Dexamethasone-Chemical Structure and Mechanisms of Action in Prophylaxis of Postoperative Side Effects

Dexamethasone is a synthetic glucocorticoid used for its anti-inflammatory and analgesic effect. In addition to these therapeutic indications, it is also recommended for nausea and vomiting treatment which may occur during the postoperative period, with impact on postoperative evolution, regarding the evolution of wound healing and length of stay (LOS), with a reflection on the costs of hospital admission. Therefore, their prevention is very important for both patients� comfort and a good recovery.

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THE EFFECT OF 10 % LIDOCAINE SPRAYED TO NASAL PACKS ON PAIN AFTER ELECTIVE SEPTOPLASTY.

Indian Journal of Medical Research and Pharmaceutical Sciences - September-2020 ◽

10.29121/ijmrps.v7.i8.2020.3 ◽

2020 ◽

Vol 7 (8) ◽

pp. 14-17

Keyword(s):

Side Effects ◽

Postoperative Period ◽

Analgesic Effect ◽

Nasal Packing ◽

Control Group ◽

Analog Scale ◽

Analgesic Requirement ◽

Significant Difference ◽

Male Patients ◽

Rescue Drug

Aim To study analgesic effect of lidocaine10 % sprayed to 10 cm х 10 cm gauze swabs with neomycin and bacitracin ointment nasal packing using visual analog scale (VAS) in postoperative period for patients underwent septoplasty operation. Materials and methods 100 patients aged between 17 and 50 years and divided into two equal groups. Group L lidocaine 10% was sprayed to gauze swabs with neomycin and bacitracin ointment nasal packing and group S control group 0.9% NaCl applied to same nasal packing. Postoperatively, VAS scale, side effects and analgesic requirements were recorded. Results There were no differences between the number of female and male patients. Postoperative pain was less in group L than group S, there was a statistically significant difference between L group and S group (p <0.05). The patient in the S group needs more rescue drug. L group had significantly better pain score versus S group at all intervals (2, 6, 12, 18, and 24) postoperative period. Conclusion Lidocaine 10% sprayed to 10 cm х 10 cm gauze swabs with neomycin and bacitracin ointment nasal pack provide better analgesic effect and reduced needs to analgesic requirement after septoplasty surgery.

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The diabetic wound healing effect of a two-herb formula and its mechanisms of action

Planta Medica ◽

10.1055/s-0032-1320306 ◽

2012 ◽

Vol 78 (11) ◽

Author(s):

CBS Lau ◽

VKM Lau ◽

CL Liu ◽

PKK Lai ◽

JCW Tam ◽

...

Keyword(s):

Wound Healing ◽

Mechanisms Of Action ◽

Diabetic Wound ◽

Healing Effect ◽

Diabetic Wound Healing ◽

Wound Healing Effect

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Progress on the Mechanism for Aspirin’s Anti-tumor Effects

Current Drug Targets ◽

10.2174/1389450121999201013152931 ◽

2020 ◽

Vol 22 (1) ◽

pp. 105-111

Author(s):

Lin Zheng ◽

Weibiao Lv ◽

Yuanqing Zhou ◽

Xu Lin ◽

Jie Yao

Keyword(s):

Platelet Aggregation ◽

Energy Metabolism ◽

Side Effects ◽

Energy Production ◽

Immune Escape ◽

Inflammatory Responses ◽

Mechanisms Of Action ◽

Proliferation And Metastasis ◽

Review Current ◽

Granule Release

: Since its discovery more than 100 years ago, aspirin has been widely used for its antipyretic, analgesic, anti-inflammatory, and anti-rheumatic activities. In addition to these applications, it is increasingly becoming clear that the drug also has great potential in the field of cancer. Here, we briefly review current insights of aspirin’s anti-tumor effects. These are multiple and vary from inhibiting the major cellular mTOR pathways, acting as a calorie-restricted mimetic by inhibition of energy production, suppressing platelet aggregation and granule release, inhibiting immune escape of tumor cells, to decreasing inflammatory responses. We consider these five mechanisms of action the most significant of aspirin’s anti-tumor effects, whereby the anti-tumor effect may ultimately stem from its inhibition of energy metabolism, platelet function, and inflammatory response. As such, aspirin can play an important role to reduce the occurrence, proliferation, and metastasis of various types of tumors. However, most of the collected data are still based on epidemiological investi-gations. More direct and effective evidence is needed, and the side effects of aspirin intake need to be solved before this drug can be widely applied in cancer treatment.

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Differences in PARP Inhibitors for the Treatment of Ovarian Cancer: Mechanisms of Action, Pharmacology, Safety, and Efficacy

International Journal of Molecular Sciences ◽

10.3390/ijms22084203 ◽

2021 ◽

Vol 22 (8) ◽

pp. 4203

Author(s):

Giorgio Valabrega ◽

Giulia Scotto ◽

Valentina Tuninetti ◽

Arianna Pani ◽

Francesco Scaglione

Keyword(s):

Ovarian Cancer ◽

Signal Transduction ◽

Dna Damage ◽

Chemical Structure ◽

Parp Inhibitors ◽

Mechanisms Of Action ◽

Point Of View ◽

Safety And Efficacy ◽

Damage Repair ◽

Pharmacokinetic Properties

Poly(ADP-ribose) polymerases (PARP) are proteins responsible for DNA damage detection and signal transduction. PARP inhibitors (PARPi) are able to interact with the binding site for PARP cofactor (NAD+) and trapping PARP on the DNA. In this way, they inhibit single-strand DNA damage repair. These drugs have been approved in recent years for the treatment of ovarian cancer. Although they share some similarities, from the point of view of the chemical structure and pharmacodynamic, pharmacokinetic properties, these drugs also have some substantial differences. These differences may underlie the different safety profiles and activity of PARPi.

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Hospital length of stay for COVID-19 patients: Data-driven methods for forward planning

BMC Infectious Diseases ◽

10.1186/s12879-021-06371-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bindu Vekaria ◽

Christopher Overton ◽

Arkadiusz Wiśniowski ◽

Shazaad Ahmad ◽

Andrea Aparicio-Castro ◽

...

Keyword(s):

Length Of Stay ◽

Hospital Admission ◽

Failure Time ◽

National Level ◽

Hospital Length ◽

Survival Model ◽

Data Driven ◽

Hospital Length Of Stay ◽

Similar Data ◽

Model Complex

Abstract Background Predicting hospital length of stay (LoS) for patients with COVID-19 infection is essential to ensure that adequate bed capacity can be provided without unnecessarily restricting care for patients with other conditions. Here, we demonstrate the utility of three complementary methods for predicting LoS using UK national- and hospital-level data. Method On a national scale, relevant patients were identified from the COVID-19 Hospitalisation in England Surveillance System (CHESS) reports. An Accelerated Failure Time (AFT) survival model and a truncation corrected method (TC), both with underlying Weibull distributions, were fitted to the data to estimate LoS from hospital admission date to an outcome (death or discharge) and from hospital admission date to Intensive Care Unit (ICU) admission date. In a second approach we fit a multi-state (MS) survival model to data directly from the Manchester University NHS Foundation Trust (MFT). We develop a planning tool that uses LoS estimates from these models to predict bed occupancy. Results All methods produced similar overall estimates of LoS for overall hospital stay, given a patient is not admitted to ICU (8.4, 9.1 and 8.0 days for AFT, TC and MS, respectively). Estimates differ more significantly between the local and national level when considering ICU. National estimates for ICU LoS from AFT and TC were 12.4 and 13.4 days, whereas in local data the MS method produced estimates of 18.9 days. Conclusions Given the complexity and partiality of different data sources and the rapidly evolving nature of the COVID-19 pandemic, it is most appropriate to use multiple analysis methods on multiple datasets. The AFT method accounts for censored cases, but does not allow for simultaneous consideration of different outcomes. The TC method does not include censored cases, instead correcting for truncation in the data, but does consider these different outcomes. The MS method can model complex pathways to different outcomes whilst accounting for censoring, but cannot handle non-random case missingness. Overall, we conclude that data-driven modelling approaches of LoS using these methods is useful in epidemic planning and management, and should be considered for widespread adoption throughout healthcare systems internationally where similar data resources exist.

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Time trends in hospital discharges in patients aged 85 years and older in Spain: data from the Spanish National Discharge Database (2000–2015)

BMC Geriatrics ◽

10.1186/s12877-021-02335-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sergio Palacios-Fernandez ◽

Mario Salcedo ◽

Gregorio Gonzalez-Alcaide ◽

Jose-Manuel Ramos-Rincon

Keyword(s):

Length Of Stay ◽

Hospital Admission ◽

Age Groups ◽

Percentage Increase ◽

Very Elderly ◽

Hospital Discharges ◽

Data Set ◽

Common Causes ◽

Discharged Patients ◽

Hospital Systems

Abstract Background The aging population is an increasing concern in Western hospital systems. The aim of this study was to describe the main characteristics and hospitalization patterns in inpatients aged 85 years or more in Spain from 2000 to 2015. Methods Retrospective observational study analyzing data from the minimum basic data set, an administrative registry recording each hospital discharge in Spain since 1997. We collected administrative, economic and clinical data for all discharges between 2000 and 2015 in patients aged 85 years and older, reporting results in three age groups and four time periods to assess differences and compare trends. Results There were 4,387,326 discharges in very elderly patients in Spain from 2000 to 2015, representing 5.32% of total discharges in 2000–2003 and 10.42% in 2012–2015. The pace of growth was faster in older age groups, with an annual percentage increase of 6% in patients aged 85–89 years, 7.79% in those aged 90–94 years, and 8.06% in those aged 95 and older. The proportion of men also rose (37.30 to 39.70%, p < 0.001). The proportion of patients that died during hospital admission decreased from 14.64% in 2000–2003 to 13.83% in 2012–2015 (p < 0.001), and mean length of stay from 9.98 days in 2000–2003 to 8.34 days in 2012–2015. Some of the most frequent primary diagnoses became even more frequent relative to the total number of primary diagnoses, such as heart failure (7.84 to 10.62%), pneumonia (6.36 to 7.36%), other respiratory diseases (3.87 to 8.49%) or other alterations of urinary tract (3.08 to 5.20%). However, there was a relative decrease in the proportion of femoral neck fractures (8.07 to 6.77%), neoplasms (7.65 to 7.34%), ischemic encephalopathy (6.97 to 5.85%), COPD (4.23 to 3.15%), ischemic cardiomyopathy (4.20 to 8.49%) and cholelithiasis (3.07 to 3.28%). Conclusions Discharges in the very elderly population are increasing in both relative and absolute terms in Spanish hospitals. Within this group, discharged patients are getting older and more frequently male. The mean length of stay and the proportion of patients that died during hospital admission are decreasing. Acute-on-chronic organ diseases, neoplasms, acute cardiovascular diseases, and infections are the most common causes of discharge.

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Can dedicated emergency team and area for older people reduce the hospital admission rate? - An observational pre- and post-intervention study

BMC Geriatrics ◽

10.1186/s12877-021-02044-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jenny Liu ◽

Therese Palmgren ◽

Sari Ponzer ◽

Italo Masiello ◽

Nasim Farrokhnia

Keyword(s):

Length Of Stay ◽

Hospital Admission ◽

Older Patients ◽

Outcome Measure ◽

Admission Rate ◽

Intervention Period ◽

Total Hospital ◽

Hospital Admission Rate ◽

Emergency Team ◽

Interprofessional Team

Abstract Background Emergency department (ED) care of older patients is often complex. Geriatric ED guidelines can help to meet this challenge. However, training requirements, the use of time-consuming tools for comprehensive geriatric assessment (CGA), a lack of golden standard to identify the frail patients, and the weak evidence of positive outcomes of using CGA in EDs pose barriers to introduce the guidelines. Dedicating an interprofessional team of regular ED medical and nursing staff and an older-friendly ED area can be another approach. Previous studies of geriatrician-led CGA in EDs have reported a reduced hospital admission rate. The aim of this study was to investigate whether a dedicated interprofessional emergency team also can reduce the hospital admission rate without the resources required by the formal use of CGA. Methods An observational pre-post study at a large adult ED, where all patients 80 years or older arriving on weekdays in the intervention period from 2016.09.26 to 2016.11.28 and the corresponding weekdays in the previous year from 2015.09.28 to 2015.11.30 were included. In the intervention period, older patients either received care in the geriatric module by the dedicated team or in the regular team modules for patients of mixed ages. In 2015, all patients received care in regular team modules. The primary outcome measure was the total hospital admission rate and the ED length of stay was the secondary outcome measure. Results We included 2377 arrivals in the intervention period, when 26.7% (N = 634) received care in the geriatric module, and 2207 arrivals in the 2015 period. The total hospital admission rate was 61.7% (N = 1466/2377) in the intervention period compared to 64.8% (N = 1431/2207) in 2015 (p = 0.03). The difference was larger for patients treated in the geriatric module, 51.1% compared to 62.1% (95% CI: 56.3 to 68.0%) for patients who would have been eligible in 2015. The ED length of stay was longer in the intervention period. Conclusions An interprofessional team and area dedicated to older patients was associated to a lower hospital admission rate. Further studies are needed to confirm the results.

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Molecular Changes Underlying Genistein Treatment of Wound Healing: A Review

Current Issues in Molecular Biology ◽

10.3390/cimb43010011 ◽

2021 ◽

Vol 43 (1) ◽

pp. 127-141

Author(s):

Matúš Čoma ◽

Veronika Lachová ◽

Petra Mitrengová ◽

Peter Gál

Keyword(s):

Wound Healing ◽

Side Effects ◽

Biologically Active ◽

Estrogen Receptor Modulators ◽

Age Related ◽

Skin Repair ◽

Genistein Treatment ◽

Anti Cancer ◽

Major Factors ◽

Promising Source

Estrogen deprivation is one of the major factors responsible for many age-related processes including poor wound healing in postmenopausal women. However, the reported side-effects of estrogen replacement therapy (ERT) have precluded broad clinical administration. Therefore, selective estrogen receptor modulators (SERMs) have been developed to overcome the detrimental side effects of ERT on breast and/or uterine tissues. The use of natural products isolated from plants (e.g., soy) may represent a promising source of biologically active compounds (e.g., genistein) as efficient alternatives to conventional treatment. Genistein as natural SERM has the unique ability to selectively act as agonist or antagonist in a tissue-specific manner, i.e., it improves skin repair and simultaneously exerts anti-cancer and chemopreventive properties. Hence, we present here a wound healing phases-based review of the most studied naturally occurring SERM.

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