The use of cyclodextrins nanoparticles for oral delivery

This review aims to highlight many of the difficulties encountered in trying to achieve the task of delivering proteins and peptides through oral administration. The necessity of controlled protein and peptide release, protection and stability in the gastrointestinal tract, and ability to target specific areas are only a handful of the many problems associated with trying to engineer a useful solution. Current research gives strong indication that both cyclodextrins and nanoparticles could be highly useful in the search for a suitable method for such successful oral delivery of proteins and peptides. This review focuses on the use of cyclodextrins in pharmaceuticals, aiming to discuss the use of cyclodextrins in conjunction with nanoparticles for oral delivery of proteins. Both classical applications and more advanced "nanomedical" approaches are discussed. In order to achieve a complete overview this review will include background information about cyclodextrins, nanomedicine and their role in oral delivery systems. The use of absorption enhancers like cyclodextrins, bile salts and surfactants was used to facilitate bio-availability into the system. The state-of-the-art technology and challenges in this area are discussed, with typical examples.

Annual high-dose oral vitamin D and falls and fractures in older women : a randomized controlled trial

Context Improving vitamin D status may be an important modifiable risk factor to reduce falls and fractures; however, adherence to daily supplementation is typically poor.

Objective To determine whether a single annual dose of 500 000 IU of cholecalciferol administered orally to older women in autumn or winter would improve adherence and reduce the risk of falls and fracture.

Design, Setting, and Participants A double-blind, placebo-controlled trial of 2256 community-dwelling women, aged 70 years or older, considered to be at high risk of fracture were recruited from June 2003 to June 2005 and were randomly assigned to receive cholecalciferol or placebo each autumn to winter for 3 to 5 years. The study concluded in 2008.

Intervention 500 000 IU of cholecalciferol or placebo.

Main Outcome Measures Falls and fractures were ascertained using monthly calendars; details were confirmed by telephone interview. Fractures were radiologically confirmed. In a substudy, 137 randomly selected participants underwent serial blood sampling for 25-hydroxycholecalciferol and parathyroid hormone levels.

Results Women in the cholecalciferol (vitamin D) group had 171 fractures vs 135 in the placebo group; 837 women in the vitamin D group fell 2892 times (rate, 83.4 per 100 person-years) while 769 women in the placebo group fell 2512 times (rate, 72.7 per 100 person-years; incidence rate ratio [RR], 1.15; 95% confidence interval [CI], 1.02-1.30; P = .03). The incidence RR for fracture in the vitamin D group was 1.26 (95% CI, 1.00-1.59; P = .047) vs the placebo group (rates per 100 person-years, 4.9 vitamin D vs 3.9 placebo). A temporal pattern was observed in a post hoc analysis of falls. The incidence RR of falling in the vitamin D group vs the placebo group was 1.31 in the first 3 months after dosing and 1.13 during the following 9 months (test for homogeneity; P = .02). In the substudy, the median baseline serum 25-hydroxycholecalciferol was 49 nmol/L. Less than 3% of the substudy participants had 25-hydroxycholecalciferol levels lower than 25 nmol/L. In the vitamin D group, 25-hydroxycholecalciferol levels increased at 1 month after dosing to approximately 120 nmol/L, were approximately 90 nmol/L at 3 months, and remained higher than the placebo group 12 months after dosing.

Conclusion Among older community-dwelling women, annual oral administration of high-dose cholecalciferol resulted in an increased risk of falls and fractures.

Parent-initiated oral corticosteroid therapy for acute asthma: a survey of current practice

Aim: To determine (i) the proportion of doctors who recommend parent-initiated oral corticosteroids (PIOCS) for acute asthma; and (ii) the proportion of parents who have received this advice.

Methods: (i) An internet-based survey of doctors involved in the care of children with asthma; and (ii) a questionnaire-based survey of parents of children aged 4–13 years who were identified from a random sample of primary schools within the Barwon region of Victoria.

Results: Eight-five per cent (95% confidence interval 80.0–89.1%) of responding doctors reported recommending PIOCS to parents of children with asthma. However, only 16.5% (95% confidence interval 14.2–18.7%) of parents of children with recent asthma symptoms report that they have received such advice.

Conclusion: The majority of responding doctors involved in the care of children with asthma report recommending PIOCS to parents. By contrast, a minority of parents of children with asthma report that they have received such advice.

Tecnica simples para identificacao de femeas de tilapia nilotica (Oreochromis niloticus) realizando incubacao oral dos ovos

In aquaculture laboratories which work with Nile tilapia (Oreochromis niloticus) reproduction and use crystalline water, is frequently necessary to verify whether the females are incubating orally the eggs. The identification of the females when there is not know-how is difficult and slow, and in most cases is stressful and damage the eggs. This study describes a simple technique, using a mirror, to identify Nile tilapia incubating eggs orally in crystalline water. The results showed that is possible to identify the females which are incubating orally with 100% efficiency.

Debating the evidence : oral contraceptives containing drospirenone and risk of blood clots

Skepticism is an essential quality in science. We doubt, re-examine and demand the highest quality of evidence. However, sometimes this puts us in an awkward situation. How much evidence do we need before we act? This dilemma is a constant problem in drug safety. Treatment decisions are always a balance of risks and benefits and there may be a paucity of evidence about rare or very rare adverse events.

Digital oral feedback written assignments as professional learning for teacher educators : a collaborative self-study.

Allan Luke (2008) uses a “pedagogical economy where literacy education is taken as a cultural gift”. This paper reports on the digital oral feedback provided to pre-service teachers in a literacy unit and explores the pedagogical gift this feedback is to the teacher educators marking this work. Rather than mark their written work as individual lecturers, we collaboratively read the assignment and recorded the sound file of the conversation around each assignment. We then participated in another conversation with a critical friend, which enabled us to explore the impact of this form of assessment on our professional identities as teacher educators. We found these conversations provided a rich context for our professional learning about ourselves as teacher educators, as well as specific content knowledge we both brought to the teaching of this unit. We found we were working as a team to provide more in-depth feedback of the assessment criteria for each assignment than we did with written feedback. Through this dialogical feedback we were able to construct the pre-service teachers' assignments as an important textual gift in our collaborative professional learning about assessment, and in exploring our beliefs and practices as teacher educators.

Oral language competence, young speakers and the Law

Purpose: This paper highlights the forensic implications of language impairment in 2 key (and overlapping) groups of young people: identified victims of maltreatment (abuse and/or neglect) and young offenders.

Method: Two lines of research pertaining to oral language competence and young people's interface with the law are considered: 1 regarding investigative interviewing with children as victims or witnesses in the context of serious allegations of sexual abuse, and the other pertaining to adolescent offenders as suspects, witnesses, or victims. The linguistic demands that forensic interviewing places on these young people are also considered. Literature concerning the impact of early maltreatment on early language acquisition is briefly reviewed, as is the role of theory of mind in relation to the requirements of investigative interviewing of children and adolescents.

Implications: High-risk young people (i.e., those who are subject to child protection orders because of suspected or confirmed maltreatment, and those who are engaged with the youth justice system) face an elevated risk for suboptimal language development but may need to draw on their language skills in high-stakes forensic interviews. Implications for early intervention policy and practice are identified, and the need for greater speech-language pathology advocacy and engagement in forensic interviewing research is emphasized.

Youth (in)justice : oral language competence in early life and risk for engagement in antisocial behaviour in adolescence

Youth offenders are complex and challenging for policymakers and practitioners alike and face high risks for long-term disadvantage and social marginalisation. In many cases, this marginalisation from the mainstream begins in early life, particularly in the classroom, where they have difficulty both with language/literacy tasks and with the interpersonal demands of the classroom. Underlying both sets of skills is oral language competence—the ability to use and understand spoken language in a range of situations and social exchanges, in order to successfully negotiate the business of everyday life. This paper highlights an emerging field of research that focuses specifically on the oral language skills of high-risk young people. It presents evidence from Australia and overseas that demonstrates that high proportions (some 50% in Australian studies) of young offenders have a clinically significant, but previously undetected, oral language disorder. The evidence presented in this paper raises important questions about how young offenders engage in forensic interviews, whether as suspects, victims or witnesses. The delivery of highly verbally mediated interventions such as counselling and restorative justice conferencing is also considered in the light of emerging international evidence on this topic.

Successful outcomes with oral fluoroquinolones combined with rifampicin in the treatment of Mycobacterium ulcerans : an observational cohort study

Background: The World Health Organization currently recommends combined streptomycin and rifampicin antibiotic treatment as first-line therapy for Mycobacterium ulcerans infections. Alternatives are needed when these are not tolerated or accepted by patients, contraindicated, or neither accessible nor affordable. Despite in vitro effectiveness, clinical evidence for fluoroquinolone antibiotic use against Mycobacterium ulcerans is lacking. We describe outcomes and tolerability of
fluoroquinolone-containing antibiotic regimens for Mycobacterium ulcerans in south-eastern Australia.

Methodology/Principal Findings: Analysis was performed of prospectively collected data including all primary Mycobacterium ulcerans infections treated at Barwon Health between 1998 and 2010. Medical treatment involved antibiotic use for more than 7 days; surgical treatment involved surgical excision of a lesion. Treatment success was defined as complete lesion healing without recurrence at 12 months follow-up. A complication was defined as an adverse event attributed to an antibiotic that required its cessation. A total of 133 patients with 137 lesions were studied. Median age was
62 years (range 3–94 years). 47 (34%) had surgical treatment alone, and 90 (66%) had combined surgical and medical treatment. Rifampicin and ciprofloxacin comprised 61% and rifampicin and clarithromycin 23% of first-line antibiotic
regimens. 13/47 (30%) treated with surgery alone failed treatment compared to 0/90 (0%) of those treated with combination medical and surgical treatment (p,0.0001). There was no difference in treatment success rate for antibiotic combinations containing a fluoroquinolone (61/61 cases; 100%) compared with those not containing a fluoroquinolone (29/29 cases; 100%). Complication rates were similar between ciprofloxacin and rifampicin (31%) and rifampicin and clarithromycin (33%) regimens (OR 0.89, 95% CI 0.27–2.99). Paradoxical reactions during treatment were observed in 8 (9%) of antibiotic treated cases.

Conclusions: Antibiotics combined with surgery may significantly increase treatment success for Mycobacterium ulcerans infections, and fluoroquinolone combined with rifampicin-containing antibiotic regimens can provide an effective and safe oral treatment option.