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Dermatology Online Journal May 2018The role of exogenous progestin in the development of acne is unclear. Progestins are known for their androgenic potential, but newer generations of progestins have low... (Review)
Review
The role of exogenous progestin in the development of acne is unclear. Progestins are known for their androgenic potential, but newer generations of progestins have low or anti-androgenic activity. This review will evaluate the association between progestins found in hormonal long-acting reversible contraceptives (intrauterine devices and subdermal implants) and acne, as well as the role of oral contraceptives in acne management. Our review demonstrates that the cause and effect relationship between progestins and acne is difficult to establish and future studies that seek to understand how progestins modulate acne are necessary.
Topics: Acne Vulgaris; Androgens; Contraceptives, Oral; Drug Implants; Humans; Intrauterine Devices, Medicated; Progestins
PubMed: 30142728
DOI: No ID Found -
Drug Discovery Today Aug 2019Topical eye-drop administration and intravitreal injections are the current standard for ocular drug delivery. However, patient adherence to the drug regimen and... (Review)
Review
Topical eye-drop administration and intravitreal injections are the current standard for ocular drug delivery. However, patient adherence to the drug regimen and insufficient administration frequency are well-documented challenges to this field. In this review, we describe recent advances in intraocular implants designed to deliver therapeutics for months to years, to obviate the issues of patient adherence. We highlight recent advances in monolithic ocular implants in the literature, the commercialization pipeline, and approved for the market. We also describe design considerations based on material selection, active pharmaceutical ingredient, and implantation site.
Topics: Delayed-Action Preparations; Drug Delivery Systems; Drug Implants; Eye; Humans; Ophthalmic Solutions
PubMed: 31173915
DOI: 10.1016/j.drudis.2019.05.031 -
Medecine Sciences : M/S Jan 2017Implants for controlled drug delivery can be very helpful to improve the therapeutic efficacy of a medical treatment, and at the same time reduce the risk of toxic side... (Review)
Review
Implants for controlled drug delivery can be very helpful to improve the therapeutic efficacy of a medical treatment, and at the same time reduce the risk of toxic side effects. In this article, four different strategies are exemplarily presented: hybrid bone substitutes combining hydroxyapatite and chitosan hydrogels; vascular stents coated with a bio-inspired polymer; cochlear implants for local dexamethasone delivery; and in-situ forming implants for periodontitis treatment. But this is only a restricted selection, and numerous other approaches and applications based on implants releasing a drug (or a combination of drugs) exist. Compared to conventional implants or pharmaceutical dosage forms, they might offer decisive advantages.
Topics: Animals; Cochlear Implants; Dental Implants; Drug Delivery Systems; Drug Implants; Drug-Eluting Stents; Graft Occlusion, Vascular; Humans; Periodontium; Polymers
PubMed: 28120753
DOI: 10.1051/medsci/20173301006 -
Current Opinion in Ophthalmology May 2015Emerging developments and research for drug delivery to the posterior segment offer a promising future for the treatment of vitreoretinal disease. As new technologies... (Review)
Review
PURPOSE OF REVIEW
Emerging developments and research for drug delivery to the posterior segment offer a promising future for the treatment of vitreoretinal disease. As new technologies enter the market, clinicians should be aware of new indications and ongoing clinical trials.
RECENT FINDINGS
This review summarizes the advantages and shortcomings of the most commonly used drug delivery methods, including vitreous dynamics, physician sustainability and patient preferences. Currently available, intravitreal, corticosteroid-release devices offer surgical and in-office management of retinal vascular disease and posterior uveitis. The suprachoroidal space offers a new anatomic location for the delivery of lower dose medications directly to the target tissue. Implantable drug reservoirs would potentially allow for less frequent intravitreal injections reducing treatment burdens and associated risks. Newer innovations in encapsulated cell technology offer promising results in early clinical trials.
SUMMARY
Although pars plana intravitreal injection remains the mainstay of therapy for many vitreoretinal diseases, targeted delivery and implantable eluting devices are rapidly demonstrating safety and efficacy. These therapeutic modalities offer promising options for the vitreoretinal therapeutic landscape.
Topics: Drug Carriers; Drug Delivery Systems; Drug Implants; Humans; Intravitreal Injections; Molecular Targeted Therapy; Retinal Diseases
PubMed: 25759965
DOI: 10.1097/ICU.0000000000000143 -
Global Health, Science and Practice Mar 2018This article draws from national surveys of every sub-Saharan African country with at least 1 recent survey published between 2015 and 2017 and 2 prior surveys from 2003... (Review)
Review
This article draws from national surveys of every sub-Saharan African country with at least 1 recent survey published between 2015 and 2017 and 2 prior surveys from 2003 to 2014. Twelve countries comprising over 60% of the region's population met these inclusion criteria. The analysis considers recent and longer-term changes in 3 key variables: modern contraceptive prevalence rate (mCPR), method-specific prevalence, and a method's share of the current modern method mix. As recently as 2011, implant CPR in sub-Saharan Africa was only 1.1%. Since then, sizeable price reductions, much-increased commodity supply, greater government commitment to rights-based family planning, broader WHO eligibility guidance, and wider adoption of high-impact service delivery practices have resulted in expanded client access and marked increases in implant prevalence and share of the method mix. Ten of the 12 countries now have an implant CPR around 6% or higher, with 3 countries above 11%. Increased implant use has been the main driver of the increased mCPR attained by 11 countries, with gains in implant use alone exceeding combined gains in use of injectables, pills, and intrauterine devices. In countries as diverse as Burkina Faso and Ethiopia, Democratic Republic of the Congo and Ghana, Kenya and Senegal, implant use now accounts for one-fourth to one-half of all modern method use. Implants have become the first or second most widely used method in 10 countries. In the 7 countries with multiple surveys conducted over a 2- to 3-year span between 2013-14 and 2016-17, average annual gains in implant prevalence range from 0.97 to 4.15 percentage points; this contrasts to historical annual gains in use of all modern methods of 0.70 percentage points in 42 sub-Saharan African countries from 1986 to 2008. Implant use has risen substantially and fairly equitably across almost all sociodemographic categories, including unmarried women, women of lower and higher parity, women in all 5 wealth quintiles, younger and older women, and women residing in rural areas. A notable exception is the category of nulliparous married women, whose implant use is mostly below 1%. These attainments represent a major success story not often seen in family planning programming. With continued program commitment and donor support, these trends in implant uptake and popularity are likely to continue for the next few years. This implies even greater need for the international family planning community to maintain its focus on rights-based programming, ensuring reliable access to implant removal as well as insertion services, and addressing issues of financing and sustainability.
Topics: Africa South of the Sahara; Contraceptive Agents, Female; Drug Implants; Female; Humans; Surveys and Questionnaires
PubMed: 29559495
DOI: 10.9745/GHSP-D-17-00396 -
The Western Journal of Medicine Mar 1991
Topics: Animals; Contraception; Delayed-Action Preparations; Drug Implants; Female; Humans; Progestins
PubMed: 2028598
DOI: No ID Found -
Contraception Aug 2020To assess etonogestrel contraceptive implant location and outcomes among women referred for "difficult" removal to a specialist clinic in South Africa. (Review)
Review
OBJECTIVES
To assess etonogestrel contraceptive implant location and outcomes among women referred for "difficult" removal to a specialist clinic in South Africa.
STUDY DESIGN
We performed a retrospective review of cases referred to our clinic for removal of nonpalpable, deep, migrated, or damaged implants, or failed removals from March to August 2017.
RESULTS
Most (n = 68, 92%) of the 74 referrals were nonpalpable in our clinic. We used ultrasound for localization and successfully removed 72 implants (97%) in the outpatient clinic.
CONCLUSION
With proper protocols and equipment, localization and removal of nonpalpable implants can be safely and effectively achieved in an outpatient African setting.
IMPLICATIONS
Access to providers specially trained in ultrasound localization should be available in all settings where implants are offered. Providing timely access to safe and effective implant removals in routine and difficult cases is essential to ensuring that implant programs are in alignment with rights-based, client-centered family planning principles.
Topics: Contraceptive Agents, Female; Desogestrel; Device Removal; Drug Implants; Female; Humans; Referral and Consultation; Retrospective Studies; South Africa
PubMed: 32339484
DOI: 10.1016/j.contraception.2020.04.013 -
Current Drug Targets 2015Implantable drug delivery systems (DDS) provide a platform for sustained release of therapeutic agents over a period of weeks to months and sometimes years. Such... (Review)
Review
Implantable drug delivery systems (DDS) provide a platform for sustained release of therapeutic agents over a period of weeks to months and sometimes years. Such strategies are typically used clinically to increase patient compliance by replacing frequent administration of drugs such as contraceptives and hormones to maintain plasma concentration within the therapeutic window. Implantable or injectable systems have also been investigated as a means of local drug administration which favors high drug concentration at a site of interest, such as a tumor, while reducing systemic drug exposure to minimize unwanted side effects. Significant advances in the field of local DDS have led to increasingly sophisticated technology with new challenges including quantification of local and systemic pharmacokinetics and implant- body interactions. Because many of these sought-after parameters are highly dependent on the tissue properties at the implantation site, and rarely represented adequately with in vitro models, new nondestructive techniques that can be used to study implants in situ are highly desirable. Versatile imaging tools can meet this need and provide quantitative data on morphological and functional aspects of implantable systems. The focus of this review article is an overview of current biomedical imaging techniques, including magnetic resonance imaging (MRI), ultrasound imaging, optical imaging, X-ray and computed tomography (CT), and their application in evaluation of implantable DDS.
Topics: Animals; Diagnostic Imaging; Drug Delivery Systems; Drug Implants; Humans; Magnetic Resonance Imaging; Optical Imaging; Tomography, X-Ray Computed; Ultrasonography
PubMed: 25418857
DOI: 10.2174/1389450115666141122211920 -
Drug Delivery Nov 2018Along with the development of nanotechnological strategies for biomaterials associated with the prevention of infections, a myriad of clinically unproven techniques have... (Review)
Review
Along with the development of nanotechnological strategies for biomaterials associated with the prevention of infections, a myriad of clinically unproven techniques have been described to date. In this work, the aim was to perform a critical analysis of the literature available concerning antibacterial biomaterials for oral implantology and to provide a practical derivation for such a purpose. As anti-adhesive strategies may affect osseointegration, they should no longer be recommended for inclusion in this class of biomaterials, despite promising results in biomedical engineering for other, non-bone load bearing organs. Targeted, antibacterial drug delivery is most likely desirable in the case of intraosseous implants. Interfering factors such as the oral cavity environment, saliva, the bacterial microbiome, as well as, the characteristics of the alveolar mucosa and peri-implant space must be taken into account when calculating the local pharmacokinetics for antibacterial coatings. Effective release is crucial for tailoring antibacterial implant longevity providing minimal inhibitory concentration (MIC) for the desired amount of time, which for oral implants, should be at least the cumulative time for the osseointegration period and functional loading period within the tissues. These parameters may differ between the implant type and its anatomical site. Also, the functional drug concentration in the peri-implant space should be calculated as the amount of the drug released from the implant surface including the concentration of the drug inactivated by biological fluids of the peri-implant space or saliva flow throughout the effective release time.
Topics: Alveolar Bone Loss; Anti-Bacterial Agents; Biocompatible Materials; Drug Delivery Systems; Drug Implants; Humans; Maxillofacial Prosthesis Implantation; Microbial Sensitivity Tests; Mouth; Osseointegration
PubMed: 29968496
DOI: 10.1080/10717544.2018.1477855 -
International Journal of Nanomedicine 2017To address the limitations of traditional drug delivery, TiO nanotubes (TNTs) are recognized as a promising material for localized drug delivery systems. With regard to... (Review)
Review
To address the limitations of traditional drug delivery, TiO nanotubes (TNTs) are recognized as a promising material for localized drug delivery systems. With regard to the excellent biocompatibility and physicochemical properties, TNTs prepared by a facile electrochemical anodizing process have been used to fabricate new drug-releasing implants for localized drug delivery. This review discusses the development of TNTs applied in localized drug delivery systems, focusing on several approaches to control drug release, including the regulation of the dimensions of TNTs, modification of internal chemical characteristics, adjusting pore openings by biopolymer coatings, and employing polymeric micelles as drug nanocarriers. Furthermore, rational strategies on external conditions-triggered stimuli-responsive drug release for localized drug delivery systems are highlighted. Finally, the review concludes with the recent advances on TNTs for controlled drug delivery and corresponding prospects in the future.
Topics: Animals; Coated Materials, Biocompatible; Drug Delivery Systems; Drug Implants; Electrochemistry; Electrodes; Humans; Hydrogen-Ion Concentration; Magnetics; Micelles; Nanotubes; Neoplasms; Polymers; Titanium; Ultrasonics
PubMed: 28053530
DOI: 10.2147/IJN.S117498