Beverage-induced enhanced bioavailability of carbamazepine and its consequent effect on antiepileptic activity and toxicity

The present study was undertaken to investigate the food–drug interaction of carbamazepine (CBZ). Common fruit juices [grapefruit juice (GFJ), lime juice (LJ)], known to inhibit the enzyme cytochrome P450 3A4 (CYP3A4), and some widely consumed beverages [milk (M), black tea (BT)] were involved in this study in the presence of CBZ, as might happen during clinical therapy. The effects of the beverages on the pharmacokinetics and drug-induced toxicity of CBZ was observed after concomitant administration for a period of 28 days. Accordingly, the influence of altered bioavailability of CBZ on its antiepileptic activity was investigated. A significant shift in the C_max as well as T_max of CBZ was observed in the presence of LJ and GFJ. This increase in bioavailability significantly enhanced hepatotoxicity and delayed the onset of tremor and piloerection against pentylene tetrazole (PTZ)-induced seizure in experimental animals. However, increased toxicity of CBZ was found to be absent with BT. Thus, from our observation, LJ or GFJ in the presence of CBZ significantly increased the bioavailability of CBZ, which might lead to increased toxicity and antiepileptic activity of the drug.     

Structural elucidation of NASICON (Na3Al2P3O12) based glass electrolyte materials: effective influence of boron and gallium

Understanding the conductivity variations induced by compositional changes in sodium super ionic conducting (NASICON) glass materials is highly relevant for applications such as solid electrolytes for sodium (Na) ion batteries. In the research reported in this paper, NASICON-based NCAP glass (Na_2.8Ca_0.1Al₂P₃O₁₂) was selected as the parent glass. The present study demonstrates the changes in the Na⁺ ion conductivity of NCAP bulk glass with the substitution of boron (NCABP: Na_2.8Ca_0.1Al₂B_0.5P_2.7O₁₂) and gallium (NCAGP: Na_2.8Ca_0.1Al₂Ga_0.5P_2.7O₁₂) for phosphorus and the resulting structural variations found in the glass network. For a detailed structural analysis of NCAP, NCABP and NCAGP glasses, micro-Raman and magic angle spinning-nuclear magnetic resonance (MAS-NMR) spectroscopic techniques (for ³¹P, ²⁷Al, ²³Na, ¹¹B and ⁷¹Ga nuclei) were used. The Raman spectrum revealed that the NCAP glass structure is more analogous to the AlPO₄ mesoporous glass structure. The ³¹P MAS-NMR spectrum illustrated that the NCAP glass structure consists of a high concentration of Q⁰ (3Al) units, followed by Q⁰ (2Al) units. The ²⁷Al MAS-NMR spectrum indicates that alumina exists at five different sites, which include AlO₄ units surrounded by AlO₆ units, Al(OP)₄, Al(OP)₅, Al(OAl)₆ and Al(OP)₆, in the NCAP glass structure. The ³¹P, ²⁷Al and ¹¹B MAS-NMR spectra of the NCABP glass revealed the absence of B–O–Al linkages and the presence of B₃–O–B₄–O–P₄ linkages which further leads to the formation of borate and borophosphate domains. The ⁷¹Ga MAS-NMR spectrum suggests that gallium cations in the NCAGP glass compete with the alumina cations and occupy four (GaO₄), five (GaO₅) and six (GaO₆) coordinated sites. The Raman spectrum of NCAGP glass indicates that sodium cations have also been substituted by gallium cations in the NCAP glass structure. From impedance analysis, the dc conductivity of the NCAP glass (∼3.13 × 10⁻⁸ S cm⁻¹) is slightly decreased with the substitution of gallium (∼2.27 × 10⁻⁸ S cm⁻¹) but considerably decreased with the substitution of boron (∼1.46 × 10⁻⁸ S cm⁻¹). The variation in the conductivity values are described based on the structural changes of NCAP glass with the substitution of gallium and boron.

Understanding the conductivity variations induced by compositional changes in sodium super ionic conducting (NASICON) glass materials is highly relevant for applications such as solid electrolytes for sodium (Na) ion batteries.     

Willingness to participate in cardiac trials

The elderly, women, and minorities are all less likely to be enrolled in randomized clinical trials (RCTs). Whether differential patient interest in RCTs contributes to these disparities is unclear. The authors surveyed 660 patients' willingness to consider two potential cardiac RCTs of medical therapy vs. percutaneous coronary angioplasty or coronary artery bypass surgery, respectively. The cohort's mean age was 67 years (43% aged ≥70 years; 35% women; and 28% nonwhite). Compared with younger patients, those aged ≥70 years were equal or more likely to consider both the percutaneous coronary angioplasty (46% vs. 41%) and coronary artery bypass surgery RCTs (35% vs. 31%). Race also had no significant impact on trial enrollment, yet women were significantly less likely than men to participate in either RCT. In conclusion, patient willingness to consider RCT participation does not explain underenrollment of elderly and minority patients. Women, however, were more reluctant to consider RCTs, an area requiring further study.     

Extra-Aortic Mycotic Aneurysm Due to Group A Streptococcus after Pharyngitis

Mycotic aneurysms, especially outside the aorta, are uncommon, with group A Streptococcus a particularly rare cause. We report a case of extra-aortic mycotic aneurysm following a sore throat without demonstrable bacteremia where identification of the pathological organism was made by molecular diagnostic techniques after a standard laboratory culture was negative.     

A Review on Joint Carotid Intima-Media Thickness and Plaque Area Measurement in Ultrasound for Cardiovascular/Stroke Risk Monitoring: Artificial Intelligence Framework

Journal of Digital Imaging - Cardiovascular diseases (CVDs) are the top ten leading causes of death worldwide. Atherosclerosis disease in the arteries is the main cause of the CVD, leading to...