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Brendon M Hart, Stephane M Ferrell, Mark W Motejunas, Lauren A Bonneval, Elyse M Cornett, Richard D Urman, Alan D Kaye
There are several new anticoagulants on the market that will impact perioperative care, including the use of these anticoagulant drugs in the setting of regional anesthesia. The ideal pharmacological agent would prevent pathological thrombosis and allow for a normal response to vascular injury to limit bleeding. At present, all antithrombotic agents have increased bleeding risk as their main side effect. We describe the different categories of drugs, e.g., antiplatelet, anticoagulant, and thrombolytic, with particular emphasis on the new drugs that have been introduced into the market...
June 2018: Best Practice & Research. Clinical Anaesthesiology
Elyse M Cornett, Matthew B Novitch, Andrew J Brunk, Kelly S Davidson, Bethany L Menard, Richard D Urman, Alan D Kaye
There are currently new drugs being developed that have benzodiazepine properties. This review will examine remimazolam, 3-hydroxyphenazapam, adinazolam, clonazolam, and deschloroetizolam as well as other novel agents. All benzodiazepines are protein bound and only moderately lipid soluble. In addition to their baseline properties, they can be enzymatically broken down into active metabolites. The mechanism of action of these medications is related to polysynaptic pathway inhibition via direct interaction with GABA and modifiable chloride channels...
June 2018: Best Practice & Research. Clinical Anaesthesiology
Alan D Kaye, Elyse M Cornett, Shilpa S Patil, Sonja A Gennuso, Matthew M Colontonio, Dustin R Latimer, Aaron J Kaye, Richard D Urman, Nalini Vadivelu
There has been significant research to develop an ideal synthetic opioid. Opioids with variable properties possessing efficacy and with reduced side effects have been synthesized when compared to previously used agents. An opioid modulator is a drug that can produce both agonistic and antagonistic effects by binding to different opioid receptors and therefore cannot be classified as one or the other alone. These compounds can differ in their structures while still possessing opioid-mediated actions. This review will discuss TRV130 receptor modulators and other novel opioid receptor modulators, including Mitragyna "Kratom," Ignavine, Salvinorin-A, DPI-289, UFP-505, LP1, SKF-10,047, Cebranopadol, Naltrexone-14-O-sulfate, and Naloxegol...
June 2018: Best Practice & Research. Clinical Anaesthesiology
Mary Geitona, Dimitra Latsou, Aikaterini Toska, Maria Saridi
Introduction Elderly patients are particularly susceptible to polypharmacy issues because of age-related changes in pharmacokinetics and pharmacodynamics as well as to chronic diseases resulting in a continuous increasing demand for drugs. Objective This study captures the prevalence of polypharmacy and adherence in Greece and identifies related risk factors in adult patients with diabetes. Design A cross-sectional study was conducted among patients diagnosed with diabetes mellitus attending public and private outpatients' clinics in the regions of Attica and Western Greece...
October 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Marlene Z Bloom
The 2018-2019 president of the American Society of Consultant Pharmacists (ASCP), has been involved in ASCP for the last 30 years. Her perspective is that all senior care pharmacists are "consultant" pharmacists because they give advice and don't just dispense, whether they work at a chain drug store or a nursing facility. Her highest priority is to meet the educational needs for the members and give them the tools they need to practice their profession.
October 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Balewgizie Sileshi Tegegne, Melkamu Merid Mengesha, Andreas A Teferra, Mamaru Ayenew Awoke, Tesfa Dejenie Habtewold
BACKGROUND: Diabetes mellitus (DM) poses a significant risk for the development of active tuberculosis (TB) and complicates its treatment. However, there is inconclusive evidence on whether the TB-DM co-morbidity is associated with a higher risk of developing multi-drug-resistant tuberculosis (MDR-TB). The aim of this meta-analysis was to summarize available evidence on the association of DM and MDR-TB and to estimate a pooled effect measure. METHODS: PubMed, Excerpta Medica Database (EMBASE), Web of Science, World Health Organization (WHO), and Global Health Library database were searched for all studies published in English until July 2018 and that reported the association of DM and MDR-TB among TB patients...
October 15, 2018: Systematic Reviews
Xavier M Teitsma, Wei Yang, Johannes W G Jacobs, Attila Pethö-Schramm, Michelle E A Borm, Amy C Harms, Thomas Hankemeier, Jacob M van Laar, Johannes W J Bijlsma, Floris P J G Lafeber
BACKGROUND: We previously identified, in newly diagnosed rheumatoid arthritis (RA) patients, networks of co-expressed genes and proteomic biomarkers associated with achieving sustained drug-free remission (sDFR) after treatment with tocilizumab- or methotrexate-based strategies. The aim of this study was to identify, within the same patients, metabolic pathways important for achieving sDFR and to subsequently study the complex interactions between different components of the biological system and how these interactions might affect the therapeutic response in early RA...
October 15, 2018: Arthritis Research & Therapy
(no author information available yet)
BACKGROUND: A body of empirical work demonstrates that wide fluctuations in a person's blood pressure across consecutive measures, known as blood pressure variability (BPV), hold prognostic value to predict stroke and transient ischemic attack. However, the magnitude of association between BPV and other neurological outcomes remains less clear. This systematic review aims to pool together data regarding BPV with respect to incident dementia, cognitive impairment, and cognitive function...
October 15, 2018: Systematic Reviews
Courtney M Schaal, Namrata Bora-Singhal, Durairaj Mohan Kumar, Srikumar P Chellappan
BACKGROUND: Lung cancer is the leading cause of cancer related deaths and its incidence is highly correlated with cigarette smoking. Nicotine, the addictive component of tobacco smoke, cannot initiate tumors, but can promote proliferation, migration, and invasion of cells in vitro and promote tumor growth and metastasis in vivo. This nicotine-mediated tumor promotion is facilitated through the activation of nicotinic acetylcholine receptors (nAChRs), specifically the α7 subunit. More recently, nicotine has been implicated in promoting self-renewal of stem-like side-population cells from lung cancers...
October 15, 2018: Molecular Cancer
Hamed Ghaffari, Linda R Petzold
BACKGROUND: In the classical pathway of retinoic acid (RA) mediated gene transcription, RA binds to a nuclear hormone receptor dimer composed of retinoic acid receptor (RAR) and retinoid X receptor (RXR), to induce the expression of its downstream target genes. In addition to nuclear receptors, there are other intracellular RA binding proteins such as cellular retinoic acid binding proteins (CRABP1 and CRABP2) and cytochrome P450 (CYP) enzymes, whose contributions to the RA signaling pathway have not been fully understood...
October 16, 2018: Theoretical Biology & Medical Modelling
Paweł Lewandowski, Jakub Baran, Paweł Maciejewski, Andrzej Budaj
BACKGROUND: Iatrogenic pseudoaneurysms (IPA) are treated with ultrasound-guided thrombin injections (UGTI). We describe a novel technique for IPA repair that applies UGTI with thrombin foam (UGTFI). METHODS AND RESULTS: Successful obliteration of 6 IPAs (IPA without a neck, n = 5; with a neck, n = 1) in 6 patients (2 males, aged 68 ± 1 years, 4 females, aged 59 ± 11 years) was performed by using UGTFI. The dose of administered thrombin was 25-75 IU. No microembolization phenomenon and no serious clinical complications were observed...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Seungwha Paik, Jin Kyung Kim, Chaeuk Chung, Eun-Kyeong Jo
Tuberculosis (TB), which is primarily caused by the major etiologic agent Mycobacterium tuberculosis (Mtb), remains a serious infectious disease worldwide. Recently, much effort has been made to develop novel/improved therapies by modulating host responses to TB (i.e., host-directed therapy). Autophagy is an intracellular catabolic process that helps maintain homeostasis or the removal of invading pathogens via a lysosomal degradation process. The activation of autophagy by diverse drugs or agents may represent a promising treatment strategy against Mtb infection, even to drug-resistant strains...
October 15, 2018: Virulence
Juhi Singh, Pooja Mittal, Gunjan Vasant Bonde, Gufran Ajmal, Brahmeshwar Mishra
Quercetin (Qu), is a flavonoid known to have anti-diabetic effects owing to its antioxidant property, thus promoting regeneration of the pancreatic islets, ultimately increasing insulin secretion. But the therapeutic application of Qu is hampered by its low oral bioavailability and its unfavourable physicochemical characteristics. The present work aimed at formulation of Quercetin loaded Soluplus® micelles (SMs) so as to enhance its bioavailability and provide prolonged release for the management of diabetes...
October 16, 2018: Artificial Cells, Nanomedicine, and Biotechnology
Matthew W McCarthy, Thomas J Walsh
The presence of Candida species in the blood is known as candidemia and may constitute a medical emergency for patients with cancer. Despite advances in diagnosis and treatment of this fungal infection, mortality remains unacceptably high. Areas covered: This paper reviews recent advances in molecular diagnostics to detect species of Candida as well as novel antifungal agents that have been developed to address candidiasis. We also review prophylaxis strategies to prevent candidiasis in high-risk cancer patients...
October 16, 2018: Expert Review of Anti-infective Therapy
Anyela Marcela Castañeda, Chang-Soon Lee, Yong-Chul Kim, Dasom Lee, Jee Youn Moon
Opioid consumption has increased worldwide, which carries the risk of opioid use disorder (OUD). However, the literature on OUD and opioid-related chemical coping (OrCC) in chronic noncancer pain (CNCP) is heterogeneous, with most studies conducted in the United States. We performed a multicenter, observational, cross-sectional study to address OrCC in long-term opioid therapy (LtOT) for CNCP in South Korea. The objectives were to determine the frequency and predictors of OrCC. We included 258 patients. Among them, fifty-five (21%) patients showed OrCC...
October 14, 2018: Journal of Clinical Medicine
Li Yan Chan, Joshua Ding Wei Teo, Kevin Shyong-Wei Tan, Keitaro Sou, Wei Lek Kwan, Chi-Lik Ken Lee
Chloroquine was among the first of several effective drug treatments against malaria until the onset of chloroquine resistance. In light of diminished clinical efficacy of chloroquine as an antimalarial therapeutic, there is potential in efforts to adapt chloroquine for other clinical applications, such as in combination therapies and in diagnostics. In this context, we designed and synthesized a novel asymmetrical squaraine dye coupled with chloroquine (SQR1-CQ). In this study, SQR1-CQ was used to label live Plasmodium falciparum ( P...
October 14, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Barbara Rath, Maximilian Hochmair, Adelina Plangger, Gerhard Hamilton
Lung cancer is a leading cause of tumor-associated mortality. Fascaplysin, a bis-indole of a marine sponge, exhibit broad anticancer activity as specific CDK4 inhibitor among several other mechanisms, and is investigated as a drug to overcome chemoresistance after the failure of targeted agents or immunotherapy. The cytotoxic activity of fascaplysin was studied using lung cancer cell lines, primary Non-Small Cell Lung Cancer (NSCLC) and Small Cell Lung Cancer (SCLC) cells, as well as SCLC circulating tumor cell lines (CTCs)...
October 14, 2018: Marine Drugs
Bremansu Osa-Andrews, Kee W Tan, Angelina Sampson, Surtaj H Iram
Multidrug resistance protein 1 (MRP1) can efflux a wide variety of molecules including toxic chemicals, drugs, and their derivatives out of cells. Substrates of MRP1 include anti-cancer agents, antibiotics, anti-virals, anti-human immunodeficiency virus (HIV), and many other drugs. To identify novel substrates and modulators of MRP1 by exploiting intramolecular fluorescence resonance energy transfer (FRET), we genetically engineered six different two-color MRP1 proteins by changing green fluorescent protein (GFP) insertion sites, while keeping the red fluorescent protein (RFP) at the C-terminal of MRP1...
October 13, 2018: Pharmaceutics
Pankaj Pandey, Kuldeep K Roy, Haining Liu, Guoyi Ma, Sara Pettaway, Walid F Alsharif, Rama S Gadepalli, John M Rimoldi, Christopher R McCurdy, Stephen J Cutler, Robert J Doerksen
Natural products are an abundant source of potential drugs, and their diversity makes them a rich and viable prospective source of bioactive cannabinoid ligands. Cannabinoid receptor 1 (CB1) antagonists are clinically established and well documented as potential therapeutics for treating obesity, obesity-related cardiometabolic disorders, pain, and drug/substance abuse, but their associated CNS-mediated adverse effects hinder the development of potential new drugs and no such drug is currently on the market...
October 13, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Cherie Ann Kruger, Heidi Abrahamse
The cancer incidence world-wide has caused an increase in the demand for effective forms of treatment. One unconventional form of treatment for cancer is photodynamic therapy (PDT). PDT has 3 fundamental factors, namely a photosensitiser (PS) drug, light and oxygen. When a PS drug is administered to a patient, it can either passively or actively accumulate within a tumour site and once exposed to a specific wavelength of light, it is excited to produce reactive oxygen species (ROS), resulting in tumour destruction...
October 13, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
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