Performance on the adult rheumatology in-training examination and relationship to outcomes on the rheumatology certification examination.

Science.gov (United States)

Lohr, Kristine M; Clauser, Amanda; Hess, Brian J; Gelber, Allan C; Valeriano-Marcet, Joanne; Lipner, Rebecca S; Haist, Steven A; Hawley, Janine L; Zirkle, Sarah; Bolster, Marcy B

2015-11-01

The American College of Rheumatology (ACR) Adult Rheumatology In-Training Examination (ITE) is a feedback tool designed to identify strengths and weaknesses in the content knowledge of individual fellows-in-training and the training program curricula. We determined whether scores on the ACR ITE, as well as scores on other major standardized medical examinations and competency-based ratings, could be used to predict performance on the American Board of Internal Medicine (ABIM) Rheumatology Certification Examination. Between 2008 and 2012, 629 second-year fellows took the ACR ITE. Bivariate correlation analyses of assessment scores and multiple linear regression analyses were used to determine whether ABIM Rheumatology Certification Examination scores could be predicted on the basis of ACR ITE scores, United States Medical Licensing Examination scores, ABIM Internal Medicine Certification Examination scores, fellowship directors' ratings of overall clinical competency, and demographic variables. Logistic regression was used to evaluate whether these assessments were predictive of a passing outcome on the Rheumatology Certification Examination. In the initial linear model, the strongest predictors of the Rheumatology Certification Examination score were the second-year fellows' ACR ITE scores (β = 0.438) and ABIM Internal Medicine Certification Examination scores (β = 0.273). Using a stepwise model, the strongest predictors of higher scores on the Rheumatology Certification Examination were second-year fellows' ACR ITE scores (β = 0.449) and ABIM Internal Medicine Certification Examination scores (β = 0.276). Based on the findings of logistic regression analysis, ACR ITE performance was predictive of a pass/fail outcome on the Rheumatology Certification Examination (odds ratio 1.016 [95% confidence interval 1.011-1.021]). The predictive value of the ACR ITE score with regard to predicting performance on the Rheumatology Certification Examination

VACCINATION IN RHEUMATOLOGY: CURRENT ASPECTS

Directory of Open Access Journals (Sweden)

B. S. Belov

2014-01-01

Full Text Available Infectious diseases still remain a serious social and medical problem. The importance of comorbid infections in rheumatology has increased substantially in recent years, particularly due to the clinical introduction of biologicals. The investigation and active use of different vaccines are one of the ways to solve the above problem. This review considers the issues concerning the use of vaccines against influenza, infections caused by pneumococci, herpesviruses, human papillomavirus, and hepatitis B virus in rheumatology patients. It discusses the safety and immunogenicity of vaccination associated with the prevention of airway infections as the most common cause of a poor outcome in rheumatic diseases. The main areas of future investigations in the problem under consideration are defined.

Downstream Processability of Crystal Habit-Modified Active Pharmaceutical Ingredient

DEFF Research Database (Denmark)

Pudasaini, Nawin; Upadhyay, Pratik Pankaj; Parker, Christian Richard

2017-01-01

Efficient downstream processing of active pharmaceutical ingredients (APIs) can depend strongly on their particulate properties, such as size and shape distributions. Especially in drug products with high API content, needle-like crystal habit of an API may show compromised flowability and tablet......Efficient downstream processing of active pharmaceutical ingredients (APIs) can depend strongly on their particulate properties, such as size and shape distributions. Especially in drug products with high API content, needle-like crystal habit of an API may show compromised flowability...

Bases and principles of rheumatology. Book

International Nuclear Information System (INIS)

Vidal, L.; Chavez, J.; Quevedo, H.; Castaneda, L.

1993-01-01

This book describes in 7 sections (42 chapters) the bases and principles of rheumatology. Section I bases and principles of rheumatology, Section II diffuse disorders of conjunctive tissue, Section III serum negatives spondyloarthropathies, Section IV arthropathies associated to infectious agents, Section V osteoarthritis diseases and different disorders, Section VI rational management rheumatic patients, Section VII therapeutics in rheumatology. In the chapter 34, the uses of radioisotope scanning in rheumatology are described. Every chapter contains also references, figures and tables

2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015-2030.

Science.gov (United States)

Battafarano, Daniel F; Ditmyer, Marcia; Bolster, Marcy B; Fitzgerald, John D; Deal, Chad; Bass, Ann R; Molina, Rodolfo; Erickson, Alan R; Hausmann, Jonathan S; Klein-Gitelman, Marisa; Imundo, Lisa F; Smith, Benjamin J; Jones, Karla; Greene, Kamilah; Monrad, Seetha U

2018-04-01

To describe the character and composition of the 2015 US adult rheumatology workforce, evaluate workforce trends, and project supply and demand for clinical rheumatology care for 2015-2030. The 2015 Workforce Study of Rheumatology Specialists in the US used primary and secondary data sources to estimate the baseline adult rheumatology workforce and determine demographic and geographic factors relevant to workforce modeling. Supply and demand was projected through 2030, utilizing data-driven estimations regarding the proportion and clinical full-time equivalent (FTE) of academic versus nonacademic practitioners. The 2015 adult workforce (physicians, nurse practitioners, and physician assistants) was estimated to be 6,013 providers (5,415 clinical FTE). At baseline, the estimated demand exceeded the supply of clinical FTE by 700 (12.9%). By 2030, the supply of rheumatology clinical providers is projected to fall to 4,882 providers, or 4,051 clinical FTE (a 25.2% decrease in supply from 2015 baseline levels). Demand in 2030 is projected to exceed supply by 4,133 clinical FTE (102%). The adult rheumatology workforce projections reflect a major demographic and geographic shift that will significantly impact the supply of the future workforce by 2030. These shifts include baby-boomer retirements, a millennial predominance, and an increase of female and part-time providers, in parallel with an increased demand for adult rheumatology care due to the growing and aging US population. Regional and innovative strategies will be necessary to manage access to care and reduce barriers to care for rheumatology patients. © 2018, American College of Rheumatology.

Promoting transparent and accurate reporting of research studies in rheumatology: endorsement of reporting guidelines in rheumatology journals.

Science.gov (United States)

Marušić, Ana; Gasparyan, Armen Yuri; Kitas, George D

2013-10-01

To adequately translate research into practice, research results should be reported in a way that is useful to practicing clinicians and policymakers. Based on evidence from systematic reviews, the implementation of reporting guidelines, such as CONSORT for randomized controlled trials, may improve the quality of research reporting. We assessed the endorsement of reporting guidelines in rheumatology journals. We analyzed guidelines for authors of all (n = 28) journals indexed in the "Rheumatology" Subject Category of the Journal Citation Reports published in 2012. Journal websites were reviewed for information relevant to reporting guidelines. Out of 28 indexed journals, only about a third (n = 10) endorsed 1 or more reporting guidelines, most commonly CONSORT. General editorial policies, such as those from the International Committee of Medical Journal editors (ICMJE), were endorsed by 19 journals (all 10 journals with and 9 out of 18 without reporting guidelines). Two rheumatology journals introduced specific reporting guidelines about economic studies and genetic association studies. The endorsement of reporting guidelines is low in rheumatology journals. To continue to serve their research community, rheumatology journals should provide the platform for the discussion on most relevant reporting guidelines and adopt them as a group, especially those specific for rheumatology research. Coordinated action of journals and other stakeholders in rheumatology research in the promotion of accurate and transparent reporting of health research studies would be an important part of knowledge translation into practice and well-being of rheumatology patients. Copyright © 2013 Elsevier Inc. All rights reserved.

21 CFR 352.10 - Sunscreen active ingredients.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Sunscreen active ingredients. 352.10 Section 352.10 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... until further notice. For the convenience of the user, the revised text is set forth as follows: § 352...

Consensus Modeling for Prediction of Estrogenic Activity of Ingredients Commonly Used in Sunscreen Products

Directory of Open Access Journals (Sweden)

Huixiao Hong

2016-09-01

Full Text Available Sunscreen products are predominantly regulated as over-the-counter (OTC drugs by the US FDA. The “active” ingredients function as ultraviolet filters. Once a sunscreen product is generally recognized as safe and effective (GRASE via an OTC drug review process, new formulations using these ingredients do not require FDA review and approval, however, the majority of ingredients have never been tested to uncover any potential endocrine activity and their ability to interact with the estrogen receptor (ER is unknown, despite the fact that this is a very extensively studied target related to endocrine activity. Consequently, we have developed an in silico model to prioritize single ingredient estrogen receptor activity for use when actual animal data are inadequate, equivocal, or absent. It relies on consensus modeling to qualitatively and quantitatively predict ER binding activity. As proof of concept, the model was applied to ingredients commonly used in sunscreen products worldwide and a few reference chemicals. Of the 32 chemicals with unknown ER binding activity that were evaluated, seven were predicted to be active estrogenic compounds. Five of the seven were confirmed by the published data. Further experimental data is needed to confirm the other two predictions.

Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice.

Science.gov (United States)

Anderson, Jaclyn; Caplan, Liron; Yazdany, Jinoos; Robbins, Mark L; Neogi, Tuhina; Michaud, Kaleb; Saag, Kenneth G; O'Dell, James R; Kazi, Salahuddin

2012-05-01

Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice. The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations. Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR-recommended RA disease activity measures. We recommend the Clinical Disease Activity Index, Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein), Patient Activity Scale (PAS), PAS-II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. Copyright © 2012 by the American College of Rheumatology.

Fixed-Dose Combination Drug Approvals, Patents and Market Exclusivities Compared to Single Active Ingredient Pharmaceuticals.

Science.gov (United States)

Hao, Jing; Rodriguez-Monguio, Rosa; Seoane-Vazquez, Enrique

2015-01-01

Fixed-dose combinations (FDC) contain two or more active ingredients. The effective patent and exclusivity life of FDC compared to single active ingredient has not been assessed. Trends in FDA approved FDC in the period 1980-2012 and time lag between approval of FDC and single active ingredients in the combination were assessed, and the effective patent and exclusivity life of FDC was compared with their single active ingredients. New molecular entities (NMEs), new therapeutic biologics license applications (BLAs) and FDC data were collected from the FDA Orange Book and Drugs@FDA. Analysis included FDC containing one or more NMEs or BLAs at first FDA approval (NMEs-FDC) and only already marketed drugs (Non-NMEs-FDC). Descriptive, Kruskal-Wallis and Wilcoxon Rank Sum analyses were performed. During the study period, the FDA approved 28 NMEs-FDC (3.5% of NMEs) and 117 non-NMEs-FDC. FDC approvals increased from 12 in the 1980s to 59 in the 2000s. Non-NMEs-FDC entered the market at a median of 5.43 years (interquartile range 1.74, 10.31) after first FDA approval of single active ingredients in the combination. The Non-NMEs-FDC entered the market at a median of 2.33 years (-7.55, 2.39) before approval of generic single active ingredient. Non-NME-FDC added a median of 9.70 (2.75, 16.24) years to the patent and exclusivity life of the single active ingredients in the combination. FDC approvals significantly increased over the last twenty years. Pharmaceutical companies market FDC drugs shortly before the generic versions of the single ingredients enter the market extending the patent and exclusivity life of drugs included in the combination.

Fixed-Dose Combination Drug Approvals, Patents and Market Exclusivities Compared to Single Active Ingredient Pharmaceuticals.

Directory of Open Access Journals (Sweden)

Jing Hao

Full Text Available Fixed-dose combinations (FDC contain two or more active ingredients. The effective patent and exclusivity life of FDC compared to single active ingredient has not been assessed.Trends in FDA approved FDC in the period 1980-2012 and time lag between approval of FDC and single active ingredients in the combination were assessed, and the effective patent and exclusivity life of FDC was compared with their single active ingredients.New molecular entities (NMEs, new therapeutic biologics license applications (BLAs and FDC data were collected from the FDA Orange Book and Drugs@FDA. Analysis included FDC containing one or more NMEs or BLAs at first FDA approval (NMEs-FDC and only already marketed drugs (Non-NMEs-FDC. Descriptive, Kruskal-Wallis and Wilcoxon Rank Sum analyses were performed.During the study period, the FDA approved 28 NMEs-FDC (3.5% of NMEs and 117 non-NMEs-FDC. FDC approvals increased from 12 in the 1980s to 59 in the 2000s. Non-NMEs-FDC entered the market at a median of 5.43 years (interquartile range 1.74, 10.31 after first FDA approval of single active ingredients in the combination. The Non-NMEs-FDC entered the market at a median of 2.33 years (-7.55, 2.39 before approval of generic single active ingredient. Non-NME-FDC added a median of 9.70 (2.75, 16.24 years to the patent and exclusivity life of the single active ingredients in the combination.FDC approvals significantly increased over the last twenty years. Pharmaceutical companies market FDC drugs shortly before the generic versions of the single ingredients enter the market extending the patent and exclusivity life of drugs included in the combination.

Data-mining of potential antitubercular activities from molecular ingredients of traditional Chinese medicines.

Science.gov (United States)

Jamal, Salma; Scaria, Vinod

2014-01-01

Background. Traditional Chinese medicine encompasses a well established alternate system of medicine based on a broad range of herbal formulations and is practiced extensively in the region for the treatment of a wide variety of diseases. In recent years, several reports describe in depth studies of the molecular ingredients of traditional Chinese medicines on the biological activities including anti-bacterial activities. The availability of a well-curated dataset of molecular ingredients of traditional Chinese medicines and accurate in-silico cheminformatics models for data mining for antitubercular agents and computational filters to prioritize molecules has prompted us to search for potential hits from these datasets. Results. We used a consensus approach to predict molecules with potential antitubercular activities from a large dataset of molecular ingredients of traditional Chinese medicines available in the public domain. We further prioritized 160 molecules based on five computational filters (SMARTSfilter) so as to avoid potentially undesirable molecules. We further examined the molecules for permeability across Mycobacterial cell wall and for potential activities against non-replicating and drug tolerant Mycobacteria. Additional in-depth literature surveys for the reported antitubercular activities of the molecular ingredients and their sources were considered for drawing support to prioritization. Conclusions. Our analysis suggests that datasets of molecular ingredients of traditional Chinese medicines offer a new opportunity to mine for potential biological activities. In this report, we suggest a proof-of-concept methodology to prioritize molecules for further experimental assays using a variety of computational tools. We also additionally suggest that a subset of prioritized molecules could be used for evaluation for tuberculosis due to their additional effect against non-replicating tuberculosis as well as the additional hepato-protection offered by

Study on THz spectra of the active ingredients in the TCM

Science.gov (United States)

Ma, ShiHua; Wang, WenFeng; Liu, GuiFeng; Ge, Min; Zhu, ZhiYong

2008-03-01

Terahertz spectroscopy has tremendous potential for applications to evaluate the quality of the drugs including the TCM. In this paper, the Terahertz Time-Domain Spectroscopy investigated two active ingredients: Andrographolide and Dehydroandrographoline, isolated from Andrographis paniculata (Burm. f.) Nees. We also measured the mixtures of two active ingredients at the different ratio and the quantitative analysis is also applied to determine the contents of compound. The Terahertz spectroscopy is a potential and promising technique in identifying the components, evaluating the drugs sanitation and inspecting the quality of medicine including TCM.

Self-management model in the scheduling of successive appointments in rheumatology.

Science.gov (United States)

Castro Corredor, David; Cuadra Díaz, José Luis; Mateos Rodríguez, Javier José; Anino Fernández, Joaquín; Mínguez Sánchez, María Dolores; de Lara Simón, Isabel María; Tébar, María Ángeles; Añó, Encarnación; Sanz, María Dolores; Ballester, María Nieves

2018-01-08

The rheumatology service of Ciudad Real Hospital, located in an autonomous community of that same name that is nearly in the center of Spain, implemented a self-management model of successive appointments more than 10 years ago. Since then, the physicians of the department schedule follow-up visits for their patients depending on the disease, its course and ancillary tests. The purpose of this study is to evaluate and compare the self-management model for successive appointments in the rheumatology service of Ciudad Real Hospital versus the model of external appointment management implemented in 8 of the hospital's 15 medical services. A comparative and multivariate analysis was performed to identify variables with statistically significant differences, in terms of activity and/or performance indicators and quality perceived by users. The comparison involved the self-management model for successive appointments employed in the rheumatology service of Ciudad Real Hospital and the model for external appointment management used in 8 hospital medical services between January 1 and May 31, 2016. In a database with more than 100,000 records of appointments involving the set of services included in the study, the mean waiting time and the numbers of non-appearances and rescheduling of follow-up visits in the rheumatology department were significantly lower than in the other services. The number of individuals treated in outpatient rheumatology services was 7,768, and a total of 280 patients were surveyed (response rate 63.21%). They showed great overall satisfaction, and the incidence rate of claims was low. Our results show that the self-management model of scheduling appointments has better results in terms of activity indicators and in quality perceived by users, despite the intense activity. Thus, this study could be fundamental for decision making in the management of health care organizations. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de

Rheumatology outpatient nurse clinics: a valuable addition?

NARCIS (Netherlands)

Temmink, D.; Hutten, J.B.F.; Francke, A.L.; Rasker, J.J.; Huijer Abu-Saad, H.; Zee, J. van der

2001-01-01

Objectives: "Transmural rheumatology nurse clinics," where nursing care is provided under the joint responsibility of a home care organization and a hospital, were recently introduced into Dutch health care. This article gives insight into outcomes of the transmural rheumatology nurse clinics.

Rheumatology outpatient nurse clinics: a valuable addition?

NARCIS (Netherlands)

Temmink, Denise; Hutten, Jack B.F.; Francke, Anneke L.; Rasker, Johannes J.; Abu-Saad, Huda Huijer

2001-01-01

Objectives: Transmural rheumatology nurse clinics, where nursing care is provided under the joint responsibility of a home care organization and a hospital, were recently introduced into Dutch health care. This article gives insight into outcomes of the transmural rheumatology nurse clinics. -

Rheumatologic services in Central Asian countries: current state of development of rheumatology in Central Asia.

Science.gov (United States)

Omurzakova, Nazgul A; Yamano, Yoshihisa; Saatova, Guli M; Shukurova, Surayo M; Mirzakhanova, Mavliuda I; Kydyralieva, Ryskul B; Jumagulova, Aynagul S; Mirrakhimov, Erkin M; Seisenbaev, Askar Sh; Nishioka, Kusuki; Nakajima, Toshihiro

2009-12-01

Rheumatologic and public health services of Central Asia's republics have suffered hugely as a result of social and economic declines following the dissolution of the Union of Soviet Socialist Republics (USSR) and transition of these republics to market economies. Between 1990 and 2000 there was a mass outflow of highly skilled rheumatologists and teachers and researchers in rheumatology to countries abroad, leading to significant deprivation of rheumatological service in Central Asian countries. During this time, there was continued growth of various rheumatic diseases (RDs) including rheumatic fever, and musculoskeletal and connective tissue disorders. The medical and social burden of RDs imposed on society was strongly underestimated until recent times. There is an urgent need to define the epidemiology of RDs and their impact on the quality of life of people afflicted by these conditions, and to improve the diagnostics and treatment of these conditions.

PROCALCITONIN TESTING IN RHEUMATOLOGY

Directory of Open Access Journals (Sweden)

D. V. Bukhanova

2017-01-01

Full Text Available Currently, differential diagnosis of systemic bacterial infection and active rheumatic process remains a challenging problem in rheumatology. In the review, current data on the role of procalcitonin biomarker in diagnosis and differential diagnosis of rheumatic diseases (RD and infectious pathology are presented. In particular, some authors recommend procalcitonin (PCT test as a marker of bacterial infection in bones and joints at levels above 0.5 ng/ml; at PCT level below 0.3 ng/ml, infection can be ruled out. In patients with microcrystalline arthritis, data on the significance of PCT for differential diagnosis are contradictory. PCT level doesn’t correlate with systemic lupus erythematosus activity and is elevated only during bacterial infection proportionally to its systematicity. In some studies, elevated PCT level was observed in ANCA-associated vasculitis with high activity without bacterial infection. It was shown that in 80 % of adults with Still’s disease, PCT level was higher than the threshold value even without infection. For patients with RD hospitalized in intensive care units, PCT clearance is a more informative predictive characteristic than its level, regardless of the cause of PCT elevation (infection, injury, severe organ damage, etc.; slowdown of its decrease is a factor of poor prognosis and is associated with higher mortality. At the same time, PCT level positively correlates with the SOFA score in presence of bacterial infection. For some rheumatic diseases, the threshold PCT value at which the test has optimal sensitivity and specificity is yet to be established. Nonetheless, PCT should be evaluated in relation to the clinical picture and data of additional examinations. The effect of various therapy methods used in rheumatology on PCT level requires further research.

Impact of the 2012 London Olympic and Paralympic Games on physical activity of rheumatology patients.

Science.gov (United States)

Müther, Michael; Williamson, Marie; Williamson, Lyn

2014-10-01

Lack of physical activity in the general population is one of the biggest health challenges we face. For rheumatology patients, and other patients with chronic disease, exercise is an essential part of disease management. However, very few patients exercise effectively.One of the aspirations of the London 2012 Olympic/Paralympic Games was to catalyze people into long-term physical activity. We surveyed our rheumatology patients at 3 high-profile times in the year after the Olympics. Two hundred fifty-three patients were enrolled within the study; the largest diagnosis subgroup being rheumatoid arthritis (36%). Ninety-five percent of our patients regard exercise as beneficial; 36% still think it does harm. Most common barriers to exercise were pain (53%), tiredness (44%), and lack of time (36%). Forty-five percent exercise daily, mostly just walking. Twnety-seven patients (16%) were motivated by the 2012 Olympic and Paralympic Games toward physical activity. They were mostly motivated by athletics' individual stories (67%), taking part in a big sports festival (11%) and demonstration of top sporting levels (4%). Eighteen patients in total (7%) increased their amount of exercise in response to the London 2012 Olympic and Paralympic Games. There was no difference between patient diagnostic groups. Only a small minority of patients increased their amount of exercise in response to the 2012 Olympic and Paralympic Games. The message about the importance of physical exercise to health needs to be clear, unambiguous, and consistent, because a significant number of patients still think that physical activity does harm. Big sporting events such as the London 2012 Olympic and Paralympic Games can be used as an opportunity to remind patients that physical activity does good and is not harmful. Athletes' individual stories could be used in future as part of a strategy to encourage exercise for all patients.

ERGOTHERAPY IN RHEUMATOLOGY

OpenAIRE

Tat’yana Vladimirovna Dubinina; M L Sukhareva; Sh F Erdes

2014-01-01

The article reports one of the most affordable rehabilitation methods, i.e. occupational therapy. The issues related to the history of occupational therapy as a treatment method, its application in rheumatology and promising directions of development are covered.

ERGOTHERAPY IN RHEUMATOLOGY

Directory of Open Access Journals (Sweden)

Tat’yana Vladimirovna Dubinina

2014-01-01

Full Text Available The article reports one of the most affordable rehabilitation methods, i.e. occupational therapy. The issues related to the history of occupational therapy as a treatment method, its application in rheumatology and promising directions of development are covered.

21 CFR 352.20 - Permitted combinations of active ingredients.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Permitted combinations of active ingredients. 352.20 Section 352.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... effective date was stayed until further notice. For the convenience of the user, the text is set forth as...

21 CFR 344.12 - Ear drying aid active ingredient.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Ear drying aid active ingredient. 344.12 Section 344.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... alcohol 95 percent in an anhydrous glycerin 5 percent base. [65 FR 48905, Aug. 10, 2000] ...

21 CFR 333.320 - Permitted combinations of active ingredients.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Permitted combinations of active ingredients. 333.320 Section 333.320 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Note: At 75 FR 9776, Mar. 4, 2010, § 333.320 was revised, effective Mar. 4, 2011. For the convenience...

Plant Cell Cultures as Source of Cosmetic Active Ingredients

Directory of Open Access Journals (Sweden)

Ani Barbulova

2014-04-01

Full Text Available The last decades witnessed a great demand of natural remedies. As a result, medicinal plants have been increasingly cultivated on a commercial scale, but the yield, the productive quality and the safety have not always been satisfactory. Plant cell cultures provide useful alternatives for the production of active ingredients for biomedical and cosmetic uses, since they represent standardized, contaminant-free and biosustainable systems, which allow the production of desired compounds on an industrial scale. Moreover, thanks to their totipotency, plant cells grown as liquid suspension cultures can be used as “biofactories” for the production of commercially interesting secondary metabolites, which are in many cases synthesized in low amounts in plant tissues and differentially distributed in the plant organs, such as roots, leaves, flowers or fruits. Although it is very widespread in the pharmaceutical industry, plant cell culture technology is not yet very common in the cosmetic field. The aim of the present review is to focus on the successful research accomplishments in the development of plant cell cultures for the production of active ingredients for cosmetic applications.

Nano-microdelivery systems for oromucosal delivery of an active ingredient

DEFF Research Database (Denmark)

2014-01-01

A composition for oromucosal delivery of at least one active ingredient, more particularly a lipid nano-microdelivery system comprising a nicotine component and/or a flavour component, wherein the nicotine component may be delivered to the oral cavity via absorption through the mucosal membranes...

Textbook of rheumatology

International Nuclear Information System (INIS)

Turner, R.A.; Wise, C.M.

1986-01-01

This book contains 23 papers. Some of the titles are: Diagnostic Radiology in the Rheumatic Diseases; Laboratory Testing in Rheumatology; Arthritis Nursing and the Team Approach in the Management of Rheumatic Disease; The Surgical Management of Arthritis; Vasculities; Neoplasms of Bone and Joints; and Rheumatic Disease of Childhood

Radiochemical neutron activation analysis for trace elements of basic ingredients of pan

International Nuclear Information System (INIS)

Zaidi, J.H.; Arif, M.; Fatima, I; Qureshi, I.H.

2002-01-01

Extensive use of pan, by one-tenth of world's population, entails the evaluation of trace element contents in its ingredients. Radiochemical neutron activation analysis (RNAA) was developed and successfully employed to determine the concentration of 36 trace elements (essential, toxic and nonessential) in its four basic ingredients, leaf of betel pepper, betel nut, catechu and lime. The radiochemical separation methodology has significantly improved the detection limits of most of these elements due to suppression of Compton background. Base-line values of certain toxic and essential elements in these ingredients is provided. The daily intake of essential and toxic elements through pan was estimated and compared with the recommended values. The cumulative intake of Mn is four times higher than the recommended value and that of toxic elements is well below the tolerance limits. (author)

[Important application of intestinal transporters and metabolism enzymes on gastrointestinal disposal of active ingredients of Chinese materia medica].

Science.gov (United States)

Bi, Xiaolin; Du, Qiu; Di, Liuqing

2010-02-01

Oral drug bioavailability depends on gastrointestinal absorption, intestinal transporters and metabolism enzymes are the important factors in drug gastrointestinal absorption and they can also be induced or inhibited by the active ingredients of Chinese materia medica. This article presents important application of intestinal transporters and metabolism enzymes on gastrointestinal disposal of the active ingredients of Chinese materia medica, and points out the importance of research on transport and metabolism of the active ingredients of Chinese materia medica in Chinese extract and Chinese medicinal formulae.

[Screening of anti-aging active ingredients and mechanism analysis based on molecular docking technology].

Science.gov (United States)

Du, Ran-Feng; Zhang, Xiao-Hua; Ye, Xiao-Tong; Yu, Wen-Kang; Wang, Yun

2016-07-01

Dampness evil is the source of all diseases, which is easy to cause disease and promote aging, while aging could also promote the occurence and development of diseases. In this paper, the relationship between the dampness evil and aging would be discussed, to find the anti-aging active ingredients in traditional Chinese medicine (TCM), and analyze the anti-aging mechanism of dampness eliminating drug. Molecular docking technology was used, with aging-related mammalian target of rapamycin as the docking receptors, and chemical components of Fuling, Sangzhi, Mugua, Yiyiren and Houpo as the docking molecules, to preliminarily screen the anti-aging active ingredients in dampness eliminating drug. Through the comparison with active drugs already on the market (temsirolimus and everolimus), 12 kinds of potential anti-aging active ingredients were found, but their drug gability still needs further study. The docking results showed that various components in the dampness eliminating drug can play anti-aging activities by acting on mammalian target of rapamycin. This result provides a new thought and direction for the method of delaying aging by eliminating dampness. Copyright© by the Chinese Pharmaceutical Association.

Anti-bacteria Effect of Active Ingredients of Cacumen Platycladi on the Spoilage Bacteria of Sauced Pork Head Meat

Science.gov (United States)

Li, Xiao; Xu, Lingyi; Cui, Yuqian; Pang, Meixia; Wang, Fang; Qi, Jinghua

2017-12-01

Extraction and anti-bacteria effect of active ingredients of Cacumen Platycladi were studied in this paper. Extraction combined with ultrasonic was adopted. The optimum extraction condition was determined by single factor test; the anti-bacteria effect of active ingredients and minimum inhibitory concentration(MIC) were valued by Oxford-cup method. The results indicated that kaempferol was the active ingredients of Cacumen Platycladi whose optimum extraction condition for ethanol concentrations were sixty-five percent and twenty minutes with ultrasonic assisted extraction.; the active ingredients of Cacumen Platycladi had anti-bacteria effect on Staphylococcus, Proteus, Bacillus, Serratia and MIC was 0.5 g/mL,0.5 g/mL,0.0313 g/mL and 0.0625 g/mL. The active constituent of Cacumen Platycladi is kaempferol which has obvious anti-bacteria effect and can be used to prolong the shelf-life of Low-temperature meat products.

Effect of penetration modifiers on the dermal and transdermal delivery of drugs and cosmetic active ingredients.

Science.gov (United States)

Otto, A; Wiechers, J W; Kelly, C L; Hadgraft, J; du Plessis, J

2008-01-01

In this study the effect of 2 penetration modifiers, dimethyl isosorbide (DMI) and diethylene glycol monoethyl ether (DGME) on the skin delivery of hydroquinone (HQ), salicylic acid (SA) and octadecenedioic acid (DIOIC) was investigated. Ten percent DMI and DGME were separately formulated into oil-in-water emulsions containing 1.8% HQ, SA and DIOIC, respectively. Skin delivery and the flux across split-thickness human skin of the active ingredients were determined using Franz diffusion cells. An emulsion with 10% water incorporated instead of the water-soluble penetration modifiers served as a control. The study showed that neither 10% DMI nor 10% DGME significantly enhanced the skin permeation of the various lipophilic active ingredients or the uptake into the skin. It was hypothesized that the addition of the penetration modifiers to the emulsions not only enhanced the solubility of the various active ingredients in the skin but also in the formulation, resulting in a reduced thermodynamic activity and hence a weaker driving force for penetration. Therefore, the effect of DMI and DGME on the solubility of the active ingredients in the skin was counteracted by a simultaneous reduction in the thermodynamic activity in the formulation. Copyright 2008 S. Karger AG, Basel.

A brief history of ultrasound in rheumatology

DEFF Research Database (Denmark)

D'Agostino, Maria Antonietta; Terslev, Lene

2014-01-01

Musculoskeletal ultrasound is an evolving technique widely used in rheumatology thanks to the numerous advances and the improved work on standardisation. This article deals with the new developments in terms of technology and validation.......Musculoskeletal ultrasound is an evolving technique widely used in rheumatology thanks to the numerous advances and the improved work on standardisation. This article deals with the new developments in terms of technology and validation....

Ananyeva Rational antibiotic use in rheumatology

Directory of Open Access Journals (Sweden)

Boris Sergeyevich Belov

2012-06-01

Full Text Available To control infections and infectious complications is one of the most urgent challenges in medicine under present-day conditions. At the same time, rational therapy with anti-infective drugs occupies a highly importance place. In rheumatology, the necessity of using antibiotics is associated with at least two factors, such as eradication of a pathogen trigger (an infectious agent that triggers the immunopathological mechanisms of inflammation and treatment of comorbid infection. The paper gives information on etiological agents and detailed antimicrobial therapy regimens for the major infections observed in modern rheumatology.

Ananyeva Rational antibiotic use in rheumatology

Directory of Open Access Journals (Sweden)

Boris Sergeyevich Belov

2012-01-01

Full Text Available To control infections and infectious complications is one of the most urgent challenges in medicine under present-day conditions. At the same time, rational therapy with anti-infective drugs occupies a highly importance place. In rheumatology, the necessity of using antibiotics is associated with at least two factors, such as eradication of a pathogen trigger (an infectious agent that triggers the immunopathological mechanisms of inflammation and treatment of comorbid infection. The paper gives information on etiological agents and detailed antimicrobial therapy regimens for the major infections observed in modern rheumatology.

[INTERNATIONAL COOPERATION IN PEDIATRIC RHEUMATOLOGY: THE SHARE PROJECT].

Science.gov (United States)

Uziel, Yosef

2017-07-01

The SHARE initiative is a project initiated by the European Society of Pediatric Rheumatology for the purpose of improving clinical care in the field of pediatric rheumatology. Towards this goal numerous working plans and surveys were conducted. All pediatric rheumatology centers were mapped in terms of staff members, quality and types of treatments in each country, in order to improve and plan the best way for the diagnosis and treatment of rheumatic disease in children. After termination of the optimal clinical approach and care, position papers were written including all recommendations based on the scientific literature in the field. In addition, recommendations were set regarding the encouragement of international research, especially in light of the major advances achieved in the genetic aspects of pediatric rheumatology diseases, and the need for sharing biological samples between researchers from different countries and continents. Information for patients became more available regarding the diseases and the medical centers in each country. Futhermore, educational programs for interns and young fellows were written for the promotion of higher and identical academic levels in different countries.

Etoricoxib (arcoxia in rheumatology

Directory of Open Access Journals (Sweden)

Fatima Magomedovna Kudaeva

2011-06-01

Full Text Available The paper gives information on the selective COX-2 inhibitor etoricoxib registered for use in many countries of the world. It gives a brief description of a few key trials of the efficacy and tolerability of etoricoxib in rheumatology

Etoricoxib (arcoxia in rheumatology

Directory of Open Access Journals (Sweden)

Fatima Magomedovna Kudaeva

2011-01-01

Full Text Available The paper gives information on the selective COX-2 inhibitor etoricoxib registered for use in many countries of the world. It gives a brief description of a few key trials of the efficacy and tolerability of etoricoxib in rheumatology

Development of new polysilsesquioxane spherical particles as stabilized active ingredients for sunscreens

Science.gov (United States)

Tolbert, Stephanie Helene

Healthy skin is a sign of positive self-worth, attractiveness and vitality. Compromises to this are frequently caused by extended periods of recreation in the sun and in turn exposure to the harmful effects of UV radiation. To maintain strength and integrity, protection of the skin is paramount. This can be achieved by implementing skin-care products which contain sunscreen active ingredients that provide UV protection. Unfortunately, photo-degradation, toxicity, and photo-allergies limit the effectiveness of present day sunscreen ingredients. Currently, this is moderated by physically embedding within inert silica particles, but leaching of the active ingredient can occur, thereby negating protective efforts. Alternatively, this research details the preparation and investigation of bridged silsesquioxane analogues of commercial ingredients which can be chemically grafted to the silica matrix. Studies with bridged salicylate particles detail facile preparation, minimized leaching, and enhanced UV stability over physically encapsulated and pendant salicylate counterparts. In terms of UVB protective ability, the highest maintenance of sun protection factor (SPF) after extended UV exposure was achieved with bridged incorporation, and has been attributed to corollary UV stability. Additionally, bridged salicylate particles can be classified as broad-spectrum, and rate from moderate to good in terms of UVA protective ability. Particles incorporated with a bridged curcuminoid silsesquioxane were also prepared and displayed comparable results. As such, an attractive method for sunscreen isolation and stabilization has been developed to eliminate the problems associated with current sunscreens, all while maintaining the established UV absorbance profiles of the parent compound. To appreciate the technology utilized in this research, a thorough understanding of sol-gel science as it pertains to hybrid organic/silica particles, including methods of organic fragment

Efficacy of an Interinstitutional Mentoring Program Within Pediatric Rheumatology.

Science.gov (United States)

Moorthy, Lakshmi Nandini; Muscal, Eyal; Riebschleger, Meredith; Klein-Gitelman, Marisa; Nigrovic, Lise E; Horon, Jeffrey R; Rouster-Stevens, Kelly; Ferguson, Polly J; Eberhard, B Anne; Brunner, Hermine I; Prahalad, Sampath; Schneider, Rayfel; Nigrovic, Peter A

2016-05-01

The small size of many pediatric rheumatology programs translates into limited mentoring options for early career physicians. To address this problem, the American College of Rheumatology (ACR) and the Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed a subspecialty-wide interinstitutional mentoring program, the ACR/CARRA Mentoring Interest Group (AMIGO). We sought to assess the impact of this program on mentoring within pediatric rheumatology. In a longitudinal 3-year study, participant ratings from the AMIGO pilot program were compared with those after the program was opened to general enrollment. Access to mentoring as a function of career stage was assessed by surveys of the US and Canadian pediatric rheumatologists in 2011 and 2014, before and after implementation of AMIGO. Participants in the pilot phase (19 dyads) and the general implementation phase (112 dyads) reported comparable success in establishing mentor contact, suitability of mentor-mentee pairing, and benefit with respect to career development, scholarship, and work-life balance. Community surveys showed that AMIGO participation as mentee was high among fellows (86%) and modest among junior faculty (31%). Implementation correlated with significant gains in breadth of mentorship and in overall satisfaction with mentoring for fellows but not junior faculty. AMIGO is a career mentoring program that serves most fellows and many junior faculty in pediatric rheumatology across the US and Canada. Program evaluation data confirm that a subspecialty-wide interinstitutional mentoring program is feasible and can translate into concrete improvement in mentoring, measurable at the level of the whole professional community. © 2016, American College of Rheumatology.

Educational issues in Rheumatology

NARCIS (Netherlands)

Rasker, Johannes J.; Dequeker, Jan; Woolf, Anthony D.

2000-01-01

Musculoskeletal conditions are the most common cause of severe long-term pain and physical disability, affecting hundreds of millions of people around the world. Nearly a quarter of all consultations in primary care are concerned with rheumatic disease, yet undergraduate education in rheumatology is

Rheumatology training in Poland vs. United Kingdom

Directory of Open Access Journals (Sweden)

Karina Lazarewicz

2017-07-01

Full Text Available When evaluating the quality of Rheumatology specialty training, it can be useful to explore similarities and differences between countries. In this article we compare the training in the UK and Poland. The two training programmes are similar in length and in the competencies that must be achieved, although they do have significant differences in the way the training is structured. The UK-based system is more out-patient based, which can be advantageous, as after completion of training the doctor is more confident in treating common rheumatological problems. On the other hand, having exposure to paediatric rheumatology and orthopaedics like one has in Polish-based training, despite a short placement time, is definitely beneficial for the trainee in gaining all-round knowledge. In conclusion, each system has its merits and can be further enhanced by observing how junior doctors are sub-speciality trained in different countries.

An accurate and precise representation of drug ingredients.

Science.gov (United States)

Hanna, Josh; Bian, Jiang; Hogan, William R

2016-01-01

In previous work, we built the Drug Ontology (DrOn) to support comparative effectiveness research use cases. Here, we have updated our representation of ingredients to include both active ingredients (and their strengths) and excipients. Our update had three primary lines of work: 1) analysing and extracting excipients, 2) analysing and extracting strength information for active ingredients, and 3) representing the binding of active ingredients to cytochrome P450 isoenzymes as substrates and inhibitors of those enzymes. To properly differentiate between excipients and active ingredients, we conducted an ontological analysis of the roles that various ingredients, including excipients, have in drug products. We used the value specification model of the Ontology for Biomedical Investigations to represent strengths of active ingredients and then analyzed RxNorm to extract excipient and strength information and modeled them according to the results of our analysis. We also analyzed and defined dispositions of molecules used in aggregate as active ingredients to bind cytochrome P450 isoenzymes. Our analysis of excipients led to 17 new classes representing the various roles that excipients can bear. We then extracted excipients from RxNorm and added them to DrOn for branded drugs. We found excipients for 5,743 branded drugs, covering ~27% of the 21,191 branded drugs in DrOn. Our analysis of active ingredients resulted in another new class, active ingredient role. We also extracted strengths for all types of tablets, capsules, and caplets, resulting in strengths for 5,782 drug forms, covering ~41% of the 14,035 total drug forms and accounting for ~97 % of the 5,970 tablets, capsules, and caplets in DrOn. We represented binding-as-substrate and binding-as-inhibitor dispositions to two cytochrome P450 (CYP) isoenzymes (CYP2C19 and CYP2D6) and linked these dispositions to 65 compounds. It is now possible to query DrOn automatically for all drug products that contain active

Rheumatologic complications in a cohort of 227 patients with common variable immunodeficiency.

Science.gov (United States)

Azizi, G; Kiaee, F; Hedayat, E; Yazdani, R; Dolatshahi, E; Alinia, T; Sharifi, L; Mohammadi, H; Kavosi, H; Jadidi-Niaragh, F; Ziaee, V; Abolhassani, H; Aghamohammadi, A

2018-05-01

Common variable immunodeficiency (CVID) is the most prevalent symptomatic type of human primary immunodeficiency diseases (PID). Clinically, CVID is characterized by increased susceptibility to infections and a wide variety of autoimmune and rheumatologic disorders. All patients with CVID registered in Iranian PID Registry (IPIDR) were enrolled in this retrospective cohort study. We investigated the frequency of rheumatologic diseases and its association with immunological and clinical phenotypes in patients with CVID. A total of 227 patients with CVID were enrolled in this study. The prevalence of rheumatologic disorders was 10.1% with a higher frequency in women than men. Most common rheumatologic manifestations were juvenile idiopathic arthritis (JIA) and adult rheumatoid arthritis (RA) followed by juvenile spondyloarthritis (JSpA) and undifferentiated inflammatory arthritis (UIA). Septic arthritis in patients with CVID with a history of RA and JIA was higher than patients without rheumatologic complication. Patients with CVID with a history of autoimmunity (both rheumatologic and non-rheumatologic autoimmunity) had lower regulatory T cells counts in comparison with patients without autoimmune disorders. There was an association between defect in specific antibody responses and negative serologic test results in patients with rheumatologic manifestations. JIA, RA, JSpA and UIA are the most frequent rheumatologic disorders in patients with CVID. Due to antibody deficiency, serologic tests may be negative in these patients. Therefore, these conditions pose significant diagnostic and therapeutic challenges for immunologists and rheumatologists in charge of the care for these patients. © 2018 The Foundation for the Scandinavian Journal of Immunology.

Inactive ingredient Search for Approved Drug Products

Data.gov (United States)

U.S. Department of Health & Human Services — According to 21 CFR 210.3(b)(8), an inactive ingredient is any component of a drug product other than the active ingredient. Only inactive ingredients in the final...

Position paper from the Spanish Society of Rheumatology on biosimilar drugs.

Science.gov (United States)

Abad Hernández, Miguel Ángel; Andreu, José Luis; Caracuel Ruiz, Miguel Ángel; Belmonte Serrano, Miguel Ángel; Díaz-González, Federico; Moreno Muelas, José Vicente

2015-01-01

A biosimilar (BS) is a biological drug that contains a version of the active substance of an already authorized original biological product. The BSs are marketed after patent period of the original drug has ended and once it has been demonstrated that the differences regarding the innovative medicine have no relevant effect on its safety or clinical efficacy. The Spanish Society of Rheumatology, in line with the European Medicines Agency, considers that because of its nature and complexity of production, a BS cannot be considered to be the same as a generic drug. The Spanish Society of Rheumatology expresses an unequivocal commitment to the sustainability of the health system in our country and our steadfast alignment with all measures designed to ensure continuity, without reducing the quality of care. Therefore, we believe that the advent of BSs will likely facilitate access of patients with rheumatic diseases to the biological drugs. This article reviews the European Medicines Agency requirements for authorization, the Spanish legal framework and controversies on BS and presents the position paper of the Spanish Society of Rheumatology on these drugs. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Assessment of email communication skills of rheumatology fellows: a pilot study

Science.gov (United States)

Dhuper, Sonal; Siva, Chokkalingam; Fresen, John L; Petruc, Marius; Velázquez, Celso R

2010-01-01

Physician–patient email communication is gaining popularity. However, a formal assessment of physicians' email communication skills has not been described. We hypothesized that the email communication skills of rheumatology fellows can be measured in an objective structured clinical examination (OSCE) setting using a novel email content analysis instrument which has 18 items. During an OSCE, we asked 50 rheumatology fellows to respond to a simulated patient email. The content of the responses was assessed using our instrument. The majority of rheumatology fellows wrote appropriate responses scoring a mean (±SD) of 10.6 (±2.6) points (maximum score 18), with high inter-rater reliability (0.86). Most fellows were concise (74%) and courteous (68%) but not formal (22%). Ninety-two percent of fellows acknowledged that the patient's condition required urgent medical attention, but only 30% took active measures to contact the patient. No one encrypted their messages. The objective assessment of email communication skills is possible using simulated emails in an OSCE setting. The variable email communication scores and incidental patient safety gaps identified, suggest a need for further training and defined proficiency standards for physicians' email communication skills. PMID:20962134

A report from the American college of rheumatology/association of rheumatology health professionals (ACR/ARHP) - 2012 annual meeting (November 9-14, 2012 - Washington, D.C., USA).

Science.gov (United States)

Croasdell, G

2013-02-01

The annual meeting of the American College of Rheumatology (ACR), jointly held with the Association of Rheumatology Health Professionals (ARHP), brought together attendees focused on all aspects of rheumatology, including researchers looking into treatment options and various services around the care of rheumatologic conditions. As well as networking opportunities at the meeting, there were a wide range of symposia and posters available covering various conditions and levels of research. There were also educational and meet-the-professor sessions. This report will cover a selection of interesting talks from poster and oral sessions on the latest preclinical and clinical research. Copyright 2013 Prous Science, S.A.U. or its licensors. All rights reserved.

Gout treatment: survey of Brazilian rheumatology residents.

Science.gov (United States)

Amorim, Rodrigo Balbino Chaves; Vargas-Santos, Ana Beatriz; Pereira, Leticia Rocha; Coutinho, Evandro Silva Freire; da Rocha Castelar-Pinheiro, Geraldo

2017-05-01

To assess the current practices in gout management among Brazilian rheumatology residents. We performed a cross-sectional online survey among all the rheumatology residents and those rheumatologists who had just completed their training (post-residency (PR)) regarding their approach to gout management. Results were compared with the 2012 American College of Rheumatology (ACR) gout guidelines and with the responses of a previous survey with a representative sample of practicing Brazilian rheumatologists (RHE). We received 224 responses (83%) from 271 subjects. Among all respondents, the first-choice treatment for gout flares was the combination of a nonsteroidal anti-inflammatory drug + colchicine for otherwise healthy patients. A target serum urate 75%. Less than 70% reported starting allopurinol at low doses (≤100 mg/day) for patients with normal renal function and gout guidelines, especially among PR. However, some important aspects of gout management need improvement. These results will guide the development of a physician education program to improve the management of gout patients in Brazil.

Anti-bacteria effect of active ingredients of siraitia grosvenorii on the spoilage bacteria isolated from sauced pork head meat

Science.gov (United States)

Li, X.; Xu, L. Y.; Cui, Y. Q.; Pang, M. X.; Wang, F.; Qi, J. H.

2018-01-01

Extraction and anti-bacteria effect of active ingredients of Siraitia grosvenorii were studied in this paper. Extraction combined with ultrasonic was adopted. The optimum extraction condition was determined by single factor test; the anti-bacteria effect of active ingredients and minimum inhibitory concentration (MIC) were valued by Oxford-cup method. The results indicated that optimum extraction condition of active ingredients extracted from Siraitia grosvenorii were described as follows: ethanol concentrations of sixty-five percent and twenty minutes with ultrasonic assisted extraction; the active ingredients of Siraitia grosvenorii had anti-bacteria effect on Staphylococcus epidermidis, Proteus vulgaris, Bacillus sp, Serratia sp and MIC was 0.125g/mL, 0.0625g/mL, 0.125g/mL and 0.125g/mL. The active constituent of Siraitia grosvenorii has obvious anti-bacteria effect on the spoilage bacteria isolated from Sauced pork head meat and can be used as a new natural food preservation to prolong the shelf-life of Low-temperature meat products.

African Journal of Rheumatology

African Journals Online (AJOL)

The journal aims to publish papers on basic and clinical research in rheumatology and be a vessel of sharing knowledge across the globe. Original research work, reviews, case reports and other relevant scientific work will be published in the journal. The readers of the journal are mainly practicing rheumatologists, ...

Herpes zoster infection, vaccination and immunocompromised rheumatology patients.

LENUS (Irish Health Repository)

O'Connor, Mortimer B

2013-01-01

Varicella is a self-limiting and relatively mild disease of childhood, although it is frequently more severe and complicated among the immunocompromised rheumatology patients on immunomodulator therapies. In addition, future reactivation of the dormant virus in dorsal root ganglia may cause herpes zoster infection, which can be very debilitating. In this manuscript, we discuss the nature of this infection along with its potential vaccine especially among rheumatology patients.

Interactions and incompatibilities of pharmaceutical excipients with active pharmaceutical ingredients: a comprehensive review

Directory of Open Access Journals (Sweden)

Sonali S. Bharate

2010-09-01

Full Text Available Studies of active drug/excipient compatibility represent an important phase in the preformulation stage of the development of all dosage forms. The potential physical and chemical interactions between drugs and excipients can affect the chemical nature, the stability and bioavailability of drugs and, consequently, their therapeutic efficacy and safety. The present review covers the literature reports of interaction and incompatibilities of commonly used pharmaceutical excipients with different active pharmaceutical ingredients in solid dosage forms. Examples of active drug/excipient interactions, such as transacylation, the Maillard browning reaction, acid base reactions and physical changes are discussed for different active pharmaceutical ingredients belonging to different therapeutic categories viz antiviral, anti-inflammatory, antidiabetic, antihypertensive, anti-convulsant, antibiotic, bronchodialator, antimalarial, antiemetic, antiamoebic, antipsychotic, antidepressant, anticancer, anticoagulant and sedative/hypnotic drugs and vitamins. Once the solid-state reactions of a pharmaceutical system are understood, the necessary steps can be taken to avoid reactivity and improve the stability of drug substances and products.

Analysis of information on rheumatology from a selected Internet forum in the context of the need for telemedicine solutions.

Science.gov (United States)

Szpakowski, Rafał; Maślińska, Maria; Dykowska, Grażyna; Zając, Patrycja

2015-01-01

The aim of this study was to determine how often patients and undiagnosed people who complain of musculoskeletal system and rheumatic diseases look for knowledge contained on an Internet forum. Content analysis was used to identify the level of Internet users' activity in the rheumatology section, compared to other areas of medicine. Material included information posted on the Internet forum established at http://medyczka.pl/. The method employed was a quantitative and qualitative analysis of the content. The method was based on qualitative assessment of the first post in each thread presented on the rheumatologic subforum, by assigning keywords, subjectively determined by the researcher, to such a post. For each keyword a specific definition was established, determining a situation in which a given keyword was used. The quantitative analysis qualified rheumatology in the last place in terms of Internet users' activity compared to other branches of medicine. The qualitative assessment of the rheumatologic forum indicated that the three most common keywords were joint pain (32), joints swelling (13), and schoolage (13). The three most common intentional keywords (arranged in order of their decreasing number) were diagnosis based on symptoms (29), interpretation of the laboratory test results (9), and how to deal with symptoms (8). The analysis leads to the conclusion that the rheumatologic subforum, along with other subforums listed above, presents a critically low level of discussion. There is a large disproportion between the number of active and passive forum users, suggesting that numerous individuals search the forum for presented information. Based on the qualitative analysis of the information stocks of the rheumatologic subforum, it was established that most of the questions posted concerned young individuals, who complained of joint pain and swelling, and asked for a possible diagnosis based on the presented symptomatology, interpretation of the laboratory

Immunology for rheumatology residents: working toward a Canadian national curriculum consensus.

Science.gov (United States)

Chow, Shirley L; Herman-Kideckel, Sari; Mahendira, Dharini; McDonald-Blumer, Heather

2015-01-01

Immunologic mechanisms play an integral role in understanding the pathogenesis and management of rheumatic conditions. Currently, there is limited access to formal instruction in immunology for rheumatology trainees across Canada. The aims of this study were (1) to describe current immunology curricula among adult rheumatology training programs across Canada and (2) to compare the perceived learning needs of rheumatology trainees from the perspective of program directors and trainees to help develop a focused nationwide immunology curriculum. Rheumatology trainees and program directors from adult rheumatology programs across Canada completed an online questionnaire and were asked to rank a comprehensive list of immunology topics. A modified Delphi approach was implemented to obtain consensus on immunology topics. Only 42% of program directors and 31% of trainees felt the current method of teaching immunology was effective. Results illustrate concordance between program directors and trainees for the highest-ranked immunology topics including innate immunity, adaptive immunity, and cells and tissues of the immune system. However, there was discordance among other topics, such as diagnostic laboratory immunology and therapeutics. There is a need to improve immunology teaching in rheumatology training programs. Results show high concordance between the basic immunology topics. This study provides the groundwork for development of future immunology curricula.

Pediatric rheumatology: An under-recognized subspecialty in India

Directory of Open Access Journals (Sweden)

Akhila Kavirayani

2017-01-01

Full Text Available Pediatrics in India at the levels of both undergraduate and postgraduate training is often viewed upon as an acute disease specialty with little emphasis on chronic medical musculoskeletal diseases. Pediatric rheumatology is an under-recognized subspecialty of pediatrics which deals specifically with childhood arthritis, noninflammatory joint pains, connective tissue diseases, autoimmune diseases, vasculitis, and other rare inflammatory disorders. This article aims to give a bird's eye view of the repertoire of commonly encountered problems seen by a pediatric rheumatologist, via a classical case vignette for each topic followed by discussion. There is also mention of some rare diseases managed within pediatric rheumatology to give a flavor of the spectrum of diseases encountered. This is to raise awareness of the importance of pediatric rheumatology as a subspecialty within India and to prompt readers to seek specialist advice when encountering challenging cases. Pediatric rheumatologists network and work collaboratively with many other specialties such as ophthalmology, dermatology, neurology, orthopedics, nephrology, infectious diseases, immunology, and gastroenterology for combined care of diverse conditions. There is an unmet need in India to develop a training program for pediatric rheumatology so that shared care pathways with sensitized pediatricians and other specialists can be developed nationwide, to serve these children better to achieve optimal outcomes.

Pesticide-exposure Matrix helps identify active ingredients in pesticides used in past years

Science.gov (United States)

Pesticide-exposure Matrix was developed to help epidemiologists and other researchers identify the active ingredients to which people were likely exposed when their homes and gardens were treated for pests in past years

Pesticide Active Ingredient Production Industry: National Emission Standards for Hazardous Air Pollutants (NESHAP)

Science.gov (United States)

This action promulgates national emission standards for hazardous air pollutants (NESHAP) for the pesticide active ingredient (PAI) production source category under section 112 of the Clean Air Act as amended (CAA or Act).

Optimization of the Method of Active Ingredients Adding to the Base of Medicinal Films Depending on Certain Variables

Directory of Open Access Journals (Sweden)

L. L. Davtian

2018-03-01

Full Text Available The influence of variables of pharmaceutical factors on the technological processes of drugs manufacturing is incredibly important. Thus, in the development of a new drug in the form of medicinal films, the relevance and necessity of determining the effect of the methods of active substances adding on the effectiveness of the drug was determined. The aim is rationalization of the method of the active pharmaceutical ingredients adding into the composition of the developed drug. Materials and methods. As experimental samples we used medicinal films, which were made using various methods of active ingredients adding. The quality of the samples was evaluated by the antimicrobial activity against Clostridium sporogenes and Staphylococcus aureus, which was determined by the diffusion method in agar. Results. The study of the antimicrobial activity of medicinal films with various methods of active ingredients adding showed that the adding of metronidazole as an aqueous solution increases the antimicrobial activity of the films by 21.23%, 16.89%, 28.59%, respectively, compared with films of similar composition, in which metronidazole was added as a suspension, and the remaining ingredients were added by the same way. The introduction of chlorhexidine bigluconate and glucosamine hydrochloride in the film-forming solution lastly together with the solution of metronidazole increases the antimicrobial activity by 24.67%, which is probably due to the absence of contact between thermolabile ingredients and solutions of film-forming substances having a high dissolution temperature. Conclusions. The most rational is adding of metronidazole to the medicinal films in the form of a 0.01% aqueous solution in a mixture with the chlorhexidine bigluconate and glucosamine hydrochloride solution to the final film-forming solution.

Quality of life in rheumatological patients: The impact of personality disorders.

Science.gov (United States)

Uguz, Faruk; Kucuk, Adem; Cicek, Erdinc; Kayhan, Fatih; Salli, Ali; Guncu, Hatice; Çilli, Ali Savas

2015-01-01

Rheumatological diseases are associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently observed in these patients. This study examined the impact of personality disorders on the QoL of patients with rheumatological diseases. The study sample consisted of 142 participants including patients suffering from rheumatological disease with a personality disorder (n = 30), without any personality disorder (n = 112), and healthy control participants without physical or psychiatric disorders (n = 60). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-II) were used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief. The subscale scores of physical health, psychological health, and social relationships were significantly lower in patients with rheumatological disease regardless of the existence of personality disorder compared with the control participants. Rheumatological patients with a personality disorder had significantly lower subscale scores of psychological health (p = 0.003) and social relationships (p personality disorder. Personality disorders seem to be a relevant factor that maybe associated with QoL in patients suffering from rheumatological disease. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The 2017 EULAR standardised procedures for ultrasound imaging in rheumatology

DEFF Research Database (Denmark)

Möller, Ingrid; Janta, Iustina; Backhaus, Marina

2017-01-01

of MSUS evaluable structures; (2) a Delphi survey among rheumatologist and radiologist experts in MSUS to select MS and non-MS anatomic structures evaluable by US that are relevant to rheumatology, to select abnormalities evaluable by US and to prioritise these pathologies for rheumatology and (3...

Process Analytical Technology for Crystallization of Active Pharmaceutical Ingredients

DEFF Research Database (Denmark)

Malwade, Chandrakant Ramkrishna; Qu, Haiyan

2018-01-01

Background: Pharmaceutical industry is witnessing increased pressure to introduce innovative and efficient processes for manufacturing of Active Pharmaceutical Ingredients (APIs) in order to be competitive as well as to meet the stringent product quality requirements set by regulatory authorities...... parameters and their impact on quality of APIs and subsequently the drug products assume great significance for pharmaceutical industry. Methods: This review paper focuses on application of PAT tools, an integral part of Quality by Design (QbD) approach, for better understanding, control, and design...

Photocatalytic degradation of sunscreen active ingredients mediated by nanostructured materials

Science.gov (United States)

Soto-Vazquez, Loraine

Water scarcity and pollution are environmental issues with terrible consequences. In recent years several pharmaceutical and personal care products, such as sunscreen active ingredients, have been detected in different water matrices. Its recalcitrant behavior in the environment has caused controversies and generated countless questions about its safety. During this research, we employed an advanced oxidation process (photocatalysis) to degrade sunscreen active ingredients. For this study, we used a 3x3 system, evaluating three photocatalysts and three different contaminants. From the three catalysts employed, two of them were synthesized. ZnO nanoparticles were obtained using zinc acetate dihydrated as the precursor, and TiO2 nanowires were synthesized from titanium tetrachloride precursor. The third catalyst employed (namely, P25) was obtained commercially. The synthesized photocatalysts were characterized in terms of the morphology, elemental composition, crystalline structure, elemental oxidation states, vibrational modes and surface area, using SEM-EDS, XRD, XPS, Raman spectroscopy and BET measurements, respectively. The photocatalysts were employed during the study of the degradation of p-aminobenzoic acid, phenylbenzimidazole sulfonic acid, and benzophenone-4. In all the cases, at least 50% degradation was achieved. P25 showed degradation efficiencies above 90%, and from the nine systems, 7 of them degraded at least 86%.

Swift Quantification of Fenofibrate and Tiemonium methylsulfate Active Ingredients in Solid Drugs Using Particle Induced X-Ray Emission

International Nuclear Information System (INIS)

Bejjani, A.; Nsouli, B.; Zahraman, K.; Assi, S.; Younes, Gh.; Yazbi, F.

2011-01-01

The quantification of active ingredients (AI) in drugs is a crucial and important step in the drug quality control process. This is usually performed by using wet chemical techniques like LC-MS, UV spectrophotometry and other appropriate organic analytical methods. However, if the active ingredient contains specific heteroatoms (F, S, Cl), elemental IBA like PIXE and PIGE techniques, using small tandem accelerator of 1-2 MV, can be explored for molecular quantification. IBA techniques permit the analysis of the sample under solid form, without any laborious sample preparations. In this work, we demonstrate the ability of the Thick Target PIXE technique for rapid and accurate quantification of both low and high concentrations of active ingredients in different commercial drugs. Fenofibrate, a chlorinated active ingredient, is present in high amounts in two different commercial drugs, its quantification was done using the relative approach to an external standard. On the other hand, Tiemonium methylsulfate which exists in relatively low amount in commercial drugs, its quantification was done using GUPIX simulation code (absolute quantification). The experimental aspects related to the quantification validity (use of external standards, absolute quantification, matrix effect,...) are presented and discussed. (author)

Eco-efficiency analysis for intensified production of an active pharmaceutical ingredient : a case study

NARCIS (Netherlands)

Dencic, I.; Ott-Reinhardt, D.; Kralisch, D.; Noel, T.; Meuldijk, J.; Croon, de M.H.J.M.; Hessel, V.; Laribi, Y.; Perrichon, P.

2014-01-01

This article presents results on cost and performance benefit analysis of optimization and intensification activities of a pharmaceutical process. A batch process for the production of a low-volume, high value active pharmaceutical ingredient, developed at Sanofi (France), has been used as a case

Active ingredients in anti-stigma programmes in mental health.

Science.gov (United States)

Pinfold, Vanessa; Thornicroft, Graham; Huxley, Peter; Farmer, Paul

2005-04-01

This paper draws upon a review of the relevant literature and the results of the recent Mental Health Awareness in Action (MHAA) programme in England to discuss the current evidence base on the active ingredients in effective anti-stigma interventions in mental health. The MHAA Programme delivered educational interventions to 109 police officers, 78 adults from different community groups whose working lives involved supporting people with mental health problems but who had received no mental health training and 472 schools students aged 14-15. Each adult target group received two intervention sessions lasting two hours. The two school lessons were 50 minutes each. Knowledge, attitudes and behavioural intent were assessed at baseline and follow-up. In addition focus groups were held with mental health service users to explore the impact of stigma on their lives and facilitators of educational workshops were interviewed to provide expert opinion on 'what works' to reduce psychiatric stigma. Personal contact was predictive of positive changes in knowledge and attitudes for the school students but not the police officers or community adult group. The key active ingredient identified by all intervention groups and workshop facilitators were the testimonies of service users. The statements of service users (consumers) about their experience of mental health problems and of their contact with a range of services had the greatest and most lasting impact on the target audiences in terms of reducing mental health stigma.

Stronger effects of Roundup than its active ingredient glyphosate in damselfly larvae.

Science.gov (United States)

Janssens, Lizanne; Stoks, Robby

2017-12-01

Pesticides are causing strong decreases in aquatic biodiversity at concentrations assumed safe by legislation. One reason for the failing risk assessment may be strong differences in the toxicity of the active ingredient of pesticides and their commercial formulations. Sublethal effects, especially those on behaviour, have been largely ignored in this context, yet can be equally important as lethal effects at the population and ecosystem levels. Here, we compared the toxicity of the herbicide Roundup and its active ingredient glyphosate on survival, but also on ecologically relevant sublethal traits (life history, behaviour and physiology) in damselfly larvae. Roundup was more toxic than glyphosate with negative effects on survival, behaviour and most of the physiological traits being present at lower concentrations (food intake, escape swimming speed) or even only present (survival, sugar and total energy content and muscle mass) following Roundup exposure. This confirms the toxicity of the surfactant POEA. Notably, also glyphosate was not harmless: a realistic concentration of 2mg/l resulted in reduced growth rate, escape swimming speed and fat content. Our results therefore indicate that the toxicity of Roundup cannot be fully attributed to its surfactant, thereby suggesting that also the new generation of glyphosate-based herbicides with other mixtures of surfactants likely will have adverse effects on non-target aquatic organisms. Ecotoxicological studies comparing the toxicity of active ingredients and their commercial formulations typically ignore behaviour while the here observed differential effects on behaviour likely will negatively impact damselfly populations. Our data highlight that risk assessment of pesticides ignoring sublethal effects may contribute to the negative effects of pesticides on aquatic biodiversity. Copyright © 2017 Elsevier B.V. All rights reserved.

Mental health care for youth with rheumatologic diseases - bridging the gap.

Science.gov (United States)

Davis, Alaina M; Rubinstein, Tamar B; Rodriguez, Martha; Knight, Andrea M

2017-12-28

Youth with rheumatologic diseases have a high prevalence of comorbid mental health disorders. Individuals with comorbid mental health disorders are at increased risk for adverse outcomes related to mental health as well as their underlying rheumatologic disease. Early identification and treatment of mental health disorders has been shown to improve outcomes, but current systems of care fall short in providing adequate mental health services to those in need. Pediatric rheumatologists are uniquely positioned to provide mental health screening and intervention for youth with rheumatologic diseases due to the frequency of patient encounters and ongoing therapeutic relationship with patients and families. However, additional training is likely required for pediatric rheumatologists to provide effective mental health care, and focusing efforts on providing trainees with mental health education is key to building competency. Potential opportunities for improved mental health education include development of clinical guidelines regarding mental health screening and management within pediatric rheumatology settings and incorporation of mental health didactics, workshops, and interdisciplinary clinic experiences into pediatric rheumatology fellowship curricula. Additional steps include mental health education for patients and families and focus on system change, targeting integration of medical and mental health care. Research is needed to better define the scope of the problem, determine effective strategies for equipping pediatric rheumatologists with skills in mental health intervention, and develop and implement sustainable systems for delivery of optimal mental health care to youth with rheumatologic diseases.

Update on rheumatology: part 1.

Science.gov (United States)

Neal-Boylan, Leslie

2009-05-01

There are many rheumatic diseases. Part 1 of this 2 part series on rheumatology presented a few of those most commonly seen in the community. Home health clinicians can be helpful in managing these diseases and preventing progression by watching for new symptoms or acute attacks of pain or disability, ensuring that patients take their medications appropriately, reminding patients to see their rheumatology providers and have their lab work done regularly, and reporting adverse effects to medications promptly. Additionally, as with most home health patients, an interdisciplinary approach that includes physical and occupational therapy, social work, nursing, nutrition, and other disciplines as needed should be implemented so that all patient needs are met and the patient is discharged at the highest level of self-care that is possible. Part 2 of this series will discuss the care of the patient with rheumatic disease at home and will provide a more in-depth look at lab diagnosis of rheumatic diseases.

Analysis of information on rheumatology from a selected Internet forum in the context of the need for telemedicine solutions

Directory of Open Access Journals (Sweden)

Rafał Szpakowski

2015-12-01

Full Text Available Objectives: The aim of this study was to determine how often patients and undiagnosed people who complain of musculoskeletal system and rheumatic diseases look for knowledge contained on an Internet forum. Content analysis was used to identify the level of Internet users’ activity in the rheumatology section, compared to other areas of medicine. Material and methods : Material included information posted on the Internet forum established at http://medyczka.pl/. The method employed was a quantitative and qualitative analysis of the content. The method was based on qualitative assessment of the first post in each thread presented on the rheumatologic subforum, by assigning keywords, subjectively determined by the researcher, to such a post. For each keyword a specific definition was established, determining a situation in which a given keyword was used. Results: The quantitative analysis qualified rheumatology in the last place in terms of Internet users’ activity compared to other branches of medicine. The qualitative assessment of the rheumatologic forum indicated that the three most common keywords were joint pain (32, joints swelling (13, and schoolage (13. The three most common intentional keywords (arranged in order of their decreasing number were diagnosis based on symptoms (29, interpretation of the laboratory test results (9, and how to deal with symptoms (8. Conclusions : The analysis leads to the conclusion that the rheumatologic subforum, along with other subforums listed above, presents a critically low level of discussion. There is a large disproportion between the number of active and passive forum users, suggesting that numerous individuals search the forum for presented information. Based on the qualitative analysis of the information stocks of the rheumatologic subforum, it was established that most of the questions posted concerned young individuals, who complained of joint pain and swelling, and asked for a possible

Triboelectrification of active pharmaceutical ingredients: week acids and their salts.

Science.gov (United States)

Fujinuma, Kenta; Ishii, Yuji; Yashihashi, Yasuo; Yonemochi, Estuo; Sugano, Kiyohiko; Tarada, Katsuhide

2015-09-30

The effect of salt formulation on the electrostatic property of active pharmaceutical ingredients was investigated. The electrostatic property of weak acids (carboxylic acids and amide-enole type acid) and their sodium salts was evaluated by a suction-type Faraday cage meter. Free carboxylic acids showed negative chargeability, whereas their sodium salts showed more positive chargeability than the free acids. However, no such trend was observed for amide-enole type acids. Copyright © 2015 Elsevier B.V. All rights reserved.

Educational needs of health professionals working in rheumatology in Europe.

Science.gov (United States)

Vliet Vlieland, Theodora P M; van den Ende, Cornelia H M; Alliot-Launois, Francoise; Beauvais, Catherine; Gobbo, Milena; Iagnocco, Annamaria; Lundberg, Ingrid E; Munuera-Martínez, Pedro V; Opava, Christina H; Prior, Yeliz; Redmond, Anthony; Smucrova, Hana; Wiek, Dieter

2016-01-01

To explore the availability of postgraduate education for health professionals (HPs) working in rheumatology in Europe, and their perceived educational needs and barriers for participation in current educational offerings. Structured interviews were conducted with national representatives of rheumatology HPs' organisations and an online survey among individual HPs was disseminated through existing European League Against Rheumatism (EULAR) networks (10 languages including English). These comprised questions on: availability of postgraduate education, familiarity with EULAR and its educational offerings, unmet needs regarding the contents and mode of delivery and potential barriers to participate in education (0-10 scales). According to 17 national representatives, postgraduate rheumatology education was most common for nurses, physical and occupational therapists. There were 1041 individuals responding to the survey, of whom 48% completed all questions. More than half (56%) were familiar with EULAR as an organisation, whereas rheumatology education for HPs in most countries. There are opportunities to raise awareness regarding EULAR educational offerings and to develop courses provided in HPs' own country, tailored to national needs and barriers and taking language barriers into consideration.

Chitin-Hyaluronan Nanoparticles: A Multifunctional Carrier to Deliver Anti-Aging Active Ingredients through the Skin

Directory of Open Access Journals (Sweden)

Pierfrancesco Morganti

2014-07-01

Full Text Available The paper describes the process to produce Chitin Nanofibril-Hyaluronan nanoparticles (CN-HA, showing their ability to easily load active ingredients, facilitate penetration through the skin layers, and increase their effectiveness and safety as an anti-aging agent. Size and characterization of CN-HA nanoparticles were determined by Scanning Electron Microscopy (SEM and Zetasizer, while encapsulation efficiency and loading capacity of the entrapped ingredients were controlled by chromatographic and spectrophotometric methods. Safeness was evidenced on fibroblasts and keratinocytes culture viability by the MTT (Methylthiazol assay; anti-aging activity was evaluated in vitro measuring antioxidant capacity, anti-collagenase activity, and metalloproteinase and pro-inflammatory release; efficacy was shown in vivo by a double-blind vehicle-controlled study for 60 days on 60 women affected by photo-aging. In addition, the CN-HA nanoparticles have shown interesting possibility to be used as active ingredients, for designing and making advanced medication by the electrospinning technology, as well as to produce transparent films for food packaging, by the casting method, and can be used also in their dry form as tissues or films without adding preservatives. These unusual CN-HA nanoparticles obtained from the use of raw materials of waste origin may offer an unprecedented occasion for making innovative products, ameliorating the quality of life, reducing pollution and safeguarding the environment’s integrity.

Design of Continuous Crystallizers for Production of Active Pharmaceutical Ingredients

DEFF Research Database (Denmark)

Capellades Mendez, Gerard; Christensen, Troels V.

The production of Active Pharmaceutical Ingredients (APIs) is conducted primarily in batch processes. This manufacturing approach is reinforced by a patent-driven business model and the need to minimize the process development times for newly patented drugs. However, the regulatory and business...... environments are now changing. The increasing costs of drug development, combined with the strict regulations and the competition from generic manufacturers, have pushed pharmaceutical companies to seek cheaper and more sustainable production methods. Transition from batch to Continuous Pharmaceutical...

Why do we choose rheumatology? Implications for future recruitment--results of the 2006 UK Trainee Survey.

Science.gov (United States)

Dunkley, L; Filer, A; Speden, D; Bax, D; Crisp, A

2008-06-01

Against changes to junior doctor career structure under MMC (Modernizing Medical Careers), and uncertainty about the future place of rheumatology, we explored critical factors in choice of rheumatology as a speciality, and asked what factors might govern choices of prospective trainees. Using these data, we developed suggestions to enhance future recruitment. A postal survey was sent to rheumatology specialist registrars (SpRs) on the Joint Committee for Higher Medical Training (JCHMT) database between December 2005 and January 2006, and concurrently by e-mail to the Rheumatologists at Training e-mail list. Seventy-three percent (165/227) of trainees responded. Of them, 89.1% had previous senior house officer (SHO) experience in rheumatology and 81.8% made a career decision in favour of rheumatology during their SHO post. The top four ranked factors influencing choice of rheumatology were SHO experience, subject matter, inspirational consultants and lifestyle aspects; 89.1% would still choose rheumatology now. Factors felt to be negatively influencing future trainees came under three key themes: poor student or postgraduate exposure, employment and service delivery issues (including concern over the future place of rheumatology in primary vs secondary care), and perceived poor profile of rheumatology. Factors positively influencing future candidates were subject matter, work/life balance and prior exposure to the speciality. Early postgraduate experience is key to choice of speciality. An overwhelming majority of trainees decide speciality during SHO experience. With ongoing changes in career structure, it is critical that rheumatology is incorporated into foundation and speciality training programmes and essential that continued measures are taken to improve the image of rheumatology.

X-ray diffraction study of kanwa used as active ingredient in achu ...

African Journals Online (AJOL)

In this study, x-ray powder diffractometry (XRPD) technique was used to identify the mineral constituents of kanwa; an earthy material widely used as active ingredient in achu soup and other vegetable soups in Cameroon and several other West African countries. Results depicted trona (Na3H (CO3)2.2H2O) to be the main ...

[Amendment of the structural quality for inpatient rheumatology. A forward-looking concept].

Science.gov (United States)

Lakomek, H-J; Braun, J; Gromnica-Ihle, E; Fiehn, C; Claus, S; Specker, C; Jung, J; Krause, A; Lorenz, H-M; Robbers, J

2011-09-01

In 2010 a total of 9 guidelines on structural quality were endorsed by the Association of Rheumatology Clinics in Germany (VRA). These 9 structural criteria replace the regulations published in 2002 and were elaborated with the support of the German Rheumatology League. With guideline number 9 even the structural requirements for university hospitals are defined for the first time.Along with taking part in the quality project "Kobra" (continuous outcome benchmarking in rheumatology inpatient treatment) compliance with the new structural criteria constitutes a prerequisite for acquiring a quality certificate, which is awarded by an external institution.By this means the VRA sets the stage for its members to be prepared for future challenges and quality competition among hospitals. Furthermore, the provision of a high quality treatment for chronically diseased patients in rheumatology clinics will be effectively supported.

Challenges and Opportunities in Using Patient-Reported Outcomes in Quality Measurement in Rheumatology

OpenAIRE

Wahl, Elizabeth; Yazdany, Jinoos

2016-01-01

Use of Patient-reported outcome measures (PROs) in rheumatology research is widespread, but use of PRO data to evaluate the quality of rheumatologic care delivered is less well established. This article reviews the use of PROs in assessing healthcare quality, and highlights challenges and opportunities specific to their use in rheumatology quality measurement. We first explore other countries’ experiences collecting and evaluating national PRO data to assess quality of care. We describe the c...

Opinions expressed by Italian National Advisory Toxicological Committee on some active ingredients of pesticides

Energy Technology Data Exchange (ETDEWEB)

Camoni, I [Ist. Superiore di Sanita` , Rome (Italy). Lab. di Tossicologia Applicata

1996-03-01

The opinions expressed by the Italian National Advisory Toxicological Committee (CCTN) on some active ingredients of pesticides are presented. Carcinogenic and mutagenic effects of these substances have been examined and, on this basis, an evaluation and relative classification were expressed.

[Changed accumulation of active ingredient in different localities and growth period of Hemsleya zhejiangensis (Cucurbitaceae)].

Science.gov (United States)

Yang, Wang-Wei; Lei, Zu-Pei; Wang, Wei-Min; Liang, Wei-qing; Zhou, Wei-Qing; Jin, Xiao-Feng

2014-08-01

In this paper, the content of moisture, ethanol-soluble extractives, total saponins and polysaccharide of different tuber samples of Hemsleya zhejiangensis, from different localities, years and seasons, were detected based upon Chinese Pharmacopoeia 2010 version. The samples of roots, stems and leaves in summer were detected as well. The results are mainly as follows. (1)With tuber quality increasing, the content of total saponins increased and then decreased. The individual quality of tubers getting 594.06 g, the content of total saponins reached the peak. (2) The content of active ingredients in different localities was significantly different, and the population of Wuyanling had the maximum content of total saponins and polysaccharide. (3) The content of active ingredients revealed stability between the years 2012 and 2013, but the content of polysaccharide was significantly different. The content in 2012 was higher than that of 2013. (4) The content of active ingredients reached the peak in autumn, which was the best harvest season. (5) Among different component content detection of nutritional organs, tubers had the maximum content of ethanol-soluble extractives, total saponins and polysaccharide. Leaves also contained higher content of ethanol-soluble extractives and total saponins than roots and stems. All of these provide theoretical basis for plant, harvest and production of H. zhejiangensis, which is an endemic, rare, and endangered medicinal plants.

Types of Pesticide Ingredients

Science.gov (United States)

Pesticide active ingredients are described by the types of pests they control or how they work. For example, algicides kill algae, biopesticides are derived from natural materials, and insecticides kill insects.

Lithium carbonate tablets. Preparation techniques influence over active ingredient liberation

International Nuclear Information System (INIS)

Bueno, J.H.F.; Oliveira, A.G. de; Toledo Salgado, P.E. de

1989-01-01

Lithium carbonate tablets, prepared using wet and dry granulation, were assessed in vitro so as to determine the active ingredient dissolution. In this study, standardized formulations were used and developed with usual adjuvants (lactose - maize starch). Parallel to the dissolution testing. The influence of the preparation process over some physical characteristics (hardness, friability and disintegration) was also analysed. Although a better performance was observed of tables prepared using dry granulation, the authors concluded that the wet process is more suitable in preparing tables with the mentioned drug. (author)

On the direct characterization and quantification of active ingredients in commercial solid drugs using PIXE, PIGE and TOF-SIMS techniques

Energy Technology Data Exchange (ETDEWEB)

Nsouli, B. [IBA laboratory, Lebanese Atomic Energy Commission (CNRS), Beirut (Lebanon)], E-mail: bnsouli@cnrs.edu.lb; Zahraman, K; Roumie, M [IBA laboratory, Lebanese Atomic Energy Commission (CNRS), Beirut (Lebanon); Yazbi, F [Faculty of Pharmacy, Department of Pharmaceutical Analytical Chemistry, Beirut Arab University, Beirut (Lebanon); Thomas, J P [Institut de Physique Nucleaire de Lyon, Universite Claude Bernard Lyon, Villeurbanne (France)

2009-07-01

The quantification of the active ingredient (AI) in drugs is a crucial and important step in the drug quality control process. This is usually performed by using wet chemical techniques like LC-MS, UV spectrophotometry and other appropriate organic analytical methods. In the case of an active ingredient contains specific heteroatoms (F, S, Cl, . . .), elemental IBA like PIXE and PIGE techniques, using small tandem accelerator of 1 - 2 MV, can be explored for molecular quantification. IBA techniques permit the analysis of the sample under solid form, without any laborious sample preparations. This is an advantage when the number of sample is relatively large. In this work, we demonstrate the ability of the Thick Target PIXE and PIGE technique for rapid and accurate quantification of low concentration of different fluorinated, sulfured and chlorinated active ingredients in several commercial anti-hyperlipidemic and anti-inflammatory commercial drugs. In this work we will demonstrate the ability of PIXE and PIGE techniques for rapid and accurate quantification of Celecoxib and Atorvastatin active ingredients contained in several solid commercial drugs. The experimental aspects related to the quantification validity are presented and discussed. In addition, the Time of Flight Secondary Ion Emission using multicharged Ar ions with {approx} 10 MeV energy, delivered by a 4 MV Vander Graaf single stage accelerator, was used for structural and chemical analysis for some cases of binary commercial drugs containing two different active ingredients. The aspect of sample preparation and the role of excipient will be highlighted and discussed. (author)

[Hospital financing in 2016. Relevant changes for rheumatology].

Science.gov (United States)

Fiori, W; Bunzemeier, H; Lakomek, H-J; Buscham, K; Lehmann, H; Fuchs, A-K; Bessler, F; Roeder, N

2016-03-01

Hospital financing 2016 will be influenced by the prospects of the approaching considerable changes. It is assumed that the following years will lead to a considerable reallocation of financial resources between hospitals. While not directly targeted by new regulations, reallocations always also affect specialties like rheumatology. Compared to the alterations in the legislative framework the financial effects of the yearly adaptation of the German diagnosis-related groups system are subordinate. Only by comprehensive consideration of current and expected changes a forward-looking and sustainable strategy can be developed. The following article presents the relevant changes and discusses the consequences for hospitals specialized in rheumatology.

HIM-herbal ingredients in-vivo metabolism database.

Science.gov (United States)

Kang, Hong; Tang, Kailin; Liu, Qi; Sun, Yi; Huang, Qi; Zhu, Ruixin; Gao, Jun; Zhang, Duanfeng; Huang, Chenggang; Cao, Zhiwei

2013-05-31

Herbal medicine has long been viewed as a valuable asset for potential new drug discovery and herbal ingredients' metabolites, especially the in vivo metabolites were often found to gain better pharmacological, pharmacokinetic and even better safety profiles compared to their parent compounds. However, these herbal metabolite information is still scattered and waiting to be collected. HIM database manually collected so far the most comprehensive available in-vivo metabolism information for herbal active ingredients, as well as their corresponding bioactivity, organs and/or tissues distribution, toxicity, ADME and the clinical research profile. Currently HIM contains 361 ingredients and 1104 corresponding in-vivo metabolites from 673 reputable herbs. Tools of structural similarity, substructure search and Lipinski's Rule of Five are also provided. Various links were made to PubChem, PubMed, TCM-ID (Traditional Chinese Medicine Information database) and HIT (Herbal ingredients' targets databases). A curated database HIM is set up for the in vivo metabolites information of the active ingredients for Chinese herbs, together with their corresponding bioactivity, toxicity and ADME profile. HIM is freely accessible to academic researchers at http://www.bioinformatics.org.cn/.

Hot topics in modern rheumatology

Directory of Open Access Journals (Sweden)

D. E. Karateev

2014-01-01

Full Text Available The Expert Council for Tofacitinib (TOFA and two symposiums on New Possibilities for Targeted Therapy of Rheumatoid Arthritis and on Success Factor of Biological Therapy for Rheumatic Diseases were held within the annual scientific-and-practical conference of the V.A. Nasonova Research Institute of Rheumatology on Comorbidity in Rheumatic Diseases in Moscow on 14–15 October 2014.

Autoimmune thyroiditis in antinuclear antibody positive children without rheumatologic disease

Directory of Open Access Journals (Sweden)

Arkachaisri Thaschawee

2010-05-01

Full Text Available Abstract Background Children are commonly referred to a pediatric rheumatology center for the laboratory finding of an Anti-nuclear antibody (ANA of undetermined significance. Previous studies regarding adult rheumatology patients have supported an association between ANA and anti-thyroid antibodies, with the prevalence of thyroid antibodies being significantly higher in patients referred to a rheumatology center for an ANA without evidence of connective tissue disease compared to the general population. The purpose of the present study was to determine the frequency of thyroid antibodies in children referred to a pediatric rheumatology center for a positive ANA without evidence of a connective tissue disease. Methods A retrospective chart review was performed on children who were referred to our pediatric rheumatology center between August 2003 and March 2007 for positive ANA with concurrent thyroid antibody and thyroid function tests performed who did not fulfill criteria for a specific connective tissue disease. Laboratory and clinical features were recorded and analyzed. Mean and standard deviation were used to describe continuous data. Chi-square or Fisher's exact tests were used to compare proportions between variables. Results One-hundred and four ANA-positive patients with concurrent thyroid studies were evaluated (88% female, 93% Caucasian, mean age 11.9 ± 4.0 years. Half of patients had an ANA titer ≥ 1:320. The ANA pattern was speckled in 60% of the patients. Thyroid antibodies were detected in 30% of the patients. Anti-Thyroglobulin (ATG was detected in 29% and Anti-thyroid peroxidase (ATPO in 21% of the patients; of these children, 14% had hypothyroidism. ANA pattern and titer were not associated with anti-thyroid antibody positivity. Conclusion Thyroid antibodies associated with chronic lymphocytic thyroiditis, ATG and ATPO, were detected significantly higher in ANA-positive children without a rheumatologic condition (30% as

Max Hirsch (1875-1941): His forgotten fate and his contributions to the founding of modern rheumatology.

Science.gov (United States)

Keitel, Wolfgang; Olsson, Leif; Matteson, Eric L

2016-09-01

To elucidate the connections between balneology and rheumatology in the founding period of the discipline of rheumatology, and describe the contributions of Max Hirsch, MD in the formation of professional rheumatology societies. Historical documents from the medical history collection of Vogelsang-Gommern, Germany, and original personal documents of the Hirsch family and information from the medical and historical period literature were used in developing this report. The first efforts at organizing rheumatology as a recognized clinical and academic discipline took place in the 1920s. Many of the first proponents were balneologists who cared for patients with chronic arthritic conditions without the benefit of effective medications. Max Hirsch, MD was a major figure in the development of modern rheumatology as it emerged from the provenance of balneology and orthopedics as a recognized organized medical discipline, contributing to the founding of the German Society for Rheumatology and the International League Against Rheumatism. Max Hirsch made significant contributions to scientific and organized rheumatology in the early days of the discipline. His contributions to the field and his fate as a Jewish physician have only recently come to light.

Validation of the quality control methods for active ingredients of Fungirex cream

International Nuclear Information System (INIS)

Perez Navarro, Maikel; Rodriguez Hernandez, Yaslenis; Suarez Perez, Yania

2014-01-01

Fungirex cream is a two-drug product, that is, undecylenic acid and zinc undecylenate over a suitable basis. Since this is a product not documented in the official monographs of the pharmacopoeia, simple analytical methods were suggested for quantitation of analytes of interest in the cream, which are useful for release of newly prepared cream batches. To validate two volumetric methods for the quality control of active ingredients in Fungirex cream

Active ingredients from natural botanicals in the treatment of obesity.

Science.gov (United States)

Zhang, W-L; Zhu, L; Jiang, J-G

2014-12-01

Obesity is considered as a chronic disease that can induce a series of comorbidities and complications. Chinese medicine has long clinical experiences in the treatment of obesity. This review summarizes the natural products from traditional Chinese medicine (TCM) that are reported to have anti-obesity effects in the past two decades. Botanic TCM comprises 90% of total Chinese crude drugs, and generally contains various active ingredients, in which the effective anti-obesity ingredients identified can be divided into saponins, polysaccharides, alkaloids, polyphenols and others. Astragaloside IV, glycyrrhizin, macrostemonoside A, berberine, betaine, capsaicin, matrine, methyl piperate, piperine, rutaecarpine, asimilobine, epigallocatechingallate, magnolol, resveratrol, soybean-isoflavone, α-linolenic acid, emodin, geniposide, phillyrin, salidroside and ursolic acid are specified in this review, and their sources, models, efficacy are described. It is concluded that the mechanisms of these components for the treatment of obesity include: (i) suppression of appetite, increase of satiety, reduction of energy intake; (ii) reduction in the digestion and absorption of exogenous lipid; (iii) attenuation of the synthesis of endogenous lipid; (iv) promotion of the oxidation and expenditure of lipid and (v) improvement of lipid metabolism disorder. Authors believe that the effective compounds from TCM will provide an alternative and hopeful way for the treatment of obesity. © 2014 World Obesity.

Acetyl aspartic acid, a novel active ingredient, demonstrates potential to improve signs of skin ageing: from consumer need to clinical proof.

Science.gov (United States)

Mavon, A

2015-10-01

The megatrend of population ageing is leading to a growing demand for "anti-ageing" treatments, especially to prevent or treat skin ageing. Facing an increasing offer, consumers are choosing more and more skin care products supported by a scientific rationale, active ingredients and clinical proof of efficacy. Considering consumer expectations, this research led to the discovery of acetyl aspartic acid (A-A-A), a novel active ingredient to improve sagging skin and loss of skin firmness. This supplement is featuring seven manuscripts aiming at presenting the research and investigations from consumer insights, discovery of A-A-A, its in vitro activity confirmation, safety assessment, formulation and its dermal absorption to the clinical proof of efficacy, investigated through two pilots' double bind randomized and placebo controlled studies on photo-aged skin. This extensive research enabled us to discover A-A-A, as an active ingredient with potential to repair sign of skin ageing and supported by clinical proof of efficacy. This active ingredient will be soon launched in a commercial innovative skin care range, delivering desirable anti-wrinkle and skin lifting benefits. © 2015 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Study on the mechanism of the bronchodilatory effects of Cynodon dactylon (Linn.) and identification of the active ingredient.

Science.gov (United States)

Patel, Maulik R; Bhalodia, Yagnik S; Pathak, Nimish L; Patel, Maulik S; Suthar, Kunal; Patel, Nilesh; Golwala, Dharmesh K; Jivani, Nurudin P

2013-12-12

In the traditional medicine, Cynodon dactylon (Linn.) is used in asthma, but scientific studies to provide evidence for medicinal uses are sparse. Thus this study was undertaken to provide evidence for medicinal use in asthma as a bronchodilator, and to identify active ingredient(s). In vivo, acetylcholine (Ach)-induced bronchospasm was conducted in guinea pig while isolated rat tracheal strip was suspended in organ bath to measure the concentration response curve using multichannel data acquisition system. The chloroform extract of Cynodon dactylon (CECD) protected against Ach-induced bronchospasm in guinea pigs, similar to atropine. In the in vitro studies, CECD relaxed carbachol (CCh) and high K+-induced contraction of rat tracheal strip, similar to atropine and verapamil respectively, suggesting antimuscarinic and calcium channel blocking (CCB) activities, which were confirmed by right ward shifting of CCh and Ca(+2) concentration response curve (CRC). The phosphodiestrase (PDE) inhibitory activity was confirmed by potentiation of isoprenaline-induced inhibitory response, similar to papaverine. Densitometry analyses led to the identification of scopoletin as an active ingredient. Effectively, it significantly inhibited high K+, and Ca(+2) induced contractile response, similar to verapamil. The phosphodiestrase (PDE) inhibitory activity was confirmed by direct evidence of potentiation of isoprenaline-induced inhibitory response, similar to papaverine. These results suggest that the bronchodilator activity of CECD is partly due to presence of scopoletin, and mediated possibly through CCB and PDE inhibition.

Current educational status of paediatric rheumatology in Europe: the results of PReS survey.

Science.gov (United States)

Demirkaya, E; Ozen, S; Türker, T; Kuis, W; Saurenmann, R K

2009-01-01

To understand the status of education and problems in paediatric rheumatology practice in Europe, through a survey. A 26-item questionnaire was conducted during the 14th Congress of the Paediatric Rheumatology European Society in Istanbul, 2007. Physicians who were practicing or studying within the field of paediatric rheumatology for at least one year were included in the survey. One hundred and twenty eight physicians, 79 paediatric rheumatologists (including 5 paediatric immunologists and 10 paediatric nephrologists), 34 paediatric rheumatology fellows and 15 adult rheumatologists completed the survey. The physicians were from: Europe 95 (81.9%), South America 12 (10.4%), Middle East 5 (4.3%), Asia 2 (1.7%), Africa 2 (1.7%). The duration of training for paediatric rheumatology ranged between 1-5 years (mean: 3.12+/-1.11). Sixty physicians scored their education as unsatisfactory and among those, 48 physicians were from Europe. Physicians reported good skills in the following items; intraarticular injections (83.3%); soft tissue injections (47.6%); evaluation of radiographs (67.5%); whereas competence in the evaluation of computed tomography/magnetic resonance imaging (30.5%); and musculoskeletal sonography (16.7%) was much lower. A need for improved basic science and rotations among relevant fields were specifically expressed. Being a relatively new speciality in the realm of paediatrics, paediatric rheumatology education at the European level needs to be further discussed, revised and uniformed.

The role of active ingredients nanopowder Stichopus hermanii gel to bone resorption in tension area of orthodontic tooth movement

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Noengki Prameswari

2017-12-01

Full Text Available Background: Orthodontic tooth movement is a continual and balanced process between bone deposition and bone resorption in pressure and tension sites. Stichopus hermanii is one of the best fishery commodities in Indonesia. It is natural and contains various active ingredients such as hyaluronic acid, chondroitin sulphate, cell growth factor, eicosa pentaenoic acid (EPA docosa hexaenoic acid (DHA and flavonoid that potentially play a role in orthodontic tooth movement. Purpose: The aim of this study was to investigate the active ingredients of nanopowder Stichopus hermanii promoting bone resorption in tension area orthodontic tooth movement. Methods: A quantitative test for active ingredients of stichopus hermanii was conducted. Thirty two male Cavia cobaya were divisibled became four groups. K (– groups as a negative control group (without treatment, K (+ groups as a positive control group which were provided with a separator rubber for orthodontic tooth movement, and P1, P2 groups, which were treated with 3% and 3.5% stichopus hermanii for orthodontic tooth movement. After treatment the cavia cobaya were sacrificed. TRAP-6 expression as a osteoclast marker was examined by means of an immunohistochemistry method. Results: A one-way Anova test confirmed that TRAP-6 expression was significantly increased with p = 0.00 (p≤0,05 in P2 compared to K (+. P2 to K (–, P2 to P1 and P1 to K (+ had no significant differences Conclusion: Nanopowder Stichopus hermanii 3.5% has an active ingredient that could increase osteoclast activity to resorb periodontal ligament and alveolar bone in tension areas of orthodontic tooth movement.

PERICARDIAL FEATURES OF IN-HOSPITAL RHEUMATOLOGY PATIENTS: AN OBSERVATIONAL STUDY.

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Bakalli, Aurora; Rexhepi, Mjellma; Rexhepi, Blerta; Koçinaj, Dardan

Rheumatic disorders can be associated with pericarditis, but severe forms of pericarditis are rare. The aim of this observational study was to evaluate pericardial features in patients with different rheumatic diseases. Thirty-five patients hospitalized at the Clinic of Rheumatology, University Clinical Center of Kosovo, from October 1 to October 21, 2014 were included in the study. Demographic data, history, laboratory, ECG, and echocardiography data, with special emphasis on the analysis of the pericardium, were obtained from each patient. Echocardiography was especially focused on the amount of pericardial fluid and pericardial thickness in the posterior wall of the heart. Mean patient age was 51.5 ± 13.8 years. 65.7% of the patients were women. Out of the patients that we analyzed, 88.6% had an inflammatory rheumatologic disease. 11.3% of the patients had mild symptoms, in 68.7% the symptoms were moderate, and in 20% severe. In all patients, pericardial hyperechogenicity was marked, with a mean pericardial thickness of 4.68 ± 1.66 mm. Pericardial effusion in a small amount was present in 57.1% of patients, with a mean pericardial fluid amount of 3.3 ± 1.9 mm. The severity of rheumatic disease had a positive and significant correlation with the presence of pericardial effusion (r= 0.29, p=0.04) and its amount (r= 0.28, p=0.05). The patients had not been aware of the pericardial involvement and did not have any clinical symptoms. In conclusion, in this short-term small observational study pericardial changes were a frequent finding in the rheumatology patients. In general, the pericarditis was subclinical and with small amounts of effusion. The disease activity of rheumatic disorders can be associated with pericarditis. Further studies with larger samples of patients and of longer duration are needed to further explore this issue.

Comparative hygienic assessment of active ingredients content in the air environment after treatment of cereal spiked crops by combined fungicides.

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Kondratiuk, Mykola; Blagaia, Anna; Pelo, Ihor

2018-01-01

Introduction: The quality of the air environment significantly affects the health of the population. Chemical plant protection products in the spring and summer time may be the main pollutants of the air environment in rural areas. Chemical plant protection products are dangerous substances of anthropogenic origin. If applying pesticides in high concentrations, the risk of poisoning by active ingredients of pesticide preparations in workers directly contacting with it increases. The aim: Comparative hygienic assessment of active ingredients content in the air environment after treatment of cereal spiked crops by combined fungicides was the aim of the work. Materials and methods: Active ingredients of the studied combined fungicides, samples of air, and swabs from workers' skin and stripes from overalls were materials of the research. Methods of full-scale in-field hygienic experiment, gas-liquid chromatography, high-performance liquid chromatography, as well as statistical and bibliographic methods were used in the research. Results and conclusions: Active ingredients of the studied combined fungicides were not detected in the working zone air and atmospheric air at the levels exceeding the limits of its detection by appropriate chromatography methods. Findings confirmed the air environment safety for agricultural workers and rural population if studied combined fungicides are applied following the hygienically approved suggested application rates and in accordance of good agricultural practice rules. However the possible complex risk for workers after certain studied fungicides application may be higher than acceptable due to the elevated values for dermal effects. The complex risk was higher than acceptable in еру case of aerial spraying of both studied fungicides, meanwhile only one combination of active ingredients revealed possible risk for workers applying fungicides by rod method of cereal spiked crops treatment.

Active ingredients in Chinese medicines promoting blood circulation as Na+/K+ -ATPase inhibitors.

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Chen, Ronald J Y; Jinn, Tzyy-rong; Chen, Yi-ching; Chung, Tse-yu; Yang, Wei-hung; Tzen, Jason T C

2011-02-01

The positive inotropic effect of cardiac glycosides lies in their reversible inhibition on the membrane-bound Na(+)/K(+)-ATPase in human myocardium. Steroid-like compounds containing a core structure similar to cardiac glycosides are found in many Chinese medicines conventionally used for promoting blood circulation. Some of them are demonstrated to be Na(+)/K(+)-ATPase inhibitors and thus putatively responsible for their therapeutic effects via the same molecular mechanism as cardiac glycosides. On the other hand, magnesium lithospermate B of danshen is also proposed to exert its cardiac therapeutic effect by effectively inhibiting Na(+)/K(+)-ATPase. Theoretical modeling suggests that the number of hydrogen bonds and the strength of hydrophobic interaction between the effective ingredients of various medicines and residues around the binding pocket of Na(+)/K(+)-ATPase are crucial for the inhibitory potency of these active ingredients. Ginsenosides, the active ingredients in ginseng and sanqi, substantially inhibit Na(+)/K(+)-ATPase when sugar moieties are attached only to the C-3 position of their steroid-like structure, equivalent to the sugar position in cardiac glycosides. Their inhibitory potency is abolished, however, when sugar moieties are linked to C-6 or C-20 position of the steroid nucleus; presumably, these sugar attachments lead to steric hindrance for the entrance of ginsenosides into the binding pocket of Na(+)/K(+)-ATPase. Neuroprotective effects of cardiac glycosides, several steroid-like compounds, and magnesium lithospermate B against ischemic stroke have been accordingly observed in a cortical brain slice-based assay model, and cumulative data support that effective inhibitors of Na(+)/K(+)-ATPase in the brain could be potential drugs for the treatment of ischemic stroke.

How active ingredient localisation in plant tissues determines the targeted pest spectrum of different chemistries

DEFF Research Database (Denmark)

Buchholz, Anke; Trapp, Stefan

2016-01-01

information sets revealed that the intracellular localisation of active ingredients determines the performance of test compounds against different target pests because of different feeding behaviours: mites feed on mesophyll, and aphids and whiteflies mostly in the vascular system. Polar compounds have a slow...

[Pain in Spanish rheumatology outpatient offices: EPIDOR epidemiological study].

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Gamero Ruiz, F; Gabriel Sánchez, R; Carbonell Abello, J; Tornero Molina, J; Sánchez-Magro, I

2005-04-01

To establish the prevalence and characteristics of rheumatologic pain in Spanish adult population cared in specialized rheumatology offices. Cross selection study in a population of patients cared in rheumatology offices of public Spanish hospitals. 1,134 patients selected through random sampling based on waiting lists of patients, during a period of 1 week, in rheumatology offices of each participating hospital. MAIN OUTCOMES OF THE STUDY: Reason behind the consultation (a new patient [NP] or a patient for revision [RP]), characteristics of the patient (sex, age, habits [alcohol/tobacco], marital status), location, type, intensity, duration, tolerance and management of pain; treatment (pharmacological or non-pharmacological) carried out; satisfaction with the treatment; and association with fibromyalgia. The prevalence of pain in NP was 98.6% and in RP 95.1%, with a global prevalence of 96%, predominating mainly in adult sedentary women with fibromyalgia. The frequency of acute pain was 20.9% and this of chronic pain 79.1% [corrected] The prevalence of fibromyalgia was 12% (2.2% in men, and 15.5% in women). The most prevalent pattern of current dominant pain was this of the mechanical type. More frequent associated pathologies were: hypertension (21.7%), depression (14.4%), gastrointestinal diseases (13.8%) and anxiety (13.4%). All variables analyzed in the study showed changes according to age, sex, and type of patient (NP or RP). Most used treatment was pharmacological; more than 57.6% of patients were receiving NSAIDs. In NP, medical prescriber of the treatment was first the general practitioner (56.1%) followed by the rheumatologist (14.1%); in PR the first one was the rheumatologist (69.9%) followed by the general practitioner (16.5%). Our results show that the prevalence of the rheumatologic pain is very high, predominating mainly in adult women with fibromyalgia. Pain location, intensity, and type, associated pathology, and treatment vary according to age

Grapefruit-felodipine interaction: effect of unprocessed fruit and probable active ingredients.

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Bailey, D G; Dresser, G K; Kreeft, J H; Munoz, C; Freeman, D J; Bend, J R

2000-11-01

To determine whether unprocessed grapefruit can cause a drug interaction, whether the active ingredients are naturally occurring, and whether specific furanocoumarins or flavonoids are involved. The oral pharmacokinetics of felodipine and its dehydrofelodipine metabolite were determined after administration of felodipine 10 mg extended-release tablet with 250 mL commercial grapefruit juice, homogenized grapefruit segments, or extract of segment-free parts equivalent to one unprocessed fruit or water in a randomized four-way crossover study. Inhibition of recombinant CYP3A4 by furanocoumarins (bergamottin, 6',7'-epoxybergamottin, 6',7'-dihydroxybergamottin) and flavonoids (naringenin optical isomers) was determined. Furanocoumarin and naringenin precursor (naringin) concentrations were measured in each grapefruit treatment. Felodipine AUC with commercial grapefruit juice, grapefruit segments, or grapefruit extract was on average 3-fold higher than that with water. Felodipine peak concentration was higher, but the half-life was unchanged. The dehydrofelodipine/felodipine AUC ratio was reduced. The furanocoumarins produced mechanism-based and competitive inhibition of CYP3A4. Bergamottin was the most potent mechanism-based inhibitor. Naringenin isomers produced only competitive inhibition. Bergamottin, 6',7'-dihydroxybergamottin, and naringin concentrations varied among grapefruit treatments but were sufficient to inhibit markedly in vitro CYP3A4 activity. Unprocessed grapefruit can cause a drug interaction with felodipine. The active ingredients are naturally occurring in the grapefruit. Bergamottin is likely important in drug interactions with commercial grapefruit juice. 6',7'-Dihydroxybergamottin and naringin may be more important in grapefruit segments because they are present in higher concentrations. Any therapeutic concern for a drug interaction with commercial grapefruit juice should now be extended to include whole fruit and possibly confectioneries made

[Complicated gastroduodenal ulcers in rheumatology patients].

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Barashkov, V G; Shemerovskaia, T G; Sergeev, P V; Bokovanov, V E

1998-01-01

An analysis of observations of 250 patients with different rheumatological diseases has shown that 18% of the patients had ulcer disease with complications. The greatest risk of bleedings and perforations took place during the first year of treatment with nonsteroidal antiinflammatory drugs. The main risk factors of complications were determined. They are: male sex, high parameters of gastric secretion.

The Role of Biologically Active Ingredients from Natural Drug Treatments for Arrhythmias in Different Mechanisms.

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Li, Jie; Hu, Dan; Song, Xiaoli; Han, Tao; Gao, Yonghong; Xing, Yanwei

2017-01-01

Arrhythmia is a disease that is caused by abnormal electrical activity in the heart rate or rhythm. It is the major cause of cardiovascular morbidity and mortality. Although several antiarrhythmic drugs have been used in clinic for decades, their application is often limited by their adverse effects. As a result, natural drugs, which have fewer side effects, are now being used to treat arrhythmias. We searched for all articles on the role of biologically active ingredients from natural drug treatments for arrhythmias in different mechanisms in PubMed. This study reviews 19 natural drug therapies, with 18 active ingredient therapies, such as alkaloids, flavonoids, saponins, quinones, and terpenes, and two kinds of traditional Chinese medicine compound (Wenxin-Keli and Shensongyangxin), all of which have been studied and reported as having antiarrhythmic effects. The primary focus is the proposed antiarrhythmic mechanism of each natural drug agent. Conclusion . We stress persistent vigilance on the part of the provider in discussing the use of natural drug agents to provide a solid theoretical foundation for further research on antiarrhythmia drugs.

The United States rheumatology workforce: supply and demand, 2005-2025.

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Deal, Chad L; Hooker, Roderick; Harrington, Timothy; Birnbaum, Neal; Hogan, Paul; Bouchery, Ellen; Klein-Gitelman, Marisa; Barr, Walter

2007-03-01

To develop and apply a model that allows prediction of current and future supply and demand for rheumatology services in the US. A supply model was developed using the age and sex distribution of current physicians, retirement and mortality rates, the number of fellowship slots and fill rates, and practice patterns of rheumatologists. A Markov projection model was used to project needs in 5-year increments from 2005 to 2025. The number of rheumatologists for adult patients in the US in 2005 is 4,946. Male and female rheumatologists are equally distributed up to age 44; above age 44, men predominate. The percent of women in adult rheumatology is projected to increase from 30.2% in 2005 to 43.6% in 2025. The mean number of visits per rheumatologist per year is 3,758 for male rheumatologists and 2,800 for female rheumatologists. Assuming rheumatology supply and demand are in equilibrium in 2005, the demand for rheumatologists in 2025 is projected to exceed supply by 2,576 adult and 33 pediatric rheumatologists. The primary factors in the excess demand are an aging population which will increase the number of people with rheumatic disorders, growth in the Gross Domestic Product, and flat rheumatology supply due to fixed numbers entering the workforce and to retirements. The productivity of younger rheumatologists and women, who will make up a greater percentage of the future workforce, may also have important effects on supply. Unknown effects that could influence these projections include technology advances, more efficient practice methods, changes in insurance reimbursements, and shifting lifestyles. Current data suggest that the pediatric rheumatology workforce is experiencing a substantial excess of demand versus supply. Based on assessment of supply and demand under current scenarios, the demand for rheumatologists is expected to exceed supply in the coming decades. Strategies for the profession to adapt to this changing health care landscape include increasing

Current provision of rheumatology education for undergraduate nursing, occupational therapy and physiotherapy students in the UK.

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Almeida, C; Clarke, B; O'Brien, A; Hammond, A; Ryan, S; Kay, L; Hewlett, S

2006-07-01

Rheumatological conditions are common and all health professionals (HPs) therefore need sufficient knowledge and skills to manage patients safely and effectively. The aim of this study was to examine current undergraduate education in rheumatology for HPs in the UK. A questionnaire was sent to curriculum organizers and clinical placement officers for all undergraduate courses in adult nursing, occupational therapy (OT) and physiotherapy (PT) in the UK to ascertain the nature and amount of rheumatology theory and clinical exposure provided. Of the 47 adult nursing, 26 OT and 30 PT undergraduate courses surveyed, 85-90% responded. Overall, rheumatology teaching is 5-10 h over 3 yr. Nursing students receive moderate/in-depth teaching on rheumatoid arthritis (RA) in only 52% of courses (OT 91%, PT 96%) and on osteoarthritis (OA) in 63% (OT 91%, PT 92%). Clinical experience of RA is probably/definitely available in only 56% of nursing courses (OT 72%, PT 88%), with similar results in OA. Overall, nursing students receive the least rheumatology exposure, particularly in psychosocial issues and symptom management, while PT students receive the most. OT students have limited opportunities for clinical exposure to psychosocial and joint protection issues. Use of local rheumatology clinical HP experts is variable (18-93%) and cross-disciplinary exposure is limited (0-36%). Many educators consider their rheumatology training to be insufficient (nursing 50%, PT 42%, OT 24%). Rheumatology training for undergraduate HPs is limited in key areas and often fails to take advantage of local clinical expertise, with nursing students particularly restricted. Clinical HP experts should consider novel methods of addressing these shortfalls within the limited curriculum time available.

Anti-cancer activities of Ganoderma lucidum: active ingredients and pathways

Directory of Open Access Journals (Sweden)

Chi H.J. Kao

2013-02-01

Full Text Available ABSTRACTGanoderma lucidum, commonly referred to as Lingzhi, has been used in Asia for health promotion for centuries. The anti-cancer effects of G. lucidum have been demonstrated in both in vitro and in vivo studies. In addition, the observed anti-cancer activities of Ganoderma have prompted its usage by cancer patients alongside chemotherapy.The main two bioactive components of G. lucidum can be broadly grouped into triterpenes and polysaccharides. Despite triterpenes and polysaccharides being widely known as the major active ingredients, the different biological pathways by which they exert their anti-cancer effect remain poorly defined. Therefore, understanding the mechanisms of action may lead to more widespread use of Ganoderma as an anti-cancer agent.The aim of this paper is to summarise the various bioactive mechanisms that have been proposed for the anti-cancer properties of triterpenes and polysaccharides extracted from G. lucidum. A literature search of published papers on NCBI with keywords “Ganoderma” and “cancer” was performed. Among those, studies which specifically examined the anti-cancer activities of Ganoderma triterpenes and polysaccharides were selected to be included in this paper.We have found five potential mechanisms which are associated with the anti-cancer activities of Ganoderma triterpenes and three potential mechanisms for Ganoderma polysaccharides. In addition, G. lucidum has been used in combination with known anti-cancer agents to improve the anti-cancer efficacies. This suggests Ganoderma’s bioactive pathways may compliment that of anti-cancer agents. In this paper we present several potential anti-cancer mechanisms of Ganoderma triterpenes and polysaccharides which can be used for the development of Ganoderma as an anti-cancer agent.

Role of Tai Chi in the treatment of rheumatologic diseases.

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Wang, Chenchen

2012-12-01

Rheumatologic diseases (e.g., fibromyalgia, osteoarthritis, and rheumatoid arthritis) consist of a complex interplay between biologic and psychological aspects, resulting in therapeutically challenging chronic conditions to control. Encouraging evidence suggests that Tai Chi, a multi-component Chinese mind-body exercise, has multiple benefits for patients with a variety of chronic disorders, particularly those with musculoskeletal conditions. Thus, Tai Chi may modulate complex factors and improve health outcomes in patients with chronic rheumatologic conditions. As a form of physical exercise, Tai Chi enhances cardiovascular fitness, muscular strength, balance, and physical function. It also appears to be associated with reduced stress, anxiety, and depression, as well as improved quality of life. Thus, Tai Chi can be safely recommended to patients with fibromyalgia, osteoarthritis, and rheumatoid arthritis as a complementary and alternative medical approach to improve patient well-being. This review highlights the current body of knowledge about the role of this ancient Chinese mind-body medicine as an effective treatment of rheumatologic diseases to better inform clinical decision-making for our patients.

Rheumatology training experience across Europe: analysis of core competences.

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Sivera, Francisca; Ramiro, Sofia; Cikes, Nada; Cutolo, Maurizio; Dougados, Maxime; Gossec, Laure; Kvien, Tore K; Lundberg, Ingrid E; Mandl, Peter; Moorthy, Arumugam; Panchal, Sonia; da Silva, José A P; Bijlsma, Johannes W

2016-09-23

The aim of this project was to analyze and compare the educational experience in rheumatology specialty training programs across European countries, with a focus on self-reported ability. An electronic survey was designed to assess the training experience in terms of self-reported ability, existence of formal education, number of patients managed and assessments performed during rheumatology training in 21 core competences including managing specific diseases, generic competences and procedures. The target population consisted of rheumatology trainees and recently certified rheumatologists across Europe. The relationship between the country of training and the self-reported ability or training methods for each competence was analyzed through linear or logistic regression, as appropriate. In total 1079 questionnaires from 41 countries were gathered. Self-reported ability was high for most competences, range 7.5-9.4 (0-10 scale) for clinical competences, 5.8-9.0 for technical procedures and 7.8-8.9 for generic competences. Competences with lower self-reported ability included managing patients with vasculitis, identifying crystals and performing an ultrasound. Between 53 and 91 % of the trainees received formal education and between 7 and 61 % of the trainees reported limited practical experience (managing ≤10 patients) in each competence. Evaluation of each competence was reported by 29-60 % of the respondents. In adjusted multivariable analysis, the country of training was associated with significant differences in self-reported ability for all individual competences. Even though self-reported ability is generally high, there are significant differences amongst European countries, including differences in the learning structure and assessment of competences. This suggests that educational outcomes may also differ. Efforts to promote European harmonization in rheumatology training should be encouraged and supported.

Derivation of general expression for variance in difference in the contents of active ingredient in raw material as determined at seller's and purchaser's site

International Nuclear Information System (INIS)

Narasimha Murty, B.; Prahlad, B.

2012-01-01

Material supply from a supplier to purchaser involve weighing of the material at both the sites. It is always of interest to know whether there is any difference in the weight of the material and more importantly in the weight of the active ingredient supplied and received. This paper describes the derivation of general expression for variance in difference in the contents of active ingredient in raw material as determined at the seller's and purchaser's site. The derived expression for the variance in difference in the content of active ingredient as determined at seller's and purchaser's site is a generic one though its application is demonstrated for two raw materials

Co-crystallization: An approach to improve the performance characteristics of active pharmaceutical ingredients

OpenAIRE

Jignasa Ketan Savjani

2015-01-01

Co-crystal chemistry has recently attracted supramolecular scientists. Co-crystals are comprising of hydrogen boding assembly between different molecules. Many issues related to performance characteristics of an active pharmaceutical ingredient (API) can be resolved using co-crystallization approach. Proper understanding of crystal structure of an API is required for successful formation of co-crystals with the selected co-former. This review article focus on explanation about co-crystals, in...

Analysis of the main active ingredients and bioactivities of essential oil from Osmanthus fragrans Var. thunbergii using a complex network approach.

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Wang, Le; Tan, Nana; Hu, Jiayao; Wang, Huan; Duan, Dongzhu; Ma, Lin; Xiao, Jian; Wang, Xiaoling

2017-12-28

Osmanthus fragrans has been used as folk medicine for thousands of years. The extracts of Osmanthus fragrans flowers were reported to have various bioactivities including free radical scavenging, anti-inflammation, neuroprotection and antitumor effects. However, there is still lack of knowledge about its essential oil. In this work, we analyzed the chemical composition of the essential oil from Osmanthus fragrans var. thunbergii by GC-MS. A complex network approach was applied to investigate the interrelationships between the ingredients, target proteins, and related pathways for the essential oil. Statistical characteristics of the networks were further studied to explore the main active ingredients and potential bioactivities of O. fragrans var. thunbergii essential oil. A total of 44 ingredients were selected from the chemical composition of O. fragrans var. thunbergii essential oil, and that 191 potential target proteins together with 70 pathways were collected for these compounds. An ingredient-target-pathway network was constructed based on these data and showed scale-free property as well as power-law degree distribution. Eugenol and geraniol were screened as main active ingredients with much higher degree values. Potential neuroprotective and anti-tumor effect of the essential oil were also found. A core subnetwork was extracted from the ingredient-target-pathway network, and indicated that eugenol and geraniol contributed most to the neuroprotection of this essential oil. Furthermore, a pathway-based protein association network was built and exhibited small-world property. MAPK1 and MAPK3 were considered as key proteins with highest scores of centrality indices, which might play an important role in the anti-tumor effect of the essential oil. This work predicted the main active ingredients and bioactivities of O. fragrans var. thunbergii essential oil, which would benefit the development and utilization of Osmanthus fragrans flowers. The application of

Anti-tumor promoting potential of selected spice ingredients with antioxidative and anti-inflammatory activities: a short review.

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Surh, Young-Joon

2002-08-01

A wide variety of phenolic substances derived from spice possess potent antimutagenic and anticarcinogenic activities. Examples are curcumin, a yellow colouring agent, contained in turmeric (Curcuma longa L., Zingiberaceae), [6]-gingerol, a pungent ingredient present in ginger (Zingiber officinale Roscoe, Zingiberaceae) and capsaicin, a principal pungent principle of hot chili pepper (Capsicum annuum L, Solanaceae). The chemopreventive effects exerted by these phytochemicals are often associated with their antioxidative and anti-inflammatory activities. Cyclo-oxygenase-2 (COX-2) has been recognized as a molecular target of many chemopreventive as well as anti-inflammatory agents. Recent studies have shown that COX-2 is regulated by the eukaryotic transcription factor NF-kappaB. This short review summarizes the molecular mechanisms underlying chemopreventive effects of the aforementioned spice ingredients in terms of their effects on intracellular signaling cascades, particularly those involving NF-kappaB and mitogen-activated protein kinases.

On-spot rheumatology consultations in a multilevel geriatric hospital.

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Lubart, Emily; Leibovitz, Arthur; Shapir, Vadim; Segal, Refael

2014-01-01

Musculoskeletal and joint disorders are extremely common in the elderly. They directly affect mobility, gait stability, quality of life, and independence. To assess the nature of joint problems encountered in a geriatric inpatient population and evaluate the contribution of a rheumatologist. We reviewed the rheumatology consultation records that were conducted in a geriatric medical center over a 10 year period. A total of 474 consultations were held; most of these patients (86%) were hospitalized in the acute geriatric departments, 10% in the rehabilitation ward and 4% in the long-term care wards. Some patients were seen more than once. A rheumatologic joint problem was the main reason for hospitalization in 53% of these patients. Monoarthritis was the most frequent complaint (50%), followed by pauciarticular arthritis (two to five joints) in 30% of patients. Arthrocentesis, diagnostic and therapeutic, was performed in 225 patients, most of them in knee joints (81%). The most frequent diagnosis was osteoarthritis with acute exacerbation (28%), followed by gout (18%), pseudo-gout (9%) and rheumatoid arthritis (9%). In 86 cases (18%) the diagnosis was a non-specific rheumatologic problem: arthralgia, nonspecific generalized pain, or fibromyalgia. Prompt and appropriate evaluation, as well as arthrocentesis and treatment initiation, including local injections, were made possible by the presence of an in-house rheumatologist.

Barriers and Facilitators of Mentoring for Trainees and Early Career Investigators in Rheumatology Research: Current State, Identification of Needs, and Road Map to an Inter-Institutional Adult Rheumatology Mentoring Program.

Science.gov (United States)

Ogdie, Alexis; Sparks, Jeffrey A; Angeles-Han, Sheila T; Bush, Kathleen; Castelino, Flavia V; Golding, Amit; Jiang, Yihui; Kahlenberg, J Michelle; Kim, Alfred H J; Lee, Yvonne C; Machireddy, Kirthi; Ombrello, Michael J; Shah, Ami A; Wallace, Zachary S; Nigrovic, Peter A; Makris, Una E

2018-03-01

To determine perceived barriers and facilitators to effective mentoring for early career rheumatology investigators and to develop a framework for an inter-institutional mentoring program. Focus groups or interviews with rheumatology fellows, junior faculty, and mentors were conducted, audiorecorded, and transcribed. Content analysis was performed using NVivo software. Themes were grouped into categories (e.g., mentor-mentee relationship, barriers, and facilitators of a productive relationship). Rheumatology fellows and early career investigators were also surveyed nationwide to identify specific needs to be addressed through an inter-institutional mentoring program. Twenty-five individuals participated in focus groups or interviews. Attributes of the ideal mentee-mentor relationship included communication, accessibility, regular meetings, shared interests, aligned goals, and mutual respect. The mentee should be proactive, efficient, engaged, committed, focused, accountable, and respectful of the mentor's time. The mentor should support/promote the mentee, shape the mentee's goals and career plan, address day-to-day questions, provide critical feedback, be available, and have team leadership skills. Barriers included difficulty with career path navigation, gaining independence, internal competition, authorship, time demands, funding, and work-life balance. Facilitators of a successful relationship included having a diverse network of mentors filling different roles, mentor-mentee relationship management, and confidence. Among 187 survey respondents, the primary uses of an inter-institutional mentoring program were career development planning and oversight, goal-setting, and networking. In this mixed-methods study, tangible factors for optimizing the mentor-mentee relationship were identified and will inform the development of an adult rheumatology inter-institutional mentoring program. © 2017, American College of Rheumatology.

21 CFR 358.710 - Active ingredients for the control of dandruff, seborrheic dermatitis, or psoriasis.

Science.gov (United States)

2010-04-01

..., seborrheic dermatitis, or psoriasis. 358.710 Section 358.710 Food and Drugs FOOD AND DRUG ADMINISTRATION... Psoriasis § 358.710 Active ingredients for the control of dandruff, seborrheic dermatitis, or psoriasis. The... psoriasis. (1) Coal tar, 0.5 to 5 percent. When a coal tar solution, derivative, or fraction is used as the...

[The G-DRG system 2008. Relevant changes for rheumatology].

Science.gov (United States)

Fiori, W; Lakomek, H-J; Buscham, K; Lehmann, H; Liman, W; Fuchs, A-K; Hülsemann, J L; Roeder, N

2008-05-01

The G-DRG system 2008 once again brings many changes to rheumatological departments in Germany. The following article presents the main general and specific changes in the G-DRG system, as well as in the classification systems for diagnoses and procedures and in invoicing for 2008. Since the G-DRG system is only a tool for the redistribution of resources, every hospital needs to analyze the economic effects of the system by applying the G-DRG transition grouper to its own cases. Depending on their clinical focus, rheumatological departments may experience positive or negative effects from the system's application. The strain placed on hospitals by the inadequate funding of increased costs needs to be assessed separately from the effects of redistribution by the G-DRG system.

An audit of influenza and pneumococcal vaccination in rheumatology outpatients

Directory of Open Access Journals (Sweden)

Mitchell William S

2007-07-01

Full Text Available Abstract Background Influenza and pneumococcal vaccination are recommended for a number of clinical risk groups including patients treated with major immunosuppressant disease modifying anti-rheumatic drugs. Such immunisation is not only safe but immunogenic in patients with rheumatic diseases. We sought to establish dual vaccination rates and significant influencing factors amongst our hospital rheumatology outpatients. Method We audited a sample of 101 patients attending hospital rheumatology outpatient clinics on any form of disease modifying treatment by clinical questionnaire and medical record perusal. Further data were collected from the local immunisation coordinating agency and analysed by logistic regression modelling. Results Although there was a high rate of awareness with regard to immunisation, fewer patients on major immunosuppressants were vaccinated than patients with additional clinical risk factors against influenza (53% vs 93%, p Conclusion Influenza and pneumococcal immunisation is suboptimal amongst patients on current immunosuppressant treatments attending rheumatology outpatient clinics. Raising awareness amongst patients may not be sufficient to improve vaccination rates and alternative strategies such as obligatory pneumococcal vaccination prior to treatment initiation and primary care provider education need to be explored.

Proceedings from the 7th Annual International Society for Musculoskeletal Imaging in Rheumatology (ISEMIR) conference

DEFF Research Database (Denmark)

Troum, Orrin M; Pimienta, Olga L; Schmidt, Wolfgang A

2015-01-01

The International Society for Musculoskeletal Imaging in Rheumatology (ISEMIR) was founded in 2005 with the goal of discussing matters related to imaging in rheumatology, particularly, validation, education, and use in clinical practice and research. Because the field of musculoskeletal (MSK...

Modern psychometrics applied in rheumatology--a systematic review.

Science.gov (United States)

Siemons, Liseth; Ten Klooster, Peter M; Taal, Erik; Glas, Cees Aw; Van de Laar, Mart Afj

2012-10-31

Although item response theory (IRT) appears to be increasingly used within health care research in general, a comprehensive overview of the frequency and characteristics of IRT analyses within the rheumatic field is lacking. An overview of the use and application of IRT in rheumatology to date may give insight into future research directions and highlight new possibilities for the improvement of outcome assessment in rheumatic conditions. Therefore, this study systematically reviewed the application of IRT to patient-reported and clinical outcome measures in rheumatology. Literature searches in PubMed, Scopus and Web of Science resulted in 99 original English-language articles which used some form of IRT-based analysis of patient-reported or clinical outcome data in patients with a rheumatic condition. Both general study information and IRT-specific information were assessed. Most studies used Rasch modeling for developing or evaluating new or existing patient-reported outcomes in rheumatoid arthritis or osteoarthritis patients. Outcomes of principle interest were physical functioning and quality of life. Since the last decade, IRT has also been applied to clinical measures more frequently. IRT was mostly used for evaluating model fit, unidimensionality and differential item functioning, the distribution of items and persons along the underlying scale, and reliability. Less frequently used IRT applications were the evaluation of local independence, the threshold ordering of items, and the measurement precision along the scale. IRT applications have markedly increased within rheumatology over the past decades. To date, IRT has primarily been applied to patient-reported outcomes, however, applications to clinical measures are gaining interest. Useful IRT applications not yet widely used within rheumatology include the cross-calibration of instrument scores and the development of computerized adaptive tests which may reduce the measurement burden for both the patient

Antidotal or protective effects of Curcuma longa (turmeric) and its active ingredient, curcumin, against natural and chemical toxicities: A review.

Science.gov (United States)

Hosseini, Azar; Hosseinzadeh, Hossein

2018-03-01

Curcuma longa is a rhizomatous perennial herb that belongs to the family Zingiberaceae, native to South Asia and is commonly known as turmeric. It is used as herbal remedy due to the prevalent belief that the plant has medical properties. C. longa possesses different effects such as antioxidant, anti-tumor, antimicrobial, anti-inflammatory, wound healing, and gastroprotective activities. The recent studies have shown that C. longa and curcumin, its important active ingredient, have protective effects against toxic agents. In this review article, we collected in vitro and animal studies which are related to protective effects of turmeric and its active ingredient against natural and chemical toxic agents. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Policy challenges for the pediatric rheumatology workforce: Part I. Education and economics

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Henrickson Michael

2011-08-01

Full Text Available Abstract For children with rheumatic conditions, the available pediatric rheumatology workforce mitigates their access to care. While the subspecialty experiences steady growth, a critical workforce shortage constrains access. This three-part review proposes both national and international interim policy solutions for the multiple causes of the existing unacceptable shortfall. Part I explores the impact of current educational deficits and economic obstacles which constrain appropriate access to care. Proposed policy solutions follow each identified barrier. Challenges consequent to obsolete, limited or unavailable exposure to pediatric rheumatology include: absent or inadequate recognition or awareness of rheumatic disease; referral patterns that commonly foster delays in timely diagnosis; and primary care providers' inappropriate or outdated perception of outcomes. Varying models of pediatric rheumatology care delivery consequent to market competition, inadequate reimbursement and uneven institutional support serve as additional barriers to care. A large proportion of pediatrics residency programs offer pediatric rheumatology rotations. However, a minority of pediatrics residents participate. The current generalist pediatrician workforce has relatively poor musculoskeletal physical examination skills, lacking basic competency in musculoskeletal medicine. To compensate, many primary care providers rely on blood tests, generating referrals that divert scarce resources away from patients who merit accelerated access to care for rheumatic disease. Pediatric rheumatology exposure could be enhanced during residency by providing a mandatory musculoskeletal medicine rotation that includes related musculoskeletal subspecialties. An important step is the progressive improvement of many providers' fixed referral and laboratory testing patterns in lieu of sound physical examination skills. Changing demographics and persistent reimbursement disparities will

Active Ingredients of Instructional Coaching: Developing a Conceptual Framework. R2Ed Working Paper 2015-3

Science.gov (United States)

White, Andrew S.; Howell Smith, Michelle; Kunz, Gina M.; Nugent, Gwen C.

2015-01-01

Although researchers have explored the impact of instructional coaching and named possible elements believed essential to effective coaching, there has yet to emerge from the literature a coherent model of those essential elements ("active ingredients"). This qualitative study sought to identify those elements through a systematic…

Active pharmaceutical ingredients detected in herbal food supplements for weight loss samples on the Dutch market

NARCIS (Netherlands)

Reeuwijk, N.M.; Venhuis, B.J.; Kaste, de D.; Hoogenboom, L.A.P.; Rietjens, I.; Martena, M.J.

2014-01-01

Herbal food supplements claiming to reduce weight may contain active pharmacological ingredients (APIs) that can be used for the treatment of overweight and obesity. The aim of this study was to determine whether herbal food supplements for weight loss on the Dutch market contain APIs with weight

Improved training of house officers in a rheumatology consult service.

Science.gov (United States)

Mazzuca, S A; Brandt, K D; Katz, B P

1993-06-01

This study examined whether the clinical environment could be used to increase internal medicine house officers' adoption of care recommendations taught in a didactic conference. Subjects were 11 internal medicine house officers who served 6-week rheumatology elective rotations. At the start of each of four rotation periods, house officers attended a 1-hour conference in which periarticular rheumatic disorders associated with knee pain (anserine bursitis, pseudothrombophlebitis) and shoulder pain (bicipital tendinitis) were discussed. All house officers also practiced physical examination techniques on anatomic models simulating the disorders. During alternate rotation periods, reminder sheets were appended to the records of arthritis patients with histories of chronic knee or shoulder pain. The frequency with which house officers followed conference recommendations was documented by direct observation (6 house officers in 17 encounters with reminders, 5 house officers in 30 encounters without reminders). Specific questioning about a recent history of knee or shoulder pain and the performance of four of five recommended physical examination maneuvers were increased significantly by reminder sheets in patients' charts (P < 0.05 for all). Although rheumatology faculty often have limited options available to increase the number of house officer trainees or to intensify clinical activity, qualitative improvements within existing logistic parameters are feasible by assuring that the clinical environment (e.g., patient records) contains salient cues that will prompt desired actions.

Non-Hodgkin Lymphoma and Occupational Exposure to Agricultural Pesticide Chemical Groups and Active Ingredients: A Systematic Review and Meta-Analysis

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Leah Schinasi

2014-04-01

Full Text Available This paper describes results from a systematic review and a series of meta-analyses of nearly three decades worth of epidemiologic research on the relationship between non-Hodgkin lymphoma (NHL and occupational exposure to agricultural pesticide active ingredients and chemical groups. Estimates of associations of NHL with 21 pesticide chemical groups and 80 active ingredients were extracted from 44 papers, all of which reported results from analyses of studies conducted in high-income countries. Random effects meta-analyses showed that phenoxy herbicides, carbamate insecticides, organophosphorus insecticides and the active ingredient lindane, an organochlorine insecticide, were positively associated with NHL. In a handful of papers, associations between pesticides and NHL subtypes were reported; B cell lymphoma was positively associated with phenoxy herbicides and the organophosphorus herbicide glyphosate. Diffuse large B-cell lymphoma was positively associated with phenoxy herbicide exposure. Despite compelling evidence that NHL is associated with certain chemicals, this review indicates the need for investigations of a larger variety of pesticides in more geographic areas, especially in low- and middle-income countries, which, despite producing a large portion of the world’s agriculture, were missing in the literature that were reviewed.

[G-DRG system 2009: relevant changes for rheumatology].

Science.gov (United States)

Fiori, W; Liedtke-Dyong, A; Lakomek, H-J; Buscham, K; Lehmann, H; Liman, W; Fuchs, A-K; Bessler, F; Roeder, N

2009-08-01

The following article presents the main general and specific changes in the G-DRG (German diagnosis-related groups) system in terms of the classification systems for diagnoses and procedures as well as the billing process for 2009. Of fundamental relevance is the national weighting of the G-DRG I97Z (complex rheumatologic treatment), which up to now had to be negotiated individually by each hospital. Emphasis is also put on case auditing by the health insurers. Being primarily a tool for redistribution of resources, every hospital has to analyze the economic effects of the 2009 G-DRG system by applying the G-DRG transition grouper to its own cases. Depending on their clinical focus rheumatological departments may experience positive or negative consequences from the development. The strain imposed on hospitals by inadequate refunding of rising costs has to be assessed separately from the effects of redistribution by the G-DRG system.

What determines ingredient awareness of consumers? A study on ten functional food ingredients

NARCIS (Netherlands)

Bornkessel, S.; Bröring, S.; Omta, S.W.F.; Trijp, van J.C.M.

2014-01-01

Given the importance of consumer awareness of functional food ingredients for healthy food choices, the aim of this study is to explore consumers’ ingredient awareness and the determinants which influence the awareness about functional food ingredients. A sample of 200 German consumers was

The Role of Biologically Active Ingredients from Natural Drug Treatments for Arrhythmias in Different Mechanisms

OpenAIRE

Li, Jie; Hu, Dan; Song, Xiaoli; Han, Tao; Gao, Yonghong; Xing, Yanwei

2017-01-01

Arrhythmia is a disease that is caused by abnormal electrical activity in the heart rate or rhythm. It is the major cause of cardiovascular morbidity and mortality. Although several antiarrhythmic drugs have been used in clinic for decades, their application is often limited by their adverse effects. As a result, natural drugs, which have fewer side effects, are now being used to treat arrhythmias. We searched for all articles on the role of biologically active ingredients from natural drug t...

The prevalence of medical nomadism of the followed patients in rheumatology.

Science.gov (United States)

Boudali, Aziza; Bahiri, Rachid; Hmamouchi, Ihssane; Abouqal, Redouane; Abouqual, Redouane; Hajjaj Hassouni, Najia

2012-06-01

The nomads are defined as patients related to multiple practicians of the same speciality or different specialities for the same symptomatology during a certain period. The objectives of this investigation were to evaluate the prevalence of medical nomadism of the followed patients in rheumatology and compare their profile with those patients followed in neurology and gastroenterology. A multicentric transverse study (September 2009-March 2010) was conducted in three departments of CHU Ibn Sina Rabat-Salé, Morocco; rheumatology, gastroenterology and neurology. Only patients seen in external consultations were included. Patients' socio-economic and demographic background (familial status, instruction level, monthly revenue, social assistance) were recorded, as well as the clinical parameters related to the pathology (pathology, duration of the illness, diagnosis final time). A questionnaire containing variables on the patients' state concerning diagnosis, satisfaction degree of the patients and other variables evaluated the notion of taking medication and the practice of alternative medicine. Medical nomadism has been defined by the consultation for the same symptomatology of three different practicians, either of the same speciality or of different specialities during the study period of 6 months. There were 250 patients included in this study (150 patients in rheumatology, 50 in gastroenterology and 50 in neurology), the mean age was 46 ± 13 years and females dominated (65.6%). The average duration of the evolution was 7 ± 5 years, 35% of the patients were illiterate, 30% had a primary school education, 22% had a secondary school education and 13% had a university-level education. Sixty-two percent of the patients were jobless, 27% were workers, 9% were the functionary and 2% were the based liberal. Fifty-six percent had no social assistance. Rheumatoid arthritis and degenerative pathology were the most frequent diagnoses in rheumatology, being 20% and

Studies on free-radical scavenging activity and identification of active ingredients of different plant crude extracts of Mentha piperita collected from Sur, Sultanate of Oman

Institute of Scientific and Technical Information of China (English)

Mohammad Amzad Hossain; Aqeela Said Hamed AL Orimi; Afaf Mohammed Weli; Qasim Al-Riyami; Jamal Nasser Al-Sabahi

2014-01-01

Objective: To determine free radical scavenging activity and active chemical ingredients of different plant crude extracts of Mentha piperita (M. piperita). Methods: The dried powder leaves of M. piperita were extracted with polar organic solvent by Soxhlet extractor. The crude extract and its fractions of hexane, chloroform, ethyl acetate and butanol crude extracts were prepared. The antioxidant activity of different crude extracts from M. piperita was carried out by DPPH method with minor modification, and the active chemical ingredients of different plant crude extracts of M. piperita were analyzed by gas chromatography-mass spectrometry (GC-MS). Results: Qualitative analysis of different polarities crude extracts by GC-MS found different types of active organic compounds. The antioxidant activity of different crude extracts were found to be in the order of chloroform extract> butanol extract> ethyl acetate extract> hexane extract>methanol extract. Majority identified compounds in the plant crude extracts by GC-MS were biologically active. Conclusions: Therefore, the isolation, purification, identification and characterization of bioactive compounds from various crude extracts of M. piperita might have ecological significance.

[Max Hirsch founder of rheumatology in Germany: banished and murdered].

Science.gov (United States)

Keitel, W

2014-08-01

The Jewish physician and scientist Dr. Max Hirsch (1875-1941) made a substantial contribution to consolidation of the foundations of his professional discipline, balneology, and in particular developed the social aspects. He recognized the economic significance of diseases of the musculoskeletal system very early on and gathered important ideas from abroad. Together with the department head in the Prussian Ministry of Education and Cultural Affairs, the Privy Councillor Prof. Dr. Eduard Dietrich and later alone, he was editor of various balneological journals. He worked as general secretary of the Deutsche Gesellschaft für Rheumatologie (German Society of Rheumatology) from the beginning of its existence (1927) and created the publication series Veröffentlichungen der Deutschen Gesellschaft für Rheumabekämpfung (Publications of the German Society against Rheumatism) and Rheuma-Jahrbuch (Annual review of rheumatology) in 1929, 1930 and 1931 and organized seven rheumatology congresses up to 1933. After the accession to power of the National Socialists, Max Hirsch and Eduard Dietrich were deposed from office. Hirsch emigrated to Latvia via Switzerland and the Soviet Union with his wife and one son where they were murdered in the course of the Jewish pogrom. The second son escaped with his family to Sweden.

[Advances in research on regulatory effects of chemical ingredients of traditional Chinese medicine on UDP-glucuronosyltransferase 1A1 expression and activity].

Science.gov (United States)

Xin, Hong; Xu, Wei

2017-02-01

Uridine 5'-diphosphate-glucuronosyltransferase1A1(UGT1A1) is a major phase Ⅱ metabolism enzyme, responsible for glucuronidation and elimination of drugs and endogenous compounds, playing a vital role in sustaining endogenous metabolism balance. Therefore, changes in UGT1A1 expression/functional can not only cause adverse clinical drug/herbs-drug interactions, but also lead to metabolic disorder of endogenous substances, causing high blood bilirubin, bilirubin encephalopathy and liver injury, as well as other side effects. To date, many studies have found that a variety of clinical medicines and medicinal ingredients can regulate UGT1A1 activity. This article would summarize the advances in research on drug metabolism and toxicology in domestic and foreign literature, and investigate the regulatory effects of different types of traditional Chinese medicine(TCM) ingredients(such as flavonoids, coumarins, alkaloids) on UGT1A1 expression and activity, including inhibitory effect of TCM chemical ingredients on UGT1A1 and effect of TCM chemical ingredients on UGT1A1. It is hoped that this review could provide depth understanding and certain reference for the interaction between chemical ingredients of TCM and UGT1A1, which is of great significance to guide the rational clinical use in future. Copyright© by the Chinese Pharmaceutical Association.

INTRAVENOUS IMMUNOGLOBULIN IN PEDIATRIC RHEUMATOLOGY PRACTICE

Directory of Open Access Journals (Sweden)

E. I. Alexeeva

2015-01-01

Full Text Available Modern successful treatment of rheumatic diseases is impossible without the use of intravenous immunoglobulin. The use of intravenous immunoglobulin is based on strict indications developed as a result of long-term multicenter controlled studies. The article highlights the issues of using immunoglobulin in pediatric rheumatology practice, and provides the review of literature with the results from the evaluation of the efficiency of intravenous immunoglobulin confirming the efficiency of the drug only for certain rheumatic diseases. 

ANTIMICROBIAL AND SYNERGISTIC ACTIVITY OF INGREDIENTS OF BETEL QUID ON ORAL AND ENTERIC PATHOGENS

OpenAIRE

Niraj A Ghanwate; Prashant Thakare

2012-01-01

In this study, antimicrobial and synergistic activity of ingredients of betel quid i.e. kattha, lime, betel leaf, betel nut, cardamom, clove and fennel seeds was tested against microbial population of oral cavity and four enteric pathogens namely Staphylococcus aureus, Salmonella typhi, Escherichia coli and Shigell flexneri. For this purpose two methods were used. Pour plate method was used for calculating the reduction in microbial population in oral cavity and disk diffusion method was u...

Development and validation of stability indicating UPLC assay method for ziprasidone active pharma ingredient

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Sonam Mittal

2012-01-01

Full Text Available Background: Ziprasidone, a novel antipsychotic, exhibits a potent highly selective antagonistic activity on D2 and 5HT2A receptors. Literature survey for ziprasidone revealed several analytical methods based on different techniques but no UPLC method has been reported so far. Aim: Aim of this research paper is to present a simple and rapid stability indicating isocratic, ultra performance liquid chromatographic (UPLC method which was developed and validated for the determination of ziprasidone active pharmaceutical ingredient. Forced degradation studies of ziprasidone were studied under acid, base, oxidative hydrolysis, thermal stress and photo stress conditions. Materials and Methods: The quantitative determination of ziprasidone drug was performed on a Supelco analytical column (100×2.1 mm i.d., 2.7 ΅m with 10 mM ammonium acetate buffer (pH: 6.7 and acetonitrile (ACN as mobile phase with the ratio (55:45-Buffer:ACN at a flow rate of 0.35 ml/ min. For UPLC method, UV detection was made at 318 nm and the run time was 3 min. Developed UPLC method was validated as per ICH guidelines. Results and Conclusion: Mild degradation of the drug substance was observed during oxidative hydrolysis and considerable degradation observed during basic hydrolysis. During method validation, parameters such as precision, linearity, ruggedness, stability, robustness, and specificity were evaluated, which remained within acceptable limits. Developed UPLC method was successfully applied for evaluating assay of Ziprasidone active Pharma ingredient.

Viewpoints of dentists on the use of bisphosphonates in rheumatology patients.

Science.gov (United States)

Daron, Coline; Deschaumes, Christophe; Soubrier, Martin; Mathieu, Sylvain

2018-02-15

Alhough typically prescribed in oncology, bisphosphonates (BPs) are also employed in rheumatology, particularly for the treatment of osteoporosis, sometimes resulting in complications, such as osteonecrosis of the jaw. Because of different opinions between rheumatologists and dentists on BP use, this study aimed to assess the views of dentists regarding administration of BPs in rheumatology. A questionnaire was sent to 880 dentists from the Auvergne region of France to determine their views on BP treatment. We obtained 382 (43.4%) responses and analysed 376 (58.7% men). In total, 156 (41.5%) of the responders analysed had attended an in-service training course (ISTC) on the topic. A total of 237 (63.0%) systematically inquired as to whether their patients were undergoing BP treatment; this proportion was higher among those who had been practicing for fewer than 10 years (P ISTC (62.6% vs. 50.7%; P < 0.03). Dentists feel ill at ease providing dental surgery to patients receiving BPs. Closer collaboration and better information-sharing between rheumatologists and dentists is necessary to facilitate the administration of BPs in rheumatology. © 2018 FDI World Dental Federation.

Standardization of the Manufacturing Process of Bee Venom Pharmacopuncture Containing Melittin as the Active Ingredient

OpenAIRE

Yoonmi Lee; Sung-Geun Kim; In-Su Kim; Hwa-Dong Lee

2018-01-01

Background. Pharmacopuncture is a unique treatment in oriental medicine that combines chemical stimulation with conventional acupuncture. However, there are no standardized methods for preparing the herbal medicines used in pharmacopuncture, and it is not clear whether the active ingredients are safe and stable. Several studies have investigated nonstandardized preparation processes, but few investigations have addressed safety and preparation methods. Pharmacopuncture may provide an alternat...

Pharmacology of biosimilar candidate drugs in rheumatology: a literature review.

Science.gov (United States)

Araújo, F; Cordeiro, I; Teixeira, F; Gonçalves, J; Fonseca, J E

2014-01-01

To review current evidence concerning pharmacology of biosimilar candidates to be used in rheumatology. A PubMed search up to August 2013 was performed using relevant search terms to include all studies assessing pharmacological properties of biosimilar candidates to be used in rheumatology. Data on study characteristics, type of intervention, pharmacokinetics (PK), pharmacodynamics (PD) and bioequivalence ratios was extracted. Of 280 articles screened, 5 fulfilled our inclusion criteria. Two trials, PLANETAS and PLANETRA, compared CT-P13 and infliximab in patients with active ankylosing spondylitis and rheumatoid arthritis, respectively. PK bioequivalence was demonstrated in the phase 1 PLANETAS trial by highly comparable area under the curve (AUC) and maximum drug concentrations (Cmax), whose geometric mean ratios fell between the accepted bioequivalence range of 80-125%. Equivalence in efficacy and safety was demonstrated in the phase 3 PLANETRA trial. Two phase 1 trials comparing etanercept biosimilar candidates TuNEX and HD203 in healthy volunteers showed a high degree of similarity in AUC and Cmax, with respective geometric mean ratios between PK bioequivalence range. The last included trial referred to GP2013, a rituximab biosimilar candidate, which demonstrated PK and PD bioequivalence to reference product in three different dosing regimens in cynomolgus monkeys. Infliximab, etanercept and rituximab biosimilar candidates have demonstrated PK bioequivalence in the trials included in this review. CT-P13 has recently been approved for use in the European market and the remaining biosimilar candidates are currently being tested in patients with rheumatoid arthritis.

The Cosmetic Ingredient Review Program-Expert Safety Assessments of Cosmetic Ingredients in an Open Forum.

Science.gov (United States)

Boyer, Ivan J; Bergfeld, Wilma F; Heldreth, Bart; Fiume, Monice M; Gill, Lillian J

The Cosmetic Ingredient Review (CIR) is a nonprofit program to assess the safety of ingredients in personal care products in an open, unbiased, and expert manner. Cosmetic Ingredient Review was established in 1976 by the Personal Care Products Council (PCPC), with the support of the US Food and Drug Administration (USFDA) and the Consumer Federation of America (CFA). Cosmetic Ingredient Review remains the only scientific program in the world committed to the systematic, independent review of cosmetic ingredient safety in a public forum. Cosmetic Ingredient Review operates in accordance with procedures modeled after the USFDA process for reviewing over-the-counter drugs. Nine voting panel members are distinguished, such as medical professionals, scientists, and professors. Three nonvoting liaisons are designated by the USFDA, CFA, and PCPC to represent government, consumer, and industry, respectively. The annual rate of completing safety assessments accelerated from about 100 to more than 400 ingredients by implementing grouping and read-across strategies and other approaches. As of March 2017, CIR had reviewed 4,740 individual cosmetic ingredients, including 4,611 determined to be safe as used or safe with qualifications, 12 determined to be unsafe, and 117 ingredients for which the information is insufficient to determine safety. Examples of especially challenging safety assessments and issues are presented here, including botanicals. Cosmetic Ingredient Review continues to strengthen its program with the ongoing cooperation of the USFDA, CFA, the cosmetics industry, and everyone else interested in contributing to the process.

Rheumatology training experience across Europe: analysis of core competences

NARCIS (Netherlands)

Sivera, Francisca; Ramiro, Sofia; Cikes, Nada; Cutolo, Maurizio; Dougados, Maxime; Gossec, Laure; Kvien, Tore K.; Lundberg, Ingrid E.; Mandl, Peter; Moorthy, Arumugam; Panchal, Sonia; Da Silva, José A. P.; Bijlsma, Johannes W.; Ҫollaku, Ledio; Aroyan, Armine; Radner, Helga; Tushina, Anastasyia; de Langhe, Ellen; Sokolovic, Sekib; Shumnalieva, Russka; Baresic, Marko; Senolt, Ladislav; Holland-Fischer, Mette; Kull, Mart; Puolitaival, Antti; Gobejishvili, Nino; Hueber, Axel; Fanouriakis, Antonis; MacMullan, Paul; Rimar, Doron; Bugatti, Serena; Zepa, Julija; Menassa, Jeanine; Karpec, Diana; Misevska-Percinkova, Snezana; Cassar, Karen; Deseatnicova, Elena; Tas, SanderW; Lie, Elisabeth; Sznajd, Jan; Berghea, Florian; Povzun, Anton; Jeremic, Ivica; Mlynarikova, Vanda; Frank-Bertoncelj, Mojca; Chatzidionysiou, Katerina; Dumusc, Alexandre; Hatemi, Gulen; Ozdemirel, Erhan; Biliavska, Iuliia

2016-01-01

Background: The aim of this project was to analyze and compare the educational experience in rheumatology specialty training programs across European countries, with a focus on self-reported ability. Method: An electronic survey was designed to assess the training experience in terms of

Musculoskeletal ultrasound in rheumatology in Korea: targeted ultrasound initiative survey.

Science.gov (United States)

Kang, Taeyoung; Wakefield, Richard J; Emery, Paul

2016-04-01

In collaboration with the Targeted Ultrasound Initiative (TUI), to conduct the first study in Korea to investigate current practices in ultrasound use among Korean rheumatologists. We translated the TUI Global Survey into Korean and added questions to better understand the specific challenges facing rheumatologists in Korea. To target as many rheumatologists in Korea as possible, we created an on-line version of this survey, which was conducted from March to April 2013. Rheumatologists are in charge of ultrasound in many Korean hospitals. Rheumatologists in hospitals and private clinics use ultrasound to examine between one and five patients daily; they use ultrasound for diagnosis more than monitoring and receive compensation of about US$30-50 per patient. There are marked differences in the rates of ultrasound usage between rheumatologists who work in private practice compared with tertiary hospitals. Korean rheumatologists not currently using ultrasound in their practice appear eager to do so. This survey provides important insights into the current status of ultrasound in rheumatology in Korea and highlights several priorities; specifically, greater provision of formal training, standardization of reporting and accrual of greater experience among ultrasound users. If these needs are addressed, all rheumatology departments in Korea are likely to use ultrasound or have access to it in the future. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

New feed ingredients

NARCIS (Netherlands)

Raamsdonk, van L.W.D.; Fels-Klerx, van der H.J.; Jong, de J.

2017-01-01

In the framework of sustainability and a circular economy, new ingredients for feed are desired and, to this end, initiatives for implementing such novel ingredients have been started. The initiatives include a range of different sources, of which insects are of particular interest. Within the

Impurities in Drug Products and Active Pharmaceutical Ingredients.

Science.gov (United States)

Kątny, M; Frankowski, M

2017-05-04

Analytical methods should be selective and fast. In modern times, scientists strive to meet the criteria of green chemistry, so they choose analytical procedures that are as short as possible and use the least toxic solvents. It is quite obvious that the products intended for human consumption should be characterized as completely as possible. The safety of a drug is dependent mainly on the impurities that it contains. High pressure liquid chromatography and ultra-high pressure liquid chromatography have been proposed as the main techniques for forced degradation and impurity profiling. The aim of this article was to characterize the relevant classification of drug impurities and to review the methods of impurities determination for atorvastatin (ATV) and duloxetine (DLX) (both in active pharmaceutical ingredients and in different dosage forms). These drugs have an impact on two systems of the human body: cardiac and nervous. Simple characteristics of ATV and DLX, their properties and specificity of action on the human body, are also included in this review. The analyzed pharmaceuticals-ATV (brand name Lipiron) and DLX (brand name Cymbalta)-were selected for this study based on annual rankings prepared by Information Medical Statistics.

Rheumatologic care of nursing home residents with rheumatoid arthritis: a comparison of the year before and after nursing home admission.

Science.gov (United States)

Luque Ramos, Andres; Albrecht, Katinka; Zink, Angela; Hoffmann, Falk

2017-12-01

The purpose of this study was to investigate health care for patients with rheumatoid arthritis (RA) before and after admission to nursing homes. Data of a German health insurance fund from persons with diagnostic codes of RA, aged ≥65 years, admitted to a nursing home between 2010 and 2014 and continuously insured 1 year before and after admission were used. The proportion of patients with ≥1 rheumatologist visit and ≥1 prescription of biologic or conventional synthetic disease-modifying antirheumatic drugs (bDMARDs or csDMARDs), glucocorticoids and non-steroidal anti-inflammatory drugs (NSAIDs) in the year before and after admission were calculated. Predictors of rheumatologic care after admission were analyzed by multivariable logistic regression. Of 75,697 nursing home residents, 2485 (3.3%) had RA (90.5% female, mean age 83.8). Treatment by rheumatologists and prescription of antirheumatic drugs decreased significantly in the year after admission (rheumatologic visits: 17.6 to 9.1%, bDMARDs: 2.1 to 1.5%, csDMARDs: 22.5 to 16.5%, glucocorticoids: 46.5 to 43.1%, NSAIDs: 47.4 to 38.5%). 60.2% of patients in rheumatologic care received csDMARDs compared with 14.5% without rheumatologic care. Rheumatologic care before admission to a nursing home strongly predicted rheumatologic care thereafter (OR 33.8, 95%-CI 23.2-49.2). Younger age and lower care level (reflecting need of help) were also associated with a higher chance of rheumatologic care. Rheumatologic care is already infrequent in old patients with RA and further decreases after admission to a nursing home. Patients without rheumatologic care are at high risk of insufficient treatment for their RA. Admission to a nursing home further increases this risk.

Preventive effects of Flos Perariae (Gehua water extract and its active ingredient puerarin in rodent alcoholism models

Directory of Open Access Journals (Sweden)

Wang Yuqiang

2010-10-01

Full Text Available Abstract Background Radix Puerariae is used in Chinese medicine to treat alcohol addiction and intoxication. The present study investigates the effects of Flos puerariae lobatae water extract (FPE and its active ingredient puerarin on alcoholism using rodent models. Methods Alcoholic animals were given FPE or puerarin by oral intubation prior or after alcohol treatment. The loss of righting reflex (LORR assay was used to evaluate sedative/hypnotic effects. Changes of gama-aminobutyric acid type A receptor (GABAAR subunits induced by alcohol treatment in hippocampus were measured with western blot. In alcoholic mice, body weight gain was monitored throughout the experiments. Alcohol dehydrogenase (ADH levels in liver were measured. Results FPE and puerarin pretreatment significantly prolonged the time of LORR induced by diazepam in acute alcoholic rat. Puerarin increased expression of gama-aminobutyric acid type A receptor alpha1 subunit and decreased expression of alpha4 subunit. In chronic alcoholic mice, puerarin pretreatment significantly increased body weight and liver ADH activity in a dose-dependent manner. Puerarin pretreatment, but not post-treatment, can reverse the changes of gama-aminobutyric acid type A receptor subunit expression and increase ADH activity in alcoholism models. Conclusion The present study demonstrates that FPE and its active ingredient puerarin have preventive effects on alcoholism related disorders.

Semiconductor lasers in rheumatological treatment

Science.gov (United States)

Pascu, Mihail-Lucian; Suteanu, S.; Ignat, P.; Pruna, Simion; Chitu, A.

1995-03-01

A computer controlled equipment, containing 6 lasers (HeNe and 5 diode lasers--DL) conceived to be used in rheumatological treatment is reported. DL emit at 895 nm and for typical applications, their expanded spots are superposed within the irradiation plane, on the HeNE defocused spot used to define the surface to be irradiated. DL emit 100 nsec pulses between 0.5 KHz and 1.5 KHz repetition rate and 0.5 mW average power (measured at 1 KHz). 150 patients with rheumathologic diseases were treated: lumbar spondylosis (75), gonarthrosis (30), cervical spondylosis (21), coxarthrosis (15), Heberden and Bouchard (9). The treatment consisted of: group I, 50 patients--laser therapy, 10 min/day, 10 days; group II, 50 patients--classical antirheumatic treatment; group III, 50 patients--mixed treatment. Assessment of sympathetic skin activity made using reactometry measurements, shows that latency time was longer before irradiation, 1867 +/- 289) msec then after, (1234 +/- 321) msec. Pain rating indexes decreasing for all three groups of patients were measured. Better results for more superficial diseases were obtained and best results were observed after irradiation with 1 KHz - 1.5 KHz repetition rate IR pulses. Better results were obtained when spot irradiation in a few points combined with zone irradiations was used.

Evaluation of active ingredients and larvicidal activity of clove and cinnamon essential oils against Anopheles gambiae (sensu lato).

Science.gov (United States)

Thomas, Adelina; Mazigo, Humphrey D; Manjurano, Alphaxard; Morona, Domenica; Kweka, Eliningaya J

2017-09-06

Mosquitoes are well-known vectors of many diseases including malaria and lymphatic filariasis. Uses of synthetic insecticides are associated with high toxicity, resistance, environmental pollution and limited alternative, effective synthetic insecticides. This study was undertaken to evaluate the larvicidal efficacy of clove and cinnamon essential oils against laboratory Anopheles gambiae (sensu stricto) and wild An. arabiensis larvae. The standard WHO guideline for larvicides evaluation was used, and the GC-MS machine was used for active compounds percentage composition analysis and structures identification. Probit regression analysis was used for LC 50 and LC 95 calculations while a t-test was used to test for significant differences between laboratory-reared and wild larvae populations in each concentration of plant extract. Mortality effect of clove and cinnamon essential oils against wild and laboratory-reared larvae had variations indicated by their LC 50 and LC 95 values. The mortality at different concentrations of cinnamon and clove post-exposure for wild and laboratory-reared larvae were dosage-dependent and were higher for cinnamon than for clove essential oils. The mortality effect following exposure to a blend of the two essential oils was higher for blends containing a greater proportion of cinnamon oil. In the chemical analysis of the active ingredients of cinnamon essential oil, the main chemical content was Eugenol, and the rarest was β-Linalool while for clove essential oil, the main chemical content was Eugenol and the rarest was Bicyclo. The essential oils showed a larvicidal effect which was concentration-dependent for both laboratory and wild collected larvae. The active ingredient compositions triggered different responses in mortality. Further research in small-scale should be conducted with concentrated extracted compounds.

Innovative natural functional ingredients from microalgae.

Science.gov (United States)

Plaza, Merichel; Herrero, Miguel; Cifuentes, Alejandro; Ibáñez, Elena

2009-08-26

Nowadays, a wide variety of compounds such as polyphenols, polyunsaturated fatty acids (PUFA), or phytosterols obtained, for example, from wine, fish byproducts, or plants are employed to prepare new functional foods. However, unexplored natural sources of bioactive ingredients are gaining much attention since they can lead to the discovery of new compounds or bioactivities. Microalgae have been proposed as an interesting, almost unlimited, natural source in the search for novel natural functional ingredients, and several works have shown the possibility to find bioactive compounds in these organisms. Some advantages can be associated with the study of microalgae such as their huge diversity, the possibility of being used as natural reactors at controlled conditions, and their ability to produce active secondary metabolites to defend themselves from adverse or extreme conditions. In this contribution, an exhaustive revision is presented involving the research for innovative functional food ingredients from microalgae. The most interesting results in this promising field are discussed including new species composition and bioactivity and new processing and extraction methods. Moreover, the future research trends are critically commented.

Potential Antitumor Effects of Pomegranates and Its Ingredients.

Science.gov (United States)

Rahmani, Arshad H; Alsahli, Mohammed A; Almatroodi, Saleh A

2017-01-01

The treatment based on plant or plant derivatives is a promising strategy in the killing of cancers cells. Moreover, wide-ranging finding has established that medicinal plant and its ingredient modulate several cells signaling pathways or inhibiting the carcinogenesis process. In this vista, pomegranates fruits, seeds and peels illustrate cancer preventive role seems to be due to rich source of antioxidant and other valuable ingredients. Furthermore, anti-tumour activities of pomegranates have been evidences through the modulation of cell signaling pathways including transcription factor, apoptosis and angiogenesis. In this review article, anti-tumor activity of pomegranates and its components or its different type of extracts are described to understand the mechanism of action of pomegranates in cancer therapy.

Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit.

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Fennelly, Orna; Blake, Catherine; FitzGerald, Oliver; Breen, Roisin; Ashton, Jennifer; Brennan, Aisling; Caffrey, Aoife; Desmeules, François; Cunningham, Caitriona

2018-06-01

Many people with musculoskeletal (MSK) disorders wait several months or years for Consultant Doctor appointments, despite often not requiring medical or surgical interventions. To allow earlier patient access to orthopaedic and rheumatology services in Ireland, Advanced Practice Physiotherapists (APPs) were introduced at 16 major acute hospitals. This study performed the first national evaluation of APP triage services. Throughout 2014, APPs (n = 22) entered clinical data on a national database. Analysis of these data using descriptive statistics determined patient wait times, Consultant Doctor involvement in clinical decisions, and patient clinical outcomes. Chi square tests were used to compare patient clinical outcomes across orthopaedic and rheumatology clinics. A pilot study at one site identified re-referral rates to orthopaedic/rheumatology services of patients managed by the APPs. In one year, 13,981 new patients accessed specialist orthopaedic and rheumatology consultations via the APP. Median wait time for an appointment was 5.6 months. Patients most commonly presented with knee (23%), lower back (22%) and shoulder (15%) disorders. APPs made autonomous clinical decisions regarding patient management at 77% of appointments, and managed patient care pathways without onward referral to Consultant Doctors in more than 80% of cases. Other onward clinical pathways recommended by APPs were: physiotherapy referrals (42%); clinical investigations (29%); injections administered (4%); and surgical listing (2%). Of those managed by the APP, the pilot study identified that only 6.5% of patients were re-referred within one year. This national evaluation of APP services demonstrated that the majority of patients assessed by an APP did not require onward referral for a Consultant Doctor appointment. Therefore, patients gained earlier access to orthopaedic and rheumatology consultations in secondary care, with most patients conservatively managed.

Rheumatology education for undergraduate nursing, physiotherapy and occupational therapy students in the UK: standards, challenges and solutions.

Science.gov (United States)

Hewlett, S; Clarke, B; O'Brien, A; Hammond, A; Ryan, S; Kay, L; Richards, P; Almeida, C

2008-07-01

Rheumatological conditions are common, thus nurses (Ns) occupational therapists (OTs) and physiotherapists (PTs) require at least basic rheumatology knowledge upon qualifying. The aim of this study was to develop a core set of teaching topics and potential ways of delivering them. A modified Delphi technique was used for clinicians to develop preliminary core sets of teaching topics for each profession. Telephone interviews with educationalists explored their views on these, and challenges and solutions for delivering them. Inter-professional workshops enabled clinicians and educationalists to finalize the core set together, and generate methods for delivery. Thirty-nine rheumatology clinicians (12N, 14OT, 13PT) completed the Delphi consensus, proposing three preliminary core sets (N71 items, OT29, PT26). Nineteen educationalists (6N, 7OT, 6PT) participated in telephone interviews, raising concerns about disease-specific vs generic teaching and proposing many methods for delivery. Three inter-professional workshops involved 34 participants (clinicians: N12, OT9, PT5; educationalists: N2, OT3, PT2; Patient 1) who reached consensus on a single core set comprising six teaching units: Anatomy and Physiology; Assessment; Management and Intervention; Psychosocial Issues; Patient Education; and the Multi-disciplinary Team, recommending some topics within the units receive greater depth for some professions. An innovative range of delivery options was generated plus two brief interventions: a Rheumatology Chat Show and a Rheumatology Road Show. Working together, clinicians and educationalists proposed a realistic core set of rheumatology topics for undergraduate health professionals. They proposed innovative delivery methods, with collaboration between educationalists, clinicians and patients strongly recommended. These potential interventions need testing.

21 CFR 310.528 - Drug products containing active ingredients offered over-the-counter (OTC) for use as an...

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Drug products containing active ingredients offered over-the-counter (OTC) for use as an aphrodisiac. 310.528 Section 310.528 Food and Drugs FOOD AND... drug product. Anise, cantharides, don qual, estrogens, fennel, ginseng, golden seal, gotu kola, Korean...

Profile of rheumatology patients willing to report adverse drug reactions: bias from selective reporting

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Protić D

2016-02-01

Full Text Available Dragana Protić,1 Nada Vujasinović-Stupar,2 Zoran Bukumirić,3 Slavica Pavlov-Dolijanović,4 Snežana Baltić,5 Slavica Mutavdžin,6 Ljiljana Markovic-Denić,7 Marija Zdravković,8 Zoran Todorović1 1Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 2Department 2, Institute of Rheumatology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 3Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 4Department 5, Institute of Rheumatology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 5Department 5, Institute of Rheumatology, Belgrade, Serbia; 6Institute of Physiology “Rihard Burjan”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 7Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 8Department of Cardiology, Medical Center “Bežanijska kosa”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia Background: Adverse drug reactions (ADRs have a significant impact on human health and health care costs. The aims of our study were to determine the profile of rheumatology patients willing to report ADRs and to identify bias in such a reporting system. Methods: Semi-intensive ADRs reporting system was used in our study. Patients willing to participate (N=261 completed the questionnaire designed for the purpose of the study at the hospital admission. They were subsequently classified into two groups according to their ability to identify whether they had experienced ADRs during the previous month. Group 1 included 214 out of 261 patients who were able to identify ADRs, and group 2 consisted of 43 out of 261 patients who were not able to identify ADRs in their recent medical history. Results: Group 1 patients were more significantly aware of their diagnosis than the patients from group 2. Marginal significance was found

An audit of influenza and pneumococcal vaccination in rheumatology outpatients.

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Sowden, Evin; Mitchell, William S

2007-07-04

Influenza and pneumococcal vaccination are recommended for a number of clinical risk groups including patients treated with major immunosuppressant disease modifying anti-rheumatic drugs. Such immunisation is not only safe but immunogenic in patients with rheumatic diseases. We sought to establish dual vaccination rates and significant influencing factors amongst our hospital rheumatology outpatients. We audited a sample of 101 patients attending hospital rheumatology outpatient clinics on any form of disease modifying treatment by clinical questionnaire and medical record perusal. Further data were collected from the local immunisation coordinating agency and analysed by logistic regression modelling. Although there was a high rate of awareness with regard to immunisation, fewer patients on major immunosuppressants were vaccinated than patients with additional clinical risk factors against influenza (53% vs 93%, p risk factors was confirmed as significant in determining vaccination status by logistic regression for both influenza (OR 10.89, p < 0.001) and streptococcus pneumoniae (OR 4.55, p = 0.002). The diagnosis of rheumatoid arthritis was also found to be a significant factor for pneumococcal vaccination (OR 5.1, p = 0.002). There was a negative trend suggesting that patients on major immunosuppressants are less likely to be immunised against pneumococcal antigen (OR 0.35, p = 0.067). Influenza and pneumococcal immunisation is suboptimal amongst patients on current immunosuppressant treatments attending rheumatology outpatient clinics. Raising awareness amongst patients may not be sufficient to improve vaccination rates and alternative strategies such as obligatory pneumococcal vaccination prior to treatment initiation and primary care provider education need to be explored.

AUTOINFLAMMATORY DISEASES IN RHEUMATOLOGY: RUSSIAN EXPERIENCE

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S. O. Salugina

2016-01-01

Full Text Available Autoinflammatory diseases (AIDs are characterized by periodic, sometimes self-limiting attacks that appear as fever and clinical symptoms resembling rheumatic ones, in the absence of autoimmune or infectious diseases. The group of AIDs encompasses a broad spectrum of nosological entities; some of them have been recently dealt with by rheumatologists.Objective: to define the spectrum of AIDs in the practice of a pediatric rheumatologist from the results of visits to the Russian Federal Rheumatology Center.Subjects and methods. The investigation enrolled patients who had visited the V.A. Nasonova Research Institute of Rheumatology in 2007 to 2015 for fever and other signs of a systemic inflammatory process in order to specify their diagnosis and to rule out infections, blood cancer, and other diseases. All underwent conventional rheumatologic examination, HLA Class A typing, and molecular genetic testing.Results and discussion. 101 patients aged 6.5 months to 60 years with AIDs were identified over 9 years and diagnosed as having the following diseases. Familial Mediterranean fever (FMF was detected in 17 patients (the female to male (M/F ratio was 6:11; Behсet's disease (BD in 25 children (M/F, 14:11, cryopyrin-associated periodic syndromes (CAPS in 17 patients, including Muckle–Wells syndrome in 13 (M/F, 4:9; chronic infantile neurologic cutaneous articular and neonatal onset multisystem inflammatory disease (CINCA/NOMID syndrome in 4 (M/F, 3:1, periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis (PFAPA syndrome in 17 (M/F, 10:7, hyper-IgD syndrome/mevalonate kinase deficiency syndrome in 3 (M/F, 0:3, tumor necrosis factor receptor periodic syndrome (TRAPS in 7 (M/F, 4:3, undifferentiated AID in 14, and Blau syndrome in one patient. The patients with BD were rather ethnically diverse: among them, there were representatives of North Caucasian peoples, Tatars, Uzbeks, Moldavians, and others; there were 7 ethnic Russians. There

A brief history of ultrasound in rheumatology: where we were.

Science.gov (United States)

Grassi, Walter; Filippucci, Emilio

2014-01-01

Ultrasonography in the '70s was a well-known and widely used method within several medical specialties but not in rheumatology. Initial development of the field was led by radiologists who mainly investigated the potential of ultrasound in the assessment of large joints. In the late '80s, the first studies supporting the role of ultrasound in the detection of soft tissue changes and bone erosions in the hands of patients with rheumatoid arthritis were published. In the '90s, the dramatic improvement of spatial resolution due to the new generation high frequency probes opened up new avenues for the exploration of otherwise undetectable anatomical details. Ultrasound research during this period was enhanced by the growing use of colour Doppler and power Doppler and by the first prototypes of three dimensional ultrasound. Over the last 10 years, the buzz words in ultrasound research in rheumatology have been standardisation, early diagnosis and therapy monitoring.

Incentives in Rheumatology: the Potential Contribution of Physician Responses to Financial Incentives, Public Reporting, and Treatment Guidelines to Health Care Sustainability.

Science.gov (United States)

Harrison, Mark; Milbers, Katherine; Mihic, Tamara; Anis, Aslam H

2016-07-01

Concerns about the sustainability of current health care expenditure are focusing attention on the cost, quality and value of health care provision. Financial incentives, for example pay-for-performance (P4P), seek to reward quality and value in health care provision. There has long been an expectation that P4P schemes are coming to rheumatology. We review the available evidence about the use of incentives in this setting and provide two emerging examples of P4P schemes which may shape the future of service provision in rheumatology. Currently, there is limited and equivocal evidence in rheumatology about the impact of incentive schemes. However, reporting variation in the quality and provision of rheumatology services has highlighted examples of inefficiencies in the delivery of care. If financial incentives can improve the delivery of timely and appropriate care for rheumatology patients, then they may have an important role to play in the sustainability of health care provision.

Mentoring of young professionals in the field of rheumatology in Europe: results from an EMerging EUlar NETwork (EMEUNET) survey

NARCIS (Netherlands)

Frank-Bertoncelj, Mojca; Hatemi, Gulen; Ospelt, Caroline; Ramiro, Sofia; Machado, Pedro; Mandl, Peter; Gossec, Laure; Buch, Maya H.

2014-01-01

To explore perceptions of, participation in and satisfaction with mentoring programmes among young clinicians and researchers in rheumatology in Europe. To identify mentoring needs and expectations focusing on gender-specific differences. A survey on mentoring in rheumatology was distributed to

[Adherence to treatment, by active ingredient, in patients over 65 years on multiple medication].

Science.gov (United States)

Núñez Montenegro, Antonio J; Montiel Luque, Alonso; Martín Aurioles, Esther; Torres Verdú, Barbara; Lara Moreno, Celinda; González Correa, José Antonio

2014-05-01

To assess the level of adherence, by active ingredient, to treatment and associated factors in polymedicated patients over 65 years-old. Observational, descriptive and cross-sectional study over polymedicated patients over 65 years of the Costa del Sol Health District and the North Malaga Health Area. The study was performed between January 2011 and September 2012 on 375 subjects obtained by simple random sampling from lists provided by each health centre. Data was collected by means of an interview with structured questions. Informed consent was given and signed by all patients before interview. Main results variable adherence to treatment (Morisky-Green's test). Prescription by active ingredient, socio-demographic variables, health care centre variables, and treatment associated variables. A descriptive analysis of variables was performed. Statistical inference was determined using univariate analysis (t test of Student or Mann-Whitney U, and Chi-squared), and controlling for confounding factors by multivariate analysis (linear and logistic regression). The result for therapeutic compliance was 51.7%. No statistically significant differences were observed as regards sex and age. A relationship was found in those who resided in rural areas (P=.001), lived with family (P<.05), and were not at risk of suffering from anxiety (P=.046). We found similar patient adherence to treatment despite the prescribing generic drugs. Failure to therapeutic compliance was greater in those patients who lived by themselves, in a city close to the coast, or in those patients who were at risk of suffering from anxiety. Copyright © 2013 Elsevier España, S.L. All rights reserved.

A survey of anatomical items relevant to the practice of rheumatology: upper extremity, head, neck, spine, and general concepts.

Science.gov (United States)

Villaseñor-Ovies, Pablo; Navarro-Zarza, José Eduardo; Saavedra, Miguel Ángel; Hernández-Díaz, Cristina; Canoso, Juan J; Biundo, Joseph J; Kalish, Robert A; de Toro Santos, Francisco Javier; McGonagle, Dennis; Carette, Simon; Alvarez-Nemegyei, José

2016-12-01

This study aimed to identify the anatomical items of the upper extremity and spine that are potentially relevant to the practice of rheumatology. Ten rheumatologists interested in clinical anatomy who published, taught, and/or participated as active members of Clinical Anatomy Interest groups (six seniors, four juniors), participated in a one-round relevance Delphi exercise. An initial, 560-item list that included 45 (8.0 %) general concepts items; 138 (24.8 %) hand items; 100 (17.8 %) forearm and elbow items; 147 (26.2 %) shoulder items; and 130 (23.2 %) head, neck, and spine items was compiled by 5 of the participants. Each item was graded for importance with a Likert scale from 1 (not important) to 5 (very important). Thus, scores could range from 10 (1 × 10) to 50 (5 × 10). An item score of ≥40 was considered most relevant to competent practice as a rheumatologist. Mean item Likert scores ranged from 2.2 ± 0.5 to 4.6 ± 0.7. A total of 115 (20.5 %) of the 560 initial items reached relevance. Broken down by categories, this final relevant item list was composed by 7 (6.1 %) general concepts items; 32 (27.8 %) hand items; 20 (17.4 %) forearm and elbow items; 33 (28.7 %) shoulder items; and 23 (17.6 %) head, neck, and spine items. In this Delphi exercise, a group of practicing academic rheumatologists with an interest in clinical anatomy compiled a list of anatomical items that were deemed important to the practice of rheumatology. We suggest these items be considered curricular priorities when training rheumatology fellows in clinical anatomy skills and in programs of continuing rheumatology education.

"Big Data" in Rheumatology: Intelligent Data Modeling Improves the Quality of Imaging Data.

Science.gov (United States)

Landewé, Robert B M; van der Heijde, Désirée

2018-05-01

Analysis of imaging data in rheumatology is a challenge. Reliability of scores is an issue for several reasons. Signal-to-noise ratio of most imaging techniques is rather unfavorable (too little signal in relation to too much noise). Optimal use of all available data may help to increase credibility of imaging data, but knowledge of complicated statistical methodology and the help of skilled statisticians are required. Clinicians should appreciate the merits of sophisticated data modeling and liaise with statisticians to increase the quality of imaging results, as proper imaging studies in rheumatology imply more than a supersensitive imaging technique alone. Copyright © 2018 Elsevier Inc. All rights reserved.

Indicadores del estrés oxidativo en pacientes afectados por VIH/sida con manifestaciones reumatológicas Oxidative stress indicators for HIV/AIDS patients with rheumatologic manifestations

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Olga Pomier Suárez

2012-09-01

Full Text Available Introducción: el estrés oxidativo se ha reconocido como cofactor en la progresión de la infección por el virus de la inmunodeficiencia humana (VIH y en las manifestaciones reumatológicas. Objetivo: valorar los indicadores del estrés oxidativo en los pacientes afectados por VIH con manifestaciones reumatológicas. Métodos: se estudiaron 31 pacientes VIH con manifestaciones reumatológicas y se compararon los índices evaluados con un grupo control, 31 individuos aparentemente sanos. Los pacientes fueron clasificados según los siguientes criterios de actividad: escala de actividad de la enfermedad para manifestaciones reumatológicas, e índice de actividad de enfermedad y la escala visual analógica de dolor nocturno para manifestaciones reumatológicas. Las concentraciones plasmáticas de los indicadores de estrés oxidativo fueron cuantificadas mediante técnicas espectrofotométricas y el análisis estadístico realizado, mediante el programa estadístico SPSS 13. Resultados: los pacientes VIH evaluados presentaron un estrés oxidativo de moderado a severo, caracterizado por aumento significativo de los parámetros indicadores de daño oxidativo y disminución de los sistemas antioxidantes (pIntroduction: the oxidative stress has been recognized as a cofactor in the progression of the human immunodeficiency virus (HIV infection and in the rheumatologic manifestations. Objective: to assess the oxidative stress indicators in those HIV patients with rheumatologic manifestations. Methods: thirty one HIV patients with rheumatologic manifestations were studied and the evaluated indexes were compared to those of a control group made up of 31 apparently healthy individuals. The patients were classified according to the following activity criteria: scale of the disease activity for the rheumatologic manifestations, and index of disease activity and the analogical visual scale of pain at night in terms of the rheumatologic manifestations. The

INGREDIENT BRANDING - A GROWTH OPPORTUNITY?

OpenAIRE

Anca BUTNARIU

2017-01-01

Co-branding is an increasingly used strategy, consisting of marketing products representing two brands or more. Ingredient branding fits in the scope of co-branding, consisting of the inclusion of key attributes of one brand into another brand as ingredients. Ingredient branding is one of the many brand strategies used in marketing to provide differentiation criteria for the customers. In recent years, its importance and incidence have dramatically increased Extant research provides disparate...

Acetylcholinesterase inhibitory activity of Thai traditional nootropic remedy and its herbal ingredients.

Science.gov (United States)

Tappayuthpijarn, Pimolvan; Itharat, Arunporn; Makchuchit, Sunita

2011-12-01

The incidence of Alzheimer disease (AD) is increasing every year in accordance with the increasing of elderly population and could pose significant health problems in the future. The use of medicinal plants as an alternative prevention or even for a possible treatment of the AD is, therefore, becoming an interesting research issue. Acetylcholinesterase (AChE) inhibitors are well-known drugs commonly used in the treatment of AD. The aim of the present study was to screen for AChE inhibitory activity of the Thai traditional nootropic recipe and its herbal ingredients. The results showed that ethanolic extracts of four out of twenty-five herbs i.e. Stephania pierrei Diels. Kaempfera parviflora Wall. ex Baker, Stephania venosa (Blume) Spreng, Piper nigrum L at 0.1 mg/mL showed % AChE inhibition of 89, 64, 59, 50; the IC50 were 6, 21, 29, 30 microg/mL respectively. The other herbs as well as combination of the whole recipe had no synergistic inhibitory effect on AChE activity. However some plants revealed antioxidant activity. More research should have be performed on this local wisdom remedy to verify the uses in scientific term.

Ingredient and labeling issues associated with allergenic foods.

Science.gov (United States)

Taylor, S L; Hefle, S L

2001-01-01

Foods contain a wide range of food ingredients that serve numerous technical functions. Per capita consumer exposure to most of these food ingredients is rather low with a few notable exceptions such as sugar and starch. Some food ingredients including edible oils, hydrolyzed proteins, lecithin, starch, lactose, flavors and gelatin may, at least in some products, be derived from sources commonly involved in IgE-mediated food allergies. These ingredients should be avoided by consumers with allergies to the source material if the ingredient contains detectable protein residues. Other food ingredients, including starch, malt, alcohol and vinegar, may be derived in some cases from wheat, rye or barley, the grains that are implicated in the causation of celiac disease. If these ingredients contain gluten residues, then they should be avoided by celiac sufferers. A few food ingredients are capable of eliciting allergic sensitization, although these ingredients would be classified as rarely allergenic. These ingredients include carmine, cochineal extract, annatto, tragacanth gum and papain. Food manufacturers should declare the presence of allergenic food ingredients in the ingredient listings on product labels so that allergic consumers can know to avoid these potentially hazardous products.

Curing Ingredients, Characteristics, Total Phenolic, and Antioxidant Activity of Commercial Indonesian Dried Meat Product (Dendeng

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T. Suryati

2012-08-01

Full Text Available Dendeng is Indonesian dried meat product that used spices rich in antioxidant component as ingredient. In addition, commercial dendeng usually use saltpeter (nitrate/nitrite salt as curing ingredient to inhibit rancidity and to produce stable red color. The aims of this study were to investigate composition of spices and saltpeter added, characteristic, total phenolic, and antioxidant activity of commercial dendeng. This research was conducted through interview with some dendeng producers to get information about saltpeter adding and spices composition used in their products. Then the interview results were verified by laboratory analysis. The results showed that spices and saltpeter adding from some producers varied. The saltpeter added in curing process produced inconsistent red color on commercial dendeng in this investigation. Total phenolic of dendeng from producers ranged from 42.47 to 102.0 mg GAE/100 g DM for raw dendeng, and 36.51 to 95.49 mg GAE/100 g DM for fried dendeng. Antioxidant capacity against DPPH ranged from 79.35 to 379.40 mg VCE/100 g DM for raw dendeng, and 94.30 to 559.40 mg VCE/100 g DM for fried dendeng. Antioxidant capacity of raw dendeng was influenced by phenolic content about 87.2%, but in fried dendeng was only 59.0%. In conclusion, dendeng has a significant antioxidant activity, even after frying, and saltpeter addition was not effective to maintain stable red color in dendeng products.

[Recent advances of synthetic biology for production of functional ingredients in Chinese materia medica].

Science.gov (United States)

Su, Xin-Yao; Xue, Jian-Ping; Wang, Cai-Xia

2016-11-01

The functional ingredients in Chinese materia medica are the main active substance for traditional Chinese medicine and most of them are secondary metabolites derivatives. Until now,the main method to obtain those functional ingredients is through direct extraction from the Chinese materia medica. However, the income is very low because of the high extraction costs and the decreased medicinal plants. Synthetic biology technology, as a new and microbial approach, can be able to carry out large-scale production of functional ingredients and greatly ease the shortage of traditional Chinese medicine ingredients. This review mainly focused on the recent advances in synthetic biology for the functional ingredients production. Copyright© by the Chinese Pharmaceutical Association.

Proceedings from The 8th Annual International Society for Musculoskeletal Imaging in Rheumatology (ISEMIR) Conference

DEFF Research Database (Denmark)

Troum, Orrin M; Pimienta, Olga L; Olech, Ewa

2016-01-01

The International Society for Musculoskeletal Imaging in Rheumatology (ISEMIR) was founded in 2005 with the goal of discussing matters related to imaging in rheumatology, particularly, validation, education, and use in both clinical practice and research. The field of musculoskeletal (MSK) imaging...... is continuously evolving; therefore, education for healthcare providers in this field is of paramount importance. ISEMIR's international faculty and world-renowned experts presented the newest information as it relates to the use of magnetic resonance imaging (MRI) and ultrasound (US) at the 8th annual ISEMIR...

The A Priori Design and Selection of Ionic Liquids as Solvents for Active Pharmaceutical Ingredients

DEFF Research Database (Denmark)

Kunov-Kruse, Andreas Jonas; Weber, Cameron C.; Rogers, Robin D.

2017-01-01

In this paper we derive a straightforward computational approach to predict the optimal ionic liquid (IL) solvent for a given compound, based on COSMO-RS calculations. These calculations were performed on 18 different active pharmaceutical ingredients (APIs) using a matrix of 210 hypothetical ILs...... on the N-alkylguanidinium cation were prepared and characterized. The solubility of the APIs in each of these classes was found to be qualitatively consistent with the predictions of the COSMO-RS model. The suitability of these novel guanidinium salts as crystallization solvents was demonstrated by the use...

On the direct characterization and quantification of active ingredients in commercial solid drugs using PIXE, PIGE and ToF-SIMS techniques

Energy Technology Data Exchange (ETDEWEB)

Nsouli, B; Zahraman, K; Bejjani, A; Roumie, M; Noun, M [Ion Beam Analysis Laboratory, Lebanese Atomic Energy Commission - CNRS, P.O.Box: 11-8281 Beirut (Lebanon); Younes, G [Faculty of Sciences, Department of Chemistry - Beirut Arab University, Beirut (Lebanon); Assi, S; El-Yazbi, F; Mahmoud, R [Faculty of Pharmacy, Department of Pharmaceutical Analytical Chemistry - Beirut Arab University, Beirut (Lebanon); Thomas, J P [Institut de Physique Nucleaire de Lyon - Universite Claude Bernard Lyon 1 (France)

2010-01-15

The quantification of the active ingredient (AI) in drugs is a crucial and important step in the drug quality control process. This is usually performed by using wet chemical techniques like HPLC, LC-MS/MS, UV spectrophotometry and other appropriate organic analytical methods. In the case of an active ingredient contains specific heteroatoms (F, S, Cl, Br, ...), elemental IBA technique can be explored for molecular quantification. IBA techniques permit the analysis of the sample under solid form, without any laborious sample preparation. This is an advantage when the number of sample is relatively large. In this work, we demonstrate the ability of the Thick target PIXE (TT-PIXE) and the TT-PIGE techniques for rapid and accurate quantification of celecoxib and atorvastatin in commercial solid drugs. The experimental aspects related to the quantification validity are presented and discussed. (author)

On the direct characterization and quantification of active ingredients in commercial solid drugs using PIXE, PIGE and ToF-SIMS techniques

International Nuclear Information System (INIS)

Nsouli, B.; Zahraman, K.; Bejjani, A.; Roumie, M.; Noun, M.; Younes, G.; Assi, S.; El-Yazbi, F.; Mahmoud, R.; Thomas, J.P.

2010-01-01

The quantification of the active ingredient (AI) in drugs is a crucial and important step in the drug quality control process. This is usually performed by using wet chemical techniques like HPLC, LC-MS/MS, UV spectrophotometry and other appropriate organic analytical methods. In the case of an active ingredient contains specific heteroatoms (F, S, Cl, Br, ...), elemental IBA technique can be explored for molecular quantification. IBA techniques permit the analysis of the sample under solid form, without any laborious sample preparation. This is an advantage when the number of sample is relatively large. In this work, we demonstrate the ability of the Thick target PIXE (TT-PIXE) and the TT-PIGE techniques for rapid and accurate quantification of celecoxib and atorvastatin in commercial solid drugs. The experimental aspects related to the quantification validity are presented and discussed. (author)

Management of gout by UK rheumatologists: a British Society for Rheumatology national audit.

Science.gov (United States)

Roddy, Edward; Packham, Jon; Obrenovic, Karen; Rivett, Ali; Ledingham, Joanna M

2018-05-01

To assess the concordance of gout management by UK rheumatologists with evidence-based best-practice recommendations. Data were collected on patients newly referred to UK rheumatology out-patient departments over an 8-week period. Baseline data included demographics, method of diagnosis, clinical features, comorbidities, urate-lowering therapy (ULT), prophylaxis and blood tests. Twelve months later, the most recent serum uric acid level was collected. Management was compared with audit standards derived from the 2006 EULAR recommendations, 2007 British Society for Rheumatology/British Health Professionals in Rheumatology guideline and the National Institute for Health and Care Excellence febuxostat technology appraisal. Data were collected for 434 patients from 91 rheumatology departments (mean age 59.8 years, 82% male). Diagnosis was crystal-proven in 13%. Of 106 taking a diuretic, this was reduced/stopped in 29%. ULT was continued/initiated in 76% of those with one or more indication for ULT. One hundred and fifty-eight patients started allopurinol: the starting dose was most commonly 100 mg daily (82%); in those with estimated glomerular filtration rate <60 ml/min the highest starting dose was 100 mg daily. Of 199 who started ULT, prophylaxis was co-prescribed for 94%. Fifty patients started a uricosuric or febuxostat: 84% had taken allopurinol previously. Of 44 commenced on febuxostat, 18% had a history of heart disease. By 12 months, serum uric acid levels ⩽360 and <300 μmol/l were achieved by 45 and 25%, respectively. Gout management by UK rheumatologists concords well with guidelines for most audit standards. However, fewer than half of patients achieved a target serum uric level over 12 months. Rheumatologists should help ensure that ULT is optimized to achieve target serum uric acid levels to benefit patients.

[Changes for rheumatology in the G-DRG system 2005].

Science.gov (United States)

Fiori, W; Roeder, N; Lakomek, H-J; Liman, W; Köneke, N; Hülsemann, J L; Lehmann, H; Wenke, A

2005-02-01

The German prospective payment system G-DRG has been recently adapted and recalculated. Apart from the adjustments of the G-DRG classification system itself changes in the legal framework like the extension of the "convergence period" or the limitation of budget loss due to DRG introduction have to be considered. Especially the introduction of new procedure codes (OPS) describing the specialized and complex rheumatologic treatment of inpatients might be of significant importance. Even though these procedures will not yet develop influence on the grouping process in 2005, it will enable a more accurate description of the efforts of acute-rheumatologic treatment which can be used for further adaptations of the DRG algorithm. Numerous newly introduced additive payment components (ZE) result in a more adequate description of the "DRG-products". Although not increasing the individual hospital budget, these additive payments contribute to more transparency of high cost services and can be addressed separately from the DRG-budget. Furthermore a lot of other relevant changes to the G-DRG catalogue, the classification systems ICD-10-GM and OPS-301 and the German Coding Standards (DKR) are presented.

FOOD AS VECTOR FOR NUTRACEUTICAL INGREDIENTS

Directory of Open Access Journals (Sweden)

Bandana Chatterjee

2016-01-01

Full Text Available Now-a-days people consumption habits are changing they are inclined to buy healthy food that fulfills the need of essential nutrients in the body. With increasing educational level, people are becoming ready to accept different types of food & beverages that have added nutritional ingredient. Hence with this change, nutraceutical ingredient is gaining importance. Nutraceutical are those that combine technological and health properties. Nutraceutical Ingredients are substances with clinically confirmed health benefits and have broad applications in foods, beverages, dietary supplements and nutritional preparations. There are huge numbers of ingredients which are still unexplored. They have still not gained popularity in food industry. In this review paper a brief introduction of nutraceutical ingredient, its market and detailed knowledge of- Ginseng, Pine Bark Extract, Seabuckthorn, Buckwheat is mentioned.

Final report of the Cosmetic Ingredient Review Expert Panel amended safety assessment of Calendula officinalis-derived cosmetic ingredients.

Science.gov (United States)

Andersen, F Alan; Bergfeld, Wilma F; Belsito, Donald V; Hill, Ronald A; Klaassen, Curtis D; Liebler, Daniel C; Marks, James G; Shank, Ronald C; Slaga, Thomas J; Snyder, Paul W

2010-01-01

Calendula officinalis extract, C officinalis flower, C officinalis flower extract, C officinalis flower oil, and C officinalis seed oil are cosmetic ingredients derived from C officinalis. These ingredients may contain minerals, carbohydrates, lipids, phenolic acids, flavonoids, tannins, coumarins, sterols and steroids, monoterpenes, sesquiterpenes, triterpenes, tocopherols, quinones, amino acids, and resins. These ingredients were not significantly toxic in single-dose oral studies using animals. The absence of reproductive/developmental toxicity was inferred from repeat-dose studies of coriander oil, with a similar composition. Overall, these ingredients were not genotoxic. They also were not irritating, sensitizing, or photosensitizing in animal or clinical tests but may be mild ocular irritants. The Cosmetic Ingredient Review (CIR) Expert Panel concluded that these ingredients are safe for use in cosmetics in the practices of use and concentration given in this amended safety assessment.

Patient's Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia.

Science.gov (United States)

Sulaiman, Wahinuddin; Seung, Ong Ping; Ismail, Rosli

2012-11-01

In Rheumatology, non-steroidal anti-inflammatory drugs (NSAIDs) has been widely prescribed and used. However, despite their clinical benefits in the management of inflammatory and degenerative joint disease, NSAIDs have considerable side effects, mostly affecting the upper gastrointestinal system, which therefore, limit their use. This study was conducted to determine the patients' knowledge and perception regarding the used of NSAIDS. A total of 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia, and received NSAIDs more than 3 months were interviewed irrespective of their rheumatological conditions. Patient's knowledge and perception on the side effects of NSAIDs were recorded. Fifty-four percent of the patients obtained information regarding the side effect of NSAIDs either from the rheumatologist, rheumatology staff nurse or other medical staffs (75.4%). The remaining 45.8% were naive of such knowledge. Fifteen percent obtained the information by surfing the internet and 9.2% from printed media. Twenty-four (24.2%) patients, experienced indigestion and/or stomach discomfort attributed to NSAIDs used. Two patients (1.7%) had hematemesis and malena once. This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients.

Clinical Nononcologic Applications of PET/CT and PET/MRI in Musculoskeletal, Orthopedic, and Rheumatologic Imaging.

Science.gov (United States)

Gholamrezanezhad, Ali; Basques, Kyle; Batouli, Ali; Matcuk, George; Alavi, Abass; Jadvar, Hossein

2018-06-01

With improvements in PET/CT and PET/MRI over the last decade, as well as increased understanding of the pathophysiology of musculoskeletal diseases, there is an emerging potential for PET as a primary or complementary modality in the management of rheumatologic and orthopedic conditions. We discuss the role of PET/CT and PET/MRI in nononcologic musculoskeletal disorders, including inflammatory and infectious conditions and postoperative complications. There is great potential for an increased role for PET to serve as a primary or complementary modality in the management of orthopedic and rheumatologic disorders.

Including health equity considerations in development of instruments for rheumatology research

DEFF Research Database (Denmark)

O'Neill, Jennifer; Rader, Tamara; Guillemin, Francis

2014-01-01

The Outcome Measures in Rheumatology (OMERACT) Equity Special Interest Group (SIG) was established in 2008 to create a preliminary core set of outcome measures for clinical trials that can assess equity gaps in healthcare and the effectiveness of interventions to close or narrow gaps between...

Case mix in paediatric rheumatology: implications for training in Australia.

Science.gov (United States)

Lim, Sern Chin; Allen, Roger C; Munro, Jane E; Akikusa, Jonathan D

2012-05-01

Despite a move towards the provision of specialist training in Australia in settings that extend beyond the public hospital system, formal comparisons of case mix between public and private specialty clinics have rarely been performed. It is therefore unclear for many specialties how well training in one setting prepares trainees for practice in the other. This study aims to compare the case mix of paediatric rheumatology patients seen in public and private settings and the referral sources of patients in each. An audit of all new patients seen in the public and private paediatric rheumatology clinics on campus at Royal Children's Hospital between June 2009 and January 2011. Data related to demographics, primary diagnosis, referral source and location seen were abstracted and compared. Eight hundred and seventy-six new patients were seen during the period of interest. Of these, 429 patients (48.9%) were seen in private clinics. The commonest diagnostic categories for both type of clinics were non-inflammatory musculoskeletal pain/orthopaedic conditions (public 39.4%, private 33.6%) followed by juvenile idiopathic arthritis (public 16.6%, %, private 18.6%), other skin/soft tissue disorders (public 8.7%, private 9.6%) and pain syndromes (public 4.9%, private 11.4%). Patients with haematological and vasculitic disorders were predominantly seen in public clinics. The commonest source of referrals to both clinics was general practitioners (public 40.6%, private 53.1%). The case mix in private paediatric rheumatology clinics closely mirrors that of public clinics at our centre. Training in either setting would provide sufficient case-mix exposure to prepare trainees for practice in the other. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Oxidation of Mixed Active Pharmaceutical Ingredients in Biologically Treated Wastewater by ClO2

DEFF Research Database (Denmark)

Moradas, Gerly; Fick, Jerker; Ledin, Anna

2011-01-01

Biologically treated wastewater containing a mixture of 53 active pharmaceutical ingredients (APIs)was treated with 0-20 mg/l chlorine dioxide (ClO2) solution. Wastewater effluents were taken from two wastewater treatment plants in Sweden, one with (low COD) and one without (high COD) extended...... removed at 5 mg/l ClO2 dose. Removal of the same APIs from the high COD effluent was observed when the ClO2 dose was increased to 1.25 mg/l and an increase in API removal only after treatment with 8 mg/l ClO2. This illustrates that treatment of wastewater effluents with chlorine dioxide has potential...

Rheumatology education for undergraduate nursing, physiotherapy and occupational therapy students in the UK: standards, challenges and solutions

OpenAIRE

Hewlett, S.; Clarke, B.; O?Brien, A.; Hammond, A.; Ryan, S.; Kay, L.; Richards, P.; Almeida, C.

2008-01-01

Objectives. Rheumatological conditions are common, thus nurses (Ns) occupational therapists (OTs) and physiotherapists (PTs) require at least basic rheumatology knowledge upon qualifying. The aim of this study was to develop a core set of teaching topics and potential ways of delivering them. Methods. A modified Delphi technique was used for clinicians to develop preliminary core sets of teaching topics for each profession. Telephone interviews with educationalists explored their views on the...

Evaluating the migration of ingredients from active packaging and development of dedicated methods: A study of two iron-based oxygen absorbers

NARCIS (Netherlands)

López-Cervantes, L.; Sánchez-Machado, D.I.; Pastorelli, S.; Rijk, R.; Paseiro-Losada, P.

2003-01-01

The behaviour of two commercial oxygen-scavenging products with respect to migration of active ingredients into foodstuffs was investigated. Migrants were identified, and by using appropriate analytical methods, migration was determined in a variety of liquid, solid or gelled food simulants and

Influence of environmental factors on the contents of active ingredients and radical scavenging property of potentilla fruticosa in the main production areas of China

International Nuclear Information System (INIS)

Liu, W.; Yin, D. X.; Wang, D. M.; Li, D. W.

2015-01-01

Extracts from Potentilla fruticosa have been applied in traditional medicine and exhibited antioxidant property, but little has been known about the diversity of phytochemicals and properties on this species from different growing environment. This study investigated the influence of environmental factors on the active ingredient contents and radical scavenging property of P. fruticosa from different production areas of China in order to discover a location could produce high-quality resources for pharmaceutical products. The contents of tannin, total flavonoids, and rutin were determined and varied within the range of 7.64 ± 0.43 ∼ 10.68 ± 0.67 percentage, 2.29 ± 0.34 ∼ 5.37 ± 0.36 percentage, and 0.19 ± 0.053 ∼ 0.79 ± 0.125 percentage, respectively. Radical scavenging property was quantified, with the IC /sub 50/ of 7.24 ± 0.423 to 17.23 ± 0.551 μ g mL-1. Principal component analysis, multiple linear stepwise regression analysis, and path analysis were conducted to further analysis the relationship between the variations of active ingredients and radical scavenging capacity and growth environment. The results showed dominant environmental factors for these variations were rapidly available nitrogen, rapidly available phosphorus, pH, July average temperature, and annual sunshine duration. Furthermore, a significant positive correlation was observed between pH, annual sunshine duration and active ingredients and radical scavenging property (p<0.05). Considering the high active ingredient contents and strong radical scavenging property, leaf extracts from P. fruticosa could become useful supplements for pharmaceutical products as a new antioxidant agent, and Huzhu Northern Mountain in Qinghai Province and E-mei Mountain in Sichuan Province were selected as favorable production locations. (author)

Review article: health benefits of some physiologically active ingredients and their suitability as yoghurt fortifiers.

Science.gov (United States)

Fayed, A E

2015-05-01

The article is concerned with health benefits of two main physiologically active ingredients namely, Isoflavones and γ-Aminobutyric acid, with emphasis on their fitness for fortification of yoghurt to be consumed as a functional food. Isoflavones (ISO) are part of the diphenol compounds, called "phytoestrogens," which are structurally and functionally similar to estradiol, the human estrogen, but much less potent. Because of this similarity, ISO were suggested to have preventive effects for many kinds of hormone-dependent diseases. In nature, ISO usually occur as glycosides and, once deconjugated by the intestinal microflora, the ISO can be absorbed into the blood. At present, it seems convincing their possible protective actions against various cancers, osteoporosis and menopausal symptoms and high levels of blood cholesterol as well as the epidemiological evidence. Γ-Aminobutyric acid (GABA), it is an amino acid that has long been reported to lower blood pressure by intravenous administration in experimental animals and in human subjects. GABA is present in many vegetables and fruits but not in dairy products. GABA was reported to lower blood pressure in people with mild hypertension. It was suggested that low-dose oral GABA has a hypotensive effect in spontaneously hypertensive. Yoghurt beyond its ability to be probiotic food via its culturing with the gut strains, it could further carry more healthy benefits when it was fortified with physiological active ingredients, especially GABA versus ISO preferring, whether, bacteriologically or biochemically, a fortification level of 50 mg ISO/kg or 200 mg GABA/kg.

Intrinsic Motivation and Engagement as "Active Ingredients" in Garden-Based Education: Examining Models and Measures Derived from Self-Determination Theory

Science.gov (United States)

Skinner, Ellen A.; Chi, Una

2012-01-01

Building on self-determination theory, this study presents a model of intrinsic motivation and engagement as "active ingredients" in garden-based education. The model was used to create reliable and valid measures of key constructs, and to guide the empirical exploration of motivational processes in garden-based learning. Teacher- and…

Developing an OMERACT Core Outcome Set for Assessing Safety Components in Rheumatology Trials

DEFF Research Database (Denmark)

Klokker, Louise; Tugwell, Peter; Furst, Daniel E

2016-01-01

in such COS. The Outcome Measures in Rheumatology (OMERACT) Filter 2.0 emphasizes the importance of measuring harms. The Safety Working Group was reestablished at the OMERACT 2016 with the objective to develop a COS for assessing safety components in trials across rheumatologic conditions. METHODS: The safety......OBJECTIVE: Failure to report harmful outcomes in clinical research can introduce bias favoring a potentially harmful intervention. While core outcome sets (COS) are available for benefits in randomized controlled trials in many rheumatic conditions, less attention has been paid to safety...... that patients consider relevant so that they will be able to make informed decisions. CONCLUSION: The OMERACT Safety Working Group will advance the work previously done within OMERACT using a new patient-driven approach....

Nursing, occupational therapy, and physical therapy preparation in rheumatology in the United States and Canada.

Science.gov (United States)

Jette, A M; Becker, M C

1980-11-01

Directors of undergraduate programs in nursing, physical therapy, and occupational therapy in the United States and Canada were surveyed to determine the amount and perceived adequacy of the current degree of classroom and clinical exposure to the rheumatic diseases. One hundred ninety-one (73%) of the 262 mailed questionnaires were returned. Results indicate that regardless of the actual degree of rheumatologic classroom exposure, directors in all three disciplines view current amounts as adequate. A larger proportion views levels of clinical exposure as inadequate. In general, the Canadian programs had a greater emphasis on rheumatology than their United States counterparts.

APT drug R&D: the right active ingredient in the right presentation for the right therapeutic use.

Science.gov (United States)

Cavalla, David

2009-11-01

Drug repurposing, in which an established active pharmaceutical ingredient is applied in a new way - for example, for a new indication, and often combined with an alternative method of presentation, such as a novel delivery route - is an evolving strategy for pharmaceutical R&D. This article discusses examples of the success of this strategy, and presents an analysis of sales of US pharmaceutical products that suggests that this low-risk approach to new product development retains substantial commercial value.

Quantification of active ingredients in suppositories by FT-Raman spectroscopy.

Science.gov (United States)

Szostak, Roman; Mazurek, Sylwester

2013-02-01

An efficient method for the quantitative determination of acetaminophen (AAP) and diclofenac sodium (DS) in commercial suppositories based on partial least squares (PLS) treatment of FT-Raman spectra is described. The relative standard errors of prediction (RSEP) were calculated for calibration and validation data sets to evaluate the quality of the constructed models. In the case of DS determination, RSEP error values of 1.9 % and 2.3 % for the calibration and validation data sets, respectively, were found. For AAP these errors amounted to 1.6-2.3 % and 1.8-2.8 %, respectively, for the different calibration models. Four commercial preparations containing 5, 12.5, 16.7 and 33.3 % (w/w) AAP and one containing 5 % (w/w) DS were successfully quantified using the developed models. Concentrations derived from the developed models correlated strongly with the declared values and yielded recoveries of 99.4-100.2 % and 99.6 % for AAP and DS, respectively. The proposed procedure can be used as a fast, economic and reliable method for quantification of the active pharmaceutical ingredients in suppositories. Copyright © 2012 John Wiley & Sons, Ltd.

Lactose in dairy ingredients: Effect on processing and storage stability.

Science.gov (United States)

Huppertz, Thom; Gazi, Inge

2016-08-01

Lactose is the main carbohydrate in the milk of most species. It is present in virtually all dry dairy ingredients, with levels ranging from lactose powders. The presence of lactose has a strong effect on ingredient processing and stability. Lactose can negatively influence powder properties and lead to undesirable effects, such as the stickiness of powder resulting in fouling during drying, or caking and related phenomena during storage. In addition, being a reducing carbohydrate, lactose can also participate in the Maillard reaction with free amino groups of proteins, peptides, and free AA. In this review, the influence of the presence (or absence) of lactose on physiochemical properties of dairy ingredients is reviewed, with particular emphasis on behavior during processing and storage. Particularly important features in this respect are whether lactose is in the (glassy) amorphous phase or in the crystalline phase, which is strongly affected by precrystallization conditions (e.g., in lactose, permeate, and whey powders) and by drying conditions. Furthermore, the moisture content and water activity of the ingredients are important parameters to consider, as they determine both mobility and reactivity, influencing Maillard reactions and concomitant browning, the crystallization of amorphous lactose during storage of dairy ingredients, glass transitions temperatures, and associated stickiness and caking phenomena. For the stickiness and caking, a crucial aspect to take into account is powder particle surface composition in relation to the bulk powder. Lactose is typically underrepresented at the powder surface, as a result of which deviations between observed lactose-induced caking and stickiness temperatures, and determined glass transition temperatures arise. By considering lactose as an integral part of ingredient composition along with all other compositional and environmental properties, lactose behavior in dairy ingredients can be understood, controlled, and

[Research advance in metabolism of effective ingredients from traditional Chinese medicines by probiotics].

Science.gov (United States)

Dai, Cheng-En; Li, Hai-Long; He, Xiao-Ping; Zheng, Fen-Fen; Zhu, Hua-Liu; Liu, Liang-Feng; Du, Wei

2018-01-01

The pharmacological activity of active ingredients from Chinese medicine depends greatly on the microecological environment of probiotics in the human body. After effective ingredients from traditional Chinese medicines are metabolized or biotransformed by probiotics, their metabolites can increase pharmacological activity, and can be absorbed more easily to improve the bioavailability. Therefore, the combination of Chinese medicines with probiotics is the innovation point in R&D of functional food and Chinese medicines, and also a new thinking for the modernization of Chinese medicine.This review summarizes and analyses the research progress on metabolism effects of gut microbiota on Chinese medicines components, the regulating effect of effective ingredients from Chinese medicine on intestinal probiotics, the application status of probiotics in traditional Chinese medicines, and the main problems and prospects in the research and development of Chinese medicines products with probiotic, aiming to provide theoretical guidance and practical value for the fermentation engineering of Chinese herbal medicine. Copyright© by the Chinese Pharmaceutical Association.

Association between antinuclear antibody titers and connective tissue diseases in a Rheumatology Department.

Science.gov (United States)

Menor Almagro, Raúl; Rodríguez Gutiérrez, Juan Francisco; Martín-Martínez, María Auxiliadora; Rodríguez Valls, María José; Aranda Valera, Concepción; de la Iglesia Salgado, José Luís

To determine the dilution titles at antinuclear antibodies (ANA) by indirect immunofluorescence observed in cell substrate HEp-2 and its association with the diagnosis of systemic connective tissue disease in ANA test requested by a Rheumatology Unit. Samples of patients attended for the first time in the rheumatology unit, without prior ANA test, between January 2010 and December 2012 were selected. The dilution titers, immunofluorescence patterns and antigen specificity were recorded. In January 2015 the diagnosis of the patients were evaluated and classified in systemic disease connective tissue (systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, undifferentiated connective, antiphospholipid syndrome, mixed connective tissue and inflammatory myophaty) or not systemic disease connective tissue. A total of 1282 ANA tests requested by the Rheumatology Unit in subjects without previous study, 293 were positive, predominance of women (81.9%). Patients with systemic connective tissue disease were recorded 105, and 188 without systemic connective tissue disease. For 1/640 dilutions the positive predictive value in the connective was 73.3% compared to 26.6% of non-connective, and for values ≥1/1,280 85% versus 15% respectively. When performing the multivariate analysis we observed a positive association between 1/320 dilution OR 3.069 (95% CI: 1.237-7.614; P=.016), 1/640 OR 12.570 (95% CI: 3.659-43.187; P=.000) and ≥1/1,280 OR 42.136 (95% CI: 8.604-206.345; P=.000). These results show association titles dilution ≥1/320 in ANA's first test requested by a Rheumatology Unit with patients with systemic connective tissue disease. The VPP in these patients was higher than previous studies requested by other medical specialties. This may indicate the importance of application of the test in a targeted way. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Musculoskeletal ultrasound in pediatric rheumatology

Directory of Open Access Journals (Sweden)

Özçakar Levent

2011-09-01

Full Text Available Abstract Although musculoskeletal ultrasound (MSUS has emerged as an indispensible tool among physicians involved in musculoskeletal medicine in the last two decades, only recently has it become more attractive to pediatric rheumatologists. Thereafter, the use of MSUS in pediatric rheumatology has started to increase. Yet, an ever-growing body of literature shows parity and even superiority of MSUS when compared to physical examination and other imaging modalities. MSUS is suitable for examination of children of all ages and it has certain advantages over other imaging modalities; as it is cheaper, mobile, instantly accessible bedside, easy to combine with clinical assessment (interactivity and non-invasive. It does not require sedation, which facilitates repetitive examinations. Assessment of multiple locations is possible during the same session. Agitation is rarely a problem and small children can be seated in their parents' lap or they can even play while being examined.

Framework for Advancing the Reporting of Patient Engagement in Rheumatology Research Projects.

Science.gov (United States)

Hamilton, Clayon B; Leese, Jenny C; Hoens, Alison M; Li, Linda C

2017-07-01

The term "patient engagement in research" refers to patients and their surrogates undertaking roles in the research process beyond those of study participants. This paper proposes a new framework for describing patient engagement in research, based on analysis of 30 publications related to patient engagement. Over the past 15 years, patients' perspectives have been instrumental in broadening the scope of rheumatology research and outcome measurement, such as evaluating fatigue in rheumatoid arthritis. Recent reviews, however, highlight low-quality reporting of patient engagement in research. Until we have more detailed information about patient engagement in rheumatology research, our understanding of how patients' perspectives are being integrated into research projects remains limited. When authors follow our guidance on the important components for describing patients' roles and function as "research partners," researchers and other knowledge users will better understand how patients' perspectives were integrated in their research projects.

Digital health: a new dimension in rheumatology patient care.

Science.gov (United States)

Kataria, Suchitra; Ravindran, Vinod

2018-04-30

The new digital health innovations have opened up several opportunities to help the clinicians, patients and other caregivers of rheumatology healthcare system in maximizing efficiencies resulting in better patient outcomes. In the global context, digital health technology has the potential to bridge the distance gap between all the key stakeholders involved in rheumatology health care. In this review, we update on the recent advances in the field of digital health and highlight unique features of these technologies which would help in routine care. Application of technology in any form to enable, facilitate or enhance the quality of care is the foundation of digitised care. The components could be smartphone apps, sensors, video, social media platforms or messenger platforms, wearables or a combination of these enabling healthcare delivery and overcoming the constraints of distance, location and time. Digital therapeutics have started evolving and an important step in this direction is the involvement of FDA in the approval process. Speciality specific apps, personalised patient education as per disease status, remote specialist consultations or virtual health coach to guide on lifestyle modifications are some of the developments which have been facilitated by increased digitization in all walks of life. Assisted care with the help of robots rendering care in the hospitals or an intelligent robot guiding a patient by voice and visual sense at home are already at the threshold of entering the mainstream of patient care. Wearable devices equipped with powerful sensors are coming handy in keeping a watch on patient symptoms all the time and providing useful insights on disease progression, clinical response or complications. In chronic care such as rheumatology the implications, possibilities and benefits seem unprecedented. Real time data analytics and artificial intelligence are helping the clinicians, healthcare systems and policy makers optimise the resources and

Ingredients and change processes in occupational therapy for children: a grounded theory study.

Science.gov (United States)

Armitage, Samantha; Swallow, Veronica; Kolehmainen, Niina

2017-05-01

There is limited evidence about the effectiveness of occupational therapy interventions for participation outcomes in children with coordination difficulties. Developing theory about the interventions, i.e. their ingredients and change processes, is the first step to advance the evidence base. To develop theory about the key ingredients of occupational therapy interventions for children with coordination difficulties and the processes through which change in participation might happen. Grounded theory methodology, as described by Kathy Charmaz, was used to develop the theory. Children and parents participated in semi-structured interviews to share their experiences of occupational therapy and processes of change. Data collection and analysis were completed concurrently using constant comparison methods. Five key ingredients of interventions were described: performing activities and tasks; achieving; carer support; helping and supporting the child; and labelling. Ingredients related to participation by changing children's mastery experience, increasing capability beliefs and sense of control. Parents' knowledge, skills, positive emotions, sense of empowerment and capability beliefs also related to children's participation. The results identify intervention ingredients and change pathways within occupational therapy to increase participation. It is unclear how explicitly and often therapists consider and make use of these ingredients and pathway.

21 CFR 701.3 - Designation of ingredients.

Science.gov (United States)

2010-04-01

... declaration of ingredients is thereby required to be used in conjunction with products of both the old and new formulations, the labeling shall declare the ingredients of both the old and new formulations separately in a... paragraph is inapplicable to any ingredient mentioned in advertising, or in labeling other than in the...

Patient’s Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia

Science.gov (United States)

Sulaiman, Wahinuddin; Seung, Ong Ping; Ismail, Rosli

2012-01-01

Objective In Rheumatology, non-steroidal anti-inflammatory drugs (NSAIDs) has been widely prescribed and used. However, despite their clinical benefits in the management of inflammatory and degenerative joint disease, NSAIDs have considerable side effects, mostly affecting the upper gastrointestinal system, which therefore, limit their use. This study was conducted to determine the patients’ knowledge and perception regarding the used of NSAIDS. Methods A total of 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia, and received NSAIDs more than 3 months were interviewed irrespective of their rheumatological conditions. Patient’s knowledge and perception on the side effects of NSAIDs were recorded. Result Fifty-four percent of the patients obtained information regarding the side effect of NSAIDs either from the rheumatologist, rheumatology staff nurse or other medical staffs (75.4%). The remaining 45.8% were naive of such knowledge. Fifteen percent obtained the information by surfing the internet and 9.2% from printed media. Twenty-four (24.2%) patients, experienced indigestion and/or stomach discomfort attributed to NSAIDs used. Two patients (1.7%) had hematemesis and malena once. Conclusion This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients. PMID:23226825

Paediatric rheumatology practice in the UK benchmarked against the British Society for Paediatric and Adolescent Rheumatology/Arthritis and Musculoskeletal Alliance Standards of Care for juvenile idiopathic arthritis.

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Kavirayani, Akhila; Foster, Helen E

2013-12-01

To describe current clinical practice against the BSPAR/ARMA Standards of Care (SOCs) for children and young people (CYP) with incident JIA. Ten UK paediatric rheumatology centres (including all current centres nationally accredited for paediatric rheumatology higher specialist training) participated in a retrospective case notes review using a pretested pro forma based on the SOC. Data collected per centre included clinical service configuration and the initial clinical care for a minimum of 30 consecutive new patients seen within the previous 2 years and followed up for at least 6 months. A total of 428 CYP with JIA (median age 11 years, range 1-21 years) were included, with complete data available for 73% (311/428). Against the key SOCs, 41% (175/428) were assessed ≤10 weeks from symptom onset, 60% (186/311) ≤4 weeks from referral, 26% (81/311) had eye screening at ≤6 weeks, 83% (282/341) had joint injections at ≤6 weeks, 59% (184/311) were assessed by a nurse specialist at ≤4 weeks and 45% (141/311) were assessed by a physiotherapist at ≤8 weeks. A median of 6% of patients per centre participated in clinical trials. All centres had access to eye screening and prescribed biologic therapies. All had access to a nurse specialist and physiotherapist. Most had access to an occupational therapist (8/10), psychologist (8/10), joint injection lists (general anaesthesia/inhaled analgesia) (9/10) and designated transitional care clinics (7/10). This first description of UK clinical practice in paediatric rheumatology benchmarked against the BSPAR/ARMA SOCs demonstrates variable clinical service delivery. Considerable delay in access to specialist care is evident and this needs to be addressed in order to improve clinical outcomes.

Getting back to the dissecting room: An evaluation of an innovative course in musculoskeletal anatomy for UK-based rheumatology training.

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Blake, Tim; Marais, Debbi; Hassell, Andrew B; Stevenson, Kay; Paskins, Zoe

2017-12-01

The rheumatologist relies heavily on clinical skills to diagnose diverse conditions, something that is correlated with one's knowledge of clinical anatomy. More recently, rheumatology has offered further career flexibility with opportunities to develop skills such as joint injection and musculoskeletal (MSK) ultrasound, both of which require a sound understanding of anatomy. Currently, there are no formal strategies to support competency-based anatomy learning in rheumatology in the UK. This study aimed to evaluate an innovative applied anatomy course utilizing cadaveric material, targeted at clinicians practising in rheumatology and MSK medicine. A new course was developed for rheumatologists, rheumatology trainees and allied health professionals practising rheumatology and MSK medicine, with the principal focus being on applied MSK anatomy. A questionnaire was given to course attendees and a mixed methods approach of evaluation used. Descriptive statistical data analysis was performed. The course received overall positive feedback and statistically significant improvements in levels of confidence in anatomy (mean 52.35-83.53, p attendees also favoured a peer-assisted and multidisciplinary learning approach. This study lends support for the use of cadaveric material in the teaching of postgraduate anatomy to rheumatologists. It has demonstrated a continual need for hands-on and interactive anatomy training in an ever-advancing digital world. To be successful, cadaveric learning should not be viewed in a purely 'pre-clinical' setting, but instead integrated with postgraduate learning. Copyright © 2017 John Wiley & Sons, Ltd.

Biosimilars in rheumatology: recommendations for regulation and use in Middle Eastern countries.

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El Zorkany, Bassel; Al Ani, Nizar; Al Emadi, Samar; Al Saleh, Jamal; Uthman, Imad; El Dershaby, Yasser; Mounir, Mohamed; Al Moallim, Hani

2018-05-01

The increasing availability of biosimilar medicines in Middle Eastern regions may provide an opportunity to increase the number of rheumatology patients who have access to traditionally more expensive biologic medicines. However, as well as a lack of real-world data on the use of biosimilar medicines in practice, the availability of intended copies in the region may undermine physician confidence in prescribing legitimate biosimilar medicines. There is a need for regional recommendations for healthcare professionals to ensure that biosimilar drugs can be used safely. Therefore, a literature search was performed with the aim of providing important recommendations for the regulation and use of biosimilar medicines in the Middle East from key opinion leaders in rheumatology from the region. These recommendations focus on improving the availability of relevant real-world data, ensuring that physicians are aware of the difference between intended copies and true biosimilars and ensuring that physicians are responsible for making any prescribing and switching decisions.

Bioequivalence of eslicarbazepine acetate from two different sources of its active product ingredient in healthy subjects.

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Falcão, Amílcar; Lima, Ricardo; Sousa, Rui; Nunes, Teresa; Soares-da-Silva, Patrício

2013-06-01

To compare the bioavailability (BA) and pharmacokinetic (PK) properties and to demonstrate the bioequivalence (BE) between two active product ingredient (API) sources of eslicarbazepine acetate (ESL) in healthy volunteers. Forty healthy male and female subjects aged 18-40 years were randomized to treatment with 400 or 800 mg ESL marketed (MF) formulation [current active pharmaceutical ingredient (API) source] and 400 or 800 mg ESL to-be-marketed (TBM) formulation (new API source) under a gender-balanced, two-period, two-sequence crossover open-label study design. Subjects were assigned to receive either 400 or 800 mg ESL dose strengths, and each was randomly administered on two occasions--either a single oral tablet of MF or a single oral tablet of TBM--separated by a washout period of at least 7 days. Formulations were to be considered bioequivalent if, for both 400 or 800 mg ESL dosage strengths, the test (TBM)/reference (MF) geometric mean ratios (GMR) and 90% confidence intervals (90% CI) of the area under the plasma concentration-time curve (AUC) and peak plasma concentration (Cmax) were within the predetermined range of 80-125%. Test/reference GMR (90% CI) for the Cmax and AUC was respectively 100% (94-109%) and 96% (94-98%) following 400 mg ESL and 100% (95-105%) and 100% (97-103%) following 800 mg ESL. Oral tablet formulations of either 400 or 800 mg ESL from the new API source were found to be bioequivalent to the corresponding marketed Zebinix® formulation according to the regulatory definition of bioequivalence.

Mycosporine-Like Amino Acids: Potential Health and Beauty Ingredients

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Ewelina Chrapusta

2017-10-01

Full Text Available Human skin is constantly exposed to damaging ultraviolet radiation (UVR, which induces a number of acute and chronic disorders. To reduce the risk of UV-induced skin injury, people apply an additional external protection in the form of cosmetic products containing sunscreens. Nowadays, because of the use of some chemical filters raises a lot of controversies, research focuses on exploring novel, fully safe and highly efficient natural UV-absorbing compounds that could be used as active ingredients in sun care products. A promising alternative is the application of multifunctional mycosporine-like amino acids (MAAs, which can effectively compete with commercially available filters. Here, we outline a complete characterization of these compounds and discuss their enormous biotechnological potential with special emphasis on their use as sunscreens, activators of cells proliferation, anti-cancer agents, anti-photoaging molecules, stimulators of skin renewal, and functional ingredients of UV-protective biomaterials.

Mycosporine-Like Amino Acids: Potential Health and Beauty Ingredients

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Chrapusta, Ewelina; Kaminski, Ariel; Duchnik, Kornelia; Bober, Beata; Adamski, Michal; Bialczyk, Jan

2017-01-01

Human skin is constantly exposed to damaging ultraviolet radiation (UVR), which induces a number of acute and chronic disorders. To reduce the risk of UV-induced skin injury, people apply an additional external protection in the form of cosmetic products containing sunscreens. Nowadays, because of the use of some chemical filters raises a lot of controversies, research focuses on exploring novel, fully safe and highly efficient natural UV-absorbing compounds that could be used as active ingredients in sun care products. A promising alternative is the application of multifunctional mycosporine-like amino acids (MAAs), which can effectively compete with commercially available filters. Here, we outline a complete characterization of these compounds and discuss their enormous biotechnological potential with special emphasis on their use as sunscreens, activators of cells proliferation, anti-cancer agents, anti-photoaging molecules, stimulators of skin renewal, and functional ingredients of UV-protective biomaterials. PMID:29065484

Analysis of Ingredient Lists to Quantitatively Characterize ...

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The EPA’s ExpoCast program is developing high throughput (HT) approaches to generate the needed exposure estimates to compare against HT bioactivity data generated from the US inter-agency Tox21 and the US EPA ToxCast programs. Assessing such exposures for the thousands of chemicals in consumer products requires data on product composition. This is a challenge since quantitative product composition data are rarely available. We developed methods to predict the weight fractions of chemicals in consumer products from weight fraction-ordered chemical ingredient lists, and curated a library of such lists from online manufacturer and retailer sites. The probabilistic model predicts weight fraction as a function of the total number of reported ingredients, the rank of the ingredient in the list, the minimum weight fraction for which ingredients were reported, and the total weight fraction of unreported ingredients. Weight fractions predicted by the model compared very well to available quantitative weight fraction data obtained from Material Safety Data Sheets for products with 3-8 ingredients. Lists were located from the online sources for 5148 products containing 8422 unique ingredient names. A total of 1100 of these names could be located in EPA’s HT chemical database (DSSTox), and linked to 864 unique Chemical Abstract Service Registration Numbers (392 of which were in the Tox21 chemical library). Weight fractions were estimated for these 864 CASRN. Using a

[Immune mechanisms of the active ingredients of Chinese medicinal herbs for chronic prostatitis].

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Wang, Hao; Zhou, Yu-chun; Xue, Jian-guo

2016-01-01

Chronic prostatitis is a common male disease, and its pathogenesis is not yet clear. Most scholars believe that oxidative stress and immune imbalance are the keys to the occurrence and progression of chronic prostatitis. Currently immunotherapy of chronic prostatitis remains in the exploratory stage. This article relates the active ingredients of 5 Chinese medicinal herbs (total glucosides of paeony, tripterigium wilfordii polglycosidium, curcumin, geniposide, and quercetin) for the treatment of chronic prostatitis and their possible action mechanisms as follows: 1) inhibiting the immune response and activation and proliferation of T-cells, and adjusting the proportion of Th1/Th2 cells; 2) upregulating the expression of Treg and enhancing the patient's tolerability; 3) suppressing the activation of the NF-kB factor, reducing the release of iNOS, and further decreasing the release of NO, IL-2 and other inflammatory cytokines, which contribute to the suppression of the immune response; 4) inhibiting the production of such chemokines as MCP-1 and MIP-1α in order to reduce their induction of inflammatory response. Studies on the immune mechanisms of Chinese medicinal herbs in the treatment of chronic prostatitis are clinically valuable for the development of new drugs for this disease.

[Structural quality of rheumatology clinics for children and adolescents. Paper by a task force of the "Society of Pediatric and Adolescent Rheumatology" and of the "Association of Rheumatology Clinics in Germany"].

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Michels, H; Ganser, G; Dannecker, G; Forster, J; Häfner, R; Horneff, G; Küster, R M; Lakomek, H-J; Lehmann, H; Minden, K; Rogalski, B; Schöntube, M

2006-07-01

Rheumatic diseases in childhood and adolescence differ from those of adulthood according to type, manifestation, treatment and course. A specialized therapy, starting as early as possible, improves the prognosis, can prevent long-term damage and saves the costs of long-term care. Only a specialized pediatric care system can guarantee optimum quality of the processes involved and the results for rheumatology in childhood and adolescence within a global financial system. This requires adequate structural quality of the specialized clinics and departments for pediatric rheumatology. The management of rheumatic diseases in childhood and adolescence is comprehensive and requires a multidisciplinary, specialized and engaged team which can cover the whole spectrum of rheumatic diseases with their various age-dependent aspects. In order to guarantee an adequate, cost-efficient routine, a specialized center which concentrates on inpatient care should treat at least 300 patients with pediatric rheumatic diseases per year. The diagnoses should be divided among the various disease categories with at least 70% of them involving inflammatory rheumatic diseases. For the inpatient care of small children, an accompanying person (parent) is necessary, requiring adequate structures and services. Patient rooms as well as diagnostic (radiography, sonography, etc.) and therapeutic services (physiotherapy, occupational therapy, pool, etc.) must be adequate for small children and school children as well as adolescents. Suitable mother-child units must also be provided and a school for patients is required within the clinic. A pediatric rheumatologist must be available 24 h a day, and it must be possible to reach other specialists within a short time. For painful therapeutic procedures, age-appropriate pain management is obligatory. A continuous adjustment of these recommendations to changing conditions in health politics is intended.

Dampened neural activity and abolition of epileptic-like activity in cortical slices by active ingredients of spices

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Pezzoli, Maurizio; Elhamdani, Abdeladim; Camacho, Susana; Meystre, Julie; González, Stephanie Michlig; le Coutre, Johannes; Markram, Henry

2014-01-01

Active ingredients of spices (AIS) modulate neural response in the peripheral nervous system, mainly through interaction with TRP channel/receptors. The present study explores how different AIS modulate neural response in layer 5 pyramidal neurons of S1 neocortex. The AIS tested are agonists of TRPV1/3, TRPM8 or TRPA1. Our results demonstrate that capsaicin, eugenol, menthol, icilin and cinnamaldehyde, but not AITC dampen the generation of APs in a voltage- and time-dependent manner. This effect was further tested for the TRPM8 ligands in the presence of a TRPM8 blocker (BCTC) and on TRPM8 KO mice. The observable effect was still present. Finally, the influence of the selected AIS was tested on in vitro gabazine-induced seizures. Results coincide with the above observations: except for cinnamaldehyde, the same AIS were able to reduce the number, duration of the AP bursts and increase the concentration of gabazine needed to elicit them. In conclusion, our data suggests that some of these AIS can modulate glutamatergic neurons in the brain through a TRP-independent pathway, regardless of whether the neurons are stimulated intracellularly or by hyperactive microcircuitry. PMID:25359561

[Enzyme kinetic analysis of Oncomelania hupensis exposed to active ingredient of Buddleja lindleyana (AIBL)].

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Bang-Xing, Han; Jun, Chen

2016-07-01

To analyze the enzyme kinetics of active ingredient of Buddleja lindleyana (AIBL) against Oncomelania hupensis , the intermediate host of Schistosoma japonicum . O . hupensis snails were placed in 1 000 ml of 3.55 mg/L AIBL solution for 24, 48 h and 72 h, respectively, and the enzyme kinetics of alanine aminotransferase (GPT) was determined by Reitman-Frankel assay, lactate dehydrogenase (LDH) by the chemical inhibition lactic acid substrate method, alkaline phosphatase (AKP) by the disodium phenyl phosphate colorimetric method, acetylcholine esterase (AChE) and malate dehydrogenas (MDH) by ELISA, and succinate dehydrogenase (SDH) by the phenazine methyl sulfate reaction method (PMS) in the soft tissues of O. hupensis before and after AIBL treatment. Following exposure to 3.55 mg/L AIBL solution for 24 h, the GPT, LDH, and AKP activities significantly improved in the soft tissues of O. hupensis , while the SDH and MDH activities were significantly lowered in the head-foot and liver. However, AIBL treatment did not cause significant effect on AChE activity in O. hupensis . AIBL causes significant damages to O. hupensis liver and can efficiently act on anaerobic and aerobic respiration loci, which will hinder energy metabolism, and cause inadequate energy supply in cells used for normal secretion, eventually leading to O. hupensis death.

Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients.

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Wurglics, Mario; Schubert-Zsilavecz, Manfred

2006-01-01

Hypericum perforatum (St John's Wort [SJW]) counts among the most favourite herbal drugs, and is the only herbal alternative to classic synthetic antidepressants in the therapy of mild to moderate depression. Several clinical studies have been conducted to verify the effectiveness of ethanolic or methanolic extracts of SJW. Alcoholic SJW extracts are a mixture of substances with widely varying physical and chemical properties and activities. Hyperforin, a phloroglucinol derivative, is the main source of pharmacological effects caused by the consumption of alcoholic extracts of SJW in the therapy of depression. However, several studies indicate that flavone derivatives, e.g. rutin, and also the naphthodianthrones hypericin and pseudohypericin, take part in the antidepressant efficacy. In contrast to the amount of documentation concerning clinical efficacy, oral bioavailability and pharmacokinetic data about the active components are rather scarce. The hyperforin plasma concentration in humans was investigated in a small number of studies. The results of these studies indicate a relevant plasma concentration, comparable with that used in in vitro tests. Furthermore, hyperforin is the only ingredient of H. perforatum that could be determined in the brain of rodents after oral administration of alcoholic extracts. The plasma concentrations of the hypericins were, compared with hyperforin, only one-tenth and, until now, the hypericins could not be found in the brain after oral administration of alcoholic H. perforatum extracts or pure hypericin. Until now, the pharmacokinetic profile of the flavonoids in humans after oral administration of an alcoholic H. perforatum extract has been investigated in only one study. More data are available for rutin and the aglycone quercetin after administration of pure substances or other flavonoid sources.

Risk of Serious Infection in Juvenile Idiopathic Arthritis Patients Associated With Tumor Necrosis Factor Inhibitors and Disease Activity in the German Biologics in Pediatric Rheumatology Registry.

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Becker, Ingrid; Horneff, Gerd

2017-04-01

To examine the effects of tumor necrosis factor inhibitors on the risk for serious infections and other influencing factors in a registry. Patients exposed for the first time to etanercept, adalimumab, or methotrexate and serious infections were identified in the German Biologic Registry for Pediatric Rheumatology (BIKER) registry. Serious infection rates per 1,000 observation-years and relative risks were calculated. Cox regression identified risk factors and provided hazard ratios (HRs) for occurrence of infections. A total of 3,350 patients with 5,919 observation-years fulfilled the inclusion criteria for the study. The first biologic agents were etanercept (1,720 cases) and adalimumab (177 cases). A total of 1,453 patients were treated with methotrexate and no biologic agent. In total, 28 serious infections were reported in 26 patients (4.7 per 1,000 patient-years), 5 with methotrexate (1.6 per 1,000 patient-years), 21 with etanercept (8.1 per 1,000 patient-years), and 2 with adalimumab (9.7 per 1,000 patient-years). Significant univariate risk factors for infection were therapy with biologic agents, disease duration before therapy start, corticosteroid medication, nonbiologic premedications, higher clinical Juvenile Arthritis Disease Activity Score including maximal 10 joints (cJADAS10) at therapy start, and higher mean cJADAS10 during therapy. In multivariate Cox regression, only biologic therapy and cJADAS10 at therapy start remained significant. Risk for infection was increased by etanercept (univariate HR 6.0 [95% confidence interval (95% CI) 2.0-17.5]) or adalimumab (HR 7.3 [95% CI 1.3-40.0]) compared to methotrexate as well as by an elevated cJADAS10 at therapy start (HR 1.1 [95% CI 1.0-1.2] per unit increase). The total rate of serious infections reported in the BIKER registry seems low. Treatment with etanercept or adalimumab increases the risk for serious infection slightly, compared to methotrexate. Disease activity expressed by cJADAS10 appears to

Attractive toxic sugar baits: Control of mosquitoes with the low risk active ingredient dinotefuran and potential impacts on non-target organisms in Morocco

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We evaluated the efficacy of ATSB in the laboratory and the field with the low risk active ingredient dinotefuran against mosquito populations. Assays indicated that dinotefuran in solution with the sugar baits was ingested and resulted in high mortality of female Culex quinquefasciatus and Aedes a...

Antiviral Effects of Saffron and its Major Ingredients.

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Soleymani, Sepehr; Zabihollahi, Rezvan; Shahbazi, Sepideh; Bolhassani, Azam

2018-01-01

The lack of an effective vaccine against viral infections, toxicity of the synthetic anti-viral drugs and the generation of resistant viral strains led to discover novel inhibitors. Recently, saffron and its compounds were used to treat different pathological conditions. In this study, we tested the anti-HSV-1 and anti-HIV-1 activities of Iranian saffron extract and its major ingredients including crocin and picrocrocin as well as cytotoxicity in vitro. The data showed that the aqueous saffron extract was not active against HIV-1 and HSV-1 virions at certain doses (i.e., a mild activity), but crocin and picrocrocin indicated significant anti-HSV-1 and also anti-HIV-1 activities. Crocin inhibited the HSV replication at before and after entry of virions into Vero cells. Indeed, crocin carotenoid suppressed HSV penetration in the target cells as well as disturbed virus replication after entry into the cells. Picrocrocin was also effective for inhibiting virus entry and also its replication. This monoterpen aldehyde showed higher anti-HSV effects after virus penetrating in the cells. Generally, these sugar-containing compounds extracted from saffron showed to be effective antiherpetic drug candidates. The recent study is the first report suggesting antiviral activities for saffron extract and its major ingredients. Crocin and picrocrocin could be a promising anti-HSV and anti-HIV agent for herbal therapy against viral infections. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

[The G-DRG System 2009--relevant changes for rheumatology].

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Fiori, W; Liedtke-Dyong, A; Lakomek, H-J; Buscham, K; Lehmann, H; Liman, W; Fuchs, A-K; Bessler, F; Roeder, N

2010-05-01

The following article presents the major general and specific changes in the G-DRG system, in the classification systems for diagnoses and procedures as well as for the billing process for 2010. Since the G-DRG system is primarily a tool for the redistribution of resources, every hospital needs to analyze the economic effects of the changes by applying the G-DRG transition-grouper to its own cases. Depending on their clinical focus, rheumatological departments may experience positive or negative consequences from the adjustments. In addition, relevant current case law is considered.

Increased occurrence of cardiovascular events and comorbidities in a general rheumatology cohort.

LENUS (Irish Health Repository)

Mohammad, A

2012-02-01

BACKGROUND: To identify cardiovascular and other comorbidities in a general rheumatology cohort. METHODS: Interviews\\/retrospective chart audits were conducted on 1,000 patients attending rheumatology outpatient clinics of a university teaching hospital. Comorbidities were classified using the Charlson comorbidity index (Ambrose et al. in Ir J Med Sci 178(1):53-55, 2009). RESULTS: Mean age 58 +\\/- 15.3 years, mean BMI 26. Of the patients, 400 (40%) were diagnosed with dyslipidemia and hypertension (p = 0.002), 160 (16%) with obesity and 80 (8%) with hypothyroidism. Overall 160 (16%) patients were diagnosed with coronary heart disease (CHD). Of these, 120 (75%) had RA (p = 0.001), 100 (63%) were male, mean age 60 +\\/- 15.8 years, 120 (75%) had dyslipidemia and BMI > 30 (p = 0.002), 112 (70%) were smokers (p = 0.002), 40 (25%) were diagnosed with diabetes mellitus and 20 (12%) with hypothyroidism. CONCLUSIONS: The increased prevalence of these comorbidities may serve as a reminder to the rheumatologists that many of their patients will have coexistent disease of which they need to be aware to properly plan their management.

Polysaccharide-Containing Macromolecules in a Kampo (Traditional Japanese Herbal Medicine, Hochuekkito: Dual Active Ingredients for Modulation of Immune Functions on Intestinal Peyer's Patches and Epithelial cells

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Hiroaki Kiyohara

2011-01-01

Full Text Available A traditional Japanese herbal (Kampo medicine, Hochuekkito (Bu-Zhong-Yi-Qi-Tang in Chinese, TJ-41 is a well-known Kampo formula, and has been found to enhance antigen-specific antibody response in not only local mucosal immune system in upper respiratory tract, but also systemic immune system through upper respiratory mucosal immune system. Although this immunopharmacological effect has been proposed to express by modulation of intestinal immune system including Peyer's patches and intestinal epithelial cells, active ingredients are not known. TJ-41 directly affected the production of bone marrow cell-proliferative growth factors from murine Peyer's patch immunocompetent cells in vitro. Among low molecular, intermediate size and macromolecular weight fractions prepared from TJ-41, only fraction containing macromolecular weight ingredients showed Peyer's patch-mediated bone marrow cell-proliferation enhancing activity. Anion-exchange chromatography and gel filtration gave 17 subfractions comprising polysaccharides and lignins from the macromolecular weight fraction of TJ-41, and some of the subfractions showed significant enhancing activities having different degrees. Some of the subfractions also expressed stimulating activity on G-CSF-production from colonic epithelial cells, and statistically significant positive correlation was observed among enhancing activities of the subfractions against Peyer's patch immunocompetent cells and epithelial cells. Among the fractions from TJ-41 oral administration of macromolecular weight ingredient fraction to mice succeeded to enhance antigen-specific antibody response in systemic immune system through upper respiratory mucosal immune system, but all the separated fractions failed to enhance the in vivo antibody response in upper respiratory tract.

Achieving serum urate targets in gout: an audit in a gout-oriented rheumatology practice.

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Corbett, Elizabeth J M; Pentony, Peta; McGill, Neil W

2017-07-01

To assess the proportion of patients with gout who achieve target serum urate levels, the drug regime required and the reasons for failing to do so. We reviewed the files of all patients with gout who presented to a gout-oriented rheumatology practice between January 2010 and September 2014. Two hundred and thirty patients agreed to commence urate lowering therapy (ULT); 73% achieved their urate target, including 74% with non-tophaceous gout (target ≤ 0.36 mmol/L) and 71% with tophi (target ≤ 0.30 mmol/L). Of the 62 who failed to reach target, in 61 it was due to non-adherence and in one due to inefficacy. Adherence remains the major challenge to successful long-term gout management. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Recommendations of the Brazilian Society of Rheumatology for the induction therapy of ANCA-associated vasculitis

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Alexandre Wagner Silva de Souza

Full Text Available Abstract The purpose of these recommendations is to guide the appropriate induction treatment of antineutrophil cytoplasmic antibody-associated vasculitis (AAV patients with active disease. The recommendations proposed by the Vasculopathies Committee of the Brazilian Society Rheumatology for induction therapy of AAV, including granulomatosis with polyangiitis, microscopic polyangiitis and renal-limited vasculitis, were based on systematic literature review and expert opinion. Literature review was performed using Medline (PubMed, EMBASE and Cochrane database to retrieve articles until October 2016. PRISMA guidelines were used for the systematic review and articles were assessed according to the Oxford levels of evidence. Sixteen recommendations were made regarding different aspects of induction therapy for AAV. The purpose of these recommendations is to serve as a guide for therapeutic decisions by health care professionals in the management of AAV patients presenting active disease.

[Study on effect of pH on rectum permeability of active ingredients in Reduning suppositories in vitro].

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Yan, Ming; Wei, Ying-chun; Meng, Jin; Xu, Dian-hong; Wu, Yun; Xiao, Wei

2015-04-01

To investigate the effect of different pH on rectum permeability of chlorogenic acid and geniposide. Four kinds of Reduning suppositories of different pH were separated and put into the rectum to study the suppositories in vitro and the content of chlorogenic acid and geniposide samples was determined by HPLC to calculate the permeation in 24 hours. With increase of pH within 2.5-7.4, the steady state flux of chlorogenic acid was increased, but the steady state flux of geniposidesamples was steady. Adjusted the pH can increase the rectum permeability of active ingredients in Reduning auppositories.

Leprae reaction resembling rheumatologic disease as presenting feature of leprosy.

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Baharuddin, Hazlyna; Taib, Tarita; Zain, Mollyza Mohd; Ch'ng, Shereen

2016-10-01

Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae with predominant involvement of skin and nerves. We present a 70-year-old man with leprosy whose initial presentation resembled rheumatologic disease, due to leprae reaction. He presented with an 8-week history of worsening neuropathic pain in the right forearm, associated with necrotic skin lesions on his fingers that had ulcerated. Physical examination revealed two tender necrotic ulcers at the tip of the right middle finger and the dorsal aspect of the left middle finger. The patient had right wrist tenosynovitis and right elbow bursitis. Apart from raised inflammatory markers, the investigations for infection, connective tissue disease, vasculitis, thromboembolic disease and malignancy were negative. During the fourth week of hospitalization, we noticed a 2-cm hypoesthetic indurated plaque on the right inner arm. Further examination revealed thickened bilateral ulnar, radial and popliteal nerves. A slit skin smear was negative. Two skin biopsies and a biopsy of the olecranon bursa revealed granulomatous inflammation. He was diagnosed with paucibacillary leprosy with neuritis. He responded well to multidrug therapy and prednisolone; his symptoms resolved over a few weeks. This case illustrates the challenges in diagnosing a case of leprosy with atypical presentation in a non-endemic country. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Antibody Response against Parvovirus in Patients with Inflammatory Rheumatological Diseases

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SH Raeisi

2011-07-01

Full Text Available Introduction: Some viral infections have been suggested to trigger or cause autoimmune diseases. One of these viruses is parvovirus B19 which can have various rheumatologic manifestations. In this study we investigated the association between parvovirus and rheumatoid arthritis (RA, systemic lupus erythematosis(SLE, systemic sclerosis(SSc and undifferentiated arthritis at the Rheumatological Clinic, Imam Khomeini hospital. Methods: In this sectional case-control study, IgM and IgG antibodies against parvovirus B19 were measured with ELISA in 41 patients with RA, 28 patients with SLE, 13 patients with SSc, 8 patients with undifferentiated arthritis as well as 90 healthy controls. The ELISA kit (DRG, Germany was semi-quantitative and qualititative. Results: Parvovirus B19 IgM was detected in one patient with RA, one with SSc and four in the control group. IgG anti- B19-specific antibody was detected in 58.5% of RA patients, 67.9% of SLE patients, 69. 2% of SSc patients, 87.5% of undifferentiated arthritis patients as compared to 53.3% of controls. The results were compared between the patient and control groups(p>0.05. Conclusion: According to the results, there was no significant correlation for the antibody titer against parvovirus B19 in the patient and control group. The highly positive response of IgG against parvovirus in undifferentiated arthritis implies the need for more research.

Chromium concentrations in ruminant feed ingredients.

Science.gov (United States)

Spears, J W; Lloyd, K E; Krafka, K

2017-05-01

Chromium (Cr), in the form of Cr propionate, has been permitted for supplementation to cattle diets in the United States at levels up to 0.50 mg of Cr/kg of DM since 2009. Little is known regarding Cr concentrations naturally present in practical feed ingredients. The present study was conducted to determine Cr concentrations in feed ingredients commonly fed to ruminants. Feed ingredients were collected from dairy farms, feed mills, grain bins, and university research farms. Mean Cr concentrations in whole cereal grains ranged from 0.025 mg/kg of DM for oats to 0.041 mg/kg of DM for wheat. Grinding whole samples of corn, soybeans, and wheat through a stainless steel Wiley mill screen greatly increased analyzed Cr concentrations. Harvested forages had greater Cr concentrations than concentrates, and alfalfa hay or haylage had greater Cr concentrations than grass hay or corn silage. Chromium in alfalfa hay or haylage (n = 13) averaged 0.522 mg/kg of DM, with a range of 0.199 to 0.889 mg/kg of DM. Corn silage (n = 21) averaged 0.220 mg of Cr/kg of DM with a range of 0.105 to 0.441 mg of Cr/kg of DM. By-product feeds ranged from 0.040 mg of Cr/kg of DM for cottonseed hulls to 1.222 mg of Cr/kg of DM for beet pulp. Of the feed ingredients analyzed, feed grade phosphate sources had the greatest Cr concentration (135.0 mg/kg). Most ruminant feedstuffs and feed ingredients had less than 0.50 mg of Cr/kg of DM. Much of the analyzed total Cr in feed ingredients appears to be due to Cr contamination from soil or metal contact during harvesting, processing, or both. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Allergenic Ingredients in Personal Hygiene Wet Wipes.

Science.gov (United States)

Aschenbeck, Kelly A; Warshaw, Erin M

Wet wipes are a significant allergen source for anogenital allergic contact dermatitis. The aim of the study was to calculate the frequency of potentially allergenic ingredients in personal hygiene wet wipes. Ingredient lists from brand name and generic personal hygiene wet wipes from 4 large retailers were compiled. In the 54 personal hygiene wet wipes evaluated, a total of 132 ingredients were identified (average of 11.9 ingredients per wipe). The most common ingredients were Aloe barbadensis (77.8%), citric acid (77.8%), fragrance (72.2%), sorbic acid derivatives (63.0%), tocopherol derivatives (63.0%), glycerin (59.3%), phenoxyethanol (55.6%), disodium cocoamphodiacetate (53.7%), disodium ethylenediaminetetraacetic acid (EDTA) (42.6%), propylene glycol (42.6%), iodopropynyl butylcarbamate (40.7%), chamomile extracts (38.9%), sodium benzoate (35.2%), bronopol (22.2%), sodium citrate (22.2%), lanolin derivatives (20.4%), parabens (20.4%), polyethylene glycol derivatives (18.5%), disodium phosphate (16.7%), dimethylol dimethyl hydantoin (DMDM) (14.8%), and cocamidopropyl propylene glycol (PG)-dimonium chloride phosphate (11.1%). Of note, methylisothiazolinone (5.6%) was uncommon; methylchloroisothiazolinone was not identified in the personal hygiene wet wipes examined. There are many potential allergens in personal hygiene wet wipes, especially fragrance and preservatives.

Sleep and physical activity: a survey of people with inflammatory arthritis and their engagement by health professionals in rheumatology in Ireland.

Science.gov (United States)

McKenna, Sean; Donnelly, Alan; Fraser, Alexander; Kennedy, Norelee

2017-06-02

Sleep is important in maintaining the body's circadian rhythm and in maintaining health. Aim was to investigate sleep and physical activity among people who have inflammatory arthritis and their engagement with Health Professionals. Members from a national charitable organisation for patients with arthritis and a national rheumatology health professionals society were invited to participate in separate cross-sectional surveys hosted on SurveyMonkey (R)TM . Ninety people responded and report an average of 5.7 (SD 1.46) hours sleep per night. A majority (61%) report their sleep quality as bad, with 31% taking medications at least once a week to help sleep. There was a statistically significant association between longer years with symptoms, taking medication at least once a week and limited in their activities, when rating their sleep quality as bad. Twenty eight (65%) health professional's responded with 53% discussing sleep with their patients. People with inflammatory arthritis report low sleep with those having symptoms longer, taking medications regularly and having limitations with their activities, reporting poorer sleep quality. Only half of health professionals discuss sleep. More research is needed in investigating poor sleep quality, disturbances, and physical activity in order to promote health and well-being in this population. Implications for Rehabilitation People with inflammatory arthritis fall far below the National Sleep Foundations' "sleep needs spectrum", which is concerning as those who have reduced levels of sleep have been associated with decreased quality of life and physical function. Due to the importance of receiving sufficient sleep, there is a need to develop education and training for health professionals in the importance of engaging their patients in their sleep quality and disturbances. The effects of physical activity interventions on poor sleep need to be examined to show if it is a positive non-pharmacological treatment approach

Value of 3-dimensional (3D) imaging in rheumatology

International Nuclear Information System (INIS)

Fredy, D.

1990-01-01

The whole body scanner (Exel 2.400) of the Centre Hospitalier Sainte-Anne enables the three-dimensional reconstruction, with visualization, of the object in its real volume in less than 10 minutes after taking 20 to 40 radiological sections. The exploration can be complete at all levels. Bone lesions can be perfectly shown, the study of osteoarticular or intraspinal abnormalities is facilitated, all solution of continuity can be detected. A soft parts program as well as a colour program enable a clear and rapid visualization of organic lesions. Three-dimensional imaging can be of great value in rheumatology [fr

Person-centred care in nurse-led outpatient rheumatology clinics: Conceptualization and initial development of a measurement instrument.

Science.gov (United States)

Bala, Sidona-Valentina; Forslind, Kristina; Fridlund, Bengt; Samuelson, Karin; Svensson, Björn; Hagell, Peter

2018-06-01

Person-centred care (PCC) is considered a key component of effective illness management and high-quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics. A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person-centredness principles and existing PCC frameworks. The resulting framework was operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum), which was tested for acceptability and content validity among 50 individuals with RA attending a nurse-led outpatient clinic. The conceptual framework focuses on the meeting between the person with RA and the nurse, and comprises five interrelated domains: social environment, personalization, shared decision-making, empowerment and communication. Operationalization of the domains into a pool of items generated a preliminary PCCoc/rheum version, which was completed in a mean (standard deviation) of 5.3 (2.5) min. Respondents found items easy to understand (77%) and relevant (93%). The Content Validity Index of the PCCoc/rheum was 0.94 (item level range, 0.87-1.0). About 80% of respondents considered some items redundant. Based on these results, the PCCoc/rheum was revised into a 24-item questionnaire. A conceptual outpatient PCC framework and a 24-item questionnaire intended to measure PCC in nurse-led outpatient rheumatology clinics were developed. The extent to which the questionnaire represents a measurement instrument remains to be tested. Copyright © 2018 John Wiley & Sons, Ltd.

Hovenia dulcis Thunb extract and its ingredient methyl vanillate activate Wnt/β-catenin pathway and increase bone mass in growing or ovariectomized mice.

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Pu-Hyeon Cha

Full Text Available The Wnt/β-catenin pathway is a potential target for development of anabolic agents to treat osteoporosis because of its role in osteoblast differentiation and bone formation. However, there is no clinically available anti-osteoporosis drug that targets this Wnt/β-catenin pathway. In this study, we screened a library of aqueous extracts of 350 plants and identified Hovenia dulcis Thunb (HDT extract as a Wnt/β-catenin pathway activator. HDT extract induced osteogenic differentiation of calvarial osteoblasts without cytotoxicity. In addition, HDT extract increased femoral bone mass without inducing significant weight changes in normal mice. In addition, thickness and area of femoral cortical bone were also significantly increased by the HDT extract. Methyl vanillate (MV, one of the ingredients in HDT, also activated the Wnt/β-catenin pathway and induced osteoblast differentiation in vitro. MV rescued trabecular or cortical femoral bone loss in the ovariectomized mice without inducing any significant weight changes or abnormality in liver tissue when administrated orally. Thus, natural HDT extract and its ingredient MV are potential anabolic agents for treating osteoporosis.

Electrostatic separation for functional food ingredient production

NARCIS (Netherlands)

Wang, J.

2016-01-01

Summary

Dry fractionation is a promising alternative to wet extraction processes for production of food ingredients, since it uses hardly any water, consumes less energy and retains the native functionality of the ingredients. It combines milling and dry separation to

Neotropics and natural ingredients for pharmaceuticals: why isn't South American biodiversity on the crest of the wave?

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Desmarchelier, Cristian

2010-06-01

Despite the advent of biotechnology and modern methods of combinatorial chemistry and rational drug design, nature still plays a surprisingly important role as a source of new pharmaceutical compounds. These are marketed either as herbal drugs or as single active ingredients. South American tropical ecosystems (or the Neotropics) encompass one-third of the botanical biodiversity of the planet. For centuries, indigenous peoples have been using plants for healing purposes, and scientists are making considerable efforts in order to validate these uses from a pharmacological/phytochemical point of view. However, and despite the unique plant diversity in the region, very few natural pharmaceutical ingredients from this part of the world have reached the markets in industrialized countries. The present review addresses the importance of single active ingredients and herbal drugs from South American flora as natural ingredients for pharmaceuticals; it highlights the most relevant cases in terms of species of interest; and discusses the key entry barriers for these products in industrialized countries. It explores the reasons why, in spite of the region's competitive advantages, South American biodiversity has been a poor source of natural ingredients for the pharmaceutical industry. (c) 2010 John Wiley & Sons, Ltd.

Continuing Professional Development Evaluation: Two Rapid Review Courses inNephrology and Rheumatology

Directory of Open Access Journals (Sweden)

Abdullah Shehab

2012-09-01

Full Text Available Objectives: Continuing professional development (CPD is anovel approach to increase professional knowledge and skills. The aim of this study is to explore participants’ characteristics and to understand participants’ views on two rapid review courses (RRCs as part of CPD program, and to assess healthcare providers’ views about the use of internet for accessing medical information.Methods: Data were collected from 150 participants who attended an RRC in Nephrology and Rheumatology as part of an ongoing CME program.Results: Participants’ response rate was 92% and 84.4% in Nephrology and Rheumatology RRCs, respectively. Participants’ Mean Age±SD were 39±2.1 and 41±2.1 years in the Nephrology and Rheumatology courses, respectively. Demographic variables, i.e., age, gender, and specialization showed a significant (p<0.01 impact on the learning objectives of the program. Further, participants reported that the course material had a significant (p<0.02 impacton their knowledge. Finding new medical information was the primary motive to search the internet among all participants. About half of the subjects reported knowledge of their preferred medical education sites and had access at their clinical setup. Barriers to internet use included lack of specific information, difficulty to download contents, and excessive material. Professional association websites, online journals, and CME programs were the most frequently searched sources of information. Most of the subjects reported significant (p<0.02 barriers to find medical resources on the internet and to adequately utilize the currently available medical search engines available in the healthcare system.Conclusion: A discipline specific and integrated CPD programmay have provided dual benefit such as accredited CME hours and a significant change in the participants’ knowledge. There is a need to increase Internet accessibility and capacity in the current healthcare facilities. Future CPD

2016 American College of Rheumatology/European League Against Rheumatism Criteria for Minimal, Moderate, and Major Clinical Response in Juvenile Dermatomyositis An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative

NARCIS (Netherlands)

Rider, Lisa G.; Aggarwal, Rohit; Pistorio, Angela; Bayat, Nastaran; Erman, Brian; Feldman, Brian M.; Huber, Adam M.; Cimaz, Rolando; Cuttica, Rubén J.; de Oliveira, Sheila Knupp; Lindsley, Carol B.; Pilkington, Clarissa A.; Punaro, Marilynn; Ravelli, Angelo; Reed, Ann M.; Rouster-Stevens, Kelly; van Royen-Kerkhof, Annet; Dressler, Frank; Magalhaes, Claudia Saad; Constantin, Tamás; Davidson, Joyce E.; Magnusson, Bo; Russo, Ricardo; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A.; Miller, Frederick W.; Vencovsky, Jiri; Ruperto, Nicolino; Hansen, Paul; Apaz, Maria; Bowyer, Suzanne; Curran, Megan; Davidson, Joyce; Griffin, Thomas; Huber, Adam H.; Jones, Olcay; Kim, Susan; Lang, Bianca; Lindsley, Carol; Lovell, Daniel; Saad Magalhaes, Claudia; Pachman, Lauren M.; Pilkington, Clarissa; Ponyi, Andrea; Quartier, Pierre; Ramanan, Athimalaipet V.; Reed, Ann; Rennebohm, Robert

2017-01-01

Objective. To develop response criteria for juvenile dermatomyositis (DM). Methods. We analyzed the performance of 312 definitions that used core set measures from either the International Myositis Assessment and Clinical Studies Group (IMACS) or the Paediatric Rheumatology International Trials

2016 American College of Rheumatology/European League Against Rheumatism Criteria for Minimal, Moderate, and Major Clinical Response in Juvenile Dermatomyositis : An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative

NARCIS (Netherlands)

Rider, Lisa G.; Aggarwal, Rohit; Pistorio, Angela; Bayat, Nastaran; Erman, Brian; Feldman, Brian M.; Huber, Adam M.; Cimaz, Rolando; Cuttica, Rubén J.; De Oliveira, Sheila Knupp; Lindsley, Carol B.; Pilkington, Clarissa A.; Punaro, Marilynn; Ravelli, Angelo; Reed, Ann M.; Rouster-Stevens, Kelly; van Royen-Kerkhof, Annet; Dressler, Frank; Magalhaes, Claudia Saad; Constantin, Tamás; Davidson, Joyce E.; Magnusson, Bo; Russo, Ricardo; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A.; Miller, Frederick W.; Vencovsky, Jiri; Ruperto, Nicolino; Rider, Lisa G.; Ruperto, Nicolino; Miller, Frederick W.; Aggarwal, Rohit; Erman, Brian; Bayat, Nastaran; Pistorio, Angela; Huber, Adam M.; Feldman, Brian M.; Hansen, Paul; Rockette, Howard; Lachenbruch, Peter A.; Ruperto, Nicolino; Rider, Lisa G.; Apaz, Maria T; Bowyer, Suzanne; Cimaz, Rolando; Constantin, Tamás; Curran, Megan; Davidson, Joyce E.; Feldman, Brian M.; Griffin, Thomas; Huber, Adam H.; Jones, Olcay; Kim, Susan; Lang, Bianca; Lindsley, Carol; Lovell, Daniel J.; Saad Magalhaes, Claudia; Pachman, Lauren M.; Pilkington, Clarissa; Ponyi, Andrea; Punaro, Marilynn; Quartier, Pierre; Ramanan, Athimalaipet V; Ravelli, Angelo; Reed, Ann M.; Rennebohm, Robert; Sherry, David D.; Silva, Clovis A.; Stringer, Elizabeth; van Royen-Kerkhof, Annet; Wallace, Carol; Miller, Frederick W.; Oddis, Chester V.; Reed, Ann M.; Rider, Lisa G.; Ruperto, Nicolino; Apaz, Maria T; Avcin, Tadej; Becker, Mara; Beresford, Michael W.; Cimaz, Rolando; Constantin, Tamás; Curran, Megan; Cuttica, Ruben; Davidson, Joyce E.; Dressler, Frank; Dvergsten, Jeffrey; Feitosa de Oliveira, Sheila Knupp; Feldman, Brian M.; Leme Ferriani, Virginia Paes; Flato, Berit; Gerloni, Valeria; Griffin, Thomas; Henrickson, Michael; Hinze, Claas; Hoeltzel, Mark; Huber, Adam M.; Ibarra, Maria; Ilowite, Norman T; Imundo, Lisa; Jones, Olcay; Kim, Susan; Kingsbury, Daniel; Lang, Bianca; Lindsley, Carol; Lovell, Daniel J.; Martini, Alberto; Saad Magalhaes, Claudia; Magnusson, Bo; Maguiness, Sheilagh; Maillard, Susan; Mathiesen, Pernille; McCann, Liza J.; Nielsen, Susan; Pachman, Lauren M.; Passo, Murray; Pilkington, Clarissa; Punaro, Marilynn; Quartier, Pierre; Rabinovich, Egla; Ramanan, Athimalaipet V; Ravelli, Angelo; Reed, Ann M.; Rennebohm, Robert; Rider, Lisa G.; Rivas-Chacon, Rafael; Byun Robinson, Angela; Rouster-Stevens, Kelly; Russo, Ricardo; Rutkowska-Sak, Lidia; Sallum, Adriana; Sanner, Helga; Schmeling, Heinrike; Selcen, Duygu; Shaham, Bracha; Sherry, David D.; Silva, Clovis A.; Spencer, Charles H.; Sundel, Robert; Tardieu, Marc; Thatayatikom, Akaluck; van der Net, Janjaap; van Royen-Kerkhof, Annet; Wahezi, Dawn; Wallace, Carol; Zulian, Francesco; analysis, Conjoint; Cimaz, Rolando; Constantin, Tamás; Cuttica, Ruben; Davidson, Joyce E.; Dressler, Frank; Knupp Feitosa de Oliveira, Sheila; Feldman, Brian M.; Griffin, Thomas; Henrickson, Michael; Huber, Adam M.; Imundo, Lisa; Lang, Bianca; Lindsley, Carol; Saad Magalhaes, Claudia; Magnusson, Bo; Maillard, Susan; Pachman, Lauren M.; Passo, Murray; Pilkington, Clarissa; Punaro, Marilynn; Ravelli, Angelo; Reed, Ann M.; Rider, Lisa G.; Rouster-Stevens, Kelly; Russo, Ricardo; Shaham, Bracha; Sundel, Robert; van der Net, Janjaap; van Royen-Kerkhof, Annet; Cimaz, Rolando; Cuttica, Rubén J.; Knupp Feitosa de Oliveira, Sheila; Feldman, Brian M.; Huber, Adam M.; Lindsley, Carol B.; Pilkington, Clarissa; Punaro, Marilynn; Ravelli, Angelo; Reed, Ann M.; Rouster-Stevens, Kelly; van Royen-Kerkhof, Annet; Amato, Anthony A; Chinoy, Hector; Cooper, Robert G.; Dastmalchi, Maryam; de Visser, Marianne; Fiorentino, David; Isenberg, David; Katz, James; Mammen, Andrew; Oddis, Chester V.; Ytterberg, Steven R.

2017-01-01

Objective: To develop response criteria for juvenile dermatomyositis (DM). Methods: We analyzed the performance of 312 definitions that used core set measures from either the International Myositis Assessment and Clinical Studies Group (IMACS) or the Paediatric Rheumatology International Trials

Pros and cons of conjoint analysis of discrete choice experiments to define classification and response criteria in rheumatology.

Science.gov (United States)

Taylor, William J

2016-03-01

Conjoint analysis of choice or preference data has been used in marketing for over 40 years but has appeared in healthcare settings much more recently. It may be a useful technique for applications within the rheumatology field. Conjoint analysis in rheumatology contexts has mainly used the approaches implemented in 1000Minds Ltd, Dunedin, New Zealand, Sawtooth Software, Orem UT, USA. Examples include classification criteria, composite response criteria, service prioritization tools and utilities assessment. Limitations imposed by very many attributes can be managed using new techniques. Conjoint analysis studies of classification and response criteria suggest that the assumption of equal weighting of attributes cannot be met, which challenges traditional approaches to composite criteria construction. Weights elicited through choice experiments with experts can derive more accurate classification criteria, than unweighted criteria. Studies that find significant variation in attribute weights for composite response criteria for gout make construction of such criteria problematic. Better understanding of various multiattribute phenomena is likely to increase with increased use of conjoint analysis, especially when the attributes concern individual perceptions or opinions. In addition to classification criteria, some applications for conjoint analysis that are emerging in rheumatology include prioritization tools, remission criteria, and utilities for life areas.

Group for Research and Assessment of Psoriasis and Psoriatic Arthritis/Outcome Measures in Rheumatology Consensus-Based Recommendations and Research Agenda for Use of Composite Measures and Treatment Targets in Psoriatic Arthritis

DEFF Research Database (Denmark)

Coates, Laura C; FitzGerald, Oliver; Merola, Joseph F

2018-01-01

OBJECTIVE: A meeting was convened by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) and Outcome Measures in Rheumatology (OMERACT) to further the development of consensus among physicians and patients regarding composite disease activity measures and targets i...

Hydrolysate from a mixture of legume flours with antifungal activity as an ingredient for prolonging the shelf-life of wheat bread.

Science.gov (United States)

Rizzello, Carlo Giuseppe; Verni, Michela; Bordignon, Stefano; Gramaglia, Valerio; Gobbetti, Marco

2017-06-01

Aiming at identifying antifungal compounds from plant matrices to be used as ingredients in the bakery industry, a water/salt-soluble extract (WSE) was produced from a legume enzyme hydrolysate, consisting of a mixture of pea, lentil, and faba bean flours, and assayed towards Penicillium roqueforti DPPMAF1. Agar diffusion assays allowed the selection of the optimal processing conditions for hydrolysis. As shown by hyphal radial growth rate, the inhibition was observed towards several fungi, including Aspergillus parasiticus CBS971.97, Penicillium carneum CBS 112297, Penicillium paneum CBS 101032, Penicillium polonicum 112490. A multi-step purification was carried out to identify the active compounds. The antifungal activity was attributed to native proteins (nsLTP, ubiquitin, lectin alpha-1 chain, wound-induced basic protein, defensin-1, defensin-2) and a mixture of peptides, which were released during hydrolysis. Nine peptides were purified and identified as sequences encrypted in legume vicilins, lectins and chitinases. WSE was used as ingredient for making bread under pilot plant conditions. Chemical, structural and sensory characterization of bread showed the lack of significant changes compared to control. The bread made with the legume hydrolysate had a longer shelf-life than that of the control. Copyright © 2016 Elsevier Ltd. All rights reserved.

A multi-centre study of interactional style in nurse specialist- and physician-led Rheumatology clinics in the UK.

Science.gov (United States)

Vinall-Collier, Karen; Madill, Anna; Firth, Jill

2016-07-01

Nurse-led care is well established in Rheumatology in the UK and provides follow-up care to people with inflammatory arthritis including treatment, monitoring, patient education and psychosocial support. The aim of this study is to compare and contrast interactional style with patients in physician-led and nurse-led Rheumatology clinics. A multi-centre mixed methods approach was adopted. Nine UK Rheumatology out-patient clinics were observed and audio-recorded May 2009-April 2010. Eighteen practitioners agreed to participate in clinic audio-recordings, researcher observations, and note-taking. Of 9 nurse specialists, 8 were female and 5 of 9 physicians were female. Eight practitioners in each group took part in audio-recorded post-clinic interviews. All patients on the clinic list for those practitioners were invited to participate and 107 were consented and observed. In the nurse specialist cohort 46% were female; 71% had a diagnosis of Rheumatoid Arthritis (RA). The physician cohort comprised 31% female; 40% with RA and 16% unconfirmed diagnosis. Nineteen (18%) of the patients observed were approached for an audio-recorded telephone interview and 15 participated (4 male, 11 female). Forty-four nurse specialist and 63 physician consultations with patients were recorded. Roter's Interactional Analysis System (RIAS) was used to code this data. Thirty-one semi-structured interviews were conducted (16 practitioner, 15 patients) within 24h of observed consultations and were analyzed using thematic analysis. RIAS results illuminated differences between practitioners that can be classified as 'socio-emotional' versus 'task-focussed'. Specifically, nurse specialists and their patients engaged significantly more in the socio-emotional activity of 'building a relationship'. Across practitioners, the greatest proportion of 'patient initiations' were in 'giving medical information' and reflected what patients wanted the practitioner to know rather than giving insight into

Validation of a method by gas chromatography for the determination of fatty acids that comprise the active ingredient D-004

International Nuclear Information System (INIS)

Rodriguez Leyes, Eduardo A; Marrero Delange, David; Gonzalez Canavaciolo, Victor L; Sierra Perez, Roxana; Adames Fajardo, Yuliamny

2009-01-01

D-004 is a new active ingredient obtained from the Cuban royal palm (Roystonea regia) fruits. This substance is mainly composed by a mixture of saturated and unsaturated free fatty acids, from 8 to 18 carbon atoms, and has shown to be effective in experimental model of prostate hyperplasia. A capillary gas chromatographic method for the determination of the fatty acids in D-004 was developed and validated. The acids were analyzed as methyl ester derivatives, which were obtained by reaction with 10 % acetyl chloride in methanol and separated in a BPX-5 wide-bore column using tridecanoic acid as internal standard. The specificity study showed no interferences regarding the determination of this mixture, once the samples were submitted to stress conditions. Determination of the total fatty acid content was linear (r > 0.999; CVs of the response factors and of the slopes lower than 5 and 2 %, respectively) and without bias in the studied concentration range, from 50 to 150 % of the nominal mass. In the accuracy study, over the range 80 to 120 % of the nominal fatty acid concentration, high recoveries (100.4 to 100.8 %) were reached. Good results were obtained in the repeatability and intermediate precision studies (CV < 2%), proving that the method is precise. These results support that this method is properly validated, being appropriate for the quality control and stability studies of this active ingredient

Patient’s Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia

Directory of Open Access Journals (Sweden)

Wahinuddin Sulaiman

2012-11-01

Full Text Available Objective: In Rheumatology, non-steroidal anti-inflammatory drugs (NSAIDs has been widely prescribed and used. However, despite their clinical benefits in the management of inflammatory and degenerative joint disease, NSAIDs have considerable side effects, mostly affecting the upper gastrointestinal system, which therefore, limit their use. This study was conducted to determine the patients’ knowledge and perception regarding the used of NSAIDS.Methods: A total of 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia, and received NSAIDs more than 3 months were interviewed irrespective of the irrheumatological conditions. Patient’s knowledge and perception on the side effects of NSAIDs were recorded.Result: Fifty-four percent of the patients obtained information regarding the side effect of NSAIDs either from the rheumatologist, rheumatology staff nurse or other medical staffs (75.4%. The remaining 45.8% were naive of such knowledge. Fifteen percent obtained the information by surfing the internet and 9.2% from printed media. Twenty-four (24.2% patients, experiencedin digestion and/or stomach discomfort attributed to NSAIDsused. Two patients (1.7% had hematemesis and malena once.Conclusion: This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients.

Continuous Hydrolysis and Liquid–Liquid Phase Separation of an Active Pharmaceutical Ingredient Intermediate Using a Miniscale Hydrophobic Membrane Separator

DEFF Research Database (Denmark)

Cervera Padrell, Albert Emili; Morthensen, Sofie Thage; Lewandowski, Daniel Jacob

2012-01-01

Continuous hydrolysis of an active pharmaceutical ingredient intermediate, and subsequent liquid–liquid (L-L) separation of the resulting organic and aqueous phases, have been achieved using a simple PTFE tube reactor connected to a miniscale hydrophobic membrane separator. An alkoxide product......, obtained in continuous mode by a Grignard reaction in THF, reacted with acidic water to produce partially miscible organic and aqueous phases containing Mg salts. Despite the partial THF–water miscibility, the two phases could be separated at total flow rates up to 40 mL/min at different flow ratios, using...

Network Understanding of Herb Medicine via Rapid Identification of Ingredient-Target Interactions

Science.gov (United States)

Zhang, Hai-Ping; Pan, Jian-Bo; Zhang, Chi; Ji, Nan; Wang, Hao; Ji, Zhi-Liang

2014-01-01

Today, herb medicines have become the major source for discovery of novel agents in countermining diseases. However, many of them are largely under-explored in pharmacology due to the limitation of current experimental approaches. Therefore, we proposed a computational framework in this study for network understanding of herb pharmacology via rapid identification of putative ingredient-target interactions in human structural proteome level. A marketing anti-cancer herb medicine in China, Yadanzi (Brucea javanica), was chosen for mechanistic study. Total 7,119 ingredient-target interactions were identified for thirteen Yadanzi active ingredients. Among them, about 29.5% were estimated to have better binding affinity than their corresponding marketing drug-target interactions. Further Bioinformatics analyses suggest that simultaneous manipulation of multiple proteins in the MAPK signaling pathway and the phosphorylation process of anti-apoptosis may largely answer for Yadanzi against non-small cell lung cancers. In summary, our strategy provides an efficient however economic solution for systematic understanding of herbs' power.

[Nailfold capillaroscopy: relevance to the practice of rheumatology].

Science.gov (United States)

Souza, Eduardo José do Rosário E; Kayser, Cristiane

2015-01-01

Nailfold capillaroscopy is a simple, low-cost method, that is extremely important in the evaluation of patients with Raynaud's phenomenon and of patients with systemic sclerosis (SSc) spectrum diseases. Besides its importance for the early diagnosis of SSc, nailfold capillaroscopy is a useful tool to identify scleroderma patients with high risk for development of vascular and visceral complications and death. The inclusion of capillaroscopy in the new classification criteria for SSc of the American College of Rheumatology (ACR) and European League Against Rheumatism (Eular) gives a new impetus to the use and dissemination of the method. In this paper, we present a didactic, non-systematic review on the subject, with emphasis on advances recently described. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

Enhancing the reporting and transparency of rheumatology research

DEFF Research Database (Denmark)

Christensen, Robin; Bliddal, Henning; Henriksen, Marius

2013-01-01

Manuscripts and abstracts from biomedical journals frequently do not contain proper information for meeting required standards and serving the multiple needs of their end users. Reporting guidelines and checklists help researchers to meet those standards by providing rules or principles......, to present a structured overview of reporting guidelines that rheumatology journals could apply, and to encourage their use by journal authors, editors, and reviewers, including those of Arthritis Research & Therapy. Internationally recognized reporting guidelines exist for a diversity of research areas. We...... encourage colleagues to consult the 'Enhancing the QUAlity and Transparency Of health Research' (EQUATOR) network when writing scientific papers. EQUATOR is an international initiative that seeks to improve the reliability and value of biomedical research literature by promoting transparent and accurate...

Infections in an inpatient rheumatology unit: how big is the problem?

Directory of Open Access Journals (Sweden)

Romana Vieira

2016-10-01

Full Text Available Patients with rheumatic diseases are at high risk of infections. As quantification and characterization of infections in daily practice is a crucial exercise to delineate strategies to overcome this problem, we aimed to describe the prevalence of infections in an inpatient rheumatology unit. A cross-sectional analysis of all patients admitted at the São João Hospital Centre Rheumatology Unit between January 1st 2012 and December 31st 2013 was performed. We found a 31.7% (n=79 period prevalence of infection and a total number of infections of 97 (1.23 infections per patient. They were the admission reason in 17.6% (n=44 and hospital acquired in 19.0% (n=15 of the cases. The urinary tract was the most commonly affected (32.0%; n=31 and Escherichia coli (17.5%; n=17 the most frequently identified infectious agent. Infection prolonged the hospital length of stay in 34.2% (n=27 of the cases but any death occurred as a direct consequence of it. Patients with infection were older, had longer rheumatic disease duration and longer hospital length of stay than those without infection. We conclude that the prevalence of infection in our inpatient population is high but most cases were non complicated, easily treated with common antibiotics and, importantly, not associated with higher lethality.

Dietary Supplement Ingredient Database

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... and US Department of Agriculture Dietary Supplement Ingredient Database Toggle navigation Menu Home About DSID Mission Current ... values can be saved to build a small database or add to an existing database for national, ...

ENRICHMENT OF POULTRY PRODUCTS WITH FUNCTIONAL INGREDIENTS

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Gordana Kralik

2012-06-01

Full Text Available Primary role of food is to provide nutritive stuffs in sufficient amounts to meet nutritive requirements. However, recent scientific findings confirm assumptions that particular food or its ingredients had positive physiological and psychological effects on health. Functional food is referred to food rich in ingredients, having beneficial effects on one or more functions in an organism. By consuming functional food consumers can expect some health benefits. Production of poultry products as functional food is getting more important on foreign markets while portion of such products on domestic food market is insignificant. The aim of this paper is to present possibilities for enrichment of poultry products, such as broiler and turkey meat and chicken eggs, as they can be characterized as functional food. Functional ingredients in poultry products are polyunsaturated fatty acids (LNA, EPA and DHA and antioxidants. Enrichment of poultry products with the stated ingredients that are beneficial for human health is subject of many researches, and only recently have researches been directed towards assessment of market sustainability of such products.

Impact of healthcare design on patients' perception of a rheumatology outpatient infusion room

DEFF Research Database (Denmark)

Bukh, Gunhild; Tommerup, Anne Marie Munk; Madsen, Ole Rintek

2015-01-01

Evidence-based healthcare design is a concept aimed at reducing stress factors in the physical environment for the benefit of patients and the medical staff. The objective of this study was to examine the impact of room modifications on patients' perception of an outpatient infusion room used...... the potential to improve patients' perception of outpatient infusion rooms used for treating rheumatologic diseases....

The changing landscape of biosimilars in rheumatology

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Dörner, Thomas; Strand, Vibeke; Cornes, Paul; Gonçalves, João; Gulácsi, László; Kvien, Tore K; Tanaka, Yoshiya; Burmester, Gerd R

2016-01-01

Biosimilars remain a hot topic in rheumatology, and some physicians are cautious about their application in the real world. With many products coming to market and a wealth of guidelines and recommendations concerning their use, there is a need to understand the changing landscape and the real clinical and health-economic potential offered by these agents. Notably, rheumatologists will be at the forefront of the use of biosimilar monoclonal antibodies/soluble receptors. Biosimilars offer cost savings and health gains for our patients and will play an important role in treating rheumatic diseases. We hope that these lower costs will compensate for inequities in access to therapy based on economic differences across countries. Since approved biosimilars have already demonstrated highly similar efficacy, it will be most important to establish pharmacovigilance databases across countries that are adequate to monitor long-term safety after marketing approval. PMID:26964144

Lifestyle and dietary habits of patients with gout followed in rheumatology settings.

Science.gov (United States)

Manara, M; Carrara, G; Scirè, C A; Cimmino, M A; Govoni, M; Montecucco, C; Matucci-Cerinic, M; Minisola, G; Study Group, The King

2015-12-23

Diet and lifestyles modification are core aspects of the non-pharmacological management of gout, but a poor consistency with suggested guidelines is reported. This study aimed to investigate dietary and lifestyle habits of patients with gout followed in rheumatology settings. Data were retrieved from the baseline dataset of the KING study, a multicentre cohort study of patients with gout followed in rheumatology settings. Dietary habits were assessed with the Italian National Institute of Statistics (ISTAT) food-frequency questionnaire and compared with reported data about general population. The relative increase of exposure was estimated by standardized prevalence ratios adjusted for gender, age and geographical distribution. The study population included 446 patients, with a mean age of 63.9 years and a M/F ratio of 9:1. Compared to the Italian population, gouty patients showed a higher prevalence of obesity [1.82 (1.52-2.18)] and a higher consumption of wine [1.85 (1.48-2.32)] and beer [2.21 (1.68-2.90)], but a lower prevalence of smoking and a lower intake of liquor. They showed a lower intake of red meat [0.80 (0.71-0.91)], but a similar intake of other tested dietary factors. Gouty patients' lifestyle is still partially different from the recommended.

Authorization and Toxicity of Veterinary Drugs and Plant Protection Products: Residues of the Active Ingredients in Food and Feed and Toxicity Problems Related to Adjuvants.

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Klátyik, Szandra; Bohus, Péter; Darvas, Béla; Székács, András

2017-01-01

Chemical substances applied in animal husbandry or veterinary medicine and in crop protection represent substantial environmental loads, and their residues occur in food and feed products. Product approval is governed differently in these two sectors in the European Union (EU), and the occurrence of veterinary drug (VD) and pesticide residues indicated by contamination notification cases in the Rapid Alert System for Food and Feed of the EU also show characteristic differences. While the initial high numbers of VD residues reported in 2002 were successfully suppressed to less than 100 cases annually by 2006 and on, the number of notification cases for pesticide residues showed a gradual increase from a low (approximately 50 cases annually) initial level until 2005 to more than 250 cases annually after 2009, with a halt occurring only in 2016. Main notifiers of VD residues include Germany, Belgium, the UK, and Italy (63, 59, 42, and 31 notifications announced, respectively), and main consigning countries of non-compliances are Vietnam, India, China, and Brazil (88, 50, 34, and 23 notifications, respectively). Thus, countries of South and Southeast Asia are considered a vulnerable point with regard to VD residues entering the EU market. Unintended side effects of VDs and plant protection products may be caused not only by the active ingredients but also by various additives in these preparations. Adjuvants (e.g., surfactants) and other co-formulants used in therapeutic agents and feed additives, as well as in pesticide formulations have long been considered as inactive ingredients in the aspects of the required main biological effect of the pharmaceutical or pesticide, and in turn, legal regulations of the approval and marketing of these additives specified significantly less stringent risk assessment requirements, than those specified for the active ingredients. However, numerous studies have shown additive, synergistic, or antagonistic side effects between the

Authorization and Toxicity of Veterinary Drugs and Plant Protection Products: Residues of the Active Ingredients in Food and Feed and Toxicity Problems Related to Adjuvants

Directory of Open Access Journals (Sweden)

Szandra Klátyik

2017-09-01

Full Text Available Chemical substances applied in animal husbandry or veterinary medicine and in crop protection represent substantial environmental loads, and their residues occur in food and feed products. Product approval is governed differently in these two sectors in the European Union (EU, and the occurrence of veterinary drug (VD and pesticide residues indicated by contamination notification cases in the Rapid Alert System for Food and Feed of the EU also show characteristic differences. While the initial high numbers of VD residues reported in 2002 were successfully suppressed to less than 100 cases annually by 2006 and on, the number of notification cases for pesticide residues showed a gradual increase from a low (approximately 50 cases annually initial level until 2005 to more than 250 cases annually after 2009, with a halt occurring only in 2016. Main notifiers of VD residues include Germany, Belgium, the UK, and Italy (63, 59, 42, and 31 notifications announced, respectively, and main consigning countries of non-compliances are Vietnam, India, China, and Brazil (88, 50, 34, and 23 notifications, respectively. Thus, countries of South and Southeast Asia are considered a vulnerable point with regard to VD residues entering the EU market. Unintended side effects of VDs and plant protection products may be caused not only by the active ingredients but also by various additives in these preparations. Adjuvants (e.g., surfactants and other co-formulants used in therapeutic agents and feed additives, as well as in pesticide formulations have long been considered as inactive ingredients in the aspects of the required main biological effect of the pharmaceutical or pesticide, and in turn, legal regulations of the approval and marketing of these additives specified significantly less stringent risk assessment requirements, than those specified for the active ingredients. However, numerous studies have shown additive, synergistic, or antagonistic side effects

EULAR task force recommendations on annual cardiovascular risk assessment for patients with rheumatoid arthritis: an audit of the success of implementation in a rheumatology outpatient clinic.

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Ikdahl, Eirik; Rollefstad, Silvia; Olsen, Inge C; Kvien, Tore K; Hansen, Inger Johanne Widding; Soldal, Dag Magnar; Haugeberg, Glenn; Semb, Anne Grete

2015-01-01

EULAR recommendations for cardiovascular disease (CVD) risk management include annual CVD risk assessments for patients with rheumatoid arthritis (RA). We evaluated the recording of CVD risk factors (CVD-RF) in a rheumatology outpatient clinic, where EULAR recommendations had been implemented. Further, we compared CVD-RF recordings between a regular rheumatology outpatient clinic (RegROC) and a structured arthritis clinic (AC). In 2012, 1142 RA patients visited the rheumatology outpatient clinic: 612 attended RegROC and 530 attended AC. We conducted a search in the patient journals to ascertain the rate of CVD-RF recording. The overall CVD-RF recording rate was 40.1% in the rheumatology outpatient clinic, reflecting a recording rate of 59.1% in the AC and 23.6% in the RegROC. The odds ratios for having CVD-RFs recorded for patients attending AC compared to RegROC were as follows: blood pressure: 12.4, lipids: 5.0-6.0, glucose: 9.1, HbA1c: 6.1, smoking: 1.4, and for having all the CVD-RFs needed to calculate the CVD risk by the systematic coronary risk evaluation (SCORE): 21.0. The CVD-RF recording rate was low in a rheumatology outpatient clinic. However, a systematic team-based model was superior compared to a RegROC. Further measures are warranted to improve CVD-RF recording in RA patients.

EULAR Task Force Recommendations on Annual Cardiovascular Risk Assessment for Patients with Rheumatoid Arthritis: An Audit of the Success of Implementation in a Rheumatology Outpatient Clinic

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Eirik Ikdahl

2015-01-01

Full Text Available Objective. EULAR recommendations for cardiovascular disease (CVD risk management include annual CVD risk assessments for patients with rheumatoid arthritis (RA. We evaluated the recording of CVD risk factors (CVD-RF in a rheumatology outpatient clinic, where EULAR recommendations had been implemented. Further, we compared CVD-RF recordings between a regular rheumatology outpatient clinic (RegROC and a structured arthritis clinic (AC. Methods. In 2012, 1142 RA patients visited the rheumatology outpatient clinic: 612 attended RegROC and 530 attended AC. We conducted a search in the patient journals to ascertain the rate of CVD-RF recording. Results. The overall CVD-RF recording rate was 40.1% in the rheumatology outpatient clinic, reflecting a recording rate of 59.1% in the AC and 23.6% in the RegROC. The odds ratios for having CVD-RFs recorded for patients attending AC compared to RegROC were as follows: blood pressure: 12.4, lipids: 5.0-6.0, glucose: 9.1, HbA1c: 6.1, smoking: 1.4, and for having all the CVD-RFs needed to calculate the CVD risk by the systematic coronary risk evaluation (SCORE: 21.0. Conclusion. The CVD-RF recording rate was low in a rheumatology outpatient clinic. However, a systematic team-based model was superior compared to a RegROC. Further measures are warranted to improve CVD-RF recording in RA patients.

Evaluation of Essential Oil and its Three Main Active Ingredients of Chinese Chenopodium Ambrosioides (Family: Chenopodiaceae Against Blattella Germanica

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Wei Xiang Zhu

2012-12-01

Full Text Available Background: The efficacy of essential oil of Chenopodium ambrosioides flowering aerial parts and its three mainactive ingredients was evaluated against Blattella germanica male adults.Methods: Composition of essential oil was determined by GC-MS. Topical application bioassay was used to evaluatecontact toxicity of essential oil and three main components. Fumigant toxicity of essential oil and its main components was measured using a sealed space method.Results: Twenty-two components were identified in the essential oil and the main components were (Z-ascaridole(29.7%, isoascaridole (13.0%, ρ-cymene (12.7% and piperitone (5.0%. The essential oil and (Z-ascaridole,isoascaridole and -cymene possessed fumigant toxicity against male German cockroaches with LC50 values of 4.13,0.55, 2.07 and 6.92 mg/L air, respectively. Topical application bioassay showed that all the three compounds weretoxic to male German cockroaches and (Z-ascaridole was the strongest with a LD50 value of 22.02 g/adult while the crude oil with a LD50 value of 67.46 g/adult.Conclusion: The essential oil from Chinese C. ambrosioides and its three main active ingredients may be explored as natural potential insecticides in the control of cockroaches.

Research priorities in pediatric rheumatology: The Childhood Arthritis and Rheumatology Research Alliance (CARRA consensus

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Mellins Elizabeth D

2008-04-01

Full Text Available Abstract Background North American pediatric rheumatologists have created an investigator-initiated research network (the Childhood Arthritis and Rheumatology Research Alliance – CARRA to facilitate multi-centre studies. One of the first projects undertaken by this network was to define, by consensus, research priorities for the group, and if possible a first group-sponsored clinical trial in which all members could participate. Methods We determined consensus using the Delphi approach. This approach has been used extensively in health research to reach consensus in large groups. It uses several successive iterations of surveys eliciting ideas and opinions from specialists in the field. Three surveys were designed based on this method and were distributed to members of CARRA to elicit and rank-order research priorities. Results A response rate of 87.6% was achieved in the final survey. The most highly ranked research suggestion was to study infliximab treatment of uveitis unresponsive to methotrexate. Other highly ranked suggestions were to study i the treatment of systemic arthritis with anakinra and ii the treatment of pediatric systemic lupus erythematosus with mycophenolate mofetil. Conclusion The Delphi approach was an effective and practical method to define research priorities in this group. Ongoing discussion and cooperation among pediatric rheumatologists in CARRA and others world-wide will help in developing further research priorities and to facilitate the execution of clinical trials in the future.

The impact factor of rheumatology journals : an analysis of 2008 and the recent 10 years

NARCIS (Netherlands)

Chen, Min; Zhao, Ming-Hui; Kallenberg, Cees G. M.

2011-01-01

Despite various weaknesses, the impact factor (IF) is still used as an important indictor for scientific quality in specific subject categories. In the current study, the IFs of rheumatology journals over the past 10 years were serially analyzed and compared with that from other fields. For the past

Potential of Insect-Derived Ingredients for Food Applications

NARCIS (Netherlands)

Tzompa Sosa, D.A.; Fogliano, V.

2017-01-01

Insects are a sustainable and efficient protein and lipid source, compared with conventional livestock. Moreover, insect proteins and lipids are highly nutritional. Therefore, insect proteins and lipids can find its place as food ingredients. The use of insect proteins and lipids as food ingredients

Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit.

LENUS (Irish Health Repository)

Fennelly, Orna

2018-06-01

Many people with musculoskeletal (MSK) disorders wait several months or years for Consultant Doctor appointments, despite often not requiring medical or surgical interventions. To allow earlier patient access to orthopaedic and rheumatology services in Ireland, Advanced Practice Physiotherapists (APPs) were introduced at 16 major acute hospitals. This study performed the first national evaluation of APP triage services.

Determining Pathways to Improvements in Fatigue in Rheumatoid Arthritis: Results From the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis.

Science.gov (United States)

Druce, Katie L; Jones, Gareth T; Macfarlane, Gary J; Basu, Neil

2015-09-01

There is debate as to the role of inflammatory disease activity in the etiology of rheumatoid arthritis (RA)-related fatigue. We undertook this study to determine the relationship of fatigue to disease activity by examining pathways associated with change in fatigue in subjects starting anti-tumor necrosis factor (anti-TNF) therapy for the first time. Participants who had been recruited to the British Society for Rheumatology Biologics Register for RA provided information on fatigue (Short Form 36 [SF-36] vitality scale) and other health status variables at the start of anti-TNF therapy and 6 months later. The Disease Activity Score in 28 joints (DAS28) and inflammation (erythrocyte sedimentation rate [ESR]/C-reactive protein [CRP] level) were also reported. A path analysis model comprising changes in fatigue, pain, disease activity, disability, and mental health, along with effects of sex and a history of depression, was used to examine those with high levels of fatigue at baseline (score of ≤12.5 units on the SF-36 vitality scale). The DAS28 was substituted for ESR/CRP to delineate the specific role of inflammation. With a total of 2,652 participants, we identified a well-fitting model (χ2  = 0.18, P = 0.98) accounting for 40% of the variance in fatigue change. There was no direct pathway from change in inflammation to change in fatigue; instead, significant pathways to change in fatigue were observed from changes in disease activity, pain, mental health, and disability, along with effects of sex and a history of depression. A total of 82% of the effect of change in disease activity was indirect, of which ∼50% was mediated through a change in pain. Improvements in fatigue do not appear to be driven by inflammatory disease activity; instead, they appear to result indirectly from improvements in pain. Additional significant pathways through disability and mental health suggest potentially modifiable factors that could be targeted to improve clinically

Sjögren SER: National registry of the Spanish Society of Rheumatology of patients with primary Sjögren syndrome: Objectives and methodology.

Science.gov (United States)

Fernández Castro, Mónica; Andreu, Jose Luis; Sánchez-Piedra, Carlos; Martínez Taboada, Víctor; Olivé, Alejandro; Rosas, José; Sánchez-Alonso, Fernando

2016-01-01

To describe the objectives and methods of the Spanish Society of Rheumatology primary Sjögren syndrome (pSS) registry (SJOGREN-SER) METHODS: This is a multicenter descriptive transversal study of a cohort of pSS patients fulfilling European/American consensus criteria collected from Rheumatology clinics all over Spain. Patients were included by randomisation from an anonymised list provided by every department. Data were collected by reviewing clinical records and an interviewing the patients. Two hundred and ninety eight variables were investigated: epidemiological, clinical, serological characteristics, treatments and complications. Informed consent was obtained and local ethics committees approved the study. Variables were analysed by descriptive statistical methods, using means, medians, and rates, with their deviations and interquartile ranges (p25-p75). A total of 3 rheumatology departments participated in the registry. A total of 437 patients were included. And 95% of them were women, with a median age of 58. Median age at pSS 's diagnosis was 50 years. Dryness symptoms (95%) were the most frequent complaint and anti-Ro/SS-A were present in 94% of the cases. Only 27% of the patients fulfilled the new 2012 SICCA-ACR classification criteria. SJOGREN-SER has been designed in order to characterize a representative pSS Spanish cohort, in clinical daily practice, to analyze the magnitude and distribution of its manifestations, activity, accumulated damage and therapeutic management of the disease. This will allow broadening the knowledge of this disease and plan strategies of action in pSS. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Rapid classification of pharmaceutical ingredients with Raman spectroscopy using compressive detection strategy with PLS-DA multivariate filters.

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Cebeci Maltaş, Derya; Kwok, Kaho; Wang, Ping; Taylor, Lynne S; Ben-Amotz, Dor

2013-06-01

Identifying pharmaceutical ingredients is a routine procedure required during industrial manufacturing. Here we show that a recently developed Raman compressive detection strategy can be employed to classify various widely used pharmaceutical materials using a hybrid supervised/unsupervised strategy in which only two ingredients are used for training and yet six other ingredients can also be distinguished. More specifically, our liquid crystal spatial light modulator (LC-SLM) based compressive detection instrument is trained using only the active ingredient, tadalafil, and the excipient, lactose, but is tested using these and various other excipients; microcrystalline cellulose, magnesium stearate, titanium (IV) oxide, talc, sodium lauryl sulfate and hydroxypropyl cellulose. Partial least squares discriminant analysis (PLS-DA) is used to generate the compressive detection filters necessary for fast chemical classification. Although the filters used in this study are trained on only lactose and tadalafil, we show that all the pharmaceutical ingredients mentioned above can be differentiated and classified using PLS-DA compressive detection filters with an accumulation time of 10ms per filter. Copyright © 2013 Elsevier B.V. All rights reserved.

Telemedicine and other care models in pediatric rheumatology: an exploratory study of parents' perceptions of barriers to care and care preferences.

Science.gov (United States)

Bullock, Danielle R; Vehe, Richard K; Zhang, Lei; Correll, Colleen K

2017-07-11

The United States pediatric rheumatology workforce is committed to a mission of providing children access to pediatric rheumatology care. With a limited number and distribution of pediatric rheumatologists, telemedicine has been proposed as one way to meet this mission, yet the adoption of this modality has been slower than expected. The purpose of this study was to explore the parent perspective on barriers to accessing pediatric rheumatology care and to explore the acceptability of telemedicine and other alternative care models. Over a period of six weeks, all new and return English-speaking parents/guardians of patients visiting a single center were offered an opportunity to complete a survey which assessed barriers to care and interest in alternative models of care. Responses were analyzed using descriptive statistics. Survey response rate was 72% (159/221). Twenty-eight percent (45/159) traveled more than three hours to the pediatric rheumatology clinic, and 43% (65/152) reported travel as inconvenient. An overwhelming majority of respondents (95%, 144/152) reported a preference for in-person visits over the option of telemedicine. This preference was similar regardless of whether respondents reported travel to the clinic as inconvenient vs convenient (inconvenient 92%, 60/65; convenient 97%, 84/87; p = 0.2881) and despite those reporting travel as inconvenient also reporting greater difficulty with several barriers to care. Those familiar with telemedicine were more likely to report a preference for telemedicine over in-person visits (27%, 3/11 vs 3%, 4/140; p = 0.0087). The option of an outreach clinic was acceptable to a majority (63%, 97/154); however, adult rheumatology and shared-care options were less acceptable (22%, 35/156 and 34%, 53/156 respectively). Among survey respondents, in-person visits were preferred over the option of telemedicine, even when travel was noted to be inconvenient. Telemedicine familiarity increased its acceptability

Model evaluation for the prediction of solubility of active pharmaceutical ingredients (APIs to guide solid–liquid separator design

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Kuveneshan Moodley

2018-05-01

Full Text Available The assumptions and models for solubility modelling or prediction in systems using non-polar solvents, or water and complex triterpene and other active pharmaceutical ingredients as solutes aren't well studied. Furthermore, the assumptions concerning heat capacity effects (negligibility, experimental values or approximations are explored, using non-polar solvents (benzene, or water as reference solvents, for systems with solute melting points in the range of 306–528 K and molecular weights in the range of 90–442 g/mol. New empirical estimation methods for the ΔfusCpi of APIs are presented which correlate the solute molecular masses and van der Waals surface areas with ΔfusCpi. Separate empirical parameters were required for oxygenated and non-oxygenated solutes. Subsequently, the predictive capabilities of the various approaches to solubility modelling for complex pharmaceuticals, for which data is limited, are analysed. The solute selection is based on a principal component analysis, considering molecular weights, fusion temperatures, and solubilities in a non-polar solvent, alcohol, and water, where data was available. New NRTL-SAC parameters were determined for selected steroids, by regression. The original UNIFAC, modified UNIFAC (Dortmund, COSMO-RS (OL, and COSMO-SAC activity coefficient predictions are then conducted, based on the availability of group constants and sigma profiles. These are undertaken to assess the predictive capabilities of these models when each assumption concerning heat capacity is employed. The predictive qualities of the models are assessed, based on the mean square deviation and provide guidelines for model selection, and assumptions concerning phase equilibrium, when designing solid–liquid separators for the pharmaceutical industry on process simulation software. The most suitable assumption regarding ΔfusCpi was found to be system specific, with modified UNIFAC (Dortmund performing well in benzene as

Structured adsorbents for isolation of functional food ingredients

NARCIS (Netherlands)

Rodriguez Illera, M.

2014-01-01

Separation and purification of functional ingredients from raw or waste streams are often done via processes that include a chromatographic step using a packed bed of resin particles that have affinity for the ingredients to be separated. A column packed with these particles presents numerous

The Paediatric Rheumatology International Trials Organisation provisional criteria for the evaluation of response to therapy in juvenile dermatomyositis

DEFF Research Database (Denmark)

Ruperto, Nicolino; Pistorio, Angela; Ravelli, Angelo

2010-01-01

To develop a provisional definition for the evaluation of response to therapy in juvenile dermatomyositis (DM) based on the Paediatric Rheumatology International Trials Organisation juvenile DM core set of variables....

DNP-enhanced solid-state NMR spectroscopy of active pharmaceutical ingredients.

Science.gov (United States)

Zhao, Li; Pinon, Arthur C; Emsley, Lyndon; Rossini, Aaron J

2017-11-28

Solid-state NMR spectroscopy has become a valuable tool for the characterization of both pure and formulated active pharmaceutical ingredients (APIs). However, NMR generally suffers from poor sensitivity that often restricts NMR experiments to nuclei with favorable properties, concentrated samples, and acquisition of one-dimensional (1D) NMR spectra. Here, we review how dynamic nuclear polarization (DNP) can be applied to routinely enhance the sensitivity of solid-state NMR experiments by one to two orders of magnitude for both pure and formulated APIs. Sample preparation protocols for relayed DNP experiments and experiments on directly doped APIs are detailed. Numerical spin diffusion models illustrate the dependence of relayed DNP enhancements on the relaxation properties and particle size of the solids and can be used for particle size determination when the other factors are known. We then describe the advanced solid-state NMR experiments that have been enabled by DNP and how they provide unique insight into the molecular and macroscopic structure of APIs. For example, with large sensitivity gains provided by DNP, natural isotopic abundance, 13 C- 13 C double-quantum single-quantum homonuclear correlation NMR spectra of pure APIs can be routinely acquired. DNP also enables solid-state NMR experiments with unreceptive quadrupolar nuclei such as 2 H, 14 N, and 35 Cl that are commonly found in APIs. Applications of DNP-enhanced solid-state NMR spectroscopy for the molecular level characterization of low API load formulations such as commercial tablets and amorphous solid dispersions are described. Future perspectives for DNP-enhanced solid-state NMR experiments on APIs are briefly discussed. Copyright © 2017 John Wiley & Sons, Ltd.

Effectiveness of computer-assisted interactive videodisc instruction in teaching rheumatology to physical and occupational therapy students.

Science.gov (United States)

Sanford, M K; Hazelwood, S E; Bridges, A J; Cutts, J H; Mitchell, J A; Reid, J C; Sharp, G

1996-01-01

A computer-assisted interactive videodisc instructional program, HP-RHEUM was designed to teach clinical findings in arthritis to occupational and physical therapy students. Using the Rheumatology Image Library videodisc produced by the National Library of Medicine, HP-RHEUM consists of instructional modules which employ advance organizers, examples/nonexamples, summaries, and immediate feedback. To see if HP-RHEUM would be as effective as traditional classroom instruction, control data were collected in 1991 from 52 OT and PT students. Treatment data were collected from 61 students in 1992 when HP-RHEUM entirely replaced lectures. Identical pre- and post-tests consisted of 70 multiple choice questions, with 24 matched to slides. On the slide questions the HP-RHEUM group had significantly higher scores. Otherwise, there was no significant difference in performance between groups. HP-RHEUM provided an independent learning method and enhanced visual comprehension of rheumatologic disease concepts.

Understanding the risks associated with the use of new psychoactive substances (NPS): high variability of active ingredients concentration, mislabelled preparations, multiple psychoactive substances in single products.

Science.gov (United States)

Zamengo, Luca; Frison, Giampietro; Bettin, Chiara; Sciarrone, Rocco

2014-08-17

New psychoactive substances (NPS), are now a large group of substances of abuse not yet completely controlled by international drug conventions, which may pose a public health threat. Anxiety, paranoia, hallucinations, seizures, hyperthermia and cardiotoxicity are some of the common adverse effects associated with these compounds. In this paper, three case reports taken from the archive of processed cases of the authors' laboratory are presented and discussed to stress the risks of possible adverse consequences for NPS users: in particular, (i) the risk deriving from the difficulty of predicting the actual consumed dose, due to variability of active ingredients concentration in consumed products, (ii) the risk deriving from the difficulty of predicting the actual active ingredients present in consumed products, as opposed to those claimed by the manufacturer, and (iii) the risk deriving from the difficulty of predicting the actual pharmacological and toxicological effects related to the simultaneous consumption of different psychoactive ingredients contained in single products, whose interactions are mostly unknown. Each of them individually provide a source of concern for possible serious health related consequences. However, they should be considered in conjunction with each others, with the worldwide availability of NPS through the web and also with the incessantly growing business derived from the manipulation and synthesis of new substances. The resulting scenario is that of a cultural challenge which demands a global approach from different fields of knowledge. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Pharmacokinetics of hederacoside C, an active ingredient in AG NPP709, in rats.

Science.gov (United States)

Kim, Ju Myung; Yoon, Ji Na; Jung, Ji Won; Choi, Hye Duck; Shin, Young June; Han, Chang Kyun; Lee, Hye Suk; Kang, Hee Eun

2013-11-01

1. Hederacoside C (HDC) is one of the active ingredients in Hedera helix leaf extract (Ivy Ex.) and AG NPP709, a new botanical drug to treat acute respiratory infection and chronic inflammatory bronchitis. However, information regarding its pharmacokinetic properties remains limited. 2. Here, we report the pharmacokinetics of HDC in rats after intravenous administration of HDC (3, 12.5, and 25 mg/kg) and after oral administration of HDC, Ivy Ex., and AG NPP709 (equivalent to 12.5, 25, and 50 mg/kg HDC). 3. Linear pharmacokinetics of HDC were identified upon its intravenous administration at doses of 3-25 mg/kg. Intravenous administration of HDC results in relatively slow clearance (1.46-2.08 mL/min/kg) and a small volume of distribution at steady state (138-222 mL/kg), while oral administration results in a low absolute oral bioavailability (F) of 0.118-0.250%. The extremely low F of HDC may be due to poor absorption of HDC from the gastrointestinal (GI) tract and/or its decomposition therein. 4. The oral pharmacokinetics of HDC did not differ significantly among pure HDC, Ivy Ex., and AG NPP709.

Patient involvement in rheumatology outpatient service design and delivery: a case study.

Science.gov (United States)

de Souza, Savia; Galloway, James; Simpson, Carol; Chura, Radka; Dobson, Joanne; Gullick, Nicola J; Steer, Sophia; Lempp, Heidi

2017-06-01

Patient involvement is increasingly recognized as important within the UK National Health Service to ensure that services delivered are relevant to users' needs. Organizations are encouraged to work with service users to achieve excellence in care. Patient education can improve health outcomes and reduce health-care costs. Mobile technologies could play a vital role in this. Patient-centred development of innovative strategies to improve the experience of rheumatology outpatients. The Group Rheumatology Initiative Involving Patients (GRIIP) project was set up in 2013 as a joint venture between patients, clinicians, academics and management at a London hospital. The project saw (i) the formation of an independent patient group which provided suggestions for service improvement - outcomes included clearer signs in the outpatient waiting area, extended phlebotomy opening hours and better access to podiatry; (ii) a rolling patient educational evening programme initiated in 2014 with topics chosen by patient experts - feedback has been positive and attendance continues to grow; and (iii) a mobile application (app) co-designed with patients launched in 2015 which provides relevant information for outpatient clinic attendees and data capture for clinicians - downloads have steadily increased as users adopt this new technology. Patients can effectively contribute to service improvement provided they are supported, respected as equals, and the organization is willing to undergo a cultural change. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Adsorption chromatography to purify Spacer disaccharide of Active Pharmaceutical Ingredient of QuimiHib vaccine

International Nuclear Information System (INIS)

Diaz, Belinda; Heynngnezz, Lazaro; Beldarrain, Alejandro

2013-01-01

In this paper we study the conditions of adsorption chromatography on Silica gel 60 for purification of Spacer disaccharide a component of Active Pharmaceutical Ingredient (API) of QuimiHib vaccine. For that, we made a scale down on an analytical scale that represented at 1.8% of industrial process, indicating reproducibility between two procedures in terms of packing efficiency, purity and recovery. Dynamic binding capacity of the resin Silicagel 60 by the DSE was roughly 125±0.2 mg /mL, 3.4 times the base process. The elution profile obtained, showed the possibility of collecting a unique fraction at range 195±2 and 260±2 minutes, if it is maintained a proper packing of the chromatography resin determined by asymmetry factor from 0.8 to 1.2, which ensures a recovery of 58.9±4.5% and high purity analyzed by Thin Layer Chromatography. Adjusting the adsorption conditions increases the productivity of chromatographic operation up to 3.5 fold, indicating that it is feasible in economic terms

Cosmetic Functional Ingredients from Botanical Sources for Anti-Pollution Skincare Products

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Claudia Juliano

2018-02-01

Full Text Available Air pollution is a rising problem in many metropolitan areas around the world. Airborne contaminants are predominantly derived from anthropogenic activities, and include carbon monoxide, sulfur dioxide, nitrogen oxides, volatile organic compounds, ozone and particulate matter (PM; a mixture of solid and liquid particles of variable size and composition, able to absorb and delivery a large number of pollutants. The exposure to these air pollutants is associated to detrimental effects on human skin, such as premature aging, pigment spot formation, skin rashes and eczema, and can worsen some skin conditions, such as atopic dermatitis. A cosmetic approach to this problem involves the topical application of skincare products containing functional ingredients able to counteract pollution-induced skin damage. Considering that the demand for natural actives is growing in all segments of global cosmetic market, the aim of this review is to describe some commercial cosmetic ingredients obtained from botanical sources able to reduce the impact of air pollutants on human skin with different mechanisms, providing a scientific rationale for their use.

Functional ingredients from microalgae

NARCIS (Netherlands)

Buono, S.; Langellotti, A.L.; Martello, A.; Rinna, F.; Fogliano, V.

2014-01-01

A wide variety of natural sources are under investigation to evaluate their possible use for new functional ingredient formulation. Some records attested the traditional and ancient use of wild harvested microalgae as human food but their cultivation for different purposes started about 40 years

Analytical method (HPLC, validation used for identification and assay of the pharmaceutical active ingredient, Tylosin tartrate for veterinary use and its finite product Tilodem 50, hydrosoluble powder

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Maria Neagu

2010-12-01

Full Text Available In SC DELOS IMPEX ’96 SRL the quality of the active pharmaceutical ingredient (API for the finite product Tilodem 50 - hydrosoluble powder was acomkplished in the respect of last European Pharmacopoeia.The method for analysis used in this purpose was the compendial method „Tylosin tartrate for veterinary use” in EurPh. in vigour edition and represent a variant developed and validation „in house”.The parameters which was included in the methodology validation for chromatographic method are the followings: Selectivity, Linearity, Linearity range, Detection and Quantification limits, Precision, Repeatability (intra day, Inter-Day Reproductibility, Accuracy, Robustness, Solutions’ stability and System suitability. According to the European Pharmacopoeia, the active pharmaceutical ingredient is consistent, in terms of quality, if it contains Tylosin A - minimum 80% and the amount of Tylosin A, B, C, D, at minimum 95%. Identification and determination of each component separately (Tylosin A, B, C, D is possible by chromatographic separation-HPLC. Validation of analytical methods is presented below.

Demyelinizing neurological disease after treatment with tumor necrosis factor alpha-inhibiting agents in a rheumatological outpatient clinic

DEFF Research Database (Denmark)

Theibich, Ali; Dreyer, Lene; Magyari, Melinda

2014-01-01

Biological treatment with inhibitors of the pro-inflammatory cytokine TNF-alpha has dramatically improved the disease course of several chronic rheumatologic conditions. Adverse events (AEs) are primarily infections and hypersensitivity reactions. Demyelinizing neurological symptoms resembling...... multiple sclerosis (MS) have been described as a rare AE. During about 10-year use of anti TNF-alpha, the Danish Medicines Agency has recorded eight cases of MS like AEs. The objective of this study was to estimate the incidence of demyelinizing AEs both in the central and peripheral nervous system after...... treatment with anti TNF-alpha in a cohort of patients from a large rheumatologic outpatient clinic in Copenhagen. In a 4-year period from January 2008 to December 2011, approximately 550 patients annually were undergoing treatment with anti TNF-alpha inhibitors in our department. We collected data on all...

Improving the peer review skills of young rheumatologists and researchers in rheumatology: the EMEUNET Peer Review Mentoring Program.

Science.gov (United States)

Rodríguez-Carrio, Javier; Putrik, Polina; Sepriano, Alexandre; Moltó, Anna; Nikiphorou, Elena; Gossec, Laure; Kvien, Tore K; Ramiro, Sofia

2018-01-01

Although peer review plays a central role in the maintenance of high standards in scientific research, training of reviewing skills is not included in the common education programmes. The Emerging EULAR (European League Against Rheumatism) Network (EMEUNET) developed a programme to address this unmet need. The EMEUNET Peer Review Mentoring Program for Rheumatology Journals promotes a systematic training of reviewing skills by engaging mentees in a 'real world' peer review experience supervised by experienced mentors with support from rheumatology journals. This viewpoint provides an overview of this initiative and its outcomes, and discusses its potential limitations. Over 4 years, 18 mentors and 86 mentees have participated. Among the 33 participants who have completed the programme, 13 (39.3%) have become independent reviewers for Annals of the Rheumatic Diseases after the training. This programme has been recently evaluated by a survey and qualitative interviews, revealing a high interest in this initiative. The main strengths (involvement of a top journal and learning opportunities) and weaknesses of the programme (limited number of places and insufficient dissemination) were identified. Overall, this programme represents an innovative and successful approach to peer review training. Continuous evaluation and improvement are key to its functioning. The EMEUNET Peer Review Mentoring Program may be used as a reference for peer review training in areas outside rheumatology.

Marine Bioactives as Functional Food Ingredients: Potential to Reduce the Incidence of Chronic Diseases

Science.gov (United States)

Lordan, Sinéad; Ross, R. Paul; Stanton, Catherine

2011-01-01

The marine environment represents a relatively untapped source of functional ingredients that can be applied to various aspects of food processing, storage, and fortification. Moreover, numerous marine-based compounds have been identified as having diverse biological activities, with some reported to interfere with the pathogenesis of diseases. Bioactive peptides isolated from fish protein hydrolysates as well as algal fucans, galactans and alginates have been shown to possess anticoagulant, anticancer and hypocholesterolemic activities. Additionally, fish oils and marine bacteria are excellent sources of omega-3 fatty acids, while crustaceans and seaweeds contain powerful antioxidants such as carotenoids and phenolic compounds. On the basis of their bioactive properties, this review focuses on the potential use of marine-derived compounds as functional food ingredients for health maintenance and the prevention of chronic diseases. PMID:21747748

Marine Bioactives as Functional Food Ingredients: Potential to Reduce the Incidence of Chronic Diseases

Directory of Open Access Journals (Sweden)

Catherine Stanton

2011-06-01

Full Text Available The marine environment represents a relatively untapped source of functional ingredients that can be applied to various aspects of food processing, storage, and fortification. Moreover, numerous marine-based compounds have been identified as having diverse biological activities, with some reported to interfere with the pathogenesis of diseases. Bioactive peptides isolated from fish protein hydrolysates as well as algal fucans, galactans and alginates have been shown to possess anticoagulant, anticancer and hypocholesterolemic activities. Additionally, fish oils and marine bacteria are excellent sources of omega-3 fatty acids, while crustaceans and seaweeds contain powerful antioxidants such as carotenoids and phenolic compounds. On the basis of their bioactive properties, this review focuses on the potential use of marine-derived compounds as functional food ingredients for health maintenance and the prevention of chronic diseases.

Evaluation of a novel 7-joint ultrasound score in daily rheumatologic practice: a pilot project.

Science.gov (United States)

Backhaus, M; Ohrndorf, S; Kellner, H; Strunk, J; Backhaus, T M; Hartung, W; Sattler, H; Albrecht, K; Kaufmann, J; Becker, K; Sörensen, H; Meier, L; Burmester, G R; Schmidt, W A

2009-09-15

To introduce a new standardized ultrasound score based on 7 joints of the clinically dominant hand and foot (German US7 score) implemented in daily rheumatologic practice. The ultrasound score included the following joints of the clinically dominant hand and foot: wrist, second and third metacarpophalangeal and proximal interphalangeal, and second and fifth metatarsophalangeal joints. Synovitis and synovial/tenosynovial vascularity were scored semiquantitatively (grade 0-3) by gray-scale (GS) and power Doppler (PD) ultrasound. Tenosynovitis and erosions were scored for presence. The scoring range was 0-27 for GS synovitis, 0-39 for PD synovitis, 0-7 for GS tenosynovitis, 0-21 for PD tenosynovitis, and 0-14 for erosions. Patients with arthritis were examined at baseline and after the start or change of disease-modifying antirheumatic drug (DMARD) and/or tumor necrosis factor alpha (TNFalpha) inhibitor therapy 3 and 6 months later. C-reactive protein level, erythrocyte sedimentation rate, rheumatoid factor, anti-cyclic citrullinated peptide, Disease Activity Score in 28 joints (DAS28), and radiographs of the hands and feet were performed. One hundred twenty patients (76% women) with rheumatoid arthritis (91%) and psoriatic arthritis (9%) were enrolled. In 52 cases (43%), erosions were seen in radiography at baseline. Patients received DMARDs (41%), DMARDs plus TNFalpha inhibitors (41%), or TNFalpha inhibitor monotherapy (18%). At baseline, the mean DAS28 was 5.0 and the synovitis scores were 8.1 in GS ultrasound and 3.3 in PD ultrasound. After 6 months of therapy, the DAS28 significantly decreased to 3.6 (Delta = 1.4), and the GS and PD ultrasound scores significantly decreased to 5.5 (-32%) and 2.0 (-39%), respectively. The German US7 score is a viable tool for examining patients with arthritis in daily rheumatologic practice because it significantly reflects therapeutic response.

Patients' Perspectives on Information and Communication About Sexual and Relational Issues in Rheumatology Health Care.

Science.gov (United States)

Helland, Ylva; Dagfinrud, Hanne; Haugen, Mona-Iren; Kjeken, Ingvild; Zangi, Heidi

2017-06-01

Men and women with rheumatic diseases report a significantly negative impact on multiple areas of life, including sexuality. Research indicates that patients want to discuss sexual issues with health professionals (HPs) in rheumatology care but these issues are rarely addressed in consultations. The objective of the present study was to explore patients' experiences of communication with HPs about disease-related sexual issues, their perceptions of the relevance of these issues in rheumatology care and their preferences for how these topics should be handled. A qualitative design was used and 18 semi-structured interviews were performed, including eight women and ten men with inflammatory rheumatic joint diseases, aged 29-62 years. The interviews were recorded and transcribed verbatim. Data were analysed thematically. Four main themes were derived from the interviews: (i) relevance of sexual issues; (ii) vital conditions for communication; (iii) individual preferences in mode and timing of information and communication; and (iv) benefits of information and communication. The participants expressed that, although sexual issues are relevant, necessary conditions for good communication are largely lacking. HPs' knowledge, experience and personal skills, as well as having sufficient time were essential. HPs lack of initiating sexual topics contributed to uncertainty about whether their sexual challenges were disease related and whether it was a legitimate topic to discuss in rheumatology care. Patients wanted HPs to possess knowledge about possible disease-related challenges in sexual life and intimate relationships, and to facilitate communication about these aspects. There is a need to develop practice guidelines to enable HPs to integrate sexual issues as an aspect of healthcare delivery in a patient-friendly manner. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Ingredient classification according to the digestible amino acid profile: an exploratory analysis

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DE Faria Filho

2005-09-01

Full Text Available This study aimed: 1 to classify ingredients according to the digestible amino acid (AA profile; 2 to determine ingredients with AA profile closer to the ideal for broiler chickens; and 3 to compare digestible AA profiles from simulated diets with the ideal protein profile. The digestible AA levels of 30 ingredients were compiled from the literature and presented as percentages of lysine according to the ideal protein concept. Cluster and principal component analyses (exploratory analyses were used to compose and describe groups of ingredients according to AA profiles. Four ingredient groups were identified by cluster analysis, and the classification of the ingredients within each of these groups was obtained from a principal component analysis, showing 11 classes of ingredients with similar digestible AA profiles. The ingredients with AA profiles closer to the ideal protein were meat and bone meal 45, fish meal 60 and wheat germ meal, all of them constituting Class 1; the ingredients from the other classes gradually diverged from the ideal protein. Soybean meal, which is the main protein source for poultry, showed good AA balance since it was included in Class 3. On the contrary, corn, which is the main energy source in poultry diets, was classified in Class 8. Dietary AA profiles were improved when corn and/or soybean meal were partially or totally replaced in the simulations by ingredients with better AA balance.

[In vitro susceptibility of Trichoconiella padwickii to various active ingredients used as fungicides in the cultivation of rice].

Science.gov (United States)

Lovato Echeverria, Alfonso D; Gutiérrez, Susana A; Carmona, Marcelo A

The aim of this study was to evaluate in vitro the mycelial susceptibility of Trichoconiella padwickii to different active ingredients through average median concentration IC 50 calculation. Inoculum disks were seeded on bean agar at different concentrations (0.1; 1; 10; 30, 50; 100 and 1000mg/l) of various fungicides. After seven days the colony diameter was measured. The data obtained were fitted to nonlinear regression models. Susceptibility was classified using the scale proposed by Edgington. The results show that the pathogen is very sensitive to products that act on the respiratory chain (quinone outside inhibitors [QoI] and succinate dehydrogenase inhibitors [SDHI]) and cell membrane (multi-site contact activity), and moderately sensitive to those products interfering with cell division (methyl benzimidazole carbamates [MBC]), synthesis of nucleic acids (phenylamides [PA]) and osmotic signal transduction (multi-site contact activity). This work is the first record on the sensitivity of T. padwickii. Copyright © 2017 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

Bactericidal active ingredient in cryopreserved plasma-treated water with the reduced-pH method for plasma disinfection

Science.gov (United States)

Kitano, Katsuhisa; Ikawa, Satoshi; Nakashima, Yoichi; Tani, Atsushi; Yokoyama, Takashi; Ohshima, Tomoko

2016-09-01

For the plasma disinfection of human body, plasma sterilization in liquid is crucial. We found that the plasma-treated water (PTW) has strong bactericidal activity under low pH condition. Physicochemical properties of PTW is discussed based on chemical kinetics. Lower temperature brings longer half-life and the bactericidal activity of PTW can be kept by cryopreservation. High performance PTW, corresponding to the disinfection power of 22 log reduction (B. subtilis spore), can be obtained by special plasma system equipped with cooling device. This is equivalent to 65% H2O2, 14% sodium hypochlorite and 0.33% peracetic acid, which are deadly poison for human. But, it is deactivated soon at higher temperature (4 sec. at body temperature), and toxicity to human body seems low. For dental application, PTW was effective on infected models of human extracted tooth. Although PTW has many chemical components, respective chemical components in PTW were isolated by ion chromatography. In addition to peaks of H2O2, NO2- and NO3-, a specific peak was detected. and only this fraction had bactericidal activity. Purified active ingredient of PTW is the precursor of HOO, and further details will be discussed in the presentation. MEXT (15H03583, 23340176, 25108505). NCCE (23-A-15).

Active Ingredients of Epimedii Folium and Ligustri Lucidi Fructus Balanced GR/HSP90 to Improve the Sensitivity of Asthmatic Rats to Budesonide

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Xiufeng Tang

2017-01-01

Full Text Available This study aimed to investigate the possible molecular mechanisms of active ingredients of Epimedii Folium (EF and Ligustri Lucidi Fructus (LLF combined with Budesonide (Bun in asthmatic rats. Rats were divided into 5 groups, including normal group, asthma model group, Bun group, group of active ingredients of EL and LLF (EL, and group of coadministration of Bun with EL (Bun&EL. The asthmatic model was prepared by ovalbumin sensitizing and challenging. Lymphocyte apoptosis, GR protein and binding, and the protein and mRNA of GRα, GRβ, and HSP90 were tested. The results showed that Bun&EL ① markedly increased lymphocyte apoptosis, GR and HSP90 protein, and GR binding in BALF and ② enhanced the expressions of GRα and HSP90 and the ratio of GRα to GRβ or to HSP90 both in protein and in mRNA levels in lung, ③ while decrease occurred in GRβ mRNA and the mRNA ratio of GRβ to HSP90 compared with asthma or Bun group. Moreover, there was a significant correlation between GRα and GRβ in protein level, or between GRα and HSP90 both in protein and in mRNA levels. EL may effectively enhance the sensitivity of asthmatic rats to Bun via balancing GR/HSP90. And these findings will be beneficial for the treatment of asthma in the future.

Pharmacokinetic Profiles of Active Ingredients and Its Metabolites Derived from Rikkunshito, a Ghrelin Enhancer, in Healthy Japanese Volunteers: A Cross-Over, Randomized Study.

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Hiroyuki Kitagawa

Full Text Available Rikkunshito, a traditional Japanese (Kampo medicine, has been used to treat upper gastrointestinal disorders such as functional dyspepsia and gastroesophageal reflux. This study investigated the exposure and pharmacokinetics of the ingredients of rikkunshito in healthy volunteers.First, an exploratory nonrandomized, open-label, one-period, noncrossover study using four healthy Japanese volunteers to detect 32 typical ingredients of rikkunshito in plasma and urine. As a result, 18 or 21 of 32 ingredients was detected in plasma or urine samples after oral administration of rikkunshito (7.5 g/day. Furthermore, a randomized, open-label, three-arm, three-period, crossover study using 21 subjects was conducted to determine the amounts of exposure and pharmacokinetic parameters of nine ingredients derived from rikkunshito (atractylodin, atractylodin carboxylic acid, pachymic acid, 3,3',4',5,6,7,8-heptamethoxyflavone, naringenin, nobiletin, liquiritigenin, isoliquiritigenin, and 18β-glycyrrhetinic acid after oral administration of rikkunshito at three different doses (2.5, 5.0, or 7.5 g/day during each period. The pharmacokinetic profiles of the nine ingredients in plasma were characterized. The geometric means (95% confidence interval for the Cmax of the ingredients at a dose of 7.5 g were 1570 (1210-2040, 14,300 (12,200-16,800, 91.0 (71.8-115, 105 (75.6-144, 1150 (802-1650, 35.9 (24.6-52.5, 800 (672-952, 42.8 (30.4-60.3, and 55,600 (39,600-78,100 pg/mL, respectively, and for the AUC0-last were 1760 (1290-2390, 12700 (11,100-14,600, 1210 (882-1650, 225 (157-322, 4630 (2930-7320, 35.7 (20.4-62.7, 4040 (3260-5010, 122 (88.2-168, and 832,000 (628,000-1,100,000 pg·h/mL respectively.We identified the ingredients of rikkunshito that are absorbed in humans. Furthermore, we determined the pharmacokinetics of nine ingredients derived from rikkunshito. This information will be useful for elucidating the pharmacological effects of rikkunshito

Flipped Learning: Can Rheumatology Lead the Shift in Medical Education?

Science.gov (United States)

El Miedany, Yasser; El Gaafary, Maha; El Aroussy, Nadia; Youssef, Sally

2018-04-16

To: 1. implement flipped classroom rheumatology teaching for undergraduate education. 2. Evaluate outcomes of teaching using OSCE assessment and student perceived effectiveness and satisfaction survey. The flipped classroom education was conducted in 3 phases. Phase 1: carried out in the students' own time. Web links were emailed to assist exposure of the instructional part of the lesson online. Phase 2: interactive in-class activity to share personal reflection and reinforce the key aspects. Phase 3: a simulated OSCE assessment. A cohort of 56-students, who were taught in the last educational year on the same topics according to standard teaching protocols, were included as control group. The clinical Outcomes were assessed using the scores of the OSCE examination model. Academic outcomes included the engagement measure as well as the students' answers to perceived effectiveness and satisfaction survey. There was no significant difference regarding demographics between the 2 students' groups. There was significant improvement (plearning, in contrast to the control group, in terms of clinical (OSCE score) as well as communication skills. Student perceived effectiveness and satisfaction was significantly higher among the flipped learning (plearning cohort showed a state of engagement significantly higher than the control group (plearning implementation musculoskeletal learning successfully demonstrated a promising platform for using technology to make better use of the students' time, and for increasing their satisfaction. Active learning increases student engagement and can lead to improved retention of knowledge. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Characterizing Active Ingredients of eHealth Interventions Targeting Persons With Poorly Controlled Type 2 Diabetes Mellitus Using the Behavior Change Techniques Taxonomy: Scoping Review.

Science.gov (United States)

Kebede, Mihiretu M; Liedtke, Tatjana P; Möllers, Tobias; Pischke, Claudia R

2017-10-12

The behavior change technique taxonomy v1 (BCTTv1; Michie and colleagues, 2013) is a comprehensive tool to characterize active ingredients of interventions and includes 93 labels that are hierarchically clustered into 16 hierarchical clusters. The aim of this study was to identify the active ingredients in electronic health (eHealth) interventions targeting patients with poorly controlled type 2 diabetes mellitus (T2DM) and relevant outcomes. We conducted a scoping review using the BCTTv1. Randomized controlled trials (RCTs), studies with or pre-post-test designs, and quasi-experimental studies examining efficacy and effectiveness of eHealth interventions for disease management or the promotion of relevant health behaviors were identified by searching PubMed, Web of Science, and PsycINFO. Reviewers independently screened titles and abstracts for eligibility using predetermined eligibility criteria. Data were extracted following a data extraction sheet. The BCTTv1 was used to characterize active ingredients of the interventions reported in the included studies. Of the 1404 unique records screened, 32 studies fulfilled the inclusion criteria and reported results on the efficacy and or or effectiveness of interventions. Of the included 32 studies, 18 (56%) were Web-based interventions delivered via personal digital assistant (PDA), tablet, computer, and/or mobile phones; 7 (22%) were telehealth interventions delivered via landline; 6 (19%) made use of text messaging (short service message, SMS); and 1 employed videoconferencing (3%). Of the 16 hierarchical clusters of the BCTTv1, 11 were identified in interventions included in this review. Of the 93 individual behavior change techniques (BCTs), 31 were identified as active ingredients of the interventions. The most common BCTs identified were instruction on how to perform behavior, adding objects to the environment, information about health consequences, self-monitoring of the outcomes and/or and prefers to be

Macroalgae-Derived Ingredients for Cosmetic Industry—An Update

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Filipa B. Pimentel

2017-12-01

Full Text Available Aging is a natural and progressive declining physiological process that is influenced by multifactorial aspects and affects individuals’ health in very different ways. The skin is one of the major organs in which aging is more evident, as it progressively loses some of its natural functions. With the new societal paradigms regarding youth and beauty have emerged new concerns about appearance, encouraging millions of consumers to use cosmetic/personal care products as part of their daily routine. Hence, cosmetics have become a global and highly competitive market in a constant state of evolution. This industry is highly committed to finding natural sources of functional/bioactive-rich compounds, preferably from sustainable and cheap raw materials, to deliver innovative products and solutions that meet consumers’ expectations. Macroalgae are an excellent example of a natural resource that can fit these requirements. The incorporation of macroalgae-derived ingredients in cosmetics has been growing, as more and more scientific evidence reports their skin health-promoting effects. This review provides an overview on the possible applications of macroalgae as active ingredients for the cosmetic field, highlighting the main compounds responsible for their bioactivity on skin.

Simultaneous determination of active ingredients in Erigeron breviscapus (Vant.) Hand-Mazz. by capillary electrophoresis with electrochemical detection.

Science.gov (United States)

Chu, Qingcui; Wu, Ting; Fu, Liang; Ye, Jiannong

2005-03-09

A high-performance capillary electrophoresis (CE) with electrochemical detection (ED) method was developed for the determination of the pharmacologically active ingredients in Erigeron breviscapus (Vant.) Hand-Mazz. and its extract phytopharmaceuticals in this work. Under the optimum conditions, nine analytes, baicalein, naringenin, scopoletin, kaempferol, apigenin, scutellarin, luteolin, caffeic acid and protocatechuic acid were separated within 24 min in a borax buffer (pH 8.7). Notably, excellent linearity was obtained over two orders of magnitude with detection limits (S/N=3) ranged from 1.0 x 10(-7) g/mL to 5.6 x 10(-7) g/mL for all nine analytes. This method was successfully used in the analysis of E. breviscapus (Vant.) Hand-Mazz. and its phytopharmaceuticals with a relatively simple extraction procedure, and the assay results were satisfactory.

Pharmacokinetics and tissue distribution of five active ingredients of Eucommiae cortex in normal and ovariectomized mice by UHPLC-MS/MS.

Science.gov (United States)

An, Jing; Hu, Fangdi; Wang, Changhong; Zhang, Zijia; Yang, Li; Wang, Zhengtao

2016-09-01

1. Pinoresinol di-O-β-d-glucopyranoside (PDG), geniposide (GE), geniposidic acid (GA), aucubin (AN) and chlorogenic acid (CA) are the representative active ingredients in Eucommiae cortex (EC), which may be estrogenic. 2. The ultra high-performance liquid chromatography/tandem mass spectrometry (UHPLC-MS/MS) method for simultaneous determination of the five ingredients showed good linearity, low limits of quantification and high extraction recoveries, as well as acceptable precision, accuracy and stability in mice plasma and tissue samples (liver, spleen, kidney and uterus). It was successfully applied to the comparative study on pharmacokinetics and tissue distribution of PDG, GE, GA, AN and CA between normal and ovariectomized (OVX) mice. 3. The results indicated that except CA, the plasma and tissue concentrations of PDG, GE, GA in OVX mice were all greater than those in normal mice. AN could only be detected in the plasma and liver homogenate of normal mice, which was poorly absorbed in OVX mice and low in other measured tissues. PDG, GE and GA seem to be better absorbed in OVX mice than in normal mice proved by the remarkable increased value of AUC0-∞ and Cmax. It is beneficial that PDG, GE, GA have better plasma absorption and tissue distribution in pathological state.

[Effect of exogenous sucrose on growth and active ingredient content of licorice seedlings under salt stress conditions].

Science.gov (United States)

Liu, Fu-zhi; Yang, Jun

2015-11-01

Licorice seedlings were taken as experimental materials, an experiment was conducted to study the effects of exogenous sucrose on growth and active ingredient content of licorice seedlings under NaCl stress conditions. The results of this study showed that under salt stress conditions, after adding a certain concentration of exogenous sucrose, the licorice seedlings day of relative growth rate was increasing, and this stress can be a significant weakening effect, indicating that exogenous sucrose salt stress-relieving effect. The total flavonoids and phenylalanine ammonia lyase (PAL) activity were significantly increased, the exogenous sucrose can mitigated the seedling roots under salt stress, the licorice flavonoid content in the enhanced growth was largely due to the activity of PAL an increased, when the concentration of exogenous sucrose wae 10 mmol x L(-1), PAL activity reaching a maximum, when the concentration of exogenous sucrose was 15 mmol x L(-1), PAL activity turned into a downward trend, the results indicating that this mitigation has concentration effect. After applying different concentrations of exogenous sugar, the contents of liquiritin changes with the change of flavonoids content was similar. After applying different concentrations of exogenous sucrose, the content of licorice acid under salt stress was higher than the levels were not reached during salt stress, the impact of exogenous sucrose concentration gradient of licorice acid accumulation was not obvious.

The uptake of influenza and pneumococcal vaccination among immunocompromised patients attending rheumatology outpatient clinics.

LENUS (Irish Health Repository)

Haroon, Muhammad

2011-07-01

PURPOSE AND OBJECTIVES: The patients using immunosuppressive agents are considered at high risk for acquiring different infections. Accordingly, international guidelines recommend vaccinating such patients against influenza and pneumococcal organisms. The aims of this study were two-fold: (1) to assess the influenza and pneumococcal vaccination uptake among our rheumatology outpatients who are immunosuppressed; (2) to identify the factors influencing immunisation uptake among our sample of patients.

Dimeric Surfactants: Promising Ingredients of Cosmetics and Toiletries

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Naveen Kumar

2013-11-01

Full Text Available Surfactants are an essential ingredient for cosmetic, toiletries and personal care products for enhancing their performance. Dimeric surfactants demonstrate superiority compared to conventional surfactants in all areas of application. Dimeric surfactants are extremely promising for utilization in various cosmetic formulations viz. shampoo, lotions, creams, conditioners etc. These surfactants possess extremely unique surface properties viz. lower surface tension, unique micellization, low critical micelle concentration (CMC and antimicrobial activity, higher solubilization etc. Dimerics enhance the performances of cosmetics in an extraordinary manner and provide eco-friendly preparations for human epidermis.

Digestibility of animal and vegetable protein ingredients by pirarucu juveniles, Arapaima gigas

Directory of Open Access Journals (Sweden)

Filipe dos Santos Cipriano

Full Text Available ABSTRACT The objective of this study was to determine the apparent digestibility coefficients of energy, protein, and amino acids in protein ingredients by pirarucu juveniles. A test was conducted with six protein ingredients: meat and bone meal, fish meal, hydrolyzed feather meal, poultry by-product meal, soybean meal, and corn gluten meal. Three repetitions were used for each tested ingredient. A reference feed was used with 430 g kg−1 crude protein and 19.63 kJ g−1 gross energy. The test feeds consisted of the replacement of 30% of the reference feeds with the test ingredients. Chromium oxide was added to the feeds at 1 g kg−1 as an external marker. Eighteen juveniles with an average weight of 235±36 g were used. The best apparent digestibility coefficients of protein were found for fish meal, followed by the poultry by-product meal and meat and bone meal. However, except for gluten, all the tested ingredients presented protein digestibilities above 0.70. The crude energy apparent digestibility coefficient was higher for animal ingredients, above 0.75, than for vegetable ingredients, which presented values below 0.60. Pirarucu efficiently uses the protein from the tested ingredients, regardless of origin. However, it has a preferential ability to use the energy from animal ingredients.

Canadian Rheumatology Association Meeting, The Westin Ottawa, Ottawa, Ontario, Canada, February 8-11, 2017.

Science.gov (United States)

Silverman, Earl D

2017-05-01

The 72nd Annual Meeting of The Canadian Rheumatology Association (CRA) was held at The Westin Ottawa, Ottawa, Ontario, Canada, February 8-11, 2017. The program consisted of presentations covering original research, symposia, awards, and lectures. Highlights of the meeting include the following 2017 award winners: Dr. Vinod Chandran, Young Investigator; Dr. Jacques P. Brown, Distinguished Investigator; Dr. David Robinson, Teacher-Educator; Dr. Michel Zummer, Distinguished Rheumatologist; Ms. Rebecca Gole, Best Abstract on SLE Research by a Trainee - Ian Watson Award; Ms. Bailey Russell, Best Abstract on Clinical or Epidemiology Research by a Trainee - Phil Rosen Award; Dr. Sahil Koppikar and Dr. Henry Averns, Practice Reflection Award; Dr. Shirine Usmani, Best Abstract on Basic Science Research by a Trainee; Ms. Carol Dou, Best Abstract for Research by an Undergraduate Student; Dr. Dania Basodan, Best Abstract on Research by a Rheumatology Resident; Dr. Claire Barber, Best Abstract on Adult Research by Young Faculty; Ms. Audrea Chen, Best Abstract by a Medical Student; Dr. Kun Huang, Best Abstract by a Post-Graduate Resident; and Dr. Ryan Lewinson, Best Abstract by a Post-Graduate Research Trainee. Lectures and other events included a Keynote Lecture by Jonathon Fowles: Exercise is Medicine: Is Exercise a Good or Bad Thing for People with Arthritis?; State of the Art Lecture by Matthew Warman: Insights into Bone Biology and Therapeutics Gleaned from the Sustained Investigation of Rare Diseases; Dunlop-Dottridge Lecture by Allen Steere: Lyme Disease: A New Problem for Rheumatologists in Canada; and the Great Debate: Be it Resolved that the Least Expensive Treatment Should be Chosen. Switch, Switch, Switch! Arguing for: Jonathan Chan and Antonio Avina, and against: Marinka Twilt and Glen Hazlewood. Topics such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren syndrome, psoriatic arthritis, spondyloarthritis, vasculitis, osteoarthritis

Safety assessment of Vitis vinifera (grape)-derived ingredients as used in cosmetics.

Science.gov (United States)

Fiume, Monice M; Bergfeld, Wilma F; Belsito, Donald V; Hill, Ronald A; Klaassen, Curtis D; Liebler, Daniel C; Marks, James G; Shank, Ronald C; Slaga, Thomas J; Snyder, Paul W; Andersen, F Alan

2014-01-01

The Cosmetic Ingredient Review Expert Panel (Panel) assessed the safety of 24 Vitis vinifera (grape)-derived ingredients and found them safe in the present practices of use and concentration in cosmetics. These ingredients function in cosmetics mostly as skin-conditioning agents, but some function as antioxidants, flavoring agents, and/or colorants. The Panel reviewed the available animal and clinical data to determine the safety of these ingredients. Additionally, some constituents of grapes have been assessed previously for safety as cosmetic ingredients by the Panel, and others are compounds that have been discussed in previous Panel safety assessments. © The Author(s) 2014.

Fit for work? Evaluation of a workshop for rheumatology teams.

Science.gov (United States)

Cohen, D; Khan, S; Marfell, N

2016-06-01

People with rheumatoid arthritis (RA) may rapidly cease work prematurely due to ill-health. A recent survey noted that a quarter of respondents with RA experienced job loss within a year of diagnosis and 50% stopped work within 6 years. To develop and pilot workshops to increase the knowledge, skills and confidence of rheumatology team members to support work-related issues in outpatient clinics. A 3-h interactive workshop, informed by rheumatology experts and the Royal College of General Practitioners (RCGP) National Education Programme (NEP) about work and health, was developed to address both knowledge and skills in the management of health and work consultations in an outpatient setting. Questionnaires were developed for use pre- and immediately post-workshop, with questions that focused on the confidence of delegates in managing these discussions and the importance they placed upon them. Ninety-nine participants attended five workshops throughout the UK between 2013 and 2104. Seventy-three per cent (72) completed the post-workshop questionnaire. Eighty-nine per cent found the workshop useful or very useful, 88% found it relevant or very relevant and 79% responded that it had an impact or a considerable impact on their practice. Wilcoxon matched pairs signed rank tests were carried out that showed an overall increase in confidence after training. The results suggest that the workshop was both relevant and useful to participants and had an impact on their practice. This was true for all specialities. The workshops also highlighted participants' desire to understand how to use the 'fit note' to enhance their patient management. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Rheumatology in the community of Madrid: current availability of rheumatologists and future needs using a predictive model.

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Lázaro y De Mercado, Pablo; Blasco Bravo, Antonio Javier; Lázaro y De Mercado, Ignacio; Castañeda, Santos; López Robledillo, Juan Carlos

2013-01-01

To: 1) describe the distribution of the public sector rheumatologists; 2) identify variables on which the workload in Rheumatology depends; and 3) build a predictive model on the need of rheumatologists for the next 10 years, in the Community of Madrid (CM). The information was obtained through structured questionnaires sent to all services/units of Rheumatology of public hospitals in the CM. The population figures, current and forecasted, were obtained from the National Statistics Institute. A predictive model was built based on information about the current and foreseeable supply, current and foreseeable demand, and the assumptions and criteria used to match supply with demand. The underlying uncertainty in the model was assessed by sensitivity analysis. In the CM in 2011 there were 150 staff rheumatologists and 49 residents in 27 centers, which is equivalent to one rheumatologist for every 33,280 inhabitants in the general population, and one for every 4,996 inhabitants over 65 years. To keep the level of assistance of 2011 in 2021 in the general population, it would be necessary to train more residents or hire more rheumatologists in scenarios of demand higher than 15%. However, to keep the level of assistance in the population over 65 years of age it would be necessary to train more residents or hire more specialists even without increased demand. The model developed may be very useful for planning, with the CM policy makers, the needs of human resources in Rheumatology in the coming years. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Ingredients derived from the slaughter of bovines in dog food

Directory of Open Access Journals (Sweden)

Karina De Carli Loureiro

Full Text Available ABSTRACT: This study evaluated the nutritional levels, apparent digestibility coefficients, and faecal characteristics of dogs fed with four by-products from bovine slaughter: testicles, residue sirloin steak, trachea, and liver. Ingredients were processed and packed in tins for heat treatment in autoclaves. For the digestibility and faeces quality, ingredients were mixed with a reference diet (commercial food in the proportion of 30g kg-1 test ingredient and 70g kg-1 reference diet (as dry matter. Ten adult dogs were distributed in double Latin block squares (5x5 with five treatments and five periods, totalling ten repetitions per treatment. The residue sirloin steak presented the highest levels of essential (414.2g kg-1 of dry matter and non-essential (399.0g kg-1 of dry matter amino acids in tested ingredients. No differences (P>0.05 were observed in apparent digestibility coefficients of dry matter - ADCDM (907g kg-1, ADCOM (930g kg-1, ADCCP (841g kg-1, ADCAEE (954g kg-1 values, and DE (5069kcal kg-1 and ME (4781kcal kg-1 values between testicle, residue sirloin steak, and liver. The trachea presented lower digestibility and energy values (digestible and metabolizable than the other ingredients. This lower trachea digestibility resulted in higher faecal volume for natural and dry matter (P0.05 in faecal score between ingredients. Ingredients tested in this study can be used in feeds for adult dogs; however, their nutritional levels and digestibility values should be considered for correct diet balance.

75 FR 60768 - Single-Ingredient Oral Colchicine Products; Enforcement Action Dates

Science.gov (United States)

2010-10-01

...)): Division of Anesthesia, Analgesia and Rheumatology Products, Office of New Drugs, Center for Drug... been performed in the elderly or in pediatric patients. However, because the elderly are more likely to have significant renal or hepatic impairment, as a whole, they are more at risk. In light of these...

Radiation processing of dry food ingredients - a review

International Nuclear Information System (INIS)

Farkas, J.

1985-01-01

Radiation decontamination of dry ingredients, herbs and enzyme preparations is a technically feasible, economically viable and safe physical process. The procedure is direct, simple, requires no additives, does not leave residues and is highly efficient. Its dose requirement is moderate. Radiation doses of 3 to 10 kGy proved to be sufficient to reduce the viable cell counts to a satisfactory level. Ionizing radiations do not cause any significant rise in temperature and the flavour, texture or other important technological or sensory properties of most ingredients are not influenced at radiation doses necessary for a satisfactory decontamination. The microflora surviving the cell-count reduction by irradiation is more sensitive to subsequent food processing treatments than the microflora of untreated ingredients. Recontamination can be prevented since the product can be irradiated in its final packaging. Irradiation can be carried out in commercial containers and it results in considerable savings of energy and labour as compared to alternative decontamination techniques. Radiation processing of dry ingredients is an emerging technology in several countries and more and more clearances on irradiated foods are issued or expected to be granted in the near future. (author)

Radiation processing of dry food ingredients - a review

Energy Technology Data Exchange (ETDEWEB)

Farkas, J

1985-01-01

Radiation decontamination of dry ingredients, herbs and enzyme preparations is a technically feasible, economically viable and safe physical process. The procedure is direct, simple, requires no additives, does not leave residues and is highly efficient. Its dose requirement is moderate. Radiation doses of 3 to 10 kGy proved to be sufficient to reduce the viable cell counts to a satisfactory level. Ionizing radiations do not cause any significant rise in temperature and the flavour, texture or other important technological or sensory properties of most ingredients are not influenced at radiation doses necessary for a satisfactory decontamination. The microflora surviving the cell-count reduction by irradiation is more sensitive to subsequent food processing treatments than the microflora of untreated ingredients. Recontamination can be prevented since the product can be irradiated in its final packaging. Irradiation can be carried out in commercial containers and it results in considerable savings of energy and labour as compared to alternative decontamination techniques. Radiation processing of dry ingredients is an emerging technology in several countries and more and more clearances on irradiated foods are issued or expected to be granted in the near future.

Genotoxic Potential of Two Herbicides and their Active Ingredients Assessed with Comet Assay on a Fish Cell Line, Epithelioma Papillosum Cyprini (EPC)

DEFF Research Database (Denmark)

Syberg, Kristian; Rank, Jette; Jensen, Klara

2013-01-01

The aim of this study was to optimize the epithelioma papillosum cyprini (EPC) cell line handling procedure for the comet assay to investigate the genotoxic potential of widely used pesticides. The effects of various media and handling of the EPC cell line were examined. Results indicated......-(2,4-dichlorophenoxy)propionic acid) individually and in a ternary mixture were examined with the comet assay. Data showed that among the active ingredients only 2,4-D andMCPA induced DNA damage, while both herbicides were genotoxic at high concentrations....

Ingredients derived from the slaughter of bovines in dog food

OpenAIRE

Loureiro, Karina De Carli; Haese, Douglas; Kill, João Luís; Pires, Achicine Furno; Fernandes, Danieli Rankel; Colnago, Geraldo Luiz; Lucas, Wendius Henrique; Gama, Gabriela Oliveira

2017-01-01

ABSTRACT: This study evaluated the nutritional levels, apparent digestibility coefficients, and faecal characteristics of dogs fed with four by-products from bovine slaughter: testicles, residue sirloin steak, trachea, and liver. Ingredients were processed and packed in tins for heat treatment in autoclaves. For the digestibility and faeces quality, ingredients were mixed with a reference diet (commercial food) in the proportion of 30g kg-1 test ingredient and 70g kg-1 reference diet (as dry ...

Leprosy Mimicking Common Rheumatologic Entities: A Trial for the Clinician in the Era of Biologics

Directory of Open Access Journals (Sweden)

Deepak Rath

2014-01-01

Full Text Available Rheumatoid arthritis and seronegative spondyloarthritis, which make up the lion’s share of cases attending a rheumatology clinic, are relatively easy to diagnose. However, when an entity of infective aetiology like leprosy known to be a great mimic of different autoimmune conditions presents with features similar to these, the possibility of it being diagnosed at the outset is very slim indeed. The ease with which the diagnosis of leprosy can be missed assumes sinister proportions as the use of disease modifying agents can have deleterious effects in these patients. In the era of increasing availability and use of biologic disease modifying agents, it is imperative not only to actively rule out the presence of leprosy but also to make it a part of the prebiologic screening of patients in whom biologics are being planned to be administered, especially in leprosy endemic areas.

Innovations in natural ingredients and their use in skin care.

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Fowler, Joseph F; Woolery-Lloyd, Heather; Waldorf, Heidi; Saini, Ritu

2010-06-01

Natural ingredients have been used traditionally for millennia and their application in topical creams, lotions and preparations within the traditional medicines and healing traditions of many cultures has been observed. Over the last 20 years, clinical and laboratory studies have identified the benefits of an array of natural ingredients for skin care. Consequently, a number of these ingredients and compounds are today being developed, used or considered not only for anti-aging effects, but also for use in dermatologic disorders. Certain ingredients, such as colloidal oatmeal and aloe vera, have been identified as beneficial in the treatment of psoriasis and atopic dermatitis, respectively, due to their anti-inflammatory properties. For combating acne and rosacea, green tea, niacinamide and feverfew are considered efficacious. As to hyperpigmentation and antioxidative capabilities, licorice, green tea, arbutin, soy, acai berry, turmeric and pomegranate are among those plants and compounds found to be most beneficial. Additional research is needed to determine to confirm and elucidate the benefits of these ingredients in the prevention and management of skin disease.

American College of Rheumatology provisional criteria for defining clinical inactive disease in select categories of juvenile idiopathic arthritis.

Science.gov (United States)

Wallace, Carol A; Giannini, Edward H; Huang, Bin; Itert, Lukasz; Ruperto, Nicolino

2011-07-01

To prospectively validate the preliminary criteria for clinical inactive disease (CID) in patients with select categories of juvenile idiopathic arthritis (JIA). We used the process for development of classification and response criteria recommended by the American College of Rheumatology Quality of Care Committee. Patient-visit profiles were extracted from the phase III randomized controlled trial of infliximab in polyarticular-course JIA (i.e., patients considered to resemble those with select categories of JIA) and sent to an international group of expert physician raters. Using the physician ratings as the gold standard, the sensitivity and specificity were calculated using the preliminary criteria. Modifications to the criteria were made, and these were sent to a larger group of pediatric rheumatologists to determine quantitative, face, and content validity. Variables weighted heaviest by physicians when making their judgment were the number of joints with active arthritis, erythrocyte sedimentation rate (ESR), physician's global assessment, and duration of morning stiffness. Three modifications were made: the definition of uveitis, the definition of abnormal ESR, and the addition of morning stiffness. These changes did not alter the accuracy of the preliminary set. The modified criteria, termed the "criteria for CID in select categories of JIA," have excellent feasibility and face, content, criterion, and discriminant validity to detect CID in select categories of JIA. The small changes made to the preliminary criteria set did not alter the area under the receiver operating characteristic curve (0.954) or accuracy (91%), but have increased face and content validity. Copyright © 2011 by the American College of Rheumatology.

Health Risk Assessment on Hazardous Ingredients in Household Deodorizing Products

Directory of Open Access Journals (Sweden)

Minjin Lee

2018-04-01

Full Text Available The inhalation of a water aerosol from a humidifier containing disinfectants has led to serious lung injuries in Korea. To promote the safe use of products, the Korean government enacted regulations on the chemicals in various consumer products that could have adverse health effects. Given the concern over the potential health risks associated with the hazardous ingredients in deodorizing consumer products, 17 ingredients were analyzed and assessed according to their health risk on 3 groups by the application type in 47 deodorizing products. The risk assessment study followed a stepwise procedure (e.g., collecting toxicological information, hazard identification/exposure assessment, and screening and detailed assessment for inhalation and dermal routes. The worst-case scenario and maximum concentration determined by the product purpose and application type were used as the screening assessment. In a detailed assessment, the 75th exposure factor values were used to estimate the assumed reasonable exposure to ingredients. The exposed concentrations of seven ingredients were calculated. Due to limitation of toxicity information, butylated hydroxyl toluene for a consumer’s exposure via the dermal route only was conducted for a detailed assessment. This study showed that the assessed ingredients have no health risks at their maximum concentrations in deodorizing products. This approach can be used to establish guidelines for ingredients that may pose inhalation and dermal hazards.

Health Risk Assessment on Hazardous Ingredients in Household Deodorizing Products

Science.gov (United States)

Lee, Minjin; Kim, Joo-Hyon; Lee, Daeyeop; Kim, Jaewoo; Lim, Hyunwoo; Seo, Jungkwan; Park, Young-Kwon

2018-01-01

The inhalation of a water aerosol from a humidifier containing disinfectants has led to serious lung injuries in Korea. To promote the safe use of products, the Korean government enacted regulations on the chemicals in various consumer products that could have adverse health effects. Given the concern over the potential health risks associated with the hazardous ingredients in deodorizing consumer products, 17 ingredients were analyzed and assessed according to their health risk on 3 groups by the application type in 47 deodorizing products. The risk assessment study followed a stepwise procedure (e.g., collecting toxicological information, hazard identification/exposure assessment, and screening and detailed assessment for inhalation and dermal routes). The worst-case scenario and maximum concentration determined by the product purpose and application type were used as the screening assessment. In a detailed assessment, the 75th exposure factor values were used to estimate the assumed reasonable exposure to ingredients. The exposed concentrations of seven ingredients were calculated. Due to limitation of toxicity information, butylated hydroxyl toluene for a consumer’s exposure via the dermal route only was conducted for a detailed assessment. This study showed that the assessed ingredients have no health risks at their maximum concentrations in deodorizing products. This approach can be used to establish guidelines for ingredients that may pose inhalation and dermal hazards. PMID:29652814

Evaluation of soy-based surface active copolymers as surfactant ingredients in model shampoo formulations.

Science.gov (United States)

Popadyuk, A; Kalita, H; Chisholm, B J; Voronov, A

2014-12-01

A new non-toxic soybean oil-based polymeric surfactant (SBPS) for personal-care products was developed and extensively characterized, including an evaluation of the polymeric surfactant performance in model shampoo formulations. To experimentally assure applicability of the soy-based macromolecules in shampoos, either in combination with common anionic surfactants (in this study, sodium lauryl sulfate, SLS) or as a single surface-active ingredient, the testing of SBPS physicochemical properties, performance and visual assessment of SBPS-based model shampoos was carried out. The results obtained, including foaming and cleaning ability of model formulations, were compared to those with only SLS as a surfactant as well as to SLS-free shampoos. Overall, the results show that the presence of SBPS improves cleaning, foaming, and conditioning of model formulations. SBPS-based formulations meet major requirements of multifunctional shampoos - mild detergency, foaming, good conditioning, and aesthetic appeal, which are comparable to commercially available shampoos. In addition, examination of SBPS/SLS mixtures in model shampoos showed that the presence of the SBPS enables the concentration of SLS to be significantly reduced without sacrificing shampoo performance. © 2014 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

Measures of Rheumatoid Arthritis Disease Activity in Australian Clinical Practice

OpenAIRE

Taylor, Andrew; Bagga, Hanish

2011-01-01

Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological...

A review of the literature analyzing benefits and concerns of infliximab biosimilar CT-P13 for the treatment of rheumatologic diseases: focus on interchangeability

Directory of Open Access Journals (Sweden)

Becciolini A

2017-06-01

Full Text Available Andrea Becciolini,1 Maria Gabriella Raimondo,2 Chiara Crotti,2 Elena Agape,2 Martina Biggioggero,2 Ennio Giulio Favalli1 1Department of Rheumatology, 2Department of Clinical Sciences and Health Community, University of Milan, Division of Rheumatology, Gaetano Pini Institute, Milan, Italy Abstract: The introduction of biological agents drastically changed the treatment paradigm of inflammatory arthritides, ameliorating the natural history of the diseases but concomitantly increasing the drug costs due to the manufacturing process. On this concern, biosimilar drugs may represent a valid option for reducing this elevated cost and increasing the availability of these highly effective treatments. Recently, CT-P13, the first biosimilar of infliximab, has been approved with the same indications established for the reference product (RP, and its daily use is progressively increasing. However, the experience with biosimilar drugs in the field of rheumatology is still limited, raising potential doubts and concerns on their correct management in real-life settings. Comparability analysis between CT-P13 and its RP was evaluated in equivalence randomized controlled trials (RCTs – PLANETRA and PLANETAS – performed on patients with rheumatoid arthritis and axial spondylitis, respectively. CT-P13 and RP showed similar profile in terms of quality, biological activity, safety, immunogenicity, and efficacy. However, the interchangeability between infliximab RP and its biosimilar still represents the most challenging issue because of a lack of a long-lasting experience. To date, reassuring preliminary data on this topic were reported in open-label extensions of PLANETRA and PLANETAS RCTs and in ongoing real-life observational studies. These findings, taken all together, significantly affect the landscape of biosimilar regulatory pathways and strongly support CT-P13 introduction as a great opportunity for expanding the accessibility to these very effective and

Polymorph characterization of active pharmaceutical ingredients (APIs) using low-frequency Raman spectroscopy.

Science.gov (United States)

Larkin, Peter J; Dabros, Marta; Sarsfield, Beth; Chan, Eric; Carriere, James T; Smith, Brian C

2014-01-01

Polymorph detection, identification, and quantitation in crystalline materials are of great importance to the pharmaceutical industry. Vibrational spectroscopic techniques used for this purpose include Fourier transform mid-infrared (FT-MIR) spectroscopy, Fourier transform near-infrared (FT-NIR) spectroscopy, Raman spectroscopy, and terahertz (THz) and far-infrared (FIR) spectroscopy. Typically, the fundamental molecular vibrations accessed using high-frequency Raman and MIR spectroscopy or the overtone and combination of bands in the NIR spectra are used to monitor the solid-state forms of active pharmaceutical ingredients (APIs). The local environmental sensitivity of the fundamental molecular vibrations provides an indirect probe of the long-range order in molecular crystals. However, low-frequency vibrational spectroscopy provides access to the lattice vibrations of molecular crystals and, hence, has the potential to more directly probe intermolecular interactions in the solid state. Recent advances in filter technology enable high-quality, low-frequency Raman spectra to be acquired using a single-stage spectrograph. This innovation enables the cost-effective collection of high-quality Raman spectra in the 200-10 cm(-1) region. In this study, we demonstrate the potential of low-frequency Raman spectroscopy for the polymorphic characterization of APIs. This approach provides several benefits over existing techniques, including ease of sampling and more intense, information-rich band structures that can potentially discriminate among crystalline forms. An improved understanding of the relationship between the crystalline structure and the low-frequency vibrational spectrum is needed for the more widespread use of the technique.

[Arthur Vick Prize 2017 of the German Society of Orthopaedic Rheumatology].

Science.gov (United States)

Bause, L; Niemeier, A; Krenn, V

2018-03-01

The German Society of Orthopaedic Rheumatology (DGORh) honored Prof. Dr. med. Veit Krenn (MVZ-ZHZMD-Trier) with the Arthur Vick Prize 2017. With this award, scientific results with high impact on the diagnosis, therapy and pathogenetic understanding of rheumatic diseases are honored. In cooperation with pathologists and colleagues from various clinical disciplines Prof. Dr. med. Veit Krenn developed several histopathologic scoring systems which contribute to the diagnosis and pathogenetic understanding of degenerative and rheumatic diseases. These scores include the synovitis score, the meniscal degeneration score, the classification of periprosthetic tissues (SLIM classification), the arthrofibrosis score, the particle score and the CD15 focus score. Of highest relevance for orthopedic rheumatology is the synovitis score which is a semiquantitative score for evaluating immunological and inflammatory changes of synovitis in a graded manner. Based on this score, it is possible to divide results into low-grade synovitis and high-grade synovitis: a synovitis score of 1-4 is called low-grade synovitis and occurs for example in association with osteoarthritis (OA), post-trauma, with meniscal lesions and hemochromatosis. A synovitis score of 5-9 is called high-grade synovitis, e.g. rheumatoid arthritis, psoriatic arthritis, Lyme arthritis, postinfection and reactive arthritis as well as peripheral arthritis with Bechterew's disease (sensitivity 61.7%, specificity 96.1%). The first publication (2002) and an associated subsequent publication (2006) of the synovitis score has led to national and international acceptance of this score as the standard for histopathological assessment of synovitis. The synovitis score provides a diagnostic, standardized and reproducible histopathological evaluation method for joint diseases, particularly when this score is applied in the context with the joint pathology algorithm.

How do we perceive activity pacing in rheumatology care?

DEFF Research Database (Denmark)

Cuperus, N.; Vliet Vlieland, T.; Brodin, N.

2015-01-01

goals of activity pacing, behaviours of activity pacing (the actions people take to meet the goal of activity pacing), strategies to change behaviour in activity pacing (for example goal setting) and contextual factors that should be acknowledged when instructing activity pacing. Besides, topics......-management programs. However, despite its wide endorsement in clinical practice, to date activity pacing is still a poorly understood concept. Objectives: To achieve consensus by means of an international Delphi exercise on the most important aspects of activity pacing as an intervention within non...... for future research on activity pacing were formulated and prioritized. Results: Of the 60 panelists, nearly two third (63%) completed all four Delphi rounds. The panel prioritized 9 goals, 11 behaviours, 9 strategies to change behaviour and 10 contextual factors of activity pacing. These items were...

Measures of rheumatoid arthritis disease activity in Australian clinical practice.

Science.gov (United States)

Taylor, Andrew; Bagga, Hanish

2011-01-01

Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological agent for rheumatoid arthritis. Disease activity measures and radiographic assessments were collected from each patient's last consultation. For biologic patients, disease activity measures were also collected from when the patient was first initiated on the biological agent. Results. At last consultation, the disease measures that were recorded most often were ESR (89.2%), haemoglobin (87.5%), and CRP (84.2%). DAS28 was infrequently recorded (16.3%). The rate of recording disease activity measures for patients receiving biologic DMARDs decreased over time (mean 27 months). Conclusion. This review has shown inconsistency of RA activity measures being recorded in Australian rheumatology clinical practice. An accurate assessment of the disease process is necessary to effectively target rheumatoid arthritis patients to treat in order to achieve optimal outcomes.

Development of a Consumer Product Ingredient Database for ...

Science.gov (United States)

Consumer products are a primary source of chemical exposures, yet little structured information is available on the chemical ingredients of these products and the concentrations at which ingredients are present. To address this data gap, we created a database of chemicals in consumer products using product Material Safety Data Sheets (MSDSs) publicly provided by a large retailer. The resulting database represents 1797 unique chemicals mapped to 8921 consumer products and a hierarchy of 353 consumer product “use categories” within a total of 15 top-level categories. We examine the utility of this database and discuss ways in which it will support (i) exposure screening and prioritization, (ii) generic or framework formulations for several indoor/consumer product exposure modeling initiatives, (iii) candidate chemical selection for monitoring near field exposure from proximal sources, and (iv) as activity tracers or ubiquitous exposure sources using “chemical space” map analyses. Chemicals present at high concentrations and across multiple consumer products and use categories that hold high exposure potential are identified. Our database is publicly available to serve regulators, retailers, manufacturers, and the public for predictive screening of chemicals in new and existing consumer products on the basis of exposure and risk. The National Exposure Research Laboratory’s (NERL’s) Human Exposure and Atmospheric Sciences Division (HEASD) conducts resear

Adaptation of the 2015 American College of Rheumatology treatment guideline for rheumatoid arthritis for the Eastern Mediterranean Region

DEFF Research Database (Denmark)

Darzi, Andrea; Harfouche, Manale; Arayssi, Thurayya

2017-01-01

BACKGROUND: It has been hypothesized that adaptation of health practice guidelines to the local setting is expected to improve their uptake and implementation while cutting on required resources. We recently adapted the published American College of Rheumatology (ACR) Rheumatoid Arthritis (RA) tr...

Study of Separation and Identification of the Active Ingredients in Gardenia jasminoides Ellis Based on a Two-Dimensional Liquid Chromatography by Coupling Reversed Phase Liquid Chromatography and Hydrophilic Interaction Liquid Chromatography.

Science.gov (United States)

Zhou, Xuan; Chen, Cen; Ye, Xiaolan; Song, Fenyun; Fan, Guorong; Wu, Fuhai

2017-01-01

In this paper, by coupling reversed phase liquid chromatography (RPLC) and hydrophilic interaction liquid chromatography (HILIC), a two-dimensional liquid chromatography system was developed for separation and identification of the active ingredients in Gardenia jasminoides Ellis (GJE). By applying the semi-preparative C18 column as the first dimension and the core-shell column as the second dimension, a total of 896 peaks of GJE were separated. Among the 896 peaks, 16 active ingredients including geniposide, gardenoside, gardoside, etc. were identified by mass spectrometry analysis. The results indicated that the proposed two-dimensional RPLC/HILIC system was an effective method for the analysis of GJE and might hold a high potential to become a useful tool for analysis of other complex mixtures. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Substantiation of the active ingredients rational concentration of ointment for treatment of allergic dermatitis complicated by fungal infection

Directory of Open Access Journals (Sweden)

O. A. Rukhmakova

2015-08-01

Full Text Available Aim. Due to the rapid growth of number of allergic skin diseases complicated by secondary fungal infection, creation of new drugs with an integrated anti-allergic and anti-fungal action for their local treatment is especially important. Methods and results. In the process of developing an ointment under conventional name “Allergolik” microbiological studies have been conducted to determine its rational composition. Concentrations of licorice root extract, terbinafine hydrochloride and lavender essential oil have been substantiated as parts of the studied medication. Study of acute toxicity of the developed dosage form has set that it belongs to the IV class of low-toxic substances due to the standard classification of K.K. Sidorova. Conclusion. This testifies the correctness of the choice of drug active ingredients and their concentrations.

Toward the Development of a Core Set of Outcome Domains to Assess Shared Decision-making Interventions in Rheumatology

DEFF Research Database (Denmark)

Toupin-April, Karine; Barton, Jennifer; Fraenkel, Liana

2017-01-01

OBJECTIVE: The aim of this Outcome Measures in Rheumatology (OMERACT) Working Group was to determine the core set of outcome domains and subdomains for measuring the effectiveness of shared decision-making (SDM) interventions in rheumatology clinical trials. METHODS: Following the OMERACT Filter 2.......0, and based on a previous literature review of SDM outcome domains and a nominal group process at OMERACT 2014, (1) an online Delphi survey was conducted to gather feedback on the draft core set and refine its domains and subdomains, and (2) a workshop was held at the OMERACT 2016 meeting to gain consensus...... ranged from 83% to 100% of respondents). At OMERACT 2016, only 8% of the 96 attendees were patients/caregivers. Despite initial votes of support in breakout groups, there was insufficient comfort about the conceptualization of these 7 domains and 17 subdomains for these to be endorsed at OMERACT 2016...

Developing an OMERACT Core Outcome Set for Assessing Safety Components in Rheumatology Trials: The OMERACT Safety Working Group.

Science.gov (United States)

Klokker, Louise; Tugwell, Peter; Furst, Daniel E; Devoe, Dan; Williamson, Paula; Terwee, Caroline B; Suarez-Almazor, Maria E; Strand, Vibeke; Woodworth, Thasia; Leong, Amye L; Goel, Niti; Boers, Maarten; Brooks, Peter M; Simon, Lee S; Christensen, Robin

2017-12-01

Failure to report harmful outcomes in clinical research can introduce bias favoring a potentially harmful intervention. While core outcome sets (COS) are available for benefits in randomized controlled trials in many rheumatic conditions, less attention has been paid to safety in such COS. The Outcome Measures in Rheumatology (OMERACT) Filter 2.0 emphasizes the importance of measuring harms. The Safety Working Group was reestablished at the OMERACT 2016 with the objective to develop a COS for assessing safety components in trials across rheumatologic conditions. The safety issue has previously been discussed at OMERACT, but without a consistent approach to ensure harms were included in COS. Our methods include (1) identifying harmful outcomes in trials of interventions studied in patients with rheumatic diseases by a systematic literature review, (2) identifying components of safety that should be measured in such trials by use of a patient-driven approach including qualitative data collection and statistical organization of data, and (3) developing a COS through consensus processes including everyone involved. Members of OMERACT including patients, clinicians, researchers, methodologists, and industry representatives reached consensus on the need to continue the efforts on developing a COS for safety in rheumatology trials. There was a general agreement about the need to identify safety-related outcomes that are meaningful to patients, framed in terms that patients consider relevant so that they will be able to make informed decisions. The OMERACT Safety Working Group will advance the work previously done within OMERACT using a new patient-driven approach.

Canadian physiotherapists' views on certification, specialisation, extended role practice, and entry-level training in rheumatology

Directory of Open Access Journals (Sweden)

Sutton Evelyn

2009-06-01

Full Text Available Abstract Background Since the last decade there has been a gradual change of boundaries of health professions in providing arthritis care. In Canada, some facilities have begun to adopt new arthritis care models, some of which involve physiotherapists (PT working in extended roles. However, little is known about PTs' interests in these new roles. The primary objective of this survey was to determine the interests among orthopaedic physiotherapists (PTs in being a certified arthritis therapist, a PT specialized in arthritis, or an extended scope practitioner in rheumatology, and to explore the associated factors, including the coverage of arthritis content in the entry-level physiotherapy training. Methods Six hundred PTs practicing in orthopaedics in Canada were randomly selected to receive a postal survey. The questionnaire covered areas related to clinical practice, perceptions of rheumatology training received, and attitudes toward PT roles in arthritis care. Logistic regression models were developed to explore the associations between PTs' interests in pursuing each of the three extended scope practice designations and the personal/professional/attitudinal variables. Results We received 286 questionnaires (response rate = 47.7%; 258 contained usable data. The average length of time in practice was 15.4 years (SD = 10.4. About 1 in 4 PTs agreed that they were interested in assuming advanced practice roles (being a certified arthritis therapist = 28.9%, being a PT specialized in rheumatology = 23.3%, being a PT practitioner = 20.9%. Having a caseload of ≥ 40% in arthritis, having a positive attitude toward advanced practice roles in arthritis care and toward the formal credentialing process, and recognizing the difference between certification and specialisation were associated with an interest in pursing advanced practice roles. Conclusion Orthopaedic PTs in Canada indicated a fair level of interest in pursuing certification, specialisation

Effect of ingredients on oxidative stability of fish oil-enriched drinking yoghurt

DEFF Research Database (Denmark)

Nielsen, Nina Skall; Klein, Anna; Jacobsen, Charlotte

2009-01-01

, pectin, citric acid or gluconodelta- lactone did not affect the oxidative stability of fish oil-enriched yoghurt emulsions. Furthermore, the fruit preparation and added sugar did not lead to increased antioxidative activity. It is concluded that yoghurt as the dairy component in the fish oil......The oxidative stabilities of fish oil-enriched milk and fish oil-enriched drinking yoghurt were compared by following the development of lipid oxidation in plain milk, plain yoghurt and yoghurt to which ingredients present in drinking yoghurt were added one by one. All samples were enriched with 1...... wt-% fish oil. After 3 weeks of storage, development of peroxide values, volatile secondary oxidation products and fishy offflavors were much more pronounced in the milk compared to any of the yoghurt samples, irrespective of any added ingredients used to prepare flavored drinking yoghurt. Thus...

BIOSIMILARS IN RHEUMATOLOGY

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E. L. Nasonov

2016-01-01

 stage. Preliminary provisions and recommendations of the All-Russian public organization «Association of Rheumatologists of Russia» concerning the place of biosimilars in rheumatology are formulated.

Galloyl-RGD as a new cosmetic ingredient

Science.gov (United States)

2014-01-01

Background The cosmetics market has rapidly increased over the last years. For example, in 2011 it reached 242.8 billion US dollars, which was a 3.9% increase compared to 2010. There have been many recent trials aimed at finding the functional ingredients for new cosmetics. Gallic acid is a phytochemical derived from various herbs, and has anti-fungal, anti-viral, and antioxidant properties. Although phytochemicals are useful as cosmetic ingredients, they have a number of drawbacks, such as thermal stability, residence time in the skin, and permeability through the dermal layer. To overcome these problems, we considered conjugation of gallic acid with a peptide. Results We synthesized galloyl-RGD, which represents a conjugate of gallic acid and the peptide RGD, purified it by HPLC and characterized by MALDI-TOF with the aim of using it as a new cosmetic ingredient. Thermal stability of galloyl-RGD was tested at alternating temperatures (consecutive 4°C, 20°C, or 40°C for 8 h each) on days 2, 21, 41, and 61. Galloyl-RGD was relatively safe to HaCaT keratinocytes, as their viability after 48 h incubation with 500 ppm galloyl-RGD was 93.53%. In the group treated with 50 ppm galloyl-RGD, 85.0% of free radicals were removed, whereas 1000 ppm galloyl-RGD suppressed not only L-DOPA formation (43.8%) but also L-DOPA oxidation (54.4%). Conclusions Galloyl-RGD is a promising candidate for a cosmetic ingredient. PMID:25103826

Quantification of active ingredients in semi-solid pharmaceutical formulations by near infrared spectroscopy.

Science.gov (United States)

Schlegel, Lisa B; Schubert-Zsilavecz, Manfred; Abdel-Tawab, Mona

2017-08-05

Near infrared (NIR) spectroscopy is increasingly gaining significance in the pharmaceutical industry for quality and in-process control. However, the potential of this method for quantitative quality control in pharmacies has long been neglected and little data is available on its application in analysis of creams and ointments. This study evaluated the applicability of NIR spectrometer with limited wavelength range (1000-1900nm) for quantitative quality control of six different dermatological semi-solid pharmaceutical preparations. Each contained a frequently used active ingredient in a common concentration either in a water-free lipid base or in an aqueous cream matrix. Based on direct NIR transflectance measurements through standardized glass beakers and partial least squares (PLS) multivariate calibration, quantitative models were generated comparing several data pre-processing methods Whereas difficulties were observed for mixtures containing 2% (w/w) metronidazole or 4% (w/w) erythromycin, content determination was possible with sufficient accuracy for salicylic acid (5 % (w/w)) and urea (10% (w/w)) in hydrophilic as well as in lipophilic formulations meeting the limit of a maximum deviation of±5% (relative) from the reference values. Exemplarily, one of the methods was successfully validated according to the EMA Guideline, determining several figures of merit such as specificity, linearity, accuracy, precision and robustness. Copyright © 2017 Elsevier B.V. All rights reserved.

A new world of ingredients

DEFF Research Database (Denmark)

Halloran, Afton Marina Szasz; Flore, Roberto

2018-01-01

Insects have been absent from European diets with only few regional exceptions, making them an uncommon ingredient in the kitchens of fine dining establishments. This chapter investigates whether a piece the puzzle of understanding the temporality or permanence of edible insects in modern Europea...

An integrated evidence-based targeting strategy for determining combinatorial bioactive ingredients of a compound herbal medicine Qishen Yiqi dripping pills.

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Zhang, Yiqian; Yu, Jiahui; Zhang, Wen; Wang, Yuewei; He, Yi; Zhou, Shuiping; Fan, Guanwei; Yang, Hua; Zhu, Yan; Li, Ping

2018-06-12

Qishen Yiqi is a widely used Chinese herbal medicine formula with "qi invigorating and blood activating" property. Its dripping pill preparation (QSYQ) is a commercial herbal medicine approved by the China Food and Drug Administration (CFDA) in 2003 and is extensively used clinically to treat cardiovascular diseases, such as ischemic heart failure and angina pectoris, as well as for the secondary prevention of myocardial infarction. However, the bioactive ingredients of QSYQ remain unclear. As QSYQ is a compound herbal formula, it is of great importance to elucidate its pharmacologically active ingredients and underlying synergetic effects. This experimental study was conducted to comprehensively determine the combinatorial bioactive ingredients (CBIs) in QSYQ and to elucidate their potential synergetic effects. The established strategy may shed new light on how to rapidly determine CBIs in complex herbal formulas with holistic properties. An integrated evidence-based targeting strategy was introduced and validated to determine CBIs in QSYQ. The strategy included the following steps: (1) Chemical ingredients in QSYQ were analyzed via UPLC-Q-TOF/MS in the negative and positive modes and were identified by comparison with standard compounds and previously reported data. Their potential therapeutic activities were predicted based on the ChEMBL database to preliminarily search for candidate bioactive ingredients, and their combination was defined as the CBIs. (2) The CBIs were directly trapped and prepared from QSYQ with a two-dimensional chromatographic separation system, and the remaining part was defined as the rest ingredients (RIs). (3) As animal and cell models, left anterior descending coronary artery ligation (LAD)-induced heart failure in rats and hypoxia-induced cardiac myocyte injury in H9c2 cells were applied to compare the potency of QSYQ, CBIs and RIs. (4) The synergetic effects on cardiac myocyte protection of multiple ingredients in CBIs were examined

Effect of added ingredients on water status and physico-chemical properties of tomato sauce.

Science.gov (United States)

Diantom, Agoura; Curti, Elena; Carini, Eleonora; Vittadini, Elena

2017-12-01

Different ingredients (guar, xanthan, carboxy methyl cellulose, locust bean gums, potato fiber, milk, potato and soy proteins) were added to tomato sauce to investigate their effect on its physico-chemical properties. The products were characterized in terms of colour, rheological properties (Bostwick consistency, flow behavior and consistency coefficient), water status (water activity, moisture content) and molecular mobility by 1 H Nuclear Magnetic Resonance (NMR). Water activity was significantly decreased only by the addition of potato fiber. Xanthan, locust bean, guar and carboxy methyl cellulose significantly enhanced Bostwick consistency and consistency coefficient. Type of ingredient and concentration significantly affected 1 H NMR mobility indicators. Principal component analysis (PCA) indicated that only 1 H NMR mobility parameters were able to differentiate the effect of milk protein, xanthan and potato fiber on tomato sauce properties. The information collected in this work provides information to intelligently modulate tomato sauce attributes and tailor its properties for specific applications. Copyright © 2017 Elsevier Ltd. All rights reserved.

Content comparison of occupation-based instruments in adult rheumatology and musculoskeletal rehabilitation based on the International Classification of Functioning, Disability and Health.

Science.gov (United States)

Stamm, Tanja A; Cieza, Alarcos; Machold, Klaus P; Smolen, Josef S; Stucki, Gerold

2004-12-15

To compare the content of clinical, occupation-based instruments that are used in adult rheumatology and musculoskeletal rehabilitation in occupational therapy based on the International Classification of Functioning, Disability and Health (ICF). Clinical instruments of occupational performance and occupation in adult rehabilitation and rheumatology were identified in a literature search. All items of these instruments were linked to the ICF categories according to 10 linking rules. On the basis of the linking, the content of these instruments was compared and the relationship between the capacity and performance component explored. The following 7 instruments were identified: the Canadian Occupational Performance Measure, the Assessment of Motor and Process Skills, the Sequential Occupational Dexterity Assessment, the Jebson Taylor Hand Function Test, the Moberg Picking Up Test, the Button Test, and the Functional Dexterity Test. The items of the 7 instruments were linked to 53 different ICF categories. Five items could not be linked to the ICF. The areas covered by the 7 occupation-based instruments differ importantly: The main focus of all 7 instruments is on the ICF component activities and participation. Body functions are covered by 2 instruments. Two instruments were linked to 1 single ICF category only. Clinicians and researchers who need to select an occupation-based instrument must be aware of the areas that are covered by this instrument and the potential areas that are not covered at all.

Usability and Workflow Evaluation of "RhEumAtic Disease activitY" (READY). A Mobile Application for Rheumatology Patients and Providers.

Science.gov (United States)

Yen, Po-Yin; Lara, Barbara; Lopetegui, Marcelo; Bharat, Aseem; Ardoin, Stacy; Johnson, Bernadette; Mathur, Puneet; Embi, Peter J; Curtis, Jeffrey R

2016-11-02

RhEumAtic Disease activitY (READY) is a mobile health (mHealth) application that aims to create a shared platform integrating data from both patients and physicians, with a particular emphasis on arthritis disease activity. We made READY available on an iPad and pilot implemented it at a rheumatology outpatient clinic. We conducted 1) a usability evaluation study to explore patients' and physicians' interactions with READY, and 2) a time motion study (TMS) to observe the clinical workflow before and after the implementation. A total of 33 patients and 15 physicians participated in the usability evaluation. We found usability problems in navigation, data entry, pain assessment, documentation, and instructions along with error messages. Despite these issues, 25 (75,76%) patients reported they liked READY. Physicians provided mixed feedback because they were concerned about the impact of READY on clinical workflow. Six physicians participated in the TMS. We observed 47 patient visits (44.72 hours) in the pre-implementation phase, and 42 patient visits (37.82 hours) in the post-implementation phase. We found that patients spent more time on READY than paper (4.39mins vs. 2.26mins), but overall, READY did not delay the workflow (pre = 52.08 mins vs. post = 45.46 mins). This time difference may be compensated with READY eliminating a workflow step for the staff. Patients preferred READY to paper documents. Many found it easier to input information because of the larger font size and the ease of 'tapping' rather than writing-out or circling answers. Even though patients spent more time on READY than using paper documents, the longer usage of READY was mainly due to when troubleshooting was needed. Most patients did not have problems after receiving initial support from the staff. This study not only enabled improvements to the software but also serves as good reference for other researchers or institutional decision makers who are interested in implementing such a

Wars in the history of rheumatology

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P. Marson

2011-09-01

Full Text Available Some important discoveries in the history of rheumatology happened during war periods. It is well known that arthritis associated with conjunctivitis and urethritis, following dysenteric episodes, has been described during the First World War from the German Hans Reiter and, nearly contemporarily, from the French Nöel Fiessinger and Edgar Leroy. Less known is instead the fact that the first cases of sympathetic algoneurodystrophy have been reported by the American Silas Weir Mitchell in soldiers wounded by fire-arms, during the Civil War of Secession. Other war episodes have been crucial for the development of some drugs now abundantly applied to the care of rheumatic diseases. The discovery of therapeutic effects of immunosuppressive agents, in fact, happened as an indirect consequence of the use of poison gas, already during the First World War (mustard gas, but above all after an episode in the port of Bari in 1943, where an American cargo boat was sunk. It had been loaded with a quantity of cylinders containing a nitrogenous mustard, whose diffusion in the environment provoked more than 80 deaths owing to bone marrow aplasia.Moreover, the history of the cortisone shows a strict link to the Second World War, when Germany imported large quantities of bovine adrenal glands from Argentina, with the purpose of producing some gland extracts for the Luftwasse aviators, in order to increase their performance ability.

Rheumatoid cachexia and other nutritional alterations in rheumatologic diseases.

Science.gov (United States)

Hurtado-Torres, Gilberto Fabián; González-Baranda, Lourdes Larisa; Abud-Mendoza, Carlos

2015-01-01

The prevalence of nutritional alterations in rheumatologic diseases ranges from 4 to 95%, depending on the detection method used. Formerly described as the single term rheumatoid cachexia, nutritional alterations can currently be grouped and subdivided based on the physiopathological mechanisms involved: chronic disease-related inflammatory conditions (cachexia), malnutrition associated to acute malnutrition inflammatory conditions (protein-caloric malnutrition) and starvation-related malnutrition. Clinical manifestations of malnutrition associated to rheumatic diseases vary from the patient with low weight or overweight and obesity; with lean body mass depletion as well as functional repercussions, and impact of quality of life as a common denominator. Additionally, the associated increase in body fat mass increases the risk for cardiovascular morbidity. A multidisciplinary approach towards rheumatic diseases should include aspects oriented towards prevention, early identification, diagnosis and correction of nutritional alterations. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Rheumatology in the Italian literary fiction: “La Longobarda” by Giorgio Conconi (1999

Directory of Open Access Journals (Sweden)

P. Marson

2011-09-01

Full Text Available In the literary fiction “La Longobarda” by Giorgio Conconi (1999 the protagonist Linda narrates her life, when about fifty she falls ill because of arthritis, thus looking prematurely older and suffering from severe disturbances of body image. This fiction represents an uncommon case of contemporary literature dealing with rheumatological topics. In the present note, it has shown how literature can contribute in several ways to achievement in the human dimension of medicine, by teaching physician concrete and powerful lessons about the lives of sick people.

7 CFR 205.305 - Multi-ingredient packaged products with less than 70 percent organically produced ingredients.

Science.gov (United States)

2010-01-01

... Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... organically produced ingredients may only identify the organic content of the product by: (1) Identifying each... statement, displaying the product's percentage of organic contents on the information panel. (b...

What Is "Natural"? Consumer Responses to Selected Ingredients.

Science.gov (United States)

Chambers, Edgar; Chambers, Edgar; Castro, Mauricio

2018-04-23

Interest in “natural” food has grown enormously over the last decade. Because the United States government has not set a legal definition for the term “natural”, customers have formed their own sensory perceptions and opinions on what constitutes natural. In this study, we examined 20 ingredients to determine what consumers consider to be natural. Using a national database, 630 consumers were sampled (50% male and 50% female) online, and the results were analyzed using percentages and chi-square tests. No ingredient was considered natural by more than 69% of respondents. We found evidence that familiarity may play a major role in consumers’ determination of naturalness. We also found evidence that chemical sounding names and the age of the consumer have an effect on whether an ingredient and potentially a food is considered natural. Interestingly, a preference towards selecting GMO (genetically modified organisms) foods had no significant impact on perceptions of natural.

The 2010 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Rheumatoid Arthritis Phase 2 Methodological Report

NARCIS (Netherlands)

Neogi, Tuhina; Aletaha, Daniel; Silman, Alan J.; Naden, Raymond L.; Felson, David T.; Aggarwal, Rohit; Bingham, Clifton O.; Birnbaum, Neal S.; Burmester, Gerd R.; Bykerk, Vivian P.; Cohen, Marc D.; Combe, Bernard; Costenbader, Karen H.; Dougados, Maxime; Emery, Paul; Ferraccioli, Gianfranco; Hazes, Johanna M. W.; Hobbs, Kathryn; Huizinga, Tom W. J.; Kavanaugh, Arthur; Kay, Jonathan; Khanna, Dinesh; Kvien, Tore K.; Laing, Timothy; Liao, Katherine; Mease, Philip; Ménard, Henri A.; Moreland, Larry W.; Nair, Raj; Pincus, Theodore; Ringold, Sarah; Smolen, Josef S.; Stanislawska-Biernat, Ewa; Symmons, Deborah; Tak, Paul P.; Upchurch, Katherine S.; Vencovský, Jiří; Wolfe, Frederick; Hawker, Gillian

2010-01-01

Objective. The American College of Rheumatology and the European League Against Rheumatism have developed new classification criteria for rheumatoid arthritis (RA). The aim of Phase 2 of the development process was to achieve expert consensus on the clinical and laboratory variables that should

The 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis: Phase 2 methodological report

NARCIS (Netherlands)

T. Neogi (Tuhina); D. Aletaha (Daniel); A.J. Silman (Alan); R.L. Naden (Raymond); D. Felson; R. Aggarwal (Rohit); C.O. Bingham (Clifton); N.S. Birnbaum (Neal); G.R. Burmester (Gerd); V.P. Bykerk (Vivian); M.D. Cohen (Marc); B. Combe (Bernard); K.H. Costenbader (Karen); M. Dougados (Maxime); P. Emery (Paul); G. Ferraccioli (Gianfranco); J.M.W. Hazes (Mieke); K. Hobbs (Kathryn); T.W.J. Huizinga (Tom); A. Kavanaugh (Arthur); J. Kay (Jonathan); D. Khanna (Dinesh); T.K. Kvien (Tore); T. Laing (Timothy); K. Liao (Katherine); P. Mease (Philip); H.A. Ménard (Henri); L.W. Moreland (Larry); R. Nair (Raj); T. Pincus (Theodore); S. Ringold (Sarah); J.S. Smolen (Josef); E. Stanislawska-Biernat (Ewa); D. Symmons (Deborah); P.P. Tak (Paul); K.S. Upchurch (Katherine); J. Vencovský (Jiří); F. Wolfe (Frederick); G. Hawker (Gillian)

2010-01-01

textabstractObjective. The American College of Rheumatology and the European League Against Rheumatism have developed new classification criteria for rheumatoid arthritis (RA). The aim of Phase 2 of the development process was to achieve expert consensus on the clinical and laboratory variables that

Zinc oxide as a new antimicrobial preservative of topical products: interactions with common formulation ingredients.

Science.gov (United States)

Pasquet, Julia; Chevalier, Yves; Couval, Emmanuelle; Bouvier, Dominique; Bolzinger, Marie-Alexandrine

2015-02-01

Zinc oxide (ZnO) appears as a promising preservative for pharmaceutical or cosmetic formulations. The other ingredients of the formulations may have specific interactions with ZnO that alter its antimicrobial properties. The influence of common formulation excipients on the antimicrobial efficacy of ZnO has been investigated in simple model systems and in typical topical products containing a complex formulation. A wide variety of formulation excipients have been investigated for their interactions with ZnO: antioxidants, chelating agents, electrolytes, titanium dioxide pigment. The antimicrobial activity of ZnO against Escherichia coli was partially inhibited by NaCl and MgSO4 salts. A synergistic influence of uncoated titanium dioxide has been observed. The interference effects of antioxidants and chelating agents were quite specific. The interactions of these substances with ZnO particles and with the soluble species released by ZnO were discussed so as to reach scientific guidelines for the choice of the ingredients. The preservative efficacy of ZnO was assessed by challenge testing in three different formulations: an oil-in-water emulsion; a water-in-oil emulsion and a dry powder. The addition of ZnO in complex formulations significantly improved the microbiological quality of the products, in spite of the presence of other ingredients that modulate the antimicrobial activity. Copyright © 2014 Elsevier B.V. All rights reserved.

Nuclear EMP: ingredients of an EMP protection engineering methodology

International Nuclear Information System (INIS)

Latorre, V.R.; Spogen, L.R. Jr.

1977-02-01

A fundamental methodology of electromagnetic pulse (EMP) protection engineering is described. Operations performed within the framework of this methodology are discussed. These operations, along with problem constraints and data, constitute the essential ingredients needed to implement the overall engineering methodology. Basic definitions and descriptions of these essential ingredients are provided. The issues discussed represent the first step in developing a methodology for protecting systems against EMP effects

Natural ingredients based cosmetics. Content of selected fragrance sensitizers

DEFF Research Database (Denmark)

Rastogi, Suresh Chandra; Johansen, J D; Menné, T

1996-01-01

In the present study, we have investigated 42 cosmetic products based on natural ingredients for content of 11 fragrance substances: geraniol, hydroxycitronellal, eugenol, isoeugenol, cinnamic aldehyde, cinnamic alcohol, alpha-amylcinnamic aldehyde, citral, coumarin, dihydrocoumarin and alpha......-hexylcinnamic aldehyde. The study revealed that the 91% (20/22) of the natural ingredients based perfumes contained 0.027%-7.706% of 1 to 7 of the target fragrances. Between 1 and 5 of the chemically defined synthetic constituents of fragrance mix were found in 82% (18/22) of the perfumes. 35% (7/20) of the other...... of hydroxycitronellal and alpha-hexylcinnamic aldehyde in some of the products demonstrates that artificial fragrances, i.e., compounds not yet regarded as natural substances, may be present in products claimed to be based on natural ingredients....

A Brief History of IL-1 and IL-1 Ra in Rheumatology

Directory of Open Access Journals (Sweden)

Jean-Michel Dayer

2017-05-01

Full Text Available The history of what, in 1979, was called interleukin-1 (IL-1, orchestrator of leukocyte inter-communication, began many years before then, initially by the observation of fever induction via the endogenous pyrogen (EP (1974 and then in rheumatology on the role in tissue destruction in rheumatoid diseases via the induction of collagenase and PGE2 in human synovial cells by a mononuclear cell factor (MCF (1977. Since then, the family has exploded to presently 11 members as well as many membrane-bound and soluble receptor forms. The discovery of a natural Interleukin-1 receptor antagonist (IL-1Ra in human biological fluids has highlighted the importance of IL-1 and IL-1Ra in human diseases. Evidence delineating its role in autoinflammatory syndromes and the elucidation of the macromolecular complex referred to as “inflammasome” have been instrumental to our understanding of the link with IL-1. At present, the IL-1blockade as therapeutic approach is crucial for many hereditary autoinflammatory diseases, as well as for adult-onset Still’s disease, crystal-induced arthropathies, certain skin diseases including neutrophil-triggered skin diseases, Behçet’s disease and deficiency of IL-1Ra and other rare fever syndromes. Its role is only marginally important in rheumatoid arthritis and is still under debate with regard to osteoarthritis, type 2 diabetes mellitus, cardiovascular diseases and cancer. This brief historical review focuses on some aspects of IL-1, mainly IL-1β and IL-Ra, in rheumatology. There are many excellent reviews focusing on the IL-1 family in general or with regard to specific diseases or biological discoveries.

21 CFR 700.18 - Use of chloroform as an ingredient in cosmetic products.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Use of chloroform as an ingredient in cosmetic... SERVICES (CONTINUED) COSMETICS GENERAL Requirements for Specific Cosmetic Products § 700.18 Use of chloroform as an ingredient in cosmetic products. (a) Chloroform has been used as an ingredient in cosmetic...

Antioxidant and antidiabetic properties of condensed tannins in acetonic extract of selected raw and processed indigenous food ingredients from Kenya.

Science.gov (United States)

Kunyanga, Catherine Nkirote; Imungi, Jasper Kathenya; Okoth, Michael; Momanyi, Clare; Biesalski, Han Konrad; Vadivel, Vellingiri

2011-05-01

Recently, tannins have received considerable attention as health-promoting component in various plant foods and several studies have reported on its nutraceutical properties. However, no study has established the role of condensed tannins in indigenous foods of Kenya. Therefore, this study was designed to evaluate the antioxidant activity (DPPH and FRAP) and antidiabetic effects (α-amylase and α-glucosidase inhibition activities) of condensed tannins in some selected raw and traditionally processed indigenous cereals, legumes, oil seeds, and vegetables. The condensed tannin content of the grains and vegetables ranged between 2.55 and 4.35 g/100 g DM and 1.53 and 5.73 g/100 g DM, respectively. The scavenging effect of acetonic extract on DPPH radical ranged from 77% to 90% while the reducing power was found to be 31 to 574 mmol Fe(II)/g DM in all the investigated food ingredients. The condensed tannin extracts of the analyzed samples showed promising antidiabetic effects with potential α-amylase and α-glucosidase inhibition activities of 23% to 44% and 58% to 88%, respectively. Condensed tannins extracted from the amaranth grain, finger millet, field bean, sunflower seeds, drumstick, and amaranth leaves exerted significantly higher antioxidant and antidiabetic activities than other food ingredients. Among the traditional processing methods, roasting of grains and cooking of vegetables were found to be more suitable mild treatments for preserving the tannin compound and its functional properties as opposed to soaking + cooking and blanching treatments. The identified elite sources of optimally processed indigenous food ingredients with promising results could be used as health-promoting ingredients through formulation of therapeutic diets. © 2011 Institute of Food Technologists®

A Cooking Recipe Recommendation System with Visual Recognition of Food Ingredients

Directory of Open Access Journals (Sweden)

Keiji Yanai

2014-04-01

Full Text Available In this paper, we propose a cooking recipe recommendation system which runs on a consumer smartphone as an interactive mobile application. The proposed system employs real-time visual object recognition of food ingredients, and recommends cooking recipes related to the recognized food ingredients. Because of visual recognition, by only pointing a built-in camera on a smartphone to food ingredients, a user can get to know a related cooking recipes instantly. The objective of the proposed system is to assist people who cook to decide a cooking recipe at grocery stores or at a kitchen. In the current implementation, the system can recognize 30 kinds of food ingredient in 0.15 seconds, and it has achieved the 83.93% recognition rate within the top six candidates. By the user study, we confirmed the effectiveness of the proposed system.

Using a behaviour change techniques taxonomy to identify active ingredients within trials of implementation interventions for diabetes care.

Science.gov (United States)

Presseau, Justin; Ivers, Noah M; Newham, James J; Knittle, Keegan; Danko, Kristin J; Grimshaw, Jeremy M

2015-04-23

Methodological guidelines for intervention reporting emphasise describing intervention content in detail. Despite this, systematic reviews of quality improvement (QI) implementation interventions continue to be limited by a lack of clarity and detail regarding the intervention content being evaluated. We aimed to apply the recently developed Behaviour Change Techniques Taxonomy version 1 (BCTTv1) to trials of implementation interventions for managing diabetes to assess the capacity and utility of this taxonomy for characterising active ingredients. Three psychologists independently coded a random sample of 23 trials of healthcare system, provider- and/or patient-focused implementation interventions from a systematic review that included 142 such studies. Intervention content was coded using the BCTTv1, which describes 93 behaviour change techniques (BCTs) grouped within 16 categories. We supplemented the generic coding instructions within the BCTTv1 with decision rules and examples from this literature. Less than a quarter of possible BCTs within the BCTTv1 were identified. For implementation interventions targeting providers, the most commonly identified BCTs included the following: adding objects to the environment, prompts/cues, instruction on how to perform the behaviour, credible source, goal setting (outcome), feedback on outcome of behaviour, and social support (practical). For implementation interventions also targeting patients, the most commonly identified BCTs included the following: prompts/cues, instruction on how to perform the behaviour, information about health consequences, restructuring the social environment, adding objects to the environment, social support (practical), and goal setting (behaviour). The BCTTv1 mapped well onto implementation interventions directly targeting clinicians and patients and could also be used to examine the impact of system-level interventions on clinician and patient behaviour. The BCTTv1 can be used to characterise

Wait times to rheumatology care for patients with rheumatic diseases: a data linkage study of primary care electronic medical records and administrative data.

Science.gov (United States)

Widdifield, Jessica; Bernatsky, Sasha; Thorne, J Carter; Bombardier, Claire; Jaakkimainen, R Liisa; Wing, Laura; Paterson, J Michael; Ivers, Noah; Butt, Debra; Lyddiatt, Anne; Hofstetter, Catherine; Ahluwalia, Vandana; Tu, Karen

2016-01-01

The Wait Time Alliance recently established wait time benchmarks for rheumatology consultations in Canada. Our aim was to quantify wait times to primary and rheumatology care for patients with rheumatic diseases. We identified patients from primary care practices in the Electronic Medical Record Administrative data Linked Database who had referrals to Ontario rheumatologists over the period 2000-2013. To assess the full care pathway, we identified dates of symptom onset, presentation in primary care and referral from electronic medical records. Dates of rheumatologist consultations were obtained by linking with physician service claims. We determined the duration of each phase of the care pathway (symptom onset to primary care encounter, primary care encounter to referral, and referral to rheumatologist consultation) and compared them with established benchmarks. Among 2430 referrals from 168 family physicians, 2015 patients (82.9%) were seen by 146 rheumatologists within 1 year of referral. Of the 2430 referrals, 2417 (99.5%) occurred between 2005 and 2013. The main reasons for referral were osteoarthritis (32.4%) and systemic inflammatory rheumatic diseases (30.6%). Wait times varied by diagnosis and geographic region. Overall, the median wait time from referral to rheumatologist consultation was 74 (interquartile range 27-101) days; it was 66 (interquartile range 18-84) days for systemic inflammatory rheumatic diseases. Wait time benchmarks were not achieved, even for the most urgent types of referral. For systemic inflammatory rheumatic diseases, most of the delays occurred before referral. Rheumatology wait times exceeded established benchmarks. Targeted efforts are needed to promote more timely access to both primary and rheumatology care. Routine linkage of electronic medical records with administrative data may help fill important gaps in knowledge about waits to primary and specialty care.

[The National Database of the Regional Collaborative Rheumatic Centers as a tool for clinical epidemiology and quality assessment in rheumatology].

Science.gov (United States)

Zink, Angela; Huscher, Dörte; Listing, Joachim

2003-01-01

The national database of the German Collaborative Arthritis Centres is a well-established tool for the observation and assessment of health care delivery to patients with rheumatic diseases in Germany. The discussion of variations in treatment practices contributes to the internal quality assessment in the participating arthritis centres. This documentation has shown deficits in primary health care including late referral to a rheumatologist, undertreatment with disease-modifying drugs and complementary therapies. In rheumatology, there is a trend towards early, intensive medical treatment including combination therapy. The frequency and length of inpatient hospital and rehabilitation treatments is decreasing, while active physiotherapy in outpatient care has been increased. Specific deficits have been identified concerning the provision of occupational therapy services and patient education.

Prediction of skin anti-aging clinical benefits of an association of ingredients from marine and maritime origins: Ex vivo evaluation using a label-free quantitative proteomic and customized data processing approach.

Science.gov (United States)

Hameury, Sebastien; Borderie, Laurent; Monneuse, Jean-Marc; Skorski, Gilbert; Pradines, Dominique

2018-05-23

The application of ingredients from marine and maritime origins is increasingly common in skin care products, driven by consumer expectations for natural ingredients. However, these ingredients are typically studied for a few isolated in vitro activities. The purpose of this study was to carry out a comprehensive evaluation of the activity on the skin of an association of ingredients from marine and maritime origins using label-free quantitative proteomic analysis, in order to predict the clinical benefits if used in a skin care product. An aqueous gel containing 6.1% of ingredients from marine and maritime origins (amino acid-enriched giant kelp extract, trace element-enriched seawater, dedifferentiated sea fennel cells) was topically applied on human skin explants. The skin explants' proteome was analyzed in a label-free manner by high-performance liquid nano-chromatography coupled with tandem mass spectrometry. A specific data processing pipeline (CORAVALID) providing an objective and comprehensive interpretation of the statistically relevant biological activities processed the results. Compared to untreated skin explants, 64 proteins were significantly regulated by the gel treatment (q-value ≤ 0.05). Computer data processing revealed an activity of the ingredients on the epidermis and the dermis. These significantly regulated proteins are involved in gene expression, cell survival and metabolism, inflammatory processes, dermal extracellular matrix synthesis, melanogenesis and keratinocyte proliferation, migration, and differentiation. These results suggest that the tested ingredients could help to preserve a healthy epidermis and dermis, and possibly to prevent the visible signs of skin aging. © 2018 The Authors. Journal of Cosmetic Dermatology Published by Wiley Periodicals, Inc.

Ultrasonic Recovery and Modification of Food Ingredients

Science.gov (United States)

Vilkhu, Kamaljit; Manasseh, Richard; Mawson, Raymond; Ashokkumar, Muthupandian

There are two general classes of effects that sound, and ultrasound in particular, can have on a fluid. First, very significant modifications to the nature of food and food ingredients can be due to the phenomena of bubble acoustics and cavitation. The applied sound oscillates bubbles in the fluid, creating intense forces at microscopic scales thus driving chemical changes. Second, the sound itself can cause the fluid to flow vigorously, both on a large scale and on a microscopic scale; furthermore, the sound can cause particles in the fluid to move relative to the fluid. These streaming phenomena can redistribute materials within food and food ingredients at both microscopic and macroscopic scales.

Pediatric rheumatology: what does the future hold?

Science.gov (United States)

Emery, Helen

2004-08-01

Effectiveness of the traditional rehabilitation approaches used in pediatric rheumatology has been difficult to prove and, in times of cost containment, this lack of evidence may lead to undertreatment with physical and occupational therapies. Quantitative methods such as those described in this issue by Broström and colleagues can be used to validate those approaches and to reinforce the need for careful attention to the effects of even minor loss of range and strength in children with juvenile arthritis. Historically, up to half of the children affected by polyarticular juvenile arthritis became disabled. Some factors that have led to improved outcomes for childhood rheumatic diseases are discussed, including medications (use of weekly low-dose methotrexate, intra-articular steroid injections, new biologic agents that specifically block mediators of inflammation, for example, tumor necrosis factor and interleukin-1), surgery (joint replacements), and psychosocial interventions (with schools and families). The importance of maintaining range of movement, strength, weight bearing, and ambulation, in an effort to prevent sequelae such as osteoporosis and wheelchair dependence, is emphasized. Early identification of children with rheumatic diseases and aggressive intervention, with a combined medical, rehabilitation, psychosocial, and, rarely, surgical approach, should now allow most affected children to reach adulthood with little or no disability.

Development and Preliminary Face and Content Validation of the "Which Health Approaches and Treatments Are You Using?" (WHAT) Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatric Rheumatology.

Science.gov (United States)

Toupin April, Karine; Stinson, Jennifer; Boon, Heather; Duffy, Ciarán M; Huber, Adam M; Gibbon, Michele; Descarreaux, Martin; Spiegel, Lynn; Vohra, Sunita; Tugwell, Peter

2016-01-01

Complementary and alternative medicine (CAM) is commonly used by children with juvenile idiopathic arthritis (JIA), yet no validated questionnaires assess that use. The objective of this study was to develop child self- and parent proxy-report questionnaires assessing CAM use and to determine the face and content validity of the "Which Health Approaches and Treatments are you using?" (WHAT) questionnaires in pediatric rheumatology. A sequential phased mixed methods approach was used to develop the questionnaires. A Delphi Survey of 126 experts followed by an interdisciplinary consensus conference of 14 stakeholders in CAM, general pediatrics and pediatric rheumatology was held to develop consensus on the content of the questionnaires using a nominal group technique. To determine face and content validity of the questionnaires, two groups, including (a) a purposive sample of 22 children with JIA 8 to 18 years and their parents from the Children's Hospital of Eastern Ontario and the Hospital for Sick Children, and (b) 21 Canadian pediatric rheumatology experts, participated in interviews. Participants were independently asked about the goal, understandability and comprehensiveness of the WHAT questionnaires, as well as the relevance of items. Consensus was reached on 17 items of the WHAT questionnaires. The domains found to be relevant were child's CAM use, factors associated with CAM use, perceived impact of CAM use, and communication about CAM. A total of 15 items in the parent proxy-report questionnaire and 13 items in the child report questionnaire showed adequate content validity. Consensus was reached by experts on the content of a pediatric CAM questionnaire. Face and content validity testing and modifications made to the WHAT questionnaires have helped ensure adequate preliminary validity for use in pediatric rheumatology. This constitutes the basis for further testing of these questionnaires in pediatric rheumatology and for adaptation to other chronic

Development and Preliminary Face and Content Validation of the "Which Health Approaches and Treatments Are You Using?" (WHAT Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatric Rheumatology.

Directory of Open Access Journals (Sweden)

Karine Toupin April

Full Text Available Complementary and alternative medicine (CAM is commonly used by children with juvenile idiopathic arthritis (JIA, yet no validated questionnaires assess that use. The objective of this study was to develop child self- and parent proxy-report questionnaires assessing CAM use and to determine the face and content validity of the "Which Health Approaches and Treatments are you using?" (WHAT questionnaires in pediatric rheumatology.A sequential phased mixed methods approach was used to develop the questionnaires. A Delphi Survey of 126 experts followed by an interdisciplinary consensus conference of 14 stakeholders in CAM, general pediatrics and pediatric rheumatology was held to develop consensus on the content of the questionnaires using a nominal group technique. To determine face and content validity of the questionnaires, two groups, including (a a purposive sample of 22 children with JIA 8 to 18 years and their parents from the Children's Hospital of Eastern Ontario and the Hospital for Sick Children, and (b 21 Canadian pediatric rheumatology experts, participated in interviews. Participants were independently asked about the goal, understandability and comprehensiveness of the WHAT questionnaires, as well as the relevance of items.Consensus was reached on 17 items of the WHAT questionnaires. The domains found to be relevant were child's CAM use, factors associated with CAM use, perceived impact of CAM use, and communication about CAM. A total of 15 items in the parent proxy-report questionnaire and 13 items in the child report questionnaire showed adequate content validity.Consensus was reached by experts on the content of a pediatric CAM questionnaire. Face and content validity testing and modifications made to the WHAT questionnaires have helped ensure adequate preliminary validity for use in pediatric rheumatology. This constitutes the basis for further testing of these questionnaires in pediatric rheumatology and for adaptation to other

Giving rheumatology patients online home access to their electronic medical record (EMR): advantages, drawbacks and preconditions according to care providers

NARCIS (Netherlands)

van der Vaart, R.; Drossaert, Constance H.C.; Taal, Erik; van de Laar, Mart A F J

2013-01-01

Technology enables patients home access to their electronic medical record (EMR), via a patient portal. This study aims to analyse (dis)advantages, preconditions and suitable content for this service, according to rheumatology health professionals. A two-phase policy Delphi study was conducted.

[Effects of Betel shisanwei ingredients pill on AC-cAMP-PKA signal transduction pathways in hippocampus and prefrontal cortex of depressive rats].

Science.gov (United States)

Tong, Hai-Ying; Wu, Jisiguleng; Bai, Liang-Feng; Bao, Wu-Ye; Hu, Rilebagen; Li, Jing; Zhang, Yue

2014-05-01

To observe the effects of Mongolian pharmaceutical Betel shisanwei ingredients pill on AC-cAMP-PKA signal transduction pathways in hippocampus and prefrontal cortex of depressive rats. Sixty male Wistar rats were randomly divided into six groups according to the sugar consumption test (10 rats in each group), normal control group,model group,fluoxetine group (3.3 mg x kg(-1)) and low dose, medium dose and high dose group (0.25, 0.5, 1 g x kg(-1)) of Betel shisanwei ingredients pill. Except the normal control,the other groups were treated with the chronic unpredictable mild stress stimulation combined with lonely raising for 28 days. 10 mL x kg(-1) of drugs were given to each rat once daily,continuously for 28 days. The AC activity of the hippocampus and prefrontal cortex were determined by radiation immunity analysis (RIA), while cAMP and PKA quantity were determinated by Enzyme-linked immunosorbent (ELISA). The AC activity, cAMP and PKA quantity of hippocampus and prefrontal of mouse model of Chronic stress depression decreased significantly than those of control group (P Betel shisanwei ingredients pill group indecreased significantly than those of model group (P Betel shisanwei ingredients pill. The AC-cAMP-PKA signal transduction pathways in hippocampus and prefrontal cortex of depression model of rats is down-regulated, whereas Mongolian pharmaceutical Betel shisanwei ingredients pill could up-regulated it to resist depression.

Safety assessment of personal care products/cosmetics and their ingredients

International Nuclear Information System (INIS)

Nohynek, Gerhard J.; Antignac, Eric; Re, Thomas; Toutain, Herve

2010-01-01

We attempt to review the safety assessment of personal care products (PCP) and ingredients that are representative and pose complex safety issues. PCP are generally applied to human skin and mainly produce local exposure, although skin penetration or use in the oral cavity, on the face, lips, eyes and mucosa may also produce human systemic exposure. In the EU, US and Japan, the safety of PCP is regulated under cosmetic and/or drug regulations. Oxidative hair dyes contain arylamines, the most chemically reactive ingredients of PCP. Although arylamines have an allergic potential, taking into account the high number of consumers exposed, the incidence and prevalence of hair dye allergy appears to be low and stable. A recent (2001) epidemiology study suggested an association of oxidative hair dye use and increased bladder cancer risk in consumers, although this was not confirmed by subsequent or previous epidemiologic investigations. The results of genetic toxicity, carcinogenicity and reproductive toxicity studies suggest that modern hair dyes and their ingredients pose no genotoxic, carcinogenic or reproductive risk. Recent reports suggest that arylamines contained in oxidative hair dyes are N-acetylated in human or mammalian skin resulting in systemic exposure to traces of detoxified, i.e. non-genotoxic, metabolites, whereas human hepatocytes were unable to transform hair dye arylamines to potentially carcinogenic metabolites. An expert panel of the International Agency on Research of Cancer (IARC) concluded that there is no evidence for a causal association of hair dye exposure with an elevated cancer risk in consumers. Ultraviolet filters have important benefits by protecting the consumer against adverse effects of UV radiation; these substances undergo a stringent safety evaluation under current international regulations prior to their marketing. Concerns were also raised about the safety of solid nanoparticles in PCP, mainly TiO 2 and ZnO in sunscreens. However

Safety assessment of personal care products/cosmetics and their ingredients.

Science.gov (United States)

Nohynek, Gerhard J; Antignac, Eric; Re, Thomas; Toutain, Herve

2010-03-01

We attempt to review the safety assessment of personal care products (PCP) and ingredients that are representative and pose complex safety issues. PCP are generally applied to human skin and mainly produce local exposure, although skin penetration or use in the oral cavity, on the face, lips, eyes and mucosa may also produce human systemic exposure. In the EU, US and Japan, the safety of PCP is regulated under cosmetic and/or drug regulations. Oxidative hair dyes contain arylamines, the most chemically reactive ingredients of PCP. Although arylamines have an allergic potential, taking into account the high number of consumers exposed, the incidence and prevalence of hair dye allergy appears to be low and stable. A recent (2001) epidemiology study suggested an association of oxidative hair dye use and increased bladder cancer risk in consumers, although this was not confirmed by subsequent or previous epidemiologic investigations. The results of genetic toxicity, carcinogenicity and reproductive toxicity studies suggest that modern hair dyes and their ingredients pose no genotoxic, carcinogenic or reproductive risk. Recent reports suggest that arylamines contained in oxidative hair dyes are N-acetylated in human or mammalian skin resulting in systemic exposure to traces of detoxified, i.e. non-genotoxic, metabolites, whereas human hepatocytes were unable to transform hair dye arylamines to potentially carcinogenic metabolites. An expert panel of the International Agency on Research of Cancer (IARC) concluded that there is no evidence for a causal association of hair dye exposure with an elevated cancer risk in consumers. Ultraviolet filters have important benefits by protecting the consumer against adverse effects of UV radiation; these substances undergo a stringent safety evaluation under current international regulations prior to their marketing. Concerns were also raised about the safety of solid nanoparticles in PCP, mainly TiO(2) and ZnO in sunscreens. However

Rapid Determination of Trace Palladium in Active Pharmaceutical Ingredients by Magnetic Solid-Phase Extraction and Flame Atomic Absorption Spectrometry

Science.gov (United States)

Yin, Q. H.; Zhu, D. M.; Yang, D. Z.; Hu, Q. F.; Yang, Y. L.

2018-01-01

Clutaraldehyde cross-linked magnetic chitosan nanoparticles were synthesized and used as an adsorbent for the dispersive solid-phase extraction of palladium in active pharmaceutical ingredients (APIs) prior to analysis by a flame atomic absorption spectrophotometer. FT-IR, X-ray diffraction, and TEM were used to characterize the adsorbent. Various parameters of experimental performance, such as adsorbent amount, pH, adsorption time, desorption solutions, coexisting ions, and adsorbent reusability, were investigated and optimized. Under the optimized conditions, good linearity was achieved in the 5.0-500 μg/L concentration range, with correlation coefficients of 0.9989. The limit of detection is 2.8 μg/L and the recoveries of spiked samples ranged from 91.7 to 97.6%. It was confirmed that the GMCNs nanocomposite was a promising adsorbing material for extraction and preconcentration of Pd in APIs.

The effect of new biosimilars in rheumatology and gastroenterology specialities on UK healthcare budgets: Results of a budget impact analysis.

Science.gov (United States)

Aladul, Mohammed I; Fitzpatrick, Raymond W; Chapman, Stephen R

2018-05-15

The approval of new biosimilars of infliximab, etanercept and adalimumab by the European Medicines Agency is expected to produce further cost savings to the healthcare system budget. This study aimed to estimate the budget impact of the introduction of new biosimilars Flixabi ® , Erelzi ® , Solymbic ® , Amgevita ® and Imraldi ® in rheumatology and gastroenterology specialities in the UK. A published budget impact model was adapted to estimate the expected cost savings following the entry of new biosimilars Flixabi ® , Erelzi ® , Solymbic ® , Amgevita ® and Imraldi ® in the UK over three-year time horizon. This model was based on retrospective market shares of biologics used in rheumatology and gastroenterology which were derived from DEFINE Software and healthcare professional perspectives. The model predicted that infliximab and etanercept biosimilars would replace their corresponding reference agents by 2020. Adalimumab biosimilars were predicted to achieve 19% of the rheumatology and gastroenterology market by 2020. Without the introduction of further biosimilars, the model predicted a reduction in expenditure of £44 million on biologics over the next three years. With the entry of Flixabi ® , Erelzi ® , Solymbic ® , Amgevita ® and Imraldi ® the model estimates cumulative savings of £285 million by 2020. The introduction of new infliximab, etanercept and adalimumab biosimilars will be associated with considerable cost savings and have a substantial favourable impact on the UK NHS budget. The number of biosimilars and time of entry of is critical to create competition which will result in maximum cost savings. Copyright © 2018 Elsevier Inc. All rights reserved.

The prevalence of vitamin D deficiency in consecutive new patients seen over a 6-month period in general rheumatology clinics.

LENUS (Irish Health Repository)

Haroon, Muhammad

2012-02-01

The objectives of this study are to assess: (a) the prevalence of vitamin D deficiency among new patients attending rheumatology outpatient departments, (b) the age profile of these low vitamin D patients and (c) whether any diagnostic category had a particularly high number of vitamin D-deficient patients. All new patients seen consecutively in general rheumatology clinics between January to June 2007 inclusive were eligible to partake in this study, and 231 out of 264 consented to do so. Parathyroid hormone, 25-hydroxyvitamin D, creatinine, calcium, phosphate, albumin and alkaline phosphatase levels were measured. We defined vitamin D deficiency as <\\/=53 nmol\\/l and severe deficiency as <\\/=25 nmol\\/l. Overall, 70% of 231 patients had vitamin D deficiency, and 26% had severe deficiency. Sixty-five percent of patients aged >\\/=65 and 78% of patients aged <\\/=30 years had low vitamin D levels. Vitamin D deficiency in each diagnostic category was as follows: (a) inflammatory joint diseases\\/connective tissue diseases (IJD\\/CTD), 69%; (b) soft tissue rheumatism, 77%; (c) osteoarthritis, 62%; (d) non-specific musculoskeletal back pain, 75% and (e) osteoporosis, 71%. Seasonal variation of vitamin D levels was noted in all diagnostic groups apart from IJD\\/CTD group, where the degree of vitamin D deficiency persisted from late winter to peak summer. Very high prevalence of vitamin D deficiency was noted in all diagnostic categories (p = 0.006), and it was independent of age (p = 0.297). The results suggest vitamin D deficiency as a possible modifiable risk factor in different rheumatologic conditions, and its role in IJD\\/CTD warrants further attention.

Silver Sucrose Octasulfate (IASOS™) as a Valid Active Ingredient into a Novel Vaginal Gel against Human Vaginal Pathogens: In Vitro Antimicrobial Activity Assessment

Science.gov (United States)

Marianelli, Cinzia; Petrucci, Paola; Comelli, Maria Cristina; Calderini, Gabriella

2014-01-01

This in vitro study assessed the antimicrobial properties of a novel octasilver salt of Sucrose Octasulfate (IASOS) as well as of an innovative vaginal gel containing IASOS (SilSOS Femme), against bacterial and yeast pathogens isolated from human clinical cases of symptomatic vaginal infections. In BHI and LAPT culture media, different ionic silver concentrations and different pHs were tested. IASOS exerted a strong antimicrobial activity towards all the pathogens tested in both culture media. The results demonstrated that salts and organic compounds present in the culture media influenced IASOS efficacy only to a moderate extent. Whereas comparable MBCs (Minimal Bactericidal Concentrations) were observed for G. vaginalis (10 mg/L Ag+), E. coli and E. aerogenes (25 mg/L Ag+) in both media, higher MBCs were found for S. aureus and S. agalactiae in LAPT cultures (50 mg/L Ag+ versus 25 mg/L Ag+). No minimal concentration totally inhibiting the growth of C. albicans was found. Nevertheless, in both media at the highest ionic silver concentrations (50–200 mg/L Ag+), a significant 34–52% drop in Candida growth was observed. pH differently affected the antimicrobial properties of IASOS against bacteria or yeasts; however, a stronger antimicrobial activity at pH higher than the physiological pH was generally observed. It can be therefore concluded that IASOS exerts a bactericidal action against all the tested bacteria and a clear fungistatic action against C. albicans. The antimicrobial activity of the whole vaginal gel SilSOS Femme further confirmed the antimicrobial activity of IASOS. Overall, our findings support IASOS as a valid active ingredient into a vaginal gel. PMID:24897299

Silver sucrose octasulfate (IASOS™ as a valid active ingredient into a novel vaginal gel against human vaginal pathogens: in vitro antimicrobial activity assessment.

Directory of Open Access Journals (Sweden)

Cinzia Marianelli

Full Text Available This in vitro study assessed the antimicrobial properties of a novel octasilver salt of Sucrose Octasulfate (IASOS as well as of an innovative vaginal gel containing IASOS (SilSOS Femme, against bacterial and yeast pathogens isolated from human clinical cases of symptomatic vaginal infections. In BHI and LAPT culture media, different ionic silver concentrations and different pHs were tested. IASOS exerted a strong antimicrobial activity towards all the pathogens tested in both culture media. The results demonstrated that salts and organic compounds present in the culture media influenced IASOS efficacy only to a moderate extent. Whereas comparable MBCs (Minimal Bactericidal Concentrations were observed for G. vaginalis (10 mg/L Ag+, E. coli and E. aerogenes (25 mg/L Ag+ in both media, higher MBCs were found for S. aureus and S. agalactiae in LAPT cultures (50 mg/L Ag+ versus 25 mg/L Ag+. No minimal concentration totally inhibiting the growth of C. albicans was found. Nevertheless, in both media at the highest ionic silver concentrations (50-200 mg/L Ag+, a significant 34-52% drop in Candida growth was observed. pH differently affected the antimicrobial properties of IASOS against bacteria or yeasts; however, a stronger antimicrobial activity at pH higher than the physiological pH was generally observed. It can be therefore concluded that IASOS exerts a bactericidal action against all the tested bacteria and a clear fungistatic action against C. albicans. The antimicrobial activity of the whole vaginal gel SilSOS Femme further confirmed the antimicrobial activity of IASOS. Overall, our findings support IASOS as a valid active ingredient into a vaginal gel.

Antistaphylococcal effect of enterocin AS-48 in bakery ingredients of vegetable origin, alone and in combination with selected antimicrobials.

Science.gov (United States)

Viedma, Pilar Martinez; Abriouel, Hikmate; Omar, Nabil Ben; López, Rosario Lucas; Gálvez, Antonio

2009-09-01

The inhibitory effect of enterocin AS-48 against Staphylococcus aureus was investigated in various types of bakery ingredients. Antibacterial activity greatly depended on the food substrate, ranging from complete inactivation of S. aureus in liquid caramel (in which the bacterium survived poorly) to no significant inhibition (as in vanilla or chocolate creams). Significant reductions of viable counts in the range of 1.8 to 2.7 log units (P enterocin AS-48 was tested in combination with other antimicrobials. Bactericidal activity increased markedly for the combinations of AS-48 and 0.1% eugenol (v/v), 0.5% 2-nitropropanol (v/v), or 3% Nisaplin (w/v). Enterocin AS-48 could be applied in combination with other antimicrobials for preservation of bakery ingredients against S. aureus.

Antifungal activity of food additives in vitro and as ingredients of hydroxypropyl methylcellulose-lipid edible coatings against Botrytis cinerea and Alternaria alternata on cherry tomato fruit.

Science.gov (United States)

Fagundes, Cristiane; Pérez-Gago, María B; Monteiro, Alcilene R; Palou, Lluís

2013-09-16

The antifungal activity of food additives or 'generally recognized as safe' (GRAS) compounds was tested in vitro against Botrytis cinerea and Alternaria alternata. Radial mycelial growth of each pathogen was measured in PDA Petri dishes amended with food preservatives at 0.2, 1.0, or 2.0% (v/v) after 3, 5, and 7 days of incubation at 25 °C. Selected additives and concentrations were tested as antifungal ingredients of hydroxypropyl methylcellulose (HPMC)-lipid edible coatings. The curative activity of stable coatings was tested in in vivo experiments. Cherry tomatoes were artificially inoculated with the pathogens, coated by immersion about 24 h later, and incubated at 20 °C and 90% RH. Disease incidence and severity (lesion diameter) were determined after 6, 10, and 15 days of incubation and the 'area under the disease progress stairs' (AUDPS) was calculated. In general, HPMC-lipid antifungal coatings controlled black spot caused by A. alternata more effectively than gray mold caused by B. cinerea. Overall, the best results for reduction of gray mold on cherry tomato fruit were obtained with coatings containing 2.0% of potassium carbonate, ammonium phosphate, potassium bicarbonate, or ammonium carbonate, while 2.0% sodium methylparaben, sodium ethylparaben, and sodium propylparaben were the best ingredients for coatings against black rot. © 2013 Elsevier B.V. All rights reserved.

A comprehensive evaluation of the toxicology of cigarette ingredients: carbohydrates and natural products.

Science.gov (United States)

Coggins, Christopher R E; Wagner, Karl A; Werley, Michael S; Oldham, Michael J

2011-06-01

Eleven carbohydrates and natural product ingredients were added individually to experimental cigarettes. A battery of tests was used to compare toxicity of mainstream smoke from these experimental cigarettes to matched control cigarettes without test ingredients. Smoke fractions from each cigarette type were evaluated using analytical chemistry; in vitro cytotoxicity (neutral red uptake) and in vitro bacterial (Salmonella) mutagenicity (five strains) testing. For 10 ingredients (β-cyclodextrin, cleargum, D-sorbitol, high fructose corn syrup, honey, invert sugar, maltodextrin, molasses, raisin juice concentrate, and sucrose), 90-day nose-only smoke inhalation studies using rats were also performed. In general, addition of each ingredient in experimental cigarettes resulted in minimal changes in smoke chemistry; the exceptions were D-sorbitol and sucrose, where reductions in amount of 60% to 80% of control values for some smoke constituents were noted. Additionally, each ingredient resulted in small increases in smoke formaldehyde concentrations. Except for a reduction in cytotoxicity by inclusion of maltodextrin and an increase by inclusion of plum juice concentrate, the cytotoxicity and mutagenicity results were unaffected by addition of the other ingredients in experimental cigarettes. There were also very few statistically significant differences within any of the 10 inhalation studies, and when present, the differences were largely sporadic and inconsistent between sexes. The carbohydrates and natural products tested here as ingredients in experimental cigarettes as a class increased formaldehyde, but resulted in minimal toxicological responses, even at high inclusion levels compared with the levels used in commercial cigarette products.

What Is “Natural”? Consumer Responses to Selected Ingredients

Directory of Open Access Journals (Sweden)

Edgar Chambers

2018-04-01

Full Text Available Interest in “natural” food has grown enormously over the last decade. Because the United States government has not set a legal definition for the term “natural”, customers have formed their own sensory perceptions and opinions on what constitutes natural. In this study, we examined 20 ingredients to determine what consumers consider to be natural. Using a national database, 630 consumers were sampled (50% male and 50% female online, and the results were analyzed using percentages and chi-square tests. No ingredient was considered natural by more than 69% of respondents. We found evidence that familiarity may play a major role in consumers’ determination of naturalness. We also found evidence that chemical sounding names and the age of the consumer have an effect on whether an ingredient and potentially a food is considered natural. Interestingly, a preference towards selecting GMO (genetically modified organisms foods had no significant impact on perceptions of natural.

What Is “Natural”? Consumer Responses to Selected Ingredients

Science.gov (United States)

Chambers, Edgar; Castro, Mauricio

2018-01-01

Interest in “natural” food has grown enormously over the last decade. Because the United States government has not set a legal definition for the term “natural”, customers have formed their own sensory perceptions and opinions on what constitutes natural. In this study, we examined 20 ingredients to determine what consumers consider to be natural. Using a national database, 630 consumers were sampled (50% male and 50% female) online, and the results were analyzed using percentages and chi-square tests. No ingredient was considered natural by more than 69% of respondents. We found evidence that familiarity may play a major role in consumers’ determination of naturalness. We also found evidence that chemical sounding names and the age of the consumer have an effect on whether an ingredient and potentially a food is considered natural. Interestingly, a preference towards selecting GMO (genetically modified organisms) foods had no significant impact on perceptions of natural. PMID:29690627

Readability of patient information and consent documents in rheumatological studies

DEFF Research Database (Denmark)

Hamnes, Bente; van Eijk-Hustings, Yvonne; Primdahl, Jette

2016-01-01

BACKGROUND: Before participation in medical research an informed consent must be obtained. This study investigates whether the readability of patient information and consent documents (PICDs) corresponds to the average educational level of participants in rheumatological studies in the Netherlands......, Denmark, and Norway. METHODS: 24 PICDs from studies were collected and readability was assessed independently using the Gunning's Fog Index (FOG) and Simple Measure of Gobbledygook (SMOG) grading. RESULTS: The mean score for the FOG and SMOG grades were 14.2 (9.0-19.0) and 14.2 (12-17) respectively....... The mean FOG and SMOG grades were 12.7 and 13.3 in the Dutch studies, 15.0 and 14.9 in the Danish studies, and 14.6 and 14.3 in the Norwegian studies, respectively. Out of the 2865 participants, more than 57 % had a lower educational level than the highest readability score calculated in the individual...

American College of Rheumatology/European League against Rheumatism Preliminary Definition of Remission in Rheumatoid Arthritis for Clinical Trials

Science.gov (United States)

Felson, David T.; Smolen, Josef S.; Wells, George; Zhang, Bin; van Tuyl, Lilian H. D.; Funovits, Julia; Aletaha, Daniel; Allaart, Renée; Bathon, Joan; Bombardieri, Stefano; Brooks, Peter; Brown, Andrew; Matucci-Cerinic, Marco; Choi, Hyon; Combe, Bernard; de Wit, Maarten; Dougados, Maxime; Emery, Paul; Furst, Dan; Gomez-Reino, Juan; Hawker , Gillian; Keystone, Edward; Khanna, Dinesh; Kirwan, John; Kvien, Tore; Landewé, Robert; Listing, Joachim; Michaud, Kaleb; Mola, Emilio Martin; Montie, Pam; Pincus, Ted; Richards, Pam; Siegel, Jeff; Simon, Lee; Sokka, Tuulikki; Strand, Vibeke; Tugwell, Peter; Tyndall, Alan; van der Heijde, Desirée; Verstappen, Suzan; White, Barbara; Wolfe, Fred; Zink, Angela; Boers, Maarten

2010-01-01

Background With remission in rheumatoid arthritis (RA) an increasingly attainable goal, there is no widely used definition of remission that is stringent but achievable and could be applied uniformly as an outcome in clinical trials. Methods A committee consisting of members of the American College of Rheumatology, the European League Against Rheumatism and the Outcome Measures in Rheumatology Initiative (OMERACT) met to guide the process and review prespecified analyses from clinical trials of patients with RA. The committee requested a stringent definition (little, if any, active disease) and decided to use core set measures to define remission including at least joint counts and an acute phase reactant. Members were surveyed to select the level of each core set measure consistent with remission. Candidate definitions of remission were tested including those that constituted a number of individual measures in remission (Boolean approach) as well as definitions using disease activity indexes. To select a definition of remission, trial data were analyzed to examine the added contribution of patient reported outcomes and the ability of candidate measures to predict later good x-ray and functional outcomes. Results Survey results for the definition of remission pointed to indexes at published thresholds and to a count of core set measures with each measure scored as 1 or less (e.g. tender and swollen joint counts, CRP and global assessments on 0-10 scale). Analyses suggested the need to include a patient reported measure. Examination of 2 year follow-up data suggested that many candidate definitions performed comparably in terms of predicting later good x-ray and functional outcomes, although DAS28 based measures of remission did not predict good radiographic outcomes as well as did the other candidate definitions. Given these and other considerations, we propose that a patient be defined as in remission based on one of two definitions : 1: When their scores on the

The effect of ingredients in dry dog foods on the risk of gastric dilatation-volvulus in dogs.

Science.gov (United States)

Raghavan, Malathi; Glickman, Nita W; Glickman, Lawrence T

2006-01-01

Using dry dog food label information, the hypothesis was tested that the risk of gastric dilatation-volvulus (GDV) increases with an increasing number of soy and cereal ingredients and a decreasing number of animal-protein ingredients among the first four ingredients. A nested case-control study was conducted with 85 GDV cases and 194 controls consuming a single brand and variety of dry food. Neither an increasing number of animal-protein ingredients (P=0.79) nor an increasing number of soy and cereal ingredients (P=0.83) among the first four ingredients significantly influenced GDV risk. An unexpected finding was that dry foods containing an oil or fat ingredient (e.g., sunflower oil, animal fat) among the first four ingredients were associated with a significant (P=0.01), 2.4-fold increased risk of GDV. These findings suggest that the feeding of dry dog foods that list oils or fats among the first four label ingredients predispose a high-risk dog to GDV.

Effects of Some Topological Ingredients on the Evolutionary Ultimatum Game

International Nuclear Information System (INIS)

Deng Lili; Zhang Jianxiong; Tang Wansheng; Zhang Wei

2012-01-01

This study aims at figuring out the crucial topological ingredients which affect the outcomes of the ultimatum game located on different networks, encompassing the regular network, the random network, the small-world network, and the scale-free network. With the aid of random interchanging algorithm, we investigate the relations between the outcomes of the ultimatum game and some topological ingredients, including the average range, the clustering coefficient and the heterogeneity, and so forth. It is found that for the regular, random and small-work networks, the average range and the clustering coefficient have evident impacts on the ultimatum game, while for the scale-free network, the original degree heterogeneity and the underlying rich-club characterizations are the mainly important topological ingredients that influence the outcomes of ultimatum game substantially.

New Trends in Cosmetics: By-Products of Plant Origin and Their Potential Use as Cosmetic Active Ingredients

Directory of Open Access Journals (Sweden)

Ani Barbulova

2015-04-01

Full Text Available In recent years, the amount of waste deriving from industrial processes has increased substantially. Many industries produce different types of disposable by-products, rich in valuable compounds. Their characterization and valorization could not only convert them into high value products with application in diverse biotechnological fields, such as Pharmaceutics, Food or Cosmetics, but would also reduce the waste environmental impact and the related treatment costs. There are many examples of cosmetic active ingredients deriving from fish, meat and dairy products, but in the present review we would like to focus on the potentialities and the current use of compounds and extracts deriving from agronomical disposable wastes in the cosmetic field. These types of products are effective, inexpensive and bio-sustainable, and thus represent a valid alternative to the regular plant derived extracts, more commonly adopted in cosmetic formulations. Moreover, if the waste products come from organic farming, they are certainly an even more valuable source of safe extracts for Cosmetics, since they lack any residual pesticide or potentially toxic chemical.

Development of baked and extruded functional foods from metabolic syndrome specific ingredient mix.

Science.gov (United States)

Miglani, Neetu; Bains, Kiran; Kaur, Harpreet

2015-09-01

The study was aimed to develop baked and extruded functional foods from Metabolic Syndrome (MS) specific designed ingredient mixes with optimum amino acid makeup using key food ingredients with functional properties such as whole cereals, legumes, skimmed milk powder, along with flaxseeds and fenugreek seeds. Two cereals viz. barley and oats and four pulses viz. mung bean, cowpea, bengal gram and soybean were blended in different proportions in order to balance the limiting amino acid lysine in the wheat flour. Three products namely bread, extruded snack and noodles prepared from twenty five ingredient mixes. Six ingredient mixes of breads and four ingredient mixes each of extruded snack and noodles specifically designed for MS patients were organoleptically at par with control wheat flour products. The acceptable products had significantly (p ≤ 0.05) higher lysine, crude protein, ash and fibre and low carbohydrates in compare control whole wheat flour products, hence appropriate for MS patients.

Botanicals and anti-inflammatories: natural ingredients for rosacea.

Science.gov (United States)

Emer, Jason; Waldorf, Heidi; Berson, Diane

2011-09-01

Rosacea is a chronic inflammatory skin condition characterized by cutaneous hypersensitivity. There are many therapeutic options available for the treatment of rosacea, but none are curative. Since the pathogenesis of rosacea remains elusive, it is not surprising that no single treatment is paramount and that many patients find therapies unsatisfactory or even exacerbating. Treatments are prescribed to work in concert with each other in order to ameliorate the common clinical manifestations, which include: papules and pustules, telangiectasias, erythema, gland hypertrophy, and ocular disease. The most validated topical therapies include metronidazole, azelaic acid, and sodium sulfacetamide-sulfur. Many other topical therapies, such as calcineurin inhibitors, benzoyl peroxide, clindamycin, retinoids, topical corticosteroids, and permethrin have demonstrated varying degrees of success. Due to the inconsistent results of the aforementioned therapies patients are increasingly turning to alternative products containing natural ingredients or botanicals to ease inflammation and remit disease. Additional research is needed to elucidate the benefits of these ingredients in the management of rosacea, but some important considerations regarding the natural ingredients with clinical data will be discussed here. Copyright © 2011 Elsevier Inc. All rights reserved.

The use of irradiated ingredients in food processing

International Nuclear Information System (INIS)

Kiss, I.; Zachariev, G.; Farkas, J.; Szabad, J.; Toth-Pesti, K.

1978-01-01

The microbe-count reducing effects of gamma radiation and of ethylene oxide were compared in ground paprika and dried onion flakes. It was established that the commercially applied ethylene oxide gas treatment has the same bactericidal effect (2-3 log cycles reduction of the total viable bacterial count) as a 5kGy radiation dose. However, ethylene oxide treatment of paprika was practically ineffective in relation to the mould count, while irradiation with 5kGy destroyed the moulds very effectively. The colour and pigment content of paprika powder were not diminished by this radiation dose. A dry mixture intended for use in canned luncheon meat was treated with 5kGy. The canned meat product produced with the radiation-decontaminated ingredients was microbiologically stable even when heat-sterilized by a sterilization equivalent of F 0 =1.1. Considering the organoleptic features and microbiological safety, a heat treatment of about F 0 =3 is suggested when using irradiated ingredients. This is about the half of the F 0 value generally proposed for completely stable canned meat products. Besides the saving of energy, a good quality can be achieved by using radiation-decontaminated ingredients. (author)

Specialized rheumatology nurse substitutes for rheumatologists in the diagnostic process of fibromyalgia: a cost-consequence analysis and a randomized controlled trial

NARCIS (Netherlands)

Kroese, Mariëlle E.; Severens, Johan L.; Schulpen, Guy J.; Bessems, Monique C.; Nijhuis, Frans J.; Landewé, Robert B.

2011-01-01

To perform a cost-consequence analysis of the substitution of specialized rheumatology nurses (SRN) for rheumatologists (RMT) in the diagnostic process of fibromyalgia (FM), using both a healthcare and societal perspective and a 9-month period. Alongside a randomized controlled trial, we measured

Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply

Directory of Open Access Journals (Sweden)

Henrickson Michael

2011-08-01

Full Text Available Abstract The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery system is primarily organized for the diagnosis and treatment of acute conditions. For pediatric patients with chronic health conditions, the typical acute problem-oriented visit actually serves as a barrier to care. The biomedical model of patient education prevails, characterized by unilateral transfer of medical information. However, the evidence basis for improvement in disease outcomes supports the use of the chronic care model, initially proposed by Dr. Edward Wagner. Six inter-related elements distinguish the success of the chronic care model, which include self-management support and care coordination by a prepared, proactive team. United States health care lacks a coherent policy direction for the management of high cost chronic conditions, including rheumatic diseases. A fundamental restructure of United States health care delivery must urgently occur which places the patient at the center of care. For the pediatric rheumatology workforce, reimbursement policies and the actions of health plans and insurers are consistent barriers to chronic disease improvement. United States reimbursement policy and overall fragmentation of health care services pose specific challenges for widespread implementation of the chronic care model. Team-based multidisciplinary care, care coordination and self-management are integral to improve outcomes. Pediatric rheumatology demand in the United States far exceeds available workforce supply. This article reviews the career

Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply.

Science.gov (United States)

Henrickson, Michael

2011-01-01

The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery system is primarily organized for the diagnosis and treatment of acute conditions. For pediatric patients with chronic health conditions, the typical acute problem-oriented visit actually serves as a barrier to care. The biomedical model of patient education prevails, characterized by unilateral transfer of medical information. However, the evidence basis for improvement in disease outcomes supports the use of the chronic care model, initially proposed by Dr. Edward Wagner. Six inter-related elements distinguish the success of the chronic care model, which include self-management support and care coordination by a prepared, proactive team. United States health care lacks a coherent policy direction for the management of high cost chronic conditions, including rheumatic diseases. A fundamental restructure of United States health care delivery must urgently occur which places the patient at the center of care. For the pediatric rheumatology workforce, reimbursement policies and the actions of health plans and insurers are consistent barriers to chronic disease improvement. United States reimbursement policy and overall fragmentation of health care services pose specific challenges for widespread implementation of the chronic care model. Team-based multidisciplinary care, care coordination and self-management are integral to improve outcomes. Pediatric rheumatology demand in the United States far exceeds available workforce supply. This article reviews the career choice decision-making process

Study of base influence on the active pharmaceutical ingredients releasing from combined ointments with antimycotic action

Directory of Open Access Journals (Sweden)

V. V. Luc

2018-03-01

characteristics of medicine and its efficacy. The aim of this work is biopharmaceutical validation of rational composition of semisolid dosage form for external use containing the combination of 2-mercaptobenzothiazole and chinosolum. Materials and methods. As a delivery vehicle for developing pharmacotherapeutical medicine the bases widely used in manufacturing of semisolid dosage forms, providing easy “wipe-off" effect after application, non-allergic and non-sensibilic after tracing, available for national producer and described in literature were studied. As the active pharmaceutical ingredients for antimycotic ointment 2-mercaptobenzothiazole and chinosolum in concentration 1% and 1% accordingly providing with suitable level of antifungal activity were used. Taking into account the advisability of high dispersion degree of medical substances in semisolid dosage forms for external use and physical-chemical properties of active pharmaceutical ingredients 2-mercaptobenzothiazole was added in all bases after preliminary dissolution in polyethylenoxyde 400 with heating and chinosolum was added after dissolution in prescribed or minimal amount of water. 2-mercaptobenzothiazole and chinosolum releasing from ointment compositions was studied with equilibrium dialysis method by Kruvchinsky at the temperature 32±0,5˚С through the semipermeable film “Kuprofan” in the Franz cell apparatus (producer PermeGear, Inc., USA. As a dialysis medium taking into account 2-mercaptobenzothiazole solubility we used solution containing methanol and water 1:1 and chinosolum releasing was carried out into water. Concentration of active pharmaceutical substances released from experimental ointments after 30 min was determined by spectrophotometric method. Results. The obtained results indicate significant advantage of the hydrophilic ointment bases, which provide an optimal level of release of 2-mercaptobenzothiazole and chinosolum from the experimental composite soft dosage forms for external

Redesign of the Attention Process of Patients with Rheumatologic Diseases: Assessing the Performance with Analytic Hierarchy Process

OpenAIRE

Gorbanev, Iouri; Cortes, Ariel; Agudelo-Londoño, Sandra

2017-01-01

Objective. To compare the Business process management and the analytic hierarchy process as the tools of process performance assessment. Instruments and Methods. Case study of the attention process of rheumatology patients. Business process management and analytic hierarchy process were applied to assess the redesign of the attention process. The two methods were compared. The data were obtained through personal observations, an interview with a Colombian health insurer’s senior executive, an...

Development and Preliminary Face and Content Validation of the “Which Health Approaches and Treatments Are You Using?” (WHAT) Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatric Rheumatology

Science.gov (United States)

Toupin April, Karine; Stinson, Jennifer; Boon, Heather; Duffy, Ciarán M.; Huber, Adam M.; Gibbon, Michele; Descarreaux, Martin; Spiegel, Lynn; Vohra, Sunita; Tugwell, Peter

2016-01-01

Objective Complementary and alternative medicine (CAM) is commonly used by children with juvenile idiopathic arthritis (JIA), yet no validated questionnaires assess that use. The objective of this study was to develop child self- and parent proxy-report questionnaires assessing CAM use and to determine the face and content validity of the “Which Health Approaches and Treatments are you using?” (WHAT) questionnaires in pediatric rheumatology. Methods A sequential phased mixed methods approach was used to develop the questionnaires. A Delphi Survey of 126 experts followed by an interdisciplinary consensus conference of 14 stakeholders in CAM, general pediatrics and pediatric rheumatology was held to develop consensus on the content of the questionnaires using a nominal group technique. To determine face and content validity of the questionnaires, two groups, including (a) a purposive sample of 22 children with JIA 8 to 18 years and their parents from the Children’s Hospital of Eastern Ontario and the Hospital for Sick Children, and (b) 21 Canadian pediatric rheumatology experts, participated in interviews. Participants were independently asked about the goal, understandability and comprehensiveness of the WHAT questionnaires, as well as the relevance of items. Results Consensus was reached on 17 items of the WHAT questionnaires. The domains found to be relevant were child’s CAM use, factors associated with CAM use, perceived impact of CAM use, and communication about CAM. A total of 15 items in the parent proxy-report questionnaire and 13 items in the child report questionnaire showed adequate content validity. Conclusions Consensus was reached by experts on the content of a pediatric CAM questionnaire. Face and content validity testing and modifications made to the WHAT questionnaires have helped ensure adequate preliminary validity for use in pediatric rheumatology. This constitutes the basis for further testing of these questionnaires in pediatric

Microencapsulation as a tool for incorporating bioactive ingredients into food.

Science.gov (United States)

Kuang, S S; Oliveira, J C; Crean, A M

2010-11-01

Microencapsulation has been developed by the pharmaceutical industry as a means to control or modify the release of drug substances from drug delivery systems. In drug delivery systems microencapsulation is used to improve the bioavailability of drugs, control drug release kinetics, minimize drug side effects, and mask the bitter taste of drug substances. The application of microencapsulation has been extended to the food industry, typically for controlling the release of flavorings and the production of foods containing functional ingredients (e.g. probiotics and bioactive ingredients). Compared to the pharmaceutical industry, the food industry has lower profit margins and therefore the criteria in selecting a suitable microencapsulation technology are more stringent. The type of microcapsule (reservoir and matrix systems) produced and its resultant release properties are dependent on the microencapsulation technology, in addition to the physicochemical properties of the core and the shell materials. This review discusses the factors that affect the release of bioactive ingredients from microcapsules produced by different microencapsulation technologies. The key criteria in selecting a suitable microencapsulation technology are also discussed. Two of the most common physical microencapsulation technologies used in pharmaceutical processing, fluidized-bed coating, and extrusion-spheronization are explained to highlight how they might be adapted to the microencapsulation of functional bioactive ingredients in the food industry.

Survey of herbal cannabis (marijuana) use in rheumatology clinic attenders with a rheumatologist confirmed diagnosis.

Science.gov (United States)

Ste-Marie, Peter A; Shir, Yoram; Rampakakis, Emmanouil; Sampalis, John S; Karellis, Angela; Cohen, Martin; Starr, Michael; Ware, Mark A; Fitzcharles, Mary-Ann

2016-12-01

Cannabinoids may hold potential for the management of rheumatic pain. Arthritis, often self-reported, is commonly cited as the reason for the use of medicinal herbal cannabis (marijuana). We have examined the prevalence of marijuana use among 1000 consecutive rheumatology patients with a rheumatologist-confirmed diagnosis and compared in an exploratory manner the clinical characteristics of medicinal users and nonusers. Current marijuana use, medicinal or recreational, was reported by 38 patients (3.8%; 95% CI: 2.8-5.2). Ever use of marijuana for medical purposes was reported by 4.3% (95% CI: 3.2-5.7), with 28 (2.8%; 95% CI: 1.9-4.0) reporting current medicinal use. Current medicinal users had a spectrum of rheumatic conditions, with over half diagnosed with osteoarthritis. Medicinal users were younger, more likely unemployed or disabled, and reported poorer global health. Pain report and opioid use was greater for users, but they had similar physician global assessment of disease status compared with nonusers. Medicinal users were more likely previous recreational users, with approximately 40% reporting concurrent recreational use. Therefore, less than 3% of rheumatology patients reported current use of medicinal marijuana. This low rate of use in patients with a rheumatologist-confirmed diagnosis is in stark contrast to the high rates of severe arthritis frequently reported by medicinal marijuana users, especially in Canada. Familiarity with marijuana as a recreational product may explain use for some as disease status was similar for both groups.

21 CFR 720.7 - Notification of person submitting cosmetic product ingredient statement.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Notification of person submitting cosmetic product... AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY FILING OF COSMETIC PRODUCT INGREDIENT COMPOSITION STATEMENTS § 720.7 Notification of person submitting cosmetic product ingredient statement. When Form FDA...

Fragranced consumer products: Chemicals emitted, ingredients unlisted

International Nuclear Information System (INIS)

Steinemann, Anne C.; MacGregor, Ian C.; Gordon, Sydney M.; Gallagher, Lisa G.; Davis, Amy L.; Ribeiro, Daniel S.; Wallace, Lance A.

2011-01-01

Fragranced consumer products are pervasive in society. Relatively little is known about the composition of these products, due to lack of prior study, complexity of formulations, and limitations and protections on ingredient disclosure in the U.S. We investigated volatile organic compounds (VOCs) emitted from 25 common fragranced consumer products-laundry products, personal care products, cleaning supplies, and air fresheners-using headspace analysis with gas chromatography/mass spectrometry (GC/MS). Our analysis found 133 different VOCs emitted from the 25 products, with an average of 17 VOCs per product. Of these 133 VOCs, 24 are classified as toxic or hazardous under U.S. federal laws, and each product emitted at least one of these compounds. For 'green' products, emissions of these compounds were not significantly different from the other products. Of all VOCs identified across the products, only 1 was listed on any product label, and only 2 were listed on any material safety data sheet (MSDS). While virtually none of the chemicals identified were listed, this nonetheless accords with U.S. regulations, which do not require disclosure of all ingredients in a consumer product, or of any ingredients in a mixture called 'fragrance.' Because the analysis focused on compounds emitted and listed, rather than exposures and effects, it makes no claims regarding possible risks from product use. Results of this study contribute to understanding emissions from common products, and their links with labeling and legislation.

A comprehensive evaluation of the toxicology of cigarette ingredients: heterocyclic nitrogen compounds.

Science.gov (United States)

Coggins, Christopher R E; Merski, Jerome A; Oldham, Michael J

2011-06-01

Three heterocyclic nitrogen compounds, 2,3-diethylpyrazine (DEP), 2,3,5,6-tetramethylpyrazine (TMP), and 2-acetyl pyridine (AP), are naturally present in tobacco and are also added to tobacco as flavor ingredients. A battery of tests was used to compare the toxicity of mainstream smoke from experimental cigarettes containing the three heterocyclic nitrogen compounds added individually at three different levels. The lowest target inclusion level of the ingredient was 10 ppm, and the highest was 10,000 ppm. Smoke from experimental and control cigarettes was evaluated in analytical smoke chemistry, in vitro cytotoxicity, and mutagenicity assays. The cigarettes with added DEP produced some minor (approximately 10%) changes in smoke chemistry when compared with the cigarettes containing no DEP. Smoke chemistry was effectively unchanged by the addition of either AP or TMP. Cytotoxicity, assessed by the neutral red uptake assay using both gas-vapor and particulate phases of smoke, was unaffected by the addition of any of the test ingredients. Mutagenicity, assessed in five strains of Salmonella treated with mainstream cigarette smoke condensate, also was unaffected by any of the test ingredients. Despite the exaggerated ingredient levels relative to commercial-use levels, there was a lack of a toxicological response for the three heterocyclic nitrogen compounds in the test systems used.

Research Gaps in the Use of Dairy Ingredients in Food Aid Products.

Science.gov (United States)

DiRienzo, Douglas

2016-03-01

Nutritional interventions to help prevent stunting, particularly in the first 1000 days from conception to 2 years of a child's life, are a major focus of numerous food aid organizations worldwide. Dairy ingredients can play an important role in enhancing the nutritional value and effectiveness of food products used in food aid. This article addresses gaps in research on malnutrition from both a broad perspective and specific to dairy ingredients. Narrative review. From a broad perspective, there is a need for gaining a consensus by the research community and funders of research on best practices for protocol development, outcomes measured, and reporting of study outcomes. Identification of biomarkers and rapid screening methods and consistent application of their use would expedite future research. A better understanding of nutritional requirements for malnourished populations, including the effects of energy deficits and disease on those requirements, is needed. More specific to dairy ingredients, a key research question is: Does dairy protein or the package of nutrients provided by dairy ingredients have a unique impact on growth, and if so, how? Also, data on the optimal levels of dairy ingredients based on the effective cost of treatment are needed, particularly in the treatment and prevention of moderate acute malnutrition and during pregnancy. © The Author(s) 2016.

Insights on in vitro models for safety and toxicity assessment of cosmetic ingredients.

Science.gov (United States)

Almeida, Andreia; Sarmento, Bruno; Rodrigues, Francisca

2017-03-15

According to the current European legislation, the safety assessment of each individual cosmetic ingredient of any formulation is the basis for the safety evaluation of a cosmetic product. Also, animal testing in the European Union is prohibited for cosmetic ingredients and products since 2004 and 2009, respectively. Additionally, the commercialization of any cosmetic products containing ingredients tested on animal models was forbidden in 2009. In consequence of these boundaries, the European Centre for the Validation of Alternative Methods (ECVAM) proposes a list of validated cell-based in vitro models for predicting the safety and toxicity of cosmetic ingredients. These models have been demonstrated as valuable and effective tools to overcome the limitations of animal in vivo studies. Although the use of in vitro cell-based models for the evaluation of absorption and permeability of cosmetic ingredients is widespread, a detailed study on the properties of these platforms and the in vitro-in vivo correlation compared with human data are required. Moreover, additional efforts must be taken to develop in vitro models to predict carcinogenicity, repeat dose toxicity and reproductive toxicity, for which no alternative in vitro methods are currently available. This review paper summarizes and characterizes the most relevant in vitro models validated by ECVAM employed to predict the safety and toxicology of cosmetic ingredients. Copyright © 2017 Elsevier B.V. All rights reserved.

Radiation decontamination of dry food ingredients and processing aids

Energy Technology Data Exchange (ETDEWEB)

Farkas, J

1984-01-01

Radiation decontamination of dry ingredients, herbs and enzyme preparations is a technically feasible, economically viable and safe physical process. The procedure is direct, simple, requires no additives and is highly efficient. Its dose requirement is moderate. Radiation doses of 3-10 kGy (0.3-1 mrad) have proved sufficient to reduce the viable counts to a satisfactory level. Ionising radiations do not cause any significant rise in temperature. The flavour, texture or other important technological or sensory properties of most ingredients are not influenced at radiation doses necessary for satisfactory decontamination, and radiation obviates the chemical residue problem. The microflora surviving radiation decontamination of dry ingredients are more susceptible to subsequent antimicrobial treatments. Recontamination can be prevented as the product can be irradiated in its final packaging. Irradiation could be carried out in commercial containers and would result in considerable savings of energy and labour as compared to alternative decontamination techniques. Radiation processing of these commodities is an established technology in several countries and more clearances on irradiated foods are expected to be granted in the near future.

Top 10 botanical ingredients in 2010 anti-aging creams.

Science.gov (United States)

Cronin, Hyland; Draelos, Zoe Diana

2010-09-01

New developments in the realm of skin rejuvenation such as phytotherapy are at an astounding increasing pace in the cosmeceutical market. Yet, many of these products that are classified as cosmeceuticals are tested less vigorously and do not have to be approved by the Food and Drug Administration to establish efficacy and safety. Thus, as clinicians, we must ask the question, "Is there science-based evidence to validate the mechanism of these new treatments?" We assessed the top anti-aging creams currently on the market specifically evaluating their botanical ingredients. Some of the most common botanicals that are hot off the market are: Rosmarinus officinalis, Vitis vinifera (grape seed extract), Citronellol, Limonene, Oenothera biennis (evening primrose), Glycyrrhiza glabra (licorice extract), Aframomum angustifolium seed extract, Diosgenin (wild yam), N6 furfuryladenine (kinetin), and Ergothioneine. Through researching each of these botanical ingredients, we have concluded that randomized controlled trials are still needed in this area, but there is promise in some of these ingredients and science to validate them. © 2010 Wiley Periodicals, Inc.

Commercial spices and industrial ingredients: evaluation of antioxidant capacity and flavonoids content for functional foods development

Directory of Open Access Journals (Sweden)

Marcela Roquim Alezandro

2011-06-01

Full Text Available The aim of this work was to evaluate spices and industrial ingredients for the development of functional foods with high phenolic contents and antioxidant capacity. Basil, bay, chives, onion, oregano, parsley, rosemary, turmeric and powdered industrial ingredients (β-carotene, green tea extract, lutein, lycopene and olive extract had their in vitro antioxidant capacity evaluated by means of the Folin-Ciocalteu reducing capacity and DPPH scavenging ability. Flavonoids identification and quantification were performed by High Performance Liquid Chromatography (HPLC. The results showed that spices presented a large variation in flavonoids content and in vitro antioxidant capacity, according to kind, brand and batches. Oregano had the highest antioxidant capacity and parsley had the highest flavonoid content. The industrial ingredient with the highest antioxidant capacity was green tea extract, which presented a high content of epigalocatechin gallate. Olive extract also showed a high antioxidant activity and it was a good source of chlorogenic acid. This study suggests that oregano, parsley, olive and green tea extract have an excellent potential for the development of functional foods rich in flavonoids as antioxidant, as long as the variability between batches/brands is controlled.

Small-Scale Shock Testing of Propellants and Ingredients

National Research Council Canada - National Science Library

Dawley, S

2004-01-01

.... The use of small-scale gap testing to evaluate the shock sensitivity of individual propellant ingredients and propellant formulations is a valuable method for experimentally establishing shock...

Molecular ingredients of heterogeneous catalysis

International Nuclear Information System (INIS)

Somorjai, G.A.

1982-06-01

The purpose of this paper is to present a review and status report to those in theoretical chemistry of the rapidly developing surface science of heterogeneous catalysis. The art of catalysis is developing into science. This profound change provides one with opportunities not only to understand the molecular ingredients of important catalytic systems but also to develop new and improved catalyst. The participation of theorists to find answers to important questions is sorely needed for the sound development of the field. It is the authors hope that some of the outstanding problems of heterogeneous catalysis that are identified in this paper will be investigated. For this purpose the paper is divided into several sections. The brief Introduction to the methodology and recent results of the surface science of heterogeneous catalysis is followed by a review of the concepts of heterogeneous catalysis. Then, the experimental results that identified the three molecular ingredients of catalysis, structure, carbonaceous deposit and the oxidation state of surface atoms are described. Each section is closed with a summary and a list of problems that require theoretical and experimental scrutiny. Finally attempts to build new catalyst systems and the theoretical and experimental problems that appeared in the course of this research are described

Molecular ingredients of heterogeneous catalysis

Energy Technology Data Exchange (ETDEWEB)

Somorjai, G.A.

1982-06-01

The purpose of this paper is to present a review and status report to those in theoretical chemistry of the rapidly developing surface science of heterogeneous catalysis. The art of catalysis is developing into science. This profound change provides one with opportunities not only to understand the molecular ingredients of important catalytic systems but also to develop new and improved catalyst. The participation of theorists to find answers to important questions is sorely needed for the sound development of the field. It is the authors hope that some of the outstanding problems of heterogeneous catalysis that are identified in this paper will be investigated. For this purpose the paper is divided into several sections. The brief Introduction to the methodology and recent results of the surface science of heterogeneous catalysis is followed by a review of the concepts of heterogeneous catalysis. Then, the experimental results that identified the three molecular ingredients of catalysis, structure, carbonaceous deposit and the oxidation state of surface atoms are described. Each section is closed with a summary and a list of problems that require theoretical and experimental scrutiny. Finally attempts to build new catalyst systems and the theoretical and experimental problems that appeared in the course of this research are described.

New feed ingredients: the insect opportunity.

Science.gov (United States)

van Raamsdonk, L W D; van der Fels-Klerx, H J; de Jong, J

2017-08-01

In the framework of sustainability and a circular economy, new ingredients for feed are desired and, to this end, initiatives for implementing such novel ingredients have been started. The initiatives include a range of different sources, of which insects are of particular interest. Within the European Union, generally, a new feed ingredient should comply with legal constraints in terms of 'yes, provided that' its safety commits to a range of legal limits for heavy metals, mycotoxins, pesticides, contaminants, pathogens etc. In the case of animal proteins, however, a second legal framework applies which is based on the principle 'no, unless'. This legislation for eradicating transmissible spongiform encephalopathy consists of prohibitions with a set of derogations applying to specific situations. Insects are currently considered animal proteins. The use of insect proteins is a good case to illustrate this difference between a positive, although restricted, modus and a negative modus for allowing animal proteins. This overview presents aspects in the areas of legislation, feed safety, environmental issues, efficiency and detection of the identity of insects. Use of insects as an extra step in the feed production chain costs extra energy and this results in a higher footprint. A measure for energy conversion should be used to facilitate the comparison between production systems based on cold- versus warm-blooded animals. Added value can be found by applying new commodities for rearing, including but not limited to category 2 animal by-products, catering and household waste including meat, and manure. Furthermore, monitoring of a correct use of insects is one possible approach for label control, traceability and prevention of fraud. The link between legislation and enforcement is strong. A principle called WISE (Witful, Indicative, Societal demands, Enforceable) is launched for governing the relationship between the above-mentioned aspects.

Home cooking and ingredient synergism improve lycopene isomer production in Sofrito.

Science.gov (United States)

Rinaldi de Alvarenga, José Fernando; Tran, Camilla; Hurtado-Barroso, Sara; Martinez-Huélamo, Miriam; Illan, Montserrat; Lamuela-Raventos, Rosa M

2017-09-01

There has been increasing interest in tomato products rich in lycopene Z-isomers since these carotenoids present greater bioavailability and antioxidant capacity than the all-E lycopene form. Intrinsic food properties as well as processing and the interaction between dietary components can all influence the content, type and bioavailability of carotenoids. The aim of this study was to evaluate whether carotenoid content and isomerization in tomato-based Mediterranean sofrito is affected by the process of home cooking and the presence of other ingredients such as extra virgin olive oil, onion and garlic. We used a full factorial design to clarify the contribution of each ingredient to the carotenoid composition of sofrito and to determine whether this can be improved by the cooking time and ingredient synergism. Cooking time and onion content were associated with a higher production of 5-Z-lycopene, 9-Z-lycopene and 13-Z-lycopene in sofrito. Onion proved to be the most interesting ingredient in the sofrito formulation due to their enhancing effect on lycopene isomerization. The use of onion combined with an adequate processing time may improve the bioavailability of lycopene in tomato products. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mass spectrometry imaging: a novel technology in rheumatology.

Science.gov (United States)

Rocha, Beatriz; Ruiz-Romero, Cristina; Blanco, Francisco J

2017-01-01

Mass spectrometry imaging (MSI) is used to determine the relative abundance and spatial distribution of biomolecules such as peptides, proteins, lipids and other organic compounds in tissue sections by their molecular masses. This technique provides a sensitive and label-free approach for high-resolution imaging, and is currently used in an increasing number of biomedical applications such as biomarker discovery, tissue classification and drug monitoring. Owing to technological advances in the past 5 years in diverse MSI strategies, this technology is expected to become a standard tool in clinical practice and provides information complementary to that obtained using existing methods. Given that MSI is able to extract mass-spectral signatures from pathological tissue samples, this technique provides a novel platform to study joint-related tissues affected by rheumatic diseases. In rheumatology, MSI has been performed on articular cartilage, synovium and bone to increase the understanding of articular destruction and to characterize diagnostic and prognostic biomarkers for osteoarthritis, rheumatoid arthritis and osteoporosis. In this Review, we provide an overview of MSI technology and of the studies in which joint tissues have been analysed by use of this methodology. This approach might increase knowledge of rheumatic pathologies and ultimately prompt the development of targeted strategies for their management.

Examining Changes in Central and Peripheral Pain as Mediates of Fatigue Improvement: Results From the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis.

Science.gov (United States)

Druce, Katie L; Jones, Gareth T; Macfarlane, Gary J; Basu, Neil

2016-07-01

Following anti-tumor necrosis factor (anti-TNF) therapy, improvements in rheumatoid arthritis (RA) fatigue are driven by reductions in pain. However, therapies may modify both central and peripheral pain. This study sought to examine the hypothesis that reductions in fatigue after anti-TNF therapy reflect changes in central, not peripheral, pain mechanisms. Data came from patients with severe baseline fatigue (Short Form 36 health survey [SF-36] vitality scale ≤12.5; n = 2,652), recruited to the British Society for Rheumatology Biologics Register for RA for commencing anti-TNF therapies between October 2000 and November 2008. Data of interest comprised change over 6 months in fatigue, pain (SF-36 bodily pain scale), and disease activity constituents (Disease Activity Score in 28 joints, erythrocyte sedimentation rate [ESR], global health, swollen joints, and tender joints). Principal components factor analysis with varimax rotation determined latent variables of symptom change; variables were accepted provided they had eigenvalues ≥1. Six factors were identified, of which 2 met acceptance criteria (eigenvalues of 2.39 and 1.14, respectively). Following rotation, loadings indicated that factor 1 comprised markers of peripheral inflammation: change in ESR, swollen joints, tender joints, and global health. This distinct loading led to factor 1 being labeled peripheral inflammation. Conversely, factor 2 comprised change in pain, fatigue, and global health and an absence of peripheral inflammation markers and was therefore labeled central inflammation. Following anti-TNF therapies, reductions in fatigue and pain appear to reflect improvements in central, rather than peripheral, inflammation. Therefore, for those seeking to treat fatigue via pain mechanisms, improvements may be maximized by the application of treatment modalities that effectively target central mechanisms. © 2016, American College of Rheumatology.

Comparison of Anti-Saccharomyces Cerevisiae Antibodies (ASCA in Behcet’s Disease Patients with Three Groups of Oral Aphthosis, other Rheumatologic Diseases and Healthy Volunteers

Directory of Open Access Journals (Sweden)

Saeed Kerdari

2015-07-01

Full Text Available Introduction: Behcet’s Disease (BD is a general and progressive vasculitis and involves various organs. Its main etiology is not yet understood; however, immunologic and infectious causes and genetic predisposition have been proposed. Saccharomyces Cerevisiae is a type of yeast which is used in the bread and wine industries. Antibodies against this yeast have a well-proven role in inflammatory bowel diseases. The aim of the present study was to assess the frequency of Anti-Saccharomyces Cerevisiae Antibody (ASCA and its relation to clinical symptoms and disease activity index in patients afflicted by BD. Materials and Methods: Serum ASCA levels, determined by ELISA, were Studied in Behcet’s disease along with oral aphthosis, other rheumatologic diseases and healthy volunteers (n=30 in each group. In the BD group the disease activity index and different clinical symptoms were recorded during the study course. Results:Serum level of ASCA in the four studied groups of BD, oral aphthosis, other rheumatologic disease and healthy volunteers was 9.18±9.69, 10.90±10.40, 11.29±17.96 and 8.86±5.31IU/ml, respectively;  indicating no meaningful difference (p=0.811. The ASCA titer was not related to Behcet’s disease severity (p=0.399. Serum level of ASCA in BD patients with oral aphthosis or with gastrointestinal symptoms was significantly higher than the other Behcet’s Disease patients (p=0.012, p=0.014. Conclusion: ASCS is not a valuable test for distinguishing BD from recurrent oral aphthosis or other connective tissue disorders. It also cannot be used for determining disease severity. However, it has a higher level in BD patients with oral aphthous ulcers and gastrointestinal symptoms.

Cost of common low back pain and lumbar radiculopathy in rheumatologic consultation in Lomé.

Science.gov (United States)

Fianyo, Eyram; Oniankitan, Owonayo; Tagbor Komi, C; Kakpovi, Kodjo; Houzou, Prénam; Koffi-Tessio Viwalé, E S; Mijiyawa, Moustafa

2017-03-01

The cost of low back pain was the subject of few studies in black Africa. To assess the cost of common low back pain and lumbar radiculopathy in Lomé. A six months study was realised in the rheumatologic department of CHU Sylvanus Olympio. 103 consecutive patients suffering from a common low back pain or lumbar radiculopathy were included. To assess direct, indirect and non-financial costs they were questioned about their expense during the year. Financial cost of common low back pain and lumbar radiculopathy amounted to 107.2 $ US (extremes: 5.8 and 726.1 $ US). This amount, quadruple of guaranteed minimum wage, felled under two headings: direct cost (56.3 $ US; 53% of total sum), indirect cost (50.3 $ US; 47% of total sum). Non-financial cost were: disruption in daily activities (94%), impact in emotional and sexual life (59%), impact on the family's budget (69%), abandon of family's projects (58%) or of leisure (42%). In black Africa top priority is given to the fight against infectious diseases those cause an important mortality. But common low back pain and lumbar radiculopathy, those have social and economic impact, should be given more attention.

Natural personal care products-analysis of ingredient lists and legal situation.

Science.gov (United States)

Klaschka, Ursula

2016-01-01

Many natural substances are classified as dangerous substances according to the European regulation on classification and labelling. Are they used in natural personal care products today? One hundred ingredient lists were analyzed to find this out. All products with natural substances contained dangerous natural substances or they contained natural substances, for which the information about their classification as dangerous substances is not available. 54 natural substances quoted in the ingredient lists were found to be classified, with 37 substances being classified due to hazardous effects for skin and eyes. However, the most frequently used natural substances are not classified as dangerous. Natural substances are multi-constituent compounds, leading to two main problems in personal care products: the potential interactions of a multitude of substances and the fact that dangerous constituents are not disclosed in the ingredient lists. For example, the fragrance allergens citral, farnesol, limonene, and linalool are frequent components of the natural substances employed. In addition, 82 products listed allergenic fragrance ingredients as single substances in their ingredient lists. Recommendations for sensitive skin in a product's name do not imply that the '26 fragrance allergens' are omitted. Furthermore, 80 products listed 'parfum'/'aroma', and 50 products listed ethanol. The data show that the loopholes for natural substances and for personal care products in the present European chemical legislation (e.g. the exception for classification and labelling of cosmetic products and the exception for information transfer in the supply chain) are not in line with an adequate consumer and environmental protection.

[Study on the ingredients of reserpine by TLC-FT-SERS].

Science.gov (United States)

Wang, Y; Zi, F; Wang, Y; Zhao, Y; Zhang, X; Weng, S

1999-12-01

A new method for analysing the ingredients of reserpine by thin layer chromatography (TLC) and surface-enhanced Raman spectroscopy (SERS) is reported in this paper. The results show that the characteristic spectral bands of reserpine satuated at the thin layer with the amount of sample about 2 microg were obtained. The difference between SERS and solid spectra was found. An absorption model of reserpine and silver sol was proposed. This method can be used to analyse the chemical ingredients with high sensitivity.

Overview of Food Ingredients, Additives and Colors

Science.gov (United States)

... In addition to maintaining the quality of the food, they help control contamination that can cause foodborne illness, including life-threatening ... still be considered safe. Regulations known as Good Manufacturing ... limit the amount of food ingredients used in foods to the amount necessary ...

Estimation of active pharmaceutical ingredients content using locally weighted partial least squares and statistical wavelength selection.

Science.gov (United States)

Kim, Sanghong; Kano, Manabu; Nakagawa, Hiroshi; Hasebe, Shinji

2011-12-15

Development of quality estimation models using near infrared spectroscopy (NIRS) and multivariate analysis has been accelerated as a process analytical technology (PAT) tool in the pharmaceutical industry. Although linear regression methods such as partial least squares (PLS) are widely used, they cannot always achieve high estimation accuracy because physical and chemical properties of a measuring object have a complex effect on NIR spectra. In this research, locally weighted PLS (LW-PLS) which utilizes a newly defined similarity between samples is proposed to estimate active pharmaceutical ingredient (API) content in granules for tableting. In addition, a statistical wavelength selection method which quantifies the effect of API content and other factors on NIR spectra is proposed. LW-PLS and the proposed wavelength selection method were applied to real process data provided by Daiichi Sankyo Co., Ltd., and the estimation accuracy was improved by 38.6% in root mean square error of prediction (RMSEP) compared to the conventional PLS using wavelengths selected on the basis of variable importance on the projection (VIP). The results clearly show that the proposed calibration modeling technique is useful for API content estimation and is superior to the conventional one. Copyright © 2011 Elsevier B.V. All rights reserved.

An analysis of chemical ingredients network of Chinese herbal formulae for the treatment of coronary heart disease.

Directory of Open Access Journals (Sweden)

Fan Ding

Full Text Available As a complex system, the complicated interactions between chemical ingredients, as well as the potential rules of interactive associations among chemical ingredients of traditional Chinese herbal formulae are not yet fully understood by modern science. On the other hand, network analysis is emerging as a powerful approach focusing on processing complex interactive data. By employing network approach in selected Chinese herbal formulae for the treatment of coronary heart disease (CHD, this article aims to construct and analyze chemical ingredients network of herbal formulae, and provide candidate herbs, chemical constituents, and ingredient groups for further investigation. As a result, chemical ingredients network composed of 1588 ingredients from 36 herbs used in 8 core formulae for the treatment of CHD was produced based on combination associations in herbal formulae. In this network, 9 communities with relative dense internal connections are significantly associated with 14 kinds of chemical structures with P<0.001. Moreover, chemical structural fingerprints of network communities were detected, while specific centralities of chemical ingredients indicating different levels of importance in the network were also measured. Finally, several distinct herbs, chemical ingredients, and ingredient groups with essential position in the network or high centrality value are recommended for further pharmacology study in the context of new drug development.

Final report on the safety assessment of Cocos nucifera (coconut) oil and related ingredients.

Science.gov (United States)

Burnett, Christina L; Bergfeld, Wilma F; Belsito, Donald V; Klaassen, Curtis D; Marks, James G; Shank, Ronald C; Slaga, Thomas J; Snyder, Paul W; Andersen, F Alan

2011-05-01

Cocos nucifera (coconut) oil, oil from the dried coconut fruit, is composed of 90% saturated triglycerides. It may function as a fragrance ingredient, hair conditioning agent, or skin-conditioning agent and is reported in 626 cosmetics at concentrations from 0.0001% to 70%. The related ingredients covered in this assessment are fatty acids, and their hydrogenated forms, corresponding fatty alcohols, simple esters, and inorganic and sulfated salts of coconut oil. The salts and esters are expected to have similar toxicological profiles as the oil, its hydrogenated forms, and its constituent fatty acids. Coconut oil and related ingredients are safe as cosmetic ingredients in the practices of use and concentration described in this safety assessment.

Ingredients for sustained excellence

International Nuclear Information System (INIS)

Johnson, A.R.; Alikhan, S.; Steed, R.G.

1992-01-01

Point Lepreau, a 680MWe CANDU reactor, has, since startup, been one of the world's best performing reactors. Many of the ingredients for this success can be found at other plants, but Pt Lepreau has found a ''chemistry'' that has sustained its performance at a very high level. Our belief is that this is the result of two major influences: Pt Lepreau is the only nuclear unit in a small utility, all its nuclear expertise exists at the station, and all necessary disciplines can be readily galvanized to solve problems and get work done. The structure of the organization is simple, with station management involvement in day to day activities. This fosters accountability and a natural efficiency that does not need slogans to achieve its purpose. Turning to the factors that have contributed to the station's success, the IAEA's technical exchange visit in July 1990 identified four items ''which are particularly noteworthy since they can be developed and used widely in the nuclear industry to enhance safety and availability. These are: quality assurance applications; the degree to which system engineers are employed; the dedication of skilled resources to and thoroughness of outage planning; and the in-house development of computers to assist directly in the day to day, medium and long term management of the generating station''. (Author)

[TLC-FT-SERS study on ingredients of Isrhynchophylline].

Science.gov (United States)

Wang, Yuan; Wang, Song-ying; Zhao, Yi-xue; Ren, Gui-fen; Zi, Feng-lan

2002-02-01

A new method for analysing the ingredients of Isrhynchophylline in Uncaria Rhynchophylla Jacks by thin layer chromatography (TLC) and the surface-enhanced Raman spectroscopy (SERS) is reported in this paper. The results show that the characteristic spectra bands of Isrhynchophylline situated at the thin layer with the amount of sample about 2.5 micrograms were obtained. The difference between SERS and solid spectra was found. Great enhancement of the 1,615 cm-1 spectral band was abstained. Molecule was absorbed in surface silver sol by pi electrons in phenyl and by pair of electrons in N together. An absorption model of Isrhynchophylline and silver sol was proposed. This method can be used to analyse the chemical ingredients with high sensitivity.

Encapsulation of health-promoting ingredients: applications in foodstuffs.

Science.gov (United States)

Tolve, Roberta; Galgano, Fernanda; Caruso, Marisa Carmela; Tchuenbou-Magaia, Fideline Laure; Condelli, Nicola; Favati, Fabio; Zhang, Zhibing

2016-12-01

Many nutritional experts and food scientists are interested in developing functional foods containing bioactive agents and many of these health-promoting ingredients may benefit from nano/micro-encapsulation technology. Encapsulation has been proven useful to improve the physical and the chemical stability of bioactive agents, as well as their bioavailability and efficacy, enabling their incorporation into a wide range of formulations aimed to functional food production. There are several reviews concerning nano/micro-encapsulation techniques, but none are focused on the incorporation of the bioactive agents into food matrices. The aim of this paper was to investigate the development of microencapsulated food, taking into account the different bioactive ingredients, the variety of processes, techniques and coating materials that can be used for this purpose.

Impact of Antiinflammatory Treatment on the Onset of Uveitis in Juvenile Idiopathic Arthritis: Longitudinal Analysis From a Nationwide Pediatric Rheumatology Database.

Science.gov (United States)

Tappeiner, Christoph; Schenck, Sandra; Niewerth, Martina; Heiligenhaus, Arnd; Minden, Kirsten; Klotsche, Jens

2016-01-01

Based on a nationwide database, this study analyzed the influence of methotrexate (MTX), tumor necrosis factor (TNF) inhibitors, and a combination of the 2 medications on uveitis occurrence in juvenile idiopathic arthritis (JIA) patients. Data from the National Paediatric Rheumatological Database in Germany were used in this study. Between 2002 and 2013, data from JIA patients were annually documented at the participating pediatric rheumatologic sites. Patients with a JIA disease duration of treatment on the occurrence of uveitis was evaluated by discrete-time survival analysis. A total of 3,512 JIA patients (mean ± SD age 8.3 ± 4.8 years, 65.7% female, 53.2% antinuclear antibody positive, and mean ± SD age at arthritis onset 7.8 ± 4.8 years) fulfilled the inclusion criteria. Mean ± SD total followup time was 3.6 ± 2.4 years. Uveitis developed in a total of 180 patients (5.1%) within 1 year after arthritis onset. Uveitis onset after the first year was observed in another 251 patients (7.1%). Disease-modifying antirheumatic drug (DMARD) treatment in the year before uveitis onset significantly reduced the risk for uveitis as follows: MTX: hazard ratio (HR) 0.63, P = 0.022; TNF inhibitors: HR 0.56, P uveitis risk (HR 0.29, P uveitis onset. Early MTX use within the first year of disease and the combination of MTX with a TNF inhibitor had the highest protective effect. © 2016 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.

Encapsulation and delivery of food ingredients using starch based systems.

Science.gov (United States)

Zhu, Fan

2017-08-15

Functional ingredients can be encapsulated by various wall materials for controlled release in food and digestion systems. Starch, as one of the most abundant natural carbohydrate polymers, is non-allergenic, GRAS, and cheap. There has been increasing interest of using starch in native and modified forms to encapsulate food ingredients such as flavours, lipids, polyphenols, carotenoids, vitamins, enzymes, and probiotics. Starches from various botanical sources in granular or amorphous forms are modified by chemical, physical, and/or enzymatic means to obtain the desired properties for targeted encapsulation. Other wall materials are also employed in combination with starch to facilitate some types of encapsulation. Various methods of crafting the starch-based encapsulation such as electrospinning, spray drying, antisolvent, amylose inclusion complexation, and nano-emulsification are introduced in this mini-review. The physicochemical and structural properties of the particles are described. The encapsulation systems can positively influence the controlled release of food ingredients in food and nutritional applications. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Hybrid MPC-PID Control System Design for the Continuous Purification and Processing of Active Pharmaceutical Ingredients

Directory of Open Access Journals (Sweden)

Maitraye Sen

2014-05-01

Full Text Available In this work, a hybrid MPC (model predictive control-PID (proportional-integral-derivative control system has been designed for the continuous purification and processing framework of active pharmaceutical ingredients (APIs. The specific unit operations associated with the purification and processing of API have been developed from first-principles and connected in a continuous framework in the form of a flowsheet model. These integrated unit operations are highly interactive along with the presence of process delays. Therefore, a hybrid MPC-PID is a promising alternative to achieve the desired control loop performance as mandated by the regulatory authorities. The integrated flowsheet model has been simulated in gPROMSTM (Process System Enterprise, London, UK. This flowsheet model has been linearized in order to design the control scheme. The ability to track the set point and reject disturbances has been evaluated. A comparative study between the performance of the hybrid MPC-PID and a PID-only control scheme has been presented. The results show that an enhanced control loop performance can be obtained under the hybrid control scheme and demonstrate that such a scheme has high potential in improving the efficiency of pharmaceutical manufacturing operations.

Indigenous food ingredients for complementary food formulations to combat infant malnutrition in Benin

NARCIS (Netherlands)

Chadare, Flora J.; Madode, Yann E.; Fanou-Fogny, Nadia; Kindossi, Janvier M.; Ayosso, Juvencio O.G.; Honfo, S.H.; Kayodé, A.P.P.; Linnemann, Anita R.; Hounhouigan, D.J.

2018-01-01

This paper reviews indigenous Beninese food resources as potential ingredients for complementary infant foods with the aim to develop affordable formulations for low-income households in each agro-ecological zone of the country. Potential ingredients were selected on their documented nutritional

Content of Selected Minerals and Active Ingredients in Teas Containing Yerba Mate and Rooibos.

Science.gov (United States)

Rusinek-Prystupa, Elżbieta; Marzec, Zbigniew; Sembratowicz, Iwona; Samolińska, Wioletta; Kiczorowska, Bożena; Kwiecień, Małgorzata

2016-07-01

The study aimed to determine the content of selected elements: sodium, potassium, copper, zinc, iron, manganese and active ingredients such as phenolic acids and tannins in teas containing Yerba Mate and Rooibos cultivated in various areas. The study material comprised six samples of Yerba Mate teas and of Rooibos teas, both tea bags and leaves, purchased in Puławy and online via Allegro. In total, 24 samples were tested. Yerba Mate was particularly abundant in Mn and Fe. The richest source of these elements was Yerba Mate Yer-Vita (2261.3 mg · kg(-1) d.m.) and (691.6 mg · kg(-1) d.m.). The highest content of zinc was determined in Yerba Mate Amanda with lime (106.0 mg · kg(-1) d.m.), while copper was most abundant in Yerba Mate Big-Active cocoa and vanilla (14.05 mg · kg(-1) d.m.). In Rooibos, the content of sodium was several times higher than in Yerba Mate. A clear difference was observed in the content of minerals in dry weight of the examined products, which could be a result of both the taxonomic distinctness and the origin of the raw material. Leaf teas turned out to be a better source of tannins; on the other hand, tea bags contained substantially more phenolic acids. The richest source of phenolic acids was Yer-Vita in bags (1.8 %), and the highest amount of tannins was recorded in the leaf tea Green Goucho caramel and dark chocolate (9.04 g · 100 g(-1) d.m.). In Rooibos products, the highest content of phenolic acids was recorded in tea bags (Savannah with honey and vanilla 0.96 %), and tannins in (Lord Nelson with strawberry and cream 7.99 g · 100 g (-1) d.m.).

Hydration and chemical ingredients in sport drinks: food safety in the European context.

Science.gov (United States)

Urdampilleta, Aritz; Gómez-Zorita, Saioa; Soriano, José M; Martínez-Sanz, José M; Medina, Sonia; Gil-Izquierdo, Angel

2015-05-01

Before, during and after physical activity, hydration is a limiting factor in athletic performance. Therefore, adequate hydration provides benefits for health and performance of athletes. Besides, hydration is associated to the intake of carbohydrates, protein, sodium, caffeine and other substances by different dietary aids, during the training and/or competition by athletes. These requirements have led to the development of different products by the food industry, to cover the nutritional needs of athletes. Currently in the European context, the legal framework for the development of products, substances and health claims concerning to sport products is incomplete and scarce. Under these conditions, there are many products with different ingredients out of European Food Safety Authority (EFSA) control where claims are wrong due to no robust scientific evidence and it can be dangerous for the health. Further scientific evidence should be constructed by new clinical trials in order to assist to the Experts Commitees at EFSA for obtaining robust scientific opinions concerning to the functional foods and the individual ingredients for sport population. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Art and rheumatology: the artist and the rheumatologist's perspective.

Science.gov (United States)

Hinojosa-Azaola, Andrea; Alcocer-Varela, Jorge

2014-10-01

The reflection of medicine in the universal arts has motivated several rheumatologists to discover features of rheumatic diseases depicted by the artist's eyes long before they were defined as specific pathologic entities. The result has been the identification of several pieces of art dating from the Middle Ages, the Renaissance, the Baroque and Post-Impressionist periods that depict clear features of several rheumatic diseases such as RA, OA, camptodactyly and temporal arteritis, among others. On the other hand, great artists such as Pierre-Auguste Renoir, Antoni Gaudí, Raoul Dufy, Paul Klee, Frida Kahlo and Niki de Saint Phalle are good examples of how rheumatic diseases such as RA, scleroderma and chronic pain can influence the artist's perspective, the technique used and the content of their work. Art can serve as a powerful resource to understand the natural course of diseases. By learning through the artist's eyes the way illnesses behave and evolve in time, rheumatologists can trace the history of several conditions. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Responses of dogs with food allergies to single-ingredient dietary provocation.

Science.gov (United States)

Jeffers, J G; Meyer, E K; Sosis, E J

1996-08-01

To characterize specific food ingredients causing allergic reactions in dogs and to assess cross-reactivity between proteins derived from a single animal source or from different plant products. Prospective study. 25 dogs with histories and cutaneous signs consistent with food-allergic dermatitis. Dogs were fed a food-elimination diet until resolution of clinical signs and then challenged with their original diet. A diagnosis of food allergy was made if there was complete return of pruritus within 14 days of challenge exposure. After diagnosis, dogs were fed the food-elimination diet until signs related to dietary challenge abated. The dogs then were fed beef, chicken, chicken eggs, cows' milk, wheat, soy, and corn in single-ingredient provocation trials for 1 week. Any cutaneous reactions to these food ingredients were recorded by their owners. Beef and soy most often caused adverse cutaneous reactions, although all ingredients induced clinical signs in at least 1 dog. Mean number of allergens per dog was 2.4, with 80% reacting to 1 or 2 proteins and 64% reacting to 2 or more of the proteins tested. A significant difference was found between dogs reacting to beef versus cows' milk and between dogs reacting to soy versus wheat; thus, the hypothesis of cross-reactivity to ingredients derived from a single animal source or to different plant products was not supported. Similar differences between chicken meat and eggs were not identified. Long-term management of dogs with food allergies is facilitated by identification of the most commonly encountered food allergens. Because cross-reactivity cannot be verified, each protein source should be included separately in food-provocation trials.

The ratio of nurse consultation and physician efficiency index of senior rheumatologists is significantly higher than junior physicians in rheumatology residency training

DEFF Research Database (Denmark)

Emamifar, Amir; van Bui Hansen, Morten Hai; Jensen Hansen, Inger Marie

2017-01-01

To elucidate the difference between ratios of nurse consultation sought by senior rheumatologists and junior physicians in rheumatology residency training, and also to evaluate physician efficiency index respecting patients with rheumatoid arthritis (RA). Data regarding outpatient visits for RA...... patients between November 2013 and 2015 were extracted. The mean interval (day) between consultations, the nurse/physician visits ratio, and physician efficiency index (nurse/physician visits ratio × mean interval) for each senior and junior physicians were calculated. Disease Activity Score in 28 joints....../physician visits ratio (P = .01) and mean efficiency index (P = .04) of senior rheumatologists were significantly higher than that of junior physicians. Regression analysis showed a positive correlation between physician postgraduate experience and physician efficiency index adjusted for DAS28 at baseline...

21 CFR 101.4 - Food; designation of ingredients.

Science.gov (United States)

2010-04-01

... ingredient shall be a specific name and not a collective (generic) name, except that: (1) Spices, flavorings..., concentrated milk, reconstituted milk, and dry whole milk may be declared as “milk”. (5) Bacterial cultures may...

High-expression β(1) adrenergic receptor/cell membrane chromatography method based on a target receptor to screen active ingredients from traditional Chinese medicines.

Science.gov (United States)

Yue, Yuan; Xue, Hui; Wang, Xin; Yang, Qian; Song, Yanhong; Li, Xiaoni

2014-02-01

β-Adrenergic receptors are important targets for drug discovery. We have developed a new β1 -adrenergic receptor cell membrane chromatography (β1 AR-CMC) with offline ultra-performance LC (UPLC) and MS method for screening active ingredients from traditional Chinese medicines. In this study, Chinese hamster ovary-S cells with high β1 AR expression levels were established and used to prepare a cell membrane stationary phase in a β1 AR-CMC model. The retention fractions were separated and identified by the UPLC-MS system. The screening results found that isoimperatorin from Rhizoma et Radix Notopterygii was the targeted component that could act on β1 AR in similar manner of metoprolol as a control drug. In addition, the biological effects of active component were also investigated in order to search for a new type of β1 AR antagonist. It will be a useful method for drug discovery as a leading compound resource. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Ingredients of success in the design and construction of the french nuclear power plants

International Nuclear Information System (INIS)

Bacher, P.; Panossian, J.; Riollet, G.

1989-01-01

A nuclear program can be compared to a pastry. There are many ingredients, a lot of know-how, an adequate cooking and some good luck to achieve success or back luck to fail. The French nuclear program has had all the ingredients of success and the necessary luck. The present paper presents the major ingredients: strong and well defined policies, an adapted industrial organization, original management methods, dedicated men, political and popular support. The main results of the French program, well known today, are only briefly be presented. The last part of the paper show the very strong interactions between operation and design, and how experience is fed back into the design both of new and of older plants. The conclusion calls for new ingredients for future success

Consumer product chemical weight fractions from ingredient lists

Science.gov (United States)

Assessing human exposures to chemicals in consumer products requires composition information. However, comprehensive composition data for products in commerce are not generally available. Many consumer products have reported ingredient lists that are constructed using specific gu...

The Videofluorographic Swallowing Study in Rheumatologic Diseases: A Comprehensive Review

Science.gov (United States)

Di Piazza, Ambra; Costanzo, Massimo; Scopelliti, Laura; Salvaggi, Francesco; Cupido, Francesco; Salerno, Sergio; Lo Casto, Antonio; Midiri, Massimo; Lo Re, Giuseppe; Lagalla, Roberto

2017-01-01

Autoimmune connective tissue diseases are a heterogeneous group of pathologies that affect about 10% of world population with chronic evolution in 20%–80%. Inflammation in autoimmune diseases may lead to serious damage to other organs including the gastrointestinal tract. Gastrointestinal tract involvement in these patients may also due to both a direct action of antibodies against organs and pharmacological therapies. Dysphagia is one of the most important symptom, and it is caused by failure of the swallowing function and may lead to aspiration pneumonia, malnutrition, dehydration, weight loss, and airway obstruction. The videofluorographic swallowing study is a key diagnostic tool in the detection of swallowing disorders, allowing to make an early diagnosis and to reduce the risk of gastrointestinal and pulmonary complications. This technique helps to identify both functional and structural anomalies of the anatomic chain involved in swallowing function. The aim of this review is to systematically analyze the basis of the pathological involvement of the swallowing function for each rheumatological disease and to show the main features of the videofluorographic study that may be encountered in these patients. PMID:28706536

Effects of tailoring ingredients in auditory persuasive health messages on fruit and vegetable intake

NARCIS (Netherlands)

Elbert, Sarah P.; Dijkstra, Arie; Rozema, Andrea

2017-01-01

Objective: Health messages can be tailored by applying different tailoring ingredients, among which personalisation, feedback and adaptation. This experiment investigated the separate effects of these tailoring ingredients on behaviour in auditory health persuasion. Furthermore, the moderating

Microalgae as healthy ingredients for functional food: a review.

Science.gov (United States)

Matos, J; Cardoso, C; Bandarra, N M; Afonso, C

2017-08-01

Microalgae are very interesting and valuable natural sources of highly valuable bioactive compounds, such as vitamins, essential amino acids, polyunsaturated fatty acids, minerals, carotenoids, enzymes and fibre. Due to their potential, microalgae have become some of the most promising and innovative sources of new food and functional products. Moreover, microalgae can be used as functional ingredients to enhance the nutritional value of foods and, thus, to favourably affect human health by improving the well-being and quality of life, but also by curtailing disease and illness risks. This review provides an overview of the current knowledge of the health benefits associated with the consumption of microalgae, bioactive compounds, functional ingredients, and health foods.

Huangqin-Tang and Ingredients in Modulating the Pathogenesis of Ulcerative Colitis.

Science.gov (United States)

Wang, Chunyan; Tang, Xudong; Zhang, Li

2017-01-01

Ulcerative colitis (UC) is the most common inflammatory bowel disease worldwide. Current therapies in UC cause limitations, and herb medicine provides an important choice for UC treatment. Huangqin-Tang (HQT) is a well-known classical traditional Chinese herbal formula and has been used in China for thousands of years. A large number of pharmacological studies demonstrated HQT and its ingredients to be effective in treating UC. Though the therapeutic effect has been evaluated, comprehensive up-to-date reviews in this field are not yet available. Here we aim to review our current understanding of HQT and its ingredients in treating UC and how the agents modulate the main pathogenesis of the disease, including the intestinal environment, immune imbalance, inflammatory pathways, and oxidative stress. The summary on this issue may provide better understanding of HQT and its ingredients in treating UC and possibly help in promoting its clinical application.

Contact allergy to ingredients of topical medications : results of the European Surveillance System on Contact Allergies (ESSCA), 2009-2012

NARCIS (Netherlands)

Uter, Wolfgang; Spiewak, Radoslaw; Cooper, Susan M.; Wilkinson, Mark; Sanchez Perez, Javier; Schnuch, Axel; Schuttelaar, Marie-Louise

2016-01-01

PurposeThe aim of this study was to give an overview of the prevalence of contact allergy to active ingredients and excipients of topical medications across Europe. MethodsRetrospective analysis of data collected by the European Surveillance System on Contact Allergies () with substances applied to

Pure analgesics in a rheumatological outpatient clinic

Directory of Open Access Journals (Sweden)

M.A. Cimmino

2011-09-01

Full Text Available Objective: Pure analgesics are only rarely used by Italian clinicians and this holds true also for rheumatologists. This work is concerned with an evaluation of the use of analgesics in a rheumatological outpatient clinic during the period 1989-1999. Methods: The records of 1705 patients consecutively seen at the clinic were downloaded on a specifically built website. Results: 4469 visits were considered. In 260 of them (5.8%, analgesics were prescribed to 234 (13.7% patients. The number of patients with a prescription of analgesics steadily increased during the years 1989-1999. The diagnoses in patients assuming analgesics were: osteoarthritis (47.1%, inflammatory arthritis (24.2%, soft tissue rheumatisms (13.7%, nonspecific arthralgia/myalgia (7.5%, and connective tissue diseases (2.6%. Peripheral analgesics were used in 188 (82.5% patients and central analgesics were used in the remaining 40 patients (17.5%. Analgesic drugs were used mainly in degenerative joint conditions. The indications for analgesics in the 55 patients with inflammatory arthrits were: (a partial or total remission of arthritis; for this reason non-steroidal anti-inflammatory drugs were no longer required in 18 patients; (b to increase the analgesic effect of NSAIDs in 23 patients; (c contraindications to NSAIDs in 14 patients (renal failure in 2 patients, gastritis in 10, allergy and bleeding in the remaining two. Conclusions: About 14% of our outpatients were treated with analgesics with an increasing trend in the examined period. The main indications for analgesics are degenerative conditions but they can be used also in selected patients with arthritis.

Bio-Guided Targeting for Preservative and Anti-Ageing Cosmetic Ingredient Development

Directory of Open Access Journals (Sweden)

Emilie Destandau

2014-01-01

Full Text Available To develop a new antioxidant, antibacterial and natural cosmetic ingredient without cytotoxicity to skin cells, bioactive molecules contained in Kalanchoe pinnata leaf methanolic extract were targeted using semi-preparative HPLC fractionation linked to biological activity tests. Chromatographic effluent was collected at the column outlet into a 96 deep-well microplate, filling successively all the wells. After freeze-drying, the microplate was ready to use for different biological tests such as antimicrobial activity on microorganisms, skin cell viability and antioxidant activity on human keratinocyte cells. The injection of only 2.64 mg of crude extract into the HPLC system reveals a good correlation between the chromatographic peaks and the different biological activities. One fraction is mainly of interest since good antibacterial and antioxidant activities without cytotoxicity are observed. The analysis of this fraction using mass spectrometry allows the identification of glycoside derivatives of quercetin, isorhamnetin and kaempferol. Thus, a correlation between biological activity and the presence of these flavonoids is obtained. This screening method allows a rapid fractionation associated with a biological activity evaluation and a first molecular identification, saving time by limiting sample treatments and solvent consumption.

[A systematic review of the effectiveness of alternative weight-loss products' ingredients].

Science.gov (United States)

de Lira-García, Cynthia; Souto-Gallardo, María; Bacardí-Gascón, Monserrat; Jiménez-Cruz, Arturo

2008-01-01

The high demand for obesity treatment and conventional therapies' lack of effectiveness increases the use of alternative products. This study was aimed at assessing evidence from randomised clinical trials regarding the effectiveness of alternative weight-loss products' ingredients. A survey was conducted in Ensenada, Baja California, to assess the frequency of consuming alternative products used for weight reduction. The ingredients in the products most in demand were included in this review. The Pubmed database was searched for all randomised clinical trial papers including these ingredients and assessing weight loss. Thirty-six percent of the subjects questioned had used alternative methods for weight-loss, 83% of them being women. The most frequently used products were shakes, tea, pills and flaxseed/linseed. Sixteen randomised clinical trials using four ingredients were used: Garcinia cambogia, green tea, L-carnitina and flaxseed. Only two studies (green tea and Garcinia cambogia) showed significant weight-loss (25%) amongst control and experimental groups. There was no significant difference between the groups in the studies regarding L-carnitina and flaxseed. There is a lack of evidence regarding quality studies justifying the use of alternative products for weight loss.

Trifolium pratense and T. repens (Leguminosae: Edible Flower Extracts as Functional Ingredients

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Rosa Tundis

2015-08-01

Full Text Available Trifolium pratense (red clover and T. repens (white clover edible flowers were investigated for their chemical profile and health properties. The total phenols and flavonoids contents were evaluated. Quercetin, kaempferol, luteolin, rutin, and myricetin were used as markers and quantified by HPLC. The antioxidant effects were investigated by using different in vitro assays. Moreover, α-amylase, α-glucosidase and lipase inhibitory activities were evaluated. T. repens flowers extract showed a good radical scavenging activity in both DPPH and ABTS tests with IC50 values of 10.3 and 21.4 μg/mL, respectively. White clover extract demonstrated promising α-amylase and lipase inhibitory activities with IC50 values of 25.0 and 1.3 μg/mL, respectively. The obtained results support the use of Trifolium flowers as healthy food ingredients.

Criteria for development of a database for safety evaluation of fragrance ingredients.

Science.gov (United States)

Ford, R A; Domeyer, B; Easterday, O; Maier, K; Middleton, J

2000-04-01

Over 2000 different ingredients are used in the manufacture of fragrances. The majority of these ingredients have been used for many decades. Despite this long history of use, all of these ingredients need continued monitoring to ensure that each ingredient meets acceptable safety standards. As with other large databases of existing chemicals, fulfilling this need requires an organized approach to identify the most important potential hazards. One such approach, specifically considering the dermal route of exposure as the most relevant one for fragrance ingredients, has been developed. This approach provides a rational selection of materials for review and gives guidance for determining the test data that would normally be considered necessary for the elevation of safety under intended conditions of use. As a first step, the process takes into account the following criteria: quantity of use, consumer exposure, and chemical structure. These are then used for the orderly selection of materials for review with higher quantity, higher exposure, and the presence of defined structural alerts all contributing to a higher priority for review. These structural alerts along with certain exposure and volume limits are then used to develop guidelines for determining the quality and quantity of data considered necessary to support an adequate safety evaluation of the chosen materials, taking into account existing data on the substance itself as well as on closely related analogs. This approach can be considered an alternative to testing; therefore, it is designed to be conservative but not so much so as to require excessive effort when not justified.

Antiulcerogenic benefits of herbal ingredients in ethanol-induced ...

African Journals Online (AJOL)

Antiulcerogenic benefits of herbal ingredients in ethanol-induced animal models. ... Although therapeutic approaches are widely available, preventive regimens are limited. Numerous studies have demonstrated that herbal ... gastric ulcer. Key words: Herbal Medicines, Gastric ulcer, Prevention, Animal models, Alcohol ...

Characterization of the size distribution and aggregation of virus-like nanoparticles used as active ingredients of the HeberNasvac therapeutic vaccine against chronic hepatitis B

Science.gov (United States)

Lopez, Matilde; Rodriguez, Elias Nelson; Lobaina, Yadira; Musacchio, Alexis; Falcon, Viviana; Guillen, Gerardo; Aguilar, Julio C.

2017-06-01

The use of virus-like particles (VLPs) as antigens constitutes a well established strategy in preventive vaccination. These non-infective particles have a composition, size, and structure favoring their interaction and processing by the immune system. Recombinant viral nucleocapsids encapsulating bacterial nucleic acids result in potent Th1-driving immunogens. Several antigens have been coadministered with VLPs or conjugated to them to further increase their immunogenicity. In the present work we characterize the size distribution of two different recombinant VLPs obtained as components of HeberNasvac, a novel therapeutic vaccine recently registered to treat chronic hepatitis B. The vaccine ingredients, hepatitis B virus surface and nucleocapsid antigens (HBsAg and HBcAg, respectively) and the vaccine formulation, were evaluated using dynamic light scattering (DLS), transmission electron microscopy (TEM) and light obscuration technology. The results demonstrate that both antigens are nanoparticles with sizes ranging between 20-30 nm, in line with reports in the literature. In addition, DLS studies evidenced the capacity of both antigens to form homologous and heterologous aggregates, both as active ingredients as well as being part of the final product. The evaluation of subvisible particles in HeberNasvac formulation fulfills the requirements in terms of quantity and size established for parenteral pharmaceutical compositions. Invited talk at 8th Int. Workshop on Advanced Materials Science and Nanotechnology (IWAMSN2016) (Ha Long City, Vietnam, 8-12 November 2016)

What are the "ingredients" for economic growth?

OpenAIRE

Wolla, Scott A.

2013-01-01

Is there a recipe for economic growth? Perhaps some Miracle-Gro for the economy? If only it were that easy. While the exact recipe is a mystery, economists have identified some of the key ingredients. This month’s newsletter discusses the role that economic institutions play in fostering long-term economic growth.

Valorization of postharvest sweet cherry discard for the development of dehydrated fruit ingredients: compositional, physical, and mechanical properties.

Science.gov (United States)

Franceschinis, Lorena; Sette, Paula; Salvatori, Daniela; Schebor, Carolina

2018-04-20

Sweet cherries are an excellent source of phenolic compounds, which may contribute to a healthy diet. The objective of this work was to generate dehydrated ingredients from postharvest discard of sweet cherries. Four dried ingredients were obtained from fresh sweet cherry discard (Lapins var.) using an osmotic dehydration pretreatment and freeze drying or air drying. The ingredients showed an important phenolic contribution (2.8-6.6 g gallic acid kg -1 of product) and preserved the natural color of the fruit to a great extent. Freeze-dried ingredients were less hygroscopic than air-dried ones, and presented with a softer texture. All the ingredients were in a supercooled state at room temperature (T g range: -23.0 to -18.8 °C). Sugar infusion pretreatment caused a decrease in water sorption capacity and molecular mobility; it also reduced the initial rehydration rate. Relevant differences in nutritional and structural characteristics of the ingredients were observed depending on the processing method used. These ingredients could be incorporated into different processed foods, such as snacks, cereal mixtures, cereal bars, and bakery and confectionery products. Air-dried control ingredients presented better nutritional qualities and air-dried sweet cherries with sugar infusion pretreatment could be appropriate ingredients for applications where sweet flavor and slow rehydration rate are required. © 2018 Society of Chemical Industry. © 2018 Society of Chemical Industry.

Occurrence of ochratoxin A in poultry feeds and feed ingredients from Pakistan.

Science.gov (United States)

Sherazi, S T H; Shar, Z H; Sumbal, G A; Tan, Eddie T; Bhanger, M I; Kara, Huseyin; Nizamani, S M

2015-02-01

A study was conducted to evaluate the occurrence of ochratoxin A (OTA) in complete poultry feeds (n=80) and poultry feed ingredients (n=286) from Pakistan. All samples were first analyzed by indirect enzyme linked immunosorbent assay (ELISA), samples with OTA concentrations above the European Union maximum regulatory limit (MRL, 100 μg/kg) were further confirmed by HPLC-FLD. Contamination frequency and mean OTA levels were 31% and 51 μg/kg in feed ingredients, and the corresponding values for complete feeds were 38% and 75 μg/kg. Ten samples of complete poultry feed and 19 samples of feed ingredients contained OTA at levels higher than the MRL. The results of the present study indicate that there is a strong need for a more intense monitoring programs for OTA in poultry feed.

2012 Brazilian Society of Rheumatology Consensus for the treatment of rheumatoid arthritis.

Science.gov (United States)

da Mota, Licia Maria Henrique; Cruz, Boris Afonso; Brenol, Claiton Viegas; Pereira, Ivanio Alves; Rezende-Fronza, Lucila Stange; Bertolo, Manoel Barros; de Freitas, Max Victor Carioca; da Silva, Nilzio Antonio; Louzada-Júnior, Paulo; Giorgi, Rina Dalva Neubarth; Lima, Rodrigo Aires Corrêa; da Rocha Castelar Pinheiro, Geraldo

2012-01-01

To elaborate recommendations for the treatment of rheumatoid arthritis in Brazil. Literature review with articles' selection based on evidence and the expert opinion of the Rheumatoid Arthritis Committee of the Brazilian Society of Rheumatology. 1) The therapeutic decision should be shared with the patient; 2) immediately after the diagnosis, a disease-modifying antirheumatic drug (DMARD) should be prescribed, and the treatment adjusted to achieve remission; 3) treatment should be conducted by a rheumatologist; 4) the initial treatment includes synthetic DMARDs; 5) methotrexate is the drug of choice; 6) patients who fail to respond after two schedules of synthetic DMARDs should be assessed for the use of biologic DMARDs; 7) exceptionally, biologic DMARDs can be considered earlier; 8) anti-TNF agents are preferentially recommended as the initial biologic therapy; 9) after therapeutic failure of a first biologic DMARD, other biologics can be used; 10) cyclophosphamide and azathioprine can be used in severe extra-articular manifestations; 11) oral corticoid is recommended at low doses and for short periods of time; 12) non-steroidal anti-inflammatory drugs should always be prescribed in association with a DMARD; 13) clinical assessments should be performed on a monthly basis at the beginning of treatment; 14) physical therapy, rehabilitation, and occupational therapy are indicated; 15) surgical treatment is recommended to correct sequelae; 16) alternative therapy does not replace traditional therapy; 17) family planning is recommended; 18) the active search and management of comorbidities are recommended; 19) the patient's vaccination status should be recorded and updated; 20) endemic-epidemic transmissible diseases should be investigated and treated.

21 CFR 310.544 - Drug products containing active ingredients offered over-the-counter (OTC) for use as a smoking...

Science.gov (United States)

2010-04-01

... offered over-the-counter (OTC) for use as a smoking deterrent. 310.544 Section 310.544 Food and Drugs FOOD... ingredients offered over-the-counter (OTC) for use as a smoking deterrent. (a) Any product that bears labeling claims that it “helps stop or reduce the cigarette urge,” “helps break the cigarette habit,” “helps stop...

D- and I-optimal design of mixture experiments in the presence of ingredient availability constraints

OpenAIRE

SYAFITRI, Utami; SARTONO, Bagus; GOOS, Peter

2015-01-01

Mixture experiments usually involve various constraints on the proportions of the ingredients of the mixture under study. In this paper, inspired by the fact that the available stock of certain ingredients is often limited, we focus on a new type of constraint, which we refer to as an ingredient availability constraint. This type of constraint substantially complicates the search for optimal designs for mixture experiments. One difficulty, for instance, is that the optimal number of experimen...

Ingredients for Good Health Policy-Making: Incorporating Power and Politics into the Mix

Directory of Open Access Journals (Sweden)

Yusra Shawar

2014-05-01

Full Text Available Eggs, flour, sugar, butter, baking soda, milk, and vanilla extract—all ingredients necessary to make a delicious cake. Similarly, good health policy-making can only be successfully pursued and understood by accounting for all of its basic ingredients, including the role of politics and power. Otherwise, the result is simply not good.

Antioxidant and α-glucosidase inhibitory ingredients identified from Jerusalem artichoke flowers.

Science.gov (United States)

Wang, Yan-Ming; Zhao, Jian-Qiang; Yang, Jun-Li; Idong, Pema Tsering; Mei, Li-Juan; Tao, Yan-Duo; Shi, Yan-Ping

2017-11-09

Jerusalem artichoke (JA, Helianthus tuberosus L.) has been researched extensively due to its wide range of uses, but there are limited studies on its flowers. In this study, we report the first detailed phytochemical study on JA flowers, which yielded 21 compounds. Compound 4 was identified as a major water-soluble yellow pigment of JA flowers. In addition, the methanol extract of JA flowers and the isolates were evaluated for their antioxidant and α-glucosidase inhibitory activities. Among the tested compounds, compound 13 showed the strongest ABTS + free radical scavenging activity with SC 50 value of 2.30 ± 0.13 μg/mL, and compound 6 showed most potent α-glucosidase inhibitory activity with inhibition rate of 60.0% ± 10.3% at a concentration of 250 μg/mL. Results showed that methanol extract of JA flowers exhibited antioxidant and α-glucosidase inhibitory activities which could be attributed to its phenolic ingredients including chlorogenic acid derivatives, flavonoids and phenols.

Teaching musculoskeletal examination skills to UK medical students: a comparative survey of Rheumatology and Orthopaedic education practice.

Science.gov (United States)

Blake, Tim

2014-03-28

Specialists in Rheumatology and Orthopaedics are frequently involved in undergraduate teaching of musculoskeletal (MSK) examination skills. Students often report that specialty-led teaching is inconsistent, confusing and bears little resemblance to the curricula. The Gait, Arms, Legs and Spine (GALS) is a MSK screening tool that provides a standardised approach to examination despite it being fraught with disapproval and low uptake. Recent studies would appear to support innovative instructional methods of engaging learners such as patient educators and interactive small group teaching. This comparative cross-sectional survey evaluates the current state of undergraduate teaching in Rheumatology and Orthopaedics, including preferred teaching methods, attitudes towards GALS, and barriers to effective teaching. An electronic questionnaire was sent to specialist trainees and Consultants in the East and West Midlands region, representing 5 UK medical schools. Descriptive statistical data analysis was performed. There were 76 respondents representing 5 medical schools. There was a request for newer teaching methodologies to be used: multi-media computer-assisted learning (35.5%), audio-visual aids (31.6%), role-playing (19.7%), and social media (3.9%). It is evident that GALS is under-utilised with 50% of clinicians not using GALS in their teaching. There is a genuine desire for clinical educators to improve their teaching ability, collaborate more with curriculum planners, and feel valued by institutions. There remains a call for implementing a standardised approach to MSK clinical teaching to supersede GALS.

Marketing dietary supplements in the United States: A review of the requirements for new dietary ingredients

International Nuclear Information System (INIS)

Noonan, Chris; Patrick Noonan, W.

2006-01-01

Since the passage of the Dietary Supplement Health and Education Act in 1994, the marketplace for dietary supplements has experienced dramatic growth. New products have redefined the entire marketplace, and new ingredients are introduced to consumers at lightning speed. As part of this act, laws were passed to ensure the safety of new dietary ingredients introduced into the United States marketplace. But more than 11 years later, these laws are frequently misunderstood, and more frequently ignored. This article reviews the regulatory landscape of new dietary ingredients and defines the issues manufacturers must contend with to legally market dietary supplements with new dietary ingredients in the U.S

21 CFR 700.15 - Use of certain halogenated salicylanilides as ingredients in cosmetic products.

Science.gov (United States)

2010-04-01

... ingredients in cosmetic products. 700.15 Section 700.15 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS GENERAL Requirements for Specific Cosmetic Products § 700.15 Use of certain halogenated salicylanilides as ingredients in cosmetic products. (a...

Ankylosing Spondylitis Patients Commencing Biologic Therapy Have High Baseline Levels of Comorbidity: A Report from the Australian Rheumatology Association Database

Directory of Open Access Journals (Sweden)

John Oldroyd

2009-01-01

Full Text Available Aims. To compare the baseline characteristics of a population-based cohort of patients with ankylosing spondylitis (AS commencing biological therapy to the reported characteristics of bDMARD randomised controlled trials (RCTs participants. Methods. Descriptive analysis of AS participants in the Australian Rheumatology Association Database (ARAD who were commencing bDMARD therapy. Results. Up to December 2008, 389 patients with AS were enrolled in ARAD. 354 (91.0% had taken bDMARDs at some time, and 198 (55.9% completed their entry questionnaire prior to or within 6 months of commencing bDMARDs. 131 (66.1% had at least one comorbid condition, and 24 (6.8% had a previous malignancy (15 nonmelanoma skin, 4 melanoma, 2 prostate, 1 breast, cervix, and bowel. Compared with RCT participants, ARAD participants were older, had longer disease duration and higher baseline disease activity. Conclusions. AS patients commencing bDMARDs in routine care are significantly different to RCT participants and have significant baseline comorbidities.

Development and validation of an ICP-MS method for the determination of elemental impurities in TP-6076 active pharmaceutical ingredient (API) according to USP 〈232〉/〈233〉.

Science.gov (United States)

Chahrour, Osama; Malone, John; Collins, Mark; Salmon, Vrushali; Greenan, Catherine; Bombardier, Amy; Ma, Zhongze; Dunwoody, Nick

2017-10-25

The new guidelines of the United States pharmacopeia (USP), European pharmacopeia (EP) and international conference on harmonization (ICH) regulating elemental impurities limits in pharmaceuticals signify the end of unspecific analysis of metals as outlined in USP 〈231〉. The new guidelines specify both daily doses and concentration/limits of elemental impurities in pharmaceutical final products, active pharmaceutical ingredients (API) and excipients. In chapter USP 〈233〉 method implementation, validation and quality control during the analytical process are described. We herein report the use of a stabilising matrix that overcomes low spike recovery problem encountered with Os and allows the determination of all USP required elemental impurities (As, Cd, Hg, Pb, V, Cr, Ni, Mo, Cu, Pt, Pd, Ru, Rh, Os and Ir) in a single analysis. The matrix was used in the validation of a method to determine elemental impurities in TP-6076 active pharmaceutical ingredient (API) by ICP-MS according to the procedures defined in USP〈233〉 and to GMP requirements. This validation will support the regulatory submission of TP-6076 which is a novel tetracycline analogue effective against the most urgent multidrug-resistant gram-negative bacteria. Evaluation of TP-6076 in IND-enabling toxicology studies has led to the initiation of a phase 1 clinical trial. Copyright © 2017 Elsevier B.V. All rights reserved.

Standardization of the Manufacturing Process of Bee Venom Pharmacopuncture Containing Melittin as the Active Ingredient.

Science.gov (United States)

Lee, Yoonmi; Kim, Sung-Geun; Kim, In-Su; Lee, Hwa-Dong

2018-01-01

Pharmacopuncture is a unique treatment in oriental medicine that combines chemical stimulation with conventional acupuncture. However, there are no standardized methods for preparing the herbal medicines used in pharmacopuncture, and it is not clear whether the active ingredients are safe and stable. Several studies have investigated nonstandardized preparation processes, but few investigations have addressed safety and preparation methods. Pharmacopuncture may provide an alternative treatment for incurable diseases. However, it must be as valid and safe as standardized medicine. In this way, the present project may contribute to the industrialization of medicine in Korea. It may also expand health insurance coverage by promoting evidence-based medical insurance benefits. Thus, the present study attempted to standardize and improve the raw materials, preparation, and efficacy of bee venom pharmacopuncture (BVP), which is a highly effective technique in oriental medicine. To purify the crude bee venom, the extract was subjected to a stepped-gradient open column (ODS-A; 120 Å, 150 mesh). Using this method, the yield of melittin was significantly increased and the allergen proteins were effectively removed. The melittin content of the purified bee venom was determined using HPLC, and the product was then diluted to 0.1 mg/mL using injection water in preparation for BVP. In the present study, we standardized the purification process to provide safe and stable BVP by increasing the main effective components and eliminating allergens. This study will be seminal in the industrialization and regulation of BVP. We developed an effective strategy for melittin purification and allergen removal from bee venom to create safe BVP.

Advances in ingredient and processing systems for meat and meat products.

Science.gov (United States)

Weiss, Jochen; Gibis, Monika; Schuh, Valerie; Salminen, Hanna

2010-09-01

Changes in consumer demand of meat products as well as increased global competition are causing an unprecedented spur in processing and ingredient system developments within the meat manufacturing sector. Consumers demand healthier meat products that are low in salt, fat, cholesterol, nitrites and calories in general and contain in addition health-promoting bioactive components such as for example carotenoids, unsaturated fatty acids, sterols, and fibers. On the other hand, consumers expect these novel meat products with altered formulations to taste, look and smell the same way as their traditionally formulated and processed counterparts. At the same time, competition is forcing the meat processing industry to use the increasingly expensive raw material "meat" more efficiently and produce products at lower costs. With these changes in mind, this article presents a review of novel ingredient systems and processing approaches that are emerging to create high quality, affordable meat products not only in batch mode but also in large-scale continuous processes. Fat replacers, fat profile modification and cholesterol reduction techniques, new texture modifiers and alternative antioxidant and antimicrobial systems are being discussed. Modern processing equipment to establish continuously operating product manufacturing lines and that allow new meat product structures to be created and novel ingredients to be effectively utilized including vacuum fillers, grinders and fine dispersers, and slicers is reviewed in the context of structure creation in meat products. Finally, trends in future developments of ingredient and processing systems for meat products are highlighted.

A system of networks and continuing education for physical therapists in rheumatology: a feasibility study

Directory of Open Access Journals (Sweden)

J. Verhoef

2004-07-01

Full Text Available Purpose: To evaluate the feasibility of regional physical therapy networks including continuing education in rheumatology. The aim of these networks was to improve care provided by primary care physical therapists by improving specific knowledge, technical and communicative skills and the collaboration with rheumatologists. Methods: In two regions in The Netherlands continuing education (CE programmes, consisting of a 5-day postgraduate training course followed by bimonthly workshops and teaching practices, were organised simultaneously. Network activities included consultations, newsletters and the development of a communication guideline. Endpoint measures included the participation rate, compliance, quality of the CE programme, teaching practices, knowledge, network activities, communication, number of patients treated and patient satisfaction. Results: Sixty-three physical therapists out of 193 practices (33% participated in the project. They all completed the education programmes and were formally registered. All evaluations of the education programmes showed positive scores. Knowledge scores increased significantly directly after the training course and at 18 months. A draft guideline on communication between physical therapists and rheumatologists was developed, and 4 newsletters were distributed. A substantial proportion of physical therapists and rheumatologists reported improved communication at 18 months. The mean number of patients treated by physical therapists participating in the networks increased significantly. Patients' satisfaction scores within the networks were significantly higher than those from outside the networks at 18 months. Conclusions: Setting up a system of networks for continuing education for physical therapists regarding the treatment of patients with rheumatic diseases is feasible. Further research will focus on the effectiveness of the system and its implementation on a larger scale.

Effect of several food ingredients on radiation inactivation of Escherichia coli and Listeria monocytogenes inoculated into ground pork

International Nuclear Information System (INIS)

Yun, Hyejeong; Lacroix, Monique; Jung, Samooel; Kim, Keehyuk; Lee, Ju Woon; Jo, Cheorun

2011-01-01

The objective of this study was to examine the effects of several food ingredients on the relative radiation sensitivity (RRS) of Escherichia coli and Listeria monocytogenes inoculated onto ground pork. Garlic, leek, onion, and ginger were prepared in 3 different forms; pressurized, freeze-dried, and 70% ethanol extracted. The prepared food ingredients were subdivided into 2 groups, non-irradiated and irradiated with 5 kGy of gamma irradiation, before addition to ground pork. The prepared food ingredients were added at concentrations of 1% and 5% (w/w) into radiation-sterilized ground pork and inoculated with E. coli and L. monocytogenes (10 6 CFU/mL). For E. coli inoculated pork, the most efficient ingredient was ethanol extracted leek (RRS=3.89), followed by freeze-dried ginger and leek (RRS=3.66 and 3.63, respectively) when used without pasteurization. However, when the food ingredients were irradiation-pasteurized, the freeze-dried ginger showed the highest RRS (4.10). When 5% natural materials were added, RRS was the highest for freeze-dried and ethanol extracted onion (4.44 and 4.65, respectively). For L. monocytogenes, the RRS was relatively lower than E. coli in general. The most efficient material was pressurized and freeze-dried onion (RRS=2.13 and 2.08, respectively) at a concentration of 1%. No increase in RRS was observed at increased concentration of food ingredients. These results suggest that the addition of particular food ingredients increased the efficiency of radiation-sterilization. However, changes in RRS were dependent on the species of microorganism as well as the form of the food ingredients. - Highlights: → Several food ingredients increased the efficiency of irradiation sterilization. → Different forms of food ingredients may affect the efficiency. → The increase of efficiency decreased the required irradiation dose, thereby avoiding sensory impairments of food.

Effect of several food ingredients on radiation inactivation of Escherichia coli and Listeria monocytogenes inoculated into ground pork

Energy Technology Data Exchange (ETDEWEB)

Yun, Hyejeong [Department of Animal Science and Biotechnology, Chungnam National University, Daejeon 305-764 (Korea, Republic of); Lacroix, Monique [Canadian Irradiation Center, Research Laboratory in Science Applied to Food, INRS-Institut Armand-Frappier, Qebec (Canada); Jung, Samooel [Department of Animal Science and Biotechnology, Chungnam National University, Daejeon 305-764 (Korea, Republic of); Kim, Keehyuk [Department of Culinary Nutrition, Woosong University, Daejeon 300-718 (Korea, Republic of); Lee, Ju Woon [Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup 580-185 (Korea, Republic of); Jo, Cheorun, E-mail: cheorun@cnu.ac.kr [Department of Animal Science and Biotechnology, Chungnam National University, Daejeon 305-764 (Korea, Republic of)

2011-09-15

The objective of this study was to examine the effects of several food ingredients on the relative radiation sensitivity (RRS) of Escherichia coli and Listeria monocytogenes inoculated onto ground pork. Garlic, leek, onion, and ginger were prepared in 3 different forms; pressurized, freeze-dried, and 70% ethanol extracted. The prepared food ingredients were subdivided into 2 groups, non-irradiated and irradiated with 5 kGy of gamma irradiation, before addition to ground pork. The prepared food ingredients were added at concentrations of 1% and 5% (w/w) into radiation-sterilized ground pork and inoculated with E. coli and L. monocytogenes (10{sup 6} CFU/mL). For E. coli inoculated pork, the most efficient ingredient was ethanol extracted leek (RRS=3.89), followed by freeze-dried ginger and leek (RRS=3.66 and 3.63, respectively) when used without pasteurization. However, when the food ingredients were irradiation-pasteurized, the freeze-dried ginger showed the highest RRS (4.10). When 5% natural materials were added, RRS was the highest for freeze-dried and ethanol extracted onion (4.44 and 4.65, respectively). For L. monocytogenes, the RRS was relatively lower than E. coli in general. The most efficient material was pressurized and freeze-dried onion (RRS=2.13 and 2.08, respectively) at a concentration of 1%. No increase in RRS was observed at increased concentration of food ingredients. These results suggest that the addition of particular food ingredients increased the efficiency of radiation-sterilization. However, changes in RRS were dependent on the species of microorganism as well as the form of the food ingredients. - Highlights: > Several food ingredients increased the efficiency of irradiation sterilization. > Different forms of food ingredients may affect the efficiency. > The increase of efficiency decreased the required irradiation dose, thereby avoiding sensory impairments of food.

Integrating rheumatology care in the community: can shared care work?

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Lim, Anita Yn; Tan, Chuen Seng; Low, Bernadette Pl; Lau, Tang Ching; Tan, Tze Lee; Goh, Lee Gan; Teng, Gim Gee

2015-01-01

Singapore's rapidly ageing population and chronic disease burden at public hospital specialist clinics herald a silver tsunami. In Singapore, "right siting" aims to manage stable chronic disease in primary care at a lower cost. To improve the quality of rheumatology care, we created shared care between rheumatologist and family physician to reduce hospital visits. Clinical practice improvement methodology was used to structure shared care of stable patients between hospital rheumatologists and eleven community family physicians; one ran a hospital clinic. A case manager coordinated the workflow. About 220 patients entered shared care over 29 months. Patients without hospital subsidies (private patients) and private family physicians independently predicted successful shared care, defined as one cycle of alternating care. Our shared care model incorporated a case manager, systematic workflows, patient selection criteria, willing family physician partners and rheumatologists in the absence of organizational integration. Health care affordability impacts successful shared care. Government subsidy hindered right siting to private primary care. Financing systems in Singapore, at health policy level, must allow transfer of hospital subsidies to primary care, both private and public, to make it more affordable than hospital care. Structural integration will create a seamless continuum between hospital and primary care.

Cadmium contamination in cereal-based diets and diet ingredients

International Nuclear Information System (INIS)

Siitonen, P.H.; Thompson, H.C. Jr.

1990-01-01

Cereal-based diet and/or diet ingredient cadmium levels were determined by graphite furnace AAS. Cadmium contamination was 88.3 and 447 ppb in two cereal-based diets, 44.6 and 48.9 ppb in two purified diets, and ranged from less than 1.1 to 22,900 ppb in the ingredients of one cereal-based diet. The major source of cadmium contamination was attributed to the calcium supplement used for diet formulation. Comparative analyses of two purified diet samples and one cereal-based diet by the National Institute of Standards and Technology (NIST, formerly the National Bureau of Standards) and the National Center for Toxicological Research (NCTR) gave virtually identical results for Cd. A comparative study of Cd levels determined by flame and furnace AAS was also made by the NCTR and the NIST

Complications encountered in patients bearers with crest syndrome in rheumatological service of the Hospital San Juan de Dios until September 2009

International Nuclear Information System (INIS)

Mendez Rodriguez, Alexis

2010-01-01

Systematic sclerosis is a disease that has caused much morbidity and dependence in patients. Despite not being the disease most prevalent in rheumatological practice, it has been perhaps one that has generated more interest in the complex pathophysiology; but, also a great sense of frustration with the great therapeutic limitations especially when is diagnosed in advanced stages. The research was conducted in order to motivate early clinical search of the major complications found in patients CREST syndrome, in rheumatological service of the Hospital San Juan de Dios until September 2009 the total of cases with a diagnosis of CREST were reviewed in outpatient records, the study population have been of 41 patients. The different clinical manifestations of the patient were taken into account, among other aspects: immunological studies, established treatments and diagnosis methods as conventional radiology, endoscopic studies, echocardiogram, capillaroscopy. This job has determined among other things, that the majority of patients with CREST come from Desamparados and the Southern Zone, representing 31.7 and 29.2%, respectively, 98% are women and 76% of patients engaged in domestic chores and no mortality case was found in relation to CREST [es

Systemic lupus erythematosus activity and beta two microglobulin levels

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Thelma Larocca Skare

Full Text Available CONTEXT AND OBJECTIVE: Systemic lupus erythematosus (SLE is an autoimmune disease with a cyclical clinical course. Evaluation of the clinical activity of this disease is important for choosing the correct treatment. The objective of this study was to analyze the value of beta-2 microglobulin (β2M serum levels in determining SLE clinical activity.DESIGN AND SETTING: Cross-sectional analytical study conducted at the rheumatology outpatient clinic of a private university hospital.METHODS: 129 SLE patients were studied regarding disease activity using SLEDAI (SLE Disease Activity Index and cumulative damage using SLICC ACR (SLE International Collaborating Clinics/American College of Rheumatology Damage Index for SLE. At the same time, the β2M serum level, ESR (erythrocyte sedimentation rate, anti-dsDNA (anti-double-stranded DNA and C3 and C4 complement fractions were determined.RESULTS: β2M levels correlated positively with SLEDAI (P = 0.02 and ESR (P = 0.0009 and negatively with C3 (P = 0.007. Patients who were positive for anti-dsDNA had higher β2M serum levels (P = 0.009.CONCLUSION: β2M levels are elevated in SLE patients with active disease.

Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity.

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Haliloglu, Sema; Carlioglu, Ayse; Akdeniz, Derya; Karaaslan, Yasar; Kosar, Ali

2014-09-01

Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain and the presence of specific tender points. The prevalence of FM has been estimated at 2-7 % of the general global population. The presence of FM in several rheumatic diseases with a structural pathology has been reported as 11-30 %. The objectives of this study were to determine the prevalence of FM and to evaluate the possible relationship between FM existence and disease activity among rheumatic diseases. The study group included 835 patients--197 rheumatoid arthritis (RA), 67 systemic lupus erythematosus (SLE), 119 ankylosing spondylitis (AS), 238 osteoarthritis (OA), 14 familial Mediterranean fever (FMF), 53 Behçet's disease (BD), 71 gout, 25 Sjögren's syndrome (SS), 20 vasculitis, 29 polymyalgia rheumatica (PMR), and two polymyositis (PM)--with or without FM. Recorded information included age, gender, laboratory parameters, presence of fatigue, and disease activity indexes. The prevalence of FM in patients with rheumatologic diseases was found to be 6.6 % for RA, 13.4 % for SLE, 12.6 % for AS, 10.1 % for OA, 5.7 % for BD, 7.1 % for FMF, 12 % for SS, 25 % for vasculitis, 1.4 % for gout, and 6.9 % for PMR. One out of two patients with PM was diagnosed with FM. Some rheumatologic cases (AS, OA) with FM were observed mostly in female patients (p = 0.000). Also, there were significant correlations between disease activity indexes and Fibromyalgia Impact Questionnaire scores for most rheumatologic patients (RA, AS, OA, and BD) (p diseases, and its recognition is important for the optimal management of these diseases. Increased pain, physical limitations, and fatigue may be interpreted as increased activity of these diseases, and a common treatment option is the prescription of higher doses of biologic agents or corticosteroids. Considerations of the FM component in the management of rheumatologic diseases increase the likelihood of the success of the treatment.

Impact of non-binder ingredients and molecular weight of polymer binders on heat assisted twin screw dry granulation.

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Liu, Y; Thompson, M R; O'Donnell, K P

2018-01-30

Two grades of commercial AFFINISOL™ HPMC HME were used as polymer binders to explore the influence of polymer viscosity and concentration on a novel heat assisted dry granulation process with a twin screw extruder. Contributions of other non-binder ingredients in the formulations were also studied for lactose, microcrystalline cellulose and an active pharmaceutical ingredient of caffeine. As sensitive indicators of processing conditions that expose the drug to high internally generated heat, dehydration of α-lactose monohydrate and polymorphic transformation of caffeine were monitored by differential scanning calorimetry (DSC) and powder X-ray diffraction (XRD). Additionally, any decomposition of caffeine was determined by high-performance liquid chromatography (HPLC). Granular samples were characterized by particle size, circularity, fracture strength and their temperature on the exit of extruder. Higher screw speed and lower feed rate were found to help particles agglomerate by allowing feed particles a greater opportunity to increase in temperature. Lower binder molecular weight and higher binder concentration enable granules to build stronger strength and thereby lead to higher particle size. This new twin screw dry granulation was demonstrated as offering advantages over conventional hot melt granulation by minimizing thermal degradation of the tested ingredients. Copyright © 2017 Elsevier B.V. All rights reserved.

Safety Evaluation of Cosmetic Ingredients Regarding Their Skin Sensitization Potential

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Winfried Steiling

2016-03-01

Full Text Available Up to today, product safety evaluation in the EU is predominantly based on data/information on their individual ingredients. Consequently, the quality and reliability of individual ingredient data is of vital interest. In this context, the knowledge about skin sensitization potential is an explicit need for both hazard and risk assessment. Proper skin sensitization data of the individual chemicals is essential, especially when dermal contact is intended, like for cosmetics. In some cases, e.g., in the presence of irritating chemicals, the combination of individual ingredients may also need to be evaluated to cover possible mixture effects. Today, it seems unlikely or even impossible that skin sensitization in humans can be adequately described by a single test result or even by a simple combination of a few data points (in vivo or in vitro. It is becoming evident that a set of data (including human data and market data and knowledge about the ingredient’s specific sensitizing potency needs to be taken into account to enable a reliable assessment of skin sensitization. A more in-depth understanding on mechanistic details of the Adverse-Outcome-Pathway of skin sensitization could contribute key data for a robust conclusion on skin sensitization.

Conversion rates of abstracts presented at the Canadian Rheumatology Association Annual Meetings into full-text journal articles.

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Yacyshyn, Elaine A; Soong, Laura C

2017-06-01

Dissemination of research studies is important for research ideas to be transformed from initial abstracts to full publications. Analyses of the scientific impact and publication record of the Canadian Rheumatology Association (CRA) Annual meeting have not been previously described. This study determines the publication rate of abstracts presented at the CRA Annual Meetings 2005-2013 to full-text journal articles and the factors associated with publication. Program records of previous CRA meetings from 2005 to 2013 were obtained. Abstracts were searched for corresponding full-text publication in Google Scholar and PubMed using a search algorithm. Abstracts and subsequent published articles were evaluated for type of abstract, time to publication, study type, publishing journal, and journal impact factor. A total of 1401 abstracts were included in the study, 567 of which were converted to full publications. The average time to publication was 19.7 months, with 89% of abstracts published within 3 years of being presented. Eighty-three percent of abstracts were clinical in nature, and 58% of published studies were observational in design. Articles were published in a wide range of journals, with the top publisher being the Journal of Rheumatology (31%). Average time to publication was 19.7 months. Eighty-six percent of articles had a Journal Impact Factor > 2. Overall, 40.5% of abstracts presented at the CRA Annual Meetings 2005-2013 were published. Further research is needed to determine barriers and reasons for abstracts not being published as full-text articles.

The Place of Nailfold Capillaroscopy Among Instrumental Methods for Assessment of Some Peripheral Ischaemic Syndromes in Rheumatology.

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Lambova, Sevdalina N

2016-01-01

Micro- and macrovascular pathology is a frequent finding in a number of common rheumatic diseases. Secondary Raynaud's phenomenon (RP) is among the most common symptoms in systemic sclerosis and several other systemic autoimmune diseases including a broad differential diagnosis. It should be also differential from other peripheral vascular syndromes such as embolism, thrombosis, etc., some of which lead to clinical manifestation of the blue toe syndrome. The current review discusses the instrumental methods for vascular assessments. Nailfold capillaroscopy is the only method among the imaging techniques that can be used for morphological assessment of the nutritive capillaries in the nailfold area. Laser-Doppler flowmetry and laser-Doppler imaging are methods for functional assessment of microcirculation, while thermography and plethysmography reflect both blood flow in peripheral arteries and microcirculation. Doppler ultrasound and angiography visualize peripheral arteries. The choice of the appropriate instrumental method is guided by the clinical presentation. The main role of capillaroscopy is to provide differential diagnosis between primary and secondary RP. In rheumatology, capillaroscopic changes in systemic sclerosis have been recently defined as diagnostic. The appearance of abnormal capillaroscopic pattern inherits high positive predictive value for the development of a connective tissue disease that is higher than the predictive value of antinuclear antibodies. In cases of abrupt onset of peripheral ischaemia, clinical signs of critical ischaemia, unilateral or lower limb involvement, Doppler ultrasound and angiography are indicated. The most common causes for such clinical picture that may be referred to rheumatologic consultation are the antiphospholipid syndrome, mimickers of vasculitides such as atherosclerosis with cholesterol emboli, and neoplasms.

Presence of active pharmaceutical ingredients in the continuum of surface and ground water used in drinking water production.

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Ahkola, Heidi; Tuominen, Sirkku; Karlsson, Sanja; Perkola, Noora; Huttula, Timo; Saraperä, Sami; Artimo, Aki; Korpiharju, Taina; Äystö, Lauri; Fjäder, Päivi; Assmuth, Timo; Rosendahl, Kirsi; Nysten, Taina

2017-12-01

Anthropogenic chemicals in surface water and groundwater cause concern especially when the water is used in drinking water production. Due to their continuous release or spill-over at waste water treatment plants, active pharmaceutical ingredients (APIs) are constantly present in aquatic environment and despite their low concentrations, APIs can still cause effects on the organisms. In the present study, Chemcatcher passive sampling was applied in surface water, surface water intake site, and groundwater observation wells to estimate whether the selected APIs are able to end up in drinking water supply through an artificial groundwater recharge system. The API concentrations measured in conventional wastewater, surface water, and groundwater grab samples were assessed with the results obtained with passive samplers. Out of the 25 APIs studied with passive sampling, four were observed in groundwater and 21 in surface water. This suggests that many anthropogenic APIs released to waste water proceed downstream and can be detectable in groundwater recharge. Chemcatcher passive samplers have previously been used in monitoring several harmful chemicals in surface and wastewaters, but the path of chemicals to groundwater has not been studied. This study provides novel information on the suitability of the Chemcatcher passive samplers for detecting APIs in groundwater wells.

A concise evaluation and management curriculum for physicians in training improved billing at an outpatient academic rheumatology clinic.

Science.gov (United States)

Hirsh, Joel M; Collier, David H; Boyle, Dennis J; Gardner, Edward M

2010-04-01

To study whether providing house staff with a brief lecture and handout about proper documentation could improve billing at an academic rheumatology clinic. The authors created an educational sheet about documentation and billing after a review of the common documentation omissions responsible for down coding (Appendix, Supplemental Digital Content 1, available at: http://links.lww.com/RHU/A8). Beginning in November of 2006, the house staff were provided with this sheet and a brief lecture regarding how outpatient evaluation and management levels of service are coded. The results of clinic billing from January 1, 2006 to October 31, 2006 and November 1, 2006 to August 31, 2007 were obtained from the physician billing office. The authors compared the average level of service, by appointment type, in the prepost comparison periods using the student t test. There was a significant improvement in the level of service billed for new visits (P < 0.001), consults (P < 0.001), and return visits (P < 0.001) after November 1, 2006. The percentage of patients evaluated for the first time who were billed as consults improved from 15% to 78% (P < 0.001 by chi2). These changes resulted in $34,342 of additional billing during the postintervention period. A simple strategy for educating the house staff about proper documentation of the history, physical examination, and clinical decision making resulted in a significant improvement in an academic rheumatology division's outpatient billing.

Italian Society of Rheumatology (SIR recommendations for performing arthrocentesis

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A. Spadaro

2011-09-01

Full Text Available Joint fluid aspiration, or arthrocentesis, is one of the most useful and commonly performed procedures for the diagnosis and treatment of rheumatic diseases, but to date no definite guidelines have been published. For this reason, a group of experts of the Italian Society of Rheumatology (SIR produced evidence based recommendations for performing arthrocentesis. Among them, the most relevant are: a arthrocentesis is necessary when synovial effusion of unknown origin is present, especially if septic or crystal arthritis is suspected; b the patient should be clearly informed of the benefits and risks of the procedure in order to give an informed consent; c ultrasonography should be used to facilitate arthrocentesis in difficult joints; d fluid evacuation often has a therapeutic effect and facilitates the success of the following intraarticular injection; e careful skin disinfection and the use of sterile, disposable material is mandatory for avoiding septic complications. Disposable, non sterile gloves should always be used by the operator, mainly for his own protection; f contraindications are the presence of skin lesions or infections in the area of the puncture; g the patient’s anticoagulant treatment is not a contraindication, providing the therapeutic range is not exceeded; h joint rest after arthrocentesis is not indicated. Several of these recommendations were based on experts’ opinion rather than on published evidence which is scanty.

Active pharmaceutical ingredients entering the aquatic environment from wastewater treatment works: A cause for concern?

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Comber, Sean; Gardner, Mike; Sörme, Pernilla; Leverett, Dean; Ellor, Brian

2018-02-01

This work reports on the variation in wastewater treatment works (WwTW) influent concentrations of a wide variety of active pharmaceutical ingredients (APIs), their removal efficiency, effluent concentrations and potential risks to the aquatic environment. The research is based on data generated from two large UK-wide WwTW monitoring programmes. Taking account of removal of parent compound from the aqueous phase during treatment in combination with estimates of dilution available it is possible to prioritise the APIs of greatest risk of exceeding estimates of predicted no effect concentrations (PNEC) in receiving waters for all WwTW in the UK. The majority of substances studied were removed to a high degree, although with significant variation, both within and between WwTW. Poorer removal (between influent and effluent) was observed for ethinyloestradiol, diclofenac, propranolol, the macrolide antibiotics, fluoxetine, tamoxifen and carbamazepine. All except the last two of these substances were present in effluents at concentrations higher than their respective estimated PNEC (based on measurement of effluents from 45 WwTW on 20 occasions). Based on available dilution data as many as 890 WwTW in the UK (approximately 13% of all WwTW) may cause exceedances of estimated riverine PNECs after mixing of their effluents with receiving waters. The overall degree of risk is driven by the toxicity value selected, which in itself is controlled by the availability of reliable and relevant ecotoxicological data and consequently the safety factors applied. The dataset and discussion, provides information to assist in the future management of these types of chemicals. Copyright © 2017 Elsevier B.V. All rights reserved.

Standardization of the Manufacturing Process of Bee Venom Pharmacopuncture Containing Melittin as the Active Ingredient

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Yoonmi Lee

2018-01-01

Full Text Available Background. Pharmacopuncture is a unique treatment in oriental medicine that combines chemical stimulation with conventional acupuncture. However, there are no standardized methods for preparing the herbal medicines used in pharmacopuncture, and it is not clear whether the active ingredients are safe and stable. Several studies have investigated nonstandardized preparation processes, but few investigations have addressed safety and preparation methods. Pharmacopuncture may provide an alternative treatment for incurable diseases. However, it must be as valid and safe as standardized medicine. In this way, the present project may contribute to the industrialization of medicine in Korea. It may also expand health insurance coverage by promoting evidence-based medical insurance benefits. Thus, the present study attempted to standardize and improve the raw materials, preparation, and efficacy of bee venom pharmacopuncture (BVP, which is a highly effective technique in oriental medicine. Method. To purify the crude bee venom, the extract was subjected to a stepped-gradient open column (ODS-A; 120 Å, 150 mesh. Using this method, the yield of melittin was significantly increased and the allergen proteins were effectively removed. The melittin content of the purified bee venom was determined using HPLC, and the product was then diluted to 0.1 mg/mL using injection water in preparation for BVP. Results. In the present study, we standardized the purification process to provide safe and stable BVP by increasing the main effective components and eliminating allergens. This study will be seminal in the industrialization and regulation of BVP. Conclusion. We developed an effective strategy for melittin purification and allergen removal from bee venom to create safe BVP.

Cosmetic Ingredients as Emerging Pollutants of Environmental and Health Concern. A Mini-Review

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Claudia Juliano

2017-04-01

Full Text Available Cosmetic and personal care products are used in huge quantities throughout the world; as a result of their regular use, they are continuously released into the environment in very large amounts. Many of these products are biologically active and are characterized by persistence and bioaccumulation potential, posing a threat to ecosystem and human health. On the basis of the most recent scientific literature available on this subject, this paper provides an overview of some cosmetic ingredients that are considered environmental emerging pollutants of particular concern such as UV filters, some preservatives (parabens, triclosan, and microplastics.

Current trends in medical English education and the Japan College of Rheumatology International School.

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Jego, Eric Hajime; Amengual, Olga

2017-11-01

In light of the present revolution happening in medical education in Japan as medical schools implement new curricula to conform to global standards, there is a growing demand for more internationalization and higher quality practical medical English education. In response, many institutions including governmental organizations, universities and academic associations are moving ahead with new initiatives to adapt to these changing demands. This paper reviews the current trends and innovations in medical English education in Japan. This paper also describes one initiative by the Japan College of Rheumatology (JCR) known as the JCR International School held yearly in Karuizawa. By examining recent trends and innovations in medical English education in Japan, the most relevant and applicable can be elucidated to illuminate a path forward for improved medical English education within the JCR.

7 CFR 58.634 - Assembling and combining mix ingredients.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Assembling and combining mix ingredients. 58.634 Section 58.634 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

Drug Pollution from Manufacturing and Antimicrobial Resistance: How Does the European Union Manage the Potential Environmental and Health Risks of Importing Pharmaceutical Active Ingredients From Third Countries?

DEFF Research Database (Denmark)

le Gal, Elodie Jeanine Odette

pollution and anti-micro-bacterial resistance within their own borders by buying and importing drugs manufactured in third countries, such as India and China. With a focus on drug pollution from manufacturing, the goal of this paper is to explore the European drug import safety regime. It intends to better...... and environmental failures. Over the past three decades, the scientific literature has been increasingly reporting case studies on environmental pollution from drug manufacturing, human excretions and improper disposal of unused or expired drug residues in different parts of the world. Active ingredients, which...... are responsible for the biological activity of drugs, have been identified as the main vector of pharmaceutical pollution. Associated with the environmental risk of pharmaceutical pollution in soils and waterways is the predicted risk of antimicrobial resistance (AMR) expected to increase and to dramatically...

A Limited Survey of Aflatoxins in Poultry Feed and Feed Ingredients in Guyana

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Donna M. Morrison

2017-11-01

Full Text Available A study was conducted to determine the presence of aflatoxins in finished poultry feed from manufacturing companies, feed ingredients, and poultry feed at the point of sale. Two collections were made. In the first collection, samples of the finished feed and feed ingredients were analyzed by high-performance liquid chromatography (HPLC. For the second collection, all samples were analyzed by ELISA while a subset was analyzed by HPLC. Of the 27 samples of finished feed, five samples had aflatoxin concentrations greater than the United States Food and Drug Administration (USFDA and European Union Commission (EUC maximum tolerable limit of 20 µg/kg, while for the feed ingredients, three of the 30 samples of feed ingredients exceeded the limit. Of the 93 samples of finished feed purchased from retailers, five samples had aflatoxin concentrations greater than the maximum tolerable limit. This survey indicates that most of the samples were below the maximum regulatory limit and maintained quality up to the point of sale for 2015 and 2016. However, given that some samples were above the limit, there is a need to monitor the production and marketing chain to ensure that the quality of the finished feed is not compromised.

Effect of several food ingredients on radiation inactivation of Escherichia coli and Listeria monocytogenes inoculated into ground pork

Science.gov (United States)

Yun, Hyejeong; Lacroix, Monique; Jung, Samooel; Kim, Keehyuk; Lee, Ju Woon; Jo, Cheorun

2011-09-01

The objective of this study was to examine the effects of several food ingredients on the relative radiation sensitivity (RRS) of Escherichia coli and Listeria monocytogenes inoculated onto ground pork. Garlic, leek, onion, and ginger were prepared in 3 different forms; pressurized, freeze-dried, and 70% ethanol extracted. The prepared food ingredients were subdivided into 2 groups, non-irradiated and irradiated with 5 kGy of gamma irradiation, before addition to ground pork. The prepared food ingredients were added at concentrations of 1% and 5% (w/w) into radiation-sterilized ground pork and inoculated with E. coli and L. monocytogenes (10 6 CFU/mL). For E. coli inoculated pork, the most efficient ingredient was ethanol extracted leek (RRS=3.89), followed by freeze-dried ginger and leek (RRS=3.66 and 3.63, respectively) when used without pasteurization. However, when the food ingredients were irradiation-pasteurized, the freeze-dried ginger showed the highest RRS (4.10). When 5% natural materials were added, RRS was the highest for freeze-dried and ethanol extracted onion (4.44 and 4.65, respectively). For L. monocytogenes, the RRS was relatively lower than E. coli in general. The most efficient material was pressurized and freeze-dried onion (RRS=2.13 and 2.08, respectively) at a concentration of 1%. No increase in RRS was observed at increased concentration of food ingredients. These results suggest that the addition of particular food ingredients increased the efficiency of radiation-sterilization. However, changes in RRS were dependent on the species of microorganism as well as the form of the food ingredients.

Sensory and physicochemical characteristics of salamis added with vegetable-based curing ingredients

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Vicky Lilge Kawski

Full Text Available ABSTRACT: The aim of this study was to evaluate the sensory and physicochemical quality of colonial salamis added with vegetable-based curing ingredients as potential enhancers of quality products. Salamis were produced according to three treatments: (A Control: 0.1% curing salt; (B rosemary: 0.05% curing salt + 0.5% rosemary extract (RE; and (C RE+celery: 0.14% Veg 503 + 0.27% Veg 504 (sea salt plus celery, nitrate and nitrite supplies, respectively + 0.5% of RE. No significant differences were observed (P>0.05 among the three treatments for dry matter (DM, crude protein (CP, ash, ether extract (EE and gross energy (GE. Sensory analysis was performed by applying the preference test and multiple comparison between the three treatments. Salamis added with vegetable-based curing ingredients were sensory equivalent to conventional level of curing salts. Vegetable extracts allowed the development of the sensory features of salami and did not interfere in the fermentation process. Results suggested that the extracts can serve as effective natural curing ingredients for the ripening process and cured meat color as well as adequate shelf-life replacing the commercial curing salts in meat and meat products. After 30 days of ripening, salami from the control treatment (conventional levels of nitrite and nitrate and the treatments with added vegetable-based curing ingredients and low nitrite and nitrate content (RE and RE + celery were equivalent in sensory quality.

Updates on chemical and biological research on botanical ingredients in dietary supplements.

Science.gov (United States)

Pawar, Rahul S; Tamta, Hemlata; Ma, Jun; Krynitsky, Alexander J; Grundel, Erich; Wamer, Wayne G; Rader, Jeanne I

2013-05-01

Increased use of dietary supplements is a phenomenon observed worldwide. In the USA, more than 40% of the population recently reported using complementary and alternative medicines, including botanical dietary supplements. Perceptions that such dietary supplements are natural and safe, may prevent disease, may replace prescription medicines, or may make up for a poor diet, play important roles in their increased use. Toxicity of botanical dietary supplements may result from the presence of naturally occurring toxic constituents or from contamination or adulteration with pharmaceutical agents, heavy metals, mycotoxins, pesticides, or bacteria, misidentification of a plant species in a product, formation of electrophilic metabolites, organ-specific reactions, or botanical-drug interactions. The topics discussed in this review illustrate several issues in recent research on botanical ingredients in dietary supplements. These include (1) whether 1,3-dimethylamylamine is a natural constituent of rose geranium (Pelargonium graveolens), (2) how analysis of the components of dietary supplements containing bitter melon (Momordica charantia) is essential to understanding their potential biological effects, and (3) how evolving methods for in vitro studies on botanical ingredients can contribute to safety evaluations. The virtual explosion in the use of botanical ingredients in hundreds of products presents a considerable challenge to the analytical community, and the need for appropriate methods cannot be overstated. We review recent developments and use of newer and increasingly sensitive methods that can contribute to increasing the safety and quality of botanical ingredients in dietary supplements.

VIRAL HEPATITIS B AND C AS COMORBIDITY IN RHEUMATIC DISEASES: ANALYSIS OF THE DATA OF THE V.A. NASONOVA RESEARCH INSTITUTE OF RHEUMATOLOGY CLINIC OVER 4 YEARS

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A. E. Karateev

2016-01-01

Full Text Available Hepatitis B virus (HBV and hepatitis C virus (HCV infection is a serious problem that substantially hinders the treatment of patients with rheumatic diseases (RD particular when there is a need for using cytotoxic and biological agents (BAs.Objective: to estimate the rate of HBV and HCV infection in RD patients followed up at the V.A. Nasonova Research Institute of Rheumatology Clinic in 2011 to 2014.Subjects and methods. All case histories of the RD patients hospitalized in the given period were analyzed. Infection with HBV and HCV was assessed from the presence of HBsAg and anti-HCV, respectively.Results and discussion. There were a total of 16,553 admissions to the V.A. Nasonova Research Institute of Rheumatology Clinic over 4 years. HBV and HCV were detected in 0.33 and 0.74%, respectively; their combination was found in 0.03% (a total of 1.1% of the patients. About half of the patients took cytotoxic agents and glucocorticoids; 29.8% received BAs, mainly rituximab. Moderate and high chronic hepatitis activity was noted in 4.9% of the patients; liver cirrhosis was observed in 2.7%. Over the follow-up period, alanine aminotransferase and aspartate aminotransferase levels were not elevated in the vast majority of patients.Conclusion. HBV and HCV infection is often detected in patients with RD. The infected patients and persons with chronic viral hepatitis require careful follow-up and the decision whether to perform prophylactic antiviral therapy when using cytotoxic agents and BAs.

The catalyst layer and its dimensionality - A look into its ingredients and how to characterize their effects

Science.gov (United States)

Zamel, Nada

2016-03-01

Development of polymer electrolyte membrane (PEM) fuel cells throughout the years is established through its component optimization. This is especially true of its catalyst layer, where structuring of the layer has led to many breakthroughs. The catalyst layer acts as the heart of the cell, where it controls the half-cell reactions and their products. The complex nature of various transport phenomena simultaneously taking place in the layer requires the layer to be heterogeneous in structure. Hence, a delicate balance of the layer's ingredients, coupled with the understanding of the ingredients' interaction, is required. State-of-the-art catalyst layers are composed of a catalyst, its support, a solvent and a binder. Changes in the morphology, structure or material of any of these components ultimately affects the layer's activity and durability. In this review paper, we provide an overview of the various works tailored to understand how each component in the catalyst's ink affects the stability and life-time of the layer.