A simplified HPLC method for quantification of torsemide from human plasma and its application to a bioequivalence study.

A simple, rapid and selective method was developed. The method was validated and found to be linear in the range of 100-4000 ng/ml. Chromatographic peaks were separated by means of a 5 mum, C18 silica column using acetonitrile and phosphate buffer (0.05 M) in proportion of 40:60 (pH 4.0) as a mobile phase. The retention time of torsemide was 5.00+/-0.20 min. The chromatograms showed good resolution and no interference from plasma. The mean recovery from human plasma was found to be above 82%. Both inter-day and intra-day accuracy and precision data showed good reproducibility. This method was applied to a single dose bioequivalence study. Log transformed values were compared by ANOVA followed by classical 90% confidence interval. Confidence limits for C(max), AUC(0-t) and AUC(0-inf) ranged from 98.6 to 102.8, 101.8 to 105.3 and 102.4 to 105.5 respectively. These results suggested that the analytical method was linear, precise and accurate. Test and reference product were found to be bioequivalent.

Oxegen 2004: the impact of a major music festival on the workload of a local hospital.

This prospective observational study was undertaken to assess the impact of a major music festival on the workload of a local hospital. Data were collected on all attendances at Naas General Hospital from the nearby Oxegen 2004 music festival. Patient demographics, disposition and diagnoses were recorded. Emergency department activity levels were compared before, during and after the festival. Seventy-two attendees were referred to Naas emergency department over a 3-day period, representing a 45% increase in the hospital's emergency department attendance rate. Thirty-seven of these attendees (51%) required inpatient or tertiary centre services. Thirty-four attendees (47%) were noted as having consumed alcohol and/or used illicit substances. We conclude that despite the provision of on-site medical facilities, major music events are associated with a significant increase in local health care activity and expenditure.

Long-term clarithromycin decreases prednisone requirements in elderly patients with prednisone-dependent asthma.

Prolonged use of prednisone is associated with serious side effects, such as osteoporosis, particularly among elderly individuals. Macrolide antibiotics exhibit anti-inflammatory effects that are distinct from their antimicrobial properties. Thus, the purpose of this case report is to describe the effects of prolonged treatment with clarithromycin, 500 mg bid, in reducing prednisone requirements in three elderly patients with prednisone-dependent asthma. Three patients (one woman and two men) aged 63 to 69 years, who had been treated with 5 to 10 mg prednisone daily for at least the last 12 months, were given clarithromycin, 500 mg bid. They were followed regularly for changes in daily prednisone dose, spirometry, quality of life, and adverse events. The prednisone dose was tapered in a stepwise fashion at each clinic visit. Within 3 to 6 months of initiation of treatment with clarithromycin, and throughout the 12-month follow-up, two of three patients discontinued prednisone therapy, while the third patient displayed increased spirometry readings and noted an increasingly better quality of life. Pulmonary function tests were stable or improved over this time period, with no reported adverse events, including increased rate of infections. One patient relapsed upon discontinuation of clarithromycin therapy but has since responded to re-initiation of treatment. Long-term oral clarithromycin may have a role in reducing prednisone requirements in elderly patients with prednisone-dependent asthma.

A self-expanding bifurcated endovascular graft for abdominal aortic aneurysm repair. An initial study in a canine model.

Approximately 50,000 abdominal aortic aneurysms (AAAs) are surgically repaired annually in the United States. Endovascular grafts (EVGs) combine a stent and a vascular graft offering great potential for reduced morbidity, mortality, and hospital stay because of minimally invasive endoluminal placement through catheters. Because most AAAs extend into one or both iliac arteries, a bifurcated EVG (bEVG) was developed, consisting of a proximal aortic trunk divided into two distinct lumens or sockets to receive two smaller diameter leg (iliac) components. All components were composed of Didcott self-expanding braided wire stents integrally attached to porous spun polycarbonate urethane liners. Successful placement of the bEVGs (trunks 10-12 mm and legs 5-6 mm diameter) by a 10 Fr introducer through the femoral arteries into the infrarenal aorta and external iliac arteries of 9 of 11 dogs was achieved. Subsequently, 11 of 12 bEVGs were successfully placed to exclude a saccular aneurysm exceeding three aortic diameters created by a fascia lata pouch extending from the aorta into the left external iliac artery, of which 7 were patent at 1 to 4 months. These findings establish design feasibility of the bEVG as well as the utility of the canine experimental model.