Gabapentin and oral antidepressants for chronic pruritus: a prospective cohort study evaluating efficacy and side effects in daily dermatological practice.

BACKGROUND: Chronic pruritus is frequently seen in daily dermatological practice and is associated with marked impact on quality of life. Research on the use of gabapentin and oral antidepressants in daily dermatological practice is scarce. OBJECTIVE: To evaluate the efficacy and safety of gabapentin and oral antidepressants in patients with chronic pruritus in daily clinical practice. METHODS: A prospective observational single-center cohort study was conducted including adult patients with chronic pruritus and an indication for systemic treatment between June 2016 and May 2019. RESULTS: Systemic treatment with gabapentin and/or antidepressants was initiated in 31 patients with severe chronic pruritus (median average pruritus NRS score 7.0), in which most cases no underlying origin was identified (83.9%). In patients treated with gabapentin 900-1800 mg/day (N = 25), median average pruritus NRS decreased to 5.5 (IQR 3.0) after 4 weeks and remained stable up to 24 weeks of treatment. Efficacy of antidepressants was variable, with the highest response after initiation of amitriptyline, nortriptyline, and mirtazapine. Side effects were frequently observed in both gabapentin and antidepressant treatments; however, were mostly mild and temporary. LIMITATIONS: This was a single-site observational study, with limited sample size. CONCLUSION: Treatment with gabapentin and antidepressants should be considered in patients with chronic pruritus unresponsive to conventional treatment.

Litho- and biostratigraphic data of lower-middle Miocene sections in the Transylvanian basin and SE Carpathian Foredeep (Romania).

Litho- and biostratigraphic data are provided of 5 stratigraphic sections in Romania covering the "Badenian" marine flooding that occurred in the Central Paratethys during the middle Miocene (Langhian). The dataset includes stratigraphic logs and descriptions of the profiles, and biostratigraphic analyses on calcareous nannofossils and foraminifera. In addition, characteristic stratigraphic features and representative fossils, including tiny Streptochilus foraminifera in the Campinita section in the SE Carpathian Foredeep, are presented in photographs. The data show that the flooding is characterized by the sudden abundance of Langhian calcareous nannofossils and foraminifera with a strong Mediterranean affinity.

Data on lithofacies, sedimentology and palaeontology of South Rifian Corridor sections (Morocco).

We provide lithological, sedimentological and micropalaeontological descriptions of 39 sections and boreholes crossing the upper Miocene deposits of the Rifian Corridor. These deposits represent the sedimentary remnants of the marine gateway that connected the Atlantic to the Mediterranean in the late Miocene. Results from these 39 sites were adopted to reconstruct the palaeogeographic evolution of the gateway presented in the associated research article (Capella et al., 2018) [1]. For each outcrop we present a synthesis of field observations, lithofacies, key sedimentological features, planktic and benthic assemblages.

Crohn's disease of the appendix.

Two patients with Crohn's disease confined to the appendix are described. The condition may present as acute appendicitis or appendiceal infiltrate. Therapy of either manifestation includes appendectomy. Concurrent Crohn's disease elsewhere in the gastrointestinal tract may be found in 25 per cent of the patients. A recurrence rate of 10 to 15 per cent in the remaining patients justifies a follow-up of some three years.

Calcium supplementation: effect on blood pressure and urinary mineral excretion in normotensive male lactoovovegetarians and omnivores.

After an initial 4-wk period, 36 healthy male subjects aged 19-28 y (14 lactoovovegetarians and 22 omnivores) were given a supplement to their usual diet of 27.9 mmol calcium/d for 5 wk. During this period 22 blood pressure measurements were taken and 30 24-h urine specimens and 15 24-h dietary records were obtained. Base-line blood pressures did not differ significantly between vegetarians and omnivores (118.3/59.3 and 119.5/60.7, respectively). At the end of the supplementation period there was a decrease in diastolic blood pressure of 1.4 mm Hg (p less than 0.10) and an unexpected increase in systolic blood pressure of 2.1 mm Hg (p less than 0.01) in the omnivores. Although not significant, the same trends were observed in the vegetarians. In both groups Ca and magnesium excretions increased significantly and phosphorus excretion decreased significantly. Blood pressure of normotensive subjects with high basal Ca intake may not be sensitive to Ca supplementation.

Progressive and fatal course of a patient with a multifocal leiomyomatous tumor.

The case history of a 53-yr-old woman exhibiting the progressive appearance of several hundreds of subcutaneous leiomyomatous tumors in a 15-yr period is presented. The occurrence of multiple tumors in the gastrointestinal tract, mesentery, and retroperitoneum, necessitated several laparotomies because of pain and chronic blood loss. On light microscopy high mitotic activity, which is generally a characteristic of sarcoma, was only encountered in lesions, surgically removed a few months before death. It is argued that our patient suffered from multiple leiomyomatous tumors with progressive growth capacity, which may represent a multifocal origin rather than a metastasized sarcoma.

The effect of dietary sodium on urinary calcium and potassium excretion in normotensive men with different calcium intakes.

On the basis of their usual calcium intake, 12 healthy normotensive male students were divided into a low and a high calcium group. Both groups were provided with complete diets containing the same calculated quantities, expressed per MJ, of protein, fat, carbohydrate, sodium, potassium, phosphorus, and calcium. After an initial period of two weeks during which all participants received an additional 100 mmol sodium daily, 6 participants received an additional 22 mmol sodium/day (low sodium), the other 6 participants 178 mmol sodium/day (high sodium). After two weeks the sodium regimes were crossed over for a subsequent two-week period. When the second week of the low sodium period is compared with the second week of the high sodium period, the increase in the calcium/creatinine ratio, expressed on molar basis, was 0.059 for the low and 0.053 for the high calcium group (p less than 0.05). The increase in the molar potassium/creatinine ratio was 0.65 for the low and 0.03 for the high calcium group (p less than 0.025). However, after correcting for the calcium intake the effect in the low calcium group was found to be greater (p less than 0.05). Sodium supplementation was found to have no effect on blood pressure, but mean systolic (p less than 0.10) and diastolic in the high calcium group were lower. This suggests that calcium may well play a role in the regulation of blood pressure.