Power Doppler enhancement of accessory pulleys confirming disease localization in psoriatic dactylitis

Objective The digital accessory pulleys are highly mechanically stressed mini-entheses that are thickened in patients with a history of PsA-related dactylits. This study explored whether these pulleys are involved in PsA dactylitis as assessed by intra-pulley US power Doppler changes. Methods Fifty-eight PsA patients with dactylitis had US of the second to fourth digits for pulleys of the dactylitic and contralateral digits. The Leeds Dactylometer was used for thickness measurement. The presence of digital pain, tenderness, and swelling in the dactylitis finger and in the contralateral side was evaluated. Results We recruited 34 patients with acute and 24 patients with chronic dactylitis, 45/58 (77%) of which had tenderness on clinical assessment. Intra-pulley power Doppler was more frequently found in the dactylitic digits compared with contralateral sides and linked to A1, A2 and A4 pulleys thickening [power Doppler signals in A1 pulley (51%), A2 (22%) and A4 (12%) in dactylitic digit; compared with 1 A1, A2 and A4 pulleys each in the contralateral side (1.7%)]. Almost all cases had peri-tendinous oedema, and 82.6% of dactylitic digits had flexor tenosynovitis with power Doppler signals in 65.2% of flexor tendons. Conclusion Despite their small size and relatively avascular, the accessory pulleys exhibit power Doppler change in active Psoriatic dactylitis, supporting a pivotal role in dactylitis-related tenosynovitis and extra-tendinous disease.

PROPERTIES, PHARMACEUTICAL APPLICATION AND VARIOUS TECHNIQUE OF CHEMICAL MODIFICATION IN NATIVE STARCH: A DESCRIPTIVE REVIEW

Starch is one important natural polymer that finds application in the formulation of dosage forms as the binder, disintegrates, diluents, gelling agent etc. Starch is drawing the attention in drug delivery as it is cheap, non-toxic, renewable, biodegradable and compatible with many other materials for industrial application. Starch has vital intrinsic properties that have made its pharmaceutical applications possible. It has also been used for a wide range of particular drug delivery applications, such as the delivery of challenging molecules and targeting to specific sites in the body. Starches are integrally unsuitable for most applications such as loss of viscosity and thickening power upon cooking and storage, retrogradation characteristics and absence of certain groups responsible for a particular function etc. So, in order to reduce its limitations and improve its applications, modification of starch is necessary. It can be modified by several ways like chemical modification, physical modification and genetic modification but the most important one is the chemical modification. This review summarizes the properties and application of native starchin conventional drug delivery systems within a world of dynamic drug production technology. It also describes the chemical modification like cross-linking, esterification, etherification and dual modification of starch.

Rheological Properties of Associative Polyelectrolytes Synthesized by Solution Polymerization

ABSTRACTWater-soluble associative polyelectrolytes of methacrylic acid [MAA] and ethyl acrylate [EA] (1:1 molar ratio), hydrophobically modified with small amounts of stearyl metacrylate [MM18], were synthesized by means of solution polymerization. Polyelectrolytes with two different molecular structures: multisticker, with hydrophobic groups randomly distributed along the hydrophilic chain and combined, with the hydrophobic groups along the chain and as terminal groups of the backbone, were obtained. Steady shear behavior and linear viscoelastic properties were studied as a function of polymer microstructure and hydrophobic group concentrations on salt-free aqueous solution using a cone-and-plate rheometer. Concentration regimes were obtained for each synthetized polymer. Viscoelastic study shows that the maximum thickening effect corresponds to the combined structure followed by multisticker structure. These polyelectrolytes exhibit high thickening power on aqueous solutions due to the synergy between the hydrophobic attractive interactions and coil expansion phenomena.