Disintegration time
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Úvod: Akutní mastoiditida je hnisavý zánět sliznice mastoidních sklípků s rozpadem mezisklípkových kostěných sept. Je to nejčastější intratemporální zánětlivá komplikace středoušního zánětu u dětí. Včasná diagnostika a léčba jsou klíčové pro prevenci šíření zánětu ze spánkové kosti extraa intrakraniálně. Cíl práce: Cílem této retrospektivní studie je analyzovat případy akutní mastoiditidy u dětí na našem pracovišti. Studie se zaměřuje na vyhodnocení incidence akutní mastoiditidy u dětské populace, identifikaci hlavních etiologických agens odpovědných za tuto infekci a analýzu současných terapeutických přístupů, prevence a její afektivity. Materiál a metody: Formou retrospektivní studie byla zpracována data pacientů ošetřených a hospitalizovaných na dětském oddělení a na oddělení ORL KZ, a. s. – Nemocnice Děčín, o.z., v období 1. 1. 2015 – 1. 9. 2022 se stanovenou diagnózou akutní mastoiditida – H-700 dle MKN-10, vyhledáno pomocí nemocničního informačního systému. Výsledky: Do hodnoceného souboru bylo zahrnuto 23 pacientů. Sledovaní pacienti v souboru byli převážně ve věku 12–18 let. Nejméně dětí bylo ve věkové skupině do 6 let. Nejčetnějším původcem v uvedené studii byl Streptococcus pneumoniae se subtypy 3 a 8, na které, jak ukázala studie, vakcína Synflorix není účinná. Všem sledovaným pacientům byla nasazena empirická antibiotická terapie. Ve skupině případů od 12 do 18 let byla terapie antibiotiky zahájena v monoterapii. U mladších pacientů sestávala antibiotická terapie vždy z dvojkombinace antibiotik, jednalo se zejména o dvojkombinaci clindamycin + gentamycin. U 13 z 23 případů byla indikována chirurgická terapie. Ve většině případů se délka hospitalizace nezměnila v závislosti na věku, ani na etiologickém agens, či místě bydliště. Nebyla nalezena závislost mezi typem léčby akutní mastoiditidy a původcem onemocnění či ovlivněním sluchu. Závěr: V naší retrospektivní studii jsme zjistili, že incidence akutní mastoiditidy koreluje se všeobecně známou incidencí v rámci České republiky a celosvětovými daty. Studie prokazuje, že jako nejčastější patogen akutní mastoiditidy u dětí je identifikován Streptococcus pneumoniae. Analýza ukázala, že vakcína Prevenar 13 vykazuje lepší účinnost v prevenci akutní mastoiditidy ve srovnání s vakcínou Synflorix. Tyto výsledky naznačují, že přehodnocení používané vakcinační strategie by mohlo přispět k dalšímu snížení incidence akutní mastoiditidy. Lze konstatovat, že délka rekonvalescence a možné ovlivnění sluchu po léčbě akutní mastoiditidy nemusí záviset na typu mikrobiálního původce. Doporučujeme pokračovat v monitorování a hodnocení účinnosti vakcín a klinických přístupů ke zlepšení prevence a léčby této závažné komplikace středoušního zánětu.
Introduction: Acute mastoiditis is a purulent inflammation of the mastoid mucosa with disintegration of the interstitial bone septa. It is the most common intratemporal inflammatory complication of otitis media in children. Early diagnosis and treatment are crucial to prevent the spread of inflammation from the temporal bone extraand intracranially. Aim of the study: The aim of this retrospective study is to analyze the cases of acute mastoiditis in children in our department. The study aims to evaluate the incidence of acute mastoiditis in the pediatric population, identify the main etiological agents responsible for this infection, and analyze current therapeutic approaches, prevention, and its effectiveness. Materials and methods: The data of patients treated and hospitalized in the children‘s ward and ENT department of KZ, a. s. – Hospital Děčín, o.z., from 1 January 2015 – 1 September 2022 with the diagnosis – acute mastoiditis – H-700 according to ICD-10, were searched using the hospital information system, and were processed in the form of a retrospective study. Results: 23 patients were included in the evaluated cohort. The study population was mainly aged 12–18 years. The smallest number of children were in the age group under 6 years. Streptococcus pneumoniae with subtypes 3 and 8 was the most frequent causative agent in the study, for which the Synflorix vaccine was shown to be ineffective. Empiric antibiotic therapy was administered to all patients studied. In the group of cases aged 12 to 18 years, antibiotic therapy was started in monotherapy. In younger patients, antibiotic therapy always consisted of a double combination of antibiotics, in particular Clindamycin and Gentamycin. Surgical therapy was indicated in 13 of 23 cases. In most cases, the length of hospital stay did not vary with age, etiologic agent, or place of residence. No dependence was found between the type of treatment for acute mastoiditis or the causative agent of the disease or the effect on hearing. Conclusion: In our retrospective study, we found that the incidence of acute mastoiditis correlates with the generally known incidence in the Czech Republic and global data.The study shows that Streptococcus pneumoniae is identified as the most common pathogen of acute mastoiditis in children. The analysis showed that the Prevenar 13 vaccine showed better efficacy in preventing acute mastoiditis compared to the Synflorix vaccine. These results suggest that reassessment of the vaccination strategy used could contribute to further reduction in the incidence of acute mastoiditis. It can be concluded that the length of recovery and possible impact on hearing after treatment of acute mastoiditis may not depend on the type of microbial agent. We recommend continued monitoring and evaluation of vaccine efficacy and clinical approaches to improve prevention and treatment of this serious complication of otitis media.
The disease currently known as frontotemporal dementia (FTD) has undergone a complex evolution from its first description by Arnold Pick and later by Alois Alzheimer, through the first clinicopathological criteria introduced by David Neary and David Mann, to its current nomenclatural perception as a complex clinicopathological entity. Currently, Frontotemporal lobar degeneration is viewed as a heterogeneous syndrome caused by progressive degeneration of the frontal and temporal lobes of the brain. Clinically, it can manifest as three syndromes of frontotemporal dementia (behavioral variant of FTD, progressive non-fluent aphasia and semantic dementia) but also as so-called "overlap" syndromes involving corticobasal degeneration and progressive supranuclear palsy. Its prevalence is about 10 % among all dementias and 40 % among dementias with onset between 45 and 65 years of age. The clinical manifestation of the different subtypes varies, the common denominator being behavioral disturbances and impairment of fatic, gnostic and executive functions. Mnestic and visuo-spatial functions, although preserved for a relatively long time, are superimposed by personality disintegration, fatic, gnostic and executive dysfunction. Compared with Alzheimer's disease, it generally has an earlier age of onset, a more rapid course and more devastating impairment of individual cognitive domains. FTD has a heritability of more than 30 % according to current knowledge. The main genes involved are MAPT, C9orf72 and GRN. More rarely affected genes are VCP, TDP-43, FUS and CHMP2B. In our article, we focus on the genetics of FTD and the clinic-genetic-pathological correlations. We also aim to provide a plastic picture of how individual mutations affect the molecular mechanisms of neurodegeneration.
- MeSH
- epigeneze genetická genetika MeSH
- frontotemporální demence * diagnóza genetika klasifikace MeSH
- genetické testování metody MeSH
- lidé MeSH
- primární progresivní nonfluentní afázie diagnóza genetika MeSH
- progranuliny genetika MeSH
- proteiny tau genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
OBJECTIVE: This research aims to design and evaluate an enteric-coated hard capsule dosage form for targeted delivery of biological materials, such as FMT (fecal microbiota transplant) or live microbes, to the distal parts of the GIT. The capsules are designed to be internally protected against destruction by hydrophilic filling during passage through the digestive tract. METHODS: Hard gelatin capsules and DRcapsTMcapsules based on HPMC and gellan were used to encapsulate a hydrophilic body temperature-liquefying gelatin hydrogel with caffeine or insoluble iron oxide mixture. Different combinations of polymers were tested for the internal (ethylcellulose, Eudragit® E, and polyvinyl acetate) and external (Eudragit® S, Acryl-EZE®, and cellacefate) coating. The external protects against the acidic gastric environment, while the internal protects against the liquid hydrophilic filling during passage. Coated capsules were evaluated using standard disintegration and modified dissolution methods for delayed-release dosage forms. RESULTS: Combining suitable internal (ethylcellulose 1.0 %) and external (Eudragit® S 20.0 %) coating of DRcapsTM capsules with the wiping and immersion method achieved colonic release times. While most coated capsules met the pharmaceutical requirements for delayed release, one combination stood out. Colonic times were indicated by the dissolution of soluble caffeine (during 120-720 min) measured by the dissolution method, and capsule rupture was indicated by the release of insoluble iron oxide (after 480 min) measured by the disintegration method. This promising result demonstrates the composition's suitability and potential to protect the content until it's released, inspiring hope for the future of colon-targeted delivery systems and its potential for the pharmaceutical and biomedical fields. CONCLUSION: Innovative and easy capsule coatings offer significant potential for targeted drugs, especially FMT water suspension, to the GIT, preferably the colon. The administration method is robust and not considerably affected by the quantity of internal or external coatings. It can be performed in regular laboratories without specialized individual and personalized treatment equipment, making it a practical and feasible method for drug delivery.
- MeSH
- bakteriální polysacharidy chemie MeSH
- biokompatibilní materiály chemie MeSH
- celulosa * chemie analogy a deriváty MeSH
- deriváty hypromelózy chemie MeSH
- hydrofobní a hydrofilní interakce * MeSH
- hydrogely chemie MeSH
- kofein chemie aplikace a dávkování MeSH
- kolon * metabolismus MeSH
- kyseliny polymethakrylové chemie MeSH
- lékové transportní systémy * metody MeSH
- léky s prodlouženým účinkem chemie MeSH
- polymery chemie MeSH
- polyvinyly chemie MeSH
- tobolky * MeSH
- uvolňování léčiv * MeSH
- želatina * chemie MeSH
- železité sloučeniny chemie aplikace a dávkování MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Dental hypersensitivity remains widespread, underscoring the need for materials that can effectively seal dental tubules. This study evaluated the potential of bioactive-glass-infused hydroxyethyl cellulose gels in this context. METHODS: Five gels were synthesized, each containing 20% bioactive glass (specifically, 45S5, S53P4, Biomin F, and Biomin C), with an additional blank gel serving as a control. Subjected to two months of accelerated aging at 37 ± 2 °C, these gels were assessed for key properties: viscosity, water disintegration time, pH level, consistency, adhesion to glass, and element release capability. RESULTS: Across the board, the gels facilitated the release of calcium, phosphate, and silicon ions, raising the pH from 9.00 ± 0.10 to 9.7 ± 0.0-a range conducive to remineralization. Dissolution in water occurred within 30-50 min post-application. Viscosity readings showed variability, with 45S5 reaching 6337 ± 24 mPa/s and Biomin F at 3269 ± 18 mPa/s after two months. Initial adhesion for the blank gel was measured at 0.27 ± 0.04 Pa, increasing to 0.73 ± 0.06 Pa for the others over time. Gels can release elements upon contact with water (Ca- Biomin C 104.8 ± 15.7 mg/L; Na- Biomin F 76.30 ± 11.44 mg/L; P- Biomin C 2.623 ± 0.393 mg/L; Si- 45S5-45.15 ± 6.77mg/L, F- Biomin F- 3.256 ± 0.651mg/L; Cl- Biomin C 135.5 ± 20.3 mg/L after 45 min). CONCLUSIONS: These findings highlight the gels' capacity to kickstart the remineralization process by delivering critical ions needed for enamel layer reconstruction. Further exploration in more dynamic, real-world conditions is recommended to fully ascertain their practical utility.
- Publikační typ
- časopisecké články MeSH
Transferring an existing marketed pharmaceutical product from batch to continuous manufacturing (CM) without changes in regulatory registration is a challenging task in the pharmaceutical industry. Continuous manufacturing can provide an increased production rate and better equipment utilisation while retaining key quality attributes of the final product. Continuous manufacturing necessitates the monitoring of critical quality attributes in real time by appropriate process analytical tools such as near infra-red (NIR) probes. The present work reports a successful transfer of an existing drug product from batch to continuous manufacturing process without changing the formulation. A key step was continuous powder blending, whose design and operating parameters including weir type, agitation rate, dynamic hold-up and residence time were systematically investigated with respect to process repeatability. A NIR-based multivariate data model for in-line composition monitoring has been developed and validated against an existing quality control method for measuring tablet content uniformity. A continuous manufacturing long-run with a throughput of 30 kg/h (approx. 128,000 tablets per hour), uninterrupted for 320 min, has been performed to test and validate the multivariate data model as well as the batch to continuous process transfer. The final disintegration and dissolution properties of tablets manufactured by the continuous process were found to be equivalent to those manufactured by the original batch process.
- MeSH
- blízká infračervená spektroskopie metody MeSH
- farmaceutická chemie metody MeSH
- farmaceutická technologie * metody MeSH
- pomocné látky chemie MeSH
- prášky, zásypy, pudry chemie MeSH
- příprava léků metody MeSH
- řízení kvality MeSH
- rozpustnost MeSH
- tablety * MeSH
- uvolňování léčiv MeSH
- Publikační typ
- časopisecké články MeSH
Cíl: Prezentace akutního retrobulbárního subperiostálního krvácení (následně hematom) v průběhu porodu. Popisujeme jeho výskyt, možné hrozby s ním spojené a metody léčby. Úvod: Akutní retrobulbární krvácení je vždy závažný stav. I když není spojen s jiným očním traumatem, může způsobit trvalou slepotu. Důvodem je konstrikce oka, snížení krevního zásobení, a tím narušení přísunu kyslíku do citlivých tkání sítnice. Po krátké době se funkce těchto tkání začne zhoršovat a ztrácejí svou přirozenou funkci. Primárním diagnostickým postupem je měření nitroočního tlaku (IOP – intraocular pressure). I když ideální diagnostické nástroje nejsou vždy dostupné, doporučuje se v akutních situacích při jeho zvýšení provést laterální kantotomii, event. s inferiorní kantolýzou. Normální nitrooční tlak je 8–21 mmHg. Vlastní pozorování: Ve druhé době porodní se u naší 29leté rodičky náhle objevilo retrobulbární krvácení s následnouexoftalmií a diplopií. Plod byl porozen krátce po této události. Následující průběh porodu vč. sutury hráze i celé šestinedělí byly normální. Naše pacientka měla štěstí, protože její zraková ostrost a IOP byly fyziologické. Mohla být proto zvolena observační léčebná strategie. Po 5 týdnech jsme zaznamenali úspěšnou resorpci hematomu, vymizení exoftalmie a diplopie bez dalších následků. Závěr: Prezentovali jsme retrobulbární subperiostální krvácení u naší pacientky v průběhu porodu. Vyzvedli jsme možné hrozby, které mohou vést až k trvalé slepotě, a doporučené postupy léčby. I když tato situace a její výskyt jsou extrémně vzácné, znalost doporučených postupů může rozšířit profesionální armamentárium zvláště v situacích, kdy není včas k dispozici oční chirurg.
Objective: Presentation of acute retrobulbar subperiostal hemorrhage (hematoma) in the course of delivery. The occurrence, possible threats and recommended methods of treatment are described. Introduction: Acute retrobulbar hemorrhage is always a serious condition. Even if not connected with other ocular trauma, it could cause permanent blindness. The reason is based on constriction of the eye, decreasing of the blood supply and thus disruption of the oxygen supply to sensitive retinal tissues. After a short time, these tissues start to deteriorate and lose their natural function. This event is often connected with exophthalmia and diplopia. The primary diagnostic procedure is to measure intraocular pressure (IOP). Even if the ideal diagnostic tools are not accessible, performing a lateral canthotomy (event. with inferior cantholysis) is recommended to relieve IOP in acute situations. Normal intraocular pressure is considered to be 8–21 mmHg. Case report: Our 29-year-old female patient was in the second stage of delivery and suddenly got retrobulbar hemorrhage, resulting in exophthalmia and diplopia. Her baby was delivered shortly after the event. The following delivery course was normal, including her perineum repair and puerperium. Our patient was fortunate because her visual acuity and IOP were normal. Therefore, we chose an observational treatment strategy. After 5 weeks, we noted successful disintegration of the hematoma and decreased exophthalmia and diplopia without other consequences. Conclusion: We described retrobulbar subperiostal bleeding in our patient in the course of delivery. We depicted possible threats that could result in blindness and described recommended methods of treatment. Even if such a situation is extremely rarely, we believe that knowledge of these guidelines could help medical professionals broaden their treatment options. This particularly occurs when a trained eye surgeon is not available.
- MeSH
- diplopie diagnóza etiologie MeSH
- dospělí MeSH
- komplikace porodu klasifikace MeSH
- lidé MeSH
- nitrooční tlak MeSH
- retrobulbární krvácení * diagnóza etiologie farmakoterapie klasifikace MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Radiofrekvenční energii bylo možné do současné doby považovat za zlatý standard katetrizační léčby fibrilace síní. Nicméně obecně s aplikací termické energie byla spojena řada limitací, jako je poškození kolaterálních struktur, časová náročnost a hlavně poměrně častá recidiva síňové arytmie, a to jak fibrilace síní, tak síňových tachykardií. Proto bylo potřeba hledat novou metodu s lepším bezpečnostním a výkonnostním profilem. Slibné výsledky přináší nově používaná ablace pomocí pulzního pole na principu ireverzibilní elektroporace, která na rozdíl od doposud použitých metod s termickým účinkem a tvorbou koagulační nekrózy způsobí převážně dezintegraci buněčné membrány. V tomto článku rozvádíme princip elektroporace, patofyziologické podklady i technické specifikace vývoje ablačních systémů využívajících pulzního pole. Dále jsou prezentovány výsledky prvních klinických studií ablační léčby s použitím metody pulzního pole u všech forem fibrilace síní a v neposlední řadě i první zkušenosti z praxe.
Catheter ablation of atrial fibrillation using radiofrequency energy has been the gold standard until these days. Nevertheless, there are limitations associated with the application of thermal energy such as damage to collateral structures, time-consuming nature, and, in particular, frequent recurrences of both atrial fibrillation and atrial tachycardias. Therefore, it was essential to find a brand new method with a better safety and efficiency profile. Promising results have been obtained with methods using pulsed field based on the principles of irreversible electroporation which, in comparison with the methods used so far that have a thermal effect and induce coagulation necrosis, predominantly cause disintegration of the cell membrane. This article deals with the principle of electroporation, pathophysiological background, and technical specification of the development of ablation systems using pulsed field energy. Also presented are the results of initial clinical trials with ablation treatment of all types of atrial fibrillation using the pulsed field method as well as the initial experience from the practice.
An important feature of orodispersible tablets (ODTs) is the convenient administration of the drugs, in some cases, faster onset of action, stability maintenance, and dose precision. This work focused on the preparation of ODTs containing mannitol-based co-processed excipients Prosolv® ODT G2, Ludiflash® and Parteck® ODT in combination with tramadol, captopril, and domperidone by direct compression. Prosolv® ODT G2 showed high energy of plastic deformation due to the content of microcrystalline cellulose. Parteck® ODT provided compact tablets due to the content of granulated mannitol. All drugs decreased tensile strength, increased friability, prolonged disintegration time, and decreased the porosity of tablets. Tablets containing Prosolv® ODT G2 with captopril, domperidone, and tramadol; and Parteck® ODT with domperidone met the requirements for ODTs production, i.e., friability ≤ 1% and disintegration time ≤ 180 s, fast wetting time, high water absorption ratio, and adequate tensile strength. The disintegration time was tested using both the pharmacopeial method and the BJKSN-13 apparatus. The results indicate the significant difference between these methods, with the disintegration time being longer when tested with the BJKSN-13 instrument.
The direct tailoring of the size, composition, or number of layers belongs to the advantages of 3D printing employment in producing orodispersible films (ODFs) compared to the frequently utilized solvent casting method. This study aimed to produce porous ODFs as a substrate for medicated ink deposited by a 2D printer. The innovative semi-solid extrusion 3D printing method was employed to produce multilayered ODFs, where the bottom layer assures the mechanical properties. In contrast, the top layer provides a porous structure for ink entrapment. Hydroxypropyl methylcellulose and polyvinyl alcohol were utilized as film-forming polymers, glycerol as a plasticizer, and sodium starch glycolate as a disintegrant in the bottom matrix. Several porogen agents (Aeroperl® 300, Fujisil®, Syloid® 244 FP, Syloid® XDP 3050, Neusilin® S2, Neusilin® US2, and Neusilin® UFL2) acted as porosity enhancers in the two types of top layer. ODFs with satisfactory disintegration time were prepared. The correlation between the porogen content and the mechanical properties was proved. A porous ODF structure was detected in most samples and linked to the porogen content. SSE 3D printing represents a promising preparation method for the production of porous ODFs as substrates for subsequent drug deposition by 2D printing, avoiding the difficulties arising in casting or printing medicated ODFs directly.
- Publikační typ
- časopisecké články MeSH
Disharmonický vývoj a narušené vztahy v rodině, spolu s genetickou predispozicí, mohou vyústit v rozvoj duševních onemocnění, včetně závislostí. Užívání návykových látek u lidí s psychotickým onemocněním je až třikrát četnější než u běžné populace. V kazuistice popisuji práci s psychotickým pacientem v období rané dospělosti, kde základním aspektem byla snaha o navázání terapeutického vztahu. Zásadním tématem pro budování vztahu v psychoterapii je nastavování hranic a přiměřených cílů, které musí být pevné, ne však rigidní. V průběhu léčby došlo k rozpadu sociálního prostředí a rodinného systému, což vedlo ke zhoršení stavu pacienta. Zranitelnost, osamělost a nemoc samotná ukazují, že k zajištění léčby pacienta by byl nezbytný dozor, nejlépe další blízké osoby, kterou pacient v současnosti nemá.
Disharmonic development and disturbed family relationships, together with genetic predisposition, can result in the development of mental illness, including addiction. Substance use in people with psychotic illness is up to three times more common than in the general population. In this case study, I describe work with a psychotic patient in early adulthood, where a fundamental aspect was the attempt to establish a therapeutic relationship. The setting of boundaries and appropriate goals, which must be firm but not rigid, is key for building relationships in psychotherapy. During the course of treatment, the patient’s social environment and family system disintegrated, which led to the deterioration of his condition. Vulnerability, loneliness, and the illness itself suggest that supervision, preferably by another person close to him, might be necessary to ensure the effective treatment of the patient. However, he is currently lacking such resources
