Child and adolescent psychiatric emergency admissions before, during and after the Covid-19 pandemic: An Interrupted time series analysis from Turkey.

BACKGROUND: Acute psychiatric care of youth is paramount as prompt evaluation is known to mitigate potentially catastrophic outcomes in the future. The aim of this study was to analyze changes in child and adolescent psychiatric (CAP) emergency admissions within a 4-year period, including the pandemic course. METHODS: Electronic patient health records of children and adolescents aged 0-18 years, admitted to the pediatric emergency department (ED) for psychiatric complaints between January 2018-December 2021, were retrospectively reviewed (n = 2014). Data including the age, sex, presenting complaint and preliminary diagnosis, length of stay in the ED, and history of previous psychiatric outpatient/emergency admissions were recorded. Interrupted Time series analysis was conducted to detect changes. RESULTS: During the first month of the COVID-19 pandemic period (March 2020); low-risk suicide attempts (60.6%;IRR=0.394;CI=0.216-0.718), high-risk suicide attempts (82.2%;IRR=0.178;CI=0.070-0.457), manic symptoms (87.9%;IRR=0.121;CI=0.016-0.896), and total CAP emergency admissions were found to have decreased (30.7%;IRR=0.693;CI=0.543-0.885). CAP consultations due to general medical conditions were found to have increased by 7.3% (IRR=1.073;CI=1.019-1.130), and total CAP emergency admissions showed a mild increase of 1.8% (IRR=1.018;CI=1.001-1.036) through April 2020 to December 2021. CONCLUSION: While suicide attempts, manic symptoms, and total CAP emergency admissions decreased during the first month of the pandemic, there was an increase in total CAP emergency admissions, especially in general medical conditions presenting with psychiatric symptoms during the following pandemic period. This study highlights the importance of accounting for underlying medical conditions in patients presenting with psychiatric complaints to the ED in the normalization phase. AVAILABILITY OF THE DATA AND MATERIAL: The datasets generated and/or analyzed during the present study are available from the corresponding author on reasonable request.

Methylprednisolone 100 mg tablet formulation with pea protein: experimental approaches over intestinal permeability and cytotoxicity.

OBJECTIVE: This study was carried out to transform the hydrolyzed pea protein into a pharmaceutical tablet form by masking methylprednisolone. SIGNIFICANCE: This study provides some crucial contributions in showing how functional excipients such as pea protein, which are generally used in food industries, can be used in pharmaceutical product formulations and their effects. METHODS: Methylprednisolone was formulated using spray drying technology. Design Expert Software (Version 13) was used for the statistical analysis. The in vitro cytotoxic effects for NIH/3T3 mouse fibroblast cells were investigated by XTT cell viability assay. HPLC was used to analyze the Caco-2 permeability studies and dissolution tests. RESULTS: The optimum formulation was evaluated against the reference product by performing cytotoxicity and cell permeability studies. According to our test results, Papp (apparent permeability) values of Methylprednisolone were measured around 3 × 10-6 cm/s and Fa (fraction absorbed) values around 30%. These data indicate that Methylprednisolone HCl has 'moderate permeability' and our study confirmed that it could have belonged to BCS Class II-IV since both low solubility and moderate permeability. CONCLUSION: The findings offer valuable information to guide and inform the use of pea protein in pharmaceutical formulations. Significant effects on methylprednisolone tablet formulation designed with the philosophy of quality by design (QbD) of pea protein have been demonstrated by both in vitro and cell studies.

Immunogenic evaluation of multi-epitope peptide-loaded PCPP microparticles as a vaccine candidate against Toxoplasma Gondii.

Toxoplasmosis is a major health problem and socioeconomic burden, affecting around 30-50% of the global population. Poly(dicarboxylatophenoxy)phosphazene (PCPP) polymer was chosen as adjuvant for the immunogenic peptide antigen. Peptide-loaded PCPP microparticles were synthesized via the coacervation method and the characterization studies of microparticles were conducted to determine their size, charge, morphology, encapsulation efficacy, and loading capacity. To evaluate in vivo efficacy of the vaccine candidate, Balb/c mice were immunized with the formulations. Brain and spleen tissues were isolated from animals to investigate cytokine levels, lymphocyte proliferation, and brain cyst formation. As a result, antibody and cytokine responses in groups immunized with peptide-loaded PCPP microparticles were found to be significantly higher when compared to the control group. In conclusion, our novel multi-epitope peptide-loaded PCPP microparticle-based vaccine formulation demonstrated considerable humoral and cellular immune responses against T. gondii and protected mice against T. gondii infection during Toxoplasmosis.