351 research outputs found
Resveratrol-loaded solid lipid nanoparticles versus nanostructured lipid carriers: evaluation of antioxidant potential for dermal applications
Evren H Gokce1, Emrah Korkmaz1, Eleonora Dellera2, Giuseppina Sandri2, M Cristina Bonferoni2, Ozgen Ozer11Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, Izmir, Turkey; 2Department of Drug Sciences, University of Pavia, Pavia, ItalyBackground: Excessive generation of radical oxygen species (ROS) is a contributor to skin pathologies. Resveratrol (RSV) is a potent antioxidant. Solid lipid nanoparticles (SLN) and nanostructured lipid carriers (NLC) can ensure close contact and increase the amount of drug absorbed into the skin. In this study, RSV was loaded into SLN and NLC for dermal applications.Methods: Nanoparticles were prepared by high shear homogenization using Compritol 888ATO, Myglyol, Poloxamer188, and Tween80. Particle size (PS), polydispersity index (PI), zeta potential (ZP), drug entrapment efficiency (EE), and production yield were determined. Differential scanning calorimetry (DSC) analysis and morphological transmission electron microscopy (TEM) examination were conducted. RSV concentration was optimized with cytotoxicity studies, and net intracellular accumulation of ROS was monitored with cytofluorimetry. The amount of RSV was determined from different layers of rat abdominal skin.Results: PS of uniform RSV-SLN and RSV-NLC were determined as 287.2 nm ± 5.1 and 110.5 nm ± 1.3, respectively. ZP was –15.3 mV ± 0.4 and –13.8 mV ± 0.1 in the same order. The drug EE was 18% higher in NLC systems. TEM studies showed that the drug in the shell model was relevant for SLN, and that the melting point of the lipid in NLC was slightly lower. Concentrations below 50 µM were determined as suitable RSV concentrations for both SLN and NLC in cell culture studies. RSV-NLC showed less fluorescence, indicating less ROS production in cytofluorometric studies. Ex vivo skin studies revealed that NLC are more efficient in carrying RSV to the epidermis.Conclusion: This study suggests that both of the lipid nanoparticles had antioxidant properties at a concentration of 50 µM. When the two systems were compared, NLC penetrated deeper into the skin. RSV-loaded NLC with smaller PS and higher drug loading appears to be superior to SLN for dermal applications.Keywords: solid lipid nanoparticles, nanostructured lipid carriers, resveratro
Morphological Features in Children with Autism Spectrum Disorders: A Matched Case-Control Study
Serum calcitonin negative Medullary thyroid carcinoma
BACKGROUND: Medullary thyroid carcinomas (MTC) constitute about 5 to 7 % of thyroid neoplasms. They originate from parafollicular C cells which produce Calcitonin, a hormone which has an impact on calcium metabolism and represents the biochemical activity of MTC. In rare cases pre-operative serum calcitonin can be negative. CASE PRESENTATION: We report on a 73-year-old female patient with a rare case of a serum calcitonin negative medullary thyroid carcinoma who suffered fulminant post-operative course and died of multiple metastasis. CONCLUSION: This case shows that in very rare cases MTCs do not secrete calcitonin making diagnosis and tumour follow-up difficult. To this date, only few reports describing this combination of circumstances were found in the English literature
Idiopathic isolated clitoromegaly: A report of two cases
BACKGROUND: Clitoromegaly is a frequent congenital malformation, but acquired clitoral enlargement is relatively rare. METHODS: Two acquired clitoromegaly cases treated in Atatürk Training Hospital, Izmir, Turkey are presented. RESULTS: History from both patients revealed clitoromegaly over the last three years. Neither gynecological nor systemic abnormalities were detected in either patient. Karyotype analyses and hormonal tests were normal. Abdominal and gynaecological ultrasound did not show any cystic lesion or other abnormal finding. Computerized tomography scan of the adrenal glands was normal. Clitoroplasty with preservation of neurovascular pedicles was performed for the treatment of clitoromegaly. CONCLUSION: The patients were diagnosed as "idiopathic isolated" clitoromegaly. To the best of our knowledge, there has been no detailed report about idiopathic clitoromegaly in the literature
Association between Variants on Chromosome 4q25, 16q22 and 1q21 and Atrial Fibrillation in the Polish Population
Genome-wide studies have shown that polymorphisms on chromosome 4q25, 16q22 and 1q21 correlate with atrial fibrillation (AF). However, the distribution of these polymorphisms differs significantly among populations.To test the polymorphisms on chromosome 4q25, 16q22 and 1q21 in a group of patients (pts) that underwent catheter ablation of AF.Four hundred and ten patients with AF that underwent pulmonary vein isolation were included in the study. Control group (n = 550) was taken from healthy population, matched for age, sex and presence of hypertension. All participants were genotyped for the presence of the rs2200733, rs10033464, rs17570669, rs3853445, rs6838973 (4q25), rs7193343 (16q22) and rs13376333 (1q21) polymorphisms.All the polymorphisms tested (except rs17570669) correlated significantly with AF in univariate analysis (p values between 0.039 for rs7193343 and 2.7e-27 for rs2200733), with the odds ratio (OR) 0.572 and 0.617 for rs3853445 and rs6838973, respectively (protective role) and OR 1.268 to 3.52 for the other polymorphisms. All 4q25 SNPs tested but rs3853445 were independently linked with AF in multivariate logistic regression analysis. In haplotype analysis six out of nine 4q25 haplotypes were significantly linked with AF. The T allele of rs2200733 favoured increased number of episodes of AF per month (p = 0.045) and larger pulmonary vein diameter (recessive model, p = 0.032).Patients qualified for catheter ablation of AF have a significantly higher frequency of 4q25, 16q22 and 1q21 variants than the control group. The T allele of rs2200733 favours larger pulmonary veins and increased number of episodes of AF
Assessing the Relative Performance of Nurses Using Data Envelopment Analysis Matrix (DEAM)
Assessing employee performance is one of the most important issue in healthcare management services. Because of their direct relationship with patients, nurses are also the most influential hospital staff who play a vital role in providing healthcare services. In this paper, a novel Data Envelopment Analysis Matrix (DEAM) approach is proposed for assessing the performance of nurses based on relative efficiency. The proposed model consists of five input variables (including type of employment, work experience, training hours, working hours and overtime hours) and eight output variables (the outputs are amount of hours each nurse spend on each of the eight activities including documentation, medical instructions, wound care and patient drainage, laboratory sampling, assessment and control care, follow-up and counseling and para-clinical measures, attendance during visiting and discharge suction) have been tested on 30 nurses from the heart department of a hospital in Iran. After determining the relative efficiency of each nurse based on the DEA model, the nurses’ performance were evaluated in a DEAM format. As results the nurses were divided into four groups; superstars, potential stars, those who are needed to be trained effectively and question marks. Finally, based on the proposed approach, we have drawn some recommendations to policy makers in order to improve and maintain the performance of each of these groups. The proposed approach provides a practical framework for hospital managers so that they can assess the relative efficiency of nurses, plan and take steps to improve the quality of healthcare delivery
Scoliotic posture as the initial symptom in adolescents with lumbar disc herniation: its curve pattern and natural history after lumbar discectomy
<p>Abstract</p> <p>Background</p> <p>There have been few studies focusing on the curve pattern of scoliosis caused by lumbar disc herniation (LDH) in adolescents and the natural history of scoliosis after discectomy. The current study was carried out to identify the curve pattern of scoliosis and investigate the effect of posterior discectomy on the curve improvement in adolescents with LDH.</p> <p>Methods</p> <p>This review focused on a group of 26 adolescents with LDH who initially presented to our clinic for evaluation of scoliosis, followed by posterior discectomy between 2000 and 2009. Radiographic measurements included curve pattern, specific curve features, trunk shift, and sagittal profile. The correlation between the side of disc herniation and the direction of lumbosacral curve and the trunk shift was evaluated.</p> <p>Results</p> <p>A typical curve pattern was initially identified in all of the patients as a short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side. 23 of 26 patients (88.5%) had a trunk shift more than 2.0 cm away from the midline, showing a poor coronal balance. A relatively straight sagittal profile was noted in all the patients. 84.6% (22/26) patients had a disc herniation at the convex side of lumbosacral curve. Similarly, 73.1% (19/26) patients showed a trunk shift toward the opposite side of disc herniation. All of the patients had an marked curve improvement immediately after discectomy. In the 17 patients with a more than 2-year follow-up, only two had a residual lumbosacral curve greater than or equal to 20 degrees. The mean ODI improved from 21.4% before surgery to 7.3% at the final follow-up.</p> <p>Conclusions</p> <p>A short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side, and a relatively straight sagittal profile have been noted in all the patients. The direction of lumbosacral curve and trunk shift was related to the side of disc herniation. A majority of patients have a small curve size while assosiated with a significant coronal imbalance. Earlier decompression can provide a greater opportunity for spontaneous correction of scoliosis.</p
A cost and performance comparison of Public Private Partnership and public hospitals in Spain
© 2016 Caballer-Tarazona and Vivas-Consuelo. Open Access This article is distributed under the terms of the Creative
Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source,
provide a link to the Creative Commons license, and indicate if changes were made.The Erratum to this article has been published in Health Economics Review 2016 6:20[EN] Public-private partnership (PPP) initiatives are extending around the world, especially in Europe, as an innovation to
traditional public health systems, with the intention of making them more efficient.
There is a varied range of PPP models with different degrees of responsibility from simple public sector contracts
with the private, up to the complete privatisation of the service. As such, we may say the involvement of the
private sector embraces the development, financing and provision of public infrastructures and delivery services.
In this paper, one of the oldest PPP initiatives developed in Spain and transferred to other European and Latin
American countries is evaluated for first time: the integrated healthcare delivery Alzira model.
Through a comparison of public and PPP hospital performance, cost and quality indicators, the efficiency of the
PPP experience in five hospitals is evaluated to identify the influence of private management in the results.
Regarding the performance and efficiency analysis, it is seen that the PPP group obtains good results, above the
average, but not always better than those directly managed. It is necessary to conduct studies with a greater
number of PPP hospitals to obtain conclusive results.Caballer Tarazona, M.; Vivas Consuelo, DJJ. (2016). A cost and performance comparison of Public Private Partnership and public hospitals in Spain. Health Economics Review. 6(17):1-7. doi:10.1186/s13561-016-0095-5S17617La Forgia GM, Harding A. Public-Private Partnerships and Public Hospital Performance in Sao Paulo, Brazil. Health Aff. 2009;28(4):1114–26.Vecchi V, Hellowell M, Longo F. Are Italian healthcare organizations paying too much for their public-private partnerships? Public Money Manage. 2010;30(2):125–32.Hellowell M, Pollock AM. The private financing of NHS hospitals: politics, policy and practice. Econ Aff. 2009;29(1):13–9.McIntosh N, Grabowski A, Jack B, Nkabane-Nkholongo EL, Vian T. A public-private partnership improves clinical performance in a hospital network in Lesotho. Health Aff. 2015;34(6):954–62.Roehrich JK, Lewis MA, George G. Are public–private partnerships a healthy option? A systematic literature review. Soc Sci Med. 2014;113:110–9.Barlow J, Roehrich J, Wright S. Europe sees mixed results from public-private partnerships for building and managing health care facilities and services. Health Aff. 2013;32(1):146–54.Hoppe EI, Kusterer DJ, Schmitz PW. Public-private partnerships versus traditional procurement: an experimental investigation. J Econ Behav Organ. 2013;89:145–66.Vivas-Consuelo D, Uso-Talamantes R, Trillo-Mata JL, Caballer-Tarazona M, Barrachina-Martinez I, Buigues-Pastor L. Predictability of pharmaceutical spending in primary health services using Clinical Risk Groups. Health Policy. 2014;116(2-3):188–95.Lopez-Casasnovas G, Costa-Font J, Planas I. Diversity and regional inequalities in the Spanish ‘system of health care services’. Health Econ. 2005;14 Suppl 1:S221–S35.Spain NHSo. National Health System of Spain. National Health System of Spain; 2010.McKee M, Edwards N, Atun R. Public-private partnerships for hospitals. Bull World Health Organ. 2006;84(11):890–6.Caballer-Tarazona M, Moya-Clemente I, Vivas-Consuelo D, Barrachina-Martínez I. A model to measure the efficiency of hospital performance. Math Comput Model. 2010;52(7-8):1095–102.Barlow J, Roehrich JK, Wright S. De facto privatization or a renewed role for the EU? Paying for Europe’s healthcare infrastructure in a recession. J R Soc Med. 2010;103(2):51–5.Herr A, Schmitz H, Augurzky B. Profit efficiency and ownership of German hospitals. Health Econ. 2011;20(6):660–74.Alonso JM, Clifton J, Díaz-Fuentes D. The impact of New Public Management on efficiency: an analysis of Madrid’s hospitals. Health Policy. 2015;119(3):333–40.IASIST. Desarrollo metodológico de los indicadores ajustados 2009 [cited 2015 July 26]. Available from: ( http://www.iasist.com/archivos/top20-2009-metodologia_161215235006.pdf ). Accessed Sept 2015.Hollingsworth B. The measurement of efficiency and productivity of health care delivery. Health Econ. 2008;17(10):1107–28.Ozgen H, Ozcan YA. A national study of efficiency for dialysis centers: an examination of market competition and facility characteristics for production of multiple dialysis outputs. Health Serv Res. 2002;37(3):711–32.Valdmanis VG, Rosko MD, Mutter RL. Hospital quality, efficiency, and input slack differentials. Health Serv Res. 2008;43(5):1830–48.Acerete B, Stafford A, Stapleton P. Spanish healthcare public private partnerships: The ‘Alzira model’. Crit Perspect Account. 2011;22(6):533–49.Allard G, Trabant A. Public-private partnerships in Spain: lessons and opportunities. Int Business Econ Res J. 2008;7(2):1–24.Shaoul J, Stafford A, Stapleton P. The cost of using private finance to build, finance and operate hospitals. Public Money Manage. 2008;28(2):101–8
Academic patenting: the importance of industry support
This paper provides evidence that university-industry collaboration is important for turning commercial opportunities into patents. The results suggest that researchers who receive a large share of research grants from industry have a higher propensity to file a patent. Small dissemination grants generally exert a positive effect, whether they come from industry or not. It also finds that these interactions do not increase the number of industry owned patents alone but benefit universities’ commercialisation efforts in general
Radiosurgery alone versus radiosurgery plus whole-brain irradiation for very few cerebral metastases from lung cancer
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