Background: A previous study has shown that variations in threshold and intensity (lipid goal attainment)
of statins for primary prevention contribute to regional differences in overall consumption of statins in
Norway. Our objective was to explore how differences in prevalences of use, dosing characteristics,
choice of statin and continuity of therapy in individual patients adds new information to previous results.
Methods: Data were retrieved from The Norwegian Prescription Database. We included individuals from
counties with high, average, and low statin consumption, who had at least one statin prescription dispensed
during 2004 (N = 40 143).
1-year prevalence, prescribed daily dose (PDD), statin of choice, and continuity of therapy assessed by
mean number of tablets per day.
Results: The high-consumption county had higher prevalence of statin use in all age groups.
Atorvastatin and simvastatin were dispensed in 79–87% of all statin users, and the proportion was
significantly higher in the high-consumption county.
The estimated PDDs were higher than the DDDs, up to twice the DDD for atorvastatin. The highconsumption
county had the highest PDD for simvastatin (25.9 mg) and atorvastatin (21.9 mg), and more
users received tablets in the upper range of available strengths. Continuity of therapy was similar in the
three counties.
Conclusion: Although differences in age-distribution seems to be an important source of variation in
statin consumption, it cannot account for the total variation between counties in Norway. Variations in
prevalences of use, and treatment intensity in terms of PDD and choice of statin also affect the total
consumption. The results in this study seems to correspond to previous findings of more frequent statin
use in primary prevention, and more statin users achieving lipid goal in the highest consuming county.
Benthic marine invertebrates collected from sub-Arctic regions of northern Norway, were found to be a promising source of novel bioactive compounds against human and fish pathogenic bacteria and fungi. Lyophilized material from seven species of ascidians, six sponges and one soft alcyonid coral were extracted with 60% acidified acetonitrile (ACN). After separation into an ACN-rich phase (ACN extract) and an aqueous phase, and subsequent solid phase extraction of the aqueous phase, fractions differing in polarity were obtained and screened for antibacterial and antifungal activities, along with the more lipophilic ACN-extracts. Antimicrobial activity was determined against two Gram-negative, two Gram-positive bacteria, and two strains of fungi. Notably, all the invertebrate species in the study showed activity against all four strains of bacteria and the two strains of fungi. In general, the aqueous fractions displayed highest antimicrobial activity, and the most potent extracts were obtained from the colonial ascidian Synoicum pulmonaria which displayed activity against bacteria and fungi at a concentration of 0.02 mg/ml; the lowest concentration tested.
Background: Poxvirus-vectored vaccines against infectious diseases and cancer are currently under
development. We hypothesized that the extensive use of poxvirus-vectored vaccine in future might result
in co-infection and recombination between the vaccine virus and naturally occurring poxviruses, resulting
in hybrid viruses with unpredictable characteristics. Previously, we confirmed that co-infecting in vitro a
Modified vaccinia virus Ankara (MVA) strain engineered to express influenza virus haemagglutinin (HA) and
nucleoprotein (NP) genes with a naturally occurring cowpox virus (CPXV-NOH1) resulted in recombinant
progeny viruses (H Hansen, MI Okeke, Ø Nilssen, T Traavik, Vaccine 23: 499–506, 2004). In this study we
analyzed the biological properties of parental and progeny hybrid viruses.
Results: Five CPXV/MVA progeny viruses were isolated based on plaque phenotype and the expression
of influenza virus HA protein. Progeny hybrid viruses displayed in vitro cell line tropism of CPXV-NOH1,
but not that of MVA. The HA transgene or its expression was lost on serial passage of transgenic viruses
and the speed at which HA expression was lost varied with cell lines. The HA transgene in the progeny
viruses or its expression was stable in African Green Monkey derived Vero cells but became unstable in
rat derived IEC-6 cells. Hybrid viruses lacking the HA transgene have higher levels of virus multiplication
in mammalian cell lines and produced more enveloped virions than the transgene positive progenitor virus
strain. Analysis of the subcellular localization of the transgenic HA protein showed that neither virus strain
nor cell line have effect on the subcellular targets of the HA protein. The influenza virus HA protein was
targeted to enveloped virions, plasma membrane, Golgi apparatus and cytoplasmic vesicles.
Conclusion: Our results suggest that homologous recombination between poxvirus-vectored vaccine
and naturally circulating poxviruses, genetic instability of the transgene, accumulation of non-transgene
expressing vectors or hybrid virus progenies, as well as cell line/type specific selection against the
transgene are potential complications that may result if poxvirus vectored vaccines are extensively used
in animals and man.
Background Polar bears (Ursus maritimus) are major predators in the Arctic marine ecosystem, feeding mainly on seals, and living closely associated with sea ice. Little is known of their gut microbial ecology and the main purpose of this study was to investigate the microbial diversity in faeces of polar bears in Svalbard, Norway (74-81 degrees N, 10-33 degrees E). In addition the level of blaTEM alleles, encoding ampicillin resistance (ampr) were determined. In total, ten samples were collected from ten individual bears, rectum swabs from five individuals in 2004 and faeces samples from five individuals in 2006. Results A 16S rRNA gene clone library was constructed, and all sequences obtained from 161 clones showed affiliation with the phylum Firmicutes, with 160 sequences identified as Clostridiales and one sequence identified as unclassified Firmicutes. The majority of the sequences (70%) were affiliated with the genus Clostridium. Aerobic heterotrophic cell counts on chocolate agar ranged between 5.0 x 104 to 1.6 x 106 colony forming units (cfu)/ml for the rectum swabs and 4.0 x 103 to 1.0 x 105 cfu/g for the faeces samples. The proportion of ampr bacteria ranged from 0% to 44%. All of 144 randomly selected ampr isolates tested positive for enzymatic beta-lactamase activity. Three % of the ampr isolates from the rectal samples yielded positive results when screened for the presence of blaTEM genes by PCR. BlaTEM alleles were also detected by PCR in two out of three total faecal DNA samples from faeces three polar bears. Conclusion The bacterial diversity in faeces from polar bears in their natural environment in Svalbard is low compared to other animal species, with all obtained clones affiliating to Firmicutes. Furthermore, only low levels of blaTEM alleles were detected in contrast to their increasing prevalence in some clinical and commensal bacterial populations.
o determine the genetic composition of the first VanA-type plasmid (pIP816) reported, which was isolated from a clinical Enterococcus faecium (BM4147) strain in France in 1986, and to reveal the genetic units responsible for the dissemination of the vanA gene cluster by comparisons with current, published and additionally generated vanA-spanning plasmid sequences obtained from a heterogeneous E. faecium strain collection (n = 28).Plasmid sequences were produced by shotgun sequencing using ABI dye chemistry and primer walking, and were subsequently annotated. Comparative sequence analysis of the vanA region was done with published plasmids, with a partial vanA plasmid (pVEF4) reported here and to >140 kb of sequence obtained from a collection of vanA-harbouring plasmid fragments. Bioinformatic analyses revealed that pIP816 from 1986 and contemporary vanA plasmids shared a conserved genetic fragment of 25 kb, spanning the 10.85 kb vanA cluster encoded by Tn1546, and that the larger unit is present in both clinical and animal complexes of E. faecium. A new group II intron in pVEF4 was characterized. Comparative DNA analyses suggest that Tn1546 disseminates in and between clonal complexes of E. faecium as part of a larger genetic unit, possibly as a composite transposon flanked by IS1216 elements.
Novel sonosensitive doxorubicin-containing liposomes comprising dioleoylphosphatidylethanolamine (DOPE) as the main lipid constituent were developed and characterized in terms of ultrasound-mediated drug release in vitro. The liposome formulation showed high sonosensitivity; where approximately 95% doxorubicin was released from liposomes after 6 min of 40 kHz US exposure in buffered sucrose solution. This represented a 30% increase in release extent in absolute terms compared to liposomes comprising the saturated lipid analogue distearoylphosphatidylethanolamine (DSPE), and a 9-fold improvement in release extent when compared to standard pegylated liposomal doxorubicin, respectively. Ultrasound release experiments in the presence of serum showed a significantly reduction in sonosensitivity of DSPE-based liposomes, whilst the release properties of DOPE-based liposomes were essentially maintained. Dynamic light scattering measurements and cryo-transmission electron microscopy of DOPE-based liposomes after ultrasound treatment indicated liposome disruption and formation of various lipid structures, corroborating the high release extent. The results point to the potential of DOPE-based liposomes as a new class of drug carriers for ultrasound-mediated drug delivery.
Oxidative damage and inflammation have been pointed out in preclinical studies as the root cause of cancer and other chronic diseases such as diabetes, hypertension, Alzheimer’s disease, etc. Epidemiological and clinical studies have suggested that cancer could be prevented or significantly reduced by treatment with anti-oxidant and anti-inflammatory drugs, therefore, curcumin, a principal component of turmeric (a curry spice) showing strong anti-oxidant and anti-inflammatory activities, might be a potential candidate for the prevention and/or treatment of cancer and other chronic diseases. However, curcumin, a highly pleiotropic molecule with an excellent safety profile targeting multiple diseases with strong evidence on the molecular level, could not achieve its
optimum therapeutic outcome in past clinical trials, largely due to its low solubility
and poor bioavailability. Curcumin can be developed as a therapeutic drug through
improvement in formulation properties or delivery systems, enabling its enhanced absorption and cellular uptake. This review mainly focuses on the anti-inflammatory potential of curcumin and recent developments in dosage form and nanoparticulate delivery systems with the possibilities of therapeutic application of curcumin for the prevention and/or treatment of cancer.
Ultrasound sensitive (sonosensitive liposomes) are drug delivery systems designed for releasing their drug load upon exposure to ultrasound (US). Inclusion of dioleoylphosphatidylethanolamine (DOPE) in liposome membranes was previously shown to induce sonosensitivity. For efficient US mediated drug delivery to solid tumours, a long blood circulation time of the liposomal drug providing high tumour uptake is required. In this study, blood pharmacokinetics of DOPE-based liposomal doxorubicin (DXR) were evaluated in mice. A markedly faster blood clearance of DXR was observed for DOPE-rich liposomes compared to Caelyx! (standard liposomal DXR). Subsequently, liposome membrane composition was altered to improve drug retention in the bloodstream, while maintaining sonosensitivity. Formulations with reduced blood clearance of DXR were obtained by
reducing the content of DOPE from 62 to 32 or 25 mol%. These formulations showed long blood circulation time, as approximately 20% of the administered DXR dose was present in the bloodstream 24 h after intravenous injection. The reduction in liposomal DOPE content did not significantly reduce US mediated DXR release in vitro, indicating that DOPE is a potent modulator to sonosensitivity. The novel liposome formulations, containing moderate amounts of DOPE, displayed similar blood pharmacokinetic profiles as standard liposomal DXR, but a markedly improved sonosensitivity.
A study of mortality for all patients with schizophrenia admitted to the University Hospital of North Norway during 1980-2006 was performed, with a special focus on gender differences and changes in mortality during a period of transition from hospital-based to community-based care. A total of 1111 patients with schizophrenia were included, and the cohort was linked to the Causes of Death Register of Norway. Males and females had 3.5 and 2.6 times, respectively, higher mortality than the general population. The standardized mortality ratios were higher during the last nine years than the first nine years, and for women admitted after 1992, we found evidence for an increasing difference in mortality compared to the general female population as well as an increase in absolute mortality. In the subgroup of patients who had always been admitted voluntarily, women tended to have higher mortality, and a particularly high standardized mortality rate (SMR) was found in this group of female schizophrenic patients. Our results confirmed a persisting mortality gap between patients with schizophrenia and the general population over a period of 27 years, with a tendency of increasing standardized mortality ratios over time. The SMR for total mortality of women with schizophrenia is rising and becoming just as high as for men, both for unnatural and natural causes of death.
This study aimed to use a population-based
Prescription Database to explore later development of diabetes
in women registered with gestational diabetes mellitus
(GDM) and/or preeclampsia in the Medical Birth Registry of
Norway (MBRN) during 2004–8. We used two nationwide
Norwegian registries, the Norwegian Prescription Database
and the MBRN, to explore the onset of later diabetes after
pregnancy complications, indicated by receiving prescriptions
of drugs used to treat diabetes, in 230,000 women
giving birth in 2004–8. The mean follow-up of the study
cohort was 3.7 years. Five years after pregnancy, about 19
and 2% of women with GDM and preeclampsia, respectively,
received drugs used to treat diabetes, compared to
0.5% of those without these complications. The risk of being
dispensed drugs used to treat diabetes within the first years
after pregnancy was estimated to be 41 times (95% CI:
35–47) and 3.0 times (95% CI: 2.4–3.6) higher in women
with GDM and preeclampsia, respectively, compared to
women without these pregnancy complications. Women
with pregnancies complicated with preeclampsia or GDM
had an increased risk of later diabetes, especially those
having GDM. If the increase in frequency of GDM observed
inMBRN in recent years is real, a further increase in diabetic
women can be expected.
Development of liposomal mucoadhesive drug delivery system, which is able to improve the bioavailability of poorly absorbed oral drugs by prolonging their gastric and intestinal residence time, through facilitating the intimate contact of the delivery system with the absorption membrane. Liposomes containing model drug atenolol were prepared by the modified ethanol injection method. Liposomes containing atenolol were coated by different mucoadhesive polymers, for example, chitosan, Carbopol 974P, Eudragit L100, and Eudragit S100, to optimize the choice of coating material. The delivery systems were tested for their in vitro mucoadhesiveness. Liposomes prepared by the ethanol injection method were of satisfactory size (around 100 nm, before coating). Through the coating of liposomes in the presence of unentrapped material, the entrapment efficiency for drug was increased. In vitro mucoadhesive test confirmed the mucoadhesive properties of the coated layer for all tested polymers; however, Eudragit S100-coated liposomes were superior to other coating materials. Eudragit coating appeared to be an optimal polymer choice. These preliminary data indicate that polymer-coated mucoadhesive liposomes are able to carry sufficient amount of drug and to remain attached to the intestinal mucosa for a sufficient period of time to enable prolonged absorption of entrapped drug. While keeping in mind that the in vivo conditions may vary with the in vitro ones, we may recommend the system described in our work for possible oral delivery of peptides and phytochemicals.
To estimate the relative fitness differences between glycopeptide-resistant Enterococcus faecium (GREF) and glycopeptide-susceptible E. faecium (GSEF) from yearly surveillance data on the occurrence of GREF in Danish poultry farm environments.
A population genetic model was adapted to retrospectively estimate the biological fitness cost of acquired resistance. Maximization of a likelihood function was used to predict the longitudinal persistence of acquired resistance.
Our analysis suggests strong selection against GREF following the 1995 ban on the glycopeptide growth promoter avoparcin. However, parameterizing the model with two selection coefficients suggesting a reduced negative effect of the acquired resistance on bacterial fitness over time significantly improved the fit of the model. Our analyses suggest that the acquired glycopeptide resistance will persist for >25 years.
Conclusions Acquired resistance determinants in commensal E. faecium populations in Danish farm environments are likely to persist for decades, even in the absence of glycopeptide use.
Chitosan is currently proposed to be one of the most promising polymers in wound dressing development. Our research focuses on its potential as a vehicle for nano-delivery systems destined for burn therapy. One of the most important features of wound dressing is its bioadhesion to the wounded site. We compared the bioadhesive properties of chitosan with those of Carbopol, a synthetic origin polymer. Chitosan-based hydrogels of different molecular weights were first analyzed by texture analysis for gel cohesiveness, adhesiveness and hardness. In vitro release studies showed no difference in release of model antimicrobial drug from the different hydrogel formulations. Bioadhesion tests were performed on pig ear skin and the detachment force, necessary to remove the die from the skin, and the amount of remaining formulation on the skin were determined. Although no significant difference regarding detachment force could be seen between Carbopol-based and chitosan-based formulations, almost double the amount of chitosan formulation remained on the skin as compared to Carbopol formulations. The findings confirmed the great potential of chitosan-based delivery systems in advanced wound therapy. Moreover, results suggest that formulation retention on the ex vivo skin samples could provide deeper insight on formulation bioadhesiveness than the determination of detachment force