2-Pyridone-containing heterocycles are considered privileged scaffolds in drug discovery due to their behavior as hydrogen bond donors and/or acceptors and nonpeptidic mimics, and remarkable ...physicochemical properties such as metabolic stability, solubility in water, and lipophilicity. This review provides a comprehensive overview of multicomponent reactions (MCRs) for the synthesis of 2-pyridone-containing heterocycles. In particular, it covers the articles published from 1999 to date related to anticancer, antibacterial, antifungal, anti-inflammatory, α-glucosidase inhibitor, and cardiotonic activities of 2-pyridone-containing heterocycles obtained exclusively by an MCR. The discussion focuses on bioactivity data, synthetic approaches, plausible reaction mechanisms, and molecular docking simulations to facilitate comparison and underscore the applications of the 2-pyridone motif in drug discovery and medicinal chemistry. We also present our conclusions and outlook for the future.
This review provides a comprehensive overview of multicomponent reactions (MCRs) for the synthesis of biologically active 2-pyridone-containing heterocycles.
The International Consortium for Health Outcomes Measurement (ICHOM) was founded in 2012 to propose consensus-based measurement tools and documentation for different conditions and populations.This ...article describes how the ICHOM Older Person Working Group followed a consensus-driven modified Delphi technique to develop multiple global outcome measures in older persons. The standard set of outcome measures developed by this group will support the ability of healthcare systems to improve their care pathways and quality of care. An additional benefit will be the opportunity to compare variations in outcomes which encourages and supports learning between different health care systems that drives quality improvement. These outcome measures were not developed for use in research. They are aimed at non researchers in healthcare provision and those who pay for these services.
A modified Delphi technique utilising a value based healthcare framework was applied by an international panel to arrive at consensus decisions.To inform the panel meetings, information was sought from literature reviews, longitudinal ageing surveys and a focus group.
The outcome measures developed and recommended were participation in decision making, autonomy and control, mood and emotional health, loneliness and isolation, pain, activities of daily living, frailty, time spent in hospital, overall survival, carer burden, polypharmacy, falls and place of death mapped to a three tier value based healthcare framework.
The first global health standard set of outcome measures in older persons has been developed to enable health care systems improve the quality of care provided to older persons.
Very old (aged ≥80 years) adults constitute an increasing proportion of the global population. Currently, this subgroup of patients represents an important percentage of patients admitted to the ...intensive care unit. Community-acquired pneumonia (CAP) frequently affects very old adults. However, there are no specific recommendations for the management of critically ill very old CAP patients. Multiple morbidities, polypharmacy, immunosenescence and frailty contribute to an increased risk of pneumonia in this population. CAP in critically ill very old patients is associated with higher short- and long-term mortality; however, because of its uncommon presentation, diagnosis can be very difficult. Management of critically ill very old CAP patients should be guided by their baseline characteristics, clinical presentation and risk factors for multidrug-resistant pathogens. Hospitalisation in intermediate care may be a good option for critical ill very old CAP patients who do not require invasive procedures and for whom intensive care is questionable in terms of benefit.
Community-based forest management, such as Community Forest Enterprises (CFEs), has the potential to generate positive socioenvironmental and economic outcomes. We performed a detailed survey of ...financial and production parameters for 30 of the approximately 992 CFEs in Mexico in order to estimate costs, income, profits, and sustainability of harvest levels for forest management, harvest, and sawmilling. Fourteen of the 30 CFEs harvested more timber than they grew in 2011, suggesting issues with sustainability, but only two of these had harvest far above annual growth, and five of those were only a fraction more than annual growth. All of the 30 CFEs except one made profits in forest management and timber growing. For timber harvesting, 22 of 30 CFEs made profits, but the losses were small for the other CFEs. For the 23 CFEs with sawmills, 18 made profits and five had losses; the greatest returns for the CFEs accrued to those with sawmills for lumber production. On average, the CFEs surveyed had high costs of production relative to other countries, but the CFEs were still profitable in national lumber markets. If Mexico were to begin importing large amounts of lumber from lower cost countries, this could pose a threat to CFE profitability.
Systemic lupus erythematosus is a prevalent autoimmune disease that affects multiples systems, exerting its most incapacitating and life-threatening impact through neuropsychiatric involvement. ...According to the American College of Rheumatology (ACR), 19 neuropsychiatric syndromes types of SLE are classified into categories encompassing the central and peripheral nervous systems. This study aimed to investigate the frequency of neuropsychiatric manifestations in systemic lupus erythematosus patients admitted to Hospital Cayetano Heredia in Lima, Peru, between 2008 and 2019.
A retrospective observational study was conducted, entailing the review of 240 medical records of patients diagnosed with systemic lupus erythematosus during the specified period, based on the Systemic Lupus International Collaborating Clinics (SLICC) 2012 criteria. Among these records, 55 patients presented neuropsychiatric systemic lupus erythematosus (NPSLE). Data were collected using standardized form and entered into Microsoft Excel 2019 database. Statistical analysis was performed using Stata v16.
The frequency of neuropsychiatric compromise in systemic lupus erythematosus patients was found to be 22.91%. Among the 55 systemic lupus erythematosus patients, 40 demonstrated involvement of the central nervous system (72.72%), 2 exhibited involvement of the peripheral nervous system (3.63%), and 13 displayed involvement in both the central nervous system and peripheral nervous system (23.63%). The most prevalent psychiatric disorder observed was a major depressive disorder, with a prevalence rate of 30.9%.
The study revealed a frequency of 22.91% for neuropsychiatric involvement in systemic lupus erythematosuspatients at Cayetano Heredia Hospital between 2008 and 2019, with central nervous system manifestations prevailing. Furthermore, the findings suggest that NPSLE commonly manifested after the diagnosis of systemic lupus erythematosus.
Community-acquired pneumonia (CAP) can occur at any time of life, but its incidence and risk of death are linked to increasing age. CAP in the elderly is a major health problem associated with high ...rates of readmission, morbidity, and mortality. Since the clinical presentation of pneumonia in the elderly may be atypical, clinicians should suspect pneumonia in older patients presenting symptoms such as falls and altered mental status, fatigue, lethargy, delirium, anorexia, in order to avoid the complications associated with delayed diagnosis and therapy.
remains the most frequently reported pathogen in this population. However, particular attention should be paid to patients with risk factors for multidrug resistant pathogens, because a large proportion of elderly persons present multimorbidity. Vaccination is one of the most important preventive approaches for CAP in the elderly. In addition, lifestyle-tailored interventions for different modifiable risk factors will help to reduce the risk of pneumonia in elderly persons. Surveillance of etiological pathogens may improve vaccination policies in this population.
The route used in the transplantation of mesenchymal stem cells (MSCs) can directly affect the treatment success. The transplantation of MSCs via the intrathecal (IT) route can be an important ...therapeutic strategy for neurological disorders. The objective of this study was to evaluate the safety and feasibility of the IT transplantation of autologous (Auto-MSCs) and allogeneic (Allo-MSCs) bone marrow mesenchymal stem cells (BM-MSCs) in healthy dogs. Based on neurodisability score, cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI), no significant differences from the control group were observed on day 1 or day 5 after IT Auto- or Allo-MSCs transplantation (P > 0.05). In addition, analysis of matrix metalloproteinase (MMP)-2 and MMP-9 expression in the CSF revealed no significant differences (P > 0.05) at 5 days after IT transplantation in the Auto- or Allo-MSCs group when compared to the control. Intrathecal transplantation of BM-MSCs in dogs provides a safe, easy and minimally invasive route for the use of cell-based therapeutics in central nervous system diseases.
Community-acquired pneumonia (CAP) remains a major health problem worldwide. The incidence of pneumonia increases with both age and the presence of specific risk factors, which lead to increased ...health care costs. However, although there is some controversy over the observed trend in CAP mortality over recent decades, it is clear that mortality in CAP patients who require intensive care unit care remains high. The increase in antibiotic resistance is an important global health problem that needs to be addressed, especially for pneumococcus the most frequent pathogen of CAP. The prudent use of current antibiotics will help to limit the spread of antibiotic resistant clones of pneumococcus. Pneumococcal and influenza vaccinations remain the primary strategy for the prevention of CAP, especially in an at-risk population. This article reviews CAP, with a focus on epidemiology, diagnosis, prognostic factors, microbial etiology, therapy, complications, and prevention.
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