Microemulsions (μEs) are being exploited as a potential route for yielding an extensive range of nanoparticles of different chemical nature, shapes and sizes. Nanodrugs offer new avenues for structuring better “drug delivery systems”. In this study, an oil‐in‐water (o/w) μE formulation comprising N‐butyl acetate/polysorbate 80/ethanol/water was developed for the preparation of nanoparticles of fluoroquinolone antibiotics (FLQ‐NPs). A pseudoternary phase diagram was mapped at constant surfactant/cosurfactant (1:2), revealing improved and high loading of FLQs in an optimum μE formulation. The as‐formulated μE showed high loading of FLQs as; levofloxacin (4.20 wt.%), ciprofloxacin (3.16 wt.%), moxifloxacin (2.53 wt.%), gatifloxacin (1.36 wt.%), ofloxacin (0.70 wt.%). Fourier transform IR analysis indicated good compatibility of each FLQ drug with μE excipients. However, dynamic light scattering showed an increase in the average particle size of the μE on drug loading, indicating the accumulation of FLQ at interface layer of the micelle. Additionally, lyophilized levofloxacin (a selected antibiotic) showed long‐term stability, amorphous morphology and improved dissolution rate, inspected by scanning transmission electron microscopy, X‐ray diffraction and electronic spectroscopy, respectively. Moreover, fluorescence measurements suggested the interfacial vicinity of levofloxacin within the μE domain, which may support controlled release of drug during systemic circulation.
Available trial evidence is heterogeneous and insufficient for comparing routine and selective invasive strategies. Therefore, in patients with non-ST-segment elevation ACS a routine invasive strategy cannot be proven to reduce deaths or nonfatal myocardial infarction.
IntroductionLimited data exists for types of venous closure and its associated complications in patients after atrial fibrillation (AF) catheter ablation. We evaluated the subcutaneous figure-of-eight closure (FO8) for achieving venous hemostasis after AF catheter ablation compared to manual pressure.Methods284 consecutive patients that underwent AF catheter ablation by two operators were included. All patients received continuous therapeutic warfarin or interrupted novel oral anticoagulants (NOAC) and heparin (ACT300-400 s) without reversal. Patients were divided into two groups: 1) sheaths were left in place and pulled once ACT < 180 s, with hemostasis being achieved with manual pressure (MP); and 2) a subcutaneous FO8 suture closed the venous access site immediately after the ablation on each groin site and sheaths were removed immediately after the ablation despite full anticoagulation with heparin and warfarin or interrupted NOAC. Sutures were removed after four hours, and the patients laid flat for an additional two hours.ResultsThe MP group (n = 105) was similar to the FO8 group (n = 179). Time in bed was 573 ± 80 min for MP group vs. 373 ± 49 min for FO8 group (p < 0.0001). Eleven hematomas were seen in the MP group compared to seven in the FO8 group (P = 0.041).ConclusionsIn fully anticoagulated patients undergoing AF catheter ablation, excellent hemostasis was achieved with figure-of-eight sutures, with no major vascular complications, a lower hematoma rate, and a significantly shorter flat-time-in-bed compared to manual pressure.
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