The Significance of Detective Arrhythmia by Using the Long- Term Ecg Monitoring in the Elderly “so Called” Healthy People: A Screening Study

BackgroundArrhythmias are potential harmful diseases to human beings, especially atrial fibrillation and ventricular arrhythmia, for causing serious consequences such as acute stroke or even sudden cardiac death. Recently the screening of asymptomatic atrial fibrillation by using the long-term ECG monitoring has been widely noticed. The study is to evaluate the significance of detective arrhythmia by using the long-term ECG monitoring in the elderly “so called” healthy people who never have the symptoms of palpitation, short breath or deny previous history of arrhythmia.MethodsWe enrolled a screening study of 1056 participants who were the elderly “so called” healthy people and ready to have a healthy examination from three different communities. They all underwent a long-term ECG monitoring（an adhesive patch）to evaluate cardiac arrhythmia. Inclusion criterias were 1) without any symptoms, 2) age ≥55, and 3) denying previous history of arrhythmia. We excluded patients with prior arrhythmias and who carried the patch for less than one day due to various factors. Then we compared the detected arrhythmia events in the first 24 hours and the total wearing time. ResultsOut of 1056 participants (69.8±12.0 years, 620 males), supraventricular tachycardia (SVT) was present in 538 subjects (44% VS 54%, 24 hours VS after 24 hours, P>0.05), atrial fibrillation (AF) was detected in 69 subjects (75% VS 25%, 24 hours VS after 24 hours, P<0.001), second degree type II atrioventricular block/third degree atrioventricular block (AVB) and sinus arrest were detected in 9 subjects(22% VS 78%, 24 hours VS after 24 hours, P<0.001),ventricular tachycardia was detected in 29 subjects (31% VS 69%, 24 hours VS after 24 hours, P<0.001). The adhesive patch monitor detected 32.10%（339/1056）arrhythmia events over the first 24 hours compared with arrhythmia events over the total wearing time of the devices, 61.08%（645/1056）(P<0.001). ConclusionsThe long-term adhesive patch monitor (APM) can improve the diagnosis of conceal arrhythmias which have high risks for life quality and lifespan in the elderly “so called ” healthy people, and the diagnostic advantage in bradycardia and ventricular arrhythmias are more obvious.

Wearable Flexible Phototherapy Device for Knee Osteoarthritis

Knee osteoarthritis (OA) is a highly prevalent and disabling disease that causes pain and gradual degeneration of the articular cartilage. Phototherapy is a new physiotherapy treatment, more effective and stable than other non-pharmacologic management. Conventional phototherapy devices typically suffer from unintelligent and bulky equipment, while existing phototherapy methods require maintain a certain phototherapy distance. Here, we introduce a wearable flexible phototherapy device worn on a knee for osteoarthritis, incorporating a phototherapy adhesive patch and a control box. The phototherapy adhesive patch is capable of softly laminating onto the curved surfaces of the knee skin to increase the effects of phototherapy. We describe the LED array, constant current drive module, key control module, and power supply module that serve as the foundations for the control box. The weight of the device is only 101.8 g. The irradiance of the device can be adjusted linearly and irradiance of the designed phototherapy device based on LED can reach 13 mW/cm2. The maximum temperature of the surface of the light source is 31.2 °C. The device proposed in this work exhibits satisfactory stability, promising a potential in phototherapy.

The effect of combination of functional and nonfunctional acrylic polymers on transdermal patches of : in vitro permeation, in vivo evaluation using biochemical parameters, and stability studies

Background A double-layer transdermal drug-in-adhesive patch of carvedilol was developed using functional and nonfunctional grades of acrylic adhesives, DURO-TAK® 387-2051, DURO-TAK® 387-2510, and DURO-TAK® 87-4098. The patch was designed to provide adequate permeation of the drug up to 2 days, with effective adhesion attributes. An optimized formulation was selected, the effect of the combination was studied and a 180° peel strength test was performed to evaluate adhesive properties. Further, the patch was assessed for in vivo studies on basis of biochemical parameters, skin irritation, and stability studies. The stability study was carried out on optimized fresh (S1) and 6 months old patches stored at room, and accelerated condition (40 ± 2 °C/75 ± 5% RH) using FTIR, DSC, and SEM techniques. Result It was studied that the steady-state flux (Jss) or permeation rate of the drug through excised rat skin has relied on the nature of acrylic and the combination of acrylic polymers. The TDDS containing –OH functional group DT 387-2510 with nonfunctional pressure-sensitive adhesives (PSAs) DT 87-4098, with Span 80 as penetration enhancer exhibited maximum flux (19.12 ± 0.64 μg/cm2/h) and form homogeneous and stable blends, controlling permeation of drug at a desired steady rate for 48 h. The data obtained from in vivo studies using biochemical parameters suggested that there were no statistical differences observed in results for the control and treated group while analyzing observations for serum creatinine, glucose test, sodium test, albumin, and potassium (p > 0.05). Also, the optimized formulation showed no sign of localized reactions and was confirmed by a skin histological study indicating the formulation was safe and compatible with the skin. A significant shift of peaks was not observed in FTIR spectra and DSC thermograms of the patches after the stability period. Conclusion The investigation reveals that the drug-in-adhesive patch of carvedilol, by a combination of functional and nonfunctional PSAs, provides a good and effective option for controlled delivery of carvedilol. From our findings, it has been concluded that drug in the adhesive patch has been able to provide satisfactory adhesion, drug uniformity, drug permeation, marked positive biochemical results, and good stability.

Formulation and Evaluation of Quetiapine Loaded Pressure Sensitive Adhesive Patch for Transdermal Drug Delivery

The present research work was intended to develop and characterize the transdermal adhesive patch of quetiapine using different types of acrylate, polyisobutylene and silicon adhesives. Various permeation enhancers such as 1, 8 – cineole, D-limonene, Azone, IPM and Oleic acid were also evaluated to achieve desired permeation rate and hence to attain the improved bioavailability of quetiapine as compared to oral formulation. Formulations prepared were evaluated for physicochemical characterization, permeability enhancement potential by ex vivo, and stability studies. The results of the optimized formulation showed peel strength of 423 ± 4.13 cN/cm, flux of 54.92 ± 0.79 (µg/h/cm2) and % drug content of 98.16 ± 0.43% which was stable up to six months in accelerated condition. The results of the study revealed that the developed transdermal patch of quetiapine can be a promising alternative which provides effective management of schizophrenia in terms of improved patient compliance and reduced dosage frequency.