By Injection Research Articles

Ayurvedic management of Vataja Yoni Vyapad - A Case Study

Vataja Yoni Vyapad is a disease condition of the female reproductive system that causes distressing menstrual symptoms and other complications such as prolapse of the reproductive organs, that severely affects the woman’s quality of life. Acharyas have mentioned a variety of oral medications and Sthanika Chikitsa that corrects the Dosha Dushti and imparts Bala to the Sthana that provide significant relief to the symptoms. In the present case study, a 34-year-old patient presented with premenstrual symptoms and severe dysmenorrhea and pain in the vaginal and vulval region. She was treated with oral medications and two cycles of Yoni Abhyanga Sweda and Veshavara Dharana after which her symptoms significantly reduced.

Intravenously Administered Nonsteroidal Anti-Inflammatory Drugs in Clinical Practice: A Narrative Review

Intravenously administered nonsteroidal anti-inflammatory drugs (NSAIDs) constitute a crucial component of multimodal analgesia strategies in surgical settings. This narrative review aims to provide an up-to-date evaluation of the efficacy, safety, and clinical use of intravenous (IV) NSAIDs for perioperative pain management in adults and children. The NSAIDs and selective COX-2 inhibitors (coxibs) approved in Europe for the short-term symptomatic treatment of acute, moderate perioperative pain via IV infusion in adults and/or children have been influenced by US and global guidelines and practice: the drugs primarily reviewed here are ibuprofen, ketorolac, ketoprofen, naproxen, paracetamol, and acetylsalicylic acid. Furthermore, intravenous ibuprofen is authorized for the short-term symptomatic treatment of fever. In contrast to intravenous ketoprofen, intravenous ibuprofen is authorized for administration to children over 6 years of age or weighing more than 20 kg. Overall, IV ibuprofen had a more favorable profile with regard to peri- and postoperative opioid sparing and pain relief. Oral ibuprofen and IV ibuprofen have similar levels of efficacy, although IV ibuprofen has a shorter onset of action and is required in patients who are unable to take oral medications. The frequency of significant adverse events appears to be similar for ibuprofen and paracetamol. Systematic reviews and meta-analyses report that intravenous NSAIDs reduce postoperative opioid consumption by approximately 20–60%, improving pain management with fewer opioid-related side effects. In indications in infants, the choice of medication is limited, and the oral route is not always feasible; IV formulations of ibuprofen are preferred in this setting. Topics for further research should include head-to-head trials of IV NSAIDs.

Early Check-In Protocol: Identifying Medication Issues in Patients with Cancer at Health System Specialty Pharmacy.

Several studies have illustrated value in early patient contact following oral anticancer medication (OAM) initiation, particularly within the first 14 days of therapy, as adverse effects may lead to early discontinuation or poor adherence. Health-system specialty pharmacies (HSSPs) are optimally positioned to adopt this best practice through formalized protocols designed to identify and mitigate medication-related issues. To outline an HSSP-led early check-in protocol for patients taking OAMs and to describe the subsequent interventions conducted by the HSSP team and their acceptance rate. HSSPs enacted a protocol in January 2021 requiring oncology pharmacists - to contact patients within 14 days of OAM initiation, aiming to optimize adverse effect management, offer supportive care, address adherence, and provide education. To evaluate the impact of the early check-in protocol, we conducted a retrospective, multicenter, observational study across CPS's health system clients from January 2022 to November 2023. HSSP pharmacists created 1698 interventions for 1184 patients from the early check-in. The cancer types most frequently associated with an intervention were breast (n = 431, 25.4%), gastrointestinal (n = 245, 14.4%), and prostate (n = 206, 12.1%). The most frequent intervention categories were adverse drug reactions (ADRs) (n = 1,548, 91.2%) and adherence (n = 55, 3.2%). Overall, 95.5% of pharmacist recommendations were accepted by patients and/or providers. Implementing an early check-in protocol allows HSSP pharmacists to mitigate barriers to OAM adherence. This study emphasizes the importance of early check-in and illustrates the scope of the oncology pharmacist's role by evaluating critically meaningful interventions and quantifying pharmacist recommendations and acceptance rate.

The application and development prospects of extracellular vesicles in oral administration.

Extracellular vesicles (EVs) are nanoscale phospholipid-based particles secreted by cells and are essential mediators responsible for intercellular signal communication. The rapid development of EV nanotechnology has brought unprecedented opportunities for nanomedicine. Among various administration methods, oral administration is the most convenient and simplest. However, most drugs (peptides, small molecule drugs, nucleic acids, and therapeutic proteins) greatly reduce their oral bioavailability due to the harsh gastrointestinal environment. Notably, some EVs have been shown to cross biological barriers, including the gastrointestinal tract (GIT). The distinctive biological properties of EVs make them a promising natural carrier for oral drug delivery. This review introduces the characteristics of EVs, covering their classification, production methods, and therapeutic efficacy in oral administration. Additionally, we explore the potential roles of EVs in disease prevention and treatment, as well as their future prospects in pharmaceutical applications. This comprehensive overview aims to provide insights into the application of EVs in oral drug delivery, highlighting their advantages, current progress, and the challenges that need to be overcome for successful clinical translation.

Bitot-like Spots and Congenital Aniridia: A Case Report

Background: Bitot’s spots, defined as white foamy triangular or round-shaped spots with the base located at the temporal limbus and the apex towards the lateral canthus, were initially associated with vitamin A deficiency (VAD). More recently, Bitot’s spots were also described in patients with normal vitamin A levels, associated with aniridia, dry-eye syndrome and post-thermal or chemical injury, as well as the usage of benzalkonium chloride (BAK) eyedrops. The aim of this article is to present the management of Bitot-like spots in a patient with congenital aniridia. Methods: An 8-year-old female patient with type 1 congenital aniridia, glaucoma, cataract, strabismus, congenital nistagmus and aniridia-associated keratopathy presented with changes in conjunctival appearance. The ophthalmological examination revealed Bitot-like spots with a foamy appearance, triangular shape, temporal location and proximity to the limbus. Further investigations were required in order to identify the cause of Bitot-like spots. Vitamin D deficiency, dry-eye syndrome, birch and Phleum genus pollen allergy were diagnosed. The patient underwent oral medication with vitamin D and topical treatment with steroids eye solution, preservative-free artificial tears and vitamin A ointment. Results: After three months of treatment, we observed the disappearance of the Bitot-like spots. Conclusions: Congenital aniridia, but also its complications such as glaucoma, dry-eye syndrome and the use of benzalkonium chloride topical medication, increases the risk of Bitot-like spots.

An Integrative approach in the management of Uncontrolled type 2 Diabetes Mellitus w.s.r. to Sthula Madhumeha: A Case Report

Introduction: Diabetes is a disease of worldwide importance and a major public healthcare concern owing to its associated morbidity. Clinically Type 2 DM resembles Madhumeha with prevalence in India was 9.6% in 2021.This case report describes an integrated approach for the treatment of uncontrolled diabetes mellitus. Main clinical Findings: A 58-year-old male patient complained of polyurea, polyphagia, polydipsia, tingling, and severe burning in all 4 limbs, fatigue, and constipation. Investigations shows FBSL level of 247mg/dl, PPBSL 415mg/dl, and HbA1C 8.9%, BMI 28.6kg /m2. Diagnosis: Sthula-Madhumeha (Type 2 Diabetes Mellitus). Interventions: Treatment includes, Panchatiktapanchaprasutika Basti for consecutive 15 days (Kalbasti Krama), local therapy, oral medications and lifestyle modifications. Outcome: Patient showed marked reduction in FBSL reduced to 82mg/dl PPBSL to 184mg/dl, and HbA1c to 6.8% after 3 months. Patient exhibited significant results in clinical signs and symptoms. Conclusions: It can be concluded that Ayurvedic intervention can be a complimentary treatment in uncontrolled DM.

Gastrointestinal autonomic neuropathy in patients with type 2 diabetes mellitus: features of diagnosis and treatment

Diabetes mellitus (DM) type 2 is one of the components of metabolic syndrome. One of the most common complications of type 2 diabetes is diabetic neuropathy, which results in damage to peripheral and/or autonomic nerve fibers. Disorders of the autonomic nervous system - diabetic autonomic neuropathy (DAN)-can occur in up to 60% of patients. One form of GAN is gastrointestinal autonomic neuropathy (GAN). There is no exact information about its prevalence due to the complexity of diagnosis, but according to some data, symptoms occur in half of patients with diabetes. The main manifestations of GAN are esophageal motility disorders (heartburn, reflux), gastroparesis (nausea, vomiting, feeling of fullness), intestinal motility disorders (diarrhea, constipation), anorectal dysfunction (fecal incontinence). Impaired gastrointestinal motility, in particular gastroparesis, leads to changes in the pharmacokinetics of oral glucose-lowering drugs, which reduces their effectiveness. And in patients receiving insulin therapy, impaired movement of food through the gastrointestinal tract can lead to hypoglycemia. In this regard, identifying and treating manifestations of GAN is an important aspect of managing a patient with type 2 diabetes. Diagnosis of GAN should be aimed at excluding other causes of gastrointestinal disorders and includes, depending on the clinical manifestations, fibrogastroduodenoscopy, barium radiography, colonoscopy, etc. The “gold standard” for diagnosing gastroparesis is considered to be measuring gastric emptying using scintigraphy of digested solids, but due to the high cost and complexity of the procedure, this method is not used in routine practice. The main therapeutic measures in the management of patients with diabetes and GAN are glycemic compensation, compliance with nutritional recommendations, treatment of neuropathy and symptomatic therapy.

Population characteristics, prescription patterns and glycemic control of users of flash glucose monitoring systems in Brazil: a real-world evidence study

BackgroundTo date, there is a lack of information on the use of flash glucose monitoring system (fCGM) in low-middle income countries, such as Brazil, as well as on digital health platforms most used to calculate the bolus insulin dose. In this study, we aimed to describe the population characteristics, prescription patterns and glycemic control of fCGM users compared to blood glucose monitoring (BGM) system in those who use Glic™, a digital health platform in Brazil, and to assess factors associated with better glycemic control in this population.MethodsThis study is a cross-sectional retrospective study using anonymized aggregated data manually inputted by Glic™ users who self-reported a diagnosis of type 1 diabetes (T1DM), type 2 diabetes (T2DM), gestational diabetes (GDM) and latent autoimmune diabetes in adults (LADA).ResultsOf the 12,727 individuals included in this study, 11,007 (86.5%) reported their glucose monitoring method to be BGM, while 1720 (13.5%) reported using fCGM. Most individuals (70.5%) had T1DM. Compared to BGM, fCGM users were significantly younger, had a higher proportion of males, resided more frequently in the Southeast region of Brazil, had a lower BMI, a longer time since diagnosis, and used Glic™ platform more frequently. fCGM users were prescribed significantly more ultra-long and ultra-rapid acting insulins as their basal and bolus insulin, respectively, and less oral anti-diabetics drugs compared to BGM users. Considering only the T1DM and LADA individuals and their manual glucose inputs, fCGM users had non-significant lower glucose levels than BGM. Use of Glic™ platform and a higher percentage of basal insulin dose were associated with a better glycemic control.ConclusionThis is the first and largest real-world evidence study that describe and compare fCGM and BGM in users of a digital health patient support platform in Brazil. fCGM users were significantly different from those who perform BGM, in terms of population characteristics and treatment patterns. Glycemic control was better in fCGM users, although not statistically significant due to a restricted sample size. Importantly, a higher frequency of Glic™ use was associated with a higher glucose time in range.

Population profile and glycemic control following initiation or switch of injectable therapies in Tianjin, China: A real-world retrospective cohort study of adults with type 2 diabetes.

To evaluate characteristics and glycemic outcomes in individuals with type 2 diabetes using injectable therapies in real-world clinical practice in Tianjin, China. Data from inpatients and outpatients receiving injectable therapies between January 2015 and December 2019 were collected from the Tianjin regional electronic medical records and retrospectively analyzed. Seven cohorts were identified, including individuals initiating injectable therapies (premixed insulin [n = 4,687], basal insulin [4,177], or glucagon-like peptide-1 receptor agonists [541]) or switching injectable therapies (premixed insulin to basal insulin [1,298], basal insulin to premixed insulin [1,457], basal insulin to basal + bolus insulin [1,772], or glucagon-like peptide-1 receptor agonists to basal insulin ± glucagon-like peptide-1 receptor agonists [82]). In participants initiating therapy, glycated hemoglobin and fasting plasma glucose were highest in the basal insulin cohort, while among participants switching therapy, the highest values were in the basal insulin ± glucagon-like peptide-1 receptor agonists cohort. Initiating therapy with premixed or basal insulin and switching from basal insulin to basal + bolus insulin improved glycemic control over 12 months. A mean delay in initiating therapy of up to 13 months after oral glucose-lowering drug failure was observed, with 60% having a delay of >6 months. This delay was associated with a lower proportion achieving glycemic control 3 months after initiation. Effectiveness was not observed at all time points in all cohorts, suggesting some treatments were not used in the appropriate population. Delays in initiating injectable therapies were observed and were associated with poor glycemic control.

Inpatient Metformin Utilization and Post-hospitalization Clinical Outcomes: An Observational Cohort Study.

Metformin is the first-line treatment for diabetes, with multiple long-term benefits. However, there is limited evidence for its use in the inpatient setting, and clinical guidelines have historically recommended holding oral diabetes medications during acute hospitalization. While studies have not found evidence of harm from continuing metformin during hospitalization, withholding may lead to unnecessary insulin prescriptions, which in turn may lead to hypoglycemia events after discharge and other associated complications. To investigate the association between metformin use during hospitalization and post-hospitalization outcomes. Observational cohort study from January 2016 to January 2022, emulating a target trial. Adults with type 2 diabetes admitted to a Veterans Health Administration hospital for common medical conditions. Continuation of an outpatient metformin prescription during hospitalization. Hypoglycemia within 90 days of discharge. Secondary outcomes included insulin prescriptions at discharge, 90-day readmissions, and 90-day mortality. The propensity-matched cohort included 67,162 hospitalizations, equally split between those who did and did not have metformin continued during hospitalization. Within 90 days of hospital discharge, those that received metformin had lower risk of hypoglycemia (1.5% vs 1.8%; OR 0.83, 95% CI 0.73-0.93; p = 0.003), readmissions (29.4% vs 30.6%; OR 0.96, 95% CI 0.92-1.00; p= 0.03), and mortality (6.4% vs 7.4%; OR 0.86, 95% CI 0.80-0.92; p <0.001). Patients receiving metformin also had lower risk of insulin prescriptions at discharge (18.5% vs 20.3%; OR 0.89, 95% CI 0.84-0.95; p<0.001). Continuation of metformin during hospitalization for patients with type 2 diabetes was associated with decreased risk of post-hospitalization insulin prescriptions and 90-day hypoglycemia, readmissions, and mortality. These findings question clinical guideline recommendations to hold metformin during hospitalization.

In vitro α-Glucosidase Inhibition, Cytotoxicity, SAR, Swiss ADME Prediction and Molecular Docking Study of New N-Substituted Hydantoin Derivatives.

Diabetes is a chronic metabolic disorder affecting about 463 million people globally. α-Glucosidase (EC.3.2.1.20) inhibitors are among the FDA-approved oral anti-diabetic medications used to treat type 2 diabetes. In search of new potential α-glucosidase inhibitors, fifteen of our previously synthesized hydantoin derivatives 8 a-o were evaluated for their antidiabetic activity. All compounds 8 a-o showed weak α-glucosidase inhibition at 10, 50 and 100 μM. However, at 200 μM, compound 8 o was the most potent among the series followed by compounds 8 a, 8 d, 8 l and 8 n exhibiting moderate inhibition. The established SAR depended upon the exchange of methyl with methoxy and dioxole derivatives at positions 3 and 4 of the phenyl ring. Cytotoxicity studies revealed that most of the compounds have no cytotoxic effect. Furthermore, Swiss ADME predictions of compounds 8 a, 8 d, 8 i, 8 l and 8 o showed high gastrointestinal intestinal absorption required for intestinal absorption of any drug. Most compounds did not obey drug-likeness character since they violated Ghose and Veber rules with MW>350 and rotors>11. Molecular docking was carried out to investigate the binding interaction of compounds with the active site of α-glucosidase. The results correlated well with those of the experimental, thereby contributing towards the development of new α-glucosidase inhibitors.

A Scoping Review of the Oral Treatment Options for the Management of Detrusor Sphincter Dyssynergia.

Adult neurogenic lower urinary tract dysfunction may be associated with detrusor sphincter dyssynergia (DSD). Given the sparsity of the literature and the absence of official guidelines regarding the use of oral medications in the management of DSD, this scoping review aims to critically assess the available evidence to guide future research and practice. We conducted a systematic scoping review of articles published from 1950 to July 2023 using PubMed, MedLine, Scopus and CINAHL databases to assess all oral treatment options for DSD. All study designs were included. The search was limited to English and French literature regarding human patients over 18 years of age with DSD. Of the 899 records screened, 15 studies were included, involving a total of 257 participants. Alpha-adrenergic blockers, nitric oxyde and muscle relaxants have been used in the treatment of DSD. A decrease of postvoid residual volumes and an improvement of symptom scores as well as urine flow rates were reported in several studies. Regarding the alpha-adrenergic blockers, five of the six studies that detailed postvoid residual volumes and subjective improvement noted benefits in most patients. Additionally, two of the three studies that addressed mean flow rate observed improvements in most patients. All six studies that documented adverse effects found side effects in only a slight minority of patients. Alpha-adrenergic blockers are promising, but there is lacking evidence on the oral treatment of DSD. This study highlights the importance of conducting more studies to draw solid conclusions and stop treating these patients empirically.

Oral TIX100 protects against obesity-associated glucose intolerance and diet-induced adiposity.

Glucagon-like peptide 1 receptor agonists and dual agonists have changed the treatment landscape of obesity and type 2 diabetes (T2D), but significant limitations have emerged due to their gastrointestinal side effects, loss of lean mass, and necessity for ongoing subcutaneous injections. Our objective was, therefore, to test a novel small molecule as a different and potentially better tolerated oral medications to improve obesity-associated impairment in glucose homeostasis. High-fat diet (HFD)-fed mice or severely obese, leptin-deficient ob/ob mice were randomly assigned to serve as controls or receive oral TIX100, a novel thioredoxin-interacting protein (TXNIP) inhibitor just approved by the FDA as an investigational new drug for type 1 diabetes (T1D). The TIX100 effects on glucose intolerance and weight control were then assessed. TIX100 protected against HFD-induced glucose intolerance, hyperinsulinemia, and hyperglucagonemia. TIX100 also reduced diet-induced adiposity resulting in 15% lower weight in treated mice as compared with controls on HFD (p <0.05), while preserving lean mass. Even though the TIX100 weight effects were lost in ob/ob mice, TIX100 improved glucose control leading to a dramatic 2.3% reduction in HbA1C (p <0.05), independent of any weight loss. This is consistent with the beneficial effects of TIX100 in non-obese diabetes models and its protection against elevated TXNIP and islet cell stress common to all diabetes types. Thus, TIX100 may provide a novel, oral therapy for T2D that targets underlying disease pathology including islet cell dysfunction and hyperglucagonemia and promotes metabolic health and weight control without aggressive weight loss.

AI-Driven Innovation in Skin Kinetics for Transdermal Drug Delivery: Overcoming Barriers and Enhancing Precision

Transdermal drug delivery systems (TDDS) offer an alternative to conventional oral and injectable drug administration by bypassing the gastrointestinal tract and liver metabolism, improving bioavailability, and minimizing systemic side effects. However, widespread adoption of TDDS is limited by challenges such as the skin’s permeability barrier, particularly the stratum corneum, and the need for optimized formulations. Factors like skin type, hydration levels, and age further complicate the development of universally effective solutions. Advances in artificial intelligence (AI) address these challenges through predictive modeling and personalized medicine approaches. Machine learning models trained on extensive molecular datasets predict skin permeability and accelerate the selection of suitable drug candidates. AI-driven algorithms optimize formulations, including penetration enhancers and advanced delivery technologies like microneedles and liposomes, while ensuring safety and efficacy. Personalized TDDS design tailors drug delivery to individual patient profiles, enhancing therapeutic precision. Innovative systems, such as sensor-integrated patches, dynamically adjust drug release based on real-time feedback, ensuring optimal outcomes. AI also streamlines the pharmaceutical process, from disease diagnosis to the prediction of drug distribution in skin layers, enabling efficient formulation development. This review highlights AI’s transformative role in TDDS, including applications of models such as Deep Neural Networks (DNN), Artificial Neural Networks (ANN), BioSIM, COMSOL, K-Nearest Neighbors (KNN), and Set Covering Machine (SVM). These technologies revolutionize TDDS for both skin and non-skin diseases, demonstrating AI’s potential to overcome existing barriers and improve patient care through innovative drug delivery solutions.

Effects of Oral Macrocyclic Lactone Heartworm Preventatives on Retinal Function and Chromatic Pupillary Light Reflex in Healthy Companion Dogs.

Determine the effect of oral macrocyclic lactone heartworm-preventative medications on retinal function and chromatic pupillary light reflex (cPLR) in healthy dogs. Cross-sectional retrospective: 60 dogs (n = 33 females) with heartworm medication administration status and electroretinogram (ERG) data available. Prospective clinical study: 25 dogs (n = 10 females) had ERG performed, 18 of which had cPLR performed. Retrospective: ERG amplitudes/peak times were compared between dogs that had or had not received oral heartworm preventatives. Bivariate and multiple variable linear regression models were used to evaluate relationships between ERG testing and heartworm preventive administration status, age, and sex. ERG and cPLR testing were performed at a baseline visit (minimum 14 days since last preventative administration), and a second visit where ERG/cPLR testing was performed 4 h after oral preventative administration. Mixed effects models and Mann-Whitney U statistics were performed. Retrospective: There was no association between heartworm preventive administration status and ERG amplitudes or peak times (all p-values > 0.12). Heartworm preventative had no effect on light- and dark-adapted ERG amplitudes or peak times (all p-values > 0.56). Similarly, there was no effect on baseline pupil size (p = 0.83), nor on cPLR (p = 0.32). No significant effects of oral macrocyclic lactones on retinal/cPLR function at preventative doses were identified. While small effects on retinal/cPLR function cannot be completely ruled out, it remains unlikely that these medications cause clinically significant visual deficits at prescribed doses, and proven antiparasitic benefits likely far outweigh small potential ophthalmic risks of administration.

Using Therapeutic Play to Increase the Oral Administration Adherence Rate of Preschool Pediatric Inpatients

Oral administration is the most common mode of medical treatment for pediatric patients. Although over 98% of the patients in the targeted pediatric unit require oral medication, the oral administration adherence rate in 2022 was 43.9%. The reasons for this low rate were identified as: (1) no relevant oral administration educational materials, (2) no relevant continued nursing education provided, and (3) lack of assistive tools and feeding aids to help administer oral medication to young children. This project was developed to increase the adherence rate of oral administration of preschool pediatric inpatients in our hospital. The improvement strategies included the design of patient-centered oral medication care guidance leaflets and QR code (quick response code) video links, the development of therapeutic play aids, adding cartoon characters to medicine feeders, and the creation of a "Rescue the Forest" picture book and video and reward stickers. The oral medication adherence rate increased from 43.9% pretest to 91.9% posttest. This project and its positive effect on the rate of oral medication adherence may be referenced by other pediatric units.

New Insights into Antiviral Natural Formulations: Biopolymeric Films for the Prevention and Treatment of a Wide Gamma of Viral Infections

Viral infections remain a major concern, as existing treatments often yield inadequate responses or lead to the development of antiviral resistance in some cases. Fucoidan extracted from Undaria pinnatifida (F) is a natural sulphated polysaccharide that exhibits antiviral action. Despite its potential, the biomedical application of F is limited due to its difficult administration through trans-mucosal, skin, or oral ingestion. The most effective way to solve these problems is to propose novel methods of administration aiming to ensure better contact between the biopolymers and pathogens, leading to their inactivation. In this work, the synthesis of films based on chitosan (Ch)-coupled F is reported, aiming to generate a synergic effect between both biopolymers in terms of their antiviral and antioxidant capability. Biocomposites were prepared by a sonochemical method. They were characterized to infer structural properties, functionality, and possible F-Ch interactions by using Zeta potential, FTIR, and XRD techniques. The biocomposites showed excellent film-forming ability. They also exhibited improved antioxidant activity with respect to F and Ch individually and proved to be non-cytotoxic. These results demonstrate, for the first time, the antiviral activity of F:Ch biocomposites against bovine coronavirus and human viruses (adenovirus, poliovirus, herpes simplex, and respiratory syncytial virus), which could be applied in film form to prevent or treat viral infections.

Recent development of micro-nano carriers for oral antineoplastic drug delivery.

Chemotherapy is widely recognized as a highly efficacious modality for cancer treatment, involving the administration of chemotherapeutic agents to target and eradicate tumor cells. Currently, oral administration stands as the prevailing and widely utilized method of delivering chemotherapy drugs. However, the majority of anti-tumor medications exhibit limited solubility and permeability, and poor stability in harsh gastrointestinal environments, thereby impeding their therapeutic efficacy for chemotherapy. Therefore, more and more micro-nano drug delivery carriers have been developed and used to effectively deliver anti-cancer drugs, which can overcome physiological barriers, facilitate oral administration, and ultimately improve drug efficacy. In this paper, we first discuss the effects of various biological barriers on micro-nano drug carriers and oral administration approach. Then, the development of micro-nano drug carriers based on various biomedical components, such as micelles, dendrimers, hydrogels, liposomes, inorganic nanoparticles, etc. were introduced. Finally, the current dilemma and the potential of oral drug delivery for clinical treatment were discussed. The primary objective of this review is to introduce various oral delivery methods and serve as a point of reference for the advancement of novel oral delivery carriers, with the ultimate goal of informing the development of future clinical applications.

Parents' experiences on handling paediatric anticancer drugs at home after an educational intervention.

The shift of treatment of paediatric cancer patients to include more care at home puts a lot of pressure on health care professionals (HCPs) to prepare and train parents on safe and correct drug handling at home. Parents must take in and understand the information presented to them while coping with their own fear related to their child's cancer diagnosis. In Sweden, parents are expected to handle and manipulate oral anticancer drugs (OADs) in the home setting. There is however a lack of a standardized method to inform and educate parents on how to handle OADs in a correct way at home. To describe parents' experiences of handling OADs at home after participating in an educational intervention. Educational intervention in the present study aimed to improve parents' knowledge in key concepts that is, handling OADs at home by using information presented in different forms. Fifteen parents to 12 children with cancer were recruited from a paediatric oncology ward in Sweden to participate in an interview. The interviews were transcribed verbatim and subjected to qualitative content analysis. Parents' experiences are presented in categories: Relieved stress, Awareness of own exposure, Facilitated my everyday life, Parents need continued support individually. The educational intervention resulted in both positive and negative feelings, increased awareness of drug exposure and correct drug handling at home. Practical training and information presented in different ways facilitated the process of drug handling. To handle the drug correctly at home parents requested to be trained and informed in the beginning of their child's oral drug treatment. In addition, parents requested to be individually approached by HCP to get answers to questions and concerns. This educational intervention study shows promising results for the method used by HCPs to inform and educate parents on complicated topics such as handling OADs at home.

Tolerance of Centrifuge-Simulated Spaceflight in Individuals with Diabetes Mellitus

INTRODUCTION: There is increasing interest in the screening and evaluation of individuals with underlying medical conditions for participation in commercial spaceflight, including those with diabetes mellitus. Diabetes risks incapacitation through hypoglycemic or hyperglycemic events. Limited analog data exist regarding tolerance of spaceflight in diabetics; here we evaluated diabetic tolerance of centrifuge-simulated spaceflight. METHODS: Aggregated data from diabetic volunteers in prior studies of centrifuge-simulated spaceflight were compared to nondiabetic subjects. There were 20 (3 women) diabetic volunteers, with glycemic control methods including diet, oral medications, and insulin, who met screening criteria for inclusion and participated in up to 7 centrifuge profiles. Heart rate data collected prior to and during centrifuge spins and subjective postspin symptom questionnaires were analyzed. RESULTS: Diabetic layperson subjects demonstrated similar hypergravity tolerance compared to nondiabetic laypersons. Two diabetic subjects did not complete all available profiles: one for nausea and one for scheduling constraints. Glycemic control methods (insulin vs. noninsulin) were not associated with differences in tolerance. There were no statistical differences in vital signs or symptoms. One subject had transient symptoms possibly related to hypoglycemia in the setting of decreased oral intake. DISCUSSION: Diabetes poses a risk of incapacitation in high performance environments. Even so, these data suggest that, with appropriate screening and stratification, diabetic individuals can successfully tolerate spaceflight hypergravity exposures. Further research may allow for inclusion of diabetic individuals in future spaceflight. King SA, Blue RS. Tolerance of centrifuge-simulated spaceflight in individuals with diabetes mellitus. Aerosp Med Hum Perform. 2025; 96(2):101–110.