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Desmopressin acetate (DA) is a first-line option for the treatment of hemophilia A, von Willebrand's disease, nocturnal enuresis, central diabetes insipidus, and various traumatic injuries. We extended previously reported desmopressin-loaded elastic liposomes (ODEL1) to investigate mechanistic insights into ODEL1 mediated augmented permeation across rat skin. HSPiP software and instrumental techniques such as differential scanning calorimeter (DSC), Fourier Transform infrared (FTIR), scanning electron microscopy (SEM), and fluorescent microscopy provided better understandings of permeation behavior. HSPiP was used to compare Hansen solubility parameter (HSP) of ODEL1, DA, components, and rat skins (control and treated) in terms of dispersion forces (δd), polar forces (δp), and hydrogen bonding (δh). FTIR, DSC, fluorescence microscopy, and SEM provided a detailed mechanistic understanding of the changes occurred after treatment. The values of δd, δp, and δH for DA were 20.6, 31.9, and 18.2 MPa1/2, respectively, whereas these were 15.6, 14.97, and 2.4 MPa1/2 for ODEL1, respectively, suggesting remarkable permeation of DA by changing innate cohesive energies of the skin. DA primarily interacts through δd and δp with the ODEL1 and the skin. Furthermore, the stretching and bending vibrations (molecular interactions) of the treated skins were quite diverse as compared to the untreated skin. ODEL1 caused a substantial thermal changes (shifted 67 to 65 °C, and 79 to 82.5 °C) for the surface protein and glycoprotein as compared to the untreated skin. Fluorescence and SEM confirmed relatively intense surface perturbation of the treated skin as compared to the control. Thus, ODEL1 was efficient in interacting with the skin surface for reversible changes and subsequently resulted in high permeation and drug deposition.

Background: Desmopressin acetate (DDAVP) and behavioral interventions (BI) are cornerstone treatments for nocturnal enuresis (NE), a common pediatric urinary disorder. Despite the growing body of clinical studies on massage therapy for NE, comprehensive evaluations comparing the effectiveness of Tuina with DDAVP or BI are scarce. This study aims to explore the efficacy of Tuina in the management of NE. Methods: A systematic search of international databases was conducted using keywords pertinent to Tuina and NE. The inclusion criteria were limited to randomized controlled trials (RCTs) that evaluated NE treatments utilizing Tuina against DDAVP or BI. This meta-analysis included nine RCTs, comprising a total of 685 children, to assess both complete and partial response rates. Results: Tuina, used as a combination therapy, showed enhanced clinical efficacy and improved long-term outcomes relative to the control group. The therapeutic efficacy of Tuina was not directly associated with the number of acupoints used. Instead, employing between 11 and 20 acupoints appeared to have the most significant effect. Conclusion: The findings of this meta-analysis support the potential of Tuina as an adjunct therapy to enhance the sustained clinical efficacy of traditional treatments for NE. However, Tuina cannot completely replace DDAVP or BI in the management of NE. While this study illuminates some aspects of the effective acupoint combinations, further research is crucial to fully understand how Tuina acupoints contribute to the treatment of NE in children. [ABSTRACT FROM AUTHOR]

The objective was to explore the efficacy of Tongdu Tuina manipulation in the treatment of primary single-symptom enuresis in children. A total of 102 children aged 5–16 with primary single-symptom enuresis were included in this study and randomly assigned to the Tuina group, the medication group and the control group, with 34 children in each group. The Tongdu Tuina group included manipulation of the Guanyuan, Qihai, Zhongji, Mingmen, kidney, Baihui, Sishencong and bladder acupoints, five times a week, the medication group was treated with 0.1 mg desmopressin acetate every night, and in the control group, the patients were given foods with high water content and underwent water deprivation 2 h before bedtime every night. The intervention time of each group was 1 month. The participants were followed up on Day 1 following treatment, as well as half a month, 1 month and 3 months after the implementation of the intervention measures, and the effective rate, the incidence of enuresis per week and the recurrence rate were calculated. As a result baseline demographic characteristics were comparable among 102 patients. Overall, 32 patients in the Tongdu Tuina group, 30 patients in the medication group and 34 patients in the control group completed the intervention. After half a month of treatment, there was no significant difference in the therapeutic efficacy among the three groups (P = 0.158), but each treatment could effectively reduce the frequency of weekly enuresis. The frequency of weekly enuresis in the Tongdu Tuina group was 3.8 ± 1.1 times, while that in the medication group was 4.0 ± 2.0 times. The frequency of weekly enuresis in the control group was 4.7 ± 1.8 times, and the difference was statistically significant (P = 0.016). After 1 month of treatment, the effective rates of the Tongdu Tuina group and the medication group were significantly increased (87.5% vs 83.33%, P < 0.0001), which was not the case with the control group. The frequency of enuresis was 1.9 ± 2.1 times per week in the Tongdu Tuina group, 2.4 ± 1.8 times per week in the medication group and 4.0 ± 0.9 times per week in the control group after 1 month of treatment. The difference between the three groups was statistically significant (P = 0.021), and there was a difference between the Tongdu Tuina group and the medication group (P < 0.0001). There was no significant difference between recurrence rate and the incidence of adverse events (P = 0.837, P = 0.856). In conclusion, both Tuina manipulation and desmopressin treatment can effectively improve children’s primary single-symptom enuresis with safety. However, Tongdu Tuina therapy may be superior to desmopressin treatment.

The objective was to explore the efficacy of Tongdu Tuina manipulation in the treatment of primary single-symptom enuresis in children. A total of 102 children aged 5–16 with primary single-symptom enuresis were included in this study and randomly assigned to the Tuina group, the medication group and the control group, with 34 children in each group. The Tongdu Tuina group included manipulation of the Guanyuan, Qihai, Zhongji, Mingmen, kidney, Baihui, Sishencong and bladder acupoints, five times a week, the medication group was treated with 0.1 mg desmopressin acetate every night, and in the control group, the patients were given foods with high water content and underwent water deprivation 2 h before bedtime every night. The intervention time of each group was 1 month. The participants were followed up on Day 1 following treatment, as well as half a month, 1 month and 3 months after the implementation of the intervention measures, and the effective rate, the incidence of enuresis per week and the recurrence rate were calculated. As a result baseline demographic characteristics were comparable among 102 patients. Overall, 32 patients in the Tongdu Tuina group, 30 patients in the medication group and 34 patients in the control group completed the intervention. After half a month of treatment, there was no significant difference in the therapeutic efficacy among the three groups (P = 0.158), but each treatment could effectively reduce the frequency of weekly enuresis. The frequency of weekly enuresis in the Tongdu Tuina group was 3.8 ± 1.1 times, while that in the medication group was 4.0 ± 2.0 times. The frequency of weekly enuresis in the control group was 4.7 ± 1.8 times, and the difference was statistically significant (P = 0.016). After 1 month of treatment, the effective rates of the Tongdu Tuina group and the medication group were significantly increased (87.5% vs 83.33%, P < 0.0001), which was not the case with the control group. The frequency of enuresis was 1.9 ± 2.1 times per week in the Tongdu Tuina group, 2.4 ± 1.8 times per week in the medication group and 4.0 ± 0.9 times per week in the control group after 1 month of treatment. The difference between the three groups was statistically significant (P = 0.021), and there was a difference between the Tongdu Tuina group and the medication group (P < 0.0001). There was no significant difference between recurrence rate and the incidence of adverse events (P = 0.837, P = 0.856). In conclusion, both Tuina manipulation and desmopressin treatment can effectively improve children’s primary singlesymptom enuresis with safety. However, Tongdu Tuina therapy may be superior to desmopressin treatment. [ABSTRACT FROM AUTHOR]

Desmopressin acetate (DA) is a first-line option for the treatment of hemophilia A, von Willebrand's disease, nocturnal enuresis, central diabetes insipidus, and various traumatic injuries. We extended previously reported desmopressin-loaded elastic liposomes (ODEL1) to investigate mechanistic insights into ODEL1 mediated augmented permeation across rat skin. HSPiP software and instrumental techniques such as differential scanning calorimeter (DSC), Fourier Transform infrared (FTIR), scanning electron microscopy (SEM), and fluorescent microscopy provided better understandings of permeation behavior. HSPiP was used to compare Hansen solubility parameter (HSP) of ODEL1, DA, components, and rat skins (control and treated) in terms of dispersion forces (δ d ), polar forces (δ p ), and hydrogen bonding (δ h ). FTIR, DSC, fluorescence microscopy, and SEM provided a detailed mechanistic understanding of the changes occurred after treatment. The values of δ d , δ p , and δ H for DA were 20.6, 31.9, and 18.2 MPa 1/2 , respectively, whereas these were 15.6, 14.97, and 2.4 MPa 1/2 for ODEL1, respectively, suggesting remarkable permeation of DA by changing innate cohesive energies of the skin. DA primarily interacts through δ d and δ p with the ODEL1 and the skin. Furthermore, the stretching and bending vibrations (molecular interactions) of the treated skins were quite diverse as compared to the untreated skin. ODEL1 caused a substantial thermal changes (shifted 67 to 65 °C, and 79 to 82.5 °C) for the surface protein and glycoprotein as compared to the untreated skin. Fluorescence and SEM confirmed relatively intense surface perturbation of the treated skin as compared to the control. Thus, ODEL1 was efficient in interacting with the skin surface for reversible changes and subsequently resulted in high permeation and drug deposition., Competing Interests: The authors report no conflict of interest., (© 2024 The Authors.)

Abstract This case report describes the clinical presentation, and the diagnostic and therapeutic approaches of a 4‐year‐old gelding presented with severe polyuria and polydipsia. The horse was diagnosed with central diabetes insipidus. After diagnosis, different therapeutic regimens with intraocular desmopressin acetate (Minirin, Ferring GmbH, Kiel, Germany) (a synthetic arginine vasopressin analog) were tested, but without success. Only the subcutaneous injection of desmopressin acetate (Minirin, Ferring GmbH) led to an increase in urine specific gravity and a decrease in water intake and urine output. Daily subcutaneous treatment with desmopressin acetate (Minirin, Ferring GmbH) was initiated and maintained for at least 5 years. The horse did not develop adverse effects or re‐occurrence of the initial complaints. This case report describes successful long‐term treatment of central diabetes insipidus in a horse.

Desmopressin acetate (DDAVP) is an oligopeptide indicated for the treatment of primary nocturnal enuresis, for example. The poor oral bioavailability of DDAVP accelerated a shift to alternative routes of administration like nasal and oromucosal, whereby nasal administration results in high fluctuations increasing the risk of undesirable side effects. Aim of the study was to use a new composite dosage form (solid matrix attached to a bilayer mucoadhesive film) to make DDAVP available via oromucosal route, reducing the risk of undesirable side effects through precise dosing. DDAVP was incorporated into a solid matrix in the form of a minitablet, and both direct tableting (AV > 30) and granulation followed by tableting (AV = 17.86) were compared. Minitablets with content uniformity could only be obtained by granulation and loss supplementation (AV = 11.27) with immediate drug release (>80% after 7–8 min) and rapid disintegration (

Objectives: To evaluate whether the efficacy of desmopressin differs between patients with and without nocturnal polyuria. Methods: A total of 65 treatment‐naïve children with monosymptomatic nocturnal enuresis were enrolled (45 boys; median age 8.9 years). Patients received desmopressin as their first‐line treatment. Four different standards were used (Akashi and Hoashi >0.9 mL/kg/sleeping hour; Hamano >[age + 2] × 25 × 130% mL; the International Children's Continence Society >[age + 1] × 30 × 130% mL; and Rittig >[age + 9] × 20 mL) to assess nocturnal polyuria. The effectiveness of desmopressin was compared between patients with and without nocturnal polyuria according to each standard. A response was defined as a reduction in wet nights of >50%. Results: The desmopressin treatment efficacy rate was 54% for polyuria and 67% for non‐polyuria patients (P = 0.20), 45% for polyuria and 68% for non‐polyuria patients (P = 0.08), 54% for polyuria and 59% for non‐polyuria patients (P = 0.80), and 52% for polyuria and 61% for non‐polyuria patients (P = 0.61), for the Akashi and Hoashi's, Hamano's, International Children's Continence Society and Rittig's standards, respectively. Conclusions: No difference was observed in the short‐term clinical efficacy of desmopressin regardless of the presence of nocturnal polyuria. Thus, this might be a feasible treatment option for patients with nocturnal enuresis without nocturnal polyuria. [ABSTRACT FROM AUTHOR]