Recurrent episodic fever. A presenting feature of familial mediterranean fever

Objectives to study the natural course and outcome of recurrent episodic fever without serositis as a presenting feature of familial Mediterranean fever [FMF]. Patients: of 309 children with FMF seen over a period of 5 years, 8 presented with recurrent episodes of fever without serositis, imposing a difficult diagnostic problem. Results the age at onset of fever ranged between 5 months and 8 years with a mean of 2.5years. five patients eventually developed serositis. The duration between onset of fever and onset of serositis ranged between 1.5-3 years with a mean of 2 years. Of the 3 patients who did not develop serositis, 2 had a family history of FMF. Therapeutic response to colchicines was dramatic in 7 children [one refused colchicines prophylaxis]. Conclusion episodic fever alone without serositis is a presenting feature of FMF. In patients from Mediterranean ancestors and / or the presence of family history of FMF, a therapeutic diagnostic test with colchicines could be rewarding

anatomical basis of pleural effusion

Pleural effusions associated with pulmonary diseases or malignancy emphasise the absorptive efficiency of the pleura. This review focuses attention on the major role of the lymphatic drainage system in absorbing fluids from the pleural cavity. Mesothelial cells of the diaphragmatic pleura in particular overlie a rich plexus of lymphatic lacunae strategically located within the submesothelial connective tissue. The existence of patent stomata between mesothelial cells of the diaphragm ensures continuity between the pleural cavity and the lymphatic lacunae. These pleurolymphatic stomata are exclusive to the diaphragm and may serve as the main drainage channels for absorption of particulates, pathogens and tumour cells from the pleural cavity. Pleural effusion may develop when production of pleural fluids exceeds the capacity of the lymphatic system and when inflammation or malignant infiltration involves any component of this drainage system

Pharmacokinetic behavior of two tablet formulations of mefenamic acid in healthy volunteers

The pharmacokinetic behavior of single dose of two mefenamic acid tablet formulations was studied in a randomized cross over design in 19 healthy male volunteers. The two products [Fendol DS and Ponstan Forte] were found similar in weight and content uniformity, however Fendol DS tablets had a faster dissolution rate compared to Ponstan Forte. Following ingestion of 500 mg of either of the products blood samples were obtained over a 14 h period and the serum drug concentrations were determined by an HPL assay with ultraviolet detection at 280 nm. The parametric 90% confidence intervals of the mean value of the ratio [Fendol DS/Ponstan Forte] of Pharmacokinetic parameters were 0.91-1.15, 0.92-1.13,0.92-1.23, and 0.94-1.15 for AUC [0'14h], AUC[0-infinity], C[max] and T[1/2], respectively. In each case values were within the acceptable bioequivalence range of 0.8-1.25. Point estimate of the difference of T [max] between the two formulations [Fendol DS - Ponstan Forte] was 0.16 hours with a 90% confidence interval of -0.33-0.64 which overlaps with the stipulated bioequivalence range of +/- 0.39. The kinetic parameters are comparable to what is reported for mefenamic acid and there were no statistically significant differences in any of them when comparing the two products. Thus, the two products could be considered bioequivalent regarding rate of absorption C [max] and T [max], extent of absorption [C[max] and AUC] and elimination t [1/2]