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  Subjects -> ALTERNATIVE MEDICINE (Total: 111 journals)
Showing 1 - 15 of 15 Journals sorted alphabetically
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 8)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 10)
Acupuncture in Medicine     Hybrid Journal   (Followers: 19)
Advanced Herbal Medicine     Open Access   (Followers: 8)
Advances in Traditional Medicine     Hybrid Journal   (Followers: 8)
African Journal of Traditional, Complementary and Alternative Medicines     Open Access   (Followers: 7)
Akupunktur & Aurikulomedizin     Full-text available via subscription   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 3)
Alternative & Integrative Medicine     Open Access   (Followers: 16)
Alternative and Complementary Therapies     Hybrid Journal   (Followers: 22)
Alternative Medicine     Full-text available via subscription   (Followers: 4)
Alternative Medicine Studies     Open Access   (Followers: 14)
Anales de Hidrología Médica     Open Access   (Followers: 2)
Ancient Science of Life     Open Access   (Followers: 6)
Arabian Journal of Medicinal and Aromatic Plants     Open Access   (Followers: 4)
Arteterapia. Papeles de arteterapia y educación artística para la inclusión social     Open Access   (Followers: 5)
Asian Journal of Plant Pathology     Open Access   (Followers: 4)
Australian Journal of Acupuncture and Chinese Medicine     Full-text available via subscription   (Followers: 4)
Australian Journal of Herbal Medicine     Full-text available via subscription   (Followers: 5)
Australian Journal of Music Therapy     Full-text available via subscription   (Followers: 11)
Avicenna Journal of Phytomedicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
BMC Complementary and Alternative Medicine     Open Access   (Followers: 23)
Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas     Open Access   (Followers: 2)
Botanics : Targets and Therapy     Open Access   (Followers: 6)
Cadernos de Naturologia e Terapias Complementares     Open Access   (Followers: 1)
Chinese Herbal Medicines     Full-text available via subscription   (Followers: 1)
Chinese Medicine     Open Access   (Followers: 5)
Cognitive Neuroscience     Hybrid Journal   (Followers: 31)
Complementary Therapies in Clinical Practice     Hybrid Journal   (Followers: 23)
Complementary Therapies in Medicine     Hybrid Journal   (Followers: 19)
Current Traditional Medicine     Hybrid Journal   (Followers: 5)
Deutsche Heilpraktiker-Zeitschrift     Hybrid Journal   (Followers: 3)
Deutsche Zeitschrift für Akupunktur     Full-text available via subscription   (Followers: 2)
Erfahrungsheilkunde     Hybrid Journal   (Followers: 1)
European Journal of Medicinal Plants     Open Access  
Evidence-based Complementary and Alternative Medicine     Open Access   (Followers: 30)
Experimental and Therapeutic Medicine     Full-text available via subscription   (Followers: 1)
Fitoterapia     Hybrid Journal   (Followers: 9)
Focus on Alternative and Complementary Therapies     Hybrid Journal   (Followers: 12)
Global Journal of Integrated Chinese Medicine and Western Medicine     Open Access   (Followers: 1)
Global Journal of Traditional Medicine     Open Access   (Followers: 2)
Herba Polonica     Open Access   (Followers: 1)
Herbal Medicines Journal     Open Access   (Followers: 1)
Indian Journal of Research in Homoeopathy     Open Access   (Followers: 2)
Indian Journal of Traditional Knowledge (IJTK)     Open Access   (Followers: 2)
Innovare Journal of Ayurvedic Sciences     Open Access   (Followers: 10)
Intas Polivet     Full-text available via subscription   (Followers: 5)
Integrative Medicine Research     Open Access   (Followers: 3)
International Journal of Health and Medicine     Open Access   (Followers: 1)
International Journal of High Dilution Research     Open Access  
International Journal of Qualitative Studies on Health and Well-Being     Open Access   (Followers: 22)
International Journal of Yoga     Open Access   (Followers: 17)
International Journal of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 7)
Ipnosi     Full-text available via subscription  
Journal of Acupuncture and Herbs     Open Access   (Followers: 3)
Journal of Acupuncture and Meridian Studies     Open Access   (Followers: 1)
Journal of Acupuncture and Tuina Science     Hybrid Journal   (Followers: 4)
Journal of Alternative and Complementary Medicine     Hybrid Journal   (Followers: 17)
Journal of Applied Arts and Health     Hybrid Journal   (Followers: 1)
Journal of Applied Research on Medicinal and Aromatic Plants     Hybrid Journal   (Followers: 1)
Journal of Asian Natural Products Research     Hybrid Journal   (Followers: 5)
Journal of Ayurveda and Integrative Medicine     Open Access   (Followers: 7)
Journal of AYUSH :- Ayurveda, Yoga, Unani, Siddha and Homeopathy     Full-text available via subscription   (Followers: 10)
Journal of Bodywork and Movement Therapies     Hybrid Journal   (Followers: 18)
Journal of Complementary and Alternative Medical Research     Open Access   (Followers: 1)
Journal of Complementary and Integrative Medicine     Hybrid Journal   (Followers: 12)
Journal of Dance Medicine & Science     Full-text available via subscription   (Followers: 14)
Journal of Evidence-Based Integrative Medicine     Open Access   (Followers: 18)
Journal of Fasting and Health     Open Access   (Followers: 1)
Journal of Ginseng Research     Open Access  
Journal of Health Science and Alternative Medicine     Open Access   (Followers: 1)
Journal of Health Sciences Scholarship     Open Access  
Journal of Herbal Drugs (An International Journal on Medicinal Herbs)     Open Access   (Followers: 1)
Journal of Herbal Medicine     Hybrid Journal   (Followers: 2)
Journal of Herbal Science     Full-text available via subscription   (Followers: 6)
Journal of Integrative Medicine     Full-text available via subscription   (Followers: 4)
Journal of Integrative Medicine & Therapy     Open Access   (Followers: 2)
Journal of Manual & Manipulative Therapy     Hybrid Journal   (Followers: 17)
Journal of Medicinal Plants for Economic Development     Open Access  
Journal of Medicinally Active Plants     Open Access   (Followers: 2)
Journal of Natural Remedies     Open Access   (Followers: 3)
Journal of Nutraceuticals and Herbal Medicine     Open Access   (Followers: 4)
Journal of Palliative Medicine     Hybrid Journal   (Followers: 48)
Journal of the Australian Traditional-Medicine Society     Full-text available via subscription   (Followers: 1)
Journal of Traditional and Complementary Medicine     Open Access   (Followers: 4)
Journal of Traditional Chinese Medical Sciences     Open Access   (Followers: 1)
Journal of Yoga & Physical Therapy     Open Access   (Followers: 9)
Lekovite Sirovine     Open Access  
Médecine Palliative : Soins de Support - Accompagnement - Éthique     Full-text available via subscription   (Followers: 2)
Medical Acupuncture     Hybrid Journal   (Followers: 6)
Medicines     Open Access   (Followers: 1)
Mersin Üniversitesi Tıp Fakültesi Lokman Hekim Tıp Tarihi ve Folklorik Tıp Dergisi     Open Access  
Muller Journal of Medical Sciences and Research     Open Access  
Natural solutions     Full-text available via subscription  
Natural Volatiles & Essential Oils     Open Access   (Followers: 1)
Nigerian Journal of Natural Products and Medicine     Full-text available via subscription  
OA Alternative Medicine     Open Access   (Followers: 1)
Oriental Pharmacy and Experimental Medicine     Partially Free   (Followers: 3)
Research Journal of Medicinal Plant     Open Access   (Followers: 2)
Research Journal of Pharmacognosy     Open Access  
Revista Brasileira de Plantas Medicinais     Open Access   (Followers: 1)
Revista Internacional de Acupuntura     Full-text available via subscription  
South African Journal of Plant and Soil     Hybrid Journal   (Followers: 1)
Synfacts     Hybrid Journal   (Followers: 7)
Traditional & Kampo Medicine     Full-text available via subscription  
Traditional Medicine Journal     Open Access   (Followers: 2)
World Journal of Acupuncture - Moxibustion     Full-text available via subscription   (Followers: 1)
World Journal of Traditional Chinese Medicine     Open Access   (Followers: 1)
Yoga Mimamsa     Open Access   (Followers: 2)
Zeitschrift für Orthomolekulare Medizin     Hybrid Journal   (Followers: 2)

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Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2305-6320
Published by MDPI Homepage  [233 journals]
  • Medicines, Vol. 8, Pages 7: Acknowledgment to Reviewers of Medicines in

    • Authors: Medicines Editorial Office Medicines Editorial Office
      First page: 7
      Abstract: Peer review is the driving force of journal development, and reviewers are gatekeepers who ensure that Medicines maintains its standards for the high quality of its published papers [...]
      Citation: Medicines
      PubDate: 2021-01-20
      DOI: 10.3390/medicines8020007
      Issue No: Vol. 8, No. 2 (2021)
  • Medicines, Vol. 8, Pages 1: Predictive Effect of Helicobacter pylori in
           Gastric Carcinoma Development: Systematic Review and Quantitative Evidence

    • Authors: Laurens Holmes, Jasmine Rios, Betyna Berice, Jacqueline Benson, Nastocia Bafford, Kadedrah Parson, Daniel Halloran
      First page: 1
      Abstract: Helicobacter pylori (H. pylori) is a bacterial pathogen implicated in gastritis, gastric ulceration, and gastric carcinoma. This study aimed to synthesize literature in providing evidence on the causative role of H. pylori in gastric carcinoma development. This study is based on assessing public literature using an applied meta-analysis, namely, quantitative evidence synthesis (QES). The analytic procedure uses DerSimonian-Laird, including assessing heterogeneity. The QES also utilizes meta-regression and the environmental effect associated with H. pylori in gastric cancer development. Eighteen studies are included in the QES. There is increased prevalence of H. pylori exposure among the cases. The heterogeneity between the CES and individual effect sizes is also significant. Despite controlling for the confoundings, there is increased exposure to H. pylori among the gastric cancer cases, regardless of the differences in the geographic location. H. pylori in this synthesized literature illustrates the contributory role of this microbe in gastric carcinoma. Additionally, regardless of geographic locale, namely, South Korea or Spain, H. pylori is implicated in gastric cancer development.
      Citation: Medicines
      PubDate: 2021-01-05
      DOI: 10.3390/medicines8010001
      Issue No: Vol. 8, No. 1 (2021)
  • Medicines, Vol. 8, Pages 2: Erectile Dysfunction Treatment Using Stem
           Cells: A Review

    • Authors: Vassilis Protogerou, Dimosthenis Chrysikos, Vasileios Karampelias, Ypatios Spanidis, El Bisari Sara, Theodoros Troupis
      First page: 2
      Abstract: Erectile dysfunction (ED) is a disorder that affects the quality of life and the sexual relations of more than half of the male population aged over 40 years. The prediction regarding the incidence of ED is devastating as it is expected that this disorder will affect more than 300 million men in the next five years. Several studies have suggested the use of stem cells for the treatment of ED and showed that this type of treatment is promising in terms of damaged tissue repair as well as of clinical efficacy; however, there are several gaps in the knowledge and evidence is lacking. In order to highlight a few of them in this review, we performed a research of the literature focusing on currently available clinical studies regarding the clinical efficacy of stem cell administration for the treatment of ED. We reviewed the methods of administration, the cell types used in the performed clinical trials and the safety and efficiency of such procedures. We conclude that there are rapidly expanding and promising results from the reported clinical studies indicating that stem cells could indeed be a potential treatment for patients with ED although more studies are necessary.
      Citation: Medicines
      PubDate: 2021-01-06
      DOI: 10.3390/medicines8010002
      Issue No: Vol. 8, No. 1 (2021)
  • Medicines, Vol. 8, Pages 3: Neurogenic Erectile Dysfunction. Where Do We

    • Authors: Charalampos Thomas, Charalampos Konstantinidis
      First page: 3
      Abstract: Erectile Dysfunction (ED) is the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance, causing tremendous effects on both patients and their partners. The pathophysiology of ED remains a labyrinth. The underlying mechanisms of ED may be vasculogenic, neurogenic, anatomical, hormonal, drug-induced and/or psychogenic. Neurogenic ED consists of a large cohort of ED, accounting for about 10% to 19% of all cases. Its diversity does not allow an in-depth clarification of all the underlying mechanisms nor a “one size fits all” therapeutical approach. In this review, we focus on neurogenic causes of ED, trying to elucidate the mechanisms that lie beneath it and how we manage these patients.
      Citation: Medicines
      PubDate: 2021-01-07
      DOI: 10.3390/medicines8010003
      Issue No: Vol. 8, No. 1 (2021)
  • Medicines, Vol. 8, Pages 4: Risk Factors, Clinical Characteristics, and
           Prognosis of Acute Kidney Injury in Hospitalized COVID-19 Patients: A
           Retrospective Cohort Study

    • Authors: Panupong Hansrivijit, Kinjal P. Gadhiya, Mounika Gangireddy, John D. Goldman
      First page: 4
      Abstract: Background: Acute kidney injury (AKI) is a serious complication of COVID-19. Methods: Records of hospitalized adult patients with confirmed SARS-CoV-2 infection from 1 March to 31 May 2020 were retrospectively reviewed. Results: Of 283 patients, AKI occurred in 40.6%. From multivariate analyses, the risk factors of AKI in COVID-19 can be divided into: (1) demographics/co-morbidities (male, increasing age, diabetes, chronic kidney disease); (2) other organ involvements (transaminitis, elevated troponin I, ST segment/T wave change on electrocardiography); (3) elevated biomarkers (ferritin, lactate dehydrogenase); (4) possible bacterial co-infection (leukocytosis, elevated procalcitonin); (5) need for advanced oxygen delivery (non-invasive positive pressure ventilation, mechanical ventilation); and (6) other critical features (ICU admission, need for vasopressors, acute respiratory distress syndrome). Most AKIs were due to pre-renal (70.4%) and intrinsic (34.8%) causes. Renal replacement therapy was more common in intrinsic AKI. Both pre-renal (HR 3.2; 95% CI 1.7–5.9) and intrinsic AKI (HR 7.7; 95% CI 3.6–16.3) were associated with higher mortality. Male, stage 3 AKI, higher baseline and peak serum creatinine and blood urea nitrogen were prevalent in intrinsic AKI. Urine analysis and the fractional excretion of sodium and urea were not helpful in distinguishing intrinsic AKI from other causes. Conclusions: AKI is very common in COVID-19 and is associated with higher mortality. Characterization of AKI is warranted due to its diverse nature and clinical outcome.
      Citation: Medicines
      PubDate: 2021-01-07
      DOI: 10.3390/medicines8010004
      Issue No: Vol. 8, No. 1 (2021)
  • Medicines, Vol. 8, Pages 5: Encephalic Leukocytoclastic Vasculitis during
           Treatment with Sunitinib for Renal Cell Carcinoma: A Case Report

    • Authors: Maria Massucci, Veronica Mollica, Alessandro Rizzo, Laura Ventrella, Ilaria Maggio, Lisa Manuzzi, Lidia Gatto, Giovanni Brandi, Francesco Massari
      First page: 5
      Abstract: Renal cell carcinoma is a malignant tumor that arises in the kidney parenchyma. For many years, sunitinib has represented the mainstay of medical treatment for metastatic renal cell carcinoma. Herein, we present the case of a 66-year-old woman with metastatic clear cell renal carcinoma undergoing treatment with sunitinib for two years that developed encephalic leukocytoclastic vasculitis, probably due to a paraneoplastic syndrome.
      Citation: Medicines
      PubDate: 2021-01-11
      DOI: 10.3390/medicines8010005
      Issue No: Vol. 8, No. 1 (2021)
  • Medicines, Vol. 8, Pages 6: Primary Small Cell Carcinoma of the Kidney:
           Disease Characteristics and Treatment Outcomes

    • Authors: Thomas F. Monaghan, Kyle P. Michelson, Nicholas R. Suss, Christina W. Agudelo, Syed N. Rahman, Dennis J. Robins, Viktor X. Flores, Brian K. McNeil, Jeffrey P. Weiss, Andrew G. Winer
      First page: 6
      Abstract: Background: Primary small cell carcinoma of the kidney (PSCCK) is exceedingly rare and data on disease characteristics and outcomes are sparse. This study examines a nationally-representative cancer registry to better characterize PSCCK. Methods: We queried the National Cancer Database to identify patients with histology-confirmed PSCCK from 2004 to 2015. Adjusted Cox proportional hazards regression and Kaplan–Meier analyses were employed to assess predictors of mortality and estimate median survival time, respectively. Results: A total of 110 patients were included (47:53% female:male, 77% ≥60 years of age, 86% Caucasian). Significant predictors of mortality included female sex, age 60–69 years, treatment at an Integrated Network Cancer Program, stage cM1, and lack of surgical and chemoradiotherapy treatment. Independent protective factors were high socioeconomic status and treatment at an Academic Research Program. The estimated median overall survival time was 9.31 (95% CI 7.28–10.98) months for all patients. No differences in estimated survival time were observed across individual treatment modalities among those patients who underwent treatment (p = 0.214). Conclusions: PSCCK is an aggressive malignancy with a median survival time of less than one year. Future studies that correlate clinical tumor staging with specific treatment modalities are needed to optimize and individualize management.
      Citation: Medicines
      PubDate: 2021-01-18
      DOI: 10.3390/medicines8010006
      Issue No: Vol. 8, No. 1 (2021)
  • Medicines, Vol. 7, Pages 48: Seasonal Changes in Continuous Sedentary
           Behavior in Community—Dwelling Japanese Adults: A Pilot Study

    • Authors: Chiaki Uehara, Nobuyuki Miyatake, Shuhei Hishii, Hiromi Suzuki, Akihiko Katayama
      First page: 48
      Abstract: Background: Sedentary behavior (SB) is associated with adverse health outcomes. The aim of this study was to clarify seasonal changes in SB including continuous SB (CSB) in community-dwelling Japanese adults. Methods: In this secondary analysis, a total of 65 community-dwelling Japanese adults (7 men and 58 women, 69 (50–78) years) were enrolled. SB (%), including CSB (≥30 min) as well as physical activity, were evaluated using a tri-accelerometer. The differences in these parameters between baseline (summer) and follow-up (winter) were examined. Results: %CSB and %SB at baseline were 20.5 (4.0–60.9) and 54.0 ± 11.5, respectively. CSB was significantly increased (6.6%), and SB was also increased (5.1%) at follow-up compared with baseline. In addition, there were positive relationships between changes in CSB and SB, and body weight and body mass index. Conclusions: These results suggest that there were significant seasonal changes in CSB and SB in community-dwelling Japanese adults.
      Citation: Medicines
      PubDate: 2020-08-25
      DOI: 10.3390/medicines7090048
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 49: Minimising Blood Stream Infection: Developing
           New Materials for Intravascular Catheters

    • Authors: Charnete Casimero, Todd Ruddock, Catherine Hegarty, Robert Barber, Amy Devine, James Davis
      First page: 49
      Abstract: Catheter related blood stream infection is an ever present hazard for those patients requiring venous access and particularly for those requiring long term medication. The implementation of more rigorous care bundles and greater adherence to aseptic techniques have yielded substantial reductions in infection rates but the latter is still far from acceptable and continues to place a heavy burden on patients and healthcare providers. While advances in engineering design and the arrival of functional materials hold considerable promise for the development of a new generation of catheters, many challenges remain. The aim of this review is to identify the issues that presently impact catheter performance and provide a critical evaluation of the design considerations that are emerging in the pursuit of these new catheter systems.
      Citation: Medicines
      PubDate: 2020-08-26
      DOI: 10.3390/medicines7090049
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 50: Development of Newly Synthesized Chromone
           Derivatives with High Tumor Specificity against Human Oral Squamous Cell

    • Authors: Yoshiaki Sugita, Koichi Takao, Yoshihiro Uesawa, Junko Nagai, Yosuke Iijima, Motohiko Sano, Hiroshi Sakagami
      First page: 50
      Abstract: Since many anticancer drugs show severe adverse effects such as mucositis, peripheral neurotoxicity, and extravasation, it was crucial to explore new compounds with much reduced adverse effects. Comprehensive investigation with human malignant and nonmalignant cells demonstrated that derivatives of chromone, back-bone structure of flavonoid, showed much higher tumor specificity as compared with three major polyphenols in the natural kingdom, such as lignin-carbohydrate complex, tannin, and flavonoid. A total 291 newly synthesized compounds of 17 groups (consisting of 12 chromones, 2 esters, and 3 amides) gave a wide range of the intensity of tumor specificity, possibly reflecting the fitness for the optimal 3D structure and electric state. Among them, 7-methoxy-3-[(1E)-2-phenylethenyl]-4H-1-benzopyran-4-one (compound 22), which belongs to 3-styrylchromones, showed the highest tumor specificity. 22 induced subG1 and G2 + M cell population in human oral squamous cell carcinoma cell line, with much less keratinocyte toxicity as compared with doxorubicin and 5-FU. However, 12 active compounds selected did not necessarily induce apoptosis and mitotic arrest. This compound can be used as a lead compound to manufacture more active compound.
      Citation: Medicines
      PubDate: 2020-08-26
      DOI: 10.3390/medicines7090050
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 51: Contrast-Enhanced Ultrasonography for
           Screening and Diagnosis of Hepatocellular Carcinoma: A Case Series and
           Review of the Literature

    • Authors: Kathryn L. McGillen, Syeda Zaidi, Amer Ahmed, Shantell Harter, Nelson S. Yee
      First page: 51
      Abstract: Background: Contrast-enhanced ultrasound (CEUS) is a safe and noninvasive imaging technique that can characterize and evaluate liver lesions, and has been approved for this use in the Unites States since 2016. CEUS has been shown to be similar in accuracy to computed tomography (CT) and magnetic resonance imaging (MRI) for noninvasive diagnosis of hepatocellular carcinoma (HCC) and offers several advantages in certain patient populations who have contraindications for CT or MRI. However, CEUS has inherent limitations and has not been widely employed for evaluation of HCC. Methods: We present three retrospective cases of liver lesions in patients with cirrhosis, who underwent screening for HCC using concurrent, well-timed CT and CEUS. Results: In these cases, the liver lesions were better visualized and then diagnosed as malignancy via CEUS, whereas the lesions were best appreciated on CT only in retrospect. Conclusions: In some cirrhotic patients, a focal lesion may be more easily identifiable via CEUS than on CT and thus accurately characterized, suggesting an important and complementary role of CEUS with CT or MRI. Further studies are indicated to support the use of CEUS for the diagnosis and characterization of liver lesions in screening patients at risk for developing HCC.
      Citation: Medicines
      PubDate: 2020-08-27
      DOI: 10.3390/medicines7090051
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 52: Effects of Lonicera japonica Flower Bud
           Extract on Citrobacter rodentium-Induced Digestive Tract Infection

    • Authors: Masaaki Minami, Toshiaki Makino
      First page: 52
      Abstract: Background: Although antibiotic therapy is currently a gold standard for bacterial infections, it is not used for severe diseases like enterohemorrhagic Escherichia coli, in which the Shiga toxin is overproduced by antibiotic action. The Lonicera japonica flower bud (LJF) is an herbal component used against purulent diseases in traditional Japanese and Chinese medicine. We investigated the effects of LJF extract (LJFE) on Citrobacter rodentium-induced digestive tract infection in a mouse model. Methods:Citrobacter rodentium and LJFE were orally administered to C57BL/6 mice. The survival rate and bacterial colonization in the large intestine, mesenteric lymph node, and blood of mice were evaluated. Cytokines secreted from intraperitoneal macrophages of LJFE-treated mice were measured using ELISA. Moreover, the phagocytic activity of intraperitoneal macrophages against Citrobacter rodentium was compared between LJFE- or chlorogenic acid (CGA)-treated mice. Results: LJFE significantly increased the survival rate and decreased Citrobacter rodentium colonization in mice. Moreover, the values of tumor necrosis factor-α, interleukin-1β, and interferon-γ secreted from macrophages were increased following LJFE treatment. While macrophages of LJFE-treated mice showed a significant phagocytic activity, macrophages of CGA-treated mice only showed a phagocytic tendency. Conclusions: LJF may be useful for treating Citrobacter rodentium-induced digestive tract infection.
      Citation: Medicines
      PubDate: 2020-08-27
      DOI: 10.3390/medicines7090052
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 53: Comorbidities Associated with Granuloma
           Annulare: A Cross-Sectional, Case-Control Study

    • Authors: Erik Almazan, Youkyung S. Roh, Micah Belzberg, Caroline X. Qin, Kyle Williams, Justin Choi, Nishadh Sutaria, Benjamin Kaffenberger, Yevgeniy R. Semenov, Jihad Alhariri, Shawn G. Kwatra
      First page: 53
      Abstract: Background: Granuloma annulare (GA) is a cutaneous granulomatous disorder of unknown etiology. There are conflicting data on the association between GA and multiple systemic conditions. As a result, we aimed to clarify the reported associations between GA and systemic conditions. Methods: A retrospective, cross-sectional, case-control study was performed in which the medical records of biopsy-confirmed GA patients ≥18 years of age, who presented to the Johns Hopkins Hospital System between 1 January 2009 and 1 June 2019, were reviewed. GA patients were compared to controls matched for age, race, and sex. Results: After adjusting for confounders, GA patients (n = 82) had higher odds of concurrent type II diabetes (odds ratio (OR) = 5.27; 95% confidence interval (CI), 1.73–16.07; p < 0.01), non-migraine headache (OR = 8.70; 95% CI, 1.61–46.88; p = 0.01), and a positive smoking history (OR = 1.93; 95% CI, 1.10–3.38; p = 0.02) compared to controls (n = 164). Among GA patients, women were more likely to have ophthalmic conditions (p = 0.04), and men were more likely to have cardiovascular disease (p < 0.01) and type II diabetes (p = 0.05). No differences in systemic condition associations were observed among GA subtypes. Conclusions: Our results support the reported association between GA and type II diabetes. Furthermore, our findings indicate that GA may be associated with cigarette smoking and non-migraine headache disorders.
      Citation: Medicines
      PubDate: 2020-08-28
      DOI: 10.3390/medicines7090053
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 54: PARP Inhibitors in Biliary Tract Cancer: A
           New Kid on the Block'

    • Authors: Angela Dalia Ricci, Alessandro Rizzo, Chiara Bonucci, Nastassja Tober, Andrea Palloni, Veronica Mollica, Ilaria Maggio, Marzia Deserti, Simona Tavolari, Giovanni Brandi
      First page: 54
      Abstract: Poly adenosine diphosphate-ribose polymerase inhibitors (PARPi) represent an effective therapeutic strategy for cancer patients harboring germline and somatic aberrations in DNA damage repair (DDR) genes. BRCA1/2 mutations occur at 1–7% across biliary tract cancers (BTCs), but a broader spectrum of DDR gene alterations is reported in 28.9–63.5% of newly diagnosed BTC patients. The open question is whether alterations in genes that are well established to have a role in DDR could be considered as emerging predictive biomarkers of response to platinum compounds and PARPi. Currently, data regarding PARPi in BTC patients harboring BRCA and DDR mutations are sparse and anecdotal; nevertheless, a variety of clinical trials are testing PARPi as monotherapy or in combination with other anticancer agents. In this review, we provide a comprehensive overview regarding the genetic landscape of DDR pathway deficiency, state of the art and future therapeutic implications of PARPi in BTC, looking at combination strategies with immune-checkpoint inhibitors and other anticancer agents in order to improve survival and quality of life in BTC patients.
      Citation: Medicines
      PubDate: 2020-08-31
      DOI: 10.3390/medicines7090054
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 55: Pitolisant and Other Histamine-3 Receptor
           Antagonists—An Update on Therapeutic Potentials and Clinical Prospects

    • Authors: Victoria Harwell, Pius S. Fasinu
      First page: 55
      Abstract: Background: Besides its well-known role as a peripheral chemical mediator of immune, vascular, and cellular responses, histamine plays major roles in the central nervous system, particularly in the mediation of arousal and cognition-enhancement. These central effects are mediated by the histamine-3 auto receptors, the modulation of which is thought to be beneficial for the treatment of disorders that impair cognition or manifest with excessive daytime sleepiness. Methods: A database search of PubMed, Google Scholar, and clinicaltrials.gov was performed in June 2020. Full-text articles were screened and reviewed to provide an update on pitolisant and other histamine-3 receptor antagonists. Results: A new class of drugs—histamine-3 receptor antagonists—has emerged with the approval of pitolisant for the treatment of narcolepsy with or without cataplexy. At the recommended dose, pitolisant is well tolerated and effective. It has also been evaluated for potential therapeutic benefit in Parkinson disease, epilepsy, attention deficit hyperactivity disorder, Alzheimer’s disease, and dementia. Limited studies have shown pitolisant to lack abuse potential which will be a major advantage over existing drug options for narcolepsy. Several histamine-3 receptor antagonists are currently in development for a variety of clinical indications. Conclusions: Although limited clinical studies have been conducted on this new class of drugs, the reviewed literature showed promising results for future additions to the clinical indications of pitolisant, and the expansion of the list of approved drugs in this class for a variety of indications.
      Citation: Medicines
      PubDate: 2020-09-01
      DOI: 10.3390/medicines7090055
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 56: Recurrent Superior Vena Cava Syndrome in a
           Patient with Sarcoidosis and Pancreatic Adenocarcinoma: A Case Report and
           Literature Review

    • Authors: Ganesh Shenoy, Yunsung Kim, Kyra Newmaster, Kathryn L. McGillen, Francesca Ruggiero, Nelson S. Yee
      First page: 56
      Abstract: Background: Superior vena cava (SVC) syndrome may result from extravascular compression or intravascular obstruction such as thrombosis. Recurrent venous thrombosis is typically associated with a hypercoagulable state such as malignancy, and inheritable or acquired coagulopathy. Sarcoidosis is a derangement of the immune system, and it has been associated with malignant diseases and hypercoagulation. The association of pancreatic cancer and sarcoidosis with SVC syndrome has not been reported previously. Here, we present a case of recurrent venous thrombosis causing SVC syndrome in a patient with pancreatic ductal adenocarcinoma and underlying thoracic sarcoidosis. Methods: The patient’s electronic health record was retrospectively analyzed. Results: A 66-year-old woman with pancreatic adenocarcinoma was treated with neoadjuvant chemotherapy followed by Whipple procedure, before developing tumor recurrence in the liver. Her treatment course was complicated with repeated incidents of venous thrombosis in the presence of a central venous catheter leading to recurrent SVC syndrome, which resolved with anti-coagulation. Conclusions: This case raises a plausible inter-relationship between sarcoidosis, pancreatic cancer, and hypercoagulable state. We suggest that patients with multiple risk factors for developing venous thrombosis should be carefully monitored for any thrombotic event, and they may benefit from prophylactic anti-coagulation.
      Citation: Medicines
      PubDate: 2020-09-04
      DOI: 10.3390/medicines7090056
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 57: Cannabidiol Content and In Vitro Biological
           Activities of Commercial Cannabidiol Oils and Hemp Seed Oils

    • Authors: Masashi Kitamura, Yuka Kiba, Ryuichiro Suzuki, Natsumi Tomida, Akemi Uwaya, Fumiyuki Isami, Shixin Deng
      First page: 57
      Abstract: Background: Hemp (Cannabis sativa L.) seed contains high contents of various nutrients, including fatty acids and proteins. Cannabidiol (CBD) is a non-psychoactive compound that can be extracted from C. sativa and used for treating epilepsy and pain. Industrial hemp products, including CBD and hemp seed oils, have become increasingly popular. Some products are marketed without a clear distinction between CBD and hemp seed oils. Herein, the CBD content and biological activities of commercial CBD and hemp seed oils were examined. Methods: CBD content was measured by high-performance liquid chromatography. For in vitro antioxidant activity determination, 2,2-diphenyl-1-picrylhydrazyl and 2,2′-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) radical-scavenging assays were performed. Results: The CBD concentrations in the two CBD oil samples were 18.9 ± 0.5 and 9.2 ± 0.4 mg/mL. Of the seven hemp seed oil samples, six samples contained CBD in concentrations ranging from 2.0 ± 0.1 to 20.5 ± 0.5 µg/mL, but it was not detected in one sample. Antioxidant activity was observed in both CBD oil samples. Conclusions: The results indicate that (1) CBD content varied by hemp seed oil sample and that (2) antioxidant activity could be a useful landmark for discriminating CBD oils from hemp seed oils.
      Citation: Medicines
      PubDate: 2020-09-07
      DOI: 10.3390/medicines7090057
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 58: How Are Medicinal Plants Useful When Added to

    • Authors: Gema Nieto
      First page: 58
      Abstract: Consumers are concerned about the use of synthetic additives in foods and this has forced food processors to find ways to produce food products without the use of these additives [...]
      Citation: Medicines
      PubDate: 2020-09-14
      DOI: 10.3390/medicines7090058
      Issue No: Vol. 7, No. 9 (2020)
  • Medicines, Vol. 7, Pages 40: Potency of Combining Eucalyptus camaldulensis
           subsp. camaldulensis with Low-Dose Cisplatin in A549 Human Lung
           Adenocarcinomas and MCF-7 Breast Adenocarcinoma

    • Authors: Mohamad Nasser, Raghida Damaj, Othmane Merah, Akram Hijazi, Christine Trabolsi, Nour Wehbe, Malak Nasser, Batoul Al-Khatib, Ziad Damaj
      First page: 40
      Abstract: Background: Lung and breast cancers are common in the world and represent major public health problems. Systemic chemotherapy is an effective way to prolong survival but it is associated with side effects. Plants are used as traditional treatments for many types of cancers, mostly in combination with chemotherapy. We investigated the antitumor effect of ethanolic (EE) and aqueous (AE) extracts of Eucalyptus camaldulensis on human alveolar adenocarcinoma basal epithelial cells (A549) and breast adenocarcinoma cell line (MCF-7) and checked the synergistic effect of the combination with low-dose cisplatin (CDDP). Methods: AE and EE were characterized for their secondary metabolites including content of phenol and antioxidant activity of both extracts. Cell viability was tested by the neutral red assay and MTT. Combinations of extract with low-dose CDDP on A549, MCF-7 cells, and normal cells peripheral blood mononuclear cells was used to study cell viability. Results: AE contains higher level of active constituents than EE. Higher antioxidant activity was observed in AE. Both extracts showed cytotoxic activity on A549 and MCF-7 cells. Moreover, combining E. camaldulensis with low-dose CDDP increases significantly the cell death of treated cells in comparison to those treated with CDDP alone. Conclusions: Our results highlight a new therapeutic concept that combines Eucalyptus camaldulensis with low-dose CDDP to treat lung and breast adenocarcinoma.
      Citation: Medicines
      PubDate: 2020-07-22
      DOI: 10.3390/medicines7080040
      Issue No: Vol. 7, No. 8 (2020)
  • Medicines, Vol. 7, Pages 41: e-Health: A Future Solution for Optimized
           Management of Elderly Patients. GER-e-TEC™ Project

    • Authors: Abrar-Ahmad Zulfiqar, Noël Lorenzo-Villalba, Oumair-Ahmad Zulfiqar, Mohamed Hajjam, Quentin Courbon, Lucie Esteoulle, Bernard Geny, Samy Talha, Dominique Letourneau, Jawad Hajjam, Sylvie Erve, Amir Hajjam El Hassani, Emmanuel Andres
      First page: 41
      Abstract: Background: Elderly residents in nursing homes have multiple comorbidities (including cognitive and psycho-behavioral pathologies, malnutrition, heart failure, diabetes, chronic obstructive pulmonary disease, and renal failure) and use multiple medications. Methods: The GER-e-TEC project aims to provide these fragile and complex patients with telemedicine tools, more specifically telemonitoring, backed by a well-defined and personalized protocol. Results: Medically, this implies the need for regular monitoring and a high level of medical and multidisciplinary expertise for the healthcare team. The tools use non-invasive communicating sensors and artificial intelligence techniques, allowing daily monitoring with the ability to detect any abnormal changes in the patient’s condition early. Conclusions: The GER-e-TEC project specifically considers the challenges of aging residents and significant challenges in nursing homes, with the main geriatric syndromes (falls, malnutrition, cognitive-behavioral disorders, and iatrogenic conditions).
      Citation: Medicines
      PubDate: 2020-07-23
      DOI: 10.3390/medicines7080041
      Issue No: Vol. 7, No. 8 (2020)
  • Medicines, Vol. 7, Pages 42: Autologous Mesenchymal Stem Cell Treatment is
           Consistently Effective for the Treatment of Knee Osteoarthritis: The
           Results of a Systematic Review of Treatment and Comparison to a Placebo

    • Authors: Chadwick Prodromos, Susan Finkle, Tobias Rumschlag, John Lotus
      First page: 42
      Abstract: Background: Numerous studies have used autologous mesenchymal stem cell injections (AMSCI) to treat osteoarthritis. We hypothesized that AMSCI is an effective osteoarthritis treatment with increasing efficacy at higher doses. Methods: We conducted a PubMed search for human clinical studies using AMSCI for the treatment of osteoarthritis (OA) and a second search for placebo arms of injectate OA treatment. Inclusion criteria included treatment outcomes ratings both pre-treatment and at least 6 months post-treatment. Results: 45 AMSCI cohorts from 34 studies met criteria. All AMSCI cohorts showed improvement at mean 15.3 months post-treatment. Mean WOMAC and VAS scores improved at 6-months and at final follow-up (p < 0.0001 for all). Scores > 2 years were also significant (WOMAC p = 0.001/VAS p = 0.004). Results greatly exceeded the minimal clinically important difference (MCID) at each time point. AMSCI improvement also substantially exceeded previously published 6-month placebo-treatment improvement. No dose–response relationship was seen. AMSCI cohorts showed continuing improvement ≥ 6 months, and continued upward at one year. Placebo scores were already trending downward by 6 months. Conclusions: AMSCI is a consistently significantly effective treatment for osteoarthritis. It should no longer be stated that data is insufficient to establish AMSCI efficacy for OA. Given its excellent safety profile, AMSCI should be widely used for the treatment of osteoarthritis.
      Citation: Medicines
      PubDate: 2020-07-24
      DOI: 10.3390/medicines7080042
      Issue No: Vol. 7, No. 8 (2020)
  • Medicines, Vol. 7, Pages 43: Relationship between Motor Estimation Error
           and Physical Function in Patients with Parkinson’s Disease

    • Authors: Katsuya Sakai, Tsubasa Kawasaki, Yumi Ikeda, Keita Tominaga, Kohei Kurihara
      First page: 43
      Abstract: Background: Motor estimation error is an index of how accurately one’s body movement is recognized. This study determines whether motor estimation error distance is a Parkinson’s disease (PD)- or age-related disability using a two-step task. Methods: The participants were 19 PD patients and 58 elderly people with disabilities. A two-step prediction test and an actual two-step test were performed. The motor estimation error distance (prediction of two-step distance minus actual two-step distance) and error rate between the two groups were compared. We conducted a correlation analysis between the motor estimation error and clinical factor (e.g., Hoehn and Yahr stage (H & Y), Unified Parkinson’s Disease Rating Scale (UPDRS)) related to PD. Results: The motor estimation error distance was not significantly different between the PD patient group and the elderly group with disabilities. However, significant correlations between motor estimation error and H & Y, and between motor estimation error and UPDRS part II, were observed. The error rate was significantly correlated with the Fall Efficacy Scale. Conclusions: The motor estimation error distance is influenced by both aging and PD.
      Citation: Medicines
      PubDate: 2020-07-28
      DOI: 10.3390/medicines7080043
      Issue No: Vol. 7, No. 8 (2020)
  • Medicines, Vol. 7, Pages 44: Genetic Alterations in Renal Cancers:
           Identification of The Mechanisms Underlying Cancer Initiation and
           Progression and of Therapeutic Targets

    • Authors: Ugo Testa, Elvira Pelosi, Germana Castelli
      First page: 44
      Abstract: Renal cell cancer (RCC) involves three most recurrent sporadic types: clear-cell RCC (70–75%, CCRCC), papillary RCCC (10–15%, PRCC), and chromophobe RCC (5%, CHRCC). Hereditary cases account for about 5% of all cases of RCC and are caused by germline pathogenic variants. Herein, we review how a better understanding of the molecular biology of RCCs has driven the inception of new diagnostic and therapeutic approaches. Genomic research has identified relevant genetic alterations associated with each RCC subtype. Molecular studies have clearly shown that CCRCC is universally initiated by Von Hippel Lindau (VHL) gene dysregulation, followed by different types of additional genetic events involving epigenetic regulatory genes, dictating disease progression, aggressiveness, and differential response to treatments. The understanding of the molecular mechanisms that underlie the development and progression of RCC has considerably expanded treatment options; genomic data might guide treatment options by enabling patients to be matched with therapeutics that specifically target the genetic alterations present in their tumors. These new targeted treatments have led to a moderate improvement of the survival of metastatic RCC patients. Ongoing studies based on the combination of immunotherapeutic agents (immune check inhibitors) with VEGF inhibitors are expected to further improve the survival of these patients.
      Citation: Medicines
      PubDate: 2020-07-29
      DOI: 10.3390/medicines7080044
      Issue No: Vol. 7, No. 8 (2020)
  • Medicines, Vol. 7, Pages 45: Trying to Solve the Puzzle of the Interaction
           of Ascorbic Acid and Iron: Redox, Chelation and Therapeutic Implications

    • Authors: George J. Kontoghiorghes, Annita Kolnagou, Christina N. Kontoghiorghe, Loukia Mourouzidis, Viktor A. Timoshnikov, Nikolay E. Polyakov
      First page: 45
      Abstract: Iron and ascorbic acid (vitamin C) are essential nutrients for the normal growth and development of humans, and their deficiency can result in serious diseases. Their interaction is of nutritional, physiological, pharmacological and toxicological interest, with major implications in health and disease. Millions of people are using pharmaceutical and nutraceutical preparations of these two nutrients, including ferrous ascorbate for the treatment of iron deficiency anaemia and ascorbate combination with deferoxamine for increasing iron excretion in iron overload. The main function and use of vitamin C is its antioxidant activity against reactive oxygen species, which are implicated in many diseases of free radical pathology, including biomolecular-, cellular- and tissue damage-related diseases, as well as cancer and ageing. Ascorbic acid and its metabolites, including the ascorbate anion and oxalate, have metal binding capacity and bind iron, copper and other metals. The biological roles of ascorbate as a vitamin are affected by metal complexation, in particular following binding with iron and copper. Ascorbate forms a complex with Fe3+ followed by reduction to Fe2+, which may potentiate free radical production. The biological and clinical activities of iron, ascorbate and the ascorbate–iron complex can also be affected by many nutrients and pharmaceutical preparations. Optimal therapeutic strategies of improved efficacy and lower toxicity could be designed for the use of ascorbate, iron and the iron–ascorbate complex in different clinical conditions based on their absorption, distribution, metabolism, excretion, toxicity (ADMET), pharmacokinetic, redox and other properties. Similar strategies could also be designed in relation to their interactions with food components and pharmaceuticals, as well as in relation to other aspects concerning personalized medicine.
      Citation: Medicines
      PubDate: 2020-07-30
      DOI: 10.3390/medicines7080045
      Issue No: Vol. 7, No. 8 (2020)
  • Medicines, Vol. 7, Pages 46: Modulation of Th1/Th2 Cytokine Balance by
           Quercetin In Vitro

    • Authors: Yoshihito Tanaka, Atsuko Furuta, Kazuhito Asano, Hitome Kobayashi
      First page: 46
      Abstract: Background: Allergic rhinitis (AR) is well known to be an IgE-mediated chronic inflammatory disease in the nasal wall, which is primarily mediated by Th2-type cytokines such as IL-4, IL-5, and IL-13. Although quercetin is also accepted to attenuate the development of allergic diseases such as AR, the influence of quercetin on Th2-type cytokine production is not well understood. The present study was designed to examine whether quercetin could attenuate the development of AR via the modulation of Th2-type cytokine production using an in vitro cell culture technique. Methods: Human peripheral-blood CD4+ T cells (1 × 106 cells/mL) were cultured with 10.0 ng/mL IL-4 in the presence or absence of quercetin. The levels of IL-5, IL-13, and INF-γ in 24 h culture supernatants were examined by ELISA. The influence of quercetin on the phosphorylation of transcription factors NF-κB and STAT6, and mRNA expression for cytokines were also examined by ELISA and RT-PCR, respectively. Results: Treatment of cells with quercetin at more than 5.0 μM inhibited the production of IL-5 and IL-13 from CD4+ T cells induced by IL-4 stimulation through the suppression of transcription factor activation and cytokine mRNA expression. On the other hand, quercetin at more than 5.0 μM abrogated the inhibitory action of IL-4 on INF-γ production from CD4+ T cells in vitro. Conclusions: The immunomodulatory effects of quercetin, especially on cytokine production, may be responsible, in part, for the mode of therapeutic action of quercetin on allergic diseases, including AR.
      Citation: Medicines
      PubDate: 2020-07-30
      DOI: 10.3390/medicines7080046
      Issue No: Vol. 7, No. 8 (2020)
  • Medicines, Vol. 7, Pages 47: Medicinal Herbs Used in Traditional
           Management of Breast Cancer: Mechanisms of Action

    • Authors: Donovan A. McGrowder, Fabian G. Miller, Chukwuemeka R. Nwokocha, Melisa S. Anderson, Cameil Wilson-Clarke, Kurt Vaz, Lennox Anderson-Jackson, Jabari Brown
      First page: 47
      Abstract: Background: Breast cancer is one of the principal causes of death among women and there is a pressing need to develop novel and effective anti-cancer agents. Natural plant products have shown promising results as anti-cancer agents. Their effectiveness is reported as decreased toxicity in usage, along with safety and less recurrent resistances compared with hormonal targeting anti-cancer agents. Methods: A literature search was conducted for all English-language literature published prior to June 2020. The search was conducted using electronic databases, including PubMed, Embase, Web of Science, and Cochrane Library. The search strategy included keywords such as breast cancer, herbs, anti-cancer biologically active components, clinical research, chemotherapy drugs amongst others. Results: The literature provides documented evidence of the chemo-preventative and chemotherapeutic properties of Ginseng, garlic (Allium sativum), Black cohosh (Actaea racemose), Tumeric (Curcuma longa), Camellia sinenis (green tea), Echinacea, Arctium (burdock), Flaxseed (Linum usitatissimum) and Black Cumin (Nigella sativa). Conclusions: The nine herbs displayed anti-cancer properties and their outcomes and mechanisms of action include inhibition of cell proliferation, angiogenesis and apoptosis as well as modulation of key intracellular pathways. However, more clinical trials and cohort human studies should be conducted to provide key evidence of their medical benefits.
      Citation: Medicines
      PubDate: 2020-08-14
      DOI: 10.3390/medicines7080047
      Issue No: Vol. 7, No. 8 (2020)
  • Medicines, Vol. 7, Pages 38: Hospital-Acquired Serum Chloride Derangements
           and Associated In-Hospital Mortality

    • Authors: Charat Thongprayoon, Wisit Cheungpasitporn, Tananchai Petnak, Michael A. Mao, Api Chewcharat, Fawad Qureshi, Juan Medaura, Tarun Bathini, Saraschandra Vallabhajosyula, Kianoush B. Kashani
      First page: 38
      Abstract: Background: We aimed to describe the incidence of hospital-acquired dyschloremia and its association with in-hospital mortality in general hospitalized patients. Methods: All hospitalized patients from 2009 to 2013 who had normal admission serum chloride and at least two serum chloride measurements in the hospital were studied. The normal range of serum chloride was defined as 100–108 mmol/L. Hospital serum chloride levels were grouped based on the occurrence of hospital-acquired hypochloremia and hyperchloremia. The association of hospital-acquired hypochloremia and hyperchloremia with in-hospital mortality was analyzed using logistic regression. Results: Among the total of 39,298 hospitalized patients, 59% had persistently normal hospital serum chloride levels, 21% had hospital-acquired hypochloremia only, 15% had hospital-acquired hyperchloremia only, and 5% had both hypochloremia and hyperchloremia. Compared with patients with persistently normal hospital serum chloride levels, hospital-acquired hyperchloremia only (odds ratio or OR 2.84; p < 0.001) and both hospital-acquired hypochloremia and hyperchloremia (OR 1.72; p = 0.004) were associated with increased in-hospital mortality, whereas hospital-acquired hypochloremia only was not (OR 0.91; p = 0.54). Conclusions: Approximately 40% of hospitalized patients developed serum chloride derangements. Hospital-acquired hyperchloremia, but not hypochloremia, was associated with increased in-hospital mortality.
      Citation: Medicines
      PubDate: 2020-06-29
      DOI: 10.3390/medicines7070038
      Issue No: Vol. 7, No. 7 (2020)
  • Medicines, Vol. 7, Pages 39: The Effects of Tai Chi and Qigong on Immune
           Responses: A Systematic Review and Meta-Analysis

    • Authors: Byeongsang Oh, Kyeore Bae, Gillian Lamoury, Thomas Eade, Frances Boyle, Brian Corless, Stephen Clarke, Albert Yeung, David Rosenthal, Lidia Schapira, Michael Back
      First page: 39
      Abstract: Background: Effective preventative health interventions are essential to maintain well-being among healthcare professionals and the public, especially during times of health crises. Several studies have suggested that Tai Chi and Qigong (TQ) have positive impacts on the immune system and its response to inflammation. The aim of this review is to evaluate the current evidence of the effects of TQ on these parameters. Methods: Electronic searches were conducted on databases (Medline, PubMed, Embase and ScienceDirect). Searches were performed using the following keywords: “Tai Chi or Qigong” and “immune system, immune function, immunity, Immun*, inflammation and cytokines”. Studies published as full-text randomized controlled trials (RCTs) in English were included. Estimates of change in the levels of immune cells and inflammatory biomarkers were pooled using a random-effects meta-analysis where randomised comparisons were available for TQ versus active controls and TQ versus non-active controls. Results: Nineteen RCTs were selected for review with a total of 1686 participants and a range of 32 to 252 participants within the studies. Overall, a random-effects meta-analysis found that, compared with control conditions, TQ has a significant small effect of increasing the levels of immune cells (SMD, 0.28; 95% CI, 0.13 to 0.43, p = 0.00), I2 = 45%, but not a significant effect on reducing the levels of inflammation (SMD, −0.15; 95% CI, −0.39 to 0.09, p = 0.21), I2 = 85%, as measured by the systemic inflammation biomarker C-reactive protein (CRP) and cell mediated biomarker cytokines. This difference in results is due to the bidirectional regulation of cytokines. An overall risk of bias assessment found three RCTs with a low risk of bias, six RCTs with some concerns of bias, and ten RCTs with a high risk of bias. Conclusions: Current evidence indicates that practising TQ has a physiologic impact on immune system functioning and inflammatory responses. Rigorous studies are needed to guide clinical guidelines and harness the power of TQ to promote health and wellbeing.
      Citation: Medicines
      PubDate: 2020-06-30
      DOI: 10.3390/medicines7070039
      Issue No: Vol. 7, No. 7 (2020)
  • Medicines, Vol. 7, Pages 31: Genista tridentata L.: A Rich Source of
           Flavonoids with Anti-inflammatory Activity

    • Authors: Pinto, Simões, Silva
      First page: 31
      Abstract: : Background: Genista tridentata L. is an endemic species from the Iberian Peninsula used in Portuguese traditional medicine to treat inflammation-related diseases; this and other health-promoting effects are usually associated with the flavonoids produced by this species. In fact, anti-inflammatory properties were established for several of these flavonoid derivatives. Methods: A careful survey of the reported data, using mainly the Scopus database and Genista tridentata and Pterospartum tridentatum as keywords, was done. We have examined the papers involving the plant and those about the most relevant flavonoids anti-inflammatory activity. Results: The literature survey demonstrates that species are used to treat several health problems such as antihyperglycemia, hypertension, and inflammatory episodes. It was also possible to establish its richness in flavonoid derivatives, from which several are potential anti-inflammatory agents. Conclusions: From our described and discussed analysis, it can be concluded that Genista tridentata is an excellent source of bioactive flavonoids. Moreover, its traditional use to treat inflammation episodes may be due to its flavonoid content, from which genistein, biochanin A, rutin, and daidzein can be emphasized.
      Citation: Medicines
      PubDate: 2020-05-30
      DOI: 10.3390/medicines7060031
      Issue No: Vol. 7, No. 6 (2020)
  • Medicines, Vol. 7, Pages 32: Circulatory Failure among Hospitalizations
           for Heatstroke in the United States

    • Authors: Tarun Bathini, Charat Thongprayoon, Tananchai Petnak, Api Chewcharat, Wisit Cheungpasitporn, Boonphiphop Boonpheng, Ronpichai Chokesuwattanaskul, Narut Prasitlumkum, Saraschandra Vallabhajosyula, Wisit Kaewput
      First page: 32
      Abstract: Background: This study aimed to assess the risk factors and the association of circulatory failure with treatments, complications, outcomes, and resource utilization in hospitalized patients for heatstroke in the United States. Methods: Hospitalized patients with a principal diagnosis of heatstroke were identified in the National Inpatient Sample dataset from the years 2003 to 2014. Circulatory failure, defined as any type of shock or hypotension, was identified using hospital diagnosis codes. Clinical characteristics, in-hospital treatment, complications, outcomes, and resource utilization between patients with and without circulatory failure were compared. Results: A total of 3372 hospital admissions primarily for heatstroke were included in the study. Of these, circulatory failure occurred in 393 (12%) admissions. Circulatory failure was more commonly found in obese patients, but less common in older patients aged ≥60 years. The need for mechanical ventilation, blood transfusion, and renal replacement therapy were higher in patients with circulatory failure. Hyperkalemia, hypocalcemia, metabolic acidosis, metabolic alkalosis, sepsis, ventricular arrhythmia or cardiac arrest, renal failure, respiratory failure, liver failure, neurological failure, and hematologic failure were associated with circulatory failure. The in-hospital mortality was 7.1-times higher in patients with circulatory failure. The length of hospital stay and hospitalization costs were higher when circulatory failure occurred while in the hospital. Conclusions: Approximately one out of nine heatstroke patients developed circulatory failure during hospitalization. Circulatory failure was associated with various complications, higher mortality, and increased resource utilizations.
      Citation: Medicines
      PubDate: 2020-06-14
      DOI: 10.3390/medicines7060032
      Issue No: Vol. 7, No. 6 (2020)
  • Medicines, Vol. 7, Pages 33: Oral Manifestations of Inflammatory Bowel
           Disease and the Role of Non-Invasive Surrogate Markers of Disease Activity

    • Authors: Davide Giuseppe Ribaldone, Selvaggia Brigo, Michela Mangia, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano
      First page: 33
      Abstract: Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), can be associated with several extra-intestinal manifestations requiring a multidisciplinary management both in terms of work-up and therapy. Oral lesions are common in patients with IBD, with a prevalence ranging from 5% to 50%. These can represent an oral location of IBD as well as a side-effect of drugs used to treat the intestinal disease. Oral manifestations, occurring in patients with IBD, can be divided in nonmalignant, specific, and non-specific ones, and malignant lesions. While there is undoubtedly a need to search for an IBD in patients with oral lesions associated with intestinal symptoms, the work-up of those with an exclusive oral lesion should be personalized. Fecal calprotectin is a non-invasive marker of intestinal inflammation and may be used to select which patients need to undergo endoscopic examination, thereby avoiding unnecessary investigations. The pharmacological armamentarium to treat oral lesions associated with IBD includes topical or systemic corticosteroids, immunosuppressive agents, and biologic drugs.
      Citation: Medicines
      PubDate: 2020-06-16
      DOI: 10.3390/medicines7060033
      Issue No: Vol. 7, No. 6 (2020)
  • Medicines, Vol. 7, Pages 34: Chrysippus and the First Known Description of
           Cataract Surgery

    • Authors: Juliusz Grzybowski, Andrzej Grzybowski
      First page: 34
      Abstract: Although the origin of cataract surgery is unknown, the earliest identified mention of cataract surgery comes from Chrysippus in the 3rd century B.C.E. This historical review analyses this first description of cataract surgery from both philosophical and linguistic perspectives, within the original context in which early cataract surgeries were performed, as well as within the context of contemporary medical knowledge.
      Citation: Medicines
      PubDate: 2020-06-22
      DOI: 10.3390/medicines7060034
      Issue No: Vol. 7, No. 6 (2020)
  • Medicines, Vol. 7, Pages 35: Chromatographic, Chemometric and Antioxidant
           Assessment of the Equivalence of Granules and Herbal Materials of
           Angelicae sinensis Radix

    • Authors: Valentina Razmovski-Naumovski, Xian Zhou, Ho Yee Wong, Antony Kam, Jarryd Pearson, Kelvin Chan
      First page: 35
      Abstract: Background: Granules are a popular way of administrating herbal decoctions. However, there are no standardised quality control methods for granules, with few studies comparing the granules to traditional herbal decoctions. This study developed a multi-analytical platform to compare the quality of granule products to herb/decoction pieces of Angelicae Sinensis Radix (Danggui). Methods: A validated ultra-performance liquid chromatography coupled with photodiode array detector (UPLC-PDA) method quantitatively compared the aqueous extracts. Hierarchical agglomerative clustering analysis (HCA) and principal component analysis (PCA) clustered the samples according to three chemical compounds: ferulic acid, caffeic acid and Z-ligustilide. Ferric ion-reducing antioxidant power (FRAP) and 2,2-Diphenyl-1-picrylhydrazyl radical scavenging capacity (DPPH) assessed the antioxidant activity of the samples. Results: HCA and PCA allocated the samples into two main groups: granule products and herb/decoction pieces. Greater differentiation between the samples was obtained with three chemical markers compared to using one marker. The herb/decoction pieces group showed comparatively higher extraction yields and significantly higher DPPH and FRAP (p < 0.05), which was positively correlated to caffeic acid and ferulic acid, respectively. Conclusions: The results confirm the need for the quality assessment of granule products using more than one chemical marker for widespread practitioner and consumer use.
      Citation: Medicines
      PubDate: 2020-06-23
      DOI: 10.3390/medicines7060035
      Issue No: Vol. 7, No. 6 (2020)
  • Medicines, Vol. 7, Pages 36: A Combination of Magnetic Resonance Imaging
           Techniques to Localize the Dural Defect in a Case of Superficial
           Siderosis—A Case Report

    • Authors: Hiroyuki Katoh, Shuhei Shibukawa, Keiko Yamaguchi, Akihiko Hiyama, Tomohiko Horie, Masato Sato, Masahiko Watanabe
      First page: 36
      Abstract: Background: Superficial siderosis is a progressively disabling disease caused by recurrent subarachnoid hemorrhage with accumulation of hemosiderin in the surface of the central nervous system. Although a wide variety of conditions may cause superficial siderosis, approximately half of the cases are reported to be associated with a defect in the ventral spinal dura mater, in which case treatment entails surgical repair of the defect. Here, we report a case of superficial siderosis and report on our method to pinpoint the dural defect using a combination of magnetic resonance imaging (MRI) techniques. Methods and Results: A 74-year-old female presented suffering from hearing loss and progressive ataxia over a duration of seven years. A T2-weighted MRI study revealed hypointensity in the superficial areas of the central nervous system, leading to the diagnosis of superficial siderosis, and the presence of a fluid-filled collection in the anterior spinal canal of C7 to T10 suggested that a dural defect was the cause of the repeated hemorrhage. A balanced turbo field echo (BTFE) MRI sequence revealed possible dural defects at T1–T2 and T5–T6, and a dynamic improved motion-sensitized driven-equilibrium steady-state free precession (dynamic iMSDE SSFP) sequence revealed an irregular flow of cerebrospinal fluid through the dura at the T5–T6 level. The dural defect was confirmed and sutured through a minimal T5–T6 laminectomy without neurological consequences, and the patient reported mild improvement in gait one year after surgery. Conclusions: A combination of MRI sequences provided the necessary information to confidently perform minimal surgery to repair the dural defect. We recommend coupling a balanced steady-state free precession (SSFP) sequence to provide high resolution, high contrast images of anatomical structures and a dynamic iMSDE SSFP sequence to confirm cerebrospinal fluid motion through the defect.
      Citation: Medicines
      PubDate: 2020-06-25
      DOI: 10.3390/medicines7060036
      Issue No: Vol. 7, No. 6 (2020)
  • Medicines, Vol. 7, Pages 37: Autologous Biologic Treatment with Fat, Bone
           Marrow Aspirate and Platelet Rich Plasma Is an Effective Alternative to
           Total Knee Arthroplasty for Patients with Moderate Knee Arthrosis

    • Authors: Chadwick Prodromos, Susan Finkle
      First page: 37
      Abstract: Background: Osteoarthrosis (OA) of the knee afflicts millions worldwide. Total Knee Arthroplasty (TKA) is common, but associated with substantial cost and morbidity. Prior studies of intra-articular injection of fat, bone marrow aspirate (BMA), and platelet rich plasma (PRP) have shown clinical benefit. We hypothesized that injection of autologous adipose tissue, BMA, and PRP would provide significant benefit for patients with moderate knee OA resulting in avoidance of total knee arthroplasty (TKA) in most, with discontinuance of NSAIDs and other drugs. Methods: 42 TKA candidate patients (47 knees) with moderate (Kellgren-Lawrence 2 and 3) knee OA who had failed conservative treatment had autologous adipose tissue, BMA, and PRP injection as an alternative to TKA in office using only local anesthetic. Patients had discontinuance of all nonsteroidal anti-inflammatory medicines (NSAIDs) and other analgesics, except acetaminophen, prior to treatment. Patients were evaluated with Knee injury and Osteoarthritis Outcome Score Physical Shortform (KOOS-PS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Single Assessment Numeric Evaluation (SANE) prior to treatment, and at 6 months, 1, and 2 years after treatment. Results: Follow up exceeded 80% at all time points. There were no significant adverse events. TKA was avoided in 97% at one and 86% at two years after treatment. Mean SANE, KOOS-PS, and WOMAC scores significantly improved at 6 months, 1, and 2 years post-treatment. WOMAC and SANE scores were higher at two versus one year post-treatment. Conclusions: Combined fat, BMA, and PRP injection is a safe and effective treatment for moderate knee OA, with reliable avoidance of TKA and possible continued improvement at two year follow-up.
      Citation: Medicines
      PubDate: 2020-06-25
      DOI: 10.3390/medicines7060037
      Issue No: Vol. 7, No. 6 (2020)
  • Medicines, Vol. 7, Pages 23: Uncharted Source of Medicinal Products: The
           Case of the Hedychium Genus

    • Authors: Wilson R. Tavares, Maria do Carmo Barreto, Ana M. L. Seca
      First page: 23
      Abstract: A current research topic of great interest is the study of the therapeutic properties of plants and of their bioactive secondary metabolites. Plants have been used to treat all types of health problems from allergies to cancer, in addition to their use in the perfumery industry and as food. Hedychium species are among those plants used in folk medicine in several countries and several works have been reported to verify if and how effectively these plants exert the effects reported in folk medicine, studying their essential oils, extracts and pure secondary metabolites. Hedychium coronarium and Hedychium spicatum are the most studied species. Interesting compounds have been identified like coronarin D, which possesses antibacterial, antifungal and antitumor activities, as well as isocoronarin D, linalool and villosin that exhibit better cytotoxicity towards tumor cell lines than the reference compounds used, with villosin not affecting the non-tumor cell line. Linalool and α-pinene are the most active compounds found in Hedychium essential oils, while β-pinene is identified as the most widespread compound, being reported in 12 different Hedychium species. Since only some Hedychium species have been investigated, this review hopes to shed some light on the uncharted territory that is the Hedychium genus.
      Citation: Medicines
      PubDate: 2020-04-28
      DOI: 10.3390/medicines7050023
      Issue No: Vol. 7, No. 5 (2020)
  • Medicines, Vol. 7, Pages 24: Emerging Research in Chronic Pruritus: From
           Bedside to Bench and Back Again

    • Authors: Kyle A. Williams, Shawn G. Kwatra
      First page: 24
      Abstract: This Medicines special issue highlights emerging research spanning from epidemiology to diagnostic workup, pathogenesis, and therapeutics for patients suffering from chronic pruritus. The special issue contains 13 articles reporting relevant epidemiologic and experimental data on chronic pruritus.
      Citation: Medicines
      PubDate: 2020-04-29
      DOI: 10.3390/medicines7050024
      Issue No: Vol. 7, No. 5 (2020)
  • Medicines, Vol. 7, Pages 25: Rare Neurologic Disease-Associated Mutations
           of AIMP1 are Related with Inhibitory Neuronal Differentiation Which is
           Reversed by Ibuprofen

    • Authors: Takeuchi, Tanaka, Okura, Fukui, Noguchi, Hayashi, Torii, Ooizumi, Ohbuchi, Mizoguchi, Miyamoto, Yamauchi
      First page: 25
      Abstract: Background: Hypomyelinating leukodystrophy 3 (HLD3), previously characterized as a congenital diseases associated with oligodendrocyte myelination, is increasingly regarded as primarily affecting neuronal cells. Methods: We used N1E-115 cells as the neuronal cell model to investigate whether HLD3-associated mutant proteins of cytoplasmic aminoacyl-tRNA synthase complex-interacting multifunctional protein 1 (AIMP1) aggregate in organelles and affect neuronal differentiation. Results: 292CA frame-shift type mutant proteins harboring a two-base (CA) deletion at the 292th nucleotide are mainly localized in the lysosome where they form aggregates. Similar results are observed in mutant proteins harboring the Gln39-to-Ter (Q39X) mutation. Interestingly, the frame-shift mutant-specific peptide specifically interacts with actin to block actin fiber formation. The presence of actin with 292CA mutant proteins, but not with wild type or Q39X ones, in the lysosome is detectable by immunoprecipitation of the lysosome. Furthermore, expression of 292CA or Q39X mutants in cells inhibits neuronal differentiation. Treatment with ibuprofen reverses mutant-mediated inhibitory differentiation as well as the localization in the lysosome. Conclusions: These results not only explain the cell pathological mechanisms inhibiting phenotype differentiation in cells expressing HLD3-associated mutants but also identify the first chemical that restores such cells in vitro.
      Citation: Medicines
      PubDate: 2020-05-06
      DOI: 10.3390/medicines7050025
      Issue No: Vol. 7, No. 5 (2020)
  • Medicines, Vol. 7, Pages 26: Plant Polyphenols, More than Just Simple
           Natural Antioxidants: Oxidative Stress, Aging and Age-Related Diseases

    • Authors: Christophe Hano, Duangjai Tungmunnithum
      First page: 26
      Abstract: The present editorial serves as an introduction to the Special Issue “Antioxidant and Anti-aging Action of Plant Polyphenols”. It also provides a summary of the polyphenols, their biological properties and possible functions as medicines, the importance of traditional medicines as a source of inspiration, the rationalization of new uses of plant extracts which lead to applications in modern medicine, the status of modern green-chemistry extraction methods, and some reflections on future prospects. Here, the articles from this Special Issue, and the main aspects of the antioxidant and anti-aging effects of plant polyphenols are discussed in the form of seven questions.
      Citation: Medicines
      PubDate: 2020-05-09
      DOI: 10.3390/medicines7050026
      Issue No: Vol. 7, No. 5 (2020)
  • Medicines, Vol. 7, Pages 27: Stem Cell Clinical Trials in Spinal Cord
           Injury: A Brief Review of Studies in the United States

    • Authors: Platt, David, Fessler
      First page: 27
      Abstract: Background: Although many therapeutic approaches have been attempted to treat spinal cord injury, cellular transplantation offers the greatest promise in reconstituting the architecture of the damaged cord. Methods: A literature review was conducted to search for clinical trials investigating stem cells as treatment for spinal cord injury in the United States. Results: Overall, eight studies met inclusion criteria. Of the included studies, four were identified as being terminated, suspended, or not yet recruiting. Two studies were identified as currently recruiting, including one phase one trial evaluating stereotactic injections of human spinal cord-derived neural stem cells in patients with chronic spinal cord injuries, and one trial of transplantation of autologous bone marrow derived stem cells via paraspinal injections, intravenous injections, and intranasal placement. One study was identified as an active study, a phase one trial of intrathecal injection of 100 million autologous, ex-vivo expanded, adipose-derived mesenchymal stem cells. One trial that was listed as completed is a phase 1/2a, dose escalation study, investigating stereotactic injection of human embryonic stem cell derived oligodendrocyte progenitor cells. Conclusions: Although few significant publications have emerged to this point, current trial results are promising.
      Citation: Medicines
      PubDate: 2020-05-12
      DOI: 10.3390/medicines7050027
      Issue No: Vol. 7, No. 5 (2020)
  • Medicines, Vol. 7, Pages 28: Silicone Implant Versus Silicone Implant
           Assisted by Stromal Enriched Lipograft Breast Augmentation: A Prospective
           Comparative Study

    • Authors: Aris Sterodimas
      First page: 28
      Abstract: Background: Implant-assisted breast augmentation is among the most performed surgeries performed by plastic surgeons today. This prospective study evaluated the patient satisfaction and complication rates using high-profile round silicone implant alone (traditional breast augmentation) Group A versus the high-profile round silicone implant assisted with stromal enriched lipograft (composite breast augmentation) Group B. Methods: A total of 50 female patient candidates to undergo breast augmentation between January to September 2017 were randomly assigned to either group. The periareolar technique for breast augmentation and the subfascial plane were used in both groups for the insertion of the high-profile round silicone implants. The stromal enriched lipograft (SEL) was used in Group B for the preparation of the autologous fat grafting to the breast. The satisfaction of each patient with body appearance following breast augmentation was rated using an already published scale of 1–5. The rate of complications was analysed. Results: AS performed all the surgeries. In Group A, the age range was between 19 and 48 years (mean of 22.5 years). In Group B, the age range was between 20 and 47 years (mean of 24.1 years). The average BMI of Group A was 24 m/kg2 and 23 m/kg2 of Group B. Patient satisfaction meta-analysis for Group A and B at 12 months shows that patients in Group B expressed a satisfaction that is superior when compared to Group A patients. The ability to camouflage the implant could explain the higher satisfaction rates in Group B. The rate of complications appears similar in both groups. Conclusions: Composite breast augmentation using a combination of round high-profile implants and SEL in breast augmentation can achieve a higher patient satisfaction and aesthetic outcome as compared to the round high-profile breast augmentation alone. The technique is safe, simple and fast with low complication rates. Large multicentre, controlled, prospective studies need to be performed to further confirm the favourable results that were observed in this study.
      Citation: Medicines
      PubDate: 2020-05-19
      DOI: 10.3390/medicines7050028
      Issue No: Vol. 7, No. 5 (2020)
  • Medicines, Vol. 7, Pages 29: Addition of Multimodal Immunotherapy to
           Combination Treatment Strategies for Children with DIPG: A Single
           Institution Experience

    • Authors: Van Gool, Makalowski, Bonner, Feyen, Domogalla, Prix, Schirrmacher, Nazarian, Stuecker
      First page: 29
      Abstract: Background: The prognosis of children with diffuse intrinsic pontine glioma (DIPG) remains dismal despite radio- and chemotherapy or molecular-targeted therapy. Immunotherapy is a powerful and promising approach for improving the overall survival (OS) of children with DIPG. Methods: A retrospective analysis for feasibility, immune responsiveness, and OS was performed on 41 children treated in compassionate use with multimodal therapy consisting of Newcastle disease virus, hyperthermia, and autologous dendritic cell vaccines as part of an individualized combinatorial treatment approach for DIPG patients. Results: Patients were treated at diagnosis (n = 28) or at the time of progression (n = 13). In the case of 16 patients, histone H3K27M mutation was confirmed by analysis of biopsy (n = 9) or liquid biopsy (n = 9) specimens. PDL1 mRNA expression was detected in circulating tumor cells of ten patients at diagnosis. Multimodal immunotherapy was feasible as scheduled, until progression, in all patients without major toxicity. When immunotherapy was part of primary treatment, median PFS and OS were 8.4 m and 14.4 m from the time of diagnosis, respectively, with a 2-year OS of 10.7%. When immunotherapy was given at the time of progression, median PFS and OS were 6.5 m and 9.1 m, respectively. A longer OS was associated with a Th1 shift and rise in PanTum Detect test scores. Conclusions: Multimodal immunotherapy is feasible without major toxicity, and warrants further investigation as part of a combinatorial treatment approach for children diagnosed with DIPG.
      Citation: Medicines
      PubDate: 2020-05-19
      DOI: 10.3390/medicines7050029
      Issue No: Vol. 7, No. 5 (2020)
  • Medicines, Vol. 7, Pages 30: Heart Failure Drug Class Effects on 30-Day
           Readmission Rates in Patients with Heart Failure with Preserved Ejection
           Fraction: A Retrospective Single Center Study

    • Authors: Priyanka Parajuli, Odalys Estefania Lara-Garcia, Manjari Rani Regmi, Warren Skoza, Mukul Bhattarai, Abhishek Kulkarni, Robert Leonard Robinson
      First page: 30
      Abstract: Background: The pharmacologic management of heart failure with preserved ejection fraction (HFpEF) involves far fewer options with demonstrated additional benefit. Therefore, we examined the effect of combination of multiple classes of HF medication in the 30-day hospital readmission in patients with HFpEF. Methods: All adult patients discharged with a diagnosis of HFpEF and a left ventricular ejection fraction (LVEF) of ≥ 50% reported during the admission or within the previous six months from our institution were retrospectively studied for a 30-day hospital readmission risk. Individual as well as combination drug therapy at the time of hospital discharge were evaluated using Pearson chi2 test and multivariate logistic regression. Results: The overall 30-day readmission rate in this HFpEF cohort of 445 discharges was 29%. Therapy with loop diuretics (p = 0.011), loop diuretics and angiotensin receptor blocker (p = 0.043) and loop diuretics and beta blockers (p = 0.049) were associated with a lower risk of 30-day hospital readmission. Multivariate logistic regression revealed only loop diuretics to be associated with a lower risk of hospital readmission in patients with HFpEF (OR 0.59; 95% CI, 0.39-0.90; p = 0.013). Conclusions: Our study revealed that loop diuretics at discharge decreases early readmission in patients with HFpEF. Further, our study highlights the implication of a lack of guidelines and treatment challenges in HFpEF patients and emphasizes the importance of a conservative approach in preventing early readmission in patients with HFpEF.
      Citation: Medicines
      PubDate: 2020-05-20
      DOI: 10.3390/medicines7050030
      Issue No: Vol. 7, No. 5 (2020)
  • Medicines, Vol. 7, Pages 16: Stem Cell Ophthalmology Treatment Study
           (SCOTS): Bone Marrow-Derived Stem Cells in the Treatment of Age-Related
           Macular Degeneration

    • Authors: Jeffrey N. Weiss, Steven Levy
      First page: 16
      Abstract: Background: Dry age-related macular degeneration (AMD) is one of the leading causes of vision loss in older patients. The macula accumulates drusen with loss of retinal pigment epithelial cells and photoreceptors. Abnormal subretinal neovascularization is absent. There is no effective drug therapy for dry AMD and a large proportion of patients progress to legal blindness from macular atrophy. The Stem Cell Ophthalmology Treatment Study (SCOTS) was conducted to assess the effect of bone marrow-derived stem cells (BMSCs) on dry AMD and other retinal and optic nerve diseases. Methods: Thirty-two eyes were treated with BMSC per the protocols in SCOTS. Provision of BMSCs in Arm 1 was via retrobulbar (RB), sub-tenons (ST) and intravenous (IV); Arm 2 via intravitreal, RB, ST and IV; Arm 3 via subretinal and IV. Patient age averaged 78 years old and ranged from 69 to 90. Visual acuity preoperatively ranged from counting fingers to 20/50-2 with an average preoperative LogMAR of 1.125. Results: Following treatment, 20 of 32 (63%) of eyes experienced improvement in visual acuity averaging 27.6% on LogMAR and ranging from 2.5% to 44.6%. The mean improvement in LogMAR was 0.963 with a standard deviation (SD) of 0.42. The visual acuity remained stable in 34% of treated eyes. One eye continued to worsen as a consequence of disease progression. The results showed high statistical significance with p ≤ 0.001. The procedures were conducted safely, and no complications were observed. Conclusion: Treatment of dry AMD with BMSC using the protocols developed in the SCOTS clinical trial has shown statistically significant clinical benefit improving visual acuity and potentially delaying visual loss in the disease.
      Citation: Medicines
      PubDate: 2020-03-28
      DOI: 10.3390/medicines7040016
      Issue No: Vol. 7, No. 4 (2020)
  • Medicines, Vol. 7, Pages 17: Acupuncture for Relief of Gag Reflex in
           Patients Undergoing Transoesophageal Echocardiography—A Protocol for a
           Randomized Placebo-Controlled Trial

    • Authors: Taras I. Usichenko, Irina Müller-Kozarez, Stephan Knigge, Raila Busch, Mathias Busch
      First page: 17
      Abstract: Background: Gagging during transesophageal echocardiography examination (TEE) can be distressing and even dangerous for patients. The needling of acupuncture point CV24 was described to be effective in reducing the gag reflex during TEE in patients with ischemic stroke or transient ischemic attack. Methods: We describe a proposal for a prospective, randomized, patient, practitioner and assessor-blinded, single-center trial with two arms/groups; real acupuncture will be compared to placebo acupuncture. A total of 60 (30 per group) patients scheduled for elective TEE in order to exclude a cardiac embolic source, endocarditis or for valve failure evaluation will be recruited according to patients’ selection criteria and receive either indwelling fixed intradermal needles at acupoints CV24 and bilateral PC6 or placebo needles at the same areas. Patients, the practitioners who will perform the TEE procedure, and the assessor of the outcome measures will be unaware of the group’s (real or placebo) allocation. Results: The primary outcome is the intensity of gagging, measured using verbal rating scale (VRS-11) from 0 = no gagging to 10 = intolerable gagging. Secondary outcomes include the incidence of gagging, the use of rescue medication, patients’ satisfaction with relief of unwanted side effects during TEE procedure, success of patients’ blinding (patients’ opinion to group allocation), heart rate and oxygen saturation measured by pulse oxymetry. Conclusions: To study the effects of acupuncture against gagging during TEE, we test the needling of acupoints CV24 and PC6 bilaterally. A placebo acupuncture is used for the control group. Trial registration number: NCT NCT0382142.
      Citation: Medicines
      PubDate: 2020-03-31
      DOI: 10.3390/medicines7040017
      Issue No: Vol. 7, No. 4 (2020)
  • Medicines, Vol. 7, Pages 18: Methylxanthines Inhibit Primary Amine Oxidase
           and Monoamine Oxidase Activities of Human Adipose Tissue

    • Authors: Wiem Haj Ahmed, Cécile Peiro, Jessica Fontaine, Barry J. Ryan, Gemma K. Kinsella, Jeff O’Sullivan, Jean-Louis Grolleau, Gary T.M. Henehan, Christian Carpéné
      First page: 18
      Abstract: Background: Methylxanthines including caffeine and theobromine are widely consumed compounds and were recently shown to interact with bovine copper-containing amine oxidase. To the best of our knowledge, no direct demonstration of any interplay between these phytochemicals and human primary amine oxidase (PrAO) has been reported to date. We took advantage of the coexistence of PrAO and monoamine oxidase (MAO) activities in human subcutaneous adipose tissue (hScAT) to test the interaction between several methylxanthines and these enzymes, which are involved in many key pathophysiological processes. Methods: Benzylamine, methylamine, and tyramine were used as substrates for PrAO and MAO in homogenates of subcutaneous adipose depots obtained from overweight women undergoing plastic surgery. Methylxanthines were tested as substrates or inhibitors by fluorimetric determination of hydrogen peroxide, an end-product of amine oxidation. Results: Semicarbazide-sensitive PrAO activity was inhibited by theobromine, caffeine, and isobutylmethylxanthine (IBMX) while theophylline, paraxanthine, and 7-methylxanthine had little effect. Theobromine inhibited PrAO activity by 54% at 2.5 mM. Overall, the relationship between methylxanthine structure and the degree of inhibition was similar to that seen with bovine PrAO, although higher concentrations (mM) were required for inhibition. Theobromine also inhibited oxidation of tyramine by MAO, at the limits of its solubility in a DMSO vehicle. At doses higher than 12 % v/v, DMSO impaired MAO activity. MAO was also inhibited by millimolar doses of IBMX, caffeine and by other methylxanthines to a lesser extent. Conclusions: This preclinical study extrapolates previous findings with bovine PrAO to human tissues. Given that PrAO is a potential target for anti-inflammatory drugs, it indicates that alongside phosphodiesterase inhibition and adenosine receptor antagonism, PrAO and MAO inhibition could contribute to the health benefits of methylxanthines, especially their anti-inflammatory effects.
      Citation: Medicines
      PubDate: 2020-04-02
      DOI: 10.3390/medicines7040018
      Issue No: Vol. 7, No. 4 (2020)
  • Medicines, Vol. 7, Pages 19: Piperine Inhibits TGF-β Signaling Pathways
           and Disrupts EMT-Related Events in Human Lung Adenocarcinoma Cells

    • Authors: Leonardo Marques da Fonseca, Lucas Rodrigues Jacques da Silva, Jhenifer Santos dos Reis, Marcos André Rodrigues da Costa Santos, Victoria de Sousa Chaves, Kelli Monteiro da Costa, Julliana de Nazareth Sa-Diniz, Celio Geraldo Freire de Lima, Alexandre Morrot, Tatiany Nunes Franklim, Douglas Chaves de Alcântara-Pinto, Marco Edilson Freire de Lima, Jose Osvaldo Previato, Lucia Mendonça-Previato, Leonardo Freire-de-Lima
      First page: 19
      Abstract: Background: Piperine, an amide extracted from the Piper spices, exhibits strong anti-tumor properties. However, its effect on the epithelial–mesenchymal transition (EMT) process has never been investigated. Herein, we evaluate the toxic effect of piperine on lung adenocarcinoma (A549), breast adenocarcinoma (MDA-MB-231) and hepatocellular carcinoma (HepG2) cell lines, as well as its ability to inhibit EMT-related events induced by TGF-β1 treatment. Methods: The cell viability was investigated by MTT assay. Protein expression was evaluated by Western blot. Gene expression was monitored by real-time PCR. Zymography assay was employed to detect metalloproteinase (MMP) activity in conditioned media. Cell motility was assessed by the wound-healing and phagokinetic gold sol assays. Results: The results revealed that piperine was cytotoxic in concentrations over 100 µM, showing IC50 values for HepG2, MDA-MB-231 and A549 cell lines of 214, 238 and 198 µM, respectively. In order to investigate whether piperine would reverse the TGF-β1 induced-EMT, the A549 cell line was pretreated with sublethal concentrations of the natural amide followed by the addition of TGF-β1. Besides disrupting EMT-related events, piperine also inhibited both ERK 1/2 and SMAD 2 phosphorylation. Conclusions: These results suggest that piperine might be further used in therapeutic strategies for metastatic cancer and EMT-related disorders.
      Citation: Medicines
      PubDate: 2020-04-08
      DOI: 10.3390/medicines7040019
      Issue No: Vol. 7, No. 4 (2020)
  • Medicines, Vol. 7, Pages 20: Residential Aged Care Pharmacist: An
           Australian Pilot Trial Exploring the Impact on Quality Use of Medicines

    • Authors: McDerby, Kosari, Bail, Shield, Peterson, Naunton
      First page: 20
      Abstract: Background: This pilot study aimed to assess whether an on-site pharmacist could influence indicators of quality use of medicines in residential aged care. Methods: A pharmacist was embedded in a residential aged care home for six months. A similar control site received usual care. Polypharmacy, drug burden index, antipsychotic and benzodiazepine use, hospital admission rates and length of stay, and emergency department presentation rates were outcomes used to indicate medication use quality. Data were extracted from participating resident health records. Results: Fifty-eight residents at the study site and 39 residents at the control site were included in the analysis. There was a reduction in the proportion of residents at the study site who had at least one hospital admission at follow-up (28% to 12%, p < 0.01), but no significant difference in other outcomes. Conclusions: This pilot study suggests that a residential care pharmacist may positively influence indicators of medication use quality in aged care; however, further research is needed to expand on these findings.
      Citation: Medicines
      PubDate: 2020-04-20
      DOI: 10.3390/medicines7040020
      Issue No: Vol. 7, No. 4 (2020)
  • Medicines, Vol. 7, Pages 21: Limited Utility of Serology and Heterophile
           Test in the Early Diagnosis of Epstein–Barr Virus Mononucleosis in a
           Child after Renal Transplantation

    • Authors: Alexandra Byrne, Rachel Bush, Felicia Johns, Kiran Upadhyay
      First page: 21
      Abstract: Background: Epstein–Barr virus (EBV) infection is associated with significant morbidity and mortality in renal transplant (RT) recipients. The spectrum of illness ranges from infectious mononucleosis (IM) to post-transplant lymphoproliferative disorder (PTLD). In association with clinical signs and symptoms, virus-specific serology and heterophile antibody tests are widely used in confirming the diagnosis of IM in the general population. However, these tests may have a limited role in immunosuppressed RT recipients from seropositive donor, especially in children who were EBV-seronegative prior to the transplant. The aim of this study is to evaluate the utility of these tests in the early diagnosis of IM in this subset of patients. Methods: This is a case study with a review of literature. Results: Here, we present a 14-year-old male with hemophilia B who presented with fever, fatigue, sore throat, palatal petechial rash, exudative tonsillitis and cervical lymphadenopathy 3 months post-RT. He was EBV seronegative prior to RT and received a deceased donor kidney transplant from a seropositive donor. Induction was done with Thymoglobulin and maintenance immunosuppression consisted of tacrolimus and mycophenolate. Initial heterophile antibody test (monospot) was negative, but became positive at 5 months and remained positive at 9 months follow-up post-RT. EBV viral capsid antigens (VCA) IgM and IgG, early antigen (EA) and nuclear antigen (EBNA) were all negative at the time of presentation. VCA IgM and IgG both became positive at 5 months and peaked at 9 months follow-up, however the EA and EBNA remained negative. EBV viral load as measured by polymerase chain reaction (PCR) was negative for the first 3 months post-RT but became positive at presentation, peaked at 6 months and started declining thereafter. Peripheral blood smear examination showed no absolute and atypical lymphocytosis. Cytomegalovirus PCR in the blood and throat culture for streptococcus were negative. There was no splenomegaly. He was managed conservatively with intravenous fluids, bed rest, antipyretics and reduction of immunosuppression. Conclusions: EBV serological markers have a limited role in the early diagnosis of EBV-IM following RT in prior seronegative children. Initial heterophile antibody test may also be negative, and hence a repeat test may be necessary. Once becoming positive, the VCA IgM may remain persistently elevated for prolonged duration. In addition to the suppressed cellular immunity secondary to immunosuppression, humoral response to viral infections is also delayed in transplant recipients, especially in the early transplant period. Hence, routine monitoring with PCR is superior to serology in diagnosing IM early and monitoring the EBV infection post-RT for timely evaluation and management.
      Citation: Medicines
      PubDate: 2020-04-22
      DOI: 10.3390/medicines7040021
      Issue No: Vol. 7, No. 4 (2020)
  • Medicines, Vol. 7, Pages 22: A Double-Blind Randomized Placebo-Controlled
           Study Assessing the Safety, Tolerability and Efficacy of a Herbal Medicine
           Containing Pycnogenol Combined with Papain and Aloe vera in the Prevention
           and Management of Pre-Diabetes

    • Authors: Luis Vitetta, Belinda Butcher, Serena Dal Forno, Gemma Vitetta, Tessa Nikov, Sean Hall, Elizabeth Steels
      First page: 22
      Abstract: Background: Herbal medicines present attractive options to patients with chronic diseases. Undertaking clinical studies with patients presenting with symptomless pre-T2D can lead to significant limitations. Methods: A 12-week randomized double-blind placebo-controlled clinical study was conducted that investigated the safety and efficacy of an herbal formulation administered orally for the treatment of pre-type 2 diabetes (pre-T2D). Results: A numerically greater proportion of subjects in the interventional arm had impaired fasting glucose (IFG) at week 12 compared to the control arm (71.0% vs. 69.0%, p = 0.75). Fewer participants had impaired glucose tolerance (IGT) at 12 weeks in the intervention arm compared to the control arm (unadjusted 58.3% vs. 66.7%, p = 0.65; adjusting for baseline IGT, p = 0.266). In a subgroup analysis, subjects with a baseline fasting plasma glucose (FPG) level in the range of 6.1–6.9 mmol/L demonstrated a non-significant lower proportion of IFG at week 12 in the intervention arm compared to the control arm (60.0% vs. 41.7% p = 0.343). Total blood cholesterol and triglyceride levels remained unchanged from baseline to week 12 in both treatment groups. Conclusions: This study suggests that a polyherbal medicine was not effective for reducing the metabolic markers associated with pre-T2D over a 12-week period. Therefore, larger studies with well-defined endpoints and of longer duration are warranted.
      Citation: Medicines
      PubDate: 2020-04-22
      DOI: 10.3390/medicines7040022
      Issue No: Vol. 7, No. 4 (2020)
  • Medicines, Vol. 7, Pages 10: Antioxidant and a-amylase Inhibitory
           Activities and Phytocompounds of Clausena indica Fruits

    • Authors: La Hoang Hoang Anh, Tran Dang Xuan, Nguyen Thi Dieu Dieu Thuy, Nguyen Van Quan, Le Thu Trang
      First page: 10
      Abstract: Background: Clausena indica fruit is commonly used for food ingredients and traditional medicines in tropical countries, however, information about its biological activities and chemical profiles has been inadequately reported. Methods: In this study, a bio-guided fractionation of antioxidants and α-amylase inhibitors from hexane (MH) and ethyl acetate (ME) extracts of C. indica fruit (pericarp and seed) was carried out. Eleven fractions from MH (D1–D11) and 17 fractions from ME (T1–T17) were obtained from column chromatography over silica gel, which were then examined for anti-radical capacity by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays, and pancreatic α-amylase inhibition, a key enzyme linked to type 2 diabetes. Results: Of isolated fractions, the fraction T4 revealed the most potent anti-DPPH activity (IC50 = 0.13 mg/mL), whereas T2 exhibits the strongest ABTS cation scavenging ability (IC50 = 0.31 mg/mL). In the enzymatic assay, the fractions D3 and T4 significantly inhibit the α-amylase reaction with IC50 values of 0.34 and 0.86 mg/mL, respectively. Remarkably, α-amylase suppression of T4 is close to acarbose and over four times stronger than palmitic acid, which are the well-known α-amylase inhibitors (IC50 = 0.07 and 1.52 mg/mL, respectively). The active constituents from fractions were identified by gas chromatography-mass spectrometry (GC-MS). The results show that the fraction D3 contains five major compounds, which are grouped in five classes consisting of fatty acids, phenols, benzodioxoles, alcohols, and sesquiterpenes. Among them, palmitic acid is the most dominant compound (32.64%), followed by 2R-acetoxymethyl-1,3,3-trimethyl-4t-(3-methyl-2-buten-1-yl)-1t-cyclohexanol (16.69%). Whilst, six major compounds belonging to fatty acid and coumarin classes are identified in the fraction T4. The most abundant compound in T4 is dentatin (47.32%), followed by palmitic acid (15.11%). Conclusions: This is the first finding that C. indica fruit can be a promising source for the development of natural antioxidant and antidiabetic agents. Additionally, the outcome reveals that dentatin, a known natural antineoplastic agent, can be feasibly exploited from C. indica fruit.
      Citation: Medicines
      PubDate: 2020-02-28
      DOI: 10.3390/medicines7030010
      Issue No: Vol. 7, No. 3 (2020)
  • Medicines, Vol. 7, Pages 11: The Antioxidant and Antihyperglycemic
           Activities of Bottlebrush Plant (Callistemon lanceolatus) Stem Extracts

    • Authors: Ramesh Kumar, Ashutosh Gupta, Amit Kumar Singh, Anupam Bishayee, Abhay K. Pandey
      First page: 11
      Abstract: Background: Diabetes mellitus, a metabolic disease, is a major health concern today throughout the world. Callistemon lanceolatus (Myrtaceae), commonly known as bottlebrush, has been used by Indian tribal communities for the treatment of many diseases. The purpose of this study was to explore antioxidant and antihyperglycemic potential of methanolic and aqueous extracts of the stem of C. lanceolatus in vitro and in vivo. Methods: Phytoconstituents of C. lanceolatus stem were extracted in methanol and water sequentially followed by phytochemical analysis. The in vitro antioxidant potential of aqueous and methanolic extracts was assessed by metal ion chelating, free radical scavenging, and reducing power assays. The in vivo antihyperglycemic activity of the oral methanolic extract was studied in alloxan-induced diabetic rats. Bodyweight and blood glucose were monitored regularly. After the treatment period, serum was examined for total cholesterol, triglycerides, high-density lipoprotein (HDL), bilirubin, creatinine, urea, glutamate pyruvate transaminase (SGPT), glutamate oxaloacetate transaminase (SGOT), and alkaline phosphatase (ALP). Results: Methanolic extract exhibited superior antioxidant activity to aqueous extract. A marked increase in levels of serum markers, viz., glucose, triglycerides, total cholesterol, bilirubin, urea, creatinine, SGOT, SGPT, and ALP along with a reduction in HDL was observed in diabetic rats. Methanol extract treatment for 28 days accounted for a decrease in blood glucose and other metabolic markers accompanied by an improvement in body weight and HDL level in hyperglycemic rats. Conclusions: The present study suggests that C. lanceolatus methanolic stem extract possesses antioxidant and antihyperglycemic activities and has potential as a therapeutic agent in diabetes.
      Citation: Medicines
      PubDate: 2020-03-04
      DOI: 10.3390/medicines7030011
      Issue No: Vol. 7, No. 3 (2020)
  • Medicines, Vol. 7, Pages 12: Primer for Mainstreaming Mind-Body Techniques
           for Extreme Climates-Insights and Future Directions

    • Authors: Anand, Kaur, Bammidi, Mathur, Battu, Sharma, Tyagi, Pannu, Bhanushali, Limaye
      First page: 12
      Abstract: Background: The deprivation of oxygen reaching the tissues (also termed as hypoxia) affects the normal functioning of the body. This results in development of many diseases like ischemia, glaucoma, MCI (Mild Cognitive Impairment), pulmonary and cerebral edema, stress and depression. There are no effective drugs that can treat such diseases. Despite such failure, alternative interventions such as mind-body techniques (MBTs) have not been adequately investigated. Methods: The first part of this review has been focused on philosophical aspects of various MBTs besides evolving an ayurgenomic perspective. The potential of MBTs as a preventive non-pharmacological intervention in the treatment of various general and hypoxic pathologies has been further described in this section. In the second part, molecular, physiological, and neuroprotective roles of MBTs in normal and hypoxic/ischemic conditions has been discussed. Results: In this respect, the importance of and in vivo studies has also been discussed. Conclusions: Although several studies have investigated the role of protective strategies in coping with the hypoxic environment, the efficacy of MBTs at the molecular level has been ignored.
      Citation: Medicines
      PubDate: 2020-03-06
      DOI: 10.3390/medicines7030012
      Issue No: Vol. 7, No. 3 (2020)
  • Medicines, Vol. 7, Pages 13: High Serum Phosphate Level as a Risk Factor
           to Determine Renal Prognosis in Autosomal Dominant Polycystic Kidney
           Disease: A Retrospective Study

    • Authors: Masayo Sato, Hiroshi Kataoka, Yusuke Ushio, Shun Manabe, Saki Watanabe, Taro Akihisa, Shiho Makabe, Rie Yoshida, Naomi Iwasa, Michihiro Mitobe, Norio Hanafusa, Ken Tsuchiya, Kosaku Nitta, Toshio Mochizuki
      First page: 13
      Abstract: Background: Serum phosphate levels, which are associated with the progression of renal dysfunction in chronic kidney disease, in patients with autosomal dominant polycystic kidney disease (ADPKD) are lower than those in patients with other kidney diseases. However, their role in ADPKD remains unclear. This study aimed to determine whether serum phosphate levels could have an association with renal prognoses among patients with ADPKD. Methods: In total, 55 patients with PKD1 or PKD2 mutations but not undergoing dialysis were evaluated. Data regarding serum phosphate levels were collected, and Cox regression analyses were used to calculate hazard ratios (HRs) with renal replacement therapy as the endpoint. Results: The median (quartile 1; quartile 3) serum phosphate concentration was 3.4 (3.1; 3.9) mg/dL, and the estimated glomerular filtration rate (eGFR) was 39.5 (17.6; 65.7) mL/min/1.73 m2. The multivariate analysis that included age, PKD1 mutation, eGFR, urinary protein excretion, hyperuricemia, and serum phosphate determined that eGFR (HR, 0.82; 95% confidence interval (CI), 0.74–0.90; p < 0.0001) and serum phosphate (HR, 6.78; 95% CI, 1.94–34.02; p = 0.0021) were independently associated with renal replacement therapy. Conclusions: We found that serum phosphate levels were significantly associated with poor renal prognoses in patients with ADPKD.
      Citation: Medicines
      PubDate: 2020-03-12
      DOI: 10.3390/medicines7030013
      Issue No: Vol. 7, No. 3 (2020)
  • Medicines, Vol. 7, Pages 14: The Combined Use of Stem Cells and Platelet
           Lysate Plasma for the Treatment of Erectile Dysfunction: A Pilot Study–6
           Months Results

    • Authors: Vassilis Protogerou, Sara El Beshari, Efstathios Michalopoulos, Panagiotis Mallis, Dimosthenis Chrysikos, Alexandros A. Samolis, Catherine Stavropoulos-Giokas, Theodoros Troupis
      First page: 14
      Abstract: Background: The current treatment of Erectile Dysfunction (ED) is mainly based on the use of drugs that provide erections shortly after use but they do not really treat the problem. Stem cell therapy is a novel treatment with regenerative properties that can possibly treat erectile dysfunction. Methods: Five patients with erectile disease were treated with Adipose-Derived Stem Cells (ADSCs) and Platelet Lysate Plasma (PLP). ADSCs were obtained through abdominal liposuction and PLP was prepared after obtaining blood samples from peripheral veins. Erectile function was evaluated with the International Index of Erectile Function questionnaire (IIEF-5) questionnaire, penile triplex at the 1st, 3rd, 6th and 12th month post-treatment. A CT scan of the head, thorax and abdomen was done before treatment and at the 12th month. Results: IIEF-5 scores were improved in all patients at the 6th month although not in the same pattern in all patients. Peak Systolic Velocity (PSV) also improved at the 6th month in all patients but also with different patterns in each patient, while End Diastolic Velocity (EDV) was more variable. Two patients decreased the treatment they used in order to obtain erection (from Intracavernosal injections (ICI) they used PDE-5Is), two had unassisted erections and one had an initial improvement which decreased at the 6th month. There were no side effects noted. Conclusions: Stem cell therapy in combination with PLP appears to show some improvement in erectile function and has minimal side effects in the short term.
      Citation: Medicines
      PubDate: 2020-03-18
      DOI: 10.3390/medicines7030014
      Issue No: Vol. 7, No. 3 (2020)
  • Medicines, Vol. 7, Pages 15: Severe Neutropenia and Agranulocytosis
           Related to Antithyroid Drugs: A Study of 30 Cases Managed in A Single
           Reference Center

    • Authors: Andrès, Lorenzo Villalba, Mourot-Cottet, Maloisel, Tebacher, Gottenberg, Goichot, Herbrecht, Zulfiqar
      First page: 15
      Abstract: Background: The most important series devoted to antithyroid drug-induced severe neutropenia and agranulocytosis are Japanese studies, almost specifically in relation to the intake of methimazole. The clinical data of 30 Caucasian patients followed up for antithyroid drug-induced neutropenia at a third-level hospital are reported. Methods: The data of 30 patients with idiosyncratic antithyroid drug-induced neutropenia and agranulocytosis from a cohort study on drug-induced neutropenia and agranulocytosis conducted at the University Hospital of Strasbourg (France) were retrospectively reviewed. Results: The mean patient age was 61.7 years old (range: 20–87), and the gender ratio (F/M) was 4. Several comorbidities were reported in 23 patients (76.7%), with the mean Charlson comorbidity index of 1. The causative drugs were carbimazole and benzylthiouracil, in 28 (93.3%) and 2 cases, respectively, prescribed primarily for multi-hetero-nodular goiter or thyroid nodule to 18 patients (60%). Sore throat and acute tonsillitis (40%), isolated fever (20%), septicemia (13.3%), documented pneumonia (6.7%), and septic shock (6.7%) were the main clinical features upon admission. The mean neutrophil count at nadir was 0.02 and 0 × 109/L (range: 0–0.3). Regarding the patients’ hospital course: 13 cases (43.3%) worsened during hospitalization, severe sepsis was found in 26.7%, systemic inflammatory response syndrome—in 13.3%, and septic shock—in 3.3% of the cases, respectively. Broad-spectrum antibiotics were indicated for all the patients, and 21 (73.3%) of them received hematopoietic growth factors. Hematological recovery (neutrophil count ≥ 1.5 × 109/L) was seen at 8.3 days (range: 2–24), but faster in those receiving hematopoietic growth factors (4.9 days, p = 0.046). Two patients died during hospitalization, and the rest had a favorable clinical outcome. Conclusions: Antithyroid drug-induced neutropenia represents a serious complication resulting from the rates of severe infections especially in those cases severe neutropenia. In this setting, an established procedure for the management of patients seems useful or even indispensable in view of potential mortality.
      Citation: Medicines
      PubDate: 2020-03-19
      DOI: 10.3390/medicines7030015
      Issue No: Vol. 7, No. 3 (2020)
  • Medicines, Vol. 7, Pages 7: The Use of Medicinal Plants in Maceió,
           Northeastern Brazil: An Ethnobotanical Survey

    • Authors: Cerqueira, Correia, Santos, Lemos, Silva, Barreto
      First page: 7
      Abstract: Background: The purpose of this study was to record and analyze the knowledge of medicinal plant use in the community in urban areas of Maceió city, Brazil. Methods: A total of 113 patients from the basic healthcare unit were assessed. Results: Approximately 95% of the interviewed stated that the plants were used for medicinal purposes. The majority of respondents were women (94.7%) who were between 51-60 years of age. Forty-eight plant species belonging to 28 families were cited as useful for medicinal purposes. The main families encountered were Lamiaceae (16.6%), Asteraceae (8.3%), Myrtaceae (6.2%), Fabaceae (6.2%), Annonaceae (4.1%), Laureaceae (4.1%), Rutaceae (4.1%), and Zingiberaceae (4.1%). These plants were used to treat a wide range of disturbances, including gastrointestinal, respiratory, and cardiovascular diseases. The majority of the respondents used decoctions of leaves that were cultivated in house (58.4%) to make their herbal preparations. The respondents revealed that medicinal plant preparations were safe and unaware of that are risks associated with their use. Conclusions: Medicinal plants still play an important role in the medical practices of the urban population from Maceió, Brazil. Our results highlight the importance of these plants for local people and indicate the need for further scientific investigations to validate their use as a complementary therapy for disease control.
      Citation: Medicines
      PubDate: 2020-01-21
      DOI: 10.3390/medicines7020007
      Issue No: Vol. 7, No. 2 (2020)
  • Medicines, Vol. 7, Pages 8: Knowledge, Attitude, and Practice of Yoga in
           Rural and Urban India, KAPY 2017: A Nationwide Cluster Sample Survey

    • Authors: Mishra, SK, HS, Nagarathna, Anand, Bhutani, Sivapuram, Singh, Nagendra
      First page: 8
      Abstract: : Background: To examine the knowledge, attitudes, and practice gap of yoga across India based on implicit perceptions. Methods: The present study is a nationwide door-to-door survey conducted using a questionnaire/screening form. The data were collected from a national survey conducted under the Niyantrit Madhumeh Bharat (NMB) program initiated by The Ministry of Ayurveda, Yoga, Unani, Siddha, Homeopathy (AYUSH), Government of India, from all major zones of the country. A total of 162,330 participants who joined the NMB program were recruited in our study. Results: Out of the total respondents to the survey, it was observed that 11.8% [13,336/112,735] practice yoga, which was highest in the north zone [4,567/112,735] and lowest in the east zone [971/112,735]. Out of 101,643 respondents, 94,135 of the individuals who participated in the survey believed that yoga improved their lifestyle, and 90,102/98,518 believed that yoga prevented diabetes, revealing a huge knowledge–practice gap. Conclusions: The scale of the knowledge–practice gap coupled with the general acceptability of yoga calls for a change in the conventional healthcare provisions by its integration with modern medicine. The population-wide positive perceptions about yoga as a preventive health tool can not only catalyze consensus disease-specific yoga modules but also bridge the knowledge–practice gap that exists because of limited yoga centers and professionals.
      Citation: Medicines
      PubDate: 2020-02-05
      DOI: 10.3390/medicines7020008
      Issue No: Vol. 7, No. 2 (2020)
  • Medicines, Vol. 7, Pages 9: Efficacy of Antihypertensive Therapy in a
           Child with Unilateral Focal Fibromuscular Dysplasia of the Renal Artery: A
           Case Study and Review of Literature

    • Authors: Ratna Acharya, Savannah Ellenwood, Kiran Upadhyay
      First page: 9
      Abstract: Background: Fibromuscular dysplasia (FMD) is one of the important etiologies of renovascular hypertension in children. It is usually resistant to multiple antihypertensive agents and can cause extreme elevation in blood pressures, which can lead to end organ damage if not promptly diagnosed and treated. Treatment options include medical management with antihypertensive agents, balloon or stent angioplasties, surgical revascularization, and nephrectomy. The aim of the study was to review the efficacy of antihypertensive therapy only in the management of FMD in a very young child. Methods: This is a retrospective chart study with review of literature. Results: Here, we report a 22-month-old toddler who presented with severe resistant hypertension and cardiomyopathy who was found to have focal FMD of the right renal artery. She also presented with proteinuria, hyponatremia that was probably secondary to pressure natriuresis, hypokalemia, hyperaldosteronism, and elevated plasma renin activity. The stabilization of blood pressures was done medically with the usage of antihypertensive medications only, without the need for angioplasty or surgical revascularization. Conclusions: We demonstrate that surgical intervention may not always be necessary in the treatment of all cases of FMD, especially in a small child where such intervention may be technically challenging and lead to potential complications. Hence, medical management alone may be sufficient, at least for the short-term, in small children with controlled hypertension and normal renal function, with surgical intervention reserved for FMD with medication-refractory hypertension and/or compromised renal function.
      Citation: Medicines
      PubDate: 2020-02-20
      DOI: 10.3390/medicines7020009
      Issue No: Vol. 7, No. 2 (2020)
  • Medicines, Vol. 7, Pages 73: Auricular Acupuncture for Preoperative
           Anxiety—Protocol of Systematic Review and Meta-Analysis of Randomized
           Controlled Trials

    • Authors: Joanna Dietzel, Mike Cummings, Kevin Hua, Klaus Hahnenkamp, Benno Brinkhaus, Taras I. Usichenko
      First page: 73
      Abstract: Background: Preoperative anxiety causes profound psychological and physiological reactions that may lead to a worse postoperative recovery, higher intensity of acute and persistent postsurgical pain and impaired quality of life in the postoperative period. Previous randomized controlled trials (RCTs) suggest that auricular acupuncture (AA) is safe and effective in the treatment of preoperative anxiety; however there is a lack of systematic evidence on this topic. Therefore, this protocol was developed following the PRISMA guidelines to adequately evaluate the existing literature regarding the value of AA for the reduction in anxiety in patients in a preoperative setting, compared to other forms of acupuncture, pharmacological, or no control interventions and measured with questionnaires regarding anxiety and fear. Methods: The following databases will be searched: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. RCTs will be included if an abstract is available in English. Data collection and analysis will be conducted by two reviewers independently. Quality and risk assessment of included studies will be done using the Cochrane 5.1.0 handbook criteria and meta-analysis of effectiveness and symptom scores will be conducted using the statistical software RevMan V.5.3. Conclusions: This systematic review will evaluate the efficacy and safety of AA for preoperative anxiety. Since all data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. The results may be published in a peer-reviewed journal or be presented in relevant conferences. Registration number: PROSPERO ID CRD42020.
      Citation: Medicines
      PubDate: 2020-11-26
      DOI: 10.3390/medicines7120073
      Issue No: Vol. 7, No. 12 (2020)
  • Medicines, Vol. 7, Pages 74: Preventive Effect of the Japanese Traditional
           Herbal Medicine Boiogito on Posttraumatic Osteoarthritis in Rats

    • Authors: Jun Oike, Takayuki Okumo, Hideshi Ikemoto, Yusuke Kunieda, Shingo Nakai, Haruka Takemura, Hiroshi Takagi, Koji Kanzaki, Masataka Sunagawa
      First page: 74
      Abstract: Background: Considering the anti-inflammatory properties of the Japanese traditional Kampo medicine Boiogito (BO), we aimed to investigate the therapeutic effect of BO to prevent the development of knee osteoarthritis (KOA) in rats with surgically induced KOA. Methods: Destabilization of the medial meniscus (DMM) was performed to induce osteoarthritis in the right knees of 12-week-old Wistar rats under general anesthesia. The rats were orally administered 3% BO in standard powder chow for 4 weeks after surgery (controls: n = 6; sham group: n = 6; DMM group: n = 5; DMM + BO group: n = 5). During this period, the rotarod test was performed to monitor locomotive function. After 4 weeks, histological assessment was performed on the right knee. Results: Oral administration of BO improved locomotive function in the rotarod test. Walking time on postoperative days 1, 14, or later was significantly longer in the DMM + BO group than in the DMM group. Histologically, the DMM group showed significant progression of KOA, which, in the DMM + BO group, was strongly suppressed, as assessed by the Osteoarthritis Research Society International score. Conclusions: Our results showed that oral administration of BO had a clinically preventive effect on early stage posttraumatic KOA.
      Citation: Medicines
      PubDate: 2020-12-04
      DOI: 10.3390/medicines7120074
      Issue No: Vol. 7, No. 12 (2020)
  • Medicines, Vol. 7, Pages 75: Analgesic Efficacy of a Combination of
           Fentanyl and a Japanese Herbal Medicine “Yokukansan” in Rats with
           Acute Inflammatory Pain

    • Authors: Yuko Akanuma, Mami Kato, Yasunori Takayama, Hideshi Ikemoto, Naoki Adachi, Yusuke Ohashi, Wakako Yogi, Takayuki Okumo, Mana Tsukada, Masataka Sunagawa
      First page: 75
      Abstract: Background: Fentanyl can induce acute opioid tolerance and postoperative hyperalgesia when administered at a single high dose; thus, this study examined the analgesic efficacy of a combination of fentanyl and Yokukansan (YKS). Methods: Rats were divided into control, formalin-injected (FOR), YKS-treated+FOR (YKS), fentanyl-treated+FOR (FEN), and YKS+FEN+FOR (YKS+FEN) groups. Acute pain was induced via subcutaneous injection of formalin into the paw. The time engaged in pain-related behavior was measured. Results: In the early (0–10 min) and intermediate (10–20 min) phases, pain-related behavior in the YKS+FEN group was significantly inhibited compared with the FOR group. In the late phase (20–60 min), pain-related behavior in the FEN group was the longest and significantly increased compared with the YKS group. We explored the influence on the extracellular signal-regulated kinase (ERK) pathway in the spinal cord, and YKS suppressed the phosphorylated ERK expression, which may be related to the analgesic effect of YKS in the late phase. Conclusions: These findings suggest that YKS could reduce the use of fentanyl and combined use of YKS and fentanyl is considered clinically useful.
      Citation: Medicines
      PubDate: 2020-12-17
      DOI: 10.3390/medicines7120075
      Issue No: Vol. 7, No. 12 (2020)
  • Medicines, Vol. 7, Pages 67: Use of Herbal Medications for Treatment of
           Osteoarthritis and Rheumatoid Arthritis

    • Authors: Breanna N. Lindler, Katelyn E. Long, Nancy A. Taylor, Wei Lei
      First page: 67
      Abstract: Arthritis is a chronic condition that affects nearly a quarter of the United States population. Osteoarthritis (OA) and rheumatoid arthritis (RA) are two major forms of arthritis associated with severe joint pain and reduced quality of life. Various pharmacological interventions may be utilized for arthritis treatment when non-pharmacological therapy is insufficient. However, pharmacological therapy can be associated with serious side effects and high costs. Therefore, alternative therapies have been under investigation. Herbal medications have shown the potential for safe and effective management of arthritis. For this review, we attempt to summarize the mechanisms, safety, and efficacy of herbal treatments for OA and RA. After searching electronic databases, we identified nine herbs among 23 clinical trials used for the treatment of OA or RA patients. Improvement of OA and RA symptoms, pain, and inflammation was demonstrated. The herbs exhibited strong anti-inflammatory and anti-oxidant activities, contributing to a reduction in inflammation and tissue damage. Several herbs elucidated new mechanisms for OA and RA treatment as well. Though these herbs have shown promise for OA and RA treatment, more studies and clinical trials are required for determining safety and efficacy, bioactivity, and optimal bioavailability.
      Citation: Medicines
      PubDate: 2020-10-28
      DOI: 10.3390/medicines7110067
      Issue No: Vol. 7, No. 11 (2020)
  • Medicines, Vol. 7, Pages 68: Identification and Classification of
           Polymyalgia Rheumatica (PMR) and PMR-Like Syndromes Following Immune
           Checkpoint Inhibitors (ICIs) Therapy: Discussion Points and Grey Areas
           Emerging from a Systematic Review of Published Literature

    • Authors: Ciro Manzo, Marco Isetta, Maria Natale, Alberto Castagna
      First page: 68
      Abstract: Background: Polymyalgia Rheumatica (PMR) is one of the most frequent rheumatologic immune-related adverse effects (IRAEs) in cancer patients following therapy with immune checkpoint inhibitors (ICIs). Atypical findings in many patients often lead to diagnosing PMR-like syndromes. Materials and methods: The aim of our research was to review reported diagnoses of PMR and PMR-like syndromes following ICIs therapy, and assess whether they can be redefined as adverse drug reaction (ADR). In line with PRISMA guidelines, we carried out a systematic search on three main bibliographic databases, based on a combination of subject headings and free text. We included all studies and case-reports published after 2011 (when FDA approved the use of the first ICI) describing the association of PMR or PMR-like syndromes with all types of ICIs therapy. We excluded reviews, conference abstracts, comments, secondary articles, and non-English language studies. Results: We reviewed data from seven studies and eight case-reports, involving a total of 54 patients. Limitations included: the small size of all studies; only one retrospective study used validated criteria for PMR; most reports assessed IRAEs by clinical judgment only and did not seek validation through assessment scales. To date, it remains a conundrum whether IRAEs-PMR is identical to the idiopathic form of the disease, or whether it should be considered a subset of the disease or a new entity. Conclusions: Our review indicates that the relationship between PMR and ICIs therapy is yet to be clearly understood and defined and that future research should remedy the current limits in study design.
      Citation: Medicines
      PubDate: 2020-11-03
      DOI: 10.3390/medicines7110068
      Issue No: Vol. 7, No. 11 (2020)
  • Medicines, Vol. 7, Pages 69: Cocculus hirsutus (L.) W.Theob.
           (Menispermaceae): A Review on Traditional Uses, Phytochemistry and
           Pharmacological Activities

    • Authors: Rajan Logesh, Niranjan Das, Anjana Adhikari-Devkota, Hari Prasad Devkota
      First page: 69
      Abstract: Background:Cocculus hirsutus (L.) W.Theob. (Menispermaceae) is a perennial climber distributed mostly in tropical and subtropical areas. The main aim of this article is to collect and analyze the scientific information related to traditional uses, bioactive chemical constituents and pharmacological activities. Methods: Scientific information on C. hirsutus was retrieved from the online bibliographic databases (e.g. MEDLINE/PubMed, SciFinder, Web of Science, Google Scholar and Scopus). Information regarding traditional uses was also acquired from secondary resources including books and proceedings. Results: Different plant parts of C. hirsutus were reported to be used for the treatment of fever, skin diseases, stomach disorders and urinary diseases. Alkaloids such as jasminitine, hirsutine, cohirsitine and their derivatives along with a few flavonoids, triterpene derivatives and volatile compounds were reported from whole plant or different plant parts. Extracts were evaluated for their antimicrobial, antidiabetic, immunomodulatory and hepatoprotective activities among others. Conclusion: Although widely used in traditional medicines, only a few studies have been performed related to chemical constituents. Most of the biological activity evaluations were carried out using in vitro evaluation methods and only a few studies were carried out in animal models. In the future, properly designed in vivo and clinical studies are necessary to evaluate the pharmacological activities of C. hirsutus along with bioassay-guided studies to isolate and identify the active constituents.
      Citation: Medicines
      PubDate: 2020-11-10
      DOI: 10.3390/medicines7110069
      Issue No: Vol. 7, No. 11 (2020)
  • Medicines, Vol. 7, Pages 70: Hospital-Acquired Serum Ionized Calcium
           Derangements and Their Associations with In-Hospital Mortality

    • Authors: Charat Thongprayoon, Panupong Hansrivijit, Tananchai Petnak, Michael A. Mao, Tarun Bathini, Saraschandra Vallabhajosyula, Ploypin Lertjitbanjong, Fawad Qureshi, Stephen B. Erickson, Wisit Cheungpasitporn
      First page: 70
      Abstract: Background: The objective of this study was to report the incidence of in-hospital serum ionized calcium derangement and its impact on mortality. Methods: We included 12,599 non-dialytic adult patients hospitalized at a tertiary medical center from January 2009 to December 2013 with normal serum ionized calcium at admission and at least 2 in-hospital serum ionized calcium values. Using serum ionized calcium of 4.60–5.40 mg/dL as the normal reference range, in-hospital serum ionized calcium levels were categorized based on the presence of hypocalcemia and hypercalcemia in hospital. We performed logistic regression to assess the relationship of in-hospital serum ionized calcium derangement with mortality. Results: Fifty-four percent of patients developed new serum ionized calcium derangements: 42% had in-hospital hypocalcemia only, 4% had in-hospital hypercalcemia only, and 8% had both in-hospital hypocalcemia and hypercalcemia. In-hospital hypocalcemia only (OR 1.28; 95% CI 1.01–1.64), in-hospital hypercalcemia only (OR 1.64; 95% CI 1.02–2.68), and both in-hospital hypocalcemia and hypercalcemia (OR 1.73; 95% CI 1.14–2.62) were all significantly associated with increased in-hospital mortality, compared with persistently normal serum ionized calcium levels. Conclusions: In-hospital serum ionized calcium derangements affect more than half of hospitalized patients and are associated with increased in-hospital mortality.
      Citation: Medicines
      PubDate: 2020-11-19
      DOI: 10.3390/medicines7110070
      Issue No: Vol. 7, No. 11 (2020)
  • Medicines, Vol. 7, Pages 71: Correction: Oral Intake of Royal Jelly Has
           Protective Effects against Tyrosine Kinase Inhibitor-Induced Toxicity in
           Patients with Renal Cell Carcinoma: A Randomized, Double-Blinded,
           Placebo-Controlled Trial. Medicines, 2019, 6, 2

    • Authors: Kyohei Araki, Yasuyoshi Miyata, Kojiro Ohba, Yuichiro Nakamura, Tomohiro Matsuo, Yasushi Mochizuki, Hideki Sakai
      First page: 71
      Abstract: We, the authors, wish to make the following correction to our published paper [...]
      Citation: Medicines
      PubDate: 2020-11-19
      DOI: 10.3390/medicines7110071
      Issue No: Vol. 7, No. 11 (2020)
  • Medicines, Vol. 7, Pages 72: Prevalence and Outcomes Associated with
           Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular
           Disease and Cerebrovascular Disorder—A Nationwide Study

    • Authors: Urvish Patel, Salma Yousuf, Komal Lakhani, Payu Raval, Nirmaljot Kaur, Toochukwu Okafor, Chail Shah, Harmandeep Singh, Mehwish Martin, Chika Nwodika, Angelina Yogarajah, Jigisha Rakholiya, Maitree Patel, Raja Chandra Chakinala, Shamik Shah
      First page: 72
      Abstract: Background: According to past studies, recovery and survival following severe vascular events such as acute myocardial infarction and stroke are negatively impacted by vitamin D deficiency. However, the national estimate on disability-related burden is unclear. We intend to evaluate the prevalence and outcomes of vitamin D deficiency (VDD) among patients with cardiovascular disease (CVD) and cerebrovascular disorder (CeVD). Methods: We performed a cross-sectional study on the Nationwide Inpatient Sample data (2016–2017) of adult (≥18 years) hospitalizations. We identified patients with a secondary diagnosis of VDD and a primary diagnosis of CVD and CeVD using the 9th revision of the International Classification of Diseases, clinical modification code (ICD-10-CM) codes. A univariate and mixed-effect multivariable survey logistic regression analysis was performed to evaluate the prevalence, disability, and discharge disposition of patients with CVD and CeVD in the presence of VDD. Results: Among 58,259,589 USA hospitalizations, 3.44%, 2.15%, 0.06%, 1.28%, 11.49%, 1.71%, 0.38%, 0.23%, and 0.08% had primary admission of IHD, acute MI, angina, AFib, CHF, AIS, TIA, ICeH, and SAH, respectively and 1.82% had VDD. The prevalence of hospitalizations due to CHF (14.66% vs. 11.43%), AIS (1.87% vs. 1.71%), and TIA (0.4% vs. 0.38%) was higher among VDD patients as compared with non-VDD patients (p < 0.0001). In a regression analysis, as compare with non-VDD patients, the VDD patients were associated with higher odds of discharge to non-home facilities with an admission diagnosis of CHF (aOR 1.08, 95% CI 1.07–1.09), IHD (aOR 1.24, 95% CI 1.21–1.28), acute MI (aOR 1.23, 95% CI 1.19–1.28), AFib (aOR 1.21, 95% CI 1.16–1.27), and TIA (aOR 1.19, 95% CI 1.11–1.28). VDD was associated with higher odds of severe or extreme disability among patients hospitalized with AIS (aOR 1.1, 95% CI 1.06–1.14), ICeH (aOR 1.22, 95% CI 1.08–1.38), TIA (aOR 1.36, 95% CI 1.25–1.47), IHD (aOR 1.37, 95% CI 1.33–1.41), acute MI (aOR 1.44, 95% CI 1.38–1.49), AFib (aOR 1.10, 95% CI 1.06–1.15), and CHF (aOR 1.03, 95% CI 1.02–1.05) as compared with non-VDD. Conclusions: CVD and CeVD in the presence of VDD increase the disability and discharge to non-home facilities among USA hospitalizations. Future studies should be planned to evaluate the effect of VDD replacement for improving outcomes.
      Citation: Medicines
      PubDate: 2020-11-22
      DOI: 10.3390/medicines7110072
      Issue No: Vol. 7, No. 11 (2020)
  • Medicines, Vol. 7, Pages 59: Composition and Antibacterial Activity of the
           Essential Oil from Pimenta dioica (L.) Merr. from Guatemala

    • Authors: Max Samuel Mérida-Reyes, Manuel Alejandro Muñoz-Wug, Bessie Evelyn Oliva-Hernández, Isabel Cristina Gaitán-Fernández, Daniel Luiz Reis Simas, Antonio Jorge Ribeiro da Silva, Juan Francisco Pérez-Sabino
      First page: 59
      Abstract: Background: Pimenta dioica is a native tree of Central America, Southern Mexico, and the Caribbean used in traditional medicine. It grows in wet forests in the Guatemalan departments of Petén and Izabal. Since the plant is not being economically exploited in Guatemala, this study was aimed at determining the composition of the essential oil of P. dioica leaves and fruits and the antibacterial activity of the leaves in order to evaluate its possible use in health products. The essential oils of fruits and leaves are used as rubefacient, anti-inflammatory, carminative, antioxidant, and antiflatulent in different countries. Fruits and leaves of P. dioica from Izabal Department were collected in April 2014 and extracted by hydrodistillation method. The oils were analyzed by gas chromatography coupled with mass spectrometry (GC/MS). Yields of 1.02 ± 0.11 % for dried leaves and 1.51 ± 0.26% for fruits were obtained. Eugenol was the main component (65.9–71.4%). The leaf oil showed growth inhibition against two Gram-positive and two Gram-negative bacteria. The authors consider that the tree’s leaves can be evaluated as a source of ingredients for antiseptic products, and that it is important to evaluate other types of properties such as anti-inflammatory activity.
      Citation: Medicines
      PubDate: 2020-09-23
      DOI: 10.3390/medicines7100059
      Issue No: Vol. 7, No. 10 (2020)
  • Medicines, Vol. 7, Pages 60: Impact of ED Organization with a Holding Area
           and a Dedicated Team on the Adherence to International Guidelines for
           Patients with Acute Pulmonary Embolism: Experience of an Emergency
           Department Organized in Areas of Intensity of Care

    • Authors: Gabriele Savioli, Iride Francesca Ceresa, Paolo Maggioni, Massimiliano Lava, Giovanni Ricevuti, Federica Manzoni, Enrico Oddone, Maria Antonietta Bressan
      First page: 60
      Abstract: Background and Objectives: Adherence to guidelines by physicians of an emergency department (ED) depends on many factors: guideline and environmental factors; patient and practitioner characteristics; the social-political context. We focused on the impact of the environmental influence and of the patients’ characteristics on adherence to the guidelines. It is our intention to demonstrate how environmental factors such as ED organization more affect adherence to guidelines than the patient’s clinical presentation, even in a clinically insidious disease such as pulmonary embolism (PE). Materials and Methods: A single-center observational study was carried out on all patients who were seen at our Department of Emergency and Acceptance from 1 January to 31 December 2017 for PE. For the assessment of adherence to guidelines, we used the European guidelines 2014 and analyzed adherence to the correct use of clinical decision rule (CDR as Wells, Geneva, and YEARS); the correct initiation of heparin therapy; and the management of patients at high risk for short-term mortality. The primary endpoint of our study was to determine whether adherence to the guidelines as a whole depends on patients’ management in a holding area. The secondary objective was to determine whether adherence to the guidelines depended on patient characteristics such as the presence of typical symptoms or severe clinical features (massive pulmonary embolism; organ damage). Results: There were significant differences between patients who passed through OBI and those who did not, in terms of both administration of heparin therapy alone (p = 0.007) and the composite endpoints of heparin therapy initiation and observation/monitoring (p = 0.004), as indicated by the guidelines. For the subgroups of patients with massive PE, organ damage, and typical symptoms, there was no greater adherence to the decision making, administration of heparin therapy alone, and the endpoints of heparin therapy initiation and guideline-based observation/monitoring. Conclusion: Patients managed in an ED holding area were managed more in accordance with the guidelines than those who were managed only in the visiting ED rooms and directly hospitalized from there.
      Citation: Medicines
      PubDate: 2020-09-24
      DOI: 10.3390/medicines7100060
      Issue No: Vol. 7, No. 10 (2020)
  • Medicines, Vol. 7, Pages 61: Effect of Orento, a Traditional Japanese
           Medicine, on IL-6, IL-8 Secretion, Type 1 Collagen Production and Alkaline
           Phosphatase Secretion in the Human Osteosarcoma Cell Line Saos-2

    • Authors: Hourei Oh, Kazuya Masuno, Nobutaka Okusa, Yoshimasa Makita, Shin-ichi Fujiwara, Yasuhiro Imamura
      First page: 61
      Abstract: Background: Orento, a traditional Japanese medicine, is known as Kampo medicine in Japan. We investigated the possible efficacy of Kampo medicine for periodontal disease. In this study, we examined the in vitro effects of orento on the proliferation of the inflammatory cytokines interleukin (IL)-6 and IL-8, the production of type 1 collagen, and the secretion of alkaline phosphatase (ALP) in the human osteosarcoma cell line Saos-2 (Saos-2 cells). Methods: The proliferation of Saos-2 cells was assessed by MTT assay. IL-6 and IL-8 levels, type 1 collagen production and ALP secretion were evaluated using enzyme-linked immunosorbent assay and ALP assays. Saos-2 cells were treated with or without 0.1, 1, 10, 100 and 1000 μg/mL of orento for 24 h. Results: Orento (10 μg/mL) significantly induced the proliferation of Saos-2 cells. At this concentration, orento suppressed IL-6 and IL-8 and enhanced type 1 collagen production and ALP secretion. Conclusions: These results indicate that orento controls the IL-6 and IL-8 secretion and cellular metabolism of osteoblasts, resulting in the secretion of early bone-related biomarkers.
      Citation: Medicines
      PubDate: 2020-09-25
      DOI: 10.3390/medicines7100061
      Issue No: Vol. 7, No. 10 (2020)
  • Medicines, Vol. 7, Pages 62: Worldwide Use of RUCAM for Causality
           Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published
           1993–Mid 2020: A Comprehensive Analysis

    • Authors: Rolf Teschke, Gaby Danan
      First page: 62
      Abstract: Background: A large number of idiosyncratic drug induced liver injury (iDILI) and herb induced liver injury(HILI) cases of variable quality has been published but some are a matter of concern if the cases were not evaluated for causality using a robust causality assessment method (CAM) such as RUCAM (Roussel Uclaf Causality Assessment Method) as diagnostiinjuryc algorithm. The purpose of this analysis was to evaluate the worldwide use of RUCAM in iDILI and HILI cases. Methods: The PubMed database (1993–30 June 2020) was searched for articles by using the following key terms: Roussel Uclaf Causality Assessment Method; RUCAM; Idiosyncratic drug induced liver injury; iDILI; Herb induced liver injury; HILI. Results: Considering reports published worldwide since 1993, our analysis showed the use of RUCAM for causality assessment in 95,885 cases of liver injury including 81,856 cases of idiosyncratic DILI and 14,029 cases of HILI. Among the top countries providing RUCAM based DILI cases were, in decreasing order, China, the US, Germany, Korea, and Italy, with China, Korea, Germany, India, and the US as the top countries for HILI. Conclusion: Since 1993 RUCAM is certainly the most widely used method to assess causality in IDILI and HILI. This should encourage practitioner, experts, and regulatory agencies to use it in order to reinforce their diagnosis and to take sound decisions.
      Citation: Medicines
      PubDate: 2020-09-29
      DOI: 10.3390/medicines7100062
      Issue No: Vol. 7, No. 10 (2020)
  • Medicines, Vol. 7, Pages 63: Genus Stachys: A Review of Traditional Uses,
           Phytochemistry and Bioactivity

    • Authors: Ekaterina-Michaela Tomou, Christina Barda, Helen Skaltsa
      First page: 63
      Abstract: The present review highlights that Stachys spp. consist an important source of bioactive phytochemicals and exemplifies the uncharted territory of this genus for new research studies.
      Citation: Medicines
      PubDate: 2020-09-29
      DOI: 10.3390/medicines7100063
      Issue No: Vol. 7, No. 10 (2020)
  • Medicines, Vol. 7, Pages 64: Quantification of the Ability of Natural
           Products to Prevent Herpes Virus Infection

    • Authors: Kunihiko Fukuchi, Hiroshi Sakagami, Yoshiaki Sugita, Koichi Takao, Daisuke Asai, Shigemi Terakubo, Hiromu Takemura, Hirokazu Ohno, Misaki Horiuchi, Madoka Suguro, Tomohiro Fujisawa, Kazuki Toeda, Hiroshi Oizumi, Toshikazu Yasui, Takaaki Oizumi
      First page: 64
      Abstract: Background: Herpes simplex virus (HSV) is usually dormant and becomes apparent when body conditions decline. We investigated the anti-HSV activity of various natural and synthetic compounds for future clinical application. Methods: Mock- and HSV-infected Vero cells were treated for three days with various concentrations of samples. For short exposure, 100-fold concentrated virus were preincubated for 3 min with samples, diluted to normal multiplicity of infection (MOI), before the addition to the cells. Anti-HSV activity was evaluated by the chemotherapy index. Results: Alkaline extracts of the leaves of Sasa sp. (SE) and pine cone (PCE) showed higher anti-HSV activity than 20 Japanese traditional herb medicines (Kampo formulas), four popular polyphenols, and 119 chromone-related compounds. Exposure of HSV to SE or PCE for 3 min almost completely eliminated the infectivity of HSV, whereas much longer exposure time was required for Kakkonto, the most active Kampo formulae. Anti-HSV activity of PCE and Kakkonto could be detected only when they were dissolved by alkaline solution (pH 8.0), but not by neutral buffer (pH 7.4). Anti-HSV activity of SE and povidone iodine was stable if they were diluted with neutral buffer. Conclusions: The present study suggests the applicability of SE and PCE for treatment of oral HSV and possibly other viruses.
      Citation: Medicines
      PubDate: 2020-10-06
      DOI: 10.3390/medicines7100064
      Issue No: Vol. 7, No. 10 (2020)
  • Medicines, Vol. 7, Pages 65: Effects of Diaphragmatic Breathing on Health:
           A Narrative Review

    • Authors: Hidetaka Hamasaki
      First page: 65
      Abstract: Background: Breathing is an essential part of life. Diaphragmatic breathing (DB) is slow and deep breathing that affects the brain and the cardiovascular, respiratory, and gastrointestinal systems through the modulation of autonomic nervous functions. However, the effects of DB on human health need to be further investigated. Methods: The author conducted a PubMed search regarding the current evidence of the effect of DB on health. Results: This review consists of a total of 10 systematic reviews and 15 randomized controlled trials (RCTs). DB appears to be effective for improving the exercise capacity and respiratory function in patients with chronic obstructive pulmonary disease (COPD). Although the effect of DB on the quality of life (QoL) of patients with asthma needs to be investigated, it may also help in reducing stress; treating eating disorders, chronic functional constipation, hypertension, migraine, and anxiety; and improving the QoL of patients with cancer and gastroesophageal reflux disease (GERD) and the cardiorespiratory fitness of patients with heart failure. Conclusions: Based on this narrative review, the exact usefulness of DB in clinical practice is unclear due to the poor quality of studies. However, it may be a feasible and practical treatment method for various disorders.
      Citation: Medicines
      PubDate: 2020-10-15
      DOI: 10.3390/medicines7100065
      Issue No: Vol. 7, No. 10 (2020)
  • Medicines, Vol. 7, Pages 66: Pomegranate Juice Extract Decreases Cisplatin
           Toxicity on Peripheral Blood Mononuclear Cells

    • Authors: Mohamad Nasser, Ziad Damaj, Akram Hijazi, Othmane Merah, Batoul Al-Khatib, Nadine Hijazi, Christine Trabolsi, Ragida Damaj, Mouhamad Nasser
      First page: 66
      Abstract: Background: Lung cancer is one of the most prevalent cancers worldwide. Chemotherapy regimens, targeted against lung cancer, are considered an effective treatment; albeit with multiple fatal side effects. An alternative strategy, nowadays, is using natural products. Medicinal plants have been used, in combination with chemotherapy, to ameliorate side effects. Aims: This study aims to investigate the antitumor effect of pomegranate juice (Punica granatum) on human lung adenocarcinoma basal epithelial cells (A549), to check the effect, when combined with low dose cisplatin (CDDP), at different doses. We also have evaluated the potential protective effect of pomegranate on normal peripheral blood mononuclear cells (PBMC). Methods: Phytochemical screening of the extract was done using standard classical tests. Total phenolic and sugar contents were determined using the Folin–Ciocalteu and anthrone reagents, respectively. The antioxidant activity of pomegranate was estimated by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method. The viability of A549 cells and PBMC was evaluated using the neutral red assay. Results: Our results demonstrated that Punica granatum or pomegranate juice (with different concentrations: 150, 300, 600 µg/mL) contained high levels of flavonoids, alkaloids, tanins, lignins, terpenoids, and phenols. The DPPH method showed that pomegranate juice had a strong antioxidant scavenging activity. Neutral red showed that combining pomegranate juice with low dose CDDP (8 µg/mL) decreased the cell viability of A549 cells, by 64%, compared to treatment with CDDP or pomegranate alone. When added to low dose CDDP, pomegranate increased the viability of normal PBMC cells by 46%. Conclusions: These results demonstrated that pomegranate could potentiate the anticancer effect of low dose CDDP on human lung adenocarcinoma cells (A549 cells) and could as well decrease its toxicity on PBMC.
      Citation: Medicines
      PubDate: 2020-10-15
      DOI: 10.3390/medicines7100066
      Issue No: Vol. 7, No. 10 (2020)
  • Medicines, Vol. 7, Pages 3: Can an Open-Label Placebo Be as Effective as a
           Deceptive Placebo' Methodological Considerations of a Study Protocol

    • Authors: Leo Druart, SaraEve Graham Longsworth, Carole Rolland, Maïa Dolgopoloff, Hugo Terrisse, Jean-Luc Bosson, Nicolas Pinsault
      First page: 3
      Abstract: Background: Placebo has been studied for many years and is ever-present in healthcare. In clinical practice, its use is limited by ethical issues raised by the deception entailed by its administration. Objective: To investigate whether, when given detailed information about pain and underlying placebo mechanisms, subjects will have a response similar to that of those subjected to a procedure in which they receive a conventional placebo treatment. Methods: The study is designed as a non-inferiority randomized, parallel with a nested crossover trial. In addition, 126 subjects without any known pathology will be included. They will be randomized into two groups. Each subject will undergo three Cold Pressor Tests (CPT): calibration, condition of interest (deceptive placebo or educated placebo), and control. Our main judgment criterion will be the comparison in pain intensity experienced on the visual analog scale between the two CPTs with placebo conditions. Results: This study will allow us to rule on the non-inferiority of an “educated” placebo compared to a deceptive placebo in the context of an acute painful stimulation. It is another step towards the understanding of open-label placebo and its use in clinical practice. Conclusions: This study has been approved by the ethics committee in France (2017-A01643-50) and registered on ClinicalTrials.gov (NCT03934138).
      Citation: Medicines
      PubDate: 2020-01-02
      DOI: 10.3390/medicines7010003
      Issue No: Vol. 7, No. 1 (2020)
  • Medicines, Vol. 7, Pages 4: Association between Prurigo Nodularis and
           Etiologies of Peripheral Neuropathy: Suggesting a Role for Neural
           Dysregulation in Pathogenesis

    • Authors: John-Douglas Matthew Hughes, Taylor E. Woo, Micah Belzberg, Raveena Khanna, Kyle A. Williams, Madan M. Kwatra, Shahzeb Hassan, Shawn G. Kwatra
      First page: 4
      Abstract: Background: Prurigo nodularis (PN) is an intensely pruritic skin condition of considerable morbidity. However, the pathogenesis of PN and its association with underlying neuropathy is unclear. Objective: We sought to investigate the association between PN and etiologies of peripheral neuropathy. Methods: A cross-sectional analysis of adult patients (≥18-year-old) with PN, AD, and Psoriasis at the Johns Hopkins Health System over a six-year period (January 2013–January 2019) was performed. The strength of association with etiologies of peripheral neuropathy were compared to a control cohort of individuals without PN, as well as those with AD or psoriasis. Results: A total of 1122 patients with PN were compared to 10,390 AD patients, 15,056 patients with psoriasis, and a control cohort of 4,949,017 individuals without PN, with respect to 25 comorbidities associated with peripheral neuropathies. Limitations: Comparisons between peripheral neuropathies and PN represent associations but are not causal relationships. Conclusion: Prurigo nodularis is strongly associated with peripheral neuropathies, suggesting a role for neural dysregulation in pathogenesis.
      Citation: Medicines
      PubDate: 2020-01-08
      DOI: 10.3390/medicines7010004
      Issue No: Vol. 7, No. 1 (2020)
  • Medicines, Vol. 7, Pages 5: Gross Hematuria as a Presenting Feature of
           Posterior Urethral Valves in a Neonate with Normal Antenatal Sonograms

    • Authors: Ratna Acharya, Romano DeMarco, Kiran Upadhyay
      First page: 5
      Abstract: Background: Posterior urethral valves (PUVs) are usually suspected during antenatal sonograms or by postnatal evidence of bilateral hydronephrosis with enlarged bladder. Gross hematuria as an initial manifestation of PUV with a history of normal antenatal sonogram is very rare. Methods: This is a retrospective chart study. Results: We describe a nine-day-old male neonate who presented with gross hematuria and was later found to have a urinary tract infection (UTI) and severe acute kidney injury (AKI). The mother apparently had normal antenatal sonograms with no evidence of fetal hydronephrosis. The child did not have postnatal renal bladder sonogram done until gross hematuria occurred at Day 9 of life. Sonogram showed bilateral severe hydronephrosis and hydroureter with enlarged bladder. The patient underwent ablation of the PUVs after initial bladder decompression with indwelling urethral catheterization. His AKI resolved after prompt treatment of UTI and PUV ablation. Conclusions: This report emphasizes the importance of a high index of suspicion for obstructive uropathy in a newborn with gross hematuria irrespective of prenatal sonogram findings.
      Citation: Medicines
      PubDate: 2020-01-08
      DOI: 10.3390/medicines7010005
      Issue No: Vol. 7, No. 1 (2020)
  • Medicines, Vol. 7, Pages 6: Acknowledgement to Reviewers of Medicines in

    • Authors: Medicines Editorial Office Medicines Editorial Office
      First page: 6
      Abstract: The editorial team greatly appreciates the reviewers who have dedicated their considerable time and expertise to the journal’s rigorous editorial process over the past 12 months, regardless of whether the papers are finally published or not [...]
      Citation: Medicines
      PubDate: 2020-01-19
      DOI: 10.3390/medicines7010006
      Issue No: Vol. 7, No. 1 (2020)
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