Management in patient with rheumatoid arthritis and tuberculous arthritis: a case report

Rheumatoid arthritis (RA) is mainly treated with immunosuppressive drugs, which affects the immunological system. Therefore, the risk of tuberculosis was increased two to ten times in RA patients. Moreover, immunosuppressant is contraindicated in patients with tuberculosis arthritis. A 51-year-old male was presented with pain in his left elbow after he slipped on the floor. He was diagnosed with RA for 16 years and only took prednisone for six years. Six months before, he came to a rheumatologist and was given corticosteroid for six months for RA. The left elbow radiograph and joint aspiration revealed a tuberculosis infection. The patient treated with chloroquine and oral antituberculosis for one year and showed good clinical outcomes. Other diseases should be suspected in RA with uncommon symptoms. Chloroquine is the drug of choice in RA patients with tuberculosis who are contraindicated in immunosuppressant therapy because chloroquine has no immunosuppressant effect

Efficacy of edelfosine lipid nanoparticles in breast cancer cells

Breast cancer is a heterogeneous group of neoplasms predominantly originating in the terminal duct lobular units. It represents the leading cause of cancer death in women and the survival frequencies for patients at advanced stages of the disease remain low. New treatment options need to be researched to improve these rates. The anti-tumor ether lipid edelfosine (ET) is the prototype of a novel generation of promising anticancer drugs. However, it presents several drawbacks for its use in cancer therapy, including gastrointestinal and hemolytic toxicity and low oral bioavailability. To overcome these obstacles, ET was encapsulated in Precirol ATO 5 lipid nanoparticles (ET-LN), and its anti-tumor potential was in vitro tested in breast cancer. The formulated ET-LN were more effective in inhibiting cell proliferation and notably decreased cell viability, showing that the cytotoxic effect of ET was considerably enhanced when ET was encapsulated. In addition, ET and ET-LN were able to promote cell cycle arrest at G1 phase. Moreover, although both treatments provoked an apoptotic effect in a time-dependent manner, such anti-tumor effects were noticeably improved with ET-LN treatment. Therefore, our results indicate that encapsulating ET in LN played an essential role in improving the efficacy of the drug

Dampak Implementasi Kebijakan Otonomi Daerah terhadap Peningkatan Kualitas Pelayanan Publik (suatu Studi pada Dinas Kependudukan dan Catatan Sipil Kabupaten Halmahera Utara)

The research objective was to determine the impact of the implementation of the regionalautonomy policy towards improving the quality of public services in the Department of Population andCivil Registration Halmahera as Minister of State for Administrative Reform (MENPAN) No. 81/1993(Anonymous, 1993) confirms that the quality of service should be in accordance with joints as follows,simplicity, clarity and certainty, Procedures / Procedure for Public Services; Public Service requirements,both technical and Administrative; Giving Public Service; Security, Openness, Efficient, Economical,Justice Yang Evenly, and timeliness. To determine the indicator then, researchers used the method with amix of evaluative-descriptive quantitative-qualitative approach. The sample in this study consisted ofelements of employee / service personnel (n1) and the user community services (n2), each of 30 people.Given the nature of the sample is paired, then the fixed sample size of 30 people, where a sample ofemployees polled neighbor variable X, while samples of people asked their opinion of the variable Y.Based on the results of data analysis known that the hypothesis 1, which states that "Theimplementation of the regional autonomy policy impact / positive effect on improving the quality ofpublic services at the Department of Population and Civil North Halmahera District", has proven validityempirically convincingly through a simple regression analysis and predict moment correlation. As well asthe Public Services Quality Differences Between Before and After Implementation of regional autonomypolicy acceptable to convince the 99% confidence level. This means that the quality of public services atthe Department of Population and Civil Registration of North Halmahera district on the condition afterthe implementation of the regional autonomy policy is much higher than before implementation regionalautonomy policy. The results showed that the average quality of public services after the implementationof the regional autonomy policy gained an average of 56.4, or in the ideal scale test rank of 0.87, or 87%,while the condition of the quality of public services prior to the implementation of regional autonomypolicy, the average is only at 49 , 6 or the ideal measurements were obtained at 0.7631 or 76.31%, so thatthere is a difference, which is about 10.69%. It that an increase in the quality of public services after theimplementation of the regional autonomy policy, amounting to 10.69%.To improve the quality of public services that are known not optimal, it would require concertedeffort from local government districts, particularly in the Department of Population and Civil RegistrationHalmahera district North to improve human resource management and governance of public services soas to encourage the improvement of the quality of public services itself , And given the decentralizationpolicy gave the positive and significant impact on the quality of public services, local governments,particularly the Office of Population and recording of Civil North Halmahera need to deal with programsrelating to the increase in the dimensions of the regional autonomy policy, particularly the dimension ofrestructuring and revitalization organizational resources

Incidence and Functional Outcomes of Scapholunate Diastases Associated Distal Radius Fractures: A 2-year Follow-Up Scapholunate Dissociation

Background: The Scapholunate Interosseous Ligament (SLIL) is the first intrinsic carpal ligament to be injured in wrist trauma, present in up to 64% of the distal radius fractures. However, it remains unclear what patients develop symptoms, making primary treatment of these injuries accompanying distal radius fractures remains questionable. Objective: The aim of this study was to evaluate the functional outcomes of patients with scapholunate diastasis associated with distal radius fractures. Methods: We evaluated 391 patients with a distal radius fracture. Using Computer Tomography (CT) scans the scapholunate interval was measured. We identified 14 patients with an SLD (>3mm) of the injured wrist, which underwent a CT-scan of the contralateral wrist. To evaluate the functional outcomes at a mean follow up of 136±90 weeks, we used the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) Score. Results: There were 8 patients with bilateral SLD and 6 patients with unilateral SLD. Five patients had a qDASH score of 0 and one patient showed a qDASH score of 18.2. The patient with a poor score had bilateral preexisting osteoarthritis of the wrist. No patient had additional surgery of the SLIL. Conclusion: In patients with distal radius fractures, more than half of the 14 patients with an SL gap on CT had widening on the contralateral side. It is therefore worthwhile to image the contralateral wrist before diagnosing a SLD. The patients with unilateral SLD should not be surgically treated at initial presentation because they may have good functional outcomes after a follow up of 2 years

Is Social Media a New Type of Social Support? Social Media Use in Spain during the COVID-19 Pandemic: A Mixed Methods Study

This study examines Spanish adults’ social media use during the COVID-19 pandemic using mixed-methods to assess and understand frequency, context, and changes in social media use during two critical time points in Spain. We conducted semi-structured interviews in April 2020, and two waves of surveys (April 2020, April 2021) among Spanish adults. We coded and analyzed qualitative data related to social media use during the first lockdown period in Spain using Dedoose software; and ran descriptive statistics and chi-square tests to assess changes in social media use over the two survey waves related to perceived social support and loneliness. Participants ranged in age from 18–92 and were representative of the Spanish population’s sociodemographics. Interview data show that WhatsApp was most commonly used, and that social media allowed for social support and engaging in healthy behaviors. Survey data show that women and individuals aged 18–34 had the greatest increases in social media use. Statistically significant associations were found between social support and loneliness with social media use. Our results show that promoting social media use as an emotional resource for social support in times of crisis or isolation can minimize loneliness and can be a beneficial tool for general worldwide crises.This research was supported by pilot grant funding from the Institute for Collaboration on Health, Intervention, and Policy (InCHIP) at University of Connecticut

In vivo biodistribution of edelfosine-loaded lipid nanoparticles radiolabeled with Technetium-99 m: Comparison of administration routes in mice

Edelfosine (ET) is a potent antitumor agent but causes severe side effects that have limited its use in clinical practice. For this reason, nanoencapsulation in lipid nanoparticles (LNs) is advantageous as it protects from ET side-effects. Interestingly, previous studies showed the efficacy of LNs containing ET in various types of tumor. In this paper, biodistribution studies of nanoencapsulated ET, administered by three routes (oral, intravenous (IV) and intraperitoneal (IP)), were tested in order to select the optimal route of administration. To do this, ET-LNs were labeled with Technetium-99 m (99mTc) and administered by the oral, IV and IP route in mice. IV admin- istration of the radiolabeled LNs led to fast elimination from the blood circulation and increased accumulation in reticulo-endothelial (RES) organs, while their oral administration could not provide any evidence on their bio- distribution since large radiocomplexes were formed in the presence of gastrointestinal fluids. However, when the LNs were administered by the IP route they could access the systemic circulation and provided more constant blood ET-LN levels compared to the IV route. These findings suggest that the IP route can be used to sustain the level of drug in the blood and avoid accumulation in RES organs

Edelfosine lipid nanoparticles overcome MDR in K-562 leukemia cells by caspaseindependent mechanism

The anti-tumor ether lipid edelfosine is the prototype of a novel generation of promising anticancer drugs that has been shown to be an effective anti-tumor agent in numerous malignancies. However, several cancer types display resistance to different anti-tumor compounds due to multi-drug resistance (MDR), which is a major drawback in anticancer therapy. The leukemic cell line K-562 shows resistance to edelfosine, which can be overcome by the use of nanotechnology. The present paper describes the rate and mechanism of internalization of free and nano-encapsulated edelfosine. The molecular mechanisms underlying this cell death is described in the present paper by characterization of several molecules implied in the apoptotic and autophagic pathways (PARP, LC3IIB, Caspases-3, - 9 and -7) and the pattern of expression is compared with cell induction in a sensitive cell line HL-60. The results showed different internalization patterns in both cells. Clathrin and lipid raftmediated endocytosis were observable in edelfosine uptake whereas these mechanism were not visible in the uptake of lipid nanoparticles which might suffer phagocytosis and macropinocytosis. Both treatments endorsed caspase-mediated apoptosis in HL-60 cells but this cell death was not observed in K-562 cells. Moreover, an important increase in autophagic vesicles was visible in K-562 cells. Thus, this mechanism might be implicated in the overcoming of K-562 resistance to the treatment by lipid nanoparticles

In vitro intestinal co-culture cell model to evaluate intestinal absorption of edelfosine lipid nanoparticles

Nanotechnology is providing a new therapeutic paradigm by enhancing drug efficacy and preventing side-effects. Edelfosine is a synthetic ether lipid analogue of platelet activating factor with high antitumor activity. The encapsulation of this potent antitumor drug in lipid nanoparticles increases its oral bioavailability; moreover, it prevents the hemolytic and gastrointestinal side-effects of the free drug. The literature points towards lymphatic absorption of lipid nanoparticles after oral administration, and previous in vitro and in vivo studies stress the protection against toxicity that these nanosystems provide. The present study is intended to assess the permeability of lipid nanoparticles across the intestinal barrier. Caco-2 monoculture and Caco-2/Raji co-culture were used as in vitro models of enterocytes and Microfold cells respectively. Results showed that free drug is internalized and possibly metabolized in enterocytes. These results do not correlate with those observed in vivo when edelfosine-lipid nanoparticles were administered orally in mice, which suggests that the microfold model is not a good model to study the absorption of edelfosine-lipid nanoparticles across the intestinal barrier in vitro