She Has The Blues: An Unusual Case of Copper Sulphate Intoxication

Background: Copper is an essential trace element of the human body. However, it is related to many diseases. Copper intoxication is not common in Western countries, but needs to be rapidly recognised because of its high lethality. Case presentation: We report the case of a 40-year-old woman who presented to the emergency department after performing intrarectal administration of a blue powder sent from Cameroon by her family, in the belief that this would help her to get pregnant. Her evolution was complicated by multiorgan failure and the unusual circumstances. The diagnosis was suspected on the basis of the clinical presentation and the colour of the powder, and confirmed by blood dosage and toxicological analysis of the powder. She underwent symptomatic treatment, and the outcome was progressively favourable, apart from persistent chronic renal failure with dependence on dialysis. Conclusion: Copper intoxications are rare but severe. Laboratory diagnosis of the condition is not an issue; the difficulty is suspecting it and quickly initiating chelation treatment associated with symptomatic treatments.

Use of ozone therapy in chronic laminitis in a horse.

A ten year-old mare, 320 kg, was referred with signs of lameness and reluctance to ambulate. On clinical examination, animal showed signs of shifting weight lameness on the forelimbs, presence of palpable supracoronary depressions and severe signs of pain with hoof test pressure over the sole on right forelimb. Digital pulses and temperature of the hoof were thought to be within normal limits. On inspection it was possible to observe a short extension of the toe and solar prolapse with hoof capsule distortion. Radiologic measurements showed displacement of the distal phalanx (30o). The animal was diagnosed with Obel grade IV chronic laminitis on the right foot. Therapeutic protocol established included exclusively corrective trimming and intramuscular, peritendinous and intrarectal administration of oxygen/ozone therapy as anti-inflammatory therapy. Oxygen/ozone therapy sessions were performed twice a week, for a total of 20 sessions. Six months after original presentation, the mare demonstrated clinical improvement with an improved body condition and better ambulation. Radiologic evaluation showed a normal relationship between the dorsal hoof wall and the distal phalanx.

Pharmacokinetics of Tenofovir following Intravaginal and Intrarectal Administration of Tenofovir Gel to Rhesus Macaques

ABSTRACTTenofovir gel (1%) is being developed as a microbicide for the prevention of human immunodeficiency virus (HIV) infection and has been shown to reduce transmission to women by 39%. The gel also prevents infection in macaques when applied intravaginally or intrarectally prior to challenge with simian-human immunodeficiency virus (SHIV), but very little pharmacokinetic information for macaques is available to help extrapolate the data to humans and thus inform future development activities. We have determined the pharmacokinetics of tenofovir in macaques following intravaginal and intrarectal administration of 0.2, 1, and 5% gels. Plasma and vaginal and rectal fluid samples were collected up to 24 h after dosing, and at 24 h postdosing biopsy specimens were taken from the vaginal wall, cervix, and rectum. Following vaginal and rectal administration, tenofovir rapidly distributed to the matrices distal to the site of administration. In all matrices, exposure increased with increasing dose, and with the 1% and 5% formulations, concentrations remained detectable in most animals 24 h after dosing. At all doses, concentrations at the dosing site were typically 1 to 2 log units higher than those in the opposite compartment and 4 to 5 log units higher than those in plasma. Exposure in vaginal fluid after vaginal dosing was 58 to 82% lower than that in rectal fluid after rectal dosing, but plasma exposure was 1- to 2-fold greater after vaginal dosing than after rectal dosing. These data suggest that a tenofovir-based microbicide may have the potential to protect when exposure is via vaginal or anal intercourse, regardless of whether the microbicide is applied vaginally or rectally.