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- Medicines, Vol. 10, Pages 33: Fluoroquinolone-Associated Movement
Disorder: A Literature Review
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
First page: 33
Abstract: Background: Fluoroquinolones (FQNs) are related to several central nervous system side effects. This review aims to evaluate the clinical-epidemiological profile, pathophysiological mechanisms, and management of FQNs-associated movement disorders (MDs). Methods: Two reviewers identified and assessed relevant reports in six databases without language restriction between 1988 and 2022. Results: A total of 45 reports containing 51 cases who developed MDs secondary to FQNs were reported. The MDs included 25 myoclonus, 13 dyskinesias, 7 dystonias, 2 cerebellar syndromes, 1 ataxia, 1 tic, and 2 undefined cases. The FQNs reported were ciprofloxacin, ofloxacin, gatifloxacin, moxifloxacin, levofloxacin, gemifloxacin, and pefloxacin. The mean and median age were 64.54 (SD: 15.45) and 67 years (range: 25–87 years). The predominant sex was male (54.16%). The mean and median time of MD onset were 6.02 (SD: 10.87) and 3 days (range: 1–68 days). The mean and median recovery time after MD treatment was 5.71 (SD: 9.01) and 3 days (range: 1–56 days). A complete recovery was achieved within one week of drug withdrawal in 80.95% of the patients. Overall, 95.83% of the individuals fully recovered after management. Conclusions: Future cases need to describe the long-term follow-up of the individuals. Additionally, FQN-induced myoclonus should include electrodiagnostic studies.
Citation: Medicines
PubDate: 2023-05-25
DOI: 10.3390/medicines10060033
Issue No: Vol. 10, No. 6 (2023)
- Medicines, Vol. 10, Pages 29: Cannabis Use in Physicians: A Systematic
Review and Meta-Analysis
Authors: Pierre-Louis Naillon, Valentin Flaudias, Georges Brousse, Catherine Laporte, Julien S. Baker, Valentin Brusseau, Aurélie Comptour, Marek Zak, Jean-Baptiste Bouillon-Minois, Frédéric Dutheil
First page: 29
Abstract: Background: Cannabis use by physicians can be detrimental for them and their patients. We conducted a systematic review and meta-analysis on the prevalence of cannabis use by medical doctors (MDs)/students. Method: PubMed, Cochrane, Embase, PsycInfo and ScienceDirect were searched for studies reporting cannabis use in MDs/students. For each frequency of use (lifetime/past year/past month/daily), we stratified a random effect meta-analysis depending on specialties, education level, continents, and periods of time, which were further compared using meta-regressions. Results: We included 54 studies with a total of 42,936 MDs/students: 20,267 MDs, 20,063 medical students, and 1976 residents. Overall, 37% had used cannabis at least once over their lifetime, 14% over the past year, 8% over the past month and 1.1 per thousand (‰) had a daily use. Medical students had a greater cannabis use than MDs over their lifetime (38% vs. 35%, p < 0.001), the past year (24% vs. 5%, p < 0.001), and the past month (10% vs. 2%, p < 0.05), without significance for daily use (0.5% vs. 0.05%, NS). Insufficient data precluded comparisons among medical specialties. MDs/students from Asian countries seemed to have the lowest cannabis use: 16% over their lifetime, 10% in the past year, 1% in the past month, and 0.4% daily. Regarding periods of time, cannabis use seems to follow a U-shape, with a high use before 1990, followed by a decrease between 1990 and 2005, and a rebound after 2005. Younger and male MDs/students had the highest cannabis use. Conclusions: If more than a third of MDs tried cannabis at least once in their lifetime, this means its daily use is low but not uncommon (1.1‰). Medical students are the biggest cannabis users. Despite being common worldwide, cannabis use is predominant in the West, with a rebound since 2005 making salient those public health interventions during the early stage of medical studies.
Citation: Medicines
PubDate: 2023-04-27
DOI: 10.3390/medicines10050029
Issue No: Vol. 10, No. 5 (2023)
- Medicines, Vol. 10, Pages 30: Clinicopathological Features of Invasive
Breast Cancer: A Five-Year Retrospective Study in Southern and
South-Western Ethiopia
Authors: Esmael Besufikad Belachew, Adey Feleke Desta, Dinksira Bekele Deneke, Bizunesh Dires Fenta, Alemwosen Teklehaymanot Alem, Abdo Kedir Abafogi, Fekade Yerakly Lukas, Mesele Bezabih, Dareskedar Tsehay Sewasew, Eva J. Kantelhardt, Tesfaye Sisay Tessema, Rawleigh Howe
First page: 30
Abstract: Background: Breast cancer (BC) is the most common type of cancer in Ethiopia. The incidence of BC is also rising, but the exact figure is still poorly known. Therefore, this study was conducted to address the gap in epidemiological data on BC in southern and southwestern Ethiopia. Materials and Methods: This is a five-year (2015–2019) retrospective study. The demographic and clinicopathological data were collected from biopsy reports of different kinds of breast carcinomas in the pathology department of Jimma University Specialized Hospital and Hawassa University Specialized Referral Hospital. Histopathological grades and stages were conducted using Nottingham grading and TNM staging system, respectively. Collected data were entered and analyzed using SPSS Version-20 software. Results: The mean age of patients at diagnosis was 42.27 (SD = 13.57) years. The pathological stage of most BC patients was stage III, and most of them had tumor sizes greater than 5 cm. Most patients had moderately differentiated tumor grade, and mastectomy was the most common type of surgery at the time of diagnosis. Invasive ductal carcinoma was the most common histological type of BC, followed by invasive lobular carcinoma. Lymph node involvement was seen in 60.5% of cases. Lymph node involvement was associated with tumor size (χ2 = 8.55, p = 0.033) and type of surgery (χ2 = 39.69, p < 0.001). Conclusions: This study showed that BC patients in southern and southwestern Ethiopia displayed advanced pathological stages, relatively young age at diagnosis, and predominant invasive ductal carcinoma histological patterns.
Citation: Medicines
PubDate: 2023-05-04
DOI: 10.3390/medicines10050030
Issue No: Vol. 10, No. 5 (2023)
- Medicines, Vol. 10, Pages 31: Averting an Unnecessary Revision of a
Roux-en-Y Hepaticojejunostomy by Surgically Creating an Access Point for
the Endoscopic Assessment of the Anastomosis: A Report of a Case
Authors: Dimitrios Symeonidis, Ismini Paraskeua, Athina A. Samara, Effrosyni Bompou, Alexandros Valaroutsos, Maria P. Ntalouka, Dimitrios Zacharoulis
First page: 31
Abstract: Introduction: Primary sclerosing cholangitis sets the scene for several pathologies of both the intrahepatic and the extrahepatic biliary tree. Surgical treatment, when needed, is almost unanimously summarized in the creation of a Roux-en-Y hepaticojejunostomy, a procedure with a relatively high associated failure rate. Presentation of case: A 70-year-old male, diagnosed with primary sclerosing cholangitis, was submitted to a Roux-en-Y hepaticojejunostomy due to a dominant stricture of the extrahepatic biliary tree. Recurrent episodes of acute cholangitis dictated a workup in the direction of a possible stenosis at the level of the anastomosis. The imaging studies were inconclusive while both the endoscopic and the transhepatic approach failed to assess the status of the anastomosis. A laparotomy, with the intent to revise a high suspicion for stenosis hepaticojejunostomy, was decided. Intraoperatively, a decision to assess the hepaticojejunostomy prior to the scheduled surgical revision, via endoscopy, was made. In this direction, an enterotomy was made on the short jejunal blind loop in order to gain luminal access and an endoscope was propelled through the enterotomy towards the biliary enteric anastomosis. Results: The inspection of the anastomosis under direct endoscopic vision showed no evidences of stenosis and averted an unnecessary, under these circumstances, revision of the anastomosis. Conclusions: The surgical revision of a Roux-en-Y hepaticojejunostomy is a highly demanding operation with an increased associated morbidity, and it should be reserved as the final resort in the treatment algorithm. An approach of utilizing surgery to facilitate the endoscopic assessment prior to proceeding to the surgical revision of the anastomosis appears justified.
Citation: Medicines
PubDate: 2023-05-11
DOI: 10.3390/medicines10050031
Issue No: Vol. 10, No. 5 (2023)
- Medicines, Vol. 10, Pages 32: Secreted Protein Acidic and Rich in Cysteine
(SPARC) to Manage Coronavirus Disease-2019 (COVID-19) Pandemic and the
Post-COVID-19 Health Crisis
Authors: Abdelaziz Ghanemi, Mayumi Yoshioka, Jonny St-Amand
First page: 32
Abstract: Coronavirus disease-2019 (COVID-19) has had and will have impacts on public health and health system expenses. Indeed, not only it has led to high numbers of confirmed COVID-19 cases and hospitalizations, but its consequences will remain even after the end of the COVID-19 crisis. Therefore, therapeutic options are required to both tackle the COVID-19 crisis and manage its consequences during the post COVID-19 era. Secreted protein acidic and rich in cysteine (SPARC) is a biomolecule that is associated with various properties and functions that situate it as a candidate which may be used to prevent, treat and manage COVID-19 as well as the post-COVID-19-era health problems. This paper highlights how SPARC could be of such therapeutic use.
Citation: Medicines
PubDate: 2023-05-16
DOI: 10.3390/medicines10050032
Issue No: Vol. 10, No. 5 (2023)
- Medicines, Vol. 10, Pages 25: Distinct Phenotypes of Non-Citizen Kidney
Transplant Recipients in the United States by Machine Learning Consensus
Clustering
Authors: Charat Thongprayoon, Pradeep Vaitla, Caroline C. Jadlowiec, Napat Leeaphorn, Shennen A. Mao, Michael A. Mao, Fahad Qureshi, Wisit Kaewput, Fawad Qureshi, Supawit Tangpanithandee, Pajaree Krisanapan, Pattharawin Pattharanitima, Prakrati C. Acharya, Pitchaphon Nissaisorakarn, Matthew Cooper, Wisit Cheungpasitporn
First page: 25
Abstract: Background: Better understanding of the different phenotypes/subgroups of non-U.S. citizen kidney transplant recipients may help the transplant community to identify strategies that improve outcomes among non-U.S. citizen kidney transplant recipients. This study aimed to cluster non-U.S. citizen kidney transplant recipients using an unsupervised machine learning approach; Methods: We conducted a consensus cluster analysis based on recipient-, donor-, and transplant- related characteristics in non-U.S. citizen kidney transplant recipients in the United States from 2010 to 2019 in the OPTN/UNOS database using recipient, donor, and transplant-related characteristics. Each cluster’s key characteristics were identified using the standardized mean difference. Post-transplant outcomes were compared among the clusters; Results: Consensus cluster analysis was performed in 11,300 non-U.S. citizen kidney transplant recipients and identified two distinct clusters best representing clinical characteristics. Cluster 1 patients were notable for young age, preemptive kidney transplant or dialysis duration of less than 1 year, working income, private insurance, non-hypertensive donors, and Hispanic living donors with a low number of HLA mismatch. In contrast, cluster 2 patients were characterized by non-ECD deceased donors with KDPI <85%. Consequently, cluster 1 patients had reduced cold ischemia time, lower proportion of machine-perfused kidneys, and lower incidence of delayed graft function after kidney transplant. Cluster 2 had higher 5-year death-censored graft failure (5.2% vs. 9.8%; p < 0.001), patient death (3.4% vs. 11.4%; p < 0.001), but similar one-year acute rejection (4.7% vs. 4.9%; p = 0.63), compared to cluster 1; Conclusions: Machine learning clustering approach successfully identified two clusters among non-U.S. citizen kidney transplant recipients with distinct phenotypes that were associated with different outcomes, including allograft loss and patient survival. These findings underscore the need for individualized care for non-U.S. citizen kidney transplant recipients.
Citation: Medicines
PubDate: 2023-03-27
DOI: 10.3390/medicines10040025
Issue No: Vol. 10, No. 4 (2023)
- Medicines, Vol. 10, Pages 26: Comorbidity Patterns in Patients at
Cardiovascular Hospital Admission
Authors: Cezara-Andreea Soysaler, Cătălina Liliana Andrei, Octavian Ceban, Crina-Julieta Sinescu
First page: 26
Abstract: Hypertension frequently coexists with obesity, diabetes, hyperlipidemia, or metabolic syndrome, anditsassociation with cardiovascular disease is well established. The identification and management of these risk factors is an important part of overall patient management. In this paper, we find the most relevant patterns of hospitalized patients with cardiovascular diseases, consideringaspects of their comorbidities, such as triglycerides, cholesterol, diabetes, hypertension, and obesity. To find the most relevant patterns, several clusterizations were made, playing with the dimensions of comorbidity and the number of clusters. There are three main patient types who require hospitalization: 20% whose comorbidities are not so severe, 44% with quite severe comorbidities, and 36% with fairly good triglycerides, cholesterol, and diabetes but quite severe hypertension and obesity. The comorbidities, such as triglycerides, cholesterol, diabetes, hypertension, and obesity, were observed in different combinations in patients upon hospital admission.
Citation: Medicines
PubDate: 2023-03-28
DOI: 10.3390/medicines10040026
Issue No: Vol. 10, No. 4 (2023)
- Medicines, Vol. 10, Pages 27: Trends in Antibody Titers after SARS-CoV-2
Vaccination—Insights from Self-Paid Tests at a General Internal
Medicine Clinic
Authors: Hiroshi Kusunoki, Kazumi Ekawa, Masakazu Ekawa, Nozomi Kato, Keita Yamasaki, Masaharu Motone, Hideo Shimizu
First page: 27
Abstract: Background: The rise in antibody titers against the novel coronavirus (SARS-CoV-2) and its duration are considered an important indicator for confirming the effect of a COVID-19 vaccine, and self-paid tests of antibody titer are conducted in many facilities nationwide. Methods: The relationship between the number of days after the second and third dose of vaccines, age, and antibody titer was determined from the medical records of general internal medicine clinics that conducted self-paid testing of the SARS-CoV-2 antibody titer using Elecsys Anti-SARS-CoV-2 S (Roche Diagnostics); the relationship between the number of days after two or more doses of vaccines and antibody titer was also determined. We also examined the antibody titers in cases of spontaneous infection with SARS-CoV-2 after two or more doses of the vaccine. Results: Log-transformed SARS-CoV-2 antibody titers measured within 1 month from the second or third dose of vaccine showed a negative correlation with age (p < 0.05). In addition, the log-transformed antibody titers also showed a negative correlation trend with the number of days after the second dose of vaccine (p = 0.055); however, there were no significant correlations between the log-transformed antibody titers and the number of days after the third dose of vaccine. The median antibody titer after the third vaccination was 18,300 U/mL, more than 10 times the median antibody titer after the second dose of vaccine, of 1185 U/mL. There were also some cases of infection after the third or fourth dose of vaccine, with antibody titers in the tens of thousands of U/ml after infection, but the patients still received further booster vaccinations after the infection. Conclusions: The antibody titers after the third vaccination did not attenuate after a short follow-up period of one month, while they tended to attenuate after the second vaccination. It is considered that many people in Japan received further booster vaccinations after spontaneous infection, even though they already had antibody titers in the tens of thousands of U/mL due to “hybrid immunity” after spontaneous infection following two or more doses of vaccine. The clinical significance of the booster vaccination in this population still needs to be thoroughly investigated and should be prioritized for those with low SARS-CoV-2 antibody titers.
Citation: Medicines
PubDate: 2023-04-20
DOI: 10.3390/medicines10040027
Issue No: Vol. 10, No. 4 (2023)
- Medicines, Vol. 10, Pages 28: Quercetin-Induced Enhancement of Nasal
Epithelial Cells’ Ability to Produce Clara Cell 10-kD Protein In
Vitro and In Vivo
Authors: Amane Otaki, Atsuko Furuta, Kazuhito Asano
First page: 28
Abstract: Background: Quercetin, a polyphenolic flavonoid found in various plants and foods, is known to have antioxidant, antiviral and anticancer effects. Although quercetin is well known to exert anti-inflammatory and anti-allergic effects, the precise mechanisms by which quercetin favorably modifies the clinical status of allergic diseases, such as allergic rhinitis (AR), remain unclear. The present study examined whether quercetin could modulate the production of the endogenous anti-inflammatory molecule, Clara cell 10-kD protein (CC10), in vitro and in vivo. Methods: Human nasal epithelial cells (1 × 105 cells/mL) were stimulated with 20 ng/mL of tumor necrosis factor-alpha (TNF) in the presence of quercetin for 24 h. CC10 levels in culture supernatants were examined by ELISA. Sprague Dawley rats were sensitised with toluene 2,4-diisocyanate (TDI) by intranasal instillation of 10% TDI in ethyl acetate at a volume of 5.0 μL once daily for five days. This sensitisation procedure was repeated after an interval of two days. The rats were treated with different dosages of quercetin once daily for five days starting on the 5th day following the second sensitization. Nasal allergy-like symptoms induced by the bilateral application of 5.0 μL of 10% TDI were assessed by counting sneezing and nasal-rubbing behaviours for 10 min immediately after the TDI nasal challenge. The levels of CC10 in nasal lavage fluids obtained 6 h after TDI nasal challenge were examined using ELISA. Results: The treatment of cells with low doses of quercetin (<2.5 μM) scarcely affected TNF-induced CC10 production from nasal epithelial cells. However, the ability of nasal epithelial cells to produce CC10 after TNF stimulation significantly increased on treatment with quercetin doses (>5.0 μM). The oral administration of quercetin (>25 mg/kg) for five days significantly increased the CC10 content in nasal lavage fluids and attenuated the nasal symptoms induced by the TDI nasal challenge. Conclusions: Quercetin inhibits AR development by increasing the ability of nasal epithelial cells to produce CC10.
Citation: Medicines
PubDate: 2023-04-21
DOI: 10.3390/medicines10040028
Issue No: Vol. 10, No. 4 (2023)
- Medicines, Vol. 10, Pages 19: Clinical Benefit of Autologous Platelet-Rich
Plasma Infusion in Ovarian Function Rejuvenation: Evidence from a
Before-After Prospective Pilot Study
Authors: Athanasios Garavelas, Panagiotis Mallis, Efstathios Michalopoulos, Eros Nikitos
First page: 19
Abstract: Background: The intraovarian administration of autologous platelet-rich plasma (PRP) acts beneficially for the stimulation of follicle production in women presenting different forms of ovarian dysfunction. This pilot study aimed to evaluate and provide significant data regarding the efficacy of PRP to rejuvenate the ovaries. Methods: A total of 253 women aged 22–56 years, were divided into five groups, based on their status. All participants signed for informed consent for the current study. Blood sampling, preparation of PRP and intraovarian infusion of the latter were performed on all participants. The evaluation of PRP efficacy, a two-month follow-up detecting the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and anti-mullerian hormone (AMH), was performed for all participants. For women with advanced ages (>48 years), the restoration and regularity of the menstrual cycle were additionally evaluated. Results: After the two-month follow-up, the majority of the participants presented improvement in their hormonal profiles. Additionally, 17% of the women in this pilot study successfully conceived. The restoration of the menstrual cycle was detected in 15% of the women with advanced ages. Conclusions: Intraovarian infusion of autologous PRP exhibited remarkable evidence and promising results to restore ovarian insufficiency.
Citation: Medicines
PubDate: 2023-02-27
DOI: 10.3390/medicines10030019
Issue No: Vol. 10, No. 3 (2023)
- Medicines, Vol. 10, Pages 20: Everyday Evaluation of Herb/Dietary
Supplement–Drug Interaction: A Pilot Study
Authors: Joao Victor Souza-Peres, Kimberly Flores, Bethany Umloff, Michelle Heinan, Paul Herscu, Mary Beth Babos
First page: 20
Abstract: A lack of reliable information hinders the clinician evaluation of suspected herb–drug interactions. This pilot study was a survey-based study conceived as a descriptive analysis of real-life experiences with herb–drug interaction from the perspective of herbalists, licensed health-care providers, and lay persons. Reported dietary supplement–drug interactions were evaluated against the resources most commonly cited for the evaluation of potential supplement–drug interactions. Disproportionality analyses were performed using tools available to most clinicians using data from the U.S. Federal Adverse Event Reporting System (FAERS) and the US Center for Food Safety and Applied Nutrition (CFSAN) Adverse Event Reporting System (CAERS). Secondary aims of the study included exploration of the reasons for respondent use of dietary supplements and qualitative analysis of respondent’s perceptions of dietary supplement–drug interaction. While agreement among reported supplement–drug interactions with commonly cited resources for supplement–drug interaction evaluation and via disproportionality analyses through FAERS was low, agreement using data from CAERS was high.
Citation: Medicines
PubDate: 2023-02-28
DOI: 10.3390/medicines10030020
Issue No: Vol. 10, No. 3 (2023)
- Medicines, Vol. 10, Pages 21: Effect of Dexamethasone on Abiraterone
Pharmacokinetics in Mice: Determined by LC/MS Analysis
Authors: Subrata Deb, Mohamed Ben-Eltriki, Hans Adomat, Mei Y. Chin, Emma S. Tomlinson Guns
First page: 21
Abstract: Background: Abiraterone acetate is a cytochrome P450 17A1 (CYP17A1) inhibitor that is indicated for use in both castration-resistant and castration-sensitive prostate cancer patients. To manage the mineralocorticoid effects of CYP17A1 inhibition, a glucocorticoid such as dexamethasone is co-administered with abiraterone. The goal of the present study was to understand the effect of dexamethasone on the disposition of abiraterone. Methods: Adult male CD-1 mice were treated with either dexamethasone (80 mg/kg/day) or vehicle for three consecutive days, followed by the administration of a single dose of abiraterone acetate (180 mg/kg) as an oral gavage. Blood samples were collected by tail bleeding at timepoints between 0 to 24 h. Subsequently, abiraterone was extracted from the mouse serum using a neutral pH condition and serum abiraterone levels were determined using a liquid chromatography–mass spectrometry assay. Results: Our results demonstrated that dexamethasone lowered the maximum plasma concentration and area under the curve parameters by approximately five- and ten-fold, respectively. Similar effects were also observed on the plasma half-life and oral clearance parameters. This is the first report of dexamethasone effect on abiraterone disposition in vivo. Conclusions: We conclude that dexamethasone has the potential to reduce the plasma abiraterone level and thus compromise its CYP17A1 inhibitory ability in the procancerous androgen biosynthesis pathway. Thus, use of a higher abiraterone dose may be warranted when used alongside dexamethasone.
Citation: Medicines
PubDate: 2023-03-06
DOI: 10.3390/medicines10030021
Issue No: Vol. 10, No. 3 (2023)
- Medicines, Vol. 10, Pages 22: Evaluation of Nutritional Status in an Acute
Geriatric Unit: Retrospective Study and Analysis of Frailty Syndrome
Authors: Abrar-Ahmad Zulfiqar, Ibrahima Amadou Dembele, Emmanuel Andres
First page: 22
Abstract: Introduction: The aim of our study is to evaluate the nutritional status of patients in an acute geriatric unit. Methods: Patients included in the study were hospitalized in an acute geriatric unit over a period of 6 months. The nutritional status of each patient was evaluated with anthropometric measurements (the BMI and MNA scales), and biological measurements (albumin). Frailty was evaluated using two scales: the Fried scale and SEGA. Results: A total of 359 patients were included, comprising 251 women (70%) with an average age of 85.28 years. The study showed that 102 elderly subjects were considered undernourished according to the BMI scale, 52 subjects were undernourished according to the MNA scale, and 50 subjects were undernourished according to their albumin levels. The relationships between undernutrition and frailty syndrome studied in our work show that elderly subjects who are undernourished according to the BMI and MNA scales are significantly frail according to Fried and Rockwood, whereas those who are undernourished according to their albumin levels are significantly frail according to Fried and the modified SEGA scale. Conclusion: The relationship between undernutrition and the frailty syndrome is close, and their joint screening is necessary, whether on an outpatient or in-hospital basis, in order to prevent negative events related to comorbidities and geriatric syndromes.
Citation: Medicines
PubDate: 2023-03-08
DOI: 10.3390/medicines10030022
Issue No: Vol. 10, No. 3 (2023)
- Medicines, Vol. 10, Pages 23: Health Technology Assessment of Different
Glucosamine Formulations and Preparations Currently Marketed in Thailand
Authors: Olivier Bruyère, Johann Detilleux, Jean-Yves Reginster
First page: 23
Abstract: Objective: The aim of this study was to evaluate the cost-effectiveness of different glucosamine formulations and preparations used for the management of osteoarthritis in Thailand compared with placebo. Methods: We used a validated model to simulate the individual patient Utility score from aggregated data available from 10 different clinical trials. We then used the Utility score to calculate the quality-adjusted life year (QALY) over 3 and 6 months treatment period. We used the public costs of glucosamine products available in Thailand in 2019 to calculate the incremental cost-effectiveness ratio. We separated the analyses for prescription-grade crystalline glucosamine sulfate (pCGS) and other formulations of glucosamine. A cost-effectiveness cut-off of 3.260 USD/QALY was considered. Results: Irrespective of the glucosamine preparation (tablet or powder/capsule), the data show that pCGS is cost-effective compared with placebo over a 3 and 6 months. However, the other glucosamine formulations (e.g., glucosamine hydrochloride) never reached the breakeven point at any time. Conclusion: Our data show that pCGS is cost-effective for the management of osteoarthritis in the Thai context while other glucosamine formulations are not.
Citation: Medicines
PubDate: 2023-03-08
DOI: 10.3390/medicines10030023
Issue No: Vol. 10, No. 3 (2023)
- Medicines, Vol. 10, Pages 24: Therapeutic Potential of Two Derivative
Prescriptions of Rokumijiogan, Hachimijiogan and Bakumijiogan against
Renal Damage in Nephrectomized Rats
Authors: Chan Hum Park, Takashi Tanaka, Yoshie Akimoto, Jin Pyeong Jeon, Takako Yokozawa
First page: 24
Abstract: Background: Hachimijiogan (HJG) and Bakumijiogan (BJG), two derivative prescriptions of Rokumijiogan (RJG), were selected to investigate their renoprotective potential in the 5/6 nephrectomized (5/6Nx) rat model. Methods: Rats were treated with HJG and BJG orally at 150 mg/kg body weight/day once daily for 10 weeks after resection of 5/6 of the renal volume, and their renoprotective effects were compared with 5/6Nx vehicle-treated and sham-operated control rats. Results: Improvements in renal lesions, glomerulosclerosis, tubulointerstitial injury, and arteriosclerotic lesions estimated by histologic scoring indices in the HJG-treated group were compared with those in the BJG-treated group. HJG- and BJG-treated groups ameliorated the renal function parameters. Elevated levels of renal oxidative stress-related biomarkers were reduced, while decreased antioxidant defence systems (superoxide dismutase and the glutathione/oxidized glutathione ratio) were increased in the HJG-treated group rather than the BJG-treated group. In contrast, BJG administration significantly reduced expression of the inflammatory response through oxidative stress. The HJG-treated group showed a decrease in inflammatory mediators through the JNK pathway. To gain a deeper understanding of their therapeutic action, the effects of the main components detected in HJG and BJG were evaluated using the LLC-PK1 renal tubular epithelial cell line, which is the renal tissue most vulnerable to oxidative stress. Corni Fructus and Moutan Cortex-originated compositions afforded important protection against oxidative stress induced by peroxynitrite. Conclusions: From our described and discussed analyses, it can be concluded that RJG-containing prescriptions, HJG and BJG are an excellent medicine for chronic kidney disease. In the future, appropriately designed clinical studies in people with chronic kidney disease are necessary to evaluate the renoprotective activities of HJG and BJG.
Citation: Medicines
PubDate: 2023-03-21
DOI: 10.3390/medicines10030024
Issue No: Vol. 10, No. 3 (2023)
- Medicines, Vol. 10, Pages 14: Acknowledgment to the Reviewers of Medicines
in 2022
Authors: Medicines Editorial Office Medicines Editorial Office
First page: 14
Abstract: High-quality academic publishing is built on rigorous peer review [...]
Citation: Medicines
PubDate: 2023-01-18
DOI: 10.3390/medicines10020014
Issue No: Vol. 10, No. 2 (2023)
- Medicines, Vol. 10, Pages 15: The Blessed Union of Glycobiology and
Immunology: A Marriage That Worked
Authors: Jhenifer Santos dos dos Reis, Israel Diniz-Lima, Marcos André Rodrigues da Costa Santos, Pedro Marçal Barcelos, Kelli Monteiro da da Costa, Raphael do Carmo Valente, Lorrane de Souza Chaves, Luma Petel de de Campos, Ariely Costa dos dos Santos, Rafaela Gomes Correia de Correia de Lima, Debora Decote-Ricardo, Alexandre Morrot, Jose Osvaldo Previato, Lucia Mendonça-Previato, Celio Geraldo Freire-de-Lima, Leonardo Marques da Fonseca, Leonardo Freire-de-Lima
First page: 15
Abstract: In this article, we discuss the main aspects regarding the recognition of cell surface glycoconjugates and the immunomodulation of responses against the progression of certain pathologies, such as cancer and infectious diseases. In the first part, we talk about different aspects of glycoconjugates and delve deeper into the importance of N-glycans in cancer immunotherapy. Then, we describe two important lectin families that have been very well studied in the last 20 years. Examples include the sialic acid-binding immunoglobulin (Ig)-like lectins (siglecs), and galectins. Finally, we discuss a topic that needs to be better addressed in the field of glycoimmunology: the impact of oncofetal antigens on the cells of the immune system. New findings in this area are of great importance for advancement, especially in the field of oncology, since it is already known that cellular interactions mediated by carbohydrate–carbohydrate and/or carbohydrate proteins are able to modulate the progression of different types of cancer in events that compromise the functionality of the immune responses.
Citation: Medicines
PubDate: 2023-01-19
DOI: 10.3390/medicines10020015
Issue No: Vol. 10, No. 2 (2023)
- Medicines, Vol. 10, Pages 16: Music Therapy in Global Aphasia: A case
Report
Authors: Adriana Piccolo, Francesco Corallo, Davide Cardile, Michele Torrisi, Chiara Smorto, Simona Cammaroto, Viviana Lo Buono
First page: 16
Abstract: Patients affected by global aphasia are no longer able to understand, produce, name objects, write and read. It occurs as a result of functional damage of ischemic or hemorrhagic origin affecting the entire peri-silvan region and frontal operculum. Rehabilitation training aims to promote an early intervention in the acute phase. We described a case of a 57-year-old female patient with left intraparenchymal fronto-temporo-parietal cerebral hemorrhage and right hemiplegia. After admission to clinical rehabilitative center, the patient was not able to perform simple orders and she presented a severe impairment of auditory and written comprehension. Eloquence was characterized by stereotypical emission of monosyllabic sounds and showed compromised praxis-constructive abilities. Rehabilitation included a program of Neurologic Music Therapy (NMT), specifically Symbolic Communication Training Through Music (SYCOM) and Musical Speech Stimulation (MUSTIM). Rehabilitative treatment was measured by improved cognitive and language performance of the patient from T0 to T1. Music rehabilitative interventions and continuous speech therapy improve visual attention and communicative intentionality. In order to confirm the effectiveness of data presented, further extensive studies of the sample would be necessary, to assess the real role of music therapy in post-stroke global aphasia.
Citation: Medicines
PubDate: 2023-01-23
DOI: 10.3390/medicines10020016
Issue No: Vol. 10, No. 2 (2023)
- Medicines, Vol. 10, Pages 17: Effect of Low- and High-Frequency Auricular
Stimulation with Electro-Acupuncture on Cutaneous Microcirculation: A
Cross-Over Study in Healthy Subjects
Authors: Veronica Gagliardi, Giuseppe Gagliardi, Francesco Ceccherelli, Antonello Lovato
First page: 17
Abstract: Background: The regulation of microcirculation depends on the dynamic interaction of different factors: the autonomic nervous system plays a pivotal role in the blood flow and acupuncture can modulate it, obtaining different results depending on the site, the frequency, and the intensity of the stimulation. Methods: 18 healthy subjects have been enrolled and have undergone two sessions of electroacupuncture stimulations: one session using high frequency and one with low frequency. Microcirculation has been monitored continuously during stimulation using the laser Doppler method. Results: The microcirculatory parameters have shown a significant difference between high and low-frequency stimulation, suggesting that low-frequency stimulation is more effective for obtaining a vasodilator effect. Discussion: Our results show that low-frequency stimulation can increase the cutaneous microcirculatory flux, without significantly modifying blood pressure and heart rate. The auricular stimulation causes an increase in the activity of the vagus nerve, increasing the cholinergic activity without acting on post-junctional muscarinic receptors. Conclusion: Auricular acupuncture has a significant impact on the regulation of microcirculation.
Citation: Medicines
PubDate: 2023-02-13
DOI: 10.3390/medicines10020017
Issue No: Vol. 10, No. 2 (2023)
- Medicines, Vol. 10, Pages 18: Fasting Protocols Do Not Improve Intestinal
Architecture and Immune Parameters in C57BL/6 Male Mice Fed a High Fat
Diet
Authors: Raed Y. Ageeli, Sunita Sharma, Melissa Puppa, Richard J. Bloomer, Randal K. Buddington, Marie van der Merwe
First page: 18
Abstract: Background: The intestinal ecosystem, including epithelium, immune cells, and microbiota, are influenced by diet and timing of food consumption. The purpose of this study was to evaluate various dietary protocols after ad libitum high fat diet (HFD) consumption on intestinal morphology and mucosal immunity. Methods: C57BL/6 male mice were fed a 45% high fat diet (HFD) for 6 weeks and then randomized to the following protocols; (1) chow, (2) a purified high fiber diet known as the Daniel Fast (DF), HFD consumed (3) ad libitum or in a restricted manner; (4) caloric-restricted, (5) time-restricted (six hours of fasting in each 24 h), or (6) alternate-day fasting (24 h fasting every other day). Intestinal morphology and gut-associated immune parameters were investigated after 2 months on respective protocols. Results: Consuming a HFD resulted in shortening of the intestine and reduction in villi and crypt size. Fasting, while consuming the HFD, did not restore these parameters to the extent seen with the chow and DF diet. Goblet cell number and regulatory T cells had improved recovery with high fiber diets, not seen with the HFD irrespective of fasting. Conclusion: Nutritional content is a critical determinant of intestinal parameters associated with gut health.
Citation: Medicines
PubDate: 2023-02-17
DOI: 10.3390/medicines10020018
Issue No: Vol. 10, No. 2 (2023)
- Medicines, Vol. 10, Pages 9: First-in-Human Study to Investigate the
Safety Assessment of Peri-Implant Soft Tissue Regeneration with
Micronized-Gingival Connective Tissue: A Pilot Case Series Study
Authors: Takashi I, Sawako Noda, Seigo Ohba, Izumi Asahina, Yoshinori Sumita
First page: 9
Abstract: Background: We have recently proposed an alternative strategy of free gingival graft (FGG) and connective tissue graft (CTG) using micronized-gingival connective tissues (MGCTs). The advantage of this strategy is that MGCTs from a small piece of maxillary tuberosity can regenerate the keratinized tissue band. However, safety and efficacy have not yet been established in patients. This clinical study was a pilot case series, and the objective was to assess the safety and the preliminary efficacy of MGCTs on peri-implant mucosa regeneration. Methods: This was a pilot interventional, single-center, first-in-human (FIH), open (no masking), uncontrolled, and single-assignment study. A total of 4 patients who needed peri-implant soft tissues reconstruction around dental implants received transplantation of atelocollagen-matrix with MGCTs micronized by the tissue disruptor technique. The duration of intervention was 4 weeks after surgery. Results: This first clinical study demonstrated that using MGCTs did not cause any irreversible adverse events, and it showed the preliminary efficacy for peri-implant soft tissues reconstruction in dental implant therapy. Conclusions: Though further studies are needed on an appropriate scale, as an alternative strategy of FGG or CTG, MGCTs might be promising for peri-implant mucosa reconstruction without requiring a high level of skills and morbidity to harvest graft tissues.
Citation: Medicines
PubDate: 2023-01-04
DOI: 10.3390/medicines10010009
Issue No: Vol. 10, No. 1 (2023)
- Medicines, Vol. 10, Pages 10: Disseminated MAI in an HIV Patient-An
Unusual Presentation
Authors: Joshni Simon, Joella Lambert, Jose Mosco-Guzman, Kaitlyn Dittmer, Alison Stern-Harbutte, Weston Connelly
First page: 10
Abstract: Patients with Human Immunodeficiency Virus (HIV), and especially Acquired Immunodeficiency Syndrome (AIDS), can present in a multitude of ways with a variety of possible pathologies. This can prove to be a challenge to a clinician. The patient, in this case, was found to have disseminated Mycobacterium-avium-intracellulare (MAI), despite compliance with antiretroviral therapy (ART), who presented with right upper quadrant pain, isolated elevated alkaline phosphatase, and sepsis. Imaging revealed multiple splenic lesions, bilateral psoas abscesses, abdominal lymphadenopathy, and a large right pleural effusion with a mediastinal shift to the left. Psoas abscesses were drained and the cultures grew acid-fast bacilli. The patient was treated with azithromycin, ethambutol and rifabutin. Classically, MAI infections of patients compliant with ART therapy present with localized disease. This case offers a different presentation of MAI despite compliance with ART therapy.
Citation: Medicines
PubDate: 2023-01-05
DOI: 10.3390/medicines10010010
Issue No: Vol. 10, No. 1 (2023)
- Medicines, Vol. 10, Pages 11: Choroidal Melanoma: A Mini Review
Authors: Noha Soliman, Diaa Mamdouh, Aisha Elkordi
First page: 11
Abstract: Choroidal melanoma is a rare malignant tumour, yet it is the most common primary intra-ocular neoplasm and second on the list of top ten most malignant melanoma sites in the body. Clinical presentation can be non-specific and includes photopsia, floaters, progressive visual field loss, and blurry vision. The tumour is quite often diagnosed clinically during fundus examination; however, the most valued diagnostic tests are A- and B-scan ultrasonography (US). Several factors affect prognosis, including the patient’s age, tumour size, histological features, and presence of metastases. Still, with primary treatment and tight surveillance, around 50% of choroidal melanoma patients metastasise.
Citation: Medicines
PubDate: 2023-01-05
DOI: 10.3390/medicines10010011
Issue No: Vol. 10, No. 1 (2023)
- Medicines, Vol. 10, Pages 12: Evaluating Cataract Surgical Rate through
Smart Partnership between Ministry of Health, Malaysia and Federal
Territory Islamic Religious Council
Authors: Nor Fariza Ngah, Nor Asiah Muhamad, Roslin Azni Abdul Aziz, Elias Hussein, Mohammad Aziz Salowi, Zabri Kamarudin, Noor Hisham Abdullah, Tahir Aris
First page: 12
Abstract: Introduction. Cataract is the leading cause of blindness. About 90% of cataract blindness occurs in low- and middle-income countries. The prevalence of blindness and low vision in any country depends on the socioeconomic status, the availability of medical and healthcare facilities, and the literacy of the population. Aim: This paper aims to estimate the cataract surgery rate (CSR) at Pusat Pembedahan Katarak, MAIWP-Hospital Selayang (Cataract Operation Centre), and provide descriptive assessments of the patients who received eye treatments in the center. Methods: The data were retrieved from the clinical database from 2013 to 2016. Information on the patient’s sociodemographic and clinical and treatment history was collected. Results: The cataract surgery rate for 2013 was about 27 and increased to 37.3 in 2014. However, it declined to 25 in 2015 before it resumed to 36 in 2016. For female patients who received eye treatments at Pusat Pembedahan Katarak, MAIWP-Hospital Selayang, the rate was higher (53.7%) compared to male patients (46.3%). The mean duration of cataract surgery from 2013 to 2016 was 21.25 ± 11.071 min. Conclusion: The increased cataract surgery rate for MAIWP-HS through smart partnerships for day care cataract surgery proved that better accessibility makes the short- and long-term strategies for the reduction and prevention of blindness in Malaysia possible to achieve.
Citation: Medicines
PubDate: 2023-01-12
DOI: 10.3390/medicines10010012
Issue No: Vol. 10, No. 1 (2023)
- Medicines, Vol. 10, Pages 13: Efficacy and Safety of Renal Function on
Edoxaban Versus Warfarin for Atrial Fibrillation: A Systematic Review and
Meta-Analysis
Authors: Yapeng Wang, Li Li, Zhanlan Wei, Shan Lu, Wenxue Liu, Janghui Zhang, Junbo Feng, Dongjin Wang
First page: 13
Abstract: Background: Edoxaban is a novel oral anticoagulant which may decrease the risk of stroke and systemic embolism in patients suffering from atrial fibrillation (AF). However, the decreased efficacy of edoxaban versus warfarin for the avoidance of stroke and systemic embolism in AF with creatinine clearance (CrCl) > 95 mL/min has been reported. The purpose of this meta-analysis is to further clarify the safety (major bleeding) and efficacy (stroke or systemic embolism) of edoxaban for AF patients with various CrCl. Methods: A systematic search of studies on edoxaban and warfarin in AF patients related to renal function was conducted in PubMed, Medline, Web of Science databases, EBSCO, Embase, and the Cochrane Central Register of Controlled Trials. In this meta-analysis (protocol number: PROSPERO CRD 42021245512), we included studies that provide specific data on three outcomes: ischemic stroke or systemic embolism (S/SE), bleeding, and all-cause mortality. Results: This meta-analysis enrolled two randomized controlled trials (RCTs) studies and two retrospective studies that enrolled 28,065 patients. According to CrCl, subjects are divided into three groups (CrCl 30–50 mL/min, CrCl 50–95 mL/min, CrCl > 95 mL/min). In AF patients with CrCl 30–50 mL/min, edoxaban 30 mg daily is similar to warfarin in the prevention of ischemic S/SE and all-cause mortality, resulting in lower bleeding rate and better net clinical outcome (ischemic S/SE: hazard ratio (HR), 0.85, 95% confidence interval (CI), 0.19–1.87; all-cause mortality: HR, 0.65, 95% CI, 0.35–1.19; bleeding: HR, 0.75, 95% CI, 0.60–0.93; net clinical outcome: HR, 0.75, 95% CI, 0.63–0.90). In the group of CrCl 50–95 mL/min, the net clinical outcome was more favorable with edoxaban 60 mg daily than warfarin (HR, 0.81, 95% CI: 0.68–0.96), and there was no significant difference between edoxaban 60 mg daily and warfarin in terms of prevention of bleeding, ischemic S/SE, and all-cause mortality. For AF patients with CrCl > 95 mL/min, there was a statistically significant difference in lower bleeding rate between edoxaban 60 mg daily and warfarin (bleeding: HR: 0.70, 95% CI: 0.58–0.84). There was no differential safety in ischemic S/SE, all-cause mortality, and net clinical outcome. Conclusion: Overall, edoxaban was superior to warfarin in terms of net clinical outcome in various groups of CrCl with AF patients. Although there was no significant difference in net clinical outcome between edoxaban and warfarin for AF patients with CrCl > 95 mL/min, edoxaban is not inferior to warfarin in safety and effectiveness in the various levels of CrCl. Edoxaban may be a more effective and safe treatment than warfarin for patients with chronic kidney disease (CKD) who require anticoagulation. More high-quality and long-term clinical research are needed to further estimate the effects of edoxaban.
Citation: Medicines
PubDate: 2023-01-16
DOI: 10.3390/medicines10010013
Issue No: Vol. 10, No. 1 (2023)
- Medicines, Vol. 9, Pages 45: Cutting the First Turf to Heal Post-SSRI
Sexual Dysfunction: A Male Retrospective Cohort Study
Authors: Rosaria De Luca, Mirjam Bonanno, Alfredo Manuli, Rocco Salvatore Calabrò
First page: 45
Abstract: Post-SSRI sexual dysfunction (PSSD) is a set of heterogeneous sexual problems, which may arise during the administration of selective serotonin reuptake inhibitors (SSRIs) and persist after their discontinuation. PSSD is a rare clinical entity, and it is commonly associated with non-sexual concerns, including emotional and cognitive problems and poor quality of life. To date, however, no effective treatment is available. The aim of this study was to retrospectively evaluate the potential efficacy of the different treatments used in clinical practice in improving male PSSD. Of the 30 patients referred to our neurobehavioral outpatient clinic from January 2020 to December 2021, 13 Caucasian male patients (mean age 29.53 ± 4.57 years), previously treated with SSRIs, were included in the study. Patients with major depressive disorder and/or psychotic symptoms were excluded a priori to avoid overlapping symptomatology, and potentially reduce the misdiagnosis rate. To treat PSSD, we decided to use drugs positively affecting the brain dopamine/serotonin ratio, such as bupropion and vortioxetine, as well as other compounds. This latter drug is known not to cause or reverse iatrogenic SD. Most patients, after treatment with vortioxetine and/or nutraceuticals, reported a significant improvement in all International Index of Erectile Function-(IIEF-5) domains (p < 0.05) from baseline (T0) to 12-month follow-up (T1). Moreover, the only patient treated with pelvic muscle vibration reached very positive results. Although our data come from a retrospective open-label study with a small sample size, drugs positively modulating the central nervous system serotonin/dopamine ratio, such as vortioxetine, could be used to potentially improve PSSD. Large-sample prospective cohort studies and randomized clinical trials are needed to investigate the real prevalence of this clinical entity and confirm such a promising approach to a potentially debilitating illness.
Citation: Medicines
PubDate: 2022-09-01
DOI: 10.3390/medicines9090045
Issue No: Vol. 9, No. 9 (2022)
- Medicines, Vol. 9, Pages 46: Chest X-ray Features in Drug-Resistant
Tuberculosis Patients in Nigeria; a Retrospective Record Review
Authors: Olanrewaju Oladimeji, Adenike Temitope Adeniji-Sofoluwe, Yasir Othman, Victor Abiola Adepoju, Kelechi Elizabeth Oladimeji, Bamidele Paul Atiba, Felix Emeka Anyiam, Babatunde A. Odugbemi, Tolulope Afolaranmi, Ayuba Ibrahim Zoakah
First page: 46
Abstract: Chest X-ray (CXR) characteristics of patients with drug-resistant tuberculosis (DR-TB) depend on a variety of factors, and therefore, identifying the influence of these factors on the appearance of DR-TB in chest X-rays can help physicians improve diagnosis and clinical suspicion. Our aim was to describe the CXR presentation of patients with DR-TB and its association with clinical and demographic factors. A retrospective analysis of the CXRs of DR-TB patients in Nigeria between 2010 and 2016 was performed, reviewing features of chest radiographs, such as cavitation, opacity and effusion, infiltration and lung destruction. The association of these abnormal CXR findings with clinical and demographic characteristics was evaluated using bivariate and multivariate models, and a p-value < 0.05 was considered statistically significant with a 95% confidence interval. A total of 2555 DR-TB patients were studied, the majority (66.9%) were male, aged 29–38 years (36.8%), previously treated (77%), from the South West treatment zone (43.5%), HIV negative (76.7%) and bacteriologically diagnosed (89%). X-ray findings were abnormal in 97% of the participants, with cavitation being the most common (41.5%). Cavitation, effusion, fibrosis, and infiltration were higher in patients presenting in the South West zone and in those previously treated for DR-TB, while lung destruction was significantly higher in patients who are from the South South zone, and in those previously treated for DR-TB. Patients from the South East zone (AOR: 6.667, 95% CI: 1.383–32.138, p = 0.018), the North East zone (AOR: 6.667, 95% CI: 1.179–37.682, p = 0.032) and the North West zone (AOR: 6.30, 95% CI: 1.332–29.787, p = 0.020) had a significantly increased likelihood of abnormal chest X-ray findings, and prior TB treatment predisposed the patient to an increased likelihood of abnormal chest X-ray findings compared to new patients (AOR: 8.256, 95% CI: 3.718–18.330, p = 0.001). The finding of a significantly higher incidence of cavities, effusions and fibrosis in DR-TB patients previously treated could indicate late detection or presentation with advanced DR-TB disease, which may require a more individualized regimen or surgical intervention.
Citation: Medicines
PubDate: 2022-09-06
DOI: 10.3390/medicines9090046
Issue No: Vol. 9, No. 9 (2022)
- Medicines, Vol. 9, Pages 47: The Effectiveness of GLP-1 Receptor Agonist
Semaglutide on Body Composition in Elderly Obese Diabetic Patients: A
Pilot Study
Authors: Yoshinori Ozeki, Takayuki Masaki, Akari Kamata, Shotaro Miyamoto, Yuichi Yoshida, Mitsuhiro Okamoto, Koro Gotoh, Hirotaka Shibata
First page: 47
Abstract: Background and Objectives: This study aimed to investigate the changes in obesity severity, glucose metabolism, and body composition in patients with obesity and type 2 diabetes mellitus treated with glucagon-like peptide 1 receptor agonist (GLP1-RA) semaglutide. Materials and Methods: Body weight (BW), metabolic parameters, and body composition were examined before and 3 months after semaglutide administration. The mass of body fat (FM), fat weight percentage (%FM), mass of skeletal muscle (MM), skeletal MM percentage (%MM), and limb muscles were measured using the bioelectrical impedance method. Results: Semaglutide dramatically reduced the weight, the body mass index (BMI), and the levels of the glucose metabolic markers, including fasting blood glucose and hemoglobin A1c, and accelerated the loss of excess BW. FM, MM, and %FM after semaglutide treatment also decreased. Conversely, semaglutide had no effect on the %MM after 3 months. In limb muscle analyses, right upper and lower leg muscle percentages, left upper and lower leg muscles, and the ratios of the lower/upper muscles were maintained by semaglutide treatment. Conclusions: These results suggest that the GLP1-RA semaglutide effectively reduces body adiposity while maintaining the MM in obese type 2 diabetic patients.
Citation: Medicines
PubDate: 2022-09-16
DOI: 10.3390/medicines9090047
Issue No: Vol. 9, No. 9 (2022)
- Medicines, Vol. 9, Pages 41: Clinical Perspectives and Management of Edema
in Chronic Venous Disease—What about Ruscus'
Authors: Imre Bihari, Jean-Jérôme Guex, Arkadiusz Jawien, Gyozo Szolnoky
First page: 41
Abstract: Background: Edema is highly prevalent in patients with cardiovascular disease and is associated with various underlying pathologic conditions, making it challenging for physicians to diagnose and manage. Methods: We report on presentations from a virtual symposium at the Annual Meeting of the European Venous Forum (25 June 2021), which examined edema classification within clinical practice, provided guidance on making differential diagnoses and reviewed evidence for the use of the treatment combination of Ruscus extract, hesperidin methyl chalcone and vitamin C. Results: The understanding of the pathophysiologic mechanisms underlying fluid build-up in chronic venous disease (CVD) is limited. Despite amendments to the classic Starling Principle, discrepancies exist between the theories proposed and real-world evidence. Given the varied disease presentations seen in edema patients, thorough clinical examinations are recommended in order to make a differential diagnosis. The recent CEAP classification update states that edema should be considered a sign of CVD. The combination of Ruscus extract, hesperidin methyl chalcone and vitamin C improves venous tone and lymph contractility and reduces macromolecule permeability and inflammation. Conclusions: Data from randomized controlled trials support guideline recommendations for the use of Ruscus extract, hesperidin methyl chalcone and vitamin C to relieve major CVD-related symptoms and edema.
Citation: Medicines
PubDate: 2022-07-25
DOI: 10.3390/medicines9080041
Issue No: Vol. 9, No. 8 (2022)
- Medicines, Vol. 9, Pages 42: Transcranial Electromagnetic Treatment Stops
Alzheimer’s Disease Cognitive Decline over a 2½-Year Period:
A Pilot Study
Authors: Gary Arendash, Haitham Abulaban, Susan Steen, Ross Andel, Yanhong Wang, Yun Bai, Rob Baranowski, Jon McGarity, Lyle Scritsmier, Xiaoyang Lin, Ning Shen, Ali Aljassabi, Yitong Li, Chuanhai Cao
First page: 42
Abstract: Background: There is currently no therapeutic that can stop or reverse the progressive memory impairment of Alzheimer’s disease (AD). However, we recently published that 2 months of daily, in-home transcranial electromagnetic treatment (TEMT) reversed the cognitive impairment in eight mild/moderate AD subjects. These cognitive enhancements were accompanied by predicted changes in AD markers within both the blood and cerebrospinal fluid (CSF). Methods: In view of these encouraging findings, the initial clinical study was extended twice to encompass a period of 2½ years. The present study reports on the resulting long-term safety, cognitive assessments, and AD marker evaluations from the five subjects who received long-term treatment. Results: TEMT administration was completely safe over the 2½-year period, with no deleterious side effects. In six cognitive/functional tasks (including the ADAS-cog13, Rey AVLT, MMSE, and ADL), no decline in any measure occurred over this 2½-year period. Long-term TEMT induced reductions in the CSF levels of C-reactive protein, p-tau217, Aβ1-40, and Aβ1-42 while modulating CSF oligomeric Aβ levels. In the plasma, long-term TEMT modulated/rebalanced levels of both p-tau217 and total tau. Conclusions: Although only a limited number of AD patients were involved in this study, the results suggest that TEMT can stop the cognitive decline of AD over a period of at least 2½ years and can do so with no safety issues.
Citation: Medicines
PubDate: 2022-08-03
DOI: 10.3390/medicines9080042
Issue No: Vol. 9, No. 8 (2022)
- Medicines, Vol. 9, Pages 43: Rare Heterogeneous Adverse Events Associated
with mRNA-Based COVID-19 Vaccines: A Systematic Review
Authors: Rana I. Oueijan, Olivia R. Hill, Peter D. Ahiawodzi, Pius S. Fasinu, Dorothea K. Thompson
First page: 43
Abstract: Background: Since the successful development, approval, and administration of vaccines against SARS-CoV-2, the causative agent of COVID-19, there have been reports in the published literature, passive surveillance systems, and other pharmacovigilance platforms of a broad spectrum of adverse events following COVID-19 vaccination. A comprehensive review of the more serious adverse events associated with the Pfizer-BioNTech and Moderna mRNA vaccines is warranted, given the massive number of vaccine doses administered worldwide and the novel mechanism of action of these mRNA vaccines in the healthcare industry. Methods: A systematic review of the literature was conducted to identify relevant studies that have reported mRNA COVID-19 vaccine-related adverse events. Results: Serious and severe adverse events following mRNA COVID-19 vaccinations are rare. While a definitive causal relationship was not established in most cases, important adverse events associated with post-vaccination included rare and non-fatal myocarditis and pericarditis in younger vaccine recipients, thrombocytopenia, neurological effects such as seizures and orofacial events, skin reactions, and allergic hypersensitivities. Conclusions: As a relatively new set of vaccines already administered to billions of people, COVID-19 mRNA-based vaccines are generally safe and efficacious. Further studies on long-term adverse events and other unpredictable reactions in close proximity to mRNA vaccination are required.
Citation: Medicines
PubDate: 2022-08-11
DOI: 10.3390/medicines9080043
Issue No: Vol. 9, No. 8 (2022)
- Medicines, Vol. 9, Pages 44: Ashi Scalp Acupuncture in the Treatment of
Secondary Trigeminal Neuralgia Induced by Multiple Sclerosis: A Case
Report
Authors: Qiong Schürer, Hamdy Shaban, Andreas R. Gantenbein, Giada Todeschini, Saroj K. Pradhan
First page: 44
Abstract: Background: Multiple sclerosis (MS) is an autoimmune, chronic, inflammatory, demyelinating, and axonal degeneration disease of the central nervous system. Trigeminal neuralgia (TN), a neuropathic facial paroxysmal pain, is prevalent among MS patients. Because of the inadequacy of the comprehension of MS-related TN pathophysiological mechanisms, TN remains arduous in its treatment approaches. Acupuncture as a non-pharmacological therapy could be a promising complementary therapy for the treatment of TN. MS gradual neural damage might affect the muscles’ function. This can lead to acute or paroxysmal pain in the form of spasms that might progress to formation of myofascial trigger points also known in traditional Chinese medicine as Ashi points (AP). Localising these AP through palpation and pain sensation feedback in patients with MS is an indicator of disease progression. Pathologically, these points reveal the disharmony of soft tissue and internal organs. Methods: This case report examined the pain relief outcome with Ashi scalp acupuncture (ASA) in a secondary TN patient who was unsuccessfully treated multiple times with body acupuncture. The main outline measure was to quantify pain intensity using a numerical rating scale (NRS) before and after each acupuncture therapy. The patient was treated on the scalp for a total of eight times, twice a week over four weeks. Results: A reduction in secondary TN pain intensity was observed after each session. On average, the patient expressed severe pain (NRS: 8.0 ± 2.20) before ASA treatment, which significantly decreased after therapy to mild pain (NRS: 2.0 ± 1.64). Conclusions: Significant improvements in pain intensity reduction after each acupuncture treatment without any adverse effects were observed.
Citation: Medicines
PubDate: 2022-08-12
DOI: 10.3390/medicines9080044
Issue No: Vol. 9, No. 8 (2022)
- Medicines, Vol. 9, Pages 38: Obesity and Frailty Syndrome in the Elderly:
Prospective Study in Primary Care
Authors: Abrar-Ahmad Zulfiqur, Perla Habchi, Ibrahima Amadou Dembele
First page: 38
Abstract: Background: Obesity is a chronic pathology that affects people of all ages, from infants to the elderly, residing in both developed and developing countries. Objective: Our aim is to study the link between obesity and frailty in the elderly. Method: A prospective study was carried out in 12 General Medicine practices in Champagne-Ardenne, in the Departments of Marne and the Ardennes, France, for a period of 12 months (from 2 May 2019 through 30 April 2020). All patients included were aged 65 or older, in consultation with a general practitioner, and had an ADL (Activity of Daily Living) greater than or equal to 4. Frailty was measured using the Fried scale and the simplified ZULFIQAR frailty scale. Results: 268 patients aged 65 and over were included, with an average age of 77.5 years. A total of 100 were obese according to BMI. The mean Fried (/5) in the series was 1.57, and the mean sZFS (/5) was 0,91. Our study shows that obesity is not significantly correlated with frailty according to the FRIED sarcopenic scale, but is significantly correlated with frailty according to the sZFS scale. Conclusions: The link between obesity and frailty remains much debated, with the underlying emergence of sarcopenic obesity equally prevalent among the elderly. This is a preliminary study that should be followed by large-scale outpatient studies to better clarify the links between sarcopenia and obesity.
Citation: Medicines
PubDate: 2022-06-24
DOI: 10.3390/medicines9070038
Issue No: Vol. 9, No. 7 (2022)
- Medicines, Vol. 9, Pages 39: Leptomeningeal Carcinomatosis in a Patient
with Pancreatic Cancer: A Rare Phenomenon'
Authors: Taichi Sayanagi, Yumiko Ohishi, Makoto Katayama, Ryota Tamura
First page: 39
Abstract: Complication of leptomeningeal carcinomatosis (LMC) is critical. It causes rapid neurological deterioration, and subsequently, discontinuation of the ineffective treatment even in body tumor dormancy. Large molecular chemotherapeutic agents that are unlikely to penetrate the CSF space, are more likely to not treat LMC, typically in chemo-sensitive tumors. With the introduction of novel regimens, significant advances in overall survival have been observed even in formerly chemo-resistant tumors, such as pancreatic cancer. Although such cases are still rare, the number of pancreatic cancer patients complicated with LMC are increasing, and this therefore needs more recognition. A 49-year-old woman was diagnosed with stage IVa pancreatic cancer. She underwent surgery, and subsequent adjuvant chemotherapy. After three lines of chemotherapy over a 3-year period, where the body disease remained dormant, the patient was complicated by LMC. The diagnosis was made 4 months after the onset of headache. The patient received intrathecal methotrexate treatment but succumbed shortly after treatment induction. Pancreatic cancer is still relatively chemo-resistant and is one of the least likely types of tumor to be complicated by LMC due to patients dying of the primary tumor. Advancements in treatments have led to a prolonged period of primary tumor control, but not in the CNS due to the poor penetration of chemo-agents to this site. The present case seems to be a typical result of modern era anti-cancer therapy. Therefore, we emphasize the necessity of earlier recognition of this complication so that we can initiate specific treatment targeting the CSF space, especially in this formerly chemo-resistant tumor in order to improve its prognosis.
Citation: Medicines
PubDate: 2022-07-12
DOI: 10.3390/medicines9070039
Issue No: Vol. 9, No. 7 (2022)
- Medicines, Vol. 9, Pages 40: Associations between Workers’ Health
and Working Conditions: Would the Physical and Mental Health of Nonregular
Employees Improve If Their Income Was Adjusted'
Authors: Mariko Nishikitani, Mutsuhiro Nakao, Mariko Inoue, Shinobu Tsurugano, Eiji Yano
First page: 40
Abstract: Precarious employment can negatively affect health, but workers may be healthy if they earn enough income. This study uses equivalent disposable income and examines the interaction between income classes and employment types to clarify whether workers’ health improves as the income classes rise. In Japan, nonstandard workers, called nonregular employees, have remained high since 2013. Therefore, using data from the national cross-sectional Comprehensive Survey of Living Conditions 2013, an official survey performed in Japan, we targeted a sample of employees aged 18 to 45 who graduated during the economic recession. Our final sample included 8282 employees (4444 males and 3838 females). The health (general and mental) status indicators used the dichotomized self-rated health and scores of the K6 questionnaires scored in the national survey. The association between income and health was almost proportional. Female workers tended to improve their health as their income class increased; however, this tendency was not observed in male workers, especially nonregular employees. Although the associations were weakened by added income information on the regression models, nonregular employees always showed inferior health to regular employees. The health status of nonregular employees, especially female nonregular employees, is statistically significantly lower than that of regular employees, even when the economic class is similar. In conclusion, improving low incomes for nonregular employees could improve health challenges, but income alone may not result in the same health status for regular and nonregular employees.
Citation: Medicines
PubDate: 2022-07-14
DOI: 10.3390/medicines9070040
Issue No: Vol. 9, No. 7 (2022)
- Medicines, Vol. 9, Pages 34: Glycobiology of Cancer: Sugar Drives the Show
Authors: Jhenifer Santos dos Reis, Marcos André Rodrigues da Costa Santos, Daniella Pereira Mendonça, Stefani Ingrid Martins do Nascimento, Pedro Marçal Barcelos, Rafaela Gomes Correia de Lima, Kelli Monteiro da Costa, Celio Geraldo Freire-de-Lima, Alexandre Morrot, Jose Osvaldo Previato, Lucia Mendonça Previato, Leonardo Marques da Fonseca, Leonardo Freire-de-Lima
First page: 34
Abstract: Cancer development and progression is associated with aberrant changes in cellular glycosylation. Cells expressing altered glycan-structures are recognized by cells of the immune system, favoring the induction of inhibitory immune processes which subsequently promote tumor growth and spreading. Here, we discuss about the importance of glycobiology in modern medicine, taking into account the impact of altered glycan structures expressed in cancer cells as potential glycobiomarkers of disease, as well as on cancer development and progression.
Citation: Medicines
PubDate: 2022-05-24
DOI: 10.3390/medicines9060034
Issue No: Vol. 9, No. 6 (2022)
- Medicines, Vol. 9, Pages 35: Dichloroacetyl Amides of
3,5-Bis(benzylidene)-4-piperidones Displaying Greater Toxicity to
Neoplasms than to Non-Malignant Cells
Authors: Mohammad Hossain, Praveen K. Roayapalley, Hiroshi Sakagami, Keitaro Satoh, Kenjiro Bandow, Umashankar Das, Jonathan R. Dimmock
First page: 35
Abstract: A series of 3,5-bis(benzylidene)-1-dichloroacetyl-4-piperidones 1a–l was evaluated against Ca9-22, HSC-2, HSC-3, and HSC-4 squamous cell carcinomas. Virtually all of the compounds displayed potent cytotoxicity, with 83% of the CC50 values being submicromolar and several CC50 values being in the double digit nanomolar range. The compounds were appreciably less toxic to human HGF, HPLF, and HPC non-malignant cells, which led to some noteworthy selectivity index (SI) figures. From these studies, 1d,g,k emerged as the lead molecules in terms of their potencies and SI values. A Quantitative Structure-Activity Relationship (QSAR) study revealed that cytotoxic potencies and potency–selectivity expression figures increased when the magnitude of the sigma values in the aryl rings was elevated. The modes of action of the representative cytotoxins in Ca9-22 cells were found to include G2/M arrest and stimulation of the cells to undergo mitosis and cause poly(ADP-ribose) polymerase (PARP) and procaspase 3 cleavage.
Citation: Medicines
PubDate: 2022-06-08
DOI: 10.3390/medicines9060035
Issue No: Vol. 9, No. 6 (2022)
- Medicines, Vol. 9, Pages 36: Potential Role of Certain Biomarkers Such as
Vitamin B12, ROS, Albumin, as Early Predictors for Prognosis of COVID-19
Outcomes
Authors: Evgenia Lymperaki, Konstantina Kazeli, Georgia Variti, Magda Gerothanasi, Argyrios Gkinoudis, Ioannis Tsamesidis, Eleni Vagdatli
First page: 36
Abstract: COVID-19 disease is still a major global concern because of its morbidity and its mortality in severe disease. Certain biomarkers including Reactive Oxygen Species (ROS), vitamins, and trace elements are known to play a crucial role in the pathophysiology of the disease. The aim of our study was to evaluate how certain biomarkers, such as ROS, biochemical indicators, trace elements in serum blood of 139 COVID-19 hospitalized patients, and 60 non-COVID cases according to age and sex variations, can serve as the predictors for prognosis of COVID-19 outcome. An attempt of correlating these biomarkers with the severity of the disease as well as with each other is represented. All subjects were hospitalized from April 2021 until June 2021. A statistically significant increase of B12 levels (p = 0.0029) and ROS levels (p < 0.0001) as well as a decrease in albumin and Total Protein (T.P.) levels (p < 0.001) was observed especially in the early stage of the disease before CRP and ferritin elevation. Additionally, a statistically significant increase in ferritin (p = 0.007), B12 (p = 0.035, sALT p = 0.069, Glucose p = 0.012 and urea p = 0.096 and a decrease in Ca p = 0.005, T.P p = 0.052 albumin p = 0.046 between stage B (CRP values 6–30 mg/L) and C (CRP values 30–100 mg/L) was evident. Thus, this study concludes that clinicians could successfully employ biomarkers such as vitamin B12, ROS and albumin as possible prognosis tools for an early diagnosis. In addition, the total biochemical profile can assist in the understanding of the severity of COVID-19 disease, and could potentially lead to a better diet or early pharmaceutical treatment to prevent some of the more acute symptoms.
Citation: Medicines
PubDate: 2022-06-15
DOI: 10.3390/medicines9060036
Issue No: Vol. 9, No. 6 (2022)
- Medicines, Vol. 9, Pages 37: The Sweet Side of Fungal Infections:
Structural Glycan Diversity and Its Importance for Pathogenic Adaptation
Authors: Israel Diniz-Lima, Leonardo Marques da Fonseca, Jhenifer Santos dos Reis, Marcos André Rodrigues da Costa Santos, Kelli Monteiro da Costa, Carlos Antonio do Nascimento Santos, Pedro Marçal Barcelos, Kamila Guimarães-Pinto, Alessandra Almeida Filardy, Marco Edilson Freire-de-Lima, Debora Decote-Ricardo, Alexandre Morrot, Celio Geraldo Freire-de-Lima, Leonardo Freire-de-Lima
First page: 37
Abstract: Fungal infections are the most common secondary infections in debilitated individuals in a state of chronic disease or immunosuppression. Despite this, most fungal infections are neglected, mainly due to the lower frequency of their more severe clinical forms in immunocompetent individuals with a healthy background. However, over the past few years, several cases of severe fungal infections in healthy individuals have provoked a change in the epidemiological dynamics of fungal infections around the world, both due to recurrent outbreaks in previously infrequent regions and the greater emergence of more pathogenic fungal variants affecting healthy individuals, such as in the Cryptococcus genus. Therefore, before the arrival of a scenario of prevalent severe fungal infections, it is necessary to assess more carefully what are the real reasons for the increased incidence of fungal infection globally. What are the factors that are currently contributing to this new possible epidemiological dynamic' Could these be of a structural nature' Herein, we propose a discussion based on the importance of the virulence factors of glycoconjugate composition in the adaptation of pathogenic fungal species into the current scenario of increasing severity of these infections.
Citation: Medicines
PubDate: 2022-06-16
DOI: 10.3390/medicines9060037
Issue No: Vol. 9, No. 6 (2022)
- 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
2021
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 59: The Incidence and Risk Factors of Urinary
Tract Infection in Patients with Type 2 Diabetes Mellitus Using SGLT2
Inhibitors: A Real-World Observational Study
Authors: Uitrakul, Aksonnam, Srivichai, Wicheannarat, Incomenoy
First page: 59
Abstract: Background: The incidence and risk of urinary tract infection (UTI) in patients with type 2 diabetes mellitus (T2DM) who use sodium glucose co-transporter-2 (SGLT2) inhibitors are still controversial. Therefore, this study aimed to investigate the incidence and risk factors of using SGLT2 inhibitors, particularly in Thai patients. Methods: Electronic medication records of all patients, who started the treatment of T2DM between 1 January 2019 and 30 June 2021 at a tertiary hospital in Thailand, were reviewed. The patients were divided into SGLT2 inhibitor and non-SGLT2 inhibitor groups to compare the incidence of UTI. Results: The overall incidence rate of UTI was 33.49% in the SGLT2 inhibitor group and 11.72% in the non-SGLT2 inhibitor group. The incidence rates of UTI were not different between dapagliflozin and empagliflozin treatment (34.00% and 33.03%, respectively). Patients treated with SGLT2 inhibitors had a 3.70 higher risk of UTI compared with those treated with non-SGLT2 inhibitors (95%CI 2.60–5.29). Moreover, the significant risk factors for UTI found in this study were gender, age, and occupation. Conclusions: This study highlighted the high incidence of UTI in patients using dapagliflozin and empagliflozin compared with non-SGLT2 inhibitors. Additionally, patients of female gender and older age had a significantly higher risk of UTI when treated with SGLT2 inhibitors, whereas those with permanent jobs had a lower risk.
Citation: Medicines
PubDate: 2022-11-22
DOI: 10.3390/medicines9120059
Issue No: Vol. 9, No. 12 (2022)
- Medicines, Vol. 9, Pages 60: Group Medical Visits for Addressing Weight
and Blood Pressure in an Underserved Population
Authors: Amit Algotar, Stephanie Trofymenko, Myra Muramoto, Amy Howerter, Randa Kutob
First page: 60
Abstract: The effect of group medical visits (GMV) compared to individual medical visits (IMV), on weight and blood pressure in a large primary care practice serving a predominantly underserved population, was assessed. The records of 304 patients attending a weight-loss program were analyzed using mixed-effects regression models. Patients in GMV lost an average of 11.63 lbs, whereas patients in IMV lost an average of 3.99 lbs (p < 0.001). A total of 55% of patients lost ≥7% in GMV compared to 11% of patients in IMV (p ≤ 0.001). Individuals who lost >5% of their baseline weight had a higher reduction in overall blood pressure. For systolic and diastolic blood pressure, the differences between baseline and three months for GMV and IMV were −7.4 vs. 4.1 mm of Hg (p = 0.002) and −4.6 vs. 4.2 mm of Hg (p = 0.003), respectively. Results from this study demonstrate that GMV may be a potentially useful modality for addressing weight and blood pressure in an underserved population.
Citation: Medicines
PubDate: 2022-12-01
DOI: 10.3390/medicines9120060
Issue No: Vol. 9, No. 12 (2022)
- Medicines, Vol. 9, Pages 61: Salvage of Hindfoot Charcot with
Osteomyelitis and Ulceration: A Case Report
Authors: Khalid Hasan, Sreenivasulu Metikala, Madana Mohana R. Vallem
First page: 61
Abstract: Diabetic Charcot arthropathy of the ankle, due to the presence of multiplanar deformities, and associated medical comorbidities, poses a challenge for treating physicians. The situation becomes more complicated when accompanied by ulceration and osteomyelitis, leaving limited salvage options. We present a case of advanced Charcot ankle arthropathy with osteomyelitis and ulcerated hindfoot. It was managed by talectomy and antibiotic-impregnated cement beads, followed by hindfoot arthrodesis using a retrograde intramedullary nail six weeks later. This two-stage reconstruction approach resulted in an ulcer-free, stable, plantigrade foot at one-year postoperative follow-up.
Citation: Medicines
PubDate: 2022-12-02
DOI: 10.3390/medicines9120061
Issue No: Vol. 9, No. 12 (2022)
- Medicines, Vol. 9, Pages 62: Antimicrobial and Toxic Effects of Boswellia
serrata Roxb. and Mentha piperita Linn. Essential Oils on Vaginal
Inhabitants
Authors: Mirjana A. Bogavac, Tamara M. Perić, Jovana Mišković, Maja Karaman
First page: 62
Abstract: Commercial essential oils (EOs) of incense, Boswellia serrata Roxb, and mint, Mentha piperita L., were investigated against vaginal bacterial and Candida albicans isolates for antimicrobial potential and safety use. The antimicrobial activity of EOs was investigated through a double-dilution micro-plate assay. A brine shrimp assay was used for the determination of toxicity, while the determination of the chemical composition of EOs was carried out using GS–MS. Obtained minimal inhibitory (MIC) and minimal bactericidal concentration (MBC) point to the activity of mint essential oil (EO) against the multi-resistant P. aeruginosa isolate (MIC/MBC at 6.25 µL/mL), while MIC and MBC values for other isolates were reached at higher concentrations (25–50 µL/mL). According to the toxicity assay, the incense EO reached the LC50 value at 3.07 µL/mL, while mint EO showed higher toxicity at lower concentrations (0.5 µL/mL) and the LC50 could not be determined. The highest antimicrobial potential was obtained for incense against P. aeruginosa. Although the toxicity assay showed high toxicity of mint EO to the eggs of aquatic crustaceans Artemia salina, further testing of EO toxicity is proposed, for example on healthy cell-lines. According to the GC/MS spectrometry, the most represented components of mint EO were the oxygenated hydrocarbons L-menthone (20.86%) and menthol (31.86%), and they could be proposed for further antimicrobial and toxicity investigation.
Citation: Medicines
PubDate: 2022-12-09
DOI: 10.3390/medicines9120062
Issue No: Vol. 9, No. 12 (2022)
- Medicines, Vol. 9, Pages 63: Post-Traumatic-Related Technical Errors in
Orthopantomographic Imaging
Authors: Oana Almășan, Raluca Ancuța Roman, Mihaela Hedeşiu, Simion Bran, Sara Roman, Bianca Petric, Cristian Dinu
First page: 63
Abstract: Background: This study aimed at identifying errors encountered in orthopantomography (OPG) in post-traumatic patients caused by limitations in performing a correct technique. Methods: A retrospective observational study was performed. Diagnosis, exposure/processing mistakes, positioning-related errors, and bimaxillary immobilization were evaluated. Results: Thirty panoramic radiographs with mandible fractures were examined. Twelve error types were encountered: errors in exposure or processing, air radiolucency in the palatoglossal space, errors in the alignment of the Frankfort horizontal plane: head in flexion, with a joyful expression or head extended, with a somber appearance, errors towards the mid-sagittal plane (lateral head inclination, deviation, or rotation), errors caused by the non-use of the bite-block or inappropriate position on the device, errors caused by positioning outside the focal plane, artifacts/shadow images produced by post-operative metal plates, and bimaxillary immobilization errors. The number of errors per radiograph ranged from two to a maximum of five. The most dominant ones were inappropriate alignment in the focal plane and lateral rotation of the head in over 70% of cases. Lateral deviation and palatoglossal air were present in more than 50% of images. Conclusions: In trauma cases, technical difficulties in obtaining a proper OPG image are common and often insurmountable, limiting the diagnosis.
Citation: Medicines
PubDate: 2022-12-09
DOI: 10.3390/medicines9120063
Issue No: Vol. 9, No. 12 (2022)
- Medicines, Vol. 9, Pages 64: Breast Reconstruction: Economic Impact Swiss
Health Insurance System
Authors: Jeanne Martin, Pietro G. di Summa, Wassim Raffoul, Nathalie Koch
First page: 64
Abstract: Background: Considering present concerns about healthcare costs and the lack of evidence and published articles on breast reconstruction costs in Switzerland, we retrospectively investigated charges to the Swiss healthcare system for different breast reconstruction procedures at the Centre Hospitalier Universitaire Vaudois. Methods: We selected all hospitalized patients at the University Hospital who underwent a “total” delayed breast reconstruction from January 2012 to December 2015. Analysis included 72 women who underwent autologous or implant-based reconstructions. Three main breast reconstruction techniques were included: Deep Inferior Epigastric Perforator (n = 46) autologous flap reconstruction, Tissue Expander followed by Implant (n = 12) and pedicled Latissimus Dorsi (n = 12) flap with or without tissue expander and implant (n = 7). For all different groups, the global costs of reconstruction and total number of required operations were statistically compared. Results: Global costs for Deep Inferior Epigastric Perforator reconstruction were 29,728 ± 1892 CHF (avg ± Std. Error of Mean), while Tissue Expander reconstruction showed a significantly higher global cost, reaching an average of 44,313 ± 5553 CHF (avg ± Std. Error of Mean). LD showed a similar cost, compared to the Deep Inferior Epigastric Perforator reconstruction (29,813 ± 3637 CHF), increasing when including an implant (37,688 ± 4840 CHF). No significant differences in the number of interventions were detected. Conclusion: These data show that autologous breast reconstruction (DIEP) delivers the best cost ratio, with lower overall costs. Implant-based reconstructions showed a greater likelihood of complications and re-intervention, globally creating superior costs when compared to autologous reconstructions.
Citation: Medicines
PubDate: 2022-12-16
DOI: 10.3390/medicines9120064
Issue No: Vol. 9, No. 12 (2022)
- Medicines, Vol. 9, Pages 52: Deep Vein Thrombosis of the Left Lower Limb
in a Sudanese Child with Sickle Cell Disease
Authors: Alam Eldin Musa Mustafa, Niemat Mohammed Tahir, Nur Allah Elnaji Ahmed Mohamed, Adil Abdullah Mohammed, Sara Ismail Mohammed
First page: 52
Abstract: This is a case of an eleven-year-old female Sudanese child, a known Sickle Cell Anemia (SCA) patient, who presented with fever, as well as left thigh and leg swelling that was associated with pain and warmness, which was diagnosed as Deep Vein Thrombosis (DVT) of her left lower limb. She had a previous history of admissions to the emergency room, during which she once received blood. The patient was managed by carrying out a basic routine initial laboratory investigation. A Doppler ultrasound scan showed features consistent with DVT. Based on the clinical findings and investigation results, management began by providing the patient with intravenous fluid, analgesia, packed Red Blood Cells (RBCs), intravenous antibiotics, and low-molecular-weight heparin. Further consultations showed that there was no need for vascular surgery or surgical intervention. This case highlights the need for more studies on DVT and Venous Thromboembolism (VTE) complications in children with SCA, so as to develop strategies for diagnosis and management in order to reduce the risk of life-threatening complications of VTE in patients with Sickle Cell Disease SCD.
Citation: Medicines
PubDate: 2022-10-22
DOI: 10.3390/medicines9110052
Issue No: Vol. 9, No. 11 (2022)
- Medicines, Vol. 9, Pages 53: Current Denture Loss in Geriatric Facilities
Authors: Miki Endo, Nami Nakayama, Miki Yamada, Yosuke Iijima, Shunsuke Hino, Kiyoko Ariya, Norio Horie, Takahiro Kaneko
First page: 53
Abstract: Purpose: Denture loss is still being reported as a problem in geriatric facilities, although losses seem less frequent than in the last decade. However, there have been no reports that have examined recent losses of dentures in detail. The aim of this study was to clarify the actual situation of recent denture loss, together with the denture loss rate in Japan. Materials and methods: This retrospective study investigated the number of cases of denture loss, the denture loss rate for denture wearers, and the details of losses in geriatric facilities during the 1-year period from 1 April 2020 to 31 March 2021. Results: Eleven special elderly nursing homes and four group homes participated in this research. The number of residents from each was 315 and 40 and the number of denture wearers was 165 and 33, respectively (p < 0.001). The loss of dentures was found in one case from a special elderly nursing home and in one case from a group home. The loss rate for denture wearers was 1.01% in total, with 0.61% for special elderly nursing homes and 3.03% for group homes, with no significant differences between the two types of facilities. Conclusion: In geriatric facilities in Japan, the current 1-year denture loss rate for denture wearers was 1.01%. This seems to represent a considerable decrease when compared with the previous report. Further, proper denture management and staff efforts appear to have contributed to a reduction in denture loss against a background of promoting oral healthcare.
Citation: Medicines
PubDate: 2022-10-26
DOI: 10.3390/medicines9110053
Issue No: Vol. 9, No. 11 (2022)
- Medicines, Vol. 9, Pages 54: Postpartum Spinal Cord Infarction: A Case
Report and Review of the Literature
Authors: Jung-Lung Hsu, Shy-Chyi Chin, Ming-Huei Cheng, Yih-Ru Wu, Aileen Ro, Long-Sun Ro
First page: 54
Abstract: Background: Postpartum spinal cord infarction is a very rare disease. Only two cases have been reported in the English literature. Methods: We reported a 26 year old female who received second doses of the mRNA-1273 vaccine 52 days before delivery. She presented as sudden onset of paraplegia, sensory level, and sphincter incontinence at postpartum period. No history of heparin exposure was noted. Imaging findings confirmed the T10-11 level infarction and her anti–human heparin platelet factor 4 (anti-PF4) antibody was positive. After 7 days of dexamethasone therapy, her paraplegia and urinary incontinence gradually improved. Results: The CT angiography (CTA) of the artery of Adamkiewicz (Aka) showed tandem narrowing, most conspicuous at the T10-11 level, which was presumably due to partial occlusion of the arteriolar lumen. The thoracolumbar spine magnetic resonance imaging with contrast medium showed owl’s eyes sign at the T10 and T11 levels. We compared our case with two other case reports from the literature. Conclusions: Post-partum spinal cord infarction with positive anti-PF4 antibody and relatively thrombocytopenia are the characteristics of our case.
Citation: Medicines
PubDate: 2022-10-31
DOI: 10.3390/medicines9110054
Issue No: Vol. 9, No. 11 (2022)
- Medicines, Vol. 9, Pages 55: Estimating Worldwide Impact of Low Physical
Activity on Risk of Developing Ischemic Heart Disease-Related Disability:
An Updated Search in the 2019 Global Health Data Exchange (GHDx)
Authors: Giuseppe Lippi, Fabian Sanchis-Gomar, Camilla Mattiuzzi, Carl J. Lavie
First page: 55
Abstract: We provide here updated analysis of the impact of physical inactivity on risk of developing ischemic heart disease (IHD)-related disability along with the latest 10-year progression. We collected data through an electronic search in the 2019 Global Health Data Exchange (GHDx) database using the keywords “low physical activity”, complemented with the additional epidemiologic variables “disability-adjusted life years” (DALYs; number); “ischemic heart disease”; “socio-demographic index” (SDI); “age”; “sex” and “year”, for calculating volume of DALYs lost due to physical activity (PA)-related disability after IHD (LPA-IHD impairment). Based on this search, the overall LPA-IHD impairment was estimated at 7.6 million DALYs in 2019 (3.9 and 3.7 million DALYs in males and females, respectively), thus representing nearly 50% of all PA-related disabilities. The highest impact of LPA-IHD impairment was observed in middle SDI countries, being the lowest in low SDI countries. The LPA-IHD DALYs increased by 17.5% in both sexes during the past 10 years (19.2% in males, and 15.8% in females, respectively), though this trend was dissimilar among different SDI areas, especially during the past two years. In high and high–middle SDI countries, the LPA-IHD grew during the past 2 years, whilst the trend remained stable or declined in other regions. In conclusion, LPA-IHD impairment remains substantial worldwide, leading the way to reinforce current policies aimed at increasing PA volume in the population.
Citation: Medicines
PubDate: 2022-11-03
DOI: 10.3390/medicines9110055
Issue No: Vol. 9, No. 11 (2022)
- Medicines, Vol. 9, Pages 56: Antidiabetic Actions of Ethanol Extract of
Camellia sinensis Leaf Ameliorates Insulin Secretion, Inhibits the DPP-IV
Enzyme, Improves Glucose Tolerance, and Increases Active GLP-1
(7–36) Levels in High-Fat-Diet-Fed Rats
Authors: Prawej Ansari, J. M. A. Hannan, Samara T. Choudhury, Sara S. Islam, Abdullah Talukder, Veronique Seidel, Yasser H. A. Abdel-Wahab
First page: 56
Abstract: Camellia sinensis (green tea) is used in traditional medicine to treat a wide range of ailments. In the present study, the insulin-releasing and glucose-lowering effects of the ethanol extract of Camellia sinensis (EECS), along with molecular mechanism/s of action, were investigated in vitro and in vivo. The insulin secretion was measured using clonal pancreatic BRIN BD11 β cells, and mouse islets. In vitro models examined the additional glucose-lowering properties of EECS, and 3T3L1 adipocytes were used to assess glucose uptake and insulin action. Non-toxic doses of EECS increased insulin secretion in a concentration-dependent manner, and this regulatory effect was similar to that of glucagon-like peptide 1 (GLP-1). The insulin release was further enhanced when combined with isobutylmethylxanthine (IBMX), tolbutamide or 30 mM KCl, but was decreased in the presence of verapamil, diazoxide and Ca2+ chelation. EECS also depolarized the β-cell membrane and elevated intracellular Ca2+, suggesting the involvement of a KATP-dependent pathway. Furthermore, EECS increased glucose uptake and insulin action in 3T3-L1 cells and inhibited dipeptidyl peptidase IV (DPP-IV) enzyme activity, starch digestion and protein glycation in vitro. Oral administration of EECS improved glucose tolerance and plasma insulin as well as inhibited plasma DPP-IV and increased active GLP-1 (7–36) levels in high-fat-diet-fed rats. Flavonoids and other phytochemicals present in EECS could be responsible for these effects. Further research on the mechanism of action of EECS compounds could lead to the development of cost-effective treatments for type 2 diabetes.
Citation: Medicines
PubDate: 2022-11-11
DOI: 10.3390/medicines9110056
Issue No: Vol. 9, No. 11 (2022)
- Medicines, Vol. 9, Pages 57: The Role of Equilibrium between Free Radicals
and Antioxidants in Depression and Bipolar Disorder
Authors: Kotzaeroglou, Tsamesidis
First page: 57
Abstract: Background: Increasing evidence suggests that the presence of oxidative stress and disorders of the antioxidant defense system are involved in a wide range of neuropsychiatric disorders, such as bipolar disorder, schizophrenia and major depression, but the exact mechanism remains unknown. This review focuses on a better appreciation of the contribution of oxidative stress to depression and bipolar disorder. Methods: This review was conducted by extracting information from other research and review studies, as well as other meta-analyses, using two search engines, PubMed and Google Scholar. Results: As far as depression is concerned, there is agreement among researchers on the association between oxidative stress and antioxidants. In bipolar disorder, however, most of them observe strong lipid peroxidation in patients, while regarding antioxidant levels, opinions are divided. Nevertheless, in recent years, it seems that on depression, there are mainly meta-analyses and reviews, rather than research studies, unlike on bipolar disorder. Conclusions: Undoubtedly, this review shows that there is an association among oxidative stress, free radicals and antioxidants in both mental disorders, but further research should be performed on the exact role of oxidative stress in the pathophysiology of these diseases.
Citation: Medicines
PubDate: 2022-11-14
DOI: 10.3390/medicines9110057
Issue No: Vol. 9, No. 11 (2022)
- Medicines, Vol. 9, Pages 58: Zulfiqar Frailty Scale (ZFS): Concordance
Study with the Clinical Frailty Scale (CFS)
Authors: Abrar-Ahmad Zulfiqar, Léo Martin, Perla Habchi, Delwende Noaga Damien Massimbo, Ibrahima Amadou Dembele, Emmanuel Andres
First page: 58
Abstract: Introduction: We designed a new scale for the rapid detection of frailty for use in primary care, referred to as the Zulfiqar Frailty Scale (ZFS). Objective: To evaluate the performance of the “ZFS” tool to screen for frailty as defined in the Clinical Frailty Scale (CFS) criteria in an ambulatory population of patients at least 75 years old. Method: A prospective study conducted in Alsace, France, for a duration of 6 months that included patients aged 75 and over was judged to be autonomous with an ADL (Activity of Daily Living) >4/6. Results: In this ambulatory population of 124 patients with an average age of 79 years, the completion time for our scale was less than two minutes, and the staff required no training beforehand. Sensibility was 67%, while specificity was 87%. The positive predictive value was 80%, and the negative predictive value was 77%. The Youden index was 59.8%. In our study, we have a moderate correlation between CFS and ZFS (r = 0.674 with 95%CI = [0.565; 0.760]; p-value < 2.2 × 10−16 < 0.05). The Pearson correlations between these two geriatric scores were all strong and roughly equivalent to each other. The kappa of Cohen (k) = 0.46 (Unweighted), moderate concordance between the ZFS and CFS scales according to Fleiss classification. Conclusion: The “ZFS” tool makes it possible to screen for frailty with a high level of specificity and positive/negative predictive value.
Citation: Medicines
PubDate: 2022-11-18
DOI: 10.3390/medicines9110058
Issue No: Vol. 9, No. 11 (2022)
- Medicines, Vol. 9, Pages 48: Association of Frailty Status with Risk of
Fall among Hospitalized Elderly Patients: A Cross-Sectional Study in an
Acute Geriatric Unit
Authors: Abrar-Ahmad Zulfiqar, Perla Habchi, Ibrahima Amadou Dembele, Emmanuel Andres
First page: 48
Abstract: Introduction: The objective was to study the association of frailty status in hospitalized elderly patients with risk of fall in an acute geriatric unit and to characterize elderly “fallers” using a comprehensive gerontological assessment. Patients and Methods: A cross-sectional study was conducted in patients over 65 years of age and hospitalized in an acute geriatric unit. This work was carried out in the Acute Geriatric Medicine Unit, Saint-Julien Hospital, Center Hospitalier Universitaire de Rouen from 1 June 2016 to 15 August 2016. Results: 172 patients were included during the collection period, with a female predominance of 115 patients (66.9%). The average age of the sample was 79.37 years old (65–85). The average CHARLSON score was 6.93 (3–16). Patients came from home in 81.4% of cases (i.e., 140 patients), and from a nursing home in 18.6% of cases (i.e., 32 patients). The risk of falling, as assessed by the Monopodal Support Test, returned as abnormal for 127 patients. In our series, there was a statistically strong link between the risk of falling and the presence of a dementia pathology (p = 0.009), the presence of a vitamin D deficiency (p = 0.03), the presence of frailty, as assessed by the three scales (modified SEGA scale, Fried scale and CFS/7 (<0.001), a high comorbidity score (p = 0.04), and a disturbed autonomy assessment according to IADL (p = 1.02 × 10−5) and according to ADL (p = 6.4 × 10−8). There was a statistically strong link between the risk of falling and the occurrence of death (p = 0.01). Conclusion: The consequences of the fall in terms of morbidity and mortality and the frequency of this event with advancing age and its impact on the quality of life as well as on health expenditure justify a systematic identification of the risk of falling in the elderly population. It is therefore important to have sensitive, specific, and reproducible tools available for identifying elderly people at high risk of falling.
Citation: Medicines
PubDate: 2022-09-20
DOI: 10.3390/medicines9100048
Issue No: Vol. 9, No. 10 (2022)
- Medicines, Vol. 9, Pages 49: Osteopathic Manipulative Treatment Decreases
Hospital Stay and Healthcare Cost in the Neonatal Intensive Care Unit
Authors: Hannah Roland, Amanda Brown, Amy Rousselot, Natalie Freeman, J. Michael Wieting, Stephen Bergman, Debasis Mondal
First page: 49
Abstract: Osteopathic manipulative treatment (OMT) is used in both inpatient and outpatient settings. Evidence suggests that OMT can reduce both patients’ recovery time and the financial cost of their acute medical treatment and rehabilitation. Multiple studies from neonatal intensive care units (NICUs) are presented in this article that demonstrate infants treated with OMT recover faster, are discharged earlier, and have lower healthcare costs than their non-OMT-treated counterparts. Data clearly show that adjunctive OMT facilitates feeding coordination in newborns, such as latching, suckling, swallowing, and breathing, and increases long-term weight gain and maintenance, which reduces hospital length of stay (LOS). Osteopathic techniques, such as soft tissue manipulation, balanced ligamentous tension, myofascial release, and osteopathic cranial manipulation (OCM), can reduce regurgitation, vomiting, milky bilious, or bloody discharge and decrease the need for constipation treatment. OMT can also be effective in reducing the complications of pneumonia in premature babies. Studies show the use of OCM and lymphatic pump technique (LPT) reduces the occurrence of both aspiration and environmentally acquired pneumonia, resulting in significantly lower morbidity and mortality in infants. Based on published findings, it is determined that OMT is clinically effective, cost efficient, a less invasive alternative to surgery, and a less toxic choice to pharmacologic drugs. Therefore, routine incorporation of OMT in the NICU can be of great benefit in infants with multiple disorders. Future OMT research should aim to initiate clinical trial designs that include randomized controlled trials with larger cohorts of infants admitted to the NICU. Furthermore, a streamlined and concerted effort to elucidate the underlying molecular mechanisms associated with the beneficial effects of OMT will aid in understanding the significant value of incorporating OMT into optimal patient care.
Citation: Medicines
PubDate: 2022-09-21
DOI: 10.3390/medicines9100049
Issue No: Vol. 9, No. 10 (2022)
- Medicines, Vol. 9, Pages 50: Management of Salter–Harris Type 1
Fracture Complicated with Osteomyelitis in a Sickle Cell Disease Patient:
A Case Report and Review of Literature
Authors: Nnennaya U. Opara, Emmanuella C. Osuala, Ugochinyere I. Nwagbara
First page: 50
Abstract: Salter–Harris fractures may occur due to a single injury or repetitive stress fractures on the extremities. Type I to III fractures are managed medically, while types IV and V, which are rare, are treated surgically. In the pediatric population, Salter–Harris I fractures of the distal tibia are commonly seen, and management of such fractures are well established in the literature. Despite the availability of a wide range of treatment for such fractures, osteonecrosis or avascular necrosis of the proximal femur can subsequently develop. Avascular necrosis is cell death secondary to metabolic disturbances, trauma, adverse effects of certain medications, or sickle cell disease. Avascular necrosis commonly affects the talus, humerus, or tibia in addition to the femoral head. Radiographic images are essential for prompt diagnosis and to minimize negative health outcomes in these patients. However, Salter–Harris I fracture in sickle cell patients can be very challenging due to these patients’ vulnerability to bone infections and sickle cell crisis. In this case report, our patient with a history of sickle cell disease and with a diagnosis of Salter–Harris I fracture was treated with surgical intervention as type V, which is discussed in this article, and responded well to treatment. Thus, this case suggests a new approach to managing Salter–Harris I fractures complicated with osteomyelitis in sickle cell patients.
Citation: Medicines
PubDate: 2022-09-22
DOI: 10.3390/medicines9100050
Issue No: Vol. 9, No. 10 (2022)
- Medicines, Vol. 9, Pages 51: Physical Activity in the Elderly and Frailty
Syndrome: A Retrospective Study in Primary Care
Authors: Abrar-Ahmad Zulfiqar, Habib Habchi, Perla Habchi, Ibrahima Amadou Dembele, Emmanuel Andres
First page: 51
Abstract: Objectives: Physical activity carries numerous therapeutic benefits, and it is more effective when applied before the onset of symptoms. The objective of this study is to compare the correlation of the evaluation of physical activity carried out using the Ricci and Gagnon test and the frailty profile measured by the mSEGA scale in a population of patients consulting in general medicine. Methods: We conducted a retrospective study within a general practitioner clinic in Chaumont and Bologne (Haute-Marne department) during a 3-month period. Patients aged 65 years and up were screened for frailty using the modified SEGA (mSEGA) assessment, and physical activity was measured using the Ricci–Gagnon questionnaire. Results: A total of 44 patients were selected, with a slightly female predominance (59.1%). Of these, 21 patients reported having worked in manual labor. Seven patients were found to be frail using the SEGAm assessment, while 10 (22.73%) patients had an inactive profile according the Ricci–Gagnon score. Malnutrition was detected in six patients (13.64%) using the MNA survey. Frailty as defined by the mSEGA scale had no statistical correlation (p = 0.68) with the Ricci–Gagnon score. A Ricci–Gagnon inactive profile showed statistical correlations with fall indicators (unipedal balance test, p = 0.014) and malnutrition scores using the MNA (p = 0.0057) as well as with the Charlson Comorbidity Index (p = 0.027). Conclusion: A systematic survey of the elderly by a general practitioner implementing a regular and suitable physical activity regimen would allow a better screening of frailty, minimizing its complications.
Citation: Medicines
PubDate: 2022-10-11
DOI: 10.3390/medicines9100051
Issue No: Vol. 9, No. 10 (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,
Nigeria
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. 10, Pages 1: Breast Cancer and Women Veterans: What Is the
Impact of Mental Health on Screening Rates'
Authors: Prathibha, Westanmo, Hui, Westanmo, Gravely, Tuttle, LaRocca
First page: 1
Abstract: Background: The proportion of women Veterans are increasing and, as such, access to high-quality breast cancer care is important. Prior studies have shown that rural location, age, and a mental health diagnosis negatively impact breast cancer screening rates. Methods: We aimed to retrospectively assess the impact of these risk factors on breast cancer screening adherence rates among Veterans at our institution. Women who were eligible for breast cancer screening per the United States Preventative Services Taskforce guidelines were included. Results: Of 2321 women, overall adherence was 78.2%. There were no significant differences in screening rates between races, various age groups, geographical distribution, and having anxiety or post-traumatic stress disorder (PTSD). However, Veterans with a diagnosis of depression were more likely to adhere to screening guidelines. Having multiple mental health diagnoses was also not a negative risk factor. Conclusions: Our Veteran population’s adherence rates are higher than the national average and rural location, race, age, and certain mental health disorders did not negatively affect adherence to screening mammography. Though more research is needed, screening reminders from our women’s health coordinator may have improved adherence rates and lowered disparities.
Citation: Medicines
PubDate: 2022-12-20
DOI: 10.3390/medicines10010001
Issue No: Vol. 10, No. 1 (2022)
- Medicines, Vol. 10, Pages 2: The Influence of Human Factors Training in
Air Rescue Service on Patient Safety in Hospitals: Results of an Online
Survey
Authors: Christian von Rüden, Andre Ewers, Andreas Brand, Sven Hungerer, Christoph J. Erichsen, Philipp Dahlmann, Daniel Werner
First page: 2
Abstract: Background: Air rescue crew members work equally in aviation and medicine, and thus occupy an important interface between the two work environments of aviation and medicine. The aim of this study was to obtain responses from participants to a validated online-based questionnaire regarding whether hospitals may benefit from the commitment of a medical hospital staff which is also professionally involved in the aviation system as emergency physicians and Helicopter Emergency Medical Services Technical Crew Members (HEMS TC). Furthermore, it focused on the question of whether the skills acquired through Crew Resource Management (CRM) training in the air rescue service might also be used in the ground-based rescue service and, if so, whether they may have a positive effect. Methods: Medical air rescue staff of 37 German air rescue stations was included. Between 27 November 2020 and 03 March 2021, 253 out of 621 employees (response rate: 40.7%) participated voluntarily in a validated anonymized online survey. A quantitative test procedure was performed using the modified questionnaire on teamwork and patient safety (German version). Results: The examination and interpretation of the internal consistency (Cronbach’s alpha) resulted in the following reliabilities: Factor I (Cooperation): α = 0.707 (good); Factor II (Human factors): α = 0.853 (very good); Factor III (Communication): α = 0.657 (acceptable); and Factor IV (Safety): α = 0.620 (acceptable). Factor analysis explained 53.1% of the variance. Conclusions: The medical clinicians participating in this online survey believed that the skills they learned in human factors training such as CRM are helpful in their daily routine work in hospitals or other medical facilities, as well as in their ground-based rescue service activities. These findings may result in the recommendation to make CRM available on a regular to the medical staff in all medical facilities and also to ground-based rescue service staff aiming to increase patient safety and employee satisfaction.
Citation: Medicines
PubDate: 2022-12-22
DOI: 10.3390/medicines10010002
Issue No: Vol. 10, No. 1 (2022)
- Medicines, Vol. 10, Pages 3: Potential of Mesenchymal Stem Cells and Their
Secretomes in Decreasing Inflammation Markers in Polycystic Ovary Syndrome
Treatment: A Systematic Review
Authors: Gunawan Dwi Prayitno, Keri Lestari, Cynthia Retna Sartika, Tono Djuwantono, Andi Widjaya, R Muharam, Yudi Mulyana Hidayat, Dewi Wulandari, Rima Haifa, Nabilla Farah Naura, Kristin Talia Marbun, Annisah Zahrah
First page: 3
Abstract: Background: Polycystic ovary syndrome (PCOS) is a chronic disorder and is one of the most common endocrine disorders in women of a reproductive age. The prevalence of PCOS is growing globally; 52% of women in Southeast Asia alone suffer from this disorder. This disorder is caused by chronic hyperandrogenism, which hinders folliculogenesis. There is also a close relationship between hyperandrogenism and hyperinsulinemia/insulin resistance (IR), and it is estimated that 40–80% of PCOS patients suffer from insulin resistance (IR). Mesenchymal stem cells (MSCs) and their secretomes have been shown to alleviate PCOS symptoms by decreasing IR and androgen secretion by reducing inflammation. This study aimed to systematically review the literature to study the reported potential of MSCs and their secretomes in decreasing inflammation markers in PCOS treatment. Methods: A systematic literature search was performed on EMBASE, PubMed (MEDLINE), and the Cochrane Library with the terms insulin-resistant PCOS, mesenchymal stem cells, and secretome or conditioned medium as the search keywords. A total of 317 articles were reviewed. Four articles were identified as relevant for this systematic review. Results: The results of this study supported the use of mesenchymal stem cells and their secretions in decreasing inflammatory markers in the treatment of polycystic ovary syndrome. Conclusions: This review provided evidence that treatment with mesenchymal stem cells and their secretomes has the potential to treat PCOS due to its ability to downregulate androgen levels and increase insulin sensitivity, which thereby lowers the level of proinflammatory factors.
Citation: Medicines
PubDate: 2022-12-23
DOI: 10.3390/medicines10010003
Issue No: Vol. 10, No. 1 (2022)
- Medicines, Vol. 10, Pages 4: DNA Damage as a Mechanistic Link between Air
Pollution and Obesity'
Authors: Abdelaziz Ghanemi, Mayumi Yoshioka, Jonny St-Amand
First page: 4
Abstract: It has been shown that the risk of developing obesity, a serious modern health problem, increases with air pollution. However, the molecular links are yet to be fully elucidated. Herein, we propose a hypothesis via which air pollution-induced DNA damage would be the mechanistic link between air pollution and the enhanced risk of obesity and overweight. Indeed, whereas air pollution leads to DNA damage, DNA damage results in inflammation, oxidative stress and metabolic impairments that could be behind energy balance changes contributing to obesity. Such thoughts, worth exploring, seems an important starting point to better understand the impact of air pollution on obesity development independently from the two main energy balance pillars that are diet and physical activity. This could possibly lead to new applications both for therapies as well as for policies and regulations.
Citation: Medicines
PubDate: 2022-12-29
DOI: 10.3390/medicines10010004
Issue No: Vol. 10, No. 1 (2022)
- Medicines, Vol. 10, Pages 5: Use of Traditional Mongolian Medicine in
Children with Concussion
Authors: Orgilbayar Ganbat, Oyuntugs Byambasukh, Tserendagva Dalkh, Byambasuren Dagvajantsan
First page: 5
Abstract: (1) Background: There is no specific treatment for concussion in modern medicine, and existing treatment is only limited to resting and restoring cognition. For centuries, Mongolians have used traditional Mongolian medicine (TMM) methods to treat a variety of diseases such as Baria zasal. In this study, we aimed to explore the treatment parents and guardians seek when their children have suffered a concussion. (2) Methods: In this study, we used an online questionnaire. The study participants (n = 400) were randomly selected parents and guardians. The definition of bariachi is an advanced practitioner of baria zasal, which covers most of the massage therapy techniques mentioned in this study. (3) Results: In total, 72% of the parents and guardians went to a bariachi when their children suffered a concussion, while only 10.3% chose western medical hospitals. When asked what they did after the initial treatment was not effective, 47.8% of the participants responded that they went to the bariachi. Based on the days of treatment result, 11.8% reported on the beneficial effects of the treatment appearing in one day, and 60.3% in 1–3 days, which shows that the participants suffered a healing effect of the baria zasal shortly after application to their children. In the regression analysis, visiting a Bariachi was independent of age, gender, or even religion. (4) Conclusions: Although Western medicine is highly developed in Mongolia, the baria zasal of TMM has not lost its appeal in treating concussion. This suggests that baria zasal could be a unique method of concussion treatment even today. This also suggests that the techniques of Baria zasal should be further studied, and as in modern medicine.
Citation: Medicines
PubDate: 2022-12-30
DOI: 10.3390/medicines10010005
Issue No: Vol. 10, No. 1 (2022)
- Medicines, Vol. 10, Pages 6: Novel Polyethylene Terephthalate Screw Sleeve
Implant: Salvage Treatment in a Case of Spine Instability after
Vertebroplasty Failure
Authors: Giacomo Drago, Giulia Pastorello, Paolo Gallinaro, Roberto Zanata, Jacopo Del Verme, Altin Stafa, Enrico Giordan
First page: 6
Abstract: Introduction: The management of osteoporotic fractures is sometimes rather challenging for spinal surgeons, and considering the longer life expectancy induced by improved living conditions, their prevalence is expected to increase. At present, the approaches to osteoporotic fractures differ depending on their severity, location, and the patient’s age. State-of-the-art treatments range from vertebroplasty/kyphoplasty to hardware-based spinal stabilization in which screw augmentation with cement is the gold standard. Case presentation: We describe the case of a 74-year-old man with an L5 osteoporotic fracture. The patient underwent a vertebroplasty (VP) procedure, which was complicated by a symptomatic cement leakage in the right L4–L5 neuroforamen. We urgently decompressed the affected pedicle via hemilaminectomy. At that point, the column required stability. The extravasation of cement had ruled out the use of cement-augmented pedicle screws but leaving the pedicular screws alone was not considered sufficient to achieve stability. We decided to cover the screws with a polyethylene terephthalate sleeve (OGmend®) to avoid additional cement leakage and to reinforce the screw strength required by the poor bone quality. Conclusion: In the evolving technologies used for spinal surgery, screws sleeve implants such as OGmend® are a useful addition to the surgeon’s armamentarium when an increased pull-out strength is required and other options are not available.
Citation: Medicines
PubDate: 2022-12-30
DOI: 10.3390/medicines10010006
Issue No: Vol. 10, No. 1 (2022)
- Medicines, Vol. 10, Pages 7: A Prospective Study of Mid-Trimester MCP-1
Levels as a Predictor of Preterm Delivery
Authors: Mirjana A. Bogavac, Dejan D. Ćelić, Tamara M. Perić
First page: 7
Abstract: Background: The prevention of preterm delivery (PTD) represents one of the major topics in modern obstetrics. The aim was to design a prospective study and investigate if mid-trimester serum and amniotic fluid levels of MCP-1 could predict the occurence of spontaneous PTD. Methods: The study involved 198 women who underwent genetic amniocentesis and blood sampling in the middle of their trimester. After applying the criteria for inclusion in the study, there were 16 respondents in the study group, and 38 respondents in the control group. Level of MCP-1 in amniotic fluid and serum was measured with commercially available enzyme-linked immunosorbent assays (ELISA) and statistical analysis was conducted. Results: There was no statistically significant difference in serum or amniotic fluid MCP1 levels between PTD and the control groups. Conclusion: The results suggest that MCP-1 is probably not the most relevant marker for predicting PTD. This study provides new normative data for MCP-1 levels in amniotic fluid and maternal sera and is a valuable tool for future diagnostic and comparative studies.
Citation: Medicines
PubDate: 2022-12-30
DOI: 10.3390/medicines10010007
Issue No: Vol. 10, No. 1 (2022)
- Medicines, Vol. 10, Pages 8: Safety and Evaluation of the Immune Response
of Coronavirus Nosode (BiosimCovex) in Healthy Volunteers: A Preliminary
Study Extending the Homeopathic Pathogenetic Trial
Authors: Paul Herscu, Gitanjali Talele, Shashikant Vaidya, Rajesh Shah
First page: 8
Abstract: Objectives: Regulatory clinical Phase I studies are aimed at establishing the human safety of an active pharmaceutical agent to be later marketed as a drug. Since homeopathic medicines are prepared by a potentizing method using alcohol, past a certain dilution, their toxicity/infectivity is assumed to be unlikely. We aimed to develop a bridge study between homeopathic pathogenetic trials and clinical trials. The primary purpose was to evaluate the safety of a nosode, developed from clinical samples of a COVID-19 patient. The secondary objectives were to explore whether a nosode developed for a specific clinical purpose, such as use during an epidemic, may elicit laboratory signals worthy of further exploration. Methods: An open-label study was designed to evaluate the safety and immune response of the Coronavirus nosode BiosimCovex, given orally on three consecutive days to ten healthy volunteers. Clinical examinations, laboratory safety and immune parameters were established. Interferon–gamma, Interleukin-6, and CD 4 were measured. (CTRI registration number: CTRI/2020/05/025496). Results: No serious/fatal adverse events were reported. Laboratory tests to measure safety were unchanged. Three subjects showed elevated Interleukin-6 (IL-6) on day 17 in comparison to the baseline, and ten subjects showed elevated IL-6 on day 34. A significant difference between IL-6 observations, calculated by repeated measures ANOVA, was found to be highly significant. On day 60, the IL-6 values of nine subjects were found to return to normal. Corresponding CD4 cell elevation was observed on day 60, when compared to day 34. Conclusions: HPT may potentially extend into physiological changes with regards to immune response and should encourage future studies.
Citation: Medicines
PubDate: 2022-12-30
DOI: 10.3390/medicines10010008
Issue No: Vol. 10, No. 1 (2022)
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Open Access journal
