Article by Disease – “Early Palliative Care in Advanced Oncologic and Non-Oncologic Chronic Diseases: A Systematic Review of Literature”

Article by Disease on “Oncology

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Abstract:

Background: To assess the role of early palliative care in patients with advanced oncologic and non-oncologic chronic diseases.

Methods: A qualitative systematic review of literature was performed. All the randomized phase III trials comparing early, simultaneous palliative care and standard care in patients with advanced oncologic and non-oncologic diseases were considered eligible and included into the analysis. The outcomes were classified into 6 classes: quality of life, symptoms control, overall survival, quality of care, patients’ and caregivers’ satisfaction, and costs of the assistance.

Results: Twelve papers reporting the data of 9 trials were considered eligible and included into the analysis. Two nonrandomized trials were also included into the selection because of the methods used by the authors. The early, simultaneous approach was reported to improve quality of life in two out of 7 papers, symptoms control in 1 out of 5 papers, overall survival in 2 out of 3 papers, quality of care in 5 out of 8 papers, patients’ or caregivers’ satisfaction in 3 out of 4 papers; and to reduce the costs of assistance in 2 out of 3 papers.

Conclusion: Early palliative care improves the main outcomes of the assistance in patients with advanced oncologic and non-oncologic chronic diseases. The available data are probably enough to consider early palliative cares a novel standard of care in these groups of patients.

Read more: http://www.eurekaselect.com/node/135802/article

Article by Disease – “Current Perspectives on Novel Drug Delivery Systems and Approaches for Management of Cervical Cancer: A Comprehensive Review”

Article by Disease on “Oncology

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Abstract:

Cervical cancer is uterine cervix carcinoma, the second deadly cancer and has a high incidence and mortality rate. In the developing world conventional treatment strategies such as surgical intervention and chemoradiotherapy are less widely available. Currently cancer research focuses on improving treatment of cervical cancer using various therapies such as gene therapy, recombinant protein therapy, photodynamic therapy, photothermal therapy and delivery of chemotherapeutic agents using nanoparticles, hydrogel and liposomal based delivery systems and also localized delivery systems which exist in a variety of forms such as intravaginal rings, intravaginal patches, intravaginal films, etc. in order to improve the drug delivery in a controlled manner to the diseased site thereby reducing systemic side effects. The present review encloses existing diverse delivery systems and approaches intended for treatment of cervical cancer.

Read more: http://www.eurekaselect.com/node/130992/article

Article by Disease – “Vitiligo in Children: A Birds Eye View”

Article by Disease on “Endocrine Diseases

Abstract:

Vitiligo in children is a distinct subset of vitiligo and differs from adult vitiligo. Characteristic features include family history of autoimmune or endocrine disease, higher incidence of segmental vitiligo, development of early or premature graying, increased incidence of autoantibodies and poor response to topical PUVA. The exact prevalence of vitiligo in children varies between 0.1-4% of the world population and seems to be higher in India than in other countries and it occurs more frequently in females. Around 12% to 35% of pediatric vitiligo patients have family members with the disease. The most common type of vitiligo in pediatric patients is vitiligo vulgaris, representing 78% of cases. The most commonly associated autoimmune disease is thyroiditis. Phototherapy and topical corticosteroids are the most commonly used treatments for adult vitiligo but are less useful in the pediatric population.

Read more: http://www.eurekaselect.com/node/138295/article

Article by Disease – “Nanowired Drug Delivery Across the Blood-Brain Barrier in Central Nervous System Injury and Repair”

Article by Disease on “Neuroscience

Abstract:

The blood-brain barrier (BBB) is a physiological regulator of transport of essential items from blood to brain for the maintenance of homeostasis of the central nervous system (CNS) within narrow limits. The BBB is also responsible for export of harmful or metabolic products from brain to blood to keep the CNS fluid microenvironment healthy. However, noxious insults to the brain caused by trauma, ischemia or environmental/chemical toxins alter the BBB function to small as well as large molecules e.g., proteins. When proteins enter the CNS fluid microenvironment, development of brain edema occurs due to altered osmotic balance between blood and brain. On the other hand, almost all neurodegenerative diseases and traumatic insults to the CNS and subsequent BBB dysfunction lead to edema formation and cell injury. To treat these brain disorders suitable drug therapy reaching their brain targets is needed. However, due to edema formation or only a focal disruption of the BBB e.g., around brain tumors, many drugs are unable to reach their CNS targets in sufficient quantity. This results in poor therapeutic outcome. Thus, new technology such as nanodelivery is needed for drugs to reach their CNS targets and be effective. In this review, use of nanowires as a possible novel tool to enhance drug delivery into the CNS in various disease models is discussed based on our investigations. These data show that nanowired delivery of drugs may have superior neuroprotective ability to treat several CNS diseases effectively indicating their role in future therapeutic strategies.

Read more: http://www.eurekaselect.com/node/144937/article

Article by Disease – “Brain Aging and Disorders of the Central Nervous System: Kynurenines and Drug Metabolism”

Article by Disease on “Metabolic Disorders”

Abstract:

Introduction: The kynurenine pathway includes several neuroactive compounds, including kynurenic acid, picolinic acid, 3-hydroxykynurenine and quinolinic acid. The enzymatic cascade of the kynurenine pathway is tightly connected with the immune system, and may provide a link between the immune system and neurotransmission.

Main Areas Covered: Alterations in this cascade are associated with neurodegenerative, neurocognitive, autoimmune and psychiatric disorders, such as Parkinson’s disease, Huntington’s disease, Alzheimer’s disease, multiple sclerosis, amyotrophic lateral sclerosis, migraine or schizophrenia.

Highlights: This review highlights the alterations in this metabolic pathway in the physiological aging process and in different disorders. A survey is also presented of therapeutic possibilities of influencing this metabolic route, which can be achieved through the use of synthetic kynurenic acid analogues, enzyme inhibitors or even nanotechnology.

Read more: http://www.eurekaselect.com/node/138027/article 

Article by Disease – “Geriatric Psychopharmacology in Acute Settings”

ARTICLE BY DISEASE ON “GERIATRIC MEDICINE

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Abstract:

Background: Pharmacological management of geriatric patients in acute settings is complex due to the presence of medical comorbidities, risk of drug-drug interactions, and potential patient sensitivity to side effects.

Objectives: This article will review the basic pharmacologic principles of management of older adults in acute settings.

Method: The aforementioned principles will be described and illustrated with two clinical examples. These principles include prioritizing the safety of patients and staff; obtaining a history that is as complete as possible, in order to support the working diagnosis; using the lowest medication dose that controls the symptoms; closely monitoring for side effects and drug-drug interactions; minimizing polypharmacy and discontinuing medications that are no longer necessary; double-checking all orders, so as to avoid medication errors; and involving the patients family and caregivers in treatment planning. Additionally, agents with anticholinergic properties, antipsychotics, benzodiazepines, nonbenzodiazepine hypnotics, and opioids should be used cautiously in older individuals, particularly those with dementia. Practical tips, formulations, dosages, and selected adverse effects of antipsychotics and mood stabilizers used with geriatric patients in acute settings are included.

Results: This clinical review will be useful for psychiatrists and other clinicians who treat older adults in acute medical settings.

Read more: http://www.eurekaselect.com/node/138957/article

Article by Disease – “Preparation and Optimization of Moxifloxacin Microspheres for Colon Targeted Delivery Using Quality by Design Approach: In Vitro and In Vivo Study”

ARTICLE BY DISEASE ON “GASTROENTEROLOGY

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Abstract:

Background: Gut microbiota has a significant role in the pathogenesis of diabetes. Colonic microflora modulation using an antibiotic might have an emerging role to treat the metabolic disorders. The present study was aimed to optimize the Moxifloxacin loaded chitosan microspheres (MCMs) by emulsion cross linking method for colon targeted delivery to alter the microflora.

Methods: Preliminary optimization of MCMs was carried out using Placket-Burman design (PBD) following by final optimization with Box-Behnken design (BBD). Optimized MCMs were evaluated for yield, particle size, entrapment efficiency and in vitro/ in vivo antimicrobial activities.

Results: FTIR spectroscopy of MCMs confirms the absence of chemical interactions during the formulation. MCMs were found to be smooth, spherical with particle size around 20μm. An enteric coating of MCMs prevented the drug release in the acidic environment of the stomach and ileum with complete release at the colon. MCMs had followed the korsmeyer – peppas model of drug release, indicating the drug release by non-fickian diffusion pattern. MCMs showed significant in vitro antimicrobial activity against Lactobacillus casei and Escherichia coli. In vivo results of MCMs exhibited prolonged antimicrobial effect of drug in the cecal content of rats. Significant protective activity observed in the ileum and colon histology in rats treated with MCMs compared to the pure drug.

Conclusion: MCMs were formulated by emulsion cross linking method using QBD approach. An enteric coating around the microspheres prevented the premature drug release at upper gastrointestinal tract, while chitosan cross linking has provided the sustain release of the drug in the colonic region over the time.

Read more: http://www.eurekaselect.com/node/142092/article 

Article by Disease – “Numerical Simulations of Tensile Tests of Red Blood Cells: Effects of the Hold Position”

ARTICLE BY DISEASE ON “HAEMATOLOGY”

Abstract:

Tensile tests have been carried out to determine the failure strain of red blood cells. However, difficulties in reproducibly arise due to problems controlling the hold position of the cells during the test, which raises questions about the reliability of experimental data. Here, we investigate the effects of the hold position of the red blood cell on strain field during tensile testing using numerical simulations. Tensile tests were simulated in three hold positions. The results show significant variations in the deformed geometry of the red blood cell during the tensile test, as well as variations in strain distribution. Of the hold patterns examined, with an applied strain of 0.8, the misaligned stretch increased the maximum of the first principal strain by 65–85% in comparison to the aligned stretch. Although it would be ideal to precisely control the hold position and reproducibility, in practice this is not straightforward, and hence the effects of variations in the hold position should be considered when interpreting experimental data.

Read more: http://www.eurekaselect.com/node/138323/article

Article by Disease – “Beta-Blockers and Nitrates: Pharmacotherapy and Indications”

ARTICLE BY DISEASE ON “CARDIOLOGY”

Abstract:

Many clinically important differences exist between beta blockers. B1-selectivity is of clinical interest because at clinically used doses, b1- selective agents block cardiac b-receptors while having minor effects on bronchial and vascular b-receptors. Beta-adrenergic blocking agents significantly decrease the frequency and duration of angina pectoris, instead the prognostic benefit of beta-blockers in stable angina has been extrapolated from studies of post myocardial infarction but has not yet been documented without left ventricular disfunction or previous myocardial infarction. Organic nitrates are among the oldest drugs, but they still remain a widely used adjuvant in the treatment of symptomatic coronary artery disease. While their efficacy in relieving angina pectoris symptoms in acute settings and in preventing angina before physical or emotional stress is undisputed, the chronic use of nitrates has been associated with potentially important side effects such as tolerance and endothelial dysfunction. B-blockers are the firstline anti-anginal therapy in stable stable angina patients without contraindications, while nitrates are the secondline anti-anginal therapy. Despite 150 years of clinical practice, they remain fascinating drugs, which in a chronic setting still deserve investigation. This review evaluated pharmacotherapy and indications of Beta-blockers and nitrates in stable angina.

Read more: http://www.eurekaselect.com/node/127075/article

Article by Disease – “Insights into the Zinc-Dependent Deacetylase LpxC: Biochemical Properties and Inhibitor Design”

ARTICLE BY DISEASE ON “DIABETES”

Abstract:

The bacterial enzyme UDP-3-O-[(R)-3-hydroxymyristoyl]-N-acetylglucosamine deacetylase (LpxC), catalyzing the first committed step of lipid A biosynthesis, represents a promising target in the development of novel antibiotics against Gram-negative bacteria. Structure, catalytic reaction mechanism and regulation of the Zn2+-dependent metalloamidase have been intensively investigated. The enzyme is required for growth and viability of Gram-negative bacteria, displays no sequence homology with any mammalian protein, but is highly conserved in Gram-negative bacteria, thus permitting the development of Gram-negative selective antibacterial agents with limited off-target effects. Several smallmolecule LpxC inhibitors have been developed, like the substrate analog TU-514 (12a), the aryloxazoline L-161,240 (13w), the sulfonamide BB-78485 (23a), the N-aroyl-L-threonine derivative CHIR-090 (24a), the sulfone-containing pyridone LpxC-3 (43e), and the uridine-based inhibitor 1-68A (47a), displaying diverse inhibitory and antibacterial activities. Most of these compounds share a Zn2+-binding hydroxamate moiety attached to a structural element addressing the hydrophobic tunnel or the UDP binding site. The butadiynyl derivative ACHN-975 (28) is the first LpxC inhibitor entering clinical trials.

Read more: http://www.eurekaselect.com/node/141238/article