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Epinephrine
Kinds of Epinephrine Terms modified by Epinephrine Selected AbstractsDigital Block With and Without Epinephrine During Chemical Matricectomy with PhenolDERMATOLOGIC SURGERY, Issue 10 2010H. CEVDET ALTINYAZAR MD BACKGROUND Digital block with epinephrine is safe in selected patients. Chemical matricectomy with phenol is a successful, cheap, and easy method for the treatment of ingrown nails. OBJECTIVE To determine the effect of digital block with epinephrine in chemical matricectomy with phenol. MATERIAL AND METHODS Forty-four patients with ingrown toenail were randomly divided into two groups. The plain lidocaine group (n=22) underwent digital anesthesia using 2% plain lidocaine, and the lidocaine with epinephrine group (n=22) underwent digital anesthesia with 2% lidocaine with 1:100,000 epinephrine. In the postoperative period, the patients were evaluated for pain, drainage, and peripheral tissue destruction and were followed for up to 18 months for recurrence. RESULTS The mean anesthetic volume used in the epinephrine group (2.2±0.4 mL) was significantly lower than the plain lidocaine group (3.1±0.6 mL). There was no statistically significant difference in postoperative pain and recurrence rates, but duration of drainage was significantly shorter in the epinephrine group (11.1±2.5 days) than in the plain lidocaine group (19.0±3.8 days). CONCLUSION Digital block with epinephrine is safe in selected patients, and epinephrine helps to shorten the postoperative drainage period. The authors have indicated no significant interest with commercial supporters. [source] Double Modification of Electrode Surface for the Selective Detection of Epinephrine and Its Application to Flow Injection Amperometric AnalysisELECTROANALYSIS, Issue 22 2009Guang-Ri Xu Abstract A glassy carbon electrode having two polymer layers has been applied to selectively detect epinephrine. The inner layer formed by electropolymerization of macrocyclic nickel complex functioned as an electrocatalyst for epinephrine oxidation and the outer layer composed of hydrolyzed polyurethane ,-benzyl L -glutamate as a screening layer. Differential pulse voltammetry showed almost 100% recovery of epinephrine even in 100-fold excess of interferents. When applied to a dual glassy carbon electrode as an amperometric detector in flow injection analysis, a linear response over 0.1,,M and 10,,M was obtained. Recovery tested for 5-fold diluted human urine samples was 97.5%. [source] A case of fatal caffeine poisoningACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2010T. RUDOLPH Caffeine is a natural alkaloid methylxanthine that is found in various plants such as coffee or tea. Symptoms of a severe overdose may present with hypokalemia, hyponatremia, ventricular arrhythmias, hypertension followed by hypotension, respiratory failure, seizures, rhabdomyolysis, ventricular fibrillation and finally circulatory collapse. A 21-year-old woman called for the ambulance herself soon after the ingestion of about 10,000 mg of caffeine. At the arrival of the ambulance, the patient went into cardiac arrest almost immediately. After a total resuscitation period of 34 min including seven counter-shocks and 2 mg epinephrine, the patient was stable enough to be transferred to the hospital. The patient soon went into VF again and received two more counter-shocks and 1 mg epinephrine and finally an intravenous bolus dose of 300 mg amiodarone. The initial arterial blood gas showed pH at 6.47, lactate at 33 mmol/l and potassium level at 2.3 mmol/l. Unfortunately, no blood samples for caffeine analysis were taken. Three days after hospital admission, the patient developed myoclonus, which did not respond to medical treatment. Excessive intake of caffeine may produce arrhythmias and pronounced hypokalemia and ensuing ventricular fibrillation. In case of counter-shock-resistant VF, it can be necessary to give an early loading dose of amiodarone. Furthermore, it may be beneficial to replace the potassium as early as possible. Epinephrine and buffer solutions used during resuscitation may further decrease blood potassium levels and should be administrated cautiously. Epinephrine can be replaced by other vasopressor drugs, such as vasopressin without effects on ,-receptors. [source] The Normal Effects of Epinephrine and Isoproterenol on Heart Rate and QT Interval: Role in Unmasking the Long QT SyndromeJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2006DAVID M. FITZGERALD M.D., F.H.R.S.Article first published online: 26 JUL 200 No abstract is available for this article. [source] Abrupt Termination of an Ethanol Regimen Provokes Ventricular Arrhythmia and Enhances Susceptibility to the Arrhythmogenic Effects of Epinephrine in RatsALCOHOLISM, Issue 2010Jinyao Liu Background:, Pathologists examining victims of sudden unexpected death encounter alcoholics more often than expected; alcohol may play a role in sudden arrhythmic death. Here we determine whether a pattern of alcohol consumption, chronic ethanol intake, and withdrawal increases the incidence of malignant ventricular arrhythmia and modulates susceptibility to the arrhythmogenic potential of sympathetic stimulation from an epinephrine test in rats. Methods:, Male Wistar rats were treated with a continuous ethanol liquid diet for 7 weeks, and then subjected to 1-day withdrawal or 21-day abstinence. Ventricular ectopy was evaluated by 24-hour electrocardiographic telemetry recording; whole-body sympathetic activation, cardiac sympathovagal balance, and susceptibility to ventricular arrhythmia induced by sympathetic stimulation were evaluated based on blood noradrenalin metabolite concentrations, heart rate variability, and a 3-step epinephrine test. Results:, Ventricular arrhythmia and related death were observed only in rats at 1 day of withdrawal, but not in nonalcoholic, continuous ethanol intake or 21-day abstinence rats. One-day withdrawal after a 7-week continuous ethanol regimen elevated circulating noradrenalin metabolite levels and induced cardiac sympathovagal imbalance. Deaths related to the epinephrine test and ventricular arrhythmia induced by low doses of epinephrine were observed only in 1-day withdrawal rats. However, all anomalies were normalized by 21-day abstinence. Conclusions:, Abrupt termination of a 7-week continuous ethanol regimen is sufficient to enhance the whole-body sympathetic activation and cardiac sympathovagal imbalance that contribute to ventricular arrhythmia and sudden death in alcoholic rats. Those providing medical care for alcoholics, including in cases of legal imprisonment, should be aware of the possibility of enhanced susceptibility to sudden arrhythmic death due to the abrupt termination of a chronic ethanol regimen. [source] Epinephrine: the drug of choice for anaphylaxis.ALLERGY, Issue 8 2008A statement of the World Allergy Organization Anaphylaxis is an acute and potentially lethal multi-system allergic reaction. Most consensus guidelines for the past 30 years have held that epinephrine is the drug of choice and the first drug that should be administered in acute anaphylaxis. Some state that properly administered epinephrine has no absolute contraindication in this clinical setting. A committee of anaphylaxis experts assembled by the World Allergy Organization has examined the evidence from the medical literature concerning the appropriate use of epinephrine for anaphylaxis. The Committee strongly believes that epinephrine is currently underutilized and often dosed suboptimally to treat anaphylaxis, is under-prescribed for potential future self-administration, that most of the reasons proposed to withhold its clinical use are flawed, and that the therapeutic benefits of epinephrine exceed the risk when given in appropriate i.m. doses. [source] Parental knowledge and use of epinephrine auto-injector for children with food allergyPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 3 2006G. Pouessel Epinephrine should be prescribed for patients at risk of anaphylaxis. Our purpose was to determine the use of Anapen® prescribed for food-allergic children, to assess parental knowledge regarding Anapen, and to evaluate the arrangements for emergency kits and personalized care projects in everyday life. A prospective study was performed with a questionnaire sent to families with a food-allergic child previously prescribed Anapen. One hundred and fifty two families were contacted and finally 111 children included (median age 6.5 yrs). Main food allergens were peanuts (n = 89), egg (n = 39) and cow's milk (n = 10). The use of Anapen had been demonstrated to 90% of parents (by prescribing physician, 69%; pharmacist, 25%; general practitioner, 5%; nurse 1%), with a training device (76%) and/or written instructions (49%). When asked to list symptoms requiring injection, 48% of parents cited more than one response: breathing difficulties only (23%), or with angio-edema (41%), collapse or faintness (38%), anaphylactic shock (48%). Of 107 children attending school, 54% had a personalized care project, 72% an Anapen device, and 60% a complete emergency kit (epinephrine, inhaled , -agonist, corticosteroid, anti-H1 drug). , -Agonists were forgotten at school by 34 children (13 asthmatics). Anapen was used in one child for angio-edema and dyspnea after inadvertent ingestion of egg at home. In our population, epinephrine auto-injectors and emergency kits were insufficiently available at schools and in daily life. The use of auto-injectors was not adequately demonstrated. The prescription of epinephrine for food-allergic children at risk of anaphylaxis requires accurate diagnosis, educational programs, information, and follow up. [source] The Effect of Topical Epinephrine on Peripheral Nerve Conduction,,§THE LARYNGOSCOPE, Issue 10 2002Quintessa Miller MD Abstract Objective/Hypothesis The aim of the study was to determine the effect of direct application of epinephrine solution on peripheral nerve conduction latency and amplitude. It was hypothesized that epinephrine does not cause neurapraxia when a standard (1:10,000) solution is applied topically. Study Design Eleven animals were divided into two groups of five and six. Group I had their left sciatic nerves and group II had their right sciatic nerves treated with epinephrine-soaked patties. The contralateral nerves of each group served as controls. Methods Nerve conduction studies were performed at baseline and immediately, at 1 minute, and at 5 minutes after patty application. Results Latency was found to increase above baseline immediately after patty application (P = .003) for the epinephrine-treated and saline-treated groups. Furthermore, the amplitude at 5 minutes after patty application increased from baseline (P = .009) for both groups. These observed differences were below what is considered to be clinically significant. Conclusion Topical epinephrine at a standard solution (1:10,000) does not lead to clinically significant nerve conduction abnormalities. [source] Epinephrine for the treatment of anaphylaxis: do all 40 mg sublingual epinephrine tablet formulations with similar in vitro characteristics have the same bioavailability?BIOPHARMACEUTICS AND DRUG DISPOSITION, Issue 9 2006Mutasem M. Rawas-Qalaji Abstract Epinephrine autoinjectors are underutilized in the first aid emergency treatment of anaphylaxis in the community; so non-invasive sublingual epinephrine administration is being proposed. In order to determine the effect of changing excipients on the bioavailability of sublingual epinephrine, four distinct fast-disintegrating epinephrine 40 mg tablet formulations, A, B, C and D, were manufactured using direct compression. All formulations were evaluated for tablet hardness (H), disintegration time (DT) and wetting time (WT). In a prospective 5-way crossover study, four sublingual formulations and epinephrine 0.3 mg i.m. as a control were tested sequentially in a validated rabbit model. Blood samples were collected before dosing and at intervals afterwards. Epinephrine plasma concentrations were measured using HPLC-EC. All tablet formulations met USP standards for weight variation and content uniformity, and resulted in similar mean H, DT and WT (n=6). The area under the curve (AUC), maximum concentration (Cmax) and time at which Cmax was achieved (Tmax) did not differ significantly after the sublingual administration of formulation A and epinephrine 0.3 mg i.m. The AUC after B, C and D were significantly lower (p<0.05) than after epinephrine 0.3 mg i.m. These results suggest that the selection of excipients used in these tablet formulations can affect the bioavailability of sublingually administered epinephrine. Copyright © 2006 John Wiley & Sons, Ltd. [source] Comparison of Nebulized Epinephrine to Albuterol in BronchiolitisACADEMIC EMERGENCY MEDICINE, Issue 4 2008Paul Walsh MB Abstract Objectives:, To compare the effect of nebulized racemic epinephrine to nebulized racemic albuterol on successful discharge from the emergency department (ED). Methods:, Children up to their 18th month of life presenting to two teaching hospital EDs with a clinical diagnosis of bronchiolitis who were ill enough to warrant treatment but did not need immediate intubation were eligible for this double-blind randomized controlled trial (RCT). Patients received either three doses of racemic albuterol or one dose of racemic epinephrine plus two saline nebulizers. Disposition was decided 2 hours after the first nebulizer. Successful discharge was defined as not requiring additional bronchodilators in the ED after study drug administration and not subsequently admitted within 72 hours. Adjusted relative risks (aRR) were estimated using the modified Poisson regression with successful discharge as the dependent variable and study drug and severity of illness as exposures. Secondary analysis was performed for patients aged less than 12 months and first presentation. Results:, The authors analyzed 703 patients; 352 patients were given albuterol and 351 epinephrine. A total of 173 in the albuterol group and 160 in the epinephrine group were successfully discharged (crude RR = 1.08, 95% confidence interval [CI] = 0.92 to 1.26). When adjusted for severity of illness, patients who received albuterol were significantly more likely than patients receiving epinephrine to be successfully discharged (aRR = 1.18, 95% CI = 1.02 to 1.36). This was also true among those with first presentation and in those less than 12 months of age. Conclusions:, In children up to the 18th month of life, ED treatment of bronchiolitis with nebulized racemic albuterol led to more successful discharges than nebulized epinephrine. [source] Incidence, clinical findings and management of intraoperative floppy iris syndrome associated with tamsulosinACTA OPHTHALMOLOGICA, Issue 3 2009Ugur Keklikci Abstract. Purpose:, To determine the risk ratios and incidence of intraoperative floppy iris syndrome (IFIS) during cataract surgery in patients using tamsulosin, and to assess management strategies for IFIS. Methods:, We performed a non-randomized, observational, prospective study, in which 594 eyes of 579 patients undergoing cataract surgery were enrolled. Surgeons were masked to the patients' drug history. Usage or non-usage of tamsulosin, duration of tamsulosin use, presence or absence of IFIS, management of IFIS and intraoperative complications were recorded in the patients' theatre notes. Results:, Twelve of 15 (80%) IFIS patients were taking systemic tamsulosin. Twelve of 23 (52%) patients using tamsulosin showed features of IFIS. The odds ratios (ORs) and relative risk (RR) ratios show strong positive correlations between tamsulosin use and IFIS. The ORs and RR ratios and the 95% confidence intervals (CIs) are as follows: OR 206.5 (95% CI 50.9,836.5); RR 99.3 (95% CI 30.0,327.8). There were no statistically significant differences between patients with or without IFIS, who were using tamsulosin, in terms of age or duration of tamsulosin use (p > 0.05). Seven eyes (46.6%) with IFIS were successfully managed with epinephrine. Eight eyes (53.4%) with IFIS needed iris hooks. Conclusions:, Patients using tamsulosin appear to be at high risk of IFIS during cataract surgery. The occurrence of IFIS may not be affected by duration of tamsulosin use or age. Epinephrine may be effective in approximately 50% of eyes with IFIS. The iris hook procedure represents an effective management strategy in IFIS. [source] Determination of Epinephrine by Flow Injection Analysis Coupled Ag(III) Complex-Luminol Chemiluminescence DetectionCHINESE JOURNAL OF CHEMISTRY, Issue 4 2009Jiangbo BAI Abstract A new Ag(III) complex-luminol chemiluminescent system which was applied to the determination of epinephrine is firstly reported. Based on the enhancing effect of epinephrine on the chemiluminescence reaction of luminol with [Ag(HIO6)2]5, in alkaline solution, a highly sensitive chemiluminescence (CL) detection by flow injection analysis (FIA) was developed for epinephrine. Under the optimum conditions, CL intensity was proportional to concentration of epinephrine in the 1.0×10,9,1.0×10,7 mol·L,1 range. The limit of detection was 8.0×10,10 mol·L,1 for epinephrine (3,), with a relative standard deviation (n=11) of 2.9% for 1.5×10,8 mol·L,1 epinephrine. The method validation was done with epinephrine determinations in commercial pharmaceutical products. The mechanism of the reactions was also discussed. [source] Simultaneous Determination of Epinephrine, Noradrenaline and Dopamine in Human Serum Samples by High Performance Liquid Chromatography with Chemiluminescence DetectionCHINESE JOURNAL OF CHEMISTRY, Issue 7 2007Fu-Nan Chen Abstract A simple, rapid and accurate high performance liquid chromatographic (HPLC) technique coupled with chemiluminescence (CL) detection was developed for the simultaneous determination of epinephrine (E), noradrenaline (NA) and dopamine (DA). It was based on the analyte enhancement effect on the CL reaction between luminol and potassium ferricyanide. The effects of various parameters, such as potassium ferricyanide concentration, luminol concentration, pH value and component of the mobile phase on chromatographic behaviors of the analytes (E, NA and DA) were investigated. The separation was carried out on C18 column using the mobile phase of 0.01 mol/L potassium hydrogen phthalate solution and methanol (92:8, V/V). Under the optimum conditions, E, NA and DA showed good linear relationships in the range of 1×10,8,5×10,6, 5.0×10,9,1.0×10,6 and 5.0×10,9,1.0×10,6 g/mL respectively. The detection limits for E, NA and DA were 4.0×10,9, 1.0×10,9 and 8.0×10,10 g/mL. The proposed method has been applied successfully to the analysis of E, NA and DA in human serum samples. [source] ,-Cyclodextrin Incorporated Carbon Nanotube-coated Electrode for the Simultaneous Determination of Dopamine and EpinephrineCHINESE JOURNAL OF CHEMISTRY, Issue 3 2005Wang Ge-Yun Abstract An ,-cyclodextrin (,-CD) incorporated carbon nanotube (CNT)-coated electrode was fabricated and applied to the simultaneous determination of dopamine (DA) and epinephrine (EP). It has been found that the modified electrode shows strong catalytic effects on the electro-separation of DA and EP, and the cathodic potential difference between DA and EP is about 390 mV. The reducing peak current is proportional to DA and EP concentrations in the range of 2.0×10 -6,1.0×10 -3 and 1.0×10 -6,1.0×10 -3 mol·L -1, respectively. Their detection limits can reach 1×10 -6 and 5×10 -7 mol·L -1, respectively. Because the oxidation of ascorbic acid (AA) is an irreversible reaction in ,-CD/CNT film, the interference of AA in determination of DA and EP is eliminated. [source] Variables influencing Platelet Function Analyzer-100TM closure times in healthy individualsBRITISH JOURNAL OF HAEMATOLOGY, Issue 5 2005Hannelore Haubelt Summary We investigated the relationship between platelet function analyzer (PFA-100TM) closure times (CT) and bleeding time (BT), platelet aggregation (PA) induced by ADP, arachidonic acid, and collagen, blood cell counts, and von Willebrand factor (VWF) in 120 well-characterised healthy individuals. Pre-analytical and analytical conditions were standardised comprehensively. In a substantial number of cases the differences between duplicate measurements exceeded 15%. The reference range (5th and 95th percentiles) for CT with the collagen/epinephrine (CEPI) and the collagen/ADP (CADP) cartridge was 93,223 s and 64,117 s respectively. Re-examination of 11 individuals with CEPI-CT above the 95th percentile revealed considerable batch-to-batch variation of CEPI-CT. Males had significantly longer CADP than females (P = 0·002). CEPI and CADP-CT measured pm were significantly longer than corresponding values determined am (P = 0·003 and P < 0·0001 respectively). Blood group O was associated with greater CEPI and CADP-CT and lower VWF levels compared with non-O blood groups (P = 0·008, P = 0·0003 and P < 0·0001 respectively). Linear regression analysis revealed association between CEPI-CT, CADP-CT and VWF (P < 0·0001), but no relationship was found between CT and BT or between CT and PA. We conclude that VWF plasma levels modulate PFA-100TM CT to a greater extent than platelet function. Establishment of reliable reference ranges and careful standardisation of pre-analytical and analytical conditions is a prerequisite for obtaining reliable PFA-100TM results. Duplicate measurements are necessary. [source] Digital Block With and Without Epinephrine During Chemical Matricectomy with PhenolDERMATOLOGIC SURGERY, Issue 10 2010H. CEVDET ALTINYAZAR MD BACKGROUND Digital block with epinephrine is safe in selected patients. Chemical matricectomy with phenol is a successful, cheap, and easy method for the treatment of ingrown nails. OBJECTIVE To determine the effect of digital block with epinephrine in chemical matricectomy with phenol. MATERIAL AND METHODS Forty-four patients with ingrown toenail were randomly divided into two groups. The plain lidocaine group (n=22) underwent digital anesthesia using 2% plain lidocaine, and the lidocaine with epinephrine group (n=22) underwent digital anesthesia with 2% lidocaine with 1:100,000 epinephrine. In the postoperative period, the patients were evaluated for pain, drainage, and peripheral tissue destruction and were followed for up to 18 months for recurrence. RESULTS The mean anesthetic volume used in the epinephrine group (2.2±0.4 mL) was significantly lower than the plain lidocaine group (3.1±0.6 mL). There was no statistically significant difference in postoperative pain and recurrence rates, but duration of drainage was significantly shorter in the epinephrine group (11.1±2.5 days) than in the plain lidocaine group (19.0±3.8 days). CONCLUSION Digital block with epinephrine is safe in selected patients, and epinephrine helps to shorten the postoperative drainage period. The authors have indicated no significant interest with commercial supporters. [source] Viability of Preadipocytes In Vitro: The Influence of Local Anesthetics and pHDERMATOLOGIC SURGERY, Issue 8 2009MAIKE KECK MD BACKGROUND Autogenous fat transfer with lipoinjection for soft tissue augmentation is a commonly used surgical technique. Abundant donor tissue availability and relative ease of harvesting have made autologous fat an attractive soft tissue filler. The overall reliability of this technique is often disputed, and different authors describe different results after autologous fat transplantation despite using similar techniques. In this study, we examined the influence of different local anesthetics commonly used in fat harvest and the pH of the anesthetic solution on the viability of harvested preadipocytes. METHODS AND MATERIALS Preadipocytes were incubated with 1% lidocaine, 1% articaine plus epinephrine 1:200,000, 0.75% ropivacaine, and 1% prilocaine or our standardized tumescent solution (1 L of 0.9% sodium chloride solution plus 25 mL of 1% articaine plus epinephrine 1:200,000 plus 25 mL of bicarbonate) for 30 minutes. Additionally, we incubated cells with the local anesthetics as described above but diluted 1:2 with phosphate buffered saline (pH 7.4). Viability was measured using trypan blue dying as well as propidium iodine staining and fluorescence-activated cell sorting analysis. RESULTS There are significant differences in the viability of preadipocytes under the influence of various local anesthetics. DISCUSSION Our data could partially explain the varying results after autogenous fat transfer. [source] A Percutaneous Approach to Eyebrow Lift: The Salvadorean OptionDERMATOLOGIC SURGERY, Issue 8 2003Enrique Hernandez-Perez MD Background Surgical eyebrow lift can result in a number of complications. A nonsurgical simple method of lifting the brow is presented. Objective To raise the eyebrows using a simple, quick, and noninvasive approach. Methods Twenty-nine patients, 27 women and 2 men, whose ages varied from 24 to 56 years (mean of 32 years) were included in the study. Preoperative and postoperative photographs were taken. In two patients, brow suspension was performed at the time of blepharoplasty. Informed consent was signed by all of the patients. For measuring the degree of satisfaction of the patients, we gave to them a sheet grading it from one to three (with one being the least satisfactory). Local anesthesia (1% lidocaine, 1:400,000 epinephrine), a conveniently sized Keith needle, and prolene 3/0 sutures were used. Results Satisfying results were obtained in all cases. The only problem encountered in two patients was temporary edema, and it settled in a few days. Conclusion This is a very simple, quick, and noncomplicated method of raising the eyebrows. It can be repeated, revised easily, or combined with other modalities, such as peels, topical tretinoin, oral isotretinoin, fat injection, Goretex, and Botox as part of a facial rejuvenation program. [source] Lidocaine Iontophoresis for Local Anesthesia Before Shave BiopsyDERMATOLOGIC SURGERY, Issue 6 2003William T. Zempsky MD Background. Lidocaine iontophoresis is a method of topical anesthesia in which lidocaine is driven into the skin under the influence of electric current. Objective. To compare lidocaine iontophoresis to placebo for topical anesthesia before shave biopsy in adult patients. Methods. This was a single-center, double-blind, placebo-controlled evaluation of iontophoresis of 2% lidocaine with 1:100,000 epinephrine in patients undergoing shave biopsy. Patients were evaluated for sensation to pinprick after iontophoresis. After completion of the procedure, those patients who did not receive supplemental lidocaine rated the pain associated with the procedure using a 10-cm visual analog scale. The investigator also evaluated the patient's pain after biopsy. Treatment sites were examined for evidence of adverse events such as erythema, urticaria, or burns. Results. Forty-one patients undergoing shave biopsy for evaluation of skin lesions were enrolled. Nineteen of 21 patients in the lidocaine group versus 2 of 20 placebo patients required no supplemental anesthesia (P<0.001). The pain reported by the patient on the visual analog scale subsequent to the procedure was significantly lower in the lidocaine group (P<0.001). In concordance with the results reported by the patients, investigators rated pain lower in the lidocaine group (P<0.001). Blanching and/or erythema occurring at the iontophoresis-treated site in 37 of 41 patients resolved within 1 hour. There were no other treatment-related events. Conclusions. Lidocaine iontophoresis is a safe and effective method of administering topical anesthesia before shave biopsy in adult patients. [source] The Impact of Herbal Medicines on Dermatologic SurgeryDERMATOLOGIC SURGERY, Issue 8 2001Lawrence K. Chang MD Background. In recent years herbal medicines and supplements have become increasingly popular. With their increased popularity, more publications are warning about the potential harmful effects of some of these products. Objective. To present scientific evidence of the benefits and surgical risks of herbal products. Methods. A Medline search and review of the literature was performed. Results. Many herbal medicines are relevant in dermatologic surgery since Ginkgo biloba, garlic, ginger, ginseng, feverfew, and vitamin E may increase the risk of bleeding, and ephedra may potentiate the side effects of epinephrine. Conclusion. Dermatologists should be aware of these herbal products and their uses. Many of these products prescribed by alternative medicine physicians or purchased over the counter should be discontinued prior to dermatologic surgery to minimize the risk of surgical complications. [source] Current Concepts of Fat Graft Survival: Histology of Aspirated Adipose Tissue and Review of the LiteratureDERMATOLOGIC SURGERY, Issue 12 2000Boris Sommer MD Background. Controversy remains about the longevity of correction in autologous fat grafts and its relation to adipocyte survival. Reported long-term fat graft survival rates differ widely, depending on harvesting method, means of reinjection, injection site, and evaluation methods. Objective. To demonstrate histologic findings of aspirated adipose tissue and compare the findings to the reports in the literature. Methods. Review of the literature and the histology of transplanted fat 7 years after subcutaneous implantation and trypan blue staining to determine the vitality of defrosted adipocytes. Results. Fat cells survive aspiration with a suction machine or syringe equally well. Use of a liposuction cannula or 14-gauge needle gives comparable results. Local anesthesia or tumescent local anesthesia is recommended for the donor site, preferably with addition of epinephrine. Conclusion. Clinical longevity of correction after autologous fat transfer is determined by the degree of augmentation resulting from the amount of fibrosis induced and the number of viable fat cells. Survival of aspirated fat cell grafts depends mainly on the anatomic site, the mobility and vascularity of the recipient tissue, or underlying causes and diseases, and less on harvesting and reinjection methods. [source] Pathophysiology of ketoacidosis in Type 2 diabetes mellitusDIABETIC MEDICINE, Issue 10 2005P. Linfoot Abstract Aims Despite an increasing number of reports of ketoacidosis in populations with Type 2 diabetes mellitus, the pathophysiology of the ketoacidosis in these patients is unclear. We therefore tested the roles of three possible mechanisms: elevated stress hormones, increased free fatty acids (FFA), and suppressed insulin secretion. Methods Forty-six patients who presented to the Emergency Department with decompensated diabetes (serum glucose > 22.2 mmol/l and/or ketoacid concentrations , 5 mmol/l), had blood sampled prior to insulin therapy. Three groups of subjects were studied: ketosis-prone Type 2 diabetes (KPDM2, n = 13) with ketoacidosis, non-ketosis-prone subjects with Type 2 diabetes (DM2, n = 15), and ketotic Type 1 diabetes (n = 18). Results All three groups had similar mean plasma glucose concentrations. The degree of ketoacidosis (plasma ketoacids, bicarbonate and anion gap) in Type 1 and 2 subjects was similar. Mean levels of counterregulatory hormones (glucagon, growth hormone, cortisol, epinephrine, norepinephrine), and FFA were not significantly different in DM2 and KPDM2 patients. In contrast, plasma C-peptide concentrations were approximately three-fold lower in KPDM2 vs. non-ketotic DM2 subjects (P = 0.0001). Type 1 ketotic subjects had significantly higher growth hormone (P = 0.024) and FFA (P < 0.002) and lower glucagon levels (P < 0.02) than DM2. Conclusions At the time of hospital presentation, the predominant mechanism for ketosis in KPDM2 is likely to be greater insulinopenia. [source] Structure,activity relationships of isoeugenol-based chlorophenylpiperazine derivatives on serotonergic/adrenergic receptor, platelet aggregation, and lipid peroxidationDRUG DEVELOPMENT RESEARCH, Issue 5 2010Kuo-Ping Shen Abstract Three isoeugenol-based eugenosedin chlorphenylpiperazine derivatives, Eu-A, Eu-B, and Eu-C, were synthesized and tested for their serotonergic, adrenergic antagonist, antioxidant, and anti-aggregation activities. In radioligand binding assays, all three agents displayed significant binding affinities on ,1, ,2, ,1, 5-HT1B, and 5-HT2A receptors. In human platelet, they inhibited epinephrine and 5-HT-induced aggregation, and in human platelet with ,2 and 5-HT2A receptors they had a competitive binding effect. Eu-B and Eu-C were more potent than Eu-A. All compounds had antioxidant effects derived from aryloxypropanolamine. Eu- A, Eu-B, or Eu-C (1, 3, 5,mg/kg iv) given to normotensive Wistar rats produced a dose-dependent decrease in mean arterial blood pressure and heart rate and when injected into the cisternum, Eu-A, Eu-B, or Eu-C (0.3, 0.03,µmol) increased blood pressure within 15,min. Pretreatment with any of the three agents inhibited clonidine (38,pmol)-induced hypotension. In vitro experiments, Eu-A, Eu-B, or Eu-C (1, 10, and 100,µM) competitively antagonized norepinephrine-, clonidine-, and 5-HT (10,8,10,4,M)-induced vasocontraction in isolated rat aorta, and competitively antagonized isoproterenol (10,8,10,4,M)-induced positive inotropic effects in a concentration-dependent manner in the isolated rat left atrium. In isolated rabbit ear arteries sensitized with 16,mM K+, all three agents antagonized 5-nonyloxytryptamine- and 5-HT-induced vasocontractions. These findings show that Eu-A, Eu-B, and Eu-C possess functional ,1, ,2, ,1, 5-HT1B, and 5-HT2A receptor blocking activities. In conclusion, the changes in the position of chloride at phenylpiperazine influenced the serotonergic receptor, adrenoceptor antagonistic activities, but not anti-aggregation and antioxidant activities. Drug Dev Res 71:1,9, 2010. © 2010 Wiley-Liss, Inc. [source] Sensitivity and reproducibility of indirect calorimetry in measurement of resting metabolic rateDRUG DEVELOPMENT RESEARCH, Issue 8 2008Cecilia Karlsson Abstract The aim of this study was to assess indirect calorimetry measurement of resting metabolic rate (RMR) with respect to sensitivity and reproducibility in a human study population suitable for early clinical studies to evaluate new anti-obesity candidate drugs. Twenty-four overweight, but otherwise healthy males were included in this randomized, single-blind, placebo-controlled, crossover study. Three different doses of epinephrine (0.005, 0.01, 0.03,µg · kg fat-free mass (FFM),1 · min,1) were used as active treatment. There were two identical study periods, separated by a 4-week washout. Increases in RMR were seen with all tested concentrations of epinephrine when compared with placebo. Changes in RMR of ,1.8% could be detected with 90% power in this crossover study design. The RMR values measured at the two study periods revealed a highly significant correlation (Spearman correlation 0.803, P=0.0007). To conclude, indirect calorimetry is a sensitive and robust means of measuring RMR. The method can be used to assess RMR in diverse clinical settings, even when considering modest differences. Drug Dev Res 69: 2008. © 2008 Wiley-Liss, Inc. [source] Double Modification of Electrode Surface for the Selective Detection of Epinephrine and Its Application to Flow Injection Amperometric AnalysisELECTROANALYSIS, Issue 22 2009Guang-Ri Xu Abstract A glassy carbon electrode having two polymer layers has been applied to selectively detect epinephrine. The inner layer formed by electropolymerization of macrocyclic nickel complex functioned as an electrocatalyst for epinephrine oxidation and the outer layer composed of hydrolyzed polyurethane ,-benzyl L -glutamate as a screening layer. Differential pulse voltammetry showed almost 100% recovery of epinephrine even in 100-fold excess of interferents. When applied to a dual glassy carbon electrode as an amperometric detector in flow injection analysis, a linear response over 0.1,,M and 10,,M was obtained. Recovery tested for 5-fold diluted human urine samples was 97.5%. [source] Multiwalled Carbon Nanotubes Encased in Ruthenium Oxide Film as a Hybrid Material for Neurotransmitters SensorELECTROANALYSIS, Issue 16 2009Chien-Chieh Ti Abstract A hybrid film (MWCNTs-RuOx,nH2O) which contains multiwalled carbon nanotubes (MWCNTs) along with the incorporation of ruthenium oxide (RuOx,nH2O) has been synthesized on glassy carbon electrode (GCE), gold (Au), indium tin oxide (ITO) and screen printed carbon electrode (SPCE) by potentiostatic methods. The presence of MWCNTs in the hybrid film enhances surface coverage concentration (,) of RuOx,nH2O to ,2100%. The surface morphology of the hybrid film deposited on ITO has been studied using scanning electron microscopy and atomic force microscopy. These two techniques reveal that the RuOx,nH2O incorporated on MWCNTs. Electrochemical quartz crystal microbalance study too reveals the incorporation of MWCNTs and RuOx,nH2O. The MWCNTs-RuOx,nH2O hybrid film exhibits promising enhanced electrocatalytic activity towards the biochemical compounds such as epinephrine and norepinephrine. The electrocatalytic responses of these analytes at RuOx,nH2O, MWCNTs and MWCNTs-RuOx,nH2O hybrid films have been measured using cyclic voltammetry. The obtained sensitivity values from electrocatalysis studies of analytes for MWCNTs-RuOx,nH2O hybrid film are higher than the RuOx,nH2O and MWCNTs films. Finally, the flow injection analysis has been used for the amperometric studies of analytes at MWCNTs-RuOx,nH2O hybrid film modified SPCEs. [source] Electrochemical Behavior of Catecholamines and Related Compounds at In Situ Surfactant Modified Carbon Paste ElectrodesELECTROANALYSIS, Issue 2-3 2007M.Carmen Blanco-López Abstract The voltammetric characteristics of catecholamines: epinephrine (E) and norepinephrine (NE) and related compounds: isoproterenol, metanephrine, L -dopa, methyldopa, vanillylmandelic acid (VMA), and homovanillic acid (HVA) at unmodified and in situ surfactant- modified carbon paste electrodes were comparatively evaluated. For the basic and amphoteric compounds the modification of the electrode surface with submicellar concentrations of anionic surfactants (sodium dodecylsulfate, sodium decylsulfate or sodium dodecylsulfonate) produce an important current enhancement in its oxidation and reduction peak current together with the improvement in the reversibility of the processes. These effects were explained in basis on electrostatic and hydrophobic interactions. On the other hand, the oxidation of acidic metabolites, HVA and VMA, was studied at electrodes modified in situ with cationic surfactants. Under certain conditions the surfactant could stabilise some of the electrochemical reaction intermediates, thus explaining the different voltammetric behaviour of HVA and VMA. [source] A LiMn2O4 Based Electrochemical Scheme for Selective Measurement of DopamineELECTROANALYSIS, Issue 3 2006Hoang, Jyh Leu Abstract A new cathodic scheme was developed for the determination of dopamine by flow injection analysis (FIA). A mild oxidizing agent, lithium manganese (III, IV) oxide (LiMn2O4), as an upstream modifier can oxidize the dopamine to produce the dopaminequinone, and then the oxidized product is subsequently detected by the downstream detector at ,0.1,V (vs. Ag/AgCl). In this work, the significant feature of LiMn2O4 based sensing scheme possesses no interference from other tested biological amines including acetylcholine, epinephrine, glutamate, and histamine. Otherwise, there is no detectable interference from ascorbic acid, but 2% and 1% negligible interferences were found from uric acid and acetaminophen, respectively. [source] Amperometric Detection of Catecholamine Neurotransmitters Using Electrocatalytic Substrate Recycling at a Laccase ElectrodeELECTROANALYSIS, Issue 2 2005Yvonne Ferry Abstract An enzyme electrode based on the coimmobilization of an osmium redox polymer and laccase on glassy carbon electrodes has been applied to ultra sensitive amperometric detection of the catecholamine neurotransmitters dopamine, epinephrine and norepinephrine, resulting in nanomolar detection limits, as low as 4,nM for dopamine. The sensitivity of the electrode is due to signal amplification via oxidation of the catecholamine by the immobilized laccase, which is regenerated by concomitant reduction of oxygen to water, coupled to the electrocatalytic re-reduction of the oxidized catecholamine by the osmium redox complex: electrocatalytic substrate recycling. In addition because the sensor can be operated in reductive mode at ,0.2,V (vs. Ag/AgCl), noise and interferences are diminished. Combined with its high sensitivity this enzyme electrode also exhibited excellent selectivity allowing the detection of catecholamines in the presence of ascorbic acid. However, differentiation between the current responses achieved for the three catecholamines is not possible. The effective mode of constant recycling, resulting in amplification of the current response, of the laccase enzyme electrode sensor combined with the inherent advantages of using electrochemical techniques holds great promise for the future of catecholamine detection and monitoring. [source] Enantioselectivity of basic analytes in CZE enantioseparation under reversed-polarity mode using sulfated ,-cyclodextrins as chiral selectors: An unusual temperature effectELECTROPHORESIS, Issue 21 2006Chen-Hsing Lin Abstract Temperature effects on the enantioselectivity of basic analytes in CZE enantioseparation were studied under reversed-polarity mode using randomly sulfate-substituted ,-CDs (MI-S-,-CD) as chiral seletors. Two catecholamines (epinephrine and isoproterenol) and two structurally related compounds (octopamine and norephedrine) were selected as test compounds in an electrophoretic system at low pH. The mobility differences between the (+)-enantiomers and the (,)-enantiomers of the two catecholamines and dopamine at 40°C are greater than those at 25°C with MI-S-,-CD, even at a concentration as low as 0.3%,w/v. Thus the enantioselectivity of these three basic analytes increases with increasing temperature. This phenomenon results from the inequality of the temperature effect on the mobility of the two enantiomers. In contrast, norephedrine behaves differently. The (+)-enantiomers of these basic analytes were found to migrate faster than the (,)-enantiomers. Consequently, the unusual temperature effect on the enantioselectivity can be observed when the mobility difference of the (+)-enantiomer between 40 and 25°C is greater than that of the (,)-enantiomer using MI-S-,-CD at a concentration greater than about 0.7%,w/v for enantioseparation of isoproterenol, 0.4%,w/v for epinephrine, and 0.3%,w/v for octopamine. This unusual temperature effect offers the advantages to enhance enantioselectivity, to improve enantioseparation, and to reduce migration times. [source] | ||||||||||||||||||||||||||||||||||||||||