Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 180
Filter
1.
J Pharmacol Toxicol Methods ; 128: 107540, 2024 Jul 10.
Article in English | MEDLINE | ID: mdl-38996943

ABSTRACT

X-376 is a novel anaplastic lymphoma kinase (ALK) inhibitor that is capable of penetrating the blood brain barrier. This makes it suitable for use in patients with ALK-positive non-small cell lung cancer (NSCLC) who have metastases in the central nervous system. This study developed a highly sensitive, fast, eco-friendly, and reliable UPLC-MS/MS approach to quantify X-376 in human liver microsomes (HLMs). This approach was used to evaluate X-376's metabolic stability in HLMs in vitro. The UPLC-MS/MS analytical technique validation followed US-FDA bio-analytical method validation guidelines. StarDrop software, containing P450 metabolic and DEREK modules, was utilized to scan X-376's chemical structure for metabolic lability and hazardous warnings. X-376 and Encorafenib (ENF as internal standard) were resoluted on the Eclipse Plus C18 column utilizing an isocratic mobile phase method. The X-376 calibration curve was linear from 1 to 3000 ng/mL. The precision and accuracy of this study's UPLC-MS/MS approach were tested for intra- and inter-day measurements. Inter-day accuracy was -1.32% to 9.36% while intra-day accuracy was -1.5% to 10.00%. The intrinsic clearance (Clint) and in vitro half-life (t1/2) of X-376 were 59.77 mL/min/kg and 13.56 min. The high extraction ratio of X-376 supports the 50 mg twice-daily dose for ALK-positive NSCLC and CNS metastases patients. In silico software suggests that simple structural changes to the piperazine ring or group substitution in drug design may improve metabolic stability and safety compared to X-376.

2.
Cureus ; 16(5): e59442, 2024 May.
Article in English | MEDLINE | ID: mdl-38826913

ABSTRACT

BACKGROUND: Digital eye strain (DES) has become a pervasive issue in contemporary society due to increased reliance on electronic devices. This study aims to comprehensively explore the symptoms, severity, and associated factors of DES, considering demographic, behavioral, and health-related variables. METHODOLOGY: A cross-sectional study was conducted among participants with diverse demographic backgrounds. A structured questionnaire collected data on participant characteristics, electronic device usage patterns, symptoms of DES, and its impact on various aspects of quality of life. Statistical analyses, including chi-square tests, were employed to assess associations and significance. RESULTS: The majority of participants reported symptoms of DES, with eye dryness, headache, and eye redness being the most prevalent. Symptom severity varied, with age, daily device usage, adherence to the 20-20-20 rule, and studying with electronic devices demonstrating statistically significant associations. Participants diagnosed with eye diseases exhibited higher symptom severity. While disagreement was common regarding DES increasing stress, a substantial proportion acknowledged its impact on productivity and attention. CONCLUSION: The current study showed that there is a significant correlation between the incidence of digital eye straining and longer screen exposure time. The findings underscore the importance of age, behavior, and ocular health in understanding and addressing DES. The results contribute to the broader discourse on digital eye health and emphasize the need for targeted interventions to alleviate the impact of DES on daily life.

3.
Pharmazie ; 79(6): 101-108, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38877681

ABSTRACT

In this study, we hypothesized that lixisenatide (LIX) and ticagrelor (TIC) could have a protective effect against type 2 diabetes mellitus (T2DM)-induced vascular damage. Furthermore, we explored the possible additional protective effect of co-administering LIX and TIC in the treatment regimen. Methods: 50 male rats were divided into five groups, each comprising 10 rats: C (control), D (T2DM rats), D + LIX (T2DM rats treated with LIX for 4 weeks), D + TIC (T2DM rats treated with TIC for 4 weeks), and D + LIX + TIC (T2DM rats treated with LIX + TIC for 4 weeks). Results: The D group showed an increase in body weight, blood glucose, hemostatic model assessment for insulin resistance (HOMA-IR), aorta reactive oxygen species (ROS), and nuclear factor kappa B (NF-κ B), along with a reduction in serum insulin, aorta superoxide dismutase (SOD), glutathione reduced (GSH), nuclear factor erythroid-2 (NrF2), hemeoxygenase-1 (HO-1), and endothelial nitric oxide synthase (eNOS). Deterioration in the aorta histopathological condition, coupled with a noticeable impairment in vascular reactivity compared to the C group, was observed. A single administration of LIX showed a reduction in body weight, blood glucose, HOMA-IR, aorta ROS, and NF-κ B, accompanied by an increase in serum insulin, aorta SOD, GSH, NrF2, HO-1, and eNOS. Amelioration in the aorta histopathological condition and improved vascular reactivity compared to the D group were reported. Similarly, a single administration of TIC showed a reduction in aorta ROS and NF-κ B, along with an increase in aorta SOD, GSH, NrF2, HO-1, and eNOS. A slight amelioration was detected in the aorta histopathological condition, with improved vascular reactivity compared to the D group. The combined administration of LIX and TIC showed a reduction in aorta ROS and NF-κ B, along with an increase in aorta GSH, SOD, HO-1, and eNOS. This was combined with evident amelioration in the aorta histopathological condition and noticeable improvement in vascular reactivity compared to the single treatment with either LIX or TIC group. Conclusion: The present study introduces clear evidence that the administration of LIX and TIC can improve metabolic and vascular complications of T2DM through modulating eNOS and NrF2 /HO-1 signaling. The combined administration of LIX and TIC produced more significant effects than a single treatment.


Subject(s)
Diabetes Mellitus, Experimental , NF-E2-Related Factor 2 , Nitric Oxide Synthase Type III , Peptides , Reactive Oxygen Species , Signal Transduction , Ticagrelor , Animals , Male , Nitric Oxide Synthase Type III/metabolism , Rats , Signal Transduction/drug effects , Ticagrelor/pharmacology , Ticagrelor/administration & dosage , Peptides/pharmacology , Peptides/administration & dosage , NF-E2-Related Factor 2/metabolism , Diabetes Mellitus, Experimental/drug therapy , Diabetes Mellitus, Experimental/complications , Reactive Oxygen Species/metabolism , Blood Glucose/drug effects , Insulin Resistance , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/metabolism , Rats, Sprague-Dawley , Heme Oxygenase (Decyclizing)/metabolism , NF-kappa B/metabolism , Hypoglycemic Agents/pharmacology , Hypoglycemic Agents/administration & dosage , Heme Oxygenase-1/metabolism , Insulin , Oxidative Stress/drug effects , Superoxide Dismutase/metabolism , Drug Synergism , Glucagon-Like Peptide-2 Receptor
4.
RSC Adv ; 14(23): 16170-16193, 2024 May 15.
Article in English | MEDLINE | ID: mdl-38769961

ABSTRACT

Acalabrutinib (CALQUENCE; ACB) is a Bruton tyrosine kinase inhibitor (BTKI) used to treat mantle cell lymphoma, small lymphocytic lymphoma (SLL), and chronic lymphocytic leukemia (CLL). On 21 November 2019, ACB was approved by the U.S. FDA for the use as a single therapy for the treatment of CLL/SLL. In silico studies were first done to propose vulnerable sites of metabolism and reactivity pathways by StarDrop software and Xenosite online software; respectively. ACB metabolites and stable adducts were characterized in vitro from rat liver microsomes (RLMs) using Ion Trap LC/MS. Generation of reactive intermediates (RIs) in the in vitro metabolism of ACB was investigated using glutathione, potassium cyanide, and methoxylamine as trapping nucleophiles for the RIs including iminopyridinone, iminium, and aldehyde, respectively, to form stable adducts that can be identified and characterized by Ion Trap LC/MS. Five phase I metabolites, seven 6-iminopyridin-3(6H)-one and five aldehyde RIs of ACB were identified. Based on literature reviews, the generation of RIs of ACB, and the subsequent drug-induced organ toxicity (DIOT) reactions may provide an explanation of ACB ADRs. Additional drug discovery investigations can be performed to facilitate the creation of novel medications with improved safety characteristics.

5.
Heliyon ; 10(8): e29782, 2024 Apr 30.
Article in English | MEDLINE | ID: mdl-38699714

ABSTRACT

The Ora Formation (late Devonian-early Carboniferous) is thought to be a potential source rocks for the Paleozoic petroleum system of Iraq. The source potential from the Ora Formation is evaluated for the first time ever in this study from western and northern Iraq which integrates data from organic geochemistry including Total Organic Carbon (TOC) analysis, HAWK pyrolysis, gas chromatography (GC), and gas chromatography mass spectrometry (GC-MS) and mineralogical X-ray diffraction and scanning electron microscopy. The shale and muddy carbonate succession within the Ora Formation from surface section in northernmost Iraq and subsurface section from two wells (Akkas-1 and Akkas -3) from western Iraq have been employed to assess the source rock potentiality, thermal maturity, kerogen type, organic content, and depositional environment. In addition to organic geochemical analyses, mineralogical XRD and SEM-EDS were used to support the paleoenvironmental interpretation of the Ora Formation. The results from TOC and HAWK analyses reveal that the Ora Formation ranges from poor to good as a source rock. However, the HAWK data suggests that the surface samples from northernmost Iraq are highly mature, highly weathered, or both. Kerogen analysis revealed that the Ora Formation contains immature type III and mixed II-III kerogens. Low TOC values were attributed to factors such as significant clastic input, weathering effects, and the prevailing oxic environment during deposition. The presence of detrital influx of quartz and feldspars, along with the occurrence of illite and kaolinite clay minerals, suggest a detrital input with weathering influence under hot arid and warm humid conditions. Biomarker analysis of the light hydrocarbons using GC and GC-MS revealed that these light hydrocarbons were generated from marine planktonic algae sources, possibly with some contributions from terrestrial and/or microbially reworked organic matter. These high mature light hydrocarbons in subsurface section were originated from anoxic marine shale source rocks. They were most likely from the Cambro-Ordovician Khabour Formation and were contaminated from another source.

6.
Entropy (Basel) ; 26(4)2024 Apr 10.
Article in English | MEDLINE | ID: mdl-38667877

ABSTRACT

Controlling the time evolution of a probability distribution that describes the dynamics of a given complex system is a challenging problem. Achieving success in this endeavour will benefit multiple practical scenarios, e.g., controlling mesoscopic systems. Here, we propose a control approach blending the model predictive control technique with insights from information geometry theory. Focusing on linear Langevin systems, we use model predictive control online optimisation capabilities to determine the system inputs that minimise deviations from the geodesic of the information length over time, ensuring dynamics with minimum "geometric information variability". We validate our methodology through numerical experimentation on the Ornstein-Uhlenbeck process and Kramers equation, demonstrating its feasibility. Furthermore, in the context of the Ornstein-Uhlenbeck process, we analyse the impact on the entropy production and entropy rate, providing a physical understanding of the effects of minimum information variability control.

7.
Cureus ; 16(3): e56528, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38646333

ABSTRACT

Introduction Obesity is a pandemic causing a significant burden on healthcare systems and carries increased morbidity and mortality. One of the options for managing obesity is endoscopic intragastric balloon (IGB) insertion. The aim of the study is to assess the efficacy, tolerance, and side effects of IGB insertion in overweight and obese patients. Methods This is a cross-sectional retrospective study that includes 71 patients who underwent IGB insertion from 2015 to 2019 at King Hamad University Hospital (KHUH), Kingdom of Bahrain. Records of these patients were accessed to assess the percentage of weight loss at the time of balloon removal, complications, and tolerance of the procedure. Furthermore, telephonic interviews were conducted to enquire about side effects and the satisfaction of the procedure. Results A total of 57 patients were included in the weight loss analysis. Thirteen patients did not tolerate the balloon, and one patient had a balloon rupture. The patients experienced a significant reduction in weight upon balloon removal with a mean of 9.74 ± 8.71 kg (p-value of <0.001) and percentage total body weight loss of 10.48 ± 8.07 (p-value of <0.001). A significant reduction was also seen in the body mass index of 3.67 ± 3.57 (p-value of <0.001). The most frequent side effects were nausea, vomiting, and abdominal pain. No major complications or mortalities occurred. Conclusion Intragastric balloons are effective in establishing weight loss. Among patients who tolerated the procedure, the most frequently reported side effects were nausea, vomiting, and abdominal pain.

8.
Community Ment Health J ; 60(5): 945-954, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38427276

ABSTRACT

To inform early intervention, this study describes correlates of substance use among young people with serious mental illness (SMI) enrolled in integrated care in community mental health settings. 227 adults ages 18-35 were assessed for clinical characteristics and substance use. Logistic regressions were used to describe relationships between substance use and participant characteristics. Over a third (38.9%) reported daily cannabis, 15.9% past month other illicit drug, 13.5% frequent/heavy alcohol and 47.4% any of these; 50.2% reported daily tobacco smoking and 23.3% current vaping. Daily cannabis and tobacco were the most common combination. Alcohol, drug, and cannabis with tobacco were associated with higher mental health symptoms but not with emergency room or hospital utilization. Cannabis and other substance use was common and associated with higher symptoms but not with greater hospital utilization, suggesting that early intervention could prevent long-term negative consequences.


Subject(s)
Mental Disorders , Substance-Related Disorders , Humans , Male , Female , Adult , Young Adult , Mental Disorders/epidemiology , Mental Disorders/psychology , Adolescent , Substance-Related Disorders/epidemiology , Substance-Related Disorders/psychology , Alcohol Drinking/epidemiology , Alcohol Drinking/psychology , Logistic Models
9.
Article in English | MEDLINE | ID: mdl-38423710

ABSTRACT

Ponatinib is a prescription medication used to treat a rare form of blood cancer called Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) and chronic myeloid leukemia (CML) that is resistant to other treatments. It belongs to a class of drugs called tyrosine kinase inhibitors, which work by blocking abnormal proteins that promote the growth of cancer cells. In this chapter, the synthesis methods and physicochemical properties of ponatinib were reviewed, besides the characterization of the ponatinib structure using different techniques such as elemental analysis, IR, UV, (1H and 13C) NMR, MS, and XRD. Furthermore, the compendial method for analysis of ponatinib was not found, while the literature review of a non-compendial method for analysis of ponatinib, such as spectroscopic, chromatographic, and immunoassay methods, was covered. Moreover, pharmacology and biochemistry were surveyed in the pharmacokinetic and pharmacodynamic studies.


Subject(s)
Antineoplastic Agents , Imidazoles , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Pyridazines , Humans , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Antineoplastic Agents/chemistry , Drug Resistance, Neoplasm , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
10.
Article in English | MEDLINE | ID: mdl-38423706

ABSTRACT

Avanafil is an oral medication used to treat erectile dysfunction (ED). As a phosphodiesterase type 5 (PDE5) inhibitor, it functions by inhibiting the PDE5 enzyme, which ultimately results in increased levels of cyclic guanosine monophosphate (cGMP) and improved blood flow to the penis. Approved by the FDA in 2012, avanafil is recognised for its rapid onset of action, short half-life, and favourable side-effects profile. While it has been explored for other potential therapeutic applications, its current approved use is limited to ED and should be used as prescribed by a medical professional. This chapter provides a comprehensive review of avanafil, encompassing its nomenclature, physicochemical properties, methods of preparation, and identification. Various techniques for analysing avanafil, such as electrochemical analysis, spectrophotometric, spectrofluorimetric, and chromatographic techniques, are discussed. The pharmacology of avanafil, including its pharmacokinetics and pharmacodynamics, is also examined.


Subject(s)
Erectile Dysfunction , Male , Humans , Erectile Dysfunction/drug therapy , Phosphodiesterase 5 Inhibitors/pharmacology , Phosphodiesterase 5 Inhibitors/therapeutic use , Pyrimidines/pharmacology , Pyrimidines/therapeutic use , Hemodynamics
11.
BMC Vet Res ; 20(1): 42, 2024 Feb 03.
Article in English | MEDLINE | ID: mdl-38308261

ABSTRACT

The aim of this study was to introduce a novel intraoral technique for performing mandibular nerve blocks in dromedary camels (Camelus dromedarius). In this study, 18 adult camel skulls of varying ages and breeds were examined to determine the position of the mandibular foramen. Using a Vernier caliper, three dimensions in millimeters were measured: (1) the distance between the mandibular foramen (MF) and the caudal edge of the third molar tooth at the occlusal surface level, (2) the distance between the MF and the rostral edge border of the mandible's ramus (RER) at the occlusal surface level, and (3) the distance between the MF and the ventral margin border of the mandible (VM). The technique was evaluated using five intact camel cadaver heads (n = 5), and a total of ten mandibular nerve blocks were described. An 18-gauge 80-mm Tuohy needle was inserted into the mouth commissure and advanced caudally while injecting a saline-methylene blue solution. The accuracy of the injection was confirmed through the infiltration of the contrast dye into the target area using computed tomography (CT) and post procedural dissection. Anatomical study of the mandibular nerve site was performed to aid the blind insertion of the needle. The findings contribute to the development of veterinary anesthesia techniques and provide anatomical considerations for clinicians performing oral surgeries in sedated camels. The results demonstrated the successful implementation of the intraoral technique, highlighting its efficacy and reliability in achieving local anesthesia for oral surgeries involving the lower jaw and teeth in sedated camels. Further research studies are needed to evaluate the long-term efficacy and safety of the technique and to compare it with existing approaches.


Subject(s)
Analgesia , Nerve Block , Animals , Camelus , Reproducibility of Results , Nerve Block/veterinary , Mandible/diagnostic imaging , Mandible/anatomy & histology , Tomography, X-Ray Computed/veterinary , Mandibular Nerve/anatomy & histology , Analgesia/veterinary , Cadaver
13.
Int J Pharm ; 652: 123820, 2024 Mar 05.
Article in English | MEDLINE | ID: mdl-38242258

ABSTRACT

Animal experimentation is a critical part of the drug development process and pharmaceutical research. General anesthesia is one of the most common procedures. Careful administration and dosing of anesthetics ensure animal safety and study success. However, repeated injections are needed to maintain anesthesia, leading to adverse effects. Ketamine, a dissociative anesthetic, is commonly used for inducing anesthesia in animals and suffers from a short half-life requiring repeated dosing. Herein, we report a novel system for controlled anesthesia post-intraperitoneal administration. A polymer solution called "premix" was developed using two stimuli-responsive polymers, Pluronic (PF) and Carbopol (CP). As the premix was mixed with ketamine solution and injected, it underwent in situ gelation, hence controlling ketamine release and anesthesia. The PF and CP concentrations were optimized for the gelation temperature and viscosity upon mixing with the ketamine solution. The optimal premix/ketamine formulation (1.5:1) was liquid at room temperature and gel at physiological conditions with favorable mucoadhesion and rheology. Premix retarded the release of ketamine, translating to tunable anesthesia in vivo. Anesthesia duration and recovery were tunable per ketamine dose with minimal side effects. Therefore, we propose the implementation of PF/CP premix as a vehicle for general anesthesia in animals for optimal duration and effect.


Subject(s)
Ketamine , Animals , Polymers , Anesthesia, General/methods , Anesthetics, Dissociative/pharmacology , Poloxamer
14.
Heliyon ; 10(2): e24433, 2024 Jan 30.
Article in English | MEDLINE | ID: mdl-38293492

ABSTRACT

Purpose: of Review: This evidence-based systematic review evaluated the safety of ketamine as regard the potential to provoke epilepsy to help better guide anesthesiologists in their practice. Recent findings: Ketamine, originally developed as a dissociative anesthetic, has gained attention for its potential therapeutic applications in various medical conditions, including epilepsy. Ketamine is generally well-tolerated and widely used in anesthesia, however, conflicting data are confusing the anesthesiologists regarding the potential risk of seizures associated with its use. The literature that claimed the proepileeptic property are inconsistent and the mechanism of action is unclear. Moreover, the case reports had been in same certain contexts, such as procedural sedation where ketamine was used as a single agent. On the other hand, the retrospective data analysis confirmed the positive role ketamine plays as antiepileptic agent. Summary: Many studies have shown promising results for the use of ketamine as antiepileptic agent. In case of epileptic patients, there is no contraindication for using ketamine, however, combining with benzodiazepine or propofol may enhance the safety.

15.
Pharmaceuticals (Basel) ; 16(12)2023 Nov 25.
Article in English | MEDLINE | ID: mdl-38139777

ABSTRACT

In the present work, a concise library of benzothiazole-derived pyrazoline-based thiazole (1-17) was designed and synthesized by employing a multistep reaction strategy. The newly synthesized compounds were screened for their α-glucosidase and urease inhibitory activities. The scaffolds (1-17) were characterized using a combination of several spectroscopic techniques, including FT-IR, 1H-NMR, 13C-NMR, and EI-MS. The majority of the synthesized compounds demonstrated a notable potency against α-glucosidase and urease enzymes. These analogues disclosed varying degrees of α-glucosidase and urease inhibitory activities, with their IC50 values ranging from 2.50 to 17.50 µM (α-glucosidase) and 14.30 to 41.50 (urease). Compounds 6, 7, 14, and 12, with IC50 values of 2.50, 3.20, 3.40, and 3.50 µM as compared to standard acarbose (IC50 = 5.30 µM), while the same compounds showed 14.30, 19.20, 21.80, and 22.30 comparable with thiourea (IC50 = 31.40 µM), respectively, showed excellent inhibitory activity. The structure-activity relationship revealed that the size and electron-donating or electron-withdrawing effects of substituents influenced the enzymatic activities such as α-glucosidase and urease. Compound 6 was a dual potent inhibitor against α-glucosidase and urease due to the presence of -CF3 electron-withdrawing functionality on the phenyl ring. To the best of our knowledge, these synthetic compounds were found to be the most potent dual inhibitors of α-glucosidase and urease with minimum IC50 values. Moreover, in silico studies on most active compounds, i.e., 6, 7, 14, and 12, were also performed to understand the binding interaction of most active compounds with active sites of α-glucosidase and urease enzymes.

16.
Pharmaceuticals (Basel) ; 16(12)2023 Nov 30.
Article in English | MEDLINE | ID: mdl-38139795

ABSTRACT

A hybrid library of compounds based on indazole-based thiadiazole containing thiazolidinone moieties (1-17) was synthesized. The synthesized compounds were screened in vitro for their inhibition profile against targetedacetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities. All the derivatives demonstrated a varied range of inhibitory activities having IC50 values ranging from 0.86 ± 0.33 µM to 26.73 ± 0.84 µM (AChE) and 0.89 ± 0.12 µM to 27.08 ± 0.19 µM (BuChE), respectively. The results obtained were compared with standard Donepezil drugs (IC50 = 1.26 ± 0.18 µM for AChE) and (1.35 ± 0.37 µM for BuChE), respectively. Specifically, the derivatives 1-17, 1, 9, and 14 were found to be significantly active, with IC50 values of 0.86 ± 0.30, 0.92 ± 0.10, and 1.10 ± 0.37 µM (against AChE) and 0.89 ± 0.12, 0.98 ± 0.48 and 1.19 ± 0.42 µM (against BuChE), respectively.The structure-activity relationship (SAR) studies revealed that derivatives bearing para-CF3, ortho-OH, and para-F substitutions on the phenyl ring attached to the thiadiazole skeleton, as well as meta-Cl, -NO2, and para-chloro substitutions on the phenyl ring, having a significant effect on inhibitory potential. The synthesized scaffolds have been further characterized by using 1H-NMR, 13C-NMR, and (HR-MS) to confirm the precise structures of the synthesized compounds. Additionally, the molecular docking approach was carried out for most active compounds to explore the binding interactions established by most active compounds, with the active sites of targeted enzymes and obtained results supporting the experimental data.

17.
Medicine (Baltimore) ; 102(51): e36713, 2023 Dec 22.
Article in English | MEDLINE | ID: mdl-38134055

ABSTRACT

Acute kidney damage (AKI) is a common cause of pediatric intensive care unit (PICU) admissions. Implementing a reno-protective strategy for AKI prediction can significantly enhance outcomes. The renal angina index (RAI) is a risk stratification tool used to predict severe AKI. We aim to assess the reliability and accuracy of the RAI scoring system in predicting AKI as compared to other conventional AKI markers. A prospective, observational study was conducted in the PICU of 2 tertiary medical centers in the Middle East. A total of 446 patients, aged 1-month to 14-years, without chronic kidney disease were enrolled. The RAI was calculated using the renal risk and renal injury score within the first 8 to 12 hours of admission. The accuracy of RAI was compared to changes in serum creatinine from baseline. The outcome was assessed on Day 3 for presence of AKI according to the kidney disease improving global outcome (KDIGO) criteria and associated sequelae. A positive RAI (RA+) was defined as RAI readings ≥ 8. Among the patients, 89 (19.9%) had a positive RAI within the first 8 to 12 hours of admission. The RA + group had a significantly higher occurrence of Day 3 severe AKI (KDIGO stages 2&3) compared to the RA- group (60.6% vs 4.2%, P < .001). The RA + group also had a significantly higher utilization of renal replacement therapy (RRT) (21.3% vs 1.1%, P < .001), longer mean PICU length of stay in days (11.1 ±â€…3.5 vs 5.5 ±â€…2.1, P < .001), and increased mortality (31.4% vs 2.8%, P < .001) compared to the RA- group. The RAI score demonstrated superior predictive ability for Day 3 AKI, with a sensitivity of 72%, specificity of 95%, and area under the curve (AUC) of 0.837, compared to changes in serum creatinine from baseline (sensitivity: 65%, specificity: 89%, AUC: 0.773), fluid overload (sensitivity: 43.7%, specificity: 79%, AUC: 0.613), and illness severity scores (sensitivity: 52.4%, specificity: 80.5%, AUC: 0.657). RAI proved to be a reliable and rapid bedside test for identifying critically ill children at risk of developing severe AKI. This enables physicians to implement reno-protective measures and intervene early, thereby improving prognosis.


Subject(s)
Acute Kidney Injury , Critical Illness , Child , Humans , Creatinine , Prospective Studies , Critical Illness/therapy , Reproducibility of Results , Acute Kidney Injury/diagnosis , Acute Kidney Injury/therapy , Acute Kidney Injury/epidemiology , Angina Pectoris/complications
18.
Molecules ; 28(22)2023 Nov 08.
Article in English | MEDLINE | ID: mdl-38005198

ABSTRACT

Infigratinib, a protein kinase inhibitor employed in the therapeutic management of cholangiocarcinoma, was subjected to various stress conditions, including hydrolytic (acidic and alkaline), oxidative, photolytic, and thermal stress, in accordance with the rules established by the International Council for Harmonization. A cumulative count of five degradation products was observed. The application of the Quality by Design principle was utilized in the development of a rapid and specific separation method for Infigratinib and its degradation products. The methodology employed in this study was derived from an experimental design approach, which was utilized to examine the critical process parameters associated with chromatographic systems. The reversed-phase high-performance liquid chromatography technique, employing a C18 column and a mobile phase composed of a gradient mixture of 25 mM ammonium acetate buffer at pH 6.0 and acetonitrile, successfully facilitated the chromatographic separation. The methodology was expanded to include the utilization of UPLC-quadrupole tandem mass spectrometry in order to conduct a comprehensive analysis of the structural properties and characterize the degradation products. Overall, five degradation products were found in different stress conditions. The method was verified at certain working points, wherein a linearity range (5.0-200.0 µg/mL) was developed and other parameters such as accuracy, repeatability, selectivity, and system suitability were evaluated. Finally, the toxicity and mutagenicity of Infigratinib and its degradation products were predicted using in silico software, namely DEREK Nexus® (version 6.2.1) and SARAH Nexus® (version 3.2.1). Various toxicity endpoints, including chromosomal damage, were predicted. Additionally, two degradation products were also predicted to be mutagenic.


Subject(s)
Chromatography, Reverse-Phase , Tandem Mass Spectrometry , Chromatography, Liquid/methods , Tandem Mass Spectrometry/methods , Hydrolysis , Oxidation-Reduction , Drug Stability , Chromatography, High Pressure Liquid/methods
19.
Molecules ; 28(22)2023 Nov 12.
Article in English | MEDLINE | ID: mdl-38005274

ABSTRACT

Gemcitabine is a chemotherapeutic agent used to treat various malignancies, including breast and bladder cancer. In the current study, three innovative selective gemcitabine hydrochloride sensors are developed using 4-tert-butylcalix-[8]-arene (sensor 1), ß-cyclodextrin (sensor 2), and γ-cyclodextrin (sensor 3) as ionophores. The three sensors were prepared by incorporating the ionophores with o-nitrophenyl octyl ether as plasticizer and potassium tetrakis(4-chlorophenyl) borate as ionic additive into a polyvinyl chloride polymer matrix. These sensors are considered environmentally friendly systems in the analytical research. The linear responses of gemcitabine hydrochloride were in the concentration range of 6.0 × 10-6 to 1.0 × 10-2 mol L-1 and 9.0 × 10-6 to 1.0 × 10-2 mol L-1 and 8.0 × 10-6 to 1.0 × 10-2 mol L-1 for sensors 1, 2, and 3, respectively. Over the pH range of 6-9, fast-Nernst slopes of 52 ± 0.6, 56 ± 0.3, and 55 ± 0.8 mV/decade were found in the same order with correlation regressions of 0.998, 0.999, and 0.998, respectively. The lower limits of detection for the prepared sensors were 2.5 × 10-6, 2.2 × 10-6, and 2.7 × 10-6 mol L-1. The sensors showed high selectivity and sensitivity for gemcitabine. Validation of the sensors was carried out in accordance with the requirements established by the IUPAC, while being inexpensive and easy to use in drug formulation. A statistical analysis of the methods in comparison with the official method showed that there was no significant difference in accuracy or precision between them. It was shown that the new sensors could selectively and accurately find gemcitabine hydrochloride in bulk powder, pharmaceutical formulations, and quality control tests. The ionophore-based sensor shows several advantages over conventional PVC membrane sensor sensors regrading the lower limit of detection, and higher selectivity towards the target ion.


Subject(s)
Antineoplastic Agents , Gemcitabine , Drug Compounding , Ionophores , Polymers , Potentiometry/methods , Polyvinyl Chloride
20.
Molecules ; 28(20)2023 Oct 23.
Article in English | MEDLINE | ID: mdl-37894699

ABSTRACT

Acalabrutinib, commercially known as Calquence®, is a pharmacological molecule that has robust inhibitory activity against Bruton tyrosine kinase. The medicine in question was carefully developed by the esteemed pharmaceutical company AstraZeneca. The FDA granted authorization on 21 November 2019 for the utilization of acalabrutinib (ACB) in the treatment of small lymphocytic lymphoma (SLL) or chronic lymphocytic leukemia (CLL) in adult patients. The aim of this study was to develop a UPLC-MS/MS method that is effective, accurate, environmentally sustainable, and has a high degree of sensitivity. The methodology was specifically developed with the intention of quantifying ACB in human liver microsomes (HLMs). The methodology described above was subsequently utilized to assess the metabolic stability of ACB in HLMs in an in vitro environment. The validation procedures for the UPLC-MS/MS method in the HLMs were conducted in accordance with the bioanalytical method validation criteria established by the U.S.- DA. The utilization of the StarDrop software (version 6.6), which integrates the P450 metabolic module and DEREK software (KB 2018 1.1), was employed for the purpose of evaluating the metabolic stability and identifying potential hazardous alarms associated with the chemical structure of ACB. The calibration curve, as established by the ACB, demonstrated a linear correlation across the concentration range of 1 to 3000 ng/mL in the matrix of HLMs. The present study conducted an assessment of the accuracy and precision of the UPLC-MS/MS method in quantifying inter-day and intra-day fluctuations. The inter-day accuracy demonstrated a spectrum of values ranging from -1.00% to 8.36%, whilst the intra-day accuracy presented a range of values spanning from -2.87% to 4.11%. The t1/2 and intrinsic clearance (Clint) of ACB were determined through in vitro testing to be 20.45 min and 39.65 mL/min/kg, respectively. The analysis concluded that the extraction ratio of ACB demonstrated a moderate level, thus supporting the recommended dosage of ACB (100 mg) to be administered twice daily for the therapeutic treatment of persons suffering from B-cell malignancies. Several computational tools have suggested that introducing minor structural alterations to the butynoyl group, particularly the alpha, beta-unsaturated amide moiety, or substituting this group during the drug design procedure, could potentially enhance the metabolic stability and safety properties of novel derivatives in comparison to ACB.


Subject(s)
Leukemia, Lymphocytic, Chronic, B-Cell , Tandem Mass Spectrometry , Humans , Chromatography, Liquid , Tandem Mass Spectrometry/methods , Benzamides , Pyrazines
SELECTION OF CITATIONS
SEARCH DETAIL
...