Endobypass Using a Heparin-bonded Covered Stent to Treat Upper Limb Claudication due to Axillary Artery Occlusion Following Axillofemoral Bypass

IntroductionPost-surgical axillary artery occlusion may present with upper limb symptoms requiring intervention.ReportA 76-year-old male had previously undergone left axillofemoral bypass for lower limb ischemia. Following an initial presentation with brachial thromboembolism, he re-presented with left axillary artery occlusion manifesting as upper limb claudication significantly affecting activities of daily living. The axillary artery was successfully recanalised following deployment of a 10 × 50mm Viabahn endoprosthesis with complete symptomatic resolution.DiscussionEndovascular recanalisation of proximal upper limb vessels affords a convenient option to open surgery. A stent-graft offers additional protection compared to a stent if there is arterial rupture during the procedure.     

Tumor growth inhibition through targeting liposomally bound curcumin to tumor vasculature

Increasing number of Phase I/II clinical studies have demonstrated clinical potential of curcumin for treatment of various types of human cancers. Despite significant anti-tumor efficacies and bio-safety profiles of curcumin, poor systemic bioavailability is retarding its clinical success. Efforts are now being directed toward developing stable formulations of curcumin using various drug delivery systems. To this end, herein we report on the development of a new tumor vasculature targeting liposomal formulation of curcumin containing a lipopeptide with RGDK-head group and two stearyl tails, di-oleyolphosphatidylcholine (DOPC) and cholesterol. We show that essentially water insoluble curcumin can be solubilized in fairly high concentrations (~ 500 μg/mL) in such formulation. Findings in the Annexin V/Propidium iodide (PI) binding based flow cytometric assays showed significant apoptosis inducing properties of the present curcumin formulation in both endothelial (HUVEC) and tumor (B16F10) cells. Using syngeneic mouse tumor model, we show that growth of solid melanoma tumor can be inhibited by targeting such liposomal formulation of curcumin to tumor vasculature. Results in immunohistochemical staining of the tumor cryosections are consistent with tumor growth inhibition being mediated by apoptosis of tumor endothelial cells. Findings in both in vitro and in vivo mechanistic studies are consistent with the supposition that the presently described liposomal formulation of curcumin inhibits tumor growth by blocking VEGF-induced STAT3 phosphorylation in tumor endothelium. To the best of our knowledge, this is the first report on inhibiting tumor growth through targeting liposomal formulation of curcumin to tumor vasculatures.     

Systematic Investigation of Parameters Affecting the Performance of an Agitated Filter-Dryer

A systematic experimental investigation of contact drying operation was carried out in an agitated Charles Thompson filter-dryer. In this study, the effect of process parameters (wall temperature, impeller speed, fill level) on the drying performance in the filter-dryer is quantified as a function of bed temperature and solvent concentration. In addition, the impact of drying conditions on the particle size distribution was also examined. It was found that in the range of parameters investigated, drying rate increased with wall temperature and reduced bed depth. The effect of impeller speed was variable where favorable drying conditions were strongly dependent on the particle properties. Moreover, decrease in the particle size was evident with an increase in impeller speed and decrease in the bed depth due to increased collision frequency and reduction in the fill volume both leading to particle attrition respectively. Besides, the average wall to solid heat transfer coefficient is also estimated for variable operating conditions. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 102:2198–2213, 2013     

Educating Women for HIV Prevention: Does Exposure to Mass Media Make Them More Knowledgeable?

Mass media is an important vehicle for health promotion in developing countries. In Bangladesh multiple media campaigns are being carried out to educate people about HIV/AIDS. We examined the extent of HIV/AIDS knowledge and the association of exposure to mass media among women in Bangladesh. The Bangladesh Demographic and Health Survey (BDHS) provides data for this article. We found that media exposure (combined index of television, radio, and newspaper) was a highly significant predictor of women's knowledge about HIV and AIDS. Other significant predictors of HIV knowledge include women's education, age, employment, and urban residence.     

Subcutaneous apomorphine and non-motor symptoms in Parkinson's disease

Non-motor symptoms (NMS) are now recognized to occur across all stages of Parkinson's disease (PD) and as a result there has been an increasing focus on their diagnosis, quantification and effective management. While in some subjects, NMS may be present before diagnosis, in advanced PD, NMS can contribute to hospitalization, severe disability and a shortened life expectancy. Strategies for continuous drug delivery have been reported to have a beneficial effect on NMS in PD and while the efficacy of apomorphine on motor function in PD has been confirmed in a number of studies, in addition to its possible anti-dyskinetic effect, a number of reports have also outlined the possible beneficial effect of apomorphine on NMS. This review sets out to examine the efficacy of apomorphine in non-motor aspects of PD, including its effect on neuropsychiatric and gastrointestinal symptoms, sleep (including restless legs syndrome), urinary dysfunction, pain and impulse control disorders. The analysis takes into consideration case reports, and open-label and comparative case–control studies published to date. Results of this review suggest that although data on the effect of apomorphine on NMS in PD patients are limited there is a strong suggestion of a beneficial effect that warrants further investigation in double-blind studies.     

Pediatric deceased donor renal transplantation: An approach to decision making II. Acceptability of a deceased donor kidney for a child,a snap decision at 3 AM

Allocation of deceased donor kidneys is based on several criteria; however, the final decision to accept or reject the offered kidney is made by the potential recipient's transplant team (surgeon/nephrologist). Several considerations including assessment of the donor quality, the HLA match between the donor and the recipient, several recipient factors, the geographical location of the recipient, and the organ all affect the decision of whether or not to finally accept the organ for a particular recipient. This decision needs to be made quickly, often on the spot. Maximizing the benefit from this scarce resource raises difficult ethical issues. The philosophies of equity and utility are often competing. This article will discuss the several considerations for the pediatric nephrologist while accepting a deceased donor kidney for a particular pediatric patient.