Protein- and peptide-based medications are recognized for their effectiveness and lower toxicity compared to chemical-based drugs, making them promising therapeutic agents. However, their application has been limited by numerous delivery challenges. Polymeric nanostructures have emerged as effective tools for protein delivery due to their versatility and customizability. Polymers’ inherent adaptability makes them ideal for meeting the specific demands of protein-delivery systems. Various strategies have been employed, such as enzyme inhibitors, absorption enhancers, mucoadhesive polymers, and chemical modifications of proteins or peptides. This study explores the hurdles associated with protein and peptide transport, the use of polymeric nanocarriers (both natural and synthetic) to overcome these challenges, and the techniques for fabricating and characterizing nanoparticles.

This paper assesses South Africa’s massive infrastructure drive to revive growth and increase employment. After years of stagnant growth, this is now facing a deep economic crisis, exacerbated by the COVID-19 pandemic. This drive also comes after years of weak infrastructure investment, widening the infrastructure deficit. The plan outlines a R1 trillion investment drive, primarily from the private sector through the Infrastructure Fund over the next 10 years (Government of South Africa, 2020). This paper argues that while infrastructure development in South Africa is much-needed, the emphasis on de-risking for private sector buy-in overshadows the key role the state must play in leading on structurally transforming the economy.

Introduction: the presence of anti-CCP is an important prognostic tool for rheumatoid arthritis (RA), but its relationship with the activity of the disease and functional capacity is still being investigated. Objectives: to study the relationship between anti-CCP and the indices of disease activity, functional capacity and structural damage, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in stabilized RA. Methods: cross-sectional study of RA patients with one to 10 years of disease. The participants were subjected to clinical evaluation with anti-CCP screening. Disease activity was assessed by means of the Clinical Disease Activity Index (CDAI) and functional capacity by means of the Health Assessment Questionnaire (HAQ). CR was analyzed by the Sharp van der Heijde index (SmvH) and MRI by the Rheumatoid Arthritis Magnetic Resonance Image Scoring System (RAMRIS). Results: 56 patients were evaluated, with median (IIq) of 55 (47.5–60.0) years, 50 (89.3%) were female among whom 37 (66.1%) were positive for anti-CCP. The median (IIq) of CDAI, HAQ, SmvH and RAMRIS were 14.75 (5.42–24.97), 1.06 (0.28–1.75), 2 (0–8) and 15 (7–35), respectively. There was no association between anti-CCP and CDAI, HAQ, SmvH and RAMRIS. Conclusion: our results did not establish the association of anti-CCP with the severity of the disease. So far, we cannot corroborate the anti-CCP as a prognostic tool in RA established.

Introduction: Stenoses in the path of arteriovenous fistulas (AVF) for hemodialysis are a very prevalent problem and there is long experience in their treatment by percutaneous angioplasty (PTA). These procedures, however, involve non-negligible equipment requirements, exposure to radiation and intravenous contrast that are not beneficial for the patient and make their performance more complex. This study reviews our initial experience with Doppler ultrasound-guided angioplasty. Methods: Prospective cohort of patients with native AVF dysfunction due to significant venous stenosis treated by Doppler echo-guided PTA. AVF puncture, lesion catheterization, balloon localization and inflation, and outcome verification were performed under ultrasound guidance. Only one fistulography was performed before and another one after dilatation. As a control, the cases performed during the same period by the usual angiographic method were also collected. Results: Between February 2015 and September 2018, 51 PTAs were performed on native AVF, of which 27 were echogenic (mean age, 65.3 years; 63% male). The technical success rate was 96%. In 26% of cases, PTA was repeated due to residual stenosis after angiographic imaging. There were 7.3% periprocedural complications. 92% of the AVFs were punctured at 24 hours. Primary patency at 1 month, 6 months and 1 year was 100%, 64.8% and 43.6%, and assisted patency was 100%, 87.2% and 74.8%. There were no significant differences in immediate or late results with respect to angiographically guided AVF angioplasty. Conclusions: AVF-PTA can be performed safely and effectively guided by Doppler ultrasound, which simplifies the logistics required for its performance, although we still need to improve the capacity for early verification of the result with this imaging technique.