By Q. Osko. University of Arkansas at Little Rock.

Cosmetic talc should be white order torsemide 20mg without prescription, free of asbestos discount torsemide 10 mg fast delivery, have high Decorative Products 291 spreadability or slip buy 10 mg torsemide, with low covering power. Micronized talc is generally lighter and fluffier but less smooth on the skin than regular grades. Although talc is fairly hydrophobic, treated talcs have been used to enhance its texture. Kaolin Kaolin or china clay is a naturally occurring, almost white, hydrated aluminum silicate. Kaolin has good absorbency, is dense, and is sometimes used to reduce bulk densities in loose powder products. It provides a matte surface effect that can reduce slight sheen left by some talc products. Calcium Carbonate Calcium carbonate or precipitated chalk has excellent absorption properties. Magnesium Carbonate Magnesium carbonate is available in a very light, fluffy grade that absorbs well and is often used to absorb perfume before mixing it into face powders. Metallic Soap Zinc and magnesium stearate are important materials for imparting adhesion to face powders, and usually incorporated at 3 to 10% of the formulation. Stearates add some water repellency to formulas while too high levels give a blotchy effect on the skin. Zinc stearate, besides imparting adhesions, gives a smoothing quality to face powders. Starch Starch in used in face powders to give a ‘‘peachlike’’ bloom and provides a smooth surface on the skin. It imparts a natural translucence when used up to 20% in formulations of face powder blushes. Sericite may be coated with silicone and other treatments for better water repellency and skin adhesion. Polymers Polymers are chiefly texture enhancers used at levels of 3 to 40% depending on whether they are to be included in a loose or pressed powder. Colorants Titanium dioxide and zinc oxide, both pigmentary and ultrafine, organics, inor- ganics, carmine and pearlescent pigments either predispersed or treated are found in all face powders because the textures of these colorants are not very satisfac- tory. Perfumes The use of perfumes is important for face powder, which requires them because most of the raw materials used are earthy smelling and should be masked. Decorative Products 293 Preservatives Preservation of face powders is usually not a problem since they are used dry, but small amounts of antibacterials are recommended. Powdered eye shadows should always contain antibacterials such as parabens, imidazolidinyl urea, and others. Loose Face Powders This type has declined in popularity in favor of pressed face powder products. The smoothness of loose face powder can be enhanced by use of the aforemen- tioned texture enhancers. In the manufacturing process, all ingredients except the pearls, if required, are combined in a stainless steel ribbon blender. Mixing time can be as long as 1 or 2 h, depending on the size of the batch and evenness of the color. Perfume, if required, is slowly sprayed into the batch, and blended until homogeneous. Color adjustments are made, if necessary, in the ribbon blender and the batch is repulverized. Pressed Face Powders Pressed face powders are more popular than loose powders because of their ease of application and portability. The basic raw materials are the same as loose powder except that a binder must be used to press the cake into a tin-plate godet. If water-based binders are used, aluminum godets should be considered to prevent corrosion. The properties of a binder are is follows: provides creaminess to the powder, aids in compression and adhesion, develops colorants, enhances water- resistance and pick-up and deposit. If the binder level is too high, it may be difficult to remove the powder with a puff.

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The most consistent association between cocaine use and fetal malfor- mations involves the genitourinary tract (Buehler et al buy torsemide 20 mg amex. These include ileal atresia in two infants (with bowel infarction in one) and genitouri- nary tract malformations in nine infants (Chasnoff et al 10 mg torsemide otc. No congenital abnormalities were observed in four studies of infants born to women who used cocaine during pregnancy (Cherukuri et al discount 10 mg torsemide mastercard. Among 114 infants born to women who used cocaine during pregnancy, the frequency of congenital anomalies (major or minor) was not increased after controlling for other substances of abuse used and maternal characteristics known to adversely affect pregnancy outcome (Zuckerman et al. The bulk of evidence supports the association between prenatal cocaine exposure and isolated major congenital anomalies. Mechanisms of embryonic and fetal effects appear to be vascular disruption, hypoperfusion, hemorrhage, and vascular occlusion, parallel- ing the known effects of cocaine on adults. Facial defects observed among 10 of 11 infants in a case series of infants exposed to cocaine during gestation included ble- pharophimosis, ptosis and facial diplegia, unilateral oro-orbital cleft, Pierre–Robin anomaly, cleft palate, cleft lip and palate, skin tags, and cutis aplasia (Kobori et al. All of the infants had major brain abnormalities, cavitations, holoproscen- cephaly, and porencephaly. One additional study reported unusual facies among cocaine-exposed infants similar to fetal alcohol syndrome, and speculated whether or not a cocaine syndrome may exist (Fries et al. We found no evidence of a syn- drome in a matched case–control study of 50 infants chronically exposed to cocaine pre- natally (Little et al. Fetal growth retardation was the only significant finding in that study, although it is clear that an increased risk of isolated congenital anomalies occurs during the first trimester, and outside the first trimester. Recently, investigators reassessed a possible cocaine syndrome and concluded that physical growth deficits were associated with prenatal cocaine exposure. However, they confirmed our earlier study that no systematic pattern of congenital anomalies (i. Perinatal distress and cerebrovascular accidents with prenatal cocaine exposure Perinatal complications (tachycardia, bradycardia, respiratory problems, jaundice, ele- vated bilirubin, etc. Thus, maternal cocaine use is associated with major neuropathology of the fetus and newborn. The mechanisms of brain injury may be vascular accidents or ischemia, or a combination of these effects. The association of cocaine abuse and cerebral palsy has not been established, but it is a plausible association that is likely causal. Neonatal hospital stay in days was significantly increased in infants born to women who used cocaine during pregnancy (Neerhof et al. This may be biased because precautionary actions were taken by physicians who were knowledgeable of prenatal drug exposure. Postnatal follow-up of infants whose mothers used cocaine during pregnancy The number of studies that reported long-term effects of prenatal cocaine exposure on child development is limited, but they have a common finding of growth and develop- ment delays and intellectual deficits (Box 16. Animal models of cocaine Animal models of the possible teratogenicity of cocaine have yielded inconsistent results. Summary of cocaine during pregnancy In summary, the epidemic use of cocaine during pregnancy has resulted in an alarming number of individuals with serious adverse outcomes in mothers, fetuses, and newborns. The use of cocaine is often compounded by frequent concomitant heavy use of other illicit drugs and alcohol. Women who use cocaine during pregnancy are at significant risk for no prenatal care, shorter gestations, premature rupture of membranes, prema- ture labor and delivery, spontaneous abortions, abruptio placentae, decreased uterine blood flow, and death. The fetuses of these women who use cocaine are growth-retarded or severely distressed, and have an increased mortality risk. Fetal and maternal cere- brovascular accidents, with attendant profound morbidity and mortality, occur in asso- ciation with maternal cocaine use during pregnancy. Major congenital anomalies involv- ing the brain, genitourinary tract, bowel, heart, limbs, and face occur with significantly increased frequency among infants whose mothers used cocaine during gestation. Use of hallucinogens during pregnancy 319 Hence, cocaine use during pregnancy is very probably teratogenic and fetotoxic. The mechanisms of cocaine’s adverse effects are vascular disruption and hypoperfusion for gross abnormalities, but molecular level mechanisms are yet to be determined.

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