Nanoparticulated Systems Based on Natural Polymers Loaded with Miconazole Nitrate and Lidocaine for the Treatment of Topical Candidiasis

People with weakened immune systems are at risk of developing candidiasis which is a fungal infection caused by several species of Candida genus. In this work, polymeric nanoparticles containing miconazole nitrate and the anesthetic lidocaine clorhydrate were developed. Miconazole was chosen as a typical drug to treat buccopharyngeal candidiasis whereas lidocaine may be useful in the management of the pain burning, and pruritus caused by the infection. Nanoparticles were synthesized using chitosan and gelatin at different ratios ranging from 10:90 to 90:10. The nano-systems presented nanometric size (between 80 and 300 nm in water; with polydispersion index ranging from 0.120 to 0.596), and positive Z potential (between 20.11 and 37.12 mV). The determined encapsulation efficiency ranges from 65 to 99% or 34 to 91% for miconazole nitrate and lidocaine clorhydrate, respectively. X-ray diffraction and DSC analysis suggested that both drugs were in amorphous state in the nanoparticles. Finally, the systems fitted best the Korsmeyer-Peppas model showing that the release from the nanoparticles was through diffusion allowing a sustained release of both drugs and prolonged the activity of miconazole nitrate over time against Candida albicans for at least 24 h.

Succinyl-β-cyclodextrin: Influence of the substitution degree on albendazole inclusion complexes probed by NMR

Succinyl-β-CD derivatives were obtained by green synthesis with degrees of substitution (DS) 1.3 and 2.9. The spray-drying technique was used to obtain albendazole (ABZ):succinyl-β-CD inclusion complexes. Phase solubility diagrams indicated that both succinyl-β-CD derivatives formed 1:1 molar ratio ABZ complexes, but the complex with DS 2.9 has a lower formation constant. The presence of stable inclusion complexes in aqueous solution was confirmed by NMR. For both complexes the aromatic moiety is encapsulated into the host cavity. In the solid-state, ¹³C and ¹⁵N NMR spectral differences between ABZ and ABZ included in spray-dried systems showed that strong structural changes occurred in the systems. At least two different ABZ amorphous species were identified based on DS. ABZ species were stable over more than six months based on spectral data. Finally, the influence of DS in the number and type of the inclusion complexes was elucidated.

Composite Microparticles Based on Natural Mucoadhesive Polymers with Promising Structural Properties to Protect and Improve the Antifungal Activity of Miconazole Nitrate

Oropharyngeal candidiasis is a recurrent oral infection caused by Candida species. Gel formulation containing miconazole nitrate is the most common approach for treating oral candidiasis. However, traditional oral topical antifungal therapies have many limitations, including short contact time with the oral mucosa and the necessity to administrate various doses per day. Thus, the aim of this work was to formulate composited microparticulated systems based on combinations of mucoadhesive cationic, anionic, and nonionic polymers that could protect and modify the drug release rate and therefore avoid a fast dilution of the drug by saliva. Microparticulated systems were prepared by the spray drying method employing chitosan, gelatin, and hydroxypropyl methylcellulose. The morphology of the systems was investigated by scanning electron microscopy; drug crystallinity was studied by X-ray, while interactions between polymers were analyzed by infrared spectroscopy. Drug release and halo zone test were employed to analyze the release and activity of the systems loaded with miconazole against Candida albicans cultures. The most appropriate microparticulated system was the one based on chitosan and gelatin which showed homogeneous morphology (mean size of 1.7 ± 0.5 μm), a protective effect of the drug, and better antifungal effect against Candida culture than miconazole nitrate and the other assayed systems. Taking into account these results, this approach should be seriously considered for further evaluation of its safety and in vivo efficacy to be considered as an alternative therapeutic system for the treatment of oral candidiasis.

Histological evaluation of ureteral involvement in women with deep infiltrating endometriosis: analysis of a large series

STUDY QUESTION

In women with deeply infiltrating endometriosis (DIE) what is the prevalence of involvement of endometriotic tissue and fibrosis in ureteral endometriosis (UE), as assessed by histological staining?

SUMMARY ANSWER

In women with DIE, ureteral involvement is more often due to endometriotic tissue rather than fibrosis.

WHAT IS KNOWN ALREADY

In the current literature, histological evaluation of ureteral endometriosis is mainly based on the degree of wall infiltration by endometriosis instead of the tissue composition. A few studies reported ill-defined and contradictory histological data on the tissue composition of UE.

STUDY DESIGN, SIZE, DURATION

Retrospective observational study based on clinical records of women affected by DIE, laparoscopically treated for UE at a tertiary referral center, between January 2010 and March 2013. All cases of ureteral nodule excision or ureterectomy with histological examination of the specimens were included. Exclusion criteria were other identified causes of hydroureteronephrosis, medical therapy for a period of at least 3 months before surgery and previous surgery for DIE.

PARTICIPANTS/MATERIALS, SETTING, METHODS

A total of 77 patients were included in the study and among them seven (9%) presented with bilateral ureteral involvement, giving a total of 84 cases of UE available for analysis. All patients had stage IV endometriosis. According, respectively, to the presence of endometrial glands and/or stroma cells or of fibrotic tissue only, the endometriotic UE and fibrotic UE groups were compared with regard to hydroureteronephrosis at pre-operative urinary tract computerized tomography scan, type of surgical procedure performed to treat UE (nodule removal or ureterectomy), association with other locations of the disease and post-operative complications (ureteral fistula or stenosis).

MAIN RESULTS AND THE ROLE OF CHANCE

For the 84 cases of UE, 65 (77%) and 19 (23%), respectively, showed endometriotic tissue and fibrotic tissue only. Presence of hydroureteronephrosis and endometriotic pattern of UE showed a significant association [endometriotic UE 44/65 (68%) versus fibrotic UE 8/19 (42%); P = 0.04]. Fibrotic pattern of UE and presence of concomitant recto-vaginal endometriosis showed a significant association [endometriotic group: 29/65 (45%) versus fibrotic group 18/19 (95%); P < 0.001].

LIMITATIONS, REASONS FOR CAUTION

The retrospective and monocentric (tertiary referral center) study design.

WIDER IMPLICATIONS OF THE FINDINGS

Besides the distinction between extrinsic and intrinsic UE based on the degree of wall infiltration by endometriosis, a new classification according to the histological pattern of UE could be useful for clinicians, both in the diagnostic and therapeutic fields.

STUDY FUNDING/COMPETING INTERESTS

None.

Detection of new genetic profiles and allelic variants in improperly classified grapevine accessions

Thirty-seven grapevine accessions, collected in Central Italy, were characterized by morphological and genetic analysis, according to guidelines developed by European Union programs of grapevine research and standardization. Traditional denominations of some sampled varieties were revealed to be incorrect; moreover, 10 synonymies and 12 homonymies were recognized. Ampelographic and ampelometric measurements of leaf characters were performed. These data generated a phenotypic similarity matrix and a relative diagram showing morphological differences between specimens. Many samples presented different morphology even in the presence of the same genotype, probably as a result of various environmental pressures. Grapevines were typed by 12 microsatellite loci and then compared with the CRA-VIT genetic resource database. Twenty-five SSR profiles were clearly identified as well-known cultivars, while nine genotypes did not find a direct correspondence: these samples could represent putative new autochthonous Latial Vitis vinifera cultivars or hybrid varieties. The genetic approach also detected three new (169 and 173 in VVMD27 locus; 179 in ISV2 locus) and seven rare allelic variants. Plant sample classification by oral history, morphological observations, and molecular results were compared and discussed. Scions of samples were planted in the Botanic Garden of the University of Rome “Tor Vergata”, to preserve grapevine biodiversity and to protect possible new autochthonous varieties.

Physicochemical, nutritional, and microstructural characteristics of chickpeas (Cicer arietinum L.) and common beans (Phaseolus vulgaris L.) following microwave cooking

Microwave cooking of legumes such as chickpeas and common beans was evaluated by assessing the cooking quality (cooking time, firmness, cooking losses, and water uptake) and the physicochemical, nutritional, and microstructural modifications in starch and nonstarch polysaccharides. Compared to conventional cooking, microwave cooking with sealed vessels enabled a drastic reduction in cooking time, from 110 to 11 min for chickpeas and from 55 to 9 min for common beans. The solid losses, released in the cooking water, were significantly less after microwave cooking than after conventional cooking (6.5 vs 10.6 g/100 g of dry seed in chickpeas and 4.5 vs 7.5 g/100 g of dry seed in common beans). Both cooking procedures produced a redistribution of the insoluble nonstarch polysaccharides to soluble fraction, although the total nonstarch polysaccharides were not affected. Increases in in vitro starch digestibility were similar after both cooking processes, since the level of resistant starch decreased from 27.2 and 32.5% of total starch in raw chickpeas and beans, respectively, to about 10% in cooked samples and the level of rapidly digestible starch increased from 35.6 and 27.5% to about 80%. SEM studies showed that the cotyledons maintained a regular structure although most of the cell wall was broken down and shattered by both cooking procedures. In addition, the ultrastructural modifications in the cotyledon's parenchima and cells are consistent with the chemical modifications in NSP and the increase in starch digestibility after cooking.

Repeated course of interferon treatment in chronic hepatitis B in childhood

Ten children affected by HBV chronic hepatitis, not responding to a previous treatment with interferon (IFN), have been treated with a reiterated IFN therapy. The response obtained is not encouraging and only one patient became negative for HBeAg and HBV-DNA.

[The nephropathic patient in ambulatory surgical practice]

The aim of this study was to define a correct preoperative approach to be used in patients affected by chronic renal insufficiency in order to neutralise possible risks associated with the pathology in question.

[Echographic aspects of kidney diseases and comparisons with needle biopsy]

A study of 38 patients who underwent renal biopsy was designed to correlate the sonographic features of the kidney with the histologic changes in various renal parenchymal diseases. This research was performed in order to determine if sonography could be useful in the diagnosis and differentiation of renal parenchymal diseases. The ultrasound examination was based on the evaluation of some codified parameters: renal dimension, parenchymal thickness, cortical echogenicity and medullary dimension. There was no correlation between the specific sonographic features and the type of renal medical disease. In 28 patients (74%) with clinical and histological signs, sonography showed morphostructural alterations of the kidney.

Low molecular weight proteins in human seminal plasma electrophoretical evidence of their vesicular origin

The protein composition of seminal plasma (SP), two-fractions split ejaculates and expressed prostatic secretions (EPS) from healthy and fertile donors or from infertile patients has been analyzed under proteolysis-blocking and denaturing conditions by 5-20% gradient SDS-PAGE. EPS protein patterns were found to be strikingly similar, both in protein types and concentrations. The same was true for the SP samples. Co-electrophoresis and comparison of the patterns obtained allowed to identify a medium-sized protein (MW 75-80,000 daltons) and low-MW proteins (MW 10-25,000 daltons) as of vesicular origin. Furthermore, prostatic and vesicular proteins were found to migrate into different zones of the gels, giving raise to an unexpected MW "complementarity". A similar finding was obtained by comparing the protein spectra of fluid from vesicular massage (EVS), EPS and SP from a man with moderate asthenozoospermia. However, analysis of nine other EVS samples by the same electrophoretical technique revealed that the majority of them were (sometimes heavily) contaminated by prostatic proteins. It was concluded that SDS-PAGE on gradient gels is of help to distinguish and characterize the proteins secreted by the two major male accessory glands. Such a finding has both research and clinical applications.

Protein characterization of multi-fraction split-ejaculates. Some physicochemical properties of prostatic and vesicular proteins

A simple method of splitting ejaculates into 10-15 consecutive fractions proved to be valuable for separating proteins of prostatic and vesicular origin. After blocking autoproteolysis by EDTA and PMSF the fractions of four multi-fraction split-ejaculates were studied by one-dimensional electrophoresis in the presence of SDS (slab SDS-PAGE). Two split-ejaculates were further analyzed by isoelectrofocusing (PAGIEF). The zinc and fructose distributions were determined for one of the samples. The results show i) that the initial third, roughly, of the ejaculate contains proteins previously characterized as of prostatic origin (Balerna et al., 1982 a); ii) that these initial fractions have a high zinc/fructose ratio; iii) that the vesicular portion of the ejaculate is characterized by low zinc/fructose ratio and by fairly high amounts of low molecular-weight proteins and; iiii) that the proteins of the initial (prostatic) part of the ejaculate are mainly acidic-neutral whereas some proteins of the final (vesicular part) have a strong cationic character.

An exploration of the dimensions of illness behavior

Illness behavior is typically studied from the perspective of medical care practitioners. Problems for which people seek medical care are often deemed to be the universe of such ailments whereas actually they represent a small percentage of total illness experienced. This paper describes the rest of the iceberg of health problems. By using a health diary, all problems recorded by 107 participants over a three-week period were analyzed. A total of 348 problems (3.25 per person) were recorded with less than six percent of the problems receiving professional medical care. Stated differently, individuals were experiencing at least one health problem on approximately half of all study days. Health beliefs regarding selected problems were also obtained, along with non-orthodox practitioner (eg, chiropractors and naturopaths) utilization patterns.

Use of the tilt test in measuring acute blood loss

We undertook to determine the accuracy of the tilt test in detecting acute blood loss. One hundred volunteers were phlebotomized a specific amount of blood (Group I, 450 cc; Group II, 1,000 cc in 500 cc increments). Orthostatic vital signs were recorded at timed intervals comparing the supine to sitting and supine to standing techniques. Using the criteria of pulse increase greater than or equal to 30/min or severe symptoms, the supine to standing test accurately distinguished 1,000 cc blood loss from no blood loss in our population. The major value of the tilt test is detecting blood loss of 1,000 cc or more.