A novel transdermal delivery route for energy supplements: Electrospun chitosan/polyvinyl alcohol nanofiber patches loaded with vitamin B12.

Nanofibrous patches have attracted much attention as a solution to resolve drug delivery challenges. In this study, vitamin B12- loaded polyvinyl alcohol (PVA)/chitosan (Cs) nanofiber patch (NFP) was electrospun and cross-linked by glutaraldehyde (GA). The physicochemical properties of the nanofiber patches were assessed by morphological studies, FTIR analysis, hydrophilicity test, mechanical tests, and in-vitro evaluations including biodegradability, MTT assay, and cumulative release test of vitamin. In-vivo studies were also carried out by measuring vitamin B12 levels in the bloodstream and conducting histopathology studies on the animal models. The results showed that the mean diameter of Cs/PVA/B12 and cross-linked patch were approximately 207 and 256 nm, respectively. Cross-linking of NFP led to the lower, slower, and more continuous release of the vitamin with a slight decrease in biodegradability, and an increase in the mechanical properties of the nanofiber patches. Furthermore, the cytocompatibility assay, MTT, and in vivo results revealed no cytotoxicity of Cs/PVA/B12 NFP towards L929 cell line. No lesion or tissue damage was observed in the skin tissue of the animal models wearing these skin patches. Therefore, B12-loaded NFP can be introduced as a potential candidate for commercial transdermal routes.

Spot urine protein measurements: are these accurate in kidney transplant recipients?

BACKGROUND: Proteinuria and albuminuria are important markers of allograft pathology and are associated with graft loss and cardiovascular disease. Traditionally, these have been quantified using a 24-hr urine collection, but spot urine measurements (albumin-creatinine and protein-creatinine ratios) have become popular because of convenience. Aside from tests of correlation, there has been little evaluation of these measurements in kidney transplantation. METHODS: To further assess the value of albumin-creatinine and protein-creatinine ratios, we measured protein-creatinine ratio and 24-hr urine protein excretion (n=192) and albumin-creatinine ratio and 24-hr urine albumin excretion (n=189) in stable renal transplant patients. Bias (measured minus estimated value), precision, and accuracy was calculated. RESULTS: For the protein-creatinine ratio, percent bias ranged from 12% to 21%, and the accuracy (within 30% of 24-hr collection) was only 47% to 56% depending on the degree of proteinuria. For the albumin-creatinine ratio, percent bias ranged from 9% to 21%, and the accuracy (within 30%) ranged from 38% to 80% depending on the degree of albuminuria. There was no statistical difference between accuracy of protein-creatinine and albumin-creatinine ratios. CONCLUSIONS: The ability of the albumin-creatinine and protein-creatinine ratios to accurately predict 24-hr albumin and protein excretion is modest. Given the similar accuracy of both measurements, either protein-creatinine ratio or albumin-creatinine ratio can be used for monitoring protein excretion. However, given the limitations of both the albumin-creatinine ratio and protein-creatinine ratio in this population, a 24-hr urine collection should be considered before making major clinical decisions (e.g., biopsy) based on the presence of proteinuria.

Peritoneal dialysis catheter insertion strategies and maintenance of catheter function.

It has been more than 40 years since permanent peritoneal dialysis (PD) access with the Tenckhoff catheter was first described, and despite much experimentation with catheter design and insertion techniques, access to timely and skilled PD catheter insertion remains a barrier to more widespread PD use in many centers. This article reviews different insertion techniques with a focus on both mechanical outcomes as well as logistic advantages associated with the embedded catheter and percutaneous techniques. Maintenance of catheter function is discussed with a focus on an organized and evidence-based approach to preventing and treating mechanical catheter problems.

Skin tag as a cutaneous marker for impaired carbohydrate metabolism: a case-control study.

BACKGROUND: Skin tags are common benign skin tumors usually occurring on the neck and major flexors of older people. A possible association with impaired carbohydrate metabolism has been suggested in previous studies, but the results are not conclusive. OBJECTIVE: To investigate and compare the prevalence of diabetes and impaired glucose tolerance (IGT) in patients with skin tag and a control group. PATIENTS AND METHODS: A case-control study was conducted in individuals over 15 years old, comparing cases (n = 104) with at least three skin tags and age-, sex-, and body mass index (BMI)-matched controls (n = 94) without skin tag. Cases and controls were recruited from patients consecutively seen at an academic outpatient dermatology clinic. All patients underwent a standard 2-h oral glucose tolerance test with 75 g glucose. RESULTS: Patients with skin tag had higher frequency of diabetes than the control group (23.07% vs. 8.51%, chi(2)-test, P = 0.005). The difference in the frequency of IGT was not significant (13.46% vs. 10.63%, chi(2)-test, P = 0.543). There was a positive correlation between the total number of skin tags and the mean fasting plasma glucose (Pearson correlation, r = 0.260, P = 0.031); patients with more than 30 skin tags were particularly at an increased risk of diabetes (52.0%). No correlation was found between the number of skin tags and BMI. We did not find any correlation between the anatomical localization of skin tags and impaired carbohydrate metabolism, except for skin tags under the breast in women. CONCLUSION: These results show an increased risk of diabetes mellitus in patients with multiple skin tags. With regard to the importance of early diagnosis of diabetes, we recommend a high level of suspicion for impaired carbohydrate metabolism in patients with skin tag.