Adjuvant palmitoylethanolamide therapy with risperidone improves negative symptoms in patients with schizophrenia: A randomized, double-blinded, placebo-controlled trial.

BACKGROUND: Primary negative symptoms of schizophrenia are usually resistant to monotherapy with antipsychotics. The present study sought to assess the efficacy and tolerability of Palmitoylethanolamide (PEA) adjunctive therapy in treatment of negative symptoms in patients with stable schizophrenia. METHODS: This 8-week (trial timepoints: baseline, week 4, week 8), double-blind, placebo-controlled clinical trial randomized patients with schizophrenia in a 1:1 ratio to compare the efficacy and safety of 600 mg twice a day of PEA and matched placebo alongside a stable dose of risperidone. Outcome measures were the positive and the negative syndrome scale (PANSS), the extrapyramidal symptom rating scale (ESRS), and the Hamilton depression rating scale (HDRS). The primary outcome was change in the negative subscale score during the trial period between the groups. Safety of interventions were controlled and addressed during the trial. RESULTS: A total of 50 participants completed the trial (25 in each group). Baseline characteristics of the groups were comparable (p>0.05). There was significant effect from time-treatment interaction on negative symptoms (p = 0.012) suggesting greater symptom improvement in the PEA group. In contrast, the longitudinal changes in positive symptoms and depressive symptoms were similar between groups (p values>0.05). Safety assessments showed no significant difference regarding extrapyramidal symptoms, measured by ESRS, and also frequency of other complications between PEA and placebo groups (p values>0.05). CONCLUSIONS: Adjunctive therapy with PEA and risperidone alleviates schizophrenia-related primary negative symptoms in a safe manner.

In Vitro and In Vivo Evaluation of Two Hydroxychloroquine Tablet Formulations: HPLC Assay Development.

The relative in vitro and in vivo evaluation of two hydroxychloroquine (HCQ) products was conducted. In vitro studies involved assay, content uniformity and dissolution test, and a two-way crossover fashion were used for in vivo studies. Blood samples were collected at appropriate intervals and HCQ levels were measured using a validated reversed-phase high-performance liquid chromatography (HPLC) method. The drug and the internal standard, chloroquine (CQ), were extracted from blood with diethyl ether, separated and dried under nitrogen gas. Residues were reconstituted in the mobile phase and analyzed at 340 nm on a µ-bondapack C18 (250 × 4.6 mm) HPLC column with acetonitrile:methanol:KH2PO4 (10:10:80) mixture containing 0.01% triethylamine. The standard curve was linear within 50-1,500 ng/mL HCQ (R2 = 0.9996), relative errors were 1.6 to 5%, and the CV% ranged from 7 to 15.4. The resolution factor and RSD were 1.62 and 0.35% and in vitro data of both products met the USP requirements. The 90% confidence intervals for the ratios of the AUC0-96, Cmax and Tmax and their corresponding logarithmically transformed values of generic product over those of Plaquenil® were within the acceptable limit of 0.80-1.20 and 0.80-1.25, respectively. Therefore, the generic HCQ was bioequivalent to the innovator formulation.

Comparison of spring characteristics of titanium-molybdenum alloy and stainless steel.

[This retracts the article on p. 84 in vol. 9, PMID: 28149469.].

Comparison of spring characteristics of titanium-molybdenum alloy and stainless steel.

BACKGROUND: Titanium-molybdenum alloy (TMA) and stainless steel (SS) wires are commonly used in orthodontics as arch-wires for tooth movement. However, plastic deformation phenomenon in these arch-wires seems to be a major concern among orthodontists. This study aimed to compare the mechanical properties of TMA and SS wires with different dimensions. MATERIAL AND METHODS: Seventy-two wire samples (36 TMA and 36 SS) of three different sizes (19×25, 17×25 and 16×22) were analyzed in vitro, with 12 samples in each group. Various mechanical properties of the wires, including spring-back, bending moment and stiffness were determined using a universal testing machine. Student's t-test showed statistically significant differences in the mean values of all the groups. In addition, metallographic comparison of SS and TMA wires was conducted under an optical microscope. RESULTS: The degree of stiffness of 16×22-sized SS and TMA springs was found to be 12±2 and 5±0.4, respectively, while the bending moment was estimated to be 1927±352 (gm-mm) and 932±16 (gm-mm), respectively; the spring-back index was determined to be 0.61±0.2 and 0.4±.09, respectively (p<0.001). There were no statistically significant differences in spring-back index in larger dimensions of the wires. CONCLUSIONS: Systematic analysis indicated that springs made of TMA were superior compared to those made of SS. Although both from economic and functionality viewpoints the use of TMA is suggested, further clinical investigations are recommended. Key words:Bending moment, optical microscope, spring-back, stainless steel, stiffness, titanium‒molybdenum alloy.

Evaluation of Patients Visiting the Dermatology Emergency Unit of a University Dermatology Hospital in Tehran, Iran.

Published studies on dermatological emergencies are limited in the literature. To our knowledge, no study has previously explored this subject in Iran. Our aim was to ascertain the characteristics of patients visiting the dermatologic emergency (DE) unit of a university skin hospital in Tehran, Iran. We studied the files of all the patients seen in the DE unit over a 3-month period, collecting data on age, sex, referral mode, duration of consultation, status (true emergency or non-emergency), and diagnosis. A total of 2539 patients were evaluated; 53% of them were female. Infection and infestation (41.9%), urticaria (16.7%), and dermatitis (13.2%) were the most prevalent entities. Almost 1% of the patients were referred by another physician and psoriasis was their most frequent diagnosis. Almost 2.6% of the patients were hospitalized; psoriasis was once again the most frequent cause. The hospitalization rate was significantly higher in referred patients (P<0.001). A sampling bias may have occurred due to the time interval (three summer months) of the study. The majority of the patients did not require emergency consultation. Even the most prevalent acute conditions such as bite, urticaria, infections, and infestations could be diagnosed and easily managed by general practitioners. The presented data showed a need for improvement in the non-dermatologist physicians' knowledge of emergency dermatologic disorders. This data could also help in tailoring the educational curriculum for medical students more appropriately in order to increase their knowledge of the most prevalent skin disorders.