Gallstone Obstructive Ileus 3 Years Post-cholecystectomy to a Patient with an Old Ileoileal Anastomosis

The present case is one of gallstone obstructive ileus due to gallstones 3 yr after laparoscopic cholecystectomy. It is interesting because of the sex of the patient, the fact that ileus occurred 3 yr after cholecystectomy and that the localization of the obstruction was an old side-to-side ileoileal anastomosis due to a diverticulectomy following intussusception of Meckels'' diverticulum at the age of 3.     

Ethambutol-induced optical neuropathy: risk of overdosing in obese subjects

BACKGROUND: Ethambutol (EMB) is one of the first-line drugs in the treatment against tuberculosis (TB). Side-effects are infrequent, but its main adverse effect, optical neuropathy, has long been recognised. The mechanisms of action and predisposing factors have not yet been fully understood. METHOD: We conducted a retrospective study (1992--2007) in an attempt to find predisposing factors for optical neuropathy. RESULTS: Visual disturbance was reported in 1.3% of the 760 patients treated with EMB; of these, 0.8% were EMB-related. We present the six cases; four were clearly overdosed, but in two obese patients dosage was correctly calculated for total body weight (TBW). CONCLUSION: Analysis of the case histories and previous reports suggest that optical neuropathy may at least partly be caused by EMB overdosing due to daily dosing based on TBW instead of dosing on lean body mass.     

Deaths from nasopharyngeal cancer among waiters and waitresses in Chinese restaurants

Objective: Previous studies have shown that waiters have a high risk of developing cancers of the buccal cavity and pharynx, but nasopharyngeal cancer (NPC) has not been specifically studied. This study was carried out to investigate whether waiters/waitresses in Chinese restaurants have an increased risk of dying from NPC. Methods: A mortality odds ratio study was used to estimate the relative risk of dying from NPC for waiters/waitresses working in Chinese restaurants in Hong Kong during the period 1986–1995, using the general population as the external comparison group and deceased kitchen workers as an internal comparison group. Cases were deaths from NPC and the controls were deaths from the selected sets of reference causes. Results: Seventeen deaths from NPC were identified among 415 deceased waiters and four NPC deaths occurred among 140 deceased waitresses. The adjusted mortality odds ratio (aMOR) for NPC was increased among waiters, being 3.02 (95% CI 1.82–5.00) and 2.61 (95% CI 1.02–6.69) in the external and internal comparisons, respectively. For waitresses, the aMOR was 4.58 (95% CI 1.63–12.86) in the external comparison. Analysis by duration of union membership suggested a dose–response relationship. Conclusions: An increased risk of dying from NPC was observed among waiters/waitresses and could not be fully explained by bias or confounding factors. Possible risk factors related to poor indoor air quality in the service areas of Chinese restaurants in Hong Kong should be further investigated.     

A multicenter, open-label study to assess the safety and efficacy of ciclopirox topical suspension 0.77% in the treatment of diaper dermatitis due to Candida albicans

Ciclopirox is a broad-spectrum antifungal, antibacterial, and anti-inflammatory agent. This open-label study investigated the safety and efficacy of ciclopirox topical suspension 0.77% in the treatment of diaper dermatitis due to Candida albicans (C. albicans). Forty-four male and female subjects aged 6 to 29 months were included in the study. Study medication was applied topically to the affected diaper area twice daily for 1 week. Subjects were clinically evaluated at baseline and days 3, 7, and 14 (7 days post-treatment). Safety and efficacy variables included adverse events, mycological culture studies, KOH tests, Severity Scores, and Global Evaluation of Clinical Response. All adverse events were mild to moderate and considered not related to the study medication. Treatment provided statistically significant improvement (P < .05) for both the rate of mycological cure and reduction of Severity Score at each time point compared with baseline. Ciclopirox was safe and effective in the treatment of diaper dermatitis due to C. albicans.     

Trisphaerolide A,a novel polyketide from the Dominican sponge Erylus trisphaerus

The structure of trisphaerolide A (1), a mildly cytotoxic metabolite isolated from extracts of the marine sponge Erylus trisphaerus collected in Dominica, has been elucidated by detailed analysis of spectroscopic data. Trisphaerolide A (1) has a putative polyketide biogenesis, incorporating a rare variant on the standard pathway, which involves the addition of methyl branches arising from C-2 carbons of acetate units to chain carbons that arise from C-1 of acetate units.