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PubMed2006

Current developments using emerging transdermal technologies in physical enhancement methods.

Transdermal drug delivery using patches offers many advantages, but is limited primarily by the stratum corneum barrier. Amongst the various methods to overcome this barrier, physical methods are gaining in popularity and commercial devices development. Macroflux, MTS and Silex are based on microporation, involving use of microneedles that pierce thereby bypassing the stratum corneum. Intraject , Powderject and Helios are based on needleless jet injectors wherein very fine, solid particulate drug, is fired directly into the skin, using high-pressure gas. Med- Tats incorporate use of modified drug-containing tattoos, which bind to the skin, wherein the drug is absorbed. CHADD is based on use of heat, which increases skin - permeation of drugs. High-power, pulsed lasers transmit positive mechanical forces to the skin and create intercellular channels into the skin transiently. Sonophoresis involves use of ultrasound, which transiently disrupts the stratum corneum barrier. This technique offers a non-invasive transdermal extraction of interstitial fluids of sampling body fluids. Modified Liposomes include Ethosomes (containing alcohol) and Transferosomes (containing surfactants), which have enhanced skin permeability. Pulsed magnetic fields may create transient pores in cell membranes, including skin, resulting in increased permeation. Iontophoresis is based on application of electric potential for enhancing the movement of substances to and from the body. Dupel, Ionzyme, Liposite, ETrans, Phoresor and Drionic are based on iontophoresis. GlucoWatch offers non-invasive blood glucose monitoring, based on reverse iontophoresis. This review outlines recent commercial developments in physical transdermal drug delivery technology and the specific devices and applications being targeted by the pharmaceutical industry.

Adjuvants, Pharmaceutic↗
PubMed2006

Patients' conceptions of quality care and barrier care.

AIM: To describe patients' conceptions of quality care and barrier care. METHODS: As this study concerned conceptions of care, a phenomenographic approach was chosen. Fourteen adult orthopaedic patients participated. Data-collection was performed by means of semi-structured interviews. The qualitative data were analysed with two foci, conceptions of quality care and conceptions of barrier care. Different categories of understanding, that is, conceptions, constitute the the essential outcome of phenomenographic analysis. The research was conducted in one county hospital and in one regional hospital situated in different cities in the south of Sweden. RESULTS AND CONCLUSIONS: Patients' conceptions of quality care resulted in six categories. When comparing the findings with previous research in this field, the findings of the present study confirmed to a large extent the findings from other studies of quality care. Patients' conceptions of barrier care resulted in five categoris. The conceptions of barrier care must be considered as elements in patients' conceptions of quality care, and this must be called atention to in efforts to measure patient satisfaction and in analyses of good care. It also can influence health care workers' compliance to guidelines in infection control procedures.

Adult↗
PubMedDate not supplied

Women's contraceptive attitudes and use in 1992.

Women aged 15-44 rate the pill, the condom, vasectomy and female sterilization most highly, according to 1992 data from an annual survey by Ortho Pharmaceutical Corporation of contraceptive attitudes and method use. The 6,955 survey respondents underrepresent women who are black or who have household annual incomes greater than $50,000, but they are similar to all American women in age, marital status and region of the country. About 74-84% of women giving an opinion view these methods favorably and 64% rate the hormonal implant favorably. The proportion of unmarried women who had had intercourse increased from 76% in 1987 to 86% in 1992. As a result, proportions of women at risk of unintended pregnancy rose from 72% to 77%. Contraceptive use also rose, from 92% to 94%. The most commonly used method is the pill (39%), followed by the condom (25%), female sterilization (19%) and vasectomy (12%). Married women exposed to the risk of unintended pregnancy are more likely to use sterilization (48%), while unmarried women are more likely to use the pill (52%) and the condom (33%). Pill use has increased since 1987, especially among married women, and condom use has increased among all women. Among unmarried women at risk of unintended pregnancy, condom use rose from 18% in 1987 to 33% in 1992. Among condom users, 40% of unmarried users and 13% of married users also use another method.

Adolescent↗
PubMed2001

Improved efficacy of chemotherapy for glioblastoma by radiation-induced opening of blood-brain barrier: clinical results.

PURPOSE: To improve the efficacy of chemotherapy for glioblastoma through the radiation-induced opening of the blood-brain barrier (BBB). METHODS AND MATERIALS: In two previous articles, we have described the results of brain scanning using technetium 99m-labeled somatostatin and the measurement of methotrexate (MTX) concentrations in blood and cerebrospinal fluid (CSF) after i.v. injection. We discovered that the BBB and blood-cerebrospinal fluid barrier opened to a certain extent after 20- to 40-Gy irradiation, thus increasing the degree to which MTX permeated the brain tissue. On the basis of these findings, we retrospectively analyzed the outcome in 56 patients with glioblastoma given either chemotherapy (CCNU) after 20- to 40-Gy irradiation (28 patients) or radiation therapy alone (28 patients). RESULTS: The 1-, 3-, and 5-year survival rates were 57.14%, 22.50%, and 15.00% in the combined-therapy group and 17.86%, 7.14%, and 3.57% in the radiotherapy alone group, respectively. The respective median survival times were 29.11 +/- 6.99 and 9.86 +/- 3.45 months (p < 0.001), which represented a statistically significant difference. CONCLUSION: Our study further confirms that opening of the BBB induced by irradiation with 20-40 Gy may optimize the effects of intracranial chemotherapy.

Adolescent↗
PubMed1998

Shielded corneosurfametry and corneoxenometry: novel bioassays for the assessment of skin barrier products.

OBJECTIVES: One of the most frequent occupational and environmental insults to the skin is linked to chronic exposure to weak irritants. There is a need for new predictive tests assessing the efficacy of barrier creams. METHODS: Shielded variants of corneosurfametry and corneoxenometry are introduced as novel ex vivo bioassays applicable for comparing protection to surfactants and organic solvents. RESULTS: Both bioassays showed good reproducibility for each offending agent and skin-protective products. Significant differences in efficacy were indicated between the presumptive barrier products. CONCLUSIONS: Shielded corneosurfametry and corneoxenometry may be convenient bioassays to compare the protection afforded by topical products against specific offending compounds to the skin. They avoid animal testing and toxicological hazards in human testing. In addition, they are cheap, rapid and reproducible.

Biological Assay↗
PubMed1987

[Possible reduction of cervical cancer by the use of barrier-type contraceptives].

Forty-four cervical cancer inpatients and 44 individually age-matched controls were surveyed. As a result, the number of the cases whose partners used condoms for contraception was significantly lower than that of the controls (P less than 0.01; the odds ratio = 0.2). The same result was obtained after adjusting possible confounding variables such as the number of pregnancies and use of other contraceptive methods. Barrier-type contraceptives like condoms may reduce the incidence of sexually transmitted viral infections, which it has been suggested are associated with the disease.

Adult↗
PubMedDate not supplied

Relationship between contraceptive method choice and beliefs about HIV and pregnancy prevention.

BACKGROUND AND OBJECTIVES: The goal of this study was to examine the relationship between contraceptive method choice and perceptions of HIV and pregnancy risk among women at risk of HIV infection and transmission. STUDY DESIGN: Women who were infected with HIV or who were at high risk of infection were administered a questionnaire assessing sexual and drug-related HIV risk behaviors and beliefs, STD and pregnancy history, and intentions, beliefs and behaviors regarding pregnancy, childbearing and contraception. RESULTS: Among women who reported using a contraceptive method every time they had intercourse, 43% used condoms only, 22% used birth control pills only, and 11% used both. Only 58% of consistent condom users believed they were very unlikely to become infected with HIV in the next year. Controlling for risk factor differences, pill-only users were less likely to believe themselves at risk of HIV infection, and more confident in their ability to prevent HIV infection, compared with condom-only users. CONCLUSION: Results suggest that women's beliefs about the effectiveness of a method for pregnancy prevention may generalize to beliefs about the efficacy of the method for disease prevention.

Adult↗
PubMed1994

Reperfusion-induced injury to the blood-brain barrier after middle cerebral artery occlusion in rats.

BACKGROUND AND PURPOSE: The integrity of the blood-brain barrier may play an important pathophysiological role during postischemic reperfusion. To determine the factors that lead to exacerbation of brain injury by reperfusion, we investigated changes in cerebral blood flow, blood-brain barrier permeability, edema formation, and infarction in permanent or temporary middle cerebral artery occlusion in rats and studied the relation between local cerebral blood flow and blood-brain barrier disruption. METHODS: Middle cerebral artery occlusion was performed with the rat suture model, allowing either permanent (6 hours) or temporary occlusion (3 hours of occlusion and 3 hours of reperfusion). We measured brain water, ion contents, and infarct volumes and determined cerebral blood flow using laser Doppler flowmetry and blood-brain barrier permeability with [3H] alpha-aminoisobutyric acid. RESULTS: During occlusion, cerebral blood flow was reduced to 7% to 15% (permanent) and 10% to 17% (temporary) of the baseline. During 3 hours of reperfusion, it returned to 47% to 80% (lateral cortex) and 78% to 98% (medial cortex) of the baseline. Compared with the contralateral hemisphere, the water content in the ischemic area increased in both permanent and temporary groups (P < .05, P < .01). Both infarct volume and blood-brain barrier disruption were greater in the reperfusion group compared with the permanent occlusion group (P < .05). Blood-brain barrier disruption correlated with cerebral blood flow during reperfusion (P < .05). CONCLUSIONS: These findings demonstrate that brain infarct and blood-brain barrier disruption are exacerbated after reperfusion in this model of focal ischemia. Blood-brain barrier disruption may relate to the degree of cerebral blood flow recovery. Thus, although early reperfusion in focal ischemia may preserve penumbra tissue, late reperfusion may increase the tissue injury.

Animals↗
PubMedDate not supplied

Strategies to contain the spread of AIDS: A review.

An attempt has been made to review the available strategies to contain the spread of the Acquired Immunodeficiency Syndrome (AIDS). Also options for clinical management of AIDS' patients are summarized. Development and production of a suitable vaccine is the ultimate goal in the attempts to stop the spread of AIDS. This however has been hampered by the continuous replication and mutation of the Human Immuno-deficiency Virus (HIV) within the body of an infected person. For now, effective health education is the most realistic method of controlling the spread of AIDS.

AIDS Vaccines↗
PubMed1991

Contraception in the perimenopause.

Pregnancy in women aged 40 and above is frequently unplanned and the legal abortion rate is high in this age group. Contraception and fertility are shrouded in popular mythology and many women do not appreciate either their risk of conception or the range of methods available to prevent conception. Either hormonal or non-hormonal methods of contraception may be appropriate.

Contraception↗
PubMedDate not supplied

The effects of contraceptive education on method use at first intercourse.

Despite long-standing public support for sex education in the schools, it has been difficult to show concrete effects of sex education on sexual and contraceptive behavior. Data from the 1988 National Survey of Family Growth indicate that exposure to a formal contraceptive education program increases the likelihood that a teenage woman will use a contraceptive method at first intercourse. According to the results of a multivariate analysis, the odds that a young woman will use any method and the odds that she will use a condom increase by about one-third following instruction about birth control; the effect on the likelihood of pill use, however, is nonsignificant. If contraceptive education occurs in the same year that a teenager becomes sexually active, the odds of any method use and of condom use are increased by 70-80%, and the odds of pill use are more than doubled. The results also suggest that with greater educational efforts, the proportion of teenagers who use condoms at first intercourse could increase from 52% to 59%, while the proportion using no method might decrease from 41% to 33%.

Adolescent↗
PubMed1995

The safety value of guardrails and crash cushions: a meta-analysis of evidence from evaluation studies.

Evidence from 32 studies that have evaluated the safety effects of median barriers, guardrails along the edge of the road, and crash cushions (impact attenuators) is summarized by means of a meta-analysis. Two hundred and thirty-two (232) estimates of safety effects are included in the meta-analysis. The presence of publication bias is tested by means of the funnel graph method. For most subsets of the data, no evidence of publication bias is found. Weighted mean estimates of safety effects are computed by means of the logodds method. Median barriers are found to increase accident rate, but reduce accident severity. Guardrails and crash cushions are found to reduce both accident rate and accident severity. The effects of guardrails and crash cushions on accident rate have been less extensively studied than the effects on accident severity. Current estimates of the effects on accident rate are highly uncertain because of methodological shortcomings of available studies. The effects of guardrails on accident severity are found to be quite robust with respect to study design and the number of confounding variables controlled in each study. In general, random variation in the number of accidents is the most important source of variation in study results.

Accidents, Traffic↗