Health sciences review (Oxford, England)最新文献

Breast cancer was first noted by the ancient Egyptians more than 3500 years ago. In India, the US, and China about 221757, 287750, and 429105 cases of breast cancer were reported in the year 2022. The conventional chemotherapeutic agents used in breast cancer not only kill the cancer cells but the healthy cells also. Hydrogels, composed of different polymers, targeted to deliver natural and synthetic cytotoxic drugs in the microenvironment of breast cancer are reviewed in this manuscript. This manuscript is focused on providing insight into smart hydrogel which improves the efficacy of chemotherapeutic agents used in the treatment of breast cancer. Smart hydrogels, in response to specific stimuli such as pH, temperature, light, etc., release cytotoxic drugs in breast cancer tissue and improve the retention time of the drug at the site of action. The site-specific delivery and retention of anticancer drugs help in reducing the adverse effects. Smart hydrogels have been gaining more attention for delivering cytotoxic drugs to tumor microenvironments in response to specific stimuli. This manuscript emphasizes the stimuli-sensitive hydrogels fabricated especially for breast cancer.

The field of genomics plays a prominent role in treatment of numerous chronic diseases. Diabetes is a persistent metabolic disorder. Current studies and reports have emphasised the importance of several epigenetic markers in the therapy of type 2 diabetes. Histone Deacetylases(HDAC) enzyme regulate the structure of chromatin and the transcription of genes in the nucleus that produce proteins that regulate metabolic processes in the body. It influences gene expression primarily by removing an acetyl group from its precursor protein, and it regulates acetylation metabolic enzymes in mitochondria and cytoplasm. The balance between histone acetylation and deacetylation is an epigenetic layer that modulates gene expression. Gene transcription is associated with histone acetylation induced by histone acetyl transferases, whereas histone hypoacetylation influenced by histone deacetylase activity is related with gene silencing. This review focuses on the role of histone deacetylase inhibitors as a newly discovered treatment for diabetes and its impediment, defining their use in preventing insulin resistance, cell death, and cytokine-mediated attack on pancreatic cells.

Periprosthetic fractures are demanding and though uncommon, tibial periprosthetic fractures are furtherly destined to impact clinical and surgical orthopaedics due to the increasing number of arthroplasties performed yearly.

Systematic research focusing on periprosthetic tibia fractures reported beginning 1990 until 2022 was conducted on the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE/PubMed, Embase, Scopus, the Science Citation Index Expanded from Web of Science, ScienceDirect, CINAHL, and LILACS.

A total of 473 records resulted from the research. Following the exclusion process the studies included were twenty-three (23) with a total of 287 patients and 357 treatments. Periprosthetic tibial fractures prevail in women (72.1 %), in the obese and in rheumatoid arthritis affected patients.

Treatments consist of conservative treatments (22.7 %), osteosynthesis (16.5 %), revision total knee arthroplasty (23.0 %), intramedullary nailing (2.5 %) and other treatments (30.8 %). Stable fractures are treated in various methods, unstable fractures are mainly treated through revision total knee arthroplasty and intraoperative fractures are treated both conservatively and operatively.

Periprosthetic tibial fractures are destined to heavily burden orthopaedics traumatology. Periprosthetic tibia fractures are complex and commonly afflict obese and elderly women with history of rheumatoid arthritis. These fractures may be managed following the ASAP algorithm. Stable fractures are treated using different methods and unstable fractures are mainly approached through revision total knee arthroplasty prior to other treatments. Intraoperative fractures are treated both conservatively and surgically.

This meta-analysis was conducted to investigate the association of elongated styloid process (Eagle syndrome) and cervical artery dissection (CeAD), particularly carotid. Medline, PubMed Central, CINAHL and ProQuest were searched for case-control studies investigating the association of styloid process length (SPL) and CeAD, particularly carotid. SPL was treated as a continuous variable and mean difference was calculated from means and standard deviations with 95 % confidence interval (CI). SPL >30 mm was compared between cases and controls as a dichotomous variable and odds ratio (OR) was calculated with 95 % CI. Heterogeneity was quantified with χ2-based Cochran's Q-test and I²-statistic. Four studies were included comparing 185 dissection cases with 278 controls. Heterogeneity was 50 %, but was reduced to 0 % with sensitivity analysis. Styloid process was significantly longer in dissection group with a mean difference of 2.50 [-0.35, 5.35], P = 0.09. Elimination of one study with high risk of bias resulted in a mean difference of 3.61 [1.47, 5.75], P = 0.0009, and a heterogeneity of 0 %. Two studies showed SPL >30 mm to be more significant in dissection group (OR = 1.53 [0.84,2.80], P = 0.17). With sensitivity analysis the pooled OR was 2.09 [1.04, 4.19], P = 0.04. Three studies showed that mean SPL was significantly longer ipsilateral compared to contralateral side of dissection (mean difference 2.63 [0.46, 4.79], P = 0.02. This meta-analysis suggests that CeAD is significantly associated with styloid process mean length and SPL >30 mm. Case-control studies with bigger numbers are required to substantiate this association.

Iron deficiency with or without anemia is a common comorbidity co-existing with heart failure patients and is an independent risk factor for heart failure exacerbation and worse prognosis. A growing number of randomized clinical trials and meta-analysis evaluated the clinical efficacy and safety of intravenous iron use in heart failure patients. However, the findings from them are inconsistent and often conflicting. This meta-analysis was performed based on PRISMA (Preferred Reporting Items or Systematic Reviews and Meta-Analyses) guidelines after registering in PROSPERO (CRD42023395888). A literature search was conducted using a systematic search of PubMed, Embase, and Scopus databases until September 30, 2023. Pertinent data from the included studies were extracted and analyzed using RevMan v5.4. Out of 4585 studies evaluated, 16 randomized control trials with 6739 acute or chronic heart failure patients were included for analysis. The intravenous iron therapy significantly lowered the composite HF hospitalization or cardiovascular death (OR 0.56; 95 % CI 0.40 to 0.79; I² = 83 %, P == 0.001), HF hospitalization (OR 0.69, 95 % CI 0.54 to 0.90; I²=57 %, P == 0.005), improved 6-minute walk test (MD: 20.02 (95 % CI 8.16 to 31.87; I²=40 %, P == 0.0009), and the change in mean LVEF (MD: 2.03, 95 % CI 0.49–3.58; P == 0.010). The risks of total and serious adverse events were not significantly increased with the iron therapy compared to the placebo/standard of care group. Based on this meta-analysis, the intravenous iron intervention among heart failure patients with iron deficiency significantly reduced the risk of hospitalization from heart failure exacerbation. In addition, there was improved exercise performance and left ventricular function from baseline with no significant increased risk of serious adverse events.

Heart failure (HF) is a chronic disorder that decreases heart function and causes a person to be less tolerant to exercise, have a lower quality of life, and prone to death. Novel therapeutic strategies are still needed despite improvements in HF management. Sotagliflozin is a promising medication for the treatment of HF, which is a dual sodium-glucose cotransporter 1 as well as 2 (SGLT1 and SGLT2) inhibitor. The purpose of this in-depth study is to assess sotagliflozin's effectiveness and safety in the treatment of HF. The effects of sotagliflozin on different facets of HF pathophysiology, such as blood flow, myocardial remodeling, and neurohormonal stimulation, are discussed in preclinical and clinical investigations. Sotagliflozin has been shown to be effective in lowering the risk of HF hospitalization and heart attack in patients with HF with either type 2 diabetic mellitus (T2DM) and chronic kidney disease (CKD), according to numerous randomized trials, including the most recent SOLOIST-WHF or SCORED trials. Sotagliflozin's simultaneous inhibition of SGLT1 along with SGLT2 creates a special pharmacological profile that addresses both the metabolic as well as non-metabolic problems seen in HF. This review provides a comprehensive summary of various aspects related to sotagliflozin and heart failure, including the pathophysiology in heart failure, US-FDA approved treatment for HF, mechanism of action, pharmacokinetic, pharmacodynamics data of sotagliflozin, reported adverse drug reactions (ADRs), and ongoing clinical trials.

Xylazine is a strong α-2 adrenergic agonist medication that was initially developed for use in veterinary medicine as an analgesic and sedative for animals. Its primary goal is to calm down animals undergoing medical procedures or testing while minimizing their suffering. Despite being used for veterinary purposes, xylazine has raised concerns because it is increasingly being misused by human populations. Because of its opioid-like sedative and euphoric effects, xylazine has become popular among illicit drug users. Xylazine is a popular recreational drug, especially when mixed with other drugs to intensify its effects. This is because it is inexpensive and readily available in markets. Xylazine addiction has quickly grown into a global concern with serious repercussions that are seen in 2023. Recent reports of xylazine misuse have increased alarmingly, with some reportedly becoming "zombies" as a result of the drug's harmful effects on the human body. The impact of xylazine misuse in 2023 is examined in this abstract, which emphasises the negative effects, including an increase in mortality and broad health effects. This review discusses the harmful effects of Xylazine and the factors that make it one of the riskiest medications. The paper also includes some case studies on the drug xylazine, which explains why it is known as a zombie drug.

Background

The majority of antidepressants have been reported to cause metabolic syndrome (MetS). Paucity of information available for the effect of Vortioxetine on MetS. The study aims to assess the systematic review of Vortioxetine on depressive patients' blood pressure (BP), central obesity, fasting plasma glucose (FPG), triglycerides (TGs), and high-density lipoprotein (HDL) levels, which are risk factors for the MetS.

Methods

PRISMA guidelines were followed in conducting this systematic review. The protocol has been registered with PROSPERO (CRD42021272614). Randomized controlled trials (RCTs) that evaluated the effect of Vortioxetine on MetS risk indicators were searched in electronic databases. RCTs that included adult patients 18–75 years of age, Major depression patients (MDD) and prescribed with Vortioxetine drug. Preclinical research, editorials, letters, reviews, case reports, studies in pediatric populations, unpublished gray literature were excluded Abstract and title screening was performed, followed by full-text screening using the Covidence software. Data were extracted, and analysis was done using Cochrane Review Manager (RevMan v5.1).

Results

Following the screening process, 8 RCTs (6 blinded and 2 open-label) were selected for systematic review. The MetS risk factors for Vortioxetine treatment in depressed patients were ambiguous from the available research. However, 4 of 8 RCTs have shown that Vortioxetine is an effective and safe treatment for depression. All the trials were methodological of high quality. Conclusions: A single study evaluating all the five MetS risk variables in depressed patients on Vortioxetine therapy is needed before recommending Vortioxetine as a first-line or switch therapy for depression.

The causative agent of the COVID-19 pandemic is undergoing several changes, and the evolutionary cascade of SARS-CoV-2 has led to the emergence of a range of variants of SARS-CoV-2. Additionally, the emergence of recombinant variants or super variants such as XBB.1.5, XBB.1.16, XBB.1.9.1, and XBB.1.9.2 has raised several concerns among the scientific community regarding the efficacy of various vaccines. The scientists are still figuring out the consequences of the variants and recombinant variants, such as their implications for the emergence of reinfection. In this context, a range of vaccines have been developed to overcome the consequences of COVID-19, but they all come with their disadvantages. While considering the disadvantages and advantages of various vaccine platforms, scientists are exploring virus-like particles (VLPs) to develop vaccines against COVID-19. Therefore, an updated review of literature has been conducted to elucidate their usage of VLPs-based vaccines to manage COVID-19. Considering the consequences of the ongoing evolution of SARS-CoV-2, the article discusses the potential role of VLPs in the development of efficient and reliable vaccines against COVID-19. Further, we have explained how VLPs generate a potent and long-lasting immune response, along with the recent VLPs in clinical trials. Additionally, we have highlighted the limitations of VLPs along with possible solutions and future directions that will overcome such limitations.