Left ventricular (LV) diastolic function is an important predictor of morbidity and mortality after acute myocardial infarction (AMI). We evaluated the role of diastolic function in predicting ...in-hospital events and LV ejection fraction (EF) 6 months after a first AMI that was treated with primary percutaneous coronary intervention (PCI). We prospectively enrolled 59 consecutive patients who were 60 ± 15 years of age (48 men), presented at our institution with their first AMI, and were treated with primary PCI. Patients underwent 2-dimensional and Doppler echocardiography, including tissue Doppler imaging of 6 basal mitral annular regions within 24 hours after primary PCI and were followed until discharge. Clinical and echocardiographic variables at index AMI were compared with a combined end point of cardiac death, ventricular tachycardia, congestive heart failure, or emergency in-hospital surgical revascularization. Follow-up echocardiographic assessment was performed at 6 months in 24 patients. During hospitalization, 3 patients died, 7 developed congestive heart failure, 4 had ventricular tachycardia, and 1 required emergency surgical revascularization. Stepwise logistic regression analysis showed the ratio of early mitral inflow diastolic filling wave (E) to peak early diastolic velocity of non–infarct-related mitral annulus (p <0.01) (E′) and mitral inflow E-wave deceleration time (p <0.02) to be independent predictors of in-hospital cardiac events (generalized R
2 = 0.66). In a stepwise multiple linear regression model, independent predictors of follow-up LVEF were mitral inflow deceleration time (R
2 = 0.39, p = 0.002), baseline LVEF (R
2 = 0.54, p <0.02), and mitral inflow peak early velocity/mitral annular peak early velocity (or E/E′) of infarct annulus (R
2 = 0.66, p = 0.02). In conclusion, in patients who are treated with primary PCI for a first AMI, E/E′ velocity ratio and mitral inflow E-wave deceleration time are strong predictors of in-hospital cardiac events and of LVEF at 6-month follow-up.
Two new triterpenoids, 6α-
O-acetyl-7-deacetylnimocinol 24,25,26,27-tetra-norapotirucalla-(apoeupha)-6α-acetoxy-7α-hydroxy-1,14,20,22-tetraen-21,23-epoxy-3-one (
1) and meliacinol ...24,25,26,27-tetranorapotirucalla-(apoeupha)-1α-trimethylacryloxy-21,23-6α,28-diepoxy-16-oxo-17-oxa-14,20,22-trien-3α,7α-diol (
2) were isolated from the methanolic extract of the fresh leaves of
Azadirachta indica (neem). Their structures have been elucidated through spectral studies, including 2D-NMR (COSY-45, NOESY, HMQC and HMBC). The bioactivity of these as well as of nimocinol, reported earlier from the same source, is reported. The first compound and nimocinol showed toxicity on fourth instar larvae of mosquitoes (
Aedes aegypti) with LC
50 values of 21 and 83 ppm, respectively. The second compound had no effect upto 100 ppm.
Summary
This prospective study determined the level of radiation exposure of anaesthetists during interventional radiological procedures performed in the endoscopic retrograde ...cholangiopancreatography suite and cardiac catheterisation laboratory and compared it with the current safety guidelines. Anaesthetists wore area‐specific lithium fluoride thermo‐luminescent dosimeter badges at standardised positions. A total of 1344 procedures were performed over a 6‐month period. Anaesthetists were involved in 39/645 (6.0%) procedures associated with ionisation radiation in the endoscopic retrograde cholangiopancreatography suite and 86/699 (12.3%) in the cardiac catheterisation laboratory. The mean (SD) duration of endoscopic retrograde cholangiopancreatography was 54.8 (29.1) min compared with 67.9 (42.8) min for cardiac catheterisation suite procedures (p = 0.058). The mean (SD) fluoroscopy time per procedure for endoscopic retrograde cholangiopancreatography was 5.5 (4.1) min compared with 12 (10.9) min in the cardiac catheterisation suite (p < 0.001). The combined net radiation exposure over 6 months was 0.28 mSv for endoscopic retrograde cholangiopancreatography procedures and 2.32 mSv in the cardiac catheterisation suite. The combined exposure was less than the maximum recommended exposure of 20 mSv per year.
Abstract
Objectives
Even in an ‘optimal’ health system, patients’ characteristics may have an impact on their care. We investigated whether age, gender and place of birth have an impact in the HIV ...care continuum in France, a country with a universal free healthcare system.
Methods
We estimated differences in the 5 year restricted mean percentage of person-time spent (i) in care, (ii) receiving ART and (iii) on ART and virally suppressed among 2432 (30.2%) women, 3925 MSM (48.7%) and 1709 men who have sex with women (MSW; 21.2%) entering care in the Dat’AIDS French prospective cohort between 1 January 2013 and 31 December 2017. Trial registration: Clinicaltrials.gov reference NCT02898987.
Results
Men and women spent 85.6% and 82.8% of person-time on ART and 69.9% and 65% suppressed, respectively. MSM, MSW and women spent 86.9%, 82.6% and 82.8% of person-time on ART and 72.5%, 63.7% and 65% suppressed, respectively. Patients born in France (47%) and patients born abroad spent 87.9% and 81.9% of person-time on ART and 74.6% and 62.9% suppressed, respectively. Young men born abroad were found to spend the smallest person-time with non-detectable viral load (53% for MSW and 58.1% for MSM).
Conclusions
Despite free access to care and universal ART in France, disparities remain in the HIV continuum care across age, country of birth and way of HIV acquisition. Clinical and public health interventions targeting specific patients’ conditions are needed.
The efficacy of isoniazid (INH) prophylaxis in renal allograft recipients who are on long-term immunossupression in a region highly prevalent for tuberculosis (TB) was studied. INH (300 mg/d in ...patients weighing more than 35 kg and 5 mg/kg/d in patients with <35 kg body weight) together with Pyridoxine 50 mg/d for 1 year was started in randomly assigned renal allograft recipients. Occurence of clinical tuberculosis during the initial 2 years posttransplantation was observed in the risk group and patients at no risk. Risks were defined as acute rejection episodes and exposure to antirejection therapy, past history of TB completely or incompletely treated, radiological evidence of past tuberculosis, history of tuberculosis in close contacts. Among 480 patients registered in the study, INH prophylaxis was given to 219 randomly assigned renal allograft recipients. Results were compared among patients developing TB during the initial 2 years posttransplantation in both the groups. Risk factors were analyzed for comparison in both groups. No significant difference was observed in terms of past history of TB, TB in close contacts, episodes of acute rejection during the initial 3 months, and comorbidities such as cytomegalovirus infection, hepatitis C virus infection, and posttransplant diabetes. One patient from the INH group and 10 patients from the non-INH group developed TB during the initial 2 years posttransplantation (
P < .0001). None of patients required discontinuation of INH. INH was observed to be safe and effective as a chemoprophylactic agent in renal allograft recipients.
Most clinical trials exclude patients with poor performance or comorbidities. To study whether patients with these characteristics can be treated within a clinical trial, we conducted a study for ...patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) with poor performance, organ dysfunction or comorbidities. Primary endpoint was 60-day survival. Study included stopping rules for survival and response. Treatment consisted on a combination of azacitidine and vorinostat. Thirty patients (16 with MDS, 14 with AML) were enrolled. Median follow-up was 7.4 months (0.3-29). Sixty-day survival was 83%. No stopping rules were met. Main adverse events (AEs) were grades 1 and 2 gastrointestinal toxicities. In view of these results, we expanded the study and treated 79 additional patients: 27 with azacitidine (AZA) and 52 with azacitidine and vorinostat (AZA+V). Median follow-up was 22.7 months (12.6-47.5). Sixty-day survival rate was 79% (AZA=67%, AZA+V=85%, P=0.07). Median overall survival was 7.6 months (4.5-10.7). Median event-free survival was 4.5 months (3.5-5.6). Main AEs included grades 1 and 2 gastrointestinal toxicities. Our results suggest this subset of patients can be safely treated within clinical trials and derive clinical benefit. Relaxation of standard exclusion criteria may increase the pool of patients likely to benefit from therapy.
An array of dicationic pyridinium ionic liquids (DILs) based hydrazone linkage were designed and synthesized via the quaternization of the appropriate bispyridine hydrazone with different phenacyl ...halides and led to the formation of halogenated DILs, which undergo metathesis reaction to give the specific task dicationic pyridinium liquids carrying fluorinated counter anions (PF6−, BF4−, CF3COO−). The newly synthesized DILs were well characterized using whole spectroscopic data. The Anticancer evaluation of DILs against breast and colon cancer cell lines revealed that compound 22 appears to be the most active compound in the series with IC50 in the two-digit micromolar range. The in-vitro anticancer results were further supported by in-silico molecular docking studies revealing the highest potency of compound 22. The docking analysis demonstrated good docking score and binding affinities of the synthesized compounds on the target protein PI3Kinase.
Display omitted
•Novel specific task fluorinated pyridinium ionic liquids (TsILs) were designed, synthesized and characterized.•In vitro anticancer activity of synthesized ILs were carried out.•In silico studies were investigated supporting the anticancer activity.
BACKGROUND: Myrin®-P Forte is a fixed-dose combination (FDC) tablet containing rifampicin (RMP, 150 mg), isoniazid (INH, 75 mg), ethambutol (EMB) hydrochloride (275 mg) and pyrazinamide (PZA, 400 mg) ...developed for the treatment of tuberculosis (TB).SETTING: This study was conducted
at a single centre-the Pfizer Clinical Research Unit in Singapore.OBJECTIVE: To demonstrate the bioequivalence of each drug component of the Myrin-P Forte FDC and the individual product in loose combination.DESIGN: In a randomized, open-label, single-dose, two-way, crossover
study, subjects received single doses of Myrin-P Forte or four individual products under fasting conditions in a crossover fashion with at least 7 days washout between doses. The primary measures for comparison were peak plasma concentration (Cmax) and the area under plasma concentration-time
curve (AUC).RESULTS: Of 36 subjects enrolled, 35 completed the study. The adjusted geometric mean ratios and 90% confidence intervals for Cmax and AUC values were completely contained within bioequivalence limits (80%, 125%) for all four drugs in both formulations. Both treatments
were generally well tolerated in the study.CONCLUSION: The Myrin-P Forte FDC tablet formulation is bioequivalent to the four single-drug references for RMP, INH, EMB hydrochloride and PZA at equivalent doses.
PDF
