Monitoring critical process parameters of chemical and biotechnological processes is an essential tool at every stage of drug manufacturing technology. The aim of Process Analytical Technology (PAT) is to provide effective tools, such as multidimensional data analysis, modern analytical methods, and monitoring tools, for the continuous improvement of process understanding and knowledge. Among the methods of wide interest are optical and spectroscopic techniques that can be used in the control of chemical and biotechnological processes. The selection of the appropriate method is crucial and depends on many factors, including the nature of the process, the number of variables, and analytical limitations. This review focuses on a brief and precise characterization of spectroscopic and optical methods that can be applied to monitoring and control of chemical and biotechnological processes.
{"title":"Real-time quality control for chemical and biotechnological processes: a brief review","authors":"Agnieszka Kołodziejczak-Radzimska, Beata Rukowicz, Sharon Davin","doi":"10.20883/medical.e901","DOIUrl":"https://doi.org/10.20883/medical.e901","url":null,"abstract":"Monitoring critical process parameters of chemical and biotechnological processes is an essential tool at every stage of drug manufacturing technology. The aim of Process Analytical Technology (PAT) is to provide effective tools, such as multidimensional data analysis, modern analytical methods, and monitoring tools, for the continuous improvement of process understanding and knowledge. Among the methods of wide interest are optical and spectroscopic techniques that can be used in the control of chemical and biotechnological processes. The selection of the appropriate method is crucial and depends on many factors, including the nature of the process, the number of variables, and analytical limitations. This review focuses on a brief and precise characterization of spectroscopic and optical methods that can be applied to monitoring and control of chemical and biotechnological processes.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135244433","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: The global pharmaceuticals market is a trillion-dollar industry which grows more than 5% annually. However, in comparison to other manufacturing industries (e.g., oil refining, automotive), the pharmaceutical sector lags in manufacturing innovation and automation. In the production of pharmaceutical solid dosage forms, the use of energy utilization as a performance measure of production efficiency has neither been implemented extensively, nor been optimized to maximize efficiency. This study will focus on the development and implementation of a smart manufacturing platform to optimize energy productivity whilst maintaining tablet quality via the consideration of different manufacturing scenarios.
Methods: This study will consider three main unit operations (wet granulation, drying and milling) which are relatively more energy intensive in pharmaceutical downstream processing, used to produce solid dosage forms, such as tablets. Four case-studies will be considered, which are 1: baseline batch, 2: baseline continuous, 3: optimized batch and 4: optimized continuous. Smart manufacturing is implemented to present optimized cases 3: and 4: Improvements in the energy and performance metrics are quantified and compared to the baseline cases.
Results and conclusions: The smart manufacturing platform used in this study, integrates advanced process model development, optimization, technoeconomic analysis and data integration. The utilization of this framework contributed to a ~70% and ~80% improvement in energy utilization in the optimized batch and continuous cases, respectively, when compared to the baseline batch case. In the optimized cases, tablet quality was maintained within targeted specifications and was comparable to the baseline batch case. This smart manufacturing framework can be generalized for drug product manufacturing and other particulate-based industries such as food, agriculture, and fine chemicals.
{"title":"Energy efficient smart manufacturing of pharmaceutical solid oral dosage forms","authors":"Ashley Dan, Rohit Ramachandran","doi":"10.20883/medical.e893","DOIUrl":"https://doi.org/10.20883/medical.e893","url":null,"abstract":"Background: The global pharmaceuticals market is a trillion-dollar industry which grows more than 5% annually. However, in comparison to other manufacturing industries (e.g., oil refining, automotive), the pharmaceutical sector lags in manufacturing innovation and automation. In the production of pharmaceutical solid dosage forms, the use of energy utilization as a performance measure of production efficiency has neither been implemented extensively, nor been optimized to maximize efficiency. This study will focus on the development and implementation of a smart manufacturing platform to optimize energy productivity whilst maintaining tablet quality via the consideration of different manufacturing scenarios.
 Methods: This study will consider three main unit operations (wet granulation, drying and milling) which are relatively more energy intensive in pharmaceutical downstream processing, used to produce solid dosage forms, such as tablets. Four case-studies will be considered, which are 1: baseline batch, 2: baseline continuous, 3: optimized batch and 4: optimized continuous. Smart manufacturing is implemented to present optimized cases 3: and 4: Improvements in the energy and performance metrics are quantified and compared to the baseline cases. 
 Results and conclusions: The smart manufacturing platform used in this study, integrates advanced process model development, optimization, technoeconomic analysis and data integration. The utilization of this framework contributed to a ~70% and ~80% improvement in energy utilization in the optimized batch and continuous cases, respectively, when compared to the baseline batch case. In the optimized cases, tablet quality was maintained within targeted specifications and was comparable to the baseline batch case. This smart manufacturing framework can be generalized for drug product manufacturing and other particulate-based industries such as food, agriculture, and fine chemicals.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135387259","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}
Adrianna Nieciecka, Julia Tomys-Składowska, Magdalena Lamch, Monika Jabłońska, Natalia Błasik, Marta Janiszewska, Agata Wójcik-Kula
Introduction. Chronic fatigue syndrome is a disease that includes a number of various symptoms, among which the most characteristic symptom is fatigue. Diagnostic criteria are not unambiguous and vary depending on the scientific society by which they were developed. The aim of this review is to discuss the phenomenon of chronic fatigue, including its diagnostic criteria, epidemiology, pathophysiology, symptoms, and pharmacological and non-pharmacological strategies. Material and methods. 45 articles published were reviewed and placed in the PubMed and Google Scholar databases. Results. Chronic fatigue syndrome is defined as a group of symptoms whose dominant symptom is fatigue that persists after rest for at least 6 months. The Oxford or CDC criteria are most commonly used to make the diagnosis. Statistics on prevalence are inconclusive. There are several theories of origin - infectious, immunological, neuroendocrine, bioenergetic, neurological, autonomic and genetic. Other symptoms of chronic fatigue syndrome include sleep and memory disorders or muscle and joint pain. Current treatment focuses on symptomatic treatment, including education, diet, and physical activity, as well as pharmacotherapy for pain, sleep, and cognition. Discussion. Diagnosis and treatment of chronic fatigue syndrome undoubtedly is a medical challenge, due to non-specific symptoms, multifactorial pathogenesis and difficult to estimate prevalence of this disease. Future scientific development should focus especially on exploring the pathomechanism of CFS, which would enable the implementation of causal treatment.
{"title":"Chronic fatigue syndrome – challenge in diagnosis and management: a literature review","authors":"Adrianna Nieciecka, Julia Tomys-Składowska, Magdalena Lamch, Monika Jabłońska, Natalia Błasik, Marta Janiszewska, Agata Wójcik-Kula","doi":"10.20883/medical.e877","DOIUrl":"https://doi.org/10.20883/medical.e877","url":null,"abstract":"Introduction. Chronic fatigue syndrome is a disease that includes a number of various symptoms, among which the most characteristic symptom is fatigue. Diagnostic criteria are not unambiguous and vary depending on the scientific society by which they were developed. The aim of this review is to discuss the phenomenon of chronic fatigue, including its diagnostic criteria, epidemiology, pathophysiology, symptoms, and pharmacological and non-pharmacological strategies. Material and methods. 45 articles published were reviewed and placed in the PubMed and Google Scholar databases. Results. Chronic fatigue syndrome is defined as a group of symptoms whose dominant symptom is fatigue that persists after rest for at least 6 months. The Oxford or CDC criteria are most commonly used to make the diagnosis. Statistics on prevalence are inconclusive. There are several theories of origin - infectious, immunological, neuroendocrine, bioenergetic, neurological, autonomic and genetic. Other symptoms of chronic fatigue syndrome include sleep and memory disorders or muscle and joint pain. Current treatment focuses on symptomatic treatment, including education, diet, and physical activity, as well as pharmacotherapy for pain, sleep, and cognition. Discussion. Diagnosis and treatment of chronic fatigue syndrome undoubtedly is a medical challenge, due to non-specific symptoms, multifactorial pathogenesis and difficult to estimate prevalence of this disease. Future scientific development should focus especially on exploring the pathomechanism of CFS, which would enable the implementation of causal treatment.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"230 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135343941","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}
Bioavailability is a prerequisite for drug activity. In vivo bioavailability (intestinal permeability), linked to drug substance solubility and drug product dissolution, became the basis of Gordon L. Amidon’s Biopharmaceutical Classification System. One method of improving the drug substance’s bioavailability is to modify its structure chemically, leading to increased lipophilicity and the ability to penetrate the phospholipid bilayer of the cell membrane. These modifications, known as prodrug strategies, involve derivatizing the drug substance by introducing substituents that reduce the hydrophilicity of the molecule. The present mini-review outlines the examples of Christopher McGuigan’s prodrug strategies used to obtain antiviral nucleosides with enhanced bioavailability and activity. These strategies primarily involve forming and optimizing the structure of esters and amino acid esters, phosphoramidates, octadecyl phosphates, and bis-pivaloxymethyl phosphates. The review discusses the optimization of the phosphoramidate prodrug moiety of the SARS-CoV-2 antiviral nucleoside remdesivir in detail. It presents the resulting improvement in bioavailability and antiviral activity. Moreover, it focuses on the modern prodrug strategy as one of the major recent advances in drug substance development. This strategy effectively optimized physicochemical properties and improved the functional activity of the existing drug substances and drug substance candidates for the first time.
生物利用度是药物活性的先决条件。体内生物利用度(肠道渗透性)与药物溶解度和药物产物溶出度有关，成为Gordon L. Amidon生物制药分类系统的基础。提高原料药生物利用度的一种方法是化学修饰其结构，从而提高其亲脂性和穿透细胞膜磷脂双层的能力。这些修饰称为前药策略，包括通过引入降低分子亲水性的取代基来衍生原料药。本综述概述了Christopher McGuigan用于获得具有增强生物利用度和活性的抗病毒核苷的前药策略的例子。这些策略主要包括形成和优化酯类和氨基酸酯类、磷酰胺类、十八烷基磷酸盐和双磷酸甲氧甲基磷酸盐的结构。本文详细讨论了SARS-CoV-2抗病毒核苷瑞德西韦的磷酸酰胺前药片段的优化。它显示了由此产生的生物利用度和抗病毒活性的改善。此外，它侧重于现代前药战略，作为原料药开发的主要最新进展之一。该策略首次有效地优化了现有原料药和候选原料药的理化性质，提高了其功能活性。
{"title":"Recent advances in drug substance development – prodrug strategies for enhancing the bioavailability and potency of antiviral nucleosides","authors":"Andrzej Kutner","doi":"10.20883/medical.e878","DOIUrl":"https://doi.org/10.20883/medical.e878","url":null,"abstract":"Bioavailability is a prerequisite for drug activity. In vivo bioavailability (intestinal permeability), linked to drug substance solubility and drug product dissolution, became the basis of Gordon L. Amidon’s Biopharmaceutical Classification System. One method of improving the drug substance’s bioavailability is to modify its structure chemically, leading to increased lipophilicity and the ability to penetrate the phospholipid bilayer of the cell membrane. These modifications, known as prodrug strategies, involve derivatizing the drug substance by introducing substituents that reduce the hydrophilicity of the molecule. The present mini-review outlines the examples of Christopher McGuigan’s prodrug strategies used to obtain antiviral nucleosides with enhanced bioavailability and activity. These strategies primarily involve forming and optimizing the structure of esters and amino acid esters, phosphoramidates, octadecyl phosphates, and bis-pivaloxymethyl phosphates. The review discusses the optimization of the phosphoramidate prodrug moiety of the SARS-CoV-2 antiviral nucleoside remdesivir in detail. It presents the resulting improvement in bioavailability and antiviral activity. Moreover, it focuses on the modern prodrug strategy as one of the major recent advances in drug substance development. This strategy effectively optimized physicochemical properties and improved the functional activity of the existing drug substances and drug substance candidates for the first time.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135386945","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}
Michał Łomiak, Zofia Gajek, Jan Stępnicki, Agnieszka Lembas, Tomasz Mikuła, Alicja Wiercińska-Drapało
Background. Tenofovir disoproxil fumarate (TDF) or its prodrug tenofovir alafenamide fumarate (TAF) are currently being recommended in treatment of HIV infection. Distinct pharmacological properties of these two forms of a this drug make TAF treatment less nephrotoxic and lead to better impact on bone density. Nevertheless, there is a rising concern about possible metabolic adverse effects of TAF. The purpose of this study was to evaluate the effects on the lipid profile among ART (antiretroviral therapy)-experienced patients switching from TDF‑containing to TAF‑containing regimen in the first year after the switch. Methods. Demographic and clinical data of HIV‑positive ART‑experienced patients treated in infectious diseases department was retrospectively collected. Changes of lipid profile with regards to baseline BMI, age and time of ART duration were analyzed. Results. In the group of 36 patients there was a significant increase in total cholesterol levels (+18.43 mg/dl, SD = 23.86 mg/dl, p < 0.0001) and LDL levels (+13.75 mg/dl SD = 23.05 mg/dl, p = 0.001) in first 12 months after switching from TDF‑containing to TAF‑containing regimen. There were no statistically significant changes in both HDL and TG levels observed. Analysis of total cholesterol and LDL levels in certain subpopulations revealed a significant increase within first year after the switch in patients younger than 40 years old and in those whose BMI was within normal range. Conclusions. Presented data suggests that switching from TDF to TAF in ART‑experienced patients may be associated with worsening lipid parameters. Early detection and management of dyslipidemias among HIV‑positive patients are needed.
背景。富马酸替诺福韦二氧吡酯(TDF)或其前药富马酸替诺福韦阿拉胺(TAF)目前被推荐用于治疗HIV感染。这两种药物的不同药理特性使得TAF治疗肾毒性更小，对骨密度的影响更好。然而，人们越来越关注TAF可能对代谢产生的不良影响。本研究的目的是评估在ART(抗逆转录病毒治疗)经验患者从含TDF方案转换为含TAF方案后的第一年对脂质谱的影响。方法。回顾性收集在传染病科接受过抗逆转录病毒治疗的HIV阳性患者的人口学和临床资料。分析脂质变化与基线BMI、年龄和ART持续时间的关系。结果。在36例患者中，总胆固醇水平显著升高(+18.43 mg/dl, SD = 23.86 mg/dl, p <0.0001)和LDL水平(+13.75 mg/dl SD = 23.05 mg/dl, p = 0.001)在从含TDF方案转为含TAF方案后的前12个月。HDL和TG水平均无统计学意义的变化。对某些亚群中总胆固醇和低密度脂蛋白水平的分析显示，在年龄小于40岁的患者和BMI在正常范围内的患者中，转换后的一年内，总胆固醇和低密度脂蛋白水平显著增加。结论。现有数据表明，接受抗逆转录病毒治疗的患者从TDF转为TAF可能与血脂参数恶化有关。需要在艾滋病毒阳性患者中早期发现和管理血脂异常。
{"title":"Lipid profile after switching from TDF (tenofovir disoproxil)-containing to TAF (tenofovir alafenamide)-containing regimen in virologically suppressed people living with HIV","authors":"Michał Łomiak, Zofia Gajek, Jan Stępnicki, Agnieszka Lembas, Tomasz Mikuła, Alicja Wiercińska-Drapało","doi":"10.20883/medical.e808","DOIUrl":"https://doi.org/10.20883/medical.e808","url":null,"abstract":"Background. Tenofovir disoproxil fumarate (TDF) or its prodrug tenofovir alafenamide fumarate (TAF) are currently being recommended in treatment of HIV infection. Distinct pharmacological properties of these two forms of a this drug make TAF treatment less nephrotoxic and lead to better impact on bone density. Nevertheless, there is a rising concern about possible metabolic adverse effects of TAF. The purpose of this study was to evaluate the effects on the lipid profile among ART (antiretroviral therapy)-experienced patients switching from TDF‑containing to TAF‑containing regimen in the first year after the switch. Methods. Demographic and clinical data of HIV‑positive ART‑experienced patients treated in infectious diseases department was retrospectively collected. Changes of lipid profile with regards to baseline BMI, age and time of ART duration were analyzed. Results. In the group of 36 patients there was a significant increase in total cholesterol levels (+18.43 mg/dl, SD = 23.86 mg/dl, p < 0.0001) and LDL levels (+13.75 mg/dl SD = 23.05 mg/dl, p = 0.001) in first 12 months after switching from TDF‑containing to TAF‑containing regimen. There were no statistically significant changes in both HDL and TG levels observed. Analysis of total cholesterol and LDL levels in certain subpopulations revealed a significant increase within first year after the switch in patients younger than 40 years old and in those whose BMI was within normal range. Conclusions. Presented data suggests that switching from TDF to TAF in ART‑experienced patients may be associated with worsening lipid parameters. Early detection and management of dyslipidemias among HIV‑positive patients are needed.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134957686","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}
From ancient times, when medicine was based on folk knowledge, to the present era of advanced science, the beneficial effects of plants on various diseases, including diabetes, have been discovered. Approximately 537 million people worldwide have diabetes, and forecasts indicate further increases. Hence, there is a need to develop new effective therapies and interventions to support diabetes treatment. Many plants impact carbohydrate metabolism, and the amount of in vitro and in vivo research on animals and humans continues to grow, updating our knowledge about their potential applications in diabetes treatment and its complications. This review discusses six plant sources with proven anti-diabetic activity. The study serves as a literature review on plants and their derived compounds that exhibit hypoglycemic effects, which are significant in managing prediabetic conditions and diagnosed diabetes.
{"title":"Plants: past and present in the battle against diabetes","authors":"Anita Balewska, Magdalena Szczechla","doi":"10.20883/medical.e896","DOIUrl":"https://doi.org/10.20883/medical.e896","url":null,"abstract":"From ancient times, when medicine was based on folk knowledge, to the present era of advanced science, the beneficial effects of plants on various diseases, including diabetes, have been discovered. Approximately 537 million people worldwide have diabetes, and forecasts indicate further increases. Hence, there is a need to develop new effective therapies and interventions to support diabetes treatment. Many plants impact carbohydrate metabolism, and the amount of in vitro and in vivo research on animals and humans continues to grow, updating our knowledge about their potential applications in diabetes treatment and its complications. This review discusses six plant sources with proven anti-diabetic activity. The study serves as a literature review on plants and their derived compounds that exhibit hypoglycemic effects, which are significant in managing prediabetic conditions and diagnosed diabetes.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134960186","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}
The advancement of healthcare therapies is under constant development due to changing demographics and evolving disease-states. To ensure continuous furtherance of the healthcare system capacity to treat such ailments, emerging technologies (ETs) are coming to the forefront of medicine. It’s the hope that ETs are capable of covering a broad scope of therapeutic treatment areas, enabling novel pharmaceutical pathways to be established. Highlighted in this mini review are examples of focus ET areas, including additive manufacturing (AM), microfluidics (MFs), microelectromechanical systems (MEMS) and machine learning (ML), that have shown promising qualities and should be targeted further to improve patient outcomes.
{"title":"Emerging Technologies Transforming Therapy","authors":"Edward Weaver, Dimitrios Lamprou","doi":"10.20883/medical.e859","DOIUrl":"https://doi.org/10.20883/medical.e859","url":null,"abstract":"The advancement of healthcare therapies is under constant development due to changing demographics and evolving disease-states. To ensure continuous furtherance of the healthcare system capacity to treat such ailments, emerging technologies (ETs) are coming to the forefront of medicine. It’s the hope that ETs are capable of covering a broad scope of therapeutic treatment areas, enabling novel pharmaceutical pathways to be established. Highlighted in this mini review are examples of focus ET areas, including additive manufacturing (AM), microfluidics (MFs), microelectromechanical systems (MEMS) and machine learning (ML), that have shown promising qualities and should be targeted further to improve patient outcomes.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135875911","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}
Maciej Michalak, Sandra Mazurkiewicz, Jakub Szymczyk, Daniel Ziental, Łukasz Sobotta
Photodynamic therapy (PDT) is getting attention treatment method all over the world. As it is overviewed in the article among others strategies this technique is useful in the treatment of diseases in a wide range of disciplines: dermatology, urology, gynecology, as well as head and neck cancers and age-related macular degeneration. Recently, the development of this method is focused on looking for new photosensitizers and optimizing the dosimetry. Current articles report that PDT in many cases is a significant supply of the conventional treatment protocols but more than once it can be used as a method of choice, providing excellent outcomes and low after treatment stress on the patient.
{"title":"Photodynamic therapy applications – review","authors":"Maciej Michalak, Sandra Mazurkiewicz, Jakub Szymczyk, Daniel Ziental, Łukasz Sobotta","doi":"10.20883/medical.e865","DOIUrl":"https://doi.org/10.20883/medical.e865","url":null,"abstract":"Photodynamic therapy (PDT) is getting attention treatment method all over the world. As it is overviewed in the article among others strategies this technique is useful in the treatment of diseases in a wide range of disciplines: dermatology, urology, gynecology, as well as head and neck cancers and age-related macular degeneration. Recently, the development of this method is focused on looking for new photosensitizers and optimizing the dosimetry. Current articles report that PDT in many cases is a significant supply of the conventional treatment protocols but more than once it can be used as a method of choice, providing excellent outcomes and low after treatment stress on the patient.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85752959","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}
Marcin Ciechański, Edyta Witkowska, Agnieszka Ostańska, Adrianna Szafran, Klaudia Wiśniewska, Laura Piasek, Grzegorz Godek, Kacper Więcław, Katarzyna Stańko, Wiktor Terelak
Introduction: Diabetes mellitus is a metabolic disorder that might result in short and long-term health complications and even death if not properly managed. This disease affected 451 million people in 2017 worldwide and these figures are expected to increase to 693 million by 2045. Currently, there is no cure for diabetes. However, self-management, especially keeping BG in the recommended range, is crucial to the treatment. Aim: The aim of this paper is to offer an overview of current literature regarding CGM technologies. We outline mechanism of action, current use of CGM and discuss pros and cons of using this method in DM management. Materials and methods: A review of the literature available in PubMed and Google Scholar databases was conducted. Results and conclusions: Blood glucose measurement using a glucometer is an invasive method, not very comfortable for the patient, it detects only one temporary blood glucose level. This method does not reflect glucose fluctuations and trends, which makes effective diabetes management difficult. Even supplementing this method with HbA1c measurement does not bring as much relevant information for making therapeutic decision as CGM. The abundance of data provided by CGM and the ability to analyze them in greater detail, provide additional information to help achieve glycemic goals. It is a discreet and minimally invasive method, and the reading of blood glucose values can be easily read from mobile device. Data storage allows the doctor to view the past course of the disease and modify treatment. Manufacturers are constantly improving their devices, eliminating flaws, and the benefits of CGM improve treatment outcomes, which should translate into a reduction in the long-term complications of diabetes. Further research is needed, leading to the development of CGM technology. Key words: Continuous glucose monitoring; Blood glucose monitoring; MARD; Diabetes mellitus; HbA1c
{"title":"Pros and cons of continous glucose monitoring","authors":"Marcin Ciechański, Edyta Witkowska, Agnieszka Ostańska, Adrianna Szafran, Klaudia Wiśniewska, Laura Piasek, Grzegorz Godek, Kacper Więcław, Katarzyna Stańko, Wiktor Terelak","doi":"10.20883/medical.e873","DOIUrl":"https://doi.org/10.20883/medical.e873","url":null,"abstract":"Introduction: Diabetes mellitus is a metabolic disorder that might result in short and long-term health complications and even death if not properly managed. This disease affected 451 million people in 2017 worldwide and these figures are expected to increase to 693 million by 2045. Currently, there is no cure for diabetes. However, self-management, especially keeping BG in the recommended range, is crucial to the treatment. \u0000 \u0000Aim: The aim of this paper is to offer an overview of current literature regarding CGM technologies. We outline mechanism of action, current use of CGM and discuss pros and cons of using this method in DM management. \u0000 \u0000Materials and methods: A review of the literature available in PubMed and Google Scholar databases was conducted. \u0000 \u0000Results and conclusions: Blood glucose measurement using a glucometer is an invasive method, not very comfortable for the patient, it detects only one temporary blood glucose level. This method does not reflect glucose fluctuations and trends, which makes effective diabetes management difficult. Even supplementing this method with HbA1c measurement does not bring as much relevant information for making therapeutic decision as CGM. The abundance of data provided by CGM and the ability to analyze them in greater detail, provide additional information to help achieve glycemic goals. It is a discreet and minimally invasive method, and the reading of blood glucose values can be easily read from mobile device. Data storage allows the doctor to view the past course of the disease and modify treatment. Manufacturers are constantly improving their devices, eliminating flaws, and the benefits of CGM improve treatment outcomes, which should translate into a reduction in the long-term complications of diabetes. Further research is needed, leading to the development of CGM technology. \u0000 \u0000Key words: Continuous glucose monitoring; Blood glucose monitoring; MARD; Diabetes mellitus; HbA1c","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"269 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76808017","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}
Ayaskant Sahoo, Padmalatha Seelan, G. Dasari, Swathi Penmatsa
Background. Spinal anesthesia was a commonly used technique in anesthetic practice for lower abdominal and lower limb surgeries. To prolong the duration of bupivacaine spinal anesthesia adjuvants like α2 agonists and opioids have been used intrathecally. Clonidine and dexmedetomidine have also been found to prolong the duration of spinal anesthesia when given intravenous. Dexmedetomidine was more suitable adjuvant to spinal anesthesia compared to clonidine as it has more sedative and analgesic effects due to more selective α2A receptor agonist activity. Dexmedetomidine has been shown to prolong the duration of analgesia of spinal anaesthesia in various studies. Here we compare the two doses of Dexmedetomidine in prolonging the duration of analgesia. Material and methods. 60 American Society of Anaesthesiologists(ASA) physical status I/II patients scheduled for elective lower abdominal and lower limb surgeries under spinal anesthesia were randomized into two groups of 30 each. Immediately after subarachnoid block with 3.5ml of 0.5% hyperbaric bupivacaine, Group A patients received a loading dose of 0.5µg/kg of dexmedetomidine intravenously in 100ml NS over 10 mins whereas Group B received 1.0µg/kg of dexmedetomidine intravenously in 100ml NS over 10 mins. Results. Time for rescue analgesic were higher in Group B compared to Group A which was statistically significant but clinically the extra duration was insignificant. Time for two segment regression and duration of motor blockade was significantly prolonged in Group B. Requirement of Mephentermine was comparable in both the groups. There was no excessive sedation in both the groups. Conclusion. Dexmedetomidine administered as isolated loading dose of 0.5 µg/kg IV immediately after spinal anaesthesia was clinically equi-efficacious in prolonging the duration of analgesia of spinal anaesthesia compared to a larger dose of 1.0 µg/kg. The side effect profile, hemodynamic stability, sedation levels, need for vasopressors and atropine were comparable in both groups.
{"title":"Comparison of effectiveness between two different doses of intravenous dexmedetomidine as adjuvant to subarachnoid block for sub umbilical surgeries","authors":"Ayaskant Sahoo, Padmalatha Seelan, G. Dasari, Swathi Penmatsa","doi":"10.20883/medical.e838","DOIUrl":"https://doi.org/10.20883/medical.e838","url":null,"abstract":"Background. Spinal anesthesia was a commonly used technique in anesthetic practice for lower abdominal and lower limb surgeries. To prolong the duration of bupivacaine spinal anesthesia adjuvants like α2 agonists and opioids have been used intrathecally. Clonidine and dexmedetomidine have also been found to prolong the duration of spinal anesthesia when given intravenous. Dexmedetomidine was more suitable adjuvant to spinal anesthesia compared to clonidine as it has more sedative and analgesic effects due to more selective α2A receptor agonist activity. Dexmedetomidine has been shown to prolong the duration of analgesia of spinal anaesthesia in various studies. Here we compare the two doses of Dexmedetomidine in prolonging the duration of analgesia.\u0000Material and methods. 60 American Society of Anaesthesiologists(ASA) physical status I/II patients scheduled for elective lower abdominal and lower limb surgeries under spinal anesthesia were randomized into two groups of 30 each. Immediately after subarachnoid block with 3.5ml of 0.5% hyperbaric bupivacaine, Group A patients received a loading dose of 0.5µg/kg of dexmedetomidine intravenously in 100ml NS over 10 mins whereas Group B received 1.0µg/kg of dexmedetomidine intravenously in 100ml NS over 10 mins.\u0000Results. Time for rescue analgesic were higher in Group B compared to Group A which was statistically significant but clinically the extra duration was insignificant. Time for two segment regression and duration of motor blockade was significantly prolonged in Group B. Requirement of Mephentermine was comparable in both the groups. There was no excessive sedation in both the groups.\u0000Conclusion. Dexmedetomidine administered as isolated loading dose of 0.5 µg/kg IV immediately after spinal anaesthesia was clinically equi-efficacious in prolonging the duration of analgesia of spinal anaesthesia compared to a larger dose of 1.0 µg/kg. The side effect profile, hemodynamic stability, sedation levels, need for vasopressors and atropine were comparable in both groups.","PeriodicalId":16350,"journal":{"name":"Journal of Medical Science","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81382307","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：