Isolation, determination and differentiation of morphine, codeine and heroin from viscera and body fluids by chromatographic analysis

1. Morphine, codeine and heroin in amounts of 0.5 to 1.0 mg. were adsorbed quantitatively from pure water -alcohol (1 :4 by volume) solutions containing from 5 to 20 per cent. trichloracetic acid and from 1 to 4 per cent. sodium chloride. The adsorption was made on an acid column (pH 6.5 to 7.0) from acid solutions (pH 6.5). 2. The three alkaloids were adsorbed quantitatively from tissue extracts, blood filtrates and urine filtrates only on alkaline columns (pH 7.5 -3.0) from alkaline solutions (pH 8.0 -8.5). 3. Mixtures of morphine and heroin in pure solutions were separated into the individual components by selective adsorption of the heroin on methyl alcohol treated columns. 4. Separation of mixtures of morphine and codeine in pure solution was also accomplished by selective adsorption of the codeine on methyl alcohol treated columns. 5. The separation into the individual components of mixtures of codeine and heroin has not been successful under the conditions described. 6. Evidence for the mutual interference of alkaloids on adsorption from acid tissue extracts or silicate -containing solution on acid columns was given. 7. The adsorption method was extended for the separation of barbiturates from the alkaloids. 8. Barbiturates were adsorbed quantitatively in amounts from 1.0 to 5.0 mg. on activated charcoal from pure water- alcohol trichloracetic acid solutions either at pH 5.5 or pH 8.5. 9. Barbiturates were adsorbed quantitatively from tissue extracts, blood and urine filtrates only in the acid range (pH 5.5)

The impossibility of low rank representations for triangle-rich complex networks

The study of complex networks is a significant development in modern science, and has enriched the social sciences, biology, physics, and computer science. Models and algorithms for such networks are pervasive in our society, and impact human behavior via social networks, search engines, and recommender systems to name a few. A widely used algorithmic technique for modeling such complex networks is to construct a low-dimensional Euclidean embedding of the vertices of the network, where proximity of vertices is interpreted as the likelihood of an edge. Contrary to the common view, we argue that such graph embeddings do not}capture salient properties of complex networks. The two properties we focus on are low degree and large clustering coefficients, which have been widely established to be empirically true for real-world networks. We mathematically prove that any embedding (that uses dot products to measure similarity) that can successfully create these two properties must have rank nearly linear in the number of vertices. Among other implications, this establishes that popular embedding techniques such as Singular Value Decomposition and node2vec fail to capture significant structural aspects of real-world complex networks. Furthermore, we empirically study a number of different embedding techniques based on dot product, and show that they all fail to capture the triangle structure

An Epidemiological Study of Hyperhidrosis Patients Visiting the Ajou University Hospital Hyperhidrosis Center in Korea

Hyperhidrosis is a disorder of perspiration in excess of the body's physiologic need and significantly impacts one's occupational, physical, emotional, and social life. The purpose of our study was to investigate the characteristics of primary hyperhidrosis in 255 patients at Ajou University Hospital Hyperhidrosis Center from March 2006, to February 2008. Information collected from the medical records was: sex, sites of hyperhidrosis, age at visit, age of onset, aggravating factors, hyperhidrosis disease severity scale (HDSS) rank, family history, occupation, and past treatment. A total of 255 patient records were reviewed; 57.6% were male. Patients with a family history (34.1%) showed a lower age of onset (13.21±5.80 yr vs. 16.04±9.83 yr in those without family history); 16.5% had previous treatment, most commonly oriental medicine. Palmar and plantar sites were the most commonly affected, and 87.9% of patients felt their sweating was intolerable and always interfered with their daily activities. Our study provides some original information on the Korean primary hyperhidrosis population. Patients who have a family history show signs of disease in early age than those without family history

Percepción de los egresados de las carreras de licenciatura en nutrición y medicina acerca del nivel de enseñanza sobre obesidad en Argentina

ARTÍCULO PUBLICADO EN REVISTA EXTERNA. La obesidad es una enfermedad crónica, progresiva y recidivante definida por el exceso de grasa cor poral. Actualmente, representa un grave problema para la Salud Pública. Es causada por múltiples fac tores: genéticos, ambientales, socioculturales, entre otros. Tiene efectos adversos en la salud, la calidad y expectativa de vida. En la Argentina, según datos de la última Encuesta Nacional de Factores de Riesgo 2018, la prevalencia de exceso de peso (sobrepeso y obesidad) fue del 61,6% y de obesidad del 25,3%1. A pesar de estas cifras alarmantes, todavía es insuficientemente diagnosticada y tratada2. Si bien está reglamentada en el Plan Médico Obligatorio (PMO) 3 no está totalmente reconocida como en fermedad y los pacientes enfrentan barreras para su tratamiento. La formación de grado de los profesionales de la salud debería dar respuesta a la demanda sanitaria que implica una enfermedad de tan alta prevalencia. Por ello, es indispensable que los médicos y licenciados en nutrición egresen con los conocimientos necesarios acerca de la prevención, el diagnóstico y tratamiento en todas sus dimensiones, incluyendo los fármacos y la cirugía bariátrica. El Grupo de Trabajo de Cirugía Bariátrica de la Sociedad Argentina de Nutrición tiene como interés evaluar la enseñanza de esta enfermedad, en especial, su tratamiento quirúrgico en la carrera de grado de Medicina y Licenciatura en Nutrición

Interventions for hyperhidrosis in secondary care : a systematic review and value-of-information analysis

Background: Hyperhidrosis is uncontrollable excessive sweating that occurs at rest, regardless of temperature. The symptoms of hyperhidrosis can significantly affect quality of life. The management of hyperhidrosis is uncertain and variable. Objective: To establish the expected value of undertaking additional research to determine the most effective interventions for the management of refractory primary hyperhidrosis in secondary care. Methods: A systematic review and economic model, including a value-of-information (VOI) analysis. Treatments to be prescribed by dermatologists and minor surgical treatments for hyperhidrosis of the hands, feet and axillae were reviewed; as endoscopic thoracic sympathectomy (ETS) is incontestably an end-of-line treatment, it was not reviewed further. Fifteen databases (e.g. CENTRAL, PubMed and PsycINFO), conference proceedings and trial registers were searched from inception to July 2016. Systematic review methods were followed. Pairwise meta-analyses were conducted for comparisons between botulinum toxin (BTX) injections and placebo for axillary hyperhidrosis, but otherwise, owing to evidence limitations, data were synthesised narratively. A decision-analytic model assessed the cost-effectiveness and VOI of five treatments (iontophoresis, medication, BTX, curettage, ETS) in 64 different sequences for axillary hyperhidrosis only. Results and conclusions: Fifty studies were included in the effectiveness review: 32 randomised controlled trials (RCTs), 17 non-RCTs and one large prospective case series. Most studies were small, rated as having a high risk of bias and poorly reported. The interventions assessed in the review were iontophoresis, BTX, anticholinergic medications, curettage and newer energy-based technologies that damage the sweat gland (e.g. laser, microwave). There is moderate-quality evidence of a large statistically significant effect of BTX on axillary hyperhidrosis symptoms, compared with placebo. There was weak but consistent evidence for iontophoresis for palmar hyperhidrosis. Evidence for other interventions was of low or very low quality. For axillary hyperhidrosis cost-effectiveness results indicated that iontophoresis, BTX, medication, curettage and ETS was the most cost-effective sequence (probability 0.8), with an incremental cost-effectiveness ratio of £9304 per quality-adjusted life-year. Uncertainty associated with study bias was not reflected in the economic results. Patients and clinicians attending an end-of-project workshop were satisfied with the sequence of treatments for axillary hyperhidrosis identified as being cost-effective. All patient advisors considered that the Hyperhidrosis Quality of Life Index was superior to other tools commonly used in hyperhidrosis research for assessing quality of life. Limitations: The evidence for the clinical effectiveness and safety of second-line treatments for primary hyperhidrosis is limited. This meant that there was insufficient evidence to draw conclusions for most interventions assessed and the cost-effectiveness analysis was restricted to hyperhidrosis of the axilla. Future work: Based on anecdotal evidence and inference from evidence for the axillae, participants agreed that a trial of BTX (with anaesthesia) compared with iontophoresis for palmar hyperhidrosis would be most useful. The VOI analysis indicates that further research into the effectiveness of existing medications might be worthwhile, but it is unclear that such trials are of clinical importance. Research that established a robust estimate of the annual incidence of axillary hyperhidrosis in the UK population would reduce the uncertainty in future VOI analyses