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Data on next-day discharge (NDD) after transcatheter aortic valve replacement (TAVR) are limited. This study investigated the feasibility and safety of NDD as a first-line option (the very-early discharge [VED] strategy) compared with the early-discharge (ED) strategy (2-3 days as a first-line option) after TAVR.We reviewed 611 consecutive patients who had minimalist TAVR (transfemoral approach under conscious sedation) and no in-hospital mortality; a total of 418 patients underwent ED strategy (since December 2013) and 193 patients underwent VED strategy (as part of a hospital initiative to reduce length of stay, since August 2016). NDD in the VED strategy was performed with heart team consensus in patients without significant complications. The primary outcome was a composite of 30-day all-cause mortality/rehospitalization.Sixty-five patients (33.7%) in the VED strategy and 10 patients (2.4%) in the ED strategy were discharged the next day (P.001). NDD patients had received balloon-expandable (n = 30) or self-expanding valves (n = 45) and showed a similar primary outcome rate compared with non-NDD patients. After adjustment using propensity score matching (172 pairs), post-TAVR length of stay was significantly shorter in the VED group (3.2 ± 3.1 days) than in the ED group (3.5 ± 2.7 days; P.01). The primary outcome did not differ between the two groups (7.0% vs 11.6%; P=.14), with comparable 30-day mortality rate (1.2% vs 2.3%; P=.68) and rehospitalization rate (5.8% vs 11.1%; P=.08).Utilization of NDD as a first-line option after minimalist TAVR is feasible and safe, and leads to further reduction in length of stay compared with an ED strategy.

Fatty acids cause endothelial dysfunction involving increased ROS (reactive oxygen species) and reduced NO (nitric oxide) bioavailability. We show that in MAECs (mouse aortic endothelial cells), the PPARß/d (peroxisome- proliferator-activated receptor ß/d) agonist GW0742 prevented the decreased A23187-stimulated NO production, phosphorylation of eNOS (endothelial nitric oxide synthase) at Ser1177 and increased intracellular ROS levels caused by exposure to palmitate in vitro. The impaired endothelium-dependent relaxation to acetylcholine in mouse aorta induced by palmitate was restored by GW0742. In vivo, GW0742 treatment prevented the reduced aortic relaxation, phosphorylation of eNOS at Ser1177, and increased ROS production and NADPH oxidase in mice fed on a high-fat diet. The PPARß/d antagonist GSK0660 abolished all of these protective effects induced by GW0742. This agonist enhanced the expression of CPT (carnitine palmitoyltransferase)-1. The effects of GW0742 on acetylcholine- induced relaxation in aorta and on NO and ROS production in MAECs exposed to palmitate were abolished by the CPT-1 inhibitor etomoxir or by siRNA targeting CPT-1. GW0742 also inhibited the increase in DAG (diacylglycerol), PKCa/ßII (protein kinase Ca/ßII) activation, and phosphorylation of eNOS at Thr495 induced by palmitate in MAECs, which were abolished by etomoxir. In conclusion, PPARß/d activation restored the lipid-induced endothelial dysfunction by up-regulation of CPT-1, thus reducing DAG accumulation and the subsequent PKC-mediated ROS production and eNOS inhibition.

Summary Background : For patients with coeliac disease (CD), compliance with a gluten-free diet, when eating food not prepared at home may be difficult. Aims : We assessed whether there are differences in the eating habits of coeliac patients when compared to the general public. In addition, we compared chefs' knowledge with the public's knowledge about CD. Method : A questionnaire survey about CD was performed on coeliac patients, chefs and the general public from the United Kingdom (UK). Results : Three hundred and nineteen coeliac patients [mean age 53.8 years, 65.8% female], 513 members of the public [49.2 years, 62.6% female] and 322 chefs [37.6 years, 15.2% female] were interviewed. Chefs were less likely to have heard of CD when compared to the public (17.1% (55/322) versus 44.2% (227/513), respectively, P 0.0001 ). Coeliac patients ate less frequently at a friend's house than the general public ( P = 0.003 ). Coeliac patients ate less frequently from take-away establishments ( P 0.0001 ). However, coeliac patients' ate as frequently in restaurants ( P = 0.078 ). Conclusions : In the UK, chefs appear to know less about CD than the general public. Patients with CD feel justifiably cautious when eating food not prepared at home. Educating chefs about a gluten-free diet may alleviate the social restrictions on coeliac patients.

In this work are presented two methods for the simultaneous determination of 17α-ethinylestradiol (EEL) and chlormadinone acetate (CMA) by second order derivative spectrophotometry. The first analytical method proposed is based in the dissolution and extraction of both drugs in acetonitrile. The solution was directly evaluated by second order derivative spectrophotometry with a smoothing factor of 8,000 and a scale factor of 10,000. The determination of EEL and CMA was carried out to 296,6 and 291.8 nm, respectively. The detection limits (3.3 σ criterion) for EEL and CMA were 6.9 x 10-7 and 9.8 x 10-8 mol/L, respectively. Furthermore, a study of the effect of the excipients containing in the pharmaceutical formulation was included. Polyvidone presents greater tendency to produce interference, but its spectral bands are located between 215 and 240 nm, so these bands do not interferes spectrally in the simultaneous determination of EEL and CMA. Both drugs were extracted from the pharmaceutical formulation with acetonitrile, obtaining a good recovery relative to the nominal content. The second method is a screening method and was applied in fortified drinking water. In this method, drugs were extracted in chloroform, which was then removed with N2 and the residue was redissolved in acetonitrile. Due to the difference in the procedure in relation to the pharmaceutical formulation a new analytical parameters were obtained. For EEL this parameters were very similar to those obtained directly in solution, however these were higher for CMA, which could be attributed to that under these conditions was found a higher standard deviation of the blank. Recoveries of fortified samples were 81.8 ± 1.5% and 101.1 ± 0.73% for EEL and CMA, respectively.

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This work presents a rapid and simple method for the parallel determination of Desogestrel (DSG) and 17a-Ethinylestradiol (EE2) by second order derivative spectrophotometry and its application in pharmaceutical formulations. Study of the effect of the solvents, excipients and spectral behavior is also included. Acetonitrile was selected as a solvent; subsequently the samples were evaluated by second order derivatives, using a smoothing factor of 8,000 and a scale factor of 10(4). The EE2 determination was carried out using the graphical method at 288 nm and DSG by the zero-crossing method at 220 nm. The determination ranges were found to be between 1.5 10-6 and 5 10-4 mol/L and 1.710-7 to 1.010-3 mol/L for DSG and EE2, respectively. The homogenized tablets are divided in two fractions, the first, called sample A, was dissolved in acetonitrile, which contains the absorbents species that is polyvidone, DGS and EE2, the latter is determined directly at 288 nm. Meanwhile, in the second fraction (sample B), after extract with water the polyvidone and partially EE2, it is possible determine DGS at 220 nm. When the pharmaceutical formulation contains Vitamin E (Vit. E) is necessary to use an equations system to be evaluated in sample B.

This work presents a rapid and simple method for the parallel determination of Desogestrel (DSG) and 17a-Ethinylestradiol (EE2) by second order derivative spectrophotometry and its application in pharmaceutical formulations. Study of the effect of the solvents, excipients and spectral behavior is also included. Acetonitrile was selected as a solvent; subsequently the samples were evaluated by second order derivatives, using a smoothing factor of 8,000 and a scale factor of 10(4). The EE2 determination was carried out using the graphical method at 288 nm and DSG by the zero-crossing method at 220 nm. The determination ranges were found to be between 1.5 10-6 and 5 10-4 mol/L and 1.710-7 to 1.010-3 mol/L for DSG and EE2, respectively. The homogenized tablets are divided in two fractions, the first, called sample A, was dissolved in acetonitrile, which contains the absorbents species that is polyvidone, DGS and EE2, the latter is determined directly at 288 nm. Meanwhile, in the second fraction (sample B), after extract with water the polyvidone and partially EE2, it is possible determine DGS at 220 nm. When the pharmaceutical formulation contains Vitamin E (Vit. E) is necessary to use an equations system to be evaluated in sample B.

In this work is proposed, a simple experiment for the simultaneous determination of losartan (L) and hydrochlorothiazide (H) in synthetic and real samples by derivative spectrophotometry technique. For the students it is relevant to know this technique for simultaneous determinations of drugs, allowing that the students recognize that this technique is simple, rapid and applicable to quality control. This experimental work, it is proposed in order to being applied to undergraduates into laboratories of analytical chemistry. Furthermore, it is given the integration of the theoretical knowledge with the experimental work; this correlation is of interest for the students.

The 3-[2´-thiazolylazo]-2,6-diaminopyridine or 2,6-TADAP have been used as chromophore reagent for the determination of metals of the platinum group. In this work a study of the stability of the 2,6-TADAP is included, a synergetic action of the temperature, the reaction time and the acidity of the medium was found. According to spectral behavior it can be postulated that 2,6-TADAP ligand suffers structural changes, having as consequence the formation of another azocompound. Besides, the mechanism of decomposition and characterization of the formed compound was also included. The characteristic chemical of new azocompound is appropriate for the development of analytic methods for the determination of metals belonging to the platinum group, using the new ligand called 3-[N,N-ethyl-met-azo]-2,6-diaminopyridine or 2,6-DAPEMA

Background: The increasing prevalence of type 2 diabetes in general and in younger people in particular has led to an increasing numbers of pregnancies with the complication of gestational hyperglycaemias. All complications associated with gestational hyperglycaemias are potentially preventable. The aim of this study is to monitor longitudinal changes in blood glucose levels in pregnancy and to co-relate it with various maternal and foetal outcomes. Material and Methods: The study was conducted in 93 pregnant women. Venous blood was collected and post prandial blood glucose (PP2BG) level was estimated by glucose oxidase-peroxidase enzyme method once in every trimester. Pregnancy outcomes including the mode of delivery (spontaneous vaginal delivery or assisted delivery), birth weight of the baby and the neonatal morbidity like asphyxia, hypoglycaemias were noted. Results: We found 6% of the women in the study group have gestational hyperglycaemias in the first trimester and 27% in the second trimester. The percentages of gestational hyperglycaemias are reduced to 11% in the third trimester. Maternal post prandial blood glucose levels affect the birth weight of the baby and also mode of delivery. Numbers of neonatal complications are higher in subjects with higher blood glucose levels. Conclusion: We recommend that estimation of maternal PP2 BG levels should be carried out in all pregnant women at the first antenatal visit and at least once in every trimester. This would help to reduce adverse perinatal outcomes.