Boletín de la Asociación Médica de Puerto Rico

Online ISSN: 0004-4849
A clinical, randomized, parallel study was undertaken to compare the efficacy of a widely known steroid preparation, triamcinolone acetonide 0.1% cream, in occlusion with two different hydrocolloid dressings, namely Duoderm and Actiderm, in the treatment of chronic plaques of psoriasis. A total of 23 patients with psoriasis were entered in the study. Two similar psoriatic plaques were identified in each patient, triamcinolone acetonide cream was applied, and a randomized table assigned the sides of the body to which each dressing was to be used for each patient. Changing of the dressing, with reapplication of the cream was done every 48 hours on each side until the lesions cleared or for a maximum of three weeks. At the end of the three weeks-therapy, period, 12 lesions had totally cleared with Duoderm and 13 with Actiderm. Seven lesions had achieved either marked or moderate improvement with duoderm and the same results were observed with Actiderm. Only three of 22 had mild improvement with Duoderm and two of 22 with Actiderm. No side effect were noted and none of the patients became worse during this treatment. This study demonstrated the beneficial effects of triamcinolone acetonide 0.1% cream under occlusion with two different hydrocolloid dressings in the treatment of chronic resistant plaques of psoriasis. The use of a hydrocolloid dressing in combination with steroid adds another therapeutic option for the treatment of chronic localized psoriatic lesions.
1,1 '-Diethyl-2,2'-cyanine iodide (decynium22; D22) is a potent blocker of the organic cation family of transporters (EMT/OCT) known to move endogenous monoamines like dopamine and norepinephrine across cell membranes. Decynium22 is a cation with a relatively high affinity for all members of the OCT family in both human and rat cells. The mechanism through which decynium22 blocks OCT transporters are poorly understood. We tested the hypothesis that denynium22 may compete with monoamines utilizing OCT to permeate the cells. Using the ability of D22 to aggregate and produce fluorescence at 570 nm, we measured D22 uptake in cultured astrocytes. The rate of D22 uptake was strongly depressed by acid pH and by elevated external K+. The rate of uptake was similar to that displayed by 4-(4-(dimethylamino)-styryl)-N-methylpyridinium (ASP+), a well established substrate for OCT and high-affinity Na+-dependent monoamine transporters. These data were supported by measurement of electrogenic uptake using whole cell voltage clamp recording. Decynium22 depressed norepinephrine, but not glutamate uptake. These data are also consistent with the described OCT transporter characteristics. Taken together, our results suggest that decynium22 accumulation might be a useful instrument to study monoamine transport in the brain, and particularly in astrocytes, where they may play a prominent role in monoamine uptake during brain dysfunction related to monoamines (like Parkinson disease) and drug addiction.
Bezoars are masses of solidified organic or nonbiological material commonly found in the stomach and small bowel. Identification, therapy, and long-term management of patients with bezoars depends on accurate classification and knowledge on the pathophysiology of formation. Four types of bezoars have been described based on their composition: phytobezoars, trichobezoars, lactobezoars, and miscellaneous. Pediatric trichobezoars are associated to emotional disturbed children with aberrant appetite (trichophagia). Hair strands become retained and attached in the folds of the gastric mucosa because the friction surface is insufficient for propulsion by peristalsis. They generally are asymptomatic until enlargement produce pain, compression or intestinal obstruction. Bezoars are diagnosed with conventional radiology and gastroscopy permits identification of its nature. Currently, management of bezoars consists of: dissolution, suction, lavage, mechanical endoscopic fragmentation using pulsating jet of water, fragmentation with extracorporeal shock wave lithotripsy and surgical removal. Treatment should also focus on prevention of recurrence, since elimination of the mass will not alter the conditions contributing to their formation.
Top-cited authors
H.O. Sedano
  • University of California, Los Angeles
Gundu H R Rao
  • University of Minnesota Twin Cities
Humberto Lugo
  • University of Puerto Rico, Medical Sciences Campus
Jose Ramirez Rivera
  • University of Puerto Rico at Rio Piedras