Effects of n-3 fatty acids on serum interleukin-6, tumour necrosis factor-alpha and soluble tumour necrosis factor receptor p55 in active rheumatoid arthritis

We investigated the effects of a low n-6 fatty acid (FA) diet supplemented with fish oil on serum pro-inflammatory cytokine concentrations and clinical variables in patients with active rheumatoid arthritis (RA). Sixty patients were randomly assigned to receive a diet low in n-6 FAs and n-3 FAs supplement (fish oil group), a diet low in n-6 FAs and placebo (placebo group), or no special diet or intervention (control group). Serum cytokines and clinical and biochemical variables were evaluated at baseline and various timepoints. At week 18 the fish oil group had significant reductions in linoleic acid, C-reactive protein (CRP) and soluble tumour necrosis factor receptor p55 (sTNF-R p55), and significant elevations in eicosapentaenoic acid and docosahexaenoic acid compared with baseline. There were no significant differences in the clinical variables between the three groups. At week 24 there were significant reductions in interleukin-6 and TNF-alpha in the fish oil and placebo groups. Supplementation with n-3 FA and a low n-6 FA intake decreased serum sTNF-R p55 and CRP levels in patients with RA.     

Assaults and Nonpatient-Induced Injuries Among Psychiatric Nursing Staff in Bahrain

This retrospective study of incident reports at the psychiatric hospital in Bahrain was carried out to describe nursing staff injuries that were reported during 1992-1999. The average assault rate (4.4%) was much lower than that reported in Western countries. Of the 111 injuries, 44.0% occurred in wards assigned for patients with acute conditions, 27.5% in chronic condition wards, 5.5% in outpatients, and 22.9% in the community. Staff assaults by patients constituted 60.4% of all injuries, of which 64.2% occurred in the 1992-1995 period. The assault rate was highest in 1992 (6.8/100) and lowest in 1998 (1.1/100), while the rate for all injuries was highest in 1994 (12.0/100) and lowest in 1998 (3.3/100). Bahraini staff had higher assault (7.0/100) and total injury (14.8/100) rates than the non-Bahraini (5.5, 6.8/100, respectively). Odds ratios for assaults vs. nonpatient-induced injuries indicated that assaults were 2.3 times (95% CI: 1.05-4.95) more likely to occur in males, 5 times more likely (95% CI: 1.99-12.15) in non-Bahraini, 1.79 times more likely (95% CI: 0.81-3.95) in staff nurses, and 2.3 times more likely (95% CI: 1.05-5.01) in the evening. Suggestions for reducing assaults and nonpatient-induced injuries are discussed.     

Solubilities and intrinsic dissolution rates of sulphamethoxazole and trimethoprim

The influence of pH on the dissolution rates and solubilities of sulphamethoxazole and trimethoprim have been examined. Sulphamethoxazole was evaluated in buffers of ionic strength 0.5 mol dm-3 over the pH range 0.45-7.8 and at 25, 32 and 37 degrees C. The minimum solubility of sulphamethoxazole was 28.1 mg/100 mL at pH 3.22 and 25 degrees C. Solubilities increased significantly with both increased and decreased pH. Intrinsic dissolution rates demonstrated a linear relationship with the solubility data. Trimethoprim solubility was both buffer- and pH-dependent. In both water and hydrochloric acid solution at 32 degrees C the solubility of trimethoprim increased from 50 mg/100 mL in water at pH 8.54 to a maximum of 1550 mg/100 mL at pH 5.5. This maximum solubility was in excess of that predicted theoretically and may be due to supersaturation. Below pH 2 the solubility of protonated trimethoprim diminished from 1125 mg/100 mL with decreasing pH. This was due to the common ion effect. Intrinsic dissolution rates increased as pH was decreased with hydrochloric acid from 6.00 to 1.78, but decreased at pH 1.48 due to the common ion effect. Dissolution profiles of trimethoprim showed complex patterns dependent upon pH. The profile was zero-order at pH 6.00 and became distinctly stepwise at pH 5.5, this effect becoming less pronounced at lower pH values. This was reconciled in terms of the rate of formation of trimethoprim hydrochloride on the surface of the disc and the differing dissolution rates of this species and trimethoprim. A simple relationship between solubility and dissolution rate was not observed.     

Sustained virological response in a predominantly hepatitis C virus genotype 4 infected population

AIM： To assess sustained virological response （SVR） rates in a predominantly hepatitis C virus （HCV） genotype 4 infected population. METHODS： Between 2003-2007, 240 patients who were treated for chronic hepatitis C infection at our center were included. Epidemiological data, viral genotypes, and treatment outcomes were evaluated in all treated patients. Patients with chronic renal failure, previous non-responders, and those who relapsed after previous treatment were excluded from the study. Among all patients, 57% were treated with PEG- interferon （IFN） α-2a and 43% patients were treated with PEG-IFN α-2b; both groups received a standard dose of ribavirin. RESULTS： 89.6% of patients completed the treatment with an overall SVR rate of 58%. The SVR rate was 54% in genotype 1, 44% in genotype 2, 73% in genotype 3, and 59% in genotype 4 patients. There was no statistical difference in the SVR rate between patients treated with PEG-IFN α-2a and PEG-IFN α-2b （61.5% vs 53%）. Patients younger than 40 years had higher SVR rates than older patients （75% vs 51%, P = 0.001）. SVR was also statistically significantly higher when the HCV RNA load （pretreatment） was below 800.000 （64% vs 50%, P = 0.023）, in patients with a body mass index （BMI） less than 28 （65% vs 49%, P = 0.01）, and in patients who completed the treatment duration （64% vs 8%, P ≤ 0.00001）.CONCLUSION： The SVR rate in our study is higher than in previous studies. Compliance with the standard duration of treatment, higher ribavirin dose, younger age, lower BMI, and low pretreatment RNA levels were associated with a higher virological response.     

Factors that Affected Women Undergoing Cryotherapy Following Cancer Screening with Visual Inspection of the Cervix Using Acetic Acid Method

Background: The Indonesian government has applied the cancer “see and treat” method which involves a visual inspection using acetic acid (VIA), followed by a cryotherapy procedure, to reduce the incidence of cervical cancer. However, compliance with the program is still low in the targeted population. This study aims to see what factors influence women to receive cryotherapy treatment if they have positive VIA result. Methods: This cross-sectional study was conducted among 356 VIA positive women, aged 30-50 years old, registered at Temanggung District Health Office, Central Java, Indonesia between March 29 and April 31, 2018. Data on whether subjects underwent cryotherapy, their demographic profile, education, knowledge about cryotherapy, and family support were collected in a direct interview using a structured questionnaire. A statistical analysis was carried out to observe the influence of all the variables on subjects’ decisions on cryotherapy. Results: In our study, 217 women (60.69%) received cryotherapy, while 139 women (39.04%) did not. Among all the variables analyzed, the factors affecting the subjects’ likelihood to undergo cryotherapy are their knowledge about cervical cancer and screening (PR=0.776;95%CI=0.660-0.913;p=0.003), their residences distance from health centre (PR=0.795;95%CI=0.650-0.971;p=0.016), permission from their family (PR=0.675;95%CI=0.556-0.820;p=0.018), and being accompanied by their family (PR=0.824;95%CI=0.700-0.970;p=0.026). Age, marital status, occupation, and education background did not show a significant correlation with the women’s decisions to receive cryotherapy. Conclusions: Interestingly, the result of our study indicates that women are less willing to undergo the cryotherapy procedure if they have good knowledge about the cryotherapy procedure and its importance in cervical cancer’s prevention. Providing higher quality and more accessible health facilities with cryotherapy services are important in influencing women’s willingness to receive cryotherapy. Family support, in the form of permission given by spouses, and if they accompanied the patient to seek cryotherapy care are observed as factors influencing women’s willingness to have the procedure.     

An investigation into the combination of low frequency ultrasound and liposomes on skin permeability

Antigen application onto skin that has been pre-treated with low frequency ultrasound leads to immunisation, and it was hypothesised that immunisation could be enhanced if antigens were entrapped within liposomes, the latter being known vaccine adjuvants. However, it has been suggested that liposomes can repair skin damage, which could limit antigen permeation and transcutaneous immunisation. The aim of the present work was therefore to investigate the influence of liposome application on subsequent: (i) in vitro antigen permeation through, and (ii) in vivo barrier properties of, ultrasound-treated skin. Sonication was conducted using either phosphate buffered saline (PBS) or an aqueous solution of sodium dodecyl sulphate (SDS) as the coupling medium, and rats were used as the animal models. Liposome application to sonicated skin reduced antigen penetration and transepidermal water loss (TEWL, used as an indication of skin integrity) when the skin had been sonicated using PBS coupling medium. The influence of liposome was evident within 5 min of its application, and smaller liposomes were more effective at repairing skin disruption caused by sonication. Such skin repair did not, however, take place when the skin had been sonicated in the presence of SDS (which caused greater skin disruption), and changes in in vitro antigen permeation and in vivo TEWL were negligible. Skin repair by liposomes seems to depend on the extent of the disruption caused by ultrasound application.     

Alterations of atherogenic low-density lipoproteins and serum fatty acids after 12 week moderate exercise training in sedentary Thai women

The potential benefit of aerobic exercise upon cardiovascular disease (CVD) through an increasing high-density lipoproteins (HDLs) is acknowledged. However, its effects on low-density lipoproteins (LDLs) and their subpopulations, are unknown in Thailand. Twenty sedentary Thai women undertook a 12-week exercise training program (60% heart rate reserve) comprising 25-minute cycling followed by 10-minute warm-up/cool-down 3 times a week with a group of 20 matched sedentary subjects as control. Triacylglycerols (TGs) and cholesterol (C) of plasma lipoproteins including triacylglycerol-rich lipoproteins (TRLs), large, buoyant LDL (lb-LDL), small, dense LDL (sd-LDL) and HDLs were analyzed while serum fatty acid profiles were also assessed. It was found that plasma TGs, TRL-TGs, sd-LDL-C and sd-LDL-C/lb-LDL-C (S/L) ratio decreased significantly after 12-weeks of exercise to -9%, -8%, -17% and -19% respectively from baseline (p < 0.05). Serum fatty acid profiles remained unchanged. No alteration of any parameters was found in the control group without exercise. These findings suggest that moderate exercise training, even without a change of HDLs, impedes the shift of lb-LDL to more atherogenic sd-LDL, thus possibly preventing cardiovascular disease in healthy, sedentary Thai women.