Dissolving polyvinylpyrrolidone-based microneedle systems for in-vitro delivery of sumatriptan succinate.

In-vitro permeation studies were conducted to assess the feasibility of fabricating dissolving-microneedle-array systems to release sumatriptan succinate. The formulations consisted mainly of the encapsulated active ingredient and a water-soluble biologically compatible polymer, polyvinylpyrrolidone (PVP), approved by the U.S. Food and Drug Administration (FDA). Tests with Franz-type diffusion cells and Göttingen minipig skins showed an increase of the transdermal flux compared to passive diffusion. A preparation, containing 30% by mass of PVP and 8.7mg sumatriptan, produced a delivery rate of 395±31µg/cm2h over a 7-hour period after a negligible lag time of approximately 39min. Theoretically, a 10.7cm2 microneedle-array patch loaded with 118.8mg of the drug would provide the required plasma concentration, 72ng/mL, for nearly 7h.

[Between Werther and Papageno effects]. / Zwischen dem Werther- und Papageno-Effekt.

Research on the impact of suicide depictions in the media is traditionally focussed on two possible outcomes: on the one hand, there is ample evidence for additional copycat effects after media coverage of suicides referred to as the Werther effect but on the other hand, suicide rates decrease after appropriate media depictions of suicides referred to as the Papageno effect. It is still uncertain what exactly qualifies studies that only limitedly support an imitative or preventive media effect, i.e. studies with ambiguous findings, as they are often disregarded. The present literature review focuses on equivocal studies (n = 25) on copycat suicides that were systematically analyzed based on theoretically derived criteria. The results of the systematic analysis of all identified studies imply that media effects on suicidality are better understood and discussed as a continuum between the two extremes that were introduced as either a damaging Werther effect or a beneficial Papageno effect. Future studies must clarify what factors contribute to a shift from ambiguous findings to harmful media effects on individual suicidality.

Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition.

PURPOSE: This survey was designed to confirm the prevalence and duration of fatigue in the cancer population and to assess its physical, mental, social, and economic impacts on the lives of patients and caregivers. Patients and Methods. A 25-minute telephone interview was completed with 379 cancer patients having a prior history of chemotherapy. Patients were recruited from a sample of 6, 125 households in the United States identified as having a member with cancer. The median patient age was 62 years, and 79% of respondents were women. Patients reporting fatigue at least a few times a month were asked a series of questions to better describe their fatigue and its impact on quality of life. RESULTS: Seventy-six percent of patients experienced fatigue at least a few days each month during their most recent chemotherapy; 30% experienced fatigue on a daily basis. Ninety-one percent of those who experienced fatigue reported that it prevented a "normal" life, and 88% indicated that fatigue caused an alteration in their daily routine. Fatigue made it more difficult to participate in social activities and perform typical cognitive tasks. Of the 177 patients who were employed, 75% changed their employment status as a result of fatigue. Furthermore, 65% of patients indicated that their fatigue resulted in their caregivers taking at least one day (mean, 4.5 days) off work in a typical month. Physicians were the health care professionals most commonly consulted (79%) to discuss fatigue. Bed rest/ relaxation was the most common treatment recommendation (37%); 40% of patients were not offered any recommendations. CONCLUSIONS: Cancer-related fatigue is common among cancer patients who have received chemotherapy and results in substantial adverse physical, psychosocial, and economic consequences for both patients and caregivers. Given the impact of fatigue, treatment options should be routinely considered in the care of patients with cancer.

Moving: characteristics of dogs and cats and those relinquishing them to 12 U.S. animal shelters.

The National Council on Pet Population Study and Policy Regional Shelter Survey identified moving as the most often cited of 71 reasons for relinquishing dogs and the 3rd most common reason for relinquishing cats. Most relinquished companion animals were less than 3 years old and female. Dogs were most often intact, whereas cats were most often altered. Friends had given the majority of these companion animals to the relinquishers, who had obtained them at no cost. Most had lived with the relinquishers for less than 2 years. The majority of relinquishers were White and female, and had at least a high school education. Based on the U.S. population age distribution, young adults seem to be using shelters at a significantly higher rate than would be expected. These age groups are also more mobile, according to U.S. Census data. Therefore, educational efforts that target young, potentially mobile adults could decrease the number of animals relinquished.

Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition.

Although fatigue is the most common symptom reported by cancer patients and has serious adverse effects on quality of life, it remains poorly understood. A survey was designed to characterize the epidemiology of cancer-related fatigue from the perspectives of the patient, primary caregiver, and oncologist. A telephone survey included 419 cancer patients recruited from 100,000 randomly selected households nationwide. Patients provided access to 200 primary caregivers (usually family members) who were also interviewed by telephone. In a separate mail survey, 197 of 600 randomly sampled oncologists (unrelated to the patients) responded to a questionnaire that assessed perceptions and attitudes concerning fatigue in cancer patients who had received chemotherapy or radiotherapy and their caregivers. The median patient age was 65 years, and the principal cancer diagnoses were breast (females) and genitourinary (males). Fifty-nine percent of the patients had received chemotherapy, 63% radiation therapy, and 24% both; 20% of patients received their last treatment within 6 weeks, 31% within 7 weeks to 1 year, and 49% more than 1 year ago. More than three quarters of patients (78%) experienced fatigue (defined as a general feeling of debilitating tiredness or loss of energy) during the course of their disease and treatment. Thirty-two percent experienced fatigue daily, and 32% reported fatigue significantly affected their daily routines. Caregivers reported observing fatigue in 86% of the index patients, and oncologists perceived that 76% of their patients experienced fatigue. Although oncologists believed that pain adversely affected their patients to a greater degree than fatigue (61% v 37%), patients felt that fatigue adversely affected their daily lives more than pain (61% v 19%). Most oncologists (80%) believed fatigue is overlooked or undertreated, and most patients (74%) considered fatigue a symptom to be endured. Fifty percent of patients did not discuss treatment options with their oncologists, and only 27% reported that their oncologists recommended any treatment for fatigue. When used, treatments for fatigue were generally perceived by patients and caregivers to be successful. These data confirm the high prevalence and adverse impact of cancer-related fatigue, although it is seldom discussed and infrequently treated. For patients and oncologists, improving the quality of life of cancer patients requires a heightened awareness of fatigue, a better understanding of its impact, and improve communication and familiarity with interventions that can reduce its debilitating effects.

People and environment: what is the relationship between exploitation of natural resources and population growth in the South?

PIP: This article reviews the nature and scale of the problems between natural resource management (NRM), agricultural productivity, and population growth in developing countries. It suggests a framework for examining the dynamics of land quality change, and reviews the evidence on land management under population pressure in tropical hillside areas and suggests some lessons learned for policy development. The evidence suggests that the effect of population on land quality is unknown; it depends upon economic and institutional factors. Aggregate data obscures the dynamics of change. There are four distinct patterns of land use changes with different market, population, and agro-environmental conditions: irrigated lands, high potential rain-fed lands, long-settled marginal lands, and frontier marginal lands. Sustainable NRM and strategies of agricultural development vary with population and market growth in these four areas. Currently 50% of the poorest people live on marginal lands. When countries and regions are more dependent upon marginal lands for food production, the key environmental issues are devegetation, nutrient depletion, and erosion. The 1997 Templeton and Scheer review examined 150 studies that focused on land use, intensity, and quality under forest, crops, and pastures in hilly-mountainous areas. Studies suggest that many hill and mountain areas could sustain high production levels without excessive resource degradation, depending upon the impact of microeconomic incentives on choice of production systems. Local populations cannot cope with the challenge of sustainable intensification without supportive policy and institutions.^ieng

Somatostatin immunoreactivity in neuritic plaques of Alzheimer's patients.

Senile dementia of the Alzheimer's type can be diagnosed with certainty only by examining neurofibrillary tangles and neuritic plaques under the microscope. Recently, it has been suggested that the condition is linked to specific neurotransmitter systems, with a decline of cortical acetylcholine, choline acetyltransferase, cholinergic neurones projecting to the cortex, cortical noradrenaline content, locus coeruleus neurones and cortical somatostatic content. Using immunocytochemical methods, we here report that somatostatin-immunoreactive processes are present in neuritic plaques in human Alzheimer's specimens. These data, as well as other reports of non-cholinergic changes, strongly imply that Alzheimer's disease cannot be linked exclusively to cortical cholinergic elements, as proposed previously. Rather, our data on plaque and somatostatin co-localization and distribution patterns suggest that Alzheimer's neuropathology may involve primarily the loss of selective cortical neurones that are targets of the implicated transmitter systems and that plaque formation may result from the degeneration of presynaptic and postsynaptic neurites of large projection neurones in layers III and V. Given the neurochemically heterogeneous input to these cells, it is not surprising that several neurotransmitter systems, one of which is somatostatin, are implicated in the pathology of Alzheimer's disease.

Sensory and metabolic feedback in the modulation of taste hedonics.

One hundred and twenty-five college students were fed a small preload composed of common foods which were either solid or liquid, sweet or non-sweet, and high or low in energy content. At 15-minute intervals following the preload subjects rated the intensity and pleasantness of of either sweet or a non-sweet test stimulus. Pleasantness reductions (alliesthesia) were observed following all preloads but were significantly larger in the high-calorie groups. In addition, solid preloads were found to provoke greater hedonic shifts than liquid preloads. While intensity ratings paralleled those for pleasantness, no correlation between the two was apparent. The results point to a metabolic explanation for the hedonic declines in the test stimuli. Nutrient (perhaps carbohydrate) detectors in the upper GI tract are proposed to trigger both central and peripheral changes which underlie the changes in pleasantness and intensity judgements.

Primary T-cell lymphoma of oral cavity.

Immunopathologic studies classify lymphoma under the T-cell or B-cell groups. Such a classification gives a better indication for prognosis and treatment of lymphomas, with the T-cell group having the worse prognosis. A patient with a T-cell lymphoma of the oral cavity is presented. The diagnostic features and management are discussed.

Primary Ewing's sarcoma of the mandibular ramus: a case report.

Primary Ewing's sarcoma of the mandible is an exceedingly rare finding in the practice of otolaryngology. A case of this neoplasm occurring as a parotid mass is presented. It represented a diagnostic dilemma because of its elusive histopathologic findings. The gross and clinical appearances, microscopic findings, differential diagnosis, and prognosis of this neoplasm are discussed.

Chronic candidiasis of the oral cavity and esophagus.

Chronic candidiasis of the oral cavity and esophagus may present with a varying clinical picture. Three cases of this entity are presented. Infection occurs when the ecologic balance of normal flora and local factors are upset. Predisposing factors are listed. The different presentations, methods of evaluation, diagnosis, treatment alternatives, and immunologic applications are discussed. The problems of the chronic form of the disease, with it becoming deeply ingrained and recurrent, are stressed.