Treatment Of Chronic Disease Research Articles

Evaluating the Safety and Efficacy of Ticagrelor vs. Clopidogrel Following Percutaneous Coronary Intervention in Chronic Coronary Disease

Evaluating the Safety and Efficacy of Ticagrelor vs. Clopidogrel Following Percutaneous Coronary Intervention in Chronic Coronary Disease

Benefits Of Omega-3 In Peruvian Anchoveta: A Review Of Its Impact On Health

Objectives: The objective of the research was to analyze the current state of knowledge about Omega-3 in the Peruvian anchovy to understand its positive effects on health and promote its adequate consumption. Theoretical framework: The Omega-3 fatty acid present in the Peruvian anchovy is widely known by the scientific community, but its information has not been disseminated enough to know its positive effects in the treatment of inflammatory and autoimmune diseases. Method: The positive effects of Omega-3 fatty acid on health were explored from various perspectives, highlighting its anti-inflammatory action and potential in the prevention and treatment of chronic diseases. Results and discussion: The anchovy, abundant in the Peruvian sea and economic for its availability of catch by the fishing fleet, offers an accessible alternative without compromising the nutritional content, especially relevant in regions with low economy where other sources of Omega-3 are unreachable. It is concluded that anchovy is an accessible source of Omega-3 with considerable nutritional and economic value. Consumption improves public health by preventing chronic and autoimmune diseases. Implications of research: Promote public health policies that include anchovy to maximize its benefits to society, especially in vulnerable populations by ensuring food security and access to low-cost animal protein. Originality/Value: It is essential to promote public health policies that include anchovy in accordance with the ecosystem approach applied to fisheries, food security and sustainable development goals. a rethinking of dietary recommendations is suggested, especially in vulnerable populations in Peru.

Physical factors in treatment of inflammatory diseases of female reproductive system: Principles and approaches

Physical therapy methods have found wide application in various fields of clinical medicine, including when treating various diseases and pathological conditions of the female body. The vast majority of studies deals with the issues of the drug-free treatments of chronic inflammatory diseases of the lesser pelvis organs, which negatively impact the health of women of reproductive age. It should be noted that the works dealing with the possibility and evaluation of the effectiveness of including physical therapy methods in the combination treatment of the acute stage of nonspecific inflammatory diseases of the lesser pelvis organs are less numerous. A number of works on the use of the hyperbaric oxygenation and general magnetic therapy as components of combination therapy in forming the therapeutic effect deal with this area of research. The article presents the basic principles of using physical therapy modalities in gynecology and the conditions for optimizing the results of treatment of gynecological patients, including the results of combination therapy with the earliest possible integration of physical therapy modalities in the programs of standard anti-inflammatory treatment of patients with acute nonspecific inflammatory diseases of the lesser pelvis organs, allowing to optimize its efficacy.

Recent Advances of Macrostructural Porous Silicon for Biomedical Applications.

Porous silicon (pSi) has gained substantial attention as a versatile material for various biomedical applications due to its unique structural and functional properties. Initially used as a semiconductor material, pSi has transitioned into a bioactive platform, enabling its use in drug delivery systems, biosensing, tissue engineering scaffolds, and implantable devices. This review explores recent advancements in macrostructural pSi, emphasizing its biocompatibility, biodegradability, high surface area, and tunable properties. In drug delivery, pSi's potential for controlled and sustained release of therapeutic agents has been well-studied, making it suitable for chronic disease treatment. Innovative approaches, like microneedle arrays and hybrid drug delivery systems, are highlighted, along with challenges, such as scalability and stability, in biological environments. pSi-based biosensors offer exceptional sensitivity for detecting biomarkers, benefiting early disease diagnosis. In tissue engineering, fibrous and particulate pSi scaffolds mimic the extracellular matrix, promoting cell proliferation and tissue regeneration. pSi is also gaining momentum in orthopedic implants, demonstrating the potential for bone regeneration. Despite its promise, challenges like mechanical strength, scalability, and long-term stability must be addressed. Looking forward, future research should focus on optimizing production methods, enhancing stability, and exploring hybrid materials for pSi, paving the way for its widespread clinical use in personalized medicine, advanced drug delivery, and next-generation biosensors and implants.

Managing risk factors and early intervention for chronic kidney disease.

Managing risk factors and early intervention for chronic kidney disease.

In-vitro approaches to evaluate the anti-inflammatory potential of phytochemicals: A Review

Phytochemicals, bioactive compounds derived from plants, have drawn considerable attention for their ability to modulate inflammatory pathways, presenting promising alternatives for the treatment of chronic inflammatory diseases. Inflammation, a complex biological response to injury or infection, involves a cascade of cellular and molecular events mediated by enzymes, cytokines, and reactive species. In vitro assays provide an essential platform for screening and investigating the anti-inflammatory potential of phytochemicals, offering valuable insights into their mechanisms of action. Commonly used techniques include the inhibition of protein denaturation and membrane stabilization, which evaluate the ability of compounds to prevent structural damage to proteins and cell membranes. Enzymatic assays, such as cyclooxygenase (COX) and 5-lipoxygenase (5-LOX) inhibition tests, focus on the suppression of key enzymes involved in arachidonic acid metabolism, thereby reducing the production of pro-inflammatory mediators like prostaglandins and leukotrienes. Other assays, like proteinase and hyaluronidase inhibition tests, assess the ability of compounds to block enzymes contributing to tissue degradation and inflammation. These assays offer robust, reproducible frameworks for evaluating phytochemicals in preclinical research, helping to identify compounds with potential therapeutic value. However, their limitations, such as lack of in vivo context and inter-assay variability, necessitate their integration with complementary studies to validate findings and understand their translational significance. Keywords: Phytochemicals, in vitro methods, anti-inflammatory activity, protein denaturation, membrane stabilization

Network pharmacology and multi-omics validation of the Jianpi-Yishen formula in the treatment of chronic kidney disease

ObjectiveChronic kidney disease (CKD) is a major global health problem. In clinical practice, the Chinese patent herbal medicine Jianpi-Yishen (JPYS) formula is commonly used to treat CKD. However, the molecular mechanisms by which JPYS targets and modulates the host immune response remain unclear.MethodsThis study utilized network pharmacology, RNA sequencing (RNA-seq), and metabolic analyses using in vivo and in vitro models to investigate the impact of the JPYS formula on inflammation and the immune system. Specifically, the study focused on macrophage polarization and metabolic changes that may slow down the progression of CKD.ResultsA total of 14,946 CKD-related targets were identified from the GeneCards and Online Mendelian Inheritance in Man (OMIM) databases through network pharmacology analyses. 227 potential targets of the JPYS formula were predicted using the TCMSP database. Additionally, network diagram demonstrated that 11 targets were associated with macrophage activity. In vivo studies indicated that the JPYS formula could reduce blood urea nitrogen and serum creatinine in adenine-induced CKD rats. Furthermore, the formula inhibited inflammatory damage and abnormal macrophage infiltration in this CKD model. RNA-seq, proteomic and metabolic analyses identified the regulation of amino acid metabolism by betaine, specifically referring to glycine, serine, and threonine metabolism, as a key target of the JPYS formula in slowing the progression of CKD. In addition, in vitro studies suggested that JPYS may enhance tryptophan metabolism in M1 macrophage polarization and betaine metabolism in M2 macrophage polarization.ConclusionsThe JPYS formula has been shown to have beneficial impact on CKD; a key mechanism is the mitigation of inflammatory damage through the interaction between amino acid metabolism and macrophage polarization. Of specific importance in this context are the roles of tryptophan in M1 polarization and betaine in M2 polarization.

Toward efficient slide-level grading of liver biopsy via explainable deep learning framework.

In the context of chronic liver diseases, where variability in progression necessitates early and precise diagnosis, this study addresses the limitations of traditional histological analysis and the shortcomings of existing deep learning approaches. A novel patch-level classification model employing multi-scale feature extraction and fusion was developed to enhance the grading accuracy and interpretability of liver biopsies, analyzing 1322 cases across various staining methods. The study also introduces a slide-level aggregation framework, comparing different diagnostic models, to efficiently integrate local histological information. Results from extensive validation show that the slide-level model consistently achieved high F1 scores, notably 0.9 for inflammatory activity and steatosis, and demonstrated rapid diagnostic capabilities with less than one minute per slide on average. The patch-level model also performed well, with an F1 score of 0.64 for ballooning and 0.99 for other indicators, and proved transferable to public datasets. The conclusion drawn is that the proposed analytical framework offers a reliable basis for the diagnosis and treatment of chronic liver diseases, with the added benefit of robust interpretability, suggesting its practical utility in clinical settings.

Exploring the Therapeutic Landscape: A Narrative Review on Topical and Oral Phosphodiesterase-4 Inhibitors in Dermatology

Phosphodiesterase-4 (PDE4) is involved in the synthesis of inflammatory cytokines that mediate several chronic inflammatory disorders, including psoriasis and atopic dermatitis. In recent years, the therapeutic armamentarium in dermatology has expanded with the introduction of PDE4 inhibitors, both in oral and topical formulations. PDE4 inhibitors have gained increasing interest due to their remarkable safety record and ease of prescription, as evidenced by the recent influx of literature detailing its off-label uses. Apremilast was the first PDE4 inhibitor approved by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for psoriasis, psoriatic arthritis, and oral ulcers of Behcet’s disease. Off-label use has been reported in diverse dermatological conditions, including aphthous stomatitis, chronic actinic dermatitis, atopic dermatitis, cutaneous sarcoidosis, hidradenitis suppurativa, lichen planus, and discoid lupus erythematosus. Roflumilast is a PDE4 inhibitor that was approved by the FDA and the EMA as an oral treatment of chronic obstructive pulmonary disease. Since patent expiration, several generic formulations of oral roflumilast have become available, and various studies have documented its off-label use in psoriasis and other dermatological conditions such as hidradenitis suppurativa, recurrent oral aphthosis, nummular eczema, lichen planus, and Behçet’s disease. Topical roflumilast has received FDA approval for treatment of plaque psoriasis and seborrheic dermatitis. The favorable safety profile encourages its long-term use as an alternative to corticosteroids, addressing the chronic nature of many dermatological conditions. New oral PDE4 inhibitors are being developed, such as orismilast (LEO-32731), mufemilast (Hemay005), difamilast (OPA-15406) or lotamilast (E6005/RVT-501), among others. This narrative review provides a comprehensive synthesis of the pharmacology, clinical efficacy, safety profile, and practical considerations regarding the oral and topical use of PDE4 inhibitors in dermatology.

Continuous increase in podocyte numbers in the first 36months of life-insights from forensic autopsies in Japanese children.

Podocyte depletion is a critical factor in glomerulosclerosis development. While podocyte numbers per glomerulus typically decline with age in adults, they are hypothesized to increase during childhood. However, studies on podocyte number progression in childhood have been limited. This retrospective analysis examined forensic autopsy cases of Japanese children without kidney disease, aged under 192months, between April 2010 and March 2023. Podocytes were identified using immunostaining with an anti-transducin-like enhancer of split 4 antibody and p57. Podometric parameters were estimated using the correction factor method, allowing estimation from a single histologic section. This study included 68 cases with a median age of 9months (interquartile range [IQR], 4-78). All podometric parameters correlated with age. Children younger than 36months displayed significantly fewer podocyte numbers per glomerulus (median, 517; IQR, 483-546) compared to those aged 36months and older (median, 616; IQR, 595-649; p < 0.001). Regression analysis revealed a significant age-related increase in podocyte numbers per glomerulus in children under 36months (slope, 3.76; p < 0.001; 95% confidence interval [CI], 2.34-5.19), but not in those aged 36months and older (slope, 0.25; p = 0.16; 95% CI, - 0.10-0.61). Additionally, the change in the slope at 36months was significant (p < 0.001; 95% CI, 1.02-2.49); however, this increase did not appear linked to podocyte division. Podocyte numbers per glomerulus increased from birth until 36months and then stabilized. These findings could facilitate the development of novel treatments for chronic kidney disease caused by glomerulosclerosis and contribute to pediatric kidney health research.

Inhalable Mucociliary-On-Chip System Revealing Pulmonary Clearance Dynamics in Nanodrug Delivery.

The development of a inhaled nanodrug delivery assessment platform is crucial for advancing treatments for chronic lung diseases. Traditional in vitro models and commercial aerosol systems fail to accurately simulate the complex human respiratory patterns and mucosal barriers. To address this, we have developed the breathing mucociliary-on-a-chip (BMC) platform, which replicates mucociliary clearance and respiratory dynamics in vitro. This platform allows for precise analysis of drug deposition and penetration, providing critical insights into how liposomes and other nanocarriers interact with lung tissues under various airflow conditions. Our results reveal that liposomes penetrate deeper into the cellular layer under high shear stress, with both static and dynamic airflows distinctly affecting their drug release rates. The BMC platform integrates dynamic inhalation systems with mucociliary clearance functionality, enabling a comprehensive evaluation of drug delivery efficacy. This approach highlights the importance of airflow dynamics in optimizing inhalable nanodrug delivery systems, improving nanocarrier design, and tailoring drug dosages and release strategies. The BMC platform represents a significant advancement in the field of inhaled nanodrug delivery, offering a more accurate and reliable method for assessing the performance of therapies. By providing a detailed understanding of drug interactions with lung tissues, this platform supports the development of personalized inhaled therapies and offers promising strategies for treating pulmonary diseases and advancing nanodrug development.

Enhancing stability, bioavailability and nutritional intervention effect of procyanidins using bio-based delivery systems: A review.

Procyanidins (PCs), a kind of polyphenolic compound, have attracted extensive attention due to their strong antioxidant, anti-inflammatory and other activities. However, PCs are susceptible to complex micro-environments, resulting in low stability, poor target tissue delivery and bioavailability, which limits their biological effects. Therefore, it is urgent to find some suitable pathways to protect PCs, avoid their degradation, and maximize their health benefits in nutritional intervention. This review focused on the design and construction of different types of bio-based delivery systems loaded with PCs, such as nanoparticles, microparticles, emulsions, liposomes, hydrogels and fibers. The advantages and biological effects of PCs-based delivery systems in promoting cellular uptake, realizing targeted release of organs, cells and organelles, and even nutritional intervention for different chronic diseases were summarized. Furthermore, the development prospects and challenges of delivery systems in the field of precision nutrition were discussed. The construction of these delivery systems can effectively improve the stability and bioavailability of PCs, and maximize their precise nutritional intervention for various chronic diseases.

Health recommender systems to facilitate collaborative decision-making in chronic disease management: A scoping review.

Health recommender systems (HRSs) are increasingly used to complement existing clinical decision-making processes, but their use for chronic diseases remains underexplored. Recognizing the importance of collaborative decision making (CDM) and patient engagement in chronic disease treatment, this review explored how HRSs support patients in managing their illness. A scoping review was conducted using the framework proposed by Arksey and O'Malley, advanced by Levac et al., in line with the PRISMA-ScR checklist. Quantitative (descriptive numerical summary) and qualitative (inductive content analysis) methods wered used to synthesize the data. Forty-five articles were included in the final review, most commonly covering diabetes (9/45, 20%), mental health (9/45, 20.0%), and tobacco dependence (7/45, 15.6%). Behavior change theories (10/45, 22.2%) and authoritative sources (10/45, 22.2%) were the most commonly referenced sources for design and development work. From the thematic analysis, we conclude: (a) the main goal of HRSs is to induce behavior change, but limited research investigates their effectiveness in achieving this aim; (b) studies acknowledge that theories, models, frameworks, and/or guidelines help design HRSs to elicit specific behavior change, but they do not implement them; (c) connections between CDM and HRS purpose should be more explicit; and (d) HRSs can often offer other self-management services, such as progress tracking and chatbots. We recommend a greater emphasis on evaluation outcomes beyond algorithmic performance to determine HRS effectiveness and the creation of an evidence-driven, methodological approach to creating HRSs to optimize their use in enhancing patient care. Our work aims to provide a summary of the current landscape of health recommender system (HRS) use for chronic disease management. HRSs are digital tools designed to help people manage their health by providing personalized recommendations based on their health history, behaviors, and preferences, enabling them to make more informed health decisions. Given the increased use of these tools for personalized care, and especially with advancements in generative artificial intelligence, understanding the current methods and evaluation processes used is integral to optimizing their effectiveness. Our findings show that HRSs are most used for diabetes, mental health, and tobacco dependence, but only a small percentage of publications directly reference and/or use relevant frameworks to help guide their design and evaluation processes. Furthermore, the goal for most of these HRSs is to induce behavior change, but there is limited research investigating how effective they are in accomplishing this. Given these findings, we recommend that evaluations shift their focus from algorithms to more holistic approaches and to be more intentional about the processes used when designing the tool to support an evidence-driven approach and ultimately create more effective and useful HRSs for chronic disease management.

Chronic disease costs from a patient’s perspective: A survey of patients with stroke, heart disease, and chronic kidney disease visiting a district hospital in Indonesia

Context: Chronic disease treatment can lead to catastrophic costs. Although most direct medical costs are covered by the National Health Insurance, direct nonmedical and indirect costs may be burdensome for patients. Aims: To estimate the cost of chronic diseases from a patient’s perspective. Methods: A total of 315 patients with stroke (n = 105), heart disease (n = 108), and chronic kidney disease (n = 102) visiting a district hospital in Yogyakarta Province in Indonesia were included in this study. Data were collected through interviews and analyzed using descriptive statistics. Significant differences in mean costs between different groups seeking healthcare facilities were determined using the Mann–Whitney U test. Results: The estimated total out-of-pocket (OOP) costs per patient within three months were IDR 3,411,662 (USD 227.4), IDR 632,665 (USD 42.2), and IDR 3,227,951 (USD 215.2) for stroke, heart disease, and chronic kidney disease, respectively. OOP costs for the three diseases accounted for 9–49% of minimum regional wages. Indirect costs were the highest costs contributing to the total OOP cost (33–64%), followed by direct medical costs (12–57%) and direct nonmedical costs (5–33%). Patients seeking additional treatment at other healthcare facilities tended to have significantly higher costs. Conclusions: This study showed that chronic diseases put a relatively high economic burden on patients. Additionally, seeking more healthcare facilities tends to increase costs.

Defective Mitophagy Impairs Response to Inflammatory Activation of Macrophage-Like Cells.

The role of mitophagy in atherosclerosis has been extensively studied during the last few years. It was shown that mitophagy is involved in the regulation of macrophages, which are important players as immune cells in atherosclerosis development. In this study, we investigated the relationship between mitophagy and response to inflammatory stimulation of macrophage-like cells. Six cybrid cell lines with normal mitophagy, that is, increasing in response to stimulation, and 7 lines with defective mitophagy not responding to stimulation were obtained. The objective of the study was to compare the nature of the inflammatory response in normal and defective mitophagy in order to elucidate the role of mitophagy defects in inflammation. We used cytoplasmic hybrids (cybrids) as cellular models, created using mitochondrial DNA from different atherosclerosis patients. Mitophagy was stimulated by carbonyl cyanide m-chlorophenyl hydrazone (CCCP) and assessed as the degree of colocalization of mitochondria with lysosomes using confocal microscopy. Western blotting methods were used for the determination of proteins involved in the exact mechanism of mitophagy. Experiments with stimulation of mitophagy show a high correlation between these two approaches (microscopy and blotting). The pro-inflammatory response of cybrids was stimulated with bacterial lipopolysaccharide (LPS). The extent of the inflammatory response was assessed by the secretion of cytokines CCL2, IL8, IL6, IL1β, and TNF measured by ELISA. Basal level of secretion of cytokines CCL2, IL8 and TNF was 1.5-2 times higher in cultures of cybrids with defective mitophagy compared to cells with normal mitophagy. This suggests a persistently elevated inflammatory response in cells with defective mitophagy, even in the absence of an inflammatory stimulus. Such cells in the tissue will constantly recruit other immune cells, which is characteristic of macrophages derived from monocytes circulating in the blood of patients with atherosclerosis. We observed significant differences in the degree and type of response to inflammatory activation in cybrids with defective mitophagy. These differences were not so much quantitative as they were dramatically qualitative. Compared with cells with normal mitophagy, in cells with defective mitophagy, the relative (to basal) secretion of IL8, IL6 and IL1b increased after the second LPS activation. This indicates a possible lack of tolerance to inflammatory activation in cells with defective mitophagy, since typically, re-activation reveals a smaller pro-inflammatory cytokine response, allowing the inflammatory process to resolve. In cells with normal mitophagy, exactly this normal (tolerant) inflammatory reaction was observed. Data on the involvement of mitophagy, including defective mitophagy, in disturbances of the inflammatory response in sepsis, viral infections, autoimmune diseases and other pathologies have previously been reported. In this work, we studied the role of defective mitophagy in non-infectious chronic inflammatory diseases using the example of atherosclerosis. We showed a dramatic disruption of the inflammatory response associated with defective mitophagy. Compared with cybrids with normal mitophagy, in cybrids with defective mitophagy, the secretion of all studied cytokines changed significantly both quantitatively and qualitatively. In particular, the secretion of 3 of 5 cytokines demonstrated an intolerant inflammatory response manifested by increased secretion after repeated inflammatory stimulation. Such an intolerant reaction likely indicates a significant disruption of the pro-inflammatory response of macrophages, which can contribute to the chronification of inflammation. Elucidating the mechanisms of chronification of inflammation is extremely important for the search for fundamentally new pharmacological targets and the development of drugs for the prevention and treatment of chronic inflammatory diseases, including atherosclerosis and diseases characteristic of inflammation. Such diseases account for up to 80% of morbidity and mortality.

Treatment of chronic kidney disease in IgA nephropathy

This article provides an overview of treatment approaches for chronic kidney disease (CKD) in patients with IgA nephropathy (IgAN). IgAN is the most common primary glomerulonephritis and results from an autoimmune reaction to aberrantly glycosylated immunoglobulin A (IgA) antibodies. Although historically considered largely benign, it is now recognized that a significant percentage of patients develop dialysis-dependent kidney disease over the years. Traditional treatments with RAAS inhibitors and newer therapies such as SGLT2 inhibitors, endothelin receptor antagonists, and delayed release, primarily locally acting enteric corticosteroids regarding their role in reducing proteinuria and preserving kidney function are also discussed. Additionally, non-immunosuppressive options and lifestyle modifications are examined for their potential to slow disease progression. Further promising medications are currently in clinical trials, including complement inhibitors and immunomodulators. These emerging therapies offer hope for significantly improving the prognosis of IgAN in the future. By presenting a comprehensive overview of current and potential future treatment strategies, this review aims to provide clinicians with up-to-date information to optimize the management of CKD in patients with IgAN.

Pro-resolving lipid mediators and therapeutic innovations in resolution of inflammation.

This review summarizes findings presented at the 19th World Congress of Basic & Clinical Pharmacology 2023 (Glasgow, Scotland, July 3rd to 7th, 2023) from 8 speakers in the field of resolution of inflammation, resolution pharmacology and resolution biology. It is now accepted that the acute inflammatory response is protective to defend the host against infection or tissue injury. Acute inflammation is self-limited and programmed to be limited in space and time: this is achieved through endogenous resolution processes that ensure return to homeostasis. Resolution is brought about by agonist mediators that include specialized pro-resolving lipid mediators (SPMs) and pro-resolving proteins and peptides such as annexin A1 and angiotensin-(1-7), all acting to initiate anti-inflammatory and pro-resolving processes. If the inflammatory reaction remains unchecked through dysfunctional resolution mechanism, it can become chronic and contribute to a plethora of human diseases, including respiratory, cardiovascular, metabolic, allergic diseases, and arthritis. Herein, we discuss how non-resolving inflammation plays a role in the pathogenesis of these diseases. In addition to SPMs, we highlight the discovery, biosynthesis, biofunctions, and latest research updates on innovative therapeutics (including annexin-A1 peptide-mimetic RTP-026, small molecule FPR2 agonist BM-986235/LAR-1219, biased agonist for FPR1/FPR2 Cmpd17b, lipoxin mimetics AT-01-KG and AT-02-CT, melanocortin receptor agonist AP1189, gold nanoparticles, angiotensin-(1-7), and CD300a) that can promote resolution of inflammation directly or through modulation of SPMs production. Drug development strategies based on the biology of the resolution of inflammation can offer novel therapeutic means and/or add-on therapies for the treatment of chronic diseases.

In Vitro Evaluation Of The Antibacterial And Antioxidant Activity Of Malva Sylvestris And Malva Pseudolavatera Malva Extracts

In the present research work has done the evaluation of the antibacterial activity of aqueous and hydroalcoholic extracts of the leaves of Malva sylvestris and Malva pseudolavatera, against three microorganisms (Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae) and antioxidant evaluation of hydroalcoholic extracts, with the goal to provide an alternative in the treatment of infectious and chronic degenerative diseases. The antibacterial activity was performed by disk diffusion assays using Cefotaxime as a reference antibiotic; The antioxidant activity was carried out by three in vitro methods, the method of FRAP (ferro-reducing capacity), 2,2-diphenyl-1-picrylhydracil (DPPH) and 2,2'- azino-bis (3-ethylbenzothiazoline)-6-sulfonic (ABTS•+). The results obtained indicated that the analyzed extracts of both Malva species showed a moderate antibacterial activity in certain concentrations against the microorganisms E. coli,S. aureus and K. pneumoniae; and taking into account the results of the antioxidant activity in the three in vitro methods tested, it was I observed that as the concentration of the extracts increased, the reducing power (FRAP test) and the anti-radicals activity (DPPH and ABTS•+ tests) increased as well, manifesting a high antioxidant activity. As a consequence of this, we can conclude that Malva sylvestris and Malva pseudolavatera leaf extracts produce inhibition halos in the strains of the microorganisms evaluated (E. coli, S. aureus, K. pneumoniae), in addition to presenting inhibition of the radicals used (DPPH, ABTS•+) and ferro- reducing capacity (FRAP).

Magnitude and precision of absolute blood volume estimated during hemodialysis

Background: Management of body fluid volumes and adequate prescription of ultrafiltration (UF) remain key issues in the treatment of chronic kidney disease patients.Objective: This study aims to estimate the magnitude as well as the precision of absolute blood volume ( V b ) modeled during regular hemodialysis (HD) using standard data available with modern dialysis machines.Methods: The estimation utilizes a two-compartment fluid model and a mathematical optimization technique to predict UF-induced changes in hematocrit measured by available on-line techniques. The method does not rely on a specific hematocrit sensor or a specific UF or volume infusion protocol and uses modeling and prediction tools to quantify the error in V b estimation.Results: The method was applied to 21 treatments (pre-UF body mass: 65.57 ± 13.44 kg, UF-volume: 3.99 ± 1.14 L) obtained in ten patients (4 female). Pre-HD V b was 5.4 ± 0.53 L with an average coefficient of variation of 9.8% (range 1 to 22%). A significant moderate correlation was obtained when V b was compared to a different method applied to the same data set (r = 0.5). Specific blood volumes remained above the critical level of 65 mL/kg in 17 treatments (80.9%).Conclusion: The method offers the opportunity to detect critical blood volumes during HD and to judge the quality and reliability of that information based on the precision of the V b estimate.

Development of technology for obtaining tablets by double granulation method with Pipsissewa (Chimaphila Umbellata) extract

The use of the therapeutic potential of medicinal plants is currently considered a physiological method of prevention and treatment, which affects the normalization of metabolic processes and the restoration of the body's functional capabilities. Medicinal products created based on plants can be used for a longer period, including in the treatment of chronic diseases. The aim of the work is to select a technology to produce tablets containing wintergreen umbrella herb liquid extract, considering the pharmaco-technological properties of the resulting dosage form. Materials and methods. The objects of the study were pipsissewa herb liquid extract and experimental model samples of mixtures of this plant substance with excipients permitted for medical use. The research on the analysis of the liquid extract and pharmaco-technological indicators of test samples of tablet mass and tablets was carried out according to the methods of the State Pharmacopoeia of Ukraine (SPhU). Determination of the optimal technology for obtaining and quantitative composition of excipients of tablets from pipsissewa herb liquid extract was carried out using mathematical design of experiments (MDE) by the method of a four-factor experiment based on the Greco-Latin square. Results. The analysis of the liquid extract of pipsissewa showed the presence of 47.0±1.0 % of extractive (dry residue) substances. It was determined that the use of Liquid-Solid technology in the technology of obtaining tablets with plant extract based on the amorphous form of magnesium aluminometasilicate (Neusilin US2) requires the use of a combined approach that will ensure the quality of the finished product. During experimental studies, the use of three interrelated production strategies was proposed. In the process of applying the proposed strategy, it was determined that microcrystalline cellulose effectively performs the function of an adsorbent and filler; the consistency of the mixtures significantly depends on the ratio of MCC 101:extract. It was investigated that the use of double granulation will allow for the increase of the amount of active ingredient in the granulate without changing the volume of MCC 101, which will allow for the achievement of a higher extract content in the finished tablets. The use of double granulation technology can also ensure uniform distribution of the active ingredient and maintain the necessary flowability of the mixture for subsequent tabletting. The use of mathematical, experimental planning in the development of double granulation (drying) technology and the composition of excipients based on studies of the fluidity of the tabletting mass; attrition, disintegration, resistance of tablets to crushing, and organoleptic indicators became the basis for the development of the composition of the medicinal product in the form of tablets containing pipsissewa liquid extract. Conclusions. The adsorption property and its influence on the tabletting process of the synthetic amorphous form of magnesium aluminometasilicate (Neusilin US2) and microcrystalline cellulose 101 (MCC 101) were determined when using these substances as a carrier for pipsissewa grass liquid extract. The possibility of conducting a double granulation process using microcrystalline cellulose 101 (MCC 101) according to a given amount of liquid extract was proven. Using mathematical planning of the experiment, the drying conditions of the granulate and the quantitative composition of excipients were selected