Monolithic Controlled Delivery Systems: Part I. Basic Characteristics and Mechanisms

The article considers contemporary systems for controlled delivery of active agents, such as drugs, agricultural chemicals, pollutants and additives in the environment. A useful classification of the available controlled release systems (CRS) is proposed according to the type of control (passive, active or self-preprogrammed) and according to the main controlling mechanism (diffusion, swelling, dissolution or erosion). Special attention is given to some of the most used CRS - polymer monoliths. The structural and physical-chemical characteristics of CRS as well as the basic approaches to their production are examined. The basic mechanisms of controlled agent release are reviewed in detail and factors influencing the release kinetics are classified according to their importance. The present study can be helpful for understanding and applying the available mathematical models and for developing more comprehensive ones intended for design of new controlled delivery systems

Numerical Modelling of Drug Release from 2D HPMC-Matrices

The article considers numerical modelling of drug release from HPMC-matrices assuming the main controlling processes are diffusion of water and drug and swelling of the matrix. A detailed mathematical description of matrix swelling, connected with the free boundary conditions of the arisen model problem, is introduced. A numerical approach to solution of the posed nonlinear 2D problem is developed on the basis of finite element domain approximation and time difference method. It is implemented in noncommercial software which is used for numerical simulation of fractional drug release under various shapes and sizes of the tablets. This investigation of the effect of aspect ratio (radius/height) and sizes of HPMC tablets on drug release is an inexpensive and effective tool to modify the release kinetics. The proposed numerical approach enables further generalization of the model and performing more profound investigations of the effect of the initial drug loading, matrix erosion and type of release medium

Reliability of a Novel Model for Drug Release from 2D HPMC-Matrices

A novel model of drug release from 2D-HPMC matrices is considered. Detailed mathematical description of matrix swelling and the effect of the initial drug loading are introduced. A numerical approach to solution of the posed nonlinear 2D problem is used on the basis of finite element domain approximation and time difference method. The reliability of the model is investigated in two steps: numerical evaluation of the water uptake parameters; evaluation of drug release parameters under available experimental data. The proposed numerical procedure for fitting the model is validated performing different numerical examples of drug release in two cases (with and without taking into account initial drug loading). The goodness of fit evaluated by the coefficient of determination is presented to be very good with few exceptions. The obtained results show better model fitting when accounting the effect of initial drug loading (especially for larger values)

Subconjunctival delivery of p75NTR antagonists reduces the inflammatory, vascular, and neurodegenerative pathologies of diabetic retinopathy

The p75NTR is a novel therapeutic target validated in a streptozotocin mouse model of diabetic retinopathy. Intravitreal (IVT) injection of small molecule p75NTR antagonist THX-B was therapeutic and resolved the inflammatory, vascular, and neurodegenerative phases of the retinal pathology. To simplify clinical translation, we sought a superior drug delivery method that circumvents risks associated with IVT injections. METHODS. We compared the pharmacokinetics of a single 40 lg subconjunctival (SCJ) depot to the reported effective 5 lg IVT injections of THX-B. We quantified therapeutic efficacy, with endpoints of inflammation, edema, and neuronal death. RESULTS. The subconjunctival depot affords retinal exposure equal to IVT injection, without resulting in detectable drug in circulation. At week 2 of diabetic retinopathy, the SCJ depot provided therapeutic efficacy similar to IVT injections, with reduced inflammation, reduced edema, reduced neuronal death, and a long-lasting protection of the retinal structure. CONCLUSIONS. Subconjunctival injections are a safe and effective route for retinal delivery of p75NTR antagonists. The subconjunctival route offers an advantageous, less-invasive, more compliant, and nonsystemic method to deliver p75NTR antagonists for the treatment of retinal diseases.Fil: Galan, Alba. Mc Gill University. Lady Davis Research Intitute; CanadáFil: Barcelona, Pablo Federico. Mc Gill University. Lady Davis Research Intitute; Canadá. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Nedev, Hinyu. Mc Gill University. Lady Davis Research Intitute; CanadáFil: Sarunic, Marinko V.. University Fraser Simon; CanadáFil: Jian, Yifan. University Fraser Simon; CanadáFil: Saragovi, H. Uri. Mc Gill University. Lady Davis Research Intitute; Canad

Rehabilitation Care In Chronic Renal Disease

Хронично бъбречното заболяване (ХБЗ) е прогресивно състояние, което може да повлияе отрицателно на мускулно-скелетната система. Предвид последиците, като ниската мускулна маса и ниската минерална плътност на костите, подходящата и навременна двигателна терапия е важна за подобряване на опорно-двигателната и бъбречна функция. Литературните данни и изследователски проучвания сочат, че двигателни упражнения, фокусирани върху възстановяване на бъбречната функция, подобряват аеробния капацитет, мускулното-скелетното функциониране, функцията на сърдечно-съдовата система, локомоцията и качеството на живот на пациенти с ХБЗ. Подходящият двигателен режим включва силови тренировки и аеробно обучение за благоприятно повлияване на вторични ХБЗ усложнения. В тази връзка физиотерапевтите са подходящи членове сред интердисциплинарния екип, предоставящ медицински и здравни услуги. Техните компетенции са напълно акуратни в лечението на съпътстващите мускулно-скелетни дисфункции при пациенти с ХБЗ.Предоставянето на възможности от законодателя за официално предписание на физически упражнения от специалист, заедно със създаване и прилагане на двигателна програма, е предизвикателство за здравеопазването на Република България. Необходимо е по-голямо разбиране и интегриране в стандартния план на рехабилитационни грижи за хора с ХБЗ.Двигателната терапия може да бъде ефективна клинична стратегия за подобряване на бъбречната функция, понижаване на риска от сърдечно-съдови заболявания при пациенти с ХБЗ.Целта на този доклад е да се обобщи влиянието на ХБЗ върху здравето на мускулно-скелетната система и да се подчертае ролята на двигателната терапия при вторичните увреждания, дължащи се на това състояние.Chronic kidney disease (CKD) is a progressive condition that can negatively affect the musculoskeletal system. Given the consequences, such as low muscle mass and low bone mineral density, appropriate and timely motor therapy is important for improving locomotor and renal function. Literary data and research studies indicate that motor exercise focused on rehabilitation of renal function improves aerobic capacity, musculoskeletal function, cardiovascular function, locomotion and quality of life of patients with CKD. A suitable motor regimen includes strength training and aerobic training to favor secondary CKD complications. In this regard, physiotherapists are good members of the interdisciplinary team providing medical and health care. Their competencies are suitable in the treatment of concomitant musculoskeletal dysfunctions in CKD patients.Providing opportunities by the legislator for official prescription of physical exercise by a specialist, together with the creation and implementation of a mobility program, is a challenge for the healthcare of the Republic of Bulgaria. Greater understanding and integration in the standard plan of rehabilitation care for people with CKD is needed.Motor therapy can be an effective clinical strategy to improve kidney function, reducing the risk of cardiovascular diseases in patients with CKD.The purpose of this report is to summarize the impact of CKD on the state of the musculoskeletal system and to highlight the role of motor therapy in secondary damage due to this condition

Rehabilitation care in patients subjected to surgical intervention for lower lung volume reduction

Emphysema is a phenotype of chronic obstructive pulmonary disease (COPD), defined as an abnormal and permanent expansion of the respiratory space distant from the terminal bronchioles and destruction of the alveolar walls. Emphysema manifests clinically with shortness of breath by restricting airflow, hyperinflation, and loss of gas exchange surfaces in the lungs (also known as increased physiologic dead space).Lung volume reduction surgery (LVRS), also called reduction pneumoplasty or bilateral pneumonectomy, is a surgical technique that may be helpful for some patients with advanced emphysema who have poor control of their disease despite maximum dose of medication.Pulmonary rehabilitation (PR) is an integral part of the preparation and recovery from surgical interventions. PR has a significant place and role in supporting the recovery and quality of life of patients undergoing LVRS. The purpose of the study is е to present the role of PR in LVRS, outline the components and describe the expected benefits.

Informed consent for Rhinoplasty

Every surgical procedure involves a certain amount of risk and it is important that you understand the risks involved with rhinoplasty surgery. This is an informed consent document that has been prepared to help your surgeon inform you concerning rhinoplasty surgery, its risks, and alternative treatment. When rhinoplasty is performed by a qualified surgeon, complications are rare and usually minor. Nevertheless, there is always a possibility that complications may occur. We can reduce your risks by closely following the doctor’s instructions both before and after surgery.--------------------------------------Всяка хирургична интервенция предполага усложнения и риск и е от особена важност запознаването на пациента и неговата информираност. Този документ представлява информирано съгласие на пациента, което ще помогне както на хирурга, така също ще подготви пациента за хирургичната интервенция, нейните рискове и алтернативно лечение. Ако ринопластиката е извършена от квалифициран и опитен хирург, компликациите са по-малки и по-редки. Въпреки това е напълно възможно да се срещнат различни компликации при тази операция. Ние бихме могли да намалим този риск и нежеланите резултати, обсъждайки предварително с пациентите възможния изход от операцията

BULGARIA’S INDEPENDENT ENERGY EXCHANGE – POSSIBILITIES FOR RISK MANAGEMENT

This article discusses the urgent problems of the Bulgarian energy market and its slow transformation from state monopoly to free exchange market. The paper aims at elaborating on the specific aspects of energy trading – basically, and in particular, the characteristics and disproportions imposed by the state and the state-owned energy holdings on the Bulgarian market. Ever since its establishment in 2014, the Bulgarian Independent Energy Exchange (BIEE) has adopted the model and rules of the north energy exchange – Nord Pool. The arguments for this choice have not been discussed publicly, but the necessity of a well-functioning energy exchange market and the need of its daily transparent activity, already in Bulgaria as well, are accepted as proven. The functioning and reliability of the Bulgarian stock exchange, however, are still the subject of certain discussions. What could have happened if the Bulgarian stock exchange had adopted the model of the European energy exchange – EEE

Respiratory Physiotherapy In Preoperative Myocardial Revascularization Surgery

Сърдечно-съдовите заболявания са сред основните причини за смърт в развитите страни.Аортокоронарен байпас е кардиохирургичен метод за реваскуларизация, при който обструкцията се заобикаля с отпрепарирана вена или артерия чрез зашиването й към аортата и към участък след запушването на засегнатата артерия (като мост). Методът рядко се ползва при пациенти с остър инфаркт на миокарда – а именно при неуспешна първична перкутанна коронарна интервенция (ПКИ/РСІ) или при неподходящи за РСІ коронарни артерии. Ясна индикация за кардиохирургично лечение са случаите с настъпили механични усложнения в хода на инфаркта. Повечето от пациентите, подложени на миокардна реваскуларизационна хирургия, развиват следоперативна белодробна дисфункция със значимо намаляване на белодробните обеми, увреждания в дихателния механизъм, намаляване обемите на белите дробове и увеличаване на дихателната работа. Намаляването на обемите и капацитета на белите дробове може да допринесе за промени в газообмена, което води до хипоксемия и намаляване на дифузионния капацитет. Като се вземе това предвид, все повече се изисква предоставяне на физиотерапевтична грижа в предоперативния период на тази операция.Целта на това изследване е да се направи преглед на литературата за различните техники на респираторната физиотерапия и тяхната ефективност в предоперативния период при миокардна реваскуларизационна хирургия, с доказан положителен ефект върху белодробните усложнения. Физиотерапията използва няколко техники в предоперативния период, като: стимулираща спирометрия, упражнения за дълбоко дишане, кашлица, обучение за вдишване на мускулите, по-ранни амбиции и физиотерапевтични ориентации.Cardiovascular diseases are one of the leading causes of death in developed countries. Aorto-coronary bypass is a cardiac surgery method for revascularization in which the obstruction is circumvented by a repaired vein or artery by suturing it to the aorta and to a section after obstruction of the affected artery (such as a bridge). The method is rarely used in patients with acute myocardial infarction - namely, failure of primary percutaneous coronary intervention (PCI / PCI) or non-PCI coronary artery failure. A clear indication for cardiac surgery are cases of mechanical complications during myocardial infarction. Most of the patients undergoing myocardial revascularization surgery develop postoperative pulmonary dysfunction with significant reduction in lung volumes, damage to the respiratory mechanism, decrease in lung volumes and increased respiratory function. Reduced lung volumes and capacity can contribute to changes in gas exchange, leading to hypoxemia and decreased diffusion capacity. With this in mind, it is increasingly required to provide physiotherapy care during the preoperative period of this operation.The purpose of this study is to review the literature on the various techniques of respiratory physiotherapy and their efficacy in the preoperative period in myocardial revascularization surgery, with a positive effect on pulmonary complications.Physiotherapy uses several techniques in the preoperative period, such as: stimulating spirometry, deep breathing exercises, coughing, muscle inhalation training, earlier ambitions and physiotherapy orientations