Application of capillary zone electrophoresis to determine second-generation H1 antihistaminic drugs, loratadine and rupatadine

Abstract The second generation of H1 antihistamines from the piperidine group are often used for treating allergic diseases due to their action on histaminic receptors, the primary mediator of allergy. Moreover, the antihistamines have anti-inflammatory action, mediated through platelet-activating factor blocking activity. A simple and rapid capillary zone electrophoresis method was developed and validated for the determination of loratadine (LOR) and rupatadine (RUP) in tablets. The analyses were carried out using a fused silica capillary of 50.2 cm (40 cm effective length), 75 µm i.d. The background electrolyte was composed of boric acid 35 mmol/L, pH 2.5. Voltage of 20 kV, hydrodynamic injection of 3447.3 Pa for 3s, temperature at 25 ºC, and UV detection at 205 nm were applied. Electrophoretic separation was achieved at 1.8 and 2.8 min for RUP and LOR, respectively. The method was linear for both drugs in a range of 50.0 to 400.0 µg/mL (r>0.99). The limits of detection and quantification were 46.37 and 140.52 µg/mL, for LOR and 29.60 and 89.69 µg/mL for RUP respectively. The precision was less than 5.0 % for both drugs. The average recovery was approximately 100 %. The proposed novel method can significantly contribute to the rapid detection of counterfeit products and in quality control of drug products containing antihistamines

Manifestações oftalmológicas de Síndrome de Klippel Trenaunay / Ophthalmological manifestation of the Klippel Trenaunay Syndrome

RESUMO A Síndrome de Klippel-Trenaunay (SKT) é uma doença congênita rara, com maior prevalência no sexo masculino e incidência de 2-5:100.000. Apresenta-se, na forma clássica, como a tríade de manchas vinho porto, hipertrofia de membros e malformação venosa e/ou linfática. O diagnóstico é essencialmente clínico e devido à complexidade da síndrome, de natureza progressiva e ampla variedade de apresentações clínicas, os pacientes devem ser tratados de forma individualizada por uma equipe multidisciplinar. Alterações oftalmológicas associadas à SKT incluem anormalidades vasculares da órbita, íris, retina, coroide e nervo óptico. Relato de caso: Paciente de 23 anos, sexo feminino, portadora de SKT, em acompanhamento no Centro da Visão - Universidade Federal do Paraná, com queixa de diminuição da acuidade visual em olho direito. A paciente apresentava manchas vinho porto em dimidio direito e hipertrofia de membros ipsilateral. Foi diagnosticado glaucoma e realizados exames complementares oftalmológicos a fim de avaliar o grau de comprometimento dos campos visuais e o fundo de olho. A visão com a melhor correção foi de 20/100 OD e foi de 20/20 OE. À fundoscopia, constatou-se aumento da escavação do nervo óptico à direita - 0,75 x 0,90 mm. Optou-se por tratamento clínico com Cloridrato de Dorzolamida, Latanoprosta, Brimonidina e Timolol, com bons resultados a longo prazo - a tonometria de aplanação mostrou 19 mmHg OD e 15 mmHg OE, apesar da dificuldade na estabilização da doença. Conclusão: Relatos demonstram que os resultados dos tratamentos clínico e cirúrgico do glaucoma em associação à SKT são insatisfatórios quando comparados a outros tipos de glaucoma - o controle clínico não é possível em cerca de 1/3 dos pacientes, e o manejo cirúrgico tem alto índice de complicações. São necessários estudos mais expressivos que estabeleçam a correlação entre glaucoma e SKT e embasem o tratamento de escolha.

ABSTRACT The Klippel-Trenaunay Syndrome (KTS) is a rare congenital disease, which the prevalence is higher in males, and its incidence of 25:100,000. It is presented in its classic form as the triad of port-wine stains, enlarged limbs and venous and / or lymphatic malformation. The diagnosis is essentially clinical and due to the complexity of the syndrome, the progressive characteristic and the wide variety of clinical presentations, a multidisciplinary team should treat patients individually. The ocular changes associated with KTS include vascular, orbit, iris, retina, choroid and optic nerve abnormalities. Case report: A 23-year-old female patient, carrier KTS, being followed at Vision Center - Federal University of Paraná, complaining of decreased visual acuity in the right eye. The patient had port-wine stains in right hemibody and hypertrophy of ipsilateral members. Glaucoma was diagnosed and eye exams were performed to assess the degree of impairment of visual fields and fundus. The best correction was checked at 20/100 OD and 20/20 OS. At fundoscopy, there was increased excavation of the optic nerve right - 0.75 x 0.90 mm. Clinical treatment was chosen with Dorzolamide Hydrochloride, Latanoprost, Brimonidine and Timolol, presenting good long-term results - the tonometry showed 19 mmHg OD and 15 mmHg OS, despite the difficulty in stabilizing the disease. Conclusion: Reports have shown that the results of clinical and surgical treatments of glaucoma in association with KTS are unsatisfactory compared to other types of glaucoma - clinical control is not possible in about 1/ 3 of patients and the surgical management has a high rate of complications. Significant studies are needed to establish the correlation between glaucoma and KTS, and base the treatment of choice.

Síndrome de malformaciones capilares-malformaciones arteriovenosas (CM-AVM) / -Capillary malformation syndrome arteriovenous malformation (CM-AVM)

El síndrome de malformaciones capilares-malformaciones arteriovenosas (CM-AVM) es una entidad descripta recientemente, que se caracteriza por la asociación de malformaciones capilares con malformaciones arteriales o fístulas arteriovenosas. Es de herencia autosómica dominante y se produce por mutaciones en el gen RASA1. Las malformaciones capilares en este síndrome presentan ciertas características particulares por lo que son llamadas atípicas. Algunas son congénitas y otras aparecen en forma progresiva. Presentan tamaño variable (desde lesiones puntiformes hasta de varios cm de diámetro), son rosadas o amarronadas, tienen aumento de temperatura local y están rodeadas por un halo pálido. En ocasiones comprometen mucosa oral. Es importante que el dermatólogo sea capaz de reconocer este síndrome, ya que en ocasiones puede asociarse con compromiso interno.

Capillary malformation-arteriovenous malformation is a recently described disorder, characterized by the association of capillary malformations with arterial malformation or arteriovenous fistulae. It is an autosomal dominant disease caused by mutations in RASA1. Capillary malformations in this syndrome are called atypical because they share some particular characteristics. Some are congenital and others appear progressively. They varied in size (from pinpoint lesions to several centimeters of diameter), are pink or brown, sometimes warmer than normal skin and are surrounded by a pale halo. Oral mucosa can be affected. It is important for the dermatologist to recognize this syndrome, taking in account that it can be associated to internal compromise.

Malformações capilares: resultados preliminares do tratamento associando laser ND:Yag 1064 nm e luz intensa pulsada / Capillary malformations: preliminary results of treatment associating ND:Yag 1064 nm laser and intense pulsed light

Introdução: As malformações vasculares congênitas do tipo capilar têm seus melhores resultados até o momento com o laser de corante. Nós associamos, em um único equipamento, o laser ND:Yag 1064 nm de pulso longo e a luz intensa pulsada, para o tratamento de lesões superficiais e profundas. Método: Dezessete pacientes foram tratados com a associação descrita em regime ambulatorial, com anestesia tópica, apenas em intervalos mensais, pelo mesmo cirurgião. O equipamento utilizado foi a plataforma Synchro (DEKA), com a ponteira de 4 mm de diâmetro e fluência de 110 J/cm2 para o laser ND:Yag 1064nm. Para a luz intensa pulsada foi utilizado um filtro de corte de 550 nm, a ponteira de 46 x 10 mm e 21 J/cm2 de fluência, divididos em dois disparos. Os resultados foram avaliados clinicamente e por meio de fotografias, em conjunto com os pacientes. Resultados: Dentre os dezessete pacientes tratados, quatro resultados foram considerados excelentes, nove, bons, quatro, regulares e nenhum insuficiente. Conclusão: O tratamento pode ser realizado adequadamente com anestesia tópica em regime ambulatorial. A associação das duas tecnologias possibilitou a obtenção de resultados satisfatórios e, provavelmente, é mais uma técnica no tratamento destas lesões.

Introduction: Congenital vascular malformations up to know, have their best results with dye laser. We associate, in single equipment, long pulse Nd:Yag 1064 nm laser and intense pulsed light, for simultaneous treatment of the superficial and deep lesions. Methods: Seventeen patients were treated with the association described in an office basis with topical anesthesia only at monthly intervals by the same surgeon. The equipment utilized was the Synchro Platform (DEKA) with a 4 mm diameter spot size and fluency of 110 J/cm2 for the ND:Yag 1064 nm laser. For the intense pulsed light was utilized a 550 nm cutoff filter with a 46 x 10 mm spot size and 21 J/cm2 as fluency, divided in two shots. Results were evaluated through clinical and photographical analysis together with the patient. Results: Among the seventeen patients treated, four results were considered excellent, nine, good,four, regular and none insufficient. Conclusion: The treatment can adequately be done in an office basis with topical anesthesia. Association of the two different technologies got a satisfactory result and it is probably one more technique for treating such lesions.

Ultrasonografía Doppler-color en el diagnóstico de las anomalías vasculares de las partes blandas superficiales en pediatría / Color Doppler ultrasonography in the diagnosis of vascular anomalies of the superficial soft tissue in children

Las anomalías vasculares de las partes blandas superficiales son frecuentes en el niño y se han clasificado en hemangiomas y malformaciones vasculares, según sus manifestaciones clínicas y hallazgos histológicos. La mayoría corresponde a hemangiomas, se presenta en el recién nacido, desaparece espontáneamente con el tiempo y sólo algunos de ellos requerirán de evaluación médica. Es importante especificar el tipo de lesión vascular para definir el tratamiento, lo que en la mayor parte de los casos es posible con los hallazgos clínicos. Sin embargo, a veces es necesario recurrir a estudios de imágenes para precisar el diagnóstico y los métodos más utilizados son la Ultrasonografía (US) Doppler-color; Resonancia magnética (RM) y Angiografía. La US Doppler-color es un método sencillo, inocuo, no invasivo, que permite diferenciar las lesiones superficiales de aquellas profundas y además permite evaluar la vascularización de la lesión y, de esta manera, lograr una adecuada aproximación diagnóstica. También permite seleccionar aquellos casos que requerirán de métodos más sofisticados, como RM o angiografía. El objetivo de esta revisión es mostrar la utilidad de la US Doppler en el estudio de las anomalías vasculares de las partes blandas superficiales en el niño.

Vascular anomalies of superficial soft tissues are frequent in children and have been classified in hemangiomas and vascular malformations, depending on clinical and histological findings. Most correspond to hemangiomas, present in the newborn period, which disappear spontaneously with time and only some may require an imaging evaluation. It is important to specify the type of vascular anomaly in order to define management, which in most cases is possible with just clinical findings. Nevertheless, some cases may require imaging studies to define diagnosis, and the most utilized methods are Doppler ultrasonography (US), magnetic resonance Imaging (MRI) and angiography. Doppler US is a non invasive, harmless and simple method which allows to differentiate between deep and superficial lesions. It also permits to evaluate vascularization and in this manner; achieve an adequate diagnosis and select those cases that will require more sophisticated methods like MRI or angiography. The main objective of this review is to show the role of Doppler US in the study of superficial soft tissue vascular anomalies in children.

Intramuscular capillary abnormalities in a case of myotonic dystrophy (Steinert's disease) / Anormalidades en los capilares intramusculares en un caso de distrofia mitónica (enfermedad de Steinert)

The structure study of a muscle biopsy from a case of myotomic dystrophy showed endothelial cell and pericyte alterations, and infiltration of lymphocytes, macrophages and mast cells. The histopathological picture was similar to that observed in the muscular compromise of some autoimmune diseases. These finding are interesting because although the aethiology of myotonic dystrophy is still obscure, it has surggested that in the origin of this disease could be involved either primary muscle fibre damage or that mystrophy is neurogenic, propositions apparenthy not directly connected with a relation cause-effect to intramuscular capillary abnormalities