Educación alimentaria en pacientes en dialisis / Nutritional education in dialysis patients

La enfermedad renal crónica terminal aumenta el riesgo cardiovascular y puede ocasionar defectos en la mineralización ósea. Para prevenir esto, se debe mantener el fósforo plasmático normal, que depende de la diálisis, los quelantes y la ingesta de fósforo, principalmente de origen inorgánico, incorporado mediante aditivos alimentarios. Las intervenciones nutricionales son pilares en el tratamiento de estos pacientes. El objetivo es facilitar estrategias alimentarias a un grupo de pacientes pediátricos en diálisis, mediante educación alimentaria nutricional, para aumentar el consumo de alimentos naturales, disminuyendo la ingesta de fósforo inorgánico especialmente de los productos cárnicos procesados. Materiales y métodos: se estudió una población pediátrica en diálisis. Se preparó un programa educativo con atención personalizada, instrucción alimentaria y seguimiento mensual, seguido de un taller. Resultados: n: 17 pacientes, edad decimal media de 12,3, 53% sexo masculino, 88% en hemodiálisis. Previo a la intervención el 64,7% consumía productos cárnicos procesados. Luego del taller el 58,8% disminuyó su consumo, el 41,2% aumentó la ingesta de preparaciones caseras, el 53% incorporó nuevos condimentos, de los cuales el 89% presentó al incorporarlos, mejor aceptación a las preparaciones. Conclusiones: la hiperfosfatemia está presente en alrededor del 50% de los pacientes en diálisis asociándose a un incremento entre 20% al 40% del riesgo de mortalidad. La presencia de fósforo oculto en los alimentos y la falta de adherencia hacen prioritario trabajar en programas educativos que favorezcan el aprendizaje colaborativo, centralizados en prácticas culinarias, para brindar herramientas que faciliten una alimentación natural, disminuyendo el consumo de ultraprocesados (AU)

Chronic end-stage renal disease increases the risk of cardiovascular disease and may lead to defects in bone mineralization. In order to prevent these risks, normal plasma phosphorus levels should be maintained. Achieving this goal depends on dialysis, chelators, and phosphorus intake, mainly of inorganic origin, incorporated through food supplements. Nutritional interventions are crucial in the treatment of these patients. The objective is to facilitate nutritional strategies to a group of pediatric dialysis patients, through food education, to increase the consumption of natural foods, decreasing the intake of inorganic phosphorus, especially from processed meat products. Materials and methods: a pediatric population undergoing dialysis was studied. An educational program was prepared with personalized care, nutritional instruction, and monthly follow-up visits, followed by a workshop. Results: n: 17 patients, mean age 12.3 years, 53% male, 88% on hemodialysis. Prior to the intervention, 64.7% consumed processed meat products. After the workshop, 58.8% decreased their consumption, 41.2% increased the intake of homemade food, 53% incorporated new seasonings, of whom 89% reported better acceptance of the preparations when they were incorporated. Conclusions: hyperphosphatemia is observed in around 50% of patients undergoing dialysis and is associated with a 20% to 40% increased risk of mortality. The presence of hidden phosphorus in food and the lack of adherence point to the need for the development of educational programs that promote collaborative learning, focusing on food-preparation practices. These programs should provide tools that facilitate a natural diet, reducing the consumption of ultra-processed food (AU)

Nestling Physiology Is Independent of Somatic Development in a Common Raptor, the American Kestrel (Falco sparverius).

AbstractAlthough many studies have documented the developmental trajectory of somatic traits in birds, few measure physiological traits, and even fewer document individual variation in developmental trajectory across ecological context. Hematological traits underlying aerobic capacity can be predictive of nestling survival, fledgling flight ability, and ultimately recruitment. This study aimed to assess individual variation in the developmental trajectory of two physiological traits that underlie aerobic capacity, hematocrit and hemoglobin concentration, in relation to somatic development and ecological context. Our study species, the American kestrel (Falco sparverius), is sexually dimorphic and therefore likely to show sexual variation in developmental trajectory and nestling maturity. We used lay date, year, brood size, nestling sex ratio, and parental nest visit rate to assess ecological context. Although somatic traits showed similar trajectories across nestlings, developmental trajectory for hematocrit and hemoglobin concentration showed individual variation not previously documented. This individual variation in developmental change, or trajectory, for physiological traits could not be explained by somatic development, sex, parental nest visit rate, lay date, year, brood size, or nestling sex ratio. However, we did find higher final hemoglobin concentration in 2018 and in nests with earlier lay dates. These findings demonstrate the importance of assessing physiological traits that capture aspects of individual quality distinct from somatic traits. Future studies are needed to understand the causes of individual variation in developmental trajectory, which cannot be explained by the ecological variables presented here, and the potential fitness consequences of this variation.

Fish growth rates and lake sulphate explain variation in mercury levels in ninespine stickleback (Pungitius pungitius) on the Arctic Coastal Plain of Alaska.

Mercury concentrations in freshwater food webs are governed by complex biogeochemical and ecological interactions that spatially vary and are often mediated by climate. The Arctic Coastal Plain of Alaska (ACP) is a heterogeneous, lake-rich landscape where variability in mercury accumulation is poorly understood. Earlier research indicated that the level of catchment influence on lakes varied spatially on the ACP, and affected mercury accumulation in lake sediments. This work sought to determine drivers of spatial variation in mercury accumulation in lake food webs on the ACP. Three lakes that were a priori identified as "high catchment influence" (Reindeer Camp region) and three lakes that were a priori identified as "low catchment influence" (Atqasuk region) were sampled, and variability in water chemistry, food web ecology, and mercury accumulation was investigated. Among-lake differences in ninespine stickleback (Pungitius pungitius) length-adjusted methylmercury concentrations were significantly explained by sulphate concentration in lake water, a tracer of catchment runoff input. This effect was mediated by fish growth, which had no pattern between regions. Together, lake water sulphate concentration and fish age-at-size (proxy for growth) accounted for nearly all of the among-lake variability in length-adjusted methylmercury concentrations in stickleback (R2adj = 0.94, p < 0.01). The percentage of total mercury as methylmercury (a proxy for net Hg methylation) was higher in sediments of more autochthonous, "low catchment influence" lakes (p < 0.05), and in the periphyton of more allochthonous, "high catchment influence" lakes (p < 0.05). The results indicate that dominant sources of primary production (littoral macrophyte/biofilm vs. pelagic phytoplankton) and food web structure (detrital vs. grazing) are regulated by catchment characteristics on the ACP, and that this ultimately influences the amount of methylmercury in the aquatic food web. These results have important implications for predicting future mercury concentrations in fish in lakes where fish growth rates and catchment inputs may change in response to a changing climate.

Patterns of violence and coercion with mental health among female and male trafficking survivors: a latent class analysis with mixture models.

AIMS: Human trafficking is a crime and a human rights violation that involves various and simultaneous traumatic events (sexual and physical violence, coercion). Yet, it is unknown how the patterning of violence and coercion affects the mental health of female and male trafficking survivors. METHODS: We conducted a cross-sectional study using a sample of 1015 female and male survivors of trafficking who received post-trafficking assistance services in Cambodia, Thailand or Vietnam. We assessed symptoms of anxiety and depression with the Hopkins Symptoms Checklist and symptoms of post-traumatic stress disorder (PTSD) with the Harvard Trauma Questionnaire. Violence was measured with questions from the World Health Organization International Study on Women's Health. Latent class analysis (LCA) was used to identify distinct patterns of violence and coercion in females and males. Novel multi-step mixture modelling techniques were employed to assess the association of the emergent classes with anxiety, depression and PTSD in females and males. RESULTS: LCA identified two distinct classes of violence and coercion experiences in females (class I: severe sexual and physical violence and coercion (20%); class II: sexual violence and coercion (80%)) and males (class I: severe physical violence and coercion (41%); class II: personal coercion (59%)). Females in class I had a two-fold increase in the odds of anxiety (OR = 2.10; 95% CI: 1.57-2.81) and PTSD (OR = 2.07; 95% CI: 1.03-4.17) compared with females in class II, but differences in the prevalence of anxiety, depression and PTSD were not significant when comparing males in class I to class II. CONCLUSIONS: Specific patterns of violence and coercion provide a more in-depth understanding of the role of gender in the experience of violence and coercion and its association with mental health in survivors of trafficking. This information could be useful to target comprehensive mental health services for female and male trafficking survivors.

Assessing bioavailability of ruminally protected methionine and lysine prototypes.

Met and Lys are essential AA that can limit lactational performance in dairy cattle fed protein-sufficient diets. Thus, there is industry demand for ruminally protected (RP) sources of Met and Lys. One method of providing ruminal protection for Met and Lys is lipid encapsulation. The objective of this work was to assess 3 lipid-encapsulated Met prototypes (P1, P2, and P3) and 1 Lys prototype (P4) to determine ruminal protection, small intestine absorption (experiment 1), and animal production responses (experiment 2). Ruminal protection was estimated from 8-h in situ retention during ruminal incubation and intestinal absorption from plasma appearance after an abomasal bolus of the in situ retentate. Blood samples were collected over time to determine plasma Met and Lys concentration responses compared with unprotected Lys and Met infused abomasally. The prototypes were not exposed to the total diet or subjected to typical feed handling methods before evaluation. The bioavailability of P1, P2, and P3 Met prototypes was found to be 14, 21, and 18% of the initial AA material, respectively. The RP-Lys prototype had a bioavailability of 45%. To evaluate production responses, 20 Holstein cows were randomly assigned to 2 trials (n = 10 each) in a replicated Latin square design with 14-d periods. The base diet was predicted to be deficient in metabolizable Met (-14.8 g/d) and Lys (-16.1 g/d) per the Cornell Net Carbohydrate and Protein System (version 6.55). In the Met trial, the base diet was supplemented with RP-Lys to meet Lys requirements, and treatments were as follows: no added RP-Met (NCM), NCM plus Smartamine M (SM; Adisseo, Alpharetta, GA), and NCM plus P1, P2, or P3 at 148% of the Met content of SM. In the Lys trial, the base diet was supplemented with RP-Met to meet the Met requirement, and treatments were as follows: no added Lys (NCL), NCL plus AjiProL (AL; Ajinomoto Heartland Inc., Chicago, IL), and NCL plus P4 at 55, 78, or 102% of the reported absorbed Lys in AL. All products were top dressed on the diet without prior mixing or extended exposure to the rest of the diet. Milk protein concentration significantly increased when diets were supplemented with P2, P3, or SM (3.12, 3.12, and 3.11%, respectively) compared with NCM (3.02%). Only P1 (3.04%) was significantly lower than SM. Prototype P2 had the greatest numerical milk protein output response among the 3 RP-Met prototypes, suggesting that it may have had the greatest efficacy when supplemented into these rations. There was a numerical milk protein concentration response to AL and a linear increase in milk protein concentration for P4. The P4 and AL treatments resulted in comparable milk protein production regardless of P4 dose.

Comparing embodiment experiences in expert meditators and non-meditators using the rubber hand illusion.

One assessment of embodiment is the rubber hand illusion (RHI), a visuo-tactile illusion in which individuals attribute a sense of ownership to a rubber hand and disownership to their real hand. Interestingly, interoception seems to influence RHI susceptibility. In this study, we administered the RHI and the Multidimensional Assessment of Interoceptive Awareness (MAIA) to examine embodiment experiences and interoceptive awareness in experienced meditators (n = 15) and non-meditators (n = 15). We found that meditators reported less intensity in rubber hand ownership, but there was no significant difference between groups with respect to disownership of their real hand or drift in finger proprioception. Moreover, we found, from our MAIA results, that disownership experiences were associated with a feeling of trusting one's body in non-meditators and with the ability to maintain attention to unpleasant bodily sensations in meditators. These results suggest a unique relationship between interoceptive awareness and embodiment related to meditation.

Prevalence and risk of violence and the mental, physical and sexual health problems associated with human trafficking: an updated systematic review.

BACKGROUND: To update and expand on a 2012 systematic review of the prevalence and risk of violence and the prevalence and risk of physical, mental and sexual health problems among trafficked people. METHOD: Systematic review and meta-analysis. Searches of 15 electronic databases of peer-reviewed articles and doctoral theses were supplemented by reference screening, citation tracking of included articles and expert recommendations. Studies were included if they reported on the prevalence or risk of violence while trafficked, or the prevalence or risk of physical, mental or sexual health outcomes among people who have been trafficked. Two reviewers independently screened papers for eligibility and appraised the quality of included studies. RESULTS: Thirty-seven papers reporting on 31 studies were identified. The majority of studies were conducted in low and middle-income countries with women and girls trafficked into the sex industry. There is limited but emerging evidence on the health of trafficked men and the health consequences of trafficking into different forms of exploitation. Studies indicate that trafficked women, men and children experience high levels of violence and report significant levels of physical health symptoms, including headaches, stomach pain and back pain. Most commonly reported mental health problems include depression, anxiety and post-traumatic stress disorder. Although serological data on sexually transmitted infections are limited, women and girls trafficked for sexual exploitation self-report symptoms suggestive of a high prevalence of infections. Limitations of the review include methodological weaknesses of primary studies and some differences in definition and operationalisation of trafficking, which hinder comparability and generalisability of the results. CONCLUSIONS: There is increasing evidence human trafficking is associated with high prevalence and increased risk of violence and a range of physical and mental health problems. Although more studies have emerged in recent years reporting on the health of trafficked men and people trafficked for forms of exploitation other than in the sex industry, further research is needed in this area. Appropriate interventions and support services to address the multiple and serious medical needs, especially mental health, of trafficked people are urgently needed.

Comparison of risk stratification tools in predicting outcomes of patients with higher-risk myelodysplastic syndromes treated with azanucleosides.

Established prognostic tools in patients with myelodysplastic syndromes (MDS) were largely derived from untreated patient cohorts. Although azanucleosides are standard therapies for higher-risk (HR)-MDS, the relative prognostic performance of existing prognostic tools among patients with HR-MDS receiving azanucleoside therapy is unknown. In the MDS Clinical Research Consortium database, we compared the prognostic utility of the International Prognostic Scoring System (IPSS), revised IPSS (IPSS-R), MD Anderson Prognostic Scoring System (MDAPSS), World Health Organization-based Prognostic Scoring System (WPSS) and the French Prognostic Scoring System (FPSS) among 632 patients who presented with HR-MDS and were treated with azanucleosides as the first-line therapy. Median follow-up from diagnosis was 15.7 months. No prognostic tool predicted the probability of achieving an objective response. Nonetheless, all five tools were associated with overall survival (OS, P=0.025 for the IPSS, P=0.011 for WPSS and P<0.001 for the other three tools). The corrected Akaike Information Criteria, which were used to compare OS with the different prognostic scoring systems as covariates (lower is better) were 4138 (MDAPSS), 4156 (FPSS), 4196 (IPSS-R), 4186 (WPSS) and 4196 (IPSS). Patients in the highest-risk groups of the prognostic tools had a median OS from diagnosis of 11-16 months and should be considered for up-front transplantation or experimental approaches.

Geography of the circadian gene clock and photoperiodic response in western North American populations of the three-spined stickleback Gasterosteus aculeatus.

Controlled laboratory experiments were used to show that Oregon and Alaskan three-spined stickleback Gasterosteus aculeatus, collected from locations differing by 18° of latitude, exhibited no significant variation in length of the polyglutamine domain of the clock protein or in photoperiodic response within or between latitudes despite the fact that male and female G. aculeatus are photoperiodic at both latitudes. Hence, caution is urged when interpreting variation in the polyglutamine repeat (PolyQ) domain of the gene clock in the context of seasonal activities or in relationship to photoperiodism along geographical gradients.

Long-term increases in young-of-the-year growth of Arctic cisco Coregonus autumnalis and environmental influences.

Arctic cisco Coregonus autumnalis young-of-year (YOY) growth was used as a proxy to examine the long-term response of a high-latitude fish population to changing climate from 1978 to 2004. YOY growth increased over time (r² = 0·29) and was correlated with monthly averages of the Arctic oscillation index, air temperature, east wind speed, sea-ice concentration and river discharge with and without time lags. Overall, the most prevalent correlates to YOY growth were sea-ice concentration lagged 1 year (significant correlations in 7 months; r² = 0·14-0·31) and Mackenzie River discharge lagged 2 years (significant correlations in 8 months; r² = 0·13-0·50). The results suggest that decreased sea-ice concentrations and increased river discharge fuel primary production and that life cycles of prey species linking increased primary production to fish growth are responsible for the time lag. Oceanographic studies also suggest that sea ice concentration and fluvial inputs from the Mackenzie River are key factors influencing productivity in the Beaufort Sea. Future research should assess the possible mechanism relating sea ice concentration and river discharge to productivity at upper trophic levels.

A series of halogenated heterodimeric inhibitors of prostate specific membrane antigen (PSMA) as radiolabeled probes for targeting prostate cancer.

Prostate specific membrane antigen (PSMA) is a validated molecular marker for prostate cancer. A series of glutamate-urea (Glu-urea-X) heterodimeric inhibitors of PSMA were designed and synthesized where X = epsilon-N-(o-I, m-I, p-I, p-Br, o-Cl, m-Cl, p-Cl, p-F, H)-benzyl-Lys and epsilon-(p-I, p-Br, p-Cl, p-F, H)-phenylureido-Lys. The affinities for PSMA were determined by screening in a competitive binding assay. PSMA binding of the benzyllysine series was significantly affected by the nature of the halogen substituent (IC(50) values, Cl < I = Br << F = H) and the ring position of the halogen atom (IC(50) values, p-I < o-I << m-I). The halogen atom had little affect on the binding affinity in the para substituted phenylureido-Lys series. Two lead iodine compounds were radiolabeled with (123)I and (131)I and demonstrated specific PSMA binding on human prostate cancer cells, warranting evaluation as radioligands for the detection, staging, and monitoring of prostate cancer.

Increased GFAP and S100beta but not NSE serum levels after subarachnoid haemorrhage are associated with clinical severity.

Assessment of initial disease severity after subarachnoid haemorrhage (SAH) remains difficult. The objective of the study is to identify biochemical markers of brain damage in peripheral blood after SAH. Hospital admission S100beta, glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE) serum levels were analysed in 67 patients with SAH. Disease severity was determined by using the World Federation of Neurological Surgeons (WFNS) scale and the Fisher CT (computerized tomography) grading scale. Mean astroglial serum concentrations taken at hospital admission were increased (S100beta 2.8-fold and GFAP 1.8-fold) compared with the upper limit of normal laboratory reference values (P95). The mean NSE concentration was within normal limits. S100beta (P < 0.001) and GFAP (P =0.011) but not NSE levels were higher in patients who were in coma at the time of hospital admission compared with patients who were not. Similarly S100beta and GFAP but not NSE serum levels increased with higher WFNS scores, raised intracranial pressure and higher CT Fisher grade scores. Concerning the location of the aneurysm, S100beta and GFAP serum levels were within normal limits after a perimesencephalic type of haemorrhage and significantly increased after aneurysmal type SAH. Increased glial (S100beta and GFAP) but not neuronal (NSE) protein serum concentrations are found after SAH, associated to the clinical severity of the initial injury.

Volunteering for early phase gene transfer research in Parkinson disease.

BACKGROUND: For early phase trials of novel interventions-such as gene transfer for Parkinson disease (PD)--whose focus is primarily on safety and tolerability, it is important that participants have a realistic understanding of the goals of such research. Recently, some have expressed concern that patients with PD may have unrealistic expectations. METHODS: The authors examined why patients with PD might volunteer for invasive early phase research by interviewing 92 patients with PD and comparing those who would (n = 46) and those who would not (n = 46) participate in a hypothetical phase I gene-transfer study. RESULTS: The two groups' demographic, clinical, functional, and quality of life measures, as well as their understanding of the research protocol, were similar. The groups did not differ on their perception of potential for personal benefit nor on the level of likelihood of benefit they saw as a precondition for volunteering. However, those willing to participate tended to perceive lower probability of risk, were tolerant of greater probability of risk, and were more optimistic about the phase I study's potential benefits to society. They also appeared more decisive and action-oriented than the unwilling group. CONCLUSIONS: It is likely that the decision whether to participate in early phase PD gene transfer studies will depend mostly on patients' attitudes regarding risk, optimism about science, and an action orientation, rather than on their clinical, functional, or demographic characteristics.

Creatine in Huntington disease is safe, tolerable, bioavailable in brain and reduces serum 8OH2'dG.

In a randomized, double-blind, placebo-controlled study in 64 subjects with Huntington disease (HD), 8 g/day of creatine administered for 16 weeks was well tolerated and safe. Serum and brain creatine concentrations increased in the creatine-treated group and returned to baseline after washout. Serum 8-hydroxy-2'-deoxyguanosine (8OH2'dG) levels, an indicator of oxidative injury to DNA, were markedly elevated in HD and reduced by creatine treatment.

Synthesis of a small, cysteine-rich, 29 amino acids long peptide in Mycoplasma pneumoniae.

A 205-210 bases long, small RNA (MP200RNA) of Mycoplasma pneumoniae encodes an open reading frame (ORF pmp200) that has the potential to be translated into a 29 amino acids long peptide with nine cysteines. The expression of this peptide in M. pneumoniae was proven indirectly by constructing a gene fusion between the ORF pmp200 and mrfp1, the gene encoding the monomeric red fluorescent protein. The fusion construct was translated in M. pneumoniae. The corresponding fusion protein, with a molecular mass of approximately 35,000 Da, was isolated and the correct sequence was proven by Edman degradation and by mass spectrometry.

Cranio-cervical stabilization of traumatic atlanto-occipital dislocation with minimal resultant neurological deficit.

Our purpose is to describe a case of atlanto-occipital dislocation and discuss treatment approaches to minimize subsequent neurological deficits. Traumatic atlanto-occipital dislocation, has traditionally been considered rare and lethal, due to resulting high levels of spinal cord injury. Outcomes are generally expected to be poor. However, recent case reports indicate that survival is increasing. Of patients who survive cranio-cervical dislocation, many endure resulting neurological deficits. We present a rare case of a 23-year-old male, who sustained an atlanto-occipital dislocation in a motor vehicle accident. The patient presented with a Glasgow Coma Scale (GCS) of 11T. Lateral C-spine x-ray and thin-section slices CT delineated a C1 ring fracture on the left side with approximately 1 cm anterior and superior subluxation of the occipital condyles of the cranium in reference to C1. The patient was completely awake, alert, and was following commands. The patient underwent a cranio-cervical stabilization from occiput to C3, using lateral mas screws (C1-C3) and transarticular screws (C2-C3). The Vertex (Medtronics) system used included longitudinal bars connected to the lateral mas plating system, which was subsequently used to place screws within the keel of the occipital bone. Motor strength and sensation remained intact following surgery. One-week post-operation, the patient was ambulating 140 feet, conversationally appropriate, and had a GCS of 15. This case illustrates the possibility for neurosurgical intervention of cranio-cervical dislocations to achieve optimal outcome and demonstrates that survival from this injury is not only conceivable, but recovery of function is also possible.

Glial and neuronal proteins in serum predict outcome after severe traumatic brain injury.

OBJECTIVE: To study the ability of glial (glial fibrillary acidic protein [GFAP] and S100b) and neuronal (neuron specific enolase [NSE]) protein levels in peripheral blood to predict outcome after severe traumatic brain injury. METHODS: Eighty-five patients with severe traumatic brain injury (admission Glasgow Coma Score [GCS] < or = 8) were included. Blood samples taken at the time of hospital admission were analyzed for S100b, GFAP, and NSE. Data collected included demographic and clinical variables. Outcome was assessed using the Glasgow Outcome Scale (GOS) at 6 months post injury. RESULTS: The median serum levels of S100b, GFAP, and NSE were raised 18.3 fold (S100b), 4.6 fold (GFAP), and twofold (NSE) compared to normal reference values. S100b, GFAP, and NSE serum levels correlated significantly with the injury severity score and CT findings but not with age, sex, or GCS. S100b, GFAP, and NSE levels were significantly higher in patients who died or had a poor outcome 6 months post injury than in those who were alive or had good outcome. S100b level >1.13 microg/L was the strongest predictor of death with 100% discrimination, but GFAP (>1.5 microg/L) and NSE (>21.7 microg/L) levels also strongly predicted death (adjusted odds ratios 5.82 [for GFAP] and 3.91 [for NSE]). S100b, GFAP, and NSE all strongly predicted poor outcome (adjusted odds ratios 5.12 [S100b], 8.82 [GFAP], and 3.95 [NSE]). CONCLUSIONS: These results suggest that determination of serum levels of glial and neuronal proteins may add to the clinical assessment of the primary damage and prediction of outcome after severe traumatic brain injury.

In vitro release of mitomycin C from collagen implants.

PURPOSE: To study Mitomycin C Loaded Collagen Implant (CI) pharmacokinetics behaviour in vitro. METHODS: The CI were incubated for 15 minutes in different MMC loading solutions with the following concentrations: 0.03 mg/mL (n = 9), 0.3 mg/mL (n = 10) and 3.0 mg/mL (n = 10). The loaded CI were transferred in 100 micro L of 0.9% NaCl. Aqueous flow of 5 micro L/min was simulated. The MMC concentrations of the samples were determined by high performance liquid chromatography (HPLC). Dissolution kinetics were evaluated by a first-order process. The half-life of dissolution and the time of 95% dissolution were determined. RESULTS: The CI absorbed on average a MMC dose of 0.054, 0.530 and 6.090 micro g when incubated in the different MMC loading solutions containing 0.03 mg/mL, 0.3 mg/mL, 3.0 mg/mL of MMC, respectively. In the release experiments, the mean total dose delivered by CI was 0.0493, 0.585 and 5.291 micro g. A linear correlation between loading concentration and the estimated total dose released was demonstrated. The kinetic parameters showed a fast MMC dissolution. The half-life of the 3 series was 8.8, 10.1 and 10.5 min. CONCLUSIONS: Commercially available CI can be loaded with MMC, and could provide relatively slower release than sponge delivery of MMC. Clinical implications of these results warrants further studies.