Recurrent hemi-hypoesthesia in a young patient: A clinical challenge

Takayasu’s arteritis (TA) is a chronic inflammatory disease of unknown etiology characterized by granulomatous vasculitis of medium and large arteries, principally the aorta and its branches. It is a rare disorder but neurological manifestations are common.The authors present a case of a 39-year-old woman that presented with several episodes of hemi-hypoesthesia that lasted several days and coursed with complete recovery. She had already preliminary workup for most neurological diseases that presented at her age range that had been normal.We emphasize in this clinical case the atypical presentation of TA with neurological symptoms of somewhat vague and prolonged course with a negative preliminary workup. We believe it is important to keep a high index of suspicion in such cases.     

Salt Intake and Risk of Gastric Intestinal Metaplasia: Systematic Review and Meta-Analysis

The understanding of the association between salt intake and precancerous lesions may contribute to clarify the causal relation with gastric cancer. We systematically reviewed 17 articles addressing the association between dietary salt exposure and gastric intestinal metaplasia and conducted meta-analyses for quantitative synthesis (random effects model). Salt exposure was estimated assessing salted/salty food consumption, preference for salted/salty foods, use of table salt, or sodium urinary excretion. Heterogeneity was also large regarding food items evaluated, consumption categories, and data analysis. The combined odds ratio (OR) was 1.68 (95% confidence interval (CI) = 0.98–2.90; I² = 55.4%) for the association between salted/salty meat and intestinal metaplasia (4 studies) and the OR was 1.53 (95% CI = 0.72–3.24; I² = 76.8%) for salt preference. There was a positive, nonstatistically significant association between intestinal metaplasia and urinary sodium excretion. The heterogeneity of methodological options and results preclude quantitative synthesis or its proper interpretation, even if the available evidence may suggest a positive association between salt and intestinal metaplasia.     

Activity of Bisnaphthalimidopropyl Derivatives against Trypanosoma brucei

Current treatments for African trypanosomiasis are either toxic, costly, difficult to administer, or prone to elicit resistance. This study evaluated the activity of bisnaphthalimidopropyl (BNIP) derivatives against Trypanosoma brucei. BNIPDiaminobutane (BNIPDabut), the most active of these compounds, showed in vitro inhibition in the single-unit nanomolar range, similar to the activity in the reference drug pentamidine, and presented low toxicity and adequate metabolic stability. Additionally, using a murine model of acute infection and live imaging, a significant decrease in parasite load in BNIPDabut-treated mice was observed. However, cure was not achieved. BNIPDabut constitutes a new scaffold for antitrypanosomal drugs that deserves further consideration.     

Intranasal delivery of nanostructured lipid carriers,solid lipid nanoparticles and nanoemulsions: A current overview of in vivo studies

The management of the central nervous system (CNS) disorders is challenging, due to the need of drugs to cross the blood‒brain barrier (BBB) and reach the brain. Among the various strategies that have been studied to circumvent this challenge, the use of the intranasal route to transport drugs from the nose directly to the brain has been showing promising results. In addition, the encapsulation of the drugs in lipid-based nanocarriers, such as solid lipid nanoparticles (SLNs), nanostructured lipid carriers (NLCs) or nanoemulsions (NEs), can improve nose-to-brain transport by increasing the bioavailability and site-specific delivery. This review provides the state-of-the-art of in vivo studies with lipid-based nanocarriers (SLNs, NLCs and NEs) for nose-to-brain delivery. Based on the literature available from the past two years, we present an insight into the different mechanisms that drugs can follow to reach the brain after intranasal administration. The results of pharmacokinetic and pharmacodynamics studies are reported and a critical analysis of the differences between the anatomy of the nasal cavity of the different animal species used in in vivo studies is carried out. Although the exact mechanism of drug transport from the nose to the brain is not fully understood and its effectiveness in humans is unclear, it appears that the intranasal route together with the use of NLCs, SLNs or NEs is advantageous for targeting drugs to the brain. These systems have been shown to be more effective for nose-to-brain delivery than other routes or formulations with non-encapsulated drugs, so they are expected to be approved by regulatory authorities in the coming years.KEY WORDS: Nose-to-brain delivery, Intranasal administration, Nanostructured lipid carriers, NLC, Solid lipid nanoparticles, SLN, Nanoemulsions, In vivo studies, Pharmacokinetic, Pharmacodynamics