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National guidelines in Sweden recommend preoperative full-body disinfection (FBD) with 4% chlorhexidine to prevent surgical-site infection (SSI) after hip fracture surgery, a method causing patients' severe pain. Although, due to little evidence in research, orthopedic clinics in Sweden are wavering in favor of simpler methods such as local disinfection (LD) of the surgical site. The aim of this study was to describe the experiences of nursing personnel regarding the performance of preoperative LD on patients prior to hip fracture surgery after having switched from FBD. This study has a qualitative design where data were collected via focus-group discussions (FGDs) including in total 12 participants and analysed using content analysis. Six categories were identified describing the aim: sparing the patients' physical harm, sparing the patients' psychological distress, involving the patients in the procedure, improving the working environment for personnel, preventing unethical situations and a more adequate utilization of resources. All participants considered LD of the surgical site as a favorable method to FBD, witnessing of an increased wellbeing in patients and the method facilitating a better involvement of patients in the procedure, findings that are supported by other studies promoting person-centered care. [ABSTRACT FROM AUTHOR]

The environment consists of a variety of different compartments and processes that act together in a complex system that complicate the environmental risk assessment after a chemical accident. The Environment-Accident Index (EAI) is an example of a tool based on a strategy to join the properties of a chemical with site-specific properties to facilitate this assessment and to be used in the planning process. In the development of the EAI it is necessary to make an unbiased judgement of relevant variables to include in the formula and to estimate their relative importance. The development of EAI has so far included the assimilation of chemical accidents, selection of a representative set of chemical accidents, and response values (representing effects in the environment after a chemical accident) have been developed by means of an expert panel. The developed responses were then related to the chemical and site-specific properties, through a mathematical model based on multivariate modelling (PLS), to create an improved EAI model. This resulted in EAInew, a PLS based EAI model connected to a new classification scale. The advantages of EAInew compared to the old EAI (EAIold) is that it can be calculated without the use of tables, it can estimate the effects for all included responses and make a rough classification of chemical accidents according to the new classification scale. Finally EAInew is a more stable model than EAIold, built on a valid base of accident scenarios which makes it more reliable to use for a variety of chemicals and situations as it covers a broader spectra of accident scenarios. EAInew can be expressed as a regression model to facilitate the calculation of the index for persons that do not have access to PLS. Future work can be; an external validation of EAInew; to complete the formula structure; to adjust the classification scale; and to make a real life evaluation of EAInew. [Copyright &y& Elsevier]

Genetic sequencing is identifying an expanding number of variants of GABA A receptors associated with human epilepsies. We identified a new de novo variant of the β2 subunit (β2L51M) of the inhibitory GABA A receptor associated with seizures. Our analysis determined the pathogenicity of the variant and the effects of anti-seizure medications. Our data demonstrates that the variant reduced cell surface trafficking and peak GABA-gated currents. Synaptic currents mediated by variant-containing receptors decayed faster than wild-type and single receptor currents showed that the variant shortened the duration of receptor activity by decreasing receptor open times. We tested the effects of the anti-seizure medications, midazolam, carbamazepine and valproate and found that all three enhance variant receptor surface expression. Additionally, midazolam restored receptor function by increasing single receptor active periods and synaptic current decay times towards wild-type levels. By contrast, valproate increased synaptic peak currents, event frequency and promoted synaptic bursting. Our study identifies a new disease-causing variant to the GABA A receptor, profiles its pathogenic effects and demonstrates how anti-seizure drugs correct its functional deficits. [Display omitted] • Through genetic screening we have discovered a new variant to the gene (GABRB2) that encodes the β2 subunit (p.Leu51Met) of the GABA A receptor. • The variant reduced cell surface expression, peak currents and synaptic current decay. • Midazolam, carbamazepine and valproate enhanced surface expression of this variant. • Midazolam restored the synaptic decay times of the variant by prolonging the active duration of single GABA A receptors. • Valproate enhanced synaptic currents of the variant and promoted synaptic bursting, thus strengthening GABAergic input. [ABSTRACT FROM AUTHOR]

The G protein-coupled receptor (GPCR) superfamily is an important drug target that includes over 1000 membrane receptors that functionally couple extracellular stimuli to intracellular effectors. Despite the potential of extracellular surface (ECS) residues in GPCRs to interact with subtype-specific allosteric modulators, few ECS pharmacophores for class A receptors have been identified. Using the turkey β1-adrenergic receptor crystal structure, we modeled the α1B-adrenoceptor (α1B-AR) to help identify the allosteric site for ρ-conopeptide TIA, an inverse agonist at this receptor. Combining mutational radioligand binding and inositol 1-phosphate signaling studies, together with molecular docking simulations using a refined NMR structure of ρ-TIA, we identified 14 residues on the ECS of the α1B-AR that influenced ρ-TIA binding. Double mutant cycle analysis and docking confirmed that ρ-TIA binding was dominated by a salt bridge and cation-π between Arg-4-ρ-TIA and Asp-327 and Phe-330, respectively, and a T-stacking-π interaction between Trp-3-ρ-TIA and Phe-330. Water-bridging hydrogen bonds between Asn-2-ρ-TIA and Val-197, Trp-3-ρ-TIA and Ser-318, and the positively charged N terminus and Glu-186, were also identified. These interactions reveal that peptide binding to the ECS on transmembrane helix 6 (TMH6) and TMH7 at the base of extracellular loop 3 (ECL3) is sufficient to allosterically inhibit agonist signaling at a GPCR. The ligand-accessible ECS residues identified provide the first view of an allosteric inhibitor pharmacophore for α1-adrenoceptors and mechanistic insight and a new set of structural constraints for the design of allosteric antagonists at related GPCRs. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine and compare the degree of swelling and the swelling kinetics of poly(ethylene oxide) (PEO) hydrophilic matrix tablets without any additives for matrixes with different molecular weight polydispersities. A wide range of “mixed” polydisperse PEO tablets were obtained by mixing two PEO batches with average molecular weights of 105 and 2 × 106, respectively. These were compared with “single-batch” tablets with narrower mono-modal molecular weight distributions. A texture analyzer (TA) was used to determine, during the entire dissolution process, the thickness of the “gel” layer, the height of the dry tablet core and the total height of the tablet. The release of polymer from the tablet was also measured using a chromatographic method. Both the swelling histories and the polymer release rates varied strongly with molecular weight and agitation rate, whereas the rate of dissolution of the solid core varied much less with molecular weight. For single-batch and mixed tablets, tuned to give the same release rate, the swelling process was found to be very similar, regardless of the molecular polydispersity (between 1.2 and 8.8). These results support a previously proposed dissolution model with the key assumption of a constant critical viscosity, independent of time or polymer molecular weight, at the surface of the gel layer of a dissolving tablet. © 2009 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 99: 1225–1238, 2010 [ABSTRACT FROM AUTHOR]

We report the discovery of conopressin-T, a novel bioactive peptide isolated from Conus tulipa venom. Conopressin-T belongs to the vasopressin-like peptide family and displays high sequence homology to the mammalian hormone oxytocin (OT) and to vasotocin, the endogenous vasopressin analogue found in teleost fish, the cone snail's prey. Conopressin-T was found to act as a selective antagonist at the human V1a receptor. All peptides in this family contain two conserved amino acids within the exocyclic tripeptide (Pro7 and Gly9), which are replaced with Leu7 and Val9 in conopressin-T. Whereas conopressin-T binds only to OT and V1a receptors, an L7P analogue had increased affinity for the V1a receptor and weak V2 receptor binding. Surprisingly, replacing Gly9 with Val9 in OT and vasopressin revealed that this position can function as an agonist/antagonist switch at the V1a receptor. NMR structures of both conopressin-T and L7P analogue revealed a marked difference in the orientation of the exocyclic tripeptide that may serve as templates for the design of novel ligands with enhanced affinity for the V1a receptor. [ABSTRACT FROM AUTHOR]

Previously, we showed that no two of seven opioids administered by the intracerebroventricular route had the same potency rank order for evoking antinociception, constipation and respiratory depression in rats. To gain insight at the cellular level, this study was designed to systematically investigate the activity profiles of six commonly used opioid ligands using the forskolin-stimulated cAMP assay and a β-arrestin2 recruitment assay in cultured HEK-293 cells transfected with MOP(μ), DOP(δ) or KOP(κ) receptors(-r). Morphine was a potent agonist at the MOP-r in the cAMP assay whereas it was a weak agonist at the KOP-r and DOP-r. Oxycodone had moderate efficacy and low potency at the MOP-r. Buprenorphine was a potent MOP-r and DOP-r agonist; its efficacy rank order was DOP > MOP > KOP. Fentanyl was a potent agonist at the MOP-r; its efficacy rank order was MOP > DOP > KOP. For DPDPE, its agonist efficacy was confined to the DOP-r, whereas for U69593, its efficacy rank order was KOP>> MOP. For the β-arrestin2 assay, fentanyl had full efficacy at the MOP-r whereas morphine and oxycodone were weak with insignificant efficacy at DOP and KOP receptors. Buprenorphine did not recruit β-arrestin2 at all three opioid-receptors. DPDPE and U69593 had full efficacy for β-arrestin2 recruitment to the DOP-r and KOP-r respectively. Despite the low efficacy and potency of morphine, oxycodone and buprenorphine in recruiting β-arrestin2 to the MOP-r herein, these opioids all evoked respiratory depression and constipation in rats. Together, our findings discount a key role for β-arrestin2 recruitment at the MOP-r in evoking opioid-related side-effects. [ABSTRACT FROM AUTHOR]