Size-switchable polymer-based nanomedicines in the advanced therapy of rheumatoid arthritis.

Chronic inflammatory diseases such as rheumatoid arthritis represent a substantial socio-economic impact and have a high prevalence in the modern world. Nano-sized polymer therapeutics have shown suitable characteristics for becoming the next generation of anti-inflammatory nanomedicines. Here, we present biocompatible and stimuli-sensitive N-(2-hydroxypropyl)methacrylamide based polymer conjugates with the anti-inflammatory drug dexamethasone (DEX), which has been tailored for prolonged blood circulation, enhanced inflammatory site accumulation, site-specific drug release and subsequent elimination of the carrier via urine excretion. The hydrodynamic size of novel polymer-DEX nanomedicine was adjusted to prolong its blood circulation whilst maintaining the renal excretability of the polymer carrier after drug release in inflamed tissue. The therapeutic efficacy of the studied polymer nanomedicines was evaluated in a model of dissipated chronic arthritis, i.e. collagen II-induced arthritis, in mice. The pH-sensitive drug attachment enabled enhanced blood circulation with minimal systemic drug release, as well as rapid drug activation in affected joints. Importantly, unlike free DEX, the polymer nanomedicines were able to diminish joint inflammation and arthritis-induced bone damage - even at a reduced dosing regimen - as evaluated by micro computed tomography (micro-CT).

Midazolam and its effect on vital signs and behavior in children under conscious sedation in dentistry.

Midazolam is a short acting sedative with small number of adverse effects. Administered orally, it is currently the most common form of conscious sedation in children. The objective of this paper is to describe effect of midazolam administered to children during dental treatment on their vital signs, and to monitor changes in children's behavior. We described values of vital signs and behavior in 418 sedations conducted in 272 children between 1-12 years of age. To achieve the following results, we used data from 272 all first-time sedations. After administration of midazolam arterial blood pressure and blood oxygen saturation decreased by values which were not clinically significant. The heart rate increased, with values staying within the limits of physiological range. The speed of onset of midazolam's clinical effects depends on age and dose. The lower age and dose correlated with the higher behavior score. The effectiveness of midazolam treatment is 97.8 %. Unwillingness of child to receive midazolam is predictor for disruptive behavior during sedation. 1.8 % of all sedation cases showed paradoxical reactions. The administration of midazolam in dose of 0.5 mg per 1 kg of child's body weight is safe and could be recommended for dental treatment in pediatric dentistry.

[Epidemiologic monitoring of tick-borne encephalitis in Rimov in Southern Bohemia]. / Epidemiologické sledování klíst'ové encefalitidy v jizních Cechách. Lokalita Rímov. Pomer manifestních a inaparentních forem infekce, stanovenî proitilátkové odezvy ve sledovaném souborn. Snaha zvýsit intervencí stupen imunity mimorádným ockováním u osob s nízkými ci negativními titry v lokalite. Rímov v období prelomu roku 2001/2002.

Southern Bohemia is one of the extensive natural foci of tick-borne encephalitis (TE) in the Czech Republic. Some professionals hold the view that people living in the focus of infection acquire naturally herd immunity and are the protected against the infection and thus it is not necessary to vaccinate them against TE. Several serious cases of the disease in temporal sequence in Rímov in the district of Ceské Budejovice led the authors to examine more closely the problem of TE in this locality. Available epidemiological data were analyzed. A group of subjects with permanent residence in the community was assembled who were interested to participate in the trial. In these serological examinations were made to assess antibodies against TE. Analysis of the assembled data proved that during permanent residence in Rímov 6.07% of the investigated group during their life in Rímov developed the manifest form of TE, 9.64% developed the inapparent form and 15% subjects had antibodies after previous vaccination. The ratio of manifest and inapparent cases is 6.07:9.64, i.e. roughly 2:3. The total seroprevalence after the disease (manifest and inapparent) is 16%. Persons with a negative result of the examination were offered vaccination. The vaccination rate increased due to the authors' intervention from 15% to 65% in the given community.