Biodistribution of PLGA and PLGA/chitosan nanoparticles after repeat-dose oral delivery in F344 rats for 7 days.

AIM: To quantify in vivo the biodistribution of poly(lactic-co-glycolic) acid (PLGA) and PLGA/chitosan nanoparticles (PLGA/Chi NPs) and assess if the positive charge of chitosan significantly enhances nanoparticle absorption in the GI tract. MATERIAL & METHODS: PLGA and PLGA/Chi NPs covalently linked to tetramethylrhodamine-5-isothiocyanate (TRITC) were orally administered to F344 rats for 7 days, and the biodistribution of fluorescent NPs was analyzed in different organs. RESULTS: The highest amount of particles (% total dose/g) was detected for both treatments in the spleen, followed by intestine and kidney, and then by liver, lung, heart and brain, with no significant difference between PLGA and PLGA/Chi NPs.  CONCLUSION: Only a small percentage of orally delivered NPs was detected in the analyzed organs. The positive charge conferred by chitosan was not sufficient to improve the absorption of the PLGA/Chi NPs over that of PLGA NPs.

The turn team: a novel strategy for reducing pressure ulcers in the surgical intensive care unit.

BACKGROUND: Pressure ulcers cause significant morbidity and mortality in the surgical intensive care unit (SICU). The purpose of this study was to determine if a dedicated team tasked with turning and repositioning all hemodynamically stable SICU patients could decrease the formation of pressure ulcers. STUDY DESIGN: A total of 507 patients in a 20-bed SICU in a university hospital were assessed for pressure ulcers using a point prevalence strategy, between December 2008 and September 2010, before and after implementation of a team tasked with turning and repositioning all hemodynamically stable patients every 2 hours around the clock. RESULTS: At baseline, when frequent turning was encouraged but not required, a total of 42 pressure ulcers were identified in 278 patients. After implementation of the turn team, a total of 12 pressure ulcers were identified in 229 patients (p < 0.0001). The preintervention group included 34 stage I and II ulcers and 8 higher stage ulcers. After implementation of the turn team, there were 7 stage I and II ulcers and 5 higher stage ulcers. The average Braden score was 16.5 in the preintervention group and 13.4 in the postintervention group (p = 0.04), suggesting that pressure ulcers were occurring in higher risk patients after implementation of the turn team. CONCLUSIONS: A team dedicated to turning SICU patients every 2 hours dramatically decreased the incidence of pressure ulcers. The majority of stage I and stage II ulcers appear to be preventable with an aggressive intervention aimed at pressure ulcer prevention.

Depressive symptoms and birth outcomes among pregnant teenagers.

STUDY OBJECTIVE: Few studies have examined the effects of maternal depressive symptoms among adolescent women. The purpose of this study was to investigate the impact of depressive symptoms on birth outcomes of infants born to adolescent mothers. DESIGN: The medical records of pregnant adolescent patients were examined. Information about maternal depressive symptoms and birth outcomes was collected. SETTING: Data were collected at Washington Hospital Center, a nonprofit, community-based hospital that serves residents throughout the Washington, DC area. PARTICIPANTS: Participants were 294 African-American and Latina adolescent mothers. Mean age was 16.2 years (standard deviation [SD] 1.4). Based on self-reports of depressive symptoms, adolescents were categorized by the following: no reported symptoms, depressive symptoms without SI/SA (suicidal ideation or attempt), and depressive symptoms with SI/SA. MAIN OUTCOME MEASURES: Infant birth weight and gestational age at delivery. RESULTS: Over one-quarter of pregnant adolescents in this study reported symptoms of depression. Adolescents reporting depressive symptoms with SI/SA delivered babies that weighed 239.5 grams (98.3% confidence interval [CI] 3.9 to 475.1) less than babies born to mothers reporting depressive symptoms without SI/SA. There was no association between reported symptoms and gestational age. CONCLUSIONS: Results suggest that compared to nonpregnant teens and adults, pregnant teens may have an increased risk for depression. Additionally, pregnant adolescents with suicidal ideation are at greater risk for delivering infants of lower birth weight compared with teens reporting depressive symptoms without SI/SA and teens reporting no symptoms. This study supports the need for early screening and treatment of depression for young pregnant women.

Impact of family environment and support on adherence, metabolic control, and quality of life in adolescents with diabetes.

BACKGROUND: Diabetes is a common disease in pediatric populations. Family functioning has been related to child adaptation to diabetes. PURPOSE: To determine the impact of family factors on diabetes, particularly the influence of family support and family environment on adherence to treatment, quality of life, and metabolic control in Portuguese adolescents with type 1 diabetes, taking in consideration age, sex, duration of disease, and social class. METHOD: This study used a cross-sectional design. A sample of 157 Portuguese diabetic patients filled disease-specific measures on adherence and quality of life and family functioning measures. Hypotheses were that family support and an organized family environment (high cohesion and low conflict) would be positively associated with better adherence, metabolic control, and quality of life. RESULTS: This study's results confirmed that adherence was predicted by family support for females and lower-class patients while metabolic control was predicted by family conflict for upper-class patients. Quality of life was predicted by lack of family conflict and family social support for both males and females as well as lower-class patients. CONCLUSION: The results highlight the importance of studying family variables in adolescents' diabetes care within the wider cultural factors affecting the patient.