The main effects and application of glucocorticosteroids in clinical practice. A multidisciplinary approach

Author(s):  
I.D. Kanner ◽  
G.R. Khafizullina ◽  
E.V. Kanner ◽  
M.L. Maksimov

Glucocorticosteroids are hormones produced by the adrenal cortex. The term also refers to semi-synthetic drugs such as prednisolone, dexamethasone and other drugs that are derivatives of hydrocortisone, the most active natural glucocorticosteroid. Cortisone is a biologically inactive compound that is converted to hydrocortisone in the liver. Both natural glucocorticosteroids have mineralocorticoid activity, but weaker than genuine mineralocorticoids.

Author(s):  
Rodrigo Ortega Pérez ◽  
Ana Pardo Sanz ◽  
Valentín García Gutiérrez ◽  
José Luis Zamorano Gómez

AbstractImproved cancer survivorship has led to an increase in cardiovascular (CV) complications in the oncologic population, mainly associated with therapeutic regimens. Hence, cardio-oncology has grown toward unifying the cancer care process in which the best prevention, early detection, treatment, and CV surveillance are offered to patients. This multidisciplinary approach allows us to optimize and agree upon clinical decisions to enhance clinical outcomes. Atrial fibrillation is one of the hot topics in the field because it is still challenging in cancer patients. The optimal antithrombotic therapy remains unclear. Nevertheless, evidence supports that specific recommendations are needed due to a hemorrhagic/thrombotic disbalance present within this subgroup of patients and a low rate of anticoagulation treatments compared with the general population. Further, cardiotoxicity management is currently transforming. Increasingly, early detection of subclinical alterations is raising awareness. When medical therapy is initiated early, fewer patients progress to ventricular dysfunction and the rate of patients completing cancer therapy gradually increases. New approaches are demonstrating better outcomes and these strategies will expectedly be established in clinical practice. Cardio-oncology enables us to find the best balance between cancer treatment and CV health protection. Nowadays, more and more physicians are being instructed in this discipline, which gradually exhibits a greater presence in conferences and scientific journals. However, given the need for physicians thoroughly trained in cardio-oncology, this subspecialty must be promoted further.


2020 ◽  
Vol 19 (4) ◽  
pp. 143-149
Author(s):  
S. S. Saliyeva ◽  
R. Z. Boranbayeva ◽  
B. M. Zhumadullayev ◽  
K. E. Khairov ◽  
E. V. Krivenko ◽  
...  

Teratoma is a germ cell tumor, which consists of derivatives of three germ layers and has various malignant potentials – from benign mature forms to immature embryonic forms with a somatic type of malignancy. Even the mature type of teratoma is biologically unpredictable providing for an ability to grow locally with invasion. Necessity for complete removal of tumors, wherever they are located, is explained by the fact that there is a risk of a possible development of growing teratoma syndrome or transformation into malignant tumors. This article describes the clinical case of growing teratoma syndrome of mediastinal localization in a teenager with Klinefelter syndrome, also as an example of the multidisciplinary approach of pediatric oncologists, surgeons, radiotherapists and pathomorphologists in decision-making for optimal treatment. The patients' parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.


1976 ◽  
Vol 7 (26) ◽  
pp. no-no
Author(s):  
ERWIN WALDVOGEL ◽  
GUSTAV SCHWARB ◽  
JEAN-MICHEL BASTIAN ◽  
JEAN-PIERRE BOURQUIN

Author(s):  
Jeremy Prout ◽  
Tanya Jones ◽  
Daniel Martin

This chapter summarizes endocrine physiology that is of particular relevance to anaesthesia. Disorders of the adrenal cortex and medulla, pituitary and thyroid are described with perioperative management considerations highlighted. Current guidelines in perioperative steroid replacement are included. Diabetes is a particularly common problem encountered in clinical practice. Diabetic complications, pre-assessment and perioperative management aims are included. The surgical stress response is summarized with details of the neuroendocrine changes and their modification with anaesthetic technique. Consequences of perioperative hypothermia and use of therapeutic hypothermia are detailed.


2005 ◽  
Vol 3 (4) ◽  
pp. 492 ◽  

In 2005, an estimated 40,340 new cases of rectal cancer will occur in the U.S., and experts estimate that during the same year, 56,290 people will die of rectal and colon cancer. As with colon cancer, however, mortality from rectal cancer has also decreased over the past 30 years. The NCCN Rectal Cancer Panel believes a multidisciplinary approach is necessary for effectively managing rectal cancer, an approach detailed here. For the most recent version of the guidelines, please visit NCCN.org


RSBO ◽  
2017 ◽  
Vol 13 (4) ◽  
pp. 275
Author(s):  
Orides Ferrari Jr ◽  
Fernando Dalitz ◽  
Marina Samara Baechtold ◽  
Ubiracy Gaião Gaião ◽  
Leonardo Fernandes da Cunha ◽  
...  

Esthetic rehabilitations require a broad and thorough evaluation of all the elements that make up the smile such as lips, dental, and periodontal structures to plan the treatment to provide harmony to the whole set. Objective: To demonstrate through a case the association of Periodontics and Restorative Dentistry in the esthetic rehabilitation of anterior teeth replacing resin restorations by modifying the gingival architecture conservatively and harmonically. Case report: It is essential for a multidisciplinary approach to succeed in treatment. The replacement of previous restorations is an increasing demand in currently clinical practice, for many reasons, mainly due to dissatisfaction with the esthetics. It is observed that many of these patients involve not only dissatisfaction with the dental structure but also with the periodontal health, for this reason, it is necessary a previous adaptation of the gingival tissues for proper restorative rehabilitation. Conclusion: Ceramic laminates have proved to be a great choice for anterior teeth restorations, but they must be indicated in specific situations, to obtain excellent results as most conservative as possible.


Author(s):  
G. Venkateshappa ◽  
G. Shivaraju ◽  
P. Raghavendra Kumar

Amino acids play important roles in organisms to sustain in living state and perform as body constituents, enzymes and antibodies. At insalubrious situations, use of amino acids derivatives as drugs in the maintenance of normal health is better choice than common unnatural synthetic drugs. This is due to the fact that the amino acids derivatives may be more bio-compatible, biodegradable and eliminate easily than others.  In this sense we have made an effort and report herein the synthesis of N-{2-(4-chlorophenyl) acetyl} amino alcohols synthesised by reduction of N-{2-(4-chlorophenyl)acetyl} derivatives of (S)-amino acids such as (S)-phenylalanine, (S)-alanine, (S)-methionine, (S)-leucine, (S)-tryptophan and (S)-proline. These newly synthesized amino acids derivatives were analysed by proton, carbon-13 NMR and FT-IR spectroscopy. The composition of solid derivatives was determined by elemental analysis. Further, antimicrobial activities of these derivatives were assessed on usual bacteria K. aerogenes, E. coli, S. aureus and P. desmolyticum and fungi A. flavus and C. albicans. The compounds were witnessed moderate activity than authorised antibacterial and fungal agents Ciprofloxacin and Fluconazole respectively. The antimicrobial studies also revealed that, these derivatives could be better antifungal agents than antibacterial agents. Finally we compared the experimental results of antimicrobial activities with docking studies.  


2019 ◽  
pp. 28-44
Author(s):  
V. V. Parchenko

Modern medicine and pharmacy has at its disposal highly efficient synthetic drugs. Large extent of these drugs accounted for derivatives of 1,2,4-triazole. The purpose of the work was an attempt to summarize the literature in recent years related to the methods of synthesis and study of physico-chemical properties 3-thio- and 3-thio-4-amino derivatives of 1,2,4-triazole. Studies national scientists in recent years indicates prospects of the search in this direction, since this class of organic compounds is interest not only to scientists pharmaceutical, medical and veterinary field, but also among researchers of engineering, metallurgical and agricultural areas. 1,2,4-triazole derivatives are also widely used in practice for optical materials, photosensitizers are used as coloring agents, antioxidants, additives for fuels and oils, some of which are widely used as corrosion inhibitors for controlling various pests in agriculture. In addition, 1,2,4-triazole derivatives belong to the class low toxic or essentially non-toxic substances. The presence of a growing number of publications about methods of synthesis, reactions, physico-chemical and biological properties of 1,2,4-triazole, inspires scientists around the world search for perspective molecules of substituted 1,2,4-triazole. It should be noted that in spite of a sufficient amount of information about the derivatives of 1,2,4-triazole, some issues related to the generalization of data in the literature synthesis presented insufficient.


Author(s):  
Johnny L. Matson ◽  
Paige E. Cervantes

Intellectual disability (ID) is characterized by significant deficits in intellectual skills and adaptive behavior. ID affects approximately 1% of the population; an individual’s ID can range from mild to profound based on the level of impairment and supports needed. Individuals often present with associated challenging behaviors and medical and psychiatric comorbidities that create a complicated clinical picture. Comprehensive assessment is critical for effective treatment. Intervention for ID is focused on addressing the discrepancies between an individual’s ability and environmental demands by providing supports to improve daily functioning. A multidisciplinary approach is necessary. Evaluation and treatment procedures will likely evolve as etiological understanding of ID improves. Greater research and policy attention to several areas of clinical practice are needed to improve prognosis and quality of life. This chapter details diagnostic criteria, assessment and intervention strategies, gaps in and future directions of research and practice, and implications for clinical practice.


2021 ◽  
Vol 18 ◽  
Author(s):  
Wahid Bux Jatoi ◽  
Ashique Hussain Balouch ◽  
Mazhar Iqbal Khaskheli ◽  
Nafeesa Khatoon Shahani ◽  
Qurat-Ul-Ain Shaikh ◽  
...  

: Piperidine-based alkaloids are undoubtedly an important class of biologically active natural products. When a unique group like trifluoromethyl (Tfm) is added to an active compound, it significantly ameliorates its bioactivity, bioavailability, physical and chemical properties. Many fluorination and trifluoromethylation methods have been reported. In the present paper, we have shown that among all other trifluoromethylation pathways, Mannich reaction also has the great tendency to introduce a Tfm group in a saturated or aromatic heterocyclic compound. Applications of this reaction are elaborated in preparing several derivatives of piperidine base alkaloids with trifluoromethyl at α-position. Furthermore, the substitution at C-4 and C-6 was successfully achieved with variety of saturated and aromatic groups.


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