de injertos, costos, días de hospitalización, número de curaciones, complicaciones, almacenamiento-estabilidad y costos. Estadística no paramétrica para el análisis univariado y regresión logística multivariado en Stata 11.2. Resultados: Los pacientes curados con Platsul® se injertaron más tardíamente y presentan más curaciones. Platsul® es peor evaluado por su almacenamiento-estabilidad y mayores costos. No hay diferencia en la incidencia de infección. Conclusiones: Ambas Técnicas son eficientes en permitir reepitelización, pero Platsul® puede demorar el injerto. La Telfa Clear® es mejor evaluado por el equipo de salud en cuanto a almacenamiento y estabilidad. El menor costo de Telfa Clear® es una ventaja.

Introduction: There are several dressings for burns. Silver sulfadiazine has been used for years but microporous membranes are increasingly preferred. Objectives: To compare the efficiency of microporous membrane (Telfa Clear®) versus silver sulfadiazine (Platsul®) in children younger than 15 years old hospitalized for burns. Patients and Methodology: Retrospective cohort study of 87 patients, divided into 2 comparable groups in extent and depth of the burn, age and sex. During January to December 2007, in 52 patients Platsul® were use and in 35 patients Telfa Clear® were use from January to October 2008. The time and extent of re-epithelialization, percentage of grafts, costs, length of stay, number of dressing change, complications, storage-stability and costs are evaluated. Non-parametric statistics were used for univariate analysis and logistic regression for multivariate analysis en Stata 11.2. Results: Platsul® was associate to a later graft and had a greater number of dressing changes. Platsul® is worst rated for its storage-stability and higher costs. No difference in infection rate was observed. Conclusions: Both techniques are efficient in allowing re-epithelialization, but burns treated with Platsul® were grafted later than when Telfa Clear® was used. Telfa Clear® is best evaluated by the health team in terms of storage and stability. The cost of Telfa Clear® is presented as an advantage.

Loxoscelismo escrotal / Scrotal loxoscelism

Loxoscelismo es el cuadro clínico originado por la mordedura de araña del género Loxosceles. Es considerado un accidente que ocurre con mayor frecuencia en las noches, debido al hábito nocturno de la araña y buena adaptación a los ambientes domésticos, preferentemente en espacios oscuros y secos. Clínicamente presenta dos escenarios, cutáneo (83,3 %) y visceral o sistémico (16 %), con una variación del cuadro cutáneo denominado loxoscelismo predominantemente edematoso. El objetivo es informar un caso inusual de loxoscelismo escrotal. El diagnóstico se realizó mediante las características clínicas y epidemiológicas del accidente. En conclusión, el loxoscelismo escrotal es una entidad muy infrecuente, el manejo del paciente influye mucho en su evolución y progresión; el tratamiento exhaustivo con sulfadiazina 2 veces al día y antibióticos intravenosos, muestra resultados muy favorables.

Loxoscelism is a condition produced by the bite of spiders from the genus Loxosceles. It is considered to be an accident that occurs mostly in the night, due to the spider's nocturnal habits and good adaptation to domestic environments, preferably dark, dry spaces. It presents in two clinical scenarios: cutaneous (83.3 %) and visceral or systemic (16 %), with a variation in the cutaneous manifestation known as predominantly edematous loxoscelism. The objective of the study was to report an unusual case of scrotal loxoscelism. Diagnosis was based on the clinical and epidemiological characteristics of the accident. It is concluded that scrotal loxoscelism is a very infrequent condition. Management of the patient greatly influences its evolution and progress. Exhaustive treatment with sulfadiazine twice daily and intravenous antibiotics yields very favorable results.

Voltammetric Sensor Based on β-Cyclodextrin-Carbon Nanosheets Modified Electrode for Rapid Determination of Sulfadiazine / 分析化学

Carbon nanosheets load beta-cyclodextrin (β-CD-CNS) as a new modified electrode materials was reported for the electrochemical determination of sulfadiazine(SD). Carbon nanosheets(CNS) were prepared by a new method of ultrasonic electrolysis in which the β-CD was attached on CNS through ultrasonic dispersion method. The β-CD-CNS composite nanomaterials were immobilized onto glassy carbon electrodes with drops of coating method to construct an SD voltammetric sensor. The differential pulse stripping voltammetry (DPSV) was used to characterize the electrocatalytic behavior of the developed sensor. The Effects of some parameters on the response behavior of the sensor such as pH,modification amount,scanning rate,stirring speed,stirring time,deposition potential and time were investigated and optimized. The results indicated that the β-CD-CNS composite nanomaterials had excellent electroactivity for the SD in neutral solution and greatly improved the current response of SD. Under the optimal conditions, the SD had an irreversible characteristic oxidation peak around+0.87 V,and the oxidation peak current ip(μA) had a good linear relationship with the concentration C ( μmol/L) of the SD in concentration range of 0.05 μmol/L-13.5 μmol/L with correlation coefficients of 0.999. The detection limit was 12.2 nmol/L (S/N=3). The sensor was successfully applied for the trace SD determination in water and milk samples and the recoveries from the spiked samples were 80.0%-102% with RSD≤5.2%.

Effect of mannatide combined with silver sulfadiazine on the burn wounds / 中国基层医药

Objective To observe the effect of mannatide combined with silver sulfadiazine for burn wound. Methods A total of 128 cases with burn wound in the People's Hospital of Yangquan Suburb were selected in the research and randomly divided into two groups according to the digital table ,with 64 cases in each group.The control group was given mannatide treatment ,the observation group was treated with mannatide combined with silver sulfadia-zine.The burn wound appearance ,burn wound healing and the incidence of adverse reactions were compared between the two groups.Results The improve rate of wound,wound exudate rate,decrustation rate in the observation group were 82.81%,18.75%,62.50%,respectively,which were higher than those in the control group (50%,46.88%, 31.25%,χ2＝14.71,11.48,12.55,all P＜0.01).The immediate pain relief rate ,infection rate,incidence rate of scar formation and wound healing time in the observation group were 90.63%,3.13%,12.50%,(16.85 ±1.63)d, respectively,which were significantly better than those in the control group [62.50%,14.06%,28.13%,(23.64 ± 2.16)d],there were statistically significant differences between the two groups (χ2＝14.11,4.87,4.83,t＝20.07, all P＜0.05).The incidence rate of adverse reactions in the observation group was 3.13%,which was significantly lower than 14.06%in the control group (χ2＝4.87,P＜0.05).Conclusion Mannatide combined with silver sulfa-diazine is safe and effective in the treatment of burn wound.It can improve burn wound appearance and shorten wound healing time,which is suitable for use in clinical practice.