Medicine Advances最新文献

Deep learning has been identified as an indispensable backbone in health data science. However, the computational constraints faced by many healthcare providers, who may lack access to high-performance computing resources, must be considered. This commentary illustrates three representative strategies from the perspective of data, model, and computing to mitigate computational constraints in resource-limited settings.

This narrative review focused on research investigating the impact of loneliness on the prevalence of dementia and its relationship with other risk factors. A comprehensive and rigorous search was conducted using a variety of scientific databases with specific keywords to identify all prior studies that examined the correlation between dementia and loneliness. The inquiry was confined to articles published in English from January 2017 to March 2024. The narrative review identified a consensus regarding the role of loneliness in enhancing the risk of all-cause dementia, with a particular emphasis on the subjective perception of loneliness. This phenomenon may be caused by the sensations of exclusion, discrimination, and alienation that are typically associated with low self-esteem and low life satisfaction, which may contribute to cognitive impairment and depressive symptoms. This finding was obtained despite the absence of robust evidence regarding the involvement of loneliness in the pathogenesis of dementia. Existing research has not yet identified a correlation between hereditary factors that influence the development of dementia and feelings of loneliness. However, loneliness is strongly associated with depression, which is a potential risk factor for dementia. Previous studies have reported a moderate correlation between depression and loneliness, as individuals who are isolated and lack a sense of community exhibit higher levels of depression. Meditation, social cognitive training, and social support are three strategies that have been implemented to address loneliness and are reported to be the most effective interventions. A strong correlation exists between dementia and loneliness. Although such strategies are unlikely to impede the progression of the disease if cognitive deterioration is already underway, understanding these associations can assist in the development of strategies to alleviate the effects of loneliness on vulnerable individuals.

Diacerein, an anthraquinone derivative, has gained interest in recent years as a potential therapeutic agent in the management of knee osteoarthritis (KOA), particularly the inflammatory subtype effusion synovitis. This commentary evaluates the effect of diacerein on KOA symptoms and functional outcomes of recent parts of a multicenter randomized controlled trial. The clinical trial of diacerein as a monotherapy for effusion synovitis concluded that not only was there no overall significant change in the knee joint's moisture content after a 24-week therapy but also there was no evidence of symptomatic or functional improvement. Furthermore, problems like diarrhea and colored urine raised questions about its safety and user-friendly profile; therefore, these findings were contentious. These outcomes highlight the need for greater investigation of diacerein, including in combination therapies where its benefits are amplified and adverse effects diminished. Further research should help to define diacerein's role in KOA treatment and increase the understanding of its actions regarding effusion synovitis, focusing on side effects.

Berdazimer sodium, marketed as Zelsuvmi, is an antiviral medication used to treat a viral infection called molluscum contagiosum (MC). MC is a common skin infection caused by a poxvirus, resulting in round, stiff, but painless papules in various places on the body. Zelsuvmi's antiviral activity is associated with the release of nitric oxide, which exhibits potent antiviral properties. Zelsuvmi is used topically by patients or caregivers to treat this extremely contagious viral skin infection at home or in medical facilities. On January 5, 2024, the U.S. Food and Drug Administration approved Zelsuvmi for treating this infection in target populations, including adults and patients aged 1 year and above. Other therapies for MC, such as retinoic acid, benzoyl peroxide, and cryotherapy, are quite painful, while Zelsuvmi is less painful. The purpose of this article is to highlight the clinical importance and potential benefits of Zelsuvmi in the treatment of MC worldwide.

PET/CT has become the reference standard imaging modality for diagnosing prostate cancer because of its ability to target prostate-specific membrane antigen (PSMA), a protein specific to prostate cells. [⁶⁸Ga]Ga-PSMA-11 was a major advance, but limitations such as a short lifespan and image blurring led to the introduction of [¹⁸F]PSMA-1007, which offers advantages such as a longer lifespan and clearer images. This study aimed to compare the effectiveness of [¹⁸F]PSMA-1007 and [⁶⁸Ga]Ga-PSMA-11 in the detection and staging of recurrent prostate cancer because there is currently insufficient evidence to conclude that one PSMA-radiotracer is better than the other. Both ⁶⁸Ga and ¹⁸F-labeled PSMA-radiotracers have similar detection rates in patients. Therefore, more investigation is required to authoritatively conclude which radiotracer results in optimal performance for diagnosing prostate cancer lesions on PET/CT. In this narrative review, we focus on comparing the effectiveness of [¹⁸F]PSMA-1007 with that of [⁶⁸Ga]Ga-PSMA-11 in the detection of recurrent prostate cancer and determination of its stage. We found that [¹⁸F]PSMA-1007 and [⁶⁸Ga]Ga-PSMA-11 showed similar diagnostic performance, with [¹⁸F]PSMA-1007 having slightly higher sensitivity for primary and metastatic recurrent prostate cancer. However, a lack of statistical significance in the differences between the two radiotracers indicates comparable diagnostic accuracy, enabling their interchangeable use based on availability and cost efficiency.

This study evaluates the safety profile of tecovirimat monotherapy compared to its combination with brincidofovir for mpox treatment Brincidofovir is associated with hepatic toxicity, raising concerns about its clinical use Tecovirimat demonstrates a favorable safety profile with minimal side effects, making it a strong candidate for standalone mpox treatment Combining tecovirimat with brincidofovir may increase hepatic toxicity risks and impair drug absorption, necessitating careful consideration A retrospective UK study found that brincidofovir-treated patients experienced liver enzyme abnormalities and prolonged hospitalization, while those on tecovirimat had no major adverse effects Tecovirimat remains the preferred option for mpox management, but further studies are required to establish safer and more effective treatment strategies.

Agentic large language models (LLMs) combine vanilla LLMs’ reasoning, planning, and reflecting acquired from vast pre-trained datasets with specialized tools to enhance problem-solving capabilities. To understand the current progress and future opportunities of agentic LLMs for healthcare, this commentary conducted a comprehensive literature search in PubMed and summarized key takeaways.

This commentary discusses three evaluation approaches for assessing large language models' generation in healthcare: programmatic metrics, human assessment, and large language models judgment. No single approach can address all challenges; however, the combination of these three methods provides a pipeline toward the comprehensive evaluation of medical text generation.