Acute drug eruption as a result of therapy with the new generation anticonvulsant drug lamotrigine : case report

Drug eruption is the most common skin manifestation of adverse drug reactions, accounting for 70% of all druginduced dermatoses. Anti-epileptic drugs as well as β-lactam antibiotics and sulphonamides are associated with about 91% of cases of all drug therapy complications. Mentioned reactions are usually non-immunological and are connected with idiosyncrasy, intolerance or pseudo-allergic reactions. Family gene polymorphisms of the HLA-DR system and genes coding enzymes of drug metabolic pathways have a special role in this process. We describe an 18-year old woman with generalized eruption which started 14 days after initiation of the new anticonvulsant drug lamotrigine. The patient was observed for mononucleosis, virus throat infection and angina before hospitalization. She was admitted to the Dermatology Clinic in Kraków in general good condition on the 4th day of steroid therapy with dexamethasone in a dose of 24 mg per day. On physical examination generalized erythema and inflammatory skin lesions were seen with colliquative tendency and positive Nikolsky sign. Laboratory tests (morphology, coagulation parameters, liver and kidney testes) were correct. Due to multi-aetiological and still unknown mechanisms of drug eruption, recommended therapy is inconsistent. We decided to stop lamotrigine therapy and to start methylprednisolone therapy in a dose of 500 mg per day for 2 days, gradually reduced during the next 6 days to 200 mg per day followed by oral Metypred therapy with a dose of 40 mg per day, which was continued with good clinical response until the 28th day. Anti-inflammatory and disinfectant care was ordered as a complementary local therapy

Elemental changes in the hippocampal formation following two different formulas of ketogenic diet : an X-ray fluorescence microscopy study

The main purpose of the following study was the determination of elemental changes occurring within hippocampal formation as a result of high-fat and carbohydrate-restricted ketogenic diet (KD). To realize it, X-ray fluorescence microscopy was applied for topographic and quantitative analysis of P, S, K, Ca, Fe, Cu, Zn and Se in hippocampal formations taken from rats fed with two different KDs and naive controls. The detailed comparisons were done for sectors 1 and 3 of the Ammon’s, the dentate gyrus and hilus of dentate gyrus. The results of elemental analysis showed that the KDs induced statistically significant changes in the accumulation of P, K, Ca, Zn and Se in particular areas of hippocampal formation and these alterations strongly depended on the composition of the diets. Much greater influence on the hippocampal areal densities of examined elements was found for the KD which was characterized by a lower content of carbohydrates, higher content of fats and increased proportion of unsaturated fatty acids. The levels of P, K and Zn decreased whilst those of Ca and Se increased as a result of the treatment with the KDs

Effect of polyols and selected dental materials on the ability to create a cariogenic biofilm : on children caries-associated "Streptococcus Mutans" isolates

Secondary caries is a disease associated with the formation of biofilm on the border of the tooth and dental filling. Its development is strongly influenced by the dietary sweet foods and the type of dental material. The aim of the study was to assess the effect of sweeteners on the ability of clinical Streptococcus mutans strains to form biofilm on dental materials. Strains were isolated from plaque samples from 40 pediatric patients from the 3–6 ICADS II group. The ability to form biofilm was tested on composite and glass ionomer dental materials used for milk teeth filling in the presence of sucrose, xylitol, sorbitol, and erythritol. The bacterial film mass after 12, 24, 48, and 72 h and the number of bacterial colonies significantly decreased (p < 0.01) compared to the initial value for 5% erythritol and sorbitol on examined materials. A greater inhibitory effect was noted for glass ionomers compared to composites. Sucrose and xylitol supported biofilm formation, while erythritol had the best inhibitory effect. The use of fluoride-releasing glass ionomers exerted an effect synergistic to erythritol, i.e., inhibited plaque formation and the amount of cariogenic S. mutans. Selection of proper type of dental material together with replacing sucrose with polyols can significantly decrease risk of secondary caries development. Erithritol in combination with glass ionomer seems to be the most effective in secondary caries prevention

Differences in sweet taste perception and its association with the "Streptococcus mutans" cariogenic profile in preschool children with caries

The aim of the study was to verify the hypothesis about differences in sweet taste perception in the group of preschool children with and without caries, and to determine its relationship with cariogenic microbiota and the frequency of sweets consumption in children. The study group included of 63 children aged 2&ndash;6 years: 32 with caries and 31 without caries. The study consisted of collecting questionnaire data and assessment of dental status using the decayed, missing, filled in primary teeth index (dmft) and the International Caries Detection and Assessment System (ICDAS II). The evaluation of sweet taste perception was carried out using a specific method that simultaneously assessed the level of taste preferences and the sensitivity threshold for a given taste. The microbiological analysis consisted of the assessment of the quantitative and qualitative compositions of the oral microbiota of the examined children. The sweet taste perception of children with caries was characterized by a lower susceptibility to sucrose (the preferred sucrose solution concentration was &gt;4 g/L) compared to children without caries (in the range &le; 4 g/L, p = 0.0015, chi-square test). A similar relationship was also observed for frequent snacking between meals (p = 0.0038, chi-square test). The analysis of studied variables showed the existence of a strong positive correlation between the perception of sweet taste and the occurrence and intensity of the cariogenic process (p = 0.007 for dmft; and p = 0.012 for ICDAS II), as well as the frequency of consuming sweets (p &le; 0.001 for frequent and repeated consumption of sweets during the day, Spearman test) in children with caries. Additionally, children with an elevated sucrose taste threshold were more than 10-times more likely to develop S. mutans presence (OR = 10.21; 95% CI 3.11&ndash;33.44). The results of this study suggest the future use of taste preferences in children as a diagnostic tool for the early detection of increased susceptibility to caries through microbial dysbiosis towards specific species of microorganisms

Hypersensitivity to aspirin : common eicosanoid alterations in urticaria and asthma

Background: Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can precipitate adverse reactions in two apparently different clinical conditions: bronchial asthma and chronic idiopathic urticaria (CIU). Recent evidence indicates that the reactions are triggered by the drugs that inhibit cyclooxygenase-1 but not cyclooxygenase-2. Objective: To assess whether patients with CIU and aspirin sensitivity share common eicosanoid alterations with patients who have aspirin-sensitive asthma. Methods: Seventy-four patients with CIU and a history of sensitivity to aspirin and NSAIDs underwent placebocontrolled oral aspirin challenge tests. Concentrations of urinary leukotriene E4 (uLTE4) were measured by ELISA and plasma stable prostaglandin D2 metabolite, 9a,11b prostaglandin F2 by GC/MS. All measurements were carried out at baseline and after aspirin dosing. Patients were genotyped for the leukotriene C4 synthase (LTC4S) promoter single nucleotide polymorphism. Results: In 30 of 74 patients, the aspirin challenge was positive, resulting in urticaria/angioedema. In these 30 patients, baseline uLTE4 levels were higher than in nonresponders and the healthy control subjects and increased further (significantly) after the onset of clinical reaction. No such increase occurred in subjects with negative aspirin challenge. Baseline uLTE4 levels correlated with severity of skin reactions. Plasma 9a,11b prostaglandin F2 levels rose significantly in both aspirin responders and nonresponders, although in the latter group the increase occurred later than in the former. In patients who reacted to aspirin, frequency of e444C allele of LTC4S was significantly higher than in patients who did not react. Conclusions: CIU with aspirin sensitivity is characterized by the eicosanoid alterations, which are similar to those present in aspirin-induced asthma

Different effects of neuroprotectants FK-506 and cyclosporin A on susceptibility to pilocarpine-induced seizures in rats with brain injured at different developmental stages

Susceptibility of the injured brain to epileptic seizures depends on the developmental stage at which the injury had been inflicted (our previous paper published in Epilepsy Res. 53 (2003) 216-224). The present Study was designed to examine whether neuroprotective agents applied following the injury can decrease the seizure susceptibility. In order to solve this problem, the left cerebral hemisphere was mechanically injured in 6- and 30-day-old Wistar rats. Neuroprotectants FK506 or Cyclosporin A (CsA) were injected 20 min and 24 h following the injury. On postnatal day 60, all the animals received single i.p. pilocarpine injections to evoke epileptic seizures. During a 6 h period following the injection, the animals were observed continuously and pilocarpine-induced symptoms were recorded and rated. The animals were sacrificed 7 days after pilocarpine injection. In rats injured on postnatal days 6 or 30 (P6 or P30, respectively) and injected with FK-506 after the injury, signs of amelioration in the course of epilepsy were observed. Generally, proportions of rats suffering from heavy seizures were lower and/or their survival periods were longer. Following treatment with CsA, proportions of rats displaying heavy seizures were greater. It was accompanied by extremely high mortality (in rats injured on P6) or a longer duration of seizures (in rats injured on P30). The results appear to point to age-dependent differences between the mechanisms of action of the two neuroprotectants