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Purpose: The purpose of this research was to evaluate the impact of a nurse-directed approach to patient education, which focused on lifestyle modification, daily weight management, diet, and medication compliance to improve the quality of life (QOL) and functional capacity in people with heart failure. Data sources: This was a prospective quasiexperimental multicenter research study of 23 patients comparing a nurse-directed care (NC) group (n= 13), which received comprehensive disease management education and weekly telephone follow-up, and the routine care (RC) group (n= 10) that received protocol-driven medical management. The study length was 12 months. Conclusions: Analysis of covariance (ANCOVA) was used to test for equality of variance-covariance matrices in the study population over time. ANCOVA measured baseline and two data intervals for a total of 9 months between the control and experimental (NC and RC) groups. There was statistically significant improvement in the NC group for the domains of total QOL: F= 3.569, p= 0.000; health and function: F= 3.995, p= 0.003; social and economic: F= 14.109, p= 0.000; psychological and spiritual: F= 13.212, p= 0.000; and family: F= 2.384, p= 0.048. Functional capacity was not significantly impacted by the study team interventions (F= 0.228, p= 0.949). Implications for practice: Results indicate that nurse-directed patient education was effective in improving QOL. A nurse-directed treatment strategy significantly improves patients' role in symptom control and disease self-management. [ABSTRACT FROM AUTHOR]

Postoperative analgesia for male circumcision surgery has been traditionally provided by a landmark based Dorsal Penile Nerve Block (DPNB-LM) (1) or by Caudal Epidural Analgesia (CEA). In this study we report on a retrospective analysis of the effectiveness and safety of CEA, DPNB-LM and Dorsal Penile Nerve block – Ultrasound guided (DPNB-US) in our institution over a 6 year period. Information was gathered from each patient's medical record. A total of 216 circumcisions were performed on patients aged from 5 months to 15 years. A total of 115 patients received CEA, 46 DPNB-LM and 55 DPNB-LM. Patients in the DPNB-LM group required rescue morphine administration in the Recovery unit more frequently (30.4%) than either the DPNB-US (3.5%) or CEA groups (3.6%). Similarly, the DPNB-LM group required a larger total dose of morphine, and had longer recovery ward stays than CEA or DPNB-US groups. Time to first analgesia was greatest for the CEA group whilst there was no significant difference between time to first analgesia for DPNB-LM and DPNB-US. About 63% of patients in the DPNB-LM group, 1.7% of CEA and 5.5% of the DPNB-US required intraoperative opiates ( P<0.0001). There was no difference in time to hospital discharge. Reference 1 Sandeman DJ, Dilley AV. Ultrasound guided dorsal penile nerve block in children. Anaesth Int Care 2007; 35(2): 266–269. [ABSTRACT FROM AUTHOR]

Recently, multi-target directed ligands have been of research interest for multifactorial disorders such as Alzheimer's disease (AD). Since H 3 receptors (H 3 Rs) and cholinesterases are involved in pathophysiology of AD, identification of dual-acting compounds capable of improving cholinergic neurotransmission is of importance in AD pharmacotherapy. In the present study, H 3 R antagonistic activity combined with anticholinesterase properties of two previously computationally identified lead compounds, that is, compound 3 (6-chloro-N-methyl-N-[3-(4-methylpiperazin-1-yl)propyl]-1H-indole-2-carboxamide) and compound 4 (7-chloro-N-[(1-methylpiperidin-3-yl)methyl]-1,2,3,4-tetrahydroisoquinoline-2-carboxamide), was tested. Moreover, molecular docking and binding free energy calculations were conducted for binding mode and affinity prediction of studied ligands toward cholinesterases. Biological evaluations revealed inhibitory activity of ligands in nanomolar (compound 3: H 3 R EC 50  = 0.73 nM; compound 4: H 3 R EC 50  = 31 nM) and micromolar values (compound 3: AChE IC 50  = 9.09 µM, BuChE IC 50  = 21.10 µM; compound 4: AChE IC 50  = 8.40 µM, BuChE IC 50  = 4.93 µM) for H 3 R antagonism and cholinesterase inhibition, respectively. Binding free energies yielded good consistency with cholinesterase inhibitory profiles. The results of this study can be used for lead optimization where dual inhibitory activity on H 3 R and cholinesterases is needed. Such ligands can exert their biological activity in a synergistic manner resulting in higher potency and efficacy., (© 2019 John Wiley & Sons Ltd.)

Histamine H 3 receptors (H 3 R), belonging to G-protein coupled receptors (GPCR) class A superfamily, are responsible for modulating the release of histamine as well as of other neurotransmitters by a negative feedback mechanism mainly in the central nervous system (CNS). These receptors have gained increased attention as therapeutic target for several CNS related neurological diseases. In the current study, we aimed to identify novel H 3 R ligands using in silico virtual screening methods. To this end, a combination of ligand- and structure-based approaches was utilized for screening of ZINC database on the homology model of human H 3 R. Structural similarity- and pharmacophore-based approaches were employed to generate compound libraries. Various molecular modeling methodologies such as molecular docking and dynamics simulation along with different drug likeness filtering criteria were applied to select anti-H 3 R ligands as promising candidate molecules based on different known parent lead compounds. In vitro binding assays of the selected molecules demonstrated three of them being active within the micromolar and submicromolar K i range. The current integrated computational and experimental methods used in this work can provide new general insights for systematic hit identification for novel anti-H 3 R agents from large compound libraries., (© 2018 John Wiley & Sons A/S.)