A novel lidocaine hydrochloride mucoadhesive films for periodontal diseases.

Periodontal diseases are inflammatory disorders caused primarily by dental plaque microorganisms that even may need surgery to remove damaged tissue. Adhesive biocompatible films may be an adequate form in order to improve drug retention or prevent microbial infections by covering the surgical site. In recent years, much attention has been focused on biocompatible inexpensive polymers, for biomedical and pharmaceutical potential applications. The objective of this research is the development of a film for mucosal application containing lidocaine hydrochloride (5%, w/w) as anesthetic drug. Lidocaine films were prepared with three biopolymers: hydroxypropylmethylcellulose (HPMC), chitosan (CH), or xanthan gum (XG). Their thickness and uniformity content were characterized. Rheological behavior of the hydrated films was studied using flow curves, creep and recovery tests and dynamic oscillatory measurements with a rheometer. The mucoadhesive assays were carried out with cheeks of Wistar rat using a universal tensile tester to know their adhesiveness. Finally, lidocaine delivery through the films was investigated in Franz cells. All films (n = 3 for each polymer) showed flexibility, a drug content of 0.015 ± 0.001 g/cm2 and a thickness of 0.25 ± 0.01 mm. The results of the maximum detachment force in tensile tests and work adhesion indicated that XG is the polymer that showed greater power of mucoadhesion (p < 0.05). These properties show a good correlation with the rheological characteristics. In all cases, the lidocaine amount released at 30 min is around 4 mg/cm2. This amount could be considered sufficient to guarantee the anesthetic effect.

Variabilidad en la realización de la espirometría y sus consecuencias en el tratamiento de la EPOC en Atención Primaria / Variability in the Performing of Spirometry and Its Consequences in the Treatment of COPD in Primary Care

Antecedentes: Algunos estudios han abordado el uso de la espirometría en la enfermedad pulmonarobstructiva crónica (EPOC) en Atención Primaria (AP), y pocos han analizado su impacto en el tratamientodel paciente con EPOC.Objetivos: Valorar la utilización de la espirometría en el diagnóstico y seguimiento de los pacientes EPOCen AP y su impacto en el tratamiento. Analizar la variabilidad en la realización de espirometrías entre loscentros de AP.Metodología: Estudio multicéntrico, observacional y transversal en pacientes EPOC atendidos en AP deCatalunya (España) durante 2004-2005. Se usó un modelo de regresión logística multinivel para identificarfactores asociados con tener espirometría y determinar la variabilidad entre los diferentes centros.Resultados: Participaron 21 centros, que incluyeron 801 pacientes. Solo el 53,2% disponían de espirometríadiagnóstica, la media (desviación estándar) del FEV1(%) fue 54,8% (18%). Los registros del hábitotabáquico, pruebas complementarias y espirometrías de seguimiento estuvieron más presentes entre lospacientes que disponían de espirometría diagnóstica respecto a aquellos que no la disponían.Nose encontrarondiferencias estadísticamente significativas respecto a variables demográficas, clínicas, tratamientoy calidad de vida entre pacientes con o sin espirometría de seguimiento. Se observó variabilidad significativaen el porcentaje de espirometrías diagnósticas entre los diferentes centros de AP (varianza = 0,217;p < 0,001).Conclusión: La espirometría en AP está infrautilizada y su realización durante el seguimiento no se asocia aunas pautas distintas de tratamiento ni a un abordaje más completo de la enfermedad. Existe variabilidadsignificativa en la realización de espirometrías entre los centros de AP(AU)

Background: Several studies have approached the use of spirometry in the treatment of chronic obstructivepulmonary disease (COPD) in Primary Care (PC), but few have analysed its impact on the treatmentof the patient with COPD.Objectives: To evaluate the use of spirometry in the diagnosis and follow-up of COPD patients in PC, andits impact on treatment. To analyse the variation in the performing of spirometry between PC centres. Methodology: A multicentre, observational and cross-sectional study of COPD patients seen in PC inCatalonia (Spain) during 2004–2005. A multilevel logistic regression model was used to identify factorsassociated with having spirometry and to determine the variation between the different centres.Results: Twenty-one centres which included 801 patients took part. Only 53.2% of them had a diagnosticspirometer available and themean(standard deviation) FEV1(%) was 54.8% (18%). The registers of smokinghabits, complementary tests and spirometry follow-up were more common among patients who had adiagnostic spirometry available compared to those who did not. No statistically significant differenceswere found as regards demographic, clinical, treatment and quality of life variables between patientswith and without follow-up spirometry. Significant variation was observed in the percentage of diagnosticspirometries between different PC centres (variance = 0.217; p < 0.001).Conclusion: Spirometry is underused in PC and performing it during follow-up is not associated to thedifferent treatments received, or with a more complete approach to the disease. There is significantvariation in the performing of spirometry among PC centres(AU)

Variability in the performing of spirometry and its consequences in the treatment of COPD in primary care.

BACKGROUND: Several studies have approached the use of spirometry in the treatment of chronic obstructive pulmonary disease (COPD) in Primary Care (PC), but few have analysed its impact on the treatment of the patient with COPD. OBJECTIVES: To evaluate the use of spirometry in the diagnosis and follow-up of COPD patients in PC, and its impact on treatment. To analyse the variation in the performing of spirometry between PC centres. METHODOLOGY: A multicentre, observational and cross-sectional study of COPD patients seen in PC in Catalonia (Spain) during 2004-2005. A multilevel logistic regression model was used to identify factors associated with having spirometry and to determine the variation between the different centres. RESULTS: Twenty-one centres which included 801 patients took part. Only 53.2% of them had a diagnostic spirometer available and the mean (standard deviation) FEV1(%) was 54.8% (18%). The registers of smoking habits, complementary tests and spirometry follow-up were more common among patients who had a diagnostic spirometry available compared to those who did not. No statistically significant differences were found as regards demographic, clinical, treatment and quality of life variables between patients with and without follow-up spirometry. Significant variation was observed in the percentage of diagnostic spirometries between different PC centres (variance=0.217; p<0.001). CONCLUSION: Spirometry is underused in PC and performing it during follow-up is not associated to the different treatments received, or with a more complete approach to the disease. There is significant variation in the performing of spirometry among PC centres.