The role of the malassezia yeasts in the etiology of seborrheic dermatitis of the capillitium

Въведение: Себорейният дерматит (СД) е често срещано хронично заболяване в дерматологичната практика, което засяга предимно капилициум и лицето. Етиологията на себорейния дерматит не е ясно дефинирана и за това често пъти се обсъжда като заболяване с мултифакторна патогенеза и комплексна нозология.Цел: Целта на настоящото отворено проучване е да установи присъствието и количеството на дрождите от род Malassezia (Pityrosporum) при пациенти със себореен дерматит на капилициума (СДК), с оглед на правилната етиологична обосновка и оптимизация на диагностиката и лечението на СДК в различни възрастови групи.Материал и методи: Обект на нашето отворено проспективно проучване са 30 амбулаторно преминали пациенти (21 мъже и 9 жени) на възраст от 16 до 59 години през ККВБ МБАЛ Александровска - гр. София, ДКЦ 3 - гр. София, Курортна поликлиника - гр. Варна, с добре изразен себореен дерматит на капилициума (СДК) и 30 здрави контроли на възраст между 25 и 34 години. За доказване и количествено определяне на дрождите Malassezia (PO) беше използван отпечатъковият метод `Tape method` (L.R.Wikler, 1984). С този метод в суспетктни за себореен дерматит лезии може да бъде доказан PО, което определя метода като високоефективен диагностичен инструмент.Резултати: При изследваните от нас 30 болни със СДК броят на колониите в засегнатите участъци беше между 80 и 800см2. Броят на колониите от изглеждаща здрава кожа от същите пациенти бе значително по-малък от 80 до 200см2 и от здравите контроли под 100 cm2.Заключение: Настоящото изследване доказва първостепенната етиологична роля на дрождите Malassezia (Pityrosporum) за възникването на СД, респ. СДК, и определя локалното антимикотично лечение като първо средство на избор при тези пациенти.Introduction: Seborrheic dermatitis (SD) is a common chronic disease in the dermatological practice which affects predominantly the capillitium and the face. The etiology of the seborrheic dermatitis is not clearly defined and thus, it is a topic of numerous discussions as a disease with a multifactorial pathogenesis and a complex nosology.Aim: The aim of this open study is to establish the presence and the quantity of Malassezia yeasts (Pityrosporum) for patients with seborrheic dermatitis of the capillitium (SDC) in order to determine the correct etiological justification and optimization of SDC diagnostics and treatment for different age groups.Materials and Methods: The subjects of our open prospective study are 30 patients (21 males and 9 females) of age between 16 and 59 years, ambulatory tested at the Clinic of Internal Disease Propaedeutics at the Alexandrovska Multi-Profile Hospital for active treatment - city of Sofia, Third Diagnostic and Consultative Center - Sofia, Resort Polyclinic - Varna, with well-expressed seborrheic dermatitis of the capillitium (SDC) and 30 healthy controls at age between 25 and 34 years. The imprint method, `Tape method` (L.R.Wikler, 1984), has been used for proving and quantitative definition of the Malassezia yeasts (PO). With the help of this method the PO can be proved for lesions suspected for seborrheic dermatitis which determines the method as a highly effective diagnostic instrument.Results: For the 30 patients with SDC studied by us, the number of the colonies in the affected areas was between 80 and 800 cm2. The number of colonies from a healthy-looking skin of the same patients was significantly lower - from 80 to 200 cm2, and from the healthy controls it was under 100 cm2.Conclusion: This study proves the primary etiological role of the Malassezia yeasts (Pityrosporum) for the occurrence of SD and SDC, respectively, and determines the local antifungal treatment as the method of choice for such patients

Self-Emulsifying Drug Delivery Systems as an Approach to Improved Oral Bioavailability of Drugs

The oral route of drug administration is the most effective and the most widely applicable, as it is characterized by high therapeutic efficiency, a low production cost, and very good patient acceptance. Before a drug enters the bloodstream, it must go through stages of dissolution and overcome biological membranes. However, most drugs are characterized by low solubility and/or permeability in the gastrointestinal tract environment. These disadvantages can be overcome by various technological approaches, such as micronization, the formation of salts and complexes, solid dispersions, the use of mucoadhesive polymers, as well as lipid-based drug delivery systems such as the self-emulsifying systems (SEDDS). In recent years, SEDDS have been one of the most popular approaches to increasing oral bioavailability, as they have the potential to reduce the administered dose and protect unstable drugs from the aggressive conditions in the gastrointestinal tract.Depending on their preparation and composition, SEDDS can improve the deficiencies of drugs belonging to biopharmaceutical classes II to IV. Furthermore, depending on the type of dispersion formed, they can be classified into micro-SEDDS, nano-SEDDS, o/w-SEDDS, and w/o/w-SEDDS.

Parkinson's Disease: Technological Approaches for Optimized Therapeutic Efficacy of Levodopa

Parkinson's disease is a progressive neurodegenerative disease affecting more than 10 million patients worldwide. The leading cause of this pathological condition is an imbalance between dopaminergic and cholinergic systems due to dopaminergic neurons' degeneration in the nigrostriatal pathways. The primary goal of Parkinson's therapy is to correct the levels of the mentioned neurotransmitters, and the administration of Levodopa has been accepted as a "gold standard" treatment. The amino acid precursor can successfully control the symptoms by compensating for the reduced concentration of endogenous dopamine and activating postsynaptic D-receptors in the striatum.The intensive enzymatic degradation of levodopa in the gastrointestinal tract is the main reason for its low concentration in the midbrain (~1%) and the increased frequency of adverse drug reactions. Despite numerous attempts to improve clinical efficacy, increasing bioavailability and reducing side effects remain difficult. This makes it necessary to use innovative drug delivery systems capable of overcoming the problems mentioned above.This literature review presents new technological approaches for improved delivery of levodopa to the central nervous system. Nanoparticles, liposomes, cyclodextrin complexes, carbon nanotubes, and others represent promising platforms for the delivery and controlled release of the dopamine precursor. With the ability to ensure optimal bioavailability, constant plasma concentration, minimal peripheral degradation, and reduced adverse drug reactions, they successfully overcome the shortcomings of conventional levodopa-containing dosage forms

Silver Nanoparticles as Multi-Functional Drug Delivery Systems

Nanoparticles can surmount some essential problems of conventional small molecules or biomacromolecules (e.g., DNA, RNA, and protein) used in some diseases by allowing targeted delivery and overcome through biological barriers. Recently, silver nanoparticles have been harnessed as delivery vehicles for therapeutic agents, including antisense oligonucleotides, and other small molecules. Silver is the most profit-oriented precious metal used in the preparation of nanoparticles and nanomaterials because of its antibacterial, antiviral, antifungal, antioxidant and unusually enhanced physicochemical properties compared to the bulk material such as optical, thermal, electrical, and catalytic properties. Small silver nanoparticles offer many advantages as drug carriers, including adjustable size and shape, enhanced stability of surface-bound nucleic acids, high-density surface ligand attachment, transmembrane delivery without harsh transfection agents, protection of the attached therapeutics from degradation, and potential for improved timed/controlled intracellular drug-delivery. Plant-mediated synthesis of silver nanoparticles is gaining interest due to its inexpensiveness, providing a healthier work environment, and protecting human health leading to lessening waste and safer products. The chapter presents the essential physicochemical characteristics, antibacterial, and anticancer properties which silver nanoparticles obtained by plant-mediated methods possess, and their application as drug-delivery systems with a critical view on the possible toxicity on the human body

Treatment algorithm for seborrheic dermatitis

Себорейният дерматит (СД) е често болестно състояние в дерматологичната практика с мултифакторна, но не ясно дефинирана патогенеза и комплексна нозология. Традиционната терапия е локална и/или системна. Съвременните терапевтични подходи включват все повече агресивни препарати (глюкокортикостероиди, имуносупресори, системни антимикотици, синтетични ретиноиди и др.). Това е свързано с потенциален риск от появата на сериозни странични ефекти, особено при продължителна и многократна употреба на тези медикаменти. Настоящият терапевтичен алгоритъм предоставя на клинициста бърз и лесен достъп за избор на лечение според тежестта на СД съобразно съвременните изисквания и достъпност до всички посочени терапевтични подходи на медицината, основана на доказателства.Seborrheic dermatitis (SD) is a common pathology in dermatological practice of multifactorial but not clearly defined pathogenesis and complex nosology. Conventional treatment is local and/or systemic. Modern approaches for management include more and more aggressive preparations such as glucocorticosteroids, immunosupressants, systemic antifungals, synthetic retinoids, etc. This is associated with a potential risk for the occurrence of severe adverse effects, especially under the conditions of long-lasting and repeated usage of these medicaments. The present therapeutic algorithm provides to the clinician a rapid and easy access for choice of treatment according to SD severity meeting the contemporary requirements and availability to any indicated therapeutic approaches of the evidence-based medicine

First-Order System Least Squares and the Energetic Variational Approach for Two-Phase Flow

This paper develops a first-order system least-squares (FOSLS) formulation for equations of two-phase flow. The main goal is to show that this discretization, along with numerical techniques such as nested iteration, algebraic multigrid, and adaptive local refinement, can be used to solve these types of complex fluid flow problems. In addition, from an energetic variational approach, it can be shown that an important quantity to preserve in a given simulation is the energy law. We discuss the energy law and inherent structure for two-phase flow using the Allen-Cahn interface model and indicate how it is related to other complex fluid models, such as magnetohydrodynamics. Finally, we show that, using the FOSLS framework, one can still satisfy the appropriate energy law globally while using well-known numerical techniques.Comment: 22 pages, 8 figures submitted to Journal of Computational Physic

Stability study of extemporaneously compounded nitrofurantoin oral suspensions for pediatric patients

Aim: To evaluate the stability of nitrofurantoin suspended in different extemporaneously compounded vehicles after storage at 4°C and at 25°C. To formulate an effective, readily available vehicle that can guarantee extended stability and precise dosing. Materials and methods: Nitrofurantoin was suspended at a concentration of 10 mg/mL in seven different vehicles compounded of different blends of Syrupus simplex, sorbitol 70%, methylcellulose 1%, gummi arabici 1%, gummi xanthani 1%, and sodium carboxymethylcellulose (NaCMC) 1%. Samples of 100 mL of every compounded suspension were stored in dark in graded glass bottles at 4°C and at 25°C. Samples were analyzed at the beginning and every 10 days up to day 30 and every 30 days after. Variations of physical properties such as sedimentation, ease of resuspension, color and odor were evaluated visually and organoleptically. Rheological analysis was also performed in order to determine suspensions’ behavior during storage and dosing. Variations in nitrofurantoin concentration and pH were evaluated with suitable analytical procedure (UV-Vis; HPLC; pH/ORP). Microbiological stability was evaluated via incubation on suitable culture media. Results: To the 30th day, only three of the compounded suspensions exhibited significant physical stability and slight change in taste and odor stored at both temperatures. Two samples stored at 25°C exhibited nitrofurantoin concentration greater than 95% and 4 samples stored at 4°C – concentration greater than 95%. All models showed no microbial growth up to day 30. At 120 days, only three of the compounded suspensions, stored at 4°C, exhibited relatively high nitrofurantoin concentrations: 88.2%, 92%, and 81.1%, respectively. Only one model suspension showed chemical and physical stability (≥95% of the initial concentration) for 102 days. No model suspension remained sterile after 30 days. Conclusions: The suspensions compounded with vehicles of blends of syrups, xanthan, croscarmellose (NaCMC), and sorbitol exhibited low to none sedimentation, good uniformity of content and are suitable organoleptically for pediatric administration. The model suspension stored at 4°C (NTF VII 4°C – with major excipients: sucrose 16%, sorbitol 17%, xanthan gum 0.25%, NaCMC 0.25%) stands out with nitrofurantoin concentration higher than 95% along with no or little signs of sedimentation. After adding a suitable preservative agent or system, a formulation with these characteristics might have an expiration date of at least 90 days

A Review of Factors Predicting Outcome of Pneumatic Dilation in Patients With Achalasia Cardia

Pneumatic dilation (PD) is an effective treatment for achalasia cardia. Outcome of PD, however, varies among different studies. Recently, some groups started considering laparoscopic myotomy to be competitive to PD in treatment of achalasia considering dreaded complication like perforation following the latter therapeutic approach. Therefore, there is need to predict outcome of PD for achalasia, so that appropriate therapy, both for treatment naïve and for treatment failed patients can be chosen. Apart from age and gender, 2 investigations, namely post-PD manometry and timed barium esophagogram are most often used to predict outcome after PD. Even though there are studies available in the literature with regard to these modalities to predict outcome of PD, these are quite few in number, including small number of patients, primarily because of rarity of the disease. In this article, we review the literature predicting outcome of PD for achalasia