Current pharmaceutical design
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Review
Cancer Therapeutics-Related Cardiovascular Complications. Mechanisms, Diagnosis and Treatment.
Chemotherapy regimens have improved prognosis and mortality of patients with malignant diseases. The development of therapies, however, has widened the cardiotoxic spectrum and the cardiacrelated effects of antineoplastic drugs. ⋯ Since the number of long-term survivors following the diagnosis and treatment of malignant disease will continue to increase, cardio-oncology will continue to evolve. Therefore, a better understanding of potential cardiovascular effects of chemotherapeutic regiments and the earlier identification and treatment of high-risk patients would be the focus of research in the future.
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This systematic review and meta-analysis of Randomized Controlled Trials (RCTs) were conducted to determine the effects of coenzyme Q10 (CoQ10) supplementation on metabolic profiles of patients diagnosed with Chronic Kidney Disease (CKD). ⋯ Overall, the current meta-analysis demonstrated that CoQ10 supplementation significantly improved metabolic profile in patients with CKD by reducing total cholesterol, LDL-cholesterol, MDA and creatinine levels, yet it did not affect fasting glucose, insulin, HOMA-IR, and CRP concentrations.
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Review Historical Article
Isolating Colchicine in 19th Century: An Old Drug Revisited.
Colchicine is a tricyclic alkaloid extracted from the herbaceous plant Colchicum autumnale. Known since antiquity for its therapeutic efficacy in the treatment of gout, colchicine was reintroduced in 19th century pharmacopeia, thanks to the work of the French chemists and pharmacists Pierre-Joseph Pelletier (1788-1842) and Joseph Bienaimé Caventou (1795-1877) who in 1819, isolated a peculiar substance in the roots of Colchicum autumnale. ⋯ In the last two centuries, colchicine's indications were furthermore expanded. From anti-gout drug during antiquity and a diuretic in 19th century, colchicine is currently administered in several affections such as Adamantiades-Behcet's disease, familial Mediterranean fever, pericarditis and atrial fibrillation.
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Despite the proven efficacy of anti-thrombotic, lipid-lowering, anti-hypertensive therapies and lifestyle modification changes for secondary ischemic stroke prevention, the risk of recurrent stroke, coronary events and vascular death remains substantial even for patients treated with high rates of established secondary preventive medications. ⋯ Inflammatory pathways seem to be key mediators in the development of atherosclerotic process, atheromatous plaque destabilization and thromboembolism. Colchicine as a novel therapeutic agent could be a safe and effective inhibitor of the inflammation cascade in patients with extra- or intracranial atherosclerosis or arteriolosclerosis, resulting in reduced vascular events.
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Approximately 10-15% of patients on DOACs have to interrupt their anticoagulant before an invasive procedure every year. The perioperative management and monitoring of DOACs have proved to be challenging, as differences in patients' status and in the invasiveness of each procedure develop different situations that need a tailored therapeutic approach to each patient's needs. ⋯ Further perioperative research studies on patients undergoing vascular surgery are needed to confirm whether currently accepted therapeutic perioperative strategy is appropriate for these patients.