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PubMed1995

Emerging delivery systems for estrogen replacement: aspects of transdermal and oral delivery.

The ideal preparation for estrogen replacement therapy has been the object of intensive research for decades, and the search continues. More than 40 new products are in development in the United States, the United Kingdom, and Europe. Most are transdermal, which reflects the growing acceptance of patch technology at a time when the overwhelming majority of women who use estrogen replacement take oral formulations. Most of the new oral formulations are a combination of estrogen and progestin. Aspects of transdermal and oral estrogen are discussed, including the advantages and disadvantages for use in women with concomitant medical conditions.

Administration, Cutaneous↗
PubMed1986

Health care delivery models: emerging trends in the delivery of health services.

Rising costs, a higher proportion of elderly in the population, proliferation of high technology and increased knowledge about efficient and effective service provision have all led to increased cost-consciousness in the health system. Historically, regulatory approaches have provided equity of access and funding, but for controlling costs they have now become inappropriate because they leave the mix of services untouched. In the future, regulatory approaches may make more use of guidelines and algorithms for care (the "soft" regulatory route), or they may directly control the supply of providers and other resources in the health system (the "hard" regulatory route). An alternative is the competition approach which allows choices by consumers on where to obtain health care based on the efficiency with which those services are provided. The danger in this approach is the potential for equity to be compromised; this may be addressed by combining the regulatory and competitive approaches.

Canada↗
PubMed2004

Iontophoresis-gentamicin delivery into the rabbit cornea, using a hydrogel delivery probe.

PURPOSE: To evaluate the efficacy of penetration of gentamicin into the cornea of rabbits using iontophoresis with a hydrogel-gentamicin containing probe. METHODS: Eight of 10 groups (groups 3-10) of 6 rabbits (one eye per rabbit), underwent corneal iontophoresis using soft stable hydroxyethyl methacrylate hydrogel discs (80% water content) loaded with gentamicin sulphate which were mounted on an iontophoresis probe. The studied current intensities were 0, 0.1, 0.3 and 0.6 mAmp, and the durations of iontophoresis were 10 and 60 sec. Two control groups received 1.4% topical drops of gentamicin every 5 min for 1 hr (group 1) or sub-conjunctival injection of 10 mg gentamicin (group 2). Following sacrifice, aqueous humour was taken, corneas were excised, and gentamicin concentration was determined in aqueous humour and cornea samples. RESULTS: Post-iontophoresis, the concentration of gentamicin in the corneas ranged from high (88.60 +/- 38.64 microg ml(-1)) to very low (0.10 +/- 0.89 microg ml(-1)). Both the control groups and those rabbits treated with current intensity of 0.1 mAmp or greater obtained therapeutic gentamicin levels in the corneas. Use of iontophoresis for 60 sec or current intensity greater than 0.1 mAmp obtained corneal gentamicin levels not different from sub-conjunctival injection. Application of current intensity of 0.1 mAmp or greater gave corneal gentamicin concentrations comparable to topical application of the drug, except when 0.6 mAmp were used for 60 sec (p = 0.05). Increasing current intensity or duration of iontophoresis significantly increased (p = 0.001 for both) gentamicin penetration into the cornea. Current intensity had more influence (Beta2 = 0.40) than duration (Beta2 = 0.13) on drug penetration. A significant interaction was found between the duration of iontophoresis and the current intensity. Very small or no concentrations of the drug were discovered in the anterior chambers of rabbits. CONCLUSIONS: Iontophoresis using hydrogel-gentamicin probe may deliver therapeutic concentrations of gentamicin into the cornea.

Animals↗
PubMed1999

Local delivery of chlorhexidine using a tooth-bonded delivery system.

Films containing 20% w/w chlorhexidine base (particle size 63-125 microm) in poly(epsilon-caprolactone), MW 35,000-45,000, were prepared by solvent evaporation and sections attached to the mesio-lingual and mesio-buccal surfaces of the lower first molar in healthy volunteers. Saliva (<1.5 microl) was collected on Periopaper and chlorhexidine concentrations measured by HPLC were typically higher in the area immediately adjacent to the tooth-bonded film sections and lower at more distant sites. Analysis of variance of chlorhexidine concentrations, adjacent to the film sections, showed concentrations were significantly different on the buccal and lingual sides of the tooth and depended on the time of sampling (n=5, P<0.05).

Administration, Oral↗