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Volume 12
Issue 2
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Medicines, Volume 12, Issue 2 (June 2025) – 6 articles

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11 pages, 185 KiB  
Article
Assessing the Market Readiness for Medical Cannabis in Greece: A Qualitative Study of Patient Perspectives
by Christos Ntais and Yioula Melanthiou
Medicines 2025, 12(2), 12; https://doi.org/10.3390/medicines12020012 - 9 May 2025
Viewed by 85
Abstract
Background: The introduction of medical cannabis in Greece marks a shift in healthcare policy, yet patient attitudes remain underexplored. Methods: This qualitative study examines the market readiness for medical cannabis through semi-structured interviews with 24 participants—12 users of cannabidiol (CBD)-based formulations and 12 [...] Read more.
Background: The introduction of medical cannabis in Greece marks a shift in healthcare policy, yet patient attitudes remain underexplored. Methods: This qualitative study examines the market readiness for medical cannabis through semi-structured interviews with 24 participants—12 users of cannabidiol (CBD)-based formulations and 12 medical cannabis-naive individuals. Results: CBD-experienced patients generally perceive cannabis-based treatments as beneficial for managing musculoskeletal pain, migraines, anxiety, stress and sleep disturbances, despite concerns over product quality, cost and limited medical guidance. Medical cannabis-naive participants express skepticism due to stigma and perceived insufficient evidence but acknowledge potential therapeutic value within a regulated framework. This study highlights the need for better patient education, physician training and clear regulatory guidelines to support responsible market entry. Conclusions: These findings offer important insights for policymakers, healthcare providers and the pharmaceutical industry, emphasizing the need for a structured, evidence-based approach to medical cannabis integration in Greece. Further research is needed to assess long-term patient experiences and the evolving impact of regulatory changes on market dynamics. Full article
26 pages, 6162 KiB  
Article
Assessment of Healing Potential of Bombyx mori L. (Silkworm) Derivatives on Second-Degree Burns: Dose-Response and Combination Therapy Analysis
by Evrydiki Katsikari, Alexandra Kyriaki, Andreas Vitsos, Margarita Vidali, Paschalis Harizanis, Ioannis Sfiniadakis, Maria Kostaki, Dimitra Ieronymaki, Asimina Terezaki, Georgios Ladopoulos, Chara Albani, Christina Barda and Michail Christou Rallis
Medicines 2025, 12(2), 11; https://doi.org/10.3390/medicines12020011 - 30 Apr 2025
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Abstract
Background/Objectives: Burn injuries present significant treatment challenges due to the intricate nature of the healing process. Bombyx mori L. (silkworm) derivatives, containing healing-promoting proteins such as sericin and fibroin, as well as the anti-inflammatory enzyme serrapeptase, have shown promise as potential healing agents. [...] Read more.
Background/Objectives: Burn injuries present significant treatment challenges due to the intricate nature of the healing process. Bombyx mori L. (silkworm) derivatives, containing healing-promoting proteins such as sericin and fibroin, as well as the anti-inflammatory enzyme serrapeptase, have shown promise as potential healing agents. This study aimed to identify the optimal dosage of silkworm body and gland extracts for burn healing, compare the selected dose’s effectiveness with that of silkworm cocoons, and assess the combined healing effects of a cocoon dressing and a silkworm body extract gel. Methods: An experimental model was employed using hairless SKH-hr2 female mice subjected to standardized second-degree burns. The mice received treatments with various formulations of silkworm body and gland extracts, silkworm cocoons, and a combined application of a cocoon dressing and silkworm body extract gel. Results: The most effective treatments were the cocoon dressing and the combination of cocoon dressing with 60% body extract gel. By Day 20, complete healing (100%) was observed in the 20% and 60% body and gland extract groups, while the cocoon and 60% gland extract groups exhibited 60% healing, significantly higher than the control group (0% healing). Wound contraction analysis showed the greatest reduction in surface area from Day 3 to Day 17 in the cocoon and 60% body extract groups (p < 0.05). Histopathological assessments revealed that the combination group exhibited the least tissue damage (score: 7), compared to the control (score: 10–13). Conclusions: The study highlights the poorly examined therapeutic potential of silkworm body and gland extracts, demonstrating their efficacy in accelerating burn healing. The effects observed by the silkworm cocoon and body extract suggests a novel and promising approach for burn wound management, warranting further clinical exploration. Full article
(This article belongs to the Section New Drugs Exploration and Development)
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11 pages, 1529 KiB  
Review
Is the Impact of Sodium–Glucose Co-Transporter 2 (SGLT2) Inhibitors on Bone Metabolism and Fracture Incidence a Class or Drug Effect? A Narrative Review
by George I. Lambrou, Athanasia Samartzi, Eugenia Vlachou and Athanasios N. Tsartsalis
Medicines 2025, 12(2), 10; https://doi.org/10.3390/medicines12020010 - 16 Apr 2025
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Abstract
Background/Objectives: Type 2 diabetes mellitus (T2DM) has a growing prevalence, even in developed countries. Because of the increase in life expectancy, the number of older people with T2DM is also increasing. The management and handling of these patients is challenging due to [...] Read more.
Background/Objectives: Type 2 diabetes mellitus (T2DM) has a growing prevalence, even in developed countries. Because of the increase in life expectancy, the number of older people with T2DM is also increasing. The management and handling of these patients is challenging due to its co-morbidities. Aim: In the present study, we reviewed the literature in order to investigate the impact of sodium–glucose co-transporter 2 inhibitors (SGLT-2 inhibitors) on bone metabolism and fracture incidence. Methods: We searched the literature using the databases of PubMed, CENTRAL and Cochrane Central Register of Controlled Trials up to December 2024. Results: There is a controversial position in the literature concerning the effects of SGLT2 inhibitors when administered in T2DM, with respect to bone metabolism and bone fracture incidence. Multiple studies suggest the SGLT2 inhibitors have a disadvantageous effect on bone metabolism and fracture incidence, while several others suggest a beneficial effect. Conclusions: Patients with type 2 diabetes mellitus are at high risk of alterations in their bone metabolism. SGLT2 inhibitors are a novel class with pleiotropic effects in many organs, such as the kidneys and heart, although their effect on bone metabolism and fracture incidence is still unclear. Until we have more clinical data, all caregivers (medical and nursing staff) should be aware of possible bone fractures in patients receiving this class of agents. Full article
(This article belongs to the Section Endocrinology and Metabolic Disorders)
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10 pages, 688 KiB  
Article
Retrospective Bayesian Reanalysis of Single Gentamicin Concentrations: A Neonatal Case Series
by Staci L. Hemmer and Sarah K. Scoular
Medicines 2025, 12(2), 9; https://doi.org/10.3390/medicines12020009 - 10 Apr 2025
Viewed by 229
Abstract
Background/Objectives: Nomograms for adjusting gentamicin therapy in neonates using a single concentration are limited. The Dersch–Mills nomogram is inefficient for short-duration therapies, while the NeoFax nomogram is outdated based on the current American Academy of Pediatrics (AAP) guidelines. Bayesian software has shown [...] Read more.
Background/Objectives: Nomograms for adjusting gentamicin therapy in neonates using a single concentration are limited. The Dersch–Mills nomogram is inefficient for short-duration therapies, while the NeoFax nomogram is outdated based on the current American Academy of Pediatrics (AAP) guidelines. Bayesian software has shown accuracy for vancomycin in adults, but its performance for gentamicin in neonates is unclear. This study evaluates the accuracy of Bayesian estimation in predicting peak and trough gentamicin concentrations from a single measured level in neonates. Methods: A single-center, retrospective re-analysis was conducted of gentamicin concentrations in neonates. InsightRx® was used to estimate maximum and minimum concentrations in a dosing interval (Cmax and Cmin) based on a single peak or trough concentration. Bias and accuracy were characterized using the mean difference (MD) between estimated and measured concentrations and the 95% limits of agreement (LOA) for the differences (±1.96 × SD). Results: Fifty-seven neonates (73 peak/trough pairs) were analyzed. Median gestational age was 34 weeks and median postnatal age was 0 days. The MD (LOA) between Cmin estimates and measured troughs was 0.03 mg/L (−0.17 to 0.13) for the trough-only analysis and 0.21 mg/L (−0.38 to 0.8) for the peak-only analysis. The MD (LOA) between Cmax estimates and measured peaks was 0.16 mg/L (−3.2 to 3.3) for the trough-only analysis and 1.2 mg/L (−0.58 to 3.0) for the peak-only analysis. Conclusions: In neonates, a Bayesian analysis of a trough concentration produces reliable Cmin estimates but is not as accurate in estimating Cmax. Analyzing a peak concentration produces Cmax and Cmin values that overestimate true concentrations. If the goal of monitoring is to ensure sufficiently low troughs, a single-level analysis is reasonable if levels are drawn near the end of the dosing interval, but Cmin predictions based on levels drawn early in the dosing interval should be avoided. Full article
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14 pages, 976 KiB  
Review
Common Bacterial Infections in Persons Who Inject Drugs
by Michael P. Lorenzo, Kathleen K. Adams and Seth T. Housman
Medicines 2025, 12(2), 8; https://doi.org/10.3390/medicines12020008 - 28 Mar 2025
Viewed by 385
Abstract
Opioid use in the United States has increased dramatically. Bacterial infections are common among persons who inject drugs (PWID), and there is a disparity in the care these individuals receive. As such, outcomes associated with these infections can be poor. Healthcare providers can [...] Read more.
Opioid use in the United States has increased dramatically. Bacterial infections are common among persons who inject drugs (PWID), and there is a disparity in the care these individuals receive. As such, outcomes associated with these infections can be poor. Healthcare providers can address these disparities through optimal pharmacotherapy recommendations and assistance with changing approaches to the management of PWID. Full article
(This article belongs to the Special Issue The 10th Anniversary of Medicines: Future Directions)
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9 pages, 198 KiB  
Case Report
Hyponatraemia Induced by Terlipressin in Patients Diagnosed with Decompensated Liver Cirrhosis and Acute Variceal Bleeding
by Mahmoud Elshehawy, Richel Merin Panicker, Alaa Amr Abdelgawad, Patrick Anthony Ball and Hana Morrissey
Medicines 2025, 12(2), 7; https://doi.org/10.3390/medicines12020007 - 28 Mar 2025
Viewed by 265
Abstract
Background: Hyponatraemia is a rare but potentially life-threatening complication of terlipressin therapy. Case history: In the current case, a 39-year-old female with decompensated liver cirrhosis (Child-Pugh C) and acute variceal bleeding experienced a precipitous decline in serum sodium—from 136 mmol/L to 115 mmol/L—within [...] Read more.
Background: Hyponatraemia is a rare but potentially life-threatening complication of terlipressin therapy. Case history: In the current case, a 39-year-old female with decompensated liver cirrhosis (Child-Pugh C) and acute variceal bleeding experienced a precipitous decline in serum sodium—from 136 mmol/L to 115 mmol/L—within 48 h of initiating terlipressin therapy. This was accompanied by marked fluid retention, reduced urine output, and symptoms of confusion and agitation. Laboratory tests confirmed dilutional hyponatraemia, characterized by urinary sodium <20 mmol/L and urine osmolality <100 mOsm/kg, indicating excessive free water reabsorption. Outcomes: The prompt discontinuation of terlipressin, fluid restriction and the cautious administration of hypertonic sodium chloride solution (2.7% NaCl) achieved a gradual normalization of sodium levels and resolution of symptoms. Fluid balance monitoring revealed a marked diuretic response following terlipressin cessation. This case aligns with existing reports, emphasizing the dual vasopressin receptor activity of terlipressin and its capacity to induce hyponatraemia, particularly in cirrhotic patients with preserved renal function and higher baseline sodium levels. Conclusions: This case and a literature review underscored the critical need for early fluid balance monitoring to detect retention. This case highlights the importance of individualized risk assessment, multidisciplinary management, and vigilant sodium correction to avoid complications. Practical recommendations are outlined to aid clinicians in the recognition and management of terlipressin-induced hyponatraemia. Full article
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