Spread of Mesalazine Rectal Foam after Single Dose in Mild Ulcer Patients

Background: The rectal foam enemas were used for ulcerative colitis of distal regions due to its desired efficacy and less side effects. The spread and persistence of the drug plays a key role in the treatment. Therefore, the objective of the present study is to study the spread and persistence of Salofalk (Mesalazine foam Enema), manufactured by Dr. Falk Pharma GmbH (mesalazine) rectal foam in mild ulcerative colitis patients. Methods: This is an open label, uncontrolled prospective study in ulcerative colitis patients. The patients received 2 g of mesalazine rectal foam (labelled with Tcm99) in two actuations (30 mL). The spread of the radiolabeled formulation was assessed over a period of 4 h by gamma scintigraphy. Results: The formulation was retained by the patients till 4 h imaging period. The foam spread in rectum, sigmoid colon and descending colon. The percentage radioactive dose exposed is more in sigmoid colon compared to rectum and descending colon in 4 h imaging period. The spread of the foam extended till descending colon for two out of 4 patients. Conclusion: The study results are consistent with the previous studies, and it supports the label indication. The obtained data of the present study provides in vivo evidence of the spread of formulation in the desired site of action.

Expression and subcellular localization of organophosphate hydrolase in acephate-degrading Pseudomonas sp. strain Ind01 and its use as a potential biocatalyst for elimination of organophosphate insecticides

Organophosphate hydrolase (OPH), the product of an organophosphate-degrading (opd) gene cloned from Brevundimonas diminuta, hydrolyses the triester linkage found in neurotoxic organophosphate (OP) insecticides and nerve agents. Despite the fact that OPHs have a broad substrate range, OP compounds with a P-S linkage, such as insecticides like acephate, are poor substrates for the enzyme. Expression of OPH in acephate-utilizing Pseudomonas sp. Ind01 generated a live biocatalyst capable of degrading a wide range of OP insecticides. The heterologously expressed OPH, which is a substrate of twin arginine transport (Tat) pathway, successfully targeted to the membrane of Pseudomonas sp. Ind01. The membrane-associated OPH had a size that coincided with the mature form of OPH (mOPH), suggesting successful processing and targeting of the expressed OPH to the membrane. Pseudomonas sp. Ind01 expressing OPH degraded a variety of OP insecticides besides using acephate as sole carbon source.

SIGNIFICANCE AND IMPACT OF THE STUDY

A biocatalyst capable of degrading a wide range of organophosphate (OP) insecticides was generated by expressing an organophosphate degradation gene in Pseudomonas sp. Ind01 involved in mineralization of acephate. The biocatalyst can be used to eliminate a wide range of OP insecticide residues from the environment.

Relationship of electro-mechanical remodeling to survival rates after cardiac resynchronization therapy

Cardiac resynchronization therapy, when added to optimal medical therapy, increases longevity in symptomatic congestive heart failure patients with left ventricular ejection fractions (LVEF)≤0.35 and QRS durations>120 ms. Cardiac resynchronization therapy is also associated with electrical and mechanical reverse remodeling. We examined whether reverse remodeling predicts increased survival rates in non-trial settings. Recipients of cardiac resynchronization therapy and defibrillators (n=112; 78 men; mean age, 69±11 yr) underwent repeat echocardiography and electrocardiography at least 90 days after device implantation. Forty patients had mechanical responses of at least 0.05 improvement in absolute LVEF; 56 had electrical responses (any narrowing of biventricular-paced QRS duration compared with the electrocardiogram immediately after therapy). During a mean follow-up period of 3.1±1.7 years, 55 patients died. The average death rate per 100 person-years was lower among mechanical responders than nonresponders (9.2% vs 23.9%; P=0.009); the unadjusted hazard ratio was 0.39 (95% confidence interval [CI], 0.19-0.79). In a multivariate model adjusted for age, sex, baseline LVEF, and QRS duration, mechanical responders had 60% better survival than nonresponders (hazard ratio=0.40; 95% CI, 0.21-0.79; P=0.008). No difference in survival was observed in electrical response. In our association of absolute change in LVEF over the observed range with death (using restricted cubic splines), we observed a linear relationship with survival. In patients given cardiac resynchronization therapy, mechanical but not electrical remodeling was associated with better survival rates, suggesting that mechanical remodeling underlies this therapy's mechanism of conferring a survival benefit.

Correlation of electrical and mechanical reverse remodeling after cardiac resynchronization therapy

BACKGROUND

Cardiac resynchronization therapy (CRT) improves clinical outcome in many patients with refractory heart failure (HF). This study examined whether CRT is associated with reverse electrical remodeling by surface electrocardiogram (ECG).

METHODS

Consecutive CRT recipients at the University of Pittsburgh Medical Center with >90 days of follow-up were included in this analysis. ECG data were abstracted from medical records. Subjects with a relative increase of > or =15% in left ventricular ejection fraction (LVEF) after CRT were considered responders.

RESULTS

A total of 113 patients (age 69 +/- 11 years, men 70%, white 92%) were followed for a mean duration of 407 +/- 290 (92-1439) days. Overall, LVEF increased after CRT (29 +/- 13% vs 24 +/- 9%; P < 0.01) and 50% of patients were responders. The mean native QRS interval among responders was higher than in nonresponders (163 +/- 32 ms vs 148 +/- 29 ms; P < 0.01). More than 3 months after CRT, there was no change in the paced QRS duration compared to baseline. Paced QRS duration, however, decreased among responders and increased among nonresponders and was significantly different by response status (P < 0.001). There was a significant correlation between increase in LVEF and decrease in paced QRS width in the overall population (r =-0.3; P < 0.01).

CONCLUSIONS

Among responders to CRT, the paced QRS width decreases significantly, whereas it increases among nonresponders. Given the paced nature of the QRS, the improved conduction probably reflects enhanced cell-to-cell coupling after CRT as opposed to improved conduction within the His-Purkinje system. These findings have significant implications as to the mechanisms of benefit from CRT.