Exaggerated QT prolongation after cardioversion of atrial fibrillation

AbstractOBJECTIVESThe purpose of this study was to test the hypothesis that the extent of drug-induced QT prolongation by dofetilide is greater in sinus rhythm (SR) after cardioversion compared with during atrial fibrillation (AF).BACKGROUNDAnecdotes suggest that when action potential–prolonging antiarrhythmic drugs are used for AF, excessive QT prolongation and torsades de pointes (TdP) often occur shortly after sinus rhythm is restored.METHODSQT was measured in nine patients with AF who received two identical infusions of dofetilide: 1) before elective direct current cardioversion and 2) within 24 h of restoration of SR.RESULTSDuring AF, dofetilide did not prolong QT (baseline: 368 ± 48 ms vs. drug: 391 ± 60, p = NS) whereas during SR, QT was prolonged from 405 ± 55 to 470 ± 67 ms (p < 0.01). In four patients (group I), the SR dofetilide infusion was terminated early because QT prolonged to >500 ms, and one patient developed asymptomatic nonsustained TdP. The remaining five patients (group II) received the entire dose during SR. Although ΔQT was greater in group I during SR (91 ± 22 vs. 45 ± 25 ms, p < 0.05), plasma dofetilide concentrations during SR were similar in the two groups (2.72 ± 0.96 vs. 2.77 ± 0.25 ng/ml), and in AF (2.76 ± 1.22 ng/ml). ΔQT in SR correlated inversely with baseline SR heart rate (r = −0.69, p < 0.05), and QT dispersion developing during the infusion (r = 0.79, p < 0.01).CONCLUSIONSShortly after restoration of SR, there was increased sensitivity to QT prolongation by this IKr-specific blocker. Slower heart rates after cardioversion and QT dispersion during treatment appear to be important predictors of this response

Template-free synthesis of hybrid silica nanoparticle with functionalized mesostructure for efficient methylene blue removal

A simple one-pot synthesis process for functionalized mesostructured silica nanoparticles (MSNP) is reported. The novel process demonstrated the possibility to achieve MSNP with a surface area up to 501 m2.g−1 using a phosphonate based nonsilane precursor such as N, N´-bis[4,6-bis(diethylphosphono)-1,3,5-triazin-yl]-1,2-diaminoethane (ED). MSNP obtained by using 20 mol% of ED achieved a surface area of 80 m2.g−1 and increasing the ED content to 30 mol% resulted in a surface area of 501 m2.g−1. Zeta potential of novel MSNPs (−65.5 and 70.0 mV) were much higher than the nanoparticle (NP) prepared from only TEOS (−49 mV), indicating the presence of a large number of –SiOH and phosphonic acid surface functional groups, as confirmed by Fourier-transform infrared spectroscopy (FT-IR) and Nuclear magnetic resonance (NMR) analysis. The functionalized MSNPs were used as an adsorbent for the removal of cationic pollutants like methylene blue (MB). The MSNP with the highest porosity displayed favorable MB adsorption behavior with ~380 mg.g−1 of MB adsorption capacity. Facile regeneration in an acidic medium (~pH 4.5) with easy recyclability (10 cycles) confirmed the practical applicability of this novel functionalized MSNPs

An analysis of Company XYZs owner controlled insurance program

Includes bibliographical references

Solid-State NMR Characterization of Mixed Phosphonic Acid Ligand Binding and Organization on Silica Nanoparticles

As ligand functionalization of nanomaterials becomes more complex, methods to characterize the organization of multiple ligands on surfaces is required. In an effort to further the understanding of ligand–surface interactions, a combination of multinuclear (¹H, ²⁹Si, ³¹P) and multidimensional solid-state nuclear magnetic resonance (NMR) techniques was utilized to characterize the phosphonic acid functionalization of fumed silica nanoparticles using methyl­phosphonic acid (MPA) and phenyl­phosphonic acid (PPA). ¹H → ²⁹Si cross-polarization (CP)–magic angle spinning (MAS) solid-state NMR was used to selectively detect silicon atoms near hydrogen atoms (primarily surface species); these results indicate that geminal silanols are preferentially depleted during the functionalization with phosphonic acids. ¹H → ³¹P CP-MAS solid-state NMR measurements on the functionalized silica nanoparticles show three distinct resonances shifted upfield (lower ppm) and broadened compared to the resonances of the crystalline ligands. Quantitative ³¹P MAS solid-state NMR measurements indicate that ligands favor a monodentate binding mode. When fumed silica nanoparticles were functionalized with an equal molar ratio of MPA and PPA, the MPA bound the nanoparticle surface preferentially. Cross-peaks apparent in the 2D ¹H exchange spectroscopy (EXSY) NMR measurements of the multiligand sample at short mixing times indicate that the MPA and PPA are spatially close (≤5 Å) on the surface of the nanostructure. Furthermore, ¹H–¹H double quantum–single quantum (DQ-SQ) back-to-back (BABA) 2D NMR spectra further confirmed that MPA and PPA are strongly dipolar coupled with observation of DQ intermolecular contacts between the ligands. DQ experimental buildup curves and simulations indicate that the average distance between MPA and PPA is no further than 4.2 ± 0.2 Å