•The membranes containing PVP demonstrated significant modifications in its thermal properties.•BMV release followed Korsmeyer and Peppas model (n > 0.89) suggesting that its diffusion in the swollen ...matrix is driven by polymer relaxation.•The developed mucoadhesive membranes are an interesting and promising system to deliver BMV for the treatment of RAS.
Mucoadhesive membranes were proposed in this study as drug delivery system for betamethasone-17-valerate (BMV) in the treatment of recurrent aphthous stomatitis (RAS). The membranes were obtained by using the polymers chitosan (CHI) in both presence and absence of polyvinilpyrrolidone (PVP), following the solvent evaporation method. The presence of PVP in the membranes causes significant modifications in its thermal properties. Changes in the thermal events at 114 and 193 °C (related to BMV melting point), and losses in mass (39.38 and 30.68% for CH:PVP and CH:PVP-B, respectively), suggests the incorporation of BMV in these membranes. However, the morphological aspects of the membranes do not change after adding PVP and BMV. PVP causes changes in swelling ratios (>80%) of the membranes, and it is suggested that the reorganization of the polymer mesh was highlighted by the chemical interactions between the polymers leading to different percentages of BMV released ∼40% and ∼80% from CH-B and CH:PVP-B. BMV release profile follows Korsmeyer and Peppas model (n > 0.89) which suggests that the diffusion of the drug in the swollen matrix is driven by polymer relaxation. In addition, the membranes containing PVP (higher swelling ability) present high rates of tensile strength, and therefore, higher mucoadhesion. Moreover, given the results presented, the developed mucoadhesive membranes are a promising system to deliver BMV for the treatment of RAS.
Abstract Patient-reported outcomes (PRO) are defined as reports coming directly from patients about how they feel or function in relation to a health condition and its therapy. Although there are ...numerous compelling reasons why PRO could be an important help in clinical care, they have not evolved into clinical tools integrated into care. The purpose of this review is to assess existing PRO instruments for heart failure with respect to their psychometric properties and potential for use in clinical care. We performed a systematic search of articles published between July 2008 and January 2015 within the MEDLINE, PROMIS, PROQOLID, and Cochrane Library databases. Included instruments had to be developed and tested for heart failure and have had their development processes and psychometric properties described. A total of 31 instruments were identified, 9 of which met all inclusion criteria. After evaluating each remaining instrument in terms of psychometric and clinical criteria and symptom coverage, only 2 instruments—Minnesota Living with Heart Failure and Kansas City Cardiomyopathy questionnaire—met all evaluation criteria. Although clinically useful PRO instruments exist, increasing education to providers on the value and interpretability of PRO instruments, as well as a more streamlined approach to their implementation in the clinical setting is necessary. A clinical trial comparing the routine use of disease-specific PRO with clinical care could further support their incorporation into practice.
Background
Many factors may influence the magnitude of individual responses to resistance training (RT). How the manipulation of training volume and frequency affects responsiveness level for muscle ...mass gain in older women has not been investigated.
Aims
This study had the objective of identifying responders (RP) and non-responders (N-RP) older women for skeletal muscle mass (SMM) gain from a 12-week resistance training (RT) program. Additionally, we analyzed whether the N-RP could gain SMM with an increase in weekly training volume over 12 additional weeks of training.
Methods
Thirty-nine older women (aged ≥ 60 years) completed 24 weeks of a whole-body RT intervention (eight exercises, 2–3×/week, 1–2 sets of 10–15 repetitions). SMM was estimated by DXA, and the responsive cut-off value was set at two times the standard error of measurement. Participants were considered as RP if they exceeded the cut-off value after a 12-week RT phase, while the N-RP were those who failed to reach the SMM cut-off.
Results
Of the 22 participants considered to be N-RP, only 3 accumulated SMM gains (
P
= 0.250) that exceeded the cut-off point for responsiveness following 12 additional weeks of training, while 19 maintained or presented negative SMM changes. Of the 17 participants considered to be RP, all continued to gain SMM after the second 12-week RT phase. No significant correlation was observed between the changes in SMM and any baseline aspect of the participants.
Conclusions
Our results suggest that some older women are RP, while others are N-RP to SMM gains resulting from RT. Furthermore, the non-responsiveness condition was not altered by an increase of training volume and intervention duration while RP participants continue to increase SMM; it appears that RP continue to be RP, and N-RP continue to be N-RP.
BACKGROUND:Quadrivalent meningococcal conjugate vaccine (Menactra MenACWY-D), was licensed in the United States in 2005 to prevent meningococcal disease in adolescents and adults. The license was ...extended to children aged 2–10 years in 2007 and extended again in 2011 to infants aged 9 months and older based, in part, on results from 3 phase III studies presented herein.
METHODS:The safety and immunogenicity of 2 doses of MenACWY-D was assessed in study-eligible childrendose 1 was administered at 9 months of age and dose 2 was administered 3 months later with or without routine childhood vaccines.
RESULTS:Thirty days after vaccination, protective serum bactericidal assay-human complement titers ≥1:8 for meningococcal serogroups A, C, Y and W-135 were achieved by 86–100% of children receiving 2 doses of MenACWY-D. When MenACWY-D was concomitantly administered with measles, mumps, rubella and varicella or heptavalent pneumococcal conjugate vaccine, 81–98% of participants achieved protective responses (serum bactericidal assay-human complement titers ≥1:8 for all serogroups). All seroprotection rates were >91% when the protective titer was defined as serum bactericidal assay-human complement ≥1:4. MenACWY-D did not interfere with measles, mumps, rubella or varicella vaccine responses (98–100% achieved protective titers). When heptavalent pneumococcal conjugate vaccine was given concomitantly with MenACWY-D, antipneumococcal antibody levels, although decreased, were protective for all serotypes by enzyme-linked immunosorbent assay (98–100% ≥ 0.35 μg/mL) and opsonophagocytic assay (99–100% ≥ 1:8). Adverse events were generally mild and similar across groups. Serious adverse events were uncommon.
CONCLUSIONS:MenACWY-D was safe and immunogenic when given in 2 doses to infants and toddlers; this vaccine can be given with other common childhood immunizations.
Objective: The purpose of the present study was to analyze whether improvements in fast walking speed induced by resistance training (RT) are associated with changes in body composition, muscle ...quality, and muscular strength in older women. Methods: Twenty-three healthy older women (69.6 ± 6.4 years, 64.95 ± 12.9 kg, 1.55 ± 0.07 m, 27.06 ± 4.6 kg/m²) performed a RT program for 8 weeks consisting of 8 exercises for the whole body, 3 sets of 10-15 repetitions maximum, 3 times a week. Anthropometric, body composition (fat-free mass FFM, skeletal muscle mass SMM, legs lean soft tissue LLST, fat mass), knee extension muscular strength (KE1RM), muscle quality index (MQI KE1RM/LLST), and 10-meter walking test (10-MWT) were performed before and after the intervention. Results: Significant (P < .05) changes were observed from pre- to post-training for FFM (+1.6%), MQI (+7.2%), SMM (+2.4%), LLST (+1.8%), KE1RM (+8.6%), fat mass (−1.4%), and time to perform 10-MWT (−3.7%). The percentage change in 10-MWT was significantly associated with percentage change in MQI (r = −0.46, P = .04) and KE1RM (r = −0.45, P = .04), however not associated percentage of changes in SMM (r = 0.01, P = .97), LLST (r = −0.22, P = .33), and body fat (r = 0.10, P = .66). Conclusion: We conclude that the improvement in the 10-MWT after an 8-week RT program is associated with increases in lower limb muscular strength and muscle quality, but not with muscle mass or body fat changes in older women.
The optimal intensity of resistance training (RT) to improve muscular, physical performance, and metabolic adaptations still needs to be well established for older adults. Based on current position ...statements, we compared the effects of two different RT loads on muscular strength, functional performance, skeletal muscle mass, hydration status, and metabolic biomarkers in older women.
One hundred one older women were randomly allocated to perform a 12-wk whole-body RT program (eight exercises, three sets, three nonconsecutive days a week) into two groups: 8-12 repetitions maximum (RM) and 10-15RM. Muscular strength (1RM tests), physical performance (motor tests), skeletal muscle mass (dual-energy X-ray absorptiometry), hydration status (bioelectrical impedance), and metabolic biomarkers (glucose, total cholesterol, HDL-c, HDL-c, triglycerides, and C-reactive protein) were measured at baseline and posttraining.
Regarding muscular strength, 8-12RM promoted higher 1RM increases in chest press (+23.2% vs +10.7%, P < 0.01) and preacher curl (+15.7% vs +7.4%, P < 0.01), but not in leg extension (+14.9% vs +12.3%, P > 0.05). Both groups improved functional performance ( P < 0.05) in gait speed (4.6%-5.6%), 30 s chair stand (4.6%-5.9%), and 6 min walking (6.7%-7.0%) tests, with no between-group differences ( P > 0.05). The 10-15RM group elicited superior improves in the hydration status (total body water, intracellular and extracellular water; P < 0.01), and higher gains of skeletal muscle mass (2.5% vs 6.3%, P < 0.01), upper (3.9% vs 9.0%, P < 0.01) and lower limbs lean soft tissue (2.1% vs 5.4%, P < 0.01). Both groups improved their metabolic profile. However, 10-15RM elicited greater glucose reductions (-0.2% vs -4.9%, P < 0.05) and greater HDL-c increases (-0.2% vs +4.7%, P < 0.01), with no between-group differences for the other metabolic biomarkers ( P > 0.05).
Our results suggest that 8-2RM seems more effective than 10-15RM for increasing upper limbs' muscular strength, whereas the adaptative responses for lower limbs and functional performance appear similar in older women. In contrast, 10-15RM seems more effective for skeletal muscle mass gains, and increased intracellular hydration and improvements in metabolic profile may accompany this adaptation.
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