Maintaining remission in ulcerative colitis – role of once daily extended-release mesalamine

The aminosalicylates (5-ASA; also referred to as mesalamine-based agents) are considered as first-line in the maintenance of remission of mild to moderate ulcerative colitis (UC). Traditionally these agents have required a large pill burden and multiple daily dosing regimens which may account for the low adherence rates, especially in patients in remission. Extended-release mesalamine is the first once daily mesalamine product approved by the Food and Drug Administration for the maintenance of UC remission. This review will examine the pharmacokinetics, dosing, efficacy, and safety data of extended-release mesalamine, and discuss the potential role of improving medication compliance and decreasing costs in UC maintenance

Study of the April 20, 2007 CME-Comet Interaction Event with an MHD Model

This study examines the tail disconnection event on April 20, 2007 on comet 2P/Encke, caused by a coronal mass ejection (CME) at a heliocentric distance of 0.34 AU. During their interaction, both the CME and the comet are visible with high temporal and spatial resolution by the STEREO-A spacecraft. Previously, only current sheets or shocks have been accepted as possible reasons for comet tail disconnections, so it is puzzling that the CME caused this event. The MHD simulation presented in this work reproduces the interaction process and demonstrates how the CME triggered a tail disconnection in the April 20 event. It is found that the CME disturbs the comet with a combination of a $180^\circ$ sudden rotation of the interplanetary magnetic field (IMF), followed by a $90^\circ$ gradual rotation. Such an interpretation applies our understanding of solar wind-comet interactions to determine the \textit{in situ} IMF orientation of the CME encountering Encke.Comment: 13 pages, 3 figures, accepted by the ApJ Letter

Some 5-13 micrometer airborne observations of Comet Wilson 1986l: Preliminary results

Comet Wilson was observed from the Kuiper Airborne Observatory approximately 23.6 and 25.7 Apr. 1987, UT (approx. 3 to 5 days after perihelion) using the NASA-Ames Faint Object Grating Spectrometer. Spectrophotometric data were observed with a 21 inch aperture between 5 and 13 micrometer and with a spectral resolution of 50 to 100. Spectra of the inner coma and nucleus reveal a fairly smooth continuum with little evidence of silicate emission. The 5 to 8 micrometer color temperature of the comet was 300 + or - 15 K, approx. 15 percent higher than the equilibrium blackbody temperature. All three spectra of the nucleus show a new emission feature at approx. 12.25 micrometer approx. two channels (.22 micrometer) wide. Visual and photographic observations made during the time of these observations showed a broad faint, possible two component tail. No outburst activity was observed

Semi-Classical Description of Antiproton Capture on Atomic Helium

A semi-classical, many-body atomic model incorporating a momentum-dependent Heisenberg core to stabilize atomic electrons is used to study antiproton capture on Helium. Details of the antiproton collisions leading to eventual capture are presented, including the energy and angular momentum states of incident antiprotons which result in capture via single or double electron ionization, i.e. into [He$^{++}\,\bar p$ or He$^{+}\,\bar p$], and the distribution of energy and angular momentum states following the Auger cascade. These final states are discussed in light of recently reported, anomalously long-lived antiproton states observed in liquid He.Comment: 15 pages, 9 figures may be obtained from authors, Revte

Prevalence of nonadherence with maintenance mesalamine in quiescent ulcerative colitis

There are scant data regarding outpatient adherence in quiescent ulcerative colitis aside from patients enrolled in controlled clinical trials. We conducted a prevalence study to determine the medication adherence rate of maintenance therapy and to identify possible risk factors for nonadherence. METHODS : Outpatients with clinically quiescent ulcerative colitis for >6 months on maintenance mesalamine (Asacol, Procter and Gamble, Cincinnati, OH) were eligible. Patients were interviewed regarding disease history, and demographics were obtained from medical records. Refill information for at least 6 months was obtained from computerized pharmacy records. Adherence was defined as at least 80% consumption of supply dispensed. Using nonadherence as the outcome of interest, stratified analysis and regression modeling were used to identify significant associations. RESULTS : Data were complete for the 94 patients recruited. The overall adherence rate was found to be 40%. The median amount of medication dispensed per patient was 71% (8–130%) of the prescribed regimen. Nonadherent patients were more likely to be male (67% vs 52%, p < 0.05 ), single (68% vs 53%, p = 0.04 ), and to have disease limited to the left side of the colon versus pancolitis (83% vs 51%, p < 0.01 ). Sixty-eight percent of patients who took more than four prescription medications were found to be nonadherent versus only 40% of those patients taking fewer medications ( p = 0.05 ). Age, occupation, a family history of inflammatory bowel disease, length of remission, quality-of-life score, or method of recruitment (telephone interview vs clinical visit) were not associated with nonadherence. Logistic regression identified that a history of more than four prescriptions (odds ratio [OR] 2.5 [1.4–5.7]) and male gender (OR 2.06 [1.17–4.88]) increased the risk of nonadherence. Two statistically significant variables, which were protective against nonadherence, were endoscopy within the past 24 months (OR 0.96 [0.93–0.99]) and being married (OR 0.46 [0.39–0.57]). CONCLUSION : Nonadherence is associated with multiple concomitant medications, male gender, and single status. These patient characteristics may be helpful in targeting those patients at higher risk for nonadherence.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75640/1/j.1572-0241.2001.04683.x.pd

Use of Biologic Therapy by Pregnant Women With Inflammatory Bowel Disease Does Not Affect Infant Response to Vaccines

BACKGROUND & AIMS: In women with inflammatory bowel diseases (IBDs), exposure to immunomodulator or biologic therapy has not been associated with adverse events during pregnancy or outcomes of newborns. We investigated whether exposure of patients to these agents during pregnancy affects serologic responses to vaccines in newborns. METHODS: We collected data from the Pregnancy in IBD and Neonatal Outcomes registry, which records outcomes of pregnant women with diagnosis of IBD receiving care at multiple centers in the United States, from 2007 through 2016. Serum samples collected from infants at least 7 months old were analyzed for titers of antibodies to Haemophilus influenzae B (HiB) or tetanus toxin; mothers completed a survey of vaccine practices and outcomes from July 2013 through October 2016. Umbilical cord blood samples from 33 infants were assayed for concentration of biologic agents. Vaccination response was compared between infants born to mothers exposed to biologic therapy (infliximab, adalimumab, certolizumab pegol, golimumab, natalizumab, vedolizumab, or ustekinumab-either as a single agent or in combination with an immunomodulator, at any time between conception and delivery) and infants born to unexposed mothers. RESULTS: A total of 179 women completed the vaccine survey (26 biologic unexposed, 153 exposed to a biologic agent). We found no significant difference in proportions of infants with protective antibody titers against HiB born to exposed mothers (n = 42, 71%) vs unexposed mothers (n = 8, 50%) (P = .41). We also found no difference in the proportion of infants with protective antibody titers to tetanus toxoid born to exposed mothers (80%) vs unexposed mothers (75%) (P = .66). The median concentration of infliximab in cord blood did not differ significantly between infants with vs without protective antibody titers to HiB (P = .30) or tetanus toxoid (P = .93). Mild reactions were observed in 7/40 infants who received rotavirus vaccine and whose mothers had been exposed to biologic therapies. CONCLUSIONS: Vaccination of infants against HiB and tetanus toxin, based on antibody titers measured when infants were at least 7 months old, does not appear to be affected by in utero exposure to biologic therapy

Spectral Irradiance Calibration in the Infrared

Five new absolutely calibrated continuous stellar spectra from 1.2 to 35 microns are presented. The spectra were constructed as far as possible from actual observed spectral fragments taken from the ground, the Kuiper Airborne Observatory (KAO), and the IRAS Low Resolution Spectrometer (LRS). These stars (beta Peg, alpha Boo, beta And, beta Gem, and alpha Hya) augment the author's already created complete absolutely calibrated spectrum for alpha Tau. All these spectra have a common calibration pedigree. The wavelength coverage is ideal for calibration of many existing and proposed ground-based, airborne, and satellite sensors

Spectral Irradiance Calibration in the Infrared

We present five new absolutely calibrated continuous stellar spectra from 1.2 to 35 microns, constructed as far as possible from actual observed spectral fragments taken from the ground, the Kuiper Airborne Observatory (KAO), and the IRAS Low Resolution Spectrometer (LRS). These stars- beta Peg, alpha Boo, beta And, beta Gem, and alpha Hya-augment our already created complete absolutely calibrated spectrum for alpha Tau. All these spectra have a common calibration pedigree. The wavelength coverage is ideal for calibration of many existing and proposed ground-based, airborne, and satellite sensors

Efficacy of Online Training for Improving Camp Staff Competency

Preparing competent staff is a critical issue within the camp community. This quasi-experimental study examined the effectiveness of an online course for improving staff competency in camp healthcare practices among college-aged camp staff and a comparison group (N = 55). We hypothesized that working in camp would increase competency test scores due to opportunities for staff to experientially apply knowledge learned online. Hierarchical linear modeling was used to analyse the cross-level effects of a between-individuals factor (assignment to experimental or comparison group) and within-individual effects of time (pre-test, post-test #1, and post-test #2) on online course test scores. At post-test #2, the difference in average test scores between groups was ~30 points, with the treatment group scoring lower on average than the comparison group. Factors that may have influenced these findings are explored, including fatigue and the limited durability of online learning. Recommendations for research and practice are discussed

Extended thromboprophylaxis with betrixaban in acutely ill medical patients

BACKGROUND: Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. METHODS: Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding. RESULTS: A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55). CONCLUSIONS: Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218.)