Varicella-zoster virus je příčinou neštovic, primární infekce, a poté následuje po různě dlouhém období latence v senzorickém gangliu reaktivace viru za vzniku projevů herpes zoster. Článek se zabývá epidemiologií, patofyziologií, diagnostikou, léčbou a prevencí herpes zoster. Běžnou komplikací herpes zoster je vznik postherpetické neuralgie. Léčba herpes zoster se zaměřuje na podání virostatik a analgetik. Postherpetická neuralgie může být léčena lokálně nebo systémově podanými léčivy. Lokálně podaný lidokain a kapsaicin jsou účinné. Pro pacienty s intenzivnější bolestí se doporučuje systémově podat antikonvulziva gabapentin a pregabalin, tricyklická antidepresiva amitriptylin a nortriptylin a opioidní analgetika.

Varicella zoster virus is the causative agent of varicella as a primary infection, and, following a variable period of ganglionic latency in neurones, it reactivates to cause herpes zoster. This article summarizes the epidemiology, pathophysiology, diagnosis, management, and prevention of herpes zoster. A common complication of herpes zoster is postherpetic neuralgia.Treatment of herpes zoster focuses on antiviral therapy and analgesics. Postherpetic neuralgia can be treated with either topical or systemic agents. Topical lidocaine and capsaicin are effective. For patients with more severe pain, the following systemic agents can be considered: the anticonvulsants gabapentin and pregabalin, the tricyclic antidepressants amitriptyline, nortriptyline, and the opioid analgesics.

• MeSH
• acyklovir aplikace a dávkování   MeSH
• herpes zoster farmakoterapie   komplikace   prevence a kontrola   MeSH
• infekce virem varicella zoster * diagnóza   patologie   terapie   MeSH
• lidé MeSH
• management bolesti metody   MeSH
• plané neštovice farmakoterapie   komplikace   prevence a kontrola   MeSH
• postherpetická neuralgie terapie   MeSH
• virus varicella zoster MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

Volatile solvents are excellent extraction media for liquid-liquid extractions. However, their use in supported liquid membranes (SLMs) is limited by their evaporation from SLM and thus poor SLM stability and they have never been considered truly useful for electromembrane extraction (EME). In this contribution, volatile solvents were systematically investigated as liquid membranes for EME and their extraction characteristics were comprehensively examined for the first time. A short plug of a water immiscible volatile solvent (a free liquid membrane (FLM)) was sandwiched between two aqueous plugs (donor and acceptor solutions) in a narrow-bore polymeric tubing. Evaporation of the volatile FLM was thus completely avoided and excellent stability of the phase interface was ensured. Suitability of volatile FLMs for EMEs was justified by μ-EMEs of nortriptyline, haloperidol, loperamide and papaverine as model non-polar basic drugs. Extraction performance of μ-EME through ethyl acetate was comparable or better to that through standard non-volatile EME solvents and a high extraction selectivity was achieved for nortriptyline and haloperidol extracted through chloroform. μ-EMEs through the volatile FLMs were characterized by high extraction recoveries (62%-99% for standards and 40-89% for body fluids), low electric currents (10-1380 nA), no susceptibility to matrix ions and suitability for pretreatment of raw body fluids (human urine and serum). Resulting extracts were analysed by capillary electrophoresis with ultraviolet detection (CE/UV). Repeatability of the μ-EME-CE/UV method was excellent with intra-day and inter-day RSD values 0.8-3.2% and 1.8-4.6%, respectively. Further experiments demonstrated additional advantages of volatile FLMs by nearly exhaustive μ-EMEs of atenolol as the polar basic drug with no need for FLM modification by ionic carriers. The presented comprehensive examination of volatile solvents has broadened the range of liquid membranes suitable for EME and it is believed that this proof-of-concept study will stimulate further interest in a deeper investigation of volatile phase interfaces in EME.

• MeSH
• elektřina MeSH
• elektroforéza kapilární MeSH
• léčivé přípravky * MeSH
• lidé MeSH
• membrány umělé * MeSH
• rozpouštědla MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

In the present work, a disposable microextraction device with a polyamide 6 nano-fibrous supported liquid membrane (SLM) is employed for the pretreatment of minute volumes of biological fluids. The device is placed in a sample vial for an at-line coupling to a commercial capillary electrophoresis instrument with UV-Vis detection (CE-UV) and injections are performed fully automatically from the free acceptor solution above the SLM with no contact between the capillary and the membrane. Up to 4-fold enrichment of model basic (nortriptyline, haloperidol, loperamide, and papaverine) and acidic (ibuprofen, naproxen, ketoprofen, and diclofenac) drugs is achieved by optimizing the ratio of the donor to the acceptor solution volumes (16 to 4 μL, respectively). The actual setup enables SLM extractions from less than a drop of sample and is suitable for pretreatment of scarce human body fluids. Two unique methods are reported for efficient clean-up and enrichment of the basic and acidic drugs from capillary blood (formed as dried blood spot), serum, and urine samples, which enable their determination at therapeutic and/or toxic levels. The hyphenation of the SLM extraction with CE-UV analysis provides good repeatability (RSD, 2.4-14.9%), linearity (r2, 0.988-1.000), sensitivity (LOD, 0.017-0.22 mg L-1), and extraction recovery (ER, 20-106%) at short extraction times (10 min) and with minimum consumption of samples and reagents. Graphical abstract.

• MeSH
• elektroforéza kapilární metody   MeSH
• koncentrace vodíkových iontů * MeSH
• léčivé přípravky metabolismus   MeSH
• lidé MeSH
• membrány umělé * MeSH
• mikroextrakce kapalné fáze metody   MeSH
• nanovlákna * MeSH
• reprodukovatelnost výsledků MeSH
• tělesné tekutiny chemie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

A two-phase micro-electromembrane extraction (μ-EME) using a floating drop of an organic solvent was presented for rapid and efficient pretreatment of complex biological samples. The μ-EME system consisted of a glass vial containing aqueous sample (donor solution) and a small drop of a water-immiscible organic solvent (4-nitrocumene), which was floating on the surface of the aqueous solution in form of a free liquid membrane (FLM). The vial geometry and the optimized volume ratios of the donor and the FLM ensured a stable position of the FLM in the center of the vial during μ-EME, and one electrode of a d.c. power supply was inserted directly into the FLM while the other electrode was placed into the aqueous sample. The active surface area of the floating drop FLM contacting the sample was considerably larger in comparison to formerly reported μ-EME formats employing FLMs and resulted in a faster and a more efficient transfer of target analytes from the sample to the FLM. Four basic drugs (nortriptyline, papaverine, loperamide, and haloperidol) were selected as model analytes and were extracted from physiological solution, human urine, and dried blood spot samples. At the optimized μ-EME conditions (250 V, 15 min, 300 rpm, acidic donor) and the optimized ratio of the sample to the FLM volume (500:14 μL), extraction recoveries between 49 and 100% and enrichment factors up to 35.7 were achieved. Quantitative analyses of the basic drugs in the resulting FLMs (diluted with methanol) were performed by capillary electrophoresis with ultraviolet detection and demonstrated excellent repeatability (RSD ≤ 4.9%) and linearity (r2 ≥ 0.9997), and low limits of detection (5-28 ng/mL) of the method.

• Publikační typ
• časopisecké články MeSH

• MeSH
• chemické látky - účinky a užití MeSH
• otrava MeSH
• patologie MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• patologie

OBJECTIVE: Genetic and environmental factors interact in the development of major depressive disorder (MDD). While neurobiological correlates have only partially been elucidated, altered levels of calcitonin gene-related peptide (CGRP)-like immunoreactivity (LI) in animal models and in the cerebrospinal fluid of depressed patients were reported, suggesting that CGRP may be involved in the pathophysiology and/or be a trait marker of MDD. However, changes in CGRP brain levels resulting from interactions between genetic and environmental risk factors and the response to antidepressant treatment have not been explored. METHODS: We therefore superimposed maternal separation (MS) onto a genetic rat model (Flinders-sensitive and -resistant lines, FSL/FRL) of depression, treated these rats with antidepressants (escitalopram and nortriptyline) and measured CGRP-LI in selected brain regions. RESULTS: CGRP was elevated in the frontal cortex, hippocampus and amygdala (but not in the hypothalamus) of FSL rats. However, MS did not significantly alter levels of this peptide. Likewise, there were no significant interactions between the genetic and environmental factors. Most importantly, neither escitalopram nor nortriptyline significantly altered brain CGRP levels. CONCLUSION: Our data demonstrate that increased brain levels of CGRP are present in a well-established rat model of depression. Given that antidepressants have virtually no effect on the brain level of this peptide, our study indicates that further research is needed to evaluate the functional role of CGRP in the FSL model for depression.

• MeSH
• amygdala účinky léků   metabolismus   MeSH
• antidepresiva farmakologie   MeSH
• čelní lalok účinky léků   metabolismus   MeSH
• citalopram farmakologie   MeSH
• deprese * farmakoterapie   etiologie   metabolismus   MeSH
• hipokampus účinky léků   metabolismus   MeSH
• interakce genů a prostředí * MeSH
• krysa rodu rattus MeSH
• maternální deprivace * MeSH
• modely nemocí na zvířatech MeSH
• mozek * účinky léků   metabolismus   MeSH
• nortriptylin farmakologie   MeSH
• peptid spojený s genem pro kalcitonin * účinky léků   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Psychosociální změny u matky a otce po narození dítěte, spojené s adaptací na novou rodičovskou roli, jsou rizikovým faktorem pro exacerbaci či nový vznik duševních onemocnění. Raná vztahová vazba rodič‑dítě je důležitá pro nenarušený neurobehaviorální vývoj dítěte. Důležitou roli v těchto procesech hraje kojení. Přítomnost dekompenzovaného duševního onemocnění u rodiče proces budování citové vazby narušuje. Proto je zásadní včasná a účinná terapeutická intervence. Při léčbě matky vybíráme farmakum s ohledem na jeho bezpečnostní profil v laktaci tak, aby terapie nemusela být přerušena. Údaje o bezpečnosti psychofarmak pocházejí z malých observačních studií či jejich meta‑analýz. U většiny léků není jejich bezpečnostní profil znám a jen jej odhadujeme. Aktuální doporučení uvádějí jako relativně bezpečná antidepresiva v laktaci sertralin, paroxetin a nortiptylin; jejich užívání je slučitelné s kojením. Zdá se, že benzodiazepiny a Z‑hypnotika přecházejí do mateřského mléka minimálně a jako nejbezpečnější se jeví oxazepam, alprazolam a zolpidem. Metylfenidát užívaný v terapii ADHD je rovněž považován za slučitelný s kojením.

Transition to parenthood is accompanied by psychosocial changes in both new mother and father. There is a higher risk of exacerbation or new onset of mental disorders in this period. Early attachment and healthy parent-child bond are determinants of infant´s undisturbed neurobehavioral development. Breastfeeding plays an important role in this process. The presence of untreated mental disorder affects early parent-child relationship in a negative way. Therefore, early and effective treatment intervention is essential. Psychotropic drugs with safe profile during lactation should be chosen, so the mother should be able to breastfeed her infant. Data on safety profile of psychotropic drugs are based on small observational studies or meta-analyses. This information is not available for most of the psychotropic drugs, thus, their safety profiles are just estimated. Sertraline, paroxetine and nortriptyline are listed in the current guidelines as relatively safe antidepressants in lactation. Published data suggests that benzodiazepines and Z-hypnotics pass into maternal milk minimally and oxazepam, alprazolam, and zolpidem have the safest profile in lactation. Methylphenidate, used for treatment of ADHD, also appears to be compatible with breastfeeding.

• MeSH
• duševní poruchy terapie   MeSH
• hyperkinetická porucha terapie   MeSH
• kojení psychologie   MeSH
• laktace psychologie   MeSH
• lidé MeSH
• poporodní období * psychologie   účinky léků   MeSH
• psychotropní léky aplikace a dávkování   terapeutické užití   MeSH
• Check Tag
• lidé MeSH

The effect of membrane thickness on extraction performance was systematically examined in extractions through supported liquid membranes (SLM), which were in-line coupled to capillary electrophoresis (CE). Three porous polypropylene membranes with different thickness (25, 100 and 170 μm) were used as supports for SLM extractions of model basic drugs (nortriptyline, papaverine, haloperidol and loperamide) from complex samples. The analytes were transferred through the SLMs by a pH gradient and were in-line injected, separated and quantified using a commercial CE instrument with ultraviolet (UV) detection. Transfers of the model drugs through SLM decreased with the increased membrane thickness (in the order: 25 > 100 > 170 μm) and highest transfers were achieved for the thinnest membrane. Interferences from complex sample matrices were efficiently eliminated, moreover, impregnation of the 25 μm membrane required significantly reduced volume of organic solvent. Mechanical stability of the impregnated 25 μm membrane was excellent during in-line injections, which necessitated direct contact of CE separation capillary with the SLM. Repeatability of the hyphenated SLM-CE-UV method (using the 25 μm membrane) was lower than 11% (RSD values of peak areas) and calibration curves were strictly linear in 0.5-30 μg/mL concentration range (coefficients of determination ≥ 0.997). Transfers of the basic drugs from donor solutions (standard and undiluted human urine/plasma) through the SLMs ranged from 45 to 231% and limits of detection were between 0.02 and 0.15 μg/mL.

• MeSH
• analýza moči přístrojové vybavení   metody   MeSH
• biochemická analýza krve přístrojové vybavení   metody   MeSH
• elektroforéza kapilární * MeSH
• lidé MeSH
• membrány umělé * MeSH
• rozpouštědla chemie   MeSH
• tělesné tekutiny chemie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Planar polyamide 6 nanofibrous membrane was for the first time used in direct coupling of supported liquid membrane (SLM) extraction to CE analysis. Disposable microextraction device with the nanofibrous membrane was preassembled and stored for immediate use. The membrane in the device was impregnated with 1 µL of 1-ethyl-2-nitrobenzene and the device was subsequently filled with 10 µL of acceptor solution (10 mM HCl) and 15 µL of donor solution (sample). The device was in-line coupled to CE system for selective extraction and direct injection, separation and quantification of model basic drugs (nortriptyline, haloperidol, loperamide and papaverine) from standard saline solutions (150 mM NaCl) and from undiluted human body fluids (urine and blood plasma). Compared to standard polypropylene supporting material, the nanofibrous membrane demonstrated superior characteristics in terms of lower consumption of organic solvents, constant volumes of operational solutions, full transparency and possibility to preassemble the devices. Extraction parameters were better or comparable for the nanofibrous vs. the polypropylene membrane and the hyphenated SLM-CE method with the nanofibrous membrane was characterized by good repeatability (RSD ≤ 11.3%), linearity (r2 ≥ 0.9953; 0.5-20 mg/L), sensitivity (LOD ≤ 0.4 mg/L) and transfer (27-126%) of the basic drugs.

• MeSH
• chemické modely MeSH
• design vybavení MeSH
• elektroforéza kapilární přístrojové vybavení   metody   MeSH
• léčivé přípravky krev   izolace a purifikace   moč   MeSH
• lidé MeSH
• lineární modely MeSH
• membrány umělé * MeSH
• nanovlákna chemie   MeSH
• reprodukovatelnost výsledků MeSH
• senzitivita a specificita MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Simultaneous extraction of basic and acidic drugs across thin supported liquid membrane (SLM) and direct injection of the extracted drugs from SLM surface into capillary electrophoresis (CE) were demonstrated. A microextraction device compatible with injection system of commercial CE instrument was filled with 20μL of sample and 10μL of acceptor solution, which were interspaced by the SLM impregnated with 5μL of organic solvent. Extractions of three basic drugs (nortriptyline, haloperidol and loperamide) and two acidic drugs (ketoprofen and naproxen) were achieved at optimized conditions including 1-ethyl-2-nitrobenzene as SLM solvent, natural pH of sample solution, 2.5mM NaOH acceptor solution and 30min extraction time. The extracted drugs were directly injected into CE for separation and quantification in a background electrolyte solution consisting of 30mM ammonium acetate adjusted to pH 4.2 with acetic acid. The entire analytical procedure including drugs extraction, injection, separation and quantification was automated in the CE instrument and the only manual procedures were SLM impregnation and filling the microextraction device with sample and acceptor solutions. The analytical method was suitable for simultaneous determination of basic and acidic drugs in undiluted human urine samples and was used for direct determination of naproxen in urine after oral administration of Nalgesin S tablet. Efficient elimination of sample matrix and selective transfer of basic and acidic drugs were achieved and the hyphenated SLM-CE method was characterized by repeatability of peak areas ranging from 3.7 to 13.4%, linear relationship between peak areas and concentrations (r2=0.994-0.999) and limits of detection between 0.05 and 1.5μg/mL.

• MeSH
• analýza moči metody   MeSH
• elektroforéza kapilární * MeSH
• léčivé přípravky moč   MeSH
• lidé MeSH
• limita detekce MeSH
• naproxen moč   MeSH
• nitrobenzeny chemie   MeSH
• reprodukovatelnost výsledků MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH