A two-dimensional mathematical model of percutaneous drug absorption

Background When a drug is applied on the skin surface, the concentration of the drug accumulated in the skin and the amount of the drug eliminated into the blood vessel depend on the value of a parameter, r. The values of r depend on the amount of diffusion and the normalized skin-capillary clearence. It is defined as the ratio of the steady-state drug concentration at the skin-capillary boundary to that at the skin-surface in one-dimensional models. The present paper studies the effect of the parameter values, when the region of contact of the skin with the drug, is a line segment on the skin surface. Methods Though a simple one-dimensional model is often useful to describe percutaneous drug absorption, it may be better represented by multi-dimensional models. A two-dimensional mathematical model is developed for percutaneous absorption of a drug, which may be used when the diffusion of the drug in the direction parallel to the skin surface must be examined, as well as in the direction into the skin, examined in one-dimensional models. This model consists of a linear second-order parabolic equation with appropriate initial conditions and boundary conditions. These boundary conditions are of Dirichlet type, Neumann type or Robin type. A finite-difference method which maintains second-order accuracy in space along the boundary, is developed to solve the parabolic equation. Extrapolation in time is applied to improve the accuracy in time. Solution of the parabolic equation gives the concentration of the drug in the skin at a given time. Results Simulation of the numerical methods described is carried out with various values of the parameter r. The illustrations are given in the form of figures. Conclusion Based on the values of r, conclusions are drawn about (1) the flow rate of the drug, (2) the flux and the cumulative amount of drug eliminated into the receptor cell, (3) the steady-state value of the flux, (4) the time to reach the steady-state value of the flux and (5) the optimal value of r, which gives the maximum absorption of the drug. The paper gives valuable information which can be obtained by this two-dimensional model, that cannot be obtained with one-dimensional models. Thus this model improves upon the much simpler one-dimensional models. Some future directions of the work based on this model and the one-dimensional non-linear models that exist in the literature, are also discussed

The Effect of Antiarrhythmic Drugs on the Ventricular Fibrillation Waveform

Carlisle, EJF, Allen, JD, Kernohan, WG, Anderson, J and Adgey, AAJ (1987) The effect of anti-arrhythmic drugs on the ventricular fibrillation waveform. Proc Eighth World Symposium on Cardiac Pacing and Electrophysiology and PACE (Pacing and clinical electrophysiology) 10:3;656

Melaena with Peutz-Jeghers syndrome: a case report

Introduction: Peutz-Jeghers syndrome (PJS) is a rare familial disorder characterised by mucocutaneous pigmentation, gastrointestinal and extragastrointestinal hamartomatous polyps and an increased risk of malignancy. Peutz-Jeghers polyps in the bowel may result in intussusception. This complication usually manifests with abdominal pain and signs of intestinal obstruction. Case Presentation: We report the case of a 24-year-old Caucasian male who presented with melaena. Pigmentation of the buccal mucosa was noted but he was pain-free and examination of the abdomen was unremarkable. Upper gastrointestinal endoscopy revealed multiple polyps. An urgent abdominal computed tomography (CT) scan revealed multiple small bowel intussusceptions. Laparotomy was undertaken on our patient, reducing the intussusceptions and removing the polyps by enterotomies. Bowel resection was not needed. Conclusion: Melaena in PJS needs to be urgently investigated through a CT scan even in the absence of abdominal pain and when clinical examination of the abdomen shows normal findings. Although rare, the underlying cause could be intussusception, which if missed could result in grave consequences

2012 Maine Child Support Guidelines: Review and Recommendations

This report summarizes the quadrennial review of Maine\u27s child support guidelines conducted by the USM Muskie School , which complies with federal law requiring each state\u27s child support guidelines be reviewed at least once every four years. Principle findings of the extensive review by the Muskie School show that many aspects of Maine\u27s child support system work well. Maine\u27s low deviation rate reflects a reasonably high level of consistency in apply the guidelines, and in large part, protect the needs and interests of the children. The report provides background and overview of child support modes and the Maine guidelines, and describes the elements of the review: Literature Review, Policy Analysis, Economic Analysis, Deviation Study, Stakeholder Input, Interviews with other State Child Support Officials, and concludes with several findings and recommendations. For additional information about the report or the study, contact Janice Daley at the Muskie School