Synthesis, Anti-Cancer and Anti-Migratory Evaluation of 3,6-Dibromocarbazole and 5-Bromoindole Derivatives.

In this study, a new series of N-alkyl-3,6-dibromocarbazole and N-alkyl-5-bromoindole derivatives have been synthesized and evaluated in vitro as anti-cancer and anti-migration agents. Cytotoxic and anti-migratory effects of these compounds were evaluated in MCF-7 and MDA-MB-231 breast cancer cell lines and an insight on the structure-activity relationship was developed. Preliminary investigations of their anti-cancer activity demonstrated that several compounds have moderate antiproliferative effects on cancer cell lines with GI50 values in the range of 4.7-32.2 µM. Moreover, carbazole derivatives 10, 14, 15, 23, and 24 inhibit migration activity of metastatic cell line MDA-MB-231 in the range of 18-20%. The effect of compounds 10, 14, and 15 in extension of invadopodia and filopodia was evaluated by fluorescence microscopy and results demonstrated a reduction in actin-based cell extensions by compounds 10 and 15.

Hospital antimicrobial stewardship: profiling the oral microbiome after exposure to COVID-19 and antibiotics.

Introduction: During the COVID-19 Delta variant surge, the CLAIRE cross-sectional study sampled saliva from 120 hospitalized patients, 116 of whom had a positive COVID-19 PCR test. Patients received antibiotics upon admission due to possible secondary bacterial infections, with patients at risk of sepsis receiving broad-spectrum antibiotics (BSA). Methods: The saliva samples were analyzed with shotgun DNA metagenomics and respiratory RNA virome sequencing. Medical records for the period of hospitalization were obtained for all patients. Once hospitalization outcomes were known, patients were classified based on their COVID-19 disease severity and the antibiotics they received. Results: Our study reveals that BSA regimens differentially impacted the human salivary microbiome and disease progression. 12 patients died and all of them received BSA. Significant associations were found between the composition of the COVID-19 saliva microbiome and BSA use, between SARS-CoV-2 genome coverage and severity of disease. We also found significant associations between the non-bacterial microbiome and severity of disease, with Candida albicans detected most frequently in critical patients. For patients who did not receive BSA before saliva sampling, our study suggests Staphylococcus aureus as a potential risk factor for sepsis. Discussion: Our results indicate that the course of the infection may be explained by both monitoring antibiotic treatment and profiling a patient's salivary microbiome, establishing a compelling link between microbiome and the specific antibiotic type and timing of treatment. This approach can aid with emergency room triage and inpatient management but also requires a better understanding of and access to narrow-spectrum agents that target pathogenic bacteria.

Evaluation of the Timing of Opioid Administration: A Pilot Study.

OBJECTIVE: Approximately 20% of the errors committed at hospitals are attributed to medication error, which is one of the main things threatening the safety of patients. Every hospital has a list of medications that are considered time-critical scheduled medications. Opioids with a specific schedule of administration are included on these lists. These medications are used to treat patients with chronic or acute pain. Any variation in the established schedule can cause undesired effects in patients. The objective of this study was to assess the compliance rate of opioid administration; that is, determine whether these medications were being administered within the appropriate window (30 minutes on either side of the scheduled time). METHODS: The data were collected by reviewing the handwritten medical records of all the hospitalized patients who received time-critical opioids from August 2020 through May 2021 at a specialty cancer hospital. RESULTS: In total, 63 interventions were evaluated. Of the 10 months included in the analysis, the percentage of administration required by the institution and accrediting agencies (95%) was met in 3. September was the month with the lowest rate of compliance, this being 57%. CONCLUSION: The study demonstrated low compliance in terms of the administration time of scheduled opioids. These data will help the hospital institution to find areas that can be improved to achieve better accuracy in the administration of this category of drugs.