Endometrial and vaginal effects of low-dose estradiol delivered by vaginal ring or vaginal tablet

Aims The major aims of the study were to compare the safety of a continuous low-dose estradiol-releasing vaginal ring (ESTring) to that of a vaginal estradiol tablet (Vagifem®) on the endometrium and the relief of subjective symptoms and signs of urogenital estrogen deficiency. Quality of life and acceptability of treatment delivery were also assessed. Study design A prospective, randomized study in which women were assigned in a 2: 1 ratio to ESTring and Vagifem and followed for 12 months. The primary endpoint was endometrial safety, based on the results of ultrasound measurement of endometrial thickness and a progestogen challenge test at baseline and week 48. Efficacy was determined by subjective assessment of urogenital estrogen deficiency symptoms at baseline and weeks 3, 12, 24, 36 and 48 and assessment of signs of vaginal epithelial atrophy by the clinician at baseline, 12 and 48 weeks. In addition, pelvic floor strength, vaginal cytological evaluation and pH, bacteruria and patient acceptability were assessed. Quality of life was assessed using a menopause-specific quality-of-life questionnire and a 2-day bladder diary at baseline and 12 and 48 weeks. The comparability of the two groups was assessed using ANOVA, χ(2) or Fisher's exact tests. Results A total of 126 women were randomized to ESTring and 59 to Vagifem. There was no statistical difference between the groups in the alleviation of symptoms and signs of urogenital estrogen deficiency. Maturation indices increased in both groups, from generally atrophic at baseline to proliferative or highly proliferative at 48 weeks. After 48 weeks of treatment, there was no statistically significant difference in endometrial thickness between the two groups. A statistically smaller proportion of bleeding/spotting occurred in the ESTring group (n = 0) compared to the Vagifem users (n = 4). Estradiol and total estrone serum levels increased during treatment in both groups but remained within the normal postmenopausal range. General health status in both groups was unchanged but the urogenital component of health burden was significantly improved in both groups. Bladder diary variables showed no differences between treatment groups. Conclusion Equivalent endometrial safety and efficacy in the relief of the symptoms and signs of urogenital estrogen deficiency were demonstrated for the 12 months' use of a low-dose estradiol-releasing vaginal ring and a vaginal estradiol tablet.

Echinacea alkamide disposition and pharmacokinetics in humans after tablet ingestion

Echinacea is a widely used herbal remedy for the treatment of colds and other infections. However, almost nothing is known about the disposition and pharmacokinetics of any of its components, particularly the alkamides and caffeic acid conjugates which are thought to be the active phytochemicals. In this investigation, we have examined serial plasma samples from 9 healthy volunteers who ingested echinacea tablets manufactured from ethanolic liquid extracts of Echinacea angustifolia and Echinacea purpurea immediately after a standard high fat breakfast. Caffeic acid conjugates could not be identified in any plasma sample at any time after tablet ingestion. Alkamides were rapidly absorbed and were measurable in plasma 20 min after tablet ingestion and remained detectable for up to 12 h. Concentration-time curves for 2,4-diene and 2-ene alkamides were determined. The maximal concentrations for the sum of alkamides in human plasma were reached within 2.3 h post ingestion and averaged 336 +/- 131 ng eq/mL plasma. No obvious differences were observed in the pharmacokinetics of individual or total alkamides in 2 additional fasted subjects who took the same dose of the echinacea preparation. This single dose study provides evidence that alkamides are orally available and that their pharmacokinetics are in agreement with the one dose three times daily regimen already recommended for echinacea.

Microhardness mapping and the hardness-yield strength relationship in high-pressure diecast magnesium alloy AZ91

Microhardness maps of cross-sections of high-pressure diecast test bars of AZ91 have been determined. Specimens with rectangular cross-sections, 1, 2 and 3 mm thick, or with a circular cross-section 6.4 mm in diameter, have been studied. The hardness is generally higher near the edges in all specimens, and more so near the corners of the rectangular specimens. The hardness at the center of the castings is generally lower, due to a coarser solidification microstructure and the concentration of porosity. The evidence confirms that the surface of the castings is harder than the core, but it does not support the concept of a skin with a sharp. and definable boundary. This harder layer is irregular in hardness and depth and is not equally hard on opposite sides of the casting. The mean hardness obtained by integrating the microhardness maps over the entire cross-section increased with decreasing thickness of the bars, and was found to be in good correlation with each bar's yield strength. (c) 2005 Elsevier B.V. All rights reserved.

Visoelastic studies on thermoplastic polyurethane nanocomposites using a nano-hardness tester

The viscoelastic behaviour of a range of polyurethane thermoplastic elastomer montmorillonite nanocomposites has been studied using a nanohardness tester. For softer Shore hardness 80A materials, the introduction of the organo-clay increased the creep strain obtained while the nano-indentor was held at constant load. The increase in creep strain was greatest for materials containing an organo-clay modified with a more hydrophilic quaternary alkylammonium surfactant and with higher loadings of the hydrophilic organo-clay. This suggested the effect might be due to a plasticising effect of the excess surfactant. For the harder Shore hardness 55D materials, the addition of the organo-clays produced only a small decrease in the creep strain, probably due to the interconnected hard domains in this material.