Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Oxidative polycondensation reaction

WOS: 000243504900002In the last few years, some monomers such as phenols, anilines, pyridines, naphtols, Schiff bases and azo phenols have been subjected to oxidative polycondensation (OP) using NaOCl, H2O2 and air O-2 as the oxidants in aqueous alkaline or aqueous acidic medium. This resulted in oligomers with potential useful properties. The major reason behind these investigations was the economic and environmentally benign reaction process of OP. Therefore, this review diccusses OP and the obtained oligomers in detail. Additionally, chemical structures, physical properties, UV-Vis, FT-IR, H-1- and C-13-NMR analyses, thermal properties and coupling mechanism of all oligomers synthesized via OP are discussed and compared to those of polymers prepared by other oxidative methods. The probable potential applications of the obtained polymers and oligomers, such as antistatic and semi-conductivity, fluorescent, photoresist, opto-electronic, electrochromic, antimicrobial and photoresponsive properties, are also discussed in the last section

New soluble azophenol polymers prepared by oxidative polycondensation

WOS: 000251014600009New azophenol polymers (P-1, P-2 and P-3) were synthesised by the oxidative polycondensation (OP) reaction of three different azophenol monomers in aqueous alkaline medium with NaOCl as the oxidant. The monomers and the polymers were characterised by elemental analyses, and UV-visible, Fourier transform infrared, H-1 NMR and C-13 NMR spectroscopic studies, which revealed that the polymers synthesised by OP are composed of oxyphenylene (C-O-C) and phenylene (C-C) units. The polymers obtained are soluble in dimethylformamide and dimethylsulfoxide. Average molecular weights of the polymers were determined by gel permeation chromatography. Additionally, P-2 and P-3 are soluble in water and methanol. On the basis of thermogravimetric analyses, 5 and 50% weight-loss temperatures of the polymers were found to be 218, 700 (P-1), 263, 609 (P-2) and 100, 809 degrees C (P-3), respectively, suggesting a high thermal stability. Thermal analyses using differential scanning calorimetry revealed that the azophenol polymers are highly amorphous, and melting peaks were not observed in the heating cycles. This suggests that all the polymers are highly amorphous. The azophenol polymers show a reversible trans-cis-trans isomerisation process. These properties of the polymer could be promising for their technological usage. (C) 2007 Society of Chemical Industry

Media effects on the optical properties of proton donor group containing azobenzene derivatives

WOS: 000271888500012A series of hydroxy and carboxy group containing azobenzene compounds were synthesized and investigated by UV-vis and fluorescence spectroscopy. It could be shown that the ambient medium exerted a strong influence on the absorption behavior and the trans-cis isomerization behavior of the azo compounds. Especially in the case of hydroxy group functionalized azobenzenes, deprotonation with NaOH or a polymeric base changed the spectral behavior of the compounds remarkably. A strong bathochromic shift of the dyes' longest wavelength absorption band was observed. Furthermore, the influence of different solvents and different polymeric matrices on the trans-cis isomerization behavior of the azobenzenes was investigated. The results are discussed in terms of utilization of the azo dyes as probe molecules for interactions in polymer blends. (C) 2009 Elsevier B.V. All rights reserved.German Federal Ministry for Education, Science, Research and Technology [TUR 04/008]; Scientific and Technical Research Council of TurkeyThe authors acknowledge the financial support of the fund for international cooperation of the German Federal Ministry for Education, Science, Research and Technology (project No. TUR 04/008) and of the Scientific and Technical Research Council of Turkey (TUBITAK)