Current drug targets
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Current drug targets · Aug 2009
ReviewClinical uses of low-dose ketamine in patients undergoing surgery.
Ketamine acts mainly as a N-methyl-D-aspartate receptor (NMDAr) antagonist. Originally developed as a general anesthetic, it is now seldom employed as such in richer countries due to the relatively high risk of psychotomimetic adverse effects. Recently, low-dose regimens in the range of 0.25-0.5 mg/kg as an initial bolus followed by 50-500 kappag/kg/h have been proposed as an adjuvant for postoperative analgesia and for the reduction of exogenous opioid-induced hyperalgesia. In this review, we examine the evidence for clinical usefulness of perioperative ketamine infusion and its role in the context of general and/or regional anesthesia.
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With the changes in health care dictated by economic pressure, there has been a realization that hospital stay could be shortened without compromising quality of care. Advances in surgical technology and anesthetic drugs have made an impact in the way perioperative care is delivered with some emphasis on multidisciplinary approach. From the expansion of ambulatory care, lessons were learnt how to apply same concepts to major surgery with the understanding that interventions to attenuate the surgical stress would facilitate the return to "baseline". ⋯ The anesthesiologist is part of this team with the specific mission to use medications and techniques which have the least side effects on organ functions, provide analgesia which in turn facilitates the intake of food and mobilization out of bed. This chapter has been conceived with the intention to direct the clinician towards procedure-specific protocols where the choice of medications and techniques is based on published evidence. The success of implementing fast-track depends more on dynamic harmony amongst the various participants (surgeons, anesthesiologists, nurses, nutrtionists, physiotherapists) than on reaching an optimum level of excellence at each separate organization level.
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Current drug targets · Jan 2018
Systemic Delivery of Free Chitosan Accelerates Femur Fracture Healing in Rats.
Chitosan-containing compounds have been shown to be suitable for bone replacement, but few studies demonstrate the impact of the chitosan as a free drug on the fracture.In this study, we aimed to evaluate possible effects of free chitosan on fracture healing. ⋯ Systemic delivery of free chitosan can accelerate the bone healing process in rat femur fracture at the early-middle stage.
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To outline recent findings concerning the efficacy of immunonutrients in patients undergoing surgery. ⋯ Immunonutrition is effective in improving outcome in a wide range of patients, particularly in malnourished individuals. However, further research using larger, better-designed trials is needed to assess whether immune function is benefited, with an improved clinical outcome in vulnerable patients.
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Cystic Fibrosis (CF) is a serious genetic condition caused by CF transmembrane conductance regulator (CFTR) mutation. CF patients have shortened lifespan due to airway obstruction, infection, and end-stage lung failure. ⋯ Gene therapy introduces correct CFTR gene into the affected airway epithelium leading to the functional expression of CFTR in CF patients. This review will sum up the current status in CF-cause targeting therapy.