Peripheral edema induced by isosorbide mononitrate in an elderly patient: A case study of dose-related risks and drug interactions.

Adverse drug reactions (ADRs) in elderly patients are frequently attributed to age-related altered pharmacokinetics and the complexities of polypharmacy to manage multiple chronic conditions, making elderly patients more susceptible to ADRs. The following is a case report of an 80-year-old female patient with systemic symptoms of chest pain, low blood sugar, mouth ulcers, and concentrates on peripheral edema due to nitrate vasodilator isosorbide mononitrate (ISMN). She had hypertension, diabetes, ischemic heart disease, and chronic obstructive pulmonary disease (COPD).

Intranasal delivery of doxepin: enhancing brain targeting efficiency utilizing nanostructured lipid carriers for a biopharmaceutics drug disposition classification system class-I drug.

Doxepin, a Class-I Biopharmaceutics Drug Disposition Classification System (BDDCS) drug, exhibits poor bioavailability due to extensive first-pass metabolism. This research focuses on enhancing the delivery of doxepin by formulating nanostructured lipid carriers (NLCs) through the utilization of the Box-Behnken Design methodology. These optimized NLCs are intended for intranasal administration, with the ultimate goal of improving nose-to-brain drug delivery.

Clozapine-laden carbon dots delivered to the brain via an intranasal pathway: Synthesis, characterization, ex vivo, and in vivo studies.

Clozapine, which is widely used to treat schizophrenia, shows low bioavailability due to poor solubility and high first-pass metabolism. The study aimed to design clozapine-loaded carbon dots (CDs) to enhance availability of the clozapine to the brain via intranasal pathway. The CDs were synthesized by pyrolysis of citric acid and urea at 200 °C by hydrothermal technique and characterized by photoluminescence, transmission electron microscopy (TEM), X-ray Photoelectron Spectrometer (XPS), and Fourier transform infrared spectrum (FTIR).

In vitro and in vivo evaluation of cyclosporine-graphene oxide laden hydrogel contact lenses.

Drug-eluting contact lens can substitute the multiple eye drop therapy. However, loading hydrophobic drug like cyclosporine in the contact lens is very challenging, due to low drug uptake (via soaking method); and alteration in the swelling and optical properties which restricts its clinical application. To address the above issues, graphene oxide (GO, large surface area with oxygen containing functional groups) was incorporated in the contact lenses during fabrication.

Proton pump inhibitors and osteoporosis risk: exploring the role of TRPM7 channel.

Background: Long-term use of proton pump inhibitors (PPIs) has been linked to an increased risk of osteoporosis, with various indirect mechanisms so far identified. Although no direct underlying mechanism for effect on bone cells have been investigated with the use of PPIs. Melastatin-like transient receptor potential 7 (TRPM7)channel has been engaged in the proliferation of bone cells.

Nose to brain delivery of tailored clozapine nanosuspension stabilized using (+)-alpha-tocopherol polyethylene glycol 1000 succinate: Optimization and in vivo pharmacokinetic studies.

Clozapine is widely used to treat schizophrenia as an atypical antipsychotic. Low solubility, poor dissolution rate, degradation in the gastrointestinal tract, high hepatic first-pass metabolism, and eventually less drug transfer in the brain are all issues with oral clozapine administration. On account of this poor pharmacokinetic parameters, the authors aimed to develop clozapine nanosuspension using (+)-alpha-tocopherol polyethylene glycol 1000 succinate (TPGS) and polyvinylpyrrolidone K-30 (PVP K-30) and deliver it through the intranasal route.

Aortic valve replacement via right minithoracotomy versus median sternotomy: a propensity score analysis.

Objective: The aim of this study was to define the relative role of a right minithoracotomy (RT) versus standard median sternotomy (ST) for open aortic valve replacement (AVR).

Methods: A retrospective analysis was performed of all 1348 patients undergoing isolated, open AVR at a single institution during a 14-year period. Because relatively few patients were technically suitable for redo AVR with the RT approach (n = 20), all redo patients (n = 209) were excluded, leaving 1139 patients available for analysis.

Minithoracotomy versus sternotomy for mitral surgery in patients with chronic renal impairment: a propensity-matched study.

Objective: Compared with median sternotomy, a right thoracotomy (RT) approach to mitral surgery is associated with decreased postoperative acute renal failure. Therefore, we examined propensity-matched patients with chronic renal impairment to compare outcomes.

Methods: A retrospective review at a single institution identified patients who underwent mitral valve surgery from 1986 to 2010.

Minimally invasive edge-to-edge mitral repair with or without artificial chordae.

Background: This study aims to analyze the midterm outcomes of minimally invasive edge-to-edge mitral valve repair (MVR) with artificial chords (CHORD) or without artificial chords (noCHORD) in patients with mitral regurgitation (MR).

Methods: Records of all patients undergoing edge-to-edge MVR through minithoracotomy at a single institution over a 7-year period were retrospectively reviewed.

Results: A total of 186 patients underwent edge-to-edge MVR through minithoracotomy.

Comparison of need for operative therapy in patients with mitral valve prolapse involving both leaflets versus posterior leaflet only.

Mitral valve prolapse may involve 1 leaflet or 2 leaflets, yet management guidelines do not differentiate posterior leaflet (PML) from bileaflet (BML) prolapse. We hypothesized that patients with BML have a prolonged natural history with more severe atrial and ventricular enlargement but less severe mitral regurgitation (MR) compared to patients with PML. Patients with mitral valve prolapse undergoing mitral repair were identified and preoperative characteristics were recorded.

Transaortic endoclamp for mitral valve operation through right minithoracotomy in 369 patients.

Objective: : The effects and benefits of a transaortic endoclamp for mitral valve operation through right minithoracotomy have not been established.

Methods: : The records were examined in 671 patients undergoing mitral valve operation using aortic cannulation through a 6-cm right minithoracotomy in the fourth intercostal space. The ascending aorta was cannulated with a 24-Fr cannula through a 12-mm port in the first intercostal space.

Aortic valve replacement through right minithoracotomy in 306 consecutive patients.

Objective: To define the role and early results of aortic valve surgery through a right minithoracotomy.

Methods: A retrospective analysis was performed on 306 consecutive patients undergoing aortic valve replacement through an 8-cm right minithoracotomy in the second intercostal space. The initial experience was included.

Comparison of Minithoracotomy versus Sternotomy in 304 Consecutive Tricuspid Valve Operations.

Objective: : The relative outcomes of sternotomy versus thoracotomy for tricuspid valve operation were examined over a 22-year period.

Methods: : Three hundred four consecutive patients undergoing tricuspid valve operation using right minithoracotomy (THORC group; n = 124) versus median sternotomy (STERN group; n = 180) between 1985 and 2007 were retrospectively analyzed. Minithoracotomy used a 6-cm incision with femoral venous cannulation and augmented venous return.

Results of 141 consecutive minimally invasive tricuspid valve operations: an 11-year experience.

Background: Reports of minimally invasive tricuspid valve operations are rare. We reviewed our experience and results of tricuspid valve operation using mini-thoracotomy during an 11-year period.

Methods: Consecutive patients (n = 141) undergoing tricuspid valve operation using mini-thoracotomy were retrospectively analyzed.

Early Results of Edge-to-Edge Alfieri Mitral Repair Via Right Mini-Thoracotomy in 68 Consecutive Patients.

Objective: : To examine early outcomes of mitral valve repair using Alfieri repair via a right mini-thoracotomy approach.

Methods: : Records were examined in 68 consecutive patients undergoing Alfieri mitral repair via 6 cm right mini-thoracotomy. Most repairs were performed under cardioplegic arrest, using percutaneous femoral cannulation and direct aortic cannulation through the right first intercostal space.