Formulation issues associated with transdermal fentanyl delivery

Supersaturation has previously been studied as a mechanism to enhance membrane transport of fentanyl from propylene glycol:water formulations (PG:H(2)O) across silicone. In this study these supersaturated fentanyl formulations were evaluated in human skin. A number of polymers were also screened for their ability to stabilise the supersaturated formulations and permeation was evaluated for both infinite and finite doses. For infinite dose studies, permeation in skin increased linearly with increasing degree of drug saturation (DS) for formulations containing 0.5, 1, 2 DS of fentanyl and a 3 DS formulation stabilised with 1% (w/v) hydroxypropylcellulose (HPC). An excellent correlation was obtained for flux values in silicone compared with flux values in skin, for infinite dose studies for formulations containing 0.5, 1, 2 DS of fentanyl and the 3 DS formulation stabilised HPC. The concentration of the fentanyl in the stratum corneum also increased in proportion to the DS. However the same trend was not observed for finite dose studies. This is because the depletion of the solvent carrier promotes drug crystallisation with consequent implications for membrane transport. Tape-stripping experiments indicated that supersaturation of the drug is maintained in the outer layers of the stratum corneum. The ideal vehicle must, therefore, maintain the drug in solution on and in the skin in a sustained manner for effective transdermal delivery.

[Coccidioidomycosis in Argentina, 1892-2009]

Clinical cases of coccidioidomycosis are rare in Argentina and are generally found in the large arid precordilleran area of the country. This study aims to perform a retrospective review of all coccidioidomycosis cases documented in the country from 1892 to 2009, and to describe those occurring in the last 4 years. One hundred and twenty eight cases were documented in the 117 year-period. Since the original description of the disease in 1892 until 1939, only 6 cases were registered; between 1940 and 1999, 59 (6-14/10 yrs) and the remaining 63 (49% of total cases) occurred in the last decade. The median age of 34 patients registered in 2006-2009 was 31 years (range: 7-89), male/female ratio was 1.3:1 and 12 patients were immunocompromised. Twenty-six cases were confirmed by direct microscopy and/or culture whereas the remaining ones by serology. All isolates were identified as Coccidioides posadasii. Thirty patients lived in a vast geographic region with epicenter in Catamarca Valley. Between 2006 and 2009, annual disease incidence rates in Catamarca Province increased from historical values below 0.5/100,000 to 2/100,000 inhabitants. Such increase suggests an emergency of coccidioidomycosis in that region.

Comparison of functional fitness in elderlies with reference values by Rikli and Jones and after one-year of health intervention programs

AIM

The purpose of this study was to characterize levels of physical fitness and compare our results with normative standards by Rikli and Jones to determine functional status of institutionalized elders. The effects of different intervention programs on physical fitness were also described.

METHODS

A total of 148 institutionalized elders completed one-year health-promotion intervention programs: aerobic training (AT), strength training (ST), health education program and control. Habitual physical activity (MTI Actigraph), physical fitness (Senior Fitness Test), health related quality of life (MOS SF-36), and body composition (BMI) were assessed.

RESULTS

Institutionalized elders performance has significantly deteriorated on functional fitness. Nevertheless, higher results than reference values were obtained on both body strength tests and aerobic endurance, specifically in men. Data of one-year intervention demonstrated that ST induced significant changes in body strength and flexibility test and the AT in lower body strength, aerobic endurance and agility/dynamic balance. The final multilevel model shows that AT Program compared with CG, education level, time of institutionalization and HRQoL were predictors for physical fitness score.

CONCLUSION

These results suggest that participation in regular exercise programs (both aerobic and strength training) elicits a number of favorable responses that contribute to healthy aging and could play a role in prevention or reducing functional decline in elders.

Enhanced permeation of fentanyl from supersaturated solutions in a model membrane

The aim of the present study was to investigate the permeation of fentanyl from supersaturated formulations when applied to silicone membrane. Silicone was chosen in order to separate the effects of supersaturation from other possible influences of volatile formulation components on biological membranes. Supersaturated formulations containing either propylene glycol/water (PG/H(2)O) or propylene glycol/ethanol (PG/Et) were prepared containing varying degrees of saturation (DS) of fentanyl. Permeation of finite and infinite doses of the PG/H(2)O formulations, and finite doses of the PG/Et formulations was investigated using Franz-type diffusion cells. For the PG/H(2)O formulations a good correlation between the flux and the DS of the formulation up to 5 DS for infinite dose studies (r(2)=0.99), and up to 7 DS for finite dose studies (r(2)=0.98), was evident. Similarly, for the PG/Et formulations there is a good correlation between the mean flux and the theoretical DS of the formulation (r(2)=0.95). Except for the 2 DS formulations, no significant differences were seen in the mean flux between PG/H(2)O and PG/Et finite dose studies. The larger fluxes observed for infinite doses of the PG/H(2)O formulations versus finite doses reflect changes in the effective area of diffusion over the time of the experiment for the latter set of experiments. The permeation enhancement observed for PG/Et formulations confirms that enhanced drug thermodynamic activity was induced by ethanol evaporation.

Seabed geoacoustic characterization with a vector sensor array

This paper proposes a vector sensor measurement model and the related Bartlett estimator based on particle velocity measurements for generic parameter estimation, illustrating the advantages of the Vector Sensor Array (VSA). A reliable estimate of the seabed properties such as sediment compressional speed, density and compressional attenuation based on matched-field inversion (MFI) techniques can be achieved using a small aperture VSA. It is shown that VSAs improve the resolution of seabed parameter estimation when compared with pressure sensor arrays with the same number of sensors. The data considered herein was acquired by a four-element VSA in the 8-14 kHz band, during the Makai Experiment in 2005. The results obtained with the MFI technique are compared with those obtained with a method proposed by C. Harrison, which determines the bottom reflection loss as the ratio between the upward and downward beam responses. The results show a good agreement and are in line with the historical information for the area. The particle velocity information provided by the VSA increases significantly the resolution of seabed parameter estimation and in some cases reliable results are obtained using only the vertical component of the particle velocity.

Antifungal activity of posaconazole against Candida spp. and non-Candida clinical yeasts isolates

The in vitro antifungal activity of posaconazole was tested against 315 yeast clinical isolates and 11 ATCC reference strains by means an agar diffusion method (Neosensitabs, Rosco,Denmark) based in CLSI M44-A2 document. Posaconazole activity was excellent against Cryptococcus and Rhodotorula species studied and showed very good activity against most species of Candida tested. A total of 13 clinical isolates (4.1%) were resistant: Candida albicans (n=5), Candida glabrata (n=5), Candida tropicalis (n=1), Geotrichum australiensis (n=1) and Geotrichum capitatum (n=1). Our results suggest posaconazole is an effective antifungal agent against the most clinically important yeasts species (92.7% of susceptibility). Agar diffusion method provides good conditions for the posaconazole susceptibility study in the routine laboratory.

Assessment of the relationship between the upper and lower arch changes with the opening of the expanding screw after the rapid maxillary expansion

OBJECTIVE

The purpose of this study is to assess the relationship of the upper and lower arch dimension changes after the rapid maxillary expansion (RME) with the screw opening of the modified Hyrax® type appliance.

MATERIALS AND METHODS

Initial (T1) and final (T2) models of study of 63 children between 7 years and 6 months and 16 years and 5 months were performed. From these, 21 showed maxillary atresia and/ or posterior crossbite and were submitted to expansion and 42 children formed the control group .The appliance used in this work was the modified Hyrax appliance using the 7mm expanding screws "Dentarum". The measures of the upper intercanine and the upper and lower intermolar distances were performed in plaster models with the help of a digital paquimeter. The opening of the appliance's screw was also assessed.

RESULTS

The RME provoked a statistically significant increase in the upper interdental distances and no statistic significance in the lower interdental distances, i.e. the change in the 16 - 26, 13 - 23 and 36 - 46 distance was of 5,85 mm, 5,31 and 0,34 mm respectively. The average opening of the expander screw, which was of 6,27 mm.

CONCLUSION

The appliance's opening is related to the interdental distance changes, i.e. for each appliance's opening mm, a 0,94 variation in the upper intermolar distance, a 0,87 in the upper intercanine distance and 0,054 in the lower intermolar distance are provoked.

Effect of interactions on vortices in a nonequilibrium polariton condensate

We demonstrate the creation of vortices in a macroscopically occupied polariton state formed in a semiconductor microcavity. A weak external laser beam carrying orbital angular momentum (OAM) is used to imprint a vortex on the condensate arising from the polariton optical parametric oscillator (OPO). The vortex core radius is found to decrease with increasing pump power, and is determined by polariton-polariton interactions. As a result of OAM conservation in the parametric scattering process, the excitation consists of a vortex in the signal and a corresponding antivortex in the idler of the OPO. The experimental results are in good agreement with a theoretical model of a vortex in the polariton OPO.

Report from the killer immunoglobulin-like receptor (KIR) anthropology component of the 15th International Histocompatibility Workshop: worldwide variation in the KIR loci and further evidence for the co-evolution of KIR and HLA

The killer immunoglobulin-like receptor (KIR) anthropology component of the 15th International Histocompatibility Workshop (IHIWS) sought to explore worldwide population variation in the KIR loci, and to examine the relationship between KIR genes and their human leukocyte antigen (HLA) ligands. Fifteen laboratories submitted KIR genotype and HLA ligand data in 27 populations from six broad ethnic groups. Data were analyzed for correlations between the frequencies of KIR and their known HLA ligands. In addition, allelic typing was performed for KIR2DL2 and 3DL1 in a subset of populations. Strong and significant correlations were observed between KIR2DL2, 2DL3 genotype frequencies and the frequency of their ligand, HLA-C1. In contrast, only weak associations were seen for 3DL1, 3DS1 and the HLA-Bw4 ligand. Although some aspects of the correlations observed here differ from those reported in other populations, these data provide additional evidence of linked evolutionary histories for some KIR and HLA loci. Investigation of allele-level variation for the B haplotype locus KIR 2DL2 showed that two alleles, *001 and *003, predominate in all populations in this study. Much more allelic variation was observed for the A haplotype locus 3DL1, with several alleles observed at moderate frequencies and extensive variation observed between populations.

Expression patterns of HLA-DR+ or HLA-DR- on CD4+/CD25++/CD127low regulatory T cells in patients with allergy

BACKGROUND

Allergic rhinoconjunctivitis induced by pollen is a highly prevalent chronic inflammatory disease in Europe. Parietariajudaica is a frequent trigger in the Mediterranean area. The function of regulatory T cells (Treg cells) in allergy has recently been investigated, but further data are necessary to better understand their role and to find new strategies to treat allergic diseases such as allergic rhinoconjunctivitis.

OBJECTIVE

To characterize gene expression of HLA-DR+ or HLA-DR- on peripheral CD4+/CD25++/CD127low Treg cells in patients with allergy.

METHODS

Peripheral Treg cells (CD4+/CD25++/CD127low) were quantified using flow cytometry and sorted according to HLA-DR expression during the pollen season in patients with allergic rhinoconjunctivitis caused by P. judaica. The results were compared with those of nonatopic controls. Expression of associated cytokines and their receptors was measured using quantitative reverse transcription-polymerase chain reaction after extraction of mRNA in sorted populations.

RESULTS

During the pollen season, no significant differences were observed between allergic patients with rhinoconjunctivitis and healthy controls in terms of the absolute number or the percentage of Treg cells in peripheral blood. All patients had a higher number/percentage of HLA-DR- Treg cells than HLA-DR+ Treg cells. In both groups we found high levels of FOXP3 mRNA expression. Despite being lower in number, HLA-DR+ Treg cells presented higher expression of CD28, PRF1, GZMB, and FASL than HLA-DR-Treg cells.

CONCLUSIONS

The most relevant results obtained suggest that HLA-DR+ Treg cells tend to present higher gene expression of molecules associated with contact-dependent cell activation and cytotoxicity.

Perception of dental aesthetics in paediatric dentistry

AIM

Assessing the perception of the aesthetic components of the oral health by paediatric patients at different stages of the child psychological development of Piaget.

MATERIALS AND METHODS

Twenty children aged between 21 months and 11 years, of both sexes, patients of a private clinic, were selected. The present study group consisted of patients treated for oral pathologies. A set of similar supplies was given to all children and they were asked to do a drawing, whose theme was "beautiful teeth and ugly teeth". The drawings were evaluated according to the classification of the cognitive development of Piaget.

RESULTS

Children of all ages clearly represent their perception of what "beautiful teeth" and "ugly teeth" are. These representations provide the dental professional a clear vision of the child's feeling about dental aesthetics.

CONCLUSION

The drawings are a useful source of information for assessing the aesthetic perception of paediatric patients. The knowledge of the children's aesthetic perception is relevant to paediatric dentists because children are conscious about their dental aesthetic appearance and that of the other children.

Human bronchial epithelial cells malignantly transformed by hexavalent chromium exhibit an aneuploid phenotype but no microsatellite instability

Hexavalent chromium [Cr(VI)] is a well-recognized human lung carcinogen. In order to gain further insight into Cr(VI)-induced carcinogenesis, we have established an adequate in vitro cellular model for the study of this process. To this end, BEAS-2B cells were used. Chronic exposure of cells to 1 microM Cr(VI) induced changes in the cells' ploidy and a decrease in cloning efficiency, although cultures continued to progress to confluence. After prolonged exposure (12 passages), the culture became heterogeneous, exhibiting areas where apparently normal epithelial cells and morphologically altered cells coexisted. Subsequent culture at a very low density strongly accentuated the Cr(VI)-induced changes in morphology and pattern of growth. Three individual colonies were then ring-cloned and expanded into three subclonal aneuploid cell lines. These subclonal cell lines showed changes in growth pattern and morphology, as well as a karyotype drift concomitant with the overexpression of genes commonly involved in malignant transformation (c-MYC, EGFR, HIF-1alpha and LDH-A). Moreover, when one of these cell lines (RenG2) was injected into nude mice, it showed the ability to induce tumors. This cell line revealed no microsatellite instability (MSI), which points to the expression of a functional MLH1 protein and an active mismatch repair (MMR) system. Therefore, the progression to malignancy of the BEAS-2B cells involved Cr(VI)-induced transformants that retained the ability to repair DNA damage, suggesting that genotoxicity underlies the ongoing carcinogenic process.

Association between overweight and early sexual maturation in Portuguese boys and girls

OBJECTIVE

The purpose of this study was to examine the relationship between sexual maturation (SM), and the prevalence of overweight among boys and girls.

SUBJECTS AND METHODS

The sample of this cross-sectional study included 819 children and adolescents (382 boys and 437 girls), aged 10-15 years old randomly selected from 30 schools in the Porto region. Anthropometrical measurements (body height, weight and skinfolds thickness) were determined by standard anthropometrical methods. Body mass index (BMI) was calculated from the ratio weight/height(2) (kg/m(2)). The sum of tricipital and subscapular skinfolds (TriSub) was also used. Physicians collected data on Tanner stages during physical examination. Subjects were grouped using the quartiles of the decimal age adjusted for Tanner stages of SM and gender.

RESULTS

The prevalence of overweight was higher in early maturing boys (30.5%) and early maturing girls (32.7%). The late maturers presented a lower prevalence (p < 0.05) of overweight (20.3% boys and 18.3% girls). Logistic regression analysis illustrates that early maturing is associated with an increased risk for overweight or obesity for boys (OR: 1.87 and 95% CI: 0.99-3.50) and girls (OR: 2.14 and 95% CI: 1.12-4.07), when compared with the boys and girls of the fourth quartile (p < 0.05).

CONCLUSIONS

We conclude that there is an association between early SM and the prevalence of overweight in both genders.