IN VITRO STABILITY AND ANTIOXIDANT POTENTIAL OF THE NEUPROTECTIVE METABOLITE 6-HYDROXY-NICOTINE

Alzheimer’s disease is complex, and it is unlikely that any one single drug or intervention can successfully treat it. The implication of nicotinic acetylcholine receptors (nAChR) in Alzheimer’s disease pathogenesis has opened a new perspective on finding drugs usable for ameliorating the memory problems associated with AD. By using nAchR modulators, the availability of nAChRs for acetylcholine will be increased and the loss of forebrain cholinergic neurons associated with AD might be overcome. The microbial metabolite 6-hydroxy-D-nicotine has the ability to sustain spatial memory in rats by lowering the levels of oxidative stress in the brain and modulating the nAChRs function probably by binding to a specific site. Its success from a lab chemical to drug depends highly on its stability or shelf life. We have shown that 6-hydroxy-D-nicotine have a more potent antioxidant effect than nicotine when measured as FRAP units. Also, the pH stability of 6-hydroxy-D-nicotine is similar to nicotine, the compounds withstanding 48h exposure to pH above 3 up to 9 at room temperature

Hydroxyapatite-ciprofloxacin delivery system: Synthesis, characterisation and antibacterial activity

The main objective of this study was to synthesize hydroxyapatite-ciprofloxacin composites using a chemical precipitation method and to evaluate the properties and in vitro release profile of the drug from the hydroxyapatite-ciprofloxacin composites. Composite characterization was achieved by FT-IR, XRD and DLS. Ciprofloxacin determination was accomplished by HPLC, resulting in good incorporation efficiency of the drug (18.13 %). The in vitro release study (Higuchi model C = K t1/2 and Ritger-Peppas model, C = K t0.6) showed a diffusion-controlled mechanism. The antibacterial activity showed that the bacterial growth inhibition zones were approximately equal for the synthesis composites and for the mechanical mixture on the Staphylococcus aureus germ. The use of hydroxyapatite, which is a biocompatible, bioactive and osteoconductive material, with ciprofloxacin, which has good antibacterial activity in this composite, makes it suitable for the development of bone grafts. Furthermore, the synthesis process allows a slow local release of the drug

Physician-patient relationship in rare diseases: an ethical approach

Rare diseases are a special category of pathology recognized as such relatively recently, starting about 30 years ago in the USA and around the year 2000 in Europe. Rare diseases are clinically and therapeutically heterogeneous, being characterized by a number of common aspects that have a negative impact on patients’ evolution and quality of life, such as: delayed diagnosis, limited scientific knowledge about some of them, lack of treatment or limited availability of treatment. At the same time, information campaigns on rare diseases are limited, and the number of association of patients that promote their interests and rights is also reduced. The quality of physician- patient relationship is particularly important in the management of rare diseases, non-medical aspects, especially the ethical and moral aspects, being often more relevant to patients than the medical aspects. The ethical framework for the analysis of rare diseases encompasses a number of particular aspects, generated on the one hand by the need to properly approach patients suffering from rare diseases in the context of rising expectations for the medical system, and on the other hand, the pro-profit behavior of the pharma companies. This paper analyzes the particular ethical issues identified in the clinical approach on rare diseases, with a focus on the particularities of the physician-patient relationship in this context

Plant-Based versus Animal-Based Low Protein Diets in the Management of Chronic Kidney Disease

Recent data reiterate low-protein diets (LPDs) as cornerstones in the conservative management of chronic kidney disease (CKD). The reduction in proteinuria, better blood pressure control and the reduction in the rate of decline in kidney function with LPDs were reported, both in non-diabetics and diabetics patients. Supplemented, vegetarian, very-low-protein diets (sVLPD, 0.3 g/kg-day) could postpone kidney replacement therapy (KRT) initiation, mainly through the better control of metabolic disorders of advanced CKD in non-diabetic patients. Plant-based diets could ameliorate gut microbiota and appear to be superior to mixed hypoproteic diets in treating advanced CKD: better control of nitrogen balance, acid-base metabolism and bone mineral disorders. Vegetarian diets generate fewer uremic toxins and reduce salt intake and acid overload. At the same time, they can improve lipid metabolism, providing a high ratio of unsaturated to saturated fatty acids, as well as insulin resistance

Low Protein Diet Reduces Proteinuria and Decline in Glomerular Filtration Rate in Advanced, Heavy Proteinuric Diabetic Kidney Disease

Low protein diet (LPD) seems beneficial in ameliorating the complications of chronic kidney disease (CKD), in reducing proteinuria and the decline in kidney function, thus postponing the need for kidney replacement therapy (KRT). However, this type of intervention was less investigated in diabetic kidney disease (DKD). This is a single-center, prospective, interventional study that aims to assess the efficacy of reducing proteinuria and the rate of decline in the estimated glomerular filtration rate (eGFR). Patients with advanced DKD (stable proteinuria > 3 g/g and eGFR 2) completed the study. Intervention consisted of LPD supplemented with ketoanalogues of essential amino acids (KA) along with conventional nephroprotective therapy. Efficacy parameters were the variation in proteinuria and in eGFR from baseline to the end of the study. Proteinuria decreased 3-fold, and the rate of decline in eGFR decreased 5-fold in the intervention phase. No patient initiated KRT or died. LPD supplemented with KA seems effective in safely postponing KRT by reducing proteinuria and the decline in kidney function in advanced DKD

Occurrence of Potentially Toxic Elements in Bottled Drinking Water—Carcinogenic and Non-Carcinogenic Risks Assessment in Adults via Ingestion

The presence of potentially toxic elements in drinking water can be dangerous for human health because of their bioaccumulation and toxicity, which is a huge concern for many researchers. In the case of bottled water, the exposure to toxic elements is achieved, especially by ingestion, leading to disorders of important functions of the human body. The aim of this study was the detection of some potentially toxic elements, from 50 samples of bottled drinking water, available on the Romanian market. Based on obtained concentrations, an assessment of the carcinogenic and non-carcinogenic health risk was performed. The concentrations of potentially toxic elements analyzed were below the maximum allowable limits, for all contaminants, excluding Pb and Fe. Moreover, the results of total risk via ingestion, showed that 30% of samples had an Hazard Quotient (HQ) < 1, and 70% had an HQ > 1; which implies a potential risk following the consumption of those samples. Concerning total cancer risk, 28% of the samples are in the acceptable level, while 72% of the samples are considered harmful and can lead to a type of cancer after repeated exposure. The study concluded that long term use of bottled water of poor quality may pose a hazard to human health; it is helpful for inhabitants to avoid ingestion of contaminated water

Not Every Dyspepsia Is Related to <i>Helicobacter pylori</i>—A Case of Esophageal Inlet Patch in a Female Teenager

Helicobacter pylori infection is one of the main causes of dyspepsia, but it is not the only cause. Esophageal inlet patches are areas of heterotopic gastric mucosa within the esophagus and are commonly located in the cervical part of the esophagus. We report the case of a 16-year-old female, previously known to display symptoms of anxiety, who was admitted to our clinic for dyspeptic symptoms lasting for approximately 1 month in spite of the treatment with proton pump inhibitors. The clinical exam revealed only abdominal tenderness in the epigastric area, while routine laboratory tests showed no abnormalities. The upper digestive endoscopy revealed a well-circumscribed salmon-pink-colored oval lesion of approximately 10 mm in the cervical esophagus, along with hyperemia of the gastric mucosa and biliary reflux. The histopathological exam established the diagnosis of esophageal inlet patch with heterotopic antral-type gastric mucosa and also revealed regenerative changes within the gastric mucosa. We continued to treat the patient with proton pump inhibitors, as well as ursodeoxycholic acid, with favorable evolution. Although rare or underdiagnosed, esophageal inlet patches should never be underestimated and all gastroenterologists should be aware of their presence when performing an upper digestive examination in a patient with dyspeptic symptoms

Biocompatible Composite Filaments Printable by Fused Deposition Modelling Technique: Selection of Tuning Parameters by Influence of Biogenic Hydroxyapatite and Graphene Nanoplatelets Ratios

The proposed strategy for the extrusion of printable composite filaments follows the favourable association of biogenic hydroxyapatite (HA) and graphene nanoplatelets (GNP) as reinforcement materials for a poly(lactic acid) (PLA) matrix. HA particles were chosen in the <40 μm range, while GNP were selected in the micrometric range. During the melt–mixing incorporation into the PLA matrix, both reinforcement ratios were simultaneously modulated for the first time at different increments. Cylindrical composite pellets/test samples were obtained only for the mechanical and wettability behaviour evaluation. The Fourier-transformed infrared spectroscopy depicted two levels of overlapping structures due to the solid molecular bond between all materials. Scanning electron microscopy and surface wettability and mechanical evaluations vouched for the (1) uniform/homogenous dispersion/embedding of HA particles up to the highest HA/GNP ratio, (2) physical adhesion at the HA-PLA interface due to the HA particles’ porosity, (3) HA-GNP bonding, and (4) PLA-GNP synergy based on GNP complete exfoliation and dispersion into the matrix

Hydroxyapatite-ciprofloxacin delivery system: Synthesis, characterisation and antibacterial activity

The main objective of this study was to synthesize hydroxyapatite-ciprofloxacin composites using a chemical precipitation method and to evaluate the properties and in vitro release profile of the drug from the hydroxyapatite-ciprofloxacin composites. Composite characterization was achieved by FT-IR, XRD and DLS. Ciprofloxacin determination was accomplished by HPLC, resulting in good incorporation efficiency of the drug (18.13 %). The in vitro release study (Higuchi model C = K t1/2 and Ritger-Peppas model, C = K t0.6) showed a diffusion-controlled mechanism. The antibacterial activity showed that the bacterial growth inhibition zones were approximately equal for the synthesis composites and for the mechanical mixture on the Staphylococcus aureus germ