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ISSN (Print) 2305-6320
Published by MDPI Homepage  [246 journals]
  • 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

    • 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

    • 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

    • 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 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,

    • 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)
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