Current Reviews in Clinical and Experimental Pharmacology最新文献

Botulinum toxin injections, a popular aesthetic treatment, have over 7.4 million beneficiaries in the U.S. Despite their safety record, these injections pose potential complications. It is essential for aesthetic practitioners to manage these complications with the least impact on the patient. Upper eyelid ptosis, though rare, is a significant side effect of botulinum toxin injections. Through our study, we have identified the etiology, anatomy, and therapeutic management of botulinum- induced blepharoptosis. Hence, the goal of this study was to identify the basic aetiology of blepharoptosis and manage this complication, as well as discuss the basis of medico-legal implications involving this popular drug. The complex medico-legal implications of botulinum toxin-induced blepharoptosis call for continuous discourse, education, and clarity on drug-use legal standards. With evolving global and Italian legislation, practitioners must ensure they meet care standards, weighing treatment benefits against potential legal and ethical outcomes. Blepharoptosis is a rare but significant complication of botulinum-type injections. Etiology and thorough anatomy are crucial for avoiding this complication and handling it with the least impact on the patient. Medico-legal implications are currently not fully established, but the basis of aesthetic treatment standards, as well as continuing medical education, will ensure correct medico-legal coverage of such complications.

Large uterine fibroids (UFs) are clonal neoplasms of the uterus that form during the mid and late-aged women. Such women generally consume oral contraceptive pills, tranexamic acid, or NSAIDS to manage heavy menstrual bleeding (HMB) and associated complications while waiting for a conclusive procedure or avoiding hysterectomy. The procoagulant effect of these medicinal agents can result in venous stasis of the lower limbs, leading to deep vein thrombosis (DVT), a challenging complication with HMB. We examine the complicated state of heavy bleeding with thrombosis and explore better management options. It has been seen that women with hypothyroidism have an increased risk of getting DVT due to an alteration in the coagulation system. These incidences are mostly associated with higher uterine weight, which is related to the extrinsic compression of the inferior vena cava. In such cases, the occurrence of postoperative thrombosis is riskier if hysterectomy/myomectomy is the only option. Utilization of appropriate anticoagulants with modification of the steroid-hormone system using hormone agonists or antagonists (e.g., levonorgestrel intrauterine system, high-dose progestin-only therapy, danazol, aromatase inhibitors, Vitamin-D supplements or selective estrogen receptor modulators) could be an effective technique, but adverse consequences of continued use should be monitored. More research is needed into the basic biology associated with the role of growth factors and genetic alterations in these malignancies. The development of new leiomyomas following conservative therapy is also a significant issue.

Introduction: Diabetic wounds are a prevalent and impairing consequence of diabetes mellitus that significantly impacts people's lives and global healthcare systems. Because of disturbances in the wound-healing cascade, these intricate, persistent wounds frequently refuse to heal. Focusing on diabetic wound formation, this study seeks to clarify the complex mechanisms and pathophysiology involved while offering a thorough overview of modern multimodal therapy techniques. The etiology of diabetic wounds entails a complex interplay between tissue destruction caused by hyperglycemia, neuropathy, ischemia, and compromised immune response. Extended inflammation, abnormal protease activity, and low oxygen levels in the tissue exacerbate the healing process. Comprehending these pathogenic mechanisms is essential for formulating efficacious therapeutic strategies.

Methodology: A thorough evaluation of the literature was done. Databases like SciFinder, ScienceDirect, PubMed, Google, Google Scholar, and the Egyptian Knowledge Bank were used to find pertinent publications. More than 200 articles and databases were studied to constitute this paper. The accuracy of the retrieved data was carefully reviewed and cross-checked. The current review aims to define wounds, various methods of classification, and various advancements for wound management. Several multidisciplinary strategies, including debridement, unloading, antimicrobial stewardship, and innovative therapeutics, are currently needed to manage diabetic wounds. Debridement-the excision of non-viable tissue-is necessary to create an environment that is conducive to recovery. Biomechanical interventions and offloading help to prevent additional tissue damage caused by repetitive stress. Antimicrobial treatments fight infections, which are a common diabetic wound consequence. Promising supplementary treatments are provided by developments in cellular and tissue-based products, ozone therapy growth factors, bioengineered skin substitutes, and hyperbaric oxygen therapy.

Results: After applying article selection criteria and reviewing the quality of the methodology a total of 200 articles were selected to be included in the review. In this review, intricate interactions between peripheral neuropathy, vascular insufficiency, and hyperglycemia in the pathophysiology of diabetic wounds are explained. The efficacy of multimodal therapies is discussed in detail.

Discussion: A thorough comprehension of the complex mechanisms that underlie diabetic wounds is essential for efficient therapy. This review emphasizes how important multimodal approaches are to treating the complex pathophysiology of these wounds. Clinicians can greatly enhance the prognosis of patients with diabetic foot ulcers by addressing vascular insufficiency, neuropathy, infection, and poor healing.

Conclusion: Timely wound resolution r

The opioid crisis has profoundly changed the interest in using nonopioid analgesics. This review identified nonopioid drugs receiving the most interest in the treatment of postoperative pain. Publication-based interest, which reflects the authors' choices of subjects for academic articles, was used to show the shifts in their interest. The authors' choices of a particular drug for an article's subject were regarded as reflective of the collective opinion of experts most knowledgeable on the subject. The frequency with which a drug was the topic of an article was measured with the use of specific bibliometric indices. They were employed to select nonopioid drugs for this review. These included acetaminophen, dexmedetomidine, dexamethasone, ketamine, gabapentin, ibuprofen, ketorolac, diclofenac, magnesium sulfate, clonidine, intravenous lidocaine, and meloxicam (in order of most to least bibliometric interest). Individual reviews on these agents described how the bibliometric indices characterized a drug. They also addressed the question of whether a nonopioid analgesic produced a marked opioid-sparing effect. Information relative to this question was presented via the results of meta-analyses with emphasis on the possible reduction of opioid-related side effects. Overall, nonopioid drugs demonstrating the largest popularity among authors and continuous interest growth in 2018-2022 include acetaminophen, dexmedetomidine, dexamethasone, and ibuprofen. The relevant meta-analyses show that nonopioids, administered as components of multimodal analgesia, provided the opioid-sparing effect; they also show that the most common change in the opioid-related side effects was a lower incidence of postoperative nausea and vomiting.

The estimated worldwide number of individuals diagnosed with Parkinson's disease (PD) might exceed 10 million by 2040. However, the underlying evidence for PD is unclear. Recent research in Parkinson's disease has focused on exploring the gut-brain axis. Researchers have proposed that gut microbiota and gut dysbiosis contribute to peripheral inflammatory conditions. The involvement of gut pathogens and dysbiosis in peripheral inflammatory diseases has been hypothesized. In Parkinson's disease, the metabolic effects associated with gut dysbiosis accelerate nerve cell loss and damage. The microbiota-gut-brain axis (MGBA) establishes the relationship between the brain and the gut through the bidirectional vagus nerve. The MGBA promotes digestive system regulation and is responsible for maintaining metabolic homeostasis under regular conditions. Helicobacter pylori, Enterococcus faecalis, and Desulfovibrio are gut bacteria whose relative abundance has been associated with Parkinson's disease etiology and treatment efficacy. Numerous clinical and preclinical studies have substantiated the therapeutic potential of probiotics in treating Parkinson's disease via the gut-brain axis. The technique appears to have benefited from a combination of favorable conditions that led to its success. The present study investigated whether administering the probiotic can be a better therapeutic intervention for PD or not. Although widespread, no medicines exist to halt the neurodegenerative effects of PD. Some probiotics raised brain dopamine levels, slowed or stopped neuronal death, and improved motor function in models of toxin-induced and genetic PD in mice, rats, flies, and induced pluripotent stem cells. Probiotics control gut dysbiosis, thereby preventing neurodegeneration in PD via the gut-brain axis. Probiotics are used to control the principal dangers of oxidative stress and alpha-synuclein (α-synuclein) aggregation. Probiotics, which contain beneficial microorganisms such as Lactobacillus, Blautia, Roseburia, Lachnospiraceae, Prevotellaceae, and Akkermansia, may help alleviate PD symptoms and slow the disease's progression. Numerous probiotic bacteria can treat the neurodegenerative condition. As a result, this review paper focuses on the current understanding of the link between PD and gut microbiota while also providing comprehensive information about the neuroprotective function of probiotics.

Objective: Pharmacotherapy is commonly used during quit attempts and has shown an increase in the likelihood of achieving abstinence. However, with established pharmacotherapies, abstinence rates following a quit attempt remain low, and relapse is common. This review aims to investigate the efficacy and harm profiles of current and emerging pharmacotherapies.

Methods: Literature review of current and emerging pharmacotherapies for smoking cessation and tobacco use disorder.

Results: Emerging pharmacotherapies include new formulations of existing therapies, drug repurposing and some new treatments. New treatments are welcome and may incorporate different mechanisms of action or different safety and tolerability profiles compared to existing treatments. However, emerging pharmacotherapies have yet to demonstrate greater efficacy compared to existing treatments. The emergence of Electronic Nicotine Delivery Systems (ENDS) or 'vaping' is a feature of the current debate around tobacco use disorder. ENDS appear to facilitate switching but not quitting and are controversial as a harm minimisation strategy.

Limitations: Studies included a broad range of therapies and trial designs that should be compared with their differences taken into consideration.

Conclusion: Strategies to successfully quit smoking vary between individuals and may extend beyond pharmacotherapy and involve complex psychosocial factors and pathways.

Fungal infections are emerging as major health challenges in recent years. The development of resistance against existing antifungal agents needs urgent attention and action. The limited classes of antifungal drugs available, their tendency to cause adverse effects, lack of effectiveness, etc., are the major limitations of current therapy. Thus, there is a pressing demand for new antifungal drug classes to cope with the present circumstances. Glucose is the key source of energy for all organisms, including fungi. Glucose plays a crucial role as a source of carbon and energy for processes like virulence, growth, invasion, biofilm formation, and resistance development. The glucose transport and sensing mechanisms are well developed in these organisms as an important strategy to sustain survival. Modulating these transport or sensor mechanisms may serve as an important strategy to inhibit fungal growth. Moreover, the structural difference between human and fungal glucose transporters makes them more appealing as drug targets. Limited literature is available for fungal glucose entry mechanisms. This review provides a comprehensive account of sugar transport mechanisms in common fungal pathogens.

Background: Individuals at higher altitudes may experience a decrease in blood oxygen levels, which can result in a variety of clinical illnesses, such as high-altitude pulmonary edema, high-altitude cerebral edema, and milder but more common acute mountain sickness (AMS).

Objective: This study aims to review the current state of knowledge related to motion sickness, the risk of AMS, and pharmacological and non-pharmacological treatments for AMS.

Methods: Several databases, including PubMed, Bentham Science, Elsevier, Springer, and Research Gate, were used to compile the data for the article following a thorough analysis of the various research findings connected to acute mountain sickness and motion sickness, along with treatments and prevention.

Results: This article covers the research on mountain sickness as well as every imaginable form of conventional and alternative medicine. It contains ten medicinal plants that are useful in treating mountain sickness and various other remedies. Additionally, case studies are provided.

Conclusion: Therefore, the information in the paper will help travel medicine specialists better personalize their appropriate care for patients who travel to high-altitude locations. Additionally, all available antiemetic medications, serotonin agonists, nonsteroidal anti-inflammatory drugs, and herbal treatments for motion sickness were discussed. The prevention and consequences of acute mountain sickness are also covered in this study.