 Subjects -> ALTERNATIVE MEDICINE (Total: 106 journals)
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- Medicines, Vol. 10, Pages 50: Collagen Hydrolysates: A Source of Bioactive
Peptides Derived from Food Sources for the Treatment of Osteoarthritis
Authors: Christina E. Larder, Michèle M. Iskandar, Stan Kubow
First page: 50
Abstract: Osteoarthritis (OA) is the most common joint disorder, with a social and financial burden that is expected to increase in the coming years. Currently, there are no effective medications to treat it. Due to limited treatment options, patients often resort to supplements, such as collagen hydrolysates (CHs). CHs are products with low molecular weight (MW) peptides, often between 3 and 6 kDa, and are a result of industrialized processed collagen. Collagen extraction is often a by-product of the meat industry, with the main source for collagen-based products being bovine, although it can also be obtained from porcine and piscine sources. CHs have demonstrated positive results in clinical trials related to joint health, such as decreased joint pain, increased mobility, and structural joint improvements. The bioactivity of CHs is primarily attributed to their bioactive peptide (BAP) content. However, there are significant knowledge gaps regarding the digestion, bioavailability, and bioactivity of CH-derived BAPs, and how different CH products compare in that regard. The present review discusses CHs and their BAP content as potential treatments for OA.
Citation: Medicines
PubDate: 2023-09-01
DOI: 10.3390/medicines10090050
Issue No: Vol. 10, No. 9 (2023)
- Medicines, Vol. 10, Pages 51: Histological Alterations in
Hashimoto’s Disease: A Case-Series Ultrastructural Study
Authors: Eleni Avramidou, Antonios Gkantaras, Iasonas Dermitzakis, Konstantinos Sapalidis, Maria Eleni Manthou, Paschalis Theotokis
First page: 51
Abstract: Background: Hashimoto’s thyroiditis (HT) is an autoimmune disease exhibiting stromal fibrosis and follicular cell destruction due to lymphoplasmacytic infiltration. Besides deprecated analyses, histopathological approaches have not employed the use of electron microscopy adequately toward delineating subcellular-level interactions. Methods: Biopsies for ultrastructural investigations were obtained from the thyroids of five patients with HT after a thyroidectomy. Transmission electron microscopy (TEM) was utilized to study representative tissue specimens. Results: Examination indicated interstitial extravasated blood cells and a plethora of plasma cells, based on their subcellular identity landmarks. These antibody-secreting cells were profoundly spotted near follicular cells, fibroblasts, and cell debris entrenched in collagenous areas. Pathological changes persistently affected subcellular components of the thyrocytes, including the nucleus, endoplasmic reticulum (ER), Golgi apparatus, mitochondria, lysosomes, and other intracellular vesicles. Interestingly, significant endothelial destruction was observed, specifically in the larger blood vessels, while the smaller vessels appeared comparatively unaffected. Conclusions: Our TEM findings highlight the immune-related alterations occurring within the thyroid stroma. The impaired vasculature component and remodeling have not been described ultrastructurally before; thus, further exploration is needed with regards to angiogenesis in HT in order to achieve successful prognostic, diagnostic, and treatment-monitoring strategies.
Citation: Medicines
PubDate: 2023-09-02
DOI: 10.3390/medicines10090051
Issue No: Vol. 10, No. 9 (2023)
- Medicines, Vol. 10, Pages 52: Gabapentin-Associated Movement Disorders: A
Literature Review
Authors: Jamir Pitton Rissardo, Ursula Medeiros Araujo de Matos, Ana Letícia Fornari Caprara
First page: 52
Abstract: Background: Gabapentin (GBP)-induced movement disorders (MDs) are under-recognized adverse drug reactions. They are commonly not discussed with patients, and their sudden occurrence can lead to misdiagnosis. This literature review aims to evaluate the clinical–epidemiological profile, pathological mechanisms, and management of GBP-associated MD. Methods: Two reviewers identified and assessed relevant reports in six databases without language restriction between 1990 and 2023. Results: A total of 99 reports of 204 individuals who developed a MD associated with GBP were identified. The MDs encountered were 135 myoclonus, 22 dyskinesias, 7 dystonia, 3 akathisia, 3 stutterings, 1 myokymia, and 1 parkinsonism. The mean and median ages were 54.54 (SD: 17.79) and 57 years (age range: 10–89), respectively. Subjects were predominantly male (53.57%). The mean and median doses of GBP when the MD occurred were 1324.66 (SD: 1117.66) and 1033 mg/daily (GBP dose range: 100–9600), respectively. The mean time from GBP-onset to GBP-associated MD was 4.58 weeks (SD: 8.08). The mean recovery time after MD treatment was 4.17 days (SD: 4.87). The MD management involved GBP discontinuation. A total of 82.5% of the individuals had a full recovery in the follow-up period. Conclusions: Myoclonus (GRADE A) and dyskinesia (GRADE C) were the most common movement disorders associated with GBP.
Citation: Medicines
PubDate: 2023-09-06
DOI: 10.3390/medicines10090052
Issue No: Vol. 10, No. 9 (2023)
- Medicines, Vol. 10, Pages 53: The Effects of Mindfulness on Glycemic
Control in People with Diabetes: An Overview of Systematic Reviews and
Meta-Analyses
Authors: Hidetaka Hamasaki
First page: 53
Abstract: Background: Previous research has demonstrated the effectiveness of mindfulness interventions in improving glycemic control. By enhancing attention control, emotion regulation, and self-awareness, mindfulness shows promise in managing the lifestyle factors associated with cardiovascular disease risk. However, the impact of mindfulness on glycemic control in people with diabetes remains unclear. This overview aims to summarize the current evidence of the impact of mindfulness interventions on glycemic control in people with diabetes and propose suggestions for future research. Methods: The author searched electronic databases (PubMed/MEDLINE, Embase, and Cochrane Library) to identify relevant systematic reviews and meta-analyses. The current evidence regarding the effects of mindfulness on glycemic control in people with diabetes was summarized. Results: This review evaluated a total of five systematic reviews and meta-analyses of randomized controlled trials (RCTs). Mindfulness interventions show potential for improving glycemic control as measured by hemoglobin A1c (HbA1c) levels, as well as reducing stress, depression, and anxiety in people with diabetes. Four out of five systematic reviews and meta-analyses reported a significant reduction in HbA1c levels by approximately 0.3%. However, the available studies lacked adequate description of key characteristics of study subjects, such as body mass index, medication, and disease conditions, which are essential for assessing the impact of mindfulness on glycemic control. Moreover, there was significant heterogeneity in the intervention methods employed across the included RCTs. Conclusions: Mindfulness interventions are effective in improving glycemic control in people with type 2 diabetes. However, the overall quality of the reviewed studies raises uncertainty regarding the effectiveness of mindfulness as a treatment for people with diabetes. Further research is necessary to elucidate the biological effects of mindfulness on physiological, neurological, and endocrinological functions in humans.
Citation: Medicines
PubDate: 2023-09-07
DOI: 10.3390/medicines10090053
Issue No: Vol. 10, No. 9 (2023)
- Medicines, Vol. 10, Pages 54: Anticonvulsant Properties of
1-Diethylamino-3-phenylprop-2-en-1-one
Authors: Swagatika Das, Praveen K. Roayapalley, Sarvesh C. Vashishtha, Umashankar Das, Jonathan R. Dimmock
First page: 54
Abstract: There is a need for novel antiepileptic agents whose modes of action differ from those of current antiepileptic drugs. The objective of this study was to determine whether 1-diethylamino-3-phenylprop-2-en-1-one (2) could prevent or at least diminish convulsions caused by different mechanisms. This amide afforded protection in the maximal electroshock and subcutaneous pentylenetetrazole screens when given intraperitoneally to both mice and rats. A number of specialized tests in mice were conducted and are explained in the text. They revealed (2) to have efficacy in the 6 Hz psychomotor seizure test, the corneal kindling model, the mouse temporal epilepsy screen and a peripheral neuronal transmission test using formalin. Three screens in rats were undertaken, which revealed that (2) blocked chloride channels, inhibited peripheral neuronal transmission (tested using sciatic ligation and von Frey fibres) and afforded protection in the lamotrigine-resistant kindled rat model. The biodata generated reveal that (2) is an important lead molecule in the quest for novel structures to combat epilepsy.
Citation: Medicines
PubDate: 2023-09-08
DOI: 10.3390/medicines10090054
Issue No: Vol. 10, No. 9 (2023)
- Medicines, Vol. 10, Pages 45: Bridging the Gap between Basic Research and
Clinical Practice: The Growing Role of Translational Neurorehabilitation
Authors: Mirjam Bonanno, Rocco Salvatore Calabrò
First page: 45
Abstract: Translational neuroscience is intended as a holistic approach in the field of brain disorders, starting from the basic research of cerebral morphology and with the function of implementing it into clinical practice. This concept can be applied to the rehabilitation field to promote promising results that positively influence the patient’s quality of life. The last decades have seen great scientific and technological improvements in the field of neurorehabilitation. In this paper, we discuss the main issues related to translational neurorehabilitation, from basic research to current clinical practice, and we also suggest possible future scenarios.
Citation: Medicines
PubDate: 2023-08-01
DOI: 10.3390/medicines10080045
Issue No: Vol. 10, No. 8 (2023)
- Medicines, Vol. 10, Pages 46: Contrast-Induced Encephalopathy in Patients
with Chronic Kidney Disease and End-Stage Kidney Disease: A Systematic
Review and Meta-Analysis
Authors: Paul W. Davis, Pajaree Krisanapan, Supawit Tangpanithandee, Charat Thongprayoon, Jing Miao, Mohamed Hassanein, Prakrati Acharya, Michael A. Mao, Iasmina M. Craici, Wisit Cheungpasitporn
First page: 46
Abstract: Background: Contrast-induced encephalopathy (CIE) is an infrequent but serious neurological condition that occurs shortly after the administration of contrast during endovascular and angiography procedures. Patients suffering from chronic kidney disease (CKD) or end-stage kidney disease (ESKD) are considered to be at a higher risk of contrast medium neurotoxicity, due to the delayed elimination of the contrast medium. However, the occurrence and characteristics of CIE in CKD/ESKD patients have not been extensively investigated. Methods: We conducted a comprehensive literature search, utilizing databases such as MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, up to September 2022. The purpose was to identify documented cases of CIE among patients with CKD or ESKD. Employing a random-effects model, we calculated the pooled incidence and odds ratio (OR) of CIE in CKD/ESKD patients. Results: Our search yielded a total of eleven articles, comprising nine case reports and two observational studies. Among these studies, 2 CKD patients and 12 ESKD patients with CIE were identified. The majority of the CKD/ESKD patients with CIE (93%) had undergone intra-arterial contrast media and/or endovascular procedures to diagnose acute cerebrovascular disease, coronary artery disease, and peripheral artery disease. The male-to-female ratio was 64%, and the median age was 63 years (with an interquartile range of 55 to 68 years). In the two observational studies, the incidence of CIE was found to be 6.8% in CKD patients and 37.5% in ESKD patients, resulting in a pooled incidence of 16.4% (95% CI, 2.4%–60.7%) among the CKD/ESKD patients. Notably, CKD and ESKD were significantly associated with an increased risk of CIE, with ORs of 5.77 (95% CI, 1.37–24.3) and 223.5 (95% CI, 30.44–1641.01), respectively. The overall pooled OR for CIE in CKD/ESKD patients was 32.9 (95% CI, 0.89–1226.44). Although dialysis prior to contrast exposure did not prevent CIE, approximately 92% of CIE cases experienced recovery after undergoing dialysis following contrast exposure. However, the effectiveness of dialysis on CIE recovery remained uncertain, as there was no control group for comparison. Conclusions: In summary, our study indicates an association between CIE and CKD/ESKD. While patients with CIE showed signs of recovery after dialysis, further investigations are necessary, especially considering the lack of a control group, which made the effects of dialysis on CIE recovery uncertain.
Citation: Medicines
PubDate: 2023-08-08
DOI: 10.3390/medicines10080046
Issue No: Vol. 10, No. 8 (2023)
- Medicines, Vol. 10, Pages 47: Spectrum of Thyroid Dysfunction in Patients
with Chronic Kidney Disease in Benin City, Nigeria
Authors: John O. Obasuyi, Mathias A. Emokpae
First page: 47
Abstract: There is an indication of abrupt rise in chronic kidney disease (CKD) in Nigeria and thyroid function involvement has not been sufficiently evaluated. This study determined thyroid gland function among subjects with CKD in Benin City, Nigeria. A total of 184 randomized CKD patients attending specialist clinic and 80 healthy control subjects were recruited for this study. A well-structured questionnaire was used to obtain data on socio-demography. Blood specimens were collected and used for the determination of thyroid function parameters; thyroid stimulating hormone (TSH), triiodothyronine (T3), free triiodothyronine (fT3), thyroxine (T4), free thyroxine (fT4), thyroid peroxidase antibody (TPO-Abs), thyroid globulin antibody (Tg-Abs) and Deiodinase enzyme Type 1 (D1). SPINA GD and SPINA GT were calculated using Michaelis-Menten model. The CKD was classified into stages using Modification of Drug in Renal Disease (MDRD) formula. Thyroid dysfunctions observed were clinical hyperthyroidism 1 (0.54%), non-thyroidal illness 78 (42.4%), clinical hypothyroidism 11 (6.0%), sub-clinical hyperthyroidism 3 (1.60%), and sub-clinical hypothyroidism 11 (6.0%), while euthyroid were 80 (43.5%). SPINA GD of CKD patients (33.85 ± 10.94) was not significantly different when compared with controls (24.85 ± 1.57), whereas, SPINA GT was significantly higher (p < 0.01) among CKD patients (3.74 ± 0.31) than controls (2.68 ± 0.11). Autoimmune thyroid disease demonstrated by positive Tg-Abs and TPO-Abs were observed among approximately 7.9% of CKD patients. Serum TPO-Abs concentration increased with CKD progression. Thyroid dysfunction is involved in the pathogenesis of CKD patients. The etiologies are multifactorial and immunological mechanisms of autoimmune thyroid disease may be a contributing factor.
Citation: Medicines
PubDate: 2023-08-09
DOI: 10.3390/medicines10080047
Issue No: Vol. 10, No. 8 (2023)
- Medicines, Vol. 10, Pages 48: Clinical Effectiveness of Mirogabalin
Besylate for Trigeminal Neuropathy after Skull Base Surgery: Illustrative
Cases
Authors: Kosuke Karatsu, Ryota Tamura, Tsubasa Miyauchi, Junki Sogano, Utaro Hino, Takashi Iwama, Masahiro Toda
First page: 48
Abstract: Background: Postoperative trigeminal neuropathy may be seen after surgery for middle and posterior cranial fossa lesions. Although neuropathic pain is a cause of reduced quality of life, global consensus on postoperative pain management is lacking. Mirogabalin besylate is a selective ligand for the α2δ subunit of voltage-gated calcium channels. Although mirogabalin has been used for patients with postherpetic neuralgia and painful diabetic peripheral neuropathy, few reports have assessed the effect on postsurgical neuropathy. In this report, we describe a clinical effectiveness of mirogabalin for trigeminal neuropathy after skull base surgery. Case description: Case 1: A 51-year-old female with right trigeminal schwannoma was operated on via the anterior transpetrosal approach. She had tingling and numb feelings in the right face postoperatively. Mirogabalin was orally administered after the operation. Her continuous facial numbness immediately improved. Case 2: A 55-year-old female with left middle fossa base meningioma extending into the infratemporal fossa was operated on via the infratemporal fossa approach. She had a tingling feeling in the left face postoperatively. Mirogabalin was orally administered for this symptom after the operation, which gradually improved. Conclusions: Mirogabalin may show significant pain relief for patients with trigeminal neuropathy after skull base surgery. Further studies using a larger number of patients are warranted to confirm these findings.
Citation: Medicines
PubDate: 2023-08-17
DOI: 10.3390/medicines10080048
Issue No: Vol. 10, No. 8 (2023)
- Medicines, Vol. 10, Pages 49: Somatosensory Auras in Epilepsy: A Narrative
Review of the Literature
Authors: Ana Leticia Fornari Caprara, Hossam Tharwat Ali, Ahmed Elrefaey, Sewar A. Elejla, Jamir Pitton Rissardo
First page: 49
Abstract: An aura is a subjective experience felt in the initial phase of a seizure. Studying auras is relevant as they can be warning signs for people with epilepsy. The incidence of aura tends to be underestimated due to misdiagnosis or underrecognition by patients unless it progresses to motor features. Also, auras are associated with seizure remission after epilepsy surgery and are an important prognostic factor, guiding the resection site and improving surgical outcomes. Somatosensory auras (SSAs) are characterized by abnormal sensations on one or more body parts that may spread to other parts following a somatotopic pattern. The occurrence of SSAs among individuals with epilepsy can range from 1.42% to 80%. The upper extremities are more commonly affected in SSAs, followed by the lower extremities and the face. The most common type of somatosensory aura is paresthetic, followed by painful and thermal auras. In the primary somatosensory auras, sensations occur more commonly contralaterally, while the secondary somatosensory auras can be ipsilateral or bilateral. Despite the high localizing features of somatosensory areas, cortical stimulation studies have shown overlapping sensations originating in the insula and the supplementary sensorimotor area.
Citation: Medicines
PubDate: 2023-08-21
DOI: 10.3390/medicines10080049
Issue No: Vol. 10, No. 8 (2023)
- Medicines, Vol. 10, Pages 38: Health-Seeking Behavior Regarding Coughs in
Urban Slums in Lagos, Nigeria
Authors: Victor Abiola Adepoju, Olanrewaju Oladimeji, Olusola Daniel Sokoya
First page: 38
Abstract: Background: TB is a major cause of morbidity and mortality, with slum residents being disproportionately affected. This study aimed to assess health-seeking behavior among adult residents of slum communities presenting with coughs in Lagos, Nigeria. Methods: A community-based, cross-sectional study was conducted across six urban slums in Nigeria as part of community outreaches to mark World TB Day. A structured, pretested questionnaire was used to capture relevant sociodemographic details and questions regarding symptoms of coughs and related symptoms as well as care-seeking behavior. Data were explored, analyzed, and presented using descriptive statistics. Results: A total of 632 respondents participated in this study. The majority were 25–34 years old (24.7%), male (65.8%), Christian (55.7%), married (73.7%), with secondary education (37.8%), with 3–4 persons per household (41%) and with 1–2 persons per room (44.5%). In total, 26.6% had had a cough for two weeks or more and were considered as presumptive TB patients. Overall, 37.2% of respondents with a cough visited patent proprietary medicine vendors (PPMVs) as the first port of call. Good health-seeking behavior was exhibited by only 36.2% of respondents. In total, 38.9% delayed seeking care from a health facility (government or private) more than one month after the onset of symptoms. None of the factors included in the multivariate analysis showed a significant association with good health-seeking behavior (i.e., visiting government or private hospitals/clinics). Conclusions: The poor health-seeking behavior, delay in seeking TB care and preference for PPMVs emphasizes the need for National tuberculosis programs (NTPs) to further engage these informal providers in TB prevention, diagnosis and treatment services in urban slum communities.
Citation: Medicines
PubDate: 2023-06-26
DOI: 10.3390/medicines10070038
Issue No: Vol. 10, No. 7 (2023)
- Medicines, Vol. 10, Pages 39: Antimicrobial Prescribing Preparedness of
Croatian Medical Students—Did It Change between 2015 and 2019'
Authors: Dora Palčevski, Andrej Belančić, Ivan Mikuličić, Eduard Oštarijaš, Robert Likić, Oliver Dyar, Vera Vlahović-Palčevski
First page: 39
Abstract: Background: Antimicrobials are some of the most prescribed drugs by junior doctors, but studies suggest most medical graduates feel unprepared for their future prescribing tasks. The aim of the present study was to compare the self-reported preparedness to prudently prescribe antimicrobials of final-year medical students in Croatia in 2015 and 2019. Methods: The same self-reported web-based survey on the preparedness to prescribe antibiotics was used in both 2015 and 2019. All final-year students at all four medical schools in Croatia (Osijek, Rijeka, Split, and Zagreb) were invited to participate in both 2015 and 2019. Preparedness scores were divided into “topic preparedness scores” and “global preparedness scores”. Topic preparedness scores represented the percentage of students at a medical school who felt sufficiently prepared for each topic. They were first established at a medical school level and then at the national level. Global preparedness scores were determined for each student separately and then calculated at the medical school and national levels. Results: The country’s global preparedness score, representing the average proportion of topics in which students felt sufficiently prepared, was slightly higher in 2015 compared with the 2019 results (62.7% vs. 56.5%; p = 0.191). Croatian students reported higher preparedness in 2015 than in 2019 for 25 out of 27 topics included in the survey. The majority of students reported a need for more education on antibiotic use both in 2015 and 2019 (78.0% vs. 83.0%; p = 0.199). Conclusions: Despite increasing antimicrobial stewardship activities in various healthcare settings, medical students who are about to start prescribing antibiotics on their own do not feel sufficiently prepared to do so. Antimicrobial stewardship programs should be designed to incorporate undergraduate medical student education, for instance, as a specific, mandatory course or integrated into other courses, such as clinical pharmacology.
Citation: Medicines
PubDate: 2023-06-29
DOI: 10.3390/medicines10070039
Issue No: Vol. 10, No. 7 (2023)
- Medicines, Vol. 10, Pages 40: Multichannel Recovery Potential with
Activated Autologous Intraovarian Platelet-Rich Plasma and Its Derivatives
Authors: E. Scott Sills, Samuel H. Wood
First page: 40
Abstract: Platelet-rich plasma (PRP) is an ‘orthobiologic’ with recognized roles in plastic surgery, musculoskeletal disorders, dentistry, dermatology, and more recently, ‘ovarian rejuvenation’. Intraovarian PRP involves a complex secretome discharged after platelet activation, comprising multiple cytokine mediators delivered surgically to older or inactive ovarian tissue. Loss of oocyte meiotic fidelity and impaired fertilization accompanying advanced maternal age are already managed by IVF, but only with eggs provided by younger donors. However, if the observed effect of rectifying embryo ploidy error can be proven beyond case reports and small series, activated PRP (or its condensed plasma cytokines) would deliver a welcome therapeutic disruption that is difficult to overstate. Because shortcomings in ovarian function are presently addressed mainly by pharmacological approaches (i.e., via recombinant gonadotropins, GnRH analogs, or luteal support), autologous PRP would represent an unusual departure from these interventions. Given the diversity of platelet cargo proteins, the target response of intraovarian PRP is probably not confined to oocytes or follicles. For example, PRP manipulates signal networks driving improved perfusion, HOX regulation, N-glycan post-translational modification, adjustment of voltage-gated ion channels, telomere stabilization, optimization of SIRT3, and ribosome and mitochondria recovery in older oocytes. While multichannel signals operating on various pathways are not unique to reproductive biology, in intraovarian PRP this feature has received little study and may help explain why its standardization has been difficult. Against this background, our report examines the research themes considered most likely to shape clinical practice.
Citation: Medicines
PubDate: 2023-07-03
DOI: 10.3390/medicines10070040
Issue No: Vol. 10, No. 7 (2023)
- Medicines, Vol. 10, Pages 41: Vitamin D Levels in Patients with Active and
Remission Graves’ Disease
Authors: Natapon Rattanamusik, Suriyon Uitrakul, Atchara Charoenpiriya
First page: 41
Abstract: Background: The association between Graves’ disease (GD) and serum vitamin D levels has been studied for decades although the results were controversial. Moreover, the difference in vitamin D levels between the different stages of GD is not well studied. Therefore, this study aimed to compare the vitamin D levels between active and remission GD and to investigate the factors affecting vitamin D levels in GD patients. Methods: This cross-sectional study was performed between 1 January to 31 December 2021. The eligible patients were in either the active or remission stage of GD. The demographic and clinical data of the patients willing to participate in the study were collected, as well as their vitamin D levels. Comparisons of continuous parameters between the active and remission groups were performed using the Mann–Whitney U test, while categorical parameters were performed using the Chi-square test. Results: 75 patients were diagnosed with GD, with 54.7% in the active stage. The mean vitamin D level was lower in the active GD group than in the remission GD group (28.23 vs. 31.58 ng/mL, respectively, p-value 0.079). The prevalence of vitamin D deficiency (i.e., serum vitamin D level < 20 ng/mL) in the active GD group was 14.6%, and in the remission GD group was 0% (p-value 0.02). Moreover, there was a significant negative correlation between the serum vitamin D level and serum free T4 level (p-value 0.03). Conclusions: In spite of non-significance, patients with active GD had lower mean vitamin D levels compared to those with remission GD. The prevalence of vitamin D deficiency was significantly higher in the active GD patients. Additionally, a negative correlation between serum vitamin D levels and serum free T4 levels was observed in this study.
Citation: Medicines
PubDate: 2023-07-06
DOI: 10.3390/medicines10070041
Issue No: Vol. 10, No. 7 (2023)
- Medicines, Vol. 10, Pages 42: Longitudinal Changes in Motor Estimation
Error and Motor Function in Patients with Parkinson’s Disease: A
Case Report
Authors: Katsuya Sakai, Tsubasa Kawasaki, Hiroya Kiminarita, Yumi Ikeda
First page: 42
Abstract: Background and Objectives: This report described two cases with clear longitudinal changes in motor estimation error (difference between the motor imagery and motor execution) and their progression and motor and activities of daily living (ADL) function changes in patients with PD. Materials and Methods: Patient 1 was a 68-year-old man (Hoehn and Yahr [H and Y] stage: IV, diagnosed with PD for 11.8 years) and patient 2 was a 68-year-old woman (H and Y stage: II, diagnosed with PD for 9.6 years). Imagined two-step test (iTST), two-step test (TST), and PD-related assessments (Unified Parkinson’s Disease Rating Scale [UPDRS], and Freezing of Gait Questionnaire [FOGQ]) were assessed at baseline and after 6 months. Motor estimation error was calculated as the iTST distance minus TST distance. Results: In patient 1, motor estimation error was greater after 6 months (baseline: 5.7 [4.8%]/after 6 months: 25.7 cm [26.1%]). Moreover, UPDRS and FOGQ total scores deteriorated after 6 months (UPDRS total: 29/34 point, and FOGQ: 9/16 point). Conversely, in patient 2, motor estimation error did not change notably (−3.6 [7.6%]/−2.5 cm [7.0%]), while UPDRS and FOGQ total scores improved after 6 months (UPDRS total: 17/12 point, and FOGQ: 6/1 point). Conclusions: This report indicated that greater motor estimation error may be associated with declining motor and ADL function and disease progression in patients with PD.
Citation: Medicines
PubDate: 2023-07-06
DOI: 10.3390/medicines10070042
Issue No: Vol. 10, No. 7 (2023)
- Medicines, Vol. 10, Pages 43: A Comparative Study of Tumor-Specificity and
Neurotoxicity between 3-Styrylchromones and Anti-Cancer Drugs
Authors: Tomoyuki Abe, Hiroshi Sakagami, Shigeru Amano, Shin Uota, Kenjiro Bandow, Yoshihiro Uesawa, Shiori U, Hiroki Shibata, Yuri Takemura, Yu Kimura, Koichi Takao, Yoshiaki Sugita, Akira Sato, Sei-ichi Tanuma, Hiroshi Takeshima
First page: 43
Abstract: Background. Many anti-cancer drugs used in clinical practice cause adverse events such as oral mucositis, neurotoxicity, and extravascular leakage. We have reported that two 3-styrylchromone derivatives, 7-methoxy-3-[(1E)-2-phenylethenyl]-4H-1-benzopyran-4-one (Compound A) and 3-[(1E)-2-(4-hydroxyphenyl)ethenyl]-7-methoxy-4H-1-benzopyran-4-one (Compound B), showed the highest tumor-specificity against human oral squamous cell carcinoma (OSCC) cell lines among 291 related compounds. After confirming their superiority by comparing their tumor specificity with newly synthesized 65 derivatives, we investigated the neurotoxicity of these compounds in comparison with four popular anti-cancer drugs. Methods: Tumor-specificity (TSM, TSE, TSN) was evaluated as the ratio of mean CC50 for human normal oral mesenchymal (gingival fibroblast, pulp cell), oral epithelial cells (gingival epithelial progenitor), and neuronal cells (PC-12, SH-SY5Y, LY-PPB6, differentiated PC-12) to OSCC cells (Ca9-22, HSC-2), respectively. Results: Compounds A and B showed one order of magnitude higher TSM than newly synthesized derivatives, confirming its prominent tumor-specificity. Docetaxel showed one order of magnitude higher TSM, but two orders of magnitude lower TSE than Compounds A and B. Compounds A and B showed higher TSM, TSE, and TSN values than doxorubicin, 5-FU, and cisplatin, damaging OSCC cells at concentrations that do not affect the viability of normal epithelial and neuronal cells. QSAR prediction based on the Tox21 database suggested that Compounds A and B may inhibit the signaling pathway of estrogen-related receptors.
Citation: Medicines
PubDate: 2023-07-14
DOI: 10.3390/medicines10070043
Issue No: Vol. 10, No. 7 (2023)
- Medicines, Vol. 10, Pages 44: Intermittent Proton Pump Inhibitor Therapy
in Low-Risk Non-Variceal Upper Gastrointestinal Bleeding May Be
Significantly Cost-Saving
Authors: Yang Lei, Jennifer Halasz, Kerri L. Novak, Stephen E. Congly
First page: 44
Abstract: Background: High-dose proton pump inhibitor (PPI) therapy, given either intermittently or continuously for non-variceal upper gastrointestinal bleeding (NV-UGIB), is efficacious. Using intermittent PPI for low-risk patients may be cost-saving. Our objective was to estimate the annual cost savings if all low-risk NV-UGIB patients received intermittent PPI therapy. Methods: Patients who presented to hospital in Calgary, Alberta, who received a PPI for NV-UGIB from July 2015 to March 2017 were identified using ICD-10 codes. Patients were stratified into no endoscopy, high-risk, and low-risk lesion groups and further subdivided into no PPI, oral PPI, intermittent intravenous (IV), and continuous IV subgroups. Average length of stay (LOS) in each subgroup and costs were calculated. Results: We identified 4141 patients with NV-UGIBs, (median age 61, 57.4% male). One-thousand two-hundred and thirty-one low-risk patients received continuous IV PPI, with an average LOS of 6.8 days (95% CI 6.2–7.3) versus 4.9 days (95% CI 3.9–5.9) for intermittent IV patients. If continuous IV PPI patients instead received intermittent IV PPI, 3852 patient days and CAD 11,714,390 (2017 CAD)/year could be saved. Conclusions: Using real-world administrative data, we demonstrate that a sizable portion of low-risk patients with NV-UGIB who were given continuous IV PPI if switched to intermittent IV therapy could generate significant potential cost savings.
Citation: Medicines
PubDate: 2023-07-20
DOI: 10.3390/medicines10070044
Issue No: Vol. 10, No. 7 (2023)
- 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 34: Evaluation of Antifungal Activity of Languas
galangal Rhizome and Development of a Topical Antifungal Cream
Authors: Lakshmi Reka, Chamari Maheshika Godage, Jayantha Wijayabandara, Aravinda Siriwardhene
First page: 34
Abstract: Background: The rhizome of Languas galangal is traditionally used in Sri Lanka for the treatment of skin infections caused by fungi. The aim of the present study was to evaluate the antifungal activity of L. galangal rhizome and to develop a topical antifungal formulation from it. Methods: The dried, powdered rhizome of L. galangal was successively extracted with hexane, dichloromethane, ethyl acetate and methanol using Soxhlet extraction. The agar well diffusion method was used to assess the antifungal activity against Candida albicans and Aspergillus nger. The antifungal activities of the extracts were compared with clotrimazole as the positive control and dimethyl sulfoxide (DMSO) as the negative control. The most active hexane extract was used to prepare the cream. The antifungal activity of the formulated cream was tested. Results: The hexane extract of L. galangal rhizome powder was more effective on C. albicans and A. niger. The hexane extract of L. galangal showed the maximum zone of inhibition against C. albicans and A. niger (20.20 mm ± 0.46, 18.20 mm ± 0.46) compared to the other three extracts, while clotrimazole, which was used as a positive control, produced a larger zone of inhibition (36.10 mm ± 0.65) and dimethyl sulfoxide (DMSO), the negative control, did not produce inhibitory zones. Stability testing of the formulated cream showed a stable and good appearance. Conclusions: The cream developed using the hexane extract showed in vitro antifungal activity against C. albicans and A. niger. Further evaluations on shelf life, stability and safety are required.
Citation: Medicines
PubDate: 2023-06-09
DOI: 10.3390/medicines10060034
Issue No: Vol. 10, No. 6 (2023)
- Medicines, Vol. 10, Pages 35: Antiseizure Medication-Induced Alopecia: A
Literature Review
Authors: Jamir Pitton Rissardo, Ana Leticia Fornari Caprara, Maritsa Casares, Holly J. Skinner, Umair Hamid
First page: 35
Abstract: Background: Adverse effects of antiseizure medications (ASMs) remain one of the major causes of non-adherence. Cosmetic side effects (CSEs) are among the most commonly reported side effects of ASMs. In this context, alopecia is one of the CSEs that has a high intolerance rate leading to poor therapeutical compliance. Methods: We performed a literature review concerning alopecia as a secondary effect of ASMs. Results: There are 1656 individuals reported with ASM-induced alopecia. Valproate (983), lamotrigine (355), and carbamazepine (225) have been extensively reported. Other ASMs associated with alopecia were cenobamate (18), levetiracetam (14), topiramate (13), lacosamide (7), vigabatrin (6), phenobarbital (5), gabapentin (5), phenytoin (4), pregabalin (4), eslicarbazepine (3), brivaracetam (2), clobazam (2), perampanel (2), trimethadione (2), rufinamide (2), zonisamide (2), primidone (1), and tiagabine (1). There were no reports of oxcarbazepine and felbamate with drug-induced alopecia. Hair loss seen with ASMs was diffuse and non-scarring. Telogen effluvium was the most common cause of alopecia. A characteristic feature was the reversibility of alopecia after ASM dose adjustment. Conclusions: Alopecia should be considered one important adverse effect of ASMs. Patients reporting hair loss with ASM therapy should be further investigated, and specialist consultation is recommended.
Citation: Medicines
PubDate: 2023-06-09
DOI: 10.3390/medicines10060035
Issue No: Vol. 10, No. 6 (2023)
- Medicines, Vol. 10, Pages 36: Bittersweet Sugars: How Unusual Glycan
Structures May Connect Epithelial-to-Mesenchymal Transition and Multidrug
Resistance in Cancer
Authors: Leonardo Marques da Fonseca, Israel Diniz-Lima, Marcos André Rodrigues da Costa Santos, Tatiany Nunes Franklim, Kelli Monteiro da Costa, Ariely Costa dos Santos, Alexandre Morrot, Debora Decote-Ricardo, Raphael do Carmo Valente, Celio Geraldo Freire-de-Lima, Jhenifer Santos dos Reis, Leonardo Freire-de-Lima
First page: 36
Abstract: Cancer cells are characterized by metabolic reprogramming, which enables their survival in of-ten inhospitable conditions. A very well-documented example that has gained attraction in re-cent years and is already considered a hallmark of transformed cells is the reprogramming of carbohydrate metabolism. Such a feature, in association with the differential expression of en-zymes involved in the biosynthesis of glycoconjugates, generically known as glycosyltransfer-ases, contributes to the expression of structurally atypical glycans when compared to those ex-pressed in healthy tissues. The latest studies have demonstrated that glycophenotypic alterations are capable of modulating multifactorial events essential for the development and/or progres-sion of the disease. Herein, we will address the importance of glycobiology in modern medi-cine, focusing on the ability of unusual/truncated O-linked glycans to modulate two complex and essential phenomena for cancer progression: the acquisition of the multidrug resistance (MDR) phenotype and the activation of molecular pathways associated with the epithelial–mesenchymal transition (EMT) process, an event deeply linked with cancer metastasis.
Citation: Medicines
PubDate: 2023-06-14
DOI: 10.3390/medicines10060036
Issue No: Vol. 10, No. 6 (2023)
- Medicines, Vol. 10, Pages 37: Rhinosinusitis Treatment with Cineole:
Patient-Reported Quality of Life Improvements from a Non-Interventional,
Pharmacy-Based Survey
Authors: Nina Werkhäuser, Ursula Pieper-Fürst, Hacer Sahin, Antonia Claas, Ralph Mösges
First page: 37
Abstract: Background: Rhinosinusitis is commonly treated with decongestants, analgesics, and local corticosteroids. Phytotherapeutics are also utilised for symptomatic relief, including cineole, the main component of eucalyptus oil. Methods: The current non-interventional, anonymised survey investigated quality of life in participants with rhinosinusitis (with or without additional symptoms of bronchitis) via the German version of a validated quality of life questionnaire (RhinoQol). Overall, 310 subjects administered a cineole preparation (Sinolpan) and 40 subjects applying nasal decongestant were recruited in German pharmacies. Results: Significant improvements in frequency (64.0%), bothersomeness (52.1%), and impact (53.9%) of rhinosinusitis symptoms were reported upon treatment with cineole over a mean treatment period of seven days (p < 0.001 each). The overall treatment efficacy of cineole was evaluated as good or very good by 90.0% of the participants, and the quality of life during work or leisure time improved upon treatment. Six (non-serious) possibly related side effects were reported in four participants who were administered cineole. The tolerability of the treatment was assessed as good or very good by 93.9% of the participants. Conclusions: Cineole can be considered as a safe and well-tolerated rhinosinusitis treatment conferring a clear improvement in quality of life outcomes.
Citation: Medicines
PubDate: 2023-06-19
DOI: 10.3390/medicines10060037
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)
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