Meyersraahauge3492

The fabricated nanocrystals demonstrated marked dissolution rate compared to the raw and marketed formulations. It is demonstrated that it is useful for industry due to high drug concentration, large batch size and retention of distinct characteristics.The study was designed to investigate the neuro-protection of lauric acid (LA) on haloperidol (HPD) induced Parkinson's disease (PkD) rat model. Rats were divided into group A (normal), group B (diseased, by HPD 1mg/kg i.p. for 14 days), group C (standard treatment, levodopa 30 mg/kg), group D (vehicle coconut oil 1ml/kg), group E (LA 0.66mg/kg) and group F (LA 1.32mg/kg) for 35 days after induction of PkD. The study displayed a state of oxidative stress in the striatum of rat model of PkD as shown from the increased MDA, NO levels and the decreased superoxide dismutase levels. HPD caused an increase in tumor necrosis factor-α level, NF-κB, IL-8 mRNA expression and suppress IL-4 expression. Neuro-protection with LA attenuated the oxidative stress and changes in pro-inflammatory cytokines induced due to PkD induction. The LA treatment also showed improvement in the histo-pathology of the rats' brain. #link# LA also improved behavioral performances, food intake, weight gain as compared to animal of diseased group and prevented decline in motor activities (assessed Rotarod, and Beam walking test). LA showed significant neuro-protection against oxidative stress, inflammatory cytokines and behavioral changes in HPD induced rat model of PkD.Vitamin D is an anti-inflammatory and immuno-modulatory secosteroid. Previous studies showed strong link between childhood and adult onset asthma with vitamin D. Interleukin 17 is an inflammatory cytokine and plays a major role in the worsening of asthma. The aim of this study is to compare the effects of serum vitamin D on serum IL 17 and pulmonary function test (FVC, FEV1, FEV1/FVC) before and after oral vitamin D supplementation. Fifty severe asthmatic patients were selected from out patient department of Chest Medicine Ward, Jinnah post graduate medical center, Karachi. Spirometry was performed by vitalograph compact. Baseline values were as follows serum vitamin D=13.19±2.37ng/ml, IL-17=20.70±2.13ng/ml, FVC=2.31±0.40L, FEV1=1.40±0.28L,FEV1/FVC=60.15±4.61%. Subjects were given 1000 IU of oral vitamin D capsule per day for six weeks. After this trial all values were found as serum vitamin D=19.03±1.26ng/ml (p less then 0.001), IL 17=15.40ng/ml (p less then 0.001), FVC=2.90±0.60 L (p less then 0.001), FEV1=2.01±0.10L (p less then 0.001), FEV1/FVC=63.79% ±1.45 (p less then 0.001). It may be concluded that improvement in serum vitamin D levels improves the status of lung functions, decreases the airway inflammation and hence may decrease the asthma severity.Oxidative stress is considered to play an important role in the pathophysiology of hypertension. The aim of this research was to find out whether Clausena lansium (Lour.) Skeels of Wampee (WP) fruits extract attenuate the progression of high blood pressure, endothelial dysfunction and preservation of antioxidant status with using a nitric oxide synthase (NOS) inhibitor, N(G) (-nitro-L-arginine methyl ester (L-NAME) induced hypertension and oxidative stress in rats. Healthy adult male rats were received L-NAME at dose of 50mg/kg/day in drinking water for 4 weeks and were orally administered 250 or 500mg/kg of an aqueous extract of WP fruits extract daily for 2 consecutive weeks. Quercetin (QC; 25 mg/kg) was served as a positive control. The results showed that arterial blood pressure, vascular superoxide production, and plasma malondialdehyde level were markedly induced in L-NAME treated rats. In addition, serum nitric oxide, and glutathione levels were also reduced after L-NAME administration. However, daily administration with the high dose of WP fruits extract significantly alleviated these deleterious effects by attenuated high blood pressure, reversed the L-NAME-induced suppression in serum levels of nitric oxide, mitigated endothelial dysfunction, reduced oxidative stress and restored antioxidant glutathione. This suggests that WP fruits extract is a potential candidate for the development as a novel antihypertensive agents in the future.

Randomised trials have demonstrated improvement in clinical outcomes with intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) compared with angiography-guided PCI. The ILUMIEN III trial demonstrated non-inferiority of an optical coherence tomography (OCT)- versus IVUS-guided PCI strategy in achieving similar post-PCI lumen dimensions. ILUMIEN IV is a large-scale, multicentre, randomised trial designed to demonstrate the superiority of OCT- versus angiography-guided stent implantation in patients with high-risk clinical characteristics (diabetes) and/or complex angiographic lesions in achieving larger post-PCI lumen dimensions and improving clinical outcomes.

ILUMIEN IV is a prospective, single-blind clinical investigation that will randomise between 2,490 and 3,656 patients using an adaptive design to OCT-guided versus angiography-guided coronary stent implantation in a 11 ratio. The primary endpoints are (1) post-PCI minimal stent area assessed by OCT in each randomised arm, and (2) target vessel failure, the composite of cardiac death, target vessel myocardial infarction, or ischaemia-driven target vessel revascularisation. Clinical follow-up will continue for up to two years. The trial is currently enrolling, and the principal results are expected in 2022.

The large-scale ILUMIEN IV randomised controlled trial will evaluate the effectiveness of OCT-guided versus angiography-guided PCI in improving post-PCI lumen dimensions and clinical outcomes in patients with diabetes and/or with complex coronary lesions.

NCT03507777.

NCT03507777.

This retrospective study aimed to evaluate the therapeutic effects of AngioJet rheolytic thrombectomy system (ART) in treating severe acute pulmonary embolism (APE), including high-risk pulmonary embolism (HR-PE) and intermediate-high-risk pulmonary embolism (IHR-PE).

Forty-four APE patients (21 HR-PE and 23 IHR-PE) were enrolled and underwent pulmonary ART using 6-French Solent Omini AngioJet device. Protein Tyrosine Kinase inhibitor were diagnosed with APE and lower extremity deep venous thrombosis (LEDVT), and underwent thrombectomy of APE and LEDVT simultaneously using ART. All patients also received local thrombolysis with urokinase. The results showed that the mean length of stay in intensive care units was 2.4 ± 1.9 days. The significant improvement in clinical, hemodynamic and angiographic parameters were observed in both groups, and the improvements in shock index, PaO 2 , and angiographic parameters were improved more obviously in the IHR-PE group. Six of 44 patients died in-hospital. During the follow-up, 35 of 38 patients were functioning well and no recurrence of APE was observed.

Pulmonary ART plus local thrombolysis of the pulmonary artery for HR-PE or IHR-PE is feasible and appears to be safe. Further studies are warranted to investigate comparative efficacy compared to existing treatments.

Pulmonary ART plus local thrombolysis of the pulmonary artery for HR-PE or IHR-PE is feasible and appears to be safe. Further studies are warranted to investigate comparative efficacy compared to existing treatments.It would be ideal for a non-hyperemic index to predict fractional flow reserve (FFR) more accurately, given FFR's extensive validation in a multitude of clinical settings. The aim of this study was to derive a novel non-hyperemic algorithm based on deep learning and to validate it in an internal validation cohort against FFR. link2 Methods and Results The ARTIST study is a post hoc analysis of 3 previously published studies. In a derivation cohort (random 80% sample of the total cohort) a deep neural network was trained with paired examples of resting coronary pressure curves and their FFR values. The resulting algorithm was validated against unseen resting pressure curves from a random 20% sample of the total cohort. The primary endpoint was diagnostic accuracy of the deep learning-derived algorithms against binary FFR≤0.8. A total of 1666 patients were included. Diagnostic accuracy of our convolutional neural network (CNN) and recurrent neural networks (RNN) against binary FFR≤0.80 were 79.6±1.9%, and 77.6±2.3%, respectively. Conclusions In the first study using a deep learning-based algorithm to predict FFR from resting coronary pressure curves, we did not find a clinically relevant increase in diagnostic accuracy versus non-hyperemic pressure ratios.

This study evaluated the long-term outcomes of patients undergoing percutaneous coronary intervention (PCI) for in-stent restenosis (ISR).

National Cardiovascular Data Registry CathPCI records for individuals aged ≥65 years undergoing PCI from July 2009-December 2014 were linked to Medicare claims. Baseline characteristics and long-term rates of death, myocardial infarction (MI), repeat revascularization including target vessel revascularization (TVR), and major adverse cardiovascular and cerebrovascular events (MACCE) were compared between ISR PCI versus de novo lesion PCI. Of 653,304 individuals, 10.2% underwent ISR PCI and 89.8% underwent de novo lesion PCI. The median duration of follow-up was 825 days (quartile 1 352 days - quartile 3 1379 days). link3 Frequency of MACCE (55.6% vs. 45.0%; P<0.001), all-cause mortality (27.8% vs. 25.5%; P<0.001), MI (19.0% vs. 12.3%; P<0.001), repeat revascularization (31.9% vs. 18.6%; P<0.001), TVR (22.4% vs. 8.0%; P<0.001), and stroke (8.8% vs. 8.3%; P=0.005) were higher after ISR PCI. After multivariable adjustment, ISR PCI remained associated with worse long-term outcomes (hazard ratio [HR] for MACCE 1.24 [95% CI 1.22, 1.26], mortality 1.07 [95% CI 1.05, 1.09], MI 1.44 [95% CI 1.40, 1.48], repeat revascularization 1.55 [95% CI 1.51, 1.59], and TVR 2.50 [95% CI 2.42, 2.58]).

ISR PCI was common and associated with significantly higher risk of recurrent long-term major ischemic events compared to patients undergoing de novo lesion PCI. There remains a need for new strategies to minimize ISR.

ISR PCI was common and associated with significantly higher risk of recurrent long-term major ischemic events compared to patients undergoing de novo lesion PCI. There remains a need for new strategies to minimize ISR.

The relevance of spontaneous echo contrast (SEC) and left atrial appendage thrombus (LAAT) in patients undergoing transcatheter aortic valve implantation (TAVI) remains unclear. In this study, we aimed to assess the prevalence of SEC and LAAT and evaluate the impact on periprocedural outcome after TAVI.

A total of 2,549 consecutive patients underwent TAVI between 2008 and 2017. After exclusion of cases with insufficient imaging, concomitant procedures or severe intraprocedural complications, 1,558 cases were analysed. Three groups were defined according to (pre)thrombotic formations - moderate or severe SEC (n=89), LAAT (n=53), and reference (n=1,416). The primary outcome was disabling ischaemic stroke within 24 hours. The prevalence was 4.4% for LAAT and 5.4% for moderate/severe SEC. The primary outcome occurred more frequently in patients with moderate/severe SEC (6.8%) compared to the reference (2.1%) and LAAT (1.9%) groups (p=0.020). SEC was identified as an independent risk factor for the primary outcome (OR 3.