Cytotoxicity and anti-inflammatory activity of cyclosporine A loaded PLGA nanoparticles for ocular use.

Cyclosporine A loaded poly(lactide-co-glycolide) nanoparticles were prepared using the o/w emulsification solvent evaporation method and the effect of four preparation parameters on particle size and zeta potential was investigated. Release properties of the nanoparticles were examined and in vitro experiments were performed in order to evaluate the cytotoxicity and anti-inflammatory activity of the nanoparticles developed. Particle sizes varied between 191 and 303 nm depending on the different preparation parameters and all nanoparticle dispersions were monodisperse. The nanoparticles showed negative zeta potential values varying between -16 and -35 mV and 57 to 70 % of the amount of loaded cyclosporine A was released after 24 h. None of the nanoparticle formulations showed significant cytotoxicity compared to the negative control using human epithelial cells (HaCaT). Cyclosporine A incorporated in the various nanoparticle formulations retained its anti-inflammatory activity as significant suppression of interleukine-2 secretion in concanavalin A stimulated Jurkat T cells was measured. As the overall influence of the freeze-drying process on the characteristics of nanoparticles was limited, trehalose and carnitine should be preferred as cryoprotectants in ocular formulations for treatment of dry eye disease.

The costs of hospital-based medical care for patients with the acquired immunodeficiency syndrome.

The costs which were incurred by patients for hospital-based care during the time from the diagnosis of the acquired immunodeficiency syndrome (AIDS) to death, range from pounds 6838 in London, England, to US$147,000 in Atlanta, USA. In 1986, a study was undertaken in Sydney to calculate the costs of the hospital-based treatment of patients with AIDS. The medical records of 39 patients who had received all their treatment at one institution were analysed retrospectively, and data were collected on their survival, hospitalizations, investigations and treatments. The mean survival time of the 39 patients was 7.2 months; during this time they had a mean of 4.0 hospital admissions that accounted for an average total stay of 34.6 days. In addition, they made, on average, 9.4 outpatient visits. There was a significant difference in the duration of hospitalization between those who presented with an opportunistic infection and those who presented with a malignancy (38.3 days and 22.4 days, respectively; P = 0.01). The mean cost for hospital-based care was $A22,332 (range, $A4229-$A58,398), of which 95% of costs were incurred for inpatient care. The mean cost of care of those who presented with an opportunistic infection was significantly higher than that of those who presented with a malignancy, but there was no difference according to the age at the time of diagnosis. If the predictions of 3000 cases of AIDS in Australia by 1991 are realized, such cases will represent--conservatively--an additional cost to the community of $A58.5 million. This study emphasizes the need for health authorities to plan for the future financial impact of the hospital-based treatment of patients with AIDS.