Phenolics from Rhagadiolus stellatus (Asteraceae, Cichorieae)

Rhagadiolus stellatus Gaertn., a Mediterranean member of the Cichorieae tribe of the Asteraceae family used as a food plant, was analyzed for its spectrum of phenolic compounds. Kaempferol 3-O-β-glucoside 1, kaempferol 3-O-β-rutinoside (nicotiflorin) 2, quercetin 3-O-β-glucoside 3, and luteolin 4 were isolated from the n-butanol layer of a methanolic extract of whole plants of Rh. stellatus of Spanish origin by repeated Sephadex LH-20 column chromatography. Structures were determined based on NMR and MS data as well as by comparison with literature data. Additionally, chlorogenic acid 5 and 3,5-dicaffeoylquinic acid 6 were detected by HPLC/DAD and HPLC/MS. Chemosystematic implications of the presented findings are discussed in comparison with other members of the Cichorieae tribe

A new eudesmane derivative from Leontodon tuberosus

Besides the known compounds 2,4,6-trihydroxyacetophenone 4-O-β -D-glucopyranoside and syringaresinol 4'-O-β -D-glucopyranoside, the novel sesquiterpenoid 1,2-dehydro-3-oxocostic acid β -D-glucopyranoside ester was isolated from Leontodon tuberosus L. and its structure established by mass spectrometry and 1D-and 2D-NMR spectroscopy. Additionally, a number of fatty and phenolic acids was identified in the crude methanolic extract by HPLC-DAD and HPLC-MS. The chemosystematic impact of the new sesquiterpenoid is discussed briefly

Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery

Minimally invasive techniques to access subcutaneous adipose tissue for glucose monitoring are successfully applied in type1 diabetic and critically ill patients. During critical illness, the addition of a lactate sensor might enhance prognosis and early intervention. Our objective was to evaluate SAT as a site for lactate measurement in critically ill patients. In 40 patients after major cardiac surgery, arterial blood and SAT microdialysis samples were taken in hourly intervals. Lactate concentrations from SAT were prospectively calibrated to arterial blood. Analysis was based on comparison of absolute lactate concentrations (arterial blood vs. SAT) and on a 6-hour lactate trend analysis, to test whether changes of arterial lactate can be described by SAT lactate. Correlation between lactate readings from arterial blood vs. SAT was highly significant (r2 = 0.71, P < .001). Nevertheless, 42% of SAT lactate readings and 35% of the SAT lactate trends were not comparable to arterial blood. When a 6-hour stabilization period after catheter insertion was introduced, 5.5% of SAT readings and 41.6% of the SAT lactate trends remained incomparable to arterial blood. In conclusion, replacement of arterial blood lactate measurements by readings from SAT is associated with a substantial shortcoming in clinical predictability in patients after major cardiac surgery

Metrology in medicine: from measurements to decision, with specific reference to anesthesia and intensive care.

Metrology is the science of measurements. Although of critical importance in medicine and especially in critical care, frequent confusion in terms and definitions impact either interphysician communications or understanding of manufacturers' and engineers' instructions and limitations when using devices. In this review, we first list the terms defined by the International Bureau of Weights and Measures regarding quantities and units, measurements, devices for measurement, properties of measuring devices, and measurement standards. The traditional tools for assessing the most important measurement quality criteria are also reviewed with clinical examples for diagnosis, alarm, and titration purposes, as well as for assessing the uncertainty of reference methods

Assessing the effectiveness of 3 months day and night home closed-loop insulin delivery in adults with suboptimally controlled type 1 diabetes: a randomised crossover study protocol.

INTRODUCTION: Despite therapeutic advances, many people with type 1 diabetes are still unable to achieve optimal glycaemic control, limited by the occurrence of hypoglycaemia. The objective of the present study is to determine the effectiveness of day and night home closed-loop over the medium term compared with sensor-augmented pump therapy in adults with type 1 diabetes and suboptimal glycaemic control. METHODS AND ANALYSIS: The study will adopt an open label, three-centre, multinational, randomised, two-period crossover study design comparing automated closed-loop glucose control with sensor augmented insulin pump therapy. The study will aim for 30 completed participants. Eligible participants will be adults (≥18 years) with type 1 diabetes treated with insulin pump therapy and suboptimal glycaemic control (glycated haemoglobin (HbA1c)≥7.5% (58 mmol/mmol) and ≤10% (86 mmol/mmol)). Following a 4-week optimisation period, participants will undergo a 3-month use of automated closed-loop insulin delivery and sensor-augmented pump therapy, with a 4-6 week washout period in between. The order of the interventions will be random. All analysis will be conducted on an intention to treat basis. The primary outcome is the time spent in the target glucose range from 3.9 to 10.0 mmol/L based on continuous glucose monitoring levels during the 3 months free living phase. Secondary outcomes include HbA1c changes; mean glucose and time spent above and below target glucose levels. Further, participants will be invited at baseline, midpoint and study end to participate in semistructured interviews and complete questionnaires to explore usability and acceptance of the technology, impact on quality of life and fear of hypoglycaemia. ETHICS AND DISSEMINATION: Ethical approval has been obtained at all sites. Before screening, all participants will be provided with oral and written information about the trial. The study will be disseminated by peer-review publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT01961622 (ClinicalTrials.gov)