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Management of thrombotic and cardiovascular disorders in the new millenium.

Anticoagulants and antithrombotic drugs have played a key role in the prophylaxis, treatment and surgica/interventional management of thrombotic and cardiovascular disorders. There are several newer drugs which are currently developed for the anticoagulant management of cardiovascular diseases in both the medical and surgical indications. These include the low molecular weight heparins (LMWHs), antithrombin agents such as the Hirudin, Hirulog and Argatroban and indirect and direct anti-Xa drugs, represented by Pentasaccharide (Arixtra) and DX 9065a, respectively. Several other agents such as t

Expedited drug review process: Fast, but flawed.

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From Selection to Use: Aptamers as Targeting Reagents in Hematology.

Aptamers are synthetic nucleic acid ligands that have been proposed as alternatives to antibodies for targeting molecules and cells. In hematology, most reviews have organized aptamer literature around diseases or technological platforms. This framing has obscured how unevenly different blood cell types have been covered. In this review, we present developed aptamers organized by blood cell lineages. Specifically, we examine aptamers for B cells, T cells, natural killer cells, and red blood cells. This organization revealed a strong concentration on a small set of canonical surface markers and

Who funds science and its publication? Does it matter?

In recent times, there have been seismic disclosures or revelations that renowned institutions and individuals with hitherto impeccable repu … stics, missiles, chemical warfare, biological warfare, cyber warfare, as well as the development of antidotes to potential poisons. Such research is never published, is necessarily (?) classified, and yet may harm or save lives. Defence departments are typically funded by governments with taxpayers' money, although non-state actors also exist in this sector …

Nitazenes: review of comparative pharmacology and antagonist action.

INTRODUCTION: Nitazenes are a class of potent synthetic opioids that have emerged in illicit drug markets and have been identified in combination with other opioids in cases of poisoning and fatalities. Originally developed in the 1950s, these compounds were abandoned due to their high toxicity and unfavourable therapeutic index. Recent reports indicate that nitazenes exhibit a wide range of potencies, with some exceeding that of fentanyl. Understanding the pharmacological and toxicological profiles of nitazenes is critical for public health and clinical management. This review synthesizes lit

2021 ACMT Annual Scientific Meeting Abstracts-Virtual.

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Selective neuronal vulnerability following mild focal brain ischemia in the mouse.

The evolution of cellular damage over time and the selective vulnerability of different neuronal subtypes was characterized in the striatum following 30-minute middle cerebral artery occlusion and reperfusion in the mouse. Using autoradiography we found an increase in the density of [3H]PK11195 binding sites--likely reflecting microglial activation--in the lesion border at 3 days and in the whole striatum from 10 days to 6 weeks. This was accompanied by a distinct loss of [3H]flumazenil and [3H]CGP39653 binding sites from 10 days up to 6 weeks reflecting neuronal loss. Brain ischemia resulted

Intravenous Lipid Emulsion Attenuates Hepatic, Renal, Cerebral and Testicular Histopathological Injury but Not Renal Dysfunction or Cardiac Histological Change in an Acute Haloperidol Overdose Model in Rats: Implications for Veterinary Toxicology.

Background: Butyrophenone neuroleptics are used in veterinary practice-haloperidol in the capture and translocation of wild ungulates, azaperone in swine-and antipsychotics prescribed to owners are a recognised cause of accidental toxicosis in dogs and cats. Organ-level toxicity data for this drug class are nonetheless almost absent in any species. Intravenous lipid emulsion (ILE) is an established antidote in small-animal emergency medicine for lipophilic intoxications, but the veterinary evidence base consists of case reports with clinical endpoints, and no controlled study has examined what

Токсичность тяжелых металлов в клиническом и экологическом здравоохранении: источники, механизмы, диагностика и научно обоснованное управление ртутью, свинцом, кадмием и арсеником.

Тяжелые металлы, включая ртуть (Hg), свинец (Pb), кадмий (Cd) и мышьяк (As), по-прежнему остаются значительными глобальными токсинами в силу их экологической стойкости, широкомасштабного антропогенного высвобождения и серьезного биологического воздействия. Этот обзор укрепляет нынешнее понимание их природных и промышленных источников, круговорота окружающей среды, маршрутов воздействия на человека и факторов уязвимости на уровне населения. Она охватывает их токсикокинетику и токсикодинамику, делая акцент на специфических для каждого вида механизмах поглощения, распределения и травмирования, вк

Emergency Care

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A clinician guide to patients afraid of dental injections and numbness.

Fears of dental injections remain a clinical problem often requiring cognitive behavioural psychology counselling and sedation in order to carry out needed dental treatment. This study, based on a national survey in Australia, compared patient concerns about numbness caused by local anaesthesia and fears of the injection itself. It also examined associations between dental fearfulness and avoidance associated with patient self-reported negative experiences and treatment need. Clinical advice on how to approach such patients is offered. Relatively high levels of dental anxiety and fear have bee

Essential Medicinal Chemistry of Essential Medicines.

Since 1977, the World Health Organization publishes a list of essential medicines, i.e., those that satisfy the priority health care needs of the population and are selected with regard to disease prevalence and public health relevance, evidence of clinical efficacy, and safety, as well as comparative costs and cost-effectiveness. The Essential Medicines List (EML) is an invaluable tool for all countries to select those medicines that have an excellent risk/benefit ratio and that are reputed to be of pivotal importance to health. In the present perspective, we describe the chemical composition

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… The most represented entities in the protein group are vaccines ( n = 24), recombinant proteins ( n = 14), monoclonal antibodies ( n = 5), immunoglobulin antidotes ( n = 5), and carbohydrates ( n = 2; enoxaparin and heparin sodium). … and other substances used in poisonings sodium nitrite potassium iodide | antifungal medicines; thyroid hormones and antithyroid medicines potassium permanganate | dermatological medicines selenium sulfide sodium thiosulfate | dermatological medicines; antidotes and other substances used in poisonings …

Pharmacovigilance in oncology.

Background Side effects of cancer therapy are one of the most important issues faced by cancer patients during their illness. Pharmacovigilance, namely the science and activities aimed at monitoring the safety of drugs, is particularly important in oncology, due to the intrinsic biologic toxicity of antineoplastic agents, their narrow therapeutic windows, and the high doses and rigid timing of treatment regimens. Aim of the review To identify the main issues in carrying out an effective pharmacovigilance activity in oncology. Method We searched PubMed for articles about pharmacovigilance in re

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… administered in intravenous infusions through CVCs Monitor patients for CVC-related infections; control regular venous flux and functioning of infusion disposables; train health care personnel Suspension of intravenous infusions; early surgical procedures to manage extravasation; surgical removal of CVCs; antidotes … administered in intravenous infusions through CVCs | Monitor patients for CVC-related infections; control regular venous flux and functioning of infusion disposables; train health care personnel | Suspension of intravenous infusions; early surgical procedures to manage extravasation; surgical removal of CVCs; antidotes …

Pancytopenia and Methemoglobinemia in a Patient With Multiple Myeloma Presenting With Syncope and Dyspnoea: A Diagnostic Challenge.

Methemoglobinaemia is a rare but important cause of hypoxia that may be overlooked, particularly in patients with complex comorbidities. We present a 76-year-old man with Multiple Myeloma undergoing chemotherapy who presented with recurrent syncope and exertional dyspnoea. Initial investigations revealed pancytopenia and hypoxia. Imaging excluded pulmonary embolism and infection. Arterial blood gas analysis demonstrated elevated methemoglobin levels (10.5%), confirming methemoglobinaemia. The patient was managed with supportive therapy, including oxygen, blood transfusion, and filgrastim, resu

Medicine manipulation: An alternative to mitigate therapeutic gaps in the Brazilian Unified Health System?

Despite the various initiatives carried out in Brazil and in the world, the challenge of offering essential medicines in adequate presentations remains, especially to the public affected by diseases considered neglected and the pediatric population, for whom the therapeutic options remain limited. The main objective of this study was to evaluate the production of manipulated medicines as a strategy to mitigate therapeutic and access gaps to essential medicines within the Brazilian public health system, called the Unified Health System (SUS). The evaluation, carried out between 2020 and 2021, i

Increasing use of sodium nitrite in suicides-an emerging trend.

Sodium nitrite (NaNO2) is a compound with broad practical applications in food preservation, automotive maintenance, and animal control. Sodium nitrite is also potentially fatal when ingested, as it interferes with the ability of red blood cells to transport oxygen. While incidents of accidental consumption have been reported in the literature, case reports of sodium nitrite being used as a pharmacological suicide agent are becoming more frequent. Therefore, a study was undertaken to evaluate trends in sodium nitrite deaths in South Australia between 2000 and 2019. All cases of fatal sodium ni

Critical analysis of the prescription and evaluation of monoclonal antibodies approved in Germany for the outpatient setting from 2010-2021.

Monoclonal antibodies (mAbs) are increasingly being launched on the German market and account for a growing share of total drug costs every year. In 2021 alone, eleven monoclonal antibodies were among the 30 best-selling drugs, accounting for 9.91% of total drug costs. In contrast, a considerable additional benefit of the newly introduced monoclonal antibodies is not predominantly demonstrable. Therefore, our objective was to analyze the drug prescriptions and associated costs in comparison to the benefit assessment of the Federal Joint Committee (GBA). This paper analyzes 62 monoclonal antibo

Aptamers: Potential Diagnostic and Therapeutic Agents for Blood Diseases.

Aptamers are RNA/DNA oligonucleotide molecules that specifically bind to a targeted complementary molecule. As potential recognition elements with promising diagnostic and therapeutic applications, aptamers, such as monoclonal antibodies, could provide many treatment and diagnostic options for blood diseases. Aptamers present several superior features over antibodies, including a simple in vitro selection and production, ease of modification and conjugation, high stability, and low immunogenicity. Emerging as promising alternatives to antibodies, aptamers could overcome the present limitations

Best of JACC: Case Reports From ACC.23.

This dedicated issue of JACC: Case Reports highlights the top ranked Complex Clinical Cases from the ACC 2023 Scientific Sessions. These cases were reviewed and selected by a committee of peers in the months leading up to the annual meeting. These reviewers were ACC members with no affiliation to the JACC: Case Reports Editorial Board. While the cases were presented at the meeting and included in the formal Abstract Book from ACC, they have not been published elsewhere. These cases illustrate how the ACC can be a place for cardiovascular professionals to come together to learn, grow, and share

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… Intoxication is known to be resistant to standard treatments with no effective antidotes. Case A 20-year-old female with a history of major depressive disorder presented to our emergency department unresponsive in pulseless ventricular tachycardia (VT) (figure 1A). … Interventional and Structural ANTIBODIES AGAINST THE ANTIDOTE: MANAGEMENT OF AN ACUTE STEMI IN A PATIENT WITH HEPARIN-INDUCED THROMBOCYTOPENIA (HIT) Krina Patel, Akshee Batra, Tyler Wark, Joshua D. Zimmer, Carrie Mahurin, Magdalena A. …

The therapeutic potential of bedside art observation in hematologic cancer inpatients: a randomized controlled pilot study.

PurposePrior research has suggested that art-based interventions may reduce anxiety in cancer patients and enhance dialogue in the healthcare setting. Through implementing Art at the Bedside, an art-based hospital visitation program, we sought to examine whether dedicated art observation sessions, and varying formats (with and without guided discussion), could have therapeutic effects on cancer patients' mental wellbeing.MethodsThis randomized controlled pilot study evaluated the effects of bedside art observation on anxiety in a sample of 73 hematologic cancer inpatients. We compared state an