Evaluation of the local irritation potential of hypertonic saline-dextran (HSD) in mice and rabbits

Topical tranexamic acid inhibits fibrinolysis more effectively when formulated with self-propelling particles

BACKGROUND

Endogenous fibrinolytic activation contributes to coagulopathy and mortality after trauma. Administering tranexamic acid (TXA), an antifibrinolytic agent, is one strategy to reduce bleeding; however, it must be given soon after injury to be effective and minimize adverse effects. Administering TXA topically to a wound site would decrease the time to treatment and could enable both local and systemic delivery if a suitable formulation existed to deliver the drug deep into wounds adequately.

OBJECTIVES

To determine whether self-propelling particles could increase the efficacy of TXA.

METHODS

Using previously developed self-propelling particles, which consist of calcium carbonate and generate CO2 gas, TXA was formulated to disperse in blood and wounds. The antifibrinolytic properties were assessed in vitro and in a murine tail bleeding assay. Self-propelled TXA was also tested in a swine model of junctional hemorrhage consisting of femoral arteriotomy without compression.

RESULTS

Self-propelled TXA was more effective than non-propelled formulations in stabilizing clots from lysis in vitro and reducing blood loss in mice. It was well tolerated when administered subcutaneously in mice up to 300 to 1000 mg/kg. When it was incorporated in gauze, four of six pigs treated after a femoral arteriotomy and without compression survived, and systemic concentrations of TXA reached approximately 6 mg/L within the first hour.

CONCLUSIONS

A formulation of TXA that disperses the drug in blood and wounds was effective in several models. It may have several advantages, including supporting local clot stabilization, reducing blood loss from wounds, and providing systemic delivery of TXA. This approach could both improve and simplify prehospital trauma care for penetrating injury.

An online survey of small animal veterinarians regarding current fluid therapy practices in dogs and cats

OBJECTIVE To determine common fluid therapy practices of small animal practitioners and identify fluid therapy-related knowledge gaps that may benefit from improved educational efforts, targeted research, or both. DESIGN Online survey. SAMPLE 1,496 small animal veterinarians PROCEDURES An online survey was provided to members of the Veterinary Information Network between December 23, 2013, and January 30, 2014. The survey consisted of 24 questions investigating the administration of crystalloid and synthetic colloid solutions, but not blood products, and focused primarily on the choice of fluid type, frequency of administration, type of patient treated with fluids, treatment with fluids subcutaneously versus IV, and potassium supplementation of fluids. Only responses from practicing small animal veterinarians were included. Not all respondents answered every question, and some questions allowed > 1 answer. RESULTS Balanced crystalloid solutions were the most common fluid type in all clinical scenarios described. The most common maintenance IV fluid rate reported by respondents (762/1,333 [57%]) was 60 mL/kg/d (27 mL/lb/d); calculation of fluid administration rate by means of body surface area was infrequent. Challenges of fluid therapy included determining the appropriate rate (572/1,496 [38%]) and fluid type (497/1,496 [33%]) and determining the need for potassium supplementation (229/1,496 [15%]). CONCLUSIONS AND CLINICAL RELEVANCE Small animal veterinarians tended to favor isotonic balanced crystalloid solutions for IV fluid therapy, compared with other common choices such as isotonic saline (0.9% NaCl) solution. Despite its ubiquity, respondents found many aspects of fluid therapy to be challenging, suggesting the need for easy to use, evidence-based guidelines.

Exercise-Associated Hyponatremia: 2017 Update

Exercise-associated hyponatremia (EAH) was initially described in the 1980s in endurance athletes, and work done since then has conclusively identified that overdrinking beyond thirst and non-osmotic arginine vasopressin release are the most common etiologic factors. In recent years, EAH has been described in a broader variety of athletic events and also has been linked to the development of rhabdomyolysis. The potential role of volume and sodium depletion in a subset of athletes has also been described. This review focuses on the most recent literature in the field of EAH and summarizes key new findings in the epidemiology, pathophysiology, treatment, and prevention of this condition.

Development of a folate-modified curcumin loaded micelle delivery system for cancer targeting

Targeted drug delivery system for tumor cells is an appealing platform on enhancing the therapeutic effects and reducing the side effects of the drug. In this study, we developed folate-modified curcumin (Cur) loaded micelles (Cur-FPPs) for cancer chemotherapy. The targeting material, Folate-PEG3000-PLA2000, was synthesized by the amide bond formation reaction. And the Cur loaded micelles were prepared by thin-film hydration method with mPEG2000-PLA2000 (Cur-PPs) or mPEG2000-PLA2000 and Folate-PEG3000-PLA2000 (Cur-FPPs) as carrier. A central composite design (CCD) was used to optimize the formulation, and the optimized Cur-FPPs was prepared with the weight ratio of Folate-PEG3000-PLA2000 and mPEG2000-PLA2000 at 1:9. The average size of the mixed micelles was 70nm, the encapsulating efficiency and drug-loading were 80.73±0.16% and 4.84±0.01%, respectively. Compared with the Cur propylene glycol solution, the in vitro release of Cur from Cur-FPPs showed a sustained manner. Furthermore, the in vitro cytotoxicity and cellular uptake of Cur-FPPs were significantly enhanced towards MCF-7 and HepG2 cells. The pharmacokinetic studies in rats indicated that a 3-fold increase in the half-life was achieved for Cur loaded micelle formulations relative to solubilized Cur. All the results demonstrated that folate-modified Cur micelles could serve as a potential nanocarrier to improve the solubility and anti-cancer activity of Cur.