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European Journal of Pharmaceutics and... Feb 2024Current strategies for smoking withdrawal conditions involve monotherapy of nicotine and combinational therapy of nicotine with varenicline or bupropion as per the CDC...
Current strategies for smoking withdrawal conditions involve monotherapy of nicotine and combinational therapy of nicotine with varenicline or bupropion as per the CDC and FDA. The available dosage forms for nicotine are patches, gums, inhalers and nasal sprays, bupropion and varenicline are available in tablet form. This research work focused on developing a microneedle delivery system to deliver combination drug for overcoming the obstacles encountered by oral route of administration of varenicline such as severe side effects (mood swings, agitation, depressed behaviour, seizures, etc), and nicotine therapy challenges such as short half-life, repeated dosing, nausea, and vomiting. The nanoparticles of nicotine prepared by nanoprecipitation method showed particle size PTZ (356.6 ± 65.98), percentage entrapment efficiency (35.55 % ± 0.007), in-vitro drug release (47.89 % ± 0.7) for 72 h. Microneedles showed height (600 μm), width (350 μm), and tip diameter (10 μm). The nanoparticles encapsulated in microneedles showed in-vitro sustained delivery of nicotine (67.00 % ± 4.92) and varenicline (79.78 % ± 1.09) in 48 h. Nicotine released in a sustained manner attaches to the nicotine acetylcholine receptors (nAchR) to release dopamine for controlling the withdrawal challenges such as anxiety, irritability, cravings, disturbed sleep pattern, etc. The varenicline released from microneedles binds to the nAchR and inhibits dopamine release responsible for the euphoric effect induced by nicotine, and thus assists in curbing the nicotine withdrawal symptoms. This combination microneedle system offers prolonged treatment in a single application for smoking withdrawal conditions wherein patients are not in stage of oral dosing because of repeated dosing resulting in adverse effects like seizures, hypertension, sleep disturbances, insomnia, and nausea.
Topics: Humans; Nicotine; Varenicline; Bupropion; Receptors, Nicotinic; Nicotinic Agonists; Dopamine; Smoking Cessation; Benzazepines; Substance Withdrawal Syndrome; Quinoxalines; Smoking; Seizures; Nausea
PubMed: 38159871
DOI: 10.1016/j.ejpb.2023.114171 -
Maturitas Mar 2024Menopause is a natural physiological phase during which women experience dramatic hormonal fluctuations. These lead to many symptoms, such as depression and anxiety,... (Review)
Review
Menopause is a natural physiological phase during which women experience dramatic hormonal fluctuations. These lead to many symptoms, such as depression and anxiety, which, in turn, can negatively affect quality of life. Proper nutrition has an influential role in alleviating depression as well as anxiety. It is well known that gut microbiota dysbiosis contributes to the development of mood disorder. There is mounting evidence that modulating the gut-brain axis may aid in improving mood swings. In this context, this narrative review summarizes recent findings on how aging changes the composition of the gut microbiota and on the association between gut microbiota and mood disorders. In addition, it evaluates the effectiveness of psychobiotics and fermented foods in treating mood swings in middle-aged and older women. A search was done using PubMed, Scopus, and Google Scholar, and thirteen recent articles are included in this review. It is evident that psychobiotic supplementation and fermented foods can improve mood swings via several routes. However, these conclusions are based on only a few studies in middle-aged and older women. Therefore, long-term, well-designed randomized controlled trials are required to fully evaluate whether psychobiotics and fermented foods can be used to treat mood swings in this population.
Topics: Humans; Female; Middle Aged; Aged; Quality of Life; Affect; Mood Disorders; Gastrointestinal Microbiome; Fermented Foods; Probiotics
PubMed: 38157685
DOI: 10.1016/j.maturitas.2023.107903 -
Clinical Biomechanics (Bristol, Avon) Jan 2024Challenging children with Down syndrome to walk fast and with external ankle load has demonstrated acute adjustments, such as increased step length and decreased step...
BACKGROUND
Challenging children with Down syndrome to walk fast and with external ankle load has demonstrated acute adjustments, such as increased step length and decreased step width, and improved joint stability. However, it is unknown to what extent these task constraints affect gait stability. Assessing dynamic gait stability through margin-of-stability not only quantifies adjustments related to balance control, but also informs safety considerations.
METHODS
Twenty-four children with and without Down syndrome participated in this study. Subjects walked overground at two speed conditions: self-selected (normal) and as fast as possible (fast); and two ankle load conditions: no load and ankle load of 2% body mass. We assessed margin-of-stability in the anteroposterior and mediolateral directions, separately, at three gait events of toe-off, mid-swing, and heel strike.
FINDINGS
Children with Down syndrome walked with greater mediolateral margin-of-stability than typically developing children. Children with Down syndrome demonstrated less anteroposterior margin-of-stability than typically developing children only before heel-strike at normal speed but increased anteroposterior margin-of-stability at fast speed. The ankle load increased the mediolateral margin-of-stability in both groups but did not impact the anteroposterior margin-of-stability. In addition, children with Down syndrome took shorter and wider steps for more lateral placement of mediolateral margin-of-stability.
INTERPRETATION
Children with Down syndrome were capable of adjusting their margin-of-stability for fast walking and ankle-load conditions. However, children with Down syndrome walked with less mediolateral stability and anteroposterior mobility than typically developing children. Children with Down syndrome overcompensate the mediolateral foot placement to recapture their margin-of-stability and maintain gait stability.
Topics: Child; Humans; Down Syndrome; Walking; Gait; Foot; Ankle Joint; Biomechanical Phenomena; Postural Balance
PubMed: 38154438
DOI: 10.1016/j.clinbiomech.2023.106163 -
Annals of Agricultural and... Dec 2023Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder with numerous hormonal, metabolic, and reproductive manifestations. Because of the variety of adverse...
INTRODUCTION AND OBJECTIVE
Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder with numerous hormonal, metabolic, and reproductive manifestations. Because of the variety of adverse consequences associated with the condition, women with PCOS suffer emotional distress, resulting in reduced health-related quality of life. Similar to other chronic conditions, eating patterns have been shown effective in impacting the quality of life of PCOS patients. Therefore, lifestyle modifications are recommended as a first-line therapy for PCOS, before prescribing any pharmaceutical management of the PCOS. The aim of the study was to investigate the relationship between dietary patterns, emotional distress, and perceived quality of life in women with diagnosed PCOS.
MATERIAL AND METHODS
The cross-sectional study included 130 women with PCOS aged 18 - 60 years from the Polish population. The respondents were asked to complete a self-administered questionnaire developed for the purpose of the study, inspired by the Food Frequency Questionnaire (FFQ), Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ), Three-Factor Eating Questionnaire (TFEQ-R18), and the Eating attitude questionnaire (Eat-26).
RESULTS
Respondents were found to experience emotional distress regardless of how healthy their diet. Nonetheless, the results showed that women who followed a healthier eating pattern had lower occurrence of experiencing mood swings, and less often felt triggered in the social context. The group did not show a tendency to over-eat, gain weight, or binge eating.
CONCLUSIONS
Healthier eating habits, besides providing advantages in weight management, may mitigate symptoms of emotional distress and improve the quality of life in women with PCOS.
Topics: Humans; Female; Polycystic Ovary Syndrome; Quality of Life; Cross-Sectional Studies; Feeding Behavior; Psychological Distress
PubMed: 38153073
DOI: 10.26444/aaem/166585 -
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi =... Dec 2023The clinical performance and failure issues are significantly influenced by prosthetic malposition in unicompartmental knee arthroplasty (UKA). Uncertainty exists about...
The clinical performance and failure issues are significantly influenced by prosthetic malposition in unicompartmental knee arthroplasty (UKA). Uncertainty exists about the impact of the prosthetic joint line height in UKA on tibial insert wear. In this study, we combined the UKA musculoskeletal multibody dynamics model, finite element model and wear model to investigate the effects of seven joint line height cases of fixed UKA implant on postoperative insert contact mechanics, cumulative sliding distance, linear wear depth and volumetric wear. As the elevation of the joint line height in UKA, the medial contact force and the joint anterior-posterior translation during swing phase were increased, and further the maximum von Mises stress, contact stress, linear wear depth, cumulative sliding distance, and the volumetric wear also were increased. Furthermore, the wear area of the insert gradually shifted from the middle region to the rear. Compared to 0 mm joint line height, the maximum linear wear depth and volumetric wear were decreased by 7.9% and 6.8% at -2 mm joint line height, and by 23.7% and 20.6% at -6 mm joint line height, the maximum linear wear depth and volumetric wear increased by 10.7% and 5.9% at +2 mm joint line height, and by 24.1% and 35.7% at +6 mm joint line height, respectively. UKA prosthetic joint line installation errors can significantly affect the wear life of the polyethylene inserted articular surfaces. Therefore, it is conservatively recommended that clinicians limit intraoperative UKA joint line height errors to -2-+2 mm.
Topics: Humans; Arthroplasty, Replacement, Knee; Knee Joint; Knee Prosthesis; Mechanical Phenomena; Polyethylene; Osteoarthritis, Knee; Tibia; Biomechanical Phenomena
PubMed: 38151943
DOI: 10.7507/1001-5515.202307051 -
Gait & Posture Feb 2024Children with unilateral spastic cerebral palsy (USCP) have muscle hypertonia, balance, and coordination defects that affect gross motor skills, especially walking....
BACKGROUND
Children with unilateral spastic cerebral palsy (USCP) have muscle hypertonia, balance, and coordination defects that affect gross motor skills, especially walking. Understanding the gait characteristics and lower limb muscle activation patterns of USCP children can provide an objective and quantitative basis for patient assessment and treatment plan formulation.
OBJECTIVE
This study compared the gait and lower limb muscle activation characteristics of children with USCP and with typical development (TD) during walking.
METHODS
We recorded gait and sEMG data of 20 children with USCP, and 20 with typical development. sEMG signals were acquired from the bilateral tibialis anterior (TA) and lateral gastrocnemius muscles (LG) during walking. The root mean square (RMS) value, integrated electromyographic (iEMG) value and co-contraction ratio (CR) were used to evaluate muscle activity. Student's t Test and non-parametric rank sum Test were used to compare the differences between the data groups (significance level of 0.05).
RESULTS
The stance time, step length, speed, single leg support time ratio, ground impact, pre-swing angle, and muscle strength of the affected side were significantly decreased compared to those of the unaffected side in children with USCP (P < 0.05), while the swing phase, muscle tonus of LG were significantly prolonged (P < 0.05). Compared with TD children, children with USCP exhibited reduced bilateral walking ability, particularly noticeable in their smaller pre-swing angle(P < 0.05), diminished muscle strength of the TA and LG, as well as LG spasms(P < 0.05).
SIGNIFICANCE
Children with USCP have decreased ambulatory gait stability. Step length, pull acceleration, pre-swing angle, and CR can be used as sensitive indicators for gait assessment. Strengthening the TA muscle and reducing ankle spasm may help improve gait and postural stability in children with USCP.
Topics: Child; Humans; Cerebral Palsy; Gait; Walking; Lower Extremity; Muscle, Skeletal; Electromyography
PubMed: 38100956
DOI: 10.1016/j.gaitpost.2023.12.007 -
International Journal of Qualitative... Dec 2024Anabolic androgenic steroids (AAS) are used for their aesthetic and performance-enhancing effects and are associated with physical and psychological side effects....
PURPOSE
Anabolic androgenic steroids (AAS) are used for their aesthetic and performance-enhancing effects and are associated with physical and psychological side effects. Behavioural changes/side effects as mood swings, aggressiveness, depression, potency problems, anxiety, and emotional coldness have been reported by next of kin to people using AAS.
METHODS
This phenomenological study is based on the reflective lifeworld research approach. Interviews were conducted with twelve next of kin about their experiences of living close to persons using AAS.
RESULTS
Next of kin to persons using AAS are particularly vulnerable because they experience little opportunity to influence their situation. Their given and safe context is lost, and their lives are circumscribed by feelings of insecurity, fear, powerlessness, and grief. Feelings of loneliness develop when their problems are not noticed by others and support is lacking from family and society.
CONCLUSIONS
Our research adds important knowledge on how the use of AAS affects next of kin. Understanding is required to approach the lifeworld of next of kin with flexibility and empathy in their difficulties and vulnerability. Healthcare professionals and other concerned professions need to be aware of next of kin existential needs to be able to meet and support them in their life situation.
Topics: Humans; Anabolic Androgenic Steroids; Emotions; Mood Disorders; Health Personnel
PubMed: 38085771
DOI: 10.1080/17482631.2023.2292826 -
PLOS Global Public Health 2023Priority setting workshops enable researchers to take the lead from people with relevant lived experience, and design research which authentically responds to community...
Priority setting workshops enable researchers to take the lead from people with relevant lived experience, and design research which authentically responds to community needs. Large-scale global priority setting exercises have previously identified key research questions related to paediatric and adolescent HIV treatment, prevention, and service delivery. However, priority setting workshops focused on the needs of young people living with HIV are lacking in southern Africa. Here, we report the outcome of a priority setting workshop organised in Cape Town, South Africa with 19 young people living with HIV and their parents and caregivers. Workshops were facilitated by trained research and clinical staff, who provided a plain-language introduction to research questions for the attendees. During the day-long workshop, attendees developed a list of research questions concerning HIV-related physical health, mental health, and psychosocial support and later voted on the order of importance for the questions which they had collectively identified. Facilitators did not prompt any questions or amend the phrasing of questions generated by the attendees. A cure for HIV was highlighted as the most important research priority for young people living with HIV. Other priorities for young people included the effects of antiretroviral therapy on the body, the brain, and their social relationships, causes of emotional issues such as depression and mood swings, and potential interventions to reduce HIV-related stigma in schools through positive education for teachers and students. Research priorities for parents and caregivers included improving antiretroviral adherence through long-acting injections, mental health impacts of HIV status disclosure without consent, and improving support provided by local community clinics. The research questions identified through this workshop may be used by researchers to develop future studies which truly benefit young people living with HIV in South Africa and beyond.
PubMed: 38079383
DOI: 10.1371/journal.pgph.0002605 -
The South African Journal of... 2023Knee hyperextension is common following stroke because of changes in joint range of motion (ROM), muscle tone and strength on the hemiparetic side. There is no clear...
BACKGROUND
Knee hyperextension is common following stroke because of changes in joint range of motion (ROM), muscle tone and strength on the hemiparetic side. There is no clear consensus in the literature as to the cause of knee hyperextension during the stance phase of gait.
OBJECTIVES
Our study aimed to determine the feasibility of methods to investigate the association between ankle joint function and knee hyperextension in patients with hemiparetic stroke during the stance phase of gait.
METHODS
We used a cross-sectional observational study to assess bilateral ankle muscle strength using a handheld dynamometer, ROM using a digital inclinometer and muscle tone using the Modified Tardieu Scale. The knee angles of the hemiparetic leg during the stance phase of gait were assessed using the Kinovea movement analysis software. Data were analysed using the Statistical Package for the Social Sciences with significance level set at 0.05 and 95% confidence intervals.
RESULTS
Twelve participants were included, and no alterations were necessary to the planned methodology. We found positive associations in six participants between the tibialis anterior muscle tone and the hemiparetic knee angles during heel strike, terminal stance and pre-swing phases ( < 0.05, < 0.01 and < 0.01, respectively).
CONCLUSION
The results of the data analysis suggests that there may be a correlation between tibialis anterior muscle tone and knee hyperextension, a larger study will be imperative to confirm this association.
CLINICAL IMPLICATIONS
The methods described in our pilot study are feasible for a larger study to be conducted with the recommendations considered.
PubMed: 38059056
DOI: 10.4102/sajp.v79i1.1926 -
Deutsche Medizinische Wochenschrift... Dec 2023Karl Valentin, one of Germany's greatest comic talents, and the surgeon Ferdinand Sauerbruch probably met in Munich about 100 years ago. Their correspondence is...
Karl Valentin, one of Germany's greatest comic talents, and the surgeon Ferdinand Sauerbruch probably met in Munich about 100 years ago. Their correspondence is outlined. Another encounter some years later in Berlin has been documented. Sauerbruch was one of many physicians whom Valentin consulted because of his fragile health, especially his "mood depressions." Sauerbruch, himself plagued by mood swings, but as a surgeon not actually responsible for such illnesses, meets this special person with empathy.
PubMed: 38052221
DOI: 10.1055/a-2102-5551