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Medicines, Volume 9, Issue 3 (March 2022) – 8 articles

Cover Story (view full-size image): The properties of synthetic cathinones on the central nervous system led to their medical application to treat depression, chronic fatigue, and obesity. Simultaneously, they are often used by undiagnosed attention-deficit/hyperactivity disorder adolescents. Synthetic cathinone exposition leads to psychostimulation and hallucinations. Its side-effects are hyperthermia and organ failure. Synthetic cannabinoids display protective and therapeutic effects for inflammatory conditions such as arthritis, neurodegenerative diseases such as Alzheimer’s, and oncologic pathologies by activating the immune system and reducing inflammation. Its psychoactive and side effects include psychosis, paranoia, panic, and seizures. Fatal cases have been reported from synthetic cathinone and cannabinoid misuse. View this paper
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5 pages, 1961 KiB  
Case Report
Unusual Presentation of Bouveret Syndrome Resulting in Both Gastric Outlet Obstruction and Small Bowel Obstruction with Perforation
by Jarod Shelton, Muhammad Adeel Samad, James Juhng and Shawn M. Terry
Medicines 2022, 9(3), 24; https://doi.org/10.3390/medicines9030024 - 15 Mar 2022
Cited by 1 | Viewed by 2091
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 [...] Read more.
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. Full article
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4 pages, 242 KiB  
Editorial
Drug-Induced Sexual Dysfunction in Individuals with Epilepsy: Beyond Antiepileptic Compounds
by Rocco Salvatore Calabrò and Antonio Cerasa
Medicines 2022, 9(3), 23; https://doi.org/10.3390/medicines9030023 - 14 Mar 2022
Cited by 3 | Viewed by 3199
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 [...] Full article
(This article belongs to the Section Neurology and Neurologic Diseases)
24 pages, 672 KiB  
Review
Wen Dan Tang: A Potential Jing Fang Decoction for Headache Disorders?
by Saroj K. Pradhan, Yiming Li, Andreas R. Gantenbein, Felix Angst, Susanne Lehmann and Hamdy Shaban
Medicines 2022, 9(3), 22; https://doi.org/10.3390/medicines9030022 - 04 Mar 2022
Cited by 1 | Viewed by 3666
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 [...] Read more.
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. Full article
8 pages, 1423 KiB  
Case Report
Acquired Hemophilia A: A Permanent Challenge for All Physicians
by Knut M. Nowak, Alexander Carpinteiro, Cynthia Szalai and Fuat H. Saner
Medicines 2022, 9(3), 21; https://doi.org/10.3390/medicines9030021 - 02 Mar 2022
Cited by 4 | Viewed by 2916
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 [...] Read more.
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. Full article
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15 pages, 2767 KiB  
Review
Salubrious Effects of Green Tea Catechins on Fatty Liver Disease: A Systematic Review
by Omar Abunofal and Chandra Mohan
Medicines 2022, 9(3), 20; https://doi.org/10.3390/medicines9030020 - 01 Mar 2022
Cited by 9 | Viewed by 8696
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 [...] Read more.
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. Full article
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31 pages, 578 KiB  
Review
Novel Psychoactive Substances: The Razor’s Edge between Therapeutical Potential and Psychoactive Recreational Misuse
by Beatriz Correia, Joana Fernandes, Maria João Botica, Carla Ferreira and Alexandre Quintas
Medicines 2022, 9(3), 19; https://doi.org/10.3390/medicines9030019 - 01 Mar 2022
Cited by 5 | Viewed by 3913
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 [...] Read more.
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. Full article
(This article belongs to the Section New Drugs Exploration and Development)
7 pages, 259 KiB  
Review
The Impact of Industry Funding on Randomized Controlled Trials of Biologic Therapies
by Aaron M. Gazendam, David Slawaska-Eng, Nicholas Nucci, Om Bhatt and Michelle Ghert
Medicines 2022, 9(3), 18; https://doi.org/10.3390/medicines9030018 - 28 Feb 2022
Cited by 6 | Viewed by 2164
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 [...] Read more.
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. Full article
10 pages, 435 KiB  
Article
Investigating Prescription Medication Expenditures and Level of Perceived Health Status among Older Adults with Pain in the United States
by David R. Axon and Leonard P. Barrios
Medicines 2022, 9(3), 17; https://doi.org/10.3390/medicines9030017 - 22 Feb 2022
Viewed by 1973
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) [...] Read more.
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. Full article
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