Metformin-associated lactic acidosis: A case reporting a serious complication in the perioperative period. / Acidosis láctica asociada a metformina: un caso clínico que reporta una complicación grave en el período perioperatorio.

The worldwide prevalence of diabetes mellitus (DM) has risen dramatically over the past two decades and this affects 10-15% of the surgical population1. Metformin represents the mainstay of anti-hyperglycaemic therapy for type 2 DM, providing numerous beneficial effects. However, a rare but severe adverse effect is the development of metformin-associated lactic acidosis (MALA) with high mortality rate. We describe a severe case of MALA in the postoperative period that culminated in cardiac arrest. Whereby anaesthetists should be knowledgeable and skilled in the care of patients with diabetes being imperative to focus on preoperative assessment, optimisation, management of pre-existing treatment during the starvation period and identification of patients medicated with metformin at risk of developing MALA.

Drug interactions during periodontal therapy in HIV-infected subjects.

Despite the beneficial effect of the HAART, adverse reactions and drug interaction have been observed. Abnormalities in lipid and glucose metabolism make HIV-positive patients to high risk for the development of coronary heart disease and diabetes, respectively. Besides adverse reactions, drug interaction with other medication can also be observed. In fact, drug interaction may interfere in the periodontal therapy in HIV-infected individuals. For instance, fluconazole, ketoconazole, itraconazole, metronidazole, ciprofloxacin, midazolam and triazolam can interact with some antiretroviral medications, such as zidovudine, nevirapine and ritonavir. The aim of the current study was to show to periodontists and general dental practitioners the importance of understanding the drug interaction in HIV-infection in order to establish a better control during periodontal treatment.

Monte Carlo study of the elastic interaction in heteroepitaxial growth.

We have studied the island-size distribution and spatial correlation function of an island growth model under the effect of an elastic interaction of the form 1/r(3). The mass distribution P(n)(t) that was obtained presents a pronounced peak that widens with the increase of the total coverage of the system, theta. The presence of this peak is an indication of the self-organization of the system, since it demonstrates that some sizes are more frequent than others. We have treated exactly the energy of the system using periodic boundary conditions that were used in the Monte Carlo simulations. A discussion about the effect of different factors is presented.