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Rectal drug delivery is an effective alternative to oral and parenteral treatments. This route allows for both local and systemic drug therapy. Traditional rectal dosage formulations have historically been used for localised treatments, including laxatives, hemorrhoid therapy and antipyretics. However, this form of drug dosage often feels alien and uncomfortable to a patient, encouraging refusal. The limitations of conventional solid suppositories can be overcome by creating a thermosensitive liquid suppository. Unfortunately, there are currently only a few studies describing their use in therapy. However, recent trends indicate an increase in the development of this modern therapeutic system. This review introduces a novel rectal drug delivery system with the goal of summarising recent developments in thermosensitive liquid suppositories for analgesic, anticancer, antiemetic, antihypertensive, psychiatric, antiallergic, anaesthetic, antimalarial drugs and insulin. The report also presents the impact of various types of components and their concentration on the properties of this rectal dosage form. Further research into such formulations is certainly needed in order to meet the high demand for modern, efficient rectal gelling systems. Continued research and development in this field would undoubtedly further reveal the hidden potential of rectal drug delivery systems.

Postmenopausal women are faced with difficulties in colposcopy, such as easy bleeding from epithelial atrophy, and thinning, atypical colposcopy images, unsatisfactory exposure, and decreased sensitivity of colposcopy. We aimed to improve the sensitivity and satisfaction of colposcopy in postmenopausal women and to evaluate the clinical efficacy of compound sea-buckthorn oil suppository on topical vaginal pretreatment in postmenopausal women prior to colposcopy. Postmenopausal patients who underwent colposcopy in the Obstetrics and Gynecology Hospital of Fudan University from April 2023 to July 2024 were randomly assigned to three groups: (A) untreated control group, (B) compound sea-buckthorn oil suppository group, (C) estrogen ointment group. Group B and group C were treated for 2 weeks before colposcopy, and the colposcopy and adverse reactions were analyzed. A total of 377 patients were included in this study, of which 9 patients were excluded from the colposcopy results for failing to complete the 2-week medication, and 368 patients were included in the colposcopy results, including 125 patients in group A, 121 patients in group B, and 122 patients in group C. The high-risk HPV infection before colposcopy accounted for 94.3% (347/368), of which HPV16 and/or HPV18 infection accounted for 20.4% (75/368), and other types of infection accounted for 75.3% (277/368). The patients with abnormal cytology (ASCUS and above) accounted for 47.6% (175/368). No significant differences were observed in age, cytology before colposcopy, and HPV type among the three groups. There were 196 cases (53.3%) of abnormal pathologies in postoperative colposcopic biopsy, among which 42 cases were high-grade cervical squamous intraepithelial lesions. After 2 weeks of medication, the integrity of vaginal epithelium, the adequacy ratio of colposcopy, and the satisfaction rate of acetic acid test and iodine staining test in groups B and C were significantly improved compared with group A ( P  < 0.001), and there was no significant difference between groups B and C. The incidence of breast discomfort in the estrogen ointment group was 5.6%, while the incidence of dizziness and headache was 4%. In contrast, no such side effects were reported in the compound sea-buckthorn oil suppository group, and the difference was statistically significant. Additionally, there was no significant statistical difference in local vaginal adverse reactions between groups B and C. Compound sea-buckthorn oil suppositories are helpful in improving the sensitivity and satisfaction of postmenopausal women with colposcopy, reduce blind biopsies. The effects are not inferior to estrogen. Compared to estrogen ointment, compound sea-buckthorn oil suppositories are most cost-effective and have fewer side effects and can be applied in clinical practice.

Two ways to deliver ultrasmall gold nanoparticles and gold-bovine serum albumin (BSA) nanoclusters to the colon were developed. First, oral administration is possible by incorporation into gelatin capsules that were coated with an enteric polymer. These permit the transfer across the stomach whose acidic environment damages many drugs. The enteric coating dissolves due to the neutral pH of the colon and releases the capsule’s cargo. Second, rectal administration is possible by incorporation into hard-fat suppositories that melt in the colon and then release the nanocarriers. The feasibility of the two concepts was demonstrated by in-vitro release studies and cell culture studies that showed the easy redispersibility after dissolution of the respective transport system. This clears a pathway for therapeutic applications of drug-loaded nanoparticles to address colon diseases, such as chronic inflammation and cancer.

The purpose of this study was to investigate whether vaginal administration of probiotic Lactobacillus results in their colonization and persistence in the vagina and whether it promotes normalization and maintenance of pH and Nugent score. A single-arm, open-label controlled towards the baseline (pre–post) study including 35 apparently healthy women was conducted. Each woman was examined three times during the study. Women were instructed to receive daily for 7 days, the probiotic suppositories SYNBIO ® gin ( Lactobacillus rhamnosus IMC 501 ® and Lactobacillus paracasei IMC 502 ® ). Vaginal swabs were collected during visit 1, 2, and 3 to determine the total lactobacilli count, the presence of the two administered bacteria, the measure of the pH, and the estimation of Nugent score. Evaluation of treatment tolerability was based on analysis of the type and occurrence of adverse events. The probiotic vaginal suppository was well tolerated and no side effects were reported. Intermediate Nugent score was registered in 40 % of women at visit 1 and these intermediate scores reverted to normal at day 7 (end of treatment) in 20 % of subjects. Administration of SYNBIO ® gin contributed to a significant increase in the lactobacilli level at visit 2. Molecular typing revealed the presence of the two strains originating from SYNBIO ® gin in 100 % of women at visit 2 and 34 % at visit 3. No significant changes were registered for pH between visits. The SYNBIO ® gin product is safe for daily use in healthy women and it could be useful to restore and maintain a normal vaginal microbiota.

Diabetes mellitus is a group of metabolic diseases mainly characterized by chronic hyperglycemia. The oral immediate release tablet formulation of Repaglinide (REP) is associated with the sudden hypoglycemia and difficulty in swallowing particularly by pediatric and geriatric patients. These limitations ultimately affect the patient compliance highlighting the need for the development of alternative formulations such as suppositories. The current study was aimed to formulate and evaluate REP suppositories as a potential alternative to inhibit diabetic activity. REP suppositories prepared by molding method were characterized via Fourier Transform Infra-Red spectroscopy and evaluated for various physicochemical parameters including FTIR analysis, disintegration, breaking, liquefaction and dissolution tests. The entrapment efficiency of the formulation was quantified by UV method. In vivo efficacy was assessed using alloxan-induced diabetic rabbits at predetermined time intervals in experimental groups. FTIR analysis confirmed the chemical compatibility of REP and suppository base. Disintegration time was 21 min, while breaking test confirmed that the suppository was able to withstand up to 1.9 kg of applied weight. Liquefaction time and E.E (%) was recorded as 10 min and 88%, respectively. In vitro drug release showed a burst release followed by sustained release up to 3 hrs (34). In vitro evaluation confirmed that the REP suppository formulations met the official standards for physicochemical evaluation, and drug-base interaction. In vivo study showed that the REP suppository caused a significant reduction of blood glucose level in a sustained release manner. Taken together, REP suppository provides the promising antidiabetic activity for a sustained period with improved efficacy as compare to oral tablets. However, further trials are needed to confirm its clinical efficacy and safety in diabetic patients. [Display omitted]

Children with autism spectrum disorder (ASD) are often delayed in achieving bowel continence, resulting in negative outcomes. In this pilot trial, 20 children with ASD and encopresis were randomly assigned to multidisciplinary intervention for encopresis (MIE; n = 10) or a waitlist control group (n = 10). The MIE group was treated for constipation and received a 10-day behavioral intervention that utilized suppositories to produce predictable bowel movements that were reinforced. Caregivers were trained to implement the intervention. Results support the feasibility of clinical trials of MIE, with high enrolment, competition, attendance, and caregiver acceptability. Preliminary outcomes were positive, with six of 10 in the MIE group achieving continence by the end of treatment compared to 0 in the control group (p = 0.005).Registered at clinicaltrials.gov (https://clinicaltrials.gov); ID: NCT02383732.

Ablation or surgical excision is the typical treatment of anal high-grade squamous intraepithelial lesions (HSIL). Recurrences are common due to the persistence of underlying human papillomavirus (HPV) infection. Additional well-tolerated and effective non-surgical options for HPV-associated anal disease are needed. This 3+3 dose escalation Phase I clinical trial evaluated the safety and tolerability of artesunate suppositories in the treatment of patients with biopsy-proven HSIL. The maximal tolerated dose was 400 mg, administered in 3 cycles. All adverse events associated with the use 200- and 400-mg artesunate suppositories were Grade 1. At the 600-mg dose, patients experienced clinically significant nausea. Artesunate suppositories are a safe treatment option for anal HSIL.

To improve treatment compliance and reach sustained and controlled drug release in the colon, we developed a hollow mesoporous silica nano-suppository that responded to both pH and redox stimuli. Firstly, we prepared hollow mesoporous silica nanoparticles containing disulfide bonds (HMSN-SS) and loaded them with 5-ASA. Secondly, we modified the surface of HMSN-SS with polydopamine (PDA) and chitosan (CS) and molded the suppository, which we named 5-ASA@HMSN-SS-PDA-CS (5-ASA@HSPC). By administering 5-ASA@HSPC rectally, it acted directly on the affected area. CS helped the nanoparticles adhere to the colon’s surface, while PDA dissociates from HMSN-SS due to protonation in the acidic environment of the ulcerative colon. The disulfide bonds were destroyed by the reducing environment of the colon, leading to a stable and slow release of encapsulated 5-ASA from the pores of HMSN. Finally, in vitro release experiments and in vivo pharmacokinetic and pharmacodynamic experiments had demonstrated that 5-ASA@HSPC exhibited a slow and steady action at the colonic site, with an excellent safety profile. This novel approach showed great potential in the treatment of ulcerative colitis. Graphical Abstract

We assessed the acceptability of three of over-the-counter products representative of potential rectal microbicide (RM) delivery systems. From 2009 to 2010, 117 HIV-uninfected males (79 %) and females (21 %) who engage in receptive anal intercourse participated in a 6-week randomized crossover acceptability trial. Participants received each of three products (enema, lubricant-filled applicator, suppository) every 2 weeks in a randomized sequence. CASI and T-ACASI scales assessed product acceptability via Likert responses. Factor analysis was used to identify underlying factors measured by each scale. Random effects models were fit to examine age and gender effects on product acceptability. Three underlying factors were identified: Satisfaction with Product Use , Sexual Pleasure , and Ease of Product Use . For acceptability, the applicator ranked highest; however, differences between product acceptability scores were greatest among females and younger participants. These findings indicate that RM delivery systems impact their acceptability and should be considered early in RM development to enhance potential use.

Objectives Chronic constipation is a common condition in pediatric patients worldwide and is associated with decreased quality of life. Inpatient management of constipation is required when outpatient therapy fails and a child becomes obstipated, and unable to pass stool or gas. There is a growing body of evidence regarding different management strategies for pediatric obstipation. This scoping review aims to map the existing literature regarding inpatient management of pediatric obstipation and identify gaps in knowledge. Methods We will follow the methodology described by the Joanna Briggs Institute and outlined in the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews guidelines. The search strategy will include Embase, PubMed, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and gray literature sources. Two independent reviewers will complete screening for eligible studies in two steps: a scan of the title and s followed by a full‐text review. Studies regarding inpatient management of pediatric obstipation, with experimental or cohort design, and with full text available in English will be included. Systematic reviews will also be included. Two independent reviewers will extract data using a standardized form. Extracted data will be presented in visual and narrative formats, including an evidence map to meet the objectives of this scoping review. This protocol is registered at Open Science Framework. Conclusion In this scoping review, we will outline the current evidence available regarding the efficacy and safety of various hospital interventions for the treatment of pediatric obstipation. What is Known Constipation is a common pediatric problem and can be treated in the outpatient setting for most patients. Inpatient colonic disimpation is done when patients fail outpatient colonic disimpaction. What is New This scoping review will outline current evidence and identify gaps in knowledge regarding inpatient management of pediatric obstipation and will be reported utilizing the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews guidelines. The search strategy for this review has been developed in collaboration with an experienced medical librarian and includes databases, reference lists, and gray literature sources to ensure all relevant literature is included.