Fracturas múltiples y consumo inusual de pastillas Juanola(R) de regaliz / Multiple fractures and unusual consumption of licorice pastillas Juanola(R)

El regaliz (Glycyrrhiza glabra) se ha considerado una planta medicinal desde hace miles de años, y actualmente se utiliza en multitud de preparados por su sabor, poder endulzante y efecto antiinflamatorio. No está exento de efectos secundarios, entre ellos, la hipertensión por su efecto mineralcorticoide. Además, los flavonoides presentes en el extracto de regaliz producen un aumento de la hormona paratiroidea (PTH) y de los niveles de calcio en la orina. Presentamos un caso de una mujer de 60 años con fracturas múltiples asociadas a un consumo inusual y exagerado de pastillas Juanola® (PJ®), producto a base de extracto de regaliz

Licorice (Glycyrrhiza glabra) has been considered a medicinal plant for thousands of years, and it is included in several compounds for its flavor, sweetener and anti-inflammatory properties. It is not free of side effects, including high blood pressure due to its mineralocorticoid effect. In addition, there are flavonoids in licorice extract which increase serum parathyroid hormone (PTH) and urinary calcium levels. We report a case of a 60-year-old woman with multiple bone fractures associated with an unusual and exaggerate consumption of pastillas Juanola (PJ), product based on licorice extract

Xantotriquia probablemente iatrogénica / Probable Iatrogenic Xanthotrichia

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Cannabis derivatives therapy for a seronegative stiff-person syndrome: a case report.

WHAT IS KNOWN AND OBJECTIVE: Stiff-person syndrome (SPS) is an uncommon and disabling disorder characterized by progressive rigidity and episodic painful spasms involving axial and limb musculature. SPS treatment is mostly based on benzodiazepines, baclofen, immunosuppressants and intravenous immunoglobulin. Cannabis derivatives [tetrahydrocannabinol (THC) and cannabidiol (CBD)] are available as an oromucosal spray (Sativex(®)), indicated as add-on treatment, for symptom improvement in patients with moderate to severe spasticity because of multiple sclerosis (MS). Our objective is to report a case of seronegative SPS successfully treated with THC-CBD oromucosal spray. CASE SUMMARY: We report a case of a 40-year-old man presenting with progressive muscle stiffness and intermittent spasms for 6-years. The diagnosis of stiff-person syndrome was based on the clinical features and neuroelectrophysiologic findings of continuous motor unit activity. Glutamic acid decarboxylase autoantibodies was absent in our patient, in both serum and cerebrospinal fluid (CSF). Cannabis derivatives oromucosal spray was introduced after a series of unsatisfactory traditional medical treatments. After 14 months treated with THC-CBD oromucosal spray, improvement was verified in the eight dimensions of the scale of SF-36 quality of life questionnaire. WHAT IS NEW AND CONCLUSION: Clinical experience with cannabis derivatives in patients with multiple sclerosis is accumulating steadily, but there is no current literature about its efficacy for SPS. Because MS and SPS share some neurological symptoms such as spasticity and rigidity, it is thought that THC-CBC can be an option for SPS patient. Our case report suggests that THC-CBD oromucosal spray is an alternative treatment for patients with refractory SPS, and further validation is appropriate.

Effect of vigabatrin on the pharmacokinetics of carbamazepine.

OBJECTIVE: To evaluate a possible interaction between vigabatrin and carbamazepine in epileptic patients. METHODS: Steady-state serum concentrations of carbamazepine with and without vigabatrin were compared. The study group consisted of 15 patients (eight females, seven males, and mean age 31 +/- 12 years), with refractory partial epilepsy. They received vigabatrin as add-on therapy. Patients received carbamazepine monotherapy for at least 6 months and the carbamazepine-vigabatrin combination for at least 3 months. Blood samples were obtained in the morning, before the first daily dose and the carbamazepine plasma concentrations were analysed by fluorescence polarization immunoassay (TDx System). RESULTS: No statistically significant differences were found in mean carbamazepine daily dose. Mean trough concentrations were 7.9 +/- 1.4 microg/mL with carbamazepine alone, and 6.5 +/- 2.0 microg/mL with carbamazepine-vigabatrin association (P < 0.03). The mean values of pharmacokinetic parameters were: level/dose ratio (L/D) = 0.59 +/- 0.20 vs. 0.45 +/- 0.15 (P < 0.05) and plasma clearance (Cl) = 78.5 +/- 25.8 vs. 105.8 +/- 38.9 mL/h/kg (P < 0.05), with carbamazepine alone and carbamazepine-vigabatrin combination, respectively. CONCLUSION: Vigabatrin produced a statistically significant increase in the plasma clearance of carbamazepine when the two drugs were given simultaneously.

Papillary carcinoma of the base of the tongue. Case clinic.

Ectopic lingual thyroid tissue is an uncommon developmental anomaly. Tumours of identical pathological characteristics as those arising in the eutropic thyroid tissue, may be present in ectopic locations. There are very few cases of malignant tumours reported in the literature. Here we report a review of this pathology and we describe a case of a papillary carcinoma of the base of the tongue, located in ectopic lingual thyroid tissue, in a 66 year-old white man, complaining of dysphagia and oral bleeding. Surgical treatment was carried out, consisting of radical resection of the right hemineck, tumour resection, right hemiglossectomy and total thyroidectomy. Postoperative treatment with 131I and substitutive thyroid hormonal therapy was prescribed.

Effects of Ca2+ channel antagonists and benzodiazepine receptor ligands in normal and skinned rat urinary bladder.

The effects of Ca2+ channel antagonists and benzodiazepine receptor ligands against concentration-dependent contractions of rat urinary bladder induced by CaCl2 (0.1-50 mM, in K(+)-depolarized tissues), KCl (1-100 mM) and acetylcholine (0.1 microM to 1 mM) were studied. Nifedipine (0.001-0.1 microM), verapamil (0.01-1 microM), diltiazem (0.01-1 microM), cinnarizine (1-100 microM), and trifluoperazine (1-100 microM) each produced a concentration-related inhibition of the log concentration-effect curve for CaCl2. The rank order of potencies of these antagonists, measured as the IC50 against Ca2+ (25 mM)-induced contraction of depolarized bladder, was nifedipine (0.01 microM) > diltiazem (0.36 microM) approximately verapamil (0.41 microM) > or = cinnarizine (2.57 microM) > trifluoperazine (17.4 microM). These antagonists depressed KCl-induced contractions with an effectiveness and potency similar to that displayed against CaCl2-induced contractions. Nifedipine, verapamil, and diltiazem but not cinnarizine and trifluoperazine had a preferential inhibitory effect on the contractions elicited by KCl when compared to those elicited by acetylcholine. Ro 5-4864, diazepam, midazolam and the non-benzodiazepine PK 11195, each at 1-100 microM, depressed CaCl2- and KCl-induced contractions (IC50 values in the micromolar range). Benzodiazepines and PK 11195, all at 100 microM, markedly depressed acetylcholine-induced contractions. Flumazenil was scarcely effective. Cinnarizine (100 microM) and trifluoperazine (100 microM), but not the other Ca2+ channel antagonists and benzodiazepine receptor ligands tested, depressed Ca2+ (20 microM)-evoked contractions of skinned bladder. It is concluded that the action of nifedipine, verapamil, and diltiazem is restricted to the plasmalemma whereas cinnarizine and trifluoperazine also act on the intracellular contractile apparatus.(ABSTRACT TRUNCATED AT 250 WORDS)