Development of a robust once-a-day glipizide matrix system

The robustness of a new hydroxypropylmethylcellulose (HPMC) based modified release glipizide (10 mg) formulation was studied. The tablet formulations were prepared by dry blending the ingredients and direct compression, incorporating a range of release modifying agents up to +/-20% w/w relative to an optimized formulation. The dissolution was assessed in 900 mL pH 6.8 buffer at 75 rev min(-1) paddle speed. Calculated difference and similarity factors (f(1) and f(2)) and results of analysis of variance suggest that the overall release profiles were similar. Compositional changes up to +/-20% w/w and a reduction of drug dose to half did not change the general release pattern of this low dose/pH-dependent drug in a significant way. It is concluded that the drug release from the developed matrix systems is highly dependent on the kinetics of hydration and erosion, and that the proposed compositional changes within +/-20% w/w did not alter this relationship. The particulate systems used were characterized by determining the Carr index, Hausner ratio and the rheological properties using a texture analyser. Results indicate that the release is reproducible and the system has potential for successful scale-up operation, while complying with recommended Food and Drug Administration guidelines "Scale Up and Post Approval Changes".     

Use of imprint cytology for assessment of surgical margins in lumpectomy specimens of breast cancer patients

In the past several years, breast-conservation therapy has provided an alternative to mastectomy. In order to reduce the subsequent local tumor recurrence, it is critical that all the measures are in place to find the residual foci of occult microscopic tumor at the time of the initial lumpectomy procedure. An accepted method to evaluate the lumpectomy margins for presence of residual tumor is the use of imprint cytology (also called touch-prep), which is assessment of the presence or absence of the tumor cells by cytological preparation. This is a rapid, cost effective, and easy to use procedure with added advantage of saving tissue for permanent sectioning and rendering a definitive diagnosis. In this report, we present our experience using intraoperative imprint cytology for evaluation of the status of lumpectomy specimens in breast cancer patients. The objective of this study was to evaluate the diagnostic accuracy of intraoperative imprint cytology for assessment of surgical resection margins in lumpectomy margins of patients with breast carcinoma. This is a retrospective study of 100 cases of breast lumpectomy specimens, which had undergone intraoperative imprint cytology. The cases were retrieved from the archived files of the University of Florida, Department of Pathology at Shands Jacksonville. The results of intraoperative imprint cytology were compared with the histological findings of the corresponding permanent sections of the same cases as the gold standard. Overall, we reviewed 510 cytology imprint slides, which were obtained from 100 lumpectomy specimens. Among these cases, 37 slides from 22 cases were reported positive and the remaining were negative. Only eight slides from six cases of lumpectomy showed discrepancy between the result of intraoperative imprint cytology and the permanent sections of the same cases. In our study, intraoperative imprint cytology showed a sensitivity of 97%, specificity of 99%, with positive predictive value of 84%, and negative predictive value of 99%. This study demonstrates that intraoperative imprint cytology can be used as a reliable diagnostic procedure for the evaluation of the status of lumpectomy margins in breast cancer patients.     

Synthesis and antibacterial activity of levofloxacin derivatives with certain bulky residues on piperazine ring

A number of levofloxacin analogues carrying a 2-aryl-2-oxoethyl or a 2-aryl-2-oxyiminoethyl moiety attached to the piperazine ring at C-10 position have been prepared and evaluated as antibacterial agents against a series of Gram-positive and Gram-negative bacteria. Some of them exhibited significant inhibitory activity against Gram-positive bacteria.     

Intraobserver and interobserver reliability of the three-dimensional ultrasound imaging of female urethral sphincter using a translabial technique

Introduction and hypothesis

The aim of the study was to assess the interobserver and intraobserver reliability of translabial 3D ultrasound imaging of the urethral sphincter in non-pregnant nulliparous asymptomatic women.

Methods

A study using a 3D translabial ultrasound on thirty-seven women was performed. Urethral sphincter parameters were measured by the same experienced clinician 2?weeks apart. Multiple axial cross-sectional areas at 1-mm distances were used to calculate urethral sphincter volumes. The same measurements were carried out by a second experienced clinician to assess the interobserver reliability.

Results

We found an excellent intraobserver reliability (interclass correlation coefficient, ICC >0.8) and good interobserver reliability (ICC >0.6).

Conclusion

The described technique using multiple axial cross-sectional areas at set distances and a translabial approach is a reliable and accurate tool in the evaluation of the urethral sphincter. This should be used instead of mathematical formulas as the urethral sphincter is not a uniform geometrical sphere. The technique and values reported may help clinicians in the assessment of women with lower urinary tract disorders.     

Integrative Review of the Experiences of Registered Nurses Who Support Breastfeeding Women

ObjectiveTo describe the experiences of registered nurses (RNs) who support breastfeeding women and to understand the factors that they believe affect practices that support breastfeeding.Data SourcesWe conducted an online search using five databases: Scopus, MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Cochrane Database of Systematic Reviews, and Joanna Briggs Institute of Systematic Reviews.Study SelectionWe included original research articles on the experiences of RNs who support breastfeeding women that were published in 2009 or after and were available in English. After title and abstract review of 785 articles, we included 22 articles for full text review. Nine articles met the eligibility criteria and were included in the review.Data ExtractionWe used Whittemore and Knafl’s five-step framework and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines to guide this integrative review. Three authors reviewed and appraised the articles independently.Data SynthesisWe categorized the findings into three themes: Workplace Issues, Personal Experiences, and Breastfeeding Knowledge and Education. Workplace Issues included the subthemes Lack of Time and Workload and Infant Health Stability. Personal Experiences included the subthemes Attitudes, Individual Experiences With Breastfeeding, and The Experiences of Family and Friends. Breastfeeding Knowledge and Education included the subthemes Prelicensure Education and Workplace Education and Training. Most researchers identified deficits in knowledge and education among RNs. The concept of confidence was influenced by all the other themes. Participants in the included studies reported that they developed confidence after learning from lactation consultants and having role models who supported the development of their knowledge and skills.ConclusionDespite the heterogeneity among the studies, findings highlighted the need for an increased focus on the preparation of RNs to support women to effectively breastfeed within health care organizations. Multitargeted efforts, such as orientation programs and in-depth breastfeeding education using role modeling, mentorship, and role playing with practical scenarios, may improve RNs’ abilities and confidence to support breastfeeding women.