Preparation and Characterization of Nitrendipine-loaded Eudragit RL 100 Microspheres Prepared by an Emulsion-Solvent Evaporation Method

Purpose: The aim of the work was to prepare nitrendipne-loaded Eudragit RL 100 microspheres to achieve sustained release nitrendipine. Method: Nitrendipne-loaded Eudragit RL 100 microspheres were prepared by an emulsion-solvent evaporation method using ethanol/liquid paraffin system. The resultant microspheres were evaluated for average particle size, drug loading, in vitro drug release and release kinetics. FTIR spectrometry, scanning electron microscopy, differential scanning calorimetry and x-ray powder diffractometry were used to investigate the physical state of the drug in the microspheres. Result: The mean particle size of the microspheres was influenced by varying drug:polymer ratio and emulsifier concentration while drug loading was dependent on drug:polymer ratio. The results of FTIR spectrometry, differential scanning calorimetry and x-ray diffractometry indicated the stable character of nitrendipne in drug-loaded microspheres and also revealed absence of drug-polymer interaction. The drug release profiles of the microspheres at pH 1.2 showed poor drug release characteristics while at pH 6.8, drug release was extended over a period of 8 h; release was influenced by polymer concentration and particle size. Drug release followed the Higuchi model. Conclusion: The nitrendipine-loaded Eudragit RL 100 microspheres prepared under optimized conditions showed a good sustained release characteristics and were stable under the conditions studied Keywords: Nitrendipine, Eudragit RL 100, Microspheres, Physicochemical characterization, Sustained release. Tropical Journal of Pharmaceutical Research Vol. 7 (3) 2008: pp. 1033-104

Formulation of Sodium Alginate Nanospheres Containing Amphotericin B for the Treatment of Systemic Candidiasis

Purpose: The aim of this work was to formulate sodium alginate nanospheres of amphotericin B by controlled gellification method and to evaluate the role of the nanospheres as a “passive carrier” in targeted antifungal therapy. Methods: Sodium alginate nanospheres of amphotericin B were prepared by controlled gellification method, and the particle size analysis was carried out by scanning electron microscopy. The carrier capacity of sodium alginate was evaluated in terms of drug to polymer ratio. In vitro release study was carried out on all drug loaded nanospheres by the dialysis method. Release kinetics of drug from different drug loaded nanospheres was also determined. The in vivo antifungal efficacy of nanospheres bound drug vis-à-vis the free drug was evaluated in candidiasis- induced mice models. Results: Preparation of nanospheres through controlled gellification method yielded particles with a size range of 419.6 ± 0.28 nm. Studies on drug to polymer ratio showed a linear relationship between concentration of drug and drug loading capacity. In vitro release kinetic study revealed that the release of drug from the nanospheres followed Fickian diffusion. In vivo studies showed that the nanosphere-bound drug produced a higher antifungal efficacy than the free drug. Conclusion: The formulated sodium alginate nanospheres containing amphotericin B was found to have better antifungal activity when compared to the free drug and also yielded sustained in vitro release. Keywords: Nanospheres, sodium alginate, amphotericin B, controlled gellification method, in vitro & in vivo release > Tropical Journal of Pharmaceutical Research Vol. 6 (1) 2007: pp. 653-65

CFD parametric study of thermal performance of different fruit packaging box designs

Air temperature and relative humidity values of cold storage conditions are the major factor affecting the perishability of fresh fruits. The sooner the field heat is extracted from the products and the proper temperature is maintained consistency throughout the cold chain, larger it will be shelf life of these products. Forced air cooling is the most commonly used technique to remove the field heat in post-harvest storage. Energy-efficient and quality-oriented cold storage mainly depends on the time to remove the heat. This time can be reduced by optimizing the configuration of the vent holes of the packaging box, namely it dimension (area), it shape, alignment and position. This paper shows the numerical predictions of air temperature and velocity by a CFD parametric study of eight different vent hole configurations. These configurations consider a packaging box with double wall. The vent holes of each wall have different dimension and shape. The vent holes of both walls can be also aligned or unaligned. The analysis of results aims to determine the best configurations that improve the cooling rate, the airflow and temperature uniformity. The numerical predictions of the air temperature show close values, but three configurations can be identified as predicting the lowest air temperature values with lowest standard deviation. These results may help on the development of new configuration for fruit boxes that promote the extension of the fruits shelflife.(undefined

Chronic Subdural Haematoma in the Elderly: Is It Time for a New Paradigm in Management?

Chronic subdural haematoma (CSDH) is a common neurological condition that usually affects the elderly. The optimal treatment strategy remains uncertain, principally because there is a lack of a good evidence base. In this paper, we review the literature concerning the peri-operative and operative care of patients. In particular, we highlight the non-surgical aspects of care that might impact on patient outcomes and CSDH recurrence. We propose that an integrated approach to care in patients with CSDH, similar to care of fragility fractures in the elderly, may be an important strategy to improve patient care and outcomes

Brain death, states of impaired consciousness, and physician-assisted death for end-of-life organ donation and transplantation

In 1968, the Harvard criteria equated irreversible coma and apnea (i.e., brain death) with human death and later, the Uniform Determination of Death Act was enacted permitting organ procurement from heart-beating donors. Since then, clinical studies have defined a spectrum of states of impaired consciousness in human beings: coma, akinetic mutism (locked-in syndrome), minimally conscious state, vegetative state and brain death. In this article, we argue against the validity of the Harvard criteria for equating brain death with human death. (1) Brain death does not disrupt somatic integrative unity and coordinated biological functioning of a living organism. (2) Neurological criteria of human death fail to determine the precise moment of an organism’s death when death is established by circulatory criterion in other states of impaired consciousness for organ procurement with non-heart-beating donation protocols. The criterion of circulatory arrest 75 s to 5 min is too short for irreversible cessation of whole brain functions and respiration controlled by the brain stem. (3) Brain-based criteria for determining death with a beating heart exclude relevant anthropologic, psychosocial, cultural, and religious aspects of death and dying in society. (4) Clinical guidelines for determining brain death are not consistently validated by the presence of irreversible brain stem ischemic injury or necrosis on autopsy; therefore, they do not completely exclude reversible loss of integrated neurological functions in donors. The questionable reliability and varying compliance with these guidelines among institutions amplify the risk of determining reversible states of impaired consciousness as irreversible brain death. (5) The scientific uncertainty of defining and determining states of impaired consciousness including brain death have been neither disclosed to the general public nor broadly debated by the medical community or by legal and religious scholars. Heart-beating or non-heart-beating organ procurement from patients with impaired consciousness is de facto a concealed practice of physician-assisted death, and therefore, violates both criminal law and the central tenet of medicine not to do harm to patients. Society must decide if physician-assisted death is permissible and desirable to resolve the conflict about procuring organs from patients with impaired consciousness within the context of the perceived need to enhance the supply of transplantable organs

A discharge summary adapted to the frail elderly to ensure transfer of relevant information from the hospital to community settings: a model

<p>Abstract</p> <p>Background</p> <p>Elderly patients admitted to Geriatric Assessment Units (GAU) typically have complex health problems that require multi-professional care. Considering the scope of human and technological resources solicited during hospitalization, as well as the many risks and discomforts incurred by the patient, it is important to ensure the communication of pertinent information for quality follow-up care in the community setting. Conventional discharge summaries do not adequately incorporate the elements specific to an aging clientele.</p> <p>Objective</p> <p>To develop a discharge summary adapted to the frail elderly patient (D-SAFE) in order to communicate relevant information from hospital to community services.</p> <p>Methods</p> <p>The items to be included in the D-SAFE have been determined by means of a modified Delphi method through consultation with clinical experts from GAUs (11 physicians and 5 pharmacists) and the community (10 physicians and 5 pharmacists). The consensus analysis and the level of agreement among the experts were reached using a modified version of the RAND^®/University of California at Los Angeles appropriateness method.</p> <p>Results</p> <p>A consensus was reached after two rounds of consultation for all the items evaluated, where none was judged «inappropriate». Among the items proposed, four were judged to be « uncertain » and were eliminated from the final D-SAFE, which was divided into two sections: the medical discharge summary (22 main items) and the discharge prescription (14 main items).</p> <p>Conclusions</p> <p>The D-SAFE was developed as a more comprehensive tool specifically designed for GAU inpatients. Additional research to validate its acceptability and practical impact on the continuity of care is needed before it can be recommended for use on a broader scale.</p

Anesthesia advanced circulatory life support

The constellation of advanced cardiac life support (ACLS) events, such as gas embolism, local anesthetic overdose, and spinal bradycardia, in the perioperative setting differs from events in the pre-hospital arena. As a result, modification of traditional ACLS protocols allows for more specific etiology-based resuscitation. Perioperative arrests are both uncommon and heterogeneous and have not been described or studied to the same extent as cardiac arrest in the community. These crises are usually witnessed, frequently anticipated, and involve a rescuer physician with knowledge of the patient's comorbidities and coexisting anesthetic or surgically related pathophysiology. When the health care provider identifies the probable cause of arrest, the practitioner has the ability to initiate medical management rapidly. Recommendations for management must be predicated on expert opinion and physiological understanding rather than on the standards currently being used in the generation of ACLS protocols in the community. Adapting ACLS algorithms and considering the differential diagnoses of these perioperative events may prevent cardiac arrest

Preparation and Characterization of Nitrendipineloaded Eudragit RL 100 Microspheres Prepared by an Emulsion-Solvent Evaporation Method

Purpose: The aim of the work was to prepare nitrendipne-loaded Eudragit RL 100 microspheres to achieve sustained release nitrendipine. Method: Nitrendipne-loaded Eudragit RL 100 microspheres were prepared by an emulsion-solvent evaporation method using ethanol/liquid paraffin system. The resultant microspheres were evaluated for average particle size, drug loading, in vitro drug release and release kinetics. FTIR spectrometry, scanning electron microscopy, differential scanning calorimetry and x-ray powder diffractometry were used to investigate the physical state of the drug in the microspheres. Result: The mean particle size of the microspheres was influenced by varying drug:polymer ratio and emulsifier concentration while drug loading was dependent on drug:polymer ratio. The results of FTIR spectrometry, differential scanning calorimetry and x-ray diffractometry indicated the stable character of nitrendipne in drug-loaded microspheres and also revealed absence of drug-polymer interaction. The drug release profiles of the microspheres at pH 1.2 showed poor drug release characteristics while at pH 6.8, drug release was extended over a period of 8 h; release was influenced by polymer concentration and particle size. Drug release followed the Higuchi model. Conclusion: The nitrendipine-loaded Eudragit RL 100 microspheres prepared under optimized conditions showed a good sustained release characteristics and were stable under the conditions studied