105 research outputs found

    Allergic Mastocytic Gastroenteritis and Colitis: An Unexplained Etiology in Chronic Abdominal Pain and Gastrointestinal Dysmotility

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    Abdominal pain, bloating, early satiety, and changes in bowel habits are common presenting symptoms in individuals with functional GI disorders. Emerging data suggests that these symptoms may be associated with mast cell excess and/or mast cell instability in the GI tract. The aim of this retrospective study was to evaluate the contribution of mast cells to the aforementioned symptoms in individuals with a history of atopic disease. A retrospective chart review of individuals seen in a university GI practice was conducted and twenty-four subjects were identified. The majority had abdominal pain, early satiety, and nocturnal awakening. 66.7% and 37.5% had a history of environmental and/or food allergy. Solid gastric emptying was increased as were the mean number of mast cells reported on biopsies from the stomach, small bowel, and colon (>37/hpf) by CD117 staining. Mean whole blood histamine levels were uniformly elevated. This study suggests that in individuals with these characteristics, consideration should be given to staining their gastrointestinal biopsies for mast cells as this may provide them with relatively non-toxic but highly targeted treatment options. Allergic gastroenteritis and colitis may represent a third type of GI mast cell disorder along with mast cell activation syndrome and mastocytic enterocolitis

    Development and Evaluation of Dissolving Microarray Patches for Co-administered and Repeated Intradermal Delivery of Long-acting Rilpivirine and Cabotegravir Nanosuspensions for Paediatric HIV Antiretroviral Therapy

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    Purpose Whilst signifcant progress has been made to defeat HIV infection, the efcacy of antiretroviral (ARV) therapyin the paediatric population is often hindered by poor adherence. Currently, two long-acting (LA) intramuscular injectablenanosuspensions of rilpivirine (RPV) and cabotegravir (CAB) are in clinical development for paediatric populations. However, administration requires access to healthcare resources, is painful, and can result in needle-stick injuries to the end user.To overcome these barriers, this proof-of-concept study was developed to evaluate the intradermal delivery of RPV LA andCAB LA via self-disabling dissolving microarray patches (MAPs).Methods Dissolving MAPs of two conformations, a conventional pyramidal and a bilayer design, were formulated, withvarious nanosuspensions of RPV and CAB incorporated within the respective MAP matrix. MAPs were mechanically robustand were capable of penetrating ex vivo skin with intradermal ARV deposition.Results In a single-dose in vivo study in rats, all ARV MAPs demonstrated sustained release profles, with therapeuticallyrelevant plasma concentrations of RPV and CAB detected to at least 63 and 28 d, respectively. In a multi-dose in vivo study,repeated MAP applications at 14-d intervals maintained therapeutically relevant plasma concentrations throughout theduration of the study.Conclusions These results illustrate the potential of the platform to repeatedly maintain plasma concentrations for RPVand CAB. As such, these MAPs could represent a viable option to improve adherence in the paediatric population, one thatis capable of being painlessly administered in the comfort of the patient’s own home on a biweekly or less frequent basis

    Does Higher Cost Inefficiency Imply Higher Profit Inefficiency? Evidence on Inefficiency and Ownership of German Hospitals

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    This paper investigates cost and profit efficiency of German hospitals. More specifically, it deals with the question how hospital efficiency varies with ownership, patient structure,and other exogenous factors, which are neither inputs nor outputs of the production process. We conduct a Stochastic Frontier Analysis (SFA) on a multifaceted administrative German dataset combined with the balance sheets of 374 hospitals for the years 2002 to 2005.The results indicate that private (for-profit) and (private) non-profit hospitals are on average less cost efficient but more profit efficient than publicly owned hospitals

    Pharmacological treatment options for mast cell activation disease

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    The effects of megamergers on efficiency and prices: evidence from a bank profit function

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    This paper examines the efficiency and price effects of mergers by applying a frontier profit function to data on bank ``megamergers.'' We find that merged banks experience a statistically significant 16 percentage point average increase in profit-efficiency rank relative to other large banks. Most of the improvement is from increasing revenues, including a shift in outputs from securities to loans, a higher-valued product. Improvements were greatest for the banks with the lowest efficiencies prior to merging, who therefore had the greatest capacity for improvement. By comparison, the effects on profits from merger-related changes in prices were found to be very small.Bank profits ; Bank mergers ; Prices

    Allergic Mastocytic Gastroenteritis and Colitis: An Unexplained Etiology in Chronic Abdominal Pain and Gastrointestinal Dysmotility

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    Abdominal pain, bloating, early satiety, and changes in bowel habits are common presenting symptoms in individuals with functional GI disorders. Emerging data suggests that these symptoms may be associated with mast cell excess and/or mast cell instability in the GI tract. The aim of this retrospective study was to evaluate the contribution of mast cells to the aforementioned symptoms in individuals with a history of atopic disease. A retrospective chart review of individuals seen in a university GI practice was conducted and twenty-four subjects were identified. Themajority had abdominal pain, early satiety, and nocturnal awakening. 66.7% and 37.5% had a history of environmental and/or food allergy. Solid gastric emptying was increased as were the mean number of mast cells reported on biopsies from the stomach, small bowel, and colon (>37/hpf) by CD117 staining. Mean whole blood histamine levels were uniformly elevated. This study suggests that in individuals with these characteristics, consideration should be given to staining their gastrointestinal biopsies for mast cells as this may provide them with relatively non-toxic but highly targeted treatment options. Allergic gastroenteritis and colitis may represent a third type of GI mast cell disorder along with mast cell activation syndrome and mastocytic enterocolitis
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