Simultaneous quantification of neutral and acidic pharmaceuticals and pesticides at the low-ng/l level in surface and waste water.

A new analytical method is presented that allows simultaneous determination of neutral and acidic pharmaceuticals and pesticides in natural waters. The compounds investigated include frequently used pharmaceuticals, i.e., the anti-epileptic carbamazepine, four analgesic/anti-flammatory drugs (ibuprofen, diclofenac, ketoprofen and naproxen) and the lipid regulator clofibric acid and important pesticides including triazines, acetamides and phenoxy acids. Sample enrichment was achieved in one step with a newly developed solid-phase extraction procedure using the Waters Oasis HLB sorbent. The neutral compounds were analyzed by GC-MS in a first step, and then the acidic compounds after derivatization with diazomethane. Relative recoveries using isotope labeled internal standards were between 71 and 118% and the detection limits were in the range of 1 to 10 ng/l in drinking water, surface water and waste water treatment plant effluents (precision: 1-15%). The developed analytical method proved to be very durable during a 3-month field study and the target analytes were detected in concentrations of 5-3,500 ng/l in waste water treatment plant effluents, river water and lake water.

Osteoarthritis of the fingers.

Osteoarthritis of the fingers is an especially common condition in postmenopausal women. Many consider it a normal part of aging or a relatively minor disease. Osteoarthritis of the fingers is a disease process that destroys interphalangeal cartilage and results in pain, swelling, decreased finger motion, joint deformities, and difficulty performing activities that require grip or pinch. Medication, rest, and supportive splinting alternated with mobility and strengthening exercises, patient education, and incorporation of joint protection techniques may alleviate symptoms and improve functional abilities. Surgery is indicated when these methods have failed to control pain, instability, and deformities or improve ease of function. Joints may be fused (arthrodesis) or replaced (arthroplasty) to manage pain and produce finger joints capable of withstanding the force of normal use without pain or further joint damage. Postoperative therapy includes splinting to protect healing structures along with range-of-motion programs to maximize functional outcomes.

Injury of the sciatic nerve associated with acetabular fracture.

In order to document functional outcome, we followed fourteen patients who had an injury of the sciatic nerve associated with a displaced acetabular fracture for a mean of twenty-seven months. In three of the patients, the injury was iatrogenic. Electromyography was useful in the localization and determination of the severity of the injury. According to the functional scale that was used, all but one patient had a satisfactory (fair or better) functional outcome, but eleven patients had residual neurological sequelae that ranged from minor paresthesia to footdrop. Seven patients who had an injury of both the tibial and peroneal divisions of the sciatic nerve had complete or nearly complete motor and sensory recovery of the tibial component. The patients who had isolated, mild involvement of the peroneal nerve had a favorable prognosis, but those who had a severe injury of the peroneal component, whether it was isolated or associated with an injury of the tibial component, did not recover good function.

Asymptomatic SLAC wrist: does it exist?

Twenty-five patients (30 wrists) had x-ray evidence of scapholunate advanced collapse. Twenty-two wrists had no pain; 12 of these were diagnosed and treated for carpal tunnel syndrome. Eight wrists had mild pain. All patients were reevaluated an average of 2 years later. At that time, 20 wrists were totally free of symptoms and 10 had occasional pain, especially with increased activity (no patients required analgesics). No patient had undergone surgical management for the scapholunate advanced collapse. We believe that there are some patients (especially older and low-demand persons) in whom x-ray evidence of arthritis and clinical findings do not correlate. In these circumstances surgical intervention for treatment of the arthritis may not be warranted.

Evaluation of the safety of ivermectin administered in a beef-based formulation to ivermectin-sensitive Collies.

Twenty-four Collies sensitive to the toxic effects of ivermectin, when administered at high dosages, were studied to evaluate the effects of repeated monthly treatment with an ivermectin beef-based formulation at amounts up to 10 times the dosage recommended for heartworm prevention in dogs. Collies were treated 3 times at 30-day intervals at rates of 12, 36, or 60 micrograms of ivermectin/kg of body weight, or with vehicle. Complete physical and neurologic examinations were performed on all dogs prior to the first treatment and after the final treatment. Clinical observations and ivermectin reaction scores were recorded daily for each dog throughout the study. Clinical or neurologic signs characteristic of ivermectin toxicosis were not observed for any dog during the study. Single episodes of vomiting were recorded for 2 vehicle-treated dogs and 2 dogs treated with ivermectin at 12 micrograms/kg from 6 to 21 days after treatment. At the end of the study, all dogs were challenge-exposed with ivermectin at 120 micrograms/kg to reconfirm their sensitivity to this class of compounds. All dogs developed signs typical of ivermectin toxicosis during the subsequent 48- to 72-hour period. Results of this study demonstrated that ivermectin can be administered repeatedly without adverse effects at rates up to 60 micrograms/kg (10 times the recommended use level) to Collies known to be sensitive to this drug.