Linear IgA Bullous Dermatosis: A Series of 17 Cases. / Dermatosis ampollar IgA lineal: serie de 17 casos.

Linear IgA bullous dermatosis is an acquired subepidermal immunoglobulin-mediated vesiculobullous disease. In this retrospective, observational, descriptive study, we describe the clinical characteristics, treatments, and outcomes of 17 patients with linear IgA bullous dermatosis. Two children had been vaccinated 2 weeks before the onset of symptoms, 2 had had bronco-obstructive respiratory symptoms, and 1 had received intravenous antibiotic therapy. We also observed an association with autoimmune hepatitis in one patient and alopecia areata in another. One boy had VACTERL association. Diagnosis was confirmed by histopathology and direct immunofluorescence. Sixteen patients were treated with dapsone, which was combined with oral corticosteroids in 8 cases and topical corticosteroids in two. Of note in this series was the occurrence of relapses in the perioral area coinciding with infections and vaccination, and the association between linear IgA bullous dermatosis and autoimmune hepatitis and VACTERL association.

Toxicity to topical dimethyl sulfoxide in a pediatric patient with anthracycline extravasation.

Accidental extravasation of vesicant chemotherapy may cause important tissue injuries. Nowadays, the majority of authors propose topical dimethyl sulfoxide (DMSO), with or without local cooling, as the treatment of choise efor anthracyclines extravasation. No significant toxicity has been reported when DMSO is used as topical treatment. This report describes a case of local toxicity consisting of severe pain after its use in a pediatric patient. An illustration shows the extravasation area.

Una nueva vacuna contra la varicela / A new vaccine against varicella

La varicela es una enfermedad universal altamente contagiosa causada por el virus VaricellaZoster (VVZ). Pese a considerarse generalmente como una enfermedad leve, en ocasiones puede provocar complicaciones graves, especialmente en adultos e inmunocomprometidos. Se ha demostrado que la nueva vacuna es altamente inmunogénica, segura y eficaz. En plena polémica sobre la introducción de la vacuna de varicela en calendario vacunal, resulta muy interesante la próxima comercialización de una nueva vacuna indicada para individuos sanos y de fácil conservación (2-8 °C), impulsando así un programa de vacunación universal contra la varicela en nuestro país (AU)

[Pseudomonas aeruginosa: a multicenter study in 136 hospitals in Spain]. / Pseudomonas aeruginosa: estudio multicéntrico en 136 hospitales españoles.

A cooperative group of 136 Spanish hospitals identified 1014 isolates of P. aeruginosa in one week. It was estimated that Spanish microbiology laboratories identified 168 P. aeruginosa isolates per 100,000 inhabitants population and year (25 isolates for every 1,000 hospital admissions/year). P. aeruginosa was recovered in 5.3% of all the samples with bacterial isolates. Seventy-five percent of samples containing P. aeruginosa came from the lower respiratory tract, wound exudates, abscesses and urine. The three most common serotypes present in Spain were found to be 0:1, 0:4 and 0:11 and constituted more than 50% of all isolates. The antimicrobials active against more than 85% of all the isolates included: ceftazidime (85.2%), piperacillin-tazobactam (92.8%), imipenem (86.2%), meropenem (92.2%) amikacin (91.4%) and tobramycin (91.2%). The study showed a high rate of resistance to ciprofloxacin (22.7%) and gentamicin (31.1%). Of the 529 patients who underwent clinical follow-up, 25.5% showed P. aeruginosa colonization and the remaining 74.5% had clinical infections. We estimated an incidence rate of 88.4 patients infected with P. aeruginosa per 100,000 inhabitants and year (13.8 cases per 1000 hospital admissions and year). Overall, 42% were community acquired. The overall mortality in this study was 15%, and mortality attributable to P. aeruginosa infections was 5%. After logistical regression analysis, the two independent predictors of mortality were the presence of a rapidly fatal underlying condition and the presence of bacteremia. In Spain, P. aeruginosa is much more than a cause of severe nosocomial infections in immunocompromised patients.

Pseudomonas aeruginosa: Estudio multicéntrico en 136 hospitales españoles / Pseudomonas aeruginosa: A multicenter study in 136 hospitals in Spain

Un grupo cooperativo de 136 hospitales españoles identificaron 1014 cepas de Pseudomonas aeruginosa en una semana. Se ha estimado que los laboratorios de microbiología españoles identifican 168 P. aeruginosa por cada 100.000 habitantes y año (25 aislamientos por cada mil ingresos hospitalarios/año). Este microorganismo se encuentra en el 5,3 por ciento de todas las muestras en que se aíslan bacterias. Las vías respiratorias bajas, los exudados de heridas y abscesos, y la orina, representan más del 75 por ciento de las muestras en que crece P. aeruginosa. Los tres serotipos más frecuentes en España son 0:1, 0:4 y 0:11, y constituyen en conjunto más del 50 por ciento de todos los aislamientos. Los antimicrobianos activos frente a más del 85 por ciento de las cepas fueron ceftazidima (85,2 por ciento), piperacilina-tazobactam (92,8 por ciento), imipenem (86,2 por ciento), meropenem (92,2 por ciento), amikacina (91,4 por ciento) y tobramicina (91,2 por ciento). Se demostró una elevada resistencia a ciprofloxacino (22,7 por ciento) y gentamicina (31,1 por ciento). De los 529 pacientes seguidos clínicamente, un 25,5 por ciento se consideraron meramente colonizados por P. aeruginosa, mientras que en el 74,5 por ciento restante se trataba de infecciones atribuibles a ella. Nuestros datos permiten estimar que, en España, se producen infecciones por P. aeruginosa en 88,4 pacientes por cada 100.000 habitantes y año, y en 13,8 de cada 1000 ingresos hospitalarios/año, un 42 por ciento de las cuales son de adquisición comunitaria. La mortalidad global asociada a la infección por P. aeruginosa fue del 15 por ciento, y la atribuible a ella fue de un 5 por ciento. El riesgo de muerte fue mayor en los pacientes con enfermedades de base rápidamente fatales y con bacteriemia. (AU)

Milk kinetics of moxidectin and doramectin in goats.

The milk kinetics of doramectin after a single subcutaneous administration and moxidectin following a single subcutaneous or oral drench were studied in goats (n = 15) at a dosage of 0.2 mg kg(-1). Doramectin could be detected in the milk for 21.0+/-2.9 days after subcutaneous treatment, and the total fraction of the dose recovered from the milk was estimated to be 2.9+/-0.88 per cent. Moxidectin, after either oral or subcutaneous administration, could be detected in the milk up to day 40 and the total fractions of the dose recovered from the milk were estimated to be 5.7+/-1.04 per cent and 22.53+/-1.09 per cent, respectively. The mean residence time after subcutaneous administration indicated that moxidectin delivered by the milk persists three times longer than doramectin; furthermore, the total fraction of the dose of moxidectin recovered from the milk was 7.7 times higher than that of doramectin.

Pharmacokinetics of moxidectin and doramectin in goats.

The pharmacokinetic behaviour of doramectin after a single subcutaneous administration and moxidectin following a single subcutaneous or oral drench were studied in goats at a dosage of 0.2 mg kg(-1). The drug plasma concentration-time data were analysed by compartmental pharmacokinetics and non-compartmental methods. Maximum plasma concentrations of moxidectin were attained earlier and to a greater extent than doramectin (shorter t(max) and greater C(max) and AUC than doramectin). MRT of doramectin (4.91 +/- 0.07 days) was also significantly shorter than that of moxidectin (12.43 +/- 1.28 days). Then, the exposure of animals to doramectin in comparison with moxidectin was significantly shorter. The apparent absorption rate of moxidectin was not significantly different after oral and subcutaneous administration but the extent of absorption, reflected in the peak concentration (C(max)) and the area under the concentration-time curve (AUC), of the subcutaneous injection (24.27 +/- 1.99 ng ml(-1) and 136.72 +/- 7.35 ng d ml(-1) respectively) was significantly greater than that of the oral administration (15.53 +/- 1.27 ng ml(-1) and 36.72 +/- 4.05 ng d ml(-1) respectively). The mean residence time (MRT) of moxidectin didn't differ significantly when administered orally or subcutaneously. Therefore low oral bioavailability and the early emergence of resistance in this minor species may be related. These results deserve to be correlated with efficacy studies for refining dosage requirements of endectocides in this species.

Pseudomonas aeruginosa: a survey of resistance in 136 hospitals in Spain. The Spanish Pseudomonas aeruginosa Study Group.

We carried out a nationwide study with all of the isolates of Pseudomonas aeruginosa collected in a week in 136 hospitals in Spain. The data on 1,014 isolates included resistance to the following antimicrobials: piperacillin-tazobactam, 7%; meropenem, 8%; amikacin, 9%; tobramycin, 10%; piperacillin, 10%; ticarcillin, 13%; imipenem, 14%; ceftazidime, 15%; cefepime, 17%; ciprofloxacin, 23%; aztreonam, 23%; ofloxacin, 30%; gentamicin, 31%. The most frequent serotypes were O:1 (25.1%), O:4 (21.6%), and O:11 (11.3%).

Single-dose pharmacokinetics of ampicillin/sulbactam (2:1) combination after intravenous administration to sheep and goats.

The pharmacokinetic behaviour of a combination of ampicillin and sulbactam (2:1) in six sheep and six goats after single intravenous doses of 20 mg kg body weight-1 (13.33 mg kg-1 of ampicillin and 6.67 mg kg-1 of sulbactam) was investigated by using a high-performance liquid chromatographic method for determining plasma concentrations. The objective was to determine whether there are differences between sheep and goats in the disposition kinetics of ampicillin and sulbactam. The plasma concentration-time curves were analysed by compartmental pharmacokinetic and non-compartmental methods. The disposition curves for both drugs were best described by a biexponential equation (two-compartment open model) in both sheep and goats. The mean (SD) elimination half-lives of ampicillin were 0.32 (0.05) h in sheep and 0.32 (0.04) h in goats, and the half-lives of sulbactam were 0.74 (0.10) h and 0.79 (0.18) h in sheep and goats, respectively. The apparent volumes of distribution of ampicillin and sulbactam were similar in the two species. Mean (SD) body clearances of ampicillin were 0.69 (0.07) litre h-1 kg-1 in sheep and 0.72 (0.11) litre h-1 kg-1 in goats, and the body clearances of sulbactam were 0.38 (0.03) and 0.38 (0.07) litre h-1 kg-1 in sheep and goats, respectively. There were no significant differences between any of the pharmacokinetic parameters of ampicillin and sulbactam in the sheep and goats.

Isolation and characterization of mammalian cell lines carrying suppressible mutations.

To obtain animal cell lines carrying nonsense mutations and the corresponding suppressors, we used a "supersuppressor" selection strategy on the CHO cell line. The wild-type strain is resistant to the aminopterin present in HAT medium (i.e., it is HATr) because it contains the enzymes hypoxanthine-guanine phosphoribosyl transferase (HPRT) and thymidine kinase (TK), whereas both HPRT- mutants - selected by their resistance to 6-thioguanine (TGr) - and TK- mutants - selected by their resistance to 5-bromodeoxyuridine (BrdUrdr) - are HATs. Therefore, from HPRT- TK- double nonsense mutants, whose phenotype would be TGr BrdUrdr (HATs), simultaneous HPRT+ TK+ double phenotypic revertants could be obtained by selecting HATr (TGs BrdUrds) variants carrying the corresponding nonsense supersuppressors. Through ethylmethane sulfonate (EMS) mutagenesis of the CHO cell line we obtained 65 TGr variants, 53 of which were HATs and the rest HATr. Among 36 TGr (HATs) variants tested, 23 did not revert to HATr, 4 reverted spontaneously and with EMS, and 9 reverted only with EMS. Some of the latter were probably HPRT- nonsense mutants because they were very stringent (had less than 2% of wild-type [3H]hypoxanthine incorporation and HPRT enzyme activity), and did not complement genetically. The introduction of a second marker (BrdUrdr) in 7 of these strains allowed us to isolate 29 TGr BrdUrdr (HATs) double drug-resistant lines. Through one-step mutagenesis and selection in HAT medium, from two double resistant strains we could isolate HATr (TGs BrdUrds) wild-type phenotypic revertants, each of which probably carries suppressible HPRT and TK nonsense (or missense) alleles and the corresponding supersuppressor. Our strategy could now be extended to obtain variants carrying suppressors in other cell lines.