Strategies for local drug delivery targeting the oesophagus

Localised, targeted drug delivery to the oesophagus offers the potential for more effective delivery and reduced drug dosages, coupled with increased patient compliance. This thesis considers bioadhesive liquids, orally retained tablets and films as well as chewable dosage forms as drug delivery systems to target the oesophagus. Miconazole nitrate was used as a model antifungal agent. Chitosan and xanthan gum hydrogels were evaluated as viscous polymer viables with the in vitro retention, drug release and minimum inhibitory concentration values of the formulations measured. Xanthan showed prolonged retention on the oesophageal surface in vitro yet chitosan reduced the MIC value; both polymers offer potential for local targeting to the oesophagus. Cellulose derivatives were investigated within orally retained dosage forms. Both drug and polymer dissolution rates were measured to investigate the drug release mechanism and to develop a formulation with concomitant drug and polymer release to target the oesophagus with solubilised drug within a viscous media. Several in vitro dissolution methods were evaluated to measure drug release from chewable dosage forms with both drug and polymer dissolution quantified to investigate the effects of dissolution apparatus on drug release. The results from this thesis show that a range of drug delivery strategies that can be used to target drug to the oesophagus. The composition of these formulations as well as the methodology used within the development are crucial to best understand the formulation and predict its performance in vivo.

Reducing the risk of sexually transmitted infections in genitourinary medicine clinic patients:A systematic review and meta-analysis of behavioural interventions

Objectives: Are behavioural interventions effective in reducing the rate of sexually transmitted infections (STIs) among genitourinary medicine (GUM) clinic patients? Design: Systematic review and meta-analysis of published articles. Data sources: Medline, CINAHL, Embase, PsychINFO, Applied Social Sciences Index and Abstracts, Cochrane Library Controlled Clinical Trials Register, National Research Register (1966 to January 2004). Review methods: Randomised controlled trials of behavioural interventions in sexual health clinic patients were included if they reported change to STI rates or self reported sexual behaviour. Trial quality was assessed using the Jadad score and results pooled using random effects meta-analyses where outcomes were consistent across studies. Results: 14 trials were included; 12 based in the United States. Experimental interventions were heterogeneous and most control interventions were more structured than typical UK care. Eight trials reported data on laboratory confirmed infections, of which four observed a greater reduction in their intervention groups (in two cases this result was statistically significant, p<0.05). Seven trials reported consistent condom use, of which six observed a greater increase among their intervention subjects. Results for other measures of sexual behaviour were inconsistent. Success in reducing STIs was related to trial quality, use of social cognition models, and formative research in the target population. However, effectiveness was not related to intervention format or length. Conclusions: While results were heterogeneous, several trials observed reductions in STI rates. The most effective interventions were developed through extensive formative research. These findings should encourage further research in the United Kingdom where new approaches to preventing STIs are urgently required.

MRI pressure and stress measurement in novel homogeneous soft solids

This paper presents MRI measurements of a novel semi solid MR contrast agent to pressure. The agent is comprised of potassium chloride cross linked carageenan gum at a concentration of 2% w/v, with micron size lipid coated bubbles of air at a concentration of 3% v/v. The choice for an optimum suspending medium, the methods of production and the preliminary MRI results are presented herein. The carageenan gum is shown to be ideally elastic for compressions relating to volume changes less than 15%, in contrast to the inelastic gellan gum also tested. Although slightly lower than that of gellan gum, carageenan has a water diffusion coefficient of 1.72×10-9 m2.s-1 indicating its suitability to this purpose. RARE imaging is performed whilst simultaneously compressing test and control samples and a maximum sensitivity of 1.6% MR signal change per % volume change is found which is shown to be independent of proton density variations due to the presence of microbubbles and compression. This contrast agent could prove useful for numerous applications, and particularly in chemical engineering. More generally the method allows the user to non-invasively image with MRI any process that causes, within the solid, local changes either in bubble size or bubble shape. © 2008 American Institute of Physics.

Paediatric drug development of ramipril:reformulation, in vitro and in vivo evaluation

Ramipril is used mainly for the treatment of hypertension and to reduce incidence of fatality following heart attacks in patients who develop indications of congestive heart failure. In the paediatric population it is used most commonly for the treatment of heart failure, hypertension in type 1 diabetes and diabetic nephropathy. Due to the lack of a suitable liquid formulation, the current study evaluates the development of a range of oral liquid formulations of ramipril along with their in vitro and in vivo absorption studies. Three different formulation development approaches were studied: solubilisation using acetic acid as a co-solvent, complexation with hydroxypropyl-β-cyclodextrin (HP-β-CD) and suspension development using xanthan gum. Systematic optimisation of formulation parameters for the different strategies resulted in the development of products stable for twelve months at long term stability conditions. In vivo evaluation showed CMAX of 10.48 µg/mL for co-solvent, 13.04µg/ml for the suspension and 29.58µg/mL for the cyclodextrin based ramipril solution. Interestingly, both ramipril solution (co-solvent) and the suspension showed a TMAX of 2.5h, however, cyclodextrin based ramipril produced TMAX at 0.75h following administration. The results presented in this study provide translatable products for oral liquid ramipril which offer preferential paediatric use over existing alternatives.

Uncertainty evaluation of an axi-symmetric measurement machine

This paper describes a method of uncertainty evaluation for axi-symmetric measurement machines which is compliant with GUM and PUMA methodologies. Specialized measuring machines for the inspection of axisymmetric components enable the measurement of properties such as roundness (radial runout), axial runout and coning. These machines typically consist of a rotary table and a number of contact measurement probes located on slideways. Sources of uncertainty include the probe calibration process, probe repeatability, probe alignment, geometric errors in the rotary table, the dimensional stability of the structure holding the probes and form errors in the reference hemisphere which is used to calibrate the system. The generic method is described and an evaluation of an industrial machine is described as a worked example. Type A uncertainties were obtained from a repeatability study of the probe calibration process, a repeatability study of the actual measurement process, a system stability test and an elastic deformation test. Type B uncertainties were obtained from calibration certificates and estimates. Expanded uncertainties, at 95% confidence, were then calculated for the measurement of; radial runout (1.2 µm with a plunger probe or 1.7 µm with a lever probe); axial runout (1.2 µm with a plunger probe or 1.5 µm with a lever probe); and coning/swash (0.44 arc seconds with a plunger probe or 0.60 arc seconds with a lever probe).

Bacteria growth, enzyme activities and TEP during KOSMOS 2011 mesocosm experiment in the Raunefjord

Marine bacteria are the main consumers of freshly produced organic matter. Many enzymatic processes involved in the bacterial digestion of organic compounds were shown to be pH sensitive in previous studies. Due to the continuous rise in atmospheric CO2 concentration, seawater pH is presently decreasing at a rate unprecedented during the last 300 million years but the consequences for microbial physiology, organic matter cycling and marine biogeochemistry are still unresolved. We studied the effects of elevated seawater pCO2 on a natural plankton community during a large-scale mesocosm study in a Norwegian fjord. Nine Kiel Off-Shore Mesocosms for Future Ocean Simulations (KOSMOS) were adjusted to different pCO2 levels ranging initially from ca. 280 to 3000 µatm and sampled every second day for 34 days. The first phytoplankton bloom developed around day 5. On day 14, inorganic nutrients were added to the enclosed, nutrient-poor waters to stimulate a second phytoplankton bloom, which occurred around day 20. Our results indicate that marine bacteria benefit directly and indirectly from decreasing seawater pH. During the first phytoplankton bloom, 5-10% more transparent exopolymer particles were formed in the high pCO2 mesocosms. Simultaneously, the efficiency of the protein-degrading enzyme leucine aminopeptidase increased with decreasing pH resulting in up to three times higher values in the highest pCO2/lowest pH mesocosm compared to the controls. In general, total and cell-specific aminopeptidase activities were elevated under low pH conditions. The combination of enhanced enzymatic hydrolysis of organic matter and increased availability of gel particles as substrate supported up to 28% higher bacterial abundance in the high pCO2 treatments. We conclude that ocean acidification has the potential to stimulate the bacterial community and facilitate the microbial recycling of freshly produced organic matter, thus strengthening the role of the microbial loop in the surface ocean.

Fluidos de perfuração aquosos: a contribuição da goma xantana e carboximetilcelulose no controle de filtrado

This study aimed mainly to evaluate the influence of xanthan gum (XG) and carboxymethylcellulose (CMC) in the filtration process of water-based drilling fluids, considering the conformational changes suffered by the polyelectrolyte with the addition of sodium chloride (NaCl) in different concentrations (0.17, 0.34 and 0.51 mol.L-1). It was also evaluated the behavior of the fluid by the addition of calcium carbonate (CaCO3) in pure water and in brine. Seeking a better understanding of the interaction between the polymers used and CaCO3, polymer adsorption analyzes were performed using a depletion method, which yielded a higher percentage of adsorption of Xanthan Gum in this material (29%), which can justify the formation of a thin and waterproof filter cake for drilling fluids containing this polymer. However, the best values of apparent viscosity (20 and 24 mPa.s) and volume of filtrate (8.0 and 8.1 mL) were obtained for the systems consisting of xanthan gum, CMC and CaCO3, in NaCl aqueous solutions concentrations of 0.34 and 0.51 mol.L-1, respectively. The values can be related to the presence of CMC that increases the apparent viscosity and reduces the volume of filtrate. In addition, the CaCO3 added acts as a bridging agent, promoting the formation of a less permeable filter cake

Aplicação de géis de goma guar no processo de clarificação de salmouras e águas produzidas

Produced water is considered the main effluent of the oil industry, due to their increased volume in mature fields and its varied composition. The oil and grease content (TOG) is the main parameter for the final disposal of produced water. In this context, it is of great significance to develop an alternative method based on guar gum gel for the treatment of synthetic produced water, and using as the differential a polymer having high hydrophilicity for clarifying waters contaminated with oil. Thus, this study aims to evaluate the efficiency of guar gum gels in the remotion of oil from produced water. Guar gum is a natural polymer that, under specific conditions, forms three-dimensional structures, with important physical and chemical properties. By crosslinking the polymer chains by borate ions in the presence of salts, the effect salting out occurs, reducing the solubility of the polymer gel in water. As a result, there is phase separation with the oil trapped in the collapsed gel. The TOG was quantified from the spectroscopy in the ultraviolet and visible region. The system was proven to be highly efficient in the removal of dispersed oil from water produced synthetically, reaching removal percentages above 90%.

Desenvolvimento e caracterização de nanoemulsões cosméticas contendo extrato de Opuntia ficus-indica L. Mill e avaliação in vivo da eficácia hidratante

Nanoemulsions are emulsified systems, characterized for reduced droplet size (50- 500nm), which the main characteristic are kinect stability and thermodynamic instability. These are promising systems on cosmetic area due to their droplet size that provide different advantages when compared to conventional systems, among others, larger surface area and better permeability. The Opuntia ficus-indica (L.) Mill is a plant cultivated on Caatinga Brazilian biome, which has great socioeconomic importance to region. This plant shows carbohydrates utilized for cosmetic industry as moisturizing active in their chemical composition. The aim of study was to develop, characterize, evaluate stability and moisturizing efficacy of cosmetic nanoemulsions added to Opuntia ficus-indica (L.) Mill extract. Nanoemulsions preparation was made using a low energy method. Different nanoemulsions were formulated varying the ratio of oil, water and surfactant phases beyond xanthan gum (0.5% e 1%) and Opuntia ficus-indica (L.) Mill hydroglycolic extract addition on 1% and 3%. Obtained nanoemulsions were submitted to preliminary and accelerated stability tests. The evaluated parameters monitored were: macroscopic aspect, pH value, droplet size, zeta potential and polydispersion index, during 60 days on different temperatures. Stable formulations were submitted to moisturizing efficacy assessment by capacitance and transepidermal water loss methodologies during 5 hours. Stable samples were white and showed homogeneous and fluid aspect, pH value was inside ideal range (4,5-6,0) to topical application and droplet size under 200nm characterizing these system as nanoemulsions. Developed nanoemulsions did not decrease transepidermal water loss, however increased the water content on stratum corneum, highlighting the nanoemulsions containing 0.5% of xanthan gum and 1% of hydroglycolic extract. This work presents cosmetic moisturizing nanoemulsions composed to vegetal raw material from Brazilian Caatinga with potential to be used on cosmetic area.

Polpa de jambolão (Eugenia jambolana Lam.) fresca e desidratada: características físico-químicas, bioativas e funcionais, efeitos biológicos em Caenorhabditis elegans e uso para produção de frozen yogurt caprino probiótico

This work evaluated the fresh, spray dried (with 10 % of Arabic Gum) and freeze dried jambolan pulp (Eugenia jambolana Lam.) in regard to physicochemical (pH, moisture, water activity, average particle diameter, solubility and color), bioactive [total phenolic content (TPC), monomeric anthocyanin, pronathocyanidin (PA), total elagic acid (TEA), myricetin and cyanidin] and in vitro functionality (antioxidant, antienzymatic and antimicrobial activities]. In addition, the in vivo functionality of jambolan pulp was investigated using the Caenorhabditis elegans model for insulin signaling, longevity and induced neurodegeneration (Alzheimer’s disease and Parkinson’s disease related symptoms). The dried jambolan pulp presented TPC retention (50% to 75%), PA (90% to 98%), TEA (31% to 83%), myricetin (40% to 84%), cyanidin (72% to 84%) and antioxidant activity (15%). The fresh jambolan pulp, the freeze dried pulp and the spray dried jambolan pulp presented high enzymatic inhibitory activity against pancreatic lipase (4,4 to 5,8 mg/mL), alpha-glycosidase (10,3 to 13,8 mg/mL) and alpha-amylase (8,9 to 11,2 mg/mL). They also were active inhibitors against the pathogen S. aureus. The dried jambolan experimental samples were able to increase the expression of several genes linked to the insulin signaling pathways (SIR-2.1, PPTR-1, DAF-16, SOD-3, e CTL) and increased the lifespan in C. elegans (18,07 % - 24,34 %), besides decreasing the amyloid AB1-42 aggregation induced paralysis and MPP+ (1-methyl-4-phenylpyridinium) induced neurodegeneration. Based on that, the jambolan pulp and the spray dried jambolan pulp were further selected for the production of caprine frozen yogurt with the addition of Bifidobacterium animalis subsp. lactis BI-07. The final product were evaluated in regard to their physicochemical (pH, acidity, total solids, protein, total reducing sugars, fat, ashes, overrun, melting test), bioactive (TPC and monomeric anthocyanin, antioxidant activity, probiotic viability and sensory analysis (sensory acceptance). The results showed that samples with probiotic had lowest pH and higher acidity, TPC, anthocyanin and antioxidant activity. It was also observed low overrun (14.2% to 22.6%). vi Samples with probiotic had lower flavor scores. Overall, this research presents the jambolan as a highly functional bioactive-rich fruit with the potential to modulate important biological pathways, extend lifespan and retard the development of neurodegenerative diseases. Jambolan is an underexploited exotic fruit with a high colorant potential and this thesis shows for the first time in the literature important technological, biological and scientific data about this fruit that could be used towards the development of health-oriented food products.

Contribuição da poliacrilamida parcialmente hidrolisada em associação com a bentonita em fluidos de perfuração aquosos

In this study, we investigated the effect of addition of partially hydrolyzed polyacrylamide (HPAM) and bentonite in the physicochemical properties of acquous drilling fluids. Two formulations were evaluated: F1 formulation, which was used as reference, containing carboxymethylcellulose (CMC), magnesium oxide (MgO), calcite (calcium carbonate - CaCO3 ), xanthan gum, sodium chloride (NaCl) and triazine (bactericidal); and F2, containig HPAM steady of CMC and bentonite in substituition of calcite. The prepared fluids were characterized by rheological properties, lubricity and fluid loss. Calcite was characterized by granulometry and thermal gravimetric analysis (TGA). The formulation F2 presented filtration control at 93◦C 34 mL while F1 had total filtration. The lubricity coefficient was 0.1623 for F2 and 0.2542 for F1, causing reduction in torque of 25% for F1 and 52 % for F2, compared to water. In the temperature of 49 ◦C and shear rate of 1022 s −1 , the apparent viscosities were 25, 5 and 48 cP for F1 and F2 formulation, respectively, showing greater thermal resistance to F2. With the confirmation of higher thermal stability of F2, factorial design was conducted in order to determine the HPAM and of bentonite concentrations that resulted in the better performance of the fluids. The statistical design response surfaces indicated the best concentrations of HPAM (4.3g/L) and bentonite (28.5 g/L) to achieve improved properties of the fluids (apparent viscosity, plastic viscosity, yield point and fluid loss) with 95% confidence, as well as the correlations between these factors (HPAM and bentonite concentrations). The thermal aging tests indicated that the formulations containing HPAM and bentonite may be used to the maximum temperature until 150 ◦C. The analyze of the filter cake formed after filtration of fluids by X-ray diffraction showed specific interactions between the bentonite and HPAM, explaining the greater thermal stability of F2 compared to the fluid F1, that supports maximum temperature of 93 ◦C.

Mastigatory efficiency in denture wears with bilateral balanced occlusion and canine guidance

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.

Mastigatory efficiency in denture wears with bilateral balanced occlusion and canine guidance

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.

Simplified versus traditional techniques for complete denture fabrication: A systematic review

STATEMENT OF PROBLEM: A number of methods have been described for the fabrication of complete dentures. There are 2 common ways to make conventional complete dentures: a traditional method and a simplified method. PURPOSE: The purpose of this study was to conduct a systematic review to compare the efficiency of simplified and traditional methods for the fabrication of complete dentures. MATERIAL AND METHODS: The review was conducted by 3 independent reviewers and included articles published up to December 2013. Three electronic databases were searched: MEDLINE-PubMed, The Cochrane Library, and ISI Web of Science. A manual search also was performed to identify clinical trials of simplified versus traditional fabrication of complete dentures. RESULTS: Six articles were classified as randomized controlled clinical trials and were included in this review. The majority of the selected articles analyzed general satisfaction, denture stability, chewing ability and function, comfort, hygiene, esthetics, speech function, quality of life, cost, and fabrication time. CONCLUSIONS: Although the studies reviewed demonstrate some advantages of simplified over traditional prostheses, such as lower cost and clinical time, good chewing efficiency, and a positive effect on the quality of life, the reports related the use of different simplified methods for the fabrication of complete dentures. Additional randomized controlled trials that used similar simplified techniques for the fabrication of complete dentures should be performed with larger sample sizes and longer follow-up periods.

Eficiência mastigatória e qualidade das próteses totais confeccionadas pelas técnicas tradicionais e simplificada: um ensaio clínico

Traditional methods for dentures fabrication require a wide clinical and laboratory procedures; however, there is no scientific evidence that these methods can produce better results when compared with simplified methods. Aim: To evaluate the effectiveness of a simplified methods for denture fabrication, comparing it to the traditional one through masticatory efficiency and prosthesis quality. Method: A randomized controlled trial was conducted with 50 patients, 25 rehabilitated with prosthesis produced by traditional technique and 25 rehabilitated by a simplified technique. The masticatory efficiency was evaluated by colorimetric method, using chewing capsules. The quality of prosthesis was obtained using a reliable and reproducible instrument. Statistical analysis of the masticatory efficiency and quality of the prosthesis was obtained by the Mann-Whitney test. Results: 39 patients completed the study, 18 on traditional group and 21 on simplified group. There was no difference between groups for the masticatory efficiency (p = 0.835) and the quality of the prosthesis (p = 0672). The evaluation of the overall quality of the prosthesis according to oral conditions, demonstrated significant difference on the height of the mandibular ridges (p = 0.010) and mandibular muscle attachments (p = 0.039). Conclusion: Complete dentures fabricated by simplified method were considered effective from the point of view of masticatory efficiency and quality of prosthetics, with results similar to those made by the traditional method.