The results of inspiratory muscle training on cardiac, respiratory, musculoskeletal, and psychological status in patients with stable angina: a randomized controlled trial.

PURPOSE: To determine the effect of inspiratory muscle training (IMT) on respiratory and peripheral muscle strength, functional exercise capacity, health-related quality of life (HRQoL), fatigue, depression, and cardiac functions in patients with stable angina. METHODS: A randomized, controlled, single-blinded study. Twenty patients (59.95 ± 7.35 y, LVEF = 58.77 ± 7.49) with stable angina received IMT at the lowest load (10 cmH2O), and 20 patients (55.85 ± 7.60 y, LVEF = 62.26 ± 7.75) received training at 30% of maximal inspiratory pressure (MIP) seven days/8 weeks. Respiratory muscle strength (MIP; maximal expiratory pressure, MEP), peripheral muscle strength, pulmonary functions, functional exercise capacity (6-min walking test; exercise test), fatigue, HRQoL, depression, and cardiac functions were evaluated before and after. RESULTS: A statistical difference was found between groups in terms of respiratory and peripheral muscle strength, pulmonary functions, functional exercise capacity (p < 0.05). The results of fatigue, depression, HRQoL, and cardiac functions were similar between the groups (p > 0.05). CONCLUSIONS: This study is the first to demonstrate the positive effects of IMT in patients with stable angina. IMT is a safe and effective method and is recommended to be added to cardiopulmonary rehabilitation programs and guidelines, as it results in increased peripheral muscle strength and functional exercise capacity in stable angina patients.Implications for rehabilitationInspiratory muscle training (IMT) is a safe and effective method for coronary artery disease (CAD) patients with stable angina.IMT improved respiratory and peripheral muscle strength, functional exercise capacity, pulmonary functions, and health-related quality of life in CAD patients with stable angina.Perception of depression and fatigue were decreased with IMT in CAD patients with stable angina.

Nano drug delivery systems and gamma radiation sterilization.

In recent years, drug delivery systems such as liposomes and microparticles have been used in clinic for the treatment of different diseases and from a regulatory point of view, a parenterally applied drug and drug delivery systems must be sterile and pyrogen free. Radiation sterilization is a method recognized by pharmacopoeias to achieve sterility criteria of parenterals. It has the ability to kill microorganisms in therapeutic products. The ability of, however, irradiation might also affect the performance of drug delivery systems. One of the most critical points is irradiation dose, because certain undesirable chemical and physical changes may accompany with the irradiation, especially with the traditionally applied dose of 25 kGy. Its ionizing property may cause fragmentation of covalent bond. The care must be paid to the applied dose. In this research, the effects of gamma irradiation on different drug delivery systems such as chitosan microparticles, liposomes, niosomes and sphingosomes were investigated. According to the experimental data, it can be concluded that gamma irradiation can be a suitable sterilization technique for liposome, niosome and sphingosome dispersions. When all irradiated drug carrier systems were taken into consideration, chitosan glutamate microparticles were found as the most radioresistant drug delivery system among the others.

Scintigraphic imaging of infections with 99m-Tc-labelled glutathione liposomes.

In this study, liposomes containing glutathione were evaluated to detect infection in mice. Glutathione liposomes were labelled by using 99mTc-labelled-HMPAO (hexamethyl propylamine oxime). Mice were infected in the thigh by intramuscular injection with turbentine. Labelled liposomes were applied to the tail vein of the mice intravenously. At fixed time intervals they were sacrificed. The animals were imaged under a gamma camera. Then, tissue samples were excised and radioactivity of all organs was counted. Abscess-to-muscle, abscess-to-liver, and abscess-to-spleen ratios were calculated. The ratios of abscess-to-muscle were found to be 1.6 and 11.6 at 1 h and 24 h, respectively. According to these data, the abscess can be defined at 1 h and it became more clear with time.

In-vivo studies in the treatment of oral ulcers with liposomal dexamethasone sodium phosphate.

Liposomes are man-made organelles composed of bimolecular lipid layers enclosing aqueous compartments. Dexamethasone Sodium Phosphate (DSP) was encapsulated in MLV liposomes and served as the test solution. DSP in solution served as control. Both were labeled with 99mTc. The rats were divided into three groups: typical application group, intramucosal injection and control group. Oral mucosal ulcers were produced by silver nitrate and was monofocal. Rats were killed at three and 24 h, respectively, after application. Ulcerated mucosa, intact adjacent mucosa and distant mucosa were excised. Biodistribution was determined by radiotracer technique in the three mucosal parts as well as in the blood, liver, spleen and brain. Liposomes increase local and decrease systemic drug concentration. Another finding was that liposomes localize the drug in the ulcerated area. In conclusion, liposomes may be useful in the treatment of oral ulcers.

In-vivo studies on dexamethasone sodium phosphate liposomes.

Dexamethasone Sodium Phosphate (DSP) is a water soluble anti-inflammatory steroid commonly used in the therapy of serious types of ophthalmic inflammation. It has been demonstrated that unless the corneal epithelium is damaged, DSP is poorly absorbed by the cornea (Kupferman et al. 1974). Thus, it is doubtful whether such a drug would cure inflammation of the anterior segments. For this purpose, several liposomal DSP formulations containing phospholipid: charge inducer: cholesterol in molar ratios of 10:1:4 were investigated. Both gel state (PL 90H: SA: Cho1) and liquid state (PL 100: SA: Cho1) liposomes were prepared. For the preparation of liposomes, the film method followed by bath sonication was used. Liposomes were labelled with (99m)-Tc and administered intra-ocularly to New Zealand white rabbits weighing 2.5-3 kg for in vivo experiments. The biodistribution of the labelled liposomes were determined. For this purpose, eye segments (such as cornea, lens, iris, ciliar body, vitreous, aqueous humor, conjuctiva and sclera) and RES organs (such as liver, pancreas, spleen) were removed at fixed time intervals. In the present study, the efficiency of liposomes for the delivery of water-soluble drugs was evaluated in rabbit eyes using DSP as a model drug in different liposomal formulations.

Studies on the formulation and in vitro release of ophthalmic liposomes containing dexamethasone sodium phosphate.

Several liposome formulations containing Dexamethasone Sodium Phosphate (DSP) were characterised in this study. For this purpose, phospholipids (gel and liquid types) and charge inducers, with or without cholesterol, were employed as bilayer components. Liquid state (PL 100:SA and PL 100:SA:CHOL) and gel state (PL 90H:SA and PL 90H:SA:CHOL) liposomes were prepared in molar ratios of (7:1:2), (10:1:4), (7:1) and (10:1). The film technique followed by sonication and membrane extrusion were used for the preparation of DSP liposomes. Particle size and particle-size distribution of MLVs, entrapment efficiency, free DSP (in supernatant) and, phospholipid content were determined for the characterization of the liposomes. The characterized liposomes were investigated for in-vitro release and different profiles were observed. The in-vitro release rates were evaluated kinetically and the best fitting equation was found to be the Higuchi equation.

Characterization, in vitro and in vivo studies on primaquine diphosphate liposomes.

In this study, several Primaquine diphosphate (PQ) liposomal formulations containing phospholipid, charge inducer and with or without cholesterol in molar ratios of 7:1:(2) and 10:1:(4) were investigated. Gel state (DPPC:CHEMS:CHOL and PL-100H:CHEMS:CHOL) and liquid-crystalline state (PL-100:CHEMS:CHOL and PL-90G:CHEMS:CHOL) liposomes were prepared. The film method followed by sonication and extrusion through polycarbonate membrane was used. Particle size distribution, percentage of entrapped active substance, content of phospholipid and bilayer type and composition were determined. Lamellarity was determined by 31P-NMR technique. In vitro release of PQ was investigated at 37 degrees C, 35 rpm and in Tris (pH: 7.4) buffer. In vitro release and its fit to kinetic models were investigated. Liposomes were labelled by 99mTc and injected intravenously to Swiss Albino mice.

Studies on the masking of unpleasant taste of beclamide: microencapsulation and tabletting.

Beclamide was microencapsulated in order to mask the taste, by a simple coacervation method using gelatin. Anhydrated sodium sulphate was used as coacervating agent. Glutaraldehyde, glutaraldehyde:isopropanol (8 : 32) and formaldehyde:isopropanol (8 : 32) were used as hardening agents. The optimum microencapsulation conditions were: 44 g water, 9 g beclamide and 47 g sodium sulphate as components at a temperature of 40 + 0.5 degrees C with glutaraldehyde (25 per cent w/v) as hardening agent. The dissolution rate of beclamide from prepared microcapsules was determined by a rotating basket and the dissolution kinetics were investigated according to the zero-order, Hixson-Crowell and Higuchi equations. The dissolution pattern of beclamide was first-order kinetic. Release rate constants, t50%, t90% and AUC values were calculated. All these values were discussed for differently obtained microcapsules. Beclamide was formulated in conventional, chewable and effervescent tablet forms. Physical tests were applied to all tablets. The paddle method was used as an in vitro dissolution test method for evaluation of conventional tablets.