Discovery and Development of Safe-in-Man Broad-Spectrum Antiviral Agents

Viral diseases are one of the leading causes of morbidity and mortality in the world. Broad-spectrum antiviral agents (BSAAs) are key players in control of human viral diseases. Here, we reviewed the discovery and development process of BSAAs, focusing on compounds with available safety profiles in human. In addition, we summarized the information on approved, investigational and experimental safe-in-man BSAAs in freely accessible database at https://drugvirus.info/. The number of approved BSAAs will be increased as well as their spectrum of indications will be expanded pending the results of further pre-clinical and clinical studies. This will ultimately reinforce the arsenal of available antiviral options and provide better protection of general population from emerging and re-emerging viral diseases.

Discovery and Development of Safe-in-Man Broad-Spectrum Antiviral Agents

Viral diseases are the leading cause of morbidity and mortality in developing countries. Broad-spectrum antiviral agents (BSAA) are key players in control of viral diseases. Here, we reviewed the discovery and development process of BSAAs, focusing on compounds with available safety profiles in human. We summarized the information on approved, investigational and experimental safe-in-man BSAAs in freely accessible database at https://drugvirus.info/. The number of these BSAAs will be increased as well as their spectrum of indications will be expanded pending the results of further pre-clinical and clinical studies. This will ultimately reinforce the arsenal of available antiviral options and provide better protection of general population from emerging and re-emerging viral diseases.

Update Regarding Imaging of Neuroendocrine Neoplasms

Background Neuroendocrine neoplasms (NEN) are a heterogeneous group of tumors characterized by the expression of typical proteins. A wide range of morphological and functional imaging methods is required in order to adequately assess the course of the disease and to optimally treat the patient. The spectrum of indications ranges from the detection of small primary tumors to the documentation of the metastasis pattern and the assessment of the suitability for certain invasive or noninvasive therapy methods. The exact recording and quantification of findings is indispensable. Methods This article is based on a comprehensive literature search on the different aspects of neuroendocrine neoplasm imaging. Results This article is intended to provide an overview of the available imaging procedures with their respective advantages and disadvantages for diagnostics and their value for the follow-up of neuroendocrine neoplasms. Recommendations for examination protocols, typical image findings, and an outlook regarding future developments are presented. Key Points: Citation Format

CAUDAL EPIDURAL ANESTHESIA IN PEDIATRIC PATIENTS

Caudal epidural block is the most widely used regional anesthetic technique in children. Its popularity in pediatric anesthesia is mainly due to its broad spectrum of indications, high success rates, and a relative low incidence of complications. The caudal epidural block is generally used for not only lower abdominal or lower extremity surgery but also for upper abdominal surgery via administration of adjuncts such as morphine, which has hydrosoluble potential. The indications, contraindications and technique of caudal epidural block are presented.

Management of an open abdomen complicated by a high output entero-atmosferic fistula after a gastric by-pass

There is a wide spectrum of indications for negative pressure woundtherapy (NPWT) including enterocutaneous fistulas, open abdomen management,abdominal wound dehiscence, open fractures, amputation wounds, sternal woundinfections, vascular bypass site infection and many others.The article shows a case report of a patient with an entero-atmospheric fistulamanaged with NPWT. Control of intestinal contents from an entero-atmosphericfistula with the NPWT minimizes the damage to the healing bed of granulationtissue until the definitive closure of the fistula can be undertaken six to twelve monthslater. After a laparoscopic gastric bypass and 5 emergency interventions because of leaksat the jejunojenunal anastomosis and complications of the abdominal wall, anentero-atmospheric fistula appeared. This fistula was managed with the NPWTduring two months. In the described case, the application of negative pressuredressing system allowed the management of the entero-atmospheric fistula until itbecame a stoma.

Biosimilar medicines and patient registries – expectations, limitations, and opportunities

Introduction: Biology therapies in a various medical specializations and for a broad spectrum of indications were launched during last two decades. As a new in class the therapies were obliged to provide additional data re gar ding efficacy and safety after their real medical practice integration. Patient registries, databases collecting various patient data, were introduced to grant data on the treatment effectiveness, safety, and long-term on treatment survival. Satisfactory treatment effect and acceptable safety profile were confirmed after couple of years of careful observation. However, the benefits were usually offered at much higher treatment costs compared to the standard therapies. Biologically similar drugs, so-called biosimilars (B.S), are being launched after original molecule patent protection expiry during recent years. They were expected as an ideal solution to avoid distinct impact on the medical budget: comparable effect for less money. The unsubstantiated doubts about biosimilar efficacy and safety were the reason of the late launch in many markets. Since biosimilars are considered as new therapy entities, the cautiousness to certain extent should be required. Information gained from post-marketing observations and patient registries over several years, confirmed the biosimilar product comparable quality. Healthcare budget savings could secure easier therapy access for more new patients.