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Oral tranexamic acid for immediate use in major trauma: implications for mass casualty events.
Emerg Med J
January 2025
Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK.
The early administration of tranexamic acid is recognised as significantly reducing mortality in traumatically injured patients with major haemorrhage, typically given via intravenous or intramuscular routes. In the context of mass casualty events, there may exist multiple traumatically injured casualties that would benefit from tranexamic acid, however, it's administration may be delayed through the need to establish intravenous access. Additionally, if the initial assessment of the traumatically injured casualty is undertaken by an individual who cannot administer intravenous or intramuscular medications, time to administration will be further delayed.
View Article and Find Full Text PDFThe role of ketamine and its enantiomer in managing depression and pain in cancer patients: A narrative review.
J Anesth Transl Med
December 2024
Department of Anesthesiology, Moffitt Cancer Center, Tampa, FL 34433, USA.
Depression and pain are common comorbidities in cancer patients, and ketamine, a dissociative anesthetic, has shown potential in managing both. This review summarizes current literature on ketamine and its enantiomer, esketamine, in managing depression and pain in the oncologic population. Studies indicate that sub-anesthetic doses of intravenous ketamine and esketamine can alleviate postoperative depressive symptoms in cancer patients with a tolerable safety profile.
View Article and Find Full Text PDFReducing off-target expression of mRNA therapeutics and vaccines in the liver with microRNA binding sites.
Mol Ther Methods Clin Dev
March 2025
Department of Medicine, Division of Infectious Diseases, Mayo Clinic, Rochester, MN 55902, USA.
Lipid nanoparticles (LNPs) are often liver tropic, presenting challenges for LNP-delivered mRNA therapeutics intended for other tissues, as off-target expression in the liver may increase side effects and modulate immune responses. To avoid off-target expression in the liver, miR-122 binding sites have been used by others in viral and non-viral therapeutics. Here, we use a luciferase reporter system to compare different copy numbers and insertion locations of miR-122 binding sequences to restrict liver expression.
View Article and Find Full Text PDFSubcutaneous route is a reliable alternative for ACTH-stimulated steroid profiling.
Endocrine
January 2025
Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, India.
Purpose: Intramuscular acton prolongatum is most often used as an alternative for intramuscular or intravenous tetracosactide for ACTH stimulation in some countries. Intramuscular administration of acton prolongatum is cumbersome whereas intended intramuscular acton prolongatum or tetracosactide may often turn subcutaneous. Hence, we compared the subcutaneous ACTH-stimulated steroid profiling with those of the intramuscular routes.
View Article and Find Full Text PDFImproving Individualized Salbutamol Treatment: A Population Pharmacokinetic Model for Oral Salbutamol in Virtual Patients.
Pharmaceutics
December 2024
PerMed Research Group, Center for Health Technology and Services Research (CINTESIS), Rua Doutor Plácido da Costa, 4200-450 Porto, Portugal.
Background: Salbutamol, a short-acting β-agonist used in asthma treatment, is available in multiple formulations, including inhalers, nebulizers, oral tablets, and intravenous, intramuscular, and subcutaneous routes. Each formulation exhibits distinct pharmacokinetic (PK) and pharmacodynamic (PD) profiles, influencing therapeutic outcomes and adverse effects. Although asthma management predominantly relies on inhaled salbutamol, understanding how these formulations interact with patient-specific characteristics could improve personalized medicine approaches, potentially uncovering the therapeutic benefits of alternative formulations for an individual patient.
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