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Oxygen-Carrying Capacity of Perfluorohexyloctane, a Novel Eye Drop for Dry Eye Disease 新型干眼病滴眼液全氟己辛烷的携氧能力
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.1016/j.curtheres.2023.100705
Neal Stolowich Ph.D. , Jason Vittitow Ph.D. , Robert Kissling M.D. , Douglas Borchman Ph.D.

Objective

One-hundred percent perfluorohexyloctane (PFHO) is a water-free, preservative-free eye drop approved by the Food and Drug Administration in the United States for the treatment of dry eye disease. PFHO has shown relief of dry eye signs and symptoms in clinical trials and has potent antievaporative action in vitro. The objective of this study was to measure the level of oxygen in PFHO.

Methods

T1 relaxation times (time taken for proton spins to translate from a random alignment to an alignment with the main magnetic field) for fluorine-19 in perfluorohexyloctane were measured using fluorine-19 nuclear magnetic resonance spectroscopy. The level of oxygen was interpolated from published data.

Results

The hydrogen-1 and fluorine-19 nuclear magnetic resonance spectra of PFHO were well resolved and the resonance assignments and intensities were as expected. The T1 values calculated for the CF3 group resonance in the current study was 0.901 seconds and 1.12 seconds at 25 °C and 37 °C, respectively. The T1 values for the CF2 group resonances increased by 17% to 24% with an increase in temperature from 25 °C to 37 °C. The mean (SD) partial pressure of oxygen in PFHO was calculated to be 257 (36) mm Hg and 270 (38) mm Hg at 25 °C and 37 °C, respectively.

Conclusions

The current study confirms that PFHO contains a significant amount of oxygen, more so than that calculated for tears in equilibrium with air. Once instilled on the eye, PFHO is not expected to be a barrier to the oxygen necessary for a healthy cornea and may in fact deliver nonreactive oxygen to the cornea to facilitate healing in patients with dry eye disease.

目的百分之百全氟己基辛烷(PFHO)是一种经美国食品药品监督管理局批准用于治疗干眼病的无水、不含防腐剂的滴眼液。PFHO在临床试验中显示出对干眼症体征和症状的缓解,并在体外具有强大的抗蒸发作用。本研究的目的是测量PFHO中的氧水平。方法使用氟-19核磁共振光谱测量全氟己基辛烷中氟-19的弛豫时间(质子自旋从随机排列转化为与主磁场排列所需的时间)。根据公布的数据对氧气水平进行插值。结果PFHO的氢-1和氟-19核磁共振谱得到了很好的分辨,共振归属和强度符合预期。当前研究中计算的CF3组共振的T1值在25°C和37°C时分别为0.901秒和1.12秒。随着温度从25°C增加到37°C,CF2组共振的T1值增加了17%到24%。PFHO中氧气的平均分压(SD)在25°C和37°C时分别为257(36)mm Hg和270(38)mm Hg。结论目前的研究证实,PFHO含有大量的氧气,比与空气平衡的眼泪所含的氧气更多。PFHO一旦滴入眼睛,预计不会成为健康角膜所需氧气的屏障,事实上可能会向角膜输送非活性氧气,以促进干眼症患者的愈合。
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引用次数: 3
Inhibition of Contractility of Isolated Caprine Detrusor by the Calcium Channel Blocker Cilnidipine and Reversal by Calcium Channel Openers 钙通道阻断剂西尼地平对分离的Caprine Detrusor收缩的抑制作用和钙通道开放剂的逆转作用。
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.1016/j.curtheres.2023.100717
Steffi A. Maria MD, Aniket Kumar PhD, Premila M. Wilfred MD, Margaret Shanthi MD, Jacob Peedicayil MD

Background

Cilnidipine is a fourth-generation calcium channel blocker that is clinically used to treat hypertension. It is a dihydropyridine that blocks L- and N-type calcium channels. The inhibitory effect of cilnidipine on isolated detrusor muscle contractility has not been studied. This study investigated the inhibitory effect of cilnidipine on isolated caprine (goat) detrusor muscle contractility and the reversal of the inhibition by calcium channel openers.

Methods

Fourteen caprine detrusor strips were made to contract using 80 mM potassium chloride before and after addition of three concentrations (20, 40, and 60 µM) of cilnidipine. Two reversal agents, the L-type calcium channel opener FPL64716, and the N-type calcium channel opener GV-58, were investigated for their ability to reverse the inhibitory effect of 40 µΜ cilnidipine on potassium chloride-induced detrusor contractility.

Results

Cilnidipine caused a dose-dependent and statistically significant inhibition of detrusor contractility at all concentrations of cilnidipine used (20, 40, and 60 µΜ). The inhibitory effect of 40 µM cilnidipine on detrusor contractility was significantly reversed by the addition of FPL64716 and GV-58.

Conclusions

Cilnidipine inhibits the contractility of the isolated detrusor by blocking L- and N-type calcium channels. Cilnidipine could be evaluated for treating clinical conditions requiring relaxation of the detrusor such as overactive bladder.

背景:西尼地平是临床上用于治疗高血压的第四代钙通道阻滞剂。它是一种阻断L型和N型钙通道的二氢吡啶。西尼地平对离体逼尿肌收缩力的抑制作用尚未得到研究。本研究研究了西尼地平对山羊逼尿肌收缩力的抑制作用以及钙通道开放剂对其抑制作用的逆转作用。方法:在添加三种浓度(20、40和60µM)的西尼地平之前和之后,使用80mM氯化钾使14条山羊逼尿肌条收缩。研究了两种拮抗剂,L型钙通道阻滞剂FPL64716和N型钙通道调节剂GV-58,逆转40µΜ西尼地平对氯化钾诱导的逼尿肌收缩力的抑制作用。结果:在所有浓度的西尼地平(20、40和60µΜ)下,西尼地平对逼尿肌收缩力产生剂量依赖性且具有统计学意义的抑制作用。40µM西尼地平对逼尿肌收缩力的抑制作用通过添加FPL64716和GV-58显著逆转。结论:西尼地平通过阻断L型和N型钙通道抑制分离的逼尿肌的收缩力。西尼地平可用于治疗需要放松逼尿肌的临床病症,如膀胱过度活动。
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引用次数: 0
Methods of Determining Irritable Bowel Syndrome and Efficiency of Probiotics in Treatment: A Review 肠易激综合征的检测方法及益生菌治疗效果综述
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.1016/j.curtheres.2023.100721
Geetika M. Ahlawat Ph. D. , Prabhat K. Singh Ph. D.

Background

Irritable bowel syndrome (IBS) is a prevalent lifestyle-associated ailment linked to the gut microbiota that significantly influences patients' quality of life. A notable correlation exists between Blastocystis infections and susceptibility to IBS, with infected individuals exhibiting an increased likelihood of developing the condition. Despite promising results from using probiotics to modulate the gut microbiota and manage IBS, the precise mechanisms and potential risks remain unclear.

Objective

This review aims to explore the therapeutic potential of probiotics, particularly Saccharomyces boulardii, in the management of IBS, highlighting the role of the gut microbiota and the gut–brain axis in IBS pathophysiology.

Methods

A comprehensive literature survey was conducted to examine the association between gut microbiota and IBS, the role of probiotics in managing IBS, the mechanisms of their action, and the potential risks associated with their long-term use. Additionally, this study addresses the influence of Blastocystis infections on IBS susceptibility and evaluates various ongoing clinical trials investigating probiotic use for IBS.

Results

S boulardii, a yeast species with probiotic properties, has demonstrated effectiveness in both the treatment and prophylaxis of IBS. Its administration is associated with a decrease in the proinflammatory cytokine interleukin 8 and an increase in the anti-inflammatory cytokine interleukin 10. Probiotics appear to function by inhibiting the growth of pathogenic microorganisms and regulating neurotransmitter activity, influencing the gut–brain axis. However, selecting appropriate probiotic strains and dosing regimens is crucial because of potential adverse effects, such as infections and allergic reactions.

Conclusions

Probiotics, specifically S boulardii, offer a promising avenue for IBS management by modulating gut microbiota. However, further research is necessary to delineate the precise mechanisms of action, optimal strains, dosing regimens for IBS treatment, and potential risks associated with long-term use. A comprehensive approach incorporating probiotics, a low-FODMAP diet, and cognitive-behavioral therapy may provide effective management of IBS symptoms.

肠易激综合征(IBS)是一种普遍的与生活方式相关的疾病,与肠道微生物群有关,显著影响患者的生活质量。囊虫感染与肠易激综合征的易感性之间存在显著的相关性,受感染的个体表现出患肠易激综合征的可能性增加。尽管使用益生菌调节肠道菌群和控制IBS取得了可喜的结果,但其确切机制和潜在风险仍不清楚。目的探讨益生菌,特别是博氏酵母在IBS治疗中的治疗潜力,强调肠道微生物群和肠-脑轴在IBS病理生理中的作用。方法通过全面的文献调查,探讨肠道菌群与IBS的关系、益生菌在IBS治疗中的作用、作用机制以及长期使用益生菌的潜在风险。此外,本研究探讨了囊胚感染对肠易激综合征易感性的影响,并评估了各种正在进行的研究益生菌治疗肠易激综合征的临床试验。结果博氏酵母是一种具有益生菌特性的酵母菌,具有治疗和预防肠易激综合征的作用。它的施用与促炎细胞因子白介素8的减少和抗炎细胞因子白介素10的增加有关。益生菌似乎通过抑制病原微生物的生长和调节神经递质活性,影响肠-脑轴发挥作用。然而,选择合适的益生菌菌株和给药方案是至关重要的,因为潜在的副作用,如感染和过敏反应。结论益生菌,特别是博氏弧菌,通过调节肠道菌群,为肠易激综合征的治疗提供了一条有前景的途径。然而,需要进一步的研究来描述肠易激综合征治疗的确切作用机制、最佳菌株、给药方案以及长期使用的潜在风险。综合益生菌、低fodmap饮食和认知行为疗法可以有效地治疗肠易激综合征症状。
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引用次数: 0
Methotrexate Increases Serum Calcium Levels in Patients with Rheumatoid Arthritis: A Retrospective Study at a Referral Hospital in Indonesia 甲氨蝶呤增加类风湿关节炎患者血清钙水平:印度尼西亚一家转诊医院的回顾性研究
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.1016/j.curtheres.2023.100726
Dika P. Destiani M. Pharm , Vida M. Utami B. Pharm , Syifa Farhanah B. Pharm , Sofa D. Alfian PhD , Sumartini Dewi PhD Prof. , Syed A.S. Sulaiman PhD Prof. , Rizky Abdulah PhD

Background

Rheumatoid arthritis (RA) is a significant issue, particularly in bone health problems, because it can prolong diseases like secondary osteoporosis. Subsequently, the anchor of drug therapy for RA is methotrexate (MTX), which also has the potential to reduce the risk of secondary osteoporosis.

Objective

This study aims to examine the effect of MTX on calcium levels, an important parameter for monitoring bone health and the risk of secondary osteoporosis in patients with RA.

Methods

A retrospective study was carried out by collecting data from the medical records of patients, which included demographic and patient characteristics, treatment data (drug and dosage), duration of treatment, and calcium levels. All patients were diagnosed with RA and fell within the age range of 18 to 59 years. Additionally, the effectiveness of MTX therapy was compared with other treatments, categorizing patient data accordingly. Statistical analyses, such as χ2 and ordinal regression, using IBM-SPSS Statistics version 25 (IBM-SPSS Inc, Armonk, New York) were used to establish associations between MTX treatment and calcium levels, reporting odds ratio and 95% CI values.

Results

The data consisted of 123 patients with RA, comprising 99 who had a history of MTX use for more than 6 months and 24 who either did not use MTX or used it for <6 months. The majority of patients were women and their ages ranged between 40 and 59 years. MTX monotherapy was the most used with a dose range of 7.5 to 15 mg. Furthermore, this study observed that patients treated with MTX between 7.5 and 15 mg have lower serum calcium levels than those who received 17.5 to 25 mg (P = 0.022; odds ratio = 5.663; 95% CI, 0.251–3.218). Most patients with RA using MTX maintained normal calcium levels. No significant differences were observed between single MTX therapy and combination therapy.

Conclusions

Although further investigation is needed, this study showed the potential properties of MTX in maintaining patients’ serum calcium levels, which may help to reduce the risk of secondary osteoporosis in patients with RA.

类风湿性关节炎(RA)是一个重要的问题,特别是在骨骼健康问题中,因为它可以延长继发性骨质疏松症等疾病。随后,RA药物治疗的锚点是甲氨蝶呤(MTX),它也有可能降低继发性骨质疏松症的风险。目的探讨甲氨蝶呤对类风湿关节炎患者钙水平的影响,钙水平是监测骨骼健康和继发性骨质疏松风险的重要指标。方法通过收集患者的病历资料进行回顾性研究,包括人口统计学和患者特征、治疗资料(药物和剂量)、治疗时间、钙水平等。所有患者均被诊断为类风湿性关节炎,年龄在18至59岁之间。此外,将MTX治疗的有效性与其他治疗进行比较,并对患者数据进行相应的分类。使用IBM-SPSS Statistics version 25 (IBM-SPSS Inc ., Armonk, New York)进行统计学分析,如χ2和序数回归,以建立MTX治疗与钙水平之间的关联,报告优势比和95% CI值。结果数据包括123例RA患者,其中99例使用MTX超过6个月,24例未使用MTX或使用MTX 6个月。大多数患者为女性,年龄在40至59岁之间。MTX单药治疗是最常用的,剂量范围为7.5至15mg。此外,本研究观察到,接受7.5 - 15 mg MTX治疗的患者血清钙水平低于接受17.5 - 25 mg MTX治疗的患者(P = 0.022;优势比 = 5.663;95% ci, 0.251-3.218)。大多数使用MTX的RA患者维持正常的钙水平。单次甲氨蝶呤治疗与联合治疗无显著差异。结论虽然需要进一步的研究,但本研究显示了MTX在维持患者血清钙水平方面的潜在特性,这可能有助于降低RA患者继发性骨质疏松症的风险。
{"title":"Methotrexate Increases Serum Calcium Levels in Patients with Rheumatoid Arthritis: A Retrospective Study at a Referral Hospital in Indonesia","authors":"Dika P. Destiani M. Pharm ,&nbsp;Vida M. Utami B. Pharm ,&nbsp;Syifa Farhanah B. Pharm ,&nbsp;Sofa D. Alfian PhD ,&nbsp;Sumartini Dewi PhD Prof. ,&nbsp;Syed A.S. Sulaiman PhD Prof. ,&nbsp;Rizky Abdulah PhD","doi":"10.1016/j.curtheres.2023.100726","DOIUrl":"10.1016/j.curtheres.2023.100726","url":null,"abstract":"<div><h3>Background</h3><p>Rheumatoid arthritis (RA) is a significant issue, particularly in bone health problems, because it can prolong diseases like secondary osteoporosis. Subsequently, the anchor of drug therapy for RA is methotrexate (MTX), which also has the potential to reduce the risk of secondary osteoporosis.</p></div><div><h3>Objective</h3><p>This study aims to examine the effect of MTX on calcium levels, an important parameter for monitoring bone health and the risk of secondary osteoporosis in patients with RA.</p></div><div><h3>Methods</h3><p>A retrospective study was carried out by collecting data from the medical records of patients, which included demographic and patient characteristics, treatment data (drug and dosage), duration of treatment, and calcium levels. All patients were diagnosed with RA and fell within the age range of 18 to 59 years. Additionally, the effectiveness of MTX therapy was compared with other treatments, categorizing patient data accordingly. Statistical analyses, such as χ<sup>2</sup> and ordinal regression, using IBM-SPSS Statistics version 25 (IBM-SPSS Inc, Armonk, New York) were used to establish associations between MTX treatment and calcium levels, reporting odds ratio and 95% CI values.</p></div><div><h3>Results</h3><p>The data consisted of 123 patients with RA, comprising 99 who had a history of MTX use for more than 6 months and 24 who either did not use MTX or used it for &lt;6 months. The majority of patients were women and their ages ranged between 40 and 59 years. MTX monotherapy was the most used with a dose range of 7.5 to 15 mg. Furthermore, this study observed that patients treated with MTX between 7.5 and 15 mg have lower serum calcium levels than those who received 17.5 to 25 mg (<em>P</em> = 0.022; odds ratio = 5.663; 95% CI, 0.251–3.218). Most patients with RA using MTX maintained normal calcium levels. No significant differences were observed between single MTX therapy and combination therapy.</p></div><div><h3>Conclusions</h3><p>Although further investigation is needed, this study showed the potential properties of MTX in maintaining patients’ serum calcium levels, which may help to reduce the risk of secondary osteoporosis in patients with RA.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"99 ","pages":"Article 100726"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0011393X23000358/pdfft?md5=9e11e420b0006eab491235a7f4a5667d&pid=1-s2.0-S0011393X23000358-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135715041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Budgetary Impact of 20-Valent Pneumococcal Conjugate Vaccine Use for Adult Expatriates Living in Dubai 20价肺炎球菌结合疫苗对居住在迪拜的成年侨民的预算影响
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.1016/j.curtheres.2023.100698
Mostafa Zayed MSc , Jean Joury BS Pharm, CMD , Mohamed Farghaly FRCGP , Sara Al Dallal MD, MSc , Bassam Mahboub MD , Emily Kutrieb BA , Ahuva Averin MPP

Background

Dubai Health Authority currently recommends sequential administration of 13-valent pneumococcal conjugate vaccine (PCV13) followed by (→) 23-valent pneumococcal polysaccharide vaccine (PPV23) to prevent pneumococcal disease among adults at elevated risk of illness. Despite recommendations, disease burden and associated costs remain substantial. A new 20-valent pneumococcal conjugate vaccine (PCV20) recently received regulatory approval in the United Arab Emirates and has the potential to further reduce burden of pneumococcal disease.

Objectives

To evaluate budget impact of use of novel PCV20 compared with current recommendations (ie, PCV13→PPV23) among expatriates in Dubai aged 50 to 99 years and those aged 19 to 49 years with risk factors.

Methods

A deterministic model depicted 5-year risks and costs of invasive pneumococcal disease and all-cause nonbacteremic pneumonia. Each year of the modeling horizon, persons could be vaccinated with either PCV20 or PCV13→PPV23 or remain unvaccinated; persons vaccinated during the modeling horizon were not eligible for vaccination in subsequent years. Annual vaccine uptake was assumed to be 5% in base cases analyses; higher uptake was considered in scenario analyses. Costs were discounted at 3.5% annually and reported in US dollars.

Results

In base case, use of PCV20 alone would prevent an additional 13 cases of invasive pneumococcal disease, 31 cases of inpatient all-cause nonbacteremic pneumonia, 139 cases of outpatient all-cause nonbacteremic pneumonia, and 5 disease-related deaths compared with PCV13→PPV23. Medical care costs would be reduced by $354,000, and total vaccination costs would decrease by $4.4 million. PCV20 would therefore yield net budgetary impact of –$4.8 million, resulting in savings of $2.47 per-person per-year over 5 years. In scenarios with higher vaccine uptake, PCV20 prevented more cases and deaths and yielded greater budget savings (vs PCV13→PPV23).

Conclusions

PCV20 would reduce burden and economic costs of pneumococcal disease among expatriates in Dubai compared with PCV13→PPV23 and would therefore be budget saving for private health insurers who cover the majority of this population.

背景迪拜卫生局目前建议依次接种13价肺炎球菌结合疫苗(PCV13),然后(→) 23价肺炎球菌多糖疫苗(PPV23),用于在患病风险较高的成年人中预防肺炎球菌疾病。尽管提出了建议,但疾病负担和相关费用仍然很大。一种新的20价肺炎球菌结合疫苗(PCV20)最近在阿拉伯联合酋长国获得了监管部门的批准,有可能进一步减轻肺炎球菌疾病的负担。目的与目前的建议(即PCV13)相比,评估新型PCV20的使用对预算的影响→PPV23)。方法一个确定性模型描述了侵袭性肺炎球菌疾病和全因非细菌性肺炎的5年风险和费用。在建模期的每一年,人们都可以接种PCV20或PCV13疫苗→PPV23或保持未接种疫苗;在建模期间接种疫苗的人在随后几年没有资格接种疫苗。在基本病例分析中,假设年疫苗接种率为5%;在情景分析中考虑了更高的吸收率。成本以每年3.5%的价格贴现,并以美元计价。结果在基础病例中,与PCV13相比,单独使用PCV20可预防13例侵袭性肺炎球菌疾病、31例住院全因非细菌性肺炎、139例门诊全因非病毒性肺炎和5例疾病相关死亡→PPV23.医疗费用将减少354000美元,疫苗接种总费用将减少440万美元。因此,PCV20将产生480万美元的净预算影响,从而在5年内每人每年节省2.47美元。在疫苗接种率较高的情况下,PCV20预防了更多的病例和死亡,并节省了更多的预算(与PCV13相比→PPV23)。结论与PCV13相比,PCV20将减轻迪拜外籍人士患肺炎球菌疾病的负担和经济成本→PPV23,因此将为覆盖大多数人口的私人医疗保险公司节省预算。
{"title":"Budgetary Impact of 20-Valent Pneumococcal Conjugate Vaccine Use for Adult Expatriates Living in Dubai","authors":"Mostafa Zayed MSc ,&nbsp;Jean Joury BS Pharm, CMD ,&nbsp;Mohamed Farghaly FRCGP ,&nbsp;Sara Al Dallal MD, MSc ,&nbsp;Bassam Mahboub MD ,&nbsp;Emily Kutrieb BA ,&nbsp;Ahuva Averin MPP","doi":"10.1016/j.curtheres.2023.100698","DOIUrl":"10.1016/j.curtheres.2023.100698","url":null,"abstract":"<div><h3>Background</h3><p>Dubai Health Authority currently recommends sequential administration of 13-valent pneumococcal conjugate vaccine (PCV13) followed by (→) 23-valent pneumococcal polysaccharide vaccine (PPV23) to prevent pneumococcal disease among adults at elevated risk of illness. Despite recommendations, disease burden and associated costs remain substantial. A new 20-valent pneumococcal conjugate vaccine (PCV20) recently received regulatory approval in the United Arab Emirates and has the potential to further reduce burden of pneumococcal disease.</p></div><div><h3>Objectives</h3><p>To evaluate budget impact of use of novel PCV20 compared with current recommendations (ie, PCV13→PPV23) among expatriates in Dubai aged 50 to 99 years and those aged 19 to 49 years with risk factors.</p></div><div><h3>Methods</h3><p>A deterministic model depicted 5-year risks and costs of invasive pneumococcal disease and all-cause nonbacteremic pneumonia. Each year of the modeling horizon, persons could be vaccinated with either PCV20 or PCV13→PPV23 or remain unvaccinated; persons vaccinated during the modeling horizon were not eligible for vaccination in subsequent years. Annual vaccine uptake was assumed to be 5% in base cases analyses; higher uptake was considered in scenario analyses. Costs were discounted at 3.5% annually and reported in US dollars.</p></div><div><h3>Results</h3><p>In base case, use of PCV20 alone would prevent an additional 13 cases of invasive pneumococcal disease, 31 cases of inpatient all-cause nonbacteremic pneumonia, 139 cases of outpatient all-cause nonbacteremic pneumonia, and 5 disease-related deaths compared with PCV13→PPV23. Medical care costs would be reduced by $354,000, and total vaccination costs would decrease by $4.4 million. PCV20 would therefore yield net budgetary impact of –$4.8 million, resulting in savings of $2.47 per-person per-year over 5 years. In scenarios with higher vaccine uptake, PCV20 prevented more cases and deaths and yielded greater budget savings (vs PCV13→PPV23).</p></div><div><h3>Conclusions</h3><p>PCV20 would reduce burden and economic costs of pneumococcal disease among expatriates in Dubai compared with PCV13→PPV23 and would therefore be budget saving for private health insurers who cover the majority of this population.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"98 ","pages":"Article 100698"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10121387/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9744147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmacotherapy for Infertility in Ghana: A Prospective Study on Prescription Patterns and Treatment Outcomes among Women undergoing Fertility Treatment 加纳不孕的药物治疗:一项对接受不孕治疗的妇女的处方模式和治疗结果的前瞻性研究
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.1016/j.curtheres.2023.100711
Stephen Mensah Arhin PhD , Kwesi Boadu Mensah PhD , Evans Kofi Agbeno MBChB, PhD , Isaac Tabiri Henneh PhD , Diallo Abdoul Azize MBChB, PhD , Abigail Boateng MBChB , Kwame Opoku-Agyeman PhD , Charles Ansah MPhil, PhD

Background

Pharmacotherapy remains a first-line and major treatment option for couples struggling with infertility, especially in sub-Saharan Africa, where other expensive alternatives are rarely available. Despite the reliance on pharmacotherapy for treating infertility in the subregion, especially for those diagnosed with unexplained infertility, little is known about the actual influence of drug therapies on conception.

Objectives

The study aimed to prospectively assess the prescription patterns and outcomes of pharmacotherapy for women undergoing fertility treatment in Ghana.

Methods

This prospective cohort study involved 482 infertile women presenting for fertility treatment in 4 fertility clinics in the Cape Coast Metropolis of Ghana between March 2019 and February 2021. A simple random sampling technique was used to recruit subjects for the study. The women were followed up for 12 months to assess the outcome of drug therapy on conception. Data analysis was done using Stata version 14. Logistic regression was used to assess the association between trends with dichotomous outcomes.

Results

The study identified that approximately 45.2% of the patients received monotherapy, whereas 24.1% received a combination of 2 drugs. Patients treated with a combination of 3 drugs were more likely to conceive (adjusted odds ratio = 4.10; 95% CI, 1.29–13.02; P = 0.02) than those without treatment.

Conclusions

Patients treated with combination therapies had higher chances of conception than those without medications. However, a combination of nutritional and herbal therapies were associated with improved outcomes compared with conventional and nutritional supplements. The study's outcome could provide fertility specialists and stakeholders insight into choosing appropriate treatment options for prospective couples seeking fertility care. Consequently, fertility patients can access specific treatment options to meet their desired needs.

背景药物治疗仍然是不孕不育夫妇的一线和主要治疗选择,尤其是在撒哈拉以南非洲,那里很少有其他昂贵的替代品。尽管该次区域的不孕不育治疗依赖药物治疗,尤其是对那些被诊断为不明原因不孕的不孕不育患者,但人们对药物治疗对受孕的实际影响知之甚少。目的本研究旨在前瞻性评估加纳接受生育治疗的妇女的药物治疗处方模式和结果。方法本前瞻性队列研究涉及2019年3月至2021年2月期间在加纳开普海岸大都市的4家生育诊所接受生育治疗。采用简单的随机抽样技术招募受试者参与研究。对这些妇女进行了12个月的随访,以评估药物治疗对受孕的影响。使用Stata版本14进行数据分析。Logistic回归用于评估趋势与二分结果之间的相关性。结果研究发现,约45.2%的患者接受单一治疗,24.1%的患者接受两种药物的联合治疗。接受3种药物联合治疗的患者更有可能怀孕(调整后的比值比 = 4.10;95%置信区间,1.29–13.02;P = 0.02)。结论接受联合治疗的患者受孕几率高于未接受药物治疗的患者。然而,与传统营养补充剂和营养补充剂相比,营养和草药疗法的结合与改善疗效有关。这项研究的结果可以让生育专家和利益相关者深入了解为寻求生育护理的准夫妇选择合适的治疗方案。因此,生育患者可以获得特定的治疗选择,以满足他们的需求。
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引用次数: 0
The Effect of Using Dexamethasone Tablets Vaginally for Improving Cervical Bishop Score in Nulliparous Pregnant Women: A Randomized Clinical Trial 阴道使用地塞米松片提高未产孕妇宫颈Bishop评分的效果:一项随机临床试验
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.1016/j.curtheres.2023.100702
Masoumeh Farahani Assistant Professor , Matineh Nirouei Doctor of Medicine , Somaye Moghadam Bachelor of Midwifery , Maryam Hashemnejad Assistant Professor , Banafsheh Mashak Assistant Professor , Tina Alinia Doctor of Medicine , Sahar Torabi Bachelor of Midwifery

Background

Cervix ripening and labor induction are common interventions in obstetrics. For optimal maternal health, labor may be induced under certain situations to improve fetal survival outcomes. Labor induction of an unripe cervix can lead to complications; therefore, several approaches can facilitate the ripening process.

Methods

This randomized clinical trial was a triple-blind study that involved 84 pregnant nulliparous women enrolled between October 2019 and June 2021 in the labor ward of Kamali Hospital, Karaj, Iran. The pregnant women in the study underwent labor induction and were randomized into 2 groups: 1 group received vaginal dexamethasone and the other group was given a placebo.

Results

There was no significant difference between the groups regarding maternal age, demographic characteristics, and initial Bishop score. The median second Bishop score (6 hours after intervention) was 3.5 in dexamethasone recipients and 3 in placebo recipients (P = 0.48). The median labor latent phase duration was 4 hours in dexamethasone recipients and 5 hours in placebo recipients (P = 0.57).

Conclusions

This randomized clinical trial demonstrated that administering dexamethasone tablets vaginally did not significantly improve cervical Bishop scores. (Curr Ther Res Clin Exp. 2023; 84:XXX–XXX). ClinicalTrials.gov identifier: NCT05070468.

背景宫颈成熟和引产是产科常见的干预措施。为了获得最佳的产妇健康,可以在某些情况下引产,以提高胎儿的存活率。宫颈未成熟的引产会导致并发症;因此,几种方法可以促进成熟过程。方法这项随机临床试验是一项三盲研究,涉及2019年10月至2021年6月在伊朗卡拉杰Kamali医院分娩病房登记的84名未产妇。研究中的孕妇接受了引产,并被随机分为两组:一组接受阴道地塞米松治疗,另一组接受安慰剂治疗。结果两组在产妇年龄、人口学特征和初始Bishop评分方面无显著差异。地塞米松受试者的第二次Bishop评分中位数(干预后6小时)为3.5,安慰剂受试者为3(P = 地塞米松组的中位产程潜伏期为4小时,安慰剂组为5小时(P = 0.57)。结论本随机临床试验表明,阴道给药地塞米松片并不能显著改善宫颈Bishop评分。(Curr Ther Res Clin Exp.2023;84:XXX–XXX)。ClinicalTrials.gov标识符:NCT05070468。
{"title":"The Effect of Using Dexamethasone Tablets Vaginally for Improving Cervical Bishop Score in Nulliparous Pregnant Women: A Randomized Clinical Trial","authors":"Masoumeh Farahani Assistant Professor ,&nbsp;Matineh Nirouei Doctor of Medicine ,&nbsp;Somaye Moghadam Bachelor of Midwifery ,&nbsp;Maryam Hashemnejad Assistant Professor ,&nbsp;Banafsheh Mashak Assistant Professor ,&nbsp;Tina Alinia Doctor of Medicine ,&nbsp;Sahar Torabi Bachelor of Midwifery","doi":"10.1016/j.curtheres.2023.100702","DOIUrl":"10.1016/j.curtheres.2023.100702","url":null,"abstract":"<div><h3>Background</h3><p>Cervix ripening and labor induction are common interventions in obstetrics. For optimal maternal health, labor may be induced under certain situations to improve fetal survival outcomes. Labor induction of an unripe cervix can lead to complications; therefore, several approaches can facilitate the ripening process.</p></div><div><h3>Methods</h3><p>This randomized clinical trial was a triple-blind study that involved 84 pregnant nulliparous women enrolled between October 2019 and June 2021 in the labor ward of Kamali Hospital, Karaj, Iran. The pregnant women in the study underwent labor induction and were randomized into 2 groups: 1 group received vaginal dexamethasone and the other group was given a placebo.</p></div><div><h3>Results</h3><p>There was no significant difference between the groups regarding maternal age, demographic characteristics, and initial Bishop score. The median second Bishop score (6 hours after intervention) was 3.5 in dexamethasone recipients and 3 in placebo recipients (<em>P</em> = 0.48). The median labor latent phase duration was 4 hours in dexamethasone recipients and 5 hours in placebo recipients (<em>P</em> = 0.57).</p></div><div><h3>Conclusions</h3><p>This randomized clinical trial demonstrated that administering dexamethasone tablets vaginally did not significantly improve cervical Bishop scores. (<em>Curr Ther Res Clin Exp</em>. 2023; 84:XXX–XXX). ClinicalTrials.gov identifier: NCT05070468.</p></div>","PeriodicalId":10920,"journal":{"name":"Current Therapeutic Research-clinical and Experimental","volume":"98 ","pages":"Article 100702"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10124091/pdf/main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9349767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of Netarsudil versus Brimonidine in Eyes already Being Treated with Glaucoma Medications at a Single Academic Tertiary Care Practice: A Comparative Study 在单一学术三级保健实践中,奈沙地尔与溴莫尼定在已经接受青光眼药物治疗的眼睛中的有效性:一项比较研究
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.1016/j.curtheres.2022.100689
Alex T. Pham BS , Chris Bradley PhD , Corinne Casey OD , Henry D. Jampel MD , Pradeep Y. Ramulu MD, PhD , Jithin Yohannan MD, MPH

Background

Rho kinase inhibitors, such as netarsudil, are a relatively new class of medications recently introduced into the market for the treatment of glaucoma, the leading cause of irreversible blindness in the world. Previous clinical trials have studied netarsudil's efficacy when used as a first- or second-line agent but limited studies have investigated its effectiveness in the real world where it is more commonly used as a third, fourth, or fifth agent in combination with other topical medications. Equally important, prior studies have not compared its effectiveness to its peer medications in these settings.

Objective

To compare intraocular pressure (IOP) lowering after initiation of netarsudil or brimonidine therapy in patients with glaucoma using >2 medications for IOP management.

Methods

A chart review of 369 eyes from 279 patients followed at a single academic tertiary practice was performed with an institutional review board waiver of consent to compare IOP lowering after prescription of netarsudil (n = 176) versus brimonidine (n = 193) as a third, fourth, or fifth IOP-lowering agent. Patients were identified by querying the electronic medical record for those with a glaucoma-related diagnosis who were prescribed either medication. Five sequential IOP measurements were obtained to determine the mean change in IOP before and after treatment (ΔIOP = mean IOP4,5 – mean IOP1,2,3). A multilevel linear mixed-effects model assessed the influence of medication (independent variable) on ΔIOP (dependent variable). Additional independent variables of interest included the number of glaucoma medications at baseline, age, sex, glaucoma type and severity, race, and pretreatment IOP. Bootstrap analysis was performed to remove sampling bias and confirm mixed-effects model findings. Kaplan-Meier survival analysis evaluated the probability of requiring additional intervention within 3 years following the date of medication prescription.

Results

The unadjusted mean (SD) ΔIOP for netarsudil and brimonidine was −2.20 (4.11) mm Hg and −2.21 (3.25) mm Hg, respectively (P = 0.484). The adjusted linear mixed-effects models and bootstrap analysis demonstrated that there was no statistical difference in IOP-lowering effectiveness between the medications. Netarsudil and brimonidine failed to adequately control IOP at similar rates with 42% and 47% probabilities of survival respectively by the 3-year follow-up (P = 0.520).

Conclusions

When escalating pharmacologic therapy, the IOP-lowering effect of netarsudil appeared to be similar to that produced by brimonidine. (Curr Ther Res Clin Exp. 2023; 84:XXX–XXX)

背景Rho激酶抑制剂,如netarsudil,是最近引入市场的一类相对较新的药物,用于治疗青光眼,青光眼是世界上不可逆失明的主要原因。先前的临床试验研究了奈他舒作为一线或二线药物的疗效,但有限的研究调查了它在现实世界中的疗效,在现实世界里,它更常见地作为第三、第四或第五种药物与其他局部药物联合使用。同样重要的是,先前的研究没有将其有效性与这些环境中的同行药物进行比较。目的比较应用>;2种用于IOP管理的药物。方法对来自279名患者的369只眼睛进行图表审查,这些患者在一个单一的学术三级诊所接受了随访,机构审查委员会放弃了同意书,以比较服用耐塔舒地尔(n = 176)与溴莫尼定(n = 193)作为第三、第四或第五IOP降低剂。通过查询与青光眼相关的诊断患者的电子医疗记录来识别患者,这些患者被开了两种药物。获得了五次连续的IOP测量,以确定治疗前后IOP的平均变化(ΔIOP = 平均IOP4,5–平均IOP1,2,3)。多水平线性混合效应模型评估了药物(自变量)对ΔIOP(因变量)的影响。其他感兴趣的自变量包括基线时青光眼药物的数量、年龄、性别、青光眼类型和严重程度、种族和治疗前眼压。进行Bootstrap分析以消除抽样偏差并确认混合效应模型的发现。Kaplan-Meier生存分析评估了在药物处方日期后3年内需要额外干预的可能性。结果奈他舒地尔和溴莫尼定的未校正平均ΔIOP分别为−2.20(4.11)mm Hg和−2.21(3.25)mm Hg(P = 0.484)。调整后的线性混合效应模型和bootstrap分析表明,两种药物在降低眼压的有效性方面没有统计学差异。耐达舒地尔和溴莫尼定未能以相似的比率充分控制眼压,3年随访的存活率分别为42%和47%(P = 0.520)。结论在递增药物治疗时,耐塔舒地尔的降眼压作用与溴莫尼定相似。(Curr Ther Res Clin Exp.2023;84:XXX–XXX)
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引用次数: 1
An Acceptance and Commitment Therapy Smartphone Application for Erectile Dysfunction: A Feasibility Study 接受和承诺治疗智能手机应用于勃起功能障碍:可行性研究
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.1016/j.curtheres.2023.100728
Junichi Saito PhD , Hiroaki Kumano MD, PhD , Mohammad Ghazizadeh MD, PhD , Chigusa Shimokawa , Hideki Tanemura

Background

Erectile dysfunction (ED) is a multifactorial disorder with both psychogenic and organic components, but psychosocial factors are usually neglected.

Objective

The purpose of this study was to develop a smartphone application targeting psychosocial factors of ED and to examine its feasibility, acceptability, and treatment response to determine the parameters for a larger clinical trial.

Methods

In this single-arm feasibility study, 8 participants with situational ED were enrolled. Dr. App, a newly developed smartphone treatment application for patients with psychogenic ED consisting of 8 weekly modules based on Acceptance and Commitment Therapy, was delivered. The primary outcome was comparison of the International Index of Erectile Function-15 domain scores measured pre- and post-intervention.

Results

Six out of 8 participants completed the Dr. App and the post-intervention measures. The Wilcoxon signed-rank test showed a significant change in erectile function (P < 0.05; r = –0.65) and a significant trend in intercourse satisfaction (P < 0.10; r = –0.47) and overall satisfaction (P < .10; r = –0.47). Additionally, the reliable change index values were used to calculate the number of participants for whom a clinically meaningful difference occurred. The results showed that 33.30% of the participants had clinically meaningful differences in erectile function and 66.70% in intercourse satisfaction and overall satisfaction. On the other hand, no significant differences were shown in orgasmic function and sexual desire.

Conclusions

Findings from this study support the feasibility, acceptability, and potential usefulness of the smartphone application targeting psychosocial factors of ED and warrant a larger randomized clinical trial to confirm the results.

背景:勃起功能障碍(ED)是一种多因素的疾病,既有心理因素,也有器质性因素,但社会心理因素往往被忽视。本研究的目的是开发一款针对ED心理社会因素的智能手机应用程序,并检查其可行性、可接受性和治疗反应,以确定更大规模临床试验的参数。方法在单臂可行性研究中,8名情境性ED患者入组。新开发的心因性ED智能手机治疗应用Dr. App,基于接受与承诺治疗,每周8个模块。主要结果是比较干预前后测量的国际勃起功能指数-15域得分。结果8名参与者中有6人完成了Dr. App和干预后措施。Wilcoxon符号秩检验显示勃起功能有显著变化(P <0.05;r = -0.65),性交满意度有显著趋势(P <0.10;r = -0.47)和总体满意度(P <.10;r = -0.47)。此外,可靠的变化指标值被用来计算有临床意义的差异发生的参与者人数。结果显示,33.30%的参与者在勃起功能方面有临床意义的差异,66.70%的参与者在性交满意度和总体满意度方面有临床意义的差异。另一方面,在性高潮功能和性欲方面没有显着差异。结论:本研究的结果支持了针对ED心理社会因素的智能手机应用程序的可行性、可接受性和潜在的有用性,并需要更大规模的随机临床试验来证实结果。
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引用次数: 0
Drugs Currently Undergoing Preclinical or Clinical Trials for the Treatment of Overactive Bladder: A Review 目前正在进行治疗膀胱过动症的临床前或临床试验的药物:综述
IF 1.9 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-04-01 DOI: 10.1016/j.curtheres.2022.100669
Silvia Joseph, Steffie Maria, J. Peedicayil
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引用次数: 11
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Current Therapeutic Research-clinical and Experimental
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