Patiromer Acetate Induced Hypercalcemia: An Unreported Adverse Effect

Hyperkalemia, a potential life threating condition, is a commonly encountered problem in chronic kidney disease (CKD) patients. Patiromer acetate, a nonabsorbable cation exchange polymer, is a gastrointestinal agent for chronic therapy in patients with persistent hyperkalemia. Patiromer is generally well tolerated in patients; common side effects are gastrointestinal, such as diarrhea, constipation, flatulence, and vomiting. Hypercalcemia, although a theoretical possibility, has not been reported in any major clinical trials. We present a case of hypercalcemia associated with patiromer acetate used for treatment of hyperkalemia in a stage IV CKD patient. Clinicians should be aware of the possibility of hypercalcemia while taking patiromer

Silver sulfadiazine Loaded Poly (epsilon-Caprolactone)/Poly (Ethylene Oxide) Composite Nanofibers for Topical Drug Delivery

In this study, silver sulfadiazine (SSD) loaded Poly (epsilon-caprolactone)/Poly (ethylene oxide) (PCL/PEO) nanofiber patches were prepared via electrospinning method for topical drug delivery applications. SSD was loaded for the first time into PCL/PEO nanofibers. Nanofiber patches were characterized by Attenuated Total Reflectance Infrared Spectroscopy (FTIR-ATR) to check the presence of chemical bonding between SSD and polymer matrix. The surface morphology of the nanofibers was observed by Scanning Electron Microscopy (SEM). SEM images showed that uniform and smooth composite nanofibers were obtained. The diameter of the nanofibers decreased with the addition of SSD. X-Ray Diffraction (XRD) analysis was carried out to examine the crystallinity of composite nanofiber patches. Energy dispersive spectroscopy (EDS) analysis was performed to confirm Ag and S contents in the SSD loaded composite nanofibers and EDS Mapping was used to show the homogeneous distribution of SSD in the fiber structure. In order to investigate the release and solubility properties of SSD, an unused buffer solution; Water/Propylene Glycol/Phosphoric Acid (82:16:2) was prepared. The release of SSD was performed in this buffer and the release amount of SSD was calculated by UV-Visible Spectrophotometer. Thereby, SSD containing PCL/PEO composite nanofiber carriers were electrospun to achieve the enhancement in solubility, effective drug release and efficient drug loading of SSD. All experimental studies demonstrated that SSD loaded PCL/PEO composite nanofibers have great potential to be used in topical drug delivery applications

Oligocene ruminants from the Kizilirmak Formation, Cankiri-Corum Basin, Central Anatolia, Turkey

WOS: 000392102400007A new assemblage of ruminants from five distinct Oligocene localities of the Kizilirmak Formation, Central Anatolia, Turkey is described. The tragulids Iberomeryx parvus, and Iberomeryx sp. (large), as well as a probable large lophiomerycid have been recognized. The stem pecoran Dremotherium guthi, cf. Palaeohypsodontus and a large indeterminate Pecora have been identified as well. In the five localities, the majority of the ruminant material is referred to Iberomeryx parvus, but the sample from the locality Tepe 641 (upper member of the Kizilirmak Formation) shows some distinctive characters suggesting a more derived species/forms that probably lived in more open environments. The ruminant taxa recorded in the Kizilirmak Formation are congruent with a late Oligocene age, probably close in age to the Benara fauna of southern Georgia. The possible occurrence of Palaeohypsodontus in Central Anatolia would significantly expand its geographical range and suggest biogeographical affinities with Central Asia. The ruminant fauna from the Kizilirmak Formation suggests the existence of lowland forests with more open landscapes in central Anatolia during the late Oligocene.TUBITAK, ParisTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK); CNRS, ParisCentre National de la Recherche Scientifique (CNRS); MNHN, Paris; General Directorate of Mineral Research and Exploration (MTA, Ankara)Ministry of Energy & Natural Resources - TurkeyThis work was carried out with the support of several agencies and institutions: the TUBITAK, the CNRS, the MNHN, Paris, and the General Directorate of Mineral Research and Exploration (MTA, Ankara). We thank C. Karaca and C. Ozturk (MTA Museum, Ankara), and all the persons who contributed to the field work. We thank P. Loubry (UMR 7207-CR2P) for the photographs. GM thanks J. van der Made for the good quality photos of the type of I. parvus. We thank the reviewers for their remarks that have improved the manuscript

Voriconazole incorporated nanofiber formulations for topical application: preparation, characterization and antifungal activity studies against <i>Candida</i> species.

In this study, voriconazole (VCZ) incorporated polyvinyl alcohol/sodium alginate electrospun nanofibers were produced and, then crosslinked with glutaraldehyde for topical antifungal treatment. The nanofibers were characterized in terms of fiber size, surface morphology, and compatibility between drug-polymer and polymer-polymer using scanning electron microscopy, atomic force microscopy, attenuated total reflection-Fourier transform infrared spectroscopy, and high pressure liquid chromatography. After optimization studies, in vitro drug release, skin penetration, and deposition studies were performed using Franz diffusion cells. Antifungal activities of the nanofiber formulations against Candida albicans, Candida tropicalis, and Candida parapysilosis strains were evaluated using susceptibility test and subsequently time-kill study was performed against C. albicans. The cytotoxicity study was performed using 4-succinate dehydrogenase viability assay on mouse fibroblast cell line. The release rate of VCZ from crosslinked nanofibers was slower than that of non-crosslinked nanofibers and Higuchi kinetic model best fitted to the in vitro release data of both of formulations. VCZ deposited in deeper skin layers from nanofiber formulations was higher than that of the control formulation (VCZ solution in propylene glycol (1% (w/v)). According to the susceptibility and time-kill studies, all of the nanofiber formulations showed antifungal activity against C. albicans with confirming no cytotoxicity on mouse fibroblast cells

Regulation of MMP 2 and MMP 9 expressions modulated by AP-1 (c-jun) in wound healing: improving role of Lucilia sericata in diabetic rats

AimsLucilia sericata larvae have been successfully used on healing of wounds in the diabetics. However, the involvement of the extraction/secretion (ES) products of larvae in the treatment of diabetic wounds is still unknown. Activator protein-1 (AP-1) transcription, composed of c-jun and c-Fos proteins, has been shown to be the principal regulator of multiple MMP transcriptions under a variety of conditions, also in diabetic wounds. Specifically, MMP-2 and MMP-9's transcriptions are known to be modulated by AP-1. c-jun has been demonstrated to be a repressor of p53 in immortalized fibroblasts. The aim of the present study is to investigate the effects of L. sericata ES on the expression of AP-1 (c-jun), p53, MMP-2, and MMP-9 in wound biopsies dissected from streptozotocin induced diabetic rats.MethodsThe expression levels of MMP-2, MMP-9, c-jun and p53 in dermal tissues were determined at days 0, 3, 7 and 14 after wounding, using immunohistochemical analysis and quantitative real-time PCR.ResultsThe treatment with ES significantly decreased through inflammation-based induction of MMP-2 and MMP-9 expression levels in the wounds of diabetic groups, compared to control groups at the third day of wound healing. At the 14th day, there were dramatic decreases in expression of c-jun, MMP-9, and p53 in ES-treated groups, compared to the diabetic group (P<0.001, P<0.05 and P<0.01, respectively).ConclusionES products of L. sericata may enhance the process of wound healing in phases of inflammation, proliferation, and re-epithelization, essentially via regulating c-jun expression and modulating MMP-2 and MMP-9 expressions

Silk-fibroin-containing nanofibers for topical sertaconazole delivery: preparation, characterization, and antifungal activity

Polyurethane/polyvinylpyrrolidone/silk nanofibers were prepared by electrospinning. Highly lipophilic antifungal drug sertaconazole nitrate was incorporated into the nanofibers, and drug release profiles were compared with polyurethane/polyvinylpyrrolidone nanofiber. Nanofibers were characterized in terms of morphology, polymer-polymer and drug-polymer compatibility, loading efficiency, surface roughness profile, and hydrophilicity by scanning electron microscopy, Fourier transform infrared spectroscopy, atomic force microscopy, optical tensiometer and high-performance liquid chromatography. In vitro release data revealed that nanofibers fabricated with silk fibroin either as polymer blend or coating material showed drug release in sustained manner. Activity and biocompatibility study analysis data proved that all sertaconazole incorporated nanofiber formulations were fungistatic against Candida albicans and had good biocompatibility, which could be considered as potential topical drug delivery systems used in the treatment of fungal infections as a scaffold applied topically

Prevalence of atopic disorders in rheumatic diseases

The aim of this study was to assess the point prevalences of hay fever, asthma, and atopic dermatitis in OA, RA, and AS, and to compare with healthy controls

Psychological status is associated with health related quality of life in patients with rheumatoid arthritis

Objective: Rheumatoid arthritis (RA) is a chronic and disabling disease frequently effects physical and psychological well being. The aim of the present study was to determine the impact of psychological status on health related quality of life in patients with RA and also to assess which quality of life (QoL) instrument - disease specific and generic - is more prone to this effect

Pattern of Disease Onset, Diagnostic Delay, and Clinical Features in Juvenile Onset and Adult Onset Ankylosing Spondylitis

Objective. To assess the frequency of juvenile onset ankylosing spondylitis (JOAS) in Turkish patients with AS and to compare with adult onset AS (AOAS) in a cross-sectional study design