Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

1062Effectiveness of recruitment and retention strategies in a population based prospective LoCARPoN AIIMS cohort study

Abstract Background In Indian population, recruitment and retention of elderly population for any study is challenging due to different demographic variations and ageing effects. In LoCARPoN (Longitudinal Cognition and Aging Research in the Population of National Capital Region) Cohort study which is first study in India to identify the risk factors for stroke or major cognitive disorders among elderly different multiple strategies were adopted for recruitment and retention of healthy participants aged 50 years and above . Methods The study was conducted in urban population in Delhi, India. The strategies adopted for recruitment and retention of participants for 3 years including follow up is done by following multiple principles viz, participants centric, resource management, system functionality, approachable facilities and other reinforcement tactics. Results Among 18294 households, 9817 households were found to be eligible to participate in the study. Out of that 7383 houses were approachable others refused (2434) at first stage. By following the strategies which incorporates participants’ satisfaction, efficient system functionality and reliable information a total of 12250 eligible participants in 7383 houses were contacted, out of them 8858 (72.3%) were consented to visit medical sites . Out of he Consented individuals 7505 (61.3 %) visited medical site. Conclusions The multiple strategies used were very effective for recruitment and retention of cohort participants Key messages Multiple strategies concerning study participants needs flexible and approachable techniques helps in recruitment and retention in any longitudinal cohort studies. </jats:sec

Role and Recent Advancements of Ionic Liquids in Drug Delivery Systems

Advancements in the fields of ionic liquids (ILs) broaden its applications not only in traditional use but also in different pharmaceutical and biomedical fields. Ionic liquids “Solutions for Your Success” have received a lot of interest from scientists due to a myriad of applications in the pharmaceutical industry for drug delivery systems as well as targeting different diseases. Solubility is a critical physicochemical property that determines the drug’s fate at the target site. Many promising drug candidates fail in various phases of drug research due to poor solubility. In this context, ionic liquids are regarded as effective drug delivery systems for poorly soluble medicines. ILs are also able to combine different anions/cations with other cations/anions to produce salts that satisfy the concept behind the ILs. The important characteristics of ionic liquids are the modularity of their physicochemical properties depending on the application. The review highlights the recent advancement and further applications of ionic liquids to deliver drugs in the pharmaceutical and biomedical fields

Role and Recent Advancements of Ionic Liquids in Drug Delivery Systems

Advancements in the fields of ionic liquids (ILs) broaden its applications not only in traditional use but also in different pharmaceutical and biomedical fields. Ionic liquids “Solutions for Your Success” have received a lot of interest from scientists due to a myriad of applications in the pharmaceutical industry for drug delivery systems as well as targeting different diseases. Solubility is a critical physicochemical property that determines the drug’s fate at the target site. Many promising drug candidates fail in various phases of drug research due to poor solubility. In this context, ionic liquids are regarded as effective drug delivery systems for poorly soluble medicines. ILs are also able to combine different anions/cations with other cations/anions to produce salts that satisfy the concept behind the ILs. The important characteristics of ionic liquids are the modularity of their physicochemical properties depending on the application. The review highlights the recent advancement and further applications of ionic liquids to deliver drugs in the pharmaceutical and biomedical fields.</jats:p