Characterization and Stability of Emulsion Gels Based on Acrylamide/Sodium Acryloyldimethyl Taurate Copolymer

Sepineo P 600, a concentrated dispersion of acrylamide/sodium acryloyldimethyl taurate copolymer in isohexadecane, has self-gelling and thickening properties and the ability to emulsify oily phases, which make it easy to use in the formulation of gels and o/w emulsion gels. In this paper, gels were prepared using a Sepineo P 600 concentration between the 0.5% and 5% (w/w), and then emulsion gel was also prepared from the 3% Sepineo gel by adding a specific amount of almond oil. All the prepared systems were analyzed and characterized by oscillation rheology and acoustic spectroscopy. The particle size of the oil droplets and the microrheological extensional moduli (G′ and G″) of the systems were determined from acoustic parameters and used together with the classical oscillatory rheological tests to assess the stability of the systems. Classical oscillatory analysis revealed that the dynamic moduli were very dependent on polymer concentration; as this parameter increased, there was progressive improvement in the sample elasticity. In fact, the mechanical spectra of the 0.5% and 1% (w/w) Sepineo samples were characterized by strong frequency dependence and multiple crossover points, typical of dilute polymer solution with no organized structure. On the other hand, the 3–5% (w/w) concentration systems showed typical gel-like spectra, marked by the absence of crossover points between the dynamic moduli and by weak dependence on frequency. Nevertheless, the elastic properties of the gel-like structure even at elevated polymer concentrations were not strongly long-lasting, as demonstrated by the increase of the viscous contribution in the low frequency range during acoustic spectroscopy analysis. This fact could indicate that the gel structure is characterized by weak polymer–polymer interactions, an advantageous characteristic for topical administration, as the sample is thus easier to rub into the skin. Finally, both rheology and acoustic spectroscopy indicated that addition of the oily phase caused minimal changes to the elastic character of the gel. Thus, Sepineo P 600 gel and emulsion gel are very effective systems for use in topical and other types of applications

A simplified primary aldosteronism surgical outcome score is a useful prediction model when target organ damage is unknown – Retrospective cohort study

Background: Cure of hypertension after adrenalectomy for primary aldosteronism is no certainty and therefore preoperative patient counseling is essential. The Primary Aldosteronism Surgical Outcome (PASO) Score is a useful prediction model with an area under the curve (AUC) of 0.839. The PASO Score includes ‘Target Organ Damage’ (TOD) (i.e., left ventricular hypertrophy and/or microalbuminuria), which is often unavailable during preoperative counseling and might therefore limit its use in clinical practice. We hypothesized that the PASO score would still be useful if TOD is unknown at time of counseling. Therefore, we aimed to examine the predictive performance of the simplified PASO Score, without taking TOD into account. Materials and methods: In this retrospective cohort study, patients who underwent unilateral adrenalectomy between 2010 and 2016 in 16 medical centers from North America, Europe and Australia were included. TOD was unknown in our database and therefore assigned as absent. Patients were classified as complete, partial or absent clinical success using the PASO consensus criteria. Results: A total of 380 (73.9%) patients were eligible for analysis. Complete, partial and absent clinical success were observed in 29.5%, 55.8% and 14.7% of patients, respectively. The simplified PASO Score had an AUC of 0.730 (95% confidence interval 0.674–0.785) in our total cohort. Conclusion: Without taking TOD into account, the simplified PASO Score had a lower predictive value as compared to the original derivation cohort. Ideally, the complete PASO Score should be used, but when data on TOD are not readily available, the simplified PASO Score is a useful and reasonable alternative

Fast Track Algorithm: How To Differentiate A “Scleroderma Pattern” From A “Non-Scleroderma Pattern”

Objectives: This study was designed to propose a simple “Fast Track algorithm” for capillaroscopists of any level of experience to differentiate “scleroderma patterns” from “non-scleroderma patterns” on capillaroscopy and to assess its inter-rater reliability. Methods: Based on existing definitions to categorise capillaroscopic images as “scleroderma patterns” and taking into account the real life variability of capillaroscopic images described standardly according to the European League Against Rheumatism (EULAR) Study Group on Microcirculation in Rheumatic Diseases, a fast track decision tree, the “Fast Track algorithm” was created by the principal expert (VS) to facilitate swift categorisation of an image as “non-scleroderma pattern (category 1)” or “scleroderma pattern (category 2)”. Mean inter-rater reliability between all raters (experts/attendees) of the 8th EULAR course on capillaroscopy in Rheumatic Diseases (Genoa, 2018) and, as external validation, of the 8th European Scleroderma Trials and Research group (EUSTAR) course on systemic sclerosis (SSc) (Nijmegen, 2019) versus the principal expert, as well as reliability between the rater pairs themselves was assessed by mean Cohen's and Light's kappa coefficients. Results: Mean Cohen's kappa was 1/0.96 (95% CI 0.95-0.98) for the 6 experts/135 attendees of the 8th EULAR capillaroscopy course and 1/0.94 (95% CI 0.92-0.96) for the 3 experts/85 attendees of the 8th EUSTAR SSc course. Light's kappa was 1/0.92 at the 8th EULAR capillaroscopy course, and 1/0.87 at the 8th EUSTAR SSc course. C Conclusion: For the first time, a clinical expert based fast track decision algorithm has been developed to differentiate a “non-scleroderma” from a “scleroderma pattern” on capillaroscopic images, demonstrating excellent reliability when applied by capillaroscopists with varying levels of expertise versus the principal expert and corroborated with external validation.Wo