Púrpura trombocitopénica idiopática en el embarazo: a propósito de un caso

Idiopathic purple thrombocytopenia is a hemorrhagic pathology, characterized by a decrease in the platelet count during pregnancy, mediated by cells and anti-platelet antibodies, causing the premature destruction of platelets by the reticuloendothelial system, which during pregnancy could lead to a commitment to maternal fetal wellbeing in severe stages. This pathology occurs in 1 out of every 1,000 to 10,000 pregnancies, and corresponds to 3% of thrombocytopenic pregnancies. The goal of management is to maintain platelet counts within safe ranges, recommending starting harmacological management when a platelet count lower than 10,000 / uL is found at any time during pregnancy or 30,000 / uL in the second or third trimester. The case presented corresponds to a 40-yearold woman in the first trimester of pregnancy with a history of chronic idiopathic purple thrombocytopenic, with severe thrombocytopenia at the time of admission to the Hospital. Keywords: Idiopathic thrombocytopenic purpura. Pregnancy. Blood platlets.

IR783 Encapsulated in TR-conjugated Liposomes for Enhancing NIR Imaging-guided Photothermal and Photodynamic Therapy

We developed an integrin αvβ3-specific liposomes, TR-conjugated liposomes (TR-LPs), loading IR783 for NIR imaging-guided both PTT and PDT. The TR-LPs was composed of soyabeanphosphatidylcholine, cholesterol, 1,2-distearoyl-sn-glycero-3-phosphoethanolamine- N- [methoxy(polyethylene glycol)-2000] (DSPE-PEG) and TR-functionalized DSPE-PEG. IR783, NIR PTT/PDT diagnostic agents, were encapsulated in the hydrophilic core of the TR-LPs. DSPE-PEG had ability of reducing the absorption of TR-LPs by the reticuloendothelial system and increase the cycle time in body. RGD fragment on the TR peptide (TR = c(RGD)-AGYLLGHINLHHLAHL(Aib)HHIL-cys) enhanced the tumor selectivity of liposomes by specifically targeting integrin αvβ3-overexpressing cancer cells. Simultaneously, the rest of fragment on the TR peptide can be changed to the positive charge in the tumor microenvironment (pH 6.5), improving cellular uptake of photoagents at tumor site. We executed a set of in vitro and in vivo experiments to verify if, by functionalizing liposomes with an integrin αvβ3-specific and pH responding peptide, it is possible to achieve NIR imaging guided PTT/PDT for tumor treatment. TR-conjugated liposomes exhibited favorable physical and chemical stability, loading capacity, biocompatibility and tumor targeting. TR-LPs can safely and efficiently delivery IR783 to tumor sites to achieve their therapeutic function. IR783-TR-LPs is promising as a potentially safe and effective phototherapeutic agents for NIR fluorescence-guided tumor therapy applications.

Anaesthetic implications for splenectomy in a child with Gaucher’s disease

Gaucher’s disease, a lysosomal storage disorder, is caused by an inherited deficiency of beta glucocerebrosidase enzyme leading to the accumulation of glucocerebroside in the reticuloendothelial system. Patients with this disease often manifest coagulation abnormalities and multi-organ complications. These factors present a challenge to the anaesthesiologist, in deciding the type as well as the conduct of anaesthesia. We aim to report the anaesthetic management in a 3-years old child with Gaucher’s disease posted for splenectomy.

Ultraflexible Liposome Nanocargo as a Dermal and Transdermal Drug Delivery System

A selected active pharmaceutical ingredient must be incorporated into a cargo carrier in a particular manner so that it achieves its goal. An amalgamation of active pharmaceutical ingredients (APIs) should be conducted in such a manner that it is simple, professional, and more beneficial. Lipids/polymers that are known to be used in nanocarriers for APIs can be transformed into a vesicular formulation, which offers elegant solutions to many problems. Phospholipids with other ingredients, such as ethanol and water, form suitable vesicular carriers for many drugs, overcoming many problems related to poor bioavailability, poor solubility, etc. Ultraflexible liposomes are novel carriers and new frontiers of drug delivery for transdermal systems. Auxiliary advances in vesicular carrier research have been made, enabling polymer-coated ethanolic liposomes to avoid detection by the body’s immune system—specifically, the cells of the reticuloendothelial system. Ultraflexible liposomes act as a cargo system and a nanotherapeutic approach for the transport of therapeutic drugs and bioactive agents. Various applications of liposome derivatives in different diseases are emphasized in this review.

Current views on the pharmacological correction of iron deficiency conditions in gynecological practice

The review considers features of iron and folic acid (FA) pharmacokinetics, which affect the effective micronutrient support: molecular mechanisms of absorption and distribution, homeostatic processes of maintaining plasma vitamin and mineral levels by the feedback mechanism, including by regulating the deposition. An important characteristic of ferrokinetics is the presence of unique iron exporter ferroportin which is controlled by a family of iron regulatory proteins. Systemic ferrotherapy and oral rout of iron delivery are distinguished. In general, parenteral iron preparation complexes consist of Fe(III) oxide/hydroxide core stabilized by a carbohydrate polymer shell. Once entering the bloodstream, iron complexes are absorbed by resident macrophages of the reticuloendothelial system of the liver, spleen and bone marrow. Systemic Fe(III) preparations are prodrugs, the active part of which, i.e. iron is released in the lysosomal matrix of phagocytes. Oral iron preparations are divided into those containing bivalent (ferrous) and trivalent (ferric) iron. The article discusses factors determining the differences in the absorption of oral ferrous and ferric iron preparation, the spectrum of side effects, as well as key pharmaceutical approaches to increase the tolerance and adherence of ferrotherapy. These include using preparations containing Fe(II) organic compounds that have a lower dissociation rate than inorganic iron salts as well as slowing down the release of the active Fe(II) pharmaceutical substance from the drug. The review pays special attention to folates as iron synergists and examines the features of FA pharmacokinetics, the molecular basis of synergism, and substantiates the use of combined iron and FA preparations.

Mesoporous Aerogel Microparticles Injected into the Abdominal Cavity of Mice Accumulate in Parathymic Lymph Nodes

Mesoporous aerogel microparticles are promising drug delivery systems. However, their in vivo biodistribution pathways and health effects are unknown. Suspensions of fluorescein-labeled silica–gelatin hybrid aerogel microparticles were injected into the peritoneum (abdominal cavity) of healthy mice in concentrations of 52 and 104 mg kg−1 in a 3-week-long acute toxicity experiment. No physiological dysfunctions were detected, and all mice were healthy. An autopsy revealed that the aerogel microparticles were not present at the site of injection in the abdominal cavity at the end of the experiment. The histological study of the liver, spleen, kidneys, thymus and lymphatic tissues showed no signs of toxicity. The localization of the aerogel microparticles in the organs was studied by fluorescence microscopy. Aerogel microparticles were not detected in any of the abdominal organs, but they were clearly visible in the cortical part of the parathymic lymph nodes, where they accumulated. The accumulation of aerogel microparticles in parathymic lymph nodes in combination with their absence in the reticuloendothelial system organs, such as the liver or spleen, suggests that the microparticles entered the lymphatic circulation. This biodistribution pathway could be exploited to design passive targeting drug delivery systems for flooding metastatic pathways of abdominal cancers that spread via the lymphatic circulation.

Pulmonary Involvement Responsive to Enzyme Replacement Therapy in an Elderly Patient with Gaucher Disease

Type 1 Gaucher disease (GD) is a rare autosomal recessive lysosomal storage disorder caused by deficient activity of beta-glucocerebrosidase, leading to accumulation of its substrate (glucosylceramide) in macrophages of the reticuloendothelial system, which are then referred to as Gaucher cells. The most frequent symptoms are asthenia, spleen and liver enlargement, bone abnormalities and cytopenia due to bone marrow infiltration. Lung involvement in GD is a rare finding, and it is unclear whether it may regress under enzyme replacement therapy (ERT) or substrate reduction therapy (SRT). Here we report a case of type 1 GD recently diagnosed in an elderly patient complicated by infiltrative lung disease, which responded to ERT.

Bilirubin and indican in the blood of pregnant women Eufinger (Arch. f. G., Bd. 125, H. 3)

Bilirubin and indican in the blood of pregnant women were investigated by Eufinger (Arch. F. G., Bd. 125, H. 3). Bilirubin is formed not only in liver cells, but also in the entire reticuloendothelial system. The author investigated its content in the blood of 80 women using direct and indirect samples v. d. Bergh a.

Multi-functionalization, a promising adaptation to overcome challenges to clinical translation of nanomedicines as nano-diagnostics and nano-therapeutics for breast cancer

Background: Breast cancer (BC) is one of the most aggressive and prevalent types of cancer which is associated with high rate of mortality and colossal potential of metastasis to other body organs. Conventionally, there are three commonly employed strategies for treatment of BC including, surgery, radiations and chemotherapy; however, these modalities are associated with several deleterious effects and high rate of relapse. Objective: This review was aimed to critically discuss and conceptualize existing evidences related to pharmaceutical significance and therapeutic feasibility of multi-functionalization of nanomedicines for early diagnosis and efficient treatment of BC. Results: Though the implication of nanotechnology-based modalities has revolutionised the outcomes of diagnosis and treatment of BC; however, the clinical translation of these nanomedicines is facing grandeur challenges. These challenges include, recognition by reticuloendothelial system (RES), short plasma half-life, non-specific accumulation in the non-cancerous cells, and expulsion of drug(s) by the efflux pump. To circumvent these challenges, various adaptations such as PEGylation, conjugation of targeting ligand(s), and site-responsive behaviour (i.e., pH-responsiveness, biochemical, or thermal-responsiveness) have been adapted. Similarly, multi-functionalization of nanomedicines has been emerged as an exceptional strategy to improve pharmacokinetic profile, specific targetability to tumor microenvironment (active targeting) and efficient internalization, and to alleviate the expulsion of internalized drug contents by silencing-off efflux pump. Conclusion: Critical analysis of the available evidences revealed that multi-functionalization of nanomedicines is a plausible and sustainable adaptation for early diagnosis and treatment of BC with better therapeutic outcomes.