Crystalline-Induced Arthropathy Following Total Knee Replacement.

Gout rarely occurs in the setting of prior total joint replacement. It can present as an acute or chronic painful joint that may mimic prosthetic joint infection with further similarities found on physical examination and initial workup. Elevated leukocyte count, erythrocyte sedimentation rate, and C-reactive protein are common to both conditions. The confirmatory test to distinguish infection versus inflammatory arthropathy is joint aspiration with crystal or micro-organism identification microscopically. Establishing proper diagnosis is important in guiding appropriate treatment, which may prevent the unnecessary removal of implants. The current study includes a review of the literature and presents a case of bilateral gouty arthropathy after total knee arthroplasty.

Diagnosis of Agglomeration and Crystallinity of Active Pharmaceutical Ingredients in Over the Counter Headache Medication by Electrospray Laser Desorption Ionization Mass Spectrometry Imaging.

Agglomeration of active pharmaceutical ingredients (API) in tablets can lead to decreased bioavailability in some enabling formulations. In a previous study, we determined that crystalline APIs can be detected as agglomeration in tablets formulated with amorphous acetaminophen tablets. Multiple method advancements are presented to better resolve agglomeration caused by crystallinity in standard tablets. In this study, we also evaluate three "budget" over-the-counter headache medications (subsequently labeled as brands A, B, and C) for agglomeration of the three APIs in the formulation: Acetaminophen, aspirin, and caffeine. Electrospray laser desorption ionization mass spectrometry imaging (ELDI-MSI) was used to diagnose agglomeration in the tablets by creating molecular images and observing the spatial distributions of the APIs. Brand A had virtually no agglomeration or clustering of the active ingredients. Brand B had extensive clustering of aspirin and caffeine, but acetaminophen was observed in near equal abundance across the tablet. Brand C also had extensive clustering of aspirin and caffeine, and minor clustering of acetaminophen. These results show that agglomeration with active ingredients in over-the-counter tablets can be simultaneously detected using ELDI-MS imaging.

Effects of acoustic streaming from moderate-intensity pulsed ultrasound for enhancing biofilm mitigation effectiveness of drug-loaded liposomes.

Because biofilms have resistance to antibiotics, their control using minimum amounts of chemicals and energy becomes a critical issue particularly for resource-constrained long-term space and deep-sea explorations. This preliminary study investigates how ultrasound promoting penetration of antibiotic-loaded liposomes into alginate-based bacterial biofilms, resulting in enhanced bacterial (Ralstonia insidiosa) killing. Nano-sized liposomes are used as a delivery vehicle for the antibiotic gentamicin. Alginate-based synthetic biofilms, which are widely acknowledged as biofilm phantoms, filled with liposome solution are formed at the bottoms of six-well Petri dishes and exposed to ultrasound (frequency = 2.25 MHz, 10% duty cycle, and spatially and temporally averaged intensity ISAPA = 4.4 W/cm(2)). Gentamicin is released from liposomes after they are lysed using detergent solution (0.05% sodium dodecyl sulfate, 1.0% Triton X-100) and incubated for 20 min. The alginate biofilm is dissolved and diluted, counting of colony-forming units shows about 80% of the bacteria are killed. It has also been shown the liposome-capture density by the alginate film increases linearly with the ultrasound intensity up to ISAPA = 6.2 W/cm(2) reaching approximately threefold that without ultrasound. Measurement by using particle-image velocimetry has demonstrated the acoustic streaming with modification by thermal convection controls the enhancement of the liposome capture rate.