Pub Date : 2023-08-30DOI: 10.37349/emed.2023.00155
S. Svetozarskiy, A. Andreev, A. V. Shvaikin, S. V. Scherbakova, Anna Sporysheva
Aim: The use of 5-fluorouracil in glaucoma surgery is associated with a high risk of corneal complications, as even minimal doses of the drug at the ocular surface inhibit corneal epithelial cell division and lead to corneal epitheliopathy and erosion. The aim of this study was to evaluate the clinical and functional results of the proposed method of postoperative adjuvant subconjunctival injection of 5-fluorouracil after non-penetrating deep sclerectomy (NPDS) in comparison with the control group. Methods: Patients with primary open-angle glaucoma who underwent NPDS and received at least 1 subconjunctival injection of 5-fluorouracil in the postoperative period were included in a two-group retrospective comparative study. Patients who received a subconjunctival injection of 5-fluorouracil after surgery using the standard technique were included in Group 1; Group 2 included patients who received an injection using the proposed method. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), rate of corneal complications, and number of office visits during the first 4 weeks after surgery were analysed. Results: The compared groups did not differ in demographic characteristics, preoperative BCVA, and IOP parameters. Fluorescein-stained corneal epithelial defects were statistically significantly more frequent in Group 1 compared to Group 2, P < 0.001. Four weeks post NPDS IOP reduction was greater in Group 2, P = 0.042. Mean BCVA loss was 1.9 lines in Group 1 and 1.3 lines in Group 2, P < 0.001. The number of follow-up visits during the first month after surgery was lower in Group 2 than in Group 1, P = 0.002. Conclusions: The proposed method was simple and effective in reducing the risk of corneal epithelial defects after subconjunctival injection of 5-fluorouracil, significantly improving clinical and functional outcomes of NPDS and reducing the need for outpatient visits.
{"title":"An easy and safe method of subconjunctival injection of antimetabolites in glaucoma surgery","authors":"S. Svetozarskiy, A. Andreev, A. V. Shvaikin, S. V. Scherbakova, Anna Sporysheva","doi":"10.37349/emed.2023.00155","DOIUrl":"https://doi.org/10.37349/emed.2023.00155","url":null,"abstract":"Aim: The use of 5-fluorouracil in glaucoma surgery is associated with a high risk of corneal complications, as even minimal doses of the drug at the ocular surface inhibit corneal epithelial cell division and lead to corneal epitheliopathy and erosion. The aim of this study was to evaluate the clinical and functional results of the proposed method of postoperative adjuvant subconjunctival injection of 5-fluorouracil after non-penetrating deep sclerectomy (NPDS) in comparison with the control group. Methods: Patients with primary open-angle glaucoma who underwent NPDS and received at least 1 subconjunctival injection of 5-fluorouracil in the postoperative period were included in a two-group retrospective comparative study. Patients who received a subconjunctival injection of 5-fluorouracil after surgery using the standard technique were included in Group 1; Group 2 included patients who received an injection using the proposed method. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), rate of corneal complications, and number of office visits during the first 4 weeks after surgery were analysed. Results: The compared groups did not differ in demographic characteristics, preoperative BCVA, and IOP parameters. Fluorescein-stained corneal epithelial defects were statistically significantly more frequent in Group 1 compared to Group 2, P < 0.001. Four weeks post NPDS IOP reduction was greater in Group 2, P = 0.042. Mean BCVA loss was 1.9 lines in Group 1 and 1.3 lines in Group 2, P < 0.001. The number of follow-up visits during the first month after surgery was lower in Group 2 than in Group 1, P = 0.002. Conclusions: The proposed method was simple and effective in reducing the risk of corneal epithelial defects after subconjunctival injection of 5-fluorouracil, significantly improving clinical and functional outcomes of NPDS and reducing the need for outpatient visits.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47406187","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}
Pub Date : 2023-07-26DOI: 10.37349/emed.2023.00153
Moses Cook, Bessi Qorri, Amruth Baskar, Jalal Ziauddin, L. Pani, Shashibushan Yenkanchi, J. Geraci
Aim: Many small datasets of significant value exist in the medical space that are being underutilized. Due to the heterogeneity of complex disorders found in oncology, systems capable of discovering patient subpopulations while elucidating etiologies are of great value as they can indicate leads for innovative drug discovery and development. Methods: Two small non-small cell lung cancer (NSCLC) datasets (GSE18842 and GSE10245) consisting of 58 samples of adenocarcinoma (ADC) and 45 samples of squamous cell carcinoma (SCC) were used in a machine intelligence framework to identify genetic biomarkers differentiating these two subtypes. Utilizing a set of standard machine learning (ML) methods, subpopulations of ADC and SCC were uncovered while simultaneously extracting which genes, in combination, were significantly involved in defining the subpopulations. A previously described interactive hypothesis-generating method designed to work with ML methods was employed to provide an alternative way of extracting the most important combination of variables to construct a new data set. Results: Several genes were uncovered that were previously implicated by other methods. This framework accurately discovered known subpopulations, such as genetic drivers associated with differing levels of aggressiveness within the SCC and ADC subtypes. Furthermore, phyosphatidylinositol glycan anchor biosynthesis, class X (PIGX) was a novel gene implicated in this study that warrants further investigation due to its role in breast cancer proliferation. Conclusions: The ability to learn from small datasets was highlighted and revealed well-established properties of NSCLC. This showcases the utility of ML techniques to reveal potential genes of interest, even from small datasets, shedding light on novel driving factors behind subpopulations of patients.
{"title":"Small patient datasets reveal genetic drivers of non-small cell lung cancer subtypes using machine learning for hypothesis generation","authors":"Moses Cook, Bessi Qorri, Amruth Baskar, Jalal Ziauddin, L. Pani, Shashibushan Yenkanchi, J. Geraci","doi":"10.37349/emed.2023.00153","DOIUrl":"https://doi.org/10.37349/emed.2023.00153","url":null,"abstract":"Aim: Many small datasets of significant value exist in the medical space that are being underutilized. Due to the heterogeneity of complex disorders found in oncology, systems capable of discovering patient subpopulations while elucidating etiologies are of great value as they can indicate leads for innovative drug discovery and development.\u0000Methods: Two small non-small cell lung cancer (NSCLC) datasets (GSE18842 and GSE10245) consisting of 58 samples of adenocarcinoma (ADC) and 45 samples of squamous cell carcinoma (SCC) were used in a machine intelligence framework to identify genetic biomarkers differentiating these two subtypes. Utilizing a set of standard machine learning (ML) methods, subpopulations of ADC and SCC were uncovered while simultaneously extracting which genes, in combination, were significantly involved in defining the subpopulations. A previously described interactive hypothesis-generating method designed to work with ML methods was employed to provide an alternative way of extracting the most important combination of variables to construct a new data set.\u0000Results: Several genes were uncovered that were previously implicated by other methods. This framework accurately discovered known subpopulations, such as genetic drivers associated with differing levels of aggressiveness within the SCC and ADC subtypes. Furthermore, phyosphatidylinositol glycan anchor biosynthesis, class X (PIGX) was a novel gene implicated in this study that warrants further investigation due to its role in breast cancer proliferation.\u0000Conclusions: The ability to learn from small datasets was highlighted and revealed well-established properties of NSCLC. This showcases the utility of ML techniques to reveal potential genes of interest, even from small datasets, shedding light on novel driving factors behind subpopulations of patients.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49629449","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}
Pub Date : 2023-07-12DOI: 10.37349/emed.2023.00152
Husam El Sharu, Zaid Alwarawrah, Mohammad Alqaisieh, Ahmed Hebishy
Bochdalek hernia (BH) is a congenital diaphragmatic defect primarily diagnosed in neonates and is usually left-sided. Adult diagnosis, especially of right-sided BH is exceedingly rare and usually presents with symptoms. Till now, only 31 cases have been diagnosed to be right-sided BH along with intrathoracic kidney. This report presents a 26-year-old asymptomatic male who was incidentally diagnosed with a massive right congenital diaphragmatic hernia. Imaging revealed severe abdominal herniation, a right intrathoracic ectopic kidney, and a right liver lobe hypoplasty along with hypertrophied left liver lobe extending down to the pelvic cavity. Several surgeons were consulted, with controversial opinions on whether elective surgery should be performed or withheld. Due to the high risk associated with surgery and the patient’s choice, the surgery was deferred. For almost 18 months, the patient did not report any symptoms or complications. This case highlights the rarity of asymptomatic right-sided BH in adults and the challenges in determining a management approach. Also, it proposes a conservative approach for such patients as a management modality. Most extensive diagrammatic defect reported is estimated to have a neck defect of 10 cm. Most BH cases have been treated surgically and reports on the outcome of a conservative approach are exceedingly rare. In such cases, patient preferences and a thorough risk assessment play vital roles in decision-making regarding conservative versus surgical approaches.
{"title":"Conservative approach in adult right-sided Bochdalek hernia with an intrathoracic ectopic kidney","authors":"Husam El Sharu, Zaid Alwarawrah, Mohammad Alqaisieh, Ahmed Hebishy","doi":"10.37349/emed.2023.00152","DOIUrl":"https://doi.org/10.37349/emed.2023.00152","url":null,"abstract":"Bochdalek hernia (BH) is a congenital diaphragmatic defect primarily diagnosed in neonates and is usually left-sided. Adult diagnosis, especially of right-sided BH is exceedingly rare and usually presents with symptoms. Till now, only 31 cases have been diagnosed to be right-sided BH along with intrathoracic kidney. This report presents a 26-year-old asymptomatic male who was incidentally diagnosed with a massive right congenital diaphragmatic hernia. Imaging revealed severe abdominal herniation, a right intrathoracic ectopic kidney, and a right liver lobe hypoplasty along with hypertrophied left liver lobe extending down to the pelvic cavity. Several surgeons were consulted, with controversial opinions on whether elective surgery should be performed or withheld. Due to the high risk associated with surgery and the patient’s choice, the surgery was deferred. For almost 18 months, the patient did not report any symptoms or complications. This case highlights the rarity of asymptomatic right-sided BH in adults and the challenges in determining a management approach. Also, it proposes a conservative approach for such patients as a management modality. Most extensive diagrammatic defect reported is estimated to have a neck defect of 10 cm. Most BH cases have been treated surgically and reports on the outcome of a conservative approach are exceedingly rare. In such cases, patient preferences and a thorough risk assessment play vital roles in decision-making regarding conservative versus surgical approaches.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42022644","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}
Pub Date : 2023-06-30DOI: 10.37349/emed.2023.00150
Elizabeth N. R. Schjelderup, Caroline A. MacCallum, Lindsay A. Lo, Jessie Dhillon, A. Christiansen, Carly Pistawka, Kathryn Rintoul, W. Panenka, A. Barr
Aim: Traumatic brain injury (TBI) is a common neurological condition, which can present with a wide range of neuropsychological symptoms. Treating this broad spectrum of symptoms represents a significant medical challenge. In part because of this, there is growing interest in the use of medical cannabis to treat the sequelae of TBI, as medical cannabis has been used to treat multiple associated conditions, such as pain. However, medical cannabis represents a heterogeneous collection of therapies, and relatively little is known about their effectiveness in treating TBI symptoms. The aim of the present study was therefore to assess medical cannabis use in patients with TBI. Methods: In the present study, a retrospective chart review was conducted of patterns of cannabis use and TBI symptoms in individuals who used medical cannabis to treat TBI-related symptoms. All subjects were recruited from a medical cannabis clinic, where cannabis was authorized by physicians, using licensed cannabis products. A total of 53 subjects provided written consent to have their charts reviewed. Results: Neuropsychiatric conditions, including depression, pain, and anxiety were frequent in this group. The most common forms of medical cannabis consumption at intake included smoking, vaping, and oral ingestion. Patients used a combination of high tetrahydrocannabinol (THC)/low cannabidiol (CBD) and low THC/high CBD products, typically 1–3 times per day. Medical cannabis appeared to be relatively well-tolerated in subjects, with few serious side effects. At follow-up, subjects self-reported improvements in TBI symptoms, although these were not statistically significant when assessed using validated questionnaires. Conclusions: Overall findings indicate modest potential benefits of medical cannabis for TBI, but further research will be required to validate these results.
{"title":"Exploring medical cannabis use in individuals with a traumatic brain injury","authors":"Elizabeth N. R. Schjelderup, Caroline A. MacCallum, Lindsay A. Lo, Jessie Dhillon, A. Christiansen, Carly Pistawka, Kathryn Rintoul, W. Panenka, A. Barr","doi":"10.37349/emed.2023.00150","DOIUrl":"https://doi.org/10.37349/emed.2023.00150","url":null,"abstract":"Aim: Traumatic brain injury (TBI) is a common neurological condition, which can present with a wide range of neuropsychological symptoms. Treating this broad spectrum of symptoms represents a significant medical challenge. In part because of this, there is growing interest in the use of medical cannabis to treat the sequelae of TBI, as medical cannabis has been used to treat multiple associated conditions, such as pain. However, medical cannabis represents a heterogeneous collection of therapies, and relatively little is known about their effectiveness in treating TBI symptoms. The aim of the present study was therefore to assess medical cannabis use in patients with TBI.\u0000Methods: In the present study, a retrospective chart review was conducted of patterns of cannabis use and TBI symptoms in individuals who used medical cannabis to treat TBI-related symptoms. All subjects were recruited from a medical cannabis clinic, where cannabis was authorized by physicians, using licensed cannabis products. A total of 53 subjects provided written consent to have their charts reviewed.\u0000Results: Neuropsychiatric conditions, including depression, pain, and anxiety were frequent in this group. The most common forms of medical cannabis consumption at intake included smoking, vaping, and oral ingestion. Patients used a combination of high tetrahydrocannabinol (THC)/low cannabidiol (CBD) and low THC/high CBD products, typically 1–3 times per day. Medical cannabis appeared to be relatively well-tolerated in subjects, with few serious side effects. At follow-up, subjects self-reported improvements in TBI symptoms, although these were not statistically significant when assessed using validated questionnaires.\u0000Conclusions: Overall findings indicate modest potential benefits of medical cannabis for TBI, but further research will be required to validate these results.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47452459","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}
Pub Date : 2023-06-30DOI: 10.37349/emed.2023.00149
Yuzhu Mao, Lifang Yang
Enhanced recovery after surgery (ERAS) is a recommended surgical strategy at present, the core content is to reduce perioperative stress response and postoperative complications through perioperative multi-mode analgesia and intensive surgery. Electroacupuncture (EA) has been widely used in various clinical applications, and its efficacy and safety have been fully proven. The application of acupuncture in ERAS will have an important impact on rehabilitation research and development. In this review, the molecular mechanism of EA in ERAS are summed up from promoting perioperative efficacy to improving postoperative immune status. The combination of EA and ERAS may better promote the recovery of patients and the development of rehabilitation.
Enhanced recovery after surgery (ERAS)是目前推荐的手术策略，其核心内容是通过围术期多模式镇痛和强化手术，减少围术期应激反应和术后并发症。电针已广泛应用于各种临床应用，其有效性和安全性已得到充分证明。针刺在ERAS中的应用将对康复研究和发展产生重要影响。本文从促进ERAS围手术期疗效到改善术后免疫状态两方面综述EA在ERAS中的分子机制。EA与ERAS的结合可以更好地促进患者的康复和康复的发展。
{"title":"Molecular mechanism of electroacupuncture for improving perioperative complications with the guidance of enhanced recovery after surgery","authors":"Yuzhu Mao, Lifang Yang","doi":"10.37349/emed.2023.00149","DOIUrl":"https://doi.org/10.37349/emed.2023.00149","url":null,"abstract":"Enhanced recovery after surgery (ERAS) is a recommended surgical strategy at present, the core content is to reduce perioperative stress response and postoperative complications through perioperative multi-mode analgesia and intensive surgery. Electroacupuncture (EA) has been widely used in various clinical applications, and its efficacy and safety have been fully proven. The application of acupuncture in ERAS will have an important impact on rehabilitation research and development. In this review, the molecular mechanism of EA in ERAS are summed up from promoting perioperative efficacy to improving postoperative immune status. The combination of EA and ERAS may better promote the recovery of patients and the development of rehabilitation.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48781200","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}
Pub Date : 2023-06-30DOI: 10.37349/emed.2023.00151
K. Jirakran, M. Maes, Napakkawat Buathong, R. Kalayasiri
Aim: There is a strong comorbidity between methamphetamine (MA) and alcohol use whereby MA use may contribute to increased alcohol consumption. This study aims to determine the associations between alcohol drinking and MA-associated behaviors among MA users in relation to mood disorders, suicidal ideation, and health-related quality of life (HR-QoL). Methods: Substance use characteristics were obtained in 106 participants with MA use at a substance abuse treatment center by using the Severity of Dependence Scale (SDS) and the Thai version of the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Current alcohol drinking behaviors were estimated using the Substance Outcomes Profile (SOP), which was developed and translated from the Treatment Outcomes Profile, by computing the number of alcohol units x days per month of alcohol use. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was used to estimate lifetime histories of mood disorders and substance abuse and current suicidal ideation. Results: Current suicidal ideation in MA users is to a large extent predicted by the severity of current alcohol and MA use, female gender, and a lifetime history of mood disorders (major depression, dysthymia, and hypo-mania). Moreover, a lifetime history of mood disorders is positively associated with the severity of MA, but not with alcohol use. Partial least squares (PLS) path modeling shows that lowered HR-QoL in MA users is predicted by the SDS score and alcohol dosing (both inversely) and that lifetime diagnoses of mood disorders and MA use (both inversely) and alcohol dependence (positively) have significant effects on HR-QoL which are completely mediated via the SDS score. Conclusions: In MA users, the severity of dependence, and MA and/or alcohol use exert adverse effects on current suicidal ideation and HR-QoL. Mechanistic explanations are given which may explain the inverse associations between the severity of MA and alcohol use in MA abusers.
{"title":"Associations between methamphetamine and alcohol use disorder, suicidal ideation, and lowered quality of life in methamphetamine users","authors":"K. Jirakran, M. Maes, Napakkawat Buathong, R. Kalayasiri","doi":"10.37349/emed.2023.00151","DOIUrl":"https://doi.org/10.37349/emed.2023.00151","url":null,"abstract":"Aim: There is a strong comorbidity between methamphetamine (MA) and alcohol use whereby MA use may contribute to increased alcohol consumption. This study aims to determine the associations between alcohol drinking and MA-associated behaviors among MA users in relation to mood disorders, suicidal ideation, and health-related quality of life (HR-QoL).\u0000Methods: Substance use characteristics were obtained in 106 participants with MA use at a substance abuse treatment center by using the Severity of Dependence Scale (SDS) and the Thai version of the Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA). Current alcohol drinking behaviors were estimated using the Substance Outcomes Profile (SOP), which was developed and translated from the Treatment Outcomes Profile, by computing the number of alcohol units x days per month of alcohol use. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was used to estimate lifetime histories of mood disorders and substance abuse and current suicidal ideation.\u0000Results: Current suicidal ideation in MA users is to a large extent predicted by the severity of current alcohol and MA use, female gender, and a lifetime history of mood disorders (major depression, dysthymia, and hypo-mania). Moreover, a lifetime history of mood disorders is positively associated with the severity of MA, but not with alcohol use. Partial least squares (PLS) path modeling shows that lowered HR-QoL in MA users is predicted by the SDS score and alcohol dosing (both inversely) and that lifetime diagnoses of mood disorders and MA use (both inversely) and alcohol dependence (positively) have significant effects on HR-QoL which are completely mediated via the SDS score.\u0000Conclusions: In MA users, the severity of dependence, and MA and/or alcohol use exert adverse effects on current suicidal ideation and HR-QoL. Mechanistic explanations are given which may explain the inverse associations between the severity of MA and alcohol use in MA abusers.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46901925","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}
Pub Date : 2023-06-30DOI: 10.37349/emed.2023.00148
Lucile Rapin, M. Arboleda, Erin Prosk, C. Su, A. Watier, M. Dworkind
Aim: Among treatments for chronic non-cancer pain (CNCP), cannabinoid-based medicines (CBMs) have become extremely popular. Evidence remains modest and limited primarily to delta-9-tetrahydrocannabinol (THC) for neuropathic pain; nevertheless, the use of various CBMs, including cannabidiol (CBD) to treat neuropathic, nociceptive, and mixed pain has increased globally. This observational case-series assessed the impact of CBMs as a complementary treatment by pain mechanism and cannabinoid profile over three months. Methods: An analysis of patients with CNCP and treated with CBMs who consented to an ongoing registry was performed. Outcomes were patient-reported such as the Edmonton symptom assessment system-revised, brief pain inventory-short form, and 36-item short form health survey. Data from patients with complete outcomes for baseline and 3-month follow-up was extracted. Characteristics of adverse drug reactions (ADRs), including a description of the suspected product were also assessed. Results: A total of 495 patients were part of this analysis (mean age = 56 years old; 67% women). At 3-month, the proportional use of THC:CBD balanced and THC-dominant products increased. Patients with neuropathic pain had higher pain-severity scores vs. nociceptive pain. In addition to patients with neuropathic pain, patients with nociceptive and mixed pain also reported improvements in pain severity and secondary symptoms such as anxiety, depression, drowsiness, fatigue, sleep disturbances, and overall, health-related quality of life. THC-dominant treatment is more likely to be recommended when pain is severe, whereas CBD-dominant is favored for less severe cases. ADRs were more frequent among cannabis-naive patients and included dizziness, headache, and somnolence among others. Conclusions: Findings suggest that CBMs can be effective for neuropathic as well as nociceptive and mixed pain. THC is more frequently recommended for neuropathic and severe pain. Future research on CBMs in pain management must include details of CBM composition, and pain mechanism and must consider potential ADRs.
{"title":"Cannabinoid-based medicines in clinical care of chronic non-cancer pain: an analysis of pain mechanism and cannabinoid profile","authors":"Lucile Rapin, M. Arboleda, Erin Prosk, C. Su, A. Watier, M. Dworkind","doi":"10.37349/emed.2023.00148","DOIUrl":"https://doi.org/10.37349/emed.2023.00148","url":null,"abstract":"Aim: Among treatments for chronic non-cancer pain (CNCP), cannabinoid-based medicines (CBMs) have become extremely popular. Evidence remains modest and limited primarily to delta-9-tetrahydrocannabinol (THC) for neuropathic pain; nevertheless, the use of various CBMs, including cannabidiol (CBD) to treat neuropathic, nociceptive, and mixed pain has increased globally. This observational case-series assessed the impact of CBMs as a complementary treatment by pain mechanism and cannabinoid profile over three months.\u0000Methods: An analysis of patients with CNCP and treated with CBMs who consented to an ongoing registry was performed. Outcomes were patient-reported such as the Edmonton symptom assessment system-revised, brief pain inventory-short form, and 36-item short form health survey. Data from patients with complete outcomes for baseline and 3-month follow-up was extracted. Characteristics of adverse drug reactions (ADRs), including a description of the suspected product were also assessed.\u0000Results: A total of 495 patients were part of this analysis (mean age = 56 years old; 67% women). At 3-month, the proportional use of THC:CBD balanced and THC-dominant products increased. Patients with neuropathic pain had higher pain-severity scores vs. nociceptive pain. In addition to patients with neuropathic pain, patients with nociceptive and mixed pain also reported improvements in pain severity and secondary symptoms such as anxiety, depression, drowsiness, fatigue, sleep disturbances, and overall, health-related quality of life. THC-dominant treatment is more likely to be recommended when pain is severe, whereas CBD-dominant is favored for less severe cases. ADRs were more frequent among cannabis-naive patients and included dizziness, headache, and somnolence among others. \u0000Conclusions: Findings suggest that CBMs can be effective for neuropathic as well as nociceptive and mixed pain. THC is more frequently recommended for neuropathic and severe pain. Future research on CBMs in pain management must include details of CBM composition, and pain mechanism and must consider potential ADRs.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47442516","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}
Pub Date : 2023-06-28DOI: 10.37349/emed.2023.00146
M. Ali, A. S. Bonna, Tajnuva Mehjabin
Aim: Pseudoneurological complaints (PNCs) are highly prevalent among the general population. Coronavirus disease 2019 (COVID-19) adversely influences such complaints in individuals who recovered from COVID-19. This study determined the prevalence and identified the predictors of PNCs among individuals who had previously experienced COVID-19 and their healthy counterparts. Methods: This case-control study analyzed the data of 878 Bangladeshi adults (439 patients). Laboratory-confirmed COVID-19 individuals were considered cases, and the controls were those who never tested positive for COVID-19. The controls were matched with cases’ sex and age. The seven-item pseudoneurological sub-scale of the subjective health complaints scale produced by Eriksen et al. evaluated PNCs. The descriptive analysis estimated the prevalence of PNCs among the subgroups, whereas multiple logistic regression models were used to determine the predictors of PNCs. Results: Overall, the prevalence of PNCs was 40%; however, patients who recovered from COVID-19 reported a PNC rate of 67.4%. The regression analysis identified COVID-19 as a robust independent predictor of PNCs. Furthermore, occupation, monthly household income, current living location, hypertension, and recovery period from acute COVID-19 were independently associated with PNCs. Conclusions: This study revealed a significant association between COVID-19 and PNCs. The results of this study will be helpful when discussing, planning, and implementing strategies to alleviate the overburden of PNCs among COVID-19 survivors.
{"title":"Association between coronavirus 2019 disease and pseudoneurological complaints: analysis of case-control data","authors":"M. Ali, A. S. Bonna, Tajnuva Mehjabin","doi":"10.37349/emed.2023.00146","DOIUrl":"https://doi.org/10.37349/emed.2023.00146","url":null,"abstract":"Aim: Pseudoneurological complaints (PNCs) are highly prevalent among the general population. Coronavirus disease 2019 (COVID-19) adversely influences such complaints in individuals who recovered from COVID-19. This study determined the prevalence and identified the predictors of PNCs among individuals who had previously experienced COVID-19 and their healthy counterparts.\u0000Methods: This case-control study analyzed the data of 878 Bangladeshi adults (439 patients). Laboratory-confirmed COVID-19 individuals were considered cases, and the controls were those who never tested positive for COVID-19. The controls were matched with cases’ sex and age. The seven-item pseudoneurological sub-scale of the subjective health complaints scale produced by Eriksen et al. evaluated PNCs. The descriptive analysis estimated the prevalence of PNCs among the subgroups, whereas multiple logistic regression models were used to determine the predictors of PNCs.\u0000Results: Overall, the prevalence of PNCs was 40%; however, patients who recovered from COVID-19 reported a PNC rate of 67.4%. The regression analysis identified COVID-19 as a robust independent predictor of PNCs. Furthermore, occupation, monthly household income, current living location, hypertension, and recovery period from acute COVID-19 were independently associated with PNCs.\u0000Conclusions: This study revealed a significant association between COVID-19 and PNCs. The results of this study will be helpful when discussing, planning, and implementing strategies to alleviate the overburden of PNCs among COVID-19 survivors.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49539160","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}
Pub Date : 2023-06-28DOI: 10.37349/emed.2023.00145
D. Shrivastav, P. Dabla, D. Singh, V. Mehta
Aim: Cardiovascular diseases (CVD) are the leading cause of death globally. In the condition of type 2 diabetes mellitus (T2DM), the prevalence of CVD increase parallel with the rise of metabolic complication and higher incidence of coronary artery stenosis. The aim of this study was to compare the level of percent stenosis in coronary arteries in patients with coronary artery disease (CAD) with and without T2DM, and to measure the severity of CVD using Gensini score (GS) through angiographic data. Methods: The current study was conducted in tertiary care specialized hospital in Delhi, India. The level of percent stenosis in coronary arteries was compared in patients with CAD with and without T2DM. The patients were divided into two groups: group I included 100 patients with T2DM, and group II included 100 non-diabetic CAD patients who underwent coronary angiography by Judkin’s technique. The severity of CVD was measured by GS through angiographic data. The serum levels of glycated haemoglobin (HbA1c) ≥ 6.5% were considered diabetic. Results: Significant difference was observed in serum HbA1c, and random blood sugar levels between group I and group II were also observed (P ≤ 0.001). Serum HbA1c shows a significant positive association with GS (r = 0.36, P = 0.007). Conclusions: The study shows a significant level of stenosis in coronary arteries of CAD diabetic patients. However, further prospective analysis of a larger population size will be needed to strengthen the findings and the significant association.
目的:心血管疾病(CVD)是全球死亡的主要原因。在2型糖尿病(T2DM)患者中，心血管疾病的患病率随着代谢并发症的增加和冠状动脉狭窄的发生率升高而增加。本研究的目的是比较合并和不合并T2DM的冠心病患者冠状动脉狭窄百分比的水平，并通过血管造影数据使用Gensini评分(GS)来衡量CVD的严重程度。方法:本研究在印度德里的三级专科医院进行。比较冠心病合并和不合并T2DM患者冠状动脉狭窄百分比的水平。患者分为两组:1组100例T2DM患者，2组100例非糖尿病性CAD患者行Judkin技术冠状动脉造影。通过血管造影资料，GS测量CVD的严重程度。血清糖化血红蛋白(HbA1c)水平≥6.5%为糖尿病。结果:两组患者血清HbA1c及随机血糖水平差异均有统计学意义(P≤0.001)。血清HbA1c与GS呈显著正相关(r = 0.36, P = 0.007)。结论:本研究显示冠心病糖尿病患者冠状动脉狭窄程度明显。然而，需要对更大的人口规模进行进一步的前瞻性分析，以加强研究结果和显著相关性。
{"title":"Type 2 diabetes mellitus and coronary artery stenosis: a risk pattern association study","authors":"D. Shrivastav, P. Dabla, D. Singh, V. Mehta","doi":"10.37349/emed.2023.00145","DOIUrl":"https://doi.org/10.37349/emed.2023.00145","url":null,"abstract":"Aim: Cardiovascular diseases (CVD) are the leading cause of death globally. In the condition of type 2 diabetes mellitus (T2DM), the prevalence of CVD increase parallel with the rise of metabolic complication and higher incidence of coronary artery stenosis. The aim of this study was to compare the level of percent stenosis in coronary arteries in patients with coronary artery disease (CAD) with and without T2DM, and to measure the severity of CVD using Gensini score (GS) through angiographic data.\u0000Methods: The current study was conducted in tertiary care specialized hospital in Delhi, India. The level of percent stenosis in coronary arteries was compared in patients with CAD with and without T2DM. The patients were divided into two groups: group I included 100 patients with T2DM, and group II included 100 non-diabetic CAD patients who underwent coronary angiography by Judkin’s technique. The severity of CVD was measured by GS through angiographic data. The serum levels of glycated haemoglobin (HbA1c) ≥ 6.5% were considered diabetic.\u0000Results: Significant difference was observed in serum HbA1c, and random blood sugar levels between group I and group II were also observed (P ≤ 0.001). Serum HbA1c shows a significant positive association with GS (r = 0.36, P = 0.007).\u0000Conclusions: The study shows a significant level of stenosis in coronary arteries of CAD diabetic patients. However, further prospective analysis of a larger population size will be needed to strengthen the findings and the significant association.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43029666","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}
Pub Date : 2023-06-28DOI: 10.37349/emed.2023.00147
B. Yoo, Ankit Patel, Kevin V. Houston, Alejandra Vargas, Ana Rosa Vilela Sangay, Steve M. D’Souza, David A. Johnson
Gastrointestinal (GI) cancer is one of the leading causes of death that affect many patients around the world. The coronavirus disease 2019 (COVID-19) pandemic significantly impacted our healthcare system in large that diagnosis and management of GI cancer have suffered with a reduction in cancer screening. This review will describe the current practices of cancer screening during COVID-19 pandemic and summarize how each GI cancer (esophageal, gastric, colorectal, and hepatocellular cancers) has been affected by COVID-19. World widely there has been a decreasing trend in screening, diagnosis, and management of GI cancers during the COVID-19 pandemic. Many healthcare institutions are now observing the effect of this change and implementing practice variations to adapt to the pandemic.
{"title":"The impact of COVID-19 pandemic on diagnosis and management of gastrointestinal cancers","authors":"B. Yoo, Ankit Patel, Kevin V. Houston, Alejandra Vargas, Ana Rosa Vilela Sangay, Steve M. D’Souza, David A. Johnson","doi":"10.37349/emed.2023.00147","DOIUrl":"https://doi.org/10.37349/emed.2023.00147","url":null,"abstract":"Gastrointestinal (GI) cancer is one of the leading causes of death that affect many patients around the world. The coronavirus disease 2019 (COVID-19) pandemic significantly impacted our healthcare system in large that diagnosis and management of GI cancer have suffered with a reduction in cancer screening. This review will describe the current practices of cancer screening during COVID-19 pandemic and summarize how each GI cancer (esophageal, gastric, colorectal, and hepatocellular cancers) has been affected by COVID-19. World widely there has been a decreasing trend in screening, diagnosis, and management of GI cancers during the COVID-19 pandemic. Many healthcare institutions are now observing the effect of this change and implementing practice variations to adapt to the pandemic.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47265274","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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