Adherence to secondary prophylaxis and disease recurrence in 536 Brazilian children with rheumatic fever

Background  

More than 15 million people worldwide have rheumatic fever (RF) and rheumatic heart disease due to RF. Secondary prophylaxis is a critical cost-effective intervention for preventing morbidity and mortality related to RF. Ensuring adequate adherence to secondary prophylaxis for RF is a challenging task. This study aimed to describe the rates of recurrent episodes of RF, quantify adherence to secondary prophylaxis, and examine the effects of medication adherence to the rates of RF in a cohort of Brazilian children and adolescents with RF.     

Nuclear magnetic resonance-based metabonomics reveals strong sex effect on plasma metabolism in 17-year-old Scandinavians and correlation to retrospective infant plasma parameters

Nuclear magnetic resonance (NMR)-based metabonomics was carried out on plasma samples from a total of seventy-five 17-year-old Danes to investigate the impact of key parameters such as sex, height, weight, and body mass index on the plasma metabolite profile in a normal, healthy population. Principal component analysis identified sex to have a large impact on the NMR plasma metabolome, whereas no apparent effects of height, weight, and body mass index were found. Partial least square regression discriminant analysis and quantification of relative metabolite concentrations by integration of NMR signals revealed that the sex effect included differences in plasma lipoproteins (mainly high-density lipoprotein), glucose, choline, and amino acid content. Accordingly, the present study suggests a higher lipid synthesis in young women than young men and a higher protein turnover in young men compared with women. Data on plasma content of triglyceride, lipoprotein fractions, and cholesterol at an age of 9 months were available for selected individuals (n = 40); and partial least square regressions revealed correlations between these infant parameters and the NMR plasma metabolome at an age of 17 years. In conclusion, the present study demonstrates the feasibility of NMR-based metabonomics for obtaining a deeper insight into interindividual differences in metabolism and for exploring relationships between parameters measured early in life and metabolic status at a later stage.     

Probiotics and the immunological response to infant vaccinations; a double-blind randomized controlled trial

Objectives

To examine the effect of a combination of probiotics on the antibody response to pneumococcal and pertussis vaccination in healthy Danish children, aged 8–14 months, at the time of starting day care. Moreover, the cytokine response to lipopolysaccharide of whole blood was assessed.

Feeding behaviors during home‐based treatment of moderate acute malnutrition using corn‐soy blends or lipid‐based nutrient supplements

Feeding behaviors have an important impact on children's nutritional status and are essential to consider when implementing nutrition programs. The objective of this study was to explore and compare feeding behaviors related to supplementary feeding with corn‐soy blends (CSB) and lipid‐based nutrient supplements (LNS) based on best practice feeding behaviors. The study was conducted as part of a randomized controlled trial assessing the effectiveness of new formulations of CSB and LNS and comprised 1,546 children from 6 to 23 months. The study included a mixed methods approach using questionnaires, focus group discussions and home visits and interviews with a subsample of 20 caretakers of trial participants. We found that LNS, compared to CSB, were more likely to be mixed into other foods (OR [95% CI] 1.7 [1.3–2.2], p = <.001), served with a meal (OR [95% CI] 1.6 [1.1–2.3], p = <.018)or between meals (OR [95% CI] 1.5 [1.1–1.9], p = <.005), and fed using an encouraging feeding style (mean difference in percentage points [95% CI] 23% [6%:40%], p = .01). CSB were more likely to be fed using a forced feeding style (mean difference in percentage points [95% CI] 18% [3%:33%], p = .02) and were often observed to be served unprepared. The main differences in feeding behaviors between the two diet groups were linked to how and when supplements were served. Educational instructions should therefore be adapted according to the supplement provided; when providing CSB, efforts should be made to promote an encouraging feeding style, and emphasis should be made to ensure preparations are made according to recommendations.     

Analysis of 3D Prints by X-ray Computed Microtomography and Terahertz Pulsed Imaging

Purpose

A 3D printer was used to realise compartmental dosage forms containing multiple active pharmaceutical ingredient (API) formulations. This work demonstrates the microstructural characterisation of 3D printed solid dosage forms using X-ray computed microtomography (XμCT) and terahertz pulsed imaging (TPI).

Methods

Printing was performed with either polyvinyl alcohol (PVA) or polylactic acid (PLA). The structures were examined by XμCT and TPI. Liquid self-nanoemulsifying drug delivery system (SNEDDS) formulations containing saquinavir and halofantrine were incorporated into the 3D printed compartmentalised structures and in vitro drug release determined.

Results

A clear difference in terms of pore structure between PVA and PLA prints was observed by extracting the porosity (5.5% for PVA and 0.2% for PLA prints), pore length and pore volume from the XμCT data. The print resolution and accuracy was characterised by XμCT and TPI on the basis of the computer-aided design (CAD) models of the dosage form (compartmentalised PVA structures were 7.5?±?0.75% larger than designed; n?=?3).

Conclusions

The 3D printer can reproduce specific structures very accurately, whereas the 3D prints can deviate from the designed model. The microstructural information extracted by XμCT and TPI will assist to gain a better understanding about the performance of 3D printed dosage forms.

     

Automated swimming activity monitor for examining temporal patterns of toxicant effects on individual Daphnia magna

Aquatic pollutants are often biologically active at low concentrations and impact on biota in combination with other abiotic stressors. Traditional toxicity tests may not detect these effects, and there is a need for sensitive high‐throughput methods for detecting sublethal effects. We have evaluated an automated infra‐red (IR) light‐based monitor for recording the swimming activity of Daphnia magna to establish temporal patterns of toxicant effects on an individual level. Activity was recorded for 48 h and the sensitivity of the monitor was evaluated by exposing D. magna to the reference chemicals K₂Cr₂O₇ at 15, 20 and 25 °C and 2,4‐dichlorophenol at 20 °C. Significant effects (P < 0.001) of toxicant concentrations, exposure time and incubation temperatures were observed. At 15 °C, the swimming activity remained unchanged for 48 h at sublethal concentrations of K₂Cr₂O₇ whereas activity at 20 and 25 °C was more biphasic with decreases in activity occurring after 12–18 h. A similar biphasic pattern was observed after 2,4‐dichlorophenol exposure at 20 °C. EC₅₀ values for 2,4‐dichlorophenol and K₂Cr₂O₇ determined from automated recording of swimming activity showed increasing toxicity with time corresponding to decreases in EC₅₀ of 0.03–0.07 mg l^–1 h^–1. EC₅₀ values determined after 48 h were comparable or lower than EC₅₀ values based on visual inspection according to ISO 6341. The results demonstrated that the swimming activity monitor is capable of detecting sublethal behavioural effects that are toxicant and temperature dependent. The method allows EC values to be established at different time points and can serve as a high‐throughput screening tool in toxicity testing. Copyright © 2015 John Wiley & Sons, Ltd.