The objective of this study was to investigate the influence of simultaneous factors that potentially keep patients far from achieving target INR range at discharge in hospitalized patients. Prospective cross-sectional observational study conducted at the Cardiology Department and Intensive Care Unit (ICU) of the Assiut University Hospitals. One-hundred and twenty patients were enrolled in the study from July 2013 to January 2014. Outcome measures were discharge INRs, bleeding and thromboembolic episodes. Bivariate analysis and multinomial logistic regression were conducted to determine independent risk factors that can keep patients outside target INR range. Patients who were newly initiated warfarin on hospital admission were given low initiation dose (2.8 mg ± 0.9). They were more likely to have INR values below 1.5 during hospital stay, 13 (27.7%) patients compared with 9 (12.3%) previously treated patients, respectively (p= .034). We found that the best predictors of achieving below target INR range relative to within target INR range were; shorter hospital stay periods (OR, 0.82 for every day increase [95% CI, 0.72–0.94]), being a male patient (OR, 2.86 [95% CI, 1.05–7.69]), concurrent infection (OR, 0.21 [95% CI, 0.07–0.59]) and new initiation of warfarin therapy on hospital admission (OR, 3.73 [95% CI,1.28–10.9]). Gender, new initiation of warfarin therapy on hospital admission, shorter hospital stay periods and concurrent infection can have a significant effect on discharge INRs. Initiation of warfarin without giving loading doses increases the risk of having INRs below 1.5 during hospital stay and increases the likelihood of a patient to be discharged with INR below target range. Following warfarin dosing nomograms and careful monitoring of the effect of various factors on warfarin response should be greatly considered

As a continuation of the work on EtOAc fraction of the Indonesian sponge Acanthostrongylophora ingens, 2 new alkaloids: one pyrimidine-β-carboline alkaloid named ingenine A (2) and one pyrimidine-γ-carboline alkaloid named ingenine B (3), along with annomontine (1) were isolated. Their structures were unambiguously established on the basis of NMR spectroscopy (1 H, 13C, 1 H-1 H COSY, HMQC, and HMBC) and mass spectral data. This is the first report of isolation pyrimidine-γ-carboline alkaloid from natural source. Compounds 1 and 3 showed pronounced cytotoxicity against the murine lymphoma L5178Y cancer cell line with ED50 7.8 and 9.1 μg/mL respectively, while compound 2 showed weak activity.

As a continuation of the work on EtOAc fraction of the Indonesian sponge Acanthostrongylophora ingens, 2 new alkaloids: one pyrimidine-β-carboline alkaloid named ingenine A (2) and one pyrimidine-γ-carboline alkaloid named ingenine B (3), along with annomontine (1) were isolated. Their structures were unambiguously established on the basis of NMR spectroscopy (1 H, 13C, 1 H-1 H COSY, HMQC, and HMBC) and mass spectral data. This is the first report of isolation pyrimidine-γ-carboline alkaloid from natural source. Compounds 1 and 3 showed pronounced cytotoxicity against the murine lymphoma L5178Y cancer cell line with ED50 7.8 and 9.1 μg/mL respectively, while compound 2 showed weak activity.

A new stigmasterol ester: stigmasterol tetracosanoate (3), along with 7 compounds: β-sitosterol (1), stigmasterol (2), (2S,3S,4R)-2[(2′R)-2′-(hydroxyeicosanoyl amino) octadecane-1,3,4-triol (4), apigenin (5), β-sitosterol-3-O-β-D-glucopyranoside (6), stigmasterol-3-O-β-D-glucopyranose (7), and apigenin-7-O-β-D-glucopyranoside (8) were isolated from Blepharis ciliaris aerial parts. Compounds 1, 2, and 5–7 are reported here for the first time from the plant and 4 for the first time from the family. GCMS analysis revealed the presence of 45 fatty acids, 53 hydrocarbons, and 24 sterols. The different fractions exhibited mild cytotoxic in brine shrimp assay and anti-hyperglycaemic activities. The EtOAc fraction and TME (total MeOH extract) showed weak anti-malarial activity against P. falciparum. The CHCl3 fraction gave potent ¬anti-inflammatory activity compared with indomethacin.

A new stigmasterol ester: stigmasterol tetracosanoate (3), along with 7 compounds: β-sitosterol (1), stigmasterol (2), (2S,3S,4R)-2[(2′R)-2′-(hydroxyeicosanoyl amino) octadecane-1,3,4-triol (4), apigenin (5), β-sitosterol-3-O-β-D-glucopyranoside (6), stigmasterol-3-O-β-D-glucopyranose (7), and apigenin-7-O-β-D-glucopyranoside (8) were isolated from Blepharis ciliaris aerial parts. Compounds 1, 2, and 5–7 are reported here for the first time from the plant and 4 for the first time from the family. GCMS analysis revealed the presence of 45 fatty acids, 53 hydrocarbons, and 24 sterols. The different fractions exhibited mild cytotoxic in brine shrimp assay and anti-hyperglycaemic activities. The EtOAc fraction and TME (total MeOH extract) showed weak anti-malarial activity against P. falciparum. The CHCl3 fraction gave potent ¬anti-inflammatory activity compared with indomethacin.

A new stigmasterol ester: stigmasterol tetracosanoate (3), along with 7 compounds: β-sitosterol (1), stigmasterol (2), (2S,3S,4R)-2[(2′R)-2′-(hydroxyeicosanoyl amino) octadecane-1,3,4-triol (4), apigenin (5), β-sitosterol-3-O-β-D-glucopyranoside (6), stigmasterol-3-O-β-D-glucopyranose (7), and apigenin-7-O-β-D-glucopyranoside (8) were isolated from Blepharis ciliaris aerial parts. Compounds 1, 2, and 5–7 are reported here for the first time from the plant and 4 for the first time from the family. GCMS analysis revealed the presence of 45 fatty acids, 53 hydrocarbons, and 24 sterols. The different fractions exhibited mild cytotoxic in brine shrimp assay and anti-hyperglycaemic activities. The EtOAc fraction and TME (total MeOH extract) showed weak anti-malarial activity against P. falciparum. The CHCl3 fraction gave potent ¬anti-inflammatory activity compared with indomethacin.

The conversion of titania (TiO2) nanotubes into titanium (Ti), while preserving their nanotubular structures, is demonstrated. Their application as bone implants and electrodes for combined local drug delivery and electrical stimulation therapy is proposed.

The principal challenge for bone therapy is to deliver an effective dose of therapeutic agent (for example antibiotic or anti-cancer drug) to the affected site within bone, while sparing other organs. The solution to this dilemma is to deliver drug locally within the bone; hence various surface/therapeutic modifications of the conventional bone implants have been suggested to achieve this. Implants composed of biocompatible materials and loaded with active therapeutics thus provide one possible option for effective bone therapy. This chapter showcases the challenges that an electrochemically nano-engineered bone implant based on titania nanotubes must overcome to survive and deliver therapeutics in conditions such as infections and cancer of bone. The fabrication of titania nanotubes, the therapeutic loading and release, ex-vivo and in vivo investigations; all are reviewed in terms of effectiveness for therapeutic action. Also discussed are the potential advances of titania nanotube technology and the future research directions to address additional clinical problems.

The use of methylmalonyl-CoA epimerase (MCEE) to improve stereoselectivity in crotonase-mediated biocatalysis is exemplified by the coupling of MCEE, crotonyl-CoA carboxylase reductase and carboxymethylproline synthase in a three-enzyme one-pot sequential synthesis of functionalised C-5 carboxyalkylprolines starting from crotonyl-CoA and carbon dioxide.

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