Sedation and Monitoring for Gastrointestinal Endoscopy.

Sedation and monitoring for gastrointestinal endoscopy.

Filed under: Drug and Alcohol Rehabilitation

World J Gastrointest Endosc. 2013 Feb 16; 5(2): 47-55
Amornyotin S

The safe sedation of patients for diagnostic or therapeutic procedures requires a combination of properly trained physicians and suitable facilities. Additionally, appropriate selection and preparation of patients, suitable sedative technique, application of drugs, adequate monitoring, and proper recovery of patients is essential. The goal of procedural sedation is the safe and effective control of pain and anxiety as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation practices for gastrointestinal endoscopy (GIE) vary widely. The majority of GIE patients are ambulatory cases. Most of this procedure requires a short time. So, short acting, rapid onset drugs with little adverse effects and improved safety profiles are commonly used. The present review focuses on commonly used regimens and monitoring practices in GIE sedation. This article is to discuss the decision making process used to determine appropriate pre-sedation assessment, monitoring, drug selection, dose of sedative agents, sedation endpoint and post-sedation care. It also reviews the current status of sedation and monitoring for GIE procedures in Thailand.
HubMed – drug

 

Hierarchical Structures Based on Functionalized Magnetic Cores and Layered Double-Hydroxide Shells: Concept, Controlled Synthesis, and Applications.

Filed under: Drug and Alcohol Rehabilitation

Chemistry. 2013 Feb 19;
Shao M, Wei M, Evans DG, Duan X

The combination of magnetic particles and layered double hydroxide (LDHs) materials leads to the formation of hierarchical composites that can take full advantages of each component; this is an effective approach for achieving multifunctional materials with intriguing properties. This Concept article summarizes several important strategies for the fabrication of magnetic-core/LDH-shell hierarchical nanocomposites, including direct coprecipitation, layer-by-layer assembly, and in situ growth methods. The obtained nanocomposites exhibit excellent performance as multifunctional materials for promising applications in targeted drug delivery, efficient separation, and catalysis. The fabrication and application of magnetic-core/LDH-shell nanocomposite materials represent a new direction in the development of LDH-based multifunctional materials, which will contribute to the progress of chemistry and material science.
HubMed – drug

 

Selective blockade of matrix metalloprotease-14 with a monoclonal antibody abrogates invasion, angiogenesis and tumor growth in ovarian cancer.

Filed under: Drug and Alcohol Rehabilitation

Cancer Res. 2013 Feb 19;
Kaimal R, Aljumaily R, Tressel SL, Pradhan RV, Covic L, Kuliopulos A, Zarwan C, Kim YB, Sharifi S, Agarwal A

Most ovarian cancer patients are diagnosed late in progression and often experience tumor recurrence and relapses due to drug resistance. Surface expression of matrix metalloprotease MMP-14 on ovarian cancer cells stimulates a tumor-stromal signaling pathway that promotes angiogenesis and tumor growth. In a cohort of 92 patients, we found that MMP-14 was increased in the serum of women with malignant ovarian tumors. Therefore, we investigated the preclinical efficacy of a MMP-14 monoclonal antibody that could inhibit the migratory and invasive properties of aggressive ovarian cancer cells in vitro. MMP-14 antibody disrupted ovarian tumor-stromal communication and was equivalent to Avastin in suppressing blood vessel growth in mice harboring matrigel plugs. These effects on angiogenesis correlated with down regulation of several important angiogenic factors. Further, mice with ovarian cancer tumors treated with anti-MMP-14 monotherapy showed a marked and sustained regression in tumor growth with decreased angiogenesis compared to IgG treated controls. In a model of advanced peritoneal ovarian cancer, MMP-14-dependent invasion and metastasis was effectively inhibited by intraperitoneal administration of monoclonal MMP-14 antibody. Together, these studies provide a preclinical proof-of-concept for MMP-14 targeting as an adjuvant treatment strategy for advanced ovarian cancer.
HubMed – drug

 

Challenges and key considerations of the enhanced permeability and retention effect (EPR) for nanomedicine drug delivery in oncology.

Filed under: Drug and Alcohol Rehabilitation

Cancer Res. 2013 Feb 19;
Prabhakar U, Blakey DC, Maeda H, Jain RK, Sevick-Muraca EM, Zamboni W, Farokhzad OC, Barry ST, Gabizon A, Grodzinski P

Enhanced permeability of the tumor vasculature allows macromolecules to enter the tumor interstitial space, while the suppressed lymphatic filtration allows them to stay there. This phenomenon – EPR has been the basis of nanotechnology platforms to deliver drugs to tumors. However, progress in developing effective drugs using this approach has been hampered by heterogeneity of EPR effect in different tumors and limited experimental data from patients on effectiveness of this mechanism as related to enhanced drug accumulation. This report summarizes the workshop discussions on key issues of the EPR effect and major gaps that need to be addressed to effectively advance nanoparticle-based drug delivery.
HubMed – drug

 


 

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