-
Advanced Healthcare Materials Feb 2015Primary or secondary hypogonadism results in a range of signs and symptoms that compromise quality of life and requires life-long testosterone replacement therapy. In...
Primary or secondary hypogonadism results in a range of signs and symptoms that compromise quality of life and requires life-long testosterone replacement therapy. In this study, an implantable nanochannel system is investigated as an alternative delivery strategy for the long-term sustained and constant release of testosterone. In vitro release tests are performed using a dissolution set up, with testosterone and testosterone:2-hydroxypropyl-β-cyclodextrin (TES:HPCD) 1:1 and 1:2 molar ratio complexes release from the implantable nanochannel system and quantify by HPLC. 1:2 TES:HPCD complex stably achieve 10-15 times higher testosterone solubility with 25-30 times higher in vitro release. Bioactivity of delivered testosterone is verified by LNCaP/LUC cell luminescence. In vivo evaluation of testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) levels by liquid chromatography mass spectrometry (LC/MS) and multiplex assay is performed in castrated Sprague-Dawley rats over 30 d. Animals are treated with the nanochannel implants or degradable testosterone pellets. The 1:2 TES:HPCD nanochannel implant exhibits sustained and clinically relevant in vivo release kinetics and attains physiologically stable plasma levels of testosterone, LH, and FSH. In conclusion, it is demonstrated that by providing long-term steady release 1:2 TES:HPCD nanochannel implants may represent a major breakthrough for the treatment of male hypogonadism.
Topics: 2-Hydroxypropyl-beta-cyclodextrin; Animals; Drug Delivery Systems; Drug Implants; Follicle Stimulating Hormone; Kinetics; Luminescent Measurements; Luteinizing Hormone; Male; Nanostructures; Orchiectomy; Rats, Sprague-Dawley; Testosterone; beta-Cyclodextrins
PubMed: 25274059
DOI: 10.1002/adhm.201400348 -
The Journal of Family Planning and... Jul 2013
Topics: Contraceptive Agents, Female; Desogestrel; Drug Implants; Ethics, Medical; Female; Humans
PubMed: 23781091
DOI: 10.1136/jfprhc-2013-100634 -
Arquivos Brasileiros de Oftalmologia 2023This case report aims to show the anatomical and functional results of a patient diagnosed as having cancer-associated retinopathy treated with a controlled-release...
This case report aims to show the anatomical and functional results of a patient diagnosed as having cancer-associated retinopathy treated with a controlled-release dexamethasone implant (Ozurdex). Anatomical outcomes were assessed using spectral domain optical coherence tomography; and functional outcomes, by measuring visual acuity, microperimetry, and mutifocal electroretinography. The follow-up period was 1 year.
Topics: Humans; Glucocorticoids; Paraneoplastic Syndromes, Ocular; Macular Edema; Retinal Vein Occlusion; Drug Implants; Prospective Studies; Dexamethasone; Tomography, Optical Coherence; Intravitreal Injections; Diabetic Retinopathy
PubMed: 35170652
DOI: 10.5935/0004-2749.20230006 -
STAR Protocols Mar 2022Ocular drug implants (ODIs) are beneficial for treating ocular diseases. However, the lack of a robust injection approach for small-eyed model organisms has been a major...
Ocular drug implants (ODIs) are beneficial for treating ocular diseases. However, the lack of a robust injection approach for small-eyed model organisms has been a major technical limitation in developing ODIs. Here, we present a cost-effective, minimally invasive protocol to deliver ODIs into the mouse vitreous called Mouse Implant Intravitreal Injection (MI3). MI3 provides two alternative surgical approaches (air-pressure or plunger) to deliver micro-scaled ODIs into milli-scaled eyes, and expands the preclinical platforms to determine ODIs' efficacy, toxicity, and pharmacokinetics. For complete details on the use and execution of this protocol, please refer to Sun et al. (2021).
Topics: Animals; Drug Implants; Intravitreal Injections; Mice; Vitreous Body
PubMed: 35141566
DOI: 10.1016/j.xpro.2022.101143 -
Frontiers in Public Health 2022Diabetic Macular Edema (DME) is the most common cause of vision loss in diabetic patients. Currently, the Vascular Endothelial Growth Factor inhibitors (anti-VEGFs) are...
BACKGROUND
Diabetic Macular Edema (DME) is the most common cause of vision loss in diabetic patients. Currently, the Vascular Endothelial Growth Factor inhibitors (anti-VEGFs) are used as the first line of DME treatment and corticosteroid implants are usually used as a second-line treatment. These implants are a safe and effective therapeutic option that can improve the quality of life of DME patients by reducing the intravitreal injections number. We determined the economic impact related to DME, also from the social perspective, and the consequences of the increased use of the dexamethasone implant.
METHODS
The analysis compares two scenarios: the first based on the current rate of recourse to the therapeutic alternatives available in the Italian healthcare setting (as is) and the second based on the assumption of an increased recourse to dexamethasone implants (to be). The results are expressed both in terms of the resource absorption associated with the two scenarios and in terms of the cost differential yielded by their comparison.
RESULTS
The increased use of the dexamethasone implant allows considerable savings in terms of healthcare professionals' time, follow-up and productivity lost by patients/caregivers. These savings would reduce healthcare costs for the management of DME patients in Italy by €2,058,238 in 5 years.
CONCLUSIONS
To optimize the healthcare resources allocation, it is necessary to implement treatments that yield not only cost reductions but also a clinical benefit for patients. The dexamethasone implant use is an example of DME management that generates value for patients, health system and society.
Topics: Dexamethasone; Diabetes Mellitus; Diabetic Retinopathy; Drug Implants; Glucocorticoids; Humans; Macular Edema; Quality of Life; Vascular Endothelial Growth Factor A; Visual Acuity
PubMed: 35937268
DOI: 10.3389/fpubh.2022.938987 -
PloS One 2018In developing regions, an estimated 214 million women have an unmet need for family planning. Reaching Family Planning 2020 (FP2020) commitments will require a shift in...
BACKGROUND
In developing regions, an estimated 214 million women have an unmet need for family planning. Reaching Family Planning 2020 (FP2020) commitments will require a shift in modern contraceptive promotion, including improved access to long-acting reversible contraceptives (LARCs). Until now, a lack of market data limited understanding of the potential of LARCs to increase contraceptive access and choice.
METHODS
From 2015, the FPwatch Project conducted representative surveys in Ethiopia, Nigeria, and Democratic Republic of Congo (DRC) using a full census approach in selected administrative areas. In these areas, every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, market share, availability, price, and outlet readiness to perform services.
RESULTS
Fifty-four percent of outlets in Ethiopia had LARC commodities or services available at the time of the survey, versus 7% and 8% of outlets in Nigeria and DRC, respectively. When present, LARCs were usually available with at least two other methods (99%, 39%, and 84% of public health facilities in Ethiopia, Nigeria and DRC, respectively). Many public facilities had both implants and IUDs in stock (76%, 47%, and 53%, respectively). Lack of readiness to provide LARCs was mostly due to a lack of equipment, private room, or the commodity itself. Market share for implants in the public sector was 60%, 53%, and 37% of Couple Years of Protection (CYP) in Ethiopia, Nigeria, and DRC.
DISCUSSION
Limited availability of LARCs in Nigeria and DRC restricts contraceptive choice and makes it difficult for women to adopt and use modern contraception consistently. Brand-specific subsidies, task shifting, and promotion of methods that require less equipment and training are promising strategies for increasing uptake. Substantial government investment is required to improve availability and affordability. Investment in implants should be prioritized to make progress towards FP2020 commitments.
Topics: Africa South of the Sahara; Choice Behavior; Contraception; Drug Implants; Family Planning Services; Female; Health Services Accessibility; Humans; Intrauterine Devices; Long-Acting Reversible Contraception; Male
PubMed: 29630607
DOI: 10.1371/journal.pone.0195228 -
Advanced Healthcare Materials Feb 2019Otitis media with effusion (OEM) is a common pediatric pathology treated with topical fluoroquinolones (ear drops) and tympanoplasty tube, also referred to as ear tube,...
Otitis media with effusion (OEM) is a common pediatric pathology treated with topical fluoroquinolones (ear drops) and tympanoplasty tube, also referred to as ear tube, implantation for middle ear drainage. Commercially available ear tubes are fabricated using poly (lactic-co-glycolic acid) synthetic materials that are associated with long-complications due to premature extrusion. Resorbable materials have emerged as desirable alternatives to reduce extrusion-related complications, but often limited by fast resorption rates. Therefore, resorbable tubes with long-term functional integrity are required for future clinical translation. In this communication, a proof-of-concept study is reported on a bioresorbable and drug-eluting silk ear tube device. Preliminary in vitro assessments reveal time-dependent drug elution and antimicrobial properties, while maintaining long-term functional integrity in vivo. This report provides evidence of a silk ear tube with potential for future clinical translation and OEM treatment.
Topics: Absorbable Implants; Animals; Anti-Bacterial Agents; Child; Chinchilla; Drug Implants; Fluoroquinolones; Humans; Otitis Media with Effusion; Silk; Time Factors; Tympanoplasty
PubMed: 30624860
DOI: 10.1002/adhm.201801409 -
Heart (British Cardiac Society) Mar 2004
Review
Topics: Angioplasty, Balloon, Coronary; Chemotherapy, Adjuvant; Coronary Disease; Coronary Restenosis; Drug Implants; Humans; Myocardial Revascularization; Stents
PubMed: 14966067
DOI: 10.1136/hrt.2003.018986 -
International Journal of Surgery... 2012The development of surgical site infection (SSI) following vascular surgery is an important issue for healthcare providers as it has serious implications for both... (Review)
Review
BACKGROUND
The development of surgical site infection (SSI) following vascular surgery is an important issue for healthcare providers as it has serious implications for both patient morbidity and mortality.
METHODS
Five publications were identified using the PubMed online database and search terms 'gentamicin-containing collagen implant' plus 'surgical site infection', 'wound infection' and 'vascular surgery'.
RESULTS
The reviewed publications demonstrated that prophylactic use of GCCI in conjunction with standard treatment reduces the SSI rate in patients operated on for femeropopliteal bypass grafting. The prophylactic use of GCCI may also have a role to play in patients at high-risk of infection (e.g. in those with co-morbidities such as obesity) and in high-risk procedures (e.g. surgical revision to correct anastomotic aneurysm or dehiscence). GCCI in conjunction with systemic antibiotics may also be effective in the treatment of wound infections of the groin following vascular reconstruction.
CONCLUSION
This review demonstrates that GCCI have a role to play in preventing and treating SSI following vascular reconstruction when used in conjunction with standard treatment approaches. Additional randomised, controlled studies are required to further establish the efficacy and cost-effectiveness of GCCI in vascular surgery.
Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteria; Cohort Studies; Collagen Type I; Drug Implants; Female; Gentamicins; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Surgical Wound Infection; Vascular Grafting
PubMed: 22659222
DOI: 10.1016/j.ijsu.2012.05.015 -
AAPS PharmSciTech Feb 2015Self-emulsifying pellets were prepared using microcrystalline cellulose, emulsions of caprylic/capric triglyceride, and three Cremophors (ELP, RH40, and RH60) at 1.5 and...
Self-emulsifying pellets were prepared using microcrystalline cellulose, emulsions of caprylic/capric triglyceride, and three Cremophors (ELP, RH40, and RH60) at 1.5 and 2.3 weight ratios, and two drugs (furosemide and propranolol) of different lipophilicity. Droplet size, zeta potential (ζ) and viscosity of emulsions, and pellet size, shape, friability, tensile strength, disintegration, and drug migration in pellets were determined. Evaluation of reconstituted emulsions was based on droplet size and ζ. Factorial design and 3-way ANOVA was applied to estimate the significance of the effects of the drug, surfactant and oil/surfactant ratio. It was found that droplet size, viscosity and ζ of emulsions, and size, shape, and friability of pellets were affected by the studied factors and were significant interactions between their effects on pellet size and friability. Migration of drug towards the pellet surface was higher for the less lipophilic furosemide and higher oil content. Linear relationships were found between the emulsion viscosity and the shape parameters of the pellets (for the aspect ratio R (2) = 0.796 for furosemide and R (2) = 0.885 for propranolol and for the shape factor, e R R (2) = 0.740 and R (2) = 0.960, respectively). For all the formulations examined, an exponential relationship was found between migration (M%) and the product of viscosity (η) and solubility of drug in oil/surfactant mixture (S) (M% = 98.1e-0.016 [η•S], R (2) = 0.856), which may be useful in formulation work.
Topics: Absorption, Physicochemical; Diffusion; Drug Compounding; Drug Implants; Drug Stability; Emulsifying Agents; Emulsions; Furosemide; Particle Size; Propranolol; Tensile Strength; Viscosity
PubMed: 25212898
DOI: 10.1208/s12249-014-0214-8