Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has reached a pandemic level. Very recently, I reported a significantly higher prevalence of diabetes and hypertension in severe COVID-19 as compared with non-severe COVID-19 by the meta-analysis. Considering that both diabetes and hypertension are risk factors for atherosclerosis, I further studied the prevalence of cardiovascular disease (CVD) in COVID-19 and found a significantly higher prevalence of CVD in severe patients than in non-severe patients. I speculate that the pre-existing vascular damage is associated with severity of COVID-19. A recent study showed that obese patients with COVID-19, despite their younger age, required more frequently assisted ventilation and access to intensive care units than normal weight patients. I thought that if the reason that COVID-19 is likely to become severe in obese people could be elucidated, the mechanism for aggravation of COVID-19 would be understood. As a result of considering a model of aggravation in obese people, I came up with the notion that pre-existing risk factors in obese people such as their vascular high-affinity for SARS-CoV-2, pro-inflammatory and pro-coagulant state and endothelial dysfunction may be likely to induce the development of “systemic severe coagulopathic vasculitis (SSCV)” in obese people. I believe that SSCV may largely contribute to the development of severe COVID-19. Here, I will describe the points of action of drugs for treating COVID-19 by using the SSCV model. J Endocrinol Metab. 2020;10(3-4):57-59 doi: https://doi.org/10.14740/jem659
{"title":"The Points of Action of Drugs for Treating COVID-19","authors":"H. Yanai","doi":"10.14740/jem659","DOIUrl":"https://doi.org/10.14740/jem659","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has reached a pandemic level. Very recently, I reported a significantly higher prevalence of diabetes and hypertension in severe COVID-19 as compared with non-severe COVID-19 by the meta-analysis. Considering that both diabetes and hypertension are risk factors for atherosclerosis, I further studied the prevalence of cardiovascular disease (CVD) in COVID-19 and found a significantly higher prevalence of CVD in severe patients than in non-severe patients. I speculate that the pre-existing vascular damage is associated with severity of COVID-19. A recent study showed that obese patients with COVID-19, despite their younger age, required more frequently assisted ventilation and access to intensive care units than normal weight patients. I thought that if the reason that COVID-19 is likely to become severe in obese people could be elucidated, the mechanism for aggravation of COVID-19 would be understood. As a result of considering a model of aggravation in obese people, I came up with the notion that pre-existing risk factors in obese people such as their vascular high-affinity for SARS-CoV-2, pro-inflammatory and pro-coagulant state and endothelial dysfunction may be likely to induce the development of “systemic severe coagulopathic vasculitis (SSCV)” in obese people. I believe that SSCV may largely contribute to the development of severe COVID-19. Here, I will describe the points of action of drugs for treating COVID-19 by using the SSCV model. J Endocrinol Metab. 2020;10(3-4):57-59 doi: https://doi.org/10.14740/jem659","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48183991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is no established standard of care for the medical management of primary hyperparathyroidism in pregnancy for those patients who are not surgical candidates. We present a case of primary hyperparathyroidism in the third trimester that was managed with cinacalcet and a literature review on the various modalities for the medical management of primary hyperparathyroidism in pregnancy. The primary aim of this case report is to document a case of hyperparathyroidism in pregnancy that was managed medically and to perform a brief systematic review of the literature available on the medical management of primary hyperparathyroidism in pregnancy. The secondary aim is to contribute to the literature available on the use of cinacalcet in pregnancy. A 37-year-old woman with untreated primary hyperparathyroidism presented at 32 weeks of gestation with hypercalcemia that was not amenable to surgical intervention. We treated her with increasing doses of cinacalcet with improvement in her serum calcium until developing pre-eclampsia which prompted emergent cesarean delivery of the infant. The neonate developed respiratory distress after delivery but did not develop hypocalcemia after birth. The neonate became transiently hypercalcemic in the setting of calcium gluconate infusions given to prevent hypocalcemia. The patient underwent surgical removal of a parathyroid adenoma and required calcium supplementation for 1 month afterwards. Hypercalcemic crisis during pregnancy is associated with significant maternal and fetal morbidity. There is limited information regarding the medical management of primary hyperparathyroidism due to the lack of high-powered studies and prospective studies owing to the relative rarity of the condition. No serious adverse maternal events were reported for either bisphosphonate or cinacalcet use. Adverse neonatal events include transient hypocalcemia of the infant with cinacalcet use and possibly low birth weight, infantile hypocalcemia, and shortened gestational periods with bisphosphonate use. J Endocrinol Metab. 2020;10(2):49-53 doi: https://doi.org/10.14740/jem624
{"title":"Medical Management of Primary Hyperparathyroidism in Pregnancy: A Case Report and Brief Literature Review","authors":"Xinyuan Ning, Wedad Rahman, R. Malek","doi":"10.14740/jem624","DOIUrl":"https://doi.org/10.14740/jem624","url":null,"abstract":"There is no established standard of care for the medical management of primary hyperparathyroidism in pregnancy for those patients who are not surgical candidates. We present a case of primary hyperparathyroidism in the third trimester that was managed with cinacalcet and a literature review on the various modalities for the medical management of primary hyperparathyroidism in pregnancy. The primary aim of this case report is to document a case of hyperparathyroidism in pregnancy that was managed medically and to perform a brief systematic review of the literature available on the medical management of primary hyperparathyroidism in pregnancy. The secondary aim is to contribute to the literature available on the use of cinacalcet in pregnancy. A 37-year-old woman with untreated primary hyperparathyroidism presented at 32 weeks of gestation with hypercalcemia that was not amenable to surgical intervention. We treated her with increasing doses of cinacalcet with improvement in her serum calcium until developing pre-eclampsia which prompted emergent cesarean delivery of the infant. The neonate developed respiratory distress after delivery but did not develop hypocalcemia after birth. The neonate became transiently hypercalcemic in the setting of calcium gluconate infusions given to prevent hypocalcemia. The patient underwent surgical removal of a parathyroid adenoma and required calcium supplementation for 1 month afterwards. Hypercalcemic crisis during pregnancy is associated with significant maternal and fetal morbidity. There is limited information regarding the medical management of primary hyperparathyroidism due to the lack of high-powered studies and prospective studies owing to the relative rarity of the condition. No serious adverse maternal events were reported for either bisphosphonate or cinacalcet use. Adverse neonatal events include transient hypocalcemia of the infant with cinacalcet use and possibly low birth weight, infantile hypocalcemia, and shortened gestational periods with bisphosphonate use. J Endocrinol Metab. 2020;10(2):49-53 doi: https://doi.org/10.14740/jem624","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42076655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liuba Arteche-Hidalgo, J. C. Fernández-Travieso, Noysbel Suarez-Camejo, Juan Marin-Preval, Victor Alvarez-Acosta, Julian Chaviano-Pereira, M. García-Sánchez, Idelsis Esquivel-Moinelo, M. Diaz-Gonzalez, Odalys Matos-Reyes, L. Fernández-Dorta, José Illnait-Ferrer, S. Mendoza-Castaño, Maicel Monzon-Perez, Victoria Sanchez Pedroso
Background: The metabolic syndrome comprises a set of cardiovascular risk factors represented by obesity of central distribution, dyslipidemias, glucose metabolism abnormalities and arterial hypertension, closely associated with insulin resistance. Policosanol is a mixture of high molecular weight alcohols purified from sugar cane wax with cholesterol-lowering and antioxidant effects. The aim of this study is to investigate in the medium term the effects of policosanol in patients with metabolic syndrome, as well as its safety and tolerability. Methods: This phase IV study had a double-blind, randomized and controlled design, with two parallel groups that received policosanol (10 mg/day) or placebo for 6 months. The study included patients with metabolic syndrome, of both sexes, aged between 25 and 70 years. As a primary efficacy variable, the effects on oxidative stress were evaluated, while the effects on lipids profile variables were considered as a secondary efficacy variable. Statistical analysis of the data was performed according to the intention-to-treat method. Results: The study included 100 patients with metabolic syndrome (81 men, 19 women) (average age: 51 years). At the end of 6 months of treatment, policosanol significantly reduced the redox index with respect to the initial values and with respect to the placebo group. Policosanol significantly reduced levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C), as well as increased serum levels of high-density lipoprotein cholesterol (HDL-C), while triglyceride levels although reduced at the end of treatment, this reduction was not significant. The policosanol was safe and well tolerate; it did not affect the physical and laboratory parameters investigated, with the exception of a significant and favorable reduction in the levels of apolipoprotein (Apo) B. Conclusions: It is concluded that policosanol therapy for 6 months produces improvements on oxidative stress in patients with metabolic syndrome, in addition to a beneficial effect on their lipid profile, being safe and well tolerated. J Endocrinol Metab. 2020;10(2):36-44 doi: https://doi.org/10.14740/jem642
{"title":"Effects of Policosanol in Patients With Metabolic Syndrome: A Six-Month Study","authors":"Liuba Arteche-Hidalgo, J. C. Fernández-Travieso, Noysbel Suarez-Camejo, Juan Marin-Preval, Victor Alvarez-Acosta, Julian Chaviano-Pereira, M. García-Sánchez, Idelsis Esquivel-Moinelo, M. Diaz-Gonzalez, Odalys Matos-Reyes, L. Fernández-Dorta, José Illnait-Ferrer, S. Mendoza-Castaño, Maicel Monzon-Perez, Victoria Sanchez Pedroso","doi":"10.14740/jem642","DOIUrl":"https://doi.org/10.14740/jem642","url":null,"abstract":"Background: The metabolic syndrome comprises a set of cardiovascular risk factors represented by obesity of central distribution, dyslipidemias, glucose metabolism abnormalities and arterial hypertension, closely associated with insulin resistance. Policosanol is a mixture of high molecular weight alcohols purified from sugar cane wax with cholesterol-lowering and antioxidant effects. The aim of this study is to investigate in the medium term the effects of policosanol in patients with metabolic syndrome, as well as its safety and tolerability. Methods: This phase IV study had a double-blind, randomized and controlled design, with two parallel groups that received policosanol (10 mg/day) or placebo for 6 months. The study included patients with metabolic syndrome, of both sexes, aged between 25 and 70 years. As a primary efficacy variable, the effects on oxidative stress were evaluated, while the effects on lipids profile variables were considered as a secondary efficacy variable. Statistical analysis of the data was performed according to the intention-to-treat method. Results: The study included 100 patients with metabolic syndrome (81 men, 19 women) (average age: 51 years). At the end of 6 months of treatment, policosanol significantly reduced the redox index with respect to the initial values and with respect to the placebo group. Policosanol significantly reduced levels of total cholesterol and low-density lipoprotein cholesterol (LDL-C), as well as increased serum levels of high-density lipoprotein cholesterol (HDL-C), while triglyceride levels although reduced at the end of treatment, this reduction was not significant. The policosanol was safe and well tolerate; it did not affect the physical and laboratory parameters investigated, with the exception of a significant and favorable reduction in the levels of apolipoprotein (Apo) B. Conclusions: It is concluded that policosanol therapy for 6 months produces improvements on oxidative stress in patients with metabolic syndrome, in addition to a beneficial effect on their lipid profile, being safe and well tolerated. J Endocrinol Metab. 2020;10(2):36-44 doi: https://doi.org/10.14740/jem642","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47933166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Hazam, A. Taha, J. Kimbugwe, Nahla Elzubeir, S. Prakash, Faiza Mubeen, Bharat Khandheria
Data supporting an association between primary hypothyroidism and non-alcoholic fatty liver disease (NAFLD) is lacking. Thyroid hormones are totally involved in the regulation of body weight, lipid metabolism, and insulin resistance. Therefore, thyroid hormones may have a role in the pathogenesis of NAFLD and nonalcoholic steatohepatitis (NASH). The results of studies investigating the association between NAFLD and thyroid dysfunction have been inconsistent; many have provided data supporting the association, while a few others have refuted it. This report presents the case of a 56-year-old obese Hispanic man who was diagnosed with liver cirrhosis secondary to NAFLD and presented 3 months later with severe hypothyroidism. J Endocrinol Metab. 2020;10(2):45-48 doi: https://doi.org/10.14740/jem644
{"title":"Hypothyroidism and Non-Alcoholic Fatty Liver Disease","authors":"R. Hazam, A. Taha, J. Kimbugwe, Nahla Elzubeir, S. Prakash, Faiza Mubeen, Bharat Khandheria","doi":"10.14740/jem644","DOIUrl":"https://doi.org/10.14740/jem644","url":null,"abstract":"Data supporting an association between primary hypothyroidism and non-alcoholic fatty liver disease (NAFLD) is lacking. Thyroid hormones are totally involved in the regulation of body weight, lipid metabolism, and insulin resistance. Therefore, thyroid hormones may have a role in the pathogenesis of NAFLD and nonalcoholic steatohepatitis (NASH). The results of studies investigating the association between NAFLD and thyroid dysfunction have been inconsistent; many have provided data supporting the association, while a few others have refuted it. This report presents the case of a 56-year-old obese Hispanic man who was diagnosed with liver cirrhosis secondary to NAFLD and presented 3 months later with severe hypothyroidism. J Endocrinol Metab. 2020;10(2):45-48 doi: https://doi.org/10.14740/jem644","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42767751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Gervasi, L. Curto, S. Fulginiti, V. Tiesi, N. Innaro
Parathyroid carcinoma is a rare endocrine malignancy. Clinical features of parathyroid carcinoma are mainly due to the effects of primary hyperparathyroidism (PHPT). Hypercalcemia produced by primary or secondary hyperparathyroidism is a rare and unclear cause of acute pancreatitis. Acute pancreatitis was rarely described before as the first manifestation of parathyroid carcinoma. The case concerns a 45-year-old man with hypercalcemia (15.9 mg/dL) and high levels of parathyroid hormone (1,089 pg/mL). Laboratory findings and ultrasound directed to right nodular goitre and an adenoma of the right lower parathyroid. The patient underwent right parathyroidectomy and ipsilateral loboistmectomy with laterocervical lymphadenectomy. On the first postoperative day he reported pain in the epigastrium, resistant to analgesics. Laboratory values and computed tomography (CT) scan, associated with clinical data, indicated exudative pancreatitis. It was treated with medical therapy; after some days there was resolution of symptoms and laboratory indexes returned to normal value. Histological examination diagnosed infiltrating parathyroid carcinoma that exceeded its capsule and infiltrated fibroadipose, muscular and perithyroidal tissues. After 18 months, no signs of local recurrence or metastases were observed. Our case report is unusual for its presentation. Acute pancreatitis can be observed in patient with PHPT, but it rarely reveals after parathyroidectomy. In patient who underwent parathyroidectomy with previous hypercalcemia associated with abdominal pain, acute pancreatitis should be suspected. J Endocrinol Metab. 2020;10(2):54-56 doi: https://doi.org/10.14740/jem636
{"title":"Acute Pancreatitis in a Patient With Parathyroid Carcinoma: A Case Report","authors":"R. Gervasi, L. Curto, S. Fulginiti, V. Tiesi, N. Innaro","doi":"10.14740/jem636","DOIUrl":"https://doi.org/10.14740/jem636","url":null,"abstract":"Parathyroid carcinoma is a rare endocrine malignancy. Clinical features of parathyroid carcinoma are mainly due to the effects of primary hyperparathyroidism (PHPT). Hypercalcemia produced by primary or secondary hyperparathyroidism is a rare and unclear cause of acute pancreatitis. Acute pancreatitis was rarely described before as the first manifestation of parathyroid carcinoma. The case concerns a 45-year-old man with hypercalcemia (15.9 mg/dL) and high levels of parathyroid hormone (1,089 pg/mL). Laboratory findings and ultrasound directed to right nodular goitre and an adenoma of the right lower parathyroid. The patient underwent right parathyroidectomy and ipsilateral loboistmectomy with laterocervical lymphadenectomy. On the first postoperative day he reported pain in the epigastrium, resistant to analgesics. Laboratory values and computed tomography (CT) scan, associated with clinical data, indicated exudative pancreatitis. It was treated with medical therapy; after some days there was resolution of symptoms and laboratory indexes returned to normal value. Histological examination diagnosed infiltrating parathyroid carcinoma that exceeded its capsule and infiltrated fibroadipose, muscular and perithyroidal tissues. After 18 months, no signs of local recurrence or metastases were observed. Our case report is unusual for its presentation. Acute pancreatitis can be observed in patient with PHPT, but it rarely reveals after parathyroidectomy. In patient who underwent parathyroidectomy with previous hypercalcemia associated with abdominal pain, acute pancreatitis should be suspected. J Endocrinol Metab. 2020;10(2):54-56 doi: https://doi.org/10.14740/jem636","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44591900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. There is an urgent need for effective treatment. Dipeptidyl peptidase 4 (DPP4; also known as cluster of differentiation 26 (CD26)) was identified as a functional receptor for the Middle East respiratory syndrome coronavirus (MERS-CoV) [1]. It has been speculated that the preferential spatial localization of DPP4 in alveolar regions may explain why MERS is characterized by lower respiratory tract diseases [2], and such characteristic was also observed in COVID-19. The S1 domain of SARS-CoV-2 spike glycoprotein potentially interacts with the human CD26, a key immunoregulatory factor for hijacking and virulence [3]. The widespread expression of DPP4 on blood vessels, myocardium, and myeloid cells and function of CD26 as a signaling and binding protein suggest a crucial role in cardiovascular regulation and inflammation [4]. DPP4 is upregulated in proinflammatory states such as obesity, diabetes and atherosclerotic diseases [4]. In a recent retrospective cohort study of COVID-19, comorbidities were present in nearly half of patients, with hypertension (30%) being the most common comorbidity, followed by diabetes (19%) and coronary artery disease (8%) [5]. In univariable analysis, odds of in-hospital death were significantly higher in patients with diabetes (2.85) or coronary artery disease (21.40) [5]. DPP4 inhibitor is the most commonly used oral antidiabetic drug, and its safety is excellent. The sub-analysis of COVID-19 retrospective cohort studies which evaluate the influence of DPP4 inhibitor use on severity, morbidity and mortality in diabetic patients may assist in the development of new therapeutics for COVID-19.
{"title":"Can Dipeptidyl Peptidase 4 Inhibitor Be the Therapeutic Candidate for the COVID-19?","authors":"H. Yanai","doi":"10.14740/jem641","DOIUrl":"https://doi.org/10.14740/jem641","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. There is an urgent need for effective treatment. Dipeptidyl peptidase 4 (DPP4; also known as cluster of differentiation 26 (CD26)) was identified as a functional receptor for the Middle East respiratory syndrome coronavirus (MERS-CoV) [1]. It has been speculated that the preferential spatial localization of DPP4 in alveolar regions may explain why MERS is characterized by lower respiratory tract diseases [2], and such characteristic was also observed in COVID-19. The S1 domain of SARS-CoV-2 spike glycoprotein potentially interacts with the human CD26, a key immunoregulatory factor for hijacking and virulence [3]. The widespread expression of DPP4 on blood vessels, myocardium, and myeloid cells and function of CD26 as a signaling and binding protein suggest a crucial role in cardiovascular regulation and inflammation [4]. DPP4 is upregulated in proinflammatory states such as obesity, diabetes and atherosclerotic diseases [4]. In a recent retrospective cohort study of COVID-19, comorbidities were present in nearly half of patients, with hypertension (30%) being the most common comorbidity, followed by diabetes (19%) and coronary artery disease (8%) [5]. In univariable analysis, odds of in-hospital death were significantly higher in patients with diabetes (2.85) or coronary artery disease (21.40) [5]. DPP4 inhibitor is the most commonly used oral antidiabetic drug, and its safety is excellent. The sub-analysis of COVID-19 retrospective cohort studies which evaluate the influence of DPP4 inhibitor use on severity, morbidity and mortality in diabetic patients may assist in the development of new therapeutics for COVID-19.","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":"10 1","pages":"35-35"},"PeriodicalIF":0.4,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49147295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. There is an urgent need for effective treatment. Currently, there is not any specific effective antiviral treatment for COVID-19. Supportive care remains the mainstay of therapy for COVID-19. At present, various antiviral and immunomodulating agents are in various stages of evaluation for COVID-19. The frequently used agents all over the world include chloroquine, hydroxychloroquine, lopinavir/ritonavir, favipiravir and remdesivir [1]. SARS-CoV-2 genome-based specific vaccines and therapeutic antibodies are currently being tested; however, we need more time to use such vaccines and antibodies. The existing therapeutic agents previously designed for other virus infections and pathologies attract attention because most of these agents have already been tested for their safety. These agents can be divided into two broad categories, those that can directly target the virus replication, and those based on immunotherapy which improves damage induced by inflammatory responses [2]. The initial clinical studies indicated the promising therapeutic potential of favipiravir, a broad-spectrum antiviral drug that interferes with the viral replication [2]. Here, I describe possible effects of favipiravir for COVID-19. Favipiravir plays as an inhibitor of the RNA-dependent RNA polymerase by structurally resembling the endogenous guanine [3]. Through competitive inhibition, the efficacy of viral replication can be largely reduced. Favipiravir has been shown to be effective in the treatment of influenza and Ebola virus [3-5]. Very recently, Wang et al showed that favipiravir was effective in reducing the SARS-CoV-2 infection in vitro [6]. In March 2020, favipiravir was approved by the National Medical Products Administration of China as the first anti-COVID-19 drug in China, because the clinical trial had demonstrated efficacy with minimal side effects. Chen et al conducted a prospective, randomized, controlled, openlabel multicenter trial involving adult patients with COVID-19 (ChiCTR2000030254) [7]. Patients were randomly assigned to receive conventional therapy plus favipiravir or arbidol which is a broad-spectrum antiviral compound that blocks viral fusion [8], for 10 days. Two hundred forty enrolled COVID-19 patients underwent randomization; 120 patients were assigned to receive favipiravir, and 120 to receive arbidol. Favipiravir led to shorter latencies to relief for both pyrexia by 1.70 days (P < 0.0001) and cough by 1.75 days (P < 0.0001). However, no difference was observed of the rate of auxiliary oxygen therapy or noninvasive mechanical ventilation. The most frequently observed favipiravir-associated adverse event was elevation of serum uric acid. Cai et al performed an open-label control study to evaluate experimental treatment with favipiravir for COVID-19 [9]. Patients were assigned to receive oral favipiravir p
{"title":"Favipiravir: A Possible Pharmaceutical Treatment for COVID-19","authors":"H. Yanai","doi":"10.14740/jem645","DOIUrl":"https://doi.org/10.14740/jem645","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. There is an urgent need for effective treatment. Currently, there is not any specific effective antiviral treatment for COVID-19. Supportive care remains the mainstay of therapy for COVID-19. At present, various antiviral and immunomodulating agents are in various stages of evaluation for COVID-19. The frequently used agents all over the world include chloroquine, hydroxychloroquine, lopinavir/ritonavir, favipiravir and remdesivir [1]. SARS-CoV-2 genome-based specific vaccines and therapeutic antibodies are currently being tested; however, we need more time to use such vaccines and antibodies. The existing therapeutic agents previously designed for other virus infections and pathologies attract attention because most of these agents have already been tested for their safety. These agents can be divided into two broad categories, those that can directly target the virus replication, and those based on immunotherapy which improves damage induced by inflammatory responses [2]. The initial clinical studies indicated the promising therapeutic potential of favipiravir, a broad-spectrum antiviral drug that interferes with the viral replication [2]. Here, I describe possible effects of favipiravir for COVID-19. Favipiravir plays as an inhibitor of the RNA-dependent RNA polymerase by structurally resembling the endogenous guanine [3]. Through competitive inhibition, the efficacy of viral replication can be largely reduced. Favipiravir has been shown to be effective in the treatment of influenza and Ebola virus [3-5]. Very recently, Wang et al showed that favipiravir was effective in reducing the SARS-CoV-2 infection in vitro [6]. In March 2020, favipiravir was approved by the National Medical Products Administration of China as the first anti-COVID-19 drug in China, because the clinical trial had demonstrated efficacy with minimal side effects. Chen et al conducted a prospective, randomized, controlled, openlabel multicenter trial involving adult patients with COVID-19 (ChiCTR2000030254) [7]. Patients were randomly assigned to receive conventional therapy plus favipiravir or arbidol which is a broad-spectrum antiviral compound that blocks viral fusion [8], for 10 days. Two hundred forty enrolled COVID-19 patients underwent randomization; 120 patients were assigned to receive favipiravir, and 120 to receive arbidol. Favipiravir led to shorter latencies to relief for both pyrexia by 1.70 days (P < 0.0001) and cough by 1.75 days (P < 0.0001). However, no difference was observed of the rate of auxiliary oxygen therapy or noninvasive mechanical ventilation. The most frequently observed favipiravir-associated adverse event was elevation of serum uric acid. Cai et al performed an open-label control study to evaluate experimental treatment with favipiravir for COVID-19 [9]. Patients were assigned to receive oral favipiravir p","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":"10 1","pages":"33-34"},"PeriodicalIF":0.4,"publicationDate":"2020-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45623234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Type 2 diabetes mellitus (T2DM) is often characterized by insulin resistance and progressive ?-cell deterioration. With longer duration of T2DM most patients treated with oral antihyperglycemic drugs (OADs), in monotherapy or in combination, will ultimately require basal insulin therapy and even further prandial intensification later on. The basal-plus regimen is one of the proposed approaches for treatment intensification by adding one injection of prandial rapid-acting insulin to basal insulin. The CONBA+ study aimed to collect real-world data of glycemic control of T2DM patients uncontrolled on insulin/OAD therapy using the basal-plus approach in Morocco. Methods: CONBA+ study was a national, prospective, non-interventional, multicenter study involving 50 endocrinologists from Morocco. The study, conducted between June 2015 and June 2017, enrolled T2DM patients uncontrolled on their previous regimen (hemoglobin A1c (HbA1c) ? 7.5% on two OADs, glargine 100 U/mL and OADs or once daily premixed insulin). Patients continued or newly initiated once-daily insulin glargine 100 U/mL (Gla-100) and also received one injection of insulin glulisine (Glu) at the main meal in replacing any previous treatment. Demographics, glycated hemoglobin (HbA1c), fasting blood glucose (FBG), postprandial glucose (PPG), insulin doses and the frequency of hypoglycemia were assessed at baseline and at 12 and 24 weeks after study entry. Results: Overall, 854 people (46.8% men) fulfilled the inclusion criteria. At baseline, mean age was 59.0 ± 9.4 years, mean duration of diabetes 10.8 ± 6.7 years (range: 1 - 45 years), mean body mass index (BMI) 27.4 ± 4.0 kg/m 2 and mean HbA1c 9.50±1.51%. After 24 weeks, 33.0% of patients achieved target HbA1c < 7.0% (primary endpoint). In addition, mean FPG and postprandial blood glucose (PPBG) improved significantly at week 24 (change from baseline: -88 mg/dL and -108 mg/dL respectively; P < 0.001) while the number of reported severe hypoglycemia was low. Conclusions: The use of a basal-plus regimen consisting of insulin glargine 100 U/mL and insulin glulisine injected at the main meal resulted in significant improvements of glycemic parameters. In addition, the basal-plus approach showed a good safety profile with a low risk of hypoglycemia. J Endocrinol Metab. 2020;10(1):16-22 doi: https://doi.org/10.14740/jem548
{"title":"Control of Glycemia With a Basal-Plus Regimen in People With Type 2 Diabetes Mellitus Insufficiently Controlled by Previous Treatment","authors":"H. Iraqi, N. Ansari","doi":"10.14740/jem548","DOIUrl":"https://doi.org/10.14740/jem548","url":null,"abstract":"Background: Type 2 diabetes mellitus (T2DM) is often characterized by insulin resistance and progressive ?-cell deterioration. With longer duration of T2DM most patients treated with oral antihyperglycemic drugs (OADs), in monotherapy or in combination, will ultimately require basal insulin therapy and even further prandial intensification later on. The basal-plus regimen is one of the proposed approaches for treatment intensification by adding one injection of prandial rapid-acting insulin to basal insulin. The CONBA+ study aimed to collect real-world data of glycemic control of T2DM patients uncontrolled on insulin/OAD therapy using the basal-plus approach in Morocco. Methods: CONBA+ study was a national, prospective, non-interventional, multicenter study involving 50 endocrinologists from Morocco. The study, conducted between June 2015 and June 2017, enrolled T2DM patients uncontrolled on their previous regimen (hemoglobin A1c (HbA1c) ? 7.5% on two OADs, glargine 100 U/mL and OADs or once daily premixed insulin). Patients continued or newly initiated once-daily insulin glargine 100 U/mL (Gla-100) and also received one injection of insulin glulisine (Glu) at the main meal in replacing any previous treatment. Demographics, glycated hemoglobin (HbA1c), fasting blood glucose (FBG), postprandial glucose (PPG), insulin doses and the frequency of hypoglycemia were assessed at baseline and at 12 and 24 weeks after study entry. Results: Overall, 854 people (46.8% men) fulfilled the inclusion criteria. At baseline, mean age was 59.0 ± 9.4 years, mean duration of diabetes 10.8 ± 6.7 years (range: 1 - 45 years), mean body mass index (BMI) 27.4 ± 4.0 kg/m 2 and mean HbA1c 9.50±1.51%. After 24 weeks, 33.0% of patients achieved target HbA1c < 7.0% (primary endpoint). In addition, mean FPG and postprandial blood glucose (PPBG) improved significantly at week 24 (change from baseline: -88 mg/dL and -108 mg/dL respectively; P < 0.001) while the number of reported severe hypoglycemia was low. Conclusions: The use of a basal-plus regimen consisting of insulin glargine 100 U/mL and insulin glulisine injected at the main meal resulted in significant improvements of glycemic parameters. In addition, the basal-plus approach showed a good safety profile with a low risk of hypoglycemia. J Endocrinol Metab. 2020;10(1):16-22 doi: https://doi.org/10.14740/jem548","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44101579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Kakuma, S. Ariki, Yuichi Yoshida, Hirotaka Shibata, Takashi Tsutsumi, Yoshikuni Kudo
Background: The impact of self-weighing on young adults attending college has not been fully clarified. The present study aimed to examine self-weighing behavior and associated gender differences in Japanese college students and investigate the relation between habitual daily self-weighing and physique, lifestyle factors and glycemic parameters. Methods: We retrospectively evaluated data from a 75-g oral glucose tolerance test (OGTT) that was performed during clinical training of medical students between 2010 and 2014. Information concerning physique (e.g. body weight and waist circumference) and a lifestyle-focused questionnaire were completed before the OGTT. Participants comprised 441 fifth-grade university students (279 males and 162 females) from the Oita University Faculty of Medicine. Results: A total of 26.8% of participants were habitual self-weighers. Females were significantly more likely to engage in habitual self-weighing than males. There were no significant differences in glucose metabolism between individuals who regularly weighed themselves and those who did not in either gender. Factors related to the performance of daily self-weighing were not skipping breakfast in males and regular exercise in females. Conclusions: Although there was no meaningful relation between habitual self-weighing and glucose metabolism in this study, eating breakfast regularly and exercising regularly independently promoted self-weighing behavior in males and females, respectively. These findings suggest that these common practices may be helpful for college students as a method to encourage habitual daily self-weighing, consequently providing a healthy environment in college life to prevent potential obesity-related diseases. J Endocrinol Metab. 2020;10(1):8-15 doi: https://doi.org/10.14740/jem633
{"title":"Relation Between Daily Self-Weighing and Physique, Lifestyle Factors, and Glycemic Parameters in Japanese College Students","authors":"T. Kakuma, S. Ariki, Yuichi Yoshida, Hirotaka Shibata, Takashi Tsutsumi, Yoshikuni Kudo","doi":"10.14740/jem633","DOIUrl":"https://doi.org/10.14740/jem633","url":null,"abstract":"Background: The impact of self-weighing on young adults attending college has not been fully clarified. The present study aimed to examine self-weighing behavior and associated gender differences in Japanese college students and investigate the relation between habitual daily self-weighing and physique, lifestyle factors and glycemic parameters. Methods: We retrospectively evaluated data from a 75-g oral glucose tolerance test (OGTT) that was performed during clinical training of medical students between 2010 and 2014. Information concerning physique (e.g. body weight and waist circumference) and a lifestyle-focused questionnaire were completed before the OGTT. Participants comprised 441 fifth-grade university students (279 males and 162 females) from the Oita University Faculty of Medicine. Results: A total of 26.8% of participants were habitual self-weighers. Females were significantly more likely to engage in habitual self-weighing than males. There were no significant differences in glucose metabolism between individuals who regularly weighed themselves and those who did not in either gender. Factors related to the performance of daily self-weighing were not skipping breakfast in males and regular exercise in females. Conclusions: Although there was no meaningful relation between habitual self-weighing and glucose metabolism in this study, eating breakfast regularly and exercising regularly independently promoted self-weighing behavior in males and females, respectively. These findings suggest that these common practices may be helpful for college students as a method to encourage habitual daily self-weighing, consequently providing a healthy environment in college life to prevent potential obesity-related diseases. J Endocrinol Metab. 2020;10(1):8-15 doi: https://doi.org/10.14740/jem633","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44477299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eman M. Albatayneh, N. Alnawaiseh, Sameeh Al-Sarayreh, Yousef M. Al-saraireh, Enas M Al-Zayadneh, Mohammad A. Abu-lobbad
{"title":"Correction to: Serologic Screening of Celiac Disease in Patients With Type 1 Diabetes","authors":"Eman M. Albatayneh, N. Alnawaiseh, Sameeh Al-Sarayreh, Yousef M. Al-saraireh, Enas M Al-Zayadneh, Mohammad A. Abu-lobbad","doi":"10.14740/jem507wc1","DOIUrl":"https://doi.org/10.14740/jem507wc1","url":null,"abstract":"","PeriodicalId":15712,"journal":{"name":"Journal of Endocrinology and Metabolism","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47155625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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