[Neutrophil-to-lymphocyte ratio as a predictor of intestinal resection in incarcerated inguinal hernias]. / Otnoshenie neitrofilov k limfotsitam kak prediktor rezektsii kishki u bol'nykh s ushchemlennymi pakhovymi gryzhami.

INTRODUCTION: Inguinal hernia is defined as a projection of an organ through the inguinal canal. This can be incarcerated as a consequence of continuous inflammation of the hernial sac, which will prevent its return, causing damage to the venous and lymphatic return of the viscera. The neutrophil-to-lymphocyte ratio (NLR) is an easily accessible inflammatory biomarker obtained from blood cell counts. Therefore, the objective was to determine if the NLR is useful as a predictor of intestinal resection in incarcerated inguinal hernias. MATERIAL AND METHOD: An observational, analytical, diagnostic test and retrospective study was carried out in a hospital in northern Peru from January 2013 to August 2019 in the Department of General Surgery and Emergency Surgery and Critical Care. Patients diagnosed with unilateral inguinal hernia with intestinal obstruction were included. For the relationship between the event and the exposure, it was analyzed using Chi square (χ2) and T-Student. The sensitivity, specificity, positive predictive value, negative predictive value of the NLR as well as the area under the ROC curve were found to determine the predictive accuracy. RESULTS: 161 patients with incarcerated inguinal hernia were studied: group I (20 patients with intestinal resection) and group II (141 patients without intestinal resection). The mean age in groups I and II were 69±16 and 60±17 years (p<0.05); the frequency in males was 70% in group I and 76% in group II (p>0.05). Intestinal obstruction and duration of incarceration >24 hours and the platelet-to-lymphocyte ratio demonstrated significant differences. With respect to NLR taking a cut-off point ≥6.5, a sensitivity of 75%, a specificity of 93.62%, a positive predictive value of 62.5% and a negative predictive value of 96.35% were observed; In addition, when analyzing with the ROC curve, a value of 5.14 was obtained as a predictor of intestinal resection with a sensitivity of 90% and a specificity of 84.4% (p<0.001). Therefore, the NLR >5.14 predicts intestinal resection in patients with incarcerated inguinal hernias with an area under the curve of 0.92 at the Belen Hospital of Trujillo. CONCLUSIONS: The neutrophil-to-lymphocyte ratio is useful for predicting intestinal resection with a diagnostic accuracy of 92%.

Characterization of yeast population from unstudied natural sources in La Mancha region.

AIMS: This study aims to identify the yeast species and strains which entitled an unstudied area of Spain and evaluate the yeast species diversity richness and the genetic variety. METHODS AND RESULTS: A total of 702 yeasts were isolated from different environments in a central Spanish region (La Mancha) with diverse sources of origin (food, animals, flowers and environmental sources) during spring season. Thanks to the analysis carried out by the PCR-RFLP technique and sequencing, 35 species were identified. A neighbour-joining phylogenetic tree was created based on D1/D2 sequences. Moreover 330 strains were determined by PCR-RAPD and their profiles were analysed using the bioinformatics programme BioNumerics 7·6. The Simpson's index (D) and the genetic diversity percentage were calculated with the aim of studying the richness of the species in each environment and the genetic variety in each species. CONCLUSIONS: This study has permitted to know that the majority of the species found was Diutina rugosa while the most ubiquitous was Rhodotorula mucilaginosa which expose the dispersion capability of this species. The diversity parameters has revealed that the highest species richness was associated to environmental samples and the highest genetic variety was presented in those species with better dispersion capability or a smaller number of isolates. SIGNIFICANCE AND IMPACT OF THE STUDY: This study permits to better understand the yeast communities in La Mancha region which gives a value the microbial potential of this region.

The highs and lows of programmed cardiovascular disease by developmental hypoxia: studies in the chicken embryo.

It is now established that adverse conditions during pregnancy can trigger a fetal origin of cardiovascular dysfunction and/or increase the risk of heart disease in later life. Suboptimal environmental conditions during early life that may promote the development of cardiovascular dysfunction in the offspring include alterations in fetal oxygenation and nutrition as well as fetal exposure to stress hormones, such as glucocorticoids. There has been growing interest in identifying the partial contributions of each of these stressors to programming of cardiovascular dysfunction. However, in humans and in many animal models this is difficult, as the challenges cannot be disentangled. By using the chicken embryo as an animal model, science has been able to circumvent a number of problems. In contrast to mammals, in the chicken embryo the effects on the developing cardiovascular system of changes in oxygenation, nutrition or stress hormones can be isolated and determined directly, independent of changes in the maternal or placental physiology. In this review, we summarise studies that have exploited the chicken embryo model to determine the effects on prenatal growth, cardiovascular development and pituitary-adrenal function of isolated chronic developmental hypoxia.

Biotechnological application of yeasts in food science: Starter cultures, probiotics and enzyme production.

This review is an account of experiences of two research teams (from Italy to Spain); the leading idea is the following: yeasts represent valuable sources in food science and microbiology and are a kind of food factories, because of the potentiality of whole cells or for their produced compounds. This review covers three major areas: the first section addresses the role of yeasts as starter cultures with a special focus on wine. The second section is an update on probiotic yeasts. Finally, the focus of the last section is on enzymes produced by yeasts, with a short description of the removal of mycotoxin.

Effectiveness of daily versus non-daily granulocyte colony-stimulating factors in patients with solid tumours undergoing chemotherapy: a multivariate analysis of data from current practice.

We conducted a multicentre, retrospective, observational study including patients with solid tumours (excluding breast cancer) that received granulocyte colony-stimulating factors (G-CSF) and chemotherapy. We investigated the effectiveness of daily vs. non-daily G-CSFs (pegfilgrastim) adjusting by potential confounders. The study included 391 patients (211 daily G-CSF; 180 pegfilgrastim), from whom 47.3% received primary prophylaxis (PP) (57.8% pegfilgrastim), 26.3% secondary prophylaxis (SP: initiation after cycle 1 and no reactive treatment in any cycle) (51.5% pegfilgrastim) and 26.3% reactive treatment (19.4% pegfilgrastim). Only 42.2% of patients with daily G-CSF and 46.2% with pegfilgrastim initiated prophylaxis within 72 h after chemotherapy, and only 10.5% of patients with daily G-CSF received it for ≥ 7 days. In the multivariate models, daily G-CSF was associated with higher risk of grade 3-4 neutropenia (G3-4N) vs. pegfilgrastim [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.004-2.97]. Relative to SP, PP protected against G3-4N (OR for SP vs. PP: 6.0, 95%CI: 3.2-11.4) and febrile neutropenia (OR: 3.1, 95%CI: 1.1-8.8), and was associated to less chemotherapy dose delays and reductions (OR for relative dose intensity <85% for SP vs. PP: 3.1, 95%CI: 1.7-5.4) and higher response rate (OR: 2.1, 95%CI: 1.2-3.7). Data suggest that pegfilgrastim, compared with a daily G-CSF, and PP, compared with SP, could be more effective in preventing neutropenia and its related events in the clinical practice.

Co-inoculation of different Saccharomyces cerevisiae strains and influence on volatile composition of wines.

Wine is the result of the performance of different yeast strains throughout the fermentation in both spontaneous and inoculated processes. 22 Saccharomyces cerevisiae strains were characterized by microsatellite fingerprinting, selecting 6 of them to formulate S. cerevisiae mixed cultures. The aim of this study was to ascertain a potential benefit to use mixed cultures to improve wine quality. For this purpose yeasts behavior was studied during co-inoculated fermentations. Aromatic composition of the wines obtained was analyzed, and despite the fact that only one strain dominated at the end of the process, co-cultures released different concentrations of major volatile compounds than single strains, especially higher alcohols and acetaldehydes. Nevertheless, no significant differences were found in the type and quantity of the amino acids assimilated. This study demonstrates that the final wine composition may be modulated and enhanced by using suitable combinations of yeast strains.

Pediatric Multisystemic Inflammatory Syndrome Temporarily associated with COVID-19: Clinical characteristics and management in a Pediatric Critical Care Unit. / Síndrome Inflamatorio Multisistémico Pediátrico asociado a COVID-19: Características clínicas y manejo en una Unidad de Paciente Crítico Pediátrico.

INTRODUCTION: In April 2020, the pediatric multisystem inflammatory syndrome temporarily associated with COVID-19 (MIS-C) was described for the first time. MIS-C could have a severe course and may require critical care support. OBJECTIVE: To describe the clinical, laboratory, and management characteristics of hospitalized children who meet MIS-C criteria with severe presentation in a pediatric critical pa tient unit. PATIENTS AND METHOD: Descriptive prospective study of children with severe MIS-C mana ged by treatment phases with immunoglobulin and methylprednisolone, according to their clinical response. Epidemiological, clinical, laboratory and imaging data were obtained. Phenotypes were classified into Kawasaki and not Kawasaki, comparing their findings. RESULTS: 20 patients were analy zed, the median age was 6 years, 60% were female, and 40% presented comorbidity. SARS-CoV-2 was detected in 90% of the patients. They presented fever as the first symptom, followed by brief and early gastrointestinal symptoms (70%). 75% presented the Kawasaki phenotype. They evolved with lymphopenia, hypoalbuminemia, coagulation alterations, and elevated systemic and cardiac in flammatory parameters. 80% of the cases presented echocardiographic alterations and 90% shock that required critical care support. All the patients had a short and favorable evolution. All patients responded to the established therapy, but 40% required a second phase of treatment. There were no differences when comparing phenotypes. No deaths were reported. CONCLUSION: MIS-C is a new childhood disease whose presentation could be life-threatening. It requires early suspicion, immuno modulatory management, critical care support, and a multidisciplinary approach to obtain the best results and optimize its prognosis.

[Myopia and Myopic Astigmatism in school-children]. / Miopía y Astigmatismo miópico en escolares.

INTRODUCTION: Worldwide, there is an epidemic increase in myopia. In children, the evidence points to a lack of ex posure to natural light. In Chile, the population situation of myopia in children is unknown. Objec tive: To estimate the tendency of myopia and myopic astigmatism in 1st- and 6th-grade students from the public education system in Chile. SUBJECTS AND METHOD: Ecological study based on diagnostic confirmations of the JUNAEB Medical Services Program, between 2012 and 2018. Annual country prevalence of myopia and astigmatism was estimated by region and sex. The screening evaluation included visual acuity using Snellen Eye Abbreviated chart, red reflex, Hirschberg test, Titmus test, Cover test, ocular motility, and anterior segment examination. Chi2 and logistic regression were used to assess differences and linear regression to estimate average annual change. RESULTS: Between 2012 and 2018, myopia and myopic astigmatism had a heterogeneous geographical presentation. Myopia and myopic astigmatism ≥ 3 dioptres increased by an annual average of 0.11% (R2 0.67) and 1.21% (R2 0.90), respectively, in 1st-grade children and by 0.2% (R2 0.65) and 8.7% (R2 0.79), respectively, in 6th-grade children. Myopia < 3 dioptres decreased by 0.13% annual average (R2 0.45) in 1st-grade children and myopic astigmatism < 3 dioptres by 0.5% (R2 0.53) in 6th-grade children. High myopic astigmatism affected men more than women and myopia < 3 dioptres affected more 6th-grade females. DISCUSSION: In schoolchildren of the public education system, myopia and myopic astigmatism > 3 dioptres tend to increase. The protective effect of natural light against myopia has been demonstrated in longitudinal and experimental studies. This evidence is to be considered in promoting children's time spent outdoors.

Morphologic Features on MR Imaging Classify Multifocal Glioblastomas in Different Prognostic Groups.

BACKGROUND AND PURPOSE: Multifocal glioblastomas (ie, glioblastomas with multiple foci, unconnected in postcontrast pretreatment T1-weighted images) represent a challenge in clinical practice due to their poor prognosis. We wished to obtain imaging biomarkers with prognostic value that have not been found previously. MATERIALS AND METHODS: A retrospective review of 1155 patients with glioblastomas from 10 local institutions during 2006-2017 provided 97 patients satisfying the inclusion criteria of the study and classified as having multifocal glioblastomas. Tumors were segmented and morphologic features were computed using different methodologies: 1) measured on the largest focus, 2) aggregating the different foci as a whole, and 3) recording the extreme value obtained for each focus. Kaplan-Meier, Cox proportional hazards, correlations, and Harrell concordance indices (c-indices) were used for the statistical analysis. RESULTS: Age (P < .001, hazard ratio = 2.11, c-index = 0.705), surgery (P < .001, hazard ratio = 2.04, c-index = 0.712), contrast-enhancing rim width (P < .001, hazard ratio = 2.15, c-index = 0.704), and surface regularity (P = .021, hazard ratio = 1.66, c-index = 0.639) measured on the largest focus were significant independent predictors of survival. Maximum contrast-enhancing rim width (P = .002, hazard ratio = 2.05, c-index = 0.668) and minimal surface regularity (P = .036, hazard ratio = 1.64, c-index = 0.600) were also significant. A multivariate model using age, surgery, and contrast-enhancing rim width measured on the largest foci classified multifocal glioblastomas into groups with different outcomes (P < .001, hazard ratio = 3.00, c-index = 0.853, median survival difference = 10.55 months). Moreover, quartiles with the highest and lowest individual prognostic scores based on the focus with the largest volume and surgery were identified as extreme groups in terms of survival (P < .001, hazard ratio = 18.67, c-index = 0.967). CONCLUSIONS: A prognostic model incorporating imaging findings on pretreatment postcontrast T1-weighted MRI classified patients with glioblastoma into different prognostic groups.

Final results of a phase II study of paclitaxel, bevacizumab, and gemcitabine as first-line therapy for patients with HER2-negative metastatic breast cancer.

BACKGROUND: Efficacy and safety data for combining bevacizumab, gemcitabine, and paclitaxel for locally advanced/metastatic breast cancer are limited. PATIENTS AND METHODS: AVALUZ trial evaluates the combination of bevacizumab 10 mg/kg, gemcitabine 2,000 mg/m(2) plus paclitaxel 150 mg/m(2), on days 1 and 15 of each 28-day course in previously untreated HER-2 negative patients. RESULTS: Median progression-free survival (PES): 12.3 months. The overall response and clinical benefit rate (CR + PR + SD) were 72 % (95 % CI 60.9-82.0 %) and 89 % (95 % CI 80.3-95.3 %), respectively. Median overall survival: 27.4 mo. Baseline circulating tumor cell (CTCs) ≥2 versus CTCs <2 was associated with lower PFS, p = 0.046. Overall response was significantly greater in patients with intense angiotensin type 1 receptor (AGTR1) expression (99 vs. 60 % [p = 0.021]). The most frequent grade 3/4 adverse events were: neutropenia (10 %); febrile neutropenia (1 %); sensory neuropathy (13 %); and asthenia (6 %). Grade 3 adverse events of interest with bevacizumab included bleeding (1 %) and hypertension (4 %). One patient developed cardiac ischemia (1 %). CONCLUSIONS: Adding bevacizumab to chemotherapy appeared feasible and well tolerated, producing toxicity comparable to other effective combined first-line regimens. Baseline circulating endothelial cells and AGTR1 expression are predictive of PFS and response.

The gut-associated lymphoid tissue (GALT) of carp (Cyprinus carpio L.): an immunocytochemical analysis.

The GALT of carp was studied with monoclonal antibodies reacting with carp Ig or carp leukocytes, using (dual) immunofluorescence or immunogold staining on cryosections, cytocentrifuge slides, and cell suspensions of the intestine. The intestinal epithelium contained many Ig-negative lymphoid cells and, in the hindgut, also many large Ig-positive macrophages, which appeared to bind Ig. The lamina propria contained numerous Ig-positive lymphoid cells next to Ig-negative lymphoid cells and granulocytes. Leukocytes isolated from the intestine mainly consisted of Ig-negative lymphoid cells (> 90%). With the methods used, leukocytes were poorly released from the connective tissue. Nevertheless, two types of Ig-containing cells were found: a conventional plasma cell, frequently showing Ig at its surface, and a more common smaller lymphoid cell having a narrow rim of Ig-positive cytoplasm but hardly any Ig on its surface. Many of the Ig-positive lymphoid cells observed in the lamina propria may represent these small Ig-containing cells. Isolated Ig-positive macrophages were frequently associated with B- and T-like cells. Our data strongly suggests an immunological function for the gut of carp, especially for the antigen-transporting hindgut.

Effect of ethanol, acetaldehyde and acetate on the antioxidant-sensitive respiration in the perfused rat liver: influence of fasting and diethylmaleate treatment.

The infusion of 45 mM ethanol or 50 microM acetaldehyde into the perfused rat liver produced comparable and significant antioxidant-sensitive respiratory rates, while marginal responses were obtained with 10 mM acetate. Ethanol-induced antioxidant-sensitive respiration was markedly increased in perfused livers from fasted rats or animals given diethylmaleate which exhibit low hepatic glutathione levels, compared to fed rats. These data point out the significant role of acetaldehyde in ethanol-induced liver oxidative stress, which can be exacerbated by glutathione depletion.

Normal hematological values for healthy persons living at 4000 meters in Bolivia.

Defining the range of normal hematocrit and hemoglobin levels in residents of high altitude is required to diagnose chronic mountain sickness (CMS) and other conditions defined, in part, by hematocrit or hemoglobin values. We studied 1,934 healthy, young (aged 15 to 29 yr) male and female residents of Potosí, Bolivia (4000 m), to determine the average and normal range of hemoglobin and hematocrit values, defining normal as within 2 standard deviations of the mean or encompassing 95% of the observed variation. Male hematocrit averaged 52.7% and hemoglobin averaged 17.3 m/dL whole blood. The corresponding female values were 48.3% and 15.8 g/dL whole blood, respectively. The range of normal values was 45% to 61% for hematocrit and 13 to 21 g/dL for hemoglobin in the men and 41% to 56% for hematocrit and 12 to 19 g/dL for hemoglobin in the women. These data indicate that hematocrit values above 61% in men or 56% in women and hemoglobin values above 21 g/dL whole blood in men or 19 g/dL whole blood in women are outside the normal range.

Comparative aspects of high-altitude adaptation in human populations.

The conditions and duration of high-altitude residence differ among high-altitude populations. The Tibetan Plateau is larger, more geographically remote, and appears to have been occupied for a longer period of time than the Andean Altiplano and, certainly, the Rocky Mountain region as judged by archaeological, linguistic, genetic and historical data. In addition, the Tibetan gene pool is less likely to have been constricted by small numbers of initial migrants and/or severe population decline, and to have been less subject to genetic admixture with lowland groups. Comparing Tibetans to other high-altitude residents demonstrates that Tibetans have less intrauterine growth retardation better neonatal oxygenation higher ventilation and hypoxic ventilatory response lower pulmonary arterial pressure and resistance lower hemoglobin concentrations and less susceptibility to CMS These findings are consistent with the conclusion that "adaptation" to high altitude increases with time, considering time in generations of high-altitude exposure. Future research is needed to compare the extent of IUGR and neonatal oxygenation in South American high-altitude residents of Andean vs. European ancestry, controlling for gestational age and other characteristics. Another fruitful line of inquiry is likely to be determining whether persons with CMS or other altitude-associated problems experienced exaggerated hypoxia during prenatal or neonatal life. Finally, the comparison of high-altitude populations with respect to the frequencies of genes involved in oxygen sensing and physiologic response to hypoxia will be useful, once candidate genes have been identified.

[Pancoast's syndrome secondary to non-Hodgkin's lymphoma]. / Síndrome de Pancoast secundario a linfoma no hodgkiniano.

Pancoast's syndrome is usually found coincident with bronchogenic carcinoma. We describe a case of non-Hodgkin's lymphoma presenting with Pancoast's syndrome in a patient with a history of thoracoplasty.

Inmunizaciones en pacientes con artritis idiopática juvenil / Immunizations in patients with juvenile idiopathic arthritis

Los pacientes con AIJ/ARJ presentan un riesgo mayor de infecciones inmunopreveni-bles, debido a su disfunción inmune, exacerbada por la actividad de su enfermedad y la terapia inmunosupresora. Las vacunas inactivadas han demostrado un perfil de seguridad adecuado en estos pacientes, por lo que no están contraindicadas, aunque su respuesta inmune puede ser inadecuada. Las vacunas vivas atenuadas, formal-mente contraindicadas, poseen una información creciente que permite evaluar su riesgo beneficio de manera individual. Por este motivo, debemos procurar mantener el calendario de vacunas actualizado y complementado, evitando el retraso en esque-mas de vacunación y poniéndolo al día lo antes posible, con estrategias basadas en el individuo, idealmente antes de iniciar la terapia inmunosupresora o de lo contrario durante ella. Para llevar a cabo esto debemos conocer y considerar los intervalos entre las vacunas, los esquemas acelerados, la solicitud de vacunas especiales, las aprobaciones vigentes y, finalmente, sus contraindicaciones.

Patients with JIA/JRA present a higher risk of vaccine-preventable infections, due to their immune dysfunction, exacerbated by the activity of their disease and immu-nosuppressive therapy. Inactivated vaccines have shown an adequate safety profile in these patients, so they are not contraindicated, although their immune response may be impaired. Live attenuated vaccines, formally contraindicated, have a growing information that allows to evaluate their risk benefit case by case. For this reason we must try to keep the vaccination schedule updated and supplemented, avoiding the delay in vaccination schemes and updating it as soon as possible, with taylor-based strategies, ideally before starting immunosuppressive therapy or otherwise during it. To carry out this we must manage and consider the intervals between the vaccines, the accelerated schemes, the request for special vaccines, the current approvals and, finally, their contraindications.

High altitude hypoxia and blood pressure dysregulation in adult chickens.

Although it is accepted that impaired placental perfusion in complicated pregnancy can slow fetal growth and programme an increased risk of cardiovascular dysfunction at adulthood, the relative contribution of reductions in fetal nutrition and in fetal oxygenation as the triggering stimulus remains unclear. By combining high altitude (HA) with the chick embryo model, we have previously isolated the direct effects of HA hypoxia on embryonic growth and cardiovascular development before hatching. This study isolated the effects of developmental hypoxia on cardiovascular function measured in vivo in conscious adult male and female chickens. Chick embryos were incubated, hatched and raised at sea level (SL, nine males and nine females) or incubated, hatched and raised at HA (seven males and seven females). At 6 months of age, vascular catheters were inserted under general anaesthesia. Five days later, basal blood gas status, basal cardiovascular function and cardiac baroreflex responses were investigated. HA chickens had significantly lower basal arterial PO2 and haemoglobin saturation, and significantly higher haematocrit than SL chickens, independent of the sex of the animal. HA chickens had significantly lower arterial blood pressure than SL chickens, independent of the sex of the animal. Although the gain of the arterial baroreflex was decreased in HA relative to SL male chickens, it was increased in HA relative to SL female chickens. We show that development at HA lowers basal arterial blood pressure and alters baroreflex sensitivity in a sex-dependent manner at adulthood.

Transdermal delivery of imipramine and doxepin from newly oil-in-water nanoemulsions for an analgesic and anti-allodynic activity: development, characterization and in vivo evaluation.

Antidepressants have been considered by their analgesic activity in numerous studies, and specifically tricyclic antidepressants to possess the greatest efficacy. Imipramine and doxepin have been reported to exhibit local anaesthetic properties. In order to investigate their cutaneous analgesic effect after topical application a nanoemulsion vehicle was developed. This nanoemulsion is composed of propilenglicol, Transcutol, water, Labrasol, Plurol Oleique, isostearyl isostearate, oleic acid, and d-limonene. The final concentration of imipramine or doxepin in the nanoemulsion system was 3% (w/w). The nanoemulsions were characterized by pH, viscosity, droplet size, polydispersity index and finally, a morphological and structural examination was carried out by using transmission electron microscopy. Furthermore, the present work also reports stability studies on the nanoemulsion formulations to evaluate the integrity of the formulation; these indicate that formulations are stable for a period of three months. Moreover ex vivo studies were performed to evaluate permeation behaviour through human skin and predict plasma concentrations concluding that topically applied imipramine and doxepin loaded nanoemulsions were safe for a local effect. Similarly, the in vivo analgesic and anti-allodynic activity in rats was evaluated being stronger for the doxepin loaded nanoemulsion. This study demonstrated that nanoemulsion containing doxepin could be promising as an alternative analgesic therapy with a potential clinical application.

Novel microparticulate systems for the vaginal delivery of nystatin: development and characterization.

To develop more effective antifungal microparticulate therapeutic systems for the treatment of Candida vaginitis, microparticles containing nystatin were elaborated by emulsification/internal gelation method. Three types of microparticles were successfully prepared, alginate microparticles, chitosan and poloxamer 407 coated alginate microparticles. DSC and FT-IR studies were performed to test the efficacy of the method. After physicochemical characterization, mean particle sizes ranged from 36.088 µm to 56.146 µm. The encapsulation efficiency was found to be similar for alginate and chitosan coated microparticles and lower for poloxamer 407 coated. Optimal mucoadhesive properties in all kind of microparticles where exhibited. Release studies showed the best kinetic parameters for poloxamer 407 coated microparticles. After ex vivo permeation studies through porcine vaginal mucosa, and determination of the amount of nystatin retained as well as microbiologic studies performed, it could be inferred that the developed microparticulate systems offered an antifungal effect against Candida albicans without toxic systemic absorption.