- [MODERN VIEWS ON THE PHARMACOGENETICS OF PAIN.] [Journal Article]
- ARAnesteziol Reanimatol 2017; 61:219-223
- Quality anesthesia during surgery and in the postoperative period remains a topical problem of modern anesthesiology. The study of genetic characteristics of a patient is a goal that may be allow us ...
Quality anesthesia during surgery and in the postoperative period remains a topical problem of modern anesthesiology. The study of genetic characteristics of a patient is a goal that may be allow us to develop a personalized approach to solve this problem. The purpose of the review is a synthesis of literature data about the influence of genetic factors on pain perception and its treatment. The review included information obtained from SCOPUS, MedLine, EMBASE. The search keywords were: pain, pharmacogenetics, polymorphism, analgesics.Describe the effect ofgene polymorphisms of OPRM, 5HTRIA, 5HTR2A, COMT GCHI, SCN9A, KCNSI, CACNA2D3, CACNG2, PTGSI, PTGS2, MDRJ/ABCB] on the perception of pain, and CYP2D6, CYP2C9, CYP3A4 on the pharmacokinetics and pharmacodynamics of medi- cations used in the treatment of pain.
- BIS monitoring versus clinical assessment for sedation in mechanically ventilated adults in the intensive care unit and its impact on clinical outcomes and resource utilization. [Review]
- CDCochrane Database Syst Rev 2018 Feb 21; 2:CD011240
- CONCLUSIONS: We found insufficient evidence about the effects of BIS monitoring for sedation in critically ill mechanically ventilated adults on clinical outcomes or resource utilization. The findings are uncertain due to the low- and very low-quality evidence derived from a limited number of studies.
- Transient Receptor Potential (TRP) Channels. [Journal Article]
- SBSubcell Biochem 2018; 87:141-165
- Transient Receptor Potential (TRP) channels are evolutionarily conserved integral membrane proteins. The mammalian TRP superfamily of ion channels consists of 28 cation permeable channels that are gr...
Transient Receptor Potential (TRP) channels are evolutionarily conserved integral membrane proteins. The mammalian TRP superfamily of ion channels consists of 28 cation permeable channels that are grouped into six subfamilies based on sequence homology (Fig. 6.1). The canonical TRP (TRPC) subfamily is known for containing the founding member of mammalian TRP channels. The vanilloid TRP (TRPV) subfamily has been extensively studied due to the heat sensitivity of its founding member. The melastatin-related TRP (TRPM) subfamily includes some of the few known bi-functional ion channels, which contain functional enzymatic domains. The ankyrin TRP (TRPA) subfamily consists of a single chemo-nociceptor that has been proposed to be a target for analgesics. The mucolipin TRP (TRPML) subfamily channels are found primarily in intracellular compartments and were discovered based on their critical role in type IV mucolipidosis (ML-IV). The polycystic TRP (TRPP) subfamily is a diverse group of proteins implicated in autosomal dominant polycystic kidney disease (ADPKD). Overall, this superfamily of channels is involved in a vast array of physiological and pathophysiological processes making the study of these channels imperative to our understanding of subcellular biochemistry.
- The concomitant use of lapatinib and paracetamol - the risk of interaction. [Journal Article]
- INInvest New Drugs 2018 Feb 20
- Lapatinib is a tyrosine kinase inhibitor used for the treatment of breast cancer. Paracetamol is an analgesic commonly applied to patients with mild or moderate pain and fever. Cancer patients are po...
Lapatinib is a tyrosine kinase inhibitor used for the treatment of breast cancer. Paracetamol is an analgesic commonly applied to patients with mild or moderate pain and fever. Cancer patients are polymedicated, which involves high risk of drug interactions during therapy. The aim of the study was to assess the interaction between lapatinib and paracetamol in rats. The rats were divided into three groups of eight animals in each. One group received lapatinib + paracetamol (IL + PA), another group received lapatinib (IIL), whereas the last group received paracetamol (IIIPA). A single dose of lapatinib (100 mg/kg b.w.) and paracetamol (100 mg/kg b.w.) was administered orally. Plasma concentrations of lapatinib, paracetamol and its metabolites - glucuronide and sulphate, were measured with the validated HPLC-MS/MS method and HPLC-UV method, respectively. The pharmacokinetic parameters of both drugs were calculated using non-compartmental methods. The co-administration of lapatinib and paracetamol increased the area under the plasma concentration-time curve (AUC) and the maximum concentration (Cmax) of lapatinib by 239.6% (p = 0.0030) and 184% (p = 0.0011), respectively. Lapatinib decreased the paracetamol AUC0-∞by 48.8% and Cmaxby 55.7%. In the IL + PAgroup the Cmaxof paracetamol glucuronide was reduced, whereas the Cmaxof paracetamol sulphate was higher than in the IIIPAgroup. Paracetamol significantly affected the enhanced plasma exposure of lapatinib. Additionally, lapatinib reduced the concentrations of paracetamol. The co-administration of lapatinib decreased the paracetamol glucuronidation but increased the sulphation. The findings of this study may be of clinical relevance to patients requiring analgesic therapy.
- An Enhanced Recovery after Surgery Pathway for Microvascular Breast Reconstruction Is Safe and Effective. [Journal Article]
- PRPlast Reconstr Surg Glob Open 2018; 6(1):e1634
- CONCLUSIONS: A clinical care pathway in microsurgical breast reconstruction using the ERAS Society guideline promotes successful early recovery.
- [Is celecoxib a safe alternative for the Fernand Widal syndrome?] [Review]
- RMRev Mal Respir 2018 Feb 17
- The Fernand Widal syndrome is a set of associations between asthma, nasal polyposis and aspirin sensitivity. Selective cyclo-oxygenase 2 (COX 2) inhibitors are recognized as being a therapeutic alter...
The Fernand Widal syndrome is a set of associations between asthma, nasal polyposis and aspirin sensitivity. Selective cyclo-oxygenase 2 (COX 2) inhibitors are recognized as being a therapeutic alternative in cases needing analgesic or anti-inflammatory treatment. In a retrospective study, we have compiled data concerning oral provocation tests (OPT) undertaken with celecoxib, one of most the selective COX 2 inhibitors, in eight patients with the Fernand Widal syndrome. They were compared with twenty-seven control patients with sensitivity to aspirin or non-steroidal anti-inflammatories, manifesting as asthma, urticaria or rhino-conjunctivitis. Four patients with the Fernand Widal syndrome developed bronchospasm after taking the usually recommended daily dose of celecoxib while all the control patients tolerated it. The Fernand Widal patients who reacted during the OPT had a lower threshold of reactivity to aspirin, a more severe reaction with aspirin, and/or more severe asthma. In patients with the Fernand Widal syndrome, celecoxib is not always a possible alternative to non-steroidal anti-inflammatory drugs. Its introduction must be carried out in a hospital environment under medical supervision.
- Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis. [Review]
- CCancers (Basel) 2018 Feb 15; 10(2)
- The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, th...
The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described. In this transgastric anterior approach, a neurolytic agent is injected around the celiac trunk under EUS guidance. The procedure gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. We focus on two relatively new techniques of EUS-guided neurolysis: EUS-guided celiac ganglia neurolysis and EUS-guided broad plexus neurolysis, which have been developed to improve efficacy. Although the techniques are safe and effective in general, some serious adverse events including ischemic and infectious complications have been reported as the procedure has gained widespread popularity. We summarize reported clinical outcomes of EUS-guided neurolysis in pancreatic cancer (from the PubMed and Embase databases) with a goal of providing information useful in developing strategies for pancreatic cancer-associated pain alleviation.
- How social media meet patients’ questions: YouTube™ review for mouth sores in children. [Journal Article]
- JBJ Biol Regul Homeost Agents 2018 Jan-Feb; 32(2 Suppl. 1):117-121
- Recurrent aphthous stomatitis (RAS) is one of the most common causes of mouth sores in children so the management of this condition is a matter of great importance. YouTube™ is increasingly being use...
Recurrent aphthous stomatitis (RAS) is one of the most common causes of mouth sores in children so the management of this condition is a matter of great importance. YouTube™ is increasingly being used by patients to obtain health-related information. The aim of this work is to examine the quality of information offered by YouTube™ about mouth sores in children (MSC). Searching the term 쎦mouth sores in children’, (MSC) displayed 12.300 results. Of the top 60 videos analyzed, 31 were excluded following exclusion criteria. The major source of upload was from healthcare information channels (HC-41,38%), followed by individual users (HP-25.59%), healthcare professionals (IU-17.24%) and generalist information channels (HC-13.78%); 20.69% of them deal with predisposing factors, and related pathologies, the majority of these propose home remedies (60.72%) rather than topical analgesic drugs (21.43%), antimicrobials (7.14%) and topical steroids (3.57). Most of the videos analyzed were slightly useful (68.97%). Information about mouth sores in children on YouTube™ was poor regardless of the upload source. Analyzing health content on social platforms is a starting point for providing greater quality of health-related information.
- Kidney function and use of nonsteroidal anti-inflammatory drugs among elderly people: a cross-sectional study on potential hazards for an at risk population. [Journal Article]
- IJInt J Clin Pharm 2018 Feb 19
- Background Renal elimination normally decreases with age. Nonsteroidal antiinflammatory drugs (NSAIDs) carry a risk of additional kidney damage. Objective The aims of this study were to assess the pr...
Background Renal elimination normally decreases with age. Nonsteroidal antiinflammatory drugs (NSAIDs) carry a risk of additional kidney damage. Objective The aims of this study were to assess the prevalence of NSAIDs in the elderly (aged ≥ 65) population in Sweden, explore reasons for any possible differences in the level of use and assess their kidney functions. Setting Data were obtained from the cohort study Good Aging in Skåne, Sweden. Patients aged 65 or more were included. Methods Medication lists were collected as well as variables such as cognition and education levels. Glomerular filtration rate was estimated from creatinine and cystatin C. Descriptive statistics and multiple linear regression analysis were used.
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- Proportional assist ventilation versus pressure support ventilation in weaning ventilation: a pilot randomised controlled trial. [Journal Article]
- CCCrit Care Resusc 2018; 20(1):33-40
- CONCLUSIONS: Both modes of ventilation were comparable in time to liberation from the ventilator.