Flow Imaging: Moving Toward Best Practices for Subvisible Particle Quantitation in Protein Products

The potential impact of subvisible particles (SVPs) in protein therapeutic products has received a great deal of attention recently. As a result, new analytical methods have emerged to characterize and quantify SVPs. Among these, flow imaging (also called flow microscopy) has been widely employed. As we have used both FlowCAM® and Micro-Flow Imaging? in a variety of development projects, we wished to share our experiences and observations, with the intention of fostering a discussion that will lead to best practices for the use of flow imaging to quantify SVP levels in biopharmaceuticals. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 102:1133–1134, 2013     

Ventricular Tachycardia

Ventricular tachycardia most often is a manifestation of intrinsic heart disease or digitalis intoxication. Differential diagnosis is of utmost importance in planning treatment.

Intravenous administration of procaine amide hydrochloride is the treatment of choice. However, if the arrhythmia occurs without underlying heart disease and is well tolerated, orally administered therapy is preferable to that given intravenously. Digitalis is no longer contraindicated in ventricular tachycardia unless intoxication with this drug is suspected.

NaEDTA has proved effective in digitalis-induced ventricular tachycardia.     

Drug Evaluation in Rheumatoid Arthritis

Pulmonary thromboembolism is an extremely common cause of respiratory distress, unremitting heart failure, and sudden death in elderly persons.     

Retrieval of the recovery filter after arm perforation, fracture, and migration to the right ventricle

The authors report a case of inferior vena cava filter arm perforation, followed by fracture and migration to the right ventricle causing chest pain and nonsustained ventricular tachycardia. Review of abdominal computed tomographic (CT) scans show the two filter arms that fractured and migrated had perforated the vena cava 2 years previously. Microscopic evaluation of the retrieved filter and limbs revealed bending metal fatigue at the fracture sites. This case and review of the literature suggest a causal relation between Bard Recovery filter arm perforation and subsequent fracture and migration. Percutaneous retrieval of filters with arm fracture or arm migration is recommended.     

Pulmonary embolism following operative treatment of ankle fractures: a report of three cases and review of the literature

The risks of thromboembolism following operative treatment of ankle fractures are deep vein thrombosis (DVT) and pulmonary embolism (PE). These are potentially life-threatening complications. Many orthopedic surgeons fail to appreciate the potential complications of thromboembolic events because of their rare and delayed occurrence in foot and ankle operations. The purpose of this report is to describe the potential for DVT and PE following ankle operations. We present three cases in which patients who underwent operative treatment of ankle fractures subsequently developed PE. We also review the literature on the prevalence of thrombosis, risk factors, methods of prophylaxis, and use of prophylaxis in surgical procedures of the lower extremity.