Medicines, Volume 8, Issue 4 (April 2021) – 4 articles

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

Background: In recent years, cosmetic acupuncture has gained popularity among individuals interested in improving their facial appearance. We have created an original facial check sheet (FCS) to obtain cosmetic acupuncture patients’ perspectives on treatment outcomes. This study examined the reliability and validity of FCS. Methods: We conducted an Internet survey on the appearance of the facial region among Japanese women. A reliability analysis was performed between each item of FCS. A multiple comparison procedure was used to determine the relationship between the age group, the FCS score, and the number of terms used in the open-ended question. Results: The most frequently stated concern was blotchiness and hyperpigmented spots (47.2%, n = 67). The FCS items showed reliability (Cronbach α = 0.871). The number of extracted terms and the FCS score showed a moderate correlation (r = 0.407; p < 0.001). There was a significant relationship between age and FCS score (p = 0.005, r² = 0.255), which indicated that the FCS score increases with aging. Conclusions: The FCS can be used as a practical tool to evaluate facial appearances and assess satisfaction levels of patients who underwent cosmetic acupuncture or other facial skin rejuvenation procedures. Full article

Background: High mobility group box 1 (HMGB1)-receptor for advanced glycation endo-products (RAGE) axis serves as a key player in linking inflammation and carcinogenesis. Recently, papaverine was revealed to suppress the HMGB1-RAGE inflammatory signaling pathway and cancer cell proliferation. Therefore, a dual suppressor targeting this axis is expected to become a new type of therapeutic agent to treat cancer. Methods: Papaverine 3D pharmacophore mimetic compounds were selected by the LigandScout software from our in-house, anti-cancer chemical library and assessed for their anti-inflammatory activities by a HMGB1-RAGE-mediated interleukin-6 production assay using macrophage-like RAW264.7 cells. Molecular-biological analyses, such as Western blotting, were performed to clarify the mechanism of action. Results: A unique 6-methoxy-3-hydroxy-styrylchromone was found to possess potent anti-inflammatory and anti-cancer activities via the suppression of the HMGB1-RAGE-extracellular signal-regulated kinase 1/2 signaling pathway. Furthermore, the 3D pharmacophore-activity relationship analyses revealed that the hydroxyl group at the C4′ position of the benzene ring in a 3-styryl moiety was significant in its dual suppressive effects. Conclusions: These findings indicated that this compound may provide a valuable scaffold for the development of a new type of anti-cancer drug possessing anti-inflammatory activity and as a tool for understanding the link between inflammation and carcinogenesis. Full article

Coagulopathy induced by major trauma is common, affecting approximately one-third of patients after trauma. It develops independently of iatrogenic, hypothermic, and dilutive causes (such as iatrogenic cause in case of fluid administration), which instead have a pejorative aspect on coagulopathy. Notwithstanding the continuous research conducted over the past decade on Trauma-Induced Coagulopathy (TIC), it remains a life-threatening condition with a significant impact on trauma mortality. We reviewed the current evidence regarding TIC diagnosis and pathophysiological mechanisms and summarized the different iterations of optimal TIC management strategies among which product resuscitation, potential drug administrations, and hemostatis-focused approaches. We have identified areas of ongoing investigation and controversy in TIC management. Full article