DOCSLIB.ORG

Adverse Effects of Xenogenic Scaffolding in the Context of A

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Adverse Effects of Xenogenic Scaffolding in the Context of A Lamas et al. Trials (2019) 20:387 https://doi.org/10.1186/s13063-019-3504-3 RESEARCH Open Access Adverse effects of xenogenic scaffolding in the context of a randomized double-blind placebo-controlled study for repairing full- thickness rotator cuff tears José Ramón Lamas1†, Carlos García-Fernández2, Pilar Tornero-Esteban1, Yaiza Lópiz2, Luis Rodriguez-Rodriguez1, Luis Ortega3, Benjamín Fernández-Gutiérrez1*† and Fernando Marco2† Abstract Purpose: The purpose of the study was to compare the safety and efficacy of autologous mesenchymal stem cells (MSCs) embedded in a xenogenic scaffold for repairing the supraspinatus tendon. Methods: This was a randomized, double-blind and placebo-controlled trial evaluating patients with full-thickness rotator cuff tears (Eudra-CT, 2007–007630-19). Effectiveness was evaluated using the Constant score and a visual analogue pain scale (VAS). Constant score has four domains including pain (15 possible points), activities of daily living (20 possible points), mobility (40 possible points), and strength (25 possible points). Scores range from 0 points (most disability) to 100 points (least disability). The structural integrity of the repaired tendon was assessed by magnetic resonance imaging (MRI) according to Patte and Thomazeau classification criteria. The primary study end point was an improvement in the Constant score by 20 points at one year compared to initial assessment. Results: The trial was stopped due to adverse effects observed in both groups. Only thirteen patients were included and analyzed. The Constant questionnaire showed a significant improvement in the MSC treatment group compared with the preoperative data (p = 0.0073). Secondary outcome measures were similar in both groups. Conclusions: Our study showed preliminary inconclusive clinical outcomes in the patients treated with MSCs. Adverse events revealed the need for further approaches using scaffolds of a different nature or perhaps no scaffolds, in the context of small joints. Trial registration: Eudra-CT, 2007-007630-19. Registered on 30 January 2008. Level of evidence: ALevel1ofevidencetreatmentstudy. Keywords: Xenogenic matrix, Mesenchymal stem cells, Clinical trial, Comparative effectiveness, Functional status, Rotator cuff * Correspondence: [email protected] †José Ramón Lamas, Benjamín Fernández-Gutiérrez and Fernando Marco share the senior authorship. 1UGC de Reumatología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Lamas et al. Trials (2019) 20:387 Page 2 of 9 Background Autologous tissue-specific cells are the gold standard The shoulder is the most mobile joint in the body, provi- for cell therapies to overcome the limited capacity for ding multiple degrees of motion. Shoulder biomechanics self-regeneration of tendons, particularly in rotator cuff are based on the interaction of multiple structures per- ruptures; however, isolation of tenocytes in adequate fectly adjusted to provide its function. Particularly, the numbers is difficult, due to their highly dense tendon rotator cuff, an anatomical term defining a set of muscles extracellular matrix (ECM). Other cell sources are and tendons, is responsible for shoulder stabilization, necessary for tendon repair and mesenchymal stem cells centring of the humeral head in place and mobility and (MSCs) have been proposed as the best source [26, 28, participating in the abduction and external rotation move- 30]. MSCs have multipotent differentiation in cells of ments that lift and rotate the humerus [36]. Defects or mesenchymal lineage and with their observed reparative lesions in this structure can cause considerable tissue effects in many clinical and preclinical models, suggest- damage including cuff tendon ruptures, pain associated ing they are crucial in injury healing as well as modulat- with shoulder motion, edema, inflammation and disability. ing the immune response [11, 32]. Clinical application of Rotator cuff tear is a common shoulder disease MSCs in animal models of tendon healing has also been increasing with age and previous trauma. Its prevalence subject of research by our group and others, reporting ranges between 4% in asymptomatic patients below the benefits of MSCs in relation to the biomechanical 40 years and 54% in patients over 60 years of age [9]. and histological properties of tendons [5, 31, 34]. Tears are the consequence of trauma or they develop However, despite the apparent advantages of MSCs in gradually due to mechanical and/or inflammatory pro- animal models of tendon repair, there are only prelimin- cesses. They cause pain, shoulder weakness and upper ary results reported in humans [19]. Therefore, the aim extremity disability. Medical management of these symp- of this study was to assess the ability of MSCs to repair toms includes the use of conservative treatments with rotator cuff tendon injuries in humans, to enhance nonsteroidal anti-inflammatory drugs (NSAIDs), cortico- shoulder function and the patient’s perception of im- steroid injections and physiotherapy [21]. provement. For this purpose, we conducted a controlled Despite the improvement in surgical techniques, ten- and randomized trial combining, or not, autologous don function is often unrecoverable. Currently there is MSCs augmented with a commercially available xeno- no clear evidence supporting or refuting the efficacy of geneic ECM of type I collagen. current surgical interventions for rotator cuff tears [15]. In fact, outcomes vary tremendously, with failure rates Methods as high as 25%, 35% and even 90% depending on the tear Study design and patients size and follow-up time [1, 7, 17, 22, 23, 38]. These dis- This was a one-year prospective, randomized, double- appointing outcomes highlight the need for alternative blind and placebo-controlled trial of patients from a therapeutic approaches allowing better restoration of single center with confirmed full-thickness rotator cuff tendon functionality after injury. tears. We included 32 eligible patients (48–66 years old) Tendons are capable of self-regeneration but this in the initial design of the study. Patients were enrolled capability is limited when the defects to be repaired are consecutively (from January 2011 to November 2012) extensive. In addition, repair challenges are highly in- after simple randomization of subjects to each treatment fluenced by mechanical loads on this anatomical structure, group. Random assignment was performed using Micro- and often, by degeneration in a tendon at the time of soft Excel randomization functions. Inclusion criteria surgery. The goal of treatment, particularly in the context were established by the orthopedic surgeons involved in of regenerative medicine, has focused on augmenting the study. These criteria were patients with unilateral suture fixation with several biologic collagen-rich scaffolds shoulder pain and positive magnetic resonance imaging such as human dermal allografts [2], crosslinked acellular (MRI) diagnosis of full-thickness rotator cuff tear, and porcine patches [12], and other bioengineered commercial patients had to have been refractory to conventional extracellular matrix materials [14]. These grafts increase medical treatment and/or rehabilitation for at least 3 the suture strength and provide a similar biochemical months. All patients enrolled gave their written in- composition to that of the tendon; however, they fail to formed consent and the study was approved following improve rotator cuff tendon healing or its biomechanical the guidelines of the institutional ethics committee functions. This failure has been attributed to differences (Comité Ético de Investigación Clínica Hospital Clínico in elasticity between grafts and native tendons. San Carlos–Madrid). Other strategies carried out using growth factors, plasma The exclusion criteria were rheumatic disease, gleno- rich in growth factors or fibrin clots promote tissue re- humeral osteoarthritis, fractures, diabetes mellitus, in- generation but they do not provide clear biomechanical fections or tumors. The treatment group was composed benefits when compared to untreated controls [29]. of patients treated with 20.106 autologous bone marrow Lamas et al. Trials (2019) 20:387 Page 3 of 9 (BM)-MSCs in combination with a type I collagen mem- surgeon’s knowledge of the group to which the patient brane (OrthADAPT™). The control group was composed belonged. The implant was then cut to the required size of patients treated only with type I collagen membrane. for the lesion augmentation. The bioimplant (either with or without BM-MSCs) was always sutured in the same Outcome measures fashion, facing the tendon over the repaired cuff. It was Functional results were assessed by the Constant score initially fixed to bone with the same sutures from
Load more

Recommended publications
  • (12) United States Patent (10) Patent No.: US 7.427.405 B2 Agrawal Et Al
    USOO7427405B2 (12) United States Patent (10) Patent No.: US 7.427.405 B2 Agrawal et al. (45) Date of Patent: Sep. 23, 2008 (54) IMMUNOSTIMULATORY Tokunaga et al., “Antitumor Activity of Deoxyribonucleic Acid Frac OLGONUCLEOTDE MULTIMERS tion from Mycobaterium bovis BCG. I. Isolation. Physicochemical Characterization, and Antitumor Activity”. J. Natl. Cancer Inst. 72: (75) Inventors: Sudhir Agrawal, Shrewsbury, MA (US); 955-962(1984). Pisetsky et al., “Stimulation of in vitro proliferation of murine lym Ekambar Kandimala, Southboro, MA phocytes by synthetic oligodeoxynucleotides'. Molecular Biology (US); Dong Yu, Westboro, MA (US) Reports 18:217-221 (1993). Krieg et al., “CpG motifs in bacterial DNA trigger direct B-cell (73) Assignee: Idera Pharmaceuticals, Inc., activation”, Nature 374: 546-549 (1995). Cambridge, MA (US) Sato et al., “Immunostimulatory DNA Sequence Necessary for Effective Intradermal Gene Immunization', Science 273: 352-354 (*) Notice: Subject to any disclaimer, the term of this (1996). patent is extended or adjusted under 35 Krieg et al., “CpG Motifs in Bacterial DNA and their Immune U.S.C. 154(b) by 209 days. Effects”, Annu. Rev. Immunol. 20: 709-760 (2002). Dalpke et al., “Immunopharmacology of CpG DNA'. Biol. Chem. (21) Appl. No.: 11/174,282 383: 1491-1500 (2002). Kandimala et al., “Towards Optimal Design of Second-Generation (22) Filed: Jul. 1, 2005 Immunomodulatory Oligonucleotides'. Curr. Opin. Mol. Ther. 4(2): 122-129 (2002). (65) Prior Publication Data Kandimala et al., “Immunomers-novel 3'-3'-Linked CpG Oligodeoxyribonucleotides as Potent Immunomodulatory Agents'. US 2006/OO19919 A1 Jan. 26, 2006 Nucleic Acids Res. 30: 4460-4469 (2002). Kandimala et al.
    [Show full text]
  • Journal of Arthroscopy and Joint Surgery 6 (2019) 98E102
    Journal of Arthroscopy and Joint Surgery 6 (2019) 98e102 Contents lists available at ScienceDirect Journal of Arthroscopy and Joint Surgery journal homepage: www.elsevier.com/locate/jajs Comparative evaluation of periarticular infiltration of two cocktail regimens for analgesia in post-operative patients of total knee replacement * V.K. Gautam a, Ajeet Kumar a, Munisha Agarwal b, Bushu Harna a, , Rishabh Saini a, Siddharth Sharma a, Dhananjaya Sabat a a Dept. of Orthopaedics, Maulana Azad Medical College, New Delhi, India b Dept. of Anaesthesia, Maulana Azad Medical College, New Delhi, India article info abstract Article history: Purpose: To compare the efficacy of two periarticular cocktail regimens for analgesia in postoperative Received 30 April 2018 patients of total knee replacement. Received in revised form Method: This is a Randomized Control study done over the duration of 1.5 years. Twenty-five knees of 28 October 2018 either gender were selected with inclusion criteria (All osteoarthritis patients planned for TKA) and Accepted 9 November 2018 exclusion criteria (Inflammatory arthritis, patients allergic to local anaesthetic e.g. Ropivacaine, bupi- Available online 19 November 2018 vacaine, known cardiac disorder patient having AV block, arrhythmia) & divided into 2 groups. Group A was given a cocktail of Ropivacaine, adrenaline, clonidine & cefuroxime. Keywords: & Periarticular Group B was given a cocktail of bupivacaine, fentanyl, methylprednisolone cefuroxime. The preoper- Multimodal approach ative pain of the patient was assessed using VAS score. Combined spinal and epidural anaesthesia was Perioperative analgesia given using 0.5% 2 ml of bupivacaine heavy in all patients. After taking bone cuts & before the placement Corticosteroids of the implant, cocktail of the drug was infiltrated using sterile technique into 9 specific sites.
    [Show full text]
  • New Zealand Regulatory Guidelines for Medicines
    New Zealand Regulatory Guidelines for Medicines Part G: Resources Edition 6.13 March 2011 (consolidation of fifth edition and subsequent updates) Table of Contents PART G: RESOURCES Section 1: Description of Dosage Form...............................................................................2 Section 2: Routes of Administration....................................................................................4 Section 3: Shelf Life and Storage Conditions .....................................................................5 Section 4: Abbreviations.......................................................................................................6 Description of Dosage Form The dosage form description for a product should be selected from the following list: Block Granules, oral Capsule Implant, subcutaneous Capsule, combination Implant, intracranial Capsule, liquid filled Implant, intraocular Capsule, modified release Infusion, concentrate Capsule, powder filled Infusion, emulsion Capsule, powder filled, nasal inhalation Infusion, powder for Capsule, soft gelatin Infusion, powder for concentrate Cement, bone, liquid component Infusion, solution Cement, bone, powder component Inhalation, capsule, liquid filled Cement, dental Inhalation, capsule, powder filled Chewing gum Inhalation, powder Chocolate, medicated Inhalation, solution Combination Inhalation, solution, powder for Condom, medicated Inhalation, suspension Condom with spermicide Inhalation, volatile liquid Cream, rectal Inhaler, aerosol, metered Cream, topical Injection
    [Show full text]
  • JMSCR Vol||05||Issue||01||Page 15625-15629||January 2017
    JMSCR Vol||05||Issue||01||Page 15625-15629||January 2017 www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i1.71 Transdermal Patch: A Comprehensive Overview of Newer Drug Delivery System in Modern Medical Science Authors Dr Neelkanth Kote1, Dr. Poornima B2 Department of Physiology and Department of Pharmacology Raja Rajeswari Medical Collegeand Hospital Bangalore, Karnataka– 560074 Corresponding Author Dr Neelkanth Kote Department of Physiology, RRMC Bangalore, Karnataka -560074 Email: [email protected] Abstract Background: Oral route of drug administration has been the most common route of drug administration since the beginning of the therapeuticarea in medical science. However this route of drug administration fails at bypassing the first pass metabolism of the drug in liver with poor bio availability. Oral route of drug administration also fails in uncooperative /unconscious semiconscious / pediatric subjects. Transdermal patch, a new drug delivery system through skin to the parenteral circulation has been the most recently discussed topic in pharmacology and medicine as it is a noninvasive route of drug administration, delivered in a sustained / pre fixed dosage with no / extremely less first pass metabolism and better bio availability. Most importantly it can be used in semiconscious / unconscious & pediatric subjects without affecting their hemodynamics. The transdermal patches have many beneficial factors however they also come with some major drawbacks like varieties of formulation, design and quality of adhesiveness. This articles provides an insight of transdermal patch in terms of its mechanism of action, advantages, disadvantages and future scope of it in the medical science.
    [Show full text]
  • WV Medical Cannabis Act
    Medical Cannabis Overview Legalized Marijuana • Medical marijuana is legal in 33 states and D.C. • Recreational marijuana is legal in 10 states and D.C. The Endocannabinoid System (ECS) • Anandamide (AEA) • Arachidonoylgycerol (2-AG) • Receptors: • CB1 • CB2 Cannabinoids • Three principle cannabinoids in cannabis: • Tetrahydrocannibinol (THC) • Cannabidiol (CBD)—the primary cannabinoid in medical marijuana • Cannabinol (CBN) Dr. Ralph Mechoulam GW Pharmaceuticals • Epidiolex—purified CBD used to control seizures • Sativex—for treatment of spasticity due to MS WV Medical Cannabis Act • Becomes effective July 1, 2019 • To be implemented and administered by Public Heath Bureau • Requires a “serious medical condition” to be certified Qualifying Medical Conditions • Cancer • Huntington’s disease • HIV • Crohn’s Disease • Amyotrophic lateral • PTSD sclerosis • Intractable seizures • Parkinson’s • Sickle cell anemia • MS • Severe chronic pain • Spinal cord damage • Terminally ill • Epilepsy • Neuropathies Lawful Use • Medical cannabis may only be dispensed to: • A patient who receives a certification from a practitioner and is in possession of a valid ID card from bureau • A caregiver in possession of valid ID card from bureau Acceptable Forms • Pill • Oil • Topical forms, including gels, creams, or ointment • A form medical appropriate for administration by vaporization or nebulization (excluding dry leaf or plant form) • Tincture • Liquid • Dermal patch Unlawful Use • Smoking and edible cannabis • No joints or brownies • Growing, unless the
    [Show full text]
  • WO 2017/172802 Al 5 October 2017 (05.10.2017) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2017/172802 Al 5 October 2017 (05.10.2017) P O P C T (51) International Patent Classification: 1 DNA Way, South San Francisco, California 94080-4990 C07C 381/10 (2006.01) C07D 211/22 (2006.01) (US). C07D 401/12 (2006.01) C07D 211/42 (2006.01) (74) Agents: HARRIS, Robert J. et al; Viksnins Harris & C07D 205/04 (2006.01) C07D 213/69 (2006.01) Padys PLLP, 785 1 Metro Parkway, Suite 325, Blooming- (21) International Application Number: ton, Minnesota 55425 (US). PCT/US2017/024584 (81) Designated States (unless otherwise indicated, for every (22) International Filing Date: kind of national protection available): AE, AG, AL, AM, 28 March 2017 (28.03.2017) AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DJ, DK, DM, (25) Filing Language: English DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (26) Publication Language: English HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KH, KN, KP, KR, KW, KZ, LA, LC, LK, LR, LS, LU, LY, MA, (30) Priority Data: MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, 62/3 15,469 30 March 2016 (30.03.2016) US NI, NO, NZ, OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, (71) Applicants: GENENTECH, INC. [US/US]; 1 DNA Way, RU, RW, SA, SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, South San Francisco, California 94080-4990 (US).
    [Show full text]
  • Literature and Registry Review
    _____________________________________________________________________________________ Literature and Registry Review 2005 - 2015 ______________________________________________________________________ “HEMICAP RESURFACING PROVIDES A UNIQUE AND FAVORABLE ALTERNATIVE TO PRIOR IMPLANT DESIGNS BY PROVIDING ANATOMIC RE-APPROXIMATION” Patellofemoral Kinematics After Limited Resurfacing of the Trochlea. Provencher M, Ghodadra N, Verma N, Cole BJ, Zaire S, Shewman E, Bach B. J Knee Surg. 2009;22:310-316 ______________________________________________________________________ Matthias R. Schurhoff _____________________________________________________________________________________ Arthrosurface Literature and Registry Review 2005-2015 _____________________________________________________________________________________________ Foreword his report is a review of the past decade outlining the introduction of inlay arthroplasty for arthrosis, early T arthritis and traumatic lesions. Arthrosurface, Inc. (Franklin, MA) was launched in 2002 bringing innovation and a sports medicine approach to primary arthroplasty. In the past decade, Arthrosurface has invested and re-invested more than $100 Million dollars in the development and commercialization of patient specific joint solutions that place the individual patient at the forefront of clinical decision making. The intraoperative choice of implant diameters and contour shapes allow the surgeon to not only cover the defect effectively, but also fit the implant to the patient while preserving healthy bone
    [Show full text]
  • Transdermal Drug Delivery System: a Review
    Indian Journal of Pharmacy and Pharmacology 2021;8(1):5–9 Content available at: https://www.ipinnovative.com/open-access-journals Indian Journal of Pharmacy and Pharmacology Journal homepage: https://www.ijpp.org.in/ Review Article Transdermal drug delivery system: A review Neha Choudhary1,*, Ajeet Pal Singh1, Amar Pal Singh1 1St. Soldier Institute of Pharmacy, Lidhran Campus, Jalandhar, Punjab, India ARTICLEINFO ABSTRACT Article history: Transdermal Drug Delivery System is controlled medicated that is set on the skin to deliver a particular Received 15-03-2021 portion of medicine through the skin and into the circulatory system. It is likewise significant because of its Accepted 17-03-2021 interesting benefit such as less absorption, more uniform plasma levels, improved bioavailability, decrease Available online 19-04-2021 side effect, efficacy and quality of the product. Transdermal dose structures may give clinicians a chance to offer more therapeutic alternatives to their patients to upgrade their consideration. Keywords: © This is an open access article distributed under the terms of the Creative Commons Attribution Advantages/Disadvantages License (https://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and Skin types reproduction in any medium, provided the original author and source are credited. Factors affecting permeation Components Evaluations 1. Introduction 4. Drug duration of action are extendable 5. GIT incompatibilities get avoided Now a day many drugs are administered orally, but they are 6. Number of dosage frequency reduced observed not more effective as desired so to upgrade such 7. Easier to remember and used character TDDS was created. Drug delivery administered 8. Large area of application in comparison with nasal and by the skin and attain a systemic effect of drug is called buccal cavity as transdermal drug delivery system.
    [Show full text]
  • A Fully Integrated Microneedle-Based Transdermal Drug Delivery System
    A Fully Integrated Microneedle-based Transdermal Drug Delivery System Niclas Roxhed MICROSYSTEM TECHNOLOGY LABORATORY SCHOOL OF ELECTRICAL ENGINEERING ROYAL INSTITUTE OF TECHNOLOGY ISBN 978-91-7178-751-4 ISSN 1653-5146 TRITA-EE 2007:046 Submitted to the School of Electrical Engineering KTH—Royal Institute of Technology, Stockholm, Sweden, in partial fulfillment of the requirements for the degree of Doctor of Philosophy Stockholm 2007 ii A Fully Integrated Microneedle-based Transdermal Drug Delivery System The left picture on the front cover shows an integrated microneedle-based drug delivery system fabricated and used for experiments by the author. An array of microneedles is located on the other side of the device. The right picture on the cover shows a magnified view of these side-opened hollow microneedles, likewise fabricated by the author. The needles are designed to penetrate skin tissue using a low insertion force. The needles are fabricated by deep reactive ion etching of silicon and the length of the needles is 400 μm. Copyright 2007 by Niclas Roxhed All rights reserved to the summary part of this thesis, including all pictures and figures. No part of this publication may be reproduced or transmitted in any form or by any means, without prior permission in writing from the copyright holder. The copyrights for the appended journal papers belong to the publishing houses of the journals concerned. The copyrights for the appended manuscripts belong to their authors. Printed by Universitetsservice US AB, Stockholm 2007. Thesis for the degree of Doctor of Philosophy at the Royal Institute of Technology, Stockholm, Sweden, 2007.
    [Show full text]
  • How to Treat Nicotine Dependence in Smokers with Schizophrenia
    pSYCHIATRY How to treat nicotine dependence in smokers with schizophrenia Improve patients’ health, help them kick addiction with this practical approach r. V, age 49, has stable but ®symptomaticDowden Health Media schizophrenia and a 33-year cigarette smoking Mhistory. He is very concerned because his primary care physicianCopyright told him heFor has personal2 serious use only smoking-related health problems: diabetes and hypertension. He tried a smoking cessation program for the general public, but it was a poor fit because of his schizophrenia symptoms. Despite adhering to his medications (ziprasidone, 20 mg hs; perphenazine, 8 mg hs; lorazepam, 1 mg hs; zonisamide, 200 mg/d, and benztropine mesylate, 2 mg hs), Mr. V has residual auditory hallucinations, paranoid ideation, and impaired concentration and attention. He smokes approximately 1.5 packs per day, particularly when VEER.COM very ill, to alleviate chronic boredom, and to diminish 2007 © distress from the hallucinations. All of his friends smoke, and they do not support his attempts to quit. Jennifer D. Gottlieb, PhD Schizophrenia clinical and research program Massachusetts General Hospital Successfully treating nicotine dependence can seem a Instructor in psychiatry formidable challenge in patients with schizophrenia: Harvard Medical School • 72% to 90% smoke cigarettes, compared with 21% A. Eden Evins, MD, MPH of the general population1 (Box, page 66).2-12 Schizophrenia and depression clinical and research programs • They tend to smoke heavily, spending about one- Director, Center for Addiction Medicine third of their incomes on cigarettes.13 and addiction research program • Their negative symptoms (such as apathy), posi- Massachusetts General Hospital Assistant professor of psychiatry tive symptoms (such as disorganized thinking), Harvard Medical School and cognitive impairment can reduce motivation to quit and adhere to a smoking cessation strategy.
    [Show full text]
  • How a Painless Patch Could One Day Deliver Vaccines
    How a painless patch could one day deliver vaccines pbs.org/newshour/health/how-a-painless-patch-could-one-day-deliver-vaccines Isabella Isaacs-Thomas July 31, 2020 When you pull up your sleeve to get your yearly flu shot, you might feel a twinge of anxiety as a health care provider readies the needle and syringe. Maybe you find yourself looking away or taking deep breaths to steel yourself, even though it’s over in just a few seconds. So what if there was a painless vaccine you could administer yourself? What if, rather than heading to the pharmacy, you could simply place the equivalent of a Band-Aid on your arm, leave it there for a few minutes to a few hours, then take it off and let your physician know you’ve been innoculated? That’s one of the main goals of vaccine patch technology. Multiple research teams have designed patches that use microneedle arrays made out of materials like stainless steel or sugar to deliver quick and pain-free vaccination by taking advantage of the key role that skin plays in training our immune system. One group is even developing a completely needle-free method to confer immunity. Vaccination is a crucial public health measure against serious, preventable illnesses, but the fear of needles — or of vaccines themselves — can be a hurdle to protection for individuals and their communities. In many places around the world, extreme conditions or lack of health care can stifle accessibility to traditional vaccines, too. Vaccine patches haven’t yet been approved for commercial use, but both global vaccine experts and researchers have acknowledged their potential for years, particularly when it comes to making vaccines more accessible worldwide.
    [Show full text]
  • 1050 GR Ondrugdelivery Issue 49
    TRANSDERMAL DELIVERY: INTERVIEW: DESIGNING AN A NEW SOURCE FOR PATRICK ALEXANDRE, CEO, ULTRASOUND-ENABLED P04 BIOPHARMA INNOVATION P18 CROSSJECT P22 INSULIN PATCH TRANSDERMAL DELIVERY, MICRONEEDLES & NEEDLE-FREE INJECTION 49 O TM ISSUE N • 2014 2014 TH MAY 16 MAY Contents ONdrugDelivery Issue No 49, May 16th, 2014 Transdermal Delivery, Microneedles CONTENTS & Needle-Free Injection This edition is one in the ONdrugDelivery series of publications from Frederick Furness Publishing. Each Introduction: Skin in the Game: issue focuses on a specific topic within the field of Transdermal Delivery as a New Source for drug delivery, and is supported by industry leaders BioPharma Innovation in that field. 04 - 06 Dr Kevin Pang, Research Director EDITORIAL CALENDAR 2014/15 Lux Research May: Pulmonary & Nasal Drug Delivery Overview: Transdermal Delivery Device Design May/June: Injectable Drug Delivery: Devices Focus Bruce K Redding, Jr, President & CEO June: Injectable Drug Delivery: 08 - 09 Transdermal Specialties, Inc Pharmaceutics Focus July: Novel Oral Delivery Systems Your Solution for Successful Sep: Drug Formulation & Delivery Solutions Intradermal Delivery & Services Dr Paul Vescovo, Project Manager, Oct: Prefilled Syringes 10 - 14 and Dr Laurent-Dominique Piveteau, Nov: Pulmonary & Nasal Drug Delivery Chief Operating Officer Dec: Delivering Biotherapeutics Debiotech SA Jan: Ophthalmic Drug Delivery Feb: Prefilled Syringes Dermal Delivery of Biologics Dr Richard Toon, SUBSCRIPTIONS: 16 - 17 Technical and Business Development Manager To arrange
    [Show full text]