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1.
N Engl J Med ; 386(21): 1986-1997, 2022 05 26.
Artigo em Inglês | MEDLINE | ID: mdl-35363452

RESUMO

BACKGROUND: Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid is an antifibrinolytic drug that may safely decrease such bleeding. METHODS: We conducted a trial involving patients undergoing noncardiac surgery. Patients were randomly assigned to receive tranexamic acid (1-g intravenous bolus) or placebo at the start and end of surgery (reported here) and, with the use of a partial factorial design, a hypotension-avoidance or hypertension-avoidance strategy (not reported here). The primary efficacy outcome was life-threatening bleeding, major bleeding, or bleeding into a critical organ (composite bleeding outcome) at 30 days. The primary safety outcome was myocardial injury after noncardiac surgery, nonhemorrhagic stroke, peripheral arterial thrombosis, or symptomatic proximal venous thromboembolism (composite cardiovascular outcome) at 30 days. To establish the noninferiority of tranexamic acid to placebo for the composite cardiovascular outcome, the upper boundary of the one-sided 97.5% confidence interval for the hazard ratio had to be below 1.125, and the one-sided P value had to be less than 0.025. RESULTS: A total of 9535 patients underwent randomization. A composite bleeding outcome event occurred in 433 of 4757 patients (9.1%) in the tranexamic acid group and in 561 of 4778 patients (11.7%) in the placebo group (hazard ratio, 0.76; 95% confidence interval [CI], 0.67 to 0.87; absolute difference, -2.6 percentage points; 95% CI, -3.8 to -1.4; two-sided P<0.001 for superiority). A composite cardiovascular outcome event occurred in 649 of 4581 patients (14.2%) in the tranexamic acid group and in 639 of 4601 patients (13.9%) in the placebo group (hazard ratio, 1.02; 95% CI, 0.92 to 1.14; upper boundary of the one-sided 97.5% CI, 1.14; absolute difference, 0.3 percentage points; 95% CI, -1.1 to 1.7; one-sided P = 0.04 for noninferiority). CONCLUSIONS: Among patients undergoing noncardiac surgery, the incidence of the composite bleeding outcome was significantly lower with tranexamic acid than with placebo. Although the between-group difference in the composite cardiovascular outcome was small, the noninferiority of tranexamic acid was not established. (Funded by the Canadian Institutes of Health Research and others; POISE-3 ClinicalTrials.gov number, NCT03505723.).


Assuntos
Antifibrinolíticos , Ácido Tranexâmico , Antifibrinolíticos/efeitos adversos , Antifibrinolíticos/uso terapêutico , Canadá , Hemorragia/etiologia , Hemorragia/prevenção & controle , Humanos , Procedimentos Cirúrgicos Operatórios , Trombose/induzido quimicamente , Trombose/tratamento farmacológico , Ácido Tranexâmico/efeitos adversos , Ácido Tranexâmico/uso terapêutico
2.
J Fluoresc ; 34(1): 139-147, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37310589

RESUMO

Bacterial contamination of water sources is a significant public health concern, and therefore, it is important to have accurate and efficient methods for monitoring bacterial concentration in water samples. Fluorescence-based methods, such as SYTO 9 and PI staining, have emerged as a promising approach for real-time bacterial quantification. In this review, we discuss the advantages of fluorescence-based methods over other bacterial quantification methods, including the plate count method and the most probable number (MPN) method. We also examine the utility of fluorescence arrays and linear regression models in improving the accuracy and reliability of fluorescence-based methods. Overall, fluorescence-based methods offer a faster, more sensitive, and more specific option for real-time bacterial quantification in water samples.


Assuntos
Bactérias , Água , Reprodutibilidade dos Testes , Coloração e Rotulagem
3.
J Fluoresc ; 32(2): 483-504, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34981281

RESUMO

A Novel calix[4]pyrrole system bearing carboxylic acid functionality [ABuCP] has been synthesized and its interaction towards various nitroaromatics compounds [NACs] were investigated. ABuCP showed significant color change with 1,3-dinitro benzene (1,3-DNB) in comparison to the solution of other nitroaromatic compounds such as 2,3-dinitro toluene (2,3-DNT), 2,4-dinitro toluene (2,4-DNT), 2,6-dinitro toluene (2,6-DNT), 4-NBB (4-nitrobenzyl bromide) and 4-nitro toluene (4-NT). The ABuCP-1,3-DNB complex produces a red shift in absorption spectra based on charge transfer mediated recognition. Additionally, the density functional theory calculation confirmed the possible mechanism for the binding of 1,3-DNB as a guest is well supported by the calculation of other parameters such as hardness, stabilization energy, softness, electrophilicity index and chemical potential. The TDDFT calculation facilitates the understanding of the proper binding mechanism in reference to experimental results. Additionally we have also developed its derivative which acts as a new fluorescent sensor which can selectively recognize Sr(II) ions. In this view its aminoanthraquinone derivative of calix[4]pyrrole i.e. ABuCPTAA is synthesized which also results in generation of high fluorescence capability sensor.

4.
Luminescence ; 37(3): 370-390, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34994071

RESUMO

Amino acids are the most important part of the human biological system due to their role in living processes. The role of amino acids stretches beyond their traditional role as a building block for proteins, and deficiency of amino acids could lead to decreased immunity, digestive problems, depression, fertility issues, lower mental alertness, slowed growth in children, and many other health issues. The acute detection of amino acids is necessary to determine the human health domain. Here, in this review, we summarize and study the calixarenes as complexes that are of immeasurable value and their utilization for amino acid detection. Key factors such as noncovalent forces, limit of detection, and the supramolecular chemistry of calixarenes with amino acids have been well described. This study presents the most recent efforts made towards the development of potential and highly efficient calixarene-based sensors for the detection of amino acids.


Assuntos
Calixarenos , Aminoácidos , Calixarenos/química , Criança , Humanos
5.
J Fluoresc ; 31(3): 635-649, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33609215

RESUMO

Nanoscience is a multifaceted field which encompasses metal nanoparticles (MNPs) having novel and size-related optical properties significantly different from the bulk level as well as at the atomic level. Amongst noble MNPs, the silver nanoparticles (AgNPs) have unique properties for metal interaction. Presently, there have been expedite reports which are taken under the review in virtue of sensing the mercury ions in aqueous media. Mercury dissemination in various forms contaminates the ecosystem. Globally mercury is ranked as the most toxic element and an urgent threat to humans since it causes major health issues. Employing MNPs, especially AgNPs for the detection of mercury ions is the economic, handy and apt method in contrast to time-consuming methods that use expensive instrumentations. The review highlights a study of colorimetric and fluorimetric detection of the level of Hg (II) ions in aqueous media selectively with high sensitivity in different courses of conditions using AgNPs synthesized by various approaches. Graphical abstract.


Assuntos
Colorimetria/métodos , Poluentes Ambientais/análise , Fluorometria/métodos , Mercúrio/análise , Nanopartículas Metálicas/química , Prata/química
6.
Luminescence ; 32(8): 1398-1404, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28590050

RESUMO

A new fluorescence receptor calix[4]pyrrole-N-(quinoline-8-yl) acetamide (CAMQ) containing a pyrrolic ring connected via the meso-position was synthesized, purified and characterized by elemental analysis, NMR and mass spectroscopy. This compound was examined for its fluorescence properties towards different metal ions e.g. Ag(I), Hg(II), Co(II), Ca(II), Ni(II), Zn(II), Cr(II), Ba(II), Fe(II), Cu(II), Pb(II)and Mg(II) ions by spectrophotometry and spectrofluorometry. It was concluded that the compound (CAMQ) possessed significantly enhanced selectivity for Pb(II) and Cu(II) ions in dimethyl sulfoxide (DMSO) even at very low concentrations (1 µM). It exhibit 'turn-on' fluorescence when exposed to Pb(II) and Cu(II) and did so in preference to other metal ions. The binding constants, stoichiometry and quantum yields have been determined. The quenching mechanism was assessed using the Stern-Volmer equation and was also discussed.


Assuntos
Aminas/química , Calixarenos/química , Cobre/análise , Corantes Fluorescentes/química , Chumbo/análise , Porfirinas/química , Quinolinas/química , Corantes Fluorescentes/síntese química , Íons/análise , Estrutura Molecular , Teoria Quântica
7.
J Biomol Struct Dyn ; : 1-12, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38497770

RESUMO

The detailed binding insight between the fluorophore and analyte plays a pivotal role in the design of an efficient chemosensor for water pollution. In this study, we designed a picolinic acid-functionalized calix[4]pyrrole ligand (PCACP). When testing out the fluorescence study with selected antibiotics, we observed remarkable enhancement of fluorescence spectra in the presence of ciprofloxacin, singling out the PCACP_Ciprofloxacin complex. The detailed binding mechanism is explored via computational methods including molecular docking and dynamics, DFT (density functional theory) and NBO (Natural Bonding Orbital) analysis. The result of this study provides the comprehensive insight into the involvement of functionalized group of PCACP and ciprofloxacin antibiotic. The results of the computational findings are further explored through NMR complexation study, which corroborate the computational findings. With the limit of detection calculated at 18 µM, we carried out the water sample analysis, which shows promising results. The outcome of this research provides a new, effortless fluorescence approach to monitor the presence of ciprofloxacin in water.In the presence of the ciprofloxacin antibiotic, the fluorescence spectra of PCACP experience remarkable enhancements. This complexation phenomenon is studied through different computational and experimental methods.Communicated by Ramaswamy H. Sarma.

8.
J Biomol Struct Dyn ; : 1-8, 2023 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-37378514

RESUMO

Functionalized calix[4]pyrroles are at forefront of host-guest aided molecular sensors. They offer unique platform for flexible functionalization to develop receptors suitable for different applications. In this context, calix[4]pyrrole derivative (TACP) was functionalized with an acidic group to investigate its binding behavior with different amino acids. The acid functionalization facilitated host-guest interactions through hydrogen bonding and increase the solubility of ligand in 90% aqueous media. The results indicated that TACP exhibited significant fluorescence enhancement in the presence of tryptophan while no considerable changes were observed with other amino acids. The other complexation properties such as LOD and LOQ were determined to be 25 µM and 22 µM respectively with 1:1 stoichiometry. In addition, the proposed binding phenomena were further confirmed through computational docking studies and NMR complexation study. Overall, this work highlights the potential of acid functionalization in developing molecular sensors for amino acid detection using calix[4]pyrrole derivatives.Communicated by Ramaswamy H. Sarma.

9.
ACS Omega ; 8(16): 14430-14439, 2023 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-37125112

RESUMO

Benzethonium chloride (BTC) has various applications in several industries. The solubility and solution thermodynamic properties of BTC were measured. The solubility of BTC in methanol, ethanol, 1-propanol, 2-propanol, 1-butanol, water, dimethyl sulfoxide, acetic acid, and dimethyl formamide neat solvents and methanol + water and ethanol + water binary solvents at 298.15-318.15 K over an atmospheric pressure was measured. The solubility data of BTC is positively related to the temperature in all selected solvents. The solubility data was fitted by the Apelblat model, λh model, Yaws model, Van't Hoff equation, CNIBS/R-K model, and modified Jouyban-Acree equation. The RMSD and ARD were chosen to evaluate the fitting of each model. The dissolution thermodynamic parameters, enthalpy of the solution, entropy of the solution, and Gibbs energy of the solution were calculated. The solubility data and dissolution thermodynamic parameters of BTC will provide significant guidance for purification, crystallization, and separation in various areas.

10.
ACS Omega ; 8(44): 41523-41536, 2023 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-37969992

RESUMO

The detection of trace amounts of sulfosulfuron, a pesticide of increasing importance, has become a pressing issue, prompting the development of effective chemosensors. In this study, we functionalized cyclotricatechylene (CTC) with propyl-phthalimide due to the presence of electronegative oxygen and nitrogen binding sites. Our optimized ligand displayed the highest docking score with sulfosulfuron, and experimental studies confirmed a significant fluorescence enhancement upon its interaction with sulfosulfuron. To gain a deeper understanding of the binding mechanism, we introduced density functional theory (DFT) studies. We carried out binding constant, Job's plot, and limit of detection (LOD) calculations to establish the effectiveness of our chemosensor as a selective detector for sulfosulfuron. These findings demonstrate the potential of our chemosensor for future applications in the field of pesticide detection.

11.
J Fluoresc ; 22(6): 1493-500, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22739703

RESUMO

Novel Supramolecular fluorescence receptor derived from calix-system i.e. calix[4]resorcinarene bearing dansylchloride as fluorophore was designed and synthesized. The compound was purified by column chromatography and characterized by elemental analysis, NMR and Mass spectroscopy. Tetradansylated calix[4] resorcinarene (TDCR) shows a boat conformation with C(2)v symmetry. The complexation behaviour of metal cations [Ag(I), Cd(II), Co(II), Fe(III), Hg(II), Cu(II), Pb(II), Zn(II), U(VI) (1 × 10(-4) M)] with tetra dansylated calix[4]resorcinarene (1 × 10(-6) M) was studied by spectophotometry and spectrofluorometry. Red shift in the absorption spectra led us to conclude that there is strong complexation Fe(III), Co(II) and Cu(II) with TDCR. These metal cations also produce quenching with red shifts in the emission spectra. The maximum quenching in emission intensity was observed in the case of Fe(III) and its binding constant was also found to be significantly higher than that of Co(II) and Cu(II). Quantum yield of metal complexes of Fe(III) was found to be lower in comparison with Co(II) and Cu(II) complexes. Stern Volmer analysis indicates that the mechanism of fluorescence quenching is either purely dynamic, or purely static.


Assuntos
Calixarenos/química , Técnicas de Química Analítica/instrumentação , Corantes Fluorescentes/química , Metais Pesados/análise , Metais Pesados/química , Compostos Organometálicos/química , Absorção , Calixarenos/síntese química , Cobalto/análise , Cobalto/química , Cobre/análise , Cobre/química , Ferro/análise , Ferro/química , Espectrometria de Fluorescência
12.
J Nanosci Nanotechnol ; 12(5): 3781-7, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22852307

RESUMO

In the present study, we report the synthesis of aqueous stable gold nanoparticles by using calix[4]arene polyhydrazide (CPH) as both reducing and capping agents. The calix[4]arene polyhydrazide reduced gold nanoparticles (CPH-AuNps) were characterized by UV/Vis, particle size analyzer (PSA) and transmission electron mictroscopy (TEM). The records confirmed high stability of CPH-AuNps in aqueous solution over a long period of time and even at varied pH. Additionally, CPH-AuNps have been investigated for its application as "Turn Off" fluorescent sensor for Hg[II]. A concentration of Hg[II] in the limit of 10 nM to 10 microM can be detected based on fluorescence quenching of the CPH-AuNPs and it was also concluded from the spectroscopic data that CPH-AuNPs possess excellent selectivity to Hg[II] over several metal ions like Pb[II], Cu[II], Cd[II], Mn[II], Zn[II] and Ni[II].

13.
Front Chem ; 10: 837111, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35360545

RESUMO

The polymeric properties are tailored and enhanced by high energy radiation processing, which is an effective technique to tune the physical, chemical, thermal, surface, and structural properties of the various thermoplastic and elastomeric polymeric components. The gamma and electron beam radiation are the most frequent radiation techniques used for crosslinking, compatibilizing, and grafting of various polymer blends and composites systems. The gamma radiation-induced grafting and crosslinking are the effective, rapid, clean, user-friendly, and well-controlled techniques for the polymeric materials for their properties improvement for high performance applications such as nuclear, automobile, electrical insulation, ink curing, surface modification, food packaging, medical, sterilization, and health-care in a different environment. Similarly, electron beam radiations crosslinking has been a well-known technique for properties development and has economic benefits over chemical crosslinking techniques. This review focuses on the development of polymeric multi component systems (functionalized polymer, blends, and nanohybrids), where partially nanoscale clay incorporation can achieve the desired properties, and partially by controlled high energy radiations crosslinking of blends and nanocomposites. In this review, various investigations have been studied on the development and modifications of polymeric systems, and controlled dose gamma radiation processed the polymer blends and clay-induced composites. Radiation induced grafting of the various monomers on the polymer backbone has been focused. Similarly, comparative studies of gamma and electron beam radiation and their effect on property devlopment have been focused. The high energy radiation modified polymers have been used in several high performance sectors, including automotive, wire and cable insulation, heat shrinkable tube, sterilization, biomedical, nuclear and space applications.

14.
Can J Kidney Health Dis ; 9: 20543581211069225, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35024154

RESUMO

BACKGROUND: Most patients who take antihypertensive medications continue taking them on the morning of surgery and during the perioperative period. However, growing evidence suggests this practice may contribute to perioperative hypotension and a higher risk of complications. This protocol describes an acute kidney injury substudy of the Perioperative Ischemic Evaluation-3 (POISE-3) trial, which is testing the effect of a perioperative hypotension-avoidance strategy versus a hypertension-avoidance strategy in patients undergoing noncardiac surgery. OBJECTIVE: To conduct a substudy of POISE-3 to determine whether a perioperative hypotension-avoidance strategy reduces the risk of acute kidney injury compared with a hypertension-avoidance strategy. DESIGN: Randomized clinical trial with 1:1 randomization to the intervention (a perioperative hypotension-avoidance strategy) or control (a hypertension-avoidance strategy). INTERVENTION: If the presurgery systolic blood pressure (SBP) is <130 mmHg, all antihypertensive medications are withheld on the morning of surgery. If the SBP is ≥130 mmHg, some medications (but not angiotensin receptor blockers [ACEIs], angiotensin receptor blockers [ARBs], or renin inhibitors) may be continued in a stepwise manner. During surgery, the patients' mean arterial pressure (MAP) is maintained at ≥80 mmHg. During the first 48 hours after surgery, some antihypertensive medications (but not ACEIs, ARBs, or renin inhibitors) may be restarted in a stepwise manner if the SBP is ≥130 mmHg. CONTROL: Patients receive their usual antihypertensive medications before and after surgery. The patients' MAP is maintained at ≥60 mmHg from anesthetic induction until the end of surgery. SETTING: Recruitment from 108 centers in 22 countries from 2018 to 2021. PATIENTS: Patients (~6800) aged ≥45 years having noncardiac surgery who have or are at risk of atherosclerotic disease and who routinely take antihypertensive medications. MEASUREMENTS: The primary outcome of the substudy is postoperative acute kidney injury, defined as an increase in serum creatinine concentration of either ≥26.5 µmol/L (≥0.3 mg/dL) within 48 hours of randomization or ≥50% within 7 days of randomization. METHODS: The primary analysis (intention-to-treat) will examine the relative risk and 95% confidence interval of acute kidney injury in the intervention versus control group. We will repeat the primary analysis using alternative definitions of acute kidney injury and examine effect modification by preexisting chronic kidney disease, defined as a prerandomization estimated glomerular filtration rate <60 mL/min/1.73 m2. RESULTS: Substudy results will be analyzed in 2022. LIMITATIONS: It is not possible to mask patients or providers to the intervention; however, objective measures will be used to assess acute kidney injury. CONCLUSIONS: This substudy will provide generalizable estimates of the effect of a perioperative hypotension-avoidance strategy on the risk of acute kidney injury.


CONTEXTE: La plupart des patients qui prennent des médicaments antihypertenseurs continuent de les prendre le matin d'une intervention chirurgicale et pendant la période périopératoire. De plus en plus de preuves suggèrent que cette pratique pourrait entraîner l'hypotension périopératoire et augmenter le risque de complications. Ce protocole décrit une sous-étude sur l'insuffisance rénale aiguë (IRA) découlant de l'essai Perioperative Ischemic Evaluation-3 (POISE-3). Cet essai teste l'effet d'une stratégie d'évitement de l'hypotension périopératoire par rapport à une stratégie d'évitement de l'hypertension chez des patients qui subissent une chirurgie non cardiaque. OBJECTIFS: Cette sous-étude de l'essai POISE-3 vise à déterminer si une stratégie d'évitement de l'hypotension périopératoire réduit le risque d'IRA comparativement à la stratégie d'évitement de l'hypertension. TYPE D'ÉTUDE: Essai clinique randomisé à répartition 1:1 au groupe intervention (stratégie d'évitement de l'hypotension périopératoire) ou au groupe témoin (stratégie d'évitement de l'hypertension). GROUPE INTERVENTION: Si la pression artérielle systolique (PAS) avant l'opération est <130 mmHg, tous les médicaments antihypertenseurs sont suspendus le matin de la chirurgie. Si la PAS est ≥130 mmHg, certains médicaments (excluant les inhibiteurs de l'enzyme de conversion de l'angiotensine [IECA], les antagonistes du récepteur de l'angiotensine [ARA] ou les inhibiteurs de la rénine) peuvent être poursuivis de façon graduelle. Pendant la chirurgie, la pression artérielle moyenne (PAM) du patient est maintenue à ≥80 mmHg. Dans les 48 heures suivant l'intervention chirurgicale, certains médicaments antihypertenseurs (excluant les IECA, les ARA ou les inhibiteurs de la rénine) peuvent être réintroduits par étapes si la PAS est ≥130 mmHg. GROUPE TÉMOIN: Les patients reçoivent leurs médicaments antihypertenseurs habituels avant et après la chirurgie. La PAM du patient est maintenue à ≥60 mmHg de l'induction de l'anesthésie à la fin de l'intervention chirurgicale. CADRE: Recrutement à partir de 108 centres dans 22 pays entre 2018 à 2021. SUJETS: Des patients (~6 800) âgés de 45 ans et plus atteints d'athérosclérose, ou présentant un risque de l'être, devant subir une chirurgie non cardiaque et prenant des médicaments antihypertenseurs sur une base régulière. MESURES: Le principal critère d'évaluation de cette sous-étude est une IRA postopératoire définie par une hausse d'au moins 26,5 µmol/L (≥0,3 mg/dL) de la créatinine sérique dans les 48 heures suivant la randomisation ou d'au moins 50 % dans les 7 jours suivant la randomisation. MÉTHODOLOGIE: L'analyse primaire (par intention de traiter) examinera le risque relatif d'une IRA et l'intervalle de confiance à 95 % dans le groupe intervention par rapport au groupe témoin. Nous répéterons l'analyse primaire en utilisant d'autres définitions de l'IRA et nous examinerons la modification de l'effet en présence d'une insuffisance rénale préexistante (définie par un DFGe prérandomisation <60 ml/min/1,73 m2). RÉSULTATS: Les résultats de cette sous-étude seront analysés en 2022. LIMITES: Il n'est pas possible de procéder à l'insu des patients ou des prestataires de soins pour cette intervention; des mesures objectives seront toutefois utilisées pour évaluer l'IRA. CONCLUSION: Cette sous-étude fournira des estimations généralisables de l'effet d'une stratégie visant à éviter l'hypotension périopératoire sur le risque d'insuffisance rénale aiguë.

15.
Trials ; 23(1): 101, 2022 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-35101083

RESUMO

BACKGROUND: For patients undergoing noncardiac surgery, bleeding and hypotension are frequent and associated with increased mortality and cardiovascular complications. Tranexamic acid (TXA) is an antifibrinolytic agent with the potential to reduce surgical bleeding; however, there is uncertainty about its efficacy and safety in noncardiac surgery. Although usual perioperative care is commonly consistent with a hypertension-avoidance strategy (i.e., most patients continue their antihypertensive medications throughout the perioperative period and intraoperative mean arterial pressures of 60 mmHg are commonly accepted), a hypotension-avoidance strategy may improve perioperative outcomes. METHODS: The PeriOperative Ischemic Evaluation (POISE)-3 Trial is a large international randomized controlled trial designed to determine if TXA is superior to placebo for the composite outcome of life-threatening, major, and critical organ bleeding, and non-inferior to placebo for the occurrence of major arterial and venous thrombotic events, at 30 days after randomization. Using a partial factorial design, POISE-3 will additionally determine the effect of a hypotension-avoidance strategy versus a hypertension-avoidance strategy on the risk of major cardiovascular events, at 30 days after randomization. The target sample size is 10,000 participants. Patients ≥45 years of age undergoing noncardiac surgery, with or at risk of cardiovascular and bleeding complications, are randomized to receive a TXA 1 g intravenous bolus or matching placebo at the start and at the end of surgery. Patients, health care providers, data collectors, outcome adjudicators, and investigators are blinded to the treatment allocation. Patients on ≥ 1 chronic antihypertensive medication are also randomized to either of the two blood pressure management strategies, which differ in the management of patient antihypertensive medications on the morning of surgery and on the first 2 days after surgery, and in the target mean arterial pressure during surgery. Outcome adjudicators are blinded to the blood pressure treatment allocation. Patients are followed up at 30 days and 1 year after randomization. DISCUSSION: Bleeding and hypotension in noncardiac surgery are common and have a substantial impact on patient prognosis. The POISE-3 trial will evaluate two interventions to determine their impact on bleeding, cardiovascular complications, and mortality. TRIAL REGISTRATION: ClinicalTrials.gov NCT03505723. Registered on 23 April 2018.


Assuntos
Antifibrinolíticos , Hipotensão , Ácido Tranexâmico , Antifibrinolíticos/efeitos adversos , Perda Sanguínea Cirúrgica/prevenção & controle , Humanos , Hipotensão/induzido quimicamente , Hipotensão/diagnóstico , Hipotensão/prevenção & controle , Assistência Perioperatória , Ácido Tranexâmico/efeitos adversos
17.
Artigo em Inglês | MEDLINE | ID: mdl-25004898

RESUMO

Calix[4]resorcinarene polyhydrazide (CPH) protected water dispersible fluorescent silver nanaoparticles (AgNps) were prepared by one-pot method using water soluble CPH and AgNO3. (CPH) bearing hydrazide group on its periphery acts as a reducing agent and its web type of structure as a stabilizing agent for the formation of calix protected silver nanoparticles (CPH-AgNps). CPH-AgNps were found to be highly stable over 120 days at room temperature and at varied pH. CPH-AgNps were characterized by UV/Vis-spectroscopy, particle size analyzer (PSA), transmission electron microscopy (TEM) and Energy dispersive X-ray analysis (EDX). Duly characterized nanoparticles were explored for their application as sensitive and selective fluorescent chemosensors for various metal ions. It was found that nanoparticles were selective and sensitive only for Fe(3+) ions with the linear range of detection from 0.1 µM to 10 µM. CPH-AgNps were also found to exhibit good antimicrobial activity when compared with standard Chloramphenicol. The selectivity and antimicrobial activity of CPH-AgNps suggests its potential use as a sensor for Fe(III) ions in ecosystems prone to industrial pollution and as an antimicrobial agent in biological applications.


Assuntos
Antibacterianos/química , Antibacterianos/farmacologia , Técnicas Biossensoriais/métodos , Ferro/análise , Nanopartículas Metálicas/química , Prata/química , Calixarenos/química , Estabilidade de Medicamentos , Fluorescência , Concentração de Íons de Hidrogênio , Íons , Limite de Detecção , Metais/química , Testes de Sensibilidade Microbiana , Microscopia Eletrônica de Transmissão , Nitrato de Prata/química , Temperatura
18.
Artigo em Inglês | MEDLINE | ID: mdl-24231744

RESUMO

Water dispersible stable gold nanoparticles (AuNps) have been synthesized by using calix[4]pyrrole octa-hydrazide (CPOH) as a reducing as well as stabilizing agent. CPOH-AuNps have been characterized by surface plasmon resonance, particle size analyzer and transmission electron microscopy. CPOH-AuNps are water dispersible, highly stable for more than 150 days at neutral pH with a size of less than 10nm and zeta potential of 15±2 MeV. Ion sensing property of CPOH-AuNps has been investigated for various metal ions Pb(II), Cd(II), Mn(II), Fe(III), Ni(II), Zn(II), Hg(II), Co(II) and Cu(II) by colorimetry and spectrofluorimetry. Among all the metal ions investigated, only Co(II) ions gives sharp colour change from ruby red to blue and is easily detectable by naked-eye. CPOH-AuNps being fluorescent in nature also shows great sensitivity and selectivity for Co(II) ions. Co(II) ions can be selectively detected at very low concentration level of 1 nM in a facile way of fluorescence quenching.


Assuntos
Calixarenos/química , Cobalto/análise , Colorimetria/instrumentação , Fluorometria/instrumentação , Ouro/química , Nanopartículas Metálicas/química , Porfirinas/química , Água/química , Cátions , Concentração de Íons de Hidrogênio , Nanopartículas Metálicas/ultraestrutura , Tamanho da Partícula , Espectrometria de Fluorescência , Espectrometria por Raios X , Espectrofotometria Ultravioleta , Ressonância de Plasmônio de Superfície , Fatores de Tempo
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