The S.L.E.E.P.ing Beauty: new Research Idea suggests sedation-led chemotherapy to avoid pain

Photo by National Cancer Institute (NIH, USA) on Unsplash.

Blog post by Dr. Marco Cirillo, Heart Failure Surgery Unit Director at the Cardiovascular Department in Poliambulanza Foundation Hospital (Brescia, Italy)

Good morning, madam,” said the doctor greeting the patient who was entering his office. 

Good morning, Doctor,” she replied. 

So, how are you?” he asked her, motioning for her to sit in one of the two chairs in front of his desk. 

Well, it’s not bad.” 

The doctor looked at her carefully. 

So, this first dose of chemo… Did you tolerate it well, right?” 

“Yes, Doctor. I passed it…” 

Troubles? Nausea? Vomiting? Other problems?” 

No, Doctor. Nothing,” she replied. 

The doctor continued to watch her carefully. After her last answer he got up and went to sit next to her in the other chair that was in front of his desk. He took her hand and asked her again: 

So, madam: how are you?

The patient shook his hand as if in silent thanks. 

Doctor, you are a good doctor.” 

I’m here to understand what you need, madam, what can I do for you.” 

The patient thought a little longer before speaking. 

So, Doctor: the chemo didn’t bother me much, maybe because it’s the first one. Except that… In short, what was difficult was waiting together with the others, all talking about their tumor, where they have it, what chemo they are at, what happened to them, then the hairless ones with the turban on their heads, and how much hemoglobin you have, and what your husband said, and if they recognized you without hair…” 

I understand, madam. But it’s also a way to exorcise it, isn’t it? A way to share this bad experience, to not feel alone…” 

She looked him directly in the eyes.

Doctor, we are not all the same. These things bother me. Seeing how I will be in a month scares me. It doesn’t solace me to know that someone is sicker than me. And knowing that someone is better terrifies me…” 

The doctor nodded his head. 

I don’t want to think about my illness and when I come here, I necessarily think about it. I have to think about it. At home I do many things, I see many people, I may not think about it. But when I come here… Then for days I see these scenes in front of me, as if I’ve never left… Believe me, I do not simply ignore the disease, I know what I have and what awaits me. But if I could, I would avoid everything in between, between me and my illness. Do you understand?

Of course, madam. I understand. For others it is the same thing.” 

They went silent for a while. 

Then, the doctor said: 

If you had a choice, ma’am, what would you want? What would make you bear it all better?” 

She answered immediately, as if she had the answer ready. 

If I could, I would like to fall asleep and wake up when it’s all over! Don’t see the others, don’t even see the hospital, don’t hear what the nurses say, don’t see the drip, don’t feel the needle entering, don’t see the drop of poison that I have to let into my body to try to survive… Don’t feel the time passing so slowly, as slow as the drop of the drip, a time ‘lost’ that is part of the little time I still have left… I am forced to hope that this time will pass quickly, but at the same time I know that it is not convenient for me to pass quickly, because even this time of treatment is taken away from my life. From what remains of it…

The doctor released her hand and leaned back in his chair. 

The lady asked him: 

Did I say something wrong?” 

No, madam, on the contrary,” said the doctor. “You told me something wonderful.” 

Ah, really? It sounds trivial to me…” 

No, what a patient says when he talks about himself and his illness is never trivial. You gave me a very good idea, madam.” 

Indeed?” 

Sure! What you ask can be done.” 

That is…” 

I can set up a study in which to administer chemo during sleep and analyze the results,” the doctor said, then corrected himself by translating his words into more direct language. “Sorry: I can make you sleep during the treatment, maybe set the treatment during night, so it doesn’t alter your days. And then you will wake up when it’s all over. That wouldn’t prevent some side effects…” 

…but it would prevent me from living consciously at the time of treatment,” the patient completed. 

Sure,” the doctor confirmed. 

Like the Sleeping Beauty…” the patient said. “You know the tale, don’t you?” 

Sure, who doesn’t know it.” 

The fairy godmothers cannot avoid the evil witch’s curse, so they make her fall asleep instead of die. Waiting for a solution,” the patient sighed deeply. “So, Doctor, if you can eliminate the evil that hangs over me, do it. Otherwise, let me sleep before the spinning wheel stings me.” 

The doctor looked at her with a grateful look. He had always felt that not only did he do something for the patients every day, but the patients also did something for him every day. 

Would you do this for me, Doctor?” 

The doctor smiled. 

Of course, ma’am. For you and for all the people who want it. Just give me some time to organize this.” 

Take your time” the lady said enthusiastically, but soon after she added with a wink: “No, on the contrary: hurry up, I wouldn’t want to waste any more time…” 

**

Every doctor’s job is to heal diseases. When it is not possible to heal them, the best cure is to relieve the suffering. In Oncology, this second option is still extremely important. The psychological aspect of dealing with something that is often not guaranteed to heal is crucial. 

This project aims to extend the concept of “care” by approaching the patient and his/her needs: it is not the patient who has to adapt to the hospital’s schemes, its timing, its protocols, but it is the hospital that must serve the patients, to “take care” after their problem in its multidimensionality.  

The disease derails the life of the patient in a decisive way. We must as far as possible try to “sew in” the disease element into their everyday life,  if we want them to experience it as something that is part of normal life. This can make them tolerate it better and perhaps improve the chances of overcoming it. 

Here, this is the concept behind my research idea.

The study could be initially applied to a selected series of patients, and then extended, if the results are promising. 

Certainly, there are some practical limitations related to this study. Arranging the administration during sleep requires many “beds”; it requires specialized nursing staff; if it is carried at home, it also needs allocating specialists for home visits.

It is true, however, that home care for cancer patients is already very common in advanced healthcare systems. Economic investment and funding of cancer research and treatment remain at the top, along with cardiovascular diseases, in all healthcare systems. 

Cancer Centers nowadays abound around the world and are increasing in numbers. Comprehensive Cancer Centers, which are the largest in America, carry out transdisciplinary research, recognizing the importance of integrating different knowledge together for more effective treatment. The assistance and therapeutic network, the shared protocols, the sector research in Oncology already boast a very high level today. The coordination between centers makes use of all that assistance know-how. If I have to think of a medical field in which research, assistance, network of knowledge and uniformity of treatment are the most coordinated and efficient, this field is undoubtedly the oncology one. 

I would gladly give my scientific contribution by collaborating with centers of Excellence and their teams, who would like to join me on this research project. I would also readily share some organizational ideas by integrating them with the specific knowledge of colleague oncologists. Let’s fight the curse and help people to bear it with the least physical and psychological suffering!

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Read the full Research Idea in Research Ideas and Outcomes (RIO Journal) at: https://doi.org/10.3897/rio.7.e71271

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Full citation:
Cirillo M (2021) Sedation-Led chEmotherapy Evades Pain (S.L.E.E.P.). Research Ideas and Outcomes 7: e71271. https://doi.org/10.3897/rio.7.e71271

Bulgarian Pharmaceutical Scientific Society’s journal moves to high-tech ARPHA platform

Bulgarian Pharmaceutical Scientific Society’s journal join the high-tech ARPHA platform and the fast-expanding portfolio of scholarly titles by Pensoft.Bulgarian Pharmaceutical Scientific Society’s journal join the high-tech ARPHA platform and the fast-expanding portfolio of scholarly titles by Pensoft.

The established Pharmacia demonstrates a complete makeover in its new issue after signing with scientific publisher and technology provider Pensoft and its signature open-access platform

Launched by the Bulgarian Pharmaceutical Scientific Society in 1954, the open-access, peer-reviewed Pharmacia has been available online as full text since 2007. As of 2019, the journal moves to the fast-expanding portfolio of scholarly publisher and technology provider Pensoft. The journal’s 2019 inaugural issue and the first since the realisation of the new partnership is already live on the journal’s new website.

Homepage of Pharmacia‘s new website, https://pharmacia.pensoft.net

Thanks to the Pensoft’s signature open-access scholarly publishing platform ARPHA, Pharmacia demonstrates a complete makeover, including a modern and user-friendly interface in addition to a long list of high-tech perks, meant to ensure that published articles are easy to discover, access, cite and reuse by both humans and machines all over the world.

Furthermore, all users of the journal’s system: authors, editors and reviewers alike, are to greatly benefit of ARPHA’s integrated approach to the publication process. This means that once submitted each manuscript goes through the whole cycle: from review and copy/layout editing to publication, dissemination and archiving without leaving ARPHA’s collaboration-focused online environment.

One of the interesting features now available in Pharmacia is the article-level metrics available thanks to the partnership between ARPHA and the revolutionary discovery and analytics tools Dimensions and Altmetric. By searching through millions of research articles, grant applications, clinical trials, as well as policy documents, news stories, blogs and social media posts, they allow for each article’s references and citations in both the academic and the public sphere to be monitored in real time.

Continuing its tradition, the journal welcomes original research and review articles, preliminary and short communications (notes) on a wide range of topics within the pharmaceutical and related sciences. In addition, the journal also publishes conference reports, biographies and book reviews. Articles in Pharmacia are published in English and subjected to single-blind peer review.

Pharmacia‘s Editor-in-Chief Prof Plamen Peikov, comments:

“We have been looking forward to our collaboration with Pensoft and ARPHA, as it is certainly going to not only help modernise Pharmacia on the outside, but also make it more appealing to our authors and readers by building on the journal’s accessibility and global outreach. I believe that this nice step forward is already clearly evident in Pharmacia‘s latest issue.”

ARPHA’s and Pensoft’s founder and CEO Prof Lyubomir Penev says:

“I’m delighted to see this particular journal joining the Pensoft’s and ARPHA’s family,” says ARPHA’s and Pensoft’s founder and CEO Prof. Lyubomir Penev. “With our strong background in scholarly publishing, technology development and open science practices, I am certain that we are able to provide the right venue for a high-quality and enterprising journal like Pharmacia.”

What’s on in the new issue?

The creeping cinquefoil – a perennial plant from the Northern hemisphere – has its status as a traditional medicine for treating diarrhoea, haemorrhoids and bleeding gums confirmed in a collaborative ethnobotanical study by researchers at the Bulgarian Academy of Sciences and the Medical University of Sofia (Bulgaria). Further, the team, led by Irena Mincheva, seek to explore the suggested use of the plant against mastitis: a relatively common disease and a major cause for milk reduction in both people and dairy cows.

Another paper, authored by Dr Illya Podolsky and Sergiy Shtrygol from the National University of Pharmacy in Ukraine, adds new information about “the pharmacological nature” of a molecule already known as a promising antidepressant with a unique spectrum of additional properties. By conducting an experiment in rats, using the preferred Morris water maze assessment method, the scientists study the effects of Atristamine on spatial memory and learning.

Pharmacia‘s latest issue is available on the new website. Available in HTML, XML and PDF formats, the articles are easy to find, access, mine, reuse and cite by both humans and computers. Check out the issue at: https://pharmacia.pensoft.net/issue/1757/.

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Pharmacia is indexed byScopusAltmetricBiotechnobaseCAplusSM/Chemical AbstractsCNKICrossRefDimensionsEBSCOhostEmbase, ExtraMED, Google ScholarJ-GateMEDLINE/PubMedMendeleyMicrosoft AcademicNaviga (Softweco)OpenAIREPascalReadCubeToxcenterUnpaywall.

About the Bulgarian Pharmaceutical Scientific Society:

The Bulgarian Pharmaceutical Scientific Society was registered in 2003 with the aim to organise national and international science forums, support education and publish academic literature. Its main objectives are to organise and encourage pharmacological research and support collaboration between pharmacology professionals and related organisations on both national and global level.

New promising compound against heart rhythm disorders and clogged arteries

The pharmacological agent outperforms current drugs in most of cases, show multiple experiments

A new pharmacological agent demonstrates promising results for the prevention of a wide range of heart rhythm disorders, including both cardiac and brain injury-induced arrhythmias. Furthermore, the compound (SS-68) demonstrates significant activity in conditions of reduced blood flow to the heart caused by obstructed arteries.

The study, conducted by a research team led by Dr Saida Bogus of the Kuban State Medical University in Russia, is published in the open-access journal Research Results in Pharmacology.

Each year, more than 17 million people from around the globe (mostly Europe and the USA) die of cardiovascular diseases and related complications, according to the World Health Organization. In Russia, about 3 out of 1,000 people suffer from the most common and malignant heart rhythm disorder: atrial fibrillation (AF), where the count is expected to at least double in the next 30 years. While sometimes lacking symptoms, atrial fibrillation could generally be recognised by a racing, irregular heartbeat, dizziness, fatigue, shortness of breath and chest pain, thereby largely compromising the quality of one’s life. The disorder could also lead to various complications, including dementia, stroke and heart failure.

Currently, the drugs administered to AF patients have major deficiencies, including narrow therapeutic windows, which means that even minimal imprecision in the dosage could result in unacceptable toxicity. Hence, patients need to be closely monitored and have their doses adjusted on a regular basis.

In their study, the team turned to the aminoindole derivatives to look for an alternative compound. This chemical group has already shown a significant potential in terms of cardio-pharmacological activity.

Having tested the SS-68 compound on multiple occasions in different animals, the researchers report that it has a pronounced antiarrhythmic effect and is able to bring the electrical activity of the heart back to normal and, in most cases, outperforming the reference drugs used in clinical practice: amiodarone, lidocaine, aymaline, ethacizine, etmozine and quinidine anaprilin.

Further, in brain injury-induced arrhythmias, the compound was found to reduce the episodes of epilepsy. It was also observed to have a positive effect in clogged blood vessels where it is reported to have successfully increased the coronary blood flow. In addition, the compound managed to decrease the area of necrosis in the heart tissue caused by a heart attack.

“To date, there have been significant achievements of Russian and foreign pharmacologists, chemists and clinicians in creating and introducing into the practical medicine a number of antiarrhythmic drugs different by their chemical structure, nature, spectrum, activity and mechanism of action; nevertheless, one of the most important tasks of modern pharmacology is searching for and developing new highly active substances of the corresponding action,” explain the scientists.

“Special attention should be paid to an in-depth study of the molecular mechanisms of action of this compound,” they conclude.

A paper looking further into the molecular mechanisms of the antiarrhythmic action of SS-68 prepared by the same research team is currently in press with Research Results in Pharmacology.

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Original source:

Bogus SK, Galenko-Yaroshevsky PA, Suzdalev KF, Sukoyan GV, Abushkevich VG (2018) 2-phenyl-1-(3-pyrrolidin-1-il-propyl)-1 H-indole hydrochloride (SS-68): Antiarrhythmic and cardioprotective activity and its molecular mechanisms of action (Part I). Research Results in Pharmacology 4(2): 133-150. https://doi.org/10.3897/rrpharmacology.4.2859

Six new sponge species and new symbiotic associations from the Indonesian coral triangle

Comprising more than 17,000 islands, the Indonesian archipelago is one of the world’s most biodiverse places on Earth.

Sponges, aquatic organisms whose bodies consist of numerous pores to allow the ingress of water, are key components of this richness and play a fundamental role in the survival of coral reef habitats. Furthermore, they are also known for their medicinal benefits.

Unfortunately, due to the paucity of taxonomic expertise, the sponges from the Indonesian reefs are often ignored in monitoring surveys and conservation programmes, while their diversity is largely underestimated.

Researchers from the Italian Università Politecnica delle Marche and Università degli Studi di GenovaPharmaMar, Spain, and University of Sam Ratulangi, Indonesia, describe six new species in their paper in the open access journal, ZooKeys.

Inspired by their extraordinary biodiversity, the researchers teamed up with the pharmaceutical company PharmaMar to conduct several expeditions in the waters of North Sulawesi Island.

Psammocinia albaThe authors reported a total of 94 demosponge species belonging to 33 families living in the North Sulawesi Island. Amongst them, there are six species new to science and two previously unknown symbiotic relationships.

Seven of the recorded species were collected for the very first time since their original description.

However, these findings are still scarce, given the abundance of the sponges in similar localities in the Indonesian archipelago.

In conclusion, the authors note that the marine diversity in Indonesia is still far from being well known.

“Thanks to this impressive diversity, these areas are important spots for diving tourism and require the urgent development of sustainable tourism practices,” they say.

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Original source:

Calcinai B, Bastari A, Bavestrello G, Bertolino M, Horcajadas SB, Pansini M, Makapedua DM, Cerrano C (2017) Demosponge diversity from North Sulawesi, with the description of six new species. ZooKeys 680: 105-150. https://doi.org/10.3897/zookeys.680.12135