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  Subjects -> ALTERNATIVE MEDICINE (Total: 106 journals)
Showing 1 - 15 of 15 Journals sorted alphabetically
Acupuncture & Electro-Therapeutics Research     Full-text available via subscription   (Followers: 3)
Acupuncture in Medicine     Hybrid Journal   (Followers: 16)
Advanced Herbal Medicine     Open Access   (Followers: 8)
Advances in Traditional Medicine     Hybrid Journal   (Followers: 3)
African Journal of Traditional, Complementary and Alternative Medicines     Open Access   (Followers: 3)
Akupunktur & Aurikulomedizin     Full-text available via subscription   (Followers: 1)
Allgemeine Homöopathische Zeitung     Hybrid Journal   (Followers: 1)
Alternative & Integrative Medicine     Open Access   (Followers: 10)
Alternative Medicine     Full-text available via subscription   (Followers: 2)
Alternative Medicine Studies     Open Access   (Followers: 6)
Anales de Hidrología Médica     Open Access   (Followers: 1)
Ancient Science of Life     Open Access   (Followers: 3)
Arteterapia. Papeles de arteterapia y educación artística para la inclusión social     Open Access   (Followers: 3)
Asian Journal of Plant Pathology     Open Access   (Followers: 4)
Australian Journal of Acupuncture and Chinese Medicine     Full-text available via subscription   (Followers: 2)
Australian Journal of Herbal Medicine     Full-text available via subscription   (Followers: 4)
Australian Journal of Music Therapy     Full-text available via subscription   (Followers: 9)
Avicenna Journal of Phytomedicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 4)
BMC Complementary Medicine and Therapies     Open Access   (Followers: 17)
Chinese Herbal Medicines     Full-text available via subscription   (Followers: 1)
Chinese Medicine     Open Access   (Followers: 3)
Chinese Medicine and Culture     Open Access   (Followers: 1)
Cognitive Neuroscience     Hybrid Journal   (Followers: 31)
Complementary Therapies in Clinical Practice     Hybrid Journal   (Followers: 18)
Complementary Therapies in Medicine     Hybrid Journal   (Followers: 16)
Deutsche Heilpraktiker-Zeitschrift     Hybrid Journal   (Followers: 2)
Erfahrungsheilkunde     Hybrid Journal   (Followers: 1)
European Journal of Medicinal Plants     Open Access   (Followers: 2)
Evidence-based Complementary and Alternative Medicine     Open Access   (Followers: 22)
Experimental and Therapeutic Medicine     Full-text available via subscription  
Fitoterapia     Hybrid Journal   (Followers: 4)
Focus on Alternative and Complementary Therapies     Hybrid Journal   (Followers: 11)
Global Journal of Integrated Chinese Medicine and Western Medicine     Open Access  
Global Journal of Traditional Medicine     Open Access  
Herba Polonica     Open Access  
Herbal Medicines Journal     Open Access   (Followers: 1)
Indian Journal of Ayurveda and lntegrative Medicine Klue     Open Access   (Followers: 3)
Indian Journal of Research in Homoeopathy     Open Access  
Indian Journal of Traditional Knowledge (IJTK)     Open Access   (Followers: 1)
Innovare Journal of Ayurvedic Sciences     Open Access   (Followers: 2)
Intas Polivet     Full-text available via subscription  
Integrative Medicine Research     Open Access   (Followers: 3)
International Journal of High Dilution Research     Open Access  
International Journal of Qualitative Studies on Health and Well-Being     Open Access   (Followers: 21)
International Journal of Yoga     Open Access   (Followers: 15)
International Journal of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 6)
Ipnosi     Full-text available via subscription  
Journal of Acupuncture and Tuina Science     Hybrid Journal   (Followers: 4)
Journal of Alternative and Complementary Medicine     Hybrid Journal   (Followers: 14)
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     Open Access   (Followers: 3)
Journal of Ayurveda and Integrative Medicine     Open Access   (Followers: 6)
Journal of Ayurveda Case Reports     Open Access   (Followers: 3)
Journal of AYUSH :- Ayurveda, Yoga, Unani, Siddha and Homeopathy     Full-text available via subscription   (Followers: 7)
Journal of Bodywork and Movement Therapies     Hybrid Journal   (Followers: 16)
Journal of Complementary and Alternative Medical Research     Open Access  
Journal of Dance Medicine & Science     Full-text available via subscription   (Followers: 10)
Journal of Drug Research in Ayurvedic Sciences     Open Access   (Followers: 3)
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  
Journal of Herbal Medicine     Hybrid Journal   (Followers: 2)
Journal of Herbal Science     Full-text available via subscription   (Followers: 3)
Journal of Integrative Medicine     Full-text available via subscription   (Followers: 2)
Journal of Integrative Medicine & Therapy     Open Access  
Journal of Manual & Manipulative Therapy     Hybrid Journal   (Followers: 17)
Journal of Medicinal Plants for Economic Development     Open Access   (Followers: 1)
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  
Journal of Palliative Medicine     Hybrid Journal   (Followers: 51)
Journal of Research in Ayurvedic Sciences     Open Access   (Followers: 3)
Journal of the Australian Traditional-Medicine Society     Full-text available via subscription  
Journal of Traditional and Complementary Medicine     Open Access   (Followers: 3)
Journal of Traditional Chinese Medical Sciences     Open Access  
Médecine Palliative     Full-text available via subscription   (Followers: 1)
Medical Acupuncture     Hybrid Journal   (Followers: 5)
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   (Followers: 1)
Natural solutions     Full-text available via subscription  
Natural Volatiles & Essential Oils     Open Access  
Nigerian Journal of Natural Products and Medicine     Full-text available via subscription  
OA Alternative Medicine     Open Access  
Oriental Pharmacy and Experimental Medicine     Partially Free   (Followers: 2)
Research Journal of Medicinal Plant     Open Access   (Followers: 2)
Research Journal of Pharmacognosy     Open Access  
Revista Internacional de Acupuntura     Full-text available via subscription  
South African Journal of Plant and Soil     Hybrid Journal   (Followers: 1)
Synfacts     Hybrid Journal   (Followers: 5)
Traditional & Kampo Medicine     Full-text available via subscription  
Traditional Medicine Journal     Open Access  
World Journal of Acupuncture - Moxibustion     Full-text available via subscription  
World Journal of Traditional Chinese Medicine     Open Access  
Yoga Mimamsa     Open Access   (Followers: 2)
Zeitschrift für Orthomolekulare Medizin     Hybrid Journal   (Followers: 1)

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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  [84 journals]
  • Medicines, Vol. 9, Pages 31: Unforeseen Outcomes Post Treatment for
           Radiation Induced Trismus: A Case Report

    • Authors: Akash Sivam, Ankit Garg, Paul Sillifant
      First page: 31
      Abstract: Post radiotherapy radiation trismus presents significant concerns for a patient’s quality of life and for the clinical monitoring for recurrence of head and neck oncology. Current treatments include scar band release surgery that has been shown to be safe and effective. We present a case with a rare, post-operative complication of difficulty of mouth closure that can pose a significant impact on quality of life that should be considered.
      Citation: Medicines
      PubDate: 2022-04-19
      DOI: 10.3390/medicines9050031
      Issue No: Vol. 9, No. 5 (2022)
  • Medicines, Vol. 9, Pages 32: Epidemiology and Clinical Characteristics of
           People with Confirmed SARS-CoV-2 Infection during the Early COVID-19
           Pandemic in Saudi Arabia

    • Authors: Fatimah S. Alhamlan, Reem S. Almaghrabi, Edward B. Devol, Anwar B. Alotaibi, Saleh M. Alageel, Dalia A. Obeid, Basem M. Alraddadi, Sahar I. Althawadi, Maysoon S. Mutabagani, Ahmed A. Al-Qahtani
      First page: 32
      Abstract: This study provides epidemiologic and clinical characteristics of 492 consecutive patients diagnosed with SARS-CoV-2 infection at King Faisal Specialist Hospital and Research Centre in Saudi Arabia between March and September 2020. Data were collected from electronic case reports. The cohort was 54% male, with 20.4% aged >60 years, 19.9% aged 31–40 years, and 17% aged 41–50 years. The median incubation period was 16 days, with upper and lower 95% quartiles of 27 and 10 days, respectively. Most patients (79.2%) were symptomatic. Variables significantly different between symptomatic and asymptomatic patients were age, blood oxygen saturation percentage, hemoglobin level, lymphocyte count, neutrophil to lymphocyte (NTL) ratio, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level. Asymptomatic patients were mostly younger, with lower body mass index and ALT and AST levels but higher lymphocyte counts, NTL ratio, and CD4, CD8, natural killer cell, IgG, and IgM levels. Factors associated with increased risk of mortality were age (>42 years) and comorbidities, particularly diabetes mellitus and hypertension. Patients who were not given an antiviral regimen were associated with better prognosis than patients who received an antiviral regimen (HR, 0.07; 95% CI, 0.011–0.25). These findings will help clinicians and policymakers adopt best management and treatment options for SARS-CoV-2 infection.
      Citation: Medicines
      PubDate: 2022-04-21
      DOI: 10.3390/medicines9050032
      Issue No: Vol. 9, No. 5 (2022)
  • Medicines, Vol. 9, Pages 33: Osteopathic Manipulative Medicine: A Brief
           Review of the Hands-On Treatment Approaches and Their Therapeutic Uses

    • Authors: Ashley Roberts, Kaylee Harris, Bethany Outen, Amar Bukvic, Ben Smith, Adam Schultz, Stephen Bergman, Debasis Mondal
      First page: 33
      Abstract: Osteopathic manipulative medicine (OMM) is an emerging practice in the healthcare field with increasing popularity and evidence-based therapy. Osteopathic manipulative treatments (OMT) include hands-on manipulations of different body structures to increase systemic homeostasis and total patient well-being. Indeed, this new realm of the whole patient-based approach is being taught in osteopathic schools around the country, and the osteopathic principles of a mind-body-spirit-based treatment are being instilled in many new Doctor of Osteopathy (D.O.) students. However, despite their proven therapeutic value, there are still many individuals, both in and outside the medical profession, who are unaware (or misinformed) of the therapeutic uses and potential benefits of OMT. Here, we provide a brief introduction to this osteopathic therapeutic approach, focusing on the hands-on techniques that are regularly implemented in the clinical setting. It is becoming increasingly evident that different OMTs can be implemented to enhance patient recovery, both alone and in conjunction with the targeted therapies used in allopathic regimens. Therefore, it may be beneficial to inform the general medical community and educate the public and those associated with the healthcare field about the benefits of using OMT as a treatment modality. OMT is lower-cost, noninvasive, and highly effective in promoting full-body healing by targeting the nervous, lymphatic, immune, and vascular systems. There is a growing body of literature related to osteopathic research and the possible molecular pathways involved in the healing process, and this burgeoning field of medicine is expected to increase in value in the healthcare field. This brief review article explains the frequently utilized OMT modalities and their recognized therapeutic benefits, which underscore the need to understand the possible molecular mechanisms and circulating biomarkers linked to the systemic benefits of osteopathic medicine.
      Citation: Medicines
      PubDate: 2022-04-27
      DOI: 10.3390/medicines9050033
      Issue No: Vol. 9, No. 5 (2022)
  • Medicines, Vol. 9, Pages 25: Novel PKD2 Missense Mutation p.Ile424Ser in
           an Individual with Multiple Hepatic Cysts: A Case Report

    • Authors: Seiko Miura, Yo Niida, Chieko Hashizume, Ai Fujii, Yuta Takagaki, Kahoru Kusama, Sumiyo Akazawa, Tetsuya Minami, Tsuyoshi Mukai, Kengo Furuichi, Mutsumi Tsuchishima, Nobuhiko Ueda, Hiroyuki Takamura, Daisuke Koya, Tohru Ito
      First page: 25
      Abstract: We report a novel missense mutation, p.Ile424Ser, in the PKD2 gene of an autosomal dominant polycystic kidney disease (ADPKD) patient with multiple liver cysts. A 57-year-old woman presented to our university hospital with abdominal fullness, decreasing appetite, and dyspnea for three months. A percutaneous drainage of hepatic cysts was performed with no significant symptomatic relief. A computed tomography (CT) scan revealed a hepatic cyst in the lateral portion of the liver with appreciable compression of the stomach. Prior to this admission, the patient had undergone three drainage procedures with serial CT-based follow-up of the cysts over the past 37 years. With a presumptive diagnosis of extrarenal manifestation of ADPKD, we performed both a hepatic cystectomy and a hepatectomy. Because the patient reported a family history of hepatic cysts, we conducted a postoperative genetic analysis. A novel missense mutation, p.Ile424Ser, was detected in the PKD2 gene. Mutations in either the PKD1 or PKD2 genes account for most cases of ADPKD. To the extent of our knowledge, this point mutation has not been reported in the general population. Our in-silico analysis suggests a hereditary likely pathogenic mutation.
      Citation: Medicines
      PubDate: 2022-03-29
      DOI: 10.3390/medicines9040025
      Issue No: Vol. 9, No. 4 (2022)
  • Medicines, Vol. 9, Pages 26: Efficacy and Adverse Events of Carboplatin
           Desensitisation Therapy for Gynaecological Cancer: A Retrospective Study

    • Authors: Akihito Yamamoto, Seiryu Kamoi, Shigeru Matsuda, Rieko Kawase, Kazuho Nakanishi, Shunji Suzuki
      First page: 26
      Abstract: Background: Carboplatin, the key drug used in treating gynaecological cancer, has an approximately 12–16% risk of hypersensitivity reactions. We aimed to investigate the efficacy and adverse effects of carboplatin desensitisation therapy for gynaecological cancer. Methods: The desensitisation protocol was standardised as a four-step, 4-h, carboplatin administration in the hospital. A retrospective medical record review was conducted on 15 patients who underwent carboplatin desensitisation for gynaecological malignancies at our hospital. Patients’ data were analysed to evaluate the treatment success rate, therapeutic effect of desensitisation, adverse events, and treatment. Results: Of 91 carboplatin desensitisation cycles scheduled; the completion rate was 93.4% (85/91). Adverse events occurred in 23 of these 91 (25.3%). In four (4.4%) of the 23 cycles, hypersensitivity reactions could be treated only by discontinuing the infusion and slowing the administration, while in the remaining 19 (20.9%), medication was administered intravenously after discontinuing the infusion to manage hypersensitivity reactions. No treatment-related deaths occurred. Overall, 23 series of anti-cancer agent regimens, including carboplatin desensitisation, were administered to the 15 patients. The therapeutic response rate was 82.6% and the disease control rate was 95.7%. Conclusions: Carboplatin desensitisation was beneficial in patients with a history of carboplatin-induced hypersensitivity reactions.
      Citation: Medicines
      PubDate: 2022-03-30
      DOI: 10.3390/medicines9040026
      Issue No: Vol. 9, No. 4 (2022)
  • Medicines, Vol. 9, Pages 27: A Lurking Threat of Community-Acquired
           Acinetobacter Meningitis—A Rare Case Report from Punjab, India

    • Authors: Navodhya Jindal, Sonia Jain, Arghya Bhowmick, Vyom Bhargava
      First page: 27
      Abstract: Background: Acinetobacter spp. are a potential life-threatening cause of severe meningitis noted as a nosocomial infection after neurosurgical procedures in patients admitted to neurosurgical ICUs. Community-acquired Acinetobacter meningitis is extremely rare, and only a few cases have been reported in the literature. Case presentation: In this study, we report a patient from Punjab, India, who was infected after a roadside accident in which he developed CSF otorrhea and subsequent meningitis with Acinetobacter lwoffii. The patient was managed with the cephalosporin group of antibiotics as per the sensitivity report. For the first time, we report a rare case report of community-acquired Acinetobacter meningitis from Punjab, India. Conclusions: This case report highlights the potential pathogenicity of Acinetobacter lwoffii and increases concerns that this organism might rapidly evolve into a dreadful antibiotic-resistant community pathogen.
      Citation: Medicines
      PubDate: 2022-03-31
      DOI: 10.3390/medicines9040027
      Issue No: Vol. 9, No. 4 (2022)
  • Medicines, Vol. 9, Pages 28: JUUL™ing and Heating Lead to a
           Worsening of Arterial Stiffness

    • Authors: Julia Benthien, Moritz Meusel, Silja Cayo Talavera, Ingo Eitel, Daniel Drömann, Klaas F. Franzen
      First page: 28
      Abstract: Background: The widespread use of the JUUL™ device ignited a discussion about the effects these products have on harm reduction. Therefore, we conducted a study directly comparing the JUUL™ device with a cigarette, a heated tobacco product, and a nicotine-free e-cigarette to examine the acute effects on arterial stiffness. Methods: This crossover-designed study examines 20 occasional smokers (age 25.2 ± 2.5 years). Study participants used each of the four smoking devices for a duration of 5 min following a protocol. Peripheral blood pressure and parameters of arterial stiffness and endothelial vasodilator function such as the reactive hyperemia index and the augmentation index were measured using the EndoPAT™2000 before and after. Results: In addition to significant peripheral hemodynamic changes after 5 and 10 min (p < 0.05), the reactive hyperemia index showed a significant decrease for all devices 15 min after consumption and remained significantly decreased after 60 min (p < 0.01). The augmentation index adjusted for a heart rate of 75 bpm increased significantly for all devices 15 and 60 min after consumption (p < 0.01). Conclusions: In conclusion, the increases in blood pressure and arterial stiffness are similar after smoking, JUUL™ing, heating, and vaping. These changes may be associated with an increase in cardiovascular risks; however, an evaluation of the long-term effects of JUUL™ing, vaping and heating is needed.
      Citation: Medicines
      PubDate: 2022-04-05
      DOI: 10.3390/medicines9040028
      Issue No: Vol. 9, No. 4 (2022)
  • Medicines, Vol. 9, Pages 29: Thyroid Dysfunction among Hypertensive
           Pregnant Women in Warri, Delta State, Nigeria

    • Authors: Philomena Nwabudike, Mathias Abiodun Emokpae
      First page: 29
      Abstract: The hypertensive pregnant woman is at a higher risk of complications either before, during or after birth and the baby can be adversely affected leading to preterm birth, low birth weight, placental separation (abruption) and other complications. The aim of the study was to evaluate thyroid dysfunction among pregnant women with hypertension. The study participants were 150 hypertensive pregnant women, 25 non-hypertensive pregnant women and 25 non-hypertensive non-pregnant women. Exactly 5mL of blood was collected and used for the assay of triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) using the enzyme-linked immunosorbent assay technique. Data were analyzed using appropriate statistical tools. The results showed a significantly higher (p < 0.05) age among hypertensive pregnant women when compared with non-hypertensive pregnant women and non-hypertensive non-pregnant women. The serum TSH was significantly higher (p < 0.035) among hypertensive pregnant women when compared with non-hypertensive pregnant women. The triiodothyronine (T3) of hypertensive pregnant women was observed to be significantly higher (p < 0.05) when compared with both non-hypertensive pregnant women and non-hypertensive non-pregnant women. Some 15/150 (10%) of hypertensive pregnant women had subclinical hypothyroidism, 13/150 (8.7%) had overt hypothyroidism, while 122/150 (81.3%) were euthyroid. Among those with thyroid dysfunction, five and four of the subjects had subclinical hypothyroidism and overt hypothyroidism during the second trimester, while ten and nine had subclinical hypothyroidism and overt hypothyroidism during the third trimester, respectively. Evaluation of hypertensive pregnant women for thyroid function may be routinely performed to enable early diagnosis and treatment.
      Citation: Medicines
      PubDate: 2022-04-07
      DOI: 10.3390/medicines9040029
      Issue No: Vol. 9, No. 4 (2022)
  • Medicines, Vol. 9, Pages 30: Meningioma Cell Invasion into DuraGen-Derived
           Dura Mater: A Case Report

    • Authors: Ryota Tamura, Yuki Kuranari, Hideki Orikasa, Makoto Katayama
      First page: 30
      Abstract: Background: Dura mater infiltration is the main growth pattern of meningiomas. Local recurrence may occur in any type of meningioma, but it is more likely so in atypical meningiomas. Therefore, a wide resection of tumor cell-invaded dura mater is necessary to avoid recurrence. DuraGen® (an artificial dural substitute) can be used for dural reconstruction in meningiomas. Here, we report a rare case of a patient with atypical meningioma that invaded into the DuraGen®-derived mature dura mater. Case presentation: A 66-year-old female showed a three-time recurrence of atypical meningioma. Simpson grade I resection (en bloc tumor with autologous dura mater and DuraGen®-derived dura mater resection) was achieved at the 3rd recurrence. Collagen fibers running regularly and transversely were observed in the DuraGen®-derived dura mater resembling the autologous meningeal layer. Meningioma cell invasion, displayed by occasional EMA immunostaining, was observed in the DuraGen®-derived dura mater. Conclusions: This case indicates that meningioma cells may invade and survive in the DuraGen®-derived dura mater. Whether or not DuraGen® is not appropriate as a dural substitute remains unanswered. Further experiences are needed to validate these findings in large sample sizes.
      Citation: Medicines
      PubDate: 2022-04-11
      DOI: 10.3390/medicines9040030
      Issue No: Vol. 9, No. 4 (2022)
  • Medicines, Vol. 9, Pages 17: Investigating Prescription Medication
           Expenditures and Level of Perceived Health Status among Older Adults with
           Pain in the United States

    • Authors: David R. Axon, Leonard P. Barrios
      First page: 17
      Abstract: Background: the objective of this retrospective, cross sectional study was to assess the relationship between different levels of perceived health status and prescription medication expenditures among United States adults aged ≥50 years with self-reported pain. Methods: using 2019 Medical Expenditure Panel Survey (MEPS) data, four levels of perceived health status were formed (excellent, very good, good, and fair/poor health). Differences between characteristics in the groups were compared using chi square tests. Adjusted linear regression models, using logged positive annual prescription medication expenditures, were constructed to assess differences in prescription medication expenditures between levels of perceived health. Results: a total of 4826 individuals were included in the study. Adjusted linear regression analysis indicated those who reported excellent health had 65.8% lower annual prescription medication expenditures than those with fair/poor health. Those with very good health had 49.7% lower annual prescription medication expenditures than those with fair/poor health, while those with good health had 27.2% lower annual prescription medication expenditures than those with fair/poor health. Conclusions: better perceived health status was generally associated with relatively lower prescription medication expenditures. Further research is needed to investigate if this pattern is also observed for other categories of healthcare expenditures and in other populations.
      Citation: Medicines
      PubDate: 2022-02-22
      DOI: 10.3390/medicines9030017
      Issue No: Vol. 9, No. 3 (2022)
  • Medicines, Vol. 9, Pages 18: The Impact of Industry Funding on Randomized
           Controlled Trials of Biologic Therapies

    • Authors: Aaron M. Gazendam, David Slawaska-Eng, Nicholas Nucci, Om Bhatt, Michelle Ghert
      First page: 18
      Abstract: Background: There has been substantial interest from the pharmaceutical industry to study and develop new biologic agents. Previous studies outside of the biologics field have demonstrated that industry funding has the potential to impact the design and findings of clinical trials. The objective of this study was to evaluate the impact of industry funding on randomized controlled trials (RCTs) that investigated the efficacy of biologic therapies. Methods: A review of all RCTs involving biologic therapies in top impact factor medical journals from January 2018 to December 2020 was performed. The relationship between industry funding and the presence of statistically significant primary outcomes and the use of active comparators were analyzed. Results: Among the 157 RCTs included, 120 (76%) were industry funded and 37 (24%) declared no industry funding. Industry-funded studies were significantly more likely to report a statistically significant positive primary outcome compared to studies without industry funding (85% vs. 67%, χ2 = 5.867, p = 0.015) and were significantly more likely to utilize placebo or no comparator than non-industry-funded trials (78% vs. 49%, χ2 = 4.430, p = 0.035). Conclusions: Industry-funded trials investigating biologic therapies are more likely to yield statistically significant positive outcomes and use placebo comparators when compared to non-industry-funded biologic therapy trials in high-impact medical journals.
      Citation: Medicines
      PubDate: 2022-02-28
      DOI: 10.3390/medicines9030018
      Issue No: Vol. 9, No. 3 (2022)
  • Medicines, Vol. 9, Pages 19: Novel Psychoactive Substances: The
           Razor’s Edge between Therapeutical Potential and Psychoactive
           Recreational Misuse

    • Authors: Beatriz Correia, Joana Fernandes, Maria João Botica, Carla Ferreira, Alexandre Quintas
      First page: 19
      Abstract: Background: Novel psychoactive substances (NPS) are compounds of natural and synthetic origin, similar to traditional drugs of abuse. NPS are involved in a contemporary trend whose origin lies in a thinner balance between legitimate therapeutic drug research and legislative control. The contemporary NPS trend resulted from the replacement of MDMA by synthetic cathinones in ‘ecstasy’ during the 2000s. The most common NPS are synthetic cannabinoids and synthetic cathinones. Interestingly, during the last 50 years, these two classes of NPS have been the object of scientific research for a set of health conditions. Methods: Searches were conducted in the online database PubMed using boolean equations. Results: Synthetic cannabinoids displayed protective and therapeutic effects for inflammatory, neurodegenerative and oncologic pathologies, activating the immune system and reducing inflammation. Synthetic cathinones act similarly to amphetamine-type stimulants and can be used for depression and chronic fatigue. Conclusions: Despite the scientific advances in this field of research, pharmacological application of NPS is being jeopardized by fatalities associated with their recreational use. This review addresses the scientific achievements of these two classes of NPS and the toxicological data, ending with a reflection on Illicit and NPS control frames.
      Citation: Medicines
      PubDate: 2022-03-01
      DOI: 10.3390/medicines9030019
      Issue No: Vol. 9, No. 3 (2022)
  • Medicines, Vol. 9, Pages 20: Salubrious Effects of Green Tea Catechins on
           Fatty Liver Disease: A Systematic Review

    • Authors: Omar Abunofal, Chandra Mohan
      First page: 20
      Abstract: Epigallocatechin-3-gallate (EGCG) is a polyphenol green tea catechin with potential health benefits and therapeutic effects in non-alcoholic fatty liver disease (NAFLD), a common liver disorder that adversely affects liver function and lipid metabolism. This systematic review surveyed the effects of EGCG or green tea extract (GTE) on NAFLD reported in studies involving rodent models or humans with a focus on clinicopathologic outcomes, lipid and carbohydrate metabolism, and inflammatory, oxidative stress, and liver injury markers. Articles involving clinical efficacy of EGCG/GTE on human subjects and rodent models were gathered by searching the PUBMED database and by referencing additional articles identified from other literature reviews. EGCG or GTE supplementation reduced body weight, adipose tissue deposits, and food intake. Mechanistically, the majority of these studies confirmed that EGCG or GTE supplementation plays a significant role in regulating lipid and glucose metabolism and expression of genes involved in lipid synthesis. Importantly, EGCG and GTE supplementation were shown to have beneficial effects on oxidative stress-related pathways that activate pro-inflammatory responses, leading to liver damage. In conclusion, green tea catechins are a potentially useful treatment option for NAFLD. More research is required to determine the ideal dosage, treatment duration, and most effective delivery method of EGCG or GTE, and to provide more definitive conclusions by performing large, randomized clinical trials.
      Citation: Medicines
      PubDate: 2022-03-01
      DOI: 10.3390/medicines9030020
      Issue No: Vol. 9, No. 3 (2022)
  • Medicines, Vol. 9, Pages 21: Acquired Hemophilia A: A Permanent Challenge
           for All Physicians

    • Authors: Knut M. Nowak, Alexander Carpinteiro, Cynthia Szalai, Fuat H. Saner
      First page: 21
      Abstract: Acquired hemophilia A (AHA) is a rare disease with a prevalence in Europe of 1.5 per million. This diagnosis is significantly delayed in about one-third of all cases, leading to deferred treatment. The main signs of AHA are spontaneous bleeding seen in about two-thirds of all patients. AHA can be lethal in 20% of all symptomatic cases. This patient population’s main standard laboratory finding is a prolonged aPTT (activated prothrombin Time) with otherwise normal coagulation results. In addition, antibodies against FVIII (in Bethesda Units) and a quantitative reduction of FVIII activity are necessary to confirm AHA. The therapy of acute bleeding related to AHA is based on the following main principles: Pharmacologic control of the bleeding is of absolute importance. It can be achieved by administering either recombinant activated FVIIa “bypass therapy”; activated prothrombin complex; or Emicizumab, a bispecific monoclonal antibody. Eradication of the FVIII antibodies should be initiated simultaneously. The combination of steroids with cyclophosphamide leads to the highest eradication rates. Causes of AHA may be related to neoplasms, autoimmune diseases, and pregnancy. We report on a patient who underwent four surgical procedures before the diagnosis of AHA was established.
      Citation: Medicines
      PubDate: 2022-03-02
      DOI: 10.3390/medicines9030021
      Issue No: Vol. 9, No. 3 (2022)
  • Medicines, Vol. 9, Pages 22: Wen Dan Tang: A Potential Jing Fang Decoction
           for Headache Disorders'

    • Authors: Saroj K. Pradhan, Yiming Li, Andreas R. Gantenbein, Felix Angst, Susanne Lehmann, Hamdy Shaban
      First page: 22
      Abstract: Background: Chinese herbal medicine is considered relatively safe, inexpensive, and easily accessible. Wen Dan Tang (WDT), a Jing Fang ancient classical Chinese herbal formula with a broad indication profile has been used for several centuries in China to treat various illnesses. Question: Are there evidence-based clinical trials that show that WDT has a significant impact on the treatment of various diseases, especially in patients with migraine and tension-type headaches (TTH)' Methods: This study is based on an online database search using PubMed, Medline, Cochrane Library, AcuTrials, Embase, Semantic Scholar, Jstor, internet research, and review of ancient and modern Chinese medical textbooks regarding WDT and its compounds. Results: There were no studies on WDT in migraine and TTH; therefore, this work gathers and describes data for every single compound in the formula. Conclusion: This study suggests that the bioactive compounds found in WDT composition show potential in treating patients with neurological, psychiatric disorders, cardiovascular diseases, metabolic syndrome, and digestive disorders. Some coherence between WDT in headache reduction and improvements in the quality of life in patients with migraines and TTH could be evaluated, showing positive results of WDT in these patients.
      Citation: Medicines
      PubDate: 2022-03-04
      DOI: 10.3390/medicines9030022
      Issue No: Vol. 9, No. 3 (2022)
  • Medicines, Vol. 9, Pages 23: Drug-Induced Sexual Dysfunction in
           Individuals with Epilepsy: Beyond Antiepileptic Compounds

    • Authors: Rocco Salvatore Calabrò, Antonio Cerasa
      First page: 23
      Abstract: Sexual dysfunction (SD) is a multifactorial problem, involving neurological, iatrogenic, endocrine, psychiatric, and psychosocial factors, and affects the quality of life of both male and female individuals with epilepsy [...]
      Citation: Medicines
      PubDate: 2022-03-14
      DOI: 10.3390/medicines9030023
      Issue No: Vol. 9, No. 3 (2022)
  • Medicines, Vol. 9, Pages 24: Unusual Presentation of Bouveret Syndrome
           Resulting in Both Gastric Outlet Obstruction and Small Bowel Obstruction
           with Perforation

    • Authors: Jarod Shelton, Muhammad Adeel Samad, James Juhng, Shawn M. Terry
      First page: 24
      Abstract: Our case describes an 83-year-old female who presented with severe abdominal pain, nausea, and bilious emesis of one day’s duration. She had an endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and percutaneous transhepatic biliary drainage (PTCD) one year prior for choledocholithiasis with acute cholangitis in her home country, Scotland. Unfortunately, while visiting family in the United States, her PTCD became dislodged, and she developed progressive worsening abdominal pain. Computerized tomography of her abdomen showed pneumobilia, perigastric inflammation, a contracted gallbladder, small bowl inflammation with a likely transition point at the mid-jejunum, and a probable duodenal mass. The patient underwent an exploratory laparotomy with intraoperative findings of choledochoduodenal fistula with coincident gastric and small bowel obstruction (SBO) secondary to three large, mixed gallstones. One 3 cm gallstone was located at the pylorus and two (2.3 and 3 cm) gallstones were isolated in the mid-jejunum, with one of those causing isolated transmural pressure necrosis with subsequent perforation. Bouveret syndrome is a rare cause of gastric outlet obstruction (GOO) that manifests via an acquired cholecystoenteric fistula. Our patient presented with a concomitant GOO and SBO with perforation of the mid-jejunum. Timely diagnosis of Bouveret syndrome is essential, as most causes require emergent surgical intervention.
      Citation: Medicines
      PubDate: 2022-03-15
      DOI: 10.3390/medicines9030024
      Issue No: Vol. 9, No. 3 (2022)
  • Medicines, Vol. 9, Pages 8: In Vitro and In Silico Antimalarial Evaluation
           of FM-AZ, a New Artemisinin Derivative

    • Authors: Ioannis Tsamesidis, Farnoush Mousavizadeh, Chinedu O. Egwu, Dionysia Amanatidou, Antonella Pantaleo, Françoise Benoit-Vical, Karine Reybier, Athanassios Giannis
      First page: 8
      Abstract: Artemisinin-based Combination Therapies (ACTs) are currently the frontline treatment against Plasmodium falciparum malaria, but parasite resistance to artemisinin (ART) and its derivatives, core components of ACTs, is spreading in the Mekong countries. In this study, we report the synthesis of several novel artemisinin derivatives and evaluate their in vitro and in silico capacity to counteract Plasmodium falciparum artemisinin resistance. Furthermore, recognizing that the malaria parasite devotes considerable resources to minimizing the oxidative stress that it creates during its rapid consumption of hemoglobin and the release of heme, we sought to explore whether further augmentation of this oxidative toxicity might constitute an important addition to artemisinins. The present report demonstrates, in vitro, that FM-AZ, a newly synthesized artemisinin derivative, has a lower IC50 than artemisinin in P. falciparum and a rapid action in killing the parasites. The docking studies for important parasite protein targets, PfATP6 and PfHDP, complemented the in vitro results, explaining the superior IC50 values of FM-AZ in comparison with ART obtained for the ART-resistant strain. However, cross-resistance between FM-AZ and artemisinins was evidenced in vitro.
      Citation: Medicines
      PubDate: 2022-01-24
      DOI: 10.3390/medicines9020008
      Issue No: Vol. 9, No. 2 (2022)
  • Medicines, Vol. 9, Pages 9: Identification of Antimycobacterial Natural
           Products from a Library of Marine Invertebrate Extracts

    • Authors: Kojo Sekyi Acquah, Denzil R. Beukes, Ronnett Seldon, Audrey Jordaan, Suthananda N. Sunassee, Digby F. Warner, David W. Gammon
      First page: 9
      Abstract: Tuberculosis (TB) remains a public health crisis, requiring the urgent identification of new anti-mycobacterial drugs. We screened several organic and aqueous marine invertebrate extracts for their in vitro inhibitory activity against the causative organism, Mycobacterium tuberculosis. Here, we report the results obtained for 54 marine invertebrate extracts. The chemical components of two of the extracts were dereplicated, using 1H NMR and HR-LCMS with GNPS molecular networking, and these extracts were further subjected to an activity-guided isolation process to purify the bioactive components. Hyrtios reticulatus yielded heteronemin 1 and Jaspis splendens was found to produce the bengamide class of compounds, of which bengamides P 2 and Q 3 were isolated, while a new derivative, bengamide S 5, was putatively identified and its structure predicted, based on the similarity of its MS/MS fragmentation pattern to those of other bengamides. The isolated bioactive metabolites and semi-pure fractions exhibited M. tuberculosis growth inhibitory activity, in the range <0.24 to 62.50 µg/mL. This study establishes the bengamides as potent antitubercular compounds, with the first report of whole-cell antitubercular activity of bengamides P 2 and Q 3.
      Citation: Medicines
      PubDate: 2022-01-28
      DOI: 10.3390/medicines9020009
      Issue No: Vol. 9, No. 2 (2022)
  • Medicines, Vol. 9, Pages 10: Ethnobotanical and Phytochemical Profiling of
           Medicinal Plants from Burkina Faso Used to Increase Physical Performance

    • Authors: Hemayoro Sama, Modeste Traoré, Samson Guenné, Ibrahim Séré, Adama Hilou, Mamoudou H. Dicko
      First page: 10
      Abstract: Background: Some ergogenic medicinal plants are used in exercise and sport in Africa in order to increase sport performance. However, data on their composition and their possible impacts on health are limited. This study was initiated to provide ethnobotanical data on plants traditionally used to optimize physical performance and to perform a qualitative characterization of their main chemical groups. Methods: Ethnobotanical surveys in two communes (Dedougou and Nouna), of the region of Boucle du Mouhoun, Burkina Faso and phytochemical analyses of the most interesting plants were conducted. Results: A total of 50 respondents including traditional hunters dozo, farmers, healers, herbalists, marabouts, etc., were interviewed. Fifty-two species used in the optimization of exercise and sports have been identified. The most cited species were Cassia sieberiana, Tamarindus indica, Annona senegalensis, Gardenia sokotensis, Securidaca longepedunculata, and Ficus tonningii. These plants are known to prevent muscle and skeletal disorders, aches and pains, and mental disorders. The study identified several types of plants including those displaying stimulation, anxiolytic, sedative, adaptogenic, or erythropoietic activities. Phytochemical screening revealed the presence of phenolic compounds, alkaloids, terpenes, and steroids, which are similar molecules families of those of doping molecules. Additionally, TLC screening allowed the characterization of numerous terpene and flavonoid compounds including rutin. Conclusions: The possible structural similarity of the characterized chemical groups of these species with those of doping families raise concerns about the consequences of their consumption. However, the identification of the active molecules of these species remains to be performed in order to predict the real risks associated with their consumption.
      Citation: Medicines
      PubDate: 2022-01-28
      DOI: 10.3390/medicines9020010
      Issue No: Vol. 9, No. 2 (2022)
  • Medicines, Vol. 9, Pages 11: Potential Application of Lung Ultrasound in
           Children with Severe Uncontrolled Asthma: Preliminary Hypothesis Based on
           a Case Series

    • Authors: Cristina De Rose, Stefano Miceli Sopo, Piero Valentini, Rosa Morello, Daniele Biasucci, Danilo Buonsenso
      First page: 11
      Abstract: In recent years, lung ultrasound (LUS) has been increasingly used for the diagnosis of respiratory diseases in both adult and pediatric patients. However, asthma is a field in which the use of LUS is not yet well defined, or is in development. In the following case series, we describe clinical, laboratory, and radiological results, as well as detailed lung ultrasound findings of six children with asthma: some of them with acute asthma attack and with inadequately controlled allergic asthma or childhood asthma; others with acute asthma and allergic or infantile asthma adequately controlled by preventive therapy. Finally, we describe the clinical, laboratory, and imaging parameters of a child with severe allergic asthma in the absence of exacerbation. In these cases, albeit at different times, LUS played an important role in both the initial diagnostic process and follow-up. It also showed different ultrasound features depending on the severity of the individual asthma based on the type of asthmatic phenotype and control of it.
      Citation: Medicines
      PubDate: 2022-02-02
      DOI: 10.3390/medicines9020011
      Issue No: Vol. 9, No. 2 (2022)
  • Medicines, Vol. 9, Pages 12: Acknowledgment to Reviewers of Medicines in

    • Authors: Medicines Editorial Office Medicines Editorial Office
      First page: 12
      Abstract: Rigorous peer-reviews are the basis of high-quality academic publishing [...]
      Citation: Medicines
      PubDate: 2022-02-02
      DOI: 10.3390/medicines9020012
      Issue No: Vol. 9, No. 2 (2022)
  • Medicines, Vol. 9, Pages 13: The medial Surface of the Auricle: Historical
           and Recent Maps. What are the Possible Expectations of the
           “Thumb-Index Technique”

    • Authors: Antonello Lovato, Francesco Ceccherelli, Giuseppe Gagliardi, Marco Postiglione
      First page: 13
      Abstract: Introduction: The medial surface of the auricle (MSotA), as compared to the lateral, has been less studied and has limited consensus among schools of auricular acupuncture (AA) due to its small size, greater difficulty in carrying out an adequate physical examination on it, and less precise and limited agreement on its anatomical references as compared to the lateral surface. The thumb-index technique TIT is performed using a guiding finger (taking advantage of the anatomical conformation of the lateral surface) to guide the explorer finger (placed on the MSotA) to project the therapeutic areas and land marks on the MSotA. TIT could be considered useful and effective in AA to make the most of diagnostic and therapeutic MSotA potential. Methods: An investigation was carried out on the impact of TIT in AA practice through a survey collected from former AA students. Results: TIT showed a high consensus, and is used and appreciated by AA practitioners. Discussion/ Conclusions: To date, in AA, there is no thoroughly shared nomenclature for MSotA. TIT is simple and quick to project on to MSotA the well-coded lateral surface auricular maps from French or Chinese AA schools.
      Citation: Medicines
      PubDate: 2022-02-17
      DOI: 10.3390/medicines9020013
      Issue No: Vol. 9, No. 2 (2022)
  • Medicines, Vol. 9, Pages 14: CHRIST: CD44-Incorporated Hepatocellular
           Carcinoma Risk Index Scoring Tool—A Novel Prognostic Scoring System
           for Hepatocellular Carcinoma Development and Aggressiveness

    • Authors: Ahmed Ali Khalifa, Nermeen Abdeen, Neveen L. Mikhael, Sawsan Elmalah, Ayman Elshayeb
      First page: 14
      Abstract: CD44 has been demonstrated to play a pivotal role in regulating tumor cell progression, including hepatocellular carcinoma (HCC) development. Here, we aimed to establish a scoring system to evaluate the risk of developing HCC utilizing CD44-rs187115 SNP polymorphism. A prospective cohort of 120 individuals was enrolled in four groups: 19 non-metastatic HCC patients, 21 metastatic, 40 patients with hepatitis C-related cirrhosis, and 40 controls. Allelic discrimination of the CD44-rs187115 gene polymorphism was assessed using TaqMan genotyping assay. HCC patients with CT/CC genotypes were more likely to have aggressive malignancy compared to TT carriers. A significant correlation was noted between the existence of CT/CC genotypes and tumor size, multicentricity, infiltration, portal vein thrombosis, and metastasis. A CD44-incorporated Hepatocellular Carcinoma Risk Index Scoring Tool (CHRIST) was formulated utilizing clinical and genetic variables. A score > 3 for HCC development demonstrated 87.5% sensitivity, 72.5% specificity, and a 76% positive predictive value (PPV) and 85% negative predictive value (NPV). Furthermore, a score > 5 for HCC metastasis demonstrated 90.4% sensitivity, 68.4% specificity, a 76% PPV and 86% NPV. A similarly significant score was noted following a six-month re-evaluation. We conclude that CD44-rs187115 may serve as a reliable prognostic biomarker for HCC and that the CHRIST prognostic model is highly predictive of the development of HCC and metastatic HCC.
      Citation: Medicines
      PubDate: 2022-02-21
      DOI: 10.3390/medicines9020014
      Issue No: Vol. 9, No. 2 (2022)
  • Medicines, Vol. 9, Pages 15: Early Time-Restricted Feeding Amends
           Circadian Clock Function and Improves Metabolic Health in Male and Female
           Nile Grass Rats

    • Authors: Chidambaram Ramanathan, Hayden Johnson, Suman Sharma, Wangkuk Son, Melissa Puppa, Saba Neyson Rohani, Aaryani Tipirneni-Sajja, Richard J. Bloomer, Marie van der Merwe
      First page: 15
      Abstract: Lengthening the daily eating period contributes to the onset of obesity and metabolic syndrome. Dietary approaches, including energy restriction and time-restricted feeding, are promising methods to combat metabolic disorders. This study explored the effect of early and late time-restricted feeding (TRF) on weight and adiposity, food consumption, glycemic control, clock gene expression, and liver metabolite composition in diurnal Nile grass rats (NGRs). Adult male and female Nile grass rats were randomly assigned to one of three groups: (1) access to a 60% high-fat (HF) diet ad-libitum (HF-AD), (2) time-restricted access to the HF diet for the first 6 h of the 12 h light/active phase (HF-AM) or (3) the second 6 h of the 12 h light/active phase (HF-PM). Animals remained on their respective protocols for six weeks. TRF reduced total energy consumption and weight gain, and early TRF (HF-AM) reduced fasting blood glucose, restored Per1 expression, and reduced liver lipid levels. Although sex-dependent differences were observed for fat storage and lipid composition, TRF improved metabolic parameters in both male and female NGRs. In conclusion, this study demonstrated that early TRF protocol benefits weight management, improves lipid and glycemic control, and restores clock gene expression in NGRs.
      Citation: Medicines
      PubDate: 2022-02-21
      DOI: 10.3390/medicines9020015
      Issue No: Vol. 9, No. 2 (2022)
  • Medicines, Vol. 9, Pages 16: Neurogenic Dysphagia and Nutrition in
           Disorder of Consciousness: An Overview with Practical Advices on an
           “Old” but Still Actual Clinical Problem

    • Authors: Loredana Raciti, Gianfranco Raciti, Grazia Pulejo, Valeria Conti-Nibali, Rocco Salvatore Calabrò
      First page: 16
      Abstract: Neurogenic dysphagia is a difficulty in swallowing food caused by disease or impairment of the nervous system, including stroke and traumatic brain injury. The most clinically apparent complication of neurogenic dysphagia is pulmonary aspiration, which may manifest itself acutely as choking or coughing, respiratory distress, wheezing, gasping or gurgling, and tachycardia. However, chronic symptoms, including weight loss, production of excessive oral secretions and aspiration pneumonia, may be also present, especially in patients with a disorder of consciousness (DOC). Usually, patients with dysphagia after the acute phase need to be treated with enteral nutrition using a feeding tube. This avoids patient malnutrition and supports the rehabilitation program. This narrative review aims to investigate dysphagia and its complications and management in patients with DOC. Clinical indications and practical advice on how to assess and treat this complex problem are also provided.
      Citation: Medicines
      PubDate: 2022-02-21
      DOI: 10.3390/medicines9020016
      Issue No: Vol. 9, No. 2 (2022)
  • Medicines, Vol. 9, Pages 2: Impact of Drug Pressure versus Limited Access
           to Drug in Malaria Control: The Dilemma

    • Authors: Chinedu Ogbonnia Egwu, Nwogo Ajuka Obasi, Chinyere Aloke, Joseph Nwafor, Ioannis Tsamesidis, Jennifer Chukwu, Sunday Elom
      First page: 2
      Abstract: Malaria burden has severe impact on the world. Several arsenals, including the use of antimalarials, are in place to curb the malaria burden. However, the application of these antimalarials has two extremes, limited access to drug and drug pressure, which may have similar impact on malaria control, leading to treatment failure through divergent mechanisms. Limited access to drugs ensures that patients do not get the right doses of the antimalarials in order to have an effective plasma concentration to kill the malaria parasites, which leads to treatment failure and overall reduction in malaria control via increased transmission rate. On the other hand, drug pressure can lead to the selection of drug resistance phenotypes in a subpopulation of the malaria parasites as they mutate in order to adapt. This also leads to a reduction in malaria control. Addressing these extremes in antimalarial application can be essential in maintaining the relevance of the conventional antimalarials in winning the war against malaria.
      Citation: Medicines
      PubDate: 2022-01-04
      DOI: 10.3390/medicines9010002
      Issue No: Vol. 9, No. 1 (2022)
  • Medicines, Vol. 9, Pages 3: The Potential Impact of Blood System on
           Dietary Habits and Smoking

    • Authors: Ioannis Tsamesidis, Evangelia Stalika, Chinedu O. Egwu, Agathi Pritsa, Maria Parpori, Argyrios Gkinoudis, Diana Samara, Evgenia Lymperaki
      First page: 3
      Abstract: The ‘Blood-Type’ diet advises individuals to eat according to their ABO blood group to improve their health and decrease the risk of chronic diseases. However, the food preferences of individuals with different blood groups have not been examined. The aim of our study was to investigate, in healthy regular blood donors (rBDs), the associations of smoke, alcohol, caffeine, vitamin and fat intake with their different blood groups and if ABO groups could be a potential predictor tool for disease prevention. A total of 329 volunteers were divided into four groups according to their ABO types: Group 1 (A) comprised 141 rBDs; Group 2 (B), 65 rBDs; Group 3 (O), 96 rBDs; and Group 4, 27 rBDs. Additionally, they were divided into two groups according to their rhesus types and their preferences for smoke, too. Dietary intake was assessed using 3-day food recall and the Food Processor computer program for nutrient analysis. Alcohol, caffeine, sugar and Vitamin D consumption were significantly (p < 0.05) higher in the O group. The A group presented statistically significantly (p < 0.05) greater preferences for cholesterol intake and a higher trend for smoking (25%) habits compared with all the other groups, whereas Group B preferred more fatty foods. The blood group AB appeared to be the most controlled food intake group. Regarding the rhesus comparisons, alcohol; caffeine; and Vitamin C, D, E and K consumptions were significantly (p < 0.05) higher in rhesus-positive individuals than their rhesus-negative counterparts. For the non-smoker group, compared with the smokers, a higher consumption of Vitamin D and fibers was found. In conclusion, in the present study, statistically significant correlations of the ABO and rhesus system with some dietary parameters were found, indicating a consequent influence of these preferences on the progression of different diseases.
      Citation: Medicines
      PubDate: 2022-01-05
      DOI: 10.3390/medicines9010003
      Issue No: Vol. 9, No. 1 (2022)
  • Medicines, Vol. 9, Pages 4: Toxic Metal Concentrations in Drinking Water
           and Possible Effect on Sex Hormones among Men in Sabongida-Ora, Edo State,

    • Authors: Osaro Ogie Enehizena, Mathias A. Emokpae
      First page: 4
      Abstract: Drinking water can be a potential source of toxic metals, which are a known leading cause of infertility in men. This study determines the concentrations of lead (Pb), cadmium (Cd), zinc (Zn), copper (Cu) in drinking water (borehole, hand-dug well and treated water) and sex hormone levels (serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PROL), estradiol (E2), progesterone (PROG), and testosterone (T) in males who drink water mainly from these sources. The concentrations of Cd, and Pb in hand-dug wells were higher than the permissible limit recommended by the World Health Organization (WHO) while Zn and Cu were within the permissible levels in drinking water. Blood Cd and Pb levels were significantly higher (p < 0.001) among subjects who consumed hand-dug and borehole water than treated water, while serum Zn was significantly lower (p < 0.001) in hand-dug well and borehole water consumers than in control subjects. Also, serum FSH (p < 0.001), LH (p < 0.001), E2 (p < 0.002), PROG (p < 0.04) and T (p < 0.001) were significantly lower among hand-dug well and borehole water consumers than controls, while PROL (p < 0.001) was significantly higher in hand-dug well and borehole water consumers than controls. Blood Cd and Pb levels were significantly higher (p < 0.001) in hand-dug well water consumers than borehole water consumers. The consumption of water from hand-dug wells may have adverse reproductive sequelae among consumers.
      Citation: Medicines
      PubDate: 2022-01-07
      DOI: 10.3390/medicines9010004
      Issue No: Vol. 9, No. 1 (2022)
  • Medicines, Vol. 9, Pages 5: Diaphragm Ultrasound in Cardiac Surgery: State
           of the Art

    • Authors: Abdallah Fayssoil, Nicolas Mansencal, Lee S. Nguyen, David Orlikowski, Hélène Prigent, Jean Bergounioux, Djillali Annane, Frédéric Lofaso
      First page: 5
      Abstract: In cardiac surgery, patients are at risk of phrenic nerve injury, which leads to diaphragm dysfunction and acute respiratory failure. Diaphragm dysfunction (DD) is relatively frequent in cardiac surgery and particularly affects patients after coronary artery bypass graft. The onset of DD affects patients’ prognosis in term of weaning from mechanical ventilation and hospital length of stay. The authors present a narrative review about diaphragm physiology, techniques used to assess diaphragm function, and the clinical application of diaphragm ultrasound in patients undergoing cardiac surgery.
      Citation: Medicines
      PubDate: 2022-01-11
      DOI: 10.3390/medicines9010005
      Issue No: Vol. 9, No. 1 (2022)
  • Medicines, Vol. 9, Pages 6: The Dilemma of Reconstructive Material Choice
           for Orbital Floor Fracture: A Narrative Review

    • Authors: Akash Sivam, Natalie Enninghorst
      First page: 6
      Abstract: The aim of this study is to present a narrative review of the properties of materials currently used for orbital floor reconstruction. Orbital floor fractures, due to their complex anatomy, physiology, and aesthetic concerns, pose complexities regarding management. Since the 1950s, a myriad of materials has been used to reconstruct orbital floor fractures. This narrative review synthesises the findings of literature retrieved from search of PubMed, Web of Science, and Google Scholar databases. This narrative review was conducted of 66 studies on reconstructive materials. Ideal material properties are that they are resorbable, osteoconductive, resistant to infection, minimally reactive, do not induce capsule formation, allow for bony ingrowth, are cheap, and readily available. Autologous implants provide reliable, lifelong, and biocompatible material choices. Allogenic materials pose a threat of catastrophic disease transmission. Newer alloplastic materials have gained popularity. Consideration must be made when deliberating the use of permanent alloplastic materials that are a foreign body with potential body interactions, or the use of resorbable alloplastic materials failing to provide adequate support for orbital contents. It is vital that surgeons have an appropriate knowledge of materials so that they are used appropriately and reduce the risks of complications.
      Citation: Medicines
      PubDate: 2022-01-13
      DOI: 10.3390/medicines9010006
      Issue No: Vol. 9, No. 1 (2022)
  • Medicines, Vol. 9, Pages 7: Exercise, Diet and Sleeping as Regenerative
           Medicine Adjuvants: Obesity and Ageing as Illustrations

    • Authors: Abdelaziz Ghanemi, Mayumi Yoshioka, Jonny St-Amand
      First page: 7
      Abstract: Regenerative medicine uses the biological and medical knowledge on how the cells and tissue regenerate and evolve in order to develop novel therapies. Health conditions such as ageing, obesity and cancer lead to an impaired regeneration ability. Exercise, diet choices and sleeping pattern have significant impacts on regeneration biology via diverse pathways including reducing the inflammatory and oxidative components. Thus, exercise, diet and sleeping management can be optimized towards therapeutic applications in regenerative medicine. It could allow to prevent degeneration, optimize the biological regeneration and also provide adjuvants for regenerative medicine.
      Citation: Medicines
      PubDate: 2022-01-14
      DOI: 10.3390/medicines9010007
      Issue No: Vol. 9, No. 1 (2022)
  • Medicines, Vol. 9, Pages 1: Hydroethanolic Extract of Defatted Buchholzia
           coriacea Seeds Alleviates Tamoxifen-Induced Hepatic Triglyceride
           Accumulation, Inflammation and Oxidative Distress in Rat

    • Authors: Ayokanmi Ore, Abideen Idowu Adeogun, Oluseyi Adeboye Akinloye
      First page: 1
      Abstract: Background: Tamoxifen (TMX) has proven to be effective in the prevention and treatment of breast cancer. However, long-term use of TMX is associated with hepatic steatosis, oxidative liver injury and hepatocarcinoma. Buchholzia coriacea seeds (BCS) have been widely applied in traditional medicine due to their nutritional and therapeutic potentials. This study investigates the protective effect of hydroethanolic extract of (defatted) B. coriacea seeds (HEBCS) against TMX–induced hepatotoxicity in rats. Methods: Thirty-six (36) male albino rats were divided into six groups (n = 6/group). Group I served as control. Group II received 50 mg/kg/day TMX orally (p.o.) (TMX) for 21 days, group III received TMX plus 125 mg/kg/d HEBCS p.o. (HEBCS 125) for 21 days, group IV received TMX plus 250 mg/kg/d HEBCS p.o. (HEBCS 250) for 21 days and rats in group V and VI received HEBCS 125 and HEBCS 250 respectively for 21 days. Results: Compared with the control, TMX caused a significant increase (p < 0.05) in serum hepatic function biomarkers: alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase by 57%, 60% and 68% respectively. TMX also caused a significant increase in hepatic triglycerides level by 166% when compared with control and a significant decrease in serum HDL-cholesterol level by 37%. Compared with control, hepatic marker of inflammation, tumour necrosis factor alpha (TNF-α) increased significantly by 220%, coupled with significant increase in expression of interleukin 6 and cyclooxygenase 2. There was also significant increase in levels of Biomarkers of oxidative stress, nitric oxide, malondialdehyde and protein carbonyls in the TMX group by 89%, 175% and 114% respectively when compared with the control. Hepatic antioxidants, reduced glutathione (GSH) level and activities of superoxide dismutase (SOD), catalase (CAT), glutathione S-transferase (GST) and glutathione peroxidase (GSH-Px) decreased significantly in the TMX group by 35%, 67%, 41%, 59% and 53% respectively when compared with the control. However, HEBCS at 250 mg/kg significantly protected against TMX–induced hepatotoxicity by decreasing hepatic triglyceride content, serum hepatic function biomarkers, hepatic inflammation and oxidative stress with significant improvement in hepatic antioxidant system. Histopathological findings show that HEBCS alleviate TMX–induced hepatocyte ballooning. Conclusions: Current data suggest that HEBCS protected against TMX–induced hepatotoxicity in rats. HEBCS may be useful in managing TMX–induced toxicities in breast cancer patients. It may also be helpful against other forms of liver injury involving steatosis, inflammation, free radicals, and oxidative damage.
      Citation: Medicines
      PubDate: 2021-12-24
      DOI: 10.3390/medicines9010001
      Issue No: Vol. 9, No. 1 (2021)
  • Medicines, Vol. 8, Pages 46: The Effective Strategies to Avoid Medication
           Errors and Improving Reporting Systems

    • Authors: Abbas Al Mutair, Saad Alhumaid, Abbas Shamsan, Abdul Rehman Zia Zaidi, Mohammed Al Mohaini, Alya Al Mutairi, Ali A. Rabaan, Mansour Awad, Awad Al-Omari
      First page: 46
      Abstract: Background: Population-based studies from several countries have constantly shown excessively high rates of medication errors and avoidable deaths. An efficient medication error reporting system is the backbone of reliable practice and a measure of progress towards achieving safety. Improvement efforts and system changes of medication error reporting systems should be targeted towards reductions in the likelihood of injury to future patients. However, the aim of this review is to provide a summary of medication errors reporting culture, incidence reporting systems, creating effective reporting methods, analysis of medication error reports, and recommendations to improve medication errors reporting systems. Methods: Electronic databases (PubMed, Ovid, EBSCOhost, EMBASE, and ProQuest) were examined from 1 January 1998 to 30 June 2020. 180 articles were found and 60 papers were ultimately included in the review. Data were mined by two reviewers and verified by two other reviewers. The search yielded 684 articles, which were then reduced to 60 after the deletion of duplicates via vetting of titles, abstracts, and full-text papers. Results: Studies were principally from the United States of America and the United Kingdom. Limited studies were from Canada, Australia, New Zealand, Korea, Japan, Greece, France, Saudi Arabia, and Egypt. Detection, measurement, and analysis of medication errors require an active rather than a passive approach. Efforts are needed to encourage medication error reporting, including involving staff in opportunities for improvement and the determination of root cause(s). The National Coordinating Council for Medication Error Reporting and Prevention taxonomy is a classification system to describe and analyze the details around individual medication error events. Conclusion: A successful medication error reporting program should be safe for the reporter, result in constructive and useful recommendations and effective changes while being inclusive of everyone and supported with required resources. Health organizations need to adopt an effectual reporting environment for the medication use process in order to advance into a sounder practice.
      Citation: Medicines
      PubDate: 2021-08-27
      DOI: 10.3390/medicines8090046
      Issue No: Vol. 8, No. 9 (2021)
  • Medicines, Vol. 8, Pages 47: A Randomized Controlled Trial of the Efficacy
           of Systemic Enzymes and Probiotics in the Resolution of Post-COVID Fatigue

    • Authors: Abhijit Rathi, Swati B. Jadhav, Neha Shah
      First page: 47
      Abstract: Muscle fatigue and cognitive disturbances persist in patients after recovery from acute COVID-19 disease. However, there are no specific treatments for post-COVID fatigue. Objective: To evaluate the efficacy and safety of the health supplements ImmunoSEB (systemic enzyme complex) and ProbioSEB CSC3 (probiotic complex) in patients suffering from COVID-19 induced fatigue. A randomized, multicentric, double blind, placebo-controlled trial was conducted in 200 patients with a complaint of post-COVID fatigue. The test arm (n = 100) received the oral supplements for 14 days and the control arm (n = 100) received a placebo. Treatment efficacy was compared using the Chalder Fatigue scale (CFQ-11), at various time points from days 1 to 14. The supplemental treatment resulted in resolution of fatigue in a greater percentage of subjects in the test vs. the control arm (91% vs. 15%) on day 14. Subjects in the test arm showed a significantly greater reduction in total as well as physical and mental fatigue scores at all time points vs. the control arm. The supplements were well tolerated with no adverse events reported. This study demonstrates that a 14 days supplementation of ImmunoSEB + ProbioSEB CSC3 resolves post-COVID-19 fatigue and can improve patients’ functional status and quality of life.
      Citation: Medicines
      PubDate: 2021-08-30
      DOI: 10.3390/medicines8090047
      Issue No: Vol. 8, No. 9 (2021)
  • Medicines, Vol. 8, Pages 48: Prospective Comparison of 24-Hour Urine
           Creatinine Clearance with Estimated Glomerular Filtration Rates in Chronic
           Renal Disease Patients of African Descent

    • Authors: Marlene Tapper, Donovan A. McGrowder, Lowell Dilworth, Adedamola Soyibo
      First page: 48
      Abstract: Background: The 24-hour (24-h) creatinine clearance (CrCl) is the most common method for measuring GFR in clinical laboratories. However, the limitations of CrCl have resulted in the widespread acceptance of mathematically derived estimated glomerular filtration rate (eGFR) using Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in predicting eGFR. The aim of the study was to compare 24-h CrCl with eGFR derived from these formulae and to identify which could be the best alternative. Method: A prospective study was conducted involving 140 CKD patients. Creatinine and cystatin C concentrations were determined using the cobas 6000 analyzer. The eGFR was calculated using the CG formula, 4-variable MDRD and CKD-EPI equations, and Bland-Alman plots bias was determined. Results: The CG and MDRD formulas had mean eGFR values similar to CrCl and correlation coefficients (r) were highest for CG (0.906) and lowest for MDRD (0.799). The CG equation was in agreement with 24-h CrCl in all but stage V CKD while the MDRD equation compared well in all except Stage IV CKD. The CG equation was positively biased (0.9857) while the MDRD had a negative bias (−0.05). Conclusion: The Cockcroft-Gault formula provides a more accurate assessment of GFR than 24-h CrCl and would be recommended as a substitute to provide the best estimate of GFR in our population.
      Citation: Medicines
      PubDate: 2021-09-01
      DOI: 10.3390/medicines8090048
      Issue No: Vol. 8, No. 9 (2021)
  • Medicines, Vol. 8, Pages 49: Coronavirus Disease 2019 (COVID-19) Crisis
           Measures: Health Protective Properties'

    • Authors: Abdelaziz Ghanemi, Mayumi Yoshioka, Jonny St-Amand
      First page: 49
      Abstract: The ongoing 2019 coronavirus disease (COVID-19) crisis has led governments to impose measures including mask wearing, physical distancing, and increased hygiene and disinfection, combined with home confinement and economic shutdown. Such measures have heavy negative consequences both on public health and the economy. However, these same measures have positive outcomes as “side effects” that are worth mentioning since they contribute to the improvement of some aspects of the population health. For instance, mask wearing helps to reduce allergies as well as the transmission of other airborne disease-causing pathogens. Physical distancing and social contact limitation help limit the spread of communicable diseases, and economic shutdown can reduce pollution and the health problems related to it. Decision makers could get inspired by these positive “side effects” to tackle and prevent diseases like allergies, infectious diseases and noncommunicable diseases, and improve health care and pathology management. Indeed, the effectiveness of such measures in tackling certain health problems encourages inspiration from COVID-19 measures towards managing selected health problems. However, with the massive damage COVID-19-related measures have caused to countries’ economies and people’s lives, the question of how to balance the advantages and disadvantages of these measures in order to further optimize them needs to be debated among health care professionals and decision makers.
      Citation: Medicines
      PubDate: 2021-09-02
      DOI: 10.3390/medicines8090049
      Issue No: Vol. 8, No. 9 (2021)
  • Medicines, Vol. 8, Pages 50: Incidence of Screw Loosening in Cortical Bone
           Trajectory Fixation Technique between Single- and Dual-Threaded Screws

    • Authors: Chao-Hsuan Chen, Chih-Hsiu Tu, Der-Cherng Chen, Hsiang-Ming Huang, Hao-Yu Chuang, Der-Yang Cho, Da-Tian Bau, Han-Chung Lee
      First page: 50
      Abstract: Purpose: This study aims to elucidate the radiological outcome after Cortical bone trajectory (CBT) screw fixation and whether dual-threaded (DT) screws should be used in the fusion surgery. Methods: 159 patients with degenerative lumbar disorder who had undergone midline lumbar inter-body fusion surgery by CBT screw-fixation technique (2014 to 2018). Patient subgroups were based on single-threaded (ST) or DT screw, fixation length, as well as whether fixation involved to sacrum level (S1). Serial dynamic plain films were reviewed and an appearance of a halo phenomenon between screw–bone interfaces was identified as a case of screw loosening. Results: 29 patients (39.7%) in ST group and 10 patients (11.6%) in DT group demonstrated a halo phenomenon (p < 0.0001 ****). After subgrouping with fixation length, the incidence rates of a halo phenomenon in each group were 11.1%:3% (ST-1L vs. DT-1L), 37%:13.8% (ST-2L vs. DT-2L), and 84.2%:23.5% (ST-3L vs. DT-3L). Among the 85 patients with a fixation involved in S1, 26 patients (52%) with single-threaded screw (STS group) and 8 patients (22.8%) with dual-threaded screw (DTS group) demonstrated a halo appearance (p = 0.0078 **). After subgrouping the fixation level, the incidence of a halo appearance in each group was 25%:0% (STS-1L vs. DTS-1L), 40.9%:26.3% (STS-2L vs. DTS-2L), and 87.5%: 30% (STS-3L vs. DTS-3L). Conclusion: Both fixation length and whether fixation involved to S1 contribute to the incidence of screw loosening, the data supports clinical evidence that DT screws had greater fixation strength with an increased fixative stability and lower incidence of screw loosening in CBT screw fixation compared with ST screws. Level of evidence: 2.
      Citation: Medicines
      PubDate: 2021-09-02
      DOI: 10.3390/medicines8090050
      Issue No: Vol. 8, No. 9 (2021)
  • Medicines, Vol. 8, Pages 51: Frailty in Primary Care: Validation of the
           simplified Zulfiqar Frailty Scale (sZFS)

    • Authors: Abrar-Ahmad Zulfiqar
      First page: 51
      Abstract: Introduction: Frailty scales are used very rarely by general practitioners as they are time consuming and are not well-adapted to current needs. Thus, we have designed with general practitioners a new scale for the early and rapid detection of frailty syndrome, called the simplified Zulfiqar Frailty Scale (sZFS). Patients and methods: This scale was tested in two general medicine practices in Normandy (France) for a total of six months and compared to the GFST tool “The Gerontopole Frailty Screening Tool”. Only patients who were over 65 years old with an ADL ≥ 4/6 were included. Results: 107 were patients included in the general medicine practice, with an average age of 74 years. The sZFS questionnaire has a shorter administration time than the GFST questionnaire (p < 0.001). Its sensitivity is of 93%, and its specificity is 58%. Its positive predictive value is 57%, and its negative predictive value is 93%. The area under the curve of the sZFS scale is 0.83 [0.76; 0.91] (IC95%). Conclusion: Our frailty screening scale is simple, relevant, and quick.
      Citation: Medicines
      PubDate: 2021-09-03
      DOI: 10.3390/medicines8090051
      Issue No: Vol. 8, No. 9 (2021)
  • Medicines, Vol. 8, Pages 52: Validation of the Zulfiqar Frailty Scale
           (ZFS): A New Tool for General Practitioners

    • Authors: Abrar-Ahmad Zulfiqar
      First page: 52
      Abstract: Introduction: The early detection of frailty, a frequent transient state that can be reversible in the elderly and is responsible for significant morbidity and mortality, helps prevent complications from it. Objective: To evaluate the performance of the “ZFS” tool to screen for frailty as defined SEGA scale criteria in an ambulatory population of patients at least 65 years of age. Methods: A prospective non-interventional study conducted in Alsace for a duration of six months that included patients aged 65 and over, judged to be autonomous with an ADL > 4/6. Results: In this ambulatory population of 102 patients with an average age of 76 years, frailty, according to modified SEGA criteria grid A, had a prevalence of 19.6%. Frailty, according to the “ZFS” tool, had a prevalence of 35.0%, and all of its elements except weight loss were significantly associated with frailty. Its threshold for identifying frailty is three criteria out of six. It was rapid (average completion time: 87s), had a sensitivity of 100%, and a negative predictive value of 100%. Conclusions: The “ZFS” tool makes it possible to screen for frailty with a high level of sensitivity and a negative predictive value.
      Citation: Medicines
      PubDate: 2021-09-04
      DOI: 10.3390/medicines8090052
      Issue No: Vol. 8, No. 9 (2021)
  • Medicines, Vol. 8, Pages 53: Advances in the Treatment of Gastrointestinal
           Bleeding: Safety and Efficiency of Transnasal Endoscopy

    • Authors: Hiroyuki Abe, Kenya Kamimura, Yoshihisa Arao, Junji Kohisa, Shuji Terai
      First page: 53
      Abstract: Acute upper gastrointestinal bleeding (UGIB) is a common disorder and a gastroenterological emergency. With the development of new techniques and devices, the survivability after gastrointestinal bleeding is improving. However, at the same time, we are facing the difficulty of severely complicated cases with various diseases. For example, while endoscopic examination with a normal diameter endoscope is essential for the diagnosis and treatment of UGIB, there are several cases in which it cannot be used. In these cases, transnasal endoscopy (TNE) may be a viable treatment option. This report reviews current hemostatic devices for endoscopic treatment and the safety and efficiency of using TNE in complicated cases. The latter will be demonstrated in a case report where TNE was employed in a patient with severe esophageal stenosis. This review summarizes the advances made in the devices used and will provide further ideas for the physician in terms of combining these devices and TNE.
      Citation: Medicines
      PubDate: 2021-09-14
      DOI: 10.3390/medicines8090053
      Issue No: Vol. 8, No. 9 (2021)
  • Medicines, Vol. 8, Pages 54: Ethics in Medicines: Exposing Unethical
           Practices and Corruption in All Sectors of Medicines Is Essential for
           Improving Global Public Health and Saving Patients’ Lives

    • Authors: George J. Kontoghiorghes
      First page: 54
      Abstract: While great strides have been made in science and medicine ensuring better living standards and health care for most human beings, many issues still remain, which are responsible for an increase in mortality and morbidity rates of millions of people worldwide, despite that in most cases the causes are preventable [...]
      Citation: Medicines
      PubDate: 2021-09-14
      DOI: 10.3390/medicines8090054
      Issue No: Vol. 8, No. 9 (2021)
  • Medicines, Vol. 8, Pages 40: Comparison of G8 and ISAR Screening Results
           in Geriatric Urology

    • Authors: Jobar Bouzan, Boris Stoilkov, Spiridon Nellas, Marcus Horstmann
      First page: 40
      Abstract: Background: The G8 and ISAR scores are two different screening tools for geriatric risk factors and frailty. The aim of this study was to compare the G8 and ISAR screening results in a cohort of urogeriatric patients to help clinicians to better understand and choose between the two tests. Methods: We retrospectively evaluated 100 patients at the age of 75 and above who were treated for different urological conditions. All routinely and prospectively underwent G8 and ISAR screening tests. A G8 score ≤ 14 and an ISAR score > 2 were considered positive. The results for the two tests were compared and correlated to clinical data. Results: The mean age of the patients was 83 y (min. 75–max. 101); 78 of the patients were male, while 22 were female; 58 of the patients were G8-positive, while 42 were G8-negative; and 24 were ISAR-positive, while 76 ISAR were negative. All the ISAR-positive patients were also G8-positive. There was a significant negative correlation between the G8 and ISAR scores (r = −0.77, p < 0.001). Both tests correlated significantly with the Charlson comorbidity index, length of stay, number of coded diagnosis, and Braden score (p < 0.05). Conclusion: Both tests are significantly correlated with each other and to clinical data related to geriatric frailty. However, the G8 score has a much higher rate of positive tests, which limits its use in daily routine, and the ISAR score is therefore preferable. For “fit” geriatric patients, however, a negative G8 score can be of great use as a confirmatory test for further decision making.
      Citation: Medicines
      PubDate: 2021-07-22
      DOI: 10.3390/medicines8080040
      Issue No: Vol. 8, No. 8 (2021)
  • Medicines, Vol. 8, Pages 41: Purification and Biological Function of

    • Authors: Akito Tomomura, Kenjiro Bandow, Mineko Tomomura
      First page: 41
      Abstract: Blood calcium homeostasis is critical for biological function. Caldecrin, or chymotrypsin-like elastase, was originally identified in the pancreas as a serum calcium-decreasing factor. The serum calcium-decreasing activity of caldecrin requires the trypsin-mediated activation of the protein. Protease activity-deficient mature caldecrin can also reduce serum calcium concentration, indicating that structural processing is necessary for serum calcium-decreasing activity. Caldecrin suppresses the differentiation of bone-resorbing osteoclasts from bone marrow macrophages (BMMs) by inhibiting receptor activator of NF-κB ligand (RANKL)-induced nuclear factor of activated T-cell cytoplasmic 1 expression via the Syk–PLCγ–Ca2+ oscillation-calcineurin signaling pathway. It also suppresses mature osteoclastic bone resorption by RANKL-stimulated TRAF6–c-Src–Syk–calcium entry and actin ring formation. Caldecrin inhibits lipopolysaccharide (LPS)-induced osteoclast formation in RANKL-primed BMMs by inducing the NF-κB negative regulator A20. In addition, caldecrin suppresses LPS-mediated M1 macrophage polarization through the immunoreceptor triggering receptor expressed on myeloid cells (TREM) 2, suggesting that caldecrin may function as an anti-osteoclastogenic and anti-inflammatory factor via TREM2. The ectopic intramuscular expression of caldecrin cDNA prevents bone resorption in ovariectomized mice, and the administration of caldecrin protein also prevents skeletal muscle destruction in dystrophic mice. In vivo and in vitro studies have indicated that caldecrin is a unique multifunctional protease and a possible therapeutic target for skeletal and inflammatory diseases.
      Citation: Medicines
      PubDate: 2021-07-23
      DOI: 10.3390/medicines8080041
      Issue No: Vol. 8, No. 8 (2021)
  • Medicines, Vol. 8, Pages 42: Psychometric Properties of the Greek Version
           of the Medical Office on Patient Safety Culture in Primary Care Settings

    • Authors: Ioannis Antonakos, Kyriakos Souliotis, Theodora Psaltopoulou, Yannis Tountas, Athanasios Papaefstathiou, Maria Kantzanou
      First page: 42
      Abstract: Background: Safety culture is considered one of the most crucial premises for further development of patient care in healthcare. During the eight-year economic crisis (2010–2018), Greece made significant reforms in the way the primary health care system operates, aiming at the more efficient operation of the system without degrading issues of safety and quality of the provided health services. In this context, this study aims to validate a specialized tool—the Medical Office Survey on Patient Safety Culture (MOSPSC)—developed by the Agency for Healthcare Research and Quality (AHRQ) to evaluate primary care settings in terms of safety culture and quality. Methods: Factor analysis determined the correlation of the factor structure in Greek data with the original questionnaire. The relation of the factor analysis with the Cronbach’s coefficient alpha was also determined, including the construct validity. Results: Eight composites with 34 items were extracted by exploratory factor analysis, with acceptable Cronbach’s alpha coefficients and good construct validity. Consequently, the composites jointly explained 62% of the variance in the responses. Five items were removed from the original version of the questionnaire. As a result, three out of the eight composites were a mixture of items from different compounds of the original tool. The composition of the five factors was similar to that in the original questionnaire. Conclusions: The MOSPSC tool in Greek primary healthcare settings can be used to assess patient safety culture in facilities across the country. From the study, the patient safety culture in Greece was positive, although few composites showed a negative correlation and needed improvement.
      Citation: Medicines
      PubDate: 2021-07-26
      DOI: 10.3390/medicines8080042
      Issue No: Vol. 8, No. 8 (2021)
  • Medicines, Vol. 8, Pages 43: Anti-Inflammatory Effects of Morinda
           citrifolia Extract against Lipopolysaccharide-Induced Inflammation in
           RAW264 Cells

    • Authors: Takashi Tanikawa, Masashi Kitamura, Yasuhiro Hayashi, Natsumi Tomida, Akemi Uwaya, Fumiyuki Isami, Yutaka Inoue
      First page: 43
      Abstract: Leaves of Morinda citrifolia (noni) have been used in Polynesian folk medicine for the treatment of pain and inflammation, and their juice is very popular worldwide as a functional food supplement. This study aimed to demonstrate that M. citrifolia seed extract exerts anti-inflammatory effects on RAW264 cells stimulated by lipopolysaccharide. To confirm the inhibitory effect of M. citrifolia seed extract, we assessed the production of nitric oxide (NO) and inflammatory cytokines. The M. citrifolia seed extract showed a significant inhibition of NO production, with no effect on cell viability, and was more active than M. citrifolia seed oil, leaf extract, and fruit extract. The M. citrifolia seed extract was found to reduce the expression of inducible NO synthase and tumor necrosis factor-alpha of pro-inflammatory cytokines. These results suggest that the anti-inflammatory effect of M. citrifolia seed extract is related to a reduction in the expression of inflammatory mediators and support its potential therapeutic use.
      Citation: Medicines
      PubDate: 2021-08-04
      DOI: 10.3390/medicines8080043
      Issue No: Vol. 8, No. 8 (2021)
  • Medicines, Vol. 8, Pages 44: Herb–Drug Interactions: Worlds Intersect
           with the Patient at the Center

    • Authors: Mary Beth Babos, Michelle Heinan, Linda Redmond, Fareeha Moiz, Joao Victor Souza-Peres, Valerie Samuels, Tarun Masimukku, David Hamilton, Myra Khalid, Paul Herscu
      First page: 44
      Abstract: This review examines three bodies of literature related to herb–drug interactions: case reports, clinical studies, evaluations found in six drug interaction checking resources. The aim of the study is to examine the congruity of resources and to assess the degree to which case reports signal for further study. A qualitative review of case reports seeks to determine needs and perspectives of case report authors. Methods: Systematic search of Medline identified clinical studies and case reports of interacting herb–drug combinations. Interacting herb–drug pairs were searched in six drug interaction resources. Case reports were analyzed qualitatively for completeness and to identify underlying themes. Results: Ninety-nine case-report documents detailed 107 cases. Sixty-five clinical studies evaluated 93 mechanisms of interaction relevant to herbs reported in case studies, involving 30 different herbal products; 52.7% of these investigations offered evidence supporting reported reactions. Cohen’s kappa found no agreement between any interaction checker and case report corpus. Case reports often lacked full information. Need for further information, attitudes about herbs and herb use, and strategies to reduce risk from interaction were three primary themes in the case report corpus. Conclusions: Reliable herb–drug information is needed, including open and respectful discussion with patients.
      Citation: Medicines
      PubDate: 2021-08-05
      DOI: 10.3390/medicines8080044
      Issue No: Vol. 8, No. 8 (2021)
  • Medicines, Vol. 8, Pages 45: Role of Microbial Infection-Induced
           Inflammation in the Development of Gastrointestinal Cancers

    • Authors: Keita Kouzu, Hironori Tsujimoto, Yoji Kishi, Hideki Ueno, Nariyoshi Shinomiya
      First page: 45
      Abstract: There has been increasing evidence that a local inflammatory response stimulates tumor cells to acquire metastatic potential, and the concept of inflammatory oncotaxis has been spreading in recent years. However, the interaction between microbial inflammation and the development of gastrointestinal cancer is still unclear. This review summarizes the present knowledge on the role of microbial inflammation in the development of gastrointestinal cancers from the perspective of molecular biological findings. Chronic inflammation caused by bacterial infection is known to induce cancers as exemplified by Helicobacter pylori, which is associated with the development of gastric cancer via the activation of the TLR4 pathway by bacterial lipopolysaccharide followed by cancer growth through CagA-MET signaling. In addition, the development of inflammatory bowel diseases has been known to become a risk factor for colorectal cancers, where inflammation caused by certain bacterial infections plays a key role. It is also known that the cancer microenvironment is associated with cancer growth. Moreover, infectious complication after surgery for gastrointestinal cancers may promote tumor progression via the stimulation of pathogen-associated molecular patterns and various inflammatory mediators secreted by immunocytes. Further research on the link between microbial inflammation and cancer progression is needed to drive a paradigm shift in cancer treatment.
      Citation: Medicines
      PubDate: 2021-08-17
      DOI: 10.3390/medicines8080045
      Issue No: Vol. 8, No. 8 (2021)
  • Medicines, Vol. 8, Pages 32: Thieno[2,3-b]Pyridine Derivative Targets
           Epithelial, Mesenchymal and Hybrid CD15s+ Breast Cancer Cells

    • Authors: Sandra Marijan, Angela Mastelić, Anita Markotić, Nikolina Režić-Mužinić, Nikolina Vučenović, David Barker, Lisa I. Pilkington, Jóhannes Reynisson, Vedrana Čikeš Čulić
      First page: 32
      Abstract: The adhesion of cancer cells to vascular endothelium is a critical process in hematogenous metastasis and might be similar to the recruitment of leukocytes at the site of inflammation. It is mediated by E-selectin and its ligands, of which the most stereospecific is a glycoconjugate sialyl Lewis x (CD15s), which may be expressed as an oligosaccharide branch of the CD44 glycoprotein, as well as a self-contained glycosphingolipid. It is also known that increased sialylation of glycoconjugates is a feature of malignant cells. The aim of the study was to analyse the effect of a novel thieno[2,3-b]pyridine, compound 1, in MDA-MB-231 triple-negative breast cancer cells (TNBCs) upon CD15s and CD44 expression in different cell subpopulations using flow cytometry. CD15s expression was compared between mesenchymal-like cancer stem cells (CSC, CD44+CD24−), epithelial cells without CD44 (CD44−CD24+ and CD44−CD24−), and CD44+CD24+ cells that exhibit mesenchymal and epithelial features. In addition, expression of CD44 in CD15s+CSC and CD15s−CSC was determined. Compound 1 significantly decreased the percentage of CD15s+CSC, CD15s+CD44+CD24+, and CD15s+CD44− subpopulations, as well as the expression of CD15s in CD44+CD24+ and CD44− cells, and therefore shows potential as a treatment for TNBC.
      Citation: Medicines
      PubDate: 2021-06-22
      DOI: 10.3390/medicines8070032
      Issue No: Vol. 8, No. 7 (2021)
  • Medicines, Vol. 8, Pages 33: Re-Evaluation of Chemotherapeutic Potential
           of Pyoktanin Blue

    • Authors: Hiroshi Sakagami, Toshiko Furukawa, Keitaro Satoh, Shigeru Amano, Yosuke Iijima, Takuro Koshikawa, Daisuke Asai, Kunihiko Fukuchi, Hiromu Takemura, Taisei Kanamoto, Satoshi Yokose
      First page: 33
      Abstract: Background: Pyoktanin blue (PB) is used for staining tissues and cells, and it is applied in photodynamic therapy due to its potent bactericidal activity. However, clinical application of PB as an antiviral and antitumor agent has been limited due to its potent toxicity. For clinical application, the antitumor and antiviral activity as well as the neurotoxicity of PB were re-evaluated with a chemotherapeutic index. Methods: Tumor-specificity (TS) was determined by the ratio of CC50 against normal oral cells/oral squamous cell carcinoma (OSCC); neurotoxicity by that of normal oral/neuronal cells; antiviral activity by that of mock-infected/virus-infected cells; and potency-selectivity expression (PSE) by dividing TS by CC50 (OSCC). Results: Antitumor activity of PB (assessed by TS and PSE) was comparable with that of DXR and much higher than that of 5-FU and melphalan. PB induced caspase-3 activation and subG1 cell accumulation in an OSCC cell line (Ca9-22). PB and anticancer drugs showed comparable cytotoxicity against both neuronal cells and OSCC cell lines. PB showed no detectable anti-HIV/HSV activity, in contrast to reverse transferase inhibitors, sulfated glucans, and alkaline extract of leaves of S.P. Conclusions: PB showed first-class anticancer activity and neurotoxicity, suggesting the importance of establishing the safe treatment schedule.
      Citation: Medicines
      PubDate: 2021-06-22
      DOI: 10.3390/medicines8070033
      Issue No: Vol. 8, No. 7 (2021)
  • Medicines, Vol. 8, Pages 34: Gut Microbiota Regulates the Interaction
           between Diet and Genetics to Influence Glucose Tolerance

    • Authors: Jeralyn Franson, Julianne Grose, Kaitlyn Larson, Laura Bridgewater
      First page: 34
      Abstract: Background: Metabolic phenotypes are the result of an intricate interplay between multiple factors, including diet, genotype, and the gut microbiome. Per–Arnt–Sim (PAS) kinase is a nutrient-sensing serine/threonine kinase, whose absence (PASK−/−) protects against triglyceride accumulation, insulin resistance, and weight gain on a high-fat diet; conditions that are associated with dysbiosis of the gut microbiome. Methods: Herein, we report the metabolic effects of the interplay of diet (high fat high sugar, HFHS), genotype (PASK−/−), and microbiome (16S sequencing). Results: Microbiome analysis identified a diet-induced, genotype-independent forked shift, with two discrete clusters of HFHS mice having increased beta and decreased alpha diversity. A “lower” cluster contained elevated levels of Firmicutes, Bacteroidetes, Actinobacteria, Proteobacteria and Defferibacteres, and was associated with increased weight gain, glucose intolerance, triglyceride accumulation, and decreased claudin-1 expression. Genotypic effects were observed within the clusters, lower cluster PASK−/− mice displayed increased weight gain and decreased triglyceride accumulation, whereas upper PASK−/− were resistant to decreased claudin-1. Conclusions: These results confirm previous reports that PAS kinase deficiency can protect mice against the deleterious effects of diet, and they suggest that microbiome imbalances can override protection. In addition, these results support a healthy diet for beneficial microbiome maintenance and suggest microbial culprits associated with metabolic disease.
      Citation: Medicines
      PubDate: 2021-07-01
      DOI: 10.3390/medicines8070034
      Issue No: Vol. 8, No. 7 (2021)
  • Medicines, Vol. 8, Pages 35: A Combination of GM-CSF and Released Factors
           from Gamma-Irradiated Tumor Cells Enhances the Differentiation of
           Macrophages from Bone Marrow Cells and Their Antigen-Presenting Function
           and Polarization to Type 1

    • Authors: Lichao Chen, Shoji Imamichi, Ying Tong, Yuka Sasaki, Takae Onodera, Satoshi Nakamura, Hiroshi Igaki, Jun Itami, Mitsuko Masutani
      First page: 35
      Abstract: Granulocyte-macrophage colony-stimulating factor (GM-CSF) promotes dendritic cell differentiation from precursors, and consequently, enhances the antigen presentation process and adaptive immune responses. With such functions, GM-CSF has been used as immunotherapy in combination with radiotherapy for cancer treatment to augment the survival and activity of immune cells. However, an immune-suppressive tumor microenvironment may cause anergy of T cells. It has also been reported that GM-CSF contributes to the development of myeloid-derived suppressor cells from the precursors. In this study, to analyze the combined effect of GM-CSF and released factors from cancer cells after gamma-ray irradiation on bone marrow cell differentiation and dynamics, we established an in vitro culture system using mouse bone marrow cells, GM-CSF, and conditioned medium from gamma ray irradiated mouse melanoma B16 cells at 24 Gy. We analyzed the gene expression changes of the bone marrow-derived cells on day 6. The results showed that GM-CSF dose-dependently enhanced the differentiation of macrophages from bone marrow cells, their antigen-presenting function and polarization to type I. The results implied the induced macrophages from the bone marrow may potentially contribute to tumor immune responses in a systemic manner when GM-CSF is boosted during photon-beam radiation therapy.
      Citation: Medicines
      PubDate: 2021-07-04
      DOI: 10.3390/medicines8070035
      Issue No: Vol. 8, No. 7 (2021)
  • Medicines, Vol. 8, Pages 36: Differences between the European Union and
           United States of America in Drug Regulatory Affairs Affect Global Patient
           Safety Standards and Public Health Awareness: The Case of Deferasirox and
           Other Iron Chelating Drugs

    • Authors: George J. Kontoghiorghes
      First page: 36
      Abstract: Regulatory policies on drugs have a major impact on patient safety and survival. Some pharmaceutical companies employ all possible methods to achieve maximum sales in relation to the monopoly of their patented drugs, leading sometimes to irregularities and illegal activities. Misinformation on the orphan drug deferasirox has reached the stage of criminal investigations and fines exceeding USD 100 million. Additional lawsuits of USD 3.5 billion for damages and civil fines were also filed by the FBI of the USA involving deferasirox and mycophenolic acid, which were later settled with an additional fine of USD 390 million. Furthermore, a USD 345 million fine was also settled for bribes and other illegal overseas operations including an EU country. However, no similar fines for illegal practises or regulatory control violations have been issued in the EU. Misconceptions and a lack of clear guidelines for the use of deferasirox in comparison to deferiprone and deferoxamine appear to reduce the effective treatment prospects and to increase the toxicity risks for thalassaemia and other iron loaded patients. Similar issues have been raised for the activities of other pharmaceutical companies promoting the use of new patented versus generic drugs. Treatments for different categories of patients using new patented drugs are mostly market driven with no clear safeguards or guidelines for risk/benefit assessment indications or for individualised effective and safe optimum therapies. There is a need for the establishment of an international organisation, which can monitor and assess the risk/benefit assessment and marketing of drugs in the EU and globally for the benefit of patients. The pivotal role of the regulatory drug authorities and the prescribing physicians for identifying individualised optimum therapies is essential for improving the survival and safety of millions of patients worldwide.
      Citation: Medicines
      PubDate: 2021-07-07
      DOI: 10.3390/medicines8070036
      Issue No: Vol. 8, No. 7 (2021)
  • Medicines, Vol. 8, Pages 37: Effectiveness of Yoga Lifestyle on Lipid
           Metabolism in a Vulnerable Population—A Community Based Multicenter
           Randomized Controlled Trial

    • Authors: Raghuram Nagarathna, Saurabh Kumar, Akshay Anand, Ishwara N. Acharya, Amit Kumar Singh, Suchitra S. Patil, Ramesh H Latha, Purnima Datey, Hongasandra Ramarao Nagendra
      First page: 37
      Abstract: Background: Dyslipidemia poses a high risk for cardiovascular disease and stroke in Type 2 diabetes (T2DM). There are no studies on the impact of a validated integrated yoga lifestyle protocol on lipid profiles in a high-risk diabetes population. Methods: Here, we report the results of lipid profile values of 11,254 (yoga 5932 and control 5322) adults (20–70 years) of both genders with high risk (≥60 on Indian diabetes risk score) for diabetes from a nationwide rural and urban community-based two group (yoga and conventional management) cluster randomized controlled trial. The yoga group practiced a validated integrated yoga lifestyle protocol (DYP) in nine day camps followed by daily one-hour practice. Biochemical profiling included glycated hemoglobin and lipid profiles before and after three months. Results: There was a significant difference between groups (p < 0.001 ANCOVA) with improved serum total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein in the yoga group compared to the control group. Further, the regulatory effect of yoga was noted with a significant decrease or increase in those with high or low values of lipids, respectively, with marginal or no change in those within the normal range. Conclusion: Yoga lifestyle improves and regulates (lowered if high, increased if low) the blood lipid levels in both genders of prediabetic and diabetic individuals in both rural and urban Indian communities.
      Citation: Medicines
      PubDate: 2021-07-13
      DOI: 10.3390/medicines8070037
      Issue No: Vol. 8, No. 7 (2021)
  • Medicines, Vol. 8, Pages 38: Importance of Apolipoprotein A-I and A-II

    • Authors: Kyung-Hyun Cho
      First page: 38
      Abstract: The composition and properties of apolipoprotein (apo) A-I and apoA-II in high-density lipoproteins (HDL) might be critical to SARS-CoV-2 infection via SR-BI and antiviral activity against COVID-19. HDL containing native apoA-I showed potent antiviral activity, while HDL containing glycated apoA-I or other apolipoproteins did not. However, there has been no report to elucidate the putative role of apoA-II in the antiviral activity of HDL.
      Citation: Medicines
      PubDate: 2021-07-16
      DOI: 10.3390/medicines8070038
      Issue No: Vol. 8, No. 7 (2021)
  • Medicines, Vol. 8, Pages 39: Clinical Significance of
           Gamma-Glutamyltranspeptidase Combined with Carbohydrate-Deficient
           Transferrin for the Assessment of Excessive Alcohol Consumption in
           Patients with Alcoholic Cirrhosis

    • Authors: Akihiko Shibamoto, Tadashi Namisaki, Junya Suzuki, Takahiro Kubo, Satoshi Iwai, Fumimasa Tomooka, Soichi Takeda, Yuki Fujimoto, Masahide Enomoto, Koji Murata, Takashi Inoue, Koji Ishida, Hiroyuki Ogawa, Hirotetsu Takagi, Daisuke Kaya, Yuki Tsuji, Takahiro Ozutsumi, Yukihisa Fujinaga, Masanori Furukawa, Norihisa Nishimura, Yasuhiko Sawada, Koh Kitagawa, Shinya Sato, Hiroaki Takaya, Kosuke Kaji, Naotaka Shimozato, Hideto Kawaratani, Kei Moriya, Takemi Akahane, Akira Mitoro, Hitoshi Yoshiji
      First page: 39
      Abstract: Background: This study aimed to compare the diagnostic performance of carbohydrate-deficient transferrin (CDT) and gamma-glutamyltranspeptidase (γ-GTP) to assess the single and combined benefits of these biological markers for the detection of chronic excessive alcohol consumption in patients with alcoholic cirrhosis. Methods: Biological markers were determined in blood samples from patients with alcoholic cirrhosis (drinking group, n = 35; nondrinking group, n = 81). The prediction accuracy of %CDT alone, γ-GTP alone, and their combination for the detection of excessive alcohol consumption was determined in patients with alcoholic cirrhosis. Results: Serum total bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-GTP, and alkaline phosphatase levels and %CDT were significantly higher and serum albumin levels were significantly lower in the drinking group than in the nondrinking group. The combination of %CDT and γ-GTP compared with %CDT or γ-GTP alone showed a higher prediction accuracy. The combination of %CDT and γ-GTP exhibited a higher specificity than γ-GTP alone. However, in terms of sensitivity, no significant difference was found between single or combined markers. Conclusions: The combination of %CDT and γ-GTP is considered a useful biomarker of chronic excessive alcohol consumption in patients with alcoholic cirrhosis.
      Citation: Medicines
      PubDate: 2021-07-19
      DOI: 10.3390/medicines8070039
      Issue No: Vol. 8, No. 7 (2021)
  • Medicines, Vol. 8, Pages 24: Recognition and Management of
           Antipsychotic-Induced Parkinsonism in Older Adults: A Narrative Review

    • Authors: Sharadha Wisidagama, Abiram Selladurai, Peter Wu, Marco Isetta, Jordi Serra-Mestres
      First page: 24
      Abstract: Background: Parkinsonism is a common side-effect of antipsychotic drugs especially in older adults, who also present with a higher frequency of neurodegenerative disorders like Idiopathic Parkinson’s disease (IPD). Distinguishing between antipsychotic-induced parkinsonism (AIP) and IPD is challenging due to clinical similarities. Up to 20% of older adults may suffer from persisting parkinsonism months after discontinuation of antipsychotics, suggesting underlying neurodegeneration. A review of the literature on AIP in older adults is presented, focusing on epidemiology, clinical aspects, and management. Methods: A literature search was undertaken on EMBASE, MEDLINE and PsycINFO, for articles on parkinsonism induced by antipsychotic drugs or other dopamine 2 receptor antagonists in subjects aged 65 or older. Results: AIP in older adults is the second most common cause of parkinsonism after IPD. Older age, female gender, exposure to high-potency first generation antipsychotics, and antipsychotic dosage are the main risk factors. The clinical presentation of AIP resembles that of IPD, but is more symmetrical, affects upper limbs more, and tends to have associated motor phenomena such as orofacial dyskinesias and akathisia. Presence of olfactory dysfunction in AIP suggests neurodegeneration. Imaging of striatal dopamine transporters is widely used in IPD diagnosis and could help to distinguish it from AIP. There is little evidence base for recommending pharmacological interventions for AIP, the best options being dose-reduction/withdrawal, or switching to a second-generation drug. Conclusions: AIP is a common occurrence in older adults and it is possible to differentiate it from IPD. Further research is needed into its pathophysiology and on its treatment.
      Citation: Medicines
      PubDate: 2021-05-26
      DOI: 10.3390/medicines8060024
      Issue No: Vol. 8, No. 6 (2021)
  • Medicines, Vol. 8, Pages 25: The Role of Poly-Herbal Extract in Sodium
           Chloride-Induced Oxidative Stress and Hyperlipidemia in Male Wistar Rats

    • Authors: Olubukola Sinbad Olorunnisola, Peter Ifeoluwa Adegbola, Bamidele Stephen Ajilore, Olayemi Adebola Akintola, Olumide Samuel Fadahunsi
      First page: 25
      Abstract: Consistent consumption of high salt diet (HSD) has been associated with increased cellular generation of free radicals, which has been implicated in the derangement of some vital organs and etiology of cardiovascular disorders. This study was designed to investigate the combined effect of some commonly employed medicinal plants on serum lipid profile and antioxidant status of aorta, kidney, and liver of high salt diet-fed animals. Out of the total fifty male Wistar rats obtained, fifteen were used for acute toxicity study, while the remaining thirty-five were divided into 5 groups of 7 animals each. Group 1 and 2 animals were fed normal rat chow (NRC) and 16% high salt diet (HSD) only, respectively. Animals in groups 3, 4 and 5 were fed 16% HSD with 800, 400, and 200 mg/kg bw poly-herbal extract (PHE), respectively, once for 28 consecutive days. Serum low-density lipoprotein (LDL), triacylglycerol (TG), total cholesterol (TC) and high-density lipoprotein (HDL), malondialdehyde, nitric oxide, catalase, superoxide dismutase, glutathione peroxidase, glutathione concentration, and activities were assessed in the aorta, kidney, and liver. Poly-herbal extract (p < 0.05) significantly reduced malondialdehyde and nitric oxide concentrations and also increased antioxidant enzymes and glutathione activity. Elevated serum TG, TC, LDL, and TC content in HSD-fed animals were significantly (p < 0.05) reduced to normal in PHE-treated rats while HDL was significantly elevated (p < 0.05) in a concentration-dependent manner in PHE treated animals. Feeding with PHE attenuated high-salt diet imposed derangement in serum lipid profile and antioxidant status in the organs of the experimental rats.
      Citation: Medicines
      PubDate: 2021-05-31
      DOI: 10.3390/medicines8060025
      Issue No: Vol. 8, No. 6 (2021)
  • Medicines, Vol. 8, Pages 26: β-Thujaplicin Enhances TRAIL-Induced
           Apoptosis via the Dual Effects of XIAP Inhibition and Degradation in
           NCI-H460 Human Lung Cancer Cells

    • Authors: Saki Seno, Minori Kimura, Yuki Yashiro, Ryutaro Kimura, Kanae Adachi, Aoi Terabayashi, Mio Takahashi, Takahiro Oyama, Hideaki Abe, Takehiko Abe, Sei-ichi Tanuma, Ryoko Takasawa
      First page: 26
      Abstract: Background: β-thujaplicin, a natural tropolone derivative, has anticancer effects on various cancer cells via apoptosis. However, the apoptosis regulatory proteins involved in this process have yet to be revealed. Methods: Trypan blue staining, a WST-8 assay, and a caspase-3/7 activity assay were used to investigate whether β-thujaplicin sensitizes cancer cells to TNF-related apoptosis-inducing ligand (TRAIL)-mediated apoptosis. Additionally, western blotting was performed to clarify the effects of β-thujaplicin on X-linked inhibitor of apoptosis protein (XIAP) in NCI-H460 cells and a fluorescence polarization binding assay was used to evaluate the binding-inhibitory activity of β-thujaplicin against XIAP-BIR3. Results: β- and γ-thujaplicins decreased the viability of NCI-H460 cells in a dose-dependent manner; they also sensitized the cells to TRAIL-induced cell growth inhibition and apoptosis. β-thujaplicin significantly potentiated the apoptosis induction effect of TRAIL on NCI-H460 cells, which was accompanied by enhanced caspase-3/7 activity. Interestingly, β-thujaplicin treatment in NCI-H460 cells decreased XIAP levels. Furthermore, β-thujaplicin was able to bind XIAP-BIR3 at the Smac binding site. Conclusions: These findings indicate that β-thujaplicin could enhance TRAIL-induced apoptosis in NCI-H460 cells via XIAP inhibition and degradation. Thus, the tropolone scaffold may be useful for designing novel nonpeptidic small-molecule inhibitors of XIAP and developing new types of anticancer drugs.
      Citation: Medicines
      PubDate: 2021-06-02
      DOI: 10.3390/medicines8060026
      Issue No: Vol. 8, No. 6 (2021)
  • Medicines, Vol. 8, Pages 27: Design, Syntheses, and Bioevaluations of Some
           Novel N2-Acryloylbenzohydrazides as Chemostimulants and Cytotoxic Agents

    • Authors: Kinjal Lakhani, Edgar A. Borrego, Karla G. Cano, Jonathan R. Dimmock, Renato J. Aguilera, Swagatika Das, Praveen K. Roayapalley, Rajendra K. Sharma, Umashankar Das
      First page: 27
      Abstract: A series of novel N2-acryloylhydrazides 1a–m and a related series of compounds 6a–c were prepared as potential chemostimulants. In general, these compounds are cytotoxic to human HCT 116 colon cancer cells, as well as human MCF-7 and MDA-MB-231 breast cancer cell lines. A representative compound N1-(3,4-dimethoxyphenylcarbonyl)-N2-acryloylhydrazine 1m sensitized HCT 116 cells to the potent antineoplastic agent 3,5-bis(benzylidene)-4-piperidone 2a, and also to 5-fluorouracil. A series of compounds was prepared that incorporated some of the molecular features of 2a and related compounds with various N2-acryloylhydrazides in series 1. These compounds are potent cytotoxins. Two modes of action of representative compounds are the lowering of mitochondrial membrane potential and increasing the concentration of reactive oxygen species.
      Citation: Medicines
      PubDate: 2021-06-03
      DOI: 10.3390/medicines8060027
      Issue No: Vol. 8, No. 6 (2021)
  • Medicines, Vol. 8, Pages 28: Anti-Tumor Effects of Ginsenoside
           20(S)-Protopanaxadiol and 1,25-Dihydroxyvitamin D3 Combination in
           Castration Resistant Prostate Cancer

    • Authors: Mohamed Ben-Eltriki, Subrata Deb, Gehana Shankar, Gray Meckling, Mohamed Hassona, Takeshi Yamazaki, Ladan Fazli, Mei Yieng Chin, Emma S. Tomlinson Guns
      First page: 28
      Abstract: In spite of possessing desirable anticancer properties, currently, limited clinical success has been achieved with 20(S)-protopanaxadiol (aPPD) and 1,25-dihydroxyvitamin D3 (calcitriol). This study is designed to evaluate if the combination of aPPD with calcitriol can inhibit human prostate cancer xenograft growth by using nuclear receptor signaling. Athymic male nude mice were utilized to establish an androgen-independent human prostate cancer C4-2 cell castration-resistant prostate cancer (CRPC) xenograft model. Mice were treated orally for six weeks with 70 mg/kg aPPD administered once daily or three times per week with 4 µg/kg calcitriol or in combination or only with vehicle control. Contrary to our expectations, calcitriol treatment alone increased C4-2 tumor growth. However, the addition of calcitriol substantially increased aPPD-mediated tumor growth suppression (76% vs. 53%, combination vs. aPPD alone). The combination treatment significantly increased levels of cleaved caspase-3 apoptotic marker compared to vehicle-treated or aPPD-treated C4-2 tumors. The mechanistic elucidations indicate that tumor inhibition by the aPPD and calcitriol combination was accompanied by elevated vitamin D receptor (VDR) protein expression. In silico data suggest that aPPD weakly binds to the native LBD pocket of VDR. Interestingly, the combination of aPPD and calcitriol activated VDR at a significantly higher level than calcitriol alone and this indicates that aPPD may be an allosteric activator of VDR. Overall, aPPD and calcitriol combination significantly inhibited tumor growth in vivo with no acute or chronic toxic effects in the C4-2 xenograft CRPC nude mice. The involvement of VDR and downstream apoptotic pathways are potential mechanistic routes of antitumor effects of this combination.
      Citation: Medicines
      PubDate: 2021-06-04
      DOI: 10.3390/medicines8060028
      Issue No: Vol. 8, No. 6 (2021)
  • Medicines, Vol. 8, Pages 29: The Scientific and Cultural Journey to
           Ovarian Rejuvenation: Background, Barriers, and Beyond the Biological

    • Authors: E. Scott Sills
      First page: 29
      Abstract: Female age has been known to define reproductive outcome since antiquity; attempts to improve ovarian function may be considered against a sociocultural landscape that foreshadows current practice. Ancient writs heralded the unlikely event of an older woman conceiving as nothing less than miraculous. Always deeply personal and sometimes dynastically pivotal, the goal of achieving pregnancy often engaged elite healers or revered clerics for help. The sorrow of defeat became a potent motif of barrenness or miscarriage lamented in art, music, and literature. Less well known is that rejuvenation practices from the 1900s were not confined to gynecology, as older men also eagerly pursued methods to turn back their biological clock. This interest coalesced within the nascent field of endocrinology, then an emerging specialty. The modern era of molecular science is now offering proof-of-concept evidence to address the once intractable problem of low or absent ovarian reserve. Yet, ovarian rejuvenation by platelet-rich plasma (PRP) originates from a heritage shared with both hormone replacement therapy (HRT) and sex reassignment surgery. These therapeutic ancestors later developed into allied, but now distinct, clinical fields. Here, current iterations of intraovarian PRP are discussed with historical and cultural precursors centering on cell and tissue regenerative effects. Intraovarian PRP thus shows promise for women in menopause as an alternative to conventional HRT, and to those seeking pregnancy—either with advanced reproductive technologies or as unassisted conceptions.
      Citation: Medicines
      PubDate: 2021-06-08
      DOI: 10.3390/medicines8060029
      Issue No: Vol. 8, No. 6 (2021)
  • Medicines, Vol. 8, Pages 30: The Etiology and Pathophysiology Genesis of
           Benign Prostatic Hyperplasia and Prostate Cancer: A New Perspective

    • Authors: Teow J. Phua
      First page: 30
      Abstract: Background: The etiology of benign prostatic hyperplasia and prostate cancer are unknown, with ageing being the greatness risk factor. Methods: This new perspective evaluates the available interdisciplinary evidence regarding prostate ageing in terms of the cell biology of regulation and homeostasis, which could explain the timeline of evolutionary cancer biology as degenerative, inflammatory and neoplasm progressions in these multifactorial and heterogeneous prostatic diseases. Results: This prostate ageing degeneration hypothesis encompasses the testosterone-vascular-inflamm-ageing triad, along with the cell biology regulation of amyloidosis and autophagy within an evolutionary tumorigenesis microenvironment. Conclusions: An understanding of these biological processes of prostate ageing can provide potential strategies for early prevention and could contribute to maintaining quality of life for the ageing individual along with substantial medical cost savings.
      Citation: Medicines
      PubDate: 2021-06-11
      DOI: 10.3390/medicines8060030
      Issue No: Vol. 8, No. 6 (2021)
  • Medicines, Vol. 8, Pages 31: Analgesic Effect of Combined Therapy with the
           Japanese Herbal Medicine “Yokukansan” and Electroacupuncture in Rats
           with Acute Inflammatory Pain

    • Authors: Nachi Ebihara, Hideshi Ikemoto, Naoki Adachi, Takayuki Okumo, Taro Kimura, Kanako Yusa, Satoshi Hattori, Atsufumi Manabe, Tadashi Hisamitsu, Masataka Sunagawa
      First page: 31
      Abstract: Background: Japanese herbal medicine, called Kampo medicine, and acupuncture are mainly used in Japanese traditional medicine. In this experiment, the analgesic effect of Yokukansan (YKS) alone and a combination of YKS and electroacupuncture (EA) on inflammatory pain induced by formalin injection were examined. Methods: Animals were divided into four groups: a control group, formalin injection group (formalin), YKS-treated formalin group (YKS), and YKS- and EA-treated formalin group (YKS + EA). The duration of pain-related behaviors and extracellular signal-regulated protein kinase (ERK) activation in the spinal cord after formalin injection in the right hind paw were determined. Results: The duration of pain-related behaviors was dramatically prolonged in the late phase (10–60 min) in the formalin group. The YKS treatment tended to reduce (p = 0.08), whereas YKS + EA significantly suppressed the pain-related behaviors (p < 0.01). Immunohistochemical and Western blot analyses revealed that the number of phosphorylated ERK1/2 (pERK1/2)-positive cells and the pERK expression level, which were increased by formalin injection, were significantly inhibited by YKS (p < 0.05) and YKS + EA (p < 0.01). Conclusions: The YKS + EA combination therapy elicited an analgesic effect on formalin-induced acute inflammatory pain.
      Citation: Medicines
      PubDate: 2021-06-17
      DOI: 10.3390/medicines8060031
      Issue No: Vol. 8, No. 6 (2021)
  • Medicines, Vol. 8, Pages 20: Green Propolis Compounds (Baccarin and
           p-Coumaric Acid) Show Beneficial Effects in Mice for Melanoma Induced by

    • Authors: Gabriel H. Gastaldello, Ana Caroline V. Cazeloto, Juliana C. Ferreira, Débora Munhoz Rodrigues, Jairo Kennup Bastos, Vanessa L. Campo, Karina F. Zoccal, Cristiane Tefé-Silva
      First page: 20
      Abstract: Background: Cutaneous melanoma is the most aggressive form of skin cancer, with the worst prognosis, and it affects a younger population than most cancers. The high metastatic index, in more advanced stages, and the high aggressiveness decrease the effectiveness of currently used therapies, such as surgical removal, radiotherapy, cryotherapy, and chemotherapy, used alone or in combination. Based on these disadvantages, research focused on alternative medicine offers great potential for therapeutic innovation. Medicinal plants represent a remarkable source of compounds for the treatment of various diseases. Methods: In this study, we investigated the tumoral behavior of melanoma under treatment with the compounds baccarin and p-coumaric acid, extracted from green propolis, in mice inoculated with B16F10 cells for 26 days. Results: A significant modulation in the number of inflammatory cells recruited to the tumor region and blood in the groups treated with the compounds was observed. In addition, a significant reduction in the amount of blood vessels and mitosis in the neoplastic area was noticed. Conclusions: Through our research, we confirmed that baccarin and coumaric acid, isolated substances from Brazilian green propolis, have a promising anticarcinogenic potential to be explored for the development of new antitumor agents, adhering to the trend of drugs with greater tolerance and biological effectiveness.
      Citation: Medicines
      PubDate: 2021-04-30
      DOI: 10.3390/medicines8050020
      Issue No: Vol. 8, No. 5 (2021)
  • Medicines, Vol. 8, Pages 21: Impact of Palliative Care Services on
           Treatment and Resource Utilization for Hepatorenal Syndrome in the United

    • Authors: Charat Thongprayoon, Wisit Kaewput, Tananchai Petnak, Oisin A. O’Corragain, Boonphiphop Boonpheng, Tarun Bathini, Saraschandra Vallabhajosyula, Pattharawin Pattharanitima, Ploypin Lertjitbanjong, Fawad Qureshi, Wisit Cheungpasitporn
      First page: 21
      Abstract: Background: This study aimed to determine the rates of inpatient palliative care service use and assess the impact of palliative care service use on in-hospital treatments and resource utilization in hospital admissions for hepatorenal syndrome. Methods: Using the National Inpatient Sample, hospital admissions with a primary diagnosis of hepatorenal syndrome were identified from 2003 through 2014. The primary outcome of interest was the temporal trend and predictors of inpatient palliative care service use. Logistic and linear regression was performed to assess the impact of inpatient palliative care service on in-hospital treatments and resource use. Results: Of 5571 hospital admissions for hepatorenal syndrome, palliative care services were used in 748 (13.4%) admissions. There was an increasing trend in the rate of palliative care service use, from 3.3% in 2003 to 21.1% in 2014 (p < 0.001). Older age, more recent year of hospitalization, acute liver failure, alcoholic cirrhosis, and hepatocellular carcinoma were predictive of increased palliative care service use, whereas race other than Caucasian, African American, and Hispanic and chronic kidney disease were predictive of decreased palliative care service use. Although hospital admission with palliative care service use had higher mortality, palliative care service was associated with lower use of invasive mechanical ventilation, blood product transfusion, paracentesis, renal replacement, vasopressor but higher DNR status. Palliative care services reduced mean length of hospital stay and hospitalization cost. Conclusion: Although there was a substantial increase in the use of palliative care service in hospitalizations for hepatorenal syndrome, inpatient palliative care service was still underutilized. The use of palliative care service was associated with reduced resource use.
      Citation: Medicines
      PubDate: 2021-05-12
      DOI: 10.3390/medicines8050021
      Issue No: Vol. 8, No. 5 (2021)
  • Medicines, Vol. 8, Pages 22: Inhibition of Angiogenic Factor Productions
           by Quercetin In Vitro and In Vivo

    • Authors: Takayuki Okumo, Atsuko Furuta, Tarou Kimura, Kanako Yusa, Kazuhito Asano, Masataka Sunagawa
      First page: 22
      Abstract: Background: Angiogenesis is well known to be an important event in the tissue remodeling observed in allergic diseases. Although there is much evidence that quercetin, one of the most abundant dietary flavonoids, exerts anti-allergic effects in both human and experimental animal models of allergic diseases, the action of quercetin on angiogenesis has not been defined. Therefore, in this study, we first examined the action of quercetin on the secretion of angiogenic factors from murine mast cells in vitro. We also examined the action of quercetin on angiogenic factor secretion in the murine allergic rhinitis model in vivo. Methods: Mast cells (1 × 105 cells/mL) sensitized with ovalbumin (OVA)-specific murine IgE were stimulated with 10.0 ng/mL OVA in the presence or the absence of quercetin for 24 h. The concentrations of angiogenic factors, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), tumor necrosis factor-α, IL-6 and IL-8 in the supernatants were examined by ELISA. BALB/c male mice immunized with OVA were challenged intranasally with OVA every other day, starting seven days after the final immunization. These mice were then orally administered quercetin once a day for five days, starting seven days after the final immunization. Clinical symptoms were assessed by counting the number of sneezes and nasal rubbing behaviors during the 10 min period just after OVA nasal provocation. The angiogenic factor concentrations in the nasal lavage fluids obtained 6 h after nasal antigenic provocation were examined by ELISA. Results: Quercetin significantly inhibited the production of angiogenetic factors induced by IgE-dependent mechanisms at 5.0 µM or more. Oral administration of 25.0 mg/kg quercetin into the mice also suppressed the appearance of angiogenetic factors in nasal lavage fluids, along with the attenuation of nasal symptoms. Conclusions: These results strongly suggest that the inhibitory action of quercetin on angiogenic factor secretion may be implicated in the therapeutic action of quercetin on allergic diseases, especially allergic rhinitis.
      Citation: Medicines
      PubDate: 2021-05-12
      DOI: 10.3390/medicines8050022
      Issue No: Vol. 8, No. 5 (2021)
  • Medicines, Vol. 8, Pages 23: Discovery of Novel eEF2K Inhibitors Using HTS
           Fingerprint Generated from Predicted Profiling of Compound-Protein

    • Authors: Atsushi Yoshimori, Enzo Kawasaki, Ryuta Murakami, Chisato Kanai
      First page: 23
      Abstract: Background: Eukaryotic elongation factor 2 kinase (eEF2K) regulates the elongation stage of protein synthesis by phosphorylating eEF2, a process related to various diseases including cancer and cardiovascular and neurodegenerative diseases. In this study, we describe the identification of novel eEF2K inhibitors using high-throughput screening fingerprints (HTSFP) generated from predicted profiling of compound-protein interactions (CPIs). Methods: We utilized computationally generated HTSFPs referred to as chemical genomics-based fingerprint (CGBFP). Generally, HTSFPs are generated from multiple biochemical or cell-based assay data. On the other hand, CGBFPs are generated from computational prediction of CPIs using the Chemical Genomics-Based Virtual Screening (CGBVS) method. Therefore, CGBFPs do not have missing information mainly caused by the absence of assay data. Results: Chemogenomics-Based Similarity Profiling (CGBSP) of the screening library (2.6 million compounds) yielded 27 compounds which were evaluated for in vitro eEF2K inhibitory activity. Three compounds with interesting results were identified. Compounds 2 (IC50 = 11.05 μM) and 4 (IC50 = 43.54 μM) are thieno[2,3-b]pyridine derivatives that have the same scaffolds with a known eEF2K inhibitor, while compound 13 (IC50 = 70.13 μM) was a new thiophene-2-amine-type eEF2K inhibitor. Conclusions: CGBSP supplied an efficient strategy in the identification of novel eEF2K inhibitors and provided useful scaffolds for optimization.
      Citation: Medicines
      PubDate: 2021-05-20
      DOI: 10.3390/medicines8050023
      Issue No: Vol. 8, No. 5 (2021)
  • Medicines, Vol. 8, Pages 16: Trauma-Induced Coagulopathy: Overview of an
           Emerging Medical Problem from Pathophysiology to Outcomes

    • Authors: Gabriele Savioli, Iride Francesca Ceresa, Luca Caneva, Sebastiano Gerosa, Giovanni Ricevuti
      First page: 16
      Abstract: Coagulopathy induced by major trauma is common, affecting approximately one-third of patients after trauma. It develops independently of iatrogenic, hypothermic, and dilutive causes (such as iatrogenic cause in case of fluid administration), which instead have a pejorative aspect on coagulopathy. Notwithstanding the continuous research conducted over the past decade on Trauma-Induced Coagulopathy (TIC), it remains a life-threatening condition with a significant impact on trauma mortality. We reviewed the current evidence regarding TIC diagnosis and pathophysiological mechanisms and summarized the different iterations of optimal TIC management strategies among which product resuscitation, potential drug administrations, and hemostatis-focused approaches. We have identified areas of ongoing investigation and controversy in TIC management.
      Citation: Medicines
      PubDate: 2021-03-24
      DOI: 10.3390/medicines8040016
      Issue No: Vol. 8, No. 4 (2021)
  • Medicines, Vol. 8, Pages 17: A Unique Anti-Cancer 3-Styrylchromone
           Suppresses Inflammatory Response via HMGB1-RAGE Signaling

    • Authors: Hideaki Abe, Miwa Okazawa, Takahiro Oyama, Hiroaki Yamazaki, Atsushi Yoshimori, Takanori Kamiya, Mitsutoshi Tsukimoto, Koichi Takao, Yoshiaki Sugita, Hiroshi Sakagami, Takehiko Abe, Sei-ichi Tanuma
      First page: 17
      Abstract: Background: High mobility group box 1 (HMGB1)-receptor for advanced glycation endo-products (RAGE) axis serves as a key player in linking inflammation and carcinogenesis. Recently, papaverine was revealed to suppress the HMGB1-RAGE inflammatory signaling pathway and cancer cell proliferation. Therefore, a dual suppressor targeting this axis is expected to become a new type of therapeutic agent to treat cancer. Methods: Papaverine 3D pharmacophore mimetic compounds were selected by the LigandScout software from our in-house, anti-cancer chemical library and assessed for their anti-inflammatory activities by a HMGB1-RAGE-mediated interleukin-6 production assay using macrophage-like RAW264.7 cells. Molecular-biological analyses, such as Western blotting, were performed to clarify the mechanism of action. Results: A unique 6-methoxy-3-hydroxy-styrylchromone was found to possess potent anti-inflammatory and anti-cancer activities via the suppression of the HMGB1-RAGE-extracellular signal-regulated kinase 1/2 signaling pathway. Furthermore, the 3D pharmacophore-activity relationship analyses revealed that the hydroxyl group at the C4′ position of the benzene ring in a 3-styryl moiety was significant in its dual suppressive effects. Conclusions: These findings indicated that this compound may provide a valuable scaffold for the development of a new type of anti-cancer drug possessing anti-inflammatory activity and as a tool for understanding the link between inflammation and carcinogenesis.
      Citation: Medicines
      PubDate: 2021-03-24
      DOI: 10.3390/medicines8040017
      Issue No: Vol. 8, No. 4 (2021)
  • Medicines, Vol. 8, Pages 18: Reliability and Validity of Facial Check
           Sheet (FCS): Checklist for Self-Satisfaction with Cosmetic Acupuncture

    • Authors: Hiroshi Kuge, Hidetoshi Mori, Tim Hideaki Tanaka, Ryouta Tsuji
      First page: 18
      Abstract: Background: In recent years, cosmetic acupuncture has gained popularity among individuals interested in improving their facial appearance. We have created an original facial check sheet (FCS) to obtain cosmetic acupuncture patients’ perspectives on treatment outcomes. This study examined the reliability and validity of FCS. Methods: We conducted an Internet survey on the appearance of the facial region among Japanese women. A reliability analysis was performed between each item of FCS. A multiple comparison procedure was used to determine the relationship between the age group, the FCS score, and the number of terms used in the open-ended question. Results: The most frequently stated concern was blotchiness and hyperpigmented spots (47.2%, n = 67). The FCS items showed reliability (Cronbach α = 0.871). The number of extracted terms and the FCS score showed a moderate correlation (r = 0.407; p < 0.001). There was a significant relationship between age and FCS score (p = 0.005, r2 = 0.255), which indicated that the FCS score increases with aging. Conclusions: The FCS can be used as a practical tool to evaluate facial appearances and assess satisfaction levels of patients who underwent cosmetic acupuncture or other facial skin rejuvenation procedures.
      Citation: Medicines
      PubDate: 2021-04-11
      DOI: 10.3390/medicines8040018
      Issue No: Vol. 8, No. 4 (2021)
  • Medicines, Vol. 8, Pages 19: Creation of a New Frailty Scale in Primary
           Care: The Zulfiqar Frailty Scale (ZFS)

    • Authors: Abrar-Ahmad Zulfiqar
      First page: 19
      Abstract: Introduction: Very few frailty scales are used by general practitioners as they are time consuming and cumbersome. We designed a new scale for the rapid detection of frailty. Methods: We developed a frailty screening tool for use in primary care, referred to as the Zulfiqar Frailty Scale (ZFS). This scale was tested in a general practitioner’s office for six months in Plancoët, France. Only patients over 75 years of age with Activities of Daily Living (ADL) ≥4 were included. The objective of this research was to validate the scale, evaluate its performance, and compare this screening tool with other scales such as the Fried Scale, the Gerontopole Frailty Screening Tool (GFST), the modified Short Emergency Geriatric Assessment (mSEGA) Grid A, and the Comprehensive Geriatric Assessment (CGA). Results: A total of 102 patients were included, with a mean age of 82.65 ± 4.79; 55 were women and 47 were men. The percentage of frail subjects was 63.7% in our scale, 67.7% in the mSEGA grid A, 75.5% in the GFST, and 60.8% for the Fried criteria. After a comprehensive geriatric assessment, frailty syndrome was found in 57 patients (55.9%). In general, both scales showed solid performance, and differences between them in the sample were minimal. As the CGA showed a prevalence of frailty of 55.9%, a similar prevalence threshold for the ZFS (i.e., 64% at the threshold ≥3 could be assessed). The completion time for our scale was less than two minutes, and staff required no training beforehand. Its sensitivity was 83.9%, and its specificity was 67.5%. Its positive predictive value was 80%, and its negative predictive value was 73%. The Pearson correlations between the geriatric scores were all strong and roughly equivalent to each other. Conclusions: Our frailty screening scale is simple, relevant, and rapid (taking less than two minutes).
      Citation: Medicines
      PubDate: 2021-04-13
      DOI: 10.3390/medicines8040019
      Issue No: Vol. 8, No. 4 (2021)
  • Medicines, Vol. 8, Pages 13: A Predictive Risk Score to Diagnose Adrenal
           Insufficiency in Outpatients: A 7 Year Retrospective Cohort Study

    • Authors: Worapaka Manosroi, Tanyong Pipanmekaporn, Jiraporn Khorana, Pichitchai Atthakomol, Mattabhorn Phimphilai
      First page: 13
      Abstract: Background: The diagnosis of adrenal insufficiency (AI) requires dynamic tests which may not be available in some institutions. This study aimed to develop a predictive risk score to help diagnose AI in outpatients with indeterminate serum cortisol levels. Methods: Five hundred and seven patients with intermediate serum cortisol levels (3–17.9 µg/dL) who had undergone ACTH (adrenocorticotropin) stimulation tests were included in the study. A predictive risk score was created using significant predictive factors identified by multivariable analysis using Poisson regression clustered by ACTH dose. Results: The seven predictive factors used in the development of a predictive model with their assigned scores are as follows: chronic kidney disease (9.0), Cushingoid appearance in exogenous steroid use (12.0), nausea and/or vomiting (6.0), fatigue (2.0), basal cortisol <9 µg/dL (12.5), cholesterol <150 mg/dL (2.5) and sodium <135 mEq/L (1.0). Predictive risk scores range from 0–50.0. A high risk level (scores of 19.5–50.0) indicates a higher possibility of having AI (positive likelihood ratio (LR+) = 11.75), while a low risk level (scores of <19.0) indicates a lower chance of having AI (LR+ = 0.09). The predictive performance of the scoring system was 0.82 based on the area under the curve. Conclusions: This predictive risk score can help to determine the probability of AI and can be used as a guide to determine which patients need treatment for AI and which require dynamic tests to confirm AI.
      Citation: Medicines
      PubDate: 2021-03-10
      DOI: 10.3390/medicines8030013
      Issue No: Vol. 8, No. 3 (2021)
  • Medicines, Vol. 8, Pages 14: Adrenal Cortical Rests in the Fallopian Tube:
           Report of a Case and Review of the Literature

    • Authors: Theodoros Tzigkalidis, Eleni Skandalou, Maria Eleni Manthou, Nikolaos Kolovogiannis, Soultana Meditskou
      First page: 14
      Abstract: We report an extremely unusual finding discovered incidentally during a routine pathologic evaluation of a fallopian tube, surgically removed on the grounds of ectopic pregnancy. We came across a minute yellowish nodule situated within the wall of the salpinx, which corresponded to ectopic adrenal cortex, as verified by microscopical examination, and coexisted with salpingitis isthmica nodosa. A research of the available English literature on this subject confirmed the rareness of the entity we encountered. This case is presented because of its uniqueness, aiming to raise awareness of a rare condition which is discussed along with potential diagnostic dilemmas, its prognostic significance, and possible complications.
      Citation: Medicines
      PubDate: 2021-03-12
      DOI: 10.3390/medicines8030014
      Issue No: Vol. 8, No. 3 (2021)
  • Medicines, Vol. 8, Pages 15: A Goal Intervention Improves Language
           Fluency: Evidence from Parkinson’s Disease and Healthy Aging

    • Authors: Gail A. Robinson, Lara Campbell, Amelia Ceslis
      First page: 15
      Abstract: Background: Parkinson’s disease [PD] is associated with reduced motor and cognitive initiation, and decreased goal-directed behavior including language generation. The current study investigated a novel goal intervention for language generation impairments in PD patients. Methods: Twenty-one PD patients and 22 healthy controls, matched for gender, age, and education, completed a cognitive baseline and language generation tasks (complex scene descriptions and phonemic/semantic word fluency) with standard and adapted instructions, which implements a target ‘goal’. In addition, participants completed self-report questionnaires for apathy and mood. Results: PD patients performed more poorly on two of three language generation tasks. The goal intervention was effective in increasing both the PD patient and healthy control groups’ language generation. However, there was no differential benefit of increased goal specificity and difficulty for PD patients. As a group, PD patients reported higher levels of apathy and depression than healthy controls. Specifically, PD patients with executive apathy were more likely to have language generation impairments than PD patients without executive apathy and controls. Apathy subscales and goal benefit were unrelated. Conclusions: The goal intervention was effective for PD patients and older adults, suggesting that enhanced goal specificity and difficulty may benefit individuals with PD or those aging naturally.
      Citation: Medicines
      PubDate: 2021-03-22
      DOI: 10.3390/medicines8030015
      Issue No: Vol. 8, No. 3 (2021)
  • Medicines, Vol. 8, Pages 73: Zulfiqar Frailty Scale: Overview, Stakes, and

    • Authors: Abrar-Ahmad Zulfiqar, Ibrahima Dembélé
      First page: 73
      Abstract: Very few frailty scales are used by general practitioners, as they are time consuming and cumbersome. We developed a frailty screening tool for use in primary care, referred to as the Zulfiqar Frailty Scale (ZFS). This scale was tested in multiple general practitioners’ offices in France, and these studies were published. In this paper, we offer a summary of these results.
      Citation: Medicines
      PubDate: 2021-11-23
      DOI: 10.3390/medicines8120073
      Issue No: Vol. 8, No. 12 (2021)
  • Medicines, Vol. 8, Pages 74: Erbium Laser for Skin Surgery: A
           Single-Center Twenty-Five Years’ Experience

    • Authors: Steven Paul Nisticò, Giovanni Cannarozzo, Piero Campolmi, Federica Dragoni, Silvia Moretti, Cataldo Patruno, Luigi Bennardo
      First page: 74
      Abstract:  (1) Introduction: The Erbium laser is a very versatile laser system used in dermatology. Its ability to be almost selectively absorbed by water makes it a perfect device for managing various cutaneous skin conditions. (2) Methods: In this paper, we report our twenty-five years’ experience with the Erbium laser. More than three thousand patients were treated for common skin disorders such as flat warts, seborrheic keratosis, xanthelasmas, and scars. (3) Results: A complete response was observed in 89.6%, without significant side effects. Local anesthesia was used in only a tiny percentage of patients. (4) Conclusions: This study confirms that the Erbium laser is a valuable and flexible procedure for laser surgery with excellent safety and short healing times.
      Citation: Medicines
      PubDate: 2021-11-24
      DOI: 10.3390/medicines8120074
      Issue No: Vol. 8, No. 12 (2021)
  • Medicines, Vol. 8, Pages 75: Mortality of Patients Infected by COVID-19
           with and without Deep-Vein Thrombosis

    • Authors: Jose Maria Pereira de Godoy, Gleison Juliano da Silva Russeff, Carolina Hungaro Costa, Debora Yuri Sato, Desirée Franccini Del Frari Silva, Maria de Fatima Guerreiro Godoy, Henrique Jose Pereira de Godoy, Paulo César Espada
      First page: 75
      Abstract: Background: Current evidence points to a state of hypercoagulability (consequence of hyperinflammation) as an important pathogenic mechanism that contributes to the increase in mortality in cases of COVID-19. The aim of the present study was to investigate the influence of deep-vein thrombosis on mortality patient’s infected with SARS-CoV-2. Method: A clinical trial was conducted involving 200 consecutive patients with COVID-19—100 patients who were positive for deep-vein thrombosis (venous Doppler ultrasound) and 100 who were negative for deep-vein thrombosis at a public hospital. Results: The mortality rate was 67% in the group positive for DVT and 31% in the group negative for DVT. Conclusion: Deep-vein thrombosis is associated with an increase in mortality in patients with COVID-19 and failures can occur with conventional prophylaxis for deep-vein thrombosis.
      Citation: Medicines
      PubDate: 2021-11-29
      DOI: 10.3390/medicines8120075
      Issue No: Vol. 8, No. 12 (2021)
  • Medicines, Vol. 8, Pages 76: The Role of New Technological Opportunities
           and the Need to Evaluate the Activities Performed in the Prevention of
           Diabetic Foot with Exercise Therapy

    • Authors: Piergiorgio Francia, Alessandra De Bellis, Giulia Iannone, Rosy Sinopoli, Leonardo Bocchi, Roberto Anichini
      First page: 76
      Abstract: The diabetic foot (DF) is one of the most feared conditions among chronic complications of diabetes, which affects a growing number of patients. Although exercise therapy (ET) has always been considered a pillar in the treatment of patients at risk of DF it is not usually used. Several causes can contribute to hindering both the organization of ET protocols for Diabetes Units and the participation in ET programs for patients at different levels of risk of foot ulceration. The risk of favoring the occurrence of ulcers and the absence of clear evidence on the role played by ET in the prevention of ulcers could be considered among the most important causes leading to the low application of ET. The increased availability of new technologies and in particular of systems and devices equipped with sensors can enable the remote monitoring and management of physical activity performed by patients. Consequently, they can become an opportunity for introducing the systematic use of ET for the treatment of patients at risk. Considering the complexity of the clinical conditions that patients at risk or with diabetic foot ulcer can show, the evaluation of how patients perform the ET proposed can consequently be very important. All this can contribute to improving the treatment of patients and avoiding possible adverse effects. The aim of this brief review was to describe that the use of new technologies and the assessment of the execution of the ET proposed allows an important step forward in the management of patients at risk.
      Citation: Medicines
      PubDate: 2021-12-02
      DOI: 10.3390/medicines8120076
      Issue No: Vol. 8, No. 12 (2021)
  • Medicines, Vol. 8, Pages 77: Magnetic Resonance Imaging of the Cervical
           Spine: Frequency of Abnormal Findings with Relation to Age

    • Authors: Ali Alghamdi, Abeer Alqahtani
      First page: 77
      Abstract: Background: Patients with neck pain are frequently encountered in cervical spine (C-spine) magnetic resonance imaging (MRI) practice. However, the exact distribution and prevalence of cervical abnormalities are not known. Aim: The aim of this study is to evaluate the association between age, gender, and prevalence of abnormal cervical MRI findings. Methods: Records of 111 cervical MRIs were collected in 12 months from January to December 2019 from adults aged 20–89 years who were referred from neurosurgery, neurology, and orthopedic clinics. Findings were classified and analyzed using the Statistical Package for Social Science (SPSS), version 24.0 (IBM, Armonk, NY, USA). The chi-square test was used to determine the association between demographics and abnormalities using a significance of p = 0.05. Results: The majority of patients were female (72.1%). The number of abnormal incidences increased with age until it reached a peak at ages 50–59. Spondylodegenerative changes were the most frequent finding, which was present in 52.2% of the total sample, and was followed by disc bulge (25.2%). Incidences increased in lower discs, with C5–C6 being the most frequent in 65% of the total sample. Younger males in their 20s had more injuries than females of the same age. However, this rate was reversed in patients over 40, as women were the dominant gender among patients in their 40s with cervical injuries, with a rate of 81.5%. Conclusion: In our study, we found that older patients developed more C-spine injuries. Gender may play a role in the rate of incidents. However, we did not find any significant differences between men and women or between different types of abnormalities.
      Citation: Medicines
      PubDate: 2021-12-14
      DOI: 10.3390/medicines8120077
      Issue No: Vol. 8, No. 12 (2021)
  • Medicines, Vol. 8, Pages 78: Cytotoxic Tumour-Selective
           1,5-Diaryl-3-Oxo-1,4-Pentadienes Mounted on a Piperidine Ring

    • Authors: Praveen K. Roayapalley, Hiroshi Sakagami, Keitaro Satoh, Shigeru Amano, Kenjiro Bandow, Renato J. Aguilera, Karla G. Cano Hernandez, Austre Y. Schiaffino Bustamante, Stephen G. Dimmock, Rajendra K. Sharma, Umashankar Das, Jonathan R. Dimmock
      First page: 78
      Abstract: A series of 3,5-bis(benzylidene)-4-piperidones 2a-u were prepared as candidate cytotoxic agents. In general, the compounds are highly toxic to human gingival carcinoma (Ca9-22), human squamous carcinoma-2 (HSC-2) and human squamous carcinoma-4 (HSC-4) neoplasms, but less so towards non-malignant human gingival fibroblast (HGF), human periodontal ligament fibroblast (HPLF) and human pulp cells (HPC), thereby demonstrating tumour-selective toxicity. A further study revealed that most of the compounds in series 2 were more toxic to the human Colo-205 adenocarcinoma cell line (Colo-205), human HT29 colorectal adenocarcinoma cells (HT-29) and human CEM lymphoid cells (CEM) neoplasms than towards non-malignant human foreskin Hs27 fibroblast line (Hs27) cells. The potency of the cytotoxins towards the six malignant cell lines increased as the sigma and sigma star values of the aryl substituents rose. Attempts to condense various aryl aldehydes with 2,2,6,6-tetramethyl-4-piperidone led to the isolation of some 1,5-diaryl-1,4-pentadien-3-ones. The highest specificity for oral cancer cells was displayed by 2e and 2r. In the case of 2r, its selective toxicity exceeded that of doxorubicin and melphalan. The enones 2k, m, o have the highest SI values towards colon cancer and leukemic cells. Both 2e,r inhibited mitosis and increased the subG1 population (with a transient increase in G2/M phase cells). Slight activation of caspase-3, based on the cleavage of poly(ADP-ribose)polymerase (PARP) and procaspase 3, was detected.
      Citation: Medicines
      PubDate: 2021-12-16
      DOI: 10.3390/medicines8120078
      Issue No: Vol. 8, No. 12 (2021)
  • Medicines, Vol. 8, Pages 79: Preclinical Trial of Traditional Plant
           Remedies for the Treatment of Complications of Gestational Malaria

    • Authors: Peter Uchenna Amadi, Emmanuel Nnabugwu Agomuo, Chinyere Nneka Ukaga, Uche Chinedu Njoku, Joy Adaku Amadi, Chinweuba Godswill Nwaekpe
      First page: 79
      Abstract: Background: Most pregnant women living in high malaria endemic regions of Nigeria use herbal remedies for the management of malaria-in-pregnancy, rather than the commonly prescribed drugs. Remedies common to this area involve a suspension of A. indica (AI) leaves and in some cases, a suspension containing a mixture of AI and D.edulis (PS). Aim: This study examined the therapeutic efficacies of AI, PS, or a combination of AI and PS in a pregnant rat model for exoerythrocytic stages of Plasmodium falciparum parasite. Method: A predetermined sample size of 30 dams was used (for a power level and confidence interval of 95%), and divided equally into six groups made up of non-malarous dams, untreated malarous dams, and malarous dams either treated exclusively with 1 mL of 3000 mg/kg b.w AI, 1000 mg/kg b.w PS, AI + PS (50% v/v), or 25 mg/kg b.w CQ. Result: No maternal mortality was recorded. AI significantly improved maternal weight gain from 32.4 to 82.2 g and placental weight from 0.44 to 0.53 g. In the curative test, AI and AI + PS significantly reduced the average percentage parasitemia (APP) in the pregnant rats from >80% to <20%. No significant difference in the APP was found between the pregnant rats treated with any of CQ or AI during the suppressive test. Results for the prophylactic test of the study groups showed that the APP was significantly reduced from 24.69% to 3.90% when treated with AI and 3.67% when combined with PS. AI + PS reduced diastolic blood pressure from 89.0 to 81.0 mm/Hg and compared with that of the non malarous dams. AI or AI + PS significantly increased the platelet counts (103 µL) from 214.1 to 364.5 and 351.2, respectively. AI and AI + PS improved birth weight from 2.5 to 3.9 g and crown rump length from 2.6 to 4.1 cm. For biomarkers of preeclampsia, combining AI and PS led to the reversal of the altered levels of creatine kinase, lactate dehydrogenase, cardiac troponin, soluble Fms-Like Tyrosine Kinase-1, and placental growth factor. Conclusions: This study validates the use of A. indica for the treatment of gestational malaria due to its antiplasmodial and related therapeutic effects and in combination with pear seeds for the management of malaria-in-pregnancy-induced preeclampsia.
      Citation: Medicines
      PubDate: 2021-12-17
      DOI: 10.3390/medicines8120079
      Issue No: Vol. 8, No. 12 (2021)
  • Medicines, Vol. 8, Pages 61: Clinical Outcome of Patients Submitted to
           Liver Resection in the Context of Metastatic Breast Cancer: A Study of a
           Tertiary Hospital Center

    • Authors: Jorge Nogueiro, Vitor Devezas, Fabiana Sousa, Cristina Fernandes, Fernando Osório, Susy Costa, André Magalhães, Henrique Mora, Diana Gonçalves, Hugo Santos-Sousa, André Costa Pinho, Luís Graça, José Luís Fougo, Elisabete Barbosa
      First page: 61
      Abstract: Introduction: Breast cancer is the most incident cancer in the world, accounting for 25% of new cancers per year in females. It is the most frequent malignancy in women, being the fifth cause of death from cancer worldwide. Approximately 5 to 10% of patients already present with metastases at diagnosis, and the liver is the site of metastases in half of these cases. Liver metastasis (LM) resection, performed after neoadjuvant systemic treatment, has been reported to increase median overall survival in this population. Aim: The aim of this analysis is to assess the outcomes of patients undergoing breast cancer liver metastasis surgical resection, including impact on survival, compared to patients where metastasectomy was not performed. Methods: retrospective review of 55 female patients with breast cancer liver metastases, diagnosed and treated in a single tertiary university hospital from January 2011 to December 2016 was performed. Results: In 32/55 patients (58.2%), multi-organ metastases were identified (the most common sites being bone, lungs, and lymph nodes). Of the remaining 23 patients, the liver was the unique metastatic site; thirteen patients had diffuse bilobar hepatic metastases. The remaining ten patients were proposed for surgical treatment; three of them had peritoneal carcinomatosis identified during surgery, and no hepatic metastasectomy was performed. As a result, only seven (12.7%) patients underwent liver metastasectomy. Overall survival was higher in patients who had LM surgery (65 months [Interquartile Range (IQR) 54–120]), in comparison to those diagnosed with diffuse bilobar hepatic metastases (17.5 months [IQR 11–41]), and with those showing concurrent liver and bone metastases (16.5 months [IQR 6–36]) (p = 0.012). In univariable analysis, the latter two groups showed worse overall survival outcomes (Hazard Ratio (HR) = 3.447, 95%CI: 1.218–9.756, p = 0.02 and HR = 3.855, 95% Confidence Interval (CI): 1.475–10.077, p = 0.006, respectively) when compared to patients with LM. Conclusion: In our series, patients submitted to metastasectomy had a median overall survival after diagnosis of LM three times greater than the non-operated patients with isolated LM, or concurrent LM and bone metastases (65 vs. 17.5 and 16.5 months, respectively). As is vastly known for colorectal cancer liver metastasis, resection of breast cancer liver metastasis may reduce tumor burden, and therefore may improve patient outcome.
      Citation: Medicines
      PubDate: 2021-10-20
      DOI: 10.3390/medicines8110061
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 62: Factors Affecting Dietary Improvements in
           Elderly Residents of Long-Term Care Institutions Receiving Domiciliary
           Dental Care

    • Authors: Hitomi Kikuchi, Akira Komatsuzaki, Sachie Ono, Miwa Sirono, Shiho Motoi, Asami Iguchi, Mio Susuga
      First page: 62
      Abstract: Background: Oral disabilities occur due to tooth loss. This study aimed to investigate oral and systemic factors related to diet in elderly residents receiving domiciliary dental care. Methods: The subjects were 74 consenting residents. Survey items included whether subjects could eat independently and diet type. Subjects were examined by the dentist for the number of teeth, occlusal support index, and wearing dentures. Contingency table analysis was performed to determine what levels of decline in general and oral functions led to difficulties eating a normal diet. Results: There was a significant difference in the mean number of activities of daily living (ADL) requiring assistance evident between subjects eating a normal diet and those eating fluid boiled rice (p < 0.01). A comparison of occlusal support and diet type showed that most subjects who ate a soft diet or gruel had no occlusal support. Almost all subjects who ate a normal diet wore dentures. However, only 38% of subjects eating a soft diet and 40% of those eating gruel did wear dentures; both group differences were significant (p < 0.01). Conclusions: Future studies need to further investigate oral factors related to the type of diet and their relationships to domiciliary dental care in older adults.
      Citation: Medicines
      PubDate: 2021-10-21
      DOI: 10.3390/medicines8110062
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 63: Concordance in mSEGA Tool to Frailty
           Diagnosis between Medical Doctors and Nurses

    • Authors: Zulfiqar, Dembélé
      First page: 63
      Abstract: Introduction: It is currently considered that screening for frailty in elderly subjects is a major public health issue. Methods: a cross-sectional pilot study involving elderly subjects (over 75 years of age) admitted at the emergency department of the hospital of Troyes, France in the period from August 24th to August 30th, 2017 was conducted. The patients were screened for frailty using the modified SEGA (Short Emergency Geriatric Assessment) (part A) grid (mSEGA), correlated with the subjective opinion of the triage nurse and the senior physician. Results: 100 patients were included during the pilot study period, the mean age was 84.34 years (range: 75–97), 56 patients (56%) were female, and the average CHARLSON score was 4.28 (range: 0–11). The patients’ previous medical histories were remarkable for cardiovascular diseases. The main reason for hospital admission was fall (26 subjects, 26%). Hospitalization was required for 52 subjects (52%). The average mSEGA score was 6.3 +/−3.59. The completion time for the SEGAm (part A) score was about 5 minutes. According to Cohen’s kappa, the concordance between the subjective opinion of the triage nurse and the mSEGA grid was average, while the concordance between the subjective opinions of the senior physicians was good. Conclusion: The mSEGA score appears to be well-suited and useful in the emergency department. It is easy to use, allows an overall evaluation of the patient, and is not time-consuming.
      Citation: Medicines
      PubDate: 2021-10-29
      DOI: 10.3390/medicines8110063
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 64: Seroprevalence of the Serological Markers of
           Transfusion-Transmissible Infections among Volunteer Blood Donors of Kosti
           Obstetrics and Gynecology Hospital

    • Authors: Almugadam, Ibrahim, Ahmed
      First page: 64
      Abstract: Background: Transfusion-transmissible infections are well-known global health challenges. The present study is proposed to investigate the seropositivity of anti-HIV1/2, anti-HCV, HBsAg, and anti-T.pallidum among volunteer blood donors of Kosti Obstetrics and Gynecology Hospital. Methods: Our study was conducted in a cross-sectional retrospective manner. The data of donors who attended Kosti Obstetrics and Gynecology Hospital throughout 2016 to 2018 were reviewed and retrieved manually from blood bank records. Results: Out of 8139 donors, 22.52% were seropositive for serological markers of TTIs and 1.67% were seropositive for at least two serological markers of TTIs. The overall seropositivity rate of anti-HIV1/2, HBsAg, anti-HCV, and anti-T.pallidum was 1.77%, 6.07%, 1.14%, and 11.87%, respectively (p < 0.000). Anti-T.pallidum was the most frequently detected (p < 0.000) marker across all study variables. TTIs seroprevalence was significantly (p < 0.000) varied according to the age, residence, occupations, and blood groups. Notably, there was a rising trend in the rate of anti-HIV1/2 and seropositivity for more than one marker with age (p < 0.000). Regionally, rural area residents had a higher rate of anti-HIV1/2 (2.20%), HBsAg (6.31%), anti-HCV (1.42%), anti-T.pallidum (18.38%), and multiple markers seropositivity (2.28%) compared to urban areas. Between occupations, the highest rate of anti-HIV1/2 (p = 0.497), HBsAg (p = 0.003), anti-HCV (p = 0.385), anti-T.pallidum (p < 0.000), and multiple markers seropositivity (p < 0.000) were detected in farmers. Regarding the screening, we also found that the frequency of anti-T.pallidum was significantly (p = 0.004) higher in donors that carry the AB+ve blood group, whereas anti-HCV (1.83%) was more frequent in O-ve blood groups (p = 0.004). Anti-T.pallidum+HBsAg was the most frequently (1.22%) co-occurring marker. In contrast, ant-T.pallidum+anti-HIV1/2+HBsAg was the lowest frequency marker (p < 0.000). Conclusions: The study showed an alarming rate of TTIs, which suggests the requirement for comprehensive surveillance and health education programs.
      Citation: Medicines
      PubDate: 2021-10-29
      DOI: 10.3390/medicines8110064
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 65: Recent Trends of Metabolic Syndrome and Its
           Components in Military Recruits from Saudi Arabia

    • Authors: Hamoud Abdullah Al-Shehri, Abdulrahman Khazim Al-Asmari, Haseeb Ahmad Khan, Ghaleb Bin Horaib, Ahmed Al-Buraidi, Abdullah Ali Al-Sharif, Saeed Ghander Kadasah, Saud Al-Omani, Fayez S. Mohammed, Rajamohamed Abbasmanthiri, Nasreddien Mohammed Osman
      First page: 65
      Abstract: Metabolic syndrome (Met-S) constitutes the risk factors and abnormalities that markedly increase the probability of developing diabetes and coronary heart disease. An early detection of Met-S, its components and risk factors can be of great help in preventing or controlling its adverse consequences. The aim of the study was to determine the prevalence of cardio-metabolic risk factors in young army recruits from Saudi Arabia. A total of 2010 Saudis aged 18–30 years were randomly selected from groups who had applied to military colleges. In addition to designed questionnaire, anthropometric measurements and blood samples were collected to measure Met-S components according to the International Diabetes Federation (IDF) criteria. Met-S prevalence was 24.3% and it was higher in older subjects than the younger ones. There were significant associations between Met-S and age, education level and marital status. The most common Met-S components were high fasting blood sugar (63.6%) followed by high blood pressure (systolic and diastolic, 63.3% and 37.3% respectively) and high body mass index (57.5%). The prevalence of pre-diabetes and diabetes were found to be 55.2% and 8.4%, respectively. Hypertriglyceridemia was found in 19.3% and low levels of high-density lipoproteins (HDL) in 11.7% of subjects. In conclusion, there is a high prevalence of Met-S in young adults of Saudi Arabia. There is a need for regular monitoring of Met-S in young populations to keep them healthy and fit for nation building. It is also important to design and launch community-based programs for educating people about the importance of physical activity, cessation of smoking and eating healthy diet in prevention of chronic diseases.
      Citation: Medicines
      PubDate: 2021-10-30
      DOI: 10.3390/medicines8110065
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 66: Feature Importance of Acute Rejection among
           Black Kidney Transplant Recipients by Utilizing Random Forest Analysis: An
           Analysis of the UNOS Database

    • Authors: Charat Thongprayoon, Caroline C. Jadlowiec, Napat Leeaphorn, Jackrapong Bruminhent, Prakrati C. Acharya, Chirag Acharya, Pattharawin Pattharanitima, Wisit Kaewput, Boonphiphop Boonpheng, Wisit Cheungpasitporn
      First page: 66
      Abstract: Background: Black kidney transplant recipients have worse allograft outcomes compared to White recipients. The feature importance and feature interaction network analysis framework of machine learning random forest (RF) analysis may provide an understanding of RF structures to design strategies to prevent acute rejection among Black recipients. Methods: We conducted tree-based RF feature importance of Black kidney transplant recipients in United States from 2015 to 2019 in the UNOS database using the number of nodes, accuracy decrease, gini decrease, times_a_root, p value, and mean minimal depth. Feature interaction analysis was also performed to evaluate the most frequent occurrences in the RF classification run between correlated and uncorrelated pairs. Results: A total of 22,687 Black kidney transplant recipients were eligible for analysis. Of these, 1330 (6%) had acute rejection within 1 year after kidney transplant. Important variables in the RF models for acute rejection among Black kidney transplant recipients included recipient age, ESKD etiology, PRA, cold ischemia time, donor age, HLA DR mismatch, BMI, serum albumin, degree of HLA mismatch, education level, and dialysis duration. The three most frequent interactions consisted of two numerical variables, including recipient age:donor age, recipient age:serum albumin, and recipient age:BMI, respectively. Conclusions: The application of tree-based RF feature importance and feature interaction network analysis framework identified recipient age, ESKD etiology, PRA, cold ischemia time, donor age, HLA DR mismatch, BMI, serum albumin, degree of HLA mismatch, education level, and dialysis duration as important variables in the RF models for acute rejection among Black kidney transplant recipients in the United States.
      Citation: Medicines
      PubDate: 2021-11-02
      DOI: 10.3390/medicines8110066
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 67: A Rare Case of Recurrent Generalized
           Peritonitis Caused by Spontaneous Urinary Bladder Rupture after
           Radiotherapy: A Case Report and Literature Review

    • Authors: Yusuke Watanabe, Shun Yamazaki, Hanako Yokoyama, Shunta Yakubo, Akihiko Osaki, Kenichi Takaku, Munehiro Sato, Nobuo Waguri, Shuji Terai
      First page: 67
      Abstract: Since generalized peritonitis is a fatal disease, accurate diagnosis and treatment are important. In this paper, we report a case of recurrent generalized peritonitis associated with spontaneous urinary bladder rupture (SBR). A 65 year old woman, who underwent radiotherapy 21 years prior, was diagnosed with generalized peritonitis. Although the cause of the generalized peritonitis could not be identified, the patient recovered with conservative treatment in short period. However, recurrent episodes of generalized peritonitis occurred four times. We diagnosed the patient with urinary ascites due to SBR, based on a history of radiotherapy and dysuria. No recurrence of generalized peritonitis had occurred after accurate diagnosis and treatment with long-term bladder catheter placement. Since SBR often occurs as a late complication after radiotherapy, it is difficult to diagnose SBR, which leads to delayed treatment. This case and literature review of similar cases suggest that the information of the following might be helpful in the diagnosis of SBR: (i) history of recurrent generalized peritonitis, (ii) pseudo-renal failure, (iii) history of radiotherapy, (iv) dysuria, and (v) increase or decrease of ascites in a short period. It is important to list SBR in the differential diagnosis by knowing the disease and understanding its clinical features. This case and literature review will serve as a reference for future practices.
      Citation: Medicines
      PubDate: 2021-11-05
      DOI: 10.3390/medicines8110067
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 68: Effects of Systemic Enzyme Supplements on
           Symptoms and Quality of Life in Patients with Pulmonary Fibrosis—A Pilot

    • Authors: Neha Shah
      First page: 68
      Abstract: Current FDA-approved antifibrotic treatments for Idiopathic Pulmonary Fibrosis slow down disease progression but have little impact on symptoms or quality of life in patients. This study was conducted to evaluate the effects of systemic enzymes in relieving symptoms associated with PF and improving quality of life. Methods: an open-label, prospective study on subjects with a confirmed diagnosis of PF was conducted as proof-of-concept. The subjects (n = 13) received the oral systemic enzyme supplements Serracor-NK and Serra Rx for 12 weeks and completed Health-Related Quality of Life (HRQL) questionnaires. The effect of this regimen was examined by comparing the end-of-treatment questionnaire scores with baseline values. Results: significant improvement was seen in 61.5% of subjects, as assessed by the WHO well-being index; an improvement in scores was seen in 84.6% of the subjects, as assessed by the UCSD Shortness of Breath Questionnaire, with 38.4% of the subjects showing minimal clinically important difference; the supplementation was found to be efficacious in 69.2%, 84.6%, 69.2% and 61.5% of the subjects, as assessed by the Saint George’s Respiratory Questionnaire total, symptom, activity, and impact scores, respectively. Conclusions: Serracor-NK and Serra Rx improve symptoms, as well as mental and physical wellbeing and HRQL in patients with PF.
      Citation: Medicines
      PubDate: 2021-11-05
      DOI: 10.3390/medicines8110068
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 69: Natural Products Induce Lysosomal Membrane
           Permeabilization as an Anticancer Strategy

    • Authors: Reginald Halaby
      First page: 69
      Abstract: Cancer is a global health and economic issue. The majority of anticancer therapies become ineffective due to frequent genomic turnover and chemoresistance. Furthermore, chemotherapy and radiation are non-specific, killing all rapidly dividing cells including healthy cells. In this review, we examine the ability of some natural products to induce lysosomal-mediated cell death in neoplastic cells as a way to kill them more specifically than conventional therapies. This list is by no means exhaustive. We postulate mechanisms to explain lysosomal membrane permeabilization and its role in triggering cell death in cancer cells.
      Citation: Medicines
      PubDate: 2021-11-10
      DOI: 10.3390/medicines8110069
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 70: The Impact of the COVID-19 Pandemic on
           Medical Imaging Case Volumes in Aseer Region: A Retrospective Study

    • Authors: Magbool Alelyani, Ali Alghamdi, Nasser Shubayr, Yazeed Alashban, Hajar Almater, Sultan Alamri, Ahmad Joman Alghamdi
      First page: 70
      Abstract: COVID-19 has had a significant impact on global health systems. The aim of this study was to evaluate how imaging volumes and imaging types in radiology departments have been affected by the COVID-19 pandemic across different locations. Methods: Imaging volumes in the Aseer region (in the south of Saudi Arabia) across main hospitals were reviewed retrospectively including all cases referred from different locations (outpatient, inpatient and emergency departments). Data for years 2019 and 2020 were compared. The mean monthly cases were compared using a t-test. Results: The total imaging volumes in 2019 were 205,805 compared to 159,107 in 2020 with a 22.7% overall reduction. A substantial decline was observed in both the April to June and the July to September periods of approximately 42.9% and 44.4%, respectively. With respect to location, between April and June, the greatest decline was observed in outpatient departments (76% decline), followed by emergency departments (25% decline), and the least impact was observed in inpatient departments, with only 6.8% decline over the same period. According to modality type, the greatest decreases were reported in nuclear medicine, ultrasound, MRI, and mammography, by 100%, 76%, 74%, and 66%, respectively. Our results show a statistically significant (p-value ≤ 0.05) decrease of cases in 2020 compared to 2019, except for mammography procedures. Conclusion: There has been a significant decline in radiology volumes due to COVID-19. The overall reduction in radiology volumes was dependent on the stage/period of lockdown, location, and imaging modality.
      Citation: Medicines
      PubDate: 2021-11-12
      DOI: 10.3390/medicines8110070
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 71: Effect of Breastfeeding and Its Duration on
           Impaired Fasting Glucose and Diabetes in Perimenopausal and Postmenopausal
           Women: Korea National Health and Nutrition Examination Survey (KNHANES)

    • Authors: Byung-Soo Kwan, In-Ae Cho, Ji-Eun Park
      First page: 71
      Abstract: Background and Objectives: To examine the effect of maternal breastfeeding on the subsequent risk of diabetes in parous Korean women aged >50 years. Materials and Methods: A total of 14,433 participants from the Korea National Health and Nutrition Examination Survey (KNHANES) were included. The subjects were divided into three groups: normal, impaired fasting glucose, and diabetes. The adjusted odds ratios (ORs) for impaired fasting glucose (IFG) and diabetes were assessed using multivariate logistic regression. Results: A total of 2301 (15.94%) women were classified as having diabetes, and 3670 (25.43%) women were classified as having impaired fasting glucose. Breastfeeding was associated with an OR for diabetes of 0.76 (95% confidence interval (CI): 0.61, 0.95) compared with non-breastfeeding after adjustment for possible confounders in the multivariable logistic regression analysis. Breastfeeding for 13–24 months was associated with an OR of 0.68 (95% CI, 0.5, 0.91), and breastfeeding for 25–36 months was associated with an OR of 0.68 (95% CI, 0.52, 0.87) for diabetes compared with breastfeeding for <1 month in the multivariable logistic regression analysis. Conclusions: Our results suggest that long-term breastfeeding, particularly breastfeeding for 13–36 months, may be associated with a lower risk for diabetes later in life.
      Citation: Medicines
      PubDate: 2021-11-12
      DOI: 10.3390/medicines8110071
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 72: Neuron-Specific Enolase (NSE) Predicts
           Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a
           Prospective Trial

    • Authors: Jonas Müller, Benjamin Bissmann, Christoph Becker, Katharina Beck, Nina Loretz, Sebastian Gross, Simon A. Amacher, Chantal Bohren, Hans Pargger, Kai Tisljar, Raoul Sutter, Stephan Marsch, Sabina Hunziker
      First page: 72
      Abstract: Background: We investigated whether Neuron-specific enolase (NSE) serum concentration predicts long-term mortality and poor neurological outcome in adult cardiac arrest patients. Methods: Within this prospective observational study, we included consecutive adult patients admitted to the intensive care unit (ICU) after cardiac arrest. NSE was measured upon ICU admission and on days 1, 2, 3, 5 and 7. Results: Of 403 patients, 176 (43.7%) survived. Median follow-up duration was 43.7 months (IQR 14.3 to 63.0 months). NSE levels on day 3 were increased more than threefold in non-survivors compared to survivors (median NSE (ng/mL) 19.8 (IQR 15.7 to 27.8) vs. 72.6 (IQR 26 to 194)) and showed the highest prognostic performance for mortality compared to other days of measurement, with an AUC of 0.81 and an adjusted hazard ratio of 1.55 (95% CI 1.41 to 1.71, p < 0.001). Subgroup analysis showed an excellent sensitivity and negative predictive value of 100% of NSE in patients <54 years of age. Conclusion: NSE measured three days after cardiac arrest is associated with long-term mortality and neurological outcome and may provide prognostic information that improves clinical decision making. Particularly in the subgroup of younger patients (<54 years), NSE showed excellent negative predictive value.
      Citation: Medicines
      PubDate: 2021-11-17
      DOI: 10.3390/medicines8110072
      Issue No: Vol. 8, No. 11 (2021)
  • Medicines, Vol. 8, Pages 55: Autoimmune Disorders & COVID-19

    • Authors: Leonardo Freire-de-Lima, Aline Miranda Scovino, Camilla Cristie Barreto Menezes, Leonardo Marques da Fonseca, Jhenifer Santos dos Reis, Marcos André Rodrigues da Costa Santos, Kelli Monteiro da Costa, Carlos Antonio do Nascimento Santos, Celio Geraldo Freire-de-Lima, Alexandre Morrot
      First page: 55
      Abstract: Coronavirus disease 2019 (COVID-19) can progress to severe pneumonia with respiratory failure and is aggravated by the deregulation of the immune system causing an excessive inflammation including the cytokine storm. Since 2019, several studies regarding the interplay between autoimmune diseases and COVID-19 infections is increasing all over the world. In addition, thanks to new scientific findings, we actually know better why certain conditions are considered a higher risk in both situations. There are instances when having an autoimmune disease increases susceptibility to COVID-19 complications, such as when autoantibodies capable of neutralizing type I IFN are present, and other situations in which having COVID-19 infection precedes the appearance of various autoimmune and autoinflammatory diseases, including multisystem inflammatory syndrome in children (MIS-C), Guillain-Barré syndrome, and Autoimmune haemolytic anaemia (AIHA), thus, adding to the growing mystery surrounding the SARS-CoV-2 virus and raising questions about the nature of its link with autoimmune and autoinflammatory sequelae. Herein, we discuss the role of host and virus genetics and some possible immunological mechanisms that might lead to the disease aggravation.
      Citation: Medicines
      PubDate: 2021-09-28
      DOI: 10.3390/medicines8100055
      Issue No: Vol. 8, No. 10 (2021)
  • Medicines, Vol. 8, Pages 56: Lignosulfonate Rapidly Inactivates Human
           Immunodeficiency and Herpes Simplex Viruses

    • Authors: Kunihiko Fukuchi, Takuro Koshikawa, Daisuke Asai, Megumi Inomata, Hiroshi Sakagami, Hiromu Takemura, Taisei Kanamoto, Hikaru Aimi, Yuji Kikkawa
      First page: 56
      Abstract: Background: Very few studies of the antiviral potential of lignosulfonates have been published. With the aim of oral application, among various groups of natural products, the relative antiviral potency of lignosulfonate and its ability to rapidly inactivate viruses were investigated. Methods: As target cells, MT-4 cells in suspension and attached Vero cells were used for infections with human immunodeficiency virus (HIV) and human herpes simplex type-1 virus (HSV). Mock- or virus-infected cells were incubated for 3–5 days with various concentrations of test samples, and the viable cell number was determined with the MTT method. For the shorter exposure experiments, higher titers of HIV or HSV were exposed to test samples for 10 or 3 min, diluted to a normal multiplicity of infection (MOI), and applied to the cells. Antiviral activity was quantified by using the chemotherapy index. Results: In the long-exposure system, lignosulfonates showed comparable anti-HIV activity with those of AZT, ddC, and sulfated polysaccharides, and it exceeded those of hundreds of tannins and flavonoids. When the exposure time was shortened, the chemotherapeutic index of the lignosulfonates for HIV was increased 27-fold. At a physiological pH, lignosulfonate showed higher anti-HIV activity than commercial alkali-lignin, dealkali-lignin, and humic acid, possibly due to the higher solubility and purity. Conclusions: With their rapid virus-inactivation capabilities, lignosulfonates may be useful for the prevention or treatment of virally induced oral diseases.
      Citation: Medicines
      PubDate: 2021-10-03
      DOI: 10.3390/medicines8100056
      Issue No: Vol. 8, No. 10 (2021)
  • Medicines, Vol. 8, Pages 57: Impact of Adiposity and Fat Distribution,
           Rather Than Obesity, on Antibodies as an Illustration of
           Weight-Loss-Independent Exercise Benefits

    • Authors: Ghanemi, Yoshioka, St-Amand
      First page: 57
      Abstract: Obesity represents a risk factor for a variety of diseases because of its inflammatory component, among other biological patterns. Recently, with the ongoing COVID-19 crisis, a special focus has been put on obesity as a status in which antibody production, among other immune functions, is impaired, which would impact both disease pathogenesis and vaccine efficacy. Within this piece of writing, we illustrate that such patterns would be due to the increased adiposity and fat distribution pattern rather than obesity (as defined by the body mass index) itself. Within this context, we also highlight the importance of the weight-loss-independent effects of exercise.
      Citation: Medicines
      PubDate: 2021-10-08
      DOI: 10.3390/medicines8100057
      Issue No: Vol. 8, No. 10 (2021)
  • Medicines, Vol. 8, Pages 58: Clinical Trials, Potential Mechanisms, and
           Adverse Effects of Arnica as an Adjunct Medication for Pain Management

    • Authors: Amanda G. Smith, Victoria N. Miles, Deltrice T. Holmes, Xin Chen, Wei Lei
      First page: 58
      Abstract: Arnica has traditionally been used in treating numerous medical conditions, including inflammation and pain. This review aims to summarize the results of studies testing Arnica products for pain management under different conditions, including post-operation, arthritis, low back pain, and other types of musculoskeletal pain. Based on data from clinical trials, Arnica extract or gel/cream containing Arnica extract shows promising effects for pain relief. These medical benefits of Arnica may be attributed to its chemical components, with demonstrated anti-inflammatory, antioxidant, anti-microbial, and other biological activities. In conclusion, Arnica could be an adjunct therapeutical approach for acute and chronic pain management.
      Citation: Medicines
      PubDate: 2021-10-09
      DOI: 10.3390/medicines8100058
      Issue No: Vol. 8, No. 10 (2021)
  • Medicines, Vol. 8, Pages 59: COVID-19 Infection and Neuropathological

    • Authors: Leonardo Freire-de-Lima, Aline Miranda Scovino, Leonardo Marques da Fonseca, Camilla Cristie Barreto Menezes, Carlos Antonio do Nascimento Santos, Marco Edilson Freire de Lima, Debora Decote-Ricardo, Matheus Freire-de-Lima, Kelli Monteiro da Costa, Jhenifer Santos dos Reis, Marcos André Rodrigues da Costa Santos, Celio Geraldo Freire-de-Lima, Alexandre Morrot
      First page: 59
      Abstract: The pathology associated with COVID-19 infection is progressively being revealed. Recent postmortem assessments have revealed acute airway inflammation as well as diffuse alveolar damage, which bears resemblance to severe acute respiratory syndromes induced by both SARS-CoV and MERS-CoV infections. Although recent papers have highlighted some neuropathologies associated with COVID-19 infection, little is known about this topic of great importance in the area of public health. Here, we discuss how neuroinflammation related to COVID-19 could be triggered by direct viral neuroinvasion and/or cytokine release over the course of the infection.
      Citation: Medicines
      PubDate: 2021-10-11
      DOI: 10.3390/medicines8100059
      Issue No: Vol. 8, No. 10 (2021)
  • Medicines, Vol. 8, Pages 60: Laparoscopy in Gynecologic and Abdominal
           Surgery in Regional (Spinal, Peridural) Anesthesia, the Utility of the
           Technique during COVID-19 Pandemic

    • Authors: Attila Louis Major, Kudrat Jumaniyazov, Shahnoza Yusupova, Ruslan Jabbarov, Olimjon Saidmamatov, Ivanna Mayboroda-Major
      First page: 60
      Abstract: Background: laparoscopic surgery is mainly performed in general anesthesia. Symptomatic patients infected with COVID-19 needing surgery are however at higher risk for COVID-19 complications in general anesthesia than in regional anesthesia. Even so, Covid transfection is a hazard to medical personnel during the intubation procedure and treatment drugs may be in shortage during a pandemic. Recovery and hospital stay are also shorter after laparoscopy. Laparoscopy performed in regional anesthesia may have several advantages in limiting Covid. Methods: international literature on the risk of COVID-19 complications development was searched. 3 topics concerning laparoscopic surgery were reviewed: (1) Achievements in laparoscopy; (2) Advantages of regional anesthesia compared to general anesthesia; (3) Feasibility to perform laparoscopy in regional anesthesia in COVID-19 pandemic. The authors reviewed abstracts and full-text articles concerning laparoscopic surgery, gynecology, anesthesia and COVID-19. Studies published in PubMed, Embase, Cochrane Library and found in Google Scholar before 1st FEB, 2021 were retrieved and analyzed. Results: a total of 83 studies were found, all of them written in English. 17 studies could be found in gynecology and in general surgery about laparoscopy with regional anesthesia. In Covid time only one study compared laparoscopic surgery in general anesthesia to laparotomy and another study laparotomy in general anesthesia to regional anesthesia. Laparoscopy showed no disadvantage compared to laparotomy in Covid pandemic and in another study laparotomy in general anesthesia was associated with higher mortality and more pulmonary complications. Trendelenburg position can be a threat if used by inexperienced personnel and can induce unintended anesthesia of breathing organs. On the other hand Trendelenburg position has advantages for cardiovascular and pulmonary functions. Pneumoperitoneum of low CO2 pressure is well tolerated by patients. Conclusions: elective surgery should be postponed in symptomatic Covid patients. In inevitable emergency surgery intubation anesthesia in COVID-19 pandemic is as far as possible to be avoided. In COVID-19 pandemic, regional anesthesia is the preferred choice. The optimum may be the combination of laparoscopic surgery with regional anesthesia. Reducing the pneumoperitoneum is a good compromise for the comfort of patients and surgeons. A special case is gynecology, which needs to be performed in Trendelenburg position to free pelvic organs.
      Citation: Medicines
      PubDate: 2021-10-19
      DOI: 10.3390/medicines8100060
      Issue No: Vol. 8, No. 10 (2021)
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